Chemotherapy induced disorders by sara ahmed yadallahPARUL UNIVERSITY
Chemotherapy is the treatment of infectious diseases or malignancy with drugs that destroy microorganisms or cancer cells preferentially with minimal damage to host tissues
Chemotherapy refers to treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing
Chemotherapy induced disorders by sara ahmed yadallahPARUL UNIVERSITY
Chemotherapy is the treatment of infectious diseases or malignancy with drugs that destroy microorganisms or cancer cells preferentially with minimal damage to host tissues
Chemotherapy refers to treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing
The current presentation include the pharmacotherapy for rheumatoid arthritis. The definition, classification, mechanism of action of drugs, pharmacokinetics, adverse effects, contraindications and uses.
The current presentation include the pharmacotherapy for rheumatoid arthritis. The definition, classification, mechanism of action of drugs, pharmacokinetics, adverse effects, contraindications and uses.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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3. Introduction
Immunomodulation
Is modulation (regulatory adjustment) of the immune
system . It has natural and human-induced forms.
Homeostasi
s
Immunomodulation as
part of immunotherapy
Immune responses are induced,
amplified, attenuated, or prevented
according to therapeutic goals
Using regulatory T
cells, cell signaling
molecules, and so
forth)
Immunosuppressi
4. Introduction cont.
Immunosuppression
Is a reduction of the activation or efficacy of
the immune system.
Divided into
Deliberately induced Non
deliberately
Medications (immunosuppressant)
surgery (splenectomy)
Plasmapheresis or radiation
Ataxia-telangiectasia,
Complement
deficiencies
Many types of cancer
Certain chronic
infections such
5. Introduction cont.
History
The ability to prolong life by transplanting organs had
long been a dream of medical practitioners
Skin and eyes were among the first successful
transplants.
The kidney was the first complex organ to be
successfully transplanted.
Initial attempts at immunosuppression were with total
body radiation, but all the patients died.
Steroids alone were then used, also without success.
15. I.GLUCOCORTICOIDS
They act by inhibiting genes that code for the cytokines IL-1, IL-2,
IL3, IL-4, IL-5, IL-6, IL-8 and TNF-γ.
Expression of smaller amounts of IL-2 and of IL-2 receptors.
Reduction of the T cell proliferation.
Suppression of the humoral immunity.
Diminishe both B cell clone expansion and antibody synthesis.
16. GLUCOCORTICOIDS cont.
Side effects
The common early adverse effects, such as :-
sweatiness, hoarse voice, loss of diurnal sleep patterns, and
appetite stimulation.
Rarely, more serious acute psychiatric disturbances are
seen such as agitation, aggression or psychosis.
The Longterm, and less reversible adverse effects, such
as:-
Cushingoid appearance, proximal myopathy,
hypertension,hyperlipidaemia, diabetes, cataract formation,
peptic ulceration, osteopenia and aseptic necrosis of bone.
17. II.CYTOSTATICS
They inhibit cell division
In immunotherapy, they are used in smaller doses
than in the treatment of malignant diseases.
They affect the proliferation of both T cells and B
cells.
They includes the following:
Alkylating agents
Antimetabolites
Cytotoxic antibiotics.
18. II.CYTOSTATICS cont.
Alkylating agents
(Cyclophosphamide) eg. Endoxan
Cyclophosphamide is probably the most potent immunosuppressive
compound.
Primary toxicities, such as bladder toxicity, gonadal toxicity, and later
malignancy, have led to attempts to minimize exposure.
It’s used as an immunosuppressant in life-threatening or severe
rheumatologic and renal diseases, including ANCA-related vasculitis,
lupus nephritis, and other systemic vasculidites.
(<250–300 mg/kg cumulative dose to avoid gonadal and <360 mg/kg cumulative
dose to minimize the risk of malignancy)
19. II.CYTOSTATICS cont.
Antimetabolites
(Inhibition of DNA Synthesis)
Azathioprine
AZA is an analog of 6
mercaptopurine; the
metabolites of these agents
act as both purine analogs
(interfering with de novo
purine synthesis and thus,
DNA and RNA synthesis)
and immunomodulatory
Mycophenolat
e
It is an inhibitor of IMPDH,
the rate-limiting enzyme of
guanine nucleotide
synthesis critical for de
novo purine synthesis and
thus, DNA synthesis.
LeflunomideMethotrexate
20. II.CYTOSTATICS cont.
Antimetabolites cont.
(Inhibition of DNA Synthesis)
Side effects
Primary side effects are bone marrow suppression
and gastrointestinal intolerance (primarily upper
gastrointestinal symptomatology).
The Efficacy of Mycophenolate in the prevention of
rejection compared with AZA together with better
tolerability than mTOR inhibitors have led to its use
as the primary antimetabolite in transplantation,
despite a lack of definitive long-term data showing
improved graft outcomes.
22. III.DRUGS ACTING ON
IMMUNOPHILINS cont.
Side effects
Cyclosporine (peptide antibiotic) eg.Neoral
Nephrotoxicity, hypertension, hyperglycemia, liver
dysfunction, hirsutism and little bone marrow toxicity.
23. III.DRUGS ACTING ON
IMMUNOPHILINS cont.
Tacrolimus FK 506 (macrolide antibiotic) eg.
Prograf
Like CAS nephrotoxicity, neurotoxicity, hypertension,
hyperkalemia, and gastrointestinal complaints but no
hirsutism and more hyperglycemia effect.
Sirolimus & EverolimusThrombocytopenia, hepatotoxicity,
diarrhea, hypertriglyceridemia,
pneumonitis, and headache.
24. IV- IMMUNOSUPPRESSVE
ANTIODIES
Polyclonal antibodies
Intravenous Ig
(IVIG)
Polyclonal Antithymocyte
Globulin
The primary mechanism of
action of ATGs is
lymphocyte depletion,
predominantly by
complement-dependent lysis
and T cell activation–
induced apoptosis.
Monoclonal antibodies
Due to their high immunogenicity
almost all patients have an acute
reaction to the treatment. As (fever,
and even anaphylaxis).
25. V. OTHER DRUGS
Interferons
IFN-β suppresses the production of Th1 cytokines and
the activation of monocytes. It is used to slow down the
progression of multiple sclerosis. IFN-γ is able to trigger
lymphocytic apoptosis.
Opioids
Decrease in proliferation as well as immune function has
been observed in macrophages as well as
lymphocytes. It is thought that these effects are
mediated by opioid receptors expressed on the surface
of these immune cells.
28. Aspects of uses cont.
Increased risk of
infections
Taking such
antibiotics as co-
trimoxazole prevents
some of these
infections.
Increased risk of
cancer
Minor side effects include
loss of appetite, nausea or
vomiting, increased hair
growth, and trembling or
shaking of the hands.
Skin cancer
29. Aspects of uses cont.
Post Transplantation
DM
According to the International Consensus Guidelines 2013, the diagnosis of
PTDM can be made using any of the following American Diabetes
Association/World Health Organization criteria for the diagnosis of diabetes .
Once the transplant recipient has been discharged from the hospital and
tapered to their maintenance immunosuppression.
1) Fasting glucose >126 mg/dL (7 mmol/L) on more than one
occasion.
2) Random glucose >200 mg/dL (11.1 mmol/L) with symptoms.
3) Two-hour glucose after a 75-g OGTT of >200 mg/dL (11.1 mmol/L).
4) HbA1c >6.5%.
Transplantation Journal. 96(4):333–360, AUG
2013
32. Aspects of uses cont.
The effects of one or both
drugs may change.
Or
The risk of side effects
may be greater.
Other drugs may also
have an adverse effect on
immunosuppressant
therapy.
33. Example
s :
The effects of azathioprine may be greater in
people who take allopurinol, a medicine
used to treat gout.
34. Examples
:
A number of drugs, including female hormones
(estrogens), male hormones (androgens), the
antifungal drug ketoconazole (Nizoral), the ulcer
drug cimetidine (Tagamet) and the
erythromycins (used to treat infections), may
increase the effects of cyclosporine.
35. Examples
:
When Sirolimus is taken at the same time as
Cyclosporin, the blood levels of sirolimus may be
increased to a level where there are severe side effects.
Although these two drugs are usually used together, the
sirolimus should be taken four hours after the dose of
cyclosporin.
36. Examples
:
Tacrolimus is eliminated through the kidneys. When
the drug is used with other drugs that may harm the
kidneys, such as antibiotics gentamicin and
amikacin, or the antifungal drug amphotericin B,
blood levels of tacrolimus may be increased. Careful
kidney monitoring is essential when tacrolimus is
given with any drug that might cause kidney
damage.