Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
learning objective includes : pathogenesis,clinical features, classification of migraine, pharmacology about specific antimigraine drugs, coverage to newer triptan- Lasmiditan and newer prophylactic drug Erenumab a CGRP receptor antagonist.
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
learning objective includes : pathogenesis,clinical features, classification of migraine, pharmacology about specific antimigraine drugs, coverage to newer triptan- Lasmiditan and newer prophylactic drug Erenumab a CGRP receptor antagonist.
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
Evaluation of Obstructive Uropathy with Computed Tomography Urography and Mag...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Obstructive uropathy presenting as primary enuresis – A case reportApollo Hospitals
An adolescent male presented with persistent nocturnal bedwetting. Confounding family history of nocturnal enuresis lead to delay in seeking medical attention. Careful history and investigations confirmed underlying obstructive uropathy and bladder dysfunction. Primary enuresis presenting beyond childhood period should be investigated to look for underlying organic cause.
Silodosin versus tamsulosin in symptomatic benign prostatic hyperplasia-Our e...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
PH1.37 Describe the mechanism of action, types, doses, side effects, indications and contraindications of the drugs used as sex hormones, their analogues
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
- 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
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
3. Introduction
• Benign Prostatic Hyperplasia
• Most common condition in elderly men
• >50% men demonstrate histopathologic BPH
by age 60 yrs
• 90% by age 80 yrs
4. Normal BPH
Hypertrophied
detrusor muscle
Obstructed urinary
flow
PROSTATE
BLADDER
URETHRA
Roehrborn CG, McConnell JD. In: Walsh PC et al, eds. Campbell’s Urology. 8th ed. Philadelphia, Pa: Saunders; 2002:1297-1336.
5. pathophysiology
• Hypertrophy of bladder neck, smooth muscle
of the prostate, prostatic capsule, proximal
urethra
• On contraction causes obstructive voiding
symptoms- dynamic component of BPH
• Increased prostatic mass mechanically blocks
the urethra – static component of BPH
8. Watchful waiting
• Regular follow ups
• In patients with mild symptoms
• Patients with moderate symptoms who are
not bothered by their symptoms
9. Medical management
• Non selective alpha 1 antagonists
a) short acting: Prazosin, Alfuzosin
b) long acting: Terazosin, Doxazosin
• Selective alpha 1 A antagonists
Tamsulosin, Silodosin
• 5- alpha reductase inhibitors
Finasteride, Dutasteride
• Miscellaneous
PDE 5 inhibitor – Tadalafil
GnRH agonists – Naferelin acetate, Leuprolide
10. Distribution of Alpha Receptors in the
Prostate and Bladder
Pelvic Floor
External Sphincter
Internal Sphincter
Trigone
Detrusor
Prostate Gland
11. Alpha 1 blockers
• Relaxation of both bladder neck and prostatic smooth
muscle, thus decreasing pressure in the bladder and
urethra improve the urinary flow
• Improve the obstructive symptoms than irritative
symptoms
• Drugs are- Prazosin
Terazosin
Doxazosin
Alfuzosin
Tamsulosin
Silodosin
12. PRAZOSIN
• α1 > α2
• Potent inhibitor of cyclic nucleotide
phosphodiesterases
• Well absorbed orally
• Bioavailability 50 – 70 %
• Tightly bound to plasma proteins
• Metabolized in liver
• Duration of action 7 to 10 hrs
• Initial dose 1mg at bed time
• Off label use in BPH, 1-5mg, twice daily
13. Terazosin
• Structural analog of prazosin
• More soluble in water than prazosin
• More effective than finasteride in treatment of
BPH
• Bioavailability is 90%, highly protein bound
• t1/2 is 12 hrs, duration of action more than 18 hrs,
once daily dosing
• Metabolized in by demethylation, dealkylation in
liver
• 40% excreted in urine
14. • Contraindicated in patients with known
sensitivity to quinazolines
• Side effects – first dose hypotension, dizziness,
fatigue
• Used with caution in patients taking diuretics,
other antihypertensive agents,
phosphodiesterase 5 inhibitors
• Dosage: initially 1 mg daily at bed time,
10 mg/day for maximal effect in BPH
15. Doxazosin
• Structural analog of prazosin
• Bioavailability 65%, highly protein bound
• t1/2 is 20 hrs, duration of action around 36hr
• Metabolized in by demethylation, dealkylation
in liver
• Most of the metabolites are excreted in feces
• Contraindicated in patients with known with
sensitivity to quinazolines
16. • Used with caution in patients taking diuretics,
other antihypertensive agents,
phosphodiesterase 5 inhibitors, in hepatic
dysfunction
• Side effects – first dose hypotension, dizziness,
fatigue, headache
• Dosage: intially 1 mg, maintainace dose is
1 – 8mgdaily
• Extended release formulations are also available
17. Alfuzosin
• Used extensively for treatment of BPH, not approved
for treatment of HTN
• Bioavailability 64%
• t1/2 is 3-5 hrs
• Substrate for CYP3A4
• Contraindicated in patients with moderate to severe
hepatic impairment, known hypersensitivity, in
patients taking other CYP3A4 inhibitors
• Avoided in patients with prolonged QT syndrome
• Dosage: 10 mg extended release tablet daily
18. Tamsulosin
• Benzene sulfonamide
• More effective in treatment of BPH, little effect on BP
• Well absorbed
• t1/2 is 5 – 10 hrs
• Extensively metabolized by CYPs
• Contraindicated in patients with sulfa allergy, in
patients taking CYP inhibitors
• Side effect is retrograde ejaculation, intra operative
floppy syndrome
• Dosage: 0.4mg starting dose, maintain with 0.4-0.8mg
19. Silodosin
• Selective for α1A receptors
• t1/2 is 13-14 hrs
• Metabolized by glucuronidation
• Dosage: 8 mg daily
• Side effects: retrograde ejaculation
• Contraindicated in patients with renal
impairment, severe hepatic impairment
20. 5 alpha reductase inhibitors
• In prostate, testosterone converted to
dihydroxy testosterone ( DHT ) by 5 alpha
reductase enzyme.
• DHT increases the growth in prostate
• Drugs: Finasteride
Dutasteride
21. Two 5-Reductase (5AR) Isoenzymes
Convert Testosterone to DHT
Testosterone
Type II 5AR
Type I 5AR Prostate
enlargement
DHT
22. Near Complete DHT Suppression Requires Inhibiting
Both 5AR Isoenzymes
Dutasteride
Dutasteride
Finasteride
Prostate
volume
reduced
Bartsch G et al. Eur Urol. 2000;37:367380.
DHTTestosterone
Type II 5AR
Type I 5AR
23. Finasteride
• Inhibits type 2 isoform of 5 alpha reductase
• Bioavailability 63%
• t1/2 is 6-8 hrs
• Dosage 5 mg daily
• Excreted in urine, semen
• Effective only in patients with palpably enlarged
prostate
• Contraindicated in patients with obstructive
uropathy or prostate cancer
24. Dutasteride
• Inhibits both isoforms of 5 alpha reductase
• Bioavailability 60%
• Half life is 5 wks
• Metabolized by cytochrome p 450
• Dosage: 0.5mg daily
• Side effects: decreased libido, ejaculatory
dysfunction, impotence, gynaecomastia
25. 5 alpha reductase inhibitors and alpha
blocker combination
• 0.5mg Dutasteride & 0.4 mg Tamsulosin
combination
• Used in treatment of symptomatic BPH in men
with enlarged prostate
26. PDE 5 INHIBITORS
• MAO: Selective inhibitor of cGMP specific
PDE5
• Decreases cGMP conc. in corpus cavernosa &
pulmonary arteries, in smooth muscles of
prostrate, bladder & blood vessels.
TADALAFIL
• Half life – 17 hrs. Metabolized by CYP 450
• Dosage: 5 mg daily
• C/ I: patients using nitrates. Not combined
with alpha blockers due to risk of bp lowering
27. • Also used in pulmonary hypertension, erectile
dysfunction
• If erection lasting for more than 4 hrs-
requires emergency treatment.
• Stop- if sudden loss of vision in one or both
eyes, if sudden decrease or loss of hearing
• Drug Interactions: CYP inhibitors increase
Tadalafil exposure, and CYP inducers decrease
exposure
28. Phytochemical Agents
• Plant derived non nutritive compounds.
• Active ingredients & dosage of active
medication not known
• Mechanism of action is not clear
• Pumpkin
- Flavonoids
- Hypoxia rooperi
- Saw palmetto- berry extracts
-African plum