This document discusses unconsciousness in dental clinics and its management. It defines unconsciousness as a lack of response to sensory stimulation. Possible causes include vasodepressor syncope, drug administration or ingestion, orthostatic hypotension, epilepsy, hypoglycemic reaction, and rare causes like adrenal insufficiency or myocardial infarction. The pathophysiology involves inadequate oxygen delivery to the brain. Management involves immediate steps like assessing consciousness, positioning the patient, opening the airway, and assessing breathing and circulation. Definitive care depends on the underlying condition and may involve oxygen, monitoring vitals, anticonvulsants, or transport to the emergency department. Specific conditions discussed in more detail include syncope,
EDIC is pleased to announce a webinar with Dr. R. Bruce Donoff, the Dean at Harvard Dental School. Dr. Donoff’s presentation will cover the risk factors for inferior alveolar and lingual nerve injury after third molar extraction, as well as the proper documentation and follow up of nerve injuries. Dr. Donoff will also discuss the potential for recovery from paresthesia after surgical intervention. The webinar will be held on May 10, 2011 at 7:00 PM.
Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program
EDIC is pleased to announce a webinar with Dr. R. Bruce Donoff, the Dean at Harvard Dental School. Dr. Donoff’s presentation will cover the risk factors for inferior alveolar and lingual nerve injury after third molar extraction, as well as the proper documentation and follow up of nerve injuries. Dr. Donoff will also discuss the potential for recovery from paresthesia after surgical intervention. The webinar will be held on May 10, 2011 at 7:00 PM.
Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program
Welcome to Dr Sachdeva Dental Clinic with a multispecialty dental layout in the heart of North Delhi. Sedentary lifestyle and hectic schedules has created surfeit of population with dental health problems.
http://www.sachdevadentalcare.com/
Anti hypertensives / /certified fixed orthodontic courses by Indian dental a...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Diabetes in dependent adults is pervasive. Many are suffering needlessly because their oral health is contributing to glucose management.
Dental hygienists in most states are unable to care for these people without a prescription from a dentist. It's an unnecessary hurdle.
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
Advance life support refer to a constellation of interventions needed to support the vital physiological process during a critical illness, while we await response with definitive therapy. These life support measures are instituted to prevent cardiac arrest.
To recognise physiological derangements that arise out of multiple etiologies and stabilize them first.
EVALUATE – IDENTIFY – INTERVENE
The steps of evaluation are
1.Initial impression
2. Primary assessment
3. Secondary assessment
4. Diagnostic test
Gives insight to overall physiological status and functioning of the brain.
TICLS
Tone: Look for general posture of the child has adopted
Interactive: Is the child responsive and interacting appropriately, unresponsive or lethargic.
Consolable: Irritable, consolable or inconsolable
Look\Gaze: How is the child looking at mother, any vacant gaze
Speech: Is the child able to speak or vocalise as is appropriate for age or is there a paucity\weak\hoarseness of voice.
IDENTIFY = Abnormality in any of these parameters point towards a brain dysfunction
Impaired consciousness is a significant alteration in the awareness of self and environment with varying degree of wakefulness.
Unconsciousness persisting for at lest 1 hr – Coma.
Younger children more likely to have coma or altered sensorium secondary to non-traumatic etiology, where as traumatic brain injury is more common in older children.
Always rule out reversible causes of coma, like hypoglycemia, hyperglycaemia and electrolyte imbalance.
Any severe systemic illness can cause altered consciousness as a result of hypoxic ischemic insult, which if on-going can aggravate raised ICT.
pediatric assessment in emergency rooms , how to pass the PALS exam , part 1 search for the other 3 parts, for any comment send to sayedahmed 1900@ g mail .com
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
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.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
- 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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
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.
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
3. DEFINITION
UNCONSCIOUSNESS : lack of response to
sensory stimulation.
Most common emergency situation reported in
dental clinic is UNCONSCIOUSNESS
20. STEP 3 SUMMONING OF
HELP
IF NO RESPONSE TO PERIPHERAL
STIMULATION
Rescuer calls for assistance immediately by
activating the dental office emergency
system
24. IN PREGNANT PATIENTS
TURN TO LEFT SIDE And tuck a pillow
on right side because the inferior vena cava,
which carries the blood from the lower body is
on the right side and so if she is on the left it
will not be compressed
25. STEP 5
A – Assess and open airway
Opening of airway and restoration of breathing
are most basic and important steps of BLS
26. HEAD TILT CHIN LIFT
APPLYING DOWNWARD PRESSURE ON
HEAD BY USING PALM
APPLYING UPWARD PRESSURE ON
MANDIBLE USING FINGERS
31. STEP 6a :assess airway patency
and (B) Breathing
Assess the patency of breathing
LOOK LISTEN AND FEEL TECHNIQUE
At chest
movements
Feel and hear air at
victims nose
33. STEP 6b:Artifical Ventilation
VICTIM MAY RECEIVE ARTIFICAL
VENTILATION IN ONE OF THE THREE
WAYS
1.EXHALED AIR VENTILATION
2.ATMOSPHERIC AIR VENTILATION
3.O2 enriched Ventilation
42. 3.O2 enriched Ventilation
E cylinder– 10 TO 15L for 30 minutes of
oxygen
It consists of
1.Portable E Cylinder
2.FACE mask
CAPACITY
A <B <C < D Type cylinder
are also available
43. STEP 7
C - Circulation
Monitoring heart rate and blood pressure
Sites FOR Monitoring Heart rate
1.Brachial and Radial Arteries in Arm
2.Carotid Artery in Neck
46. 2 mechanisms explaining the
restoration of circulation by
external cardiac massage
Cardiac pump
Thoracic
pump
47. Cardiac pump during the
cardiac massage
Blood pumping is assured by the
compression of heart between sternum
and spine
STERNUM
HEART
SPINE
Between compressions thoracic cage
is expanding and heart is filled with
blood
THORACIC CAGE
BLOOD
HEART
48. Thoracic pump at the cardiac
massage
During the chest compression blood is
directed from the pulmonary circulation
to the systemic circulation.
pulmonary circulation
systemic circulation.
blood
58. Signs & symptoms
1.
2.
3.
4.
5.
6.
7.
Early
Feeling of warmth
Loss of colour :pale or ashen gray skin tone
Heavy perspiration
Complaints of feeling “bad” or “faint”
Nausea
Blood pressure at baseline
Tachycardia
64. It is a disorder of the autonomic nervous
system in which syncope occurs when the
patient assumes an upright position
Fall in systolic pressure by 20mm of Hg or
greater or a 10mm Hg or greater fall in
diastolic pressure that occurs on standing
Failure of baroreceptor reflex mechanism
POSITION
VARIATION
decrease constriction of peripheral blood vcssels
return of blood to heart
70. Definition
:A sudden
change in behavior due
to excessive electrical activity OF
the brain
Symptoms of seizures differ depending
on what part of the brain is affected.
81. Drug administration or ingestion
Clinical signs and symptoms that result from
overly high blood levels of a drug in various
target organs and tissues
Drug overdose reactions or toxic reactions
Direct extension of normal pharmacologic
actions of the involved drug.
82. Clinical manifestations of local
anesthetic overdose
SIGNS
Low to moderate overdose levels
1. Confusion
2. Talkativeness
3. Apprehension
4. Excitedness
5. Slurred speech
6. Generalized stutter
7. Muscular twitching and tremor of the face
85. Moderate to high blood levels
1.Generalized tonic-clonic seizure,followed
by
2.Generalized central nervous system
depression
3.Depressed blood pressure,heart rate &
respiratory rate
86. Management of a severe LA
overdose with slow or rapid onset
ASSESS CONSIOUSNESS
Activate office emergency team
P – Position patient supine with feet elevated
90.
Also known as Stroke
Defined as any vascular injury that reduces
cerebral blood flow to a specific region of the
brain , causing neurologic impairment
It is a focal neurologic disorder caused by
destruction of brain substance as a result of
intra-cerebral hemorrhage , thrombosis,
embolism or vascular insufficiency.
93. Diagnostic clues
Hypertension (blood pressure above
140/90mm Hg)
Altered consciousness
Hemiparalysis
Headache and blurred vision
Asymmetry of face and pupils of eyes
100. MANAGMENT
Step 1:Termination of dental therapy
Step 1a:Activation of dental office emergency
Step 2: 2:Unconscious patients should be placed
into the supine position with their legs elevated
slightly
102.
Step 3:Removal of dental materials from
mouth
Step 4:A-B-C(basic life support)as needed.
103. DEFINITIVE CARE
Step 5 :D(definitive care)
Step 5a:summoning of medical assistance
Step 5b:IV infusion(if available)of 5%dextrose
and water or of normal saline
107.
Most dangerous complication of diabetes since
the brain is starved of glucose
Diagnosis
Deepening drowsiness
Disorientation
Excitability or aggressiveness in a diabetic
patient, especially if it is known that a meal
has been missed
110.
4 lumps of sugar
Give 150 ml glucose drink
Reassure patient
111.
give sterile glucose IV (20ml of 20-50% of
solution)or IM glucagon 1mg
Call an ambulance
Where possible, defer further immediate dental
treatment until another day.
If unconscious,
112. Management of sudden loss of
consciousness in the absence of
an obvious diagnosis
STEP 1 :Lay the patient flat . Recovery is
almost instantaneous if the patient has simply
fainted . Call for assistance
115.
STEP 4 :
If pulse is palpable give 4sugar lumps orally if the patient has
not completely lost consciousness
or
20ml of 20-50%sterile glucose IV if
unconscious.
GLUCOSE
116.
STEP 5:
Still no improvement –medical assistance should be
summoned.
Give hydrocortisone sodium succinate 200mgIV
Defer further immediate dental treatment until another day.
117. CONCLUSION
UNCONSCIUOSNESS IS THE MOST
COMMON EMERGENCY CONDITION
REPORTED IN DENTAL CLINIC
SO, as a Dentist we all should know how to
manage unconsciousness condition in the
dental clinic