The document discusses stress and its effects on the body and mind. It describes the "fight or flight" response to stressors and divides stress into "eustress" or good stress that enhances performance, and "distress" which is associated with anxiety and lack of concentration. It discusses factors like daily hassles, major life changes, and catastrophes that act as stressors. It also covers physiological responses to stress like increased heart rate and blood pressure, and psychological factors like explanatory styles, locus of control, and type A personalities that influence the stress response.
The stress response
Eustress vs. Distress
Stress Origins & Body Systems: Neurochemical and Endocrine
Symptoms
Stress Related Illnesses
Recognize the Problem: ABC Strategy
The Resilience Factor
Stress Management, Stress Reduction and Lifestyle Changes
Stress and its management in Indian soldiersRobin Victor
No human being is exempted from stress.
The army soldiers are no exception
This presentation highlights various risk factors leading to stress, depression and suicide, the clinical features of stress and various preventive strategies for prevention of stress for army soldiers.
Stress management and stress handling hand outEhatsham Riaz
We generally use the word "stress" when we feel that everything seems to have become too much - we are overloaded and wonder whether we really can cope with the pressures placed upon us.
Stress can be defined as any type of change that causes physical, emotional or psychological strain. Stress is your body's response to anything that requires attention or action. Everyone experiences stress to some degree. The way you respond to stress, however, make a big difference to your overall well-being.
The stress response
Eustress vs. Distress
Stress Origins & Body Systems: Neurochemical and Endocrine
Symptoms
Stress Related Illnesses
Recognize the Problem: ABC Strategy
The Resilience Factor
Stress Management, Stress Reduction and Lifestyle Changes
Stress and its management in Indian soldiersRobin Victor
No human being is exempted from stress.
The army soldiers are no exception
This presentation highlights various risk factors leading to stress, depression and suicide, the clinical features of stress and various preventive strategies for prevention of stress for army soldiers.
Stress management and stress handling hand outEhatsham Riaz
We generally use the word "stress" when we feel that everything seems to have become too much - we are overloaded and wonder whether we really can cope with the pressures placed upon us.
Stress can be defined as any type of change that causes physical, emotional or psychological strain. Stress is your body's response to anything that requires attention or action. Everyone experiences stress to some degree. The way you respond to stress, however, make a big difference to your overall well-being.
Stress is the body’s physical and psychological response to a specific demand made of us or to an event in our life. In some cases it motivates and encourages us to complete a task we find difficult so that we can take pride in ourselves and what we achieve.
Stress is the body’s physical and psychological response to a specific demand made of us or to an event in our life. In some cases it motivates and encourages us to complete a task we find difficult so that we can take pride in ourselves and what we achieve.
Maintenance Electroconvulsive Therapy Augmentation on Clozapine-Resistant Psy...Zahiruddin Othman
Case Report: Maintenance electroconvulsive therapy augmentation on clozapine-resistant psychosis with neurosyphilis is effective and safe but has never been reported in the literature to the authors' knowledge. It is hoped that this case report would contribute to the scarce literature on this augmentation strategy
Case Report: Schizophrenia patient with prodromal OCS is probably at increased risk of developing TTM while on atypical
antipsychotics treatment. Atypical antipsychotics and SSRI combination therapy is a useful strategy in such patient
Isolated Cerebellar Stroke Masquerades as DepressionZahiruddin Othman
There are numerous reports on neurological conditions masquerading as psychiatric disorders. However, cerebellar
stroke is not established as one of it. The 2 case reports will highlight that this masquerade is possible and the physician's
high index of suspicion is the key to accurate diagnosis.
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
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
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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
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
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.
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
2. Fight Or Flight Phenomenon
Cannon, 1939: stress as a "fight or flight"
phenomenon ... helps us to mobilize energy to
either defeat the stressor or to get away from it
Modern stress has more social or psychological
stressors than physical stressors
An ego-related stressor cannot be reduced by using a
physical response (e.g. fight)
May also continue over a longer time than a physical
stressor
An imagined stressor is impossible to fight via physical
means
3. Good And Bad Stress
Hans Selye, 1956: stressors are part of normal
daily life and can be divided into the good and the
bad:
Eustress
Action-enhancing stress which can help in sport or in
motivating someone to get moving
Distress
Either over-reaction or under-reaction, but always associated
with confusion, lack of concentration and psychological
anxiety
4. Eustress is the action-enhancing stress that
gives athlete the competitive edge
EustressEustress DistressDistress
Optimal StressOptimal Stress
Health and
Performance
7. Catastrophes
Are large-scale events
that disrupt the lives
of many people and
strain or overwhelm
community services.
Examples include
natural disasters
such as hurricane,
floods, and famine
Meteor Collision
8. War is a man made disaster – water and sanitation, electricity,
food stores, and food supply routes are destroyed
9. Major Life Changes
Are milestone events in a person's life,
which cause substantial change in one's
daily routine.
Examples include graduating from college,
changing jobs, getting married or divorced,
breaking up a long-term relationship, having
a family member diagnosed with a chronic
disease, death of a loved one, moving,
becoming a parent, and so on.
12. Daily Hassles
Are annoyances encountered in daily life.
Examples include traffic problems,
differences in lifestyles between roommates,
deadlines, expectations of parents or teachers,
bills and money problems, bad weather, car
problems, and so on.
13. Daily hassles are not necessarily encountered everyday but
represent disruptions of or annoyances to one's daily routine
15. Intervening Psychological Factors
The way individuals perceive stressors can
influence physiological reactions and subsequent
development of real physical illness.
Some examples of factors that influence how
people perceive stress, which in turn affect
health, include
Perceived Control
Type A Personality
Social Relationships
Lifestyle and Habits
17. The Triune Brain
The Thinking Brain
Intellectual
Abstract imagery
The Emotional Brain
Emotional
Dream imagery
Metaphoric imagery
The Physical Brain
Physical input/ output
Concrete imagery
18. Emotions, Thoughts And Beliefs
Emotions
Usually the result of thoughts
e.g. anger, fear, joy, guilt, jealousy, love, courage, sadness
Thoughts
Conscious thought operates as a control system
e.g. focus on some goal leads to action for accomplishment of the
goal
Conscious mind chooses behaviors in order to handle overload
e.g. withdrawing from a situation which is too difficult
e.g. being depressed or miserable
Beliefs
Beliefs are thoughts which endure over time
Learned early in life from others
Help to what we do and how we evaluate what we do
20. Optimistic Explanatory Style
Perceived control lead to longer life (Seligman's
study of baseball players) and greater job success
(Seligman's life insurance salesman study)
Attributions (explanations about past events) &
optimism or expectations about the future
Global, stable & internal dimensions
Positive events with global stable, & internal attributions +
negative events with specific, unstable, and external
attributions seem to promote optimism
21. Perceived Control
Attribution
Internal or external
Stable or unstable
Global or specific
Locus of control
Internal or external
23. Pessimistic Explanatory Style
Seligman's executive
monkey, dog, rat studies
Lack of control led to
ulcers, failure to learn in
new situation when
control was possible
Loss of perceived control
leads to learned
helplessness
24. Coping Styles
Emotional-based coping
Focus on emotions due to stress
i.e. stress reaction
Problem-based coping
Focus on the events causing stress
i.e. stressors
What happen in learned helplessness?
Pessimism no action
GAS: alarm resistance exhaustion
25. Characteristics of a Type A
Behavior Pattern
Hurry sickness
A sense of time urgency; trying to accomplish too much in too
little time.
Quest for numbers
Preoccupied with ratings, being better than others, earning more
money, etc.
Insecurity of status
Strong need for "objective" measure of self-worth, pursues
achievement to get admiration from others.
Aggression & hostility
Competes with or challenges others continually; struggles to
beat others, quick-tempered and angry
26. Type A personality individual is preoccupied with ratings,
being better than others, earning more money, etc.
27. Aggressive or Passive
Aggressiveness
Demanding
Does not consider the other person's self esteem
Belittles the other person (e.g. they are "dumb" for not
agreeing)
Usually results in counter-aggression
Communication usually blocked ... everyone leaves dissatisfied
Non-assertiveness = NOT saying what you feel ... being
passive
Might sit back and hope that others will notice their needs
Might use manipulation
28. Practice Assertiveness
Being assertive (Albert & Emmons, 1995)
OK to say no ... no guilt
OK to change your mind
OK to take your time before doing something
OK to ask for further instructions
OK to demand respect
OK to do less than you can do
OK to express your feelings
OK to feel good about yourself ... whenever ...
wherever
30. Psychosocial Factors
Relations between people and other people
Same events interpreted differently by
different individuals
Adaptation
Overload
Frustration
Deprivation
Trauma
31. Social Readjustment Rating Scale
(Holmes & Rahe)
Concept of a "life change unit" (LCU) which could be
large (e.g. death of a spouse = 100 LCU's) or small (e.g.
violation of the law = 11 LCU's)
Any kind of change (good news or bad news) requires
adaptation
NB: of course, bad news is generally harder to take because it
involves fear, self doubt and other emotions
There are individual differences in the perception of
events (e.g. good or bad news):
Since novelty is stressing, having had an experience before
helps one to adapt to it again
However, some events are stressing regardless of previous
experience (e.g. moving)
32. LCU – Life Events Of A College Student
100100 – Death of a close family member
80 – Jail term
63 – Final year or first year in college
60 – Pregnancy (to you or caused by you)
53 – Severe personal illness or injury – 53
50 – Marriage
45 – Any interpersonal problems
40 – Financial difficulties
40 –Death of a close friend
40 – Arguments with your roommate (> EOD)
33. LCU – Life Events (2)
40 – Major disagreements with your family
30 – Major change in personal habits
30 – Change in living environment
30 – Beginning or ending job
25 – Problem with your boss or professor
25 – Outstanding personal achievement
25 – Failure in a course
20 – Final exams
20 – Increase or decrease dating
20 – Change in working conditions
34. LCU – Life Events (3)
20 – Change in your academic major
18 – Change in your sleeping habits –
15 – Several-day vacation –
15 – Change in eating habits
15 – Family reunion
15 – Change in recreational activities
15 – Minor illness or injury
11 – Minor violations of the law
35. Interpreting The Scale
Predictor of physical and mental illness for
a-two year period after the accumulation of
the stressors
i.e. Total LCU in 12 months
Level of life change stress
Low: < 150
Moderate: 150 – 300
High: > 300:
36. Frustration
When we are prevented from achieving our goals,
we become frustrated
Discrimination
Bureaucracy
Socioeconomic factors
Responses to frustration
Anger and aggression
Nervous and hormonal response (i.e. the stress
response)
37. Overload
Demands > capacity
Can arise from a variety of sources:
Time pressures
Too much responsibility/accountability
Lack of support
Expectations which are too high
38. Occupational Overload
Sources of occupational overload
Responsibility/accountability
Lack of managerial/subordinate support
Unreasonably high role expectations
Air traffic controllers
Example too much occupational overload
Stress-related diseases - hypertension, peptic ulcers,
diabetes
Grayson, 1972: 32.5% suffering from gastrointestinal
ulcers
40. Academic Overload
Demands on teachers (Cooper, 1995)
Research, community service, teaching,
advising, parent-student counseling, etc.
Demands on students
Competition for entry into university (then
entry into graduate school)
Admissions tests
Need for mental health counseling in educational
institutions
41. Deprivational Stress
Boredom
Could be due to monotonous tasks, unchallenging
work
Boredom and depression are major adolescent health
problems
Loneliness
Not enough care and attention to children stimulus
deprivation
Lynch, 1977: rate of heart disease, cancer and auto
accidents higher in single, widowed and divorced
individuals. Unmarried men 45-54 years = 123%
higher death rate than married men
42. Bioecological Factors
Interpreted more or less the same by
different people
Time and body rhythm
Eating and drinking habit
Drugs
Noise pollution
Climate and altitude
44. Physiological Reaction
When people experience stressors, the typical
physiological reaction is a "fight-or -flight
response."
The sympathetic nervous system (SNS) is
activated, arousing the body to either escape from
or defend against the stressor.
With mild stressors, the "fight-or-flight" response
includes release of excitatory neurotransmitters
and hormones, increased heart rate and blood
pressure, more rapid and shallow respiration, and
perspiration on brow or palms.
45.
46. Psychosomatic Health
Control of the stress response
Autonomic nervous system
Endocrine system
Control of health and disease
Immune system
Neuropeptide system
47. Sympathetic Nervous System
Initiation of the stress response
“Fight or flight" energizing
increased HR
increased stroke volume
constriction of blood vessels in gastrointestinal tract
deeper and faster breathing
pupil dilation
adrenalin release from adrenal glands
fatty acid release from liver
epinephrine, norepinephrine and dopamine release
49. Parasympathetic Nervous System
Relaxation and termination of the stress
response
slow down HR
expansion of most blood vessels ... increased
gastrointestinal activity
bronchial constriction
pupil constriction
salivary increase
50. Autonomic Control of the Stress
Response
Hypothalamus coordinates the body's response to sight,
sound, touch, smell and taste
i.e. the fact of the reaction
Limbic system defines the sensation as being either
pleasurable or not pleasurable
i.e. the direction of the reaction
RAS defines the degree to which something is either
pleasant or unpleasant
i.e. the degree of the reaction
Cortex either boosts the present state, or attenuates it
i.e. on the basis of what is reasonable or how it is related to
other memories
51. The Adrenal Glands
Adrenal Medulla
Neuronal stimulation from hypothalamus
Secretes epinephrine (adrenalin), norepinephrine, dopamine
Adrenal Cortex
Stimulated by ACTH
Secretes glucocorticoids (cortisol):
Increases energy availability via gluconeogenesis in the liver
Suppress immune system
High levels of fatty acids contribute to atherosclerosis
Secretes aldosterone:
Sodium and water retention ... better heat/waste dissipation
Problem - increased blood volume and BP ... more work for
the CV system
52. General Adaptation Syndrome
Alarm Phase
Initial response to a
stressor
Increased ACTH
from pituitary gland
Stimulation of
adrenal glands
Fight or flight
response
Generalized stress
arousal
Resistance Phase
Channeling of
arousal response to a
specific organ
Decreases in ACTH
Arousal of a specific
organ system ...
eventual fatigue and
malfunction
Adaptation to stress
eventually becomes
a disease in itself
53. General Adaptation Syndrome
Exhaustion Phase:
Specific organ
system involved in
the resistance phase
breaks down
Increased ACTH
again
Exhaustion,
malfunction or death
54.
55. Responses To Stress
Body
Psychosomatic illness
e.g. essential hypertension, tension headache
Mind
Mental illness
e.g. depression, anxiety etc
Behavioral
Ineffective coping styles
e.g. conduct problem, drug addiction