Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
The penis may curve down in an infant and the baby may spray while urinating.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
URINARY SYSTEM DISORDERS ARE ONE OF THE MOST PREVALENT GROUP OF DISORDERS THAT NEEDS A THOROUGH UNDERSTANDING. THE MOST BASIC OF THEM ARE URINARY RETENTION AND INCONTINENCE. THIS PRESENTATION DEALS WITH A BRIEF OVERVIEW OF THE DESCRIPTION, CAUSES, DIAGNOSIS AND MANAGEMENT OF THESE DISORDERS IN AN ILLUSTRATED MANNER.
Bladder exstrophy is a congenital (present at birth) abnormality of the bladder. It happens when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly, so the bladder is open and exposed on the outside of the abdomen. In epispadias, the urethra does not form properly.
Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
The penis may curve down in an infant and the baby may spray while urinating.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
URINARY SYSTEM DISORDERS ARE ONE OF THE MOST PREVALENT GROUP OF DISORDERS THAT NEEDS A THOROUGH UNDERSTANDING. THE MOST BASIC OF THEM ARE URINARY RETENTION AND INCONTINENCE. THIS PRESENTATION DEALS WITH A BRIEF OVERVIEW OF THE DESCRIPTION, CAUSES, DIAGNOSIS AND MANAGEMENT OF THESE DISORDERS IN AN ILLUSTRATED MANNER.
Bladder exstrophy is a congenital (present at birth) abnormality of the bladder. It happens when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly, so the bladder is open and exposed on the outside of the abdomen. In epispadias, the urethra does not form properly.
What do you mean by Anomaly? What are its types? Is Anomaly Scan a ‘MUST’?
In our family there has been no case of Anomaly.
I have already undergone FTS, So will it give any additional information?
Can it guarantee that my fetus is 100% normal? If an abnormality is found, can it be cured?
What options are available if an Anomaly is detected?
Can it Surely (100%) rule out Down’s Syndrome?
Can Anomaly be 100% prevented?
If such questions arise in your mind, please watch my eight small videos on this subject.
MENDELE'S EXPERIMNENT AND TERMINOLOGY, BY MR. DINABANDHU BARAD, MSC TUTOR, DEPARTMENT OF PEDIATRIC, SUM NURSING COLLEGE, SIKSHA 'O' ANUSANDHAN DEEMED TO BE UNIVERSITY
INBORN ERRORS OF METABOLISM, PKU, PHENYLKETONURIA, BY: MR. DINABANDHU BARAD, MSC TUTOR, SUM NURSING COLLEGE, SIKSHA O ANUSANDHAN DEEMED TO BE UNIVERSITY, BHUBANESWAR, ODISHA
EUGENIC MOVEMENT, GENETIC NURSING, BY: MR. DINABANDHU BARAD, MSC TUTOR, SUM NURSING COLLEGE, SIKSHA O ANUSANDHAN DEEMED TO BE UNIVERSITY, BHUBANESWAR, ODISHA
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
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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
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.
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.
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
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.
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
4. DEFINITION
Undescended testis is the failure of one or both testes
to reach the normal position in the scrotal sac through
the inguinal canal.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
5. INCIDENCE
Cryptorchidism is the most common genital abnormality in boys,
affecting approximately 30% of baby boys born prematurely and
about 4% born at term.
Around 1 in 20 male babies born at term also has cryptorchidism.
Many of these will become descended in time. However, for around 1
in 70 cases, the testis remains undescended after the child is 1 year old.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
6. ETIOLOGICAL FACTORS
• The exact cause of an undescended testicle isn't known.
• A combination of genetics, maternal health and other environmental factors
might disrupt the hormones, physical changes and nerve activity that influence
the development of the testicles.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
7. • Impairment of the hypothalamic pituitary gonadal axis: block in the hormonal
axis to stimulate the testes to descend or the testes may fail to respond o the
stimulus due to some inherent defects
• Anatomical obstruction: there may be an obstruction in the pathway of
descend or failure of intra abdominal pressure to rise
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
ETIOLOGICAL FACTORS
9. • Heredity or chromosomal anomalies: absence of one or both testes
• Short spermatic cord and artery mechanically prevent the descend
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
ETIOLOGICAL FACTORS
10. RISK FACTORS
Factors that might increase the risk of undescended testicle in a newborn
include:
• Low birth weight
• Premature birth
• Family history of undescended testicle or other problems of genital
development
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
11. RISK FACTORS
Factors that might increase the risk of undescended testicle in a newborn
include:
• Conditions of the fetus that can restrict growth, such as Down syndrome or an
abdominal wall defect
• Alcohol use by the mother during pregnancy
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
12. • Cigarette smoking by the mother or exposure to secondhand smoke
• Obesity in the mother
• Diabetes in the mother — type 1 diabetes, type 2 diabetes or gestational
diabetes
• Parents' exposure to some pesticides
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
RISK FACTORS
13. TESTIS DEVELOPMENT
The most common theories that explain cryptorchidism.
• Shortly after 6 weeks' gestation, the testis-determining SRY gene on chromosome Y
directly affects the differentiation of the indifferent gonad into a testis.
• Around 6-7 weeks' gestation, Sertoli cells develop and secrete müllerian inhibitory
substance (MIS; also known as antimüllerian hormone [AMH]), which leads to the
regression of the female genital organs.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
14. TESTIS DEVELOPMENT
• Around 9 weeks' gestation, Leydig cells start producing testosterone, which
promotes development of the wolffian duct into portions of the male genital
tract.
• The testis remains in a retroperitoneal position until 28 weeks' gestation, at
which time inguinal descent of the testicle begins. Most testes have completed
their descent into the scrotum by 40 weeks' gestation.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
16. PATHOGENESIS
At 32–36 wk, the testis, which is anchored at the internal inguinal ring, begins its
process of descent by gubernaculum. The gubernaculum distends the inguinal
canal and guides the testis into the scrotum. Following testicular descent, the
patent processus vaginalis (hernia sac) normally involutes.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
18. THEORIES OF PATHOPHYSIOLOGY OF
CRYPTORCHIDISM
Several potential explanations for the pathophysiology of cryptorchidism have
been proposed, including
• Gubernacular abnormalities,
• Reduced intra-abdominal pressures,
• Intrinsic testicular or epididymal abnormalities
• Endocrine abnormalities,
• Anatomic anomalies (eg, fibrous bands within the inguinal canal or
abnormal arrangement of the cremasteric muscle fibers).
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
19. TYPES
• Retractile or pseudo cryptorchidism
• Palpable
• Non palpable
• Ectopic
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
20. TYPES
Retractile or pseudo cryptorchidism:
• This is NOT an undescended testicle but is often mistaken for one.
• It is caused byoveractive muscles that pull the testicle(s) out of the
scrotum.
• In this type the testicles can be placed in the scrotum manually and
stay there for a short period of time.
• This is a type of normal and does not need treatment.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
21. Palpable (80%):
• In this type, (also called prepubic or inguinal) the testicle is located anywhere
from just above the scrotum to high in the groin.
Nonpalpable (15%):
• This means the testicle is in the boy’s abdomen or is absent and not felt in the
scrotum or inguinal canal.
Ectopic (5%):
• In this case, the testicle has taken the wrong path and ended in an unusual
location in the groin area. Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
TYPES
23. CLINICAL FEATURES
• A nonpalpable testis (unable to feel on examination) is the most common
symptom of cryptorchidism.
• However, each child may experience symptoms differently.
• Symptoms of cryptorchidism may resemble other conditions or medical
problems.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
25. PHYSICAL EXAMINATION
• The patient must be examined in a warm, relaxed environment.
• Closely observing the scrotum before manipulation is important.
• The frog-leg or catcher position may be used to facilitate palpation of the testis.
• Determining if the testis is palpable is essential. If the testis is palpable, ascertain
whether it can be retracted.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
26. PHYSICAL EXAMINATION
• The best method of evaluating for an undescended testis is to start palpating at
level of the inguinal canal and perform a milking motion down toward the
scrotum.
• Look for hemiscrotal asymmetry and for contralateral testicular hypertrophy;
both are partial indicators of an absent testis.
• Examination of potential ectopic sites (eg, penile, femoral, and perineal areas) is
important if the testicle cannot be felt in the inguinal area.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
29. LABORATORY STUDIES
• Routine laboratory workup is not indicated with unilateral cryptorchidism.
• Patients with bilateral nonpalpable testis and those with unilateral or bilateral
undescended testis associated with hypospadias should undergo evaluation to
rule out a disorder of sex development (DSD).
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
30. LABORATORY STUDIES
The evaluation should include chromosomal analysis and measurement of
• 17-hydroxylase progesterone
• testosterone, luteinizing hormone (LH)
• follicle-stimulating hormone (FSH).
For bilateral nonpalpable testis, abdominal-pelvic ultrasonography (US) is
advisable, mainly to determine if any müllerian structures, such as a uterus, are
present.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
31. LABORATORY STUDIES
• Anorchia can be confirmed by means of hormonal stimulation with human
chorionic gonadotropin (hCG), with baseline and poststimulation measurement
of LH, FSH, and testosterone hormone levels. (If LH and FSH level rises without
testosterone)
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
32. LABORATORY STUDIES
• Another marker of testicular function is müllerian-inhibiting substance (MIS; also
known as antimüllerian hormone [AMH]).
• MIS levels that exceed 5 ng/mL suggest the presence of testicular tissue and are
an indication for exploration.
• However, this study is not yet in widespread use, and its applicability to older
children remains to be defined.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
33. Imaging studies have little or no role in the diagnosis of cryptorchidism.
USG, computed tomography (CT), magnetic resonance imaging (MRI), and
angiography have been used to detect undescended testes. However, these studies
have unacceptable false-positive and false-negative rates. CT exposes the patient to
high levels of radiation, and MRI requires sedation or anesthesia; both are costly
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
IMAGING STUDIES
34. Complications of a testicle not being located where it is
supposed to be include:
• Testicular cancer
• Fertility problems
• Other complications related to the abnormal location of the undescended
testicle include:
• Testicular torsion.
• Inguinal hernia.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
COMPLICATIONS
35. TREATMENT
• In most cases, the testicle will descend without treatment during the child’s first
year. If this does not occur, treatment may include:
• Hormone injections (HCG or testosterone) to try to bring the testicle into the
scrotum. It also helps in the enlargement of the testis.
• Surgery (orchiopexy) to bring the testicle into the scrotum. This is the main
treatment. If there is an associated hernia, the herniotomy along with
orchidoplexy is indicated.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
36. • Having surgery early may prevent damage to the testicles that can cause
infertility.
• An undescended testicle that is found later in life may need to be removed.
This is because the testicle is not likely to function well and could pose a risk
for cancer.
Mr. Dinabandhu Barad, MSC TUTOR, SNC,SOA,DTU
TREATMENT