This document discusses urinary obstruction, including its pathophysiology, causes, effects on renal physiology and function, histological changes, clinical impact, and renal recovery after relief of obstruction. It provides an overview of how urinary obstruction can lead to permanent kidney damage depending on the severity, chronicity, and baseline kidney condition. Both unilateral and bilateral obstruction are examined, along with the triphasic response and changes in renal blood flow, filtration, and tubular transport that occur.
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
blockage or problem in the urinary tract can mean urine is unable to drain from the kidneys or is able to flow the wrong way up into the kidneys. This can lead to a build-up of urine in the kidneys, causing them to become stretched and swollen.
blockage or problem in the urinary tract can mean urine is unable to drain from the kidneys or is able to flow the wrong way up into the kidneys. This can lead to a build-up of urine in the kidneys, causing them to become stretched and swollen.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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
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.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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
- 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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
2. Moderators:
Professors:
• Prof. Dr. G. Sivasankar, M.S., M.Ch.,
• Prof. Dr. A. Senthilvel, M.S., M.Ch.,
Asst Professors:
• Dr. J. Sivabalan, M.S., M.Ch.,
• Dr. R. Bhargavi, M.S., M.Ch.,
• Dr. S. Raju, M.S., M.Ch.,
• Dr. K. Muthurathinam, M.S., M.Ch.,
• Dr. D. Tamilselvan, M.S., M.Ch.,
• Dr. K. Senthilkumar, M.S., M.Ch.
Dept of Urology, GRH and KMC, Chennai. 2
3. Urinary Obstruction
Urinary tract obstruction can result in permanent renal
damage.
The degree of injury depends on:
• Severity of the obstruction. (Partial or complete,
unilateral or bilateral),
• Chronicity of the obstruction (acute vs chronic),
• Baseline condition of the kidneys and
• Other mitigating factors such as UTI.
3
Dept of Urology, GRH and KMC, Chennai.
14. Glomerular Filtration Rate
The GFR is determined by
1. The sum of the hydrostatic and colloid osmotic forces
across the glomerular membrane, which gives the
net filtration pressure, and
2. The glomerular capillary filtration coefficient, Kf
GFR = Kf x Net filtration pressure
14
Dept of Urology, GRH and KMC, Chennai.
15. Pressures In Filtration
1. Glomerular hydrostatic pressure,
2. Bowman’s capsule hydrostatic pressure,
3. Glomerular oncotic pressure,
4. Bowman’s capsule oncotic pressure.
15
Dept of Urology, GRH and KMC, Chennai.
16. Net filtration pressure
Net filtration pressure represents:
• The sum of the hydrostatic and colloid osmotic forces
• That either favor or oppose filtration
• Across the glomerular capillaries.
16
Dept of Urology, GRH and KMC, Chennai.
21. Unilateral Urinary Obstruction
• More commonly encountered.
• Triphasic changes in RBF and ureteral pressure changes
have been noted.
• Phase 1 – one to two hours
• Phase 2 – Three to four hours
• Phase 3- Late phase
21
Dept of Urology, GRH and KMC, Chennai.
29. iNOS in Late Phase
29
Dept of Urology, GRH and KMC, Chennai.
30. Late Phase
• NO production declines with depletion of L-arginine
substrate or
• Decreased NOS activity or
• Vascular endothelium becomes less responsive to the
action of NO following UO.
30
Dept of Urology, GRH and KMC, Chennai.
33. Bilateral Ureteric Obstruction
P Ureter ↑
GFR ↓
Hypervolemia
Atrial Natriuretic Peptide Production
Afferent Arteriolar Dilatation,
Efferent Arteriolar Constriction,
↑ P Glomerular Capillaries.
P Ureter ↑
33
Dept of Urology, GRH and KMC, Chennai.
37. Cortical Blood Flow Redistribution
37
Dept of Urology, GRH and KMC, Chennai.
38. Partial Ureteral Obstruction
• Proper animal models not available.
• Behaves mostly like UUO.
• Generally there is decreased RBF and GFR.
• Shift in blood flow from outer cortex to inner cortex is
noted.
38
Dept of Urology, GRH and KMC, Chennai.
40. Urinary Concentrating Ability
• AQP 2 expressed exclusively in Principal cells of collecting
tubule and collecting duct.
• It is vasopressin regulated.
• Downregulated in BUO.
• AQP 1, 3, 4 also decreased.
• Downregulation causes polyuria after obstruction relief.
• AQP 1 downregulation can cause polyuria upto 30 days.
40
Dept of Urology, GRH and KMC, Chennai.
43. Sodium Transport
• Down regulation of important Na transporters noted in
both UUO and BUO.
• Leads to salt wasting after relief of obstruction.
• Natriuresis is greater in BUO than UUO.
• PGE2 inhibits NaCl reabsorption acting on Na
transporters in loop of henle and through AQP 2.
43
Dept of Urology, GRH and KMC, Chennai.
44. Hydrogen ion transport
• Obstruction causes urinary acidification.
• Associated with decreased H+ secretion and defective
HCO3- absorption.
• Multiple acid-base transporters are downregulated.
• Mediated by iNOS.
44
Dept of Urology, GRH and KMC, Chennai.
45. Other Cation Transport
• In UUO, K+ secretion is decreased.
• K+ excretion increases with increase in GFR in BUO after
relief, due to ANP.
• Magnesium excretion is also increased after the release
of UUO and BUO.
45
Dept of Urology, GRH and KMC, Chennai.
47. Gross Pathologic Changes
42 Hrs
• Dilatation of collecting system
• Blunting of papillary tips with increase in kidney weight
7 Days
• Further collecting system dilatation
• Further increase in renal weight
• Edema of renal parenchyma
21-28
• Cortex and medulla diffusely thinned
6 Wks
• Enlarged cystic appearance, lower weight compared to normal kidney.
47
Dept of Urology, GRH and KMC, Chennai.
48. Microscopic Changes
Early Changes:
• Massive tubular dilatation
• Progressive tubulointerstitial fibrosis
• Inflammatory cell infiltration
• Apoptic renal tubular cell death
Late Changes:
• Glomerulosclerosis
48
Dept of Urology, GRH and KMC, Chennai.
54. Hypertension
• Common with BUO than UUO
• Mostly reversible after relief of obstruction
• Due to volume mediated mechanism due to increased
ANP and intravascular volume.
• RAS is implicated for UUO associated hypertension.
54
Dept of Urology, GRH and KMC, Chennai.
55. Compensatory Renal Growth
• Seen in UUO, in contralateral kidney.
• Influenced by age and degree and duration of
obstruction.
• Less prominent in partial UUO.
• Increase in volume is due to hypertrophy not due to
hyperplasia.
• IGF 1 is involvedin renal hypertrophy.
• Sex hormones may also have a role.
55
Dept of Urology, GRH and KMC, Chennai.
56. Renal Recovery after Obstruction
• Duration and severity of obstruction has significant
influence.
• Longer periods are associated with diminished GFR
return.
• It is due to persistent vasoconstriction of afferent
arteriole.
56
Dept of Urology, GRH and KMC, Chennai.
57. Vaughan et al, Canine model
Duration Recovery
7 days 100%
14 days 70%
4 weeks 30%
6 weeks 0%
57
Dept of Urology, GRH and KMC, Chennai.
