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.
Abstract— Cerebral palsy (CP) is the most common physical disability of childhood. Children with CP frequently grow slowly and are more prone to fractures. So this study was aimed to explore relationship of bone mineral density (BMD) with cerebral palsy by case-control study. This study was conducted at Department of Physical Medicine and Rehabilitation of Sawai Man Singh Medical College, Jaipur. Hip bone and spine bone was used to assess BMD. Bone mineral density was measured by DEXA in both groups i.e. study group and control group after ensuring the comparability of both groups. Difference in means of BMD in both the groups was inferred by unpaired student's’ test of significance. It was found in this study that bone mineral density of hip well as spine was significantly lowered in cerebral palsy cases.
Abstract— Cerebral palsy (CP) is the most common physical disability of childhood. Children with CP frequently grow slowly and are more prone to fractures. So this study was aimed to explore relationship of bone mineral density (BMD) with cerebral palsy by case-control study. This study was conducted at Department of Physical Medicine and Rehabilitation of Sawai Man Singh Medical College, Jaipur. Hip bone and spine bone was used to assess BMD. Bone mineral density was measured by DEXA in both groups i.e. study group and control group after ensuring the comparability of both groups. Difference in means of BMD in both the groups was inferred by unpaired student's’ test of significance. It was found in this study that bone mineral density of hip well as spine was significantly lowered in cerebral palsy cases.
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after ab...Takehiko Ito
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after abdominal surgery: A questionnaire survey. The 1st International Nursing Research Conference of World Academy of Nursing Science, Kobe: Program & Abstracts, 235.
Clinical prediction rule in spinal painNityal Kumar
This lecture is on spinal pain and the clinical methods used in treating the pain. Clinical prediction rules is a research method done systematically describing when to use which method of treatment approach
Preventing Osteoporosis by doing ExercisesSumit Roy
Osteoporosis can be prevented by doing some simple exercise that hel to keep your joints fit and flexible. Dr Joseph Pasanga,Chief, Physical Rehabilitation Clinic Wockhardt Hospitals shares some of the exercises with us
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after ab...Takehiko Ito
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after abdominal surgery: A questionnaire survey. The 1st International Nursing Research Conference of World Academy of Nursing Science, Kobe: Program & Abstracts, 235.
Clinical prediction rule in spinal painNityal Kumar
This lecture is on spinal pain and the clinical methods used in treating the pain. Clinical prediction rules is a research method done systematically describing when to use which method of treatment approach
Preventing Osteoporosis by doing ExercisesSumit Roy
Osteoporosis can be prevented by doing some simple exercise that hel to keep your joints fit and flexible. Dr Joseph Pasanga,Chief, Physical Rehabilitation Clinic Wockhardt Hospitals shares some of the exercises with us
Osteoporosis is a progressive systemic skeletal disease characterized by low bone mass and microarchitecture deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk.
Analytical Study of Clinicopathological Data of Saudi Patients with Osteoarth...Prof. Hesham N. Mustafa
SUMMARY: Knee osteoarthritis (OA) is a common disabling disease. Epidemiological studies have revealed various risk
factors for OA, including sex, aging, obesity, occupational illnesses, and chronic diseases. Here we evaluate the clinical, pathological,
and radiological findings of knee OA in a subset of Saudi patients who were subjected to total knee replacement (TKA). The study
population included 30 Saudi patients with knee OA who were operated by TKA (from June 2014 to December 2015) in the Department
of Orthopedics, Faculty of Medicine, King Abdulaziz University, Saudi Arabia. Patient’s clinical and radiological data were collected
from the hospital files. Pathological examination of the excised superior articular surface of tibia and femoral condyles were done.
Pearson Chi-squared analysis was used to test for differences between the variables in associated risk factors. There were more women
than men. Sixty per cent of patients were older than 60 years [mean age, 59.2 (females) and 61.7 (men) years-old]. All patients exceeded
obesity class 1, with females being more obese than males. Pathological examination of the superior articular surface of tibia and femoral
condyles showed high score lesions, which was more apparent in females than in males. Radiological findings showed that most lesions
were high grade. The findings of this study will help to understand the pathogenesis of OA and improve treatment decision making
relevant to TKA in knee OA in Saudi Arabia and elsewhere.
KEY WORDS: Osteoarthritis; Knee; Arthroplasty.
This trial aimed to evaluate the efficacy and safety of vitamin D supplementation on the residual moderate and deep pockets following nonsurgical periodontal therapy.
Frequency of Anastomotic Leak in Early Versus Dealyed Oral Feeding after Elec...semualkaira
Intestinal stoma is usually performed as component of other surgical intervention for small and large bowel
pathologies. Of these temporary colostomy are commonest stomas
created for de-functioning of the distal anastomotic site to minimise the chances of leak. Colostomy is usually reversed at 8 to 12
weeks and Ileostomy closure is often considered a minor procedure but it is associated with significant morbidity and mortality
Frequency of Anastomotic Leak in Early Versus Dealyed Oral Feeding after Elec...semualkaira
Intestinal stoma is usually performed as component of other surgical intervention for small and large bowel
pathologies. Of these temporary colostomy are commonest stomas
created for de-functioning of the distal anastomotic site to minimise the chances of leak. Colostomy is usually reversed at 8 to 12
weeks and Ileostomy closure is often considered a minor procedure but it is associated with significant morbidity and mortality
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
EVALUATION OF THE EFFICIENCY OF BISPHOSPHONATES IN THE TREATMENT OF OSTEOPORO...indexPub
Osteoporosis (OP) is a widespread metabolic disease of the skeleton, leading to decreased bone strength and increased risk of fractures. OP is a disease of varying nature that affects all age groups, but is most common in older people. For a long time, doctors did not have serious tools to treat this insidious disease and mainly dealt with its consequences - fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
To compare the different approaches and effects of pararectus approach, modified stoppa approach and ilioinguinal approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
: To compare the different approaches and effects
of pararectus approach, modified stoppa approach and ilioinguinal
approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
To compare the different approaches and effects
of pararectus approach, modified stoppa approach and ilioinguinal
approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
Through regression sorting, 44 patients with acetabular fractures who were hospitalized in our unit from September 2012 to September 2017 were summarized. Three surgical methods were used, and the operation time, intraoperative blood loss, postoperative complications, fracture reduction satisfaction and hip function were recorded in the three groups.
The Impact Visceral Abdominal Fat and Muscle Mass Using CT on Patients with S...semualkaira
The association between abdominal visceral
fatty area (VFA) and muscle mass and mortality is not fully understood despite the fact that being overweight is an established
risk factor for the onset and severity of acute pancreatitis (AP). We
assessed the effect of VFA on severe AP (SAP) mortality
The aim of this study was to investigate the association of adipose
and muscle parameters with the severity grade of AP
CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMA...Mohamed A. Galal
Mohamed A. Galal ; Mushira A. Dahaba, ; Basma M. Zaki
and Hanaa M. Elshenawy. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMALES HAVING CHRONIC PERIODONTITIS. Cairo Dental Journal (30)Number (1), 1:10January, 2014.
Current Role of Surgery in Endometriosis; Indications and ProgressCrimsonpublisherssmoaj
Endometriosis is a chronic debilitating disease , which affects women of reproductive age group, although medical therapy may be helpful in managing pain associated with Endometriosis or infertility, surgery becomes an integral part of managing this disease .Although initially surgery was limited to l aporotomy associated with ovarian cystectomy and/or TAH with BSO. Laporoscopy gradually replaced that. Though diagnostic laparoscopy is used for confirmation of endometriosis by histological examination, it is not acceptable that Laporoscopy be done in multiple steps, initially to diagnose and later for treatment. Recently a lot of advancement has come in the imaging techniques by which one can combine planning of surgery based on the imaging classification. Deep endometriosis involving bowel, genitourinary tract can be dealt by careful dissection in controlled trained hands, in a well equipped set up to achieve the optimum results .Endometriosis associated infertility may or may not warrant surgery as with multiple studies operation on ovarian endometriomas might land up in reducing ovarian reserve - while doing straight IVF may result in better pregnancy rates ,getting good oocyte retrieval in contrast to poor ovarian reserve resulting from damage to ovarian morphology. Use of laser for ovarian cystectomy helps in getting better outcomes than simple drainage and coagulation procedures. Robotic surgery is the latest addition, which aids in better dissection and management but its problem is its cost, not accessible to many patients and not many trained personnel available.
Background: Distal femur fractures make up 6 to 7% of all femur fractures. Various plating options for distal femur fracture are conventional buttress plates, fixed-angle devices, and locking plates. This study was planned to evaluate and explore locking compression plate fixation in distal end femur fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.
Methods: The study was conducted as prospective clinical study in 20 skeletally mature patients with x-ray evidence of distal femur fracture fulfilling inclusion and exclusion criteria, operated with distal femur LCP plating. Patients were assessed radiologically and classified according to distal femur fracture classification and outcome graded as excellent, good, fair and poor based on Lysholm Knee Score.
Results: Out of 15 excellent outcome cases, 3 cases were type A1 fracture, 1 case had type A3, 2 cases had type B1 and B2 each, 5 cases had type C2 and 2 cases had type C3 fracture. 1 case with good outcome was type C3. 1 case with fair outcome was type B2. While 3 cases with poor outcome were type A1, A2 and C3.
Conclusions: The DF-LCP is an ideal implant to use for fractures of the distal femur. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A and C, osteoporotic and periprosthetic fractures.
Keywords: Distal femur, DF-LCP, Lysholm score, Periprosthetic fracture
Similar to Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women (20)
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Childhood Factors that influence success in later lifeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
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.
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
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
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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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
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.
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.
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver.X (Nov. 2015), PP 52-55
www.iosrjournals.org
DOI: 10.9790/0853-1411105255 www.iosrjournals.org 52 | Page
Validity of Clinical Attachment Loss for Diagnosis of
Osteoporosis in Postmenopausal Women
Widad Farhan Jabber1
, Taghreed F. Zaidan1
, Faiq I. Gorial 2
1. Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Iraq
2. Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
Abstract:
Background: Osteoporosis is an important disease with significant fracture morbidity.
Objective: To assess validity of clinical attachment loss (CAL)for diagnose osteoporosis in post-menopausal
women
Patients and Methods: This cross sectional study included 75 postmenopausal women. Osteoporosis was
diagnosed by dual energy x-ray absorptiometry (DXA).CAL was calculated using the probing pocket depth and
the level of the gingival margin
Results: Of 75 women involved in the study, 25 were healthy postmenopausal women, 25 had osteopenia, and
25 had osteoporosis. There was no statistical significant differences between age and body mass index in all
groups (p>0.05).The effect of osteoporosis on increasing CAL was stronger (ROC area=0.92) than that of
osteopenia (ROC area=0.68). Clinical attachment loss showed high statistically significant moderately strong
(r=0.55) positive linear correlation with bone t- score. CALwas a valid parameter to predict osteoporosis in
postmenopausal woman(ROC area=0.88, p<0.001).CAL at the optimum cut off value ≥3.34has highest
accuracy (86.7%) to diagnose osteoporosis in postmenopausal women with sensitivity was 84%, specificity 88
%, positive predictive value (PPV) at pretest probability 50% was 87.5 % and PPV at pretest probability 90%
was 98.4 % and negative predictive value (NPV) at pretest probability 10% was 98 %.
Conclusions: CAL was a simple, easy, and a valid clinical test to diagnose osteoporosis in postmenopausal
women with high accuracy. This may indicate a hopeful measure for early diagnosis and treatment of
osteoporosis.
Keywords: Clinical attachment loss, Menopause, osteoporosis, validity
I. Introduction
Osteoporosis is a silent important systemic skeletal disease characterized by low bone mass and
micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture
[1] and has a major growing public health problem with impact that crosses medical, social, and economic lines
[2]. Therefore; most relevant studies have been designed to develop new measures for early diagnosis and
treatment to reduce the burden of this health problem [3].
Previous studies have shown positive association between osteoporosis and periodontitis [4, 5]. Some
studies have shown that salivary diagnostic tests can be used for predicting osteoporosis [6, 7]. Periodontitis is
an inflammatory disease characterized by resorption of the alveolar bone and loss of soft tissue attachment to the
tooth [8]. Clinical attachment loss (CAL) is one of the clinical parameters used for determining the condition of
periodontal tissues [9]. Because validity of CAL for predicting OP in postmenopausal women have not been
studied. This study was designed to assess the validity of CAL for predicting OP.
II. Patients and Methods
Study design
This cross-sectional study was conducted in Institute of radiology, Baghdad Medical City from 23rd of
September 2014 till 10th of February 2015.Informed consent and ethicalapproval had been obtained.
Participants
Eligible individuals included in the study were postmenopausal women who had experienced at least
12 consecutive months of amenorrhea. The postmenopausal stage was defined as beginning at the time of the
woman final menstrual period [10].
Subjects were excluded from the study if they had: diabetes mellitus, thyroid and parathyroiddisease,
autoimmune diseases, history of periodontal therapy within the last 3 months; current use of medications such as
corticosteroids or any immune suppressive within the previous 3 months, chemotherapy, ovarictomy; smokers,
alcohol users, fracture and neoplastic diseases.
2. Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women
DOI: 10.9790/0853-1411105255 www.iosrjournals.org 53 | Page
Data collection and measurements
Age of the postmenopausal women, weight, height were recorded and body mass index (BMI) was
measured according the equation BMI=weight / height 2
. The intra oral examination was performed under
natural light with patient seated on an office chair.
William periodontal probe was used to assess clinical attachment loss(CAL):-
1. The measurement of probing pocket depths (PPD) is a clinical diagnostic test to assess the corono-apical
extension or the depths of the periodontal pocket respectively. The probing pocket depth PPD was read out
in relation to the gingival margin using the markings of the periodontal probe, in this examination a
periodontal probe was inserted into the periodontal pocket with a simple pressure in apical direction parallel
to the tooth axis between gingiva and tooth surface until probing pressure and tissue resistance are in
balance [11].All four surfaces of the six Ramfjord teeth (3, 9,12,19,25 and28) index were examined, if an
index tooth was missing the nearest distal tooth was substituted for examination and patient was at least 5 of
6 Ramfjord teeth present.
2. Gingival recession was assessed by measuring the distance from free gingival margin to the cement enamel
junction (CEJ).
The result of these two measurements was used to calculate the clinical attachment loss: (a) the probing
pocket depth and (b) the level of the gingival margin (distance from CEJ to gingival margin) [12].
The diagnosis of the osteoporotic patients was made by rheumatologist according to the results of
BMD [13] using dual x-ray absorptiometry scan (DXA scan: central DXA type DEXXUM 3).All women were
divided into three groups according to the results of BMD:Group one: twenty five post postmenopausal women
with osteoporosis (T score ≤ -2.5), Group two: twenty five post postmenopausal women with osteopenia score
between −1 and −2.5 standard deviations below the mean value of peak bone mass. Group three: 25 healthy
postmenopausal women (T score ≥ -1.0).
III. Statistical analysis
Statistical software (SPSS version 22, IBM, USA) was used for data analysis. Kolmogorov-Semirnov
test was done to assess the distribution of continuous variables.The statistical significance of differences in
mean of a normally distributed variable between 2 groups was assessed by independent samples t-test. The
statistical significance of differences in mean of a normally distributed variable between more than 2 groups was
assessed by ANOVA test. When ANOVA model detects a statistically significant difference, further exploration
for statistical significance of difference in mean between all possible paired combinations of study groups was
performed using LSD (least significant difference).The statistical significance, direction and strength of linear
correlation between 2 quantitative variables, one of which being non-normally distributed variable was
measured by Spearman’s Rho linear correlation coefficient. A receiver operating characteristic (ROC) curve
analysis was used to assess validity parameters and set optimum cut-off values for CAL when used to
predict a diagnosis of osteoporosis P value less than the 0.05 was considered statistically significant.
IV. Results
Of 75 postmenopausal women involved in the study, 25 were healthy controls, 25 osteopenic patients,
and 25 were osteoporotic patients.There was no statistical significant difference between the mean age of the
groups(55±5.1vs 56.1±4.2 vs 52.2±5.3 years, P= 0.07) respectively and no statistical significant difference
between the meanof body mass index (BMI) in the study groups (33.8±4.9 vs 31.4±5.5 vs 30.8±5.7kg/m², p=
0.46) respectively.
Clinical attachment loss (CAL)
The mean CAL was highest in osteoporosis group (3.55) and lowest in control group (2.97).The
difference in means between studied groups was statistically significant .The mean CAL was significantly
higher in osteoporosis group (3.55) compared to control group (2.97).The mean CAL was significantly higher
in osteopenia group (3.13) compared to control group (2.97) as shown in figure 1
The effect of osteoporosis on increasing CAL was stronger (ROC area=0.92) than that of osteopenia (ROC
area=0.68). Clinical attachment loss showed high statistically significant moderately strong (r=0.55) positive
linear correlation with bone t- score.
CALwas a valid parameter to predict osteoporosis in postmenopausal woman(ROC area=0.88,
p<0.001) as in table 1.
CAL at cut off value ≥ 2.93 was associated with highest sensitivity (100%) in predicting osteoporosis .Testing
negative at this cut-off value can exclude a possible diagnosis of osteoporosis among postmenopausal women
3. Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women
DOI: 10.9790/0853-1411105255 www.iosrjournals.org 54 | Page
with 100% confidence at any pretest probability (any clinical context). Testing positive of CAL at highest
specificity (100%)where cut-off value ≥ 3.79 will establish a diagnosis of osteoporosis with 100% confidence in
any clinical context.
The best cut-off value providing the best separation between postmenopausal women with osteoporosis
and those without osteoporosis is CAL ≥ 3.34 which is associated with a sensitivity of 84.0% and specificity of
88.0% and testing positive at this the optimum cut-off value will establish a diagnosis of osteoporosis with
87.5% confidence in clinical context where the pretest probability of having osteoporosis is 50%.whiletesting
positive at the same cut-off value in clinical context where osteoporosis is of high probability based on clinical
suspicion only (pretest probability =90%) will establish the diagnosis of osteoporosis with 98.4% confidence as
shown in table 2
Figure 1: Distribution of samples according to clinical attachment loss
Table1: ROC area for clinical attachment loss when used as test to predict osteoporosis among postmenopausal
women
ROC, receiver operating characteristic
Table2:- Performance characteristics of clinical attachment loss in predicting osteoporosis.
Clinical attachment loss
Positive if ≥ cut-off value
Sensitivity
% Specificity%
Accuracy
% PPV at pretest probability = NPV at pretest
probability = 10%50% 90%
2.93 (Highest sensitivity) 100 34 56 60.2 93.2 100
3.34 (Optimum cut-off) 84 88 86.7 87.5 98.4 98
3.79 (Highest specificity) 24 100 74.7 100 100 92.2
PPV, positive predictive value; NPV, negative predictive value
V. Discussion
Bone loss is a feature of both periodontitis and osteoporosis, and several studies have analyzed whether
the periodontal destruction could have been influenced by systemic bone loss [14].Up to our knowledge, the
current study is the first observational analytic cross sectional study that assessed validation of CAL for
prediction and diagnosis of osteoporosis in postmenopausal women. It showed that CAL was a simple,
noninvasive, and valid measure for predicting OP in postmenopausal women with high accuracy, sensitivity,
specificity, PPV, and NPV.
Predicting Osteoporosis ROC P
Clinical attachment loss 0.88 <0.001
4. Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women
DOI: 10.9790/0853-1411105255 www.iosrjournals.org 55 | Page
Variable recent studies have reported significant association between osteoporosis and periodontitis,
however none of them measured the validity of that association. Juluri [15] compared the severity of periodontal
disease in postmenopausal osteoporotic women and postmenopausal women without OP and reported that
postmenopausal OP had significantly greater CAL compared to non-osteoporotic group in addition to significant
association with an increased incidence and severity of periodontal disease.Lin [5] investigated the association
between periodontitis and osteoporosis by gender in A Nationwide Population-Based Cohort Study and showed
after adjusting for age, sex, income, and geographical region, therewas a significant association between
periodontitis and osteoporosisamong women.
In aStudy assessed and correlatedosteoporosis and periodontitis in selected population of Maharashtra,
Lohana [16] concluded that there was a definite association between periodontitis and osteoporosis.Iwasaki [17]
in a cross-sectional study evaluated the possible association between BMD and attachment loss with dental
restoration information in Japanese community-dwelling postmenopausal females and concluded that that low
systemic BMD was associated with severe attachment loss in Japanese community-dwelling postmenopausal
females. Al-Habashneh [18] determined the relationship between periodontitis and osteoporosis among
postmenopausal Jordanian women and found thatosteoporosis was significantly associated with severe alveolar
crestal bone loss and the prevalence of periodontitis cases in postmenopausal Jordanian women.
The limitation of the present study is the small sample size however this may be solved by larger study
sample size. Despite that, this is the first time to validate CLA as a simple measure to predict postmenopausal
osteoporosis.
In conclusion, CAL was a simple, easy, and a valid clinical measure to predict and diagnose
osteoporosis in postmenopausal women with high accuracy.This may indicate a hopeful measure for early
diagnosis and treatment of osteoporosis.
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