Vitamin D deficiency is of concern now a days, it has important role in skeletal and non skeletal functions of the body. Good sunlight exposure, consumption of vitamin D rich foods, chemotherapy with vitamin D and supplements of vitamin D has shown positive effect on various non skeletal diseases like cancer, diabetes, diarrhoea, tuberculosis etc. Although Indians are blessed with ample sunlight, still 70 to 100% population is suffering from the vitamin D deficiency. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency
Vitamin D deficiency is of concern now a days, it has important role in skeletal and non skeletal functions of the body. Good sunlight exposure, consumption of vitamin D rich foods, chemotherapy with vitamin D and supplements of vitamin D has shown positive effect on various non skeletal diseases like cancer, diabetes, diarrhoea, tuberculosis etc. Although Indians are blessed with ample sunlight, still 70 to 100% population is suffering from the vitamin D deficiency. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency
D is for Debacle - The Sun, Vitamin D, 25(OH)D and HealthIvor Cummins
The Story of Vitamin D, and the Debacle of Human Health Impact that has unfolded over the past 50 years, as we allowed the population necessary levels to collapse. For individuals, parents, families, mothers - don't miss this understanding - this is probably the most important single factor for your health and longevity.
VITAMIN K, [MEDICINAL CHEMISTRY] BY P.RAVISANKAR,STRUCTURES OF VITAMIN K1 AND...Dr. Ravi Sankar
VITAMIN K, [MEDICINAL CHEMISTRY] BY P.RAVISANKAR,STRUCTURES OF VITAMIN K1 AND K2, CHEMISTRY, RECOMMENDED DIETARY INTAKE, SOURCES OF VITAMIN K, BLOOD COAGULATION, ROLE OF VITAMIN K, FUNCTIONS, MECHANISM OF ACTION, VITAMIN K DEFICIENCY, DURG INTERACTIONS, SUMMARY.
BY P. RAVISANKAR, VIGNAN PHARMACY COLLEGE, VADLAMUDI, GUNTUR, A.P, INDIA.
All About Vitamin D
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the powerpoint help you to know the benefits of vitamin D3 and how we can use it to help the body to improve the immunity system and how we can measure it using some devices
Vitamin D3, methods of measurement and it's correlation with diabetes mellitu...ShaymaaMAlshareefi
Diabetes mellitus is a serious metabolic disorder that has become increasingly prevalent. The number of people with diabetes is expected to increase from 285 million to 435 million people worldwide by 2030.
T2DM manifests as a result of insulin resistance, increased hepatic glucose production, and b-cell failure. This lecture will explain the association between vitamin D3 & T2DM
Vitamin D3, methods of measurement and it's correlation with diabetes mellitusShaymaaMAlshareefi
Diabetes mellitus is a serious metabolic disorder that has become increasingly prevalent. The number of people with diabetes is expected to increase from 285 million to 435 million people worldwide by 2030.
T2DM manifests as a result of insulin resistance, increased hepatic glucose production, and b-cell failure. This lecture will explain the association of vitamin D3 & T2DM
Vitamin D deficiency is widespread in both the pediatric and adult chronic kidney disease CKD population. CKD is characterized by dysregulation of vitamin D and mineral metabolism. Secondary hyperparathyroidism and its management puts patients with CKD at increased cardiovascular risk. Emergence of experimental and some clinical data suggesting beneficial effects of vitamin D on proteinuria, blood pressure, inflammation and cardiovascular outcomes has pushed it to the center stage of CKD research. Pediatric data on vitamin D dysregulation and its consequences are still in its infancy. Ongoing prospective studies such as Chronic Kidney disease in Children CKiD and the Cardiovascular Comorbidity in Children with CKD 4 C should help to delineate the evolution of disturbances in mineral metabolism and its adverse effects on growth, CKD progression and cardiovascular outcomes. Dr. Prafull Dawale | Neha Jain "Vitamin D in Chronic Kidney Disease" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd26778.pdfPaper URL: https://www.ijtsrd.com/medicine/other/26778/vitamin-d-in-chronic-kidney-disease/dr-prafull-dawale
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
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- 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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
3. Introduction
Not strictly a vitamin.
Only when sunlight exposure is
inadequate is a dietary source
required.
Main function is in the regulation of
calcium absorption and homeostasis.
Most of its actions are mediated by
way of nuclear receptors that regulate
gene expression.
4. Introduction
Also has a role in regulating cell
proliferation and differentiation.
Intakes considerably higher than are
required to maintain calcium
homeostasis reduce the risk of:
◦ Insulin resistance
◦ Obesity
◦ The metabolic syndrome
◦ Various cancers.
Deficiency, leading to rickets in
children and osteomalacia in adults.
8. Regulation
Calcitriol acts to reduce its own
synthesis by:
◦ inducing the 24-hydroxylase.
◦ repressing the 1-hydroxylase in the
kidney.
Other regulators are serum levels of:
◦ Phosphorus
◦ Calcium
◦ fibroblast growth factor 23 (FGF-23)
◦ parathormone (PTH)
9. Vit. D Receptor (VDR)
VDR: a transcription factor
Regulates expression of upto 2000
genes, directly or indirectly.
Membrane bound VDR postulated but
not yet proven.
10. Role in calcium homeostasis
vitamin D maintains plasma calcium
concentration in three ways:
◦ it increases intestinal absorption of
calcium.
◦ it reduces excretion of calcium (by
stimulating resorption in the distal renal
tubules).
◦ it mobilizes bone mineral.
11. Other actions
calcitriol is also involved in:
◦ insulin secretion.
◦ synthesis and secretion of parathyroid
and thyroid hormones.
◦ inhibition of production of interleukin by
activated T-lymphocytes and of
immunoglobulin by activated B-
lymphocytes.
◦ differentiation of monocyte precursor
cells.
◦ modulation of cell proliferation.
12. Normal levels
Commonly, 25 (OH)D is measured.
Analyte Conventional
Unit
SI Unit
25(OH) D 10-65 ng/ml 25-162 nmol/L
1,25 (OH) D 15-60 pg/ml 36-144 pmol/L
13. Causes of Vit d deficiency
Inadequate exposure to sunlight.
Inadequate dietary vit D.
Vit D malabosrption.
Severe hepatocellular disease.
Increased catabolism (e.g. drugs).
Increased loss (nephrotic syndrome).
14. Vit D deficiency and bone morphology
Vitamin D sufficiency leads to an
adequate calcium-phosphorus product
(Ca2+ × HPO42−) resulting in an
effective bone mineralization.
Maternal vitamin D insufficiency during
pregnancy associated with a
significant reduction in bone mineral
acquisition in infants, persisting upto 9
years of age.
15. In children, vitamin D deficiency with
25(OH)D levels <15 ng/mL causes:
◦ chondrocyte disorganization.
◦ hypertrophy at the mineralization front.
◦ skeletal mineralization defects.
This results in bone deformities and short
stature, the typical signs of vitamin D
deficiency rickets.
Vit D deficiency and bone morphology
16. Sister (right) and
brother (left)
ages 4 years and
6.5 years,
respectively,
demonstrating
classic knock-
knees and bow
legs, growth
retardation, and
other skeletal
deformities
17. In adults low 25(OH)D and high PTH
also lead to a low serum calcium ×
phosphorus product.
Results in osteomalacia, i.e., a
defective mineralization of the
collagen matrix .
Causes a reduction of structural
support.
Associated with an increased risk of
fracture.
Vit D deficiency and bone morphology
18. A decrease in 25(OH)D leads to
secondary hyperparathyroidism.
Associated with osteoclastogenesis,
which leads to:
◦ an increase in bone resorption exceeding
osteoblast-mediated bone formation.
Can precipitate and exacerbate
osteopenia and osteoporosis in adults.
Vit D deficiency and bone morphology
19. Muscular health
Vitamin D deficiency is associated with:
◦ diffuse muscle pain.
◦ muscle weakness predominantly in the
proximal muscle groups.
◦ a reduction in performance speed.
Vitamin D supplementation lowered the
adjusted-incidence rate ratio of falls by
72% compared to those taking placebo
over 5 months.
20. Protective role in
carcinogenesis
1,25(OH)2D inhibits carcinogenesis by
several mechanisms:
◦ promotes cyclin-dependent kinase (CDK)
inhibitor synthesis.
◦ influences several growth factors and their
signaling pathways including:
insulin-like growth factor 1 (IGF-1)
transforming growth factor β (TGFβ)
Wnt/β-catenin
MAP kinase 5 (MAPK5)
nuclear factor κB (NF-kB)
21. Beneficial effects on cardiovascular
risk factors and cardiovascular health
The vitamin D receptor is present in
endothelium, vascular smooth muscle, and
cardiomyocytes.
May protect against atherosclerosis
through:
◦ The inhibition of macrophage cholesterol uptake
and foam cell formation.
◦ reduced vascular smooth muscle cell
proliferation.
◦ reduced expression of adhesion molecules in
endothelial cells.
◦ inhibition of cytokine release from lymphocytes.
22. Protective role in Type II DM
vitamin D exerts various antidiabetic
effects.
The VDR is expressed in pancreatic beta
cells and 1,25(OH)2D stimulates insulin
secretion.
Improvement in vitamin D status also
leads to a improvement of insulin
sensitivity, mediated by upregulation of
insulin receptors.
Vit D modulates inflammation, which is
also thought to play a role in type 2
23. Additional benefits
Protective role has been found in:
◦ Autoimmune Disease:
Multiple Sclerosis
Type I DM
Rheumatoid Arthritis
◦ Infections, especially:
Tuberculosis
Influenza
Viral URTI
◦ Respiratory Diseases
26. Vit D supplementation
According to the Endocrine Society
Practice Guidelines:
Age Daily
supplementation
Safety limit
Upto 1 year 400–1000 IU up to 2000 IU
1-18 years 600–1000 IU up to 4000 IU
>18 years 1500–2000 IU up to 10,000 IU
27. Treatment of deficiency
According to the Endocrine Society Practice
Guidelines:
Age Initial therapy
for 6 weeks
Maintenance
Upto 1 year 2000 IU/day or 400–1000 IU/day
50,000 IU/wk
1-18 years 2000 IU/day or 600–1000 IU/day
50,000 IU/wk
>18 years ~6000 IU/day or 1500–2000
IU/day
50,000 IU/wk
(both for 8 wks)
In obese patients, patients with malabsorption syndromes,
and patients on medications affecting vitamin D
metabolism, two to three times higher doses are
28. Summary
Vit D synthesis.
Actions and systems affected.
Effects of deficiency.
Treatment of deficiency.
29. References
Tietz Textbook of Clinical Chemistry
and Molecular Diagnosis, Fifth Edition.
Harper’s Illustrated Biochemistry, 29th
Edition.
Wacker,M and Holick, M.F . Vitamin
D—Effects on Skeletal and
Extraskeletal Health and the Need for
Supplementation. Nutrients. 2013
January; 5(1): 111–148.