What are the main sleeping disorders and what are the sleeping disorders related to respiratory system ? how to deal with it and how to diagnose and treat?
Obstructive sleep apnea (OSA) is a prevalent chronic disease characterized by pharyngeal collapse during sleep.
Sleep disorder that involves cessation or significant decrease in airflow through the upper airway in the presence of breathing effort.
Obstructive sleep apnea is the second most common sleep disorder, insomnia being the most common.
Associated with recurrent oxyhemoglobin desaturations and arousals from sleep
Apnea index- no. of apneas /hr of total sleep time.
AHI (APNEA-HYPOPNEA INDEX)- No of apneas and hypoapneas/hr of total sleep time.
RDI (Respiratory Disturbance Index) – no. of apneas, hypoapneas and respiratory effort related arousals(RERA)/hr of total sleep time.
Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.
What are the main sleeping disorders and what are the sleeping disorders related to respiratory system ? how to deal with it and how to diagnose and treat?
Obstructive sleep apnea (OSA) is a prevalent chronic disease characterized by pharyngeal collapse during sleep.
Sleep disorder that involves cessation or significant decrease in airflow through the upper airway in the presence of breathing effort.
Obstructive sleep apnea is the second most common sleep disorder, insomnia being the most common.
Associated with recurrent oxyhemoglobin desaturations and arousals from sleep
Apnea index- no. of apneas /hr of total sleep time.
AHI (APNEA-HYPOPNEA INDEX)- No of apneas and hypoapneas/hr of total sleep time.
RDI (Respiratory Disturbance Index) – no. of apneas, hypoapneas and respiratory effort related arousals(RERA)/hr of total sleep time.
Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.
Obstructive sleep disorder /certified fixed orthodontic courses by Indian de...Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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OSA is an entity that is increasingly being managed by otolaryngologists...Hope this presentation helps to clear any doubts regarding its diagnosis and management!
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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OSA is an entity that is increasingly being managed by otolaryngologists...Hope this presentation helps to clear any doubts regarding its diagnosis and management!
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
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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.
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.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
1. What issleepapnea?
Sleepapneaisa serioussleepdisorderthatoccurswhena person’sbreathingisinterruptedduring
sleep.People withuntreatedsleepapneastopbreathingrepeatedlyduringtheirsleep,sometimes
hundredsof timesduringthe night.
There are twotypesof sleepapnea:obstructive andcentral.Obstructive sleepapneaisthe more
commonof the two.Obstructive sleepapneaoccursas repetitive episodesof complete orpartial
upperairwayblockage duringsleep.Duringanapneaepisode,the diaphragmandchestmuscles
workharder as the pressure increasestoopenthe airway.Breathingusuallyresumeswithaloud
gasp or bodyjerk.These episodescaninterfere withsoundsleep,reduce the flow of oxygentovital
organs,and cause heart rhythmirregularities.
In central sleepapnea,the airwayisnotblockedbutthe brainfailstosignal the musclestobreathe
due to instabilityinthe respiratorycontrol center.Centralapneaisnamedassuch because itis
relatedtothe functionof the central nervoussystem.
A
B
Who getssleepapnea?
Sleepapneaoccursinabout 25 percentof menand nearly10 percentof women.Sleepapneacan
affectpeople of all ages,includingbabiesandchildrenandparticularlypeople overthe age of forty
and those whoare overweight.Certainphysical traitsandclinical featuresare commoninpatients
withobstructive sleepapnea.These includeexcessiveweight,large neck,andstructural
abnormalitiesreducingthe diameterof the upperairway,suchas nasal obstruction,alow-hanging
softpalate,enlargedtonsils,orasmall jaw withan overbite.The figuresbelow illustrate the upper
airwayinnormal sleep(A;personislyingonback,face up) andin obstructive sleepapnea(B).The
arrows indicate complete obstructioninthe backof the throat.
What causessleepapnea?
2. Obstructive sleepapneaiscausedbya blockage of the airway,usuallywhenthe softtissue inthe
rear of the throatcollapsesduringsleep.Central sleepapneaisusuallyobservedinpatientswith
central nervoussystemdysfunction,suchasfollowingastroke orinpatientswithneuromuscular
diseaseslikeamyotrophiclateral sclerosis.Itisalsocommoninpatientswithheartfailure andother
formsof cardiac andpulmonarydisease.
What are the symptomsof sleepapnea?
Oftenthe firstsignsof OSA are recognizednotbythe patient,butbythe bedpartner.Many of those
affectedhave nosleepcomplaints.The mostcommonsymptomsof OSA include:
Snoring
Daytime sleepinessorfatigue
Restlessness duringsleep
Suddenawakeningswithasensationof gaspingorchoking
Dry mouthor sore throatupon awakening
Intellectual impairment,suchastrouble concentrating,forgetfulness,orirritability
Nightsweats
Sexual dysfunction
Headaches
People with central sleepapneamore oftenreportrecurrentawakeningsorinsomnia,althoughmay
alsoexperience achokingorgaspingsensationuponawakening.
Symptomsinchildrenmaynotbe as obviousandinclude:
Poorschool performance
Sluggishnessorsleepiness,oftenmisinterpretedaslazinessinthe classroom
Daytime mouthbreathingandswallowingdifficulty
Inwardmovementof the ribcage wheninhaling
Unusual sleepingpositions,suchassleepingonthe handsandknees,orwiththe neckhyper-
extended
3. Excessive sweatingatnight
Learningandbehavioral disorders
Bedwetting
What are the effectsof sleepapnea?
If leftuntreated,sleepapneacanresultina numberof healthproblemsincludinghypertension,
stroke,arrhythmias,cardiomyopathy(enlargementof the muscle tissueof the heart),congestive
heartfailure,diabetes,andheartattacks.Inaddition,untreatedsleepapneamaybe responsible for
jobimpairment,work-relatedaccidents,andmotorvehiclecrashesaswell asacademic
underachievementinchildren andadolescents.
How issleepapneadiagnosed?
The diagnosisof sleepapneaisrelativelystraightforward,basedonsleephistoryandanovernight
sleepstudycalledapolysomnogram.Polysomnographyisperformedinasleeplaboratoryunderthe
directsupervisionof atrainedtechnologist.Duringthe test,avarietyof bodyfunctions,suchasthe
electrical activityof the brain,eye movements,muscleactivity,heartrate,breathingpatterns,air
flow,andbloodoxygenlevelsare recordedatnightduringsleep.Afterthe studyiscompleted,the
numberof timesbreathingisimpairedduringsleepistalliedandthe severityof sleepapneais
graded.In some cases,a multiplesleeplatencytestisperformedonthe dayafterthe overnighttest
to measure the speedof fallingasleep.Inthistest,patientsare givenseveralopportunitiestofall
asleepduringthe course of a day whentheynormallywouldbe awake.If youhave symptomsof
sleepapnea,yourdoctormayask you to have a sleepevaluationinasleepdisordercenter.
What are the treatmentsforsleepapnea?
Conservative treatments—Inmildcasesof sleepapnea,conservative therapymaybe all thatis
needed.Overweightpersonscanbenefitfromlosingweight.Evena10 percentweightlosscan
reduce the numberof apneiceventsformostpatients.Individualswithapneashouldavoidthe use
of alcohol andsleepingpills,whichmake the airwaymore likelytocollapse duringsleepandprolong
the apneicperiods.Insome patientswithmildsleepapnea,breathing pausesoccuronlywhenthey
sleepontheirbacks.Insuch cases,usingpillowsandotherdevicesthathelpthemsleepinaside
positionmaybe helpful.People withsinusproblemsornasal congestion(suchpeopleare more likely
to experience sleepapnea) shoulduse nasal spraysorbreathingstripstoreduce snoringand
improve airflow formore comfortablenighttime breathing.Avoidingsleepdeprivationisimportant
for all patientswithsleepdisorders.
Mechanical therapy—Continuouspositive airwaypressure (CPAP) isthe preferredinitialtreatment
for mostpeople withobstructive sleepapnea.WithCPAP,patientswearamaskover theirnose
and/ormouth.An airblowerforcesairthroughthe nose and/ormouth.The air pressure isadjusted
4. so that itis justenoughtopreventthe upperairwaytissuesfromcollapsingduringsleep.The
pressure isconstantand continuous.CPAPpreventsairwayclosure while inuse,butapneaepisodes
returnwhenCPAPisstoppedorit isusedimproperly.Otherstylesandtypesof positive airway
pressure devicesare available forpeople whohave difficultytoleratingCPAP.
Mandibularadvancementdevices—Forpatientswithmildsleepapnea,dental appliancesororal
mandibularadvancementdevicesthatpreventthe tongue fromblockingthe throatand/oradvance
the lowerjawforwardcan be made.These deviceshelpkeepthe airwayopenduringsleep.A sleep
specialistandprosthodontist(withexpertise inoral appliancesforthispurpose) shouldjointly
determine if thistreatmentis bestforyou.
Surgery—Surgical proceduresmayhelppeople withsleepapnea.There are manytypesof surgical
procedures,some of whichare performedasoutpatientprocedures.Surgeryisreservedforpeople
whohave excessiveormalformedtissueobstructingairflow throughthe nose orthroat,suchas a
deviatednasal septum, markedlyenlargedtonsils,orsmall lowerjaw withanoverbite thatcauses
the throat to be abnormallynarrow.These proceduresare typicallyperformedaftersleepapneahas
failedtorespondtoconservative measuresandatrial of CPAP.Typesof surgeryinclude:
Somnoplasty—A minimallyinvasive procedure thatusesradiofrequencyenergytoreduce the soft
tissue inthe upperairway.
Uvulopalatopharyngoplasty(UPPP)—A procedurethatremovessofttissueonthe backof the throat
and palate,increasingthe widthof the airwayatthe throat opening.
Mandibular/maxillaryadvancementsurgery—Asurgical correctionof certainfacial abnormalitiesor
throat obstructionsthatcontribute tosleepapnea.Thisisaninvasive procedure thatisreservedfor
patientswithsevere sleepapneawithhead-face abnormalities.
Nasal surgery—Correctionof nasal obstructions,suchasa deviatedseptum.