IT REVIEWS Introduction and definition INTRODUCTION
BEAM-RESTRICTING DEVICES
ADVANTAGES AND DISADVANTAGES
TECHNIQUE
FILTERS
AND PHYSICS BEHIND IT AND LIGHT AND MIRROR ARRANGMENT CLEARLY EXPLAINED WELL.IT ALSO INCLUES THE FLITERS CLASSIFICATION AND COLLIMATORS CLASSIFICATION.
COLLIMATIORS ARE NOTHING BUT BEAM ALINERS
Collimators: Control the size and shape of the X-ray beam by limiting devicessudheendrapv
Collimators: Control the size and shape of the X-ray beam by limiting its aperture.
Aperture diaphragms: Restrict the size of the X-ray beam by blocking unwanted radiation.
Beam filters: Remove low-energy X-rays from the beam, reducing patient dose and improving image quality.
Gonad shields: Protect reproductive organs from unnecessary radiation exposure during X-ray procedures.
Grids: Improve image quality by reducing scatter radiation.
Positioning devices: Assist in accurately positioning patients, minimizing retakes and radiation exposure.
Lead aprons and barriers: Shield healthcare providers and patients from harmful radiation.
Compression devices: Compress body parts to reduce scatter radiation and enhance image quality.
Beam alignment devices: Ensure that the X-ray beam is properly aligned with the patient's anatomy.
Automatic exposure control (AEC) devices: Automatically adjust X-ray exposure according to patient size and anatomy for optimal image quality and dose optimization.
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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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traubleshooting in PALs,Brands and special design of PALs
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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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
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.
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
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- GENE THERAPY
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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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.
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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
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.
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
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.
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
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
3. APERTURE DIAPHRAGMS
• Simplest type
• Made up of a sheet of lead with a hole at its centre.
ADVANTAGE:
- Simplicity ( lead being soft, the aperture can be easily altered to any
desirable size and shape)
DISADVANTAGE:
- large penumbra at the periphery of the xray field
4.
5. Penumbra
• The centre of the xray field is exposed by the entire
focal spot, but the periphery sees only a portion of it.
• This partially exposed periphery of the xray field is
called the PENUMBRA.
TECHNIQUE TO REDUCE THE WIDTH OF THE
PENUMBRA:
- By positioning the aperture diaphragm as far away
from the xray target as possible.
6. CONES AND CYLINDERS
• CONES:
- flare shaped.
• CYLINDERS:
- beam restriction at the far end of the barrel, so less
penumbra.
- may be equipped with extensions to increase their
length for better beam restriction.
7. COLLIMATORS
• Best all round xray beam restrictor device.
• ADVANTAGES:
- Provides an infinite variety of rectangular
xray fields.
- light beam shows the centre and the exact
configuration of the xray field.
8. STRUCTURE OF A COLLIMATOR
• Two sets of shutters to control the
dimension.
- each shutter contains 4 or more lead plates,
which move in independent pairs.
- when the shutters are closed, they meet at
the centre.
• Light beam from a light bulb in the
collimator.
9.
10. • The light beam is deflected by a mirror mounted in the path
of the xray beam at an angle of 45 degree.
• The target of the xray tube and the light bulb should be the
exactly same distance from the centre of the mirror.
11.
12. • A collimator can also identify the center
of the xray field which is accomplished
by painting a cross line on a thin sheet
of plexiglass mounted on the end of
the collimator.
• A backup system is available in case if
the light burns out with the help of a
calibrated scale which will determine
the xray field size for various target-film
distances.
13. AUTOMATIC COLLIMATORS
• POSITIVE BEAM LIGHTING DEVICES
• Shutters are motor driven.
• When a cassette is loaded into the film holder, sensors will identify the alignment of
the cassette.
• Then the information is relayed to the collimator motors, which will position the
shutters to exactly match the size of the film being used.
• These devices must be accurate to within 2% of the source to image distance (SID).
14. • A perfectly aligned collimator will leave an unexposed border on
all sides of the developed film
15. TESTING XRAY BEAM AND LIGHT
BEAM ALIGNMENT
• Alignment has to be checked periodically.
MATERIALS REQUIRED:
• Four L shaped wires.
• 14 to 17 inch xray film
• Lead letter R
16. Procedure
• Place the film on the top of the x-ray table
• Open the shutter to a convenient size ( 10x10in)
• Carefully position the L shaped wires at the corner of the light field
• Place the R in the right lower corner.
• Then make an xray exposure. ( 40in.,3.3mAs, 40kVp) to mark the position of
the x-ray field on the film.
17. • Without touching the film or wires, enlarge the field size to
12x12 in. and expose the film for the second time.
The dark centre shows the position of the xray beam and the wires
indicate the position of the light beam.
18. HOW TO ADJUST A MISALIGNED MIRROR?
• Return the processed xray film to its original position. The R
in the right lower corner assists in orienting the film properly.
• Position the light beam to the images of the wires, as we dis
earlier for the film exposure and adjust the mirror in the
collimator until the light beam coincides exactly with the xray
field (the dark area on the film)
19. FUNCTION OF XRAY BEAM
RESTRICTORS
• PATIENT PROTECTION
• TO DECREASE SCATTER RADIATION
20. PATIENT PROTECTION
• Mechanism by which collimation protects the patient:
-smaller the xray field, smaller the volume of the patient that is
irradiated.
For example, if a 20x20 cm field is collimated to a 10x10cm, the area of the
patient that is irradiated decreases from 400 to 100cm2. (since area is a square
function, one half of decrease in x-ray beam diameter effects a 4 fold decrease
in patient exposure)
21.
22. IDEAL SHAPE OF THE FIELD
• This depends upon the part of the patient to be examined and not the shape
of either the film or collimator.
• Round field are ideal for certain parts like gallbladder and paranasal sinuses.
23. Formula to calculate the size of the aperture
• The sizes of the aperture and the xray field are proportional to the target-aperture
and target-film distances.
a/b = A/B
a- size of the aperture
b- x ray field
A- distance between aperture and the target
B- target-film distance
24. DECREASED SCATTER RADIATION
• Quantity of scatter radiation reaching the film is directly proportional to the
field size.
• So collimators by decreasing the field size, the reduce the amount of scatter
radiation.
• Xray field of or more than 30x30cm size= maximum scatter radiation
25. COLLIMATION AFFECTS EXPOSURE FACTORS.
• Small xray fields produce little scatter radiation, so the
blackening also decreases.
• TO KEEP THE FILM DENSITY CONSTANT,
WHENEVER FIELD SIZE IS REDUCED, THE
EXPOSURE FACTORS MUST BE INCREASED
26. SUMMARY
• THREE TYPES OF XRAY BEAM RESTRICTORS
• BASIC FUNCTION IS TO REGULATE THE SIZE AND SHAPE OF
THE XRAY BEAM.
• 2 ADVANRAGES OF CLOSELY COLLIMATED BEAMS:
- SMALLER AREA OF THE PATIENT EXPOSED,.
- LESS SCATTER RADIATION