Insomnia is defined as difficulty falling asleep, staying asleep, or early awakening despite opportunities for sleep, associated with impaired daytime functioning for at least 3 nights per week for over a month. It can be acute (under 3 months) or chronic. Assessment involves evaluating sleep history, screening for sleep apnea and mental health issues. Treatment goals are improving sleep quality, decreasing distress, and improving daytime function. Non-pharmacological therapies like CBT, sleep hygiene, and sleep restriction are recommended initially. Hypnotics may be used short-term but have risks and should be avoided for chronic insomnia if possible. CBT-I is the cornerstone treatment and can be combined with short-term medication
The document summarizes a seminar on generalized anxiety disorder (GAD). It defines anxiety and anxiety disorders, and classifies GAD as a chronic condition characterized by excessive and persistent worry. The seminar discusses the etiology, signs and symptoms, diagnostic criteria, differences between normal worry and GAD, and treatments for GAD including psychotherapy and medications.
This document discusses sleep disorders and provides information on various types of sleep disorders including dyssomnias, parasomnias, and disorders of sleep-wake schedules. It describes insomnia, hypersomnia, narcolepsy, sleep apnea, Kleine-Levin syndrome and other sleep disorders. It also discusses assessments and treatments for sleep disorders as well as nursing diagnoses and interventions to promote restful sleep.
Heavy drinking over a period of time can lead to alcohol withdrawal syndrome when blood alcohol levels fall, which is a potentially life-threatening condition requiring immediate medical care. Symptoms of alcohol withdrawal generally present within 6-8 hours and include anxiety, agitation, nausea, vomiting, tremors, and seizures within 12-48 hours. Delirium tremens occurs in around 5% of patients after 2-5 days and is a medical emergency characterized by severe tremors, confusion, hallucinations and fever. Benzodiazepines are commonly used to manage withdrawal symptoms while delirium tremens requires quick-acting benzodiazepines and antipsychotics.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
The document discusses Parkinson's disease (PD), a progressive nervous system disorder that causes movement-related issues like tremors and stiffness. It begins by introducing PD and its common symptoms. It then discusses the etiology, pathophysiology, clinical manifestations, complications, diagnosis, treatment options including medications and surgery, nursing management considerations, and potential nursing diagnoses for patients with PD. The main points are that PD is caused by the loss of dopamine-producing neurons in the brain, leading to motor symptoms, and is typically treated through dopamine replacement therapies like levodopa although surgery may be an option in some cases. Nursing care involves monitoring symptoms and functioning, educating on treatments and self-care, and addressing issues like impaired mobility and communication
A 33-year-old male presented with symptoms of loss of interest, lethargy, and reduced mental and physical well-being for the past 6-7 years. He has a family history of possible psychiatric illness in his grandfather. On examination, he displayed anxious and inappropriate behavior, impaired comprehension, rapid speech, an anxious mood, paranoid delusions, and impaired judgment and insight. He was diagnosed with paranoid schizophrenia based on his symptoms. Schizophrenia is a chronic mental disorder caused by genetic and environmental factors. It involves positive symptoms like hallucinations and delusions as well as negative symptoms and is typically treated with antipsychotic medication.
Dementia is a loss of mental skills that affects daily life and usually gets worse over time. It can be caused by neurodegenerative conditions like Alzheimer's disease, vascular diseases, head injuries, strokes, infections, and certain genetic disorders. Dementia is diagnosed through medical history, exams, and lab tests and stages progress from mild cognitive impairment to moderate and severe dementia. Treatment involves medications to address symptoms, care to support daily living, and management of behaviors.
1. The document discusses various sleep disorders including insomnia, hypersomnia, parasomnias, and sleep-related breathing disorders.
2. Key diagnostic tests mentioned are polysomnography, multiple sleep latency test, and actigraphy which objectively measure sleep patterns.
3. Treatment options described for different sleep disorders include lifestyle changes, medications like benzodiazepines, melatonin agonists, antidepressants, and CPAP machines for sleep apnea.
This document provides an overview of Parkinson's disease, including its etiology, incidence, pathophysiology, clinical presentation, diagnosis, prognosis, and treatment. Some key points:
- Parkinson's disease is a chronic neurodegenerative disorder that affects the basal ganglia and is characterized by bradykinesia, rigidity, tremor, and postural instability.
- It has an annual incidence of 0.2 per 1000 people and prevalence of 1.5 per 1000. Risk increases with age.
- Pathologically it involves the loss of dopamine-producing neurons in the substantia nigra and formation of Lewy bodies.
- Clinical diagnosis is based on the presence of cardinal motor symptoms
Extrapyramidal symptoms. ... These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradykinesia (slowness of movement), and tremor, and tardive dyskinesia (irregular, jerky movements).
This document provides information on dementia and various types of dementia such as Alzheimer's disease and vascular dementia. It discusses symptoms, brain changes, risk factors and diagnostic approaches for different dementias. Alzheimer's disease is the most common type of dementia, accounting for 60-80% of cases. Vascular dementia is the second most common, making up 20% of cases. Symptoms of Alzheimer's include memory loss and impaired judgment, while vascular dementia symptoms include impaired planning and reasoning abilities. Brain imaging can detect abnormalities associated with different dementias. A thorough diagnostic evaluation includes history, physical exam, neuropsychological testing, lab tests and brain imaging.
Conversion disorder, also known as functional neurological symptom disorder, is a condition where a person experiences neurological symptoms such as blindness, paralysis, or seizures that cannot be fully explained by medical issues. It occurs when psychological stressors are converted into physical symptoms affecting sensation, movement, or both. People with conversion disorder may experience weakness in the limbs, impaired coordination, or problems with senses like vision or hearing. It is diagnosed through medical history, exams, and tests to rule out other neurological or medical conditions. Treatment involves counseling therapies and sometimes medication to manage anxiety or depression. Prognosis is generally good, especially if the condition is diagnosed early and the patient engages with treatment recommendations.
Bipolar disorder is characterized by recurrent episodes of mania and depression. It is classified into Bipolar I and II based on the severity of manic episodes. The exact causes are unknown but genetic and biochemical factors are thought to play a role. Clinical features include changes in mood, energy, sleep patterns, and risk-taking behavior. Treatment involves mood stabilizers like lithium, antipsychotics, and antidepressants to control symptoms and prevent future episodes. Prognosis depends on factors like comorbidities, stress levels, and medication compliance.
Myasthenia gravis is an autoimmune disorder characterized by fluctuating weakness of the voluntary muscle groups caused by antibodies attacking acetylcholine receptors at the neuromuscular junction. Symptoms include weakness of the eyes, face, neck, throat, and limbs which worsens with activity and improves with rest. Diagnosis involves testing for acetylcholine receptor antibodies, the Tensilon test showing improved strength with edrophonium, and electrodiagnostic studies. Treatment focuses on immunosuppression and acetylcholinesterase inhibitors, with nursing care centered around maintaining airway and respiratory function, energy conservation, and education.
This document provides an overview of depression, including its definition, types, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, investigations, and treatment. Depression is defined as a common mental disorder characterized by depressed mood, loss of interest, feelings of guilt, sleep disturbances, low energy, and poor concentration. Major types include major depressive disorder, bipolar disorder, dysthymic disorder, and situational depression. Depression affects over 350 million people globally and is a leading cause of disability. Causes may include genetic, environmental, biochemical and neurological factors. Treatment involves antidepressant medications like SSRIs, TCAs, and MAOIs as well as psychotherapy and other non-pharmacological approaches.
The document summarizes mood disorders and their classification. It describes the main features of manic episodes, depressive episodes, bipolar mood disorder, recurrent depressive disorder, and persistent mood disorder. Manic episodes are characterized by elevated mood and increased psychomotor activity. Depressive episodes involve depressed mood, loss of interest, and feelings of worthlessness. Bipolar disorder involves recurrent episodes of mania and depression. Treatment involves medications like antidepressants, lithium, antipsychotics as well as psychosocial therapies.
This document summarizes information about seizures and epilepsy. It defines a seizure as abnormal excessive neuronal discharge and epilepsy as a chronic seizure disorder. Seizures are classified as partial or generalized. Common causes of epilepsy include family history, head injuries, infections, and tumors. Diagnosis involves EEG and brain imaging. Treatment depends on seizure type but may include carbamazepine, lamotrigine, valproic acid, and other anticonvulsants. The majority of people with epilepsy live normal lives, as epilepsy is not contagious or a mental illness.
This document discusses epilepsy and seizures. It defines seizures and epilepsy, describes different types of seizures including partial and generalized seizures. Common causes of epilepsy including strokes, brain injuries, tumors are mentioned. Management of seizures focuses on preventing injuries, identifying and removing seizure triggers, and treating with anti-seizure medications to control seizures. Nursing care revolves around safety during seizures, airway management, education, and supporting patients' psychosocial needs.
Insomnia is a sleep disorder characterized by difficulty falling or staying asleep. There are different types of insomnia including acute, chronic, comorbid, onset, and maintenance insomnia. Insomnia can be caused by stress, poor sleep habits, lifestyle factors, mental health conditions, physical health conditions, and certain medications. Effects of insomnia include lower performance, higher risk of accidents, psychiatric problems, health issues, and substance abuse. Treatment may include improving sleep habits and lifestyle changes for mild insomnia or prescription sleeping pills for more severe insomnia.
Drug Treatment of Insomnia discusses the diagnosis and treatment of insomnia through both pharmacological and non-pharmacological means. It notes that insomnia is the perception of poor quality or inadequate sleep accompanied by distress or impaired function. Common patient populations with high rates of insomnia include women, the elderly, and those with psychiatric or medical disorders. Treatment includes lifestyle changes, cognitive behavioral therapy, and prescription medications like benzodiazepines, non-benzodiazepines, melatonin agonists, and the newer orexin antagonist suvorexant. A comprehensive sleep history should assess sleep patterns, quality, environmental factors, and behaviors to properly diagnose and treat insomnia.
Sedatives, hypnotics, affective and antipsychotic medications for odla exercisedanielriddick
The document discusses sedative-hypnotic and antianxiety drugs, antidepressants, bipolar drugs, and antipsychotics. It covers the major drug classes in each category, their mechanisms of action, effects, side effects, and implications for physical therapy management of patients taking these medications. The learning objectives focus on understanding the pharmacology, recognizing signs and symptoms, modifying physical therapy approaches, and addressing patient safety concerns.
The document discusses sedative-hypnotic drugs and their uses. It describes the phases of sleep including non-REM sleep and REM sleep. Some key points are:
- Benzodiazepines are commonly used as hypnotics for insomnia and as anxiolytics for acute anxiety. Short acting BDZs are preferred to avoid daytime sedation.
- BDZs potentiate the effects of GABA by binding to sites adjacent to the GABA receptor. This increases chloride ion conductance and membrane hyperpolarization.
- While effective, long-term BDZ use can cause tolerance, dependence, and cognitive impairment so they should only be used short-term for severe anxiety and insomnia.
This document discusses sleep disorders and treatments for insomnia. It describes the physiological stages of sleep and the ideal criteria for sleep medications. It then classifies and compares different groups of sleep medications, including benzodiazepines, barbiturates, and newer drugs like zolpidem. Potential side effects are outlined for each group. The document also discusses treatments for seizures, classifying anticonvulsants and describing examples like phenobarbital, diphenine, and carbamazepine. Their mechanisms of action and side effect profiles are summarized.
This document discusses sedative-hypnotic drugs. It defines these drugs as those that produce sedation in small doses and sleep in larger doses. It discusses common neurotransmitters in the central nervous system and lists sleep requirements by age group. The document outlines causes of sleep problems and natural ways to induce sleep. It describes the sleep cycle and provides definitions of key terms like addiction and anxiolytic. The rest of the document summarizes different classes of sedative-hypnotic drugs like benzodiazepines, barbiturates, and other miscellaneous agents. It provides examples of specific drugs and notes their uses, dosages, durations of action, and adverse effects.
It focuses on sleep medicine - sleep disorders, sleep stages, DSM classification, types, classifications, and pharmacological and non pharmacological management.
This document discusses various sleep disorders including insomnia, narcolepsy, hypersomnolence disorder, breathing-related sleep disorders, circadian rhythm sleep-wake disorders, and parasomnias. It covers the diagnostic criteria, epidemiology, etiology, pathophysiology, assessment, and treatment approaches for each disorder. Sleep is regulated by homeostatic and circadian processes in the brain and disrupted sleep can negatively impact brain function and health. A thorough evaluation including sleep history, exams, and sometimes polysomnography is needed to diagnose the underlying cause of the sleep problem.
This document discusses anxiolytics and hypnotics such as benzodiazepines and barbiturates. It describes how these drugs work by enhancing the effects of the neurotransmitter GABA at GABA receptors in the brain, resulting in sedation, anxiety reduction, and sleep induction. Both classes of drugs are controlled substances due to their potential for dependence and withdrawal symptoms. While benzodiazepines are still commonly used, barbiturates have been largely replaced due to greater safety and tolerability of benzodiazepines.
Major depression is a mood disorder characterized by depressed mood or loss of interest in activities. It is estimated that over 300 million people worldwide suffer from depression. Treatment involves psychotherapy such as cognitive behavioral therapy and antidepressant medication. There are several classes of antidepressants including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and atypical antidepressants. SSRIs are now the first-line treatment due to their favorable side effect profile compared to other antidepressants. Research is also being conducted to develop new antidepressant drugs with novel mechanisms of action.
This document discusses terms related to pain and provides guidelines for pain management. It defines types of pain such as acute, chronic, neuropathic, and nociceptive pain. It describes the WHO analgesic ladder for treating cancer pain with non-opioids, weak opioids, and strong opioids depending on pain severity. It discusses the pharmacology and use of various analgesics like paracetamol, NSAIDs, opioids, corticosteroids, antidepressants, anticonvulsants, and others to treat different pain types and as adjuvants. It addresses myths and concerns around opioid use and emphasizes the importance of individualized treatment.
This document discusses different types of anxiety disorders and treatments. It defines anxiety and lists common emotional and physical symptoms. The main types of anxiety disorders covered are generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and phobias. The document examines different classes of antianxiety drugs including benzodiazepines, SSRIs, tricyclic antidepressants, buspirone, beta blockers, and MAO inhibitors. It details the mechanisms of action, uses, and side effects of these drug classes for treating various anxiety disorders.
The document provides information on antidepressants. It begins by defining depression and describing its various types. It then discusses the different classes of antidepressants, including SSRIs, SNRIs, TCAs, and MAOIs. For each class, it provides details on examples of drugs, their mechanisms of action, pharmacokinetics, therapeutic uses, and adverse effects. The document also discusses non-medication treatments for depression.
The document summarizes anticholinergic agents used in psychiatry. It discusses how they work by blocking acetylcholine receptors, their use in treating extrapyramidal side effects caused by antipsychotics, and precautions around their anticholinergic effects on various organ systems. The most commonly used anticholinergic agents for these psychiatric purposes are trihexyphenidyl, benztropine, biperiden, and procyclidine.
1. The document discusses different classes of antidepressant medications, including their mechanisms of action and pharmacology. The main classes covered are tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).
2. TCAs work by inhibiting the reuptake of norepinephrine and serotonin, while SSRIs and SNRIs are more selective in inhibiting reuptake. MAOIs work by inhibiting the monoamine oxidase enzyme and preventing breakdown of neurotransmitters.
3. The document reviews the practical applications of antidepressants in treatment of depression and other disorders
This document discusses sedative-hypnotics, including their classification, mechanisms of action, and uses. It covers barbiturates, benzodiazepines, and non-benzodiazepine hypnotics. Barbiturates were formerly used as hypnotics and sedatives but have mostly been replaced by benzodiazepines due to lower toxicity. Both barbiturates and benzodiazepines act by enhancing the effects of the inhibitory neurotransmitter GABA. Non-benzodiazepine hypnotics act through specific benzodiazepine receptors to induce sleep with fewer side effects than benzodiazepines. Hypnotics are used for short-term
This document discusses anxiety disorders and their symptoms, classification, epidemiology, and treatment. It defines anxiety as a feeling of tension, worry and physical changes. It describes several types of anxiety disorders including generalized anxiety disorder, panic disorder, phobic disorders, post-traumatic stress disorder, and obsessive-compulsive disorder. It provides information on the symptoms, diagnosis, risk factors, and treatment including pharmacological therapies such as SSRIs, TCAs, benzodiazepines, and non-pharmacological therapies such as cognitive behavioral therapy.
Sedative-hypnotic drugs reduce anxiety and induce sleep by depressing activity in the central nervous system. The main classes are benzodiazepines, barbiturates, and newer non-benzodiazepine agents. Benzodiazepines have largely replaced barbiturates due to their wider therapeutic index, lower risk of interactions and dependence, and the availability of antagonists. Both benzodiazepines and barbiturates work by enhancing the effects of the inhibitory neurotransmitter GABA.
Bipolar disorder is a chronic illness that causes major shifts in mood and energy, impairing various areas of life. While not curable, effective treatment exists to control symptoms and the course of the disorder. Treatment may include hospitalization if the person is a danger to self or others or unable to function. Pharmacotherapy focuses on acute symptom suppression, continuation treatment to prevent symptom return, and maintenance treatment to prevent recurrence. Treatment options include mood stabilizers, antipsychotics, antidepressants, anticonvulsants, and combination drugs. Prognosis depends on factors like episode duration, age of onset, and substance abuse history. Psychotherapy and support groups can also help manage the disorder.
This document summarizes an audit of albuminuria management in diabetic patients. The audit aimed to evaluate current clinical practice and encourage adherence to guidelines. It reviewed 133 patients with abnormal or no albumin-to-creatinine ratio testing in 2017. Key recommendations include ensuring proper documentation, informing laboratories that urine samples are for albumin-creatinine ratio testing, educating providers on proteinuria guidelines, and conducting annual audits to assess adherence.
The document discusses diabetes, hypertension (high blood pressure), and cholesterol. It defines each condition and lists risk factors, signs and symptoms, complications, and methods for management through diet, exercise, medication and regular monitoring. Maintaining a healthy lifestyle through a balanced diet low in salt, sugar, fat and cholesterol; regular physical activity; achieving and maintaining a healthy weight; and avoiding tobacco can help prevent and manage all three conditions.
This document provides guidance on common dermatological cases and their management. It discusses treatments for acne vulgaris such as topical clindamycin, benzoyl peroxide, and oral doxycycline. It also covers management of tinea corporis with topical and oral antifungals, tinea versicolor with topical and oral azole antifungals, alopecia areata with topical steroids and intralesional injections, viral warts with salicylic acid and cryotherapy, infant eczema treated with topical steroids and moisturizers, and melasma treated with topical retinoids, hydroquinone, and steroids.
Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar levels resulting from defects in insulin production, insulin action, or both. The main types are type 1 diabetes, type 2 diabetes, gestational diabetes, and other specific types. The long-term complications of diabetes include damage to various organs including the eyes, kidneys, nerves, and blood vessels. Lifestyle changes and medications are used to manage diabetes and prevent associated health problems.
This clinical audit assessed the quality of care for diabetic patients at the North Al-Khuwair Health Center in Oman in 2017. The audit reviewed records for 100 randomly selected diabetic patients. Key findings included: 1) Only 12% of patients had a healthy BMI, while most were overweight or obese; 2) 67% of patients were hypertensive but only 40% had their blood pressure well controlled; 3) 48% of patients had good blood sugar control as measured by HbA1c levels but 10% had poor control. The audit identified areas for improvement in lipid screening, nephropathy screening, foot examinations, and referrals to dieticians. Factors like patient non-compliance and incomplete physician
This document discusses iron deficiency anemia in infants and children. It defines anemia and recommends universal screening for anemia at age 1 by the WHO and AAP. For positive screens, follow up is essential. Evaluation includes history, exam, and complete blood count to differentiate anemia types. Iron deficiency anemia is the most common type and is likely if hemoglobin increases over 1 g/dL with iron supplementation. Prevention focuses on adequate iron during pregnancy, delivery by delayed cord clamping, and supplementation for breastfed infants and children ages 1-3. Iron is important for brain development but supplementation alone does not necessarily improve development in iron deficient non-anemic children.
A 6-year-old girl presented with scalp itching caused by head lice (pediculosis capitis). Examination revealed the presence of head lice and eggs (nits). Head lice are transmitted through direct head-to-head contact and infest the hair and scalp, feeding on blood. Common symptoms include itching and scratching. Treatment involves the use of topical pediculicides like pyrethroids or malathion, or oral ivermectin. Multiple treatments may be needed to kill all lice and prevent reinfestation from newly hatched nits.
This document provides an overview of a training module on sub-dermal contraceptive implants for health care providers in Oman. The first day of the three-day training covers the characteristics of implants, including what they are, how they work, effectiveness, health benefits, potential side effects, and other key points. Trainees participate in discussions, activities, and skill practices to learn how to counsel clients on implants and provide high-quality services. The goal is to standardize implant training across all governorates in Oman.
This document provides guidelines for infection prevention during contraceptive implant insertion and removal. It recommends washing the client's arm and setting up a sterile environment prior to the procedure. It also details the steps to take after the procedure, such as stopping any bleeding, applying a bandage, and properly disposing of and sterilizing instruments to prevent infections.
The document outlines the steps for removing a Nexplanon contraceptive implant. It describes:
1) Preparing the necessary equipment and having the client lie down with their arm flexed.
2) Locating the implant and administering local anesthesia near the distal end.
3) Making a small incision over the distal end and using forceps to remove the implant.
4) Closing the incision and observing for bleeding before discharging the client with post-removal instructions.
This document provides instructions for inserting a one-rod contraceptive implant. It describes the required equipment, demonstrates the 10 step process which includes cleaning and anesthetizing the insertion site, inserting the implant applicator and rod subdermally, verifying placement, and addressing post-procedure care. The goal is to properly insert the implant just under the skin to avoid blood vessels and nerves while maintaining sterility.
This document provides counseling information for contraceptive implant users. It discusses key topics to cover which include safety, efficacy, how implants work, benefits, possible side effects and STI protection. Additional topics are the insertion and removal procedures, length of protection, reasons to return and common side effects like changes in bleeding patterns. The removal procedure is described. Signs to see a provider are provided. Continuing users should be asked if satisfied and about any new health issues or concerns. Common myths are addressed such as implants not working after removal or causing infertility.
The document discusses guidelines for who can and cannot use contraceptive implants. It states that implants are safe and appropriate for nearly all women, including adolescents, women living with HIV/AIDS, and women who have had abortions or miscarriages. However, some women should not use implants, such as those who are pregnant or breastfeeding within the first 6 weeks after giving birth, or who have certain medical conditions like blood clots, breast cancer, or serious liver disease. The document reviews the WHO medical eligibility criteria for contraceptive methods and provides guidance on when implants can be initiated for different groups of women.
This document outlines the key points about contraceptive implants that health providers should convey to clients. The objectives are to describe the characteristics of implants, demonstrate insertion and removal procedures, address concerns and side effects, and identify situations that require switching or referral. Implants are highly effective, long-acting contraceptives involving rods placed under the skin that prevent pregnancy through hormonal methods. They have minimal side effects like irregular bleeding but provide health benefits and are very effective at preventing pregnancy without daily action needed. Health providers should be able to discuss all aspects of implants with clients.
1. Acute abnormal uterine bleeding (AUB) requires immediate intervention to prevent blood loss and is evaluated by assessing patient acuity, determining the likely etiology, and choosing appropriate treatment.
2. Initial assessment involves vital signs and signs of hypovolemia while etiologies consider medical history, medications, physical exam, and lab tests.
3. Treatment options for acute AUB include IV conjugated estrogen, intrauterine tamponade, combined oral contraceptives, antifibrinolytics, and surgery if medical options fail or are contraindicated. Long term options treat underlying causes.
Pityriasis rosea is a common, self-limiting skin rash characterized by oval lesions on the trunk and extremities. It is likely caused by a virus such as human herpesvirus-6 or -7. The rash begins with a single large 'herald patch' and spreads within 2-6 weeks. While usually resolving within 3 months, it causes moderate to severe itching. Treatment focuses on relieving itching with topical corticosteroids or antihistamines, with antivirals or phototherapy used in severe cases.
This document provides national guidelines for sub-dermal contraceptive implants (Implanon NXT) in Oman. It discusses the introduction of implants as a new long-acting reversible contraceptive method. The guidelines cover information about the method, including effectiveness, mechanism of action, indications, benefits, risks, and medical eligibility criteria. It also provides detailed instructions for assessment of clients, insertion of implants, management of problems or side effects, and removal of implants. The aim is to expand contraceptive options and encourage use of long-acting reversible methods.
This document outlines the evaluation of suspected dementia. It discusses the epidemiology of dementia, including that Alzheimer's disease accounts for 60-80% of cases. It also covers risk factors, diagnostic criteria through history, exams, screening tests, neuroimaging, and lab/genetic testing. The goal is to confirm cognitive impairment, identify potential causes, and rule out other intracranial abnormalities or treatable conditions.
اختبار قصير: ماذا تعلم عن التغطية الصحية الشاملة؟
أَجِب على أسئلة هذا الاختبار القصير لتتأكد من صحة إجاباتك.
1 تحتفل منظمة الصحة العالمية (المنظمة) في يوم 7 نيسان/ أبريل من كل عام بذكرى إنشائها، باليوم الذي دخل فيه دستورها حيز النفاذ. فكم ستبلغ المنظمة من العمر هذا العام (2018)؟
30 عاماً
50 عاماً
70 عاماً
90 عاماً
2 ما المقصود بالتغطية الصحية الشاملة؟
يُقصد بالتغطية الصحية الشاملة حصول جميع الأفراد والمجتمعات المحلية على الخدمات الصحية اللازمة لهم متى وحيثما لزمتهم.
التغطية الصحية الشاملة تحمي الناس من الوقوع في دائرة الفقر حينما يُسددون تكاليف الخدمات الصحية اللازمة لهم من أموالهم الخاصة.
التغطية الصحية الشاملة تُمكّن جميع الأشخاص من الحصول على الخدمات التي تعالج أهم أسباب الإصابة بالمرض والوفاة.
التغطية الصحية الشاملة تعني تقديم خدمات صحية للأفراد ومختلف فئات السكان كالقضاء على مواقع تكاثر البعوض.
جميع ما سبق.
3 ما نسبة سكان العالم غير القادرين على الحصول على الخدمات الصحية اللازمة لهم؟
ما لا يقل عن 30% من سكان العالم
ما لا يقل عن 50% من سكان العالم
ما لا يقل عن 70% من سكان العالم
ما لا يقل عن 90% من سكان العالم
4 يُدفع نحو 100 مليون شخص في العالم إلى دائرة ’الفقر المدقع‘ (أي يعيشون بدخل لا يتجاوز 1.90 دولاراً أمريكياً في اليوم) بسبب اضطرارهم إلى سداد تكاليف خدمات الرعاية الصحية اللازمة لهم.
صحيح
خطأ
5 من له دور يؤديه في الدعوة إلى تحقيق التغطية الصحية الشاملة؟
أنت
الجماعات غير الهادفة إلى الربح
العاملون في مجال الصحة
وسائط الإعلام
جميع ما سبق
Session 6 se and complications [repaired]
This document discusses important toxins and poisonings that medical professionals must be aware of. It covers the following key points:
- Identifies common toxic substance groups like opioids, sedatives, and toxins causing various "toxidromes" or symptom clusters.
- Explains how to conduct an initial assessment of a poisoned patient, including stabilizing vital signs, gathering exposure details, considering decontamination or antidotes.
- Describes common toxidromes caused by substances like sympathomimetics, anticholinergics, cholinergics, opioids, and sedatives/hypnotics; and their associated signs and symptoms.
- Emphasizes the importance
These are the class of Drugs that are used to treat and prevent cardiac arrhythmias by blocking ion channels involved in cardiac impulse generation and conduction. Class I drugs like quinidine and procainamide block sodium channels to prolong the action potential duration, while Class IB drugs like lignocaine shorten repolarization. Class III drugs like amiodarone block potassium channels to prolong the action potential. Calcium channel blockers like verapamil inhibit calcium influx. Other drugs include adenosine for paroxysmal supraventricular tachycardia, beta blockers for supraventricular arrhythmias, and atropine for bradycardias. Adverse effects vary between drugs but include arrhythmias, heart block and QT prolong
Regenerative Medicine in Chronic Pain ManagementReza Aminnejad
Regenerative technologies are the future of medicine. The current clinical strategy focuses primarily on treating the symptoms but regenerative medicine seeks to replace tissue or organs that have been damaged by age, disease, trauma, or congenital issues.
कायाकल्प क्लिनिक: पटना के अग्रणी सेक्सोलॉजिस्ट और स्किन केयर विशेषज्ञ
पटना का एक शानदार स्वास्थ्य सेवा प्रदाता, कायाकल्प क्लिनिक, आपके स्वास्थ्य और त्वचा की देखभाल में विशेषज्ञता प्रदान करता है। हमारे नवीनतम तकनीकी समाधानों और अनुभवी विशेषज्ञों के साथ, हम पुरुष और महिलाओं के स्वास्थ्य सम्बंधित मुद्दों को हल करते हैं। यहां पर हम प्रदान करते हैं:
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Discover the Best Sexologist in Patna: Expert Care at Kayakalp Clinic
Kayakalp Clinic - Best Sexologist in Patna
Kayakalp Clinic - Best Sexologist in Patna
When it comes to sexual health, finding the right expert is essential for effective diagnosis and treatment. At Kayakalp Clinic in Patna, we pride ourselves on providing exceptional care for a wide range of sexual health issues. If you’re searching for the best sexologist in Patna, look no further. Our team of highly skilled professionals is here to help you navigate and resolve your concerns with confidentiality and compassion.
Why Choose Kayakalp Clinic?
1. Experienced Professionals
Our sexologists are highly trained and experienced in dealing with various sexual health issues. They stay updated with the latest advancements in the field to provide the best care possible.
2. Comprehensive Services
At Kayakalp Clinic, we offer a wide range of services, including:
- Treatment for erectile dysfunction
- Solutions for premature ejaculation
- Counseling for low libido
- Infertility treatment
- Management of sexual pain disorders
- STI screening and treatment
- Relationship and intimacy counseling
3. Personalized Treatment Plans
We understand that every individual is unique, and so are their health concerns. Our sexologists take the time to understand your specific needs and create personalized treatment plans to ensure the best outcomes.
Osvaldo Bernardo Muchanga- MALE CIRCUMCISION, ITS Vs SOCIOCULTURAL BELIEFS (C...Osvaldo Bernardo Muchanga
MALE CIRCUMCISION consists of the surgical act of removing the foreskin (skin that covers the glans of the penis), leaving the glans more prominent and better cleanable.
MALE CIRCUMCISION itself has medical as well as sociocultural implications, as it has been proven to be an act that can minimize SEXUALLY TRANSMITTED INFECTIONS (STIs), especially HIV, but it also represents the SOCIOCULTURAL IDENTITY of some people, respectively.
Now, in a SERO-EPIDEMIOLOGICAL PROFILE like that of Mozambique where the prevalence of HIV is around 12.5% which corresponds to approximately 2 million people living with HIV, where the province of GAZA is the most seroprevalent with a positivity rate of 21% (INSIDA, 2021), it is extremely necessary to THOROUGHLY scrutinize all possibilities for preventing or minimizing the spread of HIV and other STIs.
Interventional radiology is a medical specialty that uses imaging techniques, such as X-rays, CT scans, and ultrasound, to guide minimally invasive procedures to diagnose and treat a variety of conditions. These procedures can be an alternative to open surgery, often resulting in shorter recovery times for patients.
Subcutaneous nodules in rheumatic diseases Ahmed Yehia Assistant Professor of internal Medicine, Immunology, rheumatology and allergy
How to use subcutaneous nodules as a clue for diagnosis by completing the puzzle
CASE PRESENTATION ON ACUTE GASTROENTERITIS.Bhavana
This is a case presentation of a 72 year old female patient who was admitted in the hospital with the chief complaints of loose stools since 6 Days and generalised weakness and history of one episode of vomiting (one day back).
This document contains an overview of different types of ocular neoplastic disorders or ocular tumors among pediatric patients. you can have a quick basic concept about ocular tumors among children and a basic management strategy. You will have perfect idea about almost 8 ocular tumors among pediatric patients .
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn J...rightmanforbloodline
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
Definition of mental health nursing, terminology, classification of mental disorder, ICD-10, Indian Classification, Personality development, defense mechanism, etiology of bio psychosocial factors,
Hemodialysis: Chapter 11, Venous Catheter - Basics, Insertion, Use and Care -...NephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/QeWTw_fYPlA
- Video recording of this lecture in Arabic language: https://youtu.be/fUWI9boFc7w
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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an huge problem we are facing about the anaemia , we slight our contribution to aware with one of its class , with detailed description. it is usefull for health , medicine , pharmacy , nursing.
These lecture slides, by Dr Sidra Arshad, offer a simplified description of the physiology of insulin and glucagon.
Learning objectives:
1. Describe the synthesis and release of insulin
2. Explain the mechanism of action of insulin
3. Discuss the metabolic functions of insulin
4. Elucidate the effects of insulin on adipose tissue, skeletal muscle, and liver
5. Enlist the factors which stimulate and inhibit the release of insulin
6. Explain the mechanism of action of glucagon
7. Discuss the metabolic functions of glucagon
8. Elucidate the role of insulin and glucagon in glucose homeostasis during the fasting and fed states
9. Discuss the role of other hormones in the glucose homeostasis
10. Differentiate between the types of diabetes mellitus
11. Explain the pathophysiology of the features of diabetes mellitus
12. Discuss the complications of diabetes mellitus
13. Explain the rationale of oral hypoglycemic drugs
14. Describe the features of hyperinsulinemia
Study Resources:
1. Chapter 79, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 24, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 39, Berne and Levy Physiology, 7th edition
4. Chapter 19, Human Physiology, From Cells to Systems by Lauralee Sherwood, 9th edition
5. Chapter 3, Endocrine and Reproductive Physiology, Bruce A. White and Susan P. Porterfield, 4th edition
6. Insulin and Insulin Resistance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/
7. Complications of diabetes mellitus,
https://pdb101.rcsb.org/global-health/diabetes-mellitus/monitoring/complications
Principles of Cleaning
Nonsurgical root canal treatment is a predictable method of retaining a tooth that otherwise would require extraction. Success of root canal treatment in a tooth with a vital pulp is higher than that of a tooth that is necrotic with periradicular pathosis. The difference is the persistent irritation of necrotic tissue remnants, and the inability to remove the microorganisms and their by-products. The most significant factors affecting this process are tooth anatomy and morphology, and the instruments and irrigants available for treatment. Instruments must contact and plane the canal walls to debride the canal.
Morphologic factors such as lateral and accessory canals, canal curvatures, canal wall irregularities, fins, cul-de-sacs, and isthmuses make total debridement virtually impossible. Therefore the goal of cleaning not total elimination of the irritants but it is to reduce the irritants.
Currently there are no reliable methods to assess cleaning. The presence of clean dentinal shavings, the color of the irrigant, and canal enlargement three file sizes beyond the first instrument to bind have been used to assess the adequacy; however, these do not correlate well with debridement. Obtaining glassy smooth walls is a preferred indicator. The properly prepared canals should feel smooth in all dimensions when the tip of a small file is pushed against the canal walls. This indicates that files have had contact and planed all accessible canal walls thereby maximizing debridement (recognizing that total debridement usually does not occur).
Principles of Shaping
The purpose of shaping is to
1) facilitate cleaning and
2) provide space for placing the obturating materials.
The main objective of shaping is to maintain or develop a continuously tapering funnel from the canal orifice to the apex. This decreases procedural errors when cleaning and enlarging apically. The degree of enlargement is often dictated by the method of obturation. For lateral compaction of gutta percha the canal should be enlarged sufficiently to permit placement of the spreader to within 1-2 millimeters of the corrected working length. There is a correlation between the depth of spreader penetration and the apical seal.5 For warm vertical compaction techniques the coronal enlargement must permit the placement of the pluggers to within 3 to 5 mm of the corrected working length.6
As dentin is removed from the canal walls the root is weakened.7 The degree of shaping is determined by the preoperative root dimension, the obturation technique, and the restorative treatment plan. Narrow thin roots such as the mandibular incisors cannot be enlarged to the same degree as more bulky roots such as the maxillary central incisors. Post placement is also a determining factor in the amount of coronal dentin removal.
3. insomnia :
difficulty falling asleep, staying asleep, or early awakening despite
the opportunity for sleep that is associated with impaired daytime
functioning and occurs at least 3/wk for at least one month.
4. • Insomnia can be:
acute (lasting up to 3 month )
chronic (lasting >3 month )
Insomnia (without comorbidity)
Insomnia with comorbidity:
• o Medical disorders
• o Psychiatric disorders
Insomnia with another primary sleep disorder
6. • Chronic insomnia consequences :
cognitive difficulties (e.g., problems with memory, attention, and
concentration; confusion),
anxiety and depression,
poor quality of life,
risk of suicide,
substance use relapse,
possible immune dysfunction,
increased risk of CVD (e.g., HTN, MI, or DM ) and all-cause
mortality.
7. • Excessive daytime sleepiness caused by insomnia can
lead:
to diminished work performance,
increased absenteeism,
MVC , accidents at work, fewer promotions,
increased accidents and falls in older persons,
10. ASSESSMENT
• Detailed sleep Hx
• screen for sleep apnea.
• screen for depression/anxiety disorder (GAD-7/PHQ-9)
• CONSIDER screening for other mental health conditions
if relevant (Bipolar/ADHD).
• CONSIDER screening for other medical issues such as
pain syndromes, and disease states in all other systems
that can disrupt sleep.
• Ask the patient to keep a sleep diary
12. MANAGEMENT
• The ultimate treatment goals:
• qualitatively and quantitatively improve sleep
• decrease related distress.
• improve daytime functioning
13. NON- PHARMACOLOGICAL RX
• Behavioral interventions are effective and recommended
as an initial approach to the treatment of chronic
insomnia based on RCT .
• Sleep hygiene
• Stimulus control therapy
• Sleep restriction therapy
• CBT
14. SLEEP HYGIENE
• exercise regularly (not within 4hrs of bedtime);
• avoid large meals and limit fluid intake in the evenings;
• limit caffeine, tobacco, and alcohol intake 4-6 hrs before
before bedtime.
• use the bedroom for sleep .
• maintain a regular sleep-wake cycle without daytime
napping.
• avoid negative stimuli at bedtime:
• loud noises,
• bright lights.
• extreme temperature variations.
15. STIMULUS CONTROL THERAPY
• Lie down to sleep only when feeling sleepy
• Avoid wakeful activities at bedtime (e.g., watching
television, talking on the phone, eating)
• Leave the bed if unable to fall asleep within 20 minutes
and return when sleepy
• Maintain a consistent sleep-wake cycle(temporal control
therapy ) :
set the alarm for the same time each morning regardless of how
much sleep occurs during the night.
16. SLEEP RESTRICTION THERAPY
• Limit time in bed to the number of hours actually spent
sleeping (not less than five hours); sleep time gradually
increases as sleep efficiency improves.
• There is a risk of excessive daytime sleepiness with this
approach.
17. CBT
• CBT-I significantly improves chronic insomnia
and daytime functioning for 2 years.
• is a combination of cognitive therapy,stimulus control
therapy, and sleep restriction therapy with or without the
incorporation of relaxation therapy.
18. HYPNOTICS
• There is good evidence for the efficacy of hypnotic drugs
in short-term insomnia but they do not treat any
underlying cause.
• adverse effects, :
• daytime sedation
• poor motor concentration
• cognitive impairment.
• In older people, in particular, the magnitude of the
beneficial effect of hypnotics may not justify the
increased risk of adverse effects (ie, falls and cognitive
impairment).
19. • Hypnotics should be prescribed at the lowest effective
dose for as short a period as possible.
• In transient insomnia:1-2doses of a short-
acting hypnotic
• Short term insomnia :intermittent dosing of a
short acting hypnotic given for no more than 3 weeks.
• Chronic insomnia :
• rarely benefits from the routine use of hypnotics
• should where possible be avoided.
20. • licensed hypnotic drugs :
• benzodiazepines (temazepam) .
• Z-drugs (zopiclone, zolpidem and zaleplon).
• NICE recommends that switching hypnotics should only
occur if there are documented adverse effects from a
particular agent.
21. BENZODIAZEPINES
• Effective
• many people develop tolerance ,
• Less therapeutic benefit from chronic use,
• dependence after 2-4 weeks of regular use.
• A withdrawal symptoms
• Rebound insomnia which is worse than the
original symptoms.
• Risk of misuse,
• only for severe, disabling insomnia
• The lowest dose for <4wks
22. THE ‘Z DRUGS’
• Zaleplon, zolpidem and zopiclone (the Z-drugs) are
nonbenzodiazepine hypnotics.
• Although the Z-drugs differ structurally from the
benzodiazepines, they are also agonists of the GABA
receptor complex and therefore enhanceGABA-mediated
neuronal inhibition.
• developed with the aim of overcoming some of the
disadvantages of benzodiazepines
26. • Promethazine25-50 mg : is an alternative for
patients in whom other hypnotics are not recommended.
• It has a long half-life and there is the potential for hang
over effect.
28. TAKE HOME
• CBT-I is the cornerstone of treatment for insomnia.
When CBT-I is combined with medication it may produce
faster improvements in sleep than CBT-I alone. If
combining CBT-I and medication, after the initial phase,
it is best to continue CBT-I while tapering/discontinuing
medication.
29. ACUTE INSOMNIA
• Treat acute insomnia only if there is a substantial
negative impact on daytime performance.
• Intervene early and suggest behavioral therapy .
• Consider using short term (e.g., two weeks)
pharmacotherapy with close follow-up based on the
severity and urgency of the presentation.
• Start medication at same time as CBT-I.
• Follow-up to monitor progress in two to four weeks.