Salivary gland tumors :

🌺 اغلبها حتكون benign ...
80% of parotid gland tumors are benign
50% of Submandibular tumors are benign ...

🌺 The Commonly effected is the parotid glan ...

🍃The 1st common tumor is pleomorphic Adenoma of Salivary gland >> Effects females

🍃 the 2nd common tumor is warthin tumor >> Effects females ...

نأخذها واحد واحد ...

💐Pleomorphic Adenoma of Salivary gland :

- 1st common effects females
- benign
- effects parotid gland
- (( mixed tumor))
Differentiate from both myoepithelial orgin and contains :
- 🍂 epithelial component: cords and acini
- 🍂 Mesenchymal elements:
Myxomatous and mucoid matrix with cartilage like structure and rarely bone ^^
هذا يعتبر( Microscopically )
طيب
- Gross :
*Encapsulated ( هذا لانها Benign) - lobululated and firm
* in the lower pole of parotid Gland
*rerlay exceeds 6 Cm
* cut section shows myxoid , cystic and solid foci

- treatment by surgical removement

بس مشكلتها انها لها زوائد تمتد بتخليها Incomplete excision

- may be transform to malignant due to long standing زي ما قلنا لما تنشال بتظل زوائد او ممكن De novo
- ال malignant
Rapid increase in size
وبالتالي بتاثر على النيرفات اللي ماشية في ال Parotid وتسبب hearing instability abd facial paralysis ..

✨✨✨✨✨✨✨✨✨✨✨

💐 Warthin Tumor :
- 2nd Common
- benign
- effects parotid gland
- associated with smooking and EBV
- called Papillary Cystadenoma lymhomatous

من اسمها نستنتج ال Microscopically :
انو الباروتيد جلاند عندها Duct .. بيحصل لها توسع وتتراكم فيها ال Serrous fluids and cellular debris .. ( Cystadenoma)

توسع ال Duct ممكن يخليها تعمل Papilla ( papillary)
و فيها تراكم لل Lymphoid cells وممكن تتكون ال germinal centers ..( lymhomatous )

نلخصها :
🍃Gross :
Encapsulated cystic mass with Papilla

🍃Microscopically:
-Papillary Cystadenoma with cystic spaces lined by uniform ✨doupl layers ✨of Oncocytic ( esionphiliic epithelium)
- stroma rich in lymphocytes and lympph follicles and germinal center formation..


#باثو

🌺Treatments for achalasia include oral medications, stretching of the lower esophageal sphincter (dilation), surgery to cut the sphincter (esophagomyotomy), and the injection of botulinum toxin (Botox) into the sphincter.

#باثو

Types of benign and malignant tumor of salivary gland? ذكرها الدكتور كسؤال باول المحاضره ..بالاضافه الى ماتم ذكره بالمنشور السابق #باثو

✒ Site of candidiasis :-
- in mouth ( thrush)
- in Nail ( onychomycosis)
- in skins ( cutaneous c.)
- eye , brain and bone ( invasive candidiasis)
- vagina ( vaginal yeast infection)
- penise ( penile candidiasis)

✒ Candida albican is a normal component of the oral flora and only produces disease under unusual circumstances.

✒Factors associated with HSV reactivation include :-
- trauma.
- allergies.
- exposure to ultraviolet light and extremes of temperature.
- upper-respiratory tract
infections.
- pregnancy.
- menstruation.
- immunosuppression.

Oral Candidiasis( thrush)

✒ Erythroplakia is associated with a much greater risk for malignant transformation than leukoplakia.

✒ Although the etiology is multifactorial tobacco use (cigarettes, pipes, cigars, and chewing tobacco)
is the most common risk factor for leukoplakia and erythroplakia.

Leukoplakia

حسب كلام الدكتور حسن اليوم ..

اختبار البكتيريا النصفي .. الإثنين بعد القادم. . الموافق 2/9 ..
اعملوا حسابكم على هذا الأساس. .

#بالتوفيق
#اللجنة_العلمية

Diabetes management Guidelines according to NICE ^^
الدكتور عدنان
#فارما

#Disease can causes both obstructive & restrictive lung diseases are :-

-Sarcoidosis

-BOOP (Bronchiitis obliterans with Organizing pnemonia)

-Cystic fibrosis

#باثو

🌺 Management of HbA1c levels :-

Patients should then be offered lifestyle advice ( Diet - sport )and drug treatment to support them to achieve and maintain their target HbA1c.

Haemoglobin A1c (HbA1c) testing to diagnose diabetes

An HbA1c of 48mmol/mol (6.5%) is recommended as the cut off point for diagnosing diabetes. 

A value of less than 48mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests.

If HbA1c levels are not controlled with a single drug and rise to 58mmol/mol (7.5%) or more, healthcare professionals should reinforce advice about diet, lifestyle and drug adherence and intensify drug treatment with the aim of reducing HbA1c to 48mmol/mol (6.5%)

في هذي الحالة اذا زاد عن ( 7.5%) يعطوه انسولين

HbA1c levels should be monitored at three- to six-monthly intervals until levels are stable on unchanging therapy.

الدكتور عدنان
#فارما

🌺Drug treatment :

The revised guidance states that all patients with type II diabetes should be offered standard -release 💊metformin as initial treatment, with a gradual increase in dose over several weeks to minimise the risk of gastrointestinal side-effects. If gastrointestinal intolerance occurs, prescribers should consider a trial of modified-release metformin as an alternative.

If metformin is contraindicated or not tolerated, patients may begin drug treatment with :

💊sulfonylurea ( glibenclamide ,glyburide, Diabinese)

قال هذا في حال طلع ال HbA1c اكثر من ( 6.5%) بس ما وصلش لل ( 7.5%)

💊Thiazolidinedione : pioglitazone 

💊( Gliptins ) :DPP-4 inhibitor class include sitagliptin, saxagliptin, linagliptin, and alogliptin .

الاثنين الاخيرين يستخدموا في حال حصل Hypoglycemia مع ال metformin ..

الدكتور عدنان ^^
#فارما

🌹🌹Women suffering from polycystic ovary syndrome have been treated with 💊metformin💊. 
Benefits include:
lipid lowering effects, reduction in systolic blood pressure, hyperinsulinemia and insulin resistance syndrome . Metformin has also been shown to aid in normal menstrual regulation and pregnancy.

#فارما

🍃Polycystic ovary syndrome (PCOS):

is a condition that affects a woman's hormone levels.

Women with PCOS produce higher-than-normal amounts of male hormones. 
The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

🍃Signs and symptoms :

- irregular periods
-Excess androgen : Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.

🍃 Causes : the main cause is not known . Factors might play rule include:

- hereditary
- Excess androgen
- PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens.
- Excess insulin might increase androgen production, causing difficulty with ovulation.

🍃Complications:

-Infertility

-Gestational diabetes or pregnancy-induced high blood pressure

-Miscarriage or premature birth

-Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver

-Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular diseaseType 2 diabetes or prediabetes

-Sleep apnea

-Depression, anxiety and eating disorders

-Abnormal uterine bleeding

-Cancer of the uterine lining (endometrial cancer)

🍃 Treatment:

Lifestyle changes: weight lose - exercise - limit carbohydrates

Medication: follows

يمكن #باثو. .. يمكن #فارما

💊Medication for Polycystic ovary syndrome ( PCOS)💊 :

عتكون ثلاث حاجات :
✏️To regulate menstrual cycle:

📝Compained contraceptives :
can lower risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne

📝 Progestin therapy :

regulate periods and protect against endometrial cancer. 


✏️To help ovulation :

📝Clomiphene (Clomid) .This oral anti-estrogen medication is taken during the first part menstrual cycle.

📝Metformin (Glucophage) : هذا اللي جابنا لهذا الموضوع :

🔴🔴Metformin can enhance ovulation and regulate menstrual cycles
Metformin may even improve cholesterol and hirsutism symptoms like acne and excess hair growth.

📝Letrozole : This breast cancer treatment can work to stimulate the ovaries.

📝Gonadotropins . These hormone medications are given by injection


✏️ To reduce excessive hair growth and acne :

📝 Contraceptives as been said ^

📝 Spironolactone (Aldactone) : This medication blocks the effects of androgen on the skin.
Spironolactone can cause birth defect >> contraindicated with pregnancy or planning for ..

📝 Metformin. ^^

#فارما

للتذكير :


💊💊Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low . Spironolactone is used to treat heart failure, high blood pressure (hypertension), or hypokalemia (low potassium levels in the blood)

💊Spironolactone is a moderate antiandrogen. That is, it is an antagonist of the androgen receptor (AR),
#فارما

#الأنزيمات_البكتيرية :-
تعتبر الأنزيمات عوامل حدة تفرزها بعض البكتيريا فتساعد على إنتشارها في الجسم والتسبب بالمرض، ومنها...

1-الكولاجينيز Collagenase
يحطم ألياف الكولاجين ويعزز من إنتشار العدوى
(Cl. perfringens).

2-الليسيثنيز Lecithinase يحطم الليسيثين، المكون الأساسي لغشاء البكتيريا
(Cl. perfringens).

3-الكوأقيليز Coagulase يكون جدار من ألياف الفيبرين حول مكان الإصابة يحمي الميكروب من عملية البلعمة.
(S. aureus).

4-الفيبرينولايسين Fibrinolysin أو الستربتوكينيز Streptokinase يحلل خيوط الفيبرين للمساعدة في إنتشار البكتيريابعد تحسن الظروف.
( S. pyogenes).

5-الهيالورونيديز Hyaluronidase يحلل حمض الهيالورونيك الرابط للأنسجة فيساعد في إنتشار البكتيريا
(Clostrdia,Streptococci).

6-الستربتودورنيز Streptodornase أو الديوكسي ريبونيكلييز Deoxyribonuclease يحطم DNA المتجمع في القيح Pus فيساعد على إنتشار البكتيريا.
(S. pyogenes).

7-البروتييز Protease أو الأمينوجلوبيلين أ Aminoglobulin A يحطم الجسم المضاد IgA المفرز من الأسطح المخاطية فيزيل تأثيره المضاد للبكتيريا.
(N. gonorrhoea).

#بكتيريا
#مايكرو