This document summarizes various oral manifestations of systemic diseases. It discusses oral signs of gastrointestinal diseases like ulcers and glossitis in celiac disease. It also covers oral signs of liver diseases like bleeding tendency in alcoholic cirrhosis. Further, it outlines oral manifestations of hematological conditions like gingival hypertrophy in leukemia. The document also discusses oral signs of endocrine, pulmonary, renal and nutritional deficiencies. Finally, it examines various oral lesions like aphthous ulcers, changes in tongue coating, and disorders of the salivary glands.
AIDS is defined as a condition indicative of a defect in cell-mediated immunity occurring in a person with no known cause for immunodeficiency other than the presence of HIV.
CDC defined AIDS as
“The occurrence of one or more group of life-threatening opportunistic infections, malignancies, neurologic diseases and other specific illness in patients with HIV infection or with CD4 counts less than 200/cu mm”
AIDS is defined as a condition indicative of a defect in cell-mediated immunity occurring in a person with no known cause for immunodeficiency other than the presence of HIV.
CDC defined AIDS as
“The occurrence of one or more group of life-threatening opportunistic infections, malignancies, neurologic diseases and other specific illness in patients with HIV infection or with CD4 counts less than 200/cu mm”
Morphologically altered tissue in which cancer is more likely to occur than its apparently normal counter part.
-WHO(1978)
Definition
Leukoplakia is defined as ‘white patch’ or ‘plaque’ in the oral cavity, which cannot be scraped off or stripped off easily and more over which cannot be charectarized clinically or pathologically as any other disease. –WHO
Redefined as a “ predominantly white lesion of oral mucosa that cannot be characterized as any other definable lesion; some oral leukoplakia will transform into cancer” (Axell T, 1996)
Homogenous Leukoplakia
Non-Homogenous Leukoplakia
Granular or Nodular Leukoplakia
Speckled or Erythroleukoplakia
Verruciform Leukoplakia
Proliferative Verrucous Leukoplakia
Morphologically altered tissue in which cancer is more likely to occur than its apparently normal counter part.
-WHO(1978)
Definition
Leukoplakia is defined as ‘white patch’ or ‘plaque’ in the oral cavity, which cannot be scraped off or stripped off easily and more over which cannot be charectarized clinically or pathologically as any other disease. –WHO
Redefined as a “ predominantly white lesion of oral mucosa that cannot be characterized as any other definable lesion; some oral leukoplakia will transform into cancer” (Axell T, 1996)
Homogenous Leukoplakia
Non-Homogenous Leukoplakia
Granular or Nodular Leukoplakia
Speckled or Erythroleukoplakia
Verruciform Leukoplakia
Proliferative Verrucous Leukoplakia
Richard Frye, MD, PhD, FAAP, FAAN, CPI, will discuss:
*The enteric (gut) microbiome has an important influence on health and disease states in humans.
* The enteric microbiome influences the human host using chemical mediators, some of which can directly affect mitochondrial function
* Short chain fatty acids produced by gut bacteria not only modulate mitochondrial function and cellular regulatory pathways, but can also be used as mitochondrial fuels.
Science Cabaret by Dr. Rodney Dietert "How to train your super organism..via ...Kitty Gifford
Attendees (and their microbes) at this event enjoyed a lively discussion on how we might better interact with our environment to support a healthier life for ourselves and our children. Think with your microbes about why we have to suffer from ever-increasing numbers of debilitating chronic diseases (asthma, food allergies, diabetes, autoimmune conditions, obesity, heart disease and cancer).
with Dr. Rodney Dietert, Cornell University Professor, Department of Microbiology and Immunology
Dr. Rodney Dietert is an internationally-known author, lecturer, scientist, book series editor, and educator. He is the author of Strategies for Protecting Your Child’s Immune System, and Science Sifting: Tools for Innovation in Science and Technology.
Human nutrition, gut microbiome and immune system S'eclairer
Dr Zahida Chaudnary talks with the students about nutrition, gut microbiomes, and nutrition as we look at diseases and how your body reacts to what you eat.
Check out the slideshow by itself here.
Want an audio version? Subscribe to our Podcast on iTunes!
Want to join us for the live discussion? Check out our Social Media in the noon hour every Monday as we sit down on Google Hangout OnAir! Follow us on Twitter, Facebook, or Google+ to get updated with the link when we start!
Many systemic diseases are reflected in the oral mucosa, maxilla, and mandible.
Mucosal changes may include ulceration or mucosal bleeding.
Immunodeficiency can lead to opportunistic diseases such as infection and neoplasia.
Bone disease can affect the maxilla and mandible.
Systemic disease can cause dental and periodontal changes.
Drugs prescribed for a systemic disease can affect oral tissue.
Children have oral mucosal conditions and other head and neck medical problems which have both similarities and differences to those found in adults .
A wide variety of oral lesions and soft tissue anomalies are detected in children, but the low frequency at which many of these entities occur makes them challenging to clinically diagnose.
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
3. Background
- The mouth (buccal cavity)
is the reservoir for the
chewing and mixing of
food with saliva.
- It is the primary site of
digestion and respiration
as well as the primary
communication structure.
12. • Sjögren syndrome
– autoimmune disease
– men : women - 1 : 9, 50 years and older
Main signs
– sicca syndrome
– keratoconjuctivitis sicca
– xerostomia
Oral signs
– decrease in saliva
• xerostomia
– dry, red, wrinkled mucosa
• difficulty in swalloving and eating
• disturbance in taste and speech
• increased dental caries
• infections
• atrophy of the papilae
• candidiasis
Connective-tissue diseases
13. • Kawasaki disease
– vasculitis of medium and large arteries
Oral signs
– swelling of papilae on the surface of the
tongue (strawbery tongue)
– intense erythema of the mucosal
surfaces
– cracked, cherry red, swolen and
hemorrhagic lips
Connective-tissue diseases
14. • Scleroderma
– diffuse sclerosis of the skin, GIT,
heart muscle, lungs, kidney
Oral signs
– pursed lips – dificult to open the
mouth
– esophageal sclerosis
gastroesophageal reflux – damage
of enamel
– pale, rigid mucosa
– teleangiectasias
– decreased mobility of tongue
– salivary hypofunction
Connective-tissue diseases
Limited mouth opening and decreased
tongue mobility
Gingival retraction
21. • Cushing´s syndrome
– osteoporosis pathological
fractures of the mandible,
maxilla or alveolar bone
– delayed healing of fractures
and soft tissue injuries
• Addison´s disease
– oral mucosal melanosis –
buccal mucosa, tongue
Endocrine diseases
moon face
hyperpigmentation
22. • Uremic stomatitis
– in undiagnosed and untreated chronic renal
failure
– irritation and chemical injury of mucosa by
ammonia or ammonium compounds
Signs
– painful plagues and crusts – bucal mucosa,
the floor or dosrum of the tongue, floor of the
mouth
– Type I
• generalized or localized erythema
• exudate
• pain, burning, xerostomia, halitosis,
gingival bleeding, candidiosis
– Type II
• ulceration
• secondary infection
• anemia
Renal diseases
24. Nutritional Deficiencies
• Thiamine (Vitamin B1) and Niacin/nicotinic acid
(Vitamin B3) are also reported to cause some glossitis
and cheilitis.
• Folate deficiency leads to a megaloblastic anemia that
demonstrates many of the same oral characteristics of
pernicious anemia.
• Scurvy caused by vitamin C deficiency may cause
petechiae to ecchymoses in the submucosa.
• Mucous membrane changes may lead to gingival
hypertrophy and erosive, bleeding gums.
25. Disorders of Teeth
DISORDER FINDINGS
Bulimia Erosion of enamel and loss of dentin
Congenital
cytomegalovirus
Yellow dentin and hypoplastic pitted
enamel
Congenital
porphyria
Erythrodontia of canine teeth and molars
and brown discoloration of incisors
Congenital
syphilis
Hutchinson teeth, mulberry molars
Gardner
syndrome
Supernumerary teeth
Dr. TAREK SHETA, M.D
26. Disorders of Teeth
Lepromatous leprosy Reddening of upper teeth (pink spots)
Primary biliary
cirrhosis
Green pigment deposits
Sjogren syndrome Caries, increased plaque accumulation, poor
oral hygiene
GERD Erosion of enamel due to repeated exposure to
gastric acid
Tetracycline staining Permanent gray discoloration
Tuberous sclerosis Pitted enamel of the permanent teeth
Dr. TAREK SHETA, M.D
27. Periodontitis
Definition -chronic infection of connective tissue, periodontal
ligament and alveolar bone
Aetiology: diabetes, heart disease, stroke and preterm birth
birth control pills , steroids, Down syndrome, Langerhans cell
histiocytosis, HIV
29. Aphthous ulceration
• Acute, recurrent,
painful ulcers on
nonkeratinized
mucosa
• Most common
cause of oral
ulcerations
• Effect up to 30 %
of the population
Dr. TAREK SHETA, M.D
30. Aphthous ulceration
Minor aphthae
(90 -95 %)
Major aphthae
(5-10%)
Herpetiform
ulcers
(1-5%)
Age of onset Childhood or
adolescence
Childhood or
adolescence
Young adult
Ulcer size 2–4 mm 10 mm or larger Initially tiny, but
ulcers coalesce
Number of ulcers Up to about 6 Up to about 6 10–100
Sites Mainly vestibule,
labial, buccal
mucosa &
floor of mouth
Any site Any site but often
on ventrum of
tongue
Duration of each
ulcer
Up to 10 days Up to 1 month Up to 1 month
39. Normal tongue coating is formed of:
1- Tongue papillae.
2- Food debris.
3- Bacteria.
4- Desquamated epithelium.
Dr. TAREK SHETA, M.D
40. The tongue coating
varies in different individuals.
Varies in the same individual during the day
It is continuously formed
it is marked in the morning and is removed by:
1-Mechanical factors: speaking and chewing food.
2-Salivary flow
Dr. TAREK SHETA, M.D
41. Tongue coating is in a continuous
process of removal and formation.
- If removal exceeds formation
atrophy
- If formation exceeds removal
increased tongue coating.
Dr. TAREK SHETA, M.D
43. 1- Deficient or impaired utilization of
nutrients
1-Iron deficiency anemia.
3-Vitamin B deficiency especially (vitamin B2,
B6, B12, folic acid and nicotinic acid).
Pernicious anemia.
4-Anemia associated with parasitic infection as
ascaris and bilhariziasis.
5-Malnutrition, malabsorption.
6-Chronic alcoholism.
Etiology
Dr. TAREK SHETA, M.D
45. 3- Drugs
-Drugs that:
• Interfere with the growth and maturation
of the epithelium e.g cyclosporine.
• Induce candidosis e.g. antibiotic, steroid.
• Induce xerostomia e.g anticholinergic
drugs, radiotherapy.
Dr. TAREK SHETA, M.D
46. 4- Miscellaneous
1- Frictional irritation: atrophy at tip &
lateral borders of tongue.
2- Atrophic lichen planus.
3- Epidermolysis bullosa: ulceration
healed by scar.
4- Long standing xerostomia.
5- Diabetes and chronic candidiasis may
produce a lesion called central papillary
atrophy.
Dr. TAREK SHETA, M.D
48. White hairy tongue
• hypertrophy of filiform papillae resembling hair-
like projections
• Aetiology:- heavy tobacco use, mouth breathing,
antibiotic therapy, poor oral hygiene, general
debilitation, radiation therapy, chronic use of
bismuth containing antacids, lack of dietary
roughage, Febrile illness.
• White, yellow green, brown, or black color is due
to chromogenic bacteria or staining from
exogenous sources
52. Geographic tongue
• benign inflammatory condition,
due to Loss of filiform papillae
• Erythematous plaques with well
demarcated white border
• Etiology- diabetes mellitus,
anemia, hormonal disturbances,
psoriasis, Reiter syndrome,
atopic dermatitis,, Down
syndrome, lithium therapy
53. Fissured tongue (furrowed tongue,
scrotal tongue, grooved tongue)
• normal variant in 5-
11% individuals
• Also seen in :
psoriasis, Down
syndrome,
acromegaly, Sjogren
syndrome
57. Macroglossia
• CP: Difficult mastication
and speech and accidental
tongue biting
• CAUSES:
– Down syndrome,
– hypothyroidism,
– neurofibromatosis,
– infection by mycobacteria,
– amyloidosis
58. The stratified squamous epith. if chronically irritated by:
Chemical: spices.
Thermal: smoking.
Infection: syphilis.
Mechanical: dental irritation.
Formed by thickening and hyperkeratinization with the
formation of white patches.
Precancerous: biopsy
Leukoplakia of the tongue
Dr. TAREK SHETA, M.D
59. Oral hairy leukoplakia
• caused by Epstein-Barr
virus, presents as
asymptomatic,
corrugated, white plaques
with accentuation of
vertical folds along the
lateral borders of tongue
• Mainly seen in HIV
infection, organ transplant
recipients and patients on
chemotherapy
Dr. TAREK SHETA, M.D