Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
Total Shoulder Arthroplasty | Reverse Shoulder Replacement | South Windsor, R...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses the pathology, surgical techniques, and potential complications during a total shoulder replacement and a reverse total shoulder replacement.
To learn more about shoulder replacements, please visit: https://hartfordsportsorthopedics.com/total-shoulder-replacement-arthroplasty-south-windsor-rocky-hill-glastonbury-ct/
MENISCUS REPAIR I Dr.RAJAT JANGIR JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Total Shoulder Arthroplasty | Reverse Shoulder Replacement | South Windsor, R...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses the pathology, surgical techniques, and potential complications during a total shoulder replacement and a reverse total shoulder replacement.
To learn more about shoulder replacements, please visit: https://hartfordsportsorthopedics.com/total-shoulder-replacement-arthroplasty-south-windsor-rocky-hill-glastonbury-ct/
MENISCUS REPAIR I Dr.RAJAT JANGIR JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
The hip joint is a ball and socket joint consisting of the femoral head and acetabulum. This articulation provides multiple planes of movement and is highly congruent. Articular cartilage, consisting of type II collagen, covers the majority of the femoral head. The acetabulum peripherally consists of articular cartilage while the central floor is non-articular and filled with a fatty layer termed the pulvinar. The ligamentum teres arises from both the transverse acetabular ligament and the central non-articular layer of the acetabulum and attaches to the central femoral head. It may play a role in stabilizing the hip joint.
A review of the reverse total shoulder replacement surgery and it's clinical implications for both physical rehabilitation and functional anatomy.
Objectives:
Understand basic anatomy of the shoulder complex and its implications for shoulder replacement
Understand indications for shoulder replacement
Understand differences between standard and reverse total shoulder replacements
Understand precautions following rTSA
Understand important concepts in rehabilitation following rTSA
Evolution of tunnel placement in ACL reconstructionDhananjaya Sabat
One of my talks at Delhi Arthroscopy Club....... this presentation provides a insight regarding the conceptual evolution in tunnel placement during ACL reconstruction.
ALL (antero-lateral ligament) - extra articular ACL reconstruction - basicsMilind Tanwar
history, need, how to reconstruct, when to reconstruct.
References: *Bonasia, Davide Edoardo et al. "Anterolateral Ligament Of The Knee: Back To The Future In Anterior Cruciate Ligament Reconstruction". Orthopedic Reviews 7.2 (2015)
Biomechanical Results of Lateral Extra-articular
Tenodesis Procedures of the Knee:
A Systematic Review. Erik L. Slette, B.A., Jacob D. Mikula, B.S., Jason M. Schon, B.S., Daniel C. Marchetti, B.A.,
Matthew M. Kheir, B.S., Travis Lee Turnbull, Ph.D., and Robert F. LaPrade, M.D., Ph.D.
Total shoulder arthroplasty and reverse TSA - Hussain AlgawahmedHussainAlgawahmedMBB
Discussion of the clinical presentation of shoulder arthritis followed by treatment options and the mechanical basis of total and reverse total shoulder arthroplasty
arthroscopy of the knee joint is a relatively common orthopedic procedure to treat a host of sports injuries and other knee diseases. Commonly a 4 mm size scope is used via two standard arthroscopy portals. Arthroscopic examination of the knee confirms MRI findings. Synovial fluid and biopsy can be taken to confirm diagnosis.
Assessment of Femoral Tunnel Placement in ACL ReconstructionJeremy Burnham
This study reviews the literature on tunnel placement in anterior cruciate ligament reconstruction, and assess the ability of experienced physicians and surgeons to evaluate the tunnel position using x-rays.
The hip joint is a ball and socket joint consisting of the femoral head and acetabulum. This articulation provides multiple planes of movement and is highly congruent. Articular cartilage, consisting of type II collagen, covers the majority of the femoral head. The acetabulum peripherally consists of articular cartilage while the central floor is non-articular and filled with a fatty layer termed the pulvinar. The ligamentum teres arises from both the transverse acetabular ligament and the central non-articular layer of the acetabulum and attaches to the central femoral head. It may play a role in stabilizing the hip joint.
A review of the reverse total shoulder replacement surgery and it's clinical implications for both physical rehabilitation and functional anatomy.
Objectives:
Understand basic anatomy of the shoulder complex and its implications for shoulder replacement
Understand indications for shoulder replacement
Understand differences between standard and reverse total shoulder replacements
Understand precautions following rTSA
Understand important concepts in rehabilitation following rTSA
Evolution of tunnel placement in ACL reconstructionDhananjaya Sabat
One of my talks at Delhi Arthroscopy Club....... this presentation provides a insight regarding the conceptual evolution in tunnel placement during ACL reconstruction.
ALL (antero-lateral ligament) - extra articular ACL reconstruction - basicsMilind Tanwar
history, need, how to reconstruct, when to reconstruct.
References: *Bonasia, Davide Edoardo et al. "Anterolateral Ligament Of The Knee: Back To The Future In Anterior Cruciate Ligament Reconstruction". Orthopedic Reviews 7.2 (2015)
Biomechanical Results of Lateral Extra-articular
Tenodesis Procedures of the Knee:
A Systematic Review. Erik L. Slette, B.A., Jacob D. Mikula, B.S., Jason M. Schon, B.S., Daniel C. Marchetti, B.A.,
Matthew M. Kheir, B.S., Travis Lee Turnbull, Ph.D., and Robert F. LaPrade, M.D., Ph.D.
Total shoulder arthroplasty and reverse TSA - Hussain AlgawahmedHussainAlgawahmedMBB
Discussion of the clinical presentation of shoulder arthritis followed by treatment options and the mechanical basis of total and reverse total shoulder arthroplasty
arthroscopy of the knee joint is a relatively common orthopedic procedure to treat a host of sports injuries and other knee diseases. Commonly a 4 mm size scope is used via two standard arthroscopy portals. Arthroscopic examination of the knee confirms MRI findings. Synovial fluid and biopsy can be taken to confirm diagnosis.
Assessment of Femoral Tunnel Placement in ACL ReconstructionJeremy Burnham
This study reviews the literature on tunnel placement in anterior cruciate ligament reconstruction, and assess the ability of experienced physicians and surgeons to evaluate the tunnel position using x-rays.
Acl Reconstruction Surgery In Delhi Dr. Shekhar Srivastav 09971192233DelhiArthroscopy
ACL Reconstruction Surgery in Delhi by Dr. Shekhar Srivastav - Dr. Shekhar Srivastav is an Orthopedic Surgeon attached to Sant Parmanand Hospital, Delhi with special interest in Knee & Shoulder surgery. After obtaining his M.S. Orthopedics degree he has undergone training in various centers in India and Abroad which has helped him in understanding the Orthopedics problems and their Management. He did his AO/ ASIF fellowship at University Hospital, Salzburg, Austria in 2006 and recieved training in Arthroscopy & Sports Medicine at TUM, Munich (Germany) & Rush Orthopedics Centre, Chicago( USA). He has an experience of more than fifteen years of diagnosing and treating Orthopedics & Trauma patients.
Check Out Details at http://www.delhiarthroscopy.com
Update on ACL reconstruction, with information on current direction of demineralized bone matrix (DBM) use in bone tunnels and biocartilage on chondral lesions
As an orthopedic surgeon at Aurora Advanced Healthcare Orthopaedics in Milwaukee, Wisconsin, Dr. Mark Wichman builds on his extensive experience in surgical reconstruction of the anterior cruciate ligament, or ACL. Dr. Mark Wichman contributed a section explaining the use of a particular soft tissue fastener in the ACL procedure to the surgical technique manual of Medshape Orthopaedics, a manufacturer of orthopedic devices in Atlanta, Georgia.
Arthroscopic ACL Reconstruction By Dr Shekhar ShrivastavDelhiArthroscopy
Arthroscopic Acl Reconstruction By Dr Shekhar Shrivastav.
HOW NORMAL KNEE WORKS ?
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thigh bone(femur), the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Four bands of tissue, the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments connect the femur and the tibia and provide joint stability. The surfaces where the femur, tibia and patella touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to glide freely. Semicircular rings of tough fibrous-cartilage tissue called the lateral and medial menisci act as shock absorbers and stabilizers.
WHAT IS THE ROLE OF ACL ?
ACL along with other ligaments of the knee joint and meniscus provides stability to the knee joint.
WHAT IS LIGAMENT RECONSTRUCTION ( ACL ) ?
Ligament reconstruction involves replacing the torn ligament with a tendon (graft) from your knee and fixing the graft in place with screws. This procedure is performed with the use of the arthroscope. The anterior cruciate ligament (ACL) is the most common ligament requiring reconstruction procedures. The torn ligament is excised arthroscopically and new ligament is prepared by ligament grafts taken from your own body. Bony tunnels are prepared in femur and tibia using specialized instruments through which the new ligament is passed and fixed with special screws. This procedure requires relative rest or leave from your work or studies for about 2-3 weeks after which you will be allowed normal day to day activities.
WHEN CAN THE PATIENT BE AMBULATED AFTER SURGERY ?
The patient can walk from the same evening of the surgery. Initially the patient is advised to walk with a brace and a walking cane. Strengthening and range of motion exercises for the knee are started from the next day. The patient is discharged from the hospital 2nd or 3rd day after surgery. The patient can walk without support by 10-14 days depending on muscle strengthening. Slow Jogging and other strenuous activities are permitted after 3 months and the patient can return to active sports only 8-9 months after surgery.
Torn ACL Reconstructed ACL
For Further Queries contact your Orthopedic Surgeon at
+ 91 9971192233
Similar to Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
Functional outcome of Arthroscopic reconstruction of single bundle anterior c...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate ...TheRightDoctors
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate Ligament Reconstruction Using Transportal and Transtibial Approach for Femoral Tunnel Drilling-Dr. Adarsh Reddy
The Principe of high tibial osteotomy is to reduce the stresses of the internal compartment of the knee by valgizing the tibia.The
total knee arthroplasty on this tibia with a “malunion” presents technical difficulties related to the initial approach, the presence of osteosynthesis material, the presence of malunion and the change of bone density. The objectives of this study are to determine the clinical and radiographic results of patients undergoing Total Knee Arthroplasty (TKA) after High Tibial Osteotomy (HTO). This is a retrospective descriptive study including patients undergoing Total Knee Arthroplasty (TKA) after an High Tibial Osteotomy (HTO) at the Hospital of Mont de Marsan (France) from 2008 to 2017 with a minimum follow-up of 12 months. Thirty knees (27 patients) were recruited. The sex ratio was 1.72. The average age was 70.33 years (54years-88years). The average time between High Tibial Osteotomy (HTO) and Total Knee Arthroplasty (TKA) was 10.83 years (1 year-26 years). The medial opening was 63.33% and lateral closure for the rest. Clinical improvement was observed, with an average gain of 24.97 points for pain, 1 point for stability, 1 point for knee mobility and 5 points for walking distance. The clinical result was perfect in 13.33%, excellent in 42% and medium in 36.67% of cases. The alignment was obtained in 76.67% of cases (p = 0.0039). The posterior tibial slope, epiphyseal varus, patellar height were corrected in 80% of cases respectivly (p = 0.000011, p = 0.44, p = 0.15). Residual pain was observed in 26.66%, joint stiff ness in 16.66%, skin healing disorder in
16% and infection in 6.66% of cases. Total knee arthroplasty made it possible to recover the failure of an high tibial osteotomy.
Arthroscopic Anterior Cruciate Ligament Reconstruction Using Four-Strand Hams...Apollo Hospitals
In this study, we analyzed the clinical outcomes at two years following reconstruction of the anterior cruciate ligament with use of a four-strand hamstring tendon autograft in patients who had presented with a symptomatic torn anterior cruciate ligament.
Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Superior Capsular Reconstruction Outcomes Wrightington 2020Lennard Funk
Hariharan Mohan, Jagwant Singh, Michael Walton, Lennard Funk, Puneet Monga
Cautious optimism following SCR may be offered to this challenging subset of patients with symptomatic irreparable rotator cuff tears. It is likely that the relatively low re-operation rates can be further improved by considering the negative prognostic factors in defining indications for surgery. Further studies with longer term followup are recommended.
Presentation delivered at 2020 AAOS annual meeting by Dr Adnan Saithna, Professor of Orthopedic Surgery, Overland Park, Kansas. This randomised controlled study demonstrates that combined ACL and anterolateral ligament reconstruction is not associated with an increased risk of adverse events when compared to isolated ACL reconstruction
Effect of Suture Tubularization on Quadruple Stranded Hamstring ACL Grafts wi...CrimsonPublishersOPROJ
Effect of Suture Tubularization on Quadruple Stranded Hamstring ACL Grafts with Femoral Suspensory Fixation: A Biomechanical Study by Matthew Richard Moralle* in Crimson Publishers: Orthopedic Research and Reviews Journal
Similar to Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal (20)
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
1. Tunnel Enlargement in Single Bundle ACL
Reconstruction using Bio Interference Screw,
Transfix And Tight Rope RT – A comparative
study using computed tomography
Dr. Ankit Goyal
Assistant Professor
Sports Injury Centre
Safdarjung Hospital
Delhi
Indian Arthroscopy Society,2014, Hyderabad
2. Introduction
Tunnel widening after ACL reconstruction is
a well known phenomenon. Extent to which
tunnel widens with different fixation
methods though is a matter of debate.
3. Discussion- Why this study??
*Tunnel enlargement in the revision setting
represents a difficult technical challenge
with possible compromise of graft
placement, fixation, and graft incorporation
First study in our knowledge
comparing the tunnel dilatation of
TIGHTROPE RT with other graft
fixation devices.
4. The purpose of this Prospective study was to
determine the influence of three different fixation
methods on the femoral tunnel widening and their
effect on the clinical outcomes after ACL
reconstruction using hamstring grafts.
5. Etiology- Multifactorial ???
Mechanical factors
Motion of the graft within the tunnel*
“Bungee- Cord effect”
“ Windshield Wiper Effect”
“Creep” of Graft tissue leading to
elongation
Hoher J, Moller HD, Fu FH. Bone Tunnel enlargement after Anterior Cruciate ligament reconstruction: fact or
Fiction? Knee Surg Sports Traumatol Arthrosc 1998;6:231-240.
Rodeo et al. Tendon healing in a bone tunnel differs at the tunnel entrance versus tunnel exit; an effect of graft
tunnel motion? Am J Sports Med 2006;34:1790-1800
Martin et al. Orthop Clin North Am. 2002;33:685-696
6. Etiology-
Multifactorial ???
Fixation methods/devices
*Suspensory graft fixation results in more elastic graft
construct and may contribute to the so called Bungee effect
, which has been suggested to contribute to tunnel widening.
*Wilson et al. Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med 2004;32:543-549.
**Some authors believed that graft tunnel motion was due to the non
articular fixation, but when fixation changed to the articular surface ,
the enlargement did not reduced either.
**Koboyashi etal. A retrospective review of bone tunnel enlargement after ACL reconstruction with hamstring
tendons fixed with a metal round cannulated interference screw . Arthroscopy 2006;22:1093-1099.
7. Improper graft placement*
Non- Anatomical
Anantomical
*
Etiology- Multifactorial ???
Segawa et al. Bone tunnel enlargement after ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol
Arthrosc 2001;9:206-210.
*Garofalo et al. Femoral tunnel placement in ACL reconstruction: Rationale of the two incision technique. J orthop Surg Res
2007; 2:10.
*Jepsen et al. Does the position of the femoral tunnel affect the laxity or clinical outcome of ACL reconstructed knee? A
clinical, prosp randomized study. Arthroscopy 2007;23: 1326-1333
8. Etiology-
Multifactorial ???
Redirecting Forces at the tunnel entrance
Accelerated rehabilitation
Paesseler et al . The effect of different rehabilitation protocols on Tibial
tunnel widening after ACL reconstruction with hamstrings. 2001. ISAKOS
Congress, Montreaux, Switzerland
9. Etiology- Multifactorial ???
Biological factors –
Synovial fluid propagation within the tunnels
Increased cytokine levels.
Graft swelling – in case of allograft tissue
Fink C etal. Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon
autograft.Arthroscopy2001;17:138-143.
Hoher J, et al.Bone tunnel enlargement after anterior cruciate ligament reconstruction: Fact or fiction. Knee Surg Sports Traumatol
Arthrosc 1998;6:231-240.
Insalata et al. Tunnel expansion following anterior cruciate ligament reconstruction: A comparison of hamstring and patellar tendon
autografts. Knee Surg Sports Traumatol Arthrosc 1997;5:234-238.
10. Timing of the Tunnel enlargement
Authors Timing of tunnel
enlargement
Journal
Dyer and Elrod Tunnel widening occurs in
the first 6 months
Tunnel widening in ACL reconstruction: A
prospective evaluation of hamstring and
patellar tendon grafts. Knee Surg Sports
Traumatol Arthrosc 1999;7:138-145.
Peyrache et al. Tunnel widening occurs
early and stabilizes in the
first year
Tibial tunnel enlargement after ACL
reconstruction by autogenous bone
patellar tendon-bone grafts. Knee Surg
Sports Traumatol Arthrosc. 1996;11:353-
54
Fink et al. Greatest amount of tunnel
widening occurs within the
first 6 weeks
Tibial tunnel enlargement following ACL
reconstruction with a patellar tendon
autograft. Arthroscopy 2001;17:138-43.
11. Material and methods
48 patients (January 2008 and March 2012)
16 Patients
Bio interference
Transfix
16 Patients
Bio interference
Tightrope RT
16 Patients
Bio interference
Bio interference
12. Selection Criteria
Inclusion Criteria
1. Age 20-40 years
2. Unilateral ACL rupture with or without meniscal tear
diagnosed clinically as well as by Magnetic resonance imaging
3. Time interval between ACL injury and reconstruction of 6
weeks to 2 years
4. Normal contralateral knee
Exclusion criteria
1. Meniscal tear requiring repair
2. Multiligamentous injury
13. Material and methods
The three groups were matched for
age, sex and duration since injury.
*Tunnel measurements were done on
CT scan at 2 weeks, 6 months and 1
year.
Diameter of tunnels was measured at
aperture(A), widest part of tunnel(B)
and just below suspension points in
Group 1 and 2 and at the tip of
Bioscrew(C) in both the Oblique
sagittal and Oblique Coronal
Sections.
All the three groups had similar
rehabilitation protocol.
*Marchant et al. Comparison of plain radiography, Computed tomography and magnetic resonance imaging in the
evaluation of bone tunnel widening after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2010;18(8);1059-
1064
14. Material and methods
Results were evaluated on two fronts:
1. Femoral tunnel enlargement using CT and
comparing them with each group.
2. Clinical outcome was assessed with KT-1000
Arthrometer, International Knee documentation
Committee (IKDC) and Lysholm score.
15. Statistical analysis
The unpaired t test was used to analyze the difference of
means for tunnel dilatations. The test was referenced for
2-tailed P values for its significance, and P < .05 was
assumed to be statistically significant.
The Wilcoxon signed-rank test was performed to
statistically evaluate the significance of clinical outcome by
Lysholm and IKDC 2000 Subjective Knee Evaluation scores
for all groups. The resulting P < .05 was accepted as a
statistically significant difference in the median of paired
observations.
16. Results
Maximum tunnel dilatation was at aperture (Point A) in Transfix and
Tightrope group while it was at Midway (Point B) for Bio interference
group.
There was no statistical significant difference in the femoral
widening among the three groups.
There was no statistically significant difference between the three
groups on KT 1000 side to side measurement, International Knee
Documentation Committee (IKDC) and Lysholm score.
24. Results
The IKDC 2000 Subjective Knee Evaluation score
improved by a mean of
by 41.33 points (range, 32.53 to 56.3 4) in the Transfix
group
37.3 points (range, 33.41 to 45.72) in the Tight rope RT
group (P <.001)
by 40.32 points (range, 33.56 to 55.87) in Bio-interference
group.
25. Clinical scores and KT-1000 data
Group 1- Transfix
Preoperative Post-operative
6 Months
Post-operative
1 year
IKDC
Normal
0 43.7% 46.6%
Nearly Normal 0 54.1% 52.2%
Abnormal 47.6% 2,2% 1.2%
Severely Abnormal 52.4% 0 0
Lysholm 51.8+/- 12.3 93.8+/-3.4 94.9+/- 4.1
KT-1000
(side to side
difference)
3.19+/- 1.7 1.5+/-0.7 1.5+/-0.4
26. Clinical scores and KT-1000 data
Group 2- Tightrope RT
Preoperative Post-operative
6 Months
Post-operative
1 year
IKDC
Normal
0 42.7% 44.6%
Nearly Normal 0 54% 54.2%
Abnormal 45.6% 3.3% 1.2%
Severely Abnormal 54.6% 0 0
Lysholm 56.8+/- 12.3 95.6+/-3.4 96.8+/- 4.1
KT-1000 4.1 +/- 1.6 1.8+/-0.7 1.9+/-0.4
27. Clinical scores and KT-1000 data
Group 3- Aperture fixation
Pr eoperative Post-operative
6 Months
Post-operative
1 year
IKDC
Normal
0 42.7% 44.6%
Nearly Normal 0 54% 54.2%
Abnormal 45.6% 3.3% 1.2%
Severely Abnormal 54.6% 0 0
Lysholm 56.8+/- 12.3 95.6+/-3.4 96.8+/- 4.1
KT-1000 4.3 +/- 1.2 1.6+/-0.9 1.8+/-0.4
37. Discussion
Tunnel enlargement was seen in Group 1 ( Transfix) because of:
i. Suspensory Fixation
ii. Non- anatomical tunnel
Koboyashi etal. A retrospective review of bone tunnel enlargement after ACL reconstruction with hamstring
tendons fixed with a metal round cannulated interference screw . Arthroscopy 2006;22:1093-1099.
Abebe et al. Femoral tunnel placement during ACL reconstruction. An in vivo imaging analysis comparing
transtibial and 2 incision tibial tunnel independent techniques. Am J Sports Med 2009 ;37:1904-11.
Arnold eta. Single incion technique misses the anato9mical femoral ACL insertion : A cadaver study. Knee
Surg Sports Traumatol Arthrosc 2001;9:194-99.
38. Discussion
Secondly due a more vertical tunnel a synovial fluid may
seek inside the tibial and femoral tunnels leading to
tunnel dilatation.
*Hoher at al. Bone tunnel enlargement after ACL reconstruction, fact or Fiction?
Knee Surg Sports Traumatol Arthrosc 19989;6:231-240
* Skripiotz et al. Pressure induced periprosthetic osteolysis. Rat model. J orth Res
2000;18:481-84.
39. Tunnel widening after anterior cruciate ligament reconstruction: a
prospective randomized computed tomography--based study comparing 2
different femoral fixation methods for hamstring graft
Femoral tunnel widening was significantly less in the Transfix group
compared with the EndoButton group.
Sabat D.et al. Arthroscopy. 2011 Jun;27(6):776-83.
.
Literature review
40. Discussion
Tight rope RT is suspensory fixation device and does not
have a fixed loop. The increased lengthening of the loop may
be attributed to the friction locking mechanism at very low
loads, akin to a Chinese finger trap.
Our opinion is that a long term study is required to evaluate
whether the loop of the tight rope lengthens over a period of
time when patient starts to have full range of motion.
Barrow et al. Femoral suspension devices for Anterior Cruciate Ligament
Reconstruction. Do adjustable loops Lengthen? American Journal of Sports Medicine
2014 .Vol 42,No.2.343-49.
Buck etal. Timeline of tibial tunnel expansion after the single incision hamstring ACL
reconstruction. Arthroscopy 2004;20:34-36.
41. Discussion
Tunnel widening in
Aperture Fixation
Tunnel Widening After Hamstring Anterior Cruciate Ligament
Reconstruction Is Influenced by the Type of Graft Fixation Used: A
Prospective Randomized Study
There was a significant reduction of Tunnel widening in
both the femur and the tibia using fixation points close
to the joint, compared with the system where the
distance between the fixation points is long.
Peter Fauno et al. Arthroscopy ,Volume 21, Issue 11, Pages 1337–1341,
November 2005.
42. Femoral tunnel widening after quadrupled hamstring
anterior cruciate ligament reconstruction
Femoral tunnel widening was greater in
femoral cross pin fixation, compared to
bioabsorbable screw fixation
Philip Cheung et al. Journal of
Orthopaedic Surgery 2010;18(2):198-202
43. There have been studies though which contradict this
concluding that the tunnel widening cannot be avoided by
fixation closer to the joint.
Associated with the “ Creep” of the graft on cyclical loading
leading to delayed tendon bone healing.
Buelow et al. A new Bicortical tibial fixation technique in ACL reconstruction with quadraple hamstring
tendon graft. Knee Surg Traumatol Arthrosc 2000;8:218-225.
Clatworthy et al. tunnel widening in hamstring ACL reconstruction: A prospective clinical and radiological
evaluation of four different technique. ISAKOS congress, Manteaux, Switzerland May 14-18, 2001;120.
44. Discussion
Our study found no
difference in the clinical
outcomes of all the 3 groups-independent
of the tunnel
dilation
45. From current literature, tunnel widening does not appear
to correlate with a poor clinical result, but on the other
hand, there is only very few data beyond 3 years.
Asik M et al. The mid- to long-term results of the anterior cruciate ligament reconstruction with
hamstring tendons using Transfix technique. Knee Surg Sports Traumatol Arthrosc. 2007;15:965–72
Plaweski S et al . Anterior cruciate ligament reconstruction: assessment of the hamstring autograft
femoral fixation using the EndoButton CL. Orthop Traumatol Surg Res. 2009;95:606–13
Chen CH et al. Arthroscopic single-bundle anterior cruciate ligament reconstruction with
periosteum-enveloping hamstring tendon graft: clinical outcome at 2 to 7 years. Arthroscopy.
2010;26:907–17.
Webster et al. Bone tunnel enlargement following ACL reconstruction: a randomized comparison of
hamstring and patellar tendon bone graft with 2 year follow up. Knee Surg Sports Traumatol
Arthrosc;2001:9(2):86-91
46. Limitations of the Study
Small Sample size of each group of patients
Graft Fixation:
a. Anteromedial vs. Transtibial
b. No uniformity in the Loop size in tight rope RT
c. No uniformity in the Screw size in aperture fixation
d. No uniformity in the Graft size
47. Conclusion
Tunnel widening occurs mostly in 1st year after ACL
reconstruction and occurs with every type of graft fixation
device.
Exact etiology remains unknown and is probably
multifactorial.
In literature opinion varies regarding optimal fixation
device.
In our study we did not find any significant difference in
femoral tunnel enlargement in all three fixation devices.