1) Acute hematogenous osteomyelitis is a bacterial infection of bone marrow and bone predominantly seen in children. Staphylococcus aureus is the most common causative organism.
2) It typically involves the metaphysis of long bones. Presentation includes fever, pain, swelling, and elevated inflammatory markers. Diagnosis is made through imaging and biopsy.
3) Treatment involves prolonged intravenous antibiotics for 6 weeks along with surgical drainage if abscesses are present. The goal is to remove necrotic tissue and prevent complications like bone deformity, arthritis, or chronic osteomyelitis.
Elbow is the most common joint to dislocate in children. Posterior dislocation is most common.
Simple dislocations are those without fracture.
Complex dislocations are those that occur with an associated fracture
Charcot joint or neuropathic joint are destructed joint occurs in Diabetes, syphilis, syringomyelia , leprosy, AMLS, Peripheral neuropathy and any condition leads to impair sensation of peripheral part of body
Elbow is the most common joint to dislocate in children. Posterior dislocation is most common.
Simple dislocations are those without fracture.
Complex dislocations are those that occur with an associated fracture
Charcot joint or neuropathic joint are destructed joint occurs in Diabetes, syphilis, syringomyelia , leprosy, AMLS, Peripheral neuropathy and any condition leads to impair sensation of peripheral part of body
Thus the patient is HCV reactive kindly accept reference to the same ward to the same ward to identify which is today in the evening 🌃I have not received the patient to get the same u
The root words osteon (bone) and myelo (marrow) are combined with itis (inflammation) to define the clinical state in which bone is infected with microorganisms.
Osteomyelitis is an inflammation of bone caused by an infecting organism.
Presentation on osteomyelitis for physiotherapy students
It includes the explanation along with the treatment for osteomyelitis which may be benefitial for the physiotherapy students
Thank You for watching
Bone infections
OSTEOMYELITIS
(Acute, subacute and chronic)
Etiology
Pathophysiology
Presentation
Diagnosis
Management and complications
Osteomyelitis has long been one of the most difficult and challenging problems confronted by orthopaedic surgeons.
Currently, morbidity and mortality from osteomyelitis are relatively low because of modern treatment methods, including the use of antibiotics and aggressive surgical treatment.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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.
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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!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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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.
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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.
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
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Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
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Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Acute hematogenous osteomyelitis
1. Dr chiranjeevi ortho pg
RMC , KAKINADA
ACUTE HEMATOGENOUS
OSTEOMYELITIS IN CHILDREN
2. ACUTE OSTEOMYELITIS
INTRODUCTION
Coined by Nelaton
Greek word – osteon:- bone
myelo:-marrow
itis :- inflammation
primarily marrow spaces, haversion
canals, sub periosteal spaces are involved
Auguste Nélaton was a French
physician and surgeon
4. Predisposing factors
Common in active bone growth
M:F – 1:4
Site; metaphysis
Poor nutrition
Trauma
Infections: skin, dental, resp, GIT, UTI
Burns
Iv drug abusers
Scar
Immuno compromised state
Old age
5. Host susceptability
Local factors systemic factors
• trauma,
• scar tissue,
• poor circulation,
• diminished sensibility,
• chronic bone or joint
disease
• presence of foreign
bodies
• malnutrition,
• general illness,
• debility,
• diabetes,
• rheumatoid disease,
• corticosteroid
• all forms of
immunosuppression
7. Microbial pattern in AHO
M/C organism– staph. Aureus
Vertebrae– GNB
IV drug abusers– pseudomonas
SCA– salmonella
Chronic ill pt on IV drugs – fungal
Infants– staph.aureus
LBW infants– S.A, GNB
Children 6m to 4yrs – H. influenza
8. Classification
1) The duration - acute, subacute and
chronic
2) Mechanism of infection –
exogenous or hematogenous
3) The type of host response -
pyogenic or non pyogenic
9. Route of transfer
Hematogenous( metaphyses of long bone)
Direct innoculation
Bone penetrating injury
Surgical contamonation
Contaguos focus(vascular dx)
microbe osteomyelit
is
10. AHO
M/Cly Seen in children
Bimodal age distribution < 2yrs, 8 – 12 yrs
M> F
WHAT IS M/C SITE INVOLVED…….?
Metaphysis…?
11.
12.
13. Pathophysiology
a/c inflammation of marrow
Spread of exudates in marrow space
Thrombosis of vessels due to compression
Lack of blood supply-- necrosis of bone
Liquifarction of necrotic tissue
Lifting of periosteum-- further necrosis
Abscess formation (increased)
Rise in intramedullary pressure
Cortical ischemia
Purulent material escapes from cortex into
subperiosteal space
Subperiosteal abscess develops
14.
15.
16. IN CHILDREN < 2 YRS
blood vessels cross the physis, thus epiphysis
may be involved
Limb shortening or angular deformity may
occur
Joint may be involved in some cases- hip joint
most common,
Especially for intraarticular physes- proximal
humerus,radial neck, distal fibula
Metaphysis has relatively fewer phagocytic
cells than the physis or diaphysis, hence more
infection here.
18. In children >2 years
The physis effectively acts as a barrier to the
spread of a metaphyseal abscess
Metaphyseal cortex thicker, hence diaphysis
more at risk
After physes are closed acute hematogenous
osteomyelitis is much less common
19. After the physes are closed,
infection can extend directly from the
metaphysis into the epiphysis and involve the
joint
Septic arthritis resulting from acute
hematogenous osteomyelitis generally is seen
only in infants and adults.
20. Clinical features
History and physical examination
Fever and malaise
Pain and local tenderness
Sweliing
Compartment syndrome in children
m/c in lower extremiteis
Femur>tibia>humerus
21. Investigations
Elevated acute phase reactants
WBC: >11000cell/mm3
ESR : rise slowly, peaks 3-4 days, decline over
3wks
helps in standard appropriate treatment
duration
CRP: rapidly rises, useful in monitoring dx
normalizes in 7days after initiation of
treatment
Aspiration of abscess: culture and Sn
Blood culture:+ve in 30% cases
22. BIOPSY:
NECROTIC BONE ;
Loss of osteocytes from
lacunae
Peripheral resorption
Bacterial colanisation
a/c inflammatory
infiltrates(
palymarphonuclear cells)
25. USG
may demonstrate deep soft tissue swelling earlier
Joint effusion
Abscess
DVT
26. CT
Sn 66%, Sp 97%
Limited role
Gave details about sequestrum and large
abscess
Useful in treatment monitoring
MRI
ioc
can identify marrow inflammation
great utility in initial screening test
27.
28. MANAGEMENT
ANTIBIOTICS:
Alone can cure
Based on highest bacteriological activity, least
toxicity,lowest cast
Initiate empherical treatment
Change after culture report
6wks of iv
29. Surgical treatment
INDICATION
Abscess drainage
Failure of medical management(48-72hrs)
OBJECTIVE
Removal of all dead tissue
Subperiosteal abscess ; small drill holes into
medullary canal
Intramedullary pus:window of bone removed
Splint the limb
Fallowup for 1 yr
30. NADE’S 5 PRINCIPLES OF
TREATMENT
1. An appropriate antibiotic is effective
before pus formation
2. Antibiotics do not sterilize avascular
tissues or abscesses and such areas
require surgical removal
3. If such removal is effective, antibiotics
should prevent their reformation and
primary wound closure should be safe
4. Surgery should not damage already
ischaemic bone and soft tissue
5. Antibiotics should be continued after
31. COMPLICATIONS
Epiphyseal damage and
altered bone growth --1.8%
Supparative arthritis
Metastatic infection-- rare
Pathological fracture--1.7%
Chronic osteomyelitis-- 1.7%
Reccurent infection-- 6.8%
DVT – 0.4 to 6%
32. Subacute osteomyelits
Described by Brodie
More difficult to diagnose bcz lock of
charecteristic signs and symptoms
Mild symptoms may be present for > 2wks before
medication
Lab findings are normal or mildly elevated
Radigraphic features often suggest benign /
malignant tumors
m/c/c staph.aureus
Diaphysis and epiphysis involve more than
metaphysis
Avg age is 7.5 yrs ( older than AHO)
33. Brodies abscess
Pathophysiology
Decresed bacterial
virulance/increased
host resistance
Secondary to
inadequate treatment
of AHO
Only local
inflammation
develops lead to local
bone destruction
34. Radiographic classification of SOM, based on
anatomic location,response of sorounding tissue
to infection, similarity to benign / mallignant tumor
GLEDHILL EXTENDED 6 PART CLASSIFICATION
35.
36. Biopsy and culture helps in differentiation from
bone tumors
6 wks course of antibiotics after biopsy report
COMPLICATION
Primary chronic sclerosic OM
Chronic reccurent multifocal OM