Bigliani coined the term glenoid rim lesions
glenoid rim erosion and
bony Bankart lesion,
Itoi et al. cadaveric study inferred that glenoid defect more than 21% produces anterior instability.
Lo and Burkhart named significant bone loss as
“inverted-pear glenoid” and
“engaging Hill-Sachs lesion”
shoulders associated with these significant bone loss are not suitable candidates for arthroscopic soft tissue stabilization
X ray
2D CT scan
3D CT scan
MRI
Arthroscopy
fractures of the proximal humerus are among the most common fractures of the upper limb and management options are wide according many variables mostly the age.
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.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
fractures of the proximal humerus are among the most common fractures of the upper limb and management options are wide according many variables mostly the age.
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.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
This study demonstrates that 3D-MRI is able to evaluate the anterolateral ligament fully in all normal knees. The classification system for injury to the ALL described shows high inter- and intra-observer reliability
Knee Joint Articular Cartilage Segmentation using Radial Search Method, Visua...CSCJournals
Knee is a complex and highly stressed joint of the human body. Articular Cartilage is a smooth hyaline spongy material between the tibia and femur bones of knee joint. Cartilage morphology change is an important biomarker for the progression of osteoarthritis (OA). Magnetic Resonance Imaging (MRI) is the modality widely used to image the knee joint because of its hazard free and soft tissue contrast. Cartilage thickness measurement and visualization is useful for early detection and progression of the disease in case of OA affected patients. In the present work, knee joint MR images of normal and OA affected are processed for segmentation and visualization of cartilage using semiautomatic method. The radial search method is used with minor modifications in search area to reduce computation time. Cartilage thickness and volume is measured in lateral, medial and patellar regions of femur. The overall accuracy of measurements is determined by comparing the measurements with another semiautomatic method based on edge detection and interpolation. It is observed a good correlation between quantification of cartilage in two methods. The method takes less time for segmentation because of reduced manual steps. The reduced cartilage thickness and volume is observed in OA affected knee of different level of progression.
High-Resolution Three-Dimensional Weight-Bearing Imaging of Lower Extremity U...Carestream
This paper addresses the benefits of a prototype (INVESTIGATIONAL – NOT FOR COMMERCIAL SALE) cone beam computed tomography system (hereafter referred to as the “CBCT system”) dedicated to extremity imaging. The CBCT system was co-developed by scientists at Carestream Health and John Hopkins University. The CBCT system has demonstrated spatial and contrast resolution beyond the limits of conventional multi-detector CT (MDCT) at a reduced radiation exposure1. The CBCT system was designed to image both upper and lower extremities, with the lower extremities also capable of being imaged in a weight-bearing configuration. This unique capability can unveil and better characterize certain pathologies in the knee and ankle joints such as meniscal extrusion, altered tibiofemoral joint space morphology, flatfoot deformity, and distal tibiofibular syndesmosis insufficiency.
Learn more about Carestream's portfolio of products at http://www.carestream.com/medical
about basics of cartilage imaging.
how does normal cartilage look , how does diseased cartilage look.
what are advanced techniques in cartilage imaging
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!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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.
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
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
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Assessment Of Glenoid Bone LossIn Recurrent Shoulder Dislocation
1. D R S A M I R D W I D M U T H E
M S O R T H O D N B O R T H O
A R T H R O S O C P Y F E L L O W S O U T H K O R E A
I N T E G R A S P E C I A L T Y C L I N I C S , N A G P U R
Assessment Of Glenoid Bone Loss
In Recurrent Shoulder Dislocation
3. Glenoid bone loss- HOW it happens
Bigliani coined the term
glenoid rim lesions
glenoid rim erosion and
bony Bankart lesion,
Itoi et al. cadaveric study
inferred that glenoid defect
more than 21% produces
anterior instability.
4. Lo and Burkhart named significant
bone loss as
“inverted-pear glenoid” and
“engaging Hill-Sachs lesion”
shoulders associated with these
significant bone loss are not suitable
candidates for arthroscopic soft
tissue stabilization
5. How it affects management
glenoid bone stock determines surgical success and affects
the type of surgical re- pair chosen
1-mild to moderate bone loss(less than 20%)- arthroscopic
soft-tissue stabilization alone
2- severe bone loss (20 -25 %) require bone augmentation
with open surgery
Only weak correlation exists between dislocation frequency
and glenoid bone loss.
7. Bernageau view
Good correlation with CT
with regard to the degree
of glenoid bone loss .
The average discrepancy
in glenoid bone loss
measurements between
radiography and CT was
2.28% (range, 0%– 6.5%)
(Murachovsky)
X-rayimagesobtainedby the modified
Bernageau methods. a, Normal glenoid (a
black arrow indicates normal anterior glenoid
contour). b, Glenoid with bone defect (a white
arrow indicates the defect)
9. 2D CT scan
CT enables examination
of both shoulders
simultaneously.
side-to-side glenoid
width is used to assess
glenoid bone loss.
CT measurements of
glenoid bone loss show
good correlation with
arthroscopic
measurements.
A, Normal side shows normal curved anterior glenoid
rim (arrows). Glenoid width (solid line), measured at
right angles to long axis of glenoid (dashed line),
measures 28.4 mm.
B, On dislocated side, there is anterior straight line to
anterior glenoid rim (arrows). Glenoid width (solid
line), measured at right angles to long axis of glenoid
(dashed line), measures 24.7 mm. Glenoid bone loss is
difference in glenoid width (3.7 mm) divided by normal
width (28.4 mm) × 100 = 13% glenoid bone loss.
10. 3D CT scan
The prevalence of glenoid
rim lesion has been
reported as high as 90 %,
50 % of bony Bankart
lesion
40 % of erosion
in shoulders with chronic
recurrent traumatic
anterior instability
3DCTimageswith humeral head
digitally subtracted. a, Normal
glenoid. b, Glenoid with bone defect
11. 3D CT scan
The bone loss -ratio of
the surface area of
missing bone to the
surface area of a best-
fit circle over the
inferior glenoid using
3DCT
This best-fit circle
method has been
validated by
Huijsmans et
The glenoid defect is defined as a ratio of
defect width (b) against the diameter of the
assumed inferior circle of the glenoid (a).
Sugaya H. Chapter 14. Instability with bone loss. In: Angelo,
Esch, Ryu, editors. AANA Advanced Arthroscopy: The Shoulder.
Philadel- phia: Elsevier; 2010. p.136–46.
12. Preoperative 3DCT benefits
Surgeons can recognize glenoid shape and the degree
of bone loss intuitively at a glance;
Accurate quantification of bone loss can be possible
by using an estimated inferior circle on the en face
view of 3DCT;
Surgeons can easily assess the size and shape of the
bony fragment in shoulders with bony Bankart
lesion.
13. Disadvantages of 3D CT
Radiation exposure.
Time and cost involved.
CT of both shoulders needed for comparison.
14. MRI
Owens and co-workers
the relationship between the height and width
was similar in sagittal images of MRI in
normal shoulder.
Therefore, the expected glenoid width can be
easily estimated using glenoid height in
patients with glenoid anteroposterior bone
loss
15.
16. Advantages
No radiation
Only one shoulder MRI needed.
Loss can be measured.
17. The results of MR imaging in the assessment of
glenoid bone loss correlate well with the results of CT
and arthroscopy.
When compared with arthroscopy, CT shows
marginally better correlation than MR imaging in the
measurement of glenoid bone loss because the best-
fit circle method used with MR imaging will not
always capture a noncircular configuration of the
inferior glenoid.
18. Arthroscopy
Burkhart
The percentage of bone
loss was calculated by
dividing measured
anterior distance by the
posterior distance from the
bare spot.
Overestimation of bone
loss may be possible due to
anterior cartilage wear.
19. Pitfalls of arthroscopic bare spot technique
1. The bare spot may occasionally comprise a bare area rather than a discrete bare
spot.
2. The calibrated probe inserted via the posterior portal may not always be
aligned at right angles to the long axis of the glenoid.
3. The millimeter-spaced lines along the calibration probe are counted visually via
a second scope inserted through an anterosuperior portal.
4. A cadaveric study has shown that the bare area does not consistently lie in the
center of the glenoid and tends to lie closer to the anterior rather than the
posterior glenoid margin .
The mean difference between the anterior-to-posterior glenoid widths with the
bare spot as a reference was 4.2 mm (range, 0.9–8.9 mm).
Kralinger et al. recommend preoperative CT rather than arthroscopy to assess
glenoid bone loss in patients with shoulder dislocation
20. Comparison of 2D CT, 2D CT and MRI
Rerko and colleagues estimated diagnostic accuracy
by comparing 3DCT with 2DCT, radiography, and
MRI using cadaveric specimen with native shoulders
and 3 sequential anteroinferior defects, and
concluded that 3DCT is the most accurate and
reliable imaging modality followed by 2DCT.
21. Summery
Assessment of glenoid bone loss helps in deciding the
best possible treatment plan for patients with
recurrent shoulder instability.
3-dimensionally reconstructed computed tomography
(3DCT) images with humeral head digitally
subtracted is gold standard when assessing glenoid
morphology and quantification of bone loss.
Decision regarding the type of surgery must be based
on combined assessment of Glenoid and Hill-Sach
lesion.
22. References
Hiroyuki Sugaya Techniques to evaluate glenoid bone loss. Curr Rev
Musculoskelet Med. 2014 Mar; 7(1): 1–5.
Eili ItoiNobuyuki Yamamoto, Daisuke Kurokawa, and Hirotaka Sano. Bone loss
in anterior instability. Curr Rev Musculoskelet Med. 2013 Mar; 6(1): 88–94.
Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their
relationship to failure of arthroscopic Bankart repairs: significance of the
inverted-pear glenoid and the humeral engaging Hill-Sachs
lesion. Arthroscopy. 2000;16:677–94. doi: 10.1053/jars.2000.17715.
Rerko MA1, Pan X, Donaldson C, Jones GL, Bishop JY.Comparison of various
imaging techniques to quantify glenoid bone loss in shoulder instability. J
Shoulder Elbow Surg. 2013 Apr;22(4):528-34.
Owens BD1, Burns TC, Campbell SE, Svoboda SJ, Cameron KLSimple method
of glenoid bone loss calculation using ipsilateral magnetic resonance imaging.
Am J Sports Med. 2013 Mar;41(3):622-4. d.