Back pain
Etiology
Anatomical & pathophysiological concepts
Diagnostic approach
Clinical approach
Red flags & yellow flags
Investigations
Back pain in children & elderly
Lumbar spinal canal stenosis is one of the difficult topic of spine. All the information are taken from Campbell's operative orthopedics Thirteen edition and from internet. I also took help from the lectures of renowned orthopedics professors of Bangladesh.
low back pain is very common in population occurring at least once a lifetime in nearly 60-80% of population.
This presentation was presented as a webinar in coordination with ypta and serving hands on 12-8-2021.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Back pain
Etiology
Anatomical & pathophysiological concepts
Diagnostic approach
Clinical approach
Red flags & yellow flags
Investigations
Back pain in children & elderly
Lumbar spinal canal stenosis is one of the difficult topic of spine. All the information are taken from Campbell's operative orthopedics Thirteen edition and from internet. I also took help from the lectures of renowned orthopedics professors of Bangladesh.
low back pain is very common in population occurring at least once a lifetime in nearly 60-80% of population.
This presentation was presented as a webinar in coordination with ypta and serving hands on 12-8-2021.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Evaluation of Lumbar Spine Disease starts with understanding the clinical back grounds. It starts with good history and physical examination. This is a teaching lecture given twice by Prof. Dr. Mohamed Mohi Eldin, professor of neurosurgery, in the Basic Spine Course, Egyptian Medical Syndicate, Cairo, March 2009 and in 2010.
This presentation is a comprehensive summary about all aspects of back pain. Back pain is one of the most common orthopaedic morbidity or orthopedic disability. Sciatica and lumbar disc diseases are common cause of spinal disability. Back pain are divided into Red flags, green flags and yellow flags for quick clinical screening. both treatment, prevention aspects are covered. Spinal anatomy and Biomechanics are covered. Epidemiology and role of various types of spine surgery, microdiscectomy, endoscopic spine surgery are also described.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
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
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
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.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
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
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.
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
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.
6. Mechanics of the Back
• Vertebral column is pillar like structure
supported in all directions by musculature,
• Anteriorly – the recti and abdominal muscles
• Posteriorly- erector spine and quadratus
• If any of these supports give way, vertebral
column will move to the other side, and most
of the times its anterior musculature that
gives way,
7. Homo Sapiens- we have erect spine, bearing weight of trunk
against gravity. Rest of the vertebrates do not suffer
backache
9. Causes of Low Back Ache
• Prolapsed intervertebral disc
• Spondylolisthesis
• Lumbar canal stenosis
• Tuberculosis
• Tumors
10.
11. Risk Factors
• Occupational
• Age
• Alcohol and Drug Abuse
• Family History
• Gender
• Level of Activity (Physical Fitness)
• Obesity
• Poor Posture and Alignment
• Previous Back Injury
• Psychological, Social and Spiritual Factors
• Smoking - Studies have shown that smokers have a 1.5 to 2.5 times
greater risk of developing low back pain than nonsmokers. It is
thought this may be due to reduced oxygen supply to disks and
decreased blood oxygen from the effects of nicotine on constriction
of the arteries.
• Sports
• Other factors
12. Prolapsed Intervertebral Disc
• It’s a hydrostatic load
bearing structure from C2-
C3 to L5-S1
• Nucleus pulposus + annulus
fibrosus
• Relatively avascular
• L4-L5 disc, largest avascular
structure in body
• Cervical disc much less
common.
13.
14. PIVD-clinical featues
• History of trivial trauma or lifting weight
• Shooting pain with spasm
• Pain radiating down the leg below the knee
• Aggravated by coughing/sneezing
• Usually sudden onset
• May be associated with concurrent neurological
deficit; sensory or motor, paresthesias.
• H/O remissions and excerbations.
15. Cauda equina
syndrome
• Low back pain
• Numbness in the groin or
area of contact if sitting on
a saddle (perineal or saddle
paresthesia)
• Bowel and bladder
disturbances
• Lower extremity muscle
weakness and loss of
sensations
• Reduced or absent lower
extremity reflexes
25. Spondylolisthesis- clinical features
Symptoms
• Vary from mild to severe. May even have no symptoms.
• Classically a “STEP” may be palpable.
• Can produce increased lordosis (also called swayback),
but in later stages may result in kyphosis (roundback) as
the upper spine falls off the lower spine.
• Lower back pain, tenderness
• Muscle tightness (tight hamstring muscle)
• Pain, numbness, or tingling in the thighs and buttocks
• Weakness in the legs
30. Spondylolisthesis- Treatment
• Conservative methods
for grade 2 to 3
spondylolisthesis,
including brace and
analgesics
• Spine flexion exercises
• Failure of conservative
and severe listhesis may
require operative
intervention-
intertrasverse fusion or
internal fixaton.
32. Lumbar Canal Stenosis
• Due to the common
occurrence of spinal
degeneration that occurs
with aging.
• sometimes caused by
spinal disc herniation,
osteoporosis or a tumor.
• In the cervical and
lumbar region, can be
a congenital condition to
varying degrees.
33. Lumbar Canal Stenosis- features
• Low back ache – dull
aching nature
• Weakness and tingling
sensation in b/l lower
limbs.
• frequently unable to walk
for long distances
• symptoms improved
when bending forward
while walking with the
support of a walker or
shopping cart
• Psuedo-claudication
(neurogenic claudication)
Bicycle test of van Gelderen
38. Lumbar Canal Stenosis
• Management mostly conservative on
• Analgesics
• Rest
• Specific drugs like pregabalin and gabapentin
• Epidural injections of steroid- cortisone
• Surgery indicated- no response to conservative
Laminectomy and stablisation
40. TB Spine- Pott’s
Disease
• Spine most common
extrapulmonary site
• Dorsolumbar region
common
• Paradiscal type most
common
41. Types of TB spine
Paradiscal central anterior posterior
42. TB Spine- Clinical features
• Constitutional symptoms- night cries, low apetite
• Commonest- backache
• Vary from LBA to complete paraplegia.
• Muscle spasm
• Cold abscess
• Deformity of spine- kyphosis
• Upper motor neuron type Para paresis, brisk reflexes, clonus
and increased tone.
43. Neurological complication
• Early onset paraplegia-paraplegia in active phase of disease
(generally within 2 yrs)
• Pathology-
• inflamatory edema
• granulation tissue
• abscess
• caseous material
• Late onset paraplegia-paraplegia many year after the disease
(more than 2 years)
• Pathology-debris,sequestra,internal gibbus,stenosis,deformity
44. Stages of paraplegia
Stage 1 (negligible)- Patient unaware
Ankle clonus
Plantar extensor
Stage 2 (mild)- Patient aware of deficit but manage to
walk with support
Stage 3(moderate)- Nonambulatory
Paralysis in extension
Sensory loss less than 50 %
Stage 4(severe)- 3 + flexor spasms/paralysis in
flexion/flaccid/sensory loss more
than 50 %
Bladder involvement
48. TB Spine - Treatment
• Conservative if no neurological deficit or improving deficit-
ATT and bed rest, followed by ash brace
• Indication for surgery-
• Neurologic deficit –
• Spinal deformity with instability or pain
• No response to medical therapy
• Continuing progression of kyphosis or instability
• Large paraspinal abscess
