Bone cement is a misnomer as it does not bond bone, but rather fills space to secure prosthetic implants. Originally developed for dentistry, it has been used in orthopedics for over 40 years. It is made of PMMA powder and MMA liquid that polymerize during mixing to form a hardened mass. Precise techniques are used for mixing and delivering the cement to reduce porosity and ensure a secure fit. Cemented joint replacements can loosen over time from debris at cement-bone interfaces. Antibiotics can be added to prevent infection. Potential issues include temperature rise and release of substances that can cause hypotension during surgery.
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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!
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.
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.
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
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
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.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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
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3. Bone Cement
In reality, “Bone Cement” is a misnomer .Word cement is used to
describe a substance that bonds two things together, But bone
cement acts as a space-filler that creates a tight space which holds the
implant against the bone.
Originally developed for Dental applications.
Using in orthopaedics for more than 40 years.
Gold standard in the field of joint replacement surgery.
Neither Osteoinductive, nor Osteoconductive and does no remodeling
of bone.
4. History trace back to…..
Themistokles Gluck ,a German surgeon, 1870
Fixed a total knee prosthesis made of ivory using
cement made of plaster and colophony
“...for a better fixation, I mixed plaster with
colophony, which cures up to the hardness ofglass.”
5. History trace back to…..
1958 – Sir John Charnley used self
curing PMMA to anchor femoral head
prosthesis to femur
First cement - Nulife
6. What is bone cement?
Self curing organic or inorganic formulations which may or
may not contain antibiotics used to fill up a cavity or to create
a mechanical fixation of prosthesis to living bone.
Chemical name - PMMA
7. Interest in orthopaedics
Joint Replacement Surgery
Spinal Compression Fractures
Chronic Osteomyelitis
Tumours
9. Why separate components?
Polymerisation of MMA is too slow ( hrs to days)
Pure MMA is of low viscosity can easily diffuse in blood
Much easier to shape
Heat polymerisation can boil monomer
Pure MMA volumetric shrinkage
11. 1.Mixing
Viscosity starts to increase
Chemical reaction :
1. Wetting - Surface area of Polymer beads
dissolved by MMA
2. Polymerization
Phase ends – formation of Homogenous mass
(tooth paste like consistency)
which is transferred to cement gun
12. What is polymerisation?
Free radical polymerisation.
Carbon-to-carbondouble bonds broken
and newcarbonsingle bonds form
Exothermic reaction.
Temperature reach up to 70-120 C.
May cause thermal bone damage.
Viscosity increases.
13. How to mix?
Hand mixing :
Open bowl using spatula
1 to 2 Hz, period of 2min
Disadvantages :
- Introduction of Voids
- Porosity 7% and higher
- Excessive mixing
increases porosity
14. Centrifugation
Liquid & powder hand mixed then
centrifuged
2300 – 4000 rpm for 0.5 – 3 min
Adv : Dramatic decrease in porosity by
1%
Disadv : Sedimentation of radiopacifiers
It works only in low viscosity and its
achieved by chilling MMA monomer
15. Vacuum mix
Contents placed in bowl –
mixed after vacuum conditions
Adv : Low Porosity
Low exposure of
vapours
Distribution of
Radiopacifiers
17. 3.Working phase
Cement is no longer sticky but of sufficiently low viscosity to
enable surgeon to easily apply cement
Chemical reaction :
Exothermic reaction
Polymerisation continues
Viscosity increases
19. Functions of Bone cement
Allows secure fixation of implant and bone
Mechanical interlock and space filling
Load transferring
Maintenance/restoration of bone stock
Release of antibiotics
20. How to deliver cement?
1st Generation
Hand / Finger packing
Femoral component used – stainless steel & co
– cr alloy
Failed due to geometry of implants
narrow medial margins
sharp corners
21. 2nd Generation
Cement gun
Placement of bone cement - retrograde fashion
Plastic plug – cement pressurisation
Pulsatile lavage – cleanse femoral canal of loose
cancellous bone, blood, fat, marrow contents & dried
prior to cementing
it increases the shear strength at bone cement
interface
improved survival rate of implant
25. Antibiotics Loaded Bone cement
Ideal antibiotic properties :
Preparation must be thermally stable
Antibiotic properties not affected by heat
Must be water soluble for diffusion into tissues
Bactericidal
Gradual elution over an appropriate time period
Minimal local inflammatory response
26. Contd..
Have action against common pathogens like S.aureus, S.
epidermidis ,coliforms and anaerobes.
Must not significantly compromise mechanical integrity
Must be available as a powder.
Must have a low incidence of allergy.
27. Which antibiotics to use?
Gentamycin (most common) andtobramycin are commonly
used
Vancomycin (ultrafine powder) is used as lyophilised
vancomycin. It greatly reduces fatigue strength.
Ciprofloxacin may inhibit soft tissuehealing
Penicillins and cephalosporins exhibits stability and good
elution properties. But are avoideddue to their potential
allerginicity.
29. How to asses radiologically?
Barrack’s Cement mantle grading
Gruen zones
30. Barrack’s femoral component
cementation Quality grading
Grade Radiographic charcterstics
A Complete filling of medullary canal, without radiolucent line between
cement & bone ( White-Out)
B Radiolucent line covering upto 50% of cement-bone interface
C Radiolucent line covering between 50 -99% of cement – bone
interface or incomplete cement mantle
D Complete Radiolucent line (100%) at cement-bone interface and/or
absence of cement distally to end of stem
31. Gruen zones
7 zones in AP / lateral
Radiographs
What is measured?
Radiolucent lines at bone
cement and prosthesis cement
interface
Progression of no. of Zones -
Loosening
32. Mechanism of loosening
Debris produced because of
mechanical factors
Biological response by formation of
FIBROUS MEMBRANE b/w cement &
bone interface
Results in loosening
33. Bone cement in Tumours
Benificial role
Cytotoxic effect
Direct
toxicity of
monomer
By mixing
with MTX
Mechanical
Decreases
blood
supply
Thermal
Structural
support
35. Bone Cement Implantation
Syndrome – (BCIS)
HYPOXIA, HYPOTENSION or both and/or unexpected LOSS
OF CONSCIOUSNESS
occurring around the time of cementation, prosthesis
insertion, reduction of the joint or, occasionally, tourniquet
deflation in a patient undergoing cemented bone surgery.