The document discusses Down syndrome and muscular dystrophy. It defines Down syndrome and lists its causes as trisomy 21 chromosomal abnormality. It also outlines the clinical features and discusses physiotherapy management, including focusing on individual development, family-centered care, and parent participation. The document also defines muscular dystrophy as a genetic muscle disease, discusses types like Duchenne, and notes physical therapy can assess areas like range of motion, posture, and function to support patients.
CP is the most common motor disability in childhood. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a person's ability to control his or her muscles.
CP is the most common motor disability in childhood. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a person's ability to control his or her muscles.
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
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.
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
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!
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.
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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
2. Objectives
1. To define down syndrome
2. To discuse the cause of down syndrome
3. To list clinical features of down syndrome
4. To discuss physiotherapy management of down
syndrome
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3. Down Syndrome
q DS or DNS is a neurodevelopmental syndrome named for John
Langdon Haydon Down who first described the physical and
behavioral characteristics in 1862.
qThe “father” of the syndrome
qHe described the condition as a distinct and separate entity
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4. Down Syndrome (DS)
Ø Genetic disorder attributed to chromosomal
abnormality → Trisomie 21
Ø The most common genetic cause of developmental
disability and Affects both the gross motor and fine
motor skills.
Ø Incidence 1 in 800 to 1 in 1.000 live births
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5. What Causes Down Syndrome?
qDown syndrome is usually caused by an error in cell division
qThis additional genetic material alters the course of
development and causes the characteristics associated with the
syndrome
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6. ØIn individuals with Down syndrome, the cells usually contain
47, not 46, chromosomes; the extra chromosome is the 21st.
ØThis excess genetic material, in the form of additional genes
along chromosome 21, results in Down syndrome.
ØThe extra 21st chromosome is detected by using a procedure
called a karyotype.
ØA karyotype is a visual display of the chromosomes grouped by
size, number and shape.
7. ØDown syndrome is usually caused by an error in cell
division called non-disjunction.
ØHowever, two other types of chromosomal abnormalities,
mosaicism and translocation, are also implicated in Down
syndrome although to a much lesser extent.
10. CliniCal FEaturES
Ø Short arms and legs
Ø Flat nasal bridge
Ø Folded ears
Ø Open mouth
Ø Protruding tongue
Ø Short neck
Ø Excessive skin at the nape of neck
Ø Short broad hands
Ø Short fifth finger
Ø Incurved fifth finger
Ø Transverse palmer crease
Ø Space between first and second toe
Ø Hyper flexibility of joints
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14. qAcademic/cognitive skills usually lower than
adaptive/every day skills, which show improvement
through mid-adulthood
qOnset Alzheimer dementia (losing memory and skills)
10 years earlier than general population
qDiabetes/obesity
qLower blood pressure
Down Syndrome cont…
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16. Mental Retardation
• Almost all DS babies have MR
• Mildly to moderately retarded
• IQ declines through the first 10 years of age, reaching a plateau in
adolescence that continues into adulthood
qHeart Disease
• 50 % of Down Syndrome pts have heart disease
qGI abnormalities
• 5% of cases
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17. Motor Development
qReach milestones at a later stage
qRange of age when a child reaches a milestone is wider
qOrder in which milestones are achieved are different
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18. Milestone In DNS
ØSit alone 6-30 months
ØCrawls 8-22 months
ØStands 12-39 months
Øwolks alone 12-48 months
19. Contributors to Delayed Motor Skill Development
qGreater joint ROM, presumably attributable to ligamentous laxity
qDelayed development of postural reactions and myelination
qLow muscle tone
qCongenital heart defects
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20. Physiotherapy and Down Syndrom Holistic View
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Ø Children with Down syndrome typically face delays in certain areas
of development, so early intervention is highly recommended.
Ø It can begin anytime after birth, but the sooner it starts, the
better.
Tesfalem.Y
22. Goal
qThe Goal of physical therapy for these children is to facilitate the development
of optimal movement patterns
ü This means that over the long term, you want to help the child develop good
posture, proper foot alignment, an efficient walking pattern, and a good
physical foundation for exercise throughout life.
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24. Gait
qLess ability to control anti-gravity movements of the lower extremity
qDifficulties in adjusting head position in space
qPelvic and hip instability
qReduced plantarflexion moment of force and power generation
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25. phySiothErapy For thE younG ChilD with DS
qFocus on individual development potential
qFamily centred
qCorresponding with cognitive age
qMeaningful, functional situation that correspond with the world of the
child
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26. phySiothErapy For thE younG ChilD with DS
qFormulate a problem specific motor intervention
- specific physiotherapy
- parent participation
qStimulate the development of posture and then stimulate motor
behaviour
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27. traininGS
Ø Swimming program therapy
Ø Strength and balance training
Ø Treadmill training
Ø Core Stability Training
Ø Weight Bearing Exercises
Ø Cardiovascular Exercise And others…
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28. importanCE oF parEnt partiCipation
qDevelopment takes time
qNeeds practice and repetition
qTreatment is functional
qPlay and care taking
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29. liFESpan manaGEmEnt
qGreater emphasis on physical fitness may increase
cardiopulmonary endurance and muscular strength
üStart at primary age
üWith help of parents, special educators
üGeneral goal: encourage commitment to welness by
endurance training and overall fitness
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30. mortality
qMost likely cause of death is CHD, Hypothyroidism
and Leukemia.
qImproved survival is because of changes in treatment
for common causes of death.
qSurvival is better for males and blacks.
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(Chunxiao Li,2013)
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33. • Muscular Dystrophy describes a group of muscle diseases that are
genetically determined and have a steadily progressive degenerative course.
• Dystrophies are categorized by the deficiency of proteins that characterize
their disorder
• Proteins gives stability to the muscle cell membrane
(dystrophin–glycoprotein complex (DGC)
Diagnosis
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34. Epidemiology
Ø MD can occur at any age, most in childhood
Ø Duchenne MD is the most common type of MD
Ø The incidence of DMD globally is every 1/3500 male
Ø In the UK, about 100 boys are born with DMD each year, and there are
about 2,500 boys living with the condition at a time.
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36. • Becker Muscular Dystrophy ;
– 1 in 18,000 – 1 in 31, 000
– Learn to walk later
– Experience muscle cramps when exercising
• Myotonic Dystrophy
– 1 in 8000
– Muscle stiffness
– Clouding of the lens in the eye
– Excessive sleeping or tiredness
– Swallowing difficulties
– Behavioral and learning disabilities
– Slow and irregular heartbeat
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37. • Facioscapulohumeral Muscular Dystrophy
– 1 in 7,500
– Sleeping with eyes slightly open
– Cannot squeeze eyes shut tightly
– Cannot purse their lips
• Duchenne Muscular Dystrophy
– 1 in 3,500
– Difficulty walking, running or jumping
– Difficulty standing up
– Learn to speak later than usual
– Unable to climb stairs without support
– Can have behavioural or learning disabilities
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38. DMD
Ø Duchenne muscular dystrophy(DMD), also known as pseudo
hypertrophic muscular dystrophy or progressive muscular dystrophy,
Ø It is a serious condition which starts in early childhood.
Ø The muscle weakness is not noticeable at birth, even though the child is
born with the gene which causes it.
Ø The weakness develops gradually, usually noticeable by the age of
three.
Ø Symptoms are mild at first, but become more severe as the child gets
older.
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39. Ø The child becomes weaker and usually dies of respiratory
insufficiency and/or heart failure due to myocardial involvement
in the second or third decade of life.
Ø There is an X-linked inheritance pattern to DMD whereby male
offspring inherit the disease from their mothers, who are most
often asymptomatic
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40. Cause
ØThe cause is a genetic change which affects the muscles.
ØMuscles contain a protein (chemical) called dystrophin, which
is necessary for muscles to function properly.
ØPeople with DMD have a shortage of dystrophin in their
muscles.
Ø The lack of dystrophin leads to muscle fibre damage and a
gradual weakening of the muscles.
ØThe shortage of dystrophin is caused by a faulty gene.
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41. Ø Muscle weakness
Ø Difficulty walking
Ø Frequent falling
Ø Pseudo hyperthrophy of cuff muscle
Ø Proximal muscles Weakness---- exaggerated lumbar lordosis ----
waddling gait
Ø Difficulty standing from the floor squatting
Ø Developmental delay
Clinical features (start around 2 yrs)
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43. so far ,Proactive –based symptom Multi disciplinary team
child will be well no need to treatment –advise
about the disease progression
supportive devise for leg and ankle
wheelchair
prevention of chest infections and
Ventilation
Management
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45. Assessments
Ø Range of motion (ROM)
Ø Postural alignment
Ø Developmental/functional status
Ø Muscle power (MMT)
Ø Gait
Ø Respiratory status
Ø Child and family's understanding of diagnosis
Ø Child and caregiver's inputs and concerns
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46. PT management
Ø Different types of rehabilitation needed through life
Ø Delivered mainly by physiotherapists and occupational therapists, but others may
be involved
ü Rehabilitation specialists
ü Orthotists
ü Providers of wheelchairs/other seating
ü (Potentially) orthopaedic surgeons
Ø Key: management of muscle extensibility and joint contractures
Ø Stretching aims to preserve function and maintain comfort
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47. Contractures
• Factors contributing towards contractures:
– Muscles becoming less elastic due to limited use/positioning
– Muscles out of balance around the joint
• Maintaining good range of movement and symmetry is important
– Maintains best possible function
– Prevents development of fixed deformities
– Prevents pressure problems with the skin
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48. Management of muscle extensibility and joint
contractures
Ø Stretching should be performed at least 4-6 times a week as part of
family’s daily routine
• Effective stretching may require a range of techniques including
• stretching,
• splinting, and
• standing devices
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49. Splints
• Night splints (ankle-foot
orthoses/AFOs) can help
control ankle contractures
– After loss of ambulation,
daytime splints may be
preferred
– Daytime splints not
recommended for ambulant
Long-leg splints (knee-ankle-
foot-orthoses) may be useful at
stage when walking is becoming
very difficult or impossible
Can help control
joint tightness,
prolong ambulation, and
delay the onset of scoliosis
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50. Strengthening exercises
Ølong periods of rest and immobility should be avoided, even
during periods of illness because functional losses can occur
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51. Wheelchairs, seating and assistive equipment
• Early ambulatory phase
– Wheelchair may be used for long distances to conserve strength
– posture is important: customisation of chair normally necessary
• With increased difficulty walking, provision of powered wheelchair is
recommended
– This should be adapted/customised for comfort, posture and symmetry
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52. – As the diaphragm, trunk, and abdominal muscles weaken, ability
of the patient to effectively clear secretions decreases.
RESPIRATORY CONSIDERATIONS
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53. Five major goals of management common to all children with DMD:
1. Prevent deformity
2. Prolong functional capacity
3. Improve pulmonary function
4. Facilitate the development and assistance of family support and support
of others
5. Control pain, if necessary
Physiotherapy management (summery)
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