Carpal tunnel syndrome (CTS) is a median entrapment neuropathy that causes paresthesia, pain and numbness in the distribution of the median nerve. The pathophysiology can be considered compression of the median nerve travelling through the carpal tunnel.
This is a short presentation on one of the most common entrapment neuropathy carpal tunnel syndrome. This presentation also provides information on its causes, epidemiology,diagnosis and management of carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) is a median entrapment neuropathy that causes paresthesia, pain and numbness in the distribution of the median nerve. The pathophysiology can be considered compression of the median nerve travelling through the carpal tunnel.
This is a short presentation on one of the most common entrapment neuropathy carpal tunnel syndrome. This presentation also provides information on its causes, epidemiology,diagnosis and management of carpal tunnel syndrome.
A brief topic presentation I made about Cubital Tunnel Syndrome, its definition, anatomy, causes, clinical features, risk factors, diagnosis, differential diagnosis and treatment. This presentation was done at the HSA staff in Cayman Islands
A brief topic presentation I made about Cubital Tunnel Syndrome, its definition, anatomy, causes, clinical features, risk factors, diagnosis, differential diagnosis and treatment. This presentation was done at the HSA staff in Cayman Islands
Entrapment Neuropathies in Upper Limb.pptxNeurologyKota
This presentation is about the entrapment syndrome of upper limb giving an insight regarding diagnosis clinically as well as electrophysiologically and
its management.
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
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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2. Gershon Zinger MD MS
Grad School MIT – mechanical eng
Medical School UCLA
Residency USC – orthopedic surgery
Fellowship UCLA – hand & micro
Work Private practice Denver, Colorado
Current Hadassah Medical Organization
Jerusalem, Israel
3. Definition
Carpal comes from the Greek word Karpos –
means wrist !
Carpal tunnel syndrome means wrist tunnel
syndrome
Syndrome – “A set of symptoms which occur
together” (from Dorland’s Medical Dictionary)
(AKA – we don’t really understand it !)
4. Anatomy
Wrist tunnel formed by
bone on bottom and
ligament on top
There are 9 tendons
and one nerve in the
tunnel
Analogous to 4 lanes
of traffic going to 2
lanes then back to 4 !
5. Who Gets CTS
Women more often affected (ratio 3:1)
Historically more common in retired people
Associated with repetitive activity
Can be associated with medical diseases
Diabetes
Rheumatoid Arthritis
Thyroid Disease
8. Nerve Exam - Sensory
Pattern peripheral or radicular
Check for altered
sensation, numbness on
palmar and dorsal sides
Middle finger is median n.
Small finger is ulnar n.
First dorsal webspace is
radial nerve innervated
9. Median Nerve
The median nerve
provides feeling to the
thumb, index, middle
and part of the ring
fingers
Sometimes people
complain of numbness
in the little finger that
may or may not be
CTS
10. Nerve Exam
Sensory
Numbness over first
dorsal web space may
indicate cervical origin
Numbness glove-
stocking may indicate
general neuropathy
Numbness in non
anatomic distribution
may indicate trigger
points
11. Nerve Exam
Sensory
2 point discrimination
is an objective test of
sensibility
Use large, not small
paper clip
As points get closer
together, it feels like
one instead of two
6 mm or less is normal
12. Nerve Exam
Motor – Carpal Tunnel
Look for atrophy of
thenar muscles
May be secondary to
thumb arthritis
Test strength for
opposition (median)
13. Nerve Exam
Irritability - Carpal Tunnel
Local Compression
Phalen Test (up to 60 seconds)
Tinel’s Sign
14. Other sources of nerve irritation
Cervical
Cervical testing
Reproduction of
symptoms with
extension+rotation
Numbness that
extends to shoulder
level very suspicious
for proximal origin
15. Double-Crush Phenomenon
A compression point
at one location may
lower the threshold at
another location
16. Other sources of nerve irritation
Thoracic Outlet Syndrome
90 degree abduction-external
rotation test (AER) – neither
too far forward nor too far back
17. Other sources of nerve irritation
Thoracic Outlet Syndrome
Examiner’s thumb
over anterior scalene
muscle
18. Other sources of nerve irritation
Trigger Points
Palpation of
parascapular trigger
points may cause local
pain but also reproduce
tingling and numbness
distal into hand
Trapezius
Rhomboid
Latissimus
Posterior arm
19. Nerve Conduction + EMG
Nerve Conduction EMG
Study Needles into muscles
Test speed of signal looking for defibrillation
down the nerve
20. Nerve anatomy
A nerve carries
electricity in two
directions
Axons in bundles or
fascicles
Micro-circulation
affected by
pressure
22. Seddon Classification
Neuropraxia
Interruption in
conduction
Nerve elements normal
Recovery full
Recovery can take 6-8
weeks
Axontmesis
Neurotmesis
23. Seddon Classification
Neuropraxia
Axontmesis
Loss of axon continuity
EMG 2-3 weeks later may
show denervation and
fibrillation potentials
Epineurium preserved
Axon may regenerate at
rate of 1mm/day
Incomplete recovery
Final result at one year
Neurotmesis
24. Seddon Classification
Neuropraxia
Axontmesis
Neurotmesis
neurotmesis (neuro as in
never as in fahgedaboutit)
Complete loss of nerve
function
May include loss or
scarring of all neural
elements
Surgery can still help
w/pain
25. Remember:
Nerve is brain tissue – limited ability to
recover
Numbness may go away after 1 day,
months, a year or never !
Numbness may be permanent if nerve
already damaged beyond recovery
26. Treatment of CTS
JBJS 1980 – Steroid Injection + splint
Prospective, one year, 50 hands
Overall, only 22% of hands were sx-free
In mild category, 40% hand were sx-free
J of Hand Surg 1994 – Steroid injection + splint
Prospective, 76 hands, f/up 1 yr, avg age 38 yo, excluded
DM, thyroid dz, RA, preg and “severe dz”
Overall only 13% of hands were sx-free
JAMA 2002 – surgery vs splint
Prospective, 147 patients, excluded DM
At 18 months, 90% success surgery group vs 37% for splint
group
27. Surgery - CTR
Under the skin lies
palmar fascia
There are muscles on
both sides – thenar
and hypothenar
consisting of 3
muscles each
28. Surgery - CTR
Under fascia lies
the transverse
carpal ligament
This ligament is cut
and springs apart
Ligament later
heals leaving the
tunnel larger
29. Open versus endoscopic
Open theoretically
safer
Endoscopic
theoretically has faster
recovery
30. Injuries
J of Hand Surgery* – May 1999
Survey of members of ASSH
Endoscopic – 455 major injuries
Open – 283 major injuries
* Palmer & Toivonen
31. Postoperative
Nurse visit at about 10
days for suture
removal and nerve
gliding exercise
Need to avoid heavy
or repetitive for one
month then gradual
return to activities
Palm may be sore 2-4
months