This document summarizes the case of a 72-year-old lady who presented with intermittent fever, weight loss, and joint pains for 3-4 months. On examination, she had pallor, enlarged lymph nodes, mild hepatomegaly, and joint tenderness. Investigations showed anemia, elevated inflammatory markers, hyperferritinemia, and normochromic bone marrow. She did not improve with extensive testing and therapies. The working diagnosis is adult-onset Still's disease given her clinical presentation and elevated ferritin level. She was started on steroids and scheduled for follow up.
Cns case-extramedullary compressive myelopathy, spinal cordKurian Joseph
Tracts involved-corticospinal tract
anterior and lat spinothalamic
posterior coloumn
Mostly extramedullary compressive myelopathy at T10 level
Etiology –to consider both intra and extradural causes like neurofibroma/meningioma/av malformation.
extradural-potts spine,ivdp
Cns case-extramedullary compressive myelopathy, spinal cordKurian Joseph
Tracts involved-corticospinal tract
anterior and lat spinothalamic
posterior coloumn
Mostly extramedullary compressive myelopathy at T10 level
Etiology –to consider both intra and extradural causes like neurofibroma/meningioma/av malformation.
extradural-potts spine,ivdp
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
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Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2. • 72 yrs old lady from Jaffna presented with a
H/O intermittent fever for 3/12,multiple joint
pains with difficulty in walking for last 1/12.
• Fever-mild to moderate,continuous fever with
episodes of defeverance of few days+, no
associated rashes with febrile episodes, no
h/o sorethroat
• She has a noticable LOW of about 10kg during
the coures of her illness.she claims that she
has moderate LOA.
3. • Initially she developed pain in left KJ & over
several weeks she experienced pain over right
KJ,pelvic & shoulder girdles then she had
difficulty in walking.
• She experienced a back pain & involment of
small joints of hands including left WJ where her
ADL were affected.
• No H/O morning stiffness,
• No H/O headache-genaralized or localized,no
sugestive H/O claudication including arms,legs or
jaw.
• Though she had moderate fatigue there is no H/O
musle aches,soreness or stiffness.
4. • She denies a H/O drenching night sweats,bone
pains or pathalogical fractures or lower limb
weakness.
• There is no sugestive H/O any haemorragic
diastheses including easy bruising,
• Fever was not associated with concomittent
body rashes involving the trunk or
extremities,no H/O photosensitivity, alopecia
or oral ulcers.
• No H/O chronic cough ,haemoptysis,past
histroy or contact histroy of PTB.
5. • She denies a H/O alterd bowel habbits
including abdominal pain,bleeding
PR, tenesmus ,passage of mucus or chronic
dysentry.
• Fever was not associated with gen.body
pruritus,passage of dark urine or pale stools.
• UOP had been normal with no H/O
haematuria,pyuria or incontinance.
• No H/O PV bleeding or passage of any
offensive PV discharges.
• She had not been to any malarial endemic
area in the recent past.
6. • No contact H/O domestic pets,birds or cattle
& she was not engaged In farming.
• She usually doesn’t consume food from
outside & she is a vegetarian.
• With this Hx she got admitted to CNTH
Ragama where she was investigated
extensively with laboratory investigations &
she was subjected to several invasive
procedures .
• According to her knowledge most of the
investigations were found to be normal.
7. • Despite being subjected to a battery of various
investigations and continous theraphy along
with blood transfusions she remained
symptomatic.
• PMH- no H/O DM,HTN,IHD,BA,any
rhumatological diseases
• PSH-underwent B/L LRT 20 yesrs back
• DH-not been on any regular medications
• Allergy HX-no food,drug allergies
• FH-no significant illnesses run among family
members
8. • SH-mother of 10 children,lives with her
daughter &has a good family support,due to
her illness she is unable to attend her ADL
including toileting & taking meals with her
own.
9. •
EXAMINATION• She is wasted,BMI-20.1Kg/m moderate
pallor+,not icteric, febrile to touh,
• No clubbing ,no body rashes involving the
peripheris or over the trunk including any
haemorrhagic manefestations or eschar marks.
• No peripheral stigmata of IE.
• ENT-normal
• No oral ulcers,significant alopecia or no evidence
of photosensitivity
• B/L temporal arterial pulse palpable with no scalp
tenderness.
• No bone tenderness,deformities or evidence of
pathological fractures
10. • Tendeness was elicited over B/L shoulder &
pelvic girdles,KJ & left WJ
• B/L KJ effusions were detected with positive
patellar tap,
• No dactylitis or small joint tenderness in
hands,no rheumatoid nodules
• Single group of firm L/S posterior cervical LN
were palpable, B/L axillary LN were palpable.
• Mild hirsutism detected
• Fundoscopy- normal despite R/S hard
exudates near the optic disc-9 o’clock position.
11. • Examination of the breast & thyroid gland
were normal
• AS- mild hepatomegaly ,2 fingers breath
below the costal margin,firm,spleen not
palpable & kidneys were not ballotable,no
ascites detected.
• CVS- BP 140/80 mmhg, PR
96/min, regular, Grade 2 PSM + best heard
over the apex
• RS-unremarkable
• CNS-gait difficult to elicit, tone & power
normal,reflexes not exagerated,no focal
neurological deficites.
13. • 72 years old lady presented with a H/O
continous fever with polyarthralgia & girdle
pains with impaired ADL, marked LOA,LOW for
3/12.O/E moderate pallor,mild hirsutism, L/S
posterior cervical LN & B/L axillary LN were
enlarged.AS-mild,firm hepatomegaly no other
organomegaly. L/S WJ arthritis with B/L KJ
effusions with no rheumatoid nodules or skin
manefestations.fundus-R/S hard exudates+
with no background Hx of DM or HTN.she has
a Gd 2 MR without periphrral stigmata of IE.
she remaines symptomatic despite
extensinsive Ix & therapeutic interventions.
16. • BP• RBC-normochromic normoctic with moderate
rouleaux formation.
• WBC-normal total count with a
reactivemonocytosis.some neutrophiles show
hypolobulation.
• PLT-mild thrombocytosis with clumps.
17. • BMA•
•
•
•
Site-R posterior superior iliac spine
Bone consistancy-osteoporosis
Cellularity-normocllular marrow fragments & cell traits
Erythropoisis-mildly hypocellular with normoblastic
maturation
• Granulopoisis-mildly hypercellular with
occational giant metamyelocytes.blasts< 3
• Megakaryopoisis-NL in no.&morphology
• Plasma cells-3%of nucleated marrow cells are normal
plasma cells
• Lymphocytes-3%of nucleated marrow cells are
normallymphocytes
• Histeocytes-histeocytic activity is increased
33. CT-ABDOMENMILD HEPATOMEGALY,REGULAR OUTLINE,NO
FOCAL LEASIONS.SLEEN,PANCREAS,GB,BOTH
KIDNES-NORMAL.
FEW PROMINENT PARAAORTIC LNCOELIAC/SUP.MESCENTRIC/RENAL GROUPS.
NO BOWEL MASSES,NO ASCITES,NO BONE
LEASIONS.CALCIFIED UTERINE
FIBROID+
SUGEST-FOLLOWUP SCAN.
34. •
•
•
•
•
•
REPEAT CT SCAN-ABD-contrastNo enlarged para aortic,aoroto garval nodes,
Liver,spleen,supra renal,kidneys are NORMAL
NO evidence of bowel obstruction
NO ascires,NO pleural effusions
Bones NORMAL.
• IMPRESSION-NO SIGNIFICANT ABNOMALITIES
SEEN.
35. • AXILLARY LN BIOPSY• Microscopy-vague follicular archtecture
displaying a polymorphus population of
lymphoid celles including scattered
polymorphs.
• There is no evidence of primary
haematolymphoid malignancy or metastatic
disease.
• AXILLARY LN Bx-REACTIVE LYMPH
NODES.
36. • SPUTUM FOR AFF *3-NEGATIVE
• TB-PCR-NEGATIVE
• TB CULTURE BONE MARROW-NEGATIVE
(Lowenstein Jenson medium)
• MANTOUX TEST- NEGATIVE
49. • Patient was started on a trial of
steroides(Prednesolon 60mg daily & since she
was responding the fever seems to be
setteling,she was discharged.
• She will be reviewed in the clinic in 2 weeks
time with repeat S.Ferritin,CRP,FBC.
• Dx ? Adult onset Still’s disease