- A 13-year-old female child presented with poor academic performance for the past 3-4 years and abnormal jerky movements for the past 2-3 years.
- Her symptoms included slow writing, inability to concentrate, problems with memory and math skills. Her seizures occurred frequently and consisted of rhythmic movements of the shoulders, arms and neck.
- Her neurological exam was normal except for her academic issues. She had no other developmental delays.
- The provisional diagnosis was a chronic central nervous system viral infection based on her long-standing cognitive and seizure symptoms with a normal neurological exam otherwise.
Clinico-social case format for diarrhoea, demographic details, chief complaint, history of presenting illness, treatment history, past history, brief antenatal history, birth historym postnatal history, developmental history, nutrition history, immunisation history, personal history, family history, socio-economic / psycho-social history, environmental history, KAP about the disease, general examination, systemic examination, local examiantion, investigations, summary and case management.
Clinico-social case format for diarrhoea, demographic details, chief complaint, history of presenting illness, treatment history, past history, brief antenatal history, birth historym postnatal history, developmental history, nutrition history, immunisation history, personal history, family history, socio-economic / psycho-social history, environmental history, KAP about the disease, general examination, systemic examination, local examiantion, investigations, summary and case management.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
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
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
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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
2. History
• 13 year old ( DOB: 20/07/2007) female
child
• 1st born of non-consaguineous marriage
• Resident of Khadakwasla, Pune
• Admitted on 15 June 2020 at CH (SC)
3. Chief Complaints
• Poor Scholastic performance since 3-4 year
• Abnormal jerky movements since 2-3 year
4. HOPI
• Poor scholastic performance was sub-acute in onset
• Patient complains of poor performance in exams since 6th std
• Earlier she used to score > 60% marks but now she barely pass
• Complaints from teachers regarding her studies has increased apart
from PT meetings
• Usual complaints include- 1. Slow in handwriting
• 2. Homework/syallabus not completed
• 3. constantly looking outside the window
• 4. Slow in calculating maths problem
• 5. Not able to concentrate
• 6. Both recent and past memory problems
• Presently she is in 8th std with poor scores
5. HOPI (CONTD)
• H/o abnormal jerky movements since last 2-3 year
• This condition had an sub-acute onset which is associated with constant
stare
• Brief episodes of behavior arrests which followed by rhythmic movements
of shoulder, proximal upper limbs and neck lasting for around 2-3 minutes
which were self aborted
• Initially these episodes were 1-2 in a month but for last 3-4 months the
frequency has increased to 6-8 per month
• Now the semiology has changed from last 1-2 months to paroxymal events
which started occuring after scolding from parent/teacher or under stress,
always occur in presence of family members, not occuring during sleep,
child used to fall but without any injury marks
• These events lasted for 5-10 minutes, self aborted and occuring in
frequency of 5-6/month
• The frequency of these paroxymal events has increased to 5-6 episodes
daily since last month after the demise of her mother on 10th May 2020
6. HOPI (CONTD)
• There was no episode of -
• 1. Prolonged tonic-clonic movements with uprolling of eye-balls
• 2. Neck/eye deviation with focality
• 3. Precipitation with flash of light
• 4. Precipitation with fever
• 5. Myoclonus
7. NEURAXIS HISTORY
• 1. H/o unconsciousness with interest in surroundings
• 2. No h/o speech delay
• 3. Sleep pattern is normal
• 4. No behaviour issues except emotional disturbances
• 5. No h/o loss of smell, not recognising the strangers
• 6. No h/o squint, diplopia, drooping of eye lid
• 7. No h/o loss of sensation over face, diffucilty in chewing
• 8. No h/o drooling of saliva, deviation of angle of mouth
• 9. No h/o vertigo, loss of hearing
• 10. No h/o loss of taste, dysphagia, nasal regurgitation, change of
voice
• 11. No h/o drooping of shoulder, alteration of speech
8. NEURAXIS HISTORY (CONTD)
• No h/o problem in combing of hairs and dressing/buttoning of clothes
• No h/o problem in getting up from sitting position, slipping of chappals
• No h/o thinning of muscles
• No h/o loss of perception of sensation
• Bowel and bladder control attained
9. ETIOLOGICAL HISTORY
• No h/o fever with rash
• No h/o jaundice, abnormal behaviour
• No h/o vaccination induced seizures
• No h/o encephalopathy with waxing/waning course
• No h/o headache, dementia, trauma
• No h/o other neurological disorder
10. TREATMENT HISTORY
• Child was admitted in civil hospital for the same and started with
antidepressant medications
• Psychiatry opinion was taken and they referred to us for
neurological consultation
11. ANTENATAL/POSTNATAL HISTORY
• Antenatal History was uneventful
• Born at 40 weeks POG
• NVD
• Birth wt- 2.8 kg
• Roomed in with mother after birth and started on DBF on d-1
• No h/o NNJ, NNS, NNH
• Post natal tranisition was uneventfull and discharged on d-3 of life on
DBF
•
13. IMMUNISATION HISTORY
• Immunisation status not clear
• Father admits missing of doses
• Last vaccination was given at 5 year of age
• BCG scar present
• No h/o convulsions after DPT vaccination
14. NUTRITIONAL HISTORY
• Child consumes mix diet
• Total calories intake is around 2200kcal/day
• Total protein intake is around 24gms/day
15. FAMILY HISTORY
• She has two younger siblings 11 year old sister and 09 year old
brother
• Both are developmentally normal with fair scholastic performance
16. SUMMARY
• 13 year old female child with h/o poor scholastic performance
and seizures of multiple seimiology possibility
• 1. Chronic slow CNS viral infection
• 2. Neurodegenerative disorders
• 3. SOL ( Unlikely)
• 4. Primary psychiatric illness
17. GENERAL EXAMINATION
• Child is conscious
• Well nourished
• Ambulatory
• HR- 90/min
• RR- 18/min
• Spo2- 98% on room air
• CFT<3 secs
• BP- 112/72 mmHg in right arm supine position
• No clubbing, cyanosis, pallor, edema, lymphadenopathy
• No dysmorphic features
• No neurocutaneous markers
18. ANTHROPOMETRY
• Height for age - 154cm ( 0 to -1)
• Weight for age - 50 kg ( 0 to -1)
• OFC – 52 cm ( 0 to -1)
• Child is well nourshied as per age
19. SYSTEMIC EXAMINATION
• Child is examined while sitting on chair and in lying down
position on examination couch
• Child is oriented to time, place and person
• HMF - MMSE was done with score of 30/30
• Cranial Nerve examination: Normal
• 1. Appreciate smell with each nostril
• 2. Recognises parents/ objects with visual acuity and pupillary
reflex was normal
• 3. Follows objects, no diplopia/squint
• 4. 4th/5th CN – normal
• 5. Sensation over face intact
• 6. No deviation of angle of mouth/drooling of saliva
20. SYSTEMIC EXAMINATION (CONTD)
• 7. Hearing intact
• 8. Uvula in midline with gag reflex +
• 9. No drooping of shoulder
• 10. No tongue fasciculation or wasting
22. SPINOMOTOR EXAMINATION
• Bulk : bilateral symetrical and equal
• Tone : normal in all four limbs
• Power : 5/5 in all limbs
• Reflexes : Superficial- 1. corneal and conjunctival both present
• 2. abdominal reflex present
• 3. piantar – flexor
• Deep reflexes- 1. biceps/triceps/supinator/knee -
normal
• Sensory system - Superficial- pain, touch, temperature +
• Deep- vibration, muscle, position, joint sense +
• Gait was normal
• No cerebellar signs
• No involuntary movements
• No signs of meningeal irritation
23. SYSTEMIC EXAMINATION (CONTD)
• CVS- S1 S2 normal, no murmur appreciated
• RS- air entry bilateral equal , no added sounds
• P/A- soft, bowel sounds +, no organomegaly
24. PROVISIONAL DIAGNOSIS
• 13 year old female child with h/o poor scholastic performance and
seizures of multiple semiology with MMSE score 30/30 and other
CNS examination
• High possibility of chronic CNS viral infection