paediatric injuries around the elbow
supracondylar elbow injuries
pulled elbow in paediatric age r
radiological signs around elbow in supracondylar fracture humerus
paediatric injuries around the elbow
supracondylar elbow injuries
pulled elbow in paediatric age r
radiological signs around elbow in supracondylar fracture humerus
Approach to the hip and knee joint for various procedures including the drainage of septic joint, arthroplasty, soft tissue relase and and various osteotomies around hip and knee e joints.
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.
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.
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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!
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
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
24. Indication for Operative management
• Open fracture
• Fracture with neurovascular injury
• Fracture with skin tent
• Potential for progression to open fracture
26. Plate fixation
• Incision
• Open the fracture
• Reduction of fracture
• Fixation with plate and screw
• Advantage: more secure fixation than nail
• Disadvantage: palpable hardware, iatrogenic
neurovscular injury, cosmetic deformity
33. factors responsible for development of
NONUNION
• Open fracture
• Displaced fracture
• Soft tissue interposition
• Old age
• Poor nutritional status
• Inadequate immobilisation
34.
35. Shoulder Dislocation
• Also known as glenohumeral dislocation
• Most commonaly dislocated joint of body
• Constitute 45% of all dislocation
36. Types of shoulder dislocation
• Anterior –most common type
• Poterior – second most common
• Superior
• Inferior / also known as LUXATIO ERECTA
38. • Greatest range of motion of any joint in body
• Due to shallow glenoid fossa which 25% of
size of humeral head
• Major contributor for stability is not bone
• But soft tissue envelope composed of capsule
,ligaments,and muscle are major stabiliser of
shoulder joint
51. Mechanism of injury
1. Indirect
For anterior shoulder dislocation
upper limb with shoulder abducted ,extension
and external rotation
For posterior shoulder dislocation
upper limb with shoulder adducted, flexed and
internally rotated
In inferior shoulder dislocation
shoulder is hyper abducted
52. 2. Direct
impact force directly on shoulder anteriorly
or posteriorly
3.Convulsion and electric shock produce
posterior shoulder dislocation
53. Clinical evalution
• Injured shoulder held in abduction and external
rotation
• Shoulder is painful with muscular spasm
• On examination sqauaring of shoulder with
relative prominance of acromion and hollow
beneath the acromion posteriorly and palpable
mass anteriorly
• Neurovascular examianation
check integrity of axillary nerve and
musculocutaneus nerve
55. Test for shoulder dislocation
1. Bryant test: anterior axillary fold at lower level
2. Callway test: vertical circumference of axilla is
increased
3. Dugas test: it is not possible for pt to bring
elbow near to opposite shoulder
4. Hamilton ruler test: because of flattening of
shoulder ruler placed on lateral side of arm and
it touches acromion and lateral condyle of
humerus
56.
57. Clinical presentation of inferior
shoulder dislocation
• Salute fashion; humerus locked in 110 to 160
degree of abduction and forward elevation
• Humeral head palpable on lateral chest wall
• Almost all cases associated with neurovascular
injury
59. Apprehension test
• For recurrent shoulder dislocation
• Passively shoulder placed in abduction
,extension and external rotation this position
reproduce patient sense of instability and pain
70. Indication for operative management
or open reduction
• Shoulder is not reduced by reduction methods
• Shoulder dislocation with greater tubercle
fracture
• Dislocation with Glenoid rim fracture
71. Operative management of recurrent
shoulder dislocation
1. Bankart repair: detached anterior strcture are
attached to rim of glenoid cavity with suture
2. Puttiplat operation : subscapularis tendon
and capsule overlapped and tightned
3. Latarjet bristow operation: transplantation of
coracoid with its attachment to anterior rim
of glenoid
77. Deforming muscular forces on the
osseous segment
1. Greater tuberosity displaced superiorly and
posteriorly by supraspinatous and external
rotators
2. The lesser tuberosity displaced medially by
pull of subscapularis
3. The humeral shaft is displaced medially by
pectoralis major
4. The deltoid insertion cause abduction of
proximal fragment
79. Neurovascular supply
a) Major blood supply from anterior and
posterior humeral circumflex arteries
b) Arcuate artery is continuation of ascending
branch of anterior humeral circumflex.
c) Its enter from bicipital groove and supply
most of humeral head
d) Fracture of anatomic neck have poor
prognosis because of precarious vascular
supply of humeral head
80.
81. Axillary nerve
a) It is particular risk for traction injury because
of its close vicinity
82. Mechanism of injury
1. Most common is a fall onto outstreched
upper limb from height, commonaly in older
,osteoporotic woman.
2. Proximal humerus fracture in younger patient
associated with road traffic accident
3. Less common mechanism include excessive
shoulder abduction,electric shock, seizure,
benign and malignant involvement of
proximal humerus
84. Neer’s classification
• Neer divided proximal humerus in four part
• Greater and lesser tuberosity, humeral shaft
and humeral head
• Fracture types:
1. One part fracture: no displaced fragment
regardless of fracture lines
2. Two part fracture: anatomic neck,surgical
neck, greater tuberosity,lesser tuberosity
85. 3. Three part fracture:
Surgical neck with greater tuberosity
Surgical neck with lesser tuberosity
4. Four part fracture
5.Fracture dislocation
6. Articular surface fracture
87. Treatment
1. One part fracture / not displaced
• Upto 85 % fracture are nondisplaced
• treated with Sling and immobilization
88. Two part fracture
A. Anatomic neck fracture
• Associated with high incidence of
osteonecrosis
• They require open reduction internal fixation
(ORIF)
• If fracture is not fixable required shoulder
hemiarthroplasty using neers prosthesis
92. B. Surgical neck fracture
Reducible fracture and fracture with good
bone quality fixed percutaneously using k wire
and cannulated screw
Irreducible fracture and fracture with poor
bone quality require ORIF
93. C. Greater tuberosity fracture
undisplaced fracture treated non operatively
Displaced fracture around 5 to 10 mm
require ORIF
D. Lesser tuberosity fracture
its treated when it block internal rotation
94. Three and four part fracture
management
displaced fracture require ORIF
Delto pectoral approach
In Younger patient fracture fixed using plates
older patient benefit from prosthetic
replacement(hemiarthroplasty)
95. Articular surface fracture
• Hill sach and reverse hill sach lesion
• Patient with more than 40% head involvement
require prosthetic replacement
96. Complication
1. Vascular injury: axillary artery
2. Neural injury; axillary nerve and brachial
plexus injury
3. Osteonecrosis of head
4. Shoulder stiffness
5. Malunion
6. Nonunion
97. Acromioclavicular joint injury
• It is synovial plane joint
• It is complex of four ligament :anterior
posterior, superior ,inferior
• Superior is strongest of all
• Horizontal stability conferred by AC ligaments
• Vertical stability maintained by
coracoclavicular ligaments
98.
99. Classification of acromioclavicular joint
injury
• Classification depending on degree of
direction of displacement of distal clavicle
• Rockwood classification
102. Management of AC joint injury
• For nonoperative management ice packs and
sling is useful
• For operative management with hook platting,
cancelous screw fixation, fixation with k wire,
reconstrction of ligament are useful
107. Anatomic classification
I. Scapular body fracture
II. Apophseal fracture including acromion and
coracoid
III. Fracture of scapular neck and glenoid
109. Classification of acromial fracture
I. Minimally displaced
II. Displaced but does not reduce subacromial
space
III. Displaced with narrowing of subacromial
space
110. Classification of coracoid fracture
I. Proximal to coracoclavicular ligament
II. Distal to coracoclavicular ligament
112. • Superior strut is middle third clavicle and
inferior strut is lateral scapular body
• Traumatic disruption of two or more
component described as floating shoulder
• Historically operative management has been
recommended because of potential instability
• Recent study show nonoperative treatment of
floating shoulder reported good result.
114. Indication for operative management
• Displaced intraarticular glenoid fracture involving
greater than 25% of articular surface
• Scapular neck fracture with greater than 40
degree of angulation or 1 cm medial translation
• Scapular neck fracture with associated displaced
clavicle fracture
• fracture of acromion that impinge on subacromial
space
• Fracture of coracoid process result in AC joint
sepration