Dr.Md.Monsur Rahman, Bachelor of Physiotherapy (BPT), Master of Physiotherapy (MPT) in Musculoskeletal Disorders, ABC-Spine in Osteopathic Approach,
Maharishi Markandeshwar (Deemed to be University), Ambala -Haryana.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Hand splinting in common orthopedic & neurological condition 1POLY GHOSH
This Presentation is about role of splinting in orthopedic condition and neurological condition. This presentation can be benefitted for Orthotist, Occupational therapist, phyiotherapist and Physical medicine and rehabilitation specialist.
This present power point presentation on soft tissue conditions, is an orthopedic topic useful for a quick glance of the conditions mostly of UL and LL. Physiotherapists and other health professionals will be benefited.
1.Anatomy
a.Course
b.Motor distribution
c.Sensory distribution
2.Common sites affected
3.Level of median nerve injury
4.Clinical feature with various test performed
5.Various syndromes related to median nerve
6.Treatment
7.Summary
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Sacroiliac(SI) Joint Dysfunction,Evaluation and Treatment Dr.Md.Monsur Rahman
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Understanding your spine and how it works can help you better understand some of the problems that occur from aging or injury.
Many demands are placed on your spine. It holds up your head, shoulders, and upper body. It gives you support to stand up straight, and gives you flexibility to bend and twist. It also protects your spinal cord.
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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
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 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
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!
2. Claw Hand
• Claw hand is an abnormal hand position that develops due to a problem
with the ulnar nerve or, Both ulna and median nerve.
• A hand in ulnar claw position will have the 4th and 5th fingers extended
at the metacarpophalangeal joints and flexed at the interphalangeal
joints.
• The patients with this condition can make a full fist(punch) but when
they extend their fingers, the hand posture is referred to as claw hand..
3. TYPES OF CLAW HAND
partial:
• Involving only ulnar 2 digits as in
isolated ulnar nerve palsy
Complete
• Involving all digits and resulting form
combined ulnar and median nerve palsy
3
4. PATHOGENESIS
• An ulnar claw may follow an ulnar nerve lesion which results in the partial or
complete denervation of the ulnar (medial) two lumbricals of the hand.
• The ulnar nerve also innervates the 3rd and 4th lumbricals, which flex the MCP
joints, their denervation causes these joints to become extended by unopposed action
of the long finger extensors (namely the extensor digitorum and the extensor digiti
minimi).
• The lumbricals and interossei also extend the IP (interphalangeal) joints of the
fingers by insertion into the extensor hood; their paralysis results in weakened
extension.
• The combination of hyperextension at the MCP and flexion at the IP joints gives the
hand its claw like appearance
4
5. CAUSES
• Claw hand can be a congenital defect, a defect present at birth
• Ulnar nerve palsy is due to wrist injury
• Paralysis of the ulna and median nerves
• Leprosy still remains the most common cause of the claw hand.
• Risk in gender and BMI, Older males are more likely to have ulnar
mononeuropathy than females without regard to BMI. 95% of females with
a BMI less than a 22.0 have a higher risk of ulnar nerve damage from a lack
of adipose “cushion”.
• Scarring after a severe burn of the hand or forearm.
6. Daily Activities Leading To
Ulnar Claw
Cyclist, motorcyclist
Desk jobs prolong movement, elbow leaning
When using a pizza cutter or similar hand tools
Applying upper body weight to push down on the tool over time can cause damage
to the nerve.
External compression at the elbow
High grip strength, such as string musicians, are more susceptible to ulnar
mononeuropathy
6
7. Signs & Symptoms
Hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints.
Loss of abduction/adduction of the fingers
Wasting of the interosseous muscles and hypothenar.(Abductor digiti minimi, Flexor digiti minimi
brevis,Opponens digiti minimi)
Little finger remains permanently abducted from the ring finger (Wartenberg's sign).
There will be numbness in the distribution of the involved nerve or nerves.
Median nerve thenar muscle paralysis results in the ‘simian palm’ deformity where the thumb
metacarpal moves dorsally into the plane of the finger metacarpals due to the unopposed extension of
the pollicis longus tendon.
7
8. Functional Disability
• Weakness, especially in turning doorknobs, keys in locks and taking tops off jars is a
common complaint due to the lack of abduction/adduction of the fingers.
• Pickup is clumsy especially in the full claw hand where the pulps of the fingers cannot
be presented to the object because of inability to fully extend the interphalangeal joints.
• Thumb pinch grip is also greatly weakened and clumsy due to adductor paralysis and
the collapsing interphalangeal joint converting the pulp pinch of the thumb into nail
pinch.
• Thumb disability is further magnified in the full claw hand where median innervated
thenar muscles are also paralysed.
• Strong power grip of the fingers into the palm, however, is retained, except where the
long flexors are involved in high nerve injuries.
• Fixed flexion contractures of the proximal interphalangeal joints of the clawed fingers
can develop as a secondary phenomenon due to lack of active extension and trophic
changes may occur due to numbness.
8
10. Volkmann's contracture:
o This deep flexor compartment compression
syndrome results in ischemic necrosis of the
profundus tendons in the forearm causing
flexion contracture of the fingers.
o The superficialis tendons are usually spared, but
the intrinsic tendons may also be contracted.
This produces flexion of all joints of the
fingers, rather than hyperextension of the
metacarpophalangeal joints. The flexor tendons
are tight.
10
11. Intrinsic Muscle Contracture
• This can be of ischaemic origin, due to crush injuries and
produces the opposite deformity to the claw hand, namely
tight intrinsic, or intrinsic plus hand, rather than the loose
intrinsic minus claw hand.
• This condition spontaneously occurs in rheumatoid arthritis
and may lead to Swan neck deformity.
• The Bunnell test for intrinsic tightness involves passive
extension of the metacarpophalangeal joint followed by
assessment of the passive flexibility of the interphalangeal
joints.
• In the normal hand when the metacarpophalangeal joint is
maximally extended the interphalangeal joints can be fully
flexed passively.
11
12. Dupuytren's Contracture
• Dupuytren's contracture is a condition in which one
or more fingers become permanently bent in a flexed
position.
• It usually begins as small hard nodules just under the
skin of the palm then worsens over time until the
fingers can no longer be straightened. While typically
not painful some aching or itching may be present.
• The ring finger followed by the little and middle
fingers are most commonly affected. It can interfere
with preparing food, writing, and other activities
12
13. Congenital Flexion Contracture
(CAMPTODACTYLY)
• This condition usually involves only the little
finger, it is often bilateral and is hereditary. It is
present at birth.
• The finger is flexed at the proximal
interphalangeal joint and often cannot be
passively fully straightened.
13
14. Spastic Hand
• This results from an upper motor neuron palsy
and usually involves a clasping deformity of the
thumb in the palm and tightening of the flexor
tendons that cannot be easily passively
extended.
• The wrist is also characteristically flexed.
14
15. Peripheral Neuropathy
• When a person has damage to the peripheral nervous system, this is
called peripheral neuropathy. Peripheral neuropathy is complex, and
many diseases, injuries, body chemical imbalances, tumors, repetitive
motion disorders, exposure to toxins, or genetic inheritance can cause
it.
• It can also vary in symptoms, severity, and rate of cure, depending
upon the cause. This damage can have a number of symptoms and
can include numbness, tingling, weakness of the muscles the
damaged nerves serve, and in some cases severe pain.
• If a nerve is permanently damaged, the muscles it serves can
gradually die, resulting in movement impairment. In some cases,
neuropathy can result in complete paralysis of the affected areas. On
the other hand, some conditions cause damage to the nerves
temporarily. While people with affected nerves may experience the
above conditions on a temporary basis, the nerves are able to recover,
so the condition is not permanent.
15
17. Surgical Treatment
Nerve repair or decompression where possible is the treatment of choice. If the nerves are
unrepairable or repairs have failed, tendon transfers can be considered. Tendon transfers at best
correct the claw deformity and thumb collapse, but do little to restore the functional disability of loss
of abduction/adduction of the fingers or thumb collapse.
17
18. Postoperative management includes-
• Immobilization of the operated fingers by a dorsoulnar forearm plaster cast
including the metacarpophalangeal joints which are flexed to 70°.
• After 2 weeks replacement of the cast by a thermoplastic splint for another 4 weeks.
• During the whole period exercises for the finger and thumb should be carried out.
18
19. Hand and Finger Exercises
Fist
• Make a gentle fist with thumb wrapped across the fingers and hold it for
30-60 seconds. Then release and spread the hands wide. Try to do this at
least four times with each hand.
Stretches
• Sit ups and press ups may be great for the abs but there are also versions
that are good for the hands. Finger stretches increase the motion of your
hand and can also help with pain relief. Place your hand palm down on a
flat surface and gently straightened your fingers until they are as flat as
possible without forcing it. Hold the position for 30-60 seconds then
release and try to do this at least four times per hand.
19
20. Claw
• Another exercise to help with motion range is the claw stretch. Hold out
the hand in front of you with the palm facing up. Bend over your
fingertips to touch the base of each finger joint – hence the claw – and
hold this for 30-60 seconds. Release the hand and then repeat at least four
times.
Lift
• Another fitness exercise mimicked is the finger lift. Put your hand palm
down on a flat surface and lift one finger off the top then lower it. Try
lifting all of your fingers at once if you can. Do this 8-12 times per hand.
20
21. • Squeeze The Ball
squeeze the ball into palm of the hand as hard
as you can and hold it there for a few seconds.
The idea is to do this around 10-15 times per
session and have around 2-3 sessions a week,
leaving at least 48 hours between sessions..
21
22. PREVENTION
• Preventive therapy is recommended to preserve the function of the fingers. This may
include physical exercise, stretching, proper bodily function and myofascial release
(massage, foam roller).
• Exercises are focused on the forearm muscles, such as the extensor carpi ulnaris;
extensor digitorum to antagonize the flexion of the fingers.
• Massaging the forearm muscles also alleviates the tightness that occurs with muscles
exertion.
• Stretching allows the muscles more flexibility, decreasing interference with the
innervations of the ulnar nerve to the fingers.
22