CSF examination involves collecting a sample of cerebrospinal fluid via lumbar puncture and analyzing its contents in a laboratory. The purpose is to diagnose central nervous system disorders like infections, tumors, or inflammatory diseases. Chemical analysis of glucose, protein, white blood cell count and differential provide diagnostic clues. Gram stain and cultures identify microbes. Serology tests detect diseases such as neurosyphilis. Together the test results help physicians determine appropriate treatment.
It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
It is fluid which is present
in the pericardial cavity of
heart b/w parietal pericardium n visceral pericardium.
The pericardial cavity is a
potential space lined by
mesothelium of the visceral n parietal pericardium.
Lecture notes about blood cell count (RBCs, WBCs, PLTs, as well as DLC)
For first-level students, Medical Lab Technology Dept. (Middle Technical University)
The Urine Culture Test is performed to detect and diagnose a microbial infection of the urinary tract.
For more information, visit https://www.1mg.com/labs/test/culture-urine-2232
Notes about blood hemoglobin estimation, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Investigations and Management
Sputum examination is an important aid in the diagnosis of pneumonia: color, amount, consistency, and odor. Mucopurulent sputum is commonly found in bacterial pneumonia or bronchitis. Scanty, watery sputum is often noted in atypical pneumonia; “rusty” sputum is seen in pneumococcal pneumonia; and currant-jelly or dark-red sputum suggests Klebsiella pneumoniae. Foul-smelling sputum is associated with anaerobic infections due to aspiration, lung abscess, and necrotizing pneumonia. A blood count usually reveals leukocytosis in bacterial pneumonia, a normal white cell count or leukopenia in viral infection, and eosinophilia in parasitic infection. When available, chest x-ray, serum procalcitonin, and C-reactive protein can be obtained (Fig. 1.3). Naso-pharyngeal swabs for polymerase chain reaction (PCR) can help establish the diagnosis of specific viral infections if available.
In children, the Integrated Management of Childhood Illness guidelines for treating pneumonia are recommended (Table 1.1).4 Childhood pneumonia is now classified in two classes: tachypnea and chest in-drawing indicate treatment with oral antibiotics, whereas severe pneumonia with danger signs (hypothermia, unconsciousness, convulsions) requires intravenous treatment in hospital.
WHO's strategy to reduce pneumonia burden has three components: protection, by promoting breastfeeding and vitamin A supplementation; prevention, using vaccines for measles, H. influenzae, pertussis, rotavirus, and S. pneumoniae and promoting handwashing, sanitation, HIV prevention, and cotrimoxazole prophylaxis in HIV-infected patients; and treatment, securing care seeking, proper case management, and antibiotic administration.
A detail on CSF
INTRODUCTION
PROPERTIES
COMPOSITION
FORMATION OF (CSF)
CSF is formed by choroid plexuses, situated with in the ventricles.
Choroid plexuses are tuft of capillaries present inside the ventricles.
A large amount of CSF is formed in the lateral ventricles.
SUBSTANCES AFFECTING THE FORMATION OF (CSF)
PILOCARPINE, extract of pituitary gland stimulate the secretion of CSF.
Injection of isotonic saline also stimulates CSF formation.
Injection of hypotonic saline increases CSF formation.
Hypertonic saline decreases CSF formation and CSF pressure.
ABSORPTION OF (CSF)
CSF is mostly by the archnoid villi into dural sinuses and spinal veins.
Small amount is absorbed along the perineural spaces into cervical lymphatics and into perivascular spaces.
Normally , about 500 mL of CSF is formed everyday and an equal amount is absorbed.
FUNCTIONS OF (CSF)
COLLECTION OF CSF
APPLIED PHYSIOLOGY
It is fluid which is present
in the pericardial cavity of
heart b/w parietal pericardium n visceral pericardium.
The pericardial cavity is a
potential space lined by
mesothelium of the visceral n parietal pericardium.
Lecture notes about blood cell count (RBCs, WBCs, PLTs, as well as DLC)
For first-level students, Medical Lab Technology Dept. (Middle Technical University)
The Urine Culture Test is performed to detect and diagnose a microbial infection of the urinary tract.
For more information, visit https://www.1mg.com/labs/test/culture-urine-2232
Notes about blood hemoglobin estimation, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Investigations and Management
Sputum examination is an important aid in the diagnosis of pneumonia: color, amount, consistency, and odor. Mucopurulent sputum is commonly found in bacterial pneumonia or bronchitis. Scanty, watery sputum is often noted in atypical pneumonia; “rusty” sputum is seen in pneumococcal pneumonia; and currant-jelly or dark-red sputum suggests Klebsiella pneumoniae. Foul-smelling sputum is associated with anaerobic infections due to aspiration, lung abscess, and necrotizing pneumonia. A blood count usually reveals leukocytosis in bacterial pneumonia, a normal white cell count or leukopenia in viral infection, and eosinophilia in parasitic infection. When available, chest x-ray, serum procalcitonin, and C-reactive protein can be obtained (Fig. 1.3). Naso-pharyngeal swabs for polymerase chain reaction (PCR) can help establish the diagnosis of specific viral infections if available.
In children, the Integrated Management of Childhood Illness guidelines for treating pneumonia are recommended (Table 1.1).4 Childhood pneumonia is now classified in two classes: tachypnea and chest in-drawing indicate treatment with oral antibiotics, whereas severe pneumonia with danger signs (hypothermia, unconsciousness, convulsions) requires intravenous treatment in hospital.
WHO's strategy to reduce pneumonia burden has three components: protection, by promoting breastfeeding and vitamin A supplementation; prevention, using vaccines for measles, H. influenzae, pertussis, rotavirus, and S. pneumoniae and promoting handwashing, sanitation, HIV prevention, and cotrimoxazole prophylaxis in HIV-infected patients; and treatment, securing care seeking, proper case management, and antibiotic administration.
A detail on CSF
INTRODUCTION
PROPERTIES
COMPOSITION
FORMATION OF (CSF)
CSF is formed by choroid plexuses, situated with in the ventricles.
Choroid plexuses are tuft of capillaries present inside the ventricles.
A large amount of CSF is formed in the lateral ventricles.
SUBSTANCES AFFECTING THE FORMATION OF (CSF)
PILOCARPINE, extract of pituitary gland stimulate the secretion of CSF.
Injection of isotonic saline also stimulates CSF formation.
Injection of hypotonic saline increases CSF formation.
Hypertonic saline decreases CSF formation and CSF pressure.
ABSORPTION OF (CSF)
CSF is mostly by the archnoid villi into dural sinuses and spinal veins.
Small amount is absorbed along the perineural spaces into cervical lymphatics and into perivascular spaces.
Normally , about 500 mL of CSF is formed everyday and an equal amount is absorbed.
FUNCTIONS OF (CSF)
COLLECTION OF CSF
APPLIED PHYSIOLOGY
csf is the fluid which is present around the brain and spinal card as a shock absorber, provide nutrition and keep them wet. CSF analysis is an important tool in the diagnosis of many disease especially in meningitis and hemorrhages and for the diagnosis of many malignancy.
EXUDATES DETECTION FROM DIGITAL FUNDUS IMAGE OF DIABETIC RETINOPATHYijabjournal
The aim of this paper is to detect exudates from the digital fundus images and provide information about Non Proliferative Diabetic Retinopathy. Diabetic retinopathy is very complicated disease that occurs when the retinal blood vessels changes. Exudates are the first sign of the diabetic retinopathy which cause blindness. So it is very important to find out these exudates in fundus image. In this paper we have proposed a method which is used for segmentation of optic disc and exudates. Morphological operations are used for detection of exudates. Before this operation we are applying Contrast Limited Adaptive Histogram Equalization technique. The results are compared with the standard database.
Lumbar puncture (other name are spinal tap;spinal puncture;thecal puncture and rachiocentesis) is a procedure that is often performed in the emergency department by inserting needle into fluid within the spinal canal to obtain information about the cerebrospinal fluid (CSF).
Although usually used for diagnostic purposes to rule out potential life-threatening conditions for example bacterial meningitis or subarachnoid hemorrhage,
it is also sometimes used for therapeutic purposes for example treatment of pseudo tumor cerebri.
CLINICAL CONSIDERATIONSNoncommunicating (obstructive) hydrocephalus occurs more frequentlyCSF of ventricles unable to reach subarachnoid spaceProduction of CSF continuesGyri are flattened against inside of skullIf skull is still pliable head may enlarge
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
- 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
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.
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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.
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
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.
3. Introduction
CSF is the fluid surrounding the brain and
spinal cord.
This fluid is clear, watery liquid that protects
the CNS from injury and cushions it from the
surrounding bone structure.
It contains variety of Substances such as
Glucose, Protein, and WBCs from immune
system.
4. History
CSF was 1st examined in 19th century using
primitive techniques e.g. sharpened bird
quills.
CSF Analysis reached at its peak in 1950-60s
when no workup of a significant CNS problem
was performed without a lumbar Puncture.
Advent of sophisticated imaging techniques
particularly CT Scan and MRI, LP is no longer
an important test of most intra-caranial mass
lesion.
LP remains a critical procedure in the
diagnosis of CNS infections and Inflammatory
disease.
5. Purpose
The purpose of CSF analysis is to diagnose
medical Disorders that affect the CNS.
Viral and Bacterial Infections.
Tumors of Nervous System.
Syphilis, a Sexually transmitted disease.
Bleeding around the brain and spinal cord.
Multiple sclerosis,a disease that affects the myelin
coating of the nerve fibers.
Guilain-Barre syndrome,an inflammation of the
nerves.
6. Sample Collection
The Process to remove the CSF is called as
Lumber Puncture or spinal tap.
In rare cases such as spinal fluid blockage in
the middle of the back, doctor may perform a
Spinal Tap in the neck.
The Sample is drawn from the vertebrae
known as the L4-5 is preferable because the
spinal cord stops near L2 and the needle
introduce below this level will miss the Spinal
cord & encounters only nerve roots.
7. Sample Collection (Contd..)
A lumber Puncture takes about 30
minutes.
If the Patient has spinal arthritis or
obese ,it may be necessary to introduce
the spinal needle using x-ray guidance.
In Order to get an accurate sample of
CSF it is critical that a patient is in the
proper position.
8. Sample Collection (Contd..)
During a LP the doctor drapes the back with a
sterile covering.
The doctor inserts a hollow thin needle in the
space b/w two vertebrae of the lower back
and slowly advances it towards the Spine.
A steady flow of CSF normally the color of
water will begin to fill the needle as soon as it
enters the spine canal.
The doctor measures the CSF pressure with
a special instrument called a Manometer an
withdraw several vials of fluid for lab analysis.
9. Sample Collection (Contd..)
Patients can perform their normal
activities before a lumber puncture.
After the procedure the doctor covers
the site of the puncture with a sterile
bandage.
11. Risks
For most people the most common side effect
after the removal of CSF is headache.
10-30% of adult patients.
Up to 40 % of children.
It is caused by decreased CSF pressure.
A Stiff neck and nausea may accompany the
headache.
LP headache typically begins within 2 days
after the procedure and persist for few days
to several weeks.
Control of Pain by Several medication
containing Caffeine.
12. Precautions
A LP to withdraw a Small Amount of
CSF for analysis may lead to serious
complications.
LP should be performed with extreme
cautions.
People who have blood clotting or
bleeding disorders LP can cause
bleeding that compress the spinal cord.
13. CSF Lab Examination
Examination of the CSF can provide
important diagnostic information when there
is reason to suspect there has been trauma
or a non traumatic insult to the CNS.
Disorders that can be evaluated by
examination of the CNS are intracranial
hemorrhage infections, sclerosis, GuillainBarre syndrome and neurosyphilis.
14. Analysis
Like other body fluids, the CSF provides
a sample for analysis that often reveals
biochemical and cellular changes
reflective of disease processes.
Analysis of the cerebrospinal often
provides the evidence needed by the
physician
to
initiate
appropriate
treatment.
15. Color and appearance
Normal CSF should be clear and colorless.
Any coloration or cloudiness of the CSF is
considered abnormal.
Colors observed include white or pearlescent,
red, pink, orange and yellow.
Red of pink indicates the presence of blood.
16. Cell count
Both leukocyte and RBC counts are
performed on the CSF.
Normal spinal fluid usually contain fewer than
five to eight leukocytes per cubic mm (these
ranges vary from lab to lab).
Increase numbers of leukocytles indicate an
infectious process.
Increased numbers of RBC may indicate a
hemorrhage or a traumatic condition.
17. Leukocyte-differential
This procedure is referred to as the
leukocyte or white cell differential.
Most labs perform the differential while
performing the cell count on the
hemacytometer, differentiating on the
polynuclear and mononuclear cells.
Most patients with bacterial infections
will demonstrate increased numbers of
neutrophils while those with fungal,
tubercular and viral infection will have
increase numbers of lymphocytes.
18. Leukocyte-differential (Contd..)
The differential may also reveal other
cell types that may be of interest in
diagnosing certain conditions.
Appearance of CSF may indicate the
presence of a tumor.
Plasma cells may be observed in
several different disorders, including
multiple sclerosis and tuberculous
meningitis.
20. Gram stain and culture
A Gram’s stain is performed on almost all
cerebrospinal fluid samples.
Cultures are also set up in order to retrieve
and identify organisms present in the CSF.
If
the
physician
suspects
a
viral,
mycobacterial, or rickettsia organism, it is
important that special culture techniques be
followed for isolation of these organisms.
21. Chemical analysis
Chemical analysis are important in
helping to establish a diagnosis.
The spinal fluid protein is typically about
1/100th the concentration of protein in
blood.
Increased CSF protein may be due to
damage to the, CSF brain barrier
resulting in an increased permeability,
decreased removal of protein from the
CSF.
22. Chemical analysis
(Contd..)
Decreased protein levels are less commonly
encountered.
Common reasons are removal of large amounts of
CSF and leakage of CSF caused by trauma.
Glucose concentrations can be determined using the
same methodologies as used for blood.
The most common finding is a low glucose
concentration associated with most types of CNS
infections.
If patient is hyperglycemic, then the CSF glucose
concentrations will like wise be elevated and an
infection may be masked.
If the patient is hypoglycemic the physician may be
misled by a low CSF glucose.
23. Chemical analysis (Contd..)
Lactate determination is considered to be of
some use by physicians in differentiating
bacterial, tuberculous and fungal meningitis
from viral meningitis.
The lactate concentration in viral meningitis is
generally normal or low in comparison to that
in bacterial, tuberculous, or fungal meningitis.
Other chemical anaylses include Glutamine
(an indicator of excess ammonia in the CNS),
LDH, chloride, and bilirubin.
24. Serologic examination
Serologic examination of CSF is
typically involved with diagnosis of
neurosyphilis.
A fluorescent treponemalantibody
absorption (FTA-ABS) test for CSF has
also been developed.
The VENERAL DISEASE RESEARCH
LAB. (VDRL) Test is also used.
25. Other techniques
It is important to recognize other techniques
that have been used and may still be used for
CSF.
Immunoelectrophorsis (CIE), latex
agglutination tests for bacterial antigens,
enzyme linked immunosorbent assay (ELISA)
and limulus of gram-negative bacterial).
The nucleic acid probes using PCR are the
newest of the techniques being investigated
for indentification of specific infectious
agents.