Long case examination done during MBBS and MD examination. Neurology case is mostly the long case. History, general examination , systemic examination, provisional diagnosis, investigation and final diagnosis are the sequential steps. Neurology examinations includes higher mental function, cranial nerve examination, motor and sensory system examination, cerebellar signs, gait, peripheral nerves, spine and skull and peripheral nerve examination.
Long case examination done during MBBS and MD examination. Neurology case is mostly the long case. History, general examination , systemic examination, provisional diagnosis, investigation and final diagnosis are the sequential steps. Neurology examinations includes higher mental function, cranial nerve examination, motor and sensory system examination, cerebellar signs, gait, peripheral nerves, spine and skull and peripheral nerve examination.
Long case examination done during MBBS and MD examination. Neurology case is mostly the long case. History, general examination , systemic examination, provisional diagnosis, investigation and final diagnosis are the sequential steps. Neurology examinations includes higher mental function, cranial nerve examination, motor and sensory system examination, cerebellar signs, gait, peripheral nerves, spine and skull and peripheral nerve examination.
Long case examination done during MBBS and MD examination. Neurology case is mostly the long case. History, general examination , systemic examination, provisional diagnosis, investigation and final diagnosis are the sequential steps. Neurology examinations includes higher mental function, cranial nerve examination, motor and sensory system examination, cerebellar signs, gait, peripheral nerves, spine and skull and peripheral nerve examination.
Thyroid Swelling: A practical guide on writing and presenting a clinical caseMuskaan Khosla
Every book tells us how to examine and what to examine in a clinical case. But, no book tells us exactly how to write a sheet and how to word the case. Here is a practical example ! Hope it helps!
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
Patient was apparently all-right one and half years back, when he developed sudden onset severe constricting type retrosternal pain at rest with radiation to left arm associated with shortness of breath, nausea and vomiting. He was admitted in the local hospital , ECG was done and told to have heart attack. He was discharged after 7 days and advised to attend a higher cardiac centre for coronary angiography. But he didn’t followed up after that and was on irregular oral medication.
A 62 years old diabetic, smoker, non-hypertensive male presented with acute coronary syndrome like symptoms one and half year back followed by angina of CCS class II which progressed to CCS class III over last 3 months. Patient also had shortness of breath which progressed from NYHA Class II to NYHA Class IV over last 3 months with history suggestive of orthopnea.
D/D
Ischemic heart disease
Hypertrophic cardiomyopathy
Valvular heart disease (Aortic valvular disease)
Dilated cardiomyopathy
RSOV
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Thyroid Swelling: A practical guide on writing and presenting a clinical caseMuskaan Khosla
Every book tells us how to examine and what to examine in a clinical case. But, no book tells us exactly how to write a sheet and how to word the case. Here is a practical example ! Hope it helps!
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
Patient was apparently all-right one and half years back, when he developed sudden onset severe constricting type retrosternal pain at rest with radiation to left arm associated with shortness of breath, nausea and vomiting. He was admitted in the local hospital , ECG was done and told to have heart attack. He was discharged after 7 days and advised to attend a higher cardiac centre for coronary angiography. But he didn’t followed up after that and was on irregular oral medication.
A 62 years old diabetic, smoker, non-hypertensive male presented with acute coronary syndrome like symptoms one and half year back followed by angina of CCS class II which progressed to CCS class III over last 3 months. Patient also had shortness of breath which progressed from NYHA Class II to NYHA Class IV over last 3 months with history suggestive of orthopnea.
D/D
Ischemic heart disease
Hypertrophic cardiomyopathy
Valvular heart disease (Aortic valvular disease)
Dilated cardiomyopathy
RSOV
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Embracing GenAI - A Strategic ImperativePeter 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.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
4. HISTORY OF PRESENT ILLNESS
• The condition has started 3 month ago by gradual onset progressive
course when the patient developed lower back pain which was localized
, throbbing (some times stabbing )moderate to sever ,increased with
cough ,sneezing and movement and became more sever at night ,
decreased slightly with rest and analgesia , radiating to both buttocks
• 1month later patient developed weakness in both lower limbs which was
left more than right , proximal more than distal , flexor equal extensor
associated with hypotonia completed within 1 month till patient became
wheelchair
5. 1.5 month from the onset of the condition the relevant noticed wasting
in both lower limbs especially the anterior aspect of the thigh
Patient also noticed worm like sensation at the anterior part of the thigh
at the beginning of weakness then disappeared nowadays
At the beginning of the weakness the patient has complained from
urine incontinence and lately became complaining from urine and stool
incontinence
6. • 3 weeks ago patient has complained from mid- dorsal localized pain
(carry the same character of lower back pain ) without increasing in
the previous weakness .
7. during period of the disease
Patient denied any associated fever or
significant weight loss all over the course of
disease
No history suggestive upper limbs affection
No history suggestive cranial nerve affection
No history suggestive cerebellar affection
No history suggestive trauma ,headache or
fits
No history of raw milk ingestion or contact to
animal
8. • Born and live in Giza
• Married
• Has 3 sibling the youngest is 29 y .o
• Smoker
• No other special habit of medical important
• Social history
9. PAST HISTORY
Diabetes uncontrolled for 25 year on oral treatment
Hypertensive
left head femur fraction (nail and screw fixation) 2 years ago
No history of blood transfusion
No history of trauma
No history of liver or kidney disease
No history of drug addiction .
11. FORMULATION
Male patient 71 year old diabetic uncontrolled and
hypertensive presented 3 months ago by gradual
onset progressive course of :
Lower back bony pain
Asymmetrical lower motor neuron weakness in both
lower limbs
urine and stool incontinence
Mid dorsal bony pain
13. • BP: 110/70
• Pulse: 84 beats/m, regular, average volume, equal on both sides.
• RR: 14 cycle/m.
• T: 37◦ C.
14. • Head and Neck: no characteristic facies, normal thyroid.
• Chest: fair air entry, no adventitious sounds.
• Heart: normal S1 & S2, no murmurs, gallops or rub.
• Abdomen: Lax abdomen, not tender, no detectable ascits or supra
pubic dullness.
• Skin : no rash, plaques only atrophic changes in both feet
16. MENTAL STATE
• The patient is fully conscious, attentive, well oriented to time, place,
person, with intact memory, depressed mood .
• MMSE : 25/30
18. CRANIAL NERVES
• Olfactory: intact
• Optic:
VA: Rt: 6/6; Lt: 6/6.
Color vision: intact
Visual field: NAD
Fundus examination: diabetic retinopathy
• Occulomotor, Trochlear, Abducens:
Intact ocular motility
Pupil : RRR bilateral; Light reflex: intact both direct and indirect
19. CRANIAL NERVES
• Trigeminal :
Intact motor and sensory examination.
Corneal reflex: intact
Jaw reflex: just elicited
• Facial Nerve:
No facial asymmetry
Glabellar reflex: normal
• Vestibulo-Cochlear:
Cochlear part: Intact
Vestibular part: intact .
20. CRANIAL NERVES
• Glossopharyngeal, Vagus:
Uvula: Centralized
Palatal movement: Intact on both side
Palatal& Pharyngeal Reflexes: present bilaterally
• Hypoglossal Nerve:
Tongue: no wasting, abnormal movements or fasciculation.
21. MOTOR SYSTEM
Upper limbs :
Muscle state ,wasting and guttering in the small muscle of the hands
Power : full power
Reflexes;normal reflexes
22. Lower limbs
Inspection ; wasting in the medial and
anterior side of the thigh and anterior aspect
of the leg
Power ; left more than right proximal more
than distal , adduction more than abduction
, extensors more than flexors
24. REFLEXES
• Deep tendon reflexes:
• Areflexia of both ankle
• Areflexia of both knee
• Normal biceps, brachioradialis and triceps
• Superficial reflexes
Abdominal: INTACT (upper, middle, lower)
Plantar: Bilateral flexor planter reflex.
2+
0
0 0
2+ 2+
2+
2+
2+
0
25. SENSORY SYSTEM
• Superficial: glove and HIGH stock hypothesia
• Hypothesia at saddle area
• Deep: VIBRATION SENSATION LOST ON MEDIAL MALLEOLUS and
preserved at tibial tuobersty
