A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Hemiparesis is unilateral paresis, that is, weakness of the entire left or right side of the body (hemi- means "half"). Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke
Hypenension: Commonest cause of intracerebral haemorrhage.
Rupture of an intracranial aneurysm, angioma or A-V malformation: commonest cause of subarachnoid haemorrhage.
Haemorrhagic blood diseases: purpura, haemophilia.
Anticoagulants.
Trauma to the head: commonest of subdural haematoma.
II. Infective: ;
Encephalitis
Meningitis – Brain abscess.
III. Neoplastic: e.g. Meningioma.
IV. Demyelination: multiple sclerosis may present with hemiplegia.
V. Traumatic: e.g. Cerebral laceration and subdural haematoma.
VI. Hysterical: patient suffering from paralysis in the absence of organic lesion.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
This is a presentation I did last semester in which I discuss how the OTPF applies to osteogenesis imperfecta. I collected data from scholarly as well as non-scholarly resources. I hope this is helpful to you.
Hemiparesis is unilateral paresis, that is, weakness of the entire left or right side of the body (hemi- means "half"). Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke
Hypenension: Commonest cause of intracerebral haemorrhage.
Rupture of an intracranial aneurysm, angioma or A-V malformation: commonest cause of subarachnoid haemorrhage.
Haemorrhagic blood diseases: purpura, haemophilia.
Anticoagulants.
Trauma to the head: commonest of subdural haematoma.
II. Infective: ;
Encephalitis
Meningitis – Brain abscess.
III. Neoplastic: e.g. Meningioma.
IV. Demyelination: multiple sclerosis may present with hemiplegia.
V. Traumatic: e.g. Cerebral laceration and subdural haematoma.
VI. Hysterical: patient suffering from paralysis in the absence of organic lesion.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
This is a presentation I did last semester in which I discuss how the OTPF applies to osteogenesis imperfecta. I collected data from scholarly as well as non-scholarly resources. I hope this is helpful to you.
This video is a talk by Dr. Prakash Khalap on 19 Mar 2016. Topic "Falls in Elderly". This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com.
Falls Risk Reduction And PreventionPhysical th.docxssuser454af01
Falls Risk Reduction
And Prevention
Physical therapists can use this Power Point to provide live educational sessions for Seniors or individuals who may be at risk for falls within the community.
*
1 The American Geriatrics Society. AGS/BGS Clinical Practice Guideline: Prevention of Falls in Older Persons (2010). http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/
What Is a Fall?An event whereby an individual unexpectedly comes to rest on the ground or another lower level without known loss of consciousness1
*
Why Are Falls Important to Me? 1More than 1/3 of adults 65 and older fall each year in the United States. Among older adults, falls cause over 39% of injury deaths, making them the leading cause by a wide margin. In 2007, 18,334 people 65 and older died from injuries related to falls.
1 Centers for Disease Control and Prevention, http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.
*
Why Are Falls Important to Me? 1In 2009, 2.2 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 581,000 of these patients were hospitalized. By 2020, the cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).
1 Centers for Disease Control and Prevention, http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.
*
Why Are Falls Important to Me?120% to 30% of people who fall suffer moderate-to-severe injuries such as bruises, hip fractures, or head traumas. Fall injuries can limit mobility and independent living, and can increase the risk of early death. Every hour, there are 2 deaths and 251 emergency department visits for falls-related injuries among older adults.
.
1 Centers for Disease Control and Prevention,http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.
*
What Are the Risk Factors
For Falling?
Research shows that a combined effect of many interacting factors increases fall risk.2
Difficulty With Walking/Balance
Multiple
Medications
Dizziness
Muscle
Weakness
Foot Problems
Heart Rate/ Rhythm Problem
History of
Falls
Vision
Problems
2Panel on Prevention of Falls in Older Persons. Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. American Geriatrics Society/British Geriatric Society.
http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010.
*
Am I at Risk for Falling
As I Age?
Falling and fear of falling as you age should NOT be accepted as a “normal” process of aging.
The causes of falls can be found and addressed.
*
Am I at Risk for Falling
As I Age?
There are certain changes that may cause people to fall:Less flexibility in the lower extremity jointsDecreased muscle strength around the ankles, knees, and hipsSlower walking speed ...
Back pain is one of the most difficult pains of the human body. Here we will try to provide some yoga poses so that we can help our society to get rid of back pain.
Back Pain, How do you maintain a healthy back.Sherif Watidy
Back Pain can be very painful, usually more prevailing in Adults, but did you know that you can reduce or totally relief back pain by taking only some actions into consideration. Professor Sherif ElWatidy Neurosurgeon describes them in details.
اختبار قصير: ماذا تعلم عن التغطية الصحية الشاملة؟
أَجِب على أسئلة هذا الاختبار القصير لتتأكد من صحة إجاباتك.
1 تحتفل منظمة الصحة العالمية (المنظمة) في يوم 7 نيسان/ أبريل من كل عام بذكرى إنشائها، باليوم الذي دخل فيه دستورها حيز النفاذ. فكم ستبلغ المنظمة من العمر هذا العام (2018)؟
30 عاماً
50 عاماً
70 عاماً
90 عاماً
2 ما المقصود بالتغطية الصحية الشاملة؟
يُقصد بالتغطية الصحية الشاملة حصول جميع الأفراد والمجتمعات المحلية على الخدمات الصحية اللازمة لهم متى وحيثما لزمتهم.
التغطية الصحية الشاملة تحمي الناس من الوقوع في دائرة الفقر حينما يُسددون تكاليف الخدمات الصحية اللازمة لهم من أموالهم الخاصة.
التغطية الصحية الشاملة تُمكّن جميع الأشخاص من الحصول على الخدمات التي تعالج أهم أسباب الإصابة بالمرض والوفاة.
التغطية الصحية الشاملة تعني تقديم خدمات صحية للأفراد ومختلف فئات السكان كالقضاء على مواقع تكاثر البعوض.
جميع ما سبق.
3 ما نسبة سكان العالم غير القادرين على الحصول على الخدمات الصحية اللازمة لهم؟
ما لا يقل عن 30% من سكان العالم
ما لا يقل عن 50% من سكان العالم
ما لا يقل عن 70% من سكان العالم
ما لا يقل عن 90% من سكان العالم
4 يُدفع نحو 100 مليون شخص في العالم إلى دائرة ’الفقر المدقع‘ (أي يعيشون بدخل لا يتجاوز 1.90 دولاراً أمريكياً في اليوم) بسبب اضطرارهم إلى سداد تكاليف خدمات الرعاية الصحية اللازمة لهم.
صحيح
خطأ
5 من له دور يؤديه في الدعوة إلى تحقيق التغطية الصحية الشاملة؟
أنت
الجماعات غير الهادفة إلى الربح
العاملون في مجال الصحة
وسائط الإعلام
جميع ما سبق
Session 6 se and complications [repaired]
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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!
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.
Follow us on: Pinterest
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
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.
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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.
2. Outline:
Introductions of falls in elderly.
Cause and risk factors of falls.
Consequences of falls in elderly.
Assessment of fall in elderly.
Preventing falls in older people.
Summary.
3. Definition of Falls
A fall is defined as an event which results in
a person coming to rest inadvertently on
the ground or floor or other lower level.
4. Introduction
Falls and fall-related injuries are a
common& serious problem for older
people.
Fall potentially life- threatening events
and may be simply the first signs of single
problem.
It lead to hospitalization and increase
cost and burden on society and even lead
to death .
5.
6.
7.
8.
9. Intrinsic risk factors:
Age Related changes
(Visual function
Neurological function,
Musculoskeletal
function)
Diseases
Female sex .
Extrinsic risk factors:
Drugs
Environmental
Improper assistive
devices
10.
11. (I HATE FALLING)
I: Inflammation of joints (or joint deformity)
H: Hypotension (orthostatic blood pressure changes)
A: Auditory and visual abnormalities
T: Tremor (Parkinson's disease or other causes of tremor)
E: Equilibrium (balance) problem
F: Foot problems
A: Arrhythmia, heart block or valvular disease
L: Leg-length discrepancy
L: Lack of conditioning (generalized weakness)
I: Illness
N: Nutrition (poor; weight loss)
G: Gait disturbance
12.
13. Consequence of falls
Physical:
Skin tear
internal bleeding
subdural hematoma
Hip fracture
Immobilization /
disability
Hospitalization
Psychological:
Fear of falling
increased dependency
Depression
Anxiety
loss of confidence
social withdrawal
16. How to approach elderly with fall
History Examination Investigations
17. History
A thorough history is essential to determine:
Fall ( mechanism of fall, Location, Activity,
Injury related to the fall, witness/help)
Associated symptoms concurrent with a fall
(change in level of or loss of consciousness,
chest pain, palpitations, dizziness, vertigo or
lightheadedness, Symptoms related to a
change in position ,headache,
weakness/tingling/numbness or acute change
in mental status)
18. previous falls and whether the falls were the
same or different in character.
medical history
Medications
Functional history
Social history
20. Cardiovascular: murmur ,presence of
arrhythmias & carotid bruits
Neurologic and mental evaluation:
looking for focal deficits, assessment
of lower extremity peripheral nerves,
proprioception, vibration sense, and tests
for cortical, cerebellar, and
extrapyramidal functions is important.
21. Musculoskeletal: lower-extremity
weakness, presence of contractures,
limitations or pain in range of motion
Gait and balance: abnormalities,
lower extremity strength, and joint
function.
Environmental assessment: Lighting,
walking surface, furniture, clothing,
and equipment
23. The American Geriatrics Society and British
Geriatrics Society recommend that all adults
older than 65 years be screened annually for
a history of falls or balance impairment.
24.
25.
26.
27. Evaluate gait, strength, and balance
• Recommended test:
Timed Up and Go
• Optional tests:
30-Second Chair Stand
4-Stage Balance tests
37. Multifactorial falls risk assessment
identification of falls history
assessment of visual impairment
assessment of cognitive impairment and neurological
examination
cardiovascular examination and medication review.
assessment of gait, balance and mobility, and muscle
weakness
assessment of osteoporosis risk
assessment of the older person's perceived functional
ability and fear relating to falling
assessment of urinary incontinence
assessment of home hazards
38. Multifactorial interventions
An intervention with multiple components
that aims to address the risk factors for
falling that are identified in a person's
multifactorial assessment.
39. MULTIFACTORIAL INTERVENTIONS
Multifactorial interventions should include:
Exercise, particularly balance, strength, and
gait training
Vitamin D supplementation with or without
calcium
Management of medications
Home environment modification
Management of postural hypotension, vision
problems, foot problems, and footwear.
45. Encourage participation in falls prevention programmes &
provide information and education
Multifactorial risk intervention
Multifactorial risk assessment
Identify if being at risk of falling
Healthcare professional should routinely ask about falls
Elderly aged 65 or above
Decreased hearing, including age-related changes (i.e., presbycusis [increase in pure tone threshold, predominantly high frequency], impaired speech discrimination, excessive cerumen accumulation)
Reduced vision, including age-related changes (i.e., decline in visual acuity, decline in accommodative capacity, glare intolerance, altered depth perception, presbyopia [near vision], decreased night vision, decline in peripheral vision)
, including age-related changes (i.e., postural instability; slowed reaction time; diminished sensory awareness for light touch, vibration and
temperature; decline of central integration of visual, vestibular and proprioceptive senses)
There is not enough evidence to suggest superiority of one test over another, but the Get Up and Go test is the most time-efficient, taking less than one minute to administer
