Distal femur fractures what makes it complex ,dr mohamed ashraf,hod orthopae...drashraf369
distal femur fractures are notorious for post operative complications due to malreduction and improper fixation.unless plan and execute a sound and stable fixation,this injury will lead to undesirable results.dr mohamed ashraf HOD orthopaedics govt TD medical college is presenting how to avoid complications in surgical management of these fractures..
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Distal femur fractures what makes it complex ,dr mohamed ashraf,hod orthopae...drashraf369
distal femur fractures are notorious for post operative complications due to malreduction and improper fixation.unless plan and execute a sound and stable fixation,this injury will lead to undesirable results.dr mohamed ashraf HOD orthopaedics govt TD medical college is presenting how to avoid complications in surgical management of these fractures..
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Complex Fractures and Instability of the Elbow joint: Advances in Mechanism and Pathophysiology, Injury paterns, Treatment principals and Results are discussed in this presentation.
Οι εξελίξεις στην χειρουργική των σύνθετων καταγμάτων του αγκώνα συζητούνται σε αυτή την παρουσίαση
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
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
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.
3. 1.5 to 4 % of all fractures in adult
33 % of all elbow injuries
4. Isolated Radial head
fractures
• Davidson et al- all 111 patients
with entire radial head fractures
had associated wrist or elbow
ligamentous injury( clin orthop
1993)
• 30 – 70% associated injuries in
various studies
7. Isolated Radial head
fractures
• “Entire radial head fracture or
displaced partial radial head
fracture always associated with
ligamentous injury-” Rockwood and
Green
10. APPLIED ANATOMY
• Radial head act as secondary
stabilizer to valgus stress, primary
being MCL
• Radial head resection in presence
of intact MCL does not alter valgus
instability much
21. CLINICAL
EVALUATION
• Even minor fractures are painful due
to haemarthrosis
• Document forearm rotation after LA
injection to joint to rule out
mechanical block
29. HOTCHKISS
MODIFICATION OF MASON
CLASSIFICATION
• TYPE 2- displaced partial radial head
fracture that blocks forearm rotation/
entire radial head fracture amenable to
fixation, treatment is ORIF
31. Goals of treatment
• Correcton of block to free forearm
rotation
• Stable elbow
• Prevent late arthrosis
• Early mobilisation
32. Non operative treatment
• Modified mason 1 fractures
• No associated lig injuries
• No bony block to ROM
33. Non operative treatment
• Early(3-4d) ROM
• Large undisplaced fragments need to be
monitored with x-ray
• Loss of elbow extension
• Redisplacement
• Non union
• Various studies have reported 90% favourable
results in mason 1 injury
34. Non operative treatment
• 80% favourable result with MASON
2&3 fractures treated
nonoperatively and added with
delayed radial head excision when
required for pain(JBJS (Am) :86-
A; 3, 570.)
42. CONSIDER ORIF
• Displaced MASON 2(>2mm) partial
radial head fractures which block
forearm rotations
• Entire radial head fractures with
unstable elbow if
– Less than three articular fragments
– Sufficient size and bone quality ti accept screws
– No metaphyseal bone loss
45. • Better understanding of anatomy and safezones
for implant and current implants have improved
clinical results of internal fixation
• King et al have repoted 100% excellent results
with internal fixation for Mason 2 fractures
• They have reported only 33%good results with
Mason 3 fractures treated by internal fixation
46. • Due to inadequate fixation or
selection of fracture pattern-
include
• Nonunion
• Restriction of forearm motion
• Implant failure
• Infection
• PIN injury
50. Primary Radial head
excision
Modified mason 3 fractures with
» Intact MCL
» No injury to DRUJ
» Coronoid and olecranon
intact
• Partial radial head fractures hindering
forearm rotation not amenable to
reconstruction
51. 15 yr follow up studies
• Antuna et al- 81 % painfree ,
radigraphic OA did not produce
clinical symptoms
• Hebertson et al- 90% excellent
results, OA changes in 50%
52. COMPLICATIONS
• LOSS OF ELBOW MOTION
• LOSS OF STRENGTH
• ELBOW OA CHANGES
• PROXIMAL MIGRATION OF
RADIUS( up to 2 mm assymptomatic)
• WRIST PAIN
• VALGUS INSTABILITY OF ELBOW
54. Radal head arthroplasty
• Silicone prosthesis
• Insabilty
• Destructive synovitis
• Discarded
• Metal prosthesis
– Press fit / cemented
– Smooth stem
– Unipolar or modular bipolar head
55. • Smooth stem
• Act like spacer
• Produce
radiolucencies but
asymptomatic
• No overstuffing of
radiocapitellar joint
56. • Fixed stem
• Overstuffing if radiocapitellar joint if
prosthesis more than 1 mm proximal to
coronoid process
• Open up elbow on lateral side
• Capitellar wear and synovitis
• So exact sizing must
• No significant diff b/w monopolar or bipolar
heads
58. TAKE HOME MESSAGE
• Isolated radial head fracture do occur
but is rare
• Always look for wrist or elbow
ligamentous injury
• Document forearm rotation
• Nonoperative treatment involves
supervised mobilization NOT
immobilization
59. TAKE HOME MESSAGE
• Selection of type of fracture
amenable to fixation crucial
• Follow safe zones for implants
• Radial head arthroplasty is still
evolving
