Anatomy of ankle and foot is described briefly with clinical importance and photos.
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Anatomy of ankle and foot is described briefly with clinical importance and photos.
Dr Junaid Ahmad Consultant Plastic Surgeon is best in Lahore. He offers Foot and Hand Trauma management. Call 03104037071
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
3. MOB TCD
Hip Joint
• Synovial ball and socket
joint
• Multiaxial
• Three degrees of freedom
• Movement in three planes
• Close pack extension and
medial rotation
• Least pack semiflexion
4. MOB TCD
Hip Joint
• One of most stable joints in
the body
• Articular surface of hip joint
are reciprocally curved
• Superior surface of femur and
acetabulum sustain greatest
pressure
5. MOB TCD
Acetabulum
•
•
•
•
•
Y-shaped epiphyseal cartilage
Start to ossify at 12 years
Fuse 16-17 years
Acetabular notch is inferior
Nonarticular fossa, thin related
medially to obturator internus
• Pad of fat, proprioceptive nerves
6. MOB TCD
Articular Surface of Hip Joint
• Semilunar articular surface
covered with hyaline
cartilage
• Deepened by acetabular
labrum
• Wedge shaped fibrocartilage
7. MOB TCD
Articular Surface
•
•
•
•
•
Head of femur 2/3rd of sphere
Pit for ligamentum teres
Covered with articular cartilage
Cartilage thicker posterior superior
Epiphyseal line for head
intracapsular
8. MOB TCD
Femur
• Trabeculae develop along lines
of stress
• Calcar femorale is the cortical
bone on inferior aspect of neck
• Neck is cancellous bone
9. MOB TCD
Capsule of Hip
• Proximally attached
• Margins of the acetabular
fossa
• Base of labrum
• Distally, anterior to the
intertrochanteric line
• Inferiorly, femoral neck close
to lesser trochanter
10. MOB TCD
Capsule of Hip
• Posterior
• Free border, finger’s breath
from trochanteric crest due
to insertion of obturator
externus
• Into trochanteric fossa and
• Root greater trochanter
11. MOB TCD
Capsule of Hip
• Strongest superiorly
• Anteromedially, deep fibres
reflected head of rectus
femoris
• Iliopsoas is anterior
• Lateral deep fibres of gluteus
minimus
12. MOB TCD
Retinacular Fibres
• Fibres of capsule reflected along
neck to articular margin called
retinacular fibres
• Blood supply to head run under
retinacular fibres
13. MOB TCD
Ligaments of Hip
•
•
•
•
•
•
•
Acetabular labrum
Transverse ligament
Ligament of head
Iliofemoral ligament
Pubofemoral ligaments
Ischiofemoral ligaments
Zona orbicularis
14. MOB TCD
Ligaments of Hip
• Transverse ligament is part of
the labrum
• Ligamentum teres is
triangular, its base is attached
to transverse ligament, and
the apex to the pit on the
head of femur
• Blood supply to epiphysis
from obturator artery
• Only supplies a flake of bone
in elderly
15. MOB TCD
Iliofemoral Ligament
• Thickening of capsule
• Lower half of anterior
inferior iliac spine and
adjoining acetabulum
• Distally
• Upper and lower parts of
inter trochanteric line
16. MOB TCD
Iliofemoral Ligament
• One of strongest
ligaments in body
• Tightens in extension
• Helps maintain erect
posture
• Facet on anterior aspect
of neck
• Prevents hyperextension
• Fulcrum reducing hip
17. MOB TCD
Pubofemoral Ligament
• Superior pubic ramus
• Inferior part of inter
trochanteric line and upturned
part
• Relatively weak
• Prevents abduction
• Bursa between it and
iliofemoral
18. MOB TCD
Ischiofemoral Ligament
• Ischium to posterior part of
joint (weak)
• Circular fibres called zona
orbicularis
• Centre of gravity in front of
head
• Synovial under obturator
externus
19. MOB TCD
Synovial Membrane
• Lines inner portion of capsule
and non articular structures
• Ligament of head
• Fat in acetabular fossa
• May communicate with psoas
bursa
• Bursa under obturator
externus
20. MOB TCD
Bursa Under Gluteus Maximus
• Trochanteric bursa
• Posterolateral aspect of
greater trochanter
gluteofemoral
• Vastus lateralis ischial bursa
• Ischial tuberosity
21. MOB TCD
Blood Supply to Head of Femur
• Child, obturator artery via
ligamentum teres supplies
epiphysis
• Elderly, main supply via
retinacular vessels from
trochanteric and cruciate
anastamoses
• Medial and lateral circumflex
femoral vessels
22. MOB TCD
Blood Supply
• Superior gluteal supplies the upper
part of the acetabulum
• Inferior gluteal supplies the inferior
and posterior and the capsule
• Transverse and ascending
branches of lateral circumflex
femoral artery
• Transverse and ascending branch
of medial circumflex femoral
• Cruciate and trochanteric
anastomosis
23. MOB TCD
Blood Supply
• Fractures of neck may cause
avascular necrosis, extra
capsular arteries enter the
trochanter at the base of neck
• Medial and lateral circumflex
femoral vessels and superior
gluteal
24. MOB TCD
Nerve Supply
•
•
•
•
•
Femoral nerve
Obturator nerve
Superior gluteal nerve
Nerve to quadratus femoris
Posterior dislocation may
damage sciatic
• Pain in hip referred to knee
26. MOB TCD
Inferior and Posterior Relations
• Obturator externus
• Passes inferior and then posterior
to joint
• Superior gluteal nerve
• Inferior gluteal nerve
• Sciatic nerve
• Posterior cutaneous nerve thigh
• Nerves to obturator internus and
quadratus femoris
• Pudendal nerve
27. MOB TCD
Lateral Relations
• Gluteus minimus
• Gluteus medius
• Superior gluteal vessels and
nerves between
• Iliotibial tract
• Superficial three quarters of
gluteus maximus
30. MOB TCD
Movements: Extension
• Hamstrings first 10°
• Long head of biceps
• Semitendinosus
• Semimembranosus
• 123, extended knee ++
• Adductor magnus
• Gluteus maximus most efficient when hip is
flexed 45°
37. MOB TCD
Hip Problems in Children
•
•
•
•
Apophysitis
Avulsion fractures
After 13 years
11-40% of all hip and pelvic fractures
Boyd et al., 1997
• Anterior superior iliac spine
• Anterior inferior iliac spine
• Ischial tuberosity commonest
39. MOB TCD
Pain in a Child
•
•
•
•
•
•
5-10 year old child
Aching pain in hip
Limp
Limitation of movement
Perthe’s
Osteochondritis of head of femur
40. MOB TCD
Stability of Hip
• One of the most stable
joints
• Congenital dislocations is
common
• 1.5 per 1000 live births
• Female : male = 8:1
• Ultrasound best method of
detecting
41. MOB TCD
Femoral Anteversion
• Femoral version is the angular difference between axis
of femoral neck and transcondylar axis of the knee
• Femoral anteversion ranges from 30 º - 40 º at birth
• Decreases progressively 15 º at skeletal maturation
• Adults
• Anteversion
• Average of 8 º in men and 14º in women
• Most common cause of in-toeing
• If associated with internal tibial torsion, may lead to
patellofemoral subluxation due to an increase in the
Q-angle
42. MOB TCD
Tumors and Neoplasms
•
•
•
•
Young, healthy athletes do get cancer!
Fortunately most tumors are benign!
Bone pain at night
Tumor till proved otherwise
Renström, 2008
43. MOB TCD
Hip Joint Labral Tear
• Chronic
• Secondary to acetabular
dysplasia
• Part of “rim lesion” complex
Renström, 2008
44. MOB TCD
Labrum Tears and Cartilage Loss
• Labrum tears and cartilage loss are
common in patients with mechanical
symptoms in the hip
• In young, active patients with a
complaint of groin pain
• The diagnosis of a labrum tear
should be suspected and
investigated as radiographs and the
history may be nonspecific for this
diagnosis
Burnett et al., J Bone Joint Surg (Am), 2006
45. MOB TCD
MR-Arthrography (MRA)
• MR arthrogram has an
accuracy of 91% for labral
tears
Chan et al, Arthroscopy 2005
• Sensitivity labral tear
• MR 25%,
• MRA 92%
Toomayan et al., Am J Roentgenol 2006
46. MOB TCD
Pincer Impingement
• The acetabulum covers too much of the
•
•
•
•
femoral head
Secondary to “retroversion”, of the
socket
Or a “profunda” socket that is too deep
Most of the time the cam and pincer
forms exist together
Female, 30-40 years
Renström, 2008
47. MOB TCD
Cam Impingement
•
•
Loss of roundness contributes to
abnormal contact between the head and
socket
Male, 20-30 years
Renström, 2008