This document discusses the biomechanics of the hip joint. It describes how the hip functions as a lever with the body weight and abductor muscles producing forces on either side of the fulcrum. It explains how the hip is designed to provide both mobility and stability. Key factors like the neck angle, acetabular direction, and forces during activities like standing, walking and running are summarized. The effects of conditions like coxa valga and coxa vara on hip biomechanics are also outlined. Lastly, the biomechanical goals and considerations for total hip replacement surgery are presented.
Includes detailed description of BIOMECHANICS & PATHOMECHANICS OF KNEE JOINT AND PATELLOFEMORAL JOINT with recent evidences . Hope you find it useful!!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
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Includes detailed description of BIOMECHANICS & PATHOMECHANICS OF KNEE JOINT AND PATELLOFEMORAL JOINT with recent evidences . Hope you find it useful!!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
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STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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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!
- 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
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
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
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
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
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.
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. HIP - Mobile as well as stable
• Strong bones
• Powerful muscles
• Strongest ligaments
• Depth of acetabulum , narrowing of mouth by acetabular
labrum
• Length and obliquity of neck of femur
• MOBILITY is due to the long neck which is narrower than the
diameter of the head
4. The Neck of Femur
• Angulated in relation to the shaft in 2 planes :
sagittal & coronal
• Neck Shaft angle
– 140 deg at birth
– 120-135 deg in adult
• Ante version
– Anteverted 40 deg at birth
– 12-15 deg in adults
5. Acetabular Direction
• long axis of acetabulum points
– forwards : 15-200
ante version
– 450 inferior inclination
ante version
6. Axis of lower limb
Mechanical axis line passes
between center of hip joint
and center of ankle joint.
Anatomic axis line is between
tip of greater trochanter to
center of knee joint.
Angle formed between these
two is around 70
7. Biomechanics- HIP
• First order lever
fulcrum (hip joint)
forces on either side of fulcrum
i.e, body weight & abductor tension
8. To maintain stable hip, torques produced by the body weight is
countered by abductor muscles pull.
Abductor force X lever arm1 = weight X leverarm2
Biomechanics
10. defined as force generated within a joint in response to forces
acting on the joint
in the hip, it is the result of the need to balance the moment
arms of the body weight and abductor tension
maintains a level pelvis
Joint reaction force
-2W during SLR
- 3W in single leg stance
-5W in walking
-10W while running
Joint reaction force
11.
12.
13. Coupled forces:
Certain joints move in such a way that rotation
about one axis is accompanied by an
obligatory rotation about another axis & these
movements are coupled
Joint congruence – the proper fit of two articular
surfaces, necessary for joint motion
14. Instant centre of rotation:
• Point at which a joint rotates
• Normally lies on a line perpendicular to the
tangent of the joint surface at all points of
contact
15. Centre of gravity
• Wts. of the objects act through the centre of
gravity.
• In humans just anterior to S2
16. Forces across the hip joint in
two leg stance
• L.L constitute 2/6 (1/6 + 1/6), and U.L & trunk constitute 4/6
the total body wt
• Little or no muscular forces required to maintain equilibrium
in 2 leg stance
• Body wt is equally distributed across both hips
• Each hip carries 1/3rd body weight
– (4/6 = 2/3 = 1/3 + 1/3)
17. Single leg stance - Right
• Rt. LL supports the body wt & also the Lt
LL’s i.e. 5/6th total body wt.
• Effective Centre of gravity shifts to the
non-supportive leg (L) & produces
downward force to tilt pelvis
• Rt .abductors must exert a downward
counter balancing force with right hip
joint acting as a fulcrum.
i.e. Body wt acts eccentrically on the hip
and tends to tilt the pelvis in adduction -
---- balanced by the abductors
4/6 +1/6 =5/6
Typical levels for single leg stance
are 3W, corresponding to a level
ratio of 2.5.
18. Single leg stance - Right
4/6 +1/6 =5/6
• Rt. LL supports the body wt & also the Lt
LL’s i.e. 5/6th total body wt.
• Effective Centre of gravity shifts to the
non-supporting leg(L) & produces
downward force to tilt pelvis
• Rt. abductors must exert a downward
counter balancing force with right hip
joint acting as a fulcrum.
i.e. Body wt acts eccentrically on the hip
and tends to tilt the pelvis in adduction --
--- balanced by the abductors
Typical levels for single leg stance
are 3W, corresponding to a level
ratio of 2.5.
19. USE OF CANE / WALKING STICK
• It creates an additional force that keeps the pelvis level in the face
of gravity's tendency to adduct the hip during unilateral stance.
• decreases the moment arm between the center of gravity and
the femoral head(R)
• The cane's force must substitute for the hip abductors.
• Long distance from the centre of hip to contralateral hand
offers excellent mechanical advantage
21. Cane and Limp
• Both decrease the force exerted
by the body wt on the loaded
hip
• Cane: transmits part of the
body wt to the ground thereby
decreasing the muscular force
required for balancing
• Limping shortens the body lever
arm by shifting the centre of
gravity to the loaded hip
22. Stand on LEFT leg—if RIGHT hip
drops, then it's a + LEFT
Trendelenburg
The contralateral side drops
because the ipsilateral hip
abductors do not stabilize the
pelvis to prevent the droop.
TRENDELENBURG SIGN
24. Biomechanics in neck deformities :
Coxa valga
• Increased neck shaft angle
• GT is at lower level
• Shortened abductor lever arm
• Body wt arm remains same
• Increased joint forces in hip during one leg
stance
• Less muscle force required to keep pelvis
horizontal
26. Coxa Vara
• Decreased neck shaft angle
• GT is higher than normal
• Increased abductor lever arm
• Abductor muscle length is shortened
• Decreased joint forces across the hip
during one leg stance
• Higher muscle force is required to keep
pelvis horizontal
28. WITH WEIGHT GAIN
• Abductor muscular forces are to be increased to counteract
body wt
• Increased joint forces across the joint leading to increased
degeneration
• Rationale of decreasing body wt in OA – decrease in body wt
force & hence abductor force required to counter balance
decreasing joint reaction forces across that hip
29. Biomechanics of THR
Principle – to decrease joint reaction force
• Centralization of femoral head by deepening of Acetabulum
- decreases body wt lever arm
• Increase in neck length and Lateral reattachment of trochanter
- lengthens abductor lever arm
• This decreases abductor force, hence joint reaction force, & so the
wear of the implants.
30. Joint reaction forces are minimal if hip centre placed in
anatomical position
Adjustment of neck length is important as it has effect on both
medial offset & vertical offset
31. Offsets………
• Vertical Ht (offset)
Determined by the Base length
of the Prosthetic neck and
length gained by the head
33. IF……….
• Medial offset is inadequate shortens the moment arm
limp, increase bony impingement
• Excessive medial offset – dislocation, increases stress on stem
& cement
stress # or loosening
34. • In regular THR , the Femoral component must be inserted
in the same orientation as the femoral neck to achieve the
rotational stability .
• Modular component in which stem is rotated
independently of the metaphyseal portion
• Anatomical stems have a few degrees of ante version built
into the neck
35. HEAD DIAMETER
• Large diameter head compared to Small head
– Less prone for dislocation
– Range of motion is more
36. • Femoral components available with a fixed neck shaft angle -
135º
• Restoration of the neck in ante version - 10-15º
– Increased ante version anterior dislocation
– Increased retroversion posterior dislocation
• Cup placed in 150-200 of ante version and 450 of inclination