1) Interferential therapy involves applying two alternating medium-frequency currents that intersect in the body tissue to produce an interference beat frequency current for therapeutic purposes.
2) The beat frequency current can stimulate different tissues at different frequencies - nerves at 1-150Hz, muscles at 1-100Hz, increasing blood flow at 10-25Hz, and reducing edema at 1-10Hz.
3) Indications for interferential therapy include relief of chronic pain, absorption of exudates, and stress incontinence. General contraindications include pacemakers, malignancy, and infections. Local contraindications include open wounds and metal in the skin.
It is a direct current named after inventor Dr.L. Galvani. 2. Its direction of polarity is constant and passing continuously in one direction only, so termed as constant direct current. 3. Because of its unidirectional property, when applied to a muscle tend to contract and remain in that position till it is brought to zero, which seems to be very painful. GALVANIC CURRENT
Diadynamic currents are also called Bernard's currents based on a sine wave with a frequency of 50Hz. Due to the ease of generation of this current shape, they have been known almost from the beginning of electrotherapy, and their influence on the human body has been thoroughly studied.
Knowledge about the faradic current and its physiological effects,indications and its contraindication and the methods of the application of the faradic current,motor point stimulation and its benefit used in physiotherapy
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
A motor point is a specific skin area where the targeted muscle is best stimulated with the smallest amount of current amplitude and the shortest pulse duration
It is a direct current named after inventor Dr.L. Galvani. 2. Its direction of polarity is constant and passing continuously in one direction only, so termed as constant direct current. 3. Because of its unidirectional property, when applied to a muscle tend to contract and remain in that position till it is brought to zero, which seems to be very painful. GALVANIC CURRENT
Diadynamic currents are also called Bernard's currents based on a sine wave with a frequency of 50Hz. Due to the ease of generation of this current shape, they have been known almost from the beginning of electrotherapy, and their influence on the human body has been thoroughly studied.
Knowledge about the faradic current and its physiological effects,indications and its contraindication and the methods of the application of the faradic current,motor point stimulation and its benefit used in physiotherapy
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
A motor point is a specific skin area where the targeted muscle is best stimulated with the smallest amount of current amplitude and the shortest pulse duration
IFT which stands for Interferential Therapy is one of the types of electrotherapy used for the management of pain. The principle of interferential therapy is to cause two medium frequency currents of slightly different frequencies to interfere with one another. For example, if circuit A carries a current with the frequency of 4000Hz and Circuit B carry a current with a frequency of 3980 Hz, then the low frequency produced will be 20 Hz and this frequency is very useful in pain modulation. A new low-frequency current known as the beat frequency is equal to the difference in frequencies between the two medium frequency currents produced in the tissues at the point where the two currents cross.
It is basically used for the treatment of Chronic, Post Traumatic, and Post-surgical pains. The basic principle involves the utilization of effects of low frequencies (<250pps) without painful or unpleasant side effects. The major advantage of IFT is that it produces effects in the tissue, exactly where required without unnecessary and uncomfortable skin stimulation. This technique is widely used to elicit muscle contraction, promote healing and reduce edema.
Vector effect: The interference field is rotated to an angle of 450 in each direction, the field thus covers a wider area. This is useful in diffuse pathology or if the site of the lesion cannot be accurately localized.
Frequency swing: Some equipment allows a variation in the speed of the frequency swing. A rhythmic mode may be a continuous swing from 0 to 100 Hz in 5-10s and back in similar time or it may hold for 1-6s at one frequency followed by 1-6s at another frequency with a variable time to swing between the two.
Constant frequency: Some treatments may be carried out with the interference fixed at a certain frequency. Rhythmic frequency is useful if several types of tissues are to be treated at once. A variation in the frequency also overcomes the problem of tissue accommodation where the response of a particular tissue decreases with time.
WORKING PRINCIPLE: Interferential current therapy works by sending small amounts of electrical stimulation to damaged tissues in the body. The therapy is meant to boost the body's natural process of responding to pain, by increasing circulation thus produces hormones that promote healing. IFT delivers intermittent pulses to stimulate surface nerves and block the pain signal, by delivering continuous deep stimulation into the affected tissue. IFT relieves pain, increases circulation, decreases edema, and stimulates the muscles. A frequency of 100Hz may stimulate the large diameter A-beta fibers, which have an effect on the pain gate, and inhibit the transmission of small-diameter nociceptive traffic ( C and A-delta fiber), which effectively closes the gait to painful impulses. Interferential current Increases the circulation of blood thus reduces swelling.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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
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
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.
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
2. Medium Frequency Current
Medium frequency current are the current
whose frequency fall between the range of 1000 to
10000 Htz.
ADVANTAGES
1)Greater penetration
2) High tolerance and comport
3) Can be used for pain and muscle stimulation
4) Low skin resistance
3. Types
1) Rebox-type current: rebox electrotherapeutic
method is based on non invasive transcutaneous
application of specific current to a living tissue. it is
used for acute and chronic pain, immobility
musculoskeletal and neurological disorders.
2) Russian current: The Russian current waveform is
type of electrical stimulation that delivers medium
frequency current in alternating pulses or burstof
energy. .
3) Interferential therapy
4. Interferential therapy
Historical Background
Introduced by Dr. Nemec in Vienna in the early 1950’s.
Definition: The transcutaneous application of
alternating medium-frequency electrical currents,
amplitude modulated at low frequency for therapeutic
purposes.
Or
It is the resultant current produced when two or more
alternating current are applied simultaneously at the point
of intersection in a given medium.
5. Definitions
Impedance:-The effective resistance of an
electric circuit or component to alternating current,
arising from the combined effects of ohmic resistance.
Modulation is the process of varying one or more
properties of a periodic waveform.
Beat Frequency The interference produced by
the two current in the tissue is called beat frequency
6.
7.
8.
9.
10. Basic Principles of ITF
The ITF depends upon the interferential effect of two
medium frequency currents crossing in the patient
tissue. The interference produced by the two current
in the tissue is called beat frequency.
11. Let us take two medium frequency current in circuit A
=4000Hz and circuit B=3900 Hz. Where these two
current are applied to the tissues, at he point where
current cross over, a new beat frequency current is
setup whose amplitude is modulated and the
frequency of the new current is called beat frequency
(Interferential current).
Current A: f1 (this current is set on the machine,
thus called “intrinsic/carrier frequency”)
Current B: f2 (same amplitude, but slightly higher
frequency; therapist sets this one)
F=f1-f2=4000-3900=100Hz
Frequency range can be produced 1-250Hz
12. Physiological Effects of ITF
Excitable tissues can be stimulated by low frequency alternating currents.
Although to some extent, all tissues in this category will be affected by a broad
range of stimulations, it is thought (Savage 1984) that different tissues will have
an optimal stimulation band, which can be estimated by the conduction
velocity of the tissue.
These are detailed below:
Sympathetic Nerve 1-5Hz
Parasympathetic Nerve 10-150Hz
Motor Nerve 10-50Hz
Sensory Nerve 90-100Hz
Nociceptive fibers 90-150Hz (?130Hz specific)
Smooth Muscle 0-10Hz
The clinical application of I/F therapy can be based logically
on this.
13. The are 4 main clinical applications for which I/F
appears to be used:
Pain relief
Muscle stimulation
Increased blood flow
Reduction of oedema
14. Pain Relief:
Higher frequencies (90-150Hz) to stimulate the pain
gate mechanisms & thereby mask the pain symptoms.
Short duration pulses at a frequency of 100Hz may
stimulate large diameter nerve fibers which will have
an effect on the pain gate in the posterior horn, and
inhibit transmission of small diameter nociceptive
traffic.
15. Muscle Stimulation
Stimulation of the motor nerves can be achieved with a wide
range of frequencies.
Range 1-100Hz
stimulation at
low frequency (e.g. 1-5Hz) will result in a twitches
(5-20Hz) Partial tetany
30-100Hz Tetanic contraction.
The choice of treatment parameters will depend
on the desired effect, but to combine muscle stimulation
with an increase in blood flow and a possible reduction in
edema, there is some logic in selecting a range which does
not involve strong sustained tetanic contraction & a sweep
of 10-25Hz is often used.
16. Increased blood flow
combine muscle stimulation with an increase in
blood flow and a possible reduction in oedema,
there is some logic in selecting a range which does
not involve strong sustained
tetanic contraction & a sweep of 10-25Hz is often
used.
17. Reduction of oedema
This is accelerated by a frequency of 1-10Hz
rhythmic, as a rhythmical pumping action is
produced by muscle contraction, and there
is possible effect on autonomic nerves which
can effect the diameter of blood vessels, and
therefore the circulation. Both of these
factors will help absorb exudates and thus
reduce swelling.
18. INDICATION
1. Relief of chronic pain
(i) Low back pain
(ii) Periarthritis shoulder
(iii) Osteoarthritis knee
2. Absorption of exudates
3. Stress incontinence
20. Deep X-ray and cobalt
therapy
Epileptic patients
Non cooperative patients
Mentally retarded patients
Very poor general condition
of the patient
21. Contraindications (Local)
Open wounds
Very recent fractures
Skin grafts
Severe edema
Hairy surface
Acute inflammation
Metal in the part
Hypersensitive skin
Loss of sensation
22. Methods of treatment
Skin must be clean and clear before the start of the
treatment
The part of the body to be treated should be washed and if
there is any skin lesion it should be covered by applying
petroleum jelly on it.
The electrodes should be placed in such a way that the
crossing point of two currents lie above or around the
affected part.
The suitable frequency current should be given for different
conditions.
Increase the power gently and cautiously until the
patient starts feeling the current. It can be increased
till the patient can tolerate.
23. Preparation of Apparatus
1. Check whether all the knobs are at zero
2. Checking the pins of the plugs and check
whether the switch is turned off
3. Check the insulation of wire
4. Check whether the switch in the
stimulator is working
5. Check whether fuse is present
6. Check whether hand switch of patients
use is intact and working