Lumbar spondylosis- Diagnosis | management | a brief medical study martinshaji
Lumbar spondylosis is a degenerative condition which affects the lower spine. In a patient with lumbar spondylosis, the spine is compressed by a narrowing of the space between the vertebrae, causing a variety of health problems ranging from back pain tone urological problems.
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Lumbar spondylosis- Diagnosis | management | a brief medical study martinshaji
Lumbar spondylosis is a degenerative condition which affects the lower spine. In a patient with lumbar spondylosis, the spine is compressed by a narrowing of the space between the vertebrae, causing a variety of health problems ranging from back pain tone urological problems.
please comment
thank you
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
What is structure of lumber disc? What is disc bulge/prolapse/herniation? What is difference between disc bulge, disc prolapse, disc herniation or disc extrusion? What is criteria to diagnose lumber disc prolapse? How lumber disc herniation is treated medically or surgically? How lumber disc herniation is treated by conservative method? How lumber disc herniation is treated through physical therapy? What is physiotherapy after various disc surgeries? What is radiological method to diagnose disc prolapse?
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.
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
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
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.
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
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.
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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
2. HISTORY
Aurelianus (5th century) clearly
described the symptoms of SCIATICA.
Andreas Vesalius (1543) first described
the intervertebral disc.
Middleton & Teacher (1911) described
a case of paraplegia following
attempting to lift heavy weight from
floor on postmortem they found
fibrocartilage in extradural space.
3. CONT..
• Mixter and Barr (1934)
described disc herniation as
the cause of Sciatica.
Lindblom(1948) first
described DISCOGRAPHY.
Lyman Smith (1963)
described
CHEMONUCLEOLYSIS.
Kambin & Gellman (1983)
reported percutaneous
approach for lumbar
discectomy.
14. LUMBAR DISC PROLAPSE
DEFINITION
It is condition in
which there is
outpouching of the disc
Nucleus pulposus along
with few annular fibres
and end plate cartilage
through the tears in
annulus fibrosus into
the extradural space.
15. EPIDEMIOLOGY
• AGE: 30 – 40 years.
• SEX: Male affected more than female.
• MOST COMMON LEVEL: L4-L5 (next common
level is L5-S1).
• MOST COMMON TYPE: Postero-lateral type.
18. EFFECT OF SMOKING
Blood vessel get
constricted
Transport of nutrients
& disposal of waste
products decreased
Disc cells get deficient
nutrition or die
Disc degenerates &
results in DISC
INSTABILITY
19. STAGES OF DISC DEGENERATION
Stage of dysfunction
Stage of instability
Stage of stabilization
20. STAGE OF DYSFUNCTION
Episode of
rotational or
compressive trauma
(uncoordinated
muscle contraction)
Posterior facet
joint & annular
strain
Small capsular &
annular tear
occurs
Small
subluxation of
posterior joint
Posterior joint
synovium injured
& result in
SYNOVITIS
Posterior segment
muscle protect joint by
sustained hypertonic
contraction
Muscle become
ischemic &
metabolites get
accumulated cause
pain
Muscle splints the
posterior joint
subluxation
&maintained
22. STAGE OF STABILIZATION
FACET
JOINT
Destruction
of cartilage
Fibrosis in
joint
Enlargement
of facets
Locking
facets
Fibrosis
around joint
INCREASED
STIFFNESS
STABILIZ
ATION
Fibrosis in
disc &
osteophytes
Destructio
n of plates
Approximati
on of bodies
Loss of
nucleus
DISC
23. PATHOPHYSIOLOGY OF PIVD
With aging, vascular channels start to fail and vascular
diffusion of nutrients decrease thus number of viable
chondrocytes in the nucleus pulposus diminishes
Synthesis rate & concentration of proteoglycans
decreases & proportion of collagen increase in
nucleus pulposus
Water binding capacity of the nucleus
decreases
Nucleus becomes more fibrous &
stiffer
24. CONT..
Nucleus is less able to bear & disburse load,
transferring load to the posterior annulus
ANNULU
S IN TACT
Facet joints
share even more
of the axial load
ANNULU
S FAIL
Facet joints undergo
degenerative changes &
develop osteophytes
FACET JOINT
SYNDROME
25. CONT…
ANNULUS FAIL
Fissures develop across
annular lamellae may
extend upto disc periphery
Internal disc
disruption cause
AXIAL PAIN
Expression of this degraded
nuclear material through
these radial fissures
DISC
HARNIATION
26. FATE OF DISC HARNIATION
Extrude disc & degraded nuclear material impinge
on the nerve roots
Nucleus pulposus is an immunogenic which induces
an inflammatory response mediated by TNF alpha, IL,
Phospholipase A2, Nitric oxide.
Produces radicular pain syndrome &
RADICULOPATHY
30. CLINICAL FEATURE
Level of
prolapsed
T12-L1 L1—L2 L2—L3 L3—L4 L4—L5 L5—S1
Nerve
root
compres
sed
L1 L2 L3 L4 L5 S1
pain Thorac
o
lumbar
junctio
n,
groin,
proxim
al part
of thigh
Thorac
o
lumbar
junctio
n,
groin,
proxim
al part
of thigh
Upper
lumbar
spine,
anterio
r
aspect
of
proxim
al thigh
Lower
back,
hip,
postero
lateral
thigh,
anterio
r leg
Sacroili
ac joint,
hip,
lateral
thigh &
lateral
leg
Sacroiliac
joint, hip,
postero
lateral
thigh &
postero
lateral
leg to
heel
31. Cont..
Level of
prolapsed
T12-L1 L1-L2 L2-L3 L3-L4 L4-L5 L5-S1
Nerve
root
compress
ed
L1 L2 L3 L4 L5 S1
Paresthesi
a/Sensory
loss
Oblique
band
proximal
3rd of
thigh
anteriorly
just below
inguinal
lig.
Oblique
band mid
3rd of
thigh
anteriorly
Oblique
band
lower part
of thigh
anteriorly
just above
the knee
Medial to
shin of
tibia,
medial
aspect of
the foot
Lateral
leg,
dorsum of
foot, 1st
web space
Posterior
aspect of
thigh,
back of
calf,
lateral
side and
sole of
foot
32. C0NT…
Level of
prolapsed
T12-
L1
L1-L2 L2-L3 L3-L4 L4-L5 L5-S1
Nerve root
compresse
d
L1 L2 L3 L4 L5 S1
reflexes Knee jerk
slightly
diminishe
d
Knee jerk
slightly
diminishe
d
Knee jerk
diminishe
d or
absent
Changes
uncommo
n
(Posterior
tibial
reflex
diminishe
d or
absent.
Ankle jerk
absent or
diminishe
d
33. CONT..
STAGE OF
DEGENERATIVE
DISEASE OF DISC
STAGE OF
DYSFUNCTION
STAGE OF
INSTABILITY
STAGE OF
STABILIZATION
SYMPTOMS Low back pain often
localized or referred
to groin/ greater
trochanter/
posterior thigh
- Aggravated on
movement
- Relieved on rest
Catch in back on
movement.
- Pain on coming to
standing position
after flexion.
Low back pain
decrease in severity
SIGNS Local tenderness on
one side & at one
level
-Hypo mobility
- Extension painful
- Neurological
examination normal
Abnormal
movement of spine
- Observation of
catch
Sway or shift when
coming erect after
flexion.
Muscle tenderness
- Stiffness
- Reduced
movements
- Scoliosis
34. PHYSICAL EXAMINATION
• ATTITUDE: The lumbar
spine is flattened and
slightly flexed, hip
and knee slightly
flexed on the
affected side and hip
rotates forward to
relax Piriformis
35. GAIT
• Slow and
deliberate walk
holding their
loins with the
hands.
• TIP-TOE WALK
due to not able
to put the heel to
the floor.
36. SIATIC SCOLIOSIS
• Deviation of spine to one side
to take the nerve away from
the prolapsed disc is called
SCIATIC SCOLIOSIS which
becomes more obvious on
bending forwards.
• Trunk deviated to opposite
side – SHOULDER TYPE
(lateral)
• Trunk deviated to same side –
AXILLARY TYPE (medial)
45. KEY DIAGNOSTIC POINTS
LUMBAR DISC PROLAPSE
Leg pain greater than back pain
Neurological deficit present
ANNULAR TEARS
Back pain greater than leg pain
Bilateral SLRT positive
FACET JOINT ARTHROPATHY
Localized tenderness present unilaterally over joint
Pain occurs immediately on spinal extension
Pain exacerbated with ipsilateral side bending
46. CONT..
SPINAL STENOSIS
Back and/or leg pain develops after walks a
limited distance.
Flexion relieves symptoms
MYOGENIC OR MUSCLE RELATED
Pain localised to affected muscle
Pain increases on prolonged muscle use
Pain reproduced with sustained muscle
contraction against resistance
Contralateral pain with side bending
48. PLAIN RADIOGRAPHY
• Narrowing of disc space
• Osteophytes formation
along the peripheries of
the adjacent vertebral
bodies
• Sclerosis or condensation
of subchondral bone of the
adjacent vertebral bodies
above and below the
affected disc
• Loss of lumbar lordosis
• Translation of vertebral
bodies.
50. CT SCAN
• ADVANTAGES
• highly accurate & noninvasive tool.
• superior imaging of cortical and trabecular bone.
• identify root compressive lesions such as disc
herniation.
• differentiate between bony osteophyte from soft
disc.
• to diagnose foraminal encroachment of disc
material
51. LIMITATION OF CT SCAN
• It cannot differentiate
between scar tissue
and new disc
herniation
• It does not have
sufficient soft tissue
resolution to allow
differentiation
between annulus and
nucleus.
52. MRI OF SPINE
• It allows direct
visualization of
herniated disc
material and its
relationship to
neural tissue
including
intrathecal
contents.
55. CONSERVATIVE
• Majority of disc prolapse
respond well to conservative
therapy. Resolution of first
disc prolapse takes place
approximately 95% of patients
over a period of 3 months.
61. INDICATIONS
ABSOLUTE
• Bladder and bowel involvement: The cauda equine
syndrome
• Increasing neurological deficit
RELATIVE
• Failure of conservative treatment
• Recurrent sciatica
• Significant neurological deficit with significant SLR
reduction
• Disc rupture into a stenotic canal
• Recurrent neurological deficit
62. CONTRAINDICATIONS FOR SURGERY
• Wrong patient ( poor potency for recovery)
• Wrong diagnosis
• Wrong level
• Painless HNP (do not operate for primary
complaint of weakness or paresthesia, in the
absence of pain)
• Inexperienced surgeon applying poor technical
skills
• Lack of adequate instruments
63. SOME OPERATIONS..
• HEMI OR PARTIAL LAMINECTOMY
• FENESTRATION
• TOTAL LAMINECTOMY
• LAMINOTOMY & DISCECTOMY
64. FAILED BACK SYNDROME
It is a condition characterized by persistent
postoperative backache and sciatica.
VERY COMMON CAUSES
• Recurrent/ Persistent disc material at
operated site
• Herniated Nucleus Pulposus at other site
• Epidural scar / Fibrosis
• Facet arthrosis / Spinal stenosis
