A herniated or prolapsed disc occurs when a tear in the outer ring of an intervertebral disc allows the soft inner material to bulge out. This most commonly affects the lumbar region. Symptoms include back pain and pain radiating into the legs. Diagnosis involves physical exam, x-rays, CT scans and MRI. Treatment options range from non-surgical approaches like medication, physical therapy and injections to surgical procedures like discectomy, laminectomy or spinal fusion. The goal of treatment is to relieve pressure on nerves and reduce pain.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
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?
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
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!
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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
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.
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.
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
2. DEFINITION
• Spinal disc herniation, also known as
a slipped disc, is a medical condition
affecting the spine in which a tear in the
outer, fibrous ring of an intervertebral
disc allows the soft, central portion
to bulge out beyond the damaged outer
rings.
3.
4. • Is relatively avascular structure and
the Essential minerals and fluids
required for regeneration enter the
disks passively during the night.
5. FUNCTIONS OF IVD
1-It supports the axial load on the column that is
delivered by the body mass.
2- Assist a limited range of motion at the spine.
3- Shock absorbing system.
4- Serve ligamental functions between vertebral
bodies.
5- Assist to keep the normal shape & curvature of
each spinal region (cervical, thoracic, ..etc)
6. Location
The majority of spinal disc herniation cases
occur in lumbar region (95% in L4-L5 or
L5-S1).
The second most common site is
the cervical region (C5-C6, C6-C7).
The thoracic region accounts for only
0.15% to 4.0% of cases.
7. Cervical
Cervical disc herniations occur in the neck,
most often between the fifth & sixth
(C5/6) and the sixth and seventh (C6/7)
cervical vertebral bodies.
Symptoms can affect the back of the skull,
the neck, shoulder girdle,
scapula, shoulder, arm, and hand.
The nerves of the cervical
plexus and brachial plexus can be affected.
8. Thoracic
Thoracic discs are very stable and
herniations in this region are quite
rare.
Herniation of the uppermost thoracic
discs can mimic cervical disc
herniations, while herniation of the
other discs can mimic lumbar
herniations.
9. Lumbar
Lumbar disc herniations occur in the lower
back, most often between the fourth and
fifth lumbar vertebral bodies or between
the fifth and the sacrum.
Symptoms can affect the lower
back,buttocks, thigh, anal/genital
region (via the Perineal nerve), and may
radiate into the foot and/or toe.
10.
11. Repetitive mechanical activities –
Frequent bending, twisting, lifting, and
other similar activities without breaks and
proper stretching can leave the discs
damaged.
CAUSES
12. Traumatic injury to lumbar discs-
commonly occurs when lifting
while bent at the waist, rather
than lifting with the legs while
the back is straight.
13. • Living a sedentary lifestyle –
Individuals who rarely if ever
engage in physical activity are more
prone to herniated discs because the
muscles that support the back and
neck weaken, which increases strain
on the spine.
14. Obesity – Spinal degeneration can be
quickened as a result of the burden of
supporting excess body fat.
Practicing poor posture – Improper spinal
alignment while sitting, standing, or lying
down strains the back and neck.
CAUSES
15. Tobacco abuse – The chemicals
commonly found in cigarettes can
interfere with the disc’s ability to
absorb nutrients, which results in the
weakening of the disc.
16. • Mutation-
in genes coding for proteins
involved in the regulation of the
extracellular matrix, such
as MMP2 and THBS2, has been
demonstrated to contribute to lumbar
disc herniation.
17. There is now recognition of the importance of
“chemical radiculitis” in the generation of back
pain.
A primary focus of surgery is to remove
“pressure” or reduce mechanical compression on
a neural element: either the spinal cord, or
a nerve root.
Pathophysiology
18. • But it is increasingly recognized that
back pain, rather than being solely
due to compression, may also be due
to chemical inflammation.
19. There is evidence that points to a specific
inflammatory mediator of this pain.
This inflammatory molecule, called tumor
necrosis factor-alpha (TNF), is released not
only by the herniated disc, but also in
cases of disc tear (annular tear), by facet
joints, and in spinal stenosis.
20. • In addition to causing pain and
inflammation, TNF may also contribute
to disc degeneration.
21. SYMPTOMS
• The symptoms of a herniated or prolapsed
disc may not include back or neck pain in
some individuals, although such pain is
common. The main symptoms of a prolapsed
disc include:
• In severe cases, loss of control of bladder
and/or bowels, numbness in the genital area,
and impotence (in men)
• Numbness, pins and needles, or tingling in
one or both arms or legs
22. • Pain behind the shoulder blade(s) or in the
buttock(s)
• Pain running down one or both arms or legs
• The location of these symptoms depends
upon which nerve(s) has been affected. In
other words, the precise location of the
symptoms helps determine your diagnosis.
• Weakness involving one or both arms or legs
23. TYPES OF HERNIATION
posterolateral disc herniation –
protrusion is usually posterolateral into
vertebral canal, compress the roots of a
spinal nerve.
protruded disc usually compresses next
lower nerve as that nerve crosses level of
disc in its path to its foramen.
(eg.protrusion of fifth lumbar disc usually
affects S1 instead.
24. central (posterior) herniation:
less frequently, a protruded disc
above second lumbar vertebra may
compress spinal cord itself or or may
result in cauda equina syndrome.
in the lower lumbar segments,
central herniation may result in S1
radiculopathy.
25. lateral disc herniation:
may compress the nerve root above the
level of the herniation
L4 nerve root is most often involved &
patient typically have intense radicular
pain.
26. Diagnosis is based on the history, symptoms,
and physical examination.
At some point in the evaluation, tests may be
performed to confirm or rule out other causes of
symptoms such
as spondylolisthesis,degeneration, tumors, metasta
ses and space-occupying lesions.
DIAGNOSIS
27. X-Ray : lumbo-sacral spine;
Narrowed disc spaces.
Loss of lumber lordosis.
Compensatory scoliosis.
CT scan lumber spine;
It can show the shape and
size of the spinal canal, its
contents, and the structures
around it, including soft tissues.
Bulging out disc.
28. MRI lumber spine;
Intervertebral disc protrusion.
Compression of nerve root.
Myelogram;
pressure on the spinal cord or
nerves, such as herniated discs,
tumors, or bone spurs.
34. Bed rest.
Non-steroidal anti-inflammatory
drugs (NSAIDs).
Patient education on proper body
mechanics.
Physical therapy, to address mechanical
factors, and may include modalities to
temporarily relieve pain
(i.e. traction, electrical stimulation
massage).
medical treatments.
36. Discectomy/Microdiscectomy -
• This procedure is
used to remove part
of an intervertebral
disc that is
compressing the
spinal cord or a
nerve root.
37. The Tessys method
• The Tessys method
(transforaminal
endoscopic surgical
system) is a
minimally invasive
surgical procedure
to remove herniated
discs .
40. Lumbar fusion
• Anterior lumbar fusion is an
operation done on the
front (the anterior region) of
the lower spine.
• Fusion surgery helps two or
more bones grow together
into one solid bone.
•
41. • Fusion cages are new devices, essentially hollow
screws filled with bone graft, that help the
bones of the spine heal together firmly.
• Surgeons use this procedure when patients
have symptoms from disc degeneration, disc
herniation, or spinal instability.
• lumbar fusion is only indicated for recurrent
lumbar disc herniations, not primary
herniations
42. Total Disc Replacement
• Artificial Disc Replacement (ADR), or Total
Disc Replacement (TDR), is a type
of arthroplasty.
• It is a surgical procedure in which
degenerated intervertebral discs in the spinal
column are replaced with artificial devices in
the lumbar (lower) or cervical (upper) spine.
44. NURSING MANAGEMENT
• Assess the general condition of the patient
• Check the vital signs
• Assess the level and characteristics of pain
• Provide proper back care and skin care to
the patient
• Advice patient to do proper exercise
• Provide adequate nutrition
45. • Change the position frequently
• Advice to avoid heavy exercise like heavy
weight lifting
• Put traction for the prescribed period of
time.
• Continue the medications till the doctor
adviced