This document discusses neck of femur fractures (NOF), also known as hip fractures. It covers the epidemiology, risk factors, anatomy, classification, diagnosis, and treatment of NOF fractures. NOF fractures typically occur in elderly patients from low-energy falls and are associated with osteoporosis, while in younger patients they usually result from high-energy injuries. Treatment depends on factors like the patient's age, health, and fracture classification, and may involve closed or open reduction, fixation with screws or nails, or arthroplasty. Complications can include nonunion, osteonecrosis, fixation failure, dislocation, and increased mortality risk especially in older or less healthy patients.
This is a lecture presentation on applying external fixator on open fracture specially on tibia. This method is a classical method. Various new and dynamic fixators are there but the basics are the same.
This is a lecture presentation on applying external fixator on open fracture specially on tibia. This method is a classical method. Various new and dynamic fixators are there but the basics are the same.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
fractures of the proximal humerus are among the most common fractures of the upper limb and management options are wide according many variables mostly the age.
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
defination of hernia,epidemiology,etiology,parts of hernia,classification,clinical features,pathophysiology,predisposing factors and surgical management of strangulated hernia,
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.
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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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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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
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
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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
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Neck of femur fractures
1. NECK OF FEMUR FRACTURES
Prep By
DR BADAL KHAN
PGR1 ORTHO UNIT 3 BMCH
2. EPIDEMIOLOGY
• In elderly typically NOF # results from low-
energy falls and associated with osteoporosis.
• in young typically NOF # result of a high-
energy mechanism and other associated
injuries are common.
• Mostly intra capsular and compromise blood
supply of head of femur.
3. Risk factors
• Female sex
• White race
• Increasing age
• Poor health
• Tobacco and alcohol use
• previous fracture
• Fall history
• Low estrogen level
4. ANATOMY
• The upper femoral epiphysis closes by age16
years.
• Neck-shaft angle: 130 ±7 degrees
• Femoral Anteversion: 10 ±7degrees
6. ANATOMY….
• Calcar Femorale
A vertically oriented plate from the
posteromedial portion of the femoral
Shaft radiating superiorly toward the greater
trochanter.
7. Blood Supply
1. major contributor is medial femoral
circumflex Artery
2. some contribution to anterior and inferior
head from lateral femoral circumflex
3. some contribution from inferior gluteal
artery small and insignificant supply from
artery of ligamentum teres
10. By location of fracture line
• Subcapital
• Transcervical
• Basicervical
11.
12. Garden classification
• most commonly used classification system
• based on the degree of displacement
• Garden classification is based on AP pelvis
radiograph
16. Pauwels classification
• The classification is based on the angle, the
fracture line makes in reference to the
horizontal.
Type I--fracture is between 0 and 30 degrees
in Reference to the horizontal
Type II--between 30 and 50 degrees
Type III--more than 50 degrees
20. History
• History of a traumatic event with the exception
of patients who have stress fractures of the
femoral neck.
• young patients with high-energy femoral neck
fractures have associated injuries including head
injuries.
• missed femoral neck fracture can be disastrous.
23. Radiographs
• MRI has become the imaging study of choice
to evaluate occult femoral neck fractures.
• CT scan is not routinely being used for femoral
neck fractures.
• CT scan of the chest abdomen and pelvis often
is available yield useful information.
24. Radiographs
• BONE SCAN
• Helpful to rule out occult fracture
• not helpful in reliably assessing viability of
femoral head after fracture.
26. Closed reduction
• A closed reduction can be attempted in every
patient for whom internal fixation is planned.
• Closed reduction is done by
Whitman technique
applying traction to the abducted,
extended , externally rotated hip
with subsequent internal rotation.
27. Closed reduction
• Attempts should not be forceful
• should not be repeated more than
two or three times.
• Once reduction has been attempted, the
angulation and alignment must be critically
evaluated.
• Angulation and alignment evaluated By The
Garden alignment index.
28. Garden alignment index
• On the AP image,
The angle between the medial
shaft and the central axis of the medial
compressive trabeculae should measure
between 160 and 180 degrees.
<160 degrees indicates varus,
>180 degrees indicates valgus.
.
30. Angle between medial trabecular stream in femoral head and medial
cortex of femoral shaft
31. Garden Alignment index
On the lateral image
Angulation should be approximately 180
degrees and deviation of more than 20
degrees indicates excessive anteversion or
retroversion.
33. TREATMENT….
• Non operative
• Considered in some patients who are
nonambulators
• Have minimal pain
• High risk for surgical intervention
34. TREATMENT
• ORIF
• indications
• Displaced# in young or physiologically young
patients
• most pts <65 years of age
• low-energy fragility fractures in elderly patients
• Age 65-85, ORIF for Garden I and II patterns.
physiologically young pts with Garden III and IV
• Age >85 treated with ORIF for Garden I and II
35. • cannulated screw fixation
• indications
• Nondisplaced Transcervical fx
• Displaced transcervical fx in young patient
• Achieve reduction to limit vascular insult
• reduction must be anatomic, open if
necessary
37. Four screws can be
placed in a
diamond
configuration when
significant
comminution is
present
38. FIXATION OF NOF#
WITH CANNULATED SCREWS
• Extreme care must be taken in the placement of
guide pins.
(subtrochanteric femoral fractures)
• Fixed with an apex distal screw or apex-proximal
screw configuration.
• Apex-distal configuration exhibited a greater load
to failure
39. sliding hip screw or cephalomedullary
nail
• Indications
• Basicervical fracture
• consider placement of additional cannulated
screw above sliding hip screw to prevent
rotation
42. • <65 years of age) should be treated with
anatomical reduction and stable internal
fixation.
• Displaced femoral neck fractures in older
patients should be treated with arthroplasty.
43. controversial issues
• Type of arthroplasty
(hemiarthroplasty or total hip arthroplasty)
• unipolar or bipolar
• cemented or uncemented
• femoral stem
• surgical approach
46. Potential Benefits of Total Hip
Arthroplasty over Hemiarthroplasty
• Decreased pain
• Improved ambulation
• Lower reoperation rates
• A disadvantage of total hip arthroplasty
appears to be a slightly higher Dislocation rate
48. Nonunion
• incidence of 5 to 30%
increased incidence in displaced fractures
• varus malreduction
Treatment
valgus intertrochanteric osteotomy
free vascularized fibula graft (YOUNG)
arthroplasty (OLD)
revision ORIF
49. Osteonecrosis
• Up to 10% of nondisplaced and up to 30% of displaced fractures.
• Not all cases develop evidence of radiographic collapse.
• Treatment is guided by symptoms.
• Early without x-ray changes: Protected weight bearing or possible
core decompression.
• Late with x-ray changes: Elderly individuals may be treated with
arthroplasty, whereas younger
• patients may be treated with osteotomy, arthrodesis, or
arthroplasty
50. Fixation failure
• This is usually related to osteoporotic bone or
technical problems (malreduction, poor
implant insertion).
• TREATMENT
• It may be treated with attempted repeat open
reduction and internal fixation or prosthetic
replacement.
51. Dislocation
• Higher rate of dislocation with THA (~ 10%)
• About seven times higher than
hemiarthroplasty
52. MORTALITY
• Pre-injury mobility is the most significant
determinant for post-operative survival
• In patients with chronic renal failure, rates of
mortality at 2 years postoperatively, are close
to 45%