The document discusses the anatomy and clinical features of the orbit and orbital diseases. It begins with describing the four walls that make up the bony orbit - roof, floor, medial and lateral walls. It then discusses causes of proptosis like tumors, hemorrhage, endocr
Overview of role of imaging in different intraconal and extraconal pathologies including infective,inflammatory and neoplastic pathologies.Also included is insight into anatomy,trauma,post operative imaging and certain miscellaneous disorders
thyroid eye disease is becoming a very common eye disorder with more than 42 million people affected in india with thyroid disease. About 2.9 men and 16 women/lac/year are newly diagnosed with thyoid disease.
A complete unit of the various diseases involving the orbit and the surrounding structures. It involves the unilateral and bilateral proptosis conditions. Also, the various proptosis etiologies involved in adults and children along with various tumors involving the orbit is also dealt with.
Overview of role of imaging in different intraconal and extraconal pathologies including infective,inflammatory and neoplastic pathologies.Also included is insight into anatomy,trauma,post operative imaging and certain miscellaneous disorders
thyroid eye disease is becoming a very common eye disorder with more than 42 million people affected in india with thyroid disease. About 2.9 men and 16 women/lac/year are newly diagnosed with thyoid disease.
A complete unit of the various diseases involving the orbit and the surrounding structures. It involves the unilateral and bilateral proptosis conditions. Also, the various proptosis etiologies involved in adults and children along with various tumors involving the orbit is also dealt with.
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.
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.
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
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.
- 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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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!
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.
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.
7. ROOF
Orbital plate of frontal bone
Lesser wing of sphenoid
Frontal bone
LATERAL WALL/ strongest wall
Frontal process of zygomatic
orbital surface of greater wing of sphenoid posteriorly
Thickest wall of the orbit
Separated posteriorly by superior orbital fissure ORBIT
8.
9. FLOOR
Orbital plate of maxilla
Zygomatic bone
Orbital process of palatine bone,
It roofs maxillary sinus, Its thin and is
most commonly fractured.
MEDIAL WALL / weakest wall
Orbital plate of ethmoid bone(lamina
papyracia)
lacrimal bone, At the apex – body of
sphenoid, Lacrimal bone contains fossa
for nasolacrimal sac
10. Proptosis
Proptosis refers to
forward protrusion of
the globe with respect
to the orbit. There are
many causes of
proptosis which can be
divided according to
location and it is worth
remembering that it is
not just orbital disease
processes that cause
proptosis
11. Proptosis causes
Remember the main causes of Proptosis using the mnemonic THE-I .
THE I (I~eye)
Tumor (Rhabdomyosarcoma, Retinoblastoma)
Hemorrhage (traumatic posterior orbital hematoma)
Endocrinopathy (Graves’ disease/TED)
Infection (pre septal cellulitis, orbital cellulitis,
Cavernous sinus thrombosis, orbital abscess)
14. ORBITAL SEPTUM
The orbital septum (palpebral
ligament) is a membranous sheet
that acts as the anterior boundary
of the orbit. It extends from the
orbital rims to the eyelids. It forms
the fibrous portion of the eyelids.
16. Pre septal cellulitis
Preseptal cellulitis is an inflammation and infection of the eyelid (also
of the periorbital soft tissues), anterior to orbital septum, characterized
by acute eyelid erythema and edema
It may result from the spread of the upper respiratory tract infections,
external eye infections (Stye), or eyelid trauma (laceration)
Patients with periorbital edema, erythema and increase in local
hyperemia but without proptosis, ophthalmoplegia and visual
impairment
Treatment: Antibiotics, Analdesics, Drainage of abscess
18. Clinical features
Impaired vision or sudden vision loss, RAPD POSITIVE
Pain, restricted ocular movement/ ophthalmoplegia
A red, swollen eyelid, chemosis
Proptosis
Discharge from the infected eye
Fever
Fatigue
Loss of appetite
Headache
19. Causes
The main cause of orbital cellulitis is sinusitis, which is an infection of
the sinuses, up to 86–98 % people with orbital cellulitis also have
sinusitis. Without treatment, sinus infections can spread to the fat and
muscle surrounding the eye socket
Bacteria such as the Staphylococcus aureus and Streptococci species
are the most common
An injury to the eye that penetrates the orbital septum
Complications of eye surgery
20. Indications for imaging
Eyelid edema that makes a complete examination impossible
Presence of CNS involvement (i.e seizures, focal neurologic deficits, or
altered mental status)
Deteriorated visual acuity or color vision
Proptosis
Ophthalmoplegia
Clinical worsening or no improvement after hours
23. Complications of orbital cellulitis
Intracranial extension of infection (i.e subdural empyema,
intracerebral abscess, extradural abscess and meningitis)
Cavernous venous sinus thrombosis
Septic emboli of the optic nerve
Optic nerve ischemia (due to compression) may result in
visual loss
26. Proptosis and
exophthalmos
Exophthalmos also describes forward
protrusion of the globe
Proptosis and exophthalmos are often used
interchangeably
Exophthalmos used to refer to severe (>18
mm) proptosis
Exophthalmos used to refer to endocrine-
related proptosis
Enophthalmos is the opposite,
displacement of the globe posteriorly
31. Pathophysiology
Infiltration of connective
tissue with mononuclear
cells (lymphocytes,
macrophages , plasma
cells)
Activation of CD4+ and
CD8+ T-cells and
integration with B cells,
plasmas cells and
macrophages.
Release of pro-
inflammatory
cytokines.
Accumulation of GAG in
the EOM and fat.
CD34 + fibrocytes
key in the
pathogenesis
Antigen in orbit :
Thyroglobulin
TSHR is found on
thyroid follicles and
orbital fibroblasts
32.
33.
34.
35.
36. Treatment of TED
Quit smoking
Medical Management of Hyperthyroidism• Anti-thyroid drugs :
Thinoamides (PTU), Carbimazole, Methimazole • Need 6-8 weeks to
achieve euthyroid state.
Side effects : Skin rash , urticarial , arthralgia , Fever
Corticosteroids • Intravenous , Oral , Topical
• IV pulse for Moderate to severe TED : 71% respond to IV steroid
• IV steroids for compressive ON
37. Orbital Radiation
• Mechanism : lymphocyte sterilization, destruction of tissue monocytes • 20 Gy in 10 divided
sessions over 2 weeks • More suited for patients > 35 years of age • Contra-indicated in pre-
existing retinopathy (diabetes , hypertensive)
Rituximab (for steroid resistant cases)
• it Targets CD20 • CD20 is expressed on more than 95% of B cells and plasma cells
• RTX depletes 95% of mature B cells , blocks Ab production , and decrease inflammatory
cytokine release
Botulinum Toxin / for proptosis
• Neurotoxin , inhibits acetylcholine release • For upper lid retraction (transconjunctival ,
transcutaneous route) • Effect on Muller’s muscle and LPS
• Side effects of Botox : bruising , ptosis and diplopia
Orbital Decompression for TED
• 2 wall or 3 wall • Decompression usually in stable phase of disease.
Squint surgery: later on/inactive disease
38.
39. Blow out fracture
The term Blow-out fracture
refers specifically to the
fracture of an orbital wall in the
presence of an intact orbital
rim
Mc Kenzie (1844) describe floor
fracture Smith and Converse
(1956) blow out fracture
40.
41. Clinical
features
External sign: Lid edema, subcutaneous or orbital emphysema
Ecchymosis
Subconjunctival hemorrhage
Enophthalmos
Inferior floor fracture; Diplopia due to IR entrapment
Infraorbital nerve hypesthesia (gum, side of nose)
Ocular Motility defects
42.
43. Evaluation
Visual acuity Pupil
intraocular
pressure
Biomicroscopy
and fundus
Check sensation
on
face(infraorbital
Nerve)
Ocular motility
test, Diplopia
chart & visual
fields
Photographs as
documentation
for patients to
appreciate
Force duction
test paretic and
restrictive
motility patterns
Radiology: X ray
, CT scans
44. Treatment of BOF
Conservative approach
Urgent surgical treatment
Early repair Indication
1. Symptomatic persistent diplopia with positive
force ductions.
2. CT evidence of orbital tissue or muscle
entrapment
3. No clinical improvement over 1 -2 weeks
4. Enophthalmos of 3 mm or more, globe ptosis,
floor defect > 50%
45. Conservative/ observation: if minimal diplopia with good motility, no
CT evidence of tissue entrapment, absence enophthalmos or globe
ptosis (give NSAIDs, antibiotics)
Surgical Repair: within 7 -10 days to allow swelling and hemorrhage to
subside , patient advised not to blow nose
Anesthesia: General (GA)
Approach: Transantral or transconjunctival via orbital rim, periosteum
elevated off the orbital floor until the fracture site is identified,
entrapped tissue is freed carefully and elevated from the defect insert
material for floor reconstruction