Osteoarthritis is a chronic joint disorder involving the progressive breakdown of articular cartilage and changes in the underlying bone. It most commonly affects the knees and hips. Risk factors include age, genetics, previous joint injury, and excessive weight. Symptoms include pain, stiffness, swelling, and loss of function. Treatment focuses on reducing pain and inflammation, maintaining joint mobility, managing weight, and modifying activities. Surgery such as joint replacement may be considered if more conservative measures fail to provide adequate relief.
Avascular necrosis is a condition which appears when there is a loss of blood supply to the bone, resulting in bone death. Avascular necrosis is also known as aseptic necrosis, ischemic bone necrosis, or osteonecrosis
Avascular necrosis is a condition which appears when there is a loss of blood supply to the bone, resulting in bone death. Avascular necrosis is also known as aseptic necrosis, ischemic bone necrosis, or osteonecrosis
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
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There is no “gold standard” technique for the surgical stabilization of Acromioclavicular joint (ACJ) disruptions and each of the described techniques has a failure rate. The management of failed ACJ stabilizations is a difficult problem and salvage procedures may often be constrained by the original procedure and the resultant anatomy. Reliable anatomical and biomechanically robust revision procedures for failed ACJ stabilization are therefore required. We describe a technique for revision stabilization of the ACJ that utilises a synthetic ligament in combination with augmentation from the coracoacromial ligament and biceps short head aponeurosis (‘biceps flip’ procedure).
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
There is no “gold standard” technique for the surgical stabilization of Acromioclavicular joint (ACJ) disruptions and each of the described techniques has a failure rate. The management of failed ACJ stabilizations is a difficult problem and salvage procedures may often be constrained by the original procedure and the resultant anatomy. Reliable anatomical and biomechanically robust revision procedures for failed ACJ stabilization are therefore required. We describe a technique for revision stabilization of the ACJ that utilises a synthetic ligament in combination with augmentation from the coracoacromial ligament and biceps short head aponeurosis (‘biceps flip’ procedure).
Arthroscopically assisted latissimus dorsi transfer is a viable option for treatment of patients in their 50s to 70s, without arthritis of the glenohumeral joint, who suffer from massive postero-superior rotator cuff tears that are not amendable to primary repair or that have failed previous repair attempts.
Sternoclavicular joint (SCJ) injuries are uncommon. A minority of patients with anterior dislocation progress to chronic instability associated with pain and a limitation of activities, and thus surgery should be considered. The technique is safe and effective for reconstructing chronic anterior SCJ dislocations. The all anterior approach for reconstruction of the SCJ reduces the risk to the structures posterior to the medial clavicle, manubrium sterni or first rib.
Medial patellofemoral ligament reconstruction ---- an update on techniques used. This lecture was taken by me at Trinity Arthroscopy Course, Chandigarh.
Evolution of tunnel placement in ACL reconstructionDhananjaya Sabat
One of my talks at Delhi Arthroscopy Club....... this presentation provides a insight regarding the conceptual evolution in tunnel placement during ACL reconstruction.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
- 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
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
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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.
2. A chronic joint disorder in which there is
progressive softening and disintegration
of articular cartilage accompanied by new
growth of cartilage and bone at the joint
margins (osteophytes) and capsular
fibrosis
3. OA Classification
Trauma
Primary or Osteonecrosis
idiopathic: MC Inflammatory Arthritis, Pseudogout,
joint knee Ochronosis, Wilson's disease,
Hemochromatosis
Septic arthritis
Secondary: SCFE, DDH, Skeletal dysplasia
Secondary to Ehler Danlos syndrome, Marfan
some preexisting syndrome
abnormality Acromegaly, Hyperparathyroidism
Recurrent hemarthrosis (hemophillia)
Kashin-Beck disease
Neuropathic (Charcot’s)
5. Location- most common joint involved are knee and hip
OA of DIP joint leads to “Herberden's nodes”. It has
genetic predisposition.
Nodes on PIP joints are called" Bouchard's nodes"
6. OA Mechanism
Disparity between:-
stress applied to articular cartilage & strength of articular cartilage
increased load e.g. BW or Weak cartilage
activity age
decreased area e.g. varus stiff e.g. ochronosis
knee or dysplastic hip soft e.g. inflammation
abnormal bony
support e.g. AVN
7. OA Pathology
OA is a gradual process of destruction & regeneration
Early in disease, articular cartilage loses its glistening
appearance
Later on surface layers flake off while deeper layers develop
longitudinal fissures, process termed fibrillation
Cartilage becomes thin and sometimes denuded
CARTILAGE
EROSION
CARTILAGE
ULCERATION
8. Subchondral bone:
Becomes thickened, sclerotic, & polished
(eburnation)
Subchondral bone displays thickened trabeculae and
microfractures
Tidemark is disrupted by vessels from the
subchondral layer
Cysts:
May be seen in subchondral bone
Cysts may arises from increases in intrasynovial
pressure
9. Osteophytes:
Spur like bony outgrowths covered by hyaline cartilage,
may develop at margins of joint & progressively enlarge
Small bits of cartilage-covered bone, known as joint
mice, may actually break off into the joint
13. OA Histology
Articular cartilage: Superficial zone demonstrates
earliest changes; Diminution of chondrocytes.
Cartilage matrix loses its ability to stain for
proteoglycans with alcian blue or safranin-O.
Deeper chondrocytes - proliferation in clusters (brood
capsules)
Capillary buds penetrate the layer of calcified cartilage
Newly formed sements of cartilage push up from
below
Tidemark: Demarcation between calcified and
noncalcified cartilage; Becomes split & reduplicating
tidemark
14. Synovium: becomes hypertrophied
and thrown into villous folds; May see
infiltration with plasma cells, and
lymphocytes; Synovial hypertrophy
may be involved in producing joint
pain by increased synovial fluid
production and increased intra-
articular pressure.
16. FAI Femoroacetabular impingement
hip clearance secondary to poor orientation/depth of
acetabulum shape of head-neck junction
Two types: Cam & Pincer
Precurser to OA hip
Etiology
• Acetabular retroversion
• Protrusio, coxa profunda
• Non-spherical head, Perthes, out of round head
• SCFE
• femoral offset (poor head-neck ratio)
• Retroverted femoral neck post fracture
24. OA Core treatment
Altered activity
Exercise and manual therapy irrespective of age,
comorbidity, pain severity or disability. Exercise should include: local
muscle strengthening, and general aerobic fitness. Manipulation and stretching
should be considered as an adjunct; esp. in OA hip.
Reduction of cartilage impact loading: (typically this is 6 times
body wt)-
Cane (opposite hand)
Rubber heel wedges (consider lateral wedges for medial
compartment arthrosis)
Wt loss: for overweight pts
Braces
Thermotherapy local heat or cold as an adjunct.
Electrotherapy TENS as an adjunct.
25. OA Drug T/T
Paracetamol : 1st line analgesic, upto 1gm/6hrly
Topical NSAID, Topical capsaicin should be
considered as an adjunct
If paracetamol or topical NSAIDs are insufficient for pain
relief for people with osteoarthritis, then the addition of
opioid analgesics should be considered.
No oral NSAID, COX-2 inh. . If reqd., with PPI.
26. Nutraceuticals The use of glucosamine or chondroitin
products is not recommended
Disease modifying drugs (RA): Diacerine
S-Adenosyl Methionine: lack of clinical evidence.
Intra-articular corticosteroid as an adjunct for the
relief of moderate to severe pain. 40mg Triamcinalone
(1ml) with 4ml Lidocaine. Not to be repeated in 3mo.
Intra-articular hyaluronan (Synvisc, Hyalgan) are
used for temporary pain relief, 60-70% pts get benefit
upto 6mo; not recommended as per NICE guidelines.
27. OA Invasive treatment
Knee-
Arthroscopic lavage and Arthrodesis rarely indicated -
debridement in small joints of hand,
HTO (High tibial osteotomy) wrist and ankle.
Joint replacement : Excission arthroplasty is
Unicondylar, Patellofemoral, TKR rarely indicated – 1st CMC
joint.
Hip-
Valgus extension osteotomy
Surface replacement
THR
28. OA Evaluation
Pain EXAMINATION
Gait
Function:
Walking distance Limb alignment
walking aids Range of movement
low chairs Stability
foot care Peripheral circulation
Stairs
Skin condition
Medical
Expectations
29. OA Investigation
X-ray - Alignment
- Deformity
- Previous fractures and implants
- AVN
- Osteophytes
- Bone loss
CT, MRI, bone scan - rarely
30. Arthroscopic debridement
Joint fluid washout
Removal of loose
cartilage
Ostyophytectomy
Synovectomy
Effective in early stage
disease
May be combined with
HTO
31. High tibial osteotomy
Realignment of knee wt bearing axis to transfer load
from medial to lateral compartment
Effective for 5-10yrs
ACL/PCL deficiency can be addressed.
OPEN WEDGE
Indications:
Unicompartmental arthritis
Age <60yrs
Genu varus / valgus
< 15 deg flexion deformity
ROM > 90 deg
No lateral thrust
CLOSED WEDGE
32. Unicompartmental knee
replacement
Indications
Unicompartmental arthritis
Low-demand patients who are older than 60
Weight less than 82 kg
Minimum 90° flexion arc
Flexion contracture of less than 5°
Angular deformity not exceeding 10° of varus or
15° of valgus (both of which should be
correctable to neutral passively after removal of
osteophytes),
Intact anterior cruciate ligament (ACL)
No pain or exposed bone in the patellofemoral or
opposite tibiofemoral compartment.