A woman aged 55 years of diligent work and cooking. He complained fingers of the right hand 1-3 (thumb, forefinger, and middle finger) tingling, especially at night., but when the hand on wiggle will improve. When you tap the middle of the movement of the right hand, there is a pain radiating to the finger 13.
Meralgia Paresthetica (MP) is a condition caused by impingement of the lateral femoral cutaneous nerve, causing numbness and pain along the front of the thigh. It is often caused by entrapment of the nerve under the inguinal ligament. Diagnosis involves history, physical exam including the pelvic compression test, and may include imaging or nerve blocks. Treatment options include removing any underlying causes, medications, physical therapy, injections, or surgery.
The document summarizes the assessment and treatment approaches for complex regional pain syndrome (CRPS). It describes CRPS as an abnormal neurologic processing of pain that causes disproportionate pain to the initial injury. Symptoms may include allodynia, hyperalgia, swelling and abnormal hair/nail growth. Treatment involves a multidisciplinary approach between occupational therapy and physical therapy, focusing on reducing pain and swelling, improving range of motion and function through desensitization and stress loading techniques. While no single protocol works for all patients, early intervention generally leads to quicker improvement. Further research is still needed to determine the most effective CRPS treatments.
This document discusses Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome (RSD/CRPS). It describes the stages and signs/symptoms of RSD/CRPS, including pain, swelling, discoloration, and bone changes. Diagnosis involves assessing these cardinal signs as well as secondary symptoms. Treatments include medications, nerve blocks, exercise therapy, and surgery. RSD/CRPS has several proposed pathophysiological mechanisms but its exact cause is unknown. It can develop after trauma, surgery, or other injuries and often involves an exaggerated regional inflammatory response.
CRPS I (RSD) with pictures. Differential DiagnosisNelson Hendler
This presentation is a summary of several lectures given by the past president of the Reflex Sympathetic Dystrophy of America. The Power Point presents the appropriate way to diagnose CRPS (RSD), and has pictures of CRPS compared to nerve entrapment syndromes, mistakenly diagnosed as CRPS. A list of appropriate medical testing is included, as is an explanation of the pathophysiology. See www.DiagnoseMyPain.com to take a test to clarify the diagnosis.
This document contains multiple choice questions (MCQs) about musculoskeletal disorders, including joint inflammation syndrome, degenerative joint disorders syndrome, skeletal muscle inflammation syndrome, systemic connective tissue inflammation syndrome, and inflammatory periarticular lesions syndrome. It tests knowledge of clinical signs, laboratory tests, and radiological findings associated with these conditions. Sample case studies are also provided to assess diagnosis.
Assessment Of Complex Regional Pain Syndrome Dr Candy Mccabeepicyclops
Lecture given to the North British Pain Association on 16th May 2008 by Dr Candy McCabe. In this talk, Dr McCabe discusses the mechanisms and assessment of patients with complex regional pain syndrome.
Sudeck's osteodystrophy - Dr Bipul BorthakurBipulBorthakur
This document provides an overview of Sudeck's osteodystrophy, also known as complex regional pain syndrome. It defines the condition as chronic regional pain disproportionate to any injury, characterized by sensory, motor, and trophic changes. It classifies the condition and outlines risk factors, pathophysiology, staging according to signs and symptoms, diagnostic criteria including bone scans and response to sympathetic blocks, differential diagnosis, and management approaches including pharmacotherapy, nerve stimulation, nerve blocks, sympathectomy. The prognosis is best if treated within the first 3 months to prevent irreversible changes.
Multiple Sclerosis and Sleep - A Different PerspectiveMS Trust
Neil Stanley is an independent sleep expert with over 37 years of experience in sleep research. He has worked at several research institutions and hospitals and is a member of several sleep societies. Sleep disorders in people with conditions like multiple sclerosis often remain underreported, underdiagnosed, and undertreated. A recent study found that 74% of MS patients studied had sleep disorders. Sleep plays an important role in the immune system, endocrine system, and brain function. Multiple sclerosis can cause or exacerbate existing sleep problems like insomnia, sleep apnea, and restless legs syndrome. Effective treatment of sleep disorders and underlying MS symptoms is important for managing pain, fatigue, mood, and daytime sleepiness in patients.
Meralgia Paresthetica (MP) is a condition caused by impingement of the lateral femoral cutaneous nerve, causing numbness and pain along the front of the thigh. It is often caused by entrapment of the nerve under the inguinal ligament. Diagnosis involves history, physical exam including the pelvic compression test, and may include imaging or nerve blocks. Treatment options include removing any underlying causes, medications, physical therapy, injections, or surgery.
The document summarizes the assessment and treatment approaches for complex regional pain syndrome (CRPS). It describes CRPS as an abnormal neurologic processing of pain that causes disproportionate pain to the initial injury. Symptoms may include allodynia, hyperalgia, swelling and abnormal hair/nail growth. Treatment involves a multidisciplinary approach between occupational therapy and physical therapy, focusing on reducing pain and swelling, improving range of motion and function through desensitization and stress loading techniques. While no single protocol works for all patients, early intervention generally leads to quicker improvement. Further research is still needed to determine the most effective CRPS treatments.
This document discusses Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome (RSD/CRPS). It describes the stages and signs/symptoms of RSD/CRPS, including pain, swelling, discoloration, and bone changes. Diagnosis involves assessing these cardinal signs as well as secondary symptoms. Treatments include medications, nerve blocks, exercise therapy, and surgery. RSD/CRPS has several proposed pathophysiological mechanisms but its exact cause is unknown. It can develop after trauma, surgery, or other injuries and often involves an exaggerated regional inflammatory response.
CRPS I (RSD) with pictures. Differential DiagnosisNelson Hendler
This presentation is a summary of several lectures given by the past president of the Reflex Sympathetic Dystrophy of America. The Power Point presents the appropriate way to diagnose CRPS (RSD), and has pictures of CRPS compared to nerve entrapment syndromes, mistakenly diagnosed as CRPS. A list of appropriate medical testing is included, as is an explanation of the pathophysiology. See www.DiagnoseMyPain.com to take a test to clarify the diagnosis.
This document contains multiple choice questions (MCQs) about musculoskeletal disorders, including joint inflammation syndrome, degenerative joint disorders syndrome, skeletal muscle inflammation syndrome, systemic connective tissue inflammation syndrome, and inflammatory periarticular lesions syndrome. It tests knowledge of clinical signs, laboratory tests, and radiological findings associated with these conditions. Sample case studies are also provided to assess diagnosis.
Assessment Of Complex Regional Pain Syndrome Dr Candy Mccabeepicyclops
Lecture given to the North British Pain Association on 16th May 2008 by Dr Candy McCabe. In this talk, Dr McCabe discusses the mechanisms and assessment of patients with complex regional pain syndrome.
Sudeck's osteodystrophy - Dr Bipul BorthakurBipulBorthakur
This document provides an overview of Sudeck's osteodystrophy, also known as complex regional pain syndrome. It defines the condition as chronic regional pain disproportionate to any injury, characterized by sensory, motor, and trophic changes. It classifies the condition and outlines risk factors, pathophysiology, staging according to signs and symptoms, diagnostic criteria including bone scans and response to sympathetic blocks, differential diagnosis, and management approaches including pharmacotherapy, nerve stimulation, nerve blocks, sympathectomy. The prognosis is best if treated within the first 3 months to prevent irreversible changes.
Multiple Sclerosis and Sleep - A Different PerspectiveMS Trust
Neil Stanley is an independent sleep expert with over 37 years of experience in sleep research. He has worked at several research institutions and hospitals and is a member of several sleep societies. Sleep disorders in people with conditions like multiple sclerosis often remain underreported, underdiagnosed, and undertreated. A recent study found that 74% of MS patients studied had sleep disorders. Sleep plays an important role in the immune system, endocrine system, and brain function. Multiple sclerosis can cause or exacerbate existing sleep problems like insomnia, sleep apnea, and restless legs syndrome. Effective treatment of sleep disorders and underlying MS symptoms is important for managing pain, fatigue, mood, and daytime sleepiness in patients.
Reflex Sympathetic Dystrophy (RSD), now known as Complex Regional Pain Syndrome (CRPS), is a chronic pain condition that usually affects an extremity like an arm or leg following an injury. It causes ongoing pain that is out of proportion to the original injury and involves changes in skin, bone, and blood vessels in the affected area. CRPS is classified into two types depending on whether there is confirmed nerve damage present. Treatment involves a multidisciplinary approach including medications, physical therapy, sympathetic nerve blocks, and in severe cases, surgical sympathectomy to relieve pain.
Pain and Neuralgia After Hernia Surgery: Can It Be Avoided? And How Do We Tre...George S. Ferzli
This document discusses risk factors for chronic groin pain after hernia surgery and methods for treating post-surgical neuralgia. It identifies several risk factors including age, pre-operative pain, BMI, postoperative complications, recurrent hernias, day case surgery, and open versus laparoscopic technique. Treatment methods explored include identifying and protecting nerves during surgery, avoiding mesh where possible, and non-surgical approaches like neurolysis, medications, and physical therapy.
Objective: Tennis elbow is an inflammatory condition of the common extensor origin over the lateral epicondyle. This condition does not affect tennis players only. It often follows an injury or sudden contraction of the common extensor origin.There is many treatments and approaches towards Tennis elbow but physiotherapy is the best modern conservative treatment. The aim of this study is to evaluate the effectiveness of movement with mobilization in reducing pain and increasing strength in patients with chronic lateral epicondylitis. Design and setting: A randomized controlled study design was used to examine the differences between conventional physical therapy and physical therapy with manual mobilization approach for study duration of 15 days. Subjects: Twelve subjects of both male and female gender were divided into 2 groups. Experimental group treated with ultrasound therapy, mobilization and progressive resisted exercises. Control group treated with ultrasound therapy and progressive resisted exercises only the results were analyzed. The procedure was done in Physiotherapy Department at Masterskill college of Nursing and health. Outcome Measurement: Two outcome measures were used. NPRS for the measurement of severity of pain and various weighted sand bags (0.25 kg to 2kg) were used to measure the strength. Results: The data shows a significant difference in the post test values of pain and strength between experimental group and control group. Experimental group shows much decrease in pain and increase in strength than the control group. Conclusion: The study concludes that the manual mobilization with movement along with ultrasound therapy and progressive resisted exercises is effective in reducing pain and increasing strength than that of progressive resisted exercise along with ultra sound therapy in adults with chronic lateral epicondylitis.
Sue Barnes - Pain management and Multiple SclerosisMS Trust
This document provides an overview of pain management for patients with multiple sclerosis (MS). It defines different types of pain commonly experienced by MS patients, such as Lhermitte's sign and central neuropathic dysaesthesia. Neuropathic pain is discussed in more detail, including its pathophysiology and diagnosis. Common neuropathic pain medications for MS are presented, including amitriptyline, gabapentin, pregabalin, and opioids. National guidelines for treating neuropathic pain in MS are summarized. Specialist referral is recommended for complex pain or when first-line treatments are ineffective.
Detail case discussion of dupuytren's contracture including clinical aspect and theoretical aspects.
Dupuytren's is progressive superficial palmar fibromatosis, involves superficial palmar fascia of hand and causes contracture and severe disability in advance disease.
Case discussion done under Platiquest channel.
This document discusses pain management in rheumatic diseases. It begins with a pain classification grid that categorizes different types of pain based on factors like duration and underlying pathology. Next, it reviews non-pharmacologic and pharmacologic treatment options for managing rheumatic pain, including education, exercise, analgesics, anti-inflammatory drugs and injections. It then focuses on osteoarthritis (OA) and rheumatoid arthritis (RA), discussing their prevalence, diagnostic criteria, management goals, and differences between the two conditions. Finally, it reviews the risks and benefits of NSAIDs and COX-2 inhibitors for pain relief in OA and RA patients.
IN CONCLUSION:
CRPS is a chronic debilitating painful condition
There has been significant advances in our understanding of its Pathophysiology
Early diagnosis and management – is essential to help patients and reduce suffering
The Budapest Criteria should help while excluding others
A Multidisciplinary Approach to Management has been shown to be beneficial
With particular emphasis on Patient Education and Support
A brief summary about Complex Regional Pain Syndrome( Def, Aetiology, Pathophysiolog, Diagnosis and Treatment options.
If you like it, most welcome to share it
Dr. Arohi Sharma's document summarizes the clinical presentation and assessment of ankylosing spondylitis (AS). Some key points:
- AS most commonly affects those from early 20s to 40s and is more common in males. Symptoms include chronic back pain improved by exercise.
- Late stage AS can involve fractures from minor trauma or lesions. Extra-spinal manifestations may include peripheral joint involvement, eye/lung/heart issues, or neurological problems.
- Clinical assessments for AS include range of motion tests, chest expansion measurements, and sacroiliac imaging. Definite AS requires radiologic sacroiliitis plus one clinical criterion.
- Disease activity and functional
This document discusses carpal tunnel syndrome, which is caused by compression of the median nerve as it passes through the carpal tunnel of the wrist. It can cause numbness, tingling, and weakness in the hand. The presentation outlines the causes, clinical features, diagnosis, and treatment options for carpal tunnel syndrome, which include wrist splints, oral anti-inflammatory medications, local steroid injections, and carpal tunnel release surgery if conservative measures fail. The document provides details on physical exam findings and special tests like Tinel's and Phalen's maneuvers used to diagnose carpal tunnel syndrome.
The document discusses several common rheumatological disorders seen in orthopedic departments, including osteoarthritis, gouty arthritis, calcium pyrophosphate deposition disease, and rheumatoid arthritis. It provides details on the prevalence, clinical features, imaging findings, classifications, and treatment approaches for each condition.
The seminar covered Ankylosing Spondylitis (AS), a chronic inflammatory disease affecting the spine and sacroiliac joints. The objectives were to introduce AS, identify risk factors like gender and genetics, describe the pathophysiology involving inflammation of joints and entheses, and review clinical manifestations like back pain and stiffness. Treatment aims to reduce pain, maintain mobility, and prevent deformity using medications, exercises, bracing and surgery. Nursing care focuses on pain management, improving breathing and mobility, preventing fatigue and deformity, and providing psychological support.
This document discusses complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy. It defines CRPS as a multi-symptom syndrome that usually affects one or more extremities and is characterized by disproportionate pain, vasomotor instability, trophic skin changes, and regional osteoporosis. Trauma is a common precipitating factor. Management involves a multidisciplinary approach including physical therapy, medications to relieve symptoms, and in some cases surgical or injection-based treatments.
This document summarizes information about fibromyalgia syndrome (FMS), including its classification, symptoms, pathogenesis, diagnosis, and treatment. FMS is characterized by widespread pain, joint stiffness, and other symptoms like fatigue, sleep issues, and mood disorders. It affects 2-8% of the population. The cause is unclear but may involve central and peripheral nervous system sensitization. Diagnosis involves evaluating symptoms and tender points while ruling out other conditions. Treatments aim to reduce pain and improve sleep, mood, and function, and may include medications like duloxetine, milnacipran, and gabapentin.
This document defines complex regional pain syndrome (CRPS) and discusses its epidemiology, types, pathophysiology, stages, diagnostic criteria, investigations, differential diagnosis, and treatment. CRPS is a chronic pain condition that usually affects limbs and is characterized by persistent severe pain, changes in skin color and temperature, and impaired motor function. It is classified into two types and progresses through three stages. The exact mechanisms are unknown but involve both peripheral and central sensitization. Diagnosis is based on clinical criteria and treatment requires a multidisciplinary approach including pharmacotherapy, physical therapy, interventions like sympathetic blocks, and in some cases spinal cord stimulation.
Percutaneous Fasciotomy in the management of Dupuytren"s contracture. Although PCF is associated with chances of recurrence but when done properly it gives excellent results with less number of complications.
Ankylosing spondylitis is a type of spondyloarthropathy that causes inflammation in the spine. It is characterized by low back pain that improves with exercise but not rest, limited spinal mobility, and decreased chest expansion. Physical therapy management of ankylosing spondylitis focuses on education, pain management, maintaining spinal mobility and chest expansion, general health, and activities of daily living modifications. Treatment includes hydrotherapy, TENS, exercises like stretching and aerobic exercise, manual therapy, and lifestyle modifications.
This document discusses Sudeck's osteodystrophy, also known as complex regional pain syndrome (CRPS). It defines CRPS as a chronic progressive disease characterized by disproportionate regional pain and abnormalities in sensory, motor, and autonomic nervous system function. It describes three stages of CRPS based on dystrophic and atrophic changes. Treatment involves prevention, non-operative approaches like physical therapy, nerve stimulation, nerve blockade, and in some cases surgical sympathectomy. The goal is to reduce pain and limit progression of the chronic condition.
Este documento describe el medio ambiente de la región de Pitalito en el sur del Alto Magdalena de Colombia, incluyendo la ubicación, el clima y los paisajes. La región se encuentra entre los 1,200 y 1,500 metros sobre el nivel del mar y tiene un clima templado con temperaturas entre 17°C y 23°C. El paisaje incluye zonas montañosas, terrazas planas, valles y vegas recientes formadas por la acción de los ríos en la región.
Este documento presenta diferentes tipos de preguntas relacionadas con la cultura precolombina en Colombia. Incluye preguntas de selección múltiple con única respuesta, preguntas de análisis de relación entre afirmaciones y razones, y preguntas abiertas sobre aspectos administrativos, económicos y culturales de la época precolombina. El documento provee instrucciones para responder cada tipo de pregunta.
Reflex Sympathetic Dystrophy (RSD), now known as Complex Regional Pain Syndrome (CRPS), is a chronic pain condition that usually affects an extremity like an arm or leg following an injury. It causes ongoing pain that is out of proportion to the original injury and involves changes in skin, bone, and blood vessels in the affected area. CRPS is classified into two types depending on whether there is confirmed nerve damage present. Treatment involves a multidisciplinary approach including medications, physical therapy, sympathetic nerve blocks, and in severe cases, surgical sympathectomy to relieve pain.
Pain and Neuralgia After Hernia Surgery: Can It Be Avoided? And How Do We Tre...George S. Ferzli
This document discusses risk factors for chronic groin pain after hernia surgery and methods for treating post-surgical neuralgia. It identifies several risk factors including age, pre-operative pain, BMI, postoperative complications, recurrent hernias, day case surgery, and open versus laparoscopic technique. Treatment methods explored include identifying and protecting nerves during surgery, avoiding mesh where possible, and non-surgical approaches like neurolysis, medications, and physical therapy.
Objective: Tennis elbow is an inflammatory condition of the common extensor origin over the lateral epicondyle. This condition does not affect tennis players only. It often follows an injury or sudden contraction of the common extensor origin.There is many treatments and approaches towards Tennis elbow but physiotherapy is the best modern conservative treatment. The aim of this study is to evaluate the effectiveness of movement with mobilization in reducing pain and increasing strength in patients with chronic lateral epicondylitis. Design and setting: A randomized controlled study design was used to examine the differences between conventional physical therapy and physical therapy with manual mobilization approach for study duration of 15 days. Subjects: Twelve subjects of both male and female gender were divided into 2 groups. Experimental group treated with ultrasound therapy, mobilization and progressive resisted exercises. Control group treated with ultrasound therapy and progressive resisted exercises only the results were analyzed. The procedure was done in Physiotherapy Department at Masterskill college of Nursing and health. Outcome Measurement: Two outcome measures were used. NPRS for the measurement of severity of pain and various weighted sand bags (0.25 kg to 2kg) were used to measure the strength. Results: The data shows a significant difference in the post test values of pain and strength between experimental group and control group. Experimental group shows much decrease in pain and increase in strength than the control group. Conclusion: The study concludes that the manual mobilization with movement along with ultrasound therapy and progressive resisted exercises is effective in reducing pain and increasing strength than that of progressive resisted exercise along with ultra sound therapy in adults with chronic lateral epicondylitis.
Sue Barnes - Pain management and Multiple SclerosisMS Trust
This document provides an overview of pain management for patients with multiple sclerosis (MS). It defines different types of pain commonly experienced by MS patients, such as Lhermitte's sign and central neuropathic dysaesthesia. Neuropathic pain is discussed in more detail, including its pathophysiology and diagnosis. Common neuropathic pain medications for MS are presented, including amitriptyline, gabapentin, pregabalin, and opioids. National guidelines for treating neuropathic pain in MS are summarized. Specialist referral is recommended for complex pain or when first-line treatments are ineffective.
Detail case discussion of dupuytren's contracture including clinical aspect and theoretical aspects.
Dupuytren's is progressive superficial palmar fibromatosis, involves superficial palmar fascia of hand and causes contracture and severe disability in advance disease.
Case discussion done under Platiquest channel.
This document discusses pain management in rheumatic diseases. It begins with a pain classification grid that categorizes different types of pain based on factors like duration and underlying pathology. Next, it reviews non-pharmacologic and pharmacologic treatment options for managing rheumatic pain, including education, exercise, analgesics, anti-inflammatory drugs and injections. It then focuses on osteoarthritis (OA) and rheumatoid arthritis (RA), discussing their prevalence, diagnostic criteria, management goals, and differences between the two conditions. Finally, it reviews the risks and benefits of NSAIDs and COX-2 inhibitors for pain relief in OA and RA patients.
IN CONCLUSION:
CRPS is a chronic debilitating painful condition
There has been significant advances in our understanding of its Pathophysiology
Early diagnosis and management – is essential to help patients and reduce suffering
The Budapest Criteria should help while excluding others
A Multidisciplinary Approach to Management has been shown to be beneficial
With particular emphasis on Patient Education and Support
A brief summary about Complex Regional Pain Syndrome( Def, Aetiology, Pathophysiolog, Diagnosis and Treatment options.
If you like it, most welcome to share it
Dr. Arohi Sharma's document summarizes the clinical presentation and assessment of ankylosing spondylitis (AS). Some key points:
- AS most commonly affects those from early 20s to 40s and is more common in males. Symptoms include chronic back pain improved by exercise.
- Late stage AS can involve fractures from minor trauma or lesions. Extra-spinal manifestations may include peripheral joint involvement, eye/lung/heart issues, or neurological problems.
- Clinical assessments for AS include range of motion tests, chest expansion measurements, and sacroiliac imaging. Definite AS requires radiologic sacroiliitis plus one clinical criterion.
- Disease activity and functional
This document discusses carpal tunnel syndrome, which is caused by compression of the median nerve as it passes through the carpal tunnel of the wrist. It can cause numbness, tingling, and weakness in the hand. The presentation outlines the causes, clinical features, diagnosis, and treatment options for carpal tunnel syndrome, which include wrist splints, oral anti-inflammatory medications, local steroid injections, and carpal tunnel release surgery if conservative measures fail. The document provides details on physical exam findings and special tests like Tinel's and Phalen's maneuvers used to diagnose carpal tunnel syndrome.
The document discusses several common rheumatological disorders seen in orthopedic departments, including osteoarthritis, gouty arthritis, calcium pyrophosphate deposition disease, and rheumatoid arthritis. It provides details on the prevalence, clinical features, imaging findings, classifications, and treatment approaches for each condition.
The seminar covered Ankylosing Spondylitis (AS), a chronic inflammatory disease affecting the spine and sacroiliac joints. The objectives were to introduce AS, identify risk factors like gender and genetics, describe the pathophysiology involving inflammation of joints and entheses, and review clinical manifestations like back pain and stiffness. Treatment aims to reduce pain, maintain mobility, and prevent deformity using medications, exercises, bracing and surgery. Nursing care focuses on pain management, improving breathing and mobility, preventing fatigue and deformity, and providing psychological support.
This document discusses complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy. It defines CRPS as a multi-symptom syndrome that usually affects one or more extremities and is characterized by disproportionate pain, vasomotor instability, trophic skin changes, and regional osteoporosis. Trauma is a common precipitating factor. Management involves a multidisciplinary approach including physical therapy, medications to relieve symptoms, and in some cases surgical or injection-based treatments.
This document summarizes information about fibromyalgia syndrome (FMS), including its classification, symptoms, pathogenesis, diagnosis, and treatment. FMS is characterized by widespread pain, joint stiffness, and other symptoms like fatigue, sleep issues, and mood disorders. It affects 2-8% of the population. The cause is unclear but may involve central and peripheral nervous system sensitization. Diagnosis involves evaluating symptoms and tender points while ruling out other conditions. Treatments aim to reduce pain and improve sleep, mood, and function, and may include medications like duloxetine, milnacipran, and gabapentin.
This document defines complex regional pain syndrome (CRPS) and discusses its epidemiology, types, pathophysiology, stages, diagnostic criteria, investigations, differential diagnosis, and treatment. CRPS is a chronic pain condition that usually affects limbs and is characterized by persistent severe pain, changes in skin color and temperature, and impaired motor function. It is classified into two types and progresses through three stages. The exact mechanisms are unknown but involve both peripheral and central sensitization. Diagnosis is based on clinical criteria and treatment requires a multidisciplinary approach including pharmacotherapy, physical therapy, interventions like sympathetic blocks, and in some cases spinal cord stimulation.
Percutaneous Fasciotomy in the management of Dupuytren"s contracture. Although PCF is associated with chances of recurrence but when done properly it gives excellent results with less number of complications.
Ankylosing spondylitis is a type of spondyloarthropathy that causes inflammation in the spine. It is characterized by low back pain that improves with exercise but not rest, limited spinal mobility, and decreased chest expansion. Physical therapy management of ankylosing spondylitis focuses on education, pain management, maintaining spinal mobility and chest expansion, general health, and activities of daily living modifications. Treatment includes hydrotherapy, TENS, exercises like stretching and aerobic exercise, manual therapy, and lifestyle modifications.
This document discusses Sudeck's osteodystrophy, also known as complex regional pain syndrome (CRPS). It defines CRPS as a chronic progressive disease characterized by disproportionate regional pain and abnormalities in sensory, motor, and autonomic nervous system function. It describes three stages of CRPS based on dystrophic and atrophic changes. Treatment involves prevention, non-operative approaches like physical therapy, nerve stimulation, nerve blockade, and in some cases surgical sympathectomy. The goal is to reduce pain and limit progression of the chronic condition.
Este documento describe el medio ambiente de la región de Pitalito en el sur del Alto Magdalena de Colombia, incluyendo la ubicación, el clima y los paisajes. La región se encuentra entre los 1,200 y 1,500 metros sobre el nivel del mar y tiene un clima templado con temperaturas entre 17°C y 23°C. El paisaje incluye zonas montañosas, terrazas planas, valles y vegas recientes formadas por la acción de los ríos en la región.
Este documento presenta diferentes tipos de preguntas relacionadas con la cultura precolombina en Colombia. Incluye preguntas de selección múltiple con única respuesta, preguntas de análisis de relación entre afirmaciones y razones, y preguntas abiertas sobre aspectos administrativos, económicos y culturales de la época precolombina. El documento provee instrucciones para responder cada tipo de pregunta.
Donde encontraras todo lo relacionado con la belleza, trucos de maquillaje y consejos sobre cuidados naturales para tus ojos, pies, manos. Escoge una categoria para ver todos los trucos de belleza relacionados
La diabetes gestacional afecta aproximadamente al 3% de los embarazos y puede causar complicaciones para la madre y el feto si no se controla adecuadamente. El objetivo del tratamiento es lograr la normoglucemia a través de dieta, ejercicio e insulina si es necesario, para prevenir problemas como macrosomía fetal, hipoglucemia neonatal y complicaciones obstétricas. Un diagnóstico y manejo temprano pueden reducir significativamente los riesgos asociados con la diabetes gestacional.
El documento presenta información sobre infecciones urinarias. Se divide en infecciones de las vías urinarias superiores e inferiores. Detalla signos como piuria, hematuria y bacteriuria, así como los microorganismos más comunes como Escherichia coli. También describe el análisis de orina e incluye técnicas de recolección de muestras de orina.
El documento habla sobre el cambio climático, sus causas y consecuencias, y formas en que los individuos y gobiernos pueden actuar para detenerlo. Explica brevemente qué es el cambio climático y qué lo produce antes de describir las consecuencias negativas que tendrá en el mundo si no se toman medidas. Alienta a los lectores a tomar acción a nivel individual y de gobierno para prevenir sus efectos.
Donde encontraras todo lo relacionado con la belleza, trucos de maquillaje y consejos sobre cuidados naturales para tus ojos, pies, manos. Escoge una categoria para ver todos los trucos de belleza relacionados
Tiffany & Co is a luxury brand founded in 1837 in New York City known for its fine jewelry, distinctive Tiffany Blue packaging, and strong heritage. It has achieved global recognition through its iconic Tiffany Diamond engagement rings, successful trademarking of Tiffany Blue, and by crafting trophies and medals for prestigious events like the Super Bowl and US Open. Though Tiffany began with stationery and silverware, it became renowned for diamonds and gemstones, cementing its image as the world's premier jeweler through celebrity endorsements and iconic associations with films like Breakfast at Tiffany's. Today Tiffany operates over 300 stores worldwide and continues to defend its brand against counterfeiting while emphasizing sustainability through responsible
Tecnologías de la información y la comunicación.agonzalez_c
Este documento describe las tecnologías de la información y la comunicación (TIC) y su aplicación en la educación. Define las TIC como herramientas computacionales e informáticas que procesan y presentan información de varias formas. Explica que las TIC han revolucionado la educación y han reemplazado en parte a los textos impresos. También describe el rol del docente como facilitador del aprendizaje, diseñador de materiales y asesor, y analiza tanto las ventajas como los desafíos que presentan las TIC en el aula
En el 2013, nuestros servicios se han enfocado en atender a las necesidades de nuestros clientes. Los invitamos a darnos la oportunidad de conocernos.
Más información: contacto@fitnessnutrititionagency.com.mx
El documento discute los orígenes y funciones de la lectoescritura, así como los diagnósticos y tratamientos para las dificultades relacionadas con la lectura y la escritura. Explica cómo la lectura y la escritura permiten comunicarnos y compartir información, pero que algunas personas experimentan desafíos que requieren evaluación y apoyo.
This document discusses carpal tunnel syndrome, including:
1. It provides an overview of carpal tunnel syndrome, defining it as pressure on the median nerve in the wrist that causes numbness, tingling, weakness, or muscle damage in the hand and fingers.
2. Risk factors include repetitive wrist motions, obesity, arthritis, and diabetes. Symptoms include numbness, tingling, and pain that is worse at night. Diagnosis involves physical exams and nerve conduction tests.
3. Treatment begins with splinting, medications, injections, and physical therapy. Surgery to cut the transverse carpal ligament may be considered if more conservative treatments fail.
The document discusses various chronic pain syndromes including low back pain, sciatica, complex regional pain syndrome, trigeminal neuralgia, and cancer pain. It provides details on the definition, causes, symptoms, diagnostic tools and treatment options for low back pain and sciatica, which are the most commonly discussed chronic pain conditions. The treatment sections cover medications, physical therapy, injections including epidural steroid injections, radiofrequency ablation, and other minimally invasive procedures.
This document provides information about carpal tunnel syndrome, including its definition, epidemiology, risk factors, clinical features, diagnosis, differential diagnosis, and treatment. Carpal tunnel syndrome is caused by compression of the median nerve in the carpal tunnel of the wrist. It commonly causes pain, numbness, and tingling in the hand and fingers. Diagnosis involves tests like Phalen's sign and nerve conduction studies. Conservative treatments include splinting and steroid injections. Surgery to release the transverse carpal ligament is considered if conservative measures fail to provide relief of symptoms.
Shoulder Impingement Diagnosis And Rehabilitatzagstdc
Rotator cuff impingement is a common cause of shoulder pain that occurs when the tendons of the rotator cuff are pinched between the acromion and humeral head, usually due to repetitive overhead motions. It has three stages ranging from inflammation to full tearing of the rotator cuff. Diagnosis involves physical exams like the Neer's impingement test and Hawkins-Kennedy test to identify painful arcs of motion. Treatment follows a progression from nonsurgical options like NSAIDs, physical therapy, and chiropractic adjustments to surgery if more conservative options fail. Chiropractic care uses a multimodal approach including manual therapy, exercise, and soft tissue work tailored to each patient.
This document provides information on several topics related to using acupuncture to treat medical conditions. It discusses how acupuncture can be used to treat carpal tunnel syndrome, peripheral neuropathy, Bell's palsy, restless leg syndrome, and improve brain function. For each condition, it describes symptoms and the perspective of acupuncture for treating the imbalance or obstruction causing the condition.
Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints, causing back pain and stiffness. It is strongly associated with the HLA-B27 gene and results from an autoimmune reaction. Symptoms typically begin in young adults and include inflammatory back pain and limited spinal mobility. Diagnosis is based on clinical features and x-rays showing sacroiliac joint erosion and fusion. Treatment involves physical therapy, NSAIDs, DMARDs, and anti-TNF drugs, which can significantly improve symptoms and physical function.
This document provides information on ankylosing spondylitis (AS), including its etiology, pathogenesis, pathology, symptoms, tests, treatment, and physiotherapy management. AS is an inflammatory arthritis that primarily affects the axial skeleton. It has unknown cause but is associated with the genetic marker HLA-B27 in most cases. Symptoms begin with pain in the sacroiliac region and lower back and can progress to fusion of the vertebrae. Treatments include medications like NSAIDs and TNF inhibitors, as well as regular physiotherapy focusing on exercises, hydrotherapy, electrotherapy, and education to maintain mobility and function.
This document presents a case report of a 53-year-old female who sustained a traumatic brachial plexus injury after falling down a flight of stairs. On examination, she had sensory and motor deficits in her right upper limb consistent with an infraclavicular brachial plexus palsy. She underwent conservative therapy including physiotherapy and splinting. Over an 18-month period, her function gradually improved but she was left with some residual weakness. The document discusses the anatomy of the brachial plexus, mechanisms of injury, clinical examination findings, and prognosis factors for peripheral nerve injuries.
Carpal Tunnel Syndrome is caused by compression of the median nerve in the wrist, often due to repetitive wrist motions. It causes numbness, tingling, and pain in the hand and fingers. Treatment options include splinting, medications, injections, and surgery. While most patients' symptoms improve with treatment, complete recovery can take up to a year, and carpal tunnel syndrome may occasionally recur, requiring additional surgery. Studies have found nonsurgical treatments including exercises can successfully treat around 67% of mild to moderate cases without surgery.
This document discusses various types of peripheral neuropathies, including symptoms, causes, diagnosis, and treatment. It focuses on specific entrapment neuropathies such as carpal tunnel syndrome, cubital tunnel syndrome affecting the ulnar nerve, and compression of the lateral femoral cutaneous nerve. Carpal tunnel syndrome results from median nerve compression in the wrist. Symptoms include numbness and tingling in the hand relieved by shaking. Treatment may involve bracing, steroid injections, or surgery.
Interventional spine & pain management dr manish rajManish Raj
This document provides an overview of chronic pain and interventional pain management techniques. It defines chronic pain as pain that lasts more than 3 months and outlines its prevalence and impact, noting it affects more Americans than diabetes, heart disease, and cancer combined. Interventional pain management aims to decrease or eliminate pain through minimally invasive techniques like injections, radiofrequency ablation, and spinal cord or peripheral nerve stimulation. The document reviews common causes of back pain and neck pain, as well as conditions treated by interventional techniques. It also discusses evidence-based guidelines for interventional pain management and the multidisciplinary approach needed for successful chronic pain treatment.
This document discusses finger clubbing, the Glasgow Coma Scale (GCS), and muscle power grading. It provides details on:
1) The anatomy, causes, clinical presentation, and grading of finger clubbing. Clubbing can be idiopathic or secondary to underlying conditions like lung and heart diseases.
2) The GCS, a neurological scale used to assess consciousness on a 3-15 scale. Scores indicate severity of brain injury and can be influenced by baseline status, sedation, and injury.
3) Muscle grading using the Oxford Scale from 0-5, to assess strength, power, and endurance of muscles like the shoulders, elbows, and hips. Grading
This patient, a middle aged woman, presents with symptoms of carpal tunnel syndrome in her left hand. On examination, the assistant notes wasting of the thenar eminence and weakness of thumb abduction on the left side. Tinel's sign and Phalen's test are also positive on the left. The assistant diagnoses left median nerve palsy due to carpal tunnel syndrome. No underlying causes such as arthritis or endocrine disorders are observed. The assistant wishes to examine for cervical radiculopathy before confirming the diagnosis with nerve conduction studies.
Anaesthesia is a state of temporary induced loss of sensation or awareness that enables painless medical procedures. There are three main types: general, local, and regional. Local anaesthesia involves injection of anaesthetic drugs to numb a specific body area. It has advantages over general anaesthesia like avoiding its risks while allowing consciousness. Proper assessment, consent, and preparation of the patient as well as selection of safe anaesthetic drugs and techniques are important for successful local anaesthesia with minimal complications.
1. The document summarizes common hand ailments that ceramicists may experience such as tendonitis, neuropathy, and arthritis which can result from repetitive motions.
2. Specific conditions discussed include carpal tunnel syndrome, trigger finger, and arthritis at the base of the thumb.
3. The presentation emphasizes prevention through stretches and breaks, and explores treatment options ranging from conservative measures to surgery.
Carpal tunnel syndrome is caused by compression of the median nerve in the wrist, resulting in pain and numbness in the hand and fingers. Risk factors include repetitive wrist motions, diabetes, and being female. Chiropractic care aims to address spinal misalignments that can contribute to nerve compression by putting stress on nerves running from the neck down the arm. Adjustments may help relieve symptoms by improving nerve flow.
1) Entrapment neuropathies occur when nerves are injured by chronic compression, angulations, or stretching forces, causing mechanical damage. Carpal tunnel syndrome is an example where the median nerve is compressed as it passes through the wrist.
2) Clinical features of entrapment neuropathies include pain, numbness, tingling, burning, and weakness in the affected area. Electrodiagnostic tests like nerve conduction studies and electromyography are important diagnostically.
3) Treatment involves conservative measures like splinting, steroid injections, and physical therapy. Surgery is considered if conservative treatment fails or for severe cases. Proper identification of the site of nerve entrapment is key to determining appropriate treatment
This document provides information about Achilles tendinopathy, including:
- It is a common overuse injury among athletes and the general public.
- It can be classified based on its location as insertional, non-insertional, or proximal tendinopathy.
- Risk factors include excessive loading, tight calf muscles, foot abnormalities, and medical issues.
- Diagnosis involves physical exams like the Arc sign and imaging like ultrasound or MRI.
- Treatment begins with rest, bracing, eccentric exercises, and other conservative methods, with surgery reserved for severe cases.
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. Symptoms include numbness, tingling, and pain in the thumb, index, and middle fingers. It is often caused by repetitive hand motions or improper wrist positioning. Treatment options range from wrist splints and anti-inflammatory medications to corticosteroid injections and carpal tunnel release surgery. Preventive measures include proper ergonomics, stretching, and taking breaks from repetitive tasks.
Similar to PBL modul nyeri ektremitas Blok Muskuloskeletal (20)
Dokumen tersebut membahas tentang imunisasi sebagai hak anak dan upaya pencegahan penyakit yang penting. Imunisasi merupakan cara terjangkau untuk mencegah penyakit berbahaya seperti pneumonia dan kanker leher rahim melalui vaksinasi HPV pada anak dan remaja sebelum mereka memiliki hubungan seksual.
Jurnal Generalized anxiety disorder, depressive symptoms and sleep quality du...Rindang Abas
China has been severely affected by COVID-19 (Corona Virus Disease 2019) since December, 2019. This study aimed to assess the population mental health burden during the epidemic, and to explore the potential influence factors
Our study identified a major mental health burden of the public during 38 COVID-19 epidemic in China. Young people, people who spent too much time on the epidemic, and healthcare workers were at high risk for mental illness. Continuous surveillance and monitoring of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.
Telaah jurnal Prevalence of hypochondriac symptoms among health science stude...Rindang Abas
Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance.
Jurnal insomnia among medical and paramedical students in jordanRindang Abas
Insomnia is a problem that is common in all societies and age groups. However, its importance is increasing between students especially with the highly competitive and demanding environment surrounding them even after their graduation. In spite of the deep understanding of its health and social consequences, the frequency of insomnia among medical students in Jordan was not determined.
Pasien perempuan berusia 52 tahun dirujuk ke rumah sakit dengan keluhan bibir mencong ke kanan dan mata kiri tidak bisa tertutup rapat. Pemeriksaan menemukan gangguan pada saraf wajah (Nervus Facialis) sebelah kiri. Diagnosisnya adalah parese nervus facialis tipe perifer sehingga didiagnosis menderita Bell's palsy. Pengobatan yang diberikan antara lain prednison dan antivirus.
- Hipokondriasis merupakan salah satu dari enam gangguan somatoform yang dikategorikan dalam PPDGJ-III dan DSM-IV-R. Hipokondriasis ditandai dengan preokupasi seseorang mengenai rasa takut menderita penyakit berat atau keyakinan memiliki penyakit berat.
- Hipokondriasis dapat diobati dengan beberapa terapi seperti psikoterapi kelompok, pemeriksaan fisik rutin, farmakoterapi seperti SS
ASI EKSKLUSIF DAN INISIASI MENYUSUI DINIRindang Abas
Yang terpenting bagi seorang bayi adalah mendapatkan kebutuhannya sesegera mungkin. Dengan Inisiasi menyusui dini akan membentuk ikatan antara ibu dan anak serta bayi akan mendapatkan manfaat dari air susu ibu yang pertama keluar. Colostrum yang terkandung dalam ASI yang pertama keluar begitu penting untuk pertumbuhan dan perkembangan bayi.
Panel modul mep (tumbang) skenario 1 kel.6Rindang Abas
Panel Modul Malnutrisi Energi dan Protein" oleh Kelompok Fakultas Kedokteran Universitas Muslim Indonesia tahun 2018 membahas kasus seorang anak perempuan berusia 1 tahun 2 bulan dengan keluhan berak encer selama sebulan. Anak diberi ASI hingga 2 bulan kemudian diberi susu kental manis dan makan secara sembarangan. Pemeriksaan menemukan anak pucat dengan berat badan rendah dan gejala malnutrisi. Modul ini men
A young adult woman was escorted by the investigator to a forensic installation for examination. Based on patient information, she was forced to have sex with her husband about a few hours ago. This incident has occurred several times during the two years of their marriage age. According to the patient, their marriage relationship is less harmonious and there is often mouth argument. In addition, the patient admitted to being often beaten by her husband in a state of anger. The first patient to report to the police because they can not stand it.
Osteoartritis (OA) adalah gangguan yang ditandai dengan kerusakan sendi yang progresif dimana semua struktur sendi telah mengalami perubahan patologis. (Fauci, 2009)
Osteoarthritis merupakan kelainan sendi noninflamasi yang mengenai sendi-sendi penumpu berat badan dengan gambaran patologis yang berupa memburuknya tulang rawan sendi (Dharmawirya, 2000).
Gout adalah suatu penyakit yang ditandai dengan serangan mendadak dan berulang dari artritis yang terasa sangat nyeri karena adanya endapan kristal monosodium urat, yang terkumpul di dalam sendi sebagai akibat dari tingginya kadar asam urat di dalam darah (hiperurisemia).
Dokumen tersebut membahas pentingnya peran orang tua dalam mendeteksi gejala awal kanker pada anak melalui observasi fisik dan mendengarkan keluhan anak. Selanjutnya membahas tahapan diagnosis, pengobatan, dan dukungan yang diberikan kepada anak selama menjalani pengobatan kanker.
Seorang laki-laki berusia 60 tahun datang ke unit gawat darurat rumah sakit dengan keluhan nyeri dada berat sejak 1 minggu yang memberat sejak 3 jam terakhir. Keluhan dirasakan menjalar ke lengan kiri, ke rahang disertai keringat dingin. Riwayat perokok aktif sejak 30 tahun lalu menghabiskan 2 bungkus per hari.
Pada pemeriksaan nampak dia terlihat pucat, BMI 30 kg/m2 dengan kulit dingin dan berkeringat. Nadinya lemah, dengan sekali-kali ekstrasistole (denyut ventrikuler ektopik). Tekanan darah arterial 200/100 mmHg. Bunyi jantung normal, fisis jantung ditemukan kardiomegali. Pada EKG didapatkan gambaran elevasi segemen ST di II, III, aVF disertai gambaran LVH. Laboratorium ditemukan LDL kolesterol 180 mg/dl, HDL 28 mg/dl, HbA1C 11%, SGOT 12, SGPT 18, Hb 12 gr%
PANEL MODUL ACUTE ABDOMINAL PAIN (NYERI AKUT ABDOMEN)Rindang Abas
A 17 years old female came to clinic with complaints of pain in the main section of the gastric experienced since 3 days eralier, accompanied by nausea and vomiting, especially after eating or drinking. In anamnesis, aware that she regularly taking medication to relieve pain anticolic due to menstruation.
PANEL MODUL BLOODY DEFECATION (BAB CAIR BERDARAH)Rindang Abas
A man aged 55 years, come to emergency unit with blood diarrhea complaints. Patients also complain of heartburn. A history of using medications for arthritic pain in the knee during the last 6 months. A history of suffering from the DM and irregular treatment.
Dokumen tersebut membahas tentang tautan gen, yaitu keadaan dimana terdapat banyak gen dalam satu kromosom yang akan selalu bersama ketika kromosom tersebut memisah. Tautan gen pertama kali dijelaskan oleh Bateson dan Punnett, kemudian diuji oleh Morgan pada lalat buah. Terdapat dua jenis tautan yaitu coupling dan repulsion yang dapat diuji melalui testcross.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
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বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
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A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
3. A woman aged 55 years of diligent work and cooking. He
complained fingers of the right hand 1-3 (thumb, forefinger,
and middle finger) tingling, especially at night., but when the
hand on wiggle will improve. When you tap the middle of the
movement of the right hand, there is a pain radiating to the
finger 13.
4. Tingling : a pricky
sensation in the skin
or a body part,
accompanied by
diminished
sensitivity to
stimulation of the
sensory nerves
Image source: https://edc2.healthtap.com/ht-staging/user_answer/avatars/1185971/large/open-
uri20130615-19205-189kqvm.jpeg?1386655000
5. A woman 55
years
Diligent
work and
cooking
Complained
right hand
finger 1-3
tingling
Especially at
night
Improve by
wiggle
Pain
radiating to
fingers 1-3
when tapped
7. The incidence of carpal tunnel syndrome is 1-3 cases per 1000
subjects per year; prevalence is approximately 50 cases per 1000
subjects in the general population
The gender distribution of CTS was two-thirds to one-third female
to male. According to one study, it was found the male to female
ratio to be 1:1.4
The risk of CTS increased 8% for each unit of increase in BMI (about
6 lbs.)
8. It was noted 50% of CTS cases in pregnant women occurred in the third
trimester, but will usually resolve after pregnancy
In addition, increased sleeping in the lateral position which puts the wrist at
increased risk of flexion or extension, compressing the median nerve in the
carpal tunnel
Huldani. Carpal Tunnel Syndrome. 2013. Banjarmasin: Fakultas Kedokteran Universitas Lampung Mangkurat. Pg.8-10.
9. Why there is pain
radiating when the
wrist tapped and the
fingers feel tingling?
10. Huldani. Carpal Tunnel Syndrome. 2013. Banjarmasin: Fakultas Kedokteran Universitas Lampung Mangkurat. Pg 7
12. The initial stage of CTS is characterized by paresthesia at night, and this is based on intraneural
microvascular insufficiency night due to the increasing pressure on the carpal tunnel at night.
A gradual increase in pressure of tissue fluid reflects the redistribution of body fluids in the
horizontal position, and palmar flexion of the wrist. Should not be forgotten that in addition
there is a vascular pressure drop at night, which is associated with circadian rhythm, there is
also a decrease in perfusion pressure in the carpal tunnel.
Symptoms arise due to local metabolic disorganization on the nerves, resulting in oxygen
deficiency secondary to involvement intraneural microcirculation. The symptoms are reversible
when the position of the wrist, muscles, and posture becomes normal or if surgery on carpal
ligament.
14. "Flicking“ (as also rubbing or beating the hand or repeatedly flexing the wrist and fingers):
increases thick fiber proprioceptive input,
increases venous pressure and volume, might briefly increase arteriolar pressure
and moves the nerve underneath the free distal edge of the flexor retinaculum.
Wem Pryse-Phillips. Journal Validation of a diagnostic sign in carpal tunnel syndrome. Division of Neurology, Faculty of Medicine, Memorial University of Newfoundland, Canada.
15. What is the type of
pain experienced on
the scenario?
16. NOCICEPTIKVS NEUROPATHIC
Nociceptive pain is pain that is caused by the presence of stimuli
noksius (trauma, disease or inflammation).
• Come from the stimulation to the visceral
organs, or somatic pain, when derived from
tissues such as skin, muscles, bones or joints.
VISCERAL
PAIN
• The superficial (skin) and the inside (of the
others).SOMATIC
PAIN
17. Neuropathic pain is pain with impulses coming from damage or dysfunction of either
the peripheral nervous system or central.
The cause is trauma, inflammation, metabolic disease (diabetes mellitus, DM), infection
(herpes zoster), tumors, toxins, and primary neurological disease.
Central neuropathic pain
Pain caused by a lession or disease of the central
somatosensory nervous system
Peripheral neuropathic pain
Pain caused by a lession or disease of the
peripheral somatosensory nervous system
18. What are the general
examination to the
suspected disease of the
scenario?
19. Anamnesis
• Name of the patient?
• Age of the patient?
• Occupation of the patient?
• What is the patient complain
about?
• If pain, which part?
• When the pain begins?
20. Anamnesis
• Where the source of the pain?
• What time usually the pain felt the
most?
• How long the patient feels the pain?
• Patient’s history of the disease?
• Family history of the disease?
• The drugs have been consumed?
21. PHYSICAL
EXAMINATION
• Phalen's test
• Torniquet test
• Tinel's sign
• Flick'ssign
• Thenar wasting.
• Assessing the strengths and skills
and muscle strength either
manually or by means of a
dynamometer
23. • Wrist extension test
• Pressure test
• Luthy's sign (bottle's sign)
• Examination of sensibility
• Examination of autonomic
function
PHYSICAL
EXAMINATION
Jen Sayles. 2007. Standard of Care: Carpal Tunnel Syndrome . Brigham & Women’s Hospital Department of Rehabilitation Services Occupational Therapy
25. Nerve Conduction Studies (NCS)/
electromyography
To measure nerve conduction
velocity
Measuring the impulse travel
time from the forearm to the
wrist
NCS slowed when nerve is
compressed
26. Carpal tunnel view (A) and CT scan (B) shows that calcifying mass is located just above
the capitate.
Radiologic Imaging Methods
CTSCAN
Browning, Patrick D. Carpal Tunnel Syndrome Imaging. Oct.09, 2015.
27. (A) MRI shows hypertrophied palmaris longus is compressing median
nerve in carpal tunnel (white arrow: hypertrophied palmaris longus
muscle). (B) Open transverse carpal ligament release and
hypertrophied palmaris longus excision was performed
MRI
Saidoff and Apfel. The Healthy Body Handbook. NY:Demos Medical Publishing. Pg 207-208.
28. Ultrasound shows the CSA of median nerve and
bowing of the flexor retinaculum were
significantly increased (CSA larger than about
10.5 mm)
USG
Aroori and Spence. Carpal Tunnel Syndrome. The Ulster Medical Society.2008
29. What is the differential
diagnose of the scenario?
32. SYMPTOMS
CTS
Usually paresthesias, less
feeling (numbness) or taste
like electric shock (tingling) in
the fingers 1-3 and half the
radial side of the finger 4
PTS
Heaviness, stiffness or
cramping of the hands.
Tingling sensation in the
muscles of the thenar thumb
and three fingers on his side.
Pain in the area pronator teres
muscle in the elbow or
forearm when muscles
contract.
TRIGGER FINGER
Discomfort felt at the base of
the finger or thumb, where
they join the palm
A nodule may sometimes be
found in this area
33. TREATMENT
CTS
Rest your wrist.The
non-steroidal anti-
inflammatory drugs.
Installation splint at a
neutral wrist position.
Injection of steroids.
Vitamin B6
(pyridoxine).
Physiotherapy.
PTS
Management of the
types of jobs and
hobbies:
Drugs and dosing
neurorehabilitasi
exercises to loosen the
tension fibromuscular
and to reduce pain.
Exercise actively and
dynamically in the
upper limb
TRIGGER FINGER
To eliminate the
catching or locking and
allow full movement of
the finger or thumb
without discomfort
34. What is the management
of disease based from the
scenario?
35. A. Non farmacology
1. Resting the affected hand and wrist for at least 2
weeks.
2. Immobilizing the wrist in a splint
3. If there is inflammation, applying cool packs can help
reduce swelling.
4. Exercise
5. Physical therapy
Non-surgical treatment
B. Farmacology
1. NSAIDs
2. Corticosteroid
3. vitamin B6 (pyridoxine) supplements
Department of Health and Human Services. Carpal tunnel syndrome. Public Health Service National Institutes of Health.
36. Surgical treatment
Surgery is recommended if symptoms last for 6 months or if there is evidence of muscle
damage in severe cases.The following are types of carpal tunnel release surgery:
Open release
surgery
Endoscopic
surgery
https://i.ytimg.com/vi/UMcPJhGYISQ/maxresdefault.jpg http://i1.ytimg.com/vi/uyEVwBXHAL0/hqdefault.jpg
Jen Sayles. 2007. Standard of Care: Carpal Tunnel Syndrome . Brigham & Women’s Hospital Department of Rehabilitation Services Occupational Therapy
37. Contraindication :
• Pronounced thenar muscle atrophy
• Loss of finger dexterity
• Loss of two-point discrimination (Please refer to Sensory SOC for description of Two-point
discrimination test)
• Severe pain (> 8/10 on the patient pain analog scale)
• Patients who cannot tolerate NSAIDs
• Consider a patient’s ability to provide an accurate history of symptoms, and the ability to carry over
education, written programs and directions to the home and occupational environments.
• The referring physician should be contacted if the patient’s neurological symptoms continue to
worsen or not respond to conservative treatment despite compliance with the treatment plan.
38. What are the prevention,
promotion and
rehabilitation for this
scenario?
39. Rest Periods and Avoiding Repetition.
Anyfrequent
avoid overexertion of the hand and finger muscles
whenever possible.
one who does repetitive tasks should begin with a short
warm-up period, take
Employers should be urged to vary their employees' tasks
and work.
40. Good Posture
The worker should sit with the spine against the back of the chair
with the shoulders relaxed.
The elbows should rest along the sides of the body, with wrists
straight.
The feet should be firmly on the floor or on a footrest.
Typing materials should be at eye level so that the neck does not
bend over the work.
Keeping the neck flexible and the head upright maintains circulation
and nerve function to the arms and hands.
41. Reducing Force from HandTools
No task should require the wrist to deviate from side to side or to
remain flexed or highly extended for long periods of time.
People who need to hold tools (including pencils and steering wheels)
for long periods of time should grip them as loosely as possible.
In order to apply force appropriately, the ability to feel an object is
extremely important.Tools with textured handles are helpful.
42. If possible, people should avoid working at low temperatures,
which reduces sensation in the hands and fingers.
Power tools and machines should be designed to minimize
vibrations.
Wearing thick gloves, when possible, may lessen the shock
transmitted to the hands and wrists.
Jen Sayles. 2007. Standard of Care: Carpal Tunnel Syndrome . Brigham & Women’s Hospital Department of Rehabilitation Services Occupational Therapy
43. Hand and Wrist Exercises for the Prevention of Carpal
Tunnel Syndrome
47. In mild cases of CTS, with conservative therapy
generally good prognosis.
In general, surgery prognosis is also good.
• Faulty diagnosis, may trap / pressure on the median nerve is located in a more
proximal.
• There has been a total breakdown in the median nerve.
• The new CTS occurred as a result of complications due to the surgery such as
edema, adhesions, infection, hematoma or hypertrophic scarring.
If after surgery, there was also obtained
improvements then reconsidered the following
possibilities:
PROGNOSIS
48. The most severe complication is reflex sympathetic dystrophy that is characterized
by severe pain, hyperalgesia, disestesia and trophic disorders.
Although the prognosis CTS with conservative or operative therapy is quite good, but
the risk for recurrence remains. In case of recurrence, the procedure either
conservative or operative treatment can be repeated.
COMPLICATION
49. What are the perspective
islam we can learn from
the scenario?
50. `Abdullah bin Mas'ud radi anhu narrated from the Prophet
sallallaahu 'alaihi wa sallam, he said:
المتنطعون هلك
"Woe to those who exaggerated!" He said it three times. "
51. ِنَعَلاَق سلم و عليه هللا صلى ِهللا َلْو ُسَر َّنَأ ،بِازَع ِبن اءَّرَبال:((َتَأ َاذِإْأَضَوَتَف كَعَجْضَم َتْي
ُْلق َّمُث ،ِنَمْيَألا َكِقِش على ْعِجَّطْضا َّمُث ،ِةالَصلل َكَءوُضُو:َّمُهالل،َكْيَلِإ يِسْفَن تْمَل ْسَا يِنِإ
َلِإ يِرْهَظ ُتْأَجْلَأ َو َكْيَلِإ يِرْمَأ ُتْضَوَف َو ،َكْيَلِإ يِهْجَو ُتْهَجَوَوَجْلَم َال َكْيَلِإ ًةَبْهَر و ًةَبْغَر َكْيَال َو َأ
َكِيِبَنِب َو َتْلَزْنَأ يِذَّلا َكٍباَتِكِب ُتْنَمَأ ، َََكْيَلِإ الَإ منك اَجْنَمِمَالَك َرِخآ َّنُهْلَعْاج َو َتْل َسْرَأ الذْنِإَف َك
ةَرْطِفال على َّتِم َكِتَلْيَل ْنِم َّتِم)
"From al-Barra bin Azib, that the Prophet said," If you were heading pembaringanmu, then berwudhulah as you
perform ablutions for prayers, then lie down on your ribs right side and then recite the prayer: "OAllah! I surrender my
soul just toThee, I confronted my face toThee : I put all my business only to you, I rested my back to thee alone, with
hope and fear thee, I believe that you sent down the book and to the prophet that thou hast sent "and you shall make
a prayer earlier as the cover of your conversation that evening. So if you have undoubtedly died during the night you
died on nature "