This document discusses pelvic fractures, including their classification, mechanisms of injury, clinical assessment, management principles, and associated injuries. It describes the Tile classification system that aids in prognosis determination and the Young-Burgess classification system that alerts surgeons to potential resuscitation needs and injury patterns based on the mechanism of injury being lateral compression, anteroposterior compression, vertical shear, or combined. Clinical assessment includes a rectal exam and neurological assessment, while management principles follow the ABCDE approach and include applying a pelvic binder or sheet. Associated injuries discussed are vascular, urethral, bowel, and vaginal.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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combined into a single substance use disorder (SUD) on a continuum
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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.
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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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
3. Management strategy of vascular injuries associated with pelvic fractures. J Cardiovasc Surg
33:349, 1992; Prorities in Management. Arch surg 124:422, 1989; Effective classification
4. 1 SACRAL Bone
2 INNOMINATE bones
PUBIS
ILIUM
ISCHIUM
Symphysis gap <5 mm
5.
6. No inherent stability—Ligaments give stability
Anterior SIL resist external rotation
Sacrospinous - resists external rotation
Posterior SIL and ILL - provide posterior
stability by tension band , strongest in body
Sacrotuberous - resists shear/flexion SI joint
7.
8.
9. Sacral venous plexus*
Iliolumbar a.
Internal iliac a.
Superior gluteal a.*
Lateral sacral a.
Pudendal a.*
12. AP pelvis during early phase of resuscitation is
useful to determine presence or absence of
unstable pelvic fracture
AP pelvis can identify 90% of pelvic injuries
13. Inlet View – 45 degree caudal tilt
True AP projection of the pelvic brim
Evaluates for posterior displacement
Evaluates for rotation of ilium and sacral impaction
injuries
14. Outlet View – 45 degree cephalad tilt
Evaluates for vertical shift of pelvis
provides a better demonstration of sacral fractures
and injuries to the sacroiliac joints.
15. CT Scan
Best visualization for Sacrum and SI joint
Rotational and posterior displacement can
be easily assessed
16.
17. Type A: pelvic ring stable
Type B: rotationally unstable, vertical stable
Type C: rotationally and vertically unstable
Advantages: Tile classification aids in
the determination of prognosis
18. Lateral compression (LC)
Anteroposterior compression (APC)
Vertical shear (VS)
Combined mechanism (CM)
Advantages: this classification alerts the surgeon to
potential resuscitation requirements and
associated injury patterns
19.
20. Airway Maintenance with C-spine protection
Breathing and Ventilation
Circulation with hemorrhage control
Disability: Neurologic status
Exposure/Environment Control: Undress
patient but prevent hypothermia
21. Neurologic deficit involving lumbosacral plexus
Pelvic/flank/perineal
contusions,ecchymoses,abrasions
Blood at urethral meatus
Blood in or around rectum
Open wound of groin,buttock, or preineum
Leg length inequality or external rotation of one
extremity
Abnormal pelvic motion on AP or lateral
compression of anterior iliac spines and iliac crests
22. Rectal exam for tone
Bulbocavernosus reflex
Myotomes of lower extremity
L1-2 : hip flexor
L3-4 : Quadriceps/knee extension
L4-5 : Ankle and toe dorsiflexion
S1 : ankle plantarflexion
S2-3 : toe plantarflexion
24. Return blood from lower ext. to central vascular system
Ability to close open-book-type injury, reducing pelvic
volume
Stabilize pelvic ring permitting clot formation
25. Advantage
Useful in assessing and embolization of arterial
injury - Unexplained blood loss after stabilization and aggressive
resuscitation , Pulseless extremity
Disadvantage:
Source of arterial bleeding is identified in only 10-
15% of patients with severe pelvic disruption
Does not address venous bleeding
26. Primary survey
stable unstable
Pelvic Fx No Fx Pelvic Fx
No Fx
CT,FAST,DPL
CT scan
APC LC
CT,FAST,DPL
classify Fx
Reassess Explor lap. Open bookothers
Reassess
- External compression
- Explor lap. +/- packing
- Angiography vs ext. fixation
SI jonit involvement-
consider iliac injury
27.
28. Lateral compression (LC)
Anteroposterior compression (APC)
Vertical shear (VS)
Combined mechanism (CM)
Advantages: this classification alerts the surgeon to
potential resuscitation requirements and
associated injury patterns
29.
30. LC type I:
unilateral rami fx . (transverse)
& ipsilat sacral compression.
LC type II:
unilateral rami fx.
& ipsilat post. iliac fx.
LC type III:
LC I/II & contralat. APC
31.
32. APC type I:
symphysis widened < 2cm;
SI joint intact
APC type II:
symphysis widened >2cm or rami fx
& ant. SI lig. Torn
APC type II:
symphysis widened >2cm or rami fx
& ant & post SI lig. torn
33. Vertical shear (VS)
Vertical displacement
Combined Mechanical(CM)
Combination of LC + VS or APC
37. Occurs in less than 1%
Clinical
Laceration of rectum or perforation of small and/or
large bowel
Rectal tears accompany perineal wounds
Requires diverting colostomy in 6-8hr
following injury to reduce incidence of sepsis
and death
38. Laceration of the vagina
Results from dislocation or fractures of the
pubic rami
may require operative intervention