- Visual field examination tests the peripheral sensitivity of the retina and visual pathways. It is important for assessing topographic sensitivity and detecting visual field defects.
- Automated perimetry provides standardized, quantitative tests to measure threshold sensitivity across the visual field. It allows for reliable long-term monitoring to detect glaucomatous progression.
- Interpretation of visual field tests involves analyzing parameters like total deviation plots, pattern deviation plots, and global indices to identify patterns indicative of glaucoma according to established criteria. Clinical correlation with optic nerve examination is also important.
Brückner, in 1962, published a paper in German describing a "trans-illumination" test extremely useful in the diagnosis of small angle deviations and amblyopia in young uncooperative children. A bright coaxial light source, such as a direct ophthalmoscope, is used.
Brückner, in 1962, published a paper in German describing a "trans-illumination" test extremely useful in the diagnosis of small angle deviations and amblyopia in young uncooperative children. A bright coaxial light source, such as a direct ophthalmoscope, is used.
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Maddox Rod
Use of Maddox Rod
Method of Assessment MR
Double MR Test procedure
Recording procedure of MR Test
Heterophoria, Cyclophoria, Esophoria,Exophoria,Hyperphoria,Hypophoria
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Maddox Rod
Use of Maddox Rod
Method of Assessment MR
Double MR Test procedure
Recording procedure of MR Test
Heterophoria, Cyclophoria, Esophoria,Exophoria,Hyperphoria,Hypophoria
How to interpret the visual field printout
Learn basic terms of visual field analysis
How to diagnose glaucomatous field defect
How to diagnose neurological field defect
Visual field testing is an important diagnostic consideration in the evaluation of patients with many different types of pathologies. Most commonly, it is used for conditions affecting the optic nerve and other forms of neurological disease; but it’s also helpful for retinal conditions and instances when visual field function needs to be measured.
At the end of the lecture optometrists will have a better understanding of testing and interpreting visual field results.
this presentation involves a comprehensive outlines regarding the most common different methods used in diagnostic microbiology to stain bacteria and their structures
- 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
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
2. VISUAL FIELD
• That part of environment wherein a steadily fixating eye can
detect visual stimulus.
• BASIS - presence of Photoreceptors and corresponding
visual pathways upto the periphery of retina away from point
of fixation i e fovea.
• IMPORTANCE – Reflects topographic sensitivity of various
foci on retina and corresponding visual apparatus.
Resolution – Acuity
differential light sensitivity and contrast
colour
flicker
motion
8. PHYSIOLOGICAL BLIND SPOT
Corresponding to optic nerve head
15 deg temporal to point of fixation
Span – 5 deg horizontal
-- 7 deg vertical
Two thirds below the horizontal
meridian
9. COLOUR FIELD
• Point at which passing from periphery to centre, the
colour first becomes evident
• Peripheral to the limit, the object is perceptible but
appears grey
• First red and green are used followed by blue and yellow
• Extent of field for objects of same size and intensity
white > yellow > blue > red > green
11. • SCOTOMA : focal region of abnormally decreased
sensitivity surrounded by an area of normal sensitivity
ABSOLUTE
RELATIVE
POSITIVE
NEGATIVE
• DEPRESSION : is an area of reduced sensitivity without
a surrounding area of normal sensitivity
appears as denting of isopters
12. • Generalized depression
(both peripheral and central contraction)
e g cataract
• Peripheral Contraction – retinitis pigmentosa
• Temporal contraction - age
17. KINETIC
• Test object of particular size and intensity is passed from
non seeing area to seeing area along a particular
meridian at the rate of 3 – 5 deg per sec
• Repeated every 15 – 30 deg
• To find points in the visual field of equal sensitivities –
ISOPTER (Groenouw) marking
• Intensity and size of stimulus is varied to mark various
isopters
• Thus 2 D Contour map of the hill of vision is made
• Extent of scotomas and blind spot marked from inside
out
18. STATIC
• The location, size and duration of stimulus is kept constant
and the luminance is gradually increased until seen
• Actual estimation of sensitivity ( THRESHOLD ) of each
point is made out
• SUPRA THRESHOLD stimulus used for screening
-------------------------------------------------------------------------------
IMPORTANT :
one eye is tested at a time, other is occluded
fixation of the patient has to be steady and is
monitored throughout the test
---------------------------------------------------------------------------------
20. PROJECTION OF LIGHT
In patients with very poor vision –> HM + to PL +
e g dense cataracts
-dark room, other eye occluded
-patients are constantly instructed to look straight to avoid
tendency to deviate eye towards light source
-light shown onto 4 quadrants from 30-50 cm and switched
on and off
-Patient tells about the direction of light source
Accurate in all quad
Inaccurate in some quad
Inaccurate in all quad
21. HAND IDENTIFICATION
Other eye is occluded
Patient fixates on the nose of
examiner
Examiner keeps both hands on either
side of eye 50 cm away
One hand absent or indistinct –
hemianopic defect
Either palms or fingers of both hands
missing / faint – altitudinal defect
22. FINGER COUNTING
Varying no of fingers are held in each
quadrant, 1 m and 45 deg from
fixation
If unable to count, fingers are brought
closer to fixation, until patient sees
(kinetic)
23. RED DESATURATION
Can be confirmed kinetically
Patient has to indicate when color
appears to change
Can also be used to compare the
two eyes in case of optic
neuropathy
24. CONFRONTATION
(kinetic)
Patient‟s and examiner at same level
Compares the visual field of eye of
patient with opposite eye of the
examiner in a plane perpendicular
to line of gaze
Red pin is particularly useful for
neurological cases
GROSS PERIMETRY
(kinetic)
Follows facial contour
25. AMSLER GRID
For Central 10 deg ( static )
Other eye occluded
Near correction given
Chart at held 28-30 cm – each small square subtends angle of 1
deg
Patient fixates at central dot – tells whether all corners are seen
simultaneously and about lines- parallel, distorted, missing
Can be used for mapping blind spot – patient fixates at edge of
grid
29. BJERRUM’s SCREEN ( CAMPIMETRY)
• Patient sits at 1 or 2 m from flat screen
• Kinetic and static
• For central 30 deg only
• Done under subdued lighting
30. GOLDMANN’s PERIMETER
• Bowl type
• Standardization
• Both kinetic and static
• Peripheral as well as central
31. AUTOMATED PERIMETRY
standard automated perimetry
HUMPHREY FIELD ANALYZER
OCTOPUS
• STATIC perimetry
• Measurement of threshold values
• STATPAC (HFA)- Comparison to normative data
• Inbuilt program for analysis – diagnosis and progression
32. ADVANTAGES
• Removal of examiner variability
• More sensitive to subtle field defects
• Reproducibility
• Retests abnormal points automatically
• Gives reliability parameters like
fixation monitoring – HEIJL KRAKAU method
Gaze tracking
False positive
False negative
33. SHORT COMINGS
• EXPENSIVE
• Learning curves
• Difficult to follow by older debilitated patients especially
neurological problems
• Not infallible – only 1 % of field is actually examined
• Diagnosis and management decisions based on
correlation with other clinical findings
A well performed tangent screen examination is better than
poorly carried out automated perimetry
In neurological patients, clinical methods may be the only
possible assessment techniques
34. • WHITE ON WHITE
• BACKGROUND ILLUMINATION - 31.5 asb
• STIMULUS SIZE – GOLDMANN - III
• DURATION OF SPOT EXPOSURE 0.2s
35. PROGRAMS / PATTERNS
30-2 – gold standard
24-2
10-2
MACULAR
Nasal step program – additional 12 locations upto 50 deg nasal
peripheral 60 and 60-4 prog
Estermann test – for binocular 120 deg field
36.
37. MACULA PROGRAM :16 locations
within the central 5° with 2° spacing.
Each location is tested three times
40. SWEDISH INTERACTIVE TESTING ALGORITHM (SITA)
SITA STANDARD ( Bracketing strategy based)
SITA FAST ( FASTPAC based)
Analyzes patients response and responds accordingly
Decreases overall no of stimuli presented, hence test
duration
Paces the test according to patients speed
Doesn‟t estimate Short term Fluctuations
41. • Selection of adequate test
• Proper environment
• Comfortable sitting position
• Adequate size of pupil >3mm
• Adequate Near correction
• Proper explanation – running of demonstration
• Reassurance – not all points will be seen
- test can be paused by keeping the response
button pressed
42.
43. Patient data
• Name, DOB, eye
• Vision, refraction,
• Pupil diameter
Test data
• Date and time
• Program and strategy
• Background
illumination
• Test
size, color, duration, i
nterval
ZONE 1 : REPRODUCIBILITY
44. ZONE 2 : RELIABILITY
• Fixation monitor
• Fixation target – central, small
diamond, large diamond, bottom LED
• Test duration
• Reliability indices
Fixation losses ( Heijl Krakau) <20 %
Gaze tracking
False positives < 33%
(trigger happy)
False negatives < 33 %
Foveal threshold
45.
46. ZONE 3 : GREY SCALE
• Based on actual threshold values at each location
• General identification
• Patient information
47. ZONE 4 :TOTAL DEVIATION PLOT
• Numerical plot – indicates by how
much decibels is each point depressed
compared to mean value in normal
population of similar age
• Probability plot- grey scale indicates
the probability of occurrence of the
deviation in normal population
Generalized depression due to media
opacities, refractive error, miosis may
hamper appearance of a pattern
48. ZONE 5 : PATTERN DEVIATION
PLOT
• Numerical - calculated by adjustment for
generalized depression or elevation of
visual field
• Thus brings out pattern
• Probability plot
• Significance - ANDERSON‟S CRITERIA
49. ZONE 6 : GLOBAL INDICES
single numbers to denote whole field
• MEAN DEVIATION : average loss of sensitivity from
normal age matched population along with probability
calculated from total deviation plot
• PATTERN STANDARD DEVIATION : range over which
change of sensitivity at all the points has occurred, along
with probability
compensates for effect of generalized depression or
elevation of field on mean deviation value
local defects affect PSD > MD
• SHORT TERM FLUCTUATIONS
• CORRECTED PATTERN STANDARD DEVIATION
50. ZONE 7 : GLAUCOMA HEMIFIELD TEST
• PLAIN ENGLISH LANGUAGE MESSAGE
• Comparison of 5 clusters of points in
superior hemifield with mirror images in
inferior hemifield
51. OUTSIDE NORMAL LIMITS
all cluster pairs differ @ p < 1% OR
1 cluster pair differs @ p < 0.5%
BORDERLINE
hemifields differ @ p < 3%
GENERAL REDUCTION OF SENSITIVITY
overall field depressed @ p < 0.5%
ABNORMAL HIGH SENSITIVITY
overall field elevated( best 15 % points) @ p < 0.5 %
WITHIN NORMAL LIMITS
52. ANDERSON and PATELLA CRITERIA
• 3 or more congrous „non edge points‟ in typical arcuate area
on 30-2 program
depressed @ p< 5 % with at least one point @ p<1 %
•PSD / CPSD @ p< 5%
•GHT – outside normal limits
Must be demonstrated on 2 field tests
63. SHORT WAVELENGTH AUTOMATED PERIMETERY
“BLUE ON YELLOW”
detects glaucomatous defects 3-5 years earlier than SAP
high fluctuation rates
64. FREQUENCY DOUBLING
PERIMETRY
Based on frequency doubling
illusion
Test stimulus – series of white
and black bands flickering at
25 Hz ( low spatial frequency
& high temporal frequncy)
Detects damage to
Magnocellular Ganglion cells
C – 20 17 points – screening
N – 30 19 points – diagnosis
n management
65. RANDOM DOT MOTION PERIMETRY
Patient has to tell direction in which dots are moving
HIGH PASS RESOLUTION PERIMETRY
Test resolution and not mere threshold detection