An apt yet detailed description of Polyarthritis for undergraduate level with basic definitions, classification, concept, clinical features along with descriptive images, diagnosis & assessment with distinguishing features along with differential diagnosis.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
The Musculoskeletal System under the Unit HUMAN BODY
~now active with hyperlinks.
Please note that this presentation will be more appreciated if your computer is under Microsoft 2013. Kindly consider the compatibility for more convenient and pleasing slides.
Arthritis is a large topic, and almost everyone who has a bone will develop some forms of arthritis at some point in their lives. This presentation addresses many types of arthritis, including osteoarthritis, septic arthritis, gout, rheumatoid arthritis and so forth.
This presentation focuses on different types of arthritis/joint disorders. It provides stepwise approach to evaluation and diagnoses and it's truly wonderful to have a broad overview of many joint conditions in one presentation - ranging from osteoarthritis, gout, rheumatoid arthritis, septic arthritis, to ankylosing spondilitis, and many others, including fibromyaligia.
Approach to musculoskeletal pain Ahmed Yehia Ismaeel, MD
How to approach musculoskeletal pain: Stepwise approach to musculoskeletal pain
Articular or non-articular pain
Is it arthralgia or arthritis?
Acute or chronic (Duration)
Inflammatory or non-inflammatory
Mono or polyarticular (Number)
Distribution: Symmetrical or asymmetrical; with or without axial involvement
Extraarticular manifestations present or absent
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
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.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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
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
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
6. RHEUMATOID ARTHRITIS
Chronic inflammatory joint disease with multisystem
involvement.
*Epidemiology -
• Incidence 1.4/10000 male, 3.6/10000 females
• Prevalence 0.5-2 %
• male:female 1:3
• Worldwide distribution - higher in native Americans
absent in some parts of Africa
• Onset any age but maximum - 40 - 70 years in
women , 60 - 70 years in men
7.
8. * Onset
Typical
-Insidious onset polyarthritis
-Affecting small joints of hand & feet
- Fatigue, anorexia, weakness & vague musculoskeletal
symptoms
Atypical
-Polymyalgic
-Palindromic
-Systemic
-Persistent monoarthritis
9. • Symmetrical deforming polyarthritis
-Affects synovial lining of joints, bursae and tendons
-More than just joint disease
• Progression of joint involvement
-Spread occurs within months to years to other joints
-Almost any joint may be involved
-Spontaneous remission can occur
-Poor prognosis – RA factor exists
• Symptoms Of inflammation
-Stiffness, pain, swelling, warmth, redness
* Clinical Features
10. Pattern of joint involvement
• symmetrical
• small joints of hands - DIP spared
• characteristic features
-Boutonniere
-Swan neck
-Z thumb
-Volar subluxation
-Ulnar deviation
14. • Morning stiffness > 1 hours
• Arthritis in 3 or more joints
• Bilateral compression pain in MP joints
• IgM RA factor > 5 I.U.
* Predictive factors for persistent RA
15. • Most common joint disorder
• Affects 190 million worldwide
• Nearly 70% of people over 65 years
• Aging population over 65 years
-1997~ 400 million ( 70 million plus in India )
-2025~ 800 million ( 150 million plus in India )
• In India has overtaken diabetes, and now ranks 1st in
chronic debilitating disease.
OSTEOARTHRITIS
18. • Old patient
• Females > males
• Lower limb joints~ knees, hips, 1st CM joint
• Rest pain
• Pain during movement
• Crepitus
• Characteristic deformities
* Clinical Features
19.
20. 0 – No features of osteoarthritis
1 – Doubtful, osteophyte of doubtful significance
2 – Minimal, definite osteophyte but joint space
unimpaired
3 – Moderate, moderate diminution of joint space
4 – Severe, Joint space severely impaired with sclerosis
of sub-chondral bone
* Kellegren & Lawrence Scale for Osteoarthritis
22. • Seronegative, that is, rheumatoid factor is absent
• Affect the axial skeleton; inflammatory low back pain
is common.
• Cardinal feature is involvement of sacroiliac joints
• Peripheral joint involvement is usually asymmetrical
Oligoarticular, below waist
• Usually associated with HLA-B27.
• Enthesopathy is characteristic
• Usual age < 40 years
• Male preponderance
* Features
23. I. Ankylosing Spondylitis
• Spondyloarthropathy
• Late adolescence & early adulthood
• Spine & large joints
• Leads to fibrous/bony ankylosis
24. • Male predisposition 4:1
• Autosomal inheritance
• 70% penetrance
• 90% association with HLA B27
• Rare in negroes
* Etiology
25. • Similar to RA
• Articular & bone destruction
• Fibrous & bony bridging
• Para- articular calcification & ossification
• Bamboo spine
* Pathology
28. Primary Gout
-Heritable Error of metabolism
-Causing
overproduction or retraction of uric acid
Secondary Gout
-Myeloproliferatic disease
-Chronic glomerulo-nephritis and pyelonephritis
-Hypothyroidism
* Types
29. • Hyperuricaemia
• Monoarticular in early stage
• MCP joint - great toe
• Uric acid crystal deposition
• Tophus
• Punched out para-articular lytic lesion
• Tophi & synovial fluid shows presence of MSU
crystals- confirmatory of diagnosis
* Gout
30. • Younger age group compared to gout
• Larger joints involved compared to gout
• Knee most commonly involved
• Severity of clinical features less compared to gout
• Calcification of cartilages hallmark sign
* Pseudogout
35. • Arthritis most common manifestation
• Symmetric non erosive arthritis
• Small joints of hand, wrist, knee most commonly involved
• Nodules similar to RA present
• Jaccoud’s arthropathy ( ulnar deviation + swan neck
deformity)
• Systemic features help in reaching diagnosis.
* Arthritis in SLE
36. Feature Ankylosing
Spondylitis
Reactive Arthritis Psoriatic
Arthritis
IBD associated
spondyloarthropathy
Age at onset Late teens to
early adulthood
Late teens to early
adulthood
35-35 years Any age
Male to female
ratio
4:1 5:1 1:1 1:1
HLA-B27
positive
90% 80% 40% 30%
Frequency of
sacroilitis
100% 40-60% 40% 20%
Distribution of
sacroilitis
Symmetrical Asymmetrical Asymmetrical Symmetrical
Syndesmophytes Marginal Non-marginal Non-marginal Marginal
Enthesitis Common Very common Very common Occasional
Dactylitis Uncommon Common Common Uncommon
Skin changes None Circinate
blanitis,keratoderma,
blenorrhagica
Psoriatic
lesions
Erythema nodosum,
pyoderma
gangrenosum
38. Assessment of Joint Pain
Site (distribution)
Type of pain
Associated features
Duration & onset
Risk factors
Physical Signs
Differential Diagnosis
Investigations
39. Site & distribution of pain
• Is it joint, peri-articular or muscle pain?
• Which joints are involved?
• Is it symmetrical or asymmetrical?
• Where did it start?
• Is the arthritis migratory, additive, episodic?
40. RA
PIP, MCP, wrists, elbows, shoulders, neck,knee, ankle,
MTP, symmetrical
DIP not involved
Sero-ve
DIP, dactylitis, enthesitis, spinal
PIP not involved
asymmetrical
OA
Weight bearing joints DIP, PIP, CMC, ACJ
MP not involved
41. Type of Pain
• Is it inflammatory?
• Is it mechanical / degenerative?
• What makes the pain worse/better?
Inflammatory Mechanical
Immobility stiffness Latter day EMS>30-
60 mins EMS<30-60 mins Better with
activity Worse with activity Joint
swelling, erythema, heat Instability Systemic
symptoms Locking Multi-organ
involvement Trauma, strain
42. • Is there morning stiffness?
• Have there been any symptoms of infection?
• Have there been any rashes ?
• Any urinary, genital or gut problems?
Associated features
43. • When did the joint pains begin?
• Are the symptoms getting better or worse?
Duration & Onset
Acute Chronic
* Viral - parvo/rubella
* Bacterial - strep
* Rheumatoid
* Reactive - GU/Gastro
* Erythema nodosum
* Vasculitis
* Rheumatoid
* Sero - negative - Psoriatic/ IBD
* Connective tissue disease - SLE/SjS
* Polyarticular OA
44. • Age
• Sex
• Racial/ethnic background
• Family history
• Treatment history
• Social history
Other risk factors