Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
muscle pedicle grafting for delayed presentation of intra cpasular fracture neck of Femur.. a study of 65 cases in Osmania Medical College, Hyderabad, Telengana.
Hip resurfacing has emerged as a viable alternative to replacement for arthritis in young patients. Selected individuals will benefit by Hip resurfacing arthroplasty offered by the Madras Joint replacement center in India. See if you qualify for this procedure.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
muscle pedicle grafting for delayed presentation of intra cpasular fracture neck of Femur.. a study of 65 cases in Osmania Medical College, Hyderabad, Telengana.
Hip resurfacing has emerged as a viable alternative to replacement for arthritis in young patients. Selected individuals will benefit by Hip resurfacing arthroplasty offered by the Madras Joint replacement center in India. See if you qualify for this procedure.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
A case presentation requiring wide debridement and a trephine defunctioning colostomy with operative finding photos. Includes how to diagnose and manage this potentially fatal condition.
Pprom by dr alka mukherjee dr apurva mukherjee nagpur indiaalka mukherjee
Preterm premature rupture of the membranes (PPROM) is a pregnancy complication. In this condition, the sac (amniotic membrane) surrounding your baby breaks (ruptures) before week 37 of pregnancy. Once the sac breaks, you have an increased risk for infection. You also have a higher chance of having your baby born early.
In most cases of PPROM, the cause is not known.
These things may increase risk:
• Having a preterm birth in a previous pregnancy
• Having an infection in your reproductive system
• Vaginal bleeding during pregnancy
• Smoking during pregnancy
Symptoms can occur a bit differently in each pregnancy. They can include:
• A sudden gush of fluid from your vagina
• Leaking of fluid from your vagina
• A feeling of wetness in your vagina or underwear
Call your healthcare provider right away if you have these symptoms.
The symptoms of this health problem may be similar to symptoms of other conditions. See your healthcare provider for a diagnosis.
Diagnosis
• pH (acid-base) balance testing. The pH balance of amniotic fluid is different from vaginal fluid and urine. Your healthcare provider will put the fluid on a test strip to check the balance.
• Looking at a sample under a microscope. When amniotic fluid is dry, it has a fern-like pattern.
• ultrasound exam. This is done to check the amount of amniotic fluid around baby.
Similar to Role of arthroscopic synovectomy of knee joint in ra (20)
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- 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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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.
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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
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
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Role of arthroscopic synovectomy of knee joint in ra
1. ROLE OF ARTHROSCOPIC
SYNOVECTOMY OF KNEE JOINT IN
PATIENTS WITH RHEUMATOID
ARTHRITIS
-BY
Dr. Prakhar Chhawchharia
Orthopaedic surgeon
Fellowship in Arthroscopy
9/18/2016 Dr. Prakhar Chhawchharia 1
2. INTRODUCTION
• INFLAMMATORY SYNOVITIS
• MONOARTICULAR OR POLYARTICULAR
• KNEE SYNOVIUM COMMONLY INVOLVED
• FEMALES :MALE RATIO 3:1
9/18/2016 Dr. Prakhar Chhawchharia 2
3. CLINICAL FEATURES OF KNEE JOINT
SYNOVITIS
• PAIN
• SWELLING DUE TO EFFUSION
• WARMTH
• DECREASED ROM DUE TO PAIN, EFFUSION
• STIFFNESS
9/18/2016 Dr. Prakhar Chhawchharia 3
4. CLINICAL EXAMINATION
• SWELLING
• ERYTHEMA
• WARMTH
• PATELLA BALLOTING
• PATELLA TAP
• TENDERNESS OVER SOFT TISSUE
STRUCTURES
• ROM- ACTIVE & PASSIVE
• VARUS/VALGUS STRESS TEST
9/18/2016 Dr. Prakhar Chhawchharia 4
5. PATHOPHYSIOLOGY
• IMMUNE MEDIATED INFLAMMATORY DISEASE
9/18/2016 Dr. Prakhar Chhawchharia 5
ANTIGEN BINDS
WITH MHC
C28 MOLECULE
ACTIVATES
T -CELL
PROLIFERATE AND
SECRETE IL-2,
IFN,TNF,IL-4
B CELLS GET
ACTIVATED
SECRETE CYTOKINES,
BECOME ANTIGEN
PRESENTING CELL TO
T LYMPHOCYTES
PLASMA CELLS
RELEASE RF, anti-
CCP,ACPA
6. PATHOPHYSIOLOGY OF SYNOVIUM
• INTIMAL LAYER(1-3 CELLS THICK)
HYPERTROPHIED-FILLED WITH FIBROBLASTS
AND MACROPHAGES
• SUBINTIMAL LAYER- (VASCULAR LAYER)
HEAVILY INFILTERATED WITH T & B CELLS,
MACROPHAGES, OSTEOCLASTS,
ANGIOGENESIS
• THIS IS CALLED PANNUS-HYPERTROPHIED
SYNOVIUM
• PANNUS INVADES AND ERODES THE
CONTIGOUS CARTILAGE AND BONE
9/18/2016 Dr. Prakhar Chhawchharia 6
8. TREATMENT
• MEDICAL LINE OF MANAGEMENT
• NSAID’S
• DMARD’S
9/18/2016 Dr. Prakhar Chhawchharia 8
CONVENTIONAL BIOLOGICS
METHOTREXATE ETARNECEPT
LEFLUNOMIDE INFLIXIMAB
SULFASALAZINE ADALIMUNAB
HYDROXYCHLOROQUINE ABATACEPT
AZATHIOPRINE RITUXIMAB
CYCLOSPORIN ANAKINRA
9. TREATMENT
• SURGICAL- ARTHROSCOPIC SYNOVECTOMY,
TOTAL KNEE REPLACEMENT
• INDICATIONS OF ARTHROSCOPIC
SYNOVECTOMY
1. ACUTE INFLAMMATION
2. CHRONIC INFLAMMATION NOT RESPONDING
TO DMARD’S
3. EARLY STAGE OF DISEASE
4. NO ADVANCED BONY CHANGES
5. TO DELAY TKR IN YOUNG OR WITH OTHER
CO- MORBITIES
9/18/2016 Dr. Prakhar Chhawchharia 9
10. ATHROSCOPIC SYNOVECTOMY
• ADVANTAGES
1. SIGNIFICANT IMPROVEMENT IN PAIN SCORES
2. COMPLETE REMISSION OF DISEASE IN A JOINT
3. CAN BE MANAGED WITH SINGLE DMARD
4. MORE ACCURATE DIAGNOSIS VIA SYNOVIAL
BIOPSY AND SYNOVIAL FLUID ANALYSIS
5. NEAR COMPLETE REMOVAL OF SYNOVIUM
UNDER VISUALISATION
6. DIMUNITION OF JOINT STIFFNESS POST
SURGERY
7. SHORT HOSPITAL STAY
9/18/2016 Dr. Prakhar Chhawchharia 10
11. ARHTROSCOPIC SYNOVECTOMY-
MATERIALS AND METHOD
1. STANDARD 5MM SCOPE
2. 5.5 MM RESECTOR/SHAVER
3. PUNCH BIOPSY FORCEPS
4. BITE FORCEPS
5. GRASPER
9/18/2016 Dr. Prakhar Chhawchharia 11
13. ARHTROSCOPIC SYNOVECTOMY-
MATERIALS AND METHOD
• SEQUENCE OF PERFORMING A TOTAL SYNOVECTOMY
1. INTERCONDYLAR NOTCH,
2. POSTEROLATERAL COMPARTMENT,
3. POSTEROMEDIAL COMPARTMENT,
4. MEDIAL COMPARTMENT,
5. LATERAL COMPARTMENT,
6. SUPRAPATELLAR COMPARTMENT,
7. RETROPATELLAR COMPARTMENT.
8. UNDERSURFACE OF EACH MENISCUS IS CAREFULLY
EXAMINED
9. ANY POPLITEAL CYST, FOREIGN BODY & PLICA REMOVED
10. AFTER RELEASING THE TOURNIQUET, BLEEDERS ARE
CAUTERIZED BY RF ABLATION PROBE,DRAIN KEPT AND
COMPRESSION BANDAGE GIVEN
9/18/2016 Dr. Prakhar Chhawchharia 13
14. ATHROSCOPIC SYNOVECTOMY
-POST OPERATIVE CARE
• DRAIN REMOVAL AT 24 HRS
• STATIC QUADRICEPS AND PASSIVE ROM
STARTED IN IMMEDIATE POST OP PERIOD
• PHYSIOTHERAPY REHAB PROTOCOL FOR
QUADRICEPS AND HAMSTRING
STRENGTHENING
• ACTIVE ROM EXERCISES
• MODALITIES TO DECREASE PAIN, SWELING,
STIFFNESS IN POST OP PERIOD
9/18/2016 Dr. Prakhar Chhawchharia 14
