Sacral fractures involve the irregularly shaped sacrum bone made up of five fused vertebrae. It plays a central role in pelvic and spinal stability. Sacral fractures can injure the sacral nerve roots affecting bowel, bladder, and sexual function. Imaging like CT scans are needed to identify fracture type and involvement of neurologic structures. Several classification systems exist, with the AO system describing fracture morphology, neurologic status, and modifiers. Treatment depends on fracture type but may include conservative care, plating, or various fixation procedures like iliosacral screws.
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.
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.
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Pemberton's Osteotomy for Acetabular DysplasiaLibin Thomas
This is a slideshow based on the journal- JBJS- ESSENTIAL SURGICAL TECHNIQUES, INDIAN EDITION, OCTOBER 2015, VOL.4, NO. 3, SPECIAL EDITION by Shier- Chieg, Huang, MD, PhD, Ting- Ming Wang, MD, PhD, Kuan- Wen Wu, MD, Ken N. Kuo, MD
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Pemberton's Osteotomy for Acetabular DysplasiaLibin Thomas
This is a slideshow based on the journal- JBJS- ESSENTIAL SURGICAL TECHNIQUES, INDIAN EDITION, OCTOBER 2015, VOL.4, NO. 3, SPECIAL EDITION by Shier- Chieg, Huang, MD, PhD, Ting- Ming Wang, MD, PhD, Kuan- Wen Wu, MD, Ken N. Kuo, MD
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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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.
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.
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.
- 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
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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.
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
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.
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
2. The sacrum is an irregularly shaped bone, made up of a group of five fused
vertebrae
The sacrum plays a central role in the stability of both the pelvis and the
spinal column.
The important neurologic structures the lower sacral
roots and autonomic nerves that are important for continence of the bowel
and bladder and sexual function
5. frequently missed at presentation because these
associated with high-energy trauma and present with
multiple injuries & hemodynamically unstable.
The neurologic evaluation must include DRE to assess
rectal tone
maximal contraction of the anal sphincter and
rectal tears and anterior perineal lacerations.
6.
7. The L5 nerve is at risk at the anterior junction of the ala
and the sacral promontory, and the S1 nerve root can be
injured within the foramen.
Extremity motor and sensory testing and rectal
examination
8. IMAGING STUDIOS
Plain radiographs have not proven sensitive .
CT scan of the pelvis with 2-mm slices and sagittal and
coronal reformatted images should be obtained
When associated neurologic deficits with displaced
fractures, MRI also may be of value,
9. DENIS CLASSIFCATION
Zone 1-lateral to the foramina
50% of injuries with a 6% incidenceof L5 and S1
injuries
Zone 2 -through the foramina
34% of injuries, and 28% with deficits unilaterally at
the L5, S1, or S2 levels
Zone 3- medial to the foramen
and involve the spinal canal
Remaining 16% of injuries
12. AO CLASSIFICATION
The classification system describes injuries based on
three criteria:
morphology of the injury
neurologic status
case-specific modifiers
13. MORPHOLOGY OF THE INJURY
TYPE A INJURIES
are lower sacro-coccygeal fractures with no impact on the posterior pelvic or spino-pelvic
stability.
TYPE B INJURIES
are unilateral longitudinal (vertical) sacral fractures which result in posterior pelvic
instability but no impact on spino-pelvic stability.
TYPE C INJURIES
include unilateral B injuries with L5-S1 facet involvement, bilateral longitudinal
(vertical) sacral fractures and U fracture variations resulting in spino-pelvic
instability.
14.
15.
16. NEUROLOGY
Neurological injuries are classified as follows:
Nx: Cannot be examined
N0: No neurological deficits
N1: Transient neurological injury
N2: Nerve root injury
N3: Cauda Equina Syndrome/Incomplete SCI
N4: Complete SCI*
17. MODIFIERS
These modifiers are added to distinguish
features that may impact treatment of a given
fracture type.
M1: Severe soft Tissue Injury
M2: Metabolic Bone Disease
M3: Anterior pelvic ring injury
M4: Sacroiliac joint injury
18. TREATMENT
Type A1 and A2 are managed conservatively
Type A3, by sacral alar plating or laminectomy
Type B1,B2, B3 are managed with illiosacral screws or
spinopelvic fixation.
19.
20. C0 Nondisplaced U-fracture
This is a nondisplaced
sacral U-type fracture,
result from low-energy
injuries.
commonly seen as
insufficiency fractures in
patients with metabolic
bone disease.
Treated conservatively
or by Iliosacral screws
(ISS)
21.
22. TYPE C1
This is any unilateral B-type
fracture involving a fracture of
the ipsilateral L5-S1 joint.
This fracture type may impact
spino-pelvic instability and is
therefore classified as a C
fracture
23. TYPE C2
This is a bilateral B-type
fracture without a
transverse component.
These fractures are more
unstable and have a
higher risk of neurological
injury than C1.
24. TYPE C3
This is a displaced U-type
fracture. It has a similar
instability profile as C2,
but due to the transverse
fracture displacement it has
a higher likelihood of
neurological injury.
25. Type C1, C2 and C3 are treated surgically by
spinopelvoc fixation and Fixation of associated pelvic
ring injuries.
26.
27.
28. ILIOSACRAL SCREW (ISS) FIXATION
Iliosacral screw (ISS) fixation is a fluoroscopically
guided, percutaneous procedure.
Its primary use is for fixation of satisfactorily reduced
sacral fractures or sacro-iliac joint disruptions.
Anatomic reduction must be obtained before ISS
insertion.
30. entry point should be
anterior in S1 and
inferior to the iliac
cortical density (ICD),
which parallels the sacral
alar slope, usually
slightly caudal and
posterior
31.
32. INSERTION OF ILIAC SCREW
There are two standard
iliac screw starting points
within the ilium and one
within the sacrum.
33. THE TRADITIONAL ENTRY POINT
The traditional entry point is in the posterior iliac crest
and countersunk to prevent pressure ulcers over the
implant.
An oscillating drill (3.5 mm) or awl is used to penetrate
between the two cortices in a ventral, caudal direction
toward the anterior inferior iliac spine.
34. ILIAC STARTING POINT
is referred to as anatomic starting point. It is more caudal
and medial than the traditional starting point and aligns
better with the lumbar pedicles.
The more caudal position places this screw in a wider
cross section of bone above the sciatic notch
35. SACRAL ENTRY POINT
The third starting point is at the inferolateral
aspect of the S1 foramen.