Vertebral osteomyelitis( spondylodiskitis )
usually seen in adults (median age is 50 to 60 years)
Location
50-60% of cases occur in lumbar spine
30-40% in thoracic spine
~10% in cervical spine
Vertebral osteomyelitis( spondylodiskitis )
usually seen in adults (median age is 50 to 60 years)
Location
50-60% of cases occur in lumbar spine
30-40% in thoracic spine
~10% in cervical spine
This video explains Cervical Stenosis and Cervical Spondylosis/Arthritis. When stenosis begins to affect the spinal cord this is called Cervical Spondylotic Myelopathy. 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 Cervical Stenosis/Arthritis feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
This video explains Cervical Stenosis and Cervical Spondylosis/Arthritis. When stenosis begins to affect the spinal cord this is called Cervical Spondylotic Myelopathy. 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 Cervical Stenosis/Arthritis feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Definition:-
1) Hip dislocation occurs when the head of the femur is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip.
2) A hip dislocation a disruption of the joint between the femur and pelvis.
3) A hip dislocation occurs when the ball-shaped head of the femur (thigh bone) moves out of its socket on the pelvis. In most cases, this requires a traumatic force to the thigh bone.
Fractures of the upper limb are common orthopedic injuries that can have a significant impact on a person's daily life and functionality. This PowerPoint presentation provides a comprehensive overview of upper limb fractures, encompassing the shoulder, arm, elbow, forearm, wrist, and hand.
Key Topics Covered:
Introduction to Upper Limb Fractures: An overview of the prevalence and significance of upper limb fractures in orthopedic practice.
Anatomy of the Upper Limb: A detailed look at the bones, joints, and musculature of the upper limb, providing essential context for understanding fractures.
Types of Fractures: Exploring the various types of upper limb fractures, including closed, open, displaced, and non-displaced fractures.
Etiology and Causes: Identifying the common causes and risk factors associated with upper limb fractures, such as trauma, falls, sports injuries, and pathological conditions.
Clinical Evaluation: Discussing the clinical assessment and diagnostic methods used to identify and classify upper limb fractures accurately.
Management and Treatment: A comprehensive overview of the treatment options, which may include casting, splinting, closed reduction, open reduction, internal fixation, or external fixation.
Complications and Rehabilitation: Exploring potential complications that may arise during the healing process and the importance of post-fracture rehabilitation.
Prevention and Education: Highlighting preventive measures and education strategies to reduce the risk of upper limb fractures, especially in high-risk populations.
Case Studies: Presenting real-life case studies and radiographic images of upper limb fractures to illustrate different scenarios and treatment approaches.
Future Trends: A glimpse into emerging technologies and advancements in the management of upper limb fractures.
This presentation is designed for healthcare professionals, medical students, and anyone interested in understanding the intricacies of upper limb fractures. By the end of this presentation, attendees will have a comprehensive understanding of the evaluation, management, and rehabilitation of fractures affecting the upper limb, ultimately contributing to better patient care and outcomes.
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.
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
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/
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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
2. Shoulder dislocation
Definition:
Dislocation of the glenohumeral joint is a displacement of the
humeral head from its normal position in the glenoid labral
fossa(complete separation of the articular surfaces of the
glenohumeral joint).
Prevalence:
• Shoulder dislocation is a common reason for emergency
room visits and accounts for about 45% of all dislocations
• Traumatic shoulder dislocations are far more common than
non-traumatic forms
3. Types of shoulder dislocation
According to direction of dislocation
1- Anterior shoulder dislocation ( very common)
2- Posterior shoulder dislocation ( un common)
3- Inferior shoulder dislocation( extremely rare)
According to mechanism of injury
1- Traumatic
2- A traumatic
3
4. Posterior dislocation
Definition
In a posterior glenohumeral dislocation, the head of the
humerus is forced out of its posterior capsule in an posterior
direction past the glenoid labrm
Types
• Subacromial
• Subglenoid
• Subspinous
6. Prevalence and mechanism of injury
• posterior dislocation represents 3 to 4 % of shoulder
dislocations
• It is caused by posterior driving force of the humerus
while it is adducted, flexed, and internally rotated
Risk factors for posterior shoulder dislocations include:
• seizure
• electric shock
• follow-through from throwing an object
• underlying lesions of the shoulder, such as reverse
Bankart and reverse Hill-Sachs defects
6
7. Anterior shoulder dislocation
In an anterior glenohumeral dislocation, the head of the humerus
is forced out of its anterior capsule in an anterior direction past the
glenoid labrum and then downward to rest under the coracoid
process.
8. prevalence
• Anterior shoulder dislocations contribute 96% to 98% of all
shoulder dislocations
• In 90% of cases, anterior shoulder dislocation affects
young individuals(9 out of 10 patients are 21 to 30 years of
age), many of whom are athletes
• The frequency of anterior dislocation exhibits two peaks,
during the second and sixth decades, respectively.
• Men are affected 3 times more often than women
9. Mechanism of injury
The mechanism of anterior type may be:
• Direct a forward impulse of the elevated,
abducted, and externally rotated arm (e.g.,
during a basketball smash) or
• A fall on the palm of the hand with the arm
outstretched.
9
11. 11
Inspection
The patient supports the injured arm with
the hand of the uninjured side. Signs that
suggest anterior dislocation include a
squared-off appearance of the shoulder
with loss of the normal rounded contour,
bulging of the acromion, and filling of the
delto-pectoral groove
13. Diagnosis
• Palpation
Palpation shows an empty glenoid and a bulge in the delto-pectoral
groove
• Rang of motion
The arm is abducted and cannot be actively or passively moved into
adduction.
• The initial examination should include testing for injury to the axillary
nerve or brachial plexus (sensation from the point of the shoulder to
the fingers and simple motor function testing) and blood vessels
(temperature and color of the skin over the fingers and palpation of
the distal pulses).
13
14. Diagnosis
Radiological assessment
• Both an antero-posterior and a lateral radiographic view
should be obtained
• Computed tomography (CT) offers the best accuracy
and sensitivity for detecting and evaluating a fracture
andfor assessing the extent of impaction damage.
14
15. Treatment
1-Reduction
The traditional treatment for anterior shoulder dislocation is reduction
followed by immobilization with the arm in internal rotation for 3 to 6
weeks followed by rehabilitation therapy.
The efficacy of this treatment remains unclear. The recurrence rate can
reach 95% depending on the risk factors, particularly patient age at the
first episode.
15
16. treatment
Immobilization with the arm in external rotation (ER) after
the first episode has been suggested based on magnetic
resonance imaging (MRI) studies showing that external
rotation increases the amount of tension on the sub-
scapularis muscle and maintains the labrum and capsule in
close contact with the glenoid
16
17. 17
However the ER immobilization could not
reduce the rates of recurrence after primary
anterior shoulder dislocation or improve the
quality of life compared with the IR
immobilization.
18. treatment
Reduction maneuvers may be :
1-Reduction methods without counter support
e.g Hippo-cratic method (simple traction along
the axis of the arm )
2-Reduction with countersupport on the axilla
18
19. treatment
2- Post-reduction management
• An antero-posterior radiograph should be obtained to
confirm that complete reduction has been achieved and
to look for concomitant lesions
• After reduction, the patient should be re-evaluated for
nerve and vessel injuries
19
20. Rehabilitation program
Goals of rehabilitation program
• restoring the normal axis of rotation for the
glenohumeral joint
• optimizing the stabilizing muscles length –
tension relationship
• restoring proper neuromuscular control to the
shoulder complex.
20
21. I. Protection Phase
A) Protect Tissue Healing
• After reduction shoulder is protected in a shoulder sling
for an average of 6-8 weeks (this have been found to be
the most recommended period to minimize possibility of
recurrent dislocation specially in young patients.
• During the post traumatic period (first 1week), the patient
arm may need to be continuous immobilized to reduce
pain & spasm.
• Afterwards, the arm is only removed from sling during
exercises.
21
22. B) Promote Tissue Healing
According to patient tolerance, the Following exercises
are gradually administrated:
1- Protected ROM
2- Intermittent muscle setting of the rotator cuff, deltoid and
Biceps Brachii.
3- Grade II are initiated as soon the patient tolerate them.
(Arm is positioned beside body or in resting position).
22
23. 4- Initiate a scapulothoracic exercise program, avoiding
elevated positions of the upper extremity that put stability
at risk.
6- Patients should begin an aerobic training regime with the
lower extremity like stationary biking
23
24. Precautions
• To avoid disruption the healing of the capsule and other damaged
tissues, ROM into external rotation is performed with the elbow at the
patient’s side, with the shoulder flexed in the sagittal plane, and with
the shoulder in the resting position (in the plane of the scapula,
abducted 55 and 30 to 45 anterior to the frontal plane)
• forearm is moved from in front of the trunk (maximal internal
rotation) to 0 or possibly 10 to 15 external rotation. 24
25. Contraindications at this stage
• External rotation at
90 degrees
abduction
• Shoulder
extension beyond
0 degree
. 25
28. II. Controlled Motion Phase
A) Provide Protection
• Avoid full return to unrestricted activity
• Use sling only when the shoulder is tired or
during activities where protection is needed.
28
29. B) Increase Shoulder Mobility
• The program begins with the use of an active assistive
ROM exercises
• Mobilization techniques are initiated using all appropriate
glides except the anterior glide
• The posterior joint structures are passively stretched with
horizontal adduction self-stretching techniques.
29
32. C) Increase stability and strength
The following muscle groups should be strengthened
1- Shoulder Internal rotators & Adductors: to increase
anterior stability, and support anterior capsule.
2- Shoulder external rotators: To reduce anterior translation
forces, and participate in the deltoid-rotator cuff force
couple when abducting and laterally rotating the humerus
3- Scapular stability is essential for normal shoulder
function.
4- PNF techniques to help reestablish neuromuscular
control.
32
33. Strengthening exercises are graduated as follows:
1- Isometric exercises with joint position at the side of the
trunk and progressed to various pain-free positions
2- Partial weight bearing and stabilization exercises
3- Dynamic resistance limiting external rotation to 50
degree and avoiding the position of dislocation
33
34. 4- At 3 weeks, supervised isokinetic resistance for internal
rotation and adduction are initiated.
5- At 5 weeks, all shoulder motions are incorporated into
isokinetic program except for external rotation in 90
degrees abduction
34
37. Stabilization Exercises
Closed chain exercises (CKC)
• Start with the hands on the ground or table for
strengthening the scapular stabilizers more aggressively.
These exercises should begin on a stable surface like a
table, progressing the amount of weight bearing by
advancing from the table to the ground.
• Advancing to a less stable surface like a BAPS board or
Swiss ball to reestablish neuromuscular control
"proprioceptive training". 37
40. III. Return to function phase
A) Restore functional control
• Coordination training to synchronize action of shoulder
and scapular muscles.
• Endurance training for all shoulder and scapular
muscles.
• Prophylactic stretching to gain full ROM.
• Scapular and rotator cuff strengthening ex.
• As stability improves, progress to:
1-Eccentric training to maximum load
2-Increasing speed and control
3-Simulating desired functional patterns for activity
40
41. • CKC become more challenging by adding motion to the
demands of the stabilization e.g. weight shifting on a
Fitter and closed kinetic strengthening on a stair climber
for endurance are started.
• Plyometric exercises can be added to improve dynamic
control.
41
44. B) Return to activity
• It is important that the patient learns to recognize signs of fatigue
and impingement and stays within the tolerance of the tissues.
• Return to full activity when there is
1- No muscle imbalance
2- Good coordination
3- Apprehension test is normal
• Total rehabilitation time usually lasts from 2.5-4 months. But it may It
last as long as 20 weeks depending on the patient's shoulder
strength, lack of pain, and the ability to protect the involved
shoulder.
44
45. • Between 20 and 26 weeks will be required for
rehabilitation of athletes.
• Some therapist and physicians recommend use
of a protective shoulders harness while
participating in athletic activities.
45
46. Posterior dislocation
• the management approach is the same as anterior
dislocation with one exception
• Avoid the position of flexion/ adduction / internal rotation
in the acute (protection 0 phase.
• Immobilization with hand hanging freely by the side of
the body is used if it is more comfortable than the sling
used
46