This powerpoint is intended to give an overview of observation of knee to undergraduate first year students. Students should not forget to do overall comprehensive observation of posture and other body parts before focusing the observation locally at the knee joint.
This powerpoint is intended to give an overview of observation of knee to undergraduate first year students. Students should not forget to do overall comprehensive observation of posture and other body parts before focusing the observation locally at the knee joint.
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
Assessment and Management of Frozen ShoulderThe Arm Clinic
The Arm Clinic's Mr Mike Walton presents his thoughts on assessment and management of Frozen Shoulder. Presentation for The Arm Clinic educational event #stiffshoulder at The Wilmslow Hospital, 29th April 2016.
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
Assessment and Management of Frozen ShoulderThe Arm Clinic
The Arm Clinic's Mr Mike Walton presents his thoughts on assessment and management of Frozen Shoulder. Presentation for The Arm Clinic educational event #stiffshoulder at The Wilmslow Hospital, 29th April 2016.
Physiotherapists utilize sacroiliac joint special tests to diagnose pain or dysfunction within the joint connecting the sacrum and ilium in the pelvis. These tests focus on specific movements or palpation techniques that provoke discomfort or uncover irregularities in the joint. Common assessments like Gaenslen's, FABER, and the compression test aid in evaluating pain response, joint mobility, stability, and integrity. By identifying sacroiliac joint issues through these tests, physiotherapists can tailor treatment plans to alleviate pain and restore functionality for their patients.
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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
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.
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
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
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
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
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.
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
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.
2. Chief complaints:
Pain
Swelling
Deformity
Stiffness
Instability
Weakness
Loss of function
2Shoulder examination/ Sunil Baniya
3. Examination is done either in sitting or standing position with sufficient
exposure.
1. Look :
Front
Head, neck alignment
Shoulder symmetry
Prominent AC joint/ swelling
Fullness of supra-clavicular area
Wasting of deltoid
3Shoulder examination/ Sunil Baniya
4. Axillary area
Any sinus, scars, swelling
Arm position
Small muscles of hand
Side
Wasting of supraspinatus & infraspinatus
Winging of scapula
Swelling, sinus, scars
Shoulder examination/ Sunil Baniya 4
Fig : winged scapula
5. Back
Wasting of deltoid
Drooping of shoulder
2. Feel :
a. Temperature:
- Periphery to centre or proximal to distal
b. Tenderness:
For tenderness palpate over
- Sterno-clavicular joint
- Along clavicle
5Shoulder examination/ Sunil Baniya
6. - Acromio-clavicular joint
- Spine of scapula
- Borders
- Shoulder joint line
- Coracoid process
- Biceps tendon in bicipital groove (arm flexion, elbow flexion at 90°, then
internally/ externally rotate & palpate)
- In axilla palpate humeral head
- Fullness of inferior recess in shoulder effusion
6Shoulder examination/ Sunil Baniya
7. 3. Movement:
Active movement (passive movement need not to be done)
- Flexion : 0- 160/ 180°
- Extension : 0- 180°
- Adduction : 0-15° (cross arm)
- Abduction : 0-180°
*First 15° = supraspinatus
*15-90° = deltoid
*>90° = serratous anterior
7Shoulder examination/ Sunil Baniya
8. - Internal rotation : 15° (touches inferior border of opposite scapula or thumb
touches upto T5 spine)
- External rotation : 60°
(Rotational movement at various position)
4. Special Tests:
a. Impingement tests:
i) Painful arc test
ii) Neer’s impingement test
iii) Hawkin’s / Hawkin Kennedy test
iv) Jobe’s test/ Empty can test
8Shoulder examination/ Sunil Baniya
9. b. For Rotator cuff tendon tear:
i) Drop arm test
ii) Lift off test/ Gerber’s test
c. For Rotator cuff instability:
i) Apprehension test
ii) Jobe’s relocation test
iii) Sulcus test
9Shoulder examination/ Sunil Baniya
10. Painful arc test:
for painful arc syndrome
shoulder pain occurring at 60-120° of arc
Described when arm is abducted from the side
to fully raised position
+ve in supraspinatus tendinitis
10Shoulder examination/ Sunil Baniya
During active abduction, the scapulohumeral rhythm is disturbed on the right and
the patient starts to experience pain at about 60 degrees (a). As the arm passes
beyond 120 degrees (b) the pain eases and the patient is able to abduct and elevate
up to the full 180 degrees
11. Neer’s Impingement test:
Patient standing or sitting
Hand prone
Extending at elbow, passively elevate the arm
>90° or above the shoulder
Other hand of examiner fixes the shoulder
+ve pain at anterolateral aspect of shoulder =
infraspinatous tendon impingement
Shoulder examination/ Sunil Baniya 11
Fig : Neer's impingement sign
12. Hawkin’s test/ Hawkin Kennedy test:
Fixing scapula/ shoulder
Abduction of shoulder at 90°, forward flexion of
elbow
Internal rotation by examiner by grasping just
below elbow
Finding : pain at shoulder => Subacromial
impingement
12Shoulder examination/ Sunil Baniya
Fig : Hawkin's test
13. Jobe’s test/ Empty Can test:
Patient standing
Arm forwardly flexed at the level of shoulder
Fully pronate arm into empty can position
Ask patient to resist downward force applied
Finding : pain or weakness => Supraspinatus tendon lesion
Shoulder examination/ Sunil Baniya 13
14. Drop arm test:
Passively forward flex the arm after shoulder
stabilization by other hand
Bring 90° abduction state
Let the patient to hold his hand in that position
Arm drops
Finding: complete rotator cuff tear
14Shoulder examination/ Sunil Baniya
Fig : Drop arm test
15. Lift off test/ Gerber’s test:
Patient is asked to stand
Place his/her one arm behind his/her back with the dorsum of the
hand resting against the mid-lumbar spine
The examiner then lifts the patient’s hand off the back
And the patient is told to hold it there
Finding: Inability to do so=>weakness => rupture of Sub-scapularis
tendon
(Drawback: needs full internal rotation, can not be done when restricted or pain on
doing so)
Shoulder examination/ Sunil Baniya 15
Fig : Gerber's lift-off test
16. Apprehension test:
Sitting upright position
Abduct at 90°, forwardly flex, externally rotate, then try
to push shoulder forward extending at the elbow
Pain
See patient’s face for apprehension
16Shoulder examination/ Sunil Baniya
Fig : Apprehension test for anterior subluxation or dislocation.
Abduct, externally rotate and extend the patient’s shoulder
while pushing on the head of the humerus. If the patient feels
that the joint is about to dislocate, she will forcibly resist the
manoeuvre.
17. Jobe’s Relocation test:
Patient supine
Arm ½ part at the edge of couch
Externally rotate the forearm
Pain & apprehension appear first
Then press down on arm => should relieve pain or apprehension
Finding: Again pain occurs after release of downward pressure =>
anterior instability
17Shoulder examination/ Sunil Baniya
Fig : Jobe's relocation test
18. Sulcus test:
For inferior capsular laxity or instability
Patient sitting arm by side
Relaxed arm
Elbow flexed at 90°
Give downward axial force along the humerus by holding elbow
Another hand provide grip between acromian, anterior & posterior
18Shoulder examination/ Sunil Baniya
Fig : Sulcus sign
19. OR,
Arm forward flexion at 90°
Elbow bent at 90° & internally rotated
Finding: sulcus appear between acromial arch and humeral head => test the degree
of inferior capsular laxity
Shoulder examination/ Sunil Baniya 19
20. 5. Measurement:
Take only either of two bony points as reference for girth/bulk of humerus i.e;
acromian or lateral epicondyle of humerus
6. Axillary lymph nodes
7. Cervical spines
8. Distal Neurovascular Status (DNVS)
Radial pulse
Sensory examination (autonomous zone of radial, median & ulnar nerve)
Motor examination (5 groups = C5, C6, C7, C8, T1)
20Shoulder examination/ Sunil Baniya