This document discusses shoulder instability. It defines instability as the inability to maintain the humeral head in the glenoid fossa, and describes different types including dislocation, subluxation, and laxity. Static factors like bony anatomy and dynamic factors like muscles contribute to stability. The glenoid fossa has a pear shape with retroversion and tilt. Classification systems for instability are mentioned. Surgical procedures to address instability and lesions are briefly outlined. Multi-directional instability is also referenced.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
Medial patellofemoral ligament reconstruction ---- an update on techniques used. This lecture was taken by me at Trinity Arthroscopy Course, Chandigarh.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
Medial patellofemoral ligament reconstruction ---- an update on techniques used. This lecture was taken by me at Trinity Arthroscopy Course, Chandigarh.
http://lifeinmotion.co.in/
We Provide These Services :
Total Knee Replacement,
Revision Joint Replacement Surgery,
Total Hip Replacement
In modern total knee replacement surgery, only the worn out cartilage surfaces of the joint are replaced.
The entire knee is not actually replaced. The operation is basically a resurfacing (or “retread”) procedure. On resurfaced area, hip or knee joints made up of specialized alloy metal and ultra high density polyethylene (UHDP)plastic are placed.
http://lifeinmotion.co.in/
Dr. NEERAJ AGGARWAL
MBBS –SMS Medical College, 1999
MS – SMS Medical College, 2003
Senior Residency KEM Mumbai 2004
Fellowship in Joint Replacement Depuy Fellow, Mumbai 2005
Fellowship Joint Replacement Surgery Germany,
Ranawat Adult Reconstruction Fellow, New York
Areas of Specialization:
* Primary Joint Replacement surgery Knee, Hip, Shoulder
* Revision Joint Replacement Hip, Knee
* PSI for Joint Replacement
* Difficult Intra Articular Fractures
* Osteotomies for Arthritis management
* Head salvage surgeries for AVN Hip
Work Experience:
* 2006-2011 Consultant at Monilek Hospital and Tagore Hospital
* Having done more than 7000 major Trauma surgeries
* 1000 Joint Replacement Surgeries
* At present, he is only and Sr. Joint Replacement Surgern at Narayana Multispecility Hospital, Jaipur
Awards:
* Various Awards by various social groups and clubs.
* Gold Medalist in MBBS and topper in diff pre PG Examinations.
Achievements:
* Arthritis awareness CME’s in more than 15 districts of Rajasthan.
* One of the Pioneers of Joint Replacement Surgeries in Rajasthan.
What is Muscular Dystrophy?
Types of Muscular Dystrophy
What is Duchenne muscular dystrophy (DMD), pathophysiology, clinical presentation, Gowers sign, DMD and Becker's muscular dystrophy and functional grades
Sochima Johnmark Obiekwe presentation on SpondylolisthesisObiekwe Sochi
The PowerPoint presentation on Physiotherapy Management of Spondylolisthesis has been successfully completed. This informative session explored the crucial role of physiotherapy in effectively managing spondylolisthesis, restoring spinal stability, and optimizing functional outcomes for patients.
The presentation covered various aspects of spondylolisthesis, including its definition, classification, common causes, and risk factors. Attendees gained insights into the clinical manifestations of the condition and the resulting limitations in daily activities.
The role of physiotherapy in the comprehensive management of spondylolisthesis was emphasized, highlighting the importance of collaboration between physiotherapists and healthcare professionals. The presentation discussed the comprehensive assessment techniques employed by physiotherapists to evaluate patients accurately.
Attendees learned about the goals of physiotherapy interventions, which included reducing pain and inflammation, restoring spinal stability, improving mobility and flexibility, and enhancing overall function. Evidence-based physiotherapy interventions such as therapeutic exercises, manual therapy techniques, postural education, and ergonomic modifications were showcased, providing practical knowledge for managing spondylolisthesis.
Overall, the completed PowerPoint presentation provided a comprehensive understanding of the vital role physiotherapy plays in the management of spondylolisthesis. Attendees were equipped with practical knowledge and evidence-based strategies to effectively restore stability, alleviate pain, and optimize functional outcomes for patients with this condition.
The completed PowerPoint presentation on Physiotherapy Management of Spondylolisthesis has successfully highlighted the power of physiotherapy in transforming the lives of individuals with spondylolisthesis.
This is a lecture focused on pelvic floor dysfunction in elite male sport especially football. It addressed the assessment and management of Pelvic pain in elite sport. Gerard Greene is a men's health physio who works in Birmingham UK ( Birmingham Men's Health Physio Clinic ) and Southampton UK ( Dr Ruth Jones ) .
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
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
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.
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.
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
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.
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.
Follow us on: Pinterest
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
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/
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
2. Refrences
• Recurrent Dislocation - Campbell’s Operative Orthopedics 13th ed
• https://youtu.be/4i3e3t1pND4 - Dr DinShaw Padhiwala : Understanding
Shoulder Instability
• Hermans, Job & Luime, Jolanda & Meuffels, Duncan & Reijman, Max &
Simel, David & Bierma-Zeinstra, Sita. (2013). Does This Patient With
Shoulder Pain Have Rotator Cuff Disease? The Rational Clinical
Examination Systematic Review. JAMA : the journal of the American
Medical Association. 310. 837-47. 10.1001/jama.2013.276187.
3. Definition
• Instability
• Inability to maintain humeral head in Glenoid Fossa
Dislocation Subluxation Laxity
Complete Loss of Glenohumeral
Articulation
Partial loss of Glenohumeral
Articulation
Incomplete loss of Gleno humeral
articulation unassociated with pain
Anterior instability tests
Load and shift
Apprehension test
Jobe’s Relocation Test
Rock wood test
Anterior Drawers Test
Rowe Test
Posterior Instability tests
-Load and shift
-Posterior Apprehension Test
Posterior Drawers test
Jerk test]?
MDI
Sulcus sign
+1 implies distance up to 1 cm
+2 sulcus 1-2 cm
+3 sulcus >3cm
Feagin Test
Rowe Test for multidirectional Instability
Tests for LABRAL tear
- Clunk Test
- Anterior slide Test
- O’Brien Test
- Kim Test
- Slap Prehension Test
- Labral Crank Test
Hermans, Job & Luime, Jolanda & Meuffels, Duncan & Reijman, Max & Simel, David & Bierma-Zeinstra, Sita. (2013). Does This Patient With Shoulder Pain Have Rotator Cuff Disease? The Rational Clinical Examination Systematic Review. JAMA : the journal of the American Medical Association. 310. 837-47. 10.1001/jama.2013.276187
Traumatic detachment of the antero inferior Glenoid labrum called as bankart lesion
It is the essential lesion in anterior dislocation of shoulder
Comes off with the anterior band of IGHL
If it doesn’t heal, can lead to residual instability
Sometimes it attaches to anterior aspect of Glenoid neck- non anatomical position- Anterior LABRAL PERIOSTEAL SLEEVE AVULSION (ALPSA lesion)
Traumatic detachment of the antero inferior Glenoid labrum called as bankart lesion
It is the essential lesion in anterior dislocation of shoulder
Comes off with the anterior band of IGHL
If it doesn’t heal, can lead to residual instability
Sometimes it attaches to anterior aspect of Glenoid neck- non anatomical position- Anterior LABRAL PERIOSTEAL SLEEVE AVULSION (ALPSA lesion)
If antero inferior band of IGHL ligament avulses from the humeral side- HUMERAL AVULSION OF GLENOHUMERAL LIGAMENT
If antero inferior band of IGHL ligament avulses from the humeral side- HUMERAL AVULSION OF GLENOHUMERAL LIGAMENT
Two methods
superimposition of opposite Glenoid
Best fit circle method
Posterior Shoulder Dislocations
- < 3% of total shoulder dislocations
- Increasingly seen in throwing atheletes (due to plastic deformation)
Mostly seen in young atheletes / combatants
due to repetitive throwing action, plastic deformation
Posterior LABRAL tears
Similar to edin hybinette procedure
Polar Group I
present with a positive apprehension (anterior direction) associated with rotator cuff weakness.
Subscapularis shows deficits on either the belly-press or modified lift-off tests
Global posture, single leg balance and scapular control are often undisturbed in these patients
As these patients move towards either the type II or III poles, patients begin to exhibit signs of poor scapular control, abnormal muscle activation, altered trunk stability and balance, indicating non-structural comorbidity.
Arthroscopy is useful to look for the subtleties of internal lesions of occult instability, such as bicipital and deep surface cuff lesions, soft tissue Broca defects, internal impingement and external impingement lesions.
Polar Group II
- Patients in this group present with positive anterior apprehension test with signs of increased capsular laxity, excessive external rotation and a sulcus sign.
- There may also be an associated glenohumeral internal rotation deficit (GIRD).
- The abnormal anterior translation of the GHJ within this group can be due to a combination of several factors: excessive anterior capsular laxity, scapular dyskinesis, tight posterior capsule, muscular imbalance (increased ratio of internal rotator/external rotator strength) and congenital labral pathology.
- The Presentation usually varies in individuals from different sports.
Polar Group III
- Patients lying in this spectrum of the pathology shows aberrant activation large muscles and simultaneous suppression of the rotator cuff
- Dynamic EMG has characterised latissimus dorsi, pectoralis major and anterior deltoid among the large muscles, and only infraspinatus of the rotator cuff
- If there is no clinically or electrophysiologically proven aberrant muscle activation then the condition is labelled type II
- Polar III patients will have a history of ‘party tricking’ the shoulder
- This will often occur in the midranges of movement or with the arm-dependent by the side indicating a muscular control problem
- These patients need a thorough assessment of the muscle activation pattern as well as the resting position of the GHJ (Glenohumeral Joint)
