A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. (Thanx to Sachin Dwivedi)
Spinal cord injuries complete topic about it and how to make good rehabilitation for the patient with spinal cord injuries .
wish it help people
my pleasure :)
Mostafa shakshak
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Spinal Cord Injuries are uncommon, but they are a leading cause of high cost disability, and with ageing population, the incidence is expected to increase. This presentation looks at the many facets of spinal cord injuries.
Cervical spine trauma and spinal cord injuries by Dr Shamavu Gabriel.pptxGabriel Shamavu
PAEDIATRICS TRAUMA ADVANCED LIFE SUPPORT PRESENTATION
Cervical spine trauma and spinal cord injuries
Prepared by Dr GABRIEL KAKURU SHAMAVU, Resident in Paediatrics and child health at Kampala International University Teaching Hospital. With Mentorship of Professor Yamile Arias Ortiz. Tutor of the course of "Paediatrics Emergencies and life support". Mars 2022
It is the removal of solutes and water from body across a semipermeable membrane (dialyzer)
care during and after the dialysis is very important to prevent the entry of pathogens in to the body.
Chronic kidney disease (CKD) consists of a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR).
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Myasthenia gravis (MG) is a long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness. The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, drooping eyelids, trouble talking, and trouble walking.
Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord.
it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.
Seizures are episodes of abnormal motor, sensory, autonomic, or psychic activity (or a combination of these) resulting from sudden excessive discharge from cerebral neurons.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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
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
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!
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.
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.
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.
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.
2. ANATOMY AND PHYSIOLOGY
• Originates in the brainstem,
passes through the foramen
magnum, and continues through to
the conus medullaris near the L2
before terminating in filum
terminale.
• Contains cerebrospinal fluid.
• 45 cm (18 in) in men ,43 cm (17 in)
long in women.
• 13 mm (1⁄2 in) in the cervical and
lumbar regions to 6.4 mm (1⁄4 in)
in the thoracic area.
3. Cont.…
• 31 pairs of spinal Nerve.(C1–C8),(T1–
T12), (L1–L5), (S1–S5) and Co1.
• Spinal meninges: Dura, Arachnoid. And
Pia matter.
• External surface: Conus medularis(L1-
L2) cauda equina (L3-L5)
• Spinal Tissue: Gray Matter(neuronal
cell bodies, dendrites, axons and glial
cells)
• White Matter (Myelinated Axon)
• Dorsal Root (afferent sensory root)
• Ventral Root(Efferent motor root).
Important Function:
• Conduction pathway for
impulses.(Efferent and Afferent Root)
• Serving as a reflex center.(Reflex Arc)
4. Nerve Plexus
• Nerve plexus is a
network of
intersecting nerves.
Cervical Plexus(C1-C4)—
Serves the Head, Neck and
Shoulders.
Brachial Plexus(C5-T1)—Serves
the Chest, Shoulders, Arms and
Hands.
Lumbar Plexus(L1-L4)—Serves
the Back, Abdomen, Groin,
Thighs, Knees, and Calves.
Sacral Plexus(L5-S4)—Serves
the Pelvis, Buttocks, Genitals,
Thighs, Calves, and Feet.
Coccygeal Plexus(S5-Co1)—
Serves a Small Region over the
Coccyx.
5. DEFINITION
• Spinal cord injury (SCI) is damage to the spinal cord that
results in a loss of function such as mobility or feeling.
• A spinal cord injury (SCI) is damage to the spinal cord that
causes temporary or permanent changes in its function.
Symptoms may include loss of muscle function,
sensation, or autonomic function in the parts of the body
served by the spinal cord below the level of the injury.
6. Incidence
• SCI is highest among persons age 16-30, in whom 53.1
percent of injuries.
• Males represent 81.2 percent of all reported SCIs and
89.8 percent of all sports-related SCIs.
• Among both genders, auto accidents, falls and gunshots
are the three leading causes of SCI.
• Sports and recreation-related SCI injuries primarily affect
people under age 29.
7. Causes
Road Traffic accidents.
Bullet or stab wound
Traumatic injury
Electric shock
Extreme twisting of the middle of the body
Landing on the head during a sports injury
Fall from a great height
10. Complete Spinal Cord Injuries
• Tetraplegia(Quadriplegia):-Spinal cord injury above the first
thoracic vertebra, or within the cervical sections of C1-C8. result
is some degree of paralysis in all four limbs—the legs and arms.
• Paraplegia: Spinal cord injuries below the first thoracic spinal
levels (T1-L5). Paraplegics are able to fully use their arms and
hands, but the degree to which their legs are disabled depends on
the injury.
• Complete paraplegia: It is described as permanent loss of
motor and nerve function at T1 level or below, resulting in loss
of sensation and movement in the legs, bowel, bladder, and
sexual region.
11. CENTRAL CORD SYNDROME
• Cause: Injury or edema of
the central cord, usually of
the cervical area and
cervical lesions .
• Characteristics: Motor
deficits (in the upper
extremities sensory loss
varies in the upper
extremities).
12. ANTERIOR CORD SYNDROME
• Cause: acute disk
herniation associated with
fracture-dislocation of
vertebra and also occur
injury to anterior spinal
Artery and lesion.
• Characteristics: Loss of
pain, temperature, and
motor function is noted
below the level of the
lesion or injury; light touch,
position, and vibration
sensation remain intact.
13. POSTIRIOR CORD SYNDROME
• Cause: an infarct in the
posterior spinal artery and
is caused by lesions on the
posterior portion of the
spinal cord,
Characteristics: loss of
proprioceptive sensation,
fine touch, pressure, and
vibration below the lesion;
deep tendon areflexia.
14. Brown- Sequard syndrome
• Known as Lateral Cord
Syndrome.
• Cause: The lesion is caused
by a transverse hemisection
of the cord, as a result of a
knife or missile injury, fracture
dislocation of a unilateral
articular process.
• Characteristics: Ipsilateral
paralysis or paresis is noted,
together with ipsilateral loss of
touch, pressure, and vibration
and contralateral loss of pain
and temperature.
15. Conas Medularis syndrome
• Known as Lateral Cord
Syndrome.
• Cause: blow to the back-
such as Gunshot and
spinal tumor.
• Characteristics:
• Bowel and bladder
dysfunction,
• Flaccid lower extremities.
• Sexual dysfunction.
16. Cauda Equina Syndrome
• Known as Horse tail
Syndrome.
• Cause: Injury or lesion at the
lumbosacral nerve root below
the conus medulararis.
• Characteristics: Areflexia
loss of reflexes(Lower
Extremities). Leg weakness
• Bladder/bowel dysfunction
20. CLINICAL MANIFESTATION
• Spinal Shock
• Autonomic Dysreflexia
• Pain
• Breathing difficulty
• Sensitivity to stimuli
• Muscle spasms
• Loss of sensation
• Loss of reflex function
• Loss of autonomic activity
• Loss of bowel control
• Loss of bladder control
• Sexual dysfunction
• Loss of function, such as mobility or sensation
21. CERVICAL (NECK) INJURIES
Breathing difficulties
Loss of normal bowel and bladder
control
Numbness
Sensory changes
Spasticity (increased muscle tone)
22. THORACIC (CHEST LEVEL) INJURIES
Loss of normal bowel and bladder control
Numbness
Sensory changes
Spasticity (increased muscle tone)
Weakness, paralysis
23. LUMBAR SACRAL (LOWER BACK) INJURIES
Loss of normal bowel and bladder control (you may
have constipation, leakage, and bladder spasms)
Numbness
Pain
Sensory changes
Weakness and paralysis
33. EMEGENCY MANAGEMENT
• Initial treatment of patients with cord injury focuses on two
aspects -preventing further damage and resuscitation.
• Immobilization with a hard cervical collar (in case of
cervical spine injuries) and care in transportation of
patient is of paramount importance if the spine is
unstable.
• Resuscitation is aimed at airway maintenance,
adequate oxygen saturation of peripheral blood, restoring
blood pressure to acceptable limits, preventing
bradycardia, done simultaneously to prevent any ischemic
damage to the already compromised cord.
38. NURSING DIAGNOSIS
Impaired physical mobility related to loss of
motor function
Fluid volume deficit related to decrease LOC
Risk for injury related to loss of motor function.
Urinary retention related to level of injury
Risk for Impaired skin integrity related to
trauma
Knowledge deficit regarding the treatment
modalities and current situation.
Anxiety related to outcome of diseases as
evidenced by poor concentration on work,
isolation from others, rude behavior
39. NURSING MANAGEMENT OF PATIENT
WITH SPINAL CORD INJURY
Goal
• Resuscitation according to ATLS guidelines
• Determination of neurological injury
• Prevention of neurological deterioration
• Ongoing assessment and treatment of associated injuries
• Prevention of complications
• Initiation of definitive management for vertebral column
injury.
40. Respiratory management
Closely monitor the patient’s respiratory rate, depth, and
pattern, staying alert for paradoxical breathing.
Maintain continuous pulse oximetry; when possible, use
end-tidal capnography as part of routine monitoring.
Intubation. Patients with respiratory failure require
mechanical ventilation. If your patient needs intubation,
take care to maintain spinal alignment by using a cervical
collar, manual inline traction,
Many patients with injuries at the C3 vertebral level or
higher are ventilator dependent. Those with an
intact phrenic nerve may qualify for diaphragmatic pacer
implantation, which may allow weaning from
mechanical ventilation.
41. Cardiovascular management
Patients with significant cervical and high thoracic injuries
(T6 level and above) may develop
Neurogenic shock. Caused by loss of sympathetic tone,
this distributive shock state results in vasodilation,
profound bradycardia, and hypothermia.
Hypotension, temperature dysregulation, venous stasis,
and autonomic dysregulation (AD) may occur.
42. GI management
• Acute GI problems in SCI patients may include paralytic
ileus with associated abdominal distention,
gastric ulcers, and constipation.
• Monitor the patient’s bowel sounds and abdominal
distention at least every 4 hours. If indicated and ordered,
insert a decompressive gastric tube to reduce aspiration
risk and restore diaphragm position and lung size to
normal.
• To aid bowel regulation, the patient may need a bowel
regimen of stool softeners and a high-fiber diet along with
low-volume enemas, glycerin, or bisacodyl
suppositories or digital rectal stimulation to cause
reflexive evacuation after the morning meal.
43. Genitourinary management
• A patient in neurogenic shock experiences abrupt loss of
voluntary muscle control and reflexes, resulting in acute urinary
retention.
• An indwelling urinary catheter must be placed to
decompress the bladder and allow close urinary output
monitoring.
• SCI can cause neurogenic or aneurogenic bladder.
• • In neurogenic bladder, reflex-initiated voiding may occur
when the patient has a full bladder.
• • In aneurogenic bladder, such voiding doesn’t occur,
potentially causing overflow urine leakage.
• Planned intermittent catheterization can reduce
incontinence. Longterm bladder management varies with the
patient’s bladder type, needs, and lifestyle.
44. Musculoskeletal management
• Patients with SCIs typically experience muscle spasticity
as spinal shock recedes and reflexes return.
• Nonpharmacologic strategies to manage spasticity
include
Range-ofmotion exercises,
Positioning techniques,
Weight-bearing exercises,
electrical stimulation, and orthoses or splinting to
prevent loss of muscle length and contractures.
Pharmacologic therapy may include
baclofen, benzodiazepines, alpha2-adrenergic
agonists, and regional botulism toxin or phenol
injection.
45. Dermatologic management
• Prevention and early detection are the cornerstones of
pressureulcer management. an established skin risk
assessment tool, such as the Braden scale.
• turning the patient every 2 hours or more (depending
on risk assessment findings)
• avoiding positioning the patient on bony
prominences, such as the trochanters, sacrum,
and heels
• minimizing moisture
• frequently inspecting the skin under braces and
splints
• establishing a pressure-release regimen (manual or
automated) for wheelchair sitting
47. POSSIBLE COMPLICATIONS
Blood pressure changes - can be extreme
(autonomic hyperreflexia)
Chronic kidney disease
Complications of immobility:
Deep vein thrombosis
Pulmonary infections
Skin breakdown
Contractures
48. Increased risk of urinary tract
infections
Loss of bladdercontrol
Loss of bowel control
Loss of sensation
Loss of sexual functioning (male
impotence)
Muscle spasticity
Paralysis of breathing muscles
Paralysis (paraplegia, quadriplegia)
Pressure sores