The document discusses stroke, including its definition, types, risk factors, pathophysiology, diagnosis, treatment, and management. Stroke occurs when there is ischemia or hemorrhage in the brain, cutting off blood flow and killing brain cells. The two main types are ischemic (caused by clot or embolism) and hemorrhagic (bleeding in the brain). Risk factors include age, hypertension, heart disease, smoking, and others. Diagnosis involves tests like CT, MRI, and angiography to determine the location and size of damage. Treatment focuses on controlling risk factors, administering thrombolytics if appropriate, and surgical interventions in some cases to restore blood flow.
Staphylococcal Scalded Skin Syndrome Made Very EasyDrYusraShabbir
A brief description of a very common bacterial skin condition affecting children and adults. Characterized by fever, rash and peeling of the skin. Useful information for medical students, doctors especially dermatologists and pediatricians and nurses. Helpful information for exam preparation of USMLE, FCPS, MCPS, MRCP derma.
Staphylococcal Scalded Skin Syndrome Made Very EasyDrYusraShabbir
A brief description of a very common bacterial skin condition affecting children and adults. Characterized by fever, rash and peeling of the skin. Useful information for medical students, doctors especially dermatologists and pediatricians and nurses. Helpful information for exam preparation of USMLE, FCPS, MCPS, MRCP derma.
dermatological disease caused by bacterial infection (Staphylococcus aureus & Streptococcus pyrogen) contagious disease but it is easy to cure by taking oral antibiotics and topical antibiotic cream
Myelitis is a spinal disorder. Myelitis is the infection of the white matter of spinal cord. White matter of spinal cord is a part of the central nervous system that functions as a bridge between the brain and the rest of the body.
Myelitis can result in muscle weakness or paralyzing legs and then arms.
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
dermatological disease caused by bacterial infection (Staphylococcus aureus & Streptococcus pyrogen) contagious disease but it is easy to cure by taking oral antibiotics and topical antibiotic cream
Myelitis is a spinal disorder. Myelitis is the infection of the white matter of spinal cord. White matter of spinal cord is a part of the central nervous system that functions as a bridge between the brain and the rest of the body.
Myelitis can result in muscle weakness or paralyzing legs and then arms.
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
Definition, Medical and Nursing Management of the following Neurological Disorder-Cerebrovascular Disorders, Transient Ischemic Attack, Brain Attack, Cerebral Aneurysm, Subarachnoid Hemorrhage
Is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke.
It can occur
in the carotid
artery of the
neck as well as
other arteries.
When an artery is acutely occluded by thrombus or embolus, the area of the CNS supplied by it will undergo infarction if there is no adequate collateral blood supply.
Surrounding a central necrotic zone, an ‘ischemic penumbra’ remains viable for a time, i.e. it may recover function if blood flow is restored.
CNS ischemia may be accompanied by swelling for two reasons:
● cytotoxic oedema – accumulation of water in damaged glial cells and neurones,
● vasogenic oedema – extracellular fluid accumulation as a result of breakdown of the blood–brain barrier.
In the brain, this swelling may be sufficient to produce clinical deterioration in the days following a major stroke, as a result of a rise in intracranial pressure and compression of adjacent structures.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
2. In the 1970s the World Health
Organization defined stroke as a "neurological
deficit of cerebrovascular cause that persists
beyond 24 hours or is interrupted by death within
24 hours",
Stroke occure when there is ischemia to a
part of brain or haemorrhage into the brain that
results in death of the brain cells. (Lewies)
3. Non modifiable Risk factors:-
Age
Gender
Ethnicity
Race
Family history
Heredity
4. Hypertension:- Increase systolic BP & diastolic BP
increase chances to rupture the blood vessels.
Heart disease:- Arterial fibrillation, myocardial
infraction, valve abnormalities or Endocardiatis
increase risk of stroke.
DM
Smoking:- Excessive smoking causes arterial damage.
Excessive alcohol consumption
Metabolic syndrome
Drug abuse:- Cocaine causes vasoconstriction
Obesity:- It causes HTN, DM & elevated blood lipid
level.
5. Stroke is divided in to two major categories,
those are:-
Ischemic Stroke
Hemorrhagic stroke
6. Definition:-
Ischemic stroke results from inadequate blood
flow to the brain from partial or complete occlusion of
artery.
Types:-
A person experiencing stroke losses 1.9 million
neurons neurons each minutes .
Ishemic stroke are further divided in to two types,
those are:-
Thrombotic
Embolic
7. Cerebral thrombosis is a narrowing of the artery
by fatty deposits called plaque.
The plaque can cause a clot to form, which block
the passage of blood through the artery.
Thrombotic stroke are associated with DM or
HTN.
Both the disease enhance atherosclerosis.
Extent of stroke depands upon rapidity of onset,
size of leision & presence of collateral circulation.
Ischemic stroke symptoms progress in the first 72
hours as infraction & cerebral edema increase.
8. It is the stroke due to occlusion of small penetrating
artery.
It is commonly occure in basal ganglia, thalamus,
internal casule. It generally a symptomatic but
sometimes causes hemiplasia, leg or face weakness, leg
ataxia, decrease cognitive function.
9.
10. An Embolus is a blood clot or other debris circulating in the
blood.
When it reach an artery in the brain that is too narrow to
pass through, it lodges there & block the flow of blood.
Majority of embolus originate in the endocardial layer of
heart. Here the plaque breaking from the endocardium &
enter the circulation.
The embolus travel upward to the cerebral circulation &
ludge the where the vissel narrow or bifurcate.
The heart condition which raise emboli are MI, infective
Endocardiatis, rheumatic fever, Vulvular prosthesis, fat from
long bone fracture.
Symptoms are seen rapidly.
CR:- Headache, neurologic deficit depends upon amount of
brain tissue involve.
11. • PATHOPHYSIOLOGY:-
• DUE TO ETIOLOGY ( THROMBUS OR EMBOLUS)
OBSTRUCTION IN THE BLOOD VESSELS
CEREBRAL BLOOD FLOW DECREASE TO LESS THEN 25ml PER MINUTE
ISCHEMIC CASCADE BEGINS
NEURONE ARE NO LONGER ABLE TO MAINTAIN AEROBIC RESPIRATION
MITOCHONDRIA SWICH TO MAINTAIN ANAROBIC RESPIRATION
PRODUCTION OF LARGE AMOUNT OF LACTIC ACID
CHANGE IN Ph
INEFFICIANT ANAEROBIC RESPIRATION
NEURONE INCAPABLE OF PRODUCING SUFFICIENT QUANTITIES OF ATP
DEPOLARIZATION PROCESS HAMPER
CELL MEMBRANE FAIL TO MAINTAIN ELECTROLYTE BALANCE IN
PENUMBRA REGION(area surrounding an ischemic event)
EXCESSIVE INFLUX OF CELLULAR CALCIUM & RELEASE GLUTAMATE
ACTIVATE DAMAGING PATHWAY
DESTRUCTION OF CELL MEMBRANE, VASOCONSTRICTION
12. Visual field deficits:- It occur due to disturbance in primary
sensory pathway between the eye & visual cortex.
Loss of peripheral vision:- difficulty seeing in night, unaware
of object
Diplopia:- Double vision
Motor loss:-
Damage in upper motor neurone on one hemisphere
causes damage to the opposite side of the body.
Hemiparesis:- Weakness of the face, arm & leg on opposite
site.
Hemiplasia:- Paralysis of the face, arm,& leg on opposite
site of leision.
Ataxia:- Staggering, unsteady gait, unable to keep the feet
together. Dysphasia:- Difficulty in swallowing
13. Sensory deficits:-
Difficult in interpreting visual, tactile & auditory
stimuli,
Agnosias:- Deficite in the ability to recognise previously
familiar objects.
Verbal deficits:-
Dysarthria:- Difficulty of speaking caused by paralysis
of muscles responsible for producing speech
Excessive Aphasia:- Inability to express oneself.
Receptive aphasia:- Inability to understand the
language
Global:- Both excessive aphasia & receptive aphasia
14. Cognitive Deficits:-
Short & long term memory loss
Decrease attention span
Impaired ability to concentrate.
Poor abstract reasoning
Altered judgement
Emotional deficit:-
Decrease tolerance to stressful situation
Depression
Fear, hostility, anger
Feeling of isolation
15. Assess whether there is loss of gag reflex, cough reflex,
altered respiratory pattern, cardiovascular status & gross
neurological deficit.
Identify Transient ischemic attack which results from
temporary ischemia to a specific region of the brain which
manifested as sudden loss of motor, sensory & visual
function. It is the pre stroke which suggest patient will
develop stroke & irreversible damage.
CT Scan:- It identify size & location of lesion &
differentiation between ischemic & hemorrhagic stroke.
CTA( Computerised tomographic angiography):-
Visualization of vasculature which done at the time of CT
scan.
16. MRI:- Provide clear picture the CT scan
PET:- It shows metabolic activity of the brain & shows
extent of tissue damage
SPECT:- Single photon emission computed
tomography:-
Angiography to determine the cerebral atherosclerosis
Transcranial Doppler ultrasonography:- To measure
the velocity of blood flow in the measure cranial
arteries.
Skull X-ray
Brain scan
EEG
Lumber pumpture:- If RBC found in the CSF then
haemorrhage is subarachnoid space.
17. Control of hypertension
Control of DM
Treatment of underlying cardiac problem
Anticoagulation therapy for the patient with arterial
fibrillation
No smoking
Limiting alcohol
Stenting of carotid artery
18. Innitial management:-
Ensure patient airway
Maintain adequate oxygenation with
supplemental o2
Establish IV assess for normal saline
Maintain BP according to the guideline
Obtain CT Scan immediately
Position Head midline
Position HOB 30 degree if no symptom of shock
Anticipate thrombolytic therapy for ischemic
stroke
19. Ongoing management:-
Monitor vital sign& neurologic, including level of
consciousness.
Monitor motor & sensory function, pupil size &
reactivity
Medication:-
Those with arterial fibrillation are treated with low
dose warfarin with target INF of 2-3
Thrombolytic therapy:- Used to treat ischemic stroke
by dissolving the blood clot that blocking the blood flow
to the brain.
20. Surgical therapy:-
Endarterectomy:- removal of lesion from the carotid
artery to improve blood flow
Transluminalangioplasty:- There is insertion of a balloon
to open a stenosed artery
EC-IC bypass:- Anasomosis a branch of external artery to
an intracranial artery to increase the cerebrl perfusion.
