The rule of 4 of the brainstem:
A simplified method for understanding brainstem anatomy and brainstem vascular syndromes
https://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2004.00732.x
Cerebellum is the organ that controls tone of muscle and maintains balance of body. It is also responsible for co-ordination of the movements. There are some signs which suggest the abnormalities in Cerebellar functioning.
localization of stroke, CVS, stroke, for post graduates Kurian Joseph
New localization of stroke syndromes
1.Clinical localization of the site of the lesion.
2.Identifying the vascular territory and the vessel involved.
3.Correlating with the imaging findings.
Cerebellum is the organ that controls tone of muscle and maintains balance of body. It is also responsible for co-ordination of the movements. There are some signs which suggest the abnormalities in Cerebellar functioning.
localization of stroke, CVS, stroke, for post graduates Kurian Joseph
New localization of stroke syndromes
1.Clinical localization of the site of the lesion.
2.Identifying the vascular territory and the vessel involved.
3.Correlating with the imaging findings.
Dr Abdullah Ansari
PG-2 (Medicine)
AMU ALIGARH
A general approach to periodic paralysis....
(including hypokalemic periodic paralysis and thyrotoxic periodic paralysis, and other “Channelopathies” or “Membranopathies)
Pathophysiology
Epidemiology
Primary or familial periodic paralysis
Secondary periodic paralysis
Conventional classification of periodic paralysis
Classification of primary periodic paralysis based on ion-channel abnormalities
Clinical approach to a case of periodic paralysis
History of muscle weakness
Age of onset
Family history
Timing
Intensity
History of administration of certain drugs
Clinical examination
Differential Diagnosis
Laboratory investigations
Serum K+
CPK and serum myoglobin
ECG
EMG
Nerve conduction studies
Provocative Testing
Muscle biopsy
Treatment
Prognosis
Cns case-extramedullary compressive myelopathy, Q&AKurian Joseph
Tracts involved-corticospinal tract
anterior and lat spinothalamic
posterior coloumn
Mostly extramedullary compressive myelopathy at T10 level
Etiology –to consider both intra and extradural causes like neurofibroma/meningioma/av malformation.
extradural-potts spine,ivdp
Dr Abdullah Ansari
PG-2 (Medicine)
AMU ALIGARH
A general approach to periodic paralysis....
(including hypokalemic periodic paralysis and thyrotoxic periodic paralysis, and other “Channelopathies” or “Membranopathies)
Pathophysiology
Epidemiology
Primary or familial periodic paralysis
Secondary periodic paralysis
Conventional classification of periodic paralysis
Classification of primary periodic paralysis based on ion-channel abnormalities
Clinical approach to a case of periodic paralysis
History of muscle weakness
Age of onset
Family history
Timing
Intensity
History of administration of certain drugs
Clinical examination
Differential Diagnosis
Laboratory investigations
Serum K+
CPK and serum myoglobin
ECG
EMG
Nerve conduction studies
Provocative Testing
Muscle biopsy
Treatment
Prognosis
Cns case-extramedullary compressive myelopathy, Q&AKurian Joseph
Tracts involved-corticospinal tract
anterior and lat spinothalamic
posterior coloumn
Mostly extramedullary compressive myelopathy at T10 level
Etiology –to consider both intra and extradural causes like neurofibroma/meningioma/av malformation.
extradural-potts spine,ivdp
SYBPO - Orthotics.This presentation consists of all the pathological reasons affecting the lower extremity causing various deformities. it consists of Cerebral Palsy, polio, CDH etc.
Basics of MRI interpretation; December 2022.pptxKareem Alnakeeb
In December 2022, a discussion took place in the radiology department of the National Institute of Diabetes and Endocrinology, focusing on the basics of MRI interpretation.
How to Read a Research Article? By Dr. Nizar Saleh Abdelfattah, 2017Kareem Alnakeeb
This presentation is created by Dr. Nizar Saleh Abdelfattah in 2017. He used it in his episodes of "Research Fundamentals For Dummies" on YouTube.
https://www.youtube.com/playlist?list=PLuDFktFSWZ_XVufo7h9bDIerKoo7s3ouA
* The original presentation on Mediafire:
http://www.mediafire.com/file/mu5dml695g5r8qf/How-to-Research-by-Nizar-Abdelfattah.pptx/file
Some notes in Cardiothoracic surgery. These notes were published in 2019.
You can download the file from:
- Mediafire: http://www.mediafire.com/file/zrxenwq4tjdnhsj/file
Summary notes of Anesthesia. These notes were published in 2020.
You can download them from:
-Mediafire: http://www.mediafire.com/file/wkey81yff7kv3j1/Anesthesia_Q%2526A_2020.pdf/file
Pediatrics notes about "Wheezy chest". These notes were published in 2018.
You can download them also from
- Telegram: https://t.me/pediatric_notes_2018
- Mediafire: http://www.mediafire.com/folder/u5u60m184t9z7/Pediatric_Notes_2018
Pediatrics notes about "Tuberculosis". These notes were published in 2018.
You can download them also from
- Telegram: https://t.me/pediatric_notes_2018
- Mediafire: http://www.mediafire.com/folder/u5u60m184t9z7/Pediatric_Notes_2018
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
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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.
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!
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
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.
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
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
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
The rule of 4 of the brainstem.pdf
1. The rule of 4
A simpli
fi
ed method for understanding brainstem anatomy and vascular syndromes
1⃣ There are 4 structures in the ‘midline’ beginning with M.
2⃣ There are 4 structures to the side beginning with S.
3⃣ There are 4 cranial nerves in the medulla, 4 in the pons and 4 above the pons (2 in the midbrain).
4⃣ The 4 motor nuclei that are in the midline are those that divide equally into 12 (except for 1 and 2), that is 3, 4, 6 and 12
(5, 7, 9 and 11 are in the lateral brainstem).
Thus a medial brainstem syndrome will consist of the 4 M’s and the relevant motor cranial nerve (3rd, 4th, 6th and 12th),
and a lateral brainstem syndrome will consist of the 4 S's and either the 9–11th cranial nerve if in the medulla, or the 5th,
7th and 8th cranial nerve if in the pons.
The 4 medial structures Associated de
fi
cit
The Motor pathway (or
corticospinal tract)
contralateral weakness of the arm and leg.
The Medial Lemniscus contralateral loss of vibration and proprioception in the arm and leg.
The Medial longitudinal
fasciculus
ipsilateral internuclear ophthalmoplegia (failure of adduction of the ipsilateral eye
towards the nose and nystagmus in the opposite eye as it looks laterally).
The Motor nucleus and nerve ipsilateral loss of the motor cranial nerve (3, 4, 6 or 12)
The 4 Lateral (Side) structures Associated de
fi
cit
The Spinocerebellar pathways ipsilateral ataxia of the arm and leg
The Spinothalamic pathway contralateral alteration of pain & temperature affecting the arm, leg and rarely the trunk
The Sensory nucleus of the 5th ipsilateral alteration of pain and temperature on the face in the distribution of the 5th
cranial nerve
(this nucleus is a long vertical structure that extends in the lateral aspect of the pons
down into the medulla)
The Sympathetic pathway ipsilateral Horner's syndrome, that is partial ptosis and a small pupil (miosis)
Above the pons Associated de
fi
cit
1 Olfactory Not in midbrain
2 Optic Not in midbrain
3 Oculomotor impaired adduction, supraduction and infraduction of the ipsilateral eye with or without a
dilated pupil. The eye is turned out and slightly down.
4 Trochlear eye unable to look down when the eye is looking in towards the nose
In the pons Associated de
fi
cit
5 Trigeminal ipsilateral alteration of pain, temperature and light touch on the face back as far as the
anterior two-thirds of the scalp and sparing the angle of the jaw.
6 Abducent ipsilateral weakness of abduction (lateral movement) of the eye
7 Facial ipsilateral facial weakness
8 Auditory ipsilateral deafness
In the medulla Associated de
fi
cit
9 Glossopharyngeal ipsilateral loss of pharyngeal sensation
10 Vagus ipsilateral palatal weakness
11 Spinal accessory ipsilateral weakness of the trapezius and sternocleidomastoid muscles
12 Hypoglossal ipsilateral weakness of the tongue