Conservative management of Lumbar disc prolapse.pptxvinod naneria
conservative management, non-surgical treatment of lumbar PID,
current concepts on Lumbar disc management, MRI correlation with neurological deficit in PID
Sebastian Lattuga M.D. provides patient education materials on Lumbar Spinal Stenosis.
*What is lumbar spinal stenosis?
*What are the symptoms of lumbar spinal stenosis?
*Non-surgical treatment
*Surgical treatment
*Living with lumbar spinal stenosis
Conservative management of Lumbar disc prolapse.pptxvinod naneria
conservative management, non-surgical treatment of lumbar PID,
current concepts on Lumbar disc management, MRI correlation with neurological deficit in PID
Sebastian Lattuga M.D. provides patient education materials on Lumbar Spinal Stenosis.
*What is lumbar spinal stenosis?
*What are the symptoms of lumbar spinal stenosis?
*Non-surgical treatment
*Surgical treatment
*Living with lumbar spinal stenosis
This presentation goes through an explanation of the architecture, new features and use cases behind Ubuntu Core 16, Ubuntu for IoT.
What you will learn:
★ Lessons learned by Ubuntu in IoT and the need for a new approach to security and software management
★ Choosing the right Operating System for your IoT devices, hardware choices and long-term maintainability
★ How Ubuntu Core is being used by various partners to build solutions across home gateways, industrial, building automation and digital signage
short and complete course on thoracic outlet syndrome, from introduction to etiologies, classification, clinical presentation, work-up, treatment, differential diagnosis and prognosis and complications
Hello students.
It's a lecture prepared from maheshwari with pictures attached. This is sufficient for for answering a question in examination at mbbs level.
The neonatal bowel obstruction is suspected based on polyhydramnios in utero, bilious vomiting, failure to pass meconium in the first day of life, and abdominal distension.The presentations of NBO may vary. It may be subtle and easily overlooked on physical examination or can involve massive abdominal distension, respiratory distress and cardiovascular collapse.Unlike older children, neonates with unrecognized intestinal obstruction deteriorate rapidly.
Neonatal bowel obstruction is grouped into two general categories: high, or proximal, obstruction and low, or distal obstruction, both of which are suspected by failure to pass meconium at birth. High obstruction can be suspected based on the double bubble sign. Cases without distal gas are usually related to duodenal atresia, while high obstruction with distal gas need an upper gastrointestinal series because of the need to distinguish duodenal web, duodenal stenosis and annular pancreas from midgut volvulus, the latter being a surgical emergency. Confirmation is ultimately by surgical intervention.
Jejunal and ileal atresia are caused by in utero vascular insults, leading to poor recanalization of distal small bowel segments, a condition in which surgical resection and reanastamosis are mandatory. Hirschsprung disease is due to an arrest in neural cell ganglia, leading to absent innervation of a segment distal bowel, and appears as a massively dilated segment of distal bowel on contrast enema. Surgical resection is necessary for this condition as well. Imperforate anus also requires surgical management, with the diagnosis made by inability to pass the rectal tube through the anal sphincter.[6] Supportive intravenous hydration, gastric decompression, and ventilatory support may be needed due to poor neonatal nutrition resulting from dysfunctional bowel absorption.
A low obstruction is suspected on plain film, but needs follow up with a gastrografin enema, which itself can be therapeutic. The differential for low obstruction is ileal atresia, meconium ileus, meconium plug syndrome and Hirschsprung disease. In cases of meconium ileus or ileal atresia, the colon distal to the obstruction is hypoplastic, usually less than 1 cm in caliber, as development of normal colonic caliber in utero is due to the passage of meconium, which does not occur in either of these conditions. When diffusely small caliber is seen, it is referred to as microcolon. Radiographs in meconium ileus classically demonstrate a bubbly appearance in the right lower quadrant due to a combination of ingested air and meconium. If, on contrast enema, reflux into the dilated distal small bowel loops can be achieved, the study is both diagnostic and therapeutic, as the ionic contrast medium can dissolve the meconium to allow passage of enteric content into the unused colon.
If contrast cannot be refluxed into the distal small bowel, ileal atresia remains a diagnostic possibility.
With early intervention, morbidity and mortality.
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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
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.
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
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.
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
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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2. THORACIC DISC DISEASE
the least common location for disc pathology.
Symptomatic thoracic disc herniations remain rare,
with an estimated incidence of one in 1 million
individuals per year.
They represent 0.25% to 0.75% of the total incidence
of symptomatic disc herniations.
The most common age at onset is between the fourth
and sixth decades.
the incidence of asymptomatic disc herniations is
high 37%
3. SIGNS AND SYMPTOMS
The natural history of symptomatic thoracic disc
disease is similar to that in other areas, in that
symptoms and function typically improve with
conservative treatment and time.
The differential diagnosis
nonspinal causes the cardiopulmonary, gastrointestinal,
and musculoskeletal systems.
Spinal causes infectious, neoplastic, degenerative, and
metabolic problems within the spinal column and the spinal
cord.
4. SIGNS AND SYMPTOMS
Two general patient populations
1. The smaller group of patients is younger and has a
relatively short history of symptoms, often with a
history of trauma. Typically, an acute soft disc
herniation with either acute spinal cord compression
or radiculopathy is present. Outcome generally is
favorable with operative or nonoperative treatment.
2. The larger group of patients has a longer history, often
>6 to 12 months of symptoms, which result from
chronic spinal cord or root compression. Disc
degeneration, often with calcification of the disc, is
the underlying process.
5. SIGNS AND SYMPTOMS
Pain the most common presenting
Two patterns : , and along
the course of the intercostal nerve.
The T10 dermatomal level is the most commonly
reported distribution, regardless of the level of
involvement.
This is a band extending around the lower lateral thorax
and caudad to the level of the umbilicus.
This radicular pattern is more common with upper
thoracic and lateral disc herniations.
Associated sensory changes of paresthesias and
dysesthesia in a dermatomal distribution also occur .
6.
7. SIGNS AND SYMPTOMS
High thoracic discs (T2 to T5) can manifest similarly to cervical
disc disease with upper arm pain, paresthesias, radiculopathy,
and Horner syndrome.
Myelopathy also may occur. Complaints of weakness, which may
be generalized by the patient, typically involving both lower
extremities occur in the form of mild paraparesis.
Sustained clonus, a positive Babinski sign, and wide based and
spastic gait all are signs of myelopathy.
Bowel and bladder dysfunction occur in only 15% to 20% of
these patients.
Abdominal reflexes, cremasteric reflex, dermatomal sensory
evaluation, rectus abdominis contraction symmetry, lower
extremity reflexes and strength and sensory examinations, and
determination of long tract findings all are important.
8. TREATMENT RESULTS
nonoperative treatment usually is effective.
short term rest, pain relief, antiinflammatory agents, and
progressive directed activity restoration
should be continued at least 6 to 12 weeks if feasible.
9. OPERATIVE TREATMENT
Simple laminectomy has no role in the treatment of thoracic
disc herniations.
Posterior approaches, including costotransversectomy,
transpedicular approach, transfacet pedicle sparing, transdural,
and lateral extracavitary approach, all have been used
successfully.
Most more recent studies suggest that lateral rachiotomy
(modified costotransversectomy) or an anterior transthoracic
approach for discectomy produces considerably better results
with no evidence of worsening after the procedure.
Anterior approaches via thoracotomy, a transsternal approach,
retropleural approach, or VATS also have been used
successfully.
11. Case presentation
Female
21 y/o
Back pain from 1.5 years ago
Exacerbated after child delivery (9m ago)
Pain radiated to right leg from 7m ago
12. P/E
↓L3 , L4 force
right clonus
↓ achilles DTR
QC DTR normal
Babinski sign normal
Intermittent Bladder dysfunction
Sensory normal
13.
14.
15.
16. head
foot
Ant.
lateral decubitus position.
A leftsided anterior approach usually is preferred
skin incision along the line of the rib that corresponds to the
second thoracic vertebra above the involved intervertebral disc
except for approaches to the upper five thoracic segments,
where the approach is through the third rib.
Post.
38. POSTOPERATIVE CARE
Postoperative care is the same as for a thoracotomy.
The patient is allowed to walk after the chest tubes are
removed.
Extension in any position is prohibited.
A brace or body cast that limits extension should be used if
the stability of the graft is questionable.
The graft usually is stable without support if only one disc
space is removed.
Postoperative care is the same as for anterior corpectomy
and fusion if more than one disc level is removed.
If no fusion is done, the patient is mobilized as pain
permits without a brace.