Trichotillomania is a psychological disorder where patients feel compelled to pull out their hair. It can be caused by abnormalities in brain regions involved in emotion, habit formation, and impulse control. Common symptoms include hair pulling, feeling relief after pulling hair, and trying to hide the disorder. Treatment options include habit reversal training, cognitive therapy, acceptance and commitment therapy, and medications like SSRIs.
A comprehensive PowerPoint document covering the psychiatric illness trichotillomania in different aspects including but not limited to ( definition, classification, epidemiology, comorbidity, etiology, clinical features, diagnosis, differential diagnosis, disease course, prognosis and treatment ) followed by an attached article for further reading and comprehension.
Disclaimer,
This is a product of pure student effort, it can have flaws, however the information listed in this document are authentic and genuine to the best of my knowledge.
In case of any suggestions and comments, feel free to contact me at YazzanAlotaibi@gmail.com
Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression.
If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships. Because you don't tend to show emotion, you may appear as though you don't care about others or what's going on around you.
The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
A comprehensive PowerPoint document covering the psychiatric illness trichotillomania in different aspects including but not limited to ( definition, classification, epidemiology, comorbidity, etiology, clinical features, diagnosis, differential diagnosis, disease course, prognosis and treatment ) followed by an attached article for further reading and comprehension.
Disclaimer,
This is a product of pure student effort, it can have flaws, however the information listed in this document are authentic and genuine to the best of my knowledge.
In case of any suggestions and comments, feel free to contact me at YazzanAlotaibi@gmail.com
Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression.
If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships. Because you don't tend to show emotion, you may appear as though you don't care about others or what's going on around you.
The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
obsessive compulsive and related disorders (OCD)mamtabisht10
Obsessive-Compulsive and related disorders include obsessive-compulsive disorder (OCD), body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder.
Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.
Symptoms: Compulsive behavior
Obsessive-compulsive disorder is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours.
OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.
Treatment includes talk therapy, medication or both.
Consult a doctor for medical advice.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
obsessive compulsive and related disorders (OCD)mamtabisht10
Obsessive-Compulsive and related disorders include obsessive-compulsive disorder (OCD), body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder.
Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.
Symptoms: Compulsive behavior
Obsessive-compulsive disorder is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours.
OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.
Treatment includes talk therapy, medication or both.
Consult a doctor for medical advice.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
Local and systemic complications of local anesthesiamohamed ali
Local and systemic complications of local anesthesia administration in dentistry
contents :
Introduction
Types of complications
Localized complications with their management
Generalized complications with their management
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
Primary ciliary dyskinesia (pcd) is an autosomal recessive genetic condition in which the microscopic cells in the respiratory system called cilia do not function normally.
Periventricular leukomalacia (pvl) is a form of brain damage that affects the white matter of brain, resulting in the cells in the white matter of brain either decaying or dying.
Kluver bucy syndrome is a very rare cerebral neurological disorder associated with damage to both temporal lobes resulting in abnormalities in memory, social and sexual functioning and idiosyncratic behaviours.
Hantavirus pulmonary syndrome is an infectious disease characterized by flu-like symptoms that can progress rapidly to potentially life-threatening breathing problems.
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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!
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
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.
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.
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.
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
2. Introduction of Trichotillomania
Trichotillomania is a psychological disorder. The term trichotillomania is commonly not known to
everybody but its symptoms are somewhat familiar to many of us. In trichotillomania, patients feel
strong compulsion to pull out hair from their head and other parts of the body. Generally people
mistake such symptoms with bad habits failing to realize that they have got a type ofpsychological
disorder. Anybody of any age or background can get affected with trichotillomania. Even children
have also been seen affected with this disorder.
3. Causes of Trichotillomania
•It maybe because of abnormalities of brain functions. Brain areas related to emotion, habit
formation, movement and impulse control might be affected and causing this.
•There might be an involvement of serotonin and dopamine.
•Depression or anxiety could be one more cause.
•Genes might be playing a role.
In extreme cases of trichotillomania where hair pulling, for example from scalp, becomes severe and
leads to many patchy bald spots which cause embarrassment, and disturbs personal and social life.
Trichotillomania is a long term (chronic) psychological disorder which if goes untreated, can cause
otherserious psychological problems and get worse with time.
4. Symptoms of Trichotillomania
After observing the causes, it is important to check all the symptoms of trichotillomania before starting
treatment.
•Trichotillomania patients are seen picking their skin, chewing their lips and sometime biting their nails
or eating pulled out hair.
•Trichotillomania patients often get a feeling of tension before pulling hair or when trying to resist the
urge to pull hair, and feel relieved after pulling their hair.
•In most of the cases, patients are not even aware of their behavior. It becomes so automatic that they
just do it during the moments of tension or stress, while watching TV or movie or reading.
•Mostly, circumstances and emotions trigger hair pulling. And certain positions or behavior pattern
may also trigger hair pulling, such as resting head on hand or brushing hair.
•Patients play with pulled out hair or rubbing it across lips or face.
•Sometimes patients pull hairs from pets or dolls or from materials, such as clothes or blankets, might
be an indication of trichotillomania.
•A number of patients who are suffering from trichotillomania pull hair in private and generally try to
hide the disorder from others.
5. Treatment of Trichotillomania
Trichotillomania may not always be severe and is generally manageable but for some patients, the
compulsive urge to pull hair might become overpowering. Usually, symptoms of trichotillomania keep
coming and going, and if proper treatment is taken, chance of relapse significantly reduces. In many
instances, certain treatment options have helped many people reduce their hair pulling and in some
cases it never came back.
Habit reversal training (HRT) is used to treat behavior disorders by psychotherapists and is widely used
and immensely helpful in trichotillomania cases. As the name suggests, it is used to change the behavior
patterns which have been formed by the patients causing the disorder with some other habits. During
the habit reversal therapy, patients become more aware of their thinking and behaviors, and gain control
over the impulse to pull their hair by changing it to something else.
Cognitive therapy, which is about finding out triggers which compel the patients to pull their hair and
helping them to learn from new behaviors. By forming new habits with repetition, the actual shape of
brain changes and new brain pathways are built.
6. Acceptance and commitment therapy (ACT) which is based on accepting and committing to the
solutions. It helps trichotillomania patients by making them accept and become mindful of their
hair- pulling urges then work on the ways to improve their behaviors and stay committed to them.
NLP or hypnotherapy is also very useful in helping patients recognize the stressful situations which
causes them to pull their hair and learn to relax and work on the solutions to deal with the
problems.
There might be a requirement for medications to control trichotillomania symptoms which is
something a therapist or doctor decides. They may prescribe antidepressants, such as selective
serotonin reuptake inhibitor (SSRI) orclomipramine (Anafranil) and other medication to improve
neurotransmitters e.g. N-acetylcysteine, and olanzapine (Zyprexa) or aripiprazole, etc.
7. SNRB-SELECTIVE NERVE ROOT BLOCK.
Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if
* There Is minimal or no radiological finding.
* Multilevel imaging abnormalities
* Equivocal neurological examination finding or discrepancy between clinical & radiological signs
* Post Op patient with unexplainable or recurrent pain
* Combined canal & lateral recess stenosis.
* To find out the pathological dermatome for more invasive procedures , if needed
EPIDURAL NEUROLYSIS OR PERCUTANEOUS DECOMPRESSIVE NEUROPLASTY for
•EPIDURAL FIBROSIS OR ADHESIONS
•IN FAILED BACK SURGERY SYNDROME(FBSS)
•A catheter is inserted in epidural space via caudal/ intralaminar/ transforaminal approach
•After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/hypertonic
saline in different combinations is then performed along with mechanical adenolysis with spring loaded
or stellated catheters or under direct vision with EPIDUROSCOPY.
8. FACET SYNDROME:- FACET JOINT INJECTION OR
RF MEDIAL BRANCH NEUROTOMY
It is due to mechanical stress on the Zygapophysial joints or traumatic/anatomical derangement &
degenerative facet arthropathy. It is commoner in male of younger age group during active careers . CT/
MRI/ Bone Scan show structural pathology, but diagnosis is confirmed by relief of pain with joint
injection (1 ml of LA+ 20 mg triamcinolone) which has therapeutic therapeutic value.After effective facet
joint block, fluoroscopic percutaneous radiofrequency(RF) thermal rhizotomy of two level medial
branches of dorsal ramus is a safe, effective & long term treatment.
SACROILIAC JOINT INJECTION & DENERVATION:
The only way to make a definitive diagnosis is pain relief with image guided joint injection of depo-
steroid with L.A..This Can be followed by joint denervation of L4-5 S1-3 branches to this joint providing
long term pain relief.
INTRADISCAL PROCEDURES::
PROVOCATIVE DISCOGRAPHY: coupled with CT
A diagnostic procedure or prognostic indicator for surgical outcome is necessary in the evaluation of
patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological
finding), to determine type of disc herniation /tear,finding surgical options & in assessing previously
operated spines
PERCUTANEOUS DISC DECOMPRESSION (PLDD)
After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be
employed:
9. OZONE-DISCOLYSIS: Ozone Discectomy a revolutionary least invasive safe & effective alternative to
spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a
daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with
radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these
facts have made this procedure very popular at European countries. It is also gaining popularity in
our country due to high success rate, less invasiveness, fewer chances of recurrences,remarkably
fewer side effects meaning high safety profile, short hospital stay,no post operative discomfort or
morbidity and low cost.
DEKOMPRESSOR: A mechanical percutaneous nucleotomy cuts & drills out the disc material
somewhat like macerator debulking the disc reducing nerve compression.
INTRATHECAL(SPINAL) PUMP IMPLANTS:
Opted when oral narcotics provide insufficient pain relief or side effects are troublesome in
intractable cancer & chronic pain patients. It delivers drug via an implanted catheter directly into
CSF needing a very small dose (1/300 of oral dose). The programmable pump is implanted in ant.
lower abdomen. It delivers the drug as per the patients needs. More powerful analgesia &
spasticity control is achieved using lower doses, constant relief & fewer side effects as with oral
doses eg. Somnolence, mental clouding, constipation, euphoria with decreased chances of drug
addiction or misuse.
10. NEUROMODULATION TECHNIQUES:
SPINALCORD STIMULATION (SCS) IMPLANTS :
Done for FBSS(failed back surgery syndrome) & CRPS(comlex regional pain syndromes)
inUSA.In Europe it is done for chronic intractableangina & pain of peripheral vasculardiseases
(PVD). The indications are expanding further in chronic pain states. A Set of electrodes is placed in
epidural space & connected to a pulse generator ( like a cardiac pacing device) that is implanted in
upper buttock.Low level of electric impulses replace pain signals to the brain with mild tingling
sensation. A trial stimulation is done before permanent SCS lead implant.
PERCUTANEOUS VERTEBROPLASTY / KYPHOPLASTY:
A NEWER APPROACH TO MANAGEMENT OF VERTEBRAL BODY FRACTURES
As life expectancy is increasing so is the incidence of vertebral body (VB) # now being the
commonest # of the body. PVP is an established interventional techniques in which PMMA bone
cement is injected underL.A.via a needle into a # VB with imaging guidance providing increased
bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL
and early return to work.