Physiotherapy management for rheumatoid arthritissenphysio
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It most commonly affects women and can lead to joint damage, deformity, and disability over time. Physiotherapy plays an important role in managing rheumatoid arthritis by providing pain relief, preventing deformities, improving flexibility and strength, and maintaining functional ability. Treatment involves heat/cold therapy, exercises, joint protection techniques, and alternative therapies to help reduce inflammation and preserve joint function. The goals of physiotherapy are to protect joints, relieve pain, and prevent disability through regular exercise and mobility work.
Assessment and Management of Frozen ShoulderThe Arm Clinic
The Arm Clinic's Mr Mike Walton presents his thoughts on assessment and management of Frozen Shoulder. Presentation for The Arm Clinic educational event #stiffshoulder at The Wilmslow Hospital, 29th April 2016.
Therapeutic management of knee osteoarthritis; physiotherap case studyenweluntaobed
The document discusses the therapeutic management of knee osteoarthritis. It provides background on the epidemiology and economic burden of the condition. Key points include that knee OA prevalence is rising with population aging and affects nearly 10% of those over 55 years old. Treatment involves a multidisciplinary approach including pharmacological interventions, physiotherapy, and sometimes surgery, with the overall goals of reducing pain and improving joint function and quality of life. Assessment involves evaluating pain levels, range of motion, muscle strength, and radiological imaging to determine the severity and appropriate treatment.
This case presentation describes a 57-year-old female patient experiencing left shoulder pain for 6 months. On examination, she had tenderness over the left AC joint and tight upper trapezius. All shoulder ranges of motion were limited. The physiotherapy diagnosis was adhesive capsulitis. The treatment plan focused on reducing pain and stiffness through ice, stretches, and exercises to improve range of motion and strengthen muscles. The goals were to relieve pain, increase mobility, restore posture and strength, and allow the patient to regain normal activities of daily living. After two sessions, the patient's pain level decreased and all shoulder ranges of motion improved.
The document discusses upper limb orthosis, devices used to modify the structural and functional characteristics of the upper limb. It covers the objectives of upper limb orthosis including protection, correction, and assistance. It also discusses the classification, biomechanics, principles, and assessment of upper limb orthosis and provides descriptions and examples of specific upper limb orthoses including shoulder orthoses, arm slings, arm abduction orthoses, elbow/forearm/wrist orthoses, and elbow or wrist mobilization orthoses.
The McKenzie Method is a classification system and treatment approach developed by Robin McKenzie for back, neck, and extremity pain. It involves assessing a patient's response to various movements and positions to determine the cause of their pain and develop an individualized exercise plan. The goals are to centralize or reduce pain. There are three main syndromes - postural, dysfunction, and derangement - each with different treatments like posture correction, mobilizing exercises, or movements to induce a directional preference. The McKenzie Method aims to actively involve patients to self-manage their pain.
Meniscus injuries are common in young adults, often caused by twisting or heavy lifting. Symptoms include knee pain, swelling, stiffness, tenderness, pain with squatting, popping or clicking in the knee, and limited motion. Meniscus tears are classified as longitudinal, horizontal, radial, or flap tears. Exams like McMurray's test and Apley's test are used to diagnose tears. Treatment involves medications, surgery if the meniscus cannot be repaired, physiotherapy including exercises and bracing, and rehabilitation protocols after arthroscopic surgery or meniscal repair surgery. Isokinetic training after arthroscopy can help improve knee function and muscle strength recovery.
This document provides an overview of performing an examination of the shoulder, including assessing functional anatomy, subjective factors, and objective tests. It describes the resting and closed pack positions of the glenohumeral, acromioclavicular, and sternoclavicular joints. Subjective factors covered include symptoms, aggravating/relieving factors, and past history. The objective examination involves observation, palpation, range of motion testing, strength testing, and multiple special tests to assess various structures like the labrum, biceps, rotator cuff, nerves. The goal is a thorough subjective and physical assessment of the shoulder.
Manual therapy techniques like joint mobilizations and manipulations can be used to safely restore normal joint mechanics and reduce trauma. Effective use requires knowledge of anatomy, arthrokinematics, and pathologies. Several concepts for manual therapy techniques were introduced, including Cyriax, Mulligan, Maitland, and McKenzie. Contraindications include inflammation, effusion, and hypermobility while indications include reversible hypomobility and functional limitations responding to mechanical treatment. Grading systems determine appropriate mobilization force and different joints require specific examination and treatment techniques.
The document discusses Kaltenborn manual mobilization techniques which use traction and gliding movements to reduce pain and increase joint mobility. It describes testing for restrictions in joint play, end feels, and functional movements to determine appropriate treatment grades of mobilization parallel or perpendicular to the treatment plane. Indications for treatment include restricted joint play or abnormal end feels while contraindications include various pathological bone and joint conditions.
This document provides guidance on effective history taking in physiotherapy. It discusses:
- The importance of history taking for diagnosis, disease understanding, and physical exam focus. Trust and active listening are keys.
- General guidelines for history taking, including gaining patient confidence, using simple language, and asking open, closed, or leading questions.
- Elements to cover in the history such as preliminary data, chief complaint, present and past history, social history, and family history.
- Challenges such as sensitive topics, anxious patients, language barriers, and avoiding common pitfalls like disrespecting culture or using confusing terminology.
The overall message is that history taking is essential for physiotherapy, and
CASE PRESENTATION - SPINAL CORD INJURY BY HIMANIKAUSHIK - .pptxHimani Kaushik
Spinal cord injury (SCI) is a debilitating neurological condition with tremendous socioeconomic impact on affected individuals and the health care system. Today, the estimated lifetime cost of an SCI patient is $2.35 million per patient. According to the National Spinal Cord Injury Statistical Center, there are 12,500 new cases of SCI each year in North America. More than 90% of SCI cases are traumatic and caused by incidences such as traffic accidents, violence, sports, or falls. The Male-to-female ratio of 2:1 for SCI, which happens more frequently in adults compared to children. Demographically, men are mostly affected during their early and late adulthood (3rd and 8th decades of life) while women are at higher risk during their adolescence (15–19 years) and 7th decade of their lives i.e. age distribution is bimodal, with a first peak involving young adults and a second peak involving adults over the age of 60. Those over 60 years of age who suffer SCI have considerably worse outcomes than younger patients their injuries usually result from falls and age-related bony changes.
This document discusses the assessment of the cervical spine. It begins with an introduction to the anatomy and biomechanics of the cervical spine. It then describes taking a patient history, including questions about pain and symptoms. The examination involves observation, palpation, range of motion testing, muscle strength testing, sensory testing, and special tests like Spurling's test. Diagnostic imaging options like x-rays, CT scans, and MRI are also discussed.
A 21-year old female marathon runner has begun experiencing knee pain around the patella after increasing her training from twice to 4-5 times per week on hills. This document provides an overview of patellofemoral pain syndrome (PFPS), including causes, risk factors, diagnosis, and treatment options. PFPS is caused by an imbalance of forces around the patella that leads to pain. Treatment focuses on strengthening the quadriceps and hips to correct biomechanics and management of pain. The prognosis is generally good if treatment addresses contributing factors and allows for gradual return to activity.
Hello everyone here I upload mckenzie exrercise basic details and some of its position.Its technique for use to cervical, Lumabar pain relief via particular position.Thank you.
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
This document discusses hand deformities that can occur in rheumatoid arthritis. It defines rheumatoid arthritis and describes the immune response and genetic factors involved. Common hand deformities seen in late-stage RA are described such as swan neck, boutonniere, and MP joint ulnar deviation. Evaluation of hand deformities focuses on features like synovitis, nodules, crepitus, range of motion, strength and pain level. Management principles emphasize protection of joints through rest, activity balancing, pain-free exercise and avoiding positions of deformity.
Iliotibial Band Syndrome (ITBS) is an overuse injury of the iliotibial band, a thick fascia that runs down the outside of the thigh. ITBS is caused by training errors like increasing mileage too quickly, running on uneven surfaces, or having poor form. Anatomical factors like tight muscles or leg length differences can also contribute. Diagnosis involves pain tests like the Renne Test or Noble Compression Test. Treatment starts with rest, ice, stretching, and anti-inflammatories. Later stages may include corticosteroid injections, surgery for refractory cases. Prevention focuses on gradual mileage increases, proper footwear, stretching, and avoiding uneven terrain.
Frozen Shoulder Physiotherapy ManagementVishal Deep
Adhesive capsulitis is characterized by painful restriction of shoulder movement. Management includes corticosteroid injections to reduce inflammation, NSAIDs for pain, and manipulation under anesthesia or mobilization to improve range of motion. Physiotherapy goals are to reduce pain through ultrasound, mobilization, and stretching, improve range of motion through passive, active assisted, and active exercises, and strengthen muscles with isometrics, rotator cuff exercises, and scapular exercises. A home program including pendular exercises and aquatic therapy is also recommended.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
The document describes the anatomy of the glenohumeral joint, or shoulder joint, including its ligaments, bones, and muscles. Key features include the glenoid fossa on the scapula articulating with the humerus, and ligaments like the coracoacromial, coracohumeral, and glenohumeral ligaments surrounding and supporting the joint. Muscles like the supraspinatus, infraspinatus, subscapularis, and teres minor originate on the scapula and insert on the humerus to allow shoulder movement.
The document discusses principles of joint mobilization including using lower grades to reduce pain and higher grades to increase mobility. It outlines convex-concave rules for determining glide direction in different joints. Treatment glides are described to improve range of motion in various joints like the shoulder, knee, ankle and elbow. Open-packed positions and grades of movement are also defined. The goal of a joint mobilization treatment is to increase range of motion through appropriate gliding techniques.
This case study describes the physical therapy treatment of a 61-year-old male with a partially healed proximal humeral fracture and rotator cuff tear in his right shoulder. He had limited range of motion and pain with movement after 8 weeks of immobilization. The treatment plan involved joint mobilization techniques to increase shoulder range of motion, as well as strengthening exercises to improve muscular strength. The goals were to restore normal motion and strength without exacerbating pain.
Supraspinatus tendinitis is an inflammation of the supraspinatus tendon, which is one of the most commonly affected structures in the rotator cuff. It often results from repeated overhead arm motions or other activities that cause impingement beneath the coracoacromial arch. Symptoms include pain in the shoulder region that is worsened by motions like lifting the arm overhead. Treatment involves rest, exercises to strengthen the rotator cuff muscles, modalities like ultrasound to reduce inflammation, and manual therapy such as transverse friction massage to the tendon.
This document discusses a construction project in Benghazi, Libya in the 1980s. The contractor was experiencing issues with soil settling after compacting backfill material in trenches for sewer pipes. Testing determined the soil contained montmorillonite crystals that caused it to expand when wet and shrink when dry, resulting in settling. A new testing process was implemented that fully rejected the excavated soil as unsuitable for backfilling due to this property.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
The document discusses principles of mobilization treatment techniques from Maitland's text, including factors that govern passive movement, the method for selecting techniques, and eight principles for direction, patient/therapist position, force localization/application, and progression. It also covers grades, rhythms, and uses of movements like oscillations, distraction, and compression in treatment.
- The patient is a 46-year-old male school teacher who presents with left shoulder pain localized to the deltoid muscle insertion area. The pain is dull and constant, worsened by activity and lying on the affected side.
- Examination reveals muscle wasting and spasm in the left deltoid and upper trapezius, with reduced range of motion in the left shoulder compared to the right. Special tests are positive for impingement.
- The treatment plan includes pain relief modalities, stretching and strengthening exercises to improve range of motion and muscle imbalances, with the goals of reducing pain and regaining functional ability of the shoulder.
This document presents a case study of a 55-year-old female patient who presented with 6 months of progressive back pain and lower limb weakness. On examination, she had reduced muscle bulk and increased tone in the lower limbs with weakness. Imaging revealed compressive dorsal myelopathy at the D11 level due to Pott's disease. The provisional diagnosis was spastic paraparesis due to compressive dorsal myelopathy. Surgery was planned to address the compressive lesion.
Mr. B is a 37-year-old male who experienced acute lower back pain while working in his yard. He reports dull, burning pain localized to his lower back radiating into his left buttock. Physical examination reveals tenderness over the paraspinous muscles but normal range of motion, strength, and sensation in the lower extremities. Non-surgical management including medications, exercise, and lifestyle modifications is recommended. Further investigations are not needed unless symptoms fail to improve within 4-6 weeks.
1. A 42-year-old male presented with 6 months of neck and lower back pain that radiated to his right lower limb and was aggravated by walking. He also reported difficulty walking, tingling, numbness, and weakness in his right upper and lower limbs.
2. Examination found restricted cervical and lumbar spine range of motion, spasms, exaggerated reflexes, diminished sensation, and weakness in his right lower limb.
3. Imaging showed cervical disc prolapse at C3-C4 and lumbar canal stenosis due to spondylolisthesis at L5-S1. The diagnosis was cervical myelopathy and lumbar stenosis. The treatment plan was anterior cervical discectomy and fusion for
A 49-year-old woman presented with left back and buttock pain radiating down her left leg that had been worsening over the past 3 months. On examination, she had limited range of motion, muscle weakness, and a positive piriformis test on the left side. The plan of treatment was to reduce pain, increase range of motion, strengthen muscles, and reeducate functional movements through electrotherapy, stretching, soft tissue massage, and strengthening exercises. The goal was to relieve her pain and allow her to return to normal daily activities without difficulty.
Clinical presentation in musculoskeletal physiotherapyThenukaAvinash
1. The patient is a 32-year-old software engineer complaining of pain in the medial side of the right elbow that worsens with weight lifting, computer use, and poor posture at work.
2. On examination, the physician found swelling and tenderness over the medial epicondyle, reduced strength and range of motion in the right elbow and wrist, and a positive result for the golfer's elbow test.
3. The physician diagnosed medial epicondylitis and prescribed a treatment plan including rest, ice, ultrasound, stretching, strengthening exercises, and posture advice to reduce pain and swelling and improve strength and function over several weeks.
This document discusses body mechanics, mobility, immobility, and range of motion. It defines key terms like kyphosis, lordosis, flexion, extension, supination, and pronation. It describes principles of good body mechanics for moving and lifting patients, including maintaining good posture, keeping weight close to the body, and requesting assistance for heavy loads. Common positions used for patient exams and procedures are explained, as well as range of motion exercises. The effects of immobility on body systems like musculoskeletal, cardiovascular, and integumentary are summarized. Care for immobilized patients focuses on preventing complications through skin assessments, pressure relief, proper positioning and alignment.
This document provides information on low back pain (LBP), including:
1. LBP is a common musculoskeletal condition affecting the lower back region below the costal margin. It has various causes and risk factors and can impact daily functioning.
2. Evaluation of LBP involves assessing pain characteristics, risk factors, physical exam including range of motion and special tests, and ruling out red flags.
3. Occupational therapy focuses on education, strengthening the core, improving body mechanics, use of adaptive equipment, and modifying activities and environments to reduce strain on the back.
This document discusses lumbar pain and low back pain. Some key points:
- Low back pain is very common, expensive, and a leading cause of disability.
- Physical examination and imaging tests can help evaluate the source and severity of back pain.
- Treatments may include exercise, medication, injections, and in some cases surgery. However, surgery outcomes are often similar to non-surgical treatments.
- Proper diagnosis is important to guide treatment, as many cases of back pain resolve on their own with time and conservative care.
1) The patient is a 27-year-old male who presents with 6 months of lower back pain that is worse in the morning and improves with exercise. Examination finds reduced spinal mobility and tenderness over the lower spine.
2) Tests show a positive HLA-B27 and elevated inflammatory markers. X-rays are inconclusive for ankylosing spondylitis.
3) Ankylosing spondylitis is an inflammatory arthritis affecting the spine. Treatment includes exercises, NSAIDs, DMARDs like sulfasalazine, and biologic therapies like infliximab which have revolutionized treatment.
This document provides information on back safety and prevention of back problems. It discusses that low back pain is very common, affecting 87.5 million people in India. While treatments like surgery and chiropractic care offer no long-term benefits over no treatment, prevention is key. Personal factors like age, gender, and physical fitness can impact back pain. Maintaining good posture, lifting properly, and regular exercise can help prevent back problems and injuries from everyday activities at home, work, and in the car. Strength training and flexibility are important for back health.
This document provides rules and guidelines for spinal manual therapy. It discusses assessing joint mobility and the different types of forces and glides that can be applied by a therapist. It emphasizes restoring mobility first before performing other techniques and outlines various rules for safe and effective mobilization, including loading the patient in painful positions, maintaining a pain-free approach, and pushing to the end range of motion. Assessment involves screening for red flags, classifying pain, and evaluating range of motion, posture, and neurological function.
This document provides information on the assessment and management of various low back pain conditions. It discusses acute and chronic back pain, sciatica, radiculopathy, spondylolisthesis, and spinal stenosis. Treatment approaches include education, exercises, analgesics, physical therapy, injections, and surgery if conservative options fail. Referral is recommended for urgent cases involving neurological deficits or when pain persists for over 3 months without an identified cause.
The document discusses back safety and prevention of back problems. Some key points:
- About 85% of Americans experience back trouble by age 50, so prevention is important. Common causes of back problems include poor posture, lack of exercise, and accidents.
- Proper lifting technique is important to prevent injury, such as keeping loads close to the body and bending at the knees rather than back. Exercise can help build core strength and flexibility to support the back.
- Back health requires attention not just at work but also at home and during daily activities like housework, driving, and sleeping with proper posture. Regular aerobic exercise and strength/flexibility training can help promote back health.
The document discusses musculoskeletal physical therapy assessments. It outlines topics like functional assessment, joint position and movement, and diagnostic imaging. It describes examining joints through passive range of motion, assessing end feels both normally and abnormally. Joint play and specific tests for different joints are covered. The SOAP note method of documentation is defined, with S for subjective information from the patient, O for objective physical exam findings, A for the therapist's assessment, and P for the treatment plan.
Dr. Robin McKenzie developed the McKenzie Method for treating back pain mechanically without surgery or medication. The method involves assessing a patient's pain response to various spinal movements to determine the underlying problem. Treatment focuses on specific exercises that centralize the pain by improving spinal mechanics. Exercises may involve extension, flexion, or lateral movements. The goal is to reduce pain and improve range of motion over several weeks with a home exercise program. Precautions are taken for certain conditions like spinal stenosis or recent trauma. The McKenzie Method provides an alternative to medication for many back pain issues.
Case discussion on anemia in pregnancy.pptxGottamsireesha
This document presents a case study of a 22-year-old primigravida woman at 34 weeks and 5 days of gestation who presented with easy fatiguability and generalized weakness for the past two months. On examination, she was found to be poorly nourished with severe pallor and tachycardia. Laboratory tests revealed severe anemia with a hemoglobin level of 6.9 gm%. She was diagnosed with severe anemia during pregnancy and further tests were recommended to evaluate her iron levels.
This document presents two clinical case presentations of patients with back pain. The first case involves a 28-year-old male with low back pain radiating to his right leg. Diagnostic tests revealed a prolapsed intervertebral disc at L4-L5 with lumbar canal stenosis. He underwent a laminectomy with discectomy and experienced post-operative relief. The second case involves a 34-year-old male with low back pain radiating to his left leg. Diagnostic tests revealed a prolapsed disc at L4-L5 more pronounced on the left side. He underwent a laminotomy with micro-discectomy at L4-L5 and also experienced post-operative relief.
Similar to Supraspinatus Tendinitis Case Presentation of Musculoskeletal Module (20)
A 41-year-old man presented with left ankle pain at night and after activities like walking. He had fractured his tarsal bones two years prior in a road traffic accident and underwent surgery followed by immobilization for two months. On examination, he had an antalgic gait, edema around the left ankle and lower leg, and tenderness on the medial side of the foot. Range of motion of the left ankle was limited to 5 degrees of dorsiflexion and 10 degrees of plantar flexion with pain. Treatments included massage to reduce edema, passive mobilization and stretching of the ankle to improve range of motion, and a home exercise plan of active stretching.
This case presentation describes a 57-year-old male bus driver who presented with left shoulder pain. He reported a history of sharp pain in his left shoulder two years ago while driving, and more recently severe pain when lifting his granddaughter. On examination, he had tenderness below the left acromion, limited range of motion, and positive impingement tests. He was diagnosed with supraspinatus tendinitis and frozen shoulder of the left shoulder. The treatment plan included ultrasound therapy, soft tissue mobilization, active exercises, and strength training exercises to relieve pain, increase range of motion, reduce muscle spasm, and restore strength.
This document presents a case study of a 68-year-old female patient complaining of pain and stiffness in her right shoulder when reaching overhead or placing her right hand behind her back. Her range of motion was reduced in all movements. Physical examination revealed spasms in her upper trapezius, trigger points, and right sternocleidomastoid. The treatment plan aims to reduce pain, correct faulty mechanics through manual therapy, improve range of motion with stretching and exercises, and educate the patient to prevent further injury. The long-term goals are to increase shoulder range of motion, strength, and function through a progressive home exercise program.
This case presentation documents the results of various tests and measurements taken of a patient's neck and shoulder range of motion, muscle strength, and progress over multiple physical therapy sessions. Tests performed on the neck and shoulder included compression, lateral compression, Neer's impingement, drop arm, empty can, infraspinatus, Speed's, and lift-off tests. Range of motion and muscle strength were measured bilaterally using a goniometer and scale. The patient showed gradual improvement in shoulder range of motion measurements like abduction, flexion, and rotation over three sessions.
Mrs. Weerasinghe, a 65-year-old retired nurse, presented with 6 months of right leg pain that started in her calf and radiated down to her heel. Examination found swelling, tenderness, and reduced range of motion in her right ankle. Special tests were negative for Achilles rupture. The physiotherapy goals were to relieve her pain, restore her range of motion, and strengthen weakened muscles through ultrasound therapy, soft tissue mobilization, stretching and resistance exercises.
This medical document summarizes a patient's back pain issues. A 30-year old male cricket player has been experiencing dull, lower lumbar back pain for 3 years that is aggravated by prolonged standing and vigorous activity and eased by rest. Examination found increased lumbar lordosis, tender lower back area, and tight lower back muscles. Tests were otherwise normal. The diagnosis was lumbar spondylosis and lower back muscle spasm. Treatment recommended was infrared therapy, back and core strengthening exercises, and posture education. The goal is to reduce lower back muscle spasm and back pain.
This document presents a case study of a 61-year-old male electrician who injured his right hand in a motorcycle accident. He has limited extension of his right 4th and 5th fingers. On examination, deformities and swelling were observed in the 4th and 5th fingers. Range of motion was restricted in the fingers but normal elsewhere. Tests indicated a boutonniere deformity in the 4th and 5th fingers. The physiotherapy diagnosis was decreased range of motion, joint mobility, and muscle performance in the fingers. The treatment plan focuses on pain management, maintaining joint and tendon mobility, increasing range of motion and muscle strength through various exercises over several weeks. Progress will be measured by monitoring range of motion
This document contains a medical case report for a 56-year-old female seamstress presenting with a 4-month history of lateral elbow pain aggravated by activities like sewing. On examination, palpation of the lateral epicondyle and common extensor origin was painful, and Cozen's and Mill's tests were positive, consistent with a diagnosis of lateral epicondylitis. The treatment plan involves ultrasound, transverse frictions, range of motion exercises, grip strengthening, and advice to avoid aggravating activities to relieve pain, break adhesions, restore range of motion, and strengthen muscles. Progress will be monitored using pain scales, grip strength tests, and functional assessments.
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn J...rightmanforbloodline
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
General Endocrinology and mechanism of action of hormonesMedicoseAcademics
This presentation, given by Dr. Faiza, Assistant Professor of Physiology, delves into the foundational concepts of general endocrinology. It covers the various types of chemical messengers in the body, including neuroendocrine hormones, neurotransmitters, cytokines, and traditional hormones. Dr. Faiza explains how these messengers are secreted and their modes of action, distinguishing between autocrine, paracrine, and endocrine effects.
The presentation provides detailed examples of glands and specialized cells involved in hormone secretion, such as the pituitary gland, pancreas, parathyroid gland, adrenal medulla, thyroid gland, adrenal cortex, ovaries, and testis. It outlines the special features of hormones, differentiating between peptides and proteins based on their amino acid composition.
Key principles of endocrinology are discussed, including hormone secretion in response to stimuli, the duration of hormone action, hormone concentrations in the blood, and secretion rates. Dr. Faiza highlights the importance of feedback control in hormone secretion, the occurrence of hormonal surges due to positive feedback, and the role of the suprachiasmatic nucleus (SCN) of the hypothalamus as the master clock regulating rhythmic patterns in biological clocks of neuroendocrine cells and endocrine glands.
The presentation also addresses the metabolic clearance of hormones from the blood, explaining the mechanisms involved, such as metabolic destruction by tissues, binding with tissues, and excretion by the liver and kidneys. The differences in half-life between hydrophilic and hydrophobic hormones are explored.
The mechanism of hormone action is thoroughly covered, detailing hormone receptors located on the cell membrane, in the cell cytoplasm, and in the cell nucleus. The processes of upregulation and downregulation of receptors are explained, along with various types of hormone receptors, including ligand-gated ion channels, G protein–linked hormone receptors, and enzyme-linked hormone receptors. The presentation elaborates on second messenger systems such as adenylyl cyclase, cell membrane phospholipid systems, and calcium-calmodulin linked systems.
Finally, the methods for measuring hormone concentrations in the blood, such as radioimmunoassay and enzyme-linked immunosorbent assays (ELISA), are discussed, providing a comprehensive understanding of the tools used in endocrinology research and clinical practice.
Lymphoma Made Easy , New Teaching LecturesMiadAlsulami
This lecture was presented today as part of our local Saudi Fellowship program. After three years of direct interaction with trainees and hematologists, I have started to develop an understanding of what needs to be covered. This lecture might serve as a roadmap for approaching and reporting lymphoma cases.
Heart Valves and Heart Sounds -Congenital & valvular heart disease.pdfMedicoseAcademics
This presentation, authored by Dr. Faiza, Assistant Professor of Physiology at CIMS Multan, delivers an in-depth analysis of heart valves, heart sounds, valvular heart diseases, and congenital heart defects. It begins by distinguishing between normal and abnormal heart sounds, elucidating the timing and causes of the four heart sounds—S1, S2, S3, and S4—and their clinical significance. Detailed explanations are provided on the auscultation sounds that define conditions such as mitral stenosis, mitral insufficiency, aortic stenosis, and aortic insufficiency, with a focus on how these pathological changes affect cardiac mechanics and blood pressure.
The presentation delves into abnormal heart sounds, known as murmurs, categorizing them by their causes, which include valvular lesions, rheumatic fever, aging, congenital heart diseases, viral infections during pregnancy, and hereditary factors. It explores the various types of murmurs, their timing within the cardiac cycle, and their association with specific valvular heart diseases such as stenosis and regurgitation. The intricate relationship between systolic and diastolic murmurs and conditions like anemia and ventricular septal defects is also highlighted.
Further, the presentation covers the pathophysiology of congenital heart diseases, offering a comprehensive review of conditions such as Tetralogy of Fallot and Patent Ductus Arteriosus. It explains the mechanisms of these diseases, their impact on cardiac function, and the clinical manifestations observed in affected individuals. The physiological adjustments of the circulatory system during exercise in patients with valvular lesions are discussed, emphasizing the reduced cardiac reserve and the risk of acute pulmonary edema.
Special attention is given to the compensatory mechanisms of the heart in response to valvular diseases, including the development of concentric and eccentric hypertrophy, increased venous return, and the eventual progression to heart failure. The presentation also examines rheumatic valvular lesions, aging-related aortic stenosis, and the specific challenges posed by these conditions, such as reduced stroke volume and increased metabolic demand.
This thorough exploration of heart sounds, valvular diseases, and congenital defects is designed to enhance understanding and clinical acumen, making it a valuable resource for medical students, healthcare professionals, and educators in the field of cardiology and physiology.
Interventional radiology is a medical specialty that uses imaging techniques, such as X-rays, CT scans, and ultrasound, to guide minimally invasive procedures to diagnose and treat a variety of conditions. These procedures can be an alternative to open surgery, often resulting in shorter recovery times for patients.
The impact of CD160 deficiency on alloreactive CD8 T cell responses and allog...MARIALUISADELROGONZL
CD160 is a member of the immunoglobulin superfamily with a pattern of expression
mainly restricted to cytotoxic cells. To assess the functional relevance of the HVEM/
CD160 signaling pathway in allogeneic cytotoxic responses, exon 2 of the CD160
gene was targeted by CRISPR/Cas9 to generate CD160 deficient mice. Next, we
evaluated the impact of CD160 deficiency in the course of an alloreactive
response. To that aim, parental donor WT (wild-type) or CD160 KO (knock-out) T
cells were adoptively transferred into non-irradiated semiallogeneic F1 recipients,
in which donor alloreactive CD160 KO CD4 T cells and CD8 T cells clonally
expanded less vigorously than in WT T cell counterparts. This differential proliferative
response rate at the early phase of T cell expansion influenced the course of CD8 T
cell differentiation and the composition of the effector T cell pool that led to a significant
decreased of the memory precursor effector cells (MPECs) / short-lived effector
cells (SLECs) ratio in CD160 KO CD8 T cells compared to WT CD8 T cells. Despite
these differences in T cell proliferation and differentiation, allogeneic MHC class I
mismatched (bm1) skin allograft survival in CD160 KO recipients was comparable
to that of WT recipients. However, the administration of CTLA-4.Ig showed an
enhanced survival trend of bm1 skin allografts in CD160 KO with respect to WT recipients.
Finally, CD160 deficient NK cells were as proficient as CD160 WT NK cells in
rejecting allogeneic cellular allografts or MHC class I deficient tumor cells. CD160
may represent a CD28 alternative costimulatory molecule for the modulation of
allogeneic CD8 T cell responses either in combination with costimulation blockade
or by direct targeting of alloreactive CD8 T cells that upregulate CD160 expression
in response to alloantigen stimulation
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
Anthelmintics or antihelminthics are a group of antiparasitic drugs that expel parasitic worms and other internal parasites from the body by either stunning or killing them and without causing significant damage to the host. They may also be called vermifuges or vermicides
As a leading rheumatologist in Chandigarh, Dr. Aseem specializes in the diagnosis and management of a wide range of rheumatic conditions, including but not limited to:
Rheumatoid Arthritis: An autoimmune disorder that causes chronic inflammation of the joints.
Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage.
Lupus: A systemic autoimmune disease that can affect the skin, joints, kidneys, and other organs.
Ankylosing Spondylitis: A type of arthritis that primarily affects the spine, causing pain and stiffness.
Gout: A form of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in the joints.
Psoriatic Arthritis: A type of arthritis that affects some people with psoriasis.
Vasculitis: An inflammation of the blood vessels that can cause a variety of symptoms.
Sjogren’s Syndrome: An autoimmune disorder characterized by dry eyes and mouth.
Accurate diagnosis is crucial for effective treatment. Dr. Aseem Goyal utilizes advanced diagnostic techniques to identify the underlying causes of rheumatic conditions. Our state-of-the-art facility is equipped with the latest technology to provide comprehensive diagnostic services, including:
Blood Tests: To check for markers of inflammation and autoimmune activity.
Imaging Studies: Such as X-rays, MRI, and ultrasound to assess joint and soft tissue damage.
Joint Fluid Analysis: To examine the fluid in the joints for signs of inflammation or infection.
Biopsy: In certain cases, a small tissue sample may be taken for further examination.
Treatment Approaches
Dr. Aseem Goyal adopts a holistic and patient-centered approach to treatment. Depending on the specific condition and its severity, treatment options may include:
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce inflammation and relieve pain.
Disease-Modifying Antirheumatic Drugs (DMARDs): To slow the progression of rheumatic diseases.
Biologic Agents: Targeted therapies that block specific pathways in the immune system.
Corticosteroids: To control severe inflammation quickly.
These lecture slides, by Dr Sidra Arshad, offer a simplified description of the physiology of insulin and glucagon.
Learning objectives:
1. Describe the synthesis and release of insulin
2. Explain the mechanism of action of insulin
3. Discuss the metabolic functions of insulin
4. Elucidate the effects of insulin on adipose tissue, skeletal muscle, and liver
5. Enlist the factors which stimulate and inhibit the release of insulin
6. Explain the mechanism of action of glucagon
7. Discuss the metabolic functions of glucagon
8. Elucidate the role of insulin and glucagon in glucose homeostasis during the fasting and fed states
9. Discuss the role of other hormones in the glucose homeostasis
10. Differentiate between the types of diabetes mellitus
11. Explain the pathophysiology of the features of diabetes mellitus
12. Discuss the complications of diabetes mellitus
13. Explain the rationale of oral hypoglycemic drugs
14. Describe the features of hyperinsulinemia
Study Resources:
1. Chapter 79, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 24, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 39, Berne and Levy Physiology, 7th edition
4. Chapter 19, Human Physiology, From Cells to Systems by Lauralee Sherwood, 9th edition
5. Chapter 3, Endocrine and Reproductive Physiology, Bruce A. White and Susan P. Porterfield, 4th edition
6. Insulin and Insulin Resistance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/
7. Complications of diabetes mellitus,
https://pdb101.rcsb.org/global-health/diabetes-mellitus/monitoring/complications
an huge problem we are facing about the anaemia , we slight our contribution to aware with one of its class , with detailed description. it is usefull for health , medicine , pharmacy , nursing.
Osvaldo Bernardo Muchanga- MALE CIRCUMCISION, ITS Vs SOCIOCULTURAL BELIEFS (C...Osvaldo Bernardo Muchanga
MALE CIRCUMCISION consists of the surgical act of removing the foreskin (skin that covers the glans of the penis), leaving the glans more prominent and better cleanable.
MALE CIRCUMCISION itself has medical as well as sociocultural implications, as it has been proven to be an act that can minimize SEXUALLY TRANSMITTED INFECTIONS (STIs), especially HIV, but it also represents the SOCIOCULTURAL IDENTITY of some people, respectively.
Now, in a SERO-EPIDEMIOLOGICAL PROFILE like that of Mozambique where the prevalence of HIV is around 12.5% which corresponds to approximately 2 million people living with HIV, where the province of GAZA is the most seroprevalent with a positivity rate of 21% (INSIDA, 2021), it is extremely necessary to THOROUGHLY scrutinize all possibilities for preventing or minimizing the spread of HIV and other STIs.
These simplified lecture slides by Dr Sidra Arshad offer a concise look at the cardiovascular effects of heart failure:
1. Define cardiac failure, its pathophysiology and clinical manifestations
2. Differentiate between the factors causing hyper-effective and hypo-effective heart functions
3. Differentiate between right and left heart failure based on their presentation
4. Outline the physiology of treatment of cardiac failure
Definition of mental health nursing, terminology, classification of mental disorder, ICD-10, Indian Classification, Personality development, defense mechanism, etiology of bio psychosocial factors,
Introduction to Dental Implant for undergraduate studentShamsuddin Mahmud
Introduction to Dental Implant
Dr Shamsuddin Mahmud
Assistant Professor, Department of Prosthodontics
Nortth East Medical College (Dental Unit)
Definition of Dental Implant
A prosthetic device
made of alloplastic material(s)
implanted into the oral tissues beneath the mucosal and/or periosteal layer and
on or within the bone
to provide retention and support for a fixed or removable dental prosthesis.
Classification of Dental Implant
According to placement within the tissue
Blade/Plate form implant
According to Material Used
A) METALLIC IMPLANTS
Commercially pure Titanium
Cobalt chromium molybdenum
Titanium aluminum vanadium
Stainless steel
B) NON-METALLIC IMPLANT
Zirconium
Ceramic
Carbon
According to the ability of implant to stimulate bone formation
A) Bio active
Hydroxyapatite
Tri Calcium Phosphate
B) Bio inert
Metals
Parts of Dental Implant
Implant fixture
Implant mount
Cover screw
Gingival former/healing screw/healing abutment/permucosal extension
Impression post/impression transfer abutment
Implant analogue
Abutment
Fixation screw
Implant Fixture
Implant Mount
Connected to the fixture
Function: used to carry implant from its vital to the prepared osteotomy site either by hand or with a ratchet/ handpiece adaption
Cover Screw
component that is used to cover the implant connection during the submerged healing of the implant
Function: preserves the patency of the connection by preventing any soft tissue ingrowth in the connection
Gingival former/ Healing Abutment/ Healing screw
Screw/ abutment used to create the soft tissue emergence profile around the implant.
Time of placement:
During 1st surgery – One step surgery
After Osseointegration – Two step/stage surgery
Gingival former/ Healing Abutment/ Healing screw
Placed in the site 2-3 weeks for soft tissue healing
Function:
Create gingival emergence profile
Formation of biological width
Impression post/impression transfer abutment
component that is used to trans- fer the implant Hex position and orientation from the mouth to the working cast.
Types
Closed tray
Open tray
Implant analogue/
component which has a different body but its platform and connection are exactly similar to the implant. The analogue is used to replicate the implant platform and connection in the laboratory mode.
Abutment
Abutments
Advantages of Dental Implant Retained Prosthesis
Maintain bone height and width by preventing bone resorption
Maintain facial esthetics
Improve masticatory performance
Improve stability and retention of prosthesis
More esthetics
Increase survival times of prostheses
There is no need to alter adjacent teeth
Improve psychological health
Disadvantages of Dental Implant Retained Prosthesis
Very expensive.
Cannot be used in medically compromised patients who cannot undergo surgery.
Longer duration of treatment
Requires a lot of patient co-operation because of repeated recall visits are essential
INDICATION OF DENTAL IMPLANT
Dental implants can successfully restore all
CASE PRESENTATION ON ACUTE GASTROENTERITIS.Bhavana
This is a case presentation of a 72 year old female patient who was admitted in the hospital with the chief complaints of loose stools since 6 Days and generalised weakness and history of one episode of vomiting (one day back).
2. Subjective Examination
Personal Information
• Name : Mr. X
• Age : 57 yrs
• Gender : Male
• Occupation: Bus Driver
• Address : Kelaniya
• Civil Status: Married
• Children : 2 sons and a daughter
• Health Risk : DM+
3. History of Present Complaints
• 2 yrs ago, when he was driving the bus he suddenly
felt a sharp pain over the left shoulder and had a
difficulty to change the gear.
• But after having some analgesic drugs it
disappeared and rarely present.
• 2 months ago when he was lifting his grand
daughter severe pain occurred over the same
area.
• Pain has increased gradually.
4. Present Complaints
• Severe aching pain often present around the left
shoulder joint.
• Sometimes it reffered to the lateral aspect of the
arm
• Difficulty to perform day to day activities
Eg : Unable to sleep on the affected side.
Difficulty to lift heavy weights by the affected
side.
5. Objective Examination
Observation
• Informal Observation :
Looks like a healthy man with slightly depressed mood
• Formal Observation :
Had been done by looking at the patient anteriorly,
laterally and posteriorly while he was in sitting as well
as standing.
Scapula levels were equal, slight prominent acromian
process of left side, slight muscle wasting of left side
(deltoid & supraspinatus), No skin colour changes, little
bit swelling around the left acromian process
6. Objective Examination Cont…
Palpation
• Tenderness below the left acromion process
• Pain increased with palpation
• Slight Muscle spasm over the Left shoulder area
• Left acromion was prominent
• No temperature changes
8. Mobility chart of the Shoulder Joint taken on 07/02/2015
Movement
Normal
Range
Right Side Left Side
(X °) Active Passive Active Passive
Flexion 180 180 - 180 180
Extension 60 60 - 40 55
Adduction 45 45 - 35 40
Abduction 180 180 - 73 140
Internal Rotation 70 70 - 60 70
External Rotation 90 90 - 52 85
9. Measured ROM of other relative joints
• Neck Movements Normal
• Elbow Joint Normal
• Wrist Joint Normal
Muscle power testing according to the muscle
grading scale (Left Side)
• Flexors– 5
• Extensors – 5
• Abductors – 3
• Adductors – 5
• Internal Rotators – 5
• External Rotators - 4
10. Special Tests
• Speed Test -ve
• Drop arm Test -ve
• Anterior and Posterior drawer Test *
• Supraspinatus Tendinitis Test +ve
• Apley Scratch Test +ve
• Hawkings kennedy impingement Test +ve
Physiotherapy Diagnosis : Supraspinatus Tendinitis of
Left Shoulder Region,
secondarily Frozen Shoulder
11. Treatment Plan
Objectives
• Relieve the pain
• Increase the ROM
• Reduce Muscle spasm
• Restore general muscle strength
• Prevent Recurrence and Educating the patient
Short Term Goal – Relieve the pain
Long Term Goal – Bring the patient back to the normal
functional level
12. Treatment Plan cont….
At Early Stage
• Ultra Sound Therapy – continious mode, 0.8 W/cm2,
4 min, 1 MHz, thrice a week
• Soft Tissue Mobilization - Transverse friction to the
area
• Ice therapy – after the transverse friction
• Active Exercises
At Final Stage
• ROM Exercises
• Relaxation Exercises
• Muscle Strengthning Exercises
13. Justification of the treatment plan
• Ultra Sound Therapy to relive pain, increase
circulation, increase removal of waste products
and as a micro massage
• Transverse friction to break adhesions
• After friction cryotherapy can be given to warmth
area
• Active Exercises /AROM Exercises to improve ROM,
to improve muscle properties and to prevent
forming contractures
• Relaxation Exercises to increase joint mobility
• Strengthning Exercises to Strength weak muscles
and improve muscle power
• Educate the patient to get the cooperation for the
treatment plan