Infrared radiation therapy involves using electromagnetic waves between visible light and microwaves to heat superficial tissues. It can be generated by luminous sources like tungsten filament lamps or non-luminous sources like heated coils. Infrared radiation increases blood flow, relieves pain and muscle spasms, and accelerates healing through superficial tissue heating. Proper application and monitoring are needed to provide benefits while avoiding potential risks like burns.
The document discusses ultrasound therapy, including its introduction, production, physiological effects, application techniques, methods, indications, and contraindications. Specifically, it explains that ultrasound therapy involves using high-frequency sound waves to treat soft tissue injuries and conditions. It describes how piezoelectric crystals or transducers are used to produce the therapeutic ultrasound and discusses direct contact and indirect immersion and bladder application as methods of delivery. The document also lists common uses of ultrasound therapy such as for soft tissue injuries, sprains, and arthritis, as well as who should avoid it like those with cancer lesions or metal implants.
Russian current is a medium-frequency current delivered in bursts at 2500 Hz. It produces strong muscle contractions through synchronous motor nerve depolarization. Key characteristics include a carrier frequency of 2500 Hz, burst frequency of 50 Hz, burst duration of 10 ms, and a 10/50/10 training protocol. Russian current is indicated for muscle strengthening, reducing muscle spasm and edema, such as following knee ligament injuries or surgery.
Contrast bath therapy involves soaking an injured area in alternating hot and cold water baths to increase blood flow and decrease stiffness and pain. The physiological mechanism is that it induces vasodilation and vasoconstriction through changes in water temperature, pumping edema from the injured area. The procedure involves soaking in warm water for 10 minutes, cold water for 1 minute, repeating warm water for 4 minutes and cold water for 1 minute, ending in warm water for 4 minutes for a total time of 25 minutes. Contrast baths can treat injuries like sprains, strains and bruises by removing edema through changes in blood flow. Certain precautions should be taken for conditions like open wounds, pregnancy and impaired sensation.
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Ultraviolet radiation can be used therapeutically to treat various skin conditions. It has both immediate physiological effects like erythema, tanning, and long term effects like aging and cancer. There are different types of UV generators that produce UVA, UVB or UVC. Dosage is carefully determined based on skin type and response. PUVA treatment uses oral photosensitizing drugs before UVA exposure to treat conditions like psoriasis. Precautions must be taken with UV therapy due to risks of overexposure like burns, aging and skin cancer.
This document provides information about faradic current, including its nature, therapeutic and physiological effects, techniques of application, indications, contraindications, and clinical applications. It describes faradic current as an asymmetrical alternating current with a pulse duration of 0.1-1 ms and frequency of 30-100 Hz. The document discusses the effects of faradic current such as stimulation of sensory and motor nerves and reduction of swelling and pain. It outlines various methods and techniques of faradic current application for diagnostic and therapeutic purposes, as well as precautions and potential dangers of its use.
Modified galvanic current, or interrupted direct current, is a type of electrical stimulation where a direct current is pulsed on and off at regular intervals. The document discusses how this current is produced using a source, transistors, and a timer circuit. It describes the physiological effects of interrupted direct current such as sensory stimulation, hyperemia, electrotonus, pain relief, and accelerated healing. The document also provides guidelines for administering interrupted direct current and lists contraindications.
The History of SWD
Production, Generation, Method of Application, Patient Preparation, Physiologcal and therapeutic effects, Indications, Contraindications daners of SWD, and Evidence Based Practice.
The high voltage pulsed galvanic stimulator (HVPGS) delivers a high voltage, low amperage, short duration electrical current as a twin-peak monophasic waveform up to 300 volts to produce both mechanical muscle contractions and chemical changes in the body. It has been used clinically for over 45 years to treat various musculoskeletal conditions through analgesia, muscle stimulation, and wound healing. The high voltage allows for deep tissue penetration without risk of tissue damage due to its low total current. Typical treatments last 30-40 minutes, 3 times per day.
This document discusses galvanic current and its use in stimulating denervated muscles. It defines galvanic current as a direct, unidirectional current that can cause pain due to its unidirectional nature. Interrupted galvanic current is introduced to overcome this by providing regular pauses in stimulation. Stimulating denervated muscles with galvanic current can help limit atrophy and edema until reinnervation occurs. Precautions must be taken when applying galvanic current due to potential dangers like burns or electric shock.
IFT which stands for Interferential Therapy is one of the types of electrotherapy used for the management of pain. The principle of interferential therapy is to cause two medium frequency currents of slightly different frequencies to interfere with one another. For example, if circuit A carries a current with the frequency of 4000Hz and Circuit B carry a current with a frequency of 3980 Hz, then the low frequency produced will be 20 Hz and this frequency is very useful in pain modulation. A new low-frequency current known as the beat frequency is equal to the difference in frequencies between the two medium frequency currents produced in the tissues at the point where the two currents cross.
It is basically used for the treatment of Chronic, Post Traumatic, and Post-surgical pains. The basic principle involves the utilization of effects of low frequencies (<250pps) without painful or unpleasant side effects. The major advantage of IFT is that it produces effects in the tissue, exactly where required without unnecessary and uncomfortable skin stimulation. This technique is widely used to elicit muscle contraction, promote healing and reduce edema.
Vector effect: The interference field is rotated to an angle of 450 in each direction, the field thus covers a wider area. This is useful in diffuse pathology or if the site of the lesion cannot be accurately localized.
Frequency swing: Some equipment allows a variation in the speed of the frequency swing. A rhythmic mode may be a continuous swing from 0 to 100 Hz in 5-10s and back in similar time or it may hold for 1-6s at one frequency followed by 1-6s at another frequency with a variable time to swing between the two.
Constant frequency: Some treatments may be carried out with the interference fixed at a certain frequency. Rhythmic frequency is useful if several types of tissues are to be treated at once. A variation in the frequency also overcomes the problem of tissue accommodation where the response of a particular tissue decreases with time.
WORKING PRINCIPLE: Interferential current therapy works by sending small amounts of electrical stimulation to damaged tissues in the body. The therapy is meant to boost the body's natural process of responding to pain, by increasing circulation thus produces hormones that promote healing. IFT delivers intermittent pulses to stimulate surface nerves and block the pain signal, by delivering continuous deep stimulation into the affected tissue. IFT relieves pain, increases circulation, decreases edema, and stimulates the muscles. A frequency of 100Hz may stimulate the large diameter A-beta fibers, which have an effect on the pain gate, and inhibit the transmission of small-diameter nociceptive traffic ( C and A-delta fiber), which effectively closes the gait to painful impulses. Interferential current Increases the circulation of blood thus reduces swelling.
This document discusses different types of exercises used in physiotherapy, including free exercises, assisted exercises, assisted-resisted exercises, and resisted exercises. It defines each type and describes techniques, effects, and uses. Free exercises use only voluntary muscle action and can be localised or general. Assisted exercises involve a therapist providing support and assistance during a movement. Assisted-resisted exercises combine assistance and resistance. Resisted exercises use forces like weights or elastic bands to oppose muscle movement. The document also covers types of resistance like weights, pulleys, springs, and water. It describes progression of resistance exercises by increasing weight, leverage, speed, or duration. Finally, it discusses reflex movements and specific reflexes like the stretch reflex
Short wave diathermy (s.w.d) electro therapyÂbhìšhék Singh
Electrotherapy topic shot wave diathermy ppt (physics)
Bachelor of physiotherapy topic swd . Swd introduction, and range of swd , indications and contraindications of swd
Diadynamic currents are a variation of sinusoidal currents that are produced by rectifying alternating current into monophasic pulses. There are two main types - half wave rectification produces pulses with a duration equal to the interpulse interval at the original frequency, while full wave rectification produces continuous pulses at twice the original frequency. The pulses from diadynamic currents have a duration of 10ms, causing sensations from vibration to pain depending on intensity. Different current types like MF, DF, CP and LP are used for pain relief, muscle stimulation, and preventing accommodation effects. Precautions must be taken due to the electrochemical changes and potential skin damage from the currents.
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
Ultraviolet radiation (UVR) lies between visible light and X-rays in the electromagnetic spectrum. The document discusses the different types of UVR (UVA, UVB, UVC), their effects on the skin like sunburn, tanning, and skin cancer. It also summarizes therapeutic uses of UVR for various skin conditions like psoriasis, acne, and wounds. Determining the minimal erythemal dose (MED) through a skin test is described as the basis for calculating safe UVR dosages for patients.
Sinusoidal current produces a sine wave alternating current of 50 Hz, giving 100 pulses per second with durations of 10ms each, alternating direction 50 times in each direction. It is produced from mains power by reducing the voltage to 60-80v using a step down transformer. When passed through the body, sinusoidal current causes changes in ion concentrations at cell membranes, producing muscle contraction in nerves and ionic movement in other tissues. It is commonly used to cause rhythmic muscle contractions and relieve pain and reduce swelling by alternately changing cell membrane permeability. Indications include pain and pain/swelling, while contraindications include skin lesions, infections, and impaired sensation.
1. Passive movement involves moving a joint through its range of motion without active contraction of the muscles around the joint. It is done by a therapist or machine when a patient cannot actively move on their own or has a reduced range of motion.
2. There are two main types of passive movement - relaxed passive movements and passive manual mobilization techniques. Relaxed passive movements are smooth movements done by a therapist through a patient's full available range, while manual techniques include joint mobilization, manipulation, and controlled stretching.
3. Continued passive motion devices are used after limb or joint surgery to maintain movement and limit stiffness and pain. They move the joint through its full range while the patient is in bed to prevent immobil
Infrared radiation lies between visible light and microwaves in the electromagnetic spectrum. It can be subdivided based on wavelength. There are two main types of infrared generators used in physiotherapy - luminous generators which emit infrared, visible light, and ultraviolet rays, and non-luminous generators which only emit infrared rays. Luminous generators penetrate less deeply but are used for more chronic conditions while non-luminous generators penetrate more deeply and are used for acute conditions. Infrared radiation has physiological effects like increasing metabolic rate and cutaneous blood flow, and therapeutic effects like reducing pain and increasing joint mobility. New infrared therapies have emerged but proper technique and safety precautions must still be followed to avoid potential dangers like burns.
Infrared radiation lies between visible light and microwaves, with wavelengths between 750 nm and 400,000 nm. It is subdivided into different types based on wavelength. Infrared lamps used in physiotherapy are either non-luminous generators, which produce infrared rays between 750 nm and 15,000 nm, or luminous generators, which also emit visible light and ultraviolet rays between 350 nm and 4,000 nm. Infrared radiation is mostly absorbed by water and proteins in the skin, with penetration depth depending on several factors. It is used therapeutically to relieve pain, relax muscles, increase blood supply and joint mobility, and accelerate healing.
INTRODUCTION, SOURCES OF IRR, TYPES OF IRR, PRODUCTION OF IRR, NON LUMINOUS LAMP, LUMINOUS LAMP, ABSORPTION & PENETRATION, PHYSIOLOGICAL EFFECTS, THERAPEUTIC EFFECTS, CHOICE OF LAMPS, DANGERS, CONTRAINDICATIONS,
1800 by Sir FREDERICK WILLIAM HERSHEL.
Thought colours were associated with heat.
Used 3 Thermometers with blackened bulbs to measure heat of different colours.
Studied beyond red light.
Discovered below red, infrared, light radiations.
Primary source of infrared radiation is heat or thermal radiation.
This radiation is produced by the motion of atoms.
Anything above absolute 0 emits infrared radiations
1. Infrared radiation is emitted from any heated body and has a wavelength longer than visible light, between 760nm and 1mm.
2. Infrared is classified into 3 categories - IR A between 760-1400nm used for therapeutic purposes, IR B between 1400-3000nm also used therapeutically, and IR C between 3000nm-1mm which is non-therapeutic.
3. Infrared lamps can be either luminous (bulb) or non-luminous (coil heater) generators. Luminous lamps emit across the infrared and visible light spectra while non-luminous only emit long infrared wavelengths.
Laser therapy began in the 1960s and was initially used in ophthalmology. Aesthetic laser development expanded in the 1980s-2000s to include resurfacing, vascular treatments, and non-ablative options. Lasers are classified by wavelength and pulse duration. Precise targeting relies on chromophore absorption and thermal relaxation time. Risks include eye injury, fire hazards, and airborne particles. Non-ablative options cause minimal downtime while ablative resurfacing has more risks but deeper effects. Fractional resurfacing combines benefits of each. Tattoo removal requires multiple treatments over weeks to slowly break up ink.
Infrared radiation is broadly divided into two types - near infrared with wavelengths of 750-1400nm and far infrared with wavelengths of 1500-4000nm. Non-luminous lamps produce long wavelength infrared radiation and account for 90% of infrared production, penetrating approximately 2mm into the skin. Luminous infrared lamps use tungsten filaments and penetrate 5-10mm into the skin, distributing heat energy over a larger tissue volume. Infrared radiation is used for conditions like muscle spasm, stiffness and pain relief by increasing local blood flow and metabolism.
Infrared radiation is electromagnetic energy with wavelengths between 760nm and 1mm that is used in physiotherapy to relieve pain and enhance healing. There are two types of generators: luminous generators use incandescent lamps that emit infrared radiation to penetrate 5-10mm, while non-luminous generators use coiled resistance wire to emit far infrared radiation penetrating 2mm. Infrared radiation increases blood flow, metabolism, and nerve stimulation to provide therapeutic effects for pain relief, muscle spasm reduction, and skin conditions.
Laser is an acronym for Light Amplification by Stimulated Emission of Radiation.
Ophthalmology is the first medical specialty to incorporate the use of lasers. Since its first use, lasers have been modified and adapted to different uses
This document provides information on different types of ultraviolet radiation generators and lamps, including high pressure mercury vapor burners, fluorescent tubes, and their uses. It also discusses the physiological effects of UV radiation such as erythema, pigmentation, thickening of the epidermis, production of vitamin D, and dangers of overexposure like eye damage. Various indications for UV therapy are outlined, like treatment of acne, psoriasis, skin wounds, and vitiligo. Contraindications and techniques for UV application including test dosing are described.
This document discusses the use of lasers in oncosurgery. It begins with a brief history of lasers and their clinical applications. It then describes the components, properties, and classifications of laser devices. The mechanisms of laser tissue interactions like photothermal, photomechanical, and photodynamic effects are explained. Different types of lasers used in surgery like CO2, KTP-argon, and Nd:YAG lasers are outlined. Applications of lasers in oncology, gastrointestinal cancers, liver surgery, neurosurgery, and selective cancer therapy using gold nanorods are summarized.
LASERS IN vitreoRETINAaaaaaaaaa2023.pptxMadhuri521470
Lasers are used to treat retinal disorders like diabetic retinopathy and retinal vein occlusions. For diabetic retinopathy, focal laser photocoagulation is used for microaneurysms near the macula. Grid laser photocoagulation treats diffuse leakage, while panretinal photocoagulation treats proliferative retinopathy. Branch retinal vein occlusions are treated with grid laser for macular edema or scatter photocoagulation for neovascularization. The parameters and goals of treatment are tailored based on the specific condition and location of lesions.
This document summarizes the different types of electromagnetic radiation in the ultraviolet spectrum and their effects on skin. It discusses:
- The 3 types of UV radiation - UVA, UVB, and UVC and their wavelengths. UVC is strongly absorbed by DNA and does not reach the Earth's surface.
- How UV radiation interacts with chromophores in skin to cause DNA damage, inflammation, erythema, and immunosuppression through pathways involving cytokines like IL-10.
- The role of UVB radiation in vitamin D production in skin and the optimal sunlight exposure needed for vitamin D synthesis.
- Different light sources that emit UVA and UVB radiation and their uses like phototherapy
Infrared spectroscopy analyzes the absorption of infrared light by molecules to determine their structure. It is mainly concerned with studying vibrational transitions that occur when the wavelength of infrared radiation matches the natural frequency of vibration of bonds in a molecule. Infrared spectroscopy can be used to identify functional groups and determine the structure of organic compounds. The infrared spectrum is divided into functional group and fingerprint regions that provide information about bond vibrations and molecular structure.
1. The document describes the physical properties, therapeutic effects, and application methods of infrared rays, ultraviolet rays, and LASER therapy.
2. It defines infrared rays and their classification, discusses the laws governing their absorption and emission, and lists their indications and contraindications for physiotherapy.
3. The document also covers the physiological effects of infrared rays, including local temperature rise and increased metabolism, as well as their therapeutic effects such as analgesia, muscle relaxation and increased blood flow.
Ultraviolet Light Therapy
It involves exposing the affected areas of skin to ultraviolet light (UV light). UV light reduces inflammation and slows the production of skin cells. The treatment is usually given three times a week in a dermatology practice or hospital.
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Lasers in oral and maxillofacial surgery Jeff Zacharia
This document discusses lasers used in oral and maxillofacial surgery. It begins with an introduction to lasers and their properties. It then covers the history of lasers, the components of a laser unit including the active medium and resonator cavity. It classifies lasers based on their active medium and wavelength and discusses their indications for soft and hard tissue procedures. Examples of surgical uses include cleft surgery, TMJ surgery, intraoral lesions, and implantology. Precautions for safe use and the selection of appropriate lasers are also outlined.
Microwaves are electromagnetic waves with a frequency between 300 MHz and 300 GHz that can be used for diathermy therapy. Microwaves are produced using a power supply, magnetron, and emitter/antenna. They are absorbed more by tissues with high water content like muscle and heat the surface more than deeper tissues. Microwaves can be used to treat pain, inflammation and other conditions by increasing blood flow and metabolism through localized heating, but risks include burns if moisture is present or the eyes/testes are exposed directly to the beams. Proper positioning and monitoring of the patient is needed during treatment.
- Lasers work by stimulating the emission of photons from atoms or molecules in an active medium, which are then amplified through stimulated emission to produce a coherent beam of light.
- Early lasers used ruby as the lasing medium, while modern lasers use a variety of solid, liquid, gas, and semiconductor media.
- In dermatology, lasers target chromophores like melanin, blood, and tattoo ink to selectively treat conditions while minimizing damage to surrounding tissue.
1) The document discusses various sampling techniques used in research, including probability sampling methods like simple random sampling, systematic sampling, stratified sampling, cluster sampling, multistage sampling, and multiphase sampling.
2) It also discusses non-probability sampling techniques like purposive sampling, convenience sampling, snowball sampling, and quota sampling.
3) The key aspects of each sampling technique are defined, including how the samples are selected and the merits and limitations of each approach.
This document discusses the four main types of measurement scales: nominal, ordinal, interval, and ratio.
Nominal scales assign numbers or symbols to qualitative categories for labeling purposes only, with no numerical significance or ordering. Ordinal scales arrange data in order but differences between ranks cannot be determined.
Interval scales have equidistant values where differences are meaningful, but have an arbitrary zero point. Ratio scales have a true zero point origin allowing multiplication and division, and include scales like height, weight, and money.
This document defines and describes different types of variables. It discusses variables as characteristics that can vary between individuals or objects. The main types of variables covered are independent variables, dependent variables, extraneous variables, qualitative vs. quantitative variables, discrete vs. continuous variables, and attribute vs. active variables in study design. Different examples are provided to illustrate each variable type.
This document discusses various methods for collecting data in research. It describes primary and secondary data, as well as specific methods like observation, interviews, questionnaires, schedules, and experiments. For each method, it outlines the definition, steps, classifications, advantages, and disadvantages. Primary data collection methods covered in more detail include observational, interview, questionnaire, and schedule methods. The document also discusses collecting and evaluating secondary data from sources like government and organization publications. Overall, it provides an overview of different approaches to gathering information needed to answer a research problem.
This document discusses different types of validity in psychological and medical testing. There are four main types of validity: face validity, content validity, criterion validity, and construct validity.
Face validity refers to how a test appears to measure what it aims to on the surface. Content validity concerns how well a test covers all aspects of the construct being measured. Criterion validity assesses a test against a gold standard, including predictive validity which tests against future criteria and concurrent validity which tests against present criteria. Construct validity examines how a test measures an intended concept when no gold standard exists, including convergent validity which looks at correlation with similar measures and discriminant validity which looks at lack of correlation with unrelated measures.
This document discusses various methods for collecting data in research. It describes primary and secondary data, as well as specific primary data collection methods like observation, interviews, questionnaires, schedules, and surveys. For each method, it outlines the definition, process, classification, advantages, and disadvantages. Additional topics covered include collecting secondary data, factors to consider when using secondary data like reliability and suitability, and selecting the appropriate data collection method based on the nature, scope, funding, time, and precision required for the research.
Common deformities, deviations, and injuries of ankle and footDr Vicky Kasundra
This document summarizes common foot deformities, deviations, and injuries. It describes conditions such as bunions, claw toes, hammer toes, mallet toes, clubfoot, crossover toes, and various types of flat feet and high arches. For each condition, it provides details on symptoms, causes, classifications if relevant, and clinical presentation. The document serves as an informative reference for various foot abnormalities.
The lower leg, ankle, and foot contain 28 bones that are divided into the forefoot, midfoot, and hindfoot. There are 25 joints in the foot including the tibiofibular joints, ankle joint, subtalar joint, and various tarsal joints. The principal functions of the foot are propulsion during gait and providing support and stability for upright posture. The document describes the types, articulating bones, ligaments, range of motion, and innervation of each major joint in the lower leg and foot.
The cervical region of the spine provides both stability and mobility. It has the largest range of motion of any spinal region and allows for flexion, extension, lateral flexion, and rotation. Motions at each vertebral level are coupled and dictated by bone shape, ligaments, joints, and other connective tissues. The cervical region transmits weight and stresses from the head through a combination of vertebral bodies, disks, and facet joints. Ligaments and muscles also provide stability and enable motion through their actions.
The ankle/foot complex allows both stability and mobility through its structures. It bears weight and provides stability through the ankle joint and subtalar joint. The ankle joint permits dorsiflexion and plantarflexion around an oblique axis between the talus and tibia/fibula mortise. Ligaments including the deltoid and collateral ligaments support the joints. The talus wedging in the mortise enhances stability in dorsiflexion. Plantarflexion provides less stability.
The cervical spine consists of 7 vertebrae divided into upper and lower regions. The upper region includes the atlas (C1) and axis (C2). The atlas forms a ring that supports the skull and allows nodding motions. The axis has a dens that articulates with the atlas to enable rotation. The lower region includes vertebrae C3-C7, which have typical features like transverse processes and articulating facets. Key ligaments like the transverse atlantal ligament and alar ligaments stabilize the atlanto-axial joint to allow mobility while preventing excessive movement.
Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group.
All clinical trials must be approved by Institutional Ethics Committee before initiation
It is mandatory to register clinical trials with Clinical Trials Registry of India
Informed consent from all study participants is mandatory.
A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected.
Following points high.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
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A comparative study on uroculturome antimicrobial susceptibility in apparentl...Bhoj Raj Singh
The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...rightmanforbloodline
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
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TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
Mainstreaming #CleanLanguage in healthcare.pptxJudy Rees
In healthcare, every day, millions of conversations fail. They fail to cover what’s really important, fail to resolve key issues, miss the point and lead to misunderstandings and disagreements.
Clean Language is one approach that can improve things. It’s a set of precise questions – and a way of asking them – which help us all get clear on what matters, what we’d like to have happen, and what’s needed.
Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared.
This project, which emerged from work done by the NHS England South-West End-Of-Life Network, with help from the Q Community and especially Hesham Abdalla, aims to fix that.
Ontotext’s Clinical Trials Eligibility Design Assistant helps with one of the most challenging tasks in study design: selecting the proper patient population.
Chair, Benjamin M. Greenberg, MD, MHS, discusses neuromyelitis optica spectrum disorder in this CME activity titled “Mastering Diagnosis and Navigating the Sea of Targeted Treatments in NMOSD: Practical Guidance on Optimizing Patient Care.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4av12w4. CME credit will be available until June 27, 2025.
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxsouravpaul769171
Theoretically, gene therapy is the permanent solution for genetic diseases. But it has several complexities. At its current stage, it is not accessible to most people due to its huge cost. A breakthrough may come anytime and a day may come when almost every disease will have a gene therapy Gene therapy have the potential to revolutionize the practice of medicine.
JMML is a rare cancer of blood that affects young children. There is a sustained abnormal and excessive production of myeloid progenitors and monocytes.
2. Introduction
• Infrared rays are electromagnetic waves.
• It lies between visible light and microwaves.
• Wavelength : 750 nm to 400000 nm.
• Frequency : 4 * 1014Hz and 7.5 * 1011Hz.
• Infrared radiation (IR/IRR) therapy is a superficial heating
modality.
• It works on radiation principle of heat transfer.
4. Classification
• Based on wavelength
IRA
IRB
IRC
760-1400 nm
1400-3000 nm
3000 nm-1 mm (not
used in therapy)
6. Sources of infrared radiation
• The sources of infrared can be either natural or artificial.
• Artificial infrared is generally produced by passing electric
current through coiled resistance wire.
• Sun is the natural source of infrared radiation.
• In the physiotherapy department Infrared radiation are
produced by two type if generators:
1. non-luminous generators
2. luminous generators
7. Production of Infrared
• Any heated material will produce infrared (sun, electric
bulb, coal fire, gas fire etc), the wavelength being
determined by the temperature.
heat provide to any
material
Molecular vibrations of
atoms
Collision of molecules
Production of heat or IR
8. • Higher temperature are associated with higher frequency
and shorter wavelength radiation.
• The most convenient method is to heat a resistance wire by
passing an electric current through it.
9. Non-luminous generators
• Non-luminous generator consists of a simple type of
element or coil wound on a cylinder of some insulating
material such as fireclay or porcelain.
An electric current is passed through the wire which results in the
production of heat.
This heat produces infrared rays which are transmitted through the
porcelain.
Porcelain gets heated by the method of conduction but the radiations
generates in this way also include some of the visible rays.
10. • To avoid this, the coil is embedded in fireclay or porcelain or placed
behind fireclay.
• Now the emission of rays is entirely from the fireclay which is
commonly painted black and thus very few visible rays are produced.
• The element or the coil is thus placed at the focal point of a parabolic
or spherical reflector.
• Wire –mesh screens are placed in front of reflector to prevent
accidental contact with the hot emitter.
• The reflector is mounted on a stand and its position can be adjusted as
required.
13. Disadvantage :
• All of these non-luminous generators take some time to get
heated up for the production of infrared radiations, so they
should be switched on before 5-15 minutes of the treatment.
Advantage :
• Non-luminous generators provide infrared rays only.
14. Luminous Generators
• Luminous generators emit infrared, visible and a few
ultraviolet rays.
• Heat produce by it is called radiant heat.
• These generators are in the form of incandescent lamps or
bulbs.
• An incandescent lamp consists of a wire filament enclosed
in a glass bulb, which may contain an inert gas at low
pressure.
15. • The filament is a coil of fine wire which is usually made up
of tungsten.
• Tungsten is a metal which is used because it can tolerate
repeated heating and cooling.
• Front of bulb is usually red to filter out shorter visible &
ultraviolet rays.
• Incandescent bulb is usually mounted at the center of the
parabolic reflector and the reflector is mounted on an
adjustable stand.
17. Disadvantage :
• luminous generators emit infrared rays, visible as well as
ultraviolet rays.
Advantage :
• Require less time for production of IRR.
19. Depth of penetration of rays
Luminous generator
• Produces infrared rays
having wavelength
between 750-1500 nm
(maximum 1000 nm).
• It can penetrate into
epidermis, dermis and
subcutaneous tissue (5-
10 mm)
Non-luminous generator
• Produces infrared rays
having wavelength
between 1500-12000 nm
(maximum 4000 nm).
• It can penetrate into
epidermis & superficial
dermis (2 mm)
20. Choice of luminous and non-luminous
source
• In most cases luminous and non-luminous generators are
equally suitable, but in some instances one proves more
satisfactory than the others.
• Luminous radiation : more efficient tissue heating source
since it penetrates further (because peak emission is in the
short infrared) and therefore the energy is distributed in a
larger volume of tissue.
• Non-luminous radiation : with peak emission around
4000nm, is absorbed almost entirely in the skin.
21. • If the desired effects are due to:
Heating : the luminous infrared is preferred
Sensory stimulation : the non-luminous is preferred
• When there is acute inflammation or recent injury, the nom-
luminous generator were used.
• When there is chronic lesion or injury, the luminous
generator were used.
22. Luminous Non-luminous
Sources & types Tungsten filament enclosed in bulb
with insert gas at low pressure
Electric coil wire wrapped
around fireclay or porcelain
Wavelength 750-1500 nm (maximum 1000 nm) 1500-12000 nm (maximum
4000 nm)
Emission 70% near IRR, 24% far IRR, 5%
visible light,
1%UV
90% far IRR, and 10%
near IRR
Penetration Epidermis, dermis &
subcutaneous tissue (5-10mm)
Epidermis & dermis
(2mm)
absorption Deep Superficial
Physiological
effect
Pain reduction via counter
irritant effect
Pain reduction via
sedative effect
Uses Chronic conditions Acute conditions
Distance 40-60 cm from treated area 65-80 cm from treated
area
Treatment time 15-20 minutes 20-30 minutes
23. Power
The power of IR sources can described as;
• Small lamps (luminous and non-luminous), usually
250-500W.
• Large, non-luminous, 750-1000W.
• Large, luminous, 650-1500W.
24. Emission
Non-luminous
• Mainly 3000-4000 nm (long IR), with about 10% between
1500 nm and visible (short IR)
Luminous
• Approximately 70% short IR
• 5% visible
• 24% long IR
• 1% UVR absorbed by glass of bulb
25. Absorption and penetration of infrared
radiation
• All radiations, when it strikes the body, will be reflected,
some will penetrate, to be scattered, refracted and ultimately
absorbed in the tissues.
• Close to 95%of the radiation applied perpendicular to the
skin is transmitted rather than reflected.
• The transmitted energy is rapidly absorbed so only small
amounts of radiation penetrate to the subcutaneous tissues;
most is absorbed in the skin.
26. • The absorption of infrared and the maximal penetration of
the rays will depend upon the following variables:
1. frequency or wavelength of the rays
2. thermal conductivity of the tissue
3. angle of incidence of the rays
4. density of each tissue
5. distance from the source of infrared
6. patency of the circulation
7. source of the infrared
28. Penetration
• Penetration is depends on penetration depth.
• Penetration depth : The depth at which 63% of the
original radiation has been absorbed and 37% remains.
• Very long wavelength infrared ( around 40000nm ) behaves
like microwave and penetrates several centimetres.
• However, the long infrared used therapeutically is absorbed
at the surface, much of it by the water on the skin surface.
29. • At around 3000nm, the penetration depth is about 0.1 mm.
• There is increasing penetration with decreasing wavelength
in the short infrared region, to a maximum penetration
depth of about 3mm around the 1000nm wavelength region.
• Very short infrared and red visible radiation have
penetration depths of about 1 or 2 mm, while those of the
rest of the visible spectrum penetrate much less.
• In fact, at the blue end of the visible spectrum, the
penetration depth is about 0.07 mm and decreases uniformly
with wavelength through the UVR region.
31. Physiological effect
Cutaneous vasodilatation
• Due to the heating of the cutaneous structure, infrared
radiations produce local cutaneous vasodilataion.
• This effect is due to;
1. The liberation of chemicals such as histamine and similar
substance.
2. Due to the direct effect on blood vessels.
• The vasodilatation starts after 1-2 min and is largely due to
arteriolar vasodilatation.
32. • Due to heating erythema start developing.
• The rate of erythema depends on rate and degree of heating.
• For normal individuals, heating the skin to about core
temperature (37 c) over some 20 minutes will lead to very
mild erythema; heating to around (42 c) will lead to marked
erythema.
• The local erythema lasts for about 30 minutes after radiation
has stopped.
33. Sweating
• The heat produced by the IRR increases the activity of the
sweat glands, causing release of sweat.
• Produced sweat absorb some of the applied infrared
radiation and leads to surface cooling as it evaporates.
Sensation
• Due to the effects of heating the thermal heat receptors in
the skin are stimulated, giving the sensation of warmth.
34. Increase in metabolism
• As per vant hoff’s law, which states that the chemical
changes are accelerated due to heat, the heat produced by
IRR increases the metabolisum, due to which there is
increased demand in the tissue for oxygen and food stuffs
which is maintained by an increased arterial flow.
• The waste metabolites produced are removed by increased
lymphatic and venous returns.
35. Chronic changes
• Excessive and prolonged IR application can cause the
destruction of erythrocytes, releasing pigments and causing
brown discoloration of the skin.
• This rarely occurs as a normal treatment.
• Epidemiological studies also indicate that due to prolonged
use of high temperature IR can produce carcinogenic effect.
36. Therapeutic uses
Pain relief
• Mild heating on the superficial tissues by IRR causes
sedative effects of superficial sensory nerve endings.
• Pain may be due to accumulation of waste products of
metabolism, an increased flow of blood through the part
removes these substances and thus relives the pain.
37. • The pain due to acute inflammation or recent injury is
relieved most effectively by mild heating.
• When pain is due to chronic injury, stronger heating is
required. The treatment may last up to 30 minutes.
38. Reduction of muscle spasm/muscle relaxation
• Mild heating by IR causes relaxation of muscles and thus
relieves spasm.
• Relief of pain also induces relaxation in muscles and helps
relieving muscle spasm associated with injury.
• Relaxation of muscles provide greater ROM to the
exercising part as it relieves muscular spasm.
39. Acceleration of healing and repair
• It accelerate healing and repair by increasing blood supply.
• IRR increase the temperature in the superficial tissues,
causing vasodilatation in the superficial tissues.
• It provide more WBC and fresh nutrients to the area being
treated.
40. • It also accelerates removal of waste products and helps
bring about resolution of inflammation.
• Fresh supply of blood rejuvenates the tissues, removes
waste products of metabolism and also relives muscle
spasms.
• Ex, Arthritic condition
41. Reduction of joint stiffness
• There is increased blood flow and consequent muscle
relaxation which leads to decrease in the joint stiffness and
improves range of motion.
Relives skin lesions
• In case of skin infections such as dermatitis, viral infections
caused due to bacteria.
• IRR can be given to destroy the bacteria and thus help to
reduce the infections.
42. Indications
• Subacute or chronic inflammatory conditions such as; Low
back pain, cervical spondylosis, osteo-arthritis, rheumatoid
arthritis.
• Skin infections
• Pressure sore/decubitus ulcer
• Bell’s palsy following middle ear infection
• Peripheral nerve injuries before the application of electrical
stimulation
• Prior to stretching, massage, mobilization, traction and
electrical stimulation
43. Contraindication
• Acute skin disease (dermatitis or eczema)
• Defective cutaneous circulation (Peripheral vascular
disease)
• Haemorrhagic condition
• Areas with impaired thermal sensation
• Recently radiated tissues (following radiotherapy)
• Over areas of scars
• Severe edema
• Region of suspected mallignant tumor
• Metal impalnts tissues
• Directly over Eyes
• After deep X ray or cobalt therapy
44. Advantages
• Cost effective
• Easy to use at home
• Dry heat is very comfortable in the winter
• Can be used to treat large areas, with local superficial
heating effects.
• Superficial tissue temperature can be increased; even
though the unit does not touch the patient.
45. Disadvantages
• Uneven body parts can not be treated due to uneven heating.
• Constant temperature source increases the risk of burns.
• Lack of therapeutic evidence.
• Heating only superficial tissues, not effective as moist heat
pack and paraffin wax.
46. precautions
• IRR exposure of the tissue should not be more than 30
minutes.
• Distance between the source of the lamp and the tissue
should not be less than 18 inches.
• Ask the patient not to touch the IRR lamp and wires during
the treatment.
• Ask the patient not to sleep and move towards IRR lamp
during IR radiation exposure.
• People with sensitive skin.
• Never apply IRR directly over the eyes and genitals.
47. Technique of application
Patient
• Position the patient in a suitable, well supported position
with the area to be treated exposed.
• Explain the nature and effects of the treatment to the
patient.
• Before starting the treatment examine the skin to be treated
and test the thermal sensation.
48. Apparatus
• If non-luminous lamp is chosen, switch it on at least 10
minutes prior to treatment, to allow time for it to warm and
reach its maximum emission.
• A luminous lamp needs no warm up time and can be
switched on once patient is ready for the treatment.
49. Setting up
• Expose the skin to be treated and cover the eye with towel
or goggles.
• Position the lamp 90 degree so that the radiation strikes the
surface at near right angle to achieve maximum penetration.
• Set the lamp at appropriate distance: about 60-75 cm for
large lamps and about 45-50 cm for the smaller ones.
50. Instructions and warnings
• Ask the patient to indicate the level of heat they can feel
and where.
• Advice the patient not to touch any part of lamp or not to
move during treatment and alert therapist if it is more than
comfortably warm level of heating.
51. Application
• The intensity of the heating is most IR lamps is controlled by the
distance of the lamp from the skin.
• Adjacent areas can be protected from heating by placing the
layer of towel.
• The therapist should check the level of heating on completion of
the set up and again after 5 to 8 minutes and, if required, adjust
the distance of the lamp to the skin.
• IR is usually only applied for 10 to 15 minutes as it is only part
of a treatment, not a treatment itself.
53. Termination
• On completion of the treatment the skin should be carefully
checked.
• On palpation it may feel mildly or moderately warm and a
moderate erythema should be evident.
54. Dangers
Burn
• Excessive heating of superficial tissues can causes burn.
• Erythema after the treatment is a physiological effect, but if the
intensity of IR is more, it may cause the formation of blisters.
• The burn may be caused due to the following reasons:
1. If intensity of radiation is too high
2. If sensation is not proper
3. Patients fails to report over heating
4. Unconscious patient
5. Patient moves closer to the lamp
6. Falls asleep during the treatment
7. Metal implanted tissue
55. Electric shock
• It can occur if some exposed part of the circuit is touched
by the patient.
• Due to heating of the wires in the circuit, insulation of wires
may go off and thus regular checking of wires is necessary
to avoid electric shock.
56. Faintness of giddiness
• Excessive IRR cause fall in BP which may result in
faintness or giddiness due to hypoxia of the brain.
• This is observed when the patient rises up suddenly from
the recumbent position after extensive treatment.
57. Reduced or altered peripheral blood flow
• Do not use IRR if the vascular response is insufficient
because of the risk of tissue damage.
• Areas affected by arterial disease, such as atherosclerosis,
arterial injury or after skin grafting, should not normally
treated with IRR.
58. Headache
• IRR over the back of the head may cause headache.
• Headache is also occur when treatment is given during hot
weather.
Following Radiotherapy
• Avoid IRR at least 2 months following radiotherapy.
59. Injury to eyes
• Direct heating over the eyes causes drying up and thus leads
to corneal and retinal burns.
• Another problem is forming cataracts.
Infection/skin inflammatory conditions
• Avoid applying heat over acute skin infections or previously
known tumours to prevent spreading of disease.