Pediatric Orthopedics Presentations

Absorbable Rods in Salter's Osteotomy
Between Salter's And Pemberton's Osteotomy
Angular and Rotational LL Deformities in Children
Fractures in Children for ER Phisicians
Common Orthopedic Problems in Children
Cerebral Palsy - Concepts and Current Views
Principles of Pediatric Fractures
Principles of Cerebral Palsy
Medical Ethics in The Operating Room
Arthrography-Guided Closed Reduction in CDH
Residual Acetabular Dysplasia
Which Acetabuloplasty in DDH
CDH for students
Hip Examinaton - Mamoun
Hip Spica Table - Home-made
The Cartilaginous Acetabular Angle

source:King Saud University

MEDICAL LECTURE NOTES ONLINE
visit http://medicalpptonline.blogspot.com/

HEMATOLOGY LECTURE NOTES - set 1

Acute Leukaemia (1)

Acute Leukaemia

An introduction to anaemia

Automation in Haematology

BENIGN LEUCOCYTES DISORDERS

Blood cells morphology

Blood donors_collection and storage part1

Blood donors_collection and storage part2

BLOOD TRANSFUSION REACTION

Bone marrow morphology

case report from ASH

CHRONIC MYELOID LEUKAEMIA

CHRONIC MYELOID

CPC2604

Current use of imatinib in the treatment of

FISH

G6PD- Molecular basis

Guidelines APS Journal

Guidelines for blood grouping and red cell antibody

Haemolytic anaemias1

Haemolytic anaemias2

Haemopoiesis and Clinical application

Haemopoiesis Clinical application

HAEMOSTASIS and THROMBOSIS

Hb-synthesis

HDNewborn

heparin Resistance

Ina AIHA

Introduction to Genetic

Introduction to Genetics-15.12.02

Leucocyte depleted blood products

Mesenchymal stem cells

Myelodysplastic syndrome overview.23111DEFANGED-ppt

Myeloprolifirative disorders

Normal Haemopoiesis

Panduan and Polisi Mengenai Proses Penyaringan Darah

Quality Assurance in Haematology

QUALITY ASSURANCE IN THE BLOOD BANK

RBC_memb

Slide Interpretation

Structure and function of Haemoglobin

The haematological features of HIV infection.13769DEFANGED-ppt

Thrombasthenia

THROMBOEMBOLIC DISEASES OF CHILDHOOD

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SOURCE:King Saud UniversityMEDICAL LECTURE NOTES ONLINE http://medicalpptonline.blogspot.com/

- Exploding head syndrome.

Exploding head syndrome

Def:- is a condition that causes the sufferer occasionally to experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, roar, gunshot, loud voices or screams, a ringing noise, or the sound of electrical arcing (buzzing).
This noise usually occurs within an hour or two of falling asleep, but is not necessarily the result of a dream and can happen while awake as well.

Causes:-
The cause of the exploding head syndrome (EHS) is not known, but :

• Some physicians have reported its correlation with stress, anxiety, and extreme fatigue.
• It may be the result of a sudden movement of a middle ear component or of the eustachian tube.
• It may be the result of a form of minor seizure in the temporal lobe where the nerve cells for hearing are located.

Read more �

- Renal trauma grading scale.

Basically we can divide renal trauma into five grades.

The grades I , II and III are classified as minor traumas, and the grades IV,V as major :-

• Grade I: contusion or subcapsular hematoma, without parenchymal laceration.
• Grade II: superficial cortical laceration less than 1 cm deep.
• Grade III: deep cortical laceration extending more than 1 cm.
• Grade IV:
1. corticomedullary laceration with collecting system injury and urinary extravasation.
2. vascular injury:- laceration or thrombosis of a segmental artery.

• Grade V:
1. Multiple deep lacerations.
2. Thrombosis of the main renal artery.
3. Avulsion of renal hilum which devascularizes kidney.

Read more �

- Basic bony surface anatomy of the knee.

Basic bony surface anatomy of the knee.

MICROBIOLOGY PPT LECTURE NOTES - set 2

Introduction
Bacterial Morphology and Structure
Bacterial Physiology
Disinfection and Sterilization
Bacteriophage
Bacterial Variation
Bacterial Infection and Immunity
Laboratory Diagnosis, Prevention and Treatment of Bacte rial Infection
The Staphylococci
Enteric Bacilli
Vibrio
Anaerobic Bacteria
Actinomyces and Nocardia
Diphtheria
Mycobacterium
Brucella
Campylobacter jejuni
Mycoplasmas
Rickettsia
Chlamydiae
Spirochetes
MYCOLOGY
MAIN PATHOGENIC FUNGI
General virology
Viral Infection and immunity
Laboratory Diagnosis and prevention
Respiratory viruses
Enteroviruses
Gastrointestinal Viruses
hepatitis virus
Flavivirus
Hemorrhogic Fever Virus
Herpes virus
Retrovirus
Rabies virus
PrionHuman Immunodeficiency Virus (26 slides, 1.2 MB)
Hepatitis A-E (48 slides, 1.4MB)
Herpesviruses (71 slides, 1.1MB)
Herpesvirus Infections in Immunocompromised Patients (29 slides, 397KB)
Enteroviruses (21 slides, 211KB)
Respiratory Viruses (28 slides, 401KB)
Diarrhoeal Viruses (16 slides, 286KB)
Congenital Viral Infections (25 slides, 88KB)
Arboviruses (19 slides, 805KB)
Viral Zoonoses: Rabies, Arena, and Hantaviruses (27 slides, 933KB)
Virological Tests (38 slides, 987KB)
Molecular Tests used for the Comparison of Viruses (11 slides, 114KB)
Laboratory Quality Control (19 slides, 78KB)
Surveillance of Infectious Diseases (43 slides, 677KB)
Viral Pathogenesis (32 slides, 859KB)

SOURCES:
Shanghai JiaoTong University School of Medicine
AND
virology-online.com
FOR MEDICAL LECTURE NOTES ONLINE http://medicalpptonline.blogspot.com/

- Bladder Injury.

Bladder Injury

Aetiology:-

1. Blunt trauma : 10% of pelvic fractures.
2. Penetrating trauma :gunshots or stap wounds.
3. Iatrogenic:-
• Obestetric :- 0.3% with caeserean section.
• Gynaecological e.g.during a vaginal or abdominal hysterectomy.
• Urological e.g during cystescopy.
• Orthopaedic e.g. pins and screws can commonly perforate the urinary bladder, particularly during internal fixation of pelvic fractures.
4. Idiopathic:- due to presence of a previous scar.

Classification(Pathophysiology):-

1. Extraperitoneal rupture bladder:
Usually due to fracture pelvis,and Extravasation occur at the perivesical space and may extend up to the anterior abdominal wall,If the urogenital membrane is injuried.
2. Intraperitoneal rupture bladder:(The most dangerous)
Usually due to direct trauma when the bladder is full,associated with electrolyte disturbance and may passed unnoticed for along time.

Read more �

- Side effects of antithyroid drugs.

Side effects of antithyroid drugs.

"Charge"

Cholestatic jaundice.
Hypothyroidism.
Allergy,Agranulocytosis.
Relapse on sudden stoppage.
Goiter,Git upsets.
Exophthalmos increase.

enjoy,,

Dr Ibrahim

-Duhin-Johnson syndrome.

Duhin-Johnson syndrome.

It is Autosomal recessive disease characterized by Partial defect in excretion of conjugated bilirubin into the bile.

*Clinical picture:-It is usually asymptomatic.

1. Jaundice.
2. Good general condition.

*Investigations:-

1. Bilirubin: mild elevation of direct bilirubin
2. Biopsy (dark pigment inside hepatocytes i.e the liver is black in colour), it had been proved to be a metabolite of catecholamines.
3. +ve Bromosulphthalein (BSP) Test: Normally 90% of this dye is removed from blood within 45 minutes after I.V injection in normal liver.
In Dubin-Johnson syndrome there is a late rise in plasma SSP after an initial fall due to reflux of the dye from the liver reflecting hepatic excretion defect.
4. No evidence of obstruction.
5. No evidence of LCF.

*Treatment:-

No treatment (almost normal life span).

Dr Ibrahim

Return to list of medical syndromes here

- Classification of Graves' eye disease.

Classification of Graves' eye disease. 

"NO SPECS"

• Class 0: No signs or symptoms.
• Class 1: Only signs (limited to upper lid retraction and stare, with or without lid lag).
• Class 2: Soft tissue involvement (oedema of conjunctivae and lids, conjunctival injection, etc.).
• Class 3: Proptosis.
• Class 4: Extraocular muscle involvement.
• Class 5: Corneal involvement.
• Class 6: Sight loss (due to optic nerve involvement).

Enjoy,,

Dr Ibrahim

- Source:-

• Werner SC. Modification of the classification of the eye changes of Graves' disease: recommendations of the Ad Hoc Committee of the American Thyroid Association. J Clin Endocrinol Metab 1977;44: 203-4.

- Local causes of complicated cataract.

Local causes of complicated cataract.

"Rigid"

• long standing Retinal detachment
• Inflammatory conditions:- chronic iridocyclitis,chorioretinitis
• Glaucoma.
• Intraocular tumors
• Degenerative conditions:- retnitis pigmentosa, degenerative myopia. 
local Drugs:- corticosteroids, pilocarpine, adrenaline eye drops.

Mechanism:-

• Interference with lens metabolism.
• The posterior cortex is affected early,as the posterior capsule is thin and devoid of sub capsular epithelium.

Enjoy,,,

Dr Ibrahim

- Structures of angle of Anterior chamber.

Structures of angle of Anterior chamber.

"I Can See Till Schwalbe's Line"

• Iris root.
• Cilliary Body.
• Scleral spur.
• Trabecular Meshwork.
• Schwalbe's Line.

These Structures are seen by gonioscopy.

Enjoy,,,

Dr Ibrahim

- Arterial line placement.

Arterial line placement.

An intra-arterial catheter (A-line) is a very small plastic tube (called catheter) placed in one of your blood vessels (an artery) by highly trained personnel. This is usually done during or before certain types of surgery or in the Intensive Care Unit.

To see how to undergo Arterial line see the following video from New Engeland Journal of Medicine.

you can see the video online on NEJM here or

Download it directly from here

or watch it now :D

Read more �

- ASA Grading system.

ASA Grading system

American Society of Anesthesiologists (ASA) grade is the most commonly used grading system to measure of a persons overall health, rather than a fitness for anaesthesia and surgery.   

• Grade  I   Healthy individual with no systemic disease 
• Grade II  Mild systemic disease not limiting activity
• Grade III Severe systemic disease that limits activity but is not incapacitating .
• Grade IV  Incapacitating systemic disease which is constantly life-threatening.
• Grade V   Moribund, not expected to survive 24 hours with or without surgery.
  Dr Ibrahim
  Return to list of medical grades (click here)

- Otitis Externa table.

Otitis Externa table.

This is a table for comparison between different types of Otitis Externa.

First what is Otitis Externa?

Simply it is It is Inflammation of the skin of the external auditory canal.

To download the table from MediaFire Click here size 20KB

In the table there is a comparison between

• Furunclosis( Localized otitis externa )
• Diffuse otitis externa
• Necrotizing otitis externa (Malignant otitis externa)
• Otomycosis
• Herpes zoster oticus (Ramsey- Hunt syndrome)

As regard:-

• Definition
• Aetilogy
• Predisposing Factors
• Clinical picture
• Treatment

You can print the table on large papers (A3 papers)

Good luck,

Dr Ibrahim

-Local Complications of pneumonia.

Local Complications of pneumonia
"Idea"

Incomplete resolution and followed by bronchiectasis later on.
Delayed resolution.
Pleural Effusion,Empyema.
Lung Abscess,ARDS and respiratory failure.

Dr Ibrahim

- Wagner Grading System for Diabetic Foot Infections.

Wagner Grading System for Diabetic Foot Infections

• Grade 0 :- Intact Skin,but high risky foot.
• Grade 1 :- Superficial ulcer of skin or subcutaneous tissue.
• Grade 2 :- Deep Ulcers but no abscess nor bone involvement.
• Grade 3 :- Deep ulcer with osteomyelitis, or abscess.
• Grade 4 : -Gangrene of toes,heel or forefoot (localized).
• Grade 5 :- Gangrene of whole foot.

 Dr Ibrahim
Return to list of medical grades (click here) 

-Physiological loss of abdominal superficial reflexes.

Physiological Causes of loss of abdominal superficial reflexes:-

"Foams"

Faulty techniques.
Obesity.
Attentive patient,Ascites.
Multiparous.
Scar.

Dr Ibrahim Samaha

-Variants(Types)of Scleroderma.

Variants(Types)of Scleroderma.

"Sold"

A)Systemic sclerosis without Scleroderma:-
i.e internal organ involvement without cutaneous scleroderma.
B)Overlap syndrome:-
scleroderma associated with other autoimmune disease.
C)localized scleroderma:-
scleroderma without internal organ involvement.
Charachterized by Morphoea which are local patches of scleroderma.
D)Limited scleroderma(CREST Syndrome):-
There is minimal visceral involvement, positive anticentromere antibodies and good prognosis.
Skin hardening is limited to face,feet and fingers.
(Calcinosis,Raynaud's phenomenon,Esophageal dysfunction,Sclerodactly,Telangectasia.)
E)Diffuse scleroderma:-
Diffuse thickening of trunk,proximal and distal limbs with internal organ development and damage so it is life threatening.

Dr Ibrahim

-Drugs causing intrahepatic Cholestasis.

Drugs causing intrahepatic Cholestasis

"Cheap"

Contraceptive pills,Chlorpromazine.
Hypoglycemic drugs.
Erythromycin.
Anti-thyroid drugs,Anti-coagulants,Anabolic steroids.
PAS.

Dr Ibrahim

-Poor prognosis of rheumatoid disease.

Poor prognosis of rheumatoid disease
"I'm fresh"

Insidious onset.
Male patient.

Functional disability at the 1st year after start of disease.
Radiographic evidence of erosion.
Extra-articular manifestations.
Subcutanous nodules.
High positive Rheumatoid factor.

Dr Ibrahim

-Complications of Tetralogy of fallot.

Complications of Tetralogy of fallot
"Inches"

Infective endocarditis,Low I.Q.
Neurological (e.g Brain abscess,cerebrovascular accidents)
Cyanotic spell,Clubbing.
Hematological(e.g polycythemia,IDA,Thrombosis).
Hyperuracemia and gout,Heart Failure (rare).
Exercise intolerance.
Squatting,scoliosis,Stunted growth.

Dr Ibrahim

-Drugs causing hepatitis.

Drugs causing hepatitis

"CMV Hard knife"

Cytotoxic drugs,Clonazepam.
Methyldopa.
Verapamil.

Halothane.
Atenolol.
Rifampicin.
Disulfiram.

Ketoconazole.
Nitrofurantoin,Niacin.
Isoniazid.
Fenofibrate.
Enalapril,Erythromycin.

Dr Ibrahim

-Treatment of Acute pancreatitis.

Treatment of Acute pancreatitis
"Snails"

Shock managment.
Nothing by mouth (put pancreas to rest).
Aspiration of gastric contents and Analgesics for pain.
Iv fluids and Calcuim.
Lavage of peritoneum in severe cases.
Somatostatin:- decrease pancreatic secretions.

Dr Ibrahim

-Varieties of Diabetic neuropathy.

Varieties of Diabetic neuropathy
"Stamp"

Sensorimotor polyneuropathy.
Truncal neuropathy.
Autonomic neuropathy.
Mononeuropathy.
Proximal neuropathy (diabetic amyotrophy).

Dr Ibrahim

-Atta's triad.

Atta's triad.

Atta's triad of bilharzial dysentery:-

1. Bleeding per rectum.
2. Polyposis.
3. Clubbing of fingers.

Dr Ibrahim

Return to other triads here.

-Charcot's triad.

Charcot's triad.

Charcot's triad of acute cholangitis:-

1. Fever with rigors.
2. Right hypochondrial pain.
3. Jaundice.

Dr Ibrahim
Return to other triads here.

-No in ASD.

No in Atrial septal defect.

No murmur due to ASD itself but murmur of relative MS,PS.
No ACEIs if HF occur but give diuretics and digitalis.
No spontanous closure of ASD.
No symptoms or signs in small ASD.

Dr Ibrahim

-Malabsorption syndrome.

Malabsorption syndrome.

Def:-Interference of absorption of one or more of the nutrients from small intestine,however lipids almost always fail to be absorbed leading to steatorrhea (fatty stool).

Causes:-

1)Gastric causes:-

• Cancer stomach.
• Atrophic gastritis.
• Gastrectomy.
• Gastrojejunostomy.
• Prenicious anemia.
• Zolinger Ellison syndrome.

2)Pancreatic causes(decrease Pancreatic enzymes):-

• Chronic pancreatitis.
• Cystic fibrosis.
• Pancreatic resection.
• Cancer pancrease
• Hemochromatosis.
  

Read more �

-Grading of function in rheumataid disease.

Grading of function in rheumataid disease

I Fit for all activities.
II Moderate restriction.
III Marked restriction.
IV Confined to chair or bedbound.

Dr Ibrahim
Return to list of medical grades (click here)

-Caroli's syndrome.

Caroli's syndrome.

Def:-
It is a congenital segmental dilatation of the intrahepatic biliary system.

Clinical picture:-

• Recurrent attacks of cholangitis.
• liver abscesses may occur.

Complications:-

• Biliary stones.
• Cholangiocarcinoma.

Treatment:-

• Antibiotics for cholangitis.
• Segmental liver resection for localized disease.

Dr Ibrahim

Return to list of medical syndromes here

-Iatrogenic endocrinal diseases.

Iatrogenic endocrinal diseases
"TV as Milk"

Thyroxin therapy lead to thyrotoxicosis.
Vit D lead to hypercalcaemia.

Amiodarone lead to thyroid dysfunction.
ACEIs lead to hypoaldosteronism.
Sympathomimetics lead to picture like thyrotoxicosis.
Steroid therapy lead to DM and cushing syndrome.

Metoclopramide lead to hyperprolactinaemia.
Iodide lead to hyperthyrodism.
Insulin and oral hypoglycemic lead to hypoglycemia.
Lithium lead to hypothyrodism.
Ketoconazole lead to hypoadrenalism.

Dr Ibrahim

-Psychic features of Hyperthyrodism.

Psychic features of Hyperthyrodism.

"Mania"

• Mental disturbance.
• Anxiety.
• Nervousness.
• Insomnia.
• Agitation.
   

Dr Ibrahim

-Congenital Rubella Syndrome.

Congenital Rubella Syndrome

Aetiology:-
Maternal infection by rubella leads to Maternal viremia which lead to transplacental spread of the virus to the fetus causing fetal viremia whcih in turn leads to infection invloving many fetal organs and hence congenital anomalies.

N.B:- Newborn discharge virus in his secretions for 12-18 months after birth so he is infectious.
Incidence:-
*In the 1st trimester:- 15-20%.
*In the 4th month:- 5%.
Read more �

-Factors affecting human linear growth.

Factors affecting human linear growth.

• Age
• Sex
• Race.
• Hereditary factors:- Children of two short parents will probably be short and vice versa.
• Endocrinal factors e.g Growth Hormone which is responsible for stimulation of body growth in humans.
• Nutritional factors:- Adequate nutrients must be available for normal growth.
• General health:- Any serious systemic disease in childhood is likely to reduce growth (e.g. chronic kidney disease or chronic infection).
• Intrauterine growth retardation (small birth weight):-These infants often growpoorly in the long term.
• Emotional deprivation and psychological factors:- These can impair growth by complex, poorly understood mechanisms.
• Chromosomal abnormalities.
• Skeletal maturity.

Dr Ibrahim

- Protozoa with blind end in man.

Protozoa with blind end in man
"ANTS"

Acanthamoeba castellanii(brain cyst).
Naegleria fowleri (brain cyst).
Toxoplasma gondii (cysts in male patient).
Sarcocystis lindemanni ( mascular sarcocystosis).

Dr Ibrahim