Gaur medical

Great post by about what the mechanisms of spinal manipulation are and their limitations! 😊👍
・・・
“💥SPINAL MANIPULATION💥
----------
Spinal Manipulative Therapy (SMT) involves specific positioning of the patient's body and a specific movement (direction, magnitude of force and amplitude) by the practitioner. In the spine, manipulative therapy most directly affects the facet joints, which are synovial joints that allow our spine to move in all three planes of motion (sagittal, frontal & transverse). Like other synovial joints, the facet joints contain synovial fluid and are surrounded by a fibrous joint capsule composed of connective tissue.
-
The facet joints are often thought to be a source of pain and often respond quite well to various forms of joint mobilization. What you should know, however, is that the popping sound you hear when having your spine manipulated/adjusted is nothing more than a pressure change in the facet joints, just like popping the joints of your hands. It has NOTHING to do with correcting the alignment of the spine. Any practitioner who claims otherwise and tries to convince you that 'tune-up' treatments are necessary to maintain proper spinal alignment is simply not reading the research or more interested in their bank account than your health.
-
At the end of the day, research has demonstrated time and time again that manual therapy can be helpful, but the effects are largely short-lived. A long-term recovery program should focus more on active interventions like exercise as these have much more evidence in terms of promoting long-term positive outcomes in both function and pain.
••••••••••
📚Bialosky JE, et al. Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther. 2018.
📚Bialosky JE, et al. The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model. Manual Therapy. 2009.”

Pulse Code Modulation
Advertisements
Previous Page Next Page
Modulation is the process of varying one or more parameters of a carrier signal in accordance with the instantaneous values of the message signal.

The message signal is the signal which is being transmitted for communication and the carrier signal is a high frequency signal which has no data, but is used for long distance transmission.

There are many modulation techniques, which are classified according to the type of modulation employed. Of them all, the digital modulation technique used is Pulse Code Modulation (PCM).

A signal is pulse code modulated to convert its analog information into a binary sequence, i.e., 1s and 0s. The output of a PCM will resemble a binary sequence. The following figure shows an example of PCM output with respect to instantaneous values of a given sine wave.

Instead of a pulse train, PCM produces a series of numbers or digits, and hence this process is called as digital. Each one of these digits, though in binary code, represent the approximate amplitude of the signal sample at that instant.

In Pulse Code Modulation, the message signal is represented by a sequence of coded pulses. This message signal is achieved by representing the signal in discrete form in both time and amplitude.

Basic Elements of PCM
The transmitter section of a Pulse Code Modulator circuit consists of Sampling, Quantizing and Encoding, which are performed in the analog-to-digital converter section. The low pass filter prior to sampling prevents aliasing of the message signal.

The basic operations in the receiver section are regeneration of impaired signals, decoding, and reconstruction of the quantized pulse train. Following is the block diagram of PCM which represents the basic elements of both the transmitter and the receiver sections.

Low Pass Filter
This filter eliminates the high frequency components present in the input analog signal which is greater than the highest frequency of the mes

Np

😆😆😆

Intestinal gas facts

The intestine normally contains gas that is rapidly transmitted through the small intestine to the colon. The amount of gas that is normally present is dependent on the effects of colonic bacteria on the undigested food that reaches the colon and the speed with which the gas passes through the intestines and is passed. In normal individuals, most of the lower intestinal gas that is passed (flatus) is gas produced in the colon and is not transmitted from the upper intestines.
The definition of excessive gas varies by individual, usually based on what they have considered normal in the past. Some individuals consider excessive gas to be excessive belching or excessive burping (burping a lot), others excessive passing of gas (flatulence), and still others as the sensation of fullness in the abdomen. Although everyone goes through periods of excessive gas, particularly flatulence, it is only when the symptoms become chronic that people become concerned.
The most common normal cause of belching is excessive gas in the stomach that comes from swallowed air. However, discomfort in the abdomen for any reason also may lead to excessive belching. Therefore, belching does not always indicate the presence of excessive gas in the stomach. It is not difficult usually to differentiate between excessive gas in the stomach and other causes of excessive gas. If the problem is gas in the stomach, belching brings relief. If it is not gas in the stomach belching does not bring relief. Although excessive belching may be a sign of excessive gas, it usually is not and is rather a sign of abdominal discomfort of many causes or a learned habit of swallowing and immediately regurgitating the air as a belch. Rarely excessive belching (burping a lot) is due to swallowed air during acute psychiatric issues associated with anxiety.
Bloating is the subjective feeling that the abdomen is full than it should be, but does not necessarily mean that the abdomen is enlarged. Distention is the objective enlargement of the abdomen. Bloating is not the same (synonymous) as excessive gas.
Continuous distention of the abdomen usually is caused by fluid, tumors, enlarged organs, or fat within the abdomen.
Intermittent distention of the abdomen may be caused by excessive formation of intestinal gas, but also physical or functional obstruction of the intestines.
Belching and flatulence (farting or passing gas) are virtually universal. The maximum number of farts for a normal person is 20 per day. The number that defines a "lot" of burping has not been determined.
Flatulence results from the production of gas by bacteria within the intestines (usually the colon) when they digest dietary sugars and polysaccharides that reach the colon undigested.
Increased gas is not caused by the irritable bowel syndrome (IBS) or most parasitic or bacterial intestinal infections. It also is not caused by gastritis, gastric cancer, gallstones, cholecystitis, and pancreatitis or cystic fibrosis (unless there is maldigestion of food). It also should not be confused with indigestion which has causes other than gas.
Excessive production of gas and increased flatulence may occur because of:
the greater ability of some bacteria to produce gas;
maldigestion or malabsorption of sugars and polysaccharides such as that seen in chronic pancreatitis with pancreatic insufficiency, celiac disease; and
bacterial overgrowth of the small intestine.
Abdominal pain is not a common symptom of people with excessive gas although the discomfort of bloating may be described as pain. Cramps and severe pain suggest causes other than gas, for example, intestinal obstruction that also can lead to abdominal distention and discomfort.
Remedies for truly excessive gas include changes in diet and suppression of intestinal bacteria that produce the gas. There is no evidence that digestive enzymes, activated charcoal, and simethicone (Gas-X, Mylanta, and others).
The remedy for excessive belching not d

What Are the Different Types of Hernias?
A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity. Hernias by themselves may be asymptomatic (produce no symptoms) or cause slight to severe pain. Nearly all have a potential risk of having their blood supply cut off (becoming strangulated). When the content of the hernia bulges out, the opening it bulges out through can apply enough pressure that blood vessels in the hernia are constricted and therefore the blood supply is cut off. If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency as the tissue needs oxygen, which is transported by the blood supply.
Different types of abdominal wall hernias include the following:
Inguinal (groin) hernia: Making up 75% of all abdominal wall hernias and occurring up to 25 times more often in men than women, these hernias are divided into two different types, direct and indirect. Both occur in the groin area where the skin of the thigh joins the torso (the inguinal crease), but they have slightly different origins. Both of these types of hernias can similarly appear as a bulge in the inguinal area. Distinguishing between the direct and indirect hernia, however, is important as a clinical diagnosis.ADVERTISEMENTADVERTISEMENT
Indirect inguinal hernia: An indirect hernia follows the pathway that the testicles made during fetal development, descending from the abdomen into the sc***um. This pathway normally closes before birth but may remain a possible site for a hernia in later life. Sometimes the hernia sac may protrude into the sc***um. An indirect inguinal hernia may occur at any age.
Direct inguinal hernia: The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the sc***um and can cause pain that is difficult to distinguish from testicle pain. Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because their abdominal walls weaken as they age.
Femoral hernia: The femoral canal is the path through which the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) to protrude into the canal. A femoral hernia causes a bulge just below the inguinal crease in roughly the mid-thigh area. Usually occurring in women, femoral hernias are particularly at risk of becoming irreducible (not able to be pushed back into place) and strangulated. Not all hernias that are irreducible are strangulated (have their blood supply cut off), but all hernias that are irreducible need to be evaluated by a health-care professional.
Umbilical hernia: These common hernias (10%-30%) are often noted at birth as a protrusion at the belly button (the umbilicus). This is caused when an opening in the abdominal wall, which normally closes before birth, doesn't close completely. If small (less than half an inch), this type of hernia usually closes gradually by age 2. Larger hernias and those that do not close by themselves usually require surgery between 2 to 4 years of age. Even if the area is closed at birth, umbilical hernias can appear later in life because this spot may remain a weaker place in the abdominal wall. Umbilical hernias can appear later in life or in women who are pregnant or who have given birth (due to the added stress on the area). They usually do not cause abdominal pain.
Incisional hernia: Abdominal surgery causes a flaw in the abdominal wall. This flaw can create an area of weakness through which a hernia may develop. This occurs after 2%-10% of all abdominal

Tuberculosis Treatment & Management
|
Updated: Oct 25, 2016
Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD
SECTIONS
Approach Considerations
Isolate patients with possible tuberculosis (TB) infection in a private room with negative pressure (air exhausted to outside or through a high-efficiency particulate air filter). Medical staff must wear high-efficiency disposable masks sufficient to filter the tubercle bacillus. Continue isolation until sputum smears are negative for 3 consecutive determinations (usually after approximately 2-4 wk of treatment). Unfortunately, these measures are neither possible nor practical in countries where TB is a public health problem.
Drug therapy
For initial empiric treatment of TB, start patients on a 4-drug regimen: isoniazid, rifampin, pyrazinamide, and either ethambutol or streptomycin. Once the TB isolate is known to be fully susceptible, ethambutol (or streptomycin, if it is used as a fourth drug) can be discontinued. []
Patients with TB who are receiving pyrazinamide should undergo baseline and periodic serum uric acid assessments, and patients with TB who are receiving long-term ethambutol therapy should undergo baseline and periodic visual acuity and red-green color perception testing. The latter can be performed with a standard test, such as the Ishihara test for color blindness.
After 2 months of therapy (for a fully susceptible isolate), pyrazinamide can be stopped. Isoniazid plus rifampin are continued as daily or intermittent therapy for 4 more months. If isolated isoniazid resistance is documented, discontinue isoniazid and continue treatment with rifampin, pyrazinamide, and ethambutol for the entire 6 months. Therapy must be extended if the patient has cavitary disease and remains culture-positive after 2 months of treatment.
Directly observed therapy (DOT) is recommended for all patients. With DOT, patients on the above regimens can be switched to 2- to 3-times per week dosing after an initial 2 weeks of daily dosing. Patients on twice-weekly dosing must not miss any doses. Prescribe daily therapy for patients on self-administered medication.
Monitoring
Patients diagnosed with active TB should undergo sputum analysis for Mycobacterium tuberculosis weekly until sputum conversion is documented. Monitoring for toxicity includes baseline and periodic liver enzymes, complete blood cell (CBC) count, and serum creatinine.
Seizures from isoniazid overdose
A special regimen exists for patients with TB who are actively seizing or who have overdosed on antimycobacterial medication. In these patients, overdose with isoniazid should be suspected. The administration of diazepam can be attempted to control seizure activity, but IV pyridoxine is the drug of choice, in a gram-for-isoniazid-ingested-gram dose. If the ingested dose is unknown, 5 g of pyridoxine can be used empirically. For patients who are awake and alert, an oral dose of activated charcoal (1 g/kg) with sorbitol can be administered.
Next: Treatment During

Hepatitis B facts
The hepatitis B virus is a DNA virus belonging to the Hepadnaviridae family of viruses. Hepatitis B virus is not related to the hepatitis A virus or the hepatitis C virus.
Some people with hepatitis B never clear the virus and are chronically infected. Approximately 2 billion individuals in the world have evidence of past or present hepatitis B, and 2.2 million people in the U.S. are chronically infected with hepatitis B. Many of these people appear healthy but can spread the virus to others.
Hepatitis B infection is transmitted through sexual contact, contact with contaminated blood (for example, through shared needles used for illicit, intravenous drugs), and from mother to child. Hepatitis B is not spread through food, water, or casual contact.
Serologic (blood) markers specifically for hepatitis B virus are used to diagnose hepatitis B viral infection. The blood tests can also identify the stage of the infection (past or present) and people who are at highest risk for complications.
Injury to the liver by hepatitis B virus is caused by the body's immune response as the body attempts to eliminate the virus.
In the United States, 95% of adults who get hepatitis B are able to clear the virus and cure themselves of infection. The remaining 5% of adults with acute hepatitis B go on to develop chronic hepatitis B. Those who acquire the infection in childhood are much more likely to have chronic infection. Chronic hepatitis B may lead to cirrhosis or liver failure. Approximately 15% to 25% of people with chronic infection will die prematurely as a result of the infection.
Progression of chronic hepatitis B viral infection occurs insidiously (subtly and gradually), usually over several decades. The course is determined primarily by the age at which the hepatitis B viral infection is acquired and the interaction between the virus and the body's immune system.
Treatment with current antiviral drugs suppresses viral reproduction in about 40% to 90% of patients with chronic hepatitis B. The medications are also effective in reducing inflammation and improving blood tests. This can delay or reduce complications such as cirrhosis. However, only about 50% of people achieve a sustained viral suppression, and relapse is common. The medications do not cure the infection.
Liver transplantation should be considered for patients with impending liver failure due to acute (initial) infection or advanced cirrhosis.
Hepatitis B is preventable through vaccination. All children should receive the vaccine. In addition, adults at high risk for hepatitis B should be vaccinated. Unvaccinated people who are exposed to hepatitis B should be evaluated by a physician to determine if they need specific immune globulin (HBIG).