Dr. P. N. Renjen MBBS, DM, FIMSA, FIAMS, FACA, FIAN, MNAMS Address: Mathura Road, Indraprastha Apollo Hospitals, Delhi Phone: 011 2692 5858 Dr. Rajesh

------- Communication Board------- Do you have a student struggling with communication? Want to get them ready for an advanced VOD? Or maybe just incorporate a great low-tech communication system? THIS IS IT! No-Prep for you (just print and start using), thoughtful layout (so much easier for your kiddo), and lots of words (most frequent words you need daily). Don’t pass this gem up, get yours today!! This Communication Board can be used in the classroom as an instructional tool to assist students who struggle to communicate. And with nearly 100 picture-word icons, it is great as a low-tech communication board to express thoughts, wants and needs. Built with sentence semantics and the PECS® model in mind, this communication board can be used in several ways to improve communication in the LIFE Skills classroom with students with low-incidence disabilities. Great for students with Autism! This activity will allow you to work with students on: --> Building Pre-VOD Skills --> Working on Sentence Semantics --> Improving Vocabulary --> Communicating Better Allow student multiple opportunities to work with this Communication Board by having it available in all classroom settings- Even provide a home copy so parents can help too… the ability for a nonverbal student to communicate is priceless. www.NoodleNook.Net is a resource for tips, tricks, and activities you can use for students with significant disabilities. Freebies are listed often- so subscribe today and keep up to date with new posts.Follow NoodleNook on Teachers Pay Teachers to see when new materials are added that will let you work smarter not harder in your classroom. Check out more activities like this in the NoodleNook TPT Store: Multi-Level Money Math, Token Economy- Visual Behavior Modification, and Social Stories Bundle with Three Great Books This resource was created by Ayodele Jones © 2017. All rights reserved by author. The materials in this unit were distributed and intended for single use only. The purchaser may reproduce copies for students in your classroom for classroom use only. You may not share with other teachers in your building, district, or otherwise. Redistributing, editing, selling, or posting this item (or any part thereof) on the internet is strictly prohibited. Violations are subject to penalties of the Digital Millennium Copyright Act. Additional licenses can be purchased for multi-use at a discount. Please contact the author at [email protected]. Earn your TPT credits by rating and commenting on your purchase today!

The president's moonshot project to understand the human brain is getting a boost by partnering with companies like Google and foundations for neurological disorders, the White House announced today (Sept. 30).

Educational resource on the science of neuroplasticity and wellness practices adapted from a published White Paper from the Mental Wellness Initiative of the Global Wellness Institute.

Uncover the significance of the finger tapping test in evaluating motor control efficiency. Gain insights into this essential assessment technique.

I. History II. Mental Status Mini-Mental Status Exam (MMSE) - commonly used assessment tool to quantify a person's cognitive ability. It assesses orientation, registration, attention and calculation and language. Scoring is from 0 to 30, with 30 indicating intact cognition. III. Emotional Status Normal findings: affect matches speech IV. Cranial Nerve Function CRANIAL NERVE FUNCTION CN I. Olfactory Nerve can identify variety of smells deviation: inability to identify aroma CN II. Optic Nerve has visual acuity and full visual fields fundoscopic exam reveals no pathology deviation: inability to identify full visual fields - total or partial blindness of one or both eyes CN III (Oculomotor), CN IV (Trochlear), CN VI (Abducens) follows up to six cardinal positions of gaze pupils are unremarkable exhibits no nystagmus and no ptosis deviation: one or both eyes will deviate from its normal position CN V. Trigeminal Nerve clenches teeth with firm bilateral pressure has no lateral jaw deviation with mouth open feels a cotton wisp touched to forehead, cheek and chin differentiates sharp and dull sensations on the face Corneal Reflex: blinks when cotton is touched to each cornea deviation: absent or one-sided blinking of eyelids CN VII. Facial Nerve has facial symmetry with an without a smile can raise the eyebrows symmetrically and grimace can shut eyes tightly can identify sweet, sour, salt or bitter on the anterior tongue deviation: irregular and unequal facial movements deviation: inability to taste or identify taste deviation: inability to taste or identify salt, sweet, sour or bitter substances on the anterior two-thirds of the tongue deviation: inability to smile symmetrically CN VIII. Acoustic Nerve can hear a whisper at 1-2 feet can hear a watch tick at 1-2 feet does not lateralize the Weber test can hear AC (air conduction) better than BC (bone conduction) in the Rinne's Test deviation: inability to hear a spoken word CN IX (Glossopharyngeal), CN X (Vagus) swallows and speaks without hoarseness palate and uvula rise symmetrically when patient says "ah" bilateral gag reflex can identify taste on the posterior tongue deviation: unequal or absent rise of uvula and soft palate as client says "ah" deviation: absent gag reflex deviation: inability to taste or identify taste on the posterior tongue CN XI. Spinal Accessory Nerve resists head turning can shrug against resistance deviation: weak or absent shoulder and neck movement CN XII. Hypoglossal Nerve can stick tongue out and move it from side to side can push tongue strongly against resistance deviation: tongue deviates to side PhotoCredit: dejana.nl V. Level of Consciousness (LOC): Normal Findings alert responds appropriately to visual, auditory, tactile and painful stimuli able to carry out simple commands Glasgow Coma Scale alterations in LOC ALTERATIONS IN LEVEL OF CONSCIOUSNESS Alert Awake and aware of person, place, time and situation Responds appropriately and to verbal stimuli Lethargic Sleeps but easily aroused Speaks and responds slowly and appropriately Obtunded Difficult to arouse Returns to sleep quickly; may respond inappropriately Stuporous Aroused only through pain No verbal response Semicomatose Responds only through pain Gag and blink reflexes intact Comatose No response to pain No reflexes or muscle tone Note: Dying clients will proceed through these levels in this above-listed sequence. VI. Sensory Function: Normal findings Visual - recognize objects Auditory - identifies sounds Tactile - identifies objects though blind touch; perceives pain, hot and cold and vibration; two-point discrimination Olfactory - identifies familiar smells ASSESSMENT OF SENSORY NERVE FUNCTION (Done with Client's Eyes Closed) Superficial Pain Prick with sterile needle Have client identify whether sharp or dull Temperature Two test tubes - one filled with hot water, the other with cold water Client identifies hot versus cold sensation and where it is felt Light Touch Cotton ball; apply light wisp of cotton to different surface points Client identifies when touched Vibration Low pitched tuning fork Apply to distal interphalangeal joint of finger then toe Client identifies when vibration stops Position Grasp client's finger or great toe, holding by its sides Client identifies if moving up or down Two-Point Discrimination Two safety pins Apply lightly and simultaneously to two different places on skin's surface Usually start with finger pads Find minimal distance at which client can discriminate one from two points, normally <5mm on finger pads Client identifies when can discriminate one from two points Stereognosis Use coin or paper clip or any familiar object with client's eyes closed Client identifies object to identify by touch and manipulation Graphesthesia (Number Identification) Number is traced on the client's palm by a blunt object Client identifies number Extinction Corresponding areas on both sides of body are simultaneously stimulated Client identifies where touched VII. Cerebellar Function: Position and Balance CEREBELLAR FUNCTION Romberg Test - tests position sense, note client's ability to stand upright when standing with feet together and eyes closed for 20-30 seconds Hop in Place - maintains balance while hopping on one foot Knee Bends - maintains balance while bending at knees Tandem Walking - walks heel to toe in straight line Rapid Skills pronates and supinates hands rapidly with equal timing and purposeful movements touches alternate finger to nose rhythmically with eyes open and closed moves fingers alternately from nose to examiner's finger in coordinated fashion runs contralateral heel down shin with bilateral coordination One Foot Balance maintains balance on one foot for at least five seconds bilateral response with eyes open and closed VIII. Speech and Language: Normal Findings Smooth flowing speech Able to formulate words without difficulty Varied inflection Able to write letters and numbers to dictation Vocabulary appropriate to educational level IX. Intellectual: Normal Findings Memory - immediate recall and remote recall Oriented to person, place and time Able to abstract Demonstrates consistent insight and perception of self X. Reflexes: Assessmend and Grading TESTS FOR REFLEXES I. Deep tendon reflexes with selected site stimulus Biceps reflex (C5, C6) - flexion of arm at elbow Triceps reflex (C6, C7) - extension of arm at elbow and contraction of triceps muscles Brachioradialis (supinator) reflex (C5, C6) - flexion at elbow and pronation of forearm Quadriceps (knee-jerk or patellar) reflex (L2, L3, L4) - extension of leg at knee and contraction of quadriceps Achilles (ankle-jerk) reflex (S1, S2) II. Superficial reflexes Pharyngeal reflex (CN IX, CN X) Upper abdominal reflex (T8, T9, T10) - upward movement of umbilicus toward stimulus above umbilicus Lower abdominal reflex (T10, T11, T12) - downward movement of umbilicus toward stimulus below umbilicus Cremasteric reflex (T12, L1) - elevation of ipsilateral testicle (the side stimulated) Gluteal reflex (L4-S3) - contraction of anal sphincter with gloved finger insertion III. Pathologic reflexes in adults - documented as "positive for ___" Babinski reflex (plantar) (L4-S2) - stroking lateral sole of foot causes dorsiflexion of great toe with fanning of other toes (normal expectation in children up to age 18 months on the average) Chaddock reflex (L4-S2) - stroking below lateral malleolus causes dorsiflexion of great toe with fanning of other toes Ankle clonus - brisk dorsiflexion of foot with knee flexed causes up and down movement of foot; found in severe preeclampsia Oppenheim - stroking tibial surface causes great toe fans out Gordon - squeezing calf muscle; great toe fans out Hoffman - flicking middle finger down; flexion of the tumb IV. Common Expected Reflexes: normal for all ages Gag Corneal REFLEX GRADING 0 - No response 1+ - Sluggish or diminished response 2+ - Normal 3+ - Brisker than normal 4+ - Hyperactive and very brisk (may be associated with spinal cord disorder) XI. Geriatric Alterations in Neuro Status Longer response time to sensory stimulation May resist new ideas or change Thought patterns may become more concrete Kinesthesia diminishes - the ability to perceive extent, direction or weight of movement Superficial and deep reflexes may be diminished or absent POINTS TO REMEMBER: Glasgow Coma Score not valid in patients who have used alcohol or other mind-altering drugs possibly not valid in patients who are hypoglycemic, in shock, or hypothermic (below 34 degrees Celsius) Reflexes are normally less brisk or even absent in older clients Reflex response diminishes in the lower extremities before the upper extremities are affected Absent reflexes may indicate neuropathy or lower motor neuron disorder Hyperactive reflexes suggest an upper neuron disorder

Nerve impulses have a domino effect. Each neuron receives an impulse and must pass it on to the next neuron and make sure the correct impulse continues on its p

Born from personal experiences, this eBook provides an in-depth look at ADHD, illuminating the neurological background, sharing authentic stories, and offering practical advice to help families and friends effectively support their loved ones with ADHD. Understanding Adult ADHD: What It Is and Basic Facts. The neurology behind ADHD: brain differences and the role of neurotransmitters. The ADHD experience: everyday struggles, strengths and personal stories. The Importance of Understanding: Emotional Impact and the Path to Acceptance. Communication is Key: Tips and Techniques for Effective Communication. Positive reinforcement and motivation: How to encourage and motivate without overwhelming. Setting boundaries and creating structure for your loved one with ADHD: Importance of routine and clear boundaries. Role of family, friends and support groups. Final Thoughts: The ongoing journey with ADHD and final words of encouragement. By purchasing this e-book, YOU are not only supporting the path to better understanding and support for people with ADHD, but you are also actively contributing to the mission of Fantastic Brains. Together we can make a difference and increase awareness and support for those affected by ADHD. Thank you for being part of this movement!

Explore this comprehensive guide on Rashes in Children. Explore the various differential diagnosis, how to approach them and causes, treatment and tips.

Highlights The leader in Microbiome Medicine offers a revelatory guide to the gut-thyroid connection, with cutting-edge information--and a surprising source of thyroid illness If you are one of the 20 million Americans living with thyroid disease or one of the thousands living undiagnosed, Dr. Raphael Kellman understands your suffering. About the Author: Raphael Kellman, MD, graduate of Albert Einstein College of Medicine, is the author of The Microbiome Breakthrough, The Microbiome Diet, and other books on health and healing. 336 Pages Health + Wellness, Diseases Series Name: Microbiome Medicine Library Description About the Book "Dr. Raphael Kellman is one of the pioneers in the field of microbiome medicine. In his previous books, he's helped readers to achieve long term weight loss, emotional and neurological equilibrium, and overall health through careful attention to their microbiome and the gut-brain connection. Now, with Microbiome Thyroid, Dr. Kellman addresses thyroid health, focusing on a previously rarely recognized contributor to thyroid disorders. In Dr. Kellman's extensive practice, he's identified key causes of low thyroid: general hypothyroidism; Hashimoto's thyroiditis; and Non-thyroidal Illness Syndrome (NTIS). It's this last cause, an underdiagnosed and often unrecognized contributor to thyroid disease, which Dr. Kellman explores in Microbiome Thyroid. Most doctors aren't aware of NTIS, even though as many as 20% of people diagnosed with Hashimoto's may suffer from this illness. NTIS can be the result of serious chronic illness or inflammation, and may cause unexplained fatigue, memory issues, problems with focus and decision making, and even dementia. However, Dr. Kellman's clinical expertise has shown that NTIS is a far more common condition than statistics would indicate, and his highly successful protocols have given thousands of patients a path to health. With a proven four week plan that focuses on the four P's of endocrine health: Prebiotic, Probiotic, Parabiotic, and Purpose. Microbiome Thyroid helps you take control of your environment, your diet, and your life, guiding you toward the right diagnosis, the right treatment, and overall hormone balance"-- Book Synopsis The leader in Microbiome Medicine offers a revelatory guide to the gut-thyroid connection, with cutting-edge information--and a surprising source of thyroid illness If you are one of the 20 million Americans living with thyroid disease or one of the thousands living undiagnosed, Dr. Raphael Kellman understands your suffering. Between inaccurate diagnosis, a wide spectrum of symptoms, and doctors who may not be familiar with the intricacies of thyroid dysfunction, it's hard to get the treatment you need. While general hypothyroidism and Hashimoto's thyroiditis are the most commonly known thyroid issues, there is an underdiagnosed and yet incredibly prevalent condition: Non-thyroidal Illness Syndrome (NTIS). It can cause unexplained fatigue, memory issues, problems with focus and decision making, and even dementia, and affects as many as 20% of Hashimoto's sufferers. Luckily, Dr. Kellman has a clinically proven, expert protocol that has given thousands of patients a path to health--and now he's delivering it to you. You'll discover: How your thyroid function affects your overall health--and how its dysfunction can explain your troubling symptoms The 4P Protocol for healing the microbiome How everyday household products, cosmetics, plastics, and medicines can disrupt your hormonal systems--and how to detox A 30-Day Thyroid Rescue program, including meal plans and lifestyle changes Microbiome Thyroid helps you take control of your environment, your diet, and your life, guiding you toward the right diagnosis, the right treatment, and overall hormone balance. Review Quotes Praise for Raphael Kellman"After decades of treating patients for depression, gastrointestinal problems, low thyroid, and a multitude of other 'mysterious' ailments, pioneer in holistic and functional medicine Dr. Raphael Kellman has connected the dots between the brain, the gut, the microbiome, and the thyroid. Microbiome Breakthrough offers his groundbreaking plan to diminish anxiety and depression-and to give you more energy and vitality."--Izabella Wentz, PharmD, FASCP, #1 New York Times bestselling author of Hashimoto's Protocol "Dr. Kellman has long been on the cutting-edge of health and science. Now, he introduces his groundbreaking concept of Microbiome Breakthrough: If you want to improve brain function--if you want your mind to be focused, your memory to be sharp, and your mood to be hopeful--start with a healthier microbiome, heal your gut, and balance your thyroid. This book will show you how."--Dr. Terry Wahls, author of The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions "Dr. Kellman is a rare kind of doctor. An innovative functional medicine physician? Indeed, he is that--but he helps his patients heal with the spiritual wisdom of a Rabbi. His latest book, Microbiome Breakthrough, connects the dots between your gut, microbiome, thyroid, and brain. Not only does it present actionable lifestyle remedies to help you heal physically and mentally it also offers a deeply spiritual understanding of the will to heal."--Dave Asprey, Founder and CEO of Bulletproof "In Microbiome Breakthrough, Dr. Raphael Kellman shares his groundbreaking research, showing the intimate connections between the gut, microbiome, thyroid, and brain, and then offers a proven, holistic plan that doesn't rely on prescription medication."--Mark Hyman, MD, Director of Cleveland Clinic's Center for Functional Medicine, the Founder of The UltraWellness Center, ten-time #1 New York Times bestselling author About the Author Raphael Kellman, MD, graduate of Albert Einstein College of Medicine, is the author of The Microbiome Breakthrough, The Microbiome Diet, and other books on health and healing. Dr. Kellman manages a thriving medical practice and lectures all over the world. He lives with his wife and two young daughters in New York City.

A new study finds it's possible to teach the brain to better distinguish between speech and background noise

nerve pathways | hip ligaments frontal view | hip ligaments rear view

For a dementia to be considered to be Alzheimer’s, it must meet specific criteria Memory impairment 1 or more of: Aphasia: language disturbance Apraxia: inability to carry out motor activitie…

Formally known as sensory integration dysfunction, sensory processing disorder (SPD) is a neurological condition in which the brain has difficulty receiving and responding to sensory information (e.g., smell, touch, taste, etc.) that an individual perceives, thus, resulting in atypical responses. Individuals with SPD can be hypersensitive (over responsive) and or hyposensitive (under responsive) to things in their environment. For example, some sounds may be painful or overwhelming to a child, b

In this treatise, current knowledge on the neurogenesis, axonal outgrowth, synaptogenesis, and regenerative capacity of descending supraspinal pathways in tetrapods is discussed. Although emphasis is on the clawed toad, Xenopus laevis, chicken embryos, opossum and rodent data, also the data available for primates including man are presented. It will be…

What is Bell’s Palsy?Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed.The condition causes one side of your face to droop or become stiff. You may have difficulty smiling or closing your eye on the affected side. In most cases, Bell’s palsy is temporary and symptoms usually go away after a few weeks.Although Bell’s palsy can occur at any age

xploring their significance in preventive care, early detection of health issues, and personalized recommendations for optimal well-being

A groundbreaking approach to healing from trauma and experiencing posttraumatic growth from a leading psychologist, featuring a powerful, five-stage framework to help readers not just recover, but thrive and transform. Trauma has always been part of the human experience, and traumatic events--both physical and emotional--can shake our very foundation and leave us forever changed. While we know more about the lasting neurological and physical effects of trauma than we did a decade ago, few people realize that experiencing trauma doesn't have to sentence you to a lifetime of suffering and grief.In this first book of its kind, renowned clinical psychologist Dr. Edith Shiro shares a powerful, five-stage framework for posttraumatic growth, a transformational process that helps you not just heal, but achieve growth and expand consciousness in the face of trauma. Inspired by her grandparents, who were refugees and Holocaust survivors, Dr. Shiro has dedicated her life to individuals, families, and communities facing trauma and its aftereffects. Developed over more than twenty-five years of research and practice, Dr. Shiro's stages--Awareness, Awakening, Becoming, Being, and Transforming-- provide a universal language and outline how trauma can be a catalyst for transformative growth.Grounded in science and psychology, and filled with practical tools and takeaways, The Unexpected Gift of Trauma offers a bold a new definition of trauma, touching on individual as well as collective and intergenerational trauma. Dr. Shiro brings the power of posttraumatic growth to the forefront and reveals a groundbreaking new way to think about and heal from traumatic experiences.

Classical aphasia scheme via Blumenfeld (2011)

While there are plenty to choose from the best AI stocks hold next-generation potential. AI is a rapidly evolving industry with plenty of wiggle room for co ...

Neuroscience for kids.

GI Pathology: Jaundice Jaundice is yellowing of the skin, mucous membranes, and sclera due to excess bilirubin; itching is also common. Bilirubin is a pigment in the bile; it is a by-product of heme degradation. Be aware that excess carotene can also cause skin to take on a yellow or orange color, but the sclera is spared. Causes: Accumulation of bilirubin can be due to increased production of the pigment or by impaired excretion – this framework helps us to categories various pathologies that cause jaundice. Normal bilirubin values are approximately 1 mg/dL; jaundice is usually present when levels are 2.5 mg/dL and higher. Be aware that as bilirubin accumulates, jaundice can progress from a yellowish to greenish color.Jaundice is most common in newborns and the elderly due to impaired conjugation in the liver and/or excretion. Diagnosis: Jaundice is a sign of an underlying disorder, so we need to investigate its causes to find the appropriate treatment. We use liver function tests and, when biliary obstruction is suspected, right upper quadrant ultrasound to discover and treat the origins of jaundice. Jaundice Pathophysiology: Prehepatic events, Hepatic events, and Post-Hepatic events We review the physiology of bilirubin production and excretion, which will help us understand the etiologies of various pathologies. Pre-hepatic phase: Heme is converted to unconjugated bilirubin in the reticuloendothelial cells, primarily in the spleen (also in the bone marrow and liver). Recall that heme is released from senescent red blood cells in hemolysis. Pre-hepatic jaundice is caused by increased hemolysis, which raises unconjugated bilirubin levels. - This is sometimes called "indirect hyperbilirubinemia." - This can help us remember the relationship between hemolytic anemia, in which hemolysis is increased, and jaundice. Hepatic phase: Unconjugated bilirubin travels from the reticuloendothelial cells to the liver, where it is taken up by hepatocytes and conjugated. Liver disorders that interfere with bilirubin conjugation or its excretion from the liver cause "hepatic jaundice," sometimes called "mixed hyperbilirubinemia," in which both unconjugated and conjugated bilirubin are elevated.Post-hepatic phase: Transfer of conjugated bilirubin in the bile through the biliary system; recall that the gallbladder stores most of the bile until cues from the digestive tract trigger its release to the intestines to help break down food. Conjugated bilirubin travels through the common bile duct and sphincter of Oddi to the intestines. Bacterial enzymes in the intestine reduce the conjugated bilirubin, which produces urobilinogens. Most of the urobilinogen is excreted in the feces as stercobilin, which gives the feces its brown color.A small portion is excreted in the urine as urobilin.The rest is "recycled" in the enterohepatic circulation.Post-hepatic jaundice is primarily caused by blockage in the biliary system, which prevents bile excretion and therefore increases conjugated bilirubin in the blood. This is sometimes referred to as "direct hyperbilirubinemia." Jaundice Etiologies Keep in mind the mnemonic HOT Liver – Hemolysis, Obstruction, Tumors, and Liver diseases.* #Indirect Hyperbilirubinemia:Characterized by elevated levels of unconjugated bilirubin.Unconjugated bilirubin does not appear in the urine; this is because it is not water soluble. We divide cause of causes of indirect hyperbilirubinemia into two broad categories.Situations that produce excess bilirubin in the pre-hepatic phase: Increased hemolysis, which includes disorders like Sickle cell anemia and G6PD deficiency; increased hemolysis is a top cause of jaundice.Inefficient erythropoiesis, as in thalassemia and pernicious anemia.Increased bilirubin production, as we see in massive blood transfusions and hematoma resorption.Intrahepatic situations that impair bilirubin conjugation and uptake:Medications, such as protease inhibitors and Rifampin can reduce hepatic bilirubin uptake.Two autosomal recessive disorders characterized by deficiencies of UDP-glucuronosyltransferase, which is a liver enzyme necessary for bilirubin conjugation and uptake: Gilbert syndrome, in which symptoms are generally mild and intermittent.Crigler-Najjar syndrome, which can be mild or severe, depending on the type. Be aware that Type 1 Crigler-Najjar syndrome is defined by a total lack of UDP- glucuronosyltransferase and, as a result, dangerously high levels of unconjugated bilirubin that can lead to brain damage (this is called kernicterus). #Direct hyperbilirubinemia:Characterized by elevated levels of conjugated bilirubin.Excess conjugated bilirubin is water soluble and can be excreted in the urine, so these disorders are characterized by urine darkened by bilirubin. Two autosomal recessive disorders characterized by impaired hepatic excretion and/or storage of conjugated bilirubin (by definition, these are intrahepatic causes of jaundice): Dubin-Johnson syndrome, which is often asymptomatic, is caused by defects in bilirubin secretion. Rotor syndrome, which is generally benign and self-limiting, is caused by defects in bile storage that allows bilirubin to leak into the plasma. Be aware that Rotor syndrome may present with elevated levels of both unconjugated and conjugated bilirubin. Cholestasis can have post- and intra-hepatic causes. Cholestasis is the partial or complete blockage of bile flow ("chole" refers to bile, "stasis" refers to inactivity). Cholestasis is another top cause of jaundice.Recall that stercobilin is the form of bilirubin excreted in the feces, and gives the feces its brown color. In cholestasis, the bilirubin is blocked from reaching the intestines and from mixing with the feces, so patients have pale, chalky-colored feces. Post-hepatic causes of cholestasis: - Gallstone obstruction in the gallbladder or bile duct (note that cholelithiasis is when the gallstones are trapped in the gallbladder, choledocholithiasis is when gallstones are trapped in the common bile duct). - Biliary system inflammation, atresia, or strictures that narrow the ductal system. - Ductal compression caused by tumors in the bile system or pancreas, or due to pancreatitis Intrahepatic causes of cholestasis: - Cholestatic liver disease (including primary biliary cholangitis and primary sclerosing cholangitis). - Infiltrative liver diseases (such as amyloidosis, lymphoma, sarcoidosis, and tuberculosis) - Sepsis - Pregnancy - Total parenteral nutrition - Infectious diseases, including malaria.#Mixed hyperbilirubinemia:Characterized by increased levels of both unconjugated and conjugated bilirubin. Patients will have abnormal liver functioning tests indicative of liver damage.Hepatocellular injury is a top cause of jaundice. Important causes of liver damage leading to jaundice: - Hepatitis, including viral, alcoholic, and autoimmune hepatitis, and nonalcoholic steatohepatitis. - Other viral infections, such as Yellow fever ("yellow" because of the jaundice), EBV, CMV, and HSV; - Other disorders, including cirrhosis and Wilson's disease, and, - Drugs and toxins, including estrogen, acetaminophen, and arsenic. #Newborn hyperbilirubinemia:Very common and generally benign. Newborn jaundice is most often due to the newborn's immature hepatic conjugation process; the jaundice lasts only a couple of weeks and resolves as the infant develops the ability to process and excrete bilirubin. "Breast milk jaundice"* is another form of benign newborn jaundice; the mechanisms are uncertain, but this form of jaundice lasts 3-12 weeks and resolves on its own.In contrast, "breastfeeding jaundice" (aka, breastfeeding failure jaundice) occurs when the infant takes in too little breastmilk to produce sufficient stool and bilirubin excretion is impaired. We need to rule out congenital and hemolytic disorders, such as G6PD deficiency. We need to monitor and treat bilirubin excess promptly because newborns are particularly susceptible to kernicterus, brain damage caused by bilirubin deposits.

Biogen is taking a political risk with aggressive multiple sclerosis drug pricing, but the company is under pressure to boost its share price

The presence of non-discogenic lumbar plexus neuralgia, also known as lumbar plexus compression syndrome (LPCS) is a virtually unknown and thus relatively unmentioned cause of thoracolumbar, lumbopelvic, and femoral pain. It is sometimes also referred to as Maigne’s syndrome, posterior rami syndrome and thoracolumbar junction syndrome. To some degree, this may also be true for similar [...]

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