Foulks generic zenegra 100 mg mastercard erectile dysfunction treatment centers, ea (1977) generic 100 mg zenegra impotence due to alcohol, and Keshaven purchase zenegra 100 mg amex impotence lack of sleep, ea (1989) are useful sources on anthropological psychiatry. Psychopathology per se causes considerable personal and socio-economic disability across cultures. Psychoanalysts, such as Jung, drew extensively on cultural myths in their thinking and writings about the evolution and behaviour of men. On the other hand, to say that someone is from a particular country, although subject to stereotyping, tells us very little about him. Comparisons between cultures of the epidemiology and manifestations of various psychosocial variables and disorders are of help in increasing out understanding of such dysfunctions as long as both the cross-sectional and longitudinal diagnoses are fundamentally 483 similar. Witness the claim for a better outlook, in the sense of a low relapse rate, for schizophrenia in developing countries, and the dispute as to whether some cases diagnosed as schizophrenia should in fact be diagnosed as brief reactive or acute and transient psychoses. Other ‘explanations’ include memory, hedonism, peer pressure, emotional immaturity, etc. There is no conditioned stimulus in operant conditioning: no stimulus is presented before an operant response that led to the behaviour. Similarly, members of the same culture usually describe perceived stimuli with the same words. Cultural beliefs such as possession by ghosts should not automatically lead to a diagnosis of psychiatric disorder. The meaning of the experience for the patient and the community should be ascertained from the family, using a local interpreter if required. Lack of independent social activity within a mental hospital is largely a result of a complex interaction of the social atmosphere and the incapacity of illness. The poorer, less educated sectors of society in developed countries, and a much larger part of Third World populations, tend to shun psychological explanations and presentations of their distress and to express it in somatic terms, as if ‘a weight on my shoulders’ became ‘a pain in my neck’! Various cultures believe in non-medical causes of mental illness, such as witches, spells, sorcery, breaches of taboo, soul loss, and possession by demons. Quite often such healers are noted for some personal characteristic, such as disfigurement, great age, or scholarship. The depth of belief in the efficacy of such interventions is illustrated by the fact that a sick shaman will seek the help of a fellow shaman. Some cultures shun doctors in favour of local healers while others may utilise both. It is not unusual for a patient to seek help from a doctor, a priest, and a faith healer simultaneously or at different stages of his illness. The concept of Original Sin holds that we are prone to sickness because of the sin of our First Parents. It is increasingly important that we try to understand and get on with faith healers, as long as the health of our clients is not harmed thereby. When making a diagnosis in someone from another culture certain confounding variables should be borne in mind. According to Bhugra and Ayonrinde,(2004) susceptibility to mental disorder among migrants can be divided into vulnerability (biology, psychology, social skills deficits, forced migration, persecution, negative life events, bereavement, culture shock, cultural conflicts, and discrepancy between what is achieved and what it was hoped would be achieved) and protective (psychology [e. Family dysfunction and migration have been reported to interact in the histories of children and adolescents with psychosis. It is to be expected that many refugees would show suspicion, excess vigilance, anxiety, and fearfulness. Religious faith, political beliefs and being psychologically prepared are protective. Longterm follow-up of Vietnamese refugees in Norway (Vaage ea, 2010) suggests that self- reported psychological distress may decline significantly over time but that a substantial number still have symptoms after almost a quarter of century of resettlement. Koucharang, a culture-bound syndrome found in Cambodian refugees, is defined as excessive thinking following exposure to traumatic events. Bebatchel is a depressive state found among the same people under similar circumstances. Children absorb a new culture quicker than do their parents, a fact that may lead to their being required to handle social problems for their elders. Problems associated refugee status Problems in old country: Threat to lives/security of self/loved ones Loss of relatives, friends, community, property, occupation, physical health Trauma including torture, rape, head injury (perhaps with epilepsy) Forced dislocation, concentration camp experiences Precipitation/exacerbation of mental disorder Problems in new country: 485 Detention 486 487 Insecure residency , adaptational problems, racial discrimination, poverty, poor housing, unemployed , barriers to accessing services, family disruption/violence Precipitation/exacerbation of mental disorder: anxiety, depression, grief, dissociation, somatisation, impulsivity, substance abuse 488 Cultural transference/countertransference Abbreviated version of ‘The Mental Health Service Requirements for Asylum Seekers and Refugees 489 in Ireland’ of the the College of Psychiatry of Ireland, March 2009 The asylum process needs to be rigorous in order to be fair to legitimate asylum seekers. Their skills and qualifications may atrophy, because they are barred from employing them. As self-esteem declines they can become less assertive in seeking basic human rights and necessary medical health care. A Dutch report found that if the asylum process was extended beyond two years there was a doubling of psychiatric illness. Insecure residency and associated fears of repatriation contribute to persistence of psychiatric symptoms and associated disabilities. The policy of dispersing asylum seekers around Ireland to avoid ghetto formation and to hasten integration into the wider community may unwittingly lead to the social isolation of asylum seekers. Immigrant refugees may be kept in such miserable conditions in the host country (Anonymous, 2010) that it would be surprising if they went unscathed. They may be forced to live in accommodation with asylum seekers of other nationalities with whom they share little in common. Such geographical spread impedes development of expertise in the treatment of asylum seekers. The Irish Times (May 5, 2008) reported that there were 6,844 asylum seekers living in 62 accommodation centres around Ireland in April 2008. As they await the results of the protracted process of being granted asylum they are caught in a situation of dependency and idleness that can erode self-esteem. This may lead to substance abuse as a consequence of boredom and may aggravate underlying mental health problems that may exist. Current arrangements for asylum seekers in Ireland leave them in a situation of controlled poverty. Because of current financing stringencies they now confine referrals to North-East Dublin. They have noted a tendency among the medical profession to inappropriately diagnose asylum seekers as mentally ill because of a lack of cultural awareness. In a questionnaire prepared by the Irish College of Psychiatry in 2008 (completed by 57 consultant psychiatrists) the great majority of respondents recognised that asylum seekers were a particularly difficult group to treat and most felt they were insufficiently resourced to cater for specific needs in this area. Because of the complexity of such cases a higher level of mental health assessment and care is needed than is the norm. This complexity arises from language barriers, problems with obtaining suitable translators, a lower level of trust among asylum seekers when dealing with authority, time constraints, and cultural barriers to talking about areas such as being victims of torture, intimidation, physical/sexual/emotional abuse. Half of the respondents felt that asylum seekers were over-represented at their community mental health clinics relative to their actual number within their catchment areas. There was a willingness to prepare the necessary medico-legal reports required for the asylum process and to provide the best quality service that they could deliver.

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Start by lifting up the stick in the sagittal plane (flexion- extension of the shoulder joint) and observe for striations in the patient’s back buy cheap zenegra on-line erectile dysfunction which doctor to consult. If striations are noted cheap 100mg zenegra otc erectile dysfunction drugs otc, the side purchase on line zenegra impotence 24-year-old, the spinal level, and the severity of the striation should be noted (usually with a subjective descriptor such as ‘mild’, ‘moderate’ or ‘severe’). Next, try to push the patient into lateral flexion using the stick – this is testing for frontal plane stability. Finally, try to rotate the patient via the stick – thereby assessing transverse plane stability. Combinations of the above motions and sudden changes in force provide a more functional assessment of the patient’s ability to maintain functional stability in the lumbopelvic region. This is a common outcome for those In the example given above, the same exercise has who use weight training without truly understanding been used to induce a different postural effect, while subtleties of the physiological adaptation they are tar- achieving similar performance goals. A more common clinical example may the extension with 2–2-6 tempo means that the patient is chronic back pain patient who needs to retrain their working their gluteus maximus for 10 seconds for multifidus. Since a part of the means by which the each repetition, but for 6 seconds in its inner range lumbar multifidus stabilizes the lumbar spine and and for 4 seconds in its outer range. This exercise is sacrum is through the hydraulic amplifier mechanism useful to correct a patient with a lower crossed pos- (Chek 2002, Lee 2004), this system requires that the tural pattern. The supine hip extension with the 4-4-2 multifidus has good trophic levels – if it is atrophied, tempo works the gluteus maximus for 10 seconds per the mechanism is ineffective. In this case, the multifi- repetition, yet in this instance, the muscle is being dus first needs to be consciously activated through worked for 8 seconds in its outer range and only 2 isolation training, and then integrated into functional seconds in its inner range. At this stage, loads that are designed to hyper- version of the supine hip extension perfect for someone trophy the muscle (in the 8–12 rep maximum range) with a layered or sway muscle imbalance, as it trains must be prescribed for efficient restoration of the gluteus maximus to be strong in a lengthened function. Note: Contraindications to such loading would include pain, any sign of inner unit dysfunction (such as abdominal bloating or striations at the spine), lack Sequencing the client’s rehabilitation of proper conditioning and instructing on technique. Tempo allows the clinician and the patient to perform a series of exercises to fatigue the to know how much time under tension the muscle(s) abdominal wall, multifidus and gluteus medius, is receiving. It can also be used to stress different parts then is asked to squat carrying a heavy load, of the exercise. The may only be worked in the outer range (rather than supine hip extension exercise with the back on a Swiss in the critical inner range where strength needs to be ball is a descent of the squat pattern – so may also be developed). Additionally, a facilitated psoas will used to help pain patients who are unable to complete reciprocally inhibit its antagonist (Korr 1978) – the a full weight-bearing squat with axial loading. The answer is that it is all down to the relationships and optimize axis of rotation of tempo of the movement, and therefore whether the joint) targeted muscle group is being worked in its inner or 2. Exercise order should follow from most its outer range – and for how long – to create neurologically challenging to least adaptation. Swiss ball or balance board) to non-labile surfaces (the floor) • From uncontrolled environment (competitive sports)5 to controlled Figure 9. Corrective exercise program: For further description of these exercises, see Chek • Body-weight squat (taped) (1999b, 2003a). Corrective stretching program: is no antalgic posture and this low-level disc derange- • McKenzie extension push-up ment usually responds well to the McKenzie exten- → Tape the lumbar spine into neutral lordosis sion principle with corrective exercise. For example, many • Front squat exercise physiology texts caution against children lifting any kind of weight until their bones have begun to fuse (usually • Supine hip extension (back on ball) 16 yoa+). However, this defies common sense when one • Horse stance vertical considers that even during simple sprinting the child is • Lower abdominal 1 translating up to seven times their bodyweight through one leg! Compare this with a controlled supervised of (usually) L5 on S1 – but may occur at any level of environment in the gym where even lifting their own the spine. Baechle & Earle (2000) agree that there is no lower age limit when 6Assuming the diagnosis is a McKenzie derangement – one resistance training may commence. Stability of the slippage may depend might be an engram (see above for definition). For on a number of factors, including, but not limited to, example, if an elite tennis player were to be asked to pain, local muscle function and dynamic imaging. If a casual player were asked to perform the same task, their success would be sig- What is a biomechanical attractor? An attractor, used a tennis racket was asked to perform the given as described by O’Connor & McDermott (1997), is a task, the result would be almost zero serves hitting stable, reproducible state. This is because the serve pattern orbiting the sun are in an attractor state with the sun. Complex systems seem to want to revert erately impaired by negating them of their primary to some kind of stable state. In chaos theory, order feedback tool, they are able to perform the technique tends to arise from the chaos, and it is this order that with good reliability. In the preface to their book Signs of Life – How Com- Looking more to how these attractor states may have plexity Pervades Biology, Sole & Goodwin (2000) state relevance to the naturopath, it must be considered that: how, and which, attractor states arose within the New sciences combine biology with physics in a chaos of human behavior. Such attractor states will manner that allows us to see the creative fabric of provide clues as to how the human organism has natural processes as a single dynamic unfolding. To complex dynamics from which emerge characteristic do this requires some idea of the environment in patterns of order. This emergence of order from chaos eloquently Of course, knowing Homo sapiens exact develop- describes exactly what comprises a biomechanical mental environment poses some level of challenge. Goldfield’s (1995) definitions of the features The aquatic ape hypothesis (Attenborough 2002, of an attractor (Box 9. An attractor is a region of state space (the set of all states that may be reached by a system, together habitat. This suggestion offers an explanation for the with the paths for doing so) where trajectories extraordinary leap from tetrapedalism to fully come to rest. An attractor can be a point, cycle or area of state our ancestors spent much of their time wading. Wading, of course, both supports some of the body weight, as well as providing resistance to the axial 3. A physical system can have one or more attractors, and it is the number and layout of these attractors rotation of the body during gait – as described above that influence the system. The configuration of attractors has a critical influence on the behavior of the system. A change in the layout The single biggest physical stressor on the human of attractors leads to new competition between body is gravity. Gravity is relentless, stressing our attractors and results in a shift to different modes. Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 363 What can be known, therefore, is that no matter • Instinctive sleep postures = Protein where in the world our ancestors evolved, gravity • Archetypal rest postures = Fats was exerting itself in exactly the same way with • Primal patterns = Carbohydrate exactly the same magnitude. This is why relatively one exercise pattern, will push the biomechanical narrow reference ranges in goniometric assessment of environment outside its functional physiological human biomechanics can be handed some level of range.

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We report the case of a patient with a syndrome of posterior cid paraplegia complicating spinal stenosis order genuine zenegra on line impotence may be caused from quizlet, especially at L2-L3 interosseous nerve secondary to compression by a paraostéal lipo- level generic zenegra 100mg line erectile dysfunction guilt in an affair. The patient received a decompression surgery by L2-L3-L4 ma purchase zenegra 100mg with amex icd 9 code for erectile dysfunction due to medication, surgical excision with radial neurolysis followed by rehabilita- laminectomy. Neurologically, the patient presents paraparesis with tive care adapted enabled good functional recovery after 6 months. Cu- taneo abdominal refexes are present and musculoskeletal refexes are abolished in the lower limbs. However, at the urinary level, it has conducted to North Staffordshire Rehabilitation Centre, Physical Rehabilitation 2 bladder drainage by intermittent self-catheterization. Conclusion: Medicine, Stoke-on-Trent, United Kingdom; North Staffordshire The main vertebral deformities in achondroplastic patient are the Rehabilitation Centre, Physcial Rehabilitation Medicine, Stoke-on- magnum foramen narrows and spinal stenosis. If symptomatic, pa- Trent, United Kingdom tient will present with neurological signs of myelopathy or equina Introduction/Background: Transient bone barrow oedema is a rare, cauda syndrome, as a function of the compression seat. The aim of this study is to ences of neurological signs indicate a decompression surgery. Material and 315 Methods: This is a retrospective descriptive study from the data collected through our bespoke database. Blood parameters including 1Boo-Ali hospital -Islamic Azad university of Medical Sciences infammatory markers were normal. Sayilir 1Muğla Sıtkı Koçman University- Faculty of Medicine, Physical disease that have great effect on quality of life. Material and Methods: genital anomaly characterized by variable degree of defciency In this quasi-experimental clinical trial, postmenopausal women en- along the radial (or preaxial) side of the limb. In this report, we pre- tered the study and randomized into case and control group. Case group also performed back ex- 42-year-old man with right radial bone dysgenesia applied to our tensor strengthening exercises at home. Concerning radial bone dysgenesia, he has 6 months after entering the study in both case and control groups any rehabilitation programs or surgical treatments. The medical history was otherwise non- except for role emotional as a subscale of mental health. On physical examination, right elbow was found to be trol group-, only some physical health dimensions including bodily fxed in extended and right hand fxed in fexion position. He had pain, role physical and vitality and mental health status as a mental minimal motor functions of fngers. Conclusion: In conclusion, performing as taking objects, holding or clutching at the right hand. Right elbow back exercises had major impact on improving physical and most and wrist joint showed severe degenerations. He was recommended of the mental aspects of quality of life in patients with osteoporosis for a rehabilitation program including; improving hand functions, and could be considered in routine management in these patients. Material and Methods: Forty-fve women with postmenopausal osteoporosis who were started medical Medicine and Rehabilitation Department, Ankara, Turkey treatment were prospectively included. Medications included alen- Introduction/Background: Avascular necrosis is the death of bone dronate, zoledronic acid, risedronate or ibandronic acid along with tissue due to a lack of blood supply. Also called osteonecrosis, a low or high dose of calcium plus vitamin D supplements. Patient was diagnosed with malign melanoma vitamin-D supplementation tended to have a greater improvement on right sacral region. Conclusion: Cognitive functions of women with these combination therapy patient experienced right hip pain and postmenopausal osteoporosis remained unaltered, whereas bone limitations. Higher doses of calcium vitamin d supplements were likely treated with 30 session hyperbaric oxygen treatment which did not to have better cognitive effects compared to lower doses. Patient addmited to our rehabilitation J Rehabil Med Suppl 55 Poster Abstracts 97 center for his joint pain and limitations with wheel chair dependent hadaye Tajrish Hospital from Apr 2009 to Apr 2010. Results: After 1 month, both the physiotherapy the patients general health condition and disabilities before treating and dry needling groups had decreased resting, night, and activ- with radiotherapy and chemotherapy. Yahyazadeh3 diology, Adana, Turkey 1Shiraz University of Medical sciences, Physical Medicine & Reha- bilitation- Geriatric Research Center, Shiraz, Iran; 2Shiraz Univer- Introduction/Background: The aim of this prospective pre-study sity of Medical Sciences, Physical Medicine & Rehabilitation- Shi- was to evaluate the effects of lidocaine injections to the trigger 3 points in the trapezius muscle on pain and disability in patients raz Burn Research Center, Shiraz, Iran; Farhangian University, with myofascial pain syndrome. Material and Methods: 20 patients Department of Languages, Shiraz, Iran (15 women and 5 men) with myofascial trigger points in the trape- Introduction/Background: Carpal tunnel syndrome is the most com- zius muscle were included in the study, and clinical examinations mon neurological entrapment in upper extremity and peripheral were used for the diagnosis. It was compared the Shear Wave Velocities (Vs) of the physical examination in diagnostic approach. Shear study was to compare some of these tests in diagnosis of mild carpal Wave Vs of the lesions were analyzed. All patients were treated with a 1 ml% Some different electrodiagnostic methods such as: Interpolation, 10 lidocaine injections to the trigger points by the same physiatrist. Results: The mean age method was sensory part of interpolation (sensitivity: 96% and speci- of the study population was found 43. After the lidocain injection sensitive method to detect mild cases of carpal tunnel syndrome. Conclusion: In patients with myofascial trigger points in the trapezius muscle, lidocain injec- 320 tions effectively improved the disability, and pain. Toshikazu1 prevalence of myofascial pain syndrome and lack of consensus in 1Kyoto Prefectural University of Medicine, Orthopaedics, Kyoto, the best treatment choice, we conducted this study to compare the Japan, 2Kyoto Prefectural University of Medicine, Rehabilitation effectiveness of physiotherapy with dry needling. The diagnosis is clinical and imaging is needed radical neck dissection with preservation of the accessory nerve, in- to confrm the diagnosis and to decide on the appropriate treatment cluding twenty-six men and four women with a mean age of 60. Results: At the time of rehabilitation starting after tion was entered in to the study. The correlation between different clinical tests and ultrasonographic fndings were assessed statistically. Results: Ultrasonographic fndings showed good correlation with clinical 323 fndings. We recommend its use in regular practice because it is Kashf3 user friendly and free from the risk of radiation. Ultrasound helps 1University of Social Welfare and Rehabilitation Sciences, Physi- in reaching at a correct diagnosis because many a times the clinical cal Therapy Department, Tehran, Iran, 2University of Social Wel- features may not give the accurate picture even in best hands. Thus the aim of this study was to evaluate the effect of 6 weeks shoulder girdle muscle exercises on the subacromial Introduction/Background: The aim of this study was to evaluate space and scapulohumeral rhythm in the subjects with scapular the coexistence of C5 and/or C6 root compression with rotator cuff dyskinesis. Material and Methods: Twenty subjects with obvious pathologies and its effect on pain and disability with clinical signs scapular dyskinesis were participated in the study. Material and Methods: The study with ter 6 weeks exercise program any alteration of scapular orientation 65 patients who fulflled the inclusion and exclusion criteria of the was assessed obviously by scapular dyskinesis test also the anterior study and who applied to our outpatient clinic with pain radiating outlet of subacromial space was measured via the acromiuhumeral from neck to shoulder. Exercise program consisted of stretch- were separated into two groups as patients with and without upper ing, strengthening and postural correction.

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Topical diagnosis of individual spinal nerve lesions order zenegra with paypal erectile dysfunction 23 years old, root lesions zenegra 100mg low price impotence early 30s, plexus lesions 2 h 256 11 discount 100 mg zenegra fast delivery food erectile dysfunction causes. Specific syndromes according to the location of lesion along the upper (pyramidal tract) and lower motor neuron 6. Syndrome of combined involvement of posterior funiculi, spinocerebellar pathways, and possibly pyramidal tracts 2. Definitions and neurological terms, associated with higher cortical functions and their disorders 2. Neurological case history Exercise № 2 – 2 hours Examination of normal reflexes  Gaining practical skills in working with reflex hammer  Examination of deep tendon reflexes  Examination of superficial reflexes  Examination of patient with normal reflexes Exercise № 3– 2 hours Pathological reflexes  Gaining practical skills in examination of pathological reflexes  Examination of patient with pathological reflexes  Identification of reflex abnormalities  Determination of the clinical significance of reflex changes Exercise № 4 – 2 hours Somatic sensation. Examination methods  Gaining practical skills in examination of primary sensory modalities  Gaining practical skills in examination of complex sensations  Application of tests  Examination of patient with positive sensory signs  Examination of patient with negative sensory signs Exercise № 5 – 2 hours Sensory syndromes. Clinical significance  Gaining practical skills in examination of patient with syndrome of peripheral nerve lesion  Gaining practical skills in examination of patient with syndrome of spinal nerve root  Gaining practical skills in examination of patient with syndrome of spinal cord  Gaining practical skills in examination of patient with syndrome of brainstem, thalamus, sensory cortex and psychogenic sensory disturbances 272 Exercise № 6 – 2 hours Meningeal syndrome. Syndromes of disordered motor function  Gaining practical skills in examination of muscle volume and muscle strength  Assessment of muscle tone  Application of tests for examination of latent hemiparesis  Examination of patient with upper motor neuron lesion  Examination of patient with lower motor neuron lesion Exercise № 8 – 2 hours Motor system and motor activity. Extrapyramidal system and its disorders  Examination of patient with Parkisonian syndrome or other extrapyramidal syndromes  Application of tests Exercise № 9 – 2 hours Motor system and motor activity. Brainstem syndromes  Gaining practical skills in examination of patient with spinal cord syndromes  Gaining practical skills in examination of patient with brainstem syndromes  Application of tests for main clinical signs and syndromes  Examination of patient with spinal cord or brainstem syndrome Exercise № 13 – 2 hours Internal capsule syndrome. Syndromes of lesion of the cerebral cortex  Gaining practical skills in examination of patient with internal capsule syndrome  Application of tests for main clinical signs and syndromes  Examination of patient with internal capsule syndrome or syndrome of lesion of the cerebral cortex Exercise № 14 – 2 hours Neurophysiological methods of examination of the nervous system  Indications for electrodiagnostic investigation  Electroencephalography  Electromyography  Evoked potentials study Exercise № 15 – 2 hours Topical diagnosis. Treatment  Examination of patient with meningeal irritation Exercise № 2– 2 hours Colloquium General neurology Exercise № 3 – 2 hours Peripheral nervous system disorders. Trigeminal neuralgia  Examination of patient with Bell’s palsy and trigeminal neuralgia Exercise № 4 – 2 hours Peripheral nervous system disorders. Tabes dorsalis  Examination of patient with polyneuropathy Exercise № 5 – 2 hours Encephalomyelites. Treatment  Examination of patient with multiple sclerosis Exercise № 6 – 2 hours Encephalopathies. Treatment  Examination of patient with encephalopathy Exercise № 7 – 2 hours Haemorrhagic stroke. Rehabillitation  Examination of patient with haemorrghagic stroke Exercise № 8 – 2 hours Subarachnoid haemorrhage. Treatment Exercise № 11 – 2 hours – in Neurosurgery Traumatic injuries of the nervous system. Treatment  Examination of patient with Parkinson’s disease, Alzheimer’s disease Exercise № 13 – 2 hours Epilepsy. The education in Pediatric surgery includes studing of the most often diseases in infancy and childhood like congenital anomalies of oesophagus and diaphragm, congenital hypertrophic pyloric stenosis, congenital anomaliees of small and large bowels, acute abdomen in children, acute inflamatory diseases, congenital anomalies of the abdominal wall, major tumors in infancy and childhood. Theoretical knowledge: - Presentation of esophageal atresia and pyloric stenosis, methods for diagnosis and principles in operative treatment. Practical skills: - Placement of nasogastric tube - Performing of diaphanoscopy - Performing of rectal exam 280 - Performing of thoracentesis - Ablation of the foreskin - Realization of preoperative preparation in prehospital dehydratation and intoxication. Anatomophisiological features in children’s age and their importance for surgical pathology 3. Classification of congenital intestinal atresia, presentation, diagnosis and treatment. Gastroesophageal reflux– presentation, diagnosis, conservative and operative treatment. Congenital diseases of the duodenal segment with symptoms of complete and incomplete bowel obstruction. Features of acute haematogenous osteomyelitis in childhood – principles of early diagnosis, most common mistakes, X-ray, principles of treatment. Ръководство по хирургия с атлас, том ХІІІ-Детска хирургия, под редакцията на проф. Professional practice examination: No Principal lecturer Professor or Associated professor from the department of Ophthalmology. Features of ophthalmology - High demand for ophthalmic care - Complex character - Close liaison with other medical specialties 4. History of ophthalmology 291 - Prehistoric times - Ancient civilizations: Assyria and Babylonia, Ancient Egypt, Judaic culture, Ancient Indian culture; Ancient Chinese culture, ancient cultures in America. Essentials of vision - Definition of light: theory, photometric units - Conversion of light energy into nerve impulses 8. Light perception - Definition: absolute sensitivity, descriminative sensitivity - Adaptation: to light and dark, methods for examination of adaptation - Disturbances in adaptation (hemeralopia): symptomatic, functional. Anatomy of orbit - Composition of the orbit - Features of the walls of the orbit - Major openings in the orbit - Contents of the orbit - Changes in the position of the eyeball 2. Static and dynamic clinical refraction - far point of view in different clinical refractions 7. Accommodation - definition - near point of view - mechanism of accommodation - field of accommodation - range of accommodation 8. Morbid changes in the conjunctiva: hyperemia – conjunctival and ciliary, chemosis, foliculae, papilae, phlyctena, discharge – catarrhal, purulent, fibrinous 4. Tumours of the orbit - Benign: dermoid cyst, holesteatoma, angioma, - Malignant: sarcoma, carcinoma, glioma, meningioma lymphoma. Diseases of the eyelids - Congenital anomalies - Diseases of the eyelid skin: noninflammatory and inflammatory - Diseases of eyelashes - Static and dynamic disorder of the eyelids: entropium, ektropium, blepharospasm, lagoftalm, ptosis of eyelids - Eyelid tumors: benign and malignant. Diseases of the cornea - Function of cornea - Methods for corneal investigation - Pathological changes in cornea: opacities – infiltration, cicatrix, degeneration; vascularisation: superficial, deep 1. Inflammatory corneal diseases - Superficial nonpurulent keratitides - Superficial purulent keratitides - Deep /stromal/ keratitides - Trophyc keratitides 3. Trachoma - distribution - etiology - clinical signs - differential diagnosis - complications - treatment 5. Classification of Uveitis - according to etiology: infectious – exogenous and endogenous, non-infectious - according to duration: acute, subacute and chronic - according to exudation: serous, fibrinous, purulent and hemorrhagic - according to histopathology: granulomatous and nongranulomatous - according to anatomical localization: Anterior uveitis, Intermediate uveitis, Posterior uveitis and Panuveitis 3. Anterior uveitis - subjective symptoms - objective symptoms - exogenous anterior uveitis - endogenous anterior uveitis: acute infectious diseases, chronic infectious diseases, focal infectious, metabolic diseases, rheumatological diseases - therapy of acute anterior uveitis: topical and systemic. Posterior uveitis (chorioretinitis) - subjective symptoms - objective symptoms - clinical types: diffuse, multifocal, focal, central, peripheral, juxtapapillary - complications - therapy 6. Diseases, connected with changes in lens transparency  acquired cataract: age-related, traumatic, pathologic, complicated, radiation-induced  management of the acquired cataract: medical and surgical  congenital cataract: types, clinical features, management. Primary angle-closure glaucoma - pathogenesis: relative papillary block, narrowing anterior chamber angle, plateau iris, vitreo-lenticular block - clinical features 297 - differential doagnosis 2. Primary open-angle glaucoma - pathogenesis: dystrophic changes in different parts of the aqueous drainage system, combined with partial block of the anterior chamber angle by the iris’ root or goniosynechiae. Retinal detachment - Rhegmatogenouse retinal detachment - Exudative retinal detachment - Tumour retinal detachment 10. Classification of ocular traumatism - contusions - injures: penetrating and non-penetrating – with or without foreign body - combustions A. Globe trauma - contusions - injures: non-penetrating and penetrating, with or without foreign bofy - explosive injures D. Types of blindness -absolute 300 -practic -work -professional -pedagogical -monolateral and bilateral -reversible and irreversible 4.

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