a télémédecine intégrant la technologie de la nanomédecine
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La nanomédecine est un domaine médical qui vise à utiliser la nanotechnologie – la manipulation et la création de matériaux et de dispositifs allant de 1 à 100 nanomètres (nm ; 1 nm = 0,0000001 cm) – pour la prévention des maladies et diverses applications telles que l'imagerie, le diagnostic, la surveillance. , traitement, réparation et régénération des systèmes biologiques. La présentation suivante offre une perspective visionnaire sur l’avenir potentiel de la télémédecine intégrant la technologie de la nanomédecine.
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Various causes of shoulder pain have been described. This lady presented with nonspecific right(Rt) severe shoulder pain radiating to the hand she could not sleep for 1 year with weakness at thenar eminence. The patient had history of 2 shoulder arthroscopic procedures within1 month interval. Postoperative Rt shoulder MRI evaluation revealed supraspinatous partial thickness tear, subscapularis tendinopathy and superior labrum tear from anterior to posterior(SLAP). The patient was treated successfully with a Multimodal Intereventional Pain management techniques and after6 months she was able to successfully move her shoulder without pain and regain muscle power. Introduction: Shoulder pain is one of the most frequent musculoskeletal complaints, which increases with age(1). Surgery is more successful in patients under age 40 SLAP tears(2). Common shoulder problems in old age include rotator cuff injury, secondary impingement &SLAP .Less common causes include nerve injuries(1)& long thoracic nerve in addition to vascular problems(2).One mechanism involves forceful traction on biceps tendon when someone falls onto an outstretched arm(3).The neurovascular causes can be difficult to diagnose& require special diagnostic tests such as EMG, dynamic ultrasound (US) and MRI(4). Consensus is lacking on the ideal treatment. Multimodal techniques includes Interventional-based therapy that has shown significant results in treating many conditions, including osteoarthritis (OA). Aim: The objective is to describe a multimodal interventional pain management approach in the treatment of persistent shoulder pain after failed surgery. Methods: The procedure was performed at Safwet Al-Golf Hospital, Cairo, Egypt, for a 60 years old female diabetic patient with a long-term history of untreated shoulder pain. She underwent 2 shoulder arthroscopic procedures on August & November 2021 respectively, progressed postoperatively with standard rehabilitation to increase the range of movement (ROM), however there had been no improvement. On examination, the patient had Rt dermatomal C5,6, 7 hypothesia. Bed side US examination showed Rt subscapularis tendinopathy& impingement,Rt supraspinatous partial thickness tear(Fig.1,2) & impingement,Subacromion sub-deltoid bursitis(SASD), effusion at gelnohumeral joint. MRI Rt shoulder revealed, previous surgery in the form of acromioplasty, biceps tenotomy and interosseous repair, Acromio-clavicular (AC) Joint OA, partial thickness tear of supraspinatus tendon, subscapularis tendinopathy, SLAP injury & Degenerated Anterior Glenoid labrum. She was unable to initiate abduction & limited ROM at medial and lateral rotation with severe pain. The patient completed numerical rating scale (NRS), verbally reported at the beginning of each visit, indicating her level of pain on a scale of 0 to 10, 0 = no pain and 10 = worst pain. At the initial visit she reported 10 on NRS. The patient scheduled for interventional pain management procedure.Management of Persistent Pain after Shoulder Arthroscopy using multiple Inter...
Management of Persistent Pain after Shoulder Arthroscopy using multiple Inter...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Abstract
A total of 50 procedures were performed, 25 patients were treated using SpineView decompressor and 25 patients by Nucleoplasty using the Arthrocare Coblation technology. The total population had leg pain (sciatica), 30 of which had low back pain (discogenic pain) . Mean age of patients was 30 – 60 years. The mean follow-up period was 1 year. Follow up was done weekly for the first 2 months then monthly for the first year post-procedure according to Visual Analogue Scale , Urs Muller et.al.(2008) as well as featured neurological examination.
Analgesic consumption was stopped or reduced in 9 of the 15 patients with sciatica and low back pain treated with SpineView decompressor (60%) at 2 months (66%) 4months after the procedure, and in 9 of the 15 patients with sciatica and low back pain treated by Nucleoplasty using the Arthrocare Coblation technology (60%) at 2 months (66%) 4months after the procedure.
The patients who had sciatica only has shown reduction in analgesic consumption in 9 of the 10 patients who were treated with SpineView decompressor (90%) at 2 months, and in 2 of the 10 patients who were treated by Nucleoplasty using the Arthrocare Coblation technology (20%) at 2 months.
Our results encourage us to use SpineView decompressor in carefully selected patients with sciatica and small contained disc protrusion . Also we find that applying Nucleoplasty using the Arthrocare Coblation technology in those patients with low back pain and small contained disc protrusion can give satisfactory results. These results need further efforts and researches in order to be general recommendations.
The results of nucleoplasty using the arthrocare coblation technology versus ...
The results of nucleoplasty using the arthrocare coblation technology versus ...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Abstract:
Procedures were performed for the total population in the period from March 2015 to November 2015 Cairo, Egypt. Pulsed Radiofrequency (PRF) using Ultrasound guidance (USG) has been used on medial branches supplying lumbar facet joints, investigating it’s effect in managing low back pain(LBP) caused by lumbar facet arthropathy . Conventional Radiofrequency (RF) using Fluoroscopy guidance (FG) on the medial branches is another option in treating facet arthropathy. This study is aimed to investigate the effects of PRF and RF on medial branches for facetogenic lumbar pain, demonstrating alternative ways to failed conservative methods and contradictory scientific evidence on minimally invasive procedures such as intra-articular steroid infiltration.Ultrasonography guided pulsed radio frequency in comparison to fluoroscopy-gu...
Ultrasonography guided pulsed radio frequency in comparison to fluoroscopy-gu...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Background:
Osteoarthritis (OA) is one of the most common joint disorders in the elderly
Webermedical intra-articular laser ( WEL) therapy makes it possible to irradiate directly in the tissue.Infrared laser(IR) has dose-dependent anti-inflammatory effect on OA . Thermal radiofrequency (RF) of the knee joint articular nerve branches were targeted to address the entire nociception and stiffness in OA3.This study aimed to investigate the effects of WEL and TRF on nonspecific knee joint pain.
Case report:
50 patients suffering from non-specific knee pain for more than 3 months with no response to conservative treatments ,were enrolled in the study with Knee pain rated 44 mm or greater on the pain visual analogue scale (VAS) and 4 or greater on the Numeric rating scale ( NRS).Procedures performed from Feb. to Oct. 2014 Cairo, Egypt. Assessment of pain was done at baseline then weekly post procedure for 1 month then at 1-month follow-up visits for 6 months.
Patients of the 1st group received WEL Blue and IR, using Ultrasound guided imaging, 2 WEL needles were advanced successively in the retro-patellar recess. The procedure includes 3 sessions with 1 week interval. Patients of the 2nd group received RF with temperature 80°C for 90 sec.,2 cycles, using fluoroscopy guided imaging ,3 of the 5 genicular nerves were targeted.
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Introduction: Metastatic disease to the bone has been a crippling devastating complication of various cancers, with unbearable pain . The development of medication dose-limiting side effects, limits analgesic efficacy in nearly 42% of cancer pain patients . The aim of our work is to evaluate the effectiveness and safety of Pulsed radiofrequency (PRF) and Thernal radiofrequency (RF) lesion of the Dorsal root ganglion (DRG) on a consecutive group of patients presenting with chronic thoracic axial pain due to vertebral bone metastasis.
Patient and methods: This is a randomized controlled prospective study conducted at the National Cancer Institute, Cairo University and registered in “Clinical Trial.gov” with ID number CdGrPfMiPnB. After approval from the Ethics Committee ( Approval number 201617015.3), 69 patients with intractable vertebral thoracic axial pain due to metastasis, unresponsive to conventional therapy and meeting the inclusion criteria. Assessment of pain was done at baseline then at 1 week then at 1 and 3 months after the procedure. The total number of patients were randomized into 3 equal groups. So there were 23 patients in each group. Group 1: Patients received PRF. Group 2: Patients received RF. Group 3: The control group having identical needle placement without the RF lesioning ,only local anesthetic with particulate steroid .
Comparison between Dorsal Root Ganglion Thermal Radiofrequency versus Pulsed ...
Comparison between Dorsal Root Ganglion Thermal Radiofrequency versus Pulsed ...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Recommended
Various causes of shoulder pain have been described. This lady presented with nonspecific right(Rt) severe shoulder pain radiating to the hand she could not sleep for 1 year with weakness at thenar eminence. The patient had history of 2 shoulder arthroscopic procedures within1 month interval. Postoperative Rt shoulder MRI evaluation revealed supraspinatous partial thickness tear, subscapularis tendinopathy and superior labrum tear from anterior to posterior(SLAP). The patient was treated successfully with a Multimodal Intereventional Pain management techniques and after6 months she was able to successfully move her shoulder without pain and regain muscle power. Introduction: Shoulder pain is one of the most frequent musculoskeletal complaints, which increases with age(1). Surgery is more successful in patients under age 40 SLAP tears(2). Common shoulder problems in old age include rotator cuff injury, secondary impingement &SLAP .Less common causes include nerve injuries(1)& long thoracic nerve in addition to vascular problems(2).One mechanism involves forceful traction on biceps tendon when someone falls onto an outstretched arm(3).The neurovascular causes can be difficult to diagnose& require special diagnostic tests such as EMG, dynamic ultrasound (US) and MRI(4). Consensus is lacking on the ideal treatment. Multimodal techniques includes Interventional-based therapy that has shown significant results in treating many conditions, including osteoarthritis (OA). Aim: The objective is to describe a multimodal interventional pain management approach in the treatment of persistent shoulder pain after failed surgery. Methods: The procedure was performed at Safwet Al-Golf Hospital, Cairo, Egypt, for a 60 years old female diabetic patient with a long-term history of untreated shoulder pain. She underwent 2 shoulder arthroscopic procedures on August & November 2021 respectively, progressed postoperatively with standard rehabilitation to increase the range of movement (ROM), however there had been no improvement. On examination, the patient had Rt dermatomal C5,6, 7 hypothesia. Bed side US examination showed Rt subscapularis tendinopathy& impingement,Rt supraspinatous partial thickness tear(Fig.1,2) & impingement,Subacromion sub-deltoid bursitis(SASD), effusion at gelnohumeral joint. MRI Rt shoulder revealed, previous surgery in the form of acromioplasty, biceps tenotomy and interosseous repair, Acromio-clavicular (AC) Joint OA, partial thickness tear of supraspinatus tendon, subscapularis tendinopathy, SLAP injury & Degenerated Anterior Glenoid labrum. She was unable to initiate abduction & limited ROM at medial and lateral rotation with severe pain. The patient completed numerical rating scale (NRS), verbally reported at the beginning of each visit, indicating her level of pain on a scale of 0 to 10, 0 = no pain and 10 = worst pain. At the initial visit she reported 10 on NRS. The patient scheduled for interventional pain management procedure.Management of Persistent Pain after Shoulder Arthroscopy using multiple Inter...
Management of Persistent Pain after Shoulder Arthroscopy using multiple Inter...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Abstract
A total of 50 procedures were performed, 25 patients were treated using SpineView decompressor and 25 patients by Nucleoplasty using the Arthrocare Coblation technology. The total population had leg pain (sciatica), 30 of which had low back pain (discogenic pain) . Mean age of patients was 30 – 60 years. The mean follow-up period was 1 year. Follow up was done weekly for the first 2 months then monthly for the first year post-procedure according to Visual Analogue Scale , Urs Muller et.al.(2008) as well as featured neurological examination.
Analgesic consumption was stopped or reduced in 9 of the 15 patients with sciatica and low back pain treated with SpineView decompressor (60%) at 2 months (66%) 4months after the procedure, and in 9 of the 15 patients with sciatica and low back pain treated by Nucleoplasty using the Arthrocare Coblation technology (60%) at 2 months (66%) 4months after the procedure.
The patients who had sciatica only has shown reduction in analgesic consumption in 9 of the 10 patients who were treated with SpineView decompressor (90%) at 2 months, and in 2 of the 10 patients who were treated by Nucleoplasty using the Arthrocare Coblation technology (20%) at 2 months.
Our results encourage us to use SpineView decompressor in carefully selected patients with sciatica and small contained disc protrusion . Also we find that applying Nucleoplasty using the Arthrocare Coblation technology in those patients with low back pain and small contained disc protrusion can give satisfactory results. These results need further efforts and researches in order to be general recommendations.
The results of nucleoplasty using the arthrocare coblation technology versus ...
The results of nucleoplasty using the arthrocare coblation technology versus ...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Abstract:
Procedures were performed for the total population in the period from March 2015 to November 2015 Cairo, Egypt. Pulsed Radiofrequency (PRF) using Ultrasound guidance (USG) has been used on medial branches supplying lumbar facet joints, investigating it’s effect in managing low back pain(LBP) caused by lumbar facet arthropathy . Conventional Radiofrequency (RF) using Fluoroscopy guidance (FG) on the medial branches is another option in treating facet arthropathy. This study is aimed to investigate the effects of PRF and RF on medial branches for facetogenic lumbar pain, demonstrating alternative ways to failed conservative methods and contradictory scientific evidence on minimally invasive procedures such as intra-articular steroid infiltration.Ultrasonography guided pulsed radio frequency in comparison to fluoroscopy-gu...
Ultrasonography guided pulsed radio frequency in comparison to fluoroscopy-gu...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Background:
Osteoarthritis (OA) is one of the most common joint disorders in the elderly
Webermedical intra-articular laser ( WEL) therapy makes it possible to irradiate directly in the tissue.Infrared laser(IR) has dose-dependent anti-inflammatory effect on OA . Thermal radiofrequency (RF) of the knee joint articular nerve branches were targeted to address the entire nociception and stiffness in OA3.This study aimed to investigate the effects of WEL and TRF on nonspecific knee joint pain.
Case report:
50 patients suffering from non-specific knee pain for more than 3 months with no response to conservative treatments ,were enrolled in the study with Knee pain rated 44 mm or greater on the pain visual analogue scale (VAS) and 4 or greater on the Numeric rating scale ( NRS).Procedures performed from Feb. to Oct. 2014 Cairo, Egypt. Assessment of pain was done at baseline then weekly post procedure for 1 month then at 1-month follow-up visits for 6 months.
Patients of the 1st group received WEL Blue and IR, using Ultrasound guided imaging, 2 WEL needles were advanced successively in the retro-patellar recess. The procedure includes 3 sessions with 1 week interval. Patients of the 2nd group received RF with temperature 80°C for 90 sec.,2 cycles, using fluoroscopy guided imaging ,3 of the 5 genicular nerves were targeted.
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Introduction: Metastatic disease to the bone has been a crippling devastating complication of various cancers, with unbearable pain . The development of medication dose-limiting side effects, limits analgesic efficacy in nearly 42% of cancer pain patients . The aim of our work is to evaluate the effectiveness and safety of Pulsed radiofrequency (PRF) and Thernal radiofrequency (RF) lesion of the Dorsal root ganglion (DRG) on a consecutive group of patients presenting with chronic thoracic axial pain due to vertebral bone metastasis.
Patient and methods: This is a randomized controlled prospective study conducted at the National Cancer Institute, Cairo University and registered in “Clinical Trial.gov” with ID number CdGrPfMiPnB. After approval from the Ethics Committee ( Approval number 201617015.3), 69 patients with intractable vertebral thoracic axial pain due to metastasis, unresponsive to conventional therapy and meeting the inclusion criteria. Assessment of pain was done at baseline then at 1 week then at 1 and 3 months after the procedure. The total number of patients were randomized into 3 equal groups. So there were 23 patients in each group. Group 1: Patients received PRF. Group 2: Patients received RF. Group 3: The control group having identical needle placement without the RF lesioning ,only local anesthetic with particulate steroid .
Comparison between Dorsal Root Ganglion Thermal Radiofrequency versus Pulsed ...
Comparison between Dorsal Root Ganglion Thermal Radiofrequency versus Pulsed ...Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
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a télémédecine intégrant la technologie de la nanomédecine
- 2. Capsule qui se compose de petits equipements Qui est ovale par le patient Description
- 4. Description 01 Le patient avale le NanoMedecin 02 Le NanoMedecin est distribuee a l’interieur du corps 03 Il Evalue les signes vitaux, articulations, Colonne Vertebral..etc 04 Les resultats sont envoyes au le portable du medecin
- 5. Objectif IL s’agit de Faire l’examine clinique pour le malade sans aller chez le medecin
- 6. Origine IL etait tres difficile pour les malades de se faire examiner par les medecins 1 En raison du couvre- feu et distancesociale 2 3 4 1 4 2 3 L’anne ou la COVID avait commence
- 7. Les Avantages 01 02 03 Vous pouves l’avaler sans difficulte IL est un petit capsule Vous Pouvez eviter la longue liste d’attente avant d’etre examine par le medecin Eviter l’attente Vous serez facilement examine par le NanoMedecin n’importe ou sur la plage ou a votr bureau N’importe ou You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. Content Here C A P S U L E S N a n o M e d e c i n
- 8. Exemples Choisir Vous Pouvez choisir quelle capsule de la specialite medicale que vous voulez Par exemple vous pouvez choisir entre3 capsules Medecine iInterne Cardiologie Orthopedique
- 9. Les Applications Futures Egalement il ya certains lieux ou on j’imagine NanoMedecin etre utilise comme Maisons de retraite, La salle des urgences J’ai envie de developper ce produit a utiliser pour toutes les personnes pendant le controle periodique. Meme avec des professions avec un stress corporal eleve comme le pilot et le plongeur
- 10. Conclusion NanoMedecin est l’avenir pour le diagnostic et le traitment des maladies dans un monde en evolution rapide