Great Place for MP3

http://beemp3.com/

Labony Puja 2010

Visit us at: http://www.labonypuja.in/

GNS3 -> Resources:

What is GNS3 ?

GNS3 is a graphical network simulator that allows simulation of complex networks.

To allow complete simulations, GNS3 is strongly linked with :

• Dynamips, the core program that allows Cisco IOS emulation.
• Dynagen, a text-based front-end for Dynamips.
• Qemu, a generic and open source machine emulator and virtualizer.

GNS3 is an excellent complementary tool to real labs for network engineers, administrators and people wanting to pass certifications such as CCNA, CCNP, CCIP, CCIE, JNCIA, JNCIS, JNCIE.

It can also be used to experiment features of Cisco IOS, Juniper JunOS or to check configurations that need to be deployed later on real routers.

This project is an open source, free program that may be used on multiple operating systems, including Windows, Linux, and MacOS X.

Features overview

• Design of high quality and complex network topologies.
• Emulation of many Cisco IOS router platforms, IPS, PIX and ASA firewalls, JunOS.
• Simulation of simple Ethernet, ATM and Frame Relay switches.
• Connection of the simulated network to the real world!
• Packet capture using Wireshark.

Important notice: users have to provide their own IOS/IPS/PIX/ASA/JunOS to use with GNS3.

Resource: http://www.gns3.net/

GNS3 Lab

The goal of this website is to share GNS3 and Dynamips/Dynagen network topologies.

Resource:http://www.gns3-labs.com/about-gns3-labs/

First Digest

Resource: http://www.firstdigest.com/

Interferential Therapy: Tips for Effective Treatment

Interferential therapy, during the past ten years, has increased in popularity to the point that it is now perhaps the most widely used form of electrotherapy in the United States. First developed in Europe, where this unique form of stimulation has been utilized for numerous indications, interferential units have been marketed since the early 1950's. It seems, however, that a great deal of confusion, mystery and perhaps even misinformation still exists concerning this therapy. The purpose of this article is to shed some light on areas that may be confusing to the clinician, share information on proper treatment protocols and offer a few insights into treating patients with interferential therapy effectively and safely.

"TRUE INTERFERENTIAL" VS. "PRE-MODULATE INTERFERENTIAL"

The original concept of interferential therapy was developed by Austrian physician, Dr. Hans Nemec, approximately forty years ago. Dr. Nemec proposed that by crossing two slightly different medium frequency alternating currents within the tissue; a third frequency current of greater intensity is created in the deeper tissue. As an example, a frequency of 4000Hz interfering with another frequency of 4080Hz creates a third current of 80Hz. This is caused by the in phase and out of phase relationship of the two original currents as they alternate from positive to negative polarity. The third current, referred to as the "beat frequency" becomes the actual therapeutic frequency. One output of the unit is a constant 4000Hz while the second output frequency is adjustable from perhaps 4001Hz to as much as 4250Hz. This form of interferential therapy has become known as "true interferential frequency difference interferential".

A second method of creating the interference effect has been developed in recent years and has become known as "pre-modulated interferential". With this method, both outputs of the unit provide a carrier frequency of 4000Hz, however, each output has the ability to premodulate or burst the frequency within the unit. It is important that this unit has the capability of perfectly synchronizing these bursts in the same polarity, at the same time in order to create "premodulated interferential" . Units capable of premodulation are not necessarily premodulated interferential and may only provide premodulation for the purpose of bi-polar (two electrodes) stimulation.

When considering the relative merits of these two methods, many clinicians ave noted that while both create the interference effect, there may be a distinct advantage to the pre-modulated technique. Since the "true interferential" provides an uninterrupted, constant 4000Hz frequency to the tissue, a condition known as Widensky inhibition (depolarization of the nerve fibers) will occur beneath the electrodes. This will create numbness and what will be perceived by the patient as a reduction in the intensity of current. With pre-modulated interferential, however, since the current is being burst inside the unit itself, Widensky inhibition will not occur and a larger treatment area is established with the actual therapeutic frequency.

ELECTRODES, CONTACT AND SAFETY

Virtually all interferential units are supplied with carbon rubber electrodes. The clinician should be aware that either water soaked sponges or a conducting gel should always be used between the electrode and the tissue. This will insure a uniform contact and provide for even disbursement of the current over the entire surface area of the electrode. If water only is used as a conductive agent, pooling may occur with resulting dry spots under the electrode. The current will then become intensified at the site of best conduction, the water pools, with little or no current flow elsewhere. With "true interferential" units this could result in over stimulation of tissue under the water pools and even possible tissue burns as depolarized tissue will not be able to sense the over stimulation.

While some interferential units still offer the vacuum electrode system, many clinicians have discontinued their use. Extra maintenance, tissue bruising and uneven current flow have been cited as reasons for a reduction in the popularity of vacuum systems.

Self adhesive electrodes are rapidly becoming the favorite of clinicians due to the ease of use, patient acceptance and elimination of possible cross-contamination. Difficult to apply areas such as shoulders, hips and the cervical spine are easily treated with the self-adhesive electrodes. Also, recent improvements in adhesive agents have made longer use possible and prices have been reduced substantially.

If carbon rubber electrodes are used, care should be taken to insure proper current flow. When conductive gels are used, the gel will create a glaze over the surface of the electrodes with long-term use. The glaze may prevent the flow of current over the entire electrode surface. Cleaning the electrode periodically with a mild soap and water and soft brush is recommended. It is not a good practice to use conducting mist sprays in lieu of other conducting agents. This is due to the saline content of the sprays which has been shown to destroy the carbon content of the electrode, thus rendering the electrode useless.

TREATMENT FREQUENCIES

While frequency ranges vary from manufacturer to manufacturer, basic therapy ranges are fairly consistent. Frequencies which vary from approximately 80Hz to 120Hz are considered most effective for acute pain while lower frequencies of perhaps 3Hz to 5Hz or 2Hz to 10Hz are preferred for the treatment of chronic pain. Some units feature a nerve block setting where both channels produce an output of 4000Hz to create an interferential nerve block to quickly block out acute pain. Most clinicians prefer a setting of 1 Hz to 15Hz for treating acute edema.

TREATMENT TIME

When treating acute pain with the 80Hz to 120Hz setting, interferential therapy will provide a release of enkephalin with a treatment time of 10 to 12 minutes. Chronic pain, however, requires 15 to 20 minutes of the 3Hz to 15Hz setting to provide release of beta-endorphins. Nerve block techniques, 4000Hz, normally require 10 minutes or more depending upon the size of the area being treated.

INTENSITY OF CURRENT

Interferential therapy provides a comfortable, soothing stimulation and should never be strong enough to cause any discomfort to the patient. Higher intensities should not be considered "better" as far as obtaining results. It is important to note that once the patients comfort level is established at the onset of therapy, the intensity should not be increased during the treatment. This could cause over stimulation of the tissue and even minor burns, particularly when treating with a unit that produces "true interferential" due to the Widensky inhibition effect.

RUSSIAN STIMULATION

This procedure is utilized for muscle strengthing and rehabilitation and is an added feature of interferential units. Space does not permit adequate explanation of this technique at this time; however, Russian Stimulation may be the topic of a future article.

CONTRAINDICATIONS AND PRECAUTIONS

Interferential therapy is considered a very safe modality when used properly for appropriate conditions. Most manufacturers list similar contraindications and precautions, most of which are the same as other electrotherapy devices. It is always recommended that the clinician review each manufacturer's warnings prior to treatment with any device.

Source: http://www.helium.com/items/1066142-interferential-therapy-tips-for-effective-treatment

Degenerative Disc Disease Lumbar

Lumbar Degenerative Disc Disease

Sciatica Interactive Video

Some Videos: 

Degenerative Disc Disease Interactive Video

Epidural Steroid Injections for Back Pain and Leg Pain Video 

Taken from: http://www.spine-health.com/

What is Degenerative Disc Disease?

Degenerative disc disease is one of the most common causes of low back pain, and also one of the most misunderstood. Many patients diagnosed with low back pain caused by degenerative disc disease are left wondering exactly what this diagnosis means for them. 

Degenerative disc disease is a misnomer

A large part of many patients’ confusion is that the term “degenerative disc disease” sounds like a progressive, very threatening condition. However, this condition is not strictly degenerative and is not really a disease:

• Part of the confusion probably comes from the term "degenerative", which implies to most people that the symptoms will get worse with age. The term applies to the disc degenerating, but does not apply to the symptoms. While it is true that the disc degeneration is likely to progress over time, the low back pain from degenerative disc disease usually does not get worse and in fact usually gets better over time.
• Another source of confusion is probably created by the term "disease", which is actually a misnomer. Degenerative disc disease is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc.

Disc degeneration is a natural part of aging and over time all people will exhibit changes in their discs consistent with a greater or lesser degree of degeneration. However, not all people will develop symptoms. In fact, degenerative disc disease is quite variable in its nature and severity.

Lumbar Degenerative Disc Disease Treatment Options

For most people, degenerative disc disease can be successfully treated with conservative (meaning non-surgical) care consisting of medication to control inflammation and pain (either oral or injection), and physical therapy and exercise. Surgery is only considered when patients have not achieved relief over six months of conservative care and/or are significantly constrained in performing everyday activities.

Non-surgical treatment for degenerative disc disease

The ongoing pain, as well as the frequency and intensity of the flares, can be mitigated through a number of non-surgical options. Modifying activities to preclude lifting of heavy objects and playing sports that require rotating the back (e.g. golf, basketball or football) can be a good first step. Other options include:

• Applying heat to stiff muscles or joints to increase flexibility and range of motion, or using ice packs to cool down sore muscles or numb the area where painful flares are concentrated.

• Medications such as non-steroidal anti-inflammatories (e.g., ibuprofen, naproxen, COX-2 inhibitors) and pain relievers like acetaminophen (such as Tylenol) help many patients feel good enough to engage in regular activities. Stronger prescription medications such as oral steroids, muscle relaxants or narcotic pain medications may also be used to manage intense pain episodes on a short-term basis, and some patients may benefit from an epidural steroid injection. Not all medications are right for all patients, and patients will need to discuss side effects and possible factors that would preclude taking them with their physician. 
• An exercise program is essential to relieving the pain of lumbar degenerative disc disease and should have several components, including:
  • Hamstring stretching, since tightness in these muscles can increase the stress on the back and the pain caused by a degenerative disc
  • A strengthening exercise program, such as Dynamic Lumbar Stabilization exercises, where patients are taught to find their ‘natural spine’, the position in which they feel most comfortable, and to maintain that position
  • Low-impact aerobic conditioning (such as walking, swimming, biking) to ensure adequate flow of nutrients and blood to spine structures, and relieve pressure on the discs
• Chiropractic manipulation can relieve low back pain by taking pressure off sensitive nerves or tissue, increasing range of motion, restoring blood flow, reducing muscle tension, and, like more active exercise, promoting the release of endorphins within the body to act as natural painkillers
• Epidural steroid injections can provide low back pain relief by delivering medication directly to the painful area to decrease inflammation