This document discusses chronic cough in children. It begins with definitions, noting that chronic cough is typically defined as lasting more than 4 weeks. It then covers types of cough, pathophysiology, epidemiology, and common causes. For clinical presentation and diagnosis, it lists important elements of patient history and physical examination. Treatment involves addressing the underlying cause, such as using inhaled steroids for asthma. The prognosis depends on the specific cause but ranges from excellent to potentially lethal.
What is COPD, what causes COPD? What is the pathophysiology?How can we diagnose COPD. What is it's classification depending on severity. How can we diagnose COPD clinically as well as under microscope.How can we treat and manage COPD with the help of medicine as well as socially. Let's discuss.
TUBERCULOSIS HAS BEEN EXCLUDED BECAUSE IN INDIA TUBERCULOSIS IS THE MOST COMMON CAUSE OF CHRONIC COUGH AND REST OTHER CAUSES OF CHRONIC COUGHS ARE IGNORED
What is COPD, what causes COPD? What is the pathophysiology?How can we diagnose COPD. What is it's classification depending on severity. How can we diagnose COPD clinically as well as under microscope.How can we treat and manage COPD with the help of medicine as well as socially. Let's discuss.
TUBERCULOSIS HAS BEEN EXCLUDED BECAUSE IN INDIA TUBERCULOSIS IS THE MOST COMMON CAUSE OF CHRONIC COUGH AND REST OTHER CAUSES OF CHRONIC COUGHS ARE IGNORED
Pneumonia (Pathophysiology and management) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Pneumonia . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Pneumonia (Pathophysiology and management) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Pneumonia . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Chronic cough
1. By: Dr Hisham Alrabty
Pediatrics consultant and pulmonologist at TCH
Senior lecturer at pediatrics department Tripoli university
Hisham Alrabty 2019
3. • It is common presenting symptoms in children .
• It is common in season of viral infections autumn and
winter.
• Two types dry and loose or productive in general.
• Healthy children may cough on a daily basis; one study
documented an average of 11 cough episodes every 24
hours.
• It could be the only presenting symptom of asthma.
• Cough is an important defensive reflex that is required to
maintain the health of the lungs.
• Children who do not cough effectively are at risk for
atelectasis, recurrent pneumonia, and chronic airways
disease from aspiration and retention of secretions.
Hisham Alrabty 2019
Introduction:
4. There is no consensus as to the length of time
in the definition of chronic cough in children.
The American College of Chest Physicians,
Thoracic Society of Australia and New Zealand,
and many studies have defined chronic cough
as one that lasts more than four weeks,
because most acute respiratory infections in
children resolve within this interval.
Hisham Alrabty 2019
Definition:
5. Upto onset or duration:
1. Acute lasts less than 4 weeks.
2. Chronic lasts more than 4 weeks.
Upto nature of cough:
1. Dry without phlegm.
2. Wet or productive with sputum.
Upto causes:
1. Specific with clear cause like asthma or GERD.
2. Nonspecific without clear cause.
Hisham Alrabty 2019
Types of cough:
6. Cough pathway:
Each cough is elicited by the stimulation of the cough reflex arc.
Cough receptors, which are afferent endings of the vagus
nerve (cranial nerve X), are scattered in the airway mucosa and
submucosa.
Some of these receptors are mechanosensitive and some are
chemosensitive.
Mechanoreceptors are sensitive to touch or displacement and
are located mainly in the proximal airway such as larynx and
trachea.
Chemoreceptors are sensitive to acid, heat, and capsaicin
derivatives through the activation of type 1 vanilloid receptor
(TRPV1) and are located mainly in the distal airways.
Hisham Alrabty 2019
Pathophysiology:
8. Hisham Alrabty 2019
Mechanics of coughing:
three phases:
1. Inspiratory phase: air inhalation lengthens the expiratory
muscles (favorable length-tension relationship).
2. Compressive phase: contraction of expiratory muscles
against a closed glottis leads to an increase in intrathoracic
pressure.
3. Expiratory phase: opening of the glottis results in high
expiratory flow and audible coughs.
During this phase, the airway undergoes dynamic
compression and the expulsion of air facilitates airway debris
and secretions clearance.
Pathophysiology:
10. chronic cough appears to be common, with
an estimated prevalence of 5 to 7 percent in
preschoolers, and 12 to 15 percent in older
children Cough is more common among
boys than girls up to 11 years of age and may
be less common in developing countries
than in affluent countries.
Hisham Alrabty 2019
Epidemiology:
11. 1. Infections: viral or bacterial.
2. Inflammatory: asthma.
3. Aspiration syndromes: GERD and tracheoesophygeal
fistula.
4. Allergic: allergic rhinitis.
5. Inherited diseases: CF or immunodeficiency.
6. Cardiac: CHD pulmonary edema.
7. Mechanical: FB aspiration.
8. Habitual.
9. Connective tissue diseases: may affect lungs like SLE.
10. Medicines: captopril.
11. Nonspecific in 10-15% of children.
Hisham Alrabty 2019
Causes of chronic cough:
13. History:
1. Fever: means infection.
2. With or without sputum.
3. Diurnal variation.
4. Family history of allergy or any inherited diseases like CF.
5. Is it seasonal ?
6. Is there any weight loss or FTT?
7. Night sweating.
8. Any Dysmorphic features.
9. Runny nose and or sneezing.
10. History of wheeze or chocking or chronic vomiting.
11. Interrupted feeding or cyanosis (CHD).
12. Skin manifestations pointing to connective tissue diseases or eczema.
13. Any joint involvement .
14. Chronic diarrhea pointing to CF.
Hisham Alrabty 2019
Clinical presentation:
17. Treat the cause simply cough will be soothed:
1. Inhaled steroids and bronchodilators for asthma.
2. Steroid nasal spray and antihistamines for AR.
3. Antibiotics for bacterial infections.
4. Enzymes replacement and good hydration for CF.
5. Immunoglobins for immunodeficiency.
6. Bronchoscopy FB removal.
7. antiTB for TB.
8. Mucolytics and chest physiotherapy for bronchiectasis.
9. Positioning and AR milk for GERD.
10. Surgery for tracheoesophygeal fistula.
11. Anticough medicines ???????
Hisham Alrabty 2019
Treatment:
18. WHO recommendation is:
All anticough medicines whether cough suppressants
or Mucolytics or decongestives are completely
forbidden to be given to children aging less than 6
years old.
Good hydration and treating the cause are only
recommended treatments for cough in children as
proved by many studies being done internationally.
Hisham Alrabty 2019
Anticough medicines:
19. Cause dependent ranging from
excellent as in asthma and recurrent
tonsillitis to lethal like severe
immunodeficiency.
Hisham Alrabty 2019
Prognosis: