Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumors, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.
The Importance of Identifying Sepsis in the Golden First HourHasan Arafat
A case of a patient who was missed while in early sepsis. It sheds light on the importance of sticking to the guidelines of management of sepsis and how it can protect patients from deteriorating.
gutCARE IBS Talk on 20/5/2020.
In this talk, we update Singapore local epidemiology about increasing trend of IBS locally since 1998. There is also challenges in diagnosing IBS confidently in primary care due to patient presentation and symptoms.
We also update audience about latest diagnostic criteria for IBS.
New treatment for IBS, relationship between Small intestine bacterial overgrowth and IBS and the role of hydrogen breath testing in managing IBS.
We hope you enjoy the slides.
OBSTRUCTED LABOR is an emergency that poses significant risk to the life of both mother and fetus. A condition usually associated with low socioeconomic status puts much burden on the fragile health care delivery in subsaharan Africa
Approach to Inborn errors of metabolism with Case of Maple Syrup Urine diseas...Aheed Khan
A case of MSUD and its course in the NICU. with brief description to approach to inborn errors of metabolism and how to identify and lab work of suspected neonatal encephalopathy
Similar to Infantile diarrhoea and splenomegaly (20)
Wilsons disease and hepatitis dr. abhamoni baroSanjeev Kumar
Case: Prolonged acute hepatitis – is there more to it?
Presenter: Abhamoni Baro
Moderator: Ashish Bavdekar
Panelists: Prakash Vaidya, Harshad Devarbhavi, Seema Alam
Hepatomegaly with seizures and hepatitis in a family dr. rajesh kumar meenaSanjeev Kumar
Case: Hepatomegaly with seizures and hepatitis in a family
Presenter: Rajesh Kumar Meena
Moderator: Vidyut Bhatia
Panelists: Seema Alam, Alka Jadhav, Anshu Srivastava
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
1. Diarrhea and Hepatosplenomegaly..
Presenter:
Ravindra Kumar Sharma - TNMC, Nair, Mumbai
Moderator:
Vishnu Biradar
Pediatric Gastroenterologist, D.Mangeshikar Hospital, Pune
Pediatric Gastroenterologist, Kanchi K C Trust Hospital, Chennai
Panelists:
Girish Gupte -Pediatric Hepatologist,
Birmingham Children's Hospital, UK
Rajesh Sainani - Gastroenterologist,
Jaslok Hospital, Mumbai
2. Diarrhoea and hepato-splenomegaly
Presented by:
Dr. Ravindra Kumar Sharma
Post Graduate, Dept. of Pediatrics , T.N.M.C
& Nair Hospital, Mumbai.
Under the guidance of:
Dr. Aabha Nagral
3. Case summary
A 5 year old boy, 2nd by birth order, born of a non
consanguineous marriage was found to have an incidental
finding of a moderate splenomegaly by the pediatrician
during routine examination
4. Past History
•
•
•
•
The child was a full term normal delivery , no H/O NICU stay
The child was gaining weight adequately till age of 5months
History of multiple admission in view of diarrhea.
1st admission at 6wks of age treated with IV fluids and
antibiotics.
• 2nd admission - e/o acute gastroenteritis at 5 months of age with
UTI ( Klebsiella ). USG, MCU and DMSA scan normal
• From 5 months of age onwards had chronic diarrhea with
failure to thrive (weight < 3rd centile) with features suggestive
vitamin and mineral deficiencies
5. Past History continued:
• Diarrhea was large volume, not associated with blood or mucus.
There was no history of fever
• Was treated with IV fluids, intermittent parental nutrition,
antibiotics, probiotics, supplements and elemental diet.
Investigated for the same
• stool showed fat globules with trace reducing substance
• serum liver and renal biochemistry-normal
• thyroid function tests -normal
• Antigliadian antibody negative
• Serum Immunoglobulins – low normal
• Cystic fibrosis genetic analysis- negative
• Underwent an upper GI scopy and jejunal biopsy following which
given a 6 month course of medications and improved
6. On examination
•
•
•
•
•
•
Child conscious ,oriented
Vitals stable
Anthropometry: Weight- 21 kg - 50th centile.
No pallor, icterus, lymphadenopathy , clubbing.
No dysmorphic features.
Abdominal examination: liver- 2 cm soft, non tender, spleen
3cm, firm
• Other systems: NAD
8. Summarising..
• 5 year male child with chronic diarrhea in infancy -treated
• Now with splenomegaly and liver dysfunction under
evaluation
What are the differential diagnosis?
11. Investigation cont…
Serum protien electrophoresis done –
Increased Gamma globulins(30.6; normal- 7.9-18.9%)
Liver biopsy done
Gastroscopy done - No evidence of varices, Duodenal biopsies
taken
12. Investigation continued…
Liver biopsy - Interface hepatitis – lymphocytes, plasma cell and neutrophils with
rossette formation and pan lobular inflamation. HAI score 11/18 and fibrosis score 1/6
Duodenal biopsy – Mild villous blunting
Lamina propria shows increased
lymphoplasma cell infiltrate with
lymphoid aggregates
Intraepithelial lymphocytes
(Duodenal biopsies in infancy ?suggestive of autoimmune enteropathy and had been
given 6 month course of prednisolone)
13. Treatment
• Started on oral prednisolone and azathioprine and
supplements
• Now child’s weight is appropriate for age and LFT normalised
over a period of 6 months of treatment
