Urinary tract infections (UTIs) are among the most common infections encountered by doctors. They can affect people of all ages and have a wide range of clinical manifestations, from asymptomatic to severe systemic symptoms. The urinary tract is normally sterile, and any bacterial growth in the urine constitutes a UTI regardless of bacterial count. UTIs are commonly caused by bacteria like E. coli entering the urinary tract and multiplying. Treatment depends on whether the infection is uncomplicated or complicated by anatomical or functional factors. Empiric broad-spectrum therapy is started and later adjusted based on culture and sensitivity results.
Efusi pleura adalah penumpukan cairan berlebih di rongga pleura yang dapat berupa empiema (cairan purulen), hemotoraks (darah), atau kilotoraks (cairan limfe). Efusi pleura disebabkan oleh berbagai kondisi seperti neoplasma, gagal jantung, infeksi, dan penyakit lainnya. Gejala klinisnya meliputi dispneu, nyeri dada, dan batuk. Pemeriksaan fisik menunjukkan tambak lebi
Demam dengue disebabkan oleh virus yang ditularkan melalui gigitan nyamuk Aedes, gejalanya bervariasi dari ringan hingga berbahaya seperti demam berdarah. Pencegahannya meliputi menjaga kebersihan lingkungan, menggunakan kelambu, serta menutup, menguras, dan menimbun wadah berair untuk mencegah perkembangbiakan nyamuk.
Dokumen tersebut membahas tentang gagal ginjal akut dan kronik. Gagal ginjal akut dapat disebabkan oleh faktor pre-renal, renal, atau post-renal dan umumnya bersifat reversible. Gagal ginjal kronik disebabkan oleh kerusakan ginjal yang berlangsung lebih dari 3 bulan dan dapat menyebabkan penurunan laju filtrasi ginjal. Penanganannya meliputi mengendalikan faktor penyebab, menyesuaikan dosis obat
Efusi pleura adalah penumpukan cairan berlebih di rongga pleura yang dapat berupa empiema (cairan purulen), hemotoraks (darah), atau kilotoraks (cairan limfe). Efusi pleura disebabkan oleh berbagai kondisi seperti neoplasma, gagal jantung, infeksi, dan penyakit lainnya. Gejala klinisnya meliputi dispneu, nyeri dada, dan batuk. Pemeriksaan fisik menunjukkan tambak lebi
Demam dengue disebabkan oleh virus yang ditularkan melalui gigitan nyamuk Aedes, gejalanya bervariasi dari ringan hingga berbahaya seperti demam berdarah. Pencegahannya meliputi menjaga kebersihan lingkungan, menggunakan kelambu, serta menutup, menguras, dan menimbun wadah berair untuk mencegah perkembangbiakan nyamuk.
Dokumen tersebut membahas tentang gagal ginjal akut dan kronik. Gagal ginjal akut dapat disebabkan oleh faktor pre-renal, renal, atau post-renal dan umumnya bersifat reversible. Gagal ginjal kronik disebabkan oleh kerusakan ginjal yang berlangsung lebih dari 3 bulan dan dapat menyebabkan penurunan laju filtrasi ginjal. Penanganannya meliputi mengendalikan faktor penyebab, menyesuaikan dosis obat
Dokumen tersebut membahas tentang urolithiasis atau batu ginjal dan saluran kemih. Secara ringkas, dokumen menjelaskan definisi, klasifikasi, etiologi, insidensi, faktor risiko, epidemiologi, gejala klinik, komplikasi, dasar diagnosis, pemeriksaan penunjang, dan diagnosis banding dari kondisi tersebut.
Diare adalah defekasi yang cair lebih dari 200 ml per 24 jam atau lebih dari 3 kali sehari. Diare dapat dibagi menjadi akut kurang dari 15 hari dan kronis lebih dari 15 hari. Penyebabnya meliputi bakteri, virus, parasit, jamur, dan non-infeksi. Pengobatan diare meliputi rehidrasi cairan untuk mencegah dehidrasi, terapi simtomatik untuk mengurangi gejala, dan terapi definitif se
Tamponade jantung adalah sindroma klinis yang disebabkan oleh akumulasi cairan dalam ruang perikardium yang menyebabkan berkurangnya pengisian ventrikel. Gejalanya antara lain dispnea, hipotensi, distensi vena, dan suara jantung menjauh. Pemeriksaan fisik dapat menunjukkan tanda-tanda Trias Beck. Diagnosis didukung dengan hasil laboratorium, EKG, dan echocardiografi. Penatalaksanaannya meliputi perik
Laporan kasus ini membahas seorang anak laki-laki berusia 11 tahun dengan diagnosa gagal jantung kongestif akibat penyakit jantung rematik. Pasien mengeluhkan sesak nafas, lelah, dan batuk. Pemeriksaan menemukan tanda-tanda gagal jantung seperti edema, takikardi, dan bising sistolik di katup mitral. Diagnosa ditetapkan berdasarkan riwayat demam rematik dan hasil pemeriksaan seperti E
Batu saluran kemih dapat terbentuk akibat pemekatan urin atau adanya inti asing di saluran kemih. Gejalanya bervariasi mulai dari tanpa keluhan hingga nyeri dan darah dalam kencing. Pemeriksaan seperti USG, IVP, dan analisis urin diperlukan untuk diagnosis. Tatalaksananya meliputi observasi, tindakan noninvasif, dan operasi tergantung ukuran dan komplikasi batunya. Pencegahan melalui asupan
Dokumen tersebut membahas tentang definisi, tipe, gejala, penyebab, patofisiologi, diagnosis, dan penatalaksanaan demam. Demam didefinisikan sebagai peningkatan suhu tubuh secara abnormal. Terdapat beberapa tipe demam seperti demam septik, remmiten, intermiten, kontinyu, dan siklik, yang memiliki ciri khas pada pola kenaikan suhu tubuhnya. Penyebab demam dapat berupa infeksi atau kondisi toksik, se
Laporan kasus ini membahas pasien laki-laki berusia 57 tahun dengan keluhan nyeri dan kemerahan pada mata kiri selama 3 minggu. Pemeriksaan menemukan tekanan intraokular tinggi pada mata kiri, dan didiagnosis menderita glaukoma sudut tertutup akut. Penatalaksanaan dilakukan dengan obat-obatan dan iridektomi.
Myocarditis is defined as inflammation of the heart muscle that can be caused by viruses, bacteria, parasites, toxins or drugs. Clinical signs include chest pain, palpitations, shortness of breath, edema and sudden death. Diagnosis involves endomyocardial biopsy, electrocardiogram, cardiac enzymes, scintigraphy and cardiac MRI or echocardiogram showing abnormalities. The Dallas criteria requires inflammatory cells and myocardial necrosis on biopsy. Treatment focuses on supporting heart function, treating the underlying cause, and preventing complications. Prognosis depends on the severity and cause of myocarditis.
Laporan kasus ini membahas kasus hipokalemia pada seorang pria dewasa. Pasien mengeluh lemas dan keram pada kaki selama dua hari. Pemeriksaan menunjukkan penurunan kekuatan otot dan refleks pada ekstremitas bawah serta kadar kalium serum rendah 2,5 mmol/L. Diagnosis hipokalemia ringan ditegakkan dan pasien diberi suplemen kalium secara oral dan infus.
Urinary tract infections (UTIs) can range from asymptomatic bacteriuria to severe kidney infection. Common symptoms include dysuria, urinary frequency and urgency. UTIs are more common in women than men. Types include cystitis, urethritis, prostatitis and pyelonephritis. Pyelonephritis is a kidney infection that can cause loin pain, fever and vomiting. It is generally treated with oral or IV antibiotics depending on severity. Complicated UTIs involve abnormal anatomy or immunity.
1. Urinary tract infections are usually caused by bacteria like E. coli entering the urinary tract and multiplying. Risk factors include anatomical abnormalities, catheters, diabetes, and pregnancy.
2. Symptoms depend on the location of infection, ranging from painful urination with cystitis to fever and flank pain with pyelonephritis. Diagnosis involves urine tests and culture.
3. Treatment involves antibiotics, with uncomplicated cystitis typically treated for 3 days and pyelonephritis requiring longer courses in hospital. Prevention focuses on personal hygiene and drinking plenty of fluids.
Dokumen tersebut membahas tentang urolithiasis atau batu ginjal dan saluran kemih. Secara ringkas, dokumen menjelaskan definisi, klasifikasi, etiologi, insidensi, faktor risiko, epidemiologi, gejala klinik, komplikasi, dasar diagnosis, pemeriksaan penunjang, dan diagnosis banding dari kondisi tersebut.
Diare adalah defekasi yang cair lebih dari 200 ml per 24 jam atau lebih dari 3 kali sehari. Diare dapat dibagi menjadi akut kurang dari 15 hari dan kronis lebih dari 15 hari. Penyebabnya meliputi bakteri, virus, parasit, jamur, dan non-infeksi. Pengobatan diare meliputi rehidrasi cairan untuk mencegah dehidrasi, terapi simtomatik untuk mengurangi gejala, dan terapi definitif se
Tamponade jantung adalah sindroma klinis yang disebabkan oleh akumulasi cairan dalam ruang perikardium yang menyebabkan berkurangnya pengisian ventrikel. Gejalanya antara lain dispnea, hipotensi, distensi vena, dan suara jantung menjauh. Pemeriksaan fisik dapat menunjukkan tanda-tanda Trias Beck. Diagnosis didukung dengan hasil laboratorium, EKG, dan echocardiografi. Penatalaksanaannya meliputi perik
Laporan kasus ini membahas seorang anak laki-laki berusia 11 tahun dengan diagnosa gagal jantung kongestif akibat penyakit jantung rematik. Pasien mengeluhkan sesak nafas, lelah, dan batuk. Pemeriksaan menemukan tanda-tanda gagal jantung seperti edema, takikardi, dan bising sistolik di katup mitral. Diagnosa ditetapkan berdasarkan riwayat demam rematik dan hasil pemeriksaan seperti E
Batu saluran kemih dapat terbentuk akibat pemekatan urin atau adanya inti asing di saluran kemih. Gejalanya bervariasi mulai dari tanpa keluhan hingga nyeri dan darah dalam kencing. Pemeriksaan seperti USG, IVP, dan analisis urin diperlukan untuk diagnosis. Tatalaksananya meliputi observasi, tindakan noninvasif, dan operasi tergantung ukuran dan komplikasi batunya. Pencegahan melalui asupan
Dokumen tersebut membahas tentang definisi, tipe, gejala, penyebab, patofisiologi, diagnosis, dan penatalaksanaan demam. Demam didefinisikan sebagai peningkatan suhu tubuh secara abnormal. Terdapat beberapa tipe demam seperti demam septik, remmiten, intermiten, kontinyu, dan siklik, yang memiliki ciri khas pada pola kenaikan suhu tubuhnya. Penyebab demam dapat berupa infeksi atau kondisi toksik, se
Laporan kasus ini membahas pasien laki-laki berusia 57 tahun dengan keluhan nyeri dan kemerahan pada mata kiri selama 3 minggu. Pemeriksaan menemukan tekanan intraokular tinggi pada mata kiri, dan didiagnosis menderita glaukoma sudut tertutup akut. Penatalaksanaan dilakukan dengan obat-obatan dan iridektomi.
Myocarditis is defined as inflammation of the heart muscle that can be caused by viruses, bacteria, parasites, toxins or drugs. Clinical signs include chest pain, palpitations, shortness of breath, edema and sudden death. Diagnosis involves endomyocardial biopsy, electrocardiogram, cardiac enzymes, scintigraphy and cardiac MRI or echocardiogram showing abnormalities. The Dallas criteria requires inflammatory cells and myocardial necrosis on biopsy. Treatment focuses on supporting heart function, treating the underlying cause, and preventing complications. Prognosis depends on the severity and cause of myocarditis.
Laporan kasus ini membahas kasus hipokalemia pada seorang pria dewasa. Pasien mengeluh lemas dan keram pada kaki selama dua hari. Pemeriksaan menunjukkan penurunan kekuatan otot dan refleks pada ekstremitas bawah serta kadar kalium serum rendah 2,5 mmol/L. Diagnosis hipokalemia ringan ditegakkan dan pasien diberi suplemen kalium secara oral dan infus.
Urinary tract infections (UTIs) can range from asymptomatic bacteriuria to severe kidney infection. Common symptoms include dysuria, urinary frequency and urgency. UTIs are more common in women than men. Types include cystitis, urethritis, prostatitis and pyelonephritis. Pyelonephritis is a kidney infection that can cause loin pain, fever and vomiting. It is generally treated with oral or IV antibiotics depending on severity. Complicated UTIs involve abnormal anatomy or immunity.
1. Urinary tract infections are usually caused by bacteria like E. coli entering the urinary tract and multiplying. Risk factors include anatomical abnormalities, catheters, diabetes, and pregnancy.
2. Symptoms depend on the location of infection, ranging from painful urination with cystitis to fever and flank pain with pyelonephritis. Diagnosis involves urine tests and culture.
3. Treatment involves antibiotics, with uncomplicated cystitis typically treated for 3 days and pyelonephritis requiring longer courses in hospital. Prevention focuses on personal hygiene and drinking plenty of fluids.
Urinary tract infections are caused by bacterial invasion of the urinary tract. E. coli is the most common cause, accounting for 85% of community-acquired and 50% of hospital-acquired UTIs. Women are more susceptible than men due to anatomical differences. Symptoms include dysuria, urinary frequency, and abdominal pain. Diagnosis involves urine dipstick, microscopy to check for white blood cells, and culture to confirm bacteria over 102 CFU/mL. Treatment depends on severity and location of infection, with antibiotics like ciprofloxacin as first line options. Prevention focuses on hygiene and prompt treatment of infections.
Urinary tract infections (UTIs) are common and range from asymptomatic bacteriuria to severe pyelonephritis. The most common causes are Escherichia coli, which can ascend from the urethra. Risk factors include prior UTIs, sexual activity, diabetes, and urinary obstruction. UTIs are diagnosed based on urinalysis and urine culture. Uncomplicated cystitis is typically treated with a 3-day course of antibiotics like nitrofurantoin or fosfomycin. Complicated or recurrent UTIs may require imaging, prolonged or intravenous antibiotics, and management of underlying conditions. Complications can include sepsis, renal abscesses, and renal failure.
UTIs are common bacterial infections that affect any part of the urinary tract. E. coli is the most common cause, affecting 150 million people worldwide each year. UTIs can be classified anatomically by location (upper vs lower), or clinically by severity and recurrence. Risk factors include age, sex, sexual activity, diabetes, prior UTIs, and catheter use. Symptoms range from mild dysuria and frequency in lower UTIs to fever and flank pain in pyelonephritis. Diagnosis involves urine culture and antibiotic susceptibility testing to guide treatment and prevention, which commonly includes fluids, emptying the bladder frequently, and cranberry juice.
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...Lifecare Centre
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This document discusses urinary tract infections (UTIs) in women. It notes that UTIs are the third most common infection and affect 10-20% of the general population, with higher rates in older women. The urinary tract includes the kidneys, ureters, bladder, and urethra, and UTIs can be upper (kidneys and ureters) or lower (bladder and urethra). E. coli is the most common cause of UTIs. The document recommends fosfomycin as the first-line antibiotic treatment for UTIs due to its effectiveness against E. coli and low resistance.
This document discusses urinary tract infections (UTIs). It defines UTIs and describes the pathogenesis, types, common pathogens, diagnosis, and treatment of UTIs affecting the bladder and kidneys. It also covers other related conditions like prostatitis, orchitis, epididymitis, and tuberculosis of the urinary tract. UTIs are most commonly caused by E. coli entering the urinary tract ascending from the urethra. Diagnosis involves urine analysis and culture. Uncomplicated cystitis is usually treated with a 3 day course of antibiotics.
This document discusses urinary tract infections (UTIs). It defines UTIs and describes the different types, including uncomplicated vs complicated UTIs. It covers the typical causes, risk factors, pathogenesis, clinical presentations, diagnosis, treatment and prognosis. The main points are that E. coli is the most common cause, women are more prone due to anatomical factors, symptoms range from cystitis to prostatitis, diagnosis involves urinalysis and culture, and treatment depends on the type and severity of infection.
The document discusses urinary tract infections (UTIs). It notes that UTIs are more common in females than males, especially between the ages of 1-50, due to anatomical differences. Escherichia coli is the most common cause of UTIs. Symptoms can include dysuria, urinary frequency, urgency, and in more severe cases, fever and flank pain. Diagnosis involves urine testing and culture. Treatment depends on infection severity and location, with antibiotics like nitrofurantoin and trimethoprim-sulfamethoxazole used for uncomplicated cystitis and fluoroquinolones or IV antibiotics for pyelonephritis. Recurrent UTIs can be reduced with prophylactic antibiotics or
This includes the infectious, Inflammatory diseases affecting the urinary system namely, UTI (pyelonephritis, cystitis, urethritis), urethral diverticula, renal TB.
further, it also includes the immunological diseases affecting the kidneys like GN, and nephrotic syndrome.
This document discusses urinary tract infections (UTIs). Some key points:
- UTIs affect about half of all people during their lifetime and cause over 10 million doctor visits annually in the US.
- UTIs are usually caused by bacteria like E. coli. Complicated UTIs involve anatomical abnormalities and are caused by more diverse microorganisms.
- Laboratory diagnosis of UTIs involves urine dipstick tests to detect bacteria, white blood cells, and nitrites. Microscopic examination can also find bacteria and white blood cells. Urine culture is the gold standard for confirmation.
- Definitions include uncomplicated vs complicated UTIs, asymptomatic bacteriuria, lower vs upper UTIs, and acute vs
This document defines urinary tract infections (UTIs) and discusses common types in pregnancy such as asymptomatic bacteriuria and acute pyelonephritis. It outlines causative bacteria, risk factors, symptoms, diagnostic tests including urine culture and microscopy, potential complications, and treatment approaches including hospitalization, intravenous antibiotics and monitoring for UTIs during pregnancy.
This document defines urinary tract infections (UTIs) and discusses common types in pregnancy such as asymptomatic bacteriuria and acute pyelonephritis. It outlines causative bacteria, risk factors, symptoms, diagnostic tests including urine culture and microscopy, potential complications, and treatment approaches including hospitalization, IV antibiotics, and continued oral antibiotics.
This document defines urinary tract infections (UTIs) and discusses common types of UTIs during pregnancy such as asymptomatic bacteriuria and acute pyelonephritis. It outlines the causes, symptoms, risk factors, diagnostic testing and treatment for UTIs during pregnancy.
This document defines urinary tract infections (UTIs) and discusses common types in pregnancy such as asymptomatic bacteriuria and acute pyelonephritis. It outlines causative bacteria, risk factors, symptoms, diagnostic tests including urine culture and microscopy, potential complications, and treatment approaches including hospitalization, IV antibiotics, and continued oral antibiotics.
This document provides information about renal tuberculosis, including its diagnosis and management. It begins with a brief history of tuberculosis and then focuses on renal tuberculosis. Key points include:
- Renal tuberculosis is most commonly caused by hematogenous spread from a pulmonary infection and presents with symptoms of urinary tract inflammation like dysuria, back/flank pain, or hematuria.
- Diagnosis involves urine analysis showing pyuria and sterile cultures, imaging like intravenous pyelography showing calcifications and abnormalities, and culture of urine or tissues.
- Radiological findings include calcifications, cavitary lesions, infundibular strictures, and evidence of destruction like a "putty kidney". Management involves antibiotic therapy but can be complicated
This document summarizes the diagnosis and management of adult urinary tract infections. It defines different types of UTIs like cystitis, pyelonephritis, and recurrent infections. Diagnosis involves history, examination, urinalysis, urine culture, and occasionally imaging. Uncomplicated cystitis is usually treated with a 3-5 day course of antibiotics like nitrofurantoin, TMP-SMX, or fluoroquinolones. Recurrent UTIs may require behavioral changes, continuous antibiotic prophylaxis, or non-antibiotic alternatives like cranberry, D-mannose, or estrogen.
a presentation about UTI. information from various textbooks and different journals and also from many peoples presentation is accumulated in this one file. i worked very hard for this project.
This document discusses urinary tract infections (UTIs), including epidemiology, risk factors, etiology, pathogenesis, clinical manifestations, diagnosis, and treatment. Some key points:
- UTIs are more common in females ages 1-50 and risk factors include sexual activity and anatomical abnormalities.
- Common causative organisms include E. coli, S. saprophyticus, and other bacteria depending on infection type (uncomplicated vs complicated).
- Symptoms range from asymptomatic bacteriuria to cystitis and pyelonephritis. Complications include emphysematous pyelonephritis.
- Diagnosis involves urinalysis and urine culture. Treatment depends on infection type and may include
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
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Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
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chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Milan J. Anadkat, MD, and Dale V. Reisner discuss generalized pustular psoriasis in this CME activity titled "Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communications Strategies to Improve Shared Decision-Making." For the full presentation, please visit us at www.peervoice.com/HUM870.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
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TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
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Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Applications of NMR in Protein Structure Prediction.pptxAnagha R Anil
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This presentation explores the pivotal role of Nuclear Magnetic Resonance (NMR) spectroscopy in predicting protein structures. It delves into the methodologies, advancements, and applications of NMR in determining the three-dimensional configurations of proteins, which is crucial for understanding their function and interactions.
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)MuskanShingari
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Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Fexofenadine is sold under the brand name Allegra.
It is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the bloodâbrain barrier and causes lesser sedation, as compared to first-generation antihistamines.
It is on the World Health Organization's List of Essential Medicines. Fexofenadine has been manufactured in generic form since 2011.
1. INFEKSI SALURAN KEMIH
DWI LESTARI PARTININGRUM
DWI LESTARI PARTININGRUM
Sub. Bag. Nefrologi â Hipertensi
Bag. Ilmu Penyakit Dalam
FK UNDIP / RSDK
2. Introduction: UTI
t b t i l i f ti f GP
īŦ commonest bacterial infection for GP
īŦ substantial morbidity
īŦ wide clinical spectrum (mild â severe â sepsis)
Urinary tract is normally sterile
Definition of UTI:
īŦ any bacteria multiplying in the urinary tract
īŦ regardless of bacterial count
wie pm
īŦ regardless of bacterial count
3. INFEKSI SALURAN KEMIH (ISK)
īļ Infeksi tersering dialami ī masalah kesehatan
yg sering dihadapi dokter.
īļ Dapat mengenai semua umur.
īļ Spektrum gejala klinik sangat bervariasi dari
p g j g
tanpa gejala/ keluhan sampai kelainan sistemik
yg berat.
wie pm
4. īļ Definisi :
âĸ ISK ī akibat invasi mikro organisme pada
ISK ī akibat invasi mikro organisme pada
jaringan traktus urinarius (TU) dari orifisium
uretra â korteks ginjal.
uretra korteks ginjal.
âĸ Normal TU steril.
Ad b kt i d l i (b kt i i ) ī
âĸ Adanya bakteri dalam urin (bakteriuria) ī
TU berisiko alami infeksi.
âĸ Kultur (+) : kuman > 100.000/ml urin.
wie pm
6. KLASIFIKASI
KLASIFIKASI
ī Lokasi Anatomis: ISK atas & ISK bawah.
ī ISK Complicated & ISK Uncomplicated
ī ISK Complicated & ISK Uncomplicated.
ī Klasifikasi Klinis :
īĢAsymptomatic bacteriuria
īĢAcute uncomplicated cystitis in women
īĢRecurrent infections in women
īĢAcute uncomplicated pyelonephritis in women
p py p
īĢComplicated UTIs in both sexes
īĢCatheter-associated UTIs
wie pm
7. GEJALA
ginjal ISK ATAS
Pyelonefritis
GEJALA
Demam
M i il
ureter
Menggigil
Nyeri pinggang
Mual Âą muntah
P BB
ureter
Penurunan BB
Âą gejala isk bawah
ISK BAWAH
Ureteritis
Cystitis
Nyeri supra pubis
Disuria
Kandung
kemih
Cystitis
Prostatitis
Epididimitis
Urethritis
Frekuensi
Urgensi
Hematuri
Urethritis
wie pm
8. Klasifikasi ISK
Dari segi PENATALAKSANAAN dibedakan atas :
ISK li t d ( i l )
1. ISK uncomplicated (simple) :
īŧ ISK sederhana ī anatomik maupun fungsional TU
normal.
normal.
īŧ Terutama mengenai wanita.
īŧ Infeksi hanya mengenai mukosa superfisial kandung
kemih.
īŧ Penyebab kuman tersering (90%) adalah E. coli.
2 ISK complicated
2. ISK complicated
īŧ Sering menimbulkan banyak masalah, krn didasari hal ttt.
īŧ Sering kuman penyebab sulit diberantas ī resisten
Sering kuman penyebab sulit diberantas ī resisten
terhadap beberapa macam antibiotik
īŧ Sering terjadi bakteriemia, sepsis dan syok.
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īŧ Penyebab : Pseudomonas, proteus, klebsiela dll.
9. ISK Complicated ī terdapat keadaan sbb :
1. Kelainan abnormal saluran kencing.
Contoh : batu, obstruksi, refluks vasikouretral, atoni
kandung kemih, kateter menetap, prostatitis
menahun
menahun.
2. Kelainan faal ginjal. baik GGA maupun GGK.
3. Gangguan daya tahan tubuh. Penderita DM,
3. Gangguan daya tahan tubuh. Penderita DM,
neutropenia, penderita dg terapi imunosupresif.
4. Infeksi disebabkan organisme virulen.
Seperti proteus spp yg memproduksi urease,
Infeksi metastatik staphylococcus.
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10. Pathogenesis
Routes of bacterial invasion
Routes of bacterial invasion
1. Ascending
īŦ common
2. Hematogenous
īŦ staphylococcus
īŦ mycobacterium
y
tuberculosis
īŦ salmonella
īŦ salmonella
3. Lymphatic: rare
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12. Pathogenesis of urinary infection
g y
Bacterial virulence vs. host defences
1 Inoculum
1. Inoculum
2. Adherence characteristics
3. Failure of urinary defence
īŦ obstruction, calculi, VUR
obst uct o , ca cu , U
īŦ incomplete bladder emptying
īŦ diabetes mellitus & elderly
īŦ diabetes mellitus & elderly
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13. Patogenesis lanjutan
g j
īļ Bacterial factor
īŧ 95% dari luar TU
īŧ 5% hematogen
g
īļ Host factor
īŧ Wanita : uretra pendek, kolonisasi kuman pd
introitus vagina, sex intercourse, tampon,
spermatisid, diafragma, menopause
(lactobaccili)
(lactobaccili).
īŧ 30% ISK kandung kemih (cystitis) ī invasi ke
ginjal ī akibat dari VUR
ginjal ī akibat dari VUR
īŧ Infeksi pd ginjal sering di medula ī kons
amonia â, osmol â, pH â, blood flow â, PO2
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rendahâ.
14. DIAGNOSIS
ī Jumlah organisme pada ISK :
DIAGNOSIS
ī Jumlah organisme pada ISK :
ī 70% ISK jml kuman > 100.000 kuman/ml urin.
30% ISK j l k l bih d h i d
ī 30% ISK jml kuman lebih rendah, mis; pend.
pria, wanita dg disuria akut, wanita dg ISK
berulang karena stapphylococcus
berulang karena stapphylococcus.
P ik i li
ī Pemeriksaan urinalisa :
ī Epitel skuamos ī kemungkinan kontaminasi.
ī Piuria ī infeksi/ peradangan.
ī Silinder lekosit ī pielonefritis.
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15. Pemeriksaan kultur urin, yg didapat dari :
a Urin porsi tengah (mid stream urin)
a. Urin porsi tengah (mid stream urin)
b. Urin aspirasi suprapubik
Urin kateter kandung kemih (hindari)
c. Urin kateter kandung kemih (hindari)
D l i i k l i i h !! bb
Dalam interpretasi kultur urin porsi tengah !! sbb :
īģ 95% ISK disebabkan monomikrobial
īģ 95% ISK disebabkan gram negatif/ enterococci
īģ Staphylococcus epidermidis, diptheroids &
p y p p
lactobacilli jarang menimbulkan ISK.
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17. Asymptomatic Bacteriuria
ī Umumnya terjadi pd wanita ī
ī Umumnya terjadi pd wanita ī
2% - 4% wanita muda, 10% wanita >60 th.
Bil d DM i ik ISK 3 4
ī Bila ada DM risiko ISK 3 - 4x nya.
ī Laki2 jarang sekali, kecuali umur tua dg
hi t fi t t
hipertrofi prostat.
ī Tidak perlu antibiotik. (kecuali didapatkan kultur
k âĨ 100 000 CFU/ L d 2 ik
+ kuman âĨ 100.000 CFU/mL pada 2x pemeriksaan,
dg jenis kuman sama)
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18. Asymptomatic UTI
īŦ screening & symptoms minimal (urine odour)
Prevalence (%)
Prevalence (%)
Neonates 1 (-> 50% VUR)
S h l i l 1 2
Schoolgirls 1-2
Young women 10
Non-pregnant women 3-10
Pregnant women 5-6 (15-20% -> PN)
Pregnant women 5 6 (15 20% > PN)
Elderly men & women 5-40 (age)
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19. Terapi ISK Uncomplicated ( Simple )
īŧ ISK yg paling sering dijumpai dlm praktek dokter.
īŧ Manifestasi kliniknya ī sindroma disuria-frekuensi.
īŧ Piuria > 10/lpb, kultur (+)
p , ( )
īŧ Keluhan sering kencing sedikit2, sakit waktu
kencing serta rasa tidak enak didaerah suprapubik
kencing serta rasa tidak enak didaerah suprapubik.
Disertai demam subfebril (Âą).
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21. Faktor risiko dan komplikasi ISK komplikataÂ
Anatomic or structural risk factors
Obstructive utopathy (stones, strictures, tumors, prostate associated
Instrumentation (catheter associated and nosokomial infection)
Instrumentation (catheter associated and nosokomial infection)
Renal cystic disease
Ureteral stents & surgical urinary diversions, ileal loop constructions
Other : vesicoreteral reflux (VUR), urachal remnant
Functional risk factors
Diabetes mellitus
Renal transplantation
S i l d i j & l i d f ti
Spinal cord injury & neurologic dysfunction
Neutropenia
Human immunodeficiency virus
Micellanous complicated infection
Micellanous complicated infection
Pyonephrosis
Emphysematous pyelonephritis & cystitis
Malakoplakia and xantogranulomatous pyelonephritis
Intramural vesical abcess
Urosepsis
Tuberculosis
Infections caused by atipical or resistant organism : vancomycin resistant
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Infections caused by atipical or resistant organism : vancomycin resistant
enterococci, anaerobes, etc
22. TREATMENT
TREATMENT
1. Empiric therapy must be broad spectrum with
definitive therapy based on culture and
sensitivity
2. Moderately : Levofloxacin (500 mg IV/PO q24),
y ( g q ),
ciprofloxacin (500 mg PO twice-daily/400 mg q
12h IV)
)
3. Severely : cefepime 2g IV q12 hrs, ceftazidime
2 g IV q8 hrs, Imipenem 500 mg IV q6 hrs,
2 g IV q8 hrs, Imipenem 500 mg IV q6 hrs,
meropenem 1 g IV q8 hrs, doripenem 50 mg IV
q8 hrs, piperacillin-tazobactam 3.375-4.5g IV
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q8 hrs, piperacillin tazobactam 3.375 4.5g IV
q6 hrs
24. Clinical diagnosis: pyelonephritis
g py p
1. Fever T > 38 0C, rigors, chills, sweats
2 Loin pain
2. Loin pain
3. Constitional symptoms
īŦ anorexia, nausea, vomiting, diahorrea, myalgia,
headache
4. Lower urinary symptoms
īŦ dysuria frequency (30 - 50%)
īŦ dysuria, frequency (30 - 50%)
īŦ supra-pubic discomfort
UA i l k h i
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UA: pyuria, leukocytes, hematuria
25. Leukocyte casts PMN
y
1. Formation of WBC cast
3. Degenerate WBC cast
in fibrillar matrix T b l l H&E
2. Passage into urine
in fibrillar matrix Tubular lumen
Matrix
H&E
PMN
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EM BF PMN
27. Catheter associated UTI
Catheter associated UTI
īŦ biofilm colonisation common with long-term
urinary catheters
īŦ may cause septicemia in debilitated patient
Treat with A/B when:
īŦ fever sepsis
īŦ fever, sepsis
īŦ symptoms attributable to UTI (e.g. agitation)
īŦ short-term catheter & UTI
Observe long-term biofilm colonisation
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g
28. Prevention of catheter-associated UTI
īŦ short duration
īŦ insert under aseptic technique by trained
īŦ insert under aseptic technique by trained
staff (or trained patient for intermittent self-
catheterisation)
catheterisation)
īŦ bag below bladder & emptied regularly
īŦ keep system closed sample urine by sterile
īŦ keep system closed - sample urine by sterile
aspiration
antimicrobial cream in women
īŦ antimicrobial cream in women
īŦ A/B for cardiac valvular abnormalities
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29. UTI in males
Uncircumcised boys
Uncircumcised boys
īŦ bacteria under foreskin -> UTI
Ad lt l
Adult males
īŦ prostate often source
īŦ antibacterial prostatic secretion
-> fails in chronic prostatitis
fails in chronic prostatitis
Homosexual males
5% ith UTI
īŦ 5% with UTI
īŦ E Coli: same serotype
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30. Acute bacterial prostatitis
p
Young men < 35 y.o. or STD risk
C. trachomatis or N. gonorrhoeae
g
1. Rx. as gonorrhoea then
2 doxycycline 100 mg / d x 7 days
2. doxycycline 100 mg / d x 7 days
Older men > 35 y.o.
Enterobacteriaceae
ciprofloxacin 500 mg BD x 14 days
co trimoxazole BD x 14 days
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co-trimoxazole BD x 14 days
33. Pengelolaan :
Pengelolaan :
1. Umum : cairan cukup, elektrolit & nutrisi.
2. Atasi komplikasi : syok, urosepsis, GGA atau
DIC.
3. Pikirkan tindakan bedah, ( pus karena
obstruksi saluran kemih).
4. Antibiotika parenteral sampai 24 jam bebas
demam ī ganti oral.
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34. Sambil menunggu hasil kultur, diberikan antibiotika
berspektrum luas seperti :
berspektrum luas seperti :
īŧ Kombinasi ampicilin dan sefalosporin gen I
īŧ Aminoglycoside dg Betalactam.
īŧ Ticarcillin dg clavulanic acid.
īŧ Quinolone
Antibiotika oral selama :
īą 5-14 hari = 50% relaps.
īą 4-6 minggu = angka keberhasilan mencapai 90%.
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37. AN ODE TO A NEPHRON
Like thoughts in oneâs life In our youth
Like thoughts in oneâs life,
some superficial and some deep.
Some cortical, whilst other,
down close to medulla they seep.
All along our life we learn and adsorb
In our youth,
we stand firm and resolute.
We age and experience,
distal years of our lives convolute.
All along our life, we learn and adsorb,
with efforts active and passive.
Concentrate and dilute our endeavors,
by proportions little and massive.
Like experiences of life
âĻâĻâĻâĻâĻâĻâĻ
The art of improvement and discipline,
through counter current and autoregulation.
Akin to self-control and evolution,
through practise prayer and meditation
Like experiences of life,
which we filter and retain.
So does the nephron,
adsorbs the electrolytesâ rain.
through practise, prayer and meditation.
Like our life, where experiences abound,
we improve, develop and rectify.
A little nephron sits there,
to secrete adsorb and purify
âĻâĻâĻâĻâĻâĻâĻâĻ
The life must move on, and loop its course,
descend and then to ascend.
We must advance and yearn,
to overcome and transcend
to secrete, adsorb and purify.
As life wanders and winds,
the nephron meanders its way.
To part with toxins and miseries,
all through the night and day
to overcome and transcend. all through the night and day.
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