Edema is defined and its mechanism explained with reference to the Starling's forces. The causes of localized edema and anasarca discussed.
In history taking, the site and distribution of edema, its duration, association with pain, variability, systemic illness, drug intake, trauma, radiation discussed.
The local and systemic examination described. The approach to investigation including lab tests and imaging explained.
Finally, management is discussed in short.
Edema is defined and its mechanism explained with reference to the Starling's forces. The causes of localized edema and anasarca discussed.
In history taking, the site and distribution of edema, its duration, association with pain, variability, systemic illness, drug intake, trauma, radiation discussed.
The local and systemic examination described. The approach to investigation including lab tests and imaging explained.
Finally, management is discussed in short.
Cutaneous manifestations of hiv infectiontashagarwal
Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. In some patients, skin is the first organ affected. Skin diseases have proved to be sensitive and useful measures by which HIV progression can be monitored.
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
Cutaneous manifestations of hiv infectiontashagarwal
Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. In some patients, skin is the first organ affected. Skin diseases have proved to be sensitive and useful measures by which HIV progression can be monitored.
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
hypersensitivity Undesirable reactions produced by the normal immune system. Hypersensitivity is an exaggerated immune response that results in tissue damage and is manifested in the individual on a second or subsequent contact with an antigen. Hypersensitivity reactions can be classified as either immediate or delayed. Obviously immediate reactions appear faster than delayed ones, but the main difference between them is the nature of the immune response to the antigen.
Hypersensitivity reactions for Medical StudentsNCRIMS, Meerut
Hypersensitivity (animated) for MBBS Students
Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system.
Hypersensitivity reactions require a pre-sensitized state of the host.
Four types of hypersensitivity
Type I – anaphylactic
Type II – cytotoxic
Type III – immune complex mediated
Type IV – contact, tuberculin and granulomatous
Anaphylaxis is defined as a life-threatening allergic reaction set in action by a wide range of antigens and involving multiple organ systems.
The true incidence is difficult to estimate, but in 1973 the Boston Collaborative Drug Surveillance Program reported six anaphylactic reactions and 0.87 deaths from anaphylaxis per 10,000 patients.
Reactions to insect stings alone are responsible for at least 50 deaths in the United States each year.
These figures reveal the importance of continued research into the biology of anaphylaxis along with developing new (and improving existing) therapies.
PREPARED BY DR MUHAMMAD MUQEEM MANGI BASED ON GUYTON AND HALL 14TH EDITION WITH NET HELP, FOR THE MEDICAL STUDENTS OF FIRST YEAR MBBS ,DENTAL STUDENTS , DOCTORS OF PHYSIOTHERAPY AND PARAMEDICAL PERSONEL
1. Type I Hypersensitivity:
Type I hypersensitive reactions are the commonest type among all types which is mainly induced by certain type of antigens i.e. allergens. Actually anaphylaxis means “opposite of protection” and is mediated by IgE antibodies through interaction with an allergen
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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 lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
1. LEPRA REACTIONS
INTRODUCTION- Reactions occur due to abrupt change in immunological response of the body against
M. leprae.
Leprosy reaction can develop at anytime,
at Onset of the disease
before starting the treatment
During treatment
After completion of the treatment
Persons with following features are more likely to develop reactions:
Multiple lesions
Lesions close to the peripheral nerve (predisposes to neuritis)
Lesions on the face
People with nerve thickening with / without functional impairment (including thickening)
Reaction precipitating factors:
Infections and infestations
Vaccination
Hormonal changes: Puberty, Pregnancy & Childbirth
Psychological stress
TYPES OF REACTIONS
There are two types of Leprosy reactions.
(1) Type 1 Reaction: Also called Reversal Reaction can occur in any patient with unstable CMI
(2) Type 2 Reaction: Also called Erythema Nodosum Leprosum (ENL) occurs in patients with MB leprosy
having a heavy load of bacilli
2. Type 1 reactions ( TYPE IV HS)
Occur both in PB and MB leprosy.
Cause: It occurs as a result of increased activity of the body’s immune system, particularly cell mediated
immune response
Clinical presentation Reaction may be the first presenting sign of the disease .
Signs of inflammation are seen in the existing skin lesions i.e. skin lesions become red, more prominent,
swollen, shiny and warm.
Appearance of new skin lesions: Some previously unnoticed or non visible patches may become visible,
giving an impression of appearance of new skin lesions.
Inflammation of nerves: Nerves are frequently affected in type 1 reaction
3. Acute Neuritis: Existing involved or new nerves become enlarged, painful/tender and their sensory,
autonomic and motor functions get affected.
Silent neuropathy /quiet nerve paralysis: Sometimes, nerve function may get affected without any pain
or tenderness of the nerve or inflammation of skin lesions
these patients need to be identified early and treated with corticosteroids.
TYPE 2 REACTIONS OR ENL (TYPE III HS)
Patients having high load of leprosy bacilli as in Multi- bacillary/ infiltrative type of leprosy get type 2
reaction.
Type-2 reaction can involve multiple organs & systems, causing generalized symptoms.
Cause: It occurs when large numbers of leprosy bacilli are killed, followed by release of their antigens.
These antigens from the dead bacilli provoke an arthus type allergic reaction
General condition: fever, headache and body ache
Skin lesions: Type 2 reactions exhibit the typical signs of erythema nodosum - red, firm, painful, tender
evanescent cutaneous and subcutaneous
Rarely they can break down and suppurate / necrose producing Erythema Nodosum Necroticans
(ulcerative ENL).
Inflammation of nerves: Nerves may also get affected in type 2 reactions.
Eyes-iritis , iridocyclitis
Orchitis
Arthritis
Swelling of hands and feet
Dactylitis
Glomerulonephritis
Rarely- hepatitis endocarditis
4. Diagnosis
1) Clinical-
Consider Reaction on
Sudden appearance of symptoms
Inflammation of existing skin lesions (type-1 reaction) or appearance of painful tender nodules (type-2
reaction)
Inflammation of nerves
Involvement of ocular tissue
Swelling of hands, feet and pain in small joints
2) Slit skin smear
3) Histopathology
Treatment
1) reassurance
2) bed rest
3) rest to affected nerve- splint may be required
4) continue MBMDT
5) NSAIDS in mild cases
6) oral steroids in severe cases
For Type 2 reactions- apart from above medications, clofazimine, thalidomide also given
