Measles is a most contagious disease in children characterized by skin rash, cough, runny nose, sore throat, red eyes caused by paramyxovirus. It is a fetal disease if not treated properly. In 2008 ,197000 children died of measles. Vaccination has significantly reduced the mortality rate in the world .

What causes the Measles?

Measles is caused by paramyxovirus (meales virus). Virus is transmitted though droplets from the nose, mouth and throat of a infected individual. When infected individual cough,sneeze and talks virus droplets into the air, where normal people can inhale them and get infected .

What are the risk factor for getting Measles?

1. Unimmunized children
2. Children less than 1 year
3. Low socioeconomic status
4. Vitamin A deficiency
5. Who received immunoglobulin during measles vaccination

What are the signs and symptoms of Measles ?  

1. High fever (104 to 105 F)
2. Red eyes
3. Cough
4. Photophobia
5. Runny nose
6. Sore throat
7. Loss of appetite
8. Rash : Appears 3-5 days of first symptoms and signs. Rash start from the head and spread other parts of the body . It is present either macules(flat,discolored) or as papules (solid, raised red) .
9. Koplik’s spots( Tiny bluish-white spots inside the check)

How is the measles diagnosed?

Diagnosis relies on patients history and physical examination . In doubt cases diagnosis is confirmed by blood test for antibody of virus (IgM) and virus culture.

What are the complications of the measles ?

1. Ear infection
2. Sinusitis
3. Bronchitis
4. Laryngitis
5. Pneumonia
6. Encephalitis

Miscarriage,premature delivery in pregnant women.

1. Bleeding( due to low platelets count)

How is Measles managed ?

There is no cure of measles,but some treatment relives symptoms which includes :

1. Acetaminophen(paracetamol) or ibuprofen to reduce fever and relief pain. Don t use the aspirin for the children because of the risk of developing Reye’s syndrome.
2. Plenty of fluid
3. Vitamin A supplement
4. Humidified air
5. Bed rest
6. Isolate the children from others children .
7. Antibiotic is used those who have the complications likes pneumonia, ear infection due to bacterial infection.

How is a measles prevented?

1. Immunization of MMR( measles-mumps-rubella ) vaccine is the the most effective way to prevent the measles . First dose of vaccine is given at 12-15 moths of age followed by second dose of immunization when the child is 4-6 years of old (vaccine is contraindicated who have egg allergies) .
2. Isolation of the patient( Measles is contagious from the four days before to fours days after rash)
3. Immune globulin is used for high-risk peoples who are exposed to measles includes HIV patients, child younger than 1 years old and pregnant women.

What the prognosis of Measles?

Most of the individual have good prognosis. 0.2% individual will die and few individual have sequels like panencephalitis and pneumonia .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.ehealthmd.com
• http://www.umm.edu

No related posts.

Infertility is defined when a couple not being able to get pregnant after at least 1 year of unprotected sex (using no birth control methods) .Infertility affects about 10% of people in the reproductive age. Men and women both affects equally.

What causes the Infertility ?

There are different causes of infertility in men and female.

Infertility in female is due to following reasons:

1. Unable to survive fertilized egg or embryo in the uterus
2. Unable to move eggs from the ovary.
3. Unable to produced eggs

Infertility in men is due to following reasons : .

1. Low sperm count
2. Decreased movement of sperm

Causes of infertility in female includes :

1. Polycystic ovary syndrome(POCS)
2. Ovarian cysts
3. Myomas or fibroid
4. Polyps
5. Antiphospholipid syndrome
6. Anorexia nervosa( an eating disorder consisting of loss of appetite due to and emotional states such as anxiety,irritation , anger or fear. In anorexia nervosa there is no real loss of appetite, but rather a refusal to eat or an aberration in eating patterns, so that the term anorexia may be misnomer)
7. Obesity
8. Stress, depression
9. Excessive exercise
10. Dyspareunia
11. Turners syndrome
12. Defects of the uterus and cervix
13. Endometriosis
14. Pelvic inflammatory disease
15. Adrenal hormone deficiency
16. Thyroid hormone deficiency
17. Prolactinoma
18. Autoimmune disease
19. Scar tissue after surgery
20. Diabetes
21. Hypertension
22. Urinary tract infection
23. Smoking, heroin, cocaine and heavy alcohol consumption
24. Antibiotics , Antidepressants , acetaminophen , estrogen supplement
25. Chemotherapy
26. Radiation
27. Premature menopause

Causes of infertility in male includes :

1. Genetic abnormalities
2. Erectile dysfunction
3. Dyspareunia
4. Impotence
5. Retrograde ejaculation
6. No sperm
7. Anti-sperm antibodies
8. Cystic fibrosis
9. Varicocele
10. Undescended testis
11. Deficiency of testosterone
12. Klinefelter,s syndrome
13. Sexually transmitted disease includes chlamydia and gonorrhea.
14. Exposure to radiation and chemical
15. Smoking, heroin, cocaine and heavy alcohol consumption
16. Chemotherapy
17. Post operation scar
18. Hypothyroidism
19. Diabetes
20. Hypertension
21. Urinary tract infection
22. Spinal cord injuries
23. Drugs such as cimetidine, nitrofurantion, spironolactone

What are the signs and symptoms of infertility ?

Main signs and symptoms of infertility is the inability for a couple to get pregnant after at least 1 year of unprotected sex (using no birth control methods).

How is a infertility diagnosed ?

Diagnosis relies on clinical findings ,laboratory tests and radiological imaging.

Laboratory tests includes :

1. Serum progesterone analysis
2. Thyroid function tests
3. Luteinizing hormone test
4. Testosterone level
5. FSH and LH level
6. Estrogen level
7. Genetic testing
8. Blood glucose analysis
9. Complete blood test

Radiological imaging includes:

1. Hysterosalpingography
2. Pelvic ultrasound
3. Scrotal ultrasound
4. Pelvic CT scan
5. Laparoscopy

How is a infertility managed?

Management of infertility depends upon causes , duration of infertility and age of the women.

Treatment of infertility in women :

1. Drugs used for those who have ovulation disorders includes clomiphene, hMG( human menopausal gonadotropin , FSH( follicle-stimulation hormone), HCG(Human chorionic gonadotropin hormone), Gn-RH ( Gonadotropin-releasing hormone), metformin, Bromocriptine.
2. Treatment of STD s
3. Treatment of diabetes, hypertension, hypothyroidism.
4. Surgical management of tumors, Myomas , fibroid and Polyps
5. Assisted reproductive technology (ART is the procedure that involves manipulation of eggs or sperm to establish pregnancy) is indicated when women has a healthy uterus but medical treatment fails to achieve a pregnancy. ART includes IVF( in vitro fertilization, surgical sperm aspiration , ICSI( intracytoplasmic sperm injection), ZIFT( zygote intrafallopian transfer).

Treamtment of infertility in men :

1. Treatment of impotence
2. Treatment of STD s
3. Treatment of diabetes, hypertension and hypothyroidism
4. Surgical management of undescended testis, Varicocele .
5. ART

What is the prognosis of infertility?

About 60 % of couple become pregnant after appropriate treatments( exclude ART techniques) . Couple who are candidate of ART success rate is up to 27%.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.ehealthmd.com
• http://www.umm.edu
• http://www.fertilitycommunity.com
• http://www.cdc.gov

Related posts:

1. Premature ovarian failure
2. In vitro fertilization
3. HELLP Syndrome

Scabies is a condition characterized by itchy skin caused by the mite ,Sarcoptes scabiei. It is highly contagious. The word scabies come form the Latin word scabere, which means to scratch.

What caused the Scabies?

Scabies is caused by parasite,called Sarcoptes scabiei. The mites make borrow into the skin where it deposit its egg. Eggs get mature in 21 days and spread to other ares of the body or skin of other people. Close contact or sharing clothes of infected individual can spread the mites.

What are the signs and symptoms of Scabies?

1. Itching in skin usually at night( results form allergic reaction to the mites and its eggs)
2. Rashes in the skin
3. Blister in the skin
4. Burrows or tracks appear in between fingers, around the waist, on the inner elbow, around breast, around the waist, in armpit, on knee , scalp, neck, soles of the feet

What are the differential diagnosis of Scabies?

1. Syphilis
2. Dermatitis
3. Urticaria
4. Ectoparasites

How is a Scabies diagnosed?

Diagnosis relies on patients history, physical examination and laboratory examination .

Presence of mites or its eggs under a microscope confirm the diagnosis.

How is a Scabies managed?

1. Wash clots and bed cloths in hot water
2. Personal hygiene
3. Permethrine 5% cream which kill the mites applied in whole body except in face two times in a week
4. Lindane not safe for children younger than 2 years .
5. Ivermectin with the dose of 200 micrograms per kg of body weight per mouth as a single dose and repeat is two weeks later also shown effective.
6. Antihistamines likes diphenhydramine ,cetrizine help to control the itching.
7. Treat sexual partner or closed relatives as well.

What is the prognosis of Scabies?

Prognosis is excellent.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

No related posts.

Dengue fever is an acute febrile disease characterized by high fever, headache, skin rash and joint pains caused by the dengue virus which are transmitted by Aedes aegypti mosquito. Dengue fever is also known as breakbone or dandy fever.

What causes a dengue fever?

Dengue fever is caused by any of four different type of dengue virus(DENV). Viruses are transmitted by Aedes aegypti mosquito and sometimes by Aedes albopictus mosquito .

What are the signs and symptoms of Dengue fever?

1. High fever (104 F) with chills
2. Headache
3. Fatigue
4. Joint pain
5. Muscle pain
6. Rash over most of the body
7. Pain during eye movement
8. Nausea and vomiting
9. Abdominal pain
10. Swollen lymph nodes

What are the complication of a Dengue fever?

1. Dengue hemorrhagic fever, which is characterize by high fever, bleeding from mouth and nose , bruising and ultimately death of the patients.
2. Dengue shock syndrome, is the most severe complication of a dengue fever characterize by severe abdominal pain, severe vomiting, massive bleeding, dyspnea , sudden drop of blood pressure and death.
3. Dissemination intravascular coagulation (DIC), is characterized by abnormal reduction in the elements involved in blood clotting due to their use in widespread intravascular clotting.

How is a Dengue fever diagnosed?

Diagnosis relies on patient history, physical examination, laboratory test and radiological imaging

1. ELISA to isolate the virus and detects the IgM and IgG antibody of dengue virus.
2. Reverse trancriptase-polymerase chain reaction can detect the antigens of dengue virus .
3. Complete blood test shows , thrombocytopenia and leukopenia.
4. Radiological imaging includes X-ray , CT and MRI shows pleural effusion , intracranial bleeding and cerebral edema.

How is a Dengue fever managed?

Treatment depends upon the severity and the form of the disease .

In mild form of the disease.

1. Drink plenty of fluids
2. Acetaminophen( paracetamol) or ibuprofen to reduce fever and relief pain.

In severe form of the disease:

1. Hospital admission
2. Monitor vitals regularly
3. O2 supply
4. Intravenous fluid replacement or transfusion of blood
5. Correct electrolyte and acid-base balance
6. Heparin can be used to prevent DIC
7. Antiviral medicine is not available

What is the prognosis of a Dengue fever?

Prognosis is excellent with early treatment but becomes worse if complications develop.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.medicalnewstoday.com
• http://emedicine.medscape.com
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

Related posts:

1. Mittelschmerz

Tonsillitis is an inflammation of the tonsils ( A small, rounded mass of lymphoid tissue mainly found on the upper rear wall of the mouth cavity, they are of fair size in childhood but usually shrink after puberty ) characterized by sore throat, difficulty swallowing and fever caused by virus and bacteria.

What causes the tonsillitis?

Tonsillitis is caused by:

1. Common cold viruses including adenovirus, influenza , coronavirus, rhinovirus, respiratory syncytial virus.
2. Other viruses including herpes simplex virus, Epstein-Barr virus, cytomegalovirus and HIV.
3. Bacterial infection includes Group A beta-hemolytic streptococcus , staphylococcus aureus, streptococcus pneumoniae, chlamydia pneumoniae, pertussis, diphtheria and gonorrhea.

What are the signs and symptoms of tonsillitis?

1. Sore throat
2. Difficulty in swallowing
3. Pain during swallowing
4. Red, swollen tonsils
5. White or yellow patches on the tonsils
6. Cough
7. Runny nose
8. Nasal congestion
9. Redness of eyes
10. Fever
11. Headache
12. Nausea and vomiting
13. Bad breath
14. Stiff neck
15. Hoarseness
16. Refusal to eat
17. Rash

What are the complications of tonsillitis?

1. Difficulty in breathing
2. Tonsillar abscess( collection of pus behind a tonsil)
3. Peritonsillar abscess( quinsy)
4. Rheumatic fever
5. Post-streptococcal glomerulonephritis
6. Septicemia

How is a tonsillitis diagnosed ?

Diagnosis relies on history , physical examination and laboratory tests.

Laboratory tests includes:

1. Complete blood test
2. Throat swab and culture
3. Rapid strep test
4. Mononucleosis test

How is a tonsillitis managed?

1. Plenty of rest
2. Plenty of fluids
3. Avoid smoking , alcohol and caffeine
4. Gargle with saltwater
5. Ibuprofen or acetaminophen (paracetamol) is used to control a fever and decreased throat pain .
6. Penicillin with the dosage of ( 250 mg two or three times a day for children and 500mg two or there times a day for adults for 10 days) is the first line treatment for bacterial tonsillitis . People who are allergic to penicillin erythromycin or azithromycin is used.
7. Surgical removal of tonsil( tonsillectomy ) is indicated who have recurring tonsillitis, chronic tonsillitis, obstructed sleep apnea , dyspnea and peritonsillar abscess that refuse to respond to the antibiotic treatment.

What is the prognosis of tonsillitis?

Prognosis is excellent with early treatment .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.netdoctor.co.uk
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

No related posts.

Cholelithiasis are hard, stone like deposits inside the gallbladder. Cholelithiasis is the most common gastrointestinal disorder leading to surgical management. The size of the stone range from as small as a grain of sand to as large as a golf  ball.

What are the types of Cholelithiasis?

Gallstone is divided into following types:

1. Cholesterol Gallstone(80% of total gallstone) : It is radiolucent . Mainly contain cholesterol.
2. Pigment Gallstone(20% of total gallstone): It is radiopaque. Mainly contain calcium bilirubinate.

What is the pathogenesis of Cholelithiasis?

1. Cholesterol stones is formed when the ratio of cholesterol to phospholipids or bile salts is increased , bile salts is supersaturated with cholesterol results in crystallizes and forms a focus for stone formation .
2. Pigments stones is formed due to the crystallization of calcium bilirubinate.

What are the risks factor for cholelithiasis?

1. Female
2. More than 40 years
3. Obese individual
4. Pregnant women
5. Hemolytic anemia
6. Sickle cell anemia
7. Liver cirrhosis
8. Biliary tract infection
9. Diabetes
10. Eating high fat, high cholesterol , low fiber diet
11. Taking birth control pills
12. Taking drugs which contain estrogen.
13. Rapid weight loss
14. Fasting for long time
15. Long time intravenous feeding

What are the signs and symptoms cholelithiasis?

Many people (60%-80% )who have gallstones are asymptomatic( have never had signs and symptoms) . Symptoms commonly occur when stone blocks cystic or common bile duct , which includes:

1. Biliary colic ( Acute paroxysmal pain in upper right quadrant of the abdomen )
2. Pain spread to the back and right shoulder
3. Pain occur after fatty meal
4. Fever
5. Jaundice
6. Dyspepsia
7. Flatulence
8. Food intolerance
9. Nausea and vomiting
10. Abdominal fullness
11. Clay colored stools

What are the complications of cholelithiasis?

1. Acute Cholecystitis
2. Chronic Cholecystitis
3. Empyema of the gall bladder
4. Mucocele( dilation of the ball bladder with accumulated mucous secretion)
5. Mirizzi,s syndrome ( Mirizzi syndrome is a condition when common hepatic duct obstruction caused by compression from an impacted stone in the hartmann’s pouch or in cystic duct. )
6. Biliary obstruction
7. Acute Cholangitis
8. Acute Pancreatitis
9. Gallstone ileus ( Intestinal obstruction due to gall stone)
10. Gallbladder cancer

How is a cholelithiasis diagnosed ?

Diagnosis relies on history and physical examination and laboratory test with confirmatory radiological studies which includes:

1. Abdominal ultrasound ( 90% of gallstone are visible in USG)
2. Abdominal X-ray ( 10-15% of gallstone are diagnosed by x-ray
3. Abdominal CT and MRI scan
4. ERCP( endoscopic retrograde cholangiopancreatography)
5. HIDA scan(Hepatoiminodiacetic acid)
6. PTCA( Percutaneous transhepatic cholangiogram)
7. Laboratory tests includes Liver function tests, Serum lipase , Bilirubin and complete blood test.

How is a cholelithiasis managed ?

1. Asymptomatic Gallstones don’t required treatment. Cholecystectomy(open cholecystectomy and laparoscopic cholecystectomy) is being performed for those patients who developed symptoms or complications .Prophylactic cholecystectomy is considered in diabetes patients, congenital Hemolytic anemia , those due to undergo bariatric surgery. Other treatment for cholelithiasis includes:
2. ERCP( treat gallstones in the common bile duct)
3. Lithotripsy ( Lithotripsy is done for those who cant have surgery)
4. Medication which includes chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UCDA) are prescribed to dissolve cholesterol gallstones.

What is the prognosis of cholelithiasis?

Prognosis is excellent with early treatment.

References:

1. Sabiston textbook of surgery 18th edition
2. The Washington manual of surgery, 5th edition.
3. emedicine.medscape.com
4. http://www.medicinenet.com
5. http://en.wikipedia.org
6. http://www.uptodate.com
7. http://www.ncbi.nlm.nih.gov

No related posts.

Typhoid fever also known as enteric fever , is a life-threatening infectious disease characterized by progressive high fever , profuse sweating, rash and gastroenteritis caused by Salmonella typhi.

What causes the Typhoid fever?

Typhoid fever is caused by bacterias includes Salmonella typhi and Salmonella parathyphi. Bacteria is transmitted though fecal-oral route .

What are the signs and symptoms of Typhoid fever?

Signs and symptoms are developed gradually

Clinical presentation in first week

1. Slowly progressive fever as high as 104 degree Fahrenheit.(stepladder fever pattern)
2. Headache
3. Profuse sweating
4. Decrease appetite
5. Constipation or diarrhea
6. Fatigue and weakness
7. Sore throat
8. Abdominal pain
9. Insomnia
10. Confusion
11. Psychosis
12. Jaundice
13. Sharp right lower quadrant pain
14. Joint pain , muscle pain
15. Rose spots
16. Urinary retention
17. Hematuria( blood in urine)

Clinical presentation in second week

1. Continuous high fever
2. Weight loss
3. Distention of abdomen
4. Malaise , confusion and delirium
5. Dicrotic Pulse ( a pulse characterized by two peaks, the second peak occurring in diastole )
6. Diarrhea ( pea soup like)

Clinical presentation in third week

1. Delirious
2. Motionless and exhausted eyes
3. Life-threatening complication may developed.

Clinical presentation in forth week

1. This is the recovery phase
2. Decreased fever
3. Improvement of other signs and symptoms

What are the complications of Typhoid fever?

1. Intestinal bleeding
2. Intestinal perforation ( most common complication may developed in the third week of illness)
3. Myocarditis
4. Pancreatitis
5. Pneumonia
6. Osteomyelitis
7. Meningitis
8. Cholecystitis

How is a Typhoid fever diagnosed?

Diagnosis relies on clinical findings, laboratory tests and radiological imaging.

Laboratory tests includes

1. Complete blood count (CBC) shows increased white blood cells and low platelet count. .
2. Blood culture isolate S.typhi or S.parathyphi , widely considered 100% specific.
3. Widal test shows salmonella antibodies against antigens H-falgellar and O-somatic .
4. Polymerase chain reaction(PCR) is to detect the H1-d flagellin gene of S typhi.
5. ELISA urine test shows S.typhi or S.parathyphi.
6. Bone marrow aspiration and culture of BMA is the most sensitive to detect S.typhi .

Radiological imaging includes X-ray, CT and MRI scan is useful in bowel perforation.

How is a Typhoid fever managed ?

1. Ciprofloxacin with the dose of 250-500 mg PO twice a day for 7-14 days is the drugs of choice where resistance is uncommon .If there is resistance to Ciprofloxacin third generation cephalosporin includes cefotaxime or ceftriaxone is the drugs of choice. Ampicillin, chloramphenicol , Bactrim are the alternatives to treat the typhoid fever.
2. Drinking a lot of fluid
3. Eating a hearty diet
4. Complete rest
5. Surgical management is indicated in cases of intestinal perforation.
6. Cholecystectomy is indicated in carrier state where antibiotics fails to eradicated the bacteria.

What is the prevention of typhoid fever ?

1. Maintain good hygiene
2. Avoid drinking contaminated water
3. Improved sanitation
4. Choose hot foods
5. Isolation of infected people
6. Vaccines are recommended for travel the endemic area ( vaccine is not 100% effective)

What is the prognosis of typhoid fever ?

Prognosis is excellent with early treatment but becomes worse if complications develop. 3%-4% developed as carries of thyroid fever .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://emedicine.medscape.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.netdoctor.co.uk
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

No related posts.

Diabetes insipidus is the condition characterized by polydipsia ( excessive thirst ) and polyuria ( excessive urine volume) due to decreased secretion or resistance to the antidiuretic hormone (ADH) .

What are the types of Diabetes Insipidus ?

Diabetes insipidus is divided into central and nephrogenic diabetes insipidus . Central DI is due to lack of ADH secretion where nephrogenic diabetes insipidus is caused by a failure of the kidneys to respond to antidiuretic hormone.

What causes the Diabetes Insipidus ?

Central DI is caused by Pituitary or hypothalamus gland destruction which includes :

1. Surgery
2. Tumor
3. Meningitis
4. Inflammation
5. Head injury

Nephrogenic DI is caused by:

1. Drugs includes lithium, demeclocycline, amphotericin B
2. Genetic disorder
3. Hypercalcemia ( high levels of calcium in the body)
4. Polycystic kidney disease

Other causes of diabetes insipidus includes :

1. Lung cancer , Leukemia, Lymphoma
2. Histiocytosis X, anorexia nervosa, sarcoidosis
3. Hypoxic encephalopathy
4. Aneurysms
5. Artriovenous malformation

What are the signs and symptoms of Diabetes insipidus ?

1. Polydipsia ( excessive thirst)
2. Polyuria ( excessive urination , 2.5 liters to 15 liter of urination per day )
3. Nocturia ( urinary frequency at night )
4. Fever
5. Vomiting
6. Diarrhea
7. Dry skin
8. Cold extremities
9. Crying, growth retardation , irritability , weight loss in infants
10. Anorexia, Enuresis ( Bed wetting) , growth defects in children

How is a Diabetes insipidus diagnosed ?

Diagnosis relies on clinical findings, laboratory test and radiological imaging .

1. Routine urine test: urine specific gravity 1.005 or less and osmolality of urine is less than 200 mOsm/kg .
2. Water deprivation test
3. Radiological imaging includes MRI may show abnormality of pituitary or hypothalamus gland .

“Desmopressin stimulation tests is used to differentiate between the central and nephrogenic diabetes insipidus. “

How is a Diabetes insipidus managed ?

Management depends upon the types of the diabetes insipidus.

Treatment of central DI includes:

1. Balanced salt and water intake
2. Avoid dehydration
3. Desmopressin is the drug of choice with the dose of 5-10 U SC per 3-6 hours.

Treatment of nephrogenic DI includes :

1. Low salt diet
2. Stop medication that causes the nephrogenic DI.
3. Hydrochlorothiazide with the dose of 25-50 mg PO per day.
4. Chlorpropamide, carbamazepine and indomethacin are alternatives of Hydrochlorothiazide to treat DI.

What is the prognosis of Diabetes insipidus ?

Prognosis is excellent .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://emedicine.medscape.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

No related posts.

Well.. .my idea is always that before you decide to set yourself on one of these paths do a little clinical shadowing and several lab research.

Some definitions first….

1. MD: Signifies Doctor of Medicine, a doctor’s qualification in medicine
2. PhD: Is the highest diploma obtained at a college or university, usually requiring 3 to 5 years of original study in a specific field of study.
3. MD/PhD: refers to an education consisting of both the medical training of a medical doctor (MD or DO) with the rigor of a scientific specialist (PhD)

You could also consider to get involved in some clinical research. This will likely offer you a taste of the different fields. Some MDs do clinical research, if you get interested in that, you would not need an MD/PhD.

You actually should gain some upfront exposure prior to make any decisions. Neither clinical work nor lab bench effort is just what it may appear like in theory. You need to get your hands dirty. Attempt to request information, find out about them, and have several tastes of each one.

I believe it’s more easy to find a personality niche when you are delighted by the specific work you’re doing every single day, rather than attempt to enjoy doing work you hate, even if you fit the “typical profile” of the career.

Generally a double degree is perfect for those people who are interested in both, basically. However, you will possibly not wind up doing most of the actual bench work if you are an MD/PhD. The MD/PhD who’s the P.I. of the science lab I currently work for NEVER does some of the actual experiments we currently do, he simply covers administrational stuff and discusses problems/ideas along with his henchmen.

All his time through the week is spent on clinical work. I am not sure that will be the way it always works, but that is my own experience. However , if you happen to be equally interested in both, then I would still think an MD/PhD may be worth considering.

MD/PhD will place you at some advantage in grant-writing while you’re a new researcher. (Eventually, the degree matters less because research recruiters assess you according to your actual accomplishments.)

Imagine that studying scientific research can be easier if you have been trained like a physician. This advantage isn’t definitely worth the extra 3 years, but it’s somewhat of an advantage. It provides the flexibleness to view patients if you’d prefer. A slight majority of the MD/PhD’s I have seen usually do not, but some do and in any case all of them could. It could aid in the pursuit of an academic position too.

And also you? What are your positives and negatives of choosing a MD, MD/PhD or PhD profession?

Who am I ?: S. Ochoa is writing for the clinical research training courses blog, her personal and non-commercial in nature pastime blog to produce free recommendations for clinical research training newbie’s/experts to assist them get a new profession.

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Prolactinoma is a condition in which pituitary adenoma produces too much hormone called prolactin in the body. Prolactinoma is the most common type( 25-30%) of all pituitary tumor .

What is the pathophysiology of Prolactinoma?

Adenoma is due to neoplastic change of pituitary lactotrophs , results in excess production and secretion of hormone prolactin.

What is the signs and symptoms of Prolactinoma?

Signs and symptoms is caused by secondary to the excess hormone production and to the space occupying effect by the tumor .

Symptoms in women :

1. Galactorrhea( Abnormal milk flow form the breast of non pregnant or non breast feeding women)
2. Decreased sexual desire
3. Infertility
4. Irregular menstrual periods ( oligomenorrhea to amenorrhea)
5. Dyspareunia( painful sexual intercourse)
6. Breast tenderness
7. Fracture of bones

Symptoms in Men :

1. Gynecomastia( enlarged breast )
2. Decreased sexual desire
3. Impotence ( Inability of the male to achieve of maintain an erection of sufficient rigidity to perform sexual intercourse successfully)
4. Decreased body hair
5. Small testis

Symptoms due to space occupying lesion :

1. Headache
2. Nausea and vomiting
3. Nasal drainage
4. Visual disturbance
5. Double vision
6. Problems in smelling
7. Lethargy

How is a Prolactinoma diagnosed ?

Diagnosis relies on clinical findings , Laboratory tests and radiological imaging .

1. Laboratory tests shows increased serum prolactin levels with decreased testosterone levels in men . TSH levels is needed to exclude the possibility of an increased prolactin level secondary to increased TRH level.
2. Radiological imaging which includes CT and MRI shows pituitary mass.

How is a Prolactinoma managed?

Medication is usually sufficient in treating prolactinoma but surgery is needed in some cases who have the vision problem.

1. Bromocriptine (BEC) is a choice of drugs in the treatment of prolactionma with the doses of 1.25 mg nighty with food initially and is gradually increased to 2.5 mg two times a day in 1-2 weeks.
2. Carbergloine a long acting dopamine agonist is used for the patients who do not respond to bromocriptine.
3. Surgery is indicated when drug therapy doesn’t work or have the symptoms of mass occupying lesion . Sugery includes Transsphenoidal or Transcranial removal or pituitary tumor.
4. Radiotherapy is usually reserved for those whose prolactinoma that gets worse after both medication and surgery.

What is the prognosis of Prolactinoma ?

Prognosis depends upon the response of medical therapy or surgery.

References:

• http://www.emedicinehealth.com
• http://www.mayoclinic.com
• http://en.wikipedia.org
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition
• Sabiston textbook of surgery 18th edition

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Gullain-Barre syndrome , GBS in short is an acute inflammatory demyelination polyneuropathy is a condition characterized by progressive symmetric ascending muscle weakness, hyporeflexia and muscle weakness with or with out sensory or autonomic symptoms due to autoimmune antibody attack the own peripheral nervous system . The name Gullain-Barre syndrome come from 3 french physicians Guillain, barre and strohl on 1916. GBS is the most severe condition requiring hospitalization .

What causes the Gullain-Barre syndrome?

The exact cause is still unknown but believed that it is associated with bacteria infection includes Influenza C. jejuni, Mycoplasm pneumoniae, , virus infection which includes cytomegaloviru, HIV, Ebstein-Barr virus , systemic disease and administration of certain vaccines.

What is the pathophysiology of Gullain-Barre syndrome?

The exact pathophysiology is still nuclear but believed that its results from autoimmune responses to a recent infections or any vaccination. In GBS antibody is formed against myelin sheath leads to myelin sheath injured or degraded , the nerve cant transmit the nerve signal results in signs and symptoms of GBS.

What is the signs and symptoms of Gullain-Barre syndrome?

Signs and symptoms usually presents 2-4 weeks following gastrointestinal or respiratory illness.

1. Prickling sensation of finger and toes.
2. Symmetrical lower limbs weakness and progresses to upper body.
3. Unable to walk
4. Difficulty to move eye, speaking , chewing and swallowing.
5. Sharp pain in the lower body
6. Can not control the bladder and intestine functions.
7. Decreased heart rate
8. Difficulty in breathing
9. Hypotension
10. Facial muscle weakness
11. Dysreflexia
12. Limb muscle wasting
13. Decreased bowel sound

How is Gullain-Barre syndrome diagnosis ?

Diagnosis relies on clinical finding ,laboratory tests and radiological imaging .

1. Lumber puncture : Small amount of fluid(cerebrospinal fluid is) withdrawn form the spinal canal and then tested in laboratory. If CSF shows 10 or less mononuclear cells/mm3 strongly suggest the diagnosis. Most patients have an elevated CSF protein level.
2. Radiological imaging include MRI is sensitive and may help to diagnosed GBS.
3. Muscle biopsy may help to distinguish between primary myopathy and GBS.

How is Gullain-Barre syndrome managed ?

There is no cure for Gullain-Barre syndrome but treatment help recovery and reduce the severity of the disease progresses.

1. Continuous heart monitor, pulse oxygenation blood pressure and pulse.
2. Ventilation support
3. Fluid and electrolyte balance
4. Plasmapheresis is the treatment of choice for GBS in which blood is filtered and put back into the body.
5. Intravenous immunoglobulin have proven effective for GBS with combined with Plasmapheresis.

What is the prognosis of Gullain-Barre syndrome.

Prognosis depends upon the severity of the disease progresses.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://emedicine.medscape.com
• http://www.medicinenet.com
• http://www.guillainbarresyndrome.net
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

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1. Premenstrual syndrome(PMS)

Burning mouth syndrome also know as burning tongue, orodynia, scalded mouth, stomatodynia and glossodynia is a condition characterized by sensation of tongue pain , tongue discomfort and irritation of the oral mucous membrane, gums, lips, inside the cheeks and roof of the mouth.

What causes the Glossodynia?

1. Nutritional deficiencies (Iron, B12, Folic acid)
2. Candidiasis (oral thrush)
3. Dry mouth
4. Geographic tongue
5. Trauma of tongue
6. Oral cancer
7. Lingual artery atherosclerosis
8. hyperacidity
9. Periodontal disease
10. Diabetes
11. Sjogren’s syndrome
12. Rheumatoid arthritis
13. Hypothyroidism
14. Anxiety
15. Depression
16. Cancerphobia

What are the signs and symptoms of Glossodynia?

1. Burning sensation of tongue, lips, gums , oral mucosa
2. Mouth pain increased during the end of the day.
3. Sensation of dry mouth
4. Tingling sensation of the mouth or tongue
5. Sore mouth
6. Loss of taste
7. Difficulty of chewing , swallowing
8. Tongue swelling
9. Increased thirst
10. Mood change
11. Anxiety
12. Depression

How is Glossodynia diagnosed ?

Diagnosis relies on clinical findings . Laboratory and imaging test help to rule out other problems before diagnosis the glossodynia .

How is Glossodynia managed?

There is no cure of glossodynia ,treatment help to reduce the signs and symptoms. Treatment include:

1. Good oral hygiene
2. Drink more fluids
3. Stop smoking
4. Avoid alcohol ,spicy food and acidic foods
5. Regular exercise
6. Clonazepal ,tricycle antidepressants an anticonvulsant may effective in glossodynia.
7. Alpha-Lipoic acid
8. Vitamin B
9. Oral rinses
10. Mouthwashes
11. Local anesthesia like capsaicin
12. Treatment of primary diseases.

References:

• http://www.dentistry.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• https://health.google.com

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Common cold also known as nasopharyngitis, acute coryza and cold is a self-limited upper respiratory tract infection characterized by runny nose, cough, sore throat, sneezing , fever,headache, nasal congestion caused by more than 200 viruses. Common cold is most occurs during the winter and is the most frequently occurring infection in the world.

What causes the common cold?

Common cold is caused by different viruses. More than 200 viruses are found but rhinovirus, coronaviruses, adenoviruses and respiratory syncytial virus (RSV) are the most common viruses that cause the cold. Cold is spread via direct contact, sneezing,coughing ,talking with infected individual.

What are the signs and symptoms of common cold?

1. Runny nose
2. Itchy nose , nasal congestion
3. Cough
4. Sore throat
5. Nasal congestion
6. Sneezing
7. Watery eyes
8. Fever
9. Headache
10. Body aches
11. Fatigue

How is common cold diagnosed ?

Common cold is diagnosed by signs and symptoms presents in individual.

How is common cold managed?

Common cold can’t be cured . It is self limiting infection but some remedies that can ease the sign and symptoms which includes:

1. Drink lots of fluids, which includes soup,warm lemon water and juice.
2. Gargle with salt water for sore throat.
3. Stop drinking alcohol and caffeine.
4. Stop smoking
5. Get enough rest
6. Acetaminophen (paracetamol)or ibuprofen is used for fever, sore throat and body aches.
7. Decongestant nasal sprays can relives nasal congestion.
8. Cough syrup need to be used if individual have the cough.

What is the prognosis of the common cold?

Prognosis is excellent

Cold weather does not causes the common cold but it is believed that in cold weather people stay more time indoors in close proximity that facilitating the virus spread.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.bbc.co.uk

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