October 2020 ~ Medical diseases and trems ,symptoms causes TREATMENT

Medieducator.com

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Does Ballantines liquor cause liver damage ? ALCOHOLIC LIVER DISEASE | CIRRHOSIS | LIVER DISEASE



Yes Ballantine liquor is cause liver damage . other most of alcohol may cause liver disease .

 ALCOHOLIC LIVER DISEASE 

            Alcohol-related liver disease (ARLD) is caused by damage to the liver from years of excessive drinking. Years of alcohol abuse can cause the liver to become inflamed and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage of liver disease.

Includes causes of death: Cirrhosis

SIGN AND SYMPTOM
                   The symptoms of ARLD depend on the stage of the disease. There are three stages:
  1. Alcoholic fatty liver disease: This is the first stage of ARLD, where fat starts to accumulate around the liver. It can be cured by not drinking alcohol anymore.
  2. Acute alcoholic hepatitis: Alcohol abuse causes inflammation (swelling) of the liver in this stage. The outcome depends on the severity of damage. In some cases, treatment can reverse the damage, while more severe cases of alcoholic hepatitis can lead to liver failure.
  3. Alcoholic cirrhosis: This is the most severe form of ARLD. At this point, the liver is scarred from alcohol abuse, and the damage cannot be undone. Cirrhosis can lead to liver failure.
  • nausea
  • loss of appetite
  • jaundice
  • fatigue
  • abdominal discomfort
  • increased thirst
  • swelling in the legs and abdomen
  • weight loss
  • darkening or lightening of the skin
  • red hands or feet
  • dark bowel movements
  • fainting
  • unusual agitation
  • mood swings
  • confusion
  • bleeding gums
  • enlarged breasts [ in man]
RISK FACTOR
    *   you have a family history of ARLD
    *  you often drink heavily
    *  you binge drink
    *  you have poor nutrition

DIAGNOSIS
          * CBC
          * Liver function test 
          * CT scan 
          * Abdominal ultrasound
          * Liver biopsy test is confirmatory test.
  Liver Enzyme test 
                     - gamma-glutamyltransferase (GGT)
                   - aspartate aminotransferase (AST)
                   - alanine aminotransferase (ALT)

TREATMENT OF LIVE DISEASE

ARLD treatment has two goals. The first is to help you stop drinking. This can prevent further liver damage and encourage healing. The second is to improve your liver health.

If you have ARLD, your doctor may recommend:

  • Alcoholic rehabilitation program: Programs such as Alcoholics Anonymous can help you stop drinking when you can’t stop on your own.
  • Multivitamins: B-complex vitamins are usually low in people who drink heavily. This deficiency can cause anemia or malnutrition.
  • Liver transplant: A transplant may be necessary if your liver is too scarred by cirrhosis to function properly.
  • Vitamin A supplements: Many people with ARLD are vitamin A-deficient.

It’s important to note that taking vitamin A and alcohol together can be deadly. Only people who have stopped drinking can take these supplements. Supplements will not cure liver disease, but they can prevent complications like malnutrition.

COMPLICATION 

  • permanent liver scarring and loss of function
  • bleeding esophageal varices (enlarged veins in the esophagus that develop in people who have liver disease)
  • high blood pressure in the blood vessels of the liver (portal hypertension)
  • a loss of brain function caused by the buildup of toxins in the blood (hepatic encephalopathy


HYPERTROPHIC PYLORIC STENOSIS DISEASE, SYMPTOM, CAUSES , TREATMENT ,DIAGNOSIS



DEFINITION 

                         The pyloric stenosis is a condition in which hypertrophy occur in the pyloric part of the stomach due to increase size pathway of pylorus become narrow and this condition known as hypertrophic pyloric stenosis.

                          It is an acquired condition and etiology/ causes is unknown.

 SIGN AND SYMPTOM

               * Progectile vomiting .

               * Non bilious contain in vomiting .

               *  Dehydration.

               * Electrolyte imbalance .

               * Olive shaped mass feel at epigastric region.

               * Metabolic alkalosis .

               * Visible peristalsis movement from left to right .

DIAGNOSIS 

               Physical examination and ultra sonography.

MANAGEMENT / TREATMENT

                 SURGICAL MANAGEMENT 

                           Pyloromyotomy is perform - this surgical procedure is also known as fredet ramstedt surgery. In this surgery opening is created in the muscular part of the pylorus .

  POST OPRETIVE MANAGEMENT 

                   * Monitor vital sign .

                   * start the oral feeding with in 6-12 hour .

                   * Initial clear liquid diet should be provided.

        

RESPIRATORY DISTRESS SYNDROME ,CAUSES , SYMPTOM , DIAGNOSIS, TREATMENT ,respiratory distress syndrome type 2

 


DEFINITION 

            Deficiency or absence of surfactant in the lunges this called respiratory  distress syndrome.

       surfactant - It is formed of phospholipid . it include two chemical lecithin and sphingomyelin . The normal L and S retio 2:1.

                          * surfactant is produce by alveoli type 2 cell of lunges . surfactant formation start at 20 week and complete at 30 week of gestation. the steroid hormones stimulate the alveoli type 2 cell for the production of surfactant . the surfactant reduce the surface tension in the lunges so it prevent collapsing of the alveoli.

CAUSES/ RISK FECTOR

         -Preterm new born .

         - New born of diabetic mother.

SIGN AND SYMPTOM 

      *  The new born appear normal at birth the symptom start after five to six hours.

      * Nasal flaring 

      * Intercoastal retraction .

      * Grunting sound .

      * Tachypnea .

      * Cyanosis.

     * In the let stage of disease the maximum alveoli become collapse . The lunges appear like a thick membrane and this condition is known as hyaline membrane disease.

DIAGNOSIS 

      1. Antenatal diagnosis

                          shack test -    0.5 ml amniotic fluid + 0.5 ml NS + 1 ml ethanol [95%]

                                                                               ↓

                                                    Shack the tube for 2-3 minute 

                                                                                ↓

                                                   Place the tube in vertical position

                                                                                ↓

                           1. Bubbles are absent                               2. Bubbles are present 

                                         ↓                                                                   ↓

                             Surfactant absent - RDS Positive                  Normal fetus 

  2. Postnatal  Diagnosis 

             - Shack test by gastric aspiration.

             - ABG analysis 

             - Chest x ray - Ground glass mottled appearance indicate hyaline membrane disease .

MANEGEMENT / TREATMENT 

                   Initial routine intervention should be perform provide CPAP mode of ventilator to prevent collapsing of the alveoli .

                Administer surfactant by the intra tracheal route . it is provide through the endotracheal tube .

Prevention of RDS  -   Steroid therapy is administer in the mother ,the drug of choice beta methasone .

                                  Dose 12 mg /day for 2 day route IM

      There should minimum 48 hours gap between steroid administration and delivery.

                                         






PEPTIC ULCER TREATMENT, peptic ulcer SYMPTOM, CAUSES ,TYPES of peptic ulcer, complication of peptic ulcer



 DEFINITION 

                            It is define as break down of esophagia , gastric and duodenal  mucosa . The peptic ulcer in any where in GIT which comes with contact with gastric juice.

TYPES 

    1. ESOPHAGIAL ULCER  - Common in lower part of esophagus.

    2. GASTRIC ULCER - Common in pyloric entrum of  stomach.

    3.  DUODENAL ULCER - Most common type of peptic ulcer . common in first part of duodenum.

PATHO PHYSIOLOGY

                              Peptic ulcer occur when aggressive factor excide the defensive factor.

ETIOLOGY

               Helicobacter pylori - Most common cause of peptic ulcer .

               - Excessive use of gastric irritant .

               - Family history.

               - Common in blood group 'O'.

SIGN AND SYMPTOM 

1.PAIN    

               Gastric ulcer                                         duodenal  ulcer 

- Left upper quadrent .                                - Epigastric region pain .

- Food may cause pain and vomiting          - Pain occur at empty stomach .

may relive pain.                                           - Ingation of the food may relive pain.

                                                                     - Pain occur 2-3 hour after taking food .

                                                                     - Mid night pain may occur .

2. Bleeding 

                  a. Hematemesis             b. melena 

3.Weight loss .

4. Anorexia, nausea, vomiting

5. Anemia

6.fever

DIAGNOSIS 

                * History and physical examination .

                * CBC 

                * Urea breath test for H pylori .

                * Antibody detection test [ conformity test for H pylori]

                * ENDOSCOPY - Best test for peptic ulcer .

MANAGEMENT / TREATMENT 

          1. Avoid the gastric irritant .

          2. Pharmacological treatment 

                              Tab  - Amoxiclave 625 mg

                              Tab - clarithromycin 375 mg 

                              Tab - rantac 150 mg 

                              cap - pantocid 40 mg

                              Syp - Mucaine gel 20 ml 

         3. Diet therapy   - High protein non spicy diet cold milk.

         4.Stress induce ulcer

                                      - a.  Psychotherapy

                                      - b.  Rx Tab SSRI

                                                   Tab Clonazepam 

COMPLICATION OF PEPTIC ULCER 

           1 Haemorrhage  

           2. Pyloric obstruction 

           3. perforation 

SURGICAL TREATMENT 

                1. Vagotomy - Severing of some branch of vagus nerve to decrease the parietal cell stimulation is known as vagotomy.

                2. Sub total gastrectomy.

                3. Total gastrectomy.[ Vitamin B12 is given as life long by perentral rout .


                           


                                                                  

Sickle cell Disease Definition ,Etiology ,pathophysiology , symptom ,diagnosis , Management treatment



 DEFINITION

                         It is an autosomal recessive inheritance disorder characterized by production of sickle shaped RBC from bone merrow.

ETIOLOGY 

                    It is an inheritance disorder . the defective gene found upon autosome . the gene is recessive.

PATHOPHYSIOLOGY

                 The 6 number amino acid glutamic acid of beta chain of haemoglobin are replace by valine amino acid which result defective beta chain synthesis .

                                                               

                            Defective globin synthesis .

                                                                ↓

                                         Defective haemoglobin synthesis .

                                                                ↓

                                        Production of sickle  shaped RBC.

CLINICAL MENIFESTATION 

                       * Clinical feature of anemia  

                       * Haemolytic anemia .

                       * haemolytic jaundice .

                       * Splenomegaly ,

                       * Hepatomegaly .

                 * HAND AND FOOT SYNDROME  

                                   It is condition characterized by pain and cyanosis in extremities due to ischemia which develop due to obstruction all small branch of artery by sickle shaped RBC.

THE LIFE SPAM OF SICKLE SHAPED RBC IS 10 DAYS.

                * SICKLING → Normal RBC change into the sickle shaped RBC.


DIAGNOSIS

          * History - The disorder is commonly diagnose at the age of 6 month because up to the 6 month the baby have high amount of haemoglobin-F .

          * Physical examination - Yellow ness of skin ,sclera , hepatomegaly, splenomegaly.

          * CBC TRBC ↓es ., Hb ↓es , PCV ↓ es 

          * Reticulocyte count increased .

          * USG .

          * LFT.

          * Microscopic examination .

          * Hb- electrophoresis - confirmatory test.

MANAGEMENT

   TEMPRERY MANAGEMENT -

           - BT or PCV  transfusion. 

           - To prevent the sickling .

           - Advice / Precaution 

                                        - Maintain maximum  rest .

                                        - Avoid heavy exercises/ outer game .

                                        - Avoid to go in hilly area .

                                        -Avoid play in hot weather .

                                        - Prevent himself from infection .

permanent treatment 

                                 Bone merrow transplant or hematopoietic stem cell transplant .

  

                                       

              

BLEEDING TIME ,NORMAL BT



 It is the time interval from oozing of blood up to the stoppage of blood after prick .

Normal value of bleeding time 2-6 minute .

Bleeding time mainly depend upon number and function of platelets , It is increase in following condition

    * Dengue.

    * Thrombocytopenia .

    * Purpura.

The bleeding time does not depend upon clotting factor .

Bleeding is normal in hemophilia .

Bleeding time has been increase in bleeding disorder . Example purpura