Incubation period a) 1-6 hours Staphylococcus aureus Bacillus cereus . . . mainly fried rice b) 8-16 hours Clostridium perfringens Bacillus cereus c) > 16 hours Vibrio cholerae Enterotoxigenic Escherichia coli Enterohemorrhagic Escherichia coli Salmonella spp. Shigella spp. Campylobacter jejuni Vibrio parahemolyticus
Posts
It is a common cause of food poisoning. Cause: It is due to the inoculation of toxin-producing S.aureus into food by colonized food handlers. The enterotoxin is heat stable unlike the bacteria which dies on warming/cooking. The toxin stimulates the vagus nerve and the vomiting center of the brain. It also appears to stimulate intestinal peristaltic activity. Onset: Rapid onset usually within 1-6 hr. Clinical features: Nausea and vomiting, although diarrhea, hypotension, and dehydration may also occur. The rapidity of onset, the absence of fever, and the epidemic nature of the presentation arouse suspicion of food poisoning. Symptoms generally resolve within 8–10 h. Treatment is entirely supportive.
No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician. In the care of the suffering, the physician needs technical skill, scientific knowledge, and human understanding. Tact, sympathy, and understanding are expected of the physician, for the patient is no mere collection of symptoms, signs, disordered functions, damaged organs, and disturbed emotions. The patient is human, fearful, and hopeful, seeking relief, help, and reassurance.
ACE inhibitors e.g enalapril remain one of the drug of choice to initiate anti hypertensive therapy. It acts by inhibiting the angiotensin converting enzyme and thus prevent the conversion of angiotensin I to angiotensin II. The latter is a potent vasoconstrictor. Since it is not being produced there is a resulting vasodilation and thus a decrease in the blood pressure. At the same time ACE inhibitors prevent the breakdown of bradykinin and sunbstance P. These 2 agents are potent protussive mediators in the respiratory tract and thus will cause dry cough. This is an indication to shift to angiotensin receptor blocker e.g. losartan.
The peritoneum is a thin membrane that lines the walls of the abdominal cavity and covers much of the viscera. The parietal peritoneum lines the walls of the cavity and the visceral peritoneum covers the viscera. Between the parietal and visceral layers of peritoneum is a potential space called as the peritoneal cavity. Abdominal viscera are either suspended in the peritoneal cavity by folds of peritoneum called as mesenteries or are outside the peritoneal cavity. Organs suspended in the cavity are referred to as intraperitoneal and organs outside the peritoneal cavity, with only one surface or part of one surface covered by peritoneum, are retroperitoneal. The peritoneal cavity is subdivided further into the greater sac and the omental bursa: the greater sac accounts for most of the space in the peritoneal cavity, beginning superiorly at the diaphragm and continuing inferiorly into the pelvic cavity-it is entered once the parietal peritoneum has been penetrated; the
Age/Sex Hemoglobin g/dL Hematocrit % At birth 17 52 Childhood 12 36 Adolescence 13 40 Adult man 16 (±2) 47 (±6) Adult woman (menstruating) 13 (±2) 40 (±6) Adult woman (postmenopausal) 14 (±2) 42 (±6) During pregnancy 12 (±2) 37 (±6)
Macule: A flat, colored lesion, <2 cm in diameter, not raised above the surface of the surrounding skin. Patch: A large (>2 cm) flat lesion with a color different from the surrounding skin. This differs from a macule only in size. Papule: A small, solid lesion, <0.5 cm in diameter, raised above the surface of the surrounding skin and hence palpable Nodule: A larger (0.5–5.0 cm), firm lesion raised above the surface of the surrounding skin. This differs from a papule only in size Tumor: A solid, raised growth >5 cm in diameter. Plaque: A large (>1 cm), flat-topped, raised lesion; edges may either be distinct (e.g., in psoriasis) or gradually blend with surrounding skin (e.g., in eczematous dermatitis). Vesicle: A small, fluid-filled lesion, <0.5 cm in diameter, raised above the plane of surrounding skin. Fluid is often visible, and the lesions are translucent Pustule: A vesicle filled with leukocytes. The presence of pustules does not necess