Skip to main content

Posts

Salmonella enterocolitis - food poisoning

It is a diarrheal disease and is commonly seen in cases of food poisoning. Pathogenesis: Man acquires this infection by ingesting contaminated water or food. Water is usually infected by feaces from an infected animal or human. Poultry and eggs also comprise an important source of salmonella. The organisms may be present on the outer shell or even in the yolk. The clinical syndromes that can occur in man includes gastroenteritis, enteric fever and septicaemia. In the case of enterocolitis, the salmonella bacilli attach themselves to the microvilli of the ileal mucosa by means of adhesins and then invade the cells. They cause massive efflux of fluids and electrolytes. Clinical presentaion: There is large volume watery diarrhea, fever, headache, chills, abdominal pain and tenesmus. In simple uncomplicated cases, the diarrhea will last for 3-7 days. Diagnosis is made by stool culture. The disease is self limited. Treatment consists only of correcting any fluid and electrolyte

I.V catheters - precautions

1. For adults requiring a peripheral catheter, upper extremity site is preferred. If it is for a child, then we can use both upper or lower extremities as well as scalp sites. 2. The catheter site should be evaluated everyday and if there is any sign of phlebitis, the catheter should be removed immediately. 3. For central catheters in adults, it is better to use the jugular or subclavian route rather than the femoral one. 4. Systemic antimicrobial prophylaxis is not essential when using I.V catheters.

Fatigue / stress fracture

It is a fracture that occurs not because of a single violent injury but results from repeated stress. It is commonly seen in athletes and new military or police force recruits. The pathology here is that the rate of microdamage from repeated stress exceeds the rate of repair. Thus there is accumulation of these microdamages and there is eventually a complete fracture across the full width of the bones. Majority of stress fractures occurs in the bones of the lower limbs, notably the metatarsals. Other sites may be the shaft of the tibia or the neck of femur.

Inferior wall and right ventricular infarct - ECG

ECG shows an inferior wall infarct i.e ST segment elevation in leads II, III and aVF. The precordial V leads are actually right sided on this ECG. This is evident because the tracing in V6 does not resemble lead I and aVL. Also the P waves in V4 to V6 are flat. ST depression in I and aVL along with ST elevation in right sided V3-V6 indicates right ventricular infarct.

Depression - cause, signs and symptoms

Depression is a mood disorder whereby mood is sad. About 30% of psychiatric cases deal with depression. Both males and females are affected but females are slightly more prone to be depressed. Cause: The biological cause is that there is a decrease in the serotonin neurotransmitter. Signs and symptoms: A simple mnemonic to remember is SIPS CAGE. 1) Sleep - There is late onset of sleep, intermittent awakening and early morning awakening i.e. around 2 hours before the normal waking up time. Rarely, the patient may over sleep. 2) Interest - Patient will have a decrease interest in the daily activities. This can result in social withdrawal, decreased ability to function in occupational and interpersonal areas. At times there is the inability to experience pleasure aka anhedonia . 3) Psychomotor activity - In younger patients, there is slowness in the thinking process and activities also are carried out at a slow pace. In elderly on the other hand, there is restlessness and inc

Effect of sleep on work

Sleep is an integral part of our lives. An average adult should sleep around 7-8 hours per day. Sleep is important to maintain metabolic-caloric balance, thermal regulation and even immune competence. Sleep is also essential for learning and memory consolidation as well as increasing one's concentration. An advice to students will be to sleep well after studying. Your learning sessions will not show any improved performance until you have a slow wave or slow wave plus REM sleep. Slow wave sleep refers to a deep sleep while REM sleep refers to the period in sleep whereby there is a characteristic movement of the eyeballs during the sleep. Medical interns and residents are known to burn the midnight oil. But unfortunately for them, working for more than 24 continual hours make them around 40% more prone to make medical errors. Residents are twice more likely to have attentional failure i.e. they forget what they are actually doing. Studies  have shown that 1 in 5 residents believ

Second degree atrioventricular block - ECG / Mobitz type I, type II

It consists of two types of blocks: 1) Mobitz type I block, 2) Mobitz type II block. Mobitz type I It is also called as Wenckebach pattern. In this condition, each stimulus from the atria appears to have more difficult time to pass through the AV junction. Finally one stimulus is not conducted through the defective AV node. A characteristic ECG shows progressive lengthening of the PR interval until a beat is dropped. i.e. the P wave is not followed by a QRS complex. It is also important to note that the PR interval after the dropped beat is always shorter than that before the non conducted P wave. Also the R-R interval encompassing the non conducted P wave is less than twice the preceding R-R interval. This ECG is also shows a Wenckebach pattern and we can clearly see at first glance that the narrow QRS complexes appear to be clustered and separated by a pause. This is called as group beating. If ever you find such a pattern, look out for the progressively increasing P