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Prognostic scores in alcoholic hepatitis

1. Maddrey (modified) Discriminant Function score of greater or equal to 32 indicates a high risk (30-50%) risk of mortality at 30 days. The risk is even higher is there are signs of hepatic encephalopathy. Scores should be repeated at day 7. 2. MELD stands for Model for End stage Liver Disease. It is used to estimate 90 days mortality. Poor prognosis if score is greater than 18. Score should be repeated at day 7.

Effect of weather on COPD

Exacerbations of COPD are more commonly seen during the winter season (nearly 1.6 times more frequently). The main cause of these exacerbations is infection with the respiratory virus, rhinovirus. Frequent exacerbations have been shown to lead to a faster decline in the lung function, poorer quality of life and increased mortality. A recent study showed that COPD exacerbations in colder periods of the year take longer to recover from and are more likely to involve cough or coryzal symptoms. The exacerbations in the cold seasons also have a greater impact on daily activity, with patients spending more time indoors and being more likely to be hospitalized with respiratory viral infection.

X ray spina bifida occulta

It is the case of a 16-yr old female who came to the emergency department with complaints of low back ache for the past week. She has had similar symptoms in the past but now the intensity is increasing. There is no associated numbness or weakness of extremities. She did not have any weight loss. There was neither urinary nor fecal incontinence. On examination she had an obvious limp. Lumbar spines: mild tenderness lower lumbar spines, no deformity, range of motion was normal, no stigma of spina bifida. Lower limbs length showed a discrepancy of 1.5cm being shorter by 1.5cm on the left side. Left ankle in inversion and with hyperlaxity while left ankle was stiff and with restricted inversion. X-ray of Lumbar Spines showed a spina bifida. Impression of Spina Bifida occulta was made.

Diabetes management during ramadan

Diabetes - 7 keys messages to the patients

1. Diabetes is self-managed. Caring for diabetes is more than just taking a daily pill or doing your insulin injection. It may feel like a burden but the decisions you make about physical activity, what and when you will eat will affect both how you feel today and your future health and well-being. 2. Take diabetes seriously. It is a multi-systemic disorder and indeed needs a lot of care. Since the symptoms and complications take time to appear you may think that it is a simple disease but it is not in reality!!! 3. Learn everything about the disease. Since most of diabetes care is  about self-care, the more you know about it, the better you will be able to manage it. You can control your diabetes rather than letting your diabetes control you. If possible, try to get updated with latest developments in the field and read to drive away myths about the disease. 4. Your treatment will change over time. Treatment of diabetes will eventually change over time. Changes in treatm

Mediterranean diet and cognitive decline

A Mediterranean diet is one which comprises of fresh vegetables, fruits, beans, whole grains, nuts, olives, and olive oil along with some cheese, yogurt, fish, poultry, eggs, and wine. A recent study has shown that this diet if adopted and followed leads to a slower decline in the cognitive function. The two main hypotheses are that it has a lot of anti-oxidants which prevent cell death in the brain and secondly it has a protective effect on the vasculature of the brain and thus prevents vascular dementia. Thus, the Mediterranean diet not only improve your looks and protects your cardiovascular system but also your brain cells benefit from it.

Highest prevalence of Diabetes Mellitus

Figures till November 2012 show that the top 5 countries with the highest prevalence of Diabetes Mellitus are from the pacific islands. They may be the smallest islands but the epidemic of diabetes is one of the worst there. More than a third of adults in some of these countries have diabetes and the combined toll of complications, deaths and loss of income make diabetes a real threat not just to the individuals experiencing the disease but also to the economies of the countries themselves. Above is an image showing the locations of the pacific islands.