Abnormal Resuls: we drained 7.5 LITRES out of his bladder

Helen:
5L frank pus!
Drained out of a walled-off ovarian abcess present for YEARS in an old lady...the scan looked malignant, the poor O+G reg was trying to carefully dissect this enormous thing out, when they accidentally nicked it and it essentially exploded with pus fountaning out of her abdomen. I know it was 5L because that's how many containers the suction drained into. We had a poor orderly sprinting down the corridor to find fresh containers after only 2 mins of suction.

Nadia:
I saw a guy in EAU and we drained 7.5 LITRES out of his bladder!!!! MENTAL.

Heather:
40 year old woman Hb 1.6 on admission, asymptomatic and then throughly worked up by the haematologists and the GI physicians.

Will:
Not really an abnormal test result, but most abnormal examination finding.
Motorcyclist involved in an RTA.
Discovered 3 bags of skunk tied to his penis with cotton thread.

Jill:
T cell leukaemia with neutropenic sepsis:
Initial WCC 351 on diagnosis.

Then got septic with:
Platelets 1 (post platelet transfusion!)
Total WCC 0.04
Neuts 0.00
Eosins 0.00
Lymph 0.02

Karen:
A 16 year old girl who came to A&E with the sniffles who we wanted to discharge but the nurses had taken blood from so we stuck her in CDU to await the results:

Hb 4.3
Plt 12
WCC 1.2
Neut 0
Eosin 0
Lymphs 1.2

Key Words:
abcess, bladder, Haemoglobin, skunk, Platelet Count, Lymphocyte Counts, Neutrophil Count, White blood cell count

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Abnormal results: TSH of >100 in a patient who was actually very well and is currently still alive

Madeline:
21 year old guy who had been pumping iron for a week and drinking protein shakes. CK of 748660! His presenting complaint was solely dark urine - scored a urology review in ED before being seen by the medics!

Kanaan:
Hb 1.8 in a 32 yr old lady with extensive psych hx ... believes blood is toxic, & therefore recurrently bleeds herself !

Emma:
I've seen patients who bleed themselves. From our point of view the biggest problem is they probably have red cell antibodies from the multiple transfusions they get when they reach Hb that low.

Bernadette:
Had a woman last weekend with COPD, usually runs sats 70-80% at home, noted 'very oxygen sensitive'. She came in with sats of 40%, PO2 4, PCO2 12.

After 12 hours on BiPAP PO2 7, PCO2 23 pH 7.0
After 36 hours on BiPAP PO2 8, PCO2 9, pH 7.4, sitting up and eating breakfast!

Cath:
TSH of >100 in a patient who was actually very well and is currently still alive.

Lactate of 17 in a patient who was very septic-went to itu but didnt survive

Na of 189 in a very very dry demented old lady who perked up with a lot of fluid!

Lisa:
I work in a lab, lowest Hb I've seen was 2.6, on a patient who WALKED to his GP because he was feeling breathless. Patient was both B12 and Folate deficient (MCV 130), he was admitted to A&E, then to ward for a four unit blood transfusion, within 2 hours of his test results being phoned to the GP - best bit, he complained that he only went to the GP because his wife nagged him and did he really need to come to hospital!

Lionel:
In one patient
Hb - 3.5
WCC - 0.1,
Neut 0,
Platelets 1,
Grand total 4.6!

Others (not in the same patient):
Na 97
K 9.9
Creat- around 3400ish

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A few Steps to Improve Eyesight Naturally

Natural eyesight improvement can be done in many ways which can be generalized into two categories. Specifically, they are internal and external methods.

I am going to share one technique of each category in this article which you can get in progress with right away.

Chrysanthemum tea has been recognized to be good for the eyes for a long time in China. It is often used to alleviate eye inflammation and improve eyesight as well.

If you can swallow three to four cups of chrysanthemum tea, you will not only take pleasure in refreshed eyes, but also find better eye vision. It is particularly good for those that are supposed to work all day extended in front of the computer monitor.

All that you need to stay in mind is that the lesser chrysanthemum buds are better than large and ripe flowers. And don't add other type of tea into it in order to bring it into full play.
Exercises of Eye Sight improvement:

The first exercise is the Dot exercise. To do this find a period or comma on the page and focus on creation it as clear as possible. Stare at the period until it comes into focus. Chances are after a few seconds the period will actually became less clear and blurry.

Try relaxing your eyes. Close them for a minute and let them relax. Now look at the period without straining. Don’t stare; instead, let your eyes gradually move approximately the page, over and around the period. Don’t focus only on the period, the eyes need movement. Make sure to blink a bit. Try closing your eyes and picturing the dot and then look at it again. Once the eyes are relaxed it should be easier to see the period.

Treatment of Eye Sight improvement:
While most people believe that the only cataract treatment is surgery. Well, that is what we are going to explore in this article, some natural ways that you can get your cataract treated. Firstly though, you will need to appreciate exactly what cataract is so that you know precisely how you can treat it.
Simple Steps Everyday Eye Sight improvement:
Cataract is actually a disease and most of the time, it is found in elderly people or even in people that are over forty years old. Some of the most ordinary signs that you may have waterfall is that that you will knowledge blurry, hazy or even cloudy vision. These are just some of the common symptoms that you might experience.

Get up near the beginning in the morning to depiction your eyes to the early sunlight and look at the rays for a while ( This process should only be perform in the morning, for the sunshine then is mild and does not hurt somebody's feelings to the eye. ) and then close your eyes slowly.

This procedure should be performed for 10 to 15 minutes. This is the first and also vital step to assurance the development of eyesight, known as eye sun bath.

Prepare a cup of cold water and then be relevant it on your eyes and open and close the eye the eyelids 50 times. If you think it essential, you can replace another cup of cool water and repeat the similar action above.

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Community Medicine OSPE 2010 - Part 1

Community Medicine OSPE 1

1.Cobra bite,management.
2.Strength of sewage
lung cncer ki heatlh eductin,
3.rabies vacintn for pre exposure,
4. kawashkor nd its prventn,
5.PNMR numerical,
6.pie chart wat type of data is it?nd find the degres for 35%
7.primary heatlh cre, dhq facilities
8.popltn pyramid

Community Medicine OSPE 2

1 dengue fever(identify vector mode of transmisin)
2 Snake cobra its treatmnt
3 Fruit pic 2 vit its deseases
4 Iceberg disease
5 Shannon weaver model message properties
6 septic tank(2 characteristic nd 2 uses)
7NMR
8GFR
9 oral contacptvz advntge disadvantage
10 measlz vacine dose route complictn

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What are the positives and negatives of Energy drinks?

Within the past several years, many controversy has sparked regarding whether energy drinks help make good workout drinks, in addition to whether or not the so called athletics beverages really do the job. In this post, we can attempt to create a good look at each - drinks - and weigh out the positives and negatives of every drink type.

Athletics beverages, also known as rehydration drinks, are usually drinks that includes carbs and salts in order to substitute all those lost in sweat in the course of workout. Their effectiveness is situated within the truth that the perfect beverage of carbohydrate, potassium, salt and sweets, and also electrolytes (electrically charged components which relieve hydration in the body) rehydrate the human body throughout exercising, much better than water does. There are actually 3 different types of rehydration drinks: Isotonic Fluid, Hypotonic Fluid, Hypertonic Fluid plus they vary only within the portions of carbohydrate, electrolytes and salts in them. These types of refreshments are mainly consumed throughout physical activities or maybe quickly before them.

Energy drinks are usually consist of excessive degrees of caffeine and offer a good power boost, although, as caffeine (and additional stimulants based on it, e. g. guarana on yerba mate) serves to be a diuretic, dehydrating the human body, certainly are a zero opt for workout. Energy drinks may not be exercise beverages - caffeine isn't just addictive; in addition , it dehydrates the human body, but even moderate dehydration (e. g. 1-2%) drastically cuts down complete muscle capacity of the body, therefore doing your own workout much less helpful.

Additionally , they consist of several nutritional vitamin supplements which might be thought to be able to lower the response time of the human brain. Caffeine typically sets within immediately after 2 to 3 hours, therefore energy drinks are (if at all) consumed an hour or two prior to a exercising. Caffeine serves like a stimulant and briefly improves your abilities--but do you really need that for workouts?

It is harmless to talk about that sports drinks are usually much better with regard to workout compared to energy drinks, simply because physical activities beverages are usually lighter to the entire body; they have restorative capabilities; sports drinks operate greater on your well-being. Even though one may dispute that an beverage enhance can improve the athlete's performance in competitions, there is certainly minor use to using energy drinks in sports that demand a lot of energy, including that stimulants are prohibited from use in public tournaments. Aside from that, using drinks throughout extended activities such as running a marathon is usually plain unsafe because the dehydration involved. Energy drinks, on the other hand, will be for no reason 'bad' - these are merely designed to be applied during all-nighters and celebrations, not the fitness center.

Key Words:
athletics beverages, rehydration drinks, Isotonic Fluid, Hypotonic Fluid, Hypertonic Fluid, energy drinks, workout, marathon, stimulants

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How to stay healthy as you get older

Every decade of our lives brings with it new discoveries and new experiences. For example when we are teenagers we may feel nervous about leaving school and finding a career to embark upon. When we are in our twenties and thirties it might be meeting someone and starting a family that occupies our mind. When we reach our fifties our thoughts then turn to retiring. As you can see, every decade we live through brings new things to think about.

But the one thing you hope will always remain the same as you get older is your health. No one wants to be ill and luckily we can do a lot to give ourselves the best possible chance of staying healthy for as long as possible.

The way we approach this might differ depending on how old we are however. For example if you decide to start getting some regular exercise you might think about going jogging or cycling for long distances if you are young and fit anyway. Needless to say if you are in your middle age or you have just retired, jogging for miles may not appeal to you in quite the same way it might have done twenty or thirty years ago!

To a certain extent staying healthy means being sensible about what you do – and about what you don't do. Gentle exercise might be recommended for the elderly for example, but something more active might be better for people who are still only in their thirties. In any event suddenly deciding to become far more active than you are used to is not usually a good idea. It is always better to work up gradually and get used to the renewed amount of exercise you are getting.

Another good point to think about is the need to constantly keep an eye on your own body and how you feel. If you are familiar with how you normally feel you will be better able to spot any changes and seek advice about them at an early stage. This could really relate to anything at all about your body and well being.

Sometimes you might be able to figure out what a problem is without having to seek advice of any kind. For example, if you get too used to drinking cups of coffee all the time, you could end up with regular headaches. In this example the simple process of cutting back should get rid of them.

Regular checks of all kinds can help us stay healthy in lots of different ways. Whether it is a breast check, a look at your skin for potential abnormalities or anything else, you can see that keeping an eye on your health can help you stay healthy for a long time to come.

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Common causes, Symptoms and treatment of Allergic Rhinitis

Inflammation of the nasal membranes is defined as Rhinitis. Allergic Rhinitis is also known as allergy and hey fever. Allergic Rhinitis is characterized by a number of symptom like sneezing, nasal itching, nasal congestion and rhinorrhea. Other symptoms of Allergic Rhinitis may also include ears, eye, throat and sinus. It is not a life-threatening condition. This disease occurs when the immune system overreacts to the particles present in the air and you breath that air. The particles present in the body is attacked by the immune system to prevent you from symptoms like sneezing and runny nose.

Causes of Allergic Rhinitis:

Any substance needed to trigger an allergy is known as an allergen. The body releases chemicals like histamine when a person with allergic rhinitis breathes in an allergen like pollen or dust which further causes symptoms like mucus production, itching and swelling. Hey fever is also the main causes of Allergic Rhinitis which occurs due to an allergic reaction to pollen. Hay fever vary from person to person region to region that occur due to pollens. There are some plants that are responsible for hay fever. These plants are deciduous and evergreen trees, grasses and Ragweed

Symptoms of Allergic Rhinitis:

There are list of symptoms that affect you very shortly when you come in contact with the substance you are allergic to, the symptoms include itchy nose, itchy mouth, itchy eyes, itchy throat, itchy skin, smell problem, runny nose, sneezing and tearing eyes. There are some other symptoms that may affect you later, the symptoms include stuffy nose, nasal congestion, coughing, clotted ears, decreases sense of smell, sore throat, dark circle under the eyes, puffiness under the eye, fatigue, irritability, headache, slow thinking and memory problem.

Treatment for Allergic Rhinitis:

Allergic Rhinitis is very common in the people now a days. The type of Allergic Rhinitis is not common to all the people and it also vary from person to person and from reason to reason. There are various medicine available in the medical store for the treatment of Allergic Rhinitis.

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Skin care: 4 simple steps to have beautiful desired skin

Unfortunately there are only a few people who are blessed with great skin by nature from birth, but most people aren't so lucky for their skin to preserve its health and smooth appearance whatever they do. For instance, for some people is enough to eat one piece of chocolate and their face is like a volcano or others are sensitive to sun light and their skin starts to peel. Therefore, we need to use face skin care products in order to protect our skin from free radicals and negative external factors, preserve its natural beauty and keep it young. Avoiding dull and sagging skin is possible, if you are motivated and make some efforts in order to improve the appearance of your skin. Problematic and sensitive skin requires more attention the normal skin, but if you follow a simple but effective series of rules you will obtain the beautiful desired skin.

First of all, you need to follow a daily face skin care routine by using products according to your skin type. The first and most important step is cleansing your face, and this involved more than washing it with water. You should remove any dirt and dust from the surface by applying a face cleanser appropriate to your skin type, then wipe it off with a cotton pad and use a face wash lotion to wash your face. Never use soap to wash your face as it will dry your skin. This face wash lotion must be applied in circular motions on face and neck, starting from the bottom and then washed off. The next stem is toning, as your pores are opened and you need to close them in order to avoid dust entering your pores and causing acne. For this step you should use a toner (an astringent lotion) that you apply on the entire face with the help of a cotton pad.

The first two steps will eliminate the oil excess while taking away the natural moisture of your skin. Therefore, you need to apply a good moisturizing face skin cream and massage it for the skin to absorb it faster.

In addition, at least once a week it is recommended to use scrubbing lotions in order to remove dead skin cells from the surface and leave the skin smoother and clear. Facial masks are also good for your skin and they should be applied once a week in order to improve its appearance. Getting a facial massage at a specialized salon will help your skin relax and regain its youth by rejuvenating the facial muscles, so you should take some time to do this once in a while.

Finally, it is very important to use sunscreen in order to keep your skin safe from UVA and UVB negative effects. Sun protection lotions prevent premature aging of your skin, peeling and the appearance of dark spots. Furthermore, your diet is also an influential factor over your skin's health as it directly affects your entire organism. Therefore, it is very important to eat healthy food and drink a lot of water in order to have beautiful and radiant skin.

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Most Abnormal medical Test Results: Once drained 42 litres off poor man looked 12 months pregnant

Lauren Young:
'I don't feel very well'
ALT 22876!!!!!
'Oh yes, I forgot, I did take 140 paracetamol tablets 3 days ago'

Patient was transferred to liver transplant centre, don't know the outcome.

Priscilla Ng:
Patient with prostate cancer and constipation x 10 days, c/o urinary retention, catheterised, 4.2 litres!!! (creatinine was only 286 amazingly)

Rebecca Croke:
Once saw a lady with psychogenic polydipsia with Na 99 who survived..
Also saw DKA with pH 6.7, bicarb 1.4 and co2 8! also survived!

Amanda Brooks Was Caluori:
Once drained 42 litres off poor man looked 12 months pregnant.

Karen Faulkner:
Not an abnormal result, but by far the most impressive patient. We have a frequent attender, where he turns up drunk, falls asleep, wakes up again and leaves. New Years Eve he was brought in by police unrespnsive. GCS 9. Was sedated, intubated and ventilated. After a few hours his sedation was turned off and his blood alcohol level was taken - 800mg/ml!!! He was off sedation for 8hours before he started to gag on his tube!!! I'd love to know what his blood alcohol level was when he first came in!?!?!

Emma Chambers:
I've seen our full blood count analysers give neut count 0. I then had to confirm this by blood film, and I didn't find a sinlgle neutrophil.

Have also seen haemoglobins of 2-3 (the story of the sickler with Hb 0.5 is pretty scary!). We have a regular patient who blood lets into coke cans and will only accept transfusions of the volume she knows she has lost. She generally has 2 units every 6 weeks or so, and lives with a haemoglobin of about 4-5.

We had a new ITP over Christmas who actually had no platelets at all. I spent a long time looking at that blood film in the hope I might find one somewhere!

Helen Steele:
HbA1c: 20.2
Total cholesterol: 12

In a 15yo type 1 diabetic with "Mauriac" sydrome of acute fatty liver related to poor sugar control. Her liver edge was in her RIF and as such was missed on initial physical exam. An ARX showed complete white-out due to the liver.

Also 3 weeks later her HbA1c reduced to 11. According to everyone this is physically impossible, but we checked it twice!


Key Words:
paracetamol, prostate cancer and constipation, GCS, blood alcohol level, haemoglobin, HbA1c

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Anxiety symptoms, signs, causes and natural Remedies

Anxiety is a condition which is surrounded by unpleasant physical and emotional state. In this condition any person may experience fear, worry or apprehension. Anxiety may be of short period or long period. The problem of short term anxiety is solved as soon as the particular job for which anxiety is caused is finished and the person feels relaxed. Whereas the long term anxiety continue for longer time period. It is caused due to work stress or other reasons like this and may result into other medical problems like high blood pressure, tension and migraine headache.

Some major causes of anxiety are intake of caffeine, diet pills, hypoglycemia, anemia, heart disorders, stress and hyperthyroidism.

Anxiety is a very common problem and it is experienced usually by each and every person in their life. Major symptoms of anxiety are nausea, chest pain, tension, headache, shortness of breath and heart palpitations. Some common symptoms of anxiety are given below -

1. Breathing deeper or faster than needed
2. Sweating
3. Dry mouth
4. Stomach churning or a jittery feeling in the pit of stomach
5. Fainting spells
6. Muscle tension
7. Inability to concentrate
8. A feeling of impending doom
9. Dizziness
10. Heart palpitations
11. Unexplained weakness
12. Constant headache

The major cause of anxiety is stress which is caused when a person is incapable of performing any job against its demand. To prevent anxiety you have to improve your coping skills, manage the demands and all the expectations in life. Some people change their life style to keep anxiety at bay. Some natural remedies are there to reduce anxiety from our life.

1. To keep anxiety away from our life you must avoid junk foods and drinks. To get rid from anxiety it is necessary to avoid carbohydrates and refined sugar, caffeine, artificial sweeteners, smoking and the other things similar to these things.

2. Anxiety is also reduced by doing meditation and by deep breathing. You must consult some yoga expert to learn the basic technique of deep breathing. You can also try with yourself by inhaling for longer then hold the breath for few seconds and then exhale it. To soothe nerves meditation is very fruitful.

3. To avoid the attacks of anxiety you must stay active by doing exercise. Extra adrenaline which results into anxiety is burned by doing exercise so you must walk, jog, cycle or by using treadmill for at least half an hour in a day.

4. You must be of positive attitude. To get rid from anxiety you must talk to people with positive attitude, listen to the music and all the other work which relax your mind.

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Top 5 reasons for Insomnia are depression, anxiety, chronic stress, bipolar disorder and post-traumatic stress disorder

Top 5 reasons for not sleeping well at night are depression, anxiety, chronic stress, bipolar disorder and post-traumatic stress disorder.

We don't usually need to think very much about sleep. It's just a part of life's routine. Even so, most of us sometimes find that we can't sleep properly. We call it insomnia. It's usually just for a short time, perhaps when we're worried or excited. When things settle down, we start sleeping properly again. If you can't sleep properly, it can be a real problem - we need sleep to keep healthy.

Emotional issues such as stress, anxiety, and depression cause half of all insomnia cases. But your daytime habits, sleep routine, and physical health may also play a role.

Sometimes, insomnia only lasts a few days and goes away on its own, especially when the insomnia is tied to an obvious temporary cause, such as stress over an upcoming presentation, a painful breakup, or jet lag. Other times, insomnia is stubbornly persistent.

Most people suffering from an anxiety disorder or depression have trouble sleeping. What's more, the sleep deprivation can make the symptoms of anxiety or depression worse. If your insomnia is caused by anxiety or depression, treating the underlying psychological issue is the key to the cure.

For women, there are some additional factors that can cause them to get less sleep, or have more disturbed sleep. Hormones play a huge role in sleep and women are affected by both the hormones produced during their monthly menstruation cycle and the decreased estrogen during menopause.

Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia.

Maybe you've never made the connection between your late-night TV viewing or Internet surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.

All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur during the day.

Do you lie awake at night with a sickening feeling of dread, worrying about "what ifs" and worst-case scenarios?

Constant worrying takes a heavy toll. It keeps you up at night and makes you tense and edgy during the day. The good news is that chronic worrying is a mental habit you can learn how to break.

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Most Abnormal Medical Tests Results: I drained 1600 mls after which he said he felt a lot better

Graham N. de Bever:
First catheter I put in (as a 4th year medical student) - old guy with BPH (benign prostatic hypertrophy) - I drained 1600 mls after which he said he felt a lot better and would say a special prayer for me in church! Never felt better myself!

Laura Power:
I've drained 3 litres of a female once, she had a mass in her uterus and hadn't peed for about a week.

Michelle Clarke:
19 yo female presented Wednesday with acute urinary retention & pelvic pain. Was in agony , waited 1.5 hours before being seen. At which time we drained 885mls!!!!

Richie Chan:
Hb 1.6 from a patient with haemorrhoid, no anaemic symptom at all, just complained of PRB, subsequent endoscopy revealed no other bleeding source!

Lee Ming:
PSA of over nine thousand. The cancer actually grew forward into the rectum and obstructed it.

Suzanne MacDonald;
Most grateful patient ever, elderly chap in retention - 1750mls. Once drained 600mls off a three-year old too.
Tim Clay:
Doing haematology. New diagnosis of CML in a young adult presenting to ophthalmology outpatients with visual disturbance
WCC 486.27 x10^9/L (normal 4 - 11)

Key Words:
medical student, catheter, benign prostatic hypertrophy, uterus, haemorrhoids

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Five Most common Myths about hair loss

Hair loss can get embarrassing. Most people are also equally embarrassed to go ask a doctor for help; that is why some people resort to sticking to hair loss myths. The problem is that, it is easier to deal with baldness at its earlier stage. And we aren't just talking about how it's going to save you from all the usual teasing at an earlier time.

The thing is, hair loss might be an indication of an underlying medical condition or vitamin deficiency – and we all know how people say its better to take care of health-related issues at its earlier stage. Some of the most common hair loss myths are the following:

Poor Blood Circulation . . .

You might have heard of some people who pour wine on their heads, believing this will dilate the blood vessels on the scalp. The thing is hair loss is not caused by poor blood flow; if it were, transplants wouldn't have worked. Hair loss is about your follicles not receiving nutrients. So don't do that headstand the next time someone tells you to stand on your head because it gets blood to flow to your scalp better.

Only Men Get Pattern Baldness . . .

Well, it does look like men are almost always the ones hit by pattern baldness problems. The thing is, females suffer from pattern baldness too although it doesn't appear in the famous M-shape and that it isn't as extreme. So, it is easier to hide.

Cut Hair to Make it Thicker . . .

Cutting hair will never make your hair grow thicker, although it will certainly make it look thicker. You have probably noticed that hair is thicker near the roots, so if it's really short, it might look thick. Hair density is about hair follicles so no matter how much hair cutting you do, new follicles will not appear. On the other hand, habitual hair pulling, also known as Trichotillosis, not only will cause temporary hair loss; it might also cause scalp trauma resulting to hair not growing for an extended period.

Less Sex Means Hair fall . . .

Contrary to popular belief, you aren't likely to lose hair because of ejaculation. While it is true that the male hormone testosterone is responsible for the by-product called DHT that suppresses hair growth, recent studies haven't established anything that can link sexual intercourse to hair loss, or to getting hair to grow.

Too Much Styling . . .

A perm, or frequent ironing of hair, as well as using hair products aren't likely to cause the hair loss that we have in mind. Well, frequent styling and the use of chemicals will probably cause hair fall due to breakage, but it can be counter-treated with products that can protect your hair. Another thing is that as long as the chemicals do not affect your follicles, which should be the case, your hair should grow back.

Acknowledging that you have a hair loss problem is the first step. The next is finding out about your treatment options – the real ones. You need to be accurately diagnosed for you to know what the right options are, and to find out whether your hair loss is caused by an underlying medical condition. Do not try diagnosing yourself. Consulting a professional might mean more hassle and a little more money, but when your health, physical and mental is the one at stake, you just can't be too careful.

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Signs, Symptoms and common causes of Miscarriage

A miscarriage (also termed spontaneous abortion) is any pregnancy that spontaneously ends before the fetus can survive. Any vaginal bleeding, other than spotting, during early pregnancy is considered a threatened miscarriage. Vaginal bleeding is very common in early pregnancy. About one out of every four pregnant women has some bleeding during the first few months. About half of these women stop bleeding and complete a normal pregnancy.

Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG). Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage. Chemical pregnancies may account for 50-75% of all miscarriages. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of her expected period. The woman may not realize that she conceived when she experiences a chemical pregnancy.

Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. Miscarriage is the most common complication of early pregnancy. The medical term "spontaneous abortion" is used in reference to miscarriages because the medical term "abortion" refers to any terminated pregnancy, deliberately induced or spontaneous, although in common parlance it refers specifically to active termination of pregnancy.

Some miscarriages occur before women recognize that they are pregnant. About 15% of fertilized eggs are lost before the egg even has a chance to implant (embed itself) in the wall of the uterus. A woman would not generally identify this type of miscarriage. Another 15% of conceptions are lost before eight weeks' gestation. Once fetal heart function is detected in a given pregnancy, the chance of miscarriage is less than 5%.

Signs and Symptoms of Miscarriage;

The signs of a miscarriage are the onset of bleeding, usually with abdominal cramps (like a period) in a woman who's pregnant - although in early miscarriage she may not yet be aware she's pregnant.

Bleeding may be only slight spotting, or it can be quite severe. Your health care provider will ask about how much you have bled—usually the number of pads you've soaked through. You will also be asked about blood clots or whether you saw any tissue.

Inevitable Miscarriage:

This is the occurrence of severe vaginal bleeding and/or cramps in a pregnant woman, indicating that no medical treatment can avert a miscarriage. At this point, the amniotic membranes have ruptured, the cervix is dilated, and the membranes, fetus and placenta are on their way to being expelled. The woman's clinician should be contacted immediately, and hospitalization may be necessary.

Pain:
You may have pelvic cramps, abdominal pain, or a persistent, dull ache in your lower back. Pain may start a few hours to several days after bleeding has begun.

Abdominal cramping, genitals, thighs, buttocks and lower back pain are the signs of miscarriage that usually occur soon after the vaginal bleeding commences. Unusual pain in the pelvic region is another miscarriage symptom.

Some women experience cramping, spotting, abdominal pain, fever, weakness, vomiting, or back pain. Spotting is not always a sign of a miscarriage; many women normally experience it early on in pregnancy. But just to be safe, if you have spotting or any of these other symptoms anytime during your pregnancy, it's a good idea to talk with your doctor.

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Follow these guidelines for Better Health

Get the Screenings You Need:

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Screenings are tests that look for diseases before you have symptoms. Blood pressure checks and mammograms are examples of screenings. You can get some screenings, such as blood pressure readings, in your doctor’ s office. Others, such as mammograms, need special equipment, so you may need to go to a different office. After a screening test, ask when you will see the results and who to talk to about them.

• Breast Cancer. Ask your health care team whether a mammogram is right for you based on your age, family history, overall health, and personal concerns.
  

• Cervical Cancer. Have a Pap smear every 1 to 3 years if you are 21 to 65 years old and have been sexually active. If you are older than 65 and recent Pap smears were normal, you do not need a Pap smear. If you have had a hysterectomy for a reason other than cancer, you do not need a Pap smear.
  

• Chlamydia and Other Sexually Transmitted Diseases. Sexually transmitted diseases can make it hard to get pregnant, may affect your baby, and can cause other health problems. Have a screening test for Chlamydia if you are 24 or younger and sexually active. If you are older than 24, talk to your health care team about being screened for Chlamydia. Ask your doctor or nurse whether you should be screened for other sexually transmitted diseases.

• Colorectal Cancer. Have a screening test for colorectal cancer starting at age 50. If you have a family history of colorectal cancer, you may need to be screened earlier. Several different tests can detect this cancer. Your health care team can help you decide which is best for you.
  

• Depression. Your emotional health is as important as your physical health. Talk to your health care team about being screened for depression, especially if during the last 2 weeks: You have felt down, sad, or hopeless. You have felt little interest or pleasure in doing things.
  

• Diabetes. Get screened for diabetes if your blood pressure is higher than 135/80 or if you take medication for high blood pressure. Diabetes (high blood sugar) can cause problems with your heart, brain, eyes, feet, kidneys, nerves, and other body parts.

• High Blood Pressure. Starting at age 18, have your blood pressure checked at least every 2 years. High blood pressure is 140/90 or higher. High blood pressure can cause stroke, heart attack, kidney and eye problems, and heart failure.

• High Cholesterol. Starting at age 20, have your cholesterol checked regularly if:
  

1. You use tobacco.
2. You are obese.
3. You have diabetes or high blood pressure.
4. You have a personal history of heart disease or blocked arteries.
5. A man in your family had a heart attack before age 50 or a woman, before age 60.
   

• HIV. Talk with your health care team about HIV screening if any of these apply to you:
  

1. You have had unprotected sex with multiple partners.
2. You have injected drugs.
3. You exchange sex for money or drugs or have sex partners who do.
4. You have or had a sex partner who is HIV-infected, bisexual, or injects drugs.
5. You are being treated for a sexually transmitted disease.
6. You had a blood transfusion between 1978 and 1985.
7. You have any other concerns.Osteoporosis (Bone Thinning). Have a screening test at age 65 to make sure your bones are strong. If you are younger than 65, talk to your health care team about whether you should be tested.
   

• Overweight and Obesity. The best way to learn if you are overweight or obese is to find your body mass index (BMI). You can find your BMI by entering your height and weight into a BMI calculator. A BMI between 18.5 and 25 indicates a normal weight. Persons with a BMI of 30 or higher may be obese. If you are obese, talk to your doctor or nurse about seeking intensive counseling and help with changing your behaviors to lose weight. Overweight and obesity can lead to diabetes and cardiovascular disease.

Preventive Medicines:

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If you have any of these risk factors take these preventive medicines If You Need Them

• Aspirin. If you are 55 or older, ask your health care team if you should take aspirin to prevent strokes.
  

• Breast Cancer Drugs. If your mother, sister, or daughter has had breast cancer, talk to your doctor about whether you should take medicines to prevent breast cancer.
  

Estrogen for Menopause (Hormone Replacement Therapy). Do not use estrogen to prevent heart disease or other diseases. If you need relief from symptoms of menopause, talk with your health care team.

• Immunizations.

1. Get a flu shot every year.
2. If you are 65 or older, get a pneumonia shot.
3. Depending on health problems, you may need a pneumonia shot at a younger age or need shots to prevent diseases like whooping cough or shingles. Talk with your health care team about whether you need vaccinations. You can also find which ones you need by going to.
   

Take Steps to Good Health:

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Be physically active and make healthy food choices. Get to a healthy weight and stay there. Balance the calories you take in from food and drink with the calories you burn off by your activities.

• Be tobacco free.
  

• If you drink alcohol, have no more than one drink per day. A standard drink is one 12-ounce bottle of beer or wine cooler, one 5- ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.

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Information on Fatigue causes, Symptoms and natural treatment

Whatever is causing your fatigue the number one best way to cure your symptoms is to rest. Physical and mental fatigue can be relieved through physical rest and relaxation. This gives your body and mind time to recuperate from the strain, tiredness, weariness, and exhaustion that it is going through. Although, resting is your first choice for treating and curing fatigue, the time is not always available, especially in today's busy lifestyle. Therefore, there are some additional home remedies that are quick, inexpensive and you are able to do them at home to relieve your fatigue.

Although, overworking and stress most often causes fatigue, it can also be caused by a poor diet, lack of exercise, and dehydration. When it comes to this type of fatigue the answer is simple, change your diet and lifestyle. A well balanced diet filled with fruits and vegetables, protein and complex carbohydrates fuels the body and brain to work efficiently throughout the day. Diets that are low carb or low protein can both cause the body to fatigue because you are eliminating one of the essential nutrients that the body requires to function. Plus a well balanced diet provides vitamins, minerals, amino acids and antioxidants, which boost immunity, energy and metabolism.

Part of your daily diet includes not just what you eat but when you eat as well. Breakfast is the most important meal of the day. The name breakfast literally describes the action that occurs in the body after eating, it breaks the fast that occurs during the night while you are sleeping. As you sleep the body your body fasts, however it still uses stored energy to maintain essential body functions such as breathing, heart rate, and rapid eye movement. When you wake up, your body requires fuel. If you skip breakfast, your body continues to fast. Metabolism slows to conserve energy and you become tired and fatigued because your body and brain don't have sufficient fuel to function. That is why breakfast is so essential to replenishing the body's fuel, boosting metabolism, and increasing energy.

Iron deficiency anemia is another cause of fatigue. To remedy this situation, consuming appropriate amounts of iron is required. Iron is needed in the body to help form hemoglobin, a part of red blood cells. Hemoglobin helps to transport oxygen throughout the body; therefore a lack of iron decreases the ability to carry oxygen in the body. Without sufficient oxygen fatigue sets in relatively quickly. Iron rich foods such as lean read meat, seafood, beans, leafy green vegetables, egg yolks, dried fruits, liver, artichokes and iron enriched cereals should be consumed on a regular basis. However, if you are still having difficulty maintaining appropriate amounts of iron in your body, a doctor can recommend an iron supplement. Consult a physician
before starting any nutritional supplement regiment to verify dosing and contraindications.

One way to increase the absorption of iron in the body is to consume it with vitamin C. Vitamin C is an essential vitamin that helps to stave off infections and build strong bones and muscles. Vitamin C can help to boost energy, decrease fatigue and enhances the absorption of iron, which helps to circulate oxygen within the body. Vitamin C can be found in many fruits and vegetables as well as some meats and milks.

While consuming the right foods is vital to ones nutrition, consuming the right liquids just as important. Our bodies are made up of 70% water and each day we deplete our water supply through respiration, expiration and perspiration. If these supplies are not replenished it causes dehydration, which causes the symptoms of fatigue, weakness, and mental incoherence. Drinking water daily is necessary to continuously replenish our body's water supply. Although it is recommended to drink 8, 8 ounce glasses of water a day, they say if you feel thirsty then you are already slightly dehydrated. That's why consistently drinking water throughout the day and keeping a bottle of water with you wherever you go will keep your body hydrated.

Additionally, when you are feeling fatigued drinking a cold glass of water can boost your metabolism and increase your energy. When you consume cold water the body has to warm up the water before it can be used at the cellular level. To warm the water the body increases its metabolism, which boosts energy and decreases symptoms of fatigue.

Exercise is an important part of maintaining weight, strength, balance, muscle and mobility. When there is a lack of exercise the muscles lose their strength making it harder for the body to hold itself up. Ultimately, normal activities such as walking, climbing stairs, etc. become more difficult, causing you to become fatigued very easily. Additionally, as you put on more weight (due to inactivity) it will be harder to be mobile. Therefore, physical activity is an essential aspect of maintaining a healthy lifestyle. Even if you are not looking to lose weight or gain muscle, exercise will maintain and increase the strength, agility, and mobility that you already have. So, the next time you are feeling fatigued or a little run down take a walk, do some gardening, play a sport or do some house cleaning. Physical activity doesn't have to mean going to the gym or working out on a machine for hours and hours at a time. It means 20-30 minutes of activity where you are actively engaging your body with motion an your heart rate and breathing increases. You will be pleasantly surprised by the boost to your energy.

Stretching is another great way to increase your energy, reduce symptoms of fatigue and increase mobility. Stretching is a great exercise that can be done anywhere. Stretching should be done everyday, however most people forget to do it. When feeling fatigued a quick stretch can activate energy stores that boosts energy and eliminates feelings of weariness.

If all else fails and you are looking for a quick energy boost, caffeine will do the trick. A cup of coffee, tea or a piece of dark chocolate stimulates adrenaline production which boosts ones energy, increases alertness and enhances your mood. Using caffeinated beverages or foods to reduce fatigue is all right every so often however, should not be used repeatedly day after day. This can cause your body to become dependent upon these products to boost ones energy and can have several side effects when not consumed.

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A few of the stupidest excuses men and women use to avoid exercise

When it comes to getting back in great shape, people get very imaginative when they attempt to come up with reasons not to do it. The simple truth is that, while we are still getting in condition, exercising just isn't fun; working out is hard work. Getting in better shape doesn't necessarily feel good, despite the endorphin rush many of us go through afterwards. Even with those endorphins performing exercises causes our joints and muscles to feel discomfort, tires us out and causes us to kind of hate our bodies for a while. No wonder we are so adept at identifying other things to do with our spare time! Listed here are a few of the stupidest excuses men and women use when they do not want to exercise.

How frequently have you convinced yourself "I'd love to improve my overal fitness levels but I do not have time"? This really is probably the utter worst justification to make when you do not want to exercise. In reality it is very easy to find time to do exercises because you can do it while you do other stuff. To give an example: it is possible to take the staircase as opposed to the elevator at the job. You can pack a healthy lunch and go for a walk on your lunch time break instead of just hitting a drive through. You can go walking around your working environment or do smaller sized exercises while you are on conference calls. In the evening hours, it is possible to get in an exercise session when you are watching your favorite tv show. Without a doubt there is time to do the exercise, you only need to really find it.

How frequently do you tell yourself that "you will workout later, when you can actually afford some great equipment systems or even a fitness center membership". Thats just useless and avoidance type of behavior. You don't require any pricey fitness equipment or a gym member's program to get fit. You can exercise at your home using online videos or that you've loaned from the library. You can follow workout routines you come across in magazines. You don't require anything more than your body plus some space to move to get into superior shape.

Do you think to yourself "I want to get in shape but working out makes me feel stiff, sore, and worn out"? Don't do that ever again. The truth is when you start out, your regular workout will make you fatigued and uncomfortable. As you become stronger, exercising should get easier. Ease into it so that you certainly won't feel like you're dying every time you exercise and work to build up endurance and strength levels. After you build these things up to a decent level, you'll start getting endorphin rushes. Never hurry it: ultimately they will happen for you and then you will certainly see that performing exercises can be extremely enjoyable.

There's a lot of justifications not to exercise from not having the perfect exercise clothes to not having enough time. You need to be thankful to learn that getting fit can be worked into your way of life regardless of what you may be wearing, the quantity of free time you will have (or don't as the case may very well be) and what sort of exercise products you already own.

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Anatomy of sinuses: What causes sinusitis and possible treatment

It may not seem much like it, but sinus infections are fast becoming one of the medical conditions that consume a lot of financial resources for treatment.

Consider the following information:
In the United States, the incidence of sinus infections has increased 18% over the last decade. This translates to nearly 40 million Americans who have experienced a sinus infection. The cost of sinusitis includes surgery; hospital confinement; antibiotics and other medications; physician visits and of course, the missed days at work because of the physical discomforts and pains associated with it.

The Sinus Profile:
With all the expenses and discomforts a sinus infection can give you, don't you think it makes some sense to get to know these air-filled cavities and what prompts them to go mayhem? So get a dose of this:

The sinuses, or sinus cavities, are air-filled cavities in the skull that surround the eye sockets. Among humans, there are four pairs. Each pair bears a unique name and has a different location. The maxillary sinuses are in the cheek area below the eyes, while the ethmoid sinuses lie between the eyes. The sinuses above the eyes are called frontal sinuses and finally, the sphenoid sinuses are located behind the eyes.

These sinuses communicate with the nose through small openings known as ostia (singular form: ostium) and are ventilated with each breath. The openings from the sinuses into the nose are quite small, ranging in size from one to five millimeters. Everyday, the nose and sinuses produce about two quarts of mucus, which is a clear, slippery liquid that functions to trap debris and bacteria; as well as to prevent the sinus and nasal linings from drying out. Under normal conditions, mucus doesn't remain stagnant within the cavities. It is cleared from the sinuses and moved towards the opening or the back of the nose by the action of cilia, which are fine, hair-like projections found on the surface of the cells that make up the sinus lining.

What Goes Wrong:

Sinus infection usually begins when an inflammatory process happens within the mucous membranes that line the nasal and sinus cavities. The inflammation, which is often coupled with the secretion of copious amounts of mucus, is a reaction to a lot of triggering factors like medications, dust, pollen or viral/bacterial upper respiratory tract infection. Because of the inflammation, the sinus ostia are blocked, making the drainage of mucus difficult. The stagnant mucus quickly becomes a breeding ground for bacteria. When the microbes invade the mucous linings, this is the start of a sinus infection and soon, the person will be experiencing the usual manifestations associated with this condition.

Back to Normal:

Despite the aforementioned information on the progressively rising incidence of sinus infections, the condition is very manageable. It is easy to diagnose using visualization techniques like x-ray, CT scan, endoscopy, etc. Treatments are wide range- from do-it-yourself cures to sinus surgery (but surgeries are done only as last resort). Medications are widely available, ranging from over-the-counter decongestants to especially compounded forms suitable for medicated irrigation or nebulized treatment.

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Yeas - It is possible to have panic attacks during our sleep

So is it really possible to have panic attacks during our sleep?

Yes, it is very possible! You might suddenly wake up with a rapid heartbeat and racing pulse, you may feel confused, disoriented, anxious, and disconnected from reality. Other symptoms are grinding the teeth, head pain and a feeling of pressure in the ears. Read on to find out what you need to know about this kind of attacks.

About half of people who experience panic attacks during the day experience nocturnal panic attacks. A person might suddenly wake up with a rapid heartbeat and racing pulse, the individual may feel confused, disoriented, anxious, and disconnected from reality. Other symptoms are grinding the teeth, head pain and a feeling of pressure in the ears.

Even though these attacks are rare (only about 10% occurrence), people who experience these find it more frightening than those that occur during the day. People who experience nighttime attacks begin to fear going to sleep. They fear that they might become comatose or worse, that they might never wake up again. These may develop into insomnia, and other sleeping problems, thus actually making the person become more susceptible to more panic attacks.

The exact causes for panic or anxiety attacks at night are not known. One cause of these kinds of attacks includes the increase of carbon dioxide in the body during sleep (false suffocation alarm) which may trigger our body's panic response. Another possible cause is that attacks are triggered during changes in the sleep cycle, such as when an individual moves into a deeper stage of sleep.

But one thing the experts agree on is that this kind of attacks is not caused by dreams. Studies have shown that these attacks happen during the early stages of sleep before the person begins to dream. Nightmares, on the other hand, occur during the REM (rapid eye movement) phase or the dream phase. There is another type of disorder, more common among children, which manifests in symptoms very much like panic or anxiety attacks, but this kind of sleeping disorder occurs during deep phases of sleep. Sleep panic attacks are mainly influenced by the events during the daytime. Consumption of alcohol, drugs, depression, and stress, may also influence these.

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How does the media influence Anorexia on teenagers?

When children see these images on television, in magazines, in songs, movies, etc- then it's no wonder that the rate of eating disorders among teenagers is rising rapidly, and now parents are feverishly searching for an answer.

Instead of blaming themselves, the media and others- it's important to remember that some teenagers are more susceptible to eating disorders than others, and some are going to develop Anorexia or another eating disorder with or without outside influences such as media or peers.

• But how does the media influence Anorexia on teenagers?

• And how do we stop the effects of this negative influence?

The media has become firmly focused for years, on a person's outer appearance or outer beauty. In the days of Marilyn Monroe and Rita Hayworth, women in the media were portrayed as beautiful, and they weren't "bone thin." This trend has changed over the last several years, and now unless an actress or model is thin to the point of practically being able to see bones, she is criticized as being "fat."

The latest example of this trend, is the recent come-back of Britney Spears- after she'd given birth to two children, she was ridiculed for wearing a skimpier outfit, due to being "fat." The problem is, although she'd had two children, she was far from fat- yet the media criticized her for daring to show her "less than perfect" body on national television. With issues like this, it's no wonder that children and teenagers are being bombarded with messages of what perfection is and how to "be" perfect.

When does the media influences anorexia on teenagers? If one notices television programming and magazines geared specifically for teenagers, they'll notice that it's extremely unusual- rare even- for an actor, actress, or other star to be "over-weight"- or even of a normal weight. From the pre-teen years to the middle-teen years, teenagers are bombarded with messages, whether direct or indirect, of the need to be "perfect" and what "perfect" is.

If Marilyn Monroe or Rita Hayworth were around today, they'd be labeled as "fat." What a twist, and a shocking example of how our society has misplaced standards of beauty and "perfection!" Two well-known, absolutely gorgeous, healthy-weight, sex-symbols and icons of beauty- now would be considered "flawed."

The media influences teens' self-esteem and self-worth when it constantly bombards them with what society now considers ideal, and a distorted perception of what's "perfect." To stop the negative influence that the media has on children and teenagers, it's a good idea to limit exposure of body-image damaging programs, magazines and it's good to encourage a healthy body image.

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Histology and Explanation of Bronchopneumonia (Lobular pneumonia)

Bronchopneumonia (Lobular pneumonia) is an acute exudative inflammation of the lungs characterised by foci of consolidation surrounded by normal parenchyma. Usually, bronchopneumonia affects one or more lobes and is bilateral.


Bronchopneumonia : focus of inflammatory condensation centred by a bronchiole with acute bronchiolitis (suppurative exudate in the lumen and parietal inflammation). Alveolar lumens surrounding the bronchia are filled with neutrophils ("leukocytic alveolitis"). Inflammatory foci are separated by normal, aerated parenchyma.

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Follow these tips to reduce your stressed life before you find yourself with that terrible burnout feeling

Normal in the sense that it is accepted as a part of our daily activities. It can go beyond normal though and anxiety is a form of depressive illness.

Anxiety is not that bad though. It keeps us primed, as if it trains us to be always on our toes. It also keeps us psychologically alert. These exercises can be good but to a certain extent or limit only. Beyond the limit, things may start to get nasty.

When we are engulfed with a bout of panic attack, we have one of two choices. We can either face it or get away from it. This is better known as the fight/flight response. Given a choice, would you face panic attack and experience its full impact, or would you rather retreat or run away from it?

Read these tips to reduce your stressed life before you find yourself with that terrible burnout feeling.

1. Take time out to savor the fresh scent of nature, especially flowers. The sight and the fragrance that flowers bring can be great relief to a tired, irritated, or dragged feeling. If you love nature, nothing is more invigorating than flowers and plants. If you don't have a garden you could visit a place that does.

2. Is your burnout a result of doing something you don't like to do, yet you have to face it just the same. Picture in your mind an image that you like to do and push aside the image to the thing you don't like to do.

This strategy of imagery helps to lessen the tiring weight of the thing you get stressed about acting upon. In the process, your task gets done with less resistance on your part. Before you even know it, the job is already done and probably with favorable results.

3. Try ginseng. Ginseng is an energy food. Most health food stores sell it. You can either take it as a tea drink or mix it in your cooking for a wholesome meal. Ginseng comes in a variety of strengths. If you're not very familiar with it, just ask at your health food store and they will gladly help you out.

4. A burnout can be equated to an individual who could use a time out from the hustles of life. This is similar to a coach of a basketball team asking for a time out to come up with a winning game plan when his team is not playing at its peak. Take advantage of this time out to meditate and relax those frenzied nerves. Do it today !

5. Empty your mind! Pick up and round up useful memories and discard those damaging emotions and negative thoughts.

6. Get out of your normal routine if you feel in a rut. Go on a picnic with the family, a camping trip out in the woods, or a weekend adventure to a totally different are or environment.

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Histology and Explanation of Lobar pneumonia (leukocytic alveolitis)

Lobar pneumonia is an acute exudative inflammation of an entire pulmonary lobe, produced in 95 % of cases by Streptococcus pneumoniae (pneumococci).

If not treated, lobar pneumonia evolves in four stages :

* Congestion (first 2 days)
* Red hepatisation (fibrinous alveolitis) (2nd to 4th day)
* Grey hepatisation (leukocytic alveolitis) (4th to 8th day)
* Resolution (after 8th day)


Leukocytic alveolitis is the 3rd phase of the lobar pneumonia. Alveolar lumens are filled with leukocytic (suppurative) exudate (neutrophils and macrophages, in order to remove the fibrin). Alveolar walls are thickened due to capillary congestion and edema.

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A few unique homemade acne treatment Techniques

Pimples are just another form of acne, therefore, they can be thought of in the same way and "cured" in the same way. Almost every family has their own unique homemade acne treatments that have been passed down from generation to generation. Some of these treatments are very effective in treating the blemishes that are so embarrassing to young and old alike.

1. Oatmeal is great for drawing oil from the pores. Mix a small amount of oatmeal with boiling water and mix to a thick paste. Allow to cool until warm or even cold. Add a little more water to make the mixture easy to spread and apply to the skin. Allow to stand for five minutes and then gently rinse off. The oatmeal will soothe dry skin as well and will act as a gentle exfoliant.

2. Take a slice of tomato and apply it over the acne marks everyday. The antioxidant properties of tomato juice helps to rejuvenate the damaged skin and thus reduce the appearance of the scars. Moreover, vitamin A content of tomato helps further in acne control by stopping the excessive production of sebum.

3. It can be very tempting to pick and squeeze pimples and some people believe that is a good way to get rid of them. Well, in most cases it is actually the exact opposite, when you pick and squeeze them it often makes it easier for them to spread across your face and get worse, in other words. You should try your best not to squeeze them or just try to touch your face as little as possible.

4. Strawberries can also be mashed and then applied to the face. Some people add a bit of oatmeal to the strawberry pulp to create an oatmeal-strawberry facemask. Be sure to rinse off in five to ten minutes, as it can be very drying to the face.

5. Daily massaging of olive oil on the acne marks can reduce their prominence to a great extent. Basically, olive oil has a moisturizing effect on the skin. As a result, the skin condition improves and the marks get faded out. Acne causes severe, and often painful, inflammation of the skin. Several herbs can be helpful in controlling these symptoms. Lavender compresses and rosewater applied to the skin helps to lessen inflammation, and calendula used as a face wash or as a cream aids in healing the skin tissues. These herbs are readily available at specialty herb shops.

6. Wash your bed sheets regularly - As you sleep, oils from your skin can soak into your pillow case and bed sheets, when you sleep on them again. There is a chance that they will rub back on to your face, therefore, it would be wise to wash your bed sheets quite regularly.

7. Vitamin E is also an antioxidant that flushes toxins from your body. In addition, it repairs damage to your skin and helps to heal it, which can minimize the long-term effects of acne on your skin.

8. Zinc is also an antioxidant, and a potent one. It regulates your oil glands, which is an important component in stopping breakouts before they start.

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Histology and Explanation of Ischemic fibrosis of myocardium (diffuse ventricular myocardial fibrosis)

Ischemic Heart Disease is the result of an imbalance between adequate oxygen supply to the myocardium and its' necessities, due to total or partial obstruction of the coronary arteries. Depending on the degree of coronary artery insufficiency and the rapidity of onset, ischemic heart disease might be acute or chronic. These include four anatomical and clinical entities :

* Chronic ischemic heart disease
o stabile angina pectoralis
* Acute ischemic heart disease
o unstabile angina pectoralis
o myocardium infarct
o sudden death

Etiology : coronary artery atherosclerosis (90 %), inflammation of coronary arteries (systemic lupus erythematosus, polyarteritis nodosa), tromboembolism (bacterial endocarditis), spasm, arrhythmia (e.g. : tachycardia in hyperthyroidism, anemia, intoxication, infections), syphilis.


Ischemic fibrosis of the myocardium (diffuse ventricular myocardial fibrosis) represents the morphological change in chronic ischemic heart disease. Clinically, may be silent or producing stabile angina pectoralis leading to congestive heart failure.

Pathology : during a diffuse coronary atherosclerosis, in which the stenosis is less than 70 % of the artery cross-section (this means, it is not enough to produce an infarct), some myocardial cells or small groups of cells, are inadequately supplied with blood (oxygen). These myocardial cells will become atrophic and necrotic. With time, the small areas of necrosis will be replaced by fibrosis.

At gross examination, the heart varies in size : normal, small (atrophic) or large (compensatory hypertrophy), dilated (in patients with congestive heart failure). Endocardium and pericardium are normal or with white plaques, corresponding to fibrosis. On section surface, the myocardium has a "tiger-spotted" aspect, due to intermingled normal myocardium (red) and fibrosis (ivory, white). Large areas of scarring might be visible if the patient had a previous infarct.

Microscopically, one can see small fibrous scars (with collagen fibers) surrounding viable myocardial cells (fibers), normal, with atrophy or with hypertrophy ("tiger-spotted" aspect). Also, might be present focal myocytolisis : isolated "empty" myocardial cells (no nuclei, no striations, eosinophilic cytoplasm) - ischemic necrosis.



Diffuse myocardial fibrosis (Ischemic fibrosis of the myocardium) (Simionescu trichromic staining, ob. x4) : myocardial cells (red) intermingled with collagen-rich fibrosis (blue) which completely replaced the necrotic myocardial cells. Capillaries (with yellow-orange red blood cells) within fibrosis remained from repair by connective tissue process.

Diffuse myocardial fibrosis (Ischemic fibrosis of the myocardium) (Simionescu trichromic staining, ob. x10) : viable myocardial cells (red) with nuclei (brown) surrounded by collagen-rich fibrosis (blue). Fibrosis completely replaced the necrotic myocardial cells. Capillaries (with yellow-orange red blood cells) within fibrosis remained from repair by connective tissue process.

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A few Natural remedies for acne marks removal

Most people prefer natural remedies for acne marks removal because they are inexpensive and do not have any adverse side effect on the skin. In fact, most of these ingredients can improve the overall skin condition. Since various skin types may have special needs with regards to treatment, consider using the following:

1. Mash a very ripe banana and apply to the skin. Leave on about two minutes and rinse off with warm water followed by cold.

2. We all know that sandalwood powder is highly beneficial for removal of any marks on skin surface. Make a paste of sandalwood powder and rose water and apply it over the acne scars at night before going to bed. Let the paste stay on the marks overnight and wash off in the morning. When it is done regularly, the marks will disappear really fast.

3. You can also get rid of acne by changing your diet and your lifestyle. Control your intake of fatty food because this can increase the oil in your skins surface. Get at least 7 hours of sleep every day. Drink at least eight glasses of water per day in order to leave your skin smooth and healthy. Apple cider vinegar effectively fights off bacteria, thus it works for acne control as well as the scars it leaves. It is also helpful in dealing with allergies and other skin disorders. But before applying the apple cider vinegar directly on your skin make sure you dilute it with water.

4. Prepare a face mask with apple paste to which a few drops of honey has been added. Apply this paste all over the face and leave it untouched for 15-20 minutes. Then wash off with plain water. This face mask will tighten up the skin pores which make the marks on the skin less visible.

5. Oatmeal can also be used to sooth irritated, dry skin. Mix as above and allow to cool. Apply the mask cold to the skin and gently rinse off with warm water. Do not rub or scrub, simply rinse off. Calamine lotion has been used for decades to treat itchy skin conditions such as chickenpox and poison ivy rash. Most people do not know that Calamine lotion can help reduce acne blemishes as well. It is particularly helpful in drying up and treating cystic acne, one of the more difficult acne blemishes to cure. Calamine lotion can be found at any grocery store. Shake the bottle thoroughly to maximize the concentration of the lotion. Squeeze it onto a cotton swab, and then apply it directly to acne spots. Let the Calamine lotion dry, and leave it on overnight. Rinse well with water in the morning.

6. For a very nourishing treatment, mix one egg yolk, one tsp of olive oil and one teaspoon of honey. Allow to stay on the skin for several minutes and then rinse off. Pat dry.

7. Vitamin B5 (Panthothenic Acid) reduces stress. Because stress is one of the major contributors to acne, Vitamin B5 can minimize breakouts.

8. Vitamin B2 (Riboflavin) keeps your skin, nails and hair healthy. Acne is one of the main symptoms of a riboflavin deficiency.

9. Start curing your acne by reducing your stress levels and avoiding the use of too much makeup. Abnormal stress levels can decrease your body's ability to naturally fight off bacteria. Meanwhile, makeup and sunscreens can clog your pores and infect your skin further.

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Histology and Explanation of Acute viral myocarditis

Myocarditis is an inflammation of the myocardium. Acute viral myocarditis is produced most often by Coxsackie B virus and echovisuses. Myocardial interstitium presents an abundant edema and inflammatory infiltrate, mainly with lymphocytes and macrophages. Focal destruction of myocytes may be present, generating loss of contractile function of the myocardium.

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Benefits of eat healthy foods

Most people eat healthy foods when they have to or when told so by their doctor because they are feeling something or already sick. As the saying goes, "Preventive is better that cure." Listed below are the advantages of eating healthy:
1) You will shield yourself from many illnesses and disease that are very common as you get older like high cholesterol level, heart diseases, diabetes, and cancer. You boost your energy, improve the functions of your body and organs, and strengthen your immune system when you eat healthy and combine it with proper exercise.

2) Your nutritional needs will be met. You should have a daily balance amount of fruits, vegetables, beans, grain, meat, poultry products, milk and other dairy products. With the proper consumption of the vitamins and minerals present in these foods, it will protect you and reduce the risks of acquiring serious illnesses and diseases.

3) Eating nutritious foods will make you enjoy your life more, live a vibrant life. Having more energy makes helps you accomplish more tasks. You will have the energy to reduce and manage your stress.

4) You will feel rested and will not have problems in getting to sleep.

5) When you eat the right foods, you will be able to lose weight easily and will be able to maintain it for life. If you just follow a fad diet plan, you will easily gain back the weight easily once you resume to your normal eating consumption.

6) You don't have to stay with a strict diet. Eating healthy will just be a piece of cake.

7) You will not feel guilty of eating and indulging yourself. Once you eat healthy and nutritious foods, you will not experience bad side effects. You will feel satisfied and no longer crave for unhealthy foods.

8) Your sex life will be improved. According to research, women into healthy living have more desire for a lively sex life with their partner.
9) You will have a healthy heart. Everything that you eat goes to the heart. So eating unhealthy foods will lead to heart diseases.
10) You help clean your body. If you take foods not good for your body, health problems will arise. Your body has the capacity to cure and revitalize on its own but if it's being abused, it cannot function well.

11) You will have the glowing skin. Once you eat healthy foods, you help clean the toxins thus result to a glowing skin.

12) You look fresher and younger than your age. A healthy living helps you reduce the wrinkles and signs of aging.

13) Helps remove cellulite. These are usually fat stored in legs and buttocks.

14) For women, it will cure PMS. One of the reasons why you have PMS is because of too much salt and saturated fat intake.

15) You help reduce the load of your digestive system and liver thus results the better function of your organs.

Once you follow and keep with the healthy and nutritious foods intake, everything else will follow. The list of benefits will go on and on. You will reap rewards for the rest of your life.

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How to Perform Nasogastric Intubation

• Indications:
  • Acute gastric dilatation
  • Gastric outlet obstruction
  • Upper gastrointestinal bleeding
  • Ileus
  • Small bowel obstruction
  • Enteral feeding

• Contraindications:
  • Recent esophageal or gastric surgery
  • Head trauma with possible basilar skull fracture
• Anesthesia:
  None or viscous lidocaine in the nose
• Equipment:
  • Levin or Salem sump tube
  • Water-soluble lubricant
  • Catheter-tip syringe (60 ml)
  • Cup of ice
  • Stethoscope
  • Cup of water with a straw
• Positioning:
  Sitting or supine
• Technique:
  • Measure tube from mouth to earlobe and down to anterior abdomen so that last hole on tube is below the xiphoid process. This marks the distance that the tube should be inserted.
  • Some surgeons will place tip of tube in cup of ice to stiffen it or bend the tip downward to facilitate the tube's passage into the proximal esophagus.
  • Apply lubricant liberally to tube.
  • Ask patient to flex neck, and gently insert tube into a patent naris.
    
  • Advance tube into nasopharynx aiming posteriorly, asking the patient to swallow if possible.
  • Once the tube has been swallowed, confirm that the patient can speak clearly and breathe without difficulty, and gently advance tube to estimated length. If the patient is able, instruct him or her to drink water through a straw; while the patient swallows, gently advance the tube.
  • Confirm correct placement into the stomach by injecting approximately 20 ml of air with catheter-tip syringe while auscultating epigastric area. Return of a large volume of fluid through tube also confirms placement into stomach.
  • Carefully tape tube to the patient's nose, ensuring that pressure is not applied by tube against naris. Tube should be kept well lubricated to prevent erosion at naris. With the use of tape and a safety pin, the tube can be secured to the patient's gown.
  • Irrigate tube with 30 ml of normal saline every 4 hours. Salem sump tubes will also require the injection of 30 ml of air through the sump (blue) port every 4 hours to maintain proper functioning.
  • Constant low suction may be applied to Salem sump tubes, whereas Levin tubes should have only low intermittent suction.
  • Monitor gastric pH every 4–6 hours and correct with antacids for pH < 4.5.
  • Monitor gastric residuals if tube is used for enteral feeding. Obtain a chest radiograph to confirm correct placement before using any tube for enteral feeding.
  • The tube ideally should not be clamped because it stents open the lower esophagus, increasing the risk of aspiration if the patient's stomach should distend.
  • Complications and Management:

    • Pharyngeal discomfort
      • Common due to the large caliber of these tubes.
      • Throat lozenges or sips of water may provide relief.
      • Avoid using aerosolized anesthetic for the pharynx because this may inhibit the gag reflex, interfering with the protective mechanism of the airway.
    • Erosion of the naris
      • Prevented by keeping tube well lubricated and ensuring that tube is taped so that pressure is not applied against naris. Tube should always be lower than the nose and never taped to the forehead of the patient.
      • Frequent checking of the tube position at the naris can help prevent this problem.
    • Sinusitis
      • Occurs with long-term use of nasogastric tubes.
      • Remove the tube and place in other naris.
      • Antibiotic therapy if needed.
    • Nasotracheal intubation
      • Results in airway obstruction that is fairly easy to diagnose in the awake patient (cough, inability to speak).
      • Obtain a chest radiograph to confirm placement prior to use for enteral feeding.
    • Gastritis
      • Usually manifests itself as mild, self-limited upper gastrointestinal bleeding.
      • Prophylaxis consists of maintaining gastric pH > 4.5 with antacids via the tube, intravenous (IV) histamine₂ receptor blockers, and removal of tube as soon as possible.
    • Epistaxis
      • Usually self-limited.
      • If persists, remove the tube and assess location of bleed.
      • Refer to Chapter 1 for treatment of anterior and posterior epistaxis.

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Histology and explanation of Recent coronary thrombosis

Thrombosis : recent thrombus in a coronary artery (branch in the epicardium) : The arterial lumen is completely obstructed by a recent thrombus - fibrin network (pink) containing red blood cells and platelets. The thrombus is developed on an ulcerated atherosclerotic (fibrous) plaque and is adherent to the arterial wall.

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