Tuesday, May 19, 2009

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Tuesday, May 12, 2009

TWO NEW CASES OF SWINE FLU IN THILAND

BANGKOK (AFP) - Thailand on Tuesday confirmed its first two cases of swine flu in people who had travelled to Mexico, becoming the only Southeast Asian nation hit by the virus so far.

Public Health Minister Witthaya Keawparadai said the patients, both Thai nationals, had recovered from the disease and there were no signs that the A(H1N1) virus had spread.

"There are two confirmed cases of A(H1N1), both of them contracted from Mexico," Witthaya told a press conference in Bangkok.

The first case came to light after the patient returned from a visit to Mexico, the epicentre of the outbreak, suffering from a mild fever, but recovered after treatment with anti-viral drugs, Witthaya said.

Tests by the Centers for Disease Control and Prevention in the United States confirmed the A(H1N1) virus in a sample from the person, he added.

The second case had similar symptoms after travelling to Mexico and also got better after taking anti-virals, the minister said, although he did not say where the tests on the second person were carried out.

Medical authorities were keeping three people who had been in contact with the first person and five people in contact with the second patient under surveillance, he added.

None had reported signs of infection, he said.

Prime Minister Abhisit Vejjajiva had earlier announced the first case, saying the patient had "fully recovered and has returned home".

The cases came just days after Thailand hosted a major conference on swine flu, at which Asian nations agreed to increase their stockpiles of anti-viral medicines.

Health ministers from China, Japan, South Korea and the 10-member Association of Southeast Asian Nations (ASEAN) also urged global health chiefs to ensure fair distribution of medicine in case of a pandemic.

Thailand has previously been hit by avian influenza, with 25 human cases and 17 deaths since 2004. The last case here was in 2006.

Experts have warned that preventing swine flu from infecting patients who are sick with avian flu should be a top priority, especially in Asia, to prevent the viruses mixing and mutating into a highly pathogenic form.

The World Health Organization's death toll from the A(H1N1) virus passed 50 at the weekend. It has reported 4,694 cases worlwide, most of them involving relatively mild symptoms. (AFP)

Sunday, May 10, 2009

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Saturday, May 9, 2009

Treatment of Anaphylactic shock

Treatment of anaphylactic shock

  • Airway management
  •  adrenaline--0.3 to 0.5 ml(1:1000) s.c
  •            if severe-adrenaline 3 to 5 mg (1:10000) i.v
  • antihistaminics:hyadranamine
  • steroids:prednisolone 50 mg or dexomethasone 2-3 mg i.v
  • bronchodilators-Aminophyline,salbutamol,terbutaline
  • sedatives can be given
  • chelating agents shold be given if shock is due to ingestion of drugs.
  • infiltrative adrenaline if shock due to local acting drugs..

What is kallaman sundrome?

It is a genetic disorder and the most common form of isolated gonadotropin deficiency.

CAUSE:There is gene deletion from the short arm of chromosme X.

There may be associated underdevlopement of olfactory lobes.so there is anosmia.

presentation of patient:

patient may present with one of below compaints:

  • infertility
  • delayed puberty.
  • mental retardation,
  • skeletal abmormalities
  • renal problems
  • depression etc..

Thursday, May 7, 2009

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Blood transfused from relatives can be fatal

A man meets with an accident while crossing the road. He is immediately rushed to the hospital. He is bleeding and needs blood urgently. Finally, his son’s blood is given to the man. The man recovers after a successful operation. After three weeks, the man dies.

The doctor who operated on him investigates the cause of the death as a complication due to blood transfusion from a relative, which in this case was his son, called as Transfusion Associated Graft Versus Host Disease (TA-GVHD). TA-GVHD, as the name suggests, is the engraftment and proliferation of T-lymphocytes from the donor’s blood in transfusion recipients, leading to tissue damage and death, eventually.

Even with the advent of safer blood supply management methods and newer technologies in blood transfusion, safety in blood transfusion is under a cloud of doubt with tranfusion related complications. The mortality rate due to TA-GVHD is over 90 per cent, say experts.

Says Dr S B Rajadhyaksha, head, department of Transfusion Medicine, Tata Memorial Hospital, "Contrary to the popular belief, that relative’s blood is safest for patients, blood or blood products, especially from first degree relatives, can result in the fatal complication called TA-GVHD. The complication generally arises in immuno-suppressed patients like cancer patients and new-born babies."

Based on the symptoms following transfusion of blood or any cellular blood component, the doctors have to be made aware that TA-GVHD is one of differential diagnosis. Such cases are therefore grossly under reported. Says Dr Sunil Parekh, haematologist, Bombay hospital, "TA-GVHD is often misdiagnosed and under-reported because the primary manifestations of TA-GVHD are skin rash, fever, bone marrow depression (lowering of blood counts), diarrhoea and jaundice."

Besides this, the unavailability of gamma irradiation facility in remote parts of the country has posed a hindrance. According to Dr Rajesh B Sawant, Tata Memorial hospital, irradiation is recommended for bone marrow Transplant patient, patient’s suffering from Hodgkins disease (lymphnode cancer), transfusion to new born infants, Intrauterine transfusions, cases of congenital immuno deficiency and patients receiving HLA matched blood components. "Only anecdotal case reports of individual cases scattered all over the world are available in medical literature.", he added. 

The need of the hour is therefore to educate the doctors about such a complication and to upgrade infrastructure for gamma irradiation facility in the hospitals, suggest experts. 

For patients having good immunity, the chances of developing TA- GVHD is less because the blood cells called T-lymphocytes from the transfused donor blood are recognised as foreign and therefore rejected by the recipient’s immune system. In patients, whose immunity is not good, TA-GVHD develops due to the inability to reject these T-lymphocytes, which result in their proliferation, which then attack the liver, skin, gastrointestinal tract and the bone marrow. "Although a rare complication of transfusion, it can occur even in patients whose immunity is not suppressed (immuno-competent). This happens when a patient receives blood from their first degree relatives (siblings, parents or children) or second degree relatives. In these cases, the donor’s T- lymphocytes may not be rejected as the Human Leucocyte Antigen (HLA) type of the recipient is haploidentical or bears similarity with that of the donor," said Dr Rajadhyaksha.

HLA is an important blood matching parameter, which has an important role in blood transfusion. HLA type is a genetically inherited unique marker for each individual present on the lymphocytes or white blood cells(WBC). T-Lymphocyte is a category of WBC responsible for immunity. Various treatments have been tried in patients with TA-GVHD including corticoteriods, cyclosporine, methotrexate and ATG (anti-thymocyte globulin) etc. Till date, none has proved adequately successful. Therefore Gamma irradiation of the blood or blood components from the relative’s donor is the best current technology to reduce the risk of TA-GVHD to the recipients. The usual dosage is 2500-3500 rads and requires an expensive equipment that can deliver Gamma Irradiation, currently available in very few institutions in India like CMC Hospital, Vellore, All India Institute of Medical Sciences (AIIMS), New Delhi. Sanjay Gandhi Post Graduate Institute, Lucknow, Gujarat Cancer Research Institute,Ahmedabad, Tata Memorial Hospital, Mumbai, Hinduja Hospital, Mumbai, Jaslok Hospital, Mumbai, Bombay Hospital, Mumbai etc.

World Health Organisation’s (WHO) research findings from a number of countries also indicate that blood from family donors presents a greater risk to the safety of the blood supply than blood from voluntary non-remunerated donors.

What is swine flu?

This is illnes caused by influenza virus H1N1 stain.

it was first detected in united states in 2009 and in other countries like mexicao and canada.

It spreads as other influenza virus spreads.respiratory route is main mode of tranfer.

Infact swine virus nomenclature in not appropriate....

The virus is called "quadruple reassortant"

what is Stickler syndrome?

It is a common genetic disorder,

characterised by,

flexible joints,hearing loss,facial abnormalities,eye problems,etc..

A striking feature is the Robin sequence (or Pierre Robin sequence), common in stickler syndrome.

Robin sequence includes a U-shaped cleft palate with a tongue that is too large for the space formed by the small lower jaw. Children with a cleft palate are also prone to frequent ear infections and swallowing difficulties.

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Tuesday, April 28, 2009

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Thursday, April 9, 2009

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Monday, April 6, 2009

IPL-Rajasthan Royals's Match Schedule

Apr 18 , 2009 vs Royal Challengers
Newlands, Cape Town



Apr 21 , 2009 vs Mumbai Indians
Kingsmead, Durban



Apr 23 , 2009 vs Kolkata Knight Riders
St George's Park, Port Elizabeth



Apr 26 , 2009 vs Kings XI Punjab
Newlands, Cape Town



Apr 28 , 2009 vs Delhi Daredevils
SuperSport Park, Centurion



Apr 30 , 2009 vs Chennai Super Kings
SuperSport Park, Centurion



May 02 , 2009 vs Deccan Chargers
St George's Park, Port Elizabeth



May 05 , 2009 vs Kings XI Punjab
Kingsmead, Durban



May 07 , 2009 vs Royal Challengers
SuperSport Park, Centurion



May 09 , 2009 vs Chennai Super Kings




May 11 , 2009 vs Deccan Chargers




May 14 , 2009 vs Mumbai Indians
Kingsmead, Durban



May 17 , 2009 vs Delhi Daredevils




May 20 , 2009 vs Kolkata Knight Riders
Kingsmead, Durban

IPL-Delhi Daredevils's Match Schedule

Apr 19 , 2009 vs Kings XI Punjab
Newlands, Cape Town



Apr 23 , 2009 vs Chennai Super Kings
Kingsmead, Durban



Apr 26 , 2009 vs Royal Challengers
St George's Park, Port Elizabeth



Apr 28 , 2009 vs Rajasthan Royals
SuperSport Park, Centurion



May 02 , 2009 vs Chennai Super Kings
New Wanderers Stadium, Johannesburg



May 05 , 2009 vs Kolkata Knight Riders
Kingsmead, Durban



May 08 , 2009 vs Mumbai Indians
Buffalo Park, East London



May 10 , 2009 vs Kolkata Knight Riders
New Wanderers Stadium, Johannesburg



May 13 , 2009 vs Deccan Chargers
Kingsmead, Durban



May 15 , 2009 vs Kings XI Punjab




May 17 , 2009 vs Rajasthan Royals




May 19 , 2009 vs Royal Challengers
New Wanderers Stadium, Johannesburg



May 21 , 2009 vs Mumbai Indians
SuperSport Park, Centurion

IPL-Mumbai Indians's Match Schedule

Apr 18 , 2009 vs Chennai Super Kings
Newlands, Cape Town



Apr 21 , 2009 vs Rajasthan Royals
Kingsmead, Durban



Apr 25 , 2009 vs Deccan Chargers
Kingsmead, Durban



Apr 27 , 2009 vs Kolkata Knight Riders
St George's Park, Port Elizabeth



Apr 29 , 2009 vs Kings XI Punjab
Kingsmead, Durban



May 01 , 2009 vs Kolkata Knight Riders
Buffalo Park, East London



May 03 , 2009 vs Royal Challengers
New Wanderers Stadium, Johannesburg



May 06 , 2009 vs Deccan Chargers
SuperSport Park, Centurion



May 08 , 2009 vs Delhi Daredevils
Buffalo Park, East London



May 10 , 2009 vs Royal Challengers
St George's Park, Port Elizabeth



May 12 , 2009 vs Kings XI Punjab
SuperSport Park, Centurion



May 14 , 2009 vs Rajasthan Royals
Kingsmead, Durban



May 16 , 2009 vs Chennai Super Kings
St George's Park, Port Elizabeth



May 21 , 2009 vs Delhi Daredevils
SuperSport Park, Centurion

IPL-Deccan Chargers's Match Schedule

Apr 19 , 2009 vs Kolkata Knight Riders
Newlands, Cape Town



Apr 22 , 2009 vs Royal Challengers
Newlands, Cape Town



Apr 25 , 2009 vs Mumbai Indians
Kingsmead, Durban



Apr 27 , 2009 vs Chennai Super Kings
Kingsmead, Durban



May 02 , 2009 vs Rajasthan Royals
St George's Park, Port Elizabeth



May 04 , 2009 vs Chennai Super Kings
Buffalo Park, East London



May 06 , 2009 vs Mumbai Indians
SuperSport Park, Centurion



May 09 , 2009 vs Kings XI Punjab




May 11 , 2009 vs Rajasthan Royals




May 13 , 2009 vs Delhi Daredevils
Kingsmead, Durban



May 16 , 2009 vs Kolkata Knight Riders
New Wanderers Stadium, Johannesburg



May 17 , 2009 vs Kings XI Punjab
New Wanderers Stadium, Johannesburg



May 21 , 2009 vs Royal Challengers
SuperSport Park, Centurion

IPL-Kolkata Knight Riders's Match Schedule

Apr 19 , 2009 vs Deccan Chargers
Newlands, Cape Town



Apr 21 , 2009 vs Kings XI Punjab
Kingsmead, Durban



Apr 23 , 2009 vs Rajasthan Royals
St George's Park, Port Elizabeth



Apr 25 , 2009 vs Chennai Super Kings
Newlands, Cape Town



Apr 27 , 2009 vs Mumbai Indians
St George's Park, Port Elizabeth



Apr 29 , 2009 vs Royal Challengers
Kingsmead, Durban



Apr 30 , 2009 vs Royal Challengers
Kingsmead, Durban



May 01 , 2009 vs Mumbai Indians
Buffalo Park, East London



May 03 , 2009 vs Kings XI Punjab
St George's Park, Port Elizabeth



May 05 , 2009 vs Delhi Daredevils
Kingsmead, Durban



May 10 , 2009 vs Delhi Daredevils
New Wanderers Stadium, Johannesburg



May 12 , 2009 vs Royal Challengers
SuperSport Park, Centurion



May 16 , 2009 vs Deccan Chargers
New Wanderers Stadium, Johannesburg



May 18 , 2009 vs Chennai Super Kings
SuperSport Park, Centurion



May 20 , 2009 vs Rajasthan Royals
Kingsmead, Durban

IPL-Chennai Super Kings's Match Schedule

Apr 18 , 2009 vs Mumbai Indians
Newlands, Cape Town



Apr 20 , 2009 vs Royal Challengers
St George's Park, Port Elizabeth



Apr 23 , 2009 vs Delhi Daredevils
Kingsmead, Durban



Apr 25 , 2009 vs Kolkata Knight Riders
Newlands, Cape Town



Apr 27 , 2009 vs Deccan Chargers
Kingsmead, Durban



Apr 30 , 2009 vs Rajasthan Royals
SuperSport Park, Centurion



May 02 , 2009 vs Delhi Daredevils
New Wanderers Stadium, Johannesburg



May 04 , 2009 vs Deccan Chargers
Buffalo Park, East London



May 07 , 2009 vs Kings XI Punjab
SuperSport Park, Centurion



May 09 , 2009 vs Rajasthan Royals




May 14 , 2009 vs Royal Challengers
Kingsmead, Durban



May 16 , 2009 vs Mumbai Indians
St George's Park, Port Elizabeth



May 18 , 2009 vs Kolkata Knight Riders
SuperSport Park, Centurion



May 20 , 2009 vs Kings XI Punjab
Kingsmead, Durban

IPL-Kings XI Punjab's Match Schedule

Apr 19 , 2009 vs Delhi Daredevils
Newlands, Cape Town



Apr 21 , 2009 vs Kolkata Knight Riders
Kingsmead, Durban



Apr 24 , 2009 vs Royal Challengers
Kingsmead, Durban



Apr 26 , 2009 vs Rajasthan Royals
Newlands, Cape Town



Apr 29 , 2009 vs Mumbai Indians
Kingsmead, Durban



May 01 , 2009 vs Royal Challengers
Kingsmead, Durban



May 03 , 2009 vs Kolkata Knight Riders
St George's Park, Port Elizabeth



May 05 , 2009 vs Rajasthan Royals
Kingsmead, Durban



May 07 , 2009 vs Chennai Super Kings
SuperSport Park, Centurion



May 09 , 2009 vs Deccan Chargers




May 12 , 2009 vs Mumbai Indians
SuperSport Park, Centurion



May 15 , 2009 vs Delhi Daredevils




May 17 , 2009 vs Deccan Chargers
New Wanderers Stadium, Johannesburg



May 20 , 2009 vs Chennai Super Kings
Kingsmead, Durban

IPL-Royal Challengers's Match Schedule

Apr 18 , 2009 vs Rajasthan Royals
Newlands, Cape Town



Apr 20 , 2009 vs Chennai Super Kings
St George's Park, Port Elizabeth



Apr 22 , 2009 vs Deccan Chargers
Newlands, Cape Town



Apr 24 , 2009 vs Kings XI Punjab
Kingsmead, Durban



Apr 26 , 2009 vs Delhi Daredevils
St George's Park, Port Elizabeth



Apr 29 , 2009 vs Kolkata Knight Riders
Kingsmead, Durban



Apr 30 , 2009 vs Kolkata Knight Riders
Kingsmead, Durban



May 01 , 2009 vs Kings XI Punjab
Kingsmead, Durban



May 03 , 2009 vs Mumbai Indians
New Wanderers Stadium, Johannesburg



May 07 , 2009 vs Rajasthan Royals
SuperSport Park, Centurion



May 10 , 2009 vs Mumbai Indians
St George's Park, Port Elizabeth



May 12 , 2009 vs Kolkata Knight Riders
SuperSport Park, Centurion



May 14 , 2009 vs Chennai Super Kings
Kingsmead, Durban



May 19 , 2009 vs Delhi Daredevils
New Wanderers Stadium, Johannesburg



May 21 , 2009 vs Deccan Chargers
SuperSport Park, Centurion

Wednesday, February 4, 2009

injury

 Meniscus injury: 
Injuries to the crescent-shaped cartilage pads between the two joints formed by the femur (the thigh bone) and the tibia (the shin bone). The meniscus acts as a smooth surface for the joint to move on. 
The two menisci are easily injured by the force of rotating the knee while bearing weight. A partial or total tear of a meniscus may occur when a person quickly twists or rotates the upper leg while the foot stays still (for example, when dribbling a basketball around an opponent or turning to hit a tennis ball). If the tear is tiny, the meniscus stays connected to the front and back of the knee; if the tear is large, the meniscus may be left hanging by a thread of cartilage. The seriousness of a tear depends on its location and extent.
Generally, when people injure a meniscus, they feel some pain, particularly when the knee is straightened. The pain may be mild, and the person may continue activity. Severe pain may occur if a fragment of the meniscus catches between the femur and tibia. Swelling may occur soon after injury if blood vessels are disrupted, or swelling may occur several hours later if the joint fills with fluid produced by the joint lining (synovium) as a result of inflammation. If the synovium is injured, it may become inflamed and produce fluid to protect itself. This causes swelling of the knee. Sometimes, an injury that occurred in the past but was not treated becomes painful months or years later, particularly if the knee is injured a second time. After any injury the knee may click, lock, or feel weak. Symptoms of meniscal injury may disappear on their own but frequently, symptoms persist or return and require treatment.
In addition to listening to the patient's description of the onset of pain and swelling, the physician may perform a physical examination and take x rays of the knee. The examination may include a test in which the doctor flexes (bends) the leg then rotates the leg outward and inward while extending it. Pain or an audible click suggests a meniscal tear. An MRI test may be recommended to confirm the diagnosis. Occasionally, the doctor may use arthroscopy to help diagnose and treat a meniscal tear.
If the tear is minor and the pain and other symptoms go away, the doctor may recommend a muscle-strengthening program. Exercises for meniscal problems are best performed with initial guidance from a doctor and physical therapist or exercise therapist. The therapist will make sure that the patient does the exercises properly and without risk of new or repeat injury. The following exercises after injury to the meniscus are designed to build up the quadriceps and hamstring muscles and increase flexibility and strength:

• Warming up the joint by riding a stationary bicycle, then straightening and raising the leg (but avoiding straightening the leg too much).
• Extending the leg while sitting (a weight may be worn on the ankle for this exercise).
• Raising the leg while lying on the stomach.
• Exercising in a pool, including walking as fast as possible in chest-deep water, performing small flutter kicks while holding onto the side of the pool, and raising each leg to 90 degrees in chest-deep water while pressing the back against the side of the pool.
If the tear to a meniscus is more extensive, the doctor may perform either arthroscopic surgery or open surgery" to see the extent of injury and to repair the tear. The doctor can suture (sew) the meniscus back in place if the patient is relatively young, the injury is in an area with a good blood supply, and the ligaments are intact. Most young athletes are able to return to vigorous sports with meniscus-preserving repair.
If the patient is elderly or the tear is in an area with a poor blood supply, the doctor may cut off a small portion of the meniscus to even the surface. In some cases, the doctor removes the entire meniscus. However, degenerative changes, such as osteoarthritis, are more likely to develop in the knee if the meniscus is removed. Medical researchers are currently investigating a procedure called an allograft, in which the surgeon replaces the meniscus with one from a cadaver. A grafted meniscus is fragile and may shrink and tear easily. Researchers have also attempted to replace a meniscus with an artificial one, but the procedure is even less successful than an allograft.Recovery after surgery to repair a meniscus takes several weeks longer and post-operative activity is slightly more restricted than when the meniscus is removed. Nevertheless, putting weight on the joint actually fosters recovery. Regardless of the form of surgery, rehabilitation usually includes walking, bending the legs, and doing exercises that stretch and build up the leg muscles. The best results of treatment for meniscal injury are obtained in people who do not show articular cartilage changes and who have an intact anterior cruciate ligament.