Created by - Dr. Prashant Raj
How To Perform Basic Acupressure
Acupressure is a specific massage that uses thumbs, fingers, and palms to apply pressure to numerous points on the body. Therapists might use numerous rhythms, and techniques while applying pressures. Acupressure practitioners use their fingers, palms, elbows or feet, or special devices to apply pressure to acupoints on the body's meridians. Sometimes, shiatsu conjointly involves stretching or shiatsu massage, further in different ways.During a shiatsu session, you lie on a soft massage table. The professional gently presses shiatsu points on your body. A session generally lasts nearly one hour. You would like many sessions for the most effective results.The goal of shiatsu or different forms of Asian bodywork is to revive health and balance in the body's channels of energy and to manage opposing forces of negative energy and positive energy. Some proponents claim shiatsu does not solely treat the energy fields and body but conjointly the mind, emotions, and spirit. Some even believe that therapists usually transmit the important energy (external) to a person.Few important massage points and their benefitsWrist pain -Place your hand in such a way that palm face upwards and slowly massage with another hand at a point 3 finger depths below wrist in between tendons. Hold this for at least 4 to 5 seconds and repeat it for two minutes to get relief from nausea anxiety and pain.EarsEars are famed solely to assist you in hearing. The ears do not significantly have any shiatsu purpose however these nerves hook up with your brain and stimulating them may have a positive impact on the brain. Use your thumb and finger to massage from the rear of the ear to the front and rub the lobes slowly to ease all tension and nervousness. Space between the toes Massage a point that lies three finger widths below the intersection of the 1st and second toe. Press firmly with pressure for 4 to 5 seconds and repeat for two to three minutes on each foot. It will help you feel calm and less nervous. Back of your foot This point at the rear of your leg is a vital point to relax your body and convey calming results. This is just above your ankle on the inside of the leg exactly four finger widths up the leg, slightly behind the tibia bone. Put pressure at this point for 5 sec and repeat it to get good results.
More detailsPublished - Tue, 20 Sep 2022
Created by - Dr. Prashant Raj
Cancer – Treatment, and Therapy
Cancer refers to a complex group of diseases characterized by the formation of abnormal cells that divide uncontrollably and have the tendency to infiltrate and destroy adjacent body tissue. Cancer can spread to any part of the body through metastasis. Signs and symptoms caused by cancer- • Fatigue• Lump that can be felt underneath the skin• Weight changes, both unintentional loss or gain• Skin color changes like yellow, red and getting dark• Changes in Bowel or bladder habits• Persistent cough/ labored breathing • Difficulty swallowing• Hoarseness• Persistent upset stomach or discomfort immediately after eating• Persistent, unexplained muscle or joint pain There are many approaches for treating cancer, depending on the type of cancer, how advanced it's, what forms of treatment are available, and what are the goals of treatment. Let us find out about what all are the cancer treatments · Chemotherapy -The word "chemotherapy" ("chemo") is commonly used for medicines that treat cancerChemo is a general treatment where the medicine travels throughout the body and might kill cancer cells that have metastasized to components of the body far-off from the initial (primary) tumor. This makes it completely different from treatments like surgery and radiation. Surgery removes a tumor from the body wherever cancer has been found, and radiotherapy is aimed to give radiation to the part of the body to kill or harm cancer cells. Treatments like these affect one part of the body. Goals of therapy - 1. Cure2. Control3. Palliation Palliative CarePalliative care is concentrated on scaling up the quality of life for individuals living with advanced stages of the disease. Individuals with cancer could receive palliative care at any time from the time of diagnosis, throughout treatment, and beyond. The knowledge here can assist you to learn additional concerning palliative care. Why palliative care is very important in cancer care?For cancer patients, it is important to recollect that the consequences of cancer and its treatment are often completely different from person to person. A palliative care team includes a bunch of specialists who work along to assist the patient and caregiver with varied forms of desires after scrutinizing every person's scenario. The palliative care team will facilitate by:• Controlling physical symptoms and after effects• Managing emotions that go with cancer diagnosis and treatment• Showing the family ways of handling life and family changes• Understanding any non-secular considerations• Supporting desires of caregivers• Assisting with money, work, and insurance problems• Helping fill out advance directives and alternative forms Radiation therapy – Radiation therapy is one of the foremost common treatments for cancer. Radiation is also used alone or with other treatments, like surgery, chemotherapy, hormones, or targeted medical aid. In cancer, the cells unremarkably grow and divide to create new cells and that too these cancer cells grow and divide quicker than most traditional cells. Radiation works by creating tiny breaks within the deoxyribonucleic acid within cells. This therapy breaks cancer cells from growing and dividing and causes them to die. The radiation therapy aimed toward and affects solely a part of the body needing treatment. Targeted therapy –Targeted therapy could be a kind of cancer treatment that uses medicine designed to "target" cancer cells while not affecting normal cells.Cancer cells usually have changes in their genes that make them completely different from normal cells. This therapy usually targets proteins that control the growth, division, and spread of cancer cells.The working technique of Targeted therapy targets -• A specific protein on a neoplastic cell• A protein on a neoplastic cell that's not on normal cells• A protein that's mutated (changed) in a way on a neoplastic cell• Gene (DNA) changes that are not in a normal cell. Immunotherapy-Immunotherapy is a treatment that uses components of a person’s system to fight diseases like cancer. This may be utilized in a handful of ways:• Stimulating, or boosting, the natural defenses of your system thus it works tougher or smarter to search out and attack cancer cells• Making substances in the laboratory that are similar to system parts and using them to assist restore or improve the immune system works to search out and attack cancer cells Stem cell and Bone Marrow Transplant -A bone marrow transplant is often accustomed to treat various forms of cancer. Hormone Therapy - Hormones are proteins or substances created by the body that facilitate the management of functions effectively. However certain cancer cells have hormone receptors which makes them a good target for hormone therapy to destroy these cancerous cells
More detailsPublished - Sat, 24 Sep 2022
Created by - Dr. Prashant Raj
Sepsis – Clinical Features & Differential Diagnoses
Sepsis needs to be categorized as a clinical syndrome. Two of the systemic inflammatory response syndrome requirements must be met, together with an infection source, to be classified as sepsis.Systemic Inflammatory Response Syndrome Criteria:1. Temperature > 38°C (101.4°F) or < 36°C (96.8°F)2. Heart rate > 903. Breathing rate > 20 or PaCo2 < 32 mm Hg4. While blood cells > 12,000/μL or < 4,000/μLFactors Predisposing to Sepsis1. Extremes of age2. Iatrogenic procedures (e.g., indwelling catheters, surgical or invasive diagnostic procedures).3. Social factors (e.g., alcoholism, substance abuse, intravenous drug abuse)4. Immunosuppression (e.g., neutropenia, complement deficiencies, hypo- or agammaglobulinemia, splenectomy, HIV infection).5. Medical conditions (e.g., burns, cirrhosis, cancer, diabetes mellitus, multiple trauma, complicated pregnancy or delivery).6. MalnutritionCLINICAL FEATURES: Depending on whether the patient is in the early, moderate, or late stages of the illness, it varies significantly.1. General symptoms and physical examination findingsa) Systemic findings may include chills, fever, rigorsb) Neuromuscular findings may include arthralgias and myalgias.c) Neurologic findings may include a changed state of mind.d) Cardiopulmonary findings may include arrhythmias, hypotension, hypertension, tachycardia, a widened pulse pressure, or tachypnea.e) Dermatologic findings: Petechiae, embolic lesions, and ecthyma gangrenosum are cutaneous abnormalities that might raise clinical suspicion of sepsis.2. Site-specific symptoms and physical examination findingsa) Skin: Findings that might be indicative of the initial focal source include a localized increase in temperature, erythema, induration, tenderness, lymphadenitis, and pus.b) Heart or lungs: Findings may include a cough, chest pain, cyanosis, dyspnea, sputum, rales, or edema.c) Urinary tract: Findings may include dysuria, Increased frequency, urinary urgency, tenesmus, flank pain, oliguria, or anuria.d) Gastrointestinal tract: Findings may include abdominal pain, diarrhea, nausea, vomiting, constipation, or jaundice.e) Central nervous system (CNS): Findings may include an altered sensorium, focal neurologic signs, headache, stiff neck, photophobia, retinal hemorrhages, cotton wool spots, conjunctival petechiae, endophthalmitis, or panophthalmitis.DIFFERENTIAL DIAGNOSES include the following:1. Endocrine diseases (e.g., adrenal insufficiency, thyroid storm).2. Nonseptic causes of shock (e.g., anaphylaxis, cardiogenic shock, cardiac tamponade, hypovolemic shock, neurogenic shock, pulmonary embolism, dissecting aortic aneurysm).3. Viral diseases (e.g., influenza, dengue fever, coxsackie B virus infection)4. Spirochetal diseases (e.g., syphilitic Jarisch-Herxheimer reaction, leptospirosis, relapsing fever caused by Borrelia infection).5. Rickettsial diseases (e.g., endemic typhus, Rocky Mountain spotted fever)6. Protozoal diseases (e.g., Pneumocystis carinii infection, Plasmodium falciparum infection, Toxoplasma gondii infection, Trypanosoma cruzi infection)7. Collagen vascular diseases8. Vasculitides9. Thrombocytic thrombocytopenic purpura/hemolytic–uremic syndrome
More detailsPublished - Sun, 25 Sep 2022
Created by - Dr. Prashant Raj
Complications of Kidney
Kidney disease largely affects your overall health. If your kidneys aren’t operating well, it will cause complications in various parts of your body.Some potential considerations are:Anaemia-This happens when your kidneys don’t build enough glycoprotein (EPO), which affects their ability to create red blood cells. you can also have anaemia due to the low levels of iron, folic acid, or B12 vitamin. Anaemia will deprive very important organs and tissues of oxygen.Bone weakness-once your kidneys aren’t operating well, it will cause low calcium and high phosphorus levels (hyperphosphatemia), which may lead to the weakening of your bones. This will increase the danger of bone fractures.Fluid retention - this occurs when the body hangs on to excess fluids which may cause swelling of the limbs (oedema), high blood pressure, or fluid in the lungs.Gout- this is a kind of inflammatory disease caused by a build-up of uric acid in your joints. Uric acid is filtered through the kidneysHeart illness -This affects your heart or blood vessels. once your kidneys aren’t functioning properly, it will cause heart disease.High blood pressure (hypertension) - This happens once the force of the blood pumping through your blood vessels is just too high. High blood pressure will cause worsening of kidney function which in turn may cause fluid retention and worsening high blood pressure.Hyperkalaemia - this can happen due to a sudden rise in potassium levels which will affect how the heart operates.Metabolic acidosis - once there’s an excessive amount of acid in your bodily fluids that your kidneys don’t filter, it causes ph imbalance which could eventually worsen the kidney disease and may cause problems like bone or muscle loss, or endocrine disorders. Uraemia - This can be a build-up of waste product in your blood, indicating kidney damage which could cause a range of symptoms like fatigue, nausea, restless leg syndrome, and sleep disturbances.
More detailsPublished - Mon, 26 Sep 2022
Created by - Dr. Prashant Raj
How to Evaluate Sepsis
Sepsis cannot be diagnosed by a single trustworthy laboratory test. The following extra testing is still regarded as crucial even though the presumptive diagnosis is based on the history and physical examination.1. Laboratory studies:a) Blood cultures and site-specific cultures (e.g., sputum, urine, cerebrospinal fluid [CSF]) should be obtained before initiating empiric antibiotic therapy.b) Gram staining of samples from a particular location is advised.c) Serologic studies (e.g., counter-immune electrophoresis, latex agglutination) are useful when infection with pneumococcus, Haemophilus influenza, meningococcus, or group B streptococcus is suspected.d) Complete blood count (CBC): Findings compatible with a diagnosis of sepsis include anemia, leukopenia, leukocytosis, eosinopenia, and thrombocytopenia.e) Urinalysis: A result that confirms the diagnosis of sepsis is proteinuria.f) Urine Legionella antigen: Positive results imply either a recent or historical infection. May already be visible in the urine three days after the onset of symptoms.g) The most common cause of community-acquired pneumonia is the urinary Streptococcus pneumoniae antigen.h) Coagulation profile: The presence of thrombocytopenia and a prolonged prothrombin time are signs that sepsis is present.i) Arterial blood gas profile: Hypoxemia and metabolic acidosis could be detected in a sepsis patient.j) Serum biochemical profile: Supportive findings would include hypoferremia, hypocalcemia, hyperbilirubinemia, hyper- or hypoglycemia, and azotemia.k) Lactic acid: Mostly made anaerobically in the red blood cells and muscles. Elevated levels (>1mmol/L) can be a manifestation of organ hypoperfusion in the presence or absence of hypotension and is an important component of initial sepsis workup. Keep in mind that increased levels can also be found in heart, liver, and lung diseases in addition to sepsis.l) A very unwell patient's procalcitonin level can be used to check for a systemic bacterial infection. This test is best used during the first day of the presentation of illness and subsequently to monitor the response to treatment.2. Imaging studies: It may be necessary to do site-specific radiographs, ultrasonograms, computed tomography (CT) scans, or magnetic resonance imaging scans.3. Other studies: It may be useful to analyze site-specific samples taken via biopsy or aspiration.
More detailsPublished - Tue, 27 Sep 2022
Created by - Dr. Prashant Raj
Varicella (chickenpox)
The disease is spread by airborne droplets or contact with vesicle fluid from an infected person and is highly contagious; however, patients are no longer contagious when all of the lesions have crusted over. The incubation period is 14 to 21 days.CLINICAL FEATURESPapules progress to vesicles that crust over. Lesions of various stages are seen simultaneously. The rash starts on the trunk and spreads to the face and extremities, sparing the palms and soles.DIFFERENTIAL DIAGNOSES— Herpes simplex— Bullous impetigo— Disseminated herpes zosterEVALUATIONDiagnosis is usually made based on the patient history and physical examination findings. However, a Tzanck smear of vesicle fluid or serologic titers can confirm the diagnosis.THERAPYThe patient is isolated to contain the spread of the disease till all the lesions are crusted over.1. Diphenhydramine (25 mg orally four times daily for adults; 5 mg/kg every 24 hours divided into four doses for children) can be administered to relieve itching. Itching discomfort can also be reduced using menthol lotion.2. Intravenous acyclovir (10 mg/kg every 8 hours for 7 to 10 days) is indicated for immunosuppressed patients.3. Oral antibiotics (e.g., cloxacillin) can be prescribed for patients with secondarily infected lesions.DISPOSITIONHospital admission is warranted for patients with complications (e.g., pneumonia, cellulitis, encephalitis, Reye syndrome).
More detailsPublished - Tue, 27 Sep 2022
Created by - Dr. Prashant Raj
Herpes zoster (shingles)
Herpes zoster is the reactivation of the varicella virus (chickenpox) along one or two contiguous dermatomes. The prevalence of this illness is highest in elderly patients, and immunosuppression is a contributing factor (which occurs with chemotherapy, leukemia, Hodgkin lymphoma, and other malignancies).CLINICAL FEATURES1. Pain, burning, and hyperesthesia precede the eruption of vesicles.2. Lesions occur on the face, neck, thorax, lumbosacral area, and the tip of the nose. The eruption is limited to one side of the body in most cases.a) Ramsay Hunt syndrome involves cranial nerve VII; vesicles are seen in the ear canal or on the pinna. This syndrome can lead to hearing loss, facial paralysis, and loss of taste in the anterior two-thirds of the tongue.b) Serious ocular complications can result from the involvement of the trigeminal nerve; lesions are seen on the tip of the nose. Fluorescein stain with slit-lamp eye examination may reveal a dendritic pattern consistent with a serious viral infection of the cornea.DIFFERENTIAL DIAGNOSES— Herpes simplex — Poison ivy— Contact dermatitis— Localized bacterial infectionEVALUATION1. For lesions involving the nose tip or peri-orbital area, the eye should be fluorescein-stained to evaluate for herpetic keratitis; consultation with an ophthalmologist is warranted.2. A positive Tzanck smear of vesicle fluid and rising viral titers are diagnostic but seldom needed.THERAPY1. Acyclovira) Oral acyclovir (800 mg five times daily for 5 to 10 days) is effective if therapy is initiated within 48 hours of the appearance of lesions.b) Intravenous acyclovir (10 mg/kg over 1 hour every 8 hours for 7 days) is indicated for patients with severe outbreaks, patients with herpes keratitis, and immunosuppressed patients.c) Topical acyclovir can be applied four times daily for 10 days.2. Prednisone can be administered orally to shorten the duration of symptoms and is given as a tapered dose, starting at 30 mg.3. Analgesics may be needed; some patients will require opiate medications. Capsaicin cream can be applied topically five times daily and is useful for patients with postherpetic neuralgia.DISPOSITION Admission is required for immune-compromised patients, patients with ophthalmologic herpes zoster, and patients with complications (e.g., meningitis, peripheral neuropathy, cutaneous dissemination).
More detailsPublished - Thu, 29 Sep 2022
Created by - Dr. Prashant Raj
How does Extracurricular Activity boost your physical activity?
Extracurricular sports or athletic activities give opportunities for youngsters and adolescents to play games such as football, tennis, baseball, softball, volleyball, and basketball. All the varied different sports are placed at beginner, intermediate, and difficult levels. Activities are offered at different talent levels to encourage participation. Programs can embody physical activity elements like dance, fitness exercises, or physically active games, usually as a part of health initiatives that provide several benefits such as:· Increased physical activity· Improved fitness· Reduced fatness rates· Increased learning· Reduced antisocial behavior· Reduced young physiological stateThere is some proof that increasing access to extracurricular sports, athletic activities, and active programs will increase children’s physical activity Participation in extracurricular sports and activities is related to higher physical activity levels for youngsters and adolescents. Access to publically provided recreation programs will scale back children’s risk of being overweight and obese. Overall, school students from families with low incomes in urban areas that participate in athletics (except football) have lower BMIs than their peers. Participation in a minimum of 3 hours of sports per week seems to extend physical activity levels, fitness, and total lean body mass for boys. Overall, physical activity interventions throughout dedicated sports hours are shown to extend the period of participants’ physical activity and scale back time spent watching TV. Extracurricular physical activity programs are related to sturdy tutorial performance, low juvenile arrest rates, and low young birth rates. A Physical Activity Program in a college curriculum can contribute to enhancements in students’ learning and reading scores along with the improved physical activity. Experts counsel that increasing the frequency of extracurricular activities offered might increase participants’ overall physical activity, and increase interaction among students.
More detailsPublished - Thu, 29 Sep 2022
Created by - Dr. Prashant Raj
Erythema Multiforme
1. Erythema multiforme minor is characterized by a skin rash, which may be accompanied by the involvement of one mucous membrane site.2. Erythema multiforme major (Stevens-Johnson syndrome) is characterized by severe and extensive mucous membrane involvement and the involvement of multiple organ systems.ETIOLOGYErythema multiforme appears to be a hypersensitivity reaction to drugs, infectious organisms, and other unknown entities. Causes include:1. Drugs (especially aspirin, penicillins, sulfonamides, phenytoin, rifampin, and phenobarbital).2. Infectious diseases, most commonly herpes simplex, Mycoplasma infection, Coxsackie and adenovirus infections, hepatitis B, and histoplasmosis.3. Vaccines, including Bacille Calmette-Guérin and the poliomyelitis vaccine4. Idiopathic (50% of cases)CLINICAL FEATURESThe onset is sudden. Fever, malaise, and arthralgias are common. The lesions usually spare the trunk.1. Dermal lesions: The rash may present as erythematous macules, papules, wheals, vesicles, or bullae. It appears mostly on the palms, soles, and dorsa of the extremities. The dermal lesions (“target lesions”) are papules or vesicles surrounded by a zone of normal skin and then a halo of erythema; they resemble a bull’s eye target.2. Mucosal lesions: Hemorrhagic lesions can be found on the lips and oral mucosa.3. A burning sensation is present on the skin and mucous membranes. Pruritus is absent.DIFFERENTIAL DIAGNOSES1. The dermal lesions must be differentiated from secondary syphilis, contact dermatitis, and meningococcemia.2. The mucosal lesions must be differentiated from pemphigus and herpetic stomatitis.EVALUATIONDiagnosis depends primarily on history and physical examination findings. Skin biopsy specimens show edema, extravasated erythrocytes, and necrolysis in the epidermis.THERAPY1. The cause should be treated (e.g., with antibiotics or termination of drug therapy) if it can be identified.2. The use of systemic corticosteroids is controversial and has been associated with both remissions of the disease and with secondary, fatal, respiratory infections. If steroid treatment is used, prednisone (2 mg/kg/day) is given with subsequent tapering.DISPOSITION Patients with mild cases are treated as outpatients; patients with more severe mucous membrane involvement require hospitalization. Recurrent attacks lasting 2 to 4 weeks and usually occurring in the spring or autumn have been reported.
More detailsPublished - Thu, 29 Sep 2022
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