Space of Poirier

*Space of Poirier:

Diagram of arcuate ligament (greater arc, zone of fractures and dislocations),
lesser arc (zone of dislocations), and
space of Poirier (vulnerable zone between greater and lesser arcs),

superimposed on wrist radiograph.

>Fibers of radioscaphocapitate ligament (yellow) and
ulnocapitate ligament (purple) interdigitate and form an arclike ligamentous structure, termed the arcuate ligament, in the greater arc region (black line). Note lesser arc that outlines the lunate (dashed red line).
>The scapholunate ligament and lunotriquetral ligament are part of the lesser arc, which does not extend to the distal radius and ulna.

*{The space of Poirier (white arrows) is located between the lesser and greater arcs.}

Early signs of prostate cancer

There are no definite early warning signs of prostate cancer. However, individuals report problems with the prostate gland in the initial stage of the disease. When an individual experiences difficulty initiating or stopping urine stream, or his urination frequency is more than usual, or experiences pain during urination, or pain when ejaculating, he should see a doctor for prostate cancer screening.Mentioned below are the detailed common signs of prostate cancer that are exhibited in its initial stage.Difficulty urinating – It is the condition when you feel like urinating but don’t urinate or urination stops or you have to go more often to urinate. Another case could be  difficulty in stopping urination, which is also known as urinary incontinence. Prostate tumour can interfere with urination or ejaculation as the prostate gland surrounds the urethra (tube that carries both urine and semen). Moreover, men may encounter urination difficulty or prostate enlargement leading to urinary problems as they age.Pain while urinating – Prostate tumour may suppress the urethra and cause pain while urination. However, the symptom should not be confused with prostatitis (infection of the prostate) or benign prostatic hyperplasia (BPH).Blood in urine – Blood smear in urine is another indication of prostate cancer in its initial phase. See a doctor to confirm if the blood in urine is due to developing prostate cancer or other urinary tract infections.Difficulty to keep an erection – A growing prostate tumour can prevents increase in blood flow for an erection, or prevents the erection from sustaining to ejaculation.Blood in semen – Pinkish or streaked semen in an indicator of early stage of prostate cancer, which occurs as a result of prostate tumour’s interference with urethra.Chronic constipation and intestinal problems – A developing prostrate tumour tends to hamper digestive functions, as positioning of prostate gland is just below the bladder and in front of the rectum.Frequent pain in the lower back, or hips, or upper thighs – Prostrate cancer affects or spreads to lower back, pelvis and hips. If you are experiencing pain and tenderness in these areas, you must see a doctor to clarify the root cause of unexplained sign. Usually, pain in sciatica and lower back feels deeper.Most men are surprised to learn that they are diagnosed with prostate cancer, as they encounter no specific symptoms at all. If men experience signs mentioned above, they are advised by doctor to take prostate specific antigen (PSA) test for confirming it.

10 HEALTHY EATING TIPS FOR KIDS

10 HEALTHY EATING TIPS FOR KIDS

1. Food is Fun… Enjoy your food
2. Breakfast is a very important meal
3. Eat lots of different foods every day, variety is the recipe for health 4. Which group would you tip for the top? Base your food on carbohydrates
5. Gimme five! Eat fruits and vegetables with each meal and as tasty snacks!
6. Fat facts. Too much saturated fat is not good for your health
7. Snack attack! Eat regularly and choose a variety of snacks
8. Quench your thirst. Drink plenty of liquids
9. Care for those teeth! Brush your teeth at least twice a day
10. Get moving! Be active every day

Do you remember when you learned to ride a bike? The most important part was getting the balance right. Once you could balance easily, the pedals could turn smoothly, to drive the wheels and get the bike moving.

The same thing is true when it comes to choosing our food. Once we have learned to carefully balance the amounts and types of foods eaten, all the organs in the body will function smoothly and the body will work efficiently.

Following these ten tips will help you stay fit and healthy. It’s as easy as riding a bike, once you’ve got the balance right!

1. Food is Fun… Enjoy your food

Sharing a meal with family and friends at home or at school is a great way to enjoy food. It is fun to see other people’s choice of food -what sandwich fillings do others have? Have you tried having a different filling every day? Check out your lunch box or dinner plate. How many different kinds of fruit and vegetables can you spot?

2. Breakfast is a very important meal

Our bodies always need energy, and after a night’s sleep, energy levels are low. Cars, buses and trains cannot run without fuel. So, whether you are off to school, or out and about at the weekend, start the day with breakfast. Plenty of carbohydrates is just the ticket: try cereal with semi-skimmed milk, fruit or yoghurt, toast or bread, perhaps with lean meats.

3. Eat lots of different foods every day, variety is the recipe for health

You need over 40 different kinds of vitamins and minerals every day for good health. Since there is no single food that contains them all, it is important to balance your daily choices. In fact there are no good or bad foods, so you do not need to miss out on the foods you enjoy. The best way to make sure you get the right balance is to eat a wide variety of foods each day.

4. Which group would you tip for the top? Base your food on carbohydrates

Many people don’t eat enough carbohydrate foods, such as cereals, rice, pasta, potatoes and bread. At least half the calories in your diet should come from these foods, so it is a good idea to include at least one of these at every meal. Try whole-grain bread, pasta and other cereals to give you extra fibre. Have you tried baking your own bread? It’s good fun and smells wonderful!

5. Gimme five! Eat fruits and vegetables with each meal and as tasty snacks!

Fruits and vegetables are among the most important foods for giving us enough vitamins, minerals and fibre. We should all try to eat 5 servings a day. For example, a glass of fruit juice at breakfast, perhaps an apple and banana as snacks and two vegetables at meal times then you have already reached your total. How many different kinds can you spot in the supermarket? Why not try some new ones?

6. Fat facts. Too much saturated fat is not good for your health

Eating too many of those tasty, fatty foods (such as butter, spreads, fried meats and sausages, pies and pastries) might not always be so good for your body. So remember, a big helping of potatoes, but go easy on the butter. Although we need some fats to get all the nutrients we need, it is better for our health if we don’t eat too much of these foods and get knocked off balance. So, if you have a high-fat lunch, choose a low-fat dinner.

7. Snack attack! Eat regularly and choose a variety of snacks

Even if you eat regular meals during the day, there will still be times in between that you feel hungry, especially if you have been very physically active. Snacks can fill the gap, but should not be eaten in place of meals, only as an extra. There are lots of different snacks available. Your choice may be crisps, nuts and other packet snacks, chocolate bars, cakes and biscuits. On other occasions, you may prefer a sandwich, some fresh or dried fruits, or perhaps sticks of vegetables like carrots and celery. Whichever snack you enjoy, remember it is always good to include a variety of different types to keep things in balance.

8. Quench your thirst. Drink plenty of liquids

Did you know that more than half of your weight is just water? So as well as giving your body all the food it needs each day to keep healthy, you need at least 5 glasses of liquids a day. It is particularly important if the weather is very hot or if you have done lots of exercise, to have plenty to drink to prevent dehydration. Usually – but not always – your body will tell you this, by making you feel thirsty. Plain tap water is great of course, but bottled water, fruit juices, tea, soft drinks, milk and so on, can all be okay too.

9. Care for those teeth! Brush your teeth at least twice a day

Brush your teeth at least twice a day. Eating foods high in sugar or starches too often during the day can play a part in tooth decay. So don’t nibble foods and sip drinks all day long! However, the best way to keep a nice smile is to brush your teeth twice a day with a fluoride toothpaste. Also, after brushing your teeth at bedtime, don’t eat any food, or drink anything but water!

10. Get moving! Be active every day

Just like a bike may become rusty if it is not used for some time, our muscles and bones need to be kept moving too. Activity is needed to keep your heart healthy and your bones strong. It can also be good fun. Try to include some form of activity every day: it may be just walking to school and running up the stairs. However, games like skipping and football at break times are good for giving the body a workout. Swimming is a particularly good sport for keeping you healthy.

Health benefits of CABBAGE

HEALTH BENEFITS OF CABBAGE:

The health benefits of cabbage include treatment of constipation, stomach ulcers, headache, excess weight, skin disorders, eczema, jaundice, scurvy, rheumatism, arthritis, gout, eye disorders, heart diseases, a

geing, and Alzheimer's disease.Did you know that the cheap, humble looking and so widely used cabbage could work miracles? Cabbage is a leafy vegetable of Brassica family, round or oval in shape, consisting of soft light green or whitish inner leaves covered with harder and dark green outer leaves. It is widely used throughout the world, eaten cooked or raw as salad and is a very popular vegetable.

Deficiency Symptoms:
Deficiency of Vitamin C: Scurvy, which is recognized by spongy and bleeding gums, cracked lip corners etc., very weak immune system, frequent infections and cold, ageing, depression etc.
Remedy: Cabbage is abundant is Vitamin C. You will be surprised to know that it is richer in vitamin C than the famous oranges. Vitamin C, being one of the best anti oxidant, reduces free radicals in your body which are the basic causes of ageing. It also helps repairing the wear and tears in the body. Thus it is very helpful in treating ulcers, certain cancers, depressions, for strengthening immune system and fighting against cough and cold, healing of wounds and damaged tissues, proper functioning of nervous system and thereby help curing Alzheimer’s disease etc.

Deficiency of Roughage: This is a very serious deficiency but most neglected. Lack of roughage in the food results in constipation, the root cause to innumerable other ailments and health hazards such as stomach ulcers, headache, intestinal cancer, indigestion and resultant loss of appetite, skin diseases, eczema, ageing and hundreds related problems.
Remedies: Cabbage is very rich in fiber. This helps retain water and forms the bulk of the food and the bowels. Thus it is a good cure for constipation and related problems.



Deficiency of Sulphur: Sulphur is a very useful nutrient as it fights infections. Its deficiency results in microbial infections and late healing of wounds.
Remedy: Again, cabbage is rich is sulphur. So, it helps fight infections in wounds and ulcers.

Detoxification by cabbage: Cabbage is a good detoxifier too, i.e. it purifies blood and removes toxins (primarily free radicals and uric acid which is major cause for rheumatism, gout, arthritis, renal calculi, skin diseases, eczema, hardening and de-colorization of skin etc.). This detoxifying effect of cabbage is due to the presence of vitamin C and sulphur.



Other benefits of Cabbage: Cabbage, being rich in iodine, helps in proper functioning of the brain and the nervous system, apart from keeping the endocrinal glands in proper condition. Thus, it is good for brain and treatment of neurotic disorders such as Alzheimer’s disease. The various other nutrients present in cabbage such as vitamin-E which keeps the skin, eye and hair healthy, calcium, magnesium, potassium, etc., are very useful for overall health. The cabbage can also be used for treatment of varicose veins, leg ulcers, peptic and duodenal ulcers etc.

Tension pneumothorax at a glance.

Intern special Learn " Sampling " ----------------------- Venous Blood Sampling **

Intern special
Learn " Sampling "
-----------------------
Venous Blood Sampling
************************
1- Apply a tourniquet proximal to the
venepuncture site.
2- Tap on or rub the skin overlying the
vein you want to puncture lightly to
make it standout; or if the vein is
obscure, you may be able to palpate its
course with you index finger.
3- Sterilization with alcohol and leave to
dry in air
(traces of alcohol causes hemolysis)
4- Hold the syringe between the thumb
and the middle, ring and small finger of
your dominant hand and steady the
needle using your index finger
.
" Never hold the syringe like a pencil because it limits your angle of skin
entry "
5- confirme entry of the vein by
aspiration of blood, Once the desired
volume of blood is aspirated into the
syringe, steady it with one hand and
release the tourniquet with the other
hand.
6- Use a piece of dry gauze to apply
gentle pressure to the entry site while
the needle is withdrawn. Ask the
patient to continue to apply pressure
while you attend to the specimen
obtained .
7- Remove the needle from the syringe
and drop it into the special box for
disposal of sharp instruments
immediately .
8- Uncap the specimen container and
deposit the blood sample into it directly
from the syringe. Injecting blood into
the container via the needle is not
advisable because:
(a) you may prick
yourself and
(b) forcing blood through the needle may cause hemolysis that
can adversely affect the analytical
fitness of the specimen.
■ Avoid hemolysis:-
Allow alcohol to dry
Clean tubes
Withdraw blood slowly
Do not use too fine needle
Deliver blood gently to the tube Avoid frothing
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Signs of Aortic Regurgitation

Aortic regurgitation (AR) is incompetency of the aortic valve causing flow from the aorta into the left ventricle during diastole. Causes include idiopathic valvular degeneration, rheumatic fever, endocarditis, myxomatous degeneration, congenital bicuspid aortic valve, aortic root dilatation or dissection, and connective tissue or rheumatologic disorders. Symptoms include exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, palpitations, and chest pain. Signs include widened pulse pressure and an early diastolic murmur. Diagnosis is by physical examination and echocardiography. Surgical treatment is aortic valve replacement.
Etiology
AR may be acute or chronic. The primary causes of acute AR are infective endocarditis and dissection of the ascending aorta. Mild chronic AR in adults is most often caused by a bicuspid or fenestrated aortic valve (2% of men and 1% of women), especially when severe diastolic hypertension (pressure ≥ 110 mm Hg) is present. Moderate to severe chronic AR in adults is most often caused by idiopathic degeneration of the aortic valves or root, rheumatic fever, infective endocarditis, myxomatous degeneration, or trauma. In children, the most common cause is a ventricular septal defect with aortic valve prolapse. Rarely, AR is caused by seronegative spondyloarthropathies (ankylosing spondylitis, reactive arthritis, psoriatic arthritis), RA, SLE, arthritis associated with ulcerative colitis, luetic (syphilitic) aortitis, osteogenesis imperfecta, thoracic aortic aneurysm, aortic dissection, supravalvular aortic stenosis, Takayasu's arteritis, rupture of a sinus of Valsalva, acromegaly, and temporal (giant cell) arteritis. AR due to myxomatous degeneration may develop in patients with Marfan syndrome or Ehlers-Danlos syndrome.

Pathophysiology
In chronic AR, left ventricular (LV) volume and LV stroke volume gradually increase because the LV receives aortic blood regurgitated in diastole in addition to blood from the pulmonary veins and left atrium. LV hypertrophy compensates for the increase in LV volume over years, but decompensation eventually develops. These changes may ultimately cause arrhythmias, LV impairment, and heart failure (HF).

Symptoms and Signs
Acute AR causes symptoms of HF and cardiogenic shock. Chronic AR is typically asymptomatic for years; progressive exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations develop insidiously. Symptoms of HF correlate poorly with objective measures of LV function. Chest pain (angina pectoris) affects only about 5% of patients who do not have coexisting coronary artery disease (CAD) and, when it occurs, is especially common at night. Patients may present with endocarditis (eg, fever, anemia, weight loss, embolic phenomena) because the abnormal aortic valve is predisposed to bacterial seeding.

Signs vary by severity. As chronic disease progresses, systolic BP increases while diastolic BP decreases, creating a widened pulse pressure. With time, the LV impulse may become enlarged, sustained, increased in amplitude, and displaced downward and laterally, with systolic depression of the entire left parasternal area, giving a rocking motion to the left chest.

A systolic apical or carotid thrill may become palpable in later stages of AR; it is caused by large forward stroke volumes and low aortic diastolic pressure.

Auscultatory findings include a normal 1st heart sound (S1) and a nonsplit, loud, sharp or slapping 2nd heart sound (S2) caused by increased elastic aortic recoil. The murmur of AR is often unimpressive. The murmur is blowing, high-pitched, diastolic, and decrescendo, beginning soon after the aortic component of S2 (A2); it is loudest at the 3rd or 4th left parasternal intercostal space. The murmur is heard best with the diaphragm of the stethoscope when the patient is leaning forward, with breath held at end-expiration. It increases in volume in response to maneuvers that increase afterload (eg, squatting, isometric handgrip). If AR is slight, the murmur may occur only in early diastole. If LV diastolic pressure is very high, the murmur is short because aortic and LV diastolic pressures equalize earlier in diastole.

Other abnormal sounds include a forward ejection and backward regurgitant flow (to-and-fro) murmur, an ejection click soon after the S1, and an aortic ejection flow murmur. A diastolic murmur heard near the axilla or mid left thorax (Cole-Cecil murmur) is caused by fusion of the aortic murmur with the 3rd heart sound (S3), which is due to simultaneous filling of LV from the left atrium and AR. A mid-to-late diastolic rumble heard at the apex (Austin Flint murmur) may result from rapid regurgitant flow into the LV, causing mitral valve leaflet vibration at the peak of atrial flow; this murmur mimics the diastolic murmur of mitral stenosis.

Other signs are unusual; sensitivity and specificity are low or unknown. Visible signs include head bobbing (Musset's sign) and pulsation of the fingernail capillaries (Quincke's sign, best seen with slight pressure) or uvula (Müller's sign). Palpable signs include a large-volume pulse with rapid rise and fall (slapping, water-hammer, or collapsing pulse) and pulsation of the carotid arteries (Corrigan's sign), retinal arteries (Becker's sign), liver (Rosenbach's sign), or spleen (Gerhard's sign). BP findings may include popliteal systolic pressure ≥ 60 mm Hg higher than brachial pressure (Hill's sign) and a fall in diastolic BP of > 15 mm Hg with arm elevation (Mayne's sign). Auscultatory signs include a sharp sound heard over the femoral pulse (pistol-shot sound, or Traube's sign) and a femoral systolic bruit distal and a diastolic bruit proximal to arterial compression (Duroziez's murmur).

All about MYOCARDIAL INFARCTION (heart attack)

Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of secondary to prolonged ischemia. This usually results from an imbalance in oxygen supply and demand, which is most often caused by plque ruptre with thrombus formation in a cornary vessel, resulting in an acute reduction of blood supply to a prtion of the myocardium.

RISK FACTORS:

Modifiable:

Hyperlipidemia

High blood pressure

Diabetes

Obesity

Poor
Lack of exercise

Non Modifiable :

Strong family history

Increasing age

males at all ages n females more after menopause

genetic

Male-pattern baldness

NON ATHEROSCLEROTIC causes of myocardial infarction:

Coronary occlusion secondary to vasculitis

Ventricular hypertrophy

Coronary artery emboli, secondary to cholesterol, air, or the products of sepsis

Congenital coronary anomalies

Coronary trauma

Primary coronary vasospasm variant
Drug use cocaine, amphetamines, ephedrine

Arteritis

Coronary anomalies, including aneurysms of coronary arteries

heavy exertion, fever, or hyperthyroidism

hypoxemia of severe anemia

Aortic dissection,

Infected cardiac valve through a patent foramen ovale (PFO)

Significant gastrointestinal bleed

SYMPTOMS OF MI:

Classical symptoms of acute myocardial infarction include sudden chest pain typically radiating to the left arm ,jaw,back, neck, shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety

diaphoresis,wheezing,cough may also be present

SIGNS :

not relieved by nitrates&taking rest more duration than angina.pain is squeezing, aching, burning, or even sharp.pain is relieved by narcotics only.

TIMING:

can occur at any time, more heart attacks occur between 4:00 A.M. and 10:00 A.M. because of the higher blood levels of adrenaline released from the adrenal glands during the morning hours &increased serum concentrations of plasminogen activator inhibitor-1 (PAI-1). Increased adrenaline helps in rupture of cholesterol plaques

DIAGNOSIS:

most of times plays the main role in ecg ST-T changes occur either elevation or depression which should be convex in shape

All about GUILLAIN-BARRE syndrome. Must see post

Guillain-Barré syndrome is an acute, usually rapidly progressive inflammatory polyneuropathy characterized by muscular weakness and mild distal sensory loss. Cause is thought to be autoimmune. Diagnosis is clinical. Treatment includes plasmapheresis, γ-globulin, and, for severe cases, mechanical ventilation.
Guillain-Barré syndrome is the most common acquired inflammatory neuropathy. Although the cause is not fully understood, it is thought to be autoimmune. There are several variants. In some, demyelination predominates; others affect the axon.

In about two thirds of patients, the syndrome begins 5 days to 3 wk after a banal infectious disorder, surgery, or vaccination. Infection is the trigger in > 50% of patients; common pathogens include Campylobacter jejuni, enteric viruses, herpesviruses (including cytomegalovirus and Epstein-Barr virus), and Mycoplasma sp. A cluster of cases followed the swine flu vaccination program in 1975.

Symptoms and Signs
Flaccid weakness predominates in most patients; it is always more prominent than sensory abnormalities and may be most prominent proximally. Relatively symmetric weakness with paresthesias usually begins in the legs and progresses to the arms, but it occasionally begins in the arms or head. In 90% of patients, weakness is maximal at 3 wk. Deep tendon reflexes are lost. Sphincters are usually spared. Facial and oropharyngeal muscles are weak in > 50% of patients with severe disease. Dehydration and undernutrition may result. Respiratory paralysis severe enough to require endotracheal intubation and mechanical ventilation occurs in 5 to 10%.

A few patients (possibly with a variant form) have significant, life-threatening autonomic dysfunction causing BP fluctuations, inappropriate ADH secretion, cardiac arrhythmias, GI stasis, urinary retention, and pupillary changes. An unusual variant (Fisher variant) may cause only ophthalmoparesis, ataxia, and areflexia.

Diagnosis
Clinical evaluation
Electrodiagnostic testing
CSF analysis
Diagnosis is primarily clinical. Similar acute weakness can result from myasthenia gravis, botulism, poliomyelitis (mainly outside the US), tick paralysis, West Nile virus infection, and metabolic neuropathies, but these disorders can usually be distinguished as follows:

Myasthenia gravis is intermittent and worsened by exertion.
Botulism may cause fixed dilated pupils (in 50%) and prominent cranial nerve dysfunction with normal sensation.
Poliomyelitis usually occurs in epidemics.
Tick paralysis causes ascending paralysis but spares sensation.
West Nile virus causes headache, fever, and asymmetric flaccid paralysis but spares sensation.
Metabolic neuropathies occur with a chronic metabolic disorder.
Tests for infectious disorders and immune dysfunction, including tests for hepatitis and HIV and serum protein electrophoresis, are done.

If Guillain-Barré syndrome is suspected, patients should be admitted to a hospital for electrodiagnostic testing, CSF analysis, and monitoring by measuring forced vital capacity every 6 to 8 h. Initial electrodiagnostic testing detects slow nerve conduction velocities and evidence of segmental demyelination in two thirds of patients; however, normal results do not exclude the diagnosis and should not delay treatment.

CSF analysis may detect albuminocytologic dissociation (increased protein but normal WBC count), but it may not appear for up to 1 wk and does not develop in 10% of patients.

Prognosis
This syndrome is fatal in < 2%. Most patients improve considerably over a period of months, but about 30% of adults and even more children have some residual weakness at 3 yr. Patients with residual defects may require retraining, orthopedic appliances, or surgery.

After initial improvement, 3 to 10% of patients develop chronic inflammatory demyelinating polyneuropathy (CIDP—see Peripheral Nervous System and Motor Unit Disorders: Chronic Inflammatory Demyelinating Polyneuropathy).

Treatment
Intensive supportive care
Plasmapheresis or IV immune globulin
Guillain-Barré syndrome is a medical emergency, requiring constant monitoring and support of vital functions, typically in an ICU. Forced vital capacity should be measured frequently so that respiration can be assisted if necessary; if vital capacity is < 15 mL/kg, endotracheal intubation is indicated. Inability to lift the head off the pillow by flexing the neck is another danger sign; it frequently develops simultaneously with phrenic nerve (diaphragm) weakness.

If oral fluid intake is difficult, IV fluids are given as needed to maintain a urine volume of at least 1 to 1.5 L/day. Extremities should be protected from trauma and from the pressure of bed rest. Heat therapy helps relieve pain, making early physical therapy possible. Immobilization, which may cause ankylosis and contractures, should be avoided. Passive full-range joint movement should be started immediately, and active exercises should be initiated when acute symptoms subside. Heparin 5000 units sc bid helps prevent deep venous thrombosis in bedbound patients.

Given early, immune globulin (γ-globulin) 400 mg/kg IV once/day for 5 consecutive days is the treatment of choice; it has some benefit up to 1 mo from disease onset.

Plasmapheresis (see Transfusion Medicine: Plasma exchange) helps when done early in the syndrome; it is used if γ-globulin is ineffective. Plasmapheresis is relatively safe, shortens the disease course and hospital stay, and reduces mortality risk and incidence of permanent paralysis. Plasmapheresis removes any previously administered γ-globulin, negating its benefits.

Evaluation of patients with musculoskeletal complaints from Harrison's principles

Approach:

1.Anatomic localization of complaint (articular vs nonarticular)
2.Determination of the nature of pathologic process (inflammatory vs noninflammatory)
3.Determination of the extent of involvement (monoarticular va polyarticular, focal, widespread)
4.Determination of chronology (acute vs chronic)
5.Consider the most common disorders first
6.Formulation of a differential diagnosis.

HALF MAN

HALF MAN The Story of Peng Shuilin In life we keep complaining about what is or why we don’t have. Half the time we seem dissatisfied, though full-bodied and free to choose. Fat people say,”I want to be slim.” Skinny people say,”I want to be fatter.” Poor people want to be rich and rich are never satisfied with what they have.PENG Shuilin is 78cms high. He was born in Hunan Province, China. In 1995, in Shenzhen, a freight truck sliced his body in half. His lower body and legs were beyond repairSurgeons sewed up his torso. Peng Shuilin, 37, spent nearly two years in hospital in Shenzhen, southern China, undergoing a series of operations to re-route nearly every major organ or system inside his body. Peng kept exercising his arms, building up strength, washing his face and brushing his teeth. He Survived against all odds. Now Peng Shulin has astounded doctors by learning to walk again after a decade.Considering Peng’s plight, doctors at the China Rehabilitation Research Centre in Beijing devised an ingenious way to allow him to walk on his own, creating a sophisticated egg cup-like casing to hold his body, with two bionic legs attached. It took careful consideration, skilled measurement and technical expertise. Peng has been walking the corridors of Beijing Rehabilitation Centre with the aid of his specially adapted legs and a resized walking frame. RGO is a precipitating gait orthosis, attached to a prosthetic socket bucket. There is a cable attached to both legs so when one goes forward, the other goes backwards. Rock to the side, add a bit of a twist and the leg without the weight on it advances, while the other one stays still, giving a highly efficient way of ambulation. Oh so satisfying to ‘walk’ again after ten years with half a body! Hospital vice-president Lin Liu said: “We’ve just given him a checkup; he is fitter than most men his age.” Peng Shuilin has opened his own bargain supermarket, called the Half Man-Half Price Store. The inspirational 37-year-old has become a businessman and is used as a role model for other amputees. At just 2ft 7ins tall, he moves around in a wheelchair giving lectures on recovery from disability. His attitude is amazing, he doesn’t complain. “He had good care, but his secret is cheerfulness. Nothing ever gets him down.”

HOW TO SURVIVE A HEART ATTACK WHEN ALONE

Let's say it's 6:15pm and you're going home (alone of course), after an unusually hard day on the job. You're really tired, upset and frustrated. Suddenly you start experiencing severe pain in your chest that starts to drag out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home. Unfortunately you don't know if you'll be able to make it that far. You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself. HOW TO SURVIVE A HEART ATTACK WHEN ALONE Since many people are alone when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating. The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital. Tell as many other people as possible about this. It could save their lives!! A cardiologist says If everyone who gets this broadcast sends it to 10 people, you can bet that we'll save at least one life.

Chest Xray of Heart failure.

This chest radiograph shows an enlarged cardiac silhouette and edema at the lung bases, signs of acute heart failure.

Medical Miracle

MEDICAL MIRACLE

Near-vegetative man was back to life after stimulation electrodes were implanted into his skull

A man who was left in a near-vegetative state by a serious assault was able to speak and eat again. The severely brain-injured patient, who is now 38, was unable to communicate, swallow or make coordinate movements for six years, before doctors revived him from this minimally conscious state (MCS) with a revolutionary therapy.

Since his skull was implanted with electrodes to stimulate a deep-lying and undamaged part of his brain, he has improved so dramatically that he can now feed himself, brush his hair and recognize and talk to his parents and doctors. The transformation achieved by the deep brain stimulation (DBS) technique, which is already used to treat Parkinson's disease and some neurological disorder (like Tourrett's Syndrome), has raised hopes that it could offer a way back to consciousness for many people with similarly serious brain damage.



 

A serious note about heart attacks:

A serious note about heart attacks:~

#Every one should know that not every heart attack symptom is going to be the left arm hurting.
#Be aware of intense pain in the jaw line. ·
#You may never have the first chest pain during the course of a heart attack.
#Nausea and intense sweating are also common symptoms. ·
#60% of people who have a heart attack while they are asleep do not wake up. ·
#Pain in the jaw can wake you from a sound sleep.
#Let's be careful and be aware. The more we know, the better chance we could survive...
# A cardiologist says if everyone who Share this post it to everyone they know, you can be sure that we'll save at least one life.

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