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Medical Topics

Anal Fissure

Anal fissure is a small break or tear in the skin of the anal canal , which typically runs from below the dentate line to the anal verge and is usually situated in the posterior midline
( Zaghiyan KN et al 2011 , Madalinski MH 
et al 2011 )

 

Most common cause of severe anal pain Mostly affect young people 2nd and 4th decades of life Most papers report an equal distribution between men and women Lifetime risk has been reported between
7.8 % to 11.1 % ie
Anal Fissure ( AF ) is a common problem but it is now very well known exactly how widespread this problem is Studies have shown association with pregnancy
- in a prospective study of 165 women ,

Kawasaki Disease

Kawasaki disease ( KD ) is seen worldwide First reported in 1961 by Dr Tomisaku Kawasaki in Japan Seen predominantly in Northeast Asian countries like Japan , S Korea , China and Taiwan where it happens 10-30 times more commonly than in the US or Europe More common in boys Severe cardiac complications are also more significantly over represented in boys Most common cause of acquired heart disease during childhood in most industrialized nations In the UK the disease is seen rarely with an incidence estimated to be 8 per 100 000 children under 5 yrs of age –

Diabetes Ketoacidosis ( DKA )

Diabetic ketoacidosis ( DKA ) is a complex disordered metabolic state characterized by hyperglycaemia , acidosis and ketonaemia ( Joint British Diabetes Societies Inpatient Care Group March 2013 )

 

How common -Frequent and life threatening complication of type 1 diabetes DKA is also increasingly recognised in patients with type 2 diabetes Data from UK has shown that most cases of DKA were associated with type 1 DM but one in five cases of DKA were in patients with type 2 diabetes True incidence is difficult to establish Population based studies have show the range from 4.6 to 8 episodes per 1000 patients with diabetes It has near 100 % fatality if not treated or recognised Mortality rate has reduced with better understanding ,

Abortion care

Abortion act 1967 provides the legal basis of abortion – applicable in Scotland , England and Wales 
○ amended by the Human Fertilisation and Embryology Act 1990 and regulations made under that act – currently
○ Abortion Regulations 1991

Abortion Act regulates when and where the abortions can happen lawfully.
 Guidance in relation to requirements of the Abortion Act 1967- a guidance was issued in May 2014 this has information for on organizing and running abortion services
 Patients must give consent for abortion.

Asthma

There is no consensus on definition of asthma. It can be stated that asthma represents an umbrella term for several diseases with similar clinical manifestations but different underlying pathophysiological mechanisms often referred to as asthma endotypes.

GINA ( Global initiative for asthma ) in 2015 described asthma as a heterogeneous disease , usually characterized by chronic airway inflammation .

Cardiomyopathy

ESC working group defines cardiomyopathy as a myocardial disorder in which there is abnormality in the structure and function of the myocytes, in the absence of coronary artery disease , hypertension , valvular heart disease and congenital heart disease that could justify this abnormality

 

American Heart Association defines cardiomyopathy as a heterogeneous group of 
diseases of the myocardium associated with mechanical and / or electric dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation due to a variety of etiologies that are frequently genetic

 

Down’s Syndrome

An error in number of chromosomes is called Aneuploidy. Among all the aneuploidies , trisomy of the 21st chromosome or Down’s syndrome is the most common autosomal aneuploidy with an extra 21 chromosome due to nondisjunction.

How common –Down’s syndrome ( DSynd ) is the most common chromosomal disorder It is estimated to affect approximately in 1 in 700 live births ( Kanamori et al 2000 ) DSynd is the most commonly identified genetic form of mental retardation and the leading cause of specific birth defects and medical conditions ( Sherman et al ) CDC ( USA ) reports that between 1979 and 2003 the number of babies born with DSynd increased by about 30 % Most common figure in literature quotes that DSynd occurs in 1 out of 600-800 births DSynd happens in people of all races and socio economic status No sex preponderance.

Transient Loss of Consciousness

Transient loss of consciousness is ( TLoC ) is defined as an apparent loss of consciousness with an abrupt onset , a short duration and a spontaneous and complete recovery (Gert van Dikl et al 2009 )

Consciousness is defined as the ability to maintain awareness of the self and of the environment Syncope is the form of TLoC which is caused by cerebral hypoperfusion characterized by a rapid onset ,

Dyspepsia – assessment

Dyspepsia origin from Greek word dyspeptos : dys- bad , pepsis -digestion A definition proposed by Crean et al more than two decades ago is still considered one of the most comprehensive and it describes dyspepsia as an ” episodic recurrent or persistent abdominal pain or discomfort or any other symptoms referable to the upper alimentary tract ,

Inguinal hernia

Inguinal hernia is a bulge of the peritoneum through a congenital or acquired defect in the muscular and fascial structures of the abdominal wall ( Conze et al. 2001 )

A hernia is described as a protrusion of a sac of peritonium , often containing intestine or other
 abdominal contents from its proper cavity through a weakness in the abdominal wall.

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