Dr-Lokku: Recent Posts

windows8 on "t-shirts business guideline"

windows8 — Wed, 21 Dec 2011 16:43:38 +0000

t-shirtsmanufacturers.com providing information and resources about t-shirt business for <a href='http://www.t-shirtsmanufacturers.com'>t-shirt manufacturers</a>, a multi-billion dollar industry and which more profitable business then others business.

windows8 on "Samsung Galaxy Tab"

windows8 — Wed, 21 Dec 2011 16:42:48 +0000

The <a href='http://www.samsung-galaxytab.net'>Samsung Galaxy Tab</a> is the opening tablet computer by Samsung. Samsung applied Google Android 2.2 operating system on this tablet. At samsung-galaxytab.net you can inform about the reviews of the tablet. Also, we gather pictures, videos and all the official specifications about the Samsung Galaxy Tab.

windows8 on "Windows 8, coming operating system of Microsoft"

windows8 — Wed, 21 Dec 2011 16:42:08 +0000

<a href='http://www.windows8-release.com'>windows 8</a> is the coming next version operating system of Microsoft which holds many upgrade features from present version of windows 7. A fresh Start Screen interface has been added that was intended for touch screen effort in addition with mouse, keyboard effort. The <a href='http://www.windows8-release.com/windows-8-beta/'>windows 8 beta</a> is predictable to be demonstrated near the beginning of 2012.

ranga0007 on "Neuro science"

ranga0007 — Mon, 01 Aug 2011 07:35:21 +0000

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) describes the following 10 amphetamine-related psychiatric disorders:[1] Amphetamine-induced anxiety disorder Amphetamine-induced mood disorder Amphetamine-induced psychotic disorder with delusions Amphetamine-induced psychotic disorder with hallucinations Amphetamine-induced sexual dysfunction Amphetamine-induced sleep disorder Amphetamine intoxication Amphetamine intoxication delirium Amphetamine withdrawal Amphetamine-related disorder not otherwise specified This shows that amphetamine plays a major role in the division of psychiatry. The patients of Attention Deficit Hyperactive Disorder (ADHD) are treated majorly with Amphetamine. Not only ADHD its used in the treatment of Adult ADHD, Narcolepsy, weight loss and even in some cases of depression. 3,4-methylenedioxymethamphetamine (MDMA) is more commonly known as Ecstacy in the drug market...It was legal in 1980's ... then after the discovery of some withdrawal effects and psychiatric symptoms it was banned later. para -methoxyamphetamine (PMA), 2,5-dimethoxy-4-bromo-amphetamine (DOB), methamphetamine (crystal methamphetamine, crystal meth, or "Tina"), and 3,4-methylenedioxyamphetamine (MDA)... these was the main drugs in the market which killed and affected a lot of families in the 1990. This was still illegal but maximum sold. this made a lot of effects in the role and effect on human mind. Khat (Catha edulis Forsk) is the only known organically derived amphetamine. Its found majorly on East Africa and is produced and sold there internationally. Though a lot of varieties consumed in different forms, its still used successfully in the dept of pharmacology for standing against the dreadful diseases. Can cause a lot of effects like euphoria, high energy, and social disinhibition lasting 3-6 hours...... there is a lot of other effects too ....

ranga0007 on "Neuro science"

ranga0007 — Mon, 01 Aug 2011 06:58:55 +0000

Hi Guys this is a new Forum topic for discussing new things in neuroscience .... Im in aussi now trying to kill time in here..... getting interested in neuro science >>> Neuro science and psychiatry have been my dream sciences till date.... have a nice update on this forum on the current neuro depts >>> there is a lot more to come in here on the dangers of ill assessment methods and lower research criteria's in the field >>>

ranga0007 on "VIRAL FEVER"

ranga0007 — Fri, 23 Jul 2010 07:52:24 +0000

<h2>Wat are the common viruses causin Fever ???</h2> This is a age old qn to all >>> May be they have different names and different reasons to affect the induviduals but the syptoms are as whole the same >>>>> Here they are I: dsDNA viruses (e.g. Adenoviruses, Herpesviruses, Poxviruses) II: ssDNA viruses (+)sense DNA (e.g. Parvoviruses) III: dsRNA viruses (e.g. Reoviruses) IV: (+)ssRNA viruses (+)sense RNA (e.g. Picornaviruses, Togaviruses) V: (−)ssRNA viruses (−)sense RNA (e.g. Orthomyxoviruses, Rhabdoviruses) VI: ssRNA-RT viruses (+)sense RNA with DNA intermediate in life-cycle (e.g. Retroviruses) VII: dsDNA-RT viruses (e.g. Hepadnaviruses) Almost all viruses are the Viruses are have a tendency to cause a fever and the most common one is the Adenoviruses ...............there is a frequent history of presentation accordin to the cases i ve seen all are having the same type of presentation like symptoms according to time >>> 1.cough / cold / badd throat /even tooth pain sometimes 2.headche / body ache / joint pain / muscle pain 3.fever spells mostly every four hours or six hrs 4.loss of appetite / loss of taste / lack of concentration 5.reduced urine output and reduced stools 6.>>>sorry if i have missed the xtras ..>>> and sorry to say that i have missed a lot to say abt the ..................Examples of common human diseases caused by viruses include the common cold, influenza, chickenpox and cold sores. Many serious diseases such as ebola, AIDS, avian influenza and SARS are caused by viruses. The relative ability of viruses to cause disease is described in terms of virulence. Other diseases are under investigation as to whether they too have a virus as the causative agent, such as the possible connection between human herpes virus six (HHV6) and neurological diseases such as multiple sclerosis and chronic fatigue syndrome. <h2>What do you mean by Viral fever ??</h2> In medical terms, any fever caused as a result of viral infection is a viral fever. However, colloquially, the term 'viral fever' has come to mean a special type of fever that develops and then gets treated without the offending virus being specifically identified. The course and duration of the fever too does not seem to follow any set pattern and is frequently accompanied by, though not always by all of them, generalised bodyache, running nose, cough, shivering, feeling miserable, irritable and depressed. <h2>Hw long does is last ?</h2> Normally between 3 to 7 days with the former being termed as the 'three day fever' and the latter as the 'seven day fever'. <h2>Wat shud we do ??</h2> We shud Not DO anything other than Going to a doc >>>.....There is only one way when ur not able to reach a doctor ......u can have Paracetomol 650 mg tabs 6 hrs ie four times a day or u can also take a local cough expectorant and a cetrizine and also a Painkiller if it hurts worst ....u can take also take a antihistamine like chlorophenaramine for a Better Sleep ( there may be sleep cycle changes due to increased pain durin the night .... so pepl too work can do this . <h2>Wat are the indications for special patients ??</h2> <h3>For cases with diabetes</h3> there is a lot of problems like 1> U have to check the Sugar like shud maintain at max to 250mg/dl or also thud maintain min at 100mg/dl bcoz........... Sugar increases with high temprature and also with increased cortisol levels ....so maintain it wit a slight higher level (100) 2> Since diabetic cases may have a higher sugar levels....the cases on insulin shud proper care....plz dont change ur level until ur doc advices and also plz dont listen to ur relatives who are medical students are even docs ...bcoz ur doc knows u better... 3> Diabetic cases also have a high chance of DKA during high temperatures....and the most cases are Type 1 insulin dependant and less cases on Type 2 and there is also a reasonable amnt of cases with type 2 on insulin .....so when u have a severe stoamch pain orelse ur having severe fatigueness with dysnea or ur having a sudden fruity odor in ur breath first call the doc and next is rest .......it can be fatal <h3>For cases on steroids</h3> 1> They may have high levels of platelets with cases on steroids and there is a good chance that they can mimic the features of antibiotics ....or they mask the characteristics of a fever for eg like a rash disappears makin it tuff for a doc ...but mostly it goes on well .......but there are devastating effects of steroids bcoz they decrease the immune system ... 2>Steroids also have chance of increasin the platelet levels ...and cases on longterm therapy can have a thrombus meanin a clot ....anywwhere ......in the leg vessels ( deep vein thrombosis ) ......in the heart vessels (heart attack ) ......in the brain ( stroke ) so its really very very dangerous .........so u need to take a aspirin which stops the clotting ...so u need to take it under ur doc's advice ..... <h3>For HIV cases and Hepatitis B, C,</h3> Life threatning conditn, shud check the levels ok the viral load may be due to the same virus and present as a normal Virus Infn ....i advice all docs, medical students, and medical staffs to have a yearly check up for HIV and Hep B ....y risk when u know ur under risk .....But for now cases have shown good results with new medicine regimens for HIV and Hep B ......better be safe ( always hehehehe :-)) <h3>For thyroid cases</h3> Its safe for u guys ....no probs but hypothyroid ones .....plz take ur morning pill...... <h2>How do i Confirm ???</h2> The diagnosis and management of viral fevers is based more on the clinical presentation than by laboratory investigations. Since these infections are commonly self-limited, investigations are unnecessary. The diagnosis is made by the typical history of fever with severe muscle and joint pains. Skin rash and lymph gland swellings have to be specifically looked for. Laboratory investigations are undertaken to rule out other bacterial infections rather than to confirm viral fever. Blood tests will not show any increase in the white blood cells, which typically occurs with bacterial infections. The numbers of lymphocytes may be increased. The Erythrocyte Sedimentation Rate (ESR) is not elevated. Confirmation is by culture of virus from the relevant specimens such as nasal swabs, and skin rash or by increase in antibody levels in serial blood samples. <h2>PREVENTION IS BETTER THAN CARE</h2> Vaccines are a major problem....When u get them they are not preserved well, When u Preserve them well they are not reachable and when u preserve them well and reachable then they are not administered well(lack of xperience ) ........at last when everything goes on well there is a new mutant that is resistant to the vaccines .........So they are not the only solution u have to look forward for maintaining ur own health .....health is wealth ...so dont think abt the wealth ur spending on Vaccines think abt the wealth ur gonna gt from good health ........There are other ways u can prevent not only viral manyother infections from the body is focussin cleanliness on the society and urself .....I think shud make a comment on Cleanlisness.....When us sick ( not sikh) ......Avoid going to office when ur sick ....Avoid travelling in a congested train or bus or even car.......Avoid close contacts with family memebers who can infect u ..........i think there will something more on cleanliness <h2>With Regards Dr.Lokku</h2>

ranga0007 on "SeXXXology ...For All Medicos + Non-Medicos"

ranga0007 — Tue, 06 Jul 2010 18:37:05 +0000

There is a New problem emerging now <h3>...Its all like this ...U go in the sun a lot and u roam a lot in the sun .....then u go for peeing and u feel like u have pissed some some chili water ,,,,,,,,,,,,,and u call it heat ,,,,,and i call it electrolyte imbalance .............This is often here for a POliceman In Palani and he calls me here (chennai ) every 3rd hr and asks for medicine ..........He gives a classic pic of a kidney stone and then gives a misleadin false history of pain and previous episodes of the same condition ...........Life sucks ....thats wat he says .....he drinks lmost everday ...and eats nonveg alternate days and says its a reason ...he roams the whole day in sunlight and then does not drink enuff water bcoz he does not wanna pee ...here is the biggest problem ...wats wrong in peeeing ...U can have a stricture if u control ur urine very bad u know it ...........so pepl in the same criteria plz ....stop controllin pee for hrs and start drinking enuff water ...and live healthy and fit ...This is posted here B coz its common in Sexual intercourse...... [b]Regrds DrLokku</h3>

ranga0007 on "testing the home page"

ranga0007 — Tue, 22 Jun 2010 18:56:01 +0000

Sorry Mr.Pinastro , Its been so long that i was nt able to write posts for the past 6 months due to a busy shedule .....sorry to say it !!! but still there is a probs with the discussion panel id and drlokku 's site

ranga0007 on "SeXXXology ...For All Medicos + Non-Medicos"

ranga0007 — Tue, 22 Jun 2010 18:50:50 +0000

So it works like this , Accordin to Freud's theory of ID,EGO & SUPER EGO..There is a thought of free associations ... here u can see that when the person consumes drumstick there is no way that its gonna be a high level aphrosadiac . But it has created a image of a high grade sexual stimulant . so he psychiatrically thinks he is stimulated and have a thought cycle abt sex and gets even more stimulated and also performs the art like no 2 moro . regards DrLokku

ranga0007 on "SeXXXology ...For All Medicos + Non-Medicos"

ranga0007 — Tue, 22 Jun 2010 18:42:27 +0000

hi dear mates , This is a new discovery to me nw ...... for long time there is a bliss in the state of tamil nadu 4 drumstiks ..... and i beleive thats nt the right thing to do to improve us sexual poower ......im at a very sensitive place which i wud nt like to reveal .... Here the pepl have a psychological thinking that drumstick takes u to a higher level of libido . But actually thats nt the way . Then hw does it work ???

ranga0007 on "SeXXXology ...For All Medicos + Non-Medicos"

ranga0007 — Sat, 20 Mar 2010 19:40:38 +0000

There is a new problem being realised recently that there is a lot a combinational studies between alcohol and sex . After boozin there are pepl who have a cravin for sex but if ur all prepared there is no use of bcoz of the hanging organ and there is scientific proof for impotence and oligospermia in regular alcoholics . the persons passin the cage test also have doubtful thinkin abt spouse siblings and kids . So plz this is a kind advice frm DrLokku stop regular drinkin . make it OCCASIONAL

ranga0007 on "Sleep time & BP"

ranga0007 — Thu, 19 Nov 2009 18:40:44 +0000

This is a strictly Clinical case Mr.Abilash ...does he have a history of chest pain or heart disease ...If so Please consult a good Cardiologist in ur own locality and Find out his Cholesterol profiles , ECG , Serum Creatinine and CK-MB levels too.....U shud Strictly follow the cardiologist advice ....there is no Gold standard treatment For a chest pain xcept for Nitroglycerine ....................... Regards Dr.Lokku

abilashr on "Sleep time & BP"

abilashr — Tue, 10 Nov 2009 07:16:59 +0000

My dad had a irritation near the heart for the last 3 days... and went for checkup today. His BP was found to be 160/110 and Doctor advised to get admitted. He was working fine and even drove his car to the hospital for checkup. He finds keeping the hand near his chest comfortable. What do you suggest for him?

ranga0007 on "What am I suffering from ?"

ranga0007 — Sat, 17 Oct 2009 07:42:06 +0000

Yes ur rite it is a Heat prickle most probably . U Need to to apply ABSORB powder twice daily morning after Bath and At Night B4 sleeping . I advice u to wear loose clothes and No Underwear when ur Out of work .Please mention me any History of sexual encounters in the New city and in the past 3 months... <h3>METHOD</h3> After Takin Bath in the Morning U can apply the Powder all over the Groin region and not on the Penis. U can apply it anyno: OF TIMES U WANT BUT U SHOULD MAKE SURE THAT PLACE IS CLEAN ....Sexual intercourse for a period of 1 week can be prohibhited since u have a higher chance of Spreading and encountering new infections ...... During night time plz apply soap and wash the region and then apply the powder ..... PLz make sure that if the same problem persists then it is something to do with sexually transmitted diseases (following u had a recent encounter in past 3 months )..............THANKU with Regards Dr-Lokku

mydummyprofile on "What am I suffering from ?"

mydummyprofile — Fri, 16 Oct 2009 06:33:43 +0000

I have moved to a new city and I saw few strange things on my scortal sacs. I am afraid what is this.Can anyone tell me what am i suffering from.Is it just a heat prickle ??

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 08 Oct 2009 03:58:04 +0000

No Actually Mr.Pinastro i think Dr.Praveen needs more posts to be a Moderator here and he is busy for a while Updating his knowledge Regards Drlokku

pinastro on "Thyroid Anatomy"

pinastro — Sun, 20 Sep 2009 05:13:10 +0000

nice work

pinastro on "Thyroid Anatomy"

pinastro — Tue, 15 Sep 2009 03:26:02 +0000

Nice Doctor, this could have been a blog ...why put it on a discussion forum ?? but nice job..keep the engine running..people are reading these forums for sure

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:10:50 +0000

<h2>Innervattion </h2> Principal innervation of the thyroid gland derives from the autonomic nervous system. Parasympathetic fibers come from the vagus nerves, and sympathetic fibers are distributed from the superior, middle, and inferior ganglia of the sympathetic trunk. These small nerves enter the gland along with the blood vessels. Autonomic nervous regulation of the glandular secretion is not clearly understood, but most of the effect is postulated to be on blood vessels, hence the perfusion rates of the glands.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:08:42 +0000

Inferior thyroid artery and recurrent laryngeal nerve The inferior thyroid artery arises from the thyrocervical trunk, a branch of the subclavian artery. It ascends vertically and then curves medially to enter the tracheoesophageal groove in a plane posterior to the carotid sheath. Most of its branches penetrate the posterior aspect of the lateral lobe (see Image 3). The inferior thyroid artery has a variable branching pattern and is closely associated with the recurrent laryngeal nerve. The latter also ascends in the tracheoesophageal groove and enters the larynx between the inferior cornu of the thyroid cartilage and the arch of the cricoid. The recurrent laryngeal nerve can be found after it emerges from the superior thoracic outlet, in a triangle bounded laterally by the common carotid artery, medially by the trachea, and superiorly by the thyroid lobe. The relationship between the nerve and the inferior thyroid artery is highly variable, as demonstrated by the classic work of Reed, who in 1943 described 28 variations in this relationship. The nerve can be found deep to the inferior thyroid artery (40%), superficially (20%), or between branches of the artery (35%).1 Significantly, the relationship between nerve and artery on one side of the neck is similar to that found on the other side in only 17% of the population. Furthermore, at the level of the inferior thyroid artery, branches of the recurrent laryngeal nerve that are extralaryngeal may be present (5%). Preservation of all those branches is important during thyroidectomy.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:08:08 +0000

<h2>Vascular Anatomy and Relation with Laryngeal Innervation</h2> The arterial supply to the thyroid gland comes from the superior and inferior thyroid arteries and, occasionally, the thyroidea ima. These arteries have abundant collateral anastomoses with each other, both ipsilaterally and contralaterally. The thyroid ima is a single vessel, which originates, when present, from the aortic arch or the innominate artery and enters the thyroid gland at the inferior border of the isthmus. Superior thyroid artery and superior laryngeal nerve The superior thyroid artery is the first anterior branch of the external carotid artery. In rare cases, it may arise from the common carotid artery just before its bifurcation. The superior thyroid artery descends laterally to the larynx under the cover of the omohyoid and sternohyoid muscles. The artery runs superficially on the anterior border of the lateral lobe, sending a branch deep into the gland before curving toward the isthmus where it anastomoses with the contralateral artery

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 06:44:01 +0000

<h2>Structure</h2> Under the middle layer of deep cervical fascia, the thyroid has an inner true capsule, which is thin and adheres closely to the gland. Extensions of this capsule within the substance of the gland form numerous septae, which divide it into lobes and lobules. The lobules are composed of follicles, the structural units of the gland, consisting of a layer of simple epithelium enclosing a colloid-filled cavity. This colloid (pink on hematoxylin and eosin [H&E] stain) contains an iodinated glycoprotein, iodothyroglobulin, a precursor of thyroid hormones. Follicles vary in size, depending upon the degree of distention, and they are surrounded by dense plexuses of fenestrated capillaries, lymphatic vessels, and sympathetic nerves. Epithelial cells are of 2 types: principal cells (ie, follicular) and parafollicular cells (ie, C, clear, light cells). Principal cells are responsible for formation of the colloid (iodothyroglobulin), whereas parafollicular cells produce the hormone calcitonin, a protein central to calcium homeostasis. Parafollicular cells lie adjacent to the follicles within the basal lamina.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 06:26:35 +0000

The thyroid is a brownish-red and highly vascular gland located anteriorly in the lower neck, extending from the level of the fifth cervical vertebra down to the first thoracic. The gland varies from an H to a U shape and is formed by 2 elongated lateral lobes with superior and inferior poles connected by a median isthmus (with an average height of 12-15 mm) overlying the second to fourth tracheal rings. The isthmus is encountered during routine tracheotomy and must be retracted (superiorly or inferiorly) or divided. Occasionally, the isthmus is absent, and the gland exists as 2 distinct lobes. Each lobe is 50-60 mm long, with the superior poles diverging laterally at the level of the oblique lines on the laminae of the thyroid cartilage. The lower poles diverge laterally at the level of the fifth tracheal cartilage. Thyroid weight varies but averages 25-30 g in adults (slightly heavier in women). The gland enlarges during menstruation and pregnancy. A conical pyramidal lobe often ascends from the isthmus or the adjacent part of either lobe (more often the left) toward the hyoid bone, to which it may be attached by a fibrous or fibromuscular band, the levator of the thyroid gland. Remnants of the thyroglossal duct may persist as accessory nodules or cysts of thyroid tissue between the isthmus and the foramen caecum of the tongue base. The development of the thyroid is beyond the scope of this article but is discussed elsewhere in this journal. Usually, 2 pairs of parathyroid glands lie in proximity to the thyroid gland. Anatomy and development of these glands are also discussed in the eMedicine article Embryology of the Thyroid and Parathyroids.

pinastro on "Cholelithiasis - Gall Stones"

pinastro — Sat, 01 Aug 2009 11:58:56 +0000

Dr. Praveen I see very less posts from you these days ?? why don't you try blogging ?? Pinastro

pinastro on "Cholelithiasis - Gall Stones"

pinastro — Sat, 01 Aug 2009 11:57:53 +0000

Dear Lokka You have been doing amazing stuff on discussion panel.I feel you can do equally amazing blogging. Thanks Pinastro

DR.PRAVEEN on "Cholelithiasis - Gall Stones"

DR.PRAVEEN — Sat, 01 Aug 2009 11:14:56 +0000

yes, dr. loga. this is a awe some material. it will be very useful for the medical students, they can copy it for the 10 mark question. day by day your knowledge is becoming wiser. take care

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:39:50 +0000

Treatment Surgery Mostly first duct method ....Previously done in open and nowadays its Laproscopic Surgery . see this<li><a href="http://www.youtube.com/watch?v=ycvwAfx3yF0" rel="nofollow">http://www.youtube.com/watch?v=ycvwAfx3yF0</a></li>

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:37:42 +0000

<h3>Prevention of gallstones </h3> It would be better if gallstones could be prevented rather than treated. Prevention of cholesterol gallstones is feasible since ursodiol, the bile acid medication that dissolves some cholesterol gallstones, also prevents them from forming. The difficulty is identifying a group of individuals who are at high risk for developing cholesterol gallstones during a relatively short period of time so that the duration of preventive treatment can be limited. One such group is obese individuals losing weight rapidly with very low calorie diets or with surgery. The risk of gallstones in this group is as high as 40%-60%. In fact, ursodiol has been shown in several studies to be very effective at preventing gallstones in these individuals

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:36:22 +0000

<h2>How are gallstones diagnosed? </h2> Gallstones are diagnosed in one of two situations. * The first is when there are symptoms or signs that suggest gallstones, and the diagnosis of gallstones is being pursued. * The second is coincidentally while a non-gallstone-related medical problem is being evaluated. 1)Ultrasonography 2)Endoscopic ultrasonography 3)Magnetic resonance cholangio-pancreatography (MRCP) 4)Cholescintigraphy (HIDA scan) 5)Endoscopic retrograde cholangio-pancreatography (ERCP) 6)Liver and pancreatic blood tests 7)Duodenal biliary drainage<img src="http://http://images.medicinenet.com/images/illustrations/gallstones.jpg">

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:33:25 +0000

<h3>What are gallstones?</h3> <img src="http://http://images.medicinenet.com/images/illustrations/gallstones.jpg"> Liver stones are called Gallsones ...mostly in the Gall bladder and hence the name. Gallstones usually form in the gallbladder; however, they also may form anywhere there is bile; in the intrahepatic, hepatic, common bile, and cystic ducts. Gallstones also may move about within bile, for example, from the gallbladder into the cystic or common duct. <h3>Types of Gall stones and its causes ..</h3> Cholesterol gallstones 1)Cholesterol gallstones are made primarily of cholesterol. They are the most common type of gallstone, comprising 80% of gallstones in individuals from Europe and the Americas. Cholesterol is one of the substances that liver cells secrete into bile. (Secretion of cholesterol into bile is an important way in which the liver eliminates excess cholesterol from the body.) In order for bile to carry cholesterol, the cholesterol must be dissolved in the bile. Cholesterol is a fat, however, and bile is an aqueous or watery solution; fats do not dissolve in watery solutions. In order to make the cholesterol dissolve in bile, the liver also secretes two detergents-bile acids and lecithin-into the bile. These detergents, just like dish-washing detergents, dissolve the fatty cholesterol so that it can be carried by bile through the ducts. If the liver secretes too much cholesterol for the amount of bile acids and lecithin it secretes, some of the cholesterol does not dissolve. Similarly, if the liver does not secrete enough bile acids and lecithin, some of the cholesterol also does not dissolve. In either case, the undissolved cholesterol sticks together and forms particles of cholesterol that grow in size and eventually form larger gallstones. There are two other processes that promote the formation of cholesterol gallstones though neither process is able to cause cholesterol gallstones by itself. The first is abnormally rapid formation and growth of cholesterol particles into gallstones. Thus, with the same concentrations of cholesterol, bile acids and lecithin in their bile, patients with gallstones form particles of cholesterol more rapidly than individuals without gallstones. The second process that promotes the formation and growth of gallstones is reduced contraction and emptying of the gallbladder that allows bile to sit in the gallbladder longer so that there is more time for cholesterol particles to form and grow. 2)Pigment gallstones Pigment gallstones are the second most common type of gallstone. Although pigment gallstones comprise only 15% of gallstones in individuals from Europe and the Americas, they are more common than cholesterol gallstones in Southeast Asia. There are two types of pigment gallstones 1) black pigment gallstones, and 2) brown pigment gallstones. Pigment is a waste product formed from hemoglobin, the oxygen-carrying chemical in red blood cells. The hemoglobin from old red blood cells that are being destroyed is changed into a chemical called bilirubin and released into the blood. Bilirubin is removed from the blood by the liver. The liver modifies the bilirubin and secretes the modified bilirubin or into bile. 3)Others: types of gallstones. Other types of gallstones are rare. Perhaps the most interesting type of gallstone is the gallstone that forms in patients taking the antibiotic, ceftriaxone (Rocephin). Ceftriaxone is unusual in that it is eliminated from the body in bile in high concentrations. It combines with calcium in bile and becomes insoluble. Like cholesterol and pigment, the insoluble ceftriaxone and calcium form particles that grow into gallstones. Fortunately, most of these gallstones disappear once the antibiotic is discontinued; however, they still may cause problems until they disappear. Another rare type of gallstone is formed from calcium carbonate. <h3>Who is at risk for gallstones?</h3> 1. Gender. Gallstones form more commonly in women than men. 2. Age. Gallstone prevalence increases with age. 3. Obesity. Obese individuals are more likely to form gallstones than thin individuals. 4. Pregnancy. Women who have been pregnant are more likely to form gallstones than women who have not been pregnant. Pregnancy increases the risk for cholesterol gallstones because during pregnancy, bile contains more cholesterol, and the gallbladder does not contract normally. 5. Birth control pills and hormone therapy The increased levels of hormones caused by either treatment mimics pregnancy. 6. Rapid weight loss. Rapid weight loss by whatever means, very low calorie diets or obesity surgery, causes cholesterol gallstones in up to 50% of individuals. Many of the gallstones will disappear after the weight is lost, but many do not. Moreover, until they are gone, they may cause problems. 7. Crohn's disease. Individuals with Crohn's disease of the terminal ileum are more likely to develop gallstones. Gallstones form because patients with Crohn's disease lack enough bile acids to solubilize the cholesterol in bile. Normally, bile acids that enter the small intestine from the liver and gallbladder are absorbed back into the body in the terminal ileum and are secreted again by the liver into bile. In other words, the bile acids recycle. In Crohn's disease, the terminal ileum is diseased. Bile acids are not absorbed normally, the body becomes depleted of bile acids, and less bile acids are secreted in bile. There are not enough bile acids to keep cholesterol dissolved in bile, and gallstones form. 8. Increased blood triglycerides. Gallstones occur more frequently in individuals with elevated blood triglyceride levels. <h3> What are the symptoms of gallstones?</h3> * dyspepsia (including abdominal bloating and discomfort after eating), * intolerance to fatty foods, * belching, and * flatulence (passing gas or farting). * Biliary Colic <h3> What is Biliary Colic???</h3> The most common symptom of gallstones is biliary colic. Biliary colic is a very specific type of pain, occurring as the primary or only symptom in 80% of people with gallstones who develop symptoms. Biliary colic occurs when the extrahepatic ducts-cystic, hepatic or common bile-are suddenly blocked by a gallstone. (Slowly-progressing obstruction, as from a tumor, does not cause biliary colic.) Behind the obstruction, fluid accumulates and distends the ducts and gallbladder. In the case of hepatic or common bile duct obstruction, this is due to continued secretion of bile by the liver. In the case of cystic duct obstruction, the wall of the gallbladder secretes fluid into the gallbladder. It is the distention of the ducts or gallbladder that causes biliary colic. <h3> Characteristics of Biliary colic????</h3> * It is a constant pain, it does not come and go, though it may vary in intensity while it is present. * It lasts for 15 minutes to 4-5 hours. If the pain lasts more than 4-5 hours, it means that a complication - usually cholecystitis - has developed. * The pain usually is severe, but movement does not make the pain worse. In fact, patients experiencing biliary colic often walk about or writhe (twist the body in different positions) in bed trying to find a comfortable position. * Biliary colic often is accompanied by nausea. * Most commonly, biliary colic is felt in the middle of the upper abdomen just below the sternum. * The second most common location for pain is the right upper abdomen just below the margin of the ribs. * Occasionally, the pain also may be felt in the back at the lower tip of the scapula on the right side. * On rare occasions, the pain may be felt beneath the sternum and be mistaken for angina or a heart attack. * An episode of biliary colic subsides gradually once the gallstone shifts within the duct so that it is no longer obstructing. <h3>What are the complications of gallstones?</h3> 1)Cholecystitis - Cholecystitis means inflammation of the gallbladder. 2)Cholangitis - condition in which bile in the common, hepatic, and intrahepatic ducts becomes infected. 3)Gangrene- condition in which the inflammation of cholecystitis cuts off the supply of blood to the gallbladder. 4)Jaundice - condition in which bilirubin accumulates in the body. 5)Pancreatitis - inflammation of the pancreas. 6)Sepsis - condition in which bacteria from any source within the body, including the gallbladder or bile ducts, get into the blood stream and spread throughout the body. 7) A fistula - an abnormal tract through which fluid can flow between two hollow organs or between an abscess and a hollow organ or skin. 8) Ileus - condition in which there is an obstruction of flow of digesting food, gas, and liquid within the intestine. 9)Cancer of the gallbladder almost always is associated with gallstones, but it is not clear which comes first, that is, whether the gallstones precede the cancer and, therefore, could potentially be the cause of the cancer

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:29:59 +0000

Just a Video about Malignant Melanoma <a href="http://www.youtube.com/watch?v=PO_3fTjxeBY" rel="nofollow">http://www.youtube.com/watch?v=PO_3fTjxeBY</a>

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:27:16 +0000

<h2>Malignant Melanoma </h2> General Considerations Malignant melanoma is the leading cause of death due to skin disease. There were 55,000 cases of melanoma in the United States in 2004, with 7900 deaths. One in four cases of melanoma occur before the age of 40. Overall survival for melanomas in whites has risen from 60% in 1960–1963 to more than 85% currently, primarily due to earlier detection of lesions. Tumor thickness is the single most important prognostic factor. Ten-year survival rates—related to thickness in millimeters—are as follows: < 1 mm, 95%; 1–2 mm, 80%; 2–4 mm, 55%; and > 4 mm, 30%. With lymph node involvement, the 5-year survival rate is 30%; with distant metastases, it is less than 10%. More accurate prognoses can be made on the basis of site, histologic features, and gender of the patient. <h3>Clinical Findings </h3> Primary malignant melanomas may be classified into various clinicohistologic types, including lentigo maligna melanoma (arising on chronically sun-exposed skin of older individuals); superficial spreading malignant melanoma (two-thirds of all melanomas arising on intermittently sun-exposed skin); nodular malignant melanoma, acral-lentiginous melanomas (arising on palms, soles, and nail beds); malignant melanomas on mucous membranes; and miscellaneous forms such as amelanotic (nonpigmented) melanoma and melanomas arising from blue nevi (rare) and congenital nevi. <h3>Essentials of Diagnosis</h3> 1)May be flat or raised. 2)Should be suspected in any pigmented skin lesion with recent change in appearance. 3)Examination with good light may show varying colors, including red, white, black, and bluish. 4)Borders typically irregular <h3>Treatment</h3> Treatment of melanoma consists of excision. After histologic diagnosis, the area is usually reexcised with margins dictated by the thickness of the tumor. Thin low-risk and intermediate-risk tumors require only conservative margins of 1–3 cm. More specifically, surgical margins of 0.5 cm for melanoma in situ and 1 cm for lesions less than 1 mm in thickness are recommended. Sentinel lymph node biopsy (selective lymphadenectomy) using preoperative lymphoscintigraphy and intraoperative lymphatic mapping is effective for staging melanoma patients with intermediate risk without clinical adenopathy and is recommended for all patients with lesions over 1 mm in thickness or with high-risk histologic features. -Interferon and vaccine therapy may reduce recurrences in patients with high-risk melanomas. Referral of intermediate-risk and high-risk patients to centers with expertise in melanoma is strongly recommended. <h3>Regards Dr-Lokku</h3>

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:21:48 +0000

<h3>Seborrheic Keratoses</h3> Seborrheic keratoses are benign plaques, beige to brown or even black, 3–20 mm in diameter, with a velvety or warty surface . They appear to be stuck or pasted onto the skin. They are common—especially in the elderly—and may be mistaken for melanomas or other types of cutaneous neoplasms. Although they may be frozen with liquid nitrogen or curetted if they itch or are inflamed, no treatment is needed.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:09:29 +0000

<h3>Freckles & Lentigines</h3> Freckles (ephelides) and lentigines are flat brown spots . Freckles first appear in young children, darken with ultraviolet exposure, and fade with cessation of sun exposure. In adults, depending on the fairness of the complexion, flat brown spots (lentigines), often with sharp borders, gradually appear in sun-exposed areas, particularly the dorsa of the hands. They do not fade with cessation of sun exposure. They should be evaluated like all pigmented lesions: If the pigmentation is homogeneous and they are symmetric and flat, they are most likely benign. Solar lentigines, also called liver spots, can be treated with topical 0.1% tretinoin, tazarotene 0.1%, 2% 4-hydroxyanisole with tretinoin 0.01% (Solage), laser therapy, and cryotherapy.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:09:04 +0000

<h3>Blue Nevi </h3> Blue nevi are small, slightly elevated, and blue-black lesions. They are common in persons of Asian descent, and an individual patient may have several of them. If present without change for many years, they may be considered benign, since malignant blue nevi are rare. However, blue-black papules and nodules that are new or growing must be evaluated to rule out nodular melanoma.