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Acute Gastroenteritis

On Respiratory Infections: A case discussion (PART 2)

On Respiratory Infections: A Case Discussion

Dietary Recommendations Regarding FATS INTAKE

Cerebrovascular Disease 2

Cerebrovascular Disease

The Last Part of My Elbow Discussion

Continuation of My Elbow Pain Discussion

Lateral Epicondylalgia

Steatorrhea and Lipid Absorption

Steatorrhea and Lipid Digestion Part 2

Steatorrhea and Lipid Digestion

Psychosocial Needs of the Elderly

New Approaches in HIV Management- Part 2

Bell's Palsy Management

Bell's Palsy

Motor Control and Feedback (Part 4)

Motor Control and Feedback (Part 3)

Motor Control and Feedback (Part 2)

Motor Control and Feedback: Important Elements in Rehabilitating Debilitated PAtients

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Acute Gastroenteritis

January 26th 2012 09:22

AE, 33 years old, female came in with complaints of 6 to 8 episodes of vomiting of previously ingested food and watery lined stool after eating shellfish. No fever was noted. She was conscious, coherent, not in distress, and seemingly with no signs of dehydration.

clean hospitals, good hospitals in the Philippines

Our hospitals are excellent and clean here in Manila.

A history of vomiting and diarrhea can obviously tell us that her problem is gastrointestinal. But which among the gastrointestinal conditions are we going to consider? This question is very important since we have to establish a correct diagnosis so that we can institute a correct and cost-efficient management. Physical examination to complement our history is therefore warranted. Pertinent physical findings are the following: blood pressure of 100/60 mmHg, heart rate of 72 bpm, respiratory rate of 20 cpm, and temperature of 36.8 deg Celsius. Abdominal examination revealed flat, soft abdomen with direct tenderness on the epigastric area with hyperactive bowel sounds.

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On Respiratory Infections: A case discussion (PART 2)

January 24th 2012 09:12

At this point, we would like to comment on the use of chest x-ray in diagnosing respiratory problems. We have to be reminded that x-ray is just an adjunct to our diagnosis. Diagnosis of most of the respiratory problems is clinical. Some of indications of chest x-ray include: determination of pathogens causing the disease (streaky infiltrates point to viral infection), or ruling in tuberculosis, and others.

The more common causes of acute upper respiratory tract infection are viruses. Ideally, antimicrobial drugs are delayed and supportive management is preferred, like increase in oral fluid intake, advising patient to rest, and administration of mucolytics and/or decongestants. In our case however CBC can aid in ruling in bacterial causes. Once ascertained, antimicrobial therapy is started. Among the drugs used empirically are amoxicillin, co-amoxiclav, and second generation cephalosporins. Patient was started on Cefuroxime, a second generation cephalosporin.
The focus of main concern however is not on her respiratory symptoms. Rather it is on her co-morbidities: diabetes mellitus and hypertension. Upon physical examination, BP ranged from 140-180/80-90 mmHg. CBG is also elevated at 135 mg/dL. HbA1c is elevated as well. These circumstances have been the reason for admission.
In this setting, we expect poor recovery and invasion of opportunistic microorganisms. The concern therefore is to control blood sugar and hypertension. In her case, Metformin and Glibenolamide were used. Angiotensin receptor blockers like losartan and telmisartan are the drug of choice for hypertension, since they provide less drug interaction and adverse effects.

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On Respiratory Infections: A Case Discussion

January 22nd 2012 09:11

Hello everyone! I would like to share to you a case which is very common in our medical practice. I hope I can impart something. And further look forward to comments about what other practitioners could have done in this case. THANK YOU!

RU, a 56 year-old female, complains of difficulty of breathing, fever, and occasional non-productive cough. Upon physical examination, she manifested congested turbinates, postnasal drip, and slightly hyperaemic pharyngeal walls. Auscultation revealed harsh inspiratory breath sounds.

Being faced with these manifestations, we would like to consider acute upper respiratory tract infection. This diagnosis is an umbrella diagnosis, which encompasses affection of any of the nasopharynx, epiglottis, larynx, and trachea. Lower tract infection like bronchitis or pneumonia is not considered due to the absence of adventitious sounds like crackles, rhonchi, or expiratory wheezes. Another way of differentiating an upper from a lower tract involvement is the period when we hear harshness or even wheezes. Inspiratory harshness or wheezing point to increased proximal airway resistance. This is what we saw in our patient. Abnormal expiratory findings suggest distal airway resistance....TO BE CONTINUED....

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What Vitamins are Not?

January 5th 2012 15:22

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Dietary Recommendations Regarding FATS INTAKE

January 3rd 2012 13:08

HAPPY NEW YEAR EVERYONE! I never really wanted to spoil your eating and party-ing...well here I am just the same for reminders...We don't want to get ourselves in trouble as 2011 arrives. Believe you me! This season is not only a season of happiness and eating spree. This is also a season of heart attacks and strokes...Am I being negative? Hehe...Pardon me... But please be careful with what you eat this time of the year

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Cerebrovascular Disease 2

November 1st 2011 02:53

What are the signs and symptoms of this condition? A patient could experience half-sided or whole-sided paralysis, depending on the parts of the brain affected. sensory impairment is also a common complaint among patients. Speech problem can also manifest, together with perception deficits. Gait impairment or problems in walking may also be a problem.

An occurence of another attack is possible especially if an affected individual does not modify his lifestyle and diet. Lifestyle modification includes being active and involving self to exercises prescribed by health practitioners. cessation of smoking is very important. Physical and occupational therapy is very, very important together with medications can can control symptoms.
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Cerebrovascular Disease

October 5th 2011 20:08

Lately I have been seeing a tremendous number of individuals suffering from stroke.

Cerebrovascular disease or more popularly known as stroke, has been a major killer worldwide. But what is this condition and what causes it

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The Last Part of My Elbow Discussion

August 31st 2011 13:35

The nerve roots as we all know pass through the intervertebral foramen of the spine. The inferior articular process of the upper vertebra, when joined to the superior articular process of the lower vertebra forms the intervertebral foramen. This foramen can also be a site for spur formation happening among arthritic or degenerative patients. The premiere event that can compress and impinge the nerve roots is the narrowing of the intervertebral foramen due to accumulation of spurs. And with neck motions especially extension, we further add compression to the nerves eliciting more pain over the lateral epicondyle. Even sneezing and coughing can elicit pain over the lateral epicondyle in C5-C6 radiculopathy. Many studies reveal the presence of cystic cavities in the nerve roots and ganglia, accompanying fibrosis and inflammation. These cysts apparently contain cerebrospinal fluid which becomes elevated during sneezing and coughing. This condition further increases the symptoms of radiculopathy.

Hypermobility of the neck area is also a risk factor for acquiring not only radiculopathy but also lateral epicondylalgia. As stated above there are certain motions if done excessively (like hyperflexion or hyperextension) can aggravate the structural and biomechanical faults within the cervical region.
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Continuation of My Elbow Pain Discussion

August 26th 2011 14:42

To further emphasize the greater vulnerability to injury of the wrist extensors over the flexors, Matthijs and colleagues mention how these muscles become fatigued easily. They state that the extensors’ endurance limit is only 15 % of maximal strength discussed above. If grasping or any repeated wrist activities demand the extensors to provide greater than 15 % of their maximum strength, the extensors would need to work aerobically to sustain their functions. But the aerobic work will not last that long.

In wrist motions that require repeated and/ or sustained forearm muscle activation-for example power grasping- the type of contraction that mainly occurs is isometric contraction (with respect to power grasping, as the fingers flex for grip closure the extensors initially carry out short eccentric contraction before contracting isometrically for the rest of the phase). And as more strength is required, greater isometric contraction should be generated by the extensors (greater than 15 % of maximum strength). However there is a price to pay. Isometric contraction increases pressure within the muscles, impeding capillaries that provide oxygen for the muscles to work aerobically. Consequently vascularization to the area becomes insufficient. The extensors then can become ischemic making them more prone to injury.
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Lateral Epicondylalgia

August 22nd 2011 10:39

Introduction

“Lateral epicondylalgia” as the name implies is a condition characterized by pain over the lateral epicondyle. Classically clinicians use the terms “tennis elbow” and “lateral epicondylitis” when referring to traumatic types of affectation, since these terms convey the extrinsic and intrinsic incidents that might explain the mechanical occurrence of this condition. Tennis elbow is used to denote its occurrence among tennis players caused by faulty biomechanics in a backhand stroke, observed when they flex and pronate the wrist (referring to the limb holding the racket), with inadequate forward lean of the trunk (Braddom et al, 1996). On the other hand the term lateral epicondylitis implies the presence of inflammation over the epicondyle (common origin of the wrist extensors), suspected to elicit the pain and functional limitation among persons having such condition.
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