Treatment for Recurrent Miscarraiges

CURRICULAM :

C - Circlage operation (shirodkar's and McDonald's operation)

U - Ultrasound

R - Rest

R - Reassurance and tender loving care

I - Inherited thrombophilias treatment (Heparin)

C - chromosomal anamolies detection (amniocentesis)

U - Unexplained causes

L - Luteal phase defect treatment (progesterone and hCG therapy)

A - Antiphospholipid antibody syndrome treatment (aspirin and heparin)

M - medical complications like hemoglobinopathies, cyanotic heart diseases, SLE etc treamtent

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Risk factors for Ectopic pregnancy

CAP2I2T3A

C - Contraceptive failure

A - Abortion (previous)

P - PID (pelvic inflammatory disease)and Salphingitis

P -Previous ectopic pregnancy

I - IUD use

I - Infertility
T - Tubal ligation
T - Tubal reconstructive surgery
T -  Tubal endometriosis
A - ART use

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CANDIDA ALBICANS - virtually all of us play host to it!!!

Facts :
        - Its a yeast infection and predominantly focuses on GI tract invasion
        - People having H-pylori infection also has candida overgrowth (60%-70%)
        - By age of 6 months, about 90% of the babies are positive for candida test
        - And by adulthood virtually we all have become the host of it
        - Our GI bacteria act in part to keep Candida growth in check in our body ecology

Features :
      Medium used :
                - Lownstein-Jensen medium

                - Two tubes of Sabouraud’s dextrose agar, SDA, one incubated at 37°C and the other at 20°C

     Upon culture :
                - After incubating for 48 hours typical creamy pasty colonies appeared on the blood agar and     both tubes of SDA.

                - it was then isolated and identified by the germ tube test

Disease caused by it is called Candidiasis, also called thrush or moniliasis, is a yeast infection

 Clinical pictures : for clinical pictures of candidiasis click on the below highlighted names
               1.    ORAL CANDIDIASIS
               2.   CANDIDIAL ESOPHAGITIS
               3.   YEAST VAGINITIS
               4.   CANDIDA GRANULOMA
               5.   CUTANEOUS CANDIDIASIS 

 

Symptoms : 

            1. Infection of skin : well defined patch of red, itchy skin, often leaking fluid

            2. Vaginal yeast infection : slow leakage of a thick, white, cheese-like substance, itching or burning sensation during urination and intercourse

            3. Infection of fingernail : painful, red, swollen area around the fingernail. In worse cases, the fingernail may separate, revealing a discoloured white or yellow nail bed.

            4. Oral thrush : curd like white patches in mouth, palate, tongue and around the lips

Investigations :

          - Proper diet history

          - History of medication and antibiotics which may weaken the immune system

          - History of diabetes, cancer, HIV, or other chronic disease

          - Microscopic examination after being scraped off the affected area

Treatment :

                 Candidiasis is not normally a dangerous disease except in rare cases when it enters the blood and spreads to vital organs of people with weakened immune systems

                Anti-fungal cream or powder

Precaution :

           - wipe from front to back after going to the toilet - the rectal area is full of yeast

           - take baths not showers - sitting in the bath can clear yeast from the vaginal area

           - dry yourself thoroughly afterwards, especially the pubic hair - use a hair dryer on low setting if you have to

          - don't use soap around the vagina - soap kills the bacteria you want to keep, and has no effect on yeast

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DRACUNCULUS MEDINENSIS - silent killer which remains in body silent upto 1 year !!!!!!

Facts :
          - Also known as guinea worm disease (GWD)
          - These are among the longest nematodes infecting humans.
          - Dracunculus medinensis is one of four filarial nematodes that cause subcutaneous filariasis in humans. The other three filarial nematodes are Loa loa (the African eye worm), Mansonella streptocerca, and Onchocerca volvulus (river blindness)
          - The longest adult female recorded was 800 millimetres (31 in), while the adult male was only 40 mm (1.6 in)
          - Guinea worm has been found in calcified Egyptian mummies
          - An Old Testament description of "fiery serpents" may have been referring to Guinea Worm: "And the Lord sent fiery serpents among the people, and they bit the people; and much people of Israel died."

          - Humans become infected by drinking unfiltered water containing copepods

The disease caused is  Dracunculiasis
 Symptoms include :
           - Pruritus
           - Nausea
           - Vomiting
           - Diarrhea or
           - Asthmatic attacks

 Treatment :
           - There is NO vaccine or medicine to treat or prevent Guinea worm disease
           - Once a Guinea worm begins emerging, the first step is to do a controlled submersion of the affected area in a bucket of water. This causes the worm to discharge many of its larva, making it less infectious
           - To extract the worm, a person must wrap the live worm around a piece of gauze or a stick. The process can be long, taking anywhere from hours to months.
           - Gently massaging the area around the blister can help loosen the worm up a bit.
           - Use of metronidazole or thiabendazole may make extraction easier, but also may lead to migration to other parts of the body

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OSTEOSARCOMA - most common type of bone cancer in childrens and adult !!!

                Osteosarcoma is the most common bone cancer in children and adolescents, and the third most common cancer in adolescence.
                Osteosarcoma is most common between the ages of 10 and 25 when the bones are rapidly growing

Risk factors :
        - Exact cause is unknown associated with random genetic mutations of osteoblasts
        - Transmission of diseases including retinoblastoma, Li Fraumeni syndrome, Rothmund-Thomson syndrome,- Paget's disease, and Werner's syndrome from parents to offspring
        - Only known environmental risk factor is exposure to radiation

Symptoms include :
       - Bone fracture (may occur after what seems like a routine movement)
       - Bone pain
       - Limitation of motion
       - Limping (if the tumor is in the leg)
       - Pain when lifting (if the tumor is in the arm)
       - Tenderness, swelling, or redness at the site of the tumor

Investigations :
       - Biopsy (at time of surgery for diagnosis)
       - Blood tests
       - Bone scan to see if the cancer has spread to other bones
       - CT scan of the chest to see if the cancer has spread to the lungs
       - CT scan and MRI scan
       - PET scan
       - X-ray

Diagnosis :
       - Chemotherapy is the first line of treatment, drugs include
Carboplatin (Paraplatin), Cisplatin, Cyclophosphamide (Cytoxan), Doxorubicin (Adriamycin), Epirubicin, Etoposide, Ifosfamide (Ifex), Methotrexate (high dose) with leucovorin
       - Surgery is used after chemotherapy to remove any remaining tumor. In most cases, surgery can remove the tumor while saving the affected limb (this is called limb-salvage surgery)

Prognosis :
If the tumor has not spread to the lungs (pulmonary metastasis), long-term survival rates are better

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