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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ROUND WORM - infects 1 in every 4 persons in world!!!!!!

Roundworms are one of the most common species of intestinal parasites in the world
Also known as Ascaris lumbricoides

Facts :
            - The World Health Organization (WHO) estimates that about 25% of the world's population are infected with roundworm.
            - Female round worm ranges from 16cm to 33 cm and can grow up to the size of pencil
            - WHO estimates that about 25% of the world's population are infected with roundworm.
            - Medical research studies use roundworms to study human diseases which include illnesses like muscular dystrophy and even Alzheimer's disease. This is because of the fact that human beings and roundworms have similar body organization and similar genetic code

 Clinical features :
      - perianal itching
      - abdominal pain
      - diarrhea
      - melena
      - fatigue and weight loss
      - vomiting
      - cough in case of systemic involvement

Diagnosis :
      - stool examination
      - passing of worms in stool
      - radiolophic/ USG imaging
      - endoscopy

Treatment :
Mebendazole, drug of choice
Piperazine, alternative
Albendazole, levamisole, ivermectic other medications
Diethlycarbamazine with filariasis infection

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ADIPOSE TISSUE - good or bad

Introduction :
In humans, adipose tissue is located beneath the skin (subcutaneous fat), around internal organs (visceral fat), in bone marrow (yellow bone marrow) and in breast tissue. Adipose tissue is found in specific locations, which are referred to as adipose depots. Adipose tissue contains several cell types, with the highest percentage of cells being adipocytes, which contain fat droplets. Other cell types include fibroblasts, macrophages, and endothelial cells.

WHY IT IS GOOD FOR BODY :
      - It functions as the major storage site for fat in the form of triglycerides
      - Important heat insulator in the body (subcutaneous fat)
      - As the major form of energy storage, fat provides a buffer for energy imbalances when energy intake is not equal to energy output
      - The average woman with 20% body fat has about one month of energy stored as fat.
      - In hibernating animals and neonates, brown adipose tissue is important for regulating body temperature via non-shivering thermogenesis.

WHY IT IS BAD FOR BODY :
Physiological amount of adipose tissue is needed for the body if it becomes excess then will lead to one of the most emerging problem in today's life i.e OBESITY leading to complications like
        - Metabolic complications - type 2 diabetes, insulin resistance and hyperinsulinemia, dyslipidemia, gout
        - Abnormalities of hormones - growth hormone, hypothalamic-pituitary-adrenal axis, cytokines, renin-angiotensin system, leptin, ghrelin.
        - Cardiac and vascular diseases - coronary heart disease, hypertension, congestive heart failure, cerebrovascular disease, thromboembolic disease
       - Respiratory system abnormalities - obesity-hypoventilation syndrome, sleep apnea.
       - Digestive system abnormalities - gallbladder disease, hepatic disease.
       - Nervous system - pseudotumor cerebri, adiposis dolorosa, alzheimer's disease.
       - Mechanical complications - arthritis, increased intra-abdominal pressure.
       - Other complications - immune system dysfunction, skin disease, eye disease, cancer, social complications.

Histological Features :
This histology slide shows adipose tissue surrounding the ureter. The adipocytes are shaped like a signet ring. The nucleus is pushed to the periphery of the cell. The staining process leaches the fat out of the cells, so these are just the skeleton of the cell. Some smooth muscle from the ureter is visible in this section as well.

Conclusion : body fat is one one the most useful aspect of the body and when present in excess or not properly regulated will lead to a cascade of diseases.. 

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CHRONIC PYELONEPHRITIS - why 1 out of 7,000 people develop pyelonephritis each year in the US

Introduction :
             One of the most common renal diseases, acute pyelonephritis is a sudden inflammation caused by bacteria.It is characterized by renal inflammation and fibrosis induced by recurrent or persistent renal infection, vesicoureteral reflux, or other causes of urinary tract obstruction.
Occurs almost exclusively in patients with major anatomic anomalies, most commonly in young children with vesicoureteral reflux (VUR)
               Non-obstructive secondary to obstruction or vesiculourethral reflux with recurrent infection (reflex nephropathy, most common). Vesiculourethral reflux due to an incompetent ureterovesical junction is most common in children (males < 1 year, females > 1 year). Obstruction may be due to renal stones, prostatic hyperplasia, or tumors. Hydronephrosis eventually results, with entry of infected urine into the renal medula.

Definition :
            Pyelonephritis is a serious bacterial infection of the kidney that can be acute or chronic

Clinical features :
         - high grade fever with chills
         - flank pain
         - confusion
         - headache
         - renal colic pain
         - other symptoms include hypertension, anemia and renal insufficiency

Investigations :
        - urine analysis
        - urine culture
        - ultrasound study of kidneys

Treatment :
       - broad-spectrum antibiotic therapy
       - hospitalization in severe cases

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