Month: December 2017

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Another Step Towards Preventing Heart Disease – A Vaccine To Lower Cholesterol Levels

The word cholesterol has always been able to raise eyebrows of people because the rising levels of cholesterol is a factual indicator of growing heart disease. While there has been a lot of research and development in the field of cardiac study, here is some further news around the same. Well, lowering cholesterol for a healthy heart is a known fact. We all know how high levels of low density lipo-protein (LDL), also known as bad cholesterol can lead to a stroke due to atherosclerosis or the build up of plaque in the arteries thereby clogging them.

Now, we have this vaccine named Ato4A that has the ability to lower cholesterol levels in the body. It is a cholesterol lowering vaccine by nature and its role is to induce the antibodies production against an enzyme by name PCSK9 responsible for preventing the LDL cholesterol clearance from blood. It apparently attacks the PCSK9 enzyme and reduces the buildup of LDL cholesterol.

Preventing Heart Disease

The vaccine has already been experimented on mice. After feeding the mice with high cholesterol based western food for a while in order to increase atherosclerosis. The findings clearly showed some amazing results.
While the total lowering in cholesterol was a whooping 53%, the reversal of the atherosclerotic damage to blood vessels was a startling 64% and reduction in the biological markers of blood vessel inflammation by 21-28%. The researchers also found that the antibodies were functional throughout the study with increased levels of concentrations towards the end of it.

The PROCESS
Now, the PCSK9 protein is responsible for blocking the LDL cholesterol receptors. Due to this our body fails to get rid of this Cholesterol from blood. When the vaccine Ato4a is injected in the body it starts producing antibodies that in turn block the PSCK9’s function. As a result the activity of LDL cholesterol receptors increases.

A notable difference though between the conventional vaccines and Ato4A is that usually the antibodies in conventional vaccines are only specific to foreign bacterial and viral proteins. While Ato4A induces antibodies against body proteins.

Thus, as per researchers the next step was to take the study forward to human beings and see how the results fare. If it works then surely, this discovery of sorts is going to help fight heart diseases and stroke more effectively in the times to come.

Dr. H. P. Prabhuswamy, MBBS, MS, M. CH, FICC, FIACS, Cardiac Surgery, Professor & HOD, Dept. of CTVS, RRMCH and team conducted a Minimally Invasive Cardiac Surgery.

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Stevens Johnson Syndrome

This syndrome has been named after the pediatricians AM Stevens and SC Johnson who were the first to diagnose a reaction of eye and mouth due to a drug in the year 1922. It is a rare disorder or condition but does serious damage to the mucus membranes besides the skin. Abbreviated as SJS, it is a medical emergency known as toxic epidermal necrolysis which requires immediate attention and medical care as it is known to be one of the most adverse drug reactions recognized in USA. The affected groups include Elderly and the children.

This condition causes swelling of face and lips with red and purple rash that blisters on the face accompanied by crusty lip sores. In case the eyes catch it then it can cause vision issues and corneal ulcers.

Genetic Issues – If a close family member has suffered from SJS, there is high possibility of SJS risk. There is a strong connection particularly with the Asian population between HLA-A 33:03 and HLA-C 03:03 alleles as well as allopurinol induced SJS or TEN.

Causes because of medication reactions
Usually the reaction to a certain drug appears within a week of starting the course but with some medications like anti-convulsants, the reaction might take as long as a month to surface. The antibiotics that are particularly on the list to cause SJS are Penicillins like bacampicillin and amoxicillin, cephalosporins like cephalexin and cefaclor, macrolides like azithromyvin, erythromycin and clarithromycin. Some anticonvulsantsare used for treating peilepsy, allopurinol used for gout treatment, Nevirapine for treating HIV infections, Acetaminphen, an all age group medication.

Immunity Issues – If you have an immune system that is weak like HIV infection, due to organ transplant or chemotherapy and more could increase the risk of SJS

Infections that Predispose to SJS
The viral infections that are known to precede SJS include influenza, Hepatitis A, mums, HIV and more while the bacterial include conditions like typhoid, brucellosis, mycoplasma pneumonia to name a few. Malaria and trichomoniasis are the protozoal infections.

Previous infections – There is a high risk of SJS recurring if the same medication of the same group has been used earlier and has been responsible for causing SJS infection.

Symptoms
It primarily looks like an upper respiratory tract infection, cold or cough, headache, body pain and sore throat
It is followed by blisters on the skin, mouth, nose, ears and genitals as well. The rashes are red or purple in color and with the progress of the conditons may tend to merge as well as rupture thus exposing sores that are painful. Further, the top skin layer forms a crust and sheds.

The face and lips swell and mouth catches ulcers. The lips form a crusty sore and due to the ulcer buildup in the mouth, its becomes difficult to swallow. If there are ulcers in the digestive tract, they may cause diarrhea and even dehydration.

Diagnosis
There are two ways by which the Stevens Johnson syndrome can be diagnosed.
1. Clinical Examination – The target rash characteristic plays an important role in diagnosis of SJS but to study the predisposing factor a complete clinical history is checked.
2. Skin biopsy – Sometimes even a skin biopsy could be needed to confirm the diagnosis.

Treatment –

The patient needs immediate hospitalization because it is considered to be a medical emergency. The first step is to stop the medications responsible for SJS. For treating the infection that is already developing, local antiseptics and antibiotics are used.

To stop the condition from getting worse and spreading, intravenous immunoglobulins are given.
The eye treatment involves artificial tears and lubricants so that the surface drying stops. Even antibiotics, antiseptics and topical fluids are used in order to prevent inflammation as well as infection.
For women suffering from the condition intravaginal steriod oinments are used for preventing scar tissue formation
Painkillers/ Analgesics for relief
Psychological consultancy for emotional stability and anxiety if the need be.

Prevention
If some close relative has developed SJS its important to know the drug that caused it and try and avoid that drug so as to prevent it
These days medicalert bracelets are available so that the health professional who treats come to know about any emergency situation.

Genetic testing is rarely carried out and might be suggested only in cases of South East Asian and Indian descent.
It is known that of the one third cases diagnosed with Stevens Johnson syndrome, the recurrence does occur and hence it is important to stay informed about the medications that might just not be suitable for intake for this condition.

Know More about – Best Medical Colleges in Bangalore

*Source from the internet

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What is Simulation? – Simulator Aided Inter Disciplinary Workshop

What is Simulation?

Simulation is a technique to replace or amplify real-patient experiences with guided experiences. Various types of simulators are used to train and assess different levels of learners. These include mannequin simulators, human cadaver or animal models, computer-based simulation, haptic and/or virtual simulation, as well as simulation using standardized patients. Simulation has been an accepted part of training, assessment and research in high-reliability organizations, such as aviation, nuclear power, and military. Healthcare has adopted simulation from these fields for the purpose of training healthcare providers. Simulation-based learning has been used to shorten the gap that exists between the learning environment and the real clinical environment. Many skill trainers have been developed to actualize real clinical site especially for novice residents .

Utilization of simulatiors has many advantages for medical education:
1) learning can be focused on the level of trainees with various levels of difficulties;
2) learners can either learn the whole procedure process or just focus on certain tasks of the procedure;
3) learners have the opportunity to repetitively practice in quick succession;
4) learners learn in a safe environment where they can be allowed to learn from their mistakes rather than be rescued by their supervisor to keep the patient safe;
5) simulators can provide objective evidence of performance, offering potential for their use for assessment, both formative and summative;
6) simulation can provide practice on certain procedures such as cricothyrotomy, which is a critical life-saving procedure that is uncommon and rarely performed by residents.

Simulation has a potential to promote a new paradigm compared to traditional education tools. Technical skills and non-technical skills can be taught to residents via a standardized and organized simulation program teams.

Simulation based teaching workshop by the department of Anaesthesia and critical care was conducted on 7Th and 8th of Dec 2017.The whole programme had audio-video facilities.The whole process was beamed to the another class room in the Ist floor of the college building.

After the invocation, Dr, Sahajananda welcomed the gathering and the Guest faculty from Perth and Melbourne, Australia.
The guest faculty addressed the gathering and gave introductory lecture.

There were two case scenarios on 7th.
1.A pregnant patient with RTA having sustained chest and pelvic injuries. 16 participants were split into two groups and ask to conduct the management of the case.
2.Pregnant patient with severe PIH
After the procedure the defbreefing was done by the faculty namely: Parasad B Achar and Sunanda Gargeswari,in the ist floor class room. Detailed discussions were also held.
On 8th Dec 2017:

Dr. Sahajanand welcomed the gathering and delegates.He also introduced the guest faculty Dr.Shashikanth Manikappa from Melbourne.
Delegates were split into two batches.There were two case scenarios:
Patient with sepsis and septic shock
Patient in the OT who developed Anaphylaxix.

After the procedure the defbreefing was done by the faculty namely: Dr. Shashikanth and Sahajananda H, in the Ist floor class room. Detailed discussions were also held.

The whole programme was well attended by the residents and faculty from Surgery, Orthopedics, OBG, General Medicine and Pulmonary medicine.

 

Date : 7th Dec 2017 and 8th Dec 2017

Time : 2:00 pm to 6:00 pm

Venue : College first floor lecture hall & Kadamba Auditorium (College auditorium)

Speaker : Dr B. G. Prasad Achar & Ms Sunanda Achar, Melbourne, Australia

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All You Need To Know About White Tongue

Known to cause a greyish- white coating on the tongue, this condition called White tongue is a common and generally harmless symptom that could indicate a serious condition. Rarely serious conditions like cancer causes white tongue.

White Tongue

Causes
Lack of Brushing of flossing or doing it in an improper way.
Lack of regular Tongue cleaning or doing it improperly.
Addictions like alcohol, smoking and chewing tobacco
Dry mouth that is a result of sleeping with open mouth or mouth breathing

Dehydration
Irritation due to sharp edges resulting form dentures or braces inside the mouth
Though there are certain conditions that are caused inspite of maintaining oral hygiene. These include conditions like oral thrush, Oral lichen planus and Leukoplakia.

Oral Thrush – This is a type of fungal infection caused by candida yeast. Patches develop on the tongue and mouth. White or off white in color, they can be painful and also have unpleasant taste. Oral thrush usually occurs in people with low immunity or those who have undergone a recent chemotherapy treatment or taken antibiotics. Some other causes include inhalation of asthma related medications like corticosteroids and diabetes.
Treatment – Anti-fungal medicines like oral drops are used for its treatment for a couple of weeks.

Syphillis – Also known as sexually transmitted condition (STI), if left untreated it can lead to white tongue as well as mouth sores.
Treatment – Pencillin is used for its treatment for reducing the disease causing bacteria

Oral Lichen Planus – An inflammatory condtion, Oral Lichen planus causes white patches thick in the mouth and on the tongue accompanied with painful cheek, gums as well as ulcers.
Treatment – Generally monitored but in serious cases croticosteriods are used.

Leukoplakia – This condition is a result of addictions caused by irritants like alcohol and tobacco or even due to dentures. They are harmless mostly but still a diagnosis is important to check out the rare possibility of complications.
Treatment – Continuous monitoring to avoid it from spreading further

Home Remedies
There are a few home based remedies that can help you fight the condition. These include use of probiotic foods like kimchi, konbucha and more, using baking soda while brushing teath and tongue cleaning. Consumption of raw garlic and scraping tongue properly for removal of bacteria.

Prevention
The best possible solution is maintaining proper oral hygiene backed with regular oral checkups other than that it is not always possible to get away from it.

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