- Grades of respiratory distress.

Grades of respiratory distress

1. Grade I (mild distress):- tachypnea ,working ala nasi and tachycardia .
2. Grade II (moderate distress):- Chest retraction "in-drawing" (e.g subcostal and intercostal) due to moderate hypoxemia.
3. Grade III (severe distress):- Grunting which is due to severe hypoxemia and indicate alveolar lesion (i.e parenchymatous lung disease).Here O2 supply is needed and patient must be hospitalized.Grunting is the last compensatory mechanism.
4. Grade IV:- Cyanosis and disturbed consciousness and endotracheal tube is needed here.

Dr Ibrahim

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- Grades of Dyspnea.

Grades of Dyspnea

Two scoring systems can be adopted to evaluate the dysnea changing it from subjective complaint to objective complaint.

1-American Thoracic society score (ATS):
Grade 0:- No breathlessness except with strenuous exercise.
Grade 1:- Breathlessness when hurrying on the level or walking up a slight hill.
Grade 2:- Walks slower than people of the same age on the level because of breathlessness or has to stop for breath when walking at own pace on level.
Grade 3:- stop for breath after walking about 100 yards (96 meter) or a few minutes on the level.
Grade 4:- Too breathless to heave the house or breathless when dressing or underdressing.

2-New york heart association score (NYHA)

There are four functional  grades of  Dyspnea as follows:-

1. Grade I (minimal Dyspnea):  Dyspnea on running or on doing more than ordinary effort .

2. Grade II : on doing ordinary effort .

3. Grade III (considerable Dyspnea) : on doing less than  ordinary effort .
4. Grade IV : Dyspnea at rest.

*Ordinary effort is that of the person himself as regard his previous effort tolerance and usual life style.

*Reference:-
- Basics of respiratory medicine,Staff members,Thoracic medicine department,mansourauniversity,3ed,2009,symptoms of chest disease P.g 57.

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- Breast feeding.

Breast feeding

(International Breastfeeding Symbol)

- Breastfeeding is the feeding of an infant or young child with breast milk directly from human breasts.

Advantages of Breast Feeding
( the breast is the best)

(1)For Infants:-

"Human breast milk is the healthiest form
of milk for human babies" (1) How?

*It is biochemically the most suitable for infant feeding at any stage (colostrum,transitional and mature milk).
*It contain various elements required for nutrition of infant.
*It is hypoallergic (2) and may reduce subsequent atopic diseases .
*Naturally stored at room temperature.
*Available whenever needed and automatically adjusted to infant needs.
*Anti infective properties how?
- It is naturally sterile as no preparation nor contamination.
- It contain various antimicrobial factors :-

- Oculo-cerebro-renal Syndrome.

Oculo-cerebro-renal Syndrome

-Def:- It is a X-linked recessive disorder of eye,cerebral cortex and renal tubules .

-Synonyms (1):-

• Lowe's oculocerebrorenal disease/syndrome.
• Lowe's disease/syndrome.
• Oculocerebrorenal dystrophy.

- The condition became known as "Lowe syndrome" named after Dr. Charles Lowe, the senior member of the group that described it.

-Clinical picture:-