- Parasites transmitted through trans-mammary route.

Parasites transmitted through trans-mammary route

(International Breastfeeding Symbol)

"SAT"

Strongyloides stercoralis larvae.

Ancylostoma duodenale larvae.

Toxocara canis and cati  larvae.

Dr Ibrahim 

- Grades of splenomegaly.

Grades of splenomegaly.  

1. Grade I :- Spleen is palpable under the costal margin.
2. Grade II :- Spleen is palpable between the costal margin and umbilicus.
3. Grade III :- Spleen is palpable below the  umbilicus.

Dr Ibrahim

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- Metabolic syndrome (Syndrome X).

 Metabolic syndrome

-Def :- It is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes (1).

-Synonyms :-syndrome X, insulin resistance syndrome, Reaven's syndrome or dysmetabolic syndrome.

 

- How is the metabolic syndrome diagnosed or defined?
The metabolic syndrome be identified by presence of three or more of these components:

• Elevated waist /hip ratio (i.e Abdominal obesity).
• Elevated triglycerides:Equal to or greater than 150 mg/dL, or specific treatment for this
  lipid abnormality.
• Reduced HDL or specific treatment for this lipid abnormality.
• Elevated blood pressure or treatment of previously diagnosed hypertension.
• Elevated fasting glucose levels or previously diagnosed type 2 diabetes.

-Prevention:-  life style modification which is considered the first line of prevention.

• Increased physical activity e.g walking 30 minutes every day (2).
• Healthy, reduced calorie diet (3).

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*References:-
(1) MedlinePlus:Metabolic Syndrome.
(2)Lakka TA, Laaksonen DE (2007). "Physical activity in prevention and treatment of the metabolic syndrome". Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme 32 (1): 76–88. doi:10.1139/h06-113.PMID 17332786.
(3)Feldeisen SE, Tucker KL (2007). "Nutritional strategies in the prevention and treatment of metabolic syndrome". Appl Physiol Nutr Metab 32 (1):46–60. doi:10.1139/h06-101.PMID 17332784

- 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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