Monthly Archives: August 2018

FEBRILE NEUTROPENIA

FEBRILE NEUTROPENIA DESCRIPTION Febrile neutropenia is defined as an absolute neutrophil count of < 0.5 x109/L with a temperature of greater than 38°C for > 1 hour. This is a medical emergency as these patients can rapidly develop features of

ANAEMIA, SICKLE CELL

ANAEMIA, SICKLE CELL DESCRIPTION Homozygous sickle cell anaemia (HbSS: HbS > 50–100%). Individuals with sickle cell trait have < 50% HbS and are generally asymptomatic. The disease is characterised by various crises: vaso-occlusive, aplastic, megaloblastic and sequestration crises, and infection.

ANAEMIA, MEGALOBLASTIC

ANAEMIA, MEGALOBLASTIC DESCRIPTION Anaemia caused by a deficiency of folate and/or vitamin B12. Investigations Elevated MCV (mean corpuscular volume) and MCH (mean corpuscular haemoglobin). Macro-ovalocytes on blood smear; polysegmentation of neutrophils, thrombocytopenia with giant platelets. Decreased serum vitamin B12 or

ANAEMIA, IRON DEFICIENCY

DESCRIPTION Anaemia due to iron deficiency. Common causes of iron deficiency are chronic blood loss or poor nutritional intake.  Hypochromic microcytic anaemia Investigations Assess for a haematological response to iron therapy. GENERAL MEASURES Identify and treat the cause. Dietary adjustment.

ANAEMIA, HAEMOLYTIC

DESCRIPTION Anaemia due to destruction of red blood cells. Destruction may be due to: » Extracellular factors such as auto-immunity or mechanical factors, e.g. disseminated intravascular coagulation (DIC), hypersplenism, medications. » Abnormalities of the cell membrane, e.g. hereditary spherocytosis. »

ANAEMIA, CHRONIC DISORDER

DESCRIPTION Anaemia due to chronic inflammation. This is characteristically a normochromic normocytic anaemia. Common causes of anaemia of chronic disorder include: » malignancy, e.g. haematological or solid tumours, » autoimmune disorders, e.g. rheumatoid arthritis, » acute or chronic infections, e.g.

ANAEMIA, APLASTIC

DESCRIPTION Pancytopenia due to a hypoplastic bone marrow. Clinical features: » pallor, » petechiae, » purpura, and » bleeding with frequent or severe infections. MEDICINE TREATMENT If neutropenic and febrile, see section 2.7: Febrile Neutropenia. REFERRAL » Discuss all cases

PERITONITIS

DESCRIPTION Infection of the peritoneum, usually secondary to a surgical cause such as perforated bowel. In this setting polymicrobial infection with anaerobes and Enterobacteriaceae are usually found. Primary or spontaneous bacterial peritonitis is much less common and usually complicates ascites

GIARDIASIS

DESCRIPTION Infection with the protozoan parasite, G. lamblia which colonises the proximal small intestine. GENERAL MEASURES Fluid and electrolyte replacement in severe diarrhoea. MEDICINE TREATMENT • Metronidazole, oral, 400 mg 8 hourly for 5 days. Reference and further reading Standard

AMOEBIC DYSENTERY

DESCRIPTION Diarrhoea with blood and/or mucus due to E. histolytica. GENERAL MEASURES Rehydration may be necessary. This should be done with oral rehydration solution (ORS) unless the patient is vomiting or profoundly dehydrated. Surgery for bowel perforation. MEDICINE TREATMENT Loperamide

DIARRHOEA, ANTIBIOTIC-ASSOCIATED

DESCRIPTION Diarrhoea caused by altered bowel flora due to antibiotic exposure. Severe cases present with pseudomembranous colitis. Toxins produced by Clostridium difficile can be demonstrated on stool samples. GENERAL MEASURES The most important aspect of management is discontinuing antibiotics. Rehydration

DIARRHOEA, ACUTE NON-INFLAMMATORY

DESCRIPTION Diarrhoea without blood or mucus. Common causes include viruses and enterotoxigenic strains of E. coli. GENERAL MEASURES Rehydration is the cornerstone of management. This should be done with oral rehydration solution (ORS) unless the patient is vomiting or profoundly

ACUTE INFLAMMATORY DIARRHOEA (DYSENTERY)

DESCRIPTION Diarrhoea with neutrophils, blood and/or mucus. Causes include shigella, salmonella and campylobacter. GENERAL MEASURES Rehydration is the cornerstone of management. This should be done with oral rehydration solution (ORS) unless the patient is vomiting or profoundly dehydrated. Stool culture

CHOLERA

  This is a notifiable disease. DESCRIPTION Diarrhoea due to Vibrio cholerae, often in outbreaks. GENERAL MEASURES Rehydration is the cornerstone of management. This should be done with oral rehydration solution (ORS) unless the patient is vomiting or profoundly dehydrated.

ACUTE CHOLECYSTITIS AND ACUTE CHOLANGITIS

GENERAL MEASURES Surgical drainage / cholecystectomy according to indication and/or patient’s condition. MEDICINE TREATMENT Acute cholecystitis Mild and asymptomatic cases without risk factors may not require antibiotic treatment. If signs of infection present and/or risk factors for severe disease present:

ACUTE CHOLECYSTITIS AND ACUTE CHOLANGITIS

GENERAL MEASURES Surgical drainage / cholecystectomy according to indication and/or patient’s condition. MEDICINE TREATMENT Acute cholecystitis Mild and asymptomatic cases without risk factors may not require antibiotic treatment. If signs of infection present and/or risk factors for severe disease present:

LIVER ABSCESS, AMOEBIC

DESCRIPTION Focal hepatic infection due to E. histolytica. Only about a third of cases have concomitant amoebic colitis. Diagnosis can be excluded if the serological test is negative. It is essential to exclude pyogenic infection (a diagnostic aspirate should be

LIVER ABSCESS, PYOGENIC

LIVER ABSCESS, PYOGENIC DESCRIPTION Focal bacterial infection of the liver with pus, usually polymicrobial. GENERAL MEASURES Drainage is essential in all cases. This should preferably be done percutaneously by inserting a catheter under ultrasound guidance. MEDICINE TREATMENT Empiric antibiotic therapy

ENTHALPY AND ENTHALPY CHANGES

Enthalpy is a  thermodynamic quantity equal to the internal energy of a system plus the product of its volume and pressure. Enthalpy of a system is defined by the relation, H= U + pV…………………………..1 U: is the internal energy p:

HEAT CHANGE UNDER CONSTANT VOLUME

The reactions are carried out under constant volume or under constant pressure conditions. Let us now arrive at an expression useful in calculating the heat change in a system under constant volume conditions. let us assume that the work done

HEPATITIS, VIRAL

DESCRIPTION Hepatitis caused by one of the hepatotropic viruses, hepatitis A, B, C and E. Hepatitis A and E only cause acute hepatitis, whilst B and C cause acute and chronic hepatitis. GENERAL MEASURES Acute hepatitis Bed-rest until acute phase

PREPARATION OF ETHER BY DEHYDRATION OF ALCOHOL

Preparation of ether by dehydration of alcohol is one the simple method often carried out in an industrial production ether. As such we are going to discuss ether production from simple or symmetrical alcohol   DEHYDRATION OF ALCOHOL Is simple

Solubility, and solution

the solubility of a solid is normally defined as the mass in grams which will dissolve in 100g of solvent to form a saturated solution at a given temperature. Question: an evaporating dish weighed 11.68g; partly filled with a saturated

Ether preparations

Ether preparations   On this tutorial we going discuss on ether preparation   Ether is a family of organic compound with the following general formula CnH2n+2O   Ether are group into two which are symmetrical and asymmetrical ether for easy

PORTAL HYPERTENSION AND CIRRHOSIS

DESCRIPTION The complications of portal hypertension are: » variceal bleeds » ascites and fluid overload » encephalopathy » spontaneous bacterial peritonitis in patients with ascites GENERAL MEASURES Ascites: salt restriction, i.e. < 2 g/day. Monitor weight regularly. Bed rest. Encephalopathy:

LIVER FAILURE

GENERAL MEASURES Patient education. Avoid hepatotoxic drugs and alcohol. Rest and reduced physical activity are recommended. Normal diet. Protein restriction indicated only when encephalopathy is evident. Severe protein restriction may accentuate catabolism. Use increments of 20 g protein per day

HEPATITIS, NON-VIRAL

Notifiable if caused by agricultural chemicals and insecticides. DESCRIPTION Any form of hepatitis not caused by the common hepatotropic viruses. Liver biopsy is indicated if hepatitis persists or diagnosis is unclear. GENERAL MEASURES Diet: restrict protein if features of liver

PEPTIC ULCER

DESCRIPTION Ulcer in the stomach mucosa (gastric ulcer: GU) or first few centimetres of the duodenum (duodenal ulcer: DU), which penetrates into or through the muscularis mucosa. Diagnosis is made after investigation, preferably by endoscopy, as all Gus require 4-quadrant

PANCREATITIS, CHRONIC

DESCRIPTION Chronic inflammatory condition of the pancreas, which results in functional and structural damage. In most patients this is a chronic progressive disease leading to exocrine and endocrine insufficiency. GENERAL MEASURES Abstinence from alcohol reduces abdominal pain in the early

IRRITABLE BOWEL SYNDROME (IBS)

IRRITABLE BOWEL SYNDROME (IBS) DESCRIPTION Functional bowel disorder: motility disturbance of the entire gastrointestinal tract (GIT) resulting in recurrent symptoms of pain, constipation and/or diarrhoea and bloating. GENERAL MEASURES Reassure patient, after limited investigations, that there is no serious organic

GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD)

DESCRIPTION A disorder which develops as a consequence of the reflux of gastric and duodenal contents into the oesophagus. It is usually characterised by heartburn and regurgitation. Complications that may develop in severe disease are strictures, ulceration, Barrett’s oesophagus and

DIVERTICULITIS

According to Wikipedia Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. They typically cause

CONSTIPATION/ FAECAL IMPACTION

DESCRIPTION A condition characterised by a change in usual bowel habits and dry, hard stools. There is a decreased frequency of bowel action and patients should be assessed individually. Constipation may have many causes: » incorrect diet (fibre and fluid);    

CROHN’S DISEASE (CD)

CROHN’S DISEASE (CD) DESCRIPTION Idiopathic and chronic intestinal inflammation. This is a transmural inflammatory condition affecting mainly the distal ileum or colon, but may affect the entire gastro-intestinal tract. Common complications are intestinal obstruction and abscess formation.   GENERAL MEASURES

State Variables

State Variables A thermodynamic system has to be macroscopic (having a sufficient larger size); this eases measurement of its properties such as; Pressure Volume Temperature Composition Density Such properties are consequently called macroscopic or bulks. These properties are also called

THERMODYNAMIC TERMINOLOGY

System Any part of the universe which is under study is called a system. It can be as simple as a gas contained in a closed vessel or as complicated as a rocket shooting towards moon. A system may be

Republican lawmaker arrested for in trading  relation to a company named Innate Immunotherapeutics Limited

According CNN news, This August is feeling particularly swampy in Washington, DC, and it’s not just because the mosquitoes are eating us alive. This week, New York Rep. Chris Collins was indicted on charges of insider trading in relation to

Kwara PDP Sets Up Harmonisation Committee

The Peoples Democratic Party (PDP) in Kwara State has set up a Harmonisation Committee ahead of the 2019 general elections. The Committee became necessary following the defection of Senate President Bukola Saraki, Governor Abdulfatah Ahmed, federal lawmakers and members of

KOGI PLANS TO CLEAR ARREARS OF SALARIES IN 90 DAY

Civil servants in Kogi State would soon have cause to smile as the state government has assured that it would soon release funds for the settlement of all arrears of salaries even as it has assured that the era of

Kogi Decides Results update

Agbaja LGEA primary school unit 001. APC- 96 PDP- 44 SDP – 18 NCP – 1 ADC – 4 Unit 011, Oyo-Iwa, Oworo APC – 341 PDP – 13 IRENODU POLLING UNIT IN IRENODU WARD APC – 105 PDP –

News update from kogi bye election: Kogi bye-election; Money is used to by Voters in some areas, while their stampede in some area

Voting is currently going on in kogi state now, but the deployment is that money is been used to buy the electorate, and party with highest money will take the lead. According the information made available by Jibril Usman said

Reviewed NYSC payment will come with new minimum wage, DG guarantees

Director General of the National Youth Services Corp, Brigadier General Suleiman Zakari Kazaure Director-general of National Youth Service Corps (NYSC), Brig. Zakari Kazaure, has pleased corps members of the rising review of their allowance, saying it would take influence with

WHAT A WOMEN MOST AVOID DURING MENSTRUATION TO AVOID UTERUS CANCER OR TUMOR

Share this message to any woman that you know. (If you are man and you receive this message please help forward it to the women around you), If a woman is seeing her menstrual period then please do not do

WHAT PROMINENTS NIGERIANS SAY ABOUT BUHARI

“The army after toppling our democratic regime have no option but to install Buhari as head of state so as to avoid credibility problems, especially in the sight of the international community because of his being an epitome of integrity.”

Pls note the followings and take the precautionary measures as suggested: to avoid snake in your toilet

ABOUT SNAKES IN WCs   By Engr.  Femi Olulegan:   “Pls note the followings and take the precautionary measures as suggested: MOST reptiles would find it difficult to jump or enter into the WC from within. The easiest inlet is

The five Anambra girls Secondary School Onitsha representing Nigeria and Africa won Gold Medal

The five Anambra girls from Regina Pacies Secondary School Onitsha who represented Nigeria and Africa at the World Technovation Encounter in the Silicon Valley in San Francisco, US last night have won the Gold Medal in the contest. The squad,