what is brain death and how the diagnosis will be done?

 

Brain death

What is brain death? I think you may know about it. In this blog I’m just briefing about what is it? And what is the diagnosis?

Brain death is an irreversible one. Once you get your brain dead then you will be dead slowly by terminating each part of your body. If you have a loss of function of entire cerebrum and brain stem then you will be in coma. Then you will have no spontaneous reaction and loss of reflexes.

Diagnosis:

The patient will be diagnosed by

·       serial determination of clinical criteria

·       Apnea testing

·       Sometimes EEG, brain vascular imaging

If you are declaring brain death structural and metabolically cause of brain damage must be present.

If the patient has suspected an epileptics then EEG should be done.

You should observe the patient and do examinations on the patient.

Examination includes:

·       Assessment of pupil reactivity

·       Assessment of occulovestibular, occulocephalic, and cornea reflexes

·       Apnea testing

 

For examination we need the equipment Reflex hammer, flashlight, cotton-tipped swab, tongue depressor, 60ml syringe, kidney basin, ice cold water, towel roll, arterial blood gas, oxygen source, T-piece, Suction catheter.

If we need to know the person is in brain dead we need to do the examination of patient:

If patient is in coma check the diagnosis:

To examine the patient we need to check the stimulus or automatic response for the body like if we keep pen in between toes press against the toe in the abnormal condition the foot will not remove but in normal condition you will remove the foot.

Pain full nail beds response if the patient is in normal by applying pressure to any of the nail beds then you will remove the hand but in the abnormal condition you will not remove the hand by applying the pressure. And also you need to check the pupilary response to the stimulus.

Interrogate brainstem

Check the pupillary response: in normal condition you will observe that the constriction in response to the flashlight but in the abnormal there will be no any constriction of pupil

                                      a.                                                                                     b.

But in certain conditions is difficult in assessing pupillary response like:

1.   Pre-existing pupillary abnormalities – Coloboma

2.   By administrating of certain medications to the eye –Atropine or phenylephrine

3.   Trauma to the eye

Corneal reflex: by taking cotton-tipped swab touch the cornea if your eye blinks then the patient is in normal condition if not then the patient is in abnormal condition.

Oculocephalic maneuvers: observe the patient eye can maintain mid line position when the head turned and should never perform this test in patients with known or suspected cervical spine injury. But in this case if he/she is not maintaining same position then the patient is in abnormal condition.

Oculovestibular reflexes: To do this test you need to put head of the bed in 30 degrees so you can have semicircular canals orthogonal to gravity. Since it is a good idea that we are about put water in to bed and put towel to out of the basin. The fill the basin with cold water. Then we would take into syringe 50cc’s of cold water. Before going further you need to check there is no wax in the ear and no pathology that we would prevent the test. Then hold back the eye lids. Then place the basin beside the ear insert the syringe tube(attach any IV tube to the syringe). And as rapidly install 50ml of ice water into the otic canal and observe the eye stimulus if the eye is moving more towards cold water stimulus and less towards opposite then the patient is in normal condition. If the patient eye is moving only towards the cold water then the patient is having brainstem response but no cortical response. If the patient eye is not responding then he/she having neither brainstem response nor cortical response.

Note: after installing cold water into the ear you may need to wait 90-120seconds. To observe the response before concluding that there is no response.

Difficult in evaluating oculovestibular reflex:

1.   Cerumen ( in otic canal) will prevent the cold water reaching from the typhanic membrane

Oropharyngeal response: we can this by any tongue blade or any cotton swab by keeping deep in to the mouth and you will observe elevation of palatal but in the abnormal patient you will see no response from the musculature in retropharyngeal area.

Apnea test: to observe this apnea test first we need to give oxygen to the patient by the ventilator through the T-piece, and disconnect from ventilator and ensure that the oxygen level >85% and B.P remain 5 percentile to the age. And observe for a period of 5-10 min so that PaCO₂ would raise at least 20mm of mercury

·       Note: if the O₂ level fall below 85% or BP fall below the limit then the test discontinue.

·       Before reconnecting to the ventilator draw arterial blood gas

·       If ABG demonstrates PaCO₂ > 60mmHg then the apnea test is positive. Then appear for second clinical exam

If you have not seen the breathing for 5-10 min the connect to the ventilator before it draw the arterial blood gas and wait for ABG test

If the test shows increase at least 20mmHg of PaCO₂ and the level is greater than 60mmHg: the child haven’t breathed to that stimulus.

Note: if the PaCO₂ level is < 60 do not diagnose brain death

Some experts told that the threshold should rise higher than a PaCO₂ level of 60mmHg

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what is an allergy and it's pahology

ALLERGY

Hello subscribers in this blog I’m going to write about what is allergy and how the allergy will come what are the types of allergy and what are the pathological changes occur in body when allergy occur

What is allergy?

                        Which damage the immune system in the body due to a substance such as pollen, dust, food, and it makes our body hypersensitive. It is chronic condition, which means the disease can last up to 1 year or more and it require ongoing medicines.

Symptoms of allergy are red eyes, sneezing, shortness of breath, rashes, itching…etc…

Allergy is caused by environment and genetic factors.

IgE is in a human body immune system it increases when our body gets hypersensitivity to the environment. It releases the histamine (inflammatory chemicals) due to binding of allergen to a receptor or mast cells or basophiles.

Allergy caused as:

They are many risk factors for allergy it can be described as host and environment. In host the allergy will come by heredity, race, age, and sex. The environmental factors are infectious disease, pollution, dietary changes and allergen levels.

The major type of allergy may caused as

Food allergy:

            Most of the people cause allergic reactions are due to the food such as cow’s milk, eggs, wheat, peanuts and fish…etc… milk – protein is the most common in children and it is mediated with Immunoglobulin E and cause inflammation of colon.

Pathology

 In early stage of allergy type I hypersensitivity (immediate) react against an allergen which can cause by exposure. Exposure may be ingestion, inhalation, injection or direct contact. this reaction is mediated by IgE antibodies and it causes acute inflammatory responses. The symptoms may include systemic and local. [If you don’t know about systemic and local signs don’t worry I will write here

Systemic signs which affect whole body or multiple organs not an area of a body. Examples: flu, high blood pressure, fever, vomiting, nausea, fatigue.

Local signs which affect in an area and does not affect whole body. Examples: redness (rubor), heat (calor), swelling(tumor), loss of function(munus amsi).]

Types of allergy:

·       Drug allergy : when a person have an abnormal reaction of immune system to a medication then that person have drug allergy

·       Food allergies: when person immune system reacts or if he have unpleasant for a certain food then the person having food allergy

·       Contact dermatitis: if a person get skin rashes by contact with a certain substance.

·       Animal allergy

·       Allergic rhinitis

·       Asthma allergy

Here I haven’t written all types I will give the reference you can read in that website all about allergy.

Conclusion:

In this blog I have said about allergy and types of allergy and pathological types of allergy. If you liked this blog please support us follow and share this post. If they are any mistakes feel free to comment I will try to improve it.

briefly about tuberculosis

TUBERCULOSIS

Hello subscribers here I’m going to say about tuberculosis which was a pulmonary disease. The main reason to take this topic is I saw some countries and some places still they are so many people are died by T.B. and pneumonia so I have taken this topic to give awareness on this disease. I hope you may understand this disease

About Tuberculosis:

Tuberculosis is pulmonary disease which is caused by a mycobacterium. It affects lungs and other parts of the body.

This disease cause extra pulmonary and pulmonary disease.

Tuberculosis is two types:

·       Latent tuberculosis

·       Active tuberculosis

Most of the infections show no symptom which is known as latent tuberculosis which left untreated.

Active tuberculosis is widely spread by air and the classic symptoms of the active T.B are:

·       chronic cough ( blood in mucus)

·       fever

·       loss of appetite

·       night sweats and weight loss

 

Active T.B occurs more often with HIV/AIDS and who smoke.

DAIGNOSIS:

Tuberculosis can be diagnosed by chest x-ray for active T.B

And tuberculin skin test for latent T.B.

This tuberculosis can be prevented by vaccination with  Bacillus calmette-Guerin (BCG).

TREATMENT:

Treatment required using of antibiotics for a long time.

Antibiotic is growing problem with increasing rate of multiple drug-resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB).

PATHOLOGICAL CHANGES:

Tuberculosis will come through the air from one person to another person. Then bacteria will settle in the lungs of infected person.

The Mycobacterium tuberculosis will reach the lungs (Alveolar air sacs) then they capture and replicate endosomes of alveolar macrophages. Then the bacteria will be identified by macrophages as a foreign and try to destroy by phagocytosis. While this process is going the bacteria will cover by a temporary membrane called phagosome. Then it becomes a phagolysosome by combining with lysosome. The M.tuberculosis has a thick and waxy mycolic acid capsule that protects from toxic substances.

Ghonfocus is the primary site of infection in lungs. “Simon focus” which is called when tuberculosis of lung occur via blood stream. Tuberculosis will also affect all parts of body through the blood (heart, kidney, skeletal muscles, pancreas and thyroid). The severe type of tuberculosis disease most common in young children and people with HIV is called “milary tuberculosis”. 

PROGNOSIS:

PAST CONDITION:

As of 2018 most tuberculosis occurred in the region of South-East Asia (44%) Africa (24%) and the western pacific (18%).

More than 50% cases being diagnosed in 18 countries they are:

India (27%) China (9%) Indonesia (8%) the Philippines (6%) Pakistan (6%) Nigeria (4%) and Bangladesh (4%).

Present Globally TB incidence is falling about 2% per year.

PRESENT:

Recently the Ministry of Health and family Welfare has launched the annual TB report 2020 that is eliminating the TB by 2025. India has committed to eliminating the Tuberculosis from the country by 2025, five years ahead of the globally targeted by the world health organization (WHO) i.e. 2030.

Stop spread of T.B:

·       Take all of your medicines as they’re prescribed, until your doctor takes you off them.

·       Always cover your mouth with a tissue when you cough or sneeze…..

·       Wash your hands after coughing or sneezing.

 In countries with high rates of T.B infection, infants are often given the BCG vaccine. Doctors in U.S. don’t generally recommend it because T.B is not a widespread problem there.

Conclusion: be aware of Tuberculosis and stay safe if you like this article/ blog please like, subscribe and follow and share it. If you want to know about any other diseases comment it.

If they are any mistakes please feel free to comment it and I will improve it 

 

 

                                     

 

 

 

what is pathology and subdivisions?

PATHOLOGY

Hello friends this is my first blog. I’m going to say about what pathology is and how the pathology can be described. You can easily grasp or you will know minimum basic things in it by this post. By this post you will know how the body reacts to the pathological disease. Coming to the matter;

About Pathology:

(Patho means – ‘suffering’ and logy means-“study of”)

Pathology is a study of disease and how the disease will occur. It is a connection between science and medicine. It interferes with every characteristic of patient health, from diagnostic testing and treatment advice to using cutting-edge genetic technologies and preventing disease.

By learning pathology we will know what will happens when you have illness and effects of disease and their symptoms with complications come to the body.

General pathology include number of distinct but inter-related medical specialties that diagnose disease and in different path to indicate the disease state in both physical and psychological conditions

SUBDIVISIONS:

They are many other types of subdivisions. Here the list of subdivisions:

·       Anatomical pathology

·       Clinical pathology

·       Molecular pathology

·       Surgical pathology...etc…

Pathology address as four different components of disease: Cause, mechanisms of development (pathogenesis), structural alterations of cells (morphological changes), and the consequences of changes.

·       The most infectious and non-infectious disease is conducted by experts in one of the two major specialties and they are Anatomical and clinical pathology.

·       Pathology is a major field in medical diagnosis and medical research.

·       Pathology can study as path physiology and path anatomy.

What is Path physiology?

                          It is the study of disease which is described in the physiological manner. As physiology means the pathological changes in blood and when disease occurs it affects the body and we study in physiological manner.

What is Path Anatomy?

                        It is the study of disease which is described in the anatomical manner. It means changes in structure, size, color, and other anatomical changes.

·       The major two types of pathological divisions are clinical and anatomical pathology.

What is clinical pathology?

                                The clinical pathology which concerns with diagnosis of disease by the body fluids such as urine, blood, tissues, and use the tools from microbiology, molecular science and hematology.

What is surgical pathology?

                                The disease which can be removed through the surgery by determining the treatment plan. It may also call the biopsy. In this type we determine all types of pathological changes by using microscope and other instruments to do the examination of an organ/blood...etc...

What is molecular pathology?

                                It is the study of disease and diagnosing in the examination of cells/molecules in the organ or body fluids.

It is used in diagnosis of cancer and infectious diseases.

To diagnose the disease it uses polymerase chain reaction, DNA microarray, insitu hybridization.

 

ü Rudolf Virchow recognized to be the father of microscopic pathology.

ü The first physician to make the postmortem was Avenzoar.

Conclusion:

In this blog I have written about what is pathology? And how many subdivisions are their? How do you study and what do you study?

I have started the blog and this is my first blog friends please support me. If I have written any mistakes please feel free to comment it. If you like this blog share to your friends and follow us.