Pain killer in Human saliva.

Hello readers ,Here is something new information about human saliva !.

Human saliva and pain killer :-
Human saliva contains a painkiller that is naturally produced by human body .It is called as -"Opiorphin" in very low concentration.

Opiorphin's role:-
Opiorphin prevents the breakdown of chemicals called as enkephalins . Apart from this opiorphin inhibits 3 protease.-
a)Ecto-endo peptidase.
b)Ecto-amino peptidase .
c)Dipeptidyl peptidase.
This extends the duration of enkephalins.
The enkephalins activates opiate receptors .Activated opiate receptors blocks pain signals from reaching brain!!. opiorphin is 6 times more potent than morphine .Unlike morphine opiorphin is not addictive and prolonged use may not lead to tolerance .

Current status in research:
Painkiller was successfully tested on rats.Further research is still needed before it's use on humans .Research include modifying molecular structure to avoid rapid degeneration in intestine and it's poor BBB(Blood brain barrier !).Modification includes transformation of N-terminal glutamine into pyroglutamate .

~Ojas

New drug:Tideglusib

Hello awesomites ! Today's blog is about new drug -Tideglusib.

Tideglusib is actually Alzheimer's drug and is also used in paralysis of supranuclear palsy!
However this drug is currently in news because of its ability to stimulate repair of teeth .

Use of this drug can cause end of dental fillings .
Mechanism of action of drug
The mechanism is roughly known .It acts in 2 ways
1)It stimulates stem cells in the pulp of the teeth to generate new dentine and heal small cavities.(Dentine is hard dense bony tissue that forms your teeth)
2)Inhibits an enzyme called as GSK-3 which prevents formation of dentine !,

Progress in research:
Drug is successful tested on mice .They soaked biodegradable sponges in the drug and then placed them in cavity .The sponges melts away over time,leaving only the repaired tooth but for use in humans ,the drug is still under research.

Keep smiling :)
Happy day:)

~Ojas

Interesting and rare disease:Ectopic cordis

Hello awesomites ,really tired of all the bookish knowledge so for time being I switched my self to internet,and came across some of the rarest and the most interesting diseases of all the time !
Here is the first one -Ectopic cordis.

What is -Ectopic cordis?
It is the disease where the heart is located at abnormal position that is places other than thorax or sometimes partially at thorax.It is a congenital disorder

Cause :-
It is caused due to improper maturation of the mesoderm and ventral body wall durig embryonic development.Lateral wall is responsible for fusion at midline to form ventral wall any change in this process may lead to -Ectopic cordis.

Types:-
Depending upon situation of the heart in patient ,ectopic cordis is classified into 4 parts :-
1)Thoracic.
2)Cervical.
3)Thoracoabdominal.
4)Abdominal.

Defects seen:-
1) Ventricular septal defect .
2)Atrial septal defect.
3)Absence of tricuspid valve.(Tri-cuspid atresia)
4)Fallots tetralogy. (http://www.medicowesome.com/2017/01/teratology-of-fallot.html)

Treatment:
Unfortunately the only treatment is surgery !
Not all the surgeries are successful .
Patients of ectopic cordis hardly can live for long years as there are more chances of infections to heart .

That's it for today.
Internet is interesting:)
~Ojas

MBBS practical viva tips on examination

Smile, stay confident.
Keep calm.
And rock those vivas!

This video is on how to not make silly mistakes during pracs!

The SAAG solution (Serum-Ascites Albumin Gradient simplified)

Yo people!

A good friend of mine asked me to review the concept of SAAG. So let's dive into a "Puddle" of ascitic fluid. :P

As you guys all know, SAAG stands for Serum-Ascites Albumin Gradient and it helps to differentiate the causes of ascites. What it means is pretty self explanatory, it is the difference (gradient) between the levels of albumin (a plasma protein) in two compartments i.e. Serum and Peritoneal fluid.

Tetralogy of fallot

Hello  readers today's blog is small one -Fallot's tetralogy .

What is Fallot's tetralogy?
   It is a congenital disorder of heart .It is caused to foetus may be because of  alcoholic mother or who has  diabetes or may be due to rubella infection caused during pregnancy.It is caused due to deletion of chromosome 22

Signs and symptoms:-
As the name suggest ,there are four signs
All four of them are related to heart .
Mnemonic is PVR -f cinema.
-Pulmonary stenosis
-Ventricular septal defect .
-Right ventricular hypertrophy
-Over-riding of aorta ,due to which blood from both the ventricles may enter aorta.

Due to defect in heart ,there is low oxygen supply to tissue this may lead to cyanosis when there is high amount of pulmonary stenosis but when there is moderate amount of pulmonary stenosis this may lead to pink tit that is pinkish colouration of skin.There is also clubbing  .

Treatment:
Open heart surgery is only treatment for fallots tetralogy  .
The appropriate time for surgery depends on the pulmonary stenosis .
However patient should be on life long medication for healthy life

That's all :)
Have a happy day.

~Ojas

Top 10 series: Amphotericin B

Here is the video! :)

Microbiology of legionella mnemonic

Legionella: Facultative intracellular, gram negative rod

Pili: They are all involved in adherence and intracellular replication of L. pneumophila

Flagella: Within the host cell vacuole, legionella are nonmotile, whereas in the later stages of infection and cell lysis, legionella are flagellated and highly motile. Motility enables Legionella to escape from a spent host and facilitates its attempt to find a new host by dispersion into the environment.

Extra Ocular Muscles Insertion : Mnemonic

Hello everyone ! I hope you'll have been enjoying the Top 10 Series that we've started. This is a short post on the insertion of Extra ocular muscles in the eye.

So there are 4 Extra Ocular muscles whose insertion on the sclera we need to be aware of ( in terms of distance from the Limbus). The Recti.

Remember :
I'M Low Standard

I = Inferior Rectus. 5.5
M = Medial Rectus 6.6 (or 6.5 but just remember 6.6 for easiness)
L = Lateral Rectus  6.9 (Loser)
S = Superior Rectus 7.7

So basically it starts with 5.5 , 6.6, 6.9 and finally 7.7.
3 of these are the same number repeated (5.5 , 6.6 and 7.7) but LR is a loser. Hence it does not follow the rule and is a badass hence does a 69. :p

Hope this helped !
Thank you.
Happy studying!

~A.P.Burkholderia

Temporomandibular joint: Super old notes

Hey, these are my super ugly notes from 2010.

Temporomandibular joint: Notes for MBBS exam

In today's blog, we will be showing you how to write answers of joint in your theory exams.

Example question: TMJ

I would like you guys to know that since there is a lot of time limitation in theory exams, you should:

1. Draw diagrams ("Anatomy paper without diagram is as good as flower without fragrance!")

2. Name everything  you know

3. Elaborate

Before the exam, choose the diagrams you would draw for sure and optional diagrams ("If I get time...")

ADRs of Sulphonamides mnemonic

Hey Awesomites!

Adverse drug reactions of Sulphonamides mnemonic-
SULPHONAMIDES

S- Stevens- Johnson syndrome
U- Urinary crystals formation and bleeding
L- Lyell's syndrome (TEN)
P- Photosensitivity
H- Hepatic/ Hematologic
O- Ocular side effects
N- Neonatal jaundice/ Nausea and vomiting
A- Antimetabolites (inhibit folic acid synthesis)
M- Miscarriage (pregnancy and fetal abnormalities)
I- Intolerance
D- Dermatitis
E- Eosinophilia
S- Serum sickness


Thats all
- Jaskunwar Singh

Neurodevelopmental maturity and adulthood

Hey Awesomites!

When do you really attain adulthood?
18. That's when you are legally declared an adult. Right? Oh so you already got the answer. Hey no wait.. we are medical professionals and students of science. So talking in a legal way doesn't always seem right, because from a scientific perspective, adulthood is still an unsolved mystery. Let me tell you about it here..

Increased Intracranial pressure clinical features mnemonic

Increased intracranial pressure clinical features mnemonic- 5Ps

P- Persistent projectile vomiting (due to stimulation of CTZ)

P- Persistent headache (the patient presents it as the "worst" headache of his life)

P- Palsy (sixth nerve palsy and diplopia)

P- Papilledema (bilateral)

P- Personality disturbances (behavioral changes)

Thats all

- Jaskunwar Singh

The basics :Parkinson's disease

Hey,Hello! awesomites ,this blog is just a small review of some old and new things I learned about Parkinson's disease.
The very first thing I learned is:- parkinson's disease and parkinsonism are two different terms !!!.
-Parkinsonism is a complex term it includes many symptoms while parkinson's disease is a progressive neurodegenerative disorder .
-Parkinosons disease is actually cause of parkinsonism .
       Let's start with Parkinson's disease
-Main cause is decrease dopamine secretion in body mainly due to injury to substantia nigra which sends dopamine secreting nerve fibers to caudate nucleus and putamen.
Signs and symptoms:
- Characteristics features is tremors .Tremors occurs during all walking hours and therefore it is a type of involuntary tremor in case of cerebellar disease there is an intension tremor because tremors are seen when patient perform any work.
-Also  festinant gait is found
-Akinesia is also seen
-Lead-pipe rigidity is seen earlier in hands and legs followed by neck and trunk.

Causes:
-Any  serious injury that affects dopamine secretion !
-Also some medication which decreases dopamine secretion or blocks dopamine receptors.
-Apart from that certain drugs also induces Parkinson's disease  like drugs used to treat schizophrenia and other neuroleptic drugs like
Clozapine.
Risperdal.
Quetiapine.
Apart  neuroleptic drugs,others drugs  like prochlorperazine,metoclopramide.
Also calcuim channel blockers causes Parkinson's

Drug induced Parkinson's remains same ,it doesn't progress

Categories of drugs used for treatment of parkinsonism:-
-Dopamine agonist.
-Anticholinergic.
-COMI inhibitors.

~Ojas

Step 2 CK: Pancreatic pseudocyst notes

Pancreatic pseudocyst

How does it develop?

The basics : Constipation

Today I am gonna give some brief review about how to treat constipation .So let's start with basics

Why constipation occurs ?
-Water serves as a transporter of stools ,decrease in concentration of water in intestine can lead to constipation ,it may be either due to increase absorption from the extracellular space or decrease water content in body.
-Decrease bowel moment

How to treat constipation?
-As now we know cause of the constipation ,we can treat constipation either by :-increasing water content or decrease loss of water from intestinal lumen
And also by increasing bowel moments so less water or salts are absorbed (Yet some drugs uses another mechanism.)

Drugs used :-
1)We can use Dietary fibers which will just form a bulk in intestine and will increase water content of faeces ,also due to bacterial degradation some osmotic active substances are produces which further increases water content Hey but there is one drawback ,it may causes gas :D.
2)Stool softeners:
-They permit water and lipid to penetrate stool .
-They are either given orally or rectally!
(Yes a drug acting on intestine can also given rectally)
-Again there is one drawback ,prolong use can cause impair  absorption of fat soluble vitamins ( A,D,E,K)

3)Osmotic laxatives (Laxative is term used for drugs for treatment of constipation)
-Colon can neither concentrate /dilute fecal fluid  so fecal fluid is isotonic throughout the colon
-Generally we use non-absorable sugars /salts eg:-Magnesium citrate & sodium phosphate.
-Osmotic laxatives are commonly used but should not be used in patient with renal insufficiency.
-But patient using sodium phosphate must take adequate water to compensate fluid loss due to it
,It may causes hyperphosphatemia,hyper natremia , hypocalcemia,hypokalemia.
-So should not be used in cardiac patients

4)Stimulant laxatives
    a) Anthraquinones:It after hydrolysis produces bowel moment in 6-12hrs if given orally or within 2 hrs if given rectally.!
   -It may causes melanosis coli.
   b)Diphenylmethane derivatives : It increases  bowel moments in 6-10hrs when given orally and in 30-60mins when given rectally.
-It has minimum systemic absorption

5) Opioid receptor antagonism
-Now this is  an interesting type of drug mechanism rather than increasing motility it "decreases" motility .

Confused ?!!

Still it is used in prevention of constipation ?!

Yes ,by decreasing motility it prolonges the transient time required for absorption of water and salts from surrounding
Eg:-Methylnaltrexone & alvimopan.

~Ojas

Viva questions on bulb of Foley's catheter

Since it's exam season! :D

Top 10 series: Spironolactone

The video is up!

Top 10 series: Gabapentin

Here is the video!

The basics: Peptic ulcer

Peptic ulcer is excoriated area of stomach  or intestinal mucosa caused by  excessive gastric acid secretion or upper intestinal tract secretion .A type of peptic ulcer called as marginal peptic ulcer is caused during surgical process whenever there is opening made in between stomach and jejunum of small intestine like gastrojejunostomy.

Common site of peptic ulcer ?
Mostly on lesser curvature of antral end  of stomach and rarely on lower end of stomach.

Causes of peptic ulcer ?
1)Increase in acid secretion and peptic content in stomach .
2) Irritation to mucosa.
3)Poor blood supply .
4)Poor secretion of mucus.
5)Infection by H.pylori.

Treatment of peptic ulcer.
We give anti-ulcer therapy for peptic ulcer treatment
Following are goals of anti-ulcer therapy
a) Relief of pain.
b)Ulcer healing.
c)Prevention of complications.(like bleeding ,perforation)
d)Prevention of relapse.

Approach of  treatment of peptic ulcer :
(I have made some lame tricks for memorising drugs name:D ,if you have some mnemonics please comment !)
1) Decrease acid secretion :It includes total 4 categories ,they are described below .

a) H2 Anti-histamine (They all end with -tidine)
-Cimetidine .     
-Famotidine.
-Ranitidine.
-Roxatidine.

b)Proton -pump inhibitor.(ends with -prazole)
-Omeprazole.
-Esomeprazole.(Read it as Es-omeprazole)
-Lansoprazole.
-Pantoprazole.
-Rabeprazole.
-Dexrabeprazole
(Read it as Dex-rabeprazole!)

c)Anti-cholinergic drugs:
-Pirenzepine .
-Propantheline.
(Read it as Propan-the-line).
-Oxyphenonium .

d) Prostaglandin analogue:Misoprostol !

2)Neutralization of gastric acid secretion
    (Antacids) .It includes 2 categories
a) Systemic:
-Sodium bicarbonate .
-Sodium citrate.

b)Non-systemic:
-Magnesium hydroxide .
-Magnesium trisilicate.
-Aluminium hydroxide.
-Calcuim carbonates.

c)Ulcer protective:
-Sucralfate.
-CBS (Colloidal bismuth subcitrate!).

d)Anti-H pylori drugs:
-Amoxicillin.
-Tetracyclin.
-Clarithromycin.
-Tinidazole.
-Metronidazole.

~Ojas