The Sustainable Development Goals: Mnemonics and explanation

Hi everyone! I'm back with a note. This time on the Sustainable Development Goals (SDG's).

This is a crisp summary of what we need to know about them as Doctors or Health Care Practitioners (in any part of the world). They're so important that a major chunk of the Coldplay concert in Mumbai was based on them. (And every other person spoke about them. How Magic-al).

And they're Also very important for the Community Medicine students from India. So here goes :

SDG's were adopted by nations of the world on 25th September, 2015 to be achieved till 2030. 

They want to do 3 P's. 

End Poverty,
Bring Prosperity to all and
Protect the planet. 

A. The important Health related Goals : 

(Mnemonic by our IkaN)

pH HE EWE

(HE EWE as in Adam and Eve)

1 Poverty 

2 Hunger 

3 Health care 

4 Education 

5 Equality 

6 Water 

7 Energy 

B. Goal 3: Ensure Healthy lives and Promote Well Being. 

Targets 

Remember: BAMS VIP
Baby Adult Mother Sex. 
(OR : Adult and Mother have Sex to get Baby)
Vaccine. Infections. Pollution. 

Baby:
- Neonatal Mort - has 12 letters , so to be reduced to less than 12 by 2030. 

- Under 5 Mortality Rate  - 5*5 = 25. So less than 25 by 2030 

Adult:
- Decrease the burden of NCDs to one third of present.
- Mental health burden to be reduced. Tobacco control. 
- Drug abuse to be tackled. 

Mother:
- Maternal Mortality to less than 70 per 1 lakh world wide. 

Sex: 
- Sexual health and reproductive health strengthening. 

Vaccines:
- Promote and develop.

Infections:
- Tackle TB HIV Malaria Other tropical diseases Diarrheal diseases. 

Pollution:
- Air, Water, Soil, Noise pollution to be tackled. 

Kudos to IkaN who helped me out of this tough spot. This was a life saver and you're the best :* :)

Hope this helps everyone.
Until next time.

~A.P.Burkholderia

Transient synovitis vs septic arthritis

Hello!

In this post, I'll talk on how to to differentiate transient synovitis from septic arthritis.

Transient arthritis is non specific inflammation of the synovium, related to infection or trauma.

Septic arthritis is bacterial infection of the synovium of the joint.

Modified Kochers criteria can help distinguish the two.

Fever > 38.5
ESR > 40 mm/hr
WBC > 12,000 cells/mL
CRP > 20 mg/dL
Inability to bear weight on the affected limb

More the criteria, more likely the child has septic arthritis.

Here's a mnemonic for modified Kochers criteria: FEW Can Bear Kocher!

Fever, ESR, WBC, CRP, weight bearing.

Acute transient synovitis is the most common cause of painful hip in a child younger than 10 years. It is a diagnosis of exclusion and can mimic Osteoarthritis, Legg Calve Perthes disease, SCFE.

Treatment: Rest, anti inflammatory agents.

That's all!
-IkaN

Myotonic dystrophy notes and mnemonic

Hello!

Here are my notes + a mnemonic

Congenital myotonic dystrophy
- Autosomal Dominant
- CTG trinucleotide repeat
- Genetic anticipation seen

- Hypotonia "floppy infant"
- Hollowing of temporal bones
- Tenting of upper lip
- Respiratory muscle weakness
- Arthrogryposis
- Posterior subcapsular cataracts (Subcapsular spokes in stellate conformation) 

Juvenile myotonic dystrophy

- Facial and upper body weakness (Hatchet face due to temporalis, masseter, facial muscle atrophy; frontal baldness)
- Inability to relax muscle (Sustained grip)

- Cardiomyopathy
- Heart block
- Congestive heart failure

- Intellectual impairment
- Gonadal atrophy
- Posterior subcapsular cataracts

- Thenar, hypothenar muscle atrophy (Myotonia evident on percussion)
- Tongue depression
- Dementia

That's all!
Be kind.
-IkaN

Henoch Scholein purpura notes and mnemonic

Hello! Here are my notes + mnemonic on HSP.

IgA-mediated vasculitis of small vessels (IgA and C3 in skin, renal glomeruli, and gastrointestinal tract).

Most common cause of nonthrombocytopenic purpura in children.

Usually follows an upper respiratory infection.

Clinical features are:
Maculopapular rash below waist (Progresses to petechiae to palpable purpura).
Abdominal pain.
Arthritis.
Glomerulonephritis.

That's all!
-IkaN

Rheumatoid arthritis mnemonic

Hello!

Here's an old mnemonic on some of the clinical features of Rheumatoid arthritis.
Well, the name itself tells it.. RHEUMATOID ;p

R- Respiratory distress (Interstitial lung disease, bronchiolitis, pleural effusion)
H- Haematological manifestations (anemias, thrombocytosis, neutropenia)
E- Extra- articular RA (ExRA)
U- Urinary tract infections (mainly drug- induced)
M- Median nerve compression/ Morning stiffness
A- Amyloidosis
T- Tenosynovitis and bursitis
O- Ocular manifestations (Keratoconjunctivitis sicca, scleritis, episcleritis)
I- Immunologic manifestations (Sjogren's, Felty's and Caplan's syndrome)
D- Deformities (boutonniere, swan- neck, button- hole)

Thats all :)

- Jaskunwar Singh

A case on Medical ethics

Hello Awesomites!

Today I am gonna discuss with you a simple case based on medical ethics. A Forensic Medicine professor asked me in final viva last year. So here it goes...

3 month old with hypotonia

3 month old baby with history of honey intake (Given by grandpa) presents with constipation, feeding difficulty, hypotonia. What is the cause of the baby's symptoms?

1. Ingestion of preformed toxin
2. Ingestion of pesticide
3. Ingestion of bacterial spore
4. Bacterial infection of the meninges
5. Urinary tract infection

Answer given below:
.
.
.
.
.
.
.
.
.

If you picked 1, you're wrong.

Infant botulism is caused by botulinium spores in honey, corn syrup that germinate and multiply in the intestinal tract and produce toxin.

Adult botulism is caused by ingestion of preformed toxin.

I just wanted to make that point clear. And emphasize how tricky any exam can get with word play.

Don't stress.

That's all! =)

Oh and the answer is 3.

-IkaN

How to apply for USMLE exams

Hello!

Many medicowesomites have asked about how to apply for their USMLE exams. Finally, here is the procedure. Sorry this took so long

I have answered all the queries in the end.

If you have any more questions, comment in the commments section below and I'll try to reply :)

Descriptive Epidemiology

Hello everyone !
Here's a video telling you a little bit of the Descriptive Epidemiology.
Let me know how you like it and I can continue to make some more to finish it up and tell you more about Epidemics!

Stigmata of infective endocarditis

Hey Awesome people!

Here is another stigmata apart from those mentioned previously by IkaN in a post here,

Stigmata of infective endocarditis:-
(Remember- It's all in the hands)

- Janeway's lesions: non- tender, erythematous macules on the palms and soles.
- Osler's nodes: ephemeral spots of painful nodular erythema on hands and feet.
- Splinter haemorrhages: seen on the nails.

Thats all!

- Jaskunwar Singh

Glaucoma

For all those who don't know what is glaucoma here is the quick review :-

There is damage to the optic nerve, etiology of glaucoma is yet to be known.

Generally, there is increase in intraocular tension , intraocular pressure above 25-30mm Hg which can cause loss of vision. In acute inflammation, WBCs and tissue debris can block exit of intraocular fluid through channel of Schlemm and in chronic conditions, especially in older individuals, fibrous occlusion of the trabecular spaces appears to be culprit!

Buerger's disease

Hey awesomites!

Here's a short post on important points in diagnosis of Buerger's disease (don't confuse the name with Berger's disease which is IgA nephropathy) also known as Thromboangiitis obliterans.

- Recurrent inflammation and thrombosis of small and medium sized vessels
- Hands and feet are affected the most
- Vasculitis and ischemia (causing blackish discoloration of skin)
- Chronic smoking (a definite predisposing/ risk factor)

Clinical features and diagnostic criteria:
            - male patient 30-40 years of age
            - history of chronic tobacco use
            - Angiography: - cock- screw appearance of arteries of wrists and ankles
                                      - tree root/ spider leg appearance due to collateral circulation
            - Exclusion of other vascular diseases ( Raynaud's phenomenon, atherosclerosis, diabetes, hypertension, endocarditis, hypercoagulable states, auto-immune disorders) is important.
            - Skin biopsy (rare)

Note: A possible Rickettsial infection (mostly Rickettsia rickettsiae) could be there which adds on to the pathology of the disease!  (usually in cases of  amputation of the affected area)

Thats all!

- Jaskunwar Singh

Supracondylar fracture of the humerus

Supracondylar fracture of the humerus

- Transverse fracture of the distal part of the humerus.
- Bruises of anterior elbow (Proximal fragments buttons through the brachialis muscle)
- Posterior fat pad sign is seen in non displaced fracture of the humerus.

IMPORTANT: Assess radial and ulnar pulses because brachial artery can be compromised.

That's all!
-IkaN

Submissions: Selenium deficiency mnemonic

"Selena Gomez and Ke$ha both are young and have big hearts."

Selenium deficiency causes Keshan disease which is cardiomyopathy in young children. Also, singers like to dye their hair (Loss of hair pigment is seen in Selenium deficiency aka Keshan disease).

Submitted by Krutika.

Interesting fact: Keshans disease is thought to be caused by Selenium deficiency and coxsackie virus. It's common in places where selenium content in soil is low (China).

That's all!
Thanks Krutika for the mnemonic =)
-IkaN

How to browse through knowledge on Medicowesome

So we have written over 1000 posts. It's absolutely crazy! :D

About me

Hey Awesomites!

Well, I am not a new author here. I am honored to write so many posts for the blog . Let me introduce myself so that all of you can know about me...

Treatment of cholesterol-induced Alzheimer's

Hey awesomites!

Pathology done! Now lets know about its pharmacology here :)

Cranial Nerve Exits Mnemonic (2 2 4 4 )

Hey guys, Jay here!

This is a very simple self explanatory image which I made.

Brain abscess notes

Brain abscess notes

Here's what I studied =)

Causes
- Direct spread (Paranasal sinusitis, otitis media, mastoiditis, dental infection)
- Head trauma or surgical procedure
- Hematogenous spread (Pneumonia, endocarditis)

Organisms:
- Streptococci
- Bacteroides
- Pseudomonas
- Hemophilus
- Enterobacteriaceae
- MRSA (Head trauma, neurosurgical procedure)

Symptoms:
- Headache > 75% patients
- Fever only in 50% patients (Important: Absence of fever should not exclude the diagnosis)
- Focal neurologic deficits > 60% patients
- Other symptoms - Papilledema, nausea, vomiting, drowsiness, confusion
Hemiparesis - Frontal lobe abscess
Dysphasia - Temporal lobe abscess
Nystagmus, ataxia - Cerebellar abscess

Neuroimaging:
- MRI is better than CT.
- Ring enhancing lesion with surrounding edema on neuro imaging studies is seen.
- Most accurate: Brain biopsy
High yield: Biopsy is essential to distinguish brain abscess from cancer and also to determine the precise organism.

Don'ts: Do NOT do a LP. CSF analysis doesn't contribute to diagnosis or therapy. Increases the risk of herniation.

Extra: Abscesses due to Listeria have blood culture positive > 85% of the time.

Differentials:
- Meningitis
- Meningoencephalitis
- Brain tumors (Cancer can give fever)

Treatment:
- Empirical antibiotics should be modified after results of gram stain and culture.
- Surgical drainage.
- Prophylactic anticonvulsant therapy (High risk [>35%] of seizures)
- Glucocorticoids are reserved for substantial periabscess edema and mass effect due to increased ICP.
- Serial MRI or CT scan monthly to document resolution of abscess.

That's all!
-IkaN

Hypercholesterolemia and the Alzheimer's disease

Hey awesomites!

All of you know that cholesterol is synthesized locally in brain as well as peripherally in liver, both separated by a line of blood-brain barrier. But what about the case of hypercholesterolemia and how it eventually leads to increased amyloid depositions. what is the ultimate link between high serum levels of cholesterol and the Alzheimer's disease?

Enteric nervous system (ENS)

Recently, while studying pharmacology, I came to know about the third system of ANS - Enteric nervous system, apart from sympathetic and parasympathetic systems .

Here is some information of ENS:

It consists of highly organized neurons situated in the wall of GI tract.

It mainly includes Auerbach's plexus and Meissner's plexus.

The most interesting point about ENS is this network receives preganglionic fibers from the parasympathetic system and from postganglionic sympathetic neurons.

ENS controls GI motility, secretions, mucosal blood flow.

ENS causes relaxation or stimulation of smooth muscles.

Non-cholinergic excitatory transmitters such as substance - P plays a modulatory role in controlling ENS!

~Ojas