BLOG UPDATE- THANKS TO ALL VISITORS

MY BLOG HAS BEEN VISITED BY > 17,000 INDIVIDUALS AROUND THE WORLD FROM 101 COUNTRIES...OVER LAST 2 YEARS..............THANKS TO ALL VISITORS.................WILL UPDATE REGULARLY..NEED MORE COMMENT TO DEVELOP FURTHER............................

november 16th is to be celebrated as world COPD day

we are doing a free spirometry camp and public awarness

for doctor we are doing a spirometry workshop

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A TRIBUTE TO GREAT DR BHUPEN HAZARIKA

GREAT MUSICIAN OF ASSAM DR BHUPEN HAZARIKA IS TO BE CREMATED TODAY.......... HIS CONTRIBUTION TO THE MUSIC WILL BE REMEMBERED BY THE WORLD FOR EVER...........

.SAGAR SANGAMOT KATANA SATURILU..... TOTHAPI TO HUWA NAI KLANTA............

WORLD SPIROMETRY DAY 14TH OCTOBER 2011

14TH OCTOBER 2011 IS WORLD SPIROMETRY DAY. ITS A TIME TO INCREASE KNOWLEDGE AND AWARENESS ON USE OF SPIROMETRY.... 

New TNM staging for lung cancer

New 7th edition of TNM classification lung cancer is based on International Association for the Study of
Lung Cancer (IASLC) database. The changes from previous edition are mentioned bellow. for more detail follow ERS journal (breathe ,June 2011)

The changes in relation to T (tumor) are-

1. T1a <2cm                                                                                                prev T1

2.T1b> 2-3cm                                                                                                     T1

3. T2a>3-5cm                                                                                                     T2

4.T2b >5-7 cm                                                                                                    T2

5. T3 >7cm                                                                                                          T2

6. Additional tumor node in same lobe T3                                                             T4

7. Add tumor node in another ipsilateral lobe T4                                                   M

8. Pleural inv M1a                                                                                                T4

9. Intra thoracic metastasis M1 and extrathoracic metastasis M2                           M

N remained unchanged , however nodal zone has been changed

BRAIN DEATH GUIDELINES---NEW PEDIATRIC

FOLLOW THE LINK FOR REVISED BRAIN DEATH CRITERIA FOR INFANT AND CHILDREN



http://pediatrics.aappublications.org/content/early/2011/08/24/peds.2011-1511.full.pdf

GUIDELINES FOR PEDIATRICS PNEUMONIA

NEW GUIDELINES NAMED 'The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines' by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America HAS BEEN PUBLISHED IN J clinical infectious disease

follow the link for full guidelines



http://cid.oxfordjournals.org/content/early/2011/08/30/cid.cir531.full.pdf

correct inhalation tecnique

inhaled medication is a major therapeutic option for obstructive airway disease. However the correct method to use inhaler is very important for effective delivery of drugs to lung. Here the essential steps for correct use of inhaler will be given. For more detail see the article "Correct Inhalation Technique: ERS Task Force Guidelines Eur Respir J 2011; 37: 1308–1331"

pMDIs: for patients with good actuation–inhalation coordination

1) Shake four or five times if suspension formulation.

2) Take the cap off.

3) Prime the inhaler

4) Exhale slowly, as far as comfortable

5) Hold the inhaler in an upright position.

6) Immediately place the inhaler in the mouth between the teeth, with the tongue flat under the mouthpiece.

7) Ensure that the lips have formed a good seal with the mouthpiece.

8) Start to inhale slowly, through the mouth and at the same time press the canister to actuate a dose.

9) Maintain a slow and deep inhalation, through the mouth, until the lungs are full of air. This should take an adult 4–5 s.

10) At the end of the inhalation, take the inhaler out of the mouth and close the lips.

11) Continue to hold the breath for as long as possible, or up to 10 s before breathing out.

12) Breathe normally.

13) If another dose is required, repeat steps 4–12.

pMDI + spacer with facemask: for patients ≤3 yrs old or anyone who cannot breathe consciously through the mouth

1–3) Same as above for pMDIs alone.

4) Insert the mouthpiece of the pMDI into the open end of the spacer and ensure a tight fit

5) Place the facemask over the nose and mouth and be sure the fit is tight to the face.

6) Actuate one dose into the chamber of the spacer.

7) The patient should inhale and exhale normally into the spacer at least 10 times.

8) Take the facemask off the patient's face.

9) If another dose is required, repeat steps 1–8.

ROLE OF SEROLOGICAL DIAGNOSIS FOR TUBERCULOSIS

TUBERCULOSIS IS A MAJOR DISEASE OF HUMAN KIND AND IS STILL A MAJOR PROBLEM SPECIALLY FOR DEVELOPING WORLD. HOWEVER THERE IS STILL CERTAIN CONTROVERSY IN DIAGNOSIS MOSTLY DUE TO SEROLOGICAL TEST.

RECENTLY WORLD HEALTH ORGANISATION HAS CAME OUT WITH A POLICY STATEMENT ON USE OF SEROLOGICAL TEST FOR DIAGNOSIS OF TUBERCULOSIS

WHO HAS CLEARLY RECOMMENDED AGAIST THE USE OF THESE TESTS FOR DIAGNOSIS OF TUBERCULOSIS

THE DOCUMENT IN THEIR CONCLUSION MENTIONED THAT

"Commercial serological tests provide inconsistent and imprecise findings resulting in highly variable values for sensitivity and specificity. There is no evidence that existing commercial serological assays improve patient-important outcomes, and high proportions of false-positive and false-negative results adversely impact patient safety. Overall data quality was graded as very low and it is strongly recommended that these tests not be used for the diagnosis of pulmonary and extra-pulmonary TB"

FOR MORE DETAIL GO THROUGH THE ORIGINAL WHO DOCUMENT

PARASOMNIA

Parasomnias are a group of disorders exclusive to sleep and wake to sleep transition that encompass arousal with abnormal motor, behavioural or sensory experiences.

Types of Parasomnias

disorders from NREM
1.confusonal arousal
2. sleep waking
3. sleep terror
4.NFLE

disorders from REM
1. REM sleep behaviuor disorders
2. sleep paralysis
3.nightmare disorders

other parasomnias
1. sleep enuresis
2. sleep related groaning
3. sleep related eating disorders
4. exploding head syndrome
5. sleep related dissociative disorders

Diagnosis

Based on history, video EEG, PSG

Management

counceling and support
sleep hygine
Medications- BZD, SSRI, melatonin
behavior therapy, relaxation therapy etc