Different types of Seizures.


Generalized seizures,
Absence seizures;
Absence seizures are brief episodes of staring.
During the seizure, awareness and responsiveness are impaired. People who have them usually don't realize when they've had one. There is no warning before a seizure, and the person is completely alert immediately afterward.Simple absence seizures are just stares. Many absence seizures are considered complex absence seizures, which means that they include a change in muscle activity. The most common movements are eye blinks.

 Tonic Clonic seizures;
This type is what most people think of when they hear the word "seizure." An older term for them is "grand mal." As implied by the name, they combine the characteristics of tonic seizures and clonic seizures. The tonic phase comes first: All the muscles stiffen. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face. After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed.

Myoclonic seizures;
Myoclonic  seizures are brief, shock-like jerks of a muscle or a group of muscles. "Myo" means muscle and "clonus"  means rapidly alternating contraction and relaxation—jerking or twitching—of a muscle.
Even people without epilepsy can experience myoclonus in hiccups or in a sudden jerk that may wake you up as you're just falling asleep. These things are normal.

Partial seizures,

Simple partial seizures;
They are remarkably different from person to person, depending on the part of the brain where they begin.
Doctors often divide simple partial seizures into categories depending on the type of symptoms the person experiences:

Motor seizures:

These cause a change in muscle activity. For example, a person may have abnormal movements such as jerking of a finger or stiffening of part of the body.

Sensory seizures:

These cause changes in any one of the senses. People with sensory seizures may smell or taste things that aren't there; hear clicking, ringing, or a person's voice when there is no actual sound; or feel a sensation of "pins and needles" or numbness. Seizures may even be painful for some patients. They may feel as if they are floating or spinning in space.

Autonomic seizures:

These cause changes in the part of the nervous system that automatically controls bodily functions. These common seizures may include strange or unpleasant sensations in the stomach, chest, or head; changes in the heart rate or breathing; sweating; or goose bumps.

Psychic seizures:

These seizures change how people think, feel, or experience things.hey may have problems with memory, garbled speech, an inability to find the right word, or trouble understanding spoken or written language. They may suddenly feel emotions like fear, depression, or happiness with no outside reason.

Complex partial seizures;
These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming.
Some people can have seizures of this kind without realizing that anything has happened. Because the seizure can wipe out memories of events just before or after it, however, memory lapses can be a problem.

Anti seizure Drugs,
Absence seizures;
Ethosuxamide
Valproic acid
Clonazepam
Tonic Clonic & partial seizures;
Carbamezepine
Phenytoin
Valproic acid
Lamotrigine
Myoclonic seizures;
Valproic acid
Clonazepam
Lamotrigine
Backup & Adjunctive Drugs;
Felbamate
Gabapentin
Tiagabine
Topiramide
Vigabatrin
Zonisamide
     

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Post Mortem Changes.

 
Rigor mortis is the postmortem stiffening of the body’s muscles. It may or may not involve some degree of actual shortening of the muscles. In most cases, rigor mortis begins within 1-2 hours after death; it begins to pass after 24 hours



Livor mortis is the purple-red coloration that appears on dependent portions of the body other than areas exposed to pressure after the heart ceases to beat. It results from the settling of the blood under the force of gravity


Tardieu spots are petechiae and purpuric hemorrhages that develop in areas of dependency secondary to the rupture of degenerating vessels under the influence of increased pressure from gravity

Algor mortis is the process by which the body cools after death. Cooling takes place only if the ambient temperature is cooler than the body temperature at the time of death.



Tache noire is the dark, red-brown stripe that develops horizontally across the eyes when the eyelids are not closed after death. It is a drying artifact that may mimic trauma


Decomposition is the postmortem process of endogenous autolysis and putrefaction from external and primarily internal bacterial sources.


Maceration is an autolytic postmortem process that occurs in intrauterine deaths. It is caused by endogenous enzymes; putrefactive bacteria are not a factor.



Marbling may develop with the delineation of the vasculature as a result of the reaction of hydrogen sulfide produced by bacteria with hemoglobin from the lysis of erythrocytes, as shown below. Bloating of the body occurs as a result of bacterial gas production; in intemperate conditions, bloating occurs over a period of 2–3 days. Bloating causes distortion of both the body and face.



Degloving of the skin of the palms and soles typically occurs during decomposition, as well as in cases involving thermal exposure (ie, fires) and immersions,The epidermis commonly retains enough ridge detail to allow fingerprints to be obtained, which assists in the identification of the decedent.


Adipocere formation typically occurs in bodies submerged in water or in warm, humid environments. The tissues are converted into a waxy, pasty material as a result of the reaction of clostridial enzymes with tissue fatty acids.

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Examination Of Abdomen



Bowel Sounds.
The gurgling, rumbling, or growling noises from the abdomen caused by the muscular contractions of peristalsis, the process that moves the contents of the stomach and intestines downward. Bowel sounds are normal. Their absence can indicate intestinal obstruction. Bowel sounds may also be temporarily absent after abdominal surgery.
Bowel sounds are also called borborygmus (plural: borborygmi).



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Osteoporosis & Bone fracture.

             

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REMOVE DARK CIRCLES FROM YOUR EYES!


Many people suffer from dark circles under or around the eyes. Dark circles under eyes make people look tired and exhausted, if not unhealthy, and can occur due to a wide variation of reasons. Dark circles eyes happen to people in all ages groups but seem to occur more in women.
Why do they arise?
There are a number of causes of dark circles under eyes some of which are:
Rubbing
the Eyes a Lot due to lack of sleep or itchy eyes that occur in dusty rooms or if one suffers from an allergy, for example hay fever

Sleep difficulty
(possibly due to stress or depression).
Allergies
Hay fever and dust allergies are known to cause dark circles under eyes.

Dehydration

As the skin under the eye is so close to the underlying bone, a lack of water in the body will become apparent in this area when the body is dehydrated. This will show up as a dark circle around or under the eye and will disappear once the body is properly hydrated again.

Aging

The skin tissue around the eyes is less plump and gets thinner when aging, causing dark circles. A moisturising dark circle eye cream can help to make this skin stronger and healthier again.

How to deal with them?
Take care about following,
1- Drink lots of water
2-Get plenty of sleep
3-Take healthy diet
4-Stop smoking.
 
Natural treatment;

Cucumber juice is essentially cooling and soothing, and it has mild bleaching properties. Apply it daily to your dark circles, and you will see a difference. However, this is not a permanent remedy.

Medical treatment;
Different eye creams for dark circles:

  
Glycolic acid is a skin friendly acid ,Its 2 % preparations are very helpful in removing Dark circles around the eyes,but remember its not the over night effect that glycolic acid gives!
I personally have used it,and i found wonderful results. 
Hydroquinone is a very effective bleaching and lightening agent but most people are sensitive to apply hydroquinone creams on eyes(they get red allergy,but usually it's not severe)again this can be used in 2 % preparations.

!'m sharing the link of site that carry information about different eye creams that are used for dark circle removal.
Click here!  

Facial exercise(helpful in removing dark circles)

  


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                  How to examine chest?

Examination of respiratory system consists of
1-Inspection
2-Palpation
3-Percussion
4-Auscultation.

*examine both front & back of the chest.
*compare both sides of chest with each other.




 Inspection;
Following features should be noted while Inspection
1- Respiratory rate
2- Type of Respiration
3- Shape of the chest
4- Deformity
5- Prominent veins,Pulsations,Scars
6- Chest movements

Palpation;
Palpate for
1- Tenderness,crepitus
2- Position of the trachea & apex beat
3- Movements of the chest wall
4- Expansion of the chest
5- Vocal fremitus
6- Palpable added sounds.

Percussion;



Auscultation;

It is the "most" useful step in the examination of respiratory system.
Learn to recognize the normal breath sounds by auscultating yourself.
I'm sharing with you some links of breath sounds,listen them carefully
Normal breath sounds,
Bronchial vs Vesicular breathing 

Abnormal breath sounds;

Stridor
Wheezes
Crackels

Pleural friction rub

You can listen to more lung sounds  click here  


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                 Face lift surgery (Rhytidectomy)


What is facelift surgery?
A facelift is a surgical method that removes excess facial skin to make the face appear younger. However, the aging face not only loses skin elasticity and develops looser droopy skin, but also loses fat and muscle tone. Additional procedures which may be necessary to achieve the best results include: necklift, blepharoplasty (eyelid surgery), liposuction, autologous fat injection, removal of buccal (cheek) fat pad, forehead lift, browlift, chemical or laser peel, and malar (cheek), submalar or chin implants.

How is facelift surgery performed?

 The traditional facelift procedure is performed through an incision starting in the hair or hairline above and in front of the ear (the temporal region). The incision is extended downward in front of the ear, comes under the ear and then upward behind the ear ending in the hair or hairline behind the ear. The skin and fatty tissues are then lifted off the underlying muscle and fascia (connective tissue) as far forward as is necessary to correct the loose skin problem. The underlying muscle and fascia can be tightened with sutures if the surgeon feels it is necessary. The skin is pulled back and upward and the excess skin removed. The wound is then closed with sutures and skin staples. Some surgeons leave a drain in the wounds to remove excess blood. Bandages are then applied. There are surgical techniques which go into deeper tissues rather than under the skin and fat. The results are similar.



Risks specific to facelift surgery;

  • Injury to the nerves that control facial muscles - this is usually temporary.
  • Problems with healing of the skin - this is common for patients who smoke.
  • Scarring - there will be some scarring, although the surgeon will always try to hide the face lift scars.
  • Crust on the incisions - this will be temporary.
  • Numbness or tingling around the incision areas - this should be temporary.
  • Skin or hair loss - this is rare.
  • Skin discoloration - this is a rare condition that can continue for several months.


Before & After face lift.

 





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