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Friday, September 29, 2023
Definition, Types, Risk factors, Pathogenesis, Complications, Diagnosis and Treatment of Hypertension
Thursday, September 28, 2023
Macleod's Clinical Examination 14th Edition pdf free download
Macleod's Clinical Examination 14th Edition pdf free download
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OXFORD HANDBOOK OF CLINICAL MEDICINE 10th Edition pdf free download
OXFORD HANDBOOK OF CLINICAL MEDICINE 10th Edition pdf free download
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Boards and Beyond | Step 2/3 | Video Lectures | Free Download | March 2023 |
Boards and Beyond | Step 2/3 | Video Lectures | Free Download | March 2023 |
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Pathogenesis, Clinical features, Diagnosis, and Management of Community Acquired Pneumonia
INTRODUCTION:
DEFINITIONS:
Risk factors:
MICROBIOLOGY:
PATHOGENESIS:
CAP has been viewed as an infection of the lung parenchyma, primarily caused by bacterial or viral respiratory pathogens. In this model, respiratory pathogens are transmitted from person to person via droplets or, less commonly, via aerosol inhalation (eg, as with Legionella or Coxiella species). Following inhalation, the pathogen colonizes the nasopharynx and then reaches the lung alveoli via microaspiration. When the inoculum size is sufficient and/or host immune defenses are impaired, infection results. Replication of the pathogen, the production of virulence factors, and the host immune response lead to inflammation and damage of the lung parenchyma, resulting in pneumonia (figure 3).
With the identification of the lung microbiome, that model has changed [19-21]. While the pathogenesis of pneumonia may still involve the introduction of respiratory pathogens into the alveoli, the infecting pathogen likely has to compete with resident microbes to replicate. In addition, resident microbes may also influence or modulate the host immune response to the infecting pathogen. If this is correct, an altered alveolar microbiome (alveolar dysbiosis) may be a predisposing factor for the development of pneumonia.
In some cases, CAP might also arise from uncontrolled replication of microbes that normally reside in the alveoli. The alveolar microbiome is similar to oral flora and is primarily comprised of anaerobic bacteria (eg, Prevotella and Veillonella) and microaerophilic streptococci. Hypothetically, exogenous insults such as a viral infection or smoke exposure might alter the composition of the alveolar microbiome and trigger overgrowth of certain microbes. Because organisms that compose the alveolar microbiome typically cannot be cultivated using standard cultures, this hypothesis might explain the low rate of pathogen detection among patients with CAP.
In any scenario, the host immune response to microbial replication within the alveoli plays an important role in determining disease severity. For some patients, a local inflammatory response within the lung predominates and may be sufficient for controlling infection. In others, a systemic response is necessary to control infection and to prevent spread or complications, such as bacteremia. In a minority, the systemic response can become dysregulated, leading to tissue injury, sepsis, acute respiratory distress syndrome, and/or multiorgan dysfunction.
CLINICAL PRESENTATION:
Diagnosis:
DIFFERENTIAL DIAGNOSIS:
TREATMENT:
Outpatient antibiotic therapy:
Inpatient antibiotic therapy:
PREVENTION:
Tuesday, September 26, 2023
FIRST AID for the USMLE STEP 2 CK-10th Edition.pdf Free Download
FIRST AID for the USMLE STEP 2 CK-10th Edition.pdf Free Download
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SECTION 1: GUIDE TO EFFICIENT EXAM
SECTION 2: DATABASE OF HIGH-YIELD FACTS . . . 15
SECTION 3: TOP-RATED REVIEW RESOURCES . . 589
Diabetes Mellitus
Introduction of Diabetes:
Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels. DM has several categories, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and secondary causes due to endocrinopathies, steroid use, etc. The main subtypes of DM are Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM), which classically result from defective insulin secretion (T1DM) and/or action (T2DM). T1DM presents in children or adolescents, while T2DM is thought to affect middle-aged and older adults who have prolonged hyperglycemia due to poor lifestyle and dietary choices. The pathogenesis for T1DM and T2DM is drastically different, and therefore each type has various etiologies, presentations, and treatments.
Etiology of Diabetes:
Type 1 Diabetes Mellitus:
Type 2 Diabetes Mellitus:
Maturity-onset diabetes of the young (MODY):
Gestational diabetes:
Pathophysiology:
History and Physical:
Evaluation:
Treatment / Management:
Complications:
Monday, September 18, 2023
BRS Physiology Seventh Edition Download Free Pdf
BRS Physiology Seventh Edition Download Free Pdf
Physiology
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Boards & Beyonds USMLE STEP 1 Videos with English Subtitles 2023 Free Download
Boards & Beyonds USMLE STEP 1 Videos with English Subtitles 2023 Free Download
Today, in this article, we are going to share with you Board and Beyond USMLE STEP 1 2023 for free download. We hope that our readers will find these videos helpful in their learning.
Boards & Beyond provides an online virtual curriculum to supplement your coursework and provide a comprehensive review for the USMLE Step 1 exam all in one place! Instead of buzzwords or mnemonics, we emphasize understanding of the basic and clinical sciences, so that the students can study more effectively and build a foundation to succeed in medical school, on Step 1, and beyond.
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Checklist of Board and Beyond USMLE STEP 1 2023 List of Videos
Saturday, September 16, 2023
Dietary Approaches to Stop Hypertension(DASH diet)
Dietary Approaches to Stop Hypertension (DASH diet).
DASH stands for Dietary Approaches to Stop Hypertension.
The DASH diet is a healthy-eating plan designed to help prevent or treat high blood pressure, also called hypertension. It also may help lower cholesterol linked to heart disease, called low density lipoprotein (LDL) cholesterol.
High blood pressure and high LDL cholesterol levels are two major risk factors for heart disease and stroke.
Foods in the DASH diet are rich in the minerals potassium, calcium and magnesium. The DASH diet focuses on vegetables, fruits and whole grains. It includes fat-free or low-fat dairy products, fish, poultry, beans and nuts.
The diet limits foods that are high in salt, also called sodium. It also limits added sugar and saturated fat, such as in fatty meats and full-fat dairy products.
DASH diet and sodium:
The standard DASH diet limits salt to 2,300 milligrams (mg) a day. That amount agrees with the Dietary Guidelines for Americans. That's about the amount of sodium in 1 teaspoon of table salt.
A lower sodium version of DASH restricts sodium to 1,500 mg a day. You can choose the version of the diet that meets your health needs. If you aren't sure what sodium level is right for you, talk to your health care provider.
DASH diet: What to eat:
The DASH diet is a balanced eating plan that gives choices of what to eat. The diet helps create a heart-healthy eating style for life. There's no need for special foods or drinks. Foods in the diet are at grocery stores and in most restaurants.
When following DASH, it is important to choose foods that are:
Rich in potassium, calcium, magnesium, fiber and protein.
Low in saturated fat.
Low in salt.
DASH diet: Suggested servings:
Grains: 6 to 8 servings a day. One serving may be 1/2 cup of cooked cereal, rice or pasta, 1 slice of bread or 1 ounce dry cereal.
Vegetables: 4 to 5 servings a day. One serving is 1 cup raw leafy green vegetable, 1/2 cup cut-up raw or cooked vegetables, or 1/2 cup vegetable juice.
Fruits: 4 to 5 servings a day. One serving is one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 1/2 cup fruit juice.
Fat-free or low-fat dairy products: 2 to 3 servings a day. One serving is 1 cup milk or yogurt, or 1 1/2 ounces cheese.
Lean meats, poultry and fish: six 1-ounce servings or fewer a day. One serving is 1 ounce of cooked meat, poultry or fish, or 1 egg.
Nuts, seeds, or dry beans and peas: 4 to 5 servings a week. One serving is 1/3 cup nuts, 2 tablespoons peanut butter, 2 tablespoons seeds, or 1/2 cup cooked dried beans or peas, also called legumes.
Fats and oils: 2 to 3 servings a day. One serving is 1 teaspoon soft margarine, 1 teaspoon vegetable oil, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.
Sweets and added sugars: 5 servings or fewer a week. One serving is 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet or 1 cup lemonade.
DASH diet: Alcohol and caffeine:
Drinking too much alcohol can increase blood pressure. The Dietary Guidelines for Americans recommends that men limit alcohol to no more than two drinks a day and women to one or less.
The DASH diet doesn't talk about caffeine. How caffeine affects blood pressure isn't clear. But caffeine can cause blood pressure to rise at least briefly.
If you have high blood pressure or if you think caffeine affects your blood pressure, think about cutting down. You might talk to your health care provider about caffeine.
Sunday, September 10, 2023
What is Pirola, the new variant of the Coronavirus?
What is Pirola, the new variant of the Coronavirus?
What to Know About the New BA 2.86 COVID Variant?
The CDC and the World Health Organization have dubbed the BA 2.86 variant of COVID-19 as a variant to watch.
So far, only 26 cases of "Pirola," as the new variant is being called, have been identified: 10 in Denmark, four each in Sweden and the United States, three in South Africa, two in Portugal, and one each the United Kingdom, Israel, and Canada. BA 2.86 is a subvariant of Omicron, but according to reports from the CDC, the strain has many more mutations than the ones that came before it.
What is unique about the BA 2.86 variant?
It is unique in that it has more than three mutations on the spike protein," said Purvi Parikh, MD, an infectious disease expert at New York University's Langone Health. The virus uses the spike proteins to enter our cells.
This "may mean it will be more transmissible, cause more severe disease, and/or our vaccines and treatments may not work as well, as compared to other variants," she said.
Good news ― hospital admissions with Covid plateaued last week, and at levels lower than recent troughs. none of this has anything to do with new variant BA.2.86 ("Pirola") which is a tiny tiny proportion of sequenced cases. "Eris" (EG.5.1) still not dominant either.
What do we need to watch with BA 2.86 going forward?
What should doctors know?
How well can our vaccines fight BA 2.86?
"Vaccine coverage for the BA.2.86 is an area of uncertainty right now," said Mostafa.
In its report, the CDC says scientists are still figuring out how well the updated COVID vaccine works. It's expected to be available in the fall, and for now, they believe the new shot will still make infections less severe, new variants and all.
If you weren't already aware, BA.2.86 (Pirola) is in the US Midwest%u2014probably the first time a major variant has been seen in the Midwest before the major US coastal cities.
Prior vaccinations and infections have created antibodies in many people, and that will likely provide some protection, Mostafa said. "When we experienced the Omicron wave in December 2021, even though the variant was distant from what circulated before its emergence and was associated with a very large increase in the number of cases, vaccinations were still protective against severe disease."
What is the most important thing to keep track of when it comes to this variant?
What does this stage of the virus mutation tell us about where we are in the pandemic?
The history of the coronavirus over the past few years shows that variants with many changes evolve and can spread very quickly, Mostafa said. "Now that the virus is endemic, it is essential to monitor, update vaccinations if necessary, diagnose, treat, and implement infection control measures when necessary."
With the limited data we have so far, experts seem to agree that while the the variant's makeup raises some red flags, it is too soon to jump to any conclusions about how easy it is to catch it and the ways it may change how the virus impacts those who contract it.
How do viruses mutate, exactly?
It is natural for all viruses to mutate over time and such changes are particularly common in viruses that have RNA as their genetic material, as in the case of coronaviruses and influenza viruses.
Once a virus enters the human body, its genetic material — RNA or DNA — enters the cells and starts making copies of itself which can infect the other cells. Whenever an error occurs during this copying process, it triggers a mutation.
Occasionally, a mutation comes along when the genetic mistakes that are introduced while copying prove to be advantageous for the virus — these help the virus copy itself or enter human cells more easily. Whenever a virus is widely circulating in a population, the more it spreads and replicates, its chances of mutating increases.
What differentiates Pirola?
Speaking to the Yale School of Medicine, Anne Hahn, a postdoctoral associate who leads the Yale SARS-CoV-2 Genomic Surveillance Initiative, said that this is a “much more interesting subvariant”, when compared to the Omicron subvariant known as XBB.1.9. That variant initially spread quickly but did not overwhelm populations at a significant scale.
The same report noted that it has been detected by surveillance labs in Israel and Denmark and later in labs in England, South Africa, and the United States.
According to Fortune, new data released on Twitter on Friday evening by Ben Murrell, a researcher at the Karolinska Institutet in Sweden, showed that blood samples taken last week performed better than expected when it came to neutralising BA.2.86.
Dr Eric Topol, a professor of molecular medicine at Scripps Research and founder and director of the Scripps Research Translational Institute, said in a tweet that the findings offer a more positive outlook for how new boosters might protect against the highly mutated variant.
What precautions need to be kept in mind against this new variant?
Roberts said that the US Centres for Disease Control and Prevention’s (CDC) preliminary report says there is not enough evidence right now to conclude whether Pirola could lead to more severe disease, death, or hospitalisation. “We don’t yet know how transmissible it is, and it’s very possible it doesn’t spread that well and we would see this peter out in a couple of weeks,” Dr Roberts said.
He added, “But it’s important to remember that it’s still the same virus at its core, so the same prevention methods — masking, vaccination, and hand-washing, among others — can help people avoid infection.”
Sources:
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