Seizure, epilepsy and convulsion-Are they same.

 People use “seizure” and “epilepsy” interchangeably, but they are not some. To understand better, I will put it like this, “ All epilepsy patients have seizures but all seizure patients are not epileptic” which means that there are non-epileptic causes of seizures also like hypoglycaemia, brain tumours, hypoxia, metabolic derangements, brain infections, cerebrovascular accidents etc. In other words, epilepsy is seizure without any organic cause or lesion. Sometimes, another terminology ‘convulsion’ is also used. It refers to the involuntary contraction/relaxation that occurs in seizure patients. ‘Convulsion’ is rather a layman’s term and you will find them referred to frequently in news and general discussion. It is to be remembered that some seizure disorder like absence seizure may not be manifested as ‘convulsions’

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Differential action of cortisol on tissues- the cellular checkpoints at the tissue level

 

·       Cortisol (and some amount of cortisone) is produced by the adrenal cortex in response to stress

·       Like all hormones, cortisol is secreted directly into the circulation and distributed uniformly throughout the body.

·       Most tissues of the body (mainly the liver and the adipose tissues) are rich in glucocorticoid receptors and poor in mineralocorticoid receptors. They have the enzyme HSD-11β Type 1 which converts cortisone into cortisol and promotes glucocorticoid action.

·       Some tissues of the body (kidneys, liver, lungs, colon, salivary glands) are rich in mineralocorticoid receptors and poor in glucocorticoid receptors. They are very sensitive to mineralocorticoid action of cortisol. They have the enzyme HSD-11β Type 2 which converts active cortisol into inactive cortisone and prevent excessive mineralocorticoid action of cortisol.

Oxygen delivery devices

 

Mode of O2 delivery	Maximum flow rate (litres/min	FiO2	Other notable features
Nasal cannula / prongs	5	·       1 litre/min flow rate-24%, ·       increases by 4% with every litre increase in flow rate ·       6 litres/min flow rate-44%,	·       Narrow-bored flexible tubes. ·       One end of the tube is attached to a graduated oxygen flow meter, the other end is split into two nozzles that loosely fits into the nostrils. ·       Beyond flow rates of 5 litres/min, the flow becomes turbulent leading to dissipation of delivered oxygen at the entry portal.
Face mask (simple)	5-10	35-55%	·       It is an expanded semi-rigid hollow enclosure that fits over the nose and oral orifice. ·       Flow rates less than 5 litres/min are not recommended because there is rebreathing of trapped expired air
Venturi mask	(blue-2, white-4, orange-6, yellow-8, red-10 and green-15)	24, 28, 31, 35, 40 and 60 % respectively	·       Oxygen inlet to the face mask is fitted with oxygen content regulators of varying capacity. ·       The FiO2 can therefore be tightly controlled as per need of the patient
NRBM	10-15	Up to 100%	·       The oxygen inlet to the mask is side-fitted with an inflatable oxygen reservoir bag. ·       During inspiration, oxygen is sourced from the inflowing oxygen as well as from the reservoir.
(HFNC)	Maximum rate- 70 litres/min	Up to 100%	·       electromechanical device that generates an admixture of warm humidified air containing oxygen of desired concentration

The electrophysiology of cardiac action potential in non-pacemaker cells: watch the video

 The “heart” of the functioning of the heart is the fast cell to cell communication between the cardiac myocytes. Upon generation of the pacemaker potential, the impulse is transmitted electrically to the adjacent cells. An action potential begins with rapid firing of fast Na+ channels resulting in rapid depolarisation (phase 0), following which there is an early repolarisation (phase 1). In the phase 2, Ca++ moves into the cells triggering massive release of calcium from the endoplasmic reticulum. And the cell contracts...

Delve into the depths of the molecular mechanism of the cardiac action potential. Click the 

https://youtu.be/tHttyFRjddM

Ranolizine in ischemic heart disease

 https://youtu.be/-ZoM9dIfqSE

The mid life crisis in the life of a women. What can we do to help her?

A 45 year old lady presents with the chief complaint of irregular menses. She had amenorrohoea for the last three months but 10 days back the periods started with heavy menstrual bleeding and was still continuing. She had one living child aged 20 years. An abdominal ultrasound revealed no obvious abnormality that could explain the heavy menstrual bleeding. Her thyroid status was euthyroid. She has no history of any comorbid condition. What is the most likely diagnosis?    What treatment would you suggest for the patient?

Mechanism of action of sucralfate

 https://youtu.be/-uMkwAfSb-I