Pyelonephritis:-

Infection of one or both the kidney is called as pyelonephritis. As we know, kidney is the organ forms the urine and helps in removing hydrogenous wastes from body. There are two kidneys in human body ; one or both kidneys may be infected. pyelonephritis is the medical term indicates, kidney infection. Glomerulonephritis , and bacterial pyelonephritis are the two common infections of kidney. Kidney infections are more common in women than men. Kidney infections can occur at any age.

Causes of pyelonephritis:-

* Bacterial infection are the most common causes of pyelonephritis.

* kidney stones, kidney tumor,

* Upper urinary tract infection,

* Stagnation of urine in bladder,

* pregnancy,

* Untreated lower respiratory tract infection.

* Bladder infection,

* Immune Suppression due to other diseases, or medications.

* Streptococcal, bacterial infection,

* Skin infections such as impetigo also causes kidney infection.

* Diseases such as syphilis, measles etc

Complications :-

* Hypertension,

* Renal insufficiency, and

* Renal failure.

Pyelonephritis may be Acute or chronic. Prompt medical attention is needed to treat pyelonephritis.

Tongue cancer is treated as per severity of cancer. The early detection of cancer of tongue cancer helps in treating it effectively.

The treatment options:-

1. Surgery,
2. Chemotherapy and
3. Radiation therapy.

Surgery is done for very small tongue cancer.

If whole tongue has got cancer, removal of tongue by surgery is the option.

When the cancer has spread to lymph nodes in the neck, the part of tongue affected and the lymph nodes are removed. Radiation is used as a combination with surgery.

Radiation therapy is used along with surgeries in some cases of tongue cancer.

Problems occur with eating,  speaking and drinking with tongue cancer surgeries and treatment.

Definition:-

“Aphasia is defined as inability to communicate verbally either partially or completely”.

The person with aphasia has difficulty in not only  speaking but also in writing, reading, and recognizing the objects. And also unable to understand what others’ say. Aphasia is mainly caused because of an abnormality in the brain, which affects the speech center in the brain. The conditions such as less oxygen supply to brain,  Traumatic injury to brain, stroke, cause Aphasia.

Causes of Aphasia:-

1. Stroke is the main cause of aphasia, as the speech center in the brain loses its function. Nearly 18 to 23% of stroke affected people suffer from Aphasia.
2. Head injuries,
3. Encephalitis, and other brain infections
4. Traumatic injury to head and brain.

Most cases of Aphasia are temporary and treated within few days. Complete recovery is possible with effective treatment. But the permanent Aphasia is not treatable, and still millions of Americans are suffering from some form of Aphasia.

Treatment of Aphasia:-

Treatment aids in improving the communicating ability of the person.

Rehabilitation is given by speech – language pathologist. Aphasia is treated on the basis of extent of brain damage.

Pancreas cancer :-

Malignant tumor of pancreas is called as pancreatic cancer.

More Than 90 % of pancreatic tumors are adenocarcinomas.

Smoking and familial history of pancreatic cancer are the predisposing factors of Pancreatic cancer.

Diagnosis of pancreatic cancer is difficult and thorough tests confirms pancreatic cancer.

Signs and symptoms  of pancreatic cancer

* Pain in the upper abdomen,
* Loss of appetite,
* Weight loss,
* Jaundice,
* Diarrhoea,
* bloating,
* Depression is seen in some individuals.

If any of the above symptoms appear,  immediate medical assistance to be taken.

Lung transplantation:-

* lung   transplantation is the procedure of transplanting a part or a total lung of donor to replace the damaged part of lung of the affected patient.

* lung  transplanted individuals are at risk of mismatching or immune response. hence too much care has to be taken before the transplantation.

* lung transplantation is performed during end stage lung disease.

* different types of lung transplantation are performed now a days.

* lung and blood compatibility  test is to be conducted before transplantation. here both donor and patient are subjected to medical tests.

Need for Lung transplantation:-

* Chronic obstructive pulmonary disease,

* Lung fibrosis,

* Idiopathic pulmonary hypertension,

* Cystic Fibrosis, etc….

Tuberous Sclerosis is a genetic disease, forms benign tumor in the brain and other vital organs of the body such as heart, kidney, lungs, eyes, skin etc. Tuberous Sclerosis mainly affects the central nervous system.

Tuberous Sclerosis is manifested by seizures, convulsions, behavioural problems, mental retardation, skin disorders, pulmonary and renal disorders, etc. Tuberous Sclerosis may be present at birth but the symptoms are seen during growing period of the child. The gyri, foldings of brain becomes thick and firm in the TSC affected  individual.

Causes of Tuberous Sclerosis:-

Genetic cause is the main cause of tuberous Sclerosis. Inheritance of autosomal dominant genes, causes Tuberous Sclerosis.

SIGNS AND SYMPTOMS:-

* Learning difficulties are the main symptoms of tuberous sclerosis, found in 50 % totally affected.
* Less intelligent quotient, ( IQ ), when large part of brain is involved.
* Autism is seen in nearly 25 % of Tuberous Sclerosis affected.
* Behavioural problems,
* Difficulty in adjustment to environment,
* Aggression,  OCD, etc.

The Tuberous Sclerosis individual Will have the symptoms of renal, pulmonary or integumentary system on the basis of tumors presence on those organs.

Diagnosis of Tuberous sclerosis:-

* Family history helps in diagnosing tuberous Sclerosis, as it helps in knowing any history of Genetic cause.
* Woods Lamp is used to visualise the skin, mouth, etc..
* CT scan, MRI scans provides clear image of the affected part.
* Ultrasound Scan is used to find tumors in the kidneys,
* Echo cardiogram, Fundoscopy, are the diagnostic tests performed for Tuberous Sclerosis.

Diabetes and Pregnancy:-

Untreated diabetes  pregnancy is fatal and need immediate care. Most of the women fails to plan the diabetes pregnancy and may face the number of problems. Obesity may cause diabetes pregnancy in the pregnant mother. Gestational diabetes mellitus is common in nearly 15 % of pregnant women. Carbohydrate intolerance of Gestational diabetes mellitus is seen after 24th week of pregnancy, when placenta  produces  hormones which interfere insulin activity. Maintaining normal blood glucose level is very important during pregnancy to avoid damage to growing fetus. Women with type-2 diabetes mellitus should shift from oral anti diabetic drugs to insulin therapy. Diabetes mellitus also increases the risk of coronary artery diseases. Diabetes pregnancy mother should take care of her health and growing baby’s health.

Diabetes Pregnancy and full Health check up for diabetes during pregnancy is very essential for maintaining health of pregnant mother and growing fetus. The risks of diabetes pregnancy should be reduced before end of second trimester of pregnancy. Oral glucose tolerance test is done to measure the glucose levels in the blood and effective treatment is given to treat diabetes pregnancy. when glucose is present in urine and is in high quantity in blood during pregnancy is said to be pregnancy complicated with diabetes. sometimes lactose may be present in urine which is near labour or during lactation, it is known as lactosuria. glycosuria during pregnancy is usually the result of the renal threshold for glucose, but it is essential to recognise and treat diabetes.

In more than half of the cases of diabetes associated with pregnancy or Diabetes pregnancy the disease is known to have been present before the pregnancy began.

Symptoms of diabetic glycosuria:-

* polyurea,
* polyphagia,
* polydipsia,
* peripheral neuritis,
* pruritus vulvae, etc

The diabetic or renal origin of glycosuria can be differentiated by a simple test. A blood sugar reading is made immediately after the patient has emptied her bladder. Half an hour later a specimen of urine is obtained and tested for sugar, and after a further half an hour a second blood sugar reading is made.

Diabetes pregnancy management:-

The patient must be seen frequently throughout her pregnancy and it is better if a physician and the obstetrician should co operate with each other in treating diabetes pregnancy and preventing bad results for fetus. The onset of hypertension hydramnios is a further indication for hospital management. Diet, exercise, Monitoring weight gain and insulin therapy are the main aspects of treating Diabetes pregnancy.

Diet : Postprandial hyperglycemia leads to increased level of blood glucose. So consuming the diet with the help of dietitian is good for diabetes pregnancy. Diet taken by mother who have diabetes pregnancy should include low glucose diet and a balanced diet with the physicians guidance. Protein malnutrition may occur during pregnancy and care should be taken.

Exercise : Exercises during diabetes pregnancy helps in utilization of glucose from the body and reduces increased glucose level in blood. Exercises for pregnant mother should not be harmful for baby and mild exercises are done with physicians suggestion.

Monitoring weight gain : Weight gain is normal during pregnancy and it should be normal limit. The mother who have diabetes and plans to conceive should take care to reduce weight before pregnancy. Diabetes pregnancy becomes worsen with excess weight gain.

Insulin therapy management : Appropriate and therapeutic dosage of insulin administration is recommended during diabetes pregnancy. Pregnant mother should have a clear knowledge to administer insulin at correct time. Hypoglycemia may occur with insulin therapy as a side effect and attention should be given by pregnant mother to maintain normal blood glucose during pregnancy. After 36th week of pregnancy insulin demand increases as the placental growth stops.

Treatment of  Diabetes pregnancy:-

The diabetes  pregnancy fetus is liable to die in uterus or womb at any time but particularly during the last four weeks of pregnancy. Baby or fetus  weight at this time may exceed that of a child born at time. If the patient is a primigravida with severe diabetes or multipara with a history of previous still births, Caesarean section should be carried out at about the thirty sixth week of pregnancy. In other cases surgical induction of labour may be attempted. The reason for carrying out the Cesarean section is merely to avoid intrauterine death of the fetus, but the child has only a precarious hold on life and the help of the pediatrician is required to tide it over the first few days of life.

Definition:-

The condition in which acidity of body fluids and tissues is abnormally high is known  acidosis.
Description:-

Due to imbalance in the acid and alkali maintenance, because of body mechanism failure leads to acidosis. When acid base balance is altered leads to acidosis.

Acidosis commonly found in the blood plasma, when PH of blood goes below 7.35  leads to acidity. Cellular metabolic activity and PH of the body fluid determines the acidity.

Respiratory acidosis and Metabolic acidosis are the two main type of acidosis. Kidney and lungs maintains the acid base balance in the body.

Causes of Acidosis:-
When the acid level goes up and base or bicarbonate comes down , leads to acidosis. Kidney and lungs maintain the acid base level in the body. when kidney or lung becomes unable to maintain acid base balance leads to Acidosis.

Types of Acidosis :-

1. Respiratory acidosis is caused when the carbon dioxide level increases in the blood, is mainly due to decreased breathing.

2. Metabolic acidosis is of different types, such as

a. Diabetic acidosis : is also called as ketoacidosis, caused when ketone bodies increases during uncontrolled diabetes.

b. Hyperchloremic acidosis : caused when sodium bicarbonate is lost in the body, in conditions such as severe diarrhoea.

c. Lactic acidosis : is caused when lactic acid level is increased in the body.  Lactic acidosis is caused in conditions such as

* liver failure,
* low blood sugar,
* alcoholism,
* medications such as salicylates,
* cancer,
* excess tiredness, or exercises
* seizures etc.

Kidney diseases and dehydration also can cause acidosis.

Diagnosis of acidosis:-

Arterial blood gas analysis is main confirmation test for acidosis.

Treatment of acidosis:-

Treatment includes maintaining acid base balance with medications  and fluids. Oxygen supplementation is indicated in some conditions. Treating the cause of acidosis is important.

* Typhoid fever is the enteric infection caused by the bacteria  Salmonella typhi.
*  Typhoid fever is also called as bilious fever or yellow fever.
*  Typhoid fever is transmitted by the ingestion of food or water contaminated with fecal matter of typhoid infected person.

* After entering the body the bacteria then perforate the intestinal wall and bacteria are phagocytosed by macrophages. Later the infection  spreads to different parts of the body through blood and lymphatic system.

Causes of typhoid fever:-
* Typhoid is mainly caused by the gram negative bacteria salmonella typhi. Typhoid is also caused by Salmonella paratyphi.

* Contaminated food and bacteria act as a source of typhoid infection.

* Infected human beings with typhoid also act as carrier of typhoid bacteria.
* people who travel are at risk of getting typhoid due to ingestion of contaminated food or water.

* Infection is the most common cause  of fever in human beings.
* Viral (e.g., influenza, HIV, hepatitis, herpes simplex encephalitis, mononucleosis, adenovirus)
* Bacterial (e.g., pneumonia, endocarditis, tuberculosis, meningitis, pyelonephritis, appendicitis, cholecystitis, cellulitis)
* Lyme disease
* Malaria
* Syphilis
* Tularemia

Symptoms of Typhoid fever:-

* Fever, continuous more than a week,
* Headache associated with typhoid fever,
* poor appetite,
* generalized aches and pains,
* fever,
* lethargy, and
* Diarrhea

Diagnosis of Typhoid fever:-

* History collection reveals ingestion of contaminated water and food,
* Blood culture for the presence of bacteria,
* WIDAL test is the common test performed to diagnose typhoid fever.

Treatment of typhoid fever:-

Treatment is given with broad spectrum antibiotics.

Typhoid fever  is the enteric infection caused by the bacteria, Salmonella enterica serovar Typhi. vaccination typhoid prevents typhoid.Typhoid  fever is common worldwide and is also caused as Enteric fever or bilious fever.

Transmission of bacteria salmonella typhi occures through the ingestion of food and water contaminated with fecal matter of infected person. After entering the body, salmonella typhi perforates the intestinal wall and is phagocyted by macrophages. This makes salmonella typhi to become resistant to body immune power. Then the organism spreads to different parts of the body through lymphatic system. Salmonella typhi is a gram negative organism grows best at 37 degree celsius temperature.

Causes of Typhoid fever:-

• Anybody can be infected with typhoid fever, but the travellers visits the infected places are at risk. People live slum and unsanitary environment get typhoid fever easily.
• Ingestion of contaminated food and water with infected fecal material, causes typhoid fever. After entering intestine, salmonella typhi spreads to blood stream and establishes infection.
• Salmonella typhi infects the gallbladder directly after entering the blood stream.
• Living with typhoid carriers, also cause typhoid fever.
• People who travel  in trains, refugees, may get typhoid fever.
• Poor environmental sanitation also leads to Typhoid fever.
• Eating road side selling foods, contaminated by flies, causes typhoid fever.

Symptoms of Typhoid fever:-

Typhoid symptoms are observed after two or three weeks the bacteria enters the body. Even though Typhoid is not a fatal disease, if not treated may lead to Death.

* Fever : is the main symptom of Typhoid. Fever up to 104 degree F, along with heavy sweating.
* Headache : severe headache is common with typhoid fever.
* Rose coloured spots on the trunk,
* Diarrhea, ( non bloody),
* Gastroenteritis,
* Bradycardia,
* Malaise,
* Epitaxis,
* Eosinopenia,
* lymphocytosis,
* General discomfort,
* uneasiness,
* loss of appetite,,
* weight loss,
* chills,
* delirium,
* confusion, hallucination,
* typhoid more than two weeks can cause

Diagnosis of  Typhoid fever:-

• Blood test : WIDAL test  is the common test performed to diagnose Typhoid fever. In the first week, widal test will be negative and later test becomes positive.  WIDAL test is the specific test for salmonella antibodies against antigens O- somatic and H- flagellar.
• Bone marrow culture,
• Stool test for Salmonella typhi,
• Blood Platelet count,
• ELISA test, for Vi antigen in urine, etc

Treatment of Typhoid fever:-
Typhoid fever is a bacterial infection, need to be treated with antibiotics.

* The antibiotics used to treat Typhoid are
* Ampicillin,
* Chloramphenicol,
* trimethoprim- sulfamethaxazole,
* Ciprofloxacin etc..

The duration of typhoid infection continues up to 3 weeks, if not treated. If not treated Typhoid becomes Fatal.