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Hyponatremia is defined as a serum sodium of less than 135 Meq per litre and occurs in upto 22 % of hospitalised patients. The causes of hyponatremia may be understood based on the pre-existing volume status of the patient which may either be hypovolemic, euvolemic or hypervolemic hyponatremia. This presentation discusses in detail, the causes of these underlying conditions. Also mentioned are the clinical features and management options and therapeutic sodium targets in patients with hyponatremia. Drugs such as demeclocycline and vaptans (Tolvaptan, Conivaptan) are also mentioned as management options which may be used on a case to case basis. Finally, the all important targets of sodium correction over 24 hours are also mentioned, along with a practical formula for calculation of sodium deficit which is explained with an example.
Aplastic anemia is a hematopoietic disorder caused due to T lymphocyte mediated destruction of stem cells resulting in pancytopenia with a cellular bone marrow and normal cell cytogenetics. The causes of aplastic anaemia may be inherited or acquired. The causes and the diagnostic approach, along with spectrum of severity of this disorder is discussed in this presentation. A detailed discussion of the management options, along with pharmacological therapy and supportive therapy in these cases is also discussed. The treatment options include, in addition to a stem cell transplant, anti-thymocyte globulin, cyclosporine, methyprednisolone and eltrombopag (for patients who have failed treatment on combined modality therapy with ATG and cyclosporine)
Systemic lupus erythematous is an autoimmune condition characterised by damage to organ systems due to autoantibodies and immune complex deposition. Genes, epigenetic changes and environment play a role in its pathogenesis. SLE is a truly multi system disease causing widespread clinical manifestations in almost all organ systems. Autoantibodies in SLE are numerous and mainly include ANA, dsDNA, Sm and others.
Corneal cross-linking (CXL) is an in-office eye procedure that strengthens the cornea if it's been weakened by keratoconus, other corneal disease, or (rarely) a complication of LASIK surgery. Alternative and brand names for the procedure include corneal cross-linking, corneal collagen cross-linking, C3-R, CCL and KXL.
Rubber band ligation is a procedure in which the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. This treatment is only for internal hemorrhoids. To do this procedure, a doctor inserts a viewing instrument (anoscope) into the anus. The hemorrhoid is grasped with an instrument, and a device places a rubber band around the base of the hemorrhoid. The hemorrhoid then shrinks and dies and, in about a week, falls off. A scar will form in place of the hemorrhoid, holding nearby veins so they don't bulge into the anal canal. The procedure is done in a doctor's office. You will be asked whether the rubber bands feel too tight. If the bands are extremely painful, a medicine may be injected into the banded hemorrhoids to numb them. After the procedure, you may feel pain and have a sensation of fullness in the lower abdomen. Or you may feel as if you need to have a bowel movement. Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at one time if the person has general anesthesia. Additional areas may be treated at 4- to 6-week intervals.
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