Passive immunization procedures with antisera

Disease	Passive Immunization (Antisera)
Tetanus	The usual prophylactic dose is 1500 units of horse ATS given s.c. or im. Soon after injury
Gas Gangrene	A polyvalent antitoxin is used. A patient who has sustained a wound possibly contaminated with spores of gas gangrene should receive a dose of 10,000IU of Cl.perfringens. Antitoxin, 5000 units of Cl.septicum antitoxin & 10,000 units of Cl.oedematiens antitoxin, im or in urgent cases intravenously
Rabies	Antirabies serum in a dose of of 40 IU per kg of body weight should be given im within 72 hours & preferably within 24 hrs of exposure. A part of the antiserum is applied locally to the wound.
Botulism	When Botulism is suspected, 10,000 units of polyvalent antitoxin is recommended every 3 to 4 hours
Diphtheria	A dose of 500-1,000 unit of diphtheria antitoxin is given im to susceptible contacts immediately after exposure. Protection does not last more than 2-3 weeks.

 

Human filarial infections

	Organism	Vector	Disease produced
1	Wuchereria bancrofti	Culex mosquitoes	Lymphatic filariasis
2	Brugia malayi	Mansonia mosquitoes	Lymphatic filariasis
3	Brugia timori	Anopheles mosquitoes, Mansonia mosquitoes	Lymphatic filariasis
4	Onchocerca volvulus	Simulum flies	Subcutaneous nodules, River blindness
5	Loa loa	Chrysopes flies	Recurrent, Transient subcutaneous swellings
6	T.perstans	Culicoides	Probably rarely any clinical illness
7	T.streptocerca	Culicoides	Probably rarely any clinical illness
8	Mansonella ozzardi	Culicoides	Probably rarely any clinical illness

SAFE triangle for ICD placement

1. Anterior border of the latissimus dorsi
2. Lateral border of pectoralis major muscle
3. A line superior to the horizontal level of the nipple and an apex below the axilla

Leukocoria is seen in

·         Retinoblastoma

·         Congenital cataract

·         Inflammatory deposits in the eye

·         Coloboma of choroid

·         Retrolental fibroplasia (Retinopathy of prematurity)

·         Persistent hyperplastic primary vitreous

·         Toxocara endopthalmitis

·         Exudative retinopathy of coats

·         Tuberculoma of choroid

·         Retinal detachment

tumors in children

·         Astrocytoma are the most common brain tumors in children.

·         Juvenile pilocytic astrocytoma is the most common astrocytoma in children , comprising 20% of all brain tumors.

·         Neuroblastoma is the most common intraabdominal solid tumor in children.

·         Rhabdomyosarcoma is the most common soft tissue sarcoma in children under 15 years of age .

·         The most common primary site for rhadomyosarcoma in children in head and neck region.

·         The most common malignant bone tumor in children is osteosarcoma.

·         Retinoblastoma is the most common primary ocular tumor of childhood.

 

Dobutamine Stress Echocardiogram

Dobutamine Stress Echocardiogram

What is a Dobutamine Stress Echocardiogram (Echo)?

• A Dobutamine Stress Echo is a non-invasive test used to evaluate coronary artery disease in patients who are unable to exercise on a treadmill.
• Dobutamine is a medication that increases heart rate and blood pressure similar to the effect of exercise.
• The rise in heart rate increases the oxygen demand of the heart and helps to determine if the heart muscle is getting enough blood and oxygen.
• The test includes an echocardiogram done at rest and again at peak heart rate. This procedure uses sound waves (ultrasound) to produce an image of the internal structures of the heart.
• In order to produce an image of the heart muscle, gel is applied to the patient's chest area and a transducer (a wand-like apparatus) is moved over the chest.
• Electrodes are placed on the chest to record an electrocardiogram (EKG) which monitors the heart's rate and rhythm.
• An IV line will be started and Dobutamine will be administered by a nurse.
• The cardiologist will observe for any symptoms, irregular heart rhythms, an inappropriate heart rate or blood pressure responses.
• The test takes about an hour.
• This test must be ordered by a doctor.

Why is a Dobutamine Stress Echo Done?

• This test will help the doctor evaluate the patient's cardiac condition related to the following:
  • How well the heart muscle and valves are working and how they function under stress.
  • The size of the heart's pumping chambers (ventricles).
  • Abnormal heart function: coronary artery disease and/or inadequate coronary blood supply.

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Pollicisation of the index finger

Pollicisation of the index finger

Pollicisation of the index finger is the treatment of choice

for reconstruction in children with congenital hypoplasia of

the thumb.1-5 Good outcomes have been reported for range

of movement, power, appearance and sensation,

 

Figure 1a – A 40-year-old man with bilateral congenital absence of the thumb with an associated

radial club hand on the right. Figures 1b and 1c – Radiographs showing pollicisation of the index finger

of the left hand in isolated congenital absence of the thumb (b) and of the right hand in radial club hand

(c).