ANTIBIOTIC for UTI

** preferred

For acute uncomplicated cystitis, the likely causative agents:

E. Coli
Enterobacteriaceae:
Klebsiella
Proteus
Enterobacter species
Staphylococcus - saprophyticus
Enterococcus

Antibiotic for recurrent UTI act as prophylaxis

List of likely organism that cause the condition

Acute Uncomplicated Pyelonephritis

E. Coli
Enterobacter
Proteus
Pseudomonas

Acute Complicated Pyelonephritis

Calculi especially struvite stones
Urethral stricture or tumour
Papillary necrosis
Congenital abnormalities
Neuropathic bladder
Previous genito-urinary surgery
predisposing to obstruction
Polycystic kidneys
E. Coli
Proteus sp.
Klebsiella
Pseudomonas
Serratia
Enterococci

management of asthma

How to diagnosed asthma???

Management of asthma

Level of asthma control

Management approach based on control

 Treatment step

reduce                                                        increase

Severity of asthma exacerbation

management of breast symptoms

 

In any patient who present with breast lump or other symptoms suspicious of carcinoma, the diagnosis should be made by a combination of clinical assessment, radiological imaging and a tissue cytological or histological analysis the so called triple assessment.

starting with the clinical, lets imagine that a patient come to our clinic for the first time, so we take a proper history and do physical examination to reach our diagnosis. 

Then we can proceed with the imaging which are ultrasound and mammography but we must first know what are the indication for the patient. Ultrasound is suitable for women <35 years old because the breast tissue is dense and can distinguish cystic from solid lump. Compared to mammogram, it is for women >35 years old and routinely done in 2 views : cranio-caudal ( CC ) and mediolateral oblique view ( MLO ). 

ultrasound of breast

Mammogram.cranio-caudal view (CC) and the mediolateral oblique view, which is taken from an oblique or angled view

CC position

MLO position

 Next is pathology. We can do either fine needle aspiration or core cut needle ( Tru cut ) biopsy.Histology can be obtained under local anaesthesia using a spring-loaded core needle biopsy device. Cytology is obtained using a 21G or 23G needle and 10 ml syringe with multiple passess through the lump with negative pressure in the syringe. The aspirate is then smeared on to a slide, which is air dried or fixed. FNAC is least invasive technique of obtaining a cell diagnosis. 

CORECUT BIOPSY

FNAC

MANAGEMENT COMPLICATION OF RADIOTHERAPY

MANAGEMENT COMPLICATION OF LOCAL ANESTHESIA

As a dental surgeon we should know the complications for every procedure that we attempt. Thus as local anesthesia also got their own complications. Every complications need to be managed successfully in order to restore normal condition and make patient feel confident and save in your hand. Thus I have simplified the list of complication’s management of local anesthesia.