Epilepsy- types

Generalised
    -tonic clonic
    -tonic
    -clonic
    -absent
    -myoclonic
Phases of generalised seizures
    Aura- a pre seizure even, olfactory, auditory, visual etc.. 1/3 can describe it.
   Tonic- rigidity of antigravity muscles
Flaccid body, loss of consience, pupils dilated, pale face, automation of bladder and bowel.
   Clonic- rythmic muscular contraction.
   Postictial phase- headache, confusion, loss of bladder and bowel control.
    
Partial
    - simple partial - without loss of consience.
    - complex partial- loss of consience, but localised seizures. They arise from temporal lobe.

How to overcome social anxiety

   
       We are all afraid, some more than others, we are afraid to initiate a conversation, to stand up on the stage and speak, to stand up for things we believe in or even be a little different from the crowd.
      We believe we are judged, constantly in everything we do, everything we say, sometimes we are, but most often what we don't realise is people are usually so preoccupied with themselves, that, they just don't care.
       How to overcome this fear of being rediculed or judged or being laughed at?

          The answer is very simple and we all know it, "Practice", how did you overcome the fear of riding the bike? By beginning to ride it and you kept riding it everyday until one day it seemed like a child's play.
         That is how you overcome social anxiety do everything you fear, not necessarily the things that contradict your principles and things that you think will have bad consequences but do the little things you always wanted to do but was too frightned to Or do the most silliest thing you could think of, things that you think will embarrass you to death like dancing on the road , Laying down on the subway , asking for the phone number from a random hot stranger , just do it you will realise that nothing bad will happen, even if some people do judge, you will learn to shrugg it off.
         1)  Make a list of things that you have always wanted to do but was so frightned to.  Eg- Just go say that you are in love with your crush today.

          If keep doing those things you are scared of everyday you will eventually get used to  facing your fears, you will be liberated from your confirmist prison. You will soon understand fear is just a thron sticking on the foot, might neva leave you unless you decide to throw it away.

                                

           
      
   

What are febrile sizures?

Yesterday my little nephew had a seizure and my brother in law a doctor himself went ape shit in anxiety he had no idea what to do, I mean if a seizure attack on his kid can scare a doctor, empathise the state of the non doctor parents, who have no idea that febrile seizure don't necessarily have to be serious.
  Steps
-wait for the seizure to subside.
- take him to a doctor.
They occur in 3-5 percent children, so not very rare.

Things you might need to know.

        Febrile (fever) seizures
     Seizures occurring  in a child between the ages of 6 mts to 5 yrs in absence of infection to the brain in a neurological (no mental defects) normal child.

Simple febrile seizures
          Single per febrile episode, convulsions are usually generalised ( involves the whole body)  occur within 24 hrs after onset and episodes last for less than15 mins.

Atypical febrile seizures (complex)
       These can precipitate multiple febrile seizures can cause neurological defects in the child, can be determined based on history.

Treatment
      Antipyretic medication to reduce fever,
Maintain airway breathing circulation, in prolonged seizures (complex), iv hydration to bring down temperature, and anti seizure medication, diazapam - 0.2/ .3 g/kg  can be given.

Differntiation from meningitis or enchaphalitis (hib and pneumococcus)
       Lumbar puncture
Indications
      Child less than 1 yr
      Not immunised
      Improper immunization history.

       

Mountains

How to not be lazy

         Laziness is a habit that is extremely difficult to overcome especially when the things you have to do keep piling up, and pressure seems to be raising, but you just can't move your ass and start doing something.
Is will enough?
    We all know the saying "Where there is a will there is a way".
      But is sheer will and desire to get the job done enough to overcome laziness - read for your exam or reduce your weight or  finish the article...?
      If you ask lazy people like me it definitely is not enough. "Will" will only get you as far as intiating something but what will take you all the way?, we need more will to sustain will!!. how can do something when you lack inspiration, or the intrest?.

The bone theory
               Give yourself an attractive reward at the end of the particular session, the reward must be convicing enough that you will do anything to get it.

Plan
              For us lazy people following a plan is impossible that is why we should have multiple, fix a particular time say 12 pm and that is the time you are going to start working out, and set an alarm to do that, but if you fail have multiple backups at very short interval say 12.5 12.10 etc so you,  even with your extreme inability to move will loose against the constant push your plan is giving.

Mixer
                 You know how physical activities are planned as games when we were kids so as to make the activity more attractive?
Do that I.e mix it with something you like or will love to do,  join a tennis club if you like tennis instead of running on a tread mill, or make quiz cards to read if you like quizzes, write a blog on the medicine topic you have a test on tmmro ect...

The partner
                  Make it a group activity your partner/ partners can help you make the extra effort, and you can to the same thing to the other person.
              
     

         
        
      
  

Greatest anime charecters ever

Naruto uzumaki
- Naruto
       The ninja warrior who has a very troubled, Isolated childhood, grew up to be a kind yet strong Warrior, without loosing his childishness and curiosity in the process. Animes are incomplete without a love story, his onesided crush on Sakura which later is shown to be reciprocated is complicated by the love triangle with Hinata.

      
      

Kai

- Beyblade.

        This no nonsense bey blader is the coolest ever, a loner with a childhood of trauma, betrayal and fire of vengeance Kai was my childhood icon. This Dranser master is an epic beyblader too, usually losing to Tyson in little margins ( would have been a different story if I were the writer).

Goku

  -Dragon ball Z

            This might have come off as a huge cliché but I love Goku  too much to leave him off the list, the alien who saves the world everytime, the man with an enormous appetite is someone who never gives up no matter what. The bond he shares with his son, and his never give up attitude are highlights of his character.

Jirayah sense

- Naruto

           The perv sage is  funny yet talented, powerful yet gross, experienced yet  silly. This frog sage was the best thing that happened to Naruto, his death was one of the saddest scens in the show.

Team Rocket - Jessy and James

    - pokemon

             Team rocked made pokemon very intresting, I wanted to pick ash but ash has no complexity to his charecter, he is a goody goody small town kid with a thirst for glory like we haven't seen enough of this, but team rocket is another story, these comical villans with their strange sense of humour and idiotic pride and loyalty to team rocket are remarkable charecters. And small peeks in to lives of jessy and James were moving. The rapport they have with their pokemon is also extrodinary.

Hinata

   - Naruto

    This shy girl is one of the most complex charecters ever and she grows in to a beautiful woman, the love story with naruto is extremely magical.

Piccolo

   -dragon ball Z

      This green alien who was intially the bad guy later turning in to a good guy has nerves of steel and his ofcourse he being the orginal creator of the earth dragon balls makes him the coolest.

Seishū Handa

     -barakaman

       This no cool calligrapher who kicks an old guy in the nuts for being critical of his work, is forced  to move to remote goto islands by his father. And that is where the story starts and how the islands changes him and how he changes the island is the plot.

Brock

  - pokemon

       Is a awesome pakage of entertainment, this trusted friends with his onyx and cheesy ways is definite to bag a nurse joy some day.

Itachi

    - Naruto

     No one can forget Itachi, the brother who gives it all for sauske. The most powerful ichiha, has a frightning sense of duty which made him to kill his entire along with his parents.

   

           

Nephrotic syndrome

History:-
             Edema- around the orbits first then around the legs, ascites, and on the dependent parts of the body, hydrocele and hydrothorax.
        Decreased urine output.
        Infections
        Hypertension occurs if there is  significant lesions in glomerulus.
          
Signs-
      Massive proteinuria- 3 + TO 4+ ( 1 gm/m*2 per day)
      Hypoabuminemia ( less than 2.5 g/ dl)
      Hyperlipidemia
      Hematuria
      Hypertension.

Etiology:

    Idiopathic -90 percent
  Other causes are psgn, amiloidosis, lupus etc..

Types
   1) (Low molecular weight nephrotic syndrome)- (highly selective proteinuria) albumin
   2) (High molecular wt nephrotic syndrome)- globulin

1)Minimal change disease

2)Nephrotic syndrome with significant lesion.

    A) Steroid sensitive nephrotic syndrome.

   B) Steroid resistant nephrotic syndrome.

Pathology
      Obscure
Theories-  IgM mediated glomerular damage.
     Petrubance of cell mediated immunity causing damage to glomerular epithelium causing leakage.
    
Investigation-
       Proteinuria- 3+ TO 4+
       Hematuria - gross - significant lesions.
      Low serum albumin<1g/ dl
      White plasma due to hyperlipidemia ( due to increased production of beta lipoproteins by liver)
     IgG  reduced IgM elevated.

Tests
      Urine analysis
      Complete blood count
     Tuberculin test
      Anti streptolysin O
     Blood biochemistry- urea createnin, albumin, globulin, lipids.
     Anti nuclear antibodies- lupus
     C3.

Treatment-
       High protein diet
       Low sodium intake
       Decreased lipids intake.

    In case of significant edema
       Diuretics- furasemide (1-4 mg/ kg / day)
       Spirinolactone(2-3 mg/kg/day)
Steroid therapy- prednisone
    Prednisolone.
( 2 mg/kg for 6 weeks)
(1.5 mg/kg for next 6 w in alternate days as morning dose)

Parents- explain about the disease to parents and regular check for protein levels should be checked by them.

Relapse-
      Significant relapse 3- 4+ proteinuria
  2 mg/kg/ day till no protein can be found in urine for 3 consequtive days.
Then 1.5 mg/ kg for 5- 6 wks.

Steroid dependent-
      Low doses of steroids.
      Steroid sparring agents-
         Levamisol- 2.5 mg/ kg every alternative days, Till Steroid level is reduced to .3 - .5 mg/ kg. Continue for 6 mts then stop steroids.
  Side eff- leukopenia

Cyclophospomide- 12 wk course, side eff- leukopenia, vomiting.

Cyclosporin.

Steroid resistant-
   Prednisone + Cyclosporin alt days.

ACE inhibitors- enlapril -0.3 - 0.6 mg/ kg.

Complications of nephrotic syndrome-

Edema, steroid toxicity, thrombotic complications, infections, hypovolumia, acute renal failure.

      

    
     

     

    
     

Charecters you generally see in a men's hostel 2

1)The Mama boy
         This guy talks to his parents for days on the phone, sometimes skipping meals and classes, what he talks has always been a mystery.

2)The destroyer
         This guy loves breaking things, this mortal shiva performs his duty with such passion and integrity that he does it without realising he is doing it.

3) The prey and the predator
            They are a pair and cannot work without eachother, they under isolated circumstances are very normal, but when they come in come in contact with eachother there is a shift in their anatomy, the predator automatically climbs up to fuck, and the prey bends down to make way.

4)  The romantic hero
           He is either seen roaming the college streets with a girlfriend or mutiple at times/ the city streets with a few chikas. When in hostel (accidentally) buries his head in his phone constantly messaging the lady love.

5) The farmer
           This lazy prick is an amateur botanist, who has every variety of fungi and algae in his room.

Charecters you generally see in a men's hostel.

Charecters you generally see in a men's hostel.
    ( a different perspective)

1) The loud speaker.
              These guys thrive on gossips, they like to entertain people with stories, as long as the stories are not about you, you are sure to be entertained. Beware some of these might be pure fiction so do not try them at home.

2) The chimney

       Just make sure you wear goggles before you get to his room. Have the fire department in speed dial and rock on.

3) The vegetable

         He gets out of his coma once in 3 months, if you are lucky you might see him out once in your lifetime. How he survives without eating is what has puzzled many scientists for years!!

4) The freeloader

         This guy could teach you how to eat for an entire month without a single rupee. This under rated economist is sure to shed some of his wisdom in your time of need.

5) The nightcrawler

           These are creatures of the night, and like vampires they have very sensitive skin which burn when exposed to sunlight.

6) The grinder

       These people can eat literally eat anything, anytime, anywhere. The freeloaders usually wait near them for the leftovers.

7)  The observer

          He just usually stares.  You smile he stares,  you goof, fall, talk, shout, he will stick to staring, he observes your primitive primate behaviour and is amused by it.

         

8) The burner

       This guy knows how to burn money, he will spend 10, 000 rs of his money, get your money, then from a couple of other friends  and spend it all in a day. Becoming a temporary freeloader and till someone loans him some money which he could burn.

9) The DJ

       This guy will have  5.1 speakers, will add additional 2 more to his collection and turn the music volume to loudest possible limits, will keep his doors open so everyone can have fun hearing his stitty music at 2 in the morning. You can't complain because that is how democracy works.

10) The Coven

       This is an interesting group of people which is usually brought together by a singular interest or purpose, they are sure to never separate, they eat together, sleep, drink, even go to the loo together.