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Case-01 : Case Study on Hypothyroidism

 Case-01 : Case Study on Hypothyroidism

Introduction to Hypothyroidism

Hypothyroidism is a condition where the thyroid gland doesn't produce enough thyroid hormones. These hormones are crucial for regulating metabolism, energy production, and many body systems.

Specialist : Endocrinologist

Patient Details :

  1. Name : 
  2. Age : 
  3. Gender : 
  4. Occupation : 
  5. Height :
  6. Weight : 

Present Complaints : 

  • Headache
  • Cold to intolerance
  • Dry skin
  • Weight gain
  • having Hypothyroidism since 6 years and using the tablets levothyroxine 100mcg

Past Medical History :

  • History of thyroid disorder in the family

Physical Examination : 

  • Vital Signs : Normal
  • puffy face 
  • dry skin
  • No visibility of thyroid gland

Investigations : 

Thyoid Stimulating Hormone ( TSH )

Diagnosis :

Hypothyroidism : indicated by high TSH, low T4.

Treatment Plan :

Levothyroxine 137mcg tablet orally once a daily for 60 days 

Education :

  • Stress Management
  • Regular exercise
  • Low calorie foods
  • High fiber diet

Diet advise : 

  • Avoid deep fried foods
  • Avoid cold and frozen items.
  • Consume less sugar foods.
  • Consume zera water to increase BMR rate
  • Avoid cabbage

Follow up : 

  • Next consultation after 2 monts with TSH report

References : 

1. American Thryoid Assosication Guidelines 

2. Mayo Clinic 

3. Harrisons Principles of Internal Medicine

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Pregnancy Workouts

Pregnancy Workouts

That exercise is vital to a pregnant woman’s health is now a well-recognised fact. Good muscle tone, healthy joints and general fitness help carry the pregnancy, ease labour and maintain good post-natal health.

Your doctor can provide exercise guidelines based on your medical history and level of risk.

Benefits of Exercise

  • Promotes muscle tone, strength and endurance

  • Improves posture

  • Improves emotional health

  • Helps you sleep better

  • Prevents backaches

  • Keeps you active and energised

  • May prevent gestational diabetes

  • Helps quick recovery from labour and delivery

EXERCISES YOU CAN DO

SHOULDER ROTATION

Shrug your shoulder upwards, hold for a few seconds and then relax.
Bring your shoulders forward and then rotate them up towards your ears and then back down. This is like making small circles with your shoulder in both clockwise and anti-clockwise directions.

NECK EXERCISE

Gentle relaxing neck movements are important. Sit in a relaxed position.
Now, move your neck up, down and to the left and right.

BREATHING EXERCISES

These help you relax and, in some cases, lower your blood pressure. During pregnancy, deep breathing exercises help your circulatory system work more effectively, which can help your body manage swelling and congestion.

DEEP BREATHING

Sit in a comfortable, supported position. Now, place one hand on your abdomen and inhale deeply through your nose, fully into your abdomen. In case you have nasal congestion, you can breathe in through your mouth. Remember that your abdomen should move outward as you inhale.
If you notice that only your chest is moving, then you aren’t inhaling deeply enough.
Slowly exhale through your mouth as your abdomen returns to its normal position.

PELVIC TILT

Stand straight with your back to the wall and relax your spine.
Breathe in deeply and press your back against the wall. Exhale and repeat. Continue the exercise for about five minutes. Do pelvic tilt exercises many times through the day.

SQUATTING

This is especially useful during the first trimester of pregnancy.
Lean against the wall and stand with your feet spread. Now, lower your body by bending your knees. Pause, then slowly push yourself back to the starting position.

SIT AND CYCLE

Sit on a chair, lift a leg and cycle 20 times. Repeat with the other leg.
In case you have difficulty doing this exercise as your trimester progresses, you can switch to horizontal cycling. Lying down on the mat or bed, you can air cycle with both the legs.

Pregnancy Exercises

WALL PUSH-UPS

Stand facing a wall. Now lean against the wall with your hands. Keep your knees comfortably apart. Place your hands on the wall at the level of your shoulders, slightly greater than shoulder-width apart. Slowly bend your elbows and lower your chest until your chin reaches the wall. Remember to keep your back straight and then return to the starting position.
Wall push-ups engage the triceps and pectoral muscles.

PELVIC BRIDGING

Lie face up on the floor with your knees bent and your feet flat on the floor. Now raise your hips so your body forms a straight line from your shoulders to your knees. Pause for a couple of seconds and lower your body back to the starting position.

BACK PRESS

Lie face up on the floor with legs straight. Roll a small towel and keep it under your lower back.
Now bend your knees and try to press your back against the towel. Hold this position for a few seconds and then relax.

CALF STRETCH

As your pregnancy progresses, your legs may get tired easily. With calf stretches, you can maintain good circulation in your legs.
Sit with your legs stretched out. Hold two ends of a long towel with both your hands and use the towel to pull your feet towards you.
You feel a stretch in your calf muscles. Hold this position for a few seconds and relax.

SIDE RAISES

Lying on your side, lift your leg and bring it down. Repeat on the other side.

KEGEL EXERCISE

Lie down on a flat surface. Bend both knees slightly and place a pillow between your thighs. Imagine you are trying to stop the flow of urine. When you do this, you are contracting the muscles of the pelvic floor.
Try to keep your leg, buttocks and abdominal muscles as stable as possible. You can do the same exercise in a sitting position. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax.
Kegel exercises help strengthen your pelvic floor muscles, which support the uterus, bladder, small intestine and rectum.

Always remember to drink plenty of water to stay hydrated during these exercises. Consult your doctor to discuss your workout plan. A regular workout plan goes a long way to ensure good health during and after pregnancy. Let go of all your worry and stress. Focus on enjoying this season of life. Happy pregnancy!

Reference :

  • By Dr. Roopa Menon is a Mumbai-based health writer.

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Infection control guidelines for handling blood & body fluids spills

Infection control guidelines for handling blood & body fluids spills

1. Types of spills

a. Major spill:

If spill blood/body fluid quantity is >30 ml, it should be considered as a major spill.

b. Minor Blood spill:

If spill blood or body fluid quantity is <30 ml, it should be considered as a minor spill.

2. The content of the spill:

Sputum, vomit, stools, urine, blood, or laboratory culture.

3. Whom to contact in case of spill:

a. In case of minor spill
Concerned department nursing staff should instruct housekeeping staff to wear PPE and clean the spill area with 1% Sodium hypochlorite added solution.

b. In case of major spill
In-charge nurse should inform the HAZMAT team.

4. Members of the hazmat team:

  • Floor administrator

  • Floor Housekeeping supervisor

  • Infection control nurse

  • In charge nurse

  • Shift in charge nurse

  • Ward boy

5. Contents of Spill kit

  • Gloves

  • Gown

  • Face mask

  • CAP

Universal Standard Precautions

For Infection Control

  1. Hand Hygiene

  2. Personnel Protective Equipments

  3. Safe Handling and Disposal of Sharps

  4. Follow needle stick injury protocol

  5. Safe Handling and Disposal of Wastes

  6. Managing Blood and Body Fluids

  7. Disinfection of the Equipments

  8. Environmental Disinfection

  9. Immunization

  10. Isolation

Hand Hygiene :

Hand wash/hand rub is the most effective way to prevent the spread of infections in hospitals:

  • Before and after each patient contact

  • Before and after any procedure

  • Before and after wearing gloves

  • After contact with body fluids

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beacon

List Of High Alert Medications

LIST OF HIGH ALERT MEDICATIONS

  • LEVOSIMENDAN

  • DOPAMINE

  • DOBUTAMINE

  • ADRENALINE

  • ISOPRENALINE

  • NOR-ADRENALINE

  • DIGOXIN

  • MILRINONE

  • THEOPHYLLINE

  • INSULIN

  • DILTIAZEM

  • VERAPAMIL

  • FLECAINIDE

MODERATE SEDATION AGENTS

  • MIDAZOLAM

  • DIAZEPAM

  • LORAZEPAM

NARCOTICS / OPIATES, IV AND ORAL

  • FENTANYL

  • MORPHINE

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beacon

Prolactin Hormone Test Normal Values - Hormones

 Prolactin Hormone Test Normal Values - Hormones

  • Prolactin Normal Values : 4.79 – 23.3 ng/mL

Reference Ranges :

  • Pre-menopausal females: 3.3 – 26.7 ng/mL
  • Pregnancy: 9.7 – 208.5 ng/mL
  • Post-menopausal females: 2.7 – 19.6 ng/mL
  • Males: 2.6 – 13.1 ng/mL

Possible Reasons for Elevated Prolactin:

  • Physiological causes: stress, sleep, physical activity, sexual activity, nipple stimulation
  • Pathological causes: pituitary tumors (e.g., prolactinoma), hypothyroidism, PCOS
  • Medications: antipsychotics, antidepressants, antiemetics
  • Macroprolactin: biologically inactive prolactin complex (suggested if symptoms are absent)

Videos : 



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Bedsores (Pressure Ulcers) - Symptoms, Grades, Complications and Treatment

 Bedsores ( Pressure Ulcers )

Introduction

Damage of skin and under laying tissues.

Places : 

heels, elbows, back of the herd, tailbone(coccyx).

Bedsore Grades : 

4 levels.

Grade 1 :

Skin discoloration(red, blue, purple, black)

Treatment : symptomatic Treatment

Grade 2 :

Some skin loss / damage to top layers. 

Treatment : Dressing

Grade 3 :

Necrosis(death) or damage to the skin path. limited to the skin layers. Blister Formation.

Grade 4 :

Necrosis (death) or damage of skin patch and underlying structures. 

Treatment : Antibiotic

Example : Tendon  joint or bone

COMPLICATIONS:

1) sepsis (Bacteria entering into blood stream)

2) Cellulitis (Inflammation of body tissue causing swelling and  redness.

3) Bone and Joint Infection.

4) Abscess (A collection of pus)

5) Cancer (Squamous cell carcinoma)

Treatment :

Position change : 2nd

Daily skin care : keep skin moisture

Nutritious diet : Protein, vitamin A, vitamin C, Zinc.


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Suture Removal Duration

 Suture Removal Duration

Scalp 5 days

Face 3 to 5 days

Neck 5 to 7

Arms 7 -10

Leg 10 -14

Trunk 10-14 

Thorax 10 to 12

Joints 14 dyas

Abdomen 12 to 14

palm and soles 14 to 21 days


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Medical Paint

Medical paint 

          Medical paint is different from normal paint. It applied in the wall of the particular rooms especially in clean room. It has contain various features from normal paint. It main function is to protect from the Infection in particular area.

Features : 

  • Nonporous and easy for cleaning
  • Moisture Resistant
  • Anti-bacterial
  • Anti fungal
  • Smooth
  • Has no crevice or seams
Recommended Use :
  • Interiors of Hospitals
  • All health care facilites
  • Hotesl
  • Schools
  • Washrooms
  • Kitchens
  • Living Rooms

Refferences :

  • https://www.jotunprofessionals.com/me/en/b2b/project_solutions/health_care/index.html
  • MOH UAE Outpaint Checklist

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