Epidemiology of Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a type of interstitial lung disease (ILD) classified under idiopathic fibrotic disorders of the lung. It is the most common type of ILD presenting clinically in the seventh decade of life, almost always at the later stage of illness, attributed to its earlier nonspecific presentation. The term IPF is used when no specific cause for pulmonary fibrosis is identified. Initially described in 1944, recent advances in lung biopsy and pathology have described the disease in detail. This led to further classification of ILD. Also, there have been multiple recent studies indicative of an increased incidence. However, accurate epidemiological data for IPF is minimal, with some being contradictory. Inconsistency in the case definition criteria and methodology has resulted in epidemiological inaccuracy when used to detect patients in the study population. To avoid inaccuracy American Thoracic Society collaborated with the European, Japanese, and Latin American Thoracic Society to arrive at a consensus resulting in 2010 IPF evidence-based guidelines. Notable epidemiological differences are observed in the European, American, and Asian countries. Some countries have set up national registries to collect essential patient data for future studies and comparison with other countries. In this topic, we try to glean over the epidemiology of IPF

Diagnosis of Pulmonary Embolism

Pulmonary embolism is an acute emergency due to the occlusion of the pulmonary arteries by a venous blood clot. The pathophysiology of pulmonary embolism follows Virchow\u27s triad, which encompasses stasis in veins, increased coagulation, and vessel wall trauma. Pregnancy, major trauma or surgery, prolonged immobilization, obesity, medication, and inherited risks are important risks. It is an essential rule-out diagnosis in chest pain and dyspnea patients in the emergency room. It is also responsible for significant mortality if not diagnosed and treated promptly. Physicians utilize multiple algorithmic scores and calculators to supplement diagnosis along with a high degree of clinical suspicion at initial presentation. Clinical diagnosis involves utilizing multiple modalities, including D-dimer, troponin, arterial blood gas analysis, electrocardiogram, bedside echocardiogram, and imaging modalities such as venous duplex, chest computed tomography, ventilation-perfusion scans, and pulmonary angiogram. Some imaging modalities carry the risk of radiation and being invasive. The treatment can itself be short-term or lifelong based on the causative factor. Anticoagulants used in the therapy can itself cause devastating complications if not monitored appropriately. Despite adequate treatment, some of these patients progress to chronic disease resulting in secondary pulmonary hypertension

Potassium Homeostasis

The average potassium intake in the United States population ranges from 90 to 120 mEq/day. About 98% of the total body\u27s potassium is intracellular, and only 2% is present in the extracellular compartment. This distributional proportion is essential for cellular metabolic reactions and maintaining a gradient for resting membrane potential. A loss of this gradient results in hyper- or hypopolarization of the cell membrane, especially in cardiac muscles leading to life-threatening arrhythmias. Multiple mechanisms in human maintain homeostasis. Transient initial changes are due to transcellular shifts activating sodium-potassium ATPase pumps on the cell membrane. The kidneys essentially take part in excess potassium excretion, maintaining total body stores constant within normal range. Gastrointestinal secretion of potassium is insignificant in individuals with normal renal function, however plays an essential role in individuals with compromised renal function. So far, a classic feedback mechanism was thought to maintain potassium homeostasis; however, a recently recognized feedforward mechanism acting independently also helps preserve potassium homeostasis. Hence, potassium homeostasis is vital for humans to function at a normal level

A CASE OF PRIMARY SJOGREN`S SYNDROME WITH DISTAL RENAL TUBULAR ACIDOSIS PRESENTING AS HYPOKALEMIC PARALYSIS

Renal tubular acidosis secondary to autoimmune interstitial nephritis is quite common in patients with Sjogren`s syndrome. Here we present a case of 24 year old female who presented with Acute Hypokalemic Quadriparesis and was later diagnosed with distal RTA. Patient did not have features of xerostomia or xerophthalmia but was diagnosed to have Primary Sjogren`s syndrome fromserological findings,in this case renal involvement preceded subjective Sicca syndrome.Patient recovered after giving i.v potassium. Patient was treated with corticosteroids and is asymptomatic during the one year follow up period

Vehicle Health Monitoring System Using ARDUINO and IOT

The paper portrays the execution of a model framework utilized for effective constant information securing, motor warming and blockage of fuel pipe. Legitimate vehicle observing and support can spare time, cash and enhance the possession encounter. Our framework takes a shot at Arduino and IoT stage used to separate different parameters like motor warming and blockage in fuel pipe and so forth for protected and cautious driving. The information is sent to IoT which can be checked both by vehicle producer through distributed computing and proprietor of the vehicle by the android application. The equipment unit comprises of Arduino, WI-FI module, android based portable and distinctive parameter checking sensors module

Bactericidal and Bacteriostatic Antibiotics

Of all the medications available to physicians worldwide, antibiotics play an essential role in inpatient and outpatient settings. Discovered in the early nineteenth century by Alexander Fleming, penicillin was the first antibiotic isolated from a mold. Dr. Gerhard Domagk developed synthetic sulfa drugs by altering the red dye used in chemical industries. Since then, multiple antibiotic classes have been discovered with varying antimicrobial effects enabling their use empirically or in specific clinical scenarios. Antibiotics with different mechanisms of action could be either bactericidal or bacteriostatic. However, no clinical significance has been observed between cidal and static antibiotics in multiple trials. Their presence has led to safer deep invasive surgeries, advanced chemotherapy in cancer, and organ transplantation. Indiscriminate usage of antibiotics has resulted in severe hospital-acquired infections, including nosocomial pneumonia, Clostridioides difficile infection, multidrug-resistant invasive bacterial infections, allergic reactions, and other significant side effects. Antibiotic stewardship is an essential process in the modern era to advocate judicial use of antibiotics for an appropriate duration. They play a vital role in medical and surgical intensive care units to address the various complications seen in these patients. Antibiotics are crucial in severe acute infections to improve overall mortality and morbidity

Enumerative checklist of pteridophytes from Satara district (MH), India

A checklist of pteridophytes from Satara Dt. (Maharashtra, India) presented 85 species of pteridophytes belonging to 39 genera under 26 families are listed. The most specious families found in Satara district are Pteridaceae, Ophioglossaceae, Adiantaceae, Lomariopsidaceae and Woodsiaceae followed by Polypodiaceae, Dryopteridaceae, and Davalliaceae. The most common species are Adiantum philippense, Actiniopteris radiata, Aleuritopteris bicolor, Pteridium revolutum, Pityrogramma calomelanos, Pteris biaurita, P. vittata, and Tectaria coadunata

Effect of nutrition on copper and zinc concentrations in human milk

Background: The gross composition of human milk is remarkably constant among women of varying nutritional status. Reliable information is now available on the content, and the principal factor affecting it, of most of the trace elements on human milk. However, for some of the trace elements, there is still a wide variation in reported values in the literature, which is due at least in part, to analytical difficulties. Hence this study was taken up to find out if maternal nutritional status influences the copper and zinc concentrations in colostrum of mother.Methods: Total of 100 mothers were enrolled in the study after obtaining prior informed consent. They were divided into 2 groups - group I had 50 malnourished mothers and group II had 50 well-nourished mothers. Sample digestion was attempted with different quantities of various acids. Analysis of digested colostrum was carried out for copper and zinc.Results: The mean levels of copper and zinc were slightly more among well-nourished than malnourished women. Values of copper were significantly higher in the colostrum of well-nourished as compared to that of the malnourished mothers.Conclusions: The parameters of weight, height weight/height ratio and hemoglobin varied significantly between the well-nourished and malnourished mothers. The difference in milk content of malnourished and well-nourished mothers is not significant for zinc. However, copper levels were significantly higher in well-nourished mothers

Giant Gastrointestinal Stromal Tumor Presenting as a Palpable Abdominal Mass: An Unusual Presentation

Gastrointestinal stromal tumors (GIST-) account for the majority of mesenchymal tumors arising within the gastrointestinal tract. GIST presenting as a palpable abdominal mass is extremely rare. We report four additional cases of a GIST presenting as an abdominal mass along with a pertinent review of the literature. Twenty five cases of GISTs presenting with an abdominal mass, including 4 cases discussed here, have been reported in the world literature since 2001. The mean duration of symptoms was 152.7 days. Twenty one of 25 (84%) patients received surgical resection. The mean tumor size was 17.2 cm, with an average mitotic index of 7.6 per 50 high power fields. Thirteen of 14 (92.9%) patients had a high-risk tumor. Five patients were disease-free at a mean followup of 11 months, 2 patients had stable disease and 2 patients had progressive disease, and one patient had a partial response. In conclusion, symptomatic patents have an increased incidence of high-risk tumors and metastases at presentation. Adjuvant therapy with imatinib improves disease-free survival in patients with large abdominal GIST tumors, but no change in overall survival was noted. Finally, GISTs should be considered in the differential diagnosis of an abdominal mass in an elderly patient

Review on the genus Tectaria Cav. from India

The fern genus Tectaria Cav. (Tectariaceae) is one of the largest, morphologically diverse and more complex genera having difficulties in identifying the species and their groups. Since its description, a number of new genera had been separated from it or merged within it created considerable ambiguity. Thus, the main aim of the present review is to provide comprehensive information of the taxonomy, cytology, anatomy, palynology and molecular research carried out so far on the genus Tectaria. Present work is not merely compilation but includes personal observations and is presented here after critical evaluation