STENCILDENT

                   AGRANULOCYTOSIS Lack of granulocyte  Absolute neutrophil count (less than 100 per microliter) Rare condition Suppressed immune system CAUSES: May be inherited or genetic Drugs: Anti-thyroid ,Anti-psychotic ,antibiotic Exposure to toxic substance such as ARSENIC ,MERCURY Aplastic anemia SYMPTOM : Sore throat and mouth Fever ,chill Fatigue  Headache Sweating  Swollen gland RISK: If left untreated result in sepsis Male and female both at equal risk Certain drug  DIAGNOSIS: Blood test Neutrophil count less than 100 per microliter of blood Bone marrow biopsy TREATMENT: Change of drug Transfusion of granulocyte 

                        PRESSURE SORE: INTRODUCTION: PRESSURE SORE IS ALSO KNOWN AS:  BED SORE/DECUBITUS ULCER   Trophic ulcer with underlying bone as base Non -mobile ,deep ,punched out ulcer Common in : Old age Tetanus Diabetic  Comatose patient Anemia Emaciated patient BED RIDDEN INDIVIDUAL  SITES: Occiput Heel  Sacrum Scapula Elbow Buttock PREDISPOSING FACTOR: Malnutrition Anemia Excessive sweating Edema Incontinence-skin moist, septic Friction due to foreign body, bed sheet  Superficial bed sore 75%common  Deep bed sore is painless and covered with slough TREATMENT: Change of position in bed Use of water bed ,ripple bed Bed-smooth, free from wrinkles Skin-dry, clean, washed with soap Ripple bed-alternate pressure point pad under bottom sheet of ordinary mattress Urinary incontinence- specialized silicone bed clothes Good nursing ,regular dressing  Good nutrition is necessary Antibiotics ,blood transfusion are very essential as per need Excision of dead tissue followed by skin graf

                      INTERNAL JUGULAR VEIN  Direct continuation of sigmoid sinus Extent: From jugular foramen -end clavicle along with subclavian ends at brachiocephalic vein ORGIN: Superior bulb in jugular fossa of temporal bone TERMINATION: Inferior bulb in supraclavicular fossa RELATION: SUPERFICIAL: Sternocleidomastoid Posterior belly of digastric Superior belly of omohyoid POSTERIOR: Atlas Cervical plexus MEDIAL: Internal carotid Common carotid Vagus TRIBUTARIES: Lingual vein Pharyngeal vein  Superior thyroid Middle thyroid Thoracic duct open into union of left internal and left subclavian -right duct In middle of neck internal jugular communicate with external jugular  APPLIED ANTOMY: Deep to supraclavicular fossa internal jugular can be easily accessible for recording venous pressure During cardiac failure :venous pressure increases internal jugular gets inflated  

                                     CYTOKINES  INTRODUCTION: Cells communicate at molecular level by cytokine Paracrine function: released peptide and other molecule Soluble protein SECRETD BY : Hemopoietic  Non-hemopoietic cells in response to various stimuli ROLE: Activaton of immune system  PROPERTIES EXHIBITED: PLEIOTROPHIC: One cytokine act on different cell type REDUNDANCY: Similar function by different cytokine Cascade induction: one cytokine stimulate its target cell to make another cytokine SYNERGY: Combination cytokine result in combined effect  CATEGORIES: INTERFERON-involved in antiviral response  INTERLEUKIN-produced by one leucocyte, act on other TUMOUR NECROSIS FACTOR TRANSFORMING GROWTH FACTOR COLONY STIMULATING FACTOR-support growth of blood cell GROWTH FACTOR Growth factor and other cytokine -CRINOPECTIN Cytokine involved in leukocyte endothelial cell interaction -CHEMOKINE  INTERLEUKIN: About 35 interleukin been identified  Example : T-Cell secrete -INTERLEUKIN -2 a

                          TRACHEOSTOMY INTRODUCTION: Tracheostomy is making an opening in anterior wall of trachea and covering it into stoma on skin surface Types:  Emergency tracheostomy, Elective tracheostomy Permanent tracheostomy Mid tracheostomy ideal, commonly used through 2nd and 3rd rings behind isthmus Tracheostomy tubes are made of plastic ,soft ,least irritant and disposable  They have inflatable cuff, should be deflated at regular interval to prevent -tracheal necrosis due to pressure FUNCTIONS: Respiration through alternative pathway in case of obstruction above the stoma Protection of airway from: aspiration of pharyngeal secretion in comatose patient  Blood due to injuries in pharynx ,larynx INDICATION: RESPIRATORY OBSTRUCTION: Infection- Ludwig angina, Peritonsillar infection Tumor Trauma to larynx, trachea RETAINED SECRETION: (Inability to cough) Comatose patient Painful cough -trauma to chest RESPIRATORY INSUFFICIENCY: Chronic lung conditions: Emphyema bronchiectasis

                           DERMOID CYST Dermoid cyst is lined by squamous epithelium containing  desquamated cells Origin :Face is developed from five processes two maxillary, two mandibular and 1 frontonasal process. Dermoid cyst occurs in the line of embryonic fusion of these processes. STUDENTS CORNER: lets see how to approach this question better here you go start with a small introduction to the topic, mention few common sites where dermoid cyst can usually occur in order to remember that here is pneumonic "SERF" where S- Sublingual dermoid, E-External angular dermoid, R-Root of nose, F-Forehead,  followed by listing out different clinical type of dermoid cyst, clinical features ,differential diagnosis and end it of with treatment options . Common sites:  Forehead External angular dermoid Root of nose Sublingual dermoid  CLINIAL TYPES OF DERMOID CYST: 1)CONGENITAL /SEQUESTRATIN DERMOID: They occur along the line of embryonic fusion ,due to dermal cells being buried in de

  With heavy heart I am writing this blog to you all ,my dear stencildent family member’s, never did I imagine I will have to create such a blog post that to on INDIA 78th INDEPENDENCE day . Yes not denying the fact that India is such a beautiful country to live in ,with vivid colourful places ,vast cultural diversity,  different languages all  over and yet united by one that’s our HUMANITY ,it’s time ,that has tested our humanity again that made me write this post to remind few things : 1)Do we respect each and everyone around us ?(MATHA ,PITHA,GURU,DHEIVAM) 2)Do we create a peaceful environment for people to live in, work in at peace ? 3) Do we follow these lines INDIA IS MY COUNTRY AND ALL INDIANS ARE MY BROTHERS AND SISTERS? wasn’t all these question raised and educated to us right at school, college or from our parents ,grandparents . If we were educated these basics well ahead then how come certain section of men still find faults in the way women dress up ,the way women speak ,t