Medical science

            ⭐⭐ CONSTIPATION ⭐⭐ 1) DEFINITION OF CONSTIPATION :-     Any 2 of the following criteria should be     present for >12 weeks :-      (a) Less than 3 defecations in a week     (b) Straining for > 25% defecations     (c) Hard stools for > 25% defecations     (d) Sense of incomplete evacuation for         > 25% defecations     (e) Sense of anorectal blockade for          > 25% defecations     (f) Digital evacuation of stools (by           fingers) for > 25 % defecations.           ⭐ There are no loose stools in                        constipation⭐                                      ⭐⭐⭐⭐⭐⭐⭐ 2) CAUSES OF CONSTIPATION :-      (a) Acute causes :-                                              (I) Dehydration :-             Water in the stool makes it softer            and helps it to pass more smoothly.            When there is dehydration, stools             become dry and hard .             Hence, dehydration is a common            cause of constipat

           ⭐⭐ HYPERTENSION ⭐⭐ 1) DEFINITION OF HYPERTENSION :-      Blood pressure that is higher than normal is known as Hypertension.                   ⭐⭐⭐⭐⭐⭐ 2) CRITERIA OF HYPERTENSION :-    (a) Above 60 years - There is      hypertension if       Systolic BP > 150 mm Hg       Diastolic BP > 90 mm Hg    (b) Below 60 years - There is       hypertension if       Systolic BP > 140 mm Hg      Diastolic BP > 90 mm Hg    (c) Above 18 years with diabetes or     Chronic Kidney Disease - There is      hypertension if      Systolic BP > 140 mm Hg     Diastolic BP > 90 mm Hg ⭐ White coat hypertension - BP rises in hospital. Take readings at home. (Occurs due to anxiety & increased sympathetic response in hospital) ⭐ Isolated ambulatory or masked hypertension - BP is normal at hospital but more at home. Such patients have risk of organ damage. ⭐ Paradoxical hypertension - Paradoxical rise of BP in patients taking antihypertensive drugs.  In patients with diabe

             ⭐⭐ ANAL FISSURE ⭐⭐                   ( FISSURE - IN - ANO )  EAS - External anal sphincter  IAS - Internal anal sphincter 1) DEFINITION OF Anal fissure :-      Anal fissure is a small, superficial ulcer  present along the longitudinal axis of lower part of anal canal. It can be present in the midline, posteriorly, or anteriorly. Anterior ulcers are more  common in females.                    ⭐⭐⭐⭐⭐ 2) EXTERNAL ANAL SPHINCTER ANATOMY :-  Three parts :-    (a) Deep part - It encircles the upper end     of anal canal. There is no bony                     attachment.    (b) Superficial part - It is attached     posteriorly to coccyx & anteriorly to    mid perineal point in males & to vaginal    sphincter in females.    (c) Subcutaneous part - It encircles the     lower part of anal canal. There is no     bony attachment.                     ⭐⭐⭐⭐⭐ 3) INTERNAL ANAL SPHINCTER ANATOMY :- It covers upper two third of anal canal. It  is formed by thick

               ⭐⭐ JAUNDICE ⭐⭐ 1) DEFINITION OF JAUNDICE :     # Jaundice is yellowish discoloration of       skin, mucous membrane and sclera        due to increased bilirubin.     # Sclera is yellow because it contains        large amount of elastin which has high        affinity for bilirubin.     # Normal bilirubin = 0.5 - 1.2 mg/dl        Clinically evident jaundice -        when bilirubin > 2.5 mg/dl  ⭐ NOTE ⭐-             # Urobilinogen is colourless. It gets             converted to urobilin which is              yellow coloured.            # Bilirubin - yellow             coloured            # Conjugated bilirubin - water              soluble            # Unconjugated bilirubin - not water              soluble.                            ⭐⭐⭐⭐ 2) NORMAL BILIRUBIN METABOLISM :-                     Red cell lysis                              |                         Haeme                              |          Bilirubin ( indirect or unconjugated)