Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD)
A common, chronic condition, often associated with marked anxiety and depression, characterized by obsessions and compulsions. Obsessions/compulsions must cause distress or interfere with the person's social or individual functioning (usually by wasting time), and should not be the result of another psychiatric disorder. At some point in the disorder, the person recognizes the symptoms to be excessive or unreasonable.

Clinical features
Checking (63%), washing (50%), contamination (45%), doubting (42%), bodily fears (36%), counting (36%), insistence on symmetry (31%), aggressive thoughts (28%).

Mean age: 20 yrs, 70% onset before age 25 yrs, 15% after age 35 yrs. Sex distribution equal. Prevalence: 0.5 2% of general population.

Avoidant, dependent, histrionic traits (-40% of cases), antistatic / obsessive-compulsive traits (15%) prior to disorder. In schizophrenia, 45% of patients may present with symptoms of OCD schizo-obsessive's poorer prognosis). Sydenham chorea (up to 70% of cases) and other basal ganglia disorders (e.g. TS, post-encephalitic parkinsonism).

Co morbidity
Depressive disorder (70%), alcohol- and drug-related disorders, social phobia, specific phobia, panic disorder, eating disorder, tic disorder (up to 40% in juvenile OCD) or TS.

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Paralytic ileus

Paralytic ileus
Paralytic ileus
Paralytic ileus
Paralytic ileus is a state of atony of the intestine.

Clinical features,
        - Abdominal distension without any pain
        - Vomiting (Effortless)
        - Absolute constipation
        - No platus

        - Sepsis of Peritonitis
        - Hypokalaemia (reduced K ion)
        - Uremia
        - Diabetic coma
        - Excessive bowel handling
        - Abdominal trouma
        - Prolong hypotension
        - Prolong pypoxia
        - Immoilization
        - Opioid drugs

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Correct way to taking blood pressure.

Correct way to taking blood pressure.
First of all we must use a properly calibrated machine. (Mercury column spectrophotometer)

Step 1
The blood pressure is taken in the (right) arm with the patient relaxed and comfortable.

Step 2
The spectrophotometer cuff is wrapped around the upper arm with the inflation bag placed over the brachial artery.

Step 3
The cuff is inflated until the pressure exceeds the arterial pressure when the radial pulse is  no longer palpable.
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