Arthritis

Arthritis:
Arthritis is a medical condition that causes swelling and joint pain and it means any disorder that affects joints. There are more than 100 different kinds of arthritis and the most common are osteoarthritis, rheumatoid arthritis and psoriatic arthritis. Arthritis usually happens during wear or tear, or some immune system problems.

What is a joint?
A joint is a part of your body which makes the connection between two bones, for instance, the hip bone and the lower leg. An elbow is also a form of joint (hinge joint) which is very complex. These joints are constructed so you can move your bones, your hands and feet.

Symptoms:

-Fatigue
-Joint Swell
-Joint Pain
-Joint Redness
-Joint Warmth
-Joint Tenderness
-Fever
-Anaemia







Causes:
-Injuries (OA ortheoarthritis)
-Abnormal metabolism (MA metabolism arthritis)
-Inheritance (OA...)
-Infections (LA Lyme arthritis)
-Immune systems dysfunctions (RA rheumatoid arthritis/ SLE systemic lupus erythematosus)

What if you don't treat it?
-Destruction/Damage in joint (RA rheumatoid arthritis)
-Ability of moving joint lost
-Bone thinning (Osteoporosis)
-Coronary Heart/Artery Disease due to inflammation (CHD/CAD) (RA)
-Anaemia (Lack of iron)
-Earlier death

Joint Fusion

-Depression

Treating:
=Surgery=:
-Joint repair - smoothen joint
-Joint replacement - artificial joint
-join fusion - fuse 2 bones into one (usually for smaller bones)


=Ways to kill pain=:
=Therap

-Lose weight - less joint stress
-Exercises - flex joints
-Heating packs or ice pads

=Medication=:
-Painkillers
-Counterirritants
-Antirheumatic drugs
-Biological responce modifiers
-Corticosteroids
-Anti-inflammatory drugs

Cholecystitis

Cholecystitis:
Cholecystitis happens when there is inflammation in the gallbladder, which could happen suddenly, or through a long period of time. Your gallbladder is an organ digestive fluid into your small intestines. When cholecystitis happens, it’s usually a result of gallstones building in your bile duct. Bile build up causes inflammation. Cholecystitis could also happen with bile duct problems, tumors, serious illnesses or infections. If cholecystitis is not treated, it has a potential of killing a person. 

What is a gallbladder?
The gallbladder is the organ which stores the bile. Bile is a fluid that could break down fats, and it is made in the liver. After the bile is made, it is stored in the gallbladder and the gallbladder helps squeeze the bile through the bile duct into the small intestines when fatty food is consumed.

Symptoms:

Causes:

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Gallstones: Cholecystitis usually happens when there are gallstones in the gall bladder, and the gallstones flows into the bile duct, blocking the bile duct, and the bile will get stuck in the gallbladder, causing an inflammation. 

Tumor: A tumor could cause bile to not drain out from the gall bladder properly, causing a case of cholecystitis 

Bile Duct Blockage: Kinking and scarring in the bile duct could cause blockages which could cause cholecystitis as well. 

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Infection: Some viral disease like HIV could trigger inflammation in the gallbladder and it causes cholecystitis too. 

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Blood Vessels Problems: Serious blood diseases could damage blood vessels, decreasing the blood flow to the gallbladder, causing cholecystitis. 

If you don't treat it, this will happen:

Gallbladder Infection:

Bile could build up inside the gallbladder because of the blockage, causing the bile to "expire" and infect your gallbladder, just like expired 

Gallbladder Tissue Dies:

Tissue in the gallbladder can die. Victims are waiting to get treatment or those with diabetes can have dead tissue in the gallbladder during the time and it could lead to a tear in the gallbladder, or it may cause your gallbladder to burst.

Gallbladder Torn:

A tear in your gallbladder can cause the gallbladder to swell, be infected or cause the tissue to die.

Diagnosis:
-Blood Tests
-CT (Computed Tomography)
-Ultrasound
-HIDA Scan (Cholescintigraphy)

Procedures:
Laparoscopic Cholecystectomy:

1. Anaesthesia 
2. Disinfection 
3. Cut below belly button 
4. Put a port(tube) in it and to insert Carbon dioxide to see properly 
5. Take cap off the port and put a camera in 
6. Put the other three ports in above hisp abdomen 
7. Move liver with clamps so gallbladder will be exposed 
8. Clamp off and block bile duct 
9. Cut off the bile duct 
10. Electrocautery away from liver 
11. Pull out gallbladder with clamps and the port below belly button 
12. Remove gas and other ports 
13. Staple or stitch 

Open Cholecystectomy (much more painful, only for people that can't do laparoscopic)

1. Anaesthesia 
2. Disinfection 
3. 6-inch-long cut – upper right corner of abdomen 
4. Cut through fat and muscle to gallbladder 
5. Clamp on the skin and muscle – hold in place 
6. Move liver with clamps so gallbladder will be exposed 
7. Clamp off and block bile duct 
8. Cut off the bile duct 
9. Electrocautery away from liver 
10. Pull out gallbladder 
11. Staple and stitch 
12. Small drain 

Risks of Surgery

1. excessive bleeding
2. blood clots
3. damage to blood vessels
4. heart problems
5. infection
6. injury to the bile ducts or small intestine
7. pancreatitis
8. constipation
9. diarrhoea
10. jaundice
11. fever

Coronary Heart Disease

How it happens:
Coronary Heart Disease (CHD) is an effect of Coronary Artery Disease (CAD), which usually happens when people eat too much of oily and fat-full foods such as bacons, too much that cholesterols starts settling on the heart's major coronary arteries. Your coronary arteries supplies oxygen to your heart muscles with the oxygen full red blood cells. The fats lands into the coronary arteries by diffusing through the artery walls and land on them. Day by day bits fill up and form a plaque. Sometime later, this plaque would be a blockage. When the blood flows too fast, the blood may skim and tear off the top layer of the plaque. Usually in other parts of the body, this is good, but not for the coronary artery. A blood clot would form and block almost the whole of the artery would be blocked and the blood won't be able to past through. The heart muscles would start to starve of oxygen and die. Then, the blood vessels will flow back into the lungs and you will drown yourself.

Causes:
-Age
-Sex - usually men
-Family
-Smoking
-High blood pressure
-Cholesterol
-Diabetes
-Overweight/Obesity
-Lack of exercise
-Stress
-Unhealthy diet (alcohol, oily foods, sugar)

Symptoms:
-Discomfort
-Fatigue
-Short of breath
-Nausea
-Chest discomfort





Diagnosis needed:
-ECG (Electrocardiogram)
-EKG (Echocardiogram
-Stress test/ Exercise tolerant test
-CT (Computed Tomograph)
-MRI (Magnetic Resonance Imaging)
-Cardiac Catheterization and Angiogram
-X-Ray
-Blood Test

      Procedure of surgery

      1.      Anaesthia

      2.      Cut open patient’s chest

      3.      Open rib cage

      4.      Stop heart for a while

      5.      Use heart lung machine to continue pumping blood to the body.

      6.      Remove unblocked artery and put on blocked artery.

      7.      Attach arteries

      8.      Close the hole and stitch.

Risks of Surgery:
-Blood Clots
-Infection
-Over bleeding
-Arrhythmia (Abnormal heart rhythm)
-Pneumonia
-Breathing Problems
-Fever
-Pain
-Kidney Failure
-Memory Loss
-Thought Problems

Pneumothorax and Hemothorax

How it happens:

Spontaneous Pneumothorax:

In infected peoples’ lungs, there are these blebs from the tissue that are formations of little sacs/ pockets of air, and these people could have 1 to more than 30 of these ugly balls of airs. These sacs of air can explode, causing leak of air into the pleural space – which is the space between your lung and your pleura – the outer layer of the lung. When the air leak out to the pleural space, the air will increase and force the lung to compress into smaller size, and it could even compress as small as a quarter of your original lung size. 

Tension Pneumothorax: 

Tension pneumothorax usually happens when trauma is applied to the lungs, puncturing the lung. The same thing happens to the lung as the spontaneous pneumothorax, the lung got punctured and the air go to the pleural space, compressing the lung. 

                          

Hemothorax: 

A hemothorax usually happens in blunt force trauma or penetration. A blood vessel will rupture, an intercostal vessel or an internal mammary artery. Hemorrhage comes in different ranges when the vessels rupture and the massive hemorrhage could even cause a shock. Blood then fills up the pleural space, pushing the lungs, and forcing it to compress. 

Symptoms:

Pneumothorax:

-Short of Breath

-Fatigue

-Bluish Skin

-Low Blood Pressure

-Chest Pain

-Tight Chest

-Swollen Abdomen

Hemothorax:

-Rapid Breathing

-Breathing Difficulties

-Bluish Skin

-Chest Pain

-Low Oxygen Levels

Diagnosis needed:

Tension Pneumothorax: Clinical evaluation (Pearls and pitfalls) 

Spontaneous Pneumothorax: Chest X-Ray/CT(computed tomography)  

Hemothorax: Chest X-Ray 

Causes:

-Rib Fractures (T)

-Chronic Obstructive Pulmonary Disease (S)

-Cystic Fibrosis (S)

-Pneumonia (S)

-Ruptured Air Blisters (S)

-Blunt Force Trauma (H)

*T=Tension, S=Spontaneous, H=Hemothorax)

Surgery Cure:

1. Wear protective clothing

2. Clean skin with solution

3. Apply Anaesthesia to the patient (Anaesthesia=drug that makes the patient unconsious)

4. Mark the insicion spot (4th or 5th intercostal space) with marker

5. Cut with No. 10 Blade

6. Put chest tube (which is connected to chamber) into the hole

7. Let it suck the fluid out

8. Remove tube after less than 100 ml fluid/air flow into chamber

9. Stitch the wound up.

Although surgery can cure it, there are still risks

Risks of Surgery:

•      -Lung damage
•      -Other organs damage 
•      -Bleeding/ infection to chest tube wound
•       -Wrong placement of chest tube 
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