Microscopic hematuria generally is defined as one to 10 red blood cells per high-power field of urine sediment. The American Urological Association (AUA) defines clinically significant microscopic hematuria as three or more red blood cells per high-power field on microscopic evaluation of urinary sediment from two of three properly collected urinalysis specimens. May be associated with urologic malignancy in up to 10 percent of adults.
• Class I (Ia, Ib,
Ic)
• Class II
• Class III
• Class IV
• Other anti-antiarrhythmic drugs: Adenosine, Digoxin, Ivabradine
Satyendra Dhar, MD
D-dimer is the smallest fibrinolysis-specific degradation product found in the circulation. The D-dimer is very sensitive to intravascular thrombus and may be markedly elevated in disseminated intravascular coagulation, acute aortic dissection, and pulmonary embolus. Because of its exquisite sensitivity, negative tests are useful in the exclusion venous thromboembolism. Elevations occur in normal pregnancy, rising two- to fourfold by delivery. D-dimer also rises with age, limiting its use in those > 80 years old. There is a variable rise in D-dimer in active malignancy and indicates increased thrombosis risk in active disease. Elevated D-dimer following anticoagulation for a thrombotic event indicates increased risk of recurrent thrombosis.
Lactic acid was first found & described in sour milk by Karl Wilhelm Scheele in 1780. German physician–chemist Johann Joseph Scherer (1841–1869) demonstrated the occurrence of lactic acid in human blood under pathological conditions in 1843 & 1851.
Lactic acid is essentially a carbohydrate within cellular metabolism and its levels rise with increased metabolism during exercise and with catecholamine stimulation. Glucose-6-phosphate is converted anaerobically to pyruvate via the Embden-Meyerhof pathway. Pyruvate is in equilibrium with lactate with a ratio of about 25 lactate to 1 pyruvate molecules. Thus, lactate is the normal endpoint of the anaerobic breakdown of glucose in the tissues.
The causes of lactic acidosis can generally be divided into
those associated with obviously impaired tissue oxygenation (type A) and those
in which systemic impairment in oxygenation does not exist or is not readily apparent
(type B). However, there is frequently overlap between type A and type B lactic
acidosis. In sepsis, for example, there is both an increase in lactate
production resulting from microcirculatory failure and also a decrease in
lactate clearance that is not solely due to diminished oxygen delivery.
Satyendra Dhar MD,
Monkeypox is a viral zoonotic infection that results in a rash similar to smallpox. However, person-to-person spread outside the household and mortality from a monkeypox infection are significantly less than for smallpox. The rash of monkeypox can also be similar in appearance to more common infectious rashes, such as those observed in secondary syphilis, herpes simplex infection, and varicella-zoster virus infection.
WHO has activated its highest alert level for the growing
monkeypox outbreak, declaring the virus a public health emergency of
international concern.
Monkeypox is a rare disease caused by infection with the
monkeypox virus. Monkeypox virus is part of the same family of viruses as
variola virus, the virus that causes smallpox. Monkeypox symptoms are similar
to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is
not related to chickenpox.
Symptoms of monkeypox can include:
o
The rash will go through several stages,
including scabs, before healing.
o
The rash can look like pimples or blisters and
may be painful or itchy.
Source : CDC/WHO
