What are the BACTERIA

 Bacteria are surrounding us even inside our body. As a representative of Bacteria, the structure and importance of Closteridium IS described here.


Structural features:

1.  It is rod shaped and unicellular.

2.  They live in the intestine of human being, other animal or even in soil. They are without photosynthetic pigments.



3.  They are prokaryotic, i.e. there is no nuclear membrane and nucleolus in their cell .



4.  There are flagella around the cell wall.



5.  They are anaerobic, Gram positive and Spore producing.

Importance of Bacteria :



Structure : Deadly diseases of human being, like - Phthisis (Tuberculosis),Pneumonia, Typhoid, Cholera Diphtheria, Dysentery, Tetanus, H60ping cough, Meningitis etc are caused by different Bacteria. Besides Bacteria is also responsible for various plant diseases.
Food putrification and food poisoning, water pollution and demannuring of soil etc. are also caused by Bacteria. Some antibiotics are prepared from Bacteria.
Vaccines of Cholera, Typhoid, and Phthisis etc are also prepared from Bacteria. Besides Bacteria also perform the important works like; decomposition of rubbish, blending of tea, coffee, tobacco, 'preparation of butter, curd, cheese from milk, extractivn of Jute fibre, extraction of hairs from skin in tannery, preparation of some B-Vitamins, proper management of sewerage lines, and nitrogen fixation etc.



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ENTEROGERMINA -A PROBIOTIC, MEDICINE FOR STOMACH PROBLEM

ENTEROGERMINA - IS AN ORAL SUSPENSION CONTAINING POLYANTIBIOTIC  RESISTENT SPORES OF BACILLUS CLAUSII.

COMPOSITION- IT is  1 mini bottle contains;

 Main element- 2 billions spores of polyantibiotic resistant  bacillus clausii.

what is enterogermina?
It is a probiotic which is useful for the treatment of imbalance of intestinal bacteria flora due to diverse causes.

USES-

IT is use for treating the alterations of the intestinal bacteria flora, enterogermina resore the equilibrium of the intestinal flora changed during diarrhoea, or contributing to correct the consequent dysvitaminosis (that is the imbalance of production and assimilation of the vitamins)

HOW TO USE?

ADULTS - FROM 2 TO 3 MINI BOTTLES A DAY

CHILDERN- FROM 1 TO 2 MINI BOTTLES A DAY

INFANTS- FROM 1 TO 2 BOTTLES A DAY

HOW TO USE - SHAKE THE MINI BOTTLE BEFORE USE

MECHANISM OF ACTION-  The administration of entero. contributes to the recovery of the intestinal  microbial flora altered during the course of intestinal microbial imbalance of diverse origin , due to the action of bacillus clausii 
Adminisstered orally, Bacillus clausii spores, due to their high resistance to the both chemical and physical agents, cross the barrier of the gastric juices reaching, unharmed, the intestianl tract where they are transformed  into metabolically active vegetative cells.

STORAGE- COOL PLACE

MANAGEMENT OF CHRONIC HEART FAILURE💔💔💔💔💔

MANAGEMENT OF CHRONIC HEART FAILURE

The major steps in the management of patients with chronic heart failure are outlined in Table 13–3. The 2009 update to the ACC/ AHA 2005 guidelines suggests that treatment of patients at high risk (stages A and B) should be focused on control of hyperten-sion, hyperlipidemia, and diabetes, if present. Once symptoms and signs of failure are present, stage C has been entered, and active treatment of failure must be initiated.




SODIUM REMOVAL
Sodium removal—by dietary salt restriction and a diuretic—is the mainstay in management of symptomatic heart failure, especially if edema is present. In very mild failure a thiazide diuretic may be tried, but a loop agent such as furosemide is usually required. Sodium loss causes secondary loss of potassium, which is particu-larly hazardous if the patient is to be given digitalis. Hypokalemia can be treated with potassium supplementation or through the addition of an ACE inhibitor or a potassium-sparing diuretic such as spironolactone. Spironolactone or eplerenone should probably be considered in all patients with moderate or severe heart failure, since both appear to reduce both morbidity and mortality.

ACE INHIBITORS & ANGIOTENSIN RECEPTOR BLOCKERS
In patients with left ventricular dysfunction but no edema, an ACE inhibitor should be the first drug used. Several large studies have showed clearly that ACE inhibitors are superior to both pla-cebo and to vasodilators and must be considered, along with

VASODILATORS
Vasodilator drugs can be divided into selective arteriolar dilators, venous dilators, and drugs with nonselective vasodilating effects. The choice of agent should be based on the patient’s signs and symptoms and hemodynamic measurements. Thus, in patients with high filling pressures in whom the principal symptom is dyspnea, venous dilators such as long-acting nitrates will be most helpful in reducing filling pressures and the symptoms of pulmo-nary congestion. In patients in whom fatigue due to low left ven-tricular output is a primary symptom, an arteriolar dilator such as hydralazine may be helpful in increasing forward cardiac output.In most patients with severe chronic failure that responds poorly to other therapy, the problem usually involves both elevated filling pressures and reduced cardiac output. In these circumstances, dila-tion of both arterioles and veins is required. In a trial in African-American patients already receiving ACE inhibitors, addition of hydralazine and isosorbide dinitrate reduced mortality. As a result, a fixed combination of these two agents has been made available as isosorbide dinitrate/hydralazine (BiDil), and this is currently approved for use only in African Americans.

BETA BLOCKERS & ION CHANNEL BLOCKERS
Trials of β-blocker therapy in patients with heart failure are based on the hypothesis that excessive tachycardia and adverse effects of high catecholamine levels on the heart contribute to the down-ward course of heart failure. The results clearly indicate that such therapy is beneficial if initiated cautiously at low doses, even though acutely blocking the supportive effects of catecholamines can worsen heart failure. Several months of therapy may be required before improvement is noted; this usually consists of a slight rise in ejection fraction, slower heart rate, and reduction in symptoms. As noted above, not all β blockers have proved useful, but bisoprolol, carvedilol, metoprolol, and nebivolol have been shown to reduce mortality.

In contrast, the calcium-blocking drugs appear to have no role in the treatment of patients with heart failure. Their depressant effects on the heart may worsen heart failure. On the other hand, slowing of heart rate with ivabradine (an If blocker) appears to be of benefit.

Digitalis
Digoxin is indicated in patients with heart failure and atrial fibril-lation. It is usually given only when diuretics and ACE inhibitors have failed to control symptoms.

THE BREAST ANATOMY

The Breast Anatomy

The female breasts


The female breasts, also known as the mammary glands, are accessory orgns of reproduction.



Situation One breast is situated on each side of the sternumand extends between the levels of the second and sixth rib. The breasts lie in the superficial fascia of the chest wall over the pectoralis major muscle, and are stabilized by suspensory ligaments.



Shape Each breast is a hemispherical swelling and has a tailof tissue extending towards the axilla (the axillary tail of spence).



Size The size varies with each individual and with the stage ofdevelopment as well as with age. It is not uncommon for one breast to be little or larger than the other.



Gross structure


The axillary tail is the breast tissue extending towards theaxilla.



The areoa is a circular area of loose, pigmented skin about2.5 cm in diameter the centre of each breast. It is a pale pink colour in a fair- skinned woman, darker in a brunett, the colour deepening with pregnancy. Within the area of the areola lie approximately 20 sebaceous glands. In pregnancy these enlarge and are known as montgeomery’s tubercles.



The nipple lies in the centre of the areola at the level of thefourth rib. Aprotuberance about 6mm in length, composed of pigmented erectile tissue.The surface of the nipple is perforarted by small orifices which are the openings of the lactiferous ducts. It is covered with epithelium.



Microscopic structure The breast is composed largely ofglandular tissue, but also of some fatty tissue, and is covered with skin. This glandular tissue is divided into about 18 lobes which are completely separated by bands of fibrous tissue. The internal structure is said to be resemble as the segments of a halved grape fruit or orgnge. Each lobe is a self-contained working unit and is composed of the following structures



Alveoli: Containing the milk- secreting cells. Each alveolus islined by millk-secreting cells, the acini, which extract from the mammary blood supply the factors essential for milk formation. Around each alveolus lie myoepithelial cells, sometimes called ‘basket’ or ‘spider’s cells. When these cells are stimulated by oxytocin they contract releasing milk into the lactifierous duct.



Lactifierous tubules:small ducts which connect the alveoli.



Lactifierous duct:a central duct into which the tubules run.



Amplulla:the widened-out portion of the duct where milk isstored. The ampullae lie under the areola.



Blood supply Blood is supplied to the breast by the internalmammary, the external mammary and the upper intercostals arteries.Venous drainage is through corresponding vessles into the internal mammary and axillary veins.





Lymphatic drainage This is largely into the axillary glands, with some dranage in to the portal fissure of the liver and mediastinal glands. The lymphatic vessels of each breast communicate with one another.



Nerve supply The function of the breast is largely controlledby hormone activity but the skin is supplied by breanches of the thoracic nerves. There is also some sympathetic nerve supply, especially around the areola and nipple.

ORPHAN DRUGS AND TREATMENT OF RARE DISEASES

Orphan Drugs & Treatment of Rare Diseases

Drugs for rare diseases-so-called orphan drugs-can be difficult to research, develop, and market. Proof of drug safety and efficacy in small populations must be established, but doing so is a complex process. Furthermore, because basic research in the pathophysiology and mechanisms of rare diseases receives relatively little attention or funding in both academic and industrial settings, recognized rational targets for drug action may be few. In addition, the cost of developing a drug can greatly influence priorities when the target population is relatively small. Funding for development of drugs for rare diseases or ignored diseases that do not receive priority attention from the traditional industry has received increasing sup-port via philanthropy or similar funding from not-for-profit foundations such as the Cystic Fibrosis Foundation, the Huntington’s Disease Society of America, and the Gates Foundation.

The Orphan Drug Amendments of 1983 provides incentives for the development of drugs for treatment of a rare disease or condition defined as “any disease or condition which (a) affects less than 200,000 persons in the U.S. or (b) affects more than 200,000 persons in the U.S. but for which there is no reasonable expectation that the cost of developing and making available in the U.S. a drug for such disease or condition will be recovered from sales in the U.S. of such drug.” Since 1983, the FDA has approved for marketing more than 300 orphan drugs to treat more than 82 rare diseases.

VITAMIN C (ALL INFORMATION)

Vitamin C



Vitamin C is also known as ascorbic acid. It has antioxidant properties and protects foods from oxidation, and it is required for all cell metabolism. It is read-ily destroyed by heat, air, and alkalies, and it is easily lost in cooking water.



Functions.Vitamin C is known to preventscurvy.This is a disease char-acterized by gingivitis (soft, bleeding gums and loose teeth); flesh that is easily bruised; tiny, pinpoint hemorrhages of the skin; poor wound healing; sore joints and muscles; and weight loss. In extreme cases, scurvy can result in death. Scurvy used to be common among sailors, who lived for months on bread, fish, and salted meat, with no fresh fruits or vegetables. During the middle of the eighteenth century, it was discovered that the addition of limes or lemons to their diets prevented this disease.



Vitamin C also has an important role in the formation of collagen, a pro-tein substance that holds body cells together, making it necessary for wound healing. Therefore, the requirement for vitamin C is increased during trauma, fever, and periods of growth. Tiny, pinpoint hemorrhages are symptoms of the breakdown of collagen.



Vitamin C aids in the absorption of nonheme iron (from plant and ani-mal sources and less easily absorbed than heme iron) in the small intestine when both nutrients are ingested at the same time. Because of this, it is called an iron enhancer.



Vitamin C also appears to have several other functions in the human body that are not well understood. For example, it may be involved with the forma-tion or functioning of norepinephrine (a neurotransmitter and vasoconstrictor that helps the body cope with stressful conditions), some amino acids, folate, leukocytes (white blood cells), the immune system, and allergic reactions.



It is believed to reduce the severity of colds because it is a natural antihista-mine, and it can reduce cancer risk in some cases by reducing nitrites in foods.

Vitamin C is absorbed in the small intestine.



Sources.The best sources of vitamin C are citrus fruits, melon, strawber-ries, tomatoes, potatoes, red and green peppers, cabbage, and broccoli.



Requirements.Vitamin C is measured in milligrams. Under normal cir-cumstances, an average female adult in the United States requires 75 mg a day and an average male 90 mg. In times of stress, the need is increased. Regular cigarette smokers are advised to ingest 125 mg or more a day.



It is generally considered nontoxic, but this has not been confirmed. An excess can cause diarrhea, nausea, cramps, an excessive absorption of food iron, rebound scurvy (when megadoses are stopped abruptly), and possibly oxalate kidney stones.



Deficiency.Deficiencies of vitamin C are indicated by bleeding gums, looseteeth, tendency to bruise easily, poor wound healing, and, ultimately, scurvy.

WHAT IS PATHOGEN ?

WHAT IS A PATHOGEN?

In medicine, we define a pathogen as any microorganism capable of causing disease. The emphasis is on disease, not the microorganism. However, from the microbial standpoint, being pathogenic is a strategy for survival and simply one more remarkable example of the extraordinary diversity of the microbial world. Humans, including physicians, proba-bly spend too little time reflecting on the fact that we are home to a myriad of other living creatures. From mouth to anus, from head to toe, every millimeter of our cells that is exposed to the outside world has a rich biological diversity. From the mites that inhabit the eyebrows of many of us to the seething cauldron of over 600 species of bacteria that inhabit our large bowel, we are a veritable garden of microorganisms. Most of these mi-croorganisms are not only innocuous but play a useful, if unseen, role. Not only do they provide us with protection against the few harmful microorganisms that we encounter each day, but they also give us some vitamins and nutrients and help digest our food. We have harbored them so long in our evolution that they are even a necessary part of the de-velopmental pathways required for the maturation of our intestinal mucosa and our innate local immune system.

Most human microbes are commensal; that is, they eat from the same table that we do. These microbes are constant companions and often depend on humans for their exis-tence. Although humans do not appear to be absolutely dependent on microbes for life (at least the cultivatable ones we know), we exist more comfortably with microbes than with-out them. We also encounter transient microbes, which are just passing through or on us, so to speak. Some commensal transient species may be opportunistic pathogens.
These  organisms can cause disease only if one or more of the usual defense mechanisms hu-mans have evolved to restrict microorganisms from their usually sterile internal organs and tissue are breached by accident, by intent (eg, surgery), or by an underlying meta-bolic or an infectious disorder (eg, AIDS). Nevertheless, a small group of microorganisms often causes infection and overt disease in seemingly normal individuals. These are the primary pathogens such as the common cold virus, the mumps virus, the typhoid bacil-lus, gonococcus, the tubercle bacillus, and the treponema of syphilis. Each organism is adapted exclusively to humans; other pathogens such as Salmonella typhimurium, a com-mon cause of human food poisoning, can cause disease both in humans and other ani-mals, birds, and even reptiles.

What is the difference between a commensal, an opportunist, and a primary pathogen? All of these organisms can cause disease under the proper circumstances. One distinction to make between an opportunistic pathogen and a primary pathogen is on the basis of the essentiality of the host for the long-term survival of a microbe. Long-term survival in a primary pathogen is absolutely dependent on its ability to replicate and to be transmitted in a particular host; however, this is not necessarily the case for a number of the opportunistic pathogens that infect humans. The major distinction that emerges is that primary pathogens have evolved the genetic ability to breach human cellular and anatomic barriers that ordinarily restrict or destroy commensal and transient microorgan-isms. Thus, pathogens can inherently cause damage to cells to gain access by force to a new unique niche that provides them with less competition from other microorganisms, as well as a ready new source of nutrients. For microorganisms that inhabit mammals as an essential component of their survival tactic, success can be measured by the capacity to multiply sufficiently to be maintained or be transmitted to a new susceptible host. This is true for commensal and pathogen alike. However, if the pathogen gains a new niche free of competition and rich in nutrients.