1. Powerpoint-

Developed by Microsoft Corp, is the most powerful and user-friendly application. It is also the most widely used software to prepare case presentation in Medical field.

It provides an easy interface, no need of special code or language knowledge and provides you a facility to add Media and charts to the presentation. You can always get lot of templates and sample slideshows out there in the internet.

2. Flash

Stunning presentations can be made using Flash a software from ADOBE. It is by far the best presentation technology on the market. You’ll require a high degree of  proficiency to work with flash.But the results are you can put up amazing animation effects and animations to impress your spectators. You will need a Flash course for this.

3 Apple Keynote

Even if you’ve never used Keynote before, you’ll find creating a presentation surprisingly simple. It all starts with an enhanced Theme Chooser that lets you preview an impressive collection of 44 Apple-designed themes. Drag across a theme to skim through its slide designs. Once you’ve chosen the perfect canvas for your presentation, simply substitute placeholder text and graphics with your own words and images. Thanks to the Slide Navigator, the progress of your presentation and its organization are always in view.

4. Open Office Impress

Open Office Impress is the free open source presentation technology. It contains a number of features not available in PowerPoint.IMPRESS is a truly outstanding tool for creating effective multimedia presentations. Your presentations will stand out with 2D and 3D clip art, special effects, animation, and high-impact drawing tools.

5. PowerConverter:

Anyone who creates PowerPoint® presentations can easily become a Flash author, just by using PowerCONVERTER! It lets you convert any PowerPoint presentation to Flash. A solution for those who don’t know Flash but want to use it for presentation.

Objective 1:

• To list the important causative agents of meningitis.

TYPES OF MENINGITIS

• Acute Pyogenic Meningitis
• Aseptic Meningitis
• Chronic Meningitis
  • Tuberculous
  • Fungal
  • Syphillitic
  • Protozoal
  • Helminthe

Causative agents of acute pyogenic meningitis

• Neonates
– Escherichia coli
– Group B streptococci
– Listeria monocytogenes
– Streptococcus pneumoniae

• Children
– Neisseria meningitidis
– Streptococcus pneumoniae,
– Haemophilus influenzae

• Adults
– Streptococcus pneumoniae,
– Neisseria meningitidis

• Elderly
– Listeria species

Causative Agents of Aseptic meningitis

• Common:
- Enteroviruses
- Herpes simplex virus 2 (HSV 2)
- Arthropod borne viruses (Tickborne, West Nile, Murray Valley, Japanese B)
- HIV (Human Immunodeficiency Virus)

• Less common
- Varicella zoster virus (VZV)
- Epstein Barr virus (EBV)

Causative Agents of Chronic Meningitis

Tuberculous meningitis

• Mycobacterium tuberculosis

Syphillitic meningits

• Treponema pallidum

Fungal meningitis

• Cryptococcus neoformans (most common in HIV patients)
• Candida albicans
• Mucor species
• Aspergillus fumigatus
• Coccidioides immitis
• Histoplasma capsulatum
• Blastomyces dermatitidis

Protozoal

• Toxoplasma gondii
• Trypanosoma
• Acanthamoeba

Helminthes

• Taenia solium

Objective 2:

• To outline laboratory diagnosis of bacterial meningitis.

Specimens

• CSF
• Blood
• Sample
• Nasal swab
• Peticheal lesions
• Autopsy

A. Examination of CSF

Macroscopy
• CSF is cloudy under increased pressure and blood may be seen.

CSF is centrifuged and following methods are used:

• Microscopy
• Culture

Microscopy

Unstained preparations: wet mounts

Stained smears:

• Common stains: Gram stain, Ziehl-Neelsen stain
• Fluorescent dyes: Acridine orange, Auramine rhodamine

Gram stain (left) and ZN stain (right)

Culture

Culture Media

• Enriched solid media- blood agar, chocolate agar
• Selective solid medium- MacConkey agar
• Robertson Cooked meat broth (for anaerobes)

Steps:

• CSF inoculated in culture media
• incubation at 35-36°C under 5-10% CO2
• Colonies appear after 18-24 hours, identified by morphology and biochemical reactions.

B. Blood culture

• incubated for 4-7 days, with daily subcultures

C. Nasopharyngeal Swab

• Useful for detection of carriers
• Done without contamination with saliva

D. Petechial lesions

Menigococci may be demonstrated by microscopy and culture

E. Autopsy

• Specimen from meninges, lateral ventricles, or surface of brain and spinal cord
• Within 12 hours of death of patient
• Smear or culture

Biochemical tests

• Catalase test
• Oxidase test
• Indole test
• Urease test
• Coagulase test
• Citrate Utilization test
• Triple sugar iron agar

Agglutination test:

• Direct slide agglutination test with specific antisera
• Latex agglutination test
• Immunoflourescence test
• Other rapid identification methods
• Molecular diagnosis – PCR test

Various changes in Acute Pyogenic Meningitis:

References:

• Textbook of Microbiology
• Diagnostic Microbiology

Prepared and Presented for Correlation Seminar in Kist Medical College by:

Studying Online

Pathology is an interesting subject but it is as difficult as any other subjects in medical science like anatomy, physiology, pharmacology, etc. We all are made differently and we all have different way of learning or studying. The method that I use to study may or may not be suitable to you. Lectures, books, pictures and slides are the common sources of learning. Using online resources to learn may be very helpful to many of us.

It is a vast subject and its knowledge is always expanding. So, it is more important that the pathology learnt in the undergraduate curriculum (like MBBS Basic Science) is basic and relevant, emphasizing the understanding of mechanisms and principles rather than detailed facts. As students continue their medical education into PG trainee years, more detailed systemic pathology will become more relevant and more appropriately learnt at that time.

Site home: http://medicalschoolpathology.com

Medical School Pathology is a resourceful medical website designed to assist self learner medical students for learning pathology. It provides online access to lecture notes and videos of all 29 chapters based on Robbin’s Pathology. Besides, it also provides medics with online laboratory for learning histopathology. This site probably won’t be useful to lay person because the description are mostly medical and includes medical jargons.

Chapters

GENERAL PATHOLOGY

1. Cellular Adaptations, Cell Injury, and Cell Death
2. Acute and Chronic Inflammation
3. Tissue Repair: Cellular Growth, Fibrosis, and Wound Healing
4. Hemodynamic Disorders, Thrombosis, and Shock

Textbook for pathology

5. Genetic Disorders
6. Diseases of Immunity
7. Neoplasia
8. Infectious Diseases
9. Environmental and Nutritional Pathology
10. Diseases of Infancy and Childhood

DISEASES OF ORGAN SYSTEMS

11. Blood Vessels
12. The Heart
13. Red Cells and Bleeding Disorders
14. White Cells, Lymph Nodes, Spleen, and Thymus
15. The Lung
16. Head and Neck
17. The Gastrointestinal Tract
18. The Liver and Biliary Tract
19. The Pancreas
20. The Kidney
21. The Lower Urinary Tract and the Male Genital Tract
22. The Female Genital Tract
23. The Breast
24. The Endocrine System
25. The Skin
26. Bones, Joints, and Soft Tissue Tumors
27. Peripheral Nerve and Skeletal Muscle
28. The Central Nervous System
29. The Eye

Online Resources For Self-Learning

Download Lecture notes in Powerpoint
Watch and Download Lecture videos of General Pathology
Watch and Download Lecture videos of Systemic Pathology
Watch and Download Histopathology Videos
Online Access to Rock Lab for Independent Study
Shotgun Histology

Click on the picture to enlarge

Objective

• To highlight the present status of disease modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis

Introduction

• DMARDs (disease modifying antirheumatic drugs) are drugs which can suppress the rheumatoid process and bring about a remission, but do not have nonspecific anti-inflammatory or analgesic action.

Classification of Anti-rheumatic drugs

A. DMARDs:

• Immunosuppressants: Methotrexate, Cyclosporine, Azathioprine
• Sulfasalazine
• Chloroquine or hydroxychloroquine
• Leflunomide
• Gold salts
• d-Penicillamine

B. Biological response modifiers(BRMs):

• TNF-α inhibitors: Etanercept, Infliximab
• IL-1 antagonist: Anakinra

C. Adjuvant drugs

• Corticosteroids: Prednisolone

Immunosuppressants

Methotrexate:

• First choice and standard drug for rheumatoid arthritis.
• Acts by inhibiting an enzyme dihydrofolate reductase
• Also inhibits other enzyme involve in protein synthesis as well as anti-inflammatory and cytokines modulating effect.
• Initially low dose(7.5-15 mg/week)
• Best tolerated among other DMARDs

Adverse drug effects

1. Nausea and mouth ulcer
2. Pancytopenia (low blood cells)
3. Liver cirrhosis
4. Acute pneumonitis

Contraindications
• Pregnancy
• Lactating mother
• Liver disease
• Leucopenia
• Peptic ulcer

Sulfasalazine

• It is a compound of sulfapyridine and 5-amino salicyclic acid (5-ASA)
• Useful in both RA and ulcerative colitis
• Much more safer than gold salts
• Second line drugs for milder cases
• Mode of action is unknown

Adverse drug effects:

1. Neutropenia, hemolytic anemia
2. Thrombocytopenia

Gold Salts

• Water soluble gold preparation like sodium aurothiomalate
• Gets deposited in the synovial macrophages in actively inflammed joints and inhibits their function.

Adverse drug effects:

• Dermatitis, nephropathy, bone marrow depression and liver damage.

Etanercept

• It is a recombinant fusion protein of TNF-receptor and Fc portion of human IgG
• Reserved for the patients who have failed to respond to adequate trials of atleast two DMARDs

Adverse drug reaction:

1. Pain, redness, itching, swelling at the infection site
2. Chest infection may be increasedd-Penicillamine
3. Splits the rheumatoid factor and also selectively reduces the serum levels of calcium immunoglobin
4. Adverse drug reactions incidences are high so not commonly used

Gold salts and d-penicillamine should not be combined for the treatment of RA (because of severe ADRs). Gold salts and d-penicillamine are not used in the present context because of severe adverse reactions i.e.

• Bone marrow depression
• Kidney and liver damage
• Ulceration

Presented by Students of KistMCTH 1st year students

Reference

1. Text book of Pharmacology- K D Tripathi
2. Text book of Pharmacology- Bennett and Brown