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ICEBERG PHENOMENON OF DISEASE

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  DESCRIPTION v   According to this concept, the disease in the community is compared to an Iceberg. v   When a piece of ice is allowed to float on water, a small portion is visible and a major portion is submerged in the water. v   The visible tip of ice is compared to clinical cases, which the physician sees in the community. v   The major submerged portion of ice corresponds to hidden mass of  unrecognized  diseases such as latent cases, in apparent, carriers, asymptomatic and undiagnosed cases in the community, which are responsible for the constant prevalence of the disease in the community. v   In some diseases like HTN, diabetes, anemia, malnutrition, mental illness etc. the unknown morbidity is more than the known morbidity in the community and constitutes an important, undiagnosed reservoirs of disease in the community.
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PREGNANCY SIGN

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  PRESUMPTIVE SIGN 1.        Amenorrhea 2.        Nausea & vomiting 3.        Increase size & increased feeling of fullness in breast 4.        Pronounced nipples 5.        Urinary frequency 6.        Quickening:- The first perception of fetal movement by the mother may occur at the 16 th to 20 th week of gestation 7.        Fatigue 8.        Discoloration of the vaginal mucosa PROBABLE SIGN 1.        Uterine enlargement 2.         Hegar’s Sign : Compressibility & softening of the lower uterine segment that occur at about week 6. 3.        Goodell’s Sign: Softening of the cervix that occur at the beginning of the second month 4.        Chadwick’s Sign: Violet coloration of the mucous membranes of the cervix, vagina & vulva that occur at about week 6. 5.        Ballottement: Rebounding of the fetus against the examiner’s fingers on palpation. 6.        Braxton Hicks Contraction: Irregular pain less contractions that may occur interm
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STEPS FOR DONNING & REMOVING PERSONAL PROTECTIVE EQUIPMENTS(PPE)

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      DONNING OF PPE GOWN Fully cover front of the body from neck to the knees & upper arms to the end of wrist. Fasten in the back at neck & waist, wrap around the back. MASK OR RESPIRATOR Secure ties or elastic band at neck & middle of the head. Fit snug to face & below the chin. Fit to nose bridge GOGGLES/FACE SHIELD Adjust to fit according to agency policy GLOVES Select appropriate size & extend to cover wrists of gown. REMOVAL OF PPE GLOVES Grasp outside of gloves with opposite hand & peel off. Slide fingers of ungloved hand under clean side of remaining glove at wrist & peel off. GOGGLES/FACE SHIELD Remove by touching clean band or inner part. GOWN Unfasten at neck, then at waist. Remove using a peeling motion, pulling down from each shoulder towards the hands. Allow gown to fall forward & roll into a bundle to discard. MASK OR RESPIRATOR Grasp bottom ties then top ties to remove      
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INCREASED INTRACRANIAL PRESSURE

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  OVERVIEW The rigid intracranial vault contain brain tissue 1.400 gram, blood 75 ml & CSF 75 ml.  The volume and pressure of these three component are usually in a state of equilibrium & maintain ICP.    Intracranial pressure are measured in the lateral ventricle, the normal pressure is 5-15 mmHg, 20mmHg above most be treated.    ICP can be measured by use of  pressure transducer. MONRO KELLIE HYPOTHESIS- (MENRO KELLIE DOCTORINE) ·          This Hypothesis says about dynamic equilibrium of cranial content. ·          It says that inside the skull there is a limited space for expansion of cranial content. ·          When there is increase in any one of the three content ( brain tissue, blood & CSF) it change in volume of other. Because there is limited space it expand it cause;- ²   Shift the CSF ²   Increase absorption or decrease  the production of CSF. ²   Decrease cerebral blood volume. ·          ICP also increase due to minor change in blood volume &
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