CHOLESTEROL LDL HDL

CHOLESTEROL LDL HDL

Cholesterol can,t dissolve in the blood. it has to be transported to and from the cells by carries called lipoproteins.Low Density Lipoprotein,or LDL, is Known as "Bad" Cholesterol. High- density Lipoprotein or HDL, IS KNOWN AS "GOOD" Cholesterol.

LDL/LOW DENSITY LIPOPROTEIN:-
When too much LDL(BAD) cholesterol circulates in blood, it can slowly build up in the inner wals of the arteries that feed the heart and brain, if a clot forms and blocks a narrowed artery, heat attack or stroke can result.
HDL/HIGH DENSITY LIPOPROTEIN:-
About 1/4 th to 1/3 cholesterol carried by HDL. HDL cholesterol is known as GOOD cholesterol,because high levels of HDL seem to protect against heat attack.Low levels of HDL <40 mg/dl also increase to risk of heart disease.
                                                                                                                     
Normal lab values:-
LDL:-<100 mg/dl
HDL:->50 mg/dl                                                                                                      source-vikaspedia

Blood Sampling Vial Colour Codding

BLOOD SAMPLING VIAL

As we Know there are many types of blood tubes used for lab investigations.
1.Black Top Tube:- Sodium Citrate 20% used as anticoagulant for test ESR.
2.Purple Top Tube:-EDTA(Ethylenediaminetetraacetic Acid) used as Anticoagulant for test Hb,CBC.
3.Red Top Tube:-Plain vial Contains in vial Blood coagulate result in Serum (take one Hour)
4.Green Top Tube:-small sillica beadsplasma used for biochemistry investigation like renal,electrolytes,ammonia.
5.Grey Top Tube:-Tube contains Fluoride oxalate. that inhibits glycolysis used for test Glucose.
6.Red Top Tube:-contains clot activator like small sillica beads for speed up coagulation.(take 20 min.)
7.Yellow Top Tube:-contains small silica beads with separator gel resulting sample serum.
8.Blue Top Tube:-Sodium Citrate 10% used Coagulation investigation like PT-INR,APTT. 

General Awareness For Esic Staff Nurse

General Awareness 

GA important notes for all staff nurse exam like railway,esic or other to download notes as pdf click on part I below given link Part second published on 19/2/2019.
PART I

Important Health Days

HEALTH DAYS

January:-                                                              

1. 12 National Youth Day

2.  31 Anti Leprosy Day

February:-

1. 4 World Cancer Day

March:-

1. 4 National Safety Day

2. 8 International Women's Day

3. 12 World Kidney Day

4. 15 World Consumer Rights Day

5.  22 World Disable Day

6. 23 World Water day

7. 24 World Tuberculosis Day

April:-

1. 7 World Health Day

2. 11 World Parkinson Day

3. 11 National safe motherhood Day

4. 17 World Hemophilia Day

5. 22 Earth Day

May:-

1. 05 World Asthma Day

2.  08World Thalassemia Day

3. 12  International Nurses Day

4. 19 World Hepatitis Day

5. 28 International Day of Action for Woman's Health

6. 31 Anti Tobacco Day

June:-

1. 05 World Environment Day

2. 14 World Blood Donor Day

3. 17 World Day to Combat Desertification and Drought

4. 26 International Day Against Drug Abuse and illegal Trafficking

July:-

1. 01 Doctor's Day

2. 11 World Population Day

August:-

1. 01-07 World Breast Feeding Day

2. 12 International Youth Day

3. 15 Independence Day

September:-

1. 01-07 National Nutrition Week

2. 04-11 World Pharmacy Week

3. 08 Literacy Day

4. 16 World Ozone Day

October:-

1. 11 World Mental Health Day

2. 12 World Arthritis Day

3. 16 World Anesthesia Day

4. 20 World Malaria Day

5. 21 World Iodine Deficiency Disorder Day

6. 24 UN Day

7. 31 Universal Children Day

November:-

1. 10 World Immunization Day

2. 13 World Alzheimer Day

3.  14 Children's Day

December:-

1. 01 World AIDS Day

2. 03 World Disability Day

3. 10 Human Right Day

source www.rajswasthya.nic

Antidote and Drug of Choice Prophylaxis of choice

ANTIDOTE AND DRUG OF CHOICE PROPHYLAXIS(Dx/Px):-

1.Drug for PCM poisoning :- N acetylecystine (mucomyst)

2. DOC for Acute Asthma:- Salbutamol

3.DOC for Chronic Asthma:- Salmetrol

4.Drug of choice for bipolar disorder:- Lithium

5.Drug of choice for mania:- Lithium

6.Drug of choice for acute mania:-Haloperidol

7.Drug of choice for chronic mania:-Lithum

8.Drug of choice for hyperkalamia:- Kayxalate/sodium natropuroside/insuline+dextrose

9.Drug of choice for Ketoacidosis:- Insuline+dextrose

10.Prophylaxis for Asthma:-Montalucast

11.Drug for Digitalis Toxicity:-Digibind

12.Drug of choice for Acute migraine:-Sumatripatan

13 Drug of choice for ADHD:-Methylphenidate(Amphetamine)

14.Drug of choice for Alzeihmers disease:-Tacrine/donepzil/Rivastigmine

15.Drug of choice for Myasthenia gravis:-Neostigmine

16.Drug of choice for Anaphylactic Shock:-Adrenaline

17.Drug of choice for Hyperthyroidism in pregnancy/Lactation:-Propylthiouracil

18.Drug of choice for Atonic Seizures:-Sodium valproate

19.Drug of choice for Febrile Seizures:-Diazepam

20.Antidote for Aspirine poisoning:-Sodium bicarbonate

21.Antidote for organophosphate poisoning:-Atropine

22.Drug of choice for Central Diabetic Insipidus:-Vasoprassin/desmopressin

23.DOC for Chemotherapy induced vomiting:-Ondasteron

24.DOC for chloroquine resistant malaria:-Quinine

25.DOC for cholera:Tetracycline

26.Antidote for Benzodiazapine poisoning:-Flumazenil

27.Antidote for Barbiturate poisoning:-Sodium bicarbonate 

28.Antidote for Atropine poisoning:-Physostigmine

29.DOC for Chese reaction:-Phentolamine

30.DOC for Acute Gout:-Indomethacin

31.DOC for Chronic Gout:-Allopurinol

32.DOC for complicated Malaria:-Artesunate

33.Antidote for Cyanide poisoning:-Amyl nitrate

34.DOC for Depression:-Any of SSRI                 drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone)

35.DOC for disease modifying anti Rheumatic drug(DMARD):-Methotrexate

36.DOC for drug induced parkinson disease:-Benzhexol

37.Choice of Muscle relaxant for Endotracheal intubation:-Succinylcholine

38.Choice for Relaxant for ECT:-succinylcholine

39.Treatment of choice for severe Depression:-ECT

40.DOC for Enteric Fever:-Ceftrixone

41.DOC for Epilepsy in pregnancy:-Lamotrigine

42.Antidote for Fibrinolytics:-Aminocaproic acid

43.DOC for BPH(Benign prostate hypertrophy):-Prozosin

44.Antidote for Heparine Toxicity:-Protamine sulphate

45.prophylaxis for herpes:-Acyclovir

46.prophylaxis for rheumatic fever:-Benzathaine penicilline

47.prophylaxis for MI:-Asprine

48.DOC for Malaria:-Chloroquine 

49.DOC for hypertensive emergency:-Sodium nitroprusside

50.DOC for hypertension in pregnancy:-Lobetalol

51.DOC for Eclampsia:-Mgso4

52.DOC for Hypothyroidism:-Levothyroxin

53.DOC for hypovolemic Shock:-IV fluids

54.Antidote for Iron toxicity :-Desferoxamine

55.DOC for Methanol poisoning:-Fomepizole

56.DOC FOR Methicillin resistant staphylococcus aureus :- Vencomycin

57.Mydriatic of choice in Adults:-Tropicamide

58.Mydriatic of choice in children:-Atropine

59.DOC for syphillis:-Benzathine penicilline

60.DOC for noctural enuresis :- Desmopressin/imipramine

61.DOC for obsessive compulsive disorders:-SSRI

drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone)

62.Antidote for Opiod poisoning:-Nalaxone

63. DOC for oral hypoglycemic drug in obese :- metformine

64.DOC for oral hypoglycemic drug in thin:-Sulfonylureas

65.DOC for cardiogenic Shock:-Dobutamine

66.DOC for cardiogenic Shock with Oligourea:-Dopamine

67.Doc for Status Epilepticus:-Mgso4

68.DOC for prevent surgical site infection:-Cefazolin

69.Doc for patent ductus arteriosus:-Indomethacin

70.Doc for PPH:-Carbaprost

71.Doc for Anovulation:-Clomiphene Citrate

72.Antidote for warferin:- Vita. K

73.DOC for Parkinson disease:-Levodopa+carbdopa

74.DOC for hyperprolactinemia:-Bromocriptine

75.safest ATT Drug in pregnancy:-Rifampicin

76.Drug for prevent for Vertical Transmission:-Nevirapine

CISPLASTIN

CISPLATIN

Cisplatin is  a heavy metal complex containing an atom of platinum in he center surrounded by two ammonia molecules and two chloride atoms and it is platinum based chemotherapy drug used to treat various types of cancers.

Action and pharmacology:-

Cisplatin is thought to act by producing inter-strand and cross-links of cellular DNA in a similar manner  to bifunctional ALKYLATING AGENTS. It does not appear to be cell-cycle specific.

Half life :-25 to 49 minutes and terminal half life of 58 to 73 hours was calculated.

INDICATIONS:-METASTATIC TESTICULAR TUMORS
                            METASTATIC OVARIAN TUMOR
                           ADVANCED BLADDER CA

CONTRAINDICATION:-HYPERSENSITIVITY TO CISPLATIN OF OTHER Pt contains.
                                           pregnancy
                                            laction
                                              renal impairment
                                                hearing impirment
                                                  myelosuppression

ADMINISTRATION:-
NIDDLE OR INTRAVENOUS SETS CONTAINING ALUMINUM PARTS THAT MAY COME IN CONTACT WITH CISPLATIN SHOULD NOT BE USED FOR PREPARATION OR ADMINISTRATION. ALUMINUM REACTS WITH CISPLATIN CAUSING PERCIPITATE FORMATION AND A LOSS OF POTENCY.

DRUG INTERACTIONS:- Live vaccines (contraindicated)
                                                aspirin and alcohol (GI bleeding chances)
                                                   with ototoxic and nephrotoxic durgs.

SIDE EFFECTS :- Thinned or bittle hair

                                 loss of appetite or weight

                                 diarrhoea 

                                 nausea and vommitting 

                                 change in taste

                                  tingling sensation

                                 unusual bruising or bleeding 

                                 black,tarry stools 

                                 fever chills dizziness  or feeling of faintnesspain in back

                                 swelling of the feet 

                                 seizures 

                                 rash 

                                 shortness of breath

(Ref:- united biotech private limited)

COLD CHAIN

The cold chain is a system of storing and transporting vaccines of recommended temperatures from the point of manufacture to the point of use the key elements of cold chain are:-

* PERSONNEL:- To manage vaccine store and distribution.
* EQUIPMENTS:- To store and transport vaccine and to monitor Temperature.
*PROCUDURES:- To ensure that vaccines are stored and transported at appropriate temperatures.

Keeping vaccine at the right temperature is not an easy task, but the consequencys of not doing so can be disastrous once vaccine potency is lost, it cannot be regained , the damage vaccines must be destroyed, leading to inadequate vaccine stoks and wastage of expensive vaccine, moreover, children and women who receive a vaccine that is not potent are not protected.


** AT THE PHC LEVEL ALL VACCINES ARE KEPT IN THE ILR FOR A PERIOD OF ONE MONTH AT TEMPERATURE OF +2 C TO +8 C. 

** VACCINE SENSITIVITY TO HEAT:-BCG (after reconstitution) >OPV >MEASLES> DPT > BCG (before reconstitution) > DT/TT/HEPB/JE.

** VVM:-( VACCINE VIAL MONITOR):- A VVM is a label containing a heat sensitive material which is placed on a vaccine vial to register cumulative heat exposure over time. The combined effects of time and temperature cause the inner square of the vvm to darken gradually and irreversibly. before opening a vial check the status of the vial vvm. 

STAGES OF VVM:-
1. THE INNER SQUARE IS LIGHTER THAN THE OUTER CIRCLE. IF THE EXPIRY DATE HAS NOT BEEN PASSED:- USE THE VACCINE.

2. THE INNER SQUARE IS STILL LIGHTER THAN THE OUTER CIRCLE IF THE EXPIRY DATE HAS NOT BEEN PASSED:- USE THE VACCINE.

DISCARD POINT:- 

3. THE COLOR OF THE INNER SQUARE MATCHES THE COLOR OF THE OUTER CIRCLE :- DO NOT USE THE VACCINE.

BEYOND THE DISCARD POINT:-

4.BEYOND THE DISCARD POINT THE COLOR OF THE SQUARE IS DARKEN THAN THE OUTER CIRCLE : DO NOT USE THE VACCINE.

PLACEMENT OF VACCINES IN ILR :- 
(TOP TO BOTTOM)           1. DILUTES
                                             2. HEP. B
                                             3. PANTAVALENT
                                             4. DPT
                                             5. TT
                                             6. BCG
                                             7.MEASLES
                                             8.OPV

Q2. Which vaccine placed at bottom in ILR?
A. TT    B. BCG   C. MEASLES    D. OPV    
ans. OPV (D)

Q3. Which vaccine place at bottom in ILR?
A. MEASLES  B. TT  C. BCG  D. DPT 
ans. MEASLES (A)


                                                                   

                                                         COLD CHAIN ILR AT PHC

Vaccine	TEMPERATURE AT PHC
BCG	+2C TO +8 C
OPV	+2C TO +8 C
MEASLES	+2C TO +8 C
DPT	+2C TO +8 C
HEPATITIS B	+2C TO +8 C
DT	+2C TO +8 C
TT	+2C TO +8 C

IMMUNITY (VACCINE) III

                                      REACTIONS OF VACCINES

VACCINE	REACTION	INTERVAL
BCG	1.SUPPURATIVE ADENITITIS 2.BCG OSTEITIS. 3.DISSEMINATED BCG INFECTION.	1.2-6 MONTHS 2.UPTO SEVERAL YEAR 3.1-12 MONTHS.
HIB	NONE KNOWN	-
HEP B	ANAPHYLAXSIS	0-1 HOUR
MEASLES/MMR	1.FEBRILE SEIZURES 2.THROMBOCYTOPENIA (LOW PLATELETS) 3.ANAPHYLAXSIS	1.5-12 DAYS 2.60 DAYS 3.0-1 HOUR
OPV	VACCCINE ASSOCIATED PARALYTIC POLIOMYELITIS	4-30 DAYS
TETANUS	1.BACTERAIAL NEURITIS 2.ANAPHYLAXSIS 3.STERILE ABSCESS	1.2-28 DAYS 2.0-1 HOUR 3.1-6 WEEKS
DPT	1.PERSISTANT (.3HR.) INCONSOLABLE SCREAMING. 2.SEIZURES. 3.HYPOTONIC HYPORESPONSIVE EPISODE (HHC) 4.ANAPHYLACTIC SHOCK	1.0-48 HOUR 2.0-3 DAYS 3.0-24 HOUR 4.0-1 HOUR
JE(JAPANES ENCEPHALITIS)	<![if !supportLists]>1.      <![endif]>SERIOUS ALLERGIC REACTION <![if !supportLists]>2.      <![endif]>NEUROLOGICAL EVENT	1.0-2WEEKS 2.0-2 WEEKS

                             TREATMENT FOR VACCINE REACTION CASES

REACTION	TREATMENT	VACCINE NAME
*VACCINE ASSOCIATED PARALYTIC POLIOMYELITIS	NO SPECIFIC TREATMENT AVAILABLE: SUPPORTIVE CARE	OPV
*ACUTE HYPERSENSITIVE REACTION	SELF  LIMITING ANTI HISTAMINS MAY BE USEFUL	ALL
*ANAPHYLAXSIS	ADRENALINE INJECTION	ALL
*DISSEMINATED BCSG INFECTION	SHOULD BE TREATED WITH ANTI TUBERCULOSIS REGIMENS INCLUDING ISONIAZID AND RIFAMPICINE	BCG
*ENCEPHALOPATHY	NO SPECIFIC TREATMENT AVAILABLE: SUPPORTIVE CARE	MEASLES /  PERTUSIS
*FEVER	SYMPTOMATIC: PARACETAMOL GIVE EXTRA ORAL FLUID,TEPID SPONGING,OR BATH. IN CASE OF HIGH AND EXTREME FEVER,OTHER SIGNS AND SYMPTOMS SHOULD BE SOUGHT AND REPORTED/MANAGED AS APPROPRIATE.	ALL
*HYPOTONIC HYPORESPONSIVE EPISODE	THE EPISODE IS TRANSIENT AND SELF LIMITING AND  DOES NOT REQUIRE SPECIFIC TREATMENT IT IS NOT A CONTRAINDICATION TO FURTHER DOSES OF THE VACCINE.	MAINLY DPT RARELY OTHERS
*LYMPHADENITIS	HEAT SPONTANEOUSLY OVER MONTHS AND BEST NOT TO TREAT IF LESION IS STICKING TO SKIN OR ALREADY DRAINING SURGICALLY DRAINAGE LOCAL INSTILLATION OF ANTI-TUBERCULOSIS DRUG.	BCG
*INJECTION SITE ABSCESS	INCISE AND DRAIN:ANTIBIOTIC (IF BACTERIAL)	ALL INJECTABLE VACCINES
*OSTEITIS	SHOULD BE TREATED WITH ANTI-TUBERCULOSIS REGIMENS	BCG
*SEVERE LOCAL REACTION	SETTLE SPONTANEOUSLY WITHIN A FEW DAY TO A WEEK SYMPTOMATIC TREATMENT WITH ANALGESICS(ANTIBIOTICS ARE INAPPROPRIATE)	ALL INJECTABLE VACCINES