Medical Concepts

 COMMUNITY-ACQUIRED PNEUMONIA Definition: "It indicates pneumonia occurring in a person in a community (outside hospital)". Predisposing factors: Cigarette smoking Upper GIT infection Alcohol consumption Corticosteroid therapy Old age (pneumonia also called as Oldman's friend) Recent influenzae Indoor air pollution Mode of Spread: Droplet infection Infecting agents: S.pneumoniae S.aureus H.influenza Viruses - Influenza, Measles, Herpes simplex. Parainfluenza Clinical Features: Pulmonary symptoms such as : Breathlessness, cough (non-productive or productive with sputum), hemolysis, pleuritic chest pain, shortness of breath. Systemic symptoms such as : fever with chills, rigors, tachycardia, vomiting, Decreased appetite, headache, fatigue. In elderly: new onset/ progressive confusion In severely ill : Septic shock, organ failure, tachypnea, percussion note dull to flat, bronchial breathing with crackles. Investigations: Chest Pain: to confirm the diagnosis and exclude com

 DRUG-INDUCED OTOTOXICITY What is drug Induced Ototoxicity? Drug-Induced ototoxicity can affect hearing (auditory or cochlear function0, balance (vestibular function) depending on the drug. Drugs of almost every class have been reported to produce tinnitus (sounds in ear), as have placebos. The following agents are associated with measurable changes in hearing or vestibular defect when administered systemically. 1. AMINOGLYCOSIDES: Aminoglycosides antibiotics can cause cochlear or vestibular toxicities. Cochlear toxicity: occurs as progressive hear loss, starting with highest tones and advancing to lower tones. Thus, considerable damage can occur before the patient recognizes it. S ymptoms of Vestibular damage : include;  Dizziness Vertigo Ataxia Both forms of ototoxicity are bilateral and potentially reversible, but permanent damage is common and can progress even after discontinuation of aminoglycosides. Clinically detectable ototoxicity in as many as 5% patients. Most aminoglycosid