@amitesh The study included adults who were diagnosed with cancer between January 1, 2007, and March 31, 2019, and had completed the Edmonton Symptom Assessment System (ESAS) evaluation within 36 months of their index cancer diagnosis. ESAS evaluates nine common cancer-associated symptoms, including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath, on a patient-reported scale of 0 (absence of symptom) to 10 (worst possible symptom). The analysis included 406 patients who had visited an emergency department for an NFSI within 180 days of their ESAS evaluation, as well as 1624 matched control patients with cancer who did not have an NFSI. Case patients and control patients were matched according to age at cancer diagnosis, sex, prior self-injury within 5 years of being diagnosed with cancer, and cancer type. Nonmatched covariates included psychiatric illness and therapy received before NFSI, comorbidity burden, material deprivation, and cancer stage.
Latest posts made by Litti
RE: Three Symptoms Suggest Higher Risk for Self-injury in Cancer
RE: Certain Gut Bacteria Tied to Lower Risk of Diabetes
@japmaan A diet rich in fiber and prebiotics promotes gut biome diversity, added Steinle, chief of the endocrinology and diabetes section at Maryland Veterans Affairs Medical Center in Baltimore. The findings add to other research, she noted, such as a prospective trial in which a high-fiber diet induced changes in the gut microbe that were linked to better glycemic regulation (Science. 2018;359:1151-1156) and a study of a promising probiotic formula to treat diabetes.
RE: Pathophysiology of Hypertension ?
@hardik The progression of essential hypertension begins with prehypertension in persons aged 10-30 years (by increased cardiac output); then advances to early hypertension in persons aged 20-40 years (in which increased peripheral resistance is prominent); then progresses to established hypertension in persons aged 30-50 years; and finally advances to complicated hypertension in persons aged 40-60 years. Essential hypertension (also called idiopathic hypertension) may be attributed to multiple factors, including genetic predisposition, excess dietary salt intake, and adrenergic tone, that may interact to produce hypertension. Essential hypertension accounts for 90% of human hypertension and can evolve into secondary hypertension, as renal function decreases. Thus, the distinction between primary and secondary forms of hypertension is not always clear in patients who have had uncontrolled hypertension for many years.
RE: How to reduce the bad habits of smoking?
@ganesh Urges for tobacco are likely to be strongest in the situations where you smoked or chewed tobacco most often, such as at parties or bars, or while feeling stressed or sipping coffee. Identify your trigger situations and have a plan in place to avoid them entirely or get through them without using tobacco. Don't set yourself up for a smoking relapse. If you usually smoked while you talked on the phone, for instance, keep a pen and paper nearby to occupy yourself with doodling rather than smoking. If you feel like you're going to give in to your tobacco craving, tell yourself that you must first wait 10 more minutes — and then do something to distract yourself for that period of time. Try going to a public, smoke-free zone. These simple tricks may be enough to derail your tobacco craving.
RE: What are the acute and chronic causes of diarrhoea, and what are the investigations required?
@kamal Acute diarrhea is defined as the abrupt onset of 3 or more loose stools per day and lasts no longer than 14 days; chronic or persistent diarrhea is defined as an episode that lasts longer than 14 days. Causes
Infectious - Gastroenteritis, Antibiotic associated colitis, Giardia, amoebiasis (bloody stools)
Inflammatory - Ulcerative colitis (bloody), Crohn's disease
Functional - Irritable bowel syndrome, Laxative abuse
Osmotic - related to oral intake of unabsorbed sugars
Drug induced - laxatives, colchicine, PPIs
Malabsorption - Coeliac disease, Crohn's disease
Neoplastic - colorectal (bloody), rectal villous adenoma (mucus)
Assess stool with Bristol stool scale
Stool microscopy and culture
Clostridium difficile toxin
Check U&E for dehydration. In children consider Haemolytic uraemic syndrome with certain E coli
FBC - elevated WCC, Anaemia - Microcytic suggests possibly a colonic malignancy or inflammatory
bowel disease. Macrocytosis may suggest malabsorption. Dimorphic may suggest both. LFTS - elevated ALP and Bilirubin with obstruction may cause steatorhoea
RE: Brownish discoloration in the mouth at multiple sites of a smoker. How to treat this ?
@ganesh Smoker's melanosis may be due to the effects of tobacco smoke on melanocytes located in the lining epithelium of the oral mucosa. Smoker's melanosis is likely due to direct effects of tobacco smoke on the oral mucosa. Smoke is thought to cause changes in the mucosa through a combination of physical (heat) and/or chemical (nicotine and tobacco-specific compounds) effects. If the areas become depigmented and erythematous, squamous cell carcinoma has been found in 12% of these patients, suggesting that melanin might have a protective role against noxious substances in the tobacco smoke. If the pigmentation is in an unusual location, an ulceration is present, or the lesion is elevated, a biopsy is necessary to exclude other pigmented conditions (eg, nevi, melanoma). Although smoker's melanosis is an abnormal deposition of melanin, the lesion itself is not associated with an increased risk of melanoma or carcinoma. Generally, no treatment is necessary. However, if the pigmentation is in an unusual location, such as the hard palate; if an area of ulceration is present; or the lesion is elevated, a biopsy is necessary to exclude other pigmented conditions (eg, nevi, melanoma).
RE: Acute skin failure- how to manage this condition?
@yash-0 cute skin failure is a state of total dysfunction of the skin resulting from different dermatological conditions. It constitutes a dermatological emergency and requires a multi-disciplinary, intensive care approach. Its effective management is possible only when the underlying pathomechanism of each event is clear to the treating clinician. The concept of skin failure is new to non-dermatologist clinicians and sketchy among many dermatologists.
What are the symptoms of depression?
Hello, What are the symptoms of depression? Understanding these conditions can help reduce fear and misunderstanding of mental illness, and empower everyone with the knowledge on how to care for their mental health, and that of their loved ones. Please leave your comments on this.
RE: My legs pain a lot after excessive walking, recommend some therapy?
@kamal Muscle cramps can have many causes, though sometimes the cause is unknown. Some of the most common causes include:
not stretching properly before physical activity
overuse of your muscles
low electrolyte levels
low blood supply to the muscles
The main symptom of muscle cramping is pain, which can range in intensity from mild to severe. The affected muscle may also feel hard to the touch.
A cramp can last anywhere from a few seconds to several minutes. There are steps you can take to help reduce the likelihood of having a cramp in your calf muscles. These include staying hydrated and stretching before starting any type of physical activity.
RE: Hyperprolactinaemia- what are the causes of this condition?
Stress - physical (including excessive exercise) or psychological - including venepuncture.
This refers to prolactin of high molecular mass, mostly complexes of monomeric prolactin with immunoglobulins (prolactin autoantibody complexes). These larger molecules have low bioactivity and a prolonged clearance rate similar to that of immunoglobulins. Depending on the immunoassay used, macroprolactinaemia may account for 25% of laboratory documented hyperprolactinaemia. Consider this cause in an asymptomatic patient with hyperprolactinaemia and consult laboratory staff.
Abnormally high levels of prolactin may be caused by a prolactin-secreting pituitary tumour or by a non-secreting pituitary tumour that prevents dopamine (prolactin release-inhibiting hormone) from reaching normal prolactin-producing cells.
Microprolactinomas (the most common, approximately 90%).
Macroprolactinomas (>10 mm size - approximately 10%).
Pituitary or hypothalamic tumour compressing the pituitary stalk - eg, craniopharyngioma.