Showing posts with label December 2020. Show all posts
Showing posts with label December 2020. Show all posts

Wednesday, December 23, 2020

FORMULATING A RESEARCH PROBLEM

 

INTRODUCTION:  Formulating a research problem is the first and most important step in the research process. A research problem identifies your destination: it should tell you, your research supervisor and your readers what you intend to research. 

The more specific and clearer you are the better, as everything that follows in the research process; study design, measurement procedures, sampling strategy, frame of analysis and the style of writing of your dissertation or report, is greatly influenced by the way in which you formulate your research problem. Hence, you should examine it thoroughly, carefully and critically. 

FUNCTIONS OF A RESEARCH PROBLEM:  The main function of formulating a research problem is to decide what you want to find out about.  It is extremely important to evaluate the research problem in the light of the financial resources at your disposal, the time available, and your own and your research supervisor’s expertise and knowledge in the field of study. It is equally important to identify any gaps in your knowledge of relevant disciplines, such as statistics required for analysis. Also, ask yourself whether you have sufficient knowledge about computers and software if you plan to use them.

RELATED;

1.  THE PROBLEM STATEMENT

2.  HOW TO WRITE A RESEARCH PROPOSAL

3.  MOST PREVAILING RESEARCHABLE PROBLEMS 2023

REFERENCES

Monday, December 21, 2020

HAEMOLYSINS AS BACTERIAL TOXINS

INTRODUCTION:  S. pyogenes elaborates two haemolysins. One of these is oxygen labile and hence named as streptolysin O (SLO) and the other being stable to the action of oxygen and soluble in serum is designated as streptolysin S (SLS). 

Streptolysin O (SLO).  It is responsible for haemolysis in the deeper layers of blood agar where streptococci grow in the absence of oxygen. SLO is toxic for red blood cells, white blood cells, as well as myocardial cells in tissue cultures.   

Streptolysin S (SLS).  This agent is responsible for the haemolytic zone around the streptococcal colonies growing on the surface of blood agar in the presence of oxygen.  It is a soluble product which cannot withstand boiling for more than 60 minutes.  Streptococcal pyrogenic exotoxins exert profound effect on immune system, including enhancement of susceptibility to endotoxic shock, blockade of reticuloendothelial system and alterations in the T cell function.  These toxins are produced only by those strains of group A streptococci which are carrying temperate phage in their genome.  Classically it was thought that this toxin caused red reaction in the skin of nonimmune individual (positive Dick test) and no reaction in individuals with immunity (negative Dick test).  Antitoxin injected into the skin of a patient with scarlet fever causes localised blanching due to neutralization of erythrogenic toxin (Schultz-Charlton reaction).  

Streptokinase:  This is a fibrinolysin which is produced by the group A streptococci.  Strains from groups C and G also produce it.  It transforms the plasminogen of human plasma into plasmin, an active proteolytic enzyme that digests fibrin and other proteins.

RELATED;

1.  STREPTOCOCCUS  2.  VIRULENCE FACTORS OF MICROBES

REFERENCES

COMPONENTS OF A MEDICAL RESEARCH PROPOSAL

COMPONENTS OF A RESEARCH PROPOSAL:  So much we have talked about the medical research proposal and how to start with the research project.  It will be very important for any upcoming researcher to be well versed with each entity of the research proposal before any writing can take place. On this page, we are giving an outline and a brief description of what is expected to be in a full written medical proposal.  At this point, I am expecting a student to have got their research topic approved by the research and ethics committee.  Follow the link below for ethical issues and considerations in research
Ethical issues and considerations in research

Also, you can follow the link below, to get started with formulating a research topic.
And if you are stuck on the research process, you can follow the link below for the most researchable medical problems 2022

CHAPTER ONE

1.0  Introduction:  Here, a student will be expected to outline the components of the very first chapter in order to give the reader some kind of organization.

1.1  Background of the study:  The background of the study gives a summary of the description for the research project.  It should be not more than 1 and half pages and about 3 paragraphs.

1.2  Problem statement:  The problem statement is a summery of the reason that triggered the medical student to conduct the research study.  I have discussed a lot about it and if you want to read about it in details, click on the link below.

1.3  Broad objective

1.4  Specific objectives

1.5  Purpose of the study

1.6  Justification of the study


CHAPTER TWO: LITERATURE REVIEW

2.0  Introduction

2.1  Literature 1

2.2  Literature 2

2.3  Literature 3

2.4  Conceptual framework


CHAPTER THREE:  METHODOLOGY

3.0  Introduction

3.1  Study settings

3.2  Study design

3.3  Sample size determination

3.4  Sampling procedures

3.5  Inclusion criteria

3.6  Exclusion criteria

3.7  Data analysis:  The process of data analysis involves putting the collected data in the order of interpretation as we shall be discussing more about it.  This is the main activity in chapter four and I already talked about some bit of it.  You can follow the link below for more details;  Data analysis and presentation

3.8  Ethical considerations:  The ethical considerations in medical research methods establishes the trust with which the study will be conducted.  It is highly advisable that as you conduct the research study, it should leave the study settings the way they are.

3.9  Dissemination of results:  This briefly outlines the areas where the report data or research findings will be shared.  Usually it is very vital that after conduction of the study, the stakeholders like the data collection sites get to know some of the relevant findings of the research project.

APPENDIX

RELATED;

Tuesday, December 15, 2020

BENZODIAZEPINES

Examples:  Alprazolam, Chlordiazepoxide, Clorazepate, Clonazepam, Diazepam, Estazolam, Flurazepam, Lorazepam, Midazolam, Oxazepam, Quazepam, Temazepam, Triazolam

Mechanism of action and drug effects:  Bind to specific GABA receptor subunits at central nervous system (CNS) neuronal synapses facilitating frequency of GABA-mediated chloride ion channel opening; enhance membrane hyperpolarization.

Clinical applications:  Acute anxiety states, panic attacks, generalized anxiety disorder, insomnia and other sleep disorders, relaxation of skeletal muscle, anesthesia (adjunctive), and seizure disorders.

Pharmacokinetics, toxicity and drug-drug interactions:  Half-lives from 2–40 h, oral activity.  Toxicity: Extensions of CNS depressant effects, dependence liability.  Interactions: Additive CNS depression with ethanol and many other drugs.

RELATED;

1.  ZOLPIDEM

2.  BARBITURATES

3.  PHARMACOLOGY AND THERAPEUTICS

Friday, December 04, 2020

THE PITUITARY GLAND


INTRODUCTION: The pituitary gland (or hypophysis) hangs by a short stalk also known as, infundibulum, from the hypothalamus and is enclosed by the sella turcica of the sphenoid bone. Despite its small size, the pituitary gland regulates many body functions. Its two major portions are the posterior pituitary gland also known as neurohypophysis, which is an extension of the nerve tissue of the hypothalamus, and the anterior pituitary gland also known as, adenohypophysis, which is separate glandular tissue.

POSTERIOR PITUITARY GLAND: The two hormones of the posterior pituitary gland are actually produced by the hypothalamus and simply stored in the posterior pituitary until needed. Their release is stimulated by nerve impulses from the hypothalamus.

Antidiuretic Hormone: Antidiuretic hormone, ADH, also called vasopressin, increases the reabsorption of water by kidney tubules, which decreases the amount of urine formed. The water is reabsorbed into the blood, so as urinary output is decreased, blood volume is increased, which helps maintain normal blood pressure. ADH also decreases sweating, but the amount of water conserved is much less than that conserved by the kidneys. The stimulus for secretion of ADH is decreased water content of the body. 

PATHOPHYSIOLOGY: If too much water is lost through sweating or diarrhea, for example, osmoreceptors in the hypothalamus detect the increased “saltiness” of body fluids. The hypothalamus then transmits impulses to the posterior pituitary to increase the secretion of ADH and decrease the loss of more water in urine. Any type of dehydration stimulates the secretion of ADH to conserve body water. In the case of severe hemorrhage, ADH is released in large amounts and will also cause vasoconstriction, especially in arterioles, which will help to raise or at least maintain blood pressure. This function gives ADH its other name, vasopressin.

ALCOHOL AND PITUITARY HORMONES: Ingestion of alcohol inhibits the secretion of ADH and increases urinary output. If alcohol intake is excessive and fluid is not replaced, a person will feel thirsty and dizzy the next morning. The thirst is due to the loss of body water, and the dizziness is the result of low blood pressure.


RELATED;

1. HORMONES

2. BLOOD PRESSURE

3. ALCOHOL AND ITS USE

REFERENCES


NON-DRUG MEANS OF PREVENTING PEPTIC ULCER DISEASE

NON-DRUG MEANS OF PREVENTING PEPTIC ULCER DISEASE:  Peptic ulcer disease is one of the most common problems among adults in developing countries especially here in sub Saharan Africa where almost more than 50% of the adult population in Uganda have a complaint of the disease at least once in a year.  Despite the rampant growth of populations suffering from the disease, there is little or nothing know about this mythical disease.  Currently there are many drugs developed for the condition but even so, compliance and poor medical investigation play a role in increasing number of patients in many communities.  In our discussion here, we are going to look at the non medical interventions that can help someone prevent development of peptic ulcer but before, let us first see the main causes of the disease.

THE MOST COMMON CAUSES OF PEPTIC ULCERS: 
The causes of peptic ulcer disease can be categorized into 3; 1) Microbes where the most common and the leading cause is Helicobacter pylori.  

2)  The second most common cause is hypersecretion of gastric juice and it's associated Hydrochloric acid.  In this case, either there is a tumor in the stomach that secrets more than required enzymes and or, there is delayed intake of food that makes the produced gastric juice digest it's own wall, a process known as autodigestion.  To understand more of this, read about the Pathophysiology of peptic ulcer disease discussed earlier from here.  
3) The third and last general cause of peptic ulcer disease, are the aggressive factors.  these are the things that we take in that either impair the production of the mucus layer lining the stomach walls, or disintegrate the formed mucus layer itself.  These factors are quite many but let us look at the most common ones; a) Drugs such as Non steroidal anti-inflammatory drugs (NSAIDs)  These drugs inhibit the enzyme cyclooxygenase responsible for production of mucus-like secretions from prostaglandins.

b)  Alcohol and caffeine; For alcohol and caffein users, chronic use of these drugs directly react with the mucus layer in the stomach and make it washed away, leaving the layers of the stomach bare and exposed to any injurious agents.

NON-DRUG PREVENTING MEASURES OF PEPTIC ULCER DRUGS:  From the description above, it is evident that as long as we can avoid the causative agents, we can then be free from peptic and duodenal ulcer diseases.

1.  When it comes to microbes especially H. pylori in this instance, the general preventive measure will be ensuring good hygiene and taking well cooked an prepared food stuffs.  By avoiding eating junk foods, there will be less of the foreign bacteria ingested in our bodies.

2.  For the second common cause we looked at which was hypersecretion of gastric juice, the first remedy will be eating in time or preventing living an empty stomach and then, if possible, to be checked to ensure there is no acid secreting tumor in case of an episode of signs and symptoms of peptic ulcers.

3.  Finally, we will need to get rid of the aggressive factors including but not limited to use of alcoholic beverages, smoking, caffeinated drinks and frequent use of NSAIDs for a long time to alleviate pain.  For some of such aggressive factors it may be hard to deter from them but there is a way we can reduce on the frequency.  For example with alcohol if you have been a "Daily drinking officer (DDO)", then you can become a weekly, monthly drinking officer or even quit it as long as the benefits are outweighed by the potential threats from it.  And then the other option will be taking such aggressive factor following a heavy meal, to avoid direct contact on an empty stomach.

Finally if any of the non-pharmacological interventions fails and you continue to develop the disease, aim for anti-peptic ulcer drugs as we have described them in our previous discussions in the links below to avoid development of perforations and subsequent death from a curable disease

RELATED;
5.  ALCOHOL

DATA COLLECTION TOOL (QUESTIONNAIRE)

INTRODUCTION:  A questionnaire is a written list of questions, the answers to which are recorded by respondents. In a questionnaire respondents read the questions, interpret what is expected and then write down the answers. The only difference between an interview schedule and a questionnaire is that in the former it is the interviewer who asks the questions and sometimes if necessary, explains them, and records the respondent’s replies on an interview schedule, while in the latter replies are recorded by the respondents themselves.

HOW TO CONSTRUCT A QUESTIONNAIRE:  A questionnaire is constructed basing on the specific objectives and it should be able to generate answers for study objectives.

RELATED;

INTRAMASCULAR ROUTE OF DRUG ADMINISTRATION

INTRAMASCULAR ROUTE OF DRUG ADMINISTRATION:  The intramuscular route of drug administration is another commonly used technique, where the drug bolus is directly deposited into the muscle tissue using a an injection device.  This is one of the most commonly used routes of drug administration especially in patient who are not able to swallow medication or those that need emergency medicine.  It should be noted however that this route is an invasive procedure and therefore requires a trained medical personnel to perform it, and specialized sterile techniques.


PROCEDURE:  In this type of drug administration, the very first thing is to sterilize the site where the needle is to be injected into the skin, so as not to introduce microbes into the body.  this is done via application of sterile agents such as ethyl alcohol swabs or any available disinfectant.  The needle then, is inserted into the muscle at an angle of 90 degrees perpendicular to the skin surface as shown in the picture above.  Then the drug is released and the bolus is deposited into the muscle tissue.  the released bolus will then leave the muscle tissue where it is deposited slowly, entering blood circulation.  From there, the drug will be leaving the injection site slowly entering the blood circulation to the target organs.

Examples of drugs administered intramuscularly:  1)  For severe malaria, Artemisinin component Artesunate can be administer this way in comparison to oral Artemether and Lumefantrine.

2.  Most of the vaccines are also administered this way.  To read more about administration of vaccines follow the link below.

RELATED;

METHOTREXATE


Pharmacokinetics: Methotrexate is an antimetabolite that has beneficial effects in a number of chronic inflammatory diseases, including Crohn’s disease and rheumatoid arthritis. Methotrexate may be given orally, subcutaneously, or intramuscularly. Reported oral bioavailability is 50–90% at doses used in chronic inflammatory diseases. Intramuscular and subcutaneous methotrexate exhibit nearly complete bioavailability.

Mechanism of action: The principal mechanism of action is inhibition of dihydrofolate reductase, an enzyme important in the production of thymidine and purines. At the high doses used for chemotherapy, methotrexate inhibits cellular proliferation. However, at the low doses used in the treatment of inflammatory bowel disease (12–25 mg/wk), the antiproliferative effects may not be evident. Methotrexate may interfere with the inflammatory actions of interleukin-1. It may also stimulate increased release of adenosine, an endogenous antiinflammatory autacoid. Methotrexate may also stimulate apoptosis and death of activated T lymphocytes.

Clinical Uses: Methotrexate is used to induce and maintain remission in patients with Crohn’s disease. Its efficacy in ulcerative colitis is uncertain. To induce remission, patients are treated with 15–25 mg of methotrexate once weekly by subcutaneous injection. If a satisfactory response is achieved within 8–12 weeks, the dose is reduced to 15 mg/wk.

Adverse Effects: At higher dosage, methotrexate may cause bone marrow depression, megaloblastic anemia, alopecia, and mucositis. At the doses used in the treatment of inflammatory bowel disease, these events are uncommon but warrant dose reduction if they do occur. Folate supplementation reduces the risk of these events without impairing the anti-inflammatory action. In patients with psoriasis treated with methotrexate, hepatic damage is common; however, among patients with inflammatory bowel disease and rheumatoid arthritis, the risk is significantly lower. Renal insufficiency may increase risk of hepatic accumulation and toxicity.

REFERENCES


GOUT


INTRODUCTION:  Gout is a heterogeneous group of inflammatory conditions related to a genetic defect of purine metabolism and resulting in hyperuricemia.

PATHOPHYSIOLOGY:  In gout, there is an oversecretion of uric acid or a renal defect resulting in decreased excretion of uric acid, or a combination of both. Primary hyperuricemia may be due to severe dieting or starvation, excessive intake of foods high in purines such as shellfish and organ meats, or heredity. In secondary hyperuricemia, the gout is a clinical feature secondary to any of a number of genetic or acquired processes, including conditions with an increase in cell turnover (leukemias, multiple myeloma, psoriasis, some anemias) and an increase in cell breakdown.

CLINICAL MANIFESTATIONS:  Gout is characterized by deposits of uric acid in various joints. Four stages of gout can be identified: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout, and chronic tophaceous gout.  Acute arthritis of gout is the most common early sign.  The metatarsophalangeal (MTP) joint of the big toe is most commonly affected; the tarsal area, ankle, or knee may also be affected.  The acute attack may be triggered by trauma, alcohol ingestion, dieting, medication, surgical stress, or illness.  Abrupt onset occurs at night, causing severe pain, redness, swelling, and warmth over the affected joint.  Early attacks tend to subside spontaneously over 3 to 10 days without treatment.  The next attack may not come for months or years; in time, attacks tend to occur more frequently, involve more joints, and last longer.

ASSESSMENT AND DIAGNOSTIC METHODS:  A definitive diagnosis of gouty arthritis is established by polarized light microscopy of the synovial fluid of the involved joint. Uric acid crystals are seen within the polymorphonuclear leukocytes in the fluid.

MEDICAL MANAGEMENT:  Colchicine (oral or parenteral), an NSAID such as indomethacin, or a corticosteroid is prescribed to relieve an acute attack of gout.  Hyperuricemia, tophi, joint destruction, and renal problems are treated after the acute inflammatory process has subsided.  Uricosuric agents, such as probenecid, correct hyperuricemia and dissolve deposited urate.  Allopurinol is effective when renal insufficiency or renal calculi are a risk.  Corticosteroids may be used in patients who have no response to other therapy.  Prophylactic treatment considered if patient experiences several acute episodes or there is evidence of tophi formation.

RELATED;

1.  RHEUMATOID ARTHRITIS

REFERENCES

DIGESTION OF CARBOHYDRATES

 

INTRODUCTION: In the diet carbohydrates are present as complex polysaccharides in form of starch, glycogen, and to a minor extent, as disaccharides such as, sucrose and lactose. They are hydrolysed to monosaccharide units in the gastrointestinal tract. Cooking makes the digestion process easier.

DIGESTION IN THE MOUTH: This process of digestion starts in mouth by the salivary alpha-amylase. However, the time available for digestion in the mouth is limited, because the gastric hydrochloric acid will inhibit the action of salivary amylase.

DIGESTION IN THE DUODENUM: In the pancreatic juice another alpha-amylase is available which will hydrolyse the alpha-1,4 glycosidic linkages randomly, so as to produce smaller subunits like maltose, isomaltose, dextrins and branched or unbranched oligosaccharides.

DIGESTION IN SMALL INTESTINES: The cells of brush border of intestine contain the enzymes, sucrase, maltase, isomaltase and lactase. They hydrolyse the corresponding disaccharides into component monosaccharides which are then absorbed.

Clinical Application; Lactose Intolerance is a medical condition that is characterised by inability to digest lactose. Lactase hydrolyses lactose to glucose and galactose. Lactase is present in the brush border of enterocytes. Deficiency of lactase leads to lactose this condition, where lactose accumulates in the gut. Irritant diarrhea and flatulence are seen. Lactase is an inducible enzyme. If milk is withdrawn temporarily, the diarrhoea will be limited. Curd is also an effective treatment, because the lactobacilli present in curd contains the enzyme lactase. Lactase is abundantly seen in yeast, which could also be used in treatment.

ABSORPTION OF CARBOHYDRATES: Only monosaccharides are absorbed by the intestine. Absorption rate is maximum for galactose; moderate for glucose; and minimum for fructose.

Absorption of Glucose: Glucose has specific transporters, which are transmembrane proteins. 1) Co-transport from Lumen to Intestinal Cell. This process is mediated by Sodium Dependent Glucose Transporter-1 (SgluT-1). 2) A membrane bound carrier protein is involved, which carries glucose, along with sodium. This sodium is later expelled by the sodium pump with utilization of energy. So energy is needed indirectly. The transporter in intestine is named as SGluT1 and the transporter in the kidney is called SGluT-2. The first one is involved in glucose-galactose malabsorption. The SGluT-2 is defective in congenital renal glycosuria.

CLINICAL APPLICATION: Common treatment for diarrhea is oral rehydration fluid. It contains glucose and sodium. Presence of glucose in oral rehydration fluid allows uptake of sodium to replenish body sodium chloride. Another Uniport System Releases Glucose into Blood. The same intestinal epithelial cells have a different transport mechanism on the membrane facing capillaries.


RELATED;

1. LACTOSE INTOLERANCE

2. METABOLIC PROFILE OF ORGANS

3.  DIGESTION OF LIPIDS

REFERENCES


ENZYMES AS BIOCATALYSTS


INTRODUCTION: Life is possible due to the co-ordination of numerous metabolic reactions inside the cells. Proteins can be hydrolyzed with hydrochloric acid by boiling for a very long time; but inside the body, with the help of enzymes, proteolysis takes place within a short time at body temperature.

KINETICS OF ENZYMES: Enzyme catalysis is very rapid; usually 1 molecule of an enzyme can act upon about 1000 molecules of the substrate per minute.

CONSEQUENCES OF LOW OR NO ENZYMATIC ACTION: Lack of enzymes will lead to block in metabolic pathways causing inborn errors of metabolism. The substance upon which an enzyme acts, is called the substrate. The enzyme will convert the substrate into the product or products.

CHARACTERISTICS OF ENZYMES:

1) Almost all enzymes are proteins. Enzymes follow the physical and chemical reactions of proteins.

2) They are heat labile.

3) They are water-soluble.

4) They can be precipitated by protein precipitating reagents (ammonium sulfate or trichloroacetic acid).

5) They contain 16% weight as nitrogen.


RELATED;

1. Biochemistry of enzymes

2. Glucagon

3. Catalase

References

HOW TO INSTALL ANDROID APPS USING ADB COMMANDS

HOW TO INSTALL ANDROID APPS USING ADB COMMANDS:  Installing android apps is pretty automated when you are downloading them from the play store because you just wait for the app to download and the installation process will automatically follow.  There are times however when you are offline, you have the app package you want to use, or your play store is not configured yet and you don't urgently need it.  In that case, adb commands become the most handy method of installing the app.  It is common however that, everyone see the commands as a big job and if you would like to install apps using tools, click here for some of the most useful tools downloads.

Requirements:
1. Minimal adb and fastboot:  This software tool will help you to run adb commands with ease.  It has an easy to use interface, and the commands to use with it are universal.  You can download it from the link below.

2.  The Smartphone onto which you want to install the app, and make sure USB debugging is activated on that phone.  You can click here to know how to activate USB debugging.

3.  Original USB cable of the phone

4.  Computer running windows

5.  Windows drivers for smartphones

Steps:
1.  Download and install the setup on your PC

2.  Right click on the setup and select the option "Run as administrator"

3.  Once launched, enter the commands below one by one
adb device:  This will show you whether the phone is detected by the adb.
adb install,  then followed by the package name of the application you want to install and then the directory where the app is located.  Then end with the extention ".apk"
For example, I am installing WhatApp GB which is located on my desktop in a folder named "ANDROID APPS" and this is how I will enter the command.
adb install "C:\Users\Muwanga Godfrey\Desktop\ANDROID APPS\com.gbwhatsapp_v2.22.10.73-2139210155_Android-4.1.apk"

4.  Just wait for a few seconds and you will see a success message on the PC then check on your phone and that's all.

Conclusion:  The android debug bridge is one of the most useful platforms for installing android apps and doing a lot of things.  And if you are new about it, follow the link below for details.

LINKS TO UGANDAN UNIVERSITIES AND HIGHER INSTITUTIONS OF LEARNING

LINKS TO UGANDAN UNIVERSITIES AND HIGHER INSTITUTIONS OF LEARNING
1.  Gulu University

2.  Mbarara University of Science and Technology (M.U.S.T)

3.  Makerere university

4.  University of Kisubi

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