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Recognizing and responding to stroke: Remember the BEFAST signs

A stroke is a medical condition that occurs when the blood supply to a part of the brain is disrupted, either by a blockage (ischemic stroke) or a burst blood vessel (hemorrhagic stroke). This interruption in blood flow can lead to brain cells being deprived of oxygen and nutrients, causing them to start dying within minutes.

A stroke is a medical emergency. Call 911 right away if you have any of these symptoms of a stroke:

BE FAST is an easy way to remember the signs of a stroke.

Be Fast stands for:
B is for balance. Sudden loss of balance or coordination.
E is for eyes. Vision changes in one or both eyes.
F is for face drooping. One side of the face is drooping or numb. When the person smiles, the smile is uneven.
A is for arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.
S is for speech difficulty. You may notice slurred speech or trouble speaking. The person can't repeat a simple sentence correctly when asked.
T is for time to call 911. If someone shows any of these symptoms, even if they go away, call 911 right away. Make note of the time the symptoms first appeared.
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Major Differences of Gastric &. Duodenal Ulcer

Understanding Gastric and Duodenal Ulcers
Gastric ulcers, also known as stomach ulcers, are open sores that develop on the lining of the stomach. These ulcers can be painful and may lead to various complications if left untreated.

Duodenal ulcers occur in the first part of the small intestine known as the duodenum. These ulcers are generally smaller than gastric ulcers but share similar symptoms.

Symptoms of Gastric and duodenal Ulcers
The symptoms of gastric ulcers include a burning sensation in the stomach, bloating, nausea, and vomiting. Patients may experience discomfort, especially during or after meals.

Symptoms of duodenal ulcers include burning pain in the upper abdomen, which may improve temporarily after eating or taking antacids. Patients might also experience disturbed sleep due to the discomfort.

Causes of Gastric and duodenal Ulcers
Gastric ulcers are primarily caused by the bacterium Helicobacter pylori (H. pylori) or the prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs). Other factors, such as excessive alcohol consumption and smoking, can also contribute to their development.

The primary causes of duodenal ulcers are also H. pylori infection and the use of NSAIDs. These factors lead to an imbalance between stomach acid and the protective lining of the duodenum.
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REEDA Episiotomy Healing Assessment

What is an episiotomy?
An episiotomy refers to the incision made at the perineum, which is the area between the vagina and the anus, in order to enlarge the vaginal opening during labor and delivery. Occasionally, the vaginal opening cannot stretch enough to accommodate the baby's head. In such cases, an episiotomy widens the vaginal opening to aid in delivering the baby.

What is REEDA?
The REEDA acronym stands for Redness, Edema, Ecchymosis, Discharge, and Approximation. It is a standardized tool used by healthcare professionals to assess the healing process of an episiotomy incision.

Redness around the episiotomy site is one of the indicators of inflammation or infection.

Edema. Monitoring the presence and degree of swelling helps assess healing and identify any signs of fluid retention or tissue damage.

Ecchymosis, evaluating the extent and color changes of the bruised area helps healthcare providers determine if healing is progressing appropriately.

Discharge. Assessing the type, odor, and volume of discharge is crucial in identifying potential issues such as infection.

Approximation refers to the proper alignment and closure of the episiotomy incision. It is essential to evaluate if the edges are well-approximated or if there is any separation, as it can affect healing outcomes.
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10 ways to prevent Urinary Tract Infection (UTI)

To help prevent urinary tract infections, you can follow these tips:

1. Drink plenty of water throughout the day. This helps to flush out bacteria and keep your urinary system healthy.

2. Don't hold in urine for extended periods. Urinating frequently helps to eliminate bacteria from the urinary tract.

3. Wipe from front to back after urinating or having a bowel movement. This prevents bacteria from the anal area from spreading to the urethra.

4. Avoid using harsh soaps, as they can disrupt the natural balance of bacteria in the area.

5. Urinate before and after sexual intercourse helps to flush out any bacteria that may have entered the urethra during sex.

6. Choose underwear made of natural fabrics like cotton, as they allow air circulation and help keep the genital area dry.

7. Avoid using scented sprays or other feminine hygiene products, as they can irritate the urethra and increase the risk of infection.

8. Drink cranberry juice or take cranberry supplements may help prevent UTIs by preventing bacteria from adhering to the urinary tract walls.

9. Empty your bladder completely when you urinate. Holding in urine for long periods can allow bacteria to multiply and increase the risk of infection.

10. Change sanitary pads regularly during your menstrual cycle to prevent the growth of bacteria.
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Common Oral Anti-Diabetic Medications

Metformin is often the first-line oral medication prescribed for type 2 diabetes. It belongs to the biguanide class and works by reducing glucose production in the liver, increasing insulin sensitivity, and improving glucose uptake by muscle cells. Metformin is known to lower blood sugar levels and may also have additional benefits, such as weight loss and cardiovascular protection.

Sulfonylureas stimulate the release of insulin from the pancreas, helping to lower blood sugar levels. Examples of sulfonylureas include glibenclamide, glipizide, and glimepiride. While they can be effective, it's important to monitor blood sugar levels closely to prevent hypoglycemia (low blood sugar) when using this class of medications.

Meglitinides are another class of medications that stimulate insulin release from the pancreas. Repaglinide and nateglinide are commonly prescribed meglitinides. Similar to sulfonylureas, careful monitoring is necessary to avoid hypoglycemia.

Alpha-glucosidase inhibitors, such as acarbose and miglitol, slow down the absorption of carbohydrates in the intestine. By inhibiting the enzymes responsible for breaking down complex carbohydrates into simple sugars, these medications help control blood sugar levels after meals.

Thiazolidinediones, including pioglitazone and rosiglitazone, work by improving insulin sensitivity in muscle and fat cells. They help the body use insulin more effectively, leading to better blood sugar control. However, TZDs may have side effects, such as fluid retention and an increased risk of heart failure, so careful monitoring is crucial.

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Type 1 Diabetes vs. Type 2 Diabetes
In diabetes mellitus, the body has trouble moving glucose from the blood into the tissue cells. As a result, cells starve for energy while the person has high blood glucose levels, which is called hyperglycemia.

While type 1 diabetes and type 2 diabetes share the commonality of high blood sugar levels, they differ significantly in their causes, onset, and treatment approaches.

Type 1 diabetes is an autoimmune condition that primarily affects children and requires lifelong insulin therapy.

Type 1 diabetes often appears suddenly and progresses rapidly, with symptoms such as polyuria, polydipsia, polyphagia, unexplained weight loss, fatigue, and blurred vision.

On the other hand, type 2 diabetes is associated with lifestyle factors and insulin resistance and can often be managed initially with lifestyle modifications.

Type 2 diabetes often develops gradually over time, and individuals may remain undiagnosed for years. Symptoms may include increased thirst, frequent urination, fatigue, slow-healing wounds, and recurrent infections.

The hallmark characteristic of type 2 diabetes is insulin resistance. The body's cells do not respond effectively to insulin, making it difficult for glucose to enter the cells and resulting in elevated blood sugar levels.

Initially, type 2 diabetes can often be managed through lifestyle modifications, including diet, exercise, and weight loss. Medications, including oral antidiabetic drugs or injectable insulin, may be prescribed as the disease progresses.
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Navigating Deliriums’ maze: Exploring the 3 types

Delirium is a common and distressing condition characterized by an acute onset of fluctuating cognitive impairment. It often occurs in the hospital setting, particularly among older adults.

Types of delirium:

Hyperactive delirium is characterized by increased psychomotor activity, agitation, restlessness, and hallucinations. Patients may exhibit disruptive behavior, making it challenging for healthcare professionals to provide adequate care.

Maintain a calm environment.
Encourage sleep and rest.
Reorient and cognitive stimulation such as reminiscing, reading, or puzzles to help redirect their focus and decrease agitation.

Hypoactive delirium is characterized by lethargy, reduced alertness, slowed movement, and withdrawal from social interactions. Patients with hypoactive delirium often go unnoticed or may be mistaken for depression or dementia.

Reassess the patient frequently.
Encourage mobility and physical activity.
And social stimulation

And lastly, Mixed delirium which involves a combination of hyperactive and hypoactive symptoms, fluctuating between periods of agitation and lethargy.

Reorient and provide emotional support.

The first goal of delirium treatment is to address any causes or triggers. That may include stopping certain medicines, treating an infection or treating an imbalance in the body. Treatment then focuses on creating the best setting for healing the body and calming the brain.
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