Saturday 15 August 2015

Computer Studies Made Simple : Applications of Computer


Applications of Computer

Office Automation:

This refers to the process of automating office tasks using computers.

There are a number of office tasks that can be performed using computers such as:

Handling of documents.

Decision making

Data manipulation

Communications

Storage

Computerized Systems used in Office:

Some computerized systems used in he office are below:

Document Management Systems:

This includes a number of applications such as:

Reprographics:

This is process of reproducing multiple copies of a document

Image processing:

This is application to scan and store an image in a computer.

It canbe used to modify and improve the quality of images as well.

Word processing:

This application is used to create documents electronically.

It canbe used to  produce high quality letters and reports etc.

Desktop publishing:

This application can be used to add photos and other content and graphics to the documents generated by

Word processing.

Spreadsheet application:

This is used to maintain records and calculate expenses,profits and losses.

It is also used to perform mathematical,statistical and logical processing



Sunday 2 August 2015

Endocrinology Made Simple : Paget”s Disease


Paget”s Disease:

Definition
Paget disease is a  disorder of bone remodelling characterized by excessive bone resorption followed by an increase in bone formation.

Etiology:
Some studies suggest a genetic linkage for Paget disease located on chromosome arm 18q.

Although the etiology of Paget disease is unknown, both genetic and environmental contributors have been suggested. Ethnic and geographic clustering of Paget disease is well described.

Pathophysiology:

There is  osteoclastic overactivity followed by compensatory osteoblastic activity leads to a structurally disorganized mosaic of bone (woven bone), which is mechanically weaker, larger, less compact, more vascular, and more susceptible to fracture than normal adult lamellar bone.

Clinical Features:

Approximately 70-90% of persons with Paget disease are asymptomatic; however, a minority of affected individuals experience various symptoms, including the following:

 Bone pain (the most common symptom)

 Secondary osteoarthritis (when Paget disease occurs around a joint)

 Bony deformity (most commonly bowing of an extremity)

 Excessive warmth (due to hypervascularity)

 Neurologic complications (caused by the compression of neural tissues)

Sites of involvement:

Paget disease may involve a single bone but is more frequently multifocal. It has a predilection for the axial skeleton (ie, spine, pelvis, femur, sacrum, and skull, in descending order of frequency), but any bone may be affected.

After onset, Paget disease does not spread from bone to bone, but it may become progressively worse at pre-existing sites.

Indications for Treatment :

Intolerable pain

Involvement of weight bearing joints

Neurological involvement

Hypercalcemia

Hypercalcinuria

Congestive Cardiac Failure

Management Guidelines:

Several bisphosphonates : Alendronate,Risedronate and Pamidronate are approved for treatment of Pagets”s Disease.

Six months of treatment with oral alendronate and two months of treatment with oral risedronate lead to sustained remission in a large number of patients.

Intravenous pamidronate canbe used for patients with contraindications to use of oral bisphosphonates.

A 2014 Endocrine Society Clinical Practice Guideline on Paget disease recommends the following : 

Plain radiographs of the pertinent regions of the skeleton in patients with suspected Paget disease

A radionucleotide bone scan to determine the extent of the disease if the diagnosis is confirmed

Measurement of serum total alkaline phosphatase or, when warranted, a more specific marker of bone
formation or bone resorption to assess the response to treatment or evolution of the disease in untreated patients 

Consider treatment with a bisphosphonate for most patients with active Paget disease who are at risk for future complications

Consider a single 5-mg dose of intravenous zoledronate as the treatment of choice in patients who have no contraindication

Consider measurement of a specific marker of bone formation and bone resorption in patients with monostotic disease who have a normal serum total alkaline phosphatase

Consider serial radionuclide bone scans to determine the response to treatment if the markers are normal

Bisphosphonate treatment may be effective in preventing or slowing the progress of hearing loss and osteoarthritis in joints adjacent to Paget disease and may reverse paraplegia associated with spinal Paget disease

Consider treatment with a bisphosphonate before surgery on pagetic bone