PGMEE A2Z

GCS MADE EASY
courtesy: Intellect Medicos YouTube
https://youtu.be/gE5gSU_8oHs

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Lipoarabinomannan (LAM) stain of Urine

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● Lipoarabinomannan (LAM) is an immunogenic glycolipid found in the cell wall of Mycobacterium tuberculosis.

● LAM antigen can be detected in urine.

● Highest sensitivity in patients with high bacillary burden who have more detectable antigen in urine:
a) Immunosuppressed patients e.g. HIV patients.
b) Disseminated TB

■ Sensitivity is limited in individuals with CD4 >100.

■ Many HIV+ patients have extrapulmonary TB. Antigen detection test such as rapid urine LAM is a non-invasive alternative for diagnosing TB. It can be used for TB diagnosis in HIV+ patients with low CD4 cell counts.

■ Urine-LAM antigenuria is a predictor of mortality in HIV-TB.

■ Besides its potential use as a diagnostic test, urine LAM might also be considered as a prognostic tool in TB/HIV patients. LAM-positive TB cases are characterized by markers of disease severity, such as decreased body mass index (BMI), CD4 cell count.

■ Mortality was significantly higher in TB patients with positive urine LAM results than in LAM-negative TB cases.
Courtesy : DEVESH pathology

*Dr.Emil Theodar Kocher*
Aug 25, 1841 - July 27, 1917
▪ *Kocher's arced incision* - Oblique incision for opening the knee joint
▪ *Kocher's incision I* -Subcostal incision for cholecystectomy
▪ *Kocher's incision II* -Tranverse incision in the neck for thyroidectomy
▪ *Kocher's method I* -Fixation of the fundus uteri to the abdominal wall
▪ *Kocher's method II* -Invagination method for radical operation of inguinal hernia
▪ *Kocher's method III* - Reduction method for shoulder dislocation
▪ *Kocherisation*- Operative technique in opening the duodenum to expose the ampulla of the CBD
▪ *Kocher's reflex* -Contraction of abdominal muscles following moderate compression of the testicle
▪ *Kocher's sign*- Eye sign in Basedow-Graves disease
▪ *Kocher's syndrome*- Splenomegaly with or without lymphocytosis and lymphadenopathy in thyrotoxicosis
▪ *Kocher-Debré-Semélaigne syndrome*
▪ *Kocher’s craniometer*
▪ *Kocher’s surgical clamp*
▪ *Kocher's tweezers*
▪ *Kocher’s forceps*
▪ *Kocher’s probe*

🔸Consequently, he was honoured for his enormous contribution in thyroidology with *Nobel Prize of Physiology or Medicine* in 1909. Therefore, he was the first Swiss citizen and the *First Surgeon,* who received the Nobel Prize.

An Outstanding and Immortal Surgeon
*Dr.Emil Theodor Kocher*

yield info
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Rabies diagnosis

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●Pathologically rabies is defined by presence of intracytoplasmic NEGRI BODIES in:-

A) Hippocampus

B)Brain stem, and

C) Cerebellum (purkinje neurons).(Most common site)

DEVESH PATHO