DIFFERENCES IN DIFFERENT DISEASES

Submitted to SIR KHIZAR HAYYATSubmitted byIFSHA AKHLAQ 528

SKIN CANCER Skin cancer also known as melanoma is a

cancer that begins in the melanocytes. Because most of these cells still make melanin, melanoma tumors are often brown or black.

EPIDEMIOLOGY In 2007 in united state 56940 cases of

melanoma reported. In 1996 2 per 100000 patient. In 2001 2.7 per 100000 patient reported.

PATHOPHYSIOLOGY Sun light exposure cause formation of

thymine dimers. DNA repair removes most UV induced damage. Cumulative DNA damage leads to mutation. The sunlight depresses the local immune system and decreasing immune surveillance of new tumor cells.

TYPES

SIGNS & SYMPTOMS Unusual sores Lumps Blemishes Marking changes in color.

DIAGNOSTIC TEST Physical examine Skin biopsy Sentinel lymph node biopsy CT scan MRI

TREATMENT Interferon Interleukin-2 Other medicines such as ipilimumab Chemotherapy such as dacarbazine

WARTS Warts are raised bumps on the skin caused

by the human papillomavirus (HPV).

EPIDEMIOLOGY Worldwide frequency is unknown but

estimated approximately 7-12% of the population.

In school aged children 10-20% reported.

PATHOPHYSIOLOGY The Human

papillomavirus infects the epithelium and systemic dissemination of the virus not occurs. Virus replicate in the epidermis layer.

SIGNS & SYMPTOMS Rough surface Round or oval warts Spot where warts may be lighter or darker

than other skin Some warts cause pain

DIAGNOSTIC TEST Immunohistochemical detection of HPV

structural proteins. Polymerase chain reaction may be used to

amplify viral DNA

TREATMENT Topical agents Intralesional injections Photodynamic therapy Systemic agents

ASTHMA Is a chronic disease characterized by

recurrent attacks of breathlessness and wheezing varying in severity and frequency from person to person.

EPIDEMIOLOGY In 2001 7.3% increased. - In 2010 8.4% increased. From 2001 – 2009 asthma per - Worldwide deaths by asthma is 180,000

annually.

PATHOPHYSIOLOGY Involve in three components:-1) Airway inflammation.2) Intermittent airflow obstruction.3) Bronchial hype responsiveness.

SIGNS & SYMPTOMS Wheezing Whistling sound when

breathe Shortness of breath Chest pain Chronic coughing Asthma symptoms also

known as asthma flare-ups or asthma attacks.

DIAGNOSTIC TEST Medical histories. Breathing tests. Spirometry test. Allergy test for those who have allergy with

asthma.

TREATMENT It requires continuous medical care. Moderate to Severe asthma require long

term medications daily like anti inflammatory drug.

Such as corticosteroids, budesonide, mometasone, flunisolide.

If symptoms occur short term medications (Inhaled short acting beta) agonists anticholinergics.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE Chronic obstructive pulmonary disease is a

lung disease characterized by chronic obstruction of lungs airflow that interferes with normal breathing.

EPIDEMIOLOGYCOPD is third leading cause of death in America.- In 2010 - 12.1 million in U.S - 10.1 million Americans - 4 percent in Washington - 9 percent in AlbaniaReported.Worldwide:- - 64 million in 2004 worldwide. - 3 million in 2005. - 90% die in low and middle income

countries.

PATHOPHYSIOLOGY The most common cause of COPD is chronic

exposure to cigarette smoke directly or by air pollution occupational exposure.

The smoking or other irritants o fairways cause neutrophils, T-lymphocytes and other inflammatory cells which are accumulate in airways.

SIGNS & SYMPTOMS Ongoing cough Increased mucus Shortness of breath Wheezing Fatigue Frequent flare-ups

DIAGNOSTIC TEST - X-rays or CT Scans of the chest. - Pulmonary function testing. - Oximetry or arterial blood gas testing.

TREATMENTThere are several paths for treatment of COPD.- Avoiding infections- Medications -Bronchodilators -Anti inflammatory -Antibiotics- Oxygen therapy- Pulmonary rehabilitation- Lung volume Reduction surgery.

JAUNDICE Yellowing of the skin and eyes condition

occurs when too much bilirubin is present in body.

EPIDEMIOLOGY In United states 6.1% infants in 1986 4.3 % in 2003 2.9% in 1994 reported. In Turkey 10.5% reported.

PATHOPHYSIOLOGY Bilirubin is produced by breakdown of

hemoglobin into unconjugated bilirubin. Un conjugated bilirubin binds to albumin in

the blood and transport to liver. In liver the enzyme uridine

diphosphogluconurate glucuronasyltransferase (UGT) conjugated this bilirubin with glucronic acid which is taken up by hepatocytes.

This conjugated bilirubin excreted in bile. In patients or neonates the conjugated

bilirubin is deconjugates and recycled into the circulation and not excreted from body.

SIGNS & SYMPTOMS Yellow tinted skin and eye Whites of eye turn brown but in severe

condition Dark urine Pale stool Excessive fatigue Vomiting

DIAGNOSTIC TEST CBCs Liver function test Imaging test Abdominal ultrasounds Computed tomography scans Magnetic resonance imaging Liver biopsies

TREATMENT Supportive care Jaundice caused by medication/drugs the

antidote is required. Steroids in which have autoimmune diseases

with jaundice. Diuretics and lactulose is used in jaundice with

cirrhosis. Antibiotics for infectious causes of jaundice. Blood transfusions may be required in

individuals who have anemia from hemolysis. Surgery is requiring for jaundice with gallstones. Jaundice with liver failure need liver transplant.

HEPATITIS B Hepatitis B is a viral infection that attacks the

liver and can cause both acute and chronic disease.

EPIDEMIOLOGY 780,000 people die in a year due to hepatitis

B. In Middle East and Indian subcontinent 2-5 %

chronically infected. Less than 1 % of the population of western

Europe and North American is chronically infected.

PATHOPHYSIOLOGY Blood become exposed to HBV the body cell

mediated immune response sending cytotoxic T cells and naturally killer cells against the virus and release inflammatory cytokines.

As the hepatocytes are attacked and infiltrated by the HBV. Because hepatocytes are continually proliferating the virus is constantly being shed into the blood which leads to the chronic illness.

SIGNS & SYMPTOMS Dark urine Joint pain Loss of appetite Fever Abdominal discomfort Weakness Yellow skin and eyes

DIAGNOSTIC TEST Hepatitis B surface antigen test Hepatitis B core antigen test Antibody Hepatitis B surface antigen test Liver function tests

TREATMENT Hepatitis B immune globulin Within 24hours

in contact with HBV Antiviral medication Liver transplant

HEPATITIS A Hepatitis A is a liver disease caused by the

hepatitis A virus. The virus is spread when an uninfected person ingest food or water that is contaminated with the faeces of an infected person.

EPIDEMIOLOGY - 1.4 million cases of hepatitis A every year. - In Shanghai in 1988 about 300,000 people

reported with hepatitis A. - In developing countries about 90% children

are affected.

PATHOPHYSIOLOGY HAV virus acquired by mouth and replicate in

liver. After 10-12 days virus present in blood and excreted in the biliary system into are feces.

Virus is present in serum and virus excretion begins to decline in at the onset of clinical illness.

SIGNS & SYMPTOMS Flu like symptoms (fever, fatigue body aches) -Abdominal pain -Light colored stool -Dark urine -Loss of appetite -Unexplained weight loss -Jaundice -Malaise -Diarrhea

DIAGNOSTIC TEST Detection of HAV-specific IgM and IgG

antibodies -Reverse transcriptase polymerase chain

reaction

TREATMENT No specific treatments for hepatitis A but

symptoms are treated. Therapy used to maintain comfort such as

replacement of fluids which are lost from vomiting and diarrhea.

HEPATITIS C A liver disease caused by hepatitis C virus.

Virus can cause both acute and chronic hepatitis infection.

EPIDEMIOLOGY - 130-150 million people have chronic

hepatitis C. - 350000 to 500000 people die in a year. Most affected regions are Central and East

Asia and North Africa.

PATHOPHYSIOLOGY The natural targets of HCV are hepatocytes

and B-lymphocytes. Viral clearance is associated with the development and persistence of strong virus-specific responses by T lymphocytes and helper T cells.

SIGNS & SYMPTOMS 80% patient have no symptoms but some

complain of mild to severe systems such as -Fever -Dark urine -Loss of appetite -Abdominal pain -Joint pain -Jaundice

DIAGNOSTIC TEST CBC test -Serological test -Nucleic acid test -Genotyping test -Liver function test -Liver biopsy

TREATMENT Antiviral treatment Bed rest is recommended -Antiviral combination therapy with interferon

and ribavirin.

INFECTION The invasion and multiplication of

microorganism such as bacteria, virus and parasites that are not normally present within the body.

EPIDEMIOLOGY In united state 2 millions nosocomial

infection in hospitalized patient. 3-21 % in 2002 survey Annually 1 billion pounds cost in United

kingdom 10% patient

PATHOPHYSIOLOGY the normal host cell response to infection is a

complex process that localizes and controls bacterial invasions, and initiating the repair of any injured tissues.

Involves Activation of circulating and fixed phagocyte

cells, The generation of pro inflammatory and

inflammatory mediators. Sepsis results when the response to infection

becomes generalized and involves normal tissues from the site of injury or an infection.

SIGNS & SYMPTOMS Fever Warm Painful swollen wound Blood or pus coming from the wound Dizziness Fast heart beat

DIAGNOSTIC TEST Blood tests X-rays C T scan MRI scan Wound culture

TREATMENT Wound cleaning Antibiotics NSAIDS

DISEASE Illness or sickness characterized by specific

signs and symptoms

EPIDEMIOLOGY The 95% of the world wide population

measured in disease.

PATHOPHYSIOLOGY Functional changes in the body that occurs in

the body. A disease would change the conformation of

an enzyme; something would not be spilt or altered in some way then leads to symptoms.

SIGNS & SYMPTOMS Disease may be acute, chronic, malignant or

benign. Acute disease symptoms are nausea,

vomiting and pain. Chronic disease have severe pains, diarrhea,

swelling, breathing troubles etc.

DIAGNOSTIC TEST Different type of diagnostic tests are Blood tests Computed tomography scan X-rays

TREATMENT Life style changes Follow a healthy diet Exercise regularly Manage stress Medicines Surgeries

REFERENCESSkin cancer melanoma by Michael R Holtel,MD http://www.emedicine.medscape.com/article/846566-overveiw#a11 Access date 9th October 2014Wound infections www.drugs.com/cg/wound-infection.html. Access date 9th October 2014 www.medicinenet.com/script/main/art.asp?articlekey=12923 access date 9th October 2014Pathophysiology of sepsis by Remi Neviere,MD http://www.uptodate.com/contents /pathophysiology-of-sepsis? Source=outline-

link and view=text and anchor=H544041. Date of access 13th October 2014Human diseases written by Jonathan H. Robbins M.D www.bratanmica.com/EBchecked/topic/275628/human-disease. Date of access 9th October 2014Hepatitis written by Vinod K Dhavan,MD, FACP,FRCP( C) ,FIDA www.emedia.medscape.com/article/177792-overview#aw2aab6b2b3aa Date of access 8th October 2014Hepatitis C witten by april Kalm www.healthline.com/health/hepatits-c Date of access 8th October 2014

Hepatitis AEpidemiology and prevention of vaccine-preventable diseases.The pink book course text book 12th edition second printing May 2012www.cdc.gov/vaccines/pubs/pinkbook/hepa.htmDate of access 9th 0ctober Hepatitis A written by Richard K Gilroy,MBBS, FRACPwww.emedicine.medsacpe.com/article/177484-overview#ao104Date of access 9th 0ctober 2014Definitionswww.who.int/mediacenter/factsheets/fs 164/en/www.who.int/mediacenter/factsheets/fs 328/en/www.who.int/mediacenter/factsheets/fs 204/en/www.who.int/mediacenter/factsheets/fs 315/en/www.who.int/mediacenter/factsheets/fs 307/en/Date of access 7th October 2014

American Academy of allergy, Asthma and Immunologyhttp://www.aaaai.org/conditions -and-treatments/asthma.aspxDate of access 5th October 2014Pathophysiology of asthma written by Micheal J

Morris,MD,FACP,FCCPwww.emedicine.medscape.com/article/296301-overview#aw2aab6b2b4Date of access 7th October 2014American lungs association fighting for airwww.lung.org/lung-disease/copd/resources/facts-figures/copd-fact-sheet.htmlDate of access 8th October 2014COPD written by Robin Madele Medically Reviewed by

George Kruik,MD.MBA/published on 27th February2013www.healthlin.com/health-slideshow/copd-symptomsDate of access 8th October 2014