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Cardiac Myxoma: It is derived from the Mesenchyme and usually arise within the left atrium near the fossa ovalis. It restrict the blood flow to left ventricle. Shows constitutional signs of fever, weight loss and anemia. Microscopic picture- Stellate shaped cells in the myxoid background. Complications- Embolism (mostly in the brain), Ball valve obstruction of valves. Cardiac Rhabdomyomas: Benign tumour arising from myocardium.. Associated with Tuberous sclerosis . Metastatic Disease: Most commonly from Lungs. This is more common than primary cardiac tumors.

Gross sequence of Changes in MI Time Predominant finding 0 to 18 hours No gross changes 18 to 24 hours Vague pallor and softening 1 to 7 days Yellow scar 7 to 28 days Central scar formation with red border Months Thick white Firm scar formation Microscopic changes in MI Survival Time Predominant Finding 1-4 hours Wavy myocyte fibers, contraction bands 4-24 hours Coagulative necrosis 1 to 3 days Neutrophil infiltration 3 to 7 days Macrophage infiltration 7 to 28 days Granulation tissue Months Fibrotic scar

Reversible Injury: 1. Decreased synthesis of ATP by oxidative phosphorylation.   2. Decrease function of Na-K ATPase pump- Influx of sodium and efflux of potassium Swelling of cell and endoplasmic reticulum. 3. Glycolysis- Depletion of cytoplasmic glycogen, Increased lactic acid production Decreased PH of the cell 4. Decreased protein synthesis and detachment of ribosomes from rough endoplasmic reticulum. 5. Plasma membrane blebs and myelin figures Irreversible Injury: 1. Severe membrane damage- Massive influx of calcium into the cell- Large flocculant densities in the matrix. Efflux of intra cellular enzymes into circulation. 2. Mitochondrial dysfunction- Mitochondrial swelling Large densities in mitochondrial matrix Irreparable damage of oxidative phosphorylation Inability to produce ATP 3. Rupture of lysosomes- Release of lysosomal digestive enzymes into cytosol Activation of acid hydrolases followed by autolysis 4. Nuclear changes- Pyknosis- degeneration and condensation of n...

Atenolol is not lipid soluble therefore it has longer half life than Metaprolol which is lipid soluble. Carvedilol blocks both alpha and beta receptors and is the most common beta blocker used in chronic congestive heart failure because it has Antioxidant and Antimitogenic properties in addition. Esmolol has the shortest and Nadolol has the longest half life among all beta blockers. Beta Blockers must not be used in compensated (i.e) acute heart failure. Beta blockers that are excreted in kidneys (lipid insoluble): Nadalol, Satolol, Atenolol, Acebutalol, Bisprolol, Betaxolol, Celioprolol- Should be avoided in renal failure. Endogenous Norepinephrine is metabolized by COMT and MAO. Exogenous Norepinephrin is metabolized by reuptake. Hemicholimium- Blocks the reuptake of Choline Vesamicol- prevents entry of choline into storage vesicles. Glucagon is DOC in beta blockers overdose. Other drugs that are used- Norepinephrine and Calcium chloride. Cardioselective Beta Blocker used in Glaucom...

Alpha 1 receptors are located in- Eye radial (i.e dilator) muscle Arterioles and viens, Male sex oegans, Urinary bladder, Kidney and Liver. Alpha 1 receptors use G q Coupled secondary mediators and cause increase in phospholipase C, IP3, DAG and calcium levels in the cell. Alpha1 blockers: Selective Blockers- Prazosin, Doxazocin, Terazocin Non selective Alpha blockers (both alpha 1 and alpha 2 receptor blockers)- Phentolamine(competitive inhibitor), Phenoxybenzamine (non competitive inhibitor) Effects of Alpha1 receptor blockage: Eye- Miosis Arterioles and veins- Reduced sympathetic tone in blood vessels- This results in vasodilation, Decrease in preload and after load on heart, lowering of peripheral vascular resistance and thus a fall in blood pressure is noted. The drop in blood pressure causes a reflex tachycardia. Prazosin : Prazosin can lower BP rapidly so patients are recommended to relax for 1 hour after taking the first dose and...

Mnemonic: DUMBBELSS Diarrhea Urination Miosis Bradycardia Bronchoconstriction Excitation (Muscle, CNS)- Nicotinic effects Lacrimation Salivation Sweating Fata Dose: TEPP- 50mg- IM or 100mg- Orally OMPA 80mg IM or 175mg Orally Parathion 80mg IM or 175mg Orally HETP 60mg IM or 350mg Orally Malathion and Diazinon 1gm Orally Cause of Death: Paralysis of respiratory muscles, respiratory failure and intense bronchoconstriction. Management: For Muscaranic effects- Atropine is drug of choice (Tachycardia is not a contraindication for atropine administration) For Regeneration of AchE- Pralidoxime (2-PAM) Time dependent aging requires administration of PAM as soon as possible.

Diagnosis of sperm DNA integrity of semen sample is important for consistently high reproductive efficiency. The conventional parameters of semen analysis take into account morphology, motility, and concentration of spermatozoa in the sample, which are insufficient for evaluation of reproductive potential. Current studies have implicated abnormal organization of genomic material in sperms as a probable cause in 20 per cent cases of male infertility. This is especially important in the era of assisted reproduction technique (ART) when a majority of infertile couples opt for assisted reproduction and in where cases DNA integrity is a better diagnostic and prognostic marker as compared to routine semen analysis. This article reviews and discusses some of the current techniques employed for evaluating chromatin structure or DNA damage in spermatozoa. These different techniques include single cell gel electrophoresis (COMET assay), Terminal tranferase dUTP Nick End Labelling (TUNEL), sperm ...

Mechanism of Action Antimicrobial Agents Inhibition of bacterial cell wall Penicillins, Cephalosporins, Imipenem, Aztreonam, Vancomycin Inhibition of protein synthesis Macrolides, Aminoglycosides, Choramphenicol, Tetracyclines, Streptogramins, Linezolid Inhibition of Nucleic synthesis Floroquinolones, Rifampicin Disruption of cell membrane function Anti fungal agents Inhibition of Folic acid synthesis Sulphonamides, pyrimethamine, Trimethoprim