1. 1- Mention the most important anaerobic bacteria? 2- Describe the most places for anaerobic bacteria ? 2- Mention the anaerobic infections with causative organism ? 3- Mention Dosage regimen for Asrtranida? 4- What are the 4 main features in Astranida? 5- what are the main advantage of Astranida over metronidazole ? 01022211266

3. TOPICS.. TOPICS.. By Ramy Mansour & Ahmed Elhariry

4. pain  Pain is a distressing feeling often caused by intense or damaging stimuli, such as stubbing a toe, burning a finger, putting alcohol on a cut, etc…  Pain is the main reason for visiting the emergency department in more than 50% of cases and is present in 30% of family practice visits.  The International Association for the Study of Pain's (IASP) widely used definition states: "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage“  In medical diagnosis, pain is regarded as a symptom of an underlying condition (Pain is a good thing??!!). By Ramy Mansour & Ahmed Elhariry

5. pain  Types of pain : Nociceptive neuropathic By Ramy Mansour & Ahmed Elhariry

6. inflammation  part of the complex biological response of body tissues to harmful stimuli as pathogens, damaged cells, or irritants, and is a protective response involving immune cells blood vessels.  Role of inflammation : 1. eliminate the initial cause of cell injury 2. clear out necrotic cells and tissues 3. initiate tissue repair.  types of inflammation : 1. Acute. 2. chronic 3. Sub acute By Ramy Mansour & Ahmed Elhariry

7. joints

8. Synovial joint  A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support.  Joint =Bone + Cartilage + Synovial Fluid By Ramy Mansour & Ahmed Elhariry

9. Classification of Synovial joints By Ramy Mansour & Ahmed Elhariry

10. osteoarthritis  Osteoarthritis (OA) also known degenerative joint disease is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone.  Symptoms joint pain, tenderness, stiffness, locking, and sometimes an effusion.  Causes hereditary, developmental, metabolic (diabetic), and mechanical (over weight, trauma) may initiate processes leading to loss of cartilage. By Ramy Mansour & Ahmed Elhariry

11. Statics about osteoarthritis By Ramy Mansour & Ahmed Elhariry

12. Patho-physiology of OA  The cartilage covering bones is thinned, eventually completely worn out, resulting in a "bone against bone" joint (friction), reduced motion and pain.  OA affects the joints exposed to high stress and is therefore considered the result of "wear and tear" rather than a true disease. By Ramy Mansour & Ahmed Elhariry

13. Osteoarthritis (OA) & Rheumatoid Arthritis (RA) By Ramy Mansour OsteoarthritisRheumatoid arthritis Site(s)Localized to the jointArticular & extra-articular (systemic) manifestations PathogenesisBiomechanical: leads to loss of cartilage matrix Autoimmune response leads to joint destruction SymptomsPain Stiffness < 20 minutes Limited motion Pain Stiffness > 1 hour Limited motion Joint swelling InflammationUsually limited may be present in advanced diseases Chronic OsteophytesUsually presentAbsent

14. OA Treatment  Physical therapy: weight reduction, exercises & acupuncture.  Medical treatment. 1. NSAIDs 4. NARCOTIC ANALGESICS 2. CORTICOSTEROIDS INJ 5. Glucosamine & chondroitin sulfate 3. TOPICAL ANTI-IFLAMMATORY  Intra-articular injection.  Surgical treatment. By Ramy Mansour & Ahmed Elhariry

15. Musculoskeletal system All of the muscles, bones, joints, and related structures, such as the tendons and connective tissue, that function in the movement of body parts and organs. Conditions:- 1-Chronic rheumatic diseases 2-Acute musculo-skeletal disorders By Ramy Mansour & Ahmed Elhariry

16. Chronic rheumatic disease 1-ArthritiS Inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. 2-Osteoarthritis: Arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. 3-Rheumatoid arthritis Auto-immune disease that causes chronic inflammation of the joints. 4-Gouty arthritis: Form of arthritis caused by deposits of needle-like crystals of uric acid. By Ramy Mansour & Ahmed Elhariry

17. Acute musculo-skeletal disorders 1-Low back pain: Low back pain is pain affecting the lower part of the back. 2-Strains: A strain is stretching or tear of a muscle or tendon. 3- Sprain: Is a stretch or tear of a ligament 4-Tendinitis: Inflammation or irritation of a tendon by overuse. By Ramy Mansour & Ahmed Elhariry

18. By Ramy Mansour Other pain forms Post SurgeryUnspecified renal colic Anal Fissure & Abscess & Fistula Ingrown Nail Furuncle, is a deep folliculate, infection of the hair follicle. Carbuncle is a cluster of boils, draining pus onto the skin. Cellulites is a bacterial infection involving the inner layers of the skin. SPONDYLOSIS

19. NSAID (non steroidal anti inflammatory)  Drug class that provides analgesic (pain-killing) and antipyretic (fever-reducing) effects, and, in higher doses, anti-inflammatory effects.analgesicantipyreticanti-inflammatory  The term nonsteroidal distinguishes these drugs from steroids, which, among a broad range of other effects, have a similar depressing, anti-inflammatory action.steroids  The most prominent members of this group of drugs, aspirin, ibuprofen diclofenac and naproxen. Paracetamol (acetaminophen) is generally not considered an NSAID because it has only little anti-inflammatory activity. It treats pain mainly. By Ramy Mansour & Ahmed Elhariry

20. NSAIDs MOA  NSAIDs work by preventing an enzyme from doing its job. The enzyme is called cyclooxygenase, or COX, it catalyzes the formation of prostaglandins from arachidonic acid (i.e inflammatory mediators)!!  COX has two forms:- i) COX-1 protects the stomach lining from harsh acids and digestive chemicals. ii) COX-2 is produced when joints are injured or inflamed.  Traditional NSAIDs block the actions of both COX-1 and COX-2, which is why they can cause stomach upset and bleeding as well as ease pain and inflammation.  Use of NSAIDs increases risk of having a range of gastrointestinal (GI) problems. An estimated 10–20% of NSAID patients experience dyspepsia.gastrointestinaldyspepsia