BIOSOFT HELP FILES

1)      Oral infections – gingivitis, sialadenitis, dry mouth,

2)      Perioral infections

3)      Dental devices

4)      Drug-induced – ACEI, any drug which causes dryness of mouth also can cause taste disturbances

5)      Bell’s palsy 

1)      Head injury –

2)      Nasal obstruction unilateral, persistent - Intranasal mass lesions

3)      Leukoplakia – candidiasis, HIV infection, immunodeficiency states

4)      Mass lesions intracranial -

(Bromley 2000)

1)      Poor oral hygiene

2)      Smoking, food and drink stains

3)      Drugs

4)      Trauma

5)      Caries

6)      Fluorosis

7)      Amelogenesis imperfecta

8)      Dentinogenesis

9)      Porphyria

1)      Normal  part of development

2)      Common among the sick, hungry or overstimulated child

1)      Tantrums marked by self-injury

2)      Tantrums marked by violence to others and objects

3)      Tantrums in which the child cannot calm down without help

4)      Tantrums lasting more than 25 min

5)      More than 5 tantrums per day

6)      Tantrums between 10-20 times per month

Family medicine is the medical specialty that provides continuing and comprehensive care for the individual irrespective of age, sex, organ, or disease (American Academy of Family Physicians).  What distinguishes family medicine from other medical specialties is the context in which continuing and comprehensive health care is provided.  The unique context in which such care is provided is the physician-patient relationship.  Family physicians value, nurture, develop, and maintain this relationship (American Academy of Family Physicians).  The following principles of

 TREATMENT PRINCIPLES IN FAMILY MEDICINE

1)      Reassurance

2)      Exercises

3)      Nutrition

4)      Changing the behavior

5)      Lifestyle changes

1)      Myofascial pain syndrome - anterior upper thigh pain spreading to the anterior knee in adductor longus and brevis MFPS, anterior thigh pain  spreading from groin to medial knee in adductor magnus MFPS, upper posterior thigh pain starting from buttocks in gluteus medius MFPS, posterior thigh pain, lateral thigh pain, lateral knee pain, popliteal pain, calf pain, buttock pain in gluteus minimus MFPS, medial thigh pain in gracilis MFPS, upper posterior thigh pain spreading down popliteal fossa and calf in semitendinosus and semimembranosus MFPS, posterior thigh pain starting from popliteal fossa and spreading up in biceps femoris MFPS, anterior thigh pain upper 1/3rd and lumbar paraspinal region pain in iliopsoas MFPS, upper 1/3rd anterior thigh pain in pectineus MFPS, posterior thigh pain starting from buttocks and spreading down in piriformis MFPS, posterior thigh pain starting from buttocks in quadratus lumborum, glut max, levator ani, piriformis MFPS, anterior thigh pain starting from anterior knee in rectus femoris MFPS, anterior thigh pain spreading fom upper 1/3rd to lower 1/3^rd in sartorius MFPS, posterior thigh pain starting from the sacral area in sphnicter ani, levator ani, coccygeus, obturator internus (SALACO complex), lateral thigh pain in tensor fasciae latae MFPS,  lateral thigh pain, lateral knee pain, lateral hip pain, lateral leg pain in vastus lateralis MFPS, anterior thigh pain, anterior knee pain in vastus medialis MFPS, anterior thigh pain in vastus intermedius MFPS.  See notes under myofascial pain syndrome for diagnostic criteria and treatment.

1)      TIA – Left Carotid Territory – dysarthria, paresis or paralysis of the right extremities or face or both, blindness of left eye, loss of vision in the right field of vision, paresthesiae of the right extremities OR face, aphasia, typical TIA clinical picture as mentioned below

2)      TIA – RightCarotidTerritory – paresis/paralysis left extremities, loss of vision of the right eye, rarely the left field of vision, paresthesiae  of the left  upper/lower limbs, typical TIA clinical picture as mentioned below

3)      TIA – VertegrobasialrTerritory – paresis/paresthesiae of any 1 or more of any combination of limbs, paresthesiae of any 1 or more of any combination of limbs, blindness in 1 or both visual fields, imbalance, vertigo, diplopia, dysphagia, dysarthria, typical TIA clinical picture as mentioned below

4)      TIAs – symptoms and signs typically rapid onset, climax within minutes, last less than 1 hr, range from ½ - 24 hrs, abrupt onset, loss of function/neurological deficit attributable to a single vascular territory, most recover within 1 hr, by definition within 24 hrs, repeated episodes within an attack is extremely rare except in amuarosis fugax, common patterns are listed below Ix – FBC (polycythemia, thrombocytosis, thrmbocytopenia), PT, aPTT, INR (hypercoagulable states, prelude to antocoagulation), ESR (vasculitis), Blood glucose, Urea and Creatinine levels, CT scanning (exclude SDH, tumors, ICH) Tx – management of ht, diabetes, hyperlipidemias, advice against smoking, AF or any cardiac disaes, aspirin (50-350 mg/day),  clopidogrel if aspirin not tolerated

5)      Faciobrachial paresthesiae

6)      Hemiparesthesiae

7)      CTS

8)      TTS

9)      TOS

10)    Cervical radiculopathy

11)    Lumbar radiculopathy

12)    Meralgia paresthetica

1)      Bilateral vision loss (? Early brainstem infarction)

2)      Symptoms increasing duration, severity, frequency ie. crescendo TIAs (impending infarction)

3)      Symptoms lasting less than 180 mins (candidate for tissue-type plasminogen activator tPA – referral to a center with such facilities)

4)      Acute myocardial infarction (cardiac source of emboli, aortic dissection)

5)      New onset atrial fibrillation (referral for further management)

6)      Cardiac source for cranial emboli (referral for further management)

7)      Paralysis and dysplasia severe (onset of infarction rather than ischemia)

8)      Severe carotid artery stenosis (referral for carotid duplex ultrasonography and further evaluation, 70-99% occlusion require endarterectomy, )

9)      Severe headache, photophobia, stiff neck, fainting (exclude SAH)

10)    Fever (exclude SABE)

11)    Confusion, headache, seizures, rheumatologic diseases, sympathomimetic use (CNS vasculitis)

12)    Head, neck, jaw pain (carotid, vertebral dissection)

13)    Absence of traditional risk factors for atherosclerosis like age, hypertension, diabetes, smoking, hypercholesterolemia, low HDL levels (cryptogenic strokes)

14)    Hypercoagulable states (strokes, migraine, spontaneous abortions, pulmonary emboli, DVT, F/H of any of these – hematologist evaluation )

15)    High-risk TIA’s for stroke (TIAs with hemiparesis, speech/language deficits, duration > 10 min, age > 60 yrs, diabetes)

16)    Postpartum states and dehydration (venous thrombosis)

17)    TIA and fever (SABE)

18)    TIAs and confusion, headache, seizures, rheumatoid disease, sympathomimetic use (CNS vasculitis)

19)    Women of childbearing age, recurrent abortion (Antiphospholipid syndrome)

20)    Recent head injury (SDH)