Cardiovascular disease Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood

[1] vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH C14), it is usually used to refer to those related to atherosclerosis (arterial disease). These conditions usually have similar causes, mechanisms, and treatments. Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer. In recent years, cardiovascular risk in women has been increasing and has killed more women than breast cancer. A large histological study (PDAY) showed vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.
[3][4] [2]

By the time that heart problems are detected, the underlying cause (atherosclerosis) is usually quite advanced, having progressed for decades. There is therefore increased emphasis on preventing atherosclerosis by modifying risk factors, such as healthy eating, exercise, and avoidance of smoking. Pathophysiology Population based studies show that the precursors of heart disease start in adolescence. The process of atherosclerosis evolves over decades, and begins as early as childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 79 years. However, most adolescents are more concerned about other risks such as HIV, accidents, and cancer than cardiovascular disease.
[5]

This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken. Obesity and diabetes mellitus are often linked to cardiovascular disease hypercholesterolaemia
[7] [6]

, as are a history of chronic kidney disease and

[8][9][10]

. In fact, cardiovascular disease is the most life threatening of the diabetic complications and

diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics. Diagnosis Associated diagnostic markers Low-density lipoprotein Lipoprotein(a) Apolipoprotein A1 Apolipoprotein Bho

Screening Some biomarkers are thought to offer a more detailed risk of cardiovascular disease. However, the clinical value of these biomarkers is questionable.
[11]

Currently, biomarkers which may reflect a higher risk of cardiovascular disease include:

Higher fibrinogen and PAI-1 blood concentrations Elevated homocysteine, or even upper half of normal

Elevated blood levels of asymmetric dimethylarginine Inflammation as measured by C-reactive protein Elevated blood levels of brain natriuretic peptide (also known as B-type) (BNP)

Prevention Evidence shows that the Mediterranean diet improves cardiovascular outcomes. As of 2010 however vitamins have not been found to be effective at preventing cardiovascular disease. Other modifiable risk factors to improve or prevent atherosclerosis may include: diet high in fibers from vegetables and nuts while low in saturated fat and cholesterol tobacco cessation and avoidance of second-hand smoke decreased alcohol consumption lower blood pressures if elevated through the use of antihypertensive medications strict diabetes management decrease BMI if overweight or obese increase daily activity to 30 minutes of moderate to vigorous exercise decrease emotional stress in day to day life

Note that while a generally accepted hypothesis is that dietary saturated fat and cholesterol intake is associated with cardiovascular disease, this theory has also been widely disproven. As a matter of fact, some research has shown dietary saturated fat to be inversely associated with mortality indicating that saturated fat may actually be protective against cardiovascular disease. Management Cardiovascular disease is treatable with initial treatment primarily focused on diet and lifestyle interventions.Medication may also be useful for prevention.
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Name:Patient X Age:38yrs. Old Patient history: no history of past operations condition started hours when the patient outstained an injury on the right foot after an oxygen tank accidentally fell on it while working. Patient was then rushed to BGH where he was subsequently admitted. Present: Patient has undergone pixation of right malleolus Family history: (+) diabetes mellitus Medications:
Tramadol is a centrally acting analgesic that is used in the treatment of moderate to moderately severe pain. Tramadol is a synthetic analog of the phenanthrene alkaloid codeine, is an opioid and also a prodrug. Common brand names of Tramadol are Amaryll, Cetodol, Clomadol, Dolcet, Dolmal, Dolotral, Dolpaz, Doltrahex, Gesidol, Mardol, Microdol, Milador, Mosepan, Pengesic, Peptrad, Plazadol, Siverol, Tracaine, Tradomal, Tradonal, Tramadin, Tramal, Tramid, Tramkor, Tramundin, Unitral, Vistra, and Vitral. Tramadol is classified as an Analgesic. Indication for Tramadol Tramadol is used to treat moderate to moderately sever pain. Routes and Dosage of Tramadol Moderate to Moderately Severe Pain PO: ADULTS, ELDERLY: 50-100mg every 4-6 hours. Maximum <75 years old: 400mg per day. Maximum >75 years old:300mg per day. Renal Function Impairment (Creatinine clearance <30mL per minute) Alert: Dialysis patients can receive their regular dose on day of dialysis. PO: ADULTS, ELDERLY: Increase dosing interval to 12 hours. Maximum daily dose: 200mg. Hepatic Function Impairment PO: ADULTS, ELDERLY: 50mg every 12 hours. Action of Tramadol Tramadol binds to -opiate receptors and inhibits reuptake of norepinephrine and serotonin. It reduces intensity of pain stimuli incoming from sensory nerve endings, altering pain perception and emotional response to pain (ofloxacin tablets) Tablets is a synthetic broad-spectrum antimicrobial agent for oral administration.

(ofloxacin tablets) Tablets are indicated for the treatment of adults with mild to moderate infections (unless otherwise indicated) caused by susceptible strains of the designated microorganisms in the infections listed below. Please see DOSAGE AND ADMINISTRATION for specific recommendations. Acute bacterial exacerbations of chronic bronchitis due to Haemophilus influenzae or Streptococcus pneumoniae. Community-acquired Pneumonia due to Haemophilus influenzae orStreptococcus pneumoniae. Uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Proteus mirabilis. Acute, uncomplicated urethral and cervical gonorrhea due to Neisseria gonorrhoeae. (See WARNINGS.) Nongonococcal urethritis and cervicitis due to Chlamydia trachomatis. (SeeWARNINGS.) Mixed infections of the urethra and cervix due to Chlamydia trachomatis andNeisseria gonorrhoeae. (See WARNINGS.) Acute pelvic inflammatory disease (including severe infection) due toChlamydia trachomatis and/or Neisseria gonorrhoeae. (See WARNINGS.) NOTE: If anaerobic microorganisms are suspected of contributing to the infection, appropriate therapy for anaerobic pathogens should be administered. Uncomplicated cystitis due to Citrobacter diversus, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Pseudomonas aeruginosa. Complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter diversus *, or Pseudomonas aeruginosa *. Prostatitis due to Escherichia coli. (ampicillin sodium/sulbactam sodium)

To reduce the development of drug-resistant bacteria and maintain the effectiveness of UNASYN (ampicillin and sulbactam) and other antibacterial drugs, UNASYN (ampicillin and sulbactam) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. (ampicillin and sulbactam) is an injectable antibacterial combination consisting of the semisynthetic antibiotic ampicillin sodium and the beta-lactamase inhibitor sulbactam sodium for intravenous and intramuscularadministration. Ampicillin sodium is derived from the penicillin nucleus, 6-aminopenicillanic acid. Chemically, it is monosodium (2S, 5R, 6R)-6-[(R)-2amino-2-phenylacetamido]- 3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate and has a molecular weight of 371.39. Its chemical formula is C16H18N3NaO4S. The structural formula is: Sulbactam sodium is a derivative of the basic penicillin nucleus. Chemically, sulbactam sodium is sodium penicillinate sulfone; sodium (2S, 5R)-3,3-dimethyl-7-oxo-4-thia 1-azabicyclo [3.2.0] heptane-2-carboxylate 4,4-dioxide. Its chemical formula is C8H10NNaO5S with a molecular weight of 255.22. The structural formula is: ampicillin sodium/sulbactam sodium parenteral combination, is available as a white to off-white dry powder for reconstitution. UNASYN (ampicillin and sulbactam) dry powder is freely soluble in aqueous diluents to yield pale yellow to yellow solutions containing ampicillin sodium and sulbactam sodium equivalent to 250 mg ampicillin per mL and 125 mg sulbactam per mL. The pH of the solutions is between 8.0 and 10.0. Dilute solutions (up to 30 mg ampicillin and 15 mg sulbactam per mL) are essentially colorless to pale yellow. The pH of dilute solutions remains the same.

UNASYN (ampicillin and sulbactam) pharmacy bulk package is a vial containing a sterile preparation of ampicillin sodium and sulbactam sodium for parenteral use that contains many single doses. The Pharmacy Bulk Package is for use in a pharmacy admixture setting; it provides many single doses of UNASYN (ampicillin and sulbactam) for addition to suitable parenteral fluids in the preparation of admixtures for intravenous infusion

LABORATORY: Urinalysis Color: light PH: 8.0 Specific gravity: 1.005 PUS:2-4 RBC: none Yeast:none Bacteria: none Epithelial:none Mucus thread: moderate CBC Hemoglobin: 109 Hematocrit: 0.33 WBC Count: 31.42