Diabetes mellitus, commonly referred to as sugar diabetes, is a growing problem globally associated with with a ‘modern lifestyle’, a term used to describe lack of exercise, diet high in saturated fats and refined carbohydrates and prolonged levels of stress. Diabetes mellitus is essentially a disorder with glucose metabolism and the regulation of blood glucose levels. This is a consequence of a lack of insulin, the pancreatic hormone that regulates glucose levels in the blood, or a decreased senstivity to insulin. As a result, the blood glucose levels are elevated above the norm for long periods of time which in turn causes a host of complications as damage to cells throughout the body ensues.
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Scanty, irregular, infrequent periods and bleeding in between periods are some of the common types of menstrual disorders that occur for which many women seek medical help. The menstrual cycle can vary greatly in women, ranging from 21 to 35 days normally with the average being a 28 day cycle. The menstrual flow and duration of menstruation also varies among women, or even in the same woman under different circumstances. A normal menstruation may last from 2 to 7 days, with an average blood loss of 25 to 80 mL.
The heart is surrounded by a sac known as the pericardium, which is made up of two layers – the fibrous and serous pericardium. The inner lying serous pericardium is in turn composed of two linings – the parietal and visceral layers of the serous pericardium. The visceral layer of the serous pericardium is attached to the heart and makes up the outer layer of the heart wall known as the epicardium. The parietal layer of the serous epicardium is fused with the fibrous pericardium. A potential space therefore exists between the visceral and parietal layers of the pericardium in between known as the pericardial space. Within this space is a small amount of fluid known as the pericardial fluid that serves as a lubricant for the constantly beating heart. However, excess fluid can accumulate within this cavity and cause a host of signs and symptoms.
What is a pericardial effusion?
A pericardial effusion is the accumulation of fluid in the pericardial space between the parietal and visceral layers of the pericardium. It is commonly referred to as fluid around the heart since the visceral layer is continuous with the epicardium – the outermost layer of the heart wall. Although the pericardial space can accommodate small volumes of fluid, even beyond the 15 to 50 milliliters of pericardial fluid it normally contains, an excess will ultimately restrict the heart movement and compress the heart. A pericardial effusion is therefore an abnormal and excess amount of fluid around the heart within the pericardial space.
An abscess in the abdomen (intra-abdominal abscess) is diagnosed by correlating findings on imaging studies with the signs and symptoms present. Read more on symptoms of intra-abdominal abscesses. Other laboratory findings will further confirm the diagnosis.
Blood tests may reveal :
- raised white blood cell counts
- abnormal levels of liver enzymes
Absence of these findings, especially in elderly and debilitated patients, does not rule out intra-abdominal abscess completely.
A blood culture is an important investigation in diagnosing intra-abdominal abscess. Multiple bacterial growths found in blood culture or the presence of bacterial species like Bacteroides in a blood culture are highly suggestive of an intra-abdominal abscess. Peritoneal fluid culture and blood culture are also important in choosing the antibiotics for specific antibiotic treatment.
What is a subdural empyema?
A subdural empyema is a collection of pus in the subdural space, the naturally occurring space between the dura and arachnoid mater (outer and middle meningeal layer). This is a consequence of an infection and often spreads from neighboring sites like the paranasal sinuses. Most cases occur within the cranium but can extend to the subarachnoid space of the spinal column. A collection of pus anywhere in the body is known as an abscess and an empyema, which is an accumulation of pus in a body cavity/space, also falls under the definition of an abscess. A subdural empyema may be therefore be categorized as a brain abscess but should be differentiated from a cerebral or cerebellar abscess where the pus collects within the brain parenchyma.