bhavyalatha

[bhavyalatha]

Complement system

1. Activation: The complement system can be activated through three main pathways: the classical pathway, the alternative pathway, and the lectin pathway. Each pathway involves different initiating events but converges on a common cascade of reactions.

2. Cascade of Reactions: Once activated, the complement system triggers a cascade of enzymatic reactions that result in the cleavage of complement proteins. This cascade ultimately leads to the formation of several key components, including C3b, C4b, and C5b.

3. Opsonization: C3b and C4b are opsonins, which means they can bind to pathogens and label them for phagocytosis by immune cells like macrophages and neutrophils. This enhances the removal of pathogens from the body.

4. Inflammation: Complement activation also results in the release of small peptides called anaphylatoxins, such as C3a and C5a. These peptides promote inflammation by increasing blood vessel permeability and attracting immune cells to the site of infection.

5. Membrane Attack Complex (MAC): The final step of complement activation involves the assembly of the membrane attack complex (MAC). C5b, C6, C7, C8, and multiple C9 molecules come together to form the MAC, which can create pores in the membranes of target cells, leading to cell lysis and destruction of pathogens.

References:

1. Walport, M. J. (2001). Complement. First of two parts. New England Journal of Medicine, 344(14), 1058-1066.

2. Ricklin, D., Hajishengallis, G., Yang, K., & Lambris, J. D. (2010). Complement: a key system for immune surveillance and homeostasis. Nature Immunology, 11(9), 785-797.

3. Merle, N. S., Church, S. E., Fremeaux-Bacchi, V., & Roumenina, L. T. (2015). Complement system part I – molecular mechanisms of activation and regulation. Frontiers in Immunology, 6, 262.

Please note that for the most current and detailed medical information on the complement system, I recommend consulting recent textbooks or academic journals in immunology and microbiology.

[bhavyalatha]

Rewatching organic chemistry lectures to prepare for an exam, but instead of taking notes, I’m writing down the weird things my professor says. And so…

An incomplete list of the unhinged stuff my organic chemistry professor has said:

Rule one in organic chemistry: carbon is a working girl. It bonds with basically everything

This is an alcohol. Something quite popular amongst students, I believe

A thiol kinda looks like an alcohol. But alcohols are usually enjoyed, whereas thiols is what skunks use when you’re stupid and unfortunate enough to piss them off. Do with that what you will.

There will come an age when your doctor gets worried about your high cholesterol levels, which often makes people wonder why we even have cholesterol if too much of it is so unhealthy. Let’s say it like this: if suddenly all your cholesterol vanished, your doctor would be pleased but you wouldnt be. You’d be a puddle on the floor.

How to know whether an anion is stable? Rule number one, and I’m sorry to say this, but gentlemen, your girlfriends lied. Because size does matter.

No self respecting scientist uses the IUPAC- naming system. But you still need to know it for the exam. Sucks to be you

An addition reaction is the most romantic reaction in chemistry: two things become one. But romance never lasts, and so just like that, one thing can fall apart into two again

For the exam, the bar is nearly on the floor. Just don’t write anything that is impossible and you’re good. And yet every year there are students who dig beneath the bar and fail anyway

The Sanger reaction was named after chemist Frederick Sanger, who is the only chemist to ever receive 2 Nobel prizes in chemistry. Marie Curie was also a chemist who got 2 Nobel prizes, but one of those was for physics so that’s a bit more complicated. Of course, there’s also the chemist Linus Pauling, who got 2 Nobel prizes as well… but one of them was the Nobel prize of peace and those don’t count

[bhavyalatha]

Lesson for a doctor in India nowadays;

1. Every patient is a potential litigant (however sweet and charming you find the attenders in counselling session)

2. When a case goes to trial, if you haven’t written date and time of your visit then your notes are questionable.

3. Never hesitate to over investigate. Err on the side of caution.

4. Never hesitate to admit in ICU. Financial status of the patient is not your headache. If not affordable the Govt is providing world class infrastructure and care in all government hospitals.

5. Save atleast ₹50 lakh for potential consumer forum litigation. Get a medical indemnity insurance (whether you are a resident, registrar, consultant)

6. Be firm in your counselling. Retaliate with the same tone. Don’t appear meek.

7. There is no bargaining in health care. If you have made a clinical decision. Stick by it.

8. Make sure you document the patient deteriorating and likelihood of patients death in ICU. (Don’t hesitate to use the word ‘Death’)

9. Dont show sympathy. Be empathetic.

10. Use caution while speaking in ICU. some of the patients are awake. And listening to what u say.

11. Take consent for blood transfusion also.

12. Never advise treatment on phone, whatsapp, skype, instagram,sms. Cite the supreme court ruling for the same.

13. If patient attenders call you asking what to do on a holiday and describe the patients condition, dont rely on them. Ask them to bring the patient to the hospital. (The only reason patient son/daughter calls you on a holiday is to get a false assurance that he can wait till tomorrow).

14. Don’t answer phone while driving. His fever of 98.9 is not more important than your life.

15. Take care of your health. You and only you are responsible for your health. The patient you so laboriously resuscitated, revived, treated wont thank you after 19 days of hospital admission.

16. Every stroke of your pen in the OP/IP sheet is medico legally answerable. Chose your words carefully.

17. If you really love your kids, inculcate the love of Maths and Physics also in them.

18. The ethics taught to you may not applicable for Indian scenario., with respect to how patients / family may behave

19. Dont be happy that you have the attenders signature on all the consent forms etc. It may not be his signature after all.

20. When you see a aggressive mob (read anything more than 3 persons) dont try to engage them.

You maybe a pink belt in Muay-Thai, kick boxing or Krav Maga you cant fight a mob. (It only happens in Tollywood, and you are not a Tollywood hero)

By:

Dr Lalit Shah

Urological Medicolegal Forum

[bhavyalatha]

Who says we don't exercise?

We....

'jump' to conclusions.

'throw' tantrums & our weight around.

'twist' the truth.

'stretch' our imagination.

'bend' the rules.

'push' our luck.

'chase' rainbows & our dreams.

'turn' over a new leaf.

'run' for our lives.

'skip' the lines.

'punch' jokes.

'lift' our hopes.

'push' limits.

'blow' our own trumpet.

'lift' our hopes.

'push' our boundaries.

'throw' light.

'twist' our fate.

'blow' our own trumpet.

'climb' the career ladder.

In fact...

We are absolutely fit. 💪🏻💪🏻

You are free to add to the list

Eg...and at the end of it all

We 'kick' the bucket 😂😂😂

[bhavyalatha]

[bhavyalatha]

Can u judge who is the best person of these 3?:

🤔

Mr A - He had friendship with bad politicians, consults astrologers,

Two wives,

Chain smoker,

Drinks eight to 10 times a day..🤨

Mr B - He was kicked out of office twice,

Sleeps till noon,

Chain smoker,

Used opium in college &

Drinks whiskey every evening..😟

Mr C - He is a decorated war hero, a vegetarian, doesn't smoke, doesn't drink and never cheated on his wife..😁

You would say Mr.C

right?

But..

Mr. A was Franklin Roosevelt!

( 32nd President of the USA)

Mr. B was Winston Churchill!!

(Former British Prime Minister)

Mr C Was ADOLF HITLER!!!

Strange but true..

Its risky to judge anyone by his habits !

Character is a complex phenomenon..🤗

So every person in ur life is important,

Don't judge them,

Accept them..

The same Boiling Water that

Hardens the egg,

Will Soften the Potato!

It depends upon Individual's reaction To stressful circumstances!..🤔

Enjoy "The Journey"

Called

*Life* ..

*🌷🌷🌷*

[bhavyalatha]

C/P

Secret messege that Indian Diwali Sweets carry -Positive Psychology and Sweets 😋 It's all about "Perspective".

1. Jalebi

Your shape doesn't matter, your nature does.

No matter how messed up you look or life is, keeping a sweet tone will always help.

2. Rasgulla

No matter how much you are squeezed by circumstances, never forget who you are. Come back to your original self.

Be resilient.

3. Boondi Ladoo

Every little drop of boondi matters. Similarly little and continuous efforts can bring in miraculous results.

Continue doing little things, success will follow.

4. Soan papdi

Not everyone likes you, yet the maker doesn't stop to make you.

Pursue your goals, irrespective of validation.

5. Gulab jamun

Your softness is not your weakness, it can be your strength.

Softness is a quality much appreciated, be proud of it.

6. Besan k Ladoo

If you get shattered due to pressure, you can always rebuild.

It's a symbol of HOPE. No matter what goes wrong, we can always fix it.

[bhavyalatha]

Checkout the glory of atelectatic lungs expanding

Max amount of air an average adult male’s lungs can hold is~6 liters. You breathe in ~2,000 gallons per day

Source: The Innovation | Medicine and Laurel Coons

[bhavyalatha]

*GOOD MORNING!*

*Nutty language this English...Many a times it drives you mad/ kills you harmlessly!!!*

_*Read further at your risk ....*_

*Points to Ponder:*

1. When you say *"a, e, i, o, u" your mouth gets smaller* with each vowel you say ! 😊😊

2. *You don't really wash your hands;... they wash each other* while you stand there & watch.....

3. Things are not on fire,... *fire is on things !* 😳🤔

5. When you say *'Forward' or 'Backward'...Your lips move in those directions !*

(Yes!..Just like that !!) 😄😄

6. *The word 'Australia' has three A's,*... all of which look the same, but are... *pronounced differently !* (surprised ??) 😳🤭

7. *If You rip a hole in a net,there are actually fewer holes in it than before !* 😄🤭

8. The sentence *"All the faith he had had had had no effect on the outcome of his life."... is actually correct !!* 😄😄🤭🤭 (getting too much??)

9. *Sometimes you have to sing the whole alphabet in your head...just to find the next letter!!* 🤔

13. *“Dammit I'm Mad "* backwards is still *"Dammit I'm Mad"* (& that's the condition you have almost reached !!) 🤪🤪😝😝

14. *Nothing is behind your Back. It is always in front of your back !!* (Now that's stretching it a little bit too far!!) 😂😂🙃🙃

15. *Most of the time the people who tell you to calm down are the same people that made you angry in the first place!!* (Yeah... You got that *RIGHT!!*) 🤣🤣😜😜

16. *Hippopotomonstrosesquippedaliophobia is not fun to say, but ironically, this is the medical term for the fear of long words !!* 🤭🤭😝😝 (Nailed it ??... *Right ??*).

Have an inspiring, smiling & rejuvenating day!

😂😂😂😂😂😂😂😂😂😂

[bhavyalatha]

[bhavyalatha]

" Can A Word Be Its Own Opposite? "

Yes! They are called Contronyms —words that are their own antonyms, depending on usage.

Here are a few examples

"Dust" :

can mean ‘to add fine particles’ or ‘to remove fine particles’.

"Left" :

can mean both

‘remaining’ and ‘departed’.

"Off" :

can mean both ‘activated’ and ‘deactivated’.

Eg:- “Set off” - Activated

“ Switch off - Deactivated

"Oversight" :

means both ‘watchful care’ and ‘an inadvertent error’.

"Screen" :

can mean both ‘to show’ and ‘to hide’.

"Sanction"

can mean both ‘a penalty for disobeying a law’ and ‘official permission or approval for an action.

That's Amazing English!

[bhavyalatha]

One thing that I've found is very difficult to internalize is the idea that I actually *am* an expert on certain topics. Like, I'm not just some student fucking around; my opinion actually has weight.

[bhavyalatha]

This was taken from a tourism blog where people could post queries if they were planning on making a trip to India.

The answers are the actual responses on the website, who demonstrate tolerance and an excellent sense of humor:

Hilarious!! 😁😁😆

Q: Does it ever get windy in India? I have never seen it rain on TV, how do the plants grow? (UK).

A: We import all plants fully grown and then just sit around watching them die.

Q: Will I be able to see elephants in the street? (USA)

A: Depends how much you’ve been drinking.

Q: I want to walk from Delhi to Goa – can I follow the railroad tracks? (Sweden)

A: Sure, it’s only three thousand kms, take lots of water.

Q: Are there any ATMs in India? Can you send me a list of them in Delhi, Chennai, Calcutta and Bangalore?(UK)

A: What did your last slave die of?

Q: Which direction is North in India? (USA)

A: Face south and then turn 180 degrees. Contact us when you get here and we’ll send the rest of the directions.

Q: Can I bring cutlery into India? (UK)

A: Why? Just use your fingers like we do.

Q: Can you send me the Indiana Pacers matches schedule? (France)

A: Indiana is a state in the Unites States of…oh forget it. Sure, the Indiana Pacers matches are played every Tuesday night in Goa, Come naked.

Q: Can I wear high heels in India? (UK)

A: You’re a British politician, right?

Q: Are there supermarkets in Bangalore, and is milk available all year round? (Germany)

A: No, we are a peaceful civilization of vegan hunter/gatherers. Milk is illegal.

Q: Please send a list of all doctors in India who can dispense rattlesnake serum. (USA)

A: Rattlesnakes live in A-meri-ca which is where YOU come from. All Indian snakes are perfectly harmless, can be safely handled and make good pets.

Q: Do you have perfume in India? (France)

A: No, WE don’t stink in India.

Q: I have developed a new product that is the fountain of youth. Can you tell me where I can sell it in India? (USA)

A: Anywhere significant numbers of Americans gather.

Q: Do you celebrate Christmas in India? (France)

A: Only during Christmas.

Q: Will I be able to speak English most places I go? (USA)

A: Yes, but you will have to learn it first

Q: Can I see Taj Mahal anytime? (Italy)

A: As long as you are not blind, you can see it anytime day and night.

Q: Do you have Toilet paper? (USA)

A: No, we use sand paper. We have different grades

😂🤣😂🤣

[bhavyalatha]

A delightful epistle written by a colleague *A Misconstrued Medico* :

Dear Sir,

I belong to a profession that Shashi Tharoorji would describe as ‘ *Somatic decrepitude mender* ’ and in common parlance.,

*Doctor*.

Off late, I had some weird experiences which I would like to share with you sir!

Recently, I travelled with my family by flight sir !

We reported at check-in a little late by just half an hour sir! (My patients are usually late by one hour for surgery and two hours for consultation).

The lady at the check-in counter was very upset with me sir !

Angrily, she asked us to deposit our baggage.

Then.

I had my doubts!

As it was a travel abroad , We were taking three flights with two transits!

Would the staff at the various airports know our itinerary ?

I asked the lady and she reluctantly replied that they had protocols and our baggage would be safe.

But… still I had doubts!

So I sent my wife again to clarify the same with the same lady .

Same answer….!!

But more reluctance!

Actually sir ,

I am a man of perfection and so asked my son to re-clarify again !

This time, the lady got really angry while explaining !

But sir, I wasn't convinced ,

I wanted an expert from our family to opine!

Hence I called my cousin’s brother-in-law’s friend, who is in air related business (he is an air-conditioning mechanic!) and gave the phone to the lady!

Now... You see sir!

We, doctors, always clear doubts of patients, their relatives, friends, relatives’ friends, friends’ relatives (and even pets!) in person, phone, mail, whatsapp, etc. without grumbling even in midnight sir !

But this lady was furious and asked me to go to hell and with lot of confusions we proceeded to the security check!

I could overhear her describing me as a piece of what Tharoorji would call ‘ *Haemorrhagic excrement* !’

Inside the plane,

I had a big shock sir!

A lady was demonstrating what we should do., when the plane falls into the sea!

My goodness..

I got panicky and wanted to see the pilot immediately!

The pilot came and I asked him:

“ Can I go to business class if I pay extra money?”

He agreed.

But I had some doubts: “Is business class 100% safe?

No emergency exit, oxygen stuff, etc...!! Right?”

He said “NO!”

Look sir! I am paying 3 or 4 times more than (Tharoorji’s) ‘ *cattle class* ’

But u say still the plane can fall into the sea!!

Then I asked him my second doubt:

“Does business class reach the destination a few hours earlier?”

(‘Pay more! Expect more!’ - our patients’ policy sir!)

Again a ‘NO!’

I made a last request to the pilot:

“Sir! Today…. Wednesday!

Now it is 8.40am! Yamakandam is over only at 9’o clock. Can you please delay take off by 20 minutes?”

He banged the cockpit door on my face, sir, and called me what Tharoorji would term

‘ *Progeny of un-solemnised copulation* '

Not only flight sir

.

Once , During rail travel booking too, I had problems sir!

The first class AC rail ticket charges were exorbitantly high sir!

I politely asked the booking clerk for concession.

He said, “If you want to pay less, travel in second non-AC!”

Even after explaining to him that my family always loyally travelled by their railways for more than four decades, he would not oblige.

I called him “ *Greedy fellow* !!”

Just like patients call Doctors when they see the hospital bill.

In return, that man scolded me with a word, which Tharoorji would term as ‘ *Maternal fornicator* !’

The final incident took place last week sir!

Our family had sumptuous biriyani at a hotel in our town sir .

When the bill came, I was shocked sir!

Immediately I called the manager and complained about the exorbitant charges.

He went on to explain,

“Look sir!

Do you know what ingredients we use for our biriyani?

All.... branded items! Kohinoor basmati rice, all spices from Everest and so on .....

I stopped him mid-sentence: “

You cheat! Now.... I have caught you red-handed!

Rice in ration shop is less than Rs.10 a kilo,

And

Just 2 rupees in Tamilnadu ,,

But you buy rice for Rs.300 a kilo....!

I know..... you have a secret deal with all the companies and overcharge the customers!”

The same accusation that the *Indian intelligentsia including the PM-ji throw against us doctors* !

But sir.... the manager called all his staff, threw me out after making me pay the bill with no.mercy !!

The words they used sir...... !!!

no sir.... &%£@%&

Even Tharoorji’s thesaurus would not have equivalent words!

*Written by a fellow doc.*

[bhavyalatha]

"Our ancestors didn't have access to modern medicine and they were fine!"

No. They weren't. And I don't know where your ultra romanticized idea of what life was like for people hundreds of years ago came from.

There's a reason why in many Asian cultures, celebrating a baby turning 100 days old remains an important tradition today. Because it was a huge deal for their ancestors. Their ancestors made a fuss over a baby on their 100th day of life, because a baby making it to 100 days after birth meant that baby had a chance to survive infancy.

In the Medieval times, life expectancy for the royalty and the aristocracy was 60 years if you were damn lucky. A woman had a greater than 50% chance of dying in childbirth. People married young and started having as many children as possible as soon as possible because they didn't expect to see the end of their fertile years, and maybe a quarter of their children had a shot at reaching adulthood.

If you managed to make it past childhood and you weren't one of the rich folks, you'd probably die from a cold before you were 30.

Lack of modern medicine was how 3 quarters of Europe's population got wiped out by the bubonic plague. Do you think any of us would stand a chance against the COVID-19 pandemic without hospitals and vaccines?

[bhavyalatha]

*🤪🤪Stop calling workers by their old titles*.

*Please address them by using their new titles !*🤔🤔

OLD: *Garden Boy*

NEW: *Landscape Executive*

OLD: *Gardner*

NEW: *Plant nutritionist*

OLD: *Petrol attendant*

NEW: *Fuel transmission technician*

OLD: *Car Cleaner*

NEW: *Vehicle Image Developer*

OLD: *Water Pump Operator*

NEW: *Aqua line Executive*

OLD: *Lift Operator*

NEW: *Vertical Movement Specialist*

OLD: *Receptionist*

NEW: *Front Desk Executive*

OLD: *Typist*

NEW: *Printed Document Handler*

OLD: *Messenger*

NEW: *Business Communication Conveyer*

OLD: *Telephone Operator*

NEW: *Communications Executive*

OLD: *Window Cleaner*

NEW: *Transparent Wall Technician*

OLD: *Temporary Teacher*

NEW: *Associate Teacher*

OLD: *Tea Boy*

NEW: *Refreshment Technician*

OLD: *Garbage Collector*

NEW: *Environmental Sanitation Technician*

OLD: *Guard*

NEW: *Security Enforcement Executive*

OLD: *Driver*

NEW: *Automobile Propulsion Specialist*

OLD: *Maid*

NEW: *Domestic Management Executive*

OLD: *Cook*

NEW: *Food Technician*

OLD: *Gossiper*

NEW: *Oral Research and Evaluation Executive*

*Finally, (Don’t laugh)*

OLD: *Thief*

NEW: *Wealth Relocation Specialist*

😂😂😂😂😂

[bhavyalatha]

One word in the English language that could be a noun, verb, adj, adv, prep is "UP".

Read until the end... you'll have a good laugh !!!

This two-letter word in English has more meanings than any other two-letter word. That word is, *'UP'*. It is listed in the dictionary as an [adv], [prep], [adj], [n] or [v].

It's easy to understand *UP*, meaning toward the sky or at the top of the list, but when we awaken in the morning, why do we wake *UP*?

At a meeting, why does a topic come *UP*? Why do we speak *'UP',* and why are the officers *UP* for election, if there is a tie, it is a toss *UP*, and why is it *UP* to the secretary to write *UP* a report ?

We call *UP* our friends, brighten *UP* a room, polish *UP* the silver, warm *UP* the leftovers and clean *UP* the kitchen. We lock *UP* the house and fix *UP* the old car.

At other times, this little word has real special meaning. People stir *UP* trouble, line UP for tickets, work *UP* an appetite, and think *UP* excuses.

To be dressed is one thing, but to be dressed *UP* is special.

And this *UP* can be confusing. A drain must be opened *UP* because it is blocked *UP* !!!

We open *UP* a store in the morning, but we close it *UP* at night. We seem to be pretty mixed *UP* about *UP* !!!

To be knowledgeable about the proper uses of *UP*, look *UP* the word *UP* in the dictionary. In a desk-sized dictionary, it takes *UP* almost 1/4 of the page and can add *UP* to about thirty definitions !!!

If you are *UP* to it, you might try building *UP* a list of the many ways *UP* is used. It will take *UP* a lot of your time, but if you don't give *UP*, you may wind *UP* with, *UP* to, a hundred or more.

When it threatens to rain, we say it is clouding *UP*. When the sun comes out, we say it is clearing *UP*. When it rains, it soaks *UP* the earth. When it does not rain for awhile, things dry *UP*.

One could go on and on, but I'll wrap it *UP*, for now...... my time is *UP*!

So, did this whole thing, crack you *UP*?

Send this on to someone you look *UP* in your group .... or not... it's *UP* to you.