Description:-fats &oils belong to a group of compounds called lipids. they are characterized by greasy feel, insolubility in water &solubility n some organic solvent.
Lipids contain a small proportion of oxygen &a larger proportion of hydrogen &carbon. fats are solid at 20 degree Celsius. They are called oils if they are liquid at that temperature.
Fatty acids: – A fatty acid is a long hydrocarbon chain capped by a carboxyl group (COOH). There are many common fatty acids that you hear about, four of which are shown below along with acetic acid for comparison:
The COOH cap is what makes these molecules acids. You are probably familiar with acetic acid because this is the acid found in vinegar. You can see that the fatty acids are like acetic acid, but they have much longer carbon chains.

Functions of fats: – there are many functions of fats which are following:-Fatty acids have many functions in the body, and play a role in:
• oxygen transport throughout the body
• providing energy (when glucose, a form of sugar, is not available)
• development of strong tissues and organs
• brain functioning
• lowering cholesterol and reducing risk of heart disease
• healthy looking skin
• immune system health
• Fatty acids, in particular essential fatty acids (EFAs) — alpha-linolenic (omega-3) and linoleum acid (omega-6) — are intimately related to managing inflammation in the body. Fatty acids provide the building blocks for your body to make prostaglandins, agents that increase and decrease inflammation in the body. In a nutshell, saturated fats create the prostaglandins that increase inflammation and omega-6 and omega-3 create the prostaglandins that decrease inflammation. Both inflammation and anti-inflammation are important functions in our bodies, because they are the agents of healing. But as important as it is to be able to inflame (bring healing agents to a site of damage in your body), it is just as important to then be able to anti-inflame, removing those healing agents when they’ve done their job. We need to have a balance of both.

Position :- The pharynx is the part of the throat that is behind the mouth and nasal cavity and above the esophagus and the trachea, or the tubes going down to the stomach and the lungs.
The pharynx is an organ found in vertebrates and invertebrates, though the structure is not universally the same across all of those species. In humans the pharynx is part of the digestive system and also of the respiratory system.

Parts of pharynx:-The conducting zone also includes :-
• nose
• larynx
• trachea
• bronchi
• Bronchioles
Function of pharynx:- They are following—
(1) to filter
(2) warming
(3) moisten air
(4) conducting the lungs
Sections of pharynx:-The pharynx has three sections:-
— The nasopharynx
— the oropharynx
—the laryngopharynx.
(1)Nasopharynx:-The upper portion of the pharynx, the nasopharynx, extends from the base of the to the upper surface skull of soft palate. It includes the space between the internal nares and the soft palate and lies above the oral cavity. The adenoid is a part of nasal cavity also known as the pharyngeal tonsils.
The lymphoid tissue structures located in the posterior wall of the nasopharynx.
(2)Oropharynx:-The oropharynx lies behind the oral cavity, extending from the uvula to the level of the hyoid bone.
It opens anteriorly , through the isthmus faucium into the mouth.The anterior wall consists of the base of the tongue and the epiglottic vallecula. The lateral wall is made up of the tonsil, tonsillar fossa, and tonsillar (faucial) pillars.
The superior wall consists of the inferior surface of the soft palate and the uvula. Because both food and air pass through the pharynx, a flap of connective tissue called the epiglottis closes over the glottis when food is swallowed to prevent aspiration. The oropharynx is lined by non-keratinised squamous stratified epithelium.
(3)Laryngopharynx:- The laryngopharynx, also known as hypopharynx. The part of the throat that connects to the esophagus.
It lies inferior to the epiglottis and extends to the location where this common pathway divers into the respiratory and digestive pathways.
At that point, the laryngopharynx is continuous with the esophagus posteriorly. The esophagus conducts food and fluids to the stomach; air enters the larynx anteriorly. During swallowing, food has the “right of way”, and air passage temporarily stops

INTRODUCTION:
The liver is a vital organ, plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids.

STRUCTURE
The liver is a reddish brown wedge-shaped organ with four lobes of unequal size and shape. A human liver normally weighs 1.44–1.66 kg (3.2–3.7 lb). Located in the right upper quadrant of the abdominal cavity, it rests just below the diaphragm, to the right of the stomach and overlies the gallbladder.

MICROSCOPIC ANATOMY
The study of microscopic anatomy, shows two major types of liver cell: parenchymal cells and non-parenchymal cells. 70–85% of the liver volume is occupied by parenchymal hepatocytes. Non-parenchymal cells constitute 40% of the total number of liver cells but only 6.5% of its volume. The liver sinusoids are lined with two types of cell, sinusoidal endothelial cells, and phagocytic Kupffer cells. Hepatic stellate cells are non-parenchymal cells found in the perisinusoidal space, between a sinusoid and a hepatocyte. Additionally, intrahepatic lymphocytes are often present in the sinusoidal lumen.

FUNCTIONAL ANATOMY
The central area or hilum, known as the porta hepatis is where the common bile duct, hepatic portal vein, and the hepatic artery proper enter the liver. The duct, vein, and artery divide into left and right branches, and the areas of the liver supplied by these branches constitute the functional left and right lobes.The functional lobes are separated by the imaginary plane, Cantlie’s line, joining the gallbladder fossa to the inferior vena cava. The plane separates the liver into the true right and left lobes. The middle hepatic vein also demarcates the true right and left lobes. The right lobe is further divided into an anterior and posterior segment by the right hepatic vein. The left lobe is divided into the medial and lateral segments by the left hepatic vein.
BLOOD SUPPLY
The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries.

The larynx commonly called the voice box. IT is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration.
It changes pitch and volume. The larynx houses the vocal folds (vocal cords), which are essential for phonation& sound. The vocal folds are situated just below where the tract of the pharynx into the trachea and the esophagus.

Structure:-
(1)Cartilages:-Posterior view of the larynx is cartilages (left) and intrinsic muscles (right)
There are nine cartilages, three unpaired and three paired, that support the mammalian larynx and form its skeleton.
 Unpaired cartilages:
• Thyroid cartilage: This forms the Adam’s apple. It is usually larger in males than in females. The thyrohyoid membrane is a ligament associated with the thyroid cartilage that connects the thyroid cartilage with the hyoid bone.
• Cricoids cartilage: A ring of hyaline cartilage that forms the inferior wall of the larynx. It is attached to the top of trachea.
• Epiglottis: A large, spoon-shaped piece of elastic cartilage. During swallowing, the pharynx and larynx rise. Elevation of the pharynx widens it to receive food and drink; elevation of the larynx causes the epiglottis to move down and form a lid over the glottis, closing it off.
 Paired cartilages:
• Arytenoid cartilages: Of the paired cartilages, the arytenoid cartilages are the most important because they influence the position and tension of the vocal folds. These are triangular pieces .
• Corniculate cartilages: Horn-shaped pieces of elastic cartilage located at the apex of each arytenoid cartilage.
• Cuneiform cartilages: Club-shaped pieces of elastic cartilage located anterior to the corniculate cartilages.
Muscles:-The muscles of the larynx are divided into intrinsic and extrinsic muscles.
The intrinsic muscles are divided into respiratory and the muscles (the muscles of phonation). The respiratory muscles move the vocal cords apart and serve breathing. The phonatory muscles move the vocal cords together and serve the production of voice.
The extrinsic, passing between the larynx and parts around; and intrinsic, confined entirely. The main respiratory muscles are the posterior cricoarytenoid muscles. The muscles are divided into adductors .

Introduction: – Morphea, also known as “localized scleroderma”, or “circumscribed scleroderma”, involves isolated patches of hardened skin with no internal organ involvement.
Signs and symptoms:-

Frontal linear scleroderma
Morphea is most often presents as mauls or plaques a few centimeters in diameter, but also may occur as bands or in guttate lesions or nodules.
Morphea is a thickening and hardening of the skin and subcutaneous tissues from excessive collagen deposition. Morphea includes specific conditions ranging from very small plaques only involving the skin to widespread disease causing functional and cosmetic deformities. Morphea discriminates from systemic sclerosis by its supposed lack of internal organ involvement. . This classification scheme does not include the mixed form of morphed in which different morphologies of skin lesions are present in the same individual. Up to 15% of morphed patients may fall into this previously unrecognized category.
Cause:-
Physicians and scientists do not know what causes morphed. Case reports and observational studies suggest there is a higher frequency of family history of autoimmune diseases in patients with morphed. Tests for auto antibodies associated with morphed have shown results in higher frequencies of anti-hailstone and anti-topoisomerase Imia antibodies. Case reports of morphed co-existing with other systemic autoimmune diseases such as primary billiard cirrhosis, vitiligo, and systemic lupus erythematosus lend support to morph as an autoimmune disease.
Treatment:-
Throughout the years, many different treatments have been tried for morphed including topical, intra-lesional, and systemic corticosteroids. Antimalarials such as hydroxychloroquine or chloroquine have been used. Other immunomodulators such as methotrexate, topical tacrolimus, and penicillamine have been tried. Some have tried prescription vitamin-D with success. Ultraviolet a (UVA) light, with or without psoralens have also been tried. UVA-1, a more specific wavelength of UVA light, is able to penetrate the deeper portions of the skin and thus, thought to soften the plaques in morphed by acting in two fashions:
• 1) By causing a systemic immunosuppressant from UV light.
• 2) By inducing enzymes that naturally degrade the collagen matrix in the skin as part of natural sun-aging of the skin.
As with all of these treatments for morphed, the difficulty in assessing outcomes in an objective way has limited the interpretation of most studies involving these treatment modalities.
Epidemiology:-Morphea is a form of scleroderma that is more common in women than men, in a ratio 3:1 Morphea occurs in childhood as well as in adult life.

DEFINITION- Nephritic Syndrome is a primary glomerular disease charactrised by, protenuria hypoalbumineia, oedema, & hyperlipidemia.
ETIOLOGY-
1 Primary glomerular disease – Glomerulo Nephritis
2 Multisystem Diseases – Diabetes Mellitus
3 Drug Cause – NSAID, Penicillamine,
4 Infections
5 Neoplasms
6 Allergic
PATHOPHYSIOLOGY –
Damage of glomerular capillary membrane

Loss of protein (albumin)

Hypoalbumineia

Decrease oncotic pressure

Generalize oedema (anasarca)

Activation of rennin angiotensin system

Sodium retention

Oedema
SIGN & SYMPTOMS –
• Ascites
• Head ache
• Fatigue
• Malaises
• Oedema in eye, brain, kidney
Diagnosis

Urinalysis will be able to detect high levels of proteins and occasionally microscopic haematuria.
Specifically elevated LDL, usually with concomitantly elevated VLDL, is indicative of nephrotic syndrome.
A kidney biopsy may also be used as a more specific and invasive test method. A study of a sample’s anatomical pathology may then allow the identification of the type of glomerulonephritis involved however; this procedure is usually reserved for adults as the majority of children suffer from minimum change disease that has a remission rate of 95% with corticosteroids. A biopsy is usually only indicated for children that are corticosteroid resistant as the majority suffers from focal and segmental glomeruloesclerosis.
Further investigations are indicated if the cause is not clear including analysis of auto-immune markers (ANA, ASOT, C3, cryoglobulins, serum electrophoresis), or ultrasound of the whole abdomen.
MANAGEMENT– The treatment of nephrotic syndrome can be symptomatic or can directly address the injuries caused to the kidney.
Symptomatic
The objective of this treatment is to treat the imbalances brought about by the illness: edema, hypoalbuminemia, hyperlipemia, hypercoagulability and infectious complications.
1. Edema: a return to an unswollen state is the prime objective of this treatment of nephrotic syndrome. It is carried out through the combination of a number of recommendations:
2. Rest: depending on the seriousness of the edema and taking into account the risk of thrombosis caused by prolonged bed rest.
3. Medical nutrition therapy: based on a diet with the correct energy intake and balance of proteins that will be used in synthesis processes and not as a source of calories.

4.Medication: The pharmacological treatment of edema is based on the prescription of diuretic drugs (especially loop diuretics, such as furosemide). In severe cases of edema (or in cases with physiological repercussions, such as scrotal, prenuptial or urethral edema) or in patients with one of a number of severe infections (such as sepsis or pleural effusion), the diuretics can be administered intravenously. This occurs where the risk from plasmatic expansion is considered greater than the risk of severe hypovolemia, which can be caused by the strong diuretic action of intravenous treatment

INTRODUCTION:
The kidneys are bean-shaped organs that serve several essential regulatory roles in vertebrates. Their main function is to regulate the balance of electrolytes in the blood, along with maintaining pH homeostasis.
Located at the rear of the abdominal cavity in the retroperitoneal space, the kidneys receive blood from the paired renal arteries, and drain into the paired renal veins. Each kidney excretes urine into a ureter which empties into the bladder.
STRUCTURE
The kidney has a bean-shaped structure having a convex and a concave border. It consist of:

1. Renal pyramid • 2. Interlobular artery • 3. Renal artery • 4. Renal vein 5. Renal hilum • 6. Renal pelvis • 7. Ureter • 8. Minor calyx • 9. Renal capsule • 10. Inferior renal capsule • 11. Superior renal capsule • 12. Interlobular vein • 13. Nephron • 14. Minor calyx • 15. Major calyx • 16. Renal papilla • 17. Renal column

BLOOD SUPPLY
The renal circulation supplies the blood to the kidneys via the renal arteries, left and right, which branch directly from the abdominal aorta.
FUNCTIONS
The kidney participates in whole-body homeostasis, regulating acid-base balance, electrolyte concentrations, extracellular fluid volume, and blood pressure. The kidney accomplishes these homeostatic functions both independently and in concert with other organs, particularly those of the endocrine system. Various endocrine hormones coordinate these endocrine functions; these include renin, angiotensin II, aldosterone, antidiuretic hormone, and atrial natriuretic peptide, among others.
Many of the kidney’s functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in the nephron. Filtration, which takes place at the renal corpuscle, is the process by which cells and large proteins are filtered from the blood to make an ultrafiltrate that eventually becomes urine. The kidney generates 180 liters of filtrate a day, while reabsorbing a large percentage, allowing for the generation of only approximately 2 liters of urine. Reabsorption is the transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.

INTRODUCTION: – Diverticulitis is a common digestive disease which involves the formation of pouches (diverticula) within the bowel wall. This process is known as diverticulosis, and typically occurs within the large intestine, or colon, although it can occasionally occur in the small intestine as well. Diverticulitis results when one of these diverticula becomes inflamed.
CAUSES: – The causes of diverticulitis are poorly understood, with approximately 40% due to genes and 60% due to environmental factors. Obesity another risk factor.
PATH PHYSIOLOGY: – Diverticulitis is believed to develop because of changes inside the intestines including high pressures because of faulty contracting of the intestines.
They often evolve from age-related diverticulosis and its associated pathologies resulting from increased intraluminal colonic pressure, including bleeding, abscess, perforation, stricture, fistula formation or impacted fecal matter.
Most people with diverticulosis do not have any discomfort or symptoms; however, symptoms may include mild cramps, bloating, and constipation. Other diseases such as inflammatory bowel disease (IBD) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis.
DIAGNOSIS: – People with the above symptoms are commonly studied with computed tomography, or CT scan. The CT scan is very accurate (98%) in diagnosing diverticulitis. In order to extract the most information possible about the patient’s condition, thin section (5 mm) transverse images are obtained through the entire abdomen and pelvis after the patient has been administered oral and intravascular contrast. Images reveal localized colon wall thickening, with inflammation extending into the fat surrounding the colon. The diagnosis of acute diverticulitis is made confidently when the involved segment contains diverticulae. CT may also identify patients with more complicated diverticulitis, such as those with an associated abscess. It may even allow for radiologically guided drainage of an associated abscess, sparing a patient from immediate surgical intervention.
TREATMENT:-
Most cases of simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest.
Diet
People may be placed on a low residue diet. It was previously thought that a low-fiber diet gives the colon adequate time to heal. Evidence tends to run counter to this with a 2011 review finding no evidence for the superiority of low residue diets in treating diverticular disease and that a high-fiber diet may prevent diverticular disease. A systematic review published in 2012 found no high quality studies, but found that some studies and guidelines favor a high-fiber diet for the treatment of symptomatic disease.
Antibiotics
If bacterial infection is suspected, antibiotics may be used Despite being recommended by several guidelines, the use of antibiotics in mild cases of uncomplicated diverticulitis is supported with only “sparse and of low quality” evidence, with no evidence supporting their routine use.
Complications
In complicated diverticulitis, bacteria may subsequently infect the outside of the colon if an inflamed diverticulum bursts open. If the infection spreads to the lining of the abdominal cavity, (peritoneum), this can cause a potentially fatal peritonitis. Sometimes inflamed diverticula can cause narrowing of the bowel, leading to an obstruction. Also, the affected part of the colon could adhere to the bladder or other organ in the pelvic cavity, causing a fistula, or abnormal connection between an organ and adjacent structure or organ, in this case the colon and an adjacent organ.
• Bowel obstruction
• Peritonitis
• Abscess
• Fistula
• Bleeding
• Strictures

DEFINITION
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.

RISK FACTORS
1. Genetics
Twin and family studies have shown that people with first-degree relatives (such as a parent, sibling, or child) who have OCD are at a higher risk for developing OCD themselves. treatment.
2. Brain Structure and Functioning
Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in patients with OCD.
3. Environment
People who have experienced abuse (physical or sexual) in childhood or other trauma are at an increased risk for developing OCD.

SIGNS & SYMPTOMS
People with OCD may have symptoms of obsessions, compulsions, or both. These symptoms can interfere with all aspects of life, such as work, school, and personal relationships.
Obsessions are repeated thoughts, urges, or mental images that cause anxiety.
Common symptoms include:
• Fear of germs or contamination
• Unwanted forbidden or taboo thoughts involving sex, religion, and harm
• Aggressive thoughts towards others or self
• Having things symmetrical or in a perfect order
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought.
Common compulsions include:
• Excessive cleaning and/or handwashing
• Ordering and arranging things in a particular, precise way
• Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
• Compulsive counting
Not all rituals or habits are compulsions. Everyone double checks things sometimes. But a person with OCD generally:
• Can’t control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
• Spends at least 1 hour a day on these thoughts or behaviors
• Doesn’t get pleasure when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause
• Experiences significant problems in their daily life due to these thoughts or behaviors

TREATMENT

• Medication – Antidepressants are sometimes used in conjunction with therapy for the treatment of obsessive-compulsive disorder. However, medication alone is rarely effective in relieving the symptoms of OCD. fluoxetine , fluvoxamine ,sertraline
• Family Therapy – Because OCD often causes problems in family life and social adjustment, family therapy is often advised. Family therapy promotes understanding of the disorder and can help reduce family conflicts. It can also motivate family members and teach them how to help their loved one.
• Group Therapy – Group therapy is another helpful obsessive-compulsive disorder treatment. Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.
• Cognitive behavior therapy- The cognitive therapy component for obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

INTRODUCTION
A mental health assessment is an overall picture of how well you feel emotionally and how well you are able to think, reason, and remember (cognitive functioning).
A mental health assessment may be done by primary care doctor or by a psychiatrist, psychologist, or social worker.
A mental health assessment for a child is geared to the child’s age and stage of development.
Definition
The mental status examination or mental state examination, abbreviated MSE, is an important part of the clinical assessment process in psychiatric practice. It is a structured way of observing and describing a patient’s current state of mind, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight and judgment.
Why It Is Done
A mental health assessment is done to:

1. Find out about and check on mental health problems, such as anxiety, depression, schizophrenia, Alzheimer’s disease, and anorexia nervosa.
2. Help tell the difference between mental and physical health problems.
3. Evaluate a person who has been referred for mental health treatment because of problems at school, work, or home.
For example, a mental health assessment may be used to find out if a child has learning disabilities or behavior disorders such as attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), or obsessive-compulsive disorder (OCD).
4. Check the mental health of a person who has been hospitalized or arrested for a crime, such as drunken driving or physical abuse.
Components of the Mental Status Exam
• Appearance
• Behavior
• Speech
• Mood
• Affect
• Thought process
• Thought content
• Cognition
• Insight/Judgment