Persius/hicric huggingface dataset:
Superior labial artery
The superior labial artery (superior labial branch of facial artery) is larger and more tortuous than the inferior labial artery.
It follows a similar course along the edge of the upper lip, lying between the mucous membrane and the Orbicularis oris, and anastomoses with the artery of the opposite side.
It supplies the upper lip, and gives off in its course two or three vessels which ascend to the nose; a septal branch ramifies on the nasal septum as far as the point of the nose, and an alar branch supplies the ala of the nose.
Supraclavicular nerves
The supraclavicular nerves (descending branches) arise from the third and fourth cervical nerves; they emerge beneath the posterior border of the Sternocleidomastoideus, and descend in the posterior triangle of the neck beneath the platysma and deep cervical fascia.

# Branches
Near the clavicle they perforate the fascia and Platysma to become cutaneous, and are arranged, according to their position, into three groupsanterior, middle and posterior.

## Medial supraclavicular nerve
The medial supraclavicular nerves or anterior supraclavicular nerves (nn. supraclaviculares anteriores; suprasternal nerves) cross obliquely over the external jugular vein and the clavicular and sternal heads of the sternocleidomastoideus, and supply the skin as far as the middle line. They furnish one or two filaments to the sternoclavicular joint.

## Intermedial supraclavicular nerve
The intermedial supraclavicular nerve middle supraclavicular nerves (nn. supraclaviculares medii; supraclavicular nerves) cross the clavicle, and supply the skin over the pectoralis major and deltoideus, communicating with the cutaneous branches of the upper intercostal nerves.

## Lateral supraclavicular nerve
The lateral supraclavicular nerve or posterior supraclavicular nerves pass obliquely across the outer surface of the trapezius and the acromion, and supply the skin of the upper and posterior parts of the shoulder.

# Additional images
- Dermatome distribution of the trigeminal nerve
- Cutaneous nerves of right upper extremity. Anterior view.
- Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. Anterior view.
- Cutaneous nerves of right upper extremity. Posterior view.
- Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. Posterior view.
- Side of neck, showing chief surface markings.
User:Suvekchha Devkota

# Contact
suvekchha@gmail.com

# Education
(M.B.B.S) Nepal Medical College, Kathmandu, Nepal.

# Experiences

## Work Experience
- Wikidoc Scholar for Wikidoc Scholar Program,PERFUSE Core Laboratory, MA,USA.
- Medical Officer at Department of Pediatrics, Nepal Medical College.
- Medical Officer at Department of Emergency Medicine, Alka Hospital Pvt Ltd, Lalitpur, Nepal

## Volunteer
- For Nepal Scouts as Medical Doctor since 2009.

## Research Experience
- Case Study-Sturge Weber Syndrome published at journal of NEPAS, Vol-30,Issue-3, Pg-164-165.
- Case Study- Growth Hormone Deficiency published by journal of Nepal Pediatric Society, Vol-31, Issue-2, Pg-134-135
Systemic venous system
In human anatomy, the systemic venous system is the veins that drain into the right atrium without passing through two vascular beds (i.e. they originate from a set of capillaries and do not pass through a second set of capillaries before reaching the right side of the heart).
The term systemic venous system is often used to differeniate veins from veins that drain the pulmonary system (the pulmonary venous system) and veins that drain the digestive tract (the portal venous system).
Large veins that are considered part of the system venous system are the:
- Superior vena cava
- Inferior vena cava
Tetrahydrocannabivarin
Tetrahydrocannabivarin, also known as tetrahydrocannabivarol, THCV, or THV, is a psychoactive  cannabinoid found in the hemp plant Cannabis sativa. It is an analog of tetrahydrocannabinol (THC) with the sidechain shortened by two CH2 groups. THCV can be used as a marker compound to differentiate between the consumption of hemp products and synthetic THC (Dronabinol, Marinol).
THCV is found in largest quantities from Indica strains. It has been shown to be a CB1 antagonist, i.e. blocks the effects of THC.
Some varieties that produce propyl cannabinoids in significant amounts, over five percent of total cannabinoids, have been found in plants from South Africa, Nigeria, Afghanistan, India, Pakistan and Nepal with THCV as high as 53.69% of total cannabinoids. They usually have moderate to high levels of both THC and CBD and hence have a complex cannabinoid chemistry representing some of the worlds most exotic cannabis varieties.
Tumor necrosis factors

# Overview
Tumor necrosis factors (or the TNF-family) refers to a group of cytokines family that can cause apoptosis.

# Mechanism
TNF acts via the TNF Receptor (TNF-R) and is part of the extrinsic pathway for triggering apoptosis. TNF-R is associated with procaspases through adapter proteins (FADD, TRADD, etc.) that can cleave other inactive procaspases and trigger the caspase cascade, irreversibly committing the cell to apoptosis.
TNF interacts with tumor cells to trigger cytolysis or cell death.
TNF can interact with receptors on epithelial cells, which leads to increased vascular permeability allowing leukocytes access to the  site of infection. This is a type of localized inflammatory response, although systemic release may lead to septic shock and death.

# Types
- Tumor necrosis factor-alpha (TNF-) is the most well-known member of this class, and sometimes referred to when the term "tumor necrosis factor" is used.
- Tumor necrosis factor-beta (TNF-) is a cytokine that is induced by interleukin 10
Telaprevir description

# Description
INCIVEK (telaprevir) is an inhibitor of the HCV NS3/4A protease.
The IUPAC name for telaprevir is (1S,3aR,6aS)-2-acetyl}amino)-3,3-dimethylbutanoyl]-N--3,3a,4,5,6,6a-hexahydro-1H-cyclopentapyrrole-1-carboxamide. Its molecular formula is C36H53N7O6 and its molecular weight is 679.85. Telaprevir has the following structural formula:
Telaprevir drug substance is a white to off-white powder with a solubility in water of 0.0047 mg/mL.
Telaprevir interconverts to an R-diastereomer, VRT-127394, which is the major metabolite in plasma and is approximately 30-fold less potent than telaprevir.
INCIVEK is available as a purple, capsule-shaped, film-coated tablet for oral administration containing 375 mg of telaprevir. Each tablet contains the inactive ingredients colloidal silicon dioxide, croscarmellose sodium, D&C Red No. 40, dibasic calcium phosphate (anhydrous), FD&C Blue No. 2, hypromellose acetate succinate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, sodium lauryl sulfate, sodium stearyl fumarate, talc, and titanium dioxide.
Telavancin description

# Description
VIBATIV contains telavancin hydrochloride, a lipoglycopeptide antibacterial that is a synthetic derivative of vancomycin. The chemical name of telavancin hydrochloride is vancomycin,N3--29--methyl]- hydrochloride. Telavancin hydrochloride has the following chemical structure:
Telavancin hydrochloride is an off-white to slightly colored amorphous powder with the empirical formula C80H106C12N11O27PxHCl (where x = 1 to 3) and a free-base molecular weight of 1755.6. It is highly lipophilic and slightly soluble in water.
VIBATIV is a sterile, preservative-free, white to slightly colored lyophilized powder containing telavancin hydrochloride (equivalent to either 250 mg or 750 mg of telavancin as the free base) for intravenous use. The inactive ingredients are Hydroxypropylbetadex, Ph. Eur (hydroxypropyl-beta-cyclodextrin) (2500 mg per 250 mg telavancin, 7500 mg per 750 mg telavancin), mannitol (312.5 mg per 250 mg telavancin, 937.5 mg per 750 mg telavancin), and sodium hydroxide and hydrochloric acid used in minimal quantities for pH adjustment. When reconstituted, it forms a clear to slightly colored solution with a pH of 4.5 (4.0 to 5.0).
Tellurium hexafluoride
Tellurium hexafluoride is the oldest known fluoride of tellurium.  It is a colorless and highly toxic gas that has a horrible smell.

# Preparation
Tellurium hexafluoride is most commonly prepared by passing fluorine gas over tellurium metal at 150 C.  Below this temperature a mixture of lower fluorides form, including tellurium tetrafluoride and ditellurium decafluoride.  It can also be prepared by passing fluorine gas over TeO3 or indirectly by reacting TeO2 with SeF4 to produce TeF4 and then heating TeF4 in excess of 200 C to make TeF6 and Te.

# Properties
Tellurium hexafluoride is a highly symmetric octahedral molecule.  Its physical properties resemble the sulfur and selenium analogs.  It is less volatile, however, due to the increase in molecular weight.  At temperatures below -38 C, tellurium hexafluoride condenses to a volatile white solid.

# Reactivity
Unlike the sulfur analog, tellurium hexafluoride is not chemically inert.  This can be attributed to the greater availability of the d orbitals and perhaps the availability of the f orbitals which neither sulfur or selenium have access to.  TeF6 is hydrolyzed in water to H6TeO6 and reacts with Te below 200 C.

# Health Hazards
People exposed to tellurium compounds exhibit "tellurium breath", which has a garlic-like odour.  This garlic odour is also present in sweat and urine.  Other symptoms of tellurium exposure include headache, dyspnea, weakness, bluish-black markings on fingers, neck, face and gums, metallic taste in the mouth and skin rash.  Death may occur from pulmonary edema.  People exposed to tellurium compounds should be removed from the area and seek medical attention.

## Reasons for "Tellurium-Breath"
The garlic odour that is associated with human intake of tellurium compounds is caused from the tellurium being metabolized by the body.  When the body metabolizes tellurium in any oxidation state, the tellurium gets converted into dimethyl telluride.  Dimethyl telluride is volatile and produce the garlic-like smell.

# Suppliers
Tellurium hexafluoride is not a very common chemical and can be found at only a few select suppilers (see below).  It costs approximately 2000 USD for 50 grams.
- Pfaltz and Bauer
- Fox Chemicals
Tenofovir how supplied

# How Supplied/Storage and Handling

## Tablets
VIREAD tablets, 150 mg, are triangle-shaped, white, film-coated tablets containing 150 mg of tenofovir disoproxil fumarate, which is equivalent to 123 mg of tenofovir disoproxil, are debossed with "GSI" on one side and with "150" on the other side. Each bottle contains 30 tablets, a desiccant (silica gel canister or sachet), and closed with a child-resistant closure. (NDC 61958-0404-1)
VIREAD tablets, 200 mg, are round-shaped, white, film-coated tablets containing 200 mg of tenofovir disoproxil fumarate, which is equivalent to 163 mg of tenofovir disoproxil, are debossed with "GSI" on one side and with "200" on the other side. Each bottle contains 30 tablets, a desiccant (silica gel canister or sachet), and closed with a child-resistant closure. (NDC 61958-0405-1)
VIREAD tablets, 250 mg, are capsule-shaped, white, film-coated tablets containing 250 mg of tenofovir disoproxil fumarate, which is equivalent to 204 mg of tenofovir disoproxil, are debossed with "GSI" on one side and with "250" on the other side. Each bottle contains 30 tablets, a desiccant (silica gel canister or sachet), and closed with a child-resistant closure. (NDC 61958-0406-1)
VIREAD tablets, 300 mg, are almond-shaped, light blue, film-coated tablets containing 300 mg of tenofovir disoproxil fumarate, which is equivalent to 245 mg of tenofovir disoproxil, are debossed with "GILEAD" and "4331" on one side and with "300" on the other side. Each bottle contains 30 tablets, a desiccant (silica gel canister or sachet), and closed with a child-resistant closure. (NDC 61958-0401-1)

## Oral Powder
VIREAD oral powder consists of white, coated granules containing 40 mg of tenofovir disoproxil fumarate, which is equivalent to 33 mg of tenofovir disoproxil, per gram of powder and is available in multi-use bottles containing 60 grams of oral powder, closed with a child-resistant closure, and co-packaged with a dosing scoop. (NDC 61958-0403-1)
Store VIREAD tablets and oral powder at 25 C (77 F), excursions permitted to 1530 C (5986 F) (see USP Controlled Room Temperature).
Keep the bottle tightly closed. Dispense only in original container. Do not use if seal over bottle opening is broken or missing.
tert-Butylhydroquinone
tert-Butylhydroquinone (TBHQ, tertiary butylhydroquinone) is an aromatic organic compound which is a type of phenol. It is a derivative of hydroquinone, substituted with tert-butyl group.

# Applications
TBHQ is a highly effective antioxidant for unsaturated vegetable oils and many edible animal fats. It does not cause discoloration even in the presence of iron, and does not change flavor nor odor of the material it is added to. It can be combined with other antioxidants such as butylated hydroxyanisole (BHA). As food additive, its E number is E319, where it is used as an antioxidant. It is added to a wide range of foods, with highest limit (1000 mg/kg) permitted for frozen fish and fish products. Its primary advantage is enhancing storage life.
It is used industrially as a stabilizer to inhibit autopolymerization of organic peroxides. In perfumery, it is used as a fixative to lower the evaporation rate and improve stability. It is also added to varnishes, lacquers, resins, and oil field additives.

# Carcinogenicity
In high doses, it has some negative health effects on lab animals, such as precursors to stomach tumors and damage to DNA.  A number of studies have shown that prolonged exposure to TBHQ may induce carcinogenity. Other studies, however, have shown protective effects for TBHQ and other phenolic antioxidants.
The heart in lymphomas

# Histopathological Findings
Image courtesy of Professor Peter Anderson DVM PhD and published with permission  PEIR, University of Alabama at Birmingham, Department of Pathology
- HEART: Hemorrhage In Region of Left Bundle Branches: Gross natural color of opened left ventricular outflow tract with subendocardial hemorrhage just below membranous septum. A case of Hodgkins disease with probable sepsis
- HEART: Hemopericardium Caused By Pericardiocentesis: Gross, natural color, close-up view of apex of the heart needle apparently entered the distal posterior descending artery 26 yo men with Hodgkin's disease or a T-cell lymphoma
- HEART: Metastatic Carcinoma Lung: Gross natural color external view with coronaries sectioned obvious tumor all over epicardium, a 44yo Female, an adenocarcinoma; giant cell type, right lung, occurring 25 years after treatment for Hodgkins disease
- HEART: Hodgkin's disease, marantic endocarditis, aortic valve
- HEART: Hodgkin's disease, marantic endocarditis, aortic valve

# Related Chapters
- The Heart in Breast Cancer
- The Heart in Gynecologic Tumors
- The Heart in Head and Neck Tumors
- The heart in leukemias
- The Heart in Lung Cancers
- The Heart in Multiple Myeloma
- The Heart in Osteosarcomas
- The Heart in Peritoneal and Mesothelial Tumors
- The Heart in Primary Myocardial Tumors
- The Heart in Skin Cancers
- The Heart in Thyroid and Parathyroid Cancers
- The Heart in Tumors that Originated from Vascular Structure
- The Heart in Urinary System Tumors
- The Heart in Central and Peripheral Nervous System Cancers
- The Heart in Gastrointestinal, Hepatobilier and Pancreatic Tumors
- The heart in lymphomas
The Hormone Foundation
Established in 1997 by The Endocrine Society as its public education affiliate, The Hormone Foundation serves as a resource for physicians, patients, and the public by promoting the prevention, treatment and cure of hormone-related conditions through outreach and education.
The Hormone Foundation addresses endocrine conditions such as:
- Obesity
- Diabetes
- Breast Cancer
- Thyroid Disorders
- Growth Disorders
- Hormone Abuse
- Menopause
- Osteoporosis
- Pituitary Disorders
- Low Testosterone
- Metabolic Syndrome
- Adrenal Disorders

# Projects and resources
The Hormone Foundation got its start with one simple project, an expert consensus meeting in Charlottesville, Virginia on breast cancer and estrogen use.  Since then, it has developed other educational projects on endocrine diseases and conditions.

## Bilingual fact sheets
The Hormone Foundation's bilingual fact sheets are unique in the field of endocrinology, providing information in English, Spanish, Portuguese, French, German and Italian.  The bilingual fact sheets can be found in the following areas: Cushing's Syndrome; Breast Cancer Prevention; Hormones, Women and Breast Cancer; Hormones and Hypertension; Hormones and Obesity; Hormones and Your Heart; Hyperlipidemia; The Metabolic Syndrome; Diabetes and Incretin-Based Therapy; Diabetes and New Insulins; Diabetes, High Blood Pressure and Kidney Protection; Gestational Diabetes; Self-Monitoring of Blood Glucose; Prediabetes; Type 1 Diabetes; Type 2 Diabetes and A1c; Idiopathic Short Stature; Precocious Puberty; Anabolic Steroids and Young Adults; Supplements, Steroid Precursors and Adolescent Health; Bioidentical Hormones and Menopause; Hormone Therapy for Menopausal Symptoms; Managing Menopause; Menopause and Bone Loss; Osteoporosis and Men's Health; Osteoporosis and Women's Health; Pituitary Tumors; Acromegaly; Enlarged Prostate; Prostate Cancer and Bone Loss; Erectile Dysfunction; Infertility and Men; Infertility and Women; Low Testosterone and Men's Health; Polycystic Ovary Syndrome; Hashimoto's Disease; Hyperthyroidism; Hyperthyroidism; Postpartum Thyroiditis; Thyroid Cancer; Thyroid Nodules; and Stress and Your Health.

## Patient guides
Patient Guides are more in-depth information about specific hormone-related conditions.  They include: Therapeutic Use of Androgen in Women; Growth Hormone Deficiency in Adults; and Androgen Deficiency Syndromes in Adult Men.
The Stennis Foundation
The Stennis Foundation is a registered nonprofit organization, in accordance with IRS code, section 501(c)(3). The Foundation is primarily a fundraising organization, raising money, and then sending it to various research projects. Currently, The Stennis Foundation supports research at Duke, Kennedy Krieger, and San Raffaele Institute in Milan, Italy. The Stennis Foundation is determined to make a difference, and bring an end to these insidious diseases known as the Leukodystrophies.
Besides being a nationwide organization, The Stennis Foundation is a registered charity in the states of Texas, Tennessee, New Jersey, Massachusetts, and Michigan -- having been recognized and granted credibility in these states.  
Online donations can be given through the Foundation's main website at www.stennisfoundation.org, using PayPal; or donations of any amount can be sent to:
The Stennis Foundation 
PO Box 30065 
Amarillo, TX 79120
The Stennis Foundation's commitment
According to their web site, The Stennis Foundation is committed to raising public awareness regarding the Leukodystrophies, and funds for Leukodystrophies research. Their goal is to forcefully advance research through proper funding. Their mission statement is "One Step Closer to a Cure."
Beginnings
The Foundation's beginnings were inspired by Dr. Sam Stennis, a former optometrist in Amarillo, Texas, who, at age 47, was diagnosed with adult-onset Metachromatic Leukodystrophy.

# Conditions of interest
- Leukodystrophy
- Metachromatic leukodystrophy
- Adrenoleukodystrophy
- Krabbe's disease
- Alexander's disease
- Canavan disease
- Pelizaeus-Merzbacher disease
Therapeutic ultrasound
Therapeutic ultrasound, also called Ultrasonic shock waves, is "High-amplitude compression waves, across which density, pressure, and particle velocity change drastically. The mechanical force from these shock waves can be used for mechanically disrupting tissues and deposits". Therapeutic ultrasound uses high-frequency sound waves (ultrasound) to speed healing in injured joint or muscle tissue. The frequency used is typically 1-3 Mhz. At this frequency, the waves tend to travel through tissue with high water or low protein content, and to bounce off cartilage and bone. They are absorbed primarily by connective tissue: ligaments, tendons, and fascia (and also by scar tissue).
Therapeutic ultrasound may have two types of benefit: Thermal effects involve energy absorbed from the sound waves heating the tissue. If the tissue is heated to 40-45C (104-113F), it can enter a state of hyperaemia (increased blood flow), which speeds healing and reduces chronic inflammation. Cavitational effects result from the vibration of the tissue causing microscopic air bubbles to form, which transmit the vibrations in a way that directly stimulates cell membranes. This physical stimulation appears to enhance the cell-repair effects of the inflammatory response. 
Therapeutic ultrasound is sometimes recommended for muscle as well as joint pain, although some evidence suggests it may not be effective for this purpose.
Thoracentesis overview

# Overview
Thoracentesis (also known as thoracocentesis or pleural tap) is an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula, or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia. The procedure was first described in 1852.

## Procedure
- Thoracocentesis can be performed by carefully inserting a needle into the pleural space, in order to aspirate the pathologically collected fluid or air and allow the compressed lung to re-inflate.
- Ultrasound guided needle aspiration is a very useful technique
- Ultrasound guided aspiration should be performed in order to reduce complications.

## Steps
- First, confirm the extent of the pleural effusion or pneumothorax  by chest percussion and consider an imaging study, bedside ultrasonography is recommended  to reduce the risk of pneumothorax, hemothorax and to get the successful tap.
- Needle is inserted in the mid-scapular line at the upper border of the rib one intercostal space below the top of the effusion.
- Insertion point is marked with a skin marker, and prepare the area with a skin cleansing agent such as chlorhexidine.
- Apply a sterile drape while wearing sterile gloves.
- A sterile needle is used and local anesthetic is injected subcutaneously, and wheal is raised at the point marked. Slowly advance the needle deeper and inject anesthetic until reaching the parietal pleura, Infiltarte the parietal pleura as it is very sensitive. continue to advance the needle until pleural fluid is aspirated. Note the depth at which fluid is aspirated.
- Now, take a large-bore (16- to 19-gauge) thoracentesis needle-catheter device and attach it to a 3-way stopcock, place a 30- to 50-mL syringe on one port of the stopcock and attach drainage tubing to the other port.
- Insert this needle along the upper border of the rib while aspirating and advance it into the effusion.
- When large amount of pleural fluid has to b aspirated, insert the catheter over the needle into the pleural space and withdraw the needle, leaving the catheter in the pleural space.
- While preparing to insert the catheter, cover the needle opening during inspiration to prevent entry of air into the pleural space.
- Withdraw 30 ml of fluid into the syringe and place the fluid in appropriate tubes and send for testing.
- If a larger amount of fluid is to be drained, turn the stopcock and allow fluid to drain into a collection bag. Alternatively, aspirate fluid using the syringe, taking care to regularly release pressure on the plunger.
- After the tapping is done, remove the catheter while patient is holding his breath or expiring. Apply a sterile dressing to the insertion site.
Shown below is a video demonstrating the step wise procedure of thoracentesis.