Clinical Medicine Update

Urinary Bladder Catheterisation and CAUTI - Slide presentation (abridged video version)

2011-03-15T09:56:00.000-07:00

Picture quiz

2011-03-01T07:37:00.000-08:00

Identify the skin lesion ?

PUO (Pyrexia of Unknown Origin) - Practical definition

2011-02-26T22:52:00.000-08:00

"PUO is a fever, the cause of which is unknown to the patient for weeks and even unknown to the treating physician after weeks of investigations and the byestanders are even more eager to know the cause, than the patient or the doctor !" - Definition by an 'Un known' doctor.

Doctor, what’s the right way to swallow a pill?

2011-02-24T09:20:00.000-08:00

After nearly 10 years of medical education and another 5 years of medical practice I realized that the simplest questions are OFTEN the hardest to answer. When a 50 year old lady raising her innocent eyes but with a wicked smile asked me this question during a busy morning schedule, I was stumped. Should I use my old strategy as a senior resident to my junior resident ; “what man you don’t

Thiamine - An essential component in the management of DKA/HONK

2011-02-21T07:18:00.000-08:00

A 65year old male with history of poorly controlled type 2 DM since 20years on OHA and borderline systemic hypertension on hydrochlorothiazide presented to the casualty with vomiting and tiredness. On evaluation he was found to have very high blood sugars. Urine ketone bodies were strongly positive. He was initiated on DKA regimen with insulin infusion and IV saline with hourly blood sugar

X-ray of the month: Perthe's disease of Hip

2011-01-16T07:30:00.000-08:00

Quik Review: Bronchioliotis obliterans with organizing pneumonia (BOOP)

2010-12-04T06:45:00.000-08:00

What is BOOP ? BOOP is a distinct spectrum of lung disease charecterised by wide spread inflammation of small conducting airways (unlike ARDS where the site of injury is the alveolar membrane) initiated by various injurious agents like viruses,toxic fumes and connective tissue disorders followed by an attempt to heal by forming granulation tissue predominantly in the distal bronchioles (hence

Clinical Snippets: Steroid Induced osteoporosis(SIOP)

2010-11-27T02:55:00.000-08:00

When should you be cautious regarding the possibility of SIOP? Patients receiving at least 30mg of hydrocortisone or 7.5mg of prednisolone for a period of at least 3 months are at risk for SIOP. Steroid replacement in corticosteroids deficiency states compared to immunosuppresive therapy has lesser risk for SIOP. Site of SIOP fracture? Axial skeleton (Lumbar vertebrae is the first site) Proximal

Evaluation of Solitary Pulmonary Nodule

2009-09-25T08:10:00.000-07:00

A solitary pulmonary nodule(SPN), or “coin lesion,” is an approximately round lesion that is less than 3 cm in diameter and that is completely surrounded by pulmonary parenchyma,without other abnormalities. Chest X ray usually detects the lesion but,computed tomographic (CT) imaginghas improved physicians’ ability to assess each of these features and is now critical inthe evaluation of the

Solitary Pulmonary Nodule

2009-09-25T07:47:00.000-07:00

Review article:Systemic lupus erythematosis in Males

2006-09-09T22:34:00.000-07:00

The paradigm of medical teaching in the medical training is that “SLE is a disease of females in the child bearing age group and the male to female ratio is 1:9”1. The present article is an attempt to compare the clinical profile of the rarer male SLE with female SLE which is more familiar clinical problem to a practicing physician.Much of the data on the profile of male SLE comes from relatively

Journal review: Omalizumab in Asthma

2006-07-05T01:06:00.002-07:00

What is Omalizumab?It is a recombinant,humanized IgG1 monoclonal antibody that binds the IgE molecule at the same epitope on the Fc region that IgE binds the FcE RI receptor on the mast cells or basophils.Mechanism of actionIg E plays a central role in initiating bronchial asthma, by binding the allergen to specific receptors on mast cells to cause it degranulate. Omalizumab binds with the Fc

Radiology corner: Copper T induced Calcium Stone of urinary bladder

2006-07-04T22:42:00.000-07:00

Review artcle: Locked in Syndrome (Selectively De-efferented state)

2006-05-16T03:19:00.000-07:00

Synonyms: Cerebromedullospinaldisconnection, Pseudocoma or de-efferented state.Site of lesion1. Lateral 2/3rd of cerebral peduncle bilaterally.2. Basis pontis bilaterally sparing tegmentum.3. Ventral aspect of medulla bilaterally sparing tegmentum.Characteristics of the patient:The patient is conscious, alert and awake as the tegmental ascending reticular activating system (ARAS) concerned with

CT corner: Schizencephaly

2006-05-14T07:59:00.000-07:00

Schizencephaly is an uncommon disorder of neuronal migrational characterized by a cerebrospinal fluid–filled cleft, which is lined by gray matter. The cleft extends across the entire cerebral hemisphere, from the ventricular surface (ependyma) to the periphery (pial surface) of the brain. The clefts may be unilateral or bilateral and may be closed (fused lips), as in schizencephaly type I, or

Case Report: A Deadly Siren and an uncommon connective tissue disorder

2006-05-08T09:18:00.000-07:00

Jithesh.k*, Shajith.S.*, Abhilash*, Hariprasad*, Shan** ,Geetha.P.** ,Benoy.J.Paul***.Department of Internal medicine, Calicut Medical College.(Published in CALFIM Journal)IntroductionOf all the inflammatory myopathies the chance association with malignant lesions especially in the older age group is highest with dermatomyositis. However the extent of search that should be conducted for an occult

Physical examnination: Vesicular breath sounds

2006-05-03T16:16:00.000-07:00

Vesicular breath sound productionClassically the lung sounds were thought to be produced by the vibrations of the vocal cords and the proximal airways set in by the inspiratory movement of air, which is attenuated and conducted to the chest wall and the auscultating stethoscope by the normal air filled sacs called alveoli/acinus. The normal breath sounds were initially thought to be produced in

Gastroenterology:Traube's space

2006-05-02T08:54:00.000-07:00

Surface Markings1. Draw two vertical lines one passing through the 6th rib in the midclavicular line and the next passing through the 9th rib in midaxillary lines.2. Now draw a smooth curving line with convexity upwards ftom the sixth rib in midclavicular line to 9th rib in midaxillary line.3.Draw another straight line passing through the costal margin from 6th rib to 9th rib.All these boundaries

Clinical signs: Rare signs of hypocalcaemia

2006-04-28T09:23:00.000-07:00

A. Peroneal sign consists of dorsiflexion of foot and abduction of the toes on tapping the peroneal nerve on the lateral surface of the fibula just below the knee.B. Erb's sign, or increased electrical excitability of the peripheral nerves to the galvanic current, was the most reliable proof of tetany in the days before blood chemical analyses were available. The procurement of electrical

X ray corner and Quiz zone

2006-04-27T08:48:00.002-07:00

1. Name the syndrome?2. What is the defect?3. Name related syndromes?

X ray corner and Quiz zone

2006-04-27T08:48:00.001-07:00

1. Name the syndrome?2. What is the defect?3. Name related syndromes?

Review article: Pulsus Paradoxus(Reversed Bernheim sign)

2006-04-26T00:28:00.001-07:00

DefinitionThe simplest definition of pulsus paradoxus is an exaggeration of the normal inspiratory decrease in systolic blood pressure. The current formal definition of pulsus paradoxus is an inspiratory fall of systolic blood pressure of greater than 10 mm Hg.HistoryThe reduction in pulse volume during inspiration was first described by Lomer in 1669 in constrictive pericarditis. A similar

Thought of the week: NHS reforms and its impact on Indian doctors in UK

2006-04-25T09:03:00.000-07:00

In 1963 the Conservative Health Minister Enoch Powell launched a campaign to recruit Indian doctors to save the NHS from an impending staffing crisis. Ironically, a few years later Powell warned Britain of the “rivers of blood” caused by the influx of foreign workers. By the mid-sixties more than 18,000 doctors had arrived in Britain. Most of them dreamt of working in advanced teaching hospitals.

ECG zone: Sgarbossa's Criteria: Not just another criteria

2006-04-24T16:40:00.000-07:00

The presence of left bundlebranch block on the electrocardiogram may conceal the changes of acute myocardial infarction, which can delay both its recognition and thrombolytic treatment. Elena.B.Sgarbossa et al tested electrocardiographic criteria for the diagnosis of acute infarction in the presence of left bundle-branch block in patients enrolled in the GUSTO-1 (Global Utilization of

Web trawl

2006-04-24T02:21:00.000-07:00

Editor’s notes: Ever wondered about the numerous clinical signs of aortic regurgitations, which the examiners and your colleges are so fond of. Never seen them in "standard " clinical textbooks and their mechanisms poorly described by its ardent followers, even though widely revered. Are they clinically and scientifically correct. The following article in Annals of Internal medicine may help you.