Medicaltalks
Medicaltalks
in General
Pyogenic granuloma
Pyogenic granuloma - hyperplastic lesion of the gingiva!! Pyogenic granuloma is a reactive hyperplasia of connective tissue in response to local irritants. It is misnamed because its neither infectious nor granulomatous. It is a vascular tumor-like growth of the oral cavity, frequently located surrounding the anterior teeth or skin that is considered to be neoplastic in nature, and often presents as a painless, pedunculated, or sessile mass of gingiva. While the terminology implies a benign neoplasm, most if not all fibromas represent reactive focal fibrous hyperplasias due to traumatic injury or low-grade local irritation. Histologically, the surface epithelium may be intact, or may show foci of ulcerations or even exhibiting hyperkeratosis. It overlies a mass of dense connective tissue composed of significant amounts of mature collagen. The lesion usually occurs as a solitary, glistening red papule or nodule that is prone to bleeding and ulceration. Gingiva is the most common site affected followed by buccal mucosa, tongue and lips. Pyogenic granuloma in general, is managed by surgical intervention, as seen in the video above.
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Cutaneous Lupus — “The Pimple That Never Went Away”
Cutaneous Lupus — “The Pimple That Never Went Away”
A 28-year-old woman presented with an erythematous rash involving the nose, nasolabial folds, and philtrum that appeared after she had manipulated a painful vesicular lesion at the base of her nose that she believed to be a pimple. The patient received cloxacillin for presumed erysipelas and had a partial response. However, after cloxacillin therapy, worsening induration (Panel A) prompted treatment with intravenous antibiotics, which had no effect. The patient reported recent sun exposure before noticing the extent of the symptoms. Subsequent laboratory tests were positive for antinuclear antibodies, anti-Ro antibodies (antibody index, 2.7 [normal, <1.0]), and anti-La antibodies (antibody index, >8.0 [normal, <1.0]) and showed a C3 level of 1.13 g per liter (normal, 0.79 to 1.52) and a C4 level of 0.17 g per liter (normal, 0.16 to 0.38). A punch biopsy specimen of skin from the right cheek showed vacuolar interface dermatitis and perivascular and perifollicular lymphocytic infiltration of the dermis — features that are consistent with discoid lupus erythematosus, a type of cutaneous lupus erythematosus. Cutaneous lupus erythematosus is often provoked by exposure to sunlight; the rash typically extends from the cheeks over the bridge of the nose and spares the nasolabial folds. This patient received treatment with oral prednisone and hydroxychloroquine, and the rash became less prominent, with only residual skin pigmentation (Panel B).
Dr. Shobhit
Dr. Shobhit
in Learning Materials
Anatomy 👨‍⚕️- Brain
Blood supply of Cerebrum
Anatomy of blood supply of Cerebrum and circle of Willis. For more videos SUBSCRIBE my YouTube channel SK star medlife. Thank you for watching.
Dr. Aiswarya Vijayan
Dr. Aiswarya Vijayan
in Case Study
Ectopic pregnancy
Ectopic pregnancy
A pregnancy in which the fertilised egg implants outside the uterus. The fertilised egg can't survive outside the uterus. If left to grow, it may damage nearby organs and cause life-threatening loss of blood. Often, the first warning sign of an ectopic pregnancy is pelvic pain. Light vaginal bleeding may also occur. If blood leaks from the fallopian tube, you may feel increasing abdominal pain, an urge to have a bowel movement or pelvic discomfort. An ectopic pregnancy is one that occurs outside the womb, usually in one of the fallopian tubes. Because the fetus cannot survive and the mom could suffer life-threatening internal bleeding,ectopic pregnancies, which may account for as many as one in 40 pregnancies, are terminated at the earliest sign.
Dee Pak
Dee Pak
in Discussion | 7 hours ago
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
First Branchial Cleft Cyst
First Branchial Cleft Cyst
A 3-year-old boy presented to the emergency department with pain in the right ear and swelling in the postauricular area that had begun 3 days earlier. His father reported that the boy had had a whitish discharge from his right ear 8 days earlier, for which a pediatrician had prescribed antibiotic eardrops. The patient had no fever or leukocytosis. On physical examination, the swollen postauricular area was fluctuant and tender (Panel A), and white secretions were observed in the external auditory canal. A computed tomographic scan of the temporal bone (Panels B and C) showed a hypointense cystic fluid collection (yellow arrows) with adjacent inflammation (green arrows) in the perimastoid area. There was no evidence of an infectious process in the middle ear or mastoid area. The patient was taken to the operating room, where examination of the right external auditory canal revealed a small fistula track, which raised suspicion of a first branchial cleft cyst. When gentle pressure was applied to the swollen postauricular area, keratin debris and purulence were expressed through the tract and into the osteocartilaginous junction of the ear canal (see video). In a child who presents with a neck mass, the diagnosis of a branchial cleft anomaly should be considered in addition to inflammatory, infectious, congenital, and neoplastic processes. Branchial cleft defects can manifest as cysts, sinuses, or fistulas. Branchial clefts are categorized into first, second, and third branchial cleft defects, depending on the location of the defect. First branchial cleft anomalies account for less than 10% of all branchial cleft defects; have close involvement with the external auditory canal, the facial nerve, or both; and are typically located in the periauricular area. Approximately 6 weeks after presentation, the cyst was excised in the operating room. On follow-up, the surgical site was well healed, and the patient has not had any further issues.
Medicaltalks
Medicaltalks
in General
Partially amputated his thumb doing yard work!!
This patient was clearing thigh-length grass when he reached down to unclog the machine “ not realising he had put his hand inside the gap between the lawnmowers box and blade. His thumb on the left hand has been chopped off by the powerful lawnmower blade “ leaving blood gushing from the open wound. Our patient exhibited a severe injury with loss of the majority of the amputated portion that precluded replantation. With clean-cut injury of the thumb at this level, replantation is usually the prime consideration. In those in whom replantation is not an option, such as our patient with a severe distal thumb crush-avulsion amputation, other reconstruction options may be considered. In this case, our patient after his acute injury underwent revision amputation with a good functional result and was not interested in further surgery. In cases in which replantation is unsuccessful or is not desirable, healing by secondary intention, skin grafting, revision amputation, or local flaps are options for wound coverage. Partial or complete thumb amputation distal to the interphalangeal joint has been described as "compensated amputation" because functional impairment may be minimal. Video by @marcataiza
Mohab Elzahed
Mohab Elzahed
in Discussion | a day ago
Tanu Maan
Tanu Maan
in Learning Materials
Nerve supply
Nerve supply
Medicalcortex
Medicalcortex
in General
Parkinson's disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system.As the disease worsens, non-motor symptoms become more common.The symptoms usually emerge slowly. Early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking. Thinking and behavioral problems may also occur. Dementia becomes common in the advanced stages of the disease. Pathophysiology: The main pathological characteristics of PD are cell death in the brain's basal ganglia(affecting up to 70% of the dopamine secreting neurons in the substantia nigra pars compacta by the end of life) and the presence of Lewy bodies (accumulations of the protein alpha-synuclein) in many of the remaining neurons. This loss of neurons is accompanied by the death of astrocytes (star-shaped glial cells) and a significant increase in the number of microglia (another type of glial cell) in the substantia nigra.
Medicaltalks
Medicaltalks
in General
Peristalsis of the intestines during an exploratory laparotomy!!!
Here, A 56 year old male presented to the emergency department after suffering an evisceration of the bowels due to penetrating abdominal trauma. Waves of peristalsis are clearly seen in the video. This is the rhythmic and alternate contraction of smooth muscles to propel contents through the digestive tract. Broadly speaking, in much of the gastrointestinal tract, smooth muscles contract in sequence to produce a peristaltic wave which forces a ball of food (called bolus while in the esophagus and gastrointestinal tract and chyme in the stomach) along the gastrointestinal tract. Peristaltic movement is initiated by circular smooth muscles contracting behind the chewed material to prevent it from moving back into the mouth, followed by a contraction of longitudinal smooth muscles which pushes the digested food forward. So what is an evisceration? It is the protrusion of internal organs (usually organs of the GI tract) through the abdominal wall. Evisceration can  occur due to trauma, as in this case, or it can be a result of a surgical incision opening (known as a dehiscence). In all cases of evisceration emergency medical care should be sought!
amirali
amirali
in General
I am not a mathematician 😂
I am not a mathematician 😂
Ahir Janak
Ahir Janak
in General
Anatomy of pelvis
Anatomy of pelvis
Eman
Eman
in Discussion | a day ago
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Emphysematous Cystitis
Emphysematous Cystitis
A 72-year-old woman with poorly controlled hyperlipidemia and diabetes presented to the emergency department with a 5-day history of lower abdominal pain. She also had fever and reported nausea and vomiting. Physical examination revealed lower abdominal tenderness. Blood tests revealed leukocytosis associated with a left shift (neutrophil count of 11,800 per cubic millimeter) and elevation of the levels of C-reactive protein (24.0 mg per deciliter) and glucose (735 mg per deciliter [41 mmol per liter]). A plain radiograph of the kidneys, ureters, and bladder showed air surrounding the bladder (Panel A, arrows). An abdominal computed tomographic scan revealed an area of gas dissecting the bladder wall, bilateral hydronephrosis, and intramural gas with a cobblestone or beaded-necklace appearance (Panel B, arrows), findings consistent with emphysematous cystitis. The patient was treated with broad-spectrum antimicrobial agents and placement of a Foley catheter. Subsequently, a urine culture was positive for Escherichia coli; the patient was treated with antibiotics and recovered uneventfully. Emphysematous cystitis is a urinary tract infection that is associated with gas formation and is commonly caused by E. coli and Klebsiella pneumoniae.
Irda
Irda
in General
Transvenous embolization of thalamic arteriovenous malformation under transient cardiac standstill
Leonardo Rangel-Castilla, MD,1 Hussain Shallwani, MD,2 and Adnan H. Siddiqui, MD, PhD2,3 1Departments of Neurosurgery and Radiology, Mayo Clinic, Rochester, Minnesota; and Departments of 2Neurosurgery and 3Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York Transvenous embolization (TE) has been increasingly applied for arteriovenous malformation (AVM) treatment. Transient cardiac standstill (TCS) has been described in cerebrovascular surgery but is uncommon for endovascular embolization. The authors present a patient with a ruptured thalamic AVM in whom both techniques were applied simultaneously. Surgery was considered, but the patient refused. Transarterial embolization was performed with an incomplete result. The deep-seated draining vein provided sole access to the AVM. A microcatheter was advanced into the draining vein. Under TCS, achieved with rapid ventricular pacing, complete AVM embolization was obtained. One-year magnetic resonance imaging and cerebral angiography demonstrated no residual AVM.
Pegasus MD
Pegasus MD
in Case Study
The couple is good now. Their love has become a shield around them😉
What a case
What a case
Together till die 😉
Dr Vijay Sharma
Dr Vijay Sharma
in Case Study
Down syndrome
Down syndrome
Hanin Kaa
Hanin Kaa
in Case Study
Which kind of warm where removed here? Source midicalzy
Makuo chukwu
Makuo chukwu
in Case Study
⚠️ Case of a work realted injury, where a crane malfunctioned, dropping a concrete block on a mans foot, causing a severe crush injury with complete skin avulsion.
⚠️ Case of a work realted injury, where a crane malfunctioned, dropping a concrete block on a mans foot, causing a severe crush injury with complete skin avulsion.
The outcome of this accident is not known, but based on the extent of the injury, amputation was probably the only option. Crush injuries of the foot can present with complex, difficult to manage deformities and fractures. These are serious injuries with the potential for amputation. Initiate tetanus prophylaxis if necessary. Pay special attention to the neurovascular status and soft tissue envelope. Closely monitor any contusions, abrasions, lacerations or degloving for signs of necrosis. Furthermore, if the patient is able to relate a detailed history of the incident, it can provide valuable insight into the mechanism and extent of injury. With crush injuries, the damage is often much worse than is immediately apparent. Thus, understanding the zone of injury that exists beyond the initial injury site is crical. This is an area of soft tissue and/or bone that was not directly impacted, but succumbs to pathologic changes. In a crush type injury, soft tissue and skin necrosis may extend well beyond the area of impact. This becomes important in surgical planning as it is easy to underestimate the extent of the damage. Case credit @Medicalpedia
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