DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Cholelithiasis
Cholelithiasis
A 60-year-old man with cirrhosis and a remote history of colon cancer, for which he had undergone a hemicolectomy, presented to the emergency department with a fever. He reported no diarrhea, vomiting, or abdominal pain. His temperature was 38.5°C. There was no tenderness to palpation across his abdomen. Laboratory studies revealed a white-cell count of 12,300 per cubic millimeter (normal range, 3600 to 11,000) and a total bilirubin level of 2.0 mg per deciliter (34.2 μmol per liter) (normal range, 0.2 to 1.3 mg per deciliter [3.4 to 22.2 μmol per liter]), although his baseline total bilirubin level was 2.0 mg per deciliter owing to his liver disease. The aminotransferase levels, alkaline phosphatase levels, and urinalysis results were within the normal range. Two sets of blood cultures obtained on admission grew Escherichia coli. Computed tomography, which was performed to determine possible intraabdominal sources of infection, revealed no abscess, ascites, or colitis but did show multiple small, round, calcified gallstones (Panels A and B). Although no definitive source of the bacteremia was found, the patient became afebrile within the first 48 hours after antibiotic treatment was initiated. Cholecystectomy was considered but not pursued because of the patient’s high operative risk owing to cirrhosis. He completed a course of antibiotics and was doing well at a follow-up visit 11 months after his discharge from the hospital. Ongoing surveillance has not identified a recurrence of colon cancer.
tareq alghazal
tareq alghazal
in General
Human brain
Human brain
Hanin Kaa
Hanin Kaa
in Case Study
What happens if u wear a magnetic items in the MRI machine
Samuel Asante
Samuel Asante
in Discussion | a day ago
tareq alghazal
tareq alghazal
in General
What is your diagnosis?
What is your diagnosis?
Tayler Wright
Tayler Wright
in Case Study
Abnormal Corneal scan of teenage male
Abnormal Corneal scan of teenage male
Patient was prescribed corrective lenses at ~13 years old. Vision progressively worsened over 5 years, and physician recommended corneal topography. Patient complains of migraines, blurry vision (especially at night), and occasional double vision. There appears to be no direct or significant event that would cause this. What’s your diagnosis??
Hanin Kaa
Hanin Kaa
in Case Study
Saphenous vein graft to facial vessels for facial reconstruction with a radial forearm flap ! Incredible! Source med.guide
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Insulin-Mediated Lipohypertrophy
Insulin-Mediated Lipohypertrophy
A 76-year-old man with hypertension, chronic kidney disease, and a 15-year history of type 2 diabetes mellitus was admitted to the hospital with pneumonia. Two painless, rubbery, hyperpigmented masses were noted near the umbilical area. The patient reported that for the preceding 10 years he had injected insulin detemir at those sites twice daily (50 units every morning and 25 units every evening). The masses first developed 5 or 6 years before presentation and gradually became more prominent. A clinical diagnosis of insulin-mediated lipohypertrophy was made. Insulin-induced lipohypertrophy occurs at the injection site and is thought to be the result of repeated trauma and possibly the anabolic side effects of insulin. The condition can lead to labile control of blood glucose levels owing to variable insulin absorption at these sites. Lipohypertrophy typically causes such palpable, rubbery growths, although the hyperpigmentation seen in this patient is less typical. Strategies that are used to reduce the risk of lipohypertrophy include rotation of the site of insulin administration and the use of finer needles. The patient was discharged after treatment for pneumonia and was not seen at this medical center for further follow-up.
Moniccca
Moniccca
in Learning Materials
Acute Coronary Syndrome DETAILED Overview (MI, STEMI, NSTEMI)
Indranil Sengupta
Indranil Sengupta
in Case Study
Dx plz Biopsy report - normal Ongoing medicine - Clotrimazole
Oral candidiasis
Oral candidiasis
Allaa M. El-hawat
Allaa M. El-hawat
in Discussion | a day ago
Dr Vijay Sharma
Dr Vijay Sharma
in Case Study
Strawberry tongue seen in scarlet fever
Strawberry tongue seen in scarlet fever
Medicaltalks
Medicaltalks
in General
Traumatic brain injury
Traumatic brain injury
Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. When the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.A mass lesion such as hematoma can be formed causing a significant mass effect (shift of intracranial structures). For intracranial hematomas, the collected blood may be removed using suction or forceps or it may be floated off with water. Surgeons look for hemorrhaging blood vessels and seek to control bleeding. In penetrating brain injury, damaged tissue is surgically debrided, and craniotomy may be needed. Craniotomy, in which part of the skull is removed, may be needed to remove pieces of fractured skull or objects embedded in the brain.
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Left-Middle-Lobe Pneumonia
Left-Middle-Lobe Pneumonia
A 34-year-old man presented to the emergency department with a 5-day history of fever, cough, and dyspnea. He had received a diagnosis of situs inversus when he was 2 years of age, after a chest radiograph had been obtained in order to evaluate a cough. Physical examination was notable for heart sounds in the right side of his chest and for crackles in the middle field of the left lung. Radiography of the chest revealed a cardiac apex, aortic arch, and gastric bubble in the right side of the body and a lobar infiltrate in the left lung. A left-middle-lobe pneumonia was diagnosed. The patient reported that he had had chronic cough and recurrent sinusitis since childhood, and he also reported infertility — conditions that suggest a diagnosis of Kartagener’s syndrome, which is characterized by situs inversus, recurrent sinusitis, and bronchiectasis (which was not seen on his chest radiograph). This syndrome is a form of primary ciliary dyskinesia, an autosomal recessive condition that is caused by mutations in genes encoding ciliary components, resulting in abnormal motility of sperm-cell flagella and of cilia lining the respiratory tract and fallopian tubes. Primary ciliary dyskinesia also affects organ lateralization during embryogenesis, resulting in situs inversus in approximately half the cases. The patient was treated with moxifloxacin, and his pneumonia resolved completely. He received pneumococcal and influenza vaccines and was referred to the pulmonology service for follow-up. At last follow-up, 7 months after the initial presentation, the patient was doing well.
Dr Vijay Sharma
Dr Vijay Sharma
in Case Study
Cxr spot diagnosis
Cxr spot diagnosis
Medshots
Medshots
in General
Muscle cramp
Looks painful? Imagine how it feels! - Muscle cramps are strong, painful contraction or tightening of a muscle that come on suddenly and last from a few seconds to several minutes, a muscle cramp often occurs in the legs. Overuse of a muscle, dehydration, muscle strain or simply holding a position for a prolonged period can cause a muscle cramp.
Saiful Islam
Saiful Islam
in Discussion | 2 days ago
Rajesh Kumar.R
Rajesh Kumar.R
in Articles
Source
Dx?please
Dx?please
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Sturge–Weber Syndrome
Sturge–Weber Syndrome
A 6-year-old girl was brought to the emergency department after the sudden onset of weakness in the left arm and leg. She also reported a 2-day history of pain in her right eye. No seizure activity had been witnessed. She had a nonpalpable red lesion on the right side of her face, and the intraocular pressure was elevated in both eyes. Magnetic resonance imaging (MRI) of the head revealed right cerebral atrophy with leptomeningeal enhancement along the right cerebral convexity. Susceptibility-weighted MRI (Panel A) revealed abnormal leptomeningeal capillary vessels along the right cerebral convexity. The MRI and clinical findings were consistent with the Sturge–Weber syndrome, a rare congenital vascular disorder characterized by a cutaneous capillary malformation, also called port-wine birthmark (Panel B shows the patient’s face 2 years after the initial presentation), and abnormal capillary venous vessels in the brain and eye that can lead to glaucoma, seizures, stroke, and intellectual disability. The weakness on the left side, which was thought to be postictal paresis, resolved within 24 hours. An antiepileptic medication was prescribed, as well as timolol and dorzolamide for glaucoma and daily low-dose aspirin treatment to reduce the risk of thrombotic events. Over the next 2 years, she had two presentations with seizures, which led to adjustment of the antiepileptic regimen.
Hope
Hope
in Learning Materials
Chest indrawing😷
Chest indrawing😷
Chest indrawing is the inward movement of the lower chest wall when the child breathes in, and is a sign of respiratory distress. Chest indrawing does not refer to the inward movement of the soft tissue between the ribs. Stridor is a harsh noise heard when a sick child breathes in.
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