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Photo following a surgical drainage of a brain abscess.

Photo following a surgical drainage of a brain abscess.

An abscess is the collection of pus that has built up within the tissue of a body, for example inside the brain! Brain or intracranial abscess is caused by an infection, when a bacteria or fungi find their way to the brain. intracranial abscesses can originate from infection of contagious structures such as otitis media (ear infection), dental infection, sinusitis and mastoiditis that spreads directly into the brain, or via hematogenous spread from a remote site (like a patient with an infection that causes pneumonia spreading reaching the brain via the blood). Severe head injury can also allow bacteria or fungi to enter the brain.Most of the patients experience a severe headache, mental status changes (confusion), fever, weakness and paralysis. Some may even get seizures. Brain abscess is a medical emergency, this is because the swelling caused by the abscess can disrupt the blood and oxygen supply to the brain. The most optimal treatment given to the patient includes antimicrobial or antifungal therapy and surgical drainage of the abscess. the procedures used are aspiration through a bur hole and complete excision of the abscess after craniotomy (shown in the photo).

Dirty Harry

in General

Cystic Fibrosis | Definition, Pathogenesis, Symptoms and Complications

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Eggshell Calcifications of the Bladder

Eggshell Calcifications of the Bladder

A 43-year-old man presented with a 1-month history of dysuria and intermittent hematuria. Similar episodes had occurred several times in the 6 months preceding presentation, along with episodes of rectal bleeding. The physical examination was unremarkable. Laboratory investigations revealed an elevated albumin:creatinine ratio (96 mg of albumin per millimole of creatinine), with dysmorphic red cells in the urine. Two urine cultures were sterile. A serum schistosoma antibody titer was 1:256. Renal ultrasonography revealed mild hydroureteronephrosis. Computed tomography of the abdomen and pelvis without the administration of contrast material revealed hydroureteronephrosis of the right ureter and kidney, with faint mural calcification of the ureter (Panel A, white arrow) and smooth mural calcification of the bladder (Panels A, B, and C, yellow arrows). There was also calcification of the seminal vesicles (Panel B, red arrow) and the wall of the rectosigmoid bowel (Panels B and C, white arrows). This pattern of calcification is typical of chronic genitourinary and gastrointestinal schistosomiasis, in which the larvae of the schistosoma parasite are deposited on the walls of the organs and become calcified. Diagnosis is based on a history of exposure along with a strong clinical suspicion of infection and the characteristic radiographic findings. Tuberculosis may also cause calcification of the bladder wall and should be considered in the differential diagnosis.

#GASTROINTESTINAL

#SCHISTOSOMIASIS

#CALCIFICATIONS

AshleyCooper

in General

Knee Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes dislocation of the knee and types of knee dislocations. Dislocation of the knee is a serious problem. It should be recognized and managed appropriately early. Knee dislocation is considered an orthopedic emergency. It is important to recognize the dislocation, and do reduction and perform serial neurovascular exam before the reduction and after the reduction. Approximately 50% of knee dislocations spontaneously reduce before formal evaluation. Morbid Obesity can be a risk factor for knee dislocation. Because the joint capsule is torn, knee swelling may not occur with knee dislocation. The knee dislocation associated with sports injuries have a lower incidence of neurovascular injury than those associated with a high energy mechanism. There are several types of knee dislocation that are usually described in the literature. There is a classification based on direction of displacement of the tibia and classification system based on the severity of the ligamentous damage was developed by Dr. Schenck. The dislocation of the knee usually involves at least two ligaments. Anterior knee dislocation is caused by hyperextension mechanism that causes failure of the posterior capsule, the PCL and sometimes the ACL. Anterior knee dislocations are the most common types. Posterior dislocations are seen in dashboard injuries. The posterior dislocation has the highest rate of vascular injury (about 25%), and sometimes will be a complete tear of the popliteal artery. Lateral dislocation has the highest rate of peroneal nerve injury. Posterolateral dislocation is the most common rotatory dislocation and it is usually irreducible. In rotatory dislocations, the PCL remains intact as the tibia rotates about the femur. A dimple on the medial side indicates posterolateral dislocation, which means that the dislocation cam be irreducible and the medial femoral condyle button hoes through the joint capsule. The physical examination and diagnostic studies can direct the treatment in a timely fashion. There could be an obvious deformity. See if there is a dimple sign. You need to check the pulses, get the x-ray, and reduce the knee immediately regardless if there is a pulse or no pulse. When you check the pulses, compare it to the other side. You have to do serial exam of the pulses and the whole idea is to make sure to discover if there is a vascular injury or not, because if there is a vascular injury and there is a delay more than 8 hours in reestablishing the arterial blood flow, that will result in an amputation rate of 85%. The patient may have severe pain, instability, and the exam will be difficult because of guarding and apprehension, but keep focusing on the circulation. Look at the pulses. Look at the x-rays! The patient may have a fracture, such as medical tibial plateau fracture and other intraarticular fractures, the patient may have asymmetry of the joint space, avulsion fractures such as the Segond sign for ACL tear or tibial eminence avulsion fracture. Look for asymmetry of an irregular joint space on the x-rays. After you reduce, you immobilize, get x-rays, and make sure the dislocation is reduced. Up to 1/3 of knee dislocation have associated injuries that require more urgent attention. Knee dislocation is a high energy injury that will have popliteal artery injury, nerve injury, multiple fractures, head and chest trauma, and compartment syndrome. The findings of the knee might be subtle, but having knee dislocation makes you think of these conditions and the swelling may not be that significant because the joint capsule is torn. You may have hyperextension of the knee, popliteal ecchymosis, foot drop, or vascular issues, and the patient may also be normal. The knee can be dislocated or be normal. The patient may or not be overweight. You examine the pulses and then you reduce the knee. After you reduce the knee, you examine the pulses and get post reduction A.B.I. (ankle brachial index). The ankle brachial index (A.B.I.) is very important in the knee dislocation. The systolic blood pressure measured is divided by that measured at the brachial artery. A ratio less than 0.9 is considered abnormal and needs further investigation. Scenario 1: Good pulses and symmetrical, A.B.I. is more than 0.9, then observe for 24-48 hours with serial neurovascular exam. Scenario 2: After the reduction, if the distal pulses are asymmetrical, or the A.B.I. is less than 0.9, then you will do some kind of a study to see why this is occurring (get a CTA or arteriogram). Scenario 3: If you have absent distal pulses or clear, hard signs of limb ischemia, do not waste time by doing arteriogram. Take the patient to the operating room, do emergency exploration and then on the table, do arteriogram and the patient will probably need fasciotomy. You will stabilize the knee with and external fixator.

#DR._NABIL_EBRAHEIM

Hanin Kaa

in Case Study

That’s Amaaazinggg ✨

Dr.Musa

in Learning Materials

Abdominal Aorta Branches

Abdominal Aorta Branches

#CARDIOVASCULAR

#ABDOMINAL_AORTA

Abdirafi Said Elmi

in General

#What organ is this ?

#What organ is this ?

A. Appendix B. Spleen C. Pancreas D. Liver

#GASTROENTEROLOGISTS

#ANTOMYQUESTION

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Scalp Necrosis Associated with Giant-Cell Arteritis

Scalp Necrosis Associated with Giant-Cell Arteritis

A 74-year-old man presented with a 3-month history of headache, jaw claudication, and worsening scalp ulceration. He reported no visual loss or polymyalgia rheumatica. Examination revealed areas of scalp necrosis (Panel A). Both temporal arteries were difficult to palpate but were nontender. His erythrocyte sedimentation rate was 64 mm per hour, and his C-reactive protein level 45 mg per liter. He received a diagnosis of scalp necrosis as a complication of giant-cell arteritis. Treatment was initiated with glucocorticoids (60 mg of prednisolone per day) and topical dressings that were administered daily. During the next few months, his symptoms decreased and the scalp lesions started to heal (Panels B and C). The dose of prednisolone was tapered by 10 mg every month until it reached 20 mg per day. The dose was then tapered more slowly until the lesions healed completely (Panel D), after which the medication was discontinued. Scalp necrosis is a rare and potentially life-threatening complication of giant-cell arteritis. Early recognition and treatment are important.

Fatma R. Badr

in General

Blood vessels

Suraj Maurya

in Learning Materials

Heart sounds

Konika Arora

in Case Study

Diagnose the condition??

Diagnose the condition??

Alaa Mansour

in General

Ruaa Nader

in Case Study

Chronic pancreatitis

Chronic pancreatitis

Medicaltalks

in General

Extensive clean edge laceration injury to the scalp!!

Extensive clean edge laceration injury to the scalp!!

Scalp lacerations are a common injury. Clinical evaluation should identify associated serious head injury, laceration of the galea, or bony defect of the skull. The scalp should be examined carefully to evaluate for signs of injury to the underlying structures. The layers of concern in the scalp include the subcutaneous tissue, galea aponeurosis, connective tissue and periosteum overlying the bone. Visible or palpable bony defects warrant computed tomography of the head to determine presence of intracranial injury or penetration of the wound through the skull. Control of profuse bleeding and prevention of further loss of blood is crucial. After hemostasis is achieved and the wound is irrigated, scalp lacerations are typically closed with surgical staples under local anesthesia. Sutures may be preferred over staples for large, gaping wounds and to provide hemostasis for wounds with brisk bleeding.

Suraj Maurya

in Learning Materials

Segment of lungs

Segment of lungs

Dirty Harry

in General

Ventilation (V), Hypoventilation & Hyperventilation | Pulmonary Medicine

AshleyCooper

in General

Tissue Hypoxia | Physiology | Pulmonary Medicine

Dr. Aiswarya Vijayan

in General

Intubation in children

Suraj Maurya

in Learning Materials

Tetralogy of fallot

Tetralogy of fallot

#TETRALOGYOFFALLOT

Suraj Maurya

in Learning Materials

External ear

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