"EPISTAXIS"

spot diagnosis. 35 M, 0.5 cm swelling on nasal vestibule.

40 yr old male,h/o suprapubic catheterisation 5 months back for urethral stricture;came with chief complaints of pain abdomen with o stipati on fir 3 days, on x ray multiple air fluid level with pneumoperitoneum. On exploratory laparotomy, one perforation 100cm from dj flexure ,another 150cm from dj flexure,in between two circumferential stricture was there. Resection(50cm)and anastomoses done in two layer.specimen sent for HPE. What can be the cause circumferential multiple stricture with multiple perforation??guess plz

2yrs female child presented with c/o bowing of both legs from 1yr of age. No h/o consagunity or sibling death or maternal risk factors for TORCH and other congenital infections. Normal birth,immunisation and development history. Attained milestones as per age. Negative for contact with TB and family history of hemoglobinopathies. On examination vitals stable, height less than 3rd centile,pallor present huge hepatosplenomegaly, a soft systolic murmur over mitral area, no widening of wrist, no rachitic rosary present, genu varum present with no tenderness over joints,slightly protruding tongue and depressed bridge of nose,cornea clear. Child had undergone treatment for rickets for 6months with weekly doses of vit D still no improvement rather complained of increase in leg bowing and unsteady gait. The child didnot have any neurodevelopmental regression. Xray wrist had 2 carpal bones with no metaphyseal splaying and fraying. Xray AP of lower limbs also had no features suggestive of rickets. Xray chest unremarkable. ALP level of 908U/L with normal calcium and phosphate level. Hb of 7.8gm% with microcytic hypochromic blood picture, no evidence of cytopenia. VBG unremarkable. Thyroid profile awaited. What are the D/ds possible and what to do next? Kindly opine. Thanks PS:Will attach necessary pics of investigations soon.

45 year old male presented with these lesions. He has a history of tobacco chewing. Should we go for biopsy or conservative approach first?

Good morning dear friends and colleagues, Today let's have a look at DUPUYTRENE'S CONTRACTURE of hand. It is one of the musculoskeletal complications of diabetes and seen in 5% of patients with diabetes. With regards, Dr Sepuri Tirumala Devi.