All symptoms like headache vomiting or episode of convulsions so also EEG supportive of lt temporal lesion and MRI brain showing lt temporal cerebral vasculopathy Cervical hodgkin's lymphadenopathy on lt side compressing lt carotid vessels or kinking of vessels need to be confirmed by MRA We need the opinion neurosurgeon
? INTRACRANIAL PATHOLOGY .. ? EPILEPSY.. NEED'S.. NEUROLOGISTS OPINION..
Intracranial pathology. Needs further evaluation of neurosurgeon opinion and management. Till reports complied. Symptomatic treatment.
Headache is because of cerebral Vasculitis Migraine headache
SUGGESTIVE. OF ENLARGED LT. SIDED CERVICAL. L. N AS HODGKIN'S. LYMPHOMA... WITH CEREBRAL. VASCULITIS
Epilepsy with Hodgkin's lymphadenopathy Opinion of oncologist Chemotherapy with epileptic drug
He or she may then have you undergo tests and procedures used to diagnose Hodgkin's lymphoma, including:A physical exam. Your checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver. Blood tests. A sample of your blood is examined in a lab to see if anything in your blood indicates the possibility of cancer. Imaging tests. Your may recommend imaging tests to look for signs of Hodgkin's lymphoma in other areas of your body. Tests may include X-ray, CT and positron emission tomography. Removing a lymph node for testing. Your doctor may recommend a lymph node biopsy procedure to remove a lymph node for laboratory testing. He or she will diagnose classical Hodgkin's lymphoma if abnormal cells called Reed-Sternberg cells are found within the lymph node. Removing a sample of bone marrow for testing. A bone marrow biopsy and aspiration procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for Hodgkin's lymphoma cells. Which Hodgkin's lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. Treatment-:Chemotherapy Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells. Chemotherapy drugs travel through your bloodstream and can reach nearly all areas of your body. Chemotherapy is often combined with radiation therapy in people with early-stage classical type Hodgkin's lymphoma. Radiation therapy is typically done after chemotherapy. In advanced Hodgkin's lymphoma, chemotherapy may be used alone or combined with radiation therapy. Chemotherapy drugs can be taken in pill form or through a vein in your arm, or sometimes both methods of administration are used. Several combinations of chemotherapy drugs are used to treat Hodgkin's lymphoma. Side effects of chemotherapy depend on the drugs you're given. Common side effects are nausea and hair loss. Serious long-term complications can occur, such as heart damage, lung damage, fertility problems and other cancers, such as leukemia. Radiation therapy Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. For classical Hodgkin's lymphoma, radiation therapy is often used after chemotherapy. People with early-stage nodular lymphocyte-predominant Hodgkin's lymphoma may undergo radiation therapy alone. During radiation therapy, you lie on a table and a large machine moves around you, directing the energy beams to specific points on your body. Radiation can be aimed at affected lymph nodes and the nearby area of nodes where the disease might progress. The length of radiation treatment varies, depending on the stage of the disease. A typical treatment plan might have you going to the hospital or clinic five days a week for several weeks. At each visit, you undergo a 30-minute radiation treatment. Radiation therapy can cause skin redness and hair loss at the site where the radiation is aimed. Many people experience fatigue during radiation therapy. More-serious risks include heart disease, stroke, thyroid problems, infertility and other cancers, such as breast or lung cancer Bone marrow transplant Bone marrow transplant, also known as stem cell transplant, is a treatment to replace your diseased bone marrow with healthy stem cells that help you grow new bone marrow. A bone marrow transplant may be an option if Hodgkin's lymphoma returns despite treatment. During a bone marrow transplant, your own blood stem cells are removed, frozen and stored for later use. Next you receive high-dose chemotherapy and radiation therapy to destroy cancerous cells in your body. Finally your stem cells are thawed and injected into your body through your veins. The stem cells help build healthy bone marrow. People who undergo bone marrow transplant may be at increased risk of infection. Other drug therapy Other drugs used to treat Hodgkin's lymphoma include targeted drugs that focus on specific vulnerabilities in your cancer cells and immunotherapy that works to activate your own immune system to kill the lymphoma cells. If other treatments haven't helped or if your Hodgkin's lymphoma returns, your lymphoma cells may be analyzed in a laboratory to look for genetic mutations. Your may recommend treatment with a drug that targets the particular mutations present in your lymphoma cells.
Looks disseminated lymphoma hogkins Cerebral vasculitis leads the headache and raised ICT
HODGKIN'S LYMPHOMA i think chemotherapy of radiation therapy is the ultimate option.
Epileptic disease. Intracranial pathology. Neurological evaluation. Experts opinion.
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a nine year old girl with history of cough, high grade fever since 4 months with chills and rigor with pain in body with h/o epistaxis with hb- 4 ,platelet count 26000 tlc 17700 chest b/l ronchi . on Att for abdominal Koch's. pallet with tachycardia. ps- anisopoikilocytosis macrocytic anaemia. h/o multiple joint pain. petechiae all over face since 5 days. USG Abdomen shows hepatomegaly. CERVICAL ADENITIS tender. likely d/d and management.Dr. Abhishek30 Likes60 Answers
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ABC OF : NAIL DISORDERS. ( I ). MAY BE USEFUL. *** ANONYCHIA is the absence of nails, an anomaly, which may be the result of a congenital ectodermal defect, ichthyosis, severe infection, severe allergic contact dermatitis, self-inflicted trauma, Raynaud phenomenon, lichen planus, epidermolysis bullosa, or severe exfoliative diseases....... *** PSORIASIS can also affect the fingernails and toenails, leading to thick fingernails with pitting, ridges in the nails, nail lifting away from the nail bed, and irregular contour of the nail....... *** LICHEN PLANUS of the nails can cause brittle or split nails, and the affected nails may have ridges running lengthwise....... *** FUNGAL nail infections are common infections of the fingernails or toenails that can cause the nail to become discolored, thick, and more likely to crack and break. Infections are more common in toenails than fingernails.....by some dermatophytes, Candida (Monilia) species, etc....... 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Heart defects that are present at birth (congenital) Chronic lung infections that occur in people with bronchiectasis, cystic fibrosis, or lung abscess....... *** While the NAIL BITING and picking seems to be such a common problem, the psychological and medical research does not agree on the exact motivation for the action. However, it suggests that nail biting can be the result of STRESS, VARIOUS MEDICAL DISORDERS, LEARNED BEHAVIORS, OR JUST PLAIN HABIT....... *** SPLINTER HEMORRHAGES : They run in the direction of nail growth. They are named splinter hemorrhages because they look like a splinter under the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails. Splinter hemorrhages can occur with infection of the heart valves (endocarditis)....... *** YELLOW TOENAILS in an infection by a fungus that attacks the nails..... or, in some cases, they may be a sign of skin cancer. 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*Hypothyroidism* *☝ all about☝* – also called underactive thyroid – is the most common thyroid disorder. It happens when your thyroid gland doesn’t produce enough thyroid hormone, which is essential because thyroid hormone helps regulate important body processes, such as your metabolism. But with low thyroid function, these body processes slow down. Pathophysiology The hormones produced by the thyroid gland are T3 and T4. These hormones have an action on almost all parts of the body. The secretion of these hormones is regulated by TSH or thyroid stimulating hormone that is secreted by the pituitary gland. The secretion of thyroid hormone occurs only from this particular gland. The presence of iodine and amino acid tyrosine are a must for the production of thyroid hormones. Hypothyroidism and low levels of the thyroid hormones can occur if there is a deficiency of iodine for thyroid or thyroid stimulating hormone (TSH). The hypothalamus of the brain secretes TRH thyroid releasing hormone which acts on the pituitary gland and initiates the release of TSH or thyroid stimulating hormone. TSH then acts directly on the thyroid gland to release thyroid hormones T3 and T4. The normal functioning of the thyroid (healthy thyroid) is regulated by negative feedback mechanism where the levels of thyroid hormones increase or decrease under the influence of TSH. Causes Hashimoto’s thyroiditis: This autoimmune disease is the most common cause of hypothyroidism. Medications: Certain medications, such as lithium, can cause hypothyroidism. Pregnancy: Hypothyroidism can develop during or after pregnancy. Treatment for hyperthyroidism: People who have hyperthyroidism (overactive thyroid) are treated with radioactive iodine therapy, which impairs thyroid function and can cause hypothyroidism. Thyroid surgery: If your thyroid gland is removed, you can’t make thyroid hormone, so you’ll need to take thyroid hormone replacement. Radiation therapy: Radiation used for the treatment of cancer in the head or neck, lymphoma, or leukemia, may slow or halt the production of thyroid hormone. This will almost always lead to hypothyroidism. Risk factors There are two main factors to consider – age and sex. The chances of being hypothyroid increase with age, and they are greater if an individual is a woman. You have a family history of thyroid disease or any autoimmune disease You have type 1 diabetes or rheumatoid arthritis, or other autoimmune disorders As mentioned in the causes section medications and thyroid surgery also a major risk factors Signs and Symptoms in adults Women who are over age 60, as well as men who are aging, should look out for these potential symptoms of hypothyroidism: Weight gain Fatigue Sensitivity to cold temperatures Depression Dry skin Thinning hair Heavy menstrual periods (in women) Trouble sleeping Difficulty concentrating Pain or swelling of the joints Constipation High cholesterol levels Muscle weakness Signs and symptoms in Children and teen Symptoms of hypothyroidism in children and teens are similar to symptoms in adults and can include: Poor growth or short stature Delayed puberty Slow reaction time Weight gain Coarse, dry hair or skin Muscle cramps Delayed mental development Increased menstrual flow for girls Signs and Symptoms in Infants Symptoms of hypothyroidism in infants may include: Jaundice (yellowing of the skin and whites of the eyes) Frequent choking Puffy face Constipation Complications Heart disease and stroke Hypothyroidism can lead to insulin resistance The myxedema coma Goiter Mental health issues Peripheral neuropathy Low levels of thyroid hormone can interfere with ovulation, which impairs fertility Birth defects Diagnosis and test Medical evaluation Your doctor will complete a thorough physical exam and medical history. They’ll check for physical signs of hypothyroidism, including: Dry skin Slowed reflexes Swelling A slower heart rate In addition, your doctor will ask you to report any symptoms you’ve been experiencing, such as fatigue, depression, constipation, or feeling constantly cold. Blood test There are several types of blood tests – the most definitive one is called the TSH test (thyroid-stimulating hormone). However, in some cases, physicians may refer to the free thyroxine or T4, free T4 index, or total T4 to aid in the diagnosis. TSH Test A thyroid-stimulating hormone or TSH is a blood test that measures the amount of T4 (thyroxine) that the thyroid is being signaled to make. If you have an abnormally high level of TSH, it could mean you have hypothyroidism. 0.4 mU/L to 4.0 mU/L is considered the reference range (there may be a slight variation depending on the laboratory), TSH >4.0/mU/L with a low T4 level indicates hypothyroidism. T4 (thyroxine) Test The thyroid gland produces T4 (thyroxine). The free T4 and the free T4 index are blood tests that, in combination with a TSH test, can let your physician know how your thyroid is functioning. Anti-thyroid Microsomal Antibodies Testing A third hypothyroid test is for anti-thyroid microsomal antibodies—anti-thyroid peroxidase (anti-TPO). These antibodies, which are produced by the immune system, may attack thyroid cells. If a blood test determines their presence, it shows that there has been thyroid damage which could potentially lead to hypothyroidism. Differentiation of Hypothyroidism Primary hypothyroidism Primary hypothyroidism is due to disease in the thyroid; thyroid-stimulating hormone (TSH) is increased. The most common cause is autoimmune. It usually results from Hashimoto thyroiditis and is often associated with a firm goiter or, later in the disease process, with a shrunken fibrotic thyroid with little or no function. The 2nd most common cause is post-therapeutic hypothyroidism, especially after radioactive iodine therapy or surgery for hyperthyroidism or goiter. Secondary hypothyroidism Secondary hypothyroidism occurs when the hypothalamus produces an insufficient thyrotropin-releasing hormone (TRH) or the pituitary produces insufficient TSH. Sometimes, deficient TSH secretion due to deficient TRH secretion is termed tertiary hypothyroidism. Subclinical hypothyroidism Subclinical hypothyroidism is elevated serum TSH in patients with absent or minimal symptoms of hypothyroidism and normal serum levels of free T4. Subclinical thyroid dysfunction is relatively common; it occurs in more than 15% of elderly women and 10% of elderly men, particularly in those with underlying Hashimoto thyroiditis. Treatment and medication Medications Hypothyroidism is a lifelong condition. For many people, medication reduces or alleviates symptoms. Hypothyroidism is best treated by using levothyroxine (Levothroid, Levoxyl). This synthetic version of the T4 hormone copies the action of the thyroid hormone your body would normally produce. The medication is designed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable. Animal extracts that contain thyroid hormone are available. These extracts come from the thyroid glands of pigs. They contain both T4 and triiodothyronine (T3). If you take levothyroxine, you’re only receiving T4. But that’s all you need because your body is capable of producing T3 from the synthetic T4. These alternative animal extracts are often unreliable in dosing and haven’t been shown in studies to be better than levothyroxine. For these reasons, they aren’t routinely recommended. Thyroid Hormone Replacement Therapy The main goal is to compensate for the lack of hormone secreted by the thyroid gland. In most cases, an affected individual will take a daily dose of T4 (or T3 and T4) in a pill taken orally. But it’s important to understand that every patient’s therapy may be different. There is no cookie-cutter dosage or treatment plan when it comes to thyroid hormone replacement therapy. How the body absorbs the hormones, along with the number of hormones needed to help the body function properly is very varied. Prevention Taking iodine supplements can prevent hypothyroidism. Exercises and alternative therapies may prove more than effective in minimizing symptoms of thyroid imbalance than traditional treatments. Get a screening test every five years if you are 50 years old or older. Get regular screenings if you: Have Type 1 diabetes Have infertility (females) Take certain medications Natural remedies Do not use non-stick cookware Eliminate Soy: Soy restrains functions of the thyroid, imbalances hormones & it has been appeared to cause goiters Balance Estrogen Levels: Excessive consumption of estrogen slows down the thyroid organ. This implies disposing of anti-conception medication, expanding the fiber in the eating routine & keeping away from all non- organic meats. Adhere to an Alkaline Diet: This is greatly useful when curing any severe issue. Exercise: Find a physical movement activity that is fun & does it regularly. Iodine: The thyroid requires iodine to work appropriately & loads of individuals now experience the ill effects of iodine lacks. To test yourself, put some iodine on your stomach. In case it vanishes in 12 hours, at that point you are lacking iodine. Continue including iodine in increased amounts, until it doesn’t vanish in a 12-14 hours’ time. This works because of the way that the body trans-dermally absorbs iodine at the rate at which it is required. Avoid all types of fluoride Move for natural diet: To enable the body to recuperate itself, take away the loads on its immune system. This implies every single processed food, synthetic flavors, hues, additives, white sugar, white flour, table salt, hydrogenated oils, aluminum and etc. ought to be removed from the diet chart. Organic food is perfect. Chlorophyll: Including chlorophyll gives fundamental copper, oxygenates the body, adds healthy RBC’s, and in general helps with skin health. Chlorophyll is a safe strategy for the oral supplement of copper. Pears and Apples: Pears help most when combined with or mixed with apple juice. Try this pear juice formula, and drink it routinely. Zinc and Selenium: Studies demonstrate that serious zinc or selenium insufficiencies would cause diminished thyroid levels. Never take zinc first thing in the stomach. Brazil nuts are high in both zinc and selenium. Coconut Oil: Buy natural, fresh squeezed, coconut oil from a health store. Take around 1 teaspoon every day. You can likewise use it in cooking, yet be cautioned that it smokes at low cooking temperatures, so it should just be utilized for low-warm cooking. Coconut oil speeds up the digestion improve thyroid hormone generation and cut down candida yeast. Avoid Canola Oil: Canola oil meddles with the generation of thyroid hormones, among its numerous risks. Treat canola oil like the evil, genetically engineered hereditarily designed poison.Dr. Shailendra Kawtikwar10 Likes10 Answers
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10yr old boy with H/o headache, seizures,right side loss of vision pls gv your diagnosis ??Dr. Kavi Muthu5 Likes9 Answers
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B/L minimal pleural Effusion under Ix. *Chief Complaints* A 65 yr old Male attended Mopd with chest pain since 1 week . No associated Anginal Equivalent or Respiratory symptoms of cough,SOB,Sputum production, fever. Past H/O Hypothyroidism and post Op Lateral Arachnoid Cyst. No H/O HTN,DM,Substance abuse etc. General Examination and Systemic Examination including Chest was normal. Urgent CXR and ECG was advised. CXR showed obliterated CP angle on both side.ECG was NSR. Later Routine blood IX and USG chest and Abdomen was advised. Pleural fluid was minimal to be tapped. Usg showed left sided pleural Effusion with Splenomegaly. Mantoux test is positive,CRP positive and raised ESR. ATT has been started for 1 month on Trial basis. Let's see how pt responds..other opinions are welcome.Dr. Ashutosh Chandan Dubey ( Dr Strange)1 Like4 Answers