DUPUYTREN'S CONTRACTURE

36 yr old G3 P2 at 6 weeks presented with abdinal pain *Chief Complaints* History of amenorrhea for one and half months. Lower abdominal pain since one day. *History* Pt had previous 2 normal vaginal deliveries. This time she had amenorrhea and abdominal pain . No bleeding pv *Vitals* Pulse was 106 / min. BP was 110/70 mmHg. *Physical Examination* Per abdomen- tenderness present in suprapubic region. No guarding or rigidity. PV done uterus normal size, Anteverted , right side forniceal bogginess felt. CET positive *Investigations* Hb- 8 gm%. Ultrasound revealed right adnexal mass 3*3 cm and hemoperitoneum 3 +. *Diagnosis* Pt was taken up for laparotomy . OT findings- right sided ruptured isthmic tubal ectopic pregnancy with actuve bleeding and hemoperitoneum of 500 ml *Management* Right sided salpingectomy with left sided tubal ligation done( consent taken).

9 month baby boy. Such lesions over neck region. Itching from 7 day's. Diagnosis and treatment.

Chronic skin ds x 6 years Took several treatments --> no relief. Diagnosis & management?

Blackish discoloration underneath the nails since 1 month Dx and Rx

RESPECTED CUROFIANS ,HERE IS A CASE WITH LESIONS IN BETWEEN THE TOES AND EVEN SOLE OF THE FEET ...THE LADY IS AGED ABOUT 22 YERS AND WORKS AS MAID IN VARIOUS HOUSES .KINDLY DIAGNOSE THE CASE WITH ITS MANAGEMENT ......DR.RAJESH GOPAL .....MBBS PMC.REGNO.35726 .IMA .LUDHIANA.