Bilateral pedal edema - a very common finding in many middle aged Indians Commonly ignored by patients Etiology - ? Cardiac , ? Lymphoedema Renal etiology is ruled out because there is absent urinary protein Liver etiology is ruled out as liver function test, total albumin is normal Lymphoedema - this patient has pitting Edema, in early phase all lymphoedema are pitting Edema, it only in later stage it becomes nonpitting Adv 2 D Echo Peripheral smear for microfilaria Tip - This type of edema respond very quickly to Tablet lasilactone half tablet daily, occasionally stepped up to one tablet daily Lasilactone containing fixed dose of spironolactone and furosemide
PS COMMENT,ESR,RA FACTOR,CRP, ASO, IRON PROFILE,URINE MICRO ALBUMIN, THYROID PROFILE,MICRO FILARIA... CAN BE BENEFICIAL... IF OVER WEIGHT THEN FOCUS ON THE SAME,
? RENAL PATHOLOGY.. ? CARDIAC PATHOLOGY.. ? LYMPH PATHOLOGY.. NEED'S.. KFT .. ECG..2D ECHO STUDY.. X-RAY STUDY..
PITTING EDEMA RFT WNL LFT WNL TFT WNL LYMPHANGIOGRAPHY LYMPHOEDEMA? PRIMARY LYMPHEDEMA?
PUTTING EDEMA RFT WNL LFT WNL TFT WNL LYMPHANGIOGRAPHY LYMPHEDEMA? PRIMARY LYMPHEDEMA?
T3 T4 and TSH level check once..
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G2P1L1 non consanguineous marriage. 18 weeks usg spinal dysraphism terminated yesterday. how to proceed for her next pregnancyDr. Suvarchala Pratap13 Likes31 Answers
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65 Years old women c/o fever rigor and body pain.I/E temp 102°F,Anaemic, glossitis,thin build, malnourished ,socioeconomically poor,agricultural labourer,. leg swelling both legs up to middle 1/3 of leg. fever monthly occurrence periodicity bilateral inguinal gland enlargement . Similar patients in her village more than 5 of her ages having leg swellings are living there as per history. She reported to my clinic during this summer for body pain,exhausted feeling,poor appetite, losing weight. Inguinal glands bilaterally present enlarged. Leg swelling with warmth noticed .Dehydrated. Discuss this case.Dr. Elumalai Subbarayan3 Likes25 Answers
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45 male, non diabetic, Htn on oah, Resolved anaemia by iron sucrose injection since 2 months. Current history of swelling over rts throat laryngeal. since 10 days. no pain and tenderness. Habits of bettle chewing. FNAC report attached.Dr. Ranjit Lenka3 Likes14 Answers
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A 23-year-old student presents complaining of shortness of breath on exertion. This has developed over the past 10 days, and she is now breathless after walking 5 minutes. About 2 weeks ago she had a flu-like illness with generalized muscle aches and fever. She feels extremely tired and has noticed palpitations in association with her breathlessness. In addition she has some discomfort in her anterior chest which is worse on inspiration. Previously she has been extremely fit with no significant past medical history. There is no recent history of foreign travel. She denies substance abuse. On examination, Temperature is 99.5°f. Her pulse rate is 120/min and regular. Examination of her chest is unremarkable.Nidhi Sharma1 Like13 Answers
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Friends today I am discussing about Nail Abnormalities. What are nail abnormalities? Healthy nails appear smooth and have consistent coloring. As you age, you may develop vertical ridges, or your nails may be a bit more brittle. This is harmless. Spots due to injury should grow out with the nail. Abnormalities — such as spots, discoloration, and nail separation — can result from injuries to the fingers and hands, viral warts (periungual warts), infections (onychomycosis), and some medications, such as those used for chemotherapy. Certain medical conditions can also change the appearance of your fingernails. However, these changes can be difficult to interpret. Your fingernails’ appearance alone isn’t enough to diagnose a specific illness. A doctor will use this information, along with your other symptoms and a physical exam, to make a diagnosis. Abnormalities of the fingernail Some changes in your nails are due to medical conditions that need attention. See your doctor if you have any of these symptoms: discoloration (dark streaks, white streaks, or changes in nail color) changes in nail shape (curling or clubbing) changes in nail thickness (thickening or thinning) nails that become brittle nails that are pitted bleeding around nails swelling or redness around nails pain around nails a nail separating from the skin These nail changes can be caused by a variety of different conditions, including ones we describe below. Beau’s lines Depressions that run across your fingernail are called Beau’s lines. These can be a sign of malnourishment. Other conditions that cause Beau’s lines are: diseases that cause a high fever such as measles, mumps, and scarlet fever peripheral vascular disease pneumonia uncontrolled diabetes zinc deficiency Clubbing Clubbing is when your nails thicken and curve around your fingertips, a process that generally takes years. This can be the result of low oxygen in the blood and is associated with: cardiovascular diseases inflammatory bowel disease liver diseases pulmonary diseases AIDS Koilonychia (spooning) Koilonychia is when your fingernails have raised ridges and scoop outward, like spoons. It’s also called “spooning.” Sometimes the nail is curved enough to hold a drop of liquid. Spooning can be a sign that you have: iron deficiency anemia heart disease hemochromatosis, a liver disorder that causes too much iron to be absorbed from food lupus erythematosus, an autoimmune disorder that causes inflammation hypothyroidism Raynaud’s disease, a condition that limits your blood circulation Leukonychia (white spots) Nonuniform white spots or lines on the nail are called leukonychia. They’re usually the result of a minor trauma and are harmless in healthy individuals. Sometimes leukonychia is associated with poor health or nutritional deficiencies. Factors can include infectious, metabolic, or systemic diseases as well as certain drugs. Mees’ lines Mees’ lines are transverse white lines. This can be a sign of arsenic poisoning. If you have this symptom, your doctor will take hair or tissue samples to check for arsenic in your body. Onycholysis When the nail plate separates from the nail bed, it causes a white discoloration. This is called onycholysis. This can be due to infection, trauma, or products used on the nails. Other causes for onycholysis include: psoriasis thyroid disease Pitting Pitting refers to small depressions, or little pits, in the nail. It’s common in people who have psoriasis, a skin condition that causes the skin to be dry, red, and irritated. Some systemic diseases can also cause pitting. Terry’s nails When the tip of each nail has a dark band, it’s called Terry’s nails. This is often due to aging, but it can also be caused by: congestive heart failure diabetes liver disease Yellow nail syndrome Yellow nail syndrome is when the nails get thicker and don’t grow as fast as normal. Sometimes the nail lacks a cuticle and may even pull away from the nail bed. This can be the result of: internal malignancies lymphedema, swelling of the hands pleural effusions, fluid buildup between the lungs and chest cavity respiratory illnesses such as chronic bronchitis or sinusitis rheumatoid arthritis These are just some of the signs of abnormal fingernails. Having any of these signs isn’t proof of any medical condition. You’ll need to visit your doctor to determine if your condition is serious. In many cases, proper care of your nails is enough to correct their appearance. How to care for your nails You can prevent many nail abnormalities by taking good care of your nails. Follow these general guidelines to keep your nails healthy: Tips Don’t bite or tear at your nails, or pull on hangnails. Always use nails clippers and trim them after you bathe, when nails are still soft. Keep your nails dry and clean. Using sharp manicure scissors, trim your nails straight across, rounding the tips gently. If you have a problem with brittle or weak nails, keep them short to avoid breakage. Use lotion on your nails and cuticles to keep the nail and nail beds moisturized. Homoeopathic medicines for nail abnormalities Medicines according to Cause1 Cause Medicines From a hurt Ledum pal. Prick with a needle under the nail Allium cepa, Bovista, Sulphur; Hard work Rhus tox, Sepia; Prick near the nail Iodum; Splinters Baryta carb., Hepar sulph., Iodum, Lachesis, Nitricum acidum, Petroleum, Silicea, Sulphur; Splits of the skin adhering to the nails Allium cepa, Natrum mur. TABLE 2 Medicines according to the Sensation Sensations Medicines Irritable feeling under finger nails, relieved by biting them Ammonium brom. Itching-about roof of Upas tiente Pains-Burning under Sarsarparilla Pains, gnawing, beneath finger nails Alumina; Sarsaparilla.; Sepia Pains, neuralgic, beneath finger nails Berberis vulgaris Pains, neuralgic Alumina; Allium cepa; Colchicum Pains, smarting at roots Sulphur Pains, splinter-like, beneath toe nails Fluoric acidum Pains, ulcerative, beneath toe nails Antimonium crudum; Graphites; Teucrium Medicines according to Location1 Fig. Medicines according to location pastedGraphic.png TABLE 3 Medicines according to Pathology Pathology Medicines Atrophy Silicea Blueness Digitalis; Oxalicum Acidum Deformed-brittle, thickened (onchogryposis) Alumina; Anatherium; Antimonium crudum; Arsenicum album; Causticum; Dioscorea; Fluoricum acidum; Graphites; Merc. Sol.; Natrum muriaticum; Sabadilla; Secal cor..; Senecio aureus; Sepia; Silicea; Thuja.; X-ray. Falling off Brassica napus; Butyric acid; Helleborus faetidus; Helleborus Hangnails Lycopodium; Natrum muriaticum; Sulphur; Upas tiente Hypertrophy (onychauxis) Graphites Inflammation of pulp (onychia) Arnica; Calendula; Fluoricum acidum.; Graphites; Phosphorus; Psorinum; Sarsaparilla; Silicea; Upas tiente Inflammation, under toe nails Sabadilla Ingrowing toe nails Causticum; Magnetis polus austral.; Nitricum acidum; Silicea; Staphysagria; Teucrium; Tetrodymite Softening Plumbum met; Thuja Spots, white on Alumina; Nitricum acidum Trophic changes Radium brom Ulceration Alumina; Garphites; Merc. Sol.; Phosphorus; Sanguinaria; Sarsaparilla; Silicea; Teucrium; Tetrodymite Yellow color Conium maculatumDr. Rajesh Gupta5 Likes9 Answers