HOLISTIC Approach under care of oncologist&Neurocare
Biopsy of lung lesion shows CNS metastasis.??. Is it a primary in the lung or metastasis in the lung.Hiw ever this is a case of disseminated malignancy. Primary site ?? Lung / secondary in the lung and brain. Ref the case to Oncologist for further management.
Advanced case of malignancy, metastasis. Chemotherapy, radiotherapy. Oncologist opinion. Physiotherapy too.
Early medical management is advisable. Adv MRI brain and PET scan.
Treatment and prognosis depends upon the primary disease, control the primary disease along with whole brain radiotherapy (if there are multiple metastases in the brain, if focal then SRS) along with systemic chemotherapy
Looks metastasis Advance case of malignancy Req chemo and radiotherapy Oncologist opinion Physiotherapy too
Get brain imaging CT or MRI brain Most probability brain mets
Metastasis with complications. Chemoradiotherapy or palliative therapy and after proper evaluation and assessment by oncologist .
? SECONDARIES.. IN CNS .. WITH.. COMPLICATIONS.. NEED'S.. ONCOLOGISTS OPINION.. CHEMOTHERAPY..
Chemotherapy + Radiotherapy Physiotherapy Symptomatic treatment Ref to Oncologist
Cases that would interest you
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GANGRENE is death of a body tissue which is caused due to loss of blood supply or inadequate blood supply to the tissue. . Causes of gangrene 1)Vascular– gangrene is seen is vascular diseases such as peripheral arteriosclerosis, thrombosis of the large arteries, thrombosis of terminal aorta etc. 2)Infection– gangrene is mainly produced by clostridium perfringens, and other clostridia, bacteria such as streptococcal,staphylococcal may also produce certain forms of gangrene. 3)Neoplasm– multiple myelomas are generally associated with Raynaud phenomenon which produces gangrene. 4)Neurological– peripheral neuropathy, syringomyelia, trasverse myelitis, may beassociated with gangrene. 5)Intoxication– should keep in mind that use of ergot alkaloids may also be associated with gangrene. 6)Trauma– laceration of major artery of extremities or pressure from splinters may cause gangrene. 7)Decreased temperature– extremes of cold may produce frostbite which can ultimately lead to gangrene. 8)Autoimmune diseasessuch as lupus erythematosus, sclerederma and rheumatoid arthritis may be associated with Raynaud phenomenon and gangrene. 9)Endocrine– gangrene can be associated with diabetes. Homeopathic treatment of gangrene# Homeopathy is one of the most popular holistic systems of medicine. *Arsenic album– medicine for senile gangrene; gangrene accompanied by foetid diarrhoea; ulcers extremely painful with elevated edges, better by warmth and aggravation from cold; great weakness and emaciation. *Bromium– hospital gangrene; cancerous ulcers on face; stony hard swelling of glands of lower jaw and throat *Carbo veg– senile and humid gangrene inthe persons who are cachectic in appearance; great exhaustion of vital powers; marked prostration; foul smell of secretions; indolent ulcers, burning pain; tendency to gangrene of the margins; varicose ulcers. *Bothorps– gangrene; swollen, livid, cold with hemorrhagic infiltration; malignant erysipelas. *Echinacea– enlarged lymphatics; old tibial ulcers; gangrene; recurrent boils; carbuncles. *Lachesis– gangrenous ulcers; gangrene after injury; bluish or black looking blisters; vesicles appearing here and there, violent itching and burning; swelling and inflammation of the parts; itching pain and painful spots appearing after rubbing. *Crotolus H–gangrene, skin separated from muscles by a foetid fluid; traumatic gangrene; old scars open again. *Secale cor– pustules on the arms and legs, with tendency to gangrene; in cachectic, scrawny females with rough skin; skin shriveled, numb; mottled dusky-blue tinge; blue color of skin; dry gangrene, developing slowly; varicose ulcers; boils, small, painful with green contents; skin feels too cold to touch yet covering is not tolerated. Great aversion to heat; formication under skin. *Antrhacinum– gangrene; cellular tissues swollen and oedematous; gangrenous Parotitis; septicemia; ulceration, and sloughing and intolerable burning. *Cantharis– tendency to gangrene; vesicular eruptions; burns, scalds, with burning and itching; erysipelas, vesiculartype, with marked restlessness. *Mercurius– gangrene of the lips, cheeks and gums; inflammation and swelling of the glands of neck; pains aggravated by hot or cold applications. *Sulphuric acid– traumatic gangrene; hemorrhages from wounds; dark pustules; blue spots like suggillations; bedsores. *Phosphoric acid– medicine for senile gangrene.. THANK YOU.Dr. Akshay Ingole5 Likes8 Answers
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DIABETIC NEUROPATHIES. Diabetic neuropathies are a family of nerve disorders caused by diabetes. WHAT CAUSES DIABETIC NEUROPATHY. Nerve damage is likely due to a combination of factors. 1.METABOLIC FACTORS. : hyperglycemia, long duration of diabetes, abnormal blood fat levels and low levels of insulin. 2.NEUROVASCULAR FACTORS : Neurovascular factors leading to damage of blood vessels that carry oxygen and nutrients to nerves. 3.AUTOIMMUNE FACTORS : Causes inflammation of nerves. 4.MECHANICAL FACTORS : Injury to nerves as in carpel tunnel syndrome. 5.INHERITED TRAITS : That increase susceptibility to nerve disease. 6.LIFESTYLE FACTORS : Smoking, alcohol. SYMPTOMS. Symptoms depends on the type of neuropathy and which nerves are affected.Symptoms involve sensory,motor and autonomic nervous system. 1.Tingling, numbness or pain in the toes,feet,legs,hands,arms and fingers. 2.Wasting of muscles of hand or feet. 3.Indigestion, nausea, vomiting, diarrhea,c constipation. 4. Dizziness or fainting due to a drop in blood pressure after standing or sitting up. 5.Problems with urination. 6.Erectile dysfunction. 7.Weakness. TYPES OF NEUROPATHY. Diabetic neuropathy can be classified as 1.Peripheral neuropathy. 2.Autonomic neuropathy. 3.Proximal neuropathy. 4.Focal neuropathy. PERIPHERAL NEUROPATHY. Peripheral neuropathy,also called distal symmetric neuropathy or sensorimotor neuropathy ,is nerve damage in arms and legs.Symptoms are *Numbness or insensitivity to pain or temperature. *A tingling,burning or prickling sensation. *Sharp pains or cramps. *Extreme Sensitivity to touch. *Loss of balance and coordination. Peripheral neuropathy also causes muscle weakness and loss of refle guyxes.Blisters and sites may appear on the numb areas of the foot because pressure or injury goes unnoticed.I f an infection occurs and is not treated promptly,the infection may spread to the bone and the foot may need amputation.Many amputations can be prevented if minor problems are treated in time. AUTONOMIC NEUROPATHY. Autonomic neuropathy affects the nerves that control the heart,blood pressure and blood glucose levels.Autonomic neuropathy also affects internal organs causing problems with digestion,respiration. urination,sexual response and vision. 1.HYPOGLYCEMIA UNAWARENESS. Normally,symptoms such as shakiness,sweating and palpitations occurs when the blood glucose levels drop below <<70 mg/dl.In people with autonomic neuropathy,symptoms may not occur making hypoglycemia to be recognized. 2.HEART & BLOOD VESSELS. Damage to the nerves in the cardiovascular system interferes with the body's ability to adjust blood pressure and heart rate. Due to this,blood pressuremay drop sharply after standing or sitting,causing a person to feel light headed or faint. Damage to nerves that control heart rate makes the heart rate to stay high , instead of rising and falling in response to normal body functions and physical activity. 3.DIGESTIVE SYSTEM. Nerve damage to the digestive system most commonly causes constipation. Damage can also cause the stomach to empty slowly,a condition called GASTROPARESIS. Gastroparesis can lead to persistent nausea and vomiting,bloating and loss of appetite. Gastroparesis also makes blood glucose levels to fluctuate widely ,due to abnormal food digestion. Nerve damage to the OESOPHAGUS MAKES SWALLOWING DIFFICULT. Nerve damage to bowels can cause constipation alternating with uncontrolled diarrhea, 3.URINARY TRACT & SEX ORGANS. Autonomic neuropathy often affects the organs that control urination and sexual functions. Nerve damage can prevent the bladder from emptying completely , allowing the bacteria to grow in bladder and kidneys causing urinary tract infections. When the nerves of the bladder are damaged,urinary incontinence may result because a person may not be able to sense when the bladder is full or control the muscles that release urine. Autonomic neuropathy also leads to decreased sexual response in men and women. A man may have erectile dysfunction or may reach sexual climax without ejaculating normally. A woman may have difficulty in arousal,lubrication or orgasm. 5.SWEAT GLANDS. Nerve damage may cause improper working of sweat glands.It can also result in profuse sweating at night or while eating. 6.EYES. Due to autonomic neuropathy,pupils become less responsive to changes in light.A s a result,a person may not be able to see well when light is turned on In a dark room or have trouble driving at night. PROXIMAL NEUROPATHY. Proximal neuropathy//lumbosacral plexus neuropathy //femoral neuropathy //diabetic amyotrophy causes pain in the thighs,buttocks,hips or legs,usually on one side of the body. FOCAL NEUROPATHY. Focal neuropathy appears suddenly and affects specific nerves,most often in the head,torso or leg. Focal neuropathy is painful and unpredictable.and occurs most often in older adults with diabetes. However,it tends to improve itself over weeks or months and does not cause long term damage. Focal neuropathy can cause *Inability to focus the eye. *Diplopia. *Aching behind the eye. *Bell's palsy. *Severe pain in the lower back and pelvis. *Pain in the front of the thigh. *Pain in the chest and stomach. *Pain on the outside of the shin or inside of the foot. *Chest pain and abdominal pain is mistaken for heart attack or appendicitis. CAN DIABETIC NEUROPATHIES BE PREVENTED. THE BEST WAY TO PREVENT NEUROPATHY IS TO KEEP BLOOD GLUCOSE LEVELS AS CLOSE TO THE NORMAL RANGE AS POSSIBLE.MAINTAINING SAFE BLOOD GLUCOSE LEVELS PROTECTS NERVES THROUGH OUT THE BODY.Dr. Suvarchala Pratap17 Likes28 Answers
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A female uncontrolled diabetic with complaining about the itchy eruptions over fore arms, belly & back. Diagnosis & management plan to be discussed. Dr @Sepuri Krishna Mohan , Dr @Dr. Dineshchandra Sharma , Dr @Shivraj Agarwal , Dr @Shrikant BhoyarDr. Sandip Debashis Mishra5 Likes20 Answers
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58 yr old pt having infected wound on right leg (index toe) .. Onset: 1 month ago K/C/O - DM BP- 130/70 mmHg. RBS- 176 mg/dLDr. Parekh Neelkanth95 Likes146 Answers
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A 23 year boy with complaints of ulcers on tongue and cheek with crack on tongue. with ragged edjes since his childhood.Also had no appetite on morning since 6 Years. foul odour from mouth occasionally present. no family history of suchlike tongue. no bad habits and addiction. thermally chilly patient. desire spicy foods. diagnosis and treatment pleaseDr. Hari Krishnan5 Likes55 Answers