Pakshaghate Virechanam

Dear Friends We often get cases of haemoptysis to manage. Let's have a detailed update…. HAEMOPTYSIS Differential Diagnosis of Hemoptysis PULMONARY PARENCHYMAL SOURCE.. Tuberculosis Pneumonia Lung abscess Lung contusion Mycetoma Idiopathic pulmonary hemosiderosis Wegener granulomatosis Lupus pneumonitis Goodpasture syndrome TRACHEO-BRONCHIAL SOURCE.. Bronchiectasis Neoplasm Bronchitis Broncholithiasis Airway trauma Foreign body PRIMARY VASCULAR SOURCE Arteriovenous malformation Pulmonary embolism Elevated pulmonary venous pressure Pulmonary artery rupture MISCELLANEOUS AND RARE CAUSES Systemic coagulopathy or thrombolytic agents Catamenial hemoptysis (pulmonary endometriosis) PSEUDO HAEMOPTYSIS Upper airway source(like nose) Gastrointestinal source(haematemesis) Serratia marcescens (gram-negative bacterium that produces a red pigment that may be mistaken for blood) Malingering HOW HISTORY SUGGESTS…. ETIOLOGY OF HAEMOPTYSIS…        (1)h/o ANTICOAGULANT USE..     Coagulopathy (2)h/o COUGH…             Bronchiectasis, COPD, foreign body, pneumonia,  tuberculosis (3)h/o FEVER..    Tuberculosis, Bronchitis, lung abscess, neoplasm, pneumonia, pulmonary embolism, (4)h/oHEART DISEASE..         Congestive heart failure (5)h/o RECENT SURGERY OR IMMOBILIZATION…           Pulmonary embolism (6)h/o SMOKING…         Bronchitis, COPD, neoplasia (7)h/o SPUTUM PRODUCTION         Bronchiectasis, COPD, pneumonia, tuberculosis (8)h/o TRAUMA            Airway trauma, pulmonary embolism (9)h/o WEIGHT LOSS COPD, neoplasia, tuberculosis WORKUP AND MANAGEMENT Chest radiography.. Plain x-ray or CT thorax may provide clues about the etiology, as well as guide further resuscitation and evaluation. Treatment of the possible cause of haemoptysis should be initiated. Once the bleeding site has been determined, the patient should be placed in the lateral decubitus position with the affected lung down to prevent pooling of blood in the unaffected bronchial system. Rapid bleeding warrants immediate airway control with rigid bronchoscopy or endotracheal intubation Flexible bronchoscopy is less effective in maintaining a patent airway, but can provide useful diagnostic information. For stable patients with no identifiable cause detected.. chest CT angiography and/or bronchial artery arteriography with or without embolization should be performed. Thanks I hope this information on HAEMOPTYSIS will be HELPFUL to most of us Dr K N Poddar

70 y male farmer, Vata prakriti,,two times mala pravritti,. Vata Sara purush,, .initially a small ulcer neglected by him turns to cellulitis,went to Ortho,dr, then neglected the wound. and finally came to me yesterday,. please observe the wound and give your opinion drs.

A female Pt with 57 yrs old and having this complaint since 40 yrs . Just one month before she has met me with barrel shaped lower leg looks like eliphentiasis. She had undergone test for filariasis 4 yrs back but didn't find anything .I gave medicine for her oedema and she has got some relief with it. After one month tmt her leg becomes as shown in the image

nodular hyperkeratotic lesions on both elbows and knees. is this phrynoderma?

Rough and dry skin on lateral side of index fingers.no itching or burning sensation.No h/o regular working with vibrating machines.diagnose and treatment