Resident physician program is LIVE now !!

Reasons you SHOULD marry a medical doctor: 1. Doctors are very intellectual 2. Always professionally dressed and great looking 3. You will get all the medical attention you need all the time 4. You will feel special with all the attention they get, yet you are the most important for them 5. You will learn a LOT about medicine and how to take care of others 6. Doctors are rich!!!!! 7. The most awesome dates ever, in the best places 8. You will save medical bills, discounted medical services 9. They know how to love mentally and they know how to take care of the heart 10. Doctors have seen it all, you will never be bored around them 11. If you want them away, just eat an apple a day! Copied from internet

Haemolacria is a physical condition that causes a person to produce tears that are partially composed of blood. It can manifest as tears that are anything from merely red-tinged to appearing to be entirely made of blood. ... This condition is a symptom of a number of diseases, and may also be indicative of a tumor in the lacrimal apparatus. It is most often provoked by local factors such as bacterial conjunctivitis, environmental damage or injuries. Acute haemolacria can occur in fertile women and seems to be induced by hormones, similarly to what happens in endometriosis. Haemolacria, though initially shocking, is often harmless and resolves quickly on its own. Credit: Ana Sayfa, Onedio.com

Care for Critically Ill Patients With COVID-19 Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections. Given how common the disease is becoming, as in prior major severe acute respiratory infection outbreaks—SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), avian influenza A(H7N9), and influenza A(H1N1)pdm09—critical care will be an integral component of the global response to this emerging infection. Management of severe COVID-19 is not different from management of most viral pneumonia causing respiratory failure. The principal feature of patients with severe disease is the development of ARDS: a syndrome characterized by acute onset of hypoxemic respiratory failure with bilateral infiltrates. Evidence-based treatment guidelines for ARDS should be followed, including conservative fluid strategies for patients without shock following initial resuscitation, empirical early antibiotics for suspected bacterial co-infection until a specific diagnosis is made, lung-protective ventilation, prone positioning, and consideration of extracorporeal membrane oxygenation for refractory hypoxemia. To read complete article- https://jamanetwork.com/journals/jama/fullarticle/2762996 Source- JAMA Authors- Srinivas Murthy, MD, CM, MHSc; Charles D. Gomersall, MBBS; Robert A. Fowler, MD, CM, MSc

*History* 21 y.o. man presented to the emergency room one day after playing flag football. He remembers hearing a pop and feeling pain in his right small finger during the game. *Exam* Edema and tenderness over right small finger, proximal phalanx. Limited range of motion. No sensory deficits. *Findings* Complete fracture of the right fifth proximal phalanx traversing through a 0.94 x 1.43cm well-defined geographic medullary lesion with lobulated appearance and scalloping of the adjacent cortex. Appearance consistent with a geographic 1B lesion. *Differential Diagnosis* Geographic 1B lesion (well-defined, no sclerosis): -Enchondroma -Chondroblastoma -Chondromyxoid fibroma -Fibrous dysplasia -Bone cyst -Giant cell tumor -Myeloma/Metastasis *Case Diagnosis* Enchondroma with Pathologic Fracture *Diagnosis By* Radiology *Treatment & Follow Up* Observation if the lesion is asymptomatic. If a pathologic fracture is present, the fracture is first allowed to heal. Otherwise once healed, or if the tumor becomes symptomatic, it is resected with subsequent histological tests to rule out malignancy, and the extirpation cavity can be filled with autogenous spongy bone. *Discussion* A chondroma is a benign neoplasm of hyaline cartilage. When it arises within the medullary cavity of bone, it is called an enchondroma. Multiple echondromas, or enchondromatosis, is known as Ollier disease. If the enchondromatosis is associated with soft tissue hemangiomas, this is known as Maffucci syndrome. These lesions typically present between 20 and 50 years of age and are equally frequent in men and women. Enchondromas usually occur as a solitary lesion with approximately 40-65% occurring in the hands, or less frequently, the feet. Solitary enchondromas also occur in the long tubular bones in approximately 25% of cases, more frequently in the upper extremities than in the lower extremities. Rare areas of involvement include the skull, facial bones, patella, clavicle, sternum, scapula, ulna, and vertebrae. A general rule chondroid lesions of the axial skeleton are chondrosarcomas. Solitary lesions are generally asymptomatic or associated with painless swelling. Often these tumors go unnoticed and are found incidentally on x-ray, occasionally associated with a pathologic fracture. Radiographic features of solitary enchondromas in the hand or foot are characteristic. A well-defined, medullary lesion with lobulated contour and endosteal erosion. Cortical expansion or thickening, foci of calcification(but lesions of the hand and foot are frequently not mineralized), and pathologic fracture are also possible characteristics. Magnetic resonance imaging typically show a well-circumscribed, lobulated lesion of low signal intensity (less than or equal to skeletal muscle) on T1-weighted spin echo, and high signal intensity (similar to water) on T2-weighted spin echo. Solitary lesions rarely undergo malignant transformation into chondrosarcomas, however lesions associated with enchondromatosis are more likely to undergo sarcomatous change than monostotic lesions. In addition to sarcomatous transformation, those with Maffucci syndrome are also at risk of developing other malignancies to include ovarian carcinomas and brain gliomas. Lesions larger than 5 cm in diameter are much more likely to be chondrosarcomas and patients are frequently older than those with enchondroma. Other finding in long bone cartilage lesions to suggest chondrosarcoma include greater than 2/3 endosteal scalloping, cortical thickening/remodeling, or soft tissue extension.

Dear Actor Vijay sir, Silambarasan sir and the respected Govt. of TamilNadu, I am tired. We are all tired. Thousands of doctors like me are tired. Health care workers are tired. Police officials are tired. Sanitary workers are tired. We have worked so hard at the ground level to make sure the damage done is kept to as low as possible amidst an unprecedented pandemic. I am not glorifying our work for I know there is nothing so great about it to the onlooker’s eyes. We don’t have cameras in front of us. We don’t do stunt sequences. We aren’t heroes. But we deserve some time to breath. We don’t want to fall prey to someone’s selfishness and greed. The pandemic isn’t over and we have people dying till today to the disease. A hundred percent theatre occupancy is a suicide attempt. Rather homicide , for none of the policy makers or the so called heroes are going to put themselves under the pump, to watch the movie amidst the crowd. This is a blatant barter system, trading lives for money. Can we please slowly try and concentrate on our lives and make sure we tide through this pandemic peacefully and not reignite the slowly burning out flame, that is still not completely put out? I wanted to make this post scientific and explain why we are still in danger. But that’s when I asked myself, “what’s the point?” Yours tiredly A poor, tired resident doctor https://www.facebook.com/aravinth.srinivas/posts/3937347876284519