Dermatomyositis

Dermatomyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness. Dermatomyositis’ cardinal symptom is a skin rash that precedes, accompanies, or follows progressive muscle weakness. The rash looks patchy, with purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, knees, and toes. Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations, and there may be swelling in the affected areas. The...

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Case no.2

A 56-year-old woman presented with complaints of an ulcerating lesion at the inner corner of right eye for the past 8 months. There had been an off and on history of yellowish discharge from the lesion; occasionally it is blood tinged. She had a history of trauma with a wooden stick at the affected site, 10 months earlier. Clinically, a firm mass could be palpated. Extraocular movements were full. Slit lamp and fundus examination were within normal limits in both eyes. CT scan showing coronal and axial view is shown above. 1. The most probable diagnosis is:                          ...

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Staring At An Eclipse Can Blind You

True. Never view the sun directly with the naked eye or with any unfiltered optical device, such as binoculars or a telescope!. As sunlight enters the eye, it can damage the light-sensitive nerve endings in the back of the eye -- known as the retina -- causing vision loss. Total and partial eclipses can lead to serious damage if precautions are not taken to prevent blindness. This is why there are only a few safe ways to view an eclipse, such as with a referred image. Regular sunglasses, exposed film, and even a welder's helmet are not sa...

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Waardenburg syndrome

Waardenburg syndrome (WS) is an inherited disorder often characterized by varying degrees of hearing loss and changes in skin and hair pigmentation. The syndrome got its name from a Dutch eye doctor named Petrus Johannes Waardenburg who first noticed that people with differently colored eyes often had a hearing impairment. He went on to study over a thousand individuals in deaf families and found that some of them had certain physical characteristics in common. One commonly observed characteristic of Waardenburg syndrome is two differently colored eyes. One eye is usually brown and the other blue. Sometimes, one eye has two different colors....

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Pancoast Tumor

Pancoast tumors are tumors that form at the extreme apex (very top) of either the right or left lung in the superior sulcus (a shallow furrow on the surface of the lung). Pancoast tumors are a subset of lung cancers that invade the top of the chest wall. Because of their location in the apex of the lung, they invade adjoining tissue. Pancoast tumors originate at the top margin of the lung. They form an abnormal patch of tissue over the lung apex and principally involve the chest wall structures rather than the underlying lung tissue. They invade the following structures: Lymphatics (small, thin vessels that carry lymph fluid through the...

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The Man Who Can Eat Everything

This basically means the guy can eat and even digest metal, glass and even toxic and poisonous material. Michel Lotito's stomach lining is twice as thick as normal, a rare condition that most doctors agree developed in the womb, though nobody is sure how. Lotito does not often suffer from ill-effects due to his diet, even after the consumption of materials usually considered poisonous.When performing he consumes around a kilogram of material daily, preceding it with mineral oil and drinking considerable quantities of water during the 'meal'. He apparently possesses a stomach and intestine with walls of twice the expected thickness, and his digestive...

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Surprising things that give you headaches

You've been staring at the computer for hours. You've worked late all week and have in-laws coming this weekend. You have a raging case of PMS. Eyestrain, stress, and hormonal shifts are fairly common causes of headaches, which afflict 45 million Americans (most of them women). Some people say the roots of their hair hurt when they get a headache. But sometimes the usual suspects don't explain that pain in your head. That's because some triggers are just plain weird -- like perfume, storms, earrings -- . Here's how to identify the source of your headache so you can send it packing. Perfume "Strong scents bother me instantly," says Bethany...

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Chimera

Chimera: In medicine, a person composed of two genetically distinct types of cells. Human chimeras were first discovered with the advent of blood typing when it was found that some people had more than one blood type. Most of them proved to be "blood chimeras" -- non-identical twins who shared a blood supply in the uterus. Those who were not twins are thought to have blood cells from a twin that died early in gestation. Twin embryos often share a blood supply in the placenta, allowing blood stem cells to pass from one and settle in the bone marrow of the other. About 8% of non-identical twin pairs are chimeras. Many more people are microchimeras...

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Mysterie people

Chimera EXPLAIN this. You are a doctor and one of your patients, a 52-year- old woman, comes to see you, very upset. Tests have revealed something unbelievable about two of her three grown-up sons. Although she conceived them naturally with her husband, who is definitely their father, the tests say she isn't their biological mother. Somehow she has given birth to somebody else's children. This isn't a trick question - it's a genuine case that Margot Kruskall, a doctor at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, was faced with five years ago. The patient, who we will call Jane, needed a kidney transplant, and so her...

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A 9-month-old boy presented with progressive hypotonia and developmental delays, with a weight below the fifth percentile for his age despite a normal food intake. He was born at 38 weeks' gestation after an uncomplicated vaginal birth, and there were no concerns about his growth or development until he was 7 months, when the family physician realized that the boy had been regressing developmentally over the last month. He was not yet sitting, had almost stopped rolling over and had decreased head control. There was no history of seizures or serious illnesses. Neurological examination revealed a marked central and peripheral hypotonia and normal...

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The Girl Who Was "Born" Twice

When Keri and Chad McCartney went to the ob-gyn to find out the sex of their baby-to-be six months into the pregnancy, they got some unexpected and frightening news: A grapefruit-size tumor was slowly killing the fetus. Doctors had to remove the tumor—although it wasn’t cancerous, it was sucking up the blood that the fetus needed to grow—and to do so, they performed a surgery that has been completed fewer than 20 times. They brought the baby about 80% out of her mother’s womb, excised the tumor, and then tucked her back in. Ten weeks later, in May 2008, Macie Hope McCartney was born—again. And this time for good. Source : http://www.cbs...

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Spot Diagnosis 003

A 73-year-old woman presented with new-onset periorbital purpuric, nonblanching, nonpruritic lesions. The lesions appeared spontaneously and were not associated with any recent trauma. She did not take aspirin, non-steroidal anti inflammatory drugs, or any other anticoagulant agents. On physical examination, no similar skin lesions were found elsewhere. In addition, laboratory studies revealed mild impairment of renal function and nephritic-range proteinuria. The blood count showed mild thrombocytopenia (platelet count, 80,000 per cubic millimeter), whereas the prothrombin time and partial-thromboplastin time were normal. The patient was diagnosed...

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Spot Diagnosis 002

A 3-year-old girl who suffers from congenital deafness and mutism was admitted to our pediatric outpatient clinic. What is your diagnosis? The correct answer is...

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Treatment And Prognosis for Stevens-Johnson Syndrome

Early diagnosis and recognition with prompt withdrawal of all suspected potential causative drugs are essential for a favorable outcome. Morbidity and mortality decrease if the culprit drug is withdrawn no later than the day when blisters or erosions first occurred. No difference was seen for drugs with long half-lives. The patient must be transferred to an intensive care unit or a burn center. Rapid referral reduces risk of infection, mortality rate and period of hospitalization. Supportive care is the mainstay of treatment. Intervention should include intravenous fluid and electrolyte replacement, environmental temperature control, careful...

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Diagnosis Of Stevens-Johnson Syndrome

Doctors often can identify Stevens-Johnson syndrome based on your medical history, a physical exam and the disorder's distinctive signs and symptoms. To confirm the diagnosis, your doctor may take a tissue sample of your skin (biopsy) for examination under a microscope.No specific laboratory studies (other than biopsy) exist that can definitively establish the diagnosis of Stevens-Johnson syndrome.A complete blood count (CBC) may reveal a normal white blood cell (WBC) count or a nonspecific leukocytosis. A severely elevated WBC count indicates the possibility of a superimposed bacterial infection. Skin and blood cultures have been advocated because...

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Causes Of Stevens-Johnson Syndrome

Stevens-Johnson Syndrome (SJS) is usually caused by a response to a medicine that has been taken. The response may happen within one week to two months of taking the medicine. SJS may also be caused by infection, vaccinations, or diseases involving your organs or whole body. The cause of SJS may be unknown, and SJS risk may be genetic. The most common medicines that may cause SJS are: Antibiotics (used to treat infection) Anti-seizure medicines (used to treat convulsions). Non-steroidal anti-inflammatory medicine (used to treat swelling or fever) Penicillins, which are used to treat infections SJS causes are broken into four different categories: Infections  Drug...

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Symptoms of Stevens-Johnson Syndrome

Typically, Stevens-Johnson syndrome affects the mucous membranes of the oral cavity, nostril, eyes, and both the anal and genital regions. It may or may not be associated with skin lesions elsewhere on the body. Oropharyngeal (mouth) lesions may be so intolerable as to prevent eating, and there may be recurring oral ulcers. Often, the skin lesions may look like a target-lesion (3 concentric zones of color change) or as bullae (bubble-like). A painful conjunctivitis may occur in the eye, frequently with a pus discharge, and can lead to corneal scarring and loss of vision. In addition to the mucous membrane lesions, fever and...

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Stevens-Johnson syndrome

Stevens-Johnson syndrome is a rare, serious disorder in which your skin and mucous membranes react severely to a medication or infection. Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters, eventually causing the top layer of your skin to die and shed. Stevens-Johnson syndrome presents a medical emergency that usually requires hospitalization. Treatment focuses on eliminating the underlying cause, controlling symptoms and minimizing complications. Recovery after Stevens-Johnson syndrome can take weeks to months, depending on the severity of your condition....

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