Tu ne PR kiya?

Dr.SANEL (Urology, )

73 year old male, admitted under the physician with high fever, chills uncontrolled Diabetes Mellitus, CAD. A comprehensive battery of investigations for PUO, was done but no specific cause of fever could be identified .Patient was put on Meropenam 1 gm Q8 hrly. Plain and Contrast CT Abdomen and Pelvis: normal. Urology reference for mild dysuria and frequency was sought. P. R : grade 2 non tender nodular prostatomegaly of varying consistency. TRUS heteroechoeic prostate with increased vascularity and microabscesses CLINICAL DIAGNOSIS: RESOLVING BACTERIAL PROSTATITIS

EMR In sessile Villous Adenoma of colon

Dr.Ashik (Gastroenterology, )

70 year old lady who was on anticoagulants for coronary artery disease had a 2.5 cms sessile villous Adenoma on her ileocaecal valve .The lesion was lifted with saline and adrenaline and an endoscopic mucosal mucosal resection was performed. Large vessels were hemoclipped. EMR is a safe alternative to surgery in large sessile polyps when invasive malignancy is not suspected . The major complications are bleeding and perforation none of which occurred in this patient .Histopathology showed no invasive cancer. Anticoagulants were resumed in 72 hours .

A RARE CASE OF SPONTANEOUS ACUTE CRANIAL AND SPINAL SUBDURAL HAEMATOMA

Dr.Subramaniam (Neurosurgical, )

The patient is a 17 year old girl with two weeks history of headache and backache. No history of trauma or drug intake or insect bite or any bleeding diathesis or fever or joint pains. No deficits on examination. Normal eye examination. No bladder involvement. MRI imaging revealed right acute subdural haematoma and also D8 to S2 acute posterior subdural haematoma. Angiography was normal. All haematologic investigations including full coagulation profile including platelet function tests were normal. Conservative management yielded full resolution of both the haematomas without any deficits.

ADULT MEASLES NOT UNCOMMON

Dr.Seenaj (Medicine, )

42 YRS OLD MAN PRESENTED TO OPD TODAY WITH FEVER MALAISE COUGH AND EXTENSIVE RASHES IN THE TORSO AND THE TYPICAL KOPLICKS SPOTS NO HISTORY OF VACCINATION

DYSURIA: CHILD SEXUAL ABUSE

Dr.Abey (Paediatric, )

4 year old boy of parents from infopark was brought to OPD with complaints of pain during passing urine since one month. No history of fever or other complaints. Local examination of genitals are normal. Urine routine and Urine culture were normal .Child was advised plenty of oral fluids. A course of paracetamol and antibiotics was prescribed but no relief. Since mother noticed recent abnormal behavior of the child a camera was installed inside the house. Video from the camera showing the maid sexually abusing the boy while parents were away at work clinched the diagnosis. (Police alerted)

MALARIA PRESENTING WITH HYPOGLYCAEMIA

Dr.Seenaj (Medicine, )

36 YR OLD PRESENTED TO MEDICAL OPD WITH H/O 2 DAYS FEVER MALAISE NAUSEA AND MILD SWEATING. INV REVEALED RBS OF 68 PLT 90 K TC OF 11000.O/E B/L COARSE CRACKLES ON CHEST AND TIP OF SPLEEN WAS PALPABLE. HE IS A ENGINEER BY PROFESSION IN BOTSWANA SINCE LAST 8 YEARS.& PAST HISTORY NOTHING SIGNIFICANT. HE TURNED OUT TO BE FALCIPARUM MALARIA POSITIVE AND DEVELOPED ARDS IN 3 RD DAY ASSOCIATED WITH SEVERE SEPSIS AND WAS SUCESSFULLY DISCHARGED AFTER 2 WEEKS OF STORMY HOSPITAL COURSE

A tale of two ulcers

Dr.Rajeev (Gastroenterology, General Practice / Family Medicine, )

Two patients, 38F and 48 M, were seen within the past two weeks and diagnosed with gastric and duodenal ulcers respectively. Both of them gave a history of pain occurring around 2-3 AM. Epigastric pain is a common problem, and ulcer is a frequently suspected diagnosis. However, most patients with epigastric pain do not have ulcer. It is therefore important to know the types of pain that indicate the presence of an underlying ulcer. None of the patients with daytime epigastric pain seen in the past month had ulcer on endoscopy. However, both the patients with 2-3 AM pain had ulcer.

Sclerosing Sterno-clavicular joint Arthritis

Dr.Prathap Kumar (Orthopaedic, )

52 year old homemaker lady noticed a diffuse swelling around the medial end of her right clavicle eight months ago. Largely asymptomatic and noticed by chance looking at the mirror. Investigations Including CT and MRI Scans done elsewhere normal and worried about the persistence of the swelling. This anxious patient was referred to me at this stage to rule out any sinister causes. An infection screen and an arthritis profile were done and we’re normal. This is Sclerosing Sterno-clavicular joint Arthritis which is seen very infrequently in India. More common in Western peri-menopausal women