Tuesday, September 7, 2010


Photo Description :
brown plaque in the midline of bake of this 12 years boy.tan thickened 3 cm midline plaque with fuzzy border and surrounding subtle erythema.

This 12-year-old boy had a habit of rubbing his back against his wheel chair. This area of thickened skin was present on his back for over a year. The lesion was not tender and it was contiguous with the overlyign skin.

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Urinary catheters :Do's and don'ts

It is a form of drain which Can be inserted transurethrally or suprapubically
*Commonly used to:
1- Alleviate or prevent urinary retention
2- Monitor urine output

* Catheters vary by:
o The material from which they are made (latex, plastic, silastic, teflon-coated)
o The length of the catheter (38 cm 'male' or '22 cm 'female')
o The diameter of the catheter ................

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"1,3,5,7,9,11" of Spleen

Spleen: dimensions, weight, surface anatomy


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Surgical removal of a sebaceous cyst


Toronto Notes Atlas CD

An excellent software CD accompanying the Toronto Notes Books.
This CD contains 16 different Chapters (Anesthesia and Peri-operative medicine, Cardiac & Vascular Surgery, Dermatology, Endocrinology, Gastroenterology, Geriatric Medicine, Gynecology, Hematology, Infectious Diseases, Nephrology, Neurosurgery, Ophthalmology, Otolaryngology, Pediatrics, Plastic Surgery and Rheuatology).
There is no need to install this CD. Just download it with the given links below and it will open in your browser. Along with this, an extremely helpful Functional Neuroanatomy software is also included that installs quickly and provides great audio-visual knowledge (No need of CD ROM).

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Pediatric Dermatology (Cohen, Pediatric Dermatology)

Clinically focused and practical, this diagnostic reference is ideal for anyone who treats children with skin disorders. Over 800 top-quality full-color illustrations, balanced by clear and succinct text, deliver the right amount of clinical detail to help readers identify a wide range of diseases. Plus, summary tables and differential diagnosis algorithms help simplify diagnosis.
* Contains differential diagnosis algorithms and summary tables that aid in diagnosis.
* Offers a comprehensive bibliography at the end of each chapter for further study.
* Uses an easily accessible format to locate key information.


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Keloids Pictures and Therapy

A Keloid
is a type of scar with mainly type I and some type III collagen which results in an overgrowth of tissue at the site of a healed skin injury. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to flesh-colored or red to dark brown in color. A keloid scar is benign, non-contagious, and usually accompanied by severe itchiness, sharp pains, and changes in texture. In severe cases, it can affect movement of skin.

You should not be confused with hypertrophic scars,Hypertrophic scars remain limited to the traumatized area and regress spontaneously within 12-24 months, although regression may not necessarily be complete.

It is the first line in keloid therapy. Avoid performing nonessential cosmetic surgery in patients known to form keloids; however, the risk is lower among patients who have only earlobe lesions. Close all surgical wounds with minimal tension. Incisions should not cross joint spaces. Avoid making midchest incisions, and ensure that incisions follow skin creases whenever possible.

*Occlusive dressings include silicone gel sheets and dressings, nonsilicone occlusive sheets, and Cordran tape. These measures have been used with varied success. Antikeloidal effects appear to result from a combination of occlusion and hydration, rather than from an effect of the silicone.

*Compression therapy involves pressure, which has long been known to have thinning effects on skin. Reduction in the cohesiveness of collagen fibers in pressure-treated hypertrophic scars has been demonstrated by electron microscopy.

- Compression treatments include button compression, pressure earrings, ACE bandages, elastic adhesive bandages, compression wraps, spandex or elastane (Lycra) bandages, and support bandages. In one study, button compression (2 buttons sandwiching the earlobe applied after keloid excision) prevented recurrence during 8 months to 4 years of follow-up observation.

*Corticosteroids, specifically intralesional corticosteroid injections, have been the mainstay of treatment. Corticosteroids reduce excessive scarring by reducing collagen synthesis, altering glucosaminoglycan synthesis, and reducing production of inflammatory mediators and fibroblast proliferation during wound healing. The most commonly used corticosteroid is triamcinolone acetonide (TAC) in concentrations of 10-40 mg/mL administered intralesionally with a 25- to 27-gauge needle at 4- to 6-week intervals.

Recent innovations:
New treatments for keloids and hypertrophic scars include intralesional IFN; 5-FU; doxorubicin; bleomycin; verapamil; retinoic acid; imiquimod 5% cream; tacrolimus; tamoxifen; botulinum toxin; TGF-beta3; rhIL-10; VEGF inhibitors; etanercept; manose-6-phosphate inhibitors; etanercept; onion extract; the combination of hydrocortisone, silicon, and vitamin E; PDT; intense pulsed light (IPL); UVA-1; and narrowband UVB.

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Real Video of Child Birth

Urinary tract infection

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The main causative agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they cause a UTI. The most common type of UTI is a bladder infection which is also often called cystitis. Another kind of UTI is a kidney infection, known as pyelonephritis, and is much more serious. Although they cause discomfort, urinary tract infections can usually be quickly and easily treated with a short course of antibiotics.Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine.



Algorithm for the diagnosis and treatment of epistaxis

The bloody nose is a common emergency problem. The majority are spontaneous, with no identifiable cause, although many are traumatic. Causes such as hemophilia, other coagulopathies, leukemia, hereditary hemorrhagic telangiectasia or intranasal neoplasms must be considered. As usual, a complete history is taken. Use of aspirin, NSAIDs, or sodium warfarin or (coumadin) or Plavix? other anticoagulant ingestion should be ascertained. Children and many adults often cause bleeding by nose picking. A pubertal male may have an angiofibroma. A person with a long history of smoking should be examined for an intranasal or paranasal sinus epidermoid cancer. Patients may require a laboratory examination.

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