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Aplastic anemia is a hematopoietic disorder caused due to T lymphocyte mediated destruction of stem cells resulting in pancytopenia with a cellular bone marrow and normal cell cytogenetics. The causes of aplastic anaemia may be inherited or acquired. The causes and the diagnostic approach, along with spectrum of severity of this disorder is discussed in this presentation. A detailed discussion of the management options, along with pharmacological therapy and supportive therapy in these cases is also discussed. The treatment options include, in addition to a stem cell transplant, anti-thymocyte globulin, cyclosporine, methyprednisolone and eltrombopag (for patients who have failed treatment on combined modality therapy with ATG and cyclosporine)
Pyogenic granuloma (lobular capillary hemangioma[1] ) is a relatively common benign vascular lesion of the skin and mucosa whose exact cause is unknown. Also see the Medscape Reference article Oral Pyogenic Granuloma. Pyogenic granulomas are misnamed; they are neither infectious nor granulomatous. The lesion usually occurs in children and young adults as a solitary, glistening red papule or nodule that is prone to bleeding and ulceration. Pyogenic granulomas typically evolve rapidly over a period of a few weeks, most often on the head, neck, extremities, and upper trunk. Pyogenic granuloma often arises in pregnancy (or rarely with oral contraceptive usage), particularly on the gingiva or elsewhere in the oral mucosa, and then is termed the "pregnancy tumor." Other pyogenic granuloma variants that have been well documented include the disseminated, subcutaneous, intravenous, and medication-induced (for example, retinoid, antiretroviral, and oncologic agent) subtypes. Removal of pyogenic granuloma is indicated to alleviate any bleeding, discomfort, cosmetic distress, and diagnostic uncertainty. A number of malignant tumors may clinically mimic pyogenic granuloma, making histopathologic confirmation important if the presentation is atypical. Aside from cutaneous and oral lesions, pyogenic granuloma has been reported throughout the gastrointestinal tract and upper airway, at various ocular locations, the central nervous system, the bladder, and the internal vasculature. This article discusses only cutaneous and oral involvement.
Chronic myeloid leukaemia is a common malignancy worldwide. We have come a long way from the limited treatment options and survival in this condition. Today, CML is a treatable malignancy with more than 80% patients surviving beyond 10 years after diagnosis, in absence of complications. This presentation deals with the definition, diagnostic criteria of chronic phase, accelerated and blastic phase (MD Anderson cancer centre, International bone marrow transplant registry and the WHO for the latter two) and management (first and second generation tyrosine kinase inhibitors) of this condition. Finally, a stepwise approach to chronic myeloid leukaemia is also presented including the definitive modality of treatment, allogeneic stem cell transplantation.
PARASITE REMOVED FROM THE EYEBALL OF A YOUNG N, NOT FOR THE SCREAMISH!Loa Loa worms (also known as the "eye worm") are classified as filarial worms, meaning they thrive in human tissue. The Loa Loa worm is also called the "eye worm" because they often migrate through the eye and surrounding subsurface areas. At one time, prior to the 1920s, loa loa worm infections occurred in the United States. Today, however, they mainly infect people who are native to Sudan, and those who live in or near Central and West Africa's swamps and rain forests.
Loiasis is the infestation of loa loa worms in humans. The larvae are first collected from an infected individual when a mango fly (horsefly) or a deer fly bites the individual, and acquires the larvae. The larvae then progress through the fly's body, finally reaching the feeding tube. They are then transferred to a human host when the fly bites the human. The larvae may remain unnoticed for months or years before becoming an adult, mating, and producing offspring.
Adult female Loa Loa worms can reach a length of 2 1/2 inches while males are approximately half that size. Loa Loa worms can live approximately fifteen years inside their human hosts. They travel continuously through connective and deep tissue, often without the victim experiencing any sensation other than occasional itching.
It is when the worm slows or reaches a sensitive spot that a person will often feel the greatest discomfort. At this point, immune reactions may also include localized redness and a condition called "Calabar" swelling. Skin eruptions and muscle pain may be evident.
When the Loa Loa worm reaches the eye tissue, it can be easily seen and felt within the eyeball for up to an hour. It is usually removed under local anesthesia if the patient is within proximity of a qualified physician. When an adult worm dies, the surrounding tissue may abscess and require excision. Encephalitis can occur if the worm reaches the brain.
After mating, the female will deposit eggs - called microfilariae. These tiny organisms then travel in a worm-like fashion in the bloodstream during daytime hours, when potential host flies are most abundant. They congregate in the lungs at night.
A Loa Loa worm infection is rarely fatal and treatments often cause more life-threatening side effects than the actual infestation, especially if the worms are widespread. The most common treatments are DEC (diethylcarbamazine) and Ivermectin
Wash your hands thoroughly with soap and water before and after treating the wound. Wash the area with mild soap and running water to reduce the risk of infection. Pat dry. Apply antibiotic ointment and cover with a clean bandage or sterile dressing. Antibiotic prophylaxis should be considered, especially if there is a high risk of infection, such as with cat bites, with puncture wounds, with wounds to the hand, and in persons who are immunosuppressed. Amoxicillin/clavulanate is the first-line prophylactic antibiotic.
Massive bone defects (>8 cm) will not unite without an additional intervention. They require a predictable, durable, and efficient method to regrow bone. The Ilizarov method of tension stress, or distraction osteogenesis, first involves a low-energy osteotomy1 - 5. The bone segments are then pulled apart, most often using an external device at a specific rate and rhythm (distraction phase), after which the newly formed bone (the regenerate) requires time for consolidation. The consolidation phase is variable and usually requires a substantially greater amount of time before the external device can be removed. Our technique of tibial bone transport over an intramedullary nail using cable and pulleys combines internal and external fixation, allowing the external fixator to be removed at the end of the distraction phase. This increases the efficiency of limb reconstruction and decreases the external-fixator-associated complications.
There are a number of different causes of vertigo. Vertigo can be defined based upon whether the cause is peripheral or central. Central causes of vertigo arise in the brain or spinal cord while peripheral vertigo is due to a problem within the inner ear. The inner ear can become inflamed because of illness, or small crystals or stones found normally within the inner ear can become displaced and cause irritation to the small hair cells within the semicircular canals, leading to vertigo. This is known as benign paroxysmal positional vertigo (BPPV).
Endotracheal intubation is a medical procedure in which a tube is placed into the windpipe (trachea) through the mouth or nose. In most emergency situations it is placed through the mouth. Whether you are awake (conscious) or not awake (unconscious), you will be given medicine to make it easier to insert the tube. After endotracheal intubation, you will likely be placed on a breathing machine. If you are awake after the procedure, your health care provider may give you medicine to reduce your anxiety or discomfort.
This medical 3D animation exhibit shows the left brachial plexus during birth and shoulder dystocia. Anatomy: symphysis pubis, uterus, sacrum, coccyx and fetus. "McRoberts Position". An episiotomy is cut. Brachial Plexus stretch injury. Retraction of head (turtle sign). Suprapubic pressure, gentle traction. To view our medical library of exhibits,