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Delayed puberty is defined as the absence of any signs suggestive of puberty by 14 years of age. In this case, the patient's pubertal delay appears to be constitutional because of his positive family history, absence of syndromic features or systemic illness, and bone age of 12 years. Puberty correlates more closely with bone age than chronological age. On follow-up, the patient will most likely demonstrate a similar onset of puberty as his father.
Acute kidney injury is common entity in medical practice. The present definition is based on a serum creatinine rise of more 0.3 mg/dl in 48 hours or less, a 50% increase from the baseline over a period of 07 days or a urine output of less than 0.5 ml/kg/hour for more than 06 hours. The main causes of acute kidney injury may be classified into pre renal, intrinsic or post renal causes. Rapid diagnosis and prompt treatment is essential to prevent mortality or morbidity. This presentation discusses in detail the causes of all three mechanisms, pre-renal, post renal and intrinsic.
A detailed description of the approach to a use of bleeding disorders. This presentation includes the causes, history, clinical features and diagnosis of specific bleeding disorders. These include Haemophilia, DIC, Von Willebrand Disease and others. The final differentiation is often made on the basis of the Prothrombin Time, activated Partial thromboplastin time and platelet count.
Shoutout to director/videographer Valentina Vee and producer Sean Tien for helping me bring this to life.
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Plantar warts are hard, grainy growths that usually appear on the heels or balls of your feet, areas that feel the most pressure. This pressure also may cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by the human papillomavirus (HPV). The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet. Most plantar warts aren't a serious health concern and may not require treatment. But plantar warts can cause discomfort or pain. If self-care treatments for plantar warts don't work, you may want to see your doctor to have them removed.
Limbal dermoid is a congenital growth on the eye that forms from germline cells that get trapped in this region during embryogenesis. The dermoid often has tissue from multiple germ layers including hair and fat. Dermoids on the eye can cause astigmatism and be unsightly.
Indications for intervention in patients with a renal artery aneurysm (RAA) include the following [20, 8, 13, 14] : Rupture Symptomatic RAA - Hypertension (from associated renal artery stenosis, refractory to medical management), pain, renal ischemia or infarction secondary to embolization from the aneurysm sac RAAs in females who are pregnant or are contemplating pregnancy Diameter greater than 2 cm Enlarging RAA RAA associated with acute dissection Currently, there is no consensus regarding the size at which an RAA should be repaired in an asymptomatic patient. Experts have recommended RAA repair at diameters ranging from 1.5 to 3 cm, [8] though most suggest 2 cm. Some reports have even suggest that larger asymptomatic saccular aneurysms may be managed expectantly. Note that aneurysm rupture at a diameter of 1.5 cm has been reported. Complete calcification of the wall of the aneurysm sac manifests in about 40% of patients. This was once believed to confer protection against rupture [21] ; however, this belief has since been questioned. [30] Asymptomatic, small (<2 cm in diameter) RAAs do not usually require treatment. One notable exception is an RAA in a woman who is pregnant or contemplating pregnancy. In view of the increased risk of rupture in such cases, even small asymptomatic aneurysms should be repaired in this population. For diagnosis and preinterventional planning, gadolinium-enhanced magnetic resonance angiography (MRA) and computed tomography (CT) angiography (CTA) with three-dimensional (3D) reconstruction have essentially replaced conventional arteriography. Regular follow-up examination with ultrasonography (US) or CT) is recommended in patients who are treated expectantly. Spontaneous cure by thrombosis of small aneurysms has been described. Further refinements in endovascular techniques may allow more RAAs to be treated in this manner. So far, excellent short- and intermediate-term results have been described in the literature [40] ; however, there remains a need for further long-term outcome data.
A colonoscope is the special tool used to perform a colonoscopy. It is a thin, flexible, tubular ‘telescope’ with a light and video camera that your doctor carefully guides through your colon in order to see and determine the health of your colon. Watch this animation to learn about the features of the colonoscope, how the colonoscopy procedure is performed and how polyps are removed, and the follow-up care you and your doctor should talk about after your procedure.