On 15 May 2017, the Ministry of Health and Family Welfare-Government of India (MoHFW) reported three laboratory-confirmed cases of Zika virus disease in Bapunagar area, Ahmedabad District, Gujarat, State, India. The

61 years old male, admitted for cholecystectomy surgery tomorrow. He complained that there is black mole in his face for past 10-20 years, which caused no troubles. But since few months back, the mole in the right side of

2-3 yr old children H/O small amount of kerosine drink 30 minutes back what are the best treatment for these cases complications and preventive measures.

Verified response PERICARDIAL EFFUSION --- RULE OUT CARDIAC TAMPONADE, based upon presence of ?PULSUS PARADOX, & ECHOCARDIOGRAM revealing IVC compression during inspiration [ie: Tamponade Physiology]
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Diagnosis & Management

Verified response Exfoliative keratolysis. Characterized by recurrent focal palmar peeling. There is no exact cause. Predisposing factors are hot and summer weather, allergy, constant and excessive sweating of the hands, use of soap, detergents, exposure to salt water. Treatment : usually resolves by itself. Avoiding contact with irritants such as soaps, detergents and solvents. Relief from dryness and other symptoms of exfoliative can be achieved through application of emollients containing urea and lactic acid.
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Gradual progressive visual loss since 3 months. H/o of seasonal allergic rhinitis.

Verified response horner-tranta's spots in vernal keratoconjunctovitis topical steroids, mast cell stabilizers like sodium cromoglycate, antihistamines topical application of artificial tears.
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Around 30 years old female presented with complaints of sudden onset of severe headache, vomiting....no other symptoms or signs reported or noted. in past Hx nothing significant... CT scan s/o - supratentorial ventricular system including aqueduct of Sylvius are dilated with minimal periventricular ooze.

Verified response non communicating hydrocephalus. Rx-- Acetazolamide or mannitol treat underlying cause. ventriculoperitonial or ventriculocaval shunt.
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Findings please?

Verified response Heart rate approx 53bpm QRS Axis seems normal. P waves are seen and are positive in lead I,II, aVF, v4-v6 suggestive of Sinus origin.PR segment is almost 0.24 sec can be considered prolonged but some authors suggest more than 0.24 as prolonged. P waves are bit diminished. T waves are almost peaked with Narrow base in almost all leads especially in v2-v6. Poor R wave progression seen in Precordial leads. R wave is larger in v2 than v3 which is unusual maybe due to improper lead placement. In lead v4 and v5 there is sudden tall R wave aka Late Transition Which maybe due to clockwise rotation. It maybe due to- intraventricular conduction abnormalities secondary to myocardial degeneration right ventricular heart disease shift of the septum to the left dilated cardiomyopathy shift of the whole heart pulmonary emphysema vertical heart (usually thin and tall persons). ST segment elevation in lead v2-v5. QT/QTc is almost 400/376 msec i.e. more than 350 and is normal. History is important. According to the findings Sinus Bradycardia with Hyperkalemia and clockwise rotation is most probable Diagnosis. Rule out Electrolytes abnormalities. Also check Troponin.
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a 46 year old male c/o indigestion since past 6 months . consulted many physicians in past but there was no improvement in symptoms. finally he was refered to gastroentrologist and investigated.... kindly give your expert

Verified response Viral B Hepatitis with fatty liver and early Cirrhosis.
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28 year old male, known HIV who presented with black necrotic masses on the soles of his feet and papules around his mouth, oral ulcers and a mass on his left eyelid. Diagnosis? Management?

Verified response D/D: 1.kaposis sarcoma of foot caused by HHV-8 2.fungal infection since both are opportunistic infections in AIDS patient seen in mouth as well as foot it's better examine thoroughly & investigate properly.
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painless ,hard swelling in wrist...sudden onset, appeared after doing push-ups, more prominent on ulnar deviation.....your differentials please

Verified response Diagnosis: ganglion cyst it is usually cystic in consistency occurres due to synovial fluid leak into the out pouching of joint capsule or distended tendon sheath Treatment: 1.it's better to wait for spontaneous regression because aspiration or excision leads to recurrence rate about 50% 2.aspiration by hypodermic needle with corticosteroid injection into the evacuated cyst 3.cyst excision recurrence rate high
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