Dr-Lokku: Recent Posts

ranga0007 on "Sleep time & BP"

ranga0007 — Thu, 19 Nov 2009 18:40:44 +0000

This is a strictly Clinical case Mr.Abilash ...does he have a history of chest pain or heart disease ...If so Please consult a good Cardiologist in ur own locality and Find out his Cholesterol profiles , ECG , Serum Creatinine and CK-MB levels too.....U shud Strictly follow the cardiologist advice ....there is no Gold standard treatment For a chest pain xcept for Nitroglycerine ....................... Regards Dr.Lokku

abilashr on "Sleep time & BP"

abilashr — Tue, 10 Nov 2009 07:16:59 +0000

My dad had a irritation near the heart for the last 3 days... and went for checkup today. His BP was found to be 160/110 and Doctor advised to get admitted. He was working fine and even drove his car to the hospital for checkup. He finds keeping the hand near his chest comfortable. What do you suggest for him?

ranga0007 on "What am I suffering from ?"

ranga0007 — Sat, 17 Oct 2009 07:42:06 +0000

Yes ur rite it is a Heat prickle most probably . U Need to to apply ABSORB powder twice daily morning after Bath and At Night B4 sleeping . I advice u to wear loose clothes and No Underwear when ur Out of work .Please mention me any History of sexual encounters in the New city and in the past 3 months... <h3>METHOD</h3> After Takin Bath in the Morning U can apply the Powder all over the Groin region and not on the Penis. U can apply it anyno: OF TIMES U WANT BUT U SHOULD MAKE SURE THAT PLACE IS CLEAN ....Sexual intercourse for a period of 1 week can be prohibhited since u have a higher chance of Spreading and encountering new infections ...... During night time plz apply soap and wash the region and then apply the powder ..... PLz make sure that if the same problem persists then it is something to do with sexually transmitted diseases (following u had a recent encounter in past 3 months )..............THANKU with Regards Dr-Lokku

mydummyprofile on "What am I suffering from ?"

mydummyprofile — Fri, 16 Oct 2009 06:33:43 +0000

I have moved to a new city and I saw few strange things on my scortal sacs. I am afraid what is this.Can anyone tell me what am i suffering from.Is it just a heat prickle ??

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 08 Oct 2009 03:58:04 +0000

No Actually Mr.Pinastro i think Dr.Praveen needs more posts to be a Moderator here and he is busy for a while Updating his knowledge Regards Drlokku

pinastro on "Thyroid Anatomy"

pinastro — Sun, 20 Sep 2009 05:13:10 +0000

nice work

pinastro on "Thyroid Anatomy"

pinastro — Tue, 15 Sep 2009 03:26:02 +0000

Nice Doctor, this could have been a blog ...why put it on a discussion forum ?? but nice job..keep the engine running..people are reading these forums for sure

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:10:50 +0000

<h2>Innervattion </h2> Principal innervation of the thyroid gland derives from the autonomic nervous system. Parasympathetic fibers come from the vagus nerves, and sympathetic fibers are distributed from the superior, middle, and inferior ganglia of the sympathetic trunk. These small nerves enter the gland along with the blood vessels. Autonomic nervous regulation of the glandular secretion is not clearly understood, but most of the effect is postulated to be on blood vessels, hence the perfusion rates of the glands.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:08:42 +0000

Inferior thyroid artery and recurrent laryngeal nerve The inferior thyroid artery arises from the thyrocervical trunk, a branch of the subclavian artery. It ascends vertically and then curves medially to enter the tracheoesophageal groove in a plane posterior to the carotid sheath. Most of its branches penetrate the posterior aspect of the lateral lobe (see Image 3). The inferior thyroid artery has a variable branching pattern and is closely associated with the recurrent laryngeal nerve. The latter also ascends in the tracheoesophageal groove and enters the larynx between the inferior cornu of the thyroid cartilage and the arch of the cricoid. The recurrent laryngeal nerve can be found after it emerges from the superior thoracic outlet, in a triangle bounded laterally by the common carotid artery, medially by the trachea, and superiorly by the thyroid lobe. The relationship between the nerve and the inferior thyroid artery is highly variable, as demonstrated by the classic work of Reed, who in 1943 described 28 variations in this relationship. The nerve can be found deep to the inferior thyroid artery (40%), superficially (20%), or between branches of the artery (35%).1 Significantly, the relationship between nerve and artery on one side of the neck is similar to that found on the other side in only 17% of the population. Furthermore, at the level of the inferior thyroid artery, branches of the recurrent laryngeal nerve that are extralaryngeal may be present (5%). Preservation of all those branches is important during thyroidectomy.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 07:08:08 +0000

<h2>Vascular Anatomy and Relation with Laryngeal Innervation</h2> The arterial supply to the thyroid gland comes from the superior and inferior thyroid arteries and, occasionally, the thyroidea ima. These arteries have abundant collateral anastomoses with each other, both ipsilaterally and contralaterally. The thyroid ima is a single vessel, which originates, when present, from the aortic arch or the innominate artery and enters the thyroid gland at the inferior border of the isthmus. Superior thyroid artery and superior laryngeal nerve The superior thyroid artery is the first anterior branch of the external carotid artery. In rare cases, it may arise from the common carotid artery just before its bifurcation. The superior thyroid artery descends laterally to the larynx under the cover of the omohyoid and sternohyoid muscles. The artery runs superficially on the anterior border of the lateral lobe, sending a branch deep into the gland before curving toward the isthmus where it anastomoses with the contralateral artery

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 06:44:01 +0000

<h2>Structure</h2> Under the middle layer of deep cervical fascia, the thyroid has an inner true capsule, which is thin and adheres closely to the gland. Extensions of this capsule within the substance of the gland form numerous septae, which divide it into lobes and lobules. The lobules are composed of follicles, the structural units of the gland, consisting of a layer of simple epithelium enclosing a colloid-filled cavity. This colloid (pink on hematoxylin and eosin [H&E] stain) contains an iodinated glycoprotein, iodothyroglobulin, a precursor of thyroid hormones. Follicles vary in size, depending upon the degree of distention, and they are surrounded by dense plexuses of fenestrated capillaries, lymphatic vessels, and sympathetic nerves. Epithelial cells are of 2 types: principal cells (ie, follicular) and parafollicular cells (ie, C, clear, light cells). Principal cells are responsible for formation of the colloid (iodothyroglobulin), whereas parafollicular cells produce the hormone calcitonin, a protein central to calcium homeostasis. Parafollicular cells lie adjacent to the follicles within the basal lamina.

ranga0007 on "Thyroid Anatomy"

ranga0007 — Fri, 11 Sep 2009 06:26:35 +0000

The thyroid is a brownish-red and highly vascular gland located anteriorly in the lower neck, extending from the level of the fifth cervical vertebra down to the first thoracic. The gland varies from an H to a U shape and is formed by 2 elongated lateral lobes with superior and inferior poles connected by a median isthmus (with an average height of 12-15 mm) overlying the second to fourth tracheal rings. The isthmus is encountered during routine tracheotomy and must be retracted (superiorly or inferiorly) or divided. Occasionally, the isthmus is absent, and the gland exists as 2 distinct lobes. Each lobe is 50-60 mm long, with the superior poles diverging laterally at the level of the oblique lines on the laminae of the thyroid cartilage. The lower poles diverge laterally at the level of the fifth tracheal cartilage. Thyroid weight varies but averages 25-30 g in adults (slightly heavier in women). The gland enlarges during menstruation and pregnancy. A conical pyramidal lobe often ascends from the isthmus or the adjacent part of either lobe (more often the left) toward the hyoid bone, to which it may be attached by a fibrous or fibromuscular band, the levator of the thyroid gland. Remnants of the thyroglossal duct may persist as accessory nodules or cysts of thyroid tissue between the isthmus and the foramen caecum of the tongue base. The development of the thyroid is beyond the scope of this article but is discussed elsewhere in this journal. Usually, 2 pairs of parathyroid glands lie in proximity to the thyroid gland. Anatomy and development of these glands are also discussed in the eMedicine article Embryology of the Thyroid and Parathyroids.

pinastro on "Cholelithiasis - Gall Stones"

pinastro — Sat, 01 Aug 2009 11:58:56 +0000

Dr. Praveen I see very less posts from you these days ?? why don't you try blogging ?? Pinastro

pinastro on "Cholelithiasis - Gall Stones"

pinastro — Sat, 01 Aug 2009 11:57:53 +0000

Dear Lokka You have been doing amazing stuff on discussion panel.I feel you can do equally amazing blogging. Thanks Pinastro

DR.PRAVEEN on "Cholelithiasis - Gall Stones"

DR.PRAVEEN — Sat, 01 Aug 2009 11:14:56 +0000

yes, dr. loga. this is a awe some material. it will be very useful for the medical students, they can copy it for the 10 mark question. day by day your knowledge is becoming wiser. take care

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:39:50 +0000

Treatment Surgery Mostly first duct method ....Previously done in open and nowadays its Laproscopic Surgery . see this<li><a href="http://www.youtube.com/watch?v=ycvwAfx3yF0" rel="nofollow">http://www.youtube.com/watch?v=ycvwAfx3yF0</a></li>

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:37:42 +0000

<h3>Prevention of gallstones </h3> It would be better if gallstones could be prevented rather than treated. Prevention of cholesterol gallstones is feasible since ursodiol, the bile acid medication that dissolves some cholesterol gallstones, also prevents them from forming. The difficulty is identifying a group of individuals who are at high risk for developing cholesterol gallstones during a relatively short period of time so that the duration of preventive treatment can be limited. One such group is obese individuals losing weight rapidly with very low calorie diets or with surgery. The risk of gallstones in this group is as high as 40%-60%. In fact, ursodiol has been shown in several studies to be very effective at preventing gallstones in these individuals

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:36:22 +0000

<h2>How are gallstones diagnosed? </h2> Gallstones are diagnosed in one of two situations. * The first is when there are symptoms or signs that suggest gallstones, and the diagnosis of gallstones is being pursued. * The second is coincidentally while a non-gallstone-related medical problem is being evaluated. 1)Ultrasonography 2)Endoscopic ultrasonography 3)Magnetic resonance cholangio-pancreatography (MRCP) 4)Cholescintigraphy (HIDA scan) 5)Endoscopic retrograde cholangio-pancreatography (ERCP) 6)Liver and pancreatic blood tests 7)Duodenal biliary drainage<img src="http://http://images.medicinenet.com/images/illustrations/gallstones.jpg">

ranga0007 on "Cholelithiasis - Gall Stones"

ranga0007 — Thu, 30 Jul 2009 17:33:25 +0000

<h3>What are gallstones?</h3> <img src="http://http://images.medicinenet.com/images/illustrations/gallstones.jpg"> Liver stones are called Gallsones ...mostly in the Gall bladder and hence the name. Gallstones usually form in the gallbladder; however, they also may form anywhere there is bile; in the intrahepatic, hepatic, common bile, and cystic ducts. Gallstones also may move about within bile, for example, from the gallbladder into the cystic or common duct. <h3>Types of Gall stones and its causes ..</h3> Cholesterol gallstones 1)Cholesterol gallstones are made primarily of cholesterol. They are the most common type of gallstone, comprising 80% of gallstones in individuals from Europe and the Americas. Cholesterol is one of the substances that liver cells secrete into bile. (Secretion of cholesterol into bile is an important way in which the liver eliminates excess cholesterol from the body.) In order for bile to carry cholesterol, the cholesterol must be dissolved in the bile. Cholesterol is a fat, however, and bile is an aqueous or watery solution; fats do not dissolve in watery solutions. In order to make the cholesterol dissolve in bile, the liver also secretes two detergents-bile acids and lecithin-into the bile. These detergents, just like dish-washing detergents, dissolve the fatty cholesterol so that it can be carried by bile through the ducts. If the liver secretes too much cholesterol for the amount of bile acids and lecithin it secretes, some of the cholesterol does not dissolve. Similarly, if the liver does not secrete enough bile acids and lecithin, some of the cholesterol also does not dissolve. In either case, the undissolved cholesterol sticks together and forms particles of cholesterol that grow in size and eventually form larger gallstones. There are two other processes that promote the formation of cholesterol gallstones though neither process is able to cause cholesterol gallstones by itself. The first is abnormally rapid formation and growth of cholesterol particles into gallstones. Thus, with the same concentrations of cholesterol, bile acids and lecithin in their bile, patients with gallstones form particles of cholesterol more rapidly than individuals without gallstones. The second process that promotes the formation and growth of gallstones is reduced contraction and emptying of the gallbladder that allows bile to sit in the gallbladder longer so that there is more time for cholesterol particles to form and grow. 2)Pigment gallstones Pigment gallstones are the second most common type of gallstone. Although pigment gallstones comprise only 15% of gallstones in individuals from Europe and the Americas, they are more common than cholesterol gallstones in Southeast Asia. There are two types of pigment gallstones 1) black pigment gallstones, and 2) brown pigment gallstones. Pigment is a waste product formed from hemoglobin, the oxygen-carrying chemical in red blood cells. The hemoglobin from old red blood cells that are being destroyed is changed into a chemical called bilirubin and released into the blood. Bilirubin is removed from the blood by the liver. The liver modifies the bilirubin and secretes the modified bilirubin or into bile. 3)Others: types of gallstones. Other types of gallstones are rare. Perhaps the most interesting type of gallstone is the gallstone that forms in patients taking the antibiotic, ceftriaxone (Rocephin). Ceftriaxone is unusual in that it is eliminated from the body in bile in high concentrations. It combines with calcium in bile and becomes insoluble. Like cholesterol and pigment, the insoluble ceftriaxone and calcium form particles that grow into gallstones. Fortunately, most of these gallstones disappear once the antibiotic is discontinued; however, they still may cause problems until they disappear. Another rare type of gallstone is formed from calcium carbonate. <h3>Who is at risk for gallstones?</h3> 1. Gender. Gallstones form more commonly in women than men. 2. Age. Gallstone prevalence increases with age. 3. Obesity. Obese individuals are more likely to form gallstones than thin individuals. 4. Pregnancy. Women who have been pregnant are more likely to form gallstones than women who have not been pregnant. Pregnancy increases the risk for cholesterol gallstones because during pregnancy, bile contains more cholesterol, and the gallbladder does not contract normally. 5. Birth control pills and hormone therapy The increased levels of hormones caused by either treatment mimics pregnancy. 6. Rapid weight loss. Rapid weight loss by whatever means, very low calorie diets or obesity surgery, causes cholesterol gallstones in up to 50% of individuals. Many of the gallstones will disappear after the weight is lost, but many do not. Moreover, until they are gone, they may cause problems. 7. Crohn's disease. Individuals with Crohn's disease of the terminal ileum are more likely to develop gallstones. Gallstones form because patients with Crohn's disease lack enough bile acids to solubilize the cholesterol in bile. Normally, bile acids that enter the small intestine from the liver and gallbladder are absorbed back into the body in the terminal ileum and are secreted again by the liver into bile. In other words, the bile acids recycle. In Crohn's disease, the terminal ileum is diseased. Bile acids are not absorbed normally, the body becomes depleted of bile acids, and less bile acids are secreted in bile. There are not enough bile acids to keep cholesterol dissolved in bile, and gallstones form. 8. Increased blood triglycerides. Gallstones occur more frequently in individuals with elevated blood triglyceride levels. <h3> What are the symptoms of gallstones?</h3> * dyspepsia (including abdominal bloating and discomfort after eating), * intolerance to fatty foods, * belching, and * flatulence (passing gas or farting). * Biliary Colic <h3> What is Biliary Colic???</h3> The most common symptom of gallstones is biliary colic. Biliary colic is a very specific type of pain, occurring as the primary or only symptom in 80% of people with gallstones who develop symptoms. Biliary colic occurs when the extrahepatic ducts-cystic, hepatic or common bile-are suddenly blocked by a gallstone. (Slowly-progressing obstruction, as from a tumor, does not cause biliary colic.) Behind the obstruction, fluid accumulates and distends the ducts and gallbladder. In the case of hepatic or common bile duct obstruction, this is due to continued secretion of bile by the liver. In the case of cystic duct obstruction, the wall of the gallbladder secretes fluid into the gallbladder. It is the distention of the ducts or gallbladder that causes biliary colic. <h3> Characteristics of Biliary colic????</h3> * It is a constant pain, it does not come and go, though it may vary in intensity while it is present. * It lasts for 15 minutes to 4-5 hours. If the pain lasts more than 4-5 hours, it means that a complication - usually cholecystitis - has developed. * The pain usually is severe, but movement does not make the pain worse. In fact, patients experiencing biliary colic often walk about or writhe (twist the body in different positions) in bed trying to find a comfortable position. * Biliary colic often is accompanied by nausea. * Most commonly, biliary colic is felt in the middle of the upper abdomen just below the sternum. * The second most common location for pain is the right upper abdomen just below the margin of the ribs. * Occasionally, the pain also may be felt in the back at the lower tip of the scapula on the right side. * On rare occasions, the pain may be felt beneath the sternum and be mistaken for angina or a heart attack. * An episode of biliary colic subsides gradually once the gallstone shifts within the duct so that it is no longer obstructing. <h3>What are the complications of gallstones?</h3> 1)Cholecystitis - Cholecystitis means inflammation of the gallbladder. 2)Cholangitis - condition in which bile in the common, hepatic, and intrahepatic ducts becomes infected. 3)Gangrene- condition in which the inflammation of cholecystitis cuts off the supply of blood to the gallbladder. 4)Jaundice - condition in which bilirubin accumulates in the body. 5)Pancreatitis - inflammation of the pancreas. 6)Sepsis - condition in which bacteria from any source within the body, including the gallbladder or bile ducts, get into the blood stream and spread throughout the body. 7) A fistula - an abnormal tract through which fluid can flow between two hollow organs or between an abscess and a hollow organ or skin. 8) Ileus - condition in which there is an obstruction of flow of digesting food, gas, and liquid within the intestine. 9)Cancer of the gallbladder almost always is associated with gallstones, but it is not clear which comes first, that is, whether the gallstones precede the cancer and, therefore, could potentially be the cause of the cancer

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:29:59 +0000

Just a Video about Malignant Melanoma <a href="http://www.youtube.com/watch?v=PO_3fTjxeBY" rel="nofollow">http://www.youtube.com/watch?v=PO_3fTjxeBY</a>

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:27:16 +0000

<h2>Malignant Melanoma </h2> General Considerations Malignant melanoma is the leading cause of death due to skin disease. There were 55,000 cases of melanoma in the United States in 2004, with 7900 deaths. One in four cases of melanoma occur before the age of 40. Overall survival for melanomas in whites has risen from 60% in 1960–1963 to more than 85% currently, primarily due to earlier detection of lesions. Tumor thickness is the single most important prognostic factor. Ten-year survival rates—related to thickness in millimeters—are as follows: < 1 mm, 95%; 1–2 mm, 80%; 2–4 mm, 55%; and > 4 mm, 30%. With lymph node involvement, the 5-year survival rate is 30%; with distant metastases, it is less than 10%. More accurate prognoses can be made on the basis of site, histologic features, and gender of the patient. <h3>Clinical Findings </h3> Primary malignant melanomas may be classified into various clinicohistologic types, including lentigo maligna melanoma (arising on chronically sun-exposed skin of older individuals); superficial spreading malignant melanoma (two-thirds of all melanomas arising on intermittently sun-exposed skin); nodular malignant melanoma, acral-lentiginous melanomas (arising on palms, soles, and nail beds); malignant melanomas on mucous membranes; and miscellaneous forms such as amelanotic (nonpigmented) melanoma and melanomas arising from blue nevi (rare) and congenital nevi. <h3>Essentials of Diagnosis</h3> 1)May be flat or raised. 2)Should be suspected in any pigmented skin lesion with recent change in appearance. 3)Examination with good light may show varying colors, including red, white, black, and bluish. 4)Borders typically irregular <h3>Treatment</h3> Treatment of melanoma consists of excision. After histologic diagnosis, the area is usually reexcised with margins dictated by the thickness of the tumor. Thin low-risk and intermediate-risk tumors require only conservative margins of 1–3 cm. More specifically, surgical margins of 0.5 cm for melanoma in situ and 1 cm for lesions less than 1 mm in thickness are recommended. Sentinel lymph node biopsy (selective lymphadenectomy) using preoperative lymphoscintigraphy and intraoperative lymphatic mapping is effective for staging melanoma patients with intermediate risk without clinical adenopathy and is recommended for all patients with lesions over 1 mm in thickness or with high-risk histologic features. -Interferon and vaccine therapy may reduce recurrences in patients with high-risk melanomas. Referral of intermediate-risk and high-risk patients to centers with expertise in melanoma is strongly recommended. <h3>Regards Dr-Lokku</h3>

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:21:48 +0000

<h3>Seborrheic Keratoses</h3> Seborrheic keratoses are benign plaques, beige to brown or even black, 3–20 mm in diameter, with a velvety or warty surface . They appear to be stuck or pasted onto the skin. They are common—especially in the elderly—and may be mistaken for melanomas or other types of cutaneous neoplasms. Although they may be frozen with liquid nitrogen or curetted if they itch or are inflamed, no treatment is needed.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:09:29 +0000

<h3>Freckles & Lentigines</h3> Freckles (ephelides) and lentigines are flat brown spots . Freckles first appear in young children, darken with ultraviolet exposure, and fade with cessation of sun exposure. In adults, depending on the fairness of the complexion, flat brown spots (lentigines), often with sharp borders, gradually appear in sun-exposed areas, particularly the dorsa of the hands. They do not fade with cessation of sun exposure. They should be evaluated like all pigmented lesions: If the pigmentation is homogeneous and they are symmetric and flat, they are most likely benign. Solar lentigines, also called liver spots, can be treated with topical 0.1% tretinoin, tazarotene 0.1%, 2% 4-hydroxyanisole with tretinoin 0.01% (Solage), laser therapy, and cryotherapy.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:09:04 +0000

<h3>Blue Nevi </h3> Blue nevi are small, slightly elevated, and blue-black lesions. They are common in persons of Asian descent, and an individual patient may have several of them. If present without change for many years, they may be considered benign, since malignant blue nevi are rare. However, blue-black papules and nodules that are new or growing must be evaluated to rule out nodular melanoma.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:07:41 +0000

<h3>Congenital Nevi</h3> The management of small congenital nevi—less than a few centimeters in diameter—is controversial. The vast majority will never become malignant, but some experts feel that the risk of melanoma in these lesions may be somewhat increased. Since 1% of whites are born with these lesions, management should be conservative and excision advised only for lesions in cosmetically nonsensitive areas where the patient cannot easily see the lesion and note any suspicious changes. Excision should be considered for congenital nevi whose contour (bumpiness, nodularity) or color (different shades) makes it difficult for examiners to note early signs of malignant change . Giant congenital melanocytic nevi (> 5% body surface area [BSA]) are at greater risk for development of melanoma, and surgical removal in stages is often recommended

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 21:07:19 +0000

<h3>Atypical Nevi</h3> The term "atypical nevus" or "atypical mole" has supplanted "dysplastic nevus." The diagnosis of atypical moles is made clinically and not histologically, and moles should be removed only if they are suspected to be melanomas. Clinically, these moles are large ( 6 mm in diameter), with an ill-defined, irregular border and irregularly distributed pigmentation (see photograph). It is estimated that 5–10% of the white population in the United States has one or more atypical nevi. Studies have defined an increased risk of melanoma in the following populations: patients with 50 or more nevi with one or more atypical moles and one mole at least 8 mm or larger, and patients with a few to many definitely atypical moles. These patients deserve education and regular (usually every 6–12 months) follow-up. Kindreds with familial melanoma (numerous atypical nevi and a strong family history) deserve even closer attention, as the risk of developing single or even multiple melanomas in these individuals approaches 50% by age 50.

ranga0007 on "Interesting Dermatology Reads for Doctors"

ranga0007 — Fri, 24 Jul 2009 20:59:00 +0000

<h3>Melanocytic Nevi (Normal Moles)</h3> In general, a benign mole is a small (< 6 mm), well-circumscribed lesion with a well-defined border and a single shade of pigment from beige or pink to dark brown (see photograph). The physical examination must take precedence over the history, though a reliable history that a lesion has been present without change for decades is obviously a comfort.Moles have a normal natural history. In the patient's first decade of life, moles often appear as flat, small, brown lesions. They are called junctional nevi because the nevus cells are at the junction of the epidermis and dermis. Over the next 2 decades, these moles grow in size and often become raised, reflecting the appearance of a dermal component, giving rise to compound nevi. Moles may darken and grow during pregnancy. As white patients enter their seventh and eighth decades, most moles have lost their junctional component and dark pigmentation and undergo fibrosis or other degenerative changes. Still, at every stage of life, normal moles should be well-demarcated, symmetric, and uniform in contour and color.

ranga0007 on "Colon Cancer .."

ranga0007 — Fri, 24 Jul 2009 20:32:13 +0000

Some more details about colon cancer <a href="http://www.youtube.com/watch?v=YMB44VKKVLQ]null" rel="nofollow">http://www.youtube.com/watch?v=YMB44VKKVLQ]null</a>

ranga0007 on "Colon Cancer .."

ranga0007 — Fri, 24 Jul 2009 20:30:06 +0000

<h3>What is cancer?</h3> Cancer is a group of more than 100 different diseases. They affect the body's basic unit, the cell. Cancer occurs when cells become abnormal and divide without control or order. Like all other organs of the body, the colon and rectum are made up of many types of cells. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy. <h3> What is cancer of the colon and rectum?</h3> The colon is the part of the digestive system where the waste material is stored. The rectum is the end of the colon adjacent to the anus. Together, they form a long, muscular tube called the large intestine (also known as the large bowel). Tumors of the colon and rectum are growths arising from the inner wall of the large intestine. Benign tumors of the large intestine are called polyps. Malignant tumors of the large intestine are called cancers. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can be easily removed during colonoscopy and are not life-threatening. If benign polyps are not removed from the large intestine, they can become malignant (cancerous) over time. Most of the cancers of the large intestine are believed to have developed from polyps. Cancer of the colon and rectum (also referred to as colorectal cancer) can invade and damage adjacent tissues and organs. Cancer cells can also break away and spread to other parts of the body (such as liver and lung) where new tumors form. The spread of colon cancer to distant organs is called metastasis of the colon cancer. Once metastasis has occurred in colorectal cancer, a complete cure of the cancer is unlikely. <li><a href="http://images.medicinenet.com/images/ILLUSTRATIONS/colon_cancer.jpg" rel="nofollow">http://images.medicinenet.com/images/ILLUSTRATIONS/colon_cancer.jpg</a></li> <h3>Distribution </h3> Globally, cancer of the colon and rectum is the third leading cause of cancer in males and the fourth leading cause of cancer in females. The frequency of colorectal cancer varies around the world. It is common in the Western world and is rare in Asia and Africa. In countries where the people have adopted western diets, the incidence of colorectal cancer is increasing. <h3>What are the causes of colon cancer?</h3> Doctors are certain that colorectal cancer is not contagious (a person cannot catch the disease from a cancer patient). Some people are more likely to develop colorectal cancer than others. Factors that increase a person's risk of colorectal cancer include high fat intake, a family history of colorectal cancer and polyps, the presence of polyps in the large intestine, and chronic ulcerative colitis. <h3> What are the symptoms of colon cancer?</h3> Symptoms of colon cancer are numerous and nonspecific. They include fatigue, weakness, shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating. Other conditions such as irritable bowel syndrome (spastic colon), ulcerative colitis, Crohn's disease, diverticulosis, and peptic ulcer disease can have symptoms that mimic colorectal cancer. For more information on these conditions, please read the following articles: Irritable Bowel Syndrome, Ulcerative Colitis, Crohn's Disease, Diverticulosis, and Peptic Ulcer Disease. Colon cancer can be present for several years before symptoms develop. Symptoms vary according to where in the large bowel the tumor is located. The right colon is spacious, and cancers of the right colon can grow to large sizes before they cause any abdominal symptoms. Typically, right-sided cancers cause iron deficiency anemia due to the slow loss of blood over a long period of time. Iron deficiency anemia causes fatigue, weakness, and shortness of breath. The left colon is narrower than the right colon. Therefore, cancers of the left colon are more likely to cause partial or complete bowel obstruction. Cancers causing partial bowel obstruction can cause symptoms of constipation, narrowed stool, diarrhea, abdominal pains, cramps, and bloating. Bright red blood in the stool may also indicate a growth near the end of the left colon or rectum <h3> What tests can be done to detect colon cancer?</h3> Barium Enema Lower GI Colonoscopy USG ( to see metastasis to Lungs and Liver ) Chest Xray (Lungs and Liver) CAT Scan (Lungs ,Liver and Abdomen) CEA Carcino Embryonic Antigen <h3>Prevention is Better than Cure</h3> Unfortunately, colon cancers can be well advanced before they are detected. The most effective prevention of colon cancer is early detection and removal of precancerous colon polyps before they turn cancerous. Even in cases where cancer has already developed, early detection still significantly improves the chances of a cure by surgically removing the cancer before the disease spreads to other organs. Multiple world health organizations have suggested general screening guidelines. <h3>Treatment </h3> Chemotherapy Radiotherapy Surgery is the best treatment <h3> What does the future hold for patients with colorectal cancer? </h3> Colon cancer remains a major cause of death and disease, especially in the western world. A clear understanding of the causes and course of the disease is emerging. This has allowed for recommendations regarding screening for and prevention of this disease. The removal of colon polyps helps prevent colon cancer. Early detection of colon cancer can improve the chances of a cure and overall survival. Treatment remains unsatisfactory for advanced disease, but research in this area remains strong and newer treatments continue to emerge. New and exciting preventive measures have recently focused on the possible beneficial effects of aspirin or other anti-inflammatory agents. In trials, the use of these agents has markedly limited colon cancer formation in several experimental models. Other agents being evaluated to prevent colon cancer include calcium, selenium, and vitamins A, C, and E. More studies are needed before these agents can be recommended for widespread use by the public to prevent colon cancer. <h3>Regards Dr-Lokku</h3>

pinastro on "Lip Augmentation"

pinastro — Wed, 15 Jul 2009 16:27:47 +0000

strange !!!

pinastro on "testing the home page"

pinastro — Wed, 15 Jul 2009 16:26:20 +0000

home page testing

ranga0007 on "Typhoid fever"

ranga0007 — Tue, 14 Jul 2009 19:14:39 +0000

I think its a great chance for a Patient to have this Post regards dr-lokku

pinastro on "Typhoid fever"

pinastro — Tue, 14 Jul 2009 07:53:09 +0000

Nice presentation on Typhoid fever <img src="http://www.dwi.gov.uk/children/childrens/images/illustrations/child_typhoid.gif"> <h2><a href="http://www.slideshare.net/crisbertc/typhoid-fever-presentation" rel="nofollow">http://www.slideshare.net/crisbertc/typhoid-fever-presentation</a></h2>

pinastro on "A nice presentation on stress"

pinastro — Tue, 14 Jul 2009 07:39:38 +0000

<img src="http://www.positive-thinking-for-you.com/images/stress.gif"> <h2><a href="http://www.slideshare.net/dhinman/how-to-live-the-zen-life?src=related_normal&rel=1711904" rel="nofollow">http://www.slideshare.net/dhinman/how-to-live-the-zen-life?src=related_normal&rel=1711904</a></h2>

ranga0007 on "SeXXXology ...For All Medicos + Non-Medicos"

ranga0007 — Mon, 13 Jul 2009 19:31:36 +0000

<h3>PENILE TRAUMA</h3> Most of the time, this means surgery to fix the tunica albuginea (the broken membrane) and "save" erectile and urinary capabilities. If he doesn’t get examined, he could be left with a permanently curved johnson or some sort of erectile dysfunction. So what does this feel like for your man? Know that feeling when you accidentally slam your nether regions against the support bar of a “"boy-style" bicycle? According to Fulbright, way worse than that. Also something to think about—he may not be the only one injured. "If a man is 'banging' his partner vigorously enough to cause this kind of damage, then it's likely that the partner is being harmed in some way too," Fulbright says. “So simply saying something like 'Easy cowboy, neither one of us wants to get hurt' is a gentle way of saying 'Show some restraint.'"