A Case of Lightening Strike
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A 50-year-old male was admitted to the hospital unconscious after being struck by lightning while working in a field during a rainy day. Upon examination, he had linear lacerations on his chest and groin. Brain imaging showed bilateral cerebral infarctions. He regained consciousness but had difficulty speaking and walking at first. He was discharged after 3 weeks without neurological deficits. The lightning strike caused superficial skin lacerations, loss of consciousness, bilateral brain infarcts, and transient ECG changes but no long-term effects.
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ect is the only therapy which was practiced in the ancient times .after that medicines have come. now it has wide variety of tequniques which is very common and came in to practice .
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The key features are: temperature >40C, rigidity, autonomic dysregulation. This describes malignant hyperthermia, which requires immediate dantrolene and external cooling. Acetaminophen would not be appropriate initial therapy.
spinal cord anushka.pptx - BY ANUSHKA - MBBS 1ST YR
spinal cord anushka.pptx - BY ANUSHKA - MBBS 1ST YR -----THANKS - JOIN US
Role of ECT in psychiatry
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Entrapment neuropathies
1) Entrapment neuropathies occur when nerves are injured by chronic compression, angulations, or stretching forces, causing mechanical damage. Carpal tunnel syndrome is an example where the median nerve is compressed as it passes through the wrist.
2) Clinical features of entrapment neuropathies include pain, numbness, tingling, burning, and weakness in the affected area. Electrodiagnostic tests like nerve conduction studies and electromyography are important diagnostically.
3) Treatment involves conservative measures like splinting, steroid injections, and physical therapy. Surgery is considered if conservative treatment fails or for severe cases. Proper identification of the site of nerve entrapment is key to determining appropriate treatment
Carpal tunnel Syndrom Wesam Aljabali -1.pdf
Carpal tunnel syndrome occurs when the median nerve becomes compressed at the wrist, causing numbness, tingling, and weakness in the hand. It is often caused by repetitive wrist motions combined with anatomical factors. Diagnosis involves physical exams and electrodiagnostic tests, with severity graded on nerve conduction studies. Initial treatment involves splinting and medications, while surgery is considered if symptoms persist. The most common surgical technique is endoscopic carpal tunnel release, with rehabilitation focusing on scar management, range of motion exercises, and strengthening. Full recovery can take 3-6 months as the nerve heals.
Penetratingtrauma
1. Penetrating trauma from stab or gunshot wounds can cause significant damage depending on the velocity and mass of the projectile. High velocity weapons like rifles cause more tissue damage than low velocity knives or pellet guns.
2. Upon impact, the projectile transfers kinetic energy to the tissues, causing direct damage along its path. It also creates shock waves and temporary and permanent cavitation that damages a wider area beyond the direct path.
3. Evaluation and management of penetrating trauma depends on the location and severity of injuries. Unstable patients with signs of blood loss or organ injury usually require immediate surgical exploration while stable patients can undergo further diagnostic testing and observation.
Spinal cord injury
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Electrical Burn.pptx
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spinal cord injury ppt
this slide contain introduction, definition, indication, types, risk factor, causes, pathophysiology, clinical manifestation , types, diagnostic evaluation, management - emergency, medical, nursing, treatment.
Similar to A Case of Lightening Strike (20)
spinal cord anushka.pptx - BY ANUSHKA - MBBS 1ST YR
spinal cord anushka.pptx - BY ANUSHKA - MBBS 1ST YR
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A 22-year-old male presented with jaundice, fatigue, and muscle pain for 6 months. Liver tests showed elevated bilirubin, AST, and prolonged PT/INR, suggesting a chronic liver disease. A 19-year-old female with history of chicken pox 8 months ago developed jaundice. Liver tests showed direct hyperbilirubinemia, elevated AST and markedly elevated ALP, indicating a cholestatic picture with ongoing activity. A 32-year-old alcoholic male with known cirrhosis showed mild elevation of AST and direct hyperbilirubinemia, with AST/ALT ratio of 3:1, consistent with alcoholic liver disease with ongoing activity.
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Imaging: Cortical Vein Thrombosis
A 35-year-old male chronic alcoholic presented with a week-long headache and blurry vision. On examination, he had right lateral rectus palsy. CT brain showed hyperdensity in the right frontal region, right transverse sinus, and hypodensity in the superior sagittal sinus, suggestive of parenchymal hemorrhage with cortical vein thrombosis or calcified granuloma. MRI brain found a hemorrhagic lesion in the right high parietal lobe, absence of flow voids in sinuses, and T1 hyperintensity in sinuses confirming sinus thrombosis, which was shown on MR venography. The patient was diagnosed with cerebral vein thrombosis based on imaging findings.
ECG: Findings in CNS disorders
A 73-year-old male presented with left upper and lower limb weakness. He has a history of diabetes and hypertension. On examination, his pulse was 64 beats/min, blood pressure was 160/100 mmHg, and he had left-sided hemiplegia. An ECG showed normal sinus rhythm, prolonged QT interval of 500ms, and deep anterolateral T wave inversions, which could be due to central nervous system involvement or myocardial ischemia. ECG findings associated with acute central nervous system disorders include prolonged QT interval and deeply inverted T waves in precordial leads.
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
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A Case of NASH with HYPOTHYROIDISM
This document presents the case of a 37-year-old woman admitted with abdominal distension and pain for 3 months. Her history and examination findings revealed hepatomegaly, splenomegaly, fatty liver, and hypothyroidism. Laboratory tests showed anemia and elevated liver enzymes. Imaging confirmed hepatosplenomegaly with fatty liver. She was diagnosed with non-alcoholic steatohepatitis (NASH), pre-obesity, hypothyroidism, and nutritional anemia. Literature discussed in the document suggests an association between hypothyroidism and NASH, as well as hypothyroidism contributing to anemia in some patients. The patient was treated and showed improvement in
IMAGING: NEUROCYSTICERCOSIS
A 16-year-old boy was admitted with abnormal movements of his left thumb and left eyelid for over 1 hour. MRI scans showed lesions in his brain consistent with neurocysticercosis. Neurocysticercosis is caused by the pork tapeworm Taenia solium and has four pathogenic stages seen on imaging. The patient's symptoms, travel history, imaging findings, and positive blood tests confirmed a diagnosis of neurocysticercosis. He was treated with anti-seizure medications, anti-parasitic drugs, and steroids to reduce inflammation from degenerating parasites.
ECG: Digitalis Effect / MAT / AF
A 41-year-old female presented with breathlessness, palpitations, and chest pain for 3 days. She has a history of valvular heart disease surgery 14 years ago. On examination, she was dyspneic, tachycardic, and had pedal edema. ECG showed atrial fibrillation with a rate of 160 beats/minute. Echocardiogram revealed moderate mitral stenosis and mild tricuspid regurgitation with enlarged left atrium and moderate mitral annular calcification. The patient was diagnosed with atrial fibrillation likely due to rheumatic heart disease.
Imaging: BOOP
A 28-year-old male presented with cough, dyspnea, fever, malaise, and weight loss. Chest X-ray and CT scan showed bilateral heterogeneous airspace opacities. He did not improve with antibiotics but responded well to steroids, suggestive of idiopathic bronchiolitis obliterans organizing pneumonia (BOOP). BOOP is a non-specific inflammatory reaction of small airways that can be idiopathic or secondary to various causes. It is treated with steroids and immunosuppressants if unresponsive to steroids.
ECG: Hypokalemia
1. A 52-year-old male presented with loose stools and vomiting for 4 days. Examination found hypokalemia.
2. ECG showed ST segment depression in V3-V6 and prominent U waves, consistent with changes seen in hypokalemia.
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A Case of Schmidt Syndrome
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A Case of Rodenticide Poisoning
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A Case of Emphysematous Pylonephritis
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Imaging: Multiple Pulmonary Cavitary Lesions
A 38-year-old male smoker presented with swelling all over the body for the past 4 months. Examination revealed pitting pedal edema. Investigations showed elevated ESR, CRP and P-ANCA positivity. CT scan showed multiple cavitary lung lesions. A diagnosis of Wegener's granulomatosis was made based on clinical features, lab investigations and radiological findings.
ECG: Atrial Dissociation
This ECG shows atrial dissociation in a 70-year-old male with a history of hypertension, coronary artery disease, and cardiac transplantation 6 months prior. Atrial dissociation is seen as two independent sets of P waves with varying PP and PR intervals. Atrial dissociation occurs when each atrium beats separately due to blockage of the Bachmann's bundle interatrial pathway. It can occur in orthotopic and heterotopic heart transplant patients as the posterior atrial wall is retained but denervated after orthotopic transplant.
A Case of Hepato-Pulmonary Syndrome
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A Case of Thalassemia
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A Case of Renal Amyloidosis
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CXR: Silico-Tuberculosis
A 52-year-old female patient presented with complaints of breathlessness and dry cough for the past 6 months. She has a history of treated pulmonary tuberculosis 3 years ago and treated Pott's spine 2 years ago. Examination revealed wheezing and generalized pigmentation. Chest X-ray showed bilateral lung parenchymal lesions and hilar lymph node calcifications. The final diagnosis was occupational lung disease of silicosis complicated by silicotuberculosis due to exposure to silica particles in her work in sand filtration for brick production.
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