Medicine With Sid

07/11/2025

Petechial Spots is a sign of platelet type of bleeding disorder

Based on size,various types of bleeding spots classified as:

Petechiae: < 2 mm

Purpura: 2 mm – 1 cm

Ecchymosis: > 1 cm

30/10/2025

FALSE LOCALISING SIGN IN NEUROLOGY

This patient has been diagnosed as a case of viral meningoencephalitis

Note the Left sided LR palsy

It is due to the involvement of the 6th Cranial Nerve,which has the longest intracranial course.

Hence it is susceptible to compression or stretching in conditions with raised ICP

As the ICP gradually decreases, the palsy usually recovers spontaneously.

Therefore, 6th nerve palsy due to raised ICP is considered a false localising sign in neurology — it reflects raised ICP rather than a true focal lesion at the nerve nucleus.

28/10/2025

*DVT Treatment Summarised*

•Normal renal function → NOAC preferred

•Mild–moderate renal impairment (eGFR 30–50) Apixaban preferred (least renal clearance)

•Renal dysfunction or ESRD → Warfarin

•Provoked → 3 months
Unprovoked → extended duration

27/10/2025

Management of *Gout in CKD* for GPs

27/10/2025

🧠 Ventriculomegaly on NCCT Brain

1️⃣ Ventricular Dilatation

Frontal horn width > 30 mm (normal ≤ 25 mm)

Evans index > 0.3
→ (Maximum width of frontal horns ÷ maximal internal skull diameter)

2️⃣ Temporal Horn Dilatation

Early and sensitive sign of hydrocephalus

Even mild ballooning suggests increased intraventricular pressure

3️⃣ Rounding of Frontal Horns

Normally slit-like; become rounded or ballooned in ventriculomegaly

NCCT Brain of TB Meningitis patient

Image 1: Shows the Evan's Index and Rounding of Frontal Horns

Image 2: Temporal Horn Dilatation

26/10/2025

Management of *GOUT IN CKD* for GPs

•Acute Attack-

Prednisolone(preferred)>Colchicine

Avoid NSAID

•Prophylaxis

Urice Acid Lowering Therapy(ULT)

Allopurinol(preferred)>Febuxostat

Remember risk of SJS with Allopurinol

Use Colchicine for initial 3-6months after starting ULT

To know in details click on this link of my youtube channel

24/10/2025

Can you say which stage of AML causes this typical Gingival Hypertrophy?

🦷 Etiology of Gingival Hypertrophy

1. Inflammatory causes

Chronic gingivitis due to poor oral hygiene → plaque accumulation

Periodontitis

Secondary infection (bacterial, fungal, viral)

2. Drug-induced

Anticonvulsants → Phenytoin (most classic)

Calcium channel blockers → Nifedipine, Amlodipine, Verapamil

Immunosuppressants → Cyclosporine

(Less commonly: Valproate, Phenobarbital)

3. Hormonal

Puberty → increased s*x hormones enhance gingival response to plaque

Pregnancy → “pregnancy gingivitis”

Oral contraceptive use

4. Nutritional deficiency

Vitamin C deficiency (Scurvy) → swollen, bleeding gums

5. Systemic diseases

Leukemia (esp. AML, ALL) → infiltration of leukemic cells into gingiva

Granulomatous diseases (sarcoidosis, Wegener’s, Crohn’s)

6. Idiopathic or Hereditary

Hereditary gingival fibromatosis → dense, fibrous, noninflammatory overgrowth

7. Local irritants

Dental plaque, ill-fitting restorations, orthodontic appliances, or mouth breathing

23/10/2025

Hypocalcemia is common in CKD

But when we find Hypercalcemia in CKD,think of the following

Mnemonic: “THIC” causes of hypercalcemia in CKD

T – Tertiary hyperparathyroidism

H – High calcium intake / binders

I – Iatrogenic vitamin D (calcitriol, alfacalcidol)

C – Cancer / calcitriol-producing granulomas

14/09/2020

26 y/o female has undergone CBD exploration and Laparoscopic Cholecystectomy for Choledocolithiasis

T-Tube Cholangiogram was done post operation
And this was the finding.

Irregular filling defect at the lower end of CBD

09/08/2020

Severe Respiratory Distress in a 3month old baby.

07/08/2020

https://youtu.be/sPcv0uZBNH4

COVID 19 Antigen Rapid Testing Video Demonstration.

This video demonstrates how clinicians test for COVID 19 Antigen by the help of Rapid Test Kits. Hope you like the video!!