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near death experience while light

Journey (Near Death Experience) : Poetry

August 17, 2014 – 2:40 pm |

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Blinding white light amidst silence
Her voice constantly echoed my name
In its serenity, slowly turning senseless
Waving goodbye, out of the body I came.

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CNS Examination : Meningeal signs

August 18, 2014 – 1:11 pm |

Meningitis refers to the inflammation of leptomeninges and underlying subarachnoid cerebrospinal fluid (CSF). Meningism or meningismus is a morbid state characterized by a meningitic syndrome (a triad of headache, photophobia and nuchal rigidity) without intracranial inflammation. Some authors, have also used the term “meningism” or “meningismus” to describe the characteristic signs of meningitis, which may be present in conditions other than meningitis. Apical pneumonia is an important cause of meningismus in children. If the signs of meningieal persists for >3 days into antibiotic therapy in meningitis or the initial CSF was not fully compatible with purulent bacterial meningitis, a parameningeal suppurative focus should be considered.

A. Nuchal rigidity:

  1. Relax the neck muscles by bringing the supine patient to the edge of the bed and allow the head to hang outside the bed for a few seconds.
  2. Place your hand under the supine patient’s head and gently try to flex the neck and touch the chin to chest.
  3. Undue resistance implies diffuse irritation of cervical nerve roots from meningeal inflammation.

signs of meningeal irritation

B. Kernig’s sign: Read the full story »

Practical Procedures : Lumbar Puncture (LP)

August 17, 2014 – 2:16 pm |
CSF analysis neonates

Synonyms: Spinal tap
Definition: Puncture of subarachnoid space in the lumbar region of the spinal cord to withdraw cerebrospinal fluid (CSF) for diagnostic or therapeutic purpose or inject drugs for anesthetic purpose.
A. Diagnostic:

CNS infections: Bacterial, viral, …

Vital Signs : Pulsus Paradoxus

August 15, 2014 – 11:58 am |
Pulsus paradoxus measurement clinical

Synonyms: Paradoxical pulse, Paradoxic pulse, Reversed Bernheim sign
Definition: There is normal physiological fall in Blood pressure upto 10 mmHg during inspiration. Pulsus paradoxus is the exaggeration of this normal decline in blood pressure more than …

Courvoisier’s law of Obstructive Jaundice

August 10, 2014 – 8:46 am |
Pancreas anatomy

Synonyms: Courvoisier’s sign, Courvoisier syndrome, Courvoisier-Terrier sign, Bard-Pic disease
Over years, the use of the term Courvoisier’s sign or gallbladder has been suggested instead of law, because of rising number of exceptions.
Eponymous to: Ludwig Courvoisier (1843-1918)
Definition: …

Approach to a Child with Edema

August 10, 2014 – 5:49 am |
diuretics mechanism

Before beginning the clinical approach to a child with edema, it is necessary to understand the basics of fluid compartments, starling forces and technique of eliciting edema.
Life threatening causes of Edema:

Cardiac disease

Congestive Heart Failure
Pericardial effusion

Renal …

Summary of Clinical Tests and Signs in Orthopedics

June 5, 2014 – 6:18 am |

Adson’s test: for thoracic outlet syndrome
Allen’s test: for testing patency of radial and ulnar arteries
Alli’s test: for DDH
Anvil test: for testing tenderness of the spine
Ape thumb: for median nerve injury
Apley’s grinding test: for meniscus injury
Apprehension …

Glaucoma basics : Classification of Glacuoma

June 4, 2014 – 2:44 pm |
open-closed angle glaucoma

Definition: Glaucoma is a group of disorders characterized by a progressive optic neuropathy resulting in a characterstic appearance of the optic disc and a specific pattern of irreversible visual field defects that are associated frequently but not invariably with raised intraocular …

Examination of Hip : Trendelenburg test or sign

June 4, 2014 – 7:52 am |
Trendelenburg sign test

Normal: When the body weight is supported on one limb, the abductors (gluteus medius and minimus) of the supported side contract and raise the opposite unsupported side of the pelvis.
Abnormal: If the abductor mechanism is …

Examination of Hip : Bryant’s triangle

June 4, 2014 – 7:30 am |
Bryant's triangle

Synonyms: Iliofemoral triangle
Position: The patient lies supine with the pelvis square, and the limbs in identical position.
Points of the Bryant’s triangle:
The Bryant’s triangle is a right angled formed by:

Anterior Superior Iliac Spine (ASIS)
Tip of Greater trochanter
Junction …

Pterygium Excision

June 2, 2014 – 8:19 am |
Pterygium excsion bare sclera

Indications for surgery:
1. Reduced vision secondary to:

Threatens visual axis: Pterygium advancing toward or already impinging visual axis
Induced astigmatism: Due to flattening of meridian of pterygium by fibrosis in atrophic stage

2. Cosmesis
3. Significant discomfort not relieved …

Thyroidectomy Basics

June 1, 2014 – 6:30 am |
Thyroidectomy procedure

Synonyms: Thyroid resection surgery, Thyroid removal surge
Definition: Thyroidectomy is the surgical removal of all or part of the thyroid gland. A “thyroidectomy” should not be confused with a “thyroidotomy” (“thyrotomy”), which is a cutting into the thyroid, to …