Ascitic Paracentesis : Practical Essentials

Absolute contraindications to Ascitic Tapping (Paracentesis) While some authors have claimed ascitic paracentesis to be free from absolute contraindications, others have listed following as absolute contraindications: Clinically evident fibrinolysis Disseminated Intravascular Coagulation (DIC) Clinically apparent oozing from needle sticks Acute abdomen requiring surgery Relative contraindications… Read More

Prescribing Opioids for Chronic Pain

Recommendations for Prescribing Opioid in Chronic pain 1. 1st line of therapy in chronic pain outside of active cancer, palliative or end of life care must be nonpharmacologic therapy and nonopioid pharmacologic. Consider opioid therapy in combination with nonpharmacologic or nonopioid pharmacologic therapy if benefits… Read More

Gower’s sign

Synonyms: Gower’s maneuver, Myopathic walking, Butt-first maneuver Identifying Gower’s sign To check for Gower’s sign, place the patient in the supine position and ask him to rise. A positive Gower’s sign – an inability to lift the trunk without using the hands and arms to… Read More


Synonyms Tache noire Definition of Eschar An eschar is a local skin lesions coated by a thick coagulated crust or slough that usually results from burn or infection. Causes of Eschar Tick bite fever Scrub typhus Anthrax Tularaemia Spider bites Disseminated fungal infection Post-burn Diagnostic… Read More

Lhermitte’s Sign

Synonym: Lhermitte’s phenomenon, Barber chair phenomenon Definition of Lhermitte’s Sign Lhermitte’s sign (pronounced Ler-meets) is an electric shock-like sensations, spreading along the spine in a cervico-caudal direction and into the arms and legs felt upon active or passive flexion of the neck. Reverse Lhermitte’s Sign… Read More