Interstitium is the scaffolding that supports the alveolar walls and surrounds both the alveoli and the terminal bronchioles. Neither alveoli nor interstitium is visible on a chest X-ray when normal. It is necessary to analyze whether the pattern of diffuse opacification in the lung field is alveolar or interstitial. Terms:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Systematic Approach to Frontal Chest X-ray
To make an appropriate diagnosis through a chest radiograph, it must be analyzed in a systematic manner. One of the common mistakes that students do is to miss the regions that needs to be looked for – commonest being the rib fractures. A mnemonic has been devised for this purpose:…
Clinical Skills and Approaches 
Pathological reflexes – Variations of Babinski
Normally, the pathological reflexes are not evident because they are suppressed by cerebrum at brainstem or spinal cord level by 6 months of age. Importance: Up-going (dorsiflexion) toe can be elicited at various sites and all indicated Upper Motor Neuron (UMN) lesion. Use a blunt-pointed object like fingernail or tip…
Emergency Medicine 
The Continuum: SIRS, Severe Sepsis and Septic Shock
SIRS criteria are mostly used as a screening tool to identify patients that may need further workup for sepsis and severe sepsis. In the emergency department it is a triage tool that helps determine patient acuity and identify patients that are potentially septic and in need of further screening. Septic…
Clinical Skills and Approaches 
Hematological Signs – Angular Stomatitis and Atrophic Glossitis
ANGULAR STOMATITIS/CHEILITIS Definition: Maculopapular and vesicular lesions grouped on the skin at the corners (or ‘angles’) of the mouth and the mucocutaneous junction. It is made worse by licking the lips. Causes: 1. Oral candidiasis 2. Poorly fitting dentures 3. Bacterial infection 4. Less common Nutritional deficiencies (especially riboflavin, iron and pyridoxine) Iron…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Strawberry Gallbladder (Cholesterolosis)
Synonyms: Strawberry gallbladder is also known as hyperplastic cholecystoses. Hyperplastic cholecystoses are a spectrum of non-neoplastic proliferative disorders caused by deposition of cholesterol-laden macrophages within the wall of the gall bladder. The cholecystose range from abnormalities of the gallbladder wall (adenomyomatosis and strawberry gall bladder) to gallbladder polyps extending into…
Clinical Skills and Approaches 
Dermatology Internship : 5 Common Skin Diseases Seen
Amidst the post-earthquake fear, we managed to complete our 15 days internship in the Dermatology department which was setup in the patient’s waiting hall. The posting went pretty well; the learning experience was fun – thanks to the teachers and seniors who provided us with friendly environment and guidance. A…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Cutaneous manifestation in thyroid disorders
Skin – Systemic Disease Connection “When a man has on the skin of his body a swelling or an eruption… and the disease appears to be deeper than the skin it is a leprous disease.” – Leviticus 13: 2-3 In ancient times changes in skin were taken to indicate the…