Necrotizing fasciitis can be misdiagnosed in about 75% of the cases in the intial stage of the disease. The most consistent feature of early necrotizing fasciitis is the pain out of proportion to swelling or erythema. Other features helping to differentiate from other soft tissue infections are: Tenderness extending beyond…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Kanavel Sign for Pyogenic Flexor Tenosynovitis
1. Exquisite tenderness over the course of the sheath, limited to the sheath Present in 64% cases Late sign of proximal extension of pyogenic tenosynovitis Most important sign as described by Kanavel 2. Flexion of the finger (‘hook’ sign) Present in 69% cases 3. Exquisite pain on extending the finger,…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Portal Vein : Tributaries and Portocaval Anastomoses
Origin: Hepatic Portal Vein is formed by the union of Splenic vein and Superior mesenteric Vein behind the neck of pancreas at L1 vertebral level. Termination: The portal vein terminates by branching into right branch (entering right lobe of liver) and left branch entering (left lobe of liver). Parts: Tributaries: Points to…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Cellulitis Assessment : Mnemonic
Cellulitis is a rapidly spreading acute inflammation with infection of skin and subcutaneous tissue that spreads widely through tissue spaces. It is commonly caused by either Streptococcus pyogenes or Staphylococcus aureus. Erysipelas is a superficial form of cellulitis involving lymphatics; it has a peau d’orange appearance and a sharp border. It characteristically appears on the face. Since,…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Bisphosphonate Pharmacology
Classification Non-nitrogen containing (1st generation): Etidronate Clodronate Tiludronate Nitrogen containing (2nd and 3rd generation): a. 2nd generation (alky-amino nitrogen containing): Pamidronate Alendronate Ibadronate Olpadronate b. 3rd generation (heterocyclic nitrogen containing): Risedronate Zoledronate Chemical structure Stable derivatives of inorganic pyrophosphate (PPi) Mechanism of action Strong attachment to hydroxyapatite mineral found in…
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The 5 Most Ridiculous Claims About COVID-19
Anytime there is a new sickness going around, rumors and false claims start to get out of hand. Fake cures, bad advice, and outrageous claims are incredibly common, especially with the sheer amount of disinformation on the web. COVID-19 is the newest conspiracy theory magnet, so we documented the five…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Nail Bed Injuries : Van Beek Classification and Management
Clinically, the Van Beek classification system denominates 5 principal nail bed injuries, subclassified by location within the nailbed (involving either the sterile and/or germinal matrix, respectively) and the extent of injury. Germinal Matrix Injury GI: Small subungual hematoma proximal nail (<25%) GII: Germinal matrix laceration, large subungual hematoma (>50%) GIII:…
Surgical Skills
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Surgical Sutures – Basics
Monofilament Polyfilament Absorbable Caprosyn (Polyglytone 621)Monocryl (Polyglecaprone 25)Biosyn (Polyglecaprone CV-23)Maxon (Polytrimethylate carbon)PDS (Polydiaxonone) CatgutVicryl rapide (Polyglactin 910 rapide)Vicryl (Polyglactin 910)Dexon (Polyglycolic acid) Non-absorbable NylonEthilon (Monofilament polyamide)Prolene (Polypropylene) SilkDacronEthibond (Polyester)Braided nylon (Surgilon, Nurolon)Supramid Monofilament sutures: Polyfilament/Multifilament sutures: Natural sutures: Synthetic sutures: Absorbability: There are 2 principal methods, by which the sutures…