VOMITING IN CHILDREN When we say vomiting in children, we usually have parents who would come and tell us that “my child is vomiting”. We need to spend little more time to ask few more questions – can it be vomiting or retching or nausea? After you ask these questions, you’ll realize that in most condition our patient may have all three of them. But it will help us to differentiate one over the other, in some of the rare cases. In vomiting, we’ve forceful expulsion of gastric contents due to abdominal and diaphragmatic contraction. In case of nausea, vomitus doesn’t come out and there’s an unpleasant feeling and autonomic changes which precede vomiting and the patients complaints of excessive salivation and difficulty in breathing just prior to nausea feeling. In pediatrics, we need to differentiate between vomiting and regurgitation. We should understand that if the child throws up without or minimal effort then its always Regurgitation; but if its forceful then it is vom...
Posts
Telephonic consultation(orthopedic cases)
TELEPHONIC CONVERSATION WITH PATIENTS IN ORTHOPEDICS “Listen to the patient, he is telling you the diagnosis.” Though in the field of medicine, telephonic consultation is avoided; but what if the patient trust us and calls to tell his problem; being physicians we should be ready for whatever case comes to us in which ever form. This article is based on how the physician has to ask the patient so as to reach to a conclusion for his diagnosis in orthopedics. CASE – 1 A 78-year old female, who probably slipped and had on the floor on the hips; presently suffers from severe pain in abdomen and the back region. She has been helped by her son to get up and walked till the bed. Now her son calls the doctor and asks his help. Did u support her fully or she managed to walk on her own to bed? No, she managed on her own, only initially we supported her. Now when she is lying on bed, can she turn or having difficulty to get up? S...
Eponymous fractures of Lower limb
EPONYMOUS FRACTURES (LOWER LIMB) LOWER LIMB FRACTURES Jefferson Fracture- It generally occurs at C1 vertebra; it occurs by compression of neck. Hangman’s Fracture- In this both pedicles of C2 over C3 fractures; mainly occurs due to distraction and extension of neck. Clay-Shoveler’s Fracture- It’s a stable fracture and involves lower spine of cervical and upper thoracic ( C6 or C7). Its an injury of spinous process of lower cervical spine. Chance Fracture- It’s a very common fracture which occurs due to hyperflexion of spine (seen in car accidents). There is compression injury to anterior portion of vertebral body. Duverney’s Fracture- It’s a pelvic fracture involving iliac wings. This fracture doesn’t interfere with the main pelvic ring. Malgaigne’s Fracture- Its also referred as Supra-condylar fracture of humerus. In this sacro-iliac joint along with pubic rami gets injured, compressing the pelvis front to back. ...
Eponymous fractures of Upper limb
EPONYMOUS FRACTURES (UPPER LIMB) Mostly the medical students find it difficult to remember the fractures names especially for their exams, so here are some key features to remember the main eponymous fractures which would ease the problem. UPPER LIMB FRACTURES Bankart’s Fracture- Bankart in 1938 described anterior tear of glenoid labrum as Bankart’s lesion. It’s the most common lesion associated with recurrent dislocation of shoulder which is a common complication of shoulder dislocation in young people and the corresponding bony fracture of the same area is called bankart’s fracture. Hill-Sach’s Fracture- It’s a fracture involving postero-lateral aspect of the head of humerus with depression in the anterior shoulder dislocation. Remember – if there is anterior shoulder dislocation then postero-lateral shoulder affected; and when posterior dislocation is present then antero-medial shoulder affected . Holstein-Lewis Fracture- Humerus ca...