Saturday, October 2, 2010
Lets pay tribute to a wonderful man whom without we as a country will never exist today but instead of many indipendent nations.He joined the freedom struggles of each region of this country and our neghbouring countries which were taking place at different scales in every kingdom and region into a pan-indian or should i say greater indian freedom struggle.Even after india got independence when the remaining parts of india that joined later like Goa were still being occupied by foreign occupiers ,it was his followers-as he died due to an unfortunate event by unfortunate people -who joined with the freedom fighter of goa to help us gain our freedom. Gandhi ji as true saint was a human and not supernatural as most expect him to be. He not only helped unify the greater India freedom movement into a truly pan-indian movement but also set the ball rolling by providing inspiration to leaders elsewhere in the world like the Great "Martin Luther King Juior"
and the Great "Nelson Mandela ". his principles are worth knowing about for becoming a better human being.
Friday, October 1, 2010
ACUTE DYSPNOEA DUE TO SUB CARINAL LYMPH NODE COMPRESSION AND ACUTE MYOCARDIAL INFARCTION PRESENTING AT THE SAME TIME
a 50 year old man presented with acute onset shortness of breath since last 5 days which was associated with central chest discomfort for the first 2-3 days. The shortness of breath became agravated intermittently,mainly after prolonged lying down, got relief within a few minutes after sitting up.He had mild cough and was febrile initially.He had no past history of hypertension or diabetes.He had a past history of pulmonary TB which was adequately treated. He was a non smoker and coal miner by occupation. His investigations revealed TLC-14300,n82,L16,E2,ESR65,fbs105,ppbs176,urea41,cr1.6.His troponin T was positive. His chest xray pa view revealed an illdefined rounded mass in left upper lobe and left lateral view revealed a subcarinal rounded mass. CT chest and upper abdomen showed a large calcified mass in left upper lobe of lung and left lobe of liver. There was also a large subcarinal lymph node and bilateral emphysematous changes.We plan to do a bronchoscopy followed by trans bronchial needle aspiration of the subcarinal node to reach a final tissue diagnosis.
A 60 year old non diabetic,hypertensive female presented with acute onset breathlessness.Her ECG showed antero lateral infarction,CXR-classical bats wing pattern,TROP-T was positive and her CPK-MB was 120 u/l.
She was managed with iv streptokinase,nitroglycerine,diuretics,oxygen,aspirin,clopidogrel and atorvastatin and she recovered within 4-5 days.