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Sukhakarta clinic and hospital, nimgav sava tal junnar, Pune (2026)

26/12/2025

‣ A 10-vear-old girl presented with a gradually progressing lesion extending across her anterior neck.

‣ The lesion appeared before 2 vears as an asymptomatic reddish plaque over the right side of the neck. No history of trauma at the site of lesion or any systemic complaints was reported

Examination

▪️A well-defined erythematous, scaly, indurated, 10 cm x 1 cm linear plaque with serpiginous borders was observed. It extended from one side of the neck to the other and was associated with ulceratior and crusting over the right edge.
▪️Multiple discrete, firm, freely mobile cervical and supraclavicular lymph nodes of size varying from 1-1.5 cm were present

Microscopy and Culture Findings

▪️Hematoxylin and eosin staining showed thinning of epidermis, presence of multiple epithelioid cell granulomas with Langhan's giant cells along with few foci of caseous necrosis in dermis

▪️Staining for acid-fast bacilli and mycobacterial culture was negative

22/12/2025

《Types of Blood Transfusion》

1️⃣ Whole Blood Transfusion

Contains RBCs, plasma, platelets
Uses: acute massive blood loss, trauma (rarely used now)

2️⃣ Component Blood Transfusion (Most Common)

A) Packed Red Blood Cells (PRBCs)
Increases oxygen-carrying capacity
Uses: anemia, acute blood loss

B) Platelet Transfusion
Random donor platelets / Single donor platelets
Uses: thrombocytopenia, platelet dysfunction

C) Fresh Frozen Plasma (FFP)
Contains clotting factors
Uses: coagulopathy, liver disease, DIC

D) Cryoprecipitate
Rich in fibrinogen, factor VIII, vWF
Uses: hypofibrinogenemia, hemophilia A

3️⃣ Exchange Transfusion

Patient’s blood replaced with donor blood
Uses: hemolytic disease of newborn, severe jaundice

4️⃣Autologous Transfusion

Patient’s own blood
Uses: planned surgeries
Advantage: no transfusion reaction

5️⃣Directed Donor Transfusion

Blood from a specific donor (relative/friend)
Rarely recommended

6️⃣ Massive Transfusion

Replacement of ≥1 blood volume in 24 hrs
Used in major trauma, obstetric hemorrhage

7️⃣Therapeutic Plasma Exchange
(Plasmapheresis)

Plasma removed and replaced
Uses: TTP, myasthenia gravis, Guillain-Barré

22/12/2025

Scabies 🐛

《Scabies (खाज रोग)》

Scabies is a highly contagious parasitic skin infestation caused by the mite Sarcoptes scabiei var. hominis.

《Cause》

●Female mite burrows into the stratum corneum

●Lays eggs → hypersensitivity reaction → itching

《Mode of Transmission》

🟠Prolonged skin-to-skin contact
Sexual contact

🟠Sharing clothes, bedding, towels (less common)

《Clinical Features》

Severe itching, worse at night 🌙

Burrows: thin, wavy, grayish lines

Papules, vesicles, nodules

Secondary bacterial infection due to scratching

《Common Sites》

Finger web spaces

Flexor aspect of wrist

Elbow

Axilla

Umbilicus

Genitalia (p***s, sc***um)

Buttocks

In infants: scalp, face, palms, soles

《Types》

Classic scabies

Crusted (Norwegian) scabies – immunocompromised

Nodular scabies

Infantile scabies

《Diagnosis》

Clinical features

Skin scraping → mite/eggs/fecal pellets

Dermoscopy (delta wing sign)

《Treatment》

First-line
Permethrin 5% cream
Apply neck to toe
Leave for 8–12 hours
Repeat after 7 days
Alternatives
Benzyl benzoate 25%
Sulfur ointment 5–10%
Ivermectin (oral) – severe/crusted
scabies

《Supportive Care》

Antihistamines for itching
Antibiotics if secondary infection
Treat all close contacts simultaneously

《Prevention》

Wash clothes & bedding in hot water
Sun-dry or iron clothes
Avoid close contact until treatment completed

21/12/2025

Never Get menstrual cram again and again ‼️
Pain gone naturally ‼️

Vitamin D3 and Magnesium Intake
Vitamin D3 (cholecalciferol) plays a vital role in maintaining bone health by regulating calcium and phosphorus absorption from the intestine. Adequate Vitamin D3 levels are essential for proper bone mineralization, muscle strength, and immune function. Deficiency of Vitamin D3 can lead to rickets in children and osteomalacia or osteoporosis in adults. The main source of Vitamin D3 is sunlight exposure, while dietary sources include fortified milk, egg yolk, and fatty fish. The recommended daily intake for adults is about 600–800 IU, depending on age and clinical condition.
Magnesium is an essential mineral involved in more than 300 enzymatic reactions in the body. It is important for muscle contraction, nerve conduction, cardiac rhythm, and energy metabolism. Magnesium also plays a crucial role in the activation of Vitamin D; without adequate magnesium, Vitamin D supplementation may be less effective. Dietary sources of magnesium include nuts, seeds, whole grains, green leafy vegetables, and legumes. The recommended daily intake for adults is approximately 300–420 mg.
Adequate intake of both Vitamin D3 and magnesium is important for optimal bone health, neuromuscular function, and prevention of metabolic and skeletal disorders.

20/12/2025

🩸 Blood Collection Tubes – Color Code Guide

🔴 Red Top
Additive: None / Clot activator
Use: Serum tests
Tests: LFT, RFT, Lipid profile, Serology

🟡 Yellow / Gold Top (SST)
Additive: Clot activator + Gel separator
Use: Serum separation
Tests: Biochemistry, Hormones

🟣 Lavender / Purple Top
Additive: EDTA
Use: Hematology
Tests: CBC, Hb, ESR (automated), Blood grouping

🔵 Light Blue Top
Additive: Sodium citrate
Use: Coagulation studies
Tests: PT, INR, APTT

🟢 Green Top
Additive: Heparin
Use: Plasma chemistry
Tests: ABG, Electrolytes, Ammonia

⚫ Black Top
Additive: Sodium citrate (3.8%)
Use: ESR
Tests: ESR (Westergren method)

⚪ Grey Top
Additive: Sodium fluoride + Potassium oxalate
Use: Glucose preservation
Tests: FBS, PPBS, GTT, Lactate

🟠 Orange Top
Additive: Thrombin
Use: Rapid serum tests
Tests: STAT biochemistry

🟤 Royal Blue Top
Additive: None / EDTA / Heparin
Use: Trace elements
Tests: Zinc, Copper, Heavy metals

🩷 Pink Top
Additive: EDTA
Use: Blood bank
Tests: Cross-matching, Blood grouping

📝 Order of Draw (Important for Exams)
Blood culture
Light blue
Red / Yellow
Green
Lavender / Pink
Grey

20/12/2025

IV Cannula – All Numbers (Sizes) & Uses 💉
IV cannula अलग-अलग color & gauge (number) में होती है। हर size का अपना specific use होता है:

🟠 Orange
14G
Major trauma, massive blood loss, rapid blood transfusion

⚪ Grey
16G
Emergency, surgery, blood transfusion, fluids fast देना

🟢 Green
18G
Blood transfusion, IV fluids, antibiotics

🟣 Pink
20G
Most commonly used – IV fluids, drugs, blood

🔵 Blue
22G
Children, elderly, thin veins, slow IV drugs

🟡 Yellow
24G
Neonates, infants, very fragile veins

🟤 Brown
26G
Premature babies, scalp vein, NICU use

🔑 याद रखने का आसान तरीका
Number कम = Cannula मोटी = Flow ज्यादा
Number ज्यादा = Cannula पतली = Flow कम

📌 Clinical Tips

Emergency / Blood → 14G / 16G
Routine IV / Ward patient → 18G / 20G
Pediatric / Geriatric → 22G / 24G
NICU → 24G / 26G

Kiran Bhangare

20/12/2025

⚜️PEEL AWAY IMPERFECTIONS⚜️

●LIGHTEN UNWANTED PIGMENT AND EVEN OUT SKIN TONE

●DIMINISH FINE LINES & WRINKLES
ILL

●BRIGHTEN AND SMOOTH OUT ROUGH SKIN

●INCREASE COLLAGEN & ELASTIN

●LIGHTEN ACNE BLEMISHES AND PREVENT FUTURE BREAK OUTS

18/12/2025

Anemia – Simple Explanation

Anemia is a condition in which the blood has low hemoglobin or fewer red blood cells, so the body does not get enough oxygen.

---

🔹 Common Causes

Iron deficiency (most common)

Vitamin B12 or folic acid deficiency

Blood loss (heavy periods, bleeding piles, ulcers)

Chronic diseases (kidney disease, infections)

Bone marrow problems

Genetic causes (thalassemia, sickle cell anemia)

---

🔹 Symptoms

Fatigue, weakness

Pale skin

Shortness of breath

Dizziness or headache

Palpitations

Cold hands and feet

Hair fall (common in iron deficiency)

---

🔹 Types of Anemia

Iron deficiency anemia

Megaloblastic anemia (B12 / folate deficiency)

Hemolytic anemia

Aplastic anemia

Anemia of chronic disease

---

🔹 Diagnosis

CBC (Complete Blood Count)

Hemoglobin level

Peripheral smear

Serum iron, ferritin

Vitamin B12 & folate levels

---

🔹 Treatment

Iron tablets or injections

Vitamin B12 / folic acid supplements

Treat underlying cause (bleeding, infection)

Blood transfusion (in severe cases)

---

🔹 Prevention

Iron-rich diet: green leafy vegetables, dates, jaggery, meat

Vitamin C improves iron absorption

Regular health check-ups

18/12/2025

Common catheters used in medical practice 🏥

1. Urinary Catheters

Foley catheter – Most common; indwelling urinary catheter

Nelaton (Straight) catheter – For short-term bladder drainage

Condom catheter – External catheter for males

Suprapubic catheter – Inserted directly into bladder through abdomen

2. Vascular Catheters

IV cannula (Peripheral venous catheter) – For fluids, drugs

Central venous catheter (CVC) – For ICU care, TPN, CVP monitoring

PICC line – Long-term IV therapy

Arterial catheter – BP monitoring, ABG sampling

3. Gastrointestinal Catheters

Ryle’s tube (NG tube) – Feeding, gastric decompression

PEG tube – Long-term enteral feeding

Re**al tube – Decompression, medication

4. Respiratory Catheters

Endotracheal tube – Airway management

Tracheostomy tube – Long-term airway support

Suction catheter – Airway clearance

5. Drainage Catheters

Intercostal drainage (ICD) tube – Pneumothorax, pleural effusion

Pigtail catheter – Abscess or fluid drainage

JP drain – Post-surgical drainage

6. Special Catheters

Swan-Ganz catheter – Pulmonary artery pressure monitoring

Dialysis catheter – Hemodialysis access

Ureteric catheter – Urinary tract procedures

18/12/2025

1. Nasal Feeding Tubes (Short-term use)

🔹 Nasogastric (NG) tube

From nose → stomach

Most common

Short-term feeding (≤ 4–6 weeks)

🔹 Nasojejunal (NJ) tube

From nose → jejunum

Used in pancreatitis, gastric motility problems

🔹 Nasoduodenal (ND) tube

From nose → duodenum

Less commonly used

---

2. Oral Feeding Tubes (Infants mainly)

🔹 Orogastric (OG) tube

From mouth → stomach

Used in neonates and infants

---

3. Gastrostomy Tubes (Long-term use)

🔹 Gastrostomy (G-tube)

Directly into stomach through abdomen

For long-term feeding

🔹 Percutaneous Endoscopic Gastrostomy (PEG)

Endoscopic method of G-tube insertion

Most common long-term tube

---

4. Jejunostomy Tubes

🔹 Jejunostomy (J-tube)

Directly into jejunum

Used when stomach feeding is contraindicated

🔹 PEG-J tube

PEG with extension into jejunum

---

5. Special Feeding Tubes

🔹 Button tube (Low-profile gastrostomy)

Cosmetic, comfortable

Used in children & adults

17/12/2025

🫟टेनिया पेडिस, किंवा अथलीट फूट,🫟

हा पायांचा एक सामान्य, संसर्गजन्य बुरशीजन्य🧫 त्वचेचा संसर्ग आहे ज्यामळे पायाच्या बोटांच्या दरम्यान किवा तळव्यावर लाल खाज सूटणारी, खडबडीत किंवा भेगा पडणारी त्वचा उद्भवत, जी सहसा सामुदायिक शॉवर 🚿किंवा घामाने भरलेल्या 👞सारख्या उबदार. ओलसर वातावरणात वाढते. यावर स्थानिक अँटीफंगल (क्रीम. पावडर) वापरून उपचार केले जातात आणि पाय पूर्णपणे कोरडे करून आणि श्वास घेण्यायोग्य पादत्राणे घालून ते द्रर ठेवले जाते, जर्र गंभीर प्रकरणांमध्ये तोंडावाटे औषधांची आवश्यकता असू शकते

लक्षणे

🔅बोटांच्या मध्ये किंवा तळव्यावर खाज सुटणे, डंक येणे किंवा जळजळ होणे
🔅लाल, पापुद्रा किवा सोललेली त्वचा
🔅 लहान फोड किंवा वेदनादायक फोड, कधीकधी पू सह
🔅विशेैषतः बोटांच्या मधल्या भागात, त्वचेतून पाणी येणे किंवा भेगा पडणे.

《कारणे आणि जोखीम घटक》

🔅बुरशी:
ट्रायकोफायटन प्रजातींसारखे डर्माटोफाइट्स

🔅पर्यावरणः
उबदार, ओलसर जागा (शॉवर, स्विमिंग पूल ओले मोजे)

🔅संसर्गः
सार्वजनिक ठिकाणी अनवाणी चालणे, टॉवेल।बूट शेअर करणे
🔅घटक:
जास्त घाम येणे, घट्ट बूट, मधुमह, कमकुवत रोगप्रतिकारक शक्ती.

《उपचार》

🔰ओदहर-द-काउंटरः अँटीफंगल क्रीम. स्प्रेकिंवा पावडर उदा.. टेरबिनाफाइन, मायकोनाझोल). ४

🔰 प्रिस्क्रिप्शन: संसर्गासाठी अधिक मजबूत स्थानिक किंवा तोंडी अँटीफंगल.

🔰घरची काळजी: पाय कोरडे ठेवा, दररोज मोजे बदला श्वास घेण्यायोग्य शूज घाला.

Kiran bhangare Following Payal Walekar - Gode Ajay Walekar Ajinkya Gadge

17/12/2025

■Tinea pedis, commonly known as athlete's foot,

is a fungal infection that primarily affects the skin on the feet. It's caused by dermatophytes, a group of fungi that thrive in warm, moist environments.

Tinea Pedis is most often caused by dermatophytes, such as *Trichophyton*, *Epidermophyton*, and *Microsporum*. These fungi grow well in damp, warm environments, such as those found in sweaty shoes or locker rooms.

Tinea pedis is highly contagious and can spread through direct contact with infected skin or surfaces, such as gym floors, swimming pool decks, or shared showers. It can also spread indirectly through contaminated towels, socks, or footwear.

Sukhakarta clinic and hospital

26/12/2025

22/12/2025

22/12/2025

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20/12/2025

20/12/2025

20/12/2025

18/12/2025

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18/12/2025

17/12/2025

17/12/2025

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