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IMedicals, Maryland, Enugu South, Enugu (2025)

18/01/2023

Wrist(Walker-Murdoch) and Thumb(Steinberg) sign

06/01/2023

Hydrocephalus can be defined broadly as a disturbance of formation, flow, or absorption of cerebrospinal fluid (CSF) that leads to an increase in volume occupied by this fluid in the CNS. This condition also could be termed a hydrodynamic disorder of CSF. Acute hydrocephalus occurs over days, subacute hydrocephalus occurs over weeks, and chronic hydrocephalus occurs over months or years. Conditions such as cerebral atrophy and focal destructive lesions also lead to an abnormal increase of CSF in CNS. In these situations, loss of cerebral tissue leaves a vacant space that is filled passively with CSF. Such conditions are not the result of a hydrodynamic disorder and therefore are not classified as hydrocephalus. An older misnomer used to describe these conditions was hydrocephalus ex vacuo.

Clinical features of hydrocephalus are influenced by the following:
* Patient's age
* Cause
* Location of obstruction
* Duration
* Rapidity of onset

03/01/2023

Deep venous thrombosis (DVT) is a manifestation of venous thromboembolism (VTE). Although most DVT is occult and resolves spontaneously without complication, death from DVT-associated massive pulmonary embolism (PE)

Deep venous thrombosis (DVT) and pulmonary embolism (PE) are manifestations of a single disease entity, namely, venous thromboembolism (VTE).

Signs and Symptoms
•Edema - Most specific symptom
•Leg pain - Occurs in 50% of patients but is nonspecific
•Tenderness - Occurs in 75% of patients
•Warmth or erythema of the skin over the area of thrombosis
•Clinical symptoms of PE as the primary manifestation

Complications
•As many as 40% of patients have silent PE when symptomatic DVT is diagnosed
•Paradoxic emboli (rare)
•Recurrent DVT
•Postthrombotic syndrome (PTS)

02/01/2023

Mucopolysaccharidoses type 1(Hunter syndrome)
The mucopolysaccharidoses (MPSs) are a family of metabolic disorders caused by deficiency of lysosomal enzymes needed to degrade glycosaminoglycans (GAGs), or mucopolysaccharides.

Mucopolysaccharidosis type I (MPS I) is the most common type of MPS. MPS I is heterogeneous, and symptom severity varies widely.

MPS I is now divided into two subtypes: severe MPS I and attenuated MPS I. Patients with severe MPS I typically have an earlier onset of symptoms, a decline in intellectual function, and a shorter lifespan.

Clinical presentation
•Facial dysmorphism or coarsened facial features
•Corneal clouding
•Visceral involvement
•Skeletal involvement
•Joint stiffness
•cardiopulmonary

Prognosis
MPS I-HS(Hurler Scheie syndrome) and MPS IS(Scheie syndrome) are considered attenuated forms. Symptoms tend to develop later in life, starting in the teenaged years and into the early third decade of life. Symptoms are milder than those observed in MPS IH (Hurler syndrome).

12/06/2022

Ramsay Hunt syndrome (herpes zoster oticus) occurs when a shingles outbreak affects the facial nerve near one of your ears. In addition to the painful shingles rash, Ramsay Hunt syndrome can cause facial paralysis and hearing loss in the affected ear.

Ramsay Hunt syndrome is caused by the same virus that causes chickenpox. After chickenpox clears up, the virus still lives in your nerves. Years later, it may reactivate. When it does, it can affect your facial nerves.

Prompt treatment of Ramsay Hunt syndrome can reduce the risk of complications, which can include permanent facial muscle weakness and deafness.

25/05/2022

Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and covers the white part of your eyeball. When small blood vessels in the conjunctiva become inflamed, they're more visible. This is what causes the whites of your eyes to appear reddish or pink.

Pink eye is commonly caused by a bacterial or viral infection, an allergic reaction, or — in babies — an incompletely opened tear duct.

Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, early diagnosis and treatment can help limit its spread.

21/05/2022

Cutis marmorata telangiectatica congenita (CMTC)

This is a rare congenital (present at birth)disorder characterized by discolored patches of skin caused by widened (dilated) surface blood vessels. As a result, the skin has a purple or blue “marbled” or “fishnet” appearance (cutis marmorata).

In some affected individuals, ulcerations or congenital skin defects (aplasia cutis) can be present. The latter association can be part of Adams-Oliver syndrome. Additional associated abnormalities have been reported including pink or dark red, irregularly shaped patches of skin (nevus flammeus); loss of muscle tissue (wasting) on one side of the body (hemiatrophy); elevated fluid pressure within the eye (glaucoma); and/or undergrowth (hypotrophy) of one leg.

However, many if not all of those cases represent forms of Klippel-Trenaunay syndrome or related disorders, in particular Cowden’s disease. The most common association of true CMTC is with soft tissue (subcutaneous fat and muscle) hypoplasia.

The disorder formerly known as macrocephaly-cutis marmoratatelangiectatica congenital (M-CMTC) is a distinct genetic disease and is now called macrocephaly-capillary malformation (M-CM/MCAP) Virtually all cases of CMTC occur randomly for no apparent reason (sporadically). It is thought that CMTC represents a form of genetic mosaicism.

19/05/2022

PROCESS OF CONCEPTION

Ovulation
Each month, one of a woman's two ovaries releases a mature egg in a process known as ovulation. Ovulation occurs about two weeks after the start of a woman's last menstrual period.

Moving Into the Fallopian Tube
The released egg travels into the Fallopian tube, where it is fertilized by a single s***m.

The S***m's Long Journey
When a man ej******es, 40 to 150 million s***m may be contained in the fluid. The s***m start swimming upstream in the women's reproductive tract toward the Fallopian tubes. The time it takes for s***m to reach an egg is very variable - some may reach their target in half an hour, while others may take days. S***m can live for up to 48 to 72 hours. Of the millions of s***m, only a few hundred even come close to the egg.

Fertilization: S***m Penetrates Egg
The process of fertilization takes about 24 hours. Once a s***m has penetrated the egg, the egg surface changes, preventing entry of other s***m. Fertilization completes the genetic makeup of the baby, including whether it will be a girl or boy.

The Cells Start to Divide
Once the egg is fertilized, a rapid process of division begins. The fertilized egg leaves the Fallopian tube and enters the uterus 3 to 4 days after fertilization. A tubal or ectopic pregnancy results in the rare cases in which the fertilized egg does not properly enter the uterus. An ectopic pregnancy poses serious health risks to the mother.

Implantation
Implantation is the process by which the fertilized egg attaches to the endometrium (lining tissues of the uterus). The cells in the fertilized egg continue to divide.

Fetal Development
After implantation in the uterus, some of the cells form the placenta while others form the embryo. The heartbeat begins during the fifth week of gestation. At the eighth week the developing embryo is now called a fetus. The fetus at eight weeks is about ½ inch long and constantly growing.

22/01/2022

OVARIAN CANCER
Ovarian cancer is the most common cause of cancer death from gynecologic tumors in the United States. The precise cause of ovarian cancer is unknown, but several risk and contributing factors have been identified.

RISK FACTOR
Factors that can increase your risk of ovarian cancer include:
•Older age -The risk of ovarian cancer increases as you age. It's most often diagnosed in older adults.

•Inherited gene changes - A small percentage of ovarian cancers are caused by genes changes you inherit from your parents. The genes that increase the risk of ovarian cancer include BRCA1 and BRCA2, BRIP1, RAD51C, RAD51D and Lynch syndrome.

•Family history of ovarian cancer - If you have blood relatives who have been diagnosed with ovarian cancer, you may have an increased risk of the disease.

•Being overweight or obese - Being overweight or obese increases the risk of ovarian cancer.

•Postmenopausal hormone replacement therapy - Taking hormone replacement therapy to control menopause signs and symptoms may increase the risk of ovarian cancer.

•Endometriosis - Endometriosis is an often painful disorder in which tissue similar to the tissue that lines the inside of your uterus grows outside your uterus.

•Age when menstruation started and ended - Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer.

•Never having been pregnant - If you've never been pregnant, you may have an increased risk of ovarian cancer.

PREVENTION
There is no known way to prevent ovarian cancer, but these things are associated with a lower chance of getting ovarian cancer—
•Having used birth control pills for five or more years.
•Having had a tubal ligation (getting your tubes tied), both ovaries removed, or a hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).
•Having given birth.
•Breastfeeding. Some studies suggest that women who breastfeed for a year or more may have a modestly reduced risk of ovarian cancer.

15/01/2022

SURGICAL THROMBECTOMY

08/01/2022

ASHERMAN'S SYNDROME also known as uterine synechiae, is a condition characterised by the formation of intrauterine adhesions, which are usually sequela from injury to the endometrium, and is often associated with infertility.

Synechiae are usually a consequence of uterine trauma caused by:
•Infections
•Prolonged use of intrauterine devices (IUDs)
•Post-miscarriage or postpartum curettage
•Caesarean sections in which there were infection issues
•Myoma or polyp removal procedures

However, there are cases where uterine synechiae have no apparent cause.

Patients may present with infertility, pregnancy loss, menstrual abnormalities (e.g. 2ry amenorrhoea, hypomenorrhoea, dysmenorrhoea) or abdominal pain

Intrauterine adhesions result secondary to trauma to the basal layer of the endometrium with subsequent scarring 1. This may be from a previous pregnancy, dilation and curettage, surgery, or infection (e.g. TB endometritis).

'ssyndrome

07/01/2022

MYOKYMIA(eyelid twitch or tic) of the lid is a unilateral and uncontrollable lid twitch or tic that is not caused by disease or pathology.

Causes & risk factors:
•Stress.
•Poor nutrition.
•Lack of Sleep.
•It can be an indicator of systemic disease.

Symptoms
An eyelid (usually the lower lid in one eye) twitches uncontrollably.

Treatment
Usually self-limited once self-care is in place. In cases of blepharospasm that does not resolve on its own, Botox or other surgeries can help limit the impact on daily activities.

Prevention
Low-stress healthy lifestyle with attention to good nutrition and regular exercise.

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