Dr.GR-RahiMoon-Medical Specialist

Dr.GR-RahiMoon-Medical Specialist Dr.Ghulam Rasool RahiMoon
FCPS-Internal Medicine
CHPE(AKU)
CONSULTANT PHYSICIAN
Internal Medicine Specialist. Book your Appointment:+92 340 2392262.

Maleer Medical Center Umerkot.

"Half-and-half" or Lindsay's nails, often a sign of chronic kidney disease. They are pale proximally and dark-banded dis...
06/04/2026

"Half-and-half" or Lindsay's nails, often a sign of chronic kidney disease. They are pale proximally and dark-banded distally.

ڦڦڙن ۾ پاڻي (Pleural Effusion) ۽ ان جو علاج!ڦڦڙن جي ٻاهران پردي ۾ پاڻي جو اچي وڃڻ هڪ سنجيده طبي صورتحال آهي، جنهن کي Ple...
05/04/2026

ڦڦڙن ۾ پاڻي (Pleural Effusion) ۽ ان جو علاج!

ڦڦڙن جي ٻاهران پردي ۾ پاڻي جو اچي وڃڻ هڪ سنجيده طبي صورتحال آهي، جنهن کي Pleural Effusion چيو ويندو آهي. ان جي صحيح تشخيص لاءِ "پلورل ٽيپ" (Pleural Tap) يعني سئيءَ جي مدد سان ٿورو پاڻي ڪڍڻ انتهائي ضروري آهي. صرف ڪجهه سي سي (CC) پاڻي جي ٽيسٽ مان معلوم ٿي سگهي ٿو ته پاڻي ڇو پيو آهي (مثال طور ٽي بي، ڪينسر يا دل جي تڪليف وغيره).

اهم نڪتا:

• خوف ۽ وهم: اسان جي سماج ۾ سئي لڳڻ يا پاڻي ڪڍڻ بابت ڪيترائي غلط وهم آهن، جنهن ڪري مريض ڊڄي وڃن ٿا.
• تشخيص ۾ دير: ٽيسٽ نه ڪرائڻ جي ڪري مريض سالن تائيد تڪليف ۾ رهن ٿا ۽ آخرڪار جڏهن حالت تمام گهڻي خراب ٿي وڃي ٿي، تڏهن پاڻي ڪڍرائين ٿا.
• سادو حل: بروقت پاڻي جي ٽيسٽ مريض کي سالن جي بيچيني ۽ تڪليف کان بچائي سگهي ٿي.

ياد رکو: سئيءَ ذريعي پاڻي ڪڍڻ هڪ محفوظ عمل آهي. ان کان ڊڄڻ بدران بروقت تشخيص ڪرائڻ گهرجي ته جيئن صحيح علاج شروع ٿي سگهي ۽ مريض هڪ پرسکون زندگي گذاري سگهي.

PSIM Leadership of Hyderabad Chapter meet up at Indus Hotel to discuss Upcoming Academic Events. Meeting was Chaired by ...
05/04/2026

PSIM Leadership of Hyderabad Chapter meet up at Indus Hotel to discuss Upcoming Academic Events. Meeting was Chaired by President PSIM Hyderabad Chapter Prof.Dr.Imran Ali Shaikh attended by majority of Office bearers.

Did you know adrenal glands have three layers? Each one produces different hormones your body needs to function.🔹 Zona G...
04/04/2026

Did you know adrenal glands have three layers?
Each one produces different hormones your body needs to function.

🔹 Zona Glomerulosa: Makes aldosterone, which helps control blood pressure and fluid balance.
🔹 Zona Fasciculata: Produces cortisol, the hormone that helps your body respond to stress and regulate metabolism.
🔹 Zona Reticularis: Creates androgens, hormones that contribute to growth and development.

Though they are small, the adrenal glands play a big role in keeping the body balanced and are literal life savers. 💙

Clinical Pearls: The 7 A's of Ankylosing Spondylitis!🚩1. Anterior Uveitis !• The most common (MC) extra-articular manife...
04/04/2026

Clinical Pearls: The 7 A's of Ankylosing Spondylitis!

🚩1. Anterior Uveitis !

• The most common (MC) extra-articular manifestation, occurring in about 25-30% of patients.
• Presentation: Typically unilateral, acute onset of redness, pain, and photophobia.
• Clinical Note: It is strongly associated with the HLA-B27 marker.

🚩2. Aortic Regurgitation !

• Chronic inflammation can lead to aortitis, causing dilation of the aortic root and thickening of the valve cusps.
• Surgical Note: Severe cases may require valve replacement (hence the median sternotomy reference).

🚩3. AV Block !

• Inflammation can extend into the interventricular septum, affecting the conduction system.
• Significance: Patients presenting with bradycardia or syncope should be screened for conduction delays.

🚩4. Apical Lung Fibrosis !

• Often appears as bilateral, upper lobe fibrocystic changes.
• Differential Diagnosis: It can look remarkably like Tuberculosis (TB) on a chest X-ray. Cavitation can occur, which may become colonized by Aspergillus (Aspergilloma).

🚩5. Atlantoaxial Subluxation !

• Occurs due to erosive changes in the C1-C2 joint.
• Risk: Increases the risk of spinal cord compression or fracture even with minor trauma.
• CES: Cauda Equina Syndrome is a rare but serious neurological complication related to chronic spinal changes.

🚩6. Achilles Tendonitis / Plantar Fasciitis !

• These are forms of Enthesitis (inflammation where tendons or ligaments insert into bone).
• Clinical Pearl: Enthesitis is a hallmark of spondyloarthropathies and is a key diagnostic differentiator from Rheumatoid Arthritis.

🚩7. Amyloidosis (Secondary) !

• Chronic systemic inflammation leads to the deposition of AA amyloid.
• Organ Target: Most commonly affects the kidneys, leading to proteinuria or nephrotic syndrome.

A single film can tell a thousand stories, but only if you know how to read between the lines. In clinical practice, an ...
04/04/2026

A single film can tell a thousand stories, but only if you know how to read between the lines. In clinical practice, an X-ray is never just a picture; it is a piece of a much larger puzzle.

To reach the right diagnosis, we must follow a disciplined approach:

✨• Examine the Patient: Clinical context is king. A shadow on a film means nothing without the history and physical signs accompanying it.
✨• Analyze the Film: Systematically reviewing every detail—from the bony structures to the soft tissues—ensures nothing is missed.
✨• Correlate & Compile: This is where the magic happens. We merge the bedside findings with the radiological evidence to narrow down the possibilities.
✨• Formulate Differentials: Accurate interpretation leads to a robust list of differentials, ensuring the final diagnosis is rooted in evidence.

Precision in interpretation isn’t just a skill—it’s a commitment to patient safety and excellence in care.

This patient presented with chronic complaints of vague abdominal pain, abdominal distension, and breathlessness.What ca...
04/04/2026

This patient presented with chronic complaints of vague abdominal pain, abdominal distension, and breathlessness.

What can be seen here?

03/04/2026

A 65-year-old woman was diagnosed with painless goiter. It has progressively increased in size over the past few years, but she has been asymptomatic. She reports no dyspnea, fatigue, malaise, or hoarseness, but she clears her throat more often as she feels that solid food gets stuck sometimes. An open biopsy 3 years ago revealed fibrous tissues secondary to Reidel thyroiditis. Thyroid studies have been within normal limits. On physical exam, vital signs are stable. The patient’s anterior neck findings are significant for a stiff, enlarged goiter, more prominent in the left lobe that appears stable since the last visit. Which of the following is the next management?

A.Glucocorticoids and re-evaluation.

B.Total thyroidectomy.

C.Mycophenolate mofetil.

D.Wedge resection of the thyroid isthmus.

CHPE-Agha Khan University !
03/04/2026

CHPE-Agha Khan University !

🔹 Predict the "MURMUR" even Before Auscultation !🍀 Low volume Pulse → AS / MS > others.🍀 High volume Pulse → AR / MR > o...
02/04/2026

🔹 Predict the "MURMUR" even Before Auscultation !

🍀 Low volume Pulse → AS / MS > others.

🍀 High volume Pulse → AR / MR > others.

🍀 Shifted apex beat → AR / MR > others.

🍀 Not shifted but forceful apex beat → AS > others.

🍀 Not shifted and not forceful apex beat → MS > others.

🍀 Irregular pulse → MS / MR / ASD > others.

🍀 Narrow pulse pressure (if mentioned) → AS > others.

🍀 Wide pulse pressure (if mentioned) → AR > others.

🍀 Collapsing pulse → AR / MR > others.

🍀 Parasternal heave → TR / P.HTN > others.

🍀 Bruise mark (anticoagulation)→ AF / AVR / MVR > others.

🍀 Palpable thrill → VSD / MR / AS > others.

🍀 Turner syndrome → BAV / CoA > others.

🍀 Tall - Marfan syndrome → AR / MR > others.

🍀 Holt-Oram (deformed hand) → ASD > others.

🍀 Noonan syndrome (Ear Man) → PS > others.

🍀 Midline Sternotomy Scar - AVR /MVR > other.

🍀 Lateral Thoracotomy Scar - MVR > other.

02/04/2026

جگر جي سڪڙيل مريضن ۾ انفيڪشن يا قبض جي صورت ۾ مريض بي هوش ٿي ويندا آهن، جيڪو موتمار به ٿي سگهي ٿو.جگر جي مريضن ۾ قبض يا انفيڪشن نه ٿيڻ ڏيو.

ڊاڪٽر غلام رسول راهمون
اسسٽنٽ پروفيسر آف ميڊيسن
ڪنسلٽنٽ فزيشن
انٽرنل ميڊيسن

Yellow Nail Syndrome (YNS) is a rare medical condition that serves as a significant clinical marker for underlying syste...
02/04/2026

Yellow Nail Syndrome (YNS) is a rare medical condition that serves as a significant clinical marker for underlying systemic issues. It is primarily understood as a disorder of lymphatic drainage.

🔺The Classic Triad-3

Diagnosis is typically made when a patient presents with at least two of the following three features:

🚩1. Yellow Nails: The nails become thick, slow-growing, and excessively curved. They often lose the cuticle and may separate from the nail bed (onycholysis).
🚩2. Lymphedema: Chronic swelling, usually affecting the lower limbs, caused by an accumulation of lymph fluid in the soft tissues.
🚩3. Respiratory Tract Involvement: Most commonly manifesting as pleural effusions (fluid around the lungs), but also strongly associated with chronic sinusitis and bronchiectasis.

Clinical Significance!

While the exact cause is often idiopathic, the presence of YNS requires a thorough investigation of the respiratory system.

• Bronchiectasis: As noted in your text, this occurs in roughly 40% of patients. It involves permanent enlargement of parts of the airways, leading to chronic cough and recurrent infections.

• Lymphatic Dysfunction: The "root" cause is believed to be impaired lymphatic flow or structurally abnormal lymph vessels, which explains why fluid builds up in the legs and the pleural space.

• Associations: In some cases, YNS has been linked to internal malignancies, connective tissue diseases, or certain medications, though these associations are less common.

Management Approach:

Treatment focuses on managing the individual components of the triad:
✨• Nails: Topical or oral Vitamin E is often used, though results vary.
✨• Respiratory: Pleurodesis or repeated drainage for effusions; aggressive airway clearance for bronchiectasis.
✨• Lymphedema: Compression therapy and manual lymphatic drainage.

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Umarkot

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+923101320824

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