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Case History: A 61-year-old male patient presented in the outpatient department of medicine in Capital Hospital Islamabad, complaining of severe epigastric pain that had been increased in intensity since last 15 days. The onset of pain was sudden, burning and pinching in character, aggravated by intake of food and relieved by strong painkillers and pain radiated to back. The patient also had low-grade fever since last 10 days and generalized weakness. Pain starts a few minutes after taking a meal. There was no history of dysphagia, melena, shortness of breath, cough, chest pain or discomfort, food regurgitation, vomiting, hematemesis, altered bowel habits and burning or difficult micturition. There was no significant past medical or surgical history. The patient was a non-smoker, had decreased appetite and sleep disturbance. There was no history of Diabetes mellitus , hypertension, heart diseases , asthma or cancer in the family. On examination, his pulse rate was 76 and blood ...

Stomach cancer usually presents with the symptoms of indigestion, abdominal fullness, burping, loss of appetite and heart burn. Late symptoms include, hemoptysis, melena, weight loss, weakness or fatigue, and pain after eating. Obstruction of gastric outlet, gastro-esophageal junction and pleural effusion are also late symptoms. Usually it is difficult to catch the gastric cancer in its early stages because patients of gastric cancer usually present with the similar symptoms as those of Peptic Ulcer Disease . So patients keep on getting treatment of peptic ulcer disease while cancer continue to grow. At the time of diagnosis, usually cancer has already been reached to advance stages.   In Capital Hospital Islamabad, a 61 year old male patient presented in emergency department complaining of difficulty in swallowing, unable to eat any thing, food regurgitation, vomiting, nausea, lack of appetite, epigastric pain, easy fatigability and significant weight loss. Sometime he also notice...

A forty-five years old school teacher who is a known case of rheumatoid arthritis for the last six years presents with generalized swelling of her body including face, abdomen and feet. She has been on various medications for rheumatoid arthritis in the past. However, on system review, she admits that she had been taking a new drug for the last six months for her rheumatoid arthritis prescribed by her old family physician. On examination, she looks obviously pale and puffy in the face and generalized pitting edema of her body and feet. Laboratory results are given below; Hemoglobin: 12mg% Total Leukocyte count (TLC) and Differential leukocyte count (DLC) : Normal Blood urea : 40 mg% Blood creatinine level: 1.2 mg% Urine analysis: Protein +++ , RBCs 1-2 per high power field (HPF), casts 4-5 per high power field, Liver function tests : Normal. Answer the following question. You will get your score instantly after submitting the answers. In the end, Click on “ Review Quiz ” to ...

A twenty six year old woman with no prior medical history, present with a three week history of joint swelling and stiffness. She points to all her proximal inter-phalangeal joins and as well as metacarpophalangeal joints and wrists. She informs you that she had stiffness for two hours every morning since these symptoms started and symptoms improve as the day progress. She denies of back stiffness. She has fatigue and low grade fever also. On examination the wrist, inter-phalangeal joints and metacarpophalangeal joints are tender and swollen of both hands. The distal inter-phalangeal joints are not involved. There is fluid in the joints. Now answer the following questions. At the end of the quiz, you will get your score instantly and kindly “review” the quiz to find out the correct answers. Like us on Facebook and follow us via email to get future posts. If you disagree with any answer or option kindly post a comment below we will answer with a reason within in 12-24 hours. We are...

A forty five year old lady has come to the medical OPD with a complaint of increasing fatigue, somnolence, constipation and body aches, These symptoms have gradually increased over last two years. Her weight has increased, the menstrual cycle is irregular and has difficulty in hearing. She looks pale, the skin is dry and the voice is hoarse. The pulse is 59/min and regular in character. Blood pressure is 130/80 mm of Hg, Blood sugar is checked and it is 110mg%, CPK (creatinine phospho-kinase) is 1000 ( normal range 100 – 250 ), MCV is 106%. Echocardiography was also done which shows mild pericardial effusion. Now answer the following questions. (you will get your score instantly once you submit the answers) If you feel any problem or you can’t see the questions kindly comment below. We will solve the problem as soon as possible. If you are disagree with any option comment below, we will reply you with reason. Like us on facebook and follow us via email to receive updates about future ...

A forty five year old man complains of discomfort in his throat and upper chest. This discomfort sometimes comes when he takes a heavy meal. More often he experiences it when he walks up a hill to visit his parents. He has no other symptoms and is not on any regular medication. On examination he looks well. His pulse is of low volume and the pulse rate is 68/minute. BP is 110/80 mm of Hg. He is not anemic clinically and is afebrile. Examination of cardio-vascular system reveals a systolic murmur best audible at third inter-coastal space on the left sternal border and is radiating to carotids. Respiratory examination was normal, There was no crepitations, wheezing or decreased breath sounds. He had raised LDL(Low density cholesterol) cholesterol and Low HDL (High density Cholesterol) Now kindly answer the following questions. In the end, you will find out that your are pass of fail. Kindly comment bellow if you notice any problem. It will help us to make the service better. If you...

Thirty-five years old lady has been chronically ill. She is brought to the casualty department with haematemesis and melaena. She looks pale and is drowsy. She has got multiple bruises over the skin and has flapping tremor the hands. Abdominal examination reveals moderate splenomegaly, decreased hepatic dullness and shifting dullness is also present. Loading... Answer the questions one by one and click continue for the next question. at end kindly enter your name and click submit. Upon submission, you will get the correct answers. Kindly like us on Facebook and subscribe us via email to remain in touch with us. Clinical Case of the Week. By Dr Adil Ramzan Medicotips.com Now every week a new clinical case will be posted. Previously a new clinical case was posted every month. Thank you for your visit and participating. If you feel any problem while loading, answering or getting results of the above clinical case kindly feel free to comment below. We will look into the matter and solv...

The case of the month Instructions: Watch in full screen for a better view: exit the full screen when the video ask for the name and email address as a flash player doesn't accept keyboard input in full screen Every month a clinical case is posted. This clinical case is discussed with possible answers. This case "A 35-year-old female delivered a healthy baby 15 days back presented with drowsiness for 2 days. On examination, she had 3/5 power on the left side of the body. Her MRI was performed" was presented in holy family hospital Rawalpindi Pakistan. History, Examination and investigation are done there. This case is provided by Dr Tayyab Saeed Akhtar. MO and Registrar Holy family hospital Rawalpindi Pakistan. MRI of this patient revealed a lesion. You have to identify this lesion and guess what is it. Then you should think about the type of lesion and the cause of lesion and then after determining the cause, you should think about how to eliminate this cause, Give...