MedicoTips.Com

Notice: These Services are no Longer Available Currently.  Dr. Adil Ramzan is the founder of Medicotips.com, He is a Resident Internal Medicine at Pakistan Institute of Medical Sciences and Shaheed Zulfiqar Ali Bhutto Medical University.  Dr. Adil believes in traditional allopathic medicine and appreci­ates developing a close relationship with his patients. He does not practice in an office, therefore he is easy to reach and accessible to schedule home visits. Dr. Adil Ramzan is available to manage and follow patients in their home as well as the hospital, which is very important in the continuation and management of patient care. We have helped many of patients make informative and appropriate choices that affect their short term and long term health goals.         Email: support@medicotips.com

Paramalignant pleural effusions and malignant pleural effusions are often used interchangeably which is wrong, these are two different types of pleural effusions, Said Dr Kausar Rehanna, assistant professor of the department of pulmonology, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Paramalignant and malignant pleural effusions both occur in the presence of a solid tumour, but In case of a malignant effusion , there is direct pleural involvement and pleural fluid cytology shows malignant cells, therefore, an effusion which occurs as a result of metastatic pleural involvement and contains malignant cells is called a malignant effusion.  On the other hand, a paramalignant effusion does not contain malignant cells, it occurs as a result of complication of malignancy, such as hypoalbuminemia due to malnutrition or lymphatic obstruction etc. there is no pleural involvement in case of a para-malignant pleural e...

Chest X-Ray in COPD is often normal. Even in advanced disease chest X-ray can be normal. But if the following signs are found in a chest X-Ray then they will be highly suggesting of COPD. Hyperinflation of lungs . Hyperinflation of lungs can be identified with the help of physical examination or chest X-Ray. On physical examination, you may find the upper border of liver displaced down and a barrel-shaped chest. While on chest X-Ray you may find hyper lucent lungs, flattening of hemi-diaphragms, and seven or more anterior ribs are seen over the lung shadow.  Pruning of Vessels : Central vessels are more prominent while less blood is seen in peripheral lung fields.  Large Bullae It is not necessary for a patient with COPD to have all of the above signs, as it has been mentioned earlier, the chest x-ray can be normal even when the disease is advanced, therefore, if you notice any of the above sign in a chest x-ray, then you may consider COPD as a differential in the absen...

Pulmonary artery hypertension can be caused by a number of drugs. Some drugs are known to cause pulmonary arterial hypertension, while others are thought to be involved. Below is the list of drugs that may cause pulmonary arterial hypertension (PAH) Definitive causes of Pulmonary Artery Hypertension  Aminorex : A drug which was previously prescribed for weight loss, later withdrawn from the market when it was noticed that it causes pulmonary artery hypertension.  Fenfluramine : Another drug which was used in past for the purpose of weight loss, it is an anorectic drug, and decreases appetite. It was also withdrawn because it causes pulmonary artery hypertension.  Dexfenfluramine : An isomer of fenfluramine, was being used to induce weight loss.  Topical rapeseed oil : used as an anti-ageing agent.  Benfluorex : similar structure as that of fenfluramine.  Likely causes of Pulmonary Artery Hypertension.  Amphetamines : CNS stimulant Try...

Acetaminophen is an over the counter drug, easily available without a prescription, but if taken especially if more than 12g is taken which is potentially fatal. The cause of death or the complication is usually the liver failure, which likely occurs if more than 250mg/kg of paracetamol is taken. If a patient arrives at the emergency department with paracetamol poisoning and has taken more than 200mg/kg or more than 10g of paracetamol then immediately resuscitate and start acetylcysteine which is the antidote for paracetamol poisoning. The dose of Acetylcysteine and Method of Administration Consider Oral acetylcysteine, if the patient is not confused and can easily tolerate the medicine orally, the injectable acetylcysteine may also be given by oral route. The oral dose is as follows. Oral Administration of Acetylcysteine The loading dose is 140mg/kg, after giving the loading dose, wait for four hours and after four hours give the maintenance dose, which is 70mg/kg. Repeat ...

Amiodarone has high iodine content, because of the high iodine content it may affect the thyroid gland. It can either cause hypothyroidism or thyrotoxicosis. Approximately 1 out of every 6 patients who are using amiodarone develops thyroid dysfunction. 1. Amiodarone-induced hypothyroidism (AIH).  If a patient's TSH is high and Free T4 is low, it means the patient has developed hypothyroidism. In this situation, start thyroxine and if possible amiodarone should be stopped, but it is not necessary, if the patient still has symptoms such as ventricular tachycardia or arrhythmias then you may continue amiodarone, just add thyroxine and monitor thyroid function every 6 weeks first then maybe after 3 months or 6 months, depending on the clinical scenario. 2. Amiodarone-induced thyrotoxicosis (Hyperthyroidism).  If the patient has developed hyperthyroidism, then it is advised to stop amiodarone and start an anti-thyroid drug such as carbimazole, if it is type 1 amiodarone-indu...

Chronic kidney disease, in its later stages, may cause hyperphosphatemia. Hyperphosphatemia promotes the bone resorption and tend to increase the amount of calcium in vessels and increases the risk of vascular calcification. Parathyroid hormone also increases in chronic kidney disease which also promotes bone resorption, hypercalcemia, and vascular calcification. Vitamin D 3, if given in a patient who has hyperphosphatemia, may actually promote bone resorption and vascular calcification if PTH is more than 100. So if there is hyperphosphatemia, vitamin D should be given along with a phosphate binder such as sevelamer if the calcium-phosphate product is more than 55. If Calcium phosphate product is more than 55, it means you shouldn't give calcium-based phosphate binders such as calcium acetate, instead start the patient on Sevelamer. But if Calcium phosphate product is less than 55 then give patient calcium acetate as a phosphate binder. Decide the dose of vitamin D based on PT...