2013-06-18T22:13:21Z https://www.doctorshangout.com/groups/group/forum?groupUrl=internal-medicine&feed=yes&xn_auth=no tag:www.doctorshangout.com,2012-11-03:2002836:Topic:661395 2012-11-03T17:37:21.555Z Deepak Ghimire https://www.doctorshangout.com/profile/DeepakGhimire281

<p>have you used a heavy doses of vitamin C? can some body share experience about its use in pregnancy ? cancer and tumors ? Also in obesity ? is it useful ? please share your experiences :)</p>

<p>have you used a heavy doses of vitamin C? can some body share experience about its use in pregnancy ? cancer and tumors ? Also in obesity ? is it useful ? please share your experiences :)</p> tag:www.doctorshangout.com,2012-09-26:2002836:Topic:646290 2012-09-26T14:40:40.269Z Dr.Murali Krishna https://www.doctorshangout.com/profile/DrMuraliKrishna

<p><span>my actions in this case got me a great eval. </span><br></br><br></br><span>88 yo male nh resident, presents with exertional dyspnea and fatigue. pe reveals bibasilar crackles and displaced pmi, bl le pitting edema, lt>rt; otherwise wnl. </span><br></br><br></br><span>pmh includes chf, htn, hld, chronic lt leg dvt not on ac (fall risk), h/o bladder and prostate ca with indwelling catheter placed, dmII, and sbo with ostomy placed and anemia of chronic dz/fe deficiency…</span></p>

<p><span>my actions in this case got me a great eval. </span><br/><br/><span>88 yo male nh resident, presents with exertional dyspnea and fatigue. pe reveals bibasilar crackles and displaced pmi, bl le pitting edema, lt>rt; otherwise wnl. </span><br/><br/><span>pmh includes chf, htn, hld, chronic lt leg dvt not on ac (fall risk), h/o bladder and prostate ca with indwelling catheter placed, dmII, and sbo with ostomy placed and anemia of chronic dz/fe deficiency anemia.</span><br/><br/><span>bnp was 4500; chem panel revealed cr of 2.8 (baseline is 1.8, 1.2 six months ago). ua was also +. cxr revealed bibasilar effusions with possible infiltrate in rt lung base that cannot exclude hcap.</span><br/><br/><span>pt admitted for chf exacerbation, questionable hcap (could not rule it out on cxr), and acute on chronic renal failure. patient was started on diuresis, optimization of chf meds, levaqiun (renal dosed), and monitored. he was admitted under hospitalist service from overnight but given to my teaching service team the next day since he was a resident's clinic pt.</span><br/><br/><span>the next day, pt's clinical condition improved, with some decrease in basilar effusions, but his cr bumped up to 3.1. this was thought to be as a result of his chf not perfusing the kidney properly and/or he was getting dried out to much although his i/o's were not too negative. of note his c+s came back and we started him on cefuroxime (renal dosed) in addition to the levaquin. of note his vitals were always stable, never any white count, but did have mildley elevated crp at 10-12.</span><br/><br/><span>we backed off on the diuresis that day, but the next day his cr bumped again to 3.4. my attending and senior wanted to continue monitoring with adjustments in diuresis and ordering another bnp and cxr. but I also ordered something else because I was stubborn.</span><br/><br/><span>long story short, his cr a few days later now is 1.8 and he's doing much better and on his way back to the nh. </span><br/><br/><span>what did i do?</span></p> tag:www.doctorshangout.com,2011-10-26:2002836:Topic:527679 2011-10-26T03:56:12.654Z Vidhya Vivek https://www.doctorshangout.com/profile/VidhyaVivek

I have a patient with sickle cell disease in crisis with sudden lower extremity edema and tenderness. I did duplex, no dvt . What could it be? Is it part of crisis?

I have a patient with sickle cell disease in crisis with sudden lower extremity edema and tenderness. I did duplex, no dvt . What could it be? Is it part of crisis? tag:www.doctorshangout.com,2011-08-31:2002836:Topic:492646 2011-08-31T09:54:13.748Z mohan https://www.doctorshangout.com/profile/mohan253

<p>24y female patient was having fever from one day develop ed macules all over the face excluding nose and lips...all her vitals heart and lungs tend to be normal..she gave no significant history of exposure to foreign bodies in the recent past... </p> <p> what might be the provisional diagnosis. </p>

<p>24y female patient was having fever from one day develop ed macules all over the face excluding nose and lips...all her vitals heart and lungs tend to be normal..she gave no significant history of exposure to foreign bodies in the recent past... </p> <p> what might be the provisional diagnosis. </p> tag:www.doctorshangout.com,2011-07-07:2002836:Topic:438321 2011-07-07T21:18:06.589Z Hazel Wnek Spargo https://www.doctorshangout.com/profile/HazelWnekSpargo

<p>Hello everyone,</p> <p>I need an experienced BC Geriatrics-focused Physician for a new employed practice in Houston. They're not considering Residents or Fellows at this time. An Internal Medicine physician who hasn't done a Geriatrics Fellowship but has focused much of their practice on Geriatrics is fine. We're also looking at Hospitalists, PUD/CC's, and Palliative Care physicians. An ideal candidate will be bilingual with Spanish and English. Fairly unique model in that it's more…</p>

<p>Hello everyone,</p> <p>I need an experienced BC Geriatrics-focused Physician for a new employed practice in Houston. They're not considering Residents or Fellows at this time. An Internal Medicine physician who hasn't done a Geriatrics Fellowship but has focused much of their practice on Geriatrics is fine. We're also looking at Hospitalists, PUD/CC's, and Palliative Care physicians. An ideal candidate will be bilingual with Spanish and English. Fairly unique model in that it's more patient quality care centered so the physician will only need to see about 10-12 patients per day (so he or she will actually have TIME to fully assess, diagnose and treat each patient! / read, this is perfect for anyone who is fed up with trying to see complex geriatric patients with multiple morbities in 15-minute appt. windows!) Please email me at <a href="mailto:hws@vermilliongroup.com">hws@vermilliongroup.com</a> if you're interested in discussing or if anyone comes to mind you can recommend. Note this isn't for an FQHC or underserved pop. in Houston, so unfortunately, we are not able to support Visas at this time. Thank you for your help! </p> <p> </p> <p>Sincerely,</p> <p> </p> <p>Hazel Spargo, Vermillion Group</p> <p><a href="mailto:hws@vermilliongroup.com">hws@vermilliongroup.com</a></p> <p> </p> <p> </p> <p> </p> <p> </p> tag:www.doctorshangout.com,2011-05-18:2002836:Topic:401931 2011-05-18T23:18:45.835Z MUTHU https://www.doctorshangout.com/profile/MUTHU567

hi dude wt s d modality f treatment fr popliteal cyst ? the swelling behind d knee s most probably a popliteal cyst or any differential diagnosis s there?

hi dude wt s d modality f treatment fr popliteal cyst ? the swelling behind d knee s most probably a popliteal cyst or any differential diagnosis s there? tag:www.doctorshangout.com,2011-04-02:2002836:Topic:382795 2011-04-02T00:43:27.236Z Dr.Rajan Bhonsle https://www.doctorshangout.com/profile/DrRajanBhonsle

<p><a href="http://www.hearttoheartindia.net/">THE ULTIMATE SEX EDUCATION GUIDE</a> - A complete Source Book for Value-based, Culture-Specific and Age-Appropriate Education in Human Sexuality.</p> <p> </p> <p>The Ultimate Sex Education Guide is meant for the reference of adult sex-educators such as Counsellors, Psychotherapists, Doctors, Parents, Teachers, Social workers etc., as well as for those adult individuals and couples who seek to educate themselves.<br></br> <br></br> This book endeavours to…</p>

<p><a href="http://www.hearttoheartindia.net/">THE ULTIMATE SEX EDUCATION GUIDE</a> - A complete Source Book for Value-based, Culture-Specific and Age-Appropriate Education in Human Sexuality.</p> <p> </p> <p>The Ultimate Sex Education Guide is meant for the reference of adult sex-educators such as Counsellors, Psychotherapists, Doctors, Parents, Teachers, Social workers etc., as well as for those adult individuals and couples who seek to educate themselves.<br/> <br/> This book endeavours to educate readers about the physiology and psychology of human sexuality. It also discusses social, behavioural, relational, emotional and even legal aspects of human sexuality. It is therefore, a complete and holistic guide for the adult community who need a ready-reckoner to address all queries from curious children, teenagers as well as adults.<br/> <br/> Great care has been taken to respect the sensibilities of all communities/groups/schools of thought in India, and to make it culture-specific yet contemporary, without compromising on the scientific accuracy of the subject.</p> <p> </p> <p>For more info visit <a href="http://www.hearttoheartindia.net/e-book/more-on-ebook/">http://www.hearttoheartindia.net/e-book/more-on-ebook/</a></p> tag:www.doctorshangout.com,2011-02-22:2002836:Topic:358149 2011-02-22T13:15:58.987Z u https://www.doctorshangout.com/profile/u

I have patients with isolated elevated t3 levels. do you treat high isolated t3 levels (normal tsh and t4)? and if so, how do you treat it?

I have patients with isolated elevated t3 levels. do you treat high isolated t3 levels (normal tsh and t4)? and if so, how do you treat it? tag:www.doctorshangout.com,2010-12-15:2002836:Topic:333555 2010-12-15T10:49:35.029Z shiva https://www.doctorshangout.com/profile/shiva125

<p>Evidence from randomized clinical trials, it is recommended, ACE I (Ramipril), Initiation during Acute MI has mortality benefit.</p> <p>Also similarly the The Beta blocker (Metoprolol) is recommended for Post MI patients following stabilization of LV Ejection function.</p> <p> </p> <p>So can we shift the patient from monotherapy to a combintaion of the two drugs Post MI patients at the time of discharge????</p> <p> </p> <p> </p>

<p>Evidence from randomized clinical trials, it is recommended, ACE I (Ramipril), Initiation during Acute MI has mortality benefit.</p> <p>Also similarly the The Beta blocker (Metoprolol) is recommended for Post MI patients following stabilization of LV Ejection function.</p> <p> </p> <p>So can we shift the patient from monotherapy to a combintaion of the two drugs Post MI patients at the time of discharge????</p> <p> </p> <p> </p> tag:www.doctorshangout.com,2010-10-29:2002836:Topic:319391 2010-10-29T12:37:45.082Z S.UMA DEVI https://www.doctorshangout.com/profile/SUMADEVI

<dl> <dt><a id="first_comment" name="first_comment"></a><a id="comment-2002836_Comment_318704" name="comment-2002836_Comment_318704"></a><span class="xg_avatar"><a class="fn url" href="https://www.doctorshangout.com/profile/SUMADEVI" title="S.UMA DEVI"><img alt="S.UMA DEVI" class="photo" height="48" src="http://api.ning.com/files/TqHUHJldtK5JtOXQe41-rJ8mvQwvjDpUGSLjk5hbNvCFW9R7CaTd2PBbesL8szYnDBtJM6QY64AWdo9iHrUheUqqehBuJkQyEvu*knNuyVo_/DSC00898.JPG?width=48&height=48&crop=1%3A1" width="48"></img></a></span> </dt> <dt>What is the treatment for a case of hypothyroidsm with thyroxin…</dt> </dl>

<dl> <dt><a name="first_comment" id="first_comment"></a><a id="comment-2002836_Comment_318704" name="comment-2002836_Comment_318704"></a><span class="xg_avatar"><a class="fn url" title="S.UMA DEVI" href="https://www.doctorshangout.com/profile/SUMADEVI"><img class="photo" height="48" alt="S.UMA DEVI" src="http://api.ning.com/files/TqHUHJldtK5JtOXQe41-rJ8mvQwvjDpUGSLjk5hbNvCFW9R7CaTd2PBbesL8szYnDBtJM6QY64AWdo9iHrUheUqqehBuJkQyEvu*knNuyVo_/DSC00898.JPG?width=48&height=48&crop=1%3A1" width="48"/></a></span> </dt> <dt>What is the treatment for a case of hypothyroidsm with thyroxin allergy?</dt> </dl>