Category Archives: Medicine
Development of Heart (Dr. Blandau’s Classic Animation)
If you seek it, it will find you.
Some things are classic. They are passed down from one generation to another. I am grateful to have benefited from this video which was made more than 50 years ago to explain the development of heart.
Thank You Dr. Richard Blandau (1911 – 1998)
Unknowingly Knowing
Venue: Medicine OPD
An intern was sitting across the table with two lady Associate Professors of Medicine. Both are highly experienced and are respected by the intern.
A medicine Resident enters. He is excited. “Ma’am we have a case of syphillis confirmed.” (joy is on his face, as not always we witness syphillis)
“Ok” say the doctors
Intern watches quietly.
Resident speaks “Whats the dose of Penicillin we use?” (expectantly awaits, excitement still showing on face)
One doctor looks at other, they look at each other. And then they use their weapon. Authority! “Go look in Washington’s Manual”
Resident’s excitement vanishes and leaves the OPD. (duno what he did beyond)
Intern watches quietly. He learnt a lesson. His respect for the doctors across the table some how grew even more. Because they taught him something which goes beyond books.
Today that intern (then) is reading penicillins in pharmacology and will always remember the 2.4 Million Units of penicillin and the lesson worth more than 2.4 Million.
Retinoblastoma
Retinoblastoma!
One of the most important topics when it comes to All India Pre PG Medical Entrance Exams concerned.
Some words just associated with Retinoblastoma as a PG aspirant are RB gene and Osteosarcoma.
Nothing more comes to mind at first, courtesy last 10year repeats.
So i did some research on retinoblastoma today. And the stupid that i was, i wondered how will a baby write about its disease. And as dreaded the name sounds and as the exams depict, would any one have survived to tell the story! (yes, you may laugh at my lack of knowledge, but thats how we learn, by admitting our inadequacies and going beyond). No text book stuff here, just a recollection of the case story.
A baby born normal, as the baby grows parents notice something weird about the vision of baby. Like say, baby not looking at the face or the toys, but just staring at distance to a source of light.
Photographs of baby show a white eye in contrast to red eye which often we consider the camera’s fault.
That calls for attention.
So now the doctor comes into picture. How does the doctor diagnose this? As a med student ask me, i would pounce on to say, RB gene eh! Ok so the wise doctor first of all takes out an opthalmoscope and examines the retina to see if it looks normal. Red reflex as it is called. So retinoblastoma shows an absent red reflex as it is primarily a retinal abnormality.
So suspecting retinoblastoma, doctor will order an MRI of orbit and brain to study if the retinoblastoma has reached beyond the eye.
Oh and by the way, did I mention:
Retinoblastoma has quite a good prognosis.
depending upon the size and stage of tumour, doctor decides whether to go for chemotherapy or surgery.
Tumour may be rare, it may sound dreaded, but actually we can have people grown up well in old age talk about their tumour of childhood.
And another interesting thing, since this is hereditary at times (though more than half the times it will be non hereditary) people opt for In Vitro Fertilisation.
So that is retinoblastoma beyond RB gene and osteosarcoma. An account of people who have gone through it and conquered it.
Thank You. Oh and please leave a comment if you have read this…even if its just a hi!
Thank you again.
P.S : note to self, differential diagnosis
1. Persistent hyperplastic primary vitreous (PHPV): present with whitening of the pupil.
2. Coat’s disease: a typically unilateral disease characterised by abnormal development of blood vessels behind the retina, leading to blood vessel abnormalities in the retina and retinal detachment to mimic retinoblastoma.
3. Toxocara canis: an infectious disease of the eye associated with exposure to infected puppies, which causes a retinal lesion leading to retinal detachment.
4. Retinopathy of prematurity (ROP): may lead to retinal detachment.
Vision 2020
How much of a bane can something be in my life? I have found a way of conquering you. You troubled me in AIPGE 2012!
Following diseases come under WHO’s Vision 2020 :
Mnemonic : DOG CART
Diabetic Retinopathy
Onchocerciasis
GlaucomaCataract
Age Related Macular Degeneration
Refractive Errors
Trachoma
Oh and if you care to remember these then just go one more step ahead and remember that they all are treated by the blanket therapy of Azithromycin wherever applicable.
RP or The Retinitis Pigmentosa
My this week’s quest on opthalmology made me google for Retinitis Pigmentosa. All that RP accounted to me was that its a disease of rods which secondarily involves the pigment layer. And how its a misnomer. Pretty dull and boring paragraph in the notes.
But here i was, reading an account of a RP affected individual. jodi He grew up knowing his vision was going to disappear some day. May be it already has as his last post was an year ago. All that i intend to point here is, at this stage, reading about those conditions in book is so mundane. But lookin at someone battling that condition, i really feel sorry for myself that i dont do justice to that topic giving it due importance. Lets be grateful what we are blessed with.
Thank You.
Medicography 