Dr.Sabnam

29/11/2025

27/11/2025

59 year old hypertensive male with syncope/vertigo!!

27/11/2025

75 years old lady, anemic with sob

26/11/2025

25 year old lady with chest pain!!

24/11/2025

An elderly lady with anemia presents with shortness of breath

24/11/2025

75 years old hypertensive lady with SOB!!

23/11/2025

23/11/2025

Tinea capitis, or ringworm of the scalp, is a highly contagious fungal infection that causes itchy, scaly, and sometimes bald patches on the scalp. It is most common in children and is treated with oral antifungal medications, sometimes accompanied by a special shampoo or other topical treatments, to clear the infection and prevent permanent hair loss or scarring.

22/11/2025

What is the diagnosis and treatment??

18/11/2025

Hemiblocks

Hemiblocks = Left Anterior Fascicle or Left Posterior Fascicle is blocked → changes QRS axis and QRS shape.

🔶 1. Left Anterior Hemiblock (LAH / LAFB)

📌 Most common fascicular block

Key ECG Signs
• Left axis deviation (usually –45° to –90°)
• Small Q in I, aVL
• Small R in II, III, aVF
• No LVH or inferior MI signs

Memory Trick

➡ “Q1 S3”
• Q in Lead I
• S in Lead III

🔶 2. Left Posterior Hemiblock (LPH / LPFB)

📌 Less common, usually occurs with disease

Key ECG Signs
• Right axis deviation (+90° to +120°)
• Small R in I
• Small Q in III
• No RVH or lateral MI signs

Memory Trick

➡ “S1 Q3”
• S in Lead I
• Q in Lead III

🔶 3. Bifascicular Blocks

Two fascicles are blocked at the same time.

Types
1. RBBB + Left Anterior Hemiblock (most common)
2. RBBB + Left Posterior Hemiblock

ECG Pattern
• Wide QRS (from RBBB)
• Axis shift (from fascicular block)

⚠ Clinical Concern

➡ High risk of complete (3°) AV block
Patient may need monitoring / pacemaker evaluation.

🔶 4. Trifascicular Block

All 3 fascicles involved:
• Right bundle branch
• Left anterior fascicle
• Left posterior fascicle

ECG Pattern
• RBBB
• Either LAH or LPH
• + AV block (1°, 2°, or alternating)

⚠ Danger

➡ Can progress to complete heart block.

15/11/2025

CT Scan Findings in Stroke & Hemorrhage

1. Ischemic Stroke

CT Findings:
• Area of hypodensity (dark area)
• Loss of gray–white differentiation
• Sulcal effacement

Clinical Features:
• Focal neurologic deficits
• Headache may occur
• ↓ Level of consciousness (LOC)

Examples:
• L parietal ischemic stroke
• Severe R-sided ischemic stroke

2. Intracerebral Hemorrhage (ICH)

CT Findings:
• Hyperdense area (bright white blood)
• Surrounding edema or mass effect

Clinical Features:
• ↓ LOC
• Major neurologic deficits
• Severe headache
• Nausea/Vomiting

Important:
✅ Fibrinolytics are contraindicated

Example:
• R parietal hemorrhage

3. Subarachnoid Hemorrhage (SAH)

CT Findings:
• Blood in basal cisterns or cortical sulci

Clinical Features:
• Sudden severe onset
• “Worst headache of my life”
• Neck stiffness
• Nausea/Vomiting
• ↓ LOC

Important:
✅ Fibrinolytics are contraindicated

4. Subdural Hematoma (SDH)

CT Findings:
• Crescent-shaped collection along the brain surface
• Crosses suture lines

Clinical Features:
• ↓ LOC
• Drowsiness
• Unequal or dilated pupils
• Headache, N/V
• Agitation, confusion, irritability

Important:
✅ Fibrinolytics are contraindicated

Example:
• L subdural blood