- Exploding head syndrome.

Exploding head syndrome

 

Def:- is a condition that causes the sufferer occasionally to experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, roar, gunshot, loud voices or screams, a ringing noise, or the sound of electrical arcing (buzzing).
This noise usually occurs within an hour or two of falling asleep, but is not necessarily the result of a dream and can happen while awake as well.

Causes:- 
The cause of the exploding head syndrome (EHS) is not known, but :

• Some physicians have reported its correlation with stress, anxiety, and extreme fatigue.
• It may be the result of a sudden movement of a middle ear component or of the eustachian tube. 
• It may be the result of a form of minor seizure in the temporal lobe where the nerve cells for hearing are located.

- Renal trauma grading scale.

Basically we can divide renal trauma into five grades.

The grades I , II and III are classified as minor traumas, and the grades IV,V as major :-

• Grade I: contusion or subcapsular hematoma, without parenchymal laceration.
• Grade II: superficial cortical laceration less than 1 cm deep.
• Grade III: deep cortical laceration extending more than 1 cm.
• Grade IV:
1. corticomedullary laceration with collecting system injury and urinary extravasation. 
2.  vascular injury:- laceration or thrombosis of a segmental artery.

• Grade V:
1. Multiple deep lacerations.
2. Thrombosis of the main renal artery.
3. Avulsion of renal hilum which devascularizes kidney.

- Basic bony surface anatomy of the knee.

Basic bony surface anatomy of the knee.

- Bladder Injury.

Bladder Injury

Aetiology:-

1. Blunt trauma : 10% of pelvic fractures.
2. Penetrating trauma :gunshots or stap wounds.
3. Iatrogenic:-
• Obestetric :- 0.3% with caeserean section.
• Gynaecological e.g.during a vaginal or abdominal hysterectomy.
• Urological e.g during cystescopy.
• Orthopaedic e.g. pins and screws can commonly perforate the urinary bladder, particularly during internal fixation of pelvic fractures.
4. Idiopathic:- due to presence of a previous scar.

Classification(Pathophysiology):-

1. Extraperitoneal rupture bladder:
Usually due to fracture pelvis,and Extravasation occur at the perivesical space and may extend up to the anterior abdominal wall,If the urogenital membrane is injuried.
2. Intraperitoneal rupture bladder:(The most dangerous)
Usually due to direct trauma when the bladder is full,associated with electrolyte disturbance and may passed unnoticed for along time.

- Side effects of antithyroid drugs.

Side effects of antithyroid drugs.

"Charge"

Cholestatic jaundice.
Hypothyroidism.
Allergy,Agranulocytosis.
Relapse on sudden stoppage.
Goiter,Git upsets.
Exophthalmos increase.

enjoy,,

Dr Ibrahim