Central precocious puberty

Pus discharge sine 3 days *Chief Complaints* Discharging sinus track since 3 days started with boil *History* History of boil since 3 days followed with itching causing into make pouring puss *Vitals* All stable *Physical Examination* Normal sinus with puss on palpation fluctuating *Investigations* CBC Esr Crp Puss for culture sensitive all not sent poor socio economic status *Diagnosis* Infected sinus *Management* ?

29 Y female having B/L knee joint pain from past 3 months , no physical signs of inflammation. No history of trauma / fall , She is non obese , lean body Previous medical history Not significant Investigations Uric acid - normal X RAY knee joint AP & lat RX given VIT D3 60K Zerodol SP What

How to manage this type of fracture in 7 year kid *Chief Complaints* 7 year female kid complaining of Difficulty in walking n weight bearing on left lower limb *History* 7 year kid Sustained injury following sudden collapse of bike over the left lower limb *Vitals* All stable left dorsalis pedias felt vital stable *Physical Examination* Left lower limb is shortened extremely externally rotated tense tender at mid thigh of left lower limb *Investigations* X-ray tagged *Diagnosis* ? *Management* ?

History of fall on out stretched hand complaint of pain and difficulty in lifting right shoulder *Chief Complaints* complaint of pain and difficulty in lifting right shoulder *History* Fall on out stretched hand *Vitals* Stable *Physical Examination* Difficulty in lifting right shoulder Hamilton ruler test cannot be performed due to extreme obese Cannot touch opp shoulder by right hand *Investigations* X-ray tagged *Diagnosis* Anterior shoulder dislocation *Management* ???

In upcoming season pain of Rheumatoid arthritis (आमवात) increases. Cause behind this- Monsoon is the season where the symptoms of Amavata are most likely to worsen due to the combined effect of weakened digestive fire and the cold, damp environment that aggravates both Ama and Vata.