Pyruvate kinase deficiency

Diarrhoea is a leading cause of death in children, with nearly 500,000 young lives lost to diarrhoea each year. Almost all these lives could be saved with a low-cost & widely available treatment - oral rehydration salts (ORS). A new study has revealed that ORS is under-prescribed in India; 50% of children with diarrhea did not receive this lifesaving treatment. There are several popular explanations for the under-prescription of ORS in India. What may be the major reason in your opinion?

36 years old female complained about painful Lymph nodes on the neck region. *Chief Complaints* Painful & swallon lymph nodes at submandibular region of neck. *History* She was experienced with painful lymph nodes last year. She visited ENT, endoscopy showed grade 1 Tonsillitis & Chronic Pharyngitis. Montex was negative Usg neck showed reactive lymphadenopathy. She got resolved after using Antibiotics and some other medicine last year. Now again same complaints, patient is experiencing. *Vitals* Normal *Physical Examination* Normal apart from lymph nodes.

27 female history of hit by vehicle Opened wound over knee anteriour Bleeding + O/e cripitus present Movements painful X-ray tagged Diagnosis and management *Chief Complaints* Bleeding and cut lacerated wound over front of knee *History* Hit by a vehicle *Vitals* All stable mild hypotension *Physical Examination* Crush injury with clw of 10 cm over patella with crapitus present anteriourly fracture fragments present *Investigations* X-ray tagged *Diagnosis* ? *Management* ?

32 years female, complained that reddish discoloration developed after given Nuerobian Injection at Buttock. *Chief Complaints* No Pain & inflammation No rash *History* She had taken Injection Nuerobian intramuscularly left side buttock. After some time at the Left side of the Gluteus Maximus region developed reddish brown color. This discoloration just below the injection site. Not exactly on Injection site. *Vitals* Normal Vitals *Physical Examination* Normal

The image shows a patient with multiple raised skin lesions, which are likely viral warts. Viral warts are caused by specific strains of the human papillomavirus (HPV) and can appear on various parts of the body, often spreading through direct contact. In my experience as Dr. Ashima Madan, a cosmetic dermatologist, I frequently encounter viral warts in the Kota region. I want to share my experiences to help others understand and manage this common skin condition effectively. Treatment Options at Skinssence Clinic 1. Cryotherapy: This method involves freezing the wart with liquid nitrogen. It is effective for many patients and typically requires multiple sessions. It is a favored option due to minimal scarring. 2. Topical Treatments: We use salicylic acid preparations which work by peeling off the wart gradually. This treatment is less invasive but takes longer to show results. 3. Laser Treatment: For those concerned about cosmetic outcomes, laser removal offers precision and excellent cosmetic results. It is especially useful for warts in sensitive areas like the face. 4. Electrosurgery and Curettage: This involves burning the wart with an electric current and then scraping it off. This method is highly effective for larger warts. Managing Recurrence Despite the effectiveness of these treatments, warts can recur. This is because the underlying HPV virus might persist in the skin. To minimize recurrence, I advise my patients to maintain good hygiene, avoid scratching or picking at warts, and keep affected areas dry. Prevention Tips Preventing the spread of warts is crucial. I recommend the following: - Avoid sharing personal items like towels and footwear. - Wear protective footwear in communal showers and swimming areas. - Regularly wash hands and avoid direct contact with warts. Zinc and Immune Support There is some evidence that zinc supplementation might boost the immune system and help the body fight off HPV. While more research is needed, I have seen some success with this approach in my practice. *Management* Causes? Treatment of options? Chances of recurrence? Effort if prevention?