Parkinson plus syndromes

There are number of  ''Parkinson plus'' Syndromes, which are characterized by their relative lack of response to therapy with levodopa/carbidopa

1.Parkinsonism + Vertical gaze palsy = Supranuclear palsy
2.Parkinsonism + prominent ataxia = olivopontocerebellar palsy
3. Parkinsonism + prominent orthostatic hypotension = Shy-Drager syndrome (now called multiple- system atrophy)

A useful mnemonic is to think of Mr. Parkinson as fine BRITish gentleman

Bradykinesia
Rigidity (cogwheel)
Instability (postural)
Tremor (resting)

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Normal Pregnancy Complaints

Normal Pregnancy Complaints

• Back ache 
• Bleeding gums 
• Breast enlargement 
• Carpal tunnel 
• Complexion changes
• Dizziness
• Fatigue 
• Fluid retention
• Hair & nails 
• Headaches 
• Leg cramps
• Morning sickness 
• Nose bleeds
• Stretch marks
• Stress incontinence 
• Varicose veins

Teratogenic drugs and their effects

Teratogenic drugs and their effects

Alcohol in pregnancy -- Fetal Alcohol Syndrome (FAH) - Midfacial hypoplasia and Long philtrum

Using DES in pregnancy - New born with T shaped Uterus

Dilantin/Phenytoin -- Craniofacial dysmorphism (5-10%) and also nail hypoplasia

Isotretinoin (Accutane) - Microtia -small ear - severe birth defects also heart problem

Lithium - Ebstein anomaly - large Right arium

Tetracyclin - Deciduous teeth discoloration (after 4 month)

Thalidomide - Phocomelia (Limb reduction defects exposure from Day 42-48)

Valproic Acid (Depakote) - Neural Tube Defects like Spina bifida , Congenital Heart disease

Coumadin - Chondrodysplasia punctata also optic atrophy