Ginger has been used since ancienttimes to treat many ailments.

During pelvic examinations, tissuefrom the vaginal walls often obstructsthe view of the cervix by enteringlaterally from either side of the openspeculum.

Levofloxacin, 500 mg/d, had been prescribed for a 74-year-old woman who had a urinary tract infection. The patient had type 2 diabetes and hypertension. She was allergic to sulfa drugs. Two hours after taking the first oral dose of the antibiotic, painful blisters developed on the lower lip and soft palate.

Numerous plaques, some with yellow crusting and central scarring, had erupted primarily on the face and neck of a 46-year-old man. A single lesion had developed on his left elbow as well. The lesions were initially diagnosed as impetigo, but they failed to resolve after 2 courses of oral cephalexin.

This condition is characterized bya localized narrowing of the jejunumwithout a disruption of continuityor defect in the mesentery. At thestenotic site, there is often a short,narrow segment with a minute lumenwhere the muscularis is irregularand the submucosa is thickened.The resultant intestinal obstructionis incomplete.

This obstruction is caused by a failure of intestinal peristalsis;there is no evidence of mechanical obstruction.Paralytic ileus is common after abdominal surgery, especiallyif anticholinergic drugs are given preoperativelyand/or narcotics are used postoperatively. It usually lasts2 to 3 days. Paralytic ileus may also be caused by peritonitis;ischemia or surgical manipulation of the bowel; retroperitonealhemorrhage; spinal fracture; systemic sepsis;shock; hypokalemia; uremia; pharmacologic agents (eg,vincristine, loperamide, and calcium channel blockers);diabetic ketoacidosis; and myxedema.

When children are repeatedly askedto take deep breaths during auscultationof the lungs, they often get discouragedafter the second request.

A 58-year-old man with a history of a seizure disorder was hospitalized with acute-onset shortness of breath immediately following a tonic-clonic seizure. He was afebrile; in respiratory distress; and hypoxic, with an oxygen saturation of 84% on room air. Auscultation revealed bibasilar crackles and an S3 gallop. The patient was given noninvasive mechanical ventilatory support, oxygen, and diuretics.

Persistent bloating, epigastric discomfort, and increased gastric acidity prompted a 47-year-old woman to seek medical care. Gastroesophageal reflux disease was diagnosed; antacids and H2-blockers were prescribed but provided no relief.

This obstruction results from hypertrophyof the circular and longitudinalmuscularis of the pylorus and the distalantrum of the stomach. It occursin approximately 3 of every 1000 livebirths and is 4 times more commonin boys. Pyloric stenosis (PS) is relativelyuncommon in African Americanand Asian infants. The observationthat it occurs primarily in first-borninfants has been disputed.

This disorder occurs in fetal development,when the midgut supplied bythe superior mesenteric artery growstoo rapidly to be accommodated inthe abdominal cavity. Prolapse intothe umbilical cord occurs around thesixth week of gestation. Between thetenth and eleventh weeks, the midgutretracts from its location at the exocelomicumbilical stalk back into theabdominal cavity. During this return,the midgut undergoes a 270-degreecounterclockwise rotation about theaxis of the superior mesenteric artery,followed by fixation to the posteriorabdominal wall. Malrotationresults from failure of the midgut toproperly rotate and affix itself to thiswall. This disorder occurs approximatelyonce in 500 live births.

Alimentary tract duplications are uncommon. Gastric duplication accounts for only 3.8% of these duplications. The cause is not known, but faulty separation of the endoderm and notochord early in embryonal development is thought to be responsible. The anomaly occurs in twice as many female as male infants.

Painful erosions developed on the sole of a 14-year-old girl's foot several weeksearlier. Within the last few days, the condition has spread to the other sole.The patient is otherwise healthy and takes no medications. She enjoys playingsoccer and has no history of trauma.

Four pink nodules appeared in a linear array on the proximal extensor right forearm of a 77-year-old man. The asymptomatic lesions, which ranged from 0.5 to 1.0 cm in diameter, had been present for 2 months.

In addition to standard therapy forsinusitis, suggest that patients breathein steam from water that containseucalyptus leaves or oil.

Is soaking the feet in an aluminum salt solution an effective therapy fordyshidrosis?

A middle-aged woman had had alow-grade fever, sore throat, and malaisefor 1 week. Her physician prescribedamoxicillin. Three days afterstarting the medication, an asymptomaticerythematous and petechialeruption developed over the patient’sentire body.

A 30-year-old man presented with a few-day history of aviral prodrome, including a low-grade fever, mild headache,muscle and joint aches, and malaise, accompaniedby a vesiculopapular rash. The mildly pruritic eruptionbegan on the head and neck and progressed within 36hours to the trunk and proximal extremities; the palmsand soles were spared.

A 67-year-old woman was admitted to the hospital with fever, chills, unilateral flank pain, dysuria, and urinary frequency and urgency. Her past medical history included several febrile relapses of infection.

A 40-year-old woman was concerned about an area of redness and tenderness on her left breast. Despite antibiotic therapy prescribed by another physician, the rash had progressed during the past month to erythema and nodules that involved the anterior chest and right breast.