I managed to get a copy of the CD-ROM containing all the CPGs (Clinical Practice Guidelines) in Malaysia from 2002-May 2007. I’m gonna leave a copy of it with the librarian, so guys, if you want a copy, please get it from her. I believe Malaysian doctors should know Malaysian CPGs. 
Mon, 030907 @ 1343; my ward is like a war zone. Sigh
After a week’s hiatus (might as well take a break, since all the students were off for at least a week anyway), here is another clinical puzzle to crack:
This 20+ man was admitted in the ward a few months ago with complaints of weakness. He first presented with similar complaints 2 years ago. At that time, he was semi-comatose and in shock. He was resuscitated and discharged well. Subsequently he presented twice more with the same complaints before the last admission.
When asked, he mentioned that he is “darker than the rest” of the family members.
Here are some of his pictures.
What would be your differential diagnoses?
Mon, 030907 @ 0730
