tag:blogger.com,1999:blog-12865146033578804972024-03-19T00:25:32.378-07:00MedchromeTubeBest Medical VideosSulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.comBlogger60125tag:blogger.com,1999:blog-1286514603357880497.post-21070657994324765052017-02-14T05:34:00.001-08:002017-02-14T05:43:35.511-08:00Viva Exam: Blunders and Pretentions Video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="https://www.youtube.com/embed/ISbjAY1eDuM" width="100%"></iframe>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTEqyzXR40mRg2-Sv7OQV9j9-wkRXI0O3VRwggO9Xn3ZLgWsC5TvQ6drRFWzhaGAQnlHg5GNzZVftI1QGH1-1h8lzhRtCj01K1Gm7qtto229POXq-r1dc-KqHGTRyDm4XU4uN2tUs4PD8/s1600/Capture.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="163" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTEqyzXR40mRg2-Sv7OQV9j9-wkRXI0O3VRwggO9Xn3ZLgWsC5TvQ6drRFWzhaGAQnlHg5GNzZVftI1QGH1-1h8lzhRtCj01K1Gm7qtto229POXq-r1dc-KqHGTRyDm4XU4uN2tUs4PD8/s320/Capture.JPG" width="320" /></a>Viva Exams are one of the most stressful time for Medical students, while from other point, for the examiner the viva exams can be funny or unbearable.<br />
Here is a short movie on Medical viva exam- Anatomy. Watch the Professor under go all the fun and stress of students answers. He meets even his batchmate appearing for viva.<br />
Look at all the blunders and pretension.<br />
<br />
<br /></div>
Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-79966039588994209632016-11-08T07:50:00.000-08:002016-11-08T07:52:07.875-08:00Gower's sign in a child with DMD<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/HtvKc1aazJ4" width="100%"></iframe> <br />
Gower's sign which indicates proximal muscle or hip muscle weakness. The sign describes a patient that has to use their hands and arms to "walk" up their own body from a squatting position due to lack of hip and thigh muscle strength.<br />
<br />
Besides, Duchenne muscular dystrophy, it may also be seen in:<br />
<br />
<ol style="text-align: left;">
<li>Other muscular dystrophies</li>
<li>Proximal ascending pseudomyopathic diseases</li>
<li>Spinal muscular atrophy</li>
<li>Polymyositides</li>
<li>Discitis</li>
<li>Juvenile idiopathic arthritis</li>
</ol>
Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-9628782912368926292016-08-18T07:47:00.000-07:002016-08-18T07:47:22.177-07:00History of Modern Day Adult Diapers<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/u-kpMsdOoOg" width="560"></iframe>
<br />
<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="background: white; line-height: 16.8pt; margin-top: 0in;">
<b style="line-height: 16.8pt;"><span style="color: #272a34; font-size: 10.0pt;">History:</span></b></div>
<div style="background: white; line-height: 16.8pt; margin-top: 0in;">
<span style="color: #272a34; font-size: 10.0pt;">Disposable
travel diapers for infants were first marketed prior to 1940. Those were not
waterproof. PlayTex introduced their "Stretchy Baby Pants" in 1937 in
the USA, the first mass-marketed waterproof pants. <o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<span style="color: #272a34; font-size: 10.0pt;">In the late 1950s disposable underpads
were introduced to the hospital and nursing home industry in the USA. Kendall
Mills was the leading supplier. By then infant disposables with combined
poly-plastic outer layer were being sold. Those did not have sticky tapes
attached, so they were either held together with the same diaper pins used on
cloth diapers, or separate sticky tape was used. That was similar to ordinary
medical adhesive tape.<o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<span style="color: #272a34; font-size: 10.0pt;">Based on the Pampers R&D efforts,
which advanced the design of automated disposable diaper manufacturing
machines, P&G started a division to perfect adult disposables. Marketing of
those Attends in trade ads in hospital and nursing publications began in the
early 1970s. PaperPak Corporation had become a large maker of disposable
underpads to the hospital industry by the early 1980s and started making some
adult disposables.<o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<span style="color: #272a34; font-size: 10.0pt;">Kimberly Clark Corporation decided to
enter the baby disposable business with Huggies to rival Pampers during the
1970s. Eventually they started a low key R&D effort in the adult disposable
line, but they held back actually making a major marketing effort until KCC was
convinced there actually were enough adult disposables being sold to make it
profitable.<o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<span style="color: #272a34; font-size: 10.0pt;">By the time KCC rolled out Depend in
the early 1980s Attends were being sold in most supermarkets and drug stores.
The marketing department at KCC made the bold decision to hire June Allyson, a
singing dancing sweetheart actress from the 1940s to be the spokesperson on TV
for Depend. <o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<span style="color: #272a34; font-size: 10.0pt;">Newer Diapers are now available for
adults to best comfort and usability.<o:p></o:p></span></div>
<div style="background: white; line-height: 16.8pt;">
<b><span style="color: #272a34; font-size: 10.0pt;">Problem
statement:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: white; margin-bottom: 0.0001pt;">
<i><span style="font-family: "times new roman" , serif; font-size: 10pt;">Urinary and Fecal </span></i><a href="http://www.lifree.co.in/products/adult/b01/index.html"><i><span style="font-family: "times new roman" , serif; font-size: 10.0pt;">Incontinence and Adsorbent
products</span></i></a><i><span style="font-family: "times new roman" , serif; font-size: 10pt;"> <o:p></o:p></span></i></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<span style="font-family: "times new roman" , serif; font-size: 10pt;">Incontinence
is a common embarrassing problem which has a profound effect on social and
psychological well-being. People wear absorbent products for urine and/or
faeces and protect their clothes.</span></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<span style="font-family: "times new roman" , serif; font-size: 10pt; line-height: 18.45pt;">Who
are the major users of adsorbent product?</span></div>
<div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">younger women after reproductive age <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">older men with prostate disease like BPH<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">patients with neurological conditions like paralysis, spinal
injuries, Multiple sclerosis<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">older people with mobility and mental impairment- Alzheimers
disease, Parkinson disease and more</span></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<a href="https://www.youtube.com/watch?v=Qh4NIzWAQzM"><span style="font-family: "times new roman" , serif; font-size: 10.0pt;">Adsorbent products</span></a><span style="font-family: "times new roman" , serif; font-size: 10pt;"> used:<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<span style="font-family: "times new roman" , serif; font-size: 10pt;">For
light incontinence – small pads<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<span style="font-family: "times new roman" , serif; font-size: 10pt;">For
moderate-heavy incontinence - large absorbent pads: with a capacity of 2-3
litres<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt;">
<br /></div>
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<br />
<div>
<div style="border-bottom: solid #4F81BD 6.0pt; border-left: none; border-right: none; border-top: solid #4F81BD 6.0pt; margin-left: .5in; margin-right: .5in; mso-border-bottom-themecolor: accent1; mso-border-top-themecolor: accent1; mso-element: para-border-div; padding: 8.0pt 0in 8.0pt 0in;">
<div align="center" class="MsoQuote" style="border: none; line-height: 125%; margin-bottom: 8.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt; mso-border-bottom-alt: solid #4F81BD 6.0pt; mso-border-bottom-themecolor: accent1; mso-border-top-alt: solid #4F81BD 6.0pt; mso-border-top-themecolor: accent1; mso-padding-alt: 8.0pt 0in 8.0pt 0in; padding: 0in; text-align: center;">
<span style="font-family: "arial" , sans-serif; line-height: 125%;">As per studies, of
the disposable designs, the more expensive </span><a href="https://www.youtube.com/watch?v=2XTI1YGPA34"><span style="font-family: "arial" , sans-serif; line-height: 125%;">pull-up</span></a><span style="font-family: "arial" , sans-serif; line-height: 125%;"> and T-shaped diaper designs were not better
overall than the diaper for men, but the diaper was better than the insert
(the cheapest), making the diaper the most cost-effective disposable design
for men both day and night.Washable diapers are the least
expensive design but are unacceptable to most women at any time.<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<br /></div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
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LQAUAAYACAAAACEAu+VIlAUBAAAeAgAAEwAAAAAAAAAAAAAAAAAAAAAAW0NvbnRlbnRfVHlwZXNd
LnhtbFBLAQItABQABgAIAAAAIQCtMD/xwQAAADIBAAALAAAAAAAAAAAAAAAAADYBAABfcmVscy8u
cmVsc1BLAQItABQABgAIAAAAIQADoO9txgQAAPQPAAAfAAAAAAAAAAAAAAAAACACAABjbGlwYm9h
cmQvZHJhd2luZ3MvZHJhd2luZzEueG1sUEsBAi0AFAAGAAgAAAAhAEdgDJ7yBgAATBwAABoAAAAA
AAAAAAAAAAAAIwcAAGNsaXBib2FyZC90aGVtZS90aGVtZTEueG1sUEsBAi0AFAAGAAgAAAAhAHtA
itn9AAAA3QEAACoAAAAAAAAAAAAAAAAATQ4AAGNsaXBib2FyZC9kcmF3aW5ncy9fcmVscy9kcmF3
aW5nMS54bWwucmVsc1BLBQYAAAAABQAFAGcBAACSDwAAAAA=
" o:spid="_x0000_s1026" stroked="f" strokeweight=".5pt" style="height: 190.65pt; margin-left: -6.7pt; margin-top: 5.4pt; mso-height-percent: 0; mso-height-percent: 0; mso-height-relative: margin; mso-position-horizontal-relative: margin; mso-position-horizontal: absolute; mso-position-vertical-relative: line; mso-position-vertical: absolute; mso-width-percent: 0; mso-width-percent: 0; mso-width-relative: margin; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 7.2pt; mso-wrap-distance-right: 7.2pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; v-text-anchor: top; visibility: visible; width: 470.7pt; z-index: 251659264;" type="#_x0000_t202">
<v:path arrowok="t">
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<!--[if !mso]-->
<!--[endif]--></v:textbox>
<w:wrap anchorx="margin" anchory="line" type="square">
</w:wrap></v:path></v:shape><span style="font-family: "times new roman" , serif; font-size: 10pt; line-height: 107%;">Inference:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">Diapers are the most cost-effective disposable design for
men. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">Disposable pull-ups are most preferred for women <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">Disposable inserts are a cheaper alternative (except in nursing
homes where diapers are preferred to inserts at night). <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="background: white; line-height: 18.45pt; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "times new roman" , serif; font-size: 10pt;">Washable diapers are the cheapest design but have
limited acceptability.<o:p></o:p></span></div>
<div class="MsoNormal">
<b><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;">Sponsor<o:p></o:p></span></b></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;">Lifree </span><a href="http://www.lifree.co.in/products/adult/b01/index.html"><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;">adult adsorbent diaper</span></a><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;"> is claimed to be Japan’s number one brand, now
available in Indian markets. The adsorbent product are stretchable, with high
adsorptive capacity, user friendly and leak proof. If you are user of adsorbent
products, you should give Lifree a try.<o:p></o:p></span></div>
<div class="MsoNormal">
<i><span style="border: 1pt none; font-family: inherit , serif; font-size: 9.5pt; line-height: 107%; padding: 0in;">DISCLAIMER: <b>*Data
source: INTAGE SRI, ADULT DIAPERS SALES, APR’10- JAN’16</b> . The views
about the product described here are solely in experience of the writer and
does not represent view of the Lifree company or this website.</span></i><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
<span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;">( </span><a href="https://www.youtube.com/watch?v=u-kpMsdOoOg"><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;">Youtube
video of Lifree</span></a><span style="font-family: "times new roman" , serif; font-size: 10.0pt; line-height: 107%;"> )<o:p></o:p></span></div>
</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-69601972513417065332016-07-29T07:26:00.006-07:002016-07-29T07:42:02.229-07:00How to Burp a Baby after feeding? 2 Methods video demo<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/m50PTFmmlxw" width="100%"></iframe>
Eachtime a baby feeds on breast milk or bottle milk, it swallows air (~90%). Burping a baby after each feed will allow release of gas and hence prevent feed regurgitation and abdominal colic in infants. It has also been seen to be useful in preventing GER ( Gastroesophageal reflux).<br />
<br />
Two Methods have been demonstrated in the video.<br />
<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNOX8cfeFxXSYOezSJ62BA6SX9tU9xM2B0OWimAzsyCZDyXh_LwRjKeBJzJDZ5JS6DBOfNY0fr4FuYYQ3MQCjGhFheu0gPU4PLFC-qspRhYd2eQnP1M6FzqfULHEciTbDic8Ipp1cyi4Y/s1600/how-to-burp-baby.jpg" imageanchor="1"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNOX8cfeFxXSYOezSJ62BA6SX9tU9xM2B0OWimAzsyCZDyXh_LwRjKeBJzJDZ5JS6DBOfNY0fr4FuYYQ3MQCjGhFheu0gPU4PLFC-qspRhYd2eQnP1M6FzqfULHEciTbDic8Ipp1cyi4Y/s400/how-to-burp-baby.jpg" width="363" /></a><br />
<br />
1. Over the Shoulder method<br />
<ul style="text-align: left;">
<li> Sitting </li>
<li> Standing </li>
<li> Alternate sitting and standing </li>
</ul>
<br />
2. On the Lap method<br />
<br />
Find which suites you best and don't worry if baby does not burp each time.<br />
<br />
<br />
<br />
Hope the video helped you solve your queries.</div>
Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-82084634013056104052016-06-14T07:30:00.001-07:002016-06-14T07:33:34.093-07:00Complement System Activation : Video explanation<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/eptbhepdiUw" width="100%"></iframe> <br />
Complement System is part of Innate immunity. Complement cascades are activated against foreign body, bacteria and viruses. Here is an easy explanation of activation for complement system in human body. The video is illustrative and self explanatory.<br />
<br />
The complement cascade can be activated in 3 ways:<br />
<br />
<ol style="text-align: left;">
<li>Classical pathway </li>
<li>Alternative pathway </li>
<li>Lectin pathway </li>
</ol>
<br />
<br />
For the full text on complement system: Complement system made easy</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-1541757538372407442016-02-28T00:07:00.000-08:002016-08-14T22:59:47.005-07:00Adult adsorbent briefs : How to Choose right one<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"></span><br />
<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Incontinence of urine
or stool is one of the problems of elder age group specially in people who are
affected by specific diseases or conditions. We have explained the Urinary
incontinence earlier ( link to Medchrome Article 1). One solution is the Lifree
Adsorbent pants, Japan’s number 1 brand* .</span><br />
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span>
</span><br />
<div style="text-align: center;">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/onchhMBWC2o" width="560"></iframe></span></span></div>
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span>
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
Popularly referred to as Adult
adsorbent briefs, are innovations that
allow the incontinent elderly people to stay dry . One can again become socially active and talk
with heads high. </span>
</span><br />
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 10.0pt; line-height: 115%;">[ D</span><u><span lang="EN-IN" style="color: #500050; font-family: "times new roman" , "serif"; font-size: 10.0pt; line-height: 115%;">ISCLAIMER </span></u><span lang="EN-IN" style="color: #500050; font-family: "times new roman" , "serif"; font-size: 10.0pt; line-height: 115%;">: <b>*data source:
INTAGE SRI, ADULT DIAPERS SALES, APR’10- JAN’16]</b></span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span lang="EN-IN" style="color: #500050; font-family: "times new roman" , "serif"; font-size: 10.0pt; line-height: 115%;"><b><br /></b></span></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Adsorbent diapers have
enormous soaking power and is proven leak proof, hence ensuring dryness. Built
for comfort and lightness, they allow easy consumer experience with easy
wearing and undoing. Pant type diaper has elastic that hold the pant like an under-pant.
Another type is tape type that is usually chosen for bed ridden patients,
Critically ill patients in ICUs and has been widely used by many ICUs even for
young patients. It is an innovation that changes the life style of hundreds and thousands of elderly
people suffering from issues of urinary and fetal incontinence. The video here
is a piece of inspiration.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f">
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</v:imagedata></v:shape></span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><b><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Choosing Right One –<o:p></o:p></span></b></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><b><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></b></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><b style="color: #500050; font-family: 'Times New Roman', serif; font-size: 13.3333px; line-height: 15.3333px;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBuJVGfqai3grW_YqPiK_7ic1Ownv4zMhyrVUlhe-WH6pv1eOpyLB8Z01DSLBh-xGUWXgcP_24lA91cMz5eTSmnUKTkpFcMP2Rez2G-zFZ-vI5Nd-STeaVmqBaPwnyTbL_-qAhL3nQHbU/s1600/lifee.JPG" imageanchor="1"><img border="0" height="444" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBuJVGfqai3grW_YqPiK_7ic1Ownv4zMhyrVUlhe-WH6pv1eOpyLB8Z01DSLBh-xGUWXgcP_24lA91cMz5eTSmnUKTkpFcMP2Rez2G-zFZ-vI5Nd-STeaVmqBaPwnyTbL_-qAhL3nQHbU/s640/lifee.JPG" width="640" /></a></b></span></div>
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/fl0D1vT4h88" width="560"></iframe></v:imagedata></v:shape><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">For more details visit-
<link><b><u> </u></b></span><a href="http://www.lifree.co.in/cm/index.html" target="_blank"><span style="background: white; color: #1155cc;">http://www.lifree.co.in/cm/index.html</span></a><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">,< link><o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pull up pant types are
more popular among the mobile and active population. This has set a mark in
changing the lifestyle of such population increasing their age of productivity,
socialization and a happier life. Keep no stigma, it is not a diaper, it is an<b> Adsorbent pant. <o:p></o:p></b></span></span></div>
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><i><span style="background: white; color: #333333; font-family: "calibri" , "sans-serif"; font-size: 11.0pt; line-height: 115%;"><br /></span></i>
<i><span style="background: white; color: #333333; font-family: "calibri" , "sans-serif"; font-size: 11.0pt; line-height: 115%;">Disclaimer:
The views about the product described here are solely in experience of the
writer and does not represent view of the Lifree company or this website</span></i></span><br />
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><i><span style="background: white; color: #333333; font-family: "calibri" , "sans-serif"; font-size: 11.0pt; line-height: 115%;"><br /></span></i>
<i><span style="background: white; color: #333333; font-family: "calibri" , "sans-serif"; font-size: 11.0pt; line-height: 115%;">Writer- Mr Kumar, Health Article Freelance writer, India</span></i>
</span></div>
<span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span></div>
</div>
Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-1286514603357880497.post-9323872611595433072016-01-18T11:49:00.001-08:002016-06-14T07:34:35.213-07:00Complete Neurological examination video: Best for exam<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="420" height="315" src="http://www.youtube.com/embed/u8LQXnQ2zOU" frameborder="0" allowfullscreen></iframe><br />
<br />
The Examination of Nervous system is one of the long cases that is kept for exams. All Medical students, PG students and doctors have to be in flow with the proper neurological examination.<br />
Usually time alloted for Complete neurological examination is 20 minutes - maximun 30 minutes. With practice and creating pattern, you will gradually be able to complete examination in time. For this, the steps should not come from the brain but from a spinal level.<br />
<br />
The Preferred sequence of examination is<br />
1 Higher Mental Function<br />
2. Cranial Nerves Examination<br />
3.Motor system examination<br />
4. Sensory System examination<br />
5. Cerebellar signs examination<br />
6. Gait<br />
7. Abnormal movements<br />
8.Skull and spine<br />
9. Autonomic nervous system.<br />
<br />
Macleoad's Clinical examination videos and book are the best resource available and Hutchington is equally well writtern in the CNS section.<br />
However, we have included a complete neurological examination video and the video is of 22 minute. We belive that if you follow the sequence, you will eventually be able to finish you examination by 20 minutes during exams.<br />
<br />
Tips for exam-<br />
1. Use standard book Macleods<br />
2. Keep the sequence at Spinal level via repeated practice<br />
3. Keep practicing at regular intervals before exam<br />
4. Discuss it in groups<br />
5. Keep a timer to ensure a proper timing.<br />
6. Watch friends examine a patient and try to figure the shortcomings and comment.<br />
7. Read probable viva questions.<br />
8. Neurokit<br />
<b><u><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEillxUwiWEG6x0DTPkiVuKCkzMamxTeMIuO9tKfz9MwyvKvq4OyozjhFnG3ZUIwKJYqQJngN5-HcaRZ0jI12xKvyhYO-SQemdxWUF68OLFxJGz-PCnwU9zYlCRY4PoL4xoBokqTFDFmbv0/s1600/neuro-examination-kit.jpg" imageanchor="1"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEillxUwiWEG6x0DTPkiVuKCkzMamxTeMIuO9tKfz9MwyvKvq4OyozjhFnG3ZUIwKJYqQJngN5-HcaRZ0jI12xKvyhYO-SQemdxWUF68OLFxJGz-PCnwU9zYlCRY4PoL4xoBokqTFDFmbv0/s320/neuro-examination-kit.jpg" width="320" /></a></u></b><br />
<br />
Enjoy some extra resources- https://meded.ucsd.edu/clinicalmed/neuro2.htm<br />
<br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-32894471203083528332015-06-22T03:37:00.000-07:002015-08-19T07:31:34.383-07:00No Scalpel Vasectomy (NSV) - Video<div dir="ltr" style="text-align: left;" trbidi="on">
<strong><br /></strong>
<strong>Preoperative preparation:</strong> Following medical conditions must be ruled out -<br />
<ol>
<li>Local infection—including scrotal skin infection, active sexually transmitted infection (STI), balanitis, epididymitis, or orchitis</li>
<li>Previous scrotal injury</li>
<li>Systemic infection or gastroenteritis</li>
<li>Large varicocele</li>
<li>Large hydrocele</li>
<li>Filariasis; elephantiasis</li>
<li>Local pathological condition (e.g., intrascrotal mass, cryptorchidism, or inguinal hernia)</li>
<li>Bleeding disorders</li>
<li>Diabetes</li>
<li>AIDS</li>
</ol>
<strong>Requirements:</strong> Warm room temperature to relax the scrotum - The temperature of the operating room should be at least 70 to 80 degrees F (approximately 20 to 25 degrees C)<br />
<strong><br /></strong>
<strong>Instruments:</strong><br />
<ol>
<li>Ringed clamp</li>
<li>Dissecting forceps</li>
<li>Straight scissors</li>
</ol>
<strong>Supplies:</strong><br />
<ol>
<li>Scissors for scrotal hair clipping</li>
<li>Sterile gloves</li>
<li>Antiseptic solution for cleaning the operative area</li>
<li>Sterile drapes</li>
<li>10-cc syringe with a 1 & 1⁄2-inch, 25- or 27-gauge needle</li>
<li>1% or 2% lidocaine without epinephrine</li>
<li>Supplies for vasal occlusion according to the surgeon’s preference (examples: a cautery unit; chromic catgut or nonabsorbable silk or cotton for ligation)</li>
<li>Sterile gauze</li>
<li>Adhesive tape or Band-Aid for dressing the wound</li>
</ol>
<strong>Anesthesia: </strong><br />
<ol>
<li>After making the superficial skin wheal, advance the needle parallel to the vas within the external spermatic fascial sheath toward the inguinal ring.</li>
<li>Advance the full length of the needle, 1 & 1⁄2 inches, without releasing any of the anesthetic. Gently aspirate to ascertain that the needle is not in a blood vessel.</li>
<li>Without withdrawing the syringe, slowly inject 2 to 5 cc (depending on concentration) of lidocaine within the external spermatic fascial sheath around the vas deferens.</li>
<li>When the needle is in proper position and the injection is performed inside the external spermatic fascia, there is no resistance to the injection.</li>
<li>Epinephrine is not recommended because it contracts the blood vessels and results in less apparent bleeding at the time of surgery</li>
<li>The maximum individual dose of lidocaine without epinephrine should not exceed 4.5 mg/kg (2 mg/lb) of body weight.</li>
</ol>
<strong>Procedure:</strong><br />
<br />
1. Apply ringed clamp to scrotal skin: Using the three-finger technique, tightly stretch the skin overlying the vas. Apply the ringed clamp, with the shaft at a 90-degree angle perpendicular to the vas.<br />
<div>
<br /></div>
<div>
2. Elevate the underlying vas: While the ringed clamp is still grasping the scrotal skin and the underlying right vas, transfer the instrument to your left hand. Then lower the handles of the ringed clamp, causing a bend in the vas.</div>
<div>
<br /></div>
<div style="text-align: left;">
3. Puncture the scrotal skin:<br />
<ul style="text-align: left;">
<li>Midway between the top of the testes and the base of the penis</li>
<li>Hold the dissecting forceps in the right hand, points curved downward, in preparation for puncturing the vas. Hold the instrument so that there is a 45-degree angle between the closed tips of the forceps and the lumen. Then open the forceps; using only the medial blade of the forceps, pierce the scrotal skin just superior to the upper edge of the ringed forceps.</li>
<li>Gently open the tips of the dissecting forceps transversely across the vas, to create a skin opening twice the diameter of the vas.</li>
</ul>
4. Isolate the vas: The vas and surrounding tissue may then be elevated through the incision. After further blunt dissection, the fibrous layer surrounding the vas is incised longitudinally. Now fully isolated, the vas is ready for division.<br />
<br />
5. Manage the vas:<br />
<ul style="text-align: left;">
<li>Ligate the vas at 2 sites or use electrocautery</li>
<li>Remove the segment between two vasal ends: Removal of at least 15 mm is recommended to prevent the risk of recanalization</li>
</ul>
6. Procedure must be repeated at the contralateral side as well</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
7. Clean the wound and close with tapes</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
8. Scrotal support</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-34259893245803392432015-03-27T07:12:00.000-07:002015-06-15T09:32:05.990-07:00Neonatal Seizure : Video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/tSl762nCQCo" width="662"></iframe>
Neonatal seizures are often the most difficult thing to identify, specially wen seizures are subtle.<br />
In newborns, Seizure can present with following features-<br />
<br />
<ol style="text-align: left;">
<li>Autonomic instability- Tachycardia, respiratory changes, High BP</li>
<li>Sucking movements of lips</li>
<li>Tonic eye deviation</li>
<li>Vacant staring episodes</li>
<li>Paddling/Cyclical limb movements</li>
<li>Stiffening of the body</li>
<li>In case of myoclonic seizures- head drops, salam spells.</li>
<li>Sometimes electrical seizures can occur that is identified on EEG only.</li>
</ol>
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Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-73996365312289245452015-03-20T08:09:00.002-07:002015-06-15T09:38:55.480-07:00Pill rolling tremor<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/rHuRiRHe5_I" width="662"></iframe>
Pill rolling tremor (Parkinsonism): Patient attempts to maintain body position at rest. Flexed elbow, wrist and MCP joint with flexion-extension and rotatory movement between thumb and finger (thumb moving across tips of all fingers). It is improved by activity and worsened at rest. Proximal muscles, lips and tongues are also frequently involved.
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-77930131199366799502014-09-26T19:43:00.002-07:002016-06-14T07:35:14.150-07:00Emergency decompression of Tension pneumothorax: Tutorial video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/C2eEPyjxczw" width="560"></iframe><br />
<br />
Emergency decompression of a Tension Pneumothorax can be a life saving procedure. Various causes leads to tension pneumothroax, specially in patients with lung disease, in critically ill and ventilated patients and in patients undergoing procedures, tension pneumothrax is likely. It is rapidly a fatal condtion and a dire emergency. All the time, Radiological confirmation might not be possible and clinical signs and symptoms, strong suspicion with examination can let us reach the diagnosis. Decompression of Pneumothorax is a procedure no Medical personal can not know. A simple needle decompression can be worthy enough to save a life. Knowing the right procedure and site of insertion of needle is demonstrated in this video. For the definite treatment, Intercostal drainage insertion should be planned for after this.<br />
<br />
Above video demonstrates proper device with one-way valve. For resource limited settings, Underwater seal can be used.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizZMptDBqnvvRUR09_M97Cu5fvaxpdB4Swv5mLdHFeOdkwfMoaxS3EFkTZXg9eedaBFI5XggtTh4WQyGLw-vEJSCaV3o-LCtp79dCWT6djD66fdI6XiVoriufRGU1JGdds4TaQU9q26GY/s1600/pneumothorax.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="317" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizZMptDBqnvvRUR09_M97Cu5fvaxpdB4Swv5mLdHFeOdkwfMoaxS3EFkTZXg9eedaBFI5XggtTh4WQyGLw-vEJSCaV3o-LCtp79dCWT6djD66fdI6XiVoriufRGU1JGdds4TaQU9q26GY/s1600/pneumothorax.jpg" width="320" /></a></div>
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Please provide us feed back.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-42841096674089081912014-08-23T06:05:00.003-07:002015-06-15T09:47:55.684-07:00Heart Attack Patient Time travels to his Past: What went wrong? Video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="662" height="320" src="http://www.youtube.com/embed/xUmp67YDlHY" frameborder="0" allowfullscreen></iframe>
The fate of your child depends upon how you start and maintain your child's feeding habit and lifestyle. Here is one insightful video that has re-winded the life of a patient with heart attack. Think and decide, is this what you want your child to meet at the end. Less TV, more outdoor games, regular exerciser, healthy diet and cut off sweets and drinks. </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-35957699136834591102014-08-01T06:36:00.000-07:002015-06-15T09:47:24.189-07:00How much sleep do we need in a day?<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="320" src="http://www.youtube.com/embed/SVQlcxiQlzI" width="662"></iframe>
Sleep is a necessity of body homeostasis. Inadequate sleep or sleep lapse can cause tremendous amount of consequence on brain and bodily performance. How many hours of sleep per day is required is a big question. The requirement is variable but on an average a normal human needs an 8 hour sleep. The video given below is self explanatory.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_sSc0u210TNgsvdnsUfz5PzpViqsxumsOk_RcH-tB8HSaPrOokegjtuqRPzbddGxGBGMldXU6RMNOrCxNpJDQzV5hlkCc1q2M__70NyoE-fMuZLbeGiD5vCQSUwLQxxQ9gcH_U7-LP8c/s1600/download.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_sSc0u210TNgsvdnsUfz5PzpViqsxumsOk_RcH-tB8HSaPrOokegjtuqRPzbddGxGBGMldXU6RMNOrCxNpJDQzV5hlkCc1q2M__70NyoE-fMuZLbeGiD5vCQSUwLQxxQ9gcH_U7-LP8c/s1600/download.jpg" style="cursor: move;" /></a></div>
<br />
The hazards of Sleep deprivations- Read <a href="http://medchrome.com/medicalcolleges/student-life/compromise-sleep-time-studies/" target="_blank">symptoms and signs of sleep deprivation.</a></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-27421675456656687882014-07-08T06:10:00.000-07:002015-08-19T06:36:24.692-07:00Tracheotomy Procedure with Animation tutorial<div dir="ltr" style="text-align: left;" trbidi="on">
Tracheotomy and tracheostomy are surgical procedures on the neck to open a direct airway through an incision in the trachea (the windpipe). It is performed in emergency situations, in the operating room , or at bedside of critically ill patients. This procedure, technically called a cricothyroidotomy, should be undertaken only when a person with a throat obstruction is not able to breathe at all-no gasping sounds, no coughing-and only after you have attempted to perform the Heimlich maneuver three times without dislodging the obstruction.<br />
<br />
<b><u>Procedure</u></b><br />
<ol style="text-align: left;">
<li>Find the person's Adam's apple (thyroid cartilage).</li>
<li>Move your finger about 1 inch down the neck until you feel another bulge. This is the cricoid cartilage. The indentation between the two is the cricothyroid membrane, where the incision will be made.</li>
<li>Take the razor blade or knife and make a 1/2 inch horizontal incision. The cut should be about half an inch deep. There should not be too much blood.</li>
<li>Pinch the incision open or place your finger inside the slit to open it.</li>
<li>Insert your tube in the incision, roughly one-half to one inch deep.</li>
<li>Breathe into the tube with two quick breaths. Pause 5 seconds, then give 1 breath every 5 seconds.</li>
<li>You will see the chest rise and the person should regain consciousness if you have performed the procedure correctly. The person should be able to breathe on their own, albeit with some difficulty, until help arrives.</li>
</ol>
<br />
<blockquote>
<i>The term tracheostomy is sometimes used interchangeably with tracheotomy. Strictly speaking, however, tracheostomy usually refers to the opening itself while a tracheotomy is the actual operation.</i></blockquote> </div>Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-45282631195707598432014-06-10T02:23:00.000-07:002015-08-19T06:36:45.002-07:00Nasal Myiasis Removal Video
Myiasis is the infestation of tissue with fly larvae, commonly referred to as maggots. Maggots infest nose, nasopharynx and paranasal sinuses causing extensive destruction and obvious deformity.<br />
<br />
<b>Treatment:</b><br />
<ol style="text-align: left;">
<li>Visible maggots should be picked up with forceps</li>
<li>Instillation of chloroform water/ether and oil (liquid paraffin) kills them</li>
<li>Nasal docuhe with warm saline is used to remove slough, crusts and dead maggots</li>
<li>Avoid contact of the patient with flies by use of mosquito nets</li>
<li>Nasal hygiene for prevention</li>
</ol>
<b>For complete information about nasal myiasis: </b><a href="http://medchrome.com/minor/ent/nasal-myiasis-maggots-in-nose/">http://medchrome.com/minor/ent/nasal-myiasis-maggots-in-nose/</a>Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-62414789144952910042013-11-13T02:09:00.000-08:002015-06-15T09:52:04.158-07:00Pulsus Paradoxus- Correct technique of measurement<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="662" height="320" src="http://www.youtube.com/embed/jTsjCZ9QxW8" frameborder="0" allowfullscreen></iframe>
Systolic blood pressure normally falls during quiet inspiration in normal individuals. It is the accentuation of normal physiology where there is an inspiratory fall in systolic blood pressure more than 10 mmHg.<br />
<br />
<b><a href="http://answers.medchrome.com/203/what-is-pulsus-paradoxus" target="_blank">Pulsus paradoxus</a></b> is defined as a fall of systolic blood pressure of more than 10 mmHg during the inspiratory phase. <i>[Eur Respir J. 2012 Dec 6. Pulsus paradoxus. [Hamzaoui O Et Al]</i><br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSJUuRYIPQtyeY4dqnwsdfXr5tUt-B_O9FpLUIYbYmU0j43E7nKjWeUoiXQwx5xiASpWKuuYCB1YIULr_mAJlNG7YNtNvcXM-oqZts-HOjxpQH35gYP1LzRY7v93TCwORu6GFXnr-B_bg/s1600/BP.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="293" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSJUuRYIPQtyeY4dqnwsdfXr5tUt-B_O9FpLUIYbYmU0j43E7nKjWeUoiXQwx5xiASpWKuuYCB1YIULr_mAJlNG7YNtNvcXM-oqZts-HOjxpQH35gYP1LzRY7v93TCwORu6GFXnr-B_bg/s320/BP.jpg" width="320" /></a></div>
<br />
<br />
<b><u>Measurement:</u></b><br />
1.Inflate the cuff beyond the point where you hear any Korotkoff sounds.<br />
2.Slowly deflate the cuff until you start hearing any sounds. At the highest BP when you hear sounds intermittently (rather than with every heart beat), note the blood pressure. (This corresponds to the higher systemic blood pressure which is occurring during expiration).<br />
3.Keep slowly deflating the cuff until you reach the highest BP in which you hear sounds every beat.<br />
4.The difference between #2 and #3 is the “pulsus paradoxus.” If it is >10 mmHg, it is considered significant.
<br />
<br />
<b><u>Cardiac causes</u></b><br />
Cardiac tamponade<br />
Pericardial effusion<br />
Constrictive pericarditis<br />
Restrictive cardiomyopathy<br />
Pulmonary embolism<br />
Acute myocardial infarction<br />
Cardiogenic shock<br />
<br />
<b><u>Extracardiac pulmonary causes</u></b><br />
Bronchial asthma<br />
Tension pneumothorax<br />
<br />
Early recognition of pulsus paradoxus can help to diagnose rapidly cardiac tamponade, assess the severity of acute asthma as well as its response to therapy. Its essential to have good clinical skill inspite of development of newer technology
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-10499043553519304372013-08-20T21:26:00.000-07:002015-06-15T09:54:59.736-07:00How to draw brachial plexus : Video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="662" height="320" src="http://www.youtube.com/embed/9E1eIAKLxNs" frameborder="0" allowfullscreen></iframe>
1. Write the Root values C5, C6, C7, C8 and T1 leaving almost equal space between the 2 consecutive points.<br />
<br />
2. Join C5 and C6 like in the video to get image similar to greater than sign. Join C8 and T1 in the same manner. Leave C7 alone in between.<br />
<br />
3. As demonstrated in the video, from green, blue and orange figures obtained from step 2, extend 3 curved parallel lines that drop into the same imaginary horizontal line.<br />
<br />
4. From the end of the green line extend a line (brown) to the orange line slightly above the end of the orange line as shown in the picture below.<br />
<br />
5. In between the green and blue line draw a cross touching both lines. Draw a branch from orange line on the blue line such that it meets the green line of the cross.<br />
<br />
6. For branches and labelling, follow the video or picture.<br />
<br />
Mnemonic: Real Teenager Drinks Cold Beer (R=Root, T=Trunk, D=Division, C=Cord and B=Branches)<br />
</div>Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-27669457181980758702013-05-30T03:06:00.002-07:002015-06-17T19:48:12.240-07:00Laryngeal Mask Airway (LMA) Insertion Technique<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="662" height="320" src="http://www.youtube.com/embed/KZ29OG0ZJbY" frameborder="0" allowfullscreen></iframe>
Originally designed for use in spontaneously breathing patients, it consists of a ‘mask’ that sits over the laryngeal opening, attached to which is a tube that protrudes from the mouth and connects directly to the anaesthetic breathing system. On the perimeter of the mask is an inflatable cuff that creates a seal and helps to stabilize it.<br />
<br />
<b>The use of the laryngeal mask overcomes some of the problems of the simple adjuncts:</b><br />
<br />
<ol style="text-align: left;">
<li>It is not affected by the shape of the patient’s face or the absence of teeth.</li>
<li>The anaesthetist is not required to hold it in position, avoiding fatigue and allowing any other problems to be dealt with.</li>
<li>It significantly reduces the risk of aspiration of regurgitated gastric contents, but does not eliminate it completely.</li>
</ol>
<br />
<b>Relative contraindication: </b><br />
<br />
<ol style="text-align: left;">
<li>Increased risk of regurgitation, for example in emergency cases, pregnancy and patients with a hiatus hernia. </li>
</ol>
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0qK8KJShkGachYWXClcwlJAPQmTczS6GqwSXiUYBfS6aNjEQQ_YLs32_NLrCt8gG9LVCCvKUSg8YZIFY4_8mpApdVT6AQClgYASnsfdiNBT_PyUO5R59QxZ4n9VWCNLOmMZLgt9vdbK0/s1600/LMA+insertion.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0qK8KJShkGachYWXClcwlJAPQmTczS6GqwSXiUYBfS6aNjEQQ_YLs32_NLrCt8gG9LVCCvKUSg8YZIFY4_8mpApdVT6AQClgYASnsfdiNBT_PyUO5R59QxZ4n9VWCNLOmMZLgt9vdbK0/s1600/LMA+insertion.gif" /></a></div>
<b>Technique for insertion of the standard LMA:</b><br />
<br />
<ol style="text-align: left;">
<li>The patient’s reflexes must be suppressed to a level similar to that required for the insertion of an oropharyngeal airway to prevent coughing or laryngospasm.</li>
<li>The cuff is deflated and the mask lightly lubricated.</li>
<li>A head tilt is performed, the patient’s mouth opened fully and the tip of the mask inserted along the hard palate with the open side facing but not touching the tongue.</li>
<li>The mask is further inserted, using the index finger to provide support for the tube.</li>
<li>Eventually, resistance will be felt at the point where the tip of the mask lies at the upper oesophageal sphincter.</li>
<li>The cuff is now fully inflated using an air-filled syringe attached to the valve at the end of the pilot tube.</li>
<li>The laryngeal mask is secured either by a length of bandage or adhesive strapping attached to the protruding tube.</li>
<li>A ‘bite block’ may be inserted to reduce the risk of damage to the LMA at recovery.</li>
</ol>
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-43960173505688555692013-05-25T04:24:00.000-07:002015-06-15T09:56:02.160-07:00Classification of Seizure<div dir="ltr" style="text-align: left;" trbidi="on">
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Seizure is any clinical event caused by an abnormal electrical discharge in the brain, whilst epilepsy is the tendency to have recurrent seizures.<br />
<br />
<b>Classification:</b><br />
<br />
A. Partial seizure: Focal, only part of cortex involved<br />
<br />
<ol style="text-align: left;">
<li>Simple: No loss of consciousness (LOC), no postictal state</li>
<li>Complex: Postictal state present, LOC may or may not be present</li>
</ol>
<br />
B. Generalized seizure: Always associated with LOC, whole cortex is involved<br />
<br />
<ol style="text-align: left;">
<li>Absence (petit mal): Brief episode of nonresponsiveness to external
or internal stimuli; motor tone is preserved</li>
<li>Tonic–clonic (grand mal): Generalized convulsion - brief tonic phase
(stiffening) followed by clonic phase (rhythmic jerking) </li>
</ol>
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-71080468128992640462013-05-11T05:52:00.000-07:002015-06-15T09:56:39.791-07:00Intubation procedure: Video<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe width="662" height="320" src="http://www.youtube.com/embed/BRjN3kQZLRI" frameborder="0" allowfullscreen></iframe>
<b>Indications:</b><br />
1. Maintenance of a patent airway:<br />
<br />
<ul style="text-align: left;">
<li>When an awkward intraoperative position is required (eg. lateral decubitus, prone, sitting)</li>
<li>When the airway is inaccessible (eg. during head and neck operations)</li>
<li>When difficulties with the face mask are anticipated (eg. in grossly obese or edentulous patients or those with unusual facial features).</li>
</ul>
<br />
2. Protection of the airway: from contamination by blood, pus, debris, or stomach contents<br />
<br />
3. Controlled ventilation<br />
<br />
<b>Technique of laryngoscopy and Tracheal intubation:</b><br />
<br />
<u>1. Position:</u> The patient is positioned supine with the head resting on a pillow, in the so-called 'sniffing the morning air position' (flexion of the lower cervical spine and extension of head at atlanto-occipital junction). The position aligns the oral, pharyngeal and laryngeal axis so that the pathway from the lips to the glottis is nearly a straight line.<br />
<br />
<u>2. Laryngoscopy:</u> The laryngoscope is held in the left hand, whilst the right hand is used to stabilize the head and open the mouth. The laryngoscope is inserted into the right side of the patient's mouth avoiding the incisor teeth and pushing the tongue to the left. The tip of the blade is advanced in the midline over the back of the tongue until the epiglottis comes into view. The tip of Macintosh laryngoscope blade should be positioned above the epiglottis, into the vallecula (the space between the base of tongue and the epiglottis). The tongue and pharyngeal soft tissues are then lifted, pulling the epiglottis up without directly touching it, exposing the glottic opening. You should use your arm and shoulder to lift the laryngoscope handle in an anterior and forward direction (along the long axis of handle containing the batteries). The tendency to lever the laryngoscope against the upper incisor teeth or upper gum should be avoided to prevent trauma.<br />
<br />
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<br />
<br />
The Miller blade, which is straight, is less commonly used. The tip of Miller blade is passed beneath the laryngeal surface of the epiglottis and the epiglottis itself is then lifted to expose the vocal cords. There is more risk of trauma to the epiglottis and stimulation of the laryngeal surface of the epiglottis.<br />
<br />
<u>3. Intubation:</u> The size of the tracheal tube used depends on the patient's age and body build. Usually an 8mm internal diameter cuffed tube is used for women and a 9mm tube for men. The tube is held in the right hand as one would hold a pencil and advanced through the oral cavity through the right corner of the mouth and then through the vocal cords. External pressure on the cricoid or thyroid cartilage may be required to help visualize the laryngeal inlet. The proximal end of the tube cuff is placed so that the cuff is below the vocal cords, and the length markings on the tube are noted in relation to the patient's lips. The cuff is inflated to obtain a seal in the presence of 20-30 cm H20 pressure of gas in the breathing system.<br />
<br />
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<br />
<br />
<u>4. Verification of position of tube:</u> The next step is to verify the position of the tracheal tube. The best method to determine the position of the tube is by detection of carbon dioxide in expired gas. It is possible for gas in the stomach to contain carbon dioxide but this will only be present in the first few 'breaths'. Visulaization of the end of the tube advancing through the vocal cords is also taken as a sign of correct palcement. However, tubes may be displaced after 'correct' insertion. Auscultation of both lung fields in the axilla and over the stomach may also be used to confirm correct placement, but is less reliable. Asymmetrical breath sounds may indicate that the tip of the tube lies in one or other of the main bronchi (usually the right_. The tube should be withdrawn until breath sounds are heard bilaterally.<br />
<br />
<b>Complications of orotracheal intubation include:</b><br />
<br />
<ul style="text-align: left;">
<li>Injury to lips, tongue or teeth</li>
<li>Injury to larynx (especially the arytenoid cartilages and the vocal cords)</li>
<li>Tracheal mucosa tear</li>
<li>Sympathetic stimulation</li>
</ul>
<br />
Attempting laryngoscopy or tracheal intubation in lightly anesthetized patients who are not fully relaxed can result in laryngospasm, coughing and bronchospasm. The laryngoscope should be removed, face-mask ventilation should be continued and anesthesia deepened or more muscle relaxant given to achieve adequate conditions. A peripheral nerve stimulator can be used to ensure complete neuromuscular blockade before commencing laryngoscopy and intubation. </div>Sulav Shresthahttp://www.blogger.com/profile/07867745685876547348noreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-66908132372831386352013-04-15T06:53:00.003-07:002022-01-11T14:07:44.125-08:00Brushing technique: Bass and Modified Bass Methods<div dir="ltr" style="text-align: left;" trbidi="on">
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There are 5 commonly used brushing techniques: Bass or modified bass, Charters, Modified Stillman, Rolling stroke and Modified stroke. While the rolling technique is commonly used by the children, Bass or modified bass is the commonest technique for the adults.
<br />
<br />
<b>Bass: </b><br />
<ol style="text-align: left;">
<li>Hold the toothbrush sideways against your teeth with some of the bristles touching your gums.</li>
<li>Tilt the brush so the bristles are at 45 degree angle and pointing at your gum line.</li>
<li>Move the brush back and forth, using short strokes. The tips of the bristles should stay in one place, but the head of the brush should wiggle back and forth. You also can make tiny circles with the brush. This allows the bristles to slide gently under the gum. Do this for about 20 strokes or 20 circles. </li>
<li>Repeat for every tooth, on the insides and outsides.</li>
<li>The toe bristles of the brush can be used to clean the lingual (tongue) surface of the anterior teeth.</li>
</ol>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1FUgKs4NNAGTNW4McyrKX7p0-ZPp2PZ7NhNfbsYlmONuo12Jd_0G_lo4sEZ-tFzQo7pwbl3uZjeaaHDCaYB7vHLTkO2IEauCtq1b0ahQXLv62toC6wMCCG2yp3uHPkjbg4GM2aBdSKNw/s1600/brushing+bass.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1FUgKs4NNAGTNW4McyrKX7p0-ZPp2PZ7NhNfbsYlmONuo12Jd_0G_lo4sEZ-tFzQo7pwbl3uZjeaaHDCaYB7vHLTkO2IEauCtq1b0ahQXLv62toC6wMCCG2yp3uHPkjbg4GM2aBdSKNw/s1600/brushing+bass.jpg" /></a></div>
<div>
<br /></div>
<div>
<br /></div>
<b>Modified Bass:</b><br />
<ol style="text-align: left;">
<li>Follow all the steps of the Bass technique.</li>
<li>After the vibratory motion has been completed in each area, sweep the bristles over the crown of the tooth, toward biting surface of the tooth.</li>
</ol>
<b>Importance of these methods:</b><br />
<ol style="text-align: left;">
<li>Most effective in cleaning cervical 1/3 & beneath gingival margins</li>
<li>Suitable for everyone – Periodontally healthy & periodontally disease</li>
<li>Periodontal maintenance</li>
<li>Cleanses sulcus (space between tooth and gums)</li></ol><div style="text-align: left;"><span id="docs-internal-guid-38c80a2f-7fff-894b-56e4-0a0049656e3a"><span style="background-color: white;"><span style="font-size: 12pt; font-weight: 700; text-align: justify; white-space: pre-wrap;">Importance Of Dental Visits</span><br /></span><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">You have learned the importance of the different brushing techniques. Now, it is time to know when needed to see your dentist and the importance of regular dental visits. It is imperative to see your doctor if you have a dental emergency.</span></p><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> For instance, you have a knocked-out tooth because of contact sports or a trip or slip accident. Another dental emergency cause is an excruciating tooth or gum pain. Swollen gums and any signs of infection also warrant professional dental consultation.</span></p><span style="background-color: white;"><br /></span><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white;"><span style="font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In general, you should see your dentist every six months or at least twice a year. Your dentist will evaluate your dental health by performing diagnostic procedures, such as dental x-ray. Dentists perform different treatments such as oral cleaning, tooth extraction, </span><a href="https://www.oceandental.sg/root-canal-treatment/" style="text-decoration-line: none;"><span style="color: #0563c1; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; text-decoration-line: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;">root canal treatment</span></a><span style="font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">, dental crown installation, and many more.</span></span></p><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Your dentist can also provide expert advice on the recommended brushing technique and other oral hygiene practices. So, don’t hesitate to ask your dentist any questions to shed light to common myths and correct poor dental practices.</span></p><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Conclusion</span></p><p dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt; text-align: justify;"><span style="background-color: white;"><span style="font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Protect your teeth and gums with the brushing techniques discussed above. These techniques will remove stubborn food debris and tartar in the gum line that causes dental plaque. Thoroughly brushing your teeth can help prevent </span><a href="https://medchrome.com/better-you/oral-health-problems-in-children-with-down-syndrome/" style="text-decoration-line: none;"><span style="color: #0563c1; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; text-decoration-line: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;">oral health issues</span></a><span style="font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> like gum disease and enamel damage.</span></span></p><div><span style="background-color: yellow; font-size: 12pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div>
</div>Unknownnoreply@blogger.com4tag:blogger.com,1999:blog-1286514603357880497.post-34587550706013719982013-04-14T07:20:00.003-07:002015-06-15T09:59:54.245-07:00Inferior Alveolar Nerve Block: Anatomical consideration and Technique<div dir="ltr" style="text-align: left;" trbidi="on">
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Inferior Alveolar Nerve Block (IANB) is a technique for dental anesthesia used to produce anesthesia of the mandibular teeth, gingival tissues of the mandible and the lower lip.<br />
<br />
<br />
<b>Nerves Anesthetized</b><br />
<br />
<ul style="text-align: left;">
<li>Inferior alveolar (CN V3 branch)</li>
<li>Incisive</li>
<li>Mental</li>
<li>Lingual</li>
</ul>
<br />
<b>Areas Anesthetized</b><br />
<br />
<ol style="text-align: left;">
<li>Mandibular teeth to the midline</li>
<li>Body of the mandible, inferior portion of the ramus</li>
<li>Buccal mucoperiosteum, mucous membrane anterior to the mental foramen (mental nerve)</li>
<li>Anterior two thirds of the tongue and floor of the oral cavity (lingual nerve)</li>
<li>Lingual soft tissues and periosteum (lingual nerve)</li>
</ol>
<br />
<b>Indications</b><br />
<br />
<ol style="text-align: left;">
<li>Procedures on multiple mandibular teeth in one quadrant</li>
<li>When buccal soft tissue anesthesia (anterior to the mental foramen) is necessary</li>
<li>When lingual soft tissue anesthesia is necessary</li>
</ol>
<br />
<b>Contraindications</b><br />
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<div style="text-align: left;">
</div>
<ol style="text-align: left;">
<li>Infection or acute inflammation in the area of injection (rare)</li>
<li>Patients who are more likely to bite their lip or tongue, for instance, a very young child or a physically or mentally handicapped adult or child</li>
</ol>
<br /><br />
<div style="text-align: left;">
<br /></div>
<b>Advantages</b><br />
<br />
<ul style="text-align: left;">
<li>One injection provides a wide area of anesthesia (useful for quadrant dentistry).</li>
</ul>
<br />
<b>Disadvantages</b><br />
<br />
<ul style="text-align: left;">
<li>Wide area of anesthesia (not indicated for localized procedures)</li>
<li>Rate of inadequate anesthesia (31% to 81%)</li>
<li>Intraoral landmarks not consistently reliable</li>
<li>Positive aspiration (10% to 15%, highest of all intraoral injection techniques)</li>
<li>Lingual and lower lip anesthesia, discomfiting to many patients and possibly dangerous (self-inflicted soft tissue trauma) for certain individuals</li>
<li>Partial anesthesia possible where a bifid inferior alveolar nerve and bifid mandibular canals are present; cross-innervation in lower anterior region</li>
</ul>
<br />
<b>Symptoms</b><br />
<br />
<ol style="text-align: left;">
<li>Tingling or numbness of the lower lip (mental nerve)</li>
<li>Tingling or numbness of the tongue (lingual nerve)</li>
</ol>
<br />
<b>Signs</b><br />
<br />
<ol style="text-align: left;">
<li>Using an electrical pulp tester (EPT) and eliciting no response to maximal output (80/80) on two consecutive tests at least 2 minutes apart serves as a “guarantee” of successful pulpal anesthesia in nonpulpitic teeth. </li>
<li>No pain is felt during dental therapy.</li>
</ol>
<br />
<b>Precautions</b><br />
<br />
<ol style="text-align: left;">
<li>Do not deposit local anesthetic if bone is not contacted. The needle tip may be resting within the parotid gland near the facial nerve (cranial nerve VII), and a transient blockade (paralysis) of the facial nerve may develop if local anesthetic solution is deposited.</li>
<li>Avoid pain by not contacting bone too forcefully.</li>
</ol>
<br />
<br />
<b>Text from:</b> <i>Handbook of Local Anesthesia (Malamed)</i><br />
</div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-1286514603357880497.post-65022602945597328222013-04-06T08:48:00.002-07:002013-04-06T08:48:46.301-07:00Stages of fracture healing<div dir="ltr" style="text-align: left;" trbidi="on">
[starttext]<br />
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<b><br /></b>
<b>1. Inflammation: </b>Bleeding from fracture site and surrounding soft tissues creates a hematoma, which provides a source of hematopoietic cells capable of secreting growth factors. Subsequently fibroblasts, mesenchymal cells, and osteoprogenitor cells are present at the fracture site, and granulation tissue forms around the fracture ends. Osteoblasts, from surrounding osteogenic precursor cells, fibroblasts, or both proliferate.<br />
<br />
<b>2. Repair:</b> Primary callus response occurs within 2 weeks. If the bone ends are not in continuity, bridging (soft) callus occurs. The soft callus later is replaced, via the process of enchondral ossification, by woven bone (hard callus). Another type of callus, medullary callus, supplements the bridging callus, although it forms more slowly and occurs later. The amount of callus formation is indirectly proportional to the amount of immobilization of fracture.<br />
<br />
<b>3. Remodeling:</b> This process begins during the middle of the repair phase and continues long after the fracture has clinically healed (upto 7 years). Remodeling allows the bone to assume its normal configuration and shape based on the stresses to which it is exposed (Wolff's law). Throughout the process, woven bone formed during the repair phase is replaced with lamellar bone.<br />
<br />
<i>Text source: Miller Review of Orthopaedics</i><br />
[endtext]<br /></div>
http://www.youtube.com/watch?v=VZF3xicLtTwendofvid
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-65611016052248257352013-02-25T04:31:00.001-08:002015-06-16T03:01:37.735-07:00Outbreak Investigation Basics<div dir="ltr" style="text-align: left;" trbidi="on">
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[starttext]Epidemic or outbreak is a significant rise of level of disease above the normal endemic level (expected level of disease in community). The steps in outbreak investigation are:<br />
<br />
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<br />
<br />
1. Prepare for fieldwork in advance: Literature review, decide role, team, equipments<br />
<br />
2. Establish the existence of an outbreak:<br />
<br />
<ul style="text-align: left;">
<li>Compare with previous weeks, months or years of same geographic area and time period</li>
<li>Excess may not be outbreak. It may be due to population change, media attention, improved screening, change in case definition, etc.</li>
</ul>
<br />
3. Verify the diagnosis, if possible<br />
<br />
4. Define, identify and collect data on all cases<br />
<br />
a. <u>Case definition</u>:<br />
<br />
<ul style="text-align: left;">
<li>Must include personal information, place information, time information and clinical information</li>
<li>Types:</li>
</ul>
<blockquote class="tr_bq">
<ul style="text-align: left;">
<li>Possible (Suspected): Broadest definition</li>
</ul>
<ul style="text-align: left;">
<li>Probable</li>
</ul>
<ul style="text-align: left;">
<li>Confirmed (Definite): Tightest definition (A clinically compatible case that is not laboratory confirmed and is not epidemiologically linked to laboratory-confirmed cases)</li>
</ul>
</blockquote>
<ul style="text-align: left;">
<li>Broad definition is needed in the beginning, so that cases aren't missed. It can be tightened later.</li>
</ul>
<br />
b. <u>Identify all possible cases:</u> surveillance data<br />
<br />
c. <u>Collect data on all possible cases:</u> in relation to person, place, time and clinical features<br />
<br />
5. Perform descriptive epidemiology<br />
<br />
<ul style="text-align: left;">
<li>Person</li>
<li>Place (Spot map)</li>
<li>Time (Epidemic curve)</li>
</ul>
<br />
6. Develop a hypothesis<br />
<br />
<ul style="text-align: left;">
<li>Include: What is known about likely pathogen, who is at risk, likely exposures, mode of transmission</li>
<li>Should be testable</li>
</ul>
<br />
7. Evaluate hypothesis<br />
<br />
<ul style="text-align: left;">
<li>Comparative method: all cases having same symptoms, lab confirmation, etc.</li>
<li>Analytic method: attack rates, case fatality rates, relative risks, odds ratio, statistical significance testing (chi-square, p-value)</li>
</ul>
<br />
8. Refine hypothesis and execute additional studies if required<br />
<br />
9. Immplement control and prevention measures<br />
<br />
10. Communicate findings and prepare a report<br />
<br />
A very good pictorial guide: http://dse.healthrepository.org/bitstream/123456789/80/1/Obi%20Guide.jpg<br />
<br />
<b>Some terms:</b><br />
<br />
<ul style="text-align: left;">
<li>Index case: First person to come to attention to public health authorities</li>
<li>Primary case: Acquiring disease from an exposure</li>
<li>Secondary case: Acquiring disease from exposure to primary case</li>
</ul>
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1286514603357880497.post-52969628651273575942013-02-21T22:53:00.002-08:002015-06-16T03:00:57.908-07:00Physiology and Effects of Alcohol on Brain<div dir="ltr" style="text-align: left;" trbidi="on">
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Alcohol can be regarded as a drug as it can cause physiologic addiction in all who consume it and may result in intoxication, tolerance or withdrawal.<br />
<br />
<b>Absorption and Elimination of alcohol:</b><br />
<ol style="text-align: left;">
<li>20% in stomach and 80% in small intestine</li>
<li>Can be detected in blood within 2-3 minutes of swallowing a few sips of whisky or beer</li>
<li>A single bolus of alcohol taken into an empty stomach will be completely absorbed into portal bloodstream within 30-90 minutes</li>
<li>As soon as alcohol enters the bloodstream, liver and kidneys will begin to eliminate</li>
<li>90% is eliminated by liver and 10% by kidneys, sweat and breath</li>
<li>Chronic alcoholics with induced liver Cyt. P450 (until their liver fails) can metabolize alcohol at an abnormally high rate</li>
<li>Normal rate of elimination for non-alcoholic: 10 to 25 mg/100ml/hr</li>
</ol>
<br />
<b>Blood Alcohol Concentration (BAC): </b>BAC expressed as mg/dl or mg% is the most useful measurement of alcohol, because the rapid equilibrtion of alcohol across Blood brain barrier (BBB) means that BAC reflects the concentration of alcohol currently affecting the brain.<br />
<br />
Mathematically, <b>BAC</b> = Total amount of alcohol in body/ Total amount of body water<br />
<br />
<u>The factors increasing BAC are:</u><br />
<br />
1. Decreased body water<br />
<ul style="text-align: left;">
<li>Low body weight</li>
<li>Appreciable adiposity</li>
<li>Female gender</li>
</ul>
2. Faster absorption<br />
<ul style="text-align: left;">
<li>Rapid drinking</li>
<li>Empty stomach</li>
</ul>
<blockquote class="tr_bq">
<ul style="text-align: left;">
<li>Food physically obstructs the contact of alcohol molecules with gastric mucosa</li>
</ul>
<ul style="text-align: left;">
<li>Food delays emptying through the pylorus</li>
</ul>
</blockquote>
<ul style="text-align: left;">
<li>Optimum concentration of alcohol (around 20%)</li>
</ul>
<blockquote class="tr_bq">
<ul style="text-align: left;">
<li>Week drinks like beer have poor absorption</li>
</ul>
<ul style="text-align: left;">
<li>Strong spirits (>40% concentration) irritate gastric mucosa resulting in excess secretion of mucus (barrier), cause pyloric spasm and reduce gastric motility</li>
</ul>
</blockquote>
<ul style="text-align: left;">
<li>Gastrectomy, Gastrojejunostomy</li>
</ul>
<b>Effects of Alcohol on Brain:</b><br />
<br />
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Alcohol depresses the nervous system and any apparent initial excitant effect is due to suppression of inhibition by the cerebral cortex. It begins to act at lowest concentration upon the higher centers and it affect the lower centers of CNS only when BAC becomes higher. The correlation of BAC and physiologic effects have been correlated below:<br />
<ul style="text-align: left;">
<li>0 to 50 mg%: No significant effect or mild euphoria</li>
<li>50 to 100 mg% (Cerebral cortex): Talkativeness, More self confidence, Reduced social inhibitions, Slight sensory disturbance, Poor judgement</li>
<li>100 to 150 mg% (Limbic system): Exaggerated emotions and memory loss</li>
<li>150 to 300 mg% (Cerebellum): Incoordination, unsteadiness, slurred speech, ataxia (Obvious drunkenness)</li>
<li>300 to 400 mg+ % (Hypothalamus and Medulla): Stupor, Increased BP, Decreased temperature, Bradycardia, Respiratory depression, Coma, Death </li>
</ul>
A person is likely to appear more uninhibited in a student party than in a very formal function given the same level of alcohol.<br />
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