Medical Truths, Lectures, Slides, e-Papers, ....

Pregnancy - Early Signs

noreply@blogger.com (Sharan R) — Mon, 25 Jul 2011 14:51:00 +0000

A lot of couples who are hoping to have a baby will likely react to the very slightest discomfort that they hope might signal that the woman is finally pregnant. Of course, pinpointing pregnancy so early on is typically not easy, as some of the discomfort that the lady feels may be credited to something other than pregnancy.

The following symptoms may be present but they may not necessarily be caused by a pregnancy:

1. Tiredness or fatigue – Extreme tiredness can happen as early as a week following conception. But this is more difficult to use as a gauge because fatigue can be caused by many other things, such as lack of sleep or a general physical exhaustion from a busy week or weeks.

2. Breast tenderness – You may notice your breast starting to feel tender, swollen, or simply more sensitive than usual. Although this also happens just before you get your period, as a sign of pregnancy, it can happen about one to two weeks following conception.

3. Irritability or moodiness – Hormonal changes can cause mood swings that are more pronounced than usual. Of course, you need to remember that you may also feel moody when your period is approaching. As such if this is a symptom of pregnancy it is usually disregarded in the absence of the other symptoms.

4. Headaches – Raised levels of hormones may cause headaches; as such, some women experience headaches early on in a pregnancy. But this symptom is a little too common to attribute directly to a pregnancy, as it can be caused by any myriad of factors.

5. Food cravings – Although cravings are generally joked about around someone who is pregnant, it may not be an accurate gauge of pregnancy minus other confirmation. After all, a woman may just happen to have a mood-directed choice of food, such as yearning for comfort food like ice cream during a particularly depressed moment. Women happen to be among the most emotionally-driven eaters, so this may not be too accurate.

6. Frequent urination – Some women experience a need to empty their bladders more frequently than usual.

However, this is usually not noticed as a sign as many women feel it to be too normal a change.
However, there are also early signs that are more definite in telling you that you are indeed pregnant. Among these are:

1. Missing a period – This is typically the main sign that women take before they buy a pregnancy test. Of course, an important thing to remember is that you may also miss your period, if you have it regularly, due to hormonal changes in rare cases, such as if you suddenly lost a lot of weight. It may also happen when you are taking anti-pregnancy pills, as some of them curb the production of egg cells, which eventually result in amenorrhea.

2. Morning sickness or nausea any time of the day – This is the most commonly portrayed symptom for pregnancy in movies and books. This is because you don’t normally undergo this when you are about to have your phase except for severe cases of dysmenorrhea. This can happen at about two to eight weeks following conception as your hormone levels reach top levels than usual.

3. Implantation bleeding – When the fertilized egg cell is implanted onto the uterus, some women knowledge implantation bleeding. This typically happens between six to twelve days following conception, and the bleeding is not as pronounced as a period. It is aptly described as spotting.

Although these are typical early signs of pregnancy, with the immunity of a missed period, not all women experience them, as every pregnancy is exclusive So if you find yourself experiencing most, if not all, of these symptoms, it might be the best time to buy yourself a pregnancy testing kit. If you don’t and yet confirm yourself to be pregnant, do not be anxious, as these signs are in no tactic an sign of a healthy pregnancy. In any case, just celebrate the new life rising within you and enjoy each step of the journey as you welcome a new member into your family.

Food Poisoning - Cause and Remedy

noreply@blogger.com (Sharan R) — Mon, 25 Jul 2011 14:35:00 +0000

Food poisoning includes a number of disorders presenting with diarrhea and vomiting due to acute gastroenteritis developing up to 48 hours after the consumption of food or drink. It is customary not to include under this term the enteric fevers, dysenteries and cholera which are also spread by infected food and drink.

In contrast to enteric fever which is relatively uncommon and cholera which has been almost unknown in Britain for the last 100 years, there is an increase in the reported incidence of food poisoning, of which that of bacterial origin is by far the most common type.

Food poisoning may also be due to intestinal allergy, e.g. to shellfish, or to children eating unripe fruit or other unsuitable foods. Rarely a poisonous substance may be eaten, e.g. Amanita phalloides, in mistake for a mushroom or a chemical poison in food may be unwittingly consumed. Examples of the latter range from barium carbonate used in baking in mistake for flour, to arsenic or powdered glass administered murderously in the tradition of the Borgias.

Food which has been placed in a container previously used for holding a chemical poison may be contaminated. Placing acid fruit juices in cheap enamel or zinc vessels may result in the liberation of antimony or zinc. Home-made wine kept in glazed earthenware containers may be the source of chronic lead poisoning.

Aetiology. Bacterial food poisoning is usually divided into the infection and toxin types.

INFECTION TYPE: The organisms mainly responsible belong to the Salmonella group whose source is certain birds, cattle and reptiles, such as pet tortoises. The domestic fowl is one of the commonest sources of salmonellae and modern methods of poultry husbandry involving battery-rearing and deep-freezing of carcasses encourage the spread and transmission of infection, the organisms surviving in the frozen birds.

Salmonella typhimurium causes at least three-quarters of the cases of food poisoning of the ‘infection’ type in Britain. Food may be contaminated with infected excreta of mice ot rats, or infection may be transferred by flies or by human carriers employed in the handling of food.

The size of the infecting dose of bacteria bears a close relationship to the speed of onset of symptoms and to the severity of the illness. This indicates the dangers of bacterial multiplication which may take place when food is contaminated and thereafter remains warm for many hours or days.

The types of food which are particularly likely to be affected are twice-cooked meat dishes, stews, gravies, soups, custards, milk and synthetic cream.

The danger of food poisoning is greatly reduced if such foods are kept in a refrigerator.

Ducks tend to be carriers of salmonella organisms in the oviduct and alimentary tract, and duck’s eggs are not suitable for the preparation of lightly cooked foods.

Hen’s eggs are rarely affected.

TOXIN TYPE: Such poisoning is most commonly caused by the enterotoxin produced by Staph. aureus. This frequently originates from a food handler who may be a carrier or suffering from a septic lesion and so contaminates food.

Incubation under suitable conditions of temperature leads to growth of the organism and production of toxin which is relatively heat resistant and may not be destroyed by cooking. Strains of clostridium welchii, many of them relatively resistant to heat, may contaminate certain foods, particularly meat.

Pre-cooking of stews and pies may not destroy all the spores and the keeping of such food, even when followed by heating before consumption, will lead to the formation of toxins which can give rise to gastroenteritis, sometimes severe. Other bacteria (e.g. Streptococcus and Bacillus) may contaminate food without obvious spoilage and may also cause mild gastroenteritis.

Outbreaks of food poisoning affecting large numbers of persons occur in canteens, restaurants, hospitals and other institutions.

Clinical Features.(Bacterial food Poisoning)

The simultaneous occurance of symptoms in more than one member of a household or institution often simplifies diagnosis. The incubation period is a useful pointer to the aetiology.

If vomiting starts within 30 minutes of the ingestion of suspected food, it is likely to be due to a chemical poison; if it arises 12 to 48 hours later, it is probably due to a Salmonella infection. The incubation periods of staphylococcal and clostridial food poisoning are usually intermediate between these extremes being from one to 12 hours.

The symptoms in any single outbreak vary in severity depending on the type and amount of the poisonous substance ingested. The principal symptoms are nausea, vomiting, diarrhea and central abdominal colic. Staphylococcal food poisoning may be associated only with vomiting while diarrhea and abdominal pain are more prominent with Cl. Welchii toxins.

In severe cases there may be prostration, collapse and signs of dehyderation. In the chemical and toxin types of food poisoning the onset tends to be sudden and severe and the patient may rapidly become shocked. Recovery however usually occurs within 24 hours. In the infection type, symptoms develop more slowly and there is usually pyrexia and toxicity. The patient may be ill for several days. The stools are watery and offensive, and may contain blood and some mucus, in contrast to bacillary dysentery where there is also pus.

A rare cause of bacterial food poisoning is the ingestion of one of the most potent poisons known to man, namely the toxin produced by Cl. botulinum. Imperfectly treated tinned food or preserved fish may be contaminated with the organism and be the source of the toxin. The clinical features differ from all other types of bacterial food poisoning and consist chiefly of vomiting, constipation, thirst and the secretion of viscid saliva and of ocular and pharyngeal pareses and aphonia.

Diagnosis. (Bacterial food Poisoning)

A specimen of the patient’s stool or vomit together with the suspected food, if available, should be sent for culture. Organisms of the Salmonella group can usually be readily isolated. In more severe cases blood should be sent for culture. Notification of Salmonella infection and other types of food poisoning is compulsory in Britain.

Food poisoning must be differentiated from acute surgical abdominal emergencies especially in children.

Treatment. Most cases are miled and can be treated at home. Solid food should be withheld and the patient instructed to take fluids only. A quarter teaspoonful of table salt added to one pint of water flavoured with a small quantity of fruit juice provides a satisfactory oral replacement solution. Patients who are severely ill, collapsed or dehydrated require intravenous fluid therapy.

Symptoms normally pass off spontaneously in a day or two. When acute symptoms cease, semi-fluid low-roughage diet may be taken containing bread, butter, eggs, fish, softpuddings and jellies. To control diarrhea, kaolin mixture may be given in 10 ml doses every two to four hours. Codeine phosphate 30 mg six-hourly is also useful.

Antibiotics should not be given for acute diarrhea and vomiting as they are ineffective and frequently exacerbate symptoms. If salmonella bacteraemia is suspected or confirmed, ampicillin, 1 g every six hours should be given by intramuscular injection.

If the poisoning is thought to be due to a chemical or a poisonous food, the patient’s stomach should be washed out with tepid water, using the technique described onward.

Prevention: In salmonella food poisoning the carrier state persists on the average for about 14 days after infection but may be much longer, and the patient must not be allowed to handle food until he has stopped excreting the organism. A reduction in the high incidence of food poisoning can best be achieved by improving the standards of personal hygiene, especially in those handling food, and by stressing the importance of hand-washing after using the lavatory. Increasing facilities for low temperature storage of food which has to be kept for some hours or days before being consumed is of the greatest importance. It is essential to keep frozen poultry at room temperature for at least eight hours before cooking or pathogens at the centre may survive unharmed.

PSYCHIATRY - PPT Lectures

noreply@blogger.com (Sharan R) — Sun, 24 Jul 2011 09:09:00 +0000

Paraphilias

Personality Disorders [2]

Phobias [2]

Physical Disorders

Psychiatry: Legal & Ethical Issues

Psychopharmacology [2]

Psychotherapy [2, 3]

PTSD [2, 3, 4]

Schizophrenia [2, 3, 4, 5, 6, 7]

Sexual & Gender Identity Disorders

Sleep Disorders

Social behavior

Somatoform Disorders [2, 3, 4, 5]

Studying Abnormal Behavior

Substance Abuse [2]

Suicide

Violence

Manic Disorder

Mental Retardation [2]

Mood Disorders [2, 3]

Neurotic Disorders

Obsessive Compulsive Disorder [2]

Organic Mental Disorders

Organic Psychiatry

Panic Disorders

Neuro Terminology

noreply@blogger.com (Sharan R) — Sun, 24 Jul 2011 08:58:00 +0000

ABCESS - A circumscribed collection of pus.

ACOUSTIC NEURINOMAS - Benign tumor of the hearing nerve (eighth nerve).

ACROMEGALY - Disorder marked by progressive enlargement of the head, face, hands, feet, and thorax, due to the excessive secretion of growth hormone.

ADENOMA - A benign growth formed of glandular tissue.

AGNOSIA - Absence of the ability to recognize the form and nature of persons and things.

AGRAPHIA - Loss of the power of writing due either to muscular in coordination or to an inability to phrase thought.

AMAUROSIS - Loss of vision without discoverable lesion in the eye structures or optic nerve. Amaurosis fugax - temporary blindness occurring in short periods.

AMENORRHEA - Absence of the menses due to causes other than pregnancy or advancing age.

AMNESIA - Loss of memory caused by brain damage or by severe emotional trauma.

ANALGESIA - Loss of sensibility to pain, loss of response to a painful stimulus.

ANAPLASIA - In the case of a body cell, a reversion to a more primitive condition. A term used to denote the alteration in cell character which constitutes malignancy.

ANASTOMOSIS - A communication, direct or indirect: A joining together. In the nervous system a jointing of nerves or blood vessels.

ANESTHESIOLOGIST - Physician who administers pain-killing medications during surgery.

ANENCEPHALY - Absence of the greater part of the brain, often with skull deformity.

ANESTHESIA - Loss of sensation of a body part; or of the body when induced by the administration of a drug.

ANESTHESIOLOGIST Physician who administers pain-killing medications during surgery.

ANEURYSM - Dilation of an artery, formed by a circumscribed enlargement of its wall. Saccular (berry) aneurysm - sac-like bulging on one side of an artery usually arising at an arterial branching.

ANGIOGRAM - a study which shows the blood vessels leading to and in the brain by injecting a dye or contrast substance through a catheter placed in the artery in the leg.

ANGIOGRAPHY - Radiography of blood vessels using the injection of material opaque to x-rays to give better definition to the vessels.

ANOREXIA - Loss of appetite; a condition marked by loss of appetite leading to weight loss.

ANOSMIC - Without the sense of smell.

ANOXIA - Total lack of oxygen supply.

ANTI-COAGULANT - A medication that prevents coagulation of the blood.

ANTIDIURETIC - An agent which reduces the output of urine. Antidiuretic hormone (ADH) is formed in the hypothalamus and stored in the posterior pituitary gland. Its secretion reduces urine output.

APHASIA - Difficulty with, or loss of use of language, in any of several ways including reading, writing or speaking. Failure of understanding of the written, printed or spoken word not related to intelligence but to specific lesions in the brain.

APNEA - Cessation of respiration; inability to get one's breath.

APOPLEXY - A sudden event. Often used as equivalent to stroke.

ARACHNOID - Middle layer of membranes covering the brain and spinal cord.

ARACHNOIDITIS - Inflammation of the arachnoid membrane, most commonly seen within the spinal cord around the spinal cord and cauda equina.

AREA - (Cortical) - A part of the brain having a special function as in
* Motor a. - The cortical portion of the brain controlling movement.
* Sensory a. - The cortical portion, controlling sensation.

ARTERIOGRAPHY - See angiography.

ARTERIOSCLEROSIS - Thickening and calcification of the arterial wall with loss of elasticity and contractility.

ARTERIOVENOUS - Relating to both arteries and veins.

ARTERIOVENOUS MALFORMATION - Collection of blood vessels with one or several abnormal communications between arteries and veins which may cause hemorrhage or seizures.

ASTROCYTE - Cell which supports the nerve cells (neurons) of the brain and spinal cord.

ASTROCYTOMA - Tumor within the substance of the brain or spinal cord made up of astrocytes - often classified from Grade I (slow-growing) to Grade III (rapid-growing).

ATAXIA - A loss of muscular coordination, abnormal clumsiness.

ATHETOSIS - A condition in which there is a succession of slow, writhing, involuntary movements of the fingers and hands, and sometimes of the toes and feet.

ATROPHY - A wasting of the tissues of a body part.

AUTONOMIC NERVOUS SYSTEM - Involuntary nervous system, also termed the vegetative nervous system. A system of nerve cells whose activities are beyond voluntary control.

AVASCULAR - Non-vascular, not provided with blood vessels.

AXON - The part of a nerve cell that usually sends signals to other nerves or structures.

BACTERICIDAL - Causing the death of bacteria.

BACTERIOSTATIC - Inhibiting or retarding the growth of bacteria.

BELL'S PALSY - Paralysis of facial muscles (usually one side) due to facial nerve dysfunction of unknown cause.

BIOPSY - Removal of a small portion of tissue, usually for the purpose of making a diagnosis.

BLOOD-BRAIN-BARRIER - The barrier which exists between the blood and the cerebrospinal fluid which prevents the passage of various substances from the bloodstream to the brain.

BRADYCARDIA - Slowness of the heart rate.

BRADYKINESIA - Slowness in movement.

BROWN-SEQUARD'S SYNDROME - Loss of sensation of touch, position sense, and movement on the side of a spinal cord lesion, with loss of pain sensation on the other side. Caused by a lesion limited to one side of spinal cord.

CARCINOMA - Cancer, a malignant growth of epithelial or gland cells.

CAROTID ARTERY - Large artery on either side of the neck which supplies most of the cerebral hemisphere.

CAROTID SINUS - Slight dilatation on the common carotid artery at its bifurcation containing nerve cells sensitive to blood pressure. Stimulation can cause slowing of the heart, vasodilatation and a fall in blood pressure.

CARPAL TUNNEL - Space under a ligament in wrist through which the median nerve enters the palm of the hand.

CT SCAN - (computed tomography scan): A diagnostic imaging technique in which a computer reads x-rays to create a three-dimensional map of soft tissue or bone.

CATHETER - a small tube used to inject a dye to see the blood vessles, similar to that used for looking at vessels in the heart.

CAUDA EQUINA - The bundle of spinal nerve roots arising from the end of the spinal cord and filling the lower part of the spinal canal(from approximately the thoraco-lumbar junction down).

CAUDATE NUCLEUS - part of the basal ganglia which are brain cells that lie deep in the brain.

CEREBELLUM - The lower part of the brain which is beneath the posterior portion of the cerebrum and regulates unconscious coordination of movement.

CEREBROSPINAL FLUID - Water-like fluid produced in the brain that circulates around and protects the brain and spinal cord.

CEREBRUM - The principal portion of the brain, which occupies the major portion of the interior of the skull and controls conscious movement, sensation and thought.

CERVICAL - Of or relating to the neck.

CHIASM (OPTIC) - Crossing of visual fibers as they head toward the opposite side of the brain. For each optic nerve most of the visual fibers cross to the opposite side, some run directly backward on each side without crossing.

CHOREA - A disorder, usually of childhood, characterized by irregular, spasmodic involuntary movements of the limbs or facial muscles.

CHOROID PLEXUS - A vascular structure in the ventricles of the brain which produces cerebrospinal fluid.

COCCYX - The small bone at the end of the spinal column in man, formed by the fusion of four rudimentary vertebrae. The "tail bone".

COMA - A state of profound unconsciousness from which one cannot be roused.

COMPUTED TOMOGRAPHY (CT) SCAN- A diagnostic imaging technique in which a computer reads x-rays to create a three-dimensional map of soft tissue or bone.

CONCUSSION - A disruption, usually temporary, of neurological function resulting from a blow or violent shaking.

CONTRAST MEDIUM - Any material (usually opaque to x-rays) employed to delineate or define a structure during a radiological procedure.

CONTUSION - A bruise; an area in which blood that has leaked out of blood vessels is mixed with brain tissue.

CORONAL SUTURE - The line of junction of the frontal bones and the parietal bones of the skull.

CORTEX - The external layer of gray matter covering the hemispheres of the cerebrum and cerebellum.

CRANIUM - The part of the skull that holds the brain.

CRANIECTOMY - Excision of a portion of the skull.

CRANIOPHARYNGIOMA - Congenital tumor arising from the embryonic duct between the brain and pharynx.

CRANIOPLASTY - The operative repair of a defect of the skull.

CRANIOSYNOSTOSIS - Premature closure of cranial sutures, limiting or distorting the growth of the skull.

CRANIOTOMY - Opening of the skull, usually by creating a flap of bone.

CSF - Cerebrospinal Fluid.

DEPRESSED SKULL FRACTURE - A break in the bones of the head in which some bone is pushed inward, possibly pushing on or cutting into the brain.

DIABETES INSIPIDUS - Excretion of large amounts of urine of low specific gravity. The inability to concentrate urine.

DIFFUSE AXONAL INJURY - Damage to the axons of many nerve cells that lie in different parts of the brain.

DIFFUSE BRAIN INJURY - Damage to the brain that can affect many parts of the brain, often in a subtle fashion; examples include diffuse axonal injury and inadequate blood flow.

DIPHENYLHYDANTOIN - Dilantin; a medication used to control seizures.

DIPLOPIA - Double vision, due usually to weakness or paralysis of one or more of the extra-ocular muscles.

DISC - The intervertebral disc - cartilaginous cushion found between the vertebrae of the spinal column. It may bulge beyond the vertebral body and compress the nearby nerve root, causing pain. The terms "slipped disc", "ruptured disc" and "herniated disc" are often used interchangeably even though there are subtle differences.

DOME - the round balloon like portion of the aneurysm which usually arises from the artery from a smaller portion called the neck of the aneurysm.

DOPPLER - A non-invasive study which uses sound waves to show the flow in a blood vessel and can be used to determine the degree of narrowing (percent stenosis) of the vessel. A wand is placed on the skin over the vessel to be imaged. This study has no risks and is not painful.

DURA - Dura mater.

DURA MATER - A tough fibrous membrane which covers the brain and spinal cord, but is separated from them by a small space.

DYSESTHESIA - A condition in which a disagreeable sensation is produced by ordinary touch, temperature or movement.

DYSPHASIA - Difficulty in the use of language due to a brain lesion without mental impairment.

DYSTONIA MUSCULORM DEFORMANS - An affliction occurring especially in children, marked by muscular contractions producing distortions of the spin and hips.

EDEMA - An excessive accumulation of fluid generally in extracellular.

ELECTROENCEPHALOPGRAHY (EEG) - The study of the electrical currents set up by brain actions; the record made is called an electroencephalogram.

ELECTROMYOGRAPHY (EMG) - A method of recording the electrical currents generated in a muscle during its contraction.

ENDARTERECTOMY - Removal of fatty or cholesterol plaques and calcified deposits from the internal wall of an artery.

ENDOCRINE GLAND - A gland which furnishes an internal secretion, usually having an effect on another organ.

ENDOCRINOPATHY - Any disease due to abnormality of quantity or quality in one or more of the internal gladular secretions.

EPENDYMA - The membrane lining the cerebral ventricles of the brain and central canal of the spinal cord.

EPENDYMOMA - A growth in the brain or spinal cord arising from ependymal tissue.

EPIDURAL - Immediately outside the dura mater. Same as extradural.

EPIDURAL HEMATOMA - A blood clot between the dura mater and the inside of the skull.

EPILEPSY - Disorder characterized by abnormal electrical discharges in the brain, causing abnormal sensation, movement or level of consciousness.

FALX (CEREBRI) - An extension of dura between the right and left hemispheres of the brain.

FONTANELLE - Normal openings in he skull of infants; the largest of these is the anterior fontanel or "soft spot" in the middle of the head.

FORAMINOTOMY - Surgical opening or enlargement of the bony opening traversed by a nerve root as it leaves the spinal canal.

FUSIFORM ANEURYSM - a sausage-like enlargement of the vessel

GALACTORRHEA - The discharge of milk from the breasts.

GAMMA KNIFE - Equipment that precisely delivers a concentrated dose of radiation to a predetermined target using gamma rays.

GCS - Glasgow Coma Scale.

GLASGOW COMA SCALE - The most widely used system of classifying the severity of head injuries or other neurologic diseases.

GLASGOW OUTCOME SCALE - A widely used system of classifying outcome after head injury or other neurologic diseases.

GLIA (Also termed neuroglia) - The major support cells of the brain. These cells are involved in the nutrition and maintenance of the nerve cells.

GLIOMA - A tumor formed by glial cells.

GLIOBLASTOMA - A rapidly growing tumor composed of primitive glial cells, mainly arising from astrocytes.

GLOBUS PALLIDUS - part of the basal ganglia which are brain cells that lie deep in the brain.

HEMANGIOMA - An aggregation of multiple, dilated, blood vessels.

HEMATOMA - A blood clot.

HEMIANOPIA - Loss of vision of one-half of the visual field.

HEMIATROPHY - Atrophy of half of an organ or half of the body.

HEMIPLEGIA - Paralysis of one side of the body.

HEMORRHAGE - Bleeding due to the escape of blood from a blood vessel.

HERNIATED NUCLEUS PULPOSUS (HNP) - Extrusion of the central portion of an intervertebral disc through the outer cartilaginous ring. The material can compress the spinal cord or nerves in or exiting the spinal canal.

HORMONE - A chemical substance formed in one gland or part of the body and carried by the blood to another organ which it stimulates to functional activity.

HYDROCEPHALUS - A condition, often congenital, marked by abnormal and excessive accumulation of cerebrospinal fluid in the cerebral ventricles. This dilates the ventricles and in infants and young children causes the head to enlarge.

HYDROMYELIA - Expansion of the spinal cord due to increased size of the central canal of the cord which is filled with CSF.

HYPERACUSIS - Abnormal acuteness of hearing or auditory sensation.

HYPERESTHESIA - Excessive sensibility to touch, pain or other stimuli.

HYPERTENSION - High blood pressure

HYPOTHALAMUS - A collection of specialized nerve cells at the base of the brain which controls the anterior and posterior pituitary secretions, and is involved in other basic regulatory functions such as temperature control and attention.

INFUNDIBULUM - A stalk extending from the base of the brain to the pituitary gland.

INTRA-AORTIC BALLOON COUNTER PULSATION DEVICE - a pump which is inserted into the main vessel of the body, the aorta, to help the heart deliver blood to critical organs such as the brain or kidneys.

INTRA-ARTERIAL CATHETERIZATION ANGIOGRAPHY - An invasive study in which a catheter (a small tube) is placed in the artery and contrast material is injected to which makes the blood vessels visible on an X-Ray image. The catheter is inserted in the groin into the femoral artery (the artery to the leg) through a needle, and is guided into the arteries in the neck and head. This study is associated with a very small (less than 0.05 % chance of serious complications) and requires the patient to lie in bed for approximately six hours to allow the leg vessel to heal.

INTRACEREBRAL HEMATOMA - A blood clot within the brain.

INTRACRANIAL PRESSURE (ICP) - The overall pressure inside the skull.

INTRAOPERATIVE CISTERNOGRAPHY - administration of a contrast dye into the ventricles which are chambers in the brain that contain brain fluid.

ISCHEMIA - Inadequate circulation of blood generally due to a blockage of an artery.

JUGULAR VEINS - The major veins on each side of the neck draining blood from the head towards the heart.

LABYRINTH - The internal ear, comprising the semi-circular canals, vestibule and cochlea.

LAMINA - The flattened or arched part of the vertebral arch, forming the roof of the spinal canal.

LAMINECTOMY - Excision of one or more laminae of the vertebrae.

LAMINOTOMY - An opening made in a lamina.

LEPTOMENINGES - Two thin layers of fine tissue covering the brain and spinal cord (The pia mater and arachnoid).

LEPTOMENINGITIS - Inflammation of the membranes covering the brain and spinal cord.

LEUKODYSTROPHY - Disturbance of the white matter of the brain.

LEUKOENCEPHALITIS - An inflammation of the white matter of the brain.

LINEAR ACCELERATOR - Equipment that precisely delivers a concentrated dose of radiation to a predetermined target using x-rays.

LIPOMA - A benign fatty tumor, usually composed of mature fat cells.

LORDOSIS - Curvature of the spine with the convexity forward.

LUMBAR DRAIN - A device (usually a long, thin, flexible tube) inserted through the skin into the cerebrospinal fluid space of the lower back; provides a method of draining cerebrospinal fluid.

MAGNETIC RESONANCE ANGIOGRAPHY (MRA) - A non-invasive study which is conducted in a Magnetic Resonance Imager (MRI). The magnetic images are assembled by a computer to provide an image of the arteries in the head and neck. No contrast material is needed, but some patients may experience claustrophobia in the imager.

MAGNETIC RESONANCE IMAGING (MRI) - Diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology rather than x-rays.

MEDIAN NERVE - The nerve formed from the brachial plexus that supplies muscles in the anterior forearm and thumb, as well as, sensation of the hand. It may be compressed or trapped at the wrist in carpal tunnel syndrome.

MEDULLOBLASTOMA - Tumor composed of medulloblasts which are cells which develop in the roof of the fourth ventricle (medullary velum).

MENINGES - The three membranes covering the spinal cord and brain termed dura mater, arachnoid mater and pia mater.

MENINGIOMA - A firm, often vascular, tumor arising from the coverings of the brain.

MENINGITIS - An infection or inflammation of the membranes covering the brain and spinal cord.

MENINGOCELE - A protrusion of the coverings of the spinal cord or brain through a defect in the skull or vertebral column.

MENINGOENCEPHALITIS - An inflammation or infection of the brain and meninges.

MENINGOENCEPHALOCELE - A protrusion of both the meninges and brain tissue through a skull defect.

MRA - Magnetic Resonance Angiography. A non-invasive study which is conducted in a Magnetic Resonance Imager (MRI). The magnetic images are assembled by a computer to provide an image of the arteries in the head and neck. No contrast material is needed, but some patients may experience claustrophobia in the imager.

MRI - Magnetic Resonance Imaging - Scanning technique for views of the brain or spinal cord. No radiation is involved, but rather pulsed magnetic waves are used to delineate the structures within the brain.

MYELIN - The fat-like substance which surrounds the axon of nerve fibers and forms an insulating material.

MYELOGRAM - An x-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces.

MYELOPATHY - Any functional or pathologic disturbance in the spinal cord.

MYELOMENINGOCELE - A protrusion of the spinal cord and its coverings through a defect in the vertebral column.

MYOPATHY - Any disease of muscle.

NEURALGIA - A paroxysmal pain extending along the course of one or more nerves.

NEURECTOMY - Excision of part of a nerve.

NEURITIS - Inflammation of a nerve; may also be used to denote non-inflammatory nerve lesions of the peripheral nervous system.

NEUROBLASTOMA - Tumor of sympathetic nervous system origin, found mostly in infants and children.

NEUROFIBROMA - A tumor of the peripheral nerves due to an abnormal collection of fibrous and insulating cells.

NEUROFIBROMATOSIS - A familial condition characterized by developmental changes in the nervous system, muscles and skin, marked by numerous tumors affecting these organ system.

NEUROHYPOPHYSIS - The posterior lobe of the pituitary gland.

NEUROLYSIS - Removal of scar or reactive tissue from a nerve or nerve root.

NEUROMA - A tumor or new growth largely made up of nerve fibers and connective tissue.

NEUROPATHY - Any functional or pathologic disturbance in the peripheral nervous system.

NYSTAGMUS - Involuntary rapid movement of the eyes in the horizontal, vertical or rotary planes of the eyeball.

OCCIPUT - The back part of the head.

OLIGODENDROGLIA - Non-nerve cells, (see glia) forming part of the supporting structure of the central nervous system.

OLIGODENDROGLIOMA - A growth of new cells derived from the oligodendroglia.

OPHTHALMOPLEGIA - Paralysis of one or more of the eye muscles.

OSTEOMA - A benign tumor of bone.

OSTEOMYELITIS - Inflammation of bone due to infection, which may be localized or generalized.

PAPILLEDEMA - Swelling of the optic nerve head, can be seen in the back of the retina during eye examination.

PARAPLEGIA - Paralysis of the lower part of the body including the legs.

PERITONEAL CAVITY - Body cavity in which the abdominal organs are situated.

PITUITARY- Gland at base of the brain which secretes hormones into the blood stream. Those hormones then regulate other glands including the thyroid, adrenals and gonads. The "Master Gland".

POLYNEURITIS - Inflammation of two or more nerves simultaneously.

PORENCEPHALY - Abnormal cavity within brain tissue, usually resulting from outpouching of a lateral ventricle.

POST-ICTAL - State following a seizure, often characterized by altered function of the limbs and/or mentation.

PROPRIOCEPTION - Sensation concerning movements of joints and position of the body in space.

PSEUDOTUMOR CEREBRI - Raised intracranial pressure, usually causing only headache and papilledema. No clear underlying structural abnormality.

PUPIL - The black part of the eye through which light enters; enlarges in dim light and decreases in size in bright light.

QUADRANTANOPIA - Defect in vision or blindness in one fourth of the visual field.

QUADRIPLEGIA - Paralysis of all four limbs.

RACHISCHISIS - Abnormal congenital opening of the vertebral column.

RADIATION ONCOLOGIST - A medical doctor who has received advanced training in the treatment of persons receiving x-ray treatment for an illness.

RADIATION PHYSICIST - A person having a PhD degree who is trained in the science dealing with the properties, changes and interactions of continuous energy.

RADIOLOGIST - A medical doctor who has received specialized training in interpreting x-rays, CTs, MRIs and performing angiography.

RADIOTHERAPY - Treatment of a lesion with radiation.

SACCULAR ANEURYSM - a balloon-like outpouching of a vessel (the more common type of aneurysm).

SCOTOMA - An area of decreased vision surrounded by an area of less depressed or normal vision.

SHUNT - A tube or device implanted in the body (usually made of Silastic) to redivert excess CSF away from the brain to another place in the body.

SPINA BIFIDA - A congenital defect of the spine marked by the absence of a portion of the spine.

SPINAL FUSION - Operative method of strengthening and limiting motion of the spinal column. Can be performed with a variety of metal instruments and bone grafts, or bone grafts alone.

SPONDYLOLISTHESIS - Forward displacement of one vertebra on another.

SPONDYLOSIS - Degenerative bone changes in the spine usually most marked at the vertebral joints.

STENOSIS - Narrowing.

STEREOTACTIC - Originated from the Greek words stereo meaning three dimensional and tactos meaning touched.

STEREOTACTIC RADIOSURGERY - The precise delivery of radiation to a preselected stereotactically localized target.

STRABISMUS - Deviation of eye movement which prevents the two eyes from moving in a parallel fashion.

SUBARACHNOID HEMORRHAGE - Blood in, or bleeding into, the space under the arachnoid membrane, most commonly from trauma or from rupture of an aneurysm.

SUBDURAL HEMATOMA - a collection of blood (clot) trapped under the dura matter, the outermost membrane surrounding the brain and spinal cord.

SYRINGOMYELIA - A fluid filled cavity in the spinal cord.

TERATOMA - tumor or growth made up of several different types of tissue (fat, bone, muscle, skin).

THROMBUS - A blood clot attached to the wall of an artery.

THALAMUS - brain cells which lie in the upper part of the brainstem.

TIC DOULOUREUX - (See trigeminal neuralgia)

TRANSSPHENOIDAL APPROACH - Operative method of reaching the pituitary gland or skull base traversing the nose and sinuses.

TRIGEMINAL NEURALGIA - Paroxysmal pain in the face. Pain may be so severe that it causes an involuntary grimace or "tic". (Tic Douloureux)

ULTRASOUND - The use of high-frequency sound to create images of internal body structures.

VALVE - Device placed in a shunt system to regulate the rate and direction of CSF flow.

VASOCONSTRICTION - A decrease in the diameter of blood vessels.

VASODILATATION - An increase in the diameter of blood vessels.

VASOPRESSIN - A hormone secreted by the hypothalamus and stored in the posterior pituitary which raises blood pressure and increases reabsorption of water by the kidneys.

VASOPRESSOR - An agent which constricts the arteries and raises blood pressure.

VASOSPASM - Spasm of blood vessels, decreasing their diameter.

VENTRICLE - The cavities or chambers within the brain which contain the cerebrospinal fluid. There are two lateral ventricles and midline third and fourth ventricles.

VENTRICULITIS - Inflammation and/or infection of the ventricles.

VENTRICULOGRAM - An X-ray study of the ventricles.

VENTRICULOSTOMY - An opening into the ventricles of the brain, such as by inserting a small, thin, hollow catheter.

VENTRICULAR DRAINAGE - Insertion of a small tube into the ventricles to drain cerebrospinal fluid, usually when pressure is increased.

VERMIS - Middle part of the cerebellum between the two hemispheres.

VERTEBRA- Any of the thirty-three bones of the spinal column.

VERTIGO - An abnormal sensation of rotation or movement of one's self, or the environment.

X-RAY - Application of electromagnetic radiation to produce a film or picture of a bone or soft-tissue area of the body.

Source: http://brain101.info/Neuro_Terminology

Neurology - Lectures PPT

noreply@blogger.com (Sharan R) — Sun, 24 Jul 2011 08:47:00 +0000

1 - The Neurologic Examination
2 - Back Pain
3 - CNS Developmental Anomalies
4 - Dementia
5 – Epilepsy
6 – Localization in Neurology
7 – Low Back Pain
8 - Motor Neuron Disease
9 – Movement Disorders
10 – Multiple Sclerosis
11 – Peripheral Neuropathy
12 - Subarachnoid Hemorrhage
13 – Epilepsy
14 - Introduction to Cerebrovascular Diseases
15 - Low Back Pain (Newer)
16 - Spinal Injuries
17 - Head Injury
18 - CNS Congenital Anomalies
19 - Coma
20 - Brain Circulation
21 - Cerebral Circulation
22 - Spinal Motor Function
23 - Sleep RAS EEG
24 - Sensory Receptors
25 - Pain
26 - Neurotransmitters
27 - Motor Function(Cortex)
28 - Limbic System
29 - Higher Functions (Langauge and Memory)

Source: sawa2006.com

Lectures PPT - Obstetrics & Gynecology

noreply@blogger.com (Sharan R) — Sun, 24 Jul 2011 08:40:00 +0000

Power Point Presentations of World Experts

www.obgyn.net/educational-tutorials/educational-tutorials.asp
There are many of them , the site is full of presentations
But there is copyright on it.. Download them there itself..

Educational Tutorials: Categories

Dental Lecture Notes

noreply@blogger.com (Sharan R) — Sun, 24 Jul 2011 08:30:00 +0000

Introduction to Dental Materials 2.ppt

Introduction to Dental Materials 3.ppt

Labaratory Materials In dentistry.ppt

Strength Of Amalgam.ppt

Dentalanatomy.ppt

Teethdevelopment.ppt

Dental-amalgam-material-properties-and-its-use-in-clinical.ppt

Gassionomercement.ppt

Irrev Hydrocolliod.ppt

Toothnotation.ppt

IFDEA Dental Anatomy Educational Teaching Resource.ppt
Hardtissuecharting.ppt
Terms.ppt
ToothMorphology.ppt
Maxillaryincisors.ppt
Mandibularincisors.ppt
Canines.ppt
Maxillarymolars.ppt
1e85Introduction_to_Operative_Dentistry.ppt
Cavity Preparations.ppt
ch48.ppt
classificationofdentalcaries-090721094719-phpapp02.ppt
DENTAL CARIES.ppt
Dentalhandinstruments-100306035258-phpapp02.ppt
Restorative aMaterials.ppt
Treatment-of-dental-caries-as-an-infectious-disease1450.ppt
CavityPrepPresentation1.pptx

SOURCE: utechdmd2015.wikispaces.com/

STAPHYLOCOCCAL PNEUMONIA

noreply@blogger.com (Sharan R) — Sat, 23 Jul 2011 08:13:00 +0000

Pneumonia caused by S. aureus

Serious and rapidly progressive infection.

Less frequent than viral or pneumococcal pneumonia.

Epidemiology.

Preceded by a viral upper respiratory tract infection.

30% of all patients are younger than 3 mo

70% are younger than 1 yr.

Boys are affected more commonly than girls.

Pathogenesis.

Cause confluent bronchopneumonia

Often unilateral or more prominent on one side than the other

Extensive areas of hemorrhagic necrosis and irregular areas of cavitation.

The pleural surface is covered by a thick layer of exudate.

Numerous abscesses occur, containing clusters of staphylococci, leukocytes,

erythrocytes, and necrotic debris.

Rupture of a small subpleural abscess may result in pyopneumothorax, which may erode

into a bronchus, producing a bronchopleural fistula.

Pneumonia due to S. aureus may be

Primary (hematogenous) or

Secondary after a viral infection such as influenza.

Hematogenous pneumonia may be secondary to septic emboli, right-sided endocarditis,

or the presence of intravascular devices.

Inhalation pneumonia is caused by alterations of mucociliary clearance, leukocyte

dysfunction, or bacterial adherence initiated by a viral infection.

High fever,

Abdominal pain,

Tachypnea, dyspnea,

Localized or diffuse bronchopneumonia

Lobar disease.

Staphylococci cause

necrotizing pneumonitis

empyema, pneumatoceles, pyopneumothorax,

bronchopleural fistulas

diffuse interstitial disease characterized by extreme dyspnea, tachypnea, and cyanosis.

Clinical Manifestations.

Infants younger than 1 yr are commonly affected

History of an upper respiratory tract infection for several days to 1 wk.

A rapid progression of symptoms is characteristic.

onset with high fever, cough, and evidence of respiratory distress.

Signs and symptoms

tachypnea,

grunting respirations,

sternal and subcostal retractions,

nasal flaring,

cyanosis, and

anxiety.

lethargic , irritable and toxic.

may develop severe dyspnea and a shocklike state.

gastrointestinal disturbances, = vomiting, anorexia, diarrhea, and abdominal distention

secondary to a paralytic ileus.

Physical findings depend on the stage of pneumonia.

Early

Diminished breath sounds,

Scattered rales, and rhonchi are commonly heard over the affected lung.

With the development of effusion, empyema, or pyopneumothorax, dullness on

percussion is noted, and breath sounds and vocal fremitus are markedly diminished.

A lag in respiratory excursion occurs on the affected side.

Results of physical examination may, , be misleading, in young infants, with findings

disproportionate to the degree of tachypnea.

Diagnosis.

Recognizing early staphylococcal pneumonia in infants is often difficult.

Abrupt onset and rapid progression of symptoms of pneumonia in infants should be

considered to be due to staphylococci until proved otherwise.

A history of furunculosis, a recent hospital admission, or maternal breast abscess should

also alert physicians to the possibility of this diagnosis.

Other bacterial pneumonias that cause empyema or pneumatoceles and thus may be

confused with staphylococcal disease include S. pneumoniae, group A Streptococcus,

Klebsiella, H. influenzae (both type b and nontypable), and primary tuberculous

pneumonia with cavitation.

Aspiration of a radiolucent foreign body followed by pulmonary abscesses may

occasionally lead to a similar clinical and radiologic picture.

LABORATORY FINDINGS.

Leukocytosis

increase primarily among the polymorphonuclear cells.

Mild to moderate anemia is common.

cultures -obtained by tracheal aspiration or pleural tap

Gram stain reveals gram-positive cocci in clusters.

The finding of staphylococci in the nasopharynx is of no diagnostic value,

blood cultures may be positive.

Pleural fluid reveals an exudate with polymorphonuclear cell counts of 300-

100,000/mm3 , protein above 2.5 g/dL, and a low glucose concentration.

ROENTGENOGRAPHIC FINDINGS.

nonspecific bronchopneumonia early in the illness.

The infiltrate may become patchy and limited in extent

may be dense and homogeneous and involve an entire lobe or hemithorax.

The right lung is involved in about 65% of cases

bilateral involvement occurs in fewer than 20% of patients

A pleural effusion or empyema

pyopneumothorax occurs in approximately 25%.

Pneumatoceles of various sizes

no roentgenographic change can be considered diagnostic

rapid progression from bronchopneumonia to effusion or pyopneumothorax with or

without pneumatoceles is highly suggestive of staphylococcal pneumonia

Chest films should be obtained at frequent intervals if the diagnosis is suspected

Clinical improvement usually precedes roentgenographic clearing by weeks,

pneumatoceles may persist for months.

Treatment.

antibiotics

drainage of collections of pus.

should be given oxygen and placed in a semireclining position to relieve cyanosis and

anxiety.

intravenous hydration and nutrition

Assisted ventilation may be needed.

A semisynthetic, penicillinase-resistant penicillin should be administered intravenously

immediately after cultures are obtained (cloxacillin,100 mg/kg/24 hr for 4 to 6 weeks

initially IV and when tolerates oral change to tablets. Infant can be given tablet after

making it powder mix with honey).

Pleural tap even if only a small empyema is present, in order to reduce the chance of

bronchopleural fistula

Generally, pus reaccumulates so rapidly and becomes so viscous or loculated that closed

drainage with a chest tube of the largest possible caliber is required

The appearance of pyopneumothorax is another indication for immediate insertion of a

catheter into the pleural space.

Once begins to improve and the lung has re-expanded, the tubes can be removed,

Complications.

empyema,

pyopneumothorax,

pneumatoceles = are considered part of the natural course of the illness and not complications.

Septic lesions outside the respiratory tract = pericarditis, meningitis, osteomyelitis, and

metastatic abscesses in soft tissue

Prognosis.

mortality still ranges from 10-30%

Factors =

the length of illness before hospitalization

age of the patient,

adequacy of therapy,

the presence of other illness or complications.

Source:DR.NS.MANI.MD Associate Professor in Pediatrics

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ECG Basics II - How to Analyze a Rhythm Lectures

noreply@blogger.com (Sharan R) — Sat, 23 Jul 2011 08:07:00 +0000

• Step 1: Calculate rate.
• Step 2: Determine regularity.
• Step 3: Assess the P waves.
• Step 4: Determine PR interval.
• Step 5: Determine QRS duration.

Step 1: Calculate Rate

• Option 1
– Count the # of R waves in a 6 second rhythm strip, then multiply by 10.
– Reminder: all rhythm strips in the Modules are 6 seconds in length.

Interpretation? 9 x 10 = 90 bpm

• Option 2

– Find a R wave that lands on a bold line.
– Count the # of large boxes to the next R wave. If the second R wave is 1 large box away the rate is 300, 2 boxes - 150, 3 boxes - 100, 4 boxes - 75, etc.
– Memorize the sequence:
300 - 150 - 100 - 75 - 60 - 50

Step 2: Determine regularity

• Look at the R-R distances (using a caliper or markings on a pen or paper).
• Regular (are they equidistant apart)? Occasionally irregular? Regularly irregular? Irregularly irregular?

Interpretation? Regular

Step 3: Assess the P waves

• Are there P waves?
• Do the P waves all look alike?
• Do the P waves occur at a regular rate?
• Is there one P wave before each QRS?
Interpretation? Normal P waves with 1 P wave for every QRS

Step 4: Determine PR interval

• Normal: 0.12 - 0.20 seconds.
(3 - 5 boxes)

Interpretation?0.12 seconds

Step 5: QRS duration

• Normal: 0.04 - 0.12 seconds.
(1 - 3 boxes)
Interpretation? 0.08 seconds

Rhythm Summary

• Rate 90-95 bpm
• Regularity regular
• P waves normal
• PR interval 0.12 s
• QRS duration 0.08 s
Interpretation? Normal Sinus Rhythm

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thanks: Aslam@mediconet

ECG Basics - PPT Lectures

noreply@blogger.com (Sharan R) — Sat, 23 Jul 2011 08:00:00 +0000

Normal Impulse Conduction
Sinoatrial node--AV node--Bundle of His--Bundle Branches--Purkinje fibers

The “PQRST”
►    P wave - Atrial depolarization

QRS - Ventricular    depolarization
        T wave - Ventricular   repolarization

The PR Interval
Atrial depolarization
+
delay in AV junction
(AV node/Bundle of His)

(delay allows time for the atria to contract before the ventricles contract)

Pacemakers of the Heart
►    SA Node - Dominant pacemaker with an intrinsic rate of 60 - 100 beats/minute.

►    AV Node - Back-up pacemaker with an intrinsic rate of 40 - 60 beats/minute.

►    Ventricular cells - Back-up pacemaker with an intrinsic rate of 20 - 45 bpm.

The ECG Paper

►    Horizontally
    One small box - 0.04 s
    One large box - 0.20 s
►    Vertically
    One large box - 0.5 mV

►    Every 3 seconds (15 large boxes) is marked by a vertical line.
►    This helps when calculating the heart rate.

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Download Rest of ECG PPT Slides:

First Aid - Videos (Free Download)

noreply@blogger.com (Sharan R) — Sat, 23 Jul 2011 07:39:00 +0000

Head Tilt-Chin Lift Technique

Bleeding

Types of Carries

Child CPR

Jaw Thrust Technique

Bandaging

Children and Infants

Infant Airway

Checking Breathing

Shock

Obstructed Airway - Child

Recovery Position

Rescue Breathing

Shock Treatment

Childbirth

V-fib and AED

Patient Assessment

Injured Limb

Umbilical Cord

Adult CPR

Physical Examination

Types of Splint

Hand Position

Spinal Cord Injury

Moving a Patient

Adult Airway

Up-to-date source of Drug information

noreply@blogger.com (Sharan R) — Thu, 21 Jul 2011 06:28:00 +0000

Drugs.com is the most popular, comprehensive and up-to-date source of drug information online. Providing free, accurate and independent advice on more than 24,000 prescription drugs, over-the-counter medicines & natural products.

Browse all medications A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

CIMS Online

noreply@blogger.com (Sharan R) — Thu, 21 Jul 2011 06:25:00 +0000

Famous drugs data book CIMS ONLINE version .
www.cimsasia.com for India and www.mims.com for other Asian countries ,which enables to search Drug information, Interactions, Diagnosis confirmation and Search medica dedicated healthcare search engine.

Browse Drugs

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Mobile Drug data book CIMS or MIMS

noreply@blogger.com (Sharan R) — Thu, 21 Jul 2011 06:20:00 +0000

This the most expected mobile ebook for past few years....very helpful for doctors,medicos,nurses,pharmacist..now all the drugs data is on your mobile phone........a million thanx to Dr.John.This book is mainly for asian countries, but am sure it will help others also........

Current Index of Medical Specialities (CIMS)

DOWNLOAD HERE

The eBook of CIMS India contains details about 865 medical drugs - indications and usual dosage, adverse reactions (side effects), precautions, whether to take before, with or after food, drugs interactons with other medicines and with alcohol or certain foodstuff.
There are also details about how overdosage and toxicity of the drugs are treated. There is also a list of the common brands available in india for each generic drug.

This eBook is of August 2010 and many more changes would have taken places each quarter in the official CIMS eBook.

USE isilo reade r on your mobilephone to read this book

You can also use Alternate mediafire to download the cims book

Lecture Notes - ENT - 9th Edition

noreply@blogger.com (Sharan R) — Mon, 18 Jul 2011 16:40:00 +0000

Mediafire Links

Download (PDF - 6mb)

Lecture Notes - Ophthalmology - 9th Edition

noreply@blogger.com (Sharan R) — Mon, 18 Jul 2011 15:42:00 +0000

Rapidshare Link:

Download (PDF - 5mb)