The NEET PG 2018 Result has just been declared. If you were one of the aspiring candidates who gave the NEET PG 2018, then you can check your result here.
Check Your Result Here
You can check the result on the official website of NatBoard or NBE. All you have to do is:
We are starting a new thread of ECG Basics: Conceptual Understanding Made Easy. To kick start the topic, we will discuss Axis Deviation and P wave abnormalities causes on ECG. Many Students after MBBS (and some Doctors after graduation!) give up hopes on even trying to understand ECG. The simplest mnemonic or trick for Axis Deviation has been given below. We have also simplified P Wave ECG findings below. Stay connected for more updates!
ECG Finding- 2.5mm in limb leads or >1.5mm in chest leads
Cause- Right Atrial Enlargement (Cor Pulmonale- Pulmonary Hypertension in chronic respiratory disease)
P Mitrale (bifid P wave)
ECG Finding- 0.12 secs/ >3 small squares
Cause- Left Atrial Enlargement (MS- Mitral Stenosis)
If you loved this post, or have any feedback or corrections to drop, please feel free to let us know using the comments section below. We love to respond to our precious readers.
PSVT or Paroxysmal Supraventricular Tachycardia is a Narrow complex Ventricular Tachycardia that occurs abruptly when normal electrical impulses of the heart are disrupted. We have provided short notes on PSVT for your exam preparation for Cardiology subject below (especially for Plab part 1). Any queries are welcome in the comments section below.
It is easy yet crucial to differentiate PSVT from Atrial Fibrillation from ECG as both have absent P waves. You can easily distinguish as PSVT will have regular R-R interval while AF will have irregular R-R interval.
While Management of SVT involves Carotid massage and Valsalva Manuever followed by IV Adenosine, IV Magnesium Sulphate is given for Torsades de pointes, also known as Polymorphic Ventricular Tachycardia
Management of PSVT
Initial Line
Initial step involves Valsalva manoeuvre and giving Carotid Massage
Not improved?
If the patient does not improves with above steps, we give Adenosine bolus for management.
Intravenous Adenosine (6mg Rapid IV Bolus)
Still not improved?- give additional 12mg Adenosine
Still not improved?- give another 12mg Adenosine
Still not improved?- Electrical DC “cardioversion”
Note
Adenosine is contraindicated in Asthmatics as it can cause Bronchospasm
Verapamil (CCB) is preferred option in SVT in patient with Asthma
Prevention of future episodes
Beta-blockers such as Propranolol or Radio-frequency ablation
Management of PSVT Short Notes
First step
Carotid massage and Valsalva maneuver
2nd step
IV Adenosine 6mg
Another IV Adenosine 12mg
Another IV Adenosine 18mg
3rd step
Verapamil or beta-blocker
4th step
Cardioversion (DC Shock) (First step if hemodynamically unstable)
ECG- Narrow QRS (<0.12 seconds) f/b T wave and no P wave with Regular R-R interval
Prophylaxis- Beta blocker or Radio-frequency ablation
CCB (Verapamil) instead of Adenosine in Asthmatics
Video
Check out the video below if you are looking for detailed aspects of the topic:
Conclusion
Patients of Paroxysmal Supraventricular Tachycardia usually present with racing heart and their heart rates are spiking. Once Adenosine is administered, heart rate returns to normal within seconds. It may occur again after a while, and the process is repeated. Management is crucial and it is super important to differentiate it from Atrial Fibrillation as both have different management.
We hope these short notes help you out in exams. You can ask us your queries or leave feedback in the comments section below.
Anatomy is a vast subject that is mastered only with learning and application at the same time. While Embryology, a branch of Anatomy deals with study of embryogenesis, formation of embryo from a fertilized egg. Inderbir Singh Embryology PDF book for free download is available below through direct google drive links for you to help you out with your studies into this sub-section. This First year subject for MBBS shall become easier for you if you possess the appropriate books required.
Inderbir Singh Embryology PDF Book
There are 22 Chapters in Professor Inderbir Singh Book of Embryology which are as follows:
Introduction and Some Preliminary Considerations •• Basic Qualities of Living Organisms •• Reproduction •• Development of a Human Being •• Embryology •• Subdivisions of Embryology •• Importance of Embryology in the Medical Profession •• Basic Processes in Embryology
Genetics and Molecular Biology in Embryology •• Genetic Basis of Developmental Anatomy •• Genes •• Chromosomes •• Inheritance of Genetic Disorders •• Cell Division
Reproductive System, Gametogenesis, Ovarian and Menstrual Cycles •• Male Reproductive System •• Female Reproductive System •• Gametogenesis •• Ovarian Cycle •• Menstrual Cycle •• Hormonal Control of Ovarian and Uterine Cycles
Fertilization and Formation of Germ Layers •• Fertilization •• Sex Determination •• Test Tube Babies/In Vitro Fertilization •• Cleavage •• Formation of Germ Layers •• Time Table of Events Described in this Chapter •• Embryological Explanation for Clinical Conditions or Anatomical Observations
Further Development of Embryonic Disc •• Formation of Notochord •• Formation of the Neural Tube •• Subdivisions of Intraembryonic Mesoderm •• Lateral Plate Mesoderm—Formation of Intraembryonic Coelom •• Intermediate Mesoderm •• Yolk Sac •• Folding of Embryo •• Connecting Stalk •• Allantoic Diverticulum •• Effect of Head and Tail Folds on Positions of Other Structures •• Time Table of Events Described in this Chapter
Placenta, Fetal Membranes and Twinning •• Formation of Placenta •• Fetal/Extraembryonic Membranes •• Multiple Births and Twinning •• Embryological Basis for Clinical Conditions or Anatomical Observations
Formation of Tissues of the Body •• Epithelia •• Connective Tissue •• Muscular Tissue •• Nervous Tissue
Integumentary System (Skin and Its Appendages, Mammary Gland) •• Skin •• Appendages of Skin •• Time Table of Some Events Described in this Chapter •• Embryological Explanation for Clinical Conditions or Anatomical Observations in Skin
Pharyngeal Arches •• Pharyngeal/Branchial Arches •• Derivatives of Skeletal Elements •• Nerves and Muscles of the Arches •• Fate of Ectodermal Clefts •• Fate of Endodermal Pouches •• Development of Palatine Tonsil •• Development of the Thymus •• Development of Parathyroid Glands •• Development of Thyroid Gland •• Time Table of Some Events in the Development of Pharyngeal Arches •• Embryological Explanation for Clinical Conditions or Anatomical Observations
Skeletal System and Muscular System Part 1: Skeletal System •• Somites •• Development of Axial Skeleton •• Formation of Limbs •• Joints Part 2: Muscular System •• Skeletal Muscle •• Development of Muscular System •• Time Table of Some Events •• Clinical Case with Prenatal Ultrasound and Aborted Fetal Images: Embryological and Clinical Explanation
Face, Nose and Palate •• Development of the Face •• Development of Various Parts of Face •• Development of Palate •• Time Table of Some Events in the Development of Face, Nose and Palate •• Embryological Explanation for Clinical Conditions or Anatomical Observations
Alimentary System—I: Mouth, Pharynx and Related Structures •• Mouth •• Teeth •• Pharynx •• Tongue •• Derivatives of Oral Cavity •• Salivary Glands •• Time Table of Some Events Described in this Chapter
Alimentary System—II: Gastrointestinal Tract •• Derivation of Individual Parts of Alimentary Tract •• Rotation of the Gut •• Fixation of the Gut •• Time Table of Some Events Described in this Chapter •• Embryological Basis for Clinical Conditions or Anatomical Observations
Liver and Biliary Apparatus; Pancreas and Spleen; Respiratory System; Body Cavities and Diaphragm Liver and Biliary Apparatus •• Liver and Intrahepatic Biliary Apparatus •• Gallbladder and Extrahepatic Biliary Passages (Extrahepatic Biliary Apparatus) Pancreas and Spleen •• Pancreas •• Spleen Body Cavities and Diaphragm •• Body Cavities •• Diaphragm Respiratory System •• Larynx •• Trachea •• Extrapulmonary Bronchi •• Intrapulmonary Bronchi and Lungs •• Embryological Basis for Clinical Conditions or Anatomical Observations
Cardiovascular System Part 1: Heart •• Components of Blood Vascular System •• Formation of Blood Cells and Vessels •• Extraembryonic Blood Vascular System •• Intraembryonic Blood Vascular System •• Development of Heart •• Development of Various Chambers of the Heart •• Exterior of the Heart •• Valves of the Heart •• Conducting System of the Heart •• Pericardial Cavity Part 2: Arteries •• Pharyngeal Arch Arteries and their Fate •• Development of Other Arteries Part 3: Veins •• Visceral Veins •• Somatic Veins •• Veins of the Abdomen •• Azygos System of Veins Part 4: Fetal Circulation •• Changes in the Circulation at Birth Part 5: Lymphatic System •• Time Table of Some Events Described in this Chapter •• Embryological Basis for Clinical Conditions or Anatomical Observations
Urogenital System •• Development of Kidneys •• Absorption of Lower Parts of Mesonephric Ducts into Cloaca •• Development of the Ureter •• Development of the Urinary Bladder •• Development of the Female Urethra •• Development of the Male Urethra •• Development of the Prostate •• Paramesonephric Ducts •• Development of Uterus and Uterine Tubes •• Development of Vagina •• Development of External Genitalia •• Development of Testes •• Development of the Ovary •• Fate of Mesonephric Duct and Tubules in the Male •• Fate of Mesonephric Ducts and Tubules in the Female •• Control of Differentiation of Genital Organs •• Time Table of Some Events Described in this Chapter
Nervous System •• Neural Tube and Its Subdivisions •• Neural Crest Cells •• Spinal Cord •• Brainstem •• Cerebellum •• Cerebral Hemisphere •• Autonomic Nervous System •• Time Table of Some Events in Nervous System Development •• Embryological Explanation for Clinical Conditions or Anatomical Observations of Nervous System
Endocrine Glands •• Classification of Endocrine Glands •• Hypophysis Cerebri or Pituitary Gland •• Pineal Gland •• Adrenal Gland •• Chromaffin Tissue •• Time Table of Some Events Described in this Chapter •• Embryological Explanation for Clinical Conditions or Anatomical Observations in Eyeball
Development of Eye •• Formation of the Optic Vesicle •• Formation of Lens Vesicle •• Formation of the Optic Cup •• Derivation of Parts of the Eyeball •• Accessory Structures of Eyeball •• Time Table of Some Important Events Described in this Chapter •• Embryological Explanation for Clinical Conditions or Anatomical Observations in Eyeball
Development of the Ear •• Internal Ear •• Middle Ear •• External Ear •• Time Table of Some Events Described in this Chapter •• Embryological Explanation for Clinical Conditions or Anatomical Observations in Ear
Clinical Applications of Embryology •• Gestational Period •• Growth of the Embryo •• Determining the Age of an Embryo •• Further Growth of the Fetus •• Determining the Age of a Living Fetus •• Control of Fetal Growth •• Causation of Congenital Anomalies (Teratogenesis) •• Prenatal Diagnosis of Fetal Diseases and Malformations •• Fetal Therapies
Embryology Ready Reckoner •• Developmental Anatomy at a Glance
About the Author
Professor Inderbir Singh
About the Editor
V Subhadra Devi
MS (Anatomy)
Professor and Head
Department of Anatomy
Sri Venkateswara Institute of Medical Sciences (Svims)
Inderbir Singh Embryology book is made for MBBS students who just got into MBBS and face the world-changing scenario of their life in their First Year. Juggling between studies and their personal life, they suffer from Anatomy, and super-added is Embryology which drains the blood from vessels. They seek 10-year question papers and beg for notes from seniors for Embryology, a sub-section of anatomy. The Inderbir Singh Embryology PDF Book contains 377 pages and is 29.2mb which includes 22 chapters (a painful death!)
Suggestions to those studying anatomy in first year of MBBS includes following:
Watch Acland videos and compare with your book.
Stick to BD chaurasia, it’s bible for mbbs anatomy.
Make notes every time you dissect or learn from cadaver.
Learn to make more of diagrams, examiners mostly stick to your presentation rather than your content, so a couple of diagrams and charts can help you win the race.
Don’t ever miss Cadaver dissection, you might not get the opportunity again in life.
Inderbir Singh Embryology Latest Edition Book PDF Download
You can download the Inderbir Singh Embryology Book 12th edition by the Google drive links given below. We have also provided link to 11th edition as well. If the link is not working, do let us know using the comments section, we will readily update it. If you are unable to locate the links, please refresh the page. Please also wait to load up the file as the file size may vary.
Please note these are external links and we do not host any downloads on our website. If you are the owner of the content or have disputes regarding the terms, please read our complete Disclaimer page or leave us a message via our Contact Us page. Any violation or infringement will be immediately removed upon confirmation.
As we discussed previously, Community medicine, also known as PSM for Preventive and Social Medicine, is a subject that requires mastering with theory and clinical skills. This third year subject is often a kinky part for many MBBS students giving their prof exams. We have provided the Vivek Jain PSM PDF Download links below using the Google drive links.
Vivek Jain PSM PDF Book
There are 17 Annexures with 16 chapters and a section for Image based questions which are as follows:
ANNEXURES
Annexure 1: Incubation Period of Diseases
Annexure 2: Important Days of Public Health Importance
Annexure 3: Instruments of Importance in Public Health
Annexure 4: Mode(s) of Transmission of Diseases
Annexure 5: Some Important Health Legislations Passed in India
Annexure 6: Some Important Health Programmes of India
Annexure 7: Vectors and Diseases Transmitted
Annexure 8: New Tuberculosis Diagnosis (RNTCP) Guidelines in India (w.e.f. 01 April 2009 onwards)
Annexure 9: National Population Policy (NPP) 2000
Annexure 10: National Health Policy (NHP) 2015
Annexure 11: Sustainable Development Goals (SDGs)
Annexure 12: New Malaria Treatment Guidelines in India (2013 onwards)
Dr Vivek Jain PSM book is a finely carved book for MBBS students who are preparing for NEET PG exam after MBBS and looking forward to preparatory manual for Community Medicine subject. The latest edition of the book is 18.2mb file and has over 941 pages which contains the following including Annexures, Chapters with Theory, MCQs and Explanations and finally, Image based questions.
Suggestions to those who are looking forward to establishing a clinical understanding in Medicine are as follows:
Read this book and carry it during the practicals and OPD. Have a quick look at the case studies quickly as you approach the patient with established diagnosis. You will feel more confident as you keep practicing this approach.
Learn to make Doctor-Patient relationship and learn how to approach them, deal with different types of patients and how to interact with them with the common tongue.
Learn how to examine different systems. If you don’t know how to do them, your diagnosis is going to be incomplete, you cannot always rely on lab reports and your seniors, do you?
If you need help, following are some posts that can greatly help you in clinical wards. They have been made short but explained to the level of a medical student. These are:
You can download the Vivek Jain PSM Book 8th edition by the links given below. We will update with Vivek Jain latest edition (11th and 12th edition) whenever we get the links. If the link is not working, do let us know using the comments section, we will readily update it. If you are unable to locate the links, please refresh the page. Please also wait to load up the file as the file size may vary.
Please note these are external links and we do not host any downloads on our website. If you are the owner of the content or have disputes regarding the terms, please read our complete Disclaimer page or leave us a message via our Contact Us page. Any violation or infringement will be immediately removed upon confirmation.
Have you already made up your mind to move out of your country after MBBS and move to UK and start working as a Doctor in UK after completing Plab exam held by GMC? You have just landed at the right destination! We will provide you with the most relevant list of study material you should be using for Plab part 1 exam.
Plab1keys are still on the top list if you are just starting your preparation. Unlike other preparation material, Plab 1 keys are simply notes of what you are going to face in exam. The current Plab 1 keys have 30 subjects including miscellaneous. It simply contains questionnaires and detailed information of the topics you need to cover for your exam.
They frequently provide updates on their chapters after every plab 1 exam to include any update that comes along. If you are keen to understand more, you can check out their free chapters here.
You can find their offline (not recommended and also illegal) notes in PDF format from telegram or other groups easily, however, you will be missing important updates as the Update Key Numbers keep changing very often.
If you are looking to subscribing to their plans, you should register yourself first and then opt for one here. Their minimal plan starts at 30 euros for a month.
Plabable for Plab currently have over 2500 questions with explanations for each option. They currently have plan for 3 months at 20 euros and 5 months for 25 euros.
If considered, Plabable is, by far, the best study material for Plab 1. Not just questions, it also has Revision guides, Gems (Quick way to revise high yielding topics), Webinars and the most exclusive Plab Mock tests.
Plabable beats Plab 1 keys if updates on guidelines and protocols is considered. There may be clashes between some words in Plab1keys and Plabable for Plab, but trust your instincts and stick to Plabable words in such scenarios since Plabable is updated by Doctors already working in NHS (and more importantly, their updates are often real-time and most trustworthy with a valid source)
You also get various Whatsapp group links which you can join to stay updated on information regarding different queries such as Visa applications for Plab, Webinars, Mock tests, Plab 1 seats availability, etc.
While some state that Plab 1 keys and Plabable is everything you need for Plab part 1 exam, we highly recommend that you do not miss any opportunity to grab free stuff also. The exam is focused on your clinical skills, if you are good with them, you will be seeing yourself as Licensed Doctor in UK soon. Best of luck to all Plab Aspirants out there.
Clinical Medicine is an art a medical student has to master and it goes without saying. It is something you simply do not mug up, but rather practice it again and again till you become acquainted to it. Clinical Medicine is a subject in Fourth Year of MBBS. Macleod’s is a book which can help you master your senses and help you build the clinical skills required to sit in OPD! You can download Macleod Clinical Examination 14th edition in PDF format using the Google Drive Links given below.
Macleod Clinical Examination 14th Edition PDF Book
There are 21 units in 4 sections in the book and these are as follows:
SECTION 1 PRINCIPLES OF CLINICAL HISTORY AND EXAMINATION
1. Managing clinical encounters with patients
2. General aspects of history taking
3. General aspects of examination
SECTION 2 SYSTEM-BASED EXAMINATION
4. The cardiovascular system
5. The respiratory system
6. The gastrointestinal system
7. The nervous system
8. The visual system
9. The ear, nose and throat
10. The endocrine system
11. The reproductive system
12. The renal system
13. The musculoskeletal system
14. The skin, hair and nails
SECTION 3 APPLYING HISTORY AND EXAMINATION SKILLS IN SPECIFIC SITUATIONS
15. Babies and children
16. The patient with mental disorder
17. The frail elderly patient
18. The deteriorating patient
19. The dying patient
SECTION 4 PUTTING HISTORY AND EXAMINATION SKILLS TO USE
This book is definitely not what you will be looking for exams, but yes, it can help you build the concepts required for Residency after MBBS. 402 pages embedded in a 62mb file, Macleod Clinical Examination book, this book beautifully brings in you the OPD experience in front of you. From styles of questions to asked to patients to the environment of hospital and to the responsibilities of you as a resident doctor, this book helps you visualize the workspace with amazing pictures. 21 Units in 4 sections, all you have to do is pick up which part you want to strengthen first (Personal recommendation: Go with Communication skills with patients first). Eventually, you will fall in love with book, BEWARE, don’t forget to stick to your theoretical too.
Suggestions to those who are looking forward to establishing a clinical understanding in Medicine are as follows:
Read this book and carry it during the practicals and OPD. Have a quick look at the case studies quickly as you approach the patient with established diagnosis. You will feel more confident as you keep practicing this approach.
Learn to make Doctor-Patient relationship and learn how to approach them, deal with different types of patients and how to interact with them with the common tongue.
Learn how to examine different systems. If you don’t know how to do them, your diagnosis is going to be incomplete, you cannot always rely on lab reports and your seniors, do you?
If you need help, following are some posts that can greatly help you in clinical wards. They have been made short but explained to the level of a medical student. These are:
You can download the Macleod Clinical Examination 14th Edition by the links given below. If the link is not working, do let us know using the comments section, we will readily update it. If you are unable to locate the links, please refresh the page. Please also wait to load up the file as the file size may vary.
Please note these are external links and we do not host any downloads on our website. If you are the owner of the content or have disputes regarding the terms, please read our complete Disclaimer page or leave us a message via our Contact Us page. Any violation or infringement will be immediately removed upon confirmation.
Wilson’s Disease or Hepatolenticular Degeneration is an autosomal recessive inherited disorder that causes increased accumulation of copper into organs. The typical sign of Kayser Fleischer Rings is very well pronounced as it appears as Rings at edges of cornea. It is one of the disorder one must be familiar with when reading Gastromedicine, apart from Hemochromatosis.
Physiology
Total body copper content is ~125mg. Intake ≈ 3mg/day (absorbed in proximal small intestine). In the liver, copper is incorporated into ceruloplasmin.
Presentation
Kayser Fleischer Rings
Liver dysfunction- deranged liver function tests, cirrhosis
Behavioral- Personality changes with reduced performance
Neurological- Ataxia, dysarthria, dystonia
Azure Lunulae: Blue Nails, Haemolysis, Arthritis, Hypermobile joints, Grey Skin
Investigations
Urine: 24h copper excretion is high, e.g >100mcg/24h (normal <40mcg)
Increased LFT: non-specific (but ALT >1500 is not part of the picture)
Serum copper: typically <11μmol/L
Decreased Serum ceruloplasmin: <200mg/L (<140mg/L is pathognomonic)—beware incidental low values in protein-deficiency states (e.g nephrotic syndrome, malabsorption)
Molecular genetic testing can confirm the diagnosis
Slit lamp exam: Kayser Fleischer rings: in iris/Descemet’s membrane
MRI: degeneration in basal ganglia, fronto-temporal, cerebellar, and brainstem
Kayser Fleischer Rings seen in Wilson’s Disease or Hepatolenticular Degeneration are Golden to greenish-brown annular deposition of copper in periphery of the cornea (Descemet’s membrane).
More about Kayser Fleischer Rings
The Kayser-Fleischer Rings consist of copper deposits at periphery where the cornea meets the sclera, in Descemet’s membrane, first appear as a crescent at the top of the cornea. Eventually, a second crescent forms below, at the “six o’clock position”, and ultimately completely encircles the cornea.
Other causes of KF Rings are Cholestasis (Obstruction of the bile ducts), Primary Biliary Cirrhosis and Cryptogenic Cirrhosis
Diagnosis of KF Rings is usually done by Slit lamp examination. They become visible by naked eyes in later stages.Diagnosis of KF Rings is usually done by Slit lamp examination. They become visible by naked eyes in later stages.
Treatment
Avoid foods with high copper content (eg liver, chocolate, nuts, mushrooms, legumes, and shellfish).
Lifelong Penicillamine (500mg/6–8h PO for 1yr, maintenance 0.75–1g/d)
In Acute Liver Failure or Cirrhosis- Liver Transplant
Summary
Grey Skin, Serum Ceruloplasmin <140, Urine copper excretion >100mcg/24hr and Kayser Fleischer Rings in eyes; Rx- Lifelong Penicillamine
Outside the Emergency of Rajeev Gandhi Super Specialty Hospital as I hear my senior explain the condition of my known-to patient during counsel sessions, I’m called by a staff for assistance. A young mid-20s female sitting blank over there, asks me in quiet tone- “Sir, my 1 month kid is covid positive, where should i go?” To be honest, my first clue was Chacha Nehru Hospital, but again, she said she has already been there and Ram Manohar Lohiya Hospital too.
Warriors in Rajeev Gandhi Super Specialty Hospital are already doing their best under guidance of Dr. Vikas Dogra Sir and Dr. Ajeet Jain Sir and the hospital is currently the one which is having most available vacant ventilator beds to hold the critical victims of the pandemic. But the question is, how far can we fight?
Scenario 1: What if not Covid?
Delhi government has in fact set up the best (yes i mean best) organization of medical facilities to fight Covid 19 efficiently. But there are still sections that need to be looked. People who are having medical issues other than covid, are panicking because they simply don’t know where to go when situation demands.
Let me give an example again. Where will you go if you had an accident and broke your bone? Ask yourself the same question, and then ask if others around you know it too. See, it’s that simple. Casualties happen always, but we actually got no clue which path to walk. People should know what hospitals are treating the non-covid cases, and by that, I exclusively mean government run hospitals.
Scenario 2: Lack of Concern
I’m a typical atheist, yet I firmly believe in the notion of “God’s Punishment of Covid”, when i walk outside my home and see Covidiots roaming around without masks and laughing when i ask them to wear one.
Indeed, they don’t understand the gravity of the situation, but I will gladly smile too when such people suffer out of Covid. Before you judge me, I don’t actually blame everyone, for some good bosoms also suffer for the acts of others.
Beware of Such Creatures, Infact Don’t Be One
Irregardless of the cases that have come up in the peak of third wave in Delhi, much is needed again to re-incite the cause for care in people around us. And for the cause, i almost got touched and heartbroken, for there is actually no information practically available to the people out there, when they ask themselves, “Where should i go?”
Scenario 3: Digital doesn’t reach everyone
Rather than digitalizing everything into apps and websites, people should be granted a way out of information in the very crude sources. Not everyone is used to apps and helpline platforms are doing their best, but still unable to reach everyone (i tried calling helpline for the same lady myself).
We know our leaders are most educated and always find a way to help their people, I just heed your approach on this too. We will undoubtedly come out of this together.
Conclusion
I seek Delhi government as a Doctor and a Delhite, for I know the voices are heard very often in our beloved city. Kindly help such citizens with valuable medical information they seek, so they don’t have to wander around looking for a hope.
Our guides and us will keep the fight on till our last breath, as we were taught in our Hippocratic oath to do so, but a little help will be exquisite. Concluding, Hope is everything, I’ll hope for me and you, you hope for all of us. We are always open to suggestions and feedbacks in the comments section below.
While most of Delhites have learnt to live with the Covid-19, there has been an unconquerable increase in the number of cases in the past few months. Doctors and Medical staff are turning their efforts towards saving every precious life in hospitals, where Rajeev Gandhi Super Specialty Hospital, Tahirpur, stands the finest in East Delhi. Under the leadership of Dr. Ajeet Jain, the infrastructure has set the very foundations of what we may call the beginning of the new era: Covid Free India!
Filled with enthusiasm and an untiring zeal, Doctors here are working tirelessly, to not only treat their patients, but to create an atmosphere of assurance amidst the chaos. To watch them remove their PPE kits during doffing procedure, where the sweat drags itself on the floors, is like looking at a lake of efforts.
Under the leadership of our esteemed Director, Dr. BL Sherwal and Dr. Ajeet Jain, Nodal officer of the hospital, who works more than 12hrs a day, to guide everything in a direction of integrity, making sure everyone is safe and sound. Dr. Vikas Dogra, Head of Pulmonology department, can be seen throughout the premises of hospital, making sure patients needs are met genuinely. In a sound mind, it definitely is an exquisite hospital where other government hospitals might fail to meet the standards.
Despite 382 Doctors losing their lives fighting against Covid 19, our community isn’t losing the pace. We will keep believing in the simple notion of rebuilding everything once again.
Perhaps RGSSH is one of the leading hospital where Remdesivir Therapy and Plasma Therapy are being performed with highest cure rates and most preferable outcomes. A whole lot of protocols have been set up for the safety and consequences of the therapy, for one is accountable for every action he takes towards saving a life.
To conclude, we will honour the work our Doctors are doing everyday while we sleep peacefully looking at the bright side of life. Let’s not forget the ones we have lost, and leave the footprints on sands of time, for the seeds planted today will definitely bear the fruits tomorrow. Stay safe, stay healthy.
Anemia is the most mutual medical ailment of pregnancy. The occurrence of anemia in pregnancy ranges from 40-80 % in tropics likened to 10-20% in developed countries.
“Anemia is a reduction in red blood cells (erythrocytes) which in turn decrease the oxygen carrying capacity of the blood. It reflects an abnormality in red blood cell number, structure or function”.
According to WHO, “Anemia in pregnancy is present when the hemoglobin concentration in the peripheral blood is 11g/100ml or less. Keeping in mind the socio-economic status, the level is brought down to 10g/100ml or less”. Or “Anemia is defined as a reduction below normal in the number of red blood corpuscles per cubic millimeter, the quantity of hemoglobin and the volume of packed red cells per 100 ml of blood”.
Classification of Anemia
Practically
Anemia is classified into two:
Physiological anemia of pregnancy.
Pathological anemia: it is further divided into:
Deficiency anemia (isolated or combined)
Hemorrhagic
Hemolytic (Lack of bile pigment in urine)
Bone marrow insufficiency
Hemoglobinopathies
Causes of Anemia During Pregnancy
Inadequate iron reserve
Increase demand of iron
Disturbed metabolism
Pre pregnant health status
Condition requiring excess demand
Faulty dietetic habit
Iron loss
Clinical Features
Symptoms
Lassitude and a feeling of exhaustion or weakness may be earlier manifestation.
Anorexia
Palpitation
Indigestion
Dyspnea
Gigginess
Swelling of leg
Pallor of mucus membrane
In examination
There is pallor glossitis and stomatitis.
There may be adima of leg.
A soft systolic mermer may be geared.
Crepitation may be heard.
Diagnosis of a Case of Iron Deficiency/Anemia
Hematological examination
Hemoglobin
Total red cell count
Packed cell Volume
Peripheral blood smear
MCHC, MCB and MCH values
Serum Iron
Total iron binding capacity
Serum ferritim
Examination of stool
To detect anemia due to hookworm infestation
Urine examination
To check infection and presence of protein, sugar and pus cell
Complication of Severe Anemia
During pregnancy:
Pre-eclampsia
Intercurrent infection
Heart failure
Preterm labor
Abortion
During labor:
Uterine inertia
PPH
Cardiac failure
Shock
During puerperium:
Puerperal Sepsis
Sub involution
Failing lactation
Puerperal Venus Thrombosis
Effects on Baby:
There is increased incidence of low birth weight
There are chances of intra uterine death
Nursing Management
The pregnant women should get her hemoglobin level checked at the first antenatal visit, then at 28th week and finally at 36th week.
The mother should be given iron protein and vitamin rich diet like
Liver
Meat
Egg
Green vegetable
Figs
Beans
Whole wheat
Green Plantains
Onions stalks
Jaggery
Ground nuts
She should be given oral preparation in the form of tablets and capsules
Advise the mother to continue iron preparation.
Dietary advice must be anthesised and reinforced as told earlier like richer source of iron and folic acid are to be given taken before, during and after pregnancy.
While administration of parenteral iron check for advert reaction like rigor chest pain, hypertension.
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The National Medical Commission or NMC Bill 2019 has been passed to Rajya Sabha after passing from Lok Sabha on 29th July. The government is still trying to suppress the voices of IMA representing the anger of doctors nationwide.
