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NEET PG 2018 Result Announced: Check Here

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Neet PG 2018 Result

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:

Click Here To Download Result PDF

Click Here: NEET 2018 Result

Cut Off Marks NEET PG 2018

The cut off marks (Total of 1200 Marks) have been set as:

  • General Category: 50th Percentile: 321 Marks out of 1200
  • SC/ST/OBC/SC-PH/ST-PH/OBC-PH: 40th Percentile: 281 Marks out of 1200
  • UR-PH: 45th Percentile: 300 Marks out of 1200

Score card will not be sent individually to the candidates. Candidates are requested to download their score card from website: https://nbe.edu.in

And remember, best of luck!

Goodman and Gilman Pharmacology Pdf Download

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Apart from the most used book for pharmacology, K.D Tripathi, there comes another book which is one of the finest books to read in Second year of MBBS for pharmacology. Goodman and Gilman provides beautiful insights and explanations to the students. Below are the links given to Goodman and Gilman free eBook in PDF format for Pharmacology.

Goodman and Gilman Pharmacology PDF Book

The Goodman and Gilman has 15 sections covering 65 chapters and appendices which are listed as below:

Section I: General Principles

  1. Pharmacokinetics and Pharmacodynamics: The Dynamics of Drug Absorption,
    Distribution, Action and Elimination
  2. Membrane Transporters and Drug Response
  3. Drug Metabolism
  4. Pharmacogenetics
  5. The Science of Drug Therapy

Section II: Drugs Acting at Synaptic and Neuroeffector junctional sites

  1. Neurotransmission: The Autonomic and Somatic Motor Nervous Systems
  2. Muscarinic Receptor Agonists and Antagonists
  3. Anticholinesterase Agents
  4. Agents Acting at the Neuromuscular Junction and Autonomic Ganglia
  5. Adrenergic Agonists and Antagonists
  6. 5-Hydroxytryptamine (Serotonin): Receptor Agonists
    and Antagonists

Section III: Drugs Acting on Central Nervous System

  1. Neurotransmission and the Central Nervous System
  2. General Anesthetics
  3. Local Anesthetics
  4. Therapeutic Gases: Oxygen, Carbon Dioxide, Nitric Oxide, and Helium
  5. Hypnotics and Sedatives
  6. Drug Therapy of Depression and Anxiety Disorders
  7. Pharmacotherapy of Psychosis and Mania
  8. Pharmacotherapy of the Epilepsies
  9. Treatment of Central Nervous System Degenerative Disorders
  10. Opioid Analgesics
  11. Ethanol
  12. Drug Addiction and Drug Abuse

Section IV: Autocoids: Drugs therapy of Inflammation

  1. Histamine, Bradykinin, and Their Antagonists
  2. Lipid-Derived Autacoids: Eicosanoids and Platelet-Activating Factor
  3. Analgesic-Antipyretic Agents; Pharmacotherapy of Gout
  4. Pharmacotherapy of Asthma

Section V: Drugs affecting Renal and Cardiovascular Function

  1. Diuretics
  2. Vasopressin and Other Agents Affecting the Renal Conservation of Water
  3. Renin and Angiotensin
  4. Treatment of Myocardial Ischemia
  5. Therapy of Hypertension
  6. Pharmacotherapy of Congestive Heart Failure
  7. Antiarrhythmic Drugs
  8. Drug Therapy for Hypercholesterolemia and Dyslipidemia

Section VI: Drugs affecting Gastrointestinal Function

  1. Pharmacotherapy of Gastric Acidity, Peptic Ulcers, and Gastroesophageal
    Reflux Disease
  2. Treatment of Disorders of Bowel Motility and Water Flux; Antiemetics;
    Agents Used in Biliary and Pancreatic Disease
  3. Pharmacotherapy of Inflammatory Bowel Disease

Section VII: Chemotherapy of Parasitic Infections

  1. Chemotherapy of Protozoal Infections: Malaria
  2. Chemotherapy of Protozoal Infections: Amebiasis, Giardiasis, Trichomoniasis,
    Trypanosomiasis, Leishmaniasis, and Other Protozoal Infections
  3. Chemotherapy of Helminth Infections

Section VIII: Chemotherapy of Microbial Diseases

  1. General Considerations of Antimicrobial Therapy
  2. Sulfonamides, Trimethoprim-Sulfamethoxazole, Quinolones, and Agents
    for Urinary Tract Infections
  3. Penicillins, Cephalosporins, and Other β-Lactam Antibiotics
  4. Aminoglycosides
  5. Protein Synthesis Inhibitors and Miscellaneous Antibacterial Agents
  6. Chemotherapy of Tuberculosis, Mycobacterium avium Complex Disease,
    and Leprosy
  7. Antifungal Agents
  8. Antiviral Agents (Nonretroviral)
  9. Antiretroviral Agents and Treatment of HIV Infection

Section IX: Chemotherapy of Neoplastic Diseases

  1. Antineoplastic Agents

Section X: Immunomodulators

  1. Immunosuppressants, Tolerogens, and Immunostimulants

Section XI: Drugs acting on the Blood and Blood-Forming Organs

  1. Hematopoietic Agents: Growth Factors, Minerals, and Vitamins
  2. Blood Coagulation and Anticoagulant, Thrombolytic, and Antiplatelet Drugs

Section XII: Hormones and Hormone Antagonists

  1. Pituitary Hormones and Their Hypothalamic Releasing Factors
  2. Thyroid and Antithyroid Drugs
  3. Estrogens and Progestins
  4. Androgens
  5. Adrenocorticotropic Hormone; Adrenocortical Steroids and Their Synthetic Analogs;
    Inhibitors of the Synthesis and Actions of Adrenocortical Hormones
  6. Insulin, Oral Hypoglycemic Agents, and the Pharmacology of the
    Endocrine Pancreas
  7. Agents Affecting Mineral Ion Homeostasis and Bone Turnover

Section XIII: Dermatology

  1. Dermatological Pharmacology

Section XIV: Ophthalmology

  1. Ocular Pharmacology

Section XV: Toxicology

  1. Principles of Toxicology and Treatment of Poisoning
  2. Heavy Metals and Heavy-Metal Antagonists

Appendices:

I. Principles of Prescription Order Writing and Patient Compliance

II. Design and Optimization of Dosage Regimens; Pharmacokinetic Data

Overview

Unlike KD Tripathi, Goodman and Gilman has a lot of text clustered together with some flow charts and some images. The book has over 2047 pages with deep explanations and it’s download size is 33.2 Mb. However, we still recommend that you use KD Tripathi if you are a second year MBBS student struggling to pass the prof exams.

Suggestions to those studying pharmacology in Second year MBBS are as follows:

  1. Try to read this article- How to study Pharmacology in Second Year MBBS.
  2. Most of the pharmacology is mugging up, you will end making a number of mnemonics for them. But do not miss important topics, including the drugs for cardiology, anti-biotics, etc.
  3. Do not miss Emergency medicine drugs.

Goodman And Gilman PDF Download

You can download the Goodman and Gilman Pharmacology book by link 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.

Google Drive Link

Download

Disclaimer

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.

NMC Bill In Rajya Sabha 2019: Ready To Pass

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The NMC or National Medical Commission Bill 2019 has recently been passed from Lok Sabha on 29th July and is ready to be passed in Rajya Sabha too. The fraternity of doctors is protesting massively against the bill, however, it seems the government and the doctors are bound to clash. We explore the key points of NMC bill 2019 pdf as we try to explain you why it is a disaster for the entire medical community in India.

We have been following news of EXIT exam since years, but the bill was thought to never pass at first stage. And when the rumors have become alive, the ones preparing day and night for Post-Graduation after MBBS are furthermore in stress. We have made a quick review on the updates of NMC Bill 2019 below:

1. The National Medical Commission Bill was introduced in Lok Sabha in July 22, 2019 by Dr. Harsh Vardhan, Minister of Health and Family Welfare, to replace the 63-year old MCI which was alleged to be full of corruption.

2. The Commission or the Board is to be of 25 members, who will be appointed by central government. The Bill has to be regulated within 3 years of passing, and state governments will establish State Medical Councils at the state level.

3. Apart from the basic functioning of NMC board, it will also frame guidelines for determination of fees of up to 50% seats in private colleges and universities.

4. So far, the Ayush Doctors through Bridge course has not been included in the bill after the previous wide-spread protest by MBBS doctors, however, they have not withdrawn completely and has been proposed in Lok Sabha. It will allow mid-level practitioners to prescribe for a limited level, however for others, they will need to be supervised under Registered Medical Practitioners.

5. There will be a uniform National Eligibility-cum-Entrance Test (NEXT exam) for admission to under-graduate and post-graduate education. All MBBS graduates after finishing they 5.5 years of graduation will be required to give NEXT exam to practice as physicians and register themselves in the state board, while also applying for the PG courses with the rank. In short, NEXT exam will serve as both providing license to practice and Post-Graduation after finishing final prof of MBBS.

6. It also has been postulated to regard final prof marks as the basis for admission to PG courses, however, this has not been clear so far.

We saw a protest by IMA leaders including Dr. Santanu Sen, IMA President, and thousands of students against the NMC bill. However, they were arrested by the police outside the Nirman Bhawan in Delhi, and medical community called it a black day.

There is nothing government can do when reservation protests are done, there is nothing when a doctor is beaten in the hospital, but yes, the government can call arrest of every single doctor protesting peacefully against a stupid bill that aims at destroying the medical community in India. Do we really need to NEXT exam after MBBS just to show we are eligible to work as doctors after 5.5 years of hard work? Why not same criteria for other services? Why not same for politicians drowned in countless criminal cases?

We are currently looking forward to this grave issue, while IMA has announced a wide-spread strike by withdrawal of non-emergency services all over in India on 31st July 2019. The strike will be peaceful as it was last time, when doctors demanded from government the safety at work after the incident at West Bengal. A Bench of Justices Deepak Gupta and Surya Kant said there was no urgency in the matter as the strike had been called off.

Do you support the notion of bringing this NMC Bill 2019 into act or you stand against it? Share your opinions in the comments below.

Important Topics in Biochemistry MBBS First Year

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We are often drew back when it comes to Biochemistry during First year of MBBS. It’s not simply a confusing subject, but you have to mug up a lot from this. Some even get to the brink of failing and start looking out for only important topics, so it’s much easier to pass out in the semester. For such students, we have got the list. Below are the important topics to study for Biochemistry during First year of MBBS.

Before we go, we hope you’ve got some important Biochemistry books in your pocket. If not, you can get them here for free:

Cell Membrane and Transport

  • Fluid Mosaic Model
  • Facilitated Diffusion
  • Aquapurins
  • Ionophores
  • Active Transport
  • Receptor Mediated Endocytosis

Carbohydrates

  • Glycogen Storage diseases
  • Glycolysis
  • TCA cycle
  • Glycogen Metabolism
  • Gluconeogenesis
  • Mucopolysaccharidosis
  • Glucose transporters
  • Lactose intolerance
  • Test for carbohydrates

Enzymes

  • Michaelis Menton Graph
  • Regulation
  • Kinetics

Amino acids and Proteins

  • Metabolism of Tyrosine, tryptophan & phenylalanine
  • Positively charged and negatively charged amino acids
  • Titration curves
  • Isoelectric pH
  • Essential and Non-essential Amino acids
  • Chaperones
  • Transamination & Urea cycle
  • Methods of detection of protein structures
  • Collagen
  • Heme Synthesis
  • Inborn errors of metabolism
  • Phenylketonuria

Lipids

  • Sphingolipids
  • Cholesterol synthesis
  • Omega 3 and omega 6 fatty acids
  • Ketone body synthesis and utilization
  • Rothera’s test
  • Lipoproteins
  • Fatty acid synthesis
  • Hormone sensitive lipase
  • Beta oxidation of fatty acids

Molecular biology in Biochemistry

  • PCR and RT PCR
  • DNA repair
  • Codons
  • Post transcriptional modifications
  • Post translational modifications
  • Mutation
    Heterochromatin
  • Klenow fragment
  • Mitochondrial DNA
  • Sickle cell disease
  • Pyrimidine synthesis
  • Translation
  • Nucleotides
  • DNA methylation
  • Genomic Imprinting
  • Hybridisation techniques
  • Blue white assay

Miscellaneous Biochemistry

  • Fuel for body in fed, fasting & starvation
  • Respiratory Quotient
  • Vitamins
  • Source of energy for muscles
  • Diabetes and insulin
  • Zellweger syndrome
  • Thermogenic effect

That’ll be all. Good luck for your exams. Stay tuned for more upcoming MBBS articles and videos.

Kidney Stones: Lifestyle Changes You Can Make!

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A huge amount of population suffers Kidney Stones, also known as Nephrolithiasis. We doctors commonly see patients coming up in ER with their hands on their flanks and telling us how painful it is. We do manage the situation, but what advice would you give to ones who have kidney stones? What would you tell them to eat or drink or do regarding their vulnerability to Kidney Stones?

Below are some key points that were summarized and scripted out from the Bible of Medicine, Harrison. The following points are authentic and have been validated, and do share the information to others to let them know what to do and what not to when they have Kidney Stones. Meanwhile you can also check out post on Gall Stones.

For the Doctors, here are some:

  • Kidney stones cause pain only when the stone moves in the ureter. Pain is actually a good sign.
  • 0-5mm stones pass 100%, 5-10 pass 70% and decreases further with size.
  • Surgical intervention is only required when there is UTI, intractable pain or anatomical abnormality.
  • T. Tamsulosin 0.4mg hs is quoted in Campbell and some articles to be relieve distal ureter stones, but not established yet.

For the People, here are Wise Words from The Gandalf!

  • Diclofenac is the best drug for pain in kidney stones.
  • Drink atleast 2L water, 500ml more than you pee.
  • Tomatoes and Potatoes and Spinach are most common sources of stones, but an Indian simply cannot avoid them. What to do? Take Curd with these foods.
    Note: While Dietary calcium is good, supplement calcium actually contributes to stones. Shouldn’t exceed 1200ng.
  • It’s better to use lemon on tomato in salad, and avoid tomato seeds.
  • If you are non-vegetarian, perhaps you should try taking less of animal protein.
  • Less of Sodium (salt) diet is mandatory. Sucrose and fructose are other culprits.
  • Potassium is good, perhaps banana can help?
  • Vitamin C supplements increase risk of stones.
  • Avoid Carbonated drinks, let go off Coke.
  • Tea, coffee, beer and wine are actually helpful in kidney stones.
Failing Kidney Stones Business Since Decades: Doctors

Let us know if you have any valuable feedback or doubts. We would so love to hear the responses!

Vishram Singh Anatomy Free PDF Download

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The Vishram Singh Anatomy was one of the books a first year student during his MBBS would grab to read and look the insights as he opens BD Chaurasia sideways. Although not the bible of anatomy, it still holds its place throughout the learning process of the initial semesters. You can grab your own copy of Vishram Singh Anatomy Second Edition from this post. Just scroll down as the Google Drive links of the pdf version are given below for free.

Vishram Singh Anatomy PDF Book

The Second Edition of Vishram Singh Anatomy contains three parts, Upper Limb and Thorax, Abdomen and Lower Limb and Head, Neck and Brain. The three parts of book consists of following:

Vishram Singh: Upper Limb and Thorax

The book is 375 pages long with contents as follows:

  • Chapter 1 Introduction to the Upper Limb
  • Chapter 2 Bones of the Upper Limb
  • Chapter 3 Pectoral Region
  • Chapter 4 Axilla (Armpit)
  • Chapter 5 Back of the Body and Scapular Region
  • Chapter 6 Shoulder Joint Complex (Joints of Shoulder Girdle)
  • Chapter 7 Cutaneous Innervation, Venous Drainage and Lymphatic Drainage of the Upper Limb
  • Chapter 8 Arm
  • Chapter 9 Forearm
  • Chapter 10 Elbow and Radio-ulnar Joints
  • Chapter 11 Hand
  • Chapter 12 Joints and Movements of the Hand
  • Chapter 13 Major Nerves of the Upper Limb
  • Chapter 14 Introduction to Thorax and Thoracic Cage
  • Chapter 15 Bones and Joints of the Thorax
  • Chapter 16 Thoracic Wall and Mechanism of Respiration
  • Chapter 17 Pleural Cavities
  • Chapter 18 Lungs (Pulmones)
  • Chapter 19 Mediastinum
  • Chapter 20 Pericardium and Heart
  • Chapter 21 Superior Vena Cava, Aorta, Pulmonary Trunk, and Thymus
  • Chapter 22 Trachea and Esophagus
  • Chapter 23 Thoracic Duct, Azygos and Hemiazygos Veins, and Thoracic Sympathetic Trunks

Vishram Singh: Abdomen and Lower Limb

The book is 521 pages long with following contents:

  • Chapter 1 Introduction and Overview of the Abdomen
  • Chapter 2 Osteology of the Abdomen
  • Chapter 3 Anterior Abdominal Wall
  • Chapter 4 Inguinal Region/Groin
  • Chapter 5 Male External Genital Organs
  • Chapter 6 Abdominal Cavity and Peritoneum
  • Chapter 7 Abdominal Part of Esophagus, Stomach, and Spleen
  • Chapter 8 Liver and Extrahepatic Biliary Apparatus
  • Chapter 9 Duodenum, Pancreas, and Portal Vein
  • Chapter 10 Small and Large Intestines
  • Chapter 11 Kidneys, Ureters, and Suprarenal Glands
  • Chapter 12 Posterior Abdominal Wall and Associated Structures
  • Chapter 13 Pelvis
  • Chapter 14 Pelvic Walls and Associated Soft Tissue Structures
  • Chapter 15 Perineum
  • Chapter 16 Urinary Bladder and Urethra
  • Chapter 17 Male Genital Organs
  • Chapter 18 Female Genital Organs
  • Chapter 19 Rectum and Anal Canal
  • Chapter 20 Introduction to the Lower Limb
  • Chapter 21 Bones of the Lower Limb
  • Chapter 22 Front of the Thigh
  • Chapter 23 Medial Side of the Thigh
  • Chapter 24 Gluteal Region
  • Chapter 25 Back of the Thigh and Popliteal Fossa
  • Chapter 26 Hip Joint
  • Chapter 27 Front of the Leg and Dorsum of the Foot
  • Chapter 28 Lateral and Medial Sides of the Leg
  • Chapter 29 Back of the Leg
  • Chapter 30 Sole of the Foot
  • Chapter 31 Arches of the Foot
  • Chapter 32 Joints of the Lower Limb
  • Chapter 33 Venous and Lymphatic Drainage of the Lower Limb
  • Chapter 34 Innervation of the Lower Limb

Vishram Singh: Head, Neck and Brain

The book has over 460 pages and contents of:

  • Chapter 1 Living Anatomy of the Head and Neck
  • Chapter 2 Osteology of the Head and Neck
  • Chapter 3 Scalp, Temple, and Face
  • Chapter 4 Skin, Superficial Fascia, and Deep Fascia of the Neck
  • Chapter 5 Side of the Neck
  • Chapter 6 Anterior Region of the Neck
  • Chapter 7 Back of the Neck and Cervical Spinal Column
  • Chapter 8 Parotid Region
  • Chapter 9 Submandibular Region
  • Chapter 10 Infratemporal Fossa, Temporomandibular Joint, and Pterygopalatine Fossa
  • Chapter 11 Thyroid and Parathyroid Glands, Trachea, and Esophagus
  • Chapter 12 Pre- and Paravertebral Regions and Root of the Neck
  • Chapter 13 Oral Cavity
  • Chapter 14 Pharynx and Palate
  • Chapter 15 Larynx
  • Chapter 16 Blood Supply and Lymphatic Drainage of the Head and Neck
  • Chapter 17 Nose and Paranasal Air Sinuses
  • Chapter 18 Ear
  • Chapter 19 Orbit and Eyeball
  • Chapter 20 Vertebral Canal and Its Contents
  • Chapter 21 Cranial Cavity
  • Chapter 22 Cranial Nerves
  • Chapter 23 General Plan and Membranes of the Brain
  • Chapter 24 Brainstem
  • Chapter 25 Cerebellum and Fourth Ventricle
  • Chapter 26 Diencephalon and Third Ventricle
  • Chapter 27 Cerebrum
  • Chapter 28 Basal Nuclei and Limbic System
  • Chapter 29 Blood Supply of the Brain

Download Size:
Upper Limb and Thorax: 45mb
Abdomen and Lower Limb: 45mb
Head, Neck and Brain: 39mb

If you need First Year Syllabus, you can check MBBS Syllabus here.

Check out other books:

About the Author

Vishram Singh, MS, PhD
Professor and Head, Department of Anatomy
Professor-in-Charge, Medical Education Unit
Santosh Medical College, Ghaziabad
Editor-in-Chief, Journal of the Anatomical Society of India
Member, Academic Council and Core Committee PhD Course, Santosh University
Member, Editorial Board, Indian Journal of Otology
Medicolegal Advisor, ICPS, India
Consulting Editor, ABI, North Carolina, USA
Formerly at: GSVM Medical College, Kanpur
King George’s Medical College, Lucknow
Al-Arab Medical University, Benghazi (Libya)
All India Institute of Medical Sciences, New Delhi

Overview

Vishram Singh Anatomy Book gives the First year students another option apart from the traditional BD Chaurasia book. The book has super illustrations and also holds special as it has MCQ based questions along with it. The drawings are so fine and clear with different colors to explain the details. The book also depicts clinical pictures of the same as the reader gets deep into the book. It’s a good book if you are preparing for NEET PG exams as well.

Suggestions to those studying anatomy in First Year MBBS are as follows:

  1. Try drawing more of diagrams and 3d visualizing everything you learn. The more you draw and imagine, the more you can recall them easily.
  2. There are plenty of YouTube videos around and then there are some animations, which help understand the most important topics. Just don’t skip them, you will need them in your entire medical career.
  3. If you are preparing for PG Exams, do read this book. It will pave the way of better learning. Although BD Chaurasia still remains the bible of anatomy in India.
  4. Clinically correlating it with cadavers during dissection halls posting is a great way to remembering anatomy.
  5. If you need help, following are some posts that can greatly help you in clinical anatomy. They have been made short but explained to the level of a medical student. These are:

Vishram Singh Anatomy PDF Book Download

You can download the Vishram Singh Anatomy book by 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.

Part 1: Upper Limb and Thorax

Download

Part 2: Abdomen and Lower Limb

Download

Part 3: Head, Neck and Brain

Download

Disclaimer

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.

Dr. Kayra Sings Out Her Heart

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With Great Power Comes Great Responsibility, and on becoming Doctor, one needs to give up his life for the joy of others. At least that’s what we found after graduating from our MBBS.

It was a beautiful hostel life though, and we explored so many talents inside us throughout the college years. Here, i am bringing you one of my friend presenting her latent gift which she explored gradually over the college years.

Just seeking out your love and affection for this one, meanwhile i request you all to not let your gifts get buried under the sands of time. Instead, envy them, embrace them and explore them as you move on with your medical life.

Lower GI Bleeding: Protocol For Gastrointestinal Bleeding

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Lower Gastrointestinal Tract Bleeding or LGI or Lower GI Bleeding is one of the most common serious presenting complaint by patients in emergency or OPD, to differentiate and treat according through the protocol is the art a doctor should learn. We will discuss the topic in detail along with the protocol or approach followed for same.

Definition

Lower GI (LGI) bleeding is the loss of blood from the GI tract distal to the ligament of Treitz in the form of bright red or maroon rectal bleeding called Hematocheia.

Significance

Lower GIT bleeding being a common problem not just in the multifaceted Surgical Specialities,but as well in “Emergency Medicine”,should be considered potentially life threatening until proven otherwise and accorded utmost significance.

Epidemiology

Common,seen in an incidence of 36 per 1 Lakh people – Elderly Female are most vulnerable.

Causes/Etiology

The causes in order of frequency are as follows:

  • Anal lesions such as Hemorrhoids, Fissure
  • Rectal Trauma
  • Colitis/Proctitis
  • Colonic Polyps
  • Carcinoma Colon
  • Angiodysplasia
  • Diverticular Disease
  • Intussusception
  • Solitary Ulcer
  • Blood dsycrasia
  • Vasculitis
  • Connective Tissue Disorders
  • Neurofibroma
  • Amyloidosis
  • Anti-coagulation

Lower Gi Bleeding Protocol / Approach

The following image reads out loud the Protocol of Lower GI Bleeding:

Lower GI Bleeding Protocol
Source: Harrison Medicine

History

General

History elicited includes past GI bleeding and a history of pain, trauma, ingestion or insertion of foreign bodies, and recent colonoscopies.

Specific Indications

Weight loss and changes in bowel habits may suggest Malignancy.

History of an aortic graft may suggest the possibility of an aortoenteric fistula.

Medications, such as salicylates, nonsteroidal anti-inflammatory drugs, and warfarin, increase the risk of LGI bleeding.Patients on Beta Blockers or poorly controlled hypertension might present with subtle signs of pathognomic symptoms.

Consumption of iron or bismuth can simulate melena, and certain foods, such as beets,can simulate hematochezia. However, stool guaiac testing in those cases will be negative.

Examination

General Examination

May appear Emaciated with signs of Pallor and Weakness, Altered Mental Status.

Systemic Examination

Gastrointestinal Tract

Tenderness, Masses, Ascites or Organomegaly. Lack of Abdominal tenderness might indicate Vascular causes such as diverticulosis or angiodysplasias, while its presence associated with Inflammatory Bowel Disorders. Digital Rectal Examination might detect gross bleeding and sources viz -a- viz laceration, masses, hemorrhoids, fissures or trauma.

Cardiovascular System

Hypotension, tachycardia, angina, syncope.

Skin Appearance

Signs of petechiae and purpura might provide clues on an underlying Coagulopathy or liver disease. Cool, pale skin with increased capillary refill may signal Shock.

Lab Testing

Order laboratory tests which include CBC, coagulation studies, and typed and cross-matched blood. An ABG is always helpful.

In acute, brisk bleeding, the initial hematocrit level would not reflect the actual amount of blood loss.

Coagulation profile, including prothrombin time, partial thromboplastin time, and platelet count, is vital in patients taking anticoagulants or those with underlying liver disease.

Routine tests such as blood urea nitrogen, creatinine, electrolytes, glucose, and liver function studies.

Bleeding from a source in the upper GI tract may elevate blood urea nitrogen levels through digestion and absorption of hemoglobin.

Silent ischemia can occur secondary to the decreased oxygen delivery accompanying significant GI bleeding and an Electrocardiogram is a must,in suspected population.

Radiology

Diagnostic Procedure of Choice – Angiography,Scintigraphy or Endoscopy.

Scintigraphy appears more sensitive than angiography and can localize the site of bleeding at as low a rate as 0.1 mL/min. It also has potential value over angiography if bleeding occurs intermittently but requires a minimum of 3 mL of blood to pool.

Technetium Labelled Red Cell Scans – detects Obscure Hemorrhage.

Radiographs like Chest Xray and Xray Abdomen are of limited value,unless indicated.

Recent Trends – Multidetector CT Angiography – 100% Specificity & Sensitivity.

Management

Resuscitate unstable or actively bleeding patients.

Administer oxygen and institute cardiac monitoring.

Place two large-bore IV lines and replace volume with crystalloids. Correct coagulopathy.

NEET PG 2019: Board Secretly Enforcing 3 Attempts Only?

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The NEET PG 2019 is going to see “3 Attempts Only” and is up and scheduled for 6th January for which MBBS graduates are preparing all over India. The results are to rolled out on 31st January 2019, which will see the first merit list, following the counselling from 18th February to 31st May 2019, for the students to select the specialty.

We all have been aware of the recent news of dissolving of MCI tenure and bringing of Board of Governors through government under the National Medical Commission Bill via Supreme Court.

The new regulator body has its own fundamentals and follows entirely different. While some say MCI was better, some still support the notion of government and abandoning the monarchy of MCI.

Nevertheless, we saw a weird point added this NEET PG form of 2019 that asked us to fill the number of attempts we have made previously in NEET PG. This left us with a bundle of questions. And many are still questioning it’s principal.

Does the NEET PG point of attempts affect positively to students? Will they get some sort of quota in the exam if they have more number of attempts? Or could it be the preference being given to more numbers?

On the contrary, it’s doubtful whether it’s positive or negative, being said, that number of attempts could actually be the new principal of NBC being regulated. Board could actually be picking out the students those who have attempted previously in NEET PG and have failed to gain a seat. This is, infact cruel on part of Board, and will raise alot of opposition from the doctors preparing for NEET for years.

We also heard rumors that this number of attempts, is infact a limit denoted by board. It could be possible that students could only be giving only 3 attempts in the NEET PG 2019.

Do you support the notion of number of attempts? Let us know in the comments section.

Bailey and Love Clinical Anatomy PDF Book Download

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The Bailey and Love Essential Clinical Anatomy is the finest book a medical student can use to master the art of Clinical anatomy during their first year anatomy, or it can also be used by surgeons to further enhance their skills in surgery. Bailey and Love Clinical Anatomy helps MBBS students perfect the anatomy in terms of clinical correlation. You can download Bailey and Love Essential Clinical Anatomy by the links given below.

Bailey and Love Clinical Anatomy PDF Book

The Bailey and Love Clinical Anatomy has over 471 pages that cover 6 sections as follows:

  1. The Thorax
  2. The Abdomen
  3. The Back
  4. The Upper Limb
  5. The Lower Limb
  6. The Head and Neck

Download Size: 44MB

If you need First Year Syllabus, you can check MBBS Syllabus here.

Check out other books:

About the Authors:

  • John SP Lumley
  • John L Craven
  • Peter H Abrahams
  • Richard G Tunstall

Overview

Bailey and Love Clinical Anatomy is the very best book if you are looking to establish a lifetime base on anatomy and clinically correlate it. From beautiful diagrams, to mind-blowing charts and explanations, the book is a masterpiece of anatomy. The regular MCQs at end of chapter keep you busy in recalling what you have learnt. With 25 chapters in 6 sections, the book comes packed with everything you need to learn. This book is definitely recommended for reading if you are looking for some real long term memory knowledge.

Suggestions to those studying anatomy in First Year MBBS are as follows:

  1. Try drawing more of diagrams and 3d visualizing everything you learn. The more you draw and imagine, the more you can recall them easily.
  2. There are plenty of YouTube videos around and then there are some animations, which help understand the most important topics. Just don’t skip them, you will need them in your entire medical career.
  3. If you are preparing for PG Exams, do read this book. It will pave the way of better learning. Although BD Chaurasia still remains the bible of anatomy in India.
  4. Clinically correlating it with cadavers during dissection halls posting is a great way to remembering anatomy.
  5. If you need help, following are some posts that can greatly help you in clinical anatomy. They have been made short but explained to the level of a medical student. These are:

Bailey and Love Clinical Anatomy PDF Book Download

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