tag:blogger.com,1999:blog-51321492212454876752024-02-19T10:15:28.359+05:30AcrossPG Blog!Important points for various PG entrance Exams.AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.comBlogger97125tag:blogger.com,1999:blog-5132149221245487675.post-77764292210556383592018-03-04T10:42:00.000+05:302018-03-04T10:42:49.140+05:30MBBS fee for NRI is Rs. 20 lakhs : Kerala<div dir="ltr" style="text-align: left;" trbidi="on">
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Thiruvananthapuram: Justice Rajendra Babu Committee on Tuesday fixed the tuition fee for the NRI quota as Rs 20 lakh for 2017-18 and 2018-19 and 2018-2019 for MBBS courses except for colleges under the Kerala Christian Professional College Management Federation (KCPCMF). The fee for colleges under the KCPCMF namely Amala Institute of Medical Sciences, Thrissur Jubilee Mission Medical College and Research Centre, Thrissur, Malankara Orthodox Syrian Church Medical College, Kolenchery, and Pushpagiri Institute of Medical Sciences, Thiruvalla, will be the same for 2018-2019.<br />
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For the year 2017- 18, it's Rs 18 lakh as per the order dated October 31, 2017. This fee would be applicable even now. The colleges would have earmarked an amount of `5 lakh as corpus fund for awarding scholarships to BPL category students to protect the interest of the poor and meritorious students. The amount has to be remitted as and when they receive a direction from the government, the fee regulatory panel or court. The committee fixed the fee after examining the infrastructure of the colleges and the expenses.<br />
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Source : Deccan Chronicle</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-49428986730950724512017-10-26T22:57:00.001+05:302017-10-26T22:57:31.543+05:30Several MBBS students left stranded in Russia<div dir="ltr" style="text-align: left;" trbidi="on">
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After 133 students from across India were forced to abandon their MBBS course at Smolensk State Medical University (SSMU) in Russia for being taught in the Russian medium from their second year onwards, the university, as a precautionary measure, has now altered its policy and decided to not admit any Indian students in the Russian medium's MBBS course, but only in the English medium.</div>
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The Indian students have now decided to seek relief from the Medical Council of India and have written to them regarding their plight. They have also requested the council to allow them to continue their second year in another Russsian university.</div>
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MY Dyakov, Dean, faculty for foreign students at SSMU told DNA, "We plan to not admit Indian students in the Russian medium. The education consultancy has cheated Indian students and this incident has given a bad name to the university. We have to take a firm stand on the issue so that no other Indian student is cheated again."</div>
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DNA had reported how 133 Indian students who had gained admission at SSMU for an MBBS course were left in the lurch after they were told that they were enrolled for the course in the Russian medium, not English, by a Delhi-based agency, Rus Education.</div>
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While lessons were imparted in English for the initial year, the problems for the students began when the university started instructing them in the Russian medium from the second year onwards.</div>
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133 Indian students were left in the lurch after they were told that they were enrolled for the course in the Russian medium and not English.</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-38476424870918592772017-02-12T14:07:00.000+05:302017-02-12T14:10:14.643+05:30ECG Practice MCQs Image based test<div dir="ltr" style="text-align: left;" trbidi="on">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuTpfr8D2gVYVcH_FwnDuSHeA4Z3rj6jFdEHEiHPUr54Ikw4QMoQTt7Z0Q0UfR8E939azjovmm15vA6J2g2qsCuGvc047Ba1ppYeGIQX-Y6JDRkuBmTXwAoCmC61HXb4yLkvSMx8jzMzmN/s1600/practice+test+small.jpg"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuTpfr8D2gVYVcH_FwnDuSHeA4Z3rj6jFdEHEiHPUr54Ikw4QMoQTt7Z0Q0UfR8E939azjovmm15vA6J2g2qsCuGvc047Ba1ppYeGIQX-Y6JDRkuBmTXwAoCmC61HXb4yLkvSMx8jzMzmN/s1600/practice+test+small.jpg" /></a><br />
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<a href="http://www.acrosspg.com/" style="border: 0px; color: #3ead26; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">AcrossPG</a> Practice Test – Subjects – ECG MCQs contain 15 MCQs for recent trends of NBE and AIIMS.</div>
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<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Directions for the test:</strong></div>
<ol style="background-color: white; border: 0px; color: #444444; font-family: "Open Sans", serif; font-size: 16px; font-stretch: inherit; font-variant-numeric: inherit; line-height: inherit; list-style-image: initial; list-style-position: initial; margin: 0px 0px 30px; outline: 0px; padding: 0px 0px 0px 35px; vertical-align: baseline;">
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The test contain 15 single answer type MCQs.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The test has a time limit of 15 min.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><em style="border: 0px; font-family: inherit; font-stretch: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The test can be taken by all registered members of AcrossPG. The explanations are available only to Members of <a href="http://www.acrosspg.com/memberships/details" style="border: 0px; color: #3ead26; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">AcrossPG Club</a> and <a href="http://www.acrosspg.com/memberships" style="border: 0px; color: #3ead26; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">Contributors </a>. If you are not registered, <a href="http://www.acrosspg.com/register" style="border: 0px; color: #3ead26; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">register here</a>. The test can only be taken once</em></strong>.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Each question carry 1 marks for correct answer. No negative marking.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Your score and the average score will be displayed after the test. Your score will also be mailed to you after submitting the test.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The correct answers to all the questions can be checked after finishing the test by clicking on SHOW QUESTIONS button. Please note that the correct answers will only be viewed once and will not be accessible once the result page is refreshed or closed.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The test takers can choose to display their result on the public board. Otherwise the top ten ranks will be published.</li>
<li style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="border: 0px; color: red; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">IMPORTANT</span></strong>: The PDF file containing the explanations of the test questions will be available in the email containing the result after completing the test to members of <em style="border: 0px; font-family: inherit; font-stretch: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">AcrossPG Club and Contributors only. If you face any problem in download, mail us at hi@i.acrosspg.com </strong></em></li>
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<span style="color: red; font-family: "open sans" , serif;"><a href="http://www.acrosspg.com/practice-test/ecg-practice-test-aiims-neetpg/" target="_blank">Attempt Test on AcrossPG</a></span></h3>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-27283635278250415682016-12-13T23:57:00.003+05:302016-12-13T23:57:35.689+05:30AcrossPG Android app<div dir="ltr" style="text-align: left;" trbidi="on">
Its time we launch Android app for acrosspg.com. Everybody know how deeply smartphones have penetrated our lives and recent data also show that internet usages is being shifting towards smartphones. The internet use on smartphone is increasing day by day. This is because smartphone provide almost same functionality of a PC with the ease of small size and freedom to carry it anywhere in pocket.<br />
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So following the trend we are publishing Android app for AcrossPG.com<br />
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<u><br />FEATURES:</u></h4>
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1. Get updates on new posts from AcrossPG.com<br />
2. Latest NEWS and notifications from acrosspg.com<br />
3. Access discuss and docial forums within the app. Participate in MCQ and other PG entrance related discussions.<br />
4. Get important points, short notes, Image based MCQs on docial forum.<br />
5. Much more to come.<br />
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<u>APP Details</u></h4>
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<b>Name: AcrossPG</b><br />
<b>Detail: com.acrosspg.talks.apk</b><br />
<b>Size: 10 mb</b><br />
<b>Compatibility: Androin 4 and above</b><br />
<b>Version: 0.9b</b><br />
<b>Release date: 12th Dec 2016</b><br />
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<a href="https://app.box.com/v/acrosspg-app" target="_blank"><img border="0" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiebRZhQoQQImv1uO02NQ6jTNrqOJZHlj_PFL5cpu6NPLgYB74Ek1TzsvJPiNXay0ueF-M23CySNuKvaAWzaJKoz8z_qr7GMg5cKjvqIkfTjU4_kpVmvXx2Tqc9QKteVT5NrRXiScUjQ40k/s320/bt_downloadnow.png" width="320" /></a></div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-84120141599587474582016-01-15T11:11:00.000+05:302016-01-15T11:11:09.325+05:30Doctor at RG Kar hospital fighting for live with both kidneys damaged<div dir="ltr" style="text-align: left;" trbidi="on">
Kolkata: Dr Abhishek Kumar Jha came to Bengal to study in a government medical college so that he could get exposure to better experience. Jha however was exposed to another kind of experience common in government hospitals in Bengal. Attacked by a mob at R G Kar Medical College and Hospital in the wee hours of Monday, Jha is now battling for life at the critical care unit of the hospital.<br /><br />The kicks and blows rained on him by a mob of around 50 persons have left both his kidneys damaged. The first year post-graduate student of surgery has also sustained muscle injuries all over his body. He even had to be put on dialysis twice in the last 24 hours for renal failure.<br /><br />Jha was attending the emergency service in the hospital along with other colleagues when four persons injured in road accident were rushed in around 3.30am. Jha and colleague Dr Ragini Sonkar attended to the patients.<br /><br />Accorording to colleagues present during the incident, three of them were treated and discharged while Jha told those accompanying the fourth - Deepak Singh - to get a CT scan done. for Deepak Singh. The group reportedly took Deepak away to a nearby nursing home. They returned with his body around 5am with a mob of about 50 and attacked the doctors alleging negligence.<br /><br />"The mob targeted Abhishek and Ragini as they were the attending doctors. We had to rescue Ragini and lock her up in the operation theatre, otherwise God knows what the mob would have done to her," a colleague told TOI.<br /><br />Abhishek was admitted at the surgical intensive care unit. In addition to the pain of the physical injury, Jha started suffering bouts of vomiting. A CT scan showed collection of blood near both his kidneys.<br /><br />On Tuesday night he developed renal failure and was rushed to the nephrology wing of SSKM hospital for emergency dialysis. He was brought back to RGKMCH and shifted to the critical care unit. He was given another round of dialysis on Wednesday too.<br /><br />Realizing Jha's critical condition, the hospital on Wednesday constituted a seven-member medical board headed by medicine head Dr Apurna Mukerjee. According to them, Jha had received severe blows on his abdomen and chest. He has also sustained extensive muscle damage throughout his body.<br /><br />"The seven-member medical team will be monitoring his condition closely. He is doing better after receiving two rounds of dialysis," said RGKMCH principal Dr S Batyabal.<br /><div>
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Source: TOI</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-80733771646307202422015-09-24T17:31:00.002+05:302015-09-24T17:31:49.144+05:30AcrossPG on Telegram<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="text-align: left;">AcrossPG is now also available on one of the most popular messaging and social app Telegram.</span></h2>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-large;"><b><a href="https://telegram.org/" rel="nofollow" target="_blank">Telegram</a></b></span></td></tr>
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a new era of messaging</div>
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<span style="font-size: large;">AcrossPG telegram channel can be subscribed at <a href="https://telegram.me/acrosspg" target="_blank">https://telegram.me/acrosspg</a></span><br />
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We will publish regular MCQs, important points, exam tips and entrance exam alerts on this channel.<br />
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<b><span style="font-size: large;">How to join?</span></b><br />
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For current telegram users, just click on the above link of the channel and click to join.<br />
Those who do not have telegram, the can download the app from <a href="https://telegram.org/" rel="nofollow" target="_blank">https://telegram.org</a>/. Telegram is a messaging app just like whatsapp and is available for Android, iphone, windows phone, windows PC and also on web.<br />
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For any assistance mail us at hi@i.acrosspg.com</div>
AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-74249575981089658632015-07-28T17:37:00.001+05:302015-07-28T17:37:34.788+05:30Dr. APJ Abdul Kalam will live in our heart forever<div dir="ltr" style="text-align: left;" trbidi="on">
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One of the GREATEST scientific minds of India, Dr. APJ Abdul Kalam left us yesterday after 84 yrs of great and successful journey. He will always live in the heart of our Nation and will be remembered by all of us as the greatest scientist, innovative thinker, teacher and motivator and one of the most beloved President of India. </h3>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-86072719847422664982015-07-20T16:57:00.003+05:302015-07-20T16:57:58.528+05:30Medical Jobs moved under AcrossPG<div dir="ltr" style="text-align: left;" trbidi="on">
Medical Jobs (http://medicaljobs.acrosspg.com) is our dedicated blog dedicated for jobs for doctors. To improve usability and increase user experience we have clubbed Medical Jobs with AcrossPG (<a href="http://www.acrosspg.com/" target="_blank">http://www.acrosspg.com</a>). <div>
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From now onwards all medical jobs will be posted under <a href="http://www.acrosspg.com/jobs" target="_blank">http://www.acrosspg.com/jobs</a>. This will facilitate users to find all the information on a single portal.</div>
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The archive of older posts of medicaljobs.acrosspg.com can be accessed at http://medical-vacancies.blogspot.com.</div>
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Team AcrossPG</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-36057744475639754602015-07-17T06:46:00.004+05:302015-07-17T06:46:50.247+05:30AcrossPG Exams design Updated<div dir="ltr" style="text-align: left;" trbidi="on">
In an attempt to improve the user experience at our Entrance Exam Portal <a href="http://www.exams.acrosspg.com/" target="_blank">AcrossPG Exams</a> we have updated the website with a new look.<div>
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Most prominent features of the new themes are</h3>
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<li><b>Responsive </b>- means now the site will adjust itself according to the device it is loaded on. The site will look good on PC, tablets and mobiles.</li>
<li>The posts will be arranged in <b>well organised categories</b>, for exams all posts related to AIIMS will be available at a single place. This enhance usability and help find desired content easily without need of search.</li>
<li>Modern look and feel.</li>
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we hope that you will find the new design more useful and easy to use. </div>
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The theme is new and may have some issues. If you find any problem mail us at info@mail.acrosspg.com</div>
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Team AcrossPG</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-52357754353049116692015-06-05T12:33:00.005+05:302015-06-05T12:33:57.071+05:30India declared free from maternal and neonatal tetanus<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-size: large;"><i>In yet another major achievement, India has been declared free of maternal and neonatal tetanus. </i></span><div>
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Calling it a "significant public health milestone", the World Health Organization (WHO) congratulated Indian health workers for achieving the feat which comes almost a year after the country eliminated the scourge of polio.<br /><br />India was finally declared free of maternal and neonatal tetanus on May 15, 2015. WHO Deputy Regional Director for South East Asia Poonam Khetrapal Singh said Nagaland was the last Indian state to achieve maternal and neonatal tetanus elimination.<br /><br />In 1990 neonatal tetanus accounted for almost 80,000 deaths. India was finally declared free of maternal and neonatal tetanus on May 15, 2015.<br /><br />She said the launch of the National Rural Health Mission in 2005 helped to facilitate safe deliveries by training auxiliary nurse midwives and other trained birth attendants who work at the village level.<br /><br />Polio eradication in India had acted as a model to follow for health workers. "Since 2012, the Government of India has been applying the best practices of polio eradication for routine immunisation strengthening, focusing on areas with low immunisation coverage," she added.<br /><br />In 1983 the Indian government introduced two doses of tetanus toxoid vaccine to all pregnant women during each pregnancy as nationwide expanded programme on immunisation. But in 1990 neonatal tetanus still accounted for almost 80,000 deaths, said UNICEF. But Poonam pointed out that in 2013 and 2014 fewer than 500 cases were reported.<br /><br />New Delhi's All India Institute of Medical Sciences (AIIMS) neonatology professor Dr Vinod Paul expressed happiness over the achievement and added that he was proud that India had eliminated a disease that was at one point of time responsible for almost 15% of neonatal deaths in the country. "This is truly a huge goal because at one point in time there were tens of thousands of deaths due to maternal and neonatal tetanus," he said.<br /><br />He cited three reasons why he believed India had achieved the goal. "First and foremost, maternal tetanus immunisation rates have gone up. They are not universal, but they are very high," he said.<br /><br />"Secondly, we introduced cash incentives for institutional deliveries; and lastly, delivery kits that reduce contamination along with safe umbilical cord practices have been important. In the last seven years, facility births have increased, even in rural India. We have moved from homes where deliveries are unhygienic to facility births where we are dealing with nurses and doctors where there are greater chances of better care and practices," he added.<br /><br />The elimination of neonatal tetanus is defined as less than one case in 1000 live births in every district across the country, said the WHO.<br /><br />The disease usually occurs in newborns through infection of the unhealed umbilical stump, especially when the stump is cut with a non-sterile instrument. Maternal tetanus is considered eliminated once neonatal tetanus elimination has been achieved.<br /><br />WHO had on March 27, 2014 officially declared India 'Polio Free'.</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-30765051791405367252015-06-03T23:01:00.002+05:302015-06-03T23:24:34.762+05:30Why Govt concerned only for quality of MBBS graduates? <div dir="ltr" style="text-align: left;" trbidi="on">
It looks like Indian Govt. is always after MBBS graduates, be it <a href="http://www.exams.acrosspg.com/2013/06/government-to-make-1yr-rural-service.html" target="_blank">compulsory rural postings</a>, rural service bond post PG, or the recent announcement of <a href="http://www.exams.acrosspg.com/2015/06/exit-exam-for-mbbs-passouts-soon.html" target="_blank">exit exam for MBBS graduates</a>, its always the MBBS grads who have to suffer.<br />
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The govt says that exit exam is necessary to control the quality of medicos passing out of various institutes. But i dont think, this will help even a little bit to the society and the medicos. One one hand officials (MCI) are concerned over quality of MBBS grads, and on other many states are allowing Ayush grads to practice modern medicine. If we think logically, a medical grad after studying 5.5 yrs will be better than a Ayush trained doctor in Allopathy.</div>
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<span style="background-color: white; color: #1f57a5; font-family: Georgia, 'Times New Roman', Times, serif; font-size: small;"><i>“Indian Systems of Medicine practitioners can also practice modern medicine” </i></span><span style="font-size: x-small; font-weight: normal;"><a href="http://www.thehindu.com/news/cities/Chennai/article542577.ece" rel="nofollow" target="_blank">The Hindu</a>. - </span><span style="font-size: small; font-weight: normal;">This is the article published in Tamil Nadu, where TN govt has allowed Indian Medicine doctors, to practice Allopathy side by side.</span></h1>
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In another piece of <a href="http://www.mumbaimirror.com/mumbai/others/State-govt-okays-allopathy-by-homeopaths-draws-IMA-ire/articleshow/36645932.cms" rel="nofollow" target="_blank">NEWS</a> where Maharastra govt. also allowed practice of Allopathy by Ayush doctors to curb shortage of doctors, "<i><span style="background-color: white; color: #333333; font-family: georgia; line-height: 20px;">The State Assembly and Legislative Council's nod on Friday to the Bill that allows homeopaths to practice allopathy after a one-year bridge course in pharmacology, has drawn sharp objections from the medical fraternity. While the Indian Medical Association (IMA) said it would move court over the State government move, Dr Bahubali Shah, administrator, Maharashtra Council of Homeopathy, termed it a positive development.</span><span style="background-color: white; color: #333333; font-family: georgia; line-height: 20px;"> </span></i><span style="background-color: white; color: #333333; font-family: georgia; line-height: 20px;"><i>"We have 62,000 homeopaths registered with the council, of which only 10,000 practice pure or classical homeopathy. The remaining doctors are into mixed practice anyway. This decision will be extremely helpful to patients, especially in areas where there is acute shortage of doctors," said Shah.</i></span></div>
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<span style="color: #333333; font-family: georgia;"><span style="background-color: white; line-height: 20px;">If the officials are so concerned about quality of doctors in India, why there is no check on Indian Medical System doctors. Dr. Shah himself has accepted that more than 5/6th of the Ayush doctors are in mixed practice or to say crosspathy. Govt. should keep a check on such practice too.</span></span></div>
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<span style="color: #333333; font-family: georgia;"><span style="background-color: white; line-height: 20px;">Second issue in India is <b>Quackery </b>which needs serious attention, where nursing professionals and even uneducated people are treating patients openly as doctors. Govt. is not taking proper effort to put an end to such quack clinics and stop such practice, which is not only harmful for the community but also to whole of Medical Community of India.</span></span></div>
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<span style="color: #333333; font-family: georgia;"><span style="background-color: white;"><span style="line-height: 20px;">Such quacks are prone to negligence often, the negligent practice of such quacks are contributing a major role in defamation of Medical Practitioners. </span></span></span></div>
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<span style="background-color: white;"><span style="color: #333333; font-family: georgia;"><span style="line-height: 20px;">If we look at the said exit exam, there are flaws there too. A MCQ based exam is a good practice to prepare a merit list, but such exams does not efficiently test the knowledge of a candidate. Besides this, Medicine is 60% practical learning in the wards, and merely performing in a MCQ tests wont be sufficient.</span></span></span><br />
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<span style="color: #333333; font-family: georgia;"><span style="background-color: white;"><span style="line-height: 20px;">As per official data, India is already facing scarcity of qualified doctors to serve the population. If govt. will impose such restrictions on already very long medical education, more and more students will loose interest in medical career and the condition will become worse. Due to such harassment, more and more doctors are adopting alternate careers and many are leaving the country too.</span></span></span></div>
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<span style="color: #333333; font-family: georgia;"><span style="background-color: white; line-height: 20px;"><b><i>It is time, Govt should come up with positive amendments to improve overall healthcare system and to retain best breed of doctors in India.</i></b></span></span></div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-52384632047758885612015-02-19T23:03:00.001+05:302015-02-19T23:03:32.686+05:30Regular Motivational posts on AcrossPG<div dir="ltr" style="text-align: left;" trbidi="on">
The journey to entrance exams is tough and boring. It appears twice as longer than it actually is. We at AcrossPG thought that while helping medicos in their preparation by providing few notes, practice tests and exams information etc, it is also important to give occasional motivational posts and important tips for preparation of exams, to help medicos keep going on and maintain the pace and enthusiasm for preparation till the end. <div>
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<span style="font-size: large;">We believe in:</span></div>
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We hope that by these small motivational post, we will be able to help hundreds of doctors continue their entrance preparation full energy and motivation. We all do some mistakes, some wrong decisions, some errors in our life, which may result into negative results in our life, by these posts we try to help improve their future if not yesterday.</div>
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These posts will also help making small improvements in your day to day habits.</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-515542013480075412014-08-02T22:16:00.002+05:302014-08-05T09:00:44.590+05:30Practice MCQ Tests for PG Entrance Exams<div dir="ltr" style="text-align: left;" trbidi="on">
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<em>"Practice makes the Man Perfect"</em></h2>
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For the benefit of AcrossPG Members, we will be posting Practice test on different subjects and topics on a regular basis from now on.</div>
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<strong>The Features of the practice tests:</strong></div>
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<li>You need to be a member of AcrossPG and logged in to attempt the test.</li>
<li>The Tests will be posted periodically on <a data-mce-href="http://www.acrosspg.com" href="http://www.acrosspg.com/" target="_blank">AcrossPG Portal</a>.</li>
<li>The test will consist of 10-20 MCQs from different topics and subjects.</li>
<li>Correct answers will be displayed once the test is submitted.</li>
<li>As it is practice test, there will be no time limit and the answere will not be stored and no ranks will be given.</li>
<li>Members can get the questions with answers and explaination in downloadable PDF from docial group on Practice test.</li>
<li>There is no limit on how many times a test can be attempted.</li>
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Members are encouraged to tell us which subject and topics practice test they want on AcrossPG. Give us your feedback for Improvement.</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-33956825488326920032014-06-25T23:12:00.000+05:302014-06-25T23:12:25.018+05:30Gardner Wells Tongs<div dir="ltr" style="text-align: left;" trbidi="on">
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Gardner Wells Tongs</h2>
<br />Indications for use<br /><br /><ol style="text-align: left;">
<li>Subaxial cervical fractures that are malaligned</li>
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<li>Selected odontoid fractures, hangman's fractures, and C1-C2 rotatory subluxation</li>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-37078750881358760992014-06-23T04:31:00.001+05:302014-06-23T04:31:09.112+05:30Syndrome X & Syndrome Z<div dir="ltr" style="text-align: left;" trbidi="on">
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Syndrome X</h2>
Syndrome X is the other name of Metabolic Syndrome. <span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">Metabolic syndrome is also known as </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">metabolic syndrome X</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">, </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">cardiometabolic syndrome</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">, </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">syndrome X</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">, </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">insulin resistance syndrome</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">, </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">Reaven's syndrome</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;"> (named for </span>Gerald Reaven<span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">), and </span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;">CHAOS</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.399999618530273px;"> (in Australia).</span><br />
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Clustering of cardiovascular risk factors was recognized around 1920s and is currently thought to be related to the underlying pathophysiology of insulin resistance and hyperinsulinemia. Various agencies have defined different criteria for the diagnosis of Metabolic Syndrome. The criteria proposed by the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) are the most current and widely used. According to the ATP III criteria, the metabolic syndrome is identified by the presence of three or more of these components:<b><i>[Q]</i></b><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbNjoxntYFY-ApH7DCGXMbnYaXHCqP5EMjy91nkTwFX1_fiPYLQUc3FcU2EzDO93x4zIWQl_ImdiYH9UtVoSangpaQwbBkLP5qXWfHS3E3QB5k3LHeZ5FSKG_k4MV90BS0t2ir3p63BkxD/s1600/5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbNjoxntYFY-ApH7DCGXMbnYaXHCqP5EMjy91nkTwFX1_fiPYLQUc3FcU2EzDO93x4zIWQl_ImdiYH9UtVoSangpaQwbBkLP5qXWfHS3E3QB5k3LHeZ5FSKG_k4MV90BS0t2ir3p63BkxD/s1600/5.jpg" height="259" width="320" /></a><br />
<ol style="text-align: left;">
<li>Central obesity as measured by waist circumference: In men greater than 40 inches and in women greater than 35 inches</li>
<li>Fasting blood triglycerides greater than or equal to 150 mg/dL</li>
<li>Blood HDL cholesterol: In men less than 40 mg/dL, and in women less than 50 mg/dL</li>
<li>Blood pressure greater than or equal to 130/85 mmHg</li>
<li>Fasting blood glucose greater than or equal to 110 mg/dL</li>
</ol>
<h2 style="text-align: left;">
Syndrome Z</h2>
<div>
Syndrome Z is the other name of Obstructive Sleep Apnoea (OSA). Obstructive sleep apnea (OSA) also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.</div>
<b>Signs and symptoms</b><br />
Nocturnal symptoms may include the following:<br />
<div>
<ul style="text-align: left;">
<li>Snoring, usually loud and bothersome.</li>
<li>Witnessed apneas, which often interrupt the snoring and end with a snort</li>
<li>Gasping and choking sensations that arouse the patient from sleep.</li>
<li>Nocturia</li>
<li>Insomnia; restless sleep, with patients often experiencing frequent arousals and tossing or turning during the night</li>
</ul>
Daytime symptoms may include the following:<br />
<ul style="text-align: left;">
<li>Non restorative sleep (ie, “waking up as tired as when they went to bed”)</li>
<li>Morning headache, dry or sore throat</li>
<li>Excessive daytime sleepiness that usually begins during quiet activities</li>
<li>Daytime fatigue/tiredness</li>
<li>Cognitive deficits; memory and intellectual impairment (short-term memory, concentration)</li>
<li>Decreased vigilance</li>
<li>Morning confusion</li>
<li>Personality and mood changes, including depression and anxiety</li>
<li>Sexual dysfunction, including impotence and decreased libido</li>
<li>Gastroesophageal reflux</li>
<li>Hypertension</li>
</ul>
Diagnosis</div>
<div>
Examination findings may include the following:<br />
<ul style="text-align: left;">
<li>Abnormal (increased) Mallampati score: Identifies risk for difficult tracheal intubation</li>
<li>Narrowing of the lateral airway walls: Independent predictor of the presence of obstructive sleep apnea in men but not women</li>
<li>Enlarged (ie, "kissing") tonsils (3+ to 4+)</li>
<li>Retrognathia or micrognathia</li>
<li>Large degree of overjet</li>
<li>High-arched hard palate</li>
<li>Systemic arterial hypertension: Present in about 50% of obstructive sleep apnea cases</li>
<li>Congestive heart failure</li>
<li>Pulmonary hypertension</li>
<li>Stroke</li>
<li>Metabolic syndrome</li>
<li>Type 2 diabetes mellitus</li>
</ul>
<h4 style="text-align: left;">
Why mention Syndrome X and Syndrome Z together here?</h4>
</div>
A growing body of evidence supports an association between obstructive sleep apnoea (OSA) <b>[or Syndrome Z] </b>and cardiovascular disease. Pathophysiologic mechanisms that are present in patients with OSA – including sympathetic activation, endothelial dysfunction, oxidative stress, systemic inflammation, hypercoagulability, hyperleptinemia, and insulin resistance – may influence the development and progression of cardiac and vascular pathology. OSA is widely prevalent in patients with obesity, diabetes, and hypertension <b>[Combination seen in Syndrome X]</b><br />
<div>
<br />
The clustering of cardiovascular disease mechanisms in the metabolic syndrome and OSA are remarkably similar. Patients with OSA have abnormalities in each of the “core” components of the metabolic syndrome – high blood pressure, high fasting glucose, increased waist circumference, low HDL cholesterol, and high triglycerides – as well as in many of its other features, including sympathetic activation, endothelial dysfunction, systemic inflammation, hypercoagulability, and insulin resistance.<a href="http://eurheartj.oxfordjournals.org/content/25/9/709.full#ref-1">1</a> It has even been suggested that the metabolic syndrome (“Syndrome X`') should encompass OSA (“Syndrome Z”). However, there is little information about the extent to which the cardinal features of the metabolic syndrome are present simultaneously in patients with OSA.<br />
<br />
<h3 style="text-align: left;">
Extra Edge Facts</h3>
</div>
<b><span style="font-size: large;">Cardiac syndrome X</span></b> is angina (chest pain) with signs associated with decreased blood flow to heart tissue but with normal coronary arteries. Some studies have found increased risk of other vasospastic disorders in cardiac syndrome X patients, such as migraine and Raynaud's phenomenon. It is treated with beta-blockers, such as metoprolol, and usually carries a favorable prognosis.<br />
<br />
Cardiac syndrome X is sometimes referred to as microvascular angina when there are findings of microvascular dysfunction.<br />
<div>
<br /></div>
<div>
<span style="font-size: large;">Z Syndrome </span>is a post operative complication of IOL. Asymmetric folding at the haptic-optic junction of the Crystalens IOL has been reported in the literature as a rare complication, and has been dubbed “Z syndrome.” In general, during Z syndrome, the capsule contracts and causes long-axis compression resulting in the asymmetric folding. </div>
<div>
<br /></div>
<div>
More Reading</div>
<div>
<br /></div>
<div>
<a href="http://emedicine.medscape.com/article/295807-overview" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>Obstructive Sleep Apnea</i></span></a></div>
<div>
<a href="http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>Metabolic syndrome Definition - Diseases and Conditions - Mayo Clinic</i></span></a></div>
<div>
<a href="http://en.wikipedia.org/wiki/Cardiac_syndrome_X" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>Cardiac syndrome X - Wikipedia, the free encyclopedia</i></span></a></div>
<div>
<a href="http://www.eyeworld.org/article-z-syndrome-still-possible-with-newer-generation-crystalens" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>The Best of Ophthalmology.....EyeWorld News Magazine</i></span></a></div>
<div>
<a href="http://eurheartj.oxfordjournals.org/content/25/9/709.full" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>Obstructive sleep apnoea, metabolic syndrome, and cardiovascular outcomes</i></span></a></div>
<div>
<a href="http://thorax.bmj.com/content/53/suppl_3/S25.full" rel="nofollow" target="_blank"><span style="font-size: x-small;"><i>“Syndrome Z”: the interaction of sleep apnoea, vascular risk factors and heart disease -- Wilcox et al. 53 (suppl 3): S25 -- Thorax</i></span></a></div>
<div>
<br /></div>
</div>
AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-88075386787836942292014-06-20T01:08:00.000+05:302014-06-20T01:36:18.379+05:30Important Facts: Fresh Frozen Plasma<div dir="ltr" style="text-align: left;" trbidi="on">
<b>1. Definition:</b> Fresh frozen plasma (FFP) is platelet-poor plasma, separated from whole blood within <i>6-8 hours</i> of blood collection and frozen in a dedicated freezer (at or below -20 C). It contain all coagulation factors and plasma proteins (such as albumin). Fresh frozen plasma may remain stable for 1 year if maintained in a dedicated freezer (one that does not undergo freeze-thaw cycles like household freezers) at or below -20 C. One unit of FFP is defined as that obtained from a single whole blood transfusion bag.<br />
<div>
<br /></div>
<div>
2. The approx volume of one bag of FFP is 250ml</div>
<div>
<br /></div>
<div>
3. <span style="background-color: white; font-family: arial, sans-serif; font-size: 13px;">FFP contains an average of 1 IU/mL of each coagulation factor, including the labile factors V and VIII.</span></div>
<div>
<span style="background-color: white; font-family: arial, sans-serif; font-size: 13px;"><br /></span></div>
<div>
<span style="background-color: white; font-family: arial, sans-serif; font-size: 13px;">4. FFP must be ABO compatible. Rh factor need not be considered. The guideline are as</span><br />
<span style="background-color: white; font-family: arial, sans-serif; font-size: 13px;"><br /></span>
<br />
<table border="0" cellpadding="2" cellspacing="0" style="width: 100%px;">
<colgroup><col width="81*"></col>
<col width="175*"></col>
</colgroup><tbody>
<tr bgcolor="#f5f5f5">
<td width="32%"><div style="border: none; padding: 0in;">
<strong><span style="color: #414141;">Patient’s
ABO blood group </span></strong></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<strong><span style="color: #414141;">ABO
blood group of plasma for transfusion</span></strong></div>
</td>
</tr>
<tr bgcolor="#ffffff">
<td width="32%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">Unknown</span></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">AB (if
required urgently)</span></div>
</td>
</tr>
<tr bgcolor="#f5f5f5">
<td width="32%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">O</span></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">O (1st Choice) or A / B / AB (2nd, 3rd and last choice)</span></div>
</td>
</tr>
<tr bgcolor="#ffffff">
<td width="32%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">A</span></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">A or
AB</span></div>
</td>
</tr>
<tr bgcolor="#f5f5f5">
<td width="32%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">B</span></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">B or
AB</span></div>
</td>
</tr>
<tr bgcolor="#ffffff">
<td width="32%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">AB</span></div>
</td>
<td width="68%"><div style="border: none; padding: 0in;">
<span style="color: #414141;">AB (A
if AB unobtainable)</span></div>
</td>
</tr>
</tbody></table>
</div>
<br />
<br />
5. <b>Indications</b>: Transfusion is indicated in patients with documented coagulation factor deficiencies and active bleeding, or who are about to undergo an invasive procedure.<br />
<ul style="text-align: left;">
<li>Single-factor deficiencies. Currently, specific concentrates are available for FXIII, FXI, FIX, FVIII:C, FVIII:C complexed with von Willebrand factor (Humate P), FVII, FVIIa, fibrinogen, antithrombin, protein C, and C1 esterase inhibitor.</li>
<li>Multiple-factor deficiencies, hypo/dysfibrinogenemia, and/or disseminated intravascular coagulopathy. Frozen plasma is indicated for use in patients with multiple-factor deficiencies associated with severe bleeding and/or disseminated intravascular coagulopathy.</li>
<li>Thrombotic thrombocytopenic purpura.</li>
<li>Need for urgent reversal of warfarin effect</li>
<li>Liver disease, especially in the setting of liver biopsy.</li>
</ul>
<div>
<br /></div>
<div>
FFP should not be used for Hemophilia B (Factor IX) deficiency unless Factor IX concentrate is not available. FFP, but not thawed plasma, can be used for Factor V deficiency. Recombinant or Factor VIII concentrates should be used to replace Factor VIII.<br />
<div class="sect2" style="background-color: white; font-family: arial, sans-serif; font-size: 13px; margin: 5px 0px 10px;">
<ul style="list-style: none; margin: 0px 0px 0px 5px; padding: 0px;">
<li></li>
</ul>
</div>
<div class="sect2" style="background-color: white; font-family: arial, sans-serif; font-size: 13px; margin: 5px 0px 10px;">
</div>
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEii0fuIDGqIkTYNduHUMDxkEH67y-QwPFNd1omNXkK3ImhVxoaZ3vNWot9wfLPiT-p4REjpc8Oyo3pgi7dnEtd6nCHbZt7pUN1EFBMElDpwxiIvOEZdUfk75LNDfimWuLMB74oh6RYw0jcN/s1600/ffp.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEii0fuIDGqIkTYNduHUMDxkEH67y-QwPFNd1omNXkK3ImhVxoaZ3vNWot9wfLPiT-p4REjpc8Oyo3pgi7dnEtd6nCHbZt7pUN1EFBMElDpwxiIvOEZdUfk75LNDfimWuLMB74oh6RYw0jcN/s1600/ffp.jpg" /></a></div>
<div>
<br /></div>
<div>
<br /></div>
<div>
6. <b>Dosing:</b></div>
<div>
<b><br /></b></div>
Volume of 1 Unit Plasma: 200-250 mL<br />
1 mL plasma contains 1 u coagulation factors thus 1 Unit contains 220 u coagulation factors<br />
<br />
<div>
Factor recovery with transfusion = 40%, 1 Unit provides ~80 u coagulation factors<br />
<br />
Thus In a 70 kg Patient:<br />
1 Unit Plasma increases most factors ~2.5%<br />
4 Units Plasma increase most factors ~10%</div>
<div>
<br /></div>
7. <b>Therapeutic Effect:</b> Usually an increase in factor levels of at least 10% will be needed for any significant change in coagulation status, so the usual dose is 4 units, (the amount will vary depending on the patient's size and clotting factor levels.)<br />
<div>
<br /></div>
<div>
Some related Questions:<br />
<br />
<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">Important Questions related to FFP which can be asked in Entrance Exams.</span><br style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;" /><span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">1. Volume of 1 Unit of FFP?</span><br style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;" /><br style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;" /><span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">2. Which is wrong statement regarding FFP?</span><br style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;" /><span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">a. It is indicated in Warfarin toxicity.</span><br style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;" /><span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">b. ABO compatibility is not required.</span><span class="text_exposed_show" style="background-color: white; color: #333333; display: inline; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;"><br />c. Is freezed below -18 degree Celsius.<br />d. None of above.<br /><br />3. What is the normal dose required to get desired effect?<br /><br />4. Indications of FFP?</span></div>
</div>
AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-7871188859124557602014-06-13T01:39:00.001+05:302014-06-13T01:39:48.515+05:30Genetically Modified mosquito, may help eradicate Malaria<div dir="ltr" style="text-align: left;" trbidi="on">
With the help of Genetic Engineering, scientists at <span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;">Imperial College London, have been developing a technique to develop a fully fertile male Anopheles mosquito strain which produce only male babies, which means if this technique can be replicated in the wild, after few generations the female mosquito population, which is mainly responsible for transmission of malaria will decrease significantly to block transmission of malaria to human population.</span></span><div>
<span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;"><br /></span></span></div>
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<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh08gJPnu2Z8Q6uuPqCj0U0krIBrs2a4ZZRYzZ26ZbPHl49gx9al-lzJ7jSyywWpRhtru_qKZ0gZuWA0VC_L_FXf_1TPN0HhF6t-LlS4doNp7iVH5LmHoRk1ozfRwzFHGiCgwMRxES21ck6/s1600/6133204-large.jpg" height="215" width="320" /></div>
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<span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;"><br /></span></span></div>
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<span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;"><br /></span></span></div>
<div>
<span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;">NEWS published in <a href="http://www.ndtv.com/article/world/genetically-modified-mosquitoes-offer-hope-in-malaria-fight-539332" rel="nofollow" target="_blank">NDTV</a></span></span></div>
<div>
<span style="font-family: roboto;"><span style="font-size: 14px; line-height: 18px;"><br /></span></span></div>
<blockquote class="tr_bq">
London: Scientists have found a way of genetically modifying mosquitoes to produce sperm that only creates males, offering a potential fresh approach to fighting and eventually eradicating malaria.<br />Researchers from Imperial College London tested a genetic method that distorts the sex ratio of Anopheles gambiae mosquitoes, the main transmitters of the malaria parasite, so that the female mosquitoes that bite and pass the disease to humans are no longer produced.<br />In a study published in the journal Nature Communications, the team reported that in the first laboratory tests, the technique created a fully fertile mosquito strain that produced 95 percent male offspring.<br />"For the very first time, we have been able to inhibit the production of female offspring in the laboratory and this provides a new means to eliminate the disease," said Andrea Crisanti, who led the research at Imperial's department of life sciences.<br />Nikolai Windbichler, who co-led the work, said what was most promising about the results is that they are self-sustaining.<br />"Once modified mosquitoes are introduced, males will start to produce mainly sons, and their sons will do the same, so essentially the mosquitoes carry out the work for us," he said.<br />In their experiments, which took more than six years, the scientists inserted a DNA cutting enzyme called I-PpoI into Anopheles gambiae mosquitoes.<br />The enzyme works by cutting the DNA of the female-producing X chromosome during production of sperm, so that almost no functioning sperm carry it. As a result, the offspring of the genetically modified mosquitoes was almost exclusively male.<br />SIX GENERATIONS<br />The scientists introduced the genetically modified mosquitoes to five caged wild-type mosquito populations. In four of the five cages, this eliminated the entire population within six generations due to the lack of females.<br />The hope is that if this could be replicated in the wild, this would ultimately cause the malaria-carrying mosquito population to crash.<br />Experts not directly involved in the work were impressed with its results and enthusiastic about its potential.<br />"This is super cool work," said Michael Bonsall, a reader in zoology at Britain's University of Oxford. "Reducing mating potential of mosquitoes by modifying sperm is a population suppression technology. It will be very exciting to see how this ... is now taken forward."<br />Malaria kills some 627,000 people worldwide each year, according to the World Health Organisation, and the vast majority of its victims are babies and children in sub-Saharan Africa.<br />Malaria control has been threatened by the spread of insecticide resistant mosquitoes and malaria parasites resistant to drugs, and the WHO says more than 3.4 billion people remain at risk from contracting the disease.<br />"Malaria is debilitating and often fatal and we need to find new ways of tackling it," said Crisanti. "We think our innovative approach is a huge step forward."<br />© Thomson Reuters 2014</blockquote>
</div>
AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com1tag:blogger.com,1999:blog-5132149221245487675.post-56328437923361476132014-06-11T08:06:00.000+05:302014-06-11T08:06:11.527+05:30MCI scraps 32% MBBS seats in view of quality of institutes<div dir="ltr" style="text-align: left;" trbidi="on">
The Medical Council of India (MCI) has scrapped an astonishing 32% of MBBS seats nationwide in its attempt to safeguard the quality of medical education. As a result, competition for the seats left will now be more cut-throat than ever before. <br /><br />The MCI withdrew permission for 15,890 of the 49,950 MBBS seats nationwide. It cited failure of several colleges to arrange for minimum infrastructure required for ensuring proper education and training to future doctors.<br /><br />“In order to run a medical college, one has to meet the minimum requirements and regulation set by the MCI,” president of MCI, Dr Jaishreeben Mehta told HT.<br /><br />The biggest loser was Andhra Pradesh that had 2,100 seats scrapped from its colleges, followed by Maharashtra (1,675), Karnataka (1,650), Tamil Nadu (1,450), UP (1,400) and Bengal (1,200).<br /><br />But there is still hope for the axed colleges. “June 15 is the cut-off date to send their compliance report to MCI. If we find that they have been able to meet our requirements, we might reconsider on a case-to-case basis,” said Mehta.<br /><br />It is not yet known if MBBS seats have been scrapped from private colleges.<br /><br />In 2011, the MCI in its vision document for 2031, had said the country needed to add 10,000 MBBS seats every year. The UPA 2 government added 10,000 seats in the next three years but MCI officials argued that most of these seats were added to colleges that lacked proper facilities.<br /><div class="clr_lft" style="-webkit-text-stroke-width: 0px; background-color: white; clear: left; color: black; font-family: Arial, Tahoma, Verdana; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin: 0px; orphans: auto; padding: 0px; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;">
</div>
<div>
<br /></div>
<div>
Source: <a href="http://www.hindustantimes.com/india-news/a-third-of-medical-seats-wiped-out-as-mci-focuses-on-quality/article1-1227837.aspx" rel="nofollow" target="_blank">Hindustan times</a></div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-62127726810952216392014-06-08T15:26:00.003+05:302014-06-08T15:26:51.785+05:30Litchi Virus takes life of eight children<div dir="ltr" style="text-align: left;" trbidi="on">
MALDA: At least eight children have died of encephalopathy spreading from litchi in the last 24 hours in Malda Medical College and Hospital. <br />
<br />
The abundant production of litchi in Malda this year and its falling price have naturally led to huge consumption of the fruit. But now it has turned into a nightmare with the number of ailing children rising by the day. The health department, not sure about the prevention, was waiting for a medical team from Kolkata that was expected to reach on Saturday evening. <br />
<br />
The district administration sent a team to affected villages on Saturday morning to talk to the villagers. <br />
<br />
Among the children who died of the litchi syndrome are in the age group of 3 to 5 years. These villages have produced the most litchis this year. <br />
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Dr M A Rashid, vice-principal of Malda Medical College, confirmed that the victims got high fever and their brains were affected. With the sudden rise in temperature, they began to vomit and had convulsions. "We appeal to people that whenever you see such symptoms, bring the children to hospital immediately," Rashid said. <br />
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At present, six children with the symptom are being treated at the medical college. They have been kept with other children in the same ward. While guardians are panicking, not knowing what to do, the administration has not been able to give them specific advice either. <br />
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"This kind of encephalopathy virus spreads from litchi. The disease originated in China and Vietnam years ago. Later it was seen at Muzaffarpur in Bihar," said Rashid. <br />
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This is not the first time Malda has been affected with the disease. "In 2012, more than 100 children died of encephalopathy," conceded a health official. It is feared that the number of victims who reached medical college is only a small section of the huge number affected. <br />
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Minister of food processing and horticulture, Krishnendu Choudhury, who was also the chairman of the Medical College Patients' Welfare Committee, expressed his concern. <br />
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"I've heard that the virus spreads from litchi. We will do everything required to prevent an epidemic. A four-member team from the School of Tropical Medicine in Kolkata is on its way to Malda. After getting their report, we'll take steps accordingly," he said on Saturday.<br />
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Via: <a href="http://timesofindia.indiatimes.com/city/kolkata/Litchi-virus-kills-8-kids-in-Malda/articleshow/36225598.cms?utm_source=facebook.com&utm_medium=referral" rel="nofollow" target="_blank">TOI</a></div>
AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-82130605975934408562014-06-06T21:29:00.001+05:302014-06-06T21:58:38.246+05:30Image MCQs: Downey Cells<div dir="ltr" style="text-align: left;" trbidi="on">
Atypical lymphocytes or Downey cells are lymphocytes that become large as a result of antigen stimulation.<br />
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The nucleus of a reactive lymphocyte can be round, elliptic, indented, cleft or folded and may contain nucleolus. The cytoplasm is often abundant and can be basophilic. Vacuoles and/or azurophilic granules are also sometimes present.<br />
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The distinctive cell associated with EBV or CMV is known as a "Downey cell", after Hal Downey, who contributed to the characterization of it in 1923. It is sometimes called a "Downy cell".<br />
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<tr><td><span style="font-size: x-small;">The WBC's seen here are "atypical" lymphocytes. They are atypical because they are larger (more cytoplasm) and have nucleoli in their nuclei. The cytoplasm tends to be indented by surrounding RBC's. Such atypical lymphocytes are often associated with infectious mononucleosis.</span><br /></td></tr>
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These cells are most commonly seen in EBV infections but may also be seen in CMV, Toxoplasmosis and some other viral infections.</div>
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More related info:</h3>
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Disease Mechanisms of Epstein-Barr Virus (EBV)<br />
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<li>Virus in saliva initiates infection of oral epithelia and tonsillar B cells. </li>
<li>There is productive infection of epithelial and B cells. </li>
<li>Virus promotes growth of B cells (immortalizes). </li>
<li>T cells kill and limit B-cell outgrowth. T cells are required for controlling infection. Antibody role is limited. </li>
<li>EBV establishes latency in memory B cells and is reactivated when the B cell is activated. </li>
<li><b>T-cell response (lymphocytosis) contributes to symptoms of infectious mononucleosis.</b> </li>
<li>There is causative association with lymphoma in immunosuppressed people and African children living in malarial regions (African Burkitt lymphoma) and with nasopharyngeal carcinoma in China.</li>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-1168743798199848572014-06-06T13:57:00.001+05:302014-06-06T13:57:25.051+05:30Image Based MCQs for AIPGMEE & DNB<div dir="ltr" style="text-align: left;" trbidi="on">
Q. A 39-year-old factory worker with diabetes, presented with loss of appetite of 2 months duration, generalised weakness and dysnoea on exertion. On examination, pallor was present. On investigation the below blood picture was obtained. What may be the best line of treatment?<br />
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1. Repeated blood transfusions.</div>
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2. Vitamin B12 Supplementation</div>
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3. Chelation therapy</div>
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4. Bone marrow transplant</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com2tag:blogger.com,1999:blog-5132149221245487675.post-37620540973868547902014-05-31T09:50:00.002+05:302014-05-31T09:50:46.875+05:30Interview with Dr. Anshuman Elhence - AIPGMEE 2014 Rank: 11<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="color: #4c1130; font-size: large;"><b>Name: Dr. Anshuman Elhence</b></span><div>
<span style="color: #4c1130; font-size: large;"><b>Rank: 11 in AIPGMEE 2014</b></span><br /><br />Dr. Anshuman Elhence secured rank 11 in AIPGMEE 2014. We invited him for a brief interview. Here is the interview.<br /><br /><div style="background-color: white; font-family: arial, sans-serif; font-size: 12px;">
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<b>AcrossPG : </b>Firstly Congrats on securing a good ranks! What is the secret of your success in this exam in few lines?<br /><b>Answer : </b>there is no secret about securing a good rank..all it requires is perseverance and determination</div>
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<b>AcrossPG : </b>Who inspired you to take up Medicine?<br /><b>Answer : </b>i was always fascinated by medical science and my parents are also docs..so medicine always lured me</div>
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<b>AcrossPG : </b>When did you seriously started to prepare for PG Entrance Exams?<br /><b>Answer : </b>Right from MBBS</div>
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<b>AcrossPG : </b>Were you able to prepare well during the internship period?<br /><b>Answer : </b>i did my internship from civil hospital, lucknow...it was quite hectic with night duties and all..but if u are able to read daily atleast for 6 to 8 hrs then it is sufficient</div>
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<b>AcrossPG : </b>What was your main / primary strategy for the preparation of the exams?<br /><b>Answer : </b>i started my preparation keeping in mind AIPGMEE... since the |NEET verdict was still pending when i started my prep i wasnt too sure about the examination dates but i wanted to finish by sept oct so that even if the exams were held by nov dec i stood a fare chance</div>
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<b>AcrossPG : </b>How did you prepare the time table for your studies and were you able to stick to it?<br /><b>Answer : </b>since i was aiming for AIPG..i had decided to wrap up by october for that i strictly followed the test series schedule keeping about 10 to 20 days for big subjects and 4 to 5 days for small subjects</div>
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<b>AcrossPG : </b>In your opinion, how much time one require to preparing for this exam?<br /><b>Answer : </b>if one has read well during MBBS days then it is very easy to clear the exam with internship</div>
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<b>AcrossPG : </b>We appreciate that preparing for PG Entrance is really challenging. During your preparation, did you ever doubt your ability to succeed in it, and how did you fight it?<br /><b>Answer : </b>doubts crept in every now and then but since there was no way out i kept toiling..the results of the test series also held my morale high</div>
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<b>AcrossPG : </b>What was your study strategy? Which is better, between selective-intensive study or wide-extensive study?<br /><b>Answer : </b>with the NBE conducting the exams one cant be too selective in reading the text...you have got to connect the dots wherever possible keeping a fine balance bw too selective and too extensive reading</div>
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<b>AcrossPG : </b>What changes in study pattern do you think should be adopted in view of NEW TREND in DNB and AIPGMEE exams (Multiple days and Psychometric analysis)?<br /><b>Answer : </b>if one is well prepared then the psychometric analysis doesnt matter much....when we started preparing there was much ado about chosing the right dates..reading DNB books but then all this doesnt matter...chose the date which suits u the best and go for the exam with positive mind</div>
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<b>AcrossPG : </b>Which book did you study for subject-wise theory preparation?<br /><b>Answer : </b>anatomy greys anatomy students edition physio board review series by costanzo +pretest bchem lippincot( read proteomics from harper) pharma gobind rai garg patho systemic from robbins(the basis/big book/father) micro baweja immunology Levinson fmt reddy synopsis and sumith seth ophthal..self notes..cudnt find a good and conscise book so it took me 10 days to read ophthal psm vivek jain medicine mudit khanna and nms medicine surgery again couldn't find a good book so read gastro and uro from bailey since i had read it during my ug days obgyn hacker and moore + punit bhojani for revision pedia..ghai and coaching notes ortho..coaching notes by dr apurv mehra psychiatry pretest psychiatry derma from medicne and robbins radio coaching notes and dr sumer sethi book anesthesia coaching notes</div>
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<b>AcrossPG : </b>How important is studying theory from text books for this new pattern of exam?<br /><b>Answer : </b>indeed reading textbooks is a better an foolproof way...one cant just rely on past papers and mcqs coz u need to be prepared for new questions also</div>
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<b>AcrossPG : </b>Which books did you study for MCQ practice? Exam wise and subject-wise.<br /><b>Answer : </b>i hardly referred books other than those mentioned above even for mcqs</div>
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<b>AcrossPG : </b>Which subjects should be focussed upon in your opinion?<br /><b>Answer : </b>i think physiology, pathology, pharmac and psm fo a large chunk of questions though i shud be well versed with all the subjects</div>
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<b>AcrossPG : </b>How did you plan your revision? How many months to keep for revision and which books or notes to study?<br /><b>Answer : </b>i had kept about a month or two for revision and i was only able to wrap up one revison i read all the text i had read while preparing subjectwise</div>
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<b>AcrossPG : </b>How much did internet helped you in your preparation? and did AcrossPG kept you updated about exams?<br /><b>Answer : </b>internet is very essential to keep abreast of all the recent happenings, clearing your doubts,relaxing..and with the NEET case still in court we looked for updates on these sites</div>
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<b>AcrossPG : </b>What was your strategy for the exam day? How many questions did you attempt and why? What helped you to fight the nerves?<br /><b>Answer : </b>it is very imp to stay calm on the day of exam..reach the examination centre on time and stay focused ..i had attempted all the questions even if i was able to rule out one of the options...leaving any question in these high stake medical entrance examinations can be counter intuitive and suicidal</div>
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<b>AcrossPG : </b>Did you joined any Coaching Classes? Did coaching helped in your success?<br /><b>Answer : </b>i had joined the bhatia foundation course and test series and found it to be quite helpful</div>
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<b>AcrossPG : </b>What are your comments on this new multiple session entrance exam for Medical PG Entrance? Is it fair and appropriate? Do you feel hard work or luck play more important role?<br /><b>Answer : </b>as i said earlier this psychometric analysis and its flaws only make a good drawing room discussion...rest it all boils down to how well you are prepared</div>
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<b>AcrossPG : </b>What do you want to specialize in, why and where?<br /><b>Answer : </b>i have opted for internal medicne at MAMC, infact i had started prep keping in mind that to get into MAMC med i wud require a under 25 AIR</div>
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<b>AcrossPG : </b>Whom do you attribute your success to?<br /><b>Answer : </b>my teachers ,my parents and friends</div>
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<b>AcrossPG : </b>What is your final advice to your juniors and colleagues who couldn't make it this time?<br /><b>Answer : </b>have faith in yourself...perseverance is the key</div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-11914327500447898402014-05-31T00:27:00.001+05:302014-06-01T03:37:02.956+05:30Interesting Case of Giant Lipoma<div dir="ltr" style="text-align: left;" trbidi="on">
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A interesting and rare case of Giant Lipoma of thigh, operated successfully at Bhiwani, India.</h2>
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<b>Shared by</b>: <a href="mailto:me@drtusharmehta.com" target="_blank">Dr. Tushar Mehta</a><br />
(<a href="https://www.facebook.com/tusharmehta.dr" rel="nofollow" target="_blank">Facebook Page</a>)<br />
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<b>Case</b>: A 48 year old male presented with huge thigh swelling for last 2 years. X Ray was done, which was suggestive of Soft tissue tumor - Lipoma, which was further confirmed on MRI. The patient was taken for surgery. He was successfully operated by <b>Dr. Tushar Mehta</b>, MBBS DNB (Ortho) and <b>Dr. Sanjay Singla</b>, MBBS MS at <b>Apex Trauma Center</b>, Singla Superspeciality Hospital, Bhiwani, India. </div>
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The post operative mass of the tumor was around 1.5 kg and dimensions of 30 cm x 25 cm. The tumor of this size and mass is a rare finding and has been reported quite a few times. </div>
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<b>Discussion</b>: A Lipoma is a benign tumor made up of fat tissue. Lipomas are the most common benign soft tissue tumor. Commonly lipomas are small tumors but the size differs. They are most commonly found on the upper back, shoulders, arms, buttocks, and upper thighs. Less commonly, these tumors can be found in deeper tissue of the thigh, shoulder, or calf.<br />
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Although lipomas can occur at any age, they most often appear between the ages of 40 and 60 years. They are the most common soft tissue tumor found in adults, and occur slightly more often in men than in women.</div>
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Giant lipomas like this case, are very rare. Only a few cases are reported in literature. The giant lipomas have more tendency to have recurrence and sarcomatous changes.<br />
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-5086669010143306672014-04-20T14:52:00.001+05:302014-04-20T15:00:12.957+05:30HACEK Organisms and associated Infective Endocarditis<div dir="ltr" style="text-align: left;" trbidi="on">
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HACEK: The acronym HACEK refers to a grouping of gram-negative bacilli: </div>
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<li><em>Haemophilus</em>species <em>(Haemophilus parainfluenzae, Haemophilus aphrophilus, Haemophilus paraphrophilus),</em></li>
<li><em>Actinobacillus actinomycetemcomitans, </em></li>
<li><em>Cardiobacterium hominis, </em></li>
<li><em>Eikenella corrodens,</em> and </li>
<li><em>Kingella</em> species. </li>
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These organisms share an enhanced capacity to produce endocardial infections and are responsible for approximately 3% of cases of native valve infective endocarditis (IE).<sup style="font-size: 0.85em;"> </sup>They are also the most common cause of gram-negative endocarditis among persons who do not abuse intravenous drugs.</div>
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These organisms are found as part of the normal human oral flora. </div>
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Because of their fastidious and slow growth, they are often a cause of culture-negative endocarditis.</div>
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In addition to cardiac valve infections, this group is also a cause of other infections, including </div>
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<li style="font-family: arial, sans-serif; font-size: 13px;">periodontal infections, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">bacteremia, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">abscesses, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">peritonitis, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">otitis media, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">conjunctivitis, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">pneumonia, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">septic arthritis, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">osteomyelitis, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">urinary tract infections, </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">wound infections, and </li>
<li style="font-family: arial, sans-serif; font-size: 13px;">brain abscess.</li>
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<span style="color: #444444; font-family: proxima_nova_ltsemibold, arial, sans-serif; font-size: 1.3em;">Pathophysiology</span></h3>
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1. <em>Haemophilus</em> species are pleomorphic gram-negative coccobacilli that require X (hemin) and/or V (nicotinamide adenine dinucleotide) factors for isolation (growth in culture media). These substances are found naturally in red blood cells. They are responsible for 0.5%-1% of all cases of IE. Of those, 40% are due to <em>H aphrophilus,</em> followed by <em>H parainfluenzae. H influenzae</em> rarely causes IE. The mitral valve is involved in 67% cases, and the aortic valve is involved in 17% cases. Fifty percent of patients have underlying valvular disease.</div>
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2. <em>A actinomycetemcomitans</em> was first isolated in 1912 from skin lesions associated with <em>Actinobacillus israelii.</em> Growth of this bacillus occurs in trypticase soy broth, where it forms granules that float on top or stick to the container. It is the etiologic agent of localized juvenile periodontitis, one manifestation of early-onset periodontitis (EOP). Of patients with <em>A actinomycetemcomitans</em> IE, 86% have underlying heart disease and 25% have infection of a prosthetic valve (usually aortic). The aortic valve is involved in 65%, and the mitral valve is involved in 30%. Arterial embolization occurs in 43% of cases.</div>
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3. <em>C hominis</em> has been isolated almost exclusively from patients with endocarditis. In addition to being part of the normal flora of the mouth and upper airway, it is isolated from the large bowel. However, most <em>C hominis</em> bloodstream infections are secondary to oral pathology. They are gram-negative or gram-variable pleomorphic rods with bulbous swelling of both ends that are characteristically grouped in chains, clusters, or rosettes. Seventy-five percent of cases have underlying heart disease, with 43% involving the mitral valve and 36% the aortic valve. Arterial embolization is documented in 40% of patients.</div>
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<em>4. E corrodens</em> takes its name from its ability to corrode (or pit) the agar during growth. It is a gram-negative pleomorphic, often coccobacillary, rod that exudes a chlorine bleach odor. It is facultatively anaerobic. It is part of the oral flora and many other mucosal surfaces. <em>E corrodens</em> is usually isolated with other organisms, especially strains of streptococci. This organism is a well-recognized cause of cellulitis resulting from human bites and clenched-fist injuries. It has also been found to be a common cause of soft-tissue infections and endocarditis in drug users. This association may arise from the habit of intravenous drug abusers to lick their needles for good luck. These infections are often complicated by osteomyelitis of the underlying bones. It may produce various pulmonary infections (eg, empyema, pneumonia, septic emboli) that mimic those caused by strict anaerobes. Most patients with <em>E corrodens</em> endocarditis have underlying valve lesions. Compared to cases of IE caused by the other members of the HACEK group, the valvular infections of <em>E corrodens</em> are usually due to intravenous drug abuse.</div>
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<em>5. Kingella</em> species are small gram-negative organisms whose shapes range from those of cocci to those of coccobacilli. This organism can also cause pitting of the agar. The <em>Kingella</em> genus includes 3 species: <em>Kingella kingae, Kingella denitrificans,</em> and <em>Kingella indologenes.</em> IE is usually caused by <em>K kingae.</em> Only approximately 20 cases of endocarditis have been described. Unlike with the other HACEK organisms, <em>Kingella</em> IE progresses quite rapidly.</div>
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Clinical Features:</div>
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<li>Most cases of infective endocarditis (IE) caused by the HACEK organisms are subacute. Some cases have been present for as long as 18 months before the correct diagnosis is made.</li>
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Fever is common but may be absent in elderly individuals, immunocompromised patients, or patients taking anti-inflammatory drugs. In some series, it was present in only 50% of cases.</div>
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Nonspecific symptoms, such as weight loss, anorexia, nausea and vomiting, fatigue, back pain, and night sweats, are common and may lead to a delay in diagnosis.</div>
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Patients may have a history of prior valvular disease.</div>
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A history of prior dental, urologic, and other procedures should be elicited.</div>
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A history of intravenous drug abuse should be elicited.</div>
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A sentinel headache may indicate the impending rupture of a mycotic aneurysm.</div>
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Physical Findings</h3>
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Heart: A new or changing heart murmur is the most consistent physical finding, but it may be absent, especially in right-sided endocarditis.</div>
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Peripheral<br />
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<li style="margin: 0px; padding: 4px 4px 8px 0px;">Clubbing (with or without hypertrophic osteoarthropathy), splinter hemorrhages, mucocutaneous petechiae, Osler nodes, Janeway lesions, and Roth spots may be seen.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Splenomegaly is common.</li>
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Embolic complications<br />
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<li style="margin: 0px; padding: 4px 4px 8px 0px;">Emboli to the CNS often presents as a focal neurological deficit or a stroke. Emboli to the frontal lobe may be more subtle, causing personality changes or loss of inhibition.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Emboli to the kidney may cause flank tenderness, hematuria, and/or oliguria.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Embolization to heart vessels can have various manifestations, including acute myocardial infarction and arrhythmia.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">A large mesenteric embolus can cause bowel ischemia and thus manifest as abdominal pain and tenderness.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">A right-sided vegetation can embolize to the lung and present similarly to a pulmonary embolus or focal pneumonia.</li>
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Management</h3>
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Appropriate antibiotic therapy is central to the management of infective endocarditis (IE) caused by the HACEK organisms (see Medications).<br />
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<li style="margin: 0px; padding: 4px 4px 8px 0px;">beta-lactam antibiotics were the drugs of choice for HACEK infections. However, recent data suggest that beta-lactam resistance is prevalent and that broader-spectrum agents are needed for initial therapy. Based on Infectious Diseases Society of America (IDSA)–endorsed guidelines, ceftriaxone and ampicillin-sulbactam are excellent initial choices.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">In the case of beta-lactam allergy, a fluoroquinolone (eg, ciprofloxacin, levofloxacin, moxifloxacin) may be used.Complications that arise (eg, heart failure, embolic complications) also require supportive medical therapy.</li>
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<span style="color: #444444; font-family: proxima_nova_ltsemibold, arial, sans-serif; font-size: 1.3em;">Surgical Care: May be considered in</span></div>
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<li style="margin: 0px; padding: 4px 4px 8px 0px;">Refractory CHF</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">One or more embolic episode</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Uncontrolled infection (persistently positive blood cultures after 1 week of therapy)</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Physiologically significant valve dysfunction as demonstrated by echocardiography: According to the American Heart Association Committee on IE, criteria associated with an increased need for surgical intervention include (1) persistent vegetations after a major systemic embolic episode; (2) anterior mitral valve vegetations larger than 1 cm in diameter; (3) increase in size of vegetations after 1 month of therapy; (4) periannular extension of infection; and (5) valvular dysfunction, perforation, or rupture.</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Ineffective antimicrobial therapy (usually not the case with HACEK organisms)</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Resection of mycotic aneurysms</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Most cases of prosthetic valve endocarditis caused by more resistant organisms (eg, methicillin-resistant <em>S aureus</em> [MRSA], vancomycin-resistant enterococci [VRE], enteric gram-negative bacilli)</li>
<li style="margin: 0px; padding: 4px 4px 8px 0px;">Local suppurative complications including perivalvular or myocardial abscess</li>
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PROGNOSIS:</h3>
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<li style="margin: 0px; padding: 4px 4px 8px 0px;">The prognosis is quite variable, depending on many factors, such as delay in diagnosis, age of the patient, and occurrence of complications. Patients with uncomplicated IE caused by HACEK organisms generally respond well to therapy and have an excellent prognosis.</li>
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Refrence: <a href="http://emedicine.medscape.com/article/218158-overview" target="_blank">Medscape eMedicine</a></div>
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AcrossPGhttp://www.blogger.com/profile/09854157857546755958noreply@blogger.com0tag:blogger.com,1999:blog-5132149221245487675.post-44943427185055528002014-04-16T18:37:00.001+05:302014-04-16T18:38:43.118+05:30Opening Snap<div dir="ltr" style="text-align: left;" trbidi="on">
An opening snap is a high-pitched sound that occurs in mitral stenosis at a variable distance after S2. It is due to the sudden opening of the mitral valve and is followed by the diastolic murmur of mitral stenosis. It can be difficult to distinguish from a widely split S2, but normally occurs rather later in diastole than the pulmonary component of the second heart sound. It is pitched higher than a third heart sound and so is not usually confused with this. It is best heard at the lower left sternal edge with the diaphragm of the stethoscope. Use of the term 'opening snap' implies the diagnosis of mitral or rarely of tricuspid stenosis. OS occurs ~80-90 msec after S2 at the beginning of mid diastole. <a href="http://www.easyauscultation.com/cases.aspx?coursecaseorder=8&courseid=24" rel="nofollow" target="_blank">Hear Opening Snap Here</a><br />
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<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZV4fz2P20VbgoWcqLD9Oa0yWVhYKCG9A0Ats01s2bythQapXTQ1KkfJH0O1HR_-suVzXK7s4_q_lronxwZePMtxFGaicg3S1H1aKbv7d3VG99qwwrL4pxeOjKkypA1N5L59dux4AymNX2/s1600/HSPS09_MS1.gif" /></div>
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<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjITmMWnhqnTzJJV-PSbfahV0TAP3YmO1HPOaWuQbd-JMxsVNBPiPioqm7JF8xs4qjKaTVP9PSz0t67npAJCqSstRaqXnJI1eVtLUTxCRmOgWfc2eiTacquMBBbEMX9PIsZwf-yMBRJ5wTK/s1600/MS.png" /></div>
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<h3 style="text-align: left;">
Extra Edge:</h3>
<b><u>Murmur of Mitral stenosis: Mid Diastolic Murmur</u></b><br />
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Mitral stenosis results in a uniquely shaped, low-pitched diastolic murmur best heard at the cardiac apex. The opening of the mitral valve produces an "opening snap" due to the high left atrial pressures, which is immediately followed by a decrescendo murmur as blood flows passively from the left atrium to the left ventricle through the stenosed mitral valve creating turbulence. Immediately before the S1 sound, active left ventricular filling occurs when the left atrium contracts and forces more blood through the stenosed mitral valve creating a late diastolic crescendo murmur. In the presence of atrial fibrillation, the active left ventricular filling phase does not take place and the latter part of the mitral stenosis murmur disappears.<br />
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As mitral stenosis worsens, left atrial pressure increases forcing the mitral valve open earlier in diastole. Thus, in severe mitral stenosis, the opening snap occurs earlier as does the initial decrescendo part of the murmur. The opening snap and murmur of mitral stenosis also respond to dynamic auscultation.</div>
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<h4 style="text-align: left;">
Related MCQ</h4>
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<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 18px;">5. Which one of the following is characteristic of Opening Snap (on cardiac auscultation)? (UPSC CMS 2013)</span><br />
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<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 18px;">(a) Low pitched, early diastolic</span><br />
<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 18px;">(b) High pitched. early diastolic</span><br />
<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 18px;">(c) High pitched, late diastolic</span><br />
<span style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 18px;">(d) Low pitched, late diastolic</span></div>
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