The document provides information on various goals and targets to be achieved by the National Rural Health Mission (NRHM) in India at the national level. These include reducing infant mortality rate to 30 per 1000 live births, maternal mortality ratio to 100 per 1 lakh live births, and increasing utilization of First Referral Units from less than 20% to 75%. It also lists engaging 250,000 female community health workers called ASHA in 10 states, and that NRHM was launched in 2005 for a 7 year period with focus on 18 states.
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
this is presentation done for a morning session of dhaka medical college hospital, paediatrics department by dr. tasnuba atique and nur-e-jannat naima. the information was collected from various textbooks and arranged in an easy-to-read manner to conduct a presentation of 45 minutes.
During the last decades advances in neonatal intensive care have led to an impressive decrease of neonatal mortality and morbidity. However, infectious episodes in the early postnatal period still remain serious and potentially life-threatening events with a mortality rate of up to 50% in very premature infants. [1, 2] The signs and symptoms of neonatal sepsis can be clinically indistinguishable from various noninfectious conditions such as respiratory distress syndrome or maladaptation. Therefore rapid diagnosis is crucial for preventing the child from an adverse outcome. The current practice of starting empirical antibiotic therapy in all neonates showing infection-like symptoms results in their exposure to adverse drug effects, nosocomial complications, and in the emergence of resistant strains. [3] Sepsis results from the complex interaction between the invading microorganism and the host immune, inflammatory, and coagulation response. [4, 5] Inflammatory cytokines (TNF-α, IL-1β, IL-6, IL-8, IL-15, IL-18, MIF) and growth factors (IL-3, CSFs), and their secondary mediators, including nitric oxide, thromboxanes, leukotrienes, platelet-activating factor, prostaglandins, and complement, cause activation of the coagulation cascade, the complement cascade, and the production of prostaglandins, leukotrienes, proteases and oxidants. [6] Laboratory sepsis markers represent a helpful tool in the evaluation of a child with clinical signs and complement the evaluation of a neonate with a potential infection. During the last decades efforts were done to improve laboratory sepsis diagnosis and a variety of the above mentioned markers and more were studied with different success. Despite the promising results for some of them current evidence suggests that none of them can consistently diagnose 100% of infected cases. C-reactive protein (CRP) is the most extensively acute phase reactant studied so far and despite the ongoing rise (and fall) of new infection markers it still remains the preferred index in many neonatal intensive care units.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. OSCE 1 Q
The goals to be achieved by the NRHM at national level include
1.Infant mortality rate reduced to −−−− per 1000 live births
2. Maternal mortality rate reduced to −−−per 1 lac live births
3. Malaria mortality rate reduction to −−− by 2012
4. Dengue mortality rate reduction to −−− by 2012
5. Tuberculosis DOTS services maintain −− cure rate through entire
mission period
6. Increasing utilisation of FRUs from <20% to −−
7. Engaging −−− female ASHA in 10 states
8. NRHM was launched in the year −− for a period of −− years
9. NRHM is operational in the country with special focus on −− states
3. OSCE 1 A
The goals to be achieved by the NRHM at the National level include:
a) Infant Mortality rate reduced to: 30 per 1000 live births (1)
b) Maternal Mortality ratio reduced to: 100 per 1 lac live births (1)
c) Malaria Mortality Rate reduction to: 10% by 2012 (HALF MARK
EACH)
d) Dengue Mortality Rate reduction to: 50% by 2012
e) Tuberculosis DOTS services maintain 85% cure rate through entire
mission period
f) Increasing utilization of FRUs from <20 % to 75%
g) Engaging 2,50,000 female ASHA in 10 states
h) NRHM was launched in the year 5th April 2005 for a period of seven
(2005-2012) years
i) NRHM is operational in the whole country with special focus on
eighteen states.
4. OSCE 2 Q
4 year old boy came with fever 10 days, cough and this clinical
finding
5. OSCE 2 Q
1. Describe the lesion
2. What is the diagnosis?
3. Causative organism ?
4. Transmitted by
5. Any 3 complications
6. Two treatment forms
6. OSCE 2 A
• Diagnosis: Eschar in scrub
typhus
• Lesion: Necrotic area, like the
skin burn of cigarette butt, but
painless Erythematous
rim, lymphadenopathy.
• Orientia tsutsugamushi
• Trombiculid mite
• Complications:
Meningoencephalitic, ARF, my
ocarditis,
• Treatment: IV
Azithromycin, Oral Doxycycline
• ( 1 MARK EACH)
7. OSCE 3 Q
Calorie and protein content of the following food items per 100 gm
1. Rice
2. Bengal gram
3. Groundnut
4. Fish
5. Egg
6. Dates
7. Apple
8.Almond
8. OSCE 3A
Calorie and protein content of the following food items
Rice 350 kcal 7g
Bengal gram 360 kcal 17g
Groundnut 560 kcal 25g
Fish 80 kcal 6g
Egg 80 kcal 6g
Dates 317 kcal 2.5g
Apple 59 kcal 0.2g
Almond 655 kcal 20g (8 MARKS)
10. OSCE 4 A
1. STEVEN JOHNSON SYNDROME
2. Severe bullous lesions, target lesions, mucosal
involvement(eye,oral, genital)
3. Mycoplasma & Herpes simplex
Sulphonamides, Carbamazepine
4. Antibiotics for secondary infection, topical steroids for eyes,saline
compresses for denuded skin,mouth washes
IvIg and steroids in some cases
5. Corneal ulcer, anterior uveitis, myocarditis, hepatitis, acute
tubular necrosis, osteomyelitis
(1+1+2+1+1)
11. OSCE 5 Q
3 yr old male child comes to PHC situated in an area with low
malaria risk with fever
1. What 3 questions you will ask as per IMNCI?
2. Mention the 3 categories into which the child can be classified
into
3. List the steps in the management if the child has meningeal
signs
12. OSCE 5 A
1. Duration of fever/ how long the fever?
If more than 7 days, is it every day?
History of measles in the last 3 months
2. Very severe febrile disease
Malaria
Fever- Malaria unlikely
3. Make blood smear and give first dose of im quinine
First dose of iv or im chloramphenicol/amoxicillin
Treatment to prevent low blood sugar
First dose of paracetamol
Refer urgently (2+2+2 MARK)
13. OSCE 6 Q
A 5 day old newborn male with history of oligo-hydramnios in
the antenatal period in the mother underwent MCU
1. Describe the MCU
2.What is the absolute
indication for MCU in
newborn?
3.What antenatal intervention
would have helped this child?
4. What are the chances of CKD
in adolescence in this child?
5. What are the surgical
procedures possible ?
14. OSCE 6 A
1. MCU showing narrow anterior urethral stream, dilated
posterior urethra, dilated and trabeculated bladder with
diverticulae and secondary VUR
2. Suspected PUV
3. Vesico amniotic shunting
4. 20%-30%
5. Primary fulguration, vesicostomy and high
ureterostomy/ureterostomies
(2+1+1+1+1)
15. OSCE 7 Q
A 3 yr old child had ARF following bloody diarrhea and
peripheral smear is done
1.Read the smear
2. Two Common conditions
associated with this sort of
smear?
3.Diagnosis in this child? What
are the types?
4. What is the prognosis in this
condition?
5. What is the singular description
of kidney biopsy?
16. OSCE 7 A
1. Peripheral blood smear showing many schistocytes and RBC
fragments due to hemolysis, and relatively few platelets
reflective of thrombocytopenia.
2. RBC fragmentation (Schistocytes) can be seen in
HUS, TTP, DAVC, SLE, artificial cardiac valves, intracardiac
patches and in hemolytic transfusion reaction
3. HUS – Typical (D+) and atypical (D-)
4. Relatively good in typical with small percentage settling with
residual renal failure whereas in atypical most of them have
recurrences with chances of progressing to ESRD
5. Thrombotic microangiopathy
(1+1+2+1+1)
17. OSCE 8 Q
1. What is the effect of this drug
on pulmonary blood flow?
2. What will happen if it is used
in a hypovolemic child?
3. Predominant mechanism
of action?
4. Arrange alpha, beta1 &
beta2 in order of reducing
affinity.
5. Advantage of this drug ?
6. Dose range?
18. OSCE 8 A
1. Pulmonary vasodilatation and attenuates hypoxic
vasoconstriction of pulmonary blood vessel
2. Decrease in the cardiac output
3. Beta 1 agonist
4. Beta1> beta2>alpha
5. No effect on HR, PVR & BP
6. 1-20mcg/kg/min
1 mark each
19. OSCE 9
1. What is the abnormality?
2. Ideal Lead for identifying abnormality
3. What is Bazett formula?
4. Two drugs should be avoided?
5. Two Associated syndromes?
OSCE 9 Q
20. OSCE 9 A
1) Prolonged QT interval: Beginning of the QRS
complex to the end of the T wave, of
activation and recovery of the ventricular
myocardium.
2) Ideal lead: LII, V1, V2
3) The Bazett formula is used to calculate the
QTc, as follows: QTc = QT/square root of the R-
R interval
21. OSCE 9 CONTD.
4) Drugs (Direct)
Terfenadine, Astemizole, Ketoconazole, EM(In
direct) by prolonging their metabolism
5) Syndromes associated: Romano Ward
(AD), Jervell Lange Nielsen (AR, uncommon)
1 mark each answer,2 mark for last answer
22. OSCE 10 Q
5 yr old brought with fall from a
height Develops vomiting and
GCS drops from 14/15 to 9/15
1.Describe the abnormality
2. What is the diagnosis?
3. Which is the commonest site
and vessel involved?
4. What is the differential
diagnosis and how will you
differentiate the two?
5. What is the management?
23. OSCE 10 A
1.High density biconvex shadow
2.Extradural hematoma
3.Temporoparietal region,middle meningeal artery.
4. Subdural Haematoma. Subdural Haematoma is
crescent shaped
5.Intubation due to sudden fall in GCS
Urgent neurosurgical referral for craniotomy
(1+1+2+1+1)
24. OSCE 11 Q
IPV
1. Dose and storage
2. What is the seroconversion rate after 2 doses?
3. Three antibiotics present in trace amounts in IPV which
contributes to allergic reactions?
4. IAPCOI recommendation on IPV and schedule
5. Absolute indication for IPV and what is the exception in the
schedule for that condition?
6. IPV Vaccine recommendation for the child who completed
primary series of OPV?
25. OSCE 11 A
1. 0.5 ml 2-8 degree celsius
2. 90 to 100 percent
3. Streptomycin, Neomycin & polymyxin
4. IAPCOI recommends IPV. 6,10,14 weeks and booster at one
and half years
5. B cell immunodeficiency. Second booster dose at 5 years is
recommended.
6. Two doses of IPV at 2 months interval.
(1 mark for each)
26. OSCE 12 Q
• 5yr female child brought with bleeding PV past 2 yrs,
• hyperpigmented patch over neck, thelarche+,
• X-ray bone age advanced, X-ray femur- ?#
27. 1. What is your diagnosis ?
2. What are the components of this syndrome ?
3. Name two endocrine associations.
4. How will you treat
OSCE 12 Q
29. OSCE 13 Q
5months girl with developmental
delay with breathlessness
Na 140 K 4.3 Cl 95 HCO3 5
30. OSCE 13 Q
1. List the abnormalities in ABG
2. Calculate the anion gap
3. Two conditions with increased anion gap
4. Two conditions with decreased anion gap
30
33. OSCE 14 Q
1.What is the diagnosis?
2.Incidence ?
3.If Antenatally detected what is the advise for the
mode of delivery? why?
4.How will u manage after birth?
5.What % is associated anomalies?
6.Which condition closely resembles & how will u
differentiate ?
34. OSCE 14 A
1.omphalocele
2.1 in 5,000 livebirths
3.LSCS–when defect large>5cm,bcoz it prevent rupture of sac
4.latex free products
Continuous NG sump suctioning
Warm saline soaked gauge
Monitor temp&pH
Antibiotics
5.80%
6.gastrochisis- no sac,immediate surgical evaluation,1 in 10,000
births,<5% ass anomalies
(1 mark for each point)
35. OSCE 15 Q
7 Yr old child presented with bilateral sudden loss of vision,
motor weakness and seizures following upper respiratory
Infection. There is no significant family history. MRI finding of the
child is shown here
1.Describe the abnormality and
diagnosis?
2.Give a differential diagnosis
3.How will you differentiate
between the two?
4.What is the CSF finding?
5.What is the line of treatment?
6.What is the prognosis?
36. OSCE 15 A
1. Large, patchy areas of subcortical and deep white matter hyperintensity in
the bilateral corona radiata s/o ADEM
2. Multiple sclerosis
3.ADEM MS
B/L optic neuritis Unilateral
< 10 yrs >10 yrs
Prone for recurrences
4. Lymphocytic pleocytosis
5.Intravenous methylprednisolone 30mg/kg/day for 3-5 days followed
By oral prednisolone 1mg/kg/day for 10 days.
6. 70 percent will recover without any residual disability in 6 months
(1 mark for each point)
37. OSCE 16 Q
10 month old child Santosh comes to emergency department with
complaints of fever for 1 day followed by one episode of
generalised tonic clonic seizures lasting for less than 2 min.Child is
Developmentally appropriate for age with no neonatal issues or
significant past history. How will you counsel the parents for this
Condition?
38. OSCE 16 A
1. Introduces (1/2)
2. Risk of recurrence and good long term prognosis
3. Details first aid for seizures
4. Discuss option for intermittent anticonvulsant prophylaxis or
advises the same
5. There is no need for EEG
6. Explain it is not due to intracranial infection
7. It is different from epilepsy
8. Do u have any doubts
9. Thank you (1/2)
1 mark for the other points
39. OSCE 17 Q
WRITE APPROPRIATE TERMINOLOGIES IN SCREENING TEST
1.Indicator measures actually what is supposed to measure?
2.Measured indicator has same value if measured by different
people in similar circumstances?
3.Indicator is sensitive to changes in situation concerned?
4.Indicator reflects changes only in situation concerned?
5.Indicator has ability to obtain data needed?
41. OSCE 18 Q
1. What is this device?
2. Indication?
3. Contraindication?
4. Limitation?
5. Complication?
42. OSCE 18 A
1.What is this device? Laryngeal Mask Airway (1)
2.Two Indications? Routine airway in operating
room, In cases with difficult bag mask ventilation
(0.5x2=1)
3.Contraindication? Severe airway obstruction (1)
4.Two Limitations? Dislodgement during
transport, minimizes but cannnot prevent
aspiration
5.Complication? Regurgitation and aspiration (2)