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  2. The sister of Eman Abd El Aty, an Egyptian woman thought to have been the world's heaviest, has accused doctors of lying about her weight loss after surgery in India. She underwent surgery in Mumbai's Saifee hospital, and last week doctors said she had lost 250kg (550lbs). But her sister said this was untrue, adding that her sister was in delicate health as she may have had a stroke. The hospital has angrily rejected the allegations. The row began on Monday when Ms Abd El Aty's sister, Shaimaa Selim, released a short video on social media, alleging that her sister was still unable to speak or move, and had not lost as much weight as the hospital was claiming. On Tuesday, she told the BBC that the hospital was lying about her weight loss. "He [Dr Muffazal Lakdawala, who led the operation] didn't weigh her before and after. If he has any proof of her weight loss, show us the video of her weight before and after." Describing her sister's health as delicate, she said: "Oxygen is not normal in her body. She has to wear an oxygen mask almost all the time. There is a tube from her nose to her stomach because she can't eat or drink well from her mouth. But a spokeswoman for the hospital told the BBC that Ms Abd El Aty was weighed again on Monday and she now weighed 172kg. Dr Lakdawala also strongly denied the allegations in a tweet. Image copyright TWITTER Eman Abd El Aty suffered a stroke at the age of 11 and her weight meant she was unable to leave her home for 25 years. She was flown in a special aircraft in January to Mumbai's Saifee hospital where she underwent bariatric surgery in March by a team of doctors, led by Dr Lakdawala. The hospital says she can now fit into a wheelchair and sit up for longer periods of time. It released new pictures of Ms Abd El Aty following weight reduction surgery. Reports say Ms Selim is unhappy because the hospital authorities believe that Ms Abd El Aty's treatment is almost over and that she can be sent home to Alexandria soon. "There are cases like this in other parts of the world. In America and in other countries, there are heavyweight people. They have been in the hospital for one or two years to lose weight and become normal. "But just after a month or two here, the doctors say that I can take my sister back. I asked them how, as she is still very big and if anything happens to her in Egypt, how can I go to a hospital there? "It would be impossible and nobody would help me in Egypt. I said, 'Please please keep her for a long time to help her lose weight'," her sister said. Bariatric surgery, also known as weight loss surgery, is used as a last resort to treat people who are dangerously obese (having a body mass index of 40 or above, or 35 with other obesity-related health conditions).
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  5. I am dental student ...and really this artical was of grt importance .well i always try some of above points and it works....specially connecting text with images.... One more point i would like to add....on first go ,one should avoid covering a new chapter in deep...first...brush up all the topics and then continue reading Go in deep in your second revision..on 2nd time you must go as deep as possible....its necessary to know all topic's present in a chapter,in advance it helps..{just a personal opinion}.☺
  6. Anaphylaxis
  7. Epinephrine Auto Injector helps self injecting Epinephrine in an Anaphylaxis Patient at the required doses. It is used as a shot intramuscular injection. These are used as intermediate measures while definitive treatment must be followed by a trained physician in an emergency setup. This means Epinephrine auto injector is not complete treatment for a patient with anaphylaxis. What is Epinephrine Auto Injector: Just like any other auto injector (Morphine Auto Injector, Insulin Auto injector), Epinephrine auto Injector is also a dose calibrated injector.
  8. Anaphylaxis Kit should be a standard component of any Emergency Medical Services. A patient in anaphylaxis deteriorates very fast and anaphylaxis kit is handy to save life. So, what are the anaphylaxis kit contents? How can it be prepared? An ideal Anaphylaxis Kit should contain the following: A portable bag with space for injections, syringes and vials An instruction booklet or Anaphylaxis Management Plan 02x Epinephrine Auto Injector 02× Hydrocortisone sodium succinate 100mg 01 × 1ml Chlorphenamine Injection 10mg in 1ml 01 x IV Cannula 18g Green 02 x Needle 23G x 1¼ 02 × 1ml syringe 01 x Guedel Airway Size 0, 1, 2, 3 and 4 one each 01 x Resuscitation Face Shield 01x Normal Saline 500 ml Anaphylactic Kit is not for routine use and only be used by trained medical practitioner or under supervision. Epinehrine auto injector can be used by a patient when prescribed by a doctor as self injector.
  9. Anaphylaxis management Plan helps health professionals quickly assess and treat a patient on anaphylaxis. In a true anaphylactoid reaction one seldom gets time to do investigations to establish a diagnosis. Patient sinks fast and early treatment saves life. Anaphylaxis management plan has the following components: Assesment: A quick assessment to know the status of the patient includes vitals pulse, BP, Respiratory Rate, SPO2 Life Suport: Get IV aceess, Start O2, Give ventilatory support Diagnosis: Diagnosis should be clinical and based on history. Ask following questions to patient or his Next of Kin : “Have you been exposure to a known allergy/trigger?" “When did symptoms start, and what are you current medications?" “Has this happened before?” “Are you asthmatic?” Treatment: IM ADRENALINE (1:1000) 0.5 ml (500mcg); repeat at 5 minute intervals if no improvement. This route is not recommended after cardiac arrest Or, IV (1:10,000) 0.5 ml (50mcg) if severely ill, peri-arrest or pulseless; ie the dose is different NEB SALBUTAMOL 5mg (if wheezy) IV HYDROCORTISONE 200mg IV CHLORPHENIRAMINE 10mg Procedures High flow oxygen: >10 l/min IVI + IV fluid challenge: 500 – 1000 mL. Repeat if necessary Lie patient flat, elevate legs Monitor cardiac and respiratory function
  10. Which of the following medications blocks the release of histamines? A - Hydrocortisone B - Diphenhydramine C - Pheniramine Maleate D - Epinephrine
  11. 12 Lead ECG Placement Mnemonics helps to remember placement of chest and limb ECG leads. Often the respective leads indicators are marked on chest leads. Limb leads are color coded and marked too. There are three types of ECG leads available: Banana Type Snap Type Pinch/Clip/Grabber Type Banana Type leads are common with old pattern of ECG machines. Chest leads are marked with C1, C2 or like V1, V2. Todays leads also carries a color coding. Snap Type is used very frequently and attached to the connector with a snap or button. Easy to use with disposal type of connectors and these are frequently used in ICU, NICU and Emergency deptts. Apart from color coding, often chest lead numbers are marked as V1, V2.. and Limb leads as RA, RL, LL, LA. The other type is Pinch type ECG lead and it has a clip type mouth to connect to the connector. In most cases, the leads are numbered, so that you dont have to remember them. It is true for both chest leads as well limb leads. The problem arises when the numbers fall off due wear and tear or when not numbered at all. In this case the color coding helps. The 12 ECG chest lead standard color coding are like this: With the help of numbering and color coding any lay man can place ECG leads without a mnemonic. But when only color coding is there it is really difficult. With the help of this mnemonic one can remember the color corresponding the lead. Real Yummy Glass of Bear Brings Peace Red> V1, Yellow> V2, Green> V3, Brown> V4, Black> V5, Purple> V6 For limb leads starting anticlockwise from right hand> Wrong Gemstones Return Badluck: White for Right Hand, Green for Right Leg, Red for Left Leg and Black for Left hand
  12. Dr Husam Jamil thank You so much for sharing this information for the benefit of fellow Doctors. I really appreciate it. Thank You
  13. mcq

    Which one of the following antiplatelet agents acts by inhibiting the phosphodiesterase enzyme and increasing the cellular concentration of cyclic adenosine monophosphate (cAMP)? A - Abciximab B - Ticlopidine C - Aspirin D - Clopidogrel E - Dipyridamole Show Answer Answer: E Explaination
  14. mcq

    37 year old male comes to physician for routine maintainace examination...his father was diagnosed with colon cancer at age of 50 and treated with colectomy ..he has 30 pack year smoking history which of the fallowing is initial screning test for this pt ? A - colonoscopy at age of 60 B - colonoscopy at age of 50 C - colonoscopy at age of 40 D - colonoscopy at age of 30 Show Answer Answer: C Explaination
  15. mcq

    Most accurate tool for diagnosis of Appendicitis? A - Ultrasound B - CT scan C - Diagnostic Laparoscopy D - A detailed history Show Answer Answer: B Explaination A random study on Pulmonary embolism shows (A)100 patients out of 1000 died who didnot get the treatment (B) 5 patients out of 100 died who got the proper treatment Choose the single most likely absolute risk for each of the above mentioned ? A - Absolute risk 5% B - Absolute risk 10% C - Absolute risk 2% D - Absolute risk 15% Show Answer Answer: B Explaination
  16. mcq

    Pregnant woman with UTI which is the best antibiotics to be given if she has no allergy? A - Nitrofurantoin B - Ampicillin C - Sulfatrimethoprim D - Tetracyclin E - Aminoglycoside Show Answer Answer: A Explaination Gram negative diplococcic is classical for? A - Gonorrhea B - Chlymedia C - Syphilis D - Chencroid Show Answer Answer: A Explaination Infant of HBV positive mother should receive immunoglobulin within? A - 24 hrs B - 72 hrs C - 12 hrs D - 48 hrs Show Answer Answer: A Explaination
  17. mcq

    thank you
  18. Lots of these are being used for blackmailing their boyfriends, parents, families and also for extracting gifts
  19. mcq

    Atypical pneumonia can be caused by the following microbial agents except? A - Klebsiella pneumoniae B - Human Corona virus C - Legionella pneumophila D - Mycoplasma pneumoniae Show Answer Answer: A Explaination
  20. mcq

    four dose regimen is administered in post exposure prophylaxis of rabies is? A - Day 0,3,7,14 B - Day 0,3,7,21 C - Day 0-two doses .day 7 and day 21 D - Day 0,7,14,21,28 Show Answer Answer: A Explaination Four doses at Day 0,3,7 & 14...but if patient is immunocompromised, then add d 5th dose at Day 28. if received 01 dose of rabies vaccine in the past, give only 2 doses at Day 0 & 3
  21. mcq

    A 55-year-old woman presents to the OB/Gyn clinic complaining of pain during intercourse, after which she experiences vaginal bleeding and foul discharge. She reports that she had multiple sexual partners in her youth, but has been monogamous for twenty years and has since had three children. She admits that has not seen a gynecologist in several years. On physical exam, she is pale and her cervix is nodular, with what grossly appears to be some dysplasia. Which of the following organisms is the most likely cause of her condition? A - Epstein Barr virus (EBV) B - Human immunodeficiency virus (HIV) C - Human papilloma virus (HPV) D - Human T lymphotrophic virus, type 1 (HTLV-1) E - Schistosoma hematobium Show Answer Answer: C
  22. mcq

    Which of the following ligaments prevent hyperextension of hip A - Illiofemoral Ligament B - Pubo Femoral Ligament C - Ischiofemoral Ligament D - Ligamentum Teres Femoralis Show Answer Answer: A Explaination
  23. mcq

    Angle formed by the shaft and the neck of the femur is degrees A - 115 B - 125 C - 135 D - 145 Show Answer Answer: B Explaination 125 The femoral neck and the femoral diaphysis form the femoral neck angle that normally is about 125 degrees. True about upper end of tibia is all except A - Ossification centre at the upper end fuses by 20 years B - It gives attachment to medial collateral ligament C - It gives attachment to semi-membranous D - Posterior aspect of patella articulates with upper end of tibia laterally Show Answer Answer: D Explaination Posterior aspect of patella articulates with upper end of tibia laterally Patella has no articulation with tibia; it is articulated to femur only
  24. mcq

    A 73-year-old man has his third syncopal episode in the last 6 months. An EKG done in the field shows ventricular tachycardia. His stress test is normal. What is the most appropriate next step in the management of this patient? A - Metoprolol B - Diltiazem C - Angiography D - Implantable defibrillator E - EP(Electro Physiological) studies Show Answer Answer: D Explaination As no ischemia and syncopal attack from VT best option to keep this elderly patient from risk of sudden death is D. Implantable defibrillator.
  25. mcq

    Anterior wall of the third ventricle is formed by? A - Lamina terminalis B - Pineal body C - Tuber cinereum D - Mamillary body Hide Answer Answer: A Explaination Anterior wall of third ventricle is formed by lamina terminalis, anterior commissure and anterior column of fornix.
  26. mcq

    This anatomy MCQ collection thread contains Anatomy multiple choice questions with single best answer. I will try to post MCQ explanations as well. You can click on any answer to see if youre correct. Click on Show answer button to see the explanation. You can also contribute to this topic by just pressing the button to add an MCQ All are true regarding axillary artery except? A - It is a continuation of subclavian artery B - It is crossed by pectoralis minor muscle C - It extends from outer border of second rib to the lower border of teres minor. D - The second part of part of axillary artery is posterior to pectoralis minor muscle Show Answer Answer: C Explaination Axillary artery extends from outer border of first rib to the lower border of teres major
  27. mcq

    A 10yo child who presented with fx of the radius which was treated with a plaster cast, complains of pain. Exam: limb is swollen but warm and well perfused, pulses are present. What should you do next? A - Send for repeat XR B - Remove cast C - Replace cast with more padding D - Give analgesic Hide Answer Answer: B
  28. mcq

    A 24 year old college student presents to A&E with nausea, vomiting, headache, neck stiffness and a fever of 38.4C. What is the SINGLE most appropriate empirical antibiotic to be started immediately? A - IM Benzyle Penicillin B - IV Ceftriaxone C - IV Gentamycin D - IV Tazobactum Show Answer Answer: B Explaination She has signs of meningitis. IV Ceftriaxone needs to be administered immediately. In a hospital setting, give intravenous third generation cephalosporin antibiotics (ceftriaxone or cefotaxime). In case of prehospital setup, the answer would have been A
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