Chlorine & its compounds in sanitation (this is how hospitals kill bacteria roaming in the floor)

~~Table of Contents(toc)~~

What are the Chlorine compounds used for disinfecting and sanitation purpose?

Chlorine tab

Chlorine tabs – A single tab of 0.5 gm is sufficient to disinfect 20L of water (= 35 mg’L). Easy & cheap method to disinfect household water.

(VIMP for exams)

Chlorine gas

Chlorine gas – first choice for disinfection of large body of water.

Perchloran

Perchloran – Also k/as high testhypochloride; provides 60-70% available Cl2.

How do chlorine tablets work?

Oxidizing Agent: Chlorine acts as a strong oxidizer, breaking down cell membranes and disrupting essential cellular processes in microorganisms.
Hypochlorous Acid Formation: When added to water, chlorine forms hypochlorous acid (HOCl), which is more effective at penetrating microbial cell walls than hypochlorite ions (OCl⁻).
Protein Denaturation: Chlorine reacts with microbial proteins, leading to their denaturation and loss of function, which ultimately kills the microorganism.
Disruption of DNA & Enzymes: Chlorine damages microbial DNA and inhibits enzymatic activity, preventing replication and metabolism.
Broad-Spectrum Activity: Effective against bacteria, viruses, fungi, and protozoa, including pathogens like E. coli, Salmonella, and Vibrio cholerae.
Residue Effect: Leaves a residual disinfectant effect in treated water, preventing recontamination over time.
Chlorination Byproducts: Can produce disinfection byproducts (DBPs) like trihalomethanes (THMs) and haloacetic acids (HAAs), which require monitoring for safety.
Effective in Various Forms: Available as chlorine gas, sodium hypochlorite (liquid bleach), calcium hypochlorite (solid), and chloramine for different disinfection needs.
Water pH Dependency: The effectiveness depends on water pH, with optimal disinfection occurring at pH 6-7 where hypochlorous acid predominates.
Fast-Acting: Works quickly to kill pathogens, typically within minutes, depending on concentration and exposure time.

Chemistry of Pool or Hospital Chlorine tablets

When pool chlorine (commonly sodium hypochlorite or calcium hypochlorite) is added to water, it undergoes hydrolysis to produce hypochlorous acid (HOCl), which then dissociates to release nascent chlorine (Cl•), a highly reactive disinfectant.

Chemical Reactions for Pool Chlorine in Water

For Sodium Hypochlorite (NaOCl):

$H_2O rightarrow HOCl + NaOH$
For Calcium Hypochlorite (Ca(OCl)₂):

$Ca(OCl)2+2H2O→2HOCl+Ca(OH)2Ca(OCl)_2 + 2H_2O rightarrow 2HOCl + Ca(OH)_2$
Dissociation of Hypochlorous Acid (pH-dependent reaction):

$H^+ + OCl^-$
Formation of Nascent Chlorine (Reactive Form of Chlorine):
- In acidic to neutral conditions, hypochlorous acid undergoes further dissociation to release nascent chlorine:
$H OCl \to H Cl + [O]$
- The nascent oxygen ([O]) is a powerful oxidizer that destroys microbes by attacking their cell structures.
- In water, HOCl can also directly release Cl• (chlorine radicals), contributing to its strong disinfecting power.

Possible MCQ

Percentage of chlorine available in bleaching powder is:

a. 43%

b. 20%

c. 30%

d. 33%

Ans: ‘d’

Solution

Bleaching powder (CaOCl2) contains 33% of available Cl2 if freshly prepared (most effective & cheapest way of disinfecting well).

Is ST change always an MI? Top 18 Differentials of ST elevation you must know

18 Differential diagnoses of ST elevation

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What is ECG?

ECG is a electrical graphical representation of cardiac electrical activity. It is plotted as voltage against time.

What is ST segment in an ECG?

ST segment (as shown in image) is the segment between S and T wave in the ECG. Its electrically in baseline with 0 mV.

Both ST segment elevation and depression can be sign of illness or underlying cardiac pathology.

What are causes of ST Segment elevation?

Here is a comprehensive list of differential diagnosis of ST segment elevation in ECG / EKG.

1)MI

2) Pericarditis/Myocarditis

3) Cocaine abuse, 5FU, Triptans, Ergols

4) Repolarisation abn in Children

5) Brugada

6) ICH

7) Hypothermia

8) Hyperkalemia, -calcemia

9) Takutslubo CMP

10) LV aneurysm

11) LVH

12) LBBB

13) Prinzmetal Angina

14) Post DCCV

15) Anti arrythmii IC

16) Pulmonary embolism

17) Ventricule contusion/trauma

18) Ventricular tumor

Should I get an ECG done to check ST segment elevation?

Generally if you’re young, otherwise healthy individual you do not need to check for ST segment elevation or perform an ECG evaluation.

But if you’re adult above 40, have systemic illness like hypertension (high BP), diabetes (sugar), thyroid disorder, pulmonary Illness like asthma, COPD, chronic cough, chest pain or anything similar your health care provider or doctor may order an ECG to check condition for your heart.

You do not specifically order or request and ECG for ST segment evaluation. It’s part of your whole ECG as 12 lead ECG.

What is an 12 lead ECG?

12 lead ECG is a type of ECG test most commonly done to check cardiac status.

To perform 12 lead ecg, 10 different leads(wires) coming from an ECG machine are attached in your body i. Different locations viz. four in four lumbs, and six in anterior and left lateral side of chest (as shown in image).

From the four limb leads 3 are active leads(wires) which measure current directly while one is earthing wire.

What is position of leads in 12 lead ECG?

Here is image showing position of leads in 12 lead ECG.

How does the knee jerk work?

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What is knee jerk?

Definition: A monosynaptic reflex that tests the integrity of the L2-L4 spinal segments and the femoral nerve.
Stimulus: Tapping the patellar tendon with a reflex hammer
Response: Contraction of the quadriceps muscle, causing leg extension at the knee.

How does knee jerk work?

Pathway:

Sensory input via muscle spindle (intrafusal fibers) of quadriceps.
Afferent impulse travels via the femoral nerve to the L2-L4 spinal cord.
Synapses directly with an alpha motor neuron (monosynaptic).
Efferent impulse sent back through the femoral nerve to the quadriceps.

physioogical pathway of knee jerk

What is Use of Knee Jerk in daily life?

Function: Maintains posture and balance, prevents knee buckling.
Clinical Significance:

Hyperreflexia → Suggests upper motor neuron (UMN) lesion.
Hyporeflexia/Absent reflex → Suggests lower motor neuron (LMN) lesion or peripheral nerve dysfunction.
Westphal’s Sign → Absence of knee jerk, seen in LMN lesions, neuropathies, or spinal cord damage.

What are Associated Conditions with abnormal Knee Jerk reflex:

Upper Motor Neuron (UMN) Lesions (Hyperreflexia)
- Stroke (CVA)
- Spinal cord injury (above L2-L4 level)
- Multiple sclerosis (MS)
- Amyotrophic lateral sclerosis (ALS) (UMN phase)
- Traumatic brain injury (TBI)
- Cerebral palsy
- Brain tumors affecting corticospinal tract
Lower Motor Neuron (LMN) Lesions (Hyporeflexia or Absent Reflex)
- Peripheral neuropathy (e.g., diabetic neuropathy)
- Guillain-Barré syndrome
- Poliomyelitis
- Radiculopathy (L2-L4 nerve root compression, herniated disc)
- Amyotrophic lateral sclerosis (ALS) (LMN phase)
- Cauda equina syndrome
- Spinal muscular atrophy (SMA)
- Lumbar plexopathy (e.g., trauma, diabetes, neoplastic infiltration)

Question for practice

Delayed relaxation of ankle jerk is seen in:

a. Addison’a disease

b. Hypothyroidism

c. Thyrotoxicosis

d. Diabetes mellitus

Ans: ‘b’

Explanation

Hung-up reflex refers to prolongation of deep tendon reflexes with a slow relaxation phase (as if in slow motion). Hung up reflex is typical elicited in the ankle jerk (Achilles tendon reflex) in patient with myxedema (other deep tendon reflex) in patient with myxedema may also show slow relaxation).

Brisk (Exaggerated) deep tendon reflex: Upper motor neuron lesion, Hyperthyroidism.

Absent deep tendon reflex: lower motor neuron lesion.

Pendular knee jerk: Cerebellar lesion.

MCQ 2:

A 60-year-old male presents with weakness in both lower limbs and increased knee jerk reflexes. Which of the following is the most likely cause?

A) Guillain-Barré syndrome

B) Diabetic neuropathy

C) Spinal cord injury (above L2)

D) Cauda equina syndrome

Answer: ✅ C) Spinal cord injury (above L2)

Explanation:

The knee jerk reflex (L2-L4) is exaggerated (hyperreflexia) in UMN lesions.
Spinal cord injury above L2 disrupts the descending inhibitory control from the brain, leading to increased reflexes (hyperreflexia).
Guillain-Barré syndrome (A) and diabetic neuropathy (B) cause LMN lesions, leading to absent or reduced reflexes (hyporeflexia).
Cauda equina syndrome (D) affects the lumbar and sacral nerve roots, causing flaccid paralysis and absent knee jerk reflex.

Thus, the most likely diagnosis is spinal cord injury above L2, causing bilateral weakness with hyperreflexia.

I was so scared I would GO BLIND but my doctor said THIS!

What is red eye?

Recently I had a red eyes when iI woke up in the morning.

I had fallen asleep completely well in the evening and nothing happened in the night either.

For further information, I am young healthy woman with no any illness neither taking any medication.

I eat goood food and I have well settled family and I am living happily.

After the event I was so scared that I would go blind and rushed to hopital emergency and this is what my doctor said about red eye.

My doctor said its not a big deal for now and sometimes this condition can occur without any reason and will go spontaneously after few days.

Subconjunctival hemorrhage may occur spontaneously or with Valsalva associated with coughing, sneezing, straining, or vomiting. The diagnosis is confirmed by normal acuity and the absence of discharge, photophobia, or foreign body sensation.

Further he said this about a red eye:

A red eye caused by bleeding, often called a subconjunctival hemorrhage, is
usually a harmless condition resulting from a broken blood vessel in the white
of the eye (sclera) and typically resolves on its own within a few weeks.

Here’s a more detailed explanation on why eye becomes suddenly red:

There are various causes of red eyes. Out of which some are emergency
conditions while others may not be that serious.

Category	Painful Causes	Painless Causes
Emergency Causes	Acute angle-closure glaucoma Infectious keratitis (bacterial, viral, fungal) Scleritis Endophthalmitis Corneal ulcer Hyphema Chemical burns	Subconjunctival hemorrhage (to rule out cause of it) Episcleritis (mild cases)
Non-Emergency Causes	Episcleritis (moderate-severe cases) Anterior uveitis (iritis) Foreign body (with corneal abrasion) Contact lens-related irritation Blepharitis (if severe)	Allergic conjunctivitis Dry eye syndrome Pinguecula/Pterygium Viral conjunctivitis Bacterial conjunctivitis

What is a subconjunctival hemorrhage?

Subconjunctival Hemorrhage

Common in elderly (>80 years), often linked to hypertension.
In young (<40 years), usually due to ocular trauma or contact lens use.
Risk factors: coagulopathy (anticoagulation), diabetes, Valsalva (coughing, vomiting), amyloidosis, Kaposi sarcoma.
Can occur spontaneously during sleep.
Circumferential hemorrhage after blunt trauma may indicate globe rupture

Cause:

A subconjunctival hemorrhage occurs when a small blood vessel beneath the
conjunctiva (the clear membrane covering the white of the eye) ruptures.

Appearance:

large subcinjunctival hemorrhage

This causes a bright red patch on the white of the eye, which can look
alarming but is usually not serious.

Common causes:

Sneezing, coughing, straining, or even rubbing the eye too hard can cause a
blood vessel to rupture.

Other causes:

High blood pressure, certain medications (like blood thinners), and eye
injuries can also contribute.

notes in conjunctivitis

Symptoms:

The most obvious symptom is a bright red patch on the white of the eye. You
might experience a scratchy feeling on the surface of the eye, but vision,
pain, or discharge are usually not affected.

When to seek medical attention:

Recurrent hemorrhages:

If you experience repeated subconjunctival hemorrhages, it’s a good idea to
consult with a doctor to rule out any underlying conditions.

Other symptoms:

If you experience sudden vision changes, eye pain, or other concerning
symptoms along with the red eye, seek immediate medical attention.

Suspected eye injury:

If you suspect an eye injury or a foreign object in the eye, seek medical
attention.

Bleeding elsewhere:

If you notice bleeding in other parts of your body, consult with a doctor.

Treatment and Prognosis:

Most cases resolve on their own:
Subconjunctival hemorrhages typically
resolve within a few weeks without any specific treatment.

No need for treatment:

Unless there’s an underlying medical condition or eye injury, no treatment
is usually needed.

Symptom relief:

You may use artificial tears to soothe any scratchy feeling.

notes in conjunctivitis

Follow-up:

Make sure to follow up with your doctor as needed, and be sure to make and
go to all appointments.

Other causes of red eyes

Conjunctival Laceration

Uncommon but may signal serious ocular injury (e.g., open globe, hyphema).
4% of ocular trauma cases in a large study.
Often work-related; linked to airbag deployment, projectiles, compressed air, paintball injuries.

Conjunctival Foreign Bodies

Common: sand, dirt, eyelashes, plant material, metal (welding, grinding).
Rarely, retained foreign bodies cause prolonged symptoms.

notes in conjunctivitis

Is Jimbu Good for Health? Here are 11 Health Benefits of Jimbu!

Is Jimbu Good for our Health?

Before jumpmg to health benefits of Jimbu, lets discuss what is jimbu and how
do we identify it?

What is Jimbu?

Jimbu is a traditional spice commonly used in northern and himalayan Nepal, India from Uttarakhands to Sikkim area.

It belongs to onion family and tastes similar to onion.

It has typical but slightly different flavour and smell than onion hence it is used as taste enhancer in traditional cooking of Nepal and surrounding region.

It is one of the main ingridient and taste enhancer in traditional Thakali dish in Nepal.

Jimbu is also called Faran and its scientific name is Allium hypsistum. Another species A. prezewalskianum is also found in Nepal and surrounding region.

Its used to flavour Daal and Vegetables, and is mostly used in dried form but also in raw green for during the harvesting season.

Upto 95 % of households in Northern Nepal (especially Mustang area) use Jimbu in daily cooking.

Jimbu is also called himalayan aromatic herb or himalayan allium (onion).

It is also known as jamboo/faran in Uttarakhand of India and jhiku-cha in Newari language mostly spoken in Kathmandu valley by Newar people.

Jimbu in English

In English Jimbu is also called Himalayan aromatic herb or Himalayan Allium or Himalayan Onion.

Health Benefits if Jimbu

Though there is n data of proven health benefits os Jimbu, traditionally it has been used also as a hearbal medicine in Nepal and other areas.

The potential health benefits of Jimbu may include following:

Prevention and treatment of flu
Improved digestion
Improved immune system
Prevention from cold and warin up of body
Jimbu is also supposed to make skin better and prevent oxidative damage
It prevents and treats cough and sore throat
It helps in formation and amintainance of red bloood cells precenting anemia
It prevents acidity and stomach disorders
It has Vitamin A and Vitamin C preventing infection and growth of bacteria
Its antioxidant and cholesterol lowering properties prevent cardivascular illness, hypertension and dyslipidemia
It gives stamina to keep you active for longer duration

Jimbu Substitute as taste enhancer

Though Jimbu is outstanding spice in Nepal sometimes you may not find is easily.

So, Kasuri methi (कसुरी मेथि) can be used as alternative as jimbu substitute in everyday cooking.

Conclusion

Jimbu is not only a taste enhancer but also good for health. So consumption of tradional spice “jimbu”is good for health and everyone should consume it regularly in moderate amount,

Sometimes it can also be used as medicine if you have cough, cold, stress, abdominal issues or cardiovascular illnesses.

(Via Guest)

Help! My baby’s heart is beating fast, what should I do? (Ask a doctor)

Why is my baby’s heart rate fast?

~~Table of Contents(toc)~~

A childs health conccern is the most priority for most parents. Especially
mothers who have caring nature and are more caring and notics small changes
in thei childs health.

Why do babies have high heart and respiratory rate?

According to Pediatricians and neonantologists, vital signs of neonates and
children are different than that of Adult humans. This is because of their
small organ size and increased metabolic need for fast growth and
development.

Normal Heart rate for adults is 60-100 bpm while normal respiratory
rate is 12-18 breaths per minute.

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What is the normal heart rate for my baby?

There are several different ranges of resting heart rates to consider for
patients under 10 years of age. Those ranges include:

Newborns up to one-month-old: 70-190 bpm

Infants 1-11 months: 80-160 bpm

Children 1-2 years: 80-130 bpm

Children 3-4 years: 80-120 bpm

Children 5-6 years: 75-115 bpm

Children 7-9 years: 70-110 bpm

What is normal respiratory rate for my baby?

Here’s the
correct respiratory rate (RR) ranges
for children:

Newborns (0-1 month):
30-60 breaths per minute
Infants (1-12 months):
30-50 breaths per minute
Toddlers (1-2 years):
24-40 breaths per minute
Preschoolers (3-5 years):
22-34 breaths per minute
School-age children (6-12 years):
18-30 breaths per minute
Adolescents (13-18 years):
12-20 breaths per minute

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Causes of Fast Heart rate in Children:

An increased heart rate (tachycardia) in babies and children can be caused by a variety of factors, ranging from temporary conditions to more serious medical concerns. Here’s a list of potential causes:

1. Fever

A rise in body temperature can cause an increased heart rate as the body tries to regulate itself.

2. Physical Activity or Exercise

Just like in adults, physical exertion or exercise in children leads to an elevated heart rate, which typically returns to normal after rest.

3. Stress or Anxiety

Emotional distress, anxiety, or fear can cause an increase in heart rate as part of the body’s “fight-or-flight” response.

4. Pain

Acute pain, such as from an injury or illness, can result in tachycardia.

5. Dehydration

When the body is dehydrated, blood volume decreases, causing the heart to pump faster to maintain adequate circulation.

6. Anemia

In cases of low red blood cell count, the heart compensates for the reduced oxygen-carrying capacity by increasing its rate to supply tissues with oxygen.

7. Infections

Systemic infections such as sepsis or localized infections can trigger a rapid heart rate as part of the body’s response to infection.

8. Respiratory Issues

Conditions like asthma, bronchiolitis, or pneumonia, where oxygen levels are compromised, can lead to tachycardia as the body works harder to circulate oxygen.

9. Hyperthyroidism

Overactivity of the thyroid gland can cause an elevated heart rate, as it increases the metabolism and the heart’s workload.

10. Congenital Heart Conditions

Some heart defects, such as atrial or ventricular septal defects, congenital heart failure, or arrhythmias, can cause the heart to beat abnormally fast.

11. Caffeine or Stimulants

Consumption of caffeine or other stimulants, such as certain medications or energy drinks, can cause an increase in heart rate.

12. Electrolyte Imbalance

An imbalance in electrolytes, such as potassium, calcium, or sodium, can disrupt the normal electrical activity of the heart, leading to tachycardia.

13. Shock

Conditions such as hypovolemic shock, cardiogenic shock, or septic shock can cause a rapid heart rate as the body tries to compensate for a lack of blood flow or oxygen.

14. Hypoxia

Low oxygen levels due to lung disease or high altitudes can cause tachycardia as the body attempts to increase oxygen delivery.

15. Medications

Some medications, including those used to treat respiratory conditions or other chronic illnesses, may increase heart rate as a side effect.

16. Hyperventilation

Rapid breathing can sometimes cause an increased heart rate as the body tries to balance oxygen and carbon dioxide levels.

17. Electrocardiographic Abnormalities

Conditions such as supraventricular tachycardia (SVT) or ventricular tachycardia are abnormal electrical rhythms of the heart, leading to excessively fast heart rates.

18. Hypoglycemia (Low Blood Sugar)

Low blood sugar levels can stimulate the release of stress hormones (like adrenaline), which can increase heart rate.

19. Toxin or Drug Poisoning

Ingestion of certain toxic substances or drugs (e.g., alcohol, drugs, or poisons) can lead to tachycardia as part of the body’s response.

20. Heat Stroke or Heat Exhaustion

Extreme heat can cause the body to work harder to cool down, leading to an elevated heart rate.

21. Severe Allergic Reactions (Anaphylaxis)

In anaphylaxis, the body’s extreme response to an allergen can include rapid heart rate along with other symptoms like swelling, rash, or difficulty breathing.

In cases where a child has an increased heart rate along with other symptoms such as difficulty breathing, chest pain, fainting, or fatigue, it’s important to seek medical care immediately.

Causes of Fast breathing rate in Children:

Fast breathing in babies and children can have various causes, ranging from normal responses to stress or physical activity to more serious medical conditions. Here’s a list of potential causes:

1. Respiratory Infections

Bronchiolitis: Often caused by viruses like RSV, leading to inflammation in the small airways of the lungs.
Pneumonia: Infection in the lungs that causes rapid breathing, fever, and cough.
Croup: Inflammation of the upper airway, leading to a characteristic barky cough and fast breathing.
Whooping Cough (Pertussis): A bacterial infection that leads to coughing fits and rapid breathing.

2. Asthma

A chronic condition that causes the airways to constrict, leading to wheezing, difficulty breathing, and fast breathing.

3. Allergic Reactions

Severe allergic reactions (anaphylaxis) can cause difficulty breathing and rapid respiratory rate due to swelling of the airways.

4. Fever

Fever in children can lead to faster breathing as the body works to regulate temperature.

5. Congenital Heart Conditions

Conditions such as heart defects can cause difficulty in oxygenating the blood, leading to rapid breathing (tachypnea).

6. Anemia

Low red blood cell count can cause the body to breathe faster in an attempt to deliver more oxygen to tissues.

7. Dehydration

Dehydration can lead to fast breathing due to decreased blood volume and body stress.

8. Foreign Body Aspiration

When a child inhales a small object, it can block the airways, leading to difficulty breathing and increased respiratory rate.

9. Metabolic Disorders

Conditions like diabetic ketoacidosis can cause fast, deep breathing (Kussmaul respiration) in response to the metabolic imbalance.

10. Pain

Severe pain can cause increased respiratory rate as the body reacts to distress.

11. Exercise or Physical Activity

Children may breathe faster during or after physical activity, which is a normal response.

12. Environmental Factors

Exposure to smoke or pollution can irritate the airways, leading to rapid breathing.

13. Sepsis

A severe infection in the body that can cause a rapid breathing rate as the body tries to cope with systemic infection.

14. Sleep Apnea

Children with sleep apnea may have episodes of rapid breathing during sleep, often accompanied by snoring and gasping.

15. Psychological Factors

Anxiety or panic attacks can lead to fast, shallow breathing (hyperventilation).

If a baby or child is experiencing fast breathing with additional symptoms like fever, bluish skin, trouble feeding, or lethargy, it’s crucial to seek medical attention immediately.

When to visit a dctor if my baby if breathing fast or heart beat is too
fast?

Here are the steps to know if your baby is breathing too fast or has heart
beating too fast:

Ensure that your baby is properly resting and placed in comfortable
bed or mother’s arms.
expose the chest area and abdomen to see properly.
Make sure that baby is not crying or playing.
Now count respiratiry rate by cound one cycle of inspiration and
expiration (noticed by chect movement)
Record for Complete one minute.
Check against above data.

Follow same steps for heart rate too. Heart rate can be detected by
using your had or putting head in baby’s chest or using Stethoscope.

More than above your baby should also be sick or not behaving well like
not feeding well, crying, coughing, wheezing, blue lips limbs, or face,
lose stool, vomiting, not actively playing well or drowsy.

Disclaimer: These Information are for educational purpose only and
intended for education of healthcare provider students. Please consult
your doctor for diagnosis and treatment of your problem. Information in
my website does not establish doctor-patient relationship.

Why do I have white lines in my nail? are they dangerous?

~~Table of Contents(toc)~~

Beau line

Beau’s lines are horizontal grooves or ridges that appear on fingernails or toenails, indicating a temporary disruption in nail growth, often caused by illness, injury, or certain medications.

What they are:

Beau’s lines are transverse depressions or grooves that run across the nail plate, appearing as indentations or ridges.

They are named after French physician Joseph Honoré Simon Beau, who first described them in 1846.

They are a sign that nail growth was temporarily stopped or slowed due to a specific event or condition.

Causes:

Illness: Systemic diseases, infections, or high fevers can disrupt nail growth.
Injury: Trauma to the nail or nail bed can cause Beau’s lines.
Medications: Certain medications, particularly chemotherapy, can interfere with nail growth.
Other factors: Malnutrition, stress, and certain skin conditions can also be associated with Beau’s lines.
Specific conditions: Uncontrolled diabetes, thyroid problems, and Kawasaki disease have been linked to Beau’s lines.
Pemphigus
Viral infections (eg, hand, foot, and mouth disease)
Local cutaneous disease (eg, dermatitis, paronychia)

Beau line

Appearance:

Beau’s lines typically appear as a groove or indentation that runs horizontally across the nail plate.

They start at the base of the nail (proximal nail fold) and grow out as the nail grows.

The width of the line can indicate the duration of the underlying condition.

Treatment:

Beau’s lines themselves are not harmful and will disappear as the nail grows out.

The focus of treatment is to address the underlying cause of the nail growth disruption.

Once the underlying condition is resolved, new, smooth nail growth will resume.

Nails grow slowly, so it can take several months for Beau’s lines to completely grow out.

What forms Pneumoatocoeles in Pneumonia? (My doctor said there is air bubble in my lungs)

How are pneumatoceles formed in Pneumonia?

~~Table of Contents(toc)~~

Pneumatocoeles form when the alveoli or lung tissue become inflamed and air-filled cavities develop due to the rupture of alveolar walls in severe pneumonia. This occurs when the inflammation causes a breakdown of the lung parenchyma, leading to trapped air and the formation of these cystic spaces.

Pneumoatoceles in CE CT chest

Characteristic feature of staphylococcal pneumonias.

Cavitation (single or multiple thick walled cavities) may be bilateral.
Pleural effusion/ Empyema with or without branchopleural fistulas (Pyopneumothorx).
Abscess formation.

Bacterial pneumonia are with cavitation:

Here is list of bacteria that form cavitary pneumonia:

Staphylococcus
Kleibsella
Pseudomonas
Anaeroic bacteria

Model MCQ

1. Pneumatocoele caused by:

a. E. Coli
b. Staphylococus
c. Streptococcus
d. P. carinii

Ans: ‘b’

Solution

Pneumatocoeles are thin walled cystic spaces that may contain air fluid levels is the characteristic feature of staphylococcal pneumonias.

Dog Bite and Rabies Protocol of Nepal 2025 update

Dog Bite and Rabies Protocol of Nepal 2023

~~(toc)Table of Contents~~

Introduction

Welcome to this comprehensive video on health exam questions that you might
face in Loksewa Entrance MBBS/MD/MS and PSC exams in Nepal. This video
provides you with essential tips and strategies to help you prepare
efficiently and excel in these competitive exams.

Immediate First Aid for Dog Bites:

If a dog bite occurs, immediate first aid is vital to minimize the risk of
infection and complications. Follow these steps:

Wash the wound gently with soap and water to reduce the risk of
infection.
Apply direct pressure with a clean cloth to control bleeding, if any.
Elevate the affected area if possible.
Cover the wound with a sterile bandage or clean cloth.
Seek medical attention, especially if the wound is deep, large, or shows
signs of infection.

Medical Assessment and Treatment:

A prompt medical evaluation is essential, even for seemingly minor dog
bites. A healthcare professional will assess the wound’s severity, potential
risk of infection, and the need for
tetanus vaccination
or antibiotics. In some cases, they may recommend rabies prophylaxis,
depending on the dog’s vaccination status and the risk of rabies exposure.

Monitoring for Complications:

Following medical treatment, closely monitor the wound for signs of
infection, such as increased redness, swelling, warmth, or pus formation.
Seek immediate medical attention if any complications arise.

Remember, responsible pet ownership, education, and awareness are key
factors in reducing the incidence of dog bites and fostering a safe
environment for both humans and dogs. By working together, we can promote a
harmonious relationship between people and their furry companions while
minimizing the risk of dog bite injuries.

Thank you for watching.

Please like, share and subscribe for more
informations. See you.

Video on dog bite:

Thank you

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“@type”: “VideoObject”,
“name”: “You should do this if a dog bites you #dogbite #biology #medic #medicine #rabies #woundhealing”,
“description”: “Immediate First Aid for Dog Bites:
If a dog bite occurs, immediate first aid is vital to minimize the risk of infection and complications. Follow these steps:
Wash the wound gently with soap and water to reduce the risk of infection.
Apply direct pressure with a clean cloth to control bleeding, if any.
Elevate the affected area if possible.
Cover the wound with a sterile bandage or clean cloth.
Seek medical attention, especially if the wound is deep, large, or shows signs of infection.
Medical Assessment and Treatment:
A prompt medical evaluation is essential, even for seemingly minor dog bites. A healthcare professional will assess the wound’s severity, potential risk of infection, and the need for tetanus vaccination or antibiotics. In some cases, they may recommend rabies prophylaxis, depending on the dog’s vaccination status and the risk of rabies exposure.
Monitoring for Complications:
Following medical treatment, closely monitor the wound for signs of infection, such as increased redness, swelling, warmth, or pus formation. Seek immediate medical attention if any complications arise.
Remember, responsible pet ownership, education, and awareness are key factors in reducing the incidence of dog bites and fostering a safe environment for both humans and dogs. By working together, we can promote a harmonious relationship between people and their furry companions while minimizing the risk of dog bite injuries.
Thank you for watching.”,
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How to manage Dogbite: Handbook of rabies in Nepali 2025

Handbook of rabies in Nepali 2025 रेबिज रोग बारे जानकारी हाते पुस्तिका

Rabies disease handbook protocol Nepal

~~Table of Contents (toc)~~

Introduction

Rabies is a viral illness that leades to neurological complication, muscle spastic paralysis and inevitable death and is transmitted by the mammal bite especially dogs.

Watch dogbite management video by clicking this image icon:

Click to watch video

Its very common in Nepal and goverment does free postexposure vaccination all over nepal.

रेबिज रोग बारे जानकारी हाते पुस्तिका (download rabies handbook)

कृपया सेयर गरि सबैलाई जानकारी दिनु होला।

Download rabies handbook here

पढ्नुभएकोमा धन्यवाद!

What are the Chlorine compounds used for disinfecting and sanitation purpose?

Chlorine tab

Chlorine gas

Perchloran

How do chlorine tablets work?

Chemical Reactions for Pool Chlorine in Water

Possible MCQ

Solution

18 Differential diagnoses of ST elevation

What is ECG?

What is ST segment in an ECG?

What are causes of ST Segment elevation?

Should I get an ECG done to check ST segment elevation?

What is an 12 lead ECG?

What is position of leads in 12 lead ECG?

What is knee jerk?

How does knee jerk work?

What is Use of Knee Jerk in daily life?

What are Associated Conditions with abnormal Knee Jerk reflex:

Upper Motor Neuron (UMN) Lesions (Hyperreflexia)

Lower Motor Neuron (LMN) Lesions (Hyporeflexia or Absent Reflex)

Question for practice

Delayed relaxation of ankle jerk is seen in:

Explanation

MCQ 2:

A 60-year-old male presents with weakness in both lower limbs and increased knee jerk reflexes. Which of the following is the most likely cause?

Explanation:

What is red eye?

Here’s a more detailed explanation on why eye becomes suddenly red:

What is a subconjunctival hemorrhage?

Cause:

Appearance:

Common causes:

Other causes:

Symptoms:

When to seek medical attention:

Recurrent hemorrhages:

Other symptoms:

Suspected eye injury:

Bleeding elsewhere:

Treatment and Prognosis:

No need for treatment:

Symptom relief:

Other causes of red eyes

Is Jimbu Good for our Health?

What is Jimbu?

Jimbu in English

Health Benefits if Jimbu

Jimbu Substitute as taste enhancer

Conclusion

Why is my baby’s heart rate fast?

Why do babies have high heart and respiratory rate?

What is the normal heart rate for my baby?

What is normal respiratory rate for my baby?

Causes of Fast Heart rate in Children:

1. Fever

2. Physical Activity or Exercise

3. Stress or Anxiety

4. Pain

5. Dehydration

6. Anemia

7. Infections

8. Respiratory Issues

9. Hyperthyroidism

10. Congenital Heart Conditions

11. Caffeine or Stimulants

12. Electrolyte Imbalance

13. Shock

14. Hypoxia

15. Medications

16. Hyperventilation

17. Electrocardiographic Abnormalities

18. Hypoglycemia (Low Blood Sugar)

19. Toxin or Drug Poisoning

20. Heat Stroke or Heat Exhaustion

21. Severe Allergic Reactions (Anaphylaxis)

Causes of Fast breathing rate in Children:

1. Respiratory Infections

2. Asthma

3. Allergic Reactions

When to visit a dctor if my baby if breathing fast or heart beat is too
fast?