How to perform ABG and interpretation ABG analysis results

How to perform and interpret ABG analysis

Introduction to ABG:

ABG stands for arterial blood gas. ABG is a common test done in case of critical care and severely ill patient to know the arterial bloog gas status of the patient along with various other parameters.

Sample for ABG analysis

Normal ABG value ranges:

ABG practice questions:

Normal lab test ranges and values for common tests

Blood collection tubes: Normal lab test ranges and values for common tests

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Introduction

How to read and ECG: Mnemonic for ECG reading fast

Introduction

A structured approach makes ECG interpretation systematic and reliable. A commonly used mnemonic is:

RRAHI

R = Rhythm
R = Rate
A = Axis
H = Hypertrophy
I = Ischemia

How to Calculate Heart Rate in Regular Rhythm ECG

For a regular rhythm, use either of the following methods:

Method 1 (Big boxes)

Take any two R waves
Count the number of big boxes between them
Divide 300 by that number
The result is the heart rate

Method 2 (Small boxes)

Take any two R waves
Count the number of small boxes between them
Divide 1500 by that number
The result is the heart rate

How to Calculate Heart Rate in Irregular Rhythm ECG

For irregular rhythms, use a longer rhythm strip:

Take 10 big boxes in the rhythm strip
Count the number of QRS complexes (R waves) within those 10 big boxes
Multiply that number by 30

👉 This gives the heart rate in beats per minute (bpm)

Completed Formula

Heart rate = (Number of QRS complexes in 10 big boxes) × 30

Why this works:

1 big box = 0.2 seconds
10 big boxes = 2 seconds
60 seconds ÷ 2 seconds = 30

So you are converting a 2-second sample into a 1-minute rate.

How to Check Rhythm of an ECG

To determine the rhythm:

Check if R–R intervals are regular or irregular
Look for P waves before every QRS complex
Ensure P waves have a consistent shape
Confirm that each P wave is followed by a QRS

Normal (Sinus Rhythm) Features:

Regular rhythm
One P wave before each QRS
Normal PR interval
Heart rate between 60–100 bpm

How to Check Axis of an ECG

Axis refers to the overall direction of electrical activity in the heart.

Basic Method (using limb leads):

Look at Lead I and aVF

Lead I	aVF	Axis
+	+	Normal axis
+	–	Left axis deviation
–	+	Right axis deviation
–	–	Extreme axis deviation

Normal Axis:

Between -30° to +90°

The electrical impulse normally:

Starts from the right atrium
Travels toward the left ventricle
Occurs 60–100 times per minute

How to Identify Myocardial Ischemia on ECG

Look for these three key changes:

ST segment changes
- Elevation → possible acute injury
- Depression → ischemia
T wave changes
- Inversion
- Flattening
Q waves
- May indicate previous myocardial infarction

How to Identify Hypertrophy on ECG

Hypertrophy leads to increased voltage (amplitude) on ECG.

Left Ventricular Hypertrophy (LVH)

A commonly used method:

S wave in V1 + R wave in V5 or V6 ≥ 35 mm

Additional clues:

Deep S waves in V1
Tall R waves in V5/V6
Possible left axis deviation

This completes the full ECG reading framework using the RRAHI approach, covering all essential steps: rate, rhythm, axis, hypertrophy, and ischemia.

Thyroid function test: TFT how to interpret TFT and know these dangerous disease at home

Core Tests

TSH (Thyroid Stimulating Hormone) → most sensitive
Free T4 (FT4) → active hormone
Free T3 (FT3) → useful in hyperthyroidism
± Antibodies:
- Anti-TPO
- TRAb (TSH receptor antibody)

Step 1: Look at TSH first

          TSH
        /  |   \
     Low Normal High

IF TSH LOW → Think Hyperthyroid OR Central Hypothyroid

TSH ↓
  |
  ├── FT4 ↑ / FT3 ↑ → PRIMARY HYPERTHYROIDISM
  │        (e.g. Graves', toxic nodules)
  │
  ├── FT3 ↑ only → T3 TOXICOSIS
  │
  ├── FT4 normal, FT3 normal → SUBCLINICAL HYPERTHYROIDISM
  │
  └── FT4 ↓ → CENTRAL (SECONDARY) HYPOTHYROIDISM
           (pituitary/hypothalamic disease)

Diagnoses

Graves’ disease
Toxic multinodular goiter
T3 toxicosis
Central hypothyroidism

IF TSH HIGH → Think Hypothyroidism

TSH ↑
  |
  ├── FT4 ↓ → PRIMARY HYPOTHYROIDISM
  │        (thyroid gland failure)
  │
  ├── FT4 normal → SUBCLINICAL HYPOTHYROIDISM
  │
  └── FT4 ↑ → RARE:
           - TSH-secreting adenoma
           - Thyroid hormone resistance

Diagnoses

Hashimoto thyroiditis
Iodine deficiency
Post-thyroidectomy
TSH-secreting pituitary adenoma

IF TSH NORMAL → Check FT4/FT3 carefully

TSH normal
  |
  ├── FT4 ↓ → CENTRAL HYPOTHYROIDISM
  │
  ├── FT4 ↑ → TSHOMA / RESISTANCE
  │
  └── FT4 normal → EUTHYROID

SUMMARY FLOWCHART (HIGH-YIELD)

                TSH
         ┌──────┼──────┐
        ↓       N       ↑
        |       |       |
     Check     Check    Check
     FT4/FT3   FT4      FT4
        |       |        |
   ┌────┼───┐   |    ┌───┼────┐
  ↑     N   ↓   |   ↓    N     ↑
Hyper Subclin Central   Primary Subclin Rare
thyroid hyper  hypo     hypo    hypo   causes

SPECIAL PATTERNS (EXAM FAVORITES)

1. Euthyroid Sick Syndrome

TSH: normal/low
FT3: ↓ (early)
FT4: ↓ (late)

👉 Seen in severe illness (ICU patients)

2. Subclinical Disease

Condition	TSH	FT4
Subclinical hyperthyroidism	↓	Normal
Subclinical hypothyroidism	↑	Normal

3. Pregnancy Changes

TSH ↓ (1st trimester)
FT4 slightly ↑ early

4. Drug Effects

Amiodarone → hypo OR hyper
Steroids → ↓ TSH
Lithium → hypothyroidism

MEMORY TRICKS

“TSH runs opposite to thyroid hormones”

↑ TSH = ↓ thyroid function (usually)
↓ TSH = ↑ thyroid function

“Think CENTRAL if TSH doesn’t match FT4”

Low TSH + Low FT4 → pituitary problem
Normal TSH + Low FT4 → pituitary problem

“Subclinical = TSH abnormal, FT4 normal”

QUICK CLINICAL PROTOCOL

Suspected Hypothyroidism

Check TSH
If ↑ → check FT4
If FT4 ↓ → treat
If FT4 normal → monitor / anti-TPO

Suspected Hyperthyroidism

Check TSH
If ↓ → check FT4, FT3
If elevated → confirm cause:
- TRAb → Graves’ disease
- Scan → nodules

Suspected Pituitary Disease

Always check:
- FT4
- TSH (may be misleading)

COMMON PITFALLS

Relying only on TSH in pituitary disease
Ignoring FT3 in hyperthyroidism
Misinterpreting illness-related changes

ULTRA-SHORT REVISION

TSH ↑ + FT4 ↓ → Primary hypothyroid
TSH ↓ + FT4 ↑ → Hyperthyroid
TSH ↑ + FT4 normal → Subclinical hypo
TSH ↓ + FT4 normal → Subclinical hyper
TSH ↓ + FT4 ↓ → Central hypothyroid

RFT- Renal function test (notes summary)

RFT- Renal function test: Indication, Interpretatin, Normal Range

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Introduction of Renal Function Test (RFT)

Renal Function Tests (RFTs) are a group of blood and urine tests used to assess the health and efficiency of the kidneys. These tests help in evaluating how well the kidneys are filtering waste products, maintaining electrolyte balance, and regulating fluid levels in the body.

RFTs are essential tools in diagnosing and monitoring kidney diseases, as well as in managing systemic conditions like hypertension and diabetes that can impact kidney function.

By analyzing key parameters such as serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and electrolytes, healthcare providers can detect early signs of renal impairment and initiate appropriate interventions.

Indications for RFT

Suspected kidney disease
Hypertension
Diabetes mellitus (routine monitoring)
Urinary tract infections (recurrent or severe)
Edema (swelling of legs/face)
Hematuria (blood in urine)
Proteinuria (protein in urine)
Monitoring patients on nephrotoxic drugs (e.g., aminoglycosides, NSAIDs)
Preoperative assessment
Chronic kidney disease (CKD) follow-up

Components of RFT

Serum Creatinine
Blood Urea Nitrogen (BUN) / Urea
Estimated Glomerular Filtration Rate (eGFR)
Serum Electrolytes (Na⁺, K⁺, Cl⁻, HCO₃⁻)
Urinalysis (protein, glucose, blood, specific gravity)
Creatinine Clearance (if needed)

Normal Ranges

(Note: may vary slightly by lab)

Serum Creatinine:

Males: 0.7 – 1.3 mg/dL
Females: 0.6 – 1.1 mg/dL

Blood Urea Nitrogen (BUN): 7 – 20 mg/dL
Urea (alternative to BUN): 20 – 40 mg/dL
eGFR:

Normal: >90 mL/min/1.73 m²
Mild decrease: 60–89
Moderate: 30–59
Severe: 15–29
Kidney failure: <15

Creatinine Clearance: 90 – 140 mL/min
Serum Sodium (Na⁺): 135 – 145 mEq/L
Serum Potassium (K⁺): 3.5 – 5.0 mEq/L
Serum Bicarbonate (HCO₃⁻): 22 – 29 mEq/L

Interpretation

↑ Creatinine & BUN: Indicates impaired renal function or acute/chronic kidney disease
↓ eGFR: Suggests declining kidney function
↑ Potassium (Hyperkalemia): Common in advanced renal failure
↓ Sodium (Hyponatremia): Seen in fluid overload or renal salt wasting
Urinalysis:

Proteinuria: Indicates glomerular damage
Hematuria: Suggests infection, stones, or glomerulonephritis
Low Specific Gravity: May suggest tubular dysfunction

Ultrasound – The Video Xray

What is Ultrasound – The Video Xray? is it harmful to our body?

Getty images used with permission

Introduction

Use of video x ray

benefits of video x ray

Risks of video x ray

Side effects of video x ray

Conclusion

MCQ models

Random blood sugar(RBS) Know if You’re Diabetic easily 2026 (Diabetes Criteria)

Normal Blood Glucose

FPG <100 mg/dL (5.6 mmol/L)
Two-hour glucose during OGTT <140 mg/dL (7.8 mmol/L)

Categories of increased risk for diabetes:

Impaired fasting glucose(IFG) –

FPG between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
Impaired glucose tolerance(IGT)–
Two-hour – 75 g OGTT between 140 and 199 mg/dL (7.8 to 11.0 mmol/L).

A1C –

Persons with 5.7 to 6.4 percent (39 to 46 mmol/mol

Criteria for diagnosis of diabetes mellitus

A1C ≥6.5 percent OR
Fasting Plasma Glucose ≥126 mg/dL (7.0 mmol/L) (Fasting is defined as no caloric intake for at least eight hours.) OR
Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT. (The test should be performed using a glucose load containing the equivalent of 75-gram anhydrous glucose dissolved in water.) OR
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).

DIABETIC DIET

10 Diabetes MCQs for competitive exams

Please learn to read a Lipid profile report

Lipid profile- Know the danger of cholesterol in a single test

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Introduction Lipid panel

Lipid simply means fat or cholesterol in general.

But lipid profile contains multiple parameters viz. Total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein and very low density lipoprotein.

These all parameters have their own reference range and own function in our body.

Now we will discuss each of the above aprameter individually.

Parameters that are measuted in lipid profile

Here are the parameters measured in Lipid profile

Total cholesterol
triglycerides
high density lipoprotein
low density lipoprotein
very low density lipoprotein

Total Cholesterol

Reference ranges:

< 200 mg/dL (Desirable)

• 200–239 mg/dL: Borderline high

• ≥ 240 mg/dL: High

Triglycerides

Reference ranges:

< 150 mg/dL (Normal)

• 150–199 mg/dL: Borderline high

• 200–499 mg/dL: High

• ≥ 500 mg/dL: Very high

High density lipoprotein

Reference ranges:

Men: > 40 mg/dL (Optimal)

• Women: > 50 mg/dL (Optimal)

• ≥ 60 mg/dL is considered protective against heart disease

Low density lipoprotein

Reference ranges:

Optimal: < 100 mg/dL

• 100–129 mg/dL: Near optimal

• 130–159 mg/dL: Borderline high

• 160–189 mg/dL: High

• ≥ 190 mg/dL: Very high

Very low density lipoprotein

Reference ranges: 5–30 mg/dL (Normal range)

Atherosclerosis risk of deranged lipid profile
Heart disease risk of deranged lipid profile
Arterial plaque buildup of deranged lipid profile
Coronary artery disease and deranged lipid profile
Cardiovascular health and deranged lipid profile
Cholesterol testing
Lipid profile interpretation
Cholesterol management
Dietary cholesterol impact
Lifestyle modifications
Statins and cholesterol control
Exercise and cholesterol levels
Genetic predisposition to high cholesterol
Importance of regular lipid screening

Nepal pharmacy council result notice 2080

Nepal pharmacy council has published result of license exam held on 2080. The result can be viewed in the pdf below.

Results summary of pharmacy council license exam

नेपाल फार्मेसि परिषद्को 22 औ नाम दर्ता परीक्षाको फार्मेसि

Total number of applicants सहायक को परिक्षा मा उपस्थित आवेदक सन्ख्या : १३९२

Pass number उत्तीर्ण संख्या : ४८७

Only: 35% Results 😊

Final Result 22th License Exam pharmacy

208 Pass Out of 251thank you for reading! Please download full result below.

Please write to us if you have any queries.

If you also want to preparation clases please contact us.

About Nepal pharmacy council

Nepal pharmacy council is regulatory body of Pharmacists and their practice in Nepal stabilished under laws of Nepal. All the pharmacists in order to work in Nepal should be registered and received a valid license.

You can read more here.

Nepal Health Professional Council Act, 2053

Act No. 30 of the year 2053.11.3 (1997 A.D.)

An Act made to make provisions regarding Health Professional Council

Preamble

Whereas, it is expedient to establish a Health Professional Council to make more effective the health services in Nepal, to mobilize the services of health professionals except the qualified doctors and nurses to be registered with the Medical Council in a managed and scientific manner and make provisions on the registration of their names according to their qualifications;

Be it enacted by the Parliament in the twenty fifth year of reign of His Majesty King Birendra Bir Bikram Shah Dev.

Dr health rx

Short title and commencement:

a. This Act may be called as the “Nepal Health Professional Council Act, 2053 (1997)”.

b. It shall come into force in such place and on such date as the Government of Nepal may, by a notification in the Nepal Gazette, appoint.

Establishment of Council:

A Health Professional Council is hereby established for the operation of health services in a systematic manner and registration of the names of health professional according to the qualifications.

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Formation of Council:

1. The Council established pursuant to Section 3 shall consist of the members as follows:

a. A person nominated by the Government of Nepal from amongst the persons who, having obtained at least bachelor degree in a subject related with health profession, have been involved in the health service for at least five years –Chairperson

b. Chairperson of Nepal Health Technician Association or a representative designated by him/her –Member

c. Chairperson of Nepal Pharmaceuticals Association or a representative designated by him/her –Member

d. Chairperson of Nepal Radiological-3 Society or a representative designated by him/her-Member

e. Three registered health professionals nominated by the Government of Nepal from the pathology, physiotherapy and public health, on recommendation of the Nepal Health Technician Association –Member

f. Four health professionals elected by the registered health professionals from amongst themselves, as prescribed -Member

g. Dean of the Institute of Medical Sciences or a representative designated by him/her-Member

2. The Government of Nepal may make alteration in the members of the Council, in consultation with the Council, and by a notification published in the Nepal Gazette.

3. If the Council considers necessary, it may invite any native or foreign specialist in medical profession to attend, as an observer, in its meeting.

4. Pending the formation of the Council, the Government of Nepal may form a committee covering the areas as referred to in Section 4 for the performance of the functions required to be performed by the Council. The term of the committee so formed shall be one year in maximum.

Council to be corporate body:

1. The Council shall be an autonomous body corporate with perpetual succession.

2. The Council shall have a separate seal of its own for all of its activities.

3. The Council may, like an individual, acquire, use, sell and dispose of, or otherwise manage, any movable and immovable property.

4. The Council may, like an individual, sue by its name and be also sued by the same name.

NHPC form fill up

Fund of Council:

1. The Council shall have a separate fund of its own.

2. The fund of the Council shall consist of the following amounts

a. Amounts received from the Government of Nepal,

b. Amounts obtained as the fee for the registration of name of health professional.

c. Amounts received from any other sources.

3. The operation of the fund of the Council shall be as prescribed.

Accounts and audit:

1. The accounts of the incomes and expenditures of the Council shall be maintained as prescribed.

2. The audit of the Council shall be performed as prescribed.

3. The Government of Nepal may, if it so desires, inspect, or cause to be inspected, the accounts of the fund of the Council at any time.

Term of member:

1. The term of office of the nominated or elected members of the Council shall be three years. The members whose term of office has expired may be eligible to be re-nominated or elected.

2. If the office of any member falls vacant prior to the expiration of the term of office, another member shall be nominated or elected for the remainder of term.

Dissolution of Council:

1. If the Government of Nepal thinks that the Council has failed to exercise the powers conferred to it pursuant to this Act or the Rules framed under this Act or has abused powers or used excessive powers or failed to perform its duties pursuant to this Act and the Rules framed under this Act, it may dissolve the Council.

2. After the dissolution of the Council pursuant to Sub-section (1), the Government of Nepal shall take custody of the fund and other assets of the Council, and pending the formation of another council, it may itself perform all such powers as required to be performed by the Council pursuant to this Act and the Rules or cause to be exercised such functions by a committee formed by it.

3. The Government of Nepal shall form a new council pursuant to Section 3 generally within three months after the dissolution of the Council pursuant to Sub-section (1).

4. The Government of Nepal shall hand over the fund and assets held by it in its custody pursuant to Sub-section (2) to a new council after the formation of such council.

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Thsnk you.