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NMCLE Model Questions : NMCLE license exam Nepal

Here are 50 multiple choice questions suitable for a medical graduate

1. Which of the following is the primary neurotransmitter involved in the pathophysiology of Alzheimer’s disease?

   A) Serotonin

   B) Dopamine

   C) Acetylcholine

   D) GABA

2. Which of the following is the drug of choice for treating acute asthma exacerbations?

   A) Albuterol

   B) Montelukast

   C) Ipratropium

   D) Fluticasone

3. In which part of the nephron does glucose reabsorption primarily occur?

   A) Proximal convoluted tubule

   B) Loop of Henle

   C) Distal convoluted tubule

   D) Collecting duct

4. Which of the following hormones is responsible for the regulation of calcium levels in the blood?

   A) Insulin

   B) Thyroxine

   C) Parathyroid hormone

   D) Aldosterone

5. Which of the following is the most common type of kidney stone?

   A) Uric acid

   B) Calcium oxalate

   C) Cystine

   D) Struvite

6. Which of the following is a characteristic of rheumatoid arthritis?

   A) Presence of HLA-B27 antigen

   B) Symmetric joint involvement

   C) Presence of tophi

   D) Joint deformities with sparing of the small joints

7. Which of the following is a first-line treatment for uncomplicated urinary tract infections?

   A) Ciprofloxacin

   B) Trimethoprim-sulfamethoxazole

   C) Ampicillin

   D) Metronidazole

8. Which of the following is the most common cause of community-acquired pneumonia?

   A) Streptococcus pneumoniae

   B) Haemophilus influenzae

   C) Legionella pneumophila

   D) Mycoplasma pneumoniae

9. Which of the following is a characteristic of Addison’s disease?

   A) Hyperpigmentation

   B) Hypertension

   C) Hypernatremia

   D) Hyperglycemia

10. Which of the following conditions is characterized by a deficiency of von Willebrand factor?

    A) Hemophilia A

    B) Hemophilia B

    C) von Willebrand disease

    D) Factor V Leiden deficiency

11. Which of the following is the most accurate method for confirming the diagnosis of peptic ulcer disease?

    A) Upper gastrointestinal endoscopy

    B) Barium swallow

    C) Serum gastrin levels

    D) Stool antigen test for H. pylori

12. Which of the following is the first-line treatment for acute otitis media in children?

    A) Amoxicillin

    B) Azithromycin

    C) Ceftriaxone

    D) Trimethoprim-sulfamethoxazole

13. Which of the following is a classic triad of symptoms seen in Parkinson’s disease?

    A) Bradykinesia, hyperreflexia, and dystonia

    B) Resting tremor, bradykinesia, and rigidity

    C) Ataxia, nystagmus, and dysarthria

    D) Hyperkinesia, chorea, and athetosis

14. Which of the following is the most appropriate initial management for a patient with status epilepticus?

    A) Intravenous lorazepam

    B) Intramuscular diazepam

    C) Oral phenytoin

    D) Subcutaneous midazolam

15. Which of the following is the primary mechanism of action of aspirin in cardiovascular disease prevention?

    A) Inhibition of platelet aggregation

    B) Decrease in LDL cholesterol levels

    C) Vasodilation of coronary arteries

    D) Enhancement of fibrinolysis

16. Which of the following is a key feature of acute tubular necrosis?

    A) Elevation of serum uric acid levels

    B) Oliguria with muddy brown casts in urine

    C) Hyperkalemia

    D) Hypoalbuminemia

17. Which of the following medications is contraindicated in patients with a sulfa allergy?

    A) Furosemide

    B) Lisinopril

    C) Metoprolol

    D) Amlodipine

18. Which of the following conditions is associated with Cushing’s syndrome?

    A) Hypocortisolism

    B) Hypertension

    C) Hyperkalemia

    D) Hypoglycemia

19. Which of the following vaccines is recommended for all adults over 65 years of age?

    A) Varicella

    B) MMR (measles, mumps, rubella)

    C) Pneumococcal polysaccharide

    D) Human papillomavirus (HPV)

20. Which of the following is the most common cause of bacterial meningitis in adults?

    A) Streptococcus pneumoniae

    B) Neisseria meningitidis

    C) Haemophilus influenzae

    D) Listeria monocytogenes

21. Which of the following is a common side effect of statin therapy?

    A) Hyperkalemia

    B) Rhabdomyolysis

    C) Hypoglycemia

    D) Hypertension

22. Which of the following is a characteristic feature of nephrotic syndrome?

    A) Hematuria

    B) Proteinuria >3.5 grams per day

    C) Hypoalbuminemia

    D) Hyperkalemia

23. Which of the following is the primary pharmacological treatment for bipolar disorder?

    A) Sertraline

    B) Lithium

    C) Fluoxetine

    D) Venlafaxine

24. Which of the following conditions is characterized by the presence of anti-glomerular basement membrane antibodies?

    A) Goodpasture syndrome

    B) Wegener’s granulomatosis

    C) Henoch-Schönlein purpura

    D) Microscopic polyangiitis

25. Which of the following is the primary treatment for uncomplicated acute appendicitis?

    A) Intravenous antibiotics

    B) Laparoscopic appendectomy

    C) Observation and supportive care

    D) Oral corticosteroids

26. Which of the following is a key feature of type 1 diabetes mellitus?

    A) Insulin resistance

    B) Ketosis-prone state

    C) Obesity

    D) Gradual onset of symptoms

27. Which of the following is a characteristic feature of multiple sclerosis?

    A) Asymmetric motor weakness

    B) Normal cerebrospinal fluid analysis

    C) Improvement of symptoms with exercise

    D) Peripheral neuropathy

28. Which of the following is the most common site for ectopic pregnancy?

    A) Fallopian tube

    B) Ovary

    C) Uterine cervix

    D) Abdominal cavity

29. Which of the following medications is commonly used for the treatment of attention deficit hyperactivity disorder (ADHD)?

    A) Risperidone

    B) Methylphenidate

    C) Lamotrigine

    D) Fluoxetine

30. Which of the following is a key feature of Kawasaki disease?

    A) Desquamation of the skin of the palms and soles

    B) Target-like lesions on the mucous membranes

    C) Pitting edema of the lower extremities

    D) Oral ulcers

31. Which of the following is the most common cause of chronic kidney disease worldwide?

    A) Diabetic nephropathy

    B) Hypertensive nephrosclerosis

    C) Glomerulonephritis

    D) Polycystic kidney disease

32. Which of the following is a first-line treatment for acute angle-closure glaucoma?

    A) Timolol eye drops

    B) Acetazolamide

    C) Pilocarpine eye drops

    D) Latanoprost eye drops

33. Which of the following is a characteristic feature of preeclampsia?

    A) Hypertension and proteinuria after 20 weeks of gestation

    B) Severe abdominal pain and vaginal bleeding

    C) Absent fetal heart sounds

    D) Excessive fetal movement

34. Which of the following is the primary mechanism of action of methotrexate in the treatment of rheumatoid arthritis?

    A) Inhibition of cyclooxygenase

    B) Suppression of T cell activation

    C) Stimulation of insulin secretion

    D) Enhancement of serotonin reuptake

35. Which of the following is a key feature of acute pancreatitis?

    A) Hypocalcemia

    B) Hypoglycemia

    C) Hypernatremia

    D) Hyperbilirubinemia

36. Which of the following is a common side effect of angiotensin-converting enzyme (ACE) inhibitors?

    A) Hyperkalemia

    B) Hypocalcemia

    C) Hypertension

    D) Hyperglycemia

37. Which of the following is the most common risk factor for developing primary open-angle glaucoma?

    A) Myopia

    B) Diabetes mellitus

    C) Hypertension

    D) Age

38. Which of the following is the first-line treatment for anaphylaxis?

    A) Epinephrine

    B) Diphenhydramine

    C) Albuterol

    D) Prednisone

39. Which of the following is the primary mechanism of action of warfarin?

    A) Inhibition of vitamin K epoxide reductase

    B) Inhibition of thromboxane A2 synthesis

    C) Inhibition of platelet aggregation

    D) Enhancement of fibrinolysis

40. Which of the following conditions is associated with an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)?

    A) Polycythemia vera

    B) Temporal arteritis

    C) Essential thrombocythemia

    D) Iron deficiency anemia

41. Which of the following is the primary mechanism of action of inhaled corticosteroids in the treatment of asthma?

    A) Inhibition of leukotriene synthesis

    B) Inhibition of mast cell degranulation

    C) Suppression of airway inflammation

    D) Relaxation of bronchial smooth muscle

42. Which of the following is a characteristic feature of Graves’ disease?

    A) Low serum T3 and T4 levels

    B) Hypotension

    C) Exophthalmos

    D) Bradycardia

43. Which of the following is the most appropriate initial management for a patient with suspected acute coronary syndrome?

    A) Aspirin and nitroglycerin

    B) Intravenous heparin

    C) Inhaled albuterol

    D) Oral metoprolol

44. Which of the following is the most common cause of bacterial meningitis in neonates?

    A) Group B Streptococcus

    B) Escherichia coli

    C) Listeria monocytogenes

    D) Haemophilus influenzae

45. Which of the following is a key feature of Guillain-Barré syndrome?

    A) Ascending muscle weakness and areflexia

    B) Progressive dementia and ataxia

    C) Fluctuating muscle weakness and fatigability

    D) Sensory loss and autonomic dysfunction

46. Which of the following is the primary mechanism of action of alendronate in the treatment of osteoporosis?

    A) Inhibition of osteoclast activity

    B) Stimulation of osteoblast activity

    C) Inhibition of vitamin D synthesis

    D) Enhancement of calcium absorption

47. Which of the following is a characteristic feature of polycystic ovary syndrome (PCOS)?

    A) Hypermenorrhea

    B) Hypogonadism

    C) Hyperglycemia

    D) Multiple ovarian cysts on ultrasound

48. Which of the following is a common side effect of selective serotonin reuptake inhibitors (SSRIs)?

    A) Weight gain

    B) Bradycardia

    C) Hypotension

    D) Sexual dysfunction

49. Which of the following is the most appropriate initial management for a patient with diabetic ketoacidosis (DKA)?

    A) Intravenous insulin and fluid replacement

    B) Oral hypoglycemic agents

    C) Intramuscular glucagon

    D) Oral sodium bicarbonate

50. Which of the following is a key feature of acute angle-closure glaucoma?

    A) Gradual onset of symptoms

    B) Blurred vision and halos around lights

    C) Normal intraocular pressure

    D) Improvement of symptoms with mydriatics

Answer Key:

1. C) Acetylcholine

2. A) Albuterol

3. A) Proximal convoluted tubule

4. C) Parathyroid hormone

5. B) Calcium oxalate

6. B) Symmetric joint involvement

7. B) Trimethoprim-sulfamethoxazole

8. A) Streptococcus pneumoniae

9. A) Hyperpigmentation

10. C) von Willebrand disease

11. A) Upper gastrointestinal endoscopy

12. A) Amoxicillin

13. B) Resting tremor, bradykinesia, and rigidity

14. A) Intravenous lorazepam

15. A) Inhibition of platelet aggregation

16. B) Oliguria with muddy brown casts in urine

17. A) Furosemide

18. B) Hypertension

19. C) Pneumococcal polysaccharide

20. A) Streptococcus pneumoniae

21. B)Rhabdomyolysis

22. B) Proteinuria >3.5 grams per day

23. B) Lithium

24. A) Goodpasture syndrome

25. B) Laparoscopic appendectomy

26. B) Ketosis-prone state

27. A) Asymmetric motor weakness

28. A) Fallopian tube

29. B) Methylphenidate

30. A) Desquamation of the skin of the palms and soles

31. A) Diabetic nephropathy

32. A) Timolol eye drops

33. A) Hypertension and proteinuria after 20 weeks of gestation

34. B) Suppression of T cell activation

35. A) Hypocalcemia

36. A) Hyperkalemia

37. D) Age

38. A) Epinephrine

39. A) Inhibition of vitamin K epoxide reductase

40. B) Temporal arteritis

41. C) Suppression of airway inflammation

42. C) Exophthalmos

43. A) Aspirin and nitroglycerin

44. A) Group B Streptococcus

45. A) Ascending muscle weakness and areflexia

46. A) Inhibition of osteoclast activity

47. D) Multiple ovarian cysts on ultrasound

48. D) Sexual dysfunction

49. A) Intravenous insulin and fluid replacement

50. B) Blurred vision and halos around lights

Nepal Medical Council (NMC) : Download NMC act 2020

Nepal Medical Council (NMC) with NMC act 2020

(toc)

Introduction

The Nepal Medical Council plays a crucial role in regulating the medical profession in Nepal. It’s like a guardian, ensuring that healthcare providers meet the standards necessary to serve the people. From doctors to nurses, it oversees their qualifications and practices to ensure quality care for all Nepali citizens.
Established by law, the Nepal Medical Council ensures that healthcare professionals are properly trained and licensed. It’s like a quality control system, making sure that those who treat patients are skilled and competent. This helps in maintaining trust between patients and healthcare providers, ensuring safety and reliability in medical services across the country.
Through its regulations and oversight, the Nepal Medical Council strives to uphold the integrity of the medical profession. It acts as a guiding hand, setting standards and guidelines for medical education and practice. This ensures that healthcare services in Nepal are delivered with professionalism, ethics, and the highest possible quality.

NMC act 2020 pdf download free

Definition & pathophysiology of stroke for medical students

Definition and pathophysiology of stroke for medical students(Video)

In the above video, you will be given the following topic
  • Definition of stroke
  • Science of stroke
  • Symptoms of stroke
  • Pathology of stroke
  • Difference between Haemorrhagic and ischemic stroke
  • Complication of stroke
  • Management of stroke
  • Most important points to know regarding stroke
Please watch the video completely and do not forget to like share and
subscribe.
Please subscribe my YouTube channel, Dr Chaitanya Health channel.

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“description”: “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. Looking for a one-stop-shop for all your medical-related exam preparation needs? Look no further than www.chaitanya.com.np! Our platform offers a vast array of medical-related content, including videos and articles on exam questions, study materials, and essential concepts in the health sciences. With our expert guidance and in-depth resources, you’ll have everything you need to excel in your medical entrance exams. Whether you’re a first-time test-taker or a repeat candidate, our platform will help you build a strong foundation in health science, enhance your knowledge, and improve your chances of success. So, why wait? Visit www.chaitanya.com.np today and take the first step towards it. At www.chaitanya.com.np, we understand that preparing for medical entrance exams can be challenging and time-consuming. That’s why we’ve designed our platform to provide you with the resources you need to prepare efficiently and effectively. Our content is curated by medical experts who have years of experience in the field and are committed to helping you succeed. Our platform offers a user-friendly interface that is easy to navigate and allows you to access content quickly and easily. Whether you’re looking for exam-related videos, study materials, or practice tests, you’ll find everything you need on our platform. We also offer articles and videos on various health-related topics. Our resources cover a wide range of subtopics, including human anatomy, physiology, pathology, pharmacology, healthcare management, public health, and more. With our comprehensive coverage of health science topics, you’ll be able to build a strong foundation of knowledge that will help you succeed in your medical career. At www.chaitanya.com.np, we’re committed to helping you achieve your goals. That’s why we offer high-quality content, expert guidance, and practical exam strategies to help you succeed in your medical entrance exams. The video covers a wide range of topics related to health, such as anatomy, physiology, pathology, pharmacology, health policy, healthcare management, and public health. We also discuss important aspects of healthcare careers, medical education, and medical profession. The video is designed to help you build a strong foundation in health science, enhance your knowledge, and improve your chances of success in medical entrance exams. Whether you are a first-time test-taker or a repeat candidate, our expert guidance will assist you in achieving your goal. This video is a one-stop-shop for all your exam preparation needs. It equips you with valuable study tips, exam strategies, and critical concepts to ace the health exam questions in Loksewa Entrance MBBS/MD/MS and PSC exams in Nepal. Top channel for Medical entrance exam, study materials, healthcare, medical schools, Lok Sewa Nepal, Public Service Commission, medical admission, MBBS, MD, MS, exam tips, Nepal. This video also covers various subtopics related to health sciences that are essential for the exams. We’ll discuss the different systems of the human body, including the respiratory, cardiovascular, and nervous systems, and their functions. We’ll also delve into the various types of diseases and their causes, symptoms, and treatments. You’ll learn about infectious diseases, chronic diseases, genetic disorders, and environmental factors that can impact health. Here is the complete list of URLs related to Dr. Chaitanya Joshi : 1. Official Website: https://www.chaitanya.com.np 2. Instagram Profiles: Primary Account: https://www.instagram.com/joshi.chaitanya Secondary Account: https://www.instagram.com/dr_chaitanya_mbbs 3. Facebook: Page: https://www.facebook.com/chaitanya.com.np Personal Profile: https://www.facebook.com/theunavailableusername 4. YouTube Channel: https://www.youtube.com/@cjoshi0 5. Blogger Profile: https://www.blogger.com/profile/13974568830100355114 6. Additional Website Links: About Us: https://www.chaitanya.com.np/p/about-us.html About Dr. Chaitanya Joshi: https://www.chaitanya.com.np/2022/12/about-dr-chaitanya-joshi-mbbs.html Shop Page: https://www.chaitanya.com.np/p/shop.html”,
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medical officer previous question papers 1

medical officer previous question papers 1

medical officer previous question papers

(toc)

Introduction

Accessing previous question papers for the medical officer examination is a strategic approach to preparing for upcoming exams. These old question papers serve as invaluable resources, offering a multitude of benefits to aspiring medical officers. Firstly, they provide candidates with a clear understanding of the exam format, including the types of questions asked, the distribution of marks, and the time constraints. By familiarizing themselves with the structure of the exam, candidates can develop effective time management strategies and approach each section with confidence.

Syllabus coverage

Moreover, old question papers offer insight into the exam’s content and syllabus coverage. Candidates can identify recurring topics, important concepts, and areas of emphasis, allowing them to prioritize their study efforts accordingly. Additionally, reviewing past papers enables candidates to gauge the level of difficulty of the questions and assess their readiness for the exam. This helps in identifying weak areas that require further attention and reinforcement.

Benefits of solving old questions:

Furthermore, practicing with previous question papers is an excellent way to enhance problem-solving skills and test-taking abilities. By solving questions from different sections and topics, candidates can sharpen their analytical thinking, improve their accuracy, and build their confidence in tackling challenging problems. Additionally, repeated practice with past papers helps in refining strategies for answering questions efficiently, such as identifying key information, eliminating incorrect options, and managing time effectively during the exam.
Another significant benefit of utilizing old question papers is that they provide candidates with an opportunity for self-assessment and continuous improvement. After attempting a paper, candidates can evaluate their performance, identify mistakes, and learn from them. This process of self-assessment enables candidates to track their progress, set realistic goals, and tailor their study plan to address areas of weakness effectively. Moreover, revisiting past papers allows candidates to monitor their improvement over time and build momentum towards achieving their desired score in the medical officer examination.

Conclusion

In conclusion, old question papers are indispensable tools for candidates preparing for the medical officer examination. They offer a comprehensive overview of the exam format, content, and difficulty level, helping candidates to familiarize themselves with the exam and enhance their preparation. By practicing with past papers, candidates can refine their problem-solving skills, assess their readiness, and chart a path towards success in the medical officer examination.

Old questions series 1

1. A 12- year-old girl comes to you with severe pain in right ear since last night She is suffering form Ac. coryza for last 5 days, for which she had some treatment. On Otoscopy right eardrum is red and bulging. In which quadrant of eardrum will yoy do myringotomy ?
A) Anteriosuperior 
B) Anterioinferior
C) Posteriosuperior 
D) Posterioinferior 
Correct Answer:- (D)
2. In acute bdomen the frist imaging of importance is:
A) Plain X-ray Abdomen 
B) Barium Meal X-ray
C) CT scan of Abdomen 
D) MRI of abdomen 
Correct Answer:- (A)
3. All are true about pressure sores except
A) Occur over bony Prominence 
B) Are common in Paraplegics
C) Are caused by injury 
D) Are also called decubitus ulcers
Correct Answer:- (C)
4. Ringer lactate contains all except
A) Sodium 
B) Potassium
C) Bicarbonate 
D) Chloride 
Correct Answer:- (C)
5. Live Vaccines are usually used for active immunization against 
A) Pertussis 
B) Typhoid fever
C) Mumps, Measles and rublla 
D) Heparitis B 
Correct Answer:- (C)
A) 80% of vertically transmitted infections are transplacental
B) A child born to an infected mother has a 90% chance of cquiring HIV
C) Transmission can occur vie breast milk
D) Risk of fetal trnsmission is inaffected by pre-partum antiviral agents
Correct Answer:- (C)
Thank you for reading.

All the best.

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National Antimicrobial Treatment Guidelines 2023

National Antimicrobial Treatment Guidelines 2023

National  Antimicrobial  Treatment Guidelines  2023

Contents
List of Abbreviations
i
Introduction
v
General Principles vi
Administration of Antibiotics vii
Antimicrobial Stewardship viii
Approach to Multidrug Resistant Organisms ix
Infections in Adults
Respiratory Tract Infections
1
Cardiovascular System Infections
5
Central Nervous Infections 10
Oral/Dental Infections 14
Ocular Infections 18
Otorhinolaryngological Infections 25
Gastrointestinal Tract Infections 30
Surgical Infections in Adult 34
Urinary Tract Infections 46
Infections in Immunocompromised Patients 49
Chemoprophylaxis : Surgical 53
Chemoprophylaxis : Non Surgical 65
Obstetric and Gynaecological Infections 67
Skin and Soft Tissue Infections 75
Tropical and Other Infections 89
HIV Infection in Adults 95
Infections in Peadiatric Age Group
Respiratory Tract Infection 109
Cardiovascular System Infections 112
Central Nervous System Infections 116
Ocular Infections 119
Otorhinolaryngological Infections 120
Gastrointestinal Tract Infections 122
Surgical Infections in Children 126
Urinary Tract Infections 128
Neonatal Infections 129
Chemoprophylaxis: Surgical 135
Chemoprophylaxis: Non-Surgical 139
Skin and Soft Tissue Infections 146
Tropical and Other Infections 149
Infections in Immunocompromised Patients 164
Appendix
AWaRe Classification – WHO 166
Antibiotics Not Recommended (WHO List-2021) 171
Adverse Drug Reactions Reporting Form 174
Useful Links of National and International Guidelines 176
Therapeutic Guideline Development Committee 177
Acknowledgement 178

…………………………………

NATIONAL ACTION PLAN FOR ANTIMICROBIAL RESISTANCE NEPAL 2021-2026

NATIONAL ACTION PLAN FOR ANTIMICROBIAL RESISTANCE NEPAL 2021-2026

Table of Contents

List of Abbreviations and Acronyms ………………………………………………………………………….ii

Executive summary…………………………………………………………………………………………………… v

1. Background ………………………………………………………………………………………………………. 1

1.1 Introduction………………………………………………………………………………………………..2

1.2 Situation analysis and assessment of antimicrobial use (AMU) and 

Antimicrobial resistance (AMR) in Nepal………………………………………………………………..4

1.2.1 AMR in man and animals……………………………………………………………………..4

1.2.2 Awareness and understanding of AMR………………………………………………..7

1.2.3 Surveillance of AMR …………………………………………………………………………….8

1.2.4 Infection prevention and control………………………………………………………..10

1.2.5 Optimum use of antimicrobials ………………………………………………………….10

1.2.6 Research and innovation ……………………………………………………………………12

2. Country response ……………………………………………………………………………………………. 12

2.1 Developing the National Action Plan on AMR …………………………………………..12

2.2 Governance mechanisms…………………………………………………………………………..13

2.2.1 Multisectoral steering committee – AMR……………………………………………14

2.2.2 National technical working committee (NTWC) – AMR ………………………14

2.2.3 Technical working committees (TWCs)……………………………………………….15

3. National Action Plan on Antimicrobial Resistance……………………………………………. 16

3.1 Goal ………………………………………………………………………………………………………….16

3.2 Objectives …………………………………………………………………………………………………16

3.3 Strategic priorities …………………………………………………………………………………….17

3.4 Strategic plan: interventions, activities, and key outputs ……………………………19

4. Institutional Arrangement ……………………………………………………………………………….. 55

5. Financial Resources …………………………………………………………………………………………. 55

6. Monitoring and Evaluation Plan ………………………………………………………………………. 55

7. Risks………………………………………………………………………………………………………………… 58

8. Modification in annexure…………………………………………………………………………………. 58

iii

9. Right to explain……………………………………………………………………………………………….. 58

10. Automatically invalid……………………………………………………………………………………….. 58

11. References ………………………………………………………………………………………………………. 59

Annex I: Governance committees and working group for AMR ………………………………. 64

Annex II: Prime Minister and sectoral ministers (Human, Animal, and Environment) 

messages on tackling Antimicrobial Resistance………………………………………………………. 72

Annex III : Costing of NAP AMR

 

Salter Harris Classification : The Must Know Topic in Orthopedics

Salter Harris Classification : The Must Know Topic in Orthopedics

Salter-Harris Classification — Notes

Used to classify pediatric fractures involving the growth plate (physis), since growth plate injuries carry risk of growth disturbance and need different management than adult fractures.

Mnemonic: SALTR

TypeNameDescription
ISlipFracture through the physis only (growth plate slips/separates from metaphysis and epiphysis). Epiphysis separates cleanly.
IIAboveFracture through physis and metaphysis (spares epiphysis). Most common type (~75%).
IIILow (below)Fracture through physis and epiphysis (spares metaphysis). Extends into the joint.
IVThroughFracture through metaphysis, physis, and epiphysis — crosses all three.
VRammed (crush)Compression/crush injury to the physis, with no obvious fracture line. Often missed on initial imaging.

Key details per type

Type I

  • Physis alone; epiphysis separates from metaphysis
  • Can be subtle on X-ray — may only show soft tissue swelling if non-displaced
  • Good prognosis generally

Type II

  • Most common (~75% of all Salter-Harris fractures)
  • Fracture line runs through physis then exits through metaphysis, creating a metaphyseal fragment (“Thurston-Holland fragment”)
  • Generally good prognosis

Type III

  • Intra-articular fracture (involves the joint)
  • Risk of growth disturbance is higher since it crosses the epiphysis
  • Often needs anatomic reduction (sometimes surgical) due to joint involvement

Type IV

  • Crosses metaphysis, physis, and epiphysis
  • High risk of growth arrest/deformity if not perfectly reduced
  • Usually requires surgical fixation (ORIF) for precise alignment

Type V

  • Rare
  • Crush injury to the growth plate without a clear fracture line
  • Often diagnosed retrospectively after growth arrest is noted
  • Worst prognosis for growth disturbance despite normal-looking initial X-ray

General prognosis pattern

Higher the number, the higher the risk of growth disturbance — I and II generally heal well; III and IV carry more risk (especially IV); V has the worst prognosis despite looking mild initially.

Clinical relevance

  • Growth plate injuries only occur in skeletally immature patients (open physes)
  • Any suspected physeal injury in a child with point tenderness over a growth plate should be treated as a fracture even if X-ray looks normal (especially Type I and V, which can be radiographically silent)
  • Follow-up imaging (weeks to months later) is often used to check for growth arrest lines (Harris lines) or limb-length discrepancy

Computer Vision Syndrome- CVS: How Long Does Computer Vision Syndrome Last?

Computer vision syndrome- how long does computer vision syndrome last?

Table of Contents(toc)

Introduction to CVS

Computer Vision Syndrome (CVS), also known as Digital Eye Strain, refers to a cluster of eye and vision-related problems resulting from prolonged use of digital devices such as computers, smartphones, tablets, and e-readers.
Common symptoms of CVS include eye strain, headaches, blurred vision, dry eyes, neck and shoulder pain, and difficulty focusing.
These symptoms arise due to factors such as prolonged staring at screens, poor lighting, improper viewing distances, and poor posture while using digital devices.
Although CVS doesn’t cause permanent eye damage, it can significantly impact daily productivity and quality of life if left unmanaged.
Preventive measures for CVS include adjusting screen settings, taking frequent breaks, optimizing lighting conditions, maintaining proper posture, and using computer eyewear with blue light filters.
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Understanding the Causes of Computer Vision Syndrome:

Exploring the role of prolonged screen time, blue light exposure, improper ergonomics, and other contributing factors. Here are some common causes of Computer Vision Syndrome:
  1. Extended Screen Time
  2. Poor Lighting
  3. Improper Viewing Distance
  4. Unfavorable Ergonomics
  5. Uncorrected Vision Problems
  6. Blue Light Exposure
  7. Reduced Blinking
  8. Poor Display Quality
  9. Underlying Health Conditions
  10. Inadequate Eye Care
  11. Stress and Fatigue
  12. Digital Device Overuse

It’s important to address these factors to prevent or alleviate symptoms of Computer Vision Syndrome. Simple adjustments to workstation ergonomics, frequent breaks, proper lighting, and using blue light filters on screens can help reduce eye strain. Regular eye exams are also essential for detecting and correcting any underlying vision problems.

The Impact of Blue Light on Eye Health:

  • Delving into scientific research on blue light, its effects on circadian rhythms, and strategies to mitigate its negative impact on vision. 
  • Blue light, a high-energy, short-wavelength light emitted by digital screens and LED lighting, has garnered significant attention for its potential impact on eye health. Exposure to blue light, especially from prolonged use of computers, smartphones, and other electronic devices, can have several effects on the eyes. Blue light penetrates deep into the eye, reaching the retina, which may lead to digital eye strain, characterized by symptoms like eye fatigue, dryness, and blurred vision. 
  • Moreover, blue light exposure can disrupt the body’s natural sleep-wake cycle by suppressing the production of melatonin, a hormone crucial for regulating sleep. This disruption can result in difficulties falling asleep and poor sleep quality, ultimately affecting overall health and well-being. Additionally, some studies suggest that prolonged exposure to blue light may contribute to long-term eye health issues, such as an increased risk of age-related macular degeneration (AMD), though more research is needed to fully understand this association. 
  • To mitigate the potential adverse effects of blue light, individuals can employ strategies like using blue light filters on screens, limiting screen time before bedtime, and taking regular breaks during extended periods of digital device use. Additionally, wearing glasses with lenses designed to block blue light can offer further protection against its harmful effects.
Eye flu

Practical Strategies for Eye Comfort:

  • Providing actionable tips such as adjusting screen settings, proper lighting, ergonomic workstation setup, and the 20-20-20 rule.
  1. Follow the 20-20-20 Rule
  2. Optimize Screen Settings
  3. Ensure Proper Lighting
  4. Maintain Proper Viewing Distance
  5. Blink Frequently
  6. Practice Good Posture
  7. Take Regular Breaks
  8. Stay Hydrated
  9. Consider Computer Glasses
  10. Limit Screen Time Before Bed
  11. Practice Eye Exercises
Implementing these practical strategies can help alleviate eye discomfort and promote overall eye health, especially for those who spend extended periods in front of screens.

Recognizing the Signs and Symptoms of CVS:

  • Detailing common indicators of digital eye strain and how they manifest, including eye fatigue, headaches, dry eyes, and neck pain.
  1. Eye Strain: Feeling of discomfort or tiredness in the eyes, often accompanied by soreness or irritation.
  2. Headaches: Frequent headaches, particularly after extended periods of screen use.
  3. Blurred Vision: Difficulty focusing or experiencing blurry vision, especially when shifting focus between the screen and other objects.
  4. Dry Eyes: Feeling of dryness, burning, or itching in the eyes due to reduced blinking and inadequate tear production.
  5. Double Vision: Seeing duplicate images or experiencing visual disturbances, which may occur temporarily during or after screen use.
  6. Neck and Shoulder Pain: Muscular discomfort or tension in the neck, shoulders, or upper back, often resulting from poor posture or strain while using electronic devices.
  7. Light Sensitivity: Increased sensitivity to light, particularly to glare from screens or bright lighting.
  8. Difficulty with Concentration: Difficulty concentrating on tasks, reduced productivity, or decreased attention span, which may be attributed to eye discomfort and fatigue.
  9. Watery Eyes: Experiencing excessive tearing or watery eyes as a result of eye strain and irritation.
  10. Color Distortion: Perception of colors may appear altered or washed out, particularly after prolonged screen use.

                            Preventive Measures and Treatment Options:

                            • Discussing preventive measures like regular eye exams, specialized computer eyewear, blue light filters, and lifestyle adjustments to manage and alleviate CVS symptoms.
                            1. Follow the 20-20-20 Rule: Take a break every 20 minutes by looking at something 20 feet away for at least 20 seconds to reduce eye strain.
                            2. Optimize Screen Settings: Adjust screen brightness, contrast, and font size to comfortable levels. Decrease blue light emissions by using features like night mode or blue light filters.
                            3. Ensure Proper Lighting: Position your screen to avoid glare from windows or overhead lighting. Use indirect lighting and consider adding a desk lamp with adjustable brightness.
                            4. Maintain Proper Viewing Distance: Position your screen at arm’s length (about 20-26 inches away) and adjust the screen height so that your eyes are level with the top of the monitor.
                            5. Blink Frequently: Remind yourself to blink often to keep your eyes moist and prevent dryness. Consider using lubricating eye drops if necessary.
                            6. Practice Good Posture: Sit in a comfortable, ergonomic chair and maintain proper posture to reduce strain on your neck, shoulders, and back.
                            7. Take Regular Breaks: Incorporate short breaks into your screen time routine to rest your eyes and stretch your muscles. Use break reminders or timers as a helpful cue.
                            8. Stay Hydrated: Drink plenty of water throughout the day to maintain proper hydration, which can help prevent dry eyes.
                            9. Limit Screen Time Before Bed: Avoid using electronic devices at least an hour before bedtime to minimize blue light exposure and promote better sleep quality.
                            10. Use Computer Glasses: Consult with an eye care professional about prescription or non-prescription computer glasses with lenses designed to reduce glare and filter blue light.

                            Treatment options

                            1. Artificial Tears: Use over-the-counter lubricating eye drops to relieve dryness and soothe irritated eyes.
                            2. Prescription Eyewear: If you have uncorrected vision problems, wearing prescription glasses or contact lenses can improve visual comfort and reduce eye strain.
                            3. Vision Therapy: In some cases, vision therapy exercises prescribed by an optometrist or ophthalmologist can help improve eye coordination and alleviate symptoms of CVS.
                            4. Blue Light Filters: Install blue light filters or software on your electronic devices to reduce exposure to harmful blue light wavelengths.
                            5. Anti-reflective Coatings: Consider adding anti-reflective coatings to your glasses or screens to minimize glare and reflections, which can contribute to eye strain.
                            6. Adjust Workstation Ergonomics: Make ergonomic adjustments to your workstation, such as using a proper chair, adjusting monitor height, and positioning documents properly to reduce neck and shoulder strain.
                            7. Medical Treatment: In severe cases of CVS, your healthcare provider may recommend prescription medications or other medical interventions to manage symptoms and underlying conditions.

                            How to control vectors: NHPC license preparation class

                            How to control vectors: NHPC license preparation class

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