Anesthetic Agents of Choice & Contraindications
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Ketamine: Preferred in bronchial asthma due to its potent bronchodilator effect.
Continue reading Anesthetic Agents of Choice & Contraindications
Anesthetic Agents of Choice & Contraindications
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Fingerprinting Forensics (medical student notes)
Fingerprinting (Dactylography, Galton System, Dermatoglyphics)
1. Basics of Fingerprint Patterns
✅ The most common fingerprint pattern: Loops (67%) > Whorls > Arches > Composite.
✅ Loops are the most frequent, followed by whorls, arches, and composite patterns.
2. Historical Milestones
📍 First Fingerprinting Bureau in the World: Established in Kolkata, India (1897).
3. Fingerprints as an Identification Tool
🔹 Best identification system to date (with dental status being the second best).
🔹 Quetelet’s Rule of Biological Variation:
- Even identical twins have different fingerprints.
4. Scientific Aspects of Fingerprinting
🔬 Points of Comparison: Generally, 16-20 points are accepted as proof of identity.
🔬 Poroscopy: Advanced fingerprint study described by Locard (focuses on sweat pore patterns).
5. Thumb Impression Rule
🖐 Which thumb impression is taken?
- Left thumb for males
- Right thumb for females
- (“If you are married/have a girlfriend, you will know this—females are always right!!” 😉)
6. Technological Advancements
🖥 FINDER (Fingerprint Reader)
- A computerized fingerprint maintenance system used by the FBI.
- Scans 8 fingers (excluding little fingers).
📌 Pigeonhole Method:
- All 10 fingers are recorded.
Abnormal Pulse Patterns & Clinical Significance
Abnormal Pulse Patterns and Their Clinical Significance
1. Pulsus Paradoxus
Definition: An exaggerated decrease (>10 mmHg) in systolic blood pressure during inspiration.
🔍 Seen in:
- Pericardial tamponade (classic association)
- Superior vena cava (SVC) obstruction
- Chronic obstructive pulmonary disease (COPD) / Acute severe asthma
- Constrictive pericarditis
- Pulmonary embolism
- Hypovolemic shock
- Tension pneumothorax
- Large pleural effusion
📝 Exam Tip: Pulsus paradoxus is best detected using a sphygmomanometer rather than palpation. It is a key feature of cardiac tamponade.
2. Pulsus Alternans
Definition: Regular alteration of pulse pressure with a normal rhythm (single peak per beat). Indicates left ventricular systolic dysfunction.
🔍 Seen in:
- Left ventricular failure (LVF) (hallmark sign)
- Dilated cardiomyopathy
- Severe aortic stenosis
- Advanced hypertension
📝 Exam Tip: Pulsus alternans suggests poor left ventricular function and can be confirmed using sphygmomanometry or echocardiography.
3. Bisferiens Pulse
Definition: A pulse with two distinct systolic peaks per cardiac cycle. Best felt in the carotid artery.
🔍 Seen in:
- Aortic regurgitation + Aortic stenosis (AR + AS) (combined lesion)
- Hypertrophic obstructive cardiomyopathy (HOCM)
- Severe mitral regurgitation
📝 Exam Tip: Bisferiens pulse is classically associated with HOCM and can be differentiated from other pulses using Doppler echocardiography.
4. Dicrotic Pulse
Definition: A pulse with two palpable waves: one during systole and one during diastole.
🔍 Seen in:
- Dilated cardiomyopathy (DCM)
- Septic shock (low cardiac output states)
- Hypovolemia
- Conditions with reduced systemic vascular resistance
📝 Exam Tip: Dicrotic pulse occurs due to an exaggerated dicrotic notch. It is often a sign of severe myocardial dysfunction.
Additional High-Yield Exam Points:
- Collapsing (Water hammer) pulse: Seen in Aortic regurgitation (Corrigan’s sign).
- Anacrotic pulse: Seen in Aortic stenosis (slow-rising pulse with a delayed peak).
- Bounding pulse: Seen in sepsis, fever, anemia, and thyrotoxicosis.
- Paradoxical pulse vs Pulsus alternans: Pulsus paradoxus is linked to pericardial conditions, whereas Pulsus alternans suggests ventricular failure.
Non Communicable Disesses New Epidemic? (Video)
Why are Non Communicable Disesses Becoming new Epidemic Video
Drugs contraindicated in pregnancy
Drugs contraindicated in pregnancy:
- Lithium
- ACE inhibitors
- Beta blockers
- Immunosuppressive drugs except azathioprine and cyclosporine(which are relatively safer)
- Atropine
- Diazepam
- Phenytoin
- Valproate
- Isotretinoin
- Progestins
- Aminoglycosides (streptomycin)
- Allopurinol
- Live vaccines
- Metronidazole (1st trimester)
- Warfarin (1st and 3rd trimester)
Question
Which one of the following drugs is absolutely contraindicated in pregnancy?
a. Chloroquine
c. Methotrexate
b. Cyclosporine
d. Pyrazinamide
_____________
Ans: ‘c’
Explanation
Methotrexate is contraindicated in pregnancy.
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Benign rolandic epilepsy
Benign rolandic epilepsy
Introduction:
Benign rolandic epilepsy, also known as benign epilepsy with centrotemporal spikes (BECTS), is an epilepsy syndrome affecting children, characterized by twitching, numbness, or tingling of the child’s face or tongue, and may interfere with speech and cause drooling.
Features:
Involves twitching, numbness, or tingling of the child’s face or tongue (called a focal or partial seizure).
Seizures last no more than 2 minutes.
Child remains fully conscious.
The syndrome represents about 15% of all epilepsies in children.
Because the seizures may be infrequent and usually occur at night, many children do not take medication.
In almost every case, seizures stop on their own by age 15.
Treatment:
The drug of choice for benign rolandic epilepsy: Carbamazepine
Alternative agents include gabapentin, valproate, phenytoin or levetiracetam.
Probable MCQ
Which one of the following is the drug of choice for benign rolandic epilepsy?
a. Gabapentin
c. Phenytoin
b. Barbiturates
d. Sodium valporate
Ans:’a’
What is primary health care
What is primary health care
Introduction
Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford.
Elements of primary health care:
1. Education concerning prevailing health problems and the methods of preventing and controlling them;
2. Promotion of food supply and proper nutrition;
3. An adequate supply of safe water and basic sanitation;
4. Maternal and child health care, including family planning;
5. Immunization against major infectious diseases;
6. Prevention and control of locally endemic diseases;
7. Appropriate treatment of common diseases and injuries; and
8. Provision of essential drugs.
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Human Herpes Viruses: Clinical Manifestations
Clinical Manifestations of Human Herpes Viruses
Clinical Manifestations of Human Herpes Viruses
| Virus | Primary Infection | Reactivation | Chronic Infection in Immunocompetent Persons | Immunodeficiency |
|---|---|---|---|---|
| Herpes simplex virus 1 (HSV-1) | Frequently subclinical (80–90%), Oral lesions (10–20%), Congenital infection | Oral lesions, Encephalitis | None | Large mucocutaneous lesions |
| Herpes simplex virus 2 (HSV-2) | Frequently subclinical (80–90%), Genital lesions (10–20%) | Genital ulcers, Encephalitis | None | Large mucocutaneous lesions |
| Varicella-zoster virus (VZV) | Chickenpox | Shingles | None | Multisegmental shingles or severe disseminated infection |
| Cytomegalovirus (CMV) | Mononucleosis-like disease | ? | Cofactor in atherosclerosis (?) | Retinitis, Colitis, Pneumonitis, Encephalitis |
| Epstein–Barr virus (EBV) | Mononucleosis | ? | Nasopharyngeal carcinoma, Burkitt lymphoma | B-cell lymphoma, Oral hairy leukoplakia |
| Human herpes virus 6 (HHV-6) | Exanthema subitum (Roseola) | ? | Multiple sclerosis (?) | Pneumonia, Disseminated infection |
| Human herpes virus 7 (HHV-7) | Fever, Exanthema-subitum-like illness | ? | None | ? |
| Human herpes virus 8 (HHV-8) | Febrile illness | ? | ? | Multicentric Castleman disease, Kaposi sarcoma, Primary body cavity lymphoma |
Note: (?) = Not proven
Source: Differential Diagnosis in Internal Medicine – From Symptom to Diagnosis, 2007
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Effects of Common Food Adulterations
Common Food Adulterations &Their Harmful Effects
 |
| Food |
Food adulteration is a major health concern, as it involves the addition of
harmful substances to food products, reducing their quality and making them
unsafe for consumption. Below is a table listing common food adulterations,
their sources, and their health effects.
| Food Item | Common Adulterant | Health Hazards |
|---|---|---|
| Milk | Detergent, starch, urea, synthetic milk | Digestive issues, kidney damage, food poisoning |
| Tea & Coffee | Used tea leaves colored with iron fillings | Stomach disorders, liver damage |
| Wheat & Flour | Starch, chalk powder | Indigestion, nutritional deficiency |
| Sugar | Washing soda, chalk powder | Stomach disorders, irritation in the digestive tract |
| Honey | Glucose, molasses, sugar syrup | Weight gain, diabetes risk |
| Vegetables | Malachite green (to enhance color) | Carcinogenic effects, liver damage |
| Fruits | Wax coating, carbide for ripening | Cancer risk, digestive issues |
| Pulses | Artificially polished with lead chromate | Kidney failure, cancer risk |
| Soft Drinks | Excess carbon dioxide, artificial sweeteners | Obesity, metabolic disorders |
| Ice Cream | Washing powder, synthetic milk | Gastrointestinal diseases |
| Ghee & Butter | Vanaspati, starch | Cardiovascular diseases, digestive issues |
| Pickles | Excessive salt and non-edible mineral oil | High blood pressure, digestive problems |
| Chocolates & Sweets | Non-edible synthetic dyes, aluminum foil | Liver and kidney damage, allergies |
| Meat & Fish | Formalin (used for preservation) | Highly toxic, can cause cancer |
How to Detect Food Adulteration at Home
-
Milk: Add a drop of
iodine solution; if it turns blue, starch is present. -
Tea Leaves: Rub on a wet
paper; if it leaves a color, artificial coloring is used. -
Honey: Mix with water;
pure honey settles at the bottom, while adulterated honey dissolves. -
Fruits & Vegetables:
Wash thoroughly; if color comes off, synthetic dyes are used.
Conclusion
Food adulteration can have serious health consequences. Always buy food from
trusted sources, check labels for certifications, and use simple home tests to
ensure food safety.
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Period Sex : Pros and Cons (Nepali)
महिनावारीको समयमा यौन सम्पर्क गर्न मिल्छ कि मिल्दैन? वैज्ञानिक
दृष्टिकोण
 |
| Period Sex : Pros and Cons (Nepali) |
महिनावारी (पीरियड) को समयमा यौन सम्पर्क गर्नुहुन्छ कि हुँदैन?
यो विषयमा धेरै भ्रम, सामाजिक ट्याबु र व्यक्तिगत धारणाहरू छन्।
कतिपयले यसलाई अस्वस्थकर वा गलत मान्छन्, भने अन्यले यसलाई
स्वाभाविक प्रक्रिया ठान्छन्।
तर, वैज्ञानिक दृष्टिकोणबाट हेर्दा
महिनावारीको समयमा यौन सम्पर्क सुरक्षित छ वा छैन? यसका फाइदा र
बेफाइदा के-के हुन सक्छन्? यस लेखमा हामी यिनै कुराहरूको
वैज्ञानिक आधारमा विश्लेषण गर्नेछौं।
महिनावारीको समयमा यौन सम्पर्क: वैज्ञानिक दृष्टिकोण
वैज्ञानिक अध्ययनहरूले महिनावारीको समयमा यौन सम्पर्क गर्नु
जैविक रूपमा अस्वाभाविक वा हानिकारक नरहेको देखाएका छन्। बरु, यो
व्यक्तिगत रुचि, स्वास्थ्य अवस्था, र सरसफाइको विषयसँग सम्बन्धित
छ।
१. महिनावारीको समयमा यौन सम्पर्क सुरक्षित छ?
सुरक्षित यौन सम्पर्कका लागि प्रमुख चासो यौन सङ्क्रमण (Sexually
Transmitted Infections – STIs) को जोखिम हो। महिनावारीको समयमा
पाठेघरको मुख (cervix) अलिकति खुला हुने भएकाले संक्रमणको
सम्भावना केही बढ्न सक्छ। साथै, रक्तस्रावले भाइरस तथा
ब्याक्टेरियालाई सजिलै सर्न सहयोग गर्न सक्छ, विशेषगरी HIV,
हेर्पीस (Herpes), तथा ह्युमन पेपिलोमाभाइरस (HPV) जस्ता
संक्रमणहरू।
तर, यदि तपाईं र तपाईंको साथीमा यौन सङ्क्रमणको कुनै जोखिम छैन र
तपाईंहरूले कण्डोम वा अन्य सुरक्षा उपायहरू अपनाउनुहुन्छ भने,
महिनावारीको समयमा यौन सम्पर्क वैज्ञानिक रूपमा असुरक्षित
मानिँदैन।
२. महिनावारीको समयमा यौन सम्पर्कका फाइदा
वैज्ञानिक अनुसन्धानहरूले देखाएका अनुसार महिनावारीको समयमा यौन
सम्पर्कका केही फाइदाहरू हुन सक्छन्:
-
✅
धेरै महिलाहरूमा यौन इच्छा बढ्छ
– महिनावारीको समयमा एस्ट्रोजेन (Estrogen) र टेस्टोस्टेरोन
(Testosterone) हर्मोनको उतार-चढ़ावले गर्दा केही महिलाहरूको यौन
इच्छा बढ्न सक्छ। -
✅
मासिक दुखाइ (Menstrual Cramps) कम गर्न सक्छ
– यौन सम्पर्कको समयमा अर्गाज्म (Orgasm) हुँदा शरीरमा
अक्सिटोसिन (Oxytocin) र एन्डोर्फिन (Endorphins) नामक प्राकृतिक
पेनकिलर हर्मोनहरू निस्कन्छन्, जसले पेट दुखाइ कम गर्न सक्छ। -
✅
रक्तस्राव चाँडै रोकिन सक्छ
– यौन सम्पर्कका क्रममा पाठेघर सङ्कुचन हुन्छ, जसले गर्दा
रक्तस्राव चाँडै अन्त्य हुन सक्छ। -
✅
संबन्ध अझ मजबुत हुन्छ
– यदि तपाईं र तपाईंको जोडी दुवै सहज हुनुहुन्छ भने, यस्तो समयमा
यौन सम्पर्कले आपसी समझदारी र निकटता बढाउन सक्छ।
Pros of Having Sex During Periods
| Pros | Explanation |
|---|---|
| Increased lubrication |
Natural menstrual flow reduces the need for artificial lubrication, making intercourse smoother. |
| Relieves menstrual cramps |
Orgasms cause uterine contractions that help release muscle tension, reducing cramps. |
| Shorter periods |
Orgasms can help push out menstrual blood faster, potentially shortening the duration of the period. |
| Increased arousal |
Hormonal changes during menstruation can lead to heightened sexual desire. |
| Stronger intimacy |
Engaging in sex during periods can strengthen emotional bonds and comfort levels in a relationship. |
| Possible headache relief |
The release of endorphins during sex can act as a natural painkiller, reducing headaches. |
३. महिनावारीको समयमा यौन सम्पर्कका सम्भावित
जोखिमहरू
-
⚠️
संक्रमणको जोखिम
– जस्तै HIV वा हेर्पीसजस्ता यौनजनित रोगहरू (STIs)
महिनावारीको समयमा सर्ने सम्भावना बढी हुन्छ। -
⚠️
गर्भाधारणको सम्भावना
– सामान्यतः महिनावारीको समयमा गर्भवती हुने सम्भावना कम
हुन्छ, तर असम्भव भने छैन। यदि कुनै महिलाको छोटो महिनावारी
चक्र (२१-२४ दिन) छ भने, शुक्रकीट (Sperm) पाठेघरभित्र ३-५
दिनसम्म बाँच्छ, जसका कारण गर्भधारणको सम्भावना रहन्छ। -
⚠️
सरसफाइको चुनौती
– महिनावारीको समयमा यौन सम्पर्क गर्दा चादर, कपडा वा शरीरमा
रगत लाग्न सक्छ, जसले असहजता ल्याउन सक्छ। यो व्यक्तिगत रुचिको
कुरा हो, तर सफाइमा विशेष ध्यान दिन आवश्यक छ।
Cons of Having Sex During Periods
| Cons | Explanation |
|---|---|
| Messiness |
Menstrual blood can make sex messier, requiring extra cleanup. |
| Risk of infections |
The cervix is slightly open during menstruation, increasing the risk of infections, including STIs. |
| Discomfort for some |
Some people may feel physical discomfort or emotional awkwardness. |
| Need for protection |
Although pregnancy risk is lower, it’s still possible, and STIs can spread more easily. |
| Partner preference |
Some partners may feel uncomfortable with period sex due to personal or cultural beliefs. |
सावधानी अपनाउने तरिकाहरू
यदि तपाईं महिनावारीको समयमा यौन सम्पर्क गर्न चाहनुहुन्छ भने,
यी सावधानी अपनाउन सक्नुहुन्छ:
-
✔
कण्डोम प्रयोग गर्नुहोस्
– संक्रमणको जोखिम कम गर्न र सरसफाइ सुनिश्चित गर्न कण्डोम
प्रयोग गर्नु राम्रो हुन्छ। -
✔
पछिपछि राम्रोसँग सफा गर्नुहोस्
– यौन सम्पर्कपछि नुहाउने वा सफा गरिहाल्ने बानी बसाल्नुस्। -
✔
सुरक्षित स्थान रोज्नुहोस्
– तपाईंलाई सहज लाग्ने ठाउँ छनोट गर्नुहोस्, र तौलिया वा डार्क
कलरको कपडा राख्न सक्नुहुन्छ। -
✔
संचार कायम राख्नुहोस्
– तपाईं र तपाईंको पार्टनर दुवैले सहज महसुस गरिरहेको
सुनिश्चित गर्न संवाद महत्त्वपूर्ण हुन्छ।
निष्कर्ष
महिनावारीको समयमा यौन सम्पर्क गर्नु वैज्ञानिक रूपमा अस्वस्थ वा
हानिकारक छैन, तर यो व्यक्तिगत छनोटको कुरा हो। यसका केही
फाइदाहरू छन्, जस्तै महिनावारी दुखाइ कम हुनु र यौन इच्छामा
वृद्धि आउनु, तर सावधानी नअपनाएमा संक्रमणको जोखिम पनि हुन सक्छ।
यदि तपाईं यो समयमा यौन सम्पर्क गर्न चाहनुहुन्छ भने, उचित
सरसफाइ, सुरक्षा उपायहरू, र आपसी समझदारी अनिवार्य छन्। अन्ततः,
तपाईंको शरीर र स्वास्थ्य तपाईंको निर्णय अनुसार चल्नुपर्छ।
विज्ञान के भन्छ?
महिनावारीको समयमा यौन
सम्पर्क गर्नु हानिकारक होइन, तर स्वास्थ्य सुरक्षाका उपायहरू
अवश्य अपनाउनुहोस्!
सन्दर्भ (References):
-
Harlow, S. D., & Ephross, S. A. (1995). “Menstruation
and the Menstrual Cycle: Epidemiology and Associated
Factors.”
American Journal of Public Health, 85(2), 218-224. -
Hillard, P. A. (2014).
Menstruation and Its Disorders. Cambridge University Press. -
National Health Service (NHS), UK. (2023). “Sex During
Periods – What You Should Know.” -
Mayo Clinic. (2023). “Menstrual Cycle: Normal Symptoms and
Changes.”
तपाईंलाई यो जानकारी उपयोगी लाग्यो भने, कृपया सेयर गर्नुहोस् र
स्वास्थ्यसम्बन्धी अन्य जानकारीका लागि हाम्रै ब्लगमा हेरि रहनुहोस्!
(Via Guestposting)
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