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Hi, I am Dr. Adil Ramzan : I have gone through the first and second year of the MBBS in the study. Whenever I passed an exam and got promotion to next year i wondered which book to follow. There are few books which are recommended by universities, these are authentic books and a student must follow them for reference. There are other shorter books. students love shorter books as they are less scary. Anyhow i am mentioning authentic recommended books of first-year MBBS: (I don’t remember the exact title of books, but i am mentioning the authors' names.) You may use this website ( https://www.medicotips.com ) for concise and to the point articles.  (just search the topic by using the search bar present at the top) Recommended Books of First Year MBBS: Physiology for First and Second Year MBBS Textbook of physiology by Guyton and Hall ( i read this ) Essential of Medical Physiology – Sembulingam ( i read this ) Essential of Physiology by Sheerwood Ganong’s physiology Sh

Definition of Anemia/What is Anemia: Anaemia may be defined as a state in which the blood haemoglobin level is below 13.5 g/dl in an adult male and below 11.5 g/dl in an adult female. Symptoms Of Anemia: Those problems which can be described a patient are called symptoms. For example, a patient can tell a doctor that he has a fever, headache, back pain, abdominal pain etc, All these are symptoms. Symptoms of Anemia are given below: Fatigue A headache Faintness Breathlessness Angina of effort Palpitation Intermittent claudication Signs Of Anemia: Signs are elicited by a doctor or another person, the patient may be unaware of them, for example, a patient may tell you that he has a fever, but he may not tell you that he has yellow or pale eyes or tachycardia (rapid heart beats). So, yellow or pale eyes and tachycardia are signs. Signs of Anemia are given below: Non-specific Signs of Anemia: Following signs can be present in anemia of all types Paler skin, conjunctiva &a

DYSPHAGIA Dysphagia means difficulty in swallowing. As mentioned previously the act of swallowing is divided into three stages. Dysphagia may occur in any pathology affecting any one or more than one stages of swallowing. Types of Dysphagia: Dysphagia is divided into three types; Buccal dysphagia, Pharyngeal dysphagia and Oesophageal dysphagia. What is BUCCAL DYSPHAGIA and Its Causes: Buccal dysphagia results from any lesion, which affect the first phase or buccal phase of swallowing. Diseases of the oral cavity, tongue, palate etc. cause this type of dysphagia. The common causes of buccal dysphagia are: Palatal defects e.g. cleft palate, short palate and paralysis Paralysis of the tongue Immobility of the tongue e.g. malignancy Diminished salivation, like radiation mucositis Oral carcinoma Sub-mucous fibrosis   What is Pharyngeal Dysphagia and Its Causes: When the dysphagia is due to disturbance of the pharyngeal or second phase of swallowing. Common causes of pharyng

Q: Hi there may be the dumb question I am so terrified of having a brain aneurysm I heard of two people that died instantly of them I read you could have weak arteries your whole life and not know is this true? Would my doctor be able to tell if I do by blood pressure or taking my pulse? Thank you Answer: Well if someone died of a brain aneurysm, it doesn’t mean that you will surely have that particular disease. In brain aneurysm, an abnormally dilated artery is present in the brain, which may put pressure on the surrounding healthy brain, this continuous pressure damages the brain. This result in certain symptoms, like headache, blurred vision, ataxia, loss of balance, syncope, weakness of a particular area of the body, slurred speech etc. These symptoms alarm a patient that something is wrong with him and he or she goes to a doctor. Sometimes, brain aneurysm grows rapidly and may rupture, (ruptured aneurysm) which may lead to sudden death. If you are a healthy person, and you do

Dr. Kashif Rauf had graduated from Khyber Medical University in 2012. He joined  Medicotips .com when he was a newly admitted medical student in early 2008. He took a keen interest in website development and had paid special interest. For website development, he took several online web development courses used them in the development of this website. Dr Kashif Rauf was born on 12th September 1989. He completed his early education in his native village Baffa, Pakistan. Then he moved to Mansehra district and passed matriculation and intermediate education with the distinction that helped him to get enrollment in a medical institute in late 2007, Dr Rauf is working as an Emergency Medicine Resident in King Abdullah Hospital Mansehra since 2014. Honourable Dr Kashif Rauf played a great role in the development of this wonderful website.

Author: Kashif Rauf Mechanical Ventilation When the patient continues to deteriorate or fails to improve with other measures and oxygen therapy, he needs some respiratory support with mechanical ventilation. Mechanical ventilation improves C02 elimination (confirmed by performing ABG Test ) and removes work of breathing, gives relief from exhaustion by giving rest to the respiratory muscles. Types of Mechanical Ventilation: Mechanical ventilation may be non-invasive or invasive. 1. Non- invasive mechanical ventilation In non- invasive respiration is supported with a face mask or nasal mask so that, endotracheal intubation is avoided. The patient should be conscious, cooperative, be able to breathe spontaneously and cough effectively. This technique is commonly used in acute exacerbation of COPD and pneumonia . 2. Invasive mechanical ventilation In invasive mechanical ventilation endotracheal tube is passed. The patient may require full or partial support. In full Support

Pyloric Stenosis, Pyloric Obstruction, Stomach Outlet Obstruction; A peptic  ulcer in the region of pylorus may lead to gastric outlet obstruction due to: 1. Oedema 2. Spasm 3. Fibrous stricture 4. Duodenal ulcer 5. Carcinoma of antrum 6. External compression from carcinoma of the pancreas. Signs Symptoms and Clinical Features of Pyloric Stenosis Long History of Peptic Ulcer: A long history of peptic ulcer without symptoms of peptic ulcer, gastric outlet obstruction is likely to have a pyloric carcinoma. When the cause is a peptic ulcer, nausea and vomiting become prominent. Vomiting:- It gives striking relief to the patient Vomitus contains food particles which have been eaten even 24 hours or more previously. Alkalosis:- Alkalosis develops if a large amount of HCI is lost in vomiting, as occurs particularly in obstruction due to duodenal ulcer. Wasting due to undernourishment. Dehydration Succussion splash:  Succussion splash may be elicited four hours or more

Author: Kashif Rauf INTESTINAL ISCHEMIA Intestinal ischemia results from occlusion of arterial inflow, venous outflow or failure of perfusion resulting in abdominal pain called abdominal angina. CAUSES OF INTESTINAL ISCHEMIA Intestinal ischemia may result from any one of the following causes; 1. Arterial inflow occlusion Atheroma ( Read About: atherosclerosis, risk factors, Causes and Atheroma formation ) Thrombosis Embolus Aortic disease Vasculitis e.g Takayasu’s arteritis A tumour (causing compression of the vessel) 2. Venous outflow occlusion (Mesenteric vein occlusion) Hypercoagulable states e.g malignancy, protein C, protein S, or antithrombin III deficiency). Antiphospholipid antibody Intraabdominal sepsis Portal hypertension and cirrhosis 3. Failure of perfusion Hypotension, shock Acute small intestinal ischemia An embolus from the heart in a patient with atrial fibrillation is the commonest cause, usually occluding the superior mesenteric artery. Pati

HEMOPTYSIS (Blood in Sputum) The expectoration of blood or blood-stained sputum is known as hemoptysis . The source of blood should be below the vocal cords. The lungs are supplied with dual circulation; pulmonary arteries arise from the right ventricle and supply pulmonary parenchyma while the bronchial arteries arise from the aorta or intercostals arteries and supply airways, blood vessels, hila and visceral pleura. The bronchial circulation is only 1-2% of total pulmonary blood flow but is a more common source of bleeding. Bronchial blood flow dramatically increases in inflammation. Causes of Hemoptysis (Blood in Sputum)- 1. Blood From airways in> Bronchitis Bronchiectasis Bronchial adenoma Bronchogenic carcinoma 2. From pulmonary vasculature Mitral stenosis Pulmonary infarction Left ventricular failure A-V malformation 3. From pulmonary parenchyma Pneumonia Bleeding disorders Autoimmune diseases e.g. Goodpasture’s syndrome and Wegner’s syndrome 4. Massive

Medullary Sponge Kidney: Medullary Sponge Kidney a benign disorder is presented at birth and is not diagnosed until fourth or fifth decade. Kidneys have a marked irregular enlargement of the medullary and interpapillary collecting ducts. This is associated with medullary cysts that are diffuse giving a “Swiss cheese” appearance in these regions.   Clinical features of Medullary Sponge Kidney Medullary Sponge Kidney presents in 50s or 60s with following symptoms. Hematuria: gross or microscopic (red/dark colored urine) Recurrent UTI,(increase urinary frequency, burning micturation, pain during urination, flank or abdominal pain) Renal stone formation and nephrocalcinosis. (flank pain, blood in urine, pus in urine, urinary retention, supra-pubic pain) Distal renal tubular acidosis Decreased urinary concentrating ability. (large amount of colorless colored urine)     Investigations of Medullary Sponge kidney Intravenous pyelography (IVP) (now call

Nephritic Syndrome Acute nephritic syndrome indicates an inflammatory process causing renal dysfunction over days to weeks that may or may not resolve. In severe cases it may cause more than 50% loss of nephron function over the course of just weeks or months. It affect the process of glomerular filtration and renal tubular reabsorption . It is characterized by the abrupt onset of: Hematuria with RBC casts or dysmorphic RBCs typically seen on urine microscopy. Proteinuria (usually non-nephrotic range). Renal impairment: manifesting as oliguria, uremia, raised urea and creatinine. Hypertension due to salt and water retention. Edema (usually periorbital, leg or sacral) due to salt and water retention. ACUTE NEPHRITIC SYNDROME Clinical Presentation Hematuria ( micro or macroscopic) Proteinuria Hypertension Edema Oliguria , Uremia   Glomerual diseases with nephritic presentation Diseases of glomerulus may present clinically as

Diphtheria Diphtheria is an acute infection caused by Corynebacterium diphtheriae that usually attacks the respiratory tract but may involve any mucous membrane or skin wound. It Spreads by respiratory secretions. Age : although it is considered as a disease of childhood, it is increasingly affecting adults due to non- immunization in childhood. Local manifestations are due to pseudo-membrane while the systemic manifestations are due to the formation of exotoxin. However, the presence of pseudo-membrane is not essential for diagnosis. Exotoxin produced by the organism is responsible for myocarditis and neuropathy. Nasal diphtheria It is characterized by the presence of unilateral, serosanguineous nasal discharge that crusts around the external nares. Pharyngeal diphtheria It is the most common type of diphtheria and is associated with the greatest toxicity. It is characterized by marked tonsillar and pharyngeal inflammation and the presence of pseudo-membrane. This tough

SPLENOMEGALY or Enlarged Spleen Enlargement of Spleen is called Splenomegaly. Spleen is situated in the left hypochondrium below the stomach. When It is enlarged It can be palpated in the left anterolateral coastal margin. There are various causes of splenomegaly (enlargement of the spleen). Some of the causes of splenomegaly (enlarged Spleen) are given below. Causes Of Enlarged Spleen ( Splenomegaly) Congestion Cirrhosis Hepatic vein occlusion Portal or splenic vein thrombosis Congestive cardiac failure Constrictive pericarditis Infections Acute infections Typhoid Fever , septicemia, Infective endocarditis , Infectious mononucleosis, hepatitis, CMV Chronic infections Tuberculosis , brucellosis Parasitic infestation Malaria, kalazar, schistosomiasis, trypanosomiasis Fungal infection Histoplasmosis Inflammation SLE, sarcoidosis, Felty’s syndrome Haematological disorders Hemolytic anaemias Hemoglobinopathies such as thalassemia, Autoimmune hemolyti

Hello, I have a problem with PVCs and Tachy Тhis thing happens 5 times in 3 years,2 of which there were pauses during tachycardia like this (beat.beat.beat...beat.beat...beat.beat) at very high rates. When this tachycardia starts i feel very dizzy and stomach ache, Pressure in the chest.I think it was somewhere about 200bpm without success for ECG recording. 5 days ago I was admitted to hospital in the cardiology department.Аt the hospital did blood tests (cardiac enzymes, electrolytes - which were normal), EKG's, ECG stress test and echocardiogram. Echo: slight mitral valve prolapse Ecg`s: Early Repolarization Stress Test: Heart Rate 130bpm at 150W (was stopped because of leg fatigue) doctors say that there is nothing. But I worry about the high heart rate`s which happened several times as I mentioned. Mainly worried about V-Tach and V-Fib. In order to go to EP Doc or EP Study, I should have recorded arrhythmia (the problem is in the recording)

Pain in the ears (Otalgia) may occur either due to causes in the ear or causes somewhere else having same sensory nerve supply as the ear (referred otalgia). The causes in the ear may be either in external ear or middle ear. The inner ear has no pain fibres, so diseases of the inner ear are mostly painless. The common causes in the external ear are: 1- Acute diffuse otitis externa 2- Boil 3- Otomycosis 4- Bullous myringitis 5- Herpes zoster oticus 6- Perichondritis 7- Trauma or foreign body 8- Impacted wax 9- Malignant otitis externa 10- Neoplasia The common causes in the middle ear are: 1- Acute suppurative otitis media 2- Acute on chronic otitis media 3- CSOM with complications 4- Mastoid abscess 5- Trauma 6- Otitic barotrauma 7- Neoplasms REFERRED OTALGIA: A good number of patients complaining of earache have disease somewhere else. This is due to the common sensory nerve supply with the ear. The ear is supplied by the branches of trigeminal, facial, glosso

NYSTAGMUS Nystagmus is a rhythmic oscillation of the eyes (moving eyes). It is a sign of disease of either the ocular or the vestibular system and its connections. Nystagmus impairs the visual ability of an individual. There are ocular causes of Nystagmus (defect in eye, eye muscles), Central Causes of Nystagmus (nystagmus secondary to central vertigo, central vertigo results from damage to the vestibular nucleus of the brain stem. which has connections to the visual nucleus so any lesion of the vestibular nucleus may affect the visual nuclei) Peripheral causes of nystagmus ( Peripheral causes include diseases of the ear, the vestibular apparatus of the ear, inner ear infections, damage to semicircular canals etc) Types of Nystagmus There are two types of nystagmus: Jerk Nystagmus It is the usual nystagmus of neurological disease and has two components, fast and slow. Horizontal or rotatory nystagmus Horizontal or rotatory nystagmus may be due to the peripheral lesion (in