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By Dr. Fibhaa Syed  MBBS, FCPS, MRCP, SC Endocrinology Assistant Professor of Medicine Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences Following steps should be follow while interpreting ECG. Details may be found elsewhere, in this article brief outlines regarding ECG interpretation are shared, which were explained by Assistant Professor of Medicine, Dr. Fibhaa Syed during a Post-Graduate teaching session at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad Pakistan. Please note Normal Criteria is shared here unless specified otherwise. ECG Interpretation Steps Identification Name,  Date and Time Calibration  Normally Width = 5 squares (1 big square), (one small square = 0.04 seconds) Height = 10 small squares (1 small square = 0.1mV, 10 small squares = 1mV Rate 300 divided by Number of of large squares between two QRS complex = Rate / min Rhythm Check in lead II.  QRS ...

Q: A 28 y/o F comes to OPD, she is known the case of epilepsy since childhood, taking  Valproate and levetiracetam, she has been seizure free since last 11 months, she tells you that she is 8 weeks pregnant, what will you do? Answer:  In pregnancy, the incidence of seizure may increase or decrease. But seizure in pregnancy can be potentially dangerous and life-threatening, therefore, the anti-epileptic drugs which patient is taking with optimal control of seizures should be continued and the patient should be counselled about the risk of teratogenicity and benefits. More-over, anti-epileptic drugs increase the risk to 6% as compared to placebo (3%), and among anti-epileptic drug valproate possess the highest risk (up to 20%), newer antiepileptic drugs have a far lower risk of teratogenicity as compared to valproate and topiramate (which have the highest). Alternatively if patient is not pregnant and wants to be pregnant you may choose to wean her off anti-epileptics if ...

Acromegaly is a condition which results due to excess of growth hormone. Growth hormone is secreted by the anterior lobe of the pituitary gland under the influence of growth hormone releasing hormone which is secreted by the hypothalamus. Causes of acromegaly.  In 90% of cases, the cause of growth hormone excess or acromegaly is Pituitary adenoma while other 10% causes include; Ectopic secretion of growth hormone or growth hormone releasing hormone by some tumour. Diagnosis of Acromegaly It is diagnosed by the clinical features, which include; large spade-like hands, frontal bossing, large jaw and gigantism. IGF 1 and growth hormone level are raised and MRI of the brain usually show pituitary adenoma.  Treatment of Acromegaly.  Any of the following regimens can be tried.  Surgery is the first line: Transsphenoidal resection of pituitary adenoma is the first line treatment, and usually cure the disease.  Dopamine agonists, for example, bromocr...