India\s Biggest Doctor Patient Portal.

Time 2020-11-03 15:04:03

Web Name: India\s Biggest Doctor Patient Portal.

WebSite: http://wacky5.com

ID:103597

Keywords:

Biggest,India,Doctor,

Description:

This video of dr vikram Yadav blogger on youtube is now live on wacky5.com. You can learn how to remove big size blackheads from the nose. These blackheads are more than 50 year old. These blackheads are being extracted using comedone extractor. Blackheads Whiteheads are actually form of acne vulgaris. Black one are formed as a result of oxidation due to contact with atmospheric air. While whiteheads are those which remain inside. Today we attended the golden opportunity to attend the passing out parade of Deputy Superintendent of Police at police academy Moradabad, which is the oldest police academy of Up, its around 116 years old. Here are the photographs of the moments which were captured by us. Our heartiest congratulation to all passing out gems. You can download your photographs in gallery below.Friends when you spent more than half an hour in water while bathing or swimming, you notice that skin of your finger tips or toes get wrinkled. Have you ever thought what s the reason behind it?Reason lies in your palm. Your palm does not have hairs, so no sebum is produced, so water can not be repelled. Your skin in palm region is quite thick, so it contains dead cells and keratin which is both alive and dead too. So the dead keratin absorbs water and swells up while live keratin donot. So both dead and live keratin is attached to the skin leading to formation of wrinkles. you can watch out the video below.CSF protein level – A predictor of optic atrophy in tubercular meningoencephalitis (TBM) in paediatric age groupDownload This Article In PDF Format HereThis Article is published with permission fromRAJENDRA KUMAR BUNDELA*, SARAN KUMAR SATSANGI**, LUXMI SINGH***, PRADYUMN SINGH****, BISHAN B LAL**,KAMAL N MISHRA******Assistant Professor, Department of Ophthalmology, **Professor Head, Department of Ophthalmology, ***Associate Professor, Department ofOphthalmology, ****Associate Professor, Department of Pathology, *****Associate Professor, Department of Paediatric, Era’s Lucknow MedicalCollege And Hospital, Lucknow (UP) India And S N Medical College, Agra** (UP) IndiaPurpose:To evaluate the correlation of CSF protein level with occurrence of optic atrophy in TubercularMeningoencephalitis (TBM) in pediatric age group.Design: Retrospective longitudinal study. Method: 82 diagnosedcases of TBM were included in the study. Routine ophthalmoscopic examination was done in all the cases andfundus findings with special reference to characteristic optic disc changes were recorded, the fundus examinationwas done initially at the time of diagnosis of TBM and repeated after 6 month of starting ATT. During routine CSFexamination micro protein analysis was done by standard commercial kit and using manufacturer guide line. Thetwo observations i.e. Disc changes and CSF protein level are correlated.Result: Out of total 82 diagnosed childrenwith TBM, 28 developed optic nerve involvement in form of papilloedema, temporal pallor and optic atrophy, out ofthese 28 patients of optic nerve involvement, 26 patients (92.85%) had initial CSF protein level 101 mg%. Despite6 months of continuous ATT, out of 28 patients 7(25%) developed papilloedema, 9(32.14%) had temopral pallor 12(42.9%) had Optic atrophy. In the12 patients who developed optic atrophy the initial CSF protein level was106 mg % in 1(6.7%), between 151-200mg% in 2(18.9%) and between 200-300mg% in 9(32.1%) patients. Thesefindings were statistically significant (p 0.01).Conclusion: Children with TBM having high protein content ofCSF at the time of diagnosis are more likely to develop optic atrophy. More so higher the initial protein level, moreare the chances of child developing optic atrophy.Tuberculosis in children is one of the major health hazardand it is estimated that 11% (1million) of the annual TB casesoccur in children less than 15 years of age.1 The incidence ofCNS TB (Neurotuberculosis) especially TBM is related to theprevalence of TB in community and it is still the most commontype of chronic CNS infection in developing countries.2 Manyof the clinical presentation and sequelae of TBM are the resultof an immunologically direct inflammatory reaction to theinfection.3Tubercular Bacilli implanted to meninges results in formationof small lesion (Rich foci), the location of expanding richfocus determines the type of involvement. The tubercles (foci)rupturing into the subarachnoid space cause meningitis and ifmore deeper in parenchyma it cause abscesses or tuberculoma.4In case of tubercular arachnoiditis, inflammatory exudatessurround both optic nerve, but do not infiltrate. Such denseinflammatory exudates surrounding both optic nerve canproduce optic neuritis per se. Periarteritis and occlusion ofsmall vessels is frequently seen due to direct compression aswell as ischemia causing neural damage.The common lesions in order of frequency are papillitis, opticatrophy and papilloedema.5 In addition TBM may result inarachnoiditis and infarction.6-7In children, papilloedema may progress to primary opticatrophy and blindness resulting from involvement of opticnerves and chiasma by basal exudates (i.e., Optochiasmaticarachnoiditis)2METHODEighty two diagnosed cases of TBM between the age groupof 6 months to 15 years were included in this retrospectivelongitudinal study conducted in department of ophthalmologyin collaboration with department of paediatrics at SNMedical College, Agra and Era’s Lucknow Medical Collegeand Hospital, Lucknow. India, during the period, January2005 to December 2008. The diagnosis to TBM as per WHOguidelines.1 Clinical presentation included fever, convulsions,vomiting, altered sensorium and recurrent infection, cough,neurologic deficits in the form of quadriparesis, hemiplegia,or monoplegia, Positive family history of tuberculosis,Cerebrospinal Fluid (CSF) showing pleocytosis and proteinlevel more then 40mg%, Montoux test, X-ray chest picturesuggestive of tuberculosis.Ocular fundus examination using direct ophthalmoscope(Heine beta 200 S. Germany), and fundus camera (Zeissvisucam NMFA digital camera, Germany), was done on initialdiagnosis of TBM and after 6 months of receiving ATT. Opticdisc changes were assessed and diagnosis of optic atrophywas made on the basis of altered disc color (varies from paleto white), disc margin pattern , appearance of optic disc cupshape, reduction in numbers of small blood vessels on discsurface ( Kesten Baum Index).Statistical analysisUnivariate comparisons between treatment groups and theassociation were made using the Gaussian test, Chi square testand Fisher exact test by using statistical software SPSSv16.RESULTThe findings and results of the present study were based onobservations made on 82 diagnosed patients of TBM, betweenthe age group of 6 month to 15 years (Table 2) of whom 48(58.5%) were male and 34 (41.5%) were female (Table 1),Out of these patients, 42 (51.2%) were more than or equal to5 years of age and 25 (30.5%) between ages of 1 year to lessthan 3 years.At the time of initial presentation 28 (34.2%) patients had CSFprotein level in the range of 40-100 mg% while remaining 54(65.9%) had CSF protein level in the range of 101-300 mg%(Table 3). All the patients received four anti tubercular drug i.e.,Isoniazid (H), Rifampicin (R), Pyrazinamide (Z) and fourth oneeither Ethambutol (E) or Streptomycin (S). After six monthsof continuous ATT, amongst 42(51.2%) patients who were onRHZ+E regimen and had initial CSF protein level between40-150 mg%, no patient developed optic atrophy; howeveronly single patient (16.7%) out of 11 patients who were in151-200mg% CSF protein level group and had temporal pallorof optic disc at the time of first presentation, developed inoptic atrophy. While out of 28 patients in initial higher CSFprotein level group 201-300mg%, 4(26.7%) patients developedwith optic atrophy. In patients who received RHZ+S regimen,optic atrophy developed in 3(23.1%) patients with CSF level101-200 mg% and in 4(38.6%) patients with CSF level201-300 mg% (Table 4). The result shows that incidence of opticatrophy is independent of ATT regime. Over all incidenceof ultimate optic atrophy increase with initial higher CSFprotein level. In present study it was nil with 40-100mg% CSFprotein level and 32.14% with 201-300mg% level. This wasstatistically significant (p 0.01).Observations showed that in patients having optic nerveinvolvement with initial lower CSF level, it cleared off in duecourse of treatment but in patients having higher CSF proteinlevels and initial optic nerve involvement, it either did not clearoff or landed up in optic atrophic changes as partial (temporalpallor) or frank optic atrophy (Table 5 ).DISCUSSIONOverall mortality of TBM is 15-75% as reported by variousworkers.5 There has been slight decrease in mortality due toTBM in last 10 years,1 but the morbidity due to TBM continuesto be the same over the last two decades. This is because ofexpansion of tuberculoma or development of multiple newbrain lesions during treatment of TBM, and though uncommon,has been reported in literature as “Paradoxical response” .10-13 Itis possibly due to type IV hypersensitivity reaction developingwith in the initial lesion and resulting in cerebral vasculitis,infarction and oedema.14The large majority of TBM cases (75-85%) are below theCLINICAL ANALYSISage of 5 years. The peak incidence is in 3-5 years age group.The neurological damage was maximum in children lessthan or equal to 3 years of age and optic atrophy occurred ina large majority of cases. There is preponderance of boys.5Our findings are akin with those as reported in literature. Theneurological damage is significantly enhanced in childrenwhose duration of disease is more than one month.5 The stageof TBM at which treatment is started constitutes the singularlyimportant prognostic factor for probability of optic nerveinvolvement and children developing optic atrophy.5 Kalita andassociates in their study of 65 patients of TBM with follow upfor 1 year have reported the, optic atrophy incidence as high as37%.15 In our study the incidence of optic atrophy is 42.14%.The further higher incidence of optic atrophy in TBM in ourstudy is probably because of late start of ATT in majority casesfor some practical reasons.Optic atrophy may some time be the only primary manifestationof TBM and in some case it is reversible, if adequate ATT isgiven in the early stage of disease.5Our study shows that as the initial protein level go higherthe ultimate incidence of optic atrophy goes higher. There isgeneral consensus that fixed dose combinations can be usedsafely in children.1 Our study also shows that incidence ofoptic atrophy is independent of ATT regime. BCG Vaccinationin new born confers valuable protection and prevents.hematogenous dissemination and development of TBM toextent of 60-80%.8-9A combination of patient’s awareness, early start of treatmentand regular follow up may be of avail in prevention of opticatrophy in children suffering with TBM. Further follow upstudies with still higher number series of cases are required.Since in the present study group most of the children werebrought to hospital much late and they could not get ATT in theinitial phase. Majority of them were from poor socioeconomicstatus and malnourished which in itself are the contributingfactors to high mortality and neurological damage. Well friends recently we got a golden opportunity to attend the Tv anchoring workshop at aaj tak above are the photographs of the session which you can download it. Agenda was divided into 8 points including studio tour, TV presenting basics, making showreel etc. During studio tour we visited every section of studio  and told how news room works? How ticker interface works? What are editing softwares used by these big companies? The editing softwares used  are FCP s and velocity.We were given 1 hour practice to speak in front of camera using telepromter. Even the recordings has been done, those recording i.e show reel will be given to all students by mail. Below is the video of all those people who attended the workshop and their experiences.If you want to become a TV Anchor let me tell you some of the very important points1. Feel the story while reading news, talk to the lens of camera, take care of your body movements.2. News channel is divided into Input Output. Input sends you news, visuals etc which is given by reporters- now all this information is sent to editing department where it is edited and later on you see output on tv screen.3. Elements of news story are bytes, Graphics, animations, text visuals while elements on tv screen are logo, location bugs, breaking news, ticker , anchor etc.4. Lights used are tungsten halogen lamps to produce a maximum light from 500 to 2000 watts.5. Voice matters, so you need to improve the voice by reading newspaper loudly for 10-20 minutes fast. Do not fumble, gargles with water so that no throat issues and you can produce effective voice.Dress Codes of anchors1. Fit dress (No loose clothes or very tight clothes and clothes should be ironed, check, printed and stripes shirt should not be used)2. Proper hair cut and no reflective lens.Males should have collar tight, clean shave, coat on arms, no white clothes, tie should be above belt, leave last button open.Female should take care that their top should not be deep cut. No use of sindur, bindi, ring, chudiyan. Do not wear big sized ear rings.Short and clean nails, no overmake up , If you anchoring while standing wear Chudidar instead of salvar, closed type shoes, carry make up kits, no red tie.This is a black head 18 minutes film, watch out millions of black heads on forehead, biggest black heads on eyelids being extracted out.You need to have a container, water, burner, towels, soap, isopropyl alcohol, comedone extractor, gloves and a guy with blackheads on face.Boil the water in container, this will convert the water to vapour state, tilt yourself on container so that face can be exposed to vapours, put towel on head as shown in video, this will loosen the black heads from pores.Wash your hands properly, wear gloves and start extraction of comedones, by applying gentle pressure on skin, procedure is painless, in between sterilize the comedone extractor by dipping in iso propyl alcohol.We have written informed consent from all the candidates shown in the video to put the video on youtube.Pus From Penis  click here to download watch video on pus from urethra.Here you can see pus oozing out of male genital organ, along with this patient has symptoms of pain burning sensation during passing urine, there are many causes of this condition most important includes STD caused by either clamydia, or Gonorrhea, similar conditions can be seen in uretheritis and UTI (urinary tract infection).you can see some kind of discharge, signs of inflammation, foul smelling of fermentation here you can see vestibule of vagina, labia majora minora clitoris all are inflamed. Such kind of inflammation can be due to either infection of trichomonas, candida infection, bacterial or herpes infection or even change in ph of skin. Send the swab or smear for culture and sensitivity and it must be treated with metronidazole, antifungal and broad spectrum antibiotics. Similar is condition known as vaginitis, even this also leads to vulvovaginitis.Vulvitiswell friends here we are going to show you 2 photographs of pustules in one pustules are present over glans and in another they are present over corona of glans, you people may think it to be syphilis but in primary syphilis first of all a papule develops in which central necrosis takes place leading to a hard chancre On request of our reader Shruti Gupta we uploaded video on how to increase concentration so that you can have a sharp strong memory. This video has been shot during night with mobile light so you will be able to see face only. Here we have tried to explain how you can increase your concentration and prepare smartly to crack PMT examinations in one attempt.Eye injury can be physical or chemical here I have shown a physical injury where you can see lacerated wound and a corneal ulcer in 2nd case. You can also see bluish discoloration of upper eyelid. Eye injury or trauma can be of penetrating type, non penetrating type, blow out fractures or orbital fractures. Emergencies are Corneal abrasions, deep eyelid lacerations, welders burn which I have explained in another video, orbital fracture etc.Management includes1. Irrigation of eyes by normal saline2. Patching of both eyes because if one eye is patched, person will move that eye which will automatically move another eye so both eyes to be patched.3. Suturing.You can watch out 2 interesting cases of eye injury1. This patient was hit by brick and you can see a clear lacerated wound with collection of blood in upper eyelid, abrasion of upper eyelid.2. This patient is flicked by sand patient rubbed the eye and corneal ulcer was formed, in such cases, fungal infection is the main culprit along with abrasion of cornea with sand particles.Here we have tried to explain you the differences present in preterm and term babies in form of video starting from head we go down1. hairs- woolly and fuzzy present in preterm baby but silky and black in term baby.2. Ears- lack of cartilage present in preterm, so recoil very poor, ear is soft, but in term baby recoil is good and you can feel the cartilage.3. Lanugo present all over body, less lanugo is present.4. Weight is less usually less than 3 kg, usually they are of 1.5 to 2.5 kg.5. Breast nodule present but less than 5 mm, nipple may be present or absent, may be very small in size.6. Genitals, rugae absent over testis, vulva separated apart in females7. obtuse popliteal angle8. Square Window sign negative.Watch out all of these things in a preterm baby below on youtube.Nail biting is actually an impulse control disorder, can cause multiple medical conditions, when you eat nail or skin near nail, you remove the natural barrier of protection skin , so viruses, bacteria, fungi etc enter there smartly and cause you many diseases. Nail biting also injures your teeth. Those persons who have habit of eating skin is known as wolf biters medical condition is known as dermatophagia and is a form of OCD (obsessive compulsive disorder).Treatment is apply bitter nailpolish over nail, or apply crushed garlic over them, so that when you try to eat them, you can get smell and avoid this bad habit. Watch out video belowYou can learn all suturing techniques by watching video tutorial below in this article, which includes basic sutures, mattress sutures, continuous sutures, intermittent sutures, tension sutures etc. You can practice the suturing techniques at your home by using suturing kits, or you can try on some sliced pieces of pork, or leg of pork from butcher s shop. You must watch this video twice for better grasping.Friends today one of my distant relative was diagnosed of cervical cancer with metastasis, so gynecologist recommended radiotherapy to  her so I got to know the cost of radiotherapy in India which I am updating here, the cost may vary from institution to institution, like in AIIMS it is very cheap, You can see list of all centres in India where radiotherapy is being done you can save it in Pdf format.1. Image Guided Radiation Therapy costs around INR 2 lakh, which is given for 5 days in a week for 5 weeks. These people relieve this cost to 1.6 lakh if doctor is known to them. This is actually full course price.2. Intensity Modulated Radiation Therapy costs around INR 1 lakh 5 thousand which is also given for 5 days for 5 weeks.3. 3 Dimensional Conformal Radiation Therapy which costs around INR 70,000 for same days and same weeks as for above.4. Internal Radiation costs around 25,000 INR given for once in a week for 3weeks cycle.You can get discounts on radiotherapy by requesting your doctors or if any known doctor is there.Painful cramps during menstruation can be due to without any pathology are called primary dysmenorrhoea and when associated with certain pathology are called secondary dysmenorrhoea. It is most common in teenagers. They are most severe during first day of menstruation and reduces as day passes.When this pain is felt few days before the start of menses, it is called as congestive dysmenorrhoea, here the cause may be pelvic inflammatory diseases.Investigation of choice is ultrasound, CT, MRI, Endoscopy. Cause is increased level of prostaglandins. Treatment should always be taken after consulting your doctor and not by watching this video, which includes, antispasmodic, like drotavarin, hyoscine, NSAIDS, analgesics, drugs inhibiting prostaglandins synthesis like ketoprofen and vitamin E has been found to be relive in 90% cases, surgery is required in surgical cases. Watch out video below on our Youtube ChannelBlepharitis is actually inflammation of eyelids, which can be due to staphylococcal infection, seborrheic blepharitis, ulcerative or meibomian. Patient usually complains of gritting sensation, crusts, redness, irritation, swelling etc. It is of 2 types, anterior or posterior, you can see crusts over eyelashes, even loss of eyelashes condition is known as madarosis. Ultimately leading to eyelid ulceration which will lead to entropion or ectripion.Now watch out video on how to treat it, however its quite difficult to treat, some times requiring steroids too. Girls should not use any kind of makeup when washing eye lids with luke warm water. Watch out the video belowWe have shown you how to test the chyluria, if patient has brought you white coloured urine sample, which may be chyle in urine. Chyluria is actually a white coloured urine, which may be due to taking fatty diet, or may indicate filariasis. To test you must mix equal amount of ether and urine sample, shake it well, you will see after some time it splits into 2 layers of urine and ether, but the white colour of urine goes away as fat gets dissolved. This gives you confirmation of chyluria. Treatment is performing retrograde pyelography and giving 21 days course of diethylcarbamazine in TDS dose along with multivitamins, since loss of chyle leads to deficiency of vitamins in body.When urine comes in contact with skin, urine increases the coefficient of friction of skin, which makes it to be more susceptible to clothes rubbing. When fecal incontinence is there, condition becomes even more worse, bacteria in feces convert urea of urine into ammonia, due to ammonia, pH of skin increases, so enzymes which are present in fecal matter in inactive form gets activated causing more damage to skin, ultimately some bacteria or yeast  infection occurs, you can easily see the scaly lesions, erythema over things of the patient, condition becomes even more worse, when these lesions convert to ulcers.Treatment is application of petroleum jelly, zinc oxide ointments, antifungal powder etc, if ulcer is there, you must visit your doctor for proper care of ulcer, take care that dermatitis area remains dry.For better understanding and visualizing the patient watch out the video below on youtube.BPH is known as benign prostatic hyperplasia, where the prostate gland enlarges, when median lobe enlarges, it compresses urethra first, leading to increased frequency, urgency and hesitancy of urine. Slowly slowly changes are seen in other structures, first of all muscular wall of bladder undergoes hypertrophy so as to push urine outside of body, when unable to do so, very thick muslces in form of bundles develop in bladder giving bladder a shape in which you see depressed part (sacculation) and elevated part (trabeculation) when seen from cystoscopy. The depressed part are weak, sometimes when pressure increases, herniation of these depressed part takes place leading to diverticuli in bladder, now in these diverticuli, urine is not able to pass out, leading to infection, later on some stone formation takes place. Utimately back pressure goes to ureter and kidney, leading to hydroureter, hydronephrosis of kidneys, utlimately renal shut down and death due to disturbed KFT. Watch out the video below showing you all real changes in bladder, kidney, prostate etc.Watch out video below explaining all facts related to typhoid fever, its prevention, treatment, vaccines, signs symptoms, differential diagnosis. It is caused by Salmonella Typhi or Salmonella Paratyphi bacteria, mode of transmission is faecoral route by consuming infected food and water. Differential diagnosis is malaria, dengue, viral fever, respiratory tract infection, kala azar, dysentry, SABE.Rapid diagnostic Kit for malaria are available in India, by using them you can rapidly test for plasmodium vivax, plasmodium falciparum and mixed infection, you can get results with in 20 minutes, procedure is very simple only one drop of blood is required which is put in section s of the kit, in section a 3 drops of buffer is added, all get mixed and you will get results in form of dark line as you get in pregnancy kit. One line indicates negative test of wrong procedure, CON means control, PV and PF indicates vivax and falciparum species. You can watch out complete procedure of how to test malaria at home with the help of these rapid malaria kits below on youtube. We are highly thankful to Gopal Singh for helping in this test.watch out the animated video of diabetes explaining diabetes in very excellent fashion below on youtube, you will not forget or never get confused between themIf patient comes with complain of blood in urine i.e hematuriaIf you suspect any tumor or growth in bladder.If patient is having recurrent urinary tract infection.Over active bladder or incontinence of urine or anuria that means either when patient is having frequent urge to urinate or patient is unable to control urine or there is no formation  of urine.When patient is complaining of severe pain in urine.When you suspect a calculus or stone in urinary tract or want to do lithotomy with the help of cystoscope.When you are suspecting any blockage or Benign Prostatic Hyperplasia.Cystoscopes are of two types- 1. Flexible and 2. Rigid typesIf you are the patient and having problems like pain and burning micturition after cystoscopy, you do these 3 things which will help you to come out of these problems (Post Cystocopy Care)a)  Drink as much water as you can @ of 1 litre every two hours.b) Take a bath with warm water.c)   Take a sterile bandage, wet it in warm water, apply it to urethral opening frequently.d) Ask your doctor to prescribe certain urinary analgesics like phenazopyridine.What is the cost of cystoscopy in India?It is done free of cost in Dr Ram Manohar Lohia Hospital, New Delhi, Safderjung Hospital New Delhi. Private practioner can charge accordingly.There is a video tutorial for you on how to remove a DJ Stent in your patient. This patient on which we were working was positive for hepatitis C, so extra precautions were taken since hepatitis C spreads by blood to blood contact. Let me first tell you indications for Double J stenting in urology which is commonly performed now a days.1. Neurogenic Bladder2. Small Size Bladder3. Post Renal Transplantation4. Injured Ureter5. Hydronephrosis6. Renal CalculiStents are placed and removed with the help of cystoscope. Watch out the video below explaining how we removed this DJ stent with the help of cystoscope.

TAGS:Biggest India Doctor 

<<< Thank you for your visit >>>

India’s Biggest Doctor Patient Portal

Hot Websites