NMS FUTURE BOOK

NMS

FUTURE BOOK

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ISBN: - 978-93-89960-80-8

Price: 200.00

Publishing Year 2020

Published and Printed by:

Rudra Publications

Office Address: Kapil Nagar,

New Sarkanda, Bilaspur, Chhattisgarh - 495001

Phones: +91 9522285558 +91 9522263336

Email: contact.rudrapublications@gmail.com

Website: www.rudrapublications.com

Print in India

NMS

FUTURE BOOK

[DRx. GAURAV GUPTA]

[DRx.BRAJ BHAN RATHOUR]

PUBLICATIONS

www.rudrapublications.com

rudrapublicationsmtwo@gmail.com

CONTENT

ICU Basic Knowledge Collecting

Gynaecology

Pharmacy Basic Knowledge

Motivational Thoughts

INTRODUCTION

Today I am very Happy that the Book I am making here will prove to very beneficial for the future Medical Students.

This Book provides the knowledge for Medical preparation regarding the future of Medical Students.

And I believe that every Student who read this Book and show something big in their life. Because Life always require some big thinking.

Many Thankful to New Medical Students.

Intensive Care Unit (ICU)

ICU Basic Knowledge

Temperature: -98.6°F/37°C

( Fahrenheit )/( Celsius)

Pulse Rate: - 72-100bpm (beat per

minutes )

SpO2 (Saturation of Peripheral Oxygen): -90-100%.

Blood Pressure: - 120/80 MMHg

(Systolic/Diastolic) (mmHg-Millimeter

per Mercury's Pressure )

RBS (Random Blood Sugar): - 80/140mg/dl

[miligram/deciliters].

Fasting- less than lOOmg/dl

Before meal- 70 to 130mg/dl

After meal- less thanl60mg/dl

Respiration: -12-16bpm (breath per minutes )

Haemoglobin: -12.5-13.5g/dl ( gram per decilitres)

TLC (Total Leucocytes Count): -4,000

11,000 Cumm.

Bleeding Time: - 2 to 7minutes

10. Clotting Time: - 4 to 11 minutes

NORMAL ABG REPORT

ABG- Arterial Blood Gas

pH :-

7.35-7.45

PaCO2 : -

35-45 mmHg

SaO2 : -

90-100%

HCO3- : -

22-26 meq /L

Na+ : -

135 mmol/L

K+ : -

4.5 mmol/L

Cl :-

105 mmol/L

Drug of Administration

How many types Of Injections can we give to the patient?: -

Intravenous - 25° [dermis-veins]

Intramuscular - 90° [muscle]

Intradermal - 10° - 15° [epidermis]

Subcutaneous - 45° [subconscious tissue]

Intra-arterial - 30° - 45° [artery]

How many types Medicines can we give to the patient? -

Orally

Sublingually

Rectal

Vaginal

According to the patients, blood glucose, how much insulin can be apply to him?

Blood Glucose

(mg/dl)

Normal Insulin

Sensitivity (Unit)

<150

150-199

200-249

250-299

300-349

350-399

10U

400-449

12U

450-499

14U

All Medical Term

Hypertension

Hypotension

Hypoglycemia

Hyperglycemia

Tachycardia

Bradycardia

Tachypnea

Bradypnea

Hypoxia

Cyanosis

Hematuria

Blood pressure increase

Blood pressure decrease

RBS decrease

RBS increase

Pulse rate increase

Pulse rate decraese

Respiration increase

Respiration decrease

Low Oxygen level

Urine flow with Blood

IV FLOW RATE CALCULATION

Formula

= Total Volume of Fluid(ml)X drop factor Total time of infusion(minutes)

Drop Factor: - The Drop factor means How many drops will be made in 1ml.

Sets

Drop Factor in 1 ml

1. BT Set

10 drops/ ml

2. Macro drip set

(Adult)

15 drops/ml

3. Micro Drip set

(Child)

60 drops/ml

Examples

Question: - For the administering 3000 ml of fluid in 24 hours. Then the Flow rates ? (Given Rate factor is 15).

Solution: -

Given,

Volume = 3000 ml Rate

Factor = 15

Time = 24 hours

Total Volume of Fluid (ml)xdrop

factor

Formula: — — - .—— -

Total time of infusion (minutes)

Ans=[31 drops/ minute]

-:A11 Medical abbreviations:-

Treatment

History

Diagnosis

Every

SOS

If needed

A/c

Before meal

P/c

After meal

BID

Twice a day

TIP

thrice a day

OID

Four times a day

Once a day

BBf

before breakfast

Twice a week

Subcutaneous

Intramuscular

Intradermal

Intravenous

At night

By Mouth

1 tsf

5ml

OHS

Before Bed Time

O4H

Every 4 hours

NPO

Nothing by Mouth

with Food

Vaginal

All Emergency Medicines and it's use

Deriphylline - Asthama & COPD

Atropine - Bradycardia

Soda bicarbonate - Sevear metabolic acidosis

Adrenaline - Cardiac arrest, stop superficial bleeding

Dopamine - Low blood pressure, slow heart rate, cardiac arrest

Noradrenaline - Low blood pressure

D25%dextrose - Hypoglycemia, hypercalcimia

Trenexa500mg - Uncontrollable bleeding condition

Ethamsylate500mg - Treat excessive blood loss during menstruation

Dexamethasone - Allergic reactions

Lasix & dytor - CHF & CRF

Midazolam - prolonged seizures, sedation

Diclofenac - Mild to moderate pain

Paracetamol - Mild to moderate pain, fever

Perinorm - Nausea, vomiting, heart burn

Phenytoin 100 mg - Primary generalized seizures

PhenoBarbitone - Treat and prevent epilepsy

Ondestrone - Nausea, vomiting

Normal Saline (NS) - Manegement and treated of dehydration

Tramadol - Treated sudden pain, long time pain

Metronidazole - Abdominal infection caused by bacteria

Omeprazole - Treat the symptoms of GERD

Vitamin-K - Treat and prevent low levels of certain substance [ blood clotting factors]

Avil - Allergic reactions

All Instruments used in ICU

Suction machine

Infusion pump

Ventilator machine

Monitor

Vencircuit

Ambubag

Sthetoscope

Sphygmomanometer

Glucometer

Thermometer

Opthalmoscope

Otoscope

Endo-tracheal Tube

Laryngoscope

C’ PAP & BiPAP

Reflex Hammer

Cannula

Airways

Iv Set/Bt set/micro drip set

Catheter

RT (Rayles Tube)

Doppler

Pulse Oxymeter

Nebulizer Machine

Full Explain of All ICU

Instruments

Suction Machine: -

Tracheostomy Care.

This device is used for removing an obstruction from a person’s

Airways Main purpose of this Machine is to pull out mucus, saliva, blood secretion, or other fluid clearing the airways for easy breathing.

Infusion Pump; -

An Infusion Pump draws

fluid from a standard bag

of intravenous fluid and

control the note of flow.

A Syringe pump is a

different types of infusion delivery devices, Instead of Drawing fluid from an Infusion bag.

Monitor: -

The Physiologic parameters currently displayed on ICU Monitor includes blood pressure acquired

from an arterial catheter

and external pressure

cuff, oxygen saturation

of Blood acquire from a pulse Oxymeter, heart rate and respiratory rate acquired from external transducer & electrocardiogram waveform.

Ventilator Circuit; -

A breathing system &

breathing circuit is a

medical device used to

deliver oxygen and

remove carbon dioxide and deliver inhal- ational an aesthetic agent to a patient.

5 . Ventilator Machine:-

Ventilator gently forces normal air through the breathing tube into a patient airway and move down into their lungs. Mechanical Ventilation not only ensures that the patient receives sufficient oxygen but also helps to move out carbon dioxide and other waste gases from the lungs.

Ventilator Setting

Mode: - Pressure Controlled ventilation

Respiratory rate: - 10-15b/minute

Tidal Volume: - 6-10ml/kg

PEEP:- 0-2 cmEEO (Positive End Expiratory Pressure)

Trigger sensitivity: -21/minute

Ambubag: -A bag valvei

mask sometimes known

by the proprietary name

Ambubag or generically

as a manual redistricting

self in flaming bag is a

hand held device commonly used to provide positive pressure ventilation to

patients who are not breathing adequately.

7. Stethoscope:-The Steth

oscope is an acoustic

medical device used for

and accumulation to the

internal sound of anl

animal or Human Body. It typically has a small disc shaped resonator that is placed against the chest and two tubes connected to earpieces. It is often used to listen to lung and heart sounds.

8. Sphygmomanometer: - It is a device

that measures blood pressure. It is composed] of an inflatable rubber

cuff. A Sphygmomanometer is used to listen Arterial Blood flow sound.

Glucometer: -

It is a small portable machine that is used to measure Glucose level in Blood.

Thermometer: -

This device is used to measure the body Temperature.

Opthalmoscope;-

It is also called asi fundus-copy, is test that allow sa health professional to see inside the fundus of the eye and other structure using an ophthalmascope. The main purpose of this device to an eye examination.

Otoscope:-

An Otoscope is also known as an Auris cope. It is a Medical device that allows professional healthcare to better see outer and middle portion of the ear.

Reflex Hammer: -

A Reflex Hammer Medical instrument by practitioners to deep tendon reflex.

Endotracheal tube: -

An Endotracheal tub

is a Catheter that i

inserted into the trache

for the primary purpos

of establishing and maintaining a patient airway and to ensure the adequate exchange of oxygen and carbon dioxide.

Tube Size

Pediatric Tube

Adult Tube

2.5 mm

5.5 mm

3 mm

6 mm

3.5 mm

6.5 mm

4 mm

7 mm

4.5 mm

7.5 mm

5 mm

8 mm

15»Laryngoscope; -

The most commonly used of Laryngoscope! for intubation in adults which is the curved Macintosh Blade.

16.Bi PAP & C’PAP; -

Bi PAP is also referred as BPAP which stand for Bi level Positive.

Airway Pressure. This

Machine has a very

similar function to C' PAP.C' PAP is stand for Continuous Airway Pressure which has two often used noninvaseve Ventilation. Both Bi PAP and C' PAP involves

the person breathing pressurized air through a mask attached to a small Machine.

17.Airwavs: -

The Airways or breathin

passage is the pathway

through which air flow int

the Lungs. It start from th

Nose and Mouth that includes with throat

Wind Pipe and Lungs.

18»Pulse Oximeter; -

Pulse Oximeter is

small light weight

device used to monitor

the amount of oxygen

that carried in the body. This non-invasive tool attached painlessly to the fingertip which sending to wave length of light through the finger to measure the Pulse note and oxygen amount.

19.Nebulizer Machine: -

A Nebulizer Machin is a piece of medics equipment that

person with Asthm or another respiratory^

condition can use to administer medication directly and quickly to the Lungs. A Nebulizer turns liquid Medicines into a very fine mist that a person can inhale through a face or mouth piece.

20.IV Set: -

Intravenous giving set are regularly used to provide fluid therapy. To administer medicine and blood products.

Related Sets

Blood Set: -Blood Transfusion

Micro drip set: -Pediatric Set

21. IV Cannula; -

Intravenous Cannulation is a technique in which a cannula is placed inside the vein to provide venous access allows sampling of blood.

Identification of Cannula size vary

with Colours

Cannula size

Colour

14G

Orange

16G

Grey

18G

Green

20G

Pink

22G

Blue

24G

Yellow

26G

Purple

22.Catheter; -

A flexible or rigid hollow tube employed to drain fluid from body cavities or tc distend body passage especially one for

passing into the bladder through leg vein or arm vein for diagnostic examination.

Colour

Size French

Size mm

Green

2.0

Blue

2.7

Black

3.3

White

4.0

Green(D)

4.7

Orange

5.3

Red

6.0

Yellow

6.7

Purple

7.3

Blue(D)

8.0

Black(D)

8.7

23»Rvle’s Tube: -

A Nasogastric tube is narrow bone tube passe into the stomach via th nose.

Tube Size: -

Size in FG

Colour

Light Green

Blue

Black

White

Green

Orange

Red

Yellow

Violet

Light Blue

-: All Medical Emergency: -

Process: -

Intubation: -

Intubation is the process of inserting a tube, called an endotracheal tube (ET), through the mouth and then into the airway. This is done so that a patient can be placed on a ventilator to assist with breathing during anesthesia, sedation, or severe illness.

Catheterization: -

In medicine, a catheter is a thin tube made from medical grade materials serving a broad range of functions.

Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure.

RT Intubation: -

Nasogastric intubation is a medical process involving the insertion of a plastic tube through the nose, past the throat, and down into the stomach.

Orogastric intubation is a similar process involving the insertion of a plastic tube through the mouth.

Tracheostomy; -

A tracheostomy is a medical procedure either temporary or permanent that involves creating an opening in the neck in order to place a tube into a person's windpipe. The tube is inserted through a cut in the neck below the vocal cords.

CVP Line; -

A central venous catheter also known as a central line. Central Venous Line or Central Venous Access catheter is a catheter placed into a large vein. It is a form of venous access.

CPR (Cardio Pulmonary

Resuscitation): -

Cardiopulmonary resuscitation

(CPR) is an emergency procedure that combines chest compressions often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.

Rigor: -

The sudden attack of severe shivering accompanied by a feeling of coldness is called a riger which referred to body Temperature.

It may be described by a patient as an attack of uncomfortable shivering.

Seizures: -

A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness.

If you have two or more seizures or a tendency to have recurrent seizures, you have epilepsy. There are many types of seizures, which range in severity.

RTA: -

Renal tubular acidosis (RTA) is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine.

So that, Normally the Kidney removes excess acid from blood but certain disease genetic defect or drugs can damage the kidneys ability to do this important job.

Cyanosis: -

Cyanosis is the blue discoloration seen on the tongue and lips due to lower level of oxygen in the central arterial blood.

Perforation: -

Perforation is a hole that develops through the wall of the body organ this problem may occur in the esophagus, Stomach, small intestine, Large intestine and Rectum.

Colitis: -

Ulcerative colitis is an inflammatory bowel disease that affect the large intestine.

Obstruction; -

Intestinal obstruction is a blockage that keep food or liquid from passing through the large intestine or small

intestine.

Hydrocephallus: -

Hydrocephallus is a buildup of cerebrospinal fluid (CSF) in hollow places inside the brain, these hollow places are called Ventricle.

Hysterectomy; -

A Hysterectomy is an operation to remove a woman’s uterus.

Death Diagnosis: -

We can identify the death patient in two ways:-

Cardio Pulmonary Assignment; -

Listen the heart sound(2minutes)

Listen breath sound(2minutes)

Check the Full Vital: -

Heart Rate

BloodPressure

SpO2

Neurological Assignment; -

In this condition the patients eye pupils become dilated and fixed. And there is no movement in the eyes. The we can say that the patient has finally died.

Coma; -

A Coma is a state of prolonged unconsciousness that can be caused by a variety of problems traumatic head injury, stroke brain tumor, drug or alcohol

intoxication.

Brain Death: -

Brain death is a legal definition of death. It is the complete stopping of all brain functions and cannot be reversed.

It means that because of extreme and serious trauma or injury to the brain.

Brain Haemorrhage: -

A Brain Hemorrhage comes in Two forms: -

First, it involved bleeding directly in the brain and is usually caused by either when a head takes a hard hit in a fall.

Second, it occurs in the area between the brain and tissue covering when typically,

blood vessel expands and finally burst vessel exert pressure on the brain cutting off oxygen to cells and ultimately killing them.

Note: -

Part of the brain has a stroke then It against part completely paralyzed.

Q. What is different between heart attack and cardiac arrest?

Cardiac Arrest

Heart Attack

1. Result of an elect -rical malfunction in the heart.

1. Result of

coronary artery blockage.

2.Fetal about 90% of the time.

2.Fetal about 14% of the time.

3. The Heart stop breathing.

3. The heart

continuous beating.

-: Gynaecology:-

Period:-

A Period is a release of blood from a girl's uterus out through her Vagina. It is sign that she is getting close to the end of puberty.

Film: - The story of menstruation.

Ovulation: -

It is a part of menstrual cycle occurs when an egg is released from the ovary.

When the egg is released, it may or may not be fertilized by sperm, If fertilized egg may travel to the uterus and implant to develop into a pregnancy it left unfertilized, the egg disintegrate and the uterine

lining is shed during the period.

Menstrual Cycle: -

Menstrual cycle is the regular natural change that occurs in the Female Reproductive System that makes pregnancy possible. The Cycle is required for the product of Oocytes and for the preparation of the uterus for pregnancy.

The Menstrual cycle occurs due to the rise and fall of Estrogen.

Types of Menstrual Cycle: -

Mentrual Phase (MP)

Follicular Phase (FP)

3.Ovulatory Phase (OP)

Luteal Phase (LP)

EDD: -

It is stand for Expected Date of Delivery.

Duration of Delivery: - 277 Days or 9 months 7 Days.

But, lYear = 12months

1 Week = 7 Days

Duration of Delivery in Week

=277/7 = [38 Weeks] Ans.

LMP (Last Menstrual Period): - Example 1.

LMP= 18/01/2018

EDD= ? +7/9

25/10/2018

This is the Date of EDD=25/10/2018

Example 2.

LMP= 25 / 10+1 /2018+1

EDD=? +7 / 9

2 / 20-12=8 / 2019

This is the date of EDD = 02/08/2019

Medicines allowed during

Pregnancy

Antibiotic: -

Amoxicillin +Clavulanate

Clarithromycin

Cefaclor

Erythromycin

Nitrofurantoin

Metronidazole

Penicillin

Azithromycin

. Cold/Allergy:-

Afrine Saline Chest spray

(Oxymethazoline)

Allegra

Benadryl

Chlorpheniramine

Lorotadine

Brompheniramine

Fluticasone NasalSpray

Guaifonosin (Coughsyrup)

Dextromethorphan

ChlorasepticLozenges

Cetirizine

Body Pain: -

arvocetN 100(Acetaminophen)

Paracetamol

Acetaminophen +codeine

Sleep: -

Zolpidemtartrate

Acetaminophen

+diphenhydramine

Doxylamine

Diarrhea: -

Loperamide

Lomotil (diphenoxylate Atropine)

Bismuth SubSalicylate

Topical Agents: -

Calamine lotion

Hydrocortisone lotion

Hydrocortisone cream

Neosporin ointment

d) Neomycin Sulphate

Polymyxin B Sulphate

Bacitracin Zinc

Ulcer: -

Lansoprazole

Antacids

Omeprazole

Rantidine

Fomatidine

Cefoperazone +sulbactam

Ranidom

8. Constipation: -

Methyl Cellulose

Calcium polycarbophil

Laxative Powder

Magnesium hydroxide

Docusate sodium

D&C

Dilation and Curettage: -

remove tissue from the inner lining of the womb. During this procedure the cervix or the entrance to the womb is dilated widened and a spoon shaped instruments is inserted to slowly scoop out the infected tissue or remain developing unborn foetus from the womb.

As this instrument is inserted through the

Vagina, no cut or opening are made surgically and no stiches are placed Curettage is one of the oldest gynecological operations.

IUD (Intrauterine Death)

Intrauterine fetal death is the clinical term

for still birth used to describe the death of a baby in the uterus. The term is usually

applied to the losses after the 20thweek gestation. Fetal Demise is defined differently around the world based on the gestational age and weight of the foetus.

Use of Copper T

The Intrauterine device is a Capital T shaped plastic and copper

device. The Copper T

constantly release a small

amount of copper into the uterus. The Copper T can also be used for emergency contraception instead of emergency contraceptive pills.

How effective is the copper IUD: -

It is more than 99% effective at preventing pregnancy and can last up to 5-10 years. If Copper IUD are using for emergency contraception then use it within 5 days or 120 hours after unprotected sex.

Abortion

Abortion is when al

pregnancy is ended so

that it does not result in|

the birth of child

sometimes it is called termination of pregnancy. We treat thousands of women who have decided that abortion is the right choice for them and give advice and counseling to women who don't know what to do next.

There are Two types of Abortion treatment as Medical and Surgical abortion.

First Trimester

At Your first pronatal visit, you will undergo a physical exam as well as certain tests and screening. To access the health of you and your unborn baby.

First Trimester symptoms vary from woman to woman with some experience all known symptoms and other. Only a few durations of symptoms can vary as well. After eight weeks the embryo is referred to as a foetus. Although the foetus is only 1 to 1.5 inch long. At this point all major organ and system have been formed during the first Trimester. The foetus is most susceptible to damage from substance like Alcohol drugs and certain Medicines.

How many Ultrasound do you have in your first Trimester?

The first is ideally in the first trimester to confirm. The due date and second is at 1822 weeks to confirm normal Anatomy and the sex of the baby, "Explain Mendola".

As long as these Ultrasound are normal and mom's abdominal measure consistent with her Gestation, then that is all most woman head. Mendola notes that if there are any problems with there initial Ultrasound or if there is a discrepancy in the foetus size along the way repeat ultrasound is warranted "Additionally if moms have medical issues such as diabetes or Hypertension then they will also received additional scans".

How pregnancy test gives the reading

Pregnancy test work by checking the urine for a hormone called HCG.

The Baby makes thi

hormone if the woman isr ' -

pregnant. HCG is release

when a fertilized egg attached to the lining of the uterus. When pregnancy begins if your pregnancy test result are positive. It means that the lady is pregnant if it is negative that means they are not pregnant.

Pregnant test are most accurate when you take them often you are already

missed their period. A pregnancy test will be less accurate if it's expired or if you don't use it the right way. So always check the examination date on the package and carefully read the direction that with your pregnancy test.

How to use Unwanted kit

Unwanted kit tablets should be taken with food or as your doctor's advice. You must start with dose of Mifepristone it should be taken orally by swallow the tablets whole with a drink of water if you experience vomattine within 30minutes of

Doctors or take another tablet.

FirstDay—(1) |

{Unwanted kit stops 48 days pregnacy }

What is use of Placenta

The Placenta is an organ

that develops in your

uterus during pregnant

cy. This structure provide oxygen and nutrients. To your growing baby and removes waste products from your baby's blood. The Placenta attached to the wall of your uterus and the baby's umbilical cord arise from it.

What is the use of I pill tablet

i pill (Levonorgestrel)?

Emergency contraceptive i used to prevent pregnane after unprotected sex o failure of other forms of birt control. Levonorgestrel emergency contraceptive may also be used for purposes not listed in this medication guide.

Section-C

Section-C means Caesarian section. Caesarian section is also known as Section C, or Caesarian delivery is the use of surgery to deliver babies. A Caesarian section is often necessary when a vaginal delivery would put the baby or mother at risk.

What is Ovral G used for:-

An ovral-G tablet is a combined oral contraceptives pill. It works by preventing the release of an egg (Ovulation) and affecting sperm movement in the womb to prevent its union with the egg. It also

changes the lining of the womb. And renders it unsuitable for pregnancy.

What is the use of Mala D

Mala D tablet is a medicine used for contraception and in the treatment of in regular period. It helps to prevent the release of egg. And its fertilization by the sperm.

Dose: -

Dose start on the first day of Menstrual cycle taking one tablet daily for 21 consecutive days followed by 7days of iron and folic acid supplementation.

Packaging: -

One Cycle is of 20 pills in which 21 pills are for contraception rest 7 pills are for iron supplementation.

Injection Deoo Provera

(Medroxyprogestrone acetate) AContraceptive injection that contains the hormone progesterone. Depo Provera is given as an injection every 3 months.

Depo Provera typically suppressed ovulation keeping the ovaries from releasing an egg. It also thickness cervical mucus to keep sperm from reaching the egg-

LSCS

[Lower Segment Caesarian

Section!

LSCS is the most commonly used type of Caesarian section most commonly to deliver the baby. transverse incision is made in the Lower uterine segment above the attachment of the urinary bladder to the uterus.

What is PCOS or PCOD

PCOStPolv cystic ovarian syndromes)

PCOD (Polycystic ovarian disease)

This is a very common condition affective 5% to 10% of women in the age group 1245 years. It is a problem in which a woman's hormones are out of balance. It can cause problems with menstrual period and make it difficult for

focuses on managing your individual concerned such as infertility her suitism Acne or obesity.

Lowering of Blood Glucose level

Restoration of fertility

Treatment of hersuitism oracne

HIV/AIDS: -

HIV (Human Immunodeficiency Virus) is a virus that attack Cells that helps the body fight infection, making a person more vulnerable to other infection and disease. If left untreated HIV can lead to the disease AIDS (Acquired her to conceive the principal future include no Ovulation. Irregular periods acne and hirsuitism. If not treated it can cause insulin resistant diabetes, obesity and high cho cholesterol hording to heart disease.

Common Symptoms of PCOS / PCOD include: -

Acne

Weight Gain and trouble losing weight

Thinning hair on the skull

Treatment: -

The medical treatment of PCOD/PCOS

Immunodeficiency Syndromes).

Stages of HIV infection; -

Infection

Asymptomatic

Symptomatic

AIDS progression of HIV to AIDS

Symptoms

Fever

Jointpain

Weakness

Chills

Sore throat

HIV Breast Feeding: -

HIV can be spread through breast milk. So, mothers in the us who have HIV should not breast feed their babies.

HIV in women: -

Women who are infected with HIV typically that it by having sex with a man who is infected or by sharing needles with minority races ethnicities are especially affected and black or African, American women are the more affected group.

HIV in pregnant women: -

All pregnant women should know their status of pregnant women who are HIV positive can work with their health care provides to insure their babies don't contact HIV during pregnancy delivery or

after delivery. It is possible for a mother to have HIV and not spread it to her baby. Especially if she knows about her HIV status Early and works with her health care provides to reduce the risk.

Some important Questions related to Female: -

Start Period age in the girl?

[10 to 13year]

Some important tips for the female?

First period are called menarch.

First period is a simple.

Period timing 28 days but

sometimes it is even 21 to

45 days.

d. Breast and hips begin to develop with the first period.

When a girl reaches young

condition, she has 40,000eggs.

Some important Questions Related to pregnancy

When does Vomiting occur in pregnancy?

Ans: - Vomiting can be one of the early symptoms in pregnancy and start here in the six months of pregnancy.

Does the height stop growing

after a period stop?

Ans: -Height increase until 2 year after the period start, after that the height stop increasing.

Can be Period in twice a month’s?

It is disease caused by taking a medicine.

This happens even when

hormones change inside a woman.

This happens when a woman takes birth control pills.

Qus - Female has periods from when to?

Ans: - A Female has periods from

13years to 55years.

What should be the sperm

count?

Ans: - At least 29 million to 40million.

Can we have sex during period?

Ans:- Yes, you can use safety otherwise chances of getting an infection increase.

Can we have sex during pregnancy?

Ans:- Yes, you can do it does not effect to our child and neither pregnancy is destroyed.

When should not do sex in pregnancy?

Ans: - In a situation when you have a pregnancy problem.

As:-a).Danger of premature delivery

. Vaginal bleeding

. Whole in the bag.

Then, never have sex in such a situation.

8. How many days after your baby’s birth you should have sex?

Ans: - Sex should not be done until a Female is completed in normal conditions.

Ivf

[In vitro fertilization]

In vitro fertilization [ivf] is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.

ivf mature eggs are collected from Ovaries.

And fertilized by sperm in a lab. Then the fertilized egg[embryo] or egg [embryo] are transferred to a uterus. Sometimes these steps are split into different parts and the process can take longer.

Ivf is the most effective form of assisted reproductive teachnology. The procedure can be done using your own eggs and your partner's sperm. Or ivf may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier a woman who has an embryo implanted in her uterus might be used. Your chances of having a healthy baby using ivf depend on many factors.

such as your age and the cause of infertility. In addition, ivf can be time - consuming, expensive and invasive.

If more than one embryo is transferred to your uterus, ivf can result in a pregnancy with more than one fetus.

Your doctor can help you understand how ivf works, the potential risks and whether this method of treating infertility is right for you.

Surrogacy

Surrogacy is an arrangement, often supported by a legal agreement, whereby a woman agrees to bear a child for another person or persons who will become the child's parents after birth.

Intended parents attend the birth of their child by a gestational surrogate.

People may seek a surrogacy arrangement when pregnancy is medically impossible, when pregnancy risks are too dangerous for the intended mother, or when a single man or a male couple wish to have a child.

surrogacy is considered one of many assisted reproductive teachnologies.

In surrogacy arrangements, monetary compensation may or may not be involved. Receiving money for the arrangement is known as commercial surrogacy. The legality and cost of surrogacy varies widely between jurisdictions, international or interstate surrogacy arrangements. Couples seeking a surrogacy arrangement in a country where it is banned sometimes travel to a jurisdictions, surrogacy is legal only if money does not exchange hands.

Where commercial surrogacy is legal, couples may use the help of third - party agencies to assist in the process of surrogacy by finding a surrogate and arranging a surrogacy, contract with her.

These agencies, often screen surrogates psychological and other medical tests to ensure the best chance of healthy gestation and delivery.

They also usually facilitate all legal matters concerning the intended parents and the surrogate.

Baby's position

1) Cephalic position: -

A Cephalic presentation or head.

presentation or head - first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters.

the pelvis first, the most common form of Cephalic presentation is the vertex presentation where the occiput is the leading part.

A breech birth is when a baby is born bottom first instead of head first, as is normal. Around 3 - 5 % of pregnant women at term (37 - 40 weeks pregnant) have a breech baby. Due to their higher than average rate of possible complications for the baby, breech births are generally considered higher risk. Most

babies in the breech position are delivered via caesarean section because it is seen as safer than being born vaginally.

Doctors and midwives in the developing world often lack many of the skills required to safety assist woman giving birth to a breech baby vaginally. Also, delivering all breech babies by caesarean section.

And developing countries is difficult to implement as there are not always resources available to provide this service.

3) Transverse position : -

A shoulder presentation refers to a malpresentation at childbirth where the baby is in a transverse lie thus the leading part. (The part that first enters the birth canal) is an arm, a shoulder, or the trunk.

While a baby can be delivered vaginally when either the head or the feet/ buttocks are the leading part,

it usually cannot be expected to be delivered successfully with a shoulder presentation unless a cesarean section [C/S] is performed.

How to read basic pregnancy ultrasound report

>) BPD [Biparietal Diameter] : -

it is a measurement

Of the diameter of a developing baby's skull , from one parietal bone to the other.

> ) HC [Head circumference] : -

Measurement the length

Going around your baby's head.

> ) FL [ Fetal heart rate ] : -

Measurement the length of a bone in your baby's leg.

> ) CRL [Crown - rump length] : -

The length from the top of the head to your baby's bottom, measurement taken in the first trimester.

> ) AC [ Abdominal circumference] : -

Measurement the length

Going around your baby's belly.

> ) FHR [Fetal heart rate] : -

Measurement the heart rate

Of baby.

> ) EFW [Estimate of fetal weight] : -

Measurement estimate weight of baby.

Some other basic knowledge in abdominal report

1) Excess abdominal fluid [ascites] : -

Abdominal swelling caused by accumulation of fluid, most often related to liver disease.

2) Hepatomegaly:

Hepatomegaly is having an enlarged size of liver. Your liver is the largest internal organ.

3) Splenamegaly : -

Splenomegaly is an enlargement of the spleen.

4) Cholecystitis:

inflammation of the gallbladder.

5) Cholelithiasis:

Is the medical name for hard deposits (gallstones)

that may form in the gall bladder?

6) Hepatosplenomegaly - -

Hepatosplenomegaly (HPM) is a disorder where both the liver and spleen swell beyond their normal size,

Pharmacy basic knowledge

Rx:-

Rx has devided from a Latin word. Which means 'Recap' it's basically means the action of taking something.

Receiving something or the fast of it being received.

DRx [Drug expert]: -

A drug expert who can consult patient about drug therapy in a effected and sofer way.

RPH:

(Stand for 'Regestered pharmacist']

All antibiotics medicines

There are all antibiotics medicine divided into seven group

Aminoglycosides

inj. Amikacin

inj. Gentamicin

inj. Bleomycin

inj. Streptomycin

inj. Tobramycin

Carbapenems

inj. Meropenam

inj. Imipenam

inj. Doripenam

Cephalosporins

inj. Cefazolin

inj. Cefepime

inj. Cefotaxime

inj. Ceftriaxone

inj. Cefuroxime

Fluoroquinolones

inj. Ciprofloxacin

inj. Levofloxacin

inj. Moxifloxacin

Penicillin's

inj. Ampicillin

inj. Pipracillin

inj. Oxacillin

Tetracyclines

inj. Doxycycline

inj. Minocycline

inj. Tetracycline

Identification group

➤mycin - Aminoglycosides

➤ cillin - penicillin

> cycline - tetracycline

> floxacin - fluoroquinolones

➤ cef - cephalosporins

penam - carbapenems

[ All group medicines and it's

use]

•Anti-histamine: - Use in allergy

Ex. Allegra, citirzine, etc.

•Analgesic:- use in pain killer

Ex. Aspirin, acetaminophen, etc.

• Anti pyretic: - Use in fever

Ex. Aspirin, paracetamol, acetaminophen, etc.

NSAID

[Non-steroidal anti-inflammatory drug]

Ex. Ibuprofen, naproxen, ketoprofen, nime sulide, etc.

• Anti-septic:- Use in pus septic

Ex. Calamine lotion, ciprofloxacin, chlorhexidine, clotrimazole, etc.

• Antibiotic:- infection Use in microbial

Ex. Amoxicillin etc.

•Anti-anemic: - low HB

Ex. Iron soot, ferrous sulphate,

• Anti-emetic: - Use in vomiting nausea

Ex. Ondustron, procloperazine, etc.

• Anti-acid: - stomach burn

Ex. Aluminum hydroxide Calcium carbonate

Magnesium hydroxide

• Anti flatulents: - Use in gases

Ex. Antacids, simethicone, etc.

•Anti-spasmodic:- Abdominal pain

Ex. Drotavarin, Dicyclomine, etc.

• Anti-fungal:- fungal infection

Ex. Fluconazole, Itraconazole, etc.

• Anti-bacterial:- against bacterial infection

Ex. Penicillin, aminoglycoside, etc.

• Anti-malarial:- against malaria infection

Ex. Chloroquine, pipraquine, etc.

Red line

Tablet packs with a red stripe indicate that these cannot be purchased without a doctor's prescription.

The pharmacy is allowed to sell these medicines only when a medical prescri tion is provided for the same.

This medicine use only on doctor's prescription

NRx

This medicine is narcotic's

Debossed line

Debossed means imprinted with a mark below the dosage form surface drug pro duct means finished dosage form.

What is different between generic and branded medicines

> Generic medicine: -

• Low cost version of brand drug.

• produced by generic company.

• Are as safe and effective as brand

drugs.

> Branded medicine: -

• Protected by a patient.

• Supply by single company.

• Marketed under a brand name.

What is FFP

(Fresh Frozen Plasma)

FFP is a blood product made from the liquid portion of whole blood, it is used to treat condition in which there are low

blood clotting factor or low level of other blood protein. It may also be used as the replacement fluid in plasm an exchange.

Blood

Blood is a body fluid in human and other animals that delivers necessary substances such as nutrients and Oxygen to the cells and transport metabolic waste products away from these same cells. In Vertebrae it is composed of blood cells suspended in blood plasma.

Platelets

Platelets or (Thrmbocytes) are small colourless cell fragments in our blood that from clots and stops or prevent bleeding. Platelets are made in our bone marrow. ,the sponge like tissue inside our bones. Bone marrow contain stem cells that develops into red blood cells, White Blood Cells and Red Blood Cells.

Types of blood group

Motivational thoughts

Edward Jenner

The history of smallpox holds a unique place in medicine. It was one of the deadliest diseases known to humans, and to date (2016) the only human disease to have been eradicated by vaccination. The smallpox vaccine, introduced by Edward Jenner in 1796, was the first successful vaccine to be developed. He observed that milkmaids who previously had caught cowpox did not catch smallpox and showed that inoculated vaccinia protected against inoculated variola virus.

The global eradication effort initially used a strategy of mass vaccination campaigns to achieve 80% vaccine coverage in each country, and thereafter by case-finding, followed by ring vaccination of all known and possible contacts to seal off the outbreak from the rest of the population.

In 1961 the bifurcated needle was developed as a more efficient and cost effective alternative, and was the primary instrument used during the eradication campaign from 1966 to 1977. The bifurcated needle vaccination required only one-fourth the amount of vaccine needed with previous methods and was simpler to perform.

Different types of vaccine

Smallpox vaccines produced and successfully used during the intensified eradication program are called first generation vaccines in contrast to smallpox vaccines developed at the end of the eradication phase or thereafter and produced by modern cell culture techniques. Second generation smallpox vaccines use the same smallpox vaccine strains employed for manufacture of first generation vaccines or clonal virus variants plaque purified from traditional vaccine stocks, whereas third generation smallpox vaccines represent more attenuated vaccine strains specifically developed as safer vaccines at the end of the eradication phase by further passage in cell culture or animals. Second and third generation vaccines are produced using modern cell culture techniques and current standards of Good Manufacturing Practices (GMP).

The need for WHO to maintain an emergency reserve of smallpox vaccine following eradication was recognized in 1980 when WHO was given a set of formal responsibilities for maintaining capacity and expertise to respond to a re-emergence of smallpox in the post-eradication era as both a component of a preparedness strategy and a possible deterrent to intentional release. The Smallpox Vaccine Emergency Stockpile (SVES) was originally created by consolidating WHO Member State donations given in support of the Intensified Smallpox Eradication Programme.

In 2002, World Health Assembly (WHA) Resolution 55.16 urged Member States to share expertise, supplies and resources to rapidly contain a public health emergency or mitigate its effects. The resolution further requested the WHO Director General to examine the possible development of collaborative mechanisms to prepare and stockpile resources for a potential PHEIC.

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