Offline Clinic » Basic Sciences http://offlineclinic.com fitness, health, beauty tips, exercise, gym, medical and surgery Sun, 16 Nov 2014 09:30:02 +0000 en-US hourly 1 http://wordpress.org/?v=4.0 Winging of Scapulahttp://offlineclinic.com/winging-of-scapula/1104/ http://offlineclinic.com/winging-of-scapula/1104/#comments Thu, 13 Nov 2014 11:26:30 +0000 http://offlineclinic.com/?p=1104 A winged scapula is also called scapula alata. This is a condition in which the shoulder blade formed by shoulder bones media end protrudes in an abnormal shape and position on persons back. The abnormal scapula gives the shape of a wing and thus called winged scapula.

This condition can be caused due to damage to several nerves or muscles. This posture can be normal in young children, but not in older children or adults.

Causes of Winging of Scapula

Winging of scapula can be due to:

  • Serratus anterior paralysis. This can be due to the damage to long thoracic nerve which supplies the serratus anterior muscle, located on the side of the thorax and acts by pulling the scapula forward. This injury to the long thoracic nerve can be either traumatic, non-traumatic or idiopathic
  • Trapezius and rhomboid palsy can also lead to winging of scapula in less common cases. The injury can be directly to the muscles involved or the nerves supplying them namely: accessory nerve and dorsal scapular nerve, respectively for both muscles.

The damage to the nerve or muscles causing winged scapula can be due to some injury due to blunt trauma or any surgical procedure.

Signs and Symptoms of Winged Scapula

The clinical presentation of winged scapula can vary depending upon the muscles and/or nerves involved. Pain isn’t present in all cases, however fatigue is common along with limitations of daily activities of the patient.

winging of scapula

There is clear deformity of back, specially in serratus anterior muscle involvement. While trying to contract the muscle it might clearly wing the scapula. This can be demonstrated by asking the patient to push against a resistance, such as a wall.

The patient might have limited ability to lift the arm above their head due to impairment of the movements involving scapula and scapular muscles.

Treatment of Winging of Scapula

Physiotherapy (physical therapy) is one of many treatments available for winging of the scapula, specially if there is weakness of the glenohumeral joint muscles. However if the physiotherapy fails in making the muscles strong enough to contract clinically and symptoms persists after 3-6 months of treatment, surgery is considered to be the next choice in correcting the condition.

Surgical fixation of the scapula is done for those who have isolated scapular winging. Other options include neurolysis, intercostal nerve transfer, scapulothoracic fusion, artherodesis or scapulothoracis fixation without arthrodesis.

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MBBS subjects in Pakistanhttp://offlineclinic.com/mbbs-subjects-in-pakistan/344/ http://offlineclinic.com/mbbs-subjects-in-pakistan/344/#comments Sat, 04 Jun 2011 17:41:07 +0000 http://offlineclinic.com/?p=344

This is a list of subjects for MBBS in Pakistan divided by Profs (professional examination)

Note: MB BS (bachelor of Medicine Bachelor of Surgery) is a 5 year course consisting of 4 profs. 1st prof is divided in 2 years, hence making it 5 year in total in Pakistan.

MBBS Subjects in Pakistan

Subject for 1st and 2nd year MBBS in Pakistan (1st prof):

  1. Anatomy
    • Clinical Anatomy
    • Embryology
    • Histology
  2. Physiology
  3. Biochemistry

Subject for 3rd year MBBS in Pakistan (2nd prof):

  1. General Pathology
  2. Pharmacology
  3. Forensic Medicine & Toxicology

Subject for  4th year MBBS in Pakistan (3rd prof):

  1. Special Pathology
  2. Community Medicine
  3. Eye
  4. ENT

Subject for  5th / final year MBBS in Pakistan (4rd prof):

  1. Surgery
    • General Surgery
    • Orthopedics
    • Radiology
    • Anesthesiology
  2. Medicine
    • General Medicine
    • Psychiatry
    • Dermatology
  3. Pediatrics
  4. Gynecology & Obstetrics
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Subjects in each year of MBBS (Pakistan)http://offlineclinic.com/subjects-in-each-year-of-mbbs-pakistan/259/ http://offlineclinic.com/subjects-in-each-year-of-mbbs-pakistan/259/#comments Tue, 02 Nov 2010 00:09:28 +0000 http://offlineclinic.com/?p=259 This post simply enlists subjects taught in each year of mbbs.

Please note, that in Pakistan mbbs is typically divided in to 5 years but 4 profs. First prof is divided into part one and part two, completing in two years, and then all other prof’s take 1 year each. After 5 years (4 profs) are complete, they are awarded the mbbs degree and they can start their house job (internship).

Some universities of Pakistan has already started to shift from annual system to semester and modular system. Also, some universities have started integrated study system, in which students learn relevant topics from almost all the subjects every year.

However, here I will enlist the classical pattern of dividing subjects in annual divisions for mbbs, the classical way! Please note, this list only lists the names of subjects that students have to appear in exams for, universities start teaching various subjects earlier too (medicine starting in 3rd year for example!)

Subjects for 1st and 2nd year mbbs

  1. Anatomy
    1. histology
    2. embryology
    3. clinical anatomy
  2. Physiology
  3. Biochemistry

Subjects for 3rd year mbbs

  1. General Pathology and microbiology
  2. Pharmacology
  3. Forensic medicine and toxicology

Subjects for 4th year mbbs

  1. Special Pathology
  2. ENT
  3. Eye
  4. Community medicine

Subjects for 5th / final year mbbs

  1. Medicine
    1. general medicine
    2. skin
    3. psychiatry
  2. Surgery
    1. general surgery
    2. orthopedics
    3. radiology
  3. Gynecology and obstetrics
  4. Pediatrics
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What to eat if you need more bloodhttp://offlineclinic.com/what-to-eat-if-you-need-more-blood/211/ http://offlineclinic.com/what-to-eat-if-you-need-more-blood/211/#comments Mon, 24 May 2010 02:33:50 +0000 http://offlineclinic.com/?p=211 Today a friend of mine asked randomly on messenger that:

what to eat if you need more blood?

red blood cells - what to eat if one needs more bloodSo the instant reply was:

drink, blood

Na! anyway . . . jokes apart, so what to eat in case you need more blood (inside body only) Well you need two types of things for iron / blood replenishment :

1. Diet

Apples, apple juice or as a whole

Green leafy vegetables, e.g. spinach.

2. Supplements

Ferrous sulphate tablets

Folic acid supplements

3. Treat the cause of blood deficiency

Treat the underlying cause of iron deficiency or cause of blood loss if any.

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Photonic Shampoohttp://offlineclinic.com/photonic-shampoo/204/ http://offlineclinic.com/photonic-shampoo/204/#comments Sun, 23 May 2010 02:23:02 +0000 http://offlineclinic.com/?p=204 Photonic Shampoo by PharmaHealth Pakistan (Pvt) Limited is sodium free shampoo for daily use for silky, shiny & healthy hair. Photonic shampoo is anti-dandruff and anti-fungal shampoo with normal pH level and contains photonic shampooconditioner too. Photonic shampoo review are good and suggestive of it’s efficacy.

Indications of use of Photonic Shampoo

Photonic shampoo is a medical shampoo for various medical conditions like:

  • Mild to severe dandruff
  • Seborrhoeic dermatitis
  • Flaking, scalin, itching and pruritis, associated with dandruff
  • Pityriasis Versicolor
  • Pityriasis capitus
  • Tinea capitus
  • Prophylaxis of dandruff and Seborrhoeic dermatitis

Photonic shampoo is also suitable for hair dye users as it does not alter dye color.

Composition of Photonic Shampoo

  • Shampoo base with conditioner
  • Zinc pyrithion

How to Use Photonic Shampoo:

  • Wet hair thoroughly and apply Photonic Anti-Dandruff Shampoo on wet scalp or other affected areas of the skin to produce adequate lather.
  • Leave for 3-5 minutes and then rinse with clean water thoroughly
  • You can use Photonic Anti-Dandruff shampoo once daily.

Photonic Shampoo Manufacturer:

PharmaHealth Pakistan (Pvt) Limited in scientific collaboration with  Pharma health (UK) Limited.

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Classification of Anti-Depressant Drugshttp://offlineclinic.com/classification-of-anti-depression-drugs/188/ http://offlineclinic.com/classification-of-anti-depression-drugs/188/#comments Thu, 20 May 2010 23:00:21 +0000 http://offlineclinic.com/?p=188 Anti depressants are classified in the following categories ( with example drugs )

drugsA – Tricyclics

  1. Neutral: Imipramine, Dothiepin
  2. Sedative: Amitriptyline, Trimipramine, Doxepin
  3. Stimulant: Desipramine, Nortriptyline, Protriptyline, Mianserin

B – heterocyclics

Amoxapine, Maprotiline, Trazodone, Bupropion, Venlafaxine

C – Monoamine Oxidase Inhibitors

  1. Hydrazide derivatives: Phenelzine, Isocarboxazid
  2. Non-hydrazide derivatives: Tranylcypromine, Moclobemide

D – Sympathomimetic Stimulants

Dextroamphetamine, Methylamphetamine, Methylphenidate

E – Selective Serotonini Reuptake Inhibitors

Fluoxetine, Paroxetine, Sertaline.

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Blumberg sign – Rebound tendernesshttp://offlineclinic.com/blumbergs-sign-rebound-tenderness/142/ http://offlineclinic.com/blumbergs-sign-rebound-tenderness/142/#comments Fri, 07 May 2010 06:08:54 +0000 http://offlineclinic.com/?p=142 Blumberg sign (or Rebound tenderness positive sign) is elicited by palpating slowly and deeply over a viscus and then suddenly releasing the palpating blumberg sign - rebound tenderness for appendicitishand. If rebound tenderness is positive then the patient experiences pain. The sign is explained by the fact that gradual stretching of the abdominal wall by deep palpation followed by sudden release of this pressure stimulates the parietal peritoneum which, if inflamed, produces pain. Rebound tenderness is not always a reliable sign and should be interpreted with caution, particularly in those patients with a low pain threshold.

Rebound tenderness is commonly done as part of physical examination of a patient of appendicitis. Rebound tenderness is also named positive Blumberg’s sign.

Blumberg Sign inccorect on Wikipedia

While reading about appendicitis on wikipedia.com i found out that the definition of Blumberg’s sign is given wrong over there. According to wikipedia (on 7th May, 2010) Blumberg’s sign due to inflammed vermiform appendix is:

Palpation of the left iliac fossa, followed by sudden release causes contralateral (right iliac fossa) rebound tenderness.

Which is obviously not so. It is even technically incorrect as rebound phenomenon occurs on the ipsilateral side and not the contralateral.I have submitted the correction in the wikipedia article regarding Blumberg’s sign mistake. Hopefully they will approve it.

Blumberg’s sign significance

The positive blumberg’s sign or rebound tenderness is indicative of peritonitis (inflammation of peritoneum). Which means that blumberg sign can be positive for any disease condition inside the abdominal cavity which leads to peritonitis such as appendicitis (inflammation of appendix). In appendicitis the blumber’s sign or rebound tenderness will be positive in right iliac fossa of the patient (and on the left in case of citus inversus).

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Male vs Female brain | Tabulated differenceshttp://offlineclinic.com/male-vs-female-brain-tabulated-differences/117/ http://offlineclinic.com/male-vs-female-brain-tabulated-differences/117/#comments Sat, 10 Apr 2010 02:11:19 +0000 http://health.nabtron.com/?p=117 We will be listing out some key features differentiating between the male and female brain and nervous system in a tabulated form. Hope you will find this information helpful and if you have some other information to add, please do share it too.

The differences presented here are not to declare any of them to be superior or inferior. They are just meant to understand the difference between the male and female brain because understanding the differences is important to avoid conflicts and improve the productivity. Both male and females have specific role in the world and thus their brain have been made by Allah accordingly.

During gestation, every brain starts as same (female) brain but after 8 weeks of conception, when testosterone secretion increases in male foetus, the brain starts to differentiate from a female brain.

FeatureMaleFemale
Brain size10% more than female10% less than male
Processes per cellLower than female brainHigher than male brain
Average words spoken per day7,00020,000
Hearing cortexsmallerlarger
Communication centersmallerlarger
Sex processing centerdoublehalf the male center
Memory of fightspoorstrong
Sex thoughts entryevery minuteevery couple of days
Sensing others emotionsweakstrong
Neocortical neurons22.8 billion19.3 billion
Length of Spinal cord45 cm43 cm
Length of vertebral column71 cm61 cm
Weight of brainheavier than femalelighter than male
Average IQsamesame
Limbic systemnot deepdeep
Corpus callosum (right to left bridge)smaller than femalelarger than male
Dominant side used in processingleftboth
Susceptible to depressionlessmore
Suicide attempts1/3 of women attempts3 times more than men
Gray mater (active neurons)6.5 times more6.5 times less
White mater (connections)10 times less10 times more
Processing speedslower than femalefaster than male
Density of neuronsless than femalemore than male
Map readinggoodpoor

The list never completes. Feel free to comment / correct or add to the provided list.

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Flexor hallucis longus musclehttp://offlineclinic.com/flexor-hallucis-longus-muscle/106/ http://offlineclinic.com/flexor-hallucis-longus-muscle/106/#comments Sun, 03 Jan 2010 09:39:39 +0000 http://medix.nabtron.com/?p=5 The Flexor hallucis longus is one of the deep muscles of the lower limb present in the posterior compartment of the leg along with other deep muscles of the leg: flexor digitorum longus and tibialis posterior. FHL is the largest and most powerful of these deep muscles.

Originposterior aspect of upper 1/3rd of fibula
Insertionbase of distal phalanx of hallux(big toe)
ArteryPeroneal artery (peroneal branch of the posterior tibial artery
Nervetibial nerve, S1 & S2 nerve roots
Actionsflexes all joints of the big toe, plantar flexion of the ankle joint
AntagonistExtensor hallucis longus muscle

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