MOE:014418169

patho father robbins

Anatomy bd chaurasia
Biochemistry u.satyanarayana
Microbiology p k chakraborty
Physiology a.k jain
Pharmacology k d tripathi
Com.med park n park
1. The typical symptom of diarrhea is watery stool. It is a dysentery if
the stool is in the form of mucous, includes blood and the patient
suffers from cramping and fever.
2. Diarrhea usually affects the smaller bowel while dysentery affects
the colon.
3. The effects of diarrhea are not that serious, apart from a risk of
dehydration. Dysentery can cause a lot of complications, if left
untreated.

Read more: Difference Between Dysentery and Diarrhea | Difference

Between | Dysentery vs
Diarrhea http://www.differencebetween.net/science/health/differenc
e-between-dysentery-and-diarrhea/#ixzz3GhOpc8gXHey frns the meeting that was
held yesterday @NMC and its consequence: Hey frns the points we should hoist in-front of media….

-MOH le k gardai xa….

-MOH ko notice ko skolagi lagi ho : Scholarship/donation…

-Private colz ma admission kina vayo MOH/NMC ko notice paxi pani…

-Dhulikhel ko ta cls pani suru vayo ani aru colz ma orientation ko tayari hudai xa kina…

-Scholarship wala stds haru le jahilai course xutepaxi matrai admission paune rule xa ho ra…

-NMC ko seat plan hami kaha aayeko vandai MOE le kura tarne…

-NMC le hamile banayeko seat plan MOH lai mann parena vanera tarne…
-MOHle notice nikale jasto garne donation wala ko admission vayera orientation kasari vayo….

-MOH,NMC,MOElai faida nahune vayekai karanle garda dhilo vako hunu parne…..

[email protected]

123456789bibek

Didi

Dell Inspiron Series (Touch)

4th generation, i5 processor

Ram: 4gb +

Memory: 500gb+

Budget: 500-600$

Hey effective candidates for KU nomination

I’ve been haunting every post and comments of group….and found that most of hav perplexity btn with
whom to contact MOE,NMC,MOH….

MOE & NMC have been playing the role of villain since past…ani MOE can’t forward its works unless it
receive letter from NMC….so our rage activities should focus towards NMC & MOH…hunata MOE is
the highest rank office of education tara pani nmc ko letter ko lagi pressurize dinu parne ho….yedi MOE
personal harulai benefits hunthyo vane dashain aghi nai hamro procedure suru hunthyo…hamro
procedure suru vayeni navayeni MOE personal haru ko TA/DA ma boost hudaina….. so numb baseka
hun MOE personal haru….ani NMC personal harule pani private colz ma admission vayepaxi sth budget
pauxan hola tesaile MOH le admission impede garda pani private medical colz ma admission vakai
xa….aaja ta ajai dhulikhel ma orientation class xa vanne sune ko xu…..

So MOH is portraying the role of anti-hero, hamilai sahayog gare jasto ta gareko xa….seat plan ramro
vayena vanera ani last yr ko moe stds lai aftharo hunxa vanne kura raise garera notice nikaleko xa tara
scholarship le matrai padhna napaune aru donation wala harule majjale padhne yo ta partiality vayo ni
direct….

Yedi hamile donation wala haru ko class start huna nadine ho vane we should seek help from
CIAA/Media….MOE/NMC lai ta bani pareko xa media ma aune MOH aauxa ahele ta…tesaile khei huna
sakxa….Let’s be optimistic….

It is to notify for every effective candidates for KU nomination

Be candid and express ur rage toward nmc, moe, moh through any activities u can afford like daily calling
@ office or hav frequent visit…
Share the condition u r going through to ur parents without hesitation ki seat ma nikai fluctuation aauna
pani sakxa……especially focus about hamro padhhai fix 1-2months xutxa…

If ur relatives koi moh, nmc, moe affiliated office ma hunuhunxa vane u should contact to them, so that
they can give u idea whom to contact…

Eklai le garera khei hudaina savle afule sakne garnu parxa…

Hamile ta yo past 8months ma ta kasari padhne pani bhuli sakexam hola except few the then moe fresher
haru…ani 1st lecture ta nikai crucial hunxa….

Last but not least hami sabai touch ma rahanu parxa….ani autale kunai program organize garyo vane tele
organize garyo mali contact garera vanera naaune hoina thaha paune bitikai aaunu parxa…..

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Height: 0.9” (22.0mm) / Width: 13.5” (342mm) / Depth: 9.7” (246mm)
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HDMITM 1.4a, USB 3.0 (2), USB 2.0 (1), Security slot, Media Card (SD, SDHC, SD3.0, MS, MS Pro), 10/100
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Full size, spill-resistant keyboard (backlit version standard)

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My Dell, Dropbox, PocketCloud, Dell Digital Delivery, Dell Backup & Recovery, Microsoft® Office 2013
trial, McAfee LiveSafe (30 day), Skype™6 , FastAccessTM Anywhere

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he who studies medicine without books sails an uncharted sea, but he who studies medicine without
patients does not go to sea at all -William Osler Treat the patient, not the x-ray. ~ James M. Hunter.
Until a physician has killed one or two he is not a physician. ~ Kashmiri Proverb. When a lot of remedies
are suggested for a disease, that means it cannot be cured. ~ Anton Chekhov, The Cherry Orchard.
When you treat a disease, first treat the mind. ~ Chen Jen. Diagnosis is not the end, but the beginning
of practice. ~ Martin H. Fischer. Disease is war with the laws of our being, and all war, as a great
general has said, is hell. ~ Lewis G. Janes In the sick room, ten cents' worth of human understanding
equals ten dollars' worth of medical science. ~ Martin H. Fischer. When you are called to a sick man, be
sure you know what the matter is - if you do not know, nature can do a great deal better than you can
guess. ~ Nicholas de Belleville. It is a good thing for a physician to have prematurely grey hair and
itching piles. The first makes him appear to know more than he does, and the second gives him an
expression of concern which the patient interprets as being on his behalf. ~ A. Benson Cannon.
Symptoms are the body's mother tongue; signs are in a foreign language. ~ John Brown. Symptoms,
then are in reality nothing but the cry from suffering organs. ~ Jean Martin Charcot, translated from
French To array a man's will against his sickness is the supreme art of medicine. ~ Henry Ward Beecher.
To me the ideal doctor would be a man endowed with profound knowledge of life and of the soul,
intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere
presence. ~ Henri Amiel.
Read more at: http://forum.facmedicine.com/threads/famous-14-quotes-about-medicine.19534/Hows
your anatomy and physiology? My biochemistry is within normal limits. I miss you like an ischemic heart
miss its blood supply. I love you as the TB loves the apex of lung. I care for you like the way IV Taxim
and Metrogyl care for a postoperative patient. I have implanted you in my SA node. Please don't be the
etiology of my heart failure. Miss you like ventilation. Take care of your vitals.

Read more at: http://forum.facmedicine.com/threads/a-love-letter-from-a-medical-

student.19495/Floundering period between +2 & Bachelor
#1st yr lost for seeking scholarship scheme..
#2nd yr going to edge for seeking colz admission…
moe+nmc le villain ko role portray garirako bela feri arko moh anti-hero kina dekha pareko hola navako
tension & torture thapna…
Tackling paradox situation neither ecstasy nor vexation celebrate garna sakiyo to the fullest extent…
Nepal Medical Council
Kathmandu, Nepal.
Post Box no.: 13890
Tel: +977-1-4371954/4377164
FAX: +977-1-4372318
E-mail: [email protected]
URL: www.nmc.org.npI don’t remember how many patients I saw at the health fair before George came
to me; none of them were as memorable. George was a tall, stooped man with a serious expression.
His skin was weathered but he couldn’t be called elderly by any means. I guessed that his age hovered
somewhere around forty. He looked serious and spoke quietly. He had no interest in being rude, but no
real interest in responding to my questions, either. He hadn’t come to the health and homelessness fair
for chitchat. The questions were simple. When was your last medical appointment? Have you ever had
high cholesterol? High blood pressure? Do you drink? George hesitated when I asked this. Do you drink?
He looked at me and looked at the air between us. “I used to,” he said, his voice determined and
unwavering. “Not anymore.” This was a point I could easily have ignored. Many novice medical
students, myself included, experience discomfort when presented with potentially emotional answers.
Should we ask for more? Is it medically relevant? It always seems easier to ignore the emotions and
proceed with the medical interview. Speaking with George that day, I asked him to tell me more. And
the fabric that swaddled his private life split open before me. George and I spoke for a long time. He
told me about his life and the trials he had undergone since the deaths of his wife and daughter. He
told me about how difficult things were and I found that the words, “I can’t even imagine,” were
simultaneously true and untrue. Because even as I said them I found myself imagining, caught in
George’s life, feeling a quiet echo of the things he once felt. We remained at this dance for a while —
him voicing an emotion, and that emotion resounding in me. There was little medical relevance to the
information George gave me. But I cannot stress enough the importance of the connection we made.
Lectures and simulated patient encounters could not teach me what George showed me about
empathy. My connection with him was not only a motivating factor, pushing me to seek out other
providers and ensure that he received the best care; it also allowed him to share information with me
that he otherwise may have thought unimportant, and it established a relationship where he was more
likely to take my advice. All this because I asked him for more information during that nerve-wracking
moment of emotional ambiguity. Because of George, I believe more than ever in this kind of attentive
questioning. It created between us that open, empathetic relationship that seems crucial and central
to the practice of medicine.

Read more at: http://forum.facmedicine.com/threads/attentive-questioning-you-cant-learn-this-in-a-

medical-school-classroom.19355/happy b’day fori….may this day give u solidity, fortitude, to cope with
snag that comes infront of u…Knowing the Symptoms of Liver Disease Could Save your Life
Knowing how to recognize the symptoms of liver disease can save your life. As with so many illnesses
and diseases, liver disease, if spotted early enough, can be arrested, and cured (providing the causes
have been identified and are avoided in future), and your liver can fully recover, growing new healthy
tissue to replace any that has been damaged, just as long as the disease has not been allowed to
progress too far – hence the importance of knowing what the warning signs to look out for.
An organ and a gland
Your liver is the largest internal organ (and also the largest internal gland) that you have in your body. In a
healthy adult, a normal liver will weigh somewhere between 3 to 3.5 pounds and it plays a crucial role in a
number of body system functions.
The functions of the liver
The key functions of the liver are to detoxify your blood, and to enhance your digestive system by creating
bile, which helps to break down the fats that you consume into small pieces, making them easier for your
small intestine to absorb. But that’s not all. Here is a quick summary of what your liver does for you:
It detoxes your blood, filtering out any harmful and unwanted substances like drugs and alcohol
It produces bile to aid digestion
It stores some of your body’s vitamins and iron
It stores glucose
It converts glucose into sugar that the body can use when the body’s sugar levels become depleted
It processes haemoglobin, insulin and a variety of other hormones
It converts ammonia into urea; an essential ingredient for healthy metabolism
It eliminates old red blood cells, which produces faecal matter which is normally brown in color. This is
why when your stools are discolored (i.e. not brown) it can be an indication there is something wrong with
your liver function.
Without a healthy liver, any holistic health lifestyle will become severely compromised, and depending on
the nature and severity of disease, could prove fatal; which is why it’s so important to be able to detect
and interpret the early symptoms of liver disease.
Hepatic disease
Liver disease is also sometimes referred to as hepatic disease. When any type of hepatic disease affects
up to three quarters of your liver tissue, that’s when a significantly increase in liver function can be
detected.
The causes of liver disease
Liver disease can be brought about in a number of different ways.
Its cells may be inflamed, as with hepatitis
The passage of bile may become obstructed, as in cholestasis
A build-up of cholesterol may occur
The flow of blood to the liver can be damaged
The tissue of the liver may be attacked and damaged by toxins
Alcohol abuse and cirrhosis of the liver
The most common cause of liver disease in North America is alcohol abuse. The final stage of liver
disease (when the liver sustains severe scarring and cannot regenerate replacement tissue), is known as
cirrhosis of the liver, and this is responsible for approximately 25,000 deaths per annum here in North
America.
The classic symptoms of liver disease
The most frequent and common symptoms of liver disease include:
Bad breath
Black circles beneath the eyes
Bad body odor
Brown blemishes on the skin
Coated tongue
Discolored stools
Flushed facial appearance
Inflamed palms and soles of feet
Swollen eyeballs
Jaundice-the yellowing of the skin which can often also be evidenced in the whites of the eyes
Nausea
Pain – which is felt in the uppermost right hand quadrant of the abdomen
Increased tendency to perspire excessively
Some people also suffer from fatigue and weight loss.
These symptoms of liver disease relate to hepatic disease in general. But there are also many different,
specific, illnesses or diseases that affect the liver, and each of these has its own specific symptoms.
Gallstones
The symptoms of liver disease that are associated with gallstones, include pain in the upper right
quadrant of the abdomen; vomiting, (having eaten a fatty or greasy meal); and if the gallbladder itself
becomes infected, this may also bring about a fever.
Cirrhosis of the liver
As hepatic disease progresses and reaches the stage of cirrhosis, the following symptoms of liver
disease may often appear.
A tendency to bruise more easily. This is because the liver is no longer able to efficiently clot the blood
Itchiness. The result of bile salts being deposited in the skin can cause itching
Enlarged male breasts. This is a condition known as gynecomatia and can be brought about by upsetting
the balance of sex hormones, and an increase in the hormone estradiol in particular.
Erectile dysfunction. The upsetting of the balance of sex hormones can also bring about a reduction in
sex drive and cause the testicles to shrink.
Feeling confused. Feelings of confusion can arise when the levels of ammonia in the bloodstream
become too high. This ammonia is normally removed from the bloodstream by a healthy liver, but when
liver health is compromised, the sufferer may experience feelings of confusion.
Feelings of lethargy. This is also potentially brought about by the increase in blood ammonia.
Decrease in muscle tissue. A compromised liver will also reduce its production of proteins, and this can
lead to the wasting of muscle.
Swollen stomach veins. Because blood pressure becomes increased with a cirrhotic liver, the blood flow
to that liver receives can become compromised. This may result in a swelling to the veins around the
stomach area.
The unusual metabolism of fats
Another of the prime symptoms of liver disease is the abnormal metabolism of fats, which can manifest
itself in the following ways:
Elevated levels of LDL cholesterol and triglycerides, at the same time as decreased levels of HDL
cholesterol.
Hypertension or blood pressure caused by your blood vessels becoming blocked by fatty deposits. This
can also potentially lead to stroke and heart attack.
Fatty tumors and lymphomas developing in the skin
Significant weight gain that could lead to obesity
Difficulty in losing weight, even though you may be dieting
A sluggishly slow metabolism
Bloated stomach
The appearance of cellulite
Developing a roll of fat around the upper abdomen your own armchair.
Symptoms to look for with your digestive system
The symptoms of liver disease can also be seen in relation to the digestive system and can include things
like:
Constipation
Haemorrhoids
Indigestion and/or reflux
The inability to tolerate alcohol
The inability to tolerate fatty food
Irritable bowel syndrome
Symptoms relating to blood sugar levels
The symptoms of liver damage that relate to blood sugar include things like:
Developing a craving for sweets things
Unstable levels of sugar in the blood, also known as hypoglycaemia
The onset, in later life, of type II diabetes
Symptoms relating to your immune system
Poor liver health can also affect your immune system in which case the symptoms of liver disease to
watch out for include:
Developing new, allergies such as asthma, hay fever, and hives
excessive itching
Developing skin rashes
An increased incidence of autoimmune disease
Developing fibromyalgia
An increase in the incidence of viral and bacterial infections
Spot the symptoms of liver damage and give your liver the chance to recover
The health of your liver, is not only crucial for a continued holistic health lifestyle, but is essential for any
type of healthy lifestyle. The power of the liver to heal itself from many diseases brought about by
alcoholic or non-alcoholic fatty liver is quite amazing; provided that the disease is spotted early; so
knowing what the potential symptoms of liver disease are, as discussed above, and keeping a watchful
eye out for them is absolutely crucial.

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wishes#ixzz3D6BxUJCk1- The Fisher King 2- Wit 3- Philadelphia 4- Terms of Endearment 5- Leaving Las
Vegas 6- The Doctor 7- Awakenings 8- Patch Adams 9- Something the Lord Made 10- And the Band
Played On 11- One Flew Over the Cuckoo's Nest 12- The Painted Veil 13- The Race for the Double Helix
14- Article 99 15- People Will Talk 16- Malice 17- Sicko 18- John Q 19- The Men 20- My Left Foot: The
Story of Christy Brown 21- Red Beard 22- My Own Country 23- The Hospital 24- Britannia Hospital 25-
Bringing Out the Dead 26- The gifted hands of Ben Carson 27- Pathology 28- Syndromes and a Century
29- Doctor Dolittle 30- Doctor Zhivago 31- Dr. No 32- Persona 33- House Calls 34- The Barbarian
Invasions 35- The Death of Mr. Lazarescu 36- High Anxiety 37- No Way Out 38- Whirlpool 39- Spellbound
40- The Abominable Dr. Phibes 41- Dr. Phibes Rises Again 42- Doctor Detroit 43- Red Angel 44- Tales
from the Gimli Hospital 45- Nurse Betty 46- Night Nurse 47- Doctor in the House 48- Doctor at Sea 49-
Doctor at Large 50 - Carry On Nurse 51- The Kingdom 52- Stitches 53- Medicine Man 54- The Great
Moment 55- Oh Doctor 56- The Island of Dr. Moreau 57- Tombstone 58- Dead Ringers 59- MASH 60-
Extraordinary Measures 61- Obsessed 62- dragonfly 63- City Of Angels 64- Dr. Jekyll and Mr. Hyde 65-
Malice 66- Alien 67- The Last King of Scotland 68- The Andromeda Strain 69- Coma 70- Anatomy 71-
Anatomy 2 72- Flatliners 73- Dr. Giggles 74- The Dentist 75- Cold Prey 2 76- Sick Nurses 77- Dark Floor
78- Visiting Hours 79- Rabid 80- Infection 81- Blessed 82- Death Knows Your Name 83- Body Parts 84-
Re-Animator 85- Extreme Measures 86- Dead Ringers 87- The Clinic 88- Return of the Living Dead: Rave
to the Grave 89- Shutter Island 90- Jacob's Ladder 91- Outbreak 92- Repo! The Genetic Opera 93-
Frankenstein 94- The Grudge 95- Boo 96- John Q 97- No Strings Attached 98- Bad Medicine 99- Doc
Hollywood 100- Hysteria 101- Lorenzo' s oil 102- My sister's keeper 103- The Lake House 104- Living
proof 105- The Impossible 106- The Elephant Man 107- The English Patient 108- Just Like Heaven 109-
Django Unchained 110- Errors of the Human Body 111- The World War Z 112- Las Confesiones Del
Doctor Sachs 113- American Mary 114- Side Effects 115- The Diving Bell and the Butterfly 116-
Restoration 117- Gabrielle 118- The Good Doctor 119- Contagion 120 - The Physician 121 - St. Giuseppe
Moscati: Doctor to the Poor 122- Elysium 123- Gattaca 124- Blade Runner 125- Brazil 126- Cloud Atlas
127- A.I. Artificial Intelligence 128- Eternal Sunshine of the Spotless Mind 129- Beautiful Mind 130-
Forbidden Planet 131- Inception 132- Prometheus 133- Robot & Frank 134- The Fifth Element 135- City
Of Joy 136- Blindness

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students.416/
At the Gym,
Walking the Dog,
On the Road,
Lying On the Beach!
or On a Slopes!
For example, women have larger corpus callosums, the area of the brain responsible for connecting the
right and left hemispheres and for facilitating communication. Researchers have even found people
with gender identity disorder successfully align with their gender identified differences. People who
were biologically born male have larger corpus callosums just like a female, but people born as
biological females have smaller corpus callosums. Inside a man’s brain, on the other hand, lies a larger
and denser left hippocampus, which is responsible for memory forming, organizing, and storing
information. Gender roles formed by the environment may control the size and density of certain brain
areas more than natural development. By the age 2 to 3, children are able to correctly label
themselves and others by genders, according to the Netherlands Institute of Neuroscience. It’s no
surprise that when a girl is given a doll and a boy is given a plastic tool kit, they will take on the roles
of nurturing and building and forcibly exercise and reinforce the regions of the brain that control each
of their gender roles.

Read more at: http://forum.facmedicine.com/threads/the-difference-between-male-and-female-

brain.19207/Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder
characterized by intestinal hamartomatous polyps in association with a distinct pattern of skin and
mucosal macular melanin deposition. Patients with Peutz-Jeghers syndrome have a 15-fold
increased risk of developing intestinal cancer compared with the general population..The cause of
Peutz-Jeghers syndrome (PJS) in most cases (66-94%) appears to be a germline mutation of the
STK11/LKB1 (serine/threonine kinase 11) tumor suppressor gene, located on band
19p13.3.....Peutz-Jeghers syndrome commonly present in adolescence and early adulthood.. One
third of the affected individuals experience symptoms during the first 10 years of life. The median
time of first presentation with polyps is age 11-13 years.....Well-established clinical diagnostic criteria
are noted for Peutz-Jeghers syndrome. One set includes the following elements: 3
histopathologically proven Peutz-Jeghers syndrome polyps with classic mucocutaneous
pigmentation and a positive family history

In an unexpected twist, a family of proteins that have been found to promote HIV-1 entry into cells
also potently block viral release. Interestingly, these proteins were also found to inhibit the release of
other viruses, including Ebola virus. These intriguing new findings provide us with novel insights into
both viral infection and the development of AIDS, which could ultimately lead to new antiviral
strategies. The study has been published in Proceedings of the National Academy of Sciences. Viruses
are unable to replicate by themselves and thus must hijack a host cell’s machinery in order to do so.
To get inside host cells, HIV, or human immunodeficiency virus, needs to bind to receptors found on
target cells. This triggers a series of events that ultimately lead to viral entry; once inside, HIV
converts the cell into a factory for making more viruses. Recent studies have identified a family of
proteins, called TIM proteins, which play critical roles in facilitating the entry of various viruses
including Ebola, West Nile and dengue viruses. Intriguingly, University of Missouri researchers have now
discovered that these proteins not only promote HIV-1 entry into host cells, but they also prevent viral
release. For the study, scientists investigated the interactions between HIV-1 and TIM proteins using
various molecular, biochemical and microscopic techniques. They found that as HIV-1 begins to bud
from, or escape, the host cell, TIM proteins become incorporated into the virions and tether the
particles to the cellular membrane. This is mediated through interactions with a lipid called
phosphatidylserine (PS) that is found both on the cell membrane and the outside of the virus particles.
Usually, PS is expressed on the inside of the cell, but viral infection causes it to flip to the outside,
meaning that both PS and TIM are now present on the cell and viral surface. TIM and PS then bind to
one another as HIV-1 attempts to escape from the cell, causing the particles to be retained at the cell
surface. Interestingly, the team also discovered that TIM proteins inhibited the release of other viruses
including a mouse virus belonging to the same family as HIV (murine leukemia virus), and also Ebola
virus. While these discoveries extend our understanding of viral infection, lead researcher Shan-Lu Liu
points out that it is not clear at this stage whether HIV’s interaction with TIM proteins is a positive or
negative factor. “However, this discovery furthers our ultimate goal of understanding the biology of
TIM-family proteins and potentially developing applications for future antivirus therapies,” he says.

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hiv-and-ebola-virus-release.19218/I just can't tolerate when people 'block' me, although we are
'friends' again 'remember' that I will never 'forget'
#One of the unpublished article of the NASA Times
After editing and compiling……

Pursuit for SUCCESS

Life is a race if you won’t run fast you’ll be lost in the field of darkness. It is like a
cafeteria through which we can get any sorts of things or like a chocolate box never knows what
comes after. Every individual can enjoy the fruits of success, but they’ll never get it if they wait
for someone to bring for them. We have to get it up and get it ourselves. Most of people think
success is nothing but it’s just the situation of having power and money. The way most of us
look at success is in being happy and contented not for instants but for consistently and it is
verity too.
 Success is the way which can be achieve just after a little splat. We have failed many
times, although we may not remember. We fell down the first time when we tried to walk. We
almost drowned the first time when we tried to swim. But we don’t worries about failure be
consistent all the time. If we fail, it doesn’t mean we are a failure. It does mean we are getting to
our success. Failure doesn’t mean that we’ll never make it again. It does mean that we need
more patience. Failure doesn’t mean that we have accomplished nothing it does mean we have
learned something through which we get fail. For this we can take an example of one well
known great scientist Thomas Alva Edison whose works has inspired that we shouldn’t lose our
hope unless we achieve our destination. Success isn’t a big deal but it is just a way of
expressing your hidden art inside within you and it totally depends upon you how, when, where
you expose i.e. between illiterate people if you present your speech using proverbs, idioms,
phrases using wearisome vocabulary it has no meaning just lost of precious time but when you
present such speech between literate, scholarly qualified personality it definitely works and you
will be ample of eye among those person.
The secret of success can be achieved by two words i.e. Right decisions (at right place).
And we make right decisions by our experience and we get that experience by two words i.e.
prolong efforts. Believe, dream, dare and attitude are the key for success. We should believe
ourselves and dare to achieve our dream with positive attitude through which we can get fruits
of success. The long we live the more we realize the impact of attitude on life. Attitude is more
important facts. We grow by dreams. All big men are dreamers. Also people are different in their
lifestyle, attitude, art, dream and destination so success also hugs; gives kisses to their
footsteps in different ways completely differ from others.
Some people work well under pressure while others just fail under it. Decide what you
want to be. The courage most comes from the soul within but be sure that you should be candid
you aren’t cheating your heart and soul through presenting your fake impression & personality
among your colleagues. The only work ethic that works is listening to our heart as much as
possible. Our heart suggests what to do and how to do, not somebody else or something else.
Our heart and mind are those vital organs that provide directions to all our daily activities in
order to achieve successful life so we should take right decision from mind and keeping heart
bold using 3D i.e. dedication, determination and devotion. After that do you work accordingly,
present your key art and achieve your first steps of success.
Say I can, follow your heart, focus at work, use your power of thought, forget your
wandering ideas, realize the importance of time, believe yourself and dare to achieve your
destiny with positive attitude through which you can get your success in your right hand by
closing yours eyes. And remember that Success can’t be buy or bargain it should be procure
through mind, effort and dare i.e. Success never hunt on you but we have to be silky forever
and make success to kiss your every footstep ever………….
-SoF(BD6)

*But we are surrounded by real world and real people…so enjoy the fullest life as it is
short and do right deed without hampering the soul of “compassion as great virtue”

Daydreams have been commencing with the positive hope .the aroma of hope can be
smelt over my surrounding
A long voyage without avail is just a worst nothing else….. feeling vexation
Finally getting sunder from the 7 months of hibernation. The aroma of daydreams is
commencing and smelling with positive hope after the rays of sunlight bleached eyesight,
discerned skin and fresh & cool air palpated nose. The torture & glee felt over this period was
really breathtaking…so yearning such havoc period never hunt within…” A long voyage without
avail is just a worst nothing else”
& here it ends: “A long voyage without
avail”
Nov
Dear one,
Finally heading towards a red letter day, and I’m going to recount my hibernation period
so that the glee, pain, pleasure and torture felt over that period will be equally shared between
you and me. Hope you won’t underestimate my feeling and provide me right directions,
suggestions & courage for the upcoming life events.
The aroma of daydreams is commencing and smelling with positive hope through this
very day. Finally the rays of sunlight bleached eyesight, discerned skin and fresh & cool air
palpated nose. The 7months long lasting hibernation moments were memorable and never want
to wipe out from my memory. That period was like a bad nightmare which had been hunting for
last few months. For me the hibernation period was yearn which was fulfilled after a long linger.
I used to carved before as if there were no school/colleges’ period so that I can have leisure at
any time; but my wish was fulfilled with lots of chaos, huddles, tortuous, sang veiled inside
within it which created havoc life.
The 1st month was full of revelation and joy which can be felt over my lips, eyes, gesture
and deeds but as the time abated the recurring daily routine started creating chaos in my daily
life. I was expecting such situation in my life which will bring lots of glee & pleasure so that I can
also be the part of my close & dearest friends circle; but when it happen it totally differ from the
novel one as I used to dream earlier before such period. If it had happened before 1year such
situation won’t have this much impact on me so that I’ll seat in front of the laptop sharing it to
you through putting down black and white. Why, when & how such winsome period transformed
into hibernation period can’t remember the literal date & time. The madness of the glee and joy
lost within 1month and depression, torture, pain took its way. That vary duration was like a
prodigy gift for me afterwards which will never hunt on my life back again but also can’t enjoy to
the fullest extent. Some part of my unconscious mind had strong feeling that either the decision
I had gone through will head towards dark venture or something like white feathers may hunt on
me; which kept me under hibernation all day & night.
I was in such situation where I didn’t have answer of when, where & which type of
questions done by relatives & friends; such filthy things were hunting on my mind since last few
months. So in order to get rid of such question I had decided for hibernation. Sometime I used
to be numb in front of such question but when such situation moves towards the climax I used to
take fake support and deal with those people. How could I present my answer to them which I
didn’t know…Afterwards, these people started looking at me as I was giving them false info and
hope. Since then gossip started moving around me and making my life like a desert. So to get
purge from these situations, I made plan to hibernate inside my own house neglecting relative
voices as their voices were becoming throne in flesh. Sometime I used to welled during night
recalling the past avail life and used to wipe out face through shirts sleeves. After all I started to
natter with books, mirror & sometime with myself expressing the rage roaming over my blood
through writing & walking throughout the house.
Such bad moments were moving around me & making my memory full; fading
knowledge, data, information that were gathered during last few years. I had gone through
completely bothered & uptight circumstances. I was getting duller, weaker & alone although I
used to have some fun on social networking site but those joys didn’t used to long last; that
were only for limited period. Joys used to fade up as soon as I go for sleep and again such
where, when & which types of question used to hunt on me. Since my mind wasn’t with me it
was lost for seeking something at virtual world. Form last few months I hadn’t gone through
sound sleep as I always used to think about how to get rid of such disaster situation.
In-between such bad aspect I suddenly met fairy like elf. It was my one & only great
achievement ever during that period. It was really astonishing experience that my life had also
gone through such blissful experience. Elf used to hunt me on my dream and I made a plan for
friendship. Our friendship last for 3-4months which had changed my daily routine pattern. We
started sharing our life moments. The joy & sorrow we had gone through were equally shared
between us as well we started to understand each other’s feelings. I was amazed that elf had
similar life like ours and some parts were quite harmonizing with my life. I used to have my
dinner early so that I can squander more time with elf. Sometime my mind had burly feeling why
I was so much fascinated to that elf & how can I do this/that but anyway same elf hunted me on
my dream again & again which had transferred my deserted life into savanna. I started going
through daydreaming and enjoying the glee, gratification moments with elf. The date with elf
was Shangri-La for me where I was completely lost in the fantasy world of adore, warmth,
friendliness, affairs & clout which had totally changed my life. Suddenly one day elf halted
hunting on me. I got edgy but handle my mind as that was only imaginary elf. Form that day elf
never hunted; 2-3days after disappearance of elf I had same routine so that same elf could
again come on and plant some flowers in my desert full life. But I hardly met; my act of finding
elf was crazy like searching needle in the hay stack. Having elf on my dreams & daydreams was
just all agog but moments that I had spent with elf were just like a flash in the pan.
In-between this and that I was in touch with my childhood friends with whom I was
contactless and it had been more or less 11 years. I felt glad to them as they had still my image
on their memory. But I couldn’t gather enough courage to address any of them since they were
enjoying their own life, studying but me struggling and going through hibernation period. If I had
have conversation such question where, when, which will arise which had already created mess
on my life. So I decided to stay a bit far from them. I used to seat in front of laptop and go
through social networking site but my inbox, notification used to be empty; nevertheless I used
to enjoy myself through surfing friends profile, pic where I used to smell the fragrance of love
and friendship; which used to cajole me again & again to visit their profile. I felt pleased that my
childhood friends having such status, successful life where they were enjoying with one another.
Although my inbox used to be empty but when I mesg to one of those friends I used to receive
either instant mesg or a day after that use to make me fell more happy that they haven’t
forgotten me. And with great hope & daydreaming that someday my friends will also go through
my profile and glad on me…….
The fake glee can be felt over my face but actual pain and torture were running along
with my blood all over the body. My life was similar to dusk in a thunderstorm; in which huddles,
chaos, sang were like a snake in the grass. Today I’m finally getting sunder from the 7 months
of hibernation. The torture & glee felt over this period was really breathtaking. So yearning such
havoc period (except 1st few months) never hunt within…….

Yours victim
(SoF)
* A long voyage without avail is just a worst nothing else………
*The word #elation looks great only in the way; that heading towards us....bt when it starts
sustenance result in mundane....
 Life is like a box of chocolate never knows what comes
after…..
A long voyage without avail is just a worst nothing else… A
long voyage without avail is just a worst nothing else…..feeling vexation
Joining a MBBS course is a jolt of fresh enthusiasm and
eagerness about what shall come ahead and feeling of security
and pride over the profession one has ensued. At the same time
the enumerable queries about whether the course is within own
capability and the fear of the Hearsay can make days bit of
turmoil. So a good counselling is what you people need at this
time.

Read more First Year in Medical College- MBBS students life |

Medchrome But it seems to be “A boon in disguise” using oily
tongue…
Ei Youtubewa ka link bhery good hai. Eima humra boley
wala poster dekho! youtube.com/watch?v=KDFDaw …
http://www. j XsXg

Pacemaker (Natural pacemaker = Heart)

A pacemaker (artificial pacemaker) is a medical
device that uses electrical impulses, delivered
by electrodes contracting the heart muscles, to regulate the
beating of the heart. The primary purpose of a pacemaker is
to maintain an adequate heart rate, either because the heart's
natural pacemaker is not fast enough, or there is a block in
the heart's electrical conduction system. Modern pacemakers
are externally programmable and allow the cardiologist to
select the optimum pacing modes for individual patients.
Some have multiple electrodes stimulating differing positions
within the heart to improve synchronization of the lower
chambers (ventricles) of the heart.
History:
In 1889, J A McWilliam reported in the British Medical Journal of his experiments in
which application of an electrical impulse to the human heart in asystole caused
a ventricular contraction and that a heart rhythm of 60–70 beats per minute could be evoked by
impulses applied at spacing equal to 60–70/minute.
In 1932, American physiologist Albert Hyman, working independently, described an
electro-mechanical instrument of his own, powered by a spring-wound hand-cranked
motor. Hyman himself referred to his invention as an "artificial pacemaker", the term
continuing in use to this day.
 An external pacemaker was designed and built by the Canadian electrical engineer John
Hoops in 1950 based upon observations by cardio-thoracic surgeon Wilfred Gordon
Bigelow at Toronto General Hospital . A substantial external device using vacuum
tube technology to provide transcutaneous pacing, it was somewhat crude and painful to the
patient in use and, being powered from an AC wall socket, carried a potential hazard of
electrocution of the patient by nducing ventricular fibrillation.
The development of the silicon transistor and its first commercial availability in 1956 was
the pivotal event which led to rapid development of practical cardiac pacemaking.
The first clinical implantation into a human of a fully implantable pacemaker was in 1958
at the Karolinska Institute in Solna, Sweden, using a pacemaker designed by Rune Elmqvist and
surgeon Åke Senning, connected to electrodes attached to the myocardium of the heart
by thoracotomy. The device failed after three hours. A second device was then implanted which
lasted for two days. The world's first implantable pacemaker patient, Arne Larsson, went on to
receive 26 different pacemakers during his lifetime. He died in 2001, at the age of 86, outliving
the inventor as well as the surgeon.
The preceding implantable devices all suffered from the unreliability and short lifetime of
the available primary cell technology which was mainly that of the mercury battery. In the late
1960s, several companies, including ARCO in the USA, developed isotope-
powered pacemakers, but this development was overtaken by the development in 1971 of the
lithium-iodide cell by Wilson Greatbatch. Lithium-iodide or lithium anode cells became the
standard for future pacemaker designs.

Necessary of pacemaker:
The normal electrical conduction in the heart allows the impulse that is generated by
the sinoatrial node (SA node) of the heart to be propagated to (and stimulate) the cardiac
muscle (myocardium). The myocardium contracts after stimulation. It is the ordered stimulation
of the myocardium that allows efficient contraction of the heart, thereby allowing blood to be
pumped throughout the body. Signals arising in the SA node stimulate the atria to contract and
travel to the AV node. After a delay, the stimulus is conducted through the bundle of His to
the Purkinje fibers and the endocardium at the apex of the heart, then finally to the ventricular
epicardium, which result the normal resting adult human heart rate ranges from 60–100 bpm.
Cardiac dysrhythmia (arrhythmia/irregular heartbeat) is any of a group of conditions in
which the electrical activity of the heart is irregular or is faster or slower than
normal. The heartbeat may be too fast (over 100 beats per minute) or too slow (less than 60 beats
per minute), and may be regular or irregular. A heart beat that is too fast is called tachycardia and
a heart beat that is too slow is called bradycardia. So during an arrhythmia, the heart can beat too
fast, too slow, or with an irregular rhythm. Pacemakers can relieve some arrhythmia symptoms,
such as fatigue (tiredness) and fainting. A pacemaker also can help a person who has abnormal
heart rhythms resume a more active lifestyle.
Function:
Modern pacemakers usually have multiple functions. The most basic form monitors the
heart's native electrical rhythm. When the pacemaker does not detect a heartbeat within a normal
beat-to-beat time period, it will stimulate the ventricle of the heart with a short low voltage pulse.
This sensing and stimulating activity continues on a beat by beat basis.
The equivalent atrial pacing mode is AAI or AAIR which is the mode of choice when
atrioventricular conduction is intact but the natural pacemaker the sinoatrial node is unreliable -
sinus node disease (SND) or sick sinus syndrome. Where the problem is atrioventricular
block (AVB) the pacemaker is required to detect (sense) the atrial beat and after a normal delay
(0.1-0.2 seconds) trigger a ventricular beat, unless it has already happened - this is VDD mode
and can be achieved with a single pacing lead with electrodes in the right atrium (to sense) and
ventricle (to sense and pace). These modes AAIR and VDD are unusual in the US but widely
used in Latin America and Europe. The DDDR mode is most commonly used as it covers all the
options though the pacemakers require separate atrial and ventricular leads and are more
complex, requiring careful programming of their functions for optimal results.
Advancement:
A major step forward in pacemaker function has been to attempt to mimic nature by
utilizing various inputs to produce a rate-responsive pacemaker using parameters such as the QT
interval, pO2 - pCO2 (dissolved oxygenor carbon dioxide levels) in the arterial-venous system,
physical activity as determined by an accelerometer, body temperature, ATP levels, adrenaline,
etc. Instead of producing a static, predetermined heart rate, or intermittent control, such a
pacemaker, a 'Dynamic Pacemaker', could compensate for both actual respiratory loading and
potentially anticipated respiratory loading. The first dynamic pacemaker was invented by
Anthony Rickards of the National Heart Hospital, London, UK, in 1982.
Dynamic pacemaking technology could also be applied to future artificial hearts.
Advances in transitional tissue welding would support this and other artificial organ/joint/tissue
replacement efforts. Stem cells may or may not be of interest to transitional tissue welding.
Many advancements have been made to improve the control of the pacemaker once
implanted. Many of these have been made possible by the transition to microprocessor controlled
pacemakers. Pacemakers that control not only the ventricles but the atria as well have become
common. Pacemakers that control both the atria and ventricles are called dual-chamber
pacemakers. Although these dual-chamber models are usually more expensive, timing the
contractions of the atria to precede that of the ventricles improves the pumping efficiency of the
heart and can be useful in congestive heart failure.
Insertion:
A pacemaker is typically inserted into the patient
through a simple surgery using either local anesthetic or
a general anesthetic. The patient may be given a drug for
relaxation before the surgery as well. An antibiotic is
typically administered to prevent infection. In most cases
the pacemaker is inserted in the left shoulder area where
an incision is made below the collar bone creating a
small pocket where the pacemaker is actually housed in
the patient's body. The lead or leads (the number of leads
varies depending on the type of pacemaker) are fed into
the heart through a large vein using a fluoroscope to
monitor the progress of lead insertion. The Right
Ventricular lead would be positioned away from the apex
(tip) of the right ventricle and up on the interventricular
septum, below the outflow tract, to prevent deterioration
of the strength of the heart. The actual surgery may take
about 30 to 90 minutes.
Following surgery the patient should exercise reasonable care about the wound as it
heals. There is a follow-up session during which the pacemaker is checked using a "programmer"
that can communicate with the device and allows a health care professional to evaluate the
system's integrity and determine the settings such as pacing voltage output. The patient should
have the strength of his or her heart analyzed frequently with echocardiography, every 1 or 2
years, to make sure the that placement of the right ventricular lead has not led to weakening of
the left ventricle.
Since a pacemaker uses batteries, the device itself will need replacement as the batteries
lose power. Device replacement is usually a simpler procedure than the original insertion as it
does not normally require leads to be implanted. The typical replacement requires a surgery in
which an incision is made to remove the existing device, the leads are removed from the existing
device, the leads are attached to the new device, and the new device is inserted into the patient's
body replacing the previous device.
Pacemaker patient identification card:
International pacemaker patient identification cards carry information such as patient data
(among others, symptom primary, ECG, aetiology), pacemaker center (doctor,
hospital), IPG (rate, mode, date of implantation,manufacturer, type) and lead type.
Periodic pacemaker checkups:
Two types of remote monitoring devices used by pacemaker patients:
 Periodic
 Routine
Once the pacemaker is implanted, it is periodically checked to ensure the device is
operational and performing appropriately. Depending on the frequency set by the following
physician, the device can be checked as often as is necessary. Routine pacemaker checks are
typically done in-office every six (6) months, though will vary depending upon patient/device
status and remote monitoring availability.
As modern pacemakers are "on-demand", meaning that they only pace when necessary,
device longevity is affected by how much it is utilized. Other factors affecting device longevity
include programmed output and algorithms (features) causing a higher level of current drain
from the battery.
Lifestyle considerations of user & safety measure:
A patient's lifestyle is usually not modified to any great degree after insertion of a
pacemaker. There are a few activities that are unwise such as full contact sports and activities
that involve intense magnetic fields.
The pacemaker patient may find that some types of everyday actions need to be modified. For
instance, the shoulder harness of a vehicle seatbelt may be uncomfortable if the harness should
fall across the pacemaker insertion site.
Any kind of an activity that involves intense magnetic fields should be avoided. This
includes activities such as arc welding possibly, with certain types of equipment, or maintaining
heavy equipment that may generate intense magnetic fields (such as a magnetic resonance
imaging (MRI) machine).
Some medical procedures may require the use of antibiotics to be administered before the
procedure. The patient should inform all medical personnel that he or she has a pacemaker. Some
 standard medical procedures such as the use of magnetic resonance imaging (MRI) may be ruled
out by the patient having a pacemaker.
Complications:
A possible complication of dual-chamber artificial pacemakers is pacemaker-mediated
tachycardia (PMT), a form of reentrant tachycardia. In PMT, the artificial pacemaker forms the
anterograde (atrium to ventricle) limb of the circuit and the atrioventricular (AV) node forms the
retrograde limb (ventricle to atrium) of the circuit. Treatment of PMT typically involves
reprogramming the pacemaker.
Another possible complication is "pacemaker-tracked tachycardia," where
a supraventricular tachycardia is tracked by the pacemaker and produces beats from a ventricular
lead. This is becoming exceedingly rare as newer devices are often programmed to recognize
supraventricular tachycardias and switch to non-tracking modes.

patho father robbins

Anatomy bd chaurasia
Biochemistry u.satyanarayana
Microbiology p k chakraborty
Physiology a.k jain
Pharmacology k d tripathi
Com.med park n park

ANATOMY
Textbooks:
 Human Anatomy Vol. 0,1,2 and 3 – B.D Chaurasia (Indian Writer) – Widely studied by medical students
in Nepal
 Essentials of Human Anatomy – A K Dutta
 Clinical Anatomy – Richard S Snell
 Clinically Oriented Anatomy – Keith L Moore and Arthur F Dally
References:
 Gray’s Anatomy For Students – Richard L Drake, Wayne Vogl, Adam W M Mitchell
 Human Anatomy – Van De Graff
 Interactive Atlas of Human Anatomy – Frank H Netter
 McMinn’s Colour Atlas of Human Anatomy – P H Abrahams, S C Marks Jr, R T Hutchings
 Grant’s Atlas of Anatomy – Anne M R Agur, Arthur F Dalley
 Textbook of anatomy by Inderbir Singh

Dissection:
 Cunningham’s Manual of Practical Anatomy
 Grant’s Dissector – Patrick W Tank

Neuroanatomy:

 Textbook of Human Neuroanatomy – Inderbir Singh

 Clinical Neuroanatomy – Richard S Snell

Embryology:
 Langman’s Medical Embryology – T W Sadler
 Human Embryology by Inderbir Singh and G.P. Pal
Histology:
 Wheater’s functional histology by B.Young and JW Health
 Textbook of Human histology by Inderbir Singh
BIOCHEMISTRY
 Biochemistry – Satyanarayan
 Harpers’ Illustrated Biochemistry
 Lippincott’s Biochemistry
 Lehringer Principles of biochemistry
 Marks’ Basic Medical Biochemistry
 Textbook of Biochemistry by Shinde
PHYSIOLOGY
 Essentials of Medical Physiology – Mahapatra
 BRS (Board Review Series) Physiology
 Textbook of Medical Physiology – G K Pal
 Textbook of Medical Physiology – Guyton and Hall
 Ganong’s Review of Medical Physiology
 Understanding Medical Physiology – R.L Bijlani
 Berne and Levy Physiology – Koeppen, Stanton
 Human Physiology – Sembulingham
 Concise Medical Physiology – Chaudhary
PATHOLOGY
 Textbook for pathology
 Robbin’s Basic Pathology – Kumar, Abbas, Fausto, Mitchell
 Robbin’s and Cotran’s Pathological Basis of Disease
 Textbook of Pathology – Harsh Mohan (Recommended only for pathology pictures, most teachers do not
recommend its text)
 Pathology Illustrated – Peter S Macfarlane, Robin Reid, Robin Callander (For figures and charts)
Pathology last hour review:
 Pathology Quick Review and MCQs – Harsh Mohan
 Pocket companion to Robbins Pathological Basis of Disease
MICROBIOLOGY
 A Textbook of Microbiology – P Chakraborty
 Textbook of Microbiology – R Ananthanarayan, C K J Paniker
 Clinical Microbiology Made Ridiculously Simple – Medmaster series
Parasitology:
 Textbook of Medical Parasitology by Paniker
 Medical Parasitology by RL Ichhpujani and Rajesh Bhatia
 Textbook of Medical Parasitology by Chatterjee
PHARMACOLOGY
 Essentials of Medical Pharmacology – K D Tripathi (Best)
 Clinical Pharmacology – Bennet and Brown (Reference)
 Satoskar Pharmacology and Pharmacotherapeutics
 Basic and Clinical Pharmacology – Katzung, Masters, Trevors (Reference)
 Lippincott’s Illustrated Review of Pharmacology by Mary Mycek, Richard Harvey and Pamela Champe
(Reference)
COMMUNITY MEDICINE
 Park’s Textbook Of Preventive and Social Medicine by K Park
 A Comprehensive Textbook of Community Medicine (preventive and Social Medicine) by J S Mathur
 Methods in Biostatistics by B K Mahajan
 Manual of Biostatistics by JP Baride, AP Kulkarni, RD Muzumdar
Guide Books (Available in Nepal)
 A Review of Basic Science for 1st Phase MBBS by Manoj Bhnadari (BSR)
 Integrated Basic Medical Science (IBMS) by Sujit Kumar Jha
 A Textbook of Community Medicine for 1st year MBBS (TU/KU) by Bibek Poudel, Kamal Pokhrel and
Sanjiv Bastakoti

Read more Recommended Books For MBBS Basic Science | Medchrome

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Happy Birthday my love