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20111129

KERALA PSC Answer key 2011


 

LECTURER (VARIOUS SUBJECTS)
MEDICAL EDUCATION DEPARTMENT
(CATEGORY NUMBER: 244/2011)
Date of Test: 24/11/2011
PROVISIONAL ANSWER KEY

Question booklet code:
   A B C D    A B C D
1 B D A C 51 A C A D
2 D A C B 52 C A D A
3 C C A D 53 B C A B
4 A C B D 54 A D A C
5 B A B A 55 B A B A
6 C A D C 56 C A B B
7 C B B B 57 C B D D
8 C B D A 58 D A C A
9 D C C A 59 B B C A
10 A B A B 60 A B A B
11 B C B B 61 B C B D
12 A D C C 62 A B B C
13 B B C B 63 D B C B
14 B B B B 64 B D D B
15 B B B C 65 D D B C
16 C C D D 66 D C C A
17 C D D C 67 C C A A
18 B B B C 68 A D C C
19 D D C C 69 C A A D
20 D A D A 70 A A D C
21 B B C B 71 B C A C
22 B D A A 72 C A B B
23 D C C D 73 A B C A
24 C B B B 74 A C B C
25 A D A D 75 C B A B
26 D B D A 76 B A C A
27 B C B B 77 C B C B
28 A D B D 78 B C B C
29 D A A D 79 B D B D
30 A A D B 80 D B D B
31 D B D C 81 B C D B
32 B D C A 82 C D B A
33 C B D B 83 C D B C
34 D C A C 84 D B A D
35 A C B A 85 A D C A
36 B D B D 86 D B C D
37 A C B D 87 A C D B
38 C A C B 88 B A D C
39 B A C B 89 C A C D
40 C B A C 90 D C A C
41 B B D C 91 B C C A
42 B D C B 92 C C A A
43 B B B D 93 A B B C
44 D C B B 94 C A A C
45 C B B B 95 A C D B
46 B C C D 96 B B C C
47 C C D A 97 B A B B
48 A B C C 98 A A C D
49 C D A B 99 D B A B
50 D A B C 100 C D B A
LECTURER (VARIOUS SUBJECTS)
MEDICAL EDUCATION DEPARTMENT
(CATEGORY NUMBER: 244/2011)

AIIMS NOV 2011 RESULTS:

Congrats !!!


Over all Rank Roll No. Name Community
  1 2306473 Abhimanyu Nehra                              
  2 2328825 Raghav Singla                                
  3 2320102 K Shanmugam                        OBC        
  4 2335913 Niranjan Mahishi                              
  5 2328083 Vivek Tiwari                                  
  6 2315643 Darshan Krishnappa                            
  7 2332099 Vijay G                                      
  8 2313389 Sathya C                           OBC        
  9 2321467 Geethu Antony                                
 10 2336151 Swati Tayal                                  
 11 2311461 Manish Kumar Sharma                          
 12 2320019 Anoop M K                          OBC        
 13 2328439 Suvrit Jain                                  
 14 2330270 Deepti Pandit                                
 15 2335253 Mayur Nayak                                  
 16 2300100 Shreyans Mutha                                
 17 2331356 Mankul Goyal                                      AIIMS
 18 2322503 Priyanka Madaan                              
 19 2331351 Minu Jose Chiramel                            
 20 2335663 Alpesh Goyal                                  
 21 2331813 Anghan Hirenkumar Lallubhai                  
 22 2334899 Antriksh Kumar                                
 23 2301955 Dibya Sundar Mahanta               OBC        
 24 2307643 Kutty Sharada Vinod                          
 25 2307757 Rupesh Prasad                      OBC        
 26 2330283 Joyita Bharati                                
 27 2320021 Vinay M V                                    
 28 2318451 Preethi J                                    
 29 2331269 Adarsh M B                                    
 30 2315112 Sangeetha S                        OBC        
 31 2314779 Sneha J                                      
 32 2313898 Shaikh Abdul Fahim Abdul Rahim                
 33 2325227 Kunal Dwijen Roy                              
 34 2323071 Siddharth Rakhe                              
 35 2314680 Sreekar Gundapaneni                          
 36 2309679 Rony Benson                                  
 37 2316222 Sidharth Gupta                                
 38 2324494 Vaibhav Sharma                                
 39 2327691 Abraar Sheriff M                   OBC         2
 40 2305426 Pawankumar                         OBC        
 41 2315218 Sreesanth K S                      OBC        
 42 2325870 Shikha Bathwal                                
 43 2333143 Shreyas T S                        OBC        
 44 2313078 Ezaz Mohamed H                                
 45 2323582 Praveen Chaturvedi                            
 46 2317029 Simin Muhammed Kutty               OBC        
 47 2332435 Mohammed Sadiq                     OBC        
 48 2317771 Piyush Bansal                                
 49 2300705 Chithira P V                       OBC        
 50 2328600 Simna L                            OBC        
 51 2322698 Devendra Pathrot                   OBC        
 52 2310947 Rinoy Chandran                                
 53 2302060 Sumit Gupta                                  
 54 2307937 Priya P S                                    
 55 2315538 Greeshma Raghavan                            
 56 2316396 Renu Agrawal                                  
 57 2335970 Karad Abhijeet Bhausaheb           OBC        
 58 2319055 Deepika Gupta                                      AIIMS
 59 2322672 Sandeep Ganta                                
 60 2334012 Anand Bansal                                  
 61 2307819 Senthilkumar P                     OBC        
 62 2321877 Bhirud Deepak Prakash              OBC        
 63 2325462 Raghav Dinesh Ravani                          
 64 2311347 Abdul Shameer S                    OBC        
 65 2321345 Pradeep T                                    
 66 2311538 Pavan Mulgund                                
 67 2325143 Jarin Noronha                                
 68 2332970 Priyanka Minocha                              
 69 2335118 Falera Ruchita Clara                          
 70 2315631 Shabeer B                          OBC        
 71 2306816 Akash Kumar Ambashtha                        
 72 2319082 Chaniyara Manthan Hasmukhbhai                
 73 2302416 Nikhil Agrawal                                
 74 2330983 Muthu Chidambaram N                          
 75 2307395 Neethu Thomas                                
 76 2322355 Ananya Mahapatra                              
 77 2311591 Jathar Swapnil Sudhakar                      
 78 2305010 Mohammed Naseer R                            
 79 2322731 Anil Kumar Jangid                  OBC        
 80 2315433 Chetanya Malik                                
 81 2329304 Payas Joshi                                  
 82 2315098 Suman Patra                                  
 83 2301907 Isha Garg                                    
 84 2309487 Gandhi Akanksha Krishnavadan                  
 85 2300063 Panandikar Gajanan Ashok                      
 86 2331317 Sumit Bansal                                  
 87 2329136 Abhinaya S                                    
 88 2323781 Lakshmi Priya U                                3
 89 2328021 Vadhi Mounika Reddy                          
 90 2328941 Saranya Devi K                     OBC        
 91 2330466 Suman Chatterjee                              
 92 2318881 Prateek Kakkar                                
 93 2334470 Aravinth Kumar A                              
 94 2324047 Apurva Anand                                  
 95 2334553 Madhura Mukherjee                            
 96 2306021 Asha Benazir M                     OBC        
 97 2321418 Vrinda P S                                    
 98 2313610 Sudeep Kumar K                     OBC        
 99 2332814 Pintu Sharma                       OBC        
100 2305383 Koustav Jana                          

AIPGMEE 2012: Important Dates


Last date for receipt : 21st December, 2011
of applications (5.00 PM)

● Admit Cards to be hosted at : 28th December, 2011 (Through Net only not by post)
www.aiimsexams.org by

Entrance Examination : 08th January, 2012

● Expected date of declaration : 15th February, 2012
of result*

● Allotment of seat by : 23.02.2012 to 17.03.2012**

Personal Appearance Schedule and mode for counselling will be hosted
on the Website of Ministry of Health &
Family Welfare. 22.04.2012 onwards (2nd round)**

Schedule and mode for 2 nd round of counselling will
be hosted on Ministry's website only
after completion of 1st round of
Counselling.

AIPGMEE 2012- Help Manual Online Form


Important Instructions for Applicants Filling AIPGMEE-2012 Online Application Form

Just Follow Easy 4-Steps (i.e. Step-1, Step-2, Step-3 and Step-4) to fill up Online Application

NOTE: Ensure you have completed all the 4-steps i.e. Step 1 to 4. No claim for registration in respect of
incomplete Forms/Steps will be entertained.


Step -1) Create Account by using your existing Email-ID

NOTE: Applicants provide Email-ID and password will be their username and password for accessing online application form. So, applicants must remember both of them and note down in his/her diary because if he/she forget them then online application form cannot be accessed.
All the details once submitted cannot be changed later on. So, ensure you have filled up the correct and complete information.
1. The application form must be filled by the applicant.
2. Your < Email-ID > (Email-ID should be already existing, active and should be valid for atleast one year so that AIIMS can communicate with the candidate). Email-ID once filled cannot be changed in future. Ensure Email-ID is correctly filled, failing which no communication will occur and the responsibility lies on the applicant.
3. Write your Password
4. Write Applicant Full Name : Write the Candidate’s full name in BLOCK LETTERS as given in the records of Secondary Education Board/ University.”
5. Write Father’s Name (“Write the Father name in BLOCK LETTERS as given in the records of Secondary Education Board/ University.”)
6. Write Your Date of Birth (“Select the date of birth as recorded in Secondary School Leaving Certificate or equivalent examination.”)
7. Select Category: Category once declared in the application cannot be changed later on. The candidature of such OBC candidates who are covered under the „Creamy Layer‟ will be considered only under the general category.
8. Select Centre Choice
9. Write your Mobile Number. {SMS (if any )will be send to you on this number}
10. Read declaration, if acceptable, then < select > the declaration
11. Click “Create Account” button
12. Message opens on your screen. Check information is correct. Write down your Email-ID and Password as shown on Pop up message and remember the same for further access in order to complete the other steps of online form and future communication with AIIMS.
13. Click < Submit / Next > button to reach the next Step – 2 (i.e. Challan Webpage).



Step- 2) Do the Payment to SBI Bank and fill payment details to your AIIMS Online Application.

I) How to make payment
1. Click “Please Click here to get Challan Form” link. A challan form opens.This Challan form has three copies (on single page with perforations)
 Bank Copy - One for Bank
 Student Copy-Second copy must be retained by the candidate.
 AIIMS Copy – Third copy should be brought along with Admit card which is to be handed over to invigilator in the class room during attendance, failing which you will not be allowed to appear in the Entrance Examination.
2. Print the Challan Form.
3. Go to nearby SBI bank branch and tell the Bank staff to enter following details to their computer record while taking your payment against Application-cum-Examination fee.
 Challan Number(Mentioned on Challan Form), and
 Applicant Name (Mentioned on Challan Form)
4. Bank staff will write Unique Transaction Number/Journal Number,BRANCH CODE and DEPOSIT DATE on all the three copies of Challan Form. Ensure that information must be written by bank staff on all the three Challan copies.
5. Banker retains Bank Copy of Challan Form and Give Student and AIIMS copy of Challan Form.
II) How to fill payment details
6. Come back to website www.aiimsexams.org and as you have already create a Account with AIIMS ( no need to create account again ) .So, Click on Green button with Key symbol to “Login” with Email-ID and password to your online application (do not fill new registration details). It will directly go to payment page.
7. Fill the webpage fields of
a. Unique Transaction Number/Journal Number ,
b. BRANCH CODE and
c. Deposit Date written by Bank Staff on Challan Form Copies.
NOTE: Applicant must write these details carefully and correctly.
8. Click “Next/Submit” button on Challan Form webpage. You are shown with “Application Form” webpage. Click “Next/Submit” button only when you have completed all fields correctly on this page as details once entered cannot be changed later on.
9. Internet Browser open “Online Application Form Webpage”, Follow Step 3.
NOTE: Bring Challan Form-AIIMS copy alongwith Admit Card without which you will not be allowed to appear in the Entrance Examination.



Step- 3) Fill Application form completely and submit the application. 

(Instruction for filling the form available with each field of Application form and also in detail in prospectus.)
1. Applicant can edit the Application details only before submitting application. Once “Submit” Button is clicked by Applicant, he/she will not able to edit the details. So, Click “Submit” button only when you have completed all your Online Application Form details correctly and completely (because after that no edit/alteration is allowed).
2. Use “Save As Draft” button to save your incomplete Online Application Form details. So, there is no need to type details again and again.
3. Use your Email-Id (as username) and password for accessing Incomplete Online Application form.
4. When you have completed all fields of Online Application Form click “Next” button.
5. Page to verify Applicant “Application Form details” come up, verifies your entered Application Form details then accept declaration and click “Submit” Button (Use “Back” button on webpage if any changes required).Application details once submitted cannot be changed. So, click submit button only when you have completed your application details in all respect correctly.
6. After clicking “Submit” Button webpage to upload passport photograph and signature appeared.
7. Internet Browser open “Upload Photo and Signature Webpage”, Follow Step 4.


Step -4) Upload Passport size Photograph and Signature


NOTE: You must upload photograph and signature to correct specified fields. Do not make any mistake in uploading candidate signature and photograph. Photo/Sign should be in “.jpg “ format.
1. Candidate must have softcopy/digital of passport size photograph “CandidatePhotograph.jpg” provided by photographer as per the “ AIIMS instruction for Photograph” (provided in prospectus).Keep size of photograph minimum as maximum size limit is 100 KB.
2. Put candidate signature in an area of 2” X 1” on paper with a black ball point pen. Scan that paper. Cut Signature area of 2” X 1” and Save it as CandidateSignature.jpg”. Keep size of Signature minimum as maximum size limit is 100 KB.
NOTE: MUST NOT UPLOAD signature in A4 size format/complete paper as this later on result in difficulty in getting their admit cards.
3. To upload “CandidatePhotograph.jpg” Click “Browse” Button right to the photograph field. Select the Scanned “CandidatePhotograph.jpg” file from saved location and click “Open” Button.
4. To upload “CandidateSignature.jpg” Click “Browse” Button right to the signature field. Select the Scanned “CandidateSignature.jpg” file from saved location and click “Open” Button.
5. Preview of Candidate Photo and Signature must be clearly visible to candidate, if photo/signature image is coming small or not visible in preview on website online then it mean photo/signature is not as per the AIIMS prescribe format and your application will be rejected. So, be careful while uploading your photo and signature.
A sample of quality of acceptable and non acceptable photographs/signatures is given below for the guidance of the applicants.
6. After your are satisfied with the photo and signature preview online then only Click “Next” button. Registration Slip page appears.
XYZ
01.12.2011
XYZ
01.12.2011
XYZ
01.12.2011
XYZ
01.12.2011
XYZ
01.12.2011
Applicant must not send Registration Slip and Challan (AIIMS Copy) by POST to AIIMS Examination Section as per the prospectus. But always keep copy of these with yourself safely as an proof of your candidature or in case of any discrepancy.
NOTE:
1) Ensure you have completed all the 4-steps of Help Manual i.e. Step 1 to 4. No claim for registration in respect of incomplete forms will be entertained.
2) After completing four steps process check all fields of Registration Slip must be complete and correct in all respect. If Registration slip is incomplete/incorrect your candidature will be rejected at any stage.
3) Only Candidate with Successful registration get SMS to their Mobile. No SMS will be sent to candidate who have incomplete Forms/Steps(i.e. Step 1 to 4).
4) All candidates must print Admit Cards from our website www.aiimsexams.org from date mentioned in AT A GLANCE of prospectus. No Admit Cards are being sent by POST.
5) Don’t send Registration Slip and Challan (AIIMS Copy) by SPEED POST to AIIMS Examination Section before Last date as per the prospectus. But always keep copy of these with yourself safely as an proof of your candidature.
6) Bring Challan Form-AIIMS COPY along with Admit Card without which you will not be allowed to appear in the Entrance Examination.
7) Always keep following documents with you (helpful to sort out candidate problem in case they do not get their admit cards from website www.aiimsexams.org):
i. Copy of Registration Slip.
ii. Copy of Challan Form (AIIMS and Original Student copy)
Do not miss above mentioned document. If you have lost any document then AIIMS cannot help you in any way.
Very Important Note:
1. All information and provisions in detail are mentioned in the prospectus. So, applicant must read the Prospectus of AIPGMEE Entrance Examination available on website ( i.e. on HomePage of www.aiimsexams.org Website in “Prospectus” Section) before start filling up the form.
2. In case information furnished on online form found to be false at any stage then applicant’s candidature/registration/admission/service will be cancelled/terminated.
3. Some Hints to fill up the fields of form also provided with each field of Online Application Form.
4. Making payment in no way entails you to claim candidature. You must complete the application form as per the instruction in steps 1 to 4 and take print out of Registration Slip before closing date.
5. Please do not wait for Last date to fill application form. To avoid last date hurry you are advised to made payment via challan atleast one week before last date and ready with Photo and Signature softcopy as per the instructions of Help manual and Prospectus.
6. Please note that payment by challan is not refundable in any case i.e incomplete online application or ineligibility as per the prospectus or any other reasons. Therefore payment should be made only after checking the eligibility criteria and completion of application form and proper uploading of photo and signature is mandatory. The candidate must get a Registration Slip and have Challan Form to make claim. It should also be noted that a candidate should complete these requirements within the time-limit fixed in advertisement.
7. Registration Slip (i.e. get after completing all 4 steps) is editable till last date of Online application. So, correction required if any in Online Application form should be done by applicants on or before closing date. Any representation of correction or change thereafter(i.e after closing date of Online form) cannot be entertained in any case.
8. Always keep following documents with you:
a. Copy of Registration Slip.
b. Copy of Challan Form (AIIMS and Original Student copy)
9. Always remember following information provided by you for accessing online Application & result and for future communication with AIIMS:
c. Email-ID (as Username)
d. Password
e. Unique Transaction Number/Journal Number written by Bank on Challan Form while making the payment in bank against Challan form generated online after submission of online application data.
f. Registration Number/Application Form Number generated after submission of application online
g. Date of Birth
How to sort out your problem:
In case of communication with AIIMS Exam Section for sorting your problem on urgent basis Contact AIIMS Exam Section using instructions given below:
1) Email-ID: exams.ac@gmail.com
Always write in subject of email to AIIMS following things
i. “Exam Name with session and year” and
ii. “Challan No./Registration No./Application No.”
For Example: Email Subject: “AIPGMEE MD/MS/Diploma 2012 - 8051000038”
or
“AIPGMEE MDS 2012 - 9051000038”
And in Email message always mention following things:
1. Problem description
2. Entrance Exam Name with session and year
3. Registration/Application Number
4. Candidate Name
5. Email-ID
6. Mobile Number/any other contact number
2) FAX NO.- 011-26588789
While sending FAX always write on each FAX page Following things:
1. Entrance Exam Name with session and year
2. Registration/Application Number
3. Candidate Name
4. Email-ID
5. Mobile Number/any other contact number
3) SPEED POST ADDRESS: “ Assistant Controller of Examination
Examination Section, AIIMS, Ansari Nagar,
New Delhi-110608.”
In Speed Post send following documents should reached before last date
(no late representation will be entertained):
1. Registration Slip
2. Challan Form photo copy
3. Application in favour of Asstt. Controller of Examinations requesting correction signed by applicant alongwith relevant document proof photocopy.
NOTE: Change will be subject to approval by higher authorities.

20111124

Erickon's Psychosocial Stages of Development


1Basic Trust vs. Mistrust0-1HopeDependency or Paranoia
-when the parents present consistent, adequate, and nurturing care, the child develops basic trust and realizes that people are dependable and the world can be a safe place. The child develops a sense of hope and confidence; this is a belief that things will work out well in the end-when the parents fail to provide these things, the child develops basic mistrust, resulting in depression, withdrawal, and maybe even paranoia
2Autonomy vs Shame & Doubt2-3WillObsessive/Impulsive or Avoidant
-if parents guide children gradually and firmly, praise and accept attempts to be independent, autonomy develops. The result will be a sense of will which helps us accomplish and build self-esteem as children and adults-if parents are too permissive, harsh, or demanding, the child can feel defeated, and experience extreme shame and doubt,and grow up to engage in neurotic attempts to regain feelings of control, power, and competency. This may take the form of obsessive behavior; if you follow all rules exactly then you will never be ashamed again. If the child is given no limits or guidance, the child can fail to gain any shame or doubt and be impulsive. Some is good, as it causes us to question the outcomes of our actions, and consider others' well-being. This may also result in Avoidance; if you never allow yourself to be close to others, they can never make you feel ashamed
3Initiative vs Guilt4-5PurposeConstricted or Antisocial/Narcissistic
-the child becomes curious about people and models adults. Erickson believed the child does attempt to possess the opposite sex parent and experience rivalry toward the same sex parent; however, a true Oedipal Complex only develops in very severe cases-if parents are understanding and supportive of a child's efforts to show initiative, the child develops purpose, and sets goals and acts in ways to reach them-if children are punished for attempts to show initiative, they are likely to develop a sense of guilt, which in excess can lead toinhibition. Too much purpose and no guilt can lead to ruthlessness; the person may achieve their goals without caring who they step on in the process
4Industry vs Inferiority6-12CompetencyHelplessness or Shallowness
-occurs during Latency, but Erickson did not think this was a rest period; the child begins school and must tame imagination and impulses, and please others. If adults support the child's efforts, a sense of competence develops-if caretakers do not support the child, feelings of inferiority are likely to develop. Too much inferiority, and inertia or helplessness occurs (underachievers). Too much competency and the child becomes an adult too fast, and develops either into a Histrionic or Shallow person
One way to divide Erikson's stages is into two groups of four -- the first four have to do with figuring out the world, the last four with figuring out yourself
5Identity vs Role Confusion13-19FidelityIdentity Diffusion or Fanaticism
-young adults attempt to develop identity and ideas about strengths, weaknesses, goals, occupations, sexual identity, and gender roles. Teens "try on" different identities, going through an identity crisis, and use their friends to reflect back to them. Marcia offers four resolutions: Identity Achievement (crises and commitment), Moratorium (crises and commitment later), Foreclosure (commitment without crises), and Identity Diffusion (no crises, no commitment)-if they resolve this crisis, they develop fidelity, "the ability to sustain loyalties freely pledged in spite of the inevitable contradictions of value systems" (can be friends with very different people)-if they fail to resolve the crisis, they develop identity diffusion; their sense of self is unstable and threatened; too little identity and they may join cults or hate groups, too much identity and they may show fanaticism
6Intimacy vs Isolation20-24LovePromiscuity or Exclusion
-intimacy is the ability to be close, loving, and vulnerable with romances and friends. It is based in part upon identity development, in that you have to know yourself to share it. The virtue gained here is love. Failure to develop intimacy can lead to promiscuity (getting too close too quick and not sustaining it), or exclusion (rejecting relationships and those who have them)
7Generativity vs Stagnation25-64CareStagnation or Overextension
-if you have a strong sense of creativity, success, and of having "made a mark" you develop generativity, and are concerned with the next generation; the virtue is called care, and represents connection to generations to come, and a love given without expectations of a specific return-adults that do not feel this develop a sense of stagnation, are self-absorbed, feel little connection to others, and generally offer little to society; too much stagnation can lead to rejectivity and a failure to feel any sense of meaning (the unresolved mid-life crises), and too much generativity leads to overextension (someone who has no time for themselves because they are so busy)
8Ego Integrity vs Despair65-?WisdomPresumption or Disdain



-this entails facing the ending of life, and accepting successes and failures, ageing, and loss. People develop ego integrity and accept their lives if they succeed, and develop a sense of wisdom a "detached concern with life itself in the face of death itself"-those who do not feel a sense of despair and dread their death; it's too late to change their lives (Ebenezer Scrooge justmanaged to avoid it) Too much wisdom leads to presumption, too much despair to a disdain for life

Palmer's point

Palmer's point (3 cm below the left costal margin in the mid-clavicular line) is used as an laparoscopic entry method for inserting Veeres needle.

De Lancy levels

DeLancey describes the anatomy of vaginal vault prolapse in terms of 3 levels of support 


  • Level I involves the support of the upper vagina and cervix or the vaginal cuff (in a woman who has undergone total hysterectomy) by the cardinal-uterosacral ligament complex.
  • Level II denotes the lateral support of the mid vagina to the arcus tendineus fascia pelvis (white line).
  • Level III is represented by the fusion of tissue along the base of the urethra and the distal rectovaginal septum to the perineal body.

Colon Cutoff Sign


The colon cutoff sign describes the abrupt termination of gas within the proximal colon at the level of the radiographic splenic flexure, usually with decompression of the distal colon.





Inflammatory exudate in acute pancreatitis that extends into the phrenicocolic ligament by directly spreading through the lateral attachment of the transverse mesocolon gives rise to this sign.

Infiltration of the phrenicocolic ligament results in functional spasm and/or mechanical narrowing of the splenic flexure at the level where the colon returns to the retroperitoneum.

This transition point, or cutoff, is further accentuated by distention of the intraperitoneal transverse colon from the focal adynamic ileus, which is also a result of the underlying inflammatory process. This appearance can mimic a true colonic obstruction.

Ponsetti method

Ignacio V. Ponseti can be credited with developing a comprehensive technique for treating congenital clubfoot in the 1940s. One of the major principles of this technique is the concept that the tissues of a newborn's foot, including tendons, ligaments, joint capsules, and certain bones, will yield to gentle manipulation and casting of the feet at weekly intervals. By applying this technique to clubfeet within the first few weeks of life, most clubfeet can be successfully corrected without the need for major reconstructive surgery.


The Ponseti Technique

The corrective process utilizing the Ponseti technique can be divided into two phases:
  • the treatment phase, during which time the deformity is corrected completely, and
  • the maintenance phase, during which time a brace is utilized to prevent recurrence.
During each of these phases, attention to the details of the technique is essential to minimize the possibility of incomplete correction and recurrences.
  • The Treatment Phase
    The treatment phase should begin as early as possible, optimally within the first week of life. Gentle manipulation and casting is performed on a weekly basis. Each cast holds the foot in the corrected position, allowing it to gradually re-shape. Generally, five to six casts are required to fully correct the alignment of the foot and ankle. At the time of the final cast, the majority of infants (70% or higher) will require a percutaneous surgical procedure (with a small incision through the skin) to gain adequate lengthening of their Achilles tendon.
  • The Maintenance Phase
    The final cast remains in place for three weeks, after which the infant's foot is placed into a removable orthotic device. The orthosis is worn 23 hours per day for three months and then during the night-time for several years. Failure to use the orthosis correctly may result in recurrence of the clubfoot deformity. Good results have been demonstrated at multiple centers, and long-term results indicate that foot function is comparable with that of normal feet.

Ritgen manouvre

Delivery of a child's head by pressure on the perineum while controlling the speed of delivery by pressure with the other hand on the head

20111122

Mastering multiple choice questions- a must read!

More on mastering MCQ'S



 Watch your time.  Before you start writing, assess how much time you have per question.  Don’t spend too much time on any one question.  If you don’t know the answer, simply put an identifying mark in the margin, move on
to other questions, and come back to it later.  The answer will often come to you as you work your way through the test or exam.

 Underline qualifying words like “always,” “never,” etc.  These words are crucial because they can completely change the nature of the question.

 Read the stem thoroughly.  Then think of the answer in your mind.  But be sure to read all of the alternatives because the goal is to pick the best answer, not just one that is true.

 Watch for typos as clues to the best answer.  If one of the alternatives has a typo, it is probably not the key.  Test
writers usually pay a lot of attention to the proper wording and spelling of the key.
 Eliminate wrong answers and see what is left over.  Sometimes it is easier to identify the key if there are fewer alternatives to choose from.  In addition, it can be motivating to remove those options you know are incorrect.

 Beware of true statements that don’t address the stem.  Sometimes a test-writer will include true statements in the alternatives that don’t have anything to do with the question being asked.  This is because they know students will often pick a true statement simply because it looks familiar, even though it isn’t related to the stem at all.

 If two items have similar wording, one of the parallel statements is probably correct.  Students often struggle with those alternatives that look fairly similar. Once you eliminate the dissimilar alternatives, choose the option that gives the most complete information.

 In a question with an “all of the above” choice, if you see at least two true statements, then “all of the above” is the right answer.  This is self-explanatory.

 Be systematic with confusing MCQs with many alternatives, such as “all of the above,” “A, B and D,” etc.  Many students feel overwhelmed by MCQ’s that have many different alternatives to choose from.  Evaluate each alternative carefully.  It is tempting to read quickly but you must resist doing so in order to pick the best answer.

 Review your answers.  Always leave time to check your work.  That way, you’ll catch any careless errors, such as accidentally filling in the wrong bubble on your test sheet.

20111121

The Cycling method


How you “take” the test can affect your marks more than any other factor. To make sure you finish on time, and to reduce your stress, use a "cycle method" to work through your mutliple choice exam.
The cycle method works like this: instead of completing the test in numerical order, or in a “linear” fashion, you work through the entire test numerous times. It’s as simple as can be, but many people resist this approach. Don’t resist. Allow yourself to be flexible.
Use the first pass through to do a quick skim, without answering the questions. Repeat, answering the questions you know right away, and skipping those you don't. Keep working through the multiple choice exam in this fashion - each pass through, you'll notice you get a few more questions that you weren't sure of on the last pass.

Make sure you stick to the Cycle system of taking multiple passes through the material – don’t waste too much time on questions that you can’t answer in short order.
The multi-pass technique does wonders for time management. It allows you to be constantly aware of how much you have to do in the time remaining. Stick to it and you’ll finish on time every time.

Strategies for taking Multiple Choice Exams


a)    Read the question twice.
b)    Answer the question first without looking at the answers.
c)     Look at the answers and see if your answer is one of the four choices. 
d)    If it is among the answers, mark it and move on to the next question; if not, put a star or a check next to it and go on to another question.

Tips for toppers : Guessing intelligently


While no instructor will ever advocate guessing at the correct answer, a guess is sometimes all you are left with.  Just be sure that guessing is a last resort, and that you do it intelligently.

1. Do not guess until you have eliminated all the definitely wrong responses.

2. Do not make the questions more difficult than they are - The issue that jumps out at
you is likely the issue that the correct response addresses.

3. Be wary of answers that include absolutes - There are few things in medicine that are absolute.  Therefore, words like "must," "always," and "never" often (but not always!) indicate an incorrect answer.

4. If two answers are opposites, one is probably correct.

5.Be wary of answer choices from unrelated subjects or unstudied theories.

6. Trust your instincts – once you’ve narrowed your choices down to two options, trust  what your instincts are telling you.  In the background, your mind has processed through the question and your “instinct” is really your subconscious helping you make the correct choice.

20111120

ASN -11- Patho

Q. Aplastic anaemia can progress to all except:

a. AML
b. Myelodysplastic anemia
c. Pure red cell aplasia
d. Paroxysmal Nocturnal Hemoglobinuria

Q. The anticoagulant of choice for performing coagulation studies is:

a. EDTA
b. Heparin
c. Trisodium citrate
d. Double oxalate

20111117

COMEDK PGET-2012 ENTRANCE EXAMINATION

http://www.comedk.org/Notification/Examdatenotification.pdf


COMEDK PGET-2012 ENTRANCE EXAMINATION
COMEDK PGET – 2012 Entrance Examination will be conducted on
Sunday the 12th February 2012 for admission to Postgraduate
Medical and Dental courses in COMEDK Member Institutions. The
Entrance Examination will be conducted in Bangalore City only.
Candidates from all over the country can appear for the Entrance
Examination as in previous years.
Details regarding the Entrance Examination will be notified in due
course. Candidates are required to check the COMEDK website
(www.comedk.org) for regular updates.

Transdermal Rotigotine: A Clinically Innovative Dopamine-Receptor Agonist for the Management of Parkinson's Disease

Rotigotine is a highly lipophilic dopamine-receptor agonist and the first transdermally delivered agent to demonstrate efficacy and safety as monotherapy in early Parkinson's disease and to reduce “off” hours in levodopa-treated patients with advanced Parkinson's disease. The rotigotine pharmacophore is nonergolinic and demonstrates high affinity for dopamine D2 and D3 receptors. With once-daily application, the patch matrix provides continuous, nonfluctuating plasma drug levels at steady state, resulting in continuous and steady plasma and brain levels and striatal dopamine-receptor stimulation.

Read More: http://pharmacotherapyjournal.org/doi/abs/10.1592/phco.29.12.1452?cookieSet=1

Brinzolamide

Brinzolamide is a white powder commercially formulated as a 1% ophthalmic suspension to reduce intraocular pressure (IOP). Pharmacologically, brinzolamide is a highly specific,   
non-competitive, reversible, and effective inhibitor of carbonic anhydrase II (CA-II), able to suppress formation of aqueous humor in the eye and thus to decrease IOP. 


Ref: http://www.ncbi.nlm.nih.gov/pubmed/19668749

NESTROFT


Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT)

NESTROFT is a screening test for the detection of thalassaemia & common haemoglobinopathies



The principle of NESTROFT is based on the limit of hypotonicity which the red cell can withstand. In this procedure 2 ml of 0.36% buffered saline is taken in a test tube, 20ml of whole blood is added to it, and is allowed to stand at room temperature. After 20 minutes reading is taken on a NESTROFT stand on which a thin black line is marked. If the line is visible through the solution, the test is considered as negative and if line is not visible it is considered as positive. Positive test is due to the reduced osmotic fragility of red cells (Fig. 1).
1120.jpg (15828 bytes)
Fig. 1. NESTROFT stand showing positive and negative samples in different tubes. Tubes from L to R: Tubes 1-3 and 6-8 are positive samples where black line is not visible through the solution, Tubes 4-5 and 9-10 negative samples where black line is visible through the solution.

VISION 2020


VISION 2020 is the global initiative for the elimination of avoidable blindness, a joint programme of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with an international membership of NGOs ( ORBIS), professional associations, eye care institutions and corporations.

Group A - ORBIS International

Group A - ORBIS International
Surgeon holding boy with eye patchORBIS is dedicated to the prevention of blindness ... the saving of sight ... the delivery of training ... the transfer of skills... and the creation of a world where quality eye care, education and treatment are available to every human being.

ORBIS Mission Statement

ORBIS is a non-aligned, non-profit global development organization. Our mission is to preserve and restore sight by strengthening the capacity of local partners to prevent and treat blindness.

Type D personality: the heart, stress, and cortisol

Many studies have demonstrated the role of psychosocial and behavioural risk factors in the aetiology and pathogenesis of cardiovascular disorders. Recently, a new personality construct, the type D or ‘distressed’ personality, has been proposed.


 Type D behaviour is characterized by the joint tendency to experience negative emotions and to inhibit these emotions while avoiding social contacts with others. The observation that cardiac patients with type D personality are at increased risk for cardiovascular morbidity and mortality underlines the importance of examining both acute (e.g. major depression) and chronic (e.g. certain personality features) factors in patients at risk for coronary events. Both type D dimensions (negative affectivity and social inhibition) are associated with greater cortisol reactivity to stress. Elevated cortisol may be a mediating factor in the association between type D personality and the increased risk for coronary heart disease and, possibly, other medical disorders.

20111116

LUMINATE trial

A new agent for the treatment of noninfectious uveitis: rationale and design of three LUMINATE (Lux Uveitis Multicenter Investigation of a New Approach to Treatment) trials of steroid-sparing voclosporin .


Uveitis is an inflammatory, putative Th1-mediated autoimmune disease that affects various parts of the eye and is a leading cause of visual loss. Currently available therapies are burdened with toxicities and/or lack definitive evidence of efficacy. Voclosporin, a rationally designed novel calcineurin inhibitor, exhibits a favorable safety profile, a strong correlation between pharmacokinetic and pharmacodynamic response, and a wide therapeutic window. The LUMINATE (Lux Uveitis Multicenter Investigation of a New Approach to TrEatment) clinical development program was initiated in 2007 to assess the safety and efficacy of voclosporin for the treatment, maintenance, and control of all forms of noninfectious uveitis. If LUMINATE is successful, voclosporin will become the first Food and Drug Administration-approved corticosteroid-sparing agent for this condition. 


  ref:        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699819/

HEPATIC HILAR AREA: THE PLATE SYSTEM

 The plate system consists of bile ducts and blood vessels
surrounded by a sheath that is continuous with Glisson’s
capsule, intrahepatically, and the hepatoduodenal
ligament, extrahepatically. This system also contains a
large number of lymphatics, nerves, and a small vascular
network. 
Couinaud  states that the bile ducts and
hepatic artery are located within the plate system, but
that the portal vein is covered with a separate sheath
of loose connective tissue, and that is why the plate
containing the extrahepatic bile duct and hepatic artery
can be easily separated from the portal vein. Three
plates are found in the hilar area: the hilar plate, the
cystic plate, and the umbilical plate

To know in detail, please check this pdf file:
http://www.springerlink.com/content/euykkaghl6c09t3k/fulltext.pdf

EVIDENCE-BASED MEDICINE (AIIMS NOV 2011 Discussion)



The "art of medicine" is defined traditionally as a practice combining medical knowledge (including scientific evidence), intuition, and judgment in the care of patients . EBM updates this construct by placing much greater emphasis on the processes by which clinicians gain knowledge of the most up-to-date and relevant clinical research to determine for themselves whether medical interventions alter the disease course and improve the length or quality of life. The meaning of practicing EBM becomes clearer through an examination of its four key steps:
  1. Formulating the management question to be answered
  2. Searching the literature and online databases for applicable research data
  3. Appraising the evidence gathered with regard to its validity and relevance
  4. Integrating this appraisal with knowledge about the unique aspects of the patient (including the patient's preferences about the possible outcomes)

Step 1 involves generating well-formulated questions that involve four or five components—PICOD: patient or population, intervention, comparator, outcome, and, sometimes, D for study design, (e.g., does routine percutaneous coronary intervention improve survival compared with initial medical management in 60-year-old men with stable angina and known CAD?) Steps 2 and 3 are the heart of EBM as it is currently used in practice and relate to the underlying fundamental principle that the strength of medical evidence supporting a therapy or strategy is hierarchical. The process of searching the world's research literature and appraising the quality and relevance of studies thus identified can be quite time-consuming and requires skills and training that most clinicians do not possess. Thus, the best starting point for most EBM searches is the identification of recent systematic overviews of the problem in question (Table 3-3).

Table 3-3 Selected Tools for Finding the Evidence in Evidence-Based Medicine
NameDescriptionWeb AddressAvailability
Evidence-Based Medicine ReviewsComprehensive electronic database that combines and integrates:
1. The Cochrane Database of Systematic Reviews
2. ACP Journal Club
3. The Database of Abstracts of Reviews of Effectiveness
www.ovid.comSubscription required. Available through medical center libraries and other institutions.
Cochrane LibraryCollection of EBM databases, including The Cochrane Database of Systematic Reviews—full text articles reviewing specific health care topics.www.cochrane.orgSubscription required. Abstracts of systematic reviews available free online. Some countries have funding to provide free access to all residents.
ACP Journal ClubCollection of summaries of original studies and systematic reviews. Published bimonthly. All data since 1991 available on Web site, updated yearly.www.acpjc.orgSubscription required.
Clinical EvidenceMonthly updated directory of concise overviews of common clinical interventions.www.clinicalevidence.comSubscription required. Free access for United Kingdom and developing countries.
MEDLINENational Library of Medicine database with citations back to 1966.www.nlm.nih.govFree via Internet.


Generally, the EBM tools listed in Table 3-3 provide access to research information in one of two forms. The first, primary research reports, is the original peer-reviewed research work that is published in medical journals. Initial access to this information in an EBM search may be gained through MEDLINE, which provides access to a huge amount of data in abstract form. However, in using MEDLINE it is often difficult to locate reports that are on point in a sea of irrelevant or unhelpful information and be reasonably certain that important reports have not been overlooked. The second form, systematic reviews, comprehensively summarizes the available evidence on a particular topic up to a certain date and provides the interpretation of the reviewer and thus is the highest level of evidence in the hierarchy. Explicit criteria are used to find all the relevant scientific research and grade its quality. The prototype for this kind of resource is the Cochrane Database of Systematic Reviews. One of the key components of a systematic review is a meta-analysis. The next two sections will review some of the major types of clinical research reports available in the literature and the process of aggregating those data into meta-analyses.

SOURCES OF EVIDENCE: CLINICAL TRIALS AND REGISTRIES

The notion of learning from observation of patients is as old as medicine itself. Over the last 50 years, physicians' understanding of how best to turn raw observation into useful evidence has evolved considerably. Case reports, personal anecdotal experience, and small single-center case series are now recognized as having severe limitations in validity and generalizability, and although they may generate hypotheses or be the first reports of adverse events, they have no role in formulating modern standards of practice. The major tools used to develop reliable evidence consist of the randomized clinical trial and the large observational registry. A registry or database typically is focused on a disease or syndrome (e.g., cancer, CAD, heart failure), a clinical procedure (e.g., bone marrow transplantation, coronary revascularization), or an administrative process (e.g., claims data used for billing and reimbursement).

By definition, in observational data, the care of the patient is not controlled by the investigator. Carefully collectedprospective observational data can achieve a level of quality approaching that of major clinical trial data. At the other end of the spectrum, data collected retrospectively (e.g., chart review) are limited in form and content to what previous observers thought was important to record, which may not serve the research question under study particularly well. Data not specifically collected for research (e.g., claims data) often have important limitations that cannot be overcome in the analysis phase of the research. Advantages of observational data include the ability to capture a broader population than is typically represented in clinical trials because of inclusion and exclusion criteria. In addition, observational data are the primary source of evidence for questions for which a randomized trial cannot or will not be performed. For example, it may be difficult or unethical to randomize patients to test diagnostic or therapeutic strategies that are unproven but widely accepted in practice. In addition, patients cannot be randomized to a sex, racial/ethnic group, socioeconomic status, or country of residence. Physicians are also not willing to randomize patients to a potentially harmful intervention, such as smoking or overeating to develop obesity.

The major difference between a well-done randomized clinical trial and a well-done prospective observational study of a particular management strategy is the lack of protection from treatment selection bias in the latter. The use of observational data to compare diagnostic or therapeutic strategies assumes that there is sufficient uncertainty in practice to ensure that similar patients will be managed differently by different physicians. In short, the analysis assumes that there is an element of randomness (in the sense of disorder rather than in the formal statistical sense) to clinical management. In such cases, statistical models attempt to adjust for important imbalances and "level the playing field" so that a fair comparison among treatment options can be made. When management is clearly not random (e.g., all eligible left main coronary artery disease patients are referred for coronary bypass surgery), the problem may be too confounded (biased) for statistical correction, and observational data may not provide reliable evidence.

In general, the use of concurrent controls is vastly preferable to that of historical controls. For example, comparison of current surgical management of left main CAD with left main CAD patients treated medically during the 1970s (the last time these patients were routinely treated with medicine alone) would be extremely misleading since the quality of "medical therapy" has made substantial improvements in the interval.

Randomized controlled clinical trials include the careful prospective design features of the best observational data studies but also include the use of random allocation of treatment. This design provides the best protection against confounding due to treatment selection bias (a major aspect of internal validity). However, the randomized trial may not have good external validity (generalizability) if the process of recruitment into the trial resulted in the exclusion of many potentially eligible subjects.

Consumers of medical evidence need to be aware that randomized trials vary widely in their quality and applicability to practice. The process of designing such a trial often involves a great many compromises. For example, trials designed to gain U.S. Food and Drug Administration (FDA) approval for an investigational drug or device have to address certain regulatory requirements that may result in a trial design different from what practicing clinicians would find useful.

META-ANALYSIS

The Greek prefix meta signifies something at a later or higher stage of development. Meta-analysis is research done on research data for the purpose of combining and summarizing the available evidence quantitatively. Although it can be used to combine nonrandomized studies, meta-analysis is used most typically to summarize all the randomized trials on a particular therapeutic problem. Ideally, unpublished trials should be identified and included to avoid publication bias (i.e., "negative" trials may not be published). Furthermore, some of the best meta-analyses obtain and analyze the raw individual patient-level data from all trials rather than working only with what is available in the published reports of each trial. Not all published meta-analyses are reliable sources of evidence on a particular problem. Their methodology must be scrutinized carefully to ensure proper study design and analysis. The results of a well-done meta-analysis are likely to be most persuasive if they include at least several large-scale, properly performed randomized trials. Although meta-analysis can help detect benefits when individual trials are inadequately powered (e.g., the benefits of streptokinase thrombolytic therapy in acute MI demonstrated by ISIS-2 in 1988 were evident by the early 1970s through meta-analysis), in cases in which the available trials are small or poorly done, meta-analysis should not be viewed as a remedy for the deficiency in primary trial data.

Meta-analyses typically focus on summary measures of relative treatment benefit, such as odds ratios or relative risks. Clinicians also should examine what absolute risk reduction (ARR) can be expected from the therapy. A useful summary metric of absolute treatment benefit is the number needed to treat (NNT) to prevent one adverse outcome event (e.g., death, stroke). NNT is simply 1/ARR

For example, if a hypothetical therapy reduced mortality rates over a 5-year follow-up by 33% (the relative treatment benefit) from 12% (control arm) to 8% (treatment arm), the absolute risk reduction would be 12% – 8% = 4% and the NNT would be 1/.04, or 25. Thus, it would be necessary to treat 25 patients for 5 years to prevent 1 death. If the hypothetical treatment was applied to a lower-risk population, say, with a 6% 5-year mortality, the 33% relative treatment benefit would reduce absolute mortality by 2% (from 6 to 4%), and the NNT for the same therapy in this lower-risk group of patients would be 50. Although not always made explicit, comparisons of NNT estimates from different studies should account for the duration of follow-up used to create each estimate