Chronic paronychia is an inflammatory recalcitrant disorder affecting the nail folds. It can be defined as an inflammation lasting for more than 6 weeks and involving one or more of the three nail folds (one proximal and two lateral). Surgical management is only indicated in cases of chronic paronychia, which…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Meniscal Tears on MRI
Meniscal tears are best seen on T1-weighted, gradient-echo and proton-density images. The menisci are low intensity on all sequences. Morphologies Meniscal tear morphology Description MRI appearance Horizontal Separates meniscus into superior (femoral) & inferior (tibial) fragments Primarily horizontal signal on sagittal images Vertical radial Splits central margin of meniscus Vertical…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Antibiofilm Antibiotics
Biofilms are immobile microbial communities which colonize and grow on surfaces of medical implants such as sutures, catheters and implants, by self-produced extracellular polymeric substances and cause infections which can only be treated by their removal. It provides additional resistance to the bacteria by various mechanisms like altered pH, osmolarity,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Rifampicin : Mnemonic
Synonym: Rifampin Mnemonic: RIFAMPIN R: RNA polymerase inhibition I: Induces CYP450 F: Flu-like symptoms, Fluid (sweat, urine, tears, saliva) discoloration A: AST/ALT elevation (Hepatotoxicity is a possible complication) M: Mycobacteria (M. Tuberculosis, M. Leprae, MAI treatment) and Meningitis (N. Meningitidis prophylaxis for close contacts) P: Penetrates granuloma, biofilm and blood-brain-barrier,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heel Pad Syndrome vs Plantar Fasciitis
Heel pad syndrome and plantar fasciitis both cause heel pain, but they affect different areas and have distinct characteristics. Further reading and differential diagnoses of heel pain: Heel Pain : Mnemonic Plantar Fasciitis Heel Pad Syndrome Definition Inflammation of the calcaneal origin of plantar fascia Traumatic irritation of the specialized…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Basilar Thumb or 1st CMCJ Osteoarthritis
Tips to remember this classification include: Eaton Stage Joint Subluxation Osteophyte Surgery I 1st CMCJ widened <1/3 No Volar Ligament Reconstruction II 1st CMCJ narrowed <1/3 <2 mm 1. Ligament reconstruction with tendon interposition (LRTI) 2. Single interposition 3. Suspensionplasty 4. Metacarpal osteotomy III 1st CMCJ severely narrowed ≥1/3 >2…
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Medical Education and Job Crisis in Nepal
Nepal’s medical sector is beset with serious issues. Oversupply of medical graduates, declining job satisfaction among doctors, the ongoing woes of resident doctors, and disagreements between private medical colleges and the Medical Education Commission (MEC) have rendered the situation complex and pressing. Oversaturation of Medical Graduates and Poor Employment Opportunities…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Scapular Dyskinesis
Definition: Abnormal scapular motion which may refer to – Causes: 1. Primary: Due to abnormalities arising in Scapulo-thoracic articulation, periscapular muscles and nerves 2. Secondary: Response to shoulder abnormalities Types: It is categorized into three main types based on the prominence of specific areas of the scapula during movement. Clinical…