Pattern of bone loss in Osteoporosis Trabecular bone responds faster to metabolic changes due to greater surface are compared to cortical bone. Non-weight bearing (secondary trabeculae) are lost first. Weight bearing (primary trabeculae) may appear prominent due to loss of other trabeculae and may also become thickened due to compensatory…
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics
He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music.
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Achondroplasia Mnemonic
A: Autosomal dominant C: “Champange glass” pelvis in X-rays H: Hypotonia O: Ossification affected (Enchondral > Appositional) N: Nasal bridge small D: Disproportionate Dwarfism R: Rhizomelic (proximal i.e. humerus and femur shortening) O: Out knees (varus deformity) P: Proliferative zone quantitative defect L: Little phalanx (brachydactyly) and metacarpals with Leister…
Clinical Skills and Approaches 
Approach to Thoracic and Lumbar Spine X-ray
Views Standard: Supine AP and Latero-lateral (LL) views – thoracic or lumbar Thoracic: Lateral (Fulcrum) bending views: to determine the flexibility of curves in scoliosis Lumbar: De Seze view (Lumbopelvic view): Standing AP and LL – shows T11 to head of femur Dynamic lateral (flexion-extension) views: for instability Oblique views…
Clinical Skills and Approaches 
Thoracolumbar Metastases Management : Mnemonic Approach
The primary malignancies that commonly metastasize to the spine can be recalled using the mnemonic: PB KTL (or “Lead Kettle”. Prostate Breast Kidney Thyroid Lungs In women, 80% metastases are from lung and breast and in men, 80% are from lung and prostate. LMNOP approach A. Location/Level 80% involve well-vascularized…
Blog 
Is Fever a contraindication for Blood transfusion?
In medical schools, we learn many things without knowing the actual reason behind it. One of them is the pre-transfusion fever in a patient being planned for blood transfusion which is considered as a contraindication for it in many departments and health centers. So, the questions that came into my…
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L-PRF for Chronic Wounds
L-PRF (Leukocyte-platelet rich fibrin) is a second generation platelet reach concentrate where autologous platelets and leukocytes are present in a 3D fibrin mesh which is used as a scaffold by surrounding host cells and which slowly releases growth factors and glycoproteins (≥ 7 days). It is processed without the anticoagulant,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pharmacology of Carbapenems : Mnemonics
Commonly used Carbapenems Mnemonic: MEDIC Meropenem Ertapenem Doripenem Imipenem/Cilastatin (renal dehydropeptidase I inhibitor) Besides these, there are other drugs like tebipenem (1st oral carbapenem), panipenem, tomopenem (has MRSA activity), etc. which fall under carbapenems. Coverage As the name suggests, they have carbapenems attached to beta-lactam ring which provides protection against…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Chronic Wounds : Mnemonic Approach
Chronic wounds are wounds that have failed to proceed through an orderly and timely reparative process to produce anatomic and functional integrity over a period of 3 months. Factors that Adversely Affect Wound Healing Mnemonic: DIDN’T HEAL Diabetes (Diminished sensation, peripheral perfusion and impaired polymorphonuclear phagocytosis) Infection Drugs (Steroids and…