Ficat and Arlet first classified avascular necrosis of femoral head (AVN) in 1964 before the advent of MRI which was later modified and published in 1985 to include pre-radiographic stages relying on invasive testing procedures. The classification system later underwent further modifications that include MRI findings, patient symptoms and modifies…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Development of Pituitary Gland
The pituitary gland (hypophysis cerebri) is derived from 2 sources. The anterior lobe is an upgrowth of ectoderm from the roof of the stomodeum (primitive buccal cavity), while the posterior lobe is a down growth of neuroectoderm from the diencephalon. 4th week: a diverticulum, Rathke’s pouch, grows upwards from the roof of the stomodeum towards the…
Clinical Skills and Approaches 
Bulbocavernosus Reflex (BCR)
Synonyms: Bulbospongiosus reflex (BSR), Osinski reflex Reflex arc: a. Stimulus: Briskly squeezing glans penis or clitoris or Tugging Foley’s catheter (pulling the balloon of foley’s catheter against the bladder neck) b. Afferent: Sensory fibers of pudendal nerve c. Reflex center: S2-S4 spinal segments (Polysynaptic) d. Efferent: Motor fibers of pudendal…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Micturition reflex
Micturition (Urination) is the ejection of urine from the urinary bladder through the urethra to the outside of the body. It is a type of reflex with voluntary control. The micturition cycle occurs in 2 phases: Urinary Storage Mnemonic: Storage = Sympathetic 1. Stimulus: Urine filling until tension in the…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Synovial Fluid Analysis – Made Easy
What investigations to order for synovial fluid sample? Mnemonic: 5 Cs Chemistry (pH, LDH, glucose, protein) Cell counts Cytology Culture Crystals Interpretation of synovial fluid analysis Gross Normal Non-inflammatory Inflammatory Septic Crystal Hemorrhagic Volume (ml) <3.5 >3.5 >3.5 >3.5 >3.5 >3.5 Viscosity High High Low Variable Variable Variable Color Colorless…
Case Reports 
Partial Exchange transfusion for Neonate with Polycythemia
A Late preterm, 36 weeks by gestation and small for gestation age was delivered via Cesarean section for Oligohydramnios. At birth the Apgar was 9/10, 9/10 and the baby was shifted to mother side and planned for Sugar monitoring. Hemoglobin and Packed cell volume was sent at 2 hours.Baby was…
Clinical Skills and Approaches 
Sectoral Sign : AVN hip
The rotation of the hip must be assessed both with the hip in flexion and extension as well. In general, the range of motion for rotations are 5 to 10 degrees more in flexion compared to that in extension of hip. If the range of motion for rotation varies between…
Clinical Skills and Approaches 
History Taking : A Basic Clinical Skill
As a Doc. whenever you treat a patient, the success of treatment depends upon whether you come up with the right diagnosis or at least a right set of differential diagnoses. To achieve the above mention goal the KEY is EFFECTIVE COMMUNICATION. And I can talk to you for an…