Site Point of insertion Direction Indications Olecranon (K-wire) 1.25 inches (3 cm) distal to olecranon tip – deep to subcutaneous border of upper ulna (avoids ulnar joint and open epiphysis) Medial to Lateral – At right angles to longitudinal axis of ulna (Avoids ulnar nerve) Supracondylar or Distal humerus fractures…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heart Sounds – Murmurs
Murmur is a low, indistinct sound. In terms of medicine, it is the sound produced due to turbulent flow within the heart and great vessels. They are described and named in relation to the normal heart sounds, location, and quality. Please go through these articles before reading further: Heart Sounds…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Appendix, Appendicitis and Appendicectomy
Inflammation of the Appendix is one of the most common causes of Pain Abdomen presenting in the Emergency Room. Since its first description in the texts, there has been a lot of improvement in the quality of management due to the availability of resources and technology. Appendix, in the initial…
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Quality in Living, Dignity in Dying
Most of us, we fear death like the children fear ghosts and seek for utopia forgetting that death is as natural as birth. In an essay “Of Death”, David Bacon writes, “Cogita quamdiu eadem feceris; mori velle, non tantum fortis aut miser, sed etiam fastidiosus potest” which translates as –…
Clinical Skills and Approaches 
FARES method of Shoulder Reduction
Indication: Anterior shoulder dislocation Position of patient: Supine Position of physician: Standing on the side of the dislocated shoulder Steps: Physician holds the wrist of the patient with both the arms keeping elbow of the patient extended and forearm in neutral position Arm is slowly abducted in brief oscillating movement…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Shoulder Muscles Anatomy – Simplified
Proximal humerus Insertion of Rotato Cuffs Mnemonic: SIT-S a. Greater tubercle: Supraspinatus, Infraspinatus, Teres minor b. Lesser tubercle: Subscapularis Attachment of Other muscles Anteriorly and posteriorly the muscles attach on each side of the depressions (groove and sulcus). a. Anteriorly: Insertion of 3 muscles Mnemonic: Lady between 2 Majors Crest…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Appearance and Fusion of Ossification Centers
Upper end of humerus Mnemonic: HGL – 1,3,5 a. Head – by 1 year b. Greater tuberosity – by 3 years c. Lesser tuberosity – by 5 years All 3 centers fuse together by 6 years (1 year after the last center appears) Upper end of femur Mnemonic: HGL –…
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Transportation Safety: Occupational injuries in Shipping Industry
Shipping1 is perhaps the most international of the world’s industries, serving more than 90 per cent of global trade by carrying huge quantities of cargo cost effectively, cleanly and safely. The maritime industry, as it is called, fulfils a critical role in the world economy as the primary carrier of…