The risks of malpractice litigation are proving to be harmful to the US health system; the number of practitioners practicing defensive medicine is increasing. “Defensive medicine” is a practice where a doctor suggests clinical investigations or remedies that do not have to be the best choice for the patient. The main role…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Errors and P-value
Statistical hypotheses Null hypothesis (H0): No difference or relation exists; e.g. Treatment A is not better than Treatment B Alternative or research hypothesis (H1): Some difference or relation exists, e.g. Treatment A is better than Treatment B Statistical errors Type I error (alpha): False positive (Falsely rejecting Null-hypothesis; i.e. null…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Baye’s theorem derived PPV and NPV
Let’s unveil the mathematics behind the relation between: Prevalence (Pre-test probability) Predictive value (Post-test probability) Sensitivity Specificity SYMBOLS: Total screened population = nPrevalence = PSensitivity = SnSpecificity = SpTrue positive = TPTrue negative = TNFalse positive = FPFalse negative = FNWith disease = D+Without disease = D-Positive predictive value =…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Screening tests in Series and Parallel
A. Parallel testing 2 screening tests are applied simultaneously: So, this test will have: B. Series testing After the 1st screening test is conducted, those who test positive are only tested with the 2nd screening test: So, this test will have: Formulae for combined specificity and sensitivity A. Parallel testing:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Sustainable Development Goal 3 – Points to Remember
Total SDG goals: 17 Time frame: 2016-2030 Goal 3: Good health and well beings for all ages Important targets of Goal 3 (Targeted by 2030) A. Maternal and Child health (MCH) Mnemonic: 12 letters in “NEONATE DEATH or NEWBORN DEATH“. 1. NMR reduction target: 122. U5MR reduction target: 12 X…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Key Health Indicators of Nepal to Remember (NDHS, 2022)
These rates, ratios and proportions are often questioned in PGMEE, pediatrics, obstetrics and preventive and social medicine (PSM) or community medicine examinations. NDHS = National Demographic and Health Survey a. Neonatal mortality rate (NMR): 21 per 1000 live births (i.e. 3/4 of infant deaths) b. Infant mortality rate (IMR): 28…
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United Nation’s Peacekeeping Mission – A Doctor’s Story
In a very short notice to be prepared, we left home for the residential pre-deployment training on January, 2018. In the freezing cold of the winter, we started our day in the early morning with P.T (Physical Training). We attended various sessions, which made us familiar on the topics of…
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Pediatric OPD is a Challenge : Treating the Child and Meeting Parents expectations
Scenario A concerned mother brings her 3 year child to the Outpatient Clinic; the child has had fever for 1 day, running nose and cough for 2 days. There are no other serious complaints and findings on examination are all normal, except for the running nose and a low grade…