Paraplegia in extension and paraplegia in flexion occur only after the spinal shock has ceased. Paraplegia in extension indicates an increase in the extensor muscle tone owing to the overactivity of gamma efferent nerve fibers to muscle spindles as the result of the release of these neurons from the higher…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Renal Tubular Acidosis (RTA) : Mnemonics
Renal Tubular Acidosis (RTA) cause non-anion gap metabolic acidosis. Type 1: H+ excretion defect (A proton or 1st element of periodic table) This occurs in distal tubule (hence, distal defect) K+ is excreted instead of H+ causing Hypokalemia. Distal tubule H+ is non-functioning – urine pH >5.5. Chronic acidosis leads…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Hyperkalemia Management – Mnemonic Approach
Mnemonic: C BIG K D Calcium gluconate (Cardiac stabilizer) It is generally accepted that calcium should be given when there are ECG changes associated with hyperkalaemia. Calcium gluconate 10% 10-30 ml IV (1-3 gm) over 5-10 minutes (Can be repeated after 5 minutes if ECG changes persistent) 0.5 ml/kg in…
Clinical Skills and Approaches 
Diabetes Made Easy : Epomedicine Series
Approach to Uncomplicated Diabetes Mellitus : Simplified Management of Diabetes – GLUCOSE BAD mnemonic DKA : Mnemonic Approach and Clinical Aspects GIK Regimen – Rule of Ten Simplified Guide to Statin Therapy Diabetic Ketosis without Acidosis Diabetic Foot Management
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ESR and CRP in Musculoskeletal infection
ESR (Erythrocyte Sedimentation Rate) Usually elevated within 48-72 hours of the infection onset (less reliable in the first 48 hours of infection) Continues to rise for 3-5 days after institution of successful therapy and continuing rise beyond 4th-5th day of treatment can be an indication of treatment failure (not good…
Clinical Skills and Approaches 
Common mistakes in Per Abdominal examination
1. Forgetting to Expose abdomen adequately: Before examination, patient should ideally be exposed from the nipples to mid thigh. Failure to do so may lead to missed findings during examination e.g. Hernia 2. Abdominal symmetry and movement: Abdominal symmetry and movement should be examined tangentially and from leg end. Comment…
Blog 
Jaundice in Newborn Baby : Parent’s guide
Before starting with the topic, here is a recommended reading for the medical professionals. Yellowish discoloration of skin and sclera – ” Jaundice” is a commonly encountered problem for the parents of newborn babies. Jaundice is caused by the increase in level of bilirubin in blood (serum). Many parents notice yellowness…
Clinical Skills and Approaches 
CNS examination long case: How to prepare
Central nervous system (CNS) examination is the most difficult thing to complete within a time limit during final exam and the dilemma is that, most of time the CNS is what is kept as a long case. Examiners love judging you on the basis of CNS case because: 1. CNS…