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Sunday, June 26, 2011

BIOSTATISTICS ( Community medicine) OSPE

OSPE

STATION 1:


Calculate the median for each of these set of data.
a) 7, 7, 2, 3, 4, 2, 7, 9, 31 (2)
b) 36, 41, 27, 32, 29, 38, 39, 43 (2)



STATION 2:


Weights of 20 students of class eight were recorded and the data was presented as follows:

S.no Weights (kg)
1 30
2 35
3 35
4 36
5 38
6 40
7 40
8 40
9 42
10 43
11 44
12 48
13 50
14 51
15 51
16 51
17 52
18 55
19 58
20 60


TASK:

a) Group the given data into class intervals of 5. (2)
b) Calculate the relative frequency of class three. (2)

STATION 3:


Suppose we obtain a random sample of 100 individuals. The mean systolic blood pressure is 135mmHg and standard deviation is 5mmHg.


TASK:
a) What possible range of mean systolic blood pressure could we expect within 95% confidence limits? (4)
STATION 4:
The sales (in liters) of mineral water from four super stores A, B, C and D were noted for the first week of June and data was presented as follows:

Super stores A B C D
Proportion of Sales 32.14 50 10.7 7.1
TASK:
From the given data calculate the degrees required to construct pie chart. (4)


STATION 5:

A B



A B C D E F

TASK:
a) Identify the curves A & B. (1)
b) Label the points A, B, C, D, E & F. (3)

BIOSTATISTICS MCQs with Key - (Community Medicine)

BIOSTATISTICS MCQs with Key

1. A study was conducted in America to find out the proportion of blacks and white Americans in California. This variable chosen is:
a. Nominal
b. Ordinal
c. Continuous
d. Discreet numerical
e. Dichotomous

Key: True: e

2. The median of the following data, is: 1,2,4,6,8,10,11,13
a. 6
b. 8
c. 7
d. 10
e. 9

Key: True: c

3. A household survey of 10 families was conducted by students of 4th year MBBS. In the collected data, the ages of heads of families were: 32, 34, 35, 36, 36, 42, 44, 46, 48, and 52. The mean age of heads of families is
a. 36
b. 38.5
c. 40
d. 40.5
e. 42

Key: True: d

4. A nutritional research team followed serum levels of vitamin B12 in 120 children for three years to determine the association between cyanocobalamin deficiency and the subsequent risk of developing Megaloblastic anemia. The results were as follows:
VITAMIN B12 LEVELS
Mean 260 pg/mL
Median 226 pg/mL
Mode 194 pg/mL
From the data, it can be concluded that this distribution is:
a. Normal
b. Negatively
c. Positively skewed
d. Bimodal
e. Multimodal

Key: True: c

5. Serum cholesterol levels for two groups of Americans were recorded in 1989. The mean cholesterol levels of the two groups were compared. To determine whether the measurements were significantly different or not, the most appropriate statistical test would be:
a. Chi-square test
b. Correlation analysis
c. F test (ANOVA)
d. Student’s t test
e. Regression analysis

Key: True: d

6. In a descriptive study the mean is 220 and the standard error is 10, the 95 confidence limits would be:
a. 210 to 230
b. 215 to 225
c. 200 to 240
d. 220 to 230
e. 205 to 235

Key: True: c

7. For a survey, a village is divided into 5 lanes, each lane is sampled randomly. It is an example of:
a. Simple random sampling
b. Standard random sampling
c. Systematic random sampling
d. Cluster random sampling
e. Quasi random sampling

Key: True: d

8. The birth weights in a hospital are to be presented in a graph. This is best done by a:
a. Bar diagram
b. Pie chart
c. Histogram
d. Pictogram
e. Frequency chart

Key: True: c

9. An analysis of the race of patients who visit an emergency room reveals that 40% are white, 25% are black, 20% are Native American, and 15% are Asian. These data would best be depicted graphically with a
a. Venn diagram
b. Cumulative frequency graph
c. Normal curve
d. Histogram
e. Pie chart

Key: True: e

10. If six families were surveyed and the numbers of children per family were found to be 2, 3, 4, 4, 5, 6, fine the mean number of children per family
a. 2
b. 3.5
c. 4
d. 6
e. 4.5

Key: True: c

11. If, in one of the groups of premature infants, the maximum value for hexosaminidase A was substituted with a much higher value. The value which is unlikely to be affected by this higher value is:
aVariance
a. Range
a. Standard deviation
b. Median
c. Mean

Key: True: d

12. A nutritional research team followed serum levels of vitamin B12 and folic acid in
125 children for five years to determine the association between cyanocobalamin
deficiency and the subsequent risk of developing megaloblastic anemia. The results were as follows:

VITAMIN B12 LEVELS
Mean 262 pg/mL
Median 228 pg/mL
Mode 196 pg/mL
From the data, it can be concluded that this distribution is
a. Normal
b. Positively skewed
c. Negatively skewed
d. Skewed toward the left
e. Unable to be identified

Key: True: b

14. In study carried out in the hospital ward, every 10th admitted patient was included in the sample, which sampling procedure is this:
a. Random sampling
b. Stratified sampling
c. Quota sampling
d. Convenient sampling
e. Systematic sampling

Key: True: e

15. Three groups of subjects were followed over the course of five years to compare
treatments for sideroblastic anemia. The most appropriate statistical analysis to determine the quantitative serologic differences resulting from these treatments would be a(n)
a. Regression analysis
b. F test (ANOVA)
c. Correlation analysis
d. Chi-square test
e. T test

Key: True: b

16. In a class of 134 medical students, the mean systolic blood pressure was found to be 126 mm Hg with a standard deviation of 6 mm Hg If the blood pressures in this sample are normally distributed, what portion of the medical students will have systolic blood pressures above 132 mm Hg?
a. 0.5%
b. 2.5%
c. 5%
d. 16%
e. 32%

Key: True: d

18. In a household survey conducted on ten families the frequency of family members in different age groups was less than 5 years  21, 5 – 14 years  16, 15 – 64 years  77 &> 65 years  1. The relative frequency of members in 15 – 64 years age group would be:
a. 60.5%
b. 67.5%
c. 70.5%
d. 76.5%
e. 80.5%

Key: True: b

19. Malaria cases were reported throughout the world during the year 1971 – 1978 excluding African region. These cases can be best represented by:
a. Frequency polygon
b. Histogram
c. Line diagram
d. Pictogram
e. Scatter diagram

Key: True: c

20. There are 50 individual in population and they have same hemoglobin level that is 14g/dL. As there is no variability, the standard deviation will be:
a. 0
b. 1, -1
c. 0, 1
d. +2
e. -2

Key: True: a

21. A mean hemoglobin level of 100 women in a population sample is 12g/dL with standard deviation of 2. The confidence interval for the population mean would be:
a. 10.4 – 11.6
b. 11.6 – 12.4
c. 12.4 – 13.6
d. 13.6 – 14.4
e. 14.4 – 15.6

Key: True: b

22. The students of4th year MBBS class visited a school. The numbers of students per class from class I to class IX were as follows:
27, 23, 15, 18, 30, 24, 8, 12 and 16. The median number in this series is:
a. 12
b. 15
c. 16
d. 18
e. 23

Key: True: d

23. In a village of 300 population, 60% constitute Hindus, 20% Muslims, 10% Sikhs and 10% Christians. We want to take a sample of 10% of the population to study the eating habits of this population. The best method would be:
a. Simple random sampling
b. Stratified random sampling
c. Systematic random sampling
d. Non-random sampling
e. Cluster sampling

Key: True: b

24. The median of a series of 20 observations is 10, mean is 11.5 and mode is 11, which of the following measures can be subjected to statistical manipulation:
a. Sample size
b. Mean
c. Median
d. Mode
e. Range

Key: True: b

25. Which of the following can have more than one value?
a. The mean
b. The range
c. The mode
d. The median
e. Standard deviation.

Key: True: c

26. The distribution of heights of the girls was plotted. The most frequent value was 5’ – 2”, which gives a single most important clue to its:
a. Negative skewness
b. Positive skewness
c. Normal distribution
d. Large standard deviation
e. Multi modal distribution

Key: True: c

27. A large study of bladder cancer and cigarette smoking produced the following data:
INCIDENCE OF BLADDER CANCER (per 100,000 males per year)
Cigarette smokers 48.0
Non-smokers 25.4

The relative risk of developing bladder cancers compared with non-smokers is:
a. Categorical variable
b. Ordinal data
c. Numerical, continuous variable
d. Numerical, discrete variable
e. Proportion

Key: True: c

28. Birth rates of a population of infants at 40 weeks gestational age are approximately normally distributed, with a mean of 3000 grams. Roughly 68% of such infants weigh between 2500 and 3500 at birth. If a sample of 100 infants was studied, the standard error would be
a. 50
b. 100
c. 200
d. 250
e. 500

Key: True: a

29. When the standard for accepting the difference was at P-value of 0.05 and the calculated value was 0.01, the null hypothesis was rejected by the researcher. What do you think of results?
a. Wrongly rejected
b. Significant difference
c. No difference
d. Alternate hypothesis is wrong
e. Sample size was small

Key: True: b

30. A study was conducted to assess the heights of 30 students . By chance all of the students were found to be of the same height. The standard deviation of this study sample is:
a. Zero
b. 0 −− -1
c. 0 −− +1
d. 0 −− +2
e. 0 −− -2

Key: True: a

31. In the Medical OPD of teaching hospital. diastolic blood pressures of 10 patients were as follows:
80, 75, 81, 79, 71, 95, 75, 77, 84, & 90. The mean of this data is:
a. 80
b. 81
c. 82
d. 83
e. 84

Key: True: b

32. A normal distribution curve is based mainly on:
a. Mean and sample size
b. Mean and standard deviation
c. Range and sample size
d. Range and standard deviation
e. Mean and range

Key: True: b

146. The relative frequency of a class is obtained by:
a. Dividing the frequency of that class by the sum of all frequencies
b. Multiplying the frequency of that class by 100
c. Dividing the frequency of that class by 100
d. Dividing the sum of frequencies by 100
e. Dividing the frequency of that class by the sum of all frequencies and multiplied by 100

Key: True: e

33. A study was conducted to assess the height of students of 4th year in 10 Medical colleges the values of heights ranged between 5.5 – 5.10 feet. A histogram has been selected by the researcher to present these results as it is a:
a. Nominal data
b. Categorical data
c. Both qualitative and quantitative data
d. Continuous data
e. Discrete numerical data

Key: True: d

34. A study was conducted to assess the height of students of 4th year in 10 Medical colleges. The values of heights ranged between 5.5 – 5.10 feet. Which graph should be used by the researcher to present the obtained data?
a. Bar chart
b. Histogram
c. Pie chart
d. Scatter diagram
e. Line graph

Key: True: b

35. The median of the following data, is: 1,2,4,6,8,10,11,13
a. 6
b. 8
c. 7
d. 10
e. 9

Key: True: c

36. A large study of bladder cancer and cigarette smoking produced the following data:

INCIDENCE OF BLADDER CANCER (per 100,000 males per year)
Cigarette smokers 48.0
Non-smokers 25.4

The relative risk of developing bladder cancers compared with non-smokers is:
a. Categorical variable
b. Ordinal data
c. Numerical, continuous variable
d. Numerical, discrete variable
e. None of the above

Key: True: c

37. Formula for chi square value is:
a. O- E
E
b. O – E
E2
c. (O – E)2
N
d. Σ(O – E)2
E
e. (O – E)2
E

Key:
38. The median of the following data, is:
1, 2, 4, 6, 8, 10, 11, 13
a. 6
b. 8
c. 7
d. 10
e. 5

Key: True: c

39. After arranging the data is ascending or descending order of magnitude, the value of middle observation:
a. Mean
b. Mode
c. Median
d. Geometric mean
e. Mean deviation

Key: True: c

40. The area between two standard deviations on either side of the mean (X + 2S.D) will include approx how much values in the distribution?
a. 68%
b. 95%
c. 99.7%
d. 100%
e. 90%

Key: True: b

41. Following test of significance will be used when more than two groups are to be compared?
a. “t” test
b. Chi-square test
c. Z-test
d. Standard error of proportion
e. Standard error of mean

Key: True: b

42. If the mean cholesterol value of a group of normal subjects is 230 mg% with a standard error of 20. The 95% confidence limit for the population is:
a. 220-240
b. 210-250
c. 200-260
d. 190-270
e. 180-280

Key: True: d
43. Birth rates of a population of infants at 36 weeks gestational age are approximately normally distributed, with a mean of 2500 grams. Roughly 95% of such infants weigh between 1900 and 3100 grams at birth. If a sample of 225 infants was studied the standard error would be:
a. 10
b. 20
c. 30
d. 40
e. 50

Key: True: b

44. In a Medical College there are 86 students in final year, 102 in fourth year, 106 in Third year, 104 in second year and 100 in first year. The relative frequency of fourth year students would be:
a. 5.5%
b. 10.5%
c. 15.5%
d. 20.5%
e. 25.5%

Key: True: d

45. The distribution of height of the girls in a University was plotted. The most frequent value was five feet and two inches, while mean height was five feet and eight inches. This show:
a. Negative skewness
b. Positive skewness
c. Normal distribution
d. Large standard deviation
e. Multimodal distribution

Key: True: b

46. A household survey of 10 families was conducted by students of 4th year MBBS. In the data they collected, the ages of heads of families were: 32,32,36,48,34,46,35,44,36 and 32 years. The mode in this series:
a. 32
b. 34
c. 36
d. 44
e. 46

Key: True: a

47. In the Medical OPD of teaching hospital, diastolic blood pressures of 10 patients were as follows:
80, 75, 81, 79, 71, 95, 75, 77, 84, & 90. The mean of this data is:
a. 80
b. 81
c. 82
d. 83
e. 84

Key: True: b

48. An investigator gets a positively skewed data on account of having only a small number of simple numerical observations at extremely high values. It will give an over estimate of:
a. Mean
b. Median
c. Mode
d. Correlation
e. Modal class

Key: True: a

49. An investigator gets a positively skewed data on account of having only a small number of simple numerical observations at extremely high values. Which measure of central tendency should he select if data is numerical?
a. Mean
b. Median
c. Mode
d. Geometric mean
e. Modal class

Key: True: b

50. When a relationship between the heart rate and valsalva’s ratio is studied, mean is useful but dispersion of the data is also very useful. Which method of spread will be more useful in this?
a. Range
b. Standard deviation
c. Coefficient of variance
d. Percentage
e. Inter quatile range

Key: True: c
58. In a descriptive study the mean is 200 and the standard error is 5, the 95 confidence limits would be:
f. 180 to 200
g. 190 to 200
h. 180 to 210
i. 200 to 220
j. 190 to 210
Key: e
59. An analysis of the race of patients who visit an emergency room reveals that 40% are white, 25% are black, 20% are Native American, and 15% are Asian. These data would best be depicted graphically with a
f. Venn diagram
g. Cumulative frequency graph
h. Normal curve
i. Histogram
j. Pie chart
Key: True: e

60. An investigator gets a positively skewed data on account of having only a small number of simple numerical observations at extremely high values. It will give an over estimate of:
a. Mean
b. Median
c. Mode
d. Correlation
e. Modal class
Key a
61. In a household survey conducted on ten families the frequency of family members in different age groups was less than 5 years  21, 5 – 14 years  16, 15 – 64 years  77 &> 65 years  1. The relative frequency of members in 15 – 64 years age group would be:
f. 47%
g. 57%
h. 67%
i. 77%
j. 87%
Key: b
Q15. At endocrinology unit, serum calcium levels of 200 patients of hyperparathyroidism were checked. The mean serum calcium level was 14mg/dl with a variance of 0.5. The 95%confidence interval would be:
a) 13.2-15.2
b) 13.5-14.5
c) 13.5-15.5
d) 13.7-14.3
e) 13.9-14.1
Key: e


Q1. While entering the data into SPSS, the analyst assigned numbers from 1-5 to different skin colors; cyanotic-1, reddish-2, pallor-3, bluish purple-4, yellowish-5. This type of variable will be categorized as:
a) Nominal
b) Ordinal
c) Dichotomous
d) Continuous
e) Discrete

Q2. The cardiologist expresses the amount of edema in CCF patients in terms of absent, mild, moderate and severe. The statistician will describe this data as:
a) Nominal
b) Ordinal
c) Dichotomous
d) Continuous
e) Discrete


Q3. Marks obtained by batch A of 4th year students in Community Medicine viva were as follows:
70, 68, 65, 60, 55, 55, 54, 52, 50, 50.
The mean value of given data is:
a) 55.9
b) 56.9
c) 57.9
d) 58.9
e) 59.9


Q4. While preparing the report of gastroenteritis outbreak investigation the researcher wanted to present the data i.e. no of cases related to time, graphically. Which graph would you suggest?
a) Bar chart
b) Pictogram
c) Pie chart
d) Histogram
e) Scatter diagram




Q5. During a research on dental caries the level of fluoride was checked in different region of Punjab. The measures of central tendency, for the data obtained, were as follows:
Mean 0.5mg/L
Median 0.7mg/L
Mode 1.0mg/L
If you present this data graphically it will be:
a) Normally distributed
b) Negatively skewed
c) Positively skewed
d) Bimodal
e) Polymodal

Q6. In a group of 200 patients suspected of suffering from renal failure, were tested for their blood urea levels. The mean blood urea level was 75mg/dl with a standard deviation of 5mg/dl. If these levels are normally distributed, what proportion of renal patients will have blood urea level less than 70 mg/dl?
a) 68%
b) 34%
c) 16%
d) 13.5%
e) 2.5%

Q7. A random sample of 256 students was selected from primary school to find out the nutritional status of the community by calculating BMI. The mean BMI was 22.5 and standard deviation was 2.5, the standard error of this sample mean will be:
a) 0.05
b) 0.15
c) 0.25
d) 0.35
e) 0.45

Q8. 4th year students studied the role of edema feet in impairing women’s ability to walk around in last trimester of pregnancy. The results were compared between grade I, II & III edema. The most appropriate statistical test to compare the results would be:
a) SE of difference between two means
b) chi-square test
c) SE of mean
d) ANOVA
e) SE of proportion

Q9. Cumulative frequency curve showing masses of 50 boys.





The approximate median of the data presented is:
a) 70 kg
b) 74kg
c) 75kg
d) 79kg
e) 80kg

Q10. A certain firm recuits drivers, office workers and mechanics. The firm selected members from each group to represent themselves in the workers committee. This type of sampling will be classified as:
a) Simple random
b) Systematic
c) Stratified
d) Quota
e) Cluster

Q11. Weights in kg of 10 pregnant ladies, were recorded in antenatal clinic. The mean weight was 78kg and the variance was 45kg. The standard deviation of the sample would be:
a) 6.7
b) 6.8
c) 6.9
d) 7.0
e) 7.1

Q12. Six volunteers took a cholesterol lowering diet for 3 months and mean cholesterol levels were measured before and after the trial diet. The appropriate test of statistical significance for this trial will be:
a) Chi-square test
b) Odd’s ratio
c) Paired t- test
d) unpaired t-test
e) Z test

Q13. 100 diabetic patients underwent a trial for dietary management to reduce their blood sugar levels. Analysis showed insignificant results. Which error should be ruled out in the given situation to accept the null hypothesis:
a) beta error
b) alpha error
c) Measurement error
d) Random error
e) Sampling error

Q14.Suppose you are a research officer and given two data sets to decide which set has more dispersion. The measure you will choose to take your decision accurately is:
a) Range
b) Mean deviation
c) Variance
d) Standard deviation
e) Coefficient of variance

Q15. A survey was done on 500 FSc students of 3 different colleges to see their career choices in future. 120 opted for engineering, 150 for medicine, 130 for MBA, 40 for masters in IT, 25 for arts and crafts and 35 for Armed forces. The relative frequency of students who voted for MBA would be:
a) 8%
b) 24%
c) 26%
d) 30%
e) 50%


1) Serum ALT levels of Hepatitis c positive patients taking interferon therapy were done repeatedly as a marker to see the effect of therapy. This variable chosen is:

a) Nominal
b) Ordinal
c) Discrete
d) Continuous
e) Dichotomous

Key: d

2) chairman POF board has announced scholarships for the students of WMC achieving 1st,2nd and 3rd positions in UHS in their relevant professional exams. The data of position holder students is categorized as

a) Nominal
b) Ordinal
c) Discrete
d) Continuous
e) Dichotomous

Key: b

3) A survey was conducted to see the %age of utilization of family plaining services by male and female persons among married couples. The of this variable is

a) Nominal
b) Ordinal
c) Discrete
d) Continuous
e) Dichotomous

Key: e

4) While monitoring the growth of children of 15 years in OPD. He children are divided into 3classes of ages 1-5years,6-10 and 11-15years.the class interval between these three classes of children is

a) 0
b) 2
c) 3
d) 4
e) 5

key: e


5) Chairman POF board has announced 30, 20, 10 and 5 scholarships for the students achieving 1st, 2nd, 3rd and 4th positions in professional exams of U.H.S. The central tendency of this data will be

a) 16.5
b) 15
c) 14
d) 10
e) 5

Key: b

6) birth record of obstetric ward of POF hospital for the month of july showed that
50infants (under weight) = <2500gm 150infants (normal) = >2500gm<400gm 30infants (over weight) = >400gm
This type of data is categorized as

a) Nominal
b) Ordinal
c) Discrete
d) Continuous
e) Dichotomous

Key: c

7) The data of distribution of <5mortality of Faisalabad in 2009 due to diarrhea, ARI, vaccine preventable diseases and other can be graphically represented by a) Pie chart b) Histogram c) Bar diagram d) Scatter diagram e) Pictogram

Key: a

8) The systolic blood pressures of 15 patients coming to a tertiary care hospital with stroke were recorded as follows 156,174,148,185,150,170,176,188,180,180,150,200,220,140 and 150 The mean of this data will be a) 140 b) 156 c) 164 d) 171 e) 183
Key: d

9) The data regarding the naturopathic complications of diabetes mellitus depending on the duration of illness was recorded in following 6 categories depending on the duration of illness with class interval of 5 class1 = 1-5years class11= 6-10 years class111= 11-15years Class IV = 16-20years Class V = 21-25years Class VI =>25 years
This data can be graphically represented by

a) Pie chart
b) Histogram
c) Bar diagram
d) Scatter diagram
e) Pictogram

Key: c

10) Marks obtained by the students of batch f in the subject of community medicine were as follows
220,210,240,180,185,200,170,250,50,75,195,205
The central tendency of this data would be

a) 175
b) 181
c) 185
d) 210
e) 220
Key: c

11) Birth weights of the babies of PIH patients were recorded to see the effect of PIH on fetal weight. The measures of the central tendency for the data obtained were as follows
Mean = 200gm
Median = 2500gm
Mode = 2800gm
If graphically represented this data will be

a) Normally distributed
b) Negatively skewed
c) Positively skewed
d) Bimodal
e) Poly modal

Key: b

12) The blood urea levels of the renal failure patients were recorded. The highest level was 110mg/dl and the lowest level was 50mg/dl. The range of the values will be

a) 40
b) 55
c) 60
d) 75
e) 80

Key: c

13) In a study on 100pregnant ladies to determine the average weight gain in pregnancy the mean of the sample was 14kg with a SD of 5kg.if the data is normally distributed the %age of the women that will have weight beyond the range of 4-24kg

a) 68%
b) 34%
c) 27%
d) 13.5%
e) 5%

Key: e

14) Suppose from a sampling frame of 1200 medical students, you have to conduct a survey on a sample of 100 students about their knowledge of hazards of smoking. The first value for the systematic random sampling

a) 11
b) 12
c) 13
d) 14
e) 15

Key: a

15) The data of a sample of 400 IHD patients with smoking for the last 10years was normally distributed around the mean with the SD of 8. The S.E would be

a) 0.2
b) 0.4
c) 0.8
d) 1.0
e) 1.4

Key: b

16) The mean serum cholesterol of a sample of 100 hypertensive patients was 175mg/dl with a SD of 15mg/dl. What would be 95% confidence interval for the population mean

a) 150-155
b) 163.3-169.5
c) 173.5-176.5
d) 180-189
e) 186.5-197.8

Key: c

Sunday, June 19, 2011

Learn Important Medical Procedures by using Procedures Consult apps of Epocrates


Epocrates presents Procedures Consult apps for internal and family medicine. These intuitive and thorough apps will help you with the most common medical procedures. Access about a hundred detailed procedures videos, including pre-and post-procedure steps.

Internal Medicine - General
25 common internal medicine procedures, including:
• Defibrillation
• Local Anesthesia
• Lumbar Puncture
Thoracentesis
• Tick Removal
• Transcutaneous Pacing



Internal Medicine - Musculoskeletal
22 common musculoskeletal procedures common to internal medicine, including:
• Arthrocentesis: Knee • Long Arm Splint
• Coaptation Splint • Sugar Tong Splint
• Dislocation Reduction of the PIP and DIP Joints • Dislocation Reduction of the Hip Joint

Family Medicine - General
27 common family medicine procedures, including:
• Anoscopy
• Excisional Biopsy
• Lumbar Puncture
• Shoulder Relocation
• Trigger Point Injection
Wart Treatment

Family Medicine - Women's Health & Obstetrics
24 procedures common to women's health in family medicine, including:
• Breast Cyst Aspiration • Dilation and Curettage
Cervical Polypectomy • Forceps Delivery
• Colposcopy • Word Catheter Placement


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Yes, Cell Phone Radiation shields are Scams

Here's what the FTC has to say about cell phone radiation shields:

Listen Up: Tips to Help Avoid Cell Phone Radiation Scams

Whether you call them cell phones, smart phones or mobile devices, it seems like everyone has one. According to the wireless telecommunications industry, the U.S. now has an estimated 300 million mobile subscribers, compared to 110 million subscribers a decade ago. The increase in cell phone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology, and a market for shields as possible protection against the radio waves the phones emit. The Federal Trade Commission (FTC), the nation's consumer protection agency, has some practical tips to help you avoid scams and limit your exposure to electromagnetic emissions from your cell phone.

While health studies about any relationship between the emissions from cell phones and health problems are ongoing, recent reports from the World Health Organization will no doubt convince scam artists that there's a fast buck to be made. Scam artists follow the headlines to promote products that play off the news – and prey on concerned people.

If you're looking for ways to limit your exposure to the electromagnetic emissions from your cell phone, know that, according to the FTC, there is no scientific proof that so-called shields significantly reduce exposure from these electromagnetic emissions. In fact, products that block only the earpiece – or another small portion of the phone – are totally ineffective because the entire phone emits electromagnetic waves. What's more, these shields may interfere with the phone's signal, cause it to draw even more power to communicate with the base station, and possibly emit more radiation.

To limit your exposure to cell phone electromagnetic emissions, the FTC suggests that you:
  • Increase the distance between your phone and your head by using a hands-free device, like an earpiece that is wired to the phone, or using the speakerphone feature.
  • Consider texting more and limiting your cell phone use to short conversations.
  • Wait for a good signal. When you have a weak signal, your phone works harder, emitting more radiation. Phones also give off more radiation when transmitting than when receiving, so tilt the phone away from your head when you're talking, and bring it back to your ear when you're listening.
When you're in the market for a new phone, research a phone's specific absorption rate (SAR) before you buy. Measured in watts per kilogram of tissue, the SAR reveals how much radiation the body absorbs while using the mobile device. Different phones emit different amounts of radiation. In the U.S., a phone's SAR can't exceed 1.6 watts per kilogram. The Federal Communications Commission (FCC) has SAR information for cell phones produced and marketed within the last two years. You can access this information using the phone's FCC ID number, usually located on the case of the phone, and the FCC's ID search form at www.fcc.gov/oet/ea/fccid. The Environmental Working Group also maintains a listing at www.ewg.org/cellphone-radiation

Key Words:
electromagnetic waves, hands-free device, Cell Phone Radiation Scams, smart phones, mobile devices, radiofrequency

Common Causes and Symptoms of Burning Headache


Many people suffer from this common nuisance called burning headache every day, in some cases which can even last for days. Burning headache is not a medically recognized term if you were to look around in medical journals and clinical documents, but it's pretty much commonly used. There are many different causes of burning headache, and different people have different parts of the head which aches. Besides, there are also many different causes of this headache, some of which we will be looking at today.

Different Parts of the Head:
In many instances, burning headache is related to sinusitis. In that case, the pain is usually on the frontal part of the head, on the forehead, upper cheeks, and sometimes can even travel around the whole face. In other cases, this burning headache can be caused by fever. In this, the pain is usually on both sides of the forehead, which are the weakest points of sensitivity in our head.

Causes:
As we have already known, the common reasons for burning headache would be fever, flu, and sinusitis. In these cases, the pain is constant, and can be stinging and tingling, and not to mention burning. It can originate from any side of the head, but usually after a while it will travel to other areas as well.

Some people tend to get thrusts of extreme pains. Although medically there is no proof as to what causes this sudden uprising in the burning headache symptoms, it is believed to be caused by pulsating nerves due to tension.

Burning headache can also be caused by certain other reasons besides the above listed. These are more serious cases such as tumors or growth in the head. In such cases, the pain is not constant like the ones listed above, but comes on and off. The pain is usually violent, far stronger than the ones you get for fever, and not to forget; it pulsates often.

It is also believed that toxins and chemicals can also cause acute or burning headache. This is pretty common to many people, especially those who are not so favorable of newly painted houses, chemical labs, and so on. On top of these, even certain edible toxins and foods can cause burning headache, such as alcohol, caffeine, and so on.

Alcohol and caffeine especially, are believed to be causes of many serious headaches that can cause the whole head to ache severely, with the nerves being extremely tensed.

Key Words:
burning headache, medical journals, causes of burning headache, sinusitis, fever, burning headache symptoms, tumors

Sunday, June 12, 2011

How to Perform Paracentesis

  • Indications:
    • Diagnostic studies
    • Ascites
    • Spontaneous bacterial peritonitis
    • Therapeutic purposes
    • Relief of respiratory compromise
    • Relief of abdominal pain and discomfort
  • Contraindications:
    • Coagulopathy (PT or PTT > 1.3)
    • Thrombocytopenia (plt < 60,000)
    • Bowel obstruction
    • Pregnancy
    • Infected skin or soft tissue at entry site
  • Anesthesia:
    1% lidocaine
  • Equipment:
    • Sterile prep solution
    • Sterile towels
    • Sterile gloves
    • 5-ml syringes, 20-ml syringes, 25-gauge and 22-gauge needles
    • 3-way stopcock, IV tubing
    • IV catheter (diagnostic: 20-gauge, therapeutic: 18-gauge) or long 16-gauge (CVP-type) catheter with 0.035-cm J wire
    • 500- to 1000-ml vacuum bottles and IV drip set (for therapeutic paracentesis)
  • Positioning:
    Supine
    • Preferred sites of entry to prevent bleeding from epigastric vessels (see Figure 5.7)
    • Either lower quadrant (anterior iliac spine)
    • Lateral to the rectus muscle and at the level of or just below the umbilicus
    • Infraumbilically in the midline

    • The entry site should not be the site of a prior incision and should be free of gross contamination and infection.
    • The entry sites are percussed to confirm the presence of fluid and the absence of underlying bowel.
    • The patient should empty his or her bladder prior to the procedure, and/or a Foley catheter should be placed to decrease the possibility of puncturing the bladder.
  • Technique Diagnostic Sampling:
    • Prepare site with sterile prep solution and drape with sterile towels.
    • Use 25-gauge needle to anesthetize skin and 22-gauge needle to anesthetize abdominal wall to peritoneum.
    • Introduce IV catheter into the abdominal cavity, aspirating as it is advanced. The needle should traverse the abdominal wall at an oblique angle to prevent persistent leak of ascites from the puncture site (see Figure 5.8).
    • When free flow of fluid occurs, the catheter should be advanced over the needle and the needle removed.
    • Draw 20–30 ml of fluid into a sterile syringe for diagnostic studies and culture.
  • Technique Therapeutic Drainage:
    • Prepare site with sterile prep solution and drape with sterile towels.
    • Use 25-gauge needle to anesthetize skin and 22-gauge needle to anesthetize abdominal wall to peritoneum.
    • Introduce IV catheter into the abdominal cavity, aspirating as it is advanced. The needle should traverse the abdominal wall at an oblique angle to prevent persistent leak of ascites from the puncture site.
    • When free flow of fluid occurs, the catheter should be advanced over the needle and the needle removed. Alternatively, a CVP-type catheter with extra side holes may be placed over a guide wire using the Seldinger technique.
    • After insertion of the needle and aspiration of fluid, a J-tip guide wire is placed through the needle into the peritoneal space. The needle is removed, leaving the wire in place.
    • A stiff plastic dilator is used to dilate the tract by placing it over the wire and into the abdomen. A #11-blade scalpel can be used to make a tiny nick at the entry site as well.
    • The dilator is removed, the catheter is placed over the wire and into the abdomen, and the wire is removed.
    • Draw 20–30 ml of fluid into a sterile syringe for diagnostic studies and culture.
    • IV tubing is hooked to the catheter and to a vacuum bottle to remove a large volume of fluid.
    • Should the catheter become occluded, careful manipulation of the catheter to re-establish flow may be undertaken. Alternatively, asking the patient to turn on his or her side and again onto his or her back may also help re-establish flow. However, the needle or guide wire should not be reintroduced because of the risk of bowel injury. If less than an adequate volume is withdrawn, the catheter should be removed and replaced, possibly at another entry site.
  • Complications and Management:
    • Hypotension
      • Can occur during or after procedure due to rapid mobilization of fluid from intravascular space or due to vasovagal response.
      • IV hydration can prevent and correct the hypotension in most cases.
      • 5% albumin solution or other colloid-based fluid is often used for this purpose.
  • Bowel perforation
    • Rarely recognized at time of procedure
    • Can lead to infected ascites, peritonitis, and sepsis
  • Hemorrhage
    • Rare, but can be caused by injury to mesentery or injury to inferior epigastric vessels.
    • Usually self-limited. Avoided by entering abdomen lateral to rectus and by correcting coagulopathy.
    • Hemodynamic instability requires laparotomy.
  • Persistent ascites leak
    • Usually will seal in <2 weeks. Can result in peritonitis.
    • Skin entry site may be sutured to minimize leak.
  • Bladder perforation
    • Avoided by inserting Foley catheter prior to procedure.
    • May require a period of bladder catheterization until sealed.
    • Obtain urology consult.

Friday, June 10, 2011

Mysterious Medical syndrome

  1. Werewolf Syndrome or Hypertrichosis
  2. Blashko’s Line Skin Disorder
  3. Albino Syndrome
  4. Proteus Syndrome
  5. Ondine’s Curse
  6. RAS Syndrome
  7. Mobius Syndrome
  8. Mermaid Syndrome
  9. Blue Skin Disorder
  10. Progeria Syndrome