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Announcement for Online Session No 130 16 Nov 2024 DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE: Today we will have an online session on Zoom discussing 1 Communication Station Scenario regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) WE WILL NOT RECORD THIS SESSION The Candidate for today’s session has been selected. TIMINGS : Saudia Arabia: 4 00 pm Pakistan : 6 00 pm Bangladesh : 7 00 pm India : 6 30 pm Singapore : 9 00 pm Hong Kong : 9 00 pm Malaysia : 9 00 pm Egypt : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 2 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 2 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 2 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 7 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 12 00 am Burundi : 3 00 pm Rwanda : 3 00 pm Morocco : 2 00 pm French Guiana : 10 00 am ( Please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. GOOD LUCK.

👉 IMPORTANT 775👈 Ideally blood cultures should be taken prior to empirical antibiotic therapy but this should not delay therapy in unstable patients paceUrMRCP

👉 IMPORTANT 774👈 2 major clinical criterias or 1 major and 3 monor criteria are enough to confirm the diagnosis of IE according to the modified Duke,s criteria paceUrMRCP

👉 IMPORTANT 773👈 In culture negative endocarditis please rule out fastidious organisms that fail to grow in normal blood culture like coxiella burnetti paceUrMRCP

👉 IMPORTANT 772👈 5-10 percent cases of IE are culture negative paceUrMRCP

👉 IMPORTANT 771👈 Usual cause of culture negative IE is prior antibiotic use paceUrMRCP

👉 IMPORTANT 770👈 In IE the most common native valves involved are aortic and mitrall valves but in IV drug abusers the right sided heart valves are more involved. paceUrMRCP

The candidate for tomorrow's session has been selected. Regards

*Announcement for Online Session No 125* *25 Aug 2024* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE: Tomorrow we will have an online session on Zoom discussing 1 Clinical consultation Scenario regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) WE WILL NOT RECORD THIS SESSION Interested candidates may send a personal message to take the case.. TIMINGS : Saudia Arabia: 4 00 pm Pakistan : 6 00 pm Bangladesh : 7 00 pm India : 6 30 pm Singapore : 9 00 pm Hong Kong : 9 00 pm Malaysia : 9 00 pm Egypt : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 2 00 pm Ireland ( Dublin ) : 2 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 11 00 pm Burundi : 3 00 pm Rwanda : 3 00 pm Morocco : 1 00 pm French Guiana : 10 00 am ( Please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. GOOD LUCK.

ANNOUNCEMENT FOR ONLINE COURSE NO 43 ( 12 Aug 24—30 Aug 24 ) Hello and salam everyone. We are pleased to announce admissions for our Aug 2024 online course ( 15 days ) for PACES MRCP (UK) and CLINICAL EXAM MRCPI . We will start from 12th of Aug 24 and finish on 30th of Aug 24. Active slots available on first come--first served basis. Listener slot available too. At least 90 Important exam cases ( including recent diets cases ) will be practiced and discussed as we do in our weekly Sunday sessions. After the performance detailed feedback will be given to elaborate on the weak skills. It is equally beneficial for those who are beginners or have exams in coming diet. Interested candidates may send a personal message for details. WhatsApp No: +923346036496. Email: drtanzeelbukhari@gmail.com GOOD LUCK.

Info about the SAMPLE/DEMO CLASS before joining our regular classes. Many colleagues ask for a sample/demo session before joining our regular classes. I suggest that if you are interested to join us for our regular classes and you want a demo class then please try to attend any of our SUNDAY CLASS. We are trying to conduct a free session on every alternate Sunday and so far have conducted 120 free sessions. Our regular classes are exactly similar to these. Thanks and regards

*Announcement for Online Session No 124* *11 Aug 2024* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE: Today, we will have an online session on Zoom discussing 1 Communication Scenario regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) WE WILL NOT RECORD THIS SESSION The candidate for today's session has been selected. TIMINGS : Saudia Arabia: 4 00 pm Pakistan : 6 00 pm Bangladesh : 7 00 pm India : 6 30 pm Singapore : 9 00 pm Hong Kong : 9 00 pm Malaysia : 9 00 pm Egypt : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 2 00 pm Ireland ( Dublin ) : 2 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 11 00 pm Burundi : 3 00 pm Rwanda : 3 00 pm Morocco : 1 00 pm French Guiana : 10 00 am ( Please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. GOOD LUCK.

👉 IMPORTANT 751👈 METHOTREXATE 3 *Monitoring while Prescribing methotrexate* Methotrexate is a drug with a high potential for patient harm. It is therefore important that you are familiar with guidelines relating to its use Methotrexate is taken weekly, rather than daily FBC, U&E and LFTs need to be regularly monitored. The Committee on Safety of Medicines recommend 'FBC and renal and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months' Folic acid 5mg once weekly should be co-prescribed, taken more than 24 hours after methotrexate dose The starting dose of methotrexate is 7.5 mg weekly (source: BNF) Only one strength of methotrexate tablet should be prescribed (usually 2.5 mg) paceUrMRCP

👉 IMPORTANT 750👈 METHOTREXATE 2 *Adverse effects* Mucositis Myelosuppression Pneumonitis Pulmonary fibrosis Liver fibrosis *Contraindications:* Pregnancy Women should avoid pregnancy for at least 6 months after treatment has stopped The BNF also advises that men using methotrexate need to use effective contraception for at least 6 months after treatment *Interactions* Avoid prescribing trimethoprim or co-trimoxazole concurrently - increases risk of marrow aplasia High-dose aspirin increases the risk of methotrexate toxicity secondary to reduced excretion paceUrMRCP

👉 IMPORTANT 749👈 METHOTREXATE 1 *Mechanism of action* Inhibits dihydrofolate reductase *Indications* Inflammatory arthritis, especially rheumatoid arthritis Psoriasis Some chemotherapy acute lymphoblastic leukaemia paceUrMRCP

👉 IMPORTANT 748👈 Causes of Acute abdomen *A* appendicitis *B* biliary obstruction *D* diverticulitis *O* ovarian disease *M* malignancy *I* intestinal obstruction/ ischaemic bowl *N* nephritic syndrome *A* acute pancreatitis *L* liquor *P* porphyria *A* Acid peptic disease *I* infectious peritonitis *N* non infectious peritonitis – hemoperitoneum paceUrMRCP

👉 IMPORTANT 747👈 Please remember that in Cushing Syndrome Myopathy, obesity, menstrual irregularity, osteoporosis, subtle mood changes, HTN and DM often remain after the treatment but their control may become better paceUrMRCP.

👉 IMPORTANT 746👈 MRC Dyspnoea Scale 1.Not troubled by breathlessness except on strenuous exercise. 2.Short of breath when hurrying or walking up a slight hill 3.Walks slower than contemporaries on level ground because of breathlessness or has to stop for breath when walking at own pace 4.Stops for breath after walking about 100m or after a few minutes on level ground 5.Too breathless to leave house or breathless when dressing paceUrMRCP

👉 IMPORTANT 734👈 RHEUMATOLOGIST is considered a Jargon by some examiners so avoid using it and always say JOINT SPECIALIST. paceUrMRCP

👉 IMPORTANT 733 👈 FOR HISTORY TAKING In a case of fainting, fall, syncope or fit please ask was any one was accompanying you at that time as some times it can give important clues. paceUrMRCP