Nitsbin (ንጽቢን ) Medical Resources, Health Information and Vacancy /NMR_HIV/

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WHO Malaria Guideline 2024

A 12-year-old boy is evaluated for recurrent nephrolithiasis. He spontaneously passed three stones in the last 4 years and has recently undergone shockwave lithotripsy twice without success. He has been treated in the past with an unknown medication but was discontinued because the parents believed it was of no benefit. Urinalysis demonstrates hexagonal crystals.

A 30-year-old male patient sustained fall down accident from 4-meter-high tree presented to surgical emergency department. At presentation he was complaining of chest paint. On examination BP = 130/90mmHg, PR =88bpm, RR= 20bpm and oxygen saturation was 95% at atmospheric air. Chest was clear with multiple segment rib fractures. After 6 hours of stay in the ER, he developed frothy cough, tachypnea and shortness of breath.

A 11-month-old male infant was brought to OPD with complaint of abdominal distention and subsequently vomiting of offensive fecal matter. On PR examination, blast sign was positive. Plain abdominal X-ray showed both small bowel and large bowel dilation.

A 45 year old man was admitted to orthopedic ward for right femoral shaft fracture fixation ten days back. He suddenly started to have shortness of breath and palpitation. On examination, RR = 35 bpm, PR = 100 bpm and oxygen saturation was 85%. He is restless and chest has right side crepitation. His right lower limb was on skeletal traction.

A mother bought her 1-month-old infant to the OPD after she noticed bilateral feet deformity since birth. She had ANC follow up and had vaginal delivery with breech presentation. On examination, the infant's feet were in varus, equinus and supinated position. Infant had no back problem.

ERMP Registration Updates (28/03/17 ; 4;00 DLT)


Application ended on: Sat, 07 DEC, 2024

➡️ Total Applicants who completed application  👉 2,244 out of 3,350

➡️ Total Applicants who Chose exam hub = 1,949




Top 5 program choices

1️⃣, Radiology                556
2️⃣, Internal medicine   430
3️⃣, Dermatology           291
4️⃣, ENT                          152
5️⃣, Orthopedics            116



Top 5 Exam Hub choice (Chose, remaining )

1️⃣, AAU 👉 306, 44 Remaining
2️⃣, BDU 👉 250, 0 Remaining
3️⃣, HWU 👉 200, 0 Remaining
4️⃣, AASTU 👉 166, 134 Remaining
5️⃣, SPHMMC 👉 166, 34 Remaining


⏰ Application ended on: Sat, 07 DEC, 2024


@Nitsbinteam

ለGAT የሚሆን ሀሪፍ መፅሀፍ ነው ከመጀመሪያው ገፅ ጀምራችሁ አንብቡት ትወዱታላችሁ!

@GATExamAAU

A 35-year-old female patient came to the OPD with painful anterior neck swelling of 4 weeks duration. She had history of upper respiratory tract infection. Her vital signs were stable and examination of the neck revealed tender, firm and mildly enlarged goiter. CBC and thyroid function test are normal.

የኑሮ_ውድነት_ማካካሻ_የደመወዝ_ማስተካከያ.

አብክመ ጤና ቢሮ የደሞዝ ማሻሻያን በተመለከተ በስሩ ላሉ ጤና ተቋማት በ 26/03/2017 ዓ.ም የጻፈው ደብዳቤ

@Nitsbinteam

40th batch of University of Gondar!

40 days left

© @debolteam

Regarding ERMP 2024, NO new update

For Application, 1 day and 12 hours left


Apply now

https://ermp.moh.gov.et

A 31-year-old lady presented to OPD with a complaint of right breast lump of three months duration. On physical examination, there is firm to hard irregular mass over the UOQ of the breast. Mammography revealed a3x2cm irregular density with micro calcification. Biopsy demonstrated extensive fat necrosis.

Dr. @Abris3h

Thank you for reminding the Update in this specific quizze


So, The answer according to ATLS 10th edition will be D. 5th intercostal space


Surgical residents and Seniors could you Update us whether it is applicable in Ethiopia or not?

ATLS 10th edition

Clinical Notes


The latest edition of ATLS manual is the 10th edition, which introduces several updates in trauma management. Key changes include:

- Needle decompression:

For adults, the recommended site has moved from the second intercostal space (mid-clavicular line) to the fourth or fifth intercostal space (mid-axillary line), as this location is more effective in reaching the thoracic cavity.

- Chest tubes:

A smaller chest tube size (28-32 F) is now recommended for draining hemothorax, reducing the chance of retained fluid without increasing complications.

- Focused Assessment with Sonography for Trauma (FAST):

This technique has been expanded to assess for pneumothorax.

- New Glasgow Coma Scale (GCS):

The updated GCS focuses on reporting individual score components and introduces "NT" (not testable) for when a component cannot be assessed.

- Pelvic trauma:

Preperitoneal pelvic packing is now recommended for managing hemorrhage from pelvic fractures.

- Terminology changes:

The term “spinal immobilization” has been replaced by “spinal motion restriction” to better reflect current practices.

The manual also updates treatment guidelines for blunt aortic injuries, spine trauma, and brain injury, reflecting the latest clinical research and evidence-based practices


Look at the image below

@Nitsbinteam

A 40-year-old man is brought to the emergency department after being involved in a motor vehicle collision. He has multiple lacerations on his face and extremities, and a deep wound on his right thigh. He is alert and oriented, but complains of severe pain. His vital signs are stable and his physical examination is otherwise normal.

A 22-year-old woman is brought to the emergency department after being stabbed in the left chest. She is conscious and alert, but complains of severe chest pain and dyspnea. Her blood pressure is 90/60 mm Hg, pulse is 120/min, and respirations are 28/min. On examination, she has a 2-cm stab wound in the fifth intercostal space, just lateral to the midclavicular line. She has absent breath sounds and hyper resonance to percussion on the left side. Her trachea is deviated to the right.

A 35-year-old woman undergoes a thyroidectomy for a multinodular goiter. On postoperative day 1, she develops tingling and numbness in her hands and feet, muscle cramps, and anxiety. She also has a positive Chvostek sign and a positive Trousseau sign. Her serum calcium level is 7.2 mg/dL (normal 8.5-10.2 mg/dL) and her serum parathyroid hormone (PTH) level is 10 pg/mL (normal 10-65 pg/mL).

A 45-year-old woman undergoes a laparoscopic cholecystectomy for symptomatic gallstones. During the procedure, the surgeon accidentally injures the common bile duct. The injury is recognized intraoperatively and repaired with a T- tube. The patient is discharged home on postoperative day 3 with the T-tube in place. She is instructed to return in 6 weeks for a cholangiogram and T-tube removal. Two weeks later, she develops fever, chills, and right upper quadrant pain. She also
notices that the drainage from the T-tube has increased and become purulent.

A 55-year-old male presents with chronic low back pain that radiates into the right leg. He describes numbness and tingling along the back of his thigh and calf. Straight leg raising test is positive on the right side, reproducing his symptoms. Motor strength and reflexes are normal, and there is no saddle anesthesia.

የአውሮፓ ሀገራት ከ1 ነጥብ 2 ሚሊዮን በላይ የሰራተኞች እጥረት እንደገጠማቸው ገለጹ

የህክምና ዶክተሮች፣ ነርሶች እና አዋላጅ ሙያዎች በአውሮፓ እጥረት አጋጥሟል ተብሏል

ኖርዌይ፣ ዴንማርክ፣ ሆላንድ እና ጀርመን የሰራተኛ ዕጥረቱ የተባባሰባቸው ሀገራት ናቸው

ተጨማሪ ያንብቡ

Al Ain Amharic

As usual, Refer comment section of each quiz for explanation


☝️This is to show you, Components of NGAT mathematics part

Even though there is no official announcement, we have checked ERMP registration site by 3 applicants account and it shows count down of 3 hours (@ 17/03/2017; 2:40 NLT)

Apply now

https://ermp.moh.gov.et

As usual, Refer comment section of each quiz for explanation

A 28-year-old woman at 34 weeks of gestation presents with headache, blurred vision, and swelling of the feet. She has no history of medical problems. On physical examination, her blood pressure is 160/100 mmHg and her urine protein is 2+. A blood test shows normal platelet count and liver enzymes. She is given magnesium sulfate and labetalol and admitted to the hospital.

A 25-year-old woman presents with sadness, anxiety, and crying spells for the past two weeks. She delivered a healthy baby girl four weeks ago. She says that she loves her baby, but she feels overwhelmed and inadequate as a mother. She has no history of mental illness or substance abuse. On physical examination, she is alert and oriented, but has a depressed mood and a flat affect. She denies any suicidal or homicidal thoughts.

A 32-year-old woman at 38 weeks of gestation presents with headache, blurred vision, and swelling of the feet. She has a history of chronic hypertension and gestational diabetes. On physical examination, her blood pressure is 180/110 mmHg and her urine protein is 4+. A blood test shows thrombocytopenia and elevated liver enzymes. She is given magnesium sulfate and labetalol and delivered by cesarean section. Two days later, she develops confusion, agitation, and hallucinations. She is mostly symptomatic at night.

If you want to share any medical file @Nitsbingroup, avoid Links from the file. Otherwise The group will automatically delete your file since members are allowed to send file or texts only.

በቅርብ አመታት በነበሩ ERMP Registration ወቅት ከ 4,000 በላይ ሐኪሞች ይመዘገቡ እንደነበር ይታወቃል። Reserve ሁሉ ይጠራ ነበር

በየጊዜው ግን በጣም እየቀነሰ መጥቷል በተለይ በዚህ ዓመት ይህን ያህል በግማሽ የቀነሰበት ምክንያት ምን ይሆን?

Program Quotas available in each University, 2024

@Nitsbinteam

A 28-year-old woman presents with abdominal pain and vaginal bleeding. She has a history of pelvic inflammatory disease and tubal ligation. A urine pregnancy test is positive. A transvaginal ultrasound shows a 3 x 3 cm mass in the left fallopian tube. Her serum beta-hCG level is 3000 mIU/mL.

A 40-year-old woman presents to the clinic with a 3-day history of black, tarry
stools. She has no abdominal pain, fever, or weight loss. She takes ibuprofen occasionally for headaches. Her hemoglobin concentration is 10 g/dL, and her stool test is positive for occult blood.

Exam Hub የመረጡ አባላት 1034 ደርሰዋል። በተቃራኒው ግን Apply ለማድረግ እየሞከሩ ያሉ አባላት System error Or something went Wrong የሚሉ Reply በማቅረብ እንደተቸገሩ ለማወቅ ችለናል።

መፍትሔ

👉 Try to apply with Strong wifi /data connection. Especially during Night time

👉 inform 952 what is going on when you try to apply.

Based on Followers Request

Shield’s General thoracic surgery Volume 1 & 2, 8th edition.pdf

For More  updated National and International books,Guidelines and protocols, Health information and vacancy Join our Channel

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As usual, Refer comment section of each quiz for explanation

A 55-year-old man with a history of peptic ulcer disease presents to the emergency department with sudden onset of severe abdominal pain, nausea, and vomiting. He has been taking nonsteroidal anti-inflammatory drugs (NSAIDs. for his chronic back pain. His temperature is 38.5°C (101.3°F), his blood pressure is 90/60 mm Hg, and his pulse is 120 beats/min. His abdomen is rigid and tender, with rebound and guarding. Bowel sounds are absent.

A 45-year-old man presents to the clinic with recurrent episodes of severe joint
pain, swelling, and redness, especially in his big toe. He also has a history of
hypertension, obesity, and alcohol abuse. His serum uric acid level is 9.5 mg/dL (normal range 3.5 to 7.2 mg/dL.

A 65-year-old man with a history of chronic kidney disease and hypertension presents to the clinic with fatigue, dyspnea, and chest pain. He has not been compliant with his dialysis sessions and medications. His blood pressure is 200/120 mm Hg, his pulse is 100 beats/min, and his respiratory rate is 22 breaths/min. On auscultation, there is a pericardial friction rub and a systolic murmur at the left lower sternal border. His serum creatinine is 8 mg/dL, and his blood urea nitrogen is 120 mg/dL.

ERMP Registration Updates (13/03/17 ; 2;30 DLT)

➡️ Total Applicants who completed application  👉 > 1,772 out of 3,350

➡️ Total Applicants who Choices exam hub = 855

N.B your ID may be more than 1772, since we are counting those who completed the application



Top 5 program choices

1️⃣, Radiology                443
2️⃣, Internal medicine   361
3️⃣, Dermatology           226
4️⃣, ENT                          118
5️⃣, Orthopedics            87



Top 5 Exam Hub choice (No of Choosers, Left)

1️⃣. BDU 👉 195, 55 left
2️⃣.AAU 👉 126, 224 left
3️⃣. HWU 👉 94, 106 Left
4️⃣. SPHMMC 👉 85, 115 left
5️⃣. AASTU 👉 81, 219 Left


⏰ 3 days left

Apply here

https://ermp.moh.gov.et


@Nitsbinteam

ሀሪፍ የGAT የመፅሀፍ ነው አንብቡት!

ሌሎች ጥሩ ጥሩ መፅሀፍትን እና ጥያቄዎችን በዚሁ ቻናል እንለቃለን ይጠብቁን።
@GATExamAAU

Based on Follower request

@Nitsbinteam

Nitsbin Tips

IUGR

Intrauterine growth restriction (IUGR) refers to a fetus that has not reached its genetically determined growth potential due to various factors. IUGR is classified into symmetric and asymmetric types based on the growth pattern and timing of the insult during pregnancy. Here's the distinction:


1. Symmetric IUGR

Definition: A form of IUGR where the fetus is proportionally small, with a reduction in both head circumference and abdominal circumference.

Onset: Early pregnancy (first or early second trimester).

Etiology: Often due to conditions affecting the fetus directly, leading to a global reduction in cell number and size.

Causes:

Chromosomal abnormalities (e.g., Trisomy 18, Trisomy 13)

Congenital infections (e.g., TORCH infections: Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex)

Structural anomalies (e.g., congenital heart defects)

Maternal factors (e.g., severe malnutrition, substance abuse)

Appearance: Proportional growth restriction with small head and body sizes.

Prognosis: Poorer compared to asymmetric IUGR, as the insult occurs during critical periods of organogenesis.



2. Asymmetric IUGR

Definition: A form of IUGR where the fetus has a disproportionately small abdominal circumference compared to the head circumference (head-sparing phenomenon).

Onset: Late pregnancy (third trimester).

Etiology: Typically due to placental insufficiency, leading to redistribution of blood flow to preserve brain growth at the expense of other organs.

Causes:

Uteroplacental insufficiency (e.g., preeclampsia, chronic hypertension)

Maternal diseases (e.g., diabetes, renal disease)

Smoking or other placental toxins

Appearance: Larger head relative to the smaller body, with reduced subcutaneous fat and abdominal circumference.

Prognosis: Better compared to symmetric IUGR because the insult occurs later, sparing organogenesis.


<<Educational Objective>>

Symmetric IUGR arises from early pregnancy insults, leading to global growth restriction due to reduced cell proliferation, often associated with chromosomal or congenital issues. Asymmetric IUGR occurs due to late pregnancy uteroplacental insufficiency, where blood flow redistribution spares the brain at the expense of body growth. Identifying the type aids in determining the timing and cause of the insult, which guides management and prognosis.


Reference: Uworld Notes, Pediatrics

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© File credit @atalay1259

Table of Contents @Nitsbinteam

Final NICU Training participants manual 2024

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A 65-year-old woman with a history of hypertension and obesity presents to the emergency department with sudden onset of chest pain and dyspnea. She returned from a long flight two days ago. On examination, she has a blood pressure of 180/110 mm Hg, a pulse of 120 beats/min, and a respiratory rate of 30 breaths/min. She is cyanotic and diaphoretic. Her oxygen saturation is 88% on room air. She has a loud S2 and a right ventricular heave. Her lower extremities are swollen and tender. Electrocardiogram shows sinus tachycardia, right axis deviation, and S1Q3T3 pattern. D-dimer is elevated.

A 65 year old man with a history of hypertension, diabetes, and coronary artery disease has dyspnea, orthopnea, and bilateral lower extremity edema. On examination,  he  has  elevated  jugular  venous  pressure,  bilateral  crackles  on  lung auscultation,  and  pitting  edema  in  his  lower  extremities and  his  oxygen  saturation is  90%  on  room  air.  His  chest  radiograph  shows  cardiomegaly  and  pulmonary congestion. 

A 45-year-old man with a history of rheumatic heart disease presents to the emergency department with worsening dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. He also reports a productive cough with yellowish sputum. He denies fever, chills, joint pain, or rash. On examination, he has a blood pressure of 160/100 mm Hg, a pulse of 110 beats/min, and a respiratory rate of 28 breaths/min. He has crackles in both lung bases and a pansystolic murmur at the apex. His jugular venous pressure is elevated and his lower extremities are edematous. Chest
radiograph shows cardiomegaly and bilateral alveolar infiltrates.

Update  08/03/17 ; 1;00 DLT

Total Applicants who completed application  👉 > 1,271

Total Applicants who selected exam hub = 364

8 days left

N.B your ID may be more than 1271, since we are counting those who completed the application

@Nitsbinteam

08/07/2017; 1:00 DLT

በምርጫቹህ መሰረት ከዛሬ ጀምሮ ERMP ጥያቄዎችን በ Quizzes መልኩ እያዘጋጀን እናቀርባለን። ለእያንዳንዱ ጥያቄ ማብራሪያ Comment Section ላይ ይኖረዋል። ERMP 2022 Minor Departments ጥያቄዎች በ Quiz መልኩ ሁሉም ተዘጋጅተዋል። ወደሗላ በመመለስ መሥራት ትችላላቹህ።

ከዛሬ ጀምሮ ያላዘጋጀናቸውን ጥያቄዎች እና NGAT Quizzes እንቀጥላለን።

FYI

This are the contents of ERMP. This year NGAT (70 Questions) is added

@Nitsbinteam

Update  07/03/17 ; 1;00 NLT

Total Applicants who completed application 👉 > 1,250

Total Applicants who selected exam hub = 359

9 days left

N.B your ID may be more than 1250, since we are counting those who completed the application

@Nitsbinteam

ማሳሰቢያ
_____

በተለያዩ የማህበራዊ መገናኛዎች የስኳር ህመምን ጨምሮ ሃሰተኛ የጤና መረጃዎች ሃላፊነት በጎደላቸው አካላት እየተለቀቁ ይገኛሉ። ከሰሞኑም ቴክኖሎጂን በመጠቀም በሰዓታት ውስጥ የስኳር በሽታን ማጥፋት ተችሏል በሚል እየተሰራጨ የሚገኘው መረጃ ከእዉነት የራቀና አሳሳች ነዉ።

የህክምና ሞያ ሳይኖራቸውና ለሚሠጡት አገልግሎት ህጋዊ የሆነ የብቃት ማረጋገጫ ሳይኖራቸው በማህበራዊ ሚዲያ ማህበረሰቡን የሚጎዱ፣ ከእውነት የራቁ ሀሰተኛ መረጃዎችን የሚለቁ አካላት ተበራክተዋል። ይህ ተግባር ማህበረሰቡን በእጅጉ እየጎዳና ለአላስፈላጊ ወጪና እንግልት ከመዳረግ አልፎ ፈውስ ፈላጊ ዜጎቻችን ላይ ከፍተኛና የተወሳሰበ የጤና ችግር እየፈጠረ ይገኛል።

ስለሆነም በዚህ መሰል ተግባር ላይ ተሰማርታችሁ የምትገኙ አካላት ይህ ተግባር በህግ የሚያስጠይቅ መሆኑን ተገንዝባችሁ ከእኩይ ተግባራችሁ እንድትታቀቡ እናሳስባለን።

ማህበረሰቡም ምንጫቸው ካልተረጋገጠ አካላት የሚላኩ መልእክቶችን እንዲመረምር፣ አገልግሎቶችንም ከመጠቀማችን በፊት ጥንቃቄ እንድናደርግ፣ አስፋላጊ ሆኖ ሲገኝም በ"[email protected]" ላይ ጥቆማ እንድሰጠን እየጠየቅን ፤ ህዝባችን ሀሰተኛ የጤና መረጃ የሚለቁትን በማጋለጥ ፣የጤና ባለሙያ በማማከር ጤንነቱን እንዲጠብቅ እናሳስባለን።

ጤና ሚኒስቴር

MOH

@Nitsbinteam

Fenton growth chart for premature infants - Boys and girls (each of them)


© UpToDate 2024

Based on followers request


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Lubchenco Classification of Neonates

https://peditools.org/fenton2013/


Growth chart for preterms

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Update 07/03/17 ; 4;15 DLT

Total Applicants 👉 > 1,189

Total Applicants who selected exam hub = 350
9 days left
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Message to Everyone:

If you have adequate answers to the questions raised Regarding ERMP 2024 @Nitsbingroup, please feel free to respond. The group is open for discussion, so don't rely solely on replies from the channel.

የደሞዝ ጉዳይ
@Nitsbinteam

A 16-year-old female patient presented with scanty left-side foul-smelling ear discharge since childhood, which was initially white and odorless. Otoscopic examination shows subtotal tympanic perforation with whitish flakes in the middle ear. Rhine-negative and Weber lateralization on the right ear.

As usual, Refer comment section of each quiz for explanation

A 34-year-old known asthmatic patient on regular follow-up presented with newly erupting skin lesions over the arms and the legs of two weeks duration. On evaluation at the dermatology clinic, erythematous and edematous plaques topped with vesicles and erosions were observed over antecubital and popliteal fossae bilaterally.

A 59-year-old male patient presented with a skin lesion of 1-year duration. He also has weight loss and anorexia. On examination, he has a darkly pigmented plaque with central fungating ulcer on the left plantar area. He also has bilateral palpable inguinal lymph nodes. Skin biopsy showed oval to round cells that show atypia and have darkly pigmented cytoplasm.

Vacany

BDU

@Nitsbinteam

A 71-year-old man with severe chronic obstructive pulmonary disease (COPD) comes to the office due to worsening exertional dyspnea and fatigue.  The patient takes a combination vilanterol-umeclidinium-fluticasone inhaler as prescribed but still becomes winded with light activities, such as when tying his shoes, taking a shower, and cooking.  He is reluctant to perform even minimal exertion because it provokes his dyspnea, triggers anxiety, and leaves him feeling "wiped out" for the remainder of the day.  The patient reports daily cough but minimal sputum production.  He has required outpatient antibiotics and oral corticosteroids on 2 occasions for acute exacerbations.  A recent low-dose screening CT scan of the chest showed extensive emphysema and hyperinflation with no suspicious nodules.  The patient has a 60-pack-year history but quit smoking 10 years ago.  Blood pressure is 130/80 mm Hg, pulse is 80/min and regular, respirations are 20/min, and pulse oximetry shows 95% on room air.  BMI is 19.1 kg/m2.  After walking for 6 minutes at his usual pace, his oxygen saturation on room air is 92%. 

A 47-year-old man comes to the office in mid-January due to persistent high-grade fever, headache, and severe myalgias that began abruptly 4 days ago.  The patient also has sore throat, nonproductive cough, and mild nasal congestion but no shortness of breath or chest pain.  It has been >5 years since his last appointment, and he is not up to date on health maintenance or immunizations.  The patient has no chronic medical problems, takes no medications, and has no known drug allergies.  Temperature is 38.5 C (101.3 F), blood pressure is 135/80 mm Hg, pulse is 88/min, and respirations are 16/min.  Oxygen saturation is 98% on room air.  Physical examination shows a mildly erythematous oropharynx with normal tonsils.  No significant cervical lymphadenopathy is present.  Breath sounds are clear and equal bilaterally with no dullness to percussion or egophony.  Heart sounds are normal. 

Our volunteer team is headed to Bahir Dar, Ethiopia, to provide free pediatric ENT and urology surgeries, along with vital medical education and training.

CSI's ultimate goal is to equip communities to care for their own children, paving the way for lasting, sustainable change.

Pre-screening take place on Saturday and surgeries begin Monday!

Bahir Dar university Tibebe Ghion Specialized Hospital Information Center
College of Medicine and Health Sciences, Bahir Dar University, Ethiopia.

Children's Surgery International (CSI)



@Nitsbinteam

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