https://www.firstclassmed.com/articles daily 0.75 2023-05-09 https://www.firstclassmed.com/articles/2023/murmurs-second-coming monthly 0.5 2023-07-11 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/5965b3d5-62e4-4d46-8e15-0963b2b7b109/IMG_602249B97D6F-1.jpeg Articles - Murmurs - A Second Coming - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/57a41c3b-bc4c-4be2-ab58-68fe16ea246f/56D88535-1C60-43A5-9B99-7BC55D86E193.jpeg Articles - Murmurs - A Second Coming - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.firstclassmed.com/articles/2023/oha-sulphonylureas monthly 0.5 2023-04-07 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/6a96b42d-715e-4202-bb2e-0870ddc82065/Screenshot+2023-04-05+at+5.37.09+PM.png Articles - OHA Series - Sulphonylureas - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.firstclassmed.com/articles/2023/OHA-metformin monthly 0.5 2023-04-05 https://www.firstclassmed.com/articles/2023/fissure-in-ano monthly 0.5 2023-02-17 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/22cc7651-b8be-4bbe-9b7b-f8da8db7e908/IMG_0966.PNG Articles - Fissure-in-ano - A painful embarrassment - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/b3b37836-da79-4e50-bb76-ad0716d2c6db/IMG_0965.PNG Articles - Fissure-in-ano - A painful embarrassment - Make it stand out Fig 4 - Frequency of fissure location https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/0322d72d-92d6-4a3d-b3ca-94687e4052c4/IMG_0972.PNG Articles - Fissure-in-ano - A painful embarrassment - Make it stand out Fig 1 - Anatomy of the Anal Canal https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/13e7a203-007e-4e8a-9274-c2e669b01fa3/IMG_0963.PNG Articles - Fissure-in-ano - A painful embarrassment - Make it stand out Fig 3 - Difference in morphology of acute vs chronic fissure https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1d2da935-2b54-4c89-9510-123de847cc1a/IMG_0964.PNG Articles - Fissure-in-ano - A painful embarrassment - Make it stand out Fig 2 - Inspection showing a fissure-in-ano https://www.firstclassmed.com/articles/2023/a-complete-anorectal-exam monthly 0.5 2023-02-15 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/8d812277-5723-44d8-a3d6-bbdce3ef914d/IMG_0967.PNG Articles - The Complete Anorectal Examination - An Art Forgotten - Make it stand out Fig 1: The prone jack-knife position on a proctoscopic table https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/add7761e-05f1-44db-9792-a204bb801922/IMG_0971.PNG Articles - The Complete Anorectal Examination - An Art Forgotten - Make it stand out Fig 3: Different types of Hirschmann anoscopes with obturator. The last one is a paediatric scope Courtesy - The ASCRS textbook of Colon and Rectal Surgery, 3rd Ed https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/4380f2c2-11c5-4418-bf65-813611df333b/IMG_0968.PNG Articles - The Complete Anorectal Examination - An Art Forgotten - Make it stand out Fig 2: Sims’ position used during endoscopy https://www.firstclassmed.com/articles/2023/pathophysiology-of-als monthly 0.5 2023-02-15 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/fac9a478-41fb-471f-a5cb-ee0da62d346f/Screenshot+2023-02-09+at+11.35.57+AM.png Articles - Pathophysiology of Amyotrophic Lateral Sclerosis - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.firstclassmed.com/articles/2023/pathophysiology-acute-bacterial-meningitis monthly 0.5 2023-02-15 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/b240fadf-6cb5-45b7-9e10-2a986fc1e10a/Screenshot_2020-04-24_at_7.43.13_PM.png Articles - Pathophysiology of Meningitis - Make it stand out Pathophysiology of acute bacterial meningitis from Harrison. https://www.firstclassmed.com/articles/2023/hacekorganisms monthly 0.5 2023-02-06 https://www.firstclassmed.com/articles/2022/pterygium monthly 0.5 2022-08-21 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/7a4e97c6-2bab-4900-b81a-f4f1536eaa96/ptery.jpg Articles - Pterygium - A Winged Menace - Make it stand out Image: Rajan Eye Care Hospital. https://www.firstclassmed.com/articles/2021/basic-classification-of-seizures monthly 0.5 2023-01-31 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/66430df5-1a37-446d-87c0-0656e58740d7/Screenshot+2021-11-19+at+9.52.35+AM.png Articles - Basic Classification of Seizures - Make it stand out For more such images and content head over to The Crimson Dot Instagram page. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/2f1cbdb4-c775-4b58-ad42-6a0fcd778e79/seizure-types.png Articles - Basic Classification of Seizures - Make it stand out Reproduced from the website of the Epilepsy Foundation. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/32c6043b-f250-4d4c-acc0-381b9f5d3037/Screenshot_2020-01-20_at_12.00.11_PM.png Articles - Basic Classification of Seizures - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.firstclassmed.com/articles/2021-hypertensive-retinopathy monthly 0.5 2022-08-21 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/0c36a98d-f804-414d-b37b-76e435932c28/photo_2021-11-07+19.53.27.jpeg Articles - Hypertensive Retinopathy - The Stealthy Blindness - Make it stand out Image credit: Dr. Madhuvanthi Mohan For more such ophthalmology related images and content, visit Ophthalmobytes on Instagrm. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/2a84ae0e-3d1f-4ab6-aec3-0ea04173f91f/photo_2021-11-07+19.53.31.jpeg Articles - Hypertensive Retinopathy - The Stealthy Blindness - Make it stand out Image credit: Dr. Madhuvanthi Mohan For more such ophthalmology related images and content, visit Ophthalmobytes on Instagrm. https://www.firstclassmed.com/articles/2019/sinus-tachycardia monthly 0.5 2021-11-08 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1574230355619-565U8L2VGL849PN4BJE8/Screenshot+2019-11-19+at+5.50.51+PM.png Articles - Sinus Tachycardia - Defining the Normal How electrical currents are translated into waves on the ECG. Reproduced from Goldberger’s Clinical Electrocardiography, 9th Edition https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1574230453459-UAF4MC7CSMBHHNR61Y6I/Screenshot+2019-11-19+at+5.43.47+PM.png Articles - Sinus Tachycardia - Defining the Normal The location of the SA node and the various deflections a sinus rhythm produces on an ECG in various leads. Reproduced from Harrisons Principles of Internal Medicine, 20th Edition https://www.firstclassmed.com/articles/2019/supraventricular-tachycardias monthly 0.5 2019-11-20 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573741511958-U8G9TZ40TDGT2VZWPQAH/Screenshot%2B2019-11-14%2Bat%2B7.49.05%2BPM.jpg Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos Image showing origin of atrial tachycardias. Notice the changes in the ECG caused by new source of electrical impulses. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573740040924-KVJDHM2SJ9VB0AYNFHI1/Screenshot+2019-11-14+at+7.30.23+PM.png Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos These are the two ways in which supraventricular tachycardias are initiated. (A) shows a focal stimulus firing repeatedly. (B) shows the mechanism of a reentry pathway. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573740518940-GDPEXE8NEZHF7K4VZG1E/Screenshot%2B2019-11-14%2Bat%2B7.37.37%2BPM.jpg Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos ECG showing atrial flutter in lead II and III where as in lead I there is barely any signs of a pathology. The classic “saw tooth appearance” is seen in leads II and III. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573742010852-AZ73UK2Z3WC6VJGSPVUW/Screenshot%2B2019-11-14%2Bat%2B7.49.05%2BPM.jpg Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos Image showing a reentrant pathway through the ventricles. This is called an accessory pathway. The presence of such accessory pathways can lead to supra ventricular tachycardias as well. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573740902049-ACRK7DLIOD6AGTVTZ3PV/Screenshot+2019-11-14+at+7.44.46+PM.png Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos ECG showing multifocal atrial tachycardia. Note that the morphology of the P waves in the consecutive beats is not the same, suggesting that the beats are originating from different places. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573740726116-HAMEW7JGG7PZHM7IX95R/Screenshot+2019-11-14+at+7.41.52+PM.png Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos ECG showing Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573741233923-FVRVYB57XKY645NOR6QH/Screenshot%2B2019-11-14%2Bat%2B7.49.05%2BPM.jpg Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos Image showing the normal conduction pathway and the ECG deflections in produces. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1573741785934-ZPMIELH77EGEAUVK8WZG/Screenshot%2B2019-11-14%2Bat%2B7.49.05%2BPM.jpg Articles - Supraventricular Tachycardias - The Narrow Waves of Chaos Image showing the electrical impulse going haywire in the AV node and causing the impulse to be conducted back into the atrial. This phenomenon can cause supraventricular tachycardia. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://www.firstclassmed.com/articles/2019/heart-block monthly 0.5 2019-11-14 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572952754678-IGT077EWG3Q07J52SIEW/Screenshot%2B2019-11-05%2Bat%2B4.48.08%2BPM.jpg Articles - Heart Block - An Electrical Travel Delay Note that the PR interval is prolonged (>o.2 sec) and that it is equal with each successive beat. Reproduced from Goldberger’s Clinical Electrocardiography, 9th Edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572952982551-T1XLP2URG9D4I3V6ZYT1/Screenshot+2019-11-05+at+4.52.49+PM.png Articles - Heart Block - An Electrical Travel Delay Note how there is progressive increase in the PR intervals in the first three beats. In the fourth beat, there is a P, but no QRS complex, signifying the dropped beat. Reproduced from Goldberger’s Clinical Electrocardiography, 9th Edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572954343217-QSVH46OS3OET7EJ4OVBQ/Screenshot+2019-11-05+at+5.14.45+PM.png Articles - Heart Block - An Electrical Travel Delay Causes of heart block or AV block Reproduced from Harrison’s Principles of Internal Medicine, 20th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572953138480-09VUC4YNJWQJ3FCTZF0E/Screenshot+2019-11-05+at+4.55.24+PM.png Articles - Heart Block - An Electrical Travel Delay Note how all the PR intervals are of the same duration. Two beats are followed by a missed beat without any evidence. Reproduced from Goldberger’s Clinical Electrocardiography, 9th Edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572956221361-46ROFY1XKOH2RH7NAAA8/h101+%281%29.jpg Articles - Heart Block - An Electrical Travel Delay https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572955085349-1ABH2L3V019FBQWLMJMF/image-asset.jpeg Articles - Heart Block - An Electrical Travel Delay https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572954084795-3K34HY935WOMVSM8D588/Screenshot+2019-11-05+at+5.00.08+PM.png Articles - Heart Block - An Electrical Travel Delay https://www.firstclassmed.com/articles/2019/sa-node-disorders monthly 0.5 2019-11-05 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572022641002-0HW88N6SSPKM31N2SSYJ/Screenshot+2019-10-25+at+10.22.34+PM.png Articles - Disorders of the Sinoatrial Node - When a Hero Falls Location of pacemaker tissue. Reproduced from Harrison’s Principles of Internal Medicine 20th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572024556108-NXWDNC28M84BAES55QHV/Screenshot%2B2019-10-25%2Bat%2B10.50.23%2BPM.jpg Articles - Disorders of the Sinoatrial Node - When a Hero Falls ECG showing 2:1 sinus exit block. Notice that the heart rate is normal and inbetween that there is a dropped P wave signifying a missed beat. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572024985255-KKPBAFO9PWRVXW9QTWOR/Screenshot%2B2019-10-25%2Bat%2B10.50.11%2BPM.jpg Articles - Disorders of the Sinoatrial Node - When a Hero Falls This ECG shows the tachycardia bradycardia syndrome in which tachycardia (in this case atrial fibrillation) leads to bradycardia due to overdrive suppression of the SA node. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572024280819-9CMMAN31M4IFOQI1SRZG/Screenshot%2B2019-10-25%2Bat%2B10.50.31%2BPM.jpg Articles - Disorders of the Sinoatrial Node - When a Hero Falls ECG showing sinus pause. Notice how after five beats there is a long pause. Here the SA node fails to fire despite there already being an underlying bradycardia. Reproduced from Goldberger’s Clinical Electrocardiography, 9th edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572022822324-LA93HPRXCOB5CT7LWN0Q/Screenshot+2019-10-25+at+10.29.56+PM.png Articles - Disorders of the Sinoatrial Node - When a Hero Falls Causes of sinoatrial nodal disease. Reproduced from Harrison’s Principles of Internal Medicine 20th edition. https://www.firstclassmed.com/articles/2019/introduction-to-arrhytmias monthly 0.5 2019-10-25 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1571921434830-4ORRGAUMP2OBUPWPIPUT/Screenshot%2B2019-10-24%2Bat%2B6.07.59%2BPM.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma Electrical conduction system of the heart. Reproduced from Grant’s Atlas Of Anatomy 13th Edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1571924080133-QO3VNU6J91EJ2XOC7L2W/Screenshot%2B2019-10-24%2Bat%2B6.56.41%2BPM.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma Fibrous rings separating the atria from the ventricles. Reproduced from Grant’s Atlas Of Anatomy 13th Edition. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1571922762662-PJ7H9S7NUZW1YTD9QTDQ/Screenshot%2B2019-10-24%2Bat%2B6.40.22%2BPM.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma Normal Electrocardiogram. Reproduced from Goldberger’s Clinical Electrocardiography 9th Edition https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572028672322-VH8JG2MXIS0IX5BQUPCG/conduction-system-2.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma Illustration showing the cardiac conduction apparatus and the reflection of the electrical activity of the heart on ECG. Reproduced from Ganong’s Review of Medical Physiology. https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1572028821554-HSODZ38ZMNNFX01OF4VN/1a63d0480a59b9f264748f4b84dd669b.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1571924523827-8ICIC63GMDAI2H590PU0/Untitled.jpg Articles - Introduction to Arrhythmias - An Electrical Enigma Our heart as an electrical circuit. Atria contract in parallel. Ventricles contract in parallel. But atria and ventricles contract in series. https://www.firstclassmed.com/articles/2019/heart-failure monthly 0.5 2019-10-24 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1566827659181-ZM2YYND950IUD68FINH8/Systolic-vs-Diastolic-Heart-Failure.jpg Articles - The Pathophysiology of Heart Failure - A biological civil war https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1566827762912-QMSS8NMD9F1G8BE6X19S/Screenshot+2019-08-01+at+11.58.43+AM.png Articles - The Pathophysiology of Heart Failure - A biological civil war https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1566827693175-KEQJMQ370MW2FAUGE5JK/Screenshot+2019-08-01+at+11.44.58+AM.png Articles - The Pathophysiology of Heart Failure - A biological civil war https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1566827850183-TYLNC0S3BM2NE5WEO3QP/Screenshot+2019-08-26+at+6.55.04+PM.png Articles - The Pathophysiology of Heart Failure - A biological civil war https://www.firstclassmed.com/articles/2018/scid monthly 0.5 2019-10-24 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1545306340128-M0QWD37OYNYRXFDECCW2/B9780323088541000278_f27-10-9780323088541.jpg Articles - Severe Combined Immunodeficiency - The Story of Bubble Boy https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1545305916657-ZKFAJKE5ROH5WKQE8G4Q/The-Boy-in-the-Bubble-David-Vetter-615x321.jpg Articles - Severe Combined Immunodeficiency - The Story of Bubble Boy https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1545305964687-M428IOCFIDMJBNAFSLN3/david-vetter-gall6.jpg Articles - Severe Combined Immunodeficiency - The Story of Bubble Boy https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1545304104810-QBUIVDGPSCY7FM81CJRU/Immune_system_large.jpg Articles - Severe Combined Immunodeficiency - The Story of Bubble Boy https://www.firstclassmed.com/articles/2018/immune-checkpoint-therapy monthly 0.5 2018-12-20 https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1542896202341-K74RH7Z8OW5GBPXUXR4Q/Screenshot+2018-11-22+at+7.46.04+PM.png Articles - Immune Checkpoint Therapy - Rearming Our Body Against Cancer https://images.squarespace-cdn.com/content/v1/5908027c20099e374ad3d70e/1542895683888-RS4MAK23ME0K8DV5WLPX/Screenshot+2018-11-22+at+7.37.46+PM.png Articles - Immune Checkpoint Therapy - Rearming Our Body Against Cancer These are the pillars of cancer treatment. 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