Shoaib Kanwal Academy

Revised PG induction policy 2026

🛑 بی ایس این داخلوں کے اہم نکات
• داخلے چند دنوں میں کھلنے والے ہیں۔
• صبح اور شام دونوں شفٹوں میں کسی قسم کا وظیفہ نہیں دیا جائے گا۔
• این کیٹ ٹیسٹ صرف اتھارٹی کی منظوری کی صورت میں ہوگا؛ فی الحال اس کی حتمی تصدیق نہیں ہوئی۔
• میرٹ مکمل طور پر ایف ایس سی نمبروں کی بنیاد پر بنایا جائے گا، اور اگر ایف ایس سی کے نمبر برابر ہوں تو میٹرک کے نمبروں کو ترجیح دی جائے گی۔
• نشستوں کی تعداد:
• صبح کی شفٹ: 3100 نشستیں
• شام کی شفٹ: 1400 نشستیں
• تمام منتخب طلبہ کو ہاسٹل کی سہولت اور پیڈ انٹرنشپ فراہم کی جائے گی۔

Diabetes Management Components

BNP & NT-proBNP
💓 BNP & NT-proBNP — Diagnostic Pearls for Heart Failure

✅ 1. Rule in/out Acute Heart Failure
BNP > 500 pg/mL or NT-proBNP > 1800 pg/mL strongly suggests acute heart failure.

BNP < 100 or NT-proBNP < 300 practically rules it out in most patients.

🧠 Think of BNP as a "quick cardiac rule-in/out tool" in the ER for dyspnea.

✅ 2. Age-Specific Cutoffs (NT-proBNP)
450 pg/mL suggests HF

50–75 years → >900 pg/mL

75 years → >1800 pg/mL

📌 Always adjust for age, especially in elderly patients.

✅ 3. Consider Renal Function
Renal failure (↓ GFR) increases BNP/NT-proBNP even without heart failure.

🧪 Check creatinine or eGFR alongside BNP.

✅ 4. Obesity Masks Elevated BNP
Obese patients often have artificially low BNP despite heart failure.

🔍 Lower-than-expected BNP? Look at BMI – high BMI = possibly false low BNP.

✅ 5. Monitor Treatment Response
Serial BNP measurements can monitor heart failure therapy.

📉 Decreasing BNP = improving condition
📈 Rising BNP = consider treatment escalation

✅ 6. Differentiate Cardiac vs Non-Cardiac Dyspnea
BNP can help distinguish cardiac causes of breathlessness from pulmonary (e.g., COPD, asthma).

📌 BNP > 500 = likely cardiac origin
📌 BNP < 100 = likely non-cardiac

✅ 7. BNP and Prognosis
High BNP = worse prognosis in HF, ACS, sepsis, and post-op patients.

⚠️ Persistently high BNP after treatment = increased mortality risk.

✅ 8. Use in HFpEF (Preserved EF)
Even in preserved EF (>50%), BNP is elevated if diastolic dysfunction or HFpEF exists.

🧠 Don't rely on EF alone — BNP helps uncover HFpEF.

✅ 9. Beware of False Positives
BNP can be elevated in:

Pulmonary embolism

Sepsis

Pulmonary hypertension

Myocardial infarction

Stroke

✅ Always interpret BNP in clinical context!

✅ 10. Drug Interactions Affecting BNP
ARNIs (e.g., sacubitril/valsartan) inhibit neprilysin → BNP falsely elevated, but NT-proBNP remains reliable.

✔️ Use NT-proBNP, not BNP, in patients on sacubitril-containing therapy.

💡 Bonus Tip:

BNP = biologically active, short half-life (~20 min)
NT-proBNP = inert, longer half-life (~120 min) → more stable, preferred for monitoring

Causes of chronic constipation

CPAP (Continuous Positive Airway Pressure) and BIPAP (Bilevel Positive Airway Pressure) are both types of non-invasive ventilation therapies used primarily to treat sleep-related breathing disorders like sleep apnea, but they can also help in other respiratory conditions.

CAP Guidelines

2025 AHA/ACC Hypertension Guideline Summary

Treatment of VTE (DVT/PE)
1.Loading dose of apixaban 10mg BD x7 days followed by 5mg BD thereafter or
2.Loading dose of Rivaroxaban 15mg BD x21 days followed by 20mg OD thereafter

Stroke prevention in Afib
1.Apixaban 5mg BD or
2.Rivaroxaban 20mg OD (15mg OD if CrCl is 15-50ml/min)
No loading dose is required in afib

However the dose of apixaban is reduced in afib to 2.5 mg BD in patients who meet at least two of the following three criteria:
1.age ≥80 years
2.body weight ≤60 kg
3.serum creatinine ≥1.5 mg/dL.