Mam, you are our tuition teacher.. Most of the times, you are making our subject more clear with good logical explanation.. Kindly do support us with your extraordinary academic interest.. 🙏🙏🙏

Medam you are doing a great job

Thumbs up man, pls post 2 nd part😊

Very nice

Yes mam. Make class on congenital heart disease very difficult to understand that topic

Nice👍

Excellent madam TQ madam 🙏🙏

I wish I had brain like yours 🙏🏻🙏🏻🙏🏻

Best

Madam please take classes on recent advances in pediatrics

Ma’am Plz make a video on upcoming DNB Theory exam on 24th aug reg question to expect topic wise

Second heart pls

😊

Isolated such rest sick cycle without other features?

Mam part 2??

Regarding paroxysmal nocturnal dyspnoea.. Early predictor of CCF.. In lying posture, Increased preload due to venous return from lower limbs Increased inflow in left ventricle which couldn't completely pump out due to early stages of failure.. Where end diastolic volume will increase and pressure too increase.. It reflects in left atrium to pulmonary capillary.. Pulmonary congestion . This sequence takes 3-4 hours to happen.. Usually around 2 am.. Patient will wake up.. Once the position changed from lying to sitting, patient would felt comfortable.. In later stage, this sequence happens whenever patient resumes lying posture due to failure advances ..called orthopneoa..