1) PTSD : CBT 2) Parasuicide : cuts 3) Alcohol dependence : Phenytoin has no role 4) Single neurotransmitter disease : parkinsonism 5) Haloperidol 10mg, uprolling of eyeballs : dystonia Kawasaki not seen in adults No meconium passed for 48 hrs, inv is lower gi contrast study Resp distress ques ..The child had no pneumonia (RR below 50), only cough and cold Ominous sign in neonate was conjugated hyperbilirubinemia. Intermittent watery discharge from umbilicus is patent urachus/urachal fistula Head trauma IOC:NCCT head Image-Rosacea Image-Bullous pemphigoid Burr hole-On the same side of the dilated pupil Le Veen shunt-Between peritoneum and Superior venacava Dexmedetomidine-Central alpha 2 agonist fibrous cortical defect sure cftr mutation sure pure gonadal dysgenesis sure patch clamp metod sure hartnup disorder crpc39 aldolase b antoni a and b intussuception origin from ischiopubic rami non cotrast ct neurosecretory granule gucocorticoid goserelin stab in abdomen mapelson a ecmo listeria monocytogen congenital lobar emphysema gouty arthritis volar tilt asses airway all sure when the bone lesion grows too fast and the periosteum does not have enough time to lay down a new layer, the Sharpey's fiber stretch out perpendicular to the bone, and later get calcified to give sun ray appearance.. Sharpey's fibres are connective tissue matrix composed of collagen fibres, blood vessels and nerve fibres.. Sharpey's fibres connect the periosteum to the bone.. The calcification appears along blood vessels in Sharpey's fibers.. So it is understood that 1)Sun ray/burst appearance is due to calcification of blood vessels in Sharpey's fibres. 2)It is NOT due to periosteal reaction. Periosteal reaction results in new bone formation as you see in Codmans triangle.