" We observe that our society is changing very fast. In the era of 21st century education is must. Today criteria of education is English Speaking. If one knows English speaking He / She is considered to be highly qualified and knowledgeable person. Because of certain reason vast portion of our society is unable to speak English. Reason may be studies in vernacular medium or lack of speaking practice. We want this deprived section to speak fluent English so that nobody can dominate them."
| Feature | Points | Details / Notes | | :--- | :---: | :--- | | | 3 | Both positive (Walker-Murdoch & Steinberg signs). | | Wrist OR thumb sign | 1 | Only one of the two is positive. | | Pectus carinatum (pigeon chest) | 2 | Chest protrudes outward. | | Pectus excavatum (funnel chest) | 1 | Chest is indented inward. | | Hindfoot deformity | 2 | Pes planus (flat feet) with heel valgus (tipping inward). | | Plain pes planus | 1 | Flat feet without heel deformity. | | Pneumothorax (spontaneous) | 2 | Collapsed lung without trauma (history of ≥1). | | Dural ectasia | 2 | Widening of spinal dura (seen on lumbar MRI or CT). | | Protrusio acetabuli | 2 | Hip socket bulging inward (on X-ray). | | Reduced upper segment / lower segment ratio | 1 | Arm span > height by >7.5cm in adults. | | Scoliosis or kyphosis | 1 | Spinal curvature (≥20° or surgical history). | | Elbow extension reduced | 1 | Unable to fully straighten elbow (<170°). | | Facial features (≥3 of 5) | 1 | Dolichocephaly, enophthalmos, downslanting palpebral fissures, malar hypoplasia, retrognathia. | | Skin striae (stretch marks) | 1 | Unexplained striae (not from weight gain/pregnancy). | | Myopia > 3 diopters | 1 | Severe nearsightedness. | | Mitral valve prolapse | 1 | Confirmed by echocardiogram. | Part 2: Major Diagnostic Criteria (for context) The Revised Ghent uses these as gateway criteria, not independent points:
| Feature | Points | Details / Notes | | :--- | :---: | :--- | | | 3 | Both positive (Walker-Murdoch & Steinberg signs). | | Wrist OR thumb sign | 1 | Only one of the two is positive. | | Pectus carinatum (pigeon chest) | 2 | Chest protrudes outward. | | Pectus excavatum (funnel chest) | 1 | Chest is indented inward. | | Hindfoot deformity | 2 | Pes planus (flat feet) with heel valgus (tipping inward). | | Plain pes planus | 1 | Flat feet without heel deformity. | | Pneumothorax (spontaneous) | 2 | Collapsed lung without trauma (history of ≥1). | | Dural ectasia | 2 | Widening of spinal dura (seen on lumbar MRI or CT). | | Protrusio acetabuli | 2 | Hip socket bulging inward (on X-ray). | | Reduced upper segment / lower segment ratio | 1 | Arm span > height by >7.5cm in adults. | | Scoliosis or kyphosis | 1 | Spinal curvature (≥20° or surgical history). | | Elbow extension reduced | 1 | Unable to fully straighten elbow (<170°). | | Facial features (≥3 of 5) | 1 | Dolichocephaly, enophthalmos, downslanting palpebral fissures, malar hypoplasia, retrognathia. | | Skin striae (stretch marks) | 1 | Unexplained striae (not from weight gain/pregnancy). | | Myopia > 3 diopters | 1 | Severe nearsightedness. | | Mitral valve prolapse | 1 | Confirmed by echocardiogram. | Part 2: Major Diagnostic Criteria (for context) The Revised Ghent uses these as gateway criteria, not independent points: