الموت لن يُغيب الأبطال والعظماء،
لأن التأريخ سيخلدهم

♨️ فوائد مشروب القرنفل قبل النوم:
١/يطهر الكبد من السموم.
٢/يساعد في الهضم وعسر الهضم والانتفاخ.
٣/لنزلات البرد والسعال والبلغم والربو.
٤/لتقوية الذاكرة والتركيز.
٥/مفيد للقلب .
٦/يقوي المناعة.
٧/غسول للفم لتحسين رائحة الفم والتخلص من الجير.

ليس كل مريض ماشي ع ادويه ACEi نحوله إلى
ARBs
فيه عدة توصيات حول هذا ومنها مذكوره في الصوره
مع العلم الفايدة في ال ACEi اكثر في تنقيص الوفيات والأمراضية

ليس كل معلومة فارما تصح في الثيرابيوتك

#New
🛑Mineralocorticoid receptor antagonists for heart failure with preserved ejection fraction

✅In patients with HFpEF receiving optimal therapy with a diuretic and a sodium-glucose co-transporter 2 inhibitor with or without semaglutide who have persistent NYHA class II to III heart failure symptoms,we suggest adding a mineralocorticoid receptor agonist (MRA) (Grade 2C).
✅ In order to start an MRA (spironolactone, eplerenone, or finerenone) patients should be at low risk for hyperkalemia and have intact kidney function
#UPToDate2024

#remember

🛑Rheumatoid arthritis and cardiovascular disease

✅ischaemic heart disease: Rheumatoid arthritis carries a similar risk to type 2 diabetes mellitus

#Not and Note

🛑Aetiology of Rheumatoid arthritis

✅unknown
✅number of studies have suggested a link between Proteus mirabilis infection and the

development of RA, and this may contribute to the increased incidence of RA in women, who are more susceptible to UTI🤔

#Not and Note

✅مساء الخير نعتذر عن الانقطاع عن النشر كنت في اجازه زفافي وان شاءالله من اليوم راح يكون هناك نشر بشكل شبهه يومي ونحاول نعود بمعلومات مفيدة ان شاءالله ❤️❤️

🛑when we start antiepileptics in patient with epileptic seizure ?

✅Most neurologists now start antiepileptics following a second epileptic seizure.
✅ NICE guidelines suggest starting antiepileptics after the first seizure if any of the following are present:
✅ the patient has a neurological deficit
✅ brain imaging shows a structural abnormality
✅ the EEG shows unequivocal epileptic activity
✅ the patient or their family or carers consider the risk of having a further seizure unacceptable
✅Sodium valproate is considered the first line treatment for patients with generalised seizures with carbamazepine used for partial seizures

#Not and Note

🛑Absence seizures

✅Absence seizures (petit mal) are a form of generalised epilepsy that is mostly seen in children.

✅The typical age of onset of 3-10 years old and girls are affected twice as commonly as boys.

✅Absence seizures - good prognosis: 90-95% become seizure free in adolescence

✅Ethosuximide has much better safety profile than valproic aci considered first-line treatment

#Not and Note

🛑What is the likelihood of being seizure-free after a second or third antiepileptic is added?

✅ A study of patients with previously untreated epilepsy demonstrated that 47% achieved control of seizures with the use of their first single drug
✅ 14 % became seizure-free during treatment with a second or third drug.

#remember
✅Patients on long-term steroids should have their doses doubled during intercurrent illness(when you are unwell)

✅بالعربي كذا اذا كان المريض ماشي ع ادويه steroids بشكل مزمن مثل بعض مرضى nephrotic syndrome قد نحتاج إلى زياده الجرعه في حاله اصيب المريض باي وعكه صحيه مثل ارتفاع في درجه الحراره او خضع لعمليه جراحيه ...الخ في الصوره موضح الحالات
التي قد نحتاج إلى زياده الجرعه
#NUH
#Not and Note

🛑The relationship between type 2 diabetes and colonic cancer?

✅ Type 2 diabetes is associated with a 40-60% increase in the risk of cancer of the large bowel. This increase is linked to changes in HbA1

✅ No association has been found between colonic malignancy and type 1 diabetes, nor gestational diabetes.

✅ Increased concentrations of C peptide are a marker of increased colorectal cancer risk
#Not and Note

🛑Which lipid abnormalities are most likely to be detected in a patient with type 2 diabetes?

✅→Small dense LDL molecules

✅ small dense LDL is more atherogenic, able to be oxidised more readily and penetrate endothelium and macrophages.

✅LDL is not typically elevated in type 2 diabetes ➤
✅HDL is typically low in the patient with type 2 diabetes.

✅Triglycerides are often elevated with poor glycaemic control.

#Not and Note

🛑HbA1c is affected by many factors:
✅  Elevated HbA1c can occur in iron deficiency, vitamin B12 deficiency, alcohol dependence, chronic renal failure, hyperbilirubinaemia and splenectomy

✅ Reduced HbA1c can occur in chronic liver disease, hypertriglyceridaemia, some haemoglobinopathies, splenomegaly, rheumatoid arthritis and certain medications, including iron or vitamins B12 , C or E, antiretrovirals and dapsone.

#Not and Note

#remember

🛑Intravenous insulin is the optimal management of high blood sugar in acute myocardial infarction

#Not and Note