Dr. Wek A. Agany Wek

03/11/2025

A 45 years old male patient came to OPD with complaints of epigastric pain for several weeks radiating up under his chest and worsen on lying flat for an hour. He also had a "brackish"taste in his mouth and sore throat. What is the next management?

A. Ranitidine
B. liquid antacid
C. Lansoprazole
D. Endodoscopy
E. Barium swallow

30/10/2025

"Doctors listen when the body speaks"

10/10/2025

Two friends were touring around market; accidentally an quittance friend was passing besides and insulted them. One guy got annoyed and shouted at him demanding an apology. The other guy just smiles at acquittance friend who insulted both of them as if nothing had happened.

Therein, the insulter was reduced to nothing by a man who did not demand apology from him though the insult was entitled to both of them.

👉 In summary, it is up to you to control your emotion or else you leave your emotion to control you.

20/08/2025

Don't confuse your path with destination. The path may be rocky now, but it is going to lead you to amazing places.

16/08/2025

"Don't test deepness of river with your both legs"

16/08/2025

Don't lose your smile running through all these hurdles. Look at all people running along with you, if they do smile while running. Then why not you too?

"Be like stem cells, differentiate yourself from others."

15/08/2025

is consolidation?

It means pneumonia, defined as inflammation in the lung parenchyma characterized by accumulation of secretions and inflammatory cells of alveoli.

# Types of pneumonia

1. Anatomically of 2 types
* Lobar: Commonly involves one or more lobes
* Lobular (bronchopneumonia): It is characterized by patchy alveolar opacity with bronchial and bronchiolar inflammation.

2. Clinically of 4 types:

* community acquired pneumonia (CAP)
* Nosocomial (hospital acquired)
* Suppurative and aspiration pneumonia
* Pneumonia in immunocompromised

# What are the causes of CAP?

1. Typical organisms: the most common cause is streptococcus pneumoniae 50% of cases.
2. Atypical organisms: Mycoplasma pneumoniae

# What are pathological stages of CAP?
There are 4 stages:

* Stage of congestion: It persists for 1 to 2 days.
* Stage of red hepatization: It persists for 2 to 4 days.
* Stage of grey hepatization: It persists for 4 to 8 days.
* Stage of resolution: Is from 8 to 9 days or more.

# Presentations of CAP:

* Fever with chill and rigor
* Cough
* Dyspnea and hemoptysis
* Pleuritic chest pain

# Risk factors of CAP:

* Age < 16 or > 65 years.
* Co- morbidities: HIV infection, diabetes mellitus and chronic renal disease.
* Upper respiratory tract infections
* Lifestyle; like cigarette smoking.

# Criteria of assessment for severity of CAP:
CURB-65 is criteria used to score severity of CAP.

* Confusion: minimal mental score of 8 or less.
* Urea: >7 mmol/l or >20 mg/dl.
* Respiratory rate: > 30 min.
* Blood pressure: ( systolic BP