Doctors pages

12/08/2025

This photo changed the world.
In 1987, Dr. Zbigniew Religa had just completed a 23-hour heart transplant surgery. His patient lay stable in the background - alive - while the doctor sat beside him, exhausted but watchful, surrounded by the aftermath of the procedure.
The photo became iconic. (Top photo)
30 years later, that patient was still alive - and Dr. Religa had passed away. (Bottom photo)
This is more than a picture. It's a reminder of what it means to dedicate your life to others.

Here is the Al-animated version of the photo

22/07/2025

Meanings of color-coded strips on medicine packaging.

- *Red Line*: Indicates prescription-only drugs (Schedule H/H1), which require a doctor's prescription and may include antibiotics, steroids, and psychiatric medications. Misuse can lead to resistance or severe side effects.
- *Green Line*: Denotes over-the-counter (OTC) medicines that do not require a prescription and are generally safe for minor issues like fever, cold, or acidity. These are common in everyday households.
- *Blue Line*: Signifies Schedule G drugs that should be taken under medical supervision, often including hormonal or long-term therapy drugs. Labels may carry a "Caution" warning, indicating potential dangers if taken without medical supervision.
- *Black Box Warning*: Highlights high-risk drugs (FDA) that indicate serious or life-threatening risks, requiring careful monitoring. These are commonly used in cancer therapies and antidepressants.

Understanding these color codes empowers patients and healthcare professionals to make informed decisions about medication use.
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04/07/2025

Here’s a comprehensive overview of diuretics, their types, examples, mechanisms, indications, and key side effects:

💧 What Are Diuretics?

Diuretics are medications that increase urine output by acting on the kidneys, helping the body eliminate excess sodium and water. They're used in hypertension, heart failure, edema, and certain kidney diseases.

🔹 Types of Diuretics

1. Loop Diuretics

Examples: Furosemide, Bumetanide, Torsemide

Site of Action: Loop of Henle (thick ascending limb)

Mechanism: Inhibit Na⁺/K⁺/2Cl⁻ co-transporter

Uses:

Acute pulmonary edema

Congestive heart failure (CHF)

Severe hypertension

Side Effects:

Hypokalemia

Dehydration

Ototoxicity

Hypocalcemia

2. Thiazide Diuretics

Examples: Hydrochlorothiazide, Chlorthalidone, Indapamide

Site of Action: Distal convoluted tubule

Mechanism: Inhibit Na⁺/Cl⁻ symporter

Uses:

Hypertension (1st-line)

Mild CHF

Nephrogenic diabetes insipidus

Prevention of calcium kidney stones

Side Effects:

Hypokalemia

Hyperglycemia

Hyperuricemia (gout)

Hyperlipidemia

Hypercalcemia

3. Potassium-Sparing Diuretics

Examples:

Aldosterone antagonists: Spironolactone, Eplerenone

ENaC blockers: Amiloride, Triamterene

Site of Action: Collecting ducts

Mechanism: Inhibit sodium reabsorption while retaining potassium

Uses:

CHF

Cirrhosis-related ascites

Primary hyperaldosteronism (Conn’s)

Combined with other diuretics to prevent hypokalemia

Side Effects:

Hyperkalemia

Spironolactone → gynecomastia, menstrual irregularities

4. Carbonic Anhydrase Inhibitors

Example: Acetazolamide

Site of Action: Proximal tubule

Mechanism: Inhibits carbonic anhydrase → ↓ HCO₃⁻ reabsorption

Uses:

Glaucoma

Altitude sickness

Metabolic alkalosis

Pseudotumor cerebri

Side Effects:

Metabolic acidosis

Hypokalemia

Renal stones

5. Osmotic Diuretics

Example: Mannitol

Site of Action: Proximal tubule & loop of Henle

Mechanism: Increases osmotic pressure in filtrate → inhibits water reabsorption

Uses:

Cerebral edema

Raised intracranial or intraocular pressure

Acute renal failure (early phase)

Side Effects:

Fluid overload in heart failure

Electrolyte imbalance

📌 Summary Table

Type Main Drug(s) Key Use Risk

Loop Furosemide CHF, edema, HTN Hypokalemia, ototoxicity
Thiazide HCTZ, Chlorthalidone HTN, nephrolithiasis ↑Glucose, ↑Ca²⁺, ↓K⁺
K⁺-sparing Spironolactone CHF, hyperaldosteronism Hyperkalemia
Carbonic Anhydrase Acetazolamide Glaucoma, altitude sickness Acidosis, ↓K⁺
Osmotic Mannitol Cerebral edema Fluid overload

04/07/2025

1. Thrombosis

Definition: Formation of a blood clot (thrombus) inside a blood vessel.

Effect: Obstructs blood flow.

Causes: Injury to vessel wall, stasis, hypercoagulability (Virchow’s triad).

Example: Deep vein thrombosis (DVT).

2. Embolism

Definition: A traveling clot or material (embolus) that lodges in a distant vessel.

Types: Thromboembolism (most common), fat embolism, air embolism.

Effect: Sudden blockage of blood flow.

Example: Pulmonary embolism (PE).

3. Spasm

Definition: Sudden, temporary constriction of a blood vessel.

Effect: Reduces blood supply (ischemia).

Example: Coronary artery spasm → angina.

4. Atheroma

Definition: A fatty plaque within the inner layer of an artery.

Effect: Narrows lumen, reduces elasticity.

Leads to: Atherosclerosis, risk of clot formation.

5. Compression

Definition: External pressure on a blood vessel, reducing or blocking flow.

Causes: Tumors, tight casts, hematomas, or anatomical abnormalities.

Effect: Ischemia or venous congestion.

6. Vasculitis

Definition: Inflammation of blood vessel walls.

Effect: Vessel wall damage, narrowing, rupture, or blockage.

Causes: Autoimmune diseases, infections.

Examples: Giant cell arteritis, Kawasaki disease.

7. Steal Phenomenon

Definition: Blood is “stolen” from one vascular territory to supply another, usually due to abnormal connections or vasodilation.

Effect: Ischemia in the under-perfused area.

Example: Subclavian steal syndrome.

8. Hyperviscosity

Definition: Thickened blood, leading to sluggish flow.

Causes: High red cell count (polycythemia), multiple myeloma (high proteins).

Effect: Risk of thrombosis, poor tissue perfusion

11/02/2025

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09/02/2025

Did you know the difference?

08/02/2025

08/02/2025

Mounting and removing the blade of scalpel.

07/02/2025

Lists of Drug of Choice!

06/02/2025

Types of shock.

27/01/2025

A rare and unusual case was reported in China, where doctors surgically removed a malformed twin from the brain of a 1-year-old girl.

The little girl had shown signs of developmental delays and had an unusually large head, leading to the discovery. The mass was actually a partially formed twin, with bones like a spine, arms, and even finger-like buds.

This rare condition, known as fetus-in-fetu, happens in about 1 in 500,000 births, where one twin grows inside the other.

Fetus-in-fetu is often mistaken for a type of tumor, but it can be identified by the presence of actual body parts.

While most cases involve the mass growing in the abdomen, it's incredibly rare for it to be found in the brain. Fewer than 200 cases have been documented worldwide, and this adds to the small number of cases where the twin developed in such an unusual location.

Learn more: https://www.neurology.org/doi/10.1212/wnl.0000000000201578

08/01/2025

In 1990, a nurse named Vilma Wong cared for a tiny premature baby fighting for survival in her NICU.
Twenty-eight years later, that same baby just walked into her hospital... as a pediatric resident doctor!
Now they work side by side, saving other babies together.
Isn't it beautiful how life comes full circle sometimes?