Amin Hamza

NUSU Graduate |

[Parky ,MD @Walk_yea]

A Urologist prescribed Tamsulosin to a woman !
What do you think maybe wrong with her?

[Ryan O'Keefe @ROKeefeMD]

Daily Pearl(s):

Why do we give rectal indomethacin after ERCP?

ERCP can lead to pancreatitis from papillary or ductal injury caused by cannulation, contrast, or trauma. NSAIDs keep the inflammatory cascade that drives that pancreatitis from propagating.

Smart people will tell you the rectal route is rapid-acting with reliable bioavailability. The other, more practical reason is that it can be given immediately after the procedure. You don’t have to wait for the patient to wake up and take a pill.

Suppositories peak within 30 to 90 minutes, which is good timing to stave off the inflammatory response.

In the 2012 NEJM trial, a single 100mg rectal dose cut post-ERCP pancreatitis from 16.9% to 9.2%, an NNT of about 13.

Some centers also give post-procedure LR to reduce risk. If the patient can handle the fluid, why not?

[The Infectious Diseases (ID) Doctor @venkat_id]

@transplantID Hmmm… LRTI is worse!

Worse still- viral pyrexia.

[SeMoS @dr92semos]

مريضه اول شكوى لها كانت عباره عن ذبحه صدريه وكانت المفاجأة فشل عمليه القسطره والقلب المفتوح وبعد الفحوصات والكشف الكامل اتضح انها حاله takayasu arteries complication
دي تفاصيل الحاله النادره الجاتنا في المستشفى واتقبلت في مؤتمرين في هذا الشهر

[Yash @DoctorBhavsar]

Antibiotics pearls for real life scenarios

• Penicillins :

Don't double up on anaerobes. If a patient is on a beta-lactam/beta-lactamase inhibitor combo (like Piperacillin-Tazobactam or Amoxicillin-Clavulanate), adding Metronidazole is redundant and only increases the risk of GI side effects.

• Cephalosporins :

Beware the "LAME" gap. Cephalosporins have no activity against Listeria, Atypical bacteria (Mycoplasma/Chlamydia), MRSA (except Ceftaroline), and Enterococci.

• Carbapenems :

Seizure risk is real but specific. While all carbapenems can technically lower the seizure threshold, Imipenem carries the highest risk, especially in patients with renal impairment; Meropenem is generally much safer in this regard.

• Fluoroquinolones :

Think of them as "IV poles in a pill." Drugs like Levofloxacin and Moxifloxacin have nearly 100% bioavailability, meaning the oral dose achieves the same blood concentration as the IV version—switch to PO as soon as the patient is eating.

• Aminoglycosides :

It’s all about the "Peak." These drugs exhibit concentration-dependent killing, which is why we typically use high-dose, once-daily extended-interval dosing to maximize efficacy while giving the kidneys a "washout" period to reduce toxicity.

• Vancomycin :

Stop chasing the "Trough." For serious MRSA infections, modern guidelines have shifted from trough-based monitoring to AUC/MIC based dosing.
~ (AUC/MIC > 400) to better predict efficacy while minimizing nephrotoxicity.

• Tetracyclines :

More than just "bone and teeth." Beyond infection, Doxycycline is a potent anti-inflammatory; however, remind patients to stay upright for 30 minutes after taking it to prevent severe pill-induced esophagitis.

• Macrolides :

Watch the "Electricals." Azithromycin and Clarithromycin are notorious for QTc prolongation; always check a baseline EKG if the patient is on other QTc-prolonging meds like Ondansetron or Amiodarone.

• Linezolid :

Mind the "Serotonin." Linezolid is a weak MAO inhibitor; monitor for Serotonin Syndrome if the patient is also taking SSRIs, and watch for thrombocytopenia if the treatment duration exceeds two weeks.

• Metronidazole :

The "Disulfiram" myth vs. reality. While the "no alcohol" rule is classic teaching, the evidence for a true disulfiram-like reaction is thin; however, it remains a high-yield board fact and a safe clinical recommendation to avoid nausea.

[وهج الفؤاد @arwicl]

قيام الليل والدعاء فيه ومناجاة الله عز وجل في الثلث الأخير من الليل من النعيم المعجّل تشعر أنه مأوى وراحة للعبد في آخر اليوم من مثاقل الحياة ، تشعر أنه مرفأ أمان يأوي إليه العبد بكافّة كسره ووجعه وضيقه ويخرج منه بقلبٍ آخر وبشعور مختلف.

[Eric Topol @EricTopol]

A good, new review of orthostatic hypotension, POTS @JAMAInternalMed https://t.co/hKCdwtOFIY

[J. C. Henry @henry_jibunor]

Power is of two kinds. One is obtained by the fear of punishment and the other by acts of love. Power based on love is a thousand times more effective and permanent than the one derived from fear of punishment." – Mahatma Gandhi

[Amin Hamza @HamzaAmino]

It’s not pessimistic—it’s actually grounding. Very stoic.and Very spiritual too.

[Mariam • @unfmariam]

بمناسبة موضوع انت طلعت بايه من السنه دي
(من أصبح منكم آمنا في سربه، معافى في جسده، عنده قوت يومه، فكأنما حيزت له الدنيا)

الحمد لله رب العالمين

[EE @_popnotcorn]

Potassium is absorbed faster and hence it has a faster onset while Sodium is absorbed slower and yields an extended action🎈

[Amin Hamza @HamzaAmino]

@mohamedyehyaheg 🤣

[Amin Hamza @HamzaAmino]

"تلون زبوراً في الحنين منزلا ... عليهن فيه الصبر غير حلال
وأنشدن من شعر المطايا قصيدة ... وأودعنها في الشوق كل مقال" - المعري

[Amin Hamza @HamzaAmino]

الحمدالله الصوابر جوابر

[Amin Hamza @HamzaAmino]

الحمدلله

[Amin Hamza @HamzaAmino]

الصبرُ كالنهر الجاري، يُنقّي النفس، ويُلين القلوب، ويغسلها من شوائب التسرّع، ويُعيد تشكيل الإنسان بروحٍ أكثر نضجًا، وأقرب إلى الله.
فاصبر، فإنك على طريق التهذيب، ولا تهذب الأرواح إلا بالنار الطاهرة التي تُنبت فيها أجمل الصفات

[Amin Hamza @HamzaAmino]

وعدٌ مني أن أظل أسير على الطريق الذي آمنت أنني سأضيئه
رحمك المولى عز و جل بقدر ما زرعت من أمل، بقدر ما غرست من المحبة
رحمك الله رحمةً واسعة و اسكنك فسيح جناته

[Abbas @AbbasComics]

دكتور بشرى إبن عوف - برنامج مساحة آمنه مع دكتور مازن أحمد.