✅القلب من أندر الأعضاء اللي يجيها primary cardiac tumor خصوصاً لو كان malignant، والسبب الرئيسي إن خلايا عضلة القلب (cardiac myocytes) تكون terminally differentiated يعني وصلت لمرحلة نهائية من النضج وما تنقسم وتتكاثر تقريباً أبداً بعد مرحلة معينة من العمر، وبما إن السرطان أساساً هو انقسام خلوي غير منضبط، فلو الخلية أصلاً ما تنقسم، احتمالية تحول لخلية سرطانية تكون شبه معدومة، بالإضافة إن القلب معرض لحرارة داخلية عالية نسبياً وتروية دموية قوية ومستمرة تساعد على "غسل" أي خلايا غير طبيعية بسرعة قبل ما تتراكم وتتحول لورم، ولو صار وتكون ورم بالقلب فالأغلبية الساحقة تكون benign وأشهرها myxoma، وأي ورم خبيث موجود بالقلب غالباً يكون metastatic يعني انتشر من عضو ثاني وليس نشأ أصلاً من عضلة القلب نفسها.
Goals of mechanical ventilation
Tidal volume 6-8 ml/kg
RR 12-18 bpm
FiO2. 21-100%
PEEP >5 cm H20
Plateau pressure <30cm H20
In ARDS
If PaO₂/SpO₂ is too high → Reduce FiO₂ first.
Once FiO₂ ≤ 60%, if more oxygenation is still needed, then adjust PEEP.
#NEETPG
To the reasonable and clear-minded Americans!
Those who are not arrogant, not colonial-minded, not seeking to steal the wealth of others, and not naive:
What does Iran want from Trump and America?
Its so-called “impossible demands.”
These are the “impossible demands” that Iran is supposedly asking for:
It wants to live in peace without another American or Israeli attack against it, and it wants guarantees.
It wants its money that was seized, frozen, or allegedly confiscated and taken through actions by U.S. presidents and the U.S. Congress.
It wants the removal of the economic sanctions imposed on it through American international bullying and according to the law of the jungle.
In short: Iran wants Trump to stop acting like the president of a rogue power — a bully that creates chaos around the world.
What do most Americans want?
Almost the same demands as Iran, but expressed in a different way:
America First.
No foreign dominance over America. No dominance and dependence on any small country that drags the United States into foreign wars for its own interests — Israel.
A focus on domestic issues and improving the economy so that American citizens can enjoy a higher quality of life, with universal healthcare coverage, a strong social welfare system, economic security, and a country that is respected and admired around the world.
This is what Iran and the countries of the world are asking from Trump, but in different ways:
Stop the bullying, stop the war crimes, stop the blackmail, and focus on the internal affairs of your own country.
What does Israel want?
Israeli dominance over key parts of the American state, influence over many politicians and presidents — whether through blackmail, financial tools, or other means.
Israel wants to use American military, economic, intelligence, diplomatic, and technological power for its own interests and wars, regardless of the consequences America faces because of this dominance.
It wants wars and mass destruction in the Middle East through the puppet sitting in the White House in order to achieve Greater Israel.
If Israel has been unable to gain full control over Gaza for 80 years, and has been unable to bring back Israeli prisoners from Gaza despite reducing Gaza to rubble, then how will it control 200 million people in the Middle East and establish the myth of Greater Israel?
What do the peoples of the world want from America?
They want America to stop supporting dictatorships, stop preventing the rise of democracies in the region, and stop changing regimes by force and interfering in the affairs of other countries.
They want this so that people are not forced to migrate to the Western world, and so that migrants can return to their own countries.
Supporting dictatorships and American interventions in Iraq, Libya, Syria, Yemen, and elsewhere, in addition to supporting Israel in Palestine, are among the reasons millions migrate to the West.
Are the demands of the peoples of the world fair?
Do you believe that Iran’s demands are impossible and threaten American national security — a country located 10,000 kilometers away — or are its demands basic and legitimate?
And is the real threat to American national security and the world Iran, or is it the Israeli dominance and policies that have dragged America into endless wars?
#AmericaFirst #EndEndlessWars #PeaceNotWar #USForeignPolicy #MiddleEast #Iran
This will go down in history as the greatest video of our time. Three thousand years from now it will still be played.
Our children will learn about the brave men and women who fought against the evil of Zionism.
Professor Seyed Marandi @s_m_marandi we salute you!
Diltiazem for rate control without knowing EF.
30 ml/kg bolus for sepsis without assessing volume responsiveness. (It’s rarely the “right” amount)
Using cefepime in renal dysfunction (or at all…jk, kinda)
NPO after midnight for a procedure tomorrow. (Learn the 2-4-6-8 rule!)
🇮🇷🇺🇸🇮🇱 Iran has drawn up a list of targets that would destroy the economy of the region and the world, including Israel. It would destroy all power plants, water desalination plants, nuclear reactors, oil refineries, and gas platforms, per Fars News
Israel is number one target and would become like Lebanon, or even worse.