ahmed zawaky

[ahmed zawaky @AhmdQnah]

@IhabFathiSulima PRKAG2 syndrome

[ahmed zawaky @AhmdQnah]

زجاجه جلوكوز 5% =25 جم من الجلوكوز، أي ما يعادل تقريبًا ملعقتين كبيرتين من السكر.

[ahmed zawaky @AhmdQnah]

If anaphylactic shock is not responding to epinephrine, always ask one question:
"Is the patient taking a β-blocker?"The answer may lead you to the life-saving adjunct: IV glucagon.

[Petria Arab @petriaarab]

لحظة استهداف مسيرة إيرانية ميناء دمياط في مصر

حيث تم ضرب سفينة تابعة لشركة أمريكية تعمل في مجال الغاز

[ahmed zawaky @AhmdQnah]

https://t.co/oMJYqZOetq

[ahmed zawaky @AhmdQnah]

https://t.co/oMJYqZOetq

[Gregg Fonarow MD @gcfmd]

💊 SGLT inhibitors for HF (irrespective of EF)

🚀 Ultra-rapid clinical benefits

❤️‍🩹 Benefits >>potential risks

⬇️ CV☠️/HF🏨

⬆️ HRQoL

��� Amazing value

$60 a year in med costs ▶️

$2500 a year in ⬇️🏨s savings

✅ Start now

[YARA @gomanadiaa]

القناة دي من ألذ قنوات الاشعه مشروح فيها فيديوهات سونار ودوبلر في صورة cases قصيرة ❤️

[Mind Muscle Project @mindmusclepro]

From Food to the Cells: Vitamin B12 Absorption

1️⃣ B12 in Food

Vitamin B12 in your food like Meat, Fish & other animal products are tightly bound to Proteins.

It cannot be Absorbed yet.

2️⃣ Stomach acid frees B12

Stomach Acid (HCL) & Pepsin breaks down the protein & frees B12.

At the same time, your stomach releases something called the Intrinsic Factor (IF).

3️⃣ Haptocorrin grabs B12

B12 then binds to another protein called Haptocorrin present in saliva & gastric secretions.

Think of Haptocorrin as B12’s bodyguard, it protects the vitamin from being damaged by stomach acid.

4️⃣ Intrinsic factor gets hold of B12

As B12 enters the small intestine, pancreatic enzymes digest Haptocorrin & release B12 once again.

Now B12 binds to Intrinsic Factor (IF), forming the B12 Intrinsic Factor complex.

This is the only form that can be efficiently absorbed.

5️⃣ Absorption in the Ileum

In the last part of the stomach (ileum), there are receptors that can detect B12-IF complex.

In the intestinal Cells, IF is discarded & B12 enters the blood stream.

This is what you get when you test for serum Vitamin B12.

6️⃣ Delivery to the Cells

Some of the Vitamin B12 in the serum bind to transcobalamin (carrier protein) for Cellular uptake.

This is what you get when you do the Active B12 or the Holotranscobalamin test.

7️⃣ Storage in the liver

The liver stores B12 (around 2-5ug) as

- Adenosylcobalamin

- Methylcobalamin (Small amount)

The liver doesn’t just store B12, it also recycles it.

The liver secretes 5–10 ug of B12 per day into bile.

What makes a person B12 deficient inspite of having a B12 rich diet?

❌ Low stomach acid (B12 doesn’t free properly from food)

❌ Lack of Intrinsic factor (Autoimmune, Chronic atrophic gastritis, Genetic disorder etc)

⚠️ Intramuscular injection works best here

❌ Ileal disease like Crohns or surgery that prevents absorption

❌ Pancreatic disease (Cannot free from Haptocorrin)

❌ Certain Meds (ex Metformin reduces ileal absorption, PPIs suppress acid)

[Massimo @Rainmaker1973]

How water heaters cause electrocution and how to find the solution

[🎞️ Zero-Harm International]

[Mr. Kenelumchukwu Munagi @Rad_Munagi]

Scar endometriosis

Tender Palpable lump at the previous incision site. Painful throughout the month but becomes severe during menses

[ahmed zawaky @AhmdQnah]

@nervemed OdorPoisoning🧄 GarlicArsenic, organophosphates, phosphorus, selenium, tellurium🍎 FruityIsopropyl alcohol, diabetic ketoacidosis🥜 Bitter almondsCyanide (not everyone can detect it genetically)🥚 Rotten eggsHydrogen sulfideFishyOrganophosphates (occasionally reported), trimethy

[Sheikhspeare @SheikhspearePk]

Messi champion😂

[Dr sthanu subramanian @drsthanus]

Muehrcke’s sign.

Muehrcke's Lines.

Hypoalbuminemia.

Seen in..
Autoimmune, inflammatoryNephrotic syndrome, glomerulonephritis, liver disease

Paired, transverse, narrowed white bands that run parallel to the lunula of the nails and are seen in patients with hypoalbuminemia.

Dr Robert Muehrcke first described this novel clinical finding in an article published in the British Medical Journal in 1956.

Image:

https://t.co/UZMdozmUZv

[ريان | MD1TALK🌟 @md1talk]

فيه حالة طوارئ في الهيماتولوجي ممنوع فيها rectal exam، مين يعرفها ؟!!

[ريان | MD1TALK🌟 @md1talk]

الهايبوناتريما ما تخلص !

مين قد سمع في ال Lipoprotien X

معلومتين تقدرون تستخدمونها في الراوند:
- يسوي pseudohyponatremia - يعن�� ال osmolality نورمال

- نشوفها في obstructive liver disease

[ahmed zawaky @AhmdQnah]

@ALNEMERK عرق السوس + أدوية الضغط = ⬆️ ضغط الدم و⬇️ البوتاسيوم، وقد يقلل فعالية علاج الضغط.
نبتة St. John's wort + Digoxin = ⬇️ مفعول الدواء.
نبتة St. John's wort + Apixaban أو Rivaroxaban = ⬇️ فعالية مضاد التجلط ⟶ ⬆️ خطر الجلطات.

[ahmed zawaky @AhmdQnah]

@ALNEMERK الثوم + Warfarin أو Clopidogrel = ⬆️ خطر النزيف.
الجنكة + Aspirin = ⬆️ خطر النزيف.
الزنجبيل بجرعات كبيرة + Warfarin = قد ⬆️ خطر النزيف.
الجريب فروت + بعض الستاتينات (مثل Simvastatin وAtorvastatin) = ⬆️ تركيز الدواء ⟶ ⬆️ آلام العضلات وانحلال العضلات.

[ahmed zawaky @AhmdQnah]

@DrNovinoTailor Botox = Blocks the muscle → Flaccid Tetanus = Takes away the brakes → Spastic