Nabil Azhar

But tomorrow, the sun will rise. And, as will I.

[Nabil Azhar @nabilazzhar]

Bismillah.

Hari ini kita akan belajar basic interpretation for ECG.

Basic ni wajib semua medical student kena tahu at least before terjun sebagai HO.

I got it from my honorable lecturers, doctors & MEDICORP, so why not share the knowledge, right?

Let's go..

#NotaNabil

[Nabil Azhar @nabilazzhar]

One of the most common nephropathy (leading to renal failure) in Malaysia is due to Diabetes Mellitus.

Almost all of my 100++ patients in MOPD clinic related with Diabetes Mellitus.

With this kind of recent Malaysian's dietary habit, no wonder Malaysia is on top.

Take care.

[Nabil Azhar @nabilazzhar]

@RSaidKnight Yes. The main component that brings down the potassium inside 'lytic cocktail' itself is insulin.

Ca gluconate is for heart protection since hyperkalemic issues, while glucose is to counterpart the insulin (leading to significant drop in sugar).

[Nabil Azhar @nabilazzhar]

Cases during my latest oncall:
- Acute kidney injury with advanced CKD progression
- Stroke, stroke, stroke, stroke
- APO, APO, APO, APO
- AEBA, AEBA, AEBA, AEBA
- Diabetic emergencies (DKA, HHS)
- Severe hyponatremia (Na 98) 🥺
- Fever of unknown origin, cover for Meliodosis

[Nabil Azhar @nabilazzhar]

Alhamdulillah, 2 referral medical saja sepanjang malam. Wad pun no issues. Colleagues lain pun sedap lena semalaman.

1 admit wad.
1 lagi tibai ke gynae sebab post chemo under gynae onco.

Wishing for everyday like this. If only la. 😂

[Nabil Azhar @nabilazzhar]

Sweep the tongue to the left. 👅

Slowly (don't rush) advance the blade with your left hand until you see the tip of the epiglottis. 👀

Then, lift UP, UP & AWAY. ⬆️⬆️

Keep your elbows in ✅️
Keep your back straight ✅️
Rotate the wrist ❌️
Use teeth as fulcrum ❌️

[Nabil Azhar @nabilazzhar]

Indication for Intubation ⚠️

The following are signs that a patient may require intubation, which is the process of inserting a respiratory tube into the respiratory tract and assisting their breathing with a ventilator machine.

Sharing one of the important inputs from ALS.

[Nabil Azhar @nabilazzhar]

@RSaidKnight Kalau dah preggy kau nk intubate itu bukan difficult intubate je, itu dah red alert 🫢

[Nabil Azhar @nabilazzhar]

Hereby, this is my sharing on recent experience at the hospital with you all. Thank you for your attention. Please do not hesitate to ask your doctor any questions you may have. They are responsible for taking care of you. Have a bless day and take care!

[Nabil Azhar @nabilazzhar]

CKD ni burden kepada society kita, dgn peningkatan kes darah tinggi dan kencing manis yg tk terkawal. 2 penyakit kronik ini punca utama berlakunya kerosakan buah pinggang yg membawa kpd advanced progression of CKD.

[Nabil Azhar @nabilazzhar]

Anda kena ingat, jika kidney mula worsening & deteriorate, tiada agen-agen overclaimed product yg akan take responsibility. Sebaliknya anda berisiko jd tercungap-cungap gasping dgn fluid overload, uremia, acidosis dan refractory hyperkalemia. Terpaksa crash landed di Red Zone.

[Nabil Azhar @nabilazzhar]

@ahmadsyahmiDE So, maksudnya skrg dah takleh mcm dulu la even 5 minit pun sempat lari2 lagi naik tangga bagai. Skrg dah ubah kena check in 30 minit sebelum la kiranya? Omg 😩

[Nabil Azhar @nabilazzhar]

Those who overclaim suka guna result begini claim Creatinine drop drpd 209 ➡️ 77.

Kidney deteriorate in 2 ways, ACUTE or CHRONIC.

Baseline Creatinine last year: 80

Upon this admission, rise up to 209. On proper hydration, renal improving.

Does he need RM14k for reverse CKD?

[Nabil Azhar @nabilazzhar]

@abd_jabbar The Paeds MO one from Seberang Jaya, Penang. 🥲

[Nabil Azhar @nabilazzhar]

The CT scan shows bleeding in the thalamus with intraventricular extension.

The patient woke up unresponsive after throwing up. He's not been taking their blood pressure medication regularly.

Thalamic bleeding is usually a result of poorly controlled long-standing hypertension.