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Dr.IskandarMirza

20 Feb, 7 tweets, 3 min read

@MedTweetMYHQ

Anda ada atrial fibrillation?

Anda faham apa itu atrial fibrillation?
Anda faham mengapa anda perlu makan ubat cair darah?

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Atria fibrillation adalah masalah rentak jantung yang tidak sekata dan ianya boleh menyebabkan rasa jantung berdenyut laju, berdebar dan rasa jantung turun-naik dengan cepat.

Simptom Atrial flutter adalah

- Jantung rasa berdebar secara tiba-tiba
- Cepat rasa penat
- Sesak nafas
- Rasa hendak pitam
- atau sesetengah pesakit tidak mempunyai apa- apa simptom

Pesakit yang menghidapi atrial flutter mempunyai 5 kali ganda risiko untuk mendapat stroke berbanding dengan pesakit yang tidak mempunyai atrial flutter

Anda perlu berjumpa dengan doktor jika anda mempunyai simptom- simptom seperti yang saya berikan di atas.

Doktor akan:
- membuat pemeriksaan
- membuat ecg
- dan jika positive untuk atrial fibrillation, doktor akan membuat test tambahan untuk mencari punca terjadinya AF

Jika anda mempunyai AF

Doktor akan mengira markah CHAD2VASc dan juga HASBLED bagi menentukan anda perlu ubat cair darah ataupun tidak.

Kenapa perlu ubat cair darah?

AF membuat anda mendapat risiko tinggi untuk membentuk darah beku di dalam jantung.

Darah beku ini boleh terapung di dalam darah dan pergi ke salur darah yang paling kecil dan menyebabkan pengeradan darah terhenti.

Jika di otak -> stroke

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More from @DIskandarmirza

Dr.IskandarMirza

@DIskandarmirza

21 Feb

For Junior Doctors

Do you really know how diabetic medications mechanism of action?

It is really important so that you know what to explain to the patient and thus making them more compliant towards their diabetic medications.

Follow this thread

First you guys need to understand how patient developed diabetes mellitus.

Refer to diagram below

Diabetes mellitus pathophysiology is involving multi-organ involvement

And each diabetic medications will inhibit part of the organs involved.

Now you understand right how hyperglycemia happened in diabetic patient? it took me all night to do all this diagram 😆

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Dr.IskandarMirza

@DIskandarmirza

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For junior doctors

How to Decide on anticoagulant for Atrial Fibrillation

Follow this steps
You need to calculate the CHA2DS-VASc score first

This is how you calculate a CHA2DS-VASc score

If CHAD2DS-VASc score=

1(male) or 2 (female) = OAC should be considered (Class iia)
>2 (male) or >3 (female) + OAC is recomended (Class 1A)

OAC : oral anticoagulant

Do you understand about the class of recommendation?

Just a little bit about it, because it is important for you guys to know it.

Class 1 means: it is recommended
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Dr.IskandarMirza

@DIskandarmirza

18 Feb

@MedTweetMYHQ

For Junior Doctors

Have you guys heard of Chiladaiti syndrome?

I'm sharing my case from HTAN, Pilah and how I managed this case.

@MedTweetMYHQ
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62 y.o guy with
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- dm
- hypertension
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Came with right hypochondriac and epigastric tenderness
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Cxr
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Patient was treated for chiladaiti syndrome
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Dr.IskandarMirza

@DIskandarmirza

1 Jan

Anda merupakan pesakit Migraine?
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1)Sentiasa mencatat apa yang dimakan atau minum di dalam diari.
Catatkan apa yang anda makan atau minum sebelum berlakunya migraine. Anda akan mendapat pattern makanan yang menyebabkan anda mendapat migraine dan ini memudahkan anda untuk megelakkan dari memakan makanan tersebut.