Selalu rasa kepala berpusing semasa bergerak?
Mengambil masa untuk bergerak kerana terlalu pening? Tetapi bila sudah mula berjalan rasa pening hilang dengan sendirinya?

Anda mungkin menghidapi masalah BPPV

BPPV: Benign Paroxysmal Positional Vertigo
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Pengenalan

- Penyebab utama untuk masalah pening dan tidak seimbang badan
- Terasa tiba2 kepala berasa berpusing atau badan berpusing
- Rasa berpusing lagi teruk dengan pergerakan kepala
Simptom BPPV

- Pening
- Rasa badan atau Kawasan persekitaran brepusing dan bergerak
- Rasa badan tidak stabil
- Rasa loya
- Muntah
Kebiasaanya symptom BPPV ini datang dan pergi dan bertahan kurang dari 1 minit. BPPV boleh hilang dan berlaku semula.

Bila untuk berjumpa doktor?
Jika anda mengalami rasa muntah dan tidak seimbang badan berlanjutan, dan kerap berlaku.
Berjumpa dengan doctor segera jika

- Sakit kepala yang teruk
- Demam
- Penglihatan menjadi samar
- Kurang deria pendengaran
- Masalah percakapan
- Rasa kebas atau lemah di tangan dan kaki
- Pengsan
- Tidak dapat berjalan
- Rasa kebas
Punca BPPV

- Kebiasaanya, tiada penyebab yang dapat ditemui (idiopathic BPPV)

Penyebab lain BPPV
oHentakan kepala yang kuat
oKerosakan bahagian dalam telinga
oMigraine
oKerosakan telinga selepas operation telinga
Peranan Telinga

- Didalam telinga terdapat organ kecil dinamakan vestibular labyrinth
- Ianya akan memantau pergerakan kepala
Peranan Telinga continue

Struktur lain didalam telinga (otolith organ) juga memantau pergerakan kepala berdasarkan graviti.

Di dalam otolith organ ini terdapat kristal yang membuat kita sensitive terhadap gravity.
Kristal ini boleh tercabut/tertanggal. Dan apabila ianya tertanggal, ianya akan memasuki ke dalam semicircular cannals, terutama apabila kita baring lurus.

Ini menyebabkan semicircular canal menjadi terlalu sensitive terhadap pergerakan kepala dan menyebabkan anda berasa pening.
Risiko untuk mendapat BPPV

- Kebanyakan pesakit berumur lebih 50 tahun
- Kerap berlaku kepada perempuan berbanding lelaki
- Sejarah trauma di bahagian kepala
Rawatan BPPV

- Kebiasaannya ia akan hilang sendiri dalam masa beberapa minggu atau bulan
- Anda akan dirujuk kepada pakar telinga, tekak dan hidung (ENT) untuk rawatan selanjutnya dimana anda akan diajar cara untuk membuat canalith repositioning untuk mengurangkan symptom BPPV

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More from @DIskandarmirza

6 Mar
For Junior Doctors

Do you see many case of vertigo?
It is the most common case admitted under internal medical ward, with an improper diagnosis
So, do you really know how to assess vertigo?

Let us do some discussion shall we?
Follow this thread
There are so many causes of vertigo. So proper clinical history can examination is prudent to get proper diagnosis

Evaluation focuses on determining whether the etiology is peripheral or central.
-Peripheral are usually benign
-Central often require urgent treatment
Peripheral causes of vertigo

-Benign paroxysmal positional vertigo
-Vestibular neuritis
-Meniere disease
-Otosclerosis
Read 14 tweets
28 Feb
For Junior Doctors and Pharmacists

Topic: The Pathophysiology of Thyroid Hormones and Anti thyroid Medications

Remember guys, to master the topic you first need to understand the pathophysiology of
-Thyroid hormones production
-Anti thyroid medications

Follow this thread
Thyroid synthesis

1)Iodine transport

Iodide (I-) from the blood is actively transported into the follicular lumen
2)Thyroglobulin synthesis

Thyroglobulin is a protein that contains large numbers of tyrosine amino acids that go on to become individual thyroid hormone molecules. Thyroglobulin is synthesized within the follicular epithelial cell and secreted into the follicular lumen.
Read 15 tweets
27 Feb
Anda tahu apa itu penyakit Tetanus? (kancing gigi)

Bagaimana ianya berlaku?
Bangaimana untuk megelak dari mendapat tetanus?

Sila follow bebenang ini
Pengenalan

Penyakit tetanus adalah penyakit yang serius berpunca daripada toksin bakteria yang merosakkan sistem saraf dan menyebabkan kekejangan otot yang menyakitkan terutama di bahagian rahang dan otot leher.
Tetanus boleh mengganggu sistem pernafasan anda dan membuat anda susah untuk bernafas.

Sakit Tetanus adalah sangat jarang berlaku di Malaysia disebabkan oleh program immunisasi yang diberikan oleh kerajaan Malaysia.
Read 12 tweets
25 Feb
For Junior Doctors

Let us have a brainstorming session shall we?
Real patient with real management from me 😉

Scenario

40 years old
- obese
- came with back carbuncle
- operated with no complication

This is his cxr prior to admission Image
Day 4 of admission

- Having shortness of breath
- suddenly desaturated, needing oxygen support
- Hypotensive needing inotropic support
- no fever, cough

- lungs: clear
- S1S2 no murmur

Blood investigation
- no leucocytosis
This is his repeated chest xray on day 4 of admission

What you guys can see from this chest xray? Image
Read 10 tweets
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 😆

now we go to each medications and remember this is simplified version as i only can type few words in twitter
Read 14 tweets
20 Feb
Anda ada atrial fibrillation?

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

Follow bebenang ini

@MedTweetMYHQ
#MedTweetMY
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
Read 7 tweets

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