Today marks the final day of my wife's gazettement as a specialist, culminating in her successful solo operation of a 15 kg cyst. The past six months have transpired quickly, with both of us previously strategizing how to manage our daily lives as she undertakes frequent on-call duties and I remain occupied, even on weekends.

Heat stroke:

Heat stroke is a serious medical emergency that occurs when your body is unable to regulate its temperature properly. It can be caused by prolonged exposure to high temperatures, dehydration, and overexertion.

Here are some tips to prevent heat stroke:
🧵 1) Stay Hydrated:

Drink plenty of fluids, especially water, to replace fluids lost through sweating. Avoid drinks that contain caffeine, alcohol or high amounts of sugar as they can cause dehydration.

Today I was asked about vaccine and ivermectin from one of the patient in clinic.

1st question
Why KKM don't want to give ivermectin for patient?

Answer
Up to date there is no concrete data showing the effectiveness of ivermectin. 2nd question
Why my friend covid cat 1 recover from covid 19 after taking ivermectin?

Answer
For most young patients or those who completed vaccination, it is very rare for them to progress to cat 4 and above. For cat 1 and 2 no treatment required. Regardless with ivmc or not.

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

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
Follow bebenang ini 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

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

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.

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 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

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.

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.

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

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
#MedTweetMY 62 y.o guy with
- PTB on intensive phase day 40
- dm
- hypertension
- dyslipidemia

Came with right hypochondriac and epigastric tenderness
- associated with nausea and vomiting
- no fever
- reduced oral intake
- able to pass flatus and BO
- no aggravating or relieving factor

Anda merupakan pesakit Migraine?
6 cara untuk mengelakkan dari medapat serangan migraine 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.