Adverse effects of DHP CCBs

Non-DHP CCBs (Verapamil & Diltiazem)

Tapeworms😂

Edward Jenner and the smallpox vaccine

شلون اكتشفنا أول لقاح بالعالم:

The word 'parasite' meant someone who shared one’s food in return for providing amusement and flattery. The ‘parasitus ridiculus’ was a popular character in Greek and early Roman comedies and they even had joke books to help them should they run out of witticisms. The greed of the parasite was a constant source of fun for dramatists and he was often given crude nicknames such as ‘little brush–because he swept the table clean’.

Why the Ebola virus became as famous as the Kardashians?

The Ebola virus is well known in the developed world because of its appalling pathology and images of patients being treated by nurses and doctors dressed in spacesuit-like protective clothing. However, although the Ebola virus causes about 70% mortality, the numbers of people who have actually died of the infection are relatively few.
The fact that Ebola virus has been touted as a possible biological warfare agent has also helped to engender interest in the disease and funds to study and control it. By comparison, Human African Trypanosomiasis (often referred to as ‘sleeping sickness’) causes 100% mortality if untreated and kills many more people than Ebola but is seldom mentioned in the media. The reason is simple, Human African Trypanosomiasis kills slowly by comparison and those who suffer are among the poorest in Africa and live in some of the most war-torn and disorganised regions of the continent.

A lot of the appeal of internal medicine is Sherlockian—solving the case from the clues. We are detectives; we revel in the process of figuring it all out. It’s what doctors most love to do.

- Every patient tells a story

What the patient brings to the process of diagnosis is unique: the particular and private facts of his life and illness.” And what the physician brings is the knowledge and understanding that will help him order that story so that it makes sense both to the doctor—who uses it to make a diagnosis—and to the patient—who must then incorporate that subplot into the larger story of his life.

- Every patient tells a story

يأتي المريض لعملية التشخيص بشيءٍ فريد: التفاصيل الخاصة بحياته الشخصية ومرَضِه. أمّا ما يأتي به الطبيب، فهو المعرفة العلمية والقدرة الإستنتاجية التي تجعله قادرًا على ترتيب اللغز وحياكة القصة بشكلٍ يجعلها مفهومة للطبيب—الذي يستخدمها للوصول لتشخيص طبي—وللمريض—الذي يدمج قصة المرض مع القصة الأكبر التي هي حياتُه.

From the outset, the clinician is assimilating potentially relevant information from the patient’s posture, appearance, speech, demeanour and response to questions. Who is this patient? What kind of person is he? What are his anxieties? What is the reason for consulting a doctor at this time?

يجمع الطبيبُ منذ بداية اللقاءِ معلوماتٍ قد تكون ذات صلة بالتشخيص مثل وقفة المريض ومظهره وطريقته بالكلام وتصرّفاته وطريقته بالإجابة. من هو هذا المريض؟ أيُّ نوعٍ من الأشخاصِ هو؟ ما هي مخاوفه والأسباب التي جعلته يزور الطبيب الآن؟

Much information comes out of the first interaction.
The face, particularly the eyes, indicate real feelings better than words. Did your patient smile when you introduced yourself? Was it symmetrical or was there obvious facial weakness? Did he make eye contact? Was the face animated or expressionless as in Parkinson’s disease? Was the voice hoarse due to laryngeal disease, recurrent laryngeal nerve palsy or myxoedema?
Was the speech pressured, as in thyrotoxicosis or mania, or monotonous and expressionless as in severe depression? Was it slurred from cerebellar disease or a previous stroke?

يمكن الحصول على الكثير من المعلومات من اللقاء الأول.
إذ يعبِّر الوجهُ، والعيونُ تحديدًا، عن المشاعر بشكل حقيقيٍ أكثر من الكلمات. هل ابتسمَ المريض عندما حيّيتَه؟ هل كانت الإبتسامة متناسقةً أم أنّ هناك ضعفًا واضحًا في أحد جانبيه؟ هل قام بأي تواصل بصري؟
هل كان الوجه طبيعيًا أم بلا تعابير كما في مرضى الشلل الرعاشي؟ هل كان الصوت غليظًا كما في أمراض الحنجرة (مثل الـ Laryngeal nerve palsy)؟ هل كان كثير الكلام ومتسرعًا كما في بعض أمراض الغدة الدرقية أو الهوس؟ أم كان رتيبًا وبلا تعابير كما في الإكتئاب الشديد؟ أو كان ثقيلًا وغير واضح كما بأمراض المخيخ والجلطات الدماغية؟