.

خُذ مثلًا عددَ الأمراضِ التي تصيب الإنسان: تتباينُ التقديرات بين عدةِ آلاف إلى عشراتِ الآلاف (وإنْ كانت أغلبُها أمراضًا نادرة). قارِن عدد الأمراض مع عدد الأعراض التي يمكن أنْ تظهر على المريض، مثل الحمّى والألم والصداع والتقيؤ؛ إذ لا تعدو الأخيرة على بضعِ مئاتٍ في أفضل الأحوال. أعطالُ الجسدِ لا تُحصى لكنّ لغة الجسد، التي يعبّر بها عن هذه الأعطال، ليس فيها إلا بضعُ مئاتٍ من الكلمات.

Pills vs Scalpels ?

A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis

CONCLUSIONS
For the treatment of appendicitis, antibiotics were noninferior to appendectomy on the basis of results of a standard health-status measure. In the antibiotics group, nearly 3 in 10 participants had undergone appendectomy by 90 days. Participants with an appendicolith were at a higher risk for appendectomy and for complications than those without an appendicolith.

Antibiotics should only be used in non-obstructed appendicitis.

It must also be remembered that a significant number of patients treated medically had to undergo appendectomy 1 year later.

A scientific evaluation proposed that CPR enhances the defibrillation threshold by restoring substrates to myocytes for the facilitation or resumption of normal excitation-contraction coupling. Furthermore, CPR may wash out myocardial depressants that have built up during prolonged VF. Therefore administration of CPR before defibrillation in patients with suspected, prolonged VF is recommended in the prehospital setting.

باختصار، يكلك من يجيك مريض عنده VF قبلما يدخل للطوارئ، أول شي تسويله هو CPR بعدين defibrillation. لأن الـ CPR رح يخلّص الخلايا من الـ toxic metabolites وبالنتيجة يزيد فرص الـ defibrillation بالنجاح

A new TB guideline just dropped

This is milf MLF (Medial Longitudinal fasciculus).

It makes horizontal gaze (moving your eyes sideways) possible, since it connects the nuclei for cranial nerves III & VI so they can work in unison.

When MLF doesn't work properly, cranial nerve VI abducts the eye, as it normally would, but it won't be able to send the signal to the contralateral cranial nerve III to make it adduct the contralateral eye (so both eyes look in the same direction). This condition then is called internuclear ophthalmoplegia. Why inernuclear? Because the connection between (inter-) nuclei of cranial nerves III & VI becomes disrupted.

Internuclear ophthalmoplegia (picture A)

There's a weird variant to internuclear ophthalmoplegia called one and a half syndrome. It can be seen with foville syndrome which is damage in the postero-medial pons.

It is often useful when obtaining a patient's medical history to ask something in line with "Is there anything else that's bothering you?". This type of questions makes the patient remember and mention other symptoms which might've been forgotten or assumed to be 'minor' issues that are falsly assumed to be irrelevant and not worthy of mentioning.

هواي مرات المرضى ينسون أو يتجاهلون أعراض مهمة طبيًا وتساعد بالوصول للتشخيص، لكنهم يعتقدونها غير مهمة خاصةً إذا ما جانت تزعجهم بشكل جبير.

من الشائع جدًا أنْ يشتكي المريض من ألم قوي، لكنه يتجاهل أو ينسى تغيّر لون الإدرار أو الطفح الجلدي.

Patients usually only report the symptoms that capture their attention or disrupt their life. They don't report the most important nor the most medically relevant ones. Patients typically report pain, nausea, itching, vertigo, fatigue more than heartburn, a simple rash or discoloration, forgetfulness, "some stiffness" in the morning, or sleep disturbances.

Lipoproteins & Fat transport in the body