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AAS Medical Notes

AAS Medical Notes

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The True Medicine ุฑุงุจุท ู‚ู†ุงุชูŠ ุนู„ู‰ ุงู„ูŠูˆุชูŠูˆุจ https://www.youtube.com/@the_true_medicine ุฑุงุจุท ุตูุญุชูŠ ุนู„ู‰ ุงู„ุฃู†ุณุชุง (ุงู†ุดุฑ ุจูŠู‡ุง ูƒูŠุณุงุช ุชููŠุฏ ุงู„ู…ู‡ุชู…ูŠู†) https://www.instagram.com/ahmedabdsam?igsh=MTBldm4yaHk2ZnFoYw==

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๐Ÿ“ˆ Analytical overview of Telegram channel AAS Medical Notes

Channel AAS Medical Notes (@amedicalnotes) is an active participant. Currently, the community unites 19 866 subscribers, ranking 1 161 in the Medicine category and 3 650 in the Saudi Arabia region.

๐Ÿ“Š Audience metrics and dynamics

Since its creation on ะฝะตะฒั–ะดะพะผะพ, the project has demonstrated rapid growth, gathering an audience of 19 866 subscribers.

According to the latest data from 03 July, 2026, the channel demonstrates stable activity. Although there has been a change in the number of participants by -45 over the last 30 days and by 1 over the last 24 hours, overall reach remains high.

  • Verification status: Not verified
  • Engagement rate (ER): The average audience engagement rate is 24.72%. Within the first 24 hours after publication, content typically collects 8.36% reactions from the total number of subscribers.
  • Post reach: On average, each post receives 4 912 views. Within the first day, a publication typically gains 1 662 views.
  • Reactions and interaction: The audience actively supports content: the average number of reactions per post is 102.
  • Thematic interests: Content is focused on key topics such as ู…ูŽุฑููŠุถ, ูƒูŽูŠุณ, ูƒูุชูŽุงุจ, ุทูŽุจููŠุจ, ุฌูุฏู‘.

๐Ÿ“ Description and content policy

The author describes the resource as a platform for expressing subjective opinions:
โ€œThe True Medicine ุฑุงุจุท ู‚ู†ุงุชูŠ ุนู„ู‰ ุงู„ูŠูˆุชูŠูˆุจ https://www.youtube.com/@the_true_medicine ุฑุงุจุท ุตูุญุชูŠ ุนู„ู‰ ุงู„ุฃู†ุณุชุง (ุงู†ุดุฑ ุจูŠู‡ุง ูƒูŠุณุงุช ุชููŠุฏ ุงู„ู…ู‡ุชู…ูŠู†) https://www.instagram.com/ahmedabdsam?igsh=MTBldm4yaHk2ZnFoYw==โ€

Thanks to the high frequency of updates (latest data received on 04 July, 2026), the channel maintains relevance and a high level of publication reach. Analytics show that the audience actively interacts with content, making it an important point of influence in the Medicine category.

19 866
Subscribers
+124 hours
-337 days
-4530 days
Posts Archive
๐Ÿ“‘ calcium + Phosphate + ALP ๐Ÿ”– High calcium + low PTH + normal ALP ๐Ÿ‘‰ Malignancy ๐Ÿ”– High calcium +high phosphate + normal ALP ๐Ÿ‘‰ Multiple myeloma ๐Ÿ”– Low calcium + low phosphate + high ALP ๐Ÿ‘‰ Osteomalacia / vitamin D deficiency ๐Ÿ”– Normal calcium + normal Phosphate + high ALP ๐Ÿ‘‰ Paget disease ๐Ÿ”– High calcium + low phosphate + high ALP ๐Ÿ‘‰ Primary hyperparathyroidism ๐Ÿ”– Low calcium + high phosphate + Normal ALP ๐Ÿ‘‰ Hypoparathyroidism ๐Ÿ”– Normal calcium +Normal Phosphate + normal ALP ๐Ÿ‘‰ Osteoporosis ๐Ÿ”– High Calcium + high Phosphate + high ALP ๐Ÿ‘‰ Bone metastasis

old age M, presented with typical chest pain PMHx: DM & HTN ุทุจุนุง ECG ูˆุงุถุญ MI ุดู†ูˆ ุชุนู„ูŠู‚ูƒู… ู‚ุจู„ ูˆุจุนุฏ ุงู„ุงูƒุชูŠู„ุฒุŸุŸุŸ @AASmedicalbot
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old age M, presented with typical chest pain PMHx: DM & HTN ุทุจุนุง ECG ูˆุงุถุญ MI ุดู†ูˆ ุชุนู„ูŠู‚ูƒู… ู‚ุจู„ ูˆุจุนุฏ ุงู„ุงูƒุชูŠู„ุฒุŸุŸุŸ @AASmedicalbot #ECG

ุงุฎูˆุงู† ูƒู„ ู…ุฑูŠุถ chronic kidney disease ูˆ ูŠุฏุฎู„ ู„ู„ุทูˆุงุฑุฆ ู„ุฃูŠ ุณุจุจ ูƒุงู† ู„ุงุฒู… ุชุณูˆูŠู„ู‡ ecg ุงูˆู„ ุดูŠ ู‡ูˆ ู…ูˆ ุฎุณุงุฑุฉ ุซุงู†ูŠ ุดูŠุŒ ู…ู…ูƒู† ู†ุดูˆู ุงู„ู€ hyper Kalaemia changes ุงู„ูŠ ูƒู„ุด ูƒู…ู† ุนุฏู‡ู… ุซุงู„ุซ ุดูŠ ู…ู…ูƒู† ู†ุดูˆู Uraemic pericarditis ุงู„ูŠ ุบุงู„ุจุง ุชูƒูˆู† silent ุงุชูู‚ู†ุงุŸุŸุŸ ุงู„ู…ู„ุงุญุธุฉ ุงู„ุซุงู†ูŠุฉุŒ ูƒู„ ู…ุฑูŠุถ DKA ู„ุงุฒู… ุชุณูˆูŠู„ุฉ ecg : ุงูˆู„ ุดูŠ: ู…ูˆ ุฎุณุงุฑุฉ ุซุงู†ูŠ ุดูŠ: ู…ู…ูƒู† ู†ุดูˆู ุนู„ุงู…ุงุช ู†ู‚ุตุงู† ุฃูˆ ุฒูŠุงุฏุฉ ุงู„ุจูˆุชุงุณูŠูˆู… ุซุงู„ุซ ุดูŠ: ู…ู…ูƒู† ุงู„ู€ MI ู‡ูŠ ุงู„ูŠ ุณูˆุช Precipitation of DKA ุฃุชูู‚ู†ุงุŸุŸุŸ ู…ู„ุงุญุธุฉ ุซุงู„ุซุฉ : ูƒู„ ู…ุฑูŠุถ ุฌุงูŠูƒ ุจู€ Slurred speach ูˆ hemiparesis ู„ุงุฒู… ุชุณูˆูŠู„ุฉ ecg To exclude AF as the cause of embolization. #emergency

Pterygium #ophthalmology
Pterygium #ophthalmology

Fragmented QRS Wellens and pseudo-wellens pattern #ECG

ู‚ุจู„ ูุชุฑุฉ ุดูุช ู‡ุงูŠ ุงู„ุงู…ุจูˆู„ุฉ ู…ุงู„ ุงู†ุฌุณูŠุฏ 25mg/5cc ุงู†ุง ุงุชุฐูƒุฑ ุงู„ูŠ ู‚ุจู„ ู…ุชูˆูุฑุฉ 10mg/10cc ุตุญุŒ ู„ูˆ ุงู†ุง ู…ุดุชุจู‡ุŸ!!!!
ู‚ุจู„ ูุชุฑุฉ ุดูุช ู‡ุงูŠ ุงู„ุงู…ุจูˆู„ุฉ ู…ุงู„ ุงู†ุฌุณูŠุฏ 25mg/5cc ุงู†ุง ุงุชุฐูƒุฑ ุงู„ูŠ ู‚ุจู„ ู…ุชูˆูุฑุฉ 10mg/10cc ุตุญุŒ ู„ูˆ ุงู†ุง ู…ุดุชุจู‡ุŸ!!!!

"ุฏูƒุชูˆุฑ ูˆ ุงู„ู„ู‡ ุฏุฎู„ู†ุง ูƒูˆุฑุณุงุช ecg ุญุชู‰ ู†ุฌุงูˆุจ ุนู„ู‰ ูƒูŠุณุงุช ุงู„ู€ ecg ุฃู„ูŠ ุชู†ุฒู„ู‡ุงุŒ ูˆ ุตุงุฑู„ูƒ ูุชุฑุฉ ู…ุง ู†ุงุดุฑ ุนู† ุงู„ุชุฎุทูŠุทุŒ ูŠู…ูƒู† ุน ุนูŠูˆู†ุง ๐Ÿ˜ข๐Ÿ˜ข" ู‡ู‡
"ุฏูƒุชูˆุฑ ูˆ ุงู„ู„ู‡ ุฏุฎู„ู†ุง ูƒูˆุฑุณุงุช ecg ุญุชู‰ ู†ุฌุงูˆุจ ุนู„ู‰ ูƒูŠุณุงุช ุงู„ู€ ecg ุฃู„ูŠ ุชู†ุฒู„ู‡ุงุŒ ูˆ ุตุงุฑู„ูƒ ูุชุฑุฉ ู…ุง ู†ุงุดุฑ ุนู† ุงู„ุชุฎุทูŠุทุŒ ูŠู…ูƒู† ุน ุนูŠูˆู†ุง ๐Ÿ˜ข๐Ÿ˜ข" ู‡ู‡ู‡ู‡ู‡ู‡ู‡ ุฑุณุงู„ู‡ ู…ู† ุฃุญุฏ ุงู„ุฃุดุฎุงุต ุน ุงู„ุจูˆุช. ูŠู„ุง ู‡ุฐุง ุงู„ ecg ุจูŠู‡ ู‡ูˆุงูŠ ูุงูŠู†ุฏู†ูƒุŒ ุงุญุฌูˆู„ู†ุง ุนู†ู‡ #ECG @AASmedicalbot

Tips about Metoclopromide (Plasil) 1. Below 20 year ๐Ÿ‘‰๐Ÿ‘‰ give 0.1 mg/kg/dose. Avoid it below 1 year. Don't use it more than 5 days. 2. It increases serum aldosterone ๐Ÿ‘‰๐Ÿ‘‰ fluid retention + hypo K + metabolic alkalosis. Avoid it in patients with CKD, HF, and liver impairment. 3. In renal colic, plasil has analgesic effect similar to narcotics, beside its anti-emetic effect 4. It block dopamine receptors in pituitary ๐Ÿ‘‰๐Ÿ‘‰ no inhibitiry hormone to prolactin ๐Ÿ‘‰๐Ÿ‘‰ hyper prolactinaemia ๐Ÿ‘‰๐Ÿ‘‰ infertility, on long term use. 5. It decreases seizure threshold ๐Ÿ‘‰๐Ÿ‘‰ avoided in Epilipsy 6. It has prokinetic effects ๐Ÿ‘‰๐Ÿ‘‰ used in diabetic gastroparesis, 10 mg 30 min before meals. 7. Dose adjustment in CKD: If eGFR < 40% ๐Ÿ‘‰๐Ÿ‘‰ decreases the dose by 50%. If eGFR < 10 ๐Ÿ‘‰๐Ÿ‘‰ decrease it by 75%. 8. The most common side effect is acute dystonic reaction ADR ๐Ÿ‘‰๐Ÿ‘‰ Rx by allermine. 9. Safe in pregnancy, better to be avoided in breast-feeding 10. Don't combine it with Stemetil ๐Ÿ‘‰๐Ÿ‘‰ both have anti-dopaminergic effect ๐Ÿ‘‰๐Ÿ‘‰ increase the chance of extrapyramidal side effect #pharma

๐Ÿ“‘ Heart dominance It is described by which coronary artery branch gives off the posterior descending artery(PDA) that suppli
๐Ÿ“‘ Heart dominance It is described by which coronary artery branch gives off the posterior descending artery(PDA) that supplies inferior and posterior walls of the LV (Left Ventricle): ๐Ÿ‘‰ Right-dominant (โˆผ 85% ): posterior descending artery (PDA) supplied by the right coronary artery(RCA) ๐Ÿ”– Clinically: - Awareness of the most common anatomic RCA patterns provides to possible associated inferio-posterior -/+ RV involvement. - AV Wenckebach (Mobitz Type I 2nd-degree AV block) is most commonly seen with acute inferior MI โ€” is that that the AVN usually arises from the RCA ๐Ÿ‘‰ Left-dominant (โˆผ 8% ): PDA supplied by the left circumflex artery (LCX) ๐Ÿ”– Clinically: - Awareness of the left-dominant anatomic variant accounts for the occurrence of most infero-postero-lateral infarction patterns. - May manifest Mobitz I 2nd-degree AV block (because the AV Nodal artery is usually supplied by the LCx when this vessel is dominant). ๐Ÿ‘‰ Codominant ( โˆผ 7%): PDA supplied by both RCA and LCX

Tips about PPIs 1. The fastest acting ppi is Rabeprazole (within 5-8 min), that is why is called rape-, from rapid. 2. The safest ppi Regarding drug drug interaction is Pantoprazole. 3. Pantoprazole, Rabeprazole, and nexium (form of esomperazole) can be taken Regardless the meal. 4. The highest affinity to H/K ATPase pump is Esomperazole 5. One daily PPIs dose better to be taken before breakfast 30-60 min, rather than other meal times. 6. All ppi particularly Rabeprazole can lower serum TSH level 7. Re-bound hyperacidity phenomenon is seen particularly with omperazole 8. Clopidogrel-PPIs interaction is no longer significant, you don't need to switch into Pantoprazole or seperate between these 2 drugs 8-10 hrs. 9. Extremely rare side effect of ppi is interstitial nephritis 10. Long term PPIs use + peripheral numbness ๐Ÿ‘‰๐Ÿ‘‰ think about PPIs - induced B12 deficiency. #pharma

Pediatric diarrhea: ูƒู„ุด ูƒู…ู†ุŒ ุฃุญู†ู‡ ูุจู„ ุดุงุฑุญูŠู† ุนู† ุงู„ู€ severe diarrhea ูˆ ุดู„ูˆู† ู†ุจุฏูŠ ุจู€ IV fluid. ู‡ุณู‡ ุฎู„ ู†ุดุฑุญ ุนู† ุงู„ู€ mild to moderate diarrhea (ุจุทู„ุจ ู…ู† ุฃุญุฏ ุงู„ุฃุตุฏู‚ุงุก). ุนู„ุงุฌู‡ุง ูŠุชูƒูˆู† ู…ู† ูฃ ุนู„ุงุฌุงุช ุจุตูˆุฑุฉ ุฃุณุงุณูŠุฉุŒ ูˆ ุนู„ุงุฌ ูˆุงุญุฏ ู…ู…ูƒู† ู†ุถูŠูู‡ ุงูˆ ู„ุง 1. Oral rehydration solution ORS 2. Zinc syrup 3. Probiotic 4. +/- Antibiotics (not essential, have special indications) ุทุจุนุงู‹ ู‡ุฐุง ุงู„ุดูŠุก ู…ุง ุฌุงูŠ ูŠูุทุจู‚ ุจุตูˆุฑุฉ ุตุญูŠุญุฉ ูˆ ุนุฏู‡ู… ุงู„ุนู„ุงุฌ ุงู„ุงุณุงุณูŠ ู‡ูˆ ุงู„ุงู†ุชูŠุจุงูŠูˆุชูƒ. ู†ุฌูŠ ู„ู„ู€ ORS : ูŠุฌูŠ ุนู„ู‰ ุดูƒู„ sachet ุจุชุฑุงูƒูŠุฒ ู…ุฎุชู„ูุฉ 20.5 g, 10.25 g, and 4 gram ู†ุญู„ ุงู„ุณุงุดูŠุช ุงุจูˆ ุงู„ุนุดุฑูŠู† ุจู€ ูกู ู ู  ุณูŠุณูŠ ู…ุงุกุŒ ู†ุญู„ ุฃุจูˆ ุงู„ุนุดุฑุฉ ุจู€ ูฅู ู  ุณูŠุณูŠุŒ ูˆ ู†ุญู„ ุฃุจูˆ ุงู„ู€ 4 ุจู€ ูขู ู  ุณูŠุณูŠ. ูŠูุญู„ ูู‚ุท ุจุงู„ู…ุงุก (ู„ุง ุนุตูŠุฑ ูˆ ู„ุง ุญู„ูŠุจ ูˆ ู„ุง ุดูŠุก ุขุฎุฑ)ุŒ ุงู„ู…ุงุก ู„ุงุฒู… ูŠูƒูˆู† ู…ูˆ ุญุงุฑุŒ ูŠุนู†ูŠ ู…ูˆ ุชุบู„ูŠ ุงู„ู…ุงูŠ ูˆ ุชุฌูŠ ุชุญู„ ุงู„ุณุงุดูŠุช ุจูŠู‡. ู…ู† ุชุญู„ู‡ุŒ ู…ุจุงุดุฑุฉ ุชุฎู„ูŠู‡ ุจุงู„ูุฑูŠุฒุฑ ู…ุงู„ ุงู„ุซู„ุงุฌุฉ ุญุชู‰ ูŠุทูˆู‘ู„ ูขูค ุณุงุนุฉ ุนู†ุฏูƒ ๐Ÿ‘ˆ๐Ÿ‘ˆ ุฃุฐุง ู…ุง ุชุฎู„ูŠู‡ ุจู€ ุงู„ูุฑูŠุฒุฑุŒ ุณุงุนุฉ ูˆ ูŠู†ุชู‡ูŠ ู…ูุนูˆู„ุฉ . ุดู„ูˆู† ุชู†ุทูŠุฉ: Mild dehydration: Deficit 50ml/kg/4 hr [12ml/kg/hr] + maintenance 100 ml/kg/day Moderate dehydration : 75 ml/kg/4hr + 100 ml/kg/24hr ู…ุซู„ุงุŒ ุทูู„ ูˆุฒู†ุฉ 20kg ูˆ ุนู†ุฏุฉ ู…ูˆุฏูŠุฑูŠุช ุฏูŠู‡ุงูŠุฏุฑูŠุดู† ๐Ÿ‘ˆ๐Ÿ‘ˆ Deficit: 75 * 20 = 1500 ml/4 hr ๐Ÿ‘‰๐Ÿฝ๐Ÿ‘‰๐Ÿฝ 375 ml/hr Maintenance: 100 * 20 = 2000/ day ๐Ÿ‘‰๐Ÿฝ๐Ÿ‘‰๐Ÿฝ 83 ml/hr So each hr, the pt should take 375 + 83 = 458 ml/hr ุณู‡ู„ุฉ ูƒู„ุดุŒ ูู‡ู‘ู… ุงู„ุงู…ุŒ ูˆ ูƒู„ู„ู‡ุง ุชุณุชู…ุฑ ุน ุงู„ุนู„ุงุฌ ุญุชู‰ ุชูˆู‚ู ุงู„ุฃุณู‡ุงู„. ู†ุฌูŠ ู„ู„ู€ zinc syrup ูŠุฌูŠ ุจุชุฑุงูƒูŠุฒ 10-20 ู…ุบู…/5cc Dose of zinc: Less than 6 month ๐Ÿ‘‰๐Ÿฝ๐Ÿ‘‰๐Ÿฝ 10 mg/day More than 6 mn ๐Ÿ‘‰๐Ÿฝ๐Ÿ‘‰๐Ÿฝ 20mg/day ูˆ ูŠุณุชู…ุฑ ุนู„ูŠู‡ ู„ู…ุฏุฉ ุฃุณุจูˆุนูŠู† ุณูˆุงุก ุชูˆู‚ู ุงูˆ ู…ุง ุชูˆู‚ู ุงู„ุฃุณู‡ุงู„. ู†ุฌูŠ ู„ู„ู€ probiotics : ุฃู„ูŠ ู…ูˆุฌูˆุฏ ุนุฏู†ุง ู‡ูˆ enterogerminia ุดุฑุงุจ. ุฃูƒูˆ ู‡ูˆุงูŠ ุดุฑุงุจุงุช ุฃุญุณู† ู…ู† ุนู†ุฏู‡ ุจุณ ู…ูˆ ุดุงุฆุนู‡ ุนุฏู†ุง ู„ู„ุฃุณู . ูˆ ู„ุง ุชุณุชุนู…ู„ ุงู†ุชูŠ ุจุงูŠุชูƒ ุจูƒู„ ุงู„ุญุงู„ุงุช ุฅู„ุง ุฃุฐุง ูƒุงู† ุงู†ุฏูƒูŠุชูŠุฏุŒ ุฑุฌุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุงุกุงู‹ #pediatric

ู‡ู„ูˆ ุฑุงุฌุนุช ุงู„ู€ FDA ู„ฺฏูŠุชู‡ุง ุฃุตู„ุงู‹ ุณุงุญุจุฉ ุงู„ู€ phenylpropanolamine ู…ู† ุงู„ุฃุณูˆุงู‚. ูˆ ุงูŠุถุงู‹ ู…ุณุญูˆุจ ู…ู† ุจุฑูŠุทุงู†ูŠุง. ุจุณุจุจ ุงู„ู€ haemorrhagic stroke ูŠุนู†ูŠ ูƒู„ ุนู„ุงุฌ ูƒุญุฉ ูŠุญุชูˆูŠ ุนู„ู‰ ู‡ุงูŠ ุงู„ู…ุงุฏุฉุŒ ุฃู†ุณุญุจ ู…ู† ุงู„ุตูŠุฏู„ูŠุงุช. ุงู„ุฃูŠุชู… ุฅู„ูŠ ู…ูˆุฌูˆุฏุฉ ุนุฏู†ุง ูˆ ูŠุฌุชูˆูŠ ุนู„ู‰ ู‡ุงูŠ ุงู„ู…ุงุฏุฉ ู‡ูˆ Dolo-coldุŒ ูˆ ุฅู„ูŠ ูŠูุณุชุนู…ู„ ูˆ ุจูƒุซุฑุฉ Dolo-cold contains : paracetamol + allermine + caffiene + pseudophedrine + phenylpropanolamine ูู€ ุฎู„ุตุŒ ุจุนุฏ ู„ุญุฏ ูŠูƒุชุจ ุงู„ุนู„ุงุฌุงุช ุงู„ูŠ ุชุญุชูˆูŠ ุนู„ู‰ ุงู„ู€ phenylpropanolamine. ุฃุนูŠุฏ ูˆ ุฃูƒุฑุฑ: ุฃู†ุง ู…ูˆ ู…ู†ุฏูˆุจ ูˆ ู„ุง ู‡ุฏููŠ ุฃู† ุฃุฑูˆู‘ุฌ ู„ุดุฑูƒุฉ ูˆ ุฃุณู‚ุท ุดุฑูƒุฉ ุซุงู†ูŠู‡ุŒ ุจุณ ุฃูƒูˆ ุฃุดูŠุงุก ู„ุงุฒู… ุงู„ูƒู„ ูŠุนุฑูู‡ุง. #pharma

Scientifically, all pts with MI should be send for CRP ๐Ÿ‘‰๐Ÿ‘‰ patients with high CRP, have poor prognosis on short and long terms. ู„ูŠุด ุงู„ู€ high CRP ุนู†ุฏู‡ Poor prognosisุŸุŸ Atherosclerosis is an Inflammatory process, just like all other Inflammatory diseases. ูุชุชูƒูˆู† ุนู†ุฏูƒ atheroma ูˆ ุญุชู‰ ู‡ุงูŠ ุงู„ู€ atheroma ูŠุตูŠุฑ ุจูŠู‡ุง destabilization ู†ุญุชุงุฌ acute intensive inflammation ุงู„ูŠ ุฑุงุญ ูŠุณูˆูŠ rupture of atheroma ูˆ ูŠุญูˆู„ู‰ ุงู„ู€ chronic stable angina ุฅู„ู‰ ACS. ููƒู„ ู…ุง ูŠูƒูˆู† ุงู„ู€ CRP ู…ุฑุชูุน ุฃูƒุซุฑุŒ ูƒู„ ู…ุง ูŠุนู†ูŠ ุงู† ุงู„ุงู†ูู„ุงู…ูŠุดู† ุงู„ูŠ ุตุงุฑ ุฏุงุฎู„ ุงู„ู€ Plaque ู‡ูˆ ุฃู‚ูˆู‰. ุฒูŠู† ุงู†ูŠ ุดุณุชูุงุฏ ู…ู† ู‡ุฐุง ุงู„ูƒู„ุงู…ุŸุŸ Statins has intra-plaque anti-Inflammatory action ูˆ ุงู„ู…ุฑูŠุถ ู…ูˆ ู†ู†ุทูŠุฉ ุณุชุงุชู† ูู‚ุท ุนู„ู…ูˆุฏ ู†ู†ุฒู„ ุงู„ู€ lipidsุŒ ุจุงู„ุนูƒุณ ุญุชู‰ ู„ูˆ ูƒุงู†ุช ุงู„ุฏู‡ูˆู† ุทุจูŠุนูŠุฉ ู„ุงุฒู… ู†ู†ุทูŠ ุณุชุงุชู†ุŒ ูˆ ุงู„ุณุจุจ ู‡ูˆ ุฃู„ูŠ ุฐูƒุฑุชู‡ Statins improve plaque stability via exertion anti inflammatory action inside the plaque. ูˆ ุฃูƒุซุฑ ุณุชุงุชู† ุชู…ุชู„ูƒ ู‡ุงูŠ ุงู„ุฎุงุตูŠุฉ ู‡ูŠ Atrovastatin and Rosuvastatin ู‡ุฐุง ู…ู„ุฎุต ุจุณูŠุท ุนู† ู…ุนุฑูุฉ ุฃู‡ู…ูŠุฉ ุงู„ู€ CRP ููŠ ุญุงู„ุงุช ุงู„ู€ MI. #cardio

๐Ÿ”– Mx of HypoCa Calcium infusion can promote vasoconstriction & ischemia in any vital organ and especially in pt has: ๐Ÿ‘‰ Low cardiac output or ๐Ÿ‘‰ Circulatory shock So it wise to avoid correcting ionized hypocalcemia with intravenous calcium except there is evidence of serious complication linked to hypocalcemia

ุฃุฑูŠุฏ ุฃฺฏูˆู„ ุดูŠ ๐Ÿ˜‘๐Ÿ˜‘๐Ÿ˜‘ ุฌุงูŠ ุชุดูˆููˆู† ุฃู† ุงู„ู€ haemorrhagic stroke ูƒู…ู† ุฎู„ุงู„ ู‡ุงูŠ ุงู„ูุชุฑุฉ ุฃูˆ ุจุดูƒู„ ุนุงู… ุงู„ุณุชุฑูˆูƒ ุจุฃู†ูˆุงุนู‡ุง ุตุญุญุŸุŸุŸ ูƒู€ ุชุญู„ูŠู„ ู…ู† ูŠู…ูŠ (ูˆ ุงู„ู„ู‡ ุงู„ุนุงู„ู…) ู‡ุฐุง ุจุณุจุจ ุฃุณุชุนู…ุงู„ ุฃุฏูˆูŠุฉ ุงู„ู†ุดู„ุฉ ูˆ ุงู„ูƒุญุฉ. ู‡ูˆุงูŠ ุฃุฏูˆูŠุฉ ู†ุณุชุนู…ู„ู‡ุง ู„ู„ฺฏุญุฉ ุชุญุชูˆูŠ ุนู„ู‰ Alpha agonist like ephidrine or pseudophedrine or phenylpropanolamine ูู‡ุงูŠ ุงู„ุฃุฏูˆูŠุฉ ุชุณูˆูŠ vasoconstriction ูˆ ุจุงู„ุชุงู„ูŠ ุชุณูˆูŠ Hypertension and vessels rupture ููŠุตูŠุฑ ุนุฏู‡ู… haemorrhagic stroke. ุฃุฐุง ุชุฑูŠุฏ ุชุณุชุนู…ู„ ุนู„ุงุฌ ู„ู„ูƒุญุฉ ู„ู€ ุดุฎุต ุนู†ุฏุฉ hypertensionุŒ ูุฃุชุฌู†ุจ ู‡ุงูŠ ุงู„ุนู„ุงุฌุงุช ุงู„ูŠ ุชุญุชูˆูŠ ุนู„ู‰ alpha agonist. ุงูƒูˆ ู‡ูˆุงูŠ ุนู„ุงุฌุงุช ุจูŠู‡ุง combination ู„ุทูŠู ูˆ ุขู…ู†. ู…ุจุฏุฆูŠุงุŒ ูƒู„ู‡ู… ู†ู†ุทูŠู‡ู… Lukafen (ู…ุซู„ ู…ุง ุงุชูู‚ู†ุง ููˆฺฏ) ุฃูˆ ู†ู†ุทูŠู‡ู… Bronchorest ุงู„ูŠ ู‡ูˆ Montelukast + levocitrizine (3rd generation anti histamine) ุจุนุฏู‡ุง ุชุดูˆู ุงู„ฺฏุญุฉ ู…ุงู„ุชู‡ dry or wetุŸุŸุŸ 1. Dry cough: use dextromethorphan + 1st generation anti-histamines (like allermine or triprolidine) ูˆ ุงู„ุฃู…ุซู„ุฉ ูƒุซูŠุฑุฉ ุฌุฏุง ุฌุฏุง ุนู† ุนู„ุงุฌุงุช ุจูŠู‡ุง ู‡ุฐุง ุงู„ูƒูˆู…ุจู†ูŠุดู†ุŒ ู…ุง ุฑุงุญ ุงุฐูƒุฑู‡ู… ุญุชู‰ ู…ุง ูŠุตูŠุฑ ุชุฑูˆูŠุฌ. 2. Wet cough: use drugs that contain Bromehxine + Guiafensin ูˆ ุงู„ุฃู…ุซู„ุฉ ุฃูŠุถุง ูƒุซูŠุฑุฉ ุฌุฏุง ุฌุฏุง ุนู† ุนู„ุงุฌุงุช ุจู‡ุฐุง ุงู„ูƒูˆู…ุจู†ูŠุดู† 3. Slightly wet (or slightly dry): use drugs that contain Guiafensin + dextromethorphan ูˆ ุฃูŠุถุง ุฃู…ุซู„ุฉ ูƒุซูŠุฑุฉ ุนุฏู†ุง ุจู€ elderly ุญุงูˆู„ ุชุชุฌู†ุจ ุฃุฏูˆูŠุฉ ุงู„ฺฏุญุฉ ุฃู„ูŠ ุชุญุชูˆูŠ ุนู„ู‰ theophylline ู…ุซู„ Exidil syrup or Exvent syrup or bronchiuum ุจุงู„ุฃุดุฎุงุต ุฃู„ูŠ ุนุฏู‡ู… ู‚ุฑุญุฉ ู…ุนุฏุฉุŒ ุญุงูˆู„ ุชุชุฌู†ุจ ุงู„ุฃุฏูˆูŠุฉ ุงู„ูŠ ุชุญุชูˆูŠ ุนู„ู‰ bromehxine ู…ุซู„ Solvodine syrup or tab, Bronchovet, bronchosolvin, Bronchomark ูˆ ุบูŠุฑู‡ุง #pharma

ุงู„ูƒุชุงุจุฉ ุชุทู„ุน ุนุฏูƒู… ู…ุฑุชุจุฉ ู„ูˆ ู…ุฎุฑุจุทุฉุŒ ู„ุฃู† ู…ุฑุงุช ุจุณุจุจ ุงู„ุนุฑุจูŠ ูˆ ุงู„ุฅู†ูƒู„ูŠุฒูŠ ูŠุตูŠุฑ ุตุนุจ ู‚ุฑุขุฉ ุงู„ู…ู†ุดูˆุฑ. ุญุชู‰ ุฅุฐุง ู…ุง ู…ุฑุชุจุฉุŒ ุฃุฑุชุจู‡ุง ุจ ุงู„ู…ู†ุดูˆุฑุงุช ุงู„ุฌุงูŠุฉ. @AASmedicalbot

ุฎู„ ู†ุชูู‚ุŒ ุฃู† ู‡ุฐุง ุงู„ู…ู†ุดูˆุฑ ู…ูˆ ุชุฑูˆูŠุฌ ู„ุนู„ุงุฌ ู…ุนูŠู† ุงูˆ ุดุฑูƒุฉ ู…ุนูŠู†ุฉุŒ ุจุณ ุงู„ูƒู„ ูŠุญุชุงุฌ ูŠุนุฑู ู‡ุงูŠ ุงู„ู…ุนู„ูˆู…ุงุช: ุงู„ุฃู„ุชู‡ุงุจุงุช ุจุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠ ุชุฎุชู„ู ุนู† ุจู‚ูŠุฉ ุงู„ุฃู„ุชู‡ุงุจุงุช ู„ุญุฏู ู…ุงุŒ ู„ุฃู† ุชูƒูˆู† The main mediators of inflammation in respiratory system are leukotriens and histamines ูˆ ุจุตูˆุฑุฉ ุฃู‚ู„ ูŠูƒูˆู† prostoglandinุŒ ูู„ุฐู„ูƒ anti prostoglandin medications ุฃู„ูŠ ู‡ู† NSAIDs ู…ุซู„ ุงู„ุจุฑูˆููŠู† ูˆ ุบูŠุฑู‡ุงุŒ ู…ูˆ ูƒู„ุด ุชููŠุฏู†ุง. ุจุงู„ุนูƒุณ ู…ู…ูƒู† ุชุถุฑู†ุง. ูู…ู† ูŠุฌูŠูƒ ุดุฎุต ุนู†ุฏุฉ ู…ุซู„ุง Cough, allergic rhinitis, tracheitis ูŠุนู†ูŠ ุฃูŠ ุฃุนุฑุงุถ ู…ุงู„ ุงู„ุชู‡ุงุจุงุช ุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠุŒ ูู„ุงุฒู… ู†ู†ุทูŠ Anti histamine + anti leukotriens ุฃู‚ูˆู‰ ุงู†ุชูŠ ู‡ุณุชุงู…ูŠู† ูˆ ุจู†ูุณ ุงู„ูˆู‚ุช ูŠูุนุชูŽุจุฑ ุกุงู…ู† ูˆุงุญุฏ ู‡ูˆ Fexofenadine (Telfast) 120 mg or 180 mg ูˆ ุจุงู„ู†ุณุจุฉ ู„ู„ู€ leukotrien antagonist ุงู„ู…ุดู‡ูˆุฑ ุนุฏู†ุง ู‡ูˆ montelukast. ุฃูƒูˆ ุนู„ุงุฌ ุฃุณู…ู‡ Lukafen (montelukast + Fexofenadine) ูƒู„ุด effective ู„ู„ุฃุดุฎุงุต ุงู„ูŠ ุนุฏู‡ู… Sore throat, allergic sinusitis, asthma, etc. ู…ูˆุฌูˆุฏ ุจุฃุบู„ุจ ุงู„ุตูŠุฏู„ูŠุงุช ูˆ ู…ูˆ ูƒู„ุด ุบุงู„ูŠ. ู‡ุฐุง ู…ูˆ ุชุฑูˆูŠุฌ ู„ู„ู€ LukafenุŒ ุงุตู„ุง ู…ุง ุงุนุฑู ุงู„ุดุฑูƒุฉ ุงู„ู…ุตู†ุนู‡ ูˆ ุงู„ู„ู‡. ุจุณ ุชุญุชุงุฌูˆู† ู‡ุฐุง ุงู„ุนู„ุงุฌ ุนู„ู‰ ุงู„ุฃู‚ู„ ู„ุฃู‡ู„ูƒู…ุŒ ู„ู„ูŠ ุนุฏู‡ู… ุญุณุงุณูŠุฉ ุนู†ูŠูุฉุŒ ุฃูˆ ุฃูŠ ุฃุนุฑุงุถ ู…ุงู„ ูƒูˆูุฏ #pharma

ู„ูŠุด ุงู„ู€ ACEIs ุงูุถู„ ู…ู† ุงู„ู€ ARBs ูˆ ุงู„ู€ survival benefit ู„ุงุญุธูˆู‡ุง ุจุงู„ู€ ACEIs ุฃูƒุซุฑ ู…ู† ุงู„ู€ ARBSsุŸุŸ ูˆ ู…ูˆ ุจุณ ู‡ุงูŠุŒ ุงู„ู€ Lisinopril ุฃู„ูŠ
ู„ูŠุด ุงู„ู€ ACEIs ุงูุถู„ ู…ู† ุงู„ู€ ARBs ูˆ ุงู„ู€ survival benefit ู„ุงุญุธูˆู‡ุง ุจุงู„ู€ ACEIs ุฃูƒุซุฑ ู…ู† ุงู„ู€ ARBSsุŸุŸ ูˆ ู…ูˆ ุจุณ ู‡ุงูŠุŒ ุงู„ู€ Lisinopril ุฃู„ูŠ ู‡ูˆ ุฃุณูˆุก ACEIs ูŠูุนุชูŽุจุฑ ุฃูุถู„ ู…ู† ูƒู„ ุงู„ู€ ARBs. The answer in this sheet. #cardio

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Acute heart failure: 1. BP > 110 mmHg ๐Ÿ‘‰๐Ÿ‘‰ angiseed, started with SL 0.5 mg repeated 3 times 5 min 2. BP > 180 mmHg ๐Ÿ‘‰๐Ÿ‘‰ angiseed infusion 3. BP 90-110 mmHg ๐Ÿ‘‰๐Ÿ‘‰ lasix 4. BP 80-90 mmHg ๐Ÿ‘‰๐Ÿ‘‰ dobutamine 5. BP 70-80 mmHg ๐Ÿ‘‰๐Ÿ‘‰ dobutamine + noradrenaline 6. BP < 70 mmHg ๐Ÿ‘‰๐Ÿ‘‰ adrenaline or noradrenaline ุณู‡ู„ุฉ ู…ูˆูˆ ูˆ ูƒู„ ูˆุงุญุฏ ุดุงุฑุญูŠู†ุฉ ุดู„ูˆู† ุชู†ุทูŠู‡ ูˆ ุดู„ูˆู† ุชุฑุงู‚ุจู‡ #cardio