Doctor Shakyhands @doctorshakyhands - Tumblr Blog

ادْفَعْ بِالَّتِي هِيَ أَحْسَنُ السَّيِّيَةَ

"Repel evil with that which is better." [Surah Al-Mu'minun (23:96)]

This is like the Ayah:

ادْفَعْ بِالَّتِى هِىَ أَحْسَنُ فَإِذَا الَّذِى بَيْنَكَ وَبَيْنَهُ عَدَاوَةٌ كَأَنَّهُ وَلِىٌّ حَمِيمٌوَمَا يُلَقَّاهَا إِلاَّ الَّذِينَ صَبَرُواْ

"Repel (the evil) with one which is better, then verily he, between whom and you there was enmity, (will become) as though he was a close friend. But none is granted it except those who are patient."

meaning, nobody will be helped or inspired to follow this advice or attain this quality,

إِلاَّ الَّذِينَ صَبَرُواْ

"except those who are patient", meaning, those who patiently bear people's insults and bad treatment and deal with them in a good manner when they are on the receiving end of bad treatment from them,

وَمَا يُلَقَّاهَأ إِلاَّ ذُو حَظِّ عَظِيمٍ

"and none is granted it except the owner of the great portion." means, in this world and the Hereafter. (41:34-35)

— Tafseer Ibn Katheer (Abridged)

....

Abdullaah ibn Amr reported that Allaah has described the Prophet ﷺ as follows:

سَمَّيْتُكَ الْمُتَوَكِّلَ لَيْسَ بِفَظٍّ وَلاَ غَلِيظٍ وَلاَ صَخَّابٍ فِي الأَسْوَاقِ وَلاَ يَدْفَعُ بِالسَّيِّئَةِ السَّيِّئَةَ وَلَكِنْ يَعْفُو وَيَغْفِرُ

I have called you a trustworthy man who is neither rude nor loud in the markets, nor does he return evil with evil, but rather he pardons and forgives. [Saheeh Bukhari, 2018]

writtenduas

‎Ibn Abbaas (رضي الله عنه) said:

‎لا تجالس أهل الأهواء فإن مجالستهم ممرضة للقلوب

‎“Do not sit with the people of desires (i.e. ahlul bidah) for indeed sitting with them will cause sickness to the hearts.”

‎[Al-Ibaanah 2/438]

writtenduas

‎Sheikh ibn ‘Uthaymeen رحمه الله said:

‎“The intellectual person is the one who recites the Qur’ān and contemplates over it. He becomes aware of the value of the worldly-life and that it is of no value [i.e. worthless] and it is a place of cultivation [to perform good deeds and actions], for the Afterlife. Therefore look to what you have sown therein, for [the betterment of] your Afterlife.”

[Sharh Riyādh us-Sāliheen, 3/358]

writtenduas

Ibn al Qayyim رَحِمَ اللهُ عَلَيْهِ said,

“A girl died of the plague and her father saw her in his dream. He said, ‘my daughter, tell me about the hereafter. So she said, 'We’ve approached a serious matter. We used to know but we didn’t act. I swear by Allah, to add one tasbeehah (saying Subhan Allah) or a single Rak'ah to my book of deeds is more beloved to me than the whole world and everything in it.’

This girl said words of great importance. 'We used to know but we didn’t act’, but many of us don’t understand what she means.

We used to know, that if we say Subhan Allah wa bi Hamdihi 100 times our sins are forgiven even if they’re like the foam of the sea (yet days and nights pass and we don’t say it)

We used to know that two rak'ahs of Duha prayer is the equivalent of giving 360 charities (yet day after day pass and we don’t pray it)

We used to know that a house in the middle of Jannah is guaranteed for one who abandons lying even while joking (yet every second sentence we utter is a lie)

We used to know that fasting a day voluntarily for the sake of Allah puts a distance between our face and the fire the size of seven trenches and Allah distances our face from the fire the distance travelled in 70 years, (and we haven’t fasted single day this week)

We used to know that whoever visits a sick person is followed by 70,000 angels seeking Allah’s forgiveness on his behalf (but we haven’t visited a sick person this week)

We used to know that whoever prayed a funeral prayer and followed it till it was burried has two Qiraats of reward and a Qiraat is like the mountain of Uhud (yet weeks pass and we haven’t been to the graveyard.)

We used to know that whoever builds a mosque even if it’s like a bird’s nest Allah builds a house for them in paradise (yet we haven’t contributed to the building of a Masjid, even with 10 dinars)

We used to know that the one who supports the widow and her children is like the fighter in the path of Allah and the one who fasts all day and prays all night without sleeping. (Yet we haven’t contributed to sponsoring a widow and her children)

We used to know that whoever reads a single letter from the Quran has a good deed and every deed is multiplied by 10. Yet we haven’t made a point to read it every day.

We used to know that an accepted Hajj has the reward of jannah and it sends the person who completed it off like the day his mother gave birth to him. (With a clean book of deeds) yet we haven’t performed the rites of Hajj although our circumstances have made it easy for us.

We knew the honor of a believer is in Qiyam Al-layl, and that the Prophet (pbuh) and his companions never missed it all their lives despite being busy with making a living and fighting in the path of Allah and spreading the religion. But we have neglected this matter terribly.

We knew the Day of Judgment was coming without a doubt and that Allah will resurrect us from our graves but we haven’t prepared for that day.

We used to bury the deceased and pray over them but haven’t prepared ourselves for a day like this one, as if we have a guarantee that it won’t happen to us.

We know that every breath we breathe is getting us closer to death yet we’re still busy with amusement and playing. It’s time we change the way we’re living and prepare properly for the day of accounting.

"On the Day a man will flee from his brother. And his mother and his father; And his wife and his children, For every man, that Day, will be a matter adequate for him.” Quran (80:34-37)

Kitab Al Ruh by Ibn Al Qayyim رَحِمَ اللهُ عَلَيْهِ

Been my home since 2 years now

#covid 19 #covid virus #corona virus #virology #mediblr #studyblr #medicine #medico #study motivation #medblr #mbbs #mdcommunity #house md #laboratory

#C56

A sand artist had visited the skin OPD complaining about his 4 cms long erythematous lesion on his right thumb. He had acquired it 3 days ago after he had his recent sand sculpture done. He complained of intense itch and burning sensation around the lesion since 3 days. His worry was that the lesion had been growing longer with every passing day.

On examination the lesion appeared to be erythematous papules with a slightly elevated erythematous tract of 4 cms × 3 mm.

The patient demonstrated peripheral eosinophilia on CBC count and increased immunoglobulin E (IgE) levels.

Diagnosis: Cutaneous larva migrans/Creeping erruption

m/c/c: Ancylostoma braziliense

Infective stage: filariform (third-stage) larvae

Route of transmission: direct contact with infected soil.

Eggs pass through faeces of cats and dogs, hatch in the soil where they mature. They directly penetrate the skin causing erythematous lesions which advance by several cms/day.

The course of the disease is self limiting since the organism doesn't mature in humans and dies in a span of few weeks to months with the skin lesions being resolved.

Treatment:

> Self limiting

> Oral Albendazole: 400mg/day × 3 days

> Topical ivermectin/thiabendazole 4 times/day application, resolves within a week with topical therapy

Doctor Shakyhands,

www.aim4pg.com team

#studyblr #mediblr #covid 19 #medicine #medico #study motivation #medblr #infectious diseases #infection #microbiology #microscope #case study #mbbs #mdcommunity #house md

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janedoemd

ECG: quick and dirty

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career.

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough.

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number.

3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.

4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II.

up in lead I, up in lead II: normal axis

up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)

down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)

5. did someone say HYPERTROPHY?

look at V1

is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.

is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.

6. P-waves

look at lead II

is it wide? left atrial enlargement.

is it tall? right atrial enlargement.

7. PR interval

should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].

long PR interval means there’s some sort of block at the AV node.

1st deg block. PR interval is long. everything else is normal. cool.

2nd deg block

type I: PR interval progressively gets long. eventually a dropped QRS.

type II: PR interval is constant, but randomly dropped QRS.

3rd deg block “complete block”

there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg.

8. QRS complex

narrow or wide?

narrow: good. signal coming from somewhere above ventricles.

wide: think BBB (bundle branch block)

LOOK AT V1 ONLY.

if the last deflection of QRS is DOWN, then it’s a left BBB

if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap.

9. ST segment

always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval).

elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes.

look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:

posterior up, anterior down

anterior up, inferior down

inferior up, lateral down

lateral up, septal down.

LBBB can look like STEMI. How to tell?

disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)

concordant changes is abnormal.

massive discordance is abnormal. (STEMI is greater than 5mm)

this isn’t that important. Moving on.

Inferior STEMI. Could right ventricle be involved?

DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.

order a 15 lead

is STE in lead III > lead II? likely RV involvement

INFERIOR MI? 15 LEAD NO NITRO

10. T waves

is it inverted? indicates recent ischemic changes.

11. Q waves

is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs).

I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart.

Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.

priorisn7-deactivated20180719

This is Medblr gold. Reblogging for anyone staring down the barrel at 1 July.

cranquis

I learned a lot here.

medicalmiracle

can never reblog this enough. working in a COVID field hospital now and the lifepack ecg is literally the only diagnostic tool i have besides my physical exam. GOLD IS NOT ENOUGH.