M.H.A.

Med- student ;)

[wellspringcounseling]

It’s not too difficult to get the skeletons out of the closet with people, but to get the gold out is a different matter. That is therapy. Psychology is the art of finding the gold of the spirit.

Robert A. Johnson (via wellspringcounseling)

[warag-3nb]

الحب هو أسمى من أللي نقوله .. بالمختصر شخصين في قلب واحد ..

Translation: Love is superior to what we say it is .. In to be precise it’s to people sharing one heart ..

[mernaateya]

2 ppl sharing one heart.

[artsciencenursing-blog]

[daydutynurse]

Oh so important!

[mernaateya]

Take care.

[sevenintelligences]

Major Classes of Antibiotics - The Longitude Prize

There is still time to enter the Longitude Prize… I might do so, just for the hell of it! The theme was: to create a cheap, accurate, rapid and easy-to-use point of care test kit for bacterial infections. Point-of-care test kits will allow more targeted use of antibiotics, and an overall reduction in misdiagnosis and prescription. Effective and accurate point of care tests will form a vital part of the toolkit for stewardship of antibiotics in the future. This will ensure that the antibiotics we have now will be effective for longer and we can continue to control infections during routine and major procedures. The issue is that we cannot outpace microbial evolution. A new broad-spectrum antibiotic, if applied with current methods, would eventually meet new forms of resistance. The overall solution involves a long-term path towards a more intelligent use of antibiotics enabling a future of more effective prevention, targeted treatments and smart clinical decision support systems.

Beta-Lactams

Beta-lactams are a wide range of antibiotics, the first of which to be discovered was penicillin, which Alexander Fleming identified in 1928. All beta-lactam antibiotics contain a beta-lactam ring; they include penicillins, such as amoxicillin, and cephalosporins. Bacteria can develop resistance to beta-lactams via several routes, including the production of enzymes that break down the beta-lactam ring. In the NHS, penicillins are the most commonly prescribed antibiotics, with amoxicillin being the most common in the class.

Sulfonamides

Prontosil, a sulfonamide, was the first commercially available antibiotic, developed in 1932. In the present day, sulfonamides are rarely used, partially due to the development of bacterial resistance, but also due to concern about unwanted effects such as damage to the liver of patients.

Aminoglycosides

Aminoglycosides inhibit the synthesis of proteins in bacteria, eventually leading to cell death. In the treatment of tuberculosis, streptomycin was the first drug found to be effective; however, due to issues with toxicity of aminoglycosides, their present day use is limited.

Tetracyclines

Tetracyclines are broad-spectrum antibiotics, active against both Gram-positive and Gram-negative bacteria. Their use is decreasing to increasing instances of bacterial resistance; however, they still find use in treatment of acne, urinary tract, and respiratory tract infections, as well as chlamydia infections.

Chloramphenicol

Another broad-spectrum antibiotic, chloramphenicol also acts by inhibiting protein synthesis, and thus growth and reproduction of bacteria. Due to the possibility of serious toxic effects, in developed countries it is generally only used in cases where infections are deemed to be life-threatening, although it is a much more common antibiotic in developing countries due to its low cost and availability.

Macrolides

Macrolides’ effectiveness is marginally broader than that of penicillins, and they have been shown to be effective against several species of bacteria that penicillins are not. Whilst some bacterial species have developed resistance to macrolides, they are still the second most commonly prescribed antibiotics in the NHS, with erythromycin being the most commonly prescribed in the class.

Glycopeptides

Glycopeptides include the drug vancomycin – commonly used as a ‘drug of last resort’, when other antibiotics have failed. There are strict guidelines on the circumstances in which vancomycin can be used to treat infections, in order to delay the development of resistance. The bacteria against which glycopeptides are active are otherwise somewhat limited, and in most they inhibit growth and reproduction rather than killing bacteria directly.

Oxazolidinones

Oxazolidinones are active against Gram-positive bacteria, and act by inhibiting protein synthesis, and hence growth and reproduction. Linezolid, approved for use in 2000, was the first marketed antibiotic in the class, and resistance seems to be developing relatively slowly since its introduction.

Ansamycins

This class of antibiotics are effective against Gram-positive bacteria, as well as some Gram-negative bacteria. A subclass of antibiotics, rifamycins, are used to treat tuberculosis and leprosy. Uncommonly, ansamycins can also demonstrate anti-viral activity.

Quinolones

Quinolones are widely used for urinary tract infections, as well as other hospital-acquired infections where resistance to older classes of antibiotics is suspected. Resistance to quinolones can be particularly rapid in its development; in the US, they were the most commonly prescribed antibiotics in 2002, and their prescription for unrecommended conditions or viral infections is also thought to be a significant contributor to the development of resistance.

Streptogramins

Streptogramins are unusual in that they are usually administered as a combination of two antibiotic drugs from the different groups within the class; combined they have a synergistic effect and are capable of directly killing bacteria cells. They are often used to treat resistant infections, although resistance to the streptogramins themselves has also developed.

Lipopeptides

Discovered in 1987, lipopeptides are the most recent class of antibiotics. Daptomycin is the most commonly used member of the class; it has a unique mechanism of action, disrupting several aspects of cell membrane function in bacteria. This unique mechanism of action also seems to be advantageous in that, currently, incidences of resistance to the drug seem to be rare – though they have been reported.

[jewsee-medicalstudent]

Common painkillers.

No, this isn’t the Judas Priest song (furthermore I like it). This is a guide to drugs used to stop pain, maybe the most used drugs with cardiovascular drugs and antidepressant. Painkillers, or analgesics, come in a number of forms, but fall broadly into two main classes: non-steroid anti-inflammatory drugs (NSAIDs) and opioids. This graphic takes a look at a selection of common painkillers, their common brand names, and how they work.

Non-steroid anti-inflammatory drugs include analgesics such as aspirin and ibuprofen, shown in the graphic, as well as naproxen. These drugs all work by inhibiting the synthesis of a class of chemical compounds called prostaglandins. Prostaglandins are produced by the body during inflammation, and they contribute significantly towards pain. NSAIDs work by inhibiting the activity of two enzymes, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These enzymes catalyse prostaglandin synthesis, so when their activity is inhibited, so is the body’s manufacture of prostaglandins. The net result is a reduction in inflammation, and subsequently a reduction in pain. Painkillers have no innate method of reaching only the site of pain, but rather are distributed evenly through-out the body when you take them. They’re also non-discriminative in terms of their action, and will inhibit prostaglandin synthesis all over your body, not just at the site of pain. Prostaglandins don’t just have a role in pain in our bodies – they’re also found in the gut, where their role includes protection of the gut lining. As such, use of NSAIDs increases the risk of stomach ulcers and gastrointestinal irritation. For this reason, during sustained course of NSAIDs (for example, after surgery), drugs to help protect the gut lining may also be prescribed.

Opioids are the second major class of painkillers. These are a class of drugs related to morphine, the compound found in significant concentrations in the opium poppy. The opium poppy itself has been used for its natural painkilling properties for centuries, as the opium which can be extracted from it contains around 12% morphine. The synthetic drug heroin is also obtained from a simple chemical modification of morphines structure; many of the painkilling opioids have similarly minor differences in chemical structure. The opioids work in a different way to the NSAIDs; rather than combatting the pain at its source, they instead prevent the sensation of pain by binding to and blocking the receptors in the brain and spinal cord that are responsible for the transmission of the sensation of pain. This group of receptors are known as opioid receptors, and there are four different subtypes; the exact manner in which many of the opioids inhibit pain by binding to these receptors isn’t fully understood. Opioids may be potent painkillers, but their overuse comes with the spectre of opioid addiction. Excessive use leads to over-stimulation of the brain’s ‘reward’ pathways; the brain also tries to compensate by reducing the number of opioid receptors, meaning progressively more of the opioid is required to achieve the same highs. No single treatment is effective for all opioid dependent patients, and oddly enough, some of the opioids drugs are used in some treatments. Methadone and buprenorphine are both commonly prescribed, as they are longer acting than, for example, heroin, and so allow for less frequent dosing. Tolerance is also slow to develop, and as such their use has been associated with a reduction in the use of other opioids in opioid dependent individuals. Although fentanyl is the most potent opioid shown on the chart, more powerful opioids do exist. The most potent used in humans is sufentanil, considered to be approximately 500-1000 times stronger than morphine. Carfentanil, with a potency considered to be around 10,000 times that of morphine, is used as a general anaesthetic in large animals.

Paracetamol is something of an oddity among the painkillers, in that it’s categorized separately, rather than in one of the two main groups. Part of the reason behind this is that we still don’t have a very good idea of how paracetamol exerts its painkilling effects. It’s thought that, like the NSAIDs, it works by inhibiting cyclooxygenase enzymes, but there are also suggestions that it works on the endocannabinoid system in the body, which plays a part in pain. In short, we still don’t really know how it functions. Paracetamol also has a detraction, in that its toxic dose is relatively close to the effective dose. Excessive use or overdose can lead to damage to cells in the liver, which can in turn lead to liver failure and death.

(Source: Compound Interest).

[mernaateya]

sneezing's big myth

 " your heart stops on sneezing. "

It's not true that your heart stops when you sneeze. When your chest contracts because of a sneeze, your blood flow is momentarily constricted as well. As a result, the rhythm of your heart may change, but it definitely doesn't stop.

[mernaateya]

Totally insensitive cells :D 

[mernaateya]

I learned to give, not because I've much;but because I know exactly how it feels to have NOTHING.

[mernaateya]

"Biology gives you a brain. Life turns it into a mind"

Jeffrey Eugenides

[medicowesome]

Minor clinical problems observed in normal infants during first week of life illustration.

I can’t seem to add the second image through the app:( I’ll fix it when I have access to my PC.

You can check it out here in the meantime: http://medicowesome.blogspot.com/2014/12/minor-clinical-problems-observed-in.html

[mernaateya]

[mernaateya]

“شعور سخيف إنك تحس بإن وطنك شيء ضعيف صوتك ضعيف رأيك ضعيف إنك تبيع قلبك وجسمك وإنك تبيع قلمك وإسمك ما يجيبوش حق الرغيف” #الجخ

[mernaateya]

[scienceshenanigans]

[mernaateya]

All vital things.

[ihearthisto]

Histology look-a-like #81

Reed-Sternberg cell in a lymphocyte  v A teddy bear

Reed–Sternberg cells are giant cells found in biopsies from individuals with Hodgkin’s lymphoma (aka Hodgkin’s disease; a type of lymphoma).

Not so cuddly now huh?

The cells are usually derived from B lymphocytes, classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody

They are named after Dorothy Reed Mendenhall and Carl Sternberg, who provided the first definitive microscopic descriptions of Hodgkin’s disease.

i-heart-histo

x

[etincarnatusest]

Colored SEM depicting numerous clumps of methicillin-resistant Staphylococcus aureus bacteria (MRSA)

[hishamelsayed]

Egypt ♥

[mernaateya]

lovely photo ♥♥♥