NIAT

Wells Score for pulmonary embolism (PE).

Wells Score for pulmonary embolism (PE).
The mnemonic is: Don’t die, tell the team to calculate criteria! The first letters in the saying correspond to a criteria for diagnosis. If the first letters are the same, they also have the same numerical point value for calculating the total sore.
Don’t (DVT symptoms) 3 points   
Die (Diagnosis most likely PE) 3 points 
 Tell (Tachycardia) 1.5 points  The Team (Three days [at least] of immobilization, or surgery in the past Thirty days) 1.5 points 
 To (Thromboembolism in the past [DVT or PE]) 1.5 points 
 Calculate (Coughing up blood [hemoptysis]) 1 point   Criteria (Cancer) 1 point

This is what the scores mean:
> 6 High probability of PE
2-6 Moderate probability of PE
< 2 Low probability of PE
The modified Wells Criteria is a bit simpler:
> 4 PE is likely
≤ 4 PE is unlikely

Picture from: http://doctorstock.photoshelter.com/image/I0000FUaFtGQCIg0

From: “Well’s Criteria for Pulmonary Embolism / PE.” MDCalc. Web. 11 Nov. 2011

SIRS-systemic inflammatory response syndrome

 SIRS: At least 2 conditions:

1. T>38'C @ <36'C
2. Heart rate >90
3. Respiratory Rate >20 @ PaCO2<32mmhg
4. White cell counts >12k/mm3  @ <4k/mm3, @ >10% immature band form

 

Pic & further info from: http://nrsged.wikispaces.com/6.+SIRS+vs+Sepsis

Al-Humaza

                             

Budd Chiari Syndrome atau sindrom budd chiari

Saluran keluar vena hati tersumbat menyebabkan sakit perut, perut kembung berisi air, kekuningan, encephalopati, pendarahan varices dan bengkak hati dan limpa ( disebabkan oleh tekanan darah tinggi  di saluran darah sistem porta. 

Sebab

Salaur darahvena tersumbat disebabkan oleh tahap beku darah yang tinggi atau malignansi. Jarang-jarang disebabkan oleh rangkaian selaput vena di IVC.

investigasi

Darah: Ujian Fungsi hati (↑transaminases), Ujian Jumlah bilangan sel darah, AIR KENCING DAN ELEKTOLIT, taham pembekuan darah dan ujian saringan kekurangan sel darah kuning

Ultrasound doppler: ↓ Aliran darah dalam vena hepatik . Ujian Hepatic venogram and inferior venacavagram. MRI.

Pengurusan

Rawatan Perubatan (jagaan sokongan, ejen anti pembekuan darah, dan proses pencairan ketulan darah bergumpal dalam peringkat awal ), prosedur radigraphy (angioplasty, TIPS, dan stenting) dan pembedahan (prosedur shunting dan penanaman hati, merawat komplikasi berkaitan dengan cecair yg berkumpul, merawat malnutrisis dan merawat tekanan darah tinggi di salur darah sistem porta.

    

           

  

Having Acute Gastroenteritis

Hi guys. Have u ever had an  Acute gastroenteritis attack? yeah..diarhea diarhea diarhoea few time /day..body feels weak, all your muscle feel like sloopy(betul ke? ke slurpy) Nevemind. I had one attack yesterday. After making food recalls several times, I've concluded it due to fish sausages + its sauce. sedap kot.. but what to do. if you are the culprit, i've to blacklisted you. You have made my life terrible. Working non stop overnight in a place like night market situation, while you tummy making a lot sounds, your gut hyperactively singing the peristaltic colicky music, which only heard and felt by yourself, made you super duper pain dilemma.Anyhow, know what you eat. Know it from scratch before its become something delicious. Along the process, if it mishandle inappropriately, it will end up like time bomb in your tummy. Must remember, things happens for a reason. cheers!