Metformin is held around IV iodinated contrast CT scans to prevent metformin-associated lactic acidosis, which can develop if contrast temporarily impairs kidney function and causes drug buildup. Guidelines typically advise stopping metformin at or before contrast administration and restarting only after confirming stable renal function 48 hours later, especially for patients with reduced eGFR.

The serum glucose is 40 mg/dL, yet the patient is fully alert and asymptomatic. What does this suggest about the chronicity of the process?

Let me explain to you stepwise why this happens. • One of their primary jobs of the kidneys is to clear and degrade circulating insulin. In a healthy person, the kidneys are responsible for clearing up to half of the insulin from the bloodstream. • ​When a patient develops advanced Chronic Kidney Disease, that renal tissue dies. The failing kidneys completely lose their ability to degrade insulin. Because of this, the insulin (whether produced by the pancreas or injected) just circulates in the blood for much longer, constantly driving blood sugars down. • ​But it gets worse. The kidneys also act as a backup glucose factory. Through a process called renal gluconeogenesis, they normally produce new glucose during fasting states to keep your levels stable. ​• In advanced CKD, this backup factory completely shuts down. So the patient loses their ability to produce baseline glucose, while simultaneously having prolonged, uncleared insulin circulating in their blood. • ​Add in the fact that the buildup of toxic kidney waste (uremia) makes the patient chronically nauseous so they eat significantly less, and you have a perfect storm for severe, spontaneous low blood sugar. • ​This is clinically known as the Burnt-Out Diabetes phenomenon. The diabetes isn't cured; the kidneys have just failed so severely that the body's entire metabolic clearance has collapsed. • ​This is exactly why we have to drastically reduce or even stop anti-diabetic medications in severe CKD patients otherwise, that uncleared insulin will cause fatal hypoglycemia. 👉​Hi, I am Dr. Priyam. I break down complex medical science and advocate for Evidence-Based Medicine. Follow me for more clinical facts.

👉Answer: Acute Cardiogenic Pulmonary Edema (Acute Left Ventricular Failure) The classic “LMNO” approach included: L – Loop diuretic (Furosemide IV) M – Morphine IV N – Nitrates O – Oxygen It was traditionally used for patients

A feminist can humiliate even her own father for online validation, while a misogynist can fight the entire world to defend his mother's honor

Say no to GBV.

I have so many funny stories about my mother. I remember when she got appointed acting Governor of the CBK, they had this Range Rover assigned to her. She got so pissed off about it, she hardly used it. She liked her Peugeot 504 which used to jerk from a sensitive clutch.

Ndoa imekuwa ngumu hadi wedding show iliisha🤔🤣hamuoani!!

I was working with the red cross when the Kyanguli fire happened. The morning after the fire we went to pick up bodies. I removed severed limbs of kids that tried to escape through the roof. The dormitory door had been chained from outside. At the said door, was a pile of bodies

Answer:- Brucellosis. Standard first-line oral therapy for brucellosis, typically given for 6 weeks as doxycycline 100 mg BID plus rifampin 600-900 mg daily.

The urea breath test and H. pylori stool antigen test are excellent non-invasive tools for detecting active H. pylori infection, one of the commonest causes of peptic ulcer disease. High sensitivity, high specificity, very useful clinically. But they do NOT confirm the presence of an actual ulcer. You can carry H. pylori WITHOUT ULCERATION, and you can also develop ulcers from NSAIDs, alcohol, smoking, severe physiologic stress, etc., WITHOUT H. PYLORI INVOLVEMENT. Definitive ulcer diagnosis, including location, size, bleeding risk, and exclusion of malignancy, still requires upper GI endoscopy with direct visualization. So a negative H. pylori test does not automatically mean “no ulcer,” just as a positive result does not automatically mean an ulcer exists.

My baby has been sleeping for longer hours since my mum took over the responsibility of caring for him. He’s also sitting up and rolling over, all in less than a week of being with my mum. My husband and I are just bowing our heads in shame. Medicine- 0 Tradition- 10

Kenya has been officially honored by the WHO for eliminating Sleeping Sickness (Trypanosomiasis)! Huge win for the country, though honestly, with this current economy and the price of diesel, nobody can even afford to sleep anyway. Survival mechanism 100%.

RT @kelevitch: The Muslim world’s financial “backwardness” is actually proof that classical Islamic scholars were the most sophisticated ma…

Researchers at the University of Bergen ran a study comparing 213 Sudanese men. Half brushed their teeth with a chewed tree root. Half used a regular plastic toothbrush. The tree root group came out with healthier gums and less plaque. That stick is called a miswak. The WHO has been quietly recommending it since 1986. In 2011, scientists at Sweden’s Karolinska Institute finally cracked the chemistry. The active ingredient is benzyl isothiocyanate, a natural plant defense compound from the same family of sulfur molecules that give cabbage and mustard their sharp bite. The compound punches through the outer wall of bacteria that cause gum disease. From there, it dismantles the chemistry that keeps the bacteria alive. The Karolinska team isolated it by running root extracts through a chemical analyzer that identifies individual molecules. The stick comes from the Salvadora persica tree, which grows in dry parts of Africa, the Middle East, and India. Inside the wood you also find natural fluoride, a gentle abrasive called silica that polishes off plaque, sulfur compounds, and tannins that tighten gum tissue. A separate team at Sweden’s University of Gothenburg ran another trial. They soaked the sticks in a fluoride solution. The fluoride left in the test group’s saliva came out higher than what people got from regular fluoride toothpaste. A more recent systematic review pulled together a stack of randomized trials. Miswak on its own controlled plaque about as well as a regular toothbrush. Used alongside the toothbrush, it actually beat brushing alone on both plaque and gum inflammation scores. The Princess Nourah University trial from 2024 complicates that. Over two weeks, the miswak group’s plaque held steady while the toothbrush group’s dropped further. And gums in the miswak group got noticeably worse for people who sawed at their teeth too hard. Aggressive horizontal scrubbing tears at the soft tissue along the gum line. One stick costs under 10 cents in the regions where the tree grows, and a single twig lasts for weeks. In sub-Saharan Africa, herbal toothpastes built around miswak and neem (another bitter chewing-stick tree) made up over a quarter of toothpaste sales in 2023. The honest caveat is that Western dental literature treats the miswak as an add-on rather than a replacement, mostly because reaching the back molars with a stick is awkward. Used correctly, with soft perpendicular brushing along the gum line and no aggressive sawing, it does what a toothbrush does and adds a low-grade antibiotic on top. For most of human dental history, this is what cleaning your teeth looked like.

Found a book named- Everything is Tuberculosis... It fits so perfectly with the Indian scenario A contrasting version of It's never lupus, everything is TB

All peads and NBU wards zinafaa kuwa na BP cuffs too. When being trained on PALS, the following ni reference ranges of BPs as per the age classification

It has happened. The boy ABANDONED ME at the school gate, ran and jumped into the teacher's arms. Then ran back to me and I thought he'd come to hug me. Nope. Snatched his book from my hand and ran back to his bestie I guess😭😭😭

Medicine residents!!!! Here comes a single cheat sheet, how to manage hyperkalemia. Enjoy #medtwitter

Med students, listen up! Today let me explain how to analyze a Complete Blood Count (CBC) report step by step. A CBC is more than just numbers; it’s a clinical narrative. Let’s break down this real patient’s report together. 👇