Doctor

Really nice phone.Used it for over 9 months.Flawless and has all the features you need. Unfortunately I sold it to buy iPhone 

Although good doctor-patient communication is an important component of good medical practice, such good communication in an emergency department setting poses some very unique challenges: 1. Mismatch between physician's and patient's expectations. - Most patients in emergency department come with sudden, often unexpected, serious illnesses (including trauma). Such sudden nature results in an inadequate time for the patient and relatives to adjust or even to swallow the bitter reality, - Secondly, some patients may have problems with the way they are triaged; most patients that come  to the emergency department have the perception that they are suffering from an urgent illness  (although in actual case, they may not be so). Such mismatches can often be compounded with: - Social - Cultural and - Language differences between the doctor and the patient - Thirdly, not only that the patient does not have much of a choice when it comes to treatment options  i...

Bowel Obstruction Small bowel obstruction Large bowel obstruction Clinical Symptoms * the four cardinal symptoms of bowel obstruction are: - vomiting - colicky abdominal pain - constipation - abdominal distension Less distension, vomiting occurs earlier, pain is higher in the abdomen More distension, vomiting occurs later and feculent, pain is lower in the abdomen Radiologic features Small bowel features: Valvulae conniventes – folds that cross the lumen completely Normal features of small bowel: - No more than 3 mm wall thickness - Generally no more than 3 air fluid levels - No more than 3 cm diameter Large bowel features: Haustrations: incomplete crossing of folds across the lumen 3,6,9 rule Maximal normal diameter in small bowel 3 cm Maximal normal diameter in large bowel 6 cm Maximal normal diameter in cecum 9 cm In colorectal Carcinoma Left sided tumors: generally presented with altered bowel habit, blood or mucus PR, mass PR Right sided tumors: generally presented...

3 hours of chest pain. Is it STEMI or is it normal (or early repolarization)? This looks quite normal, with only moderate ST elevation, upward concavity, good R-wave amplitude, no ST depression or T-wave inversion. But one characteristic makes it unlikely to be normal: the computerized QTc is 455 milliseconds. In a study of early repolarization (ER) (n=167) near completion, only 2 of 167 (2%) cases of ER had a QTc > 455. The mean QTc was 394, compared to 420 for MI (n=125) from LAD occlusion. Conversely, only 4% of LAD occlusion, vs. 40% of ER, had a QTc < 380 ms. These clues were not appreciated by the clinicians. 70 minutes later, they repeated the ECG, which is shown here: Note that now there are tiny Q-waves in V2-V4 , making this unequivocally diagnostic of acute STEMI. These subtle Q-waves were not appreciated, but the clinicians were astute and ordered a stat echocardiogram, which confirmed anterior wall motion abnormality. The patient was taken to the cath lab and had...