Dia-Med

Dia-Med M.Sc Anaesthesia & Surgical ICU . M.Sc International Health Management . FREE PALESTINE .
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A breakthrough in emergency care.The vine-like airway device has the potential to revolutionize airway management, espec...
25/09/2025

A breakthrough in emergency care.
The vine-like airway device has the potential to revolutionize airway management, especially in resource-limited settings and emergency situations where every second counts.

By making life-saving airway access simpler, faster, and more widely available, this innovation could dramatically expand access to critical care and save countless lives. 🫁💙

💡 A step toward equitable healthcare for all.




In pregnancy:Unobstructed uterine venous return either through: 1) The .2) The compensatory collateral (LVVA system) ...
10/09/2025

In pregnancy:
Unobstructed uterine venous return either through: 1) The .
2) The compensatory collateral (LVVA system) , venous, and system is important not only because it keeps the maternal cardiac output high but also because it keeps the uterine venous pressure low but only if the LVVA pathway is sufficiently well developed.
Maybe that's why some pregnancies develope + & and some don't due LVVA compensatory system (which also includes peripheral VC)

Either way positioning for all pregnant patients going for vaginal or C/S delivery is the principal for safer 3rd trimester and less fetal distress.




fans

: The master of iron, produced by the liver. : The cellular iron , found on the surface of enterocytes (gut), hepato...
08/09/2025

: The master of iron, produced by the liver.

: The cellular iron , found on the surface of enterocytes (gut), hepatocytes (liver), and macrophages (spleen).

🚩Mechanism: Hepcidin binds to ferroportin, causing it to be & .
✋️️This blocks iron export into the plasma thus= serum Iron Overload.
dietary iron absorption from enterocytes iron in storage cells (hepatocytes & splenic macrophages).

🏁 the opposite happens when hepcidin is low.

⁉️So What influences (+) hepcidin production from liver (Reducing Plasma Iron) ?
1) Inflammation: (chronic disease):
why inflammatory states cause anemia of chronic disease. 🩺🩺🩺🩺
2) Iron Overload: no need to explain it quess .

⁉️
What Suppress (-)Hepcidin (increasing Plasma Iron):
1) Erythropoiesis: The body's need to make new red blood cells is the strongest suppressor of hepcidin(allowing maximum iron availability for hemoglobin synthesis)🩺🩺
2) Hypoxia: Low oxygen levels suppress hepcidin to facilitate increased iron uptake & mobilization.
3) Iron Deficiency: Low iron levels directly suppress hepcidin production to enable iron absorption.

There is a link 🩺🩺
in β-thalassemia: remember that Ineffective erythropoiesis is a powerful stimulus that (-) suppresses hepcidin, leading to increased gut iron absorption & eventual iron overload, leading to iron deposition and complications such :
1) (cardiomyopathy).
2) cirrhosis.
3) dysfunction (DM, hypothyroidism)

And all thus Worsened by blood transfusions which is a treatment method for Thalassemia causing (transfusional hemosiderosis).

Trt for iron overload = iron chelation (deferoxamine/deferasirox).

It is all linked together...

✍️🏿Dr Fidow


fans

comparing Carbetocin vs Oxytocin based on :1) Blood loss. 2) Postoperative Hb/HCT.3) Need for additional uterotonics4) ...
07/09/2025

comparing Carbetocin vs Oxytocin based on :
1) Blood loss.
2) Postoperative Hb/HCT.
3) Need for additional uterotonics
4) incidence of PPH

But Oxytocin remains the standard first-line drug in mettings, while carbetocin is an effective (but
) alternative where resources allow

This is potentially dangerous The possibility of diseases transmitted by is not limited to (HPV) and , and the exis...
02/09/2025

This is potentially dangerous

The possibility of diseases transmitted by is not limited to (HPV) and , and the existence of viable ( ) cells is another important factor.

Laser Smoke Inhalation : more with CO2 laser Contains particulate matter (0.3 µm), chemicals, & viable viral DNA fragments .

Dia-Med


A maneuver worth the try ..When Seated in the standard flexed position with legs supported and cradling a pillow, patien...
01/09/2025

A maneuver worth the try ..

When Seated in the standard flexed position with legs supported and cradling a pillow, patients were asked to rotate their shoulders to a 45° angle

(a) The spine is shown in the rotated position
(b) with the inset depicting the effect on the T9/10 vertebrae.
The original position of the vertebrae is shown with the grey shadow.

separates the spinous processes and further opens up the interlaminar space by causing the T9 spinous process to move away from the T10 lamina thus increases dimension of the target window for paramedian thoracic epidural access , This potentially .

Theoretically, a larger ‘target window’ should translate into a decreased incidence of bony contact and improve the success rate for correct placement of a needle for thoracic epidural anaesthesia.

In the spine, flexion is the principal mechanism for widening the interspinous and interlaminar spaces to facilitate neuraxial access.

In the region, the thoracic vertebrae permit flexion and rotation of the spine to open the interlaminar space.

You can read the whole paper on
DOI: 10.1093/bja/aet385.

Dia-Med

Canadian rule designed to diagnose cervical spine injury and identify patients who require further (computed tomogra...
30/08/2025

Canadian rule designed to diagnose cervical spine injury and identify patients who require further (computed tomography) evaluation.

DIAMED

■ Cause of low platelet : 1) ITP.2) TTP & HUS .3) Uremia: CRF. / 4) Drug induce: Aspirin, NSIAD, heparin, quinine .5)...
29/08/2025

■ Cause of low platelet :
1) ITP.
2) TTP & HUS .
3) Uremia: CRF. /
4) Drug induce: Aspirin, NSIAD, heparin, quinine .
5) High consumption of platelet: DIC.
6) Low production: Aplastic anemia , Megaloblastic anemia leukemia, chemo , HIV , TB.
7- Excessive distortion: Hypersplenism ITP, dengue.

■ Treatment :
1. Platelet transfusion .
2. Fresh blood transfusion
Transfusion time line ( 30minutes to 4hr)


Dr Fidow


Preoperative hematology
fans

• Durant’s maneuver = Left lateral + Trendelenburg positioning for Venous air embolism .🛑 Keeps the air bubble in the ri...
24/08/2025

• Durant’s maneuver = Left lateral + Trendelenburg positioning for Venous air embolism .

🛑 Keeps the air bubble in the right atrium/ventricle apex, preventing it from entering the pulmonary artery (air lock).

🛑 Improves chances of aspiration of air via a central venous catheter placed in the right atrium.

☆Muscle relaxant releasing Histamine . Succinylcholine . . Mivacurium . . Atracurium . Tubocurarine ....
21/08/2025

☆Muscle relaxant releasing Histamine
. Succinylcholine .
. Mivacurium .
. Atracurium .
Tubocurarine .
Hypotension.🚨 (Reduced MAP & CBF & CPP)+ Bronchospasm + flushing +/_ (reflex tachy)

☆No Histamine release:
increases MAP & CPP & CBF..

DIAMED
Drfidow

15/08/2025

CSF
🩺PHYSIOLOGY
💉Direct Drug Administration
⚖️Intracranial Pressure (ICP) Monitoring
🔬DIAGNOSTIC CSF Sampling

So An understanding of CSF is vital for anesthesiologists, influencing drug choice, delivery, and patient safety.

It ensures precision in and effective management of CNS-related anesthesia complications.

CSF Dynamics in Regional Anesthesia
● of Anesthetic Agents: Anesthetic solutions are adjusted for baricity ( , , or ) to within the CSF and target specific regions.
●Positioning Matters: Patient positioning significantly impacts drug distribution in the CSF, influencing outcomes in spinal anesthesia.
●CSF and Post-Dural (PDPH): CSF Volume Maintenance: Accidental CSF leaks, such as from epidural needle punctures, can lead to , a common complication. Understanding CSF physiology helps anesthesiologists manage and prevent these issues.

DIAMED

Areas with no BBB = Circumventricular organs: represent a particularly vulnerable site for xenobiotic entry, as they ar...
15/08/2025

Areas with no BBB = Circumventricular organs: represent a particularly vulnerable site for xenobiotic entry, as they are in close proximity to the blood-cerebrospinal fluid barrier which is lined with fenestrated (porous) endothelial cells.

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