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68M/ UGI bleed, acute GE, AKI s/p CABG

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  Clinical Problem Representation: A late 60s male with a history of diabetes and CABG on DAPT, presents with acute onset of fever, vomiting, and diarrhea, now complicated by AKI, elevated cardiac markers, and sepsis indicated by high procalcitonin. Imaging shows pulmonary and gastrointestinal involvement with systemic inflammatory response, currently requiring intensive support including mechanical ventilation and vasopressors. Most Likely Differential Diagnosis: Sepsis secondary to gastrointestinal source : The patient's presentation with fever, elevated procalcitonin, and systemic inflammatory response, alongside gastrointestinal symptoms and findings of esophageal ulcers and erosive gastritis on endoscopy, strongly suggest a septic process originating from a gastrointestinal source. The presence of blood in the stomach and duodenum could indicate significant mucosal damage leading to translocation of bacteria. Acute gastrointestinal bleeding with hypovolemic shock : The finding...
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Dietery modifications in diabetes

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  Based on the latest evidence-based research, here are the top 10 foods that diabetic patients should eat and foods they should avoid: Foods to Eat: 1. Non-Starchy Vegetables: Broccoli, spinach, kale, and bell peppers. These are low in carbohydrates and high in fiber, helping to control blood sugar levels [(Salaki et al., 2023)]. 2. Whole Grains: Brown rice, quinoa, barley, and whole oats. Whole grains have a lower glycemic index and are rich in fiber, aiding in blood sugar management [(Dwipajati et al., 2022)] 3. Lean Proteins: Chicken breast, turkey, tofu, and fish.  Lean proteins help maintain muscle mass without adding unhealthy fats, supporting overall health [(Petroni et al., 2021)] 4. Healthy Fats: Avocados, nuts, seeds, and olive oil. Healthy fats improve heart health and help with the absorption of fat-soluble vitamins [(Zepeda-Hernández et al., 2021)] 5. Low-Glycemic Fruits: Berries, apples, pears, and cherries. These fruits do not cause significant spikes in blood ...
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dietary modifications in hypertension

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  Here are the top 10 dietary modifications needed to control hypertension based on the latest evidence from indexed journals and guidelines published in the last 2-3 years: 1. Reduce Sodium Intake : Lowering sodium intake is essential for reducing blood pressure. The DASH diet combined with sodium reduction has shown significant benefits [(Filippou et al., 2021)] 2. Increase Potassium Intake : Consuming foods rich in potassium, such as fruits and vegetables, helps balance sodium levels and lower blood pressure [(Chiu et al., 2021)] 3. Adopt the DASH Diet : The DASH diet, high in fruits, vegetables, whole grains, and low-fat dairy, is effective in reducing blood pressure [(Guo et al., 2021)] 4. Limit Alcohol Consumption : Reducing alcohol intake is associated with lower blood pressure and better cardiovascular health [(Blumenthal et al., 2021)] 5. Reduce Saturated and Trans Fats : Limiting these fats and choosing healthier options like olive oil, nuts, and avocados can improve blo...
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Nicotine levels as a predictor for various cardiopulmonary outcomes

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  Detecting nicotine levels in blood, urine, and bronchoalveolar lavage (BAL) can be achieved through various methods, each with different sensitivities and specificities. Here are some commonly used methods: ### Blood 1. **Gas Chromatography-Mass Spectrometry (GC-MS)**:    - **Description**: This is a highly sensitive and specific method for detecting nicotine and its metabolites.    - **Procedure**: Blood samples are processed and nicotine is extracted. The extract is then analyzed using GC-MS.    - **Advantages**: High accuracy and specificity; can detect low levels of nicotine. 2. **Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)**:    - **Description**: Another highly sensitive method that uses liquid chromatography coupled with mass spectrometry.    - **Procedure**: Similar to GC-MS, but the nicotine is separated using liquid chromatography before mass spectrometry analysis.    - **Advantages**: High sensit...
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ONLINE RESUME ( CV )

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  Dr.Saicharan Kulkarni   MBBS, MD General Medicine General Medicine Specialist | Precision Medicine Advocate |  AI Healthcare Enthusiast | Health Influencer & Coach         Contact Hyderabad 9154575937 Twitter Threads Instagram Email   Hi..👋 i am Dr. Sai charan kulkarni  a dedicated  General Medicine Doctor  committed to enhance patient well-being through a holistic approach. With expertise in  preventive and therapeutic medicine ,  precision healthcare , and the integration of  artificial intelligence  into clinical practice, To empower individuals to take charge of their health, one personalized step at a time. 🌿💙 Objective As a dedicated  General Medicine Doctor , I am committed to enhancing patient well-being through a holistic approach. My expertise spans   preventive and therapeutic medicine ,   precision healthcare , and the integration of   artificial intelligence   into ...
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26 year old woman with multiple joint pains

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  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan  A 26 year old female graduated in MSc chemistry presented to our outpatient unit with the complaints of Multiple joint pains since the past 2 years. Present Illness: A 26 year old female was apparently asympt...
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