clinical

#Statistics

Data presentation

By Dr. Ahmed Hafez

Summary Data can be binary, nominal, ordered, discrete quantitative, or continuous quantitative. Graphs include bar-charts, pie-charts, histograms, box-and-whisker plots and scatter diagrams. The type of graph used should be chosen according to the type of data being displayed. Be aware that graphs may be presented in misleading ways. Furthermore, graphs can be symmetrical, positively skewed or negatively skewed. Types of average include the mean, median, and mode. Measures of spread include the range, interquartile range, variance, and standard deviation. Means and measures of spread should be chosen according to the type of data being summarised and some measures are susceptible

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#Pharmacology

Antiarrhythmics

By Dr. Ahmed Hafez

Vaughan-William’s classification Anti-arrhythmics are drugs that modify cardiac conduction, they are used to treat arrhythmias and are classified according to the Vaughan-William’s system. This classification divides these drugs into four classes according to their effects on cardiac action potential. Anti-arrhythmics have complex actions and classes may overlap. It is important to note, that this classification system has become increasingly inadequate with improved understandings of drug mechanisms and development of new antiarrhythmics.     Arrhythmogenesis To understand the action of the antiarrhythmics it helps to understand how arrhythmias may develop. Arrhythmias are disorders of rate and rhythm of the heart, which

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#Histories

Basic history

By Dr. Ahmed Hafez

Introduction The art of medicine is to determine why a patient has sought help. The key skills to help establish the underlying cause of a patients’ symptoms (the diagnosis) is based on talking to the patient (the history), examining the patient (the examination) and requesting testslike bloods and x-rays (the investigations). The information gathered from the history and examination is used to form a hypothesis of the possible underlying diagnosis. Investigations can then be used to either confirm or refute this diagnosis. Some diagnoses can be made just by talking to a patient, while others are reliant on a specific

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#ECGs

How to read an ECG

By Dr. Ahmed Hafez

Introduction Conduction through the heart is dependent on pacemaker cells, which are organised into key structures. The heart is a dual pump that sits at the centre of the cardiovascular system. It is composed of both contractile cells and autorhythmic cells (also known as pacemaker cells). Approximately 1% of cardiac tissue is composed pacemaker cells, which are organised into key structures and can undergo spontaneous depolarisation. Depolarisation refers to the electrical changes that occur within a muscle to allow it to contract. The heart is essentially one big muscle that can contract by itself. We can detect these electrical changes,

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#Consepts

Confirmation of death

By Dr. Ahmed Hafez

Overview Confirmation of death is an important part of healthcare practice. The confirmation of death is an essential part of practice within both the community and hospital setting. In 2008, the Academy of Royal Medical Colleges issued a generalised code of practice for the confirmation of death. Death may occur from: Irreversible cessation of brain-stem function (i.e. brain-stem death) Following cessation of cardiorespiratory function (including failed resuscitation) The confirmation of brain-stem death (i.e. the heart and lungs can only be maintained by artificial ventilation) is advanced and has to be carried out by at least two medical practitioners (minimum one

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#ABG

ABG interpretation

By Dr. Ahmed Hafez

Overview Interpretation of an arterial blood gas is an essential skill required by all doctors and most healthcare professionals. In simplistic terms, an arterial blood gas (ABG) tells us about three main things: Oxygenation: measurement of oxygen within the blood. Ventilation: process of respiratory function (i.e. breathing). Acid-base balance: the control of pH. To enable us to interpret oxygenation, respiratory function and acid-base balance, an ABG analyser gives us key bits of information. This includes the pH, partial pressure of oxygen, partial pressure of carbon dioxide and calculated bicarbonate. Key components pH (normal range 7.35-7.45): refers to the acidity or

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