Medicine Hack

1. Maddrey (modified) Discriminant Function score of greater or equal to 32 indicates a high risk (30-50%) risk of mortality at 30 days. The risk is even higher is there are signs of hepatic encephalopathy. Scores should be repeated at day 7. 2. MELD stands for Model for End stage Liver Disease. It is used to estimate 90 days mortality. Poor prognosis if score is greater than 18. Score should be repeated at day 7.

Exacerbations of COPD are more commonly seen during the winter season (nearly 1.6 times more frequently). The main cause of these exacerbations is infection with the respiratory virus, rhinovirus. Frequent exacerbations have been shown to lead to a faster decline in the lung function, poorer quality of life and increased mortality. A recent study showed that COPD exacerbations in colder periods of the year take longer to recover from and are more likely to involve cough or coryzal symptoms. The exacerbations in the cold seasons also have a greater impact on daily activity, with patients spending more time indoors and being more likely to be hospitalized with respiratory viral infection.

It is the case of a 16-yr old female who came to the emergency department with complaints of low back ache for the past week. She has had similar symptoms in the past but now the intensity is increasing. There is no associated numbness or weakness of extremities. She did not have any weight loss. There was neither urinary nor fecal incontinence. On examination she had an obvious limp. Lumbar spines: mild tenderness lower lumbar spines, no deformity, range of motion was normal, no stigma of spina bifida. Lower limbs length showed a discrepancy of 1.5cm being shorter by 1.5cm on the left side. Left ankle in inversion and with hyperlaxity while left ankle was stiff and with restricted inversion. X-ray of Lumbar Spines showed a spina bifida. Impression of Spina Bifida occulta was made.

1. Diabetes is self-managed. Caring for diabetes is more than just taking a daily pill or doing your insulin injection. It may feel like a burden but the decisions you make about physical activity, what and when you will eat will affect both how you feel today and your future health and well-being. 2. Take diabetes seriously. It is a multi-systemic disorder and indeed needs a lot of care. Since the symptoms and complications take time to appear you may think that it is a simple disease but it is not in reality!!! 3. Learn everything about the disease. Since most of diabetes care is  about self-care, the more you know about it, the better you will be able to manage it. You can control your diabetes rather than letting your diabetes control you. If possible, try to get updated with latest developments in the field and read to drive away myths about the disease. 4. Your treatment will change over time. Treatment of diabetes will eventually change over time. Changes in treatm