Friday, December 06, 2013

"Angels we have heard on high" by The Piano Guys

Another fantastic work by The Piano Guys. Christmas mood is everywhere now. Enjoy! ;)

Monday, December 02, 2013

Hot Bath for CKD?

Came across this interesting paper by Ting Y et al.

Authors found that a 30-min hot water bath daily or 2-hour sauna bath three times a week is effective for fluid and solute clearance for patients with chronic kidney disease (CKD). The weight loss per session can be as high as 1.5-2kg (sweat rates in sauna and hot water bath were 56 and 40ml/min respectively), and calculated losses of urea and potassium in sweat fluid were 43 and 12 mmol/hr compared with 117 and 20 mmol/hr by hemodialysis.

Moreover, the "side benefits" of it include a decrease in systolic BP without affecting heart rate, and a significant decrease in plasma epinephrine and norepinephrine. Earlier studies also showed role of thermal vasodilation resulting in hemodynamic improvement in congestive cardiac failure.

Authors concluded that eccrine sweat fluid assumes a natural alternative route for nitrogenous metabolites excretion; and hot bath or sauna bath can be used as valuable adjunct to conventional renal replacement methods for CKD patients.

Saturday, November 23, 2013

David Blaine: Real or Magic



Blaine is back in a groundbreaking new special: Real or Magic. Watch it and be astonished - magic that you'll never believe. The first act itself, ice pick through palm act, is completely mind-boggling. There are many more - PK touch (the twins effect), reading Stephen Hawking's mind, card-to-anywhere, reviving the stunt of water & kerosene regurgitation etc - just to name a few that I'm totally impressed.

Do watch it, and put yourself into an entirely unreal world.

Thursday, November 21, 2013

Interesting ECG (8)


(Image from Nakamura K et al. Arch Intern Med 2012; 172(5):389)

Recently there was a patient with typical anginic chest pain with similar ECG changes. If this ECG is alarming to you (it should be!), can you name where is the most likely coronary lesion?

Tuesday, November 12, 2013

生死的智慧 - by 柯文哲



A talk worths sharing - speech by Dr Ko Wen-Je during TEDxTaipei 2013 about life and death.

Sunday, November 10, 2013

Docs will go Jobless?

The nightmare is probably becoming the truth sooner as you may think or imagine.

Read the news here:

"...too many medical graduates, and too many private medical colleges; almost 40 now for a population of about 28 million...This is probably one of the highest per capita in the world."

"The consequence of these mass, factory-like productions is insufficient exposure to patients."

"...there was one house officer (HO) manning an entire ward of 40 to 50 patients. Now, we have more HOs than patients in a ward."

"It's a well acknowledged fact that the standard of medical practice in the country is gradually waning.."

"The MMA is appealing for several measures to be taken immediately to arrest the situation."

Saturday, November 09, 2013

Interesting CXR (10)


A patient was admitted for fluid overload. HO called as he found patient to have increased coughing with the abnormal findings on the CXR. He is worried of right pneumothorax and whether he should proceed with chest tube insertion.

What do you think?

Sunday, November 03, 2013

The UpToDate Story



It's all started from an idea, and it's now one of the most widely used evidence-based resources among medical world.

I'm sharing this because I'm inspired.

The key message is to teach. Learning in medical world is never individual, it has to be through knowledge sharing and teaching.

We are who we are today because we are fortunate to have our great mentors who guide us along the journey. From zero, they grow and shape our knowledge, personality and values, directly or indirectly, leading us in fields of clinical medicine, education or research. And this is also our responsibility - to keep it sustained and to teach and guide the subsequent generations.

Back

Yes I'm back.

It's been quite a while. The blog was closed down for some reasons, and now it's back for some reasons, too.

Obviously lack of time is never a good excuse, and facebook somehow just can't really replace blogging.

The emails that I've received throughout this period are indeed encouraging and I really appreciate it. It is amazing I still bump into my blog readers in a few different work places that I go. Many of them are now MRCP-ians, and one even became my working colleague now. The world is just small.

As I am now more involved in educational aspect of Medicine, I feel that I shouldn't stop blogging - it should remain a good platform to share what I learned. I'm not that ambitious to hope it can inspire - but if it does any, to anyone who has passion in magic, medicine or Nephrology - I will be very pleased and gratified.

Let's continue on this journey. And to those who have emailed me, you know who you are,

thank you.

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