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Pemphigus Vulgaris (PV):• Intraepidermal blister (suprabasal).• Mucosa commonly involved (oral lesions)• Fragile, fl...
23/09/2025

Pemphigus Vulgaris (PV):
• Intraepidermal blister (suprabasal).
• Mucosa commonly involved (oral lesions)
• Fragile, flaccid bullae that rupture easily → painful erosions.
• Positive Nikolsky sign
• Autoantibodies against desmoglein 1 & 3
• Histology: “Row of tombstones”
• DIF: Fish-net pattern of IgG & C3.
• More severe, requires systemic steroids + immunosuppressants (rituximab, azathioprine).

Bullous Pemphigoid (BP):
• Subepidermal blister (below basement ).
• Mucosa usually spared, skin lesions
• Tense bullae, rarely rupture ,less painful, often itchy.
• Negative Nikolsky sign
• Autoantibodies against BP180, BP230
• Histology: Subepidermal blister with eosinophils.
• DIF: Linear IgG & C3 along basement membrane.
• Better prognosis, often responds to topical/systemic steroids ± tetracyclines.

23/09/2025

The FDA approved Teprotumumab (Tepezza) in 2020 as the first treatment for Thyroid Eye Disease (Graves’ orbitopathy)

Works by targeting the IGF-1 receptor
Especially helpful for patients with eye bulging (proptosis) and other eye symptoms caused by Graves’ disease.

A real breakthrough for patients who previously had very limited options!

Causes of Pancytopenia
22/09/2025

Causes of Pancytopenia

Management of DIC
22/09/2025

Management of DIC

𝐀𝐧𝐭𝐢-𝐏𝐚𝐫𝐤𝐢𝐧𝐬𝐨𝐧𝐢𝐬𝐦 𝐃𝐫𝐮𝐠𝐬 – 𝐂𝐥𝐚𝐬𝐬𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧 & 𝐃𝐨𝐬𝐞𝐬𝟏. 𝐃𝐨𝐩𝐚𝐦𝐢𝐧𝐞 𝐏𝐫𝐞𝐜𝐮𝐫𝐬𝐨𝐫 • Levodopa + Carbidopa (Sinemet, Madopar) • Start:...
21/09/2025

𝐀𝐧𝐭𝐢-𝐏𝐚𝐫𝐤𝐢𝐧𝐬𝐨𝐧𝐢𝐬𝐦 𝐃𝐫𝐮𝐠𝐬 – 𝐂𝐥𝐚𝐬𝐬𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧 & 𝐃𝐨𝐬𝐞𝐬

𝟏. 𝐃𝐨𝐩𝐚𝐦𝐢𝐧𝐞 𝐏𝐫𝐞𝐜𝐮𝐫𝐬𝐨𝐫
• Levodopa + Carbidopa (Sinemet, Madopar)
• Start: 25/100 mg 3 times daily
• Usual: 300–800 mg/day of levodopa in divided doses
• Max: ~2000 mg/day levodopa
• 𝐌𝐨𝐬𝐭 𝐞𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞 𝐛𝐮𝐭 𝐥𝐨𝐧𝐠-𝐭𝐞𝐫𝐦 𝐮𝐬𝐞 lead 𝐝𝐲𝐬𝐤𝐢𝐧𝐞𝐬𝐢𝐚𝐬, 𝐦𝐨𝐭𝐨𝐫 𝐟𝐥𝐮𝐜𝐭𝐮𝐚𝐭𝐢𝐨𝐧𝐬

𝟐. 𝐃𝐨𝐩𝐚𝐦𝐢𝐧𝐞 𝐀𝐠𝐨𝐧𝐢𝐬𝐭𝐬

𝐒𝐭𝐢𝐦𝐮𝐥𝐚𝐭𝐞 𝐝𝐨𝐩𝐚𝐦𝐢𝐧𝐞 𝐫𝐞𝐜𝐞𝐩𝐭𝐨𝐫𝐬 𝐝𝐢𝐫𝐞𝐜𝐭𝐥𝐲.
• Pramipexole: 0.125 mg TID → titrate up; usual 0.75–4.5 mg/day
• Ropinirole: 0.25 mg TID → up to 24 mg/day
• Rotigotine (patch): 2 mg/24 h → up to 16 mg/24 h
• Apomorphine (SC injection): 2–6 mg as rescue for “off” episodes
• 𝐒𝐢𝐝𝐞 𝐞𝐟𝐟𝐞𝐜𝐭𝐬: 𝐡𝐚𝐥𝐥𝐮𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧𝐬, 𝐢𝐦𝐩𝐮𝐥𝐬𝐞-𝐜𝐨𝐧𝐭𝐫𝐨𝐥 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬

21/09/2025

𝐊𝐞𝐲 𝐏𝐫𝐢𝐧𝐜𝐢𝐩𝐥𝐞𝐬 𝐢𝐧 𝐌𝐞𝐝𝐢𝐜𝐚𝐥 𝐌𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭 𝐨𝐟 𝐏𝐚𝐫𝐤𝐢𝐧𝐬𝐨𝐧’𝐬 𝐃𝐢𝐬𝐞𝐚𝐬𝐞

𝟏. 𝐀𝐠𝐞 𝐚𝐧𝐝 𝐅𝐮𝐧𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐒𝐭𝐚𝐭𝐮𝐬 𝐌𝐚𝐭𝐭𝐞𝐫

• 𝐘𝐨𝐮𝐧𝐠𝐞𝐫 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 (

21/09/2025

Semaglutide in Diabetes vs Weight Loss

1. Type 2 Diabetes (T2DM)
• Brands:
Ozempic(injection, weekly)
Rybelsus (oral, daily)

• FDA Indication: Improve glycemic control in adults with T2DM

• Typical Doses (per FDA labeling):
• Ozempic: 0.25 mg → 0.5 mg → 1 mg → up to 2 mg weekly
• Rybelsus: 7 mg or 14 mg daily (max 14 mg)
• Main Focus: Lowering HbA1c, reducing CV risk, modest weight loss as secondary benefit

2. Obesity / Weight Management
• Brand: Wegovy (injection, weekly)
• FDA Indication: Chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27 with comorbidity)

• Typical Doses (per FDA labeling):
• 0.25 mg → 0.5 mg → 1 mg → 1.7 mg → 2.4 mg weekly (maintenance)
• Main Focus: Significant and sustained weight reduction

Key Point:
• Same drug (semaglutide), but different dosing schedules, maximum doses, and FDA indications.
• Ozempic (≤2 mg) → mainly for diabetes
• Wegovy (2.4 mg) → mainly for weight loss

⚠️ Disclaimer:
This post is for educational purposes only. It is not medical advice and does not replace consultation with a qualified healthcare provider. If you have questions about semaglutide, diabetes, or weight management, please discuss with your doctor or pharmacist.

20/09/2025

𝐀 𝐍𝐞𝐰 𝐍𝐚𝐬𝐚𝐥 𝐑𝐨𝐮𝐭𝐞 𝐟𝐨𝐫 𝐄𝐝𝐞𝐦𝐚 𝐌𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭

Enbumyst (bumetanide nasal spray) has been FDA-approved as a novel nasal delivery option for treating edema associated with:
• Congestive heart failure
• Hepatic disease
• Renal disease (nephrotic syndrome)

𝐈𝐧𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧: 𝐀𝐝𝐮𝐥𝐭 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐰𝐢𝐭𝐡 𝐟𝐥𝐮𝐢𝐝 𝐨𝐯𝐞𝐫𝐥𝐨𝐚𝐝 𝐰𝐡𝐨 𝐫𝐞𝐪𝐮𝐢𝐫𝐞 𝐞𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞 𝐝𝐢𝐮𝐫𝐞𝐭𝐢𝐜 𝐭𝐡𝐞𝐫𝐚𝐩𝐲.

20/09/2025

Definition of Autism

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by:

1. Persistent deficits in social communication and social interaction across multiple contexts.

2.Restricted, repetitive patterns of behavior, interests, or activities.

Autism Spectrum Disorders (ASD)

According to the DSM-5, all previously separate conditions are now grouped under Autism Spectrum Disorder, including:
• Autistic Disorder (classic autism)
• Asperger’s Syndrome (milder form, no language/intellectual delay)
• Childhood Disintegrative Disorder
• Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS)

Key Features
• Difficulty with eye contact, social reciprocity, understanding emotions
• Delayed or unusual speech/language development
• Repetitive behaviors (hand-flapping, lining up toys, rigid routines)
• Hyper- or hypo-reactivity to sensory input (sounds, textures, lights)

𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐋𝐚𝐝𝐝𝐞𝐫 𝐢𝐧 𝐃𝐢𝐚𝐛𝐞𝐭𝐢𝐜 𝐍𝐞𝐩𝐡𝐫𝐨𝐩𝐚𝐭𝐡𝐲1️⃣ 𝐅𝐢𝐫𝐬𝐭-𝐥𝐢𝐧𝐞 (𝐅𝐨𝐮𝐧𝐝𝐚𝐭𝐢𝐨𝐧)ACE inhibitor or ARB (maximal tolerated dose)Indefini...
20/09/2025

𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐋𝐚𝐝𝐝𝐞𝐫 𝐢𝐧 𝐃𝐢𝐚𝐛𝐞𝐭𝐢𝐜 𝐍𝐞𝐩𝐡𝐫𝐨𝐩𝐚𝐭𝐡𝐲
1️⃣ 𝐅𝐢𝐫𝐬𝐭-𝐥𝐢𝐧𝐞 (𝐅𝐨𝐮𝐧𝐝𝐚𝐭𝐢𝐨𝐧)

ACE inhibitor or ARB (maximal tolerated dose)
Indefinite therapy
Monitor creatinine, potassium, and proteinuria

2️⃣ 𝐒𝐞𝐜𝐨𝐧𝐝-𝐥𝐢𝐧𝐞 (𝐀𝐝𝐝-𝐨𝐧 𝐢𝐟 𝐚𝐥𝐛𝐮𝐦𝐢𝐧𝐮𝐫𝐢𝐚 𝐩𝐞𝐫𝐬𝐢𝐬𝐭𝐬 ≥𝟑𝟎 𝐦𝐠/𝐠 𝐝𝐞𝐬𝐩𝐢𝐭𝐞 𝐀𝐂𝐄/𝐀𝐑𝐁)

a) SGLT2 inhibitors
b) Non-steroidal mineralocorticoid receptor antagonist (ns-MRA)

𝐚) 𝐒𝐆𝐋𝐓𝟐 𝐢𝐧𝐡𝐢𝐛𝐢𝐭𝐨𝐫𝐬
Drugs: Empagliflozin, Dapagliflozin, Canagliflozin

𝐁𝐞𝐧𝐞𝐟𝐢𝐭𝐬:
Reduce albuminuria
Slow CKD progression
CV protection (↓HF & CV death)
Use if eGFR ≥20–25 mL/min (drug-specific cutoff).

𝐛) 𝐍𝐨𝐧-𝐬𝐭𝐞𝐫𝐨𝐢𝐝𝐚𝐥 𝐦𝐢𝐧𝐞𝐫𝐚𝐥𝐨𝐜𝐨𝐫𝐭𝐢𝐜𝐨𝐢𝐝 𝐫𝐞𝐜𝐞𝐩𝐭𝐨𝐫 𝐚𝐧𝐭𝐚𝐠𝐨𝐧𝐢𝐬𝐭 (𝐧𝐬-𝐌𝐑𝐀)

𝐅𝐢𝐧𝐞𝐫𝐞𝐧𝐨𝐧𝐞 (𝐩𝐫𝐞𝐟𝐞𝐫𝐫𝐞𝐝 𝐨𝐯𝐞𝐫 𝐬𝐩𝐢𝐫𝐨𝐧𝐨𝐥𝐚𝐜𝐭𝐨𝐧𝐞/𝐞𝐩𝐥𝐞𝐫𝐞𝐧𝐨𝐧𝐞 𝐢𝐧 𝐃𝐍).

𝐁𝐞𝐧𝐞𝐟𝐢𝐭𝐬:↓ proteinuria, CV and renal outcomes (FIDELIO & FIGARO trials).

Indicated if:
Persistent albuminuria despite ACE/ARB ± SGLT2i
eGFR ≥25 mL/min, K⁺

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