Author: dr.kijakarn junda MD. first class hon. , FRCP(t)
Types of biases from a psychological perspective
In psychology, biases refer to systematic deviations from rational or objective thinking, often influenced by cognitive, emotional, or social factors. Here are some key types of biases from a psychological perspective: Cognitive Biases: Errors in thinking that affect how we process information. Confirmation Bias: Favoring information that confirms pre-existing beliefs and ignoring contradictory evidence.Anchoring Bias:…
The best treatment of psoriasis (2025)
The best treatment for psoriasis depends on the type, severity, and location of the disease, as well as patient-specific factors. Here are some commonly recommended treatments: For severe cases with joint involvement (psoriatic arthritis), medications targeting TNF-alpha, IL-17, or IL-23 are often used. Regular monitoring is essential due to potential side effects of systemic therapies.…
Ordering for sepsis patient in clinical practice.
Initial Laboratory Evaluation for Sepsis: Complete Blood Count (CBC) with Differential: To assess for leukocytosis, leukopenia, or bandemia, which are common in sepsis. – Basic Metabolic Panel (BMP): To evaluate electrolyte imbalances, renal function, and metabolic acidosis. – Liver Function Tests (LFTs): To detect hepatic dysfunction, which may indicate severe sepsis or organ dysfunction. –…
Prediction of Thyroid storm
Factors and precipitation and scaling of thyroid storm prediction Precipitating Factors (common triggers):Infection (e.g., pneumonia, urinary tract infection)Trauma, surgery (e.g., thyroidectomy, radioiodine therapy)Discontinuation of antithyroid medications in thyrotoxicosisMyocardial infarction, strokeDiabetic ketoacidosis, pregnancy, labor Clinical Features (Burch-Wartofsky Point Scale for diagnosis):Temperature >38°C (1 point per degree above 37°C)Heart rate >140 bpm (1 point per 10 bpm…
CHA2DS2-VA score
dr.kijakarn junda MD. first class hon. , FRCP(t)Internist , Thai Board of Internal Medicine. board.thaihealth.net
DOAC list , updates
Direct Oral Anticoagulants (DOACs) in 2025: –Apixaban (Factor Xa inhibitor) –Rivaroxaban (Factor Xa inhibitor) –Edoxaban(Factor Xa inhibitor)Dabigatran (Direct thrombin inhibitor) –Betrixaban (Factor Xa inhibitor, approved for extended VTE prophylaxis) Apixaban (Eliquis)–Onset: Rapid, with peak plasma concentrations reached in 3–4 hours. –Action: Direct factor Xa inhibitor, preventing clot formation. –Side Effects: – Bleeding (most common, including…
Osteoporosis , recent treatment update
Antiresorptive Agents (First-Line for Postmenopausal Osteoporosis): dr.kijakarn junda MD. first class hon. , FRCP(t)Internist , Thai Board of Internal Medicine. board.thaihealth.net
diabetes recent study (2023 up)
Beta-blockers and thiazide diuretics: May increase or have no change in type 2 diabetes incidence. – ACE inhibitors and calcium antagonists: May decrease or have no change in type 2 diabetes incidence. – Rationale: Data from high-quality studies suggest variable effects on diabetes risk, with some drugs potentially exacerbating metabolic dysfunction. – Euglycemic DKA in…
Complications of covid vaccines
Thrombosis with Thrombocytopenia Syndrome (TTS): Rare, but serious complication associated with adenovirus vector vaccines (e.g., AstraZeneca, Janssen). – Presents with thrombosis (e.g., cerebral venous sinus thrombosis, splanchnic vein thrombosis) and thrombocytopenia. – Management: Consult hematologist, consider anticoagulation with non-heparin agents (e.g., argatroban, fondaparinux). – Rationale: TTS is immune-mediated, requiring specialized care. – Myocarditis/Pericarditis:Rare, more common…
SGLT-2 inhibitor for diabetes
Mechanism of Action: SGLT2 inhibitors block the reabsorption of glucose in the proximal tubule, increasing urinary glucose excretion (UGE) and lowering plasma glucose levels. They also have beneficial effects on blood pressure, body weight, and cardiovascular outcomes. – Dosing: Empagliflozin: 10–25 mg once daily (start at 10 mg, max 25 mg). – Dapagliflozin: 5–10 mg…