Browsing by Author "Tinawi, Mohammad"

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    Disorders of Calcium Metabolism: Hypocalcemia and Hypercalcemia
    (Cureus, 2021-01-01) Tinawi, Mohammad; Medicine, School of Medicine
    Calcium (Ca+2) is a divalent cation that plays a critical role in numerous body functions such as skeletal mineralization, signal transduction, nerve conduction, muscle contraction, and blood coagulation. Ca+2 metabolism is linked to magnesium (Mg+2) and phosphate metabolism. Ca+2 homeostasis is dependent on intestinal absorption, bone turnover, and renal reabsorption. The hormonal regulators of these processes are the parathyroid hormone (PTH), calcitriol {1,25-dihydroxyvitamin D [1,25(OH)2D]}, and serum ionized Ca+2. Cloning of the Ca+2-sensing receptor (CaSR) has greatly advanced the understanding of Ca+2 metabolism. Disorders of Ca+2 metabolism are easily recognized because Ca+2 is included in routine chemistry panels. Measurement of ionized Ca+2 is the preferred way to ascertain the diagnosis of hypocalcemia and hypercalcemia.
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    New Trends in the Diagnosis and Management of Hypertension
    (Cureus, 2022-02-19) Tinawi, Mohammad; Medicine, School of Medicine
    Hypertension is the leading risk factor for disability and death globally. This is attributed to two major complications of hypertension, cerebrovascular accidents (CVA) and ischemic heart disease. This update provides a concise overview of several timely hypertension topics. These topics were chosen based on recent significant advances in the field. Examples include the use of renin-angiotensin-aldosterone inhibitors in coronavirus disease 2019 (COVID-19) patients, the landmark Systolic Blood Pressure Intervention Trial (SPRINT), management of resistant hypertension, and primary aldosteronism. The articles reviewed also include other recent landmark clinical trials, prior clinical trials of great significance, and medical societies guidelines. Ten topics were chosen based on their relevance to the practicing clinician. Each topic is discussed in a condensed manner highlighting recent advances in the field of hypertension.
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    New Trends in the Utilization of Intravenous Fluids
    (Cureus, 2021-04-21) Tinawi, Mohammad; Medicine, School of Medicine
    Intravenous fluids (IVFs) are the most commonly used drugs in hospitalized patients. Knowledge of the indications and pharmacokinetics of IVFs is critical for all medical disciplines. Isotonic saline (normal saline, 0.9% NS) is the most utilized intravenous solution. Isotonic saline effectively expands the intravascular compartment, as one-quarter of the infusate goes intravascularly, while the remaining three-quarters go into the interstitial space. The proper use of IVFs in different clinical scenarios is paramount. IVFs differ with regard to their half-life, intravascular volume expansion, preparation, and cost. Crystalloids are more commonly utilized due to their relatively low cost and availability. Colloids are very advantageous in cases of shock or hemorrhage, as they remain in the intravascular space, thus facilitating an increase in blood pressure (BP) prior to blood administration. Colloids are also advantageous in cases of burns and severe hypoglobulinemia. Human albumin (5%, 20%, and 25%) is the most used colloid solution. It remains intravascularly provided and there is no capillary leak as in systematic inflammation. The goal in hospitalized patients is timely and adequate intravenous fluid resuscitation. Utilization of a large volume of isotonic saline may lead to hypervolemia, hypernatremia, hyperchloremia, metabolic acidosis, and hypokalemia. The use of balanced intravenous solutions has been advocated to avoid these complications.
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    Pathophysiology, Evaluation, and Management of Metabolic Alkalosis
    (Cureus, 2021-01-21) Tinawi, Mohammad; Medicine, School of Medicine
    Metabolic alkalosis is an increase in blood pH to >7.45 due to a primary increase in serum bicarbonate (HCO3−). Metabolic alkalosis results from alkali accumulation or acid loss, and it is associated with a secondary increase in carbon dioxide arterial pressure (PaCO2). Metabolic alkalosis is a common acid-base disorder, especially in critically ill patients. The pathogenesis of chronic metabolic alkalosis includes two derangements, generation of metabolic alkalosis via gain of alkali or loss of acid and maintenance of metabolic alkalosis by increased tubular HCO3− reabsorption (failure of the kidneys to excrete excess alkali). Metabolic alkalosis is the most common acid-base disorder in hospitalized patients, particularly in the surgical critical care unit. Mortality increases as pH increases.
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    Severe Rhabdomyolysis Due to Strenuous Exercise With a Potential Role of a High-Caffeine Energy Drink
    (Cureus, 2022-01-01) Tinawi, Mohammad; Medicine, School of Medicine
    Caffeine is the core ingredient in energy drinks. These drinks are commonly consumed by athletes around the time of their workout to boost energy levels. The patient in the case presented is a 40-year-old-man who developed severe rhabdomyolysis after consuming an energy drink with high content of caffeine prior to a strenuous workout. He was successfully treated with isotonic intravenous solutions. Clinicians should be aware of the potential adverse reactions associated with the use of energy drinks.