Dr MurtaXa KaMal

25/04/2026

New DM Management Landscape (NICE 2026 Update)

BIGGEST CHANGE: First-Line Therapy

New Standard:

Modified-release Metformin (MRM) + SGLT2 inhibitor for most patients

If Metformin not tolerated:
SGLT2 inhibitor alone

This is a major change: SGLT2 inhibitors moved from 2nd line → 1st line

COMORBIDITY-BASED PATHWAYS (Core of New NICE)

❤️ A. Heart Failure

Metformin + SGLT2 inhibitor
Avoid unnecessary escalation

❤️‍🔥 B. ASCVD (Atherosclerotic CVD)

Triple early therapy:

Metformin
SGLT2 inhibitor
GLP-1 RA (e.g., semaglutide)

Early aggressive therapy = ↓ CV events

-C. CKD (Chronic Kidney Disease)

eGFR >30 → Metformin + SGLT2
eGFR 20–30 → SGLT2 (dapagliflozin/empagliflozin) + DPP-4

eGFR

27/03/2026

🎓 MBBS IN CHINA – 2026 INTAKE 🇨🇳

Admissions Open for International Students

📢 Intake Details

• 🗓 Fall Intake (September 2026) – Main intake
• ⏳ Apply early to secure admission

👉 Admissions for 2026 are currently open, and seats are limited due to high international demand

🏥 Course Information
• 🎓 Degree: MBBS (Clinical Medicine)
• ⏱ Duration: 5 + 1 years (including internship)
• 🌍 Medium: English
• ✔️ Recognized by: WHO, NMC, FAIMER, PMDC, PMC, ECFMG

👉 China is one of the most budget-friendly countries for MBBS abroad

🏫 Top Medical Universities
• china medical university
• Shandong first medical university
• Nanjing Medical University
• Jilin University
• Chongqing Medical University

📋 Eligibility Criteria
• ✔️ 50–70% marks in Biology, Chemistry, Physics
• ✔️ Age: 17+ years
• ✔️ NEET required (for some countries)
• ❌ IELTS not required (in most universities)

📑 Required Documents
• Passport
• Academic certificates
• Medical certificate
• Passport-size photos

🌟 Why Choose China?
• Affordable fees
• English-medium education
• Modern hospitals & practical training
• High global recognition 📩 Apply Now
• Submit documents online
• Get admission letter
• Apply for visa
• Fly to China ✈️

01/03/2026

اِنَّالِلّٰہِ وَاِنَّااِلَیہِ رٰجِعُون

08/12/2025

28/05/2025

یوم تکبیر مبارک.
آج کا دن محسن پاکستان ڈاکٹر عبد القدیر خان کے نام.مرد مجاہد کی قبر جس جس کی نظروں سے گزرے ہاتھ اٹھا کر فاتحہ پڑھیں.
اللہ پاک آپ کو اپنے وطن کی دفاعی کوششوں کے عوض جنت الفردوس میں اعلیٰ مقام عطا فرمائے. آمین!

25/05/2025

This image is an ultrasound-based depiction of various stages and complications of appendicitis, progressing from acute inflammation to perforation and abscess formation. Here's a breakdown of each labeled condition:

---

A. Acute Appendicitis

Ultrasound appearance: Tubular, non-compressible, blind-ended structure with thickened wall.

Diameter: 0.9 cm (above normal threshold of 6 mm).

Features: Wall thickening, increased echogenicity of surrounding fat (not shown here), often tender with probe pressure.

---

B. Gangrenous Appendicitis

Ultrasound appearance: Increased diameter (1.5 cm), loss of normal wall layers, hypoechoic center.

Features: Wall necrosis, decreased vascularity on Doppler (not shown), possibly gas within wall or lumen.

---

C. Appendicitis with Appendicolith

Ultrasound appearance: Hyperechoic focus with posterior acoustic shadowing (classic sign of appendicolith).

Features: Increased risk of perforation, often associated with more severe inflammation.

---

D. Perforated Appendix with Abscess

Ultrasound appearance: Loss of defined appendix border, surrounding heterogeneous collection with internal echoes (suggestive of abscess).

Features: Fluid collection, localized or generalized peritonitis, complex fluid or gas bubbles may be visible.

---

Clinical Relevance

Ultrasound is particularly useful in pediatric and pregnant patients.

Progressive increase in diameter and complexity of findings correlates with disease severity.

Identification of appendicoliths and abscess formation helps guide surgical vs. conservative management.

29/12/2024

Injury of recurrent laryngeal nerve

07/10/2024

Don't leave anything for later.
Later, the coffee gets cold.
Later, you lose interest.
Later, the day turns into night.
Later, people grow up.
Later, people grow old.
Later, life goes by.
Later, you regret not doing something...
When you had the chance.

Life is a fleeting dance, a delicate balance of moments that unfold before us, never to return in quite the same way again.
Regret is a bitter pill to swallow, a weight that bears down upon the soul with the burden of missed chances and unspoken words.
So, let us not leave anything for later. Let us seize the moments as they come, with hearts open and arms outstretched to embrace the possibilities that lie before us. For in the end, it is not the things we did that we regret, but the things we left undone, the words left unspoken, the dreams left unfulfilled. ~Toshikazu Kawaguchi

(Book: Before the Coffee Gets Cold https://amzn.to/4ewRQsT [ad])

16/08/2024

For those who don’t know the actual context;

Utterly shocked. Literally shivering after reading about it.

Context: A 31y/o Doctor in India was R £d at her Working Place Hospital at Night while she was taking a Nap after 36 hours Shift by almost 10 Men, Her father found her body semi n , her pelvis girdle was broken, her legs were at 90° in opposite direction, her eyes were bleeding, there were 120 marks of injuries on her body and the Hospital Management asked her parents your daughter has co+mitted su +de and waited them 3 hours before handing them the body, This is so sick & frustrating.

02/02/2024

شعور جب بکتا ہے تو وہ جاہلیت سے کہیں زیادہ خطرناک ثابت ہوتا ہے!!
~چی گویرا