Fady Magdy Fouad

Frieden In Mir Frieden Mit Dir Frieden Zwischen allen Völkern und Religionen

@drbennisahmed Could you define diuretic resistance? Is it on the basis of low urinary Na? Poor progression with less than optimal weight loss or UO <100mls/ hr. How do you pick it up early?

Diuretic resistance is not a therapeutic dead end → it’s a signal that we need a smarter strategy.” The perfect closing slide from Dr. Ana Belen Mendez Fernandez at #HeartFailure26 👏 5-step framework for smarter decongestion: 1️⃣ Recognize the problem Multifactorial, common, predictable — requires a structured approach 2️⃣ Objective assessment Weight, ultrasound, BNP, renal function, volume status, urine output 3️⃣ Optimize loop diuretics Adequate dose & frequency, IV route, check absorption 4️⃣ Sequential nephron blockade Target different nephron segments, overcome compensatory mechanisms 5️⃣ Treat the drivers Venous congestion, low cardiac output, neurohormonal activation And the line that should be on every HF ward wall: “Decongestion is not just symptomatic relief. It changes outcomes.” #CardioTwitter #HeartFailure #Cardiology #Decongestion #Diuretics

HE PROTECTED 54,000 DOCTORS. THE @NHS PROTECTED ITSELF. In January 2014, Dr Chris Day (@drcmday) was working overnight in the intensive care unit at Queen Elizabeth Hospital in Woolwich. Two locum doctors didn't show up. The unit was running at double the patient load the national guidelines allow. He raised the alarm. He reported unsafe staffing. He linked the situation to two patient deaths. That's what the NHS calls a whistleblower. What followed was eight years of litigation, a legal battle all the way to the Court of Appeal, and over £700,000 of public money spent by Health Education England (@NHSE_WTE) and Lewisham and Greenwich NHS Trust (@LG_NHS) trying to stop his case being heard at all. Here's the really elegant bit. HEE's opening legal argument wasn't that they'd done nothing wrong. It was that whistleblowing law simply didn't apply to them, because they didn't directly employ junior doctors. They were just the organisation that controlled the career progression of every single one of England's 54,000 junior doctors. Totally different thing. Dr Day fought that argument to the Court of Appeal and won. The law was clarified. All 54,000 junior doctors below consultant grade in England now have statutory whistleblowing protection. One man, crowdfunding against three QCs, changed employment law for an entire profession. No formal apology from the NHS. No reinstatement. No path back to a consultant career. He has worked as a locum A&E doctor ever since, doing overnight shifts while his opponents collected salaries, pensions, and the occasional glowing tribute to NHS transparency. During the 2022 tribunal hearing, the communications director at Lewisham and Greenwich NHS Trust deleted up to 90,000 emails. The director whose entire NHS email archive was also deleted during live litigation happened to be the instructing legal client in the case. The tribunal described the conduct as extraordinary. Nobody was prosecuted. The trust issued a partial apology about a press release. The system did exactly what it always does. It absorbed the cost, deflected accountability, and waited for the man it destroyed to run out of money or energy. He hasn't. Sources: The Guardian | @BBC | BMJ | Westminster Confidential @davidhencke | Protect @WhistleUK | @BylineTimes | @CrowdJustice

Another alarming attack on London’s Jewish community, today with the stabbing of two innocent men in the streets of North London. We must stand together not only to pray for our religious communities, but to speak against these abhorrent acts perpetrated against people purely because of their faith or belief. Tonight, we pray for these two men who are being treated after their injuries and for their families and communities at this time of great pain, as we pray for our sisters, brothers and colleagues in the Jewish community who feel additionally vulnerable after today’s attack. We also pray that anyone who considers perpetrating such attacks recognises the sanctity of every life, and that acting in this way targets a bearer of the image and likeness of God, while also acting against that very same image within him or herself.

"In these unprecedented times, we need to be honest and clear about what’s feasible within existing staffing and funding envelopes in the #NHS....." Via @bmj_latest in 2020.. 6 years later? It resonates even louder. bmj.com/content/371/bm…

I was up last night with a STEMI until 4:30. For my entire career I’ve gone to work the next day with whatever sleep I could get. Not anymore. Today, I slept in and did chart work from home. You can’t fly an airplane or drive a truck if you’ve been up all night. Why should it be different for docs?

Students who take notes by hand get better grades than those who use laptops, especially in STEM fields.

It is not enough anymore in modern day NHS to ask someone if they are a Doctor- when they introduce themselves as such. You must ask "Are you a Doctor of Medicine" Because that's the modern NHS for you You want a 'Doctor'? You never know what you will get. Amazing.

Inflation up to 3.3%, The DDRB’s recommendation of 3.5% as expected looking ludicrous. Even before the fact they stated consultants total pay had been markedly eroded but then rather than doing their job they said should be reset by giving away contractual protections - paying for our own pay restoration.

Ⲡⲓⲭ̀ⲣⲓⲥⲧⲟⲥ ⲁϥⲧⲱⲛϥ Christ is Risen! “O Death, where is your sting? O Hades, where is your victory? 1 Corinthians 15:55 “By His death salvation has come to all, and all creation has been filled with light. He has risen from the dead, and death no longer has dominion.” Saint Athanasious the Apostolic A very blessed Feast of the Glorious Resurrection to you all, with prayers for peace and reconciliation upon our injured world and struggling communities.

“If we look at the state of the world around us, much seems to be impossible. How do we weather the storm of a financial crisis, of social loneliness, of divided communities, and of families struggling with a variety of complex issues?How do we navigate a time of global conflict, of war and destruction, of hateful rhetoric, and of apparently irreconcilable difference? The God of the impossible is the solution to all of our concerns, and the God of the impossible is our hope. Whether it be in our personal lives or amidst global challenges, we place all of our concerns and our struggles into His faithful and capable hands. We trust that in the fulness of time, as the Cross was transformed into the empty tomb, our struggles will be transformed into the inconceivable victory in our Lord” A blessed and joyous Feast of the Glorious Resurrection to you all!

Happy Orthodox Easter Ⲭ̀ⲣⲓⲥⲧⲟⲥ ⲁ̀ⲛⲉⲥⲧⲏ Ⲁ̀ⲗⲏⲑⲟⲥ ⲁ̀ⲛⲉⲥⲧⲏ Ⲡⲓⲭ̀ⲣⲓⲥⲧⲟⲥ ⲁϥⲧⲱⲛϥ

No surprise that patients don’t want strikes Patients want to be seen promptly by doctors - we need funding for more GPs and consultants Meanwhile @wesstreeting is cutting training posts and planning wholesale doctor substitution with people who aren’t medically trained

"One bullying approach is to punish doctors for disagreeing with the government’s wishes." The intention to withdraw the promised extra training places unless resident doctors call off strike action is desperate and delusional, writes @KamranAbbasi bmj.com/content/393/bm…

It’s simple, treat hospital doctors fairly, we work for a monopoly employer. Since 2008 average workers pay up 68%, consultants only 30%. Our comparator professions up 79%. We’re effectively working for more than a quarter of the year for free compared to 2008.

Canada, Australia, Ireland - doctors’ salaries are more than double those in the UK, with better care despite smaller economies Can’t help but think the problem isn’t UK doctors, but the performance of UK politicians and government

As we celebrate #PalmSynday today according to the Julian Calendar, we wish every blessing upon our sisters and brothers celebrating #Easter, bringing together the beautiful tapestry of the Christian Family, united in our Risen and Victorious Lord. Calendars may be different, but our Faith and hope are most certainly one. A blessed #PalmSunday and #EasterSunday to all!

The promise was always of hard years as a junior doctor then good pay as a consultant and a solid pension Instead huge debts at extortionate interest rates, real terms pay cuts to consultant salaries, excellence awards cut and not-pensionable, huge pension taxes based on a pot you’ll never access, lower pensions It’s all moved in the wrong direction

2 things of note-as reported: 1. 'The Physician Associate was supervising a Physician Associate Apprenticeship clinic' 2. 'Since Miss Sellars' death there have been changes at the surgery to the type of patients seen by physician associates' Read those 2 lines again. An untrained person supervising an even more untrained person. And a death needed to change practice. @wesstreeting there was this thing called @lengreview What is happening to safety in this country regards health? @drruthannharpur @DOckendenLtd @catherineroyuk stokesentinel.co.uk/news/stoke-on-…

When Government says your pay is up over the last four years they are correct, but so is everyone else’s. Compared to 2008 however consultant pay is up 30%, average workers pay 68% and comparator professions 79%. We’re still paying for bankers, we’re not paying for Trump too.

It’s disappointing that @wesstreeting has failed to negotiate a path to #payrestoration for resident doctors Absurd that @Emmabarnett suggests the war in the Middle East justifies further real terms pay cuts so that doctors subsidise the NHS @fletchjack @BMAResidents chair patient despite repeated interruptions talked about pay and jobs on @BBCr4today Restore pay and end strikes @wesstreeting