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    The main IP address: 77.104.129.242,Your server Bulgaria,Sofia ISP:GetClouder EOOD  TLD:uk CountryCode:BG

    The description :skip to content menu home disclaimer medcalc bnf online common drugs calendar paediatric vital signs paediatric traffic light fracture help google my pacs figure one trips pacs nhs.net refer a patient...

    This report updates in 06-Jul-2018

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Latitude: 42.697509765625
Longitude: 23.324150085449
Country: Bulgaria (BG)
City: Sofia
Region: Grad Sofiya
ISP: GetClouder EOOD

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Transfer-Encoding:chunked
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Host-Header:192fc2e7e50945beb8231a492d6a8024
Link:; rel="https://api.w.org/", ; rel=shortlink
Date:Fri, 06 Jul 2018 12:19:25 GMT
Content-Type:text/html; charset=UTF-8
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DNS

soa:ns1.uk13.siteground.eu. dnsadmin.serv01.uk13.siteground.eu. 2016051706 3600 7200 1209600 86400
txt:"v=spf1 +a +mx +ip4:185.123.97.177 include:_spf.mailspamprotection.com ~all"
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ipv4:IP:77.104.129.242
ASN:36351
OWNER:SOFTLAYER - SoftLayer Technologies Inc., US
Country:BG
mx:MX preference = 30, mail exchanger = mx30.mailspamprotection.com.
MX preference = 20, mail exchanger = mx20.mailspamprotection.com.
MX preference = 10, mail exchanger = mx10.mailspamprotection.com.

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skip to content menu home disclaimer medcalc bnf online common drugs calendar paediatric vital signs paediatric traffic light fracture help google my pacs figure one trips pacs nhs.net refer a patient think io access! for trauma/or any pts arriving in extremis, the io route was fast and had a very high success rate compared to peripheral iv or central line. why does this matter? obtaining iv access is critical for any resuscitation. we often forget about the io route. we need to break out of our tunnel vision and be reminded sometimes that there is another viable option for access. a retrospective study did a video review of 38 trauma pts in extremis, defined as arrival with no palpable pulse or measurable blood pressure, and vascular access attempted. of these 38, 93% were from penetrating trauma; 145 vascular access attempts were made. peripheral iv (piv) and io were statistically the same regarding time to access, about 20-40 seconds. central venous catheters (cvc) took about 3 minutes. io success was 95%; piv 42%; cvc 46%. don’t forget about this highly successful and rapid way to gain vascular access in severely ill patients. reference: the intraosseous have it: a prospective observational study of vascular access success rates in patients in extremis using video review. j trauma acute care surg. 2018 apr;84(4):558-563. author forderit posted on june 30, 2018 june 30, 2018 categories bitesize can your patient with dementia refuse treatment? medical decision-making capacity refers to the pt’s ability to make informed decisions regarding their care, and emergency practitioners are frequently required to assess whether a pt possess this capacity. pts with acute or chronic neurological diseases (such as dementia) may lack this capacity, and this should be identified, especially in life-threatening situations. the patient must have the ability to: communicate a consistent choice understand (and express) the risks, benefits, alternatives and consequences appreciate how the information applies to the particular situation reason through the choices to make a decision there are numerous tools that may help with this assessment, but none has been validated in the ed. be careful of determining that the patient lacks capacity just because of the diagnosis they carry. remember: capacity is a fluid concept; a pt may have the capacity to make simple decisions but not more complex ones. capacity may also change over time psychiatry consultation to determine capacity is not obligatory but may be utilized for a second opinion. reference: rodgers jj, kass js. assessment of medical decision-making capacity in patients with dementia. continuum 2018;24(3):920–925. author forderit posted on june 29, 2018 categories bitesize gout ed visits for acute gout increased almost 27% between 2006 & 2014. presentation: acute severe pain, swelling, redness, warmth. pain peaks between 12 to 24 hours and onset more likely at night quiet, calm period between flares vs other arthritic disorders signs of inflammation can extend beyond the joint normal to low serum urate values have been noted in 12 to 43% of pts with gout flares accurate time for assessment of serum urate is greater than 2 weeks after flare subsides most hyperuricemic individuals never experience a clinical event resulting from urate crystal deposition. gout flares may occasionally coexist with another type of joint disease (septic joint, psedugout), a clinical decision rule has shown to be more accurate than clinical diagnosis (17 versus 36%) acute gout diagnosis rule can be used for pts presenting with mono arthritis. male sex (2 points) previous pt-reported arthritis flare (2 points) onset within one day (0.5 points) joint redness (1 point) first metatarsal phalangeal joint involvement (2.5 points) hypertension or at least one cardiovascular disease (1.5 points) serum urate level greater than 5.88 mg/dl (3.5 points) ≤4 points: unlikely gout. other causes of monoarthritis should be considered, for example: pseudogout, septic arthritis, reactive arthritis, psoriatic, rheumatoid, or osteoarthritis. 4-8 points: these patients are most likely to benefit from joint aspiration and fluid analysis for urate crystals. ≥8 points: gouty arthritis is very likely, and empiric gout medications can be started as opposed to more generic arthritis treatments (like nsaids). management gout flares are often treated with some combination of steroids, nsaids, opioids for extreme pain, and colchicine, depending on a pt’s age and other risk factors for complications. after the initial flare, pts may benefit from urate-lowering therapies like allopurinol. bottom line: consider supplementing your clinical decision with this rule in the future reference: becker, ma. clinical manifestations and diagnosis of gout. up to date. 2018 author forderit posted on june 26, 2018 june 26, 2018 categories bitesize fluid administration in paediatric dka children with diabetic ketoacidosis (dka) may have brain injuries ranging from mild to severe. the debate over the contribution from iv fluids towards poor neurologic outcomes has been ongoing for decades. pecarn’s large multicenter randomized, controlled trial examined the effects of the rate of administration and the sodium chloride content of iv fluids on neurologic outcomes in children with dka may finally put the controversy to rest. there was no difference on significant neurologic outcomes based on the rate (fast vs slow) or concentration (0.9% vs 0.45%) of iv fluid administration. clinically apparent brain injury occurred in 12 of 1389 episodes (0.9%) of children in dka. any change in the mental or neurological status of the pt should be concerning for life threatening edema and should be treated with mannitol 1g/kg iv bolus or hypertonic saline (3%) 5-10 ml/kg iv over 30 minutes. bottom line: “neither the rate of administration nor the sodium chloride content of iv fluids significantly influenced neurologic outcomes in children with dka”. reference: kuppermann n, ghetti s, schunk je, stoner mj, rewers a, mcmanemy jk, myers sr, nigrovic le, garro a, brown km, quayle ks, trainor jl, tzimenatos l, bennett je, depiero ad, kwok my, perry cs 3rd, olsen cs, casper tc, dean jm, glaser ns; pecarn dka fluid study group. clinical trial of fluid infusion rates for pediatric diabetic ketoacidosis. n engl j med. 2018 jun 14;378(24):2275-2287. author forderit posted on june 25, 2018 june 25, 2018 categories bitesize check yourself before you wreck yourself! a cluster rct of physicians in france who presented their pts’ cases to the other physician on duty three times a day compared with those who did not. overall, 840 cross-check patients and 840 standard care patients were enrolled. in the cross-check group, 54/840 patients (6.4%) had adverse events, as opposed to 90/840 (10.7%) in the standard care group, nnt =24 . there was also a reduction in near-misses. we all understand how important this is for training, but this was among consultant physicians. what it tells me is that when i have a tough case, discussing it with a colleague can reduce my chance of making an error in management. it takes a lot of courage and humility to ask for help and advice especially as you get more senior, but doing so may lead to a charmed existence in the ed. bottom line: simply presenting pts to another physician reduced serious adverse events (nnt = 24) and near-misses. now we just need to overcome our resistance and ask our colleagues for advice and input. reference: effect of systematic physician cross-checking on reducing adverse events in the emergency department: the charmed cluster randomized trial. jama intern med. 2018 apr 23. doi: 10.1001/jamainternmed.2018.0607. [epub ahead of print] author forderit posted on june 22, 2018 categories bitesize do we aim to simply treat or also heal? interesting concepts around system redesign include thoughts about offering things to pts that ultimately make the difference for qu

URL analysis for yazdani.co.uk


http://yazdani.co.uk/2016/05/
http://yazdani.co.uk/wp-content/uploads/2016/07/support-for-education-and-learning-educational-resource-traffic-light-table-189985789.pdf
http://yazdani.co.uk/2018/06/29/can-your-patient-with-dementia-refuse-treatment/
http://yazdani.co.uk/category/uncategorized/
http://yazdani.co.uk/2017/12/
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http://yazdani.co.uk/2018/06/14/is-neuroimaging-necessary-in-syncope/
http://yazdani.co.uk/2016/05/24/frequently-used-drugs-doses/
http://yazdani.co.uk/2016/07/
http://yazdani.co.uk/2018/01/
http://yazdani.co.uk/2018/03/
http://yazdani.co.uk/author/forderit/
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Whois Information


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Error for "yazdani.co.uk".

the WHOIS query quota for 2600:3c03:0000:0000:f03c:91ff:feae:779d has been exceeded
and will be replenished in 118 seconds

WHOIS lookup made at 19:10:29 26-Aug-2017

--
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  REFERRER http://www.nominet.org.uk

  REGISTRAR Nominet UK

SERVERS

  SERVER co.uk.whois-servers.net

  ARGS yazdani.co.uk

  PORT 43

  TYPE domain

DISCLAIMER
This WHOIS information is provided for free by Nominet UK the central registry
for .uk domain names. This information and the .uk WHOIS are:
Copyright Nominet UK 1996 - 2017.
You may not access the .uk WHOIS or use any data from it except as permitted
by the terms of use available in full at http://www.nominet.uk/whoisterms,
which includes restrictions on: (A) use of the data for advertising, or its
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or hiding any or all of this notice and (C) exceeding query rate or volume
limits. The data is provided on an 'as-is' basis and may lag behind the
register. Access may be withdrawn or restricted at any time.

  REGISTERED no

DOMAIN

  NAME yazdani.co.uk

NSERVER

  NS1.UK13.SITEGROUND.EU 185.123.97.177

  NS2.UK13.SITEGROUND.EU 77.104.128.188

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