Blessed are those who mourn, for they will be comforted. Matthew 5:4. From comfort comes happiness and joy.
The Kingdom of Heaven is here, but not yet is a common expression of the state we are at the moment on earth. Jesus introduced the spiritual Kingdom of Heaven which resides in our hearts (body, mind and soul).
When a person sins against God, the Holy Spirit convicts him. Realising the sin committed the person mourns, repents and seek forgiveness.
God will bless and comfort the sinful person who mourns about his inapt actions, and true repentance will bring about happiness. Happiness then becomes joy, which has a deeper sense of fulfilment and contentment, when he is liberated from the sin which he had committed.
A believer of Christ holds fast to the teachings of Christ. Unfortunately he is tempted to do things which are sinful in the eyes of God. Believers are still sinners (while in this world) who require a total cleansing from within and this cleansing is made possible by the presence of the Holy Spirit who continuously counsels the believer and corrects his inner character.
When a believer sins there are consequences or punishments which may be meted according to moral, civil or God's Mosaic laws. The Holy Spirit convicts a believer of wrong doing and continues to counsel him so as to bring the believer back to walk in the righteous, straight path again.
The believers' only God is truly loving and ever faithful and will forgive the sins of the believers when they repent and turn away from their sins and repeat them no more.
God forgives and saves, judges and rewards the believers. There is no condemnation to hell for the believer as he is saved when he puts his faith in Christ, obeys his commands and live according to God's purpose and will. His God's loves and keeps His promise of every lasting life for all who believe in Him.
This Get Well message was made using Canva. Several steps involved. First to choose the background picture. Selected a picture with many fruits as fruits are usually given when visiting ill persons. Second comes the message and choosing the fonts and colours to go with it. Then needed to frame the words with some added transparency. The signature came with a new tool just available in Canva. Finally took some time to select an appropriate bible verse to go with the message. Chose John 14:21. Hope you like it!
I have taken the liberty to split up the long virtual workshop on Managing Cough and Excessive Phlegm into several smaller video segments. The segments contain information on how to perform home chest physiotherapy. These videos are suitable for patients having chronic bronchitis, COPD, bronchiectasis, cystic fibrosis, lung infection etc.
This is a
picture of the passion fruit flower. This flower is also known as the “flower
of five wounds”. The purple flower is believed to resemble the wounds of Jesus
Christ.
The Passion
of Christ includes the time period from the night prior to the crucifixion of
Jesus until his death upon the cross. Much emphasis has been placed on this
time period to emphasize the sufferings of Jesus leading to his death and His
ultimate sacrifice for sin. This time period is traditionally marked by His
time in the Garden of Gethsemane, and includes His prayers, betrayal by Judas
Iscariot, abandonment and denial by His disciples, arrest, trials, beatings,
and period of time on the cross.
Jesus died
on the cross and rose from the dead on the third day. His resurrected body was
witnessed by many people, including His disciples. Jesus is alive today.
Before
Jesus ascension to heaven he spoke of His Great Commission to His disciples. Jesus
said in Matthew 28: 18-20. “All authority in heaven and on earth has been given
to me. Therefore, go and make disciples of all nations, baptizing them in the
name of the Father and of the Son and of the Holy Spirit, and teaching them to
obey everything I have commanded you. And surely I am with you always to the
very end of the age”.
This is an interesting topic. The ejection fraction is a measurement of left heart function obtained during echocardiography. The question is how does the heart fail when the measured EF is normal?
Heart failure is an important cause of shortness of breath which has to be differentiated from lung causes of shortness of breath. Often the distinction between the two conditions is not obvious clinically without further investigations. Relevant investigations include ECG, NT proBNP (blood test), echocardiography, chest x-ray and coronary angiography.
Heart failure with preserved ejection fraction is a type of heart failure with normal or near normal ejection fraction and objective evidence of diastolic dysfunction.
More than half of heart failure patients have heart failure with a maintained ejection fraction. The illness primarily affects the elderly, accounting for 4.9 percent of the population over the age of 60. It appears to be more common in women, and it is projected to become more widespread as people live longer.
Link to this interesting article which I have read:
Feger, J., Worsley, C. Heart failure with preserved ejection fraction. Reference article, Radiopaedia.org. (accessed on 24 Mar 2022) https://doi.org/10.53347/rID-93980
Monday, February 28, 2022
Tracheostomy for Ventilated Patient
Doctors struggle to accurately predict which patients will require prolonged mechanical ventilation. Doctors need a clear understanding of the nature and typical course of chronic critical illness.
Communication about chronic critical illness should begin before its onset and, ideally, as early as the initiation of mechanical ventilation (or even at decision-making about whether to initiate ventilation). Doctors should inform not only of the risk of death in the ICU, but also the chance the patient might survive but remain dependent on the ventilator and other intensive therapies for a prolonged period.
These initial discussions allow a longer time for doctors to “cultivate prognostic awareness” i.e. the capacity to understand prognosis and the likely illness trajectory and help patients and families prepare psychologically and practically for further developments.
Based on the available evidence, routine placement of tracheostomy prior to day 10 of mechanical ventilation is not indicated. General consensus is that a tracheostomy should be placed after day 10 if the patient is likely to require more than a few additional days of ventilation i.e. the patient will neither be liberated from the ventilator nor die in the near future i.e. the patient is chronically critically ill.
Benefits of tracheostomy include:
Improved patient comfort
Easier oral care and suctioning
Reduced need for sedation or analgesia
Reduced accidental extubation
Improved weaning from mechanical ventilation
Easier facilitation of rehabilitation
Earlier communication and oral nutrition
Facilitated transfer to lower level of care
Early Complications:
Bleeding
Air leak causing subcutaneous emphysema, pneumothorax, pneumomediastinum
Damage to the swallowing tube (esophagus)
Injury to the nerve of the vocal cords (recurrent laryngeal nerve)
Tracheostomy tube can be blocked by blood clots, mucus, or pressure of the airway walls.
Late Complications:
Accidental removal of the tracheostomy tube
Infection in the trachea and around the tracheostomy tube
Trachea may be damaged by pressure from the tube resulting in bacterial infections and scar tissue formation
Delayed Complications:
Thinning of the trachea from the tube rubbing against it (tracheomalacia)
