SGH again,prescribe medicine wrongly
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haha...resort to personal attacks because you cannot win any arguments? Doesn't hurt me...Originally posted by maurizio13:I don't think you can call him a doctor just because he answered some questions on diabetes insipidus on his own forum. The reply looks as it's been paraphrase from some website. Unless, you know him personally and know where he is practicing. The kind of attitude he possesses would hardly justify him to be a person who heals, as compassion and understanding is the basic quality of a good doctor.
When I confront him with questions like PQRSTU, he scuttles away like a headless chicken.
I think it's better that eggprata sticks to his family doctor, afterall, you can be sure of his family doctor's status.
I may be a doctor but I cannot treat your problem. There is no cure for lacking a brain -
The TS received an antibiotic that combines two drugs, amoxicillin (a type of penicillin) and clavulanic acid, a beta-lactamase inhibitor. The latter inhibits the breakdown of amoxicillin by some bacteria that are resistant through the production of lactamase, an enzyme that breaks down the antibiotic.
This combination is effective against a wide range of bacteria and has been used for more than a decade.
As for the pharmacokinetics, amoxicillin has greater oral bioavailability compared to PenV and ampicillin. This is what the FDA says:
"Approximately 74-92% of a single dose of amoxicillin is absorbed while approximately 60-70% of an oral penicillin V dose and 30-55% of an oral ampicillin dose are absorbed. Peak serum amoxicillin concentrations (Cmax) are reached 1-2 hours after an oral dose of the capsules, film-coated tablets, chewable tablets, or oral suspension in fasting and non-fasting adults. Non-linearity in absorption of amoxicillin has been reported when increasing doses of 250mg, 500mg, and 1000mg of amoxicillin were administered to fasting adults. A significant reduction in the percentage of the dose absorbed was observed for the 1000mg dose (5)."
(http://www.fda.gov/cder/drugprepare/amox-anthrax.htm)
The clavulanic acid component is shown not to interfere with the absorption of amoxicillin and vice versa. However, oral absorption of clavulanic acid can be highly variable (http://cat.inist.fr/?aModele=afficheN&cpsidt=14518475).
The bio-availability of amoxicillin/clavulanic acid combination has been shown to be unaffected by food. Here's an abstract of a study done to address this very question:
"Augmentin’, the novel antibiotic formulation containing the ß-lactamase inhibitor, clavulanic acid, and the -lactam antibiotic, amoxycillin, has been the subject of two studies reported here on bioavailability and tolerance.
Eighteen subjects took part in a two-part crossover study to compare the bioavailability when taken fasting and with food. The bioavailability was shown to be unimpaired when taken with food.
Forty-five healthy subjects took part in a series of crossover studies to compare the tolerance of ‘Augmentin’ taken fasting and with food. ‘Augmentin’ was also compared with cephalexin under the same conditions. The gastro-intestinal side effects reported in these volunteer studies, which are rare in clinical practice, were reduced when ‘Augmentin’ was taken with food. "
(Staniforth DH, Lillystone RJ, Jackson D. Effect of food on the bioavailability and tolerance of clavulanic acid/amoxycillin combination. Journal of Antimicrobial Chemotherapy (1982) 10, 131-139)
In other words, this antibiotic combination can be taken either before or after meals. It does not matter to the bioavailability. However, because some people get tummy upset as a side effect of this antibiotic, the recommendation is to take it with food to reduce that side effect.
There are many reasons why the antibiotic did not work as well as it did. First, the bacteria may not be sensitive to the antibiotic. Perhaps the wound was infected with a bacteria that is not sensitive to this antibiotic or surgical debridement is needed. The medication the TS received sounds like a generic rather than Augmentin (the original 'branded' drug). Depending on where it was manufactured, the formulation and bioavailability may differ. -
huh, eggprata, you are just one of the many who were treated the same way. Hey, I have been receiving negative feedback about the doctors there.Originally posted by eggprata:I cant remember rane,not sure myself,but it was Clinic H at block 3.Absolutely terrible man,i told him about the swelling and he was kinda rude as well.Sigh.Doubt would ever wanna go sgh again and hopefully none need to also haha.
Scums they are.
Do do cautious when you are approached to take blood. It happened when my neighbour brought her husband to see the doctor. Doctor/nurse asked patient to sign the form to take blood, when asked he said it is nothing just sign the form. My neighbour sensed something wrong and read the form carefully then realised it was a consent form requesting for blood from patients for research. AFter knowing what it was about, my neighbour was infuriated and told the doctor and nurse off. Doctor put the blame on the nurse. My neighbour was very angry that the doctor and nurse were trying to trick her husband into signing the form by not knowingly giving permission for them to take blood from him.. It is plain deception. She asked the husband not to sign the form (husband is chinese educated, understand very little of English). See the way they stoop so low to get what they want, scary!!! Be careful people!
Don't go SGH they provide nasty and bad service! -
Originally posted by maurizio13:
Why are you asking him about PQRSTU? If I recall correctly is a memory technique albeit imo a useless one.
I don't think you can call him a doctor just because he answered some questions on diabetes insipidus on his own forum. The reply looks as it's been paraphrase from some website. Unless, you know him personally and know where he is practicing. The kind of attitude he possesses would hardly justify him to be a person who heals, as compassion and understanding is the basic quality of a good doctor.
When I confront him with questions like PQRSTU, he scuttles away like a headless chicken.
I think it's better that eggprata sticks to his family doctor, afterall, you can be sure of his family doctor's status. -
Nah. It's what a doc should know. But seriously, I doubt that toadstool is a doc. His posting is nothing more than reading from the web and posting it here. Judging from his personal attributes, I seriously doubt he is someone from the medical profession.Originally posted by Skibi:Why are you asking him about PQRSTU? If I recall correctly is a memory technique albeit imo a useless one. -
Originally posted by maurizio13:Nah. It's what a doc should know. But seriously, I doubt that toadstool is a doc. His posting is nothing more than reading from the web and posting it here. Judging from his personal attributes, I seriously doubt he is someone from the medical profession.
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He is not a Doc but a Dog!!!!Originally posted by maurizio13:Nah. It's what a doc should know. But seriously, I doubt that toadstool is a doc. His posting is nothing more than reading from the web and posting it here. Judging from his personal attributes, I seriously doubt he is someone from the medical profession. -
There was no argument to be won here in the first place. Moreover, you haven't respond to any of my post at all, it's more like you lost all the arguments in all the previous thread.Originally posted by oxford mushroom:haha...resort to personal attacks because you cannot win any arguments? Doesn't hurt me... I may be a doctor but I cannot treat your problem. There is no cure for lacking a brain
I am merely stating facts that your profession is of a dubious nature. The kind of personal attributes you possess, I won't be surprised if you are working as a kopi boy. -
but dogs are lovely, sensitive, loyal and kind animals and he is not!!Originally posted by foomwee88:He is not a Doc but a Dog!!!! -
It's a rabid dog!!!Originally posted by rane:but dogs are lovely, sensitive, loyal and kind animals and he is not!!
Yikes!!! -
You mean he is worst than a Dog!!!!Originally posted by rane:but dogs are lovely, sensitive, loyal and kind animals and he is not!!
I think u r right!!!dogs cheat sometimes but he cheats and is a fake all the times!!! -
For more serious illness, it is always wise to search for more information before consulting a doctor. Information on treatments and what each medicine does is freely available on the internet at reputable gov or drug company websites. Most of us probably can't afford to sue the doctor if anything goes wrong.
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A little knowledge is a dangerous thing. When that knowledge comes from a feeble mind, we have a disasterOriginally posted by maurizio13:Taking it before food is to reduce the effect that your gastric juices will nullify the effects of the medication. Suggest you consult lawyers and take a legal course of action for the negligence on the part of the SGH doctors. -
Haha..what response can there be to mindless ranting? The TS raised a question and I have answered it. On the other hand, you resort to wild allegations without a shred of understanding of the issue. Tsk tsk...Originally posted by maurizio13:There was no argument to be won here in the first place. Moreover, you haven't respond to any of my post at all, it's more like you lost all the arguments in all the previous thread.
I am merely stating facts that your profession is of a dubious nature. The kind of personal attributes you possess, I won't be surprised if you are working as a kopi boy. -
A doctor working at the NHS contesting the fact the NHS is free. How much more ridiculous could it possibly get?Originally posted by maurizio13:There was no argument to be won here in the first place. Moreover, you haven't respond to any of my post at all, it's more like you lost all the arguments in all the previous thread.
I am merely stating facts that your profession is of a dubious nature. The kind of personal attributes you possess, I won't be surprised if you are working as a kopi boy. It's akin to someone residing in Singapore arguing that winter actually exists on these shores... -
hey, don't compare him with dogs lah!! whether dogs are healthy or sick, they are the same - lovely, loyal, sensitive, faithful, cute, grateful . . . . .Originally posted by foomwee88:You mean he is worst than a Dog!!!!
I think u r right!!!dogs cheat sometimes but he cheats and is a fake all the times!!! -
You know why you couldn't answer my question as to "PQRSTU"? It's because you can't find any websites to give you anything conclusive, either that or you think that it has nothing to do with the medical profession.Originally posted by oxford mushroom:Haha..what response can there be to mindless ranting? The TS raised a question and I have answered it. On the other hand, you resort to wild allegations without a shred of understanding of the issue. Tsk tsk...
Answering questions that could be found when you do a yahoo or google search is nothing to be proud of. I noticed that you were missing in action for a couple of days after the questions was asked. Were you busy researching the websites? It's not difficult for a person with a knowledge of biology to understand what was explained in those websites.
Claiming credit for answering a question, that is not someone who has professionalism in the medical profession does. Imagine a doctor coming in here, claiming credit because he managed to answer a question about antibiotics and telling a layman that he (as a doctor) can answer it but you can't. Why would a doctor go around telling people that he can answer those questions and you a layman can't? Just goes to prove that you aren't a doctor. Only a non doctor would need to prove to others that he is one.
I will tell you what is "PQRSTU" it's the different phases of a heartbeat measured on an electrocardiogram. It's in the syllabus of first year medical students, if you look up your first year medical physiology book, you will find it under "origin of the heartbeat and electrical activity of the heart" in Ganong. -
Originally posted by maurizio13:
He had already given himself away when he claimed to be working in NHS, yet know next-to-nothing about some of the most fundamental issues, hadn't he?
[b]You know why you couldn't answer my question as to "PQRSTU"? It's because you can't find any websites to give you anything conclusive, either that or you think that it has nothing to do with the medical profession.
Answering questions that could be found when you do a yahoo or google search is nothing to be proud of. I noticed that you were missing in action for a couple of days after the questions was asked. Were you busy researching the websites? It's not difficult for a person with a knowledge of biology to understand what was explained in those websites.
Claiming credit for answering a question, that is not someone who has professionalism in the medical profession does. Imagine a doctor coming in here, claiming credit because he managed to answer a question about antibiotics and telling a layman that he (as a doctor) can answer it but you can't. Why would a doctor go around telling people that he can answer those questions and you a layman can't? Just goes to prove that you aren't a doctor. Only a non doctor would need to prove to others that he is one.
I will tell you what is "PQRSTU" it's the different phases of a heartbeat measured on an electrocardiogram. It's in the syllabus of first year medical students, if you look up your first year medical physiology book, you will find it under "origin of the heartbeat and electrical activity of the heart" in Ganong.[/b] -
He is just a doctor wannabe, but turns out to be dog.Originally posted by walesa:He had already given himself away when he claimed to be working in NHS, yet know next-to-nothing about some of the most fundamental issues, hadn't he?
If you really want to test him, don't ask him things that can be googled on the internet.
He is delusional. He should seek psychiatric help.
You know, I asked him the "PQRSTU" question for more than a month, in so many threads, but when posed with the question, he will run away and hide. Why? It's because he can't google this, as it will turn up garbage, unlike all the other stuff.
Big scammer!!! -
Originally posted by oxford mushroom:
Frankly, "jljl" would be more of a doctor than you. Compare his/her reply to yours, you just cut and paste loads of crap to sound intelligent, that's what non-intelligent people need to prove. By putting so much medical jargon into your replies, goes to show how stupid you are. When you go see a doctor, is the doctor going to tell you about bioavailability, cephalexin, clavulanic acid and beta-lactamase.
The TS received an antibiotic that combines two drugs, amoxicillin (a type of penicillin) and clavulanic acid, a beta-lactamase inhibitor. The latter inhibits the breakdown of amoxicillin by some bacteria that are resistant through the production of lactamase, an enzyme that breaks down the antibiotic.
This combination is effective against a wide range of bacteria and has been used for more than a decade.
As for the pharmacokinetics, amoxicillin has greater oral bioavailability compared to PenV and ampicillin. This is what the FDA says:
"Approximately 74-92% of a single dose of amoxicillin is absorbed while approximately 60-70% of an oral penicillin V dose and 30-55% of an oral ampicillin dose are absorbed. Peak serum amoxicillin concentrations (Cmax) are reached 1-2 hours after an oral dose of the capsules, film-coated tablets, chewable tablets, or oral suspension [b]in fasting and non-fasting adults. Non-linearity in absorption of amoxicillin has been reported when increasing doses of 250mg, 500mg, and 1000mg of amoxicillin were administered to fasting adults. A significant reduction in the percentage of the dose absorbed was observed for the 1000mg dose (5)."
(http://www.fda.gov/cder/drugprepare/amox-anthrax.htm)
The clavulanic acid component is shown not to interfere with the absorption of amoxicillin and vice versa. However, oral absorption of clavulanic acid can be highly variable (http://cat.inist.fr/?aModele=afficheN&cpsidt=14518475).
The bio-availability of amoxicillin/clavulanic acid combination has been shown to be unaffected by food. Here's an abstract of a study done to address this very question:
"Augmentin’, the novel antibiotic formulation containing the ß-lactamase inhibitor, clavulanic acid, and the -lactam antibiotic, amoxycillin, has been the subject of two studies reported here on bioavailability and tolerance.
Eighteen subjects took part in a two-part crossover study to compare the bioavailability when taken fasting and with food. The bioavailability was shown to be unimpaired when taken with food.
Forty-five healthy subjects took part in a series of crossover studies to compare the tolerance of ‘Augmentin’ taken fasting and with food. ‘Augmentin’ was also compared with cephalexin under the same conditions. The gastro-intestinal side effects reported in these volunteer studies, which are rare in clinical practice, were reduced when ‘Augmentin’ was taken with food. "
(Staniforth DH, Lillystone RJ, Jackson D. Effect of food on the bioavailability and tolerance of clavulanic acid/amoxycillin combination. Journal of Antimicrobial Chemotherapy (1982) 10, 131-139)
In other words, this antibiotic combination can be taken either before or after meals. It does not matter to the bioavailability. However, because some people get tummy upset as a side effect of this antibiotic, the recommendation is to take it with food to reduce that side effect.
There are many reasons why the antibiotic did not work as well as it did. First, the bacteria may not be sensitive to the antibiotic. Perhaps the wound was infected with a bacteria that is not sensitive to this antibiotic or surgical debridement is needed. The medication the TS received sounds like a generic rather than Augmentin (the original 'branded' drug). Depending on where it was manufactured, the formulation and bioavailability may differ.
[/b]
Compare with jljl's reply:
honestly, taking augmentin or any other antiobiotics before or after food is not really a big issue. with food, augmentin or (co-amoxiclav) is easier on the stomach with less side effects...
more likely reasons that wound is not healing?
1. antibiotic not working because of bacterial resistance; ie need to change to another type of antibiotics
2. insufficient dose.. (taken twice a day, augmentin is actually very low dose.. sometimes u need up to three to 4 tabs /day ) to even make a difference
3. remnant unresolve wound problems e.g. unremoved stitches, deep seated bad infections that may need to be drained surgically
4. other poor skin healing factors e.g. genetically poor ability to heal, immune compromised (e.g. on long term steroids, diabetes, AIDs etc)
fyi
OM, you are a sad delusional individual, who has high ambition of being a doctor but failed. -
Unfortunately there are arrogant fools who just cannot read simple English but will never admit they made a wrong call....tsk tsk...
Pity SGH will not bother to being a defamation suit against idiots...they will plead insanity -
Doctors who prescribe medicines actually follow the clinical chart closely. To give a right dosage, patients are monitored closely on hourly basis or daily basis. Antibiotics are meant to fight bad bacteria in the body. If its a viral infection, then probably the antibodies in the body are not enough to fight the fever or any other infections in the body. For dressing purpose, personal hygiene and they way you handle the wound is very important. Cross-infection can occur if you don't handle properly.