#Angina pectoris

[mrcardio]

[pier-carlo-universe]

“Angina pectoris” di Nazim Hikmet: il cuore di un poeta tra oppressione e libertà. Recensione di Alessandria today

Un inno alla sofferenza universale e alla speranza senza confini

Un inno alla sofferenza universale e alla speranza senza confini Biografia dell’autore.Nazim Hikmet (1902-1963) è universalmente riconosciuto come uno dei maggiori poeti turchi del XX secolo. Nato a Salonicco, allora parte dell’Impero Ottomano, Hikmet ha vissuto una vita segnata dall’impegno politico e dalle lotte per la libertà. Le sue idee comuniste lo portarono spesso in conflitto con il…

[zdravljeirecepti]

Šta su pravi uzročnici infarkta i šloga?

[bekamasysyifa]

Bekam untuk Angin Duduk

22 Juni 2024 membekam pak Herman (37 tahun) dengan keluhan kepala pusing, bahu dan leher kaku dan sakit, serta masuk angin. Kata orang dulu ini adalah Angin Duduk. Kata dokter, Angina Pectoris. Gejala serangan jantung. Gejala tambahan betis dan telapak kaki kebas. Continue reading Bekam untuk Angin Duduk

[bjugnakraekir]

what do you MEAN nitroglycerine was invented for heart problems????

[harmeet-saggi]

What's Causing My Chest Pain?

Chest pain can be caused by several things, from a heart attack to acid reflux. However, in most cases, chest pain is not caused by a serious problem and can be treated with home remedies.

[emilioalessioloiacono]

🔵 Angina pectoris stabile, instabile o secondaria: cos'è, come si manifesta, quali i rischi, come si cura? 👉 Leggi l’articolo: https://medicinaonline.co/2016/12/04/angina-pectoris-stabile-instabile-secondaria-sintomi-interpretazione-e-terapia/ ✅  #cuore #sangue #circolazione #coronarie #angina #dolore #infarto #miocardio #EmilioAlessioLoiacono #MedicinaOnLine

[drsibia]

EE

[vasanthasworld]

Drugs Used In Angina Pectoris and Myocardial Infarction Short And Long Essay Question And Answers

[felix-healthcare]

Angina Pectoris is a medical condition characterized by chest pain or discomfort caused by reduced blood flow to the heart muscle. It's a symptom of underlying heart disease and can be a warning sign of a heart attack. If your loved one is experiencing symptoms of Angina Pectoris, seeking timely and appropriate medical care is important. Here is a guide to visiting an Angina Pectoris Treatment Hospital in Noida to help you navigate the process more effectively.

[tussive]

I remember being with my friend William one time several years ago. We had driven like 40 minutes to the closest sex shop so we could buy poppers. Then we went to Walmart and drove around on the scooters while doing the poppers. He kept yelling out, "I need this for my angina pectoris!"

For some reason, they kicked us out. Idk, I guess they have a problem with people with heart conditions? Pretty fucked up. I questioned Walmart corporate about it one time but they never responded. Typical ableist shit, you know how Walmart is.

[zdravljeirecepti]

🥚Čaroban lijek za štitnjaču, srce, krv i kosti – LJUSKA OD JAJA + Lijek ...

[tanadrin]

Angor animi (also referred to as angina animi,[1][2] Gairdner's disease[2] and also angina pectoris sine dolore[2]), in medicine, is a symptom defined as a patient's perception that they are in fact dying. Most cases of angor animi are found in patients with acute coronary syndrome (cardiac-related chest pain) such as myocardial infarction.

If you are having a heart attack and think you might be dying aren’t you just like. Accurately assessing the situation?

[gravemakamura]

Let Me Tell Ya Something: Artists and Writers of the Aestheticism Movement

(Note: I've gone bonkers at the end of it)

The art movement called ‘Aestheticism” is both interesting and weird.

The movement originally started back in 1860 and ended in 1900 (At least according to articles and Youtube videos).

There are two sections or categories that Aestheticism is found in (or at least I'm interested in). Art and Literature. But first…

What Is Aestheticism?

Aestheticism is basically the embodiment of “Art for the sake of art”

As Aestheticism was uninspired by the natural world, and instead only showed the shallow beauty of things. As the article that I read wrote; Beauty escapism. Or something along those lines. The movement chose beauty over sharing political and/or social ideas. Aestheticism showcased the beauty of manly or female beauty and created a new fashion trend as it influenced public consciousness. Aestheticism was also associated with the Decadent movement. Aestheticism looks back to the art of the past, similar to the Renaissance, but with no substance other than being food for the eyes. (You can correct me if I'm wrong)

Aestheticism is also a philosophy. The study and nature of beauty.

Artists During The Aestheticism Movement

(Note that information about these artists and writers in this blog may be insufficient, and I will shorten the description of each individual as much as possible)

- Dante Gabriel Rossetti (I am unsure how his surname is spelled, as it kept changing between sources)

- Lord Leighton

Dante Gabriel Rossetti

Born in London, England on May 12, 1828. He was the most celebrated member of the Rossetti family. Rossetti was an English artist and poet. He helped found the Pre-raphaelites Brotherhood, painters who were just haters of Raphael’s and Michelangelo’s works to put it simply and lightly. But, by the 1860s, he moved on from the pre-raphaelites and was searching for something new to paint.

Rossetti was known for painting his muse (and wife, which is cute) Elizabeth Siddal, who had pale skin and bright red hair. A trait considered to be ‘undesirable’ back then (and also they associate them with witches if I’m correct?) But, because Rossetti continued to paint Elizabeth, the beauty standard between people with red hair began to change, he made red hair socially acceptable.

He eventually died in 1882 on Easter Sunday. His health withered due to Chloral, while his wife died due to Laudanum (a drug made of 10% opium). Rossetti died of Bright’s disease, which he was suffering from for quite some time now.

This is unfortunately the only information that I wrote down about him. I do not have the time to do further research about him. For I have a group activity to do ;-;

Lord Fredric Leighton

Born in Scarborough, United Kingdom on December 3, 1830.

Now, let me tell you this. HE IS RICH AF. His dad paid his allowance for his whole life. Like, are you fr????

Anyways. Based on my notes he:

Became the President of the Royal Academy in 1878 and lasted until he died in 1896.

He was the most famous artist of his day and won many honours and national awards. He also worked on a house till his death, he lived inside that house for 30 years and worked on it around the mid-1860s. The house had multiple styles (And looks rad af). The sources came from Italian Renaissance and the architecture from the near east. The house is often described to as a “Private palace of art”

Leighton would travel around Europe and often come back to Florence and Rome until his death. And, up to this day, it is debated whether he had an illegitimate child with one of his models, or if he was a homosexual. (tbh, I think he’s the latter)

Lord Leighton died on January 25, 1896. Due to Angina Pectoris. A symptom of heart disease, but could be a sign of a heart attack.

Writers During The Aestheticism Movement

- Oscar Wilde

- Algernon Charles Swinburne (will forever remember such a badassatron surname)

- Ernest Dowson

Oscar Wilde

(As his surname implies, dude’s a wildin’)

The most famous artist and writer during the Aestheticism movement. Born on October 16, 1854, in Westland Row, Dublin, Ireland. Wilde was both a poet and a playwrite. Wilde attended Trinity College and Oxford University. His works were often flamboyant and witty. He won the Newdigate prize back in 1878. He was first inspired by aestheticism through what Walter Pater taught.

And just like a peacock, he LOVED attention, good or bad he would GOBBLE IT UP. He got married in 1884 and had two kids with his wife. And since a peacock is a bird and birds can be gay (not peacocks though, which ruins this analogy), Oscar Wilde was imprisoned due to his gayness, to say the least. He had a relationship with Lord Alfred Douglas, and he (Oscar Wilde) was accused to be a ‘Sodomite” aka; he likes hot butt sex. (iyyk)

When he was finally freed from prison, he went to France. But he went bankrupt and died broke. He died due to meningitis and a condition called “I’m Broke Bruh” (IBB) in Paris in 1900.

Algernon Charles Swinburne

Born in London, 5th of April 1837. Swinburne was a famous lyric poem of his time. Mostly a poet, but he also wrote novels, plays and critics. Swinburne contributed to the Encyclopedia Brittanica,

Swinburne’s works tackled subjects such as atheism and cannibalism, subjects not often read in books, poetry or of any kind. He went to Eton and Oxford University. There, he met Dante Gabriel Rossetti.

And according to my notes, he liked scaring people. His works that were often tackling sadomasochism shocked people, so much so their heads must’ve split open, an image I wish I didn’t imagined while writing this. One of his famous work was called “Poems and Ballads” a collection of… well.. poems and ballads.

Swinburne eventually died on April 10, 1909, due to flu. Bro had a badassatron name but died in a not do badassatron way (I'm not saying dying due to flu is boring, I just didn't expect him to die that way)

Ernest Dowson

Born in Kent, England back in 1867. He was a novelist and a poet (like me, but he was successful). He was considered a Decadent writer due to his age and reputation. He also followed the ideals of the Aestheticism movement. And his most famous work came to fruition because of an unrequited love. And just like most authors, he died broke. (That’s my future right there) He died of tuberculosis at the age of 32, on February 23, 1900.

Moral of the Story

If you're a writer, you're going to die broke, and maybe young.

If you're an artist, and have not been born in a wealthy family. You're going to die broke.

[kk095]

Christine’s Malpractice Case

Every year, there are thousands of medical malpractice cases reported in the United States. Ranging from surgical or procedural errors, to misdiagnosis, to anesthesia errors, and many other possible factors not listed. We all have a certain level of trust in medical professionals because of their many years of training and education. However, these professionals are people too, and are prone to making mistakes from time to time. Unfortunately when medical professionals make a mistake, it can have major consequences for their patient- leading to further injury, disability, or even death. Sadly, one such case took place at our hospital recently.

The patient was Christine Rossi. She was 47 years old and stood at only 5 feet tall, but her big personality made up for her lack of height. She had a pleasantly plump figure, beautiful brown eyes, shoulder length brown hair, was olive skinned since she was of Italian descent, and always had a fresh mani+pedi. She looked good for her age since she never had kids, and she was never married- but definitely married to her career as a medical malpractice attorney.

Christine’s case began when she was brought into our emergency department one evening straight from her office. She was wheeled into trauma 1 sitting up on the gurney, stripped down to just her bra and underwear. She was wearing an oxygen mask, had EKG electrodes all over her chest, and had IVs going in both arms. “hi, I’m Dr Lindsay. Can you tell me what’s wrong?” Dr Lindsay, the ER attending from that evening asked Christine in a calm, inviting tone. Christine was gasping for air and had one hand on her chest. Her eyes were absolutely bugging out at times, and she was visibly uncomfortable. “my chest…” Christine utters to Lindsay. “your chest hurts? How long has it been hurting you?” Dr Lindsay asks in response. “since yesterday… but it got worse- a lot worse just now…” Christine tells Dr Lindsay.

On the heart monitors, Dr Lindsay saw that Christine was tachycardic, hypotensive, and had an abnormal EKG. The EKG showed unifocal PVCs with ST elevation. The doctor ordered some blood tests: a CBC, BMP, tox screen, and a stat cardiac enzyme test. An echocardiogram and chest x ray were also ordered while the blood was being drawn for the labs.

While the blood samples were sent off to the lab, the chest x ray was performed first. The only thing that was abnormal was some swelling and irritation in both lungs. This can be caused in part by Christine’s rapid, labored breathing, but it can also be associated with blood clots in the lungs, heart attacks, or fluid buildup in the lungs (for example, from pneumonia, covid, and sometimes severe bronchitis). The chest x ray definitely provided some good information, but it didn’t give Dr Lindsay the whole picture, so an echocardiogram was ordered. The echo showed right ventricular hypertrophy. Basically, the right side of her heart was enlarged and working much harder than it should. With the stat cardiac enzyme lab still pending, a dose of nitro was given for chest pain, and cardiology was called for consultation.

The two members of our cardio team to arrive were Dr Rachel, one of our cardiothoracic surgeons, and her cardio resident Dr Sarah. “hey guys, I appreciate you coming down. I think she’s having an acute STEMI and needs the cath lab, just waiting on the cardiac enzyme test to come back to confirm. What do you think?” Dr Lindsay says to the 2 cardio doctors. Dr Sarah looks at Dr Rachel, waiting for her to do the talking. “don’t look at me! What do you think of Dr Lindsay’s assessment?” Dr Rachel told Sarah, trying to get her resident to take some initiative. “I um… I agree.” The resident replies hesitantly. “why do you agree? Go on!” Dr Rachel tells Sarah. “well… um… the EKG shows ST elevation. And uh…. The patient has angina pectoris and shortness of breath.” The resident replies, nervously, and without confidence.

Nurse Nancy walks into the room with a few pieces of paper. “labs are back.” She says, handing the papers to Dr Lindsay. “Cardiac enzymes are high. This is definitely a STEMI.” Dr Lindsay says thinking out loud. “ok, let’s get her to the cath lab. We need to start a central line and get a stent in her.” Dr Rachel called out to the rest of the ER team. “what… what’s going on?” a nervous Christine asked, still breathing heavily. “you’re having a heart attack and we have to put a stent in, ok?’” Dr Lindsay tells the nervous lawyer. “a heart attack?!” Christine asks in response, surprised at what she’s heard. “am I going to die?!” Christine continued. “you’re in great hands! We’ve seen plenty of heart attacks like this. We’re going to place a stent, keep you here for a day or two, and you should be good to go.” Dr Lindsay replies with relative confidence, oblivious to the fact of what was to come. “Can you call my mom? I’m scared…” Christine asks Lindsay, still short of breath, visibly in pain from the crushing pressure she felt in her chest. “of course! We’ll have one of the nurses reach out to her, ok?” Lindsay replies, reassuring.

Over the following few minutes, Christine is taken up to the cardiac catheterization lab. She’s laid flat on the table and her bra is removed, allowing her large, D cup breasts to spill out. “alright Christine, our resident Dr Sarah will place the line and the stent. We’ll be getting started shortly.” Dr Rachel tells the nervous attorney. “the resident? I don’t want her to practice on me…” Christine protests, having a gut feeling against having the resident perform the catheterization and stent placement. “don’t worry ma’am, me and Dr Lindsay have done these plenty of times. Sarah will have plenty of adult supervision!” Dr Rachel tells Christine, attempting to add a little comedic relief to the urgent situation. Christine still had a bad feeling about it, but ultimately agreed to let Sarah perform the procedure.

The upper right portion of Christine’s chest was splashed with betadine to sterilize the area. The resident identifies the superior midpoint of the clavicle, and moves down a few centimeters. This is the location of the subclavian vein, so it’s important that the correct location be identified in the early stages of the procedure. Next, a local anesthetic is injected into Christine’s chest to numb the skin and some of the underlying tissues. She winced in pain, feeling a pinch and a burn from the injection. It normally takes 45-60 seconds for the local anesthetic to numb the area effectively, so in the meantime, an ultrasound was set up. This is to further confirm the location of the subclavian vein, and to follow the catheter’s path once placed. Next, a hollow needle was advanced through the skin. Christine could feel the pressure of the needle being inserted, but no pain. The resident Sarah advanced the needle slowly into the beautiful attorney’s chest, looking at the ultrasound monitor. Eventually, the needle was in the correct depth and blood was aspirated. The needle was held in place for a moment while the blunt guide wire was maneuvered through the needle and into the subclavian vein. While inserting the guide wire, Sarah pulled it out and inserted it again quickly, unnoticed by Rachel or Lindsay. However, everything seemed fine at the time. But in that moment, unbeknownst to everyone, Sarah introduced an air bubble into the central line, which would now become a ticking time bomb.

Eventually, the guide wire and catheter were sent to the correct location, and the occluded coronary artery was identified. A small stent was navigated into the central line and carefully and methodically navigated to the correct location. Once the stent was in place, it was placed and opened, restoring blood flow to the previously blocked artery. After confirming the placement of the stent via ultrasound and x ray, the guide wire was removed and a port was left in the initial site to leave the central line open for the duration of Christine’s hospital stay.

After the procedure was completed, Christine was brought back to an exam room in the ER to wait until a bed opened up in the recovery area. “how’re you feeling?” Dr Lindsay asked. “I definitely notice a difference. Thank you…” Christine replied, no longer breathing heavily, and seemed a lot more calm than earlier. “look who’s here!” nurse Nancy says excited, bringing Christine’s 70 year old mother Marie into the room. Marie hurries over to the bed as fast as her 70 year old body can, and gives her daughter a hug and a kiss. “How are you doing sweetie? They said you had a heart attack!” the concerned mother asks. “I’m doing a lot better mom! Thanks for coming.” She replies, with a smile on her face. “we’ll leave you two alone. It’s been quite a day, right?” Dr Lindsay said, exiting the room with nurse Nancy.

Approximately 2 hours go by. “something’s wrong! Come in, quick!” 70 year old Marie shouts to the ER team while scurrying out of the exam room, visibly worried. Dr Lindsay, nurse Heather, and nurse Nancy head into the room. The heart monitors are chirping loudly, showing that Christine is severely hypotensive and tachycardic. Christine’s eyes are shut, but she’s groaning. “christine? What’s wrong?” Dr Lindsay asks, doing a gentle sternal rub, to which Christine doesn’t respond. “she passed out and won’t wake up! What happened?!” Marie asks in a panicked tone. “We’re gonna get to the bottom of this, ok?” Dr Lindsay replied. Heather shined a pen light into Christine’s eyes and both pupils were fixed and dilated. “Pupils blown Linds” Heather tells Lindsay, shaking her head. “lets get her intubated! Get cardio back down here NOW!” Lindsay shouts, wondering what the hell just happened. “christine? Can you squeeze my hand?” Lindsay asks, receiving no response. Marie was holding her daughter’s other hand and talking to her while chaos ensued. “get me a 7.0 ET tube!” Lindsay shouted.

The ET tube was being navigated carefully into the woman’s airway by Lindsay. “no pulse, starting compressions!” Heather called out. “damn it!” Lindsay said frustrated, finishing her rapid sequence intubation. Heather delivered deep, violent chest compressions on Christine while her 70 year old mother continued to hold her hand and stroke her hair. “she’s in PEA. Push epi and atropine. And where the hell’s cardio?!” Dr Lindsay shouted again, frustrated. While Lindsay ambu bagged and lead the code, Heather continued delivering CPR. Christine’s chest caved in, and her belly jiggled outwards. Her breasts shook and trembled from the residual force of the compressions being received.

Dr Rachel and Sarah enter the room and are shocked, seeing their seemingly stable patient having her chest pumped violently. “what happened?!” Rachel asked, stunned. “I figured you two might try to figure that out for us. Any ideas?” Lindsay replied sternly. “what do you mean? She was fine a little while ago!” Rachel replied. “sarah even did a good job on her first stent placement and central line.” Rachel continued. “wait! This was the first time she ever operated on someone?!” Marie shouted, overhearing what was said. “ma’am… believe me, she is absolutely qualified. And every procedure has its risks.” Rachel replied, jumping to Sarah’s immediate defense. “did she kill my baby girl?!” Marie asked, becoming teary eyed. “Ma’am, why don’t we bring you to a private waiting room while the doctors work.” Nurse Nancy suggested, trying to gently direct the 70 year old woman out of the room. “no no no, I’m not going anywhere! That’s my daughter!” Marie shouted, tears running down her face, still holding her daughter’s hand as her chest was being absolutely pummeled.

The heartbreaking scene was interrupted by Dr Lindsay announcing that v-fib was on the monitors. “alright, charge the paddles to 200.” Lindsay called out. Nancy gently made Marie back away from the table because of the impending shock. The paddles were pressed up against Marie’s bare chest, the ambu bag was temporarily detached, and the shock was delivered. Marie’s body flopped on the table while a KA-THUNK was heard in the room. “still no change, charge to 250.” Lindsay called out, shaking her head a bit. After a cycle of compressions, the next shock was delivered. The electricity ran through the 47 year old’s limp, lifeless body, causing her to twitch sharply in response. “no pulse, let’s hit her again at 300.” Lindsay responded, looking at the monitors. “please… save my baby! That’s my little girl!” Marie begged the team while living every parent’s worst nightmare. “paddles charged.” Heather called out. The defibs were placed back onto Christine’s chest, and shock #3 was promptly delivered. Christine’s feet kicked up above the table and slammed back down half a second later, showing off the deep, soft, silky, prominent wrinkles throughout the soles of her size 7 feet. “still nothing doc.” Heather said, having 2 fingers placed on Christine’s neck for a carotid pulse. The paddles were recharged, and in a moment’s notice, Christine was shocked at 360j. Her body reacted more violently to the stronger shock, with her eyes opening up halfway, staring blankly up above. “PEA, resuming compressions.” Dr Lindsay said, taking over CPR for Heather.

More meds were pushed while CPR went on. However, it took another 6 minutes to produce another shockable rhythm. Nonetheless, when v-fib appeared on the monitors again, the paddles were recharged to 360 joules, and Christine was shocked again. Marie’s lifeless body twitched abruptly in reaction to the shock while her eyes remained open, staring blankly at the ceiling above. After another cycle of chest compressions, the next shock was delivered, causing Christine’s toes to curl, once again showing off the deep, soft wrinkles in the soles of her feet. But unfortunately at that point, the code started to become more redundant: CPR, shock, meds, repeat.

It was now 24 minutes into the code and Christine was still in v-fib. Her complexion was a ghastly pale color, her skin was ice cold to the touch, and there was a huge bruise on the center of her chest from all the CPR she’d received. At that point it was Dr Rachel doing CPR while Lindsay still ran the code. Lindsay looked around the room, eventually making eye contact with Rachel. Lindsay shook her head at Rachel, knowing Christine wasn’t coming back. Dr Rachel backed off, and nurse Heather detached the ambu bag. “what’s going on? Why are you stopping?” Marie asked the team, still holding her daughter’s hand. “I’m so sorry ma’am…” Dr Lindsay said, before Marie interrupted, “no no no! Shock her again! Keep pounding her chest! There’s gotta be SOMETHING you can do, right?!” Dr Lindsay paused for a moment, then said “I’m so sorry ma’am. We did everything we could. Your daughter’s heart won’t restart, and her brain has been deprived of oxygen for so long.” Marie started to cry at the point, practically crumbling to the floor. “time of death, 8:45pm.” Dr Lindsay said, peeling her gloves off. “no no no!” Marie wept. Nurse Nancy scurried over to try and console the woman while Heather began basic postmortem care.

The monitors were switched off, the EKG electrodes were disconnected, and the ambu bag was detached. A toe tag was filled out and placed on the big toe of Christine’s left foot, dangling in front of her beautiful, wrinkly soles. Her body was covered up, but Heather lowered the blanket down to Christine’s shoulders so Marie could have as much time as she needed to grieve her daughter’s tragic passing.

Since the exact cause of Christine’s death was unknown, an autopsy was ordered. The results of said autopsy concluded that Christine died from an air embolism that traveled to her brain. Essentially, air was introduced in the central line by Sarah, and it eventually traveled to the brain and got stuck in the smaller, more delicate vessels there. With these findings in mind, Marie was able to sue the hospital for Malpractice and received a hefty settlement payment. It was an absolute tragedy that Marie witnessed the death of her own daughter, and it was also a bit ironic that a medical malpractice attorney died from medical malpractice.

[darkmaga-returns]

When I was born, my maternal great grandmother gave me a generous gift of Pfizer stock. She had been impressed by Pfizer’s key role in discovering how to mass produce penicillin during World War II (in which her son was killed in action). Eighteen years later her gift paid for my university education. And then, in 1998, Pfizer received FDA approval to sell Viagra.

Pfizer initially developed the drug to treat high blood pressure and angina pectoris. However, as Pfizer’s researchers discovered in clinical trials, the drug was better at inducing erections than managing angina. And so, the company repurposed the drug for erectile dysfunction and launched a massive, global PR and marketing campaign—including seeking moral approval from Pope John Paul II and contracting the war hero and 1996 presidential candidate Bob Dole to be the brand’s poster gentleman—that succeeded in making Viagra a blockbuster.

So, I learned why pharmaceutical companies seek to develop blockbuster drugs with fanatical zeal. Formulating a safe and effective new medicine to address a large, unmet need is very difficult and expensive. Performing clinical trials and obtaining FDA-approval is an arduous process that normally takes several years. Thus, if an opportunity for a new blockbuster presents itself, a big drug company like Pfizer will go to extreme lengths to seize it.

Three years after the release of Viagra, I learned that Pfizer was not the respectable company my great grandmother had believed it to be. I arrived at this realization through my interest in British spy novels. In 2001 I lived in Vienna, around the corner from the Burgkino (Burg Cinema) which still played the 1949 film noir classic The Third Man on its big screen every weekend. I spent many a dreary winter Sunday afternoon watching the film. Based on the novella and screenplay by Graham Greene, The Third Man is a crime story about Harry Lime—an American running a medical charity in Vienna, who makes a killing selling penicillin on the bombed out, impoverished city’s black market. To increase his profits, he cuts the drug with other substances, thereby destroying its efficacy and causing the patients (including children) to die horribly from their infections.