#arb association

[courage-a-word-of-justice]

To a Festival on a Summer Evening (夏の宵に縁日へ) Alt. Stream

Reference images here. If you like this, then you can see similar content on this Google doc.

Rei: Hyottoko mask. A mask of a male character, as opposed to the female otafuku. The character plays the role of a clown (fitting for a member of DH). Apparently named as such because the mouth looks like it’s breathing fire.

Ichiro: Kitsune mask. Kitsune have various connotations in Japan, but outside the festival setting, this one’s a bit of an odd choice, since Sasara has more fox connotations than Ichiro (Sasara has what are called kitsune no me).

Ramuda: Rabbit mask. A pretty uncommon type of mask, in comparison to the kitsune, hyottoko and otafuku masks. Also cute, childish and pink to go with his colour scheme. (Update: Also harmless-seeming, as well as going with his "pyon pyon pyon!" - most notably from Drops - and his calling of "Usa-pyon" to Jyuto.)

At first, I thought Rei's was the only mask of particular note (particularly because Rei's speaker has a phoenix, which is represented by fire), but there are also some interesting connotations with Ichiro's kitsune mask - some kitsune can breathe fire, there is the concept of kitsunebi (fox fire) and some festivals have special fires.

The toffee apple in Ramuda's hand also has a fire element - through the melted sugar which comprises the toffee - and...well, it's red.

BB's theme colour is red and red is usually the colour used to represent fire (see: the ancient Chinese 5 element theory behind Saburo's 3rd solo). Also, red and yellow - BB and FP's theme colours respectively - make orange, or DH's theme colour.

On top of that, within ARB, all 3 of these characters were present during the fireworks event which is featured during this Alt. Stream (across both parts) and in the manga, Ramuda's senpai of sorts is called Hanabi. (Although the kanji used for Hanabi's name are roughly "flower light/lamp" - the second character of which can be read tomoshibi in other contexts, like the MTR song - the usual kanji for "fireworks" literally translates to "flower fire".)

(Sidenote: In terms of words, the word meaning "festival" (縁日) includes the character 縁 (enishi), which is the name of a DH song. Indeed, this kanji combo is read ennichi.)

(Then again, this fanart reminded me Hitoya also has fox associations, since he was possessed by the nine tailed fox in one of the soul swaps...)

[covid-safer-hotties]

Shadow left by COVID-19 pandemic on the future - Republished Aug 1, 2024

The rapid global spread of vaccinations for coronavirus disease 2019 (COVID-19), the development of effective anti-COVID-19 drugs, and the establishment of treatment for preventing and managing severe cases have become great game changers in bringing the COVID-19 pandemic to an end, leading us into a life of coexistence with COVID-19, namely “with COVID-19 era”. Now is the time to look back and examine what happened during the COVID-19 pandemic, how healthcare, society, and culture were affected, and what problems have been left for the future.

In 2020, in the early stages of the COVID-19 pandemic, it was reported that the COVID-19 virus utilizes ACE2 as a receptor when infecting host cells [1]. Because there were earlier experimental studies in which ARBs and ACE inhibitors increased ACE2 expression in animal tissues, some researchers considered that COVID-19 infectivity may be augmented in patients with hypertension or heart failure who are taking these drugs [2]. Based on this hypothesis, concerns that ARBs and ACE inhibitors might be risk factors for COVID-19 infection and worsening spread through SNS and some mass media. In fact, during the first wave of COVID-19 infections in the Europe, not a little number of patients self-discontinued taking ARBs and ACE inhibitors. Therefore, the Japanese Society of Hypertension and Japanese Circulation Society, as well as the European Society of Cardiology, European Society of Hypertension, and American Heart Association released urgent statements as academic specialists that ARBs and ACE inhibitors prescribed under the guideline-directed medical treatment should not be discontinued [3, 4]. Thereafter, numerous observational and registry studies conducted in countries around the world, including Japan, showed that ARBs and ACE inhibitors had neutral or negative impact on infectivity or severity of COVID-19 [5, 6], confirming that these statements were correct. Kai et al. conducted a systematic review of animal studies including 88 articles and found that administration of ARBs and ACE inhibitors, as well as other antihypertensive drugs, rarely increased ACE2 expression or activity in the tissues, including the hearts, kidney, arteries, and lungs, of the intact animals and animal models of hypertension or heart, kidney, and vascular diseases [7]. In this issue of Hypertension Research, Natsume et al. reported that the number of ARB and ACE inhibitor prescriptions did not decrease, but rather increased, during the COVID-19 pandemic in Japan, based on the Japanese National Database (NDB) Open Data [8]. This finding suggests the importance of academia to take a decisive stance in pointing in the right direction based on scientific evidence and expert consensus to the public and practitioners in emergency situations such as COVID-19 pandemics, and is proof that proper medical care has been achieved in Japan during the pandemic.

Read the rest and get the references at either link!

[aoyama-division]

ARB Birthday Special: Tomi Chōten

~~ August 14th ~~

"It’s all about the money."

Login Lines:

"...Yes, yes, I'll be sure to attend your party later this week. Thank you ever so much for your time. *sighs* How I detest the fact that I have to appease these sycophants. They are all the same: they simply wish to be seen with me, or they want something from me. *sighs* What's next on the agenda, Hino-san?"

"Hmm... 'prepare for my birthday celebration'? ...Hino-san, did you purposely leave this off my calendar so I wouldn't know today is my day of birth? ...You wanted me to see this last since I'll have the rest of the day free? ...Very well, I'll accept this, but please give me some notice next time."

Voice Lines:

*Sighs* "Maybe I should have kept quiet about today being my birthday. It seems every time it comes around, more and more people try to bring me meaningless gifts in an attempt to gain my favor. And they're all of low-quality too. But considering they are all commoners, my expectations weren't very high to begin with."

"...Still, I suppose there's something to be said for gifts that come from the heart instead of being bought off of a shelf from a store just because it's convenient. I can't even recall the last time my parents gave me a gift that wasn't just money or some expensive piece of jewelry. The only person in my family who actually gave me something of actual worth was my brot... gah! Why am I remembering useless things like this?!"

"My parents are planning a large party for my birthday, as they do every time my birthday rolls around. I'd ask if it were possible to just have a small one, but I'd just be wasting my breath. They'd give me the same speech they always give about how important it is to 'make a good impression' or 'uphold the Chōten legacy'. Different day, same thing..."

"Thank you, Karada. I'm glad to see you've stopped by. ...Yes, it's hard to believe we've associated with each other for such a long time. Honestly, I'm glad I decided to speak with you. If I hadn't, I wouldn't have gotten to know you. You are... a good friend. ...Yes, I do mean that."

"And what is this now? ...A phone screen magnifier? For viewing my phone up close? ...And pray tell, why exactly would I need this? If I want to watch movies, that is what my 64-inch flat screen is for. ...Very well, I'll accept it. I suppose it would be good to use when I'm FaceTiming someone."

"Ah, Luis. For the second time in a year, you've actually made it out for my birthday. Keep this up, and I may start to think that you actually value me. ...Ha, so you aren't able to stop Karada from dragging you out of your restaurant? Aren't you older and taller than him? Sorry, but I don't buy that excuse."

"Fine, I'll keep my comments to myself in exchange for the gift that you've graciously bought for me. So, what is it? A... food smoker? ...Luis, are you sure you didn't buy this for yourself? Did you forget that I have chefs cook for me? Why would I ever use this? ...It can also be used for cocktails? ...Fine, I'll give it a try. But FYI, if I don't like this thing, I'm giving it to my head chef."

Karada Lines:

"Happy birthday, Tomi! Man, I tell you, I can't believe we've only known each other for only seven years! It feels so much longer! ...Yeah man, I'm glad you spoke to me too! You're a good guy, despite what anyone else says and thinks. ...Aww! Thanks, Tomi! That means a lot to me, man!"

"Here's your birthday gift! I'll admit, I had trouble finding something good, but I saw this in a catalog and realized it would be good for you. It's a phone screen magnifier for viewing your phone screen up close. Pretty nifty, huh? ...Well, I mean you may not want to use your TV all the time. And it's not just for videos, you can also use it when you're browsing the Internet or something. Great, glad you like it, man! Happy birthday again!"

Luis Lines:

"Yeah yeah, happy birthday, Tomi. ...Oh, don't get a big head. You're not that important to me. I'm only here because of Karada. Honestly, if he hadn't reminded me that today was your birthday, I would have forgotten. ...Keep running off at your mouth, and I'll take this gift I bought you back with me. Your choice."

"Good. So... here. It's a food smoker. You use it to blow out smoke onto food and drinks to give it a nice aroma. ...It's not just for your food, smartass. I just said you can also use it for your drinks, like cocktails. ...Fine, whatever. I gave you a gift, which means I'm done. Now, I'm heading out. Happy birthday or whatever, you ungrateful ass."

[shinagawa-division]

ARB Birthday Special: Miho Kobayashi

~~ May 16th ~~

“Pursue the things you love doing, and then do them so well that people can’t take their eyes off you.”

Login Lines:

“Hm? Yes, what is it? I’m extremely busy today to you’ll have to make it quick.”

“A…present? Why would you—oh, I see, it appears that it is my birthday once again, how lovely, I had completely forgotten, well, thank you for the gift.”

Voice Lines:

“Once again, Goro starts off the day right by preparing me a delicious breakfast with all my favorites. He understands me so well, I truly could not ask for a better butler. Not that I want to.”

“As always, my employees and colleagues are adamant about throwing me a birthday party, honestly, I think it’s more for themselves than for me but I’ll be generous this once, business has been doing well these past couple of months, they deserve the celebration.”

“I will be taking the next couple of hours to prepare, both mentally and physically, for the influx of gifts and party invitations from my associates from the upper circle, no doubt news about my birthday has reached them, I bet they’re all just salivating at the chance to finally impress me and earn my good favor.”

“It is currently the afternoon and not once have I heard an explosion or sorts coming from Sumire’s lab and I am extremely on edge, it is one thing having her nearly blow up the entire estate but when she gets quiet like this, that only means that bad, bad things are happening or about to happen.”

“Speaking of bad things, hello Ritsuko, what ‘gift’ do you have for me this year? I want to hope that it’s nothing devious but knowing you that’s very unrealistic.”

“Good lord, Ritsuko! Where did you find this?! It’s…it’s absolutely beautiful! I’m actually surprised, I didn’t think you would get me and actual gift! Oh hush, you know what I meant, I’m curious to know how much this cost….wait what? Oh goddamnit Ritsuko, leave it to you to turn jewelry into a lethal weapon!”

“What. did. you. do…what do you mean ‘what do you mean’?! You have been silent all day and I haven’t even seen you since yesterday! Now we both know that can only mean that you’ve done something so nefarious that you have to go into hiding so now I will ask you one more time. What the hell have you done now?!”

“….What? Yes, yes, I know…I just…I’m…surprised? This is…actually quite nice…wait, you aren’t just distracting me, aren’t you?…I-okay, okay, I get it!…Sumire, thank you…do you perhaps—and she’s gone….”

“Goro? You have something for me? You didn’t have to, just being here is more than enough…yes, yes, I know that’s overused but it’s the truth…okay, fine, I could never turn you down, what is it that you got me?”

“This is…no, this is perfect, absolutely perfect. I…you have always been like a father to me, a father that I desperately wished I could have, you mean so dear to me and I am honored to be your daughter, thank you, Goro.”

Ritsuko Lines:

“Happy Birthday, Miho. My, how fast time flies, it just seemed like we’ve already celebrated your birthday but I digress, I wanted to give you this, I tried to match your style, I hope that you will wear it one day.”

“I’m glad you like it and I find it offensive that you think I can’t do something nice for you just for the sake of it. Hm, yes, well, it didn’t cost me anything, I had made it myself, I made it so that it will release a deadly toxin should you feel like your life is in danger, it won’t hurt you of course but I can’t say the same for people around you in a 30 mile radius.”

Sumire Lines:

“Happy Birthday, Miho….what do you mean? Well yeah, I didn’t get home until 3am and I spent the day in my lab…oh for fuck sake, you really have so little faith in me that you would accuse me of doing something evil every time I fucking go out?! For you information, no! I wasn’t doing something “nefarious”, I was making you this!”

“Yeah, I know, shocking that I would make you an actual gift, no, I’m not distracting you! How hard is it to believe that I did something nice for you?! You know what? Whatever, I’m heading out, enjoy your birthday.”

Bonus! Goro Lines:

“My lady? I hope you don’t mind the intrusion but I have something for you, it’s from me personality. Forgive me for stepping out of line, my lady but that line is horribly overused haha and I wanted to get you a gift for your birthday, I do hope you’ll accept it.”

“I am upmost pleased that you like my gift, my lady, I know it’s not as extravagant as the ones you’ve gotten but I personally think that nothing can beat a lovely card. My lady, you hold a very dear place in my heart, I never had any children but I consider you to be my daughter and I will be forever grateful for the day we met. Happy birthday, my lady.”

[astro-break]

Thoughts on the 3rd ep of Hypmic Rhyme Anima+. Spoilers beware

Season 1 | Ep.1 | Ep.2 |

i love how its samatoki who tsks when ichiro talks, they never stop and i love it fuugen looking dude still has a great design love the fact that they kept the Ramuda is scared of ghosts plotline ww TBH is a silly name DJ or not, but it does tie in some ARB lore eyyy joint mission! does that mean that nagoya and oosaka will be enemies? might be and interesting naughty busters and MCD interactions OFC theres gonna be some good good ichiro/kuko and samatoki/sasara KUKOOO I LOVE YOU the kinshachi! love those little dudes, they're tiger-headed dolphins lol JYUSHIIII you chuuni dork i love your flowery wordss Mr. Kuko wwwwwwww nooo amandaaaa so ripped up oh more visual kei!! i am so happyyy www this villain is so silly i love silly villains. how unfortunate that they'll be plot slaves but they genuinely had something fun going on awww look a kuko being silly and amagani being a silly lawyer LETS GOOO JAKUHITOOO eyyyyy lets go grandmaaaa the MVP of repairing Ichikuko relationship lets gooo naughty butters!!!!! i love themmmm were they also a influence ichiro to get onto the right track? thats sweet ofc they had to tie in different characters together still love that sun shadowing them the moment they talk about the villains the squeakkkkkkkkkkk amanda thats so cuuteeeeee awww no magical girl transformation? rip -

Damn the imagery on this MV goes super hard i love the non-traditional stuff you'll find scattered around at a glance the ones i spot are: buhddist funeral rites with from, what i can count 39 candles which can mean thank you… those funeral flowers look like white chrysanthemums (grief, honesty, truth which the later two may be nods to the fact that they're not in their right minds), pink, and purple carnations which symbolize capaciousness and unpredictability Kuko also references gokurakujoudo which is the most well known higher buddhist celestial land known as the land of bliss so basically he's saying that he's so hot shit that he'll reincarnate into the holiest of holy lands Ragnarok is the end of the known gods according to nordic mythology aside from like. two gods and two humans which means either Jyushi is a ghost as shown in the scene or he's just that cool and survived Kuko's second verse is a reference to old paintings that depicted monks training their spiritual disciplines by mountainsides. if you're an old soul like me, think Libra Dohko's Mnt. Roshi Hitoya's second rap scene is mimicking an egyptian depiction of a weighing of the heart, specifically it seems to be parodying the scene found in the Papyrus of Hunefer. interestingly, the three opponents are on the side in which the feather of maat is commonly depicted on, the thing which the heart is weighed against while Amanda is the heart Hitoya and Kuko's spots on the papyrus is where anubis would be, setting them as the judges who preside over this battle. Jyushi is also sitting where Ammit, the devour of the dead, would be depicted sitting. Ammit is also a goddess, which is fun Given the red moon behind him, Jyushi also plays at a fallen angel The chorus' first scene is another very famous generic buhdist scene. while i don't think it references anything specifically, the three sitting on lotus flowers and the bodhi tree's in the back implies that they are buddah. like no joke, they are actually buddha don't know if this is actually a reference, but the red hell-like place that the three find themselves in might be Sañjīva, one of the buddhist naraka's where those who are reincarnated there are born fully grown and are attacked by other people and monsters return of the kinshachi! kaleidoscopic imagery which is also heavily associated with buddhist imagery That ending is a reference to the spider's thread by ryunosuke akutaguwa! you might remember it if you've played Danganronpa V3 but its a story about a man trying to escape from hell from a spider thread but ultimately falls back into hell because of his greed - that Obaaachannnn is so cute. and the bait and switch was so silly Kuko as always is just the absolute star of the show even if the spotlight isn't on him Huh???? Are Doppo and Hifumi okay???? Please??? you can't just cliffhang that???? how dareeee

Badass Temple endingg lets gooooo Kuko verson is so cute!!! that illust tooo Jyushi is just so stylish and silly, treading that fine line. also is that just water in his champagne glass www this is such a fun ending version i love it. Its just a lot warmer and more comforting in my opinion, super sweet and heartwarming. a lot more electric guitar as well

I'm so glad for their first feature episode I really enjoyed BAT! The song was such a banger and the imagery along with it so evocative. I really liked the episode how it brought everyone together for a chaotic jaunt. I hope next week with dotsuhompo will be just as silly

[pokemonxhyperfixation]

So um… im only half way through Lotus Eaters, but I’ve fallen so MADLY in love with it and namely the star character Miyoi I HAD to make her a team!

Wailmer is kinda easy. Miyoi is kinda associated with whales, so obviously she gets a whale mon. Only reason I didn't give her a Wailord is because there's not a world where she could fit one.

Musharna is here as a representation of her ability. She fucks with your head, kulls your memories and gives you horrible nightmares and hallucinations. Musharna is kinda great for that.

Shiinotic is a neet one. The idea is she uses shiinotic to make stronger drinks with the spores and all. Also to get people to come to the pub with hypnosis.

Lombrey is a cute idea. It helps her serve drinks with the dish on its head. Or food, but lets be honest, that Lombre is walking over to a regular with either a dish full of sake or a dish with a bunch of servings of sake and a bottle.

Shuckle is a stand in for the gourd (so yes, Suika is also getting a Shuckle, obviously) Shuckle is a base of her entire operation, doing the fermentation for at least some of the drinks! So yeah.

The idea is that she semi-inherits the Arboliva (took three tries to get that name spelled right) from the actual owner. Arb is here for ingredients with that juicy harvest ability. Arb is here to ensure the freshest ingredients in the food, and the highest quality ingredients in the alcohol. (If I do a playthrough with this team, this will be replaced with Exeggutor, since it also has harvest.)

[mcatmemoranda]

Diabetes Lecture

Dr. Samaan

8/23/23

HgbA1c 5.7%-6.4% is prediabetes

HgbA1c 6.5% is diabetic

Normal HgbA1c 4.8-5.6% is normal

DM: A1c 6.5%, BG 126, random BG >200 with symptoms

The A1c has to be a lab draw in order for you to use it to make the diagnosis. So a POC HgbA1c doesn’t count to make the diagnosis.

Screen everyone age 40-70 who are overweight or have risk factors; younger than 40 and obese with risk factor; screen q1-3 years. Risk factors: HDL<35, TG >250, depression, on atypical antipsychotics, high risk populations (non-white), OSA/sleep issues, HIV+ for 15+ years on meds. Old HIV meds caused endocrine issues. Newer HIV meds don’t unless they’ve been on them for a long time.

You don’t need to be fasting to check HgbA1c. Not covered as screening by CMS. A1c not accurate in GDM, renal failure, anemias, renal failure, liver disease.

Prediabetes: 5-7% weight loss will cut the risk of progressing to diabetes by 1/2! Moderate exercise: of 150 minutes a week (e.g., brisk walking 3+ mph), water aerobics, bicycling 10 mph or less, tennis (doubles), gardening—OR 75 minutes of vigorous intensity exercise a week.

Metformin started in prediabetics decreases progression by 31%! Shown to decrease CVD risk. Works best for BMI>35. Metformin can cause low B12. We should use “med monitoring” code annually in pts on metformin. Diarrhea is a common adverse effect. If pt can’t leave the house because of the diarrhea, try the extended release form.

GLP1 agonists and SGLT2 inhibitors could be used in prediabetics. It’s in the works.

If A1c of 9 and BG >200, you will have less fatigue, polyuria, blurred visions, skin infections.

A1c <7.5 à improved quality of life and increased productivity at work

Goal A1c is <7%

Tighter control in younger pts is ok.

Older pts can have A1c goal of 8.0%; avoid hypoglycemia and side effects of increased meds.

Metformin and lifestyle modifications are first line management.

You can start with something other than metformin, but insurance might not cover it.

DM education can help drop A1c by 0.6% or more. WDH and PRH have diabetes education classes.

Diabetic Benchmarks/Screenings:

Statins! All diabetics over 40 should be on moderate to high intensity statin. Under 40 if additional CVD risk factors.

Pts with DM have increased number of small LDL particles which tend to be more associated with ASCVD.

DM is the leading cause of CKD. Check urine microalbumin yearly. ACE/ARB is HTN and proteinuria, urine Cr >300. Go yearly for dilated eye exam. DM is the #1 cause of blindness in the US.

Nerve damage causes the fat pad on the sole of the foot to move, leaving decreased cushioning which predisposes to diabetic foot ulcers. Foot exam should be every visit if loss of sensation. Should do a foot exam annually. Check the skin, document hammer toe, charcot foot, bunion, pes planus.

Get an Ankle Brachial Index (ABI) if you cannot palpate a pulse. Get Toe Brachial Index (TBI) if ABI is not accurate.

Document presence of diabetic neuropathy. Assess for B12 deficiency, TSH, metals, etc.

Metformin, statin, annual vision screen and urine microalbumin, foot exams, diabetes education.

Sulfonylureas (e.g., glipizide) have no long-term benefits, cause hypoglycemia.

[rebelcliche-archived]

i’m going on record right now to say: n/ancy never cheated on s/teve and people who think she did don’t have a brain.

also, she does love him, but it’s far easier for her to say it back than to say it first. and this stems from her being terrified that she’ll jinx their relationship and that they’ll wind up miserable like her parents as a result and she cares about s/teve too much to want that kind of life for them so she holds back from saying ‘i love you’ FIRST, but she DOES love him.

then, when she goes to m/urray’s, he plays on her insecurities and makes her question if her love is even VALID bc she’s scared to say it first, and as a result, she convinces herself to let s/teve go ( on top of her associating s/teve with the guilt of losing b/arb that she has to work through ) because he’s better off without her and m/urray ( and others who don’t even know her like that ) has her convinced that she’d be happier with j/on bc he’s handling their trauma in a way more similar to n/ancy than s/teve is, and so it goes...

but then being around s/teve in s/4 is rekindling old feelings and just makes things even more complicated for her, on top of her already complicated relationship with j/on.

but my point remains: she’ll always love s/teve, end of.

[dollofdeath]

art summaries for this year >w<

template by @/Taxkha

(I / II / III is a comm i haven't posted anywhere / IV / V / VI / VII/ VIII / IX / X / XI / XII)

template by @/sabattons

more stuff under the read more, because there's quite a few stuff i actually liked this year!

january

this was a comm for kiz, but i think it came out pretty bomb. any hypsters who are into projmoon/projmoon fans into hypmic pspspsps --

actually i think this was my first ever piece this year, so it's interesting to see how much i've improved in over the past couple of months!

also i did some comms between feb and may to help raise some money for my relatives in the philippines, but i don't think i should post the ones i really like since the project isn't complete yet. but i think they came out bomb too, trust me -- (the volo art in my art summary is one of these comms lol)

april

i just wanted to post these two together since they're a set LOL thank u arb for giving me flowers that aren't roses to associate with hifugen....

also here are the unblurred versions of this set lol

may

this is just one of my fave hifugen headcanons KJFSDJKJKF

gentaro about hifumi: 🙄😒😑 gentaro about hifumi, when hifumi's fangirls are around: *draping himself over hifumi* excuse me ladies, do you have any business with My man?

KJFSJKDFSJKJH

august

i think i went rly hard in august. august was really a turning point for me this year too i think, so maybe my art reflected that haha, but anyhow. i really love these

everyone and their mom has done a religious jakurai art, but i wanted to do one too... the detail i rly like is the blood on his hands. because i like to headcanon that jakurai has vitiligo on his hands. i like how i incorporated that hc in this without making it too busy lol

THIS ONE. HELL YEAH. this is a redraw of an older art i made for thanatos' anniversary, and i thought the first one was cool but i was like "i think i have the skills to make this even better now" and I DID!!! idk, i'm glad i could capture the horror vibes more poignantly

september

this one is?? i don't think i made her a full reference sheet, i realized lol but i started streaming for friends because i have a bunch of game recs and no attention span to play them WKJGJKD so i decided streaming them so i could be held accountable for them would be the best way to do it LMFAO

anyways this is my pngtuber. they have no name, but she's a shopkeeper of a mysterious antique store. originally that doll on the bookshelf was gonna my pngtuber and i came up with a bunch of lore for her, but then i realized i had another oc design i really dig and was also simpler, so i revamped that for streaming FJKSDJKF but i would like to put that doll to use somehow or another. anyways if u can pinpoint all the references on the shopkeeper and their bookshelf and even her store's very existence, i love u --

catch me on twitch on sundays and mondays for mhyk and ace attorney respectively --

october

as much as possible, i try to do a vanistar anniversary art because noël is my baby boy... i'm so happy with how this year's came out!! ofc there's areas that could use work, but i like the colors and lighting c:

I'VE BEEN MEANING TO DO AN IBERIA AU FOR JAKUDO FOR SO LONG... probably as long as the koibito AU for hifugen, but i just haven't been able to put it into words... i'm glad i could at least do a bit of this year, and i hope one day i can manage the whole concept!! also this idea's been in my head for so long that arb managed to reveal demon designs for both jakurai and doppo, sparing me the effort of designing them myself FSJKJKKJH

this one is also a set, so i wanted to post them together hehe again this is based off a horror rpg concept me and gianna came up together back in high school that will probably never see the light of day lol this probably doesn't surprise anyone who knows us, but these characters are based on us FKJSKJH

wah... i think my artist wrapped really covers what i have to say! quantity-wise, i'm not too happy with how much i made... it can't really be helped considering how busy and tiresome it's been this year, and i really wish i could say i can do more next year, but it's likely i'll be posting less and less in the future TwT but as much as possible, i'd still like to share my work! i think this might be my time to start focusing on original stuff, but i still wanna do fandom related stuff because there's still a lot of ideas and concepts i wanna see realized!! also i just love my fandom blorbos a lot lol, so i'll find ways to do things for them >w<

quality-wise though, i think i'm pretty pleased! last year i got csp, so i was still figuring it out, but now i think i got a better hang of it! and that means my art looks more confident i think haha. of course, there's still a lot of room for improvement, but it's nice that i can look at my stuff and go "yeah i like this!" i'm excited to see where my artistic journey goes from here!!

but yeah, maybe it wasn't a plentiful year for me re: art, but i made some pretty nice stuff despite that! thank you all for the support, and here's to next year!!

[verdantpharma]

CAS NO 144689-63-4 (Olmesartan)

Understanding Olmesartan (CAS No. 144689-63-4): A Comprehensive Overview

Olmesartan, a medication widely prescribed for the management of hypertension (high blood pressure), belongs to a class of drugs known as angiotensin II receptor antagonists (ARBs). Chemically identified by its CAS number 144689-63-4, Olmesartan works by blocking the action of a hormone called angiotensin II, which constricts blood vessels. By preventing this constriction, Olmesartan helps to relax and widen the blood vessels, ultimately lowering blood pressure and reducing the risk of complications associated with hypertension, such as stroke, heart attack, and kidney damage.

How Olmesartan Works

The body's natural blood pressure regulation involves a hormone system known as the renin-angiotensin-aldosterone system (RAAS). One key element of this system is angiotensin II, a potent vasoconstrictor that raises blood pressure by narrowing blood vessels. When the body produces too much angiotensin II, it can lead to elevated blood pressure.

Olmesartan blocks the binding of angiotensin II to its receptor, known as the AT1 receptor. By doing so, it prevents blood vessel constriction and thus helps to lower blood pressure. Olmesartan also has additional beneficial effects on the cardiovascular system, such as improving blood flow and reducing the workload on the heart.

Therapeutic Uses of Olmesartan

The primary medical use of Olmesartan is in the treatment of hypertension, but it may also be prescribed in certain cases for the management of chronic kidney disease (CKD) and heart failure. By lowering blood pressure, Olmesartan helps reduce the strain on the heart and kidneys, thereby preventing further complications.

In some cases, Olmesartan is used in combination with other antihypertensive medications to achieve better blood pressure control in patients who do not respond adequately to monotherapy.

Dosage and Administration

The typical starting dose of Olmesartan for treating high blood pressure is 20 mg once a day, although the dose can be adjusted depending on the patient's response and medical condition. The maximum recommended dose is 40 mg per day. Olmesartan can be taken with or without food, and it is important for patients to follow their healthcare provider's instructions to achieve optimal therapeutic effects.

It’s also worth noting that Olmesartan is generally well-tolerated, but like all medications, it can have side effects in some people.

Potential Side Effects

Olmesartan is usually well tolerated, but some individuals may experience side effects. Common side effects include:

Fatigue

Headache

Gastrointestinal issues, such as diarrhea or nausea

In rare cases, Olmesartan may cause more serious side effects, such as:

Low blood pressure (hypotension), which may lead to fainting or dizziness

Elevated potassium levels in the blood (hyperkalemia), which can affect heart function

Kidney dysfunction or renal impairment, particularly in patients with pre-existing kidney disease

Angioedema, a condition characterized by swelling, typically of the face, lips, or throat

Patients taking Olmesartan should contact their healthcare provider if they experience any unusual symptoms or side effects, particularly signs of allergic reactions or severe dizziness.

Precautions and Warnings

Before starting Olmesartan, patients should inform their healthcare provider if they have any of the following conditions:

Kidney disease: Olmesartan may affect kidney function, so regular monitoring of kidney function is important for patients with pre-existing kidney issues.

Pregnancy: Olmesartan is not recommended during pregnancy, as it may harm the developing fetus, particularly in the second and third trimesters. 

Dehydration or Salt Depletion: People who are dehydrated or have low salt levels may be at increased risk of low blood pressure when taking Olmesartan.

Liver Disease: Those with liver problems should use Olmesartan with caution, as it may affect liver function.

Patients should also inform their healthcare provider about any other medications they are taking, as Olmesartan can interact with other drugs, including certain diuretics, potassium supplements, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Drug Interactions

Olmesartan may interact with other medications, which could either enhance its effects or increase the risk of side effects. 

Diuretics (water pills): Combined use with Olmesartan can increase the risk of low blood pressure and kidney problems.

Potassium supplements: Taking potassium supplements or potassium-sparing diuretics (such as spironolactone) with Olmesartan can increase potassium levels in the blood, potentially leading to hyperkalemia.

NSAIDs: Nonsteroidal anti-inflammatory drugs, like ibuprofen, can reduce the effectiveness of Olmesartan and may increase the risk of kidney damage.

Conclusion

Olmesartan (CAS No. 144689-63-4) is a widely used and effective medication for managing hypertension and preventing cardiovascular complications. As an angiotensin II receptor blocker, it helps lower blood pressure by relaxing blood vessels and reducing the workload on the heart. While generally safe, it’s important for patients to be aware of potential side effects, interactions, and contraindications.

As always, individuals should consult with their healthcare provider to determine the appropriate treatment plan based on their specific medical conditions and needs. Regular monitoring and follow-up care are essential for ensuring the safe and effective use of Olmesartan in managing hypertension.

URL: For more information, visit Verdant Pharma :  CAS number 144689-63-4, Olmesartan

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Diabetic Nephropathy: Protecting Your Kidneys with Expert Care

Diabetes doesn’t only impact blood sugar levels; it can also have a significant effect on other organs, particularly the kidneys. Diabetic nephropathy, or diabetic kidney disease, is a serious complication that affects millions of people worldwide. At the World Diabetes Centre, our team of specialized nephrologists is committed to educating, preventing, and treating diabetic nephropathy to ensure our patients can lead full and healthy lives.

Understanding Diabetic Nephropathy

Diabetic nephropathy is a condition that results from prolonged high blood sugar levels, which can damage the kidneys’ delicate filtering system. Over time, this damage can lead to the kidneys’ inability to efficiently filter waste and excess fluids, eventually causing toxins to build up in the blood. Left untreated, diabetic nephropathy can progress to chronic kidney disease (CKD) or even kidney failure, which may require dialysis or a kidney transplant.

Early Symptoms and Stages of Diabetic Nephropathy

Diabetic nephropathy progresses slowly, often without noticeable symptoms in the early stages. Regular testing is essential for early detection, especially for people with longstanding diabetes or poor blood sugar control. Here are some stages and their associated symptoms:

Microalbuminuria (Early-Stage): Small amounts of protein in the urine, which can only be detected with lab tests.

Macroalbuminuria (Progressive Stage): Higher protein levels in the urine, which can cause swelling in the legs, hands, or feet.

Advanced Kidney Disease: Symptoms include fatigue, nausea, swelling, and high blood pressure, indicating a more serious decline in kidney function.

Key Prevention Strategies for Diabetic Kidney Health

Control Blood Sugar Levels: The cornerstone of preventing diabetic nephropathy is maintaining stable blood glucose levels. By following a healthy diet, exercising regularly, and adhering to prescribed medication, blood sugar can be kept within target ranges.

Manage Blood Pressure: High blood pressure can exacerbate kidney damage. Aim for a blood pressure of 130/80 mm Hg or lower, as recommended for diabetics. Certain medications, such as ACE inhibitors or ARBs, can help manage both blood pressure and kidney health.

Regular Kidney Function Tests: Early detection of kidney problems can make a substantial difference in managing diabetic nephropathy. Annual tests for microalbuminuria, serum creatinine, and glomerular filtration rate (GFR) are crucial to monitor kidney health.

Stay Hydrated, Avoid Excessive Protein: Staying well-hydrated and managing protein intake can reduce the kidneys’ workload. Limiting high-protein foods, especially for those with early kidney damage, can prevent further strain on kidney function.

Quit Smoking: Smoking can impair kidney function and worsen diabetic complications. Quitting smoking is one of the most effective steps to protect kidney health.

Specialized Care and Treatments Available at the World Diabetes Centre

At the World Diabetes Centre, our diabetic nephropathy doctors offer a range of diagnostic and therapeutic services to help patients at any stage of kidney disease. Our approach combines advanced technology with personalized care to support every step of kidney health management.

Comprehensive Kidney Health Assessments: Our nephrologists conduct detailed assessments to evaluate kidney health, including blood tests, urine tests, and imaging studies to identify any underlying issues early.

Personalized Treatment Plans: Each patient’s care plan is tailored to their specific needs, considering factors like blood sugar levels, kidney function, lifestyle, and existing medications. Our team works collaboratively with endocrinologists, dietitians, and primary care providers to create a holistic treatment approach.

Advanced Therapeutic Options: For patients with advanced kidney disease, we offer dialysis support, transplant evaluation, and counseling services. Our specialists use the latest therapies to slow disease progression and improve quality of life.

Patient Education and Support Programs: Education plays a vital role in managing diabetic nephropathy. We provide resources and support programs that empower patients to make informed decisions about their health.

Embrace a Healthier Future with Proactive Kidney Care

Diabetic nephropathy doesn’t have to define your life. With regular monitoring, lifestyle adjustments, and specialized care from a dedicated team, kidney health can be maintained, allowing for a vibrant and active life. At the World Diabetes Centre, we’re here to guide you through every step of managing diabetic nephropathy, from prevention to advanced care. Together, let’s take proactive steps to protect your kidneys and embrace a healthier future.

Visit us at: Opp Octroi Post, Hambran Road, Ludhiana-141004, Punjab

Call us today to book your session: +91(+91) 709 830 0000

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Cilacar T Tablet: Uses, Dosage, Side Effects, and More

Cilacar T Tablet is a medication that is commonly prescribed to help manage various cardiovascular conditions. This article aims to provide an in-depth overview of Cilacar T Tablet, including its uses, dosage guidelines, potential side effects, and other essential information for those considering or currently using this medication.

What is Cilacar T Tablet?

Cilacar T Tablet is a combination medication that typically contains two active ingredients: Cilnidipine and Telmisartan. Cilnidipine belongs to the class of calcium channel blockers, while Telmisartan is an angiotensin receptor blocker (ARB). This combination is often prescribed to treat hypertension (high blood pressure) and other cardiovascular conditions.

Uses of Cilacar T Tablet

Hypertension: Cilacar T Tablet is primarily used to lower blood pressure in patients with hypertension. The combination of Cilnidipine and Telmisartan helps relax blood vessels, making it easier for the heart to pump blood and reducing the workload on the heart.

Cardiovascular Protection: In addition to managing high blood pressure, Cilacar T Tablet may also offer cardiovascular protection by reducing the risk of heart-related complications in patients with underlying heart conditions.

Dosage and Administration

Dosage: The dosage of Cilacar T Tablet can vary based on individual factors such as the patient's age, medical condition, and response to treatment. It is crucial to follow the dosage instructions provided by your healthcare provider.

Administration: Cilacar T Tablet is typically taken orally with or without food. It is essential to swallow the tablet whole with a glass of water and not crush or chew it unless advised otherwise by your doctor.

Possible Side Effects

Like any medication, Cilacar T Tablet may cause side effects in some individuals. Common side effects associated with this medication may include:

Dizziness

Headache

Fatigue

Swelling of the ankles or feet

Nausea or vomiting

Muscle pain

It is essential to consult your healthcare provider if you experience any persistent or severe side effects while taking Cilacar T Tablet.

Precautions and Warnings

Before starting Cilacar T Tablet, inform your healthcare provider about any existing medical conditions, allergies, or medications you are currently taking. Additionally, consider the following precautions:

Avoid consuming alcohol while taking Cilacar T Tablet, as it may increase the risk of side effects.

Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using this medication.

Regular monitoring of blood pressure and kidney function may be necessary while taking Cilacar T Tablet.

Conclusion

Cilacar T Tablet is a combination medication used to manage hypertension and provide cardiovascular protection. While it can be effective in controlling blood pressure and reducing the risk of heart-related complications, it is essential to follow your healthcare provider's recommendations regarding dosage, administration, and monitoring. If you experience any concerning side effects or have questions about Cilacar T Tablet, consult your doctor promptly for guidance and appropriate management.

[susantaylor01]

Understanding the Impact of diabetes on kidneys

What is diabetes?

Diabetes happens when your body does not make enough insulin or cannot use insulin properly. Insulin is a hormone. It controls how much sugar is in your blood. A high level of sugar in your blood can cause problems in many parts of your body, including your heart, kidneys, eyes, and brain. Over time, this can lead to kidney disease and kidney failure.

There are two main types of diabetes. Type 1 diabetes generally begins when people are young. In this case, the body does not make enough insulin. Type 2 diabetes is usually found in adults over 40, but is becoming more common in younger people. It is usually associated with being overweight and tends to run in families. In type 2 diabetes, the body makes insulin, but cannot use it well.

 Impact of diabetes on the kidneys?

The kidneys filter waste and extra water from the blood to make urine. They also help control blood pressure and make hormones. Kidney disease harms the kidney's ability to filter and work right over time.

Your kidneys contain tiny filters called nephrons. High blood sugar can damage these. This can clog and narrow blood vessels making it hard for kidneys to work. Hyperfiltration makes kidneys work too hard, which can cause nephrons to stop working .

"When these blood vessels get damaged, the kidney starts to leak proteins called albumin,"More protein leakage means the kidney disease gets worse. Too much sugar also makes toxins pile up in the kidneys causing inflammation and stress on cells. This stress and damage can kill kidney cells."

Diabetes can also hurt the kidneys by harming the nerves in your body that send signals to your organs, and high sugar levels can make bacteria in urine grow fast.

Symptoms

Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.

People who have more severe and long-term (chronic) kidney disease may have symptoms such as:

Fatigue most of the time

General ill feeling

Headache

Irregular heartbeat

Nausea and vomiting

Poor appetite

Swelling of the legs

Shortness of breath

Itchy skin

Easily develop infections

SIMPLE TECHNIQUE TO HELP MANAGE BLOOD SUGAR

Preventive measures to control  kidney function damage while having diabetes

Controlling your blood sugar To prevent or slow down kidney damage, you need to keep your blood sugar in check. You can do this through diet, exercise, and, if necessary, insulin or pills that lower your blood sugar.

Controlling high blood pressure High blood pressure can make kidney failure more likely. Talk to your doctor about what your blood pressure goal should be.

Protecting kidney function by taking ACE inhibitors or ARBs ACE inhibitors or ARBs have an impact on kidney function protection.

Cutting back on the amount of protein you eat-Individuals with diabetes and kidney disease need to eat enough protein to stay healthy, but should steer clear of eating too much. Studies show that cutting down on protein can help slow kidney damage. It's a good idea to chat with your doctor about this. If you need to start a low-protein diet, make sure to plan it with a dietitian who knows all about kidney disease. Don't jump into this kind of diet without talking to a dietitian first - you want to make sure you're changing your eating habits in a healthy way.

Telling your doctor right away if you have trouble peeing-Getting treatment for urinary tract infections matters a lot. You might have a urinary infection if you notice these signs: you need to pee often, it hurts or burns when you pee, your pee looks cloudy or has spots of blood, or your pee smells strong.

Cutting down on salt in what you eat to keep high blood pressure in check and stop your body from swelling up.

Staying away from drugs that could hurt your kidneys NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like ibuprofen and naproxen. Ask your doctor before you take any herbal supplements because some can damage your kidneys.

Controlling cholesterol and lipid levels. This helps stop more harm to bigger blood vessels, like those in the brain and heart.

[sociomi]

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List Symbol Standard Deviation, Change and Ordinary dissemination

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[drchiraggupta]

What medications are commonly prescribed for kidney disease treatment?

 Here’s an overview of commonly prescribed medications for various aspects of kidney disease treatment:

1. Blood Pressure Control:

Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor Blockers (ARBs): These medications help relax blood vessels, lower blood pressure, and reduce proteinuria (excess protein in urine), which can help protect kidney function.

2. Diabetes Management (if applicable):

Insulin or Oral Antidiabetic Agents: For diabetic nephropathy (kidney disease caused by diabetes), tight control of blood sugar levels is essential to slow kidney damage.

3. Treatment of Anemia:

Erythropoiesis-Stimulating Agents (ESAs): These stimulate the production of red blood cells and can help manage anemia associated with chronic kidney disease.

4. Phosphate Binders:

Phosphate binders: Used to lower phosphate levels in the blood, which can be elevated in kidney disease due to impaired kidney function.

5. Treatment of Hyperkalemia (High Potassium):

Potassium Binders: These medications help lower potassium levels in the blood, which can rise in kidney disease and cause serious heart problems.

6. Diuretics:

Loop Diuretics: Often used to help manage fluid retention and swelling (edema) in individuals with impaired kidney function.

7. Cholesterol Medications:

Statins: Used to manage cholesterol levels, which can be elevated in kidney disease and contribute to cardiovascular complications.

8. Immunosuppressants (in certain cases):

Immunosuppressant medications: Prescribed for autoimmune conditions affecting the kidneys, such as lupus nephritis or certain types of glomerulonephritis.

9. Calcium and Vitamin D Supplements:

Calcium and Vitamin D: Essential for bone health, as kidney disease can disrupt the body’s ability to regulate calcium and vitamin D levels.

10. Pain Management:

Pain relievers: Such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) prescribed cautiously due to their potential impact on kidney function.

Lifestyle Modifications:

Alongside medications, lifestyle changes including a kidney-friendly diet (low in sodium, potassium, and phosphorus), regular exercise, and avoiding tobacco and excessive alcohol use are crucial in managing kidney disease.

It’s important for individuals with kidney disease to work closely with healthcare providers to monitor medication effectiveness, adjust dosages as needed, and manage potential side effects. Treatment goals focus on preserving kidney function, managing symptoms, and improving overall quality of life

[drrichardzelman]

Acute Coronary Syndromes (ACS) by Dr. Richard Zelman

Dr. Richard Zelman is a recognized expert in cardiology, particularly in the area of acute coronary syndromes (ACS). Here is a comprehensive overview of ACS based on general cardiology knowledge and the insights that would be expected from an expert like Dr. Zelman:

Overview of Acute Coronary Syndromes (ACS)

Definition

Acute Coronary Syndromes (ACS) represent a range of urgent heart conditions associated with sudden, reduced blood flow to the heart. This spectrum includes:

Unstable Angina (UA)

Non-ST-Elevation Myocardial Infarction (NSTEMI)

ST-Elevation Myocardial Infarction (STEMI)

These conditions are often caused by the rupture of atherosclerotic plaques and subsequent thrombosis within coronary arteries.

Pathophysiology

Plaque Rupture: Atherosclerotic plaques in the coronary arteries can rupture, exposing the underlying tissue to the bloodstream.

Thrombus Formation: Platelets aggregate at the site of rupture, forming a thrombus (blood clot) that can partially or completely block blood flow.

Ischemia: Reduced blood flow (ischemia) to the heart muscle can cause damage or death to myocardial cells.

Symptoms

Chest Pain: Sudden, severe chest pain or discomfort, often described as pressure, squeezing, or tightness. It may radiate to the arms, neck, jaw, or back.

Shortness of Breath: Difficulty breathing or breathlessness.

Other Symptoms: Nausea, sweating, lightheadedness, and palpitations.

Diagnosis

Electrocardiogram (ECG): Essential for differentiating between STEMI and NSTEMI. STEMI shows ST-segment elevation, while NSTEMI and unstable angina may show ST-segment depression or T-wave inversions.

Blood Tests: Cardiac biomarkers (e.g., troponin) help confirm myocardial injury.

Imaging: Echocardiography, coronary angiography, and other imaging modalities can provide detailed information about the extent of coronary artery disease and myocardial function.

Management

Immediate Treatment:

Aspirin: To inhibit platelet aggregation.

Nitroglycerin: To relieve chest pain and improve blood flow.

Oxygen: If the patient is hypoxic.

Morphine: For pain relief if needed.

Reperfusion Therapy: Critical for STEMI to restore blood flow.

Percutaneous Coronary Intervention (PCI): Primary method for reperfusion in STEMI, ideally within 90 minutes of first medical contact.

Thrombolytics: If PCI is not available, thrombolytic therapy can be used to dissolve the clot.

Medical Management for NSTEMI/UA:

Antiplatelet Agents: Aspirin and P2Y12 inhibitors (e.g., clopidogrel, ticagrelor).

Anticoagulants: Heparin, low molecular weight heparin (LMWH), or direct thrombin inhibitors.

Beta-Blockers: To reduce myocardial oxygen demand.

ACE Inhibitors/ARBs: For patients with reduced left ventricular function.

Statins: To stabilize plaques and reduce cholesterol levels.

Long-Term Management

Lifestyle Changes: Smoking cessation, diet modification, regular exercise, and weight management.

Medications: Long-term use of antiplatelet agents, beta-blockers, ACE inhibitors, and statins to prevent recurrence.

Cardiac Rehabilitation: Structured program to improve cardiovascular health through monitored exercise and education.

Prognosis

Early Intervention: Timely diagnosis and treatment significantly improve outcomes.

Risk Stratification: Ongoing assessment of risk factors and cardiac function is crucial for long-term management.

Summary

Acute Coronary Syndromes are a critical group of conditions requiring prompt diagnosis and management to prevent significant morbidity and mortality. Advances in interventional cardiology and medical therapy have significantly improved the prognosis for patients with ACS. Experts like Richard Zelman MD contribute to the field through clinical expertise, research, and education, continually advancing the understanding and treatment of these life-threatening conditions.