Dr Harshit Aggarwal

Heart Failure with Preserved Ejection Fraction

Cardiac Critical care /

Heart Failure with Preserved Ejection Fraction (HFpEF) 1. Definition  Symptoms ± signs of heart failure LVEF ≥50% Evidence of cardiac structural and/or functional abnormality Elevated natriuretic peptides Feature HFpEF HFrEF EF ≥50% ≤50% Dysfunction Diastolic Systolic LV Geometry Concentric Eccentric Main cause HTN CAD 2.  Pathophysiology  A. Central Concept It is  systemic disease with multi-organ […]

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Pulmonary Embolism

Pulmonology Critical care /

Pulmonary Embolism Pulmonary embolism is obstruction of the pulmonary arterial circulation, usually by thrombus originating from the deep veins of the lower extremities or pelvis. Risk Factors—Virchow’s Triad  Mechanism Examples Venous stasis Immobilization, ICU stay Hypercoagulability Cancer, pregnancy Endothelial injury Surgery, trauma,Central venous Catheter Major Major surgery Trauma Malignancy Prior VTE Pregnancy/postpartum Moderate OCP use

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Synovium

Rheumatology /

Synovium  lines the joint cavity ( Diarthroses – freely moveable joints located in the limbs and jaw ) -> covers the fibrous joint capsule and extends to the bone – cartilage interface.  Not a true lining epithelium ( no basement membrane) Healthy synovium also covers intra-articular ligaments and tendons. Functions :  Nutrient and metabolite trafficking.

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Inter scalene block

Ortho and Regional Anesthesia /

Inter scalene block Brief history: First brachial plexus block was performed by William Steward Halsted in 1889 → by exposing the brachial plexus and using cocaine for blockade. Inter-scalene block was first described by Winnie in 1970. It often spares the lower branches of the plexus the C8 and T1 fibres innervating ulnar border of

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Physiological Changes in Pregnancy and Their Anaesthetic Implications

Obstetrics Anesthesia /

Physiological Changes in Pregnancy and Their Anaesthetic Implications   Physiological adaptation in pregnancy occurs due to three broad mechanisms (Miller’s Anesthesia, 10th ed.): (1) Hormonal changes – oestrogen, progesterone, relaxin, prostaglandins, human placental lactogen, renin–angiotensin–aldosterone activation. (2) Mechanical effects of the enlarging gravid uterus (aortocaval compression, diaphragmatic splinting, altered spinal curvature). (3) Increased maternal metabolic

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AWAKE CRANIOTOMY

NeuroAnesthesia /

AWAKE CRANIOTOMY Dr. Surya Tej PV INTRODUCTION: Specialised Neurosurgical technique Permits intraoperative neurological assessment and functional brain mapping during tumour resection. (1) Depends on appropriate patient selection and preparation+ effective regional analgesia+ titrated sedation Why Awake Craniotomy? Allows real time functional mapping of the brain’s eloquent areas during tumour resection Allows preservation of eloquent areas

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BARRETT’S ESOPHAGUS

Gastroenterology /

BARRETT’S ESOPHAGUS  AT A GLANCE Definition Metaplastic replacement of the normal stratified squamous epithelium of the distal esophagus by specialized intestinal-type columnar epithelium, usually as a consequence of chronic gastroesophageal reflux. Major association Chronic gastroesophageal reflux disease (GERD). Major cancer risk Esophageal adenocarcinoma (EAC). Site lower 1/3 of esophagus Major risk factors Male sex, age

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DVT prophylaxis in hospitalized and critically ill patients

General ICU Care /

DVT prophylaxis in hospitalized and critically ill patients  Every hospitalized/critically ill patient should undergo a daily assessment of VTE risk AND bleeding risk. If VTE risk is significant and bleeding risk is acceptable → pharmacological prophylaxis, usually LMWH, is preferred. If pharmacological prophylaxis is contraindicated → intermittent pneumatic compression (IPC) should be used.   Why

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ASTHMA EXACERBATION

Pulmonology Critical care /

ASTHMA EXACERBATION  Recommendations below are aligned primarily with the 2026 GINA Strategy Report, the current GINA reference available in 2026.  ADULT ASTHMA EXACERBATION — QUICK DOSE TABLE 1. WHAT IS AN ASTHMA EXACERBATION? An asthma exacerbation is an acute or subacute worsening of asthma symptoms and lung function compared with the patient’s usual state.Typical manifestations:

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LVOT-VTI

POCUS /

LVOT-VTI — Left Ventricular Outflow Tract Velocity–Time Integral   LVOT-VTI is the distance that blood travels through the LV outflow tract during one systolic ejection. It is one of the most useful echocardiographic measurements for estimating stroke volume (SV) and cardiac output (CO). How to measure LVOT-VTI Step 1 —Apical 5-chamber view or Apical 3-chamber

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