Dr Harshit Aggarwal

Fetal Circulation

1. Introduction The circulation of blood from the placenta to and through the fetus and back to the placenta is known as fetal circulation. It is a parallel circuit, unlike adult circulation, which is a serial circuit. Both the right and left ventricles pump blood in parallel to the systemic and placental circuits, rather than […]

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JVP

JVP(Jugular Venous Pressure)   INTRODUCTION Topic Key Point Jugular Venous Pulse (JVP) • Oscillating top of vertical column of blood in right IJV that reflects pressure changes in Right Atrium in cardiac cycle. Jugular Venous Pressure (JVP) • Vertical height of oscillating column of blood. WHY RIGHT IJV OVER EJV ? • IJV has a

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Neurotransmitters in Pain

Neurotransmitters in Pain Neurotransmitter Role in Pain Modulation Mechanism of Action Glutamate Primary excitatory neurotransmitter; mediates nociceptive signal transmission in the spinal cord and brain. Activates NMDA and AMPA receptors, facilitating excitatory neurotransmission and central sensitization. Substance P Facilitates pain transmission and inflammation by promoting neurogenic inflammation and sensitization. Binds to neurokinin-1 (NK1) receptors; increases

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Pain Assessment

Pain Assessment Tools & Scales 1. Core Principles of Pain Assessment Pain is inherently subjective, making self-reporting the gold standard of pain assessment whenever possible. However, the inability to communicate verbally does not negate the possibility that a patient is experiencing pain. Modern clinical guidelines (such as the PADIS guidelines) emphasize a hierarchical approach to

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Referred Pain

Referred Pain and Dermatomes  Referred Pain: Pathophysiology & Mechanisms Referred pain is a phenomenon where pain is perceived in an area remote from the site of the actual nociceptive stimulus. This is a highly tested concept across critical care and anaesthesia boards, heavily relying on neuroanatomical principles. The definitive, evidence-based explanation for referred pain is

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Central and Peripheral Sensitization

Central and peripheral sensitization IASP Definitions & Taxonomy The foundation of any pain chapter must align with the International Association for the Study of Pain (IASP) taxonomy. Peripheral Sensitization: “Increased responsiveness and reduced threshold of nociceptive neurons in the periphery to the stimulation of their receptive fields” (Curatolo, 2024). It is clinically associated with primary

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Anatomical and physiological differences in child vs adult Anesthesia

Anatomical and Physiological Differences: Child vs Adult Children and neonates in particular are not simply small adults. Every organ system undergoes structural and functional maturation over the first years of life, and these differences directly shape anaesthetic risk, airway management, drug dosing, fluid therapy and perioperative monitoring.  1. Body Size, Proportions & Surface Area Parameter

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Huntington’s Disease

Huntington’s Disease (HD) Huntington’s Disease (HD) is a progressive, autosomal dominant neurodegenerative disease caused by a CAG trinucleotide repeat expansion in the HTT (IT15) gene on chromosome 4p, leading to toxic polyglutamine accumulation, striatal neuronal loss, chorea, cognitive decline, and progressive motor, cognitive, and behavioral deterioration over roughly 15–20 years. At a Glance Domain Practical

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CHRONIC PANCREATITIS

CHRONIC PANCREATITIS At a glance Domain Practical point Definition Progressive fibro-inflammatory pancreatic condition with irreversible structural injury and leading to both exocrine/endocrine dysfunction. Etiology Use TIGAR-O: toxic-metabolic, idiopathic, genetic, autoimmune, recurrent/severe acute pancreatitis, obstructive. Clinical pattern Pain (major presentation) and/or maldigestion; later steatorrhea, weight loss, diabetes, nutritional and bone complications. Diagnosis CT or MRI/MRCP is

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ACUTE PANCREATITIS

ACUTE PANCREATITIS At a glance Domain Practical point Diagnosis (Revised Atlanta Classification 2012) 2 of 3: characteristic upper abdominal pain, Sr. Amylase/lipase ≥3× ULN, or compatible imaging. Etiology Gallstones and alcohol account for about two-thirds of cases; actively assess biliary, alcohol, metabolic, drug, structural and uncommon causes. Severity Persistent organ failure >48 h is the

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