Dr Harshit Aggarwal

Remimazolam

Recent Advances in Anesthesia /

Remimazolam  Introduction Ultra-short-acting intravenous benzodiazepine Structurally related to midazolam Rapid, predictable metabolism resembles the pharmacokinetic concept of remifentanil Available as remimazolam besylate Water-soluble formulation Trade name: Byfavo Chemistry Imidazobenzodiazepine containing a metabolically labile carboxylic ester linkage Molecular formula: C₂₁H₁₉BrN₄O₂ Molecular weight: approximately 439.3 Da The ester linkage permits rapid hydrolysis to an inactive metabolite Mechanism […]

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Apnoeic Oxygenation

Recent Advances in Anesthesia /

Apnoeic Oxygenation Definition Apnoeic oxygenation is the continuous delivery of oxygen to the airway during apnoea, allowing ongoing alveolar oxygen uptake without spontaneous breathing or positive-pressure ventilation. It delays desaturation and prolongs safe apnoea time during airway management. Important: It maintains oxygenation but does not provide adequate ventilation. Mechanism O₂ continues to diffuse from alveoli

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Neuropathic Pain 

Pain and Palliative Care Anesthesia /

NEUROPATHIC PAIN  BRIEFThis guide translates Neuropatic pain: Fundamental neurophysiology and pharmacology into structured bedside diagnostic and therapeutic pathways. DEFINITION AND ETIOLOGY Neuropathic pain: Defined by the International Association for the Study of Pain (IASP) as pain caused by a lesion or disease of the somatosensory nervous system .  It is critical to recognize that neuropathic

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Pediatric airway anatomy and assessment

Pediatric Anesthesia /

Paediatric Airway Anatomy and Assessment Introduction Paediatric airway management differs significantly from adult airway management because of unique anatomical and physiological characteristics. A relatively large tongue, cephalad larynx, compliant airway structures, and limited oxygen reserves predispose children to airway obstruction and rapid desaturation. Understanding these differences and performing a systematic airway assessment are essential for

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Irritable Bowel Syndrome

Gastroenterology /

IRRITABLE BOWEL SYNDROME 2026 UPDATE Rome V is now available and updates IBS diagnostic criteria: recurrent abdominal pain or discomfort, on average ≥3 days/month during the previous 3 months, with symptom onset ≥6 months before diagnosis, plus ≥2 of: relationship to defecation, change in stool frequency, or change in stool form. The 2021 ACG/BSG guidance

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Acute Disseminated Encephalomyelitis

Neurology /

Acute Disseminated Encephalomyelitis (ADEM) Acute disseminated encephalomyelitis (ADEM) is a monophasic (in most cases), immune-mediated, demyelinating disorder of the CNS that classically follows a viral infection or vaccination — characterized by multifocal white and grey matter demyelination with encephalopathy, predominantly affecting children. At a Glance Domain Practical Point Definition CNS demyelinating syndrome, almost always monophasic,

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Nociceptors and Pain Fiber Classification

Pain and Palliative Care Anesthesia /

Nociceptor Classification and Molecular Transduction Clinical Pearls & Key Takeaways •  Temporal Distinction: The dichotomy between ‘first’ and ‘second’ pain is purely a function of conduction velocities between fast myelinated Aδ and slow unmyelinated C fibres. •  Molecular Transduction: TRPV1 acts as a non-selective gating channel responsive to heat and local acidosis, whereas mechanical noxious

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Pre anesthetic Check up

Must Know Anesthesia Topics /

Pre-Anaesthetic Check-up (PAC) Objectives of PAC The Pre-Anaesthetic Check-up (PAC) is a systematic evaluation performed before anaesthesia to assess the patient’s current health status, identify potential preoperative risks, optimise the patient, and formulate an individualised anaesthetic plan. The main objectives are: Assess the patient’s current health status Identify existing medical conditions and their severity. Assess

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Fetal Circulation

Cardiac Anesthesia /

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

Cardiology /

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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