Dr Harshit Aggarwal

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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BRACHIAL PLEXUS ANATOMY

 BRACHIAL PLEXUS ANATOMY Provides sensory and motor innervation to upper limb.   Formation– Constitutes anterior primary rami C5 – C8 along with T1. Pre-fixed plexus – C4 is involved Post- fixed plexus – T2 is involved Variations are often associated with cervical rib. Parts of the brachial plexus: Roots, Trunks, Divisions, Cords, Branches.   Roots:

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Immune Thrombocytopenic Purpura

Immune Thrombocytopenic Purpura (ITP) Definition Immune Thrombocytopenic Purpura (ITP) — also known as Immune Thrombocytopenia — is an acquired autoimmune disorder characterized by isolated thrombocytopenia (platelet count <100,000/µL)  It is a diagnosis of exclusion — no other cause of thrombocytopenia should be present. Hematologist Referral is must Classification Type Description Primary ITP Isolated thrombocytopenia without

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