Dr Harshit Aggarwal

Hypertensive Crisis

Cardiac Critical care /

Hypertensive Crisis Hypertensive crisis is a spectrum of severe blood pressure elevation associated with actual or potential acute target-organ damage. It is broadly classified into: Hypertensive Emergency Hypertensive Urgency (The 2024 AHA Scientific Statement and 2025 AHA/ACC Hypertension Guideline recommend abandoning the term “hypertensive urgency.” Instead, patients are classified as:severe asymptomatic hypertension) Hypertensive Emergency Severe […]

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Acute Pancreatitis in ICU

Gastro and HepatoBilliary Critical Care​ /

Acute Pancreatitis Acute Pancreatitis is an acute inflammatory process of the pancreas caused by premature activation of pancreatic digestive enzymes leading to autodigestion, inflammation, edema, necrosis, and systemic inflammatory response. It ranges from: Mild self-limiting interstitial edema to Severe necrotizing pancreatitis with multiorgan failure. Diagnostic Criteria (Revised Atlanta Classification) Diagnosis requires 2 of 3 criteria:

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Ventilator Settings

Pulmonology Critical care /

Ventilator Settings  Trigger Trigger is the mechanism that initiates a ventilator breath. In simple words:”What tells the ventilator to start inspiration?” The trigger may be:Patient generated or Time generated Types of Trigger A. Time Trigger Ventilator starts breath according to set respiratory rate. Example:RR = 12/min so Breath every: 60/12 = 5 sec Ventilator triggers

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Can Intensivists Ever Have True Autonomy? The Answer May Lie Outside the ICU.

Reality of medicine /

One of the most common frustrations among intensivists is the lack of autonomy. In many hospitals, the intensivist manages the ventilator, vasopressors, CRRT, and life-threatening emergencies—but the final decisions often remain with the admitting consultant. The debate usually revolves around open ICUs vs. closed ICUs. But perhaps we’re asking the wrong question. The Real Problem

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Do Medical Conferences Really Need to Be So Expensive—Or Are We Paying for Goodies Instead of Education?

Reality of medicine /

Every conference promises the same thing: “Advancing medical education.” Yet every delegate leaves with a branded bag, a notebook they’ll never use, a pen that disappears within a week, a conference T-shirt, souvenirs, and sometimes an extravagant gala dinner. It raises an uncomfortable question: Are we paying for education—or for packaging? Where Does the Registration

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“Guidelines Are Meant Only to Guide You”—But Have We Actually Read the Guidelines?

Reality of medicine /

One of the most repeated phrases in medicine is: “Guidelines are only meant to guide you.” It sounds wise. It sounds balanced. But here’s the uncomfortable question: How many of us have actually read the guideline before saying that? Guidelines Are More Than Recommendations Modern clinical guidelines are not someone’s opinion. They are the result

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Medical Conferences: Are They Really Improving Patient Care—Or Have They Become Professionally Justified Vacations?

Reality of medicine /

Every year, thousands of doctors travel across the country to attend conferences. The justification is almost always the same: “It’s for academic purposes.” But an uncomfortable question deserves an honest discussion: How much of what we learn at conferences actually changes our clinical practice? The Original Purpose Medical conferences were designed to: When these objectives

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Do You Really Need a Super-Specialty Degree—Or Is It Just About Employability?

Reality of medicine /

For today’s MD graduates, one question comes up repeatedly: “Should I pursue DM/DrNB, or should I start practicing?” A decade ago, an MD was considered the final milestone. Today, for many residents, it feels like just another entrance examination. So, has super-specialization become a necessity—or is it mainly about employability? Medicine Has Changed Medical knowledge

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Is Internal Medicine has some Value—or Has It Become Just a Stepping Stone to Super-Specialization?

Reality of medicine /

Ask an MBBS student today about their dream branch, and many will say DM Cardiology, Gastroenterology, Neurology, or Critical Care Medicine. For many, MD Internal Medicine is no longer the destination—it’s the entrance exam for NEET SS. But does that mean Internal Medicine has lost its value? Absolutely not. The Numbers Tell a Different Story

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Emergency Medicine in India: Why Is the Specialty Still Searching for Its Identity?

Reality of medicine /

Emergency Medicine (EM) was officially recognized as a specialty in India in 2009. More than 15 years later, it remains one of the fastest-growing yet least understood branches of medicine. The question isn’t “Do we need Emergency Medicine?” The answer is obvious. The real question is: Why is the specialty still struggling to establish its

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