Dr Harshit Aggarwal

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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Snake Bite

Toxicology Critical Care /

Snake Bite (Snake Envenomation)  India accounts for one of the highest snakebite burdens globally. Important venomous snakes: “Big Four” of India Snake Scientific Name Major Toxicity Indian Cobra Naja naja Neurotoxic + Cytotoxic Common Krait Bungarus caeruleus Neurotoxic Russell’s Viper Daboia russelii Hemotoxic + Nephrotoxic Saw-scaled Viper Echis carinatus Hemotoxic Other important species: King cobra

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Subarachnoid Hemorrhage

Neuro Critical Care, Trauma Critical Care /

Subarachnoid Hemorrhage (SAH)  Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space between the arachnoid mater and pia mater where cerebrospinal fluid (CSF) circulates. It is one of the most devastating neurological emergencies with: Mortality: 25–50% Significant disability among survivors Peak incidence: 40–60 years Approximately 80–85% of spontaneous SAH results from rupture of an intracranial

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Anaphylaxis

General ICU Care /

Anaphylaxis  According to the World Allergy Organization (WAO): Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterized by rapidly developing airway, breathing and/or circulation problems, usually associated with skin and mucosal changes. Types of Anaphylaxis Feature IgE-Mediated Anaphylaxis (Classic) Non-IgE Mediated Anaphylaxis (Formerly “Anaphylactoid”) Frequency Most common type Less common Immune Mechanism IgE antibody-mediated hypersensitivity

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Cervical Spine injury

Trauma Critical Care /

Cervical Spine injury  Etiology 1. Traumatic Causes (≈80%) Motor vehicle accidents (most common) Falls (especially in elderly) Sports injuries Violence (gunshot, stab wounds) Industrial accidents 2. Non-traumatic Causes Tumors (intramedullary/extramedullary) Infections (TB, epidural abscess) Ischemia/infarction (e.g., aortic surgery) Degenerative diseases (cervical spondylotic myelopathy) Inflammatory (transverse myelitis, MS) Anatomy  Region Vertebral Levels Function Loss  Cervical (C1–C8)

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Ventilator Asynchronies

Pulmonology Critical care /

Ventilator Asynchronies  Ventilator asynchrony refers to a mismatch between the patient’s neural respiratory drive and the ventilator’s delivered breath (trigger, flow, cycling, or mode). It leads to: ↑ Work of breathing (WOB) Patient discomfort Sedation escalation Delirium Prolonged mechanical ventilation Increased ICU stay Possibly increased mortalityAsynchrony is present in up to 20–40% of ventilated ICU

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