Can we use Ivabrad to control HR , along with Dobutamine

Gudmrng @tapesh sir what is the reason for thrombocytopenia in trauma patients, as thrombocytopenia becomes contraindication for epidural in many patient sir?

Excellent talk

Thanks for such a great presentation

Content are good , quality of video / editing has to be improved

Thank you so much Tapesh sir for so informative discussion

Can we use the same strategy of treating severe hypokalemia (K <2) with mannitol and K in normal ICU patients in emergency situations to build up potassium (when we dont have a central line and are limited in the amount of K we can use through peripheral iv)?

EXCELLENT

Sir then which oral antibiotic should be given ico uncomplicated uti? Cotri?

Sir, I have a few queries. 1. Static vs. Cidal Antibiotics: What is your perspective on the relevance of bacteriostatic versus bactericidal antibiotics in clinical practice? Is this distinction more of a microbiological concept, or does it hold significant clinical implications backed by any good quality data ? Mandel describes it in myths around ID .. also clinically never ever any cidal has fared better than static .. levo vs azee , vanco vs linid.. no data 2. Role of Double Coverage: In patients not on polymyxins, where we typically combine agents like meropenem or other carbapenems, what is the role of double coverage? When is it advisable to use this strategy or even back by good data ? 3. Empirical Use of Aminoglycosides: Is it appropriate to use aminoglycosides empirically without culture sensitivity? I am particularly concerned about fluoroquinolones, as Dr. Pratik mentioned, along with linezolid and amikacin-due to their anti-tubercular activity and the potential for causing false-negative results in suspected TB cases. That being potentially relevant in our settings 4. Clinical Usage of Aminoglycosides: During my DM residency at AIIMS, we rarely used aminoglycosides except for specific indications, and there was a general preference for alternative agents. However, since I started practicing as a consultant in Punjab, aminoglycosides are frequently used empirically, often without an antibiogram or known sensitivity patterns, which I have found challenging to locate. 5. Indications Where Aminoglycosides are Irreplaceable: Given the toxicity profile, are there any clinical scenarios where aminoglycosides are irreplaceable, or are there always alternative options? Thank you, Sir.

Sir what is your opinion about 1. Cidal vs static 2. Double coverage unless we aren’t on polymyxins . 3. Do we have any empirical role of aminoglycosides.. at AIIMS in my residency we wouldn’t use amino glycosides atleast empirically … but here in Punjab it is used right and left … I don’t have data and antibiogram here … what u say sir about .. 4. What are their irreplaceable indications .

Thanks.

it is surprising , that despite high vasopressor scores just 35 percent on MV before ECMO..that too in those who had cardiac arrest , hypoxemia or low sensorium then only they would intubate them ... can I say they were optimised? .IF WE SEE THEIR MEAN PH , LACTATE and vasopressor score ....It is surprising to see just 1/3 patients only intubated...at such altered metabolic and hemodynamic parameters .. it is hard to say what outcomes would have been if they were optimised on mechanical ventilation prior to ECMO. also least duration of ECMO IS 10 hours ..maybe patient expired ... also sir is it like the variant with cold extremities unlike typical septic warm shock is only candidate for ECMO ... as it is mixed type of shock .. should there be lesser component of vasoplegia as like physiologically suitable for VA ECMO should they use some threshold SVR like they use threshold EF Also a review mentions NAC is only evidence based mortality reducing drug … Wonderful presentation and content sir

Very nice presesntation

Many thanks sir

I can't get my eyes off That Tie

Thanks

Thank you sir for making such Content

Thanks

Any lecture on ckd??

Hi sir....management of severe metabolic acidosis...euglycemic dka....indications for intubating them and ventilatory management in severe met acidosis...if possible a video on that sir🙏

Thanks for discussing the topic and case I have asked sir

Thankyou for crp and procal sir

Sir , Colistin is prodrug which activates in renal parenchyma so preferred choice of urosepsis and poly B is active molecule preferred for bacteremia In CNS infection due to carbapenem resistant GNB , intrathecal colistin preferred over poly B? And what is funda of nebulized colistin if it is a prodrug It's need to be activated in kidney then why don't we use poly B in place of colistin for local effect?

Excellent lecture the entire series of lectures in this channel are a boon to all of us

Elaborate n excellent, Ma'm.

Thanks

1cycle means 1set of 30:2 , in 2min we should perform 5 cycle ( 5 turns/ sets of 30:2) right sir...if person received 10 min CPR means he received 25 cycles... hope my understanding is right?

Sir plz give a short notes on Levocetrizin & Levosalbutamol dose in paediatric

Should aminoglycosides be given in divided doses in pts of cystic fibrosis?

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