Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile
Satyendra Dhar, MD SFHM

@dharsaty

Assist Clin Professor, 🗣️ The more I read, the more I acquire, the more certain I am that I know Nothing🫀
Support: Dharsaty.com/p/scholarship.…

ID: 1262408459636674560

linkhttps://www.DharSaty.com calendar_today18-05-2020 15:44:31

1,1K Tweet

9,9K Followers

338 Following

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Education is a fundamental human right that should be accessible to all individuals regardless of their background, ethnicity, gender, or socioeconomic status. Providing education for all is essential in promoting equality, reducing poverty, improving health outcomes, and

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Drugs associated with worsening of Myasthenia Gravis (MG): · D-penicillamine · Botulinum toxin. · Telithromycin · Fluoroquinolones · Quinine · Magnesium · Macrolide antibiotics · Corticosteroids (may cause transient worsening within first 2 wks). · Aminoglycoside antibiotics. ·

Drugs associated with worsening of Myasthenia Gravis (MG):
· D-penicillamine
· Botulinum toxin.
· Telithromycin
· Fluoroquinolones
· Quinine
· Magnesium
· Macrolide antibiotics
· Corticosteroids (may cause transient worsening within first 2 wks).
· Aminoglycoside antibiotics.
·
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Attend the first SHM Michigan Chapter Tri-City Conference! 📅 Saturday, June 22, at 8 a.m. ET 📍 Courtyard by Marriot Bay City, MI 💡 Learn more and register today!⤵️ 🔗 bit.ly/4b0TBw2

Attend the first SHM Michigan Chapter Tri-City Conference!

📅 Saturday, June 22, at 8 a.m. ET
📍 Courtyard by Marriot Bay City, MI
💡 Learn more and register today!⤵️ 

🔗 bit.ly/4b0TBw2
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LACTIC ACID (or lactate) Measured to assess for tissue hypoxia, shock, sepsis, and metabolic conditions. Elevated levels indicate that cells are not getting enough oxygen, leading to anaerobic metabolism. 👉Ranges: Normal Range: •Typically, the normal range for blood

LACTIC ACID (or lactate) 

Measured to assess for tissue hypoxia, shock, sepsis, and metabolic conditions. 

Elevated levels indicate that cells are not getting enough oxygen, leading to anaerobic metabolism.

👉Ranges:

Normal Range:
•Typically, the normal range for blood
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LIVER ABSCESS · Pyogenic abscess, accounts for 80% of abscess. · Amebic abscess due to Entamoeba histolytica, accounts for 10%. · Fungal abscess, accounts for < 10%. · 50% of solitary liver abscesses occur in the right Liver lobe. · Right hepatic lobe (~75%), less commonly left

LIVER ABSCESS

· Pyogenic abscess, accounts for 80% of abscess.
· Amebic abscess due to Entamoeba histolytica, accounts for 10%.
· Fungal abscess, accounts for &lt; 10%.
· 50% of solitary liver abscesses occur in the right Liver lobe.
· Right hepatic lobe (~75%), less commonly left
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MUSCLE WEAKNESS ✅UMN INJURY Typically produces: 👉Weakness or paralysis. 👉Disuse atrophy (minimal) or contractures. 👉Pyramidal pattern of weakness (extensors weaker than flexors in arms, and vice versa in legs). 👉Spasticity/Rigidity. 👉Clonus. 👉Hyper-reflexia, and

MUSCLE WEAKNESS

✅UMN INJURY
Typically produces:
👉Weakness or paralysis.
👉Disuse atrophy (minimal) or contractures.
👉Pyramidal pattern of weakness (extensors weaker than flexors in arms, and vice versa in legs).
👉Spasticity/Rigidity.
👉Clonus.
👉Hyper-reflexia, and
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⚕️BACTERIAL MENINGITIS 👉Opening pressure > 300 mm H2O (39% of patients). 👉Cloudy, green, or purulent. 👉Glucose < 34 mg per dL, 👉Protein > 220 mg per dL, 👉WBCs > 2,000 per μL, or Neutrophils > 1,180 per μL. 👉Gram stain testing: specificity of 97% and

⚕️BACTERIAL MENINGITIS
👉Opening pressure &gt; 300 mm H2O (39% of patients).
👉Cloudy, green, or purulent.
👉Glucose &lt; 34 mg per dL,
👉Protein &gt; 220 mg per dL,
👉WBCs &gt; 2,000 per μL, or
                 Neutrophils &gt; 1,180 per μL.
👉Gram stain testing: specificity of 97% and
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Diabetes-related foot infection (DFI) Recommendation (IWGDF/IDSA Guidelines): 👉Perform MRI when osteomyelitis remains in doubt despite clinical, plain X-rays and laboratory findings. 👉When suspicion of osteomyelitis, bone (rather than soft tissue) samples should be obtained.

Diabetes-related foot infection (DFI)

Recommendation (IWGDF/IDSA Guidelines):

👉Perform MRI when osteomyelitis remains in doubt despite clinical, plain X-rays and laboratory findings. 
👉When suspicion of osteomyelitis, bone (rather than soft tissue) samples should be obtained.
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HYPOGLYCEMIA IN NON-DIABETICS: 👉Hormonal dysfunction Addison's disease Hypopituitarism 👉Non-B cell tumors. 👉Post-gastric bypass 👉Insulinomas. 👉Drugs: NSAID’s, phenylbutazone, propoxyphene, Quinine Lithium, TCA,

HYPOGLYCEMIA IN NON-DIABETICS:

👉Hormonal dysfunction
           Addison's disease
           Hypopituitarism
👉Non-B cell tumors.
👉Post-gastric bypass
👉Insulinomas.
👉Drugs:
           NSAID’s, phenylbutazone, propoxyphene,
           Quinine
           Lithium, TCA,
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

DIGOXIN: 👉Comes from the foxgloves plant. 👉Is a cardiotonic glycoside. 👉Not the first line drug 👉Beneficial in HFrEF No benefit in mortality reduction. 👉For rate control in A Fib/Flutter 👉Not be administered in cases of pre-excitation caused by accessory pathways.

DIGOXIN:

👉Comes from the foxgloves plant.
👉Is a cardiotonic glycoside.
👉Not the first line drug 
👉Beneficial in HFrEF
      No benefit in mortality reduction.
👉For rate control in A Fib/Flutter
👉Not be administered in cases of pre-excitation caused by accessory pathways.
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

LOW DOSE ASPIRIN (75-100 mg) AHA primary prevention guideline: 👉Might be considered for the primary prevention of ASCVD among select adults 40 -70 years of age who are at higher risk ASCVD risk but not at increased bleeding risk. 👉Should NOT be administered on a routine basis

LOW DOSE ASPIRIN (75-100 mg)

AHA primary prevention guideline:

👉Might be considered for the primary prevention of ASCVD among select adults 40 -70 years of age who are at higher risk ASCVD risk but not at increased bleeding risk.
👉Should NOT be administered on a routine basis
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

Bariatric Surgery Criteria - BMI > 40 without co-existing Obesity related conditions (ORC). - BMI > 35 with a potentially reversible ORC. - BMI 30- 34.9 & type2 DM with inadequate glycemic control.

Bariatric Surgery Criteria
- BMI &gt; 40 without co-existing Obesity related conditions (ORC).
- BMI &gt; 35 with a potentially reversible ORC.
- BMI 30- 34.9 &amp; type2 DM with inadequate glycemic control.
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

ILEAL CONDUIT 👉An ileal conduit is the urinary diversion performed by urologists after a patient undergoes a radical cystectomy. 👉It is a form of urinary tract reconstruction that uses the ileum as an alternative pathway for urine to exit the body. 👉One end of a short

ILEAL CONDUIT

👉An ileal conduit is the urinary diversion performed by urologists after a patient undergoes a radical cystectomy. 
👉It is a form of urinary tract reconstruction that uses the ileum as an alternative pathway for urine to exit the body.
👉One end of a short
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

Current US FDA/Expert Consensus Guidance 👉SGLT2i contraindicated in patients with baseline eGFR< 20. 👉Sacubitril/valsartan contraindicated in patients with baseline eGFR< 30 and should be discontinued if eGFR falls below 30. 👉MRA contraindicated in patients with baseline

Current US FDA/Expert Consensus Guidance

👉SGLT2i contraindicated in patients with baseline eGFR&lt; 20.

👉Sacubitril/valsartan contraindicated in patients with baseline eGFR&lt; 30 and should be discontinued if eGFR falls below 30.

👉MRA contraindicated in patients with baseline
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

Patients with HF and ESRD on HD have been excluded from landmark trials of all these therapies. GDMT in patients with HFrEF who are on dialysis is often withheld or not uptitrated to recommended target doses due to safety and tolerability concerns and lack of available clinical

Patients with HF and ESRD on HD have been excluded from landmark trials of all these therapies. GDMT in patients with HFrEF who are on dialysis is often withheld or not uptitrated to recommended target doses due to safety and tolerability concerns and lack of available clinical
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CAPNOGRAPHY V/S PULSE OXIMETRY 👉CAPNOGRAPHY 🫁Provides a measure of ventilation – or concentration of CO2 exhaled air (aka End tidal CO2 or EtCO2). 🫁Not affected by supplemental oxygen. 🫁Reflects breath-to-breath ventilation. 🫁Appear abnormal if patient has stopped

CAPNOGRAPHY V/S PULSE OXIMETRY

👉CAPNOGRAPHY
🫁Provides a measure of ventilation – or concentration of CO2 exhaled air (aka End tidal CO2 or EtCO2).
🫁Not affected by supplemental oxygen.
🫁Reflects breath-to-breath ventilation.
🫁Appear abnormal if patient has stopped
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

My 2 cents: Integrating 👇 elements through practices like mindfulness and heart-centered breathing can lead to greater balance, clarity, and overall well-being. MIND🧠 Shapes reality through thoughts and focus, helps manage stress, and enhances performance via visualization.

My 2 cents:

Integrating 👇 elements through practices like mindfulness and heart-centered breathing can lead to greater balance, clarity, and overall well-being.
MIND🧠 Shapes reality through thoughts and focus, helps manage stress, and enhances performance via visualization.
Satyendra Dhar, MD SFHM (@dharsaty) 's Twitter Profile Photo

URINALYSIS 👉Leukocyte esterase: Enzymes released by lysed WBCs. Surrogate marker for pyuria. 👉Nitrite: Metabolic byproduct of nitrate produced by bacteria. Produced by E Coli & Enterobacteriaceae family. Not produced by pseudomonas, enterococci, & S saprophyticus.

URINALYSIS

👉Leukocyte esterase: 
Enzymes released by lysed WBCs.
Surrogate marker for pyuria.
👉Nitrite: 
Metabolic byproduct of nitrate produced by bacteria.
Produced by E Coli &amp; Enterobacteriaceae family.
Not produced by pseudomonas, enterococci, &amp; S saprophyticus.