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Diabetes Mellitus and its management
Diabetes Mellitus is a chronic metabolic disorder characterized by high blood sugar levels due to either insufficient insulin production (Type 1) or insulin resistance (Type 2). Type 1 Diabetes is an autoimmune condition where the body's immune system attacks and destroys insulin-producing cells in the pancreas. Type 2 Diabetes typically develops due to a combination of genetic factors, lifestyle choices, and obesity, leading to insulin resistance and reduced insulin effectiveness. Gestational Diabetes occurs during pregnancy when hormonal changes lead to insulin resistance, often resolving after childbirth. Chronic hyperglycemia in Diabetes can lead to complications affecting the eyes, kidneys, nerves, heart, and blood vessels. Diabetes management includes blood sugar monitoring, healthy eating, regular physical activity, and medication or insulin therapy. A balanced diet rich in whole grains, lean protein, healthy fats, and vegetables is crucial for blood sugar control.
About the Speaker

Dr.Ramkumar Sundaraperumal
HOD and Specialist Internal Medicine, Zulekha hospital, Dubai
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Cardiac arrhythmias and their treatment in critical care
In critical care, cardiac arrhythmias demand swift and precise intervention to prevent hemodynamic compromise. Treatment strategies include identifying and addressing underlying causes such as ischemia or electrolyte imbalances. Anti-arrhythmic medications may be administered, and in cases of severe arrhythmias, electrical therapies like cardioversion or pacing are employed to restore normal rhythm. Continuous monitoring and collaboration among critical care specialists, cardiologists, and electrophysiologists are essential for prompt diagnosis, tailored management, and minimizing complications associated with cardiac arrhythmias in critically ill patients.
Hepatitis B & C: Overview
Hepatitis B and C are two distinct viral infections that affect the liver, causing a range of liver-related diseases. Hepatitis B is primarily transmitted through exposure to infected blood and other bodily fluids. It can be acute or chronic, with chronic infections posing a higher risk of liver cirrhosis and liver cancer.Hepatitis C is caused by the hepatitis C virus, typically transmitted through blood-to-blood contact. Chronic HCV infection can also lead to liver cirrhosis and liver cancer. Both HBV and HCV can be asymptomatic or present with similar symptoms, including jaundice, fatigue, and abdominal discomfort. HBV can be transmitted from an infected mother to her baby during childbirth, through sexual contact, and sharing needles. HCV is primarily spread through sharing needles, contaminated medical equipment, or in rare cases, sexual contact. Both diseases are global health concerns. HBV is more common in regions like Asia and Africa, while HCV is more prevalent in some parts of the United States and Europe. There is an effective vaccine for HBV that has significantly reduced new infections. No vaccine for HCV exists, but direct-acting antiviral drugs have revolutionized HCV treatment. Chronic hepatitis B can be managed with antiviral medications, while hepatitis C can be cured with a combination of antiviral drugs.
ARDS : Clinical Diagnosis and Management
Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition characterized by rapid onset of severe respiratory failure, often resulting from underlying illnesses like pneumonia, sepsis, or trauma. Clinical diagnosis of ARDS is based on criteria including acute onset of respiratory distress, bilateral lung infiltrates on chest imaging, and impaired oxygenation not fully explained by cardiac failure. Early recognition and management are essential in ARDS to prevent further lung damage and improve patient outcomes. Oxygen therapy and mechanical ventilation are typically necessary to provide adequate oxygen levels while minimizing the risk of ventilator-induced lung injury. Positive End-Expiratory Pressure (PEEP) is commonly used to maintain lung recruitment and improve oxygenation. Management strategies focus on treating the underlying cause, such as antibiotics for infections or addressing fluid balance issues. Prone positioning, a technique where the patient lies face down, can improve oxygenation in some cases. Low tidal volume ventilation, which involves using smaller breath volumes, is a recommended ventilatory strategy to prevent further lung injury.
Acute Management of Seizure
Acute management of a seizure is a critical medical intervention that focuses on ensuring the safety and well-being of the individual experiencing the seizure. The first step is to assess the situation. Ensure the safety of the individual and those around them by moving objects or people that may pose a risk during the seizure. Note the time the seizure begins. Seizures lasting longer than five minutes or recurrent seizures without recovery in between may require immediate medical attention. If the seizure lasts longer than five minutes, is followed by another seizure, or if it is the person's first seizure, seek immediate medical attention. Also, if the person is pregnant, injured during the seizure, or has a known seizure disorder but this episode is unusually severe or prolonged, medical evaluation is essential.
Management of Diabetic Ketoacidosis in Hospitalized Patients
The management of diabetic ketoacidosis (DKA) in hospitalized patients is a time-sensitive process that aims to correct dehydration and electrolyte imbalances, reverse the ketoacidosis, and identify and treat the underlying cause.Fluid resuscitation is the cornerstone of treatment, typically done with normal saline (0.9% sodium chloride) at a rate of 1-2 liters per hour. Once the patient is clinically stable, fluids can be switched to half-normal saline (0.45% sodium chloride) or dextrose 5% in water.Electrolyte replacement is also essential, with the most important electrolytes to replace being sodium, potassium, and phosphate. Sodium is replaced with normal saline or half-normal saline, potassium with potassium chloride, and phosphate with potassium phosphate or sodium phosphate.Insulin therapy is used to reverse the ketoacidosis, typically initiated with a bolus dose of regular insulin, followed by a continuous infusion of regular insulin. The dose of insulin is adjusted based on the patient's blood glucose levels.