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ICU Management of Acute Severe Pancreatitis
The management of acute severe pancreatitis (ASP) in the ICU involves a multifaceted approach to stabilize the patient and prevent complications. Initial management focuses on aggressive fluid resuscitation with lactated Ringer's solution, hemodynamic monitoring, and the use of vasopressors if necessary. Respiratory support may include oxygen therapy or mechanical ventilation for cases of acute respiratory distress syndrome (ARDS). Pain control is primarily achieved with opioids, supplemented by non-opioid analgesics. Early enteral nutrition is preferred to maintain gut integrity, while parenteral nutrition is reserved for intolerant patients. Close monitoring for complications such as infected pancreatic necrosis and acute kidney injury is essential, with appropriate interventions as needed. A multidisciplinary team approach ensures comprehensive care and improves patient outcomes.
About the Speaker
Dr. Rishabh Kumar Mittal
Associate Director & Head Department of Critical Care Medicine Sarvodaya Healthcare, Faridabad
Dr Rishabh Kumar Mittal is a well known intensive care physician having more than 12 years ofexperience in the field of Critical Care Medicine. After completing his post graduation from prestigious S.M.S Medical College and attached group hospitals , Jaipur; he ventured in the field of Critical Care Medicine and completed F.N.B in Critical Care Medicine from Fortis Escorts Heart Institute, New Delhi. He is an astute clinician and academician and is a teacher & guide for DrNB,F.N.B, IDCCM, IFCCM and IDCCN courses in Critical Care Medicine. He has published many articles in indexed journals and has written many chapter in various critical care medicine books. He has delivered many talks in Critical Care and Anaesthesiology National and International conferences. His key areas of interest are Nutrition in Critically ill, Ventilation in ARDS patients , ECMO, Gastro Critical care, Post organ transplant care and antibiotic stewardship in Critical Care. Before joining Max Hospital , Dr Rishabh has served as academic coordinator and In-charge of Gastro Medical & Liver Transplant Intensive care units at Fortis Escorts Hospital, New Delhi.
Upcoming Case Discussions
Treatment of Renal Disease in ANCA Vasculitis
The treatment of renal disease in ANCA-associated vasculitis (AAV) typically involves a combination of immunosuppressive therapies to control inflammation and prevent further kidney damage. First-line treatment often includes high-dose corticosteroids and cyclophosphamide or rituximab, both of which help to induce remission by targeting the underlying immune system dysfunction. In cases of kidney failure or rapidly progressive glomerulonephritis, plasmapheresis may be used to remove circulating autoantibodies. Once remission is achieved, maintenance therapy with lower doses of immunosuppressants, such as azathioprine or mycophenolate mofetil, is used to prevent relapses and preserve kidney function.
Pulmonary Tuberculosis: Challenges in Diagnosis
Diagnosing pulmonary tuberculosis (TB) poses significant challenges, particularly in resource-limited settings. The disease often mimics other respiratory conditions, leading to delayed or missed diagnoses. Traditional diagnostic methods like sputum smear microscopy have limited sensitivity, especially in HIV co-infected or low-bacterial-load patients. Advanced techniques such as GeneXpert and culture tests, though more accurate, are often unavailable in remote areas. Children and immunocompromised patients present additional hurdles due to atypical symptoms and difficulty obtaining diagnostic samples. Non-specific imaging findings further complicate diagnosis. Addressing these challenges requires expanded access to molecular diagnostics, improved point-of-care tools, and greater healthcare awareness.
NIV in Acute Respiratory Failure
Dr Viny Kantroo is a Chest, Critical Care & Sleep medicine specialist based in Delhi, boasting over more than 15 years of professional experience. She is currently practising as a full time Senior consultant in Indraprastha Apollo Hospitals New Delhi and Visiting Consultant Apollo Hospitals Noida in the department of Respiratory, Critical Care and Sleep Medicine. She is recognised for her expertise in various aspects of Chest medicine, which includes EBUS (Convex probe, Radial), Bronchoscopic procedures, pleural effusion management, interstitial lung disease, Covid-19, lung cancer, pneumonia, and intensive care patient management. Dr Kantroo is renowned not only for her medical proficiency but also for her empathy and positive attitude towards patient care. Patients consulting with Dr Viny can be assured of receiving an accurate diagnosis and effective treatment, thanks to her commitment to prompt and comprehensive care.
AI in Genetics and Genomics
AI is revolutionizing genetics and genomics by enabling faster and more accurate analysis of complex genetic data. Machine learning algorithms can identify patterns in DNA sequences, helping to discover new genetic variants linked to diseases. Additionally, AI assists in predicting gene functions, personalizing medicine, and accelerating drug development. Its integration promises significant advancements in understanding genetic diseases and improving healthcare outcomes.
Management of Pediatric Type 1 Diabetes
Pediatric type 1 diabetes management focuses on maintaining glycemic control while supporting normal growth. Insulin therapy, via multiple daily injections or pumps, is essential, with doses adjusted based on blood glucose monitoring or continuous glucose monitoring (CGM). Nutrition plans emphasizing carbohydrate counting and balanced meals are crucial, alongside adjustments for physical activity to prevent glucose fluctuations. Education for families on recognizing hypo- and hyperglycemia symptoms and managing sick days is vital. Regular follow-ups with a pediatric endocrinologist help monitor HbA1c levels, growth, and complications. Psychosocial support is key for ensuring adherence and addressing emotional challenges.