Dr gireesh sir is excellent mentor... I m lucky to have such wonderful teacher.....apart from lectures/ case discussion on u tube i read the books written by him... Thank u so much sir... being there
I feeling lucky to get this channel.. It helped me lot to gain knowledge, while being a intern of hospital no one use to guide us.. So thank u so much sir n keeping posting videos 🙏
Every nice explanation by dr . Gireesh kumar sir. For the patient who developed end organ damage 30/70 insulin regimen is better intially or combination of 30/70 in morning plus 50/50 in evening which is better ?
A woman of 46 yo feeling frequently hungry and associated fatigue ,dizziness despite of taking meal timely . (Polyphagia) . RBS is 100-110 generally. What could be the reason? Is she going towards the prediabetic zone. But her glycated HbA1c is within normal limits.
RBS test done within one or two hours of eating then the RBS normal value should be 180 mg/dl as per the American Diabetes Association and the RBS normal range should be anywhere between 80 mg/dl and 130 mg/dl prior to eating for healthy blood sugar levels in the body. Best approach should be Check the timings of RBS test and then make Differentials accordingly Drugs/ diet Infection Endocrine (hyperthyroid)
Excellent discussion! Sir A 52 year old man whose HbA1 11.3 % after 3 months completion of triple therapy of metformin,empagliflozin,sitagliptin What is the next step of managment Adding insulin ? If we are going to add insulin what type it should be ?( insulin lispro or NPH insulin or soluble insulin ?
Hi sir,my hand is fractured ,orif was done....I plan to take emergency medicine in future....is there any problem with fractured hand while doing emergency medicine dutys??
Hello sir, i had received a 26 year old female patient who was a student, with a history of sudden loss of consciousness while walking and the patient fell down. The patient was brought in an unconscious state and on doing grbs she was found hypoglycemic with grbs of 60mg/dl. Even after giving her iv bolus of 25D and also iv DNS infusion, she couldn't gain her consciousness and was repeatedly becoming brady from a normal PR to a PR of 48 (Hypoglycemic brady cardia). The case was then reffered to higher centre. What was tge reason she was not gaining her consciousness and was becoming hypoglycemic repeatedly .?
prolonged hyooglycemia which could have affected the CNS can have similar episodes, but need to look for other causes of altered sensorium as 60 mg/dl of glucose might not be the culprit.. Usually hypoglycemia coma will be less than 30mg/dl..
Sir can we give the 25 percent dextrose through peripheral lines?as we have studied that the maxm 12.5 percent dextrose can be given through peripheral lines.
I wish I had such videos to guide during my undergraduate days...
Exactly. I wld hv been a gold medalist
Thank you so 🙏🏻🙏🏻
This channel is a goldmine for Final Year Medicos ❤️
Dr gireesh sir is excellent mentor...
I m lucky to have such wonderful teacher.....apart from lectures/ case discussion on u tube i read the books written by him...
Thank u so much sir... being there
Dr geerish Kumar is one of the greatest Dr in India
I feeling lucky to get this channel..
It helped me lot to gain knowledge, while being a intern of hospital no one use to guide us..
So thank u so much sir n keeping posting videos 🙏
Excellent, excellent, thank you so much keep em coming , hats off
Please continue making such videos. I have learnt so much. Watching from Zambia 🇿🇲
Resp .dr Gireesh sir u and u r all team doing excellent job, i wish u continue for long long time ..thanks all team member
You are the real hero. Carry on
Nice conversation between teacher and student
Thank you sir your nice lecture I learnt about approach hypoglycemia Pt sir
Very nice case discussion...
As always, wonderful 👌
Thank you Dr Gireesh sir
Sir you are a legend 😘.. love you sir . Love from Pakistan
Very informative 🔥🔥🔥
Tq and very good presentation
Excellent ✨
Sir ,excellent video sir…thank u. Could u give the protocol or how to prescribe OHA for diabetic patients? It wound be much helpful sir .Thank u
Excellent discussion
Bhap re hope I had such a good doctor like this to help me.
Great work 👍👍
Great discussion 😊✌🏻
Plz plz plz....segregate videos on basis of blocks or subjects in playlist
Thank you very much sir 🙏
great sir
Very helpful sir
Well explained sir👏👏
Every nice explanation by dr . Gireesh kumar sir. For the patient who developed end organ damage 30/70 insulin regimen is better intially or combination of 30/70 in morning plus 50/50 in evening which is better ?
Prefer short acting initially.. Elimination will be delayed, also glucoeogensis can be affected..
@@AETCMEmergencyMedicine Subscribe
Thank you team, doing great job👍could you please make some video on management of hypercalcemia
Already available please check
Thank you sir 🙏
Is there chance of getting encephalopathy in pt with hypoglycemic coma
Dr.giresh Kumar Sir clinical approach regarding book name please mention sir
SIR, we see many clinicians prescribing pregabalin/neuroforte for DM patients with peripheral neuropathy and dont add insulin? whats your take on that
Is it ok to discharge a patient with hypoglycemia secondary to OHA?
What about sepsis? we have to do any workup, dont we?
Admit
In hypo condistion we can give sugar substance directly like tea coffee any juice ?
If pt is conscious you can give
Thanku so much for this video..its really helpfull ...plz upload video on important of renal and urethral stone size and location..
Already available please check
👌💯
In outside setting other than hospital...how much tablespoon of sugar should be given to a hypoglycemic patient? Is there any specific quantity ?
Rule of 15 you can remember, 15 g of glucose will increasse by 15 mg/dl over 15 mts
@@AETCMEmergencyMedicine thank you sir
Send the link for peripheral neuropathy & cellulitis
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A woman of 46 yo feeling frequently hungry and associated fatigue ,dizziness despite of taking meal timely . (Polyphagia) . RBS is 100-110 generally. What could be the reason? Is she going towards the prediabetic zone. But her glycated HbA1c is within normal limits.
RBS test done within one or two hours of eating then the RBS normal value should be 180 mg/dl as per the American Diabetes Association and the RBS normal range should be anywhere between 80 mg/dl and 130 mg/dl prior to eating for healthy blood sugar levels in the body.
Best approach should be
Check the timings of RBS test and then make Differentials accordingly
Drugs/ diet
Infection
Endocrine (hyperthyroid)
Great sir ….plz make a video on sepsis
Alreday available please check
What to do for refractory hypoglycemia
Glucagon
Daily choco 🍫 bd
Why we should give thiamine with dectrose in alcoholic hypoglycemia
Which mechanism here helps
Pls watch the video on alcoholic withdrawl
@@AETCMEmergencyMedicine thank you
Excellent discussion!
Sir A 52 year old man whose HbA1 11.3 % after 3 months completion of triple therapy of metformin,empagliflozin,sitagliptin
What is the next step of managment Adding insulin ? If we are going to add insulin what type it should be ?( insulin lispro or NPH insulin or soluble insulin ?
Start with short then long
Start sulphonylureas if not control b
Then insulin
Hi sir,my hand is fractured ,orif was done....I plan to take emergency medicine in future....is there any problem with fractured hand while doing emergency medicine dutys??
If you are able to day today activity without trouble it should be fine..try doing cpr in a manikin if you dont have any issues then it should be fine
@@AETCMEmergencyMedicine thnq sir 🙏
Hello sir, i had received a 26 year old female patient who was a student, with a history of sudden loss of consciousness while walking and the patient fell down. The patient was brought in an unconscious state and on doing grbs she was found hypoglycemic with grbs of 60mg/dl. Even after giving her iv bolus of 25D and also iv DNS infusion, she couldn't gain her consciousness and was repeatedly becoming brady from a normal PR to a PR of 48 (Hypoglycemic brady cardia). The case was then reffered to higher centre. What was tge reason she was not gaining her consciousness and was becoming hypoglycemic repeatedly .?
prolonged hyooglycemia which could have affected the CNS can have similar episodes, but need to look for other causes of altered sensorium as 60 mg/dl of glucose might not be the culprit.. Usually hypoglycemia coma will be less than 30mg/dl..
Sir can we give the 25 percent dextrose through peripheral lines?as we have studied that the maxm 12.5 percent dextrose can be given through peripheral lines.
Yes
Insulin pen
?