While historically, NS and RL have been thought to be generally equivalent for resuscitation, there has been an associated risk of hyperchloremic metabolic acidosis with large-volume resuscitation using normal saline. Hyperchoremic metabolic acidosis has been found to increase the risk of acute kidney injury. This is thought to be due to the…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Wound Strength
Wound strength is determined by both quantity and quality of collagen and an appropriate balance of deposition and breakdown. The amount of collagen in a wound plateaus at several weeks post-injury. Timeline: 1. First few weeks: Strength increases rapidly, reaching about 20% of pre-injury strength at 3 weeks. 2. Around 6 weeks: Wound strength…
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Dementia vs. Normal Aging: Understanding the Differences
When an older loved one begins forgetting things, it’s natural to wonder if it’s just part of aging, or something more serious like dementia. The two lines can feel blurry, especially in the early stages. Families often struggle with knowing when to be concerned, what to expect, or how to…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
SIMPLE approach to Nutritional Care in Elderly Patients
The essence of this approach is that, rather than requiring a highly specialized nutritionist, a systematic assessment on the part of all the disciplines that are interacting with the patients can achieve what is needed for the nutritional care of the older patient with a fragility fracture, regardless of setting…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
How to Fix the Skin That Overreacts to Almost Everything
If your skin throws a tantrum every time you try something new, you’re certainly not alone, and no, it’s not “all in your head.” While it may seem like your face has declared war on every product in existence, the reality is far different. Studies show that dermatological disorders affect…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Golden Rules of Anesthesia : Mnemonic
The “golden rules of anesthesia” are a set of principles and practices designed to ensure patient safety during anesthesia administration. These rules emphasize careful pre-operative preparation, vigilant intraoperative monitoring, and prompt management of potential emergencies. Mnemonic: ANESTHESIA
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Dexmedetomidine – Mnemonic
Mnemonic: BARASH Uses of Dexmedetomidine: This mnemonic, BARASH, is dedicated to Dr. Paul G. Barash, whose work in anesthesiology has profoundly shaped medical education and clinical practice. Just as his textbook has guided countless practitioners, may this mnemonic serve as a concise tool for remembering key concepts with clarity and…
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How to Get Over Long-Term Prescription Opioid Use Following Surgery
Most people walk into surgery expecting that the after-effects will fade with the stitches. Yet for many, the strongest echo of the operation is a small plastic bottle of prescription opioids that never seems to empty. When it comes to short-term pain, opioids can offer really effective relief. But when…