Razib Ahmed Raj

03/10/2025

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03/10/2025

🔴 Potassium (K⁺)
• Normal range: 3.5 – 5.0 mEq/L
• Role:
• Essential for heart and muscle function
• Maintains fluid balance and blood pressure
• Interactions:
• ↑K⁺ = ↓Na⁺
• ↓K⁺ = ↑Na⁺
• ↑K⁺ = ↑Mg²⁺
• ↓K⁺ = ↓Mg²⁺

💧 Sodium (Na⁺)
• Normal range: 135 – 145 mEq/L
• Role:
• Regulates blood volume and blood pressure
• Maintains fluid balance
• Interactions:
• ↑Na⁺ = ↓K⁺
• ↓Na⁺ = ↑K⁺

⚪ Magnesium (Mg²⁺)
• Normal range: 1.3 – 2.1 mEq/L
• Role:
• Helps in muscle relaxation
• Supports the immune system
• Controls blood glucose levels
• Important for bone health
• Interactions:
• ↑Mg²⁺ = ↑K⁺
• ↓Mg²⁺ = ↓K⁺
• ↑Mg²⁺ = ↑Ca²⁺
• ↓Mg²⁺ = ↓Ca²⁺

🧠 Calcium (Ca²⁺)
• Normal range: 8.5 – 10.5 mEq/L
• Role:
• Provides neuron stability
• Maintains bone strength
• Regulates heart rate
• Essential for clotting factors (blood clotting)
• Interactions:
• ↑Ca²⁺ = ↑Mg²⁺
• ↓Ca²⁺ = ↓Mg²⁺

29/09/2025

Extra Corporal Membrane of Oxygenation

21/09/2025

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Hyperkalemia ⚡ (K⁺ >5.5 mEq/L)

Causes ⚠️

Renal failure / CKD

Drugs: ACEi/ARB, K⁺-sparing diuretics, NSAIDs

Cell lysis: Rhabdomyolysis, Tumor lysis, Hemolysis

Metabolic acidosis, Addison’s disease

Symptoms 🤒

Muscle weakness, paralysis

Paresthesia

Cardiac: Palpitations, arrhythmias, cardiac arrest

Investigations 🔬

Serum K⁺ >5.5 mEq/L

ECG: Peaked T waves → wide QRS → sine wave

ABG: metabolic acidosis (sometimes)

Renal function tests

Treatment 💊

Stabilize heart: IV Calcium gluconate

Shift K⁺ into cells: Insulin + glucose, β₂-agonists, NaHCO₃ (if acidosis)

Remove K⁺: Loop diuretics, dialysis, cation-exchange resins (e.g., sodium polystyrene)

Stop offending drugs

21/09/2025

️🏥🩺

🧪 CAUTI = Catheter-Associated Urinary Tract Infection

🛑 Risk Factors:

Long-term catheter use

Poor hygiene or insertion technique

Immunosuppression, female gender

🔍 Diagnosis:

Urine Routine, Culture

CBC

Ultrasound KUB

💊 Treatment:

Remove/replace catheter

Start antibiotics (e.g., Nitrofurantoin, Ceftriaxone)

Hydration + symptom relief

🛡️ Prevention = Key!
✅ Aseptic insertion
✅ Daily care
✅ Early removal
✅ CAUTI bundle compliance

21/09/2025

TYPES OF OXYGEN EQUIPMENT

Cannula:
• Flow: 1–6 L/min
• FiO2: 24–44%
• Supported by multiple sources, which note that FiO2 increases by approximately 4% for each additional liter per minute of oxygen flow.
Face Mask:
• Flow: 5–8 L/min
• FiO2: 40–60%
• Recommended for moderate oxygen requirements, with flow rates typically starting at 5 L/min to avoid CO2 buildup.
Rebreather Mask:
• Flow: 6–10 L/min
• FiO2: 60–80%
• Delivers higher oxygen concentrations due to the reservoir bag, with some rebreathing of exhaled gases.
-Rebreather Mask:
• Flow: 10–15 L/min
• FiO2: 60–95%
• Provides the highest oxygen concentrations short of intubation, with one-way valves to prevent room air entrainment.
Mask:
• Flow: 4–10 L/min (can vary based on manufacturer and FiO2 setting)
• FiO2: 24–55% (some sources extend up to 60%)
• Allows precise control of delivered oxygen concentration, commonly used in COPD patients.
Tent:
• Flow: 10 L/min
• FiO2: Varies, often used when masks are not tolerated; typically delivers moderate oxygen concentrations.

Details
• FiO2 values are always approximate and can be affected by the patient’s breathing pattern, tidal volume, and inspiratory flow rate. Charts and tables assume average inspiratory flows for adults.
• Venturi masks are unique in their ability to deliver a fixed and predictable FiO2, making them suitable for patients who require controlled oxygen therapy.
• Non-rebreather masks are used in emergencies for rapid oxygen delivery, while partial rebreather masks are used when high concentrations are needed but not as high as with non-rebreathers.

20/09/2025

16/09/2025

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🩺 Indications for Thoracocentesis

📌 Diagnostic Indications
– Unexplained pleural effusion
– Suspected infection (e.g., empyema, TB)
– Suspected malignancy
– Hemothorax or chylothorax
– Transudate vs exudate (Light’s criteria)

📌 Therapeutic Indications
– Relieve dyspnea from large effusion
– Drain pus or blood (empyema, hemothorax)
– Palliative drainage in malignancy

⚠️ Relative Contraindications
– Uncorrected coagulopathy
– Small or loculated effusions
– Mechanical ventilation (↑ pneumothorax risk)

🛠️ Thoracocentesis – Procedure (USG-Guided)

1. Position: Patient seated, leaning forward with arms supported

2. Site: Posterior/lateral chest, 1–2 spaces below fluid level
→ Always above the rib

3. Prep: Sterile technique + local anesthesia

4. Insert Needle/Catheter: Under ultrasound guidance

5. Aspirate Pleural Fluid: Slowly, avoid excessive removal

6. Sample: Send for biochemistry, microbiology, cytology

7. Post-procedure: Monitor vitals, check for pneumothorax (CXR if needed)

⚠️ Watch for:
– Pneumothorax
– Hemothorax
– Re-expansion pulmonary edema
– Infection

11/09/2025

09/09/2025

জাপান বদলে দিল ক্ষত চিকিৎসার ভবিষ্যৎ!
ভাবুন তো, সুঁই-সেলাই ছাড়া মাত্র ১৫ সেকেন্ডে ক্ষত বন্ধ!

জাপানি বিজ্ঞানীরা আবিষ্কার করেছেন এক অবিশ্বাস্য বায়ো-জেল ব্যান্ডেজ, যা রক্তপাত বন্ধ করে দেয় মুহূর্তেই, এমনকি ভেজা বা রক্তাক্ত অবস্থাতেও।

স্বচ্ছ জেলি-জাতীয় পদার্থ, ক্ষতে লাগালে সঙ্গে সঙ্গে লেগে যায়। ১০০% বায়োডিগ্রেডেবল ক্ষত সারলেই শরীর নিজেই এটাকে শোষণ করে নেয়। দ্রুত ক্ষত সারায়, সংক্রমণের ঝুঁকি কমায়, আর সেলাই বা দাগের ঝামেলা থাকে না।

ভবিষ্যতের ব্যান্ডেজ হবে কাপড়ের নয়, জাপানের তৈরি স্মার্ট বায়ো-জেল!
আর আমাদের দেশের বিজ্ঞানীরা ফেসবুক মেসেঞ্জার আর টিকটক নিয়েই ব্যস্ত থাকে ।