ErasmusMD

@DrBalukuJoseph @OkethwenguWill2 Buh, ability to acquire knowledge in any field drives one way too far from qualifying to hold the title of “absolute” or even just “simple” “fool”. Could just mean it’s an area of non-exposure or non-interest, hence less- or uninformed, not fool.

@OkethwenguWill2 I genuinely do not think there is anyone rich in knowledge. You can have specific knowledge in paediatric haemoncology but be an absolute fool at obstructed labor.

Those rich in knowledge don't brag. The half-baked are everywhere showing off.

In light of the ongoing misinformation, we wish to clarify and set the record straight.

@LorickFox @stephanamayer @NEJM Rich experience. Pretty rare adverse events though honestly. Just bad when they happen. That Rhabdo patient though—vasculopathic perhaps?

Thanks. I have practiced in resource poor environments. The first pre-hospital arrest patient for whom I was ever the sole provider managing resuscitation walked out of the hospital but had to return for skin grafts where dopamine had infiltrated (and the hospital had NO Phentolamine-I woke the pharmacist at home). I also had a patient develop rhabdo (admittedly ONLY 1) due to too frequent NIBP cycling. (That's not supposed to happen I was assured by all) I will indeed take a look at that literature and I appreciate the data. I am definitely prejudiced: when (2000) I covered 60 ICU beds at night solo in Atlanta, GA, our standard of care was a CCO swan and A-line in every unstable patient on inotrope or pressor. We failed to track outcomes but I am confident we would have exceeded the outcomes and had shorter LOS compared with other centers. Since none of the studies that were used to discredit swans used CCO swans, I still maintain that those studies used obsolete equipment (not SvO2) and thus should not have changed care (to discourage swans). During my almost 8 years in Egypt, I had many smart and capable Egyptian colleagues, but when I needed surgery I came home, not for the surgeon, but for the ICU should there be a problem (there wasn't, went home same day after lap chole😂)

This mind-bending @nejm trial randomized septic shock patents to A-line vs cuff BP monitoring The signal showed that outcomes were actually worse in those randomized to A-line. By a bit. So at least cuff monitoring is non-inferior. I find that I am using A-lines less and less with patients on vasoactive meds. What about you? nejm.org/doi/full/10.10…

@LorickFox @stephanamayer @NEJM You may need to dig into the experiences of leading practices in the LMICs where circumstantial lack of resources for invasive lines forces them to use inopressors peripherally & NIBP in place of A-lines. Their data would inform practically the gravity of risk taught about these.

I am amazed at the data, haven't had time to review study in any detail, however, if someone is so poorly perfused that they require pressors, they are not stable and so the question is how often will you cycle that BP cuff, and will it catch sudden decompensation? If I'm in ICU and on levo, epi, or Neo, please place an A-line.

Advanced Trauma Life Support simulation skills session for the medical students with Dr. @ErasmusMD The next session will focus on Basic Life Support and Advanced Critical Care Life Support.

✅ Day One of #AAUxICSU2025 was a success! Insightful sessions, engaging discussions, and great connections all around. See you tomorrow for Day 2 of 3 — more learning, sharing, and innovation ahead! 🙌

The anaesthesia fraternity, friends, and partners united at the #AAUxICSU2025 — sharing knowledge, strengthening collaborations, and celebrating progress in anaesthesia and critical care.

@rkalyes1 @DrOribaDan @YaleNephrology @ACCESS_UG @AfricanAFRAN @ISNkidneycare @SemitalaFred @CelestinoGutirr @kafeeromj @ASNM39971 @graekan @eddympuuga

@rkalyes1 @DrOribaDan @YaleNephrology @ACCESS_UG @AfricanAFRAN @ISNkidneycare @SemitalaFred @CelestinoGutirr @kafeeromj @ASNM39971 @graekan @eddympuuga Rastegar, Asghar! Peerlessly the kindest, humblest, yet most brilliant Physician I’ve met in my no longer short life. A walking monument of clinical & academic excellence. Total inspiration!

🔥 We just had lunch with my mentor and his family. 🔥 He is a fountain that never stops giving. 🔥 He urged me to finalize my biography & put great emphasis on my health as I prepare to hit the 5th floor. 👇 If you have no mentor(s), you are definitely lost! @YaleNephrology

@NutritionistKD We are all entirely reliant on each other. But in our attempts to coordinate this reliance, we have turned cooperation into competition. Let’s allow the advances in medicine and specialization to free us of burdensome barriers to excellence so we reach the best of ourselves.

@NutritionistKD There is a lot a pharmacist does and the same applies to other providers in healthcare. The idea is to bring the best of all specialists in healthcare together to serve the best care package to the patient. It’s collaborative. Every specialist knows their role professionally.

@rkalyes1 @DrOribaDan @ChefKarim02 @ACCESS_UG @DennisPhd1 @dr_katumwa @dr_RaymondM @graekan @KisuuleIvan3 @SemitalaFred @CelestinoGutirr If it was one of you, I’m moving a motion to suspend the NHL Intensivist that day from AAU/ICSU membership for a year! So uncritical! Usually you two would argue in some corner as the dose goes in, ensuring the patient is alive long enough to see each one of you claim the dose 😂

@DrOribaDan @ChefKarim02 @ACCESS_UG @DennisPhd1 @dr_katumwa @dr_RaymondM @graekan @KisuuleIvan3 @SemitalaFred @CelestinoGutirr There you go! Of course you know who did the last prescription!

🔥 Guess who I met in the ICU? Hint: We were arguing about the lasix dose!

@ChefKarim02 @NiravValand30 @rkalyes1 Things haven’t been critical here in a while. Regular people things mostly 😉. I’m good…

Where is Doctor @ErasmusMD, Doctor @NiravValand30 are they safe well and good. Doctor @rkalyes1

During critical illness, the body shifts into survival mode — shutting down non-essential functions like skin renewal, hair growth, and fertility. Weight loss, dry skin, darkening, and brittle nails are common. These changes often reverse with recovery. #DearPatientSeries

In the ICU, the body is already under intense stress — and life-saving tubes and catheters can open doors for infection. That’s why strict infection control, like limited physical contact, is essential to protect your loved one during this critical time. #DearPatientSeries

@SeniorBala @francis_kuloba @IGNATIOUST Deuteronomy 14:22-26

@francis_kuloba @IGNATIOUST Is not tithing a sin? I need scriptural guidance

Rethinking Tithing ✋🏽📖 Let’s be honest — tithing as it’s often preached today doesn’t match what Scripture actually teaches. In the Old Testament, tithing was about crops and livestock, given under the Law to support the Levites and care for the needy. It was never about mandatory money-giving for everyone. As New Covenant believers, we’re not under that system anymore. The New Testament encourages generosity, not percentages: “Each one must give as he has decided in his heart, not reluctantly or under compulsion…” (2 Cor 9:7) We give — not because of fear or obligation — but out of love, freedom, and faith. Let’s stop preaching guilt-based giving and start embracing Spirit-led generosity. 💛

@mugyenyi01 @rkalyes1 @DrOribaDan @TSM_Humanist @ChefKarim02 @ps_lukwago @InternalmedMak @DrKisaBrian @DMavine @CelestinoGutirr @NewtonAllan6 @dr_katumwa @DennisPhd1 @drkakamekeith @JoyMoreen1 @dr_RaymondM Check Urine SG and correlate with possibility of cDI. To estimate Urine Osmo, multiple the last two digits of the Urine SG by 30. Check if it falls in the range of DI for that much volume lost.

@rkalyes1 @DrOribaDan @TSM_Humanist @ChefKarim02 @ps_lukwago @InternalmedMak @DrKisaBrian @DMavine @CelestinoGutirr @NewtonAllan6 @dr_katumwa @DennisPhd1 @drkakamekeith @JoyMoreen1 @dr_RaymondM 𝐶𝑒𝑛𝑡𝑟𝑎𝑙 𝐷𝑖𝑎𝑏𝑒𝑡𝑒𝑠 𝑖𝑛𝑠𝑝𝑖𝑑𝑢𝑠 2ⁿ 𝑡𝑜 ℎ𝑦𝑝𝑜𝑡ℎ𝑎𝑙𝑎𝑚𝑖𝑐 𝑜𝑟 𝑝𝑜𝑠𝑡𝑒𝑟𝑖𝑜𝑟 𝑝𝑖𝑡𝑢𝑖𝑡𝑎𝑟𝑦 𝑖𝑛𝑗𝑢𝑟𝑦 𝑎𝑓𝑡𝑒𝑟 𝑏𝑟𝑎𝑖𝑛 𝑠𝑢𝑟𝑔𝑒𝑟𝑦 -𝑅𝑒𝑑𝑢𝑐𝑒𝑑 𝑚𝑒𝑛𝑡𝑎𝑡𝑖𝑜𝑛 𝑚𝑎𝑦 𝑏𝑒 𝑑𝑢𝑒 ℎ𝑦𝑝𝑒𝑟𝑛𝑎𝑡𝑟𝑒𝑚𝑖𝑎...

🏥 A 47 yr old soldier presents with reduced mentation. 🔥 After undergoing a 🧠 surgery. He passed 4.5 liters of urine in 11 hours. 👉 What is going on here? 👉 What do we do next? @DrOribaDan @TSM_Humanist @ChefKarim02 @ps_lukwago @InternalmedMak

@rkalyes1 @DrOribaDan @TSM_Humanist @ChefKarim02 @ps_lukwago @InternalmedMak @DrKisaBrian @DMavine @CelestinoGutirr @NewtonAllan6 @dr_katumwa @DennisPhd1 @drkakamekeith @JoyMoreen1 @dr_RaymondM Head injury (surgical), postop polyuria, Urine SG 1.020 ~UOsm 600 -What’s hemodynamic state? JVP? -How much mannitol did he get periop for brain relaxation and/or postop for apparent control of post surgical brain swelling? -Serum & urine electrolytes for CSWS please?

@rkalyes1 Do you have follow up pancreatic enzymes?

@rkalyes1 Degree of peritonism may be less in chemical peritonitis than septic so classic signs of peritonitis may not play out. Still the ascitic fluid analysis should give it away.

📚 Our patient had obstructive jaundice. ERCP was done and a stent was placed. 🔥 His jaundice worsened! X ray and. Shows air fluid level and a stent( probably obstructed). C-xay shows raised hemi diaphragms from abd distension. Kidney injury- from IAP and pre renal. 👇