Dr. S. Merish

surviving sepsis campaign 2026: What changed in pediatric sepsis management at the bedside according to the new guidelines? #sepsis #PedsICU #ssc2026 @yoncabulutmd @SapnaKmd @rjabornisky @danicds72 @ClaudioFlauzino @sgdambrauskas

Cardiometabolic Consequences After Discontinuation of GLP-1 RA dom-pubs.onlinelibrary.wiley.com/doi/abs/10.111… @DrNadolsky @DrKarlNadolsky @NutritionMadeS3 @drmatthewnagra @BevTchangMD @MichaelAlbertMD

Causes of gastrointestinal malabsorption

Exercise timing and circadian regulation of metabolism in type 2 diabetes cell.com/trends/endocri…

MDNIY under the @moayush presents a NEW module - “Yoga for Air Travel.” A 5-Minute In-Flight Yoga Protocol for Frequent Flyers designed to help reduce travel fatigue and support physical & mental well-being during flights. From postural stiffness and poor circulation to dehydration, jet lag, and travel stress, long flights can challenge your health. This simple seated Yoga, breathing, and meditation routine can be practiced right in your airplane seat. @PIB_India @mygovindia @MoCA_GoI @RamMNK

Types of Vaginal Discharge & What They Mean

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PhD Students – Use this FREE tool to analyze data in 10 sec. This tool is used by more than 500,000 researchers. 1. Go to answerthis.io/home-2?ref=fah… 2. Click on Data Analysis and upload your data file. 3. Write your prompt for data analysis. 4. For example, generate graphs for data analysis. 5. @answerthisio will generate variety of graphs for you. 6. It also generates an insightful data analysis report. You can download the graphs and the report. Try AnswerThis today. It’s FREE. AnswerThis link: answerthis.io/home-2?ref=fah…

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How to write an abstract for your paper. You can do it in 5 parts: 1. Background 2. Justification 3. Major Finding 4. Key Results 5. Conclusion But these are the basics. Apply and adjust. Follow me for me for more writing tips. #phd #Research

If choosing the right statsistical test gives you anxiety.. Save & Share this quick reference guide of common statistical tests ⤵ [descriptive stats set the stage but aren't a test] ✅ Z-Test: Large samples with known population variance ✅ T-Test: Comparing means, typically for smaller samples ✅ ANOVA: Juggling 3+ groups? This is your go-to ✅ Pearson's Correlation: Linear relationships between continuous variables ✅ Mann-Whitney U: Non-parametric alternative when normality is violated To pick a test, understand WHY it fits your data and research question! 💬 𝐖𝐡𝐢𝐜𝐡 𝐬𝐭𝐚𝐭𝐢𝐬𝐭𝐢𝐜𝐚𝐥 𝐭𝐞𝐬𝐭 𝐰𝐨𝐮𝐥𝐝 𝐲𝐨𝐮 𝐚𝐝𝐝? 𝐏𝐒. 𝘓𝘦𝘮𝘮𝘦 𝘬𝘯𝘰𝘸 𝘪𝘧 𝘺𝘰𝘶'𝘥 𝘭𝘪𝘬𝘦 𝘢 𝘗𝘋𝘍 𝘰𝘧 𝘵𝘩𝘪𝘴 𝘨𝘶𝘪𝘥𝘦! ------------------------------------------------------ Useful find? Pass it on! 🔄 𝐑𝐞𝐩𝐨𝐬𝐭 Receive exclusive FREE tips on using AI in research ⤵️ 🔗 in bio & Click @RaziaAliani + follow + 🔔 I test AI tools to simplify your research & analysis (& 𝘤𝘰𝘯𝘥𝘶𝘤𝘵 𝘵𝘳𝘢𝘪𝘯𝘪𝘯𝘨𝘴 𝘰𝘯 𝘵𝘩𝘦𝘮)

Lipids simplified! 🧱 Cholesterol – is the material needed for building cell walls, making hormones etc 🛻 Lipoproteins - are basically Trucks transporting Cholesterol along with other things through blood. Depending on size they are of many types. ⛽ Triglycerides – are portable Fuel containers that trucks are carrying along. 🚛 HDL – They are the Recycling Trucks the patrol the roads collecting leftover cholesterol bricks from tissues & arteries, & bringing it back to the liver’s recycling center. HDL- C in your reports is the total leftover bricks in circulation currently. 🚚 LDL – They are the Delivery Trucks that deliver cholesterol bricks from the liver warehouse to construction sites (cells) around the body. LDL- C in your reports is the total unused bricks in circulation currently. 🚨 Lp(a) - Some of these LDL delivery trucks have an extra problem. They are wheel that are extra sticky. 🚛📦 VLDL – They are the Fat Cargo Trucks that mainly transports big boxes of triglycerides (fat) from the liver to storage sites. 🪪♦️ApoB (Apolipoprotein B) - All the main delivery trucks (LDL, Lpa, VLDL..) have a common license plate called ApoB. Counting them gives an idea of the no of trucks on road currently. More means too many cholesterol bricks & extra fuel (Tg) are being transported 🪪🔹ApoA1 (Apolipoprotein A1) - The recycling trucks have a different license plate called ApoA1. If more of these license plates are in action means more cleanup is done. ————— What to Target? ▶️ Total Cholesterol: This number is important, but the break up is more important (usually high means more LDL, VLDL… hence a problem) - Total Cholesterol of around 200 with the right breakup is ideal 🟢 - Too Low & Too High is not ideal 🔴 ▶️ HDL-C: More cleaned up bricks is always better - For men > 40 mg/dL 🟢 - For women > 50 mg/dL 🟢 ▶️ Triglyceride: Lot of portable Fuel being transported means excess energy/calories in the system. - Ideal: < 100 mg/dL 🟢 - High Risk: > 150 mg/dL 🔴 ▶️ VLDL: More of portable fuel trucks is indirectly saying more portable fuel is produced. Hence It is not directly measured, but estimated as 20% of triglycerides - VLDL < 20 mg/dL 🟢 ▶️ LDL-C More unused bricks in circulation is a concern as more delivery trucks can cause a traffic jam (plaque) - Ideal: < 130 mg/dL 🟢 - High Risk: > 160 mg/dL 🔴 ▶️ Lp(a): The more unused bricks in circulation especially inside those trucks with sticky tired is a big cause of concern. But it’s not under your control. - Optimal: < 20 🟢 - SubOptimal: 20- 50🟡 - High risk: 50- 100🟠 - Very high risk > 100🔴 ▶️ ApoB: You want less of trucks with these license plate on the road. They are either carrying unused bricks or extra portable fuel, either way not good. - Optimal: < 80 mg/dL (high risk patients) : < 90 mg/dL (general population) 🟢 - High: > 120 mg/dL 🔴 ▶️ ApoA1: You want more of cleanup trucks with these license plate on the road. - Optimal: < 0.6 🟢 - Acceptable: < 0.8 🟡 - High risk: > 0.9 (men), > 0.8 (women) 🔴 ▶️ ApoB / ApoA1 Ratio: This ratio reflects the balance between Delivery trucks & Clean up trucks. More clean up trucks is always better - Optimal: < 0.6 🟢 - Acceptable: < 0.8 🟡 - High risk: > 0.9 (men), > 0.8 (women) 🔴 ▶️ Triglycerides / HDL Ratio: This ratio reflects the balance between large Cargo trucks specifically & Clean up trucks. Again more clean up trucks & less portable fuel on the road is always better - Excellent: < 1 🟢 - Good: < 2 🟡 - At risk: > 2 🟠 - High risk: > 4 🔴

Adult-Onset Still’s Disease (AOSD) Still’s syndrome, or Adult-Onset Still’s Disease, is a relatively rare systemic autoinflammatory disease, but it is clinically important because the diagnosis is often a diagnosis of exclusion, made after ruling out infections, malignancies, and autoimmune disorders. More 👇👇

Fluid restriction in patients with heart failure: a systematic review heart.bmj.com/content/early/…

How to lower high sensitivity CRP (hsCRP) 🟢Target Goal: hsCRP less than 2.0 mg/L Step 1: Lifestyle Measures ▶️Eat an Anti-Inflammatory Diet: 🔸Focus on deeply coloured vegetables (such as spinach), berries, walnuts, and fatty fish (salmon/mackerel) rich in Omega-3 fatty acids. 🔸Use spices such as turmeric and ginger in your cooking; they have natural anti-inflammatory properties. 🔸Avoid highly processed foods, sugary drinks, and refined flours, which act like "fuel" for the fire. ▶️Consistent, Moderate Movement: 🔸Aim for 30-40 minutes of brisk walking 5 days a week. 🔸You don’t need to be an elite athlete; consistent, moderate activity is often better at lowering hsCRP than extreme, irregular workouts. ▶️Prioritize Your Sleep: 🔸Lack of sleep (less than 6 hours) significantly spikes inflammation. 🔸Aim for 7–8 hours of quality rest to allow your body to "reset" its inflammatory markers. ▶️Manage Visceral Fat: 🔸Belly fat spikes up the inflammatory chemicals. 🔸Losing even 3–5 kg can drastically lower your hsCRP levels. Quit Smoking: If you are a smoker, quit smoking Step 2: Medical Management If lifestyle changes are not enough to reach the target of < 2.0 mg/L, we may use specific medications to lower the "residual risk": 🔸Statins: These are "dual-action" drugs; they lower your cholesterol and your inflammation. 🔸Low-Dose Colchicine: A targeted anti-inflammatory medication (now a Class IIa recommendation for heart patients) that specifically lowers the risk of another heart event. 🔸Bempedoic Acid or GLP-1s: Depending on your other health needs (like weight or statin tolerance), these can provide significant inflammation-lowering benefits. Dr. Sudhir Kumar Department of Neurology, Apollo Hospitals, Hyderabad Follow for updates: @hyderabaddoctor

Patient: "I have been on Pantoprazole daily since 2006." What’s the FIRST clinical sign or lab abnormality you’re looking for? 👇

🛑 Answer: Vitamin B12 deficiency 🔷️ Long-term PPI use ↓ gastric acid 🔷️ Impaired release of Vitamin B12 from food 🔷️ Leads to B12 malabsorption over time 🔷️ Megaloblastic anemia may develop 🔷️ Peripheral neuropathy / paresthesia can occur 🔷️ Glossitis & fatigue are common clues 🔷️ Check serum Vitamin B12 levels in chronic PPI users.

2026 ACC/AHA Dyslipidemia Guideline — Key Points 1️⃣ LDL targets are officially back The 2018 guideline emphasized percentage reduction. The 2026 guideline reintroduces explicit LDL goals. Typical targets: Clinical settingLDL goal High ASCVD risk primary prevention<70 mg/dL Secondary prevention<55 mg/dL Severe hypercholesterolemia<100 or <70 mg/dL depending risk Percent reduction remains important: •Moderate statin → 30–49% reduction •High-intensity statin → ≥50% reduction This hybrid strategy combines relative reduction + absolute targets.  2️⃣ Universal Lp(a) measurement For the first time: ➡ Measure Lp(a) at least once in all adults Thresholds: •≥50 mg/dL (125 nmol/L) → risk-enhancing •≥100 mg/dL (250 nmol/L) → ~2× ASCVD risk Management: •Intensify LDL lowering when elevated.  3️⃣ ApoB enters clinical decision making ApoB testing is recommended when: •triglycerides elevated •diabetes •very low LDL levels •suspected residual risk It helps identify atherogenic particle burden when LDL appears controlled.  4️⃣ New risk calculator: PREVENT equations The guideline replaces Pooled Cohort Equations. New system: PREVENT-ASCVD Risk categories: Risk10-year risk Low<3% Borderline3–5% Intermediate5–10% High≥10% Used for ages 30–79.  5️⃣ CAC scoring becomes central CAC is strongly integrated in treatment decisions. Key recommendations: •CAC = 0 → therapy can be deferred in selected patients •CAC ≥100 → statin recommended •CAC ≥300–1000 → aggressive LDL targets Also important: ➡ Incidental CAC on non-cardiac CT should influence treatment decisions.  (This has big implications for CT imaging specialists.) 6️⃣ Earlier treatment philosophy Major conceptual shift: Reduce lifetime exposure to atherogenic lipoproteins. Treatment may start earlier if: •LDL ≥160 mg/dL •family history •subclinical atherosclerosis Even in relatively low 10-year risk patients.  7️⃣ Expanded drug arsenal Guideline integrates new agents: DrugClass PCSK9 inhibitorsmonoclonal antibodies InclisiransiRNA Bempedoic acidACL inhibitor EvinacumabANGPTL3 inhibitor OlezarsenapoC3 inhibitor These are used to reach LDL goals when statins insufficient.  8️⃣ Dyslipidemia definition expanded The guideline is renamed “Dyslipidemia” rather than “Cholesterol” to reflect broader biology: Includes: •LDL •triglycerides •remnant particles •Lp(a) ASCVD risk is considered apoB-lipoprotein driven, not LDL alone.  9️⃣ New emphasis on subclinical atherosclerosis Patients with: •CAC ≥100 •incidental coronary calcification •imaging evidence of plaque should receive lipid-lowering therapy even without clinical ASCVD.  🔟 Hypertriglyceridemia management updated Important additions: •apoC3 inhibitor olezarsen for familial chylomicronemia •statins remain first-line for ASCVD prevention •triglyceride therapy mainly for pancreatitis prevention.  💡 Big conceptual shifts The 2026 guideline essentially reflects three paradigm changes: 1️⃣ Lifetime exposure model Risk depends on years of exposure to apoB lipoproteins. 2️⃣ Imaging-guided prevention Subclinical disease → treatment. 3️⃣ Particle-based risk LDL alone is insufficient → ApoB and Lp(a).

This 50-minute lecture by Jeff Bezos will teach you more about business than a 2-year MBA program:

The Women’s Microbiome ▶️ This narrative review synthesizes current molecular insights into the women’s microbiome across endocrine interactions, pregnancy, reproductive & metabolic health, lifestyle influences, & microbiome-based therapeutic strategies ▶️ Accumulating evidence demonstrates that microbial ecosystems across the gut, vagina, skin, breast tissue, & reproductive tract are dynamically shaped by female hormones, life-stage transitions, & environmental exposures. ▶️ These interactions influence immune regulation, metabolic homeostasis, reproductive outcomes, mental health, & cancer risk, in part through microbiome-mediated endocrine pathways such as the estrobolome. ✅️ This review positions the microbiome as a critical yet underutilized axis in women’s health & outlines a roadmap toward personalized, evidence-based care across the female lifespan. mdpi.com/1422-0067/27/6… Microbiome dynamics across the female lifespan & stage-specific microbiome-targeted recommendations. Illustration depicting hormonal fluctuations across key female life stages—puberty, reproductive years, pregnancy, postpartum, & menopause—& their associated effects on gut and vaginal microbiome composition & function. The upper panel shows hormonal fluctuations over the female lifespan w/consequent changes in gut & vaginal microbiomes. The lower panel highlights recommended microbiome-supportive interventions, including dietary fibers & polyphenols, probiotics (e.g., Lactobacillus crispatus, Bifidobacterium spp.), nutrient-rich or healthy dietary patterns, & postbiotics such as short-chain fatty acids (SCFAs) & indole derivatives.