Hypothyroidism in pregnancy

 Hypothyroidism in pregnancy is most common finding after diabetes in pregnancy. We should never take hypothyroidism lightly. Hypothyroidism causes more birth defects than does hyperthyroidism. Children born to mothers with severe, untreated hypothyroidism during pregnancy has chances of lower IQ scores and impaired mental development. I think, you can still have a perfectly normal child if the treatment goal is maintained at thyroid hormone level within high normal range. Col Pradeep Pendyala 🙏

Women

 I always have great regards for women ...I know too very well that they've different qualities and different skills. Frankly, they are more creative ...have more integrity and have more strength of personality. It just takes fifteen seconds to know that they're better skilled. One should learn how to multitask from them. They always act and behave in a way which I admire the most... Col Pradeep Pendyala 🙏🙏

Renal failure

 Millions die of renal failure each year. When your kidneys fail, it means they have stopped working well enough to survive without dialysis or a kidney transplant. It's also known as end stage renal disease. The most common cause being hypertension or diabetes. Treatment is either dialysis or renal transplant at a later stage. Kidney can be donated from the living donor or a deceased donor. There are legal and ethical aspects of organ transplantation. I would say, keep your kidneys healthy by healthy food, physical activity and managing your blood pressure and diabetes. Col Pradeep Pendyala 🙏🙏

Vocabulary

 Vocabulary has always fascinated me. I did read few books on vocabulary improvement but they were not much of a help. I think, it can improve only if you have good reading habit and you watch lots of movies and use dictionary or Google search more often, whenever you come across a new word. Usage of new words in your conversation or in writing would definitely improve your skills. By improving your vocabulary, you'd definitely improve your communication skills 🙏🙏Col Pradeep Pendyala

Tranexamic acid

 Postpartum haemorrhage has been a nightmare for obstetricians as well as the Anaesthesiologists since ages. Active management of the 3rd stage, in the form of intramuscular ergometrine at delivery of the anterior shoulder or 10-20 units of oxytocin infusion in 500 ml of normal saline and a controlled cord traction are practised routinely. Uterine atony, retained placentae and ruptured uteri are very often the real cause. But I also feel sincerely that morbidity in such cases do happen due to the late arrival at the hospital.As a last resort to control bleeding, major surgical interventions such as hysterectomy and bilateral uterine artery ligation are also required occasionally. In my experience, one drug which should not be forgotten in such cases is Tranexamic acid...Tranexamic acid is cheap, heat-resistant, easy to store  and it is proven to save lives. Col Pradeep Pendyala

Intralipid

 Maximum dose of lidocaine (plain, without vasoconstrictor)  is 4.5 mg/kg (not to exceed 300 mg) and similarly for Bupivacaine it's 2.5 mg /kg not to exceed 175 mg in a single dose. These figures could be read in almost all the standard text books of Anaesthesiology. But interestingly, nowhere it's written what's the safe dose of each of them when they're mixed together. As we're aware we always mix these two drugs when we give blocks. Wonder why no author has ever bothered to write about the safe dose when they're mixed. Accidental intravascular injection is the major cause of systemic toxicity, for example, regional anesthesia of the neck (interscalene block ) can cause direct intra-arterial injection and cause rapid toxicity from early entry to the cerebral circulation. Epidural anesthesia holds a risk of intravenous injection into the engorged epidural venous plexus of the parturient. The accidental overdose of local anaesthetics may prove fatal. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anaesthetic for  cardiotoxicity. Hence I would request all  Anaesthesiologists to keep intralipid always available in the operation theatre fridge. Col Pradeep Pendyala.