From Obese to Lean

I am not a fan of Hindi movies. Usually my wife has to drag me kicking and screaming to watch a Hindi movie with her . The same happened this weekend when I accompanied my wife  to watch a Hindi movie named Dangal (has English Subtitles). Boy, was I in for a surprise. This movie... Continue Reading →


Encouraging the Veteran’s use of the VA Patient Portal

Encouraging the veteran to use the patient portal goes a long way in making life easier for the veteran. Instructions detailing setting up of an account at the patient portal must be given to the veteran at their very first visit to see their PCP (Primary Care Provider). Getting access to the patient portal offers... Continue Reading →

Anticoagulation after Intracranial Hemorrhage in Atrial Fibrillation

Do you continue  anticoagulation in a patient who comes in with Intracranial Hemorrhage secondary to anti-coagulation for atrial fibrillation? In the initial phase, the answer is easy. NO, you immediately discontinue anticoagulation and reverse the Anti-coagulant. For Warfarin, use FFP, Prothrombin Complex Concentrate or Factor VII. If the bleed is critical and the patient needs... Continue Reading →

Brain Death

Most of us are uncomfortable in declaring  Brain Death. Through this post, I want to attempt to increase your comfort level in the determination of brain death. Death as we know it can be Cardiac or Neurologic. Cradiac death fortunately remains something most physicians are comfortable pronouncing. Brain death on the other hand is a... Continue Reading →

Hypertension management in stroke

1. When should I treat severe  hypertension in patients with acute  brain  injury? Does treatment treshold/target differ between patients? TREATMENT target for different conditions vary Ischemic Stroke - in acute setting (within first few hours after onset of symptoms) no need for active treatment unless SBP > 220 or DBP > 110 HOWEVER, if patient... Continue Reading →

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