Piyush

student

[Association of International Doctors. (India). @int_doctors]

Dr. Abhishek Shukla (Geriatrician) in Conversation with Dr. Mridul Mehrotra (MBBS, MD – KGMC, Lucknow), Senior Pathologist

Urinary tract infections (UTIs) are among the most common bacterial infections, particularly in older adults. In an insightful discussion, Dr. Abhishek Shukla spoke with senior pathologist Dr. Mridul Mehrotra about the interpretation of urine reports, the significance of pus cells, and the role of Minimum Inhibitory Concentration (MIC) in antibiotic selection.

Dr. Mehrotra explained that the traditional belief that a UTI can only be diagnosed when urine contains more than five pus cells is now outdated. Modern medicine recognizes that infections caused by organisms such as Chlamydia, anaerobic bacteria, or certain viruses may produce little or no pus cells despite causing significant urinary symptoms. Therefore, a normal urine microscopy does not always rule out infection. Clinical symptoms, patient history, and, when required, specialized laboratory investigations remain essential for an accurate diagnosis.

The discussion also highlighted the importance of MIC (Minimum Inhibitory Concentration), which represents the lowest concentration of an antibiotic required to inhibit bacterial growth. In general, a lower MIC indicates that the organism is more susceptible to that antibiotic. However, laboratory sensitivity results are performed in vitro, whereas treatment occurs in vivo, and the two may not always correlate perfectly. Slow-growing organisms such as Enterococcus faecalis may initially appear sensitive but later demonstrate resistance, emphasizing the need for clinical judgment alongside laboratory findings.

Dr. Abhishek Shukla concluded by stressing that UTIs in elderly patients should never be ignored. Untreated infections can progress to pyelonephritis, kidney damage, urosepsis, and even life-threatening complications requiring intensive care. Early diagnosis, timely urine culture, appropriate antibiotic therapy, and careful interpretation of laboratory reports are the keys to preventing these serious outcomes and ensuring the best possible patient care. #Microbiology #AntimicrobialResistance #AMR#Antibiotics #MedEd #ClinicalMicrobiology#InfectiousDisease #infectioncontrol #UTI #UTIAwareness #UrinaryTractInfection#WomensHealth #UrinaryHealth #Infection

[ANI @ANI]

#WATCH | Arrah, Bihar | Bharat Tiwari case | Family member of Bharat Tiwari says, "All the guilty police and officials are involved in this incident... Until the arrest of Jagdishpur DSP Rajesh Sharma, Shahpur police station SHO Rajesh Kumar Mallkar, SI Ankit Aryan, and STF jawan Akshay Kumar, my mother, Asha Devi, will continue her indefinite fast. The security of my family should be ensured at the earliest. If any official related to this case is coming for investigation, they should inform me. So that cooperation can be provided in the investigation. The false case registered by the police against the people of my village should be withdrawn at the earliest..." (04.07)

[Association of International Doctors. (India). @int_doctors]

How do you identify the patient's most important complaint in the Emergency Department? According to Dr. Abhishek Shukla (Geriatrician), the first step in emergency medicine is not prescribing medicines—it is understanding why the patient has come to the hospital today. Every emergency assessment begins with effective communication, careful history-taking, and identifying the Chief Complaint or Most Relevant Complaint.

The doctor should begin with simple, open-ended questions such as, "What happened? Where is the pain?" If the patient says, "I have unbearable pain," it should be documented precisely as severe pain in the back and both legs. Other symptoms should also be recorded accurately, such as increased thirst or difficulty holding urine with involuntary urinary leakage.

Further questioning often uncovers the real problem. If the patient has gradually become weak, dependent on family members, and unable to perform daily activities or climb stairs normally, these findings suggest progressive mobility impairment and possible underlying serious illness.

Dr. Shukla emphasizes remembering the Four I's of Geriatrics: Immobility, Instability, Incontinence, and Intellectual Impairment. These common geriatric syndromes must always be evaluated while taking the history of an elderly patient.

Doctors should also inquire about previous illnesses, medications, allergies, and past hospitalizations. Finally, ask one crucial question: "What is the single most important reason you came to the hospital today?" The answer often reveals the patient's greatest concern and guides immediate management.

After a detailed history, a thorough physical examination, review of investigations, and correlation with previous medical records help establish an accurate diagnosis and appropriate treatment plan.

As Dr. Abhishek Shukla says, "A careful history is the foundation of emergency medicine. Identifying the true chief complaint guides every diagnosis and every life-saving decision."

#EmergencyMedicine #UrgentCare #EmergencyCare #ChiefComplaint #HistoryTaking #Geriatrics #MedicalEducation #PatientAssessment #EmergencyDepartment #DrAbhishekShukla

[उम्दा_पंक्तियां @umda_panktiyaan]

क्‍या हार में क्‍या जीत में
किंचित नहीं भयभीत मैं
संघर्ष पथ पर जो मिले यह भी सही वह भी सही
वरदान माँगूँगा नहीं

~ शिवमंगल सिंह ‘सुमन’

[HasnaZarooriHai🇮🇳 @HasnaZaruriHai]

Birthday party हो तो ऐसी! 😜🎉

[Arun K. Yadav @Arun73326698]

😆 ये वीडियो मिस मत करना! पवन सिंह (कीकू शारदा) की मस्ती, कॉमेडी और अतरंगी जोक्स आपको हंसने पर मजबूर कर देंगे। 😂🔥

[छपरा जिला 🇮🇳 @ChapraZila]

भोजपुरी में यह पंडित जी बहुत ही सुन्दर भजन गाते हैं।

[Acharya Prashant @Advait_Prashant]

मैं भूल जाती हूँ ...

[MANOJ SHARMA/ मनोज शर्मा @manojpehul]

81 साल का हो गया... बिना exercise... मदिरापान ज़रुरी है.. रोजाना : सुरेंद्र शर्मा..!!

[Singh is King @Navjotk99429168]

😲🎤 Asrani Ne Kapil Sharma Show Mein Sunayi Apni Zindagi Ki Ankahi Kahani – Hairan Kar Dene Wale Khulason Ne Sabko Kar Diya Sann! 🌟🎬

[BCCI @BCCI]

A historic day for Indian cricket 💙

Vaibhav Sooryavanshi makes his #TeamIndia debut at 1️⃣5️⃣ years, 9⃣9⃣ days 👏

#ENGvIND

[Association of International Doctors. (India). @int_doctors]

Dr. Abhishek Shukla (Geriatrician) Explained
Shreya, a nursing student posted in the Emergency Ward, asked a very practical question: “Sir, an unconscious patient was brought in with very high blood pressure, and I didn’t understand how to give the medicine. After some time, he also developed seizures.”
Dr. Abhishek Shukla asked, “What was the blood pressure?”
Shreya replied, “It was around 180/100 mmHg.”
Dr. Shukla explained that this is a classic example of hypertensive crisis—a condition where blood pressure rises so high that it starts damaging vital organs, especially the brain. In such cases, the patient may develop brain swelling, confusion, unconsciousness, and even seizures.
The first important point is: never force tablets into the mouth of an unconscious patient, as it can cause choking and aspiration.
So what should be done?
The first option is the sublingual route (under the tongue). Medicines like Nifedipine can be used. Nifedipine soft gelatin capsules can be punctured, and a few drops placed under the tongue for quick absorption. These drugs work by causing vasodilation, which widens blood vessels and lowers blood pressure.
The second option is to secure an IV line and use injectable antihypertensive medicines. Common emergency drugs include Labetalol and Enalapril, which can safely reduce blood pressure under monitoring.
Dr. Shukla clarified an important mistake: Noradrenaline (Norad) is not used to lower blood pressure. It is actually used in low blood pressure (shock) to raise BP.
The third option, if BP remains dangerously high, is an IV Nitroglycerin (NTG) infusion, started carefully with continuous monitoring.
If IV drugs are not available, a Ryle’s tube can be inserted to give oral medicines like Telmisartan or Amlodipine.
The key message: Recognize hypertensive crisis early, avoid unsafe oral administration, and act quickly to prevent brain damage or death. #HypertensiveEmergency #SilentKiller, #strokeprevention #hypertensionawareness #BloodPressure #HighBP #hypertension

[Khushboo Anand 🇮🇳 @Tchr_Khushboo]

Read the line..🧑‍🏫

[Bhumihar_of_Bihar (भूमिहार बिहार का) @BhumiharOfBihar]

शहीद भरत तिवारी के घर सब लोग आये सब ने न्याय दिलाने की बात कही।

अब धीरे धीरे लोगो का आना कम हो गया एक समय के बाद कोई नही आएगा।

राज्य मे कोई नया मुद्दा आ जायेगा सबलोग भूल जाएगे भरत तिवारी कौन थे। बस न्याय की उम्मीद मे उसके माता पिता को पुरा जीवन बिताना परेगा लेकिन न्याय नही मिलगा।
यही परम सत्य है

[Association of International Doctors. (India). @int_doctors]

Dr. Abhishek Shukla (Geriatrician) was in conversation with Dr. Mridul Mehrotra (MBBS, MD – KGMC, Lucknow), Senior Pathologist, on a very important and practical issue that doctors, nurses, and paramedical staff face almost daily — what to do when a urine culture report shows resistance to almost all antibiotics?

Dr. Abhishek asked, “Sir, many times we get urine culture reports where the bacteria, often E. coli, appear resistant to nearly every antibiotic — even levofloxacin, faropenem, or stronger drugs. If the patient has fever, burning urination, or even septicemia, how should we proceed?”

Dr. Mehrotra explained that one of the most common reasons behind such alarming reports is sample contamination. He emphasized that improper urine collection can introduce environmental or skin bacteria into the sample. These organisms may not actually be causing disease, but because they are often naturally resistant to multiple antibiotics, the report may falsely suggest a dangerous multidrug-resistant infection.

He highlighted that this problem is especially common in female patients due to anatomical reasons and greater chances of contamination during collection.

Dr. Mehrotra stressed the importance of a clean-catch midstream urine sample. Patients should wash the genital area properly before collecting the sample. In females, the labia should be separated, and in males, the foreskin should be retracted. The first part of urine should be discarded, and only the midstream urine should be collected in a sterile wide-mouthed container.

He explained that if the sample is collected properly, the laboratory can identify the true pathogen and provide an accurate antibiotic sensitivity report.

Dr. Abhishek concluded by saying that if a report shows “all drugs resistant,” doctors should not panic immediately. First, consider the possibility of contamination, repeat the urine culture correctly, and meanwhile start treatment based on clinical judgment or specialist advice. Proper sample collection can prevent confusion and guide the right treatment. #UrineCulture #Urinalysis #Microbiology #pathology #UTI #UrinaryTractInfection #UrinaryHealth #healthtips #UrineTest #DiagnosticTests #LabTesting #HealthAwareness

[Information & PR, J&K @diprjk]

🚩 Journey with Faith, Travel with Care 🙏

Every step of the Shri Amarnath Ji Yatra is a sacred experience. Follow the guidelines shared below to ensure a safe, comfortable, and spiritually enriching pilgrimage.

Har Har Mahadev! 🚩

#SANJY2026 #ShriAmarnathJiYatra2026 @OfficeOfLGJandK @CM_JnK @DivComKash @Divcomjammu @ShriSasb

[Defence Squad @Defence_Squad_]

The journey has begun.
The first batch of pilgrims for Amarnath Yatra 2026 has departed from Jammu under a multi-tier security cover.

Thousands of security personnel, surveillance systems and coordinated deployments are in place to ensure a safe pilgrimage.
🇮🇳

#Amarnath

[Allen @Allen__girl]

ये डॉ साहिबा वीर्य रोकने पर बता रही हैं फिर इतनी देर टिक कैसे रहेंगे ?

[Association of International Doctors. (India). @int_doctors]

Dr. Abhishek Shukla (Senior Geriatrician) in conversation with Dr. Rohit Kapoor (MCh Urology) a senior urologist, to discuss a very common problem seen in elderly men—weak urine flow, frequent urination, and the feeling of incomplete bladder emptying.”

Dr. Abhishek Shukla asked, “Many senior citizens complain that their urinary stream has become weak, urine comes drop by drop or intermittently, and they need to wake up multiple times at night to pass urine. Even after urinating, they feel that the bladder is not empty. What could be the reason?”

Dr. Rohit Kapoor explained that these symptoms are most commonly related to the prostate gland. The prostate is a small gland located below the urinary bladder and surrounds the urinary passage (urethra). As men grow older, the prostate often enlarges and can obstruct the urine flow.

He explained that this enlargement may be Benign Prostatic Hyperplasia (BPH), which is non-cancerous and very common with aging. In many cases, medicines can effectively control symptoms. However, an important point is that the size of the prostate alone does not decide treatment.

A large prostate does not always need surgery if symptoms are controlled with medicines. On the other hand, even a smaller prostate can cause severe blockage and may require surgery if medicines fail.

Dr. Kapoor also emphasized the importance of PSA (Prostate-Specific Antigen) testing for men above 50 years of age. Along with ultrasound and uroflowmetry, PSA helps detect prostate cancer early. He advised that every man above 50 should get a PSA test yearly.

Dr. Abhishek Shukla concluded by reminding viewers that urinary problems should never be ignored. Early diagnosis and treatment can prevent complications and improve quality of life. Modern treatments, including advanced robotic surgery, now offer safer and highly precise solutions. #UrinaryHealth #Urology #pelvichealth #Incontinence #OveractiveBladder #BladderControl #BPH (Benign Prostatic Hyperplasia) #ProstateHealth #enlargedprostate #urinarytractinfection #uti #bladderhealth #urinarysystem #urology #urinary #urinaryincontinence #womenshealth #healthylifestyle #bladder #urologist

[Samreen @7am_reen]

The sweetest summer vacation memories.

May Allah bless them, protect them, and fill their lives with endless smiles and innocent laughter.

#kashmir ❤️