Thursday 24 September 2020

BPLS VT

 ########################





###############################



##############################


DOUGLAS Never take a solemn oath. People think you mean it."

##################

VAN GOETHE Nature knows no pause in progress and development, and attaches her curse on all inaction."

#################
"If you could say it in words there would be no reason to paint."HOPPER

#####################


##################

||HARI OM||

||THE SECRETS OF GITA||

Summary of Chapter 9: The Yoga of Sovereign Science and Sovereign Secret.

This chapter reveals the sovereign science and the sovereign secret of Shri Krishna's supreme 𝗚𝗼𝗱𝗵𝗼𝗼𝗱. Shri Krishna’s exalted nature is stressed, and warning is given to those who think that He is limited to His creation and those who do not have faith in this 𝗗𝗵𝗮𝗿𝗺𝗮.

Shri Krishna is transcendent, but His unmanifest (𝗮𝘃𝘆𝗮𝗸𝘁𝗮) presence pervades the world. 𝗙𝗼𝗼𝗹𝗶𝘀𝗵 people do not understand Shri Krishna’s divine identity, but there are great Souls who do, and on the basis of this realization, they engage in acts of 𝗗𝗲𝘃𝗼𝘁𝗶𝗼𝗻 either by praising and worshipping Him. Shri Krishna points out many gods and goddesses of the 𝗩𝗲𝗱𝗶𝗰 𝗽𝗮𝗻𝘁𝗵𝗲𝗼𝗻, each of which represents a different divine power but Shri Krishna contains within Himself all such powers. It is Shri Krishna and Shri Krishna alone who is to be worshipped: He is the Father, the Mother, the Vedas, the goal, the support, the only refuge, the one true friend, He is the beginning, the middle and the end.

The 𝘝𝘦𝘥𝘪𝘤 𝘳𝘪𝘵𝘶𝘢𝘭 and 𝘸𝘰𝘳𝘴𝘩𝘪𝘱𝘱𝘪𝘯𝘨 of other Gods is performed without knowledge of the Supreme Lord and yields only temporary results, whereas worship of Shri Hari leads to 𝗹𝗶𝗯𝗲𝗿𝗮𝘁𝗶𝗼𝗻. Even these Souls, however, are really worshipping Shri Hari, though in an unauthorized way. True, they do enjoy desired fruits here on earth or heaven after death but they do not achieve the highest good.

However, the 𝗚𝗶𝘁𝗮 does not dwell on the obstacles, but quickly goes on to reveal Shri Krishna’s more compassionate nature. In particular, to have real, selfless love, regardless of the object, to love Shri Krishna, the ultimate good called 𝗕𝗵𝗮𝗸𝘁𝗶, is far more potent than observances, cognition and rituals. Therefore, the Lord instructs Arjuna that: Whatever you do, make it an offering to Me – the food you eat, the sacrifices you make, the help you give, even your suffering. Shri Krishna accepts every offering made to Him in sincere devotion. If Arjuna can live in complete union with Shri Krishna’s will, doing everything for Shri Krishna alone, then by that very purity of will he will be free from selfish motives and thus released from 𝗞𝗮𝗿𝗺𝗮.

Shri Krishna declares that He is impartial to all creatures: He neither favors nor rejects anyone. It is their sincere 𝗟𝗼𝘃𝗲 that is important. Those who are truly devoted to Shri Krishna live in Him, and He abides in them. The Lord’s divine 𝗽𝗿𝗼𝘁𝗲𝗰𝘁𝗶𝗼𝗻 is assured to all those who take refuge in Him. He adds that even a sinner who takes wholehearted refuge in Him becomes righteous (𝗦𝗮𝗱𝗵𝘂). He promises that His devotees must attain eternal peace at last, whatever vocation one follows, one can attain the Lord if one seeks earnestly and with loving 𝗗𝗲𝘃𝗼𝘁𝗶𝗼𝗻. The essential thing is to fix the mind on the Lord Hari, like Arjuna, and dedicate everything unto Him - our body, mind, actions, emotion, will and be His devotee, worship Him and surrender unto Him.

||OM SHANTI SHANTI SHANTI||

#GitaSeries #TheSecretsofGita


#######################

P CR-

Paediatric case of left subclavian artery steal syndrome with an abnormal connection between the left subclavian artery and pulmonary artery


#######################

Ventricular Tachycardia Classification is based on:

1. Morphology
2. Duration
  • Sustained = Duration > 30 seconds or requiring intervention due to hemodynamic compromise.
  • Non-sustained = Three or more consecutive ventricular complexes terminating spontaneously in < 30 seconds.
3. Clinical Presentation
  • Haemodynamically stable.
  • Haemodynamically unstable — e.g hypotension, chest pain, cardiac failure, decreased conscious level.



######################
PSYD People report feeling happier when they are with their friends than their family, new research finds.

######################

Vitamin D3 supplements can aid weight loss, a new review of 10 studies has found.

PSYD#

#########################

DESTINY = GXE

###########

VT  MANAGEMENT M

Immediate management.

Sustained VT with hemodynamic embarrassment requires immediate attention. Electrical cardioversion (EC) is required. If the patient is awake, alert with “good” blood pressure, IV drugs (e.g., lidocaine), or even synchronized EC after sedation are options.

Torsades is often self-limiting, the reason being that the tachycardia itself will lead to termination.

We see this response by increasing the heart rate with either Isuprel or pacing. Magnesium supplement is often used and can be helpful in terminating or preventing torsades episodes. The cause of the torsades must be determined-acquired, long Q–T drugs (the list is quite long and includes sotalol, dofetilide, methadone, or a congenital condition), long Q–T 1-3 being most common. The offending drug must be discontinued.

In the congenital variety, history and ECGs might offer clues. Beta-blockers can offer some protection in long Q–T 1 and 2, and mexiletine in long Q–T 3. In the presence of syncope, the ICD is preferred (Table 1).


RX

Sustained VT often requires ICD therapy and /or revascularization. Ablation is an option in RVOT/LVOT, bundle branch reentry VT.


Amiodarone is perhaps the most potent antiarrhythmic in suppressing all types ventricular arrhythmia episodes.






#########################

















No comments: