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Kamran Boka

Pickwickian Legacy: Obesity Hypoventilation Syndrome (Past to Present)

bicarbonate

Pickwickian Legacy: Obesity Hypoventilation Syndrome (Past to Present)

In its pages, the rotund and perpetually sleepy character Joe the Fat Boy embodies what 20th-century clinicians first described as the “Pickwickian syndrome”: profound obesity, excessive daytime somnolence, and elevated CO2 (earlier known to be polycythemia).

By Kamran Boka 12 Nov 2025
“Quad-Strength” Levophed: What It Really Means — And When It Matters

criticalcare

“Quad-Strength” Levophed: What It Really Means — And When It Matters

“Levophed leave ‘em 💀?” “Fingers, nose, pen*s, toes”

By Kamran Boka 04 Oct 2025
Have you ever wondered: WHY do we reach for Sodium Bicarbonate in the ICU?

CO2

Have you ever wondered: WHY do we reach for Sodium Bicarbonate in the ICU?

A History, A Physiology, A Philosophy My apologies to this growing readership. After taking the summer of 2025 off from blogging, I’m back. I appreciate your patience 😀. Let’s try a new take today— I’ll attempt to weave history, physiology, evidence, controversy, and philosophy into a practical piece.

By Kamran Boka 21 Sep 2025
Have you ever wondered: WHY a MAP of 65 mmHg?

EvidenceBasedMedicine

Have you ever wondered: WHY a MAP of 65 mmHg?

The 65 mmHg MAP target in critical care medicine has deep historical roots—from Hippocrates’ humors to Poiseuille’s equations.

By Kamran Boka 06 Apr 2025
Match Day 2025: Finding Meaning Beyond the Algorithm

MedicalStudent

Match Day 2025: Finding Meaning Beyond the Algorithm

#MatchDay is here, Med Students!!

By Kamran Boka 16 Mar 2025
Article of the Week: Vocal Cord Dysfunction

cough

Article of the Week: Vocal Cord Dysfunction

In VCD, the inspiratory limb often appears flattened or coved due to paradoxical vocal fold closure during inspiration. This pattern is a key diagnostic clue that differentiates VCD from asthma, where the expiratory limb is predominantly affected.

By Kamran Boka 07 Mar 2025
The Lingering Cough

cough

The Lingering Cough

Have you ever wondered why coughs outlast colds? Studies shows that post-infectious cough persists in approximately 25% of patients with upper respiratory infections, sometimes for up to two months after the initial illness has resolved.

By Kamran Boka 02 Mar 2025
ILD Differentials

ILD

ILD Differentials

ILD Q and A

By Kamran Boka 24 Feb 2025
Diddling with Diamox (acetazolamide): Mountains to Medicine

pulmonary

Diddling with Diamox (acetazolamide): Mountains to Medicine

👁️ ➡️ 🧗‍♀️ ➡️ 🧠➡️ 🩸 Let’s talk about a drug you see prescribed for use in a few different scenarios: acetazolamide. Who made this and when? • Robin & Clapp at American Cyanamid • Attribution to them 1951 Why was it developed? • To treat glaucoma • First medically used in 1952 How does this drug treat glaucoma?

By Kamran Boka 20 Feb 2025

Hemodynamics

Article of the Week: Sepsis-Induced Cardiogenic Shock (SICS)

Okay. Now I know what you are thinking: does the title really combine sepsis and cardiogenic shock into a single term? SICS is an important concept, and the diagnostic criteria are a bid muddled for some. I for one don’t recall it being called SICS. It is basically a

By Kamran Boka 17 Feb 2025
Mentally Predict ABG Results

Mentally Predict ABG Results

It is a sophisticated display when the seasoned intensivist or veteran RT predicts the next arterial blood gas results after conjuring ventilator settings based on current ABG results. Although it may appear as magic to some and confusing to others, it is actually easy math. Learn this post for your

By Kamran Boka 14 Feb 2025
Septic shock: The Vasopressin Drip

SepticShock

Septic shock: The Vasopressin Drip

HOW does vasopressin work? • Released by pituitary ➡️ activates V1 receptors on vascular smooth muscle ➡️ increases phospholipase C causing calcium ion release ➡️ causing arterial vasoconstriction ➡️ thus raising blood pressure and SVR. • Promotes water retention via activation of V2 receptors (by adenyl cyclase). Hence ADH effect. • Lowers HR Name the trial that

By Kamran Boka 08 Feb 2025
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