Dr RR Baliga's "Got Knowledge Doc" Podkast

LVAD patients are increasingly encountered in emergency rooms and ICUs, yet many clinicians remain uncertain about initial management. A recent  JACC State-of-the-Art Review provides a practical framework for recognizing and treating LVAD emergencies , from pump thrombosis and right-heart failure to arrhythmias and GI bleeding. Key pearls: LVAD patients may lack a palpable pulse , Doppler is prefe...

Jiddu Krishnamurti challenged one of humanity's deepest assumptions—that wisdom must come from teachers, traditions, or systems. Instead, he argued that genuine understanding begins with self-observation and choiceless awareness .   In this short slide set, I summarize the life and ideas of Jiddu Krishnamurti (1895–1986) —the thinker who famously declared: "Truth is a pathless land."   📚 The slid...

🧠🦠 Microbes. Metabolites. Memory.   A fascinating new Nature study reveals a gut–brain pathway driving age-related cognitive decline.   Expansion of Parabacteroides goldsteinii in aging microbiomes increases medium-chain fatty acids , activating GPR84 signaling in peripheral myeloid cells . The resulting inflammation suppresses vagal sensory signaling , blunting hippocampal neuronal activation a...

Lipids remain central to cardiovascular prevention. The 2026 ACC/AHA Dyslipidemia Guideline introduces several important shifts:   • PREVENT equations replace older ASCVD risk calculators • Lipoprotein(a) measurement recommended at least once in all adults • ApoB helps identify residual lipoprotein risk • Coronary artery calcium scoring refines treatment decisions • LDL-C targets return, with

🧬🧠❤️ The Immune System Is Not Just Defense — It Is Physiology   A superb Science Review (Nahrendorf, Ginhoux, Swirski, 2025) reframes immunity as a systems integrator , shaping brain function, heart rhythm, metabolism, pregnancy, and tissue repair—quietly maintaining homeostasis across the lifespan.   Immune cells are not visitors; they are residents, communicators, and regulators in every organ...

A fascinating new study reveals a previously underappreciated pathway for tau clearance in the brain .   Researchers show that tanycytes—specialized hypothalamic glial cells—actively transport tau from cerebrospinal fluid into the bloodstream . In Alzheimer disease, these cells become fragmented and dysfunctional, impairing tau clearance and potentially accelerating neurodegeneration.   This work...

Obesity is not simply excess weight—it is a metabolic and inflammatory state that can reshape cancer biology . Adipose tissue alters hormones, insulin signaling, inflammatory cytokines, and immune responses , creating conditions that favor tumor development. Evidence now links obesity with cancers of the breast, colon, endometrium, pancreas, liver, kidney, and esophagus . Understanding these mecha...

🧬 Apolipoprotein M (ApoM) is emerging as a key regulator of vascular biology.   ApoM, an HDL-associated lipocalin, transports sphingosine-1-phosphate (S1P) and selectively activates S1PR1 signaling in endothelial cells.   This pathway stabilizes the endothelial barrier, promotes nitric-oxide mediated vasodilation, and suppresses vascular inflammation.   Clinical studies increasingly link lower Ap...

📚 Simone de Beauvoir (1908–1986) — philosopher, writer, and architect of modern feminism.   Her groundbreaking book The Second Sex (1949) reshaped global conversations on gender with one powerful line: "One is not born, but becomes, a woman."   She challenged stereotypes, defended women's autonomy, and influenced second-wave feminism worldwide.   Her ideas still echo in medicine, education, ethic...

🫁 Pulmonary Embolism in 2026 — A Precision Framework The new AHA/ACC Acute Pulmonary Embolism Guideline redefines how we classify and treat PE. Key updates: • Category A–E clinical classification integrating hemodynamics, biomarkers, and RV imaging • Age-adjusted D-dimer and YEARS algorithm to reduce unnecessary imaging • CT pulmonary angiography as preferred diagnostic modality • RV/LV ratio rep...

Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting ~37.6 million people globally , with prevalence expected to double in the coming decades.     A recent Lancet Seminar (2026) highlights several key principles shaping modern AF care:   • Stroke prevention with oral anticoagulation remains the cornerstone • Early rhythm control strategies improve cardiovascular outcomes...

🧬✨ Can we make the ageing immune system young again?   A fascinating Nature study shows that a three-part mRNA cocktail (DFI) can temporarily rejuvenate T cells in aged mice , improving responses to vaccines and cancer immunotherapy —without breaking immune tolerance. By turning the liver into a short-term factory for key immune signals (DLL1, FLT3L, IL-7), the authors demonstrate that immune ag...

🧬 Protein Restriction, Aging, and Longevity ⏳   A remarkable new study in Cell shows that moderate protein restriction —especially when started in midlife —can reprogram aging biology across 41 organs , improving metabolic and cardiovascular health . 🫀⚙️   Using deep multi-organ proteomics in mice and human plasma validation , the authors demonstrate benefits mediated through ↓ IGF-1 , ↓ mTOR ,...

Resistant hypertension remains one of the most stubborn challenges in cardiovascular medicine.   The Bax24 phase 3 trial , published in The Lancet (2026) , evaluated baxdrostat , a selective aldosterone synthase inhibitor , in patients already receiving multiple antihypertensive agents.   Key findings: • −16.6 mmHg reduction in 24-hour ambulatory SBP • −14.0 mmHg placebo-corrected difference (p

🏃‍♀️🏋️‍♂️ Does variety in physical activity matter for longevity? A large prospective analysis suggests it does: people who engaged in a wider mix of activity types tended to have lower all-cause mortality , even after accounting for total activity and key covariates. 🌈📉   Key practical takeaway: don't just "do more"— do different (walk + cycle + swim + strength, etc.). ✅🫀   As always, this i...

Chronic diarrhea affects approximately 6–7% of adults, and the vast majority of cases are noninfectious. The most common causes are irritable bowel syndrome with diarrhea and functional diarrhea. A systematic approach matters: • Screen with CBC, CMP, fecal calprotectin, IgA-tTG • Identify alarm features • Biopsy for microscopic colitis when needed • Start with lifestyle + low-FODMAP • Escalate to...

Jean-Paul Sartre (1905–1980) forced a generation to confront a radical idea: existence precedes essence .   We are not born with a fixed nature — we create ourselves through choices. That freedom is powerful… and unsettling. 🧠   In Being and Nothingness and Existentialism Is a Humanism , Sartre explored authenticity vs. "bad faith" — the temptation to hide from responsibility.   Philosopher, play...

Can lifting light weights help lift grades? 💪📚   A recent cross-sectional study reports that adolescents engaging in regular muscle-strengthening exercise demonstrated better performance in literacy, mathematics, and language outcomes. 📊🧠 Even after adjusting for sociodemographic and lifestyle factors, the association persisted—highlighting a potential link between resistance training and cogn...

Type 1 Diabetes is more than high sugar — it is autoimmunity, absolute insulin deficiency, and lifelong vigilance. 🧬💉   Early recognition of polyuria, polydipsia, and weight loss can prevent diabetic ketoacidosis. Timely diagnosis with islet autoantibodies and C-peptide testing guides care. 📊   Modern insulin strategies and continuous glucose monitoring have transformed outcomes — yet microvasc...

Sepsis: Detect. Treat. Survive.   Sepsis remains a major global health threat, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition, prompt antibiotics, and timely hemodynamic support save lives. ⏱️💉💧   The latest The Lancet Seminar (Feb 26, 2026) highlights evolving definitions, pathobiology, global burden, and the need for precisi...

Can the aging brain still make new neurons?   A landmark 2026 Nature study analyzed 355,997 human hippocampal nuclei using single-nucleus RNA sequencing and ATAC sequencing. Neurogenesis persists into adulthood—but chromatin accessibility collapses early in Alzheimer's disease.   SuperAgers showed a 2.5-fold increase in immature neurons and a preserved resilience signature.   Epigenetics may be th...

  Radiation. Regions. Responsibility. 🌍⚡   A JAMA study (INCAPS-4) analyzing 19,302 patients across 101 countries reveals striking global disparities in radiation exposure from cardiac imaging.   Median CCTA dose in Africa: 25.2 mSv Western Europe: 4.6 mSv Low-income nations had 96% higher CCTA doses. Technology and training—not just access—determine safety. As CAD rises worldwide, dose optimiza...

Can a single bolus change the fate of a devastating stroke? 🧠💉 The TRACE-5 trial (Lancet 2026) shows that  tenecteplase within 24 h for basilar artery occlusion improves excellent functional outcomes (38% vs 29%; RR 1.50, p=0.014) without increased haemorrhage or mortality. 📊 Pragmatic design. No mandatory advanced imaging. Feasible globally. 🌍 If confirmed beyond Asian cohorts, this could res...

Ludwig Wittgenstein (1889–1951) reshaped modern philosophy by asking a deceptively simple question: How does language work? 🧠   In the Tractatus , he argued that language "pictures" reality — and that what cannot be clearly said must be passed over in silence. Later, in Philosophical Investigations , he reversed course: meaning is not fixed — it is use, embedded in "language games." 🎯   His last...

Light smoking is not harmless. 🚬   A powerful New England Journal of Medicine Perspective highlights the rising challenge of nondaily and low-intensity smokers in Latin America. Even fewer than 10 cigarettes per day carry meaningful cardiovascular and cancer risk — yet these smokers often underestimate harm and receive limited cessation support.   The future of tobacco control must address the "l...