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Tired of getting yellow cards from the infectious diseases team for prescribing meropenem for 3 months?

Sick of Scott appearing behind you with a cat o’ nine tails to administer the requisite antibiotic punishment?

Well this episode has it all – what is antimicrobial stewardship? why do so many people care about it? what can you do to avoid being on the pharmacy’s wanted list? Most importantly, we expertly blend in some music and cold openings for the first time. Jump in, the water is warm!

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2023 got you feeling out of rhythm? Finding yourself a bit behind the beat when it comes to pacemakers? Pour yourself a frosty, frothy, fibre-filled glass of your favourite plum juice and strap on your electric earmuffs. We’re going charging on an audio adventure from cathode to anode with Scott and Rahul which will help you nail pacemakers with aplomb!

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Nasty Bugs. You gotta treat ‘em! In this, truly, tremendous second antibiotic episode, Sleepy Scott, Deranged Davor, Crooked Bec (and Obama Zala) cover all the gram negative bacteria – from microbiology to antibiotics and resistance. Believe me, you’ll be tired of winning!

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This is part 2 of our series on depression. Davor and Dean chat about how to evaluate someone you think might have depression. As fascinating as part 1 was, this is much more clinically relevant. Filled with Dean’s wisdom and clinical pearls, listen on if you want to smash your psych OSCEs or perhaps even to be a better doctor.

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This episode is a bit of new thing we’re trying – interviews with our friends! As we’ve progressed in our careers, we’ve all started specializing and become increasingly unqualified to talk about large swathes of medicine. On the flipside, our mates have done the same thing in all manner of interesting fields, so we’ve decided to start utilizing this amazing resource.

In this episode, Davor talks to senior psychiatry registrar Dean Whitty about depression. This episode is an overview of the Black Dog – definitions, burden of disease and pathophysiology. To be completely honest, only the first 20 minutes or so are directly clinically applicable. If you decide to stay onboard for the whole journey though, you’ll get Dean’s fascinating thoughts on whether you can make epidemiological conclusions across cultures, the different models of depression and how you might be able to unify them, as well the inherent tension between the biological and psychosocial approaches. We’re planning on following this one up with episodes on evaluation and management.

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Curious about what all those party drugs you’ve been taking with your grandma down at the local aged care facility are? Wondering why you always need to cough after you’ve taken your morning ramipril?

Jump on board the high pressure conga line with Rahul and Davor as we cover the ins, outs and sideways of hypertension therapy.

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Episode on radiculopathy!

Davor, Bec and Scott sit down and chat about nerve roots. Well, to be honest, it’s more like Davor relentlessly interrogates Bec and Rahul about radiculopathy for an hour. Although ethically questionable, it appears to have worked because by the end they seemed to understand which nerve roots are damaged by which disc, how to differentiate between L5 and other causes of foot drop and lots of other cool stuff. Hopefully you will too!

This is also the first episode we recorded with our new equipment. We saw some of the feedback about audio issues, and we reckon things sound much, much better with our new gear. If you’ve stopped listening because you were sick of it sounding like one of us was in a different room, give this ep a whirl.

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We’re back with a mammoth topic. Often consigned to a 1-liner in the past history – it’s time to find out just how little you know about the silent killer. Much like the mounds of hair that accumulate in your drain pipes, hypertension is known for a sudden and unexpected day-wrecking by blocking up your plumbing.

Sit back, grab the saltiest nuts you can find and prepare for part 1 of our bigger than Ben-Hur epic on the mechanisms and pathophysiology of hypertension.

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Low back pain! Rahul and Davor discuss one of the most common presentations in medicine. What are the most common causes? What are the most serious causes? Who do you image? What on earth does Rahul mean when he says “test the anal reflex”? Listen in to find out the answers to these eternally-vexing questions and more.

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There’s been a lot of demand for off in the weeds neurology podcasts. Luckily we have our arcane neurology specialist Davor ‘The Slovenian Sledgehammer’ Pavlin-Premrl ready and waiting.

Rahul and Davor discuss cartesian dualism and hysteria, and then after about half an hour of philoso-broing we get to some stuff that might (emphasis on the might) be clinically useful

Apologies for the sound quality – we are still working out some remote-casting CoVID solutions

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We’re back in the COVID era all the way from dirty Melbourne to breathe around your masks and cough on your food.

Have you been fighting with your bed-partner about excessive nocturnal noise emissions? Struggling to stay alert whilst reviewing the latest hydroxychloroquine ‘Orange’ Paper from the White House?

Well we’ve got the podcast to get you inspired before you expire. Strap on your CPAP mask and get ready to fly the skies of knowledge with Bec, Scott and Rahul.

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Drugs. Death. Hidden infections. Bad mix tapes.No, you’re not tripping out on LSD at your uncle’s mail-order bride wedding, you’re just listening to MedConversations’ latest educational podcast packed full of infective endocarditis wisdom and copyright infringing references to one of our most beloved fictional drug dabblers.

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Davor’s back doing his Davor thing and sprucing neurology to the world (whether they want to hear about it or not).

So, if the holiday blues have you feeling numb to the world or passion for the new year has you unexpectedly weak at the knees then tune in because, as usual, we’ve got the balm for your blues.

Join Rahul and Davor as they lead you with a high-stepping gait through the world of peripheral neuropathies. Perhaps after this you won’t feel so lost in the nerve network…Emphasis on the perhaps.

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Has your troubled history of pot plant homicide led to legal action over your plant carer registration AND/OR  your grandmother giving up on you and gifting all her cuttings to her previously second favourite grandchild? We can’t help you with your congenitally absent green thumb AND/OR unlovable personality but this practical episode on clinical fluid assessment will keep your patients from either wilting away or drowning in bottomless bags of normal saline.  

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Think you might have what it takes to join the extraordinary league of gentle-people against epilepsy? Well you’ll need some training first. Come join Davor and Rahul for a shake-down of the epilepsy world.

P.S. I tried my best to stop Davor from inflicting another neurology episode on us all, but the man is just so damn charismatic.

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Charge your batteries and prepare for a shock to the brain. Today we witness the return of a MedConversations legend, Davor who joins Rahul to get your jumbled signals back in alignment about first seizures.

Hot take, listen in for some big news.

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Call up your injection crew and gather around the gramophone, it’s time for Scott and Rahul to bring you the good news about Hepatitis C – there’s a cure and we’ve distilled it here ready for an acoustic injection. Keep the naloxone on standby, we’ll be your spiritual guides as we go deep!

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Missing a bit of Scott and Rahul in your life? Satisfy your morning stiffness by taking a bite out of this dissection of Giant Cell Arteritis.

Which exposure would NOT be an indication for Post Exposure Prophylaxis (PEP) in an Australian (low HIV prevalence) context?

1. A man presents after sharing needles with another man who he believes may be HIV positive.
2. A woman presents following receptive anal intercourse with a HIV + source known to be well controlled on antiretroviral therapy
3. A lady presents after unprotected vaginal intercourse with a man from a high HIV prevalence country
4. A healthcare worker presents following a needlestick injury in a patient with poorly controlled HIV’

Answer B

New evidence from the partner study suggests that the chance of HIV transmission from a viral load suppressed source is negligible. This groundbreaking study of 1166 serodiscordant partners in whom the HIV+ partner had viral suppression reported 0 cases of HIV transmission between the partners, despite 22,000 condomless sex acts among MSM and 36000 among heterosexual partners. The study was powered to give a 95% upper confidence of 0.3/100 couple years of condomless sex, suggesting that the risk is lower than it was previously thought to be a few years ago.

Add in the the weight of new evidence about the morbidity benefits of ART in the SMART and TEMPRANO trials has led to recent changes in WHO and Australian ASHM, which now recommend starting antiretroviral therapy in almost all HIV patients.

A, C, and D would all be indications for PEP by Australian guidelines. B would not be a indication, nor would even unprotected receptive anal sex with a source with unknown HIV status from the standard Australian low prevalence community – although it could be considered if the source was from a higher prevalence group – eg a country with higher prevalence or a subgroup like IVDU. Remember, this more conservative administration of PEP reflects both new evidence and low Australian prevalence, and many countries might have higher prevalence or not have updated older more conservative guidelines yet.

For tons of extra information including probabilities of  transmission risks by different exposures and current indications for PEP check out ASHMs great guidelines here.

http://www.ashm.org.au/products/product/978-1-920773-47-2

And the 2016 WHO guidelines here

http://www.who.int/hiv/pub/arv/arv-2016/en/

THe PARTNER study is here

https://jamanetwork.com/journals/jama/fullarticle/2533066

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Ever pondered whether you might suit the professorial lifestyle? This episode, featuring special guests Dr. Adam Brown and Dr. Nitesh Nerlekar, will run through what the appeals of including research in your career are and some basics on how to get started. Drs. Brown and Nitesh are academic cardiologists from Monash Health in Melbourne and have mentored many medical students, junior doctors and PhD candidates in their nascent careers. So sit back, grab a Pina Colada and get caught in the research rain. 

Nitesh, Adam and Rahul (alongside a few other academic doctors) are running a research skills course in Melbourne at the Alfred Hospital over the weekend of May 19-20. This course will provide a more in-depth guide on the skills needed get some publications to your name and avoid some of the traps that many young doctors fall into. You can sign up at www.medcube.com.au