Joined August 2008
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This is so touching
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Systemic sclerosis is a disease of vasculopathy, autoimmunity, and fibrosis. 10 red flags you should never miss: • Raynaud puffy fingers = VEDOSS • Normal PFT ≠ No ILD • Anti-topoisomerase I → ILD • RNA Pol III → renal crisis risk • Loud P2 → PAH • Digital ulcers = vascular events Which red flag is most commonly overlooked? Dr. Aravind Palraj #SystemicSclerosis #Scleroderma #Rheumatology #MedTwitter #MedEd @IhabFathiSulima @docakx
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There is no perfect solution in real world People often search for the “right answer.” Mathematics teaches that most real-world problems have no perfect answer. There are only trade-offs. also called as Optimization : Given constraints, what is the best achievable outcome? An example: In Healthcare, suppose a screening test catches more cancers. That is wonderful. But it also generates more false positives. Which is better? The answer depends on values and consequences. To explain further: There is no such thing as a perfect screening test. Every screening strategy sits on a spectrum: Catch more disease → more false positives aka a normal person reported as having cancer. Reduce false positives → miss more disease. The question is not “Which test is best?” The question is: “What balance of harms and benefits are we willing to accept?” #mathematics #life
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Replying to @hiiragi2280
Because unlike a haircut, a consultation can suddenly become a cancer diagnosis, a suicidal patient, a difficult airway, or a conversation that changes someone’s life. Healthcare runs on schedules. Medicine runs on uncertainty. 🩺
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Most people think schizophrenia means “multiple personalities.” It doesn’t. In reality, schizophrenia is a disorder of thought, perception, and behavior that affects millions worldwide. Here’s the high-yield guide I wish every medical student had before exams. 🧠👇 ❤️ Save 🔄 Repost 📚 Learn something new today #MedTwitter #Psychiatry #MedicalEducation #MentalHealthAwareness
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😜🤣 Mine have been under good control for some time. Lowered over these past several months. Highest 6.2 a few years ago! For one my Hb was low then at close to 8.5 :) Lakshmi insisted I take iron and I did. Iron deficiency anemia can falsely raise HbA1c too. Now 14. No bleeding
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Listening to this :) Love Simon Sinek and Trevor Noah. Both amazing people who speak the truth with kindness and compassion and humor thrown in @ShashiTharoor 🫂🌹 Love ur initiatives @deeptisawhney 🫂🌹🤝 @idrlakshmi 🫂🌹❤️ @monty_doc 🫂🌹 youtu.be/oEy3gqypKvE
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Delhi's trees are not falling because of storms. They are falling because we hv spent decades suffocating roots with concrete, cutting growing space, damaging root zones & neglecting scientific tree care. The storm only exposed the damage. Nature didn't fail. Urban planning did.
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🎯 Diagnosis: Brucellosis (Brucella melitensis) The clues are classic: ✅ History of drinking raw/unpasteurized milk 🥛 ✅ Undulating fever with drenching night sweats 🌡️ ✅ Characteristic "wet hay" or musty odor of sweat 🌾 ✅ Unilateral testicular swelling → epididymo-orchitis, a recognized complication of brucellosis Why is an Echocardiogram (Echo) ordered? ❤️ Because Brucella endocarditis is the most serious complication and the leading cause of death in brucellosis. 🔍 Echo is performed to look for: Valvular vegetations New valvular regurgitation Destructive endocarditis (especially of the aortic valve) Cardiac complications requiring surgery 🧪 Diagnostic Workup Blood cultures (may require prolonged incubation) Brucella serology (Standard Agglutination Test) PCR where available 💊 Treatment Doxycycline Rifampicin for at least 6 weeks Severe disease/endocarditis may require addition of an aminoglycoside (e.g., gentamicin) and prolonged therapy 💎 Exam Pearl: Raw milk undulating fever drenching "wet hay" sweats orchitis = Brucellosis until proven otherwise. Echo is ordered to exclude Brucella endocarditis, the most feared complication. 🩺✨
What is the description or diagnosis? Why Echo is ordered?
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pathetic if its true
Axis Bank reported its costumer as NPA over 10 paise and dropped CIBIL by 140 points. Now they've assigned a recovery agent for 90 paise.
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“I used to think that the worst thing in life was to end up alone. It's not. The worst thing in life is to end up with people who make you feel alone.” Robin Williams
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ankhe khol de
Last week, India scrapped capital gains tax for foreign investors in government bonds. The commentary was full of praise. I don't see it. Nobody asked the obvious question: why would a foreign bond investor pick India at all? Take Brazil. Look at what each government pays you to lend it money for ten years. 🇮🇳 India: ~6.9%. Inflation is 3.5%. Real return — what you keep after prices rise — about 3.5%. 🇧🇷 Brazil: ~14.8%. Inflation is 4.4%. Real return: about 10%. Triple. Not a rounding error. Triple. 🧾 And Brazil's tax exemption for foreigners in government bonds? Already there. We just matched the table stakes — with the rupee at 95 — and called it a masterstroke. 💱 Now the currency. Over the past year the rupee fell about 8.6% against the dollar. The Brazilian real rose about 6.6% — the best-performing currency in the world this year. A dollar investor in Indian bonds watched the currency eat his coupon. In Brazil the currency added to it. And that's not luck. It's structure. 🛢️ Brazil sells what this decade demands: oil, iron ore — and it sits on the world's second-largest rare-earth reserves, the one input every chip war runs through. When commodities spike, dollars flow into Brazil. India imports ~88% of its crude — the same spike blows out our import bill. 🤖 And AI? Both countries will pay the dollar-denominated token bill. But for Brazil, AI is a net tailwind — every data centre is steel, copper, and power, and AI can't automate iron ore out of a blast furnace. For India it cuts the other way: our one big dollar earner, $418 billion of services exports — the surplus that pays for all that oil — is precisely the thing AI is learning to automate. The same technology that buys Brazil's exports competes with ours. So the two defining forces of this cycle — expensive energy and AI — push the real and the rupee in opposite directions. One currency is a claim on commodities the world must buy. The other is a claim on services the world is learning to automate. Step back. We sit in India calling 3.5% real a good deal and a falling rupee "stable," and we applaud a tax tweak as if it changes the math a foreign investor actually runs.
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Long-term testosterone replacement and Suppressed spermatogenesis. The suppression of spermatogenesis during long-term Testosterone Replacement Therapy (TRT) is an expected consequence. While TRT successfully restores libido and energy by returning circulating hormone levels to normal, it simultaneously suppresses the brain's release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Without these signals, the testes stop producing the high levels of local testosterone needed to create sperm. Most men recover spermatogenesis after cessation of exogenous testosterone; *however, restoration of sperm production might take months or years and fail to achieve baseline levels depending on the duration and degree of supratherapeutic administration. ●Surgical sperm retrieval and assisted reproductive technology might be appropriate in men with persistently diminished sperm production following testosterone exposure. nature.com/articles/s41585-0…
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Replying to @o_o_dr
🚨 Clinical Pearl: Diabetic patients may have atypical or even silent myocardial infarctions. Jaw pain, toothache, neck pain, epigastric discomfort, nausea, or unexplained sweating may be the only clues. An ECG is cheaper than a missed MI.
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This sudden normalization of blood sugar in an advanced diabetic patient is often a clinical warning sign known as "burnt-out diabetes". This phenomenon, heavily associated with the progression of chronic kidney disease (CKD) or end-stage renal disease (ESRD), occurs due to a combination of factors: *Impaired Insulin Clearance *Decreased Gluconeogenesis *Malnutrition and Wasting Rather than a medical improvement, this normalization of HbA1c often requires immediate reduction or cessation of diabetic medications to prevent severe, life-threatening hypoglycemia. Because standard HbA1c tests can be misleading in dialysis patients,rely on alternative markers like Glycated albumin for accurate monitoring. seminarsinnephrology.org/art…
My junior asked on rounds today: "This patient had severe diabetes for 15 years, but now that they have Chronic Kidney Disease, their blood sugar is suddenly normal. Are they cured?" No. It’s actually a massive clinical red flag.
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Borrowed from the WhatsApp status of my ex FIL. Should have been a great teacher and mentor! Brillaint mind. Also neurodivergent but abused by his mother! These patterns :)) Disrupting the cycle!!! @KabraVrinda 🫂❤️ @ShashiTharoor 🫂❤️✍️✍️✍️ @mahattattva 🫂✍️❤️ @neurodocente 🌹
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Replying to @DocPriyamMD
Primary diagnosis: Chronic Myeloid Leukemia (CML) until proven otherwise. Why CML? The combination of: Massive splenomegaly Marked leukocytosis (WBC >137,000/µL) Severe anemia (Hb 6.3 g/dL) Peripheral smear showing a full spectrum of myeloid maturation (myelocytes, metamyelocytes, bands, neutrophils) Basophilia is highly characteristic of chronic-phase CML. Crucial next step ✅ Confirm BCR-ABL1 fusion (Philadelphia chromosome) Tests: Quantitative PCR for BCR-ABL1 (preferred) FISH for BCR-ABL1 Cytogenetics demonstrating t(9;22)(q34;q11) Additional workup Bone marrow aspiration/biopsy Differential count with blast percentage Baseline uric acid, LDH, renal function Risk stratification (Sokal/ELTS score) Management after confirmation Start a tyrosine kinase inhibitor (TKI) such as: Imatinib Dasatinib Nilotinib If symptomatic hyperleukocytosis is present, supportive measures (hydration, cytoreduction) may be needed while awaiting confirmation. Exam pearl > Massive splenomegaly very high WBC basophilia all stages of myeloid precursors on peripheral smear = CML until proven otherwise. The next diagnostic step is BCR-ABL1 testing (Philadelphia chromosome).
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"If you pass by the beautiful flower in a field and don't notice it, God gets real pissed off." Good evening, friends ✨ Happy #RoseWednesday 🩷🌹 #theme_pic_India_flowers #VtClicks #NatureLovers #FlowersOnX #FlowersOnWednesday
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Sunshine
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