Vikram Jadhav @imvikram2207
Junior Resident, Dept. of Medicine at Grant Medical College & JJ hospital,Mumbai. MBBS(GMC,Miraj) Dreamers create Legacy! Mumbai, India Joined January 2017-
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We are excited to start the month off with a new #RadiologyRounds 🫁 A young adult man in his 20s presents with dyspnea on exertion, productive cough, intermittent wheezing and general fatigue. A chest x-ray was obtained as part of his work-up.
राकट देशा! कणखर देशा!!! राष्ट्रालाही दिशा देणारा महाराष्ट्र राष्ट्राच्या भरभराटीत अशीच भर देत जाओ!!! 🙏🙏🙏
A 41 year old man comes in for help with headache He’s had 5-6 severe headaches/month for years, but over the last 6 months has had daily, bifrontal, throbbing headaches Each month he takes: Acetaminophen ~10 days Ibuprofen ~9 days Sumatriptan 6-7 days What do you tell him?
8. In cases of unexplained hyperkalemia in hospitalized pts, please do not overlook the role of heparin (H). H can inhibit aldosterone synthesis even at low doses & lead to ⬆️ Na excretion & ⬆️ K retention. This is more pronounced in elderly pts w renal dysfunction & diabetes 🧐
1/12 - Mystery #1 You are seeing a patient recently diagnosed with heart failure and started on GDMT. You notice that their hemoglobin (HGB) has increased (12 → 13 g/dL) in the intervening weeks. 🤔Which medication is the likely cause of this increase in HGB?
ICU Pharmacology Secrets: Some drug side effects, even if relatively rare, are well entrenched in our memory. For example, most intensivists & hospitalists are aware of cefepime-induced neurotoxicity or clindamycin’s association w C difficile infection (or even the seemingly
1/13 Welcome to another installment of the #ACCTweetorialSeries covering key trials from #ACCMedStudent #JournalClub! ⏰Today we'll be discussing the ADVOR trial on Acetazolamide for Acute Decompensated Heart Failure.🔎
What is the most useless test in medicine and why is it the widal test? #MedTwitter
What is the most useless test in medicine and why is it the widal test? #MedTwitter
An easy way to remember serum protein electrophoresis for #MedstudentTwitter ! In myeloma, the thumb goes ⤴️ and the pinky finger goes ⤵️ To know more than this, follow along 👇🏼 #MedTwitter 1/16
🤔Freeze/Stop CKD progression How ✍️ ✅Annual gfr decline in proteinuric CKD-10-12ml/min 💊ACEi/ARB can lower gfr decline to 5-6 💊💊Add SGLT2i to ACE/ARB- ⬇️gfr decline 2-3 💊💊💊Add Finerenone to SGLT2i+ ACE/ARB-⬇️gfr decline 1-1.5 👏This is akin to normal aging gfr…
Chitta: Great watch! @DearthOfSid Engrossing performance to say the least. Especially the part where he is being considered the accused.
Beautiful film! Personal favorite was the 'Rishwat' scene and उद्गम! @JaideepAhlawat was like magic on screen. @ShefaliShah_ was perfect as always! @swanandkirkire @varungrover @AvinashDha87598 ❤️
A different Monday morning!
Wholesome movie❤️
Hi Papa on @NetflixIndia is wholesome! Rewatching the climax, feels like this story should never end! You might weep for the brilliant performances by @mrunal0801 @NameisNani and Kiara💯 Frames and music make make it a perfect watch❤️
Jigarthanda DoubleX is the cinema! Film making doesn't get better than this! @karthiksubbaraj @offl_Lawrence @iam_SJSuryah Kudos to the team💯
A 🧵 on LACTULOSE 💥Correct method to give lactulose enema in Hepatic Encephalopathy (HE) Coma : 300 mL mixed with 700 mL tap water or normal saline, given as a 30 to 60 minutes retention enema every 4 to 8 hrs until patient is able to take medication orally. #MedTwitter
Both Dunki and Salaar are disappointments for sure!
A🧵 on 5️⃣ categories of ascitic fluid infection that can happen in long standing ASCITES #MedTwitter #MedEd #MedX First a question ❓️ A patient with ascites underwent difficult and traumatic paracentesis. ......contiunued in 🧵 👇
🆕When suspect atherosclerotic RAS 🙇♀️ @NDTsocial 🔥Resistant hypertension/sudden worsening of preexisting HTN 🫘Asymmetry kidney size difference>1.5cm 🫘GFR📉🔽 >30% after starting RAASi 🫁Flash pulmonary edema/recurrent HF episodes+preserved EF academic.oup.com/ndt/advance-ar…
pain @pain917890
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Gastronomer @Middle_class_xo
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jidda.al.arabi🇷�.. @Jiddarh_arabi
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Dr. Priyanka V. Sheno.. @shenuyanka
953 Followers 420 Following Cardiologist in the making@ LTMMC & Sion, Mumbai| 🫀 Ravenclaw, crazy cat lady, chai is life ❤️
Tariq Mir @TSM_Humanist
5K Followers 186 Following Doctor ▶️ Internal Medicine. Dow alumnus. Progressive. Rights Defender. Medical Literature/Art. History Buff #Seek_Knowledge
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7K Followers 2K Following Emergency physician, devoted student of emergency electrocardiography and echocardiography. Plus all the other stuff. @brookswalsh.bsky.social
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45K Followers 0 Following Making India smarter, kinder & funnier one fact at a time! 20% bad jokes | 80% fun facts https://t.co/LzZgDhhVkD https://t.co/J7pTeOI4dX
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NDT @NDTsocial
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✅ANA titres >1:160 are considered significant ✍️Even 30% healthy population have Low titres ANA (1:40 and 1:80) positive Source-UpToDate
So, RV pressure at the end of RV diastole, or at the end of RV filling, is the closest we can get to a RV preload marker. Again: not a good marker but if you decide to use CVP as a preload marker, focus on the "c" base...
This is a graph from one of Sheldon Magder's lectures. As you can see if we superimpose the R atrial & R ventricular pressure waveforms, the "c" wave base also aligns with the RV pressure "just before" the onset of RV systole. "Just before" RV systole = at the end of RV diastole!
There are other options: v, mean etc. However, most would measure CVP at the base of the "c" wave, especially if they wanted to use CVP as a surrogate of '"preload". OK, now we are in a slippery slope, since "preload" & "fluid responsiveness" are vague concepts. Having said that,
We are excited to start the month off with a new #RadiologyRounds 🫁 A young adult man in his 20s presents with dyspnea on exertion, productive cough, intermittent wheezing and general fatigue. A chest x-ray was obtained as part of his work-up.
Given upper lobe bronchiectasis you are concerned for cystic fibrosis. A sweat chloride test is obtained and was elevated suggesting CF and further genetic testing was sent to confirm the diagnosis.
You should have Sarcoidosis, Cystic Fibrosis (CF), Hypersensitivity Pneumonitis (HP) and Lymphangioleiomyomatosis (LAM) on the differential
Case of the day A 15 yr old boy C/o- cough and fever on & off for last 7-10 days Chest pain left sided for last 5 days No/h/o- hemoptysis , pharyngitis (sore thorat ) O/e - pallor + (no edema ) Vitals on Arrival- Bp- 100/70 mmhg Pr-110bpm Spo2-98% RA Temp -99.6 f 1/2
Maharashtra and its Marathi people are among the most inclusive and tolerant people in India. Whenever there is a crisis in the nation, Maharashtra has consistently shown the way forward. दिल्लीचेही तख्त राखितो, महाराष्ट्र माझा जय जय महाराष्ट्र माझा Happy Maharashtra Day to all…
राकट देशा! कणखर देशा!!! राष्ट्रालाही दिशा देणारा महाराष्ट्र राष्ट्राच्या भरभराटीत अशीच भर देत जाओ!!! 🙏🙏🙏
Huge shout out to @SimonWuMD and @glavaidguy for creating brilliant infographics for our hospital that guided my care this morning. Patient admitted w/ sepsis from CAP but recently hospitalized. When do you cover for MRSA? How about pseudomonas? When do you de-escalate? How…
A 41 year old man comes in for help with headache He’s had 5-6 severe headaches/month for years, but over the last 6 months has had daily, bifrontal, throbbing headaches Each month he takes: Acetaminophen ~10 days Ibuprofen ~9 days Sumatriptan 6-7 days What do you tell him?
The pathobiology of MOH is complex and incompletely understood In general, use of individual analgesics >10 days/month (or combinations >15 days/month) increases the risk of MOH in patients who already have headache MOH is common: it’s a contributor to ~50% of chronic migraine!
Based on the history and a normal neuro exam, you determine the patient has episodic migraine and medication overuse headache (MOH) MOH diagnostic criteria:
🫘🩸 Drugs used and approach to anemia in CKD @NDTsocial @hjanders_hans academic.oup.com/ndt/advance-ar…
👇How to manage and initiate thyroid replacement therapy in Hypothyroidism Source UpToDate
➡️SoB is due to Anaemia ➡️High Vol/Water Hammer Pulse is sec to Anaemic High Cardiac Output state ➡️Hemic Murmur of Anaemia ➡️Pale Conjunctiva ➡️Pigmentation of Fingers/Face⬆️Melanin Synthesis & ⬇️ Transfer to keratinocytes ➡️Low Hb ⬆️MCV 🔺Megaloblastic Anaemia-B12 Deficiency)
Patients presenting with whipple’s triad : hypoglycemia + symptoms of hypoglycemia (+) -> that responds quickly to IV dextrose or feeding : The best next step is to check 1. Serum Insulin/pro-insulin & C-peptide levels 2. Blood screen for hypoglycemic agents/medication
Meet the culprits: 🦶Platinums 🦶🏻Antimicrotubular - taxanes and vinca alkaloids. 🦶🏽Proteosome inhibitors (bortezimib is particularly naughty!) 🦶🏾Thalidomide 🦶🏼Immune checkpoint inhibitors 🦶🏿Alkylating agents 2/
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