MBBS, DNB, PGDGM, FGID. Physician. Geriatrician. Asst. Prof. of Medicine. 'Primum Non Nocere'. Amateur photographer. Love to learn and to teach. IG
@dr
.anujmed
I take 30-45 minutes to drive to work. I realised I was wasting a lot of time and had to put it to use. I came across podcasts and one by one I was introduced to a number of medical podcasts. Here are few podcasts which are useful for people in medicine.
#MedTwitter
Absolutely ridiculous take by a young doctor.
We as doctors don’t judge our patients. As far as multiple partners are considered, thats an individual choice. As long as they understand the risks / benefits, let them do what they want.
Irrespective of your ideology,
@theliverdr
should be supported in this issue. What he stood for is science and EBM, this will set a bad precedent. Tomorrow any company selling harmful drugs will start suing doctors for merely stating things that benefits community at large.
Bengaluru Civil Court passes ex-parte injunction order to X to suspend the account of Dr Cyriac Abby Philips (
@theliverdr
).
The order was passed in a suit filed by Himalaya Wellness Corporation which alleged that
@theliverdr
made defamatory allegations against the company.
Written outside a lecture hall in a govt med college. We don't realize it's importance while we are studying in there, it's only when you leave it.
#MedTwitter
A guy comes in for consultation with his 2.5 yr old kid. Kid tries to climb the consultation table, I say 'Upar nahi' with a stern voice.
Kids reply 'aye tutiya', kept on repeating till his mom took him out of the room.
My eyes were wide open for a good 5 minutes!
#TrueStory
To all interns / doctors, how much ever busy you are with work, if you get a needle prick, leave your work and take stat dose of TLD within 2 hrs.
DO NOT IGNORE A NEEDLE PRICK!
Also as a HCW, get vaccinated for Hep B asap if not done already.
#MedTwitter
#Medtwitter
Resolutions for 2023 -
1 De-prescribe PPIs as much as possible
2 Keep the history long, prescription short
3 Reduce Antibiotic usage, cut down when not indicated.
4. Make a habit to check for drug interaction on every visit
Add more 👇🏽
What would you think if you see this xray?
#MedTwitter
I've seen many such x rays in last 2 years.
A hint, all during monsoons in Mumbai.
Detailed history later.
Doxycycline 200mg single dose if you’ve walked in flooded waters on the streets of Mumbai this monsoon.
Don’t ignore even a single spike of fever in monsoons.
#Mumbai
#Monsoon
#leptospirosis
@paradoxgeni
Two problems with that, thinking that sex workers job is worse than yours and other is having a god complex just because you’re a doctor. Everyone is doing their jobs, whatever that maybe. We are no one to judge or demean a person coz of their occupation.
Many years ago a post call intern had no money in his wallet. It was 10am, last meal was 10pm the previous night. He took some time out to try the ATM in campus, it wasn’t working. There was an ATM across the road, as luck would have it, it was out of service.
1/n
Patient admitted in prayagraj with pancytopenja, weakness. No fever. High MCV. Doctor over there gave Ceftriaxone, Piperacillin+ Tazobactam and Meropenem, all at once. Antibiotic stewardship will be a joke till we don't educate doctors in small towns.
#India
The feeling that intern had is something he still thinks about. It was satisfaction in its pure form. He thanked the sister and finished it in minutes.
#HappyNursesDay
To the people who take care of patients as well as doctors!
5/5
To all the interns working in hospitals post MBBS, don't just blindly collect samples, take ECGs etc. See what the case is, why a blood test was ordered, what does that ECG tell you. You can learn a lot. I often tell my juniors to not commit the mistakes that we did.
#MedTwitter
For med resident and interns ❗
Reminder : Normal ECG doesn't rule out angina/MI.
If symptoms are suggestive, work up further. Need to have high index of suspicion even if one risk factor is present.
#MedTwitter
A lot of people are joining residency now.
It's been 3 years since I finished off my residency and now I'm on the other side, teaching post grads. Here are a few tips for residency from medicine point of view after experiencing both the sides.
A thread
#Medtwitter
#NEETPG2022
1/n
Story of a single disease, one that may come back to haunt you even if you’ve recovered from it.
Humans will have a tough time eradicating this one.
#MedTwitter
#MedX
A rough guide to infectious diseases that I've learnt over the past one year combined into a short thread.
This is for newbies/students, experts can add to the thread. A humble attempt -
#MedTwitter
#IDtwitter
1/n
Ever saw Pan D BD on prescription?
Stop it immediately.
Max dose should not exceed 30mg/day.
Domperidone >30mg / day can lead to Sudden cardiac arrest due to prolonged QTc.
There are formulations with 40mg panto and 10mg dom that can be given BD
#MedX
#MedTwitter
#uptodate
Ophthalmologist spoke to the elderly male who was on the operating table for cataract surgery,
“Have you been having issues with your prostate? “
What do you think is happening?
#Medtwitter
Took a lecture for 1st yr MBBS on basics of ECG. I was anxious as to what to tell them from clinical point of view since they aren’t exposed to clinical medicine. Spoke non stop for 50 minutes and they were clapping in the end. Mission accomplished, maybe?
#MedX
#Medtwitter
Today’s rounds in ICU started with telling a mother that her only kid in his late 20s is no more due to a heart attack.
Take care of your health people, life is too unpredictable.
#MedTwitter
Qualifying percentile for NEET PG being zero is absurd. One has to just appear for the exam and leave it all blank. I am really hoping this is some kind of fake news. Imagine the rich abusing this, just appear, pay crores and get a seat in a private college all without a bare
Stayed up till late to prepare for a lecture, woke up early. No PPT, Made notes.. only to find out that students opted for a mass Bunk! Not a single soul! 😅🤷🏻♂️
#Medtwitter
Two most difficult areas in counseling in medicine -
1. Convincing a patient with widal positive test that they don't need an antibiotic
2. Convincing patient to start/switch to insulin when the situation demands.
#MedTwitter
Any other issues frequently faced in counseling?
Medicine as a profession can sometimes get emotionally stressful. I counselled 3 relatives today, about critical condition of their loved ones
1.Husband of a 35 yr old lady who lost her kid in the womb and is on ventilator since 10 days with no improvement in her lung condition
One simply does not pay for the 2 min or 10 minute consultation, you pay for the years of education, experience and skill. Don’t want to pay, go to someone who charges less or even better, go to government hospitals.
@Nainamishr94
THIS. IS. NOT. CPR!
CPR is performed when the patient has no pulse and not in an awake Patient
People should check facts before using the word CPR.
It will send out a wrong message.
Even if the patient is lying, one has no right to physically abuse a patient or anyone for that matter. You can refuse treatment and refer the patient to someone else, but hitting is definitely not the way to respond.
This Viral vedio from 'MY Hospital' in Indore, Madhya Pradesh,
in Which A patient endure scolding and slaps from doctors
★★★★
Clarifications ;
Patient was suffering from STD ,But he tried to hide it from all and put the lives of all health workers in danger.
#MedTwitter
Another day, another patient who received antibiotics coz he/she had ‘High grade fever’. Students and newly minted physicians - HIGH GRADE FEVER DOESNT MEAN PATIENT NEEDS ANTIBIOTICS.
Complete symptomatology and not just ‘high grade fever’ should be your guide to Abx.
#MedTwitter
MBBS students have started using chatGPT to fill log books! 😂
#MedTwitter
Feedback of session - 15 days of exposure to infectious diseases. The chatGPT feedback👇🏼
The more academic
#MedTwitter
tweets you come across, the more you realise how vast medicine is and how less you know. It definitely pushes to read more.
Done with Fellowship in General Infectious Diseases from CMC Vellore.
Have learnt soo much over the past 1 year! A whole new perspective regarding infections, it's treatment and ofcourse Antimicrobial Stewardship!
#IDtwitter
#MedTwitter
@DrDhruvchauhan
Just be careful Dr Dhruv, it doesn’t take long for the personal life judgements to spill over to professional life. Once you start practising and seeing more of patients and their lives, you’ll be less judgemental.
PS - problem is not multiple sexual partners but more of Safe
Scaring kids in the name of injections given by doctors has to stop. Not a single social event goes by without demonising doctors in front of a kid and then that kid refuses to play or come near to you! 😭
#Doctor
Vice president and spokesperson of ISCKON Kolkata! Religious leaders should stay away from medicine and science. If you can’t do good, at least don’t misguide the thousands who follow you. Horrible state of affairs.
The extent to which the allopathic establishment is unsettled by
@yogrishiramdev
is evident from the following quoted tweet.
STOP blindly believing in & consulting allopathic doctors like
@nihardesai7
. They will drain your bank balance and harm your health.
Ayurveda and
This knee jerk reflex of giving Ceftriaxone/Artesunate/ doxycycline for every damn fever needs to stop. Residents need to be taught better. In more than 90% of cases a good history can help you which one of these needs to be given empirically or nothing at all.
#MedTwitter
#MedX
Mumps wave in India? I recently saw a few cases in Mumbai.
Comment below if you’ve come across a case of mumps in your practice and the area where you stay in.
#India
#medtwitter
#MedX
#healthcare
I’d like to weigh in here, a relatively young faculty.
NEET MCQS solving skill does not substitute for patient management skill. Those who get fancy ranks and come to wards and ER struggle to apply that mcq knowledge for patient management.
This is a two way street. 🧵
If students are skipping (free)lectures on weekdays to attend (paid)coaching lectures - the problem is not in students but lectures.
A faculty can simply see past NEET MCQs related to the and also put those MCQs at the end for discussion.
Win win for both.
A weird finding.
Don't look at the obvious, but something weird in here. I can't understand what it is. A trivial, yet curious finding. Zoom in to see.
Anyone in
#medtwitter
can help?
Possibly not related to his complaints of breathlessness on exertion.
Wholesome! A typical North Indian Thali!
Courtesy - my sister, who is one of the best cooks!
Show me how a plate full of food looks in your culture?
#Food
#thali
NO! NO! NO!
One doesn’t need toxicity to hone their skills. What they need is a supportive environment and helpful seniors. You need to be a good human before you can be a good doctor.
#MedTwitter
Unpopular opinion
It's not neet pg rank
It's training like these what will make you surgeon.
Surgery unlike other branches requires a certain amount of physical and mental endurance.
If you are finding residency toxic then trust me life after residency is even more toxic.
These guys should be made to sit in a government hospital OPD, listen to the plight of our patients. Lifestyle modification is a f*cking luxury for most of our patients. They work 16-18 hrs a day, barely are able to have a nutritious meal a day.
#MedTwitter
Techbros and health nuts love talking about how the average Indian doctor is a pill pusher and will NEVER RECOMMEND lifestyle modification for metabolic diseases.
They think that pushing pills is part of our conspiracy to keep them under the control of Big Pharma.
Covid Pandemic should have shown people how important PSM is. To medical students, don’t ridicule any branch. Ranks don’t decide the importance of a branch. we clinicians have egos to satisfy and hence we think we are doing great work, we are but not like others aren’t.
1/n
Keep an eye on the amount of oxygen your COPD patient is receiving. It has more chances of harming them than helping. Accept spo2 of 88-92 at lowest possible O2 supply.
#MedTwitter
Unpopular opinion but TB mukt Bharat by even 2035 is unrealistic to think of, let alone 2025. Till we have the whole Armamentariam of diagnostic tests available at district level hospitals, we won’t be even close to eliminating it.
#TB
#India
#NTEP
How do you not let these stories affect you? How do you prevent grief from seeping into your consciousness? How do you not think about such stories of struggle and sorrow when you shut your eyes and go to bed? How do you balance out life in medicine?
If your patient is on any SGLT2 inhibitor, do ask for itching in genital area on every follow up. Many a times they underplay it and don't say it unless you ask them.
#MedTwitter
#Diabetes
#SGLT2i
The MUHS medicine paper for this year looks great but might be a bit too much for MBBS level, a fairly okay one for MD level. I feel a bit sorry for the students. But on the other hand I’m happy that we are shifting towards clinical questions rather than one liners.
#MUHS
Always send some background of symptoms, etc even for a second opinion.
Always better to show the patient in person over teleconsult.
Why the f*ck is this combination still available?
Apparently this was prescribed for ‘Viral fever’
#MedTwitter
#medX
2. Another gem all because of
@drjohnm
As the name suggests, you'll learn a lot about Cardiology. But the real catch is the way Dr. John critically appraises the studies he mentions. Absolutely brilliant.
#MedTwitter
@DrDhishanSai
It's not about ADR. The reason for which they give metro is covered by Pipzo unless one is suspecting parasite infection or C dif which is usually not so frequent compared to its usage. Pipzo had good anaerobic coverage.
We need to stop comparing Indian health care system with UK. You don’t pay anything in UK, the drawback is the wait. Here in India, you don’t have to wait as long but you have to pay up and mind you, the majority can’t pay 1.5k for a CT scan.
#health
Must have apps in Medicine residency -
MDcalC
Medscape
Adobe Acrobat reader
Any online Pharma app to check for drug content and brand names
UpToDate if you can afford
And ofcourse google!
#Medtwitter
Lot of people in DM asking me DNB vs MD.
Difficult question to answer. It really depends on what you're looking for. If you're planning to go for SS later on, shouldn't make a much of a difference. The line is getting blurred between DNB/MD but completely not yet.
1/n
A thread
Fellowships in medicine are nothing but cheap skilled labour for the big hospitals/consultants. The worst affected field is ophthalmology. It’s a shame that a post MS doc gets peanuts to perform surgeries on a daily basis in the name of developing skills.
#MedTwitter
#MedX
24 yr old, history of cough since 2 months with weight loss now presented with breathlessness.
Not the first investigation you'd do but try to connect the dots. X ray chest is a give away.
#MedTwitter
If there's a problem with your health or someone in your family, the one thing you shouldn't do is to DM a random doctor on Twitter or any other social media.
Rushing to the nearest hospital is a good move in such cases.
If you’re ever prescribing a NSAID to a patient, before you do it, all you have to do is ask them if they have any kidney/liver/heart issue, if they say yes, just don’t without consulting their primary doctor. And if you can, always check last creatinine.
#MedX
#Medtwitter
She said, I know you’re hungry, should have told us. She made the intern sit and kept a full glass of tea and 4 big breads in front of him. Patted on the back and said ‘eat and then go wherever you want to, if you need more let me know’
4/n
Saddened and shocked to hear about Dr Jay. I’m still processing it. It’s high time residency is restructured in India. We need to take care of our students in much better way. My heart goes out to his family.
Someone who attended the lecture reached out. This is why teaching will always be a satisfying experience! As a doctor I might be able to save a few hundred lives, as a teacher I might be able to save many thousands!
#Medtwitter
#medX
#ECG
Took a lecture for 1st yr MBBS on basics of ECG. I was anxious as to what to tell them from clinical point of view since they aren’t exposed to clinical medicine. Spoke non stop for 50 minutes and they were clapping in the end. Mission accomplished, maybe?
#MedX
#Medtwitter
YOU CANNOT BLAME THE RESIDENTS OR THE INTERNS FOR FAILURE OF A HEALTH CARE SYSTEM.
Even asking them as to why it happened, it's ridiculous. Just go to a government hospital and see how over worked they are.
@Chulbulpanda420
Yep, that’s why I said, fight to end casteism so that reservations can stop as well. Casteism leads to reservations and not the other way rounds. So if you really want reservations to end, you must fight to end casteism.
One thing that interns and residents should remember, the moment u have fever on history n you live in in India, Avoid NSAIDs till diagnosis is done❗
Specially if you're suspecting Malaria/Dengue/lepto etc. NSAIDs to be avoided at any cost
#MedTwitter
#Learningpoint
All casualty are supposed to first check and triage the patient and not delay it for Paper work. I was shocked to know this happened. Then the patient is seen by someone. He is a medical intern. No Registered Doctor saw the patient in casualty though there is stamp of someone.
A good and a detailed history will save a lot of money of the patient and earn you an equivalent of goodwill.
And it’s value increases in resource limited settings.
#MedTwitter
Mumbai doesn’t need AIIMS. It already has a good number of hospitals under BMC. What it needs is strengthening of the existing secondary health centres which will take the load of the handful tertiary care ones.
#mumbai
#healthcare
Why is there still no AIIMS in these major state capitals? 🏥
1. Mumbai
2. Chennai
3. Lucknow
4. Jaipur
5. Bengaluru
6. Gandhinagar
Which other cities do you think need AIIMS? Comment below!
#Healthcare
#AIIMS
#India
Travelling to the mountains? Going to go higher than 2000m?
Keep Acetazolamide 250mg / Dexamethasone 4mg / Nifedipine 30mg / pulse oximeter in your medicine kit. Get in touch with your doc if you get any symptoms.
#Travel
#mountainsickness
#MedX
#Medtwitter