#  @docrustic Dr shiv Kumar Dr shiv Kumar posts on X about dr, what is, in the, the most the most. They currently have [-----] followers and [---] posts still getting attention that total [-------] engagements in the last [--] hours. ### Engagements: [-------] [#](/creator/twitter::1593419311225638912/interactions)  - [--] Week [-------] -29% - [--] Month [-------] +423% - [--] Months [-------] +3,787% ### Mentions: [---] [#](/creator/twitter::1593419311225638912/posts_active)  - [--] Month [--] -90% - [--] Months [--] +200% ### Followers: [-----] [#](/creator/twitter::1593419311225638912/followers)  - [--] Week [-----] +15% - [--] Month [-----] +131% - [--] Months [-----] +18,722% ### CreatorRank: [-------] [#](/creator/twitter::1593419311225638912/influencer_rank)  ### Social Influence **Social category influence** [cryptocurrencies](/list/cryptocurrencies) [finance](/list/finance) [countries](/list/countries) [automotive brands](/list/automotive-brands) [currencies](/list/currencies) [technology brands](/list/technology-brands) [stocks](/list/stocks) [travel destinations](/list/travel-destinations) [musicians](/list/musicians) [nfl](/list/nfl) **Social topic influence** [dr](/topic/dr), [what is](/topic/what-is) #1315, [in the](/topic/in-the), [the most](/topic/the-most), [history](/topic/history), [ans](/topic/ans) #1255, [skin](/topic/skin), [sir](/topic/sir), [transient](/topic/transient), [lcx](/topic/lcx) #5 **Top accounts mentioned or mentioned by** [@albertoortegana](/creator/undefined) [@sameeryogi14](/creator/undefined) [@drakhilx](/creator/undefined) [@drmanishydv](/creator/undefined) [@shakiled](/creator/undefined) [@medlearnhub](/creator/undefined) [@daoo100](/creator/undefined) [@docpriyammd](/creator/undefined) [@miguelp23970914](/creator/undefined) [@chshafiullah15](/creator/undefined) [@drydvhitesh01](/creator/undefined) [@dr_manish_ydv](/creator/undefined) [@fzn733](/creator/undefined) [@frances98392343](/creator/undefined) [@ihabfathisulima](/creator/undefined) [@drarslan480](/creator/undefined) [@drmedica13](/creator/undefined) [@khannaa](/creator/undefined) [@esanum](/creator/undefined) [@vikrammshahpura](/creator/undefined) **Top assets mentioned** [LCX (LCX)](/topic/lcx) [General Motors Company (GM)](/topic/general-motors) [GrokCoin (GROKCOIN)](/topic/grok) ### Top Social Posts Top posts by engagements in the last [--] hours "@Rainmaker1973 @grok why" [X Link](https://x.com/docrustic/status/1916948848506728765) 2025-04-28T20:13Z [--] followers, [--] engagements "I never wish any son to go through the pain this gentleman is going through i wish india would be a better place without Pro pakistani boot lickers & double face Hindus who recite the prayers of secularism I am proud of my country #PahalgamTerrorAttack They asked my father to recite the Kalma. He didn't know it so they shot him. -Son of Dinesh Mirania who was killed by MusIim Terrorist in Pahalgam This Video should go Viral https://t.co/SevmwU0Ptg They asked my father to recite the Kalma. He didn't know it so they shot him. -Son of Dinesh Mirania who was killed by MusIim Terrorist in Pahalgam" [X Link](https://x.com/docrustic/status/1919485419600629827) 2025-05-05T20:12Z [--] followers, [--] engagements "@Nikhilsingh21_ Jai hind to our brave armed forces ♥" [X Link](https://x.com/docrustic/status/1920389921879306468) 2025-05-08T08:06Z [--] followers, [----] engagements "@mountain_rats Work from home eh" [X Link](https://x.com/docrustic/status/1921638188222656642) 2025-05-11T18:47Z [--] followers, [--] engagements "@Warlock_Shubh Breaking news- I saw a pakistani nuclear submarine in the Bangalore port" [X Link](https://x.com/docrustic/status/1921667753716437390) 2025-05-11T20:44Z [--] followers, [--] engagements "@IndiaWarZone Inka alag hi work from home chal rha h bhai" [X Link](https://x.com/docrustic/status/1921670362556739880) 2025-05-11T20:54Z [--] followers, [--] engagements "@mountain_rats Inka alag hi work from home chal rha h bhai" [X Link](https://x.com/docrustic/status/1922227666616303961) 2025-05-13T09:49Z [--] followers, [---] engagements "@miryar_baloch Brother how can we contribute you As in money wise I would love to donate you i am sure there are so many indians like me would like to contribute baloch folks" [X Link](https://x.com/docrustic/status/1922742226813116925) 2025-05-14T19:54Z [--] followers, [--] engagements "@Freeblochistan I would definitely visit Republic of Balochistan" [X Link](https://x.com/docrustic/status/1922770379233206769) 2025-05-14T21:45Z [--] followers, [---] engagements "@TheSkandar @UN @UNHumanRights Congratulations Republic of Balochistan people" [X Link](https://x.com/docrustic/status/1922775904050135528) 2025-05-14T22:07Z [--] followers, [--] engagements "@IndianTechGuide @grok @AskPerplexity whats the forex reserve of terrorist harbouring country Pakistan" [X Link](https://x.com/docrustic/status/1923405989190992344) 2025-05-16T15:51Z [--] followers, [--] engagements "@Ssriwastav30 @grok whos in the video When was it" [X Link](https://x.com/docrustic/status/1923679575575331161) 2025-05-17T09:58Z [--] followers, [----] engagements "@RussiaIsntEnemy @grok whats happening here" [X Link](https://x.com/docrustic/status/1923793995978899748) 2025-05-17T17:33Z [--] followers, [--] engagements "@BreathForBharat @grok what does the maroon hat means in army" [X Link](https://x.com/docrustic/status/1923870899167691073) 2025-05-17T22:39Z [--] followers, [---] engagements "@ReviewVayu @grok tell me about this missile" [X Link](https://x.com/docrustic/status/1924168204399804862) 2025-05-18T18:20Z [--] followers, [---] engagements "@MeghUpdates Only sane thing i have ever heard from supreme court lately" [X Link](https://x.com/docrustic/status/1924414693709340779) 2025-05-19T10:39Z [--] followers, [--] engagements "@vanshkumar421 @arunpudur AMCA Engine from General motors" [X Link](https://x.com/docrustic/status/1925286525639835687) 2025-05-21T20:24Z [--] followers, [--] engagements "@Noumanarshad746 @MeghUpdates This is your country this is your culture stfu" [X Link](https://x.com/docrustic/status/1925537989863555446) 2025-05-22T13:03Z [--] followers, [---] engagements "@vladimirputiniu London will not survive even a day😭 they think they are in british era Russia would sweep em off lol" [X Link](https://x.com/docrustic/status/1929753999055769717) 2025-06-03T04:16Z [--] followers, [--] engagements "@realMaalouf Disgusting creatures resides in pakistan you all will rot in hell man This is so sad Poor kid" [X Link](https://x.com/docrustic/status/1930515131059912828) 2025-06-05T06:40Z [--] followers, [--] engagements "@Madan_Chikna @grok whats the name of this product & where can i buy this" [X Link](https://x.com/docrustic/status/1931593054651105763) 2025-06-08T06:04Z [--] followers, [---] engagements "Just visit the hospital once again like you did yesterday with your Land rover & you can bring your photographer with you & ask for the apologies why so much of ego Nothing wrong in asking for apologies from a a doctor whos academically much superior to you #GoaMedicalCollege During the broadcast with Prudent Media last night I openly extended my heartfelt apology to Dr. Rudresh Kuttikar for the harsh words spoken by me during my visit to GMC. In the heat of the moment my emotions overtook my expression and I deeply regret the manner in which I During the broadcast with Prudent Media last" [X Link](https://x.com/docrustic/status/1932033325495123979) 2025-06-09T11:13Z [--] followers, [--] engagements "@visrane drive your land rover to the hospital and apologise to the doctor with the same intensity you terrorised the doctor you hooligan" [X Link](https://x.com/docrustic/status/1932063752020467831) 2025-06-09T13:14Z [--] followers, [--] engagements "@AugadhBhudeva @grok tell me the content of this video in a nutshell" [X Link](https://x.com/docrustic/status/1933783682344759732) 2025-06-14T07:08Z [--] followers, [----] engagements "@Indian_Analyzer @grok where to do this" [X Link](https://x.com/docrustic/status/1934959283394736619) 2025-06-17T13:00Z [--] followers, [--] engagements "@RVCJ_FB @grok what is the name of the channel of this prank" [X Link](https://x.com/docrustic/status/1935357532664643991) 2025-06-18T15:22Z [--] followers, [----] engagements "@ShivAroor @RoyalNavy @grok add donald trumps dance steps to this pic" [X Link](https://x.com/docrustic/status/1935576779298926643) 2025-06-19T05:54Z [--] followers, [--] engagements "@RanadheeraGowda Get your blood checked once Especially your vitamin B2 B3 B12 vitamin D & iron levels" [X Link](https://x.com/docrustic/status/1937030296039551199) 2025-06-23T06:09Z [--] followers, [--] engagements "@RajeshB18566468 Try reading full article and post the verdict too why are you posting half baking story for your engagement forming" [X Link](https://x.com/docrustic/status/1941217402022396072) 2025-07-04T19:27Z [--] followers, [--] engagements "@__phoenix_fire_ @grok tell me about this" [X Link](https://x.com/docrustic/status/1924522386046779428) 2025-05-19T17:47Z [--] followers, [----] engagements "@DrAkhilX @grok give me the link of this article" [X Link](https://x.com/docrustic/status/1988488620265926705) 2025-11-12T06:06Z [--] followers, 52.6K engagements "@BaluGorade Tata Sierras NA engine power train is impressive compared to its rivals including the Creta Seltos Hyundai and MS. If it manages to deliver good mileage & reliability nothing will stop it from capturing the market. What they are providing is a class apart" [X Link](https://x.com/docrustic/status/1995375096052191585) 2025-12-01T06:11Z [--] followers, [---] engagements "@neha_basic Why would a doctor prescribe azithromycin just for a simple cold Thats unethical practice. Most colds are viral & resolve on their own with rest and hydration no need to load up on unnecessary antibiotics" [X Link](https://x.com/docrustic/status/1998013947790889223) 2025-12-08T12:57Z [--] followers, [--] engagements "@Rightanglenews Wherever terror strikes its roots trace back to one rotten source Pakistan. #BondiBeachTerrorAttack is no different from #PahalgamTerroristAttack of kashmir . Deport these parasites back to where they belong" [X Link](https://x.com/docrustic/status/2000759544054735312) 2025-12-16T02:47Z [--] followers, [--] engagements "@Doctors__squad Blunt trauma or repeated force to the ear. Separation of perichondrium from auricular cartilage( commonly seen in combat sport athletes) Bleeding into the subperichondrial space auricular hematoma. Rx- Needle aspiration or I&D" [X Link](https://x.com/Dr_Shiv_kumar_/status/2003782324622938611) 2025-12-24T10:58Z [--] followers, [----] engagements "@Tayfun_demir1 @Frances98392343 @ecgandrhythmRoe @Charanreddy246 ECG: Sinus rhythm with LBBB STT elevation in V1-V3 with deep s wave. ST depression & T wave inversion in lateral leads ( I aVL V5 V6) These ST changes are discordant to QTS complexes. No Sgarbossa-positive STEMI" [X Link](https://x.com/Dr_Shiv_kumar_/status/2003877306801295647) 2025-12-24T17:15Z [---] followers, [---] engagements "@MTD_MED @IhabFathiSulima @medcrux @Sage_medics @modernHealthMe ACEIs: Bradykinin breakdown Bradykinin capillary leakage angioedema *ARBs: No ACE block but Ang II bradykinin & substance P (much rarer) CCBs: Arteriolar vasodilation with unchanged venous tone capillary hydrostatic pressure fluid extravasation" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004151648869061109) 2025-12-25T11:26Z [---] followers, [--] engagements "@TrackYourHeart Delayed ankle jerk (hung-up reflex) Most sensitive clinical sign of hypothyroidism Characteristic delay in relaxation phase (not contraction) Constipation- Due to reduced gut motility due to low T3/T4. Both result from reduced metabolic & N.muscular activity caused by low T3/T4" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004157767393882330) 2025-12-25T11:50Z [---] followers, 22.1K engagements "@Charanreddy246 @ecgandrhythmRoe @Frances98392343 @Tayfun_demir1 @ECGWeekly @josecruz2102 Deep symmetric T-wave inversions in V2V4 (V5) with resolution of prior ST elevation classic reperfusion pattern. After successful PTCA restored flow causes transient myocardial stunning altering repolarization & inverting T waves in the infarct territory" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004172990385381466) 2025-12-25T12:50Z [--] followers, [---] engagements "@ManualOMedicine ST elevation in II III aVF Inferior wall STEMI Reciprocal ST depression in I and aVL ST depression in V1V3 with tall R waves posterior wall involvement So this is not just inferior MI it is an: Infero-posterior STEMI. Culprit artery- RCA. Could be LCx involvement" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004215729198191020) 2025-12-25T15:40Z [---] followers, [---] engagements "@DrAkhilX Body packers syndrome-On plain abdominal X-ray each packet shows: Central uniform opacity drug material Surrounding thin radiolucent rim air trapped between multiple layers of condom wrapping ➡This creates the appearance of one condom inside another = double condom sign" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004389421807030777) 2025-12-26T03:10Z [---] followers, [---] engagements "@DrNikhilMD Dx- Kawasaki Bilateral non-purulent conjunctival injection Strawberry tongue Erythema of palms Polymorphous rash / facial changes Classic CRASH features: Conjunctivitis Rash Adenopathy (cervical) Strawberry tongue / oral mucosal changes Hand & foot changes" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004397439751803327) 2025-12-26T03:42Z [--] followers, [---] engagements "@DrAkhilX Electric shock ⚡Rosette cataract Electrical/thermal injury denatures lens proteins Star/flower-shaped (stellate) opacity Often bilateral delayed onset Classic lens finding after Blunt ocular trauma electrocution ionising radiation exposure" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004432441965207615) 2025-12-26T06:01Z [---] followers, [----] engagements "@DrRajeshG1 Regular narrow-complex tachycardia rate 150/min Saw-tooth flutter waves (V1 II III aVF) 2:1 AV conduction Diagnosis: Atrial flutter with 2:1 AV block Correct me if i wrong sir" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004436075331391603) 2025-12-26T06:16Z [--] followers, [---] engagements "@DrRajeshG1 Adenosine does not terminate atrial flutter. It transiently blocks the AV node but the flutter circuit is atrial macro-reentry and AV-node independent. Diltiazem slows AV conduction converting 2:1 to 3:1 or 4:1 block revealing flutter waves best seen in II III aVF" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004448196656091470) 2025-12-26T07:04Z [--] followers, [---] engagements "@Doctors_GUILD Giant Cell Tumor (GCT) of bone 🦴 Young adults (2040 yrs) Site: epiphysis of long bones (knee most common) X-ray: eccentric lytic soap-bubble lesion Benign but locally aggressive Tx: curettage adjuvant Recurrence can occur" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004518618332307693) 2025-12-26T11:44Z [--] followers, [---] engagements "@IrmaMDv Sinus rhythm with frequent premature ventricular complexes occurring as a ventricular couplet with wide QRS morphology and compensatory pause. Please correct if am wrong" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004528932239093812) 2025-12-26T12:25Z [--] followers, [---] engagements "@IhabFathiSulima Methanol poisoning toxic metabolites (formaldehyde formic acid). Ethanol drip works as an antidote because ethanol has higher affinity for alcohol dehydrogenase blocks methanol metabolism less acidosis & optic injury while methanol is excreted" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004601099509268888) 2025-12-26T17:12Z [---] followers, [---] engagements "@Doctors__squad Tunneled double-lumen hemodialysis catheter (Permcath): Inserted via internal jugular vein exits on chest. Subcutaneously tunneled to reduce infection. Two lumens 🔴 red (arterial blood out) & 🔵 blue (venous blood in). Dacron cuff anchors catheter & limits infection" [X Link](https://x.com/Dr_Shiv_kumar_/status/2004763822524170302) 2025-12-27T03:58Z [---] followers, [----] engagements "@Charanreddy246 @ecgandrhythmRoe @Frances98392343 @Tayfun_demir1 @josecruz2102 Post-RTA syncope with deep symmetric T-wave inversion (V2V5) + QT prolongation = Cerebral T waves. Cause: acute brain injury massive sympathetic (catecholamine) surge myocardial repolarization abnormality" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005309438526414962) 2025-12-28T16:06Z [---] followers, [---] engagements "@KakkamKrishna @KostekMilan Regular narrow-complex tachycardia 150/min due to typical atrial flutter with 2:1 AV conduction. Flutter waves are best seen in inferior leads with one wave buried in the ST segment causing a post-QRS negative notch. Normal axis no acute ischemia" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005493627712413781) 2025-12-29T04:18Z [---] followers, [--] engagements "@Abhilasha21822 Pseudomembranous candidiasis White curd like plaques on oral mucosa that scrape off leaving an erythematous / bleeding base. Seen in diabetes HIV steroid use immunosuppression. * Caused by Candida albicans" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005510941400772660) 2025-12-29T05:27Z [---] followers, [---] engagements "@Doctors__squad Corrigan (water-hammer) pulse in Aortic regurgitation: A bounding pulse with rapid upstroke and sudden collapse. AR stroke volume (high systolic BP) + diastolic backflow into LV (low diastolic BP) wide pulse pressure" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005641601721479556) 2025-12-29T14:06Z [---] followers, [---] engagements "@DrNikhilMD Atrial fibrillation + bioprosthetic mitral valve👉🏻 Warfarin for first [--] months ( INR level- 2.0-3.0) after that DOACs are acceptable" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005849763132924360) 2025-12-30T03:53Z [---] followers, [----] engagements "@mednomics Severe hypertriglyceridemia (1000 mg/dL) 👉🏻 chylomicrons clog pancreatic capillaries. Pancreatic lipase breaks TGs into toxic free fatty acids 👉🏻 ischemia fat necrosis & enzyme activation 👉🏻acute pancreatitis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005850509370855467) 2025-12-30T03:56Z [---] followers, [---] engagements "@DrNikhilMD Its for warfarin sir. NOAC point noted thanks" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005889368112738493) 2025-12-30T06:31Z [---] followers, [---] engagements "@TrackYourHeart 🔺 Triangle of safety- ICD placement done here safe. Chest tube goes in the triangle of safety 4th5th ICS just anterior to mid-axillary line above the rib. This spot avoids the VAN structures heart diaphragm & abdominal organs 👉🏻 safest pleural access fewer complications" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005897631596491050) 2025-12-30T07:03Z [---] followers, [----] engagements "@modernHealthMe Bauer (Crawling) Reflex Its a primitive spinal reflex. When a newborn is placed prone (on the abdomen) & gentle support/pressure is given to the soles the baby makes forward crawling movements with the back facing upward. Disappears by 3-4 months" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005904812567867888) 2025-12-30T07:32Z [---] followers, [---] engagements "@DrAkhilX Pudendal neuropathy aka toilet-seat neuropathy Prolonged sitting on a toilet seat can cause pudendal neuropathy. Constant pressure compresses the pudendal nerve (S2S4) 👉🏻 perineal-genital numbness or burning pain. Clue: pain worsens on sitting improves on standing" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005959299932344413) 2025-12-30T11:09Z [---] followers, 18K engagements "@DrSharadMutalik StevensJohnson syndrome (SJS) Triggered by drugs (antibiotics anticonvulsants NSAIDs). Starts with fever sore throat 👉🏻painful red rash 👉🏻blisters skin peeling & severe oral/eye/genital erosions. Ddx- TEN" [X Link](https://x.com/Dr_Shiv_kumar_/status/2005992061410107522) 2025-12-30T13:19Z [---] followers, [---] engagements "@dr_manish_ydv @Doctors__squad @doctors_squad @DrAkhilX @DrNikhilMD Answer- A : Comminuted intra-articular distal tibial fracture = Pilon fracture" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006281553467564421) 2025-12-31T08:29Z [---] followers, [---] engagements "@nervemed C. Clavicle Cleidocranial dysostosis: AD RUNX2 mutation 👉🏻 defective intramembranous ossification. Hallmarks: absent/hypoplastic clavicles (shoulders meet like the video above) delayed fontanelle closure frontal bossing & multiple supernumerary teeth. Dx - clinical + X-ray" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006298311289090365) 2025-12-31T09:36Z [---] followers, [----] engagements "@dr_manish_ydv D. All of the above Mainly used for fibrinogen deficiency its the fastest way to increase fibrinogen. Indications *Hypofibrinogenemia *DIC- if bleeding + low fibrinogen *Congenital deficiencies- Factor XIII deficiency *von Willebrand disease / Hemophilia A" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006325107946606750) 2025-12-31T11:22Z [---] followers, [---] engagements "@dr_manish_ydv Ans- B - Lateral femoral cutaneous nerve Entrapment causes purely sensory neuropathy ( nerve passed through inguinal ligament ) 👉🏻burning pain numbness tingling over the anterolateral thigh with no motor weakness" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006346960438206717) 2025-12-31T12:49Z [---] followers, [---] engagements "@dr_manish_ydv @daoo100 @Doctors__squad @doctors_squad @ArvindaJAP @DrAkhilX @DrArslan480 @MoarSahitoPTI @Rania_22100 Ans- Acute pancreatitis. This can become so severe that leaked enzymes digest surrounding tissue causing fat necrosis & retroperitoneal bleeding. Blood tracks along fascial planes to the flanks producing ecchymosis a rare sign that indicates severe disease" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006379918243065869) 2025-12-31T15:00Z [---] followers, [--] engagements "@TrackYourHeart Sustained polymorphic ventricular tachycardia (likely torsades de pointes morphology) causing near syncope. Wide QRS complex beat to beat QRS morphology. Check Mg+/ K+ /Ca+" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006617512524525649) 2026-01-01T06:44Z [---] followers, [----] engagements "@dr_manish_ydv @DrAkhilX @albertoortegana @daoo100 @MedEd_Cases @RavikantBh99255 @Amhar_47 @DrYdv_hitesh01 Thank you doc saab🙏🏼" [X Link](https://x.com/Dr_Shiv_kumar_/status/2006713458860114076) 2026-01-01T13:05Z [---] followers, [---] engagements "@sohrab1104 @Frances98392343 @ecgandrhythmRoe @Ecgloverr @ecgrhythms @DrRazi4 @DrRajeshG1 Acute anterior wall myocardial infarction primary ventricular fibrillation Pathophysiology: Acute LAD occlusion Severe transmural ischemia 👉🏻 Chaotic irregular waveform. No identifiable P waves (2nd ecg) 1st ecg- Hyperacute T waves in anterior precordial leads" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007025488704033148) 2026-01-02T09:45Z [---] followers, [---] engagements "@albertoortegana Mobitz I (Wenckebach) AV block Progressive PR interval prolongation on each beat until a P wave fails to conduct 👉🏻dropped QRS. Then the cycle repeats. 👉 Key point: pathology usually involves the AV node not the His-Purkinje system" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007283469089681801) 2026-01-03T02:50Z [---] followers, [--] engagements "@docxusofficial Long-term PPI use benign. Chronic acid suppression 👉🏻 hypergastrinemia decreased B12/Fe/Ca/Mg absorption fractures C. diff AIN 👉🏻CKD & rebound acid hypersecretion on stopping" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007426091921879236) 2026-01-03T12:17Z [---] followers, [----] engagements "@TheECGMedic Suspected pericardial effusion with electrical alternans on ECG (notably lead II) low QRS voltage + beattobeat height shift fits tamponade. Needs urgent echo to confirm plus hemodynamic assessment & possible pericardiocentesis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007675600677597233) 2026-01-04T04:48Z [---] followers, [---] engagements "@TrackYourHeart Ans- C Verapamil is contraindicated in VT because VT is Na channel mediated not AV-node dependent ( verapamil block ca+ channel in the AVN so terminate SVTs) It wont terminate VT & its negative inotropy + vasodilation can crash BP 👉🏻cardiogenic shock pulseless VT or VF" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007696093191254359) 2026-01-04T06:10Z [---] followers, [----] engagements "Case alert 🚨 72-y man T2DM on metformin [--] yrs + daily PPI [--] yrs presents with numb feet gait imbalance exertional dyspnea. Hb [----] g/dL MCV [---] fL B12 [---] pg/mL MMA & homocysteine. Anemia absent earlier whats the link" [X Link](https://x.com/Dr_Shiv_kumar_/status/2007791769791152223) 2026-01-04T12:30Z [---] followers, [----] engagements "@dr_manish_ydv @daoo100 @angna_86 @VikramMShahpura @DrYdv_hitesh01 Very nice chart doc saab thanks for sharing" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008131868944961839) 2026-01-05T11:02Z [---] followers, [--] engagements "@ECGWeekly Severe bradycardia with complete AV dissociation narrow QRS (junctional escape (20-30bpm) & ST elevation in III & aVF & reciprocal STD in I & aVL 👉🏻inferior wall STEMI (RCA)👉🏻 AV nodal ischemia causes transient complete AV block" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008166268076171354) 2026-01-05T13:18Z [---] followers, [---] engagements "@dr_manish_ydv Ans- B - katG Mutation Isoniazid is a prodrug meaning it needs activation by the KatG enzyme mutation in katG enzyme prevent proper activation of isoniazid & drug becomes ineffective" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008174583116124317) 2026-01-05T13:51Z [---] followers, [--] engagements "@dr_manish_ydv @daoo100 @VikramMShahpura @DrYdv_hitesh01 @DrAkhilX Ans C : HCM myocardium shows: ➡Myocyte hypertrophy. Myofibrillar disarray. Patchy interstitial fibrosis ➡ This creates electrical heterogeneity ➡ Leads to VT/VF especially during exertion Death is usually arrhythmic not pump failure" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008176291615514731) 2026-01-05T13:58Z [---] followers, [--] engagements "@dr_manish_ydv @DrAkhilX @VikramMShahpura @DrYdv_hitesh01 @daoo100 Ans- C : PTU PTU and methimazole block thyroid hormone synthesis in the thyroid gland. However PTU has dual action which acutely inhibits the enzyme 5-deiodinase in peripheral tissues which is responsible for converting thyroxine (T4) to the (T3)" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008178264305729874) 2026-01-05T14:06Z [---] followers, [---] engagements "@FibrilloFlutter @ecgandrhythmRoe @KostekMilan @makkyecg @ecgrhythms @Frances98392343 @Charanreddy246 @capuzzi_luciano @koggelnoggel @DrAkhilX Wandering Atrial Pacemaker (WAP/MAR) Irregular rhythm with [--] P wave morphologies with each beat variable PR narrow QRS HR [---]. Also shows marked sinus arrhythmia with phasic RR variation" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008251118133145872) 2026-01-05T18:55Z [---] followers, [---] engagements "@TrackYourHeart ST elevation in I aVL V5V6 with reciprocal STD in II III aVF = High-lateral STEMI ( culprit vessel likely to be LCX) + ST depression in V1V2V3 + Tall R wave in the anterior leads suggestive of posterior involvement" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008516819062325642) 2026-01-06T12:31Z [---] followers, [----] engagements "@joeroganhq Its astonishing how he believed ivermectin and Fenbendazole cure cancer. You dont need to be a doctor to understand the natural course of a disease" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008738987343835420) 2026-01-07T03:14Z [---] followers, [----] engagements "@dr_manish_ydv Dissection = intimal tear with fragile aortic wall. Thrombolytics dissolve stabilizing clots 👉🏻massive bleeding aortic rupture" [X Link](https://x.com/Dr_Shiv_kumar_/status/2008963146564948472) 2026-01-07T18:05Z [---] followers, [--] engagements "@drsthanus Multiple Sclerosis periventricular hyperintense plaques 👉🏻CNS demyelination👉🏻 Results in limbs paresthesia paresis general weakness" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009243424881561737) 2026-01-08T12:38Z [---] followers, [---] engagements "@IhabFathiSulima [--] degree AV block (Complete heart block): More P waves than QRS (atrial rate ventricular). Regular PP & RR but no fixed PR. P waves march through independently. AV dissociation atria (sinus [-----] bpm) & ventricles (escape [----] bpm) beat independent of each other" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009254270345019790) 2026-01-08T13:22Z [---] followers, [---] engagements "@Doctors_GUILD Pelvic X-ray shows a well defined radiopaque object shaped like a firearm projected over the rectum 👉🏻 Rectal foreign body. Key risks: perforation bleeding sepsis. Removal: endoscopic or surgical based on stability & shape" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009302394786730249) 2026-01-08T16:33Z [---] followers, [---] engagements "@albertoortegana Long standing Raynauds now presents with painful fingertip ulcers/necrosis 👉🏻 critical digital ischemia. This is a vascular emergency. Treat first Start IV prostaglandins (e.g. iloprost) to restore flow. Autoantibodies & imaging come later come later" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009354652031308065) 2026-01-08T20:00Z [---] followers, [--] engagements "@Doctors__squad Corrigan sign (Water-hammer pulse) 👉🏻Aortic Regurgitation A forceful bounding pulse with rapid rise and sudden collapse felt best in the carotid or radial artery. Stroke volume (LV ejects a large volume) Diastolic pressure (blood leaks back into LV) ➡ wide pulse pressure" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009476826620678347) 2026-01-09T04:06Z [---] followers, [--] engagements "@Tayfun_demir1 Bradyarrhythmia with advanced AV block I can see RAD ( degenerative His purkinje disease ) + T wave inversion in II III aVF + anterior precordial leads it could be secondary to brady arrhythmia & conduction abnormality suggestive of demand ischemia" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009531194111873097) 2026-01-09T07:42Z [---] followers, [---] engagements "@Doctors__squad Flat wart (Verruca plana): HPV types: [--] [--] Sites: Face forehead dorsum of hands shins Look: Small flat-topped skin coloured papules" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009562017049485323) 2026-01-09T09:44Z [---] followers, [---] engagements "@ManualOMedicine Hb [----] g/dL MCV [----] fL ( microcytic) RDW 18.9% Platelets 410k RBC histogram: left-shifted High RDW + reactive thrombocytosis 👉🏻Iron deficiency anemia in pregnancy" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009687493814432164) 2026-01-09T18:03Z [---] followers, [---] engagements "@DrAkhilX Facioscapulohumeral Muscular Dystrophy (FSHD) AD disorder 🙂 Facial weakness (cant whistle) 🪽 Scapular winging 👉🏻Asymmetric slowly progressive 👉🏻Beevor sign 👉🏻CK normal/mild" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009836686201762066) 2026-01-10T03:56Z [---] followers, [----] engagements "I still think about it when bro just casually dropped [---] carcinogens [---] cancer agents [--] COPD like it was Harrison's page number. No source. No pause. No shame Evidence based medicine ❌ Evidence based screenplay ✅ Doctors watching this scene: 😐" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009841028279455974) 2026-01-10T04:13Z [---] followers, [---] engagements "@dr_manish_ydv @Doctors__squad @Doctors_GUILD @DrYdv_hitesh01 @DrAkhilX @VikramMShahpura HRCT chest: classically shows multiple nodules with surrounding ground-glass opacity (halo sign) Fever+ neutropenia +no response to antibiotics + sterile culture ( pro cal is low ) i am learning towards Invasive fungal infection most commonly Aspergillus" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009842951581774138) 2026-01-10T04:21Z [---] followers, [--] engagements "@medcrux Rapid vomiting after eating pastry Think Bacillus cereus ➡ Spores survive baking ➡ Improper storage 👉🏻pre-formed heat-stable toxin (cereulide) Incubation: [--] hrs 🤢 Predominant nausea & vomiting no fever Treatment: supportive only" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009886057224122822) 2026-01-10T07:12Z [---] followers, [---] engagements "@DrAkhilX Dermatology and orthopedics the never ending saga 🤣" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009898775440216070) 2026-01-10T08:03Z [---] followers, [----] engagements "@TrackYourHeart Addison disease (Primary adrenal insufficiency) Destruction of adrenal glands 👉🏻 Cortisol & aldosterone 👉🏻 ACTH. Clues: diffuse hyperpigmentation (skin/mucosa/scars) hypotension weight loss GI symptoms weakness vitiligo. Labs: Na K" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009917755919872228) 2026-01-10T09:18Z [---] followers, [----] engagements "Case alert 🚨 40F with chronic migraine on sumatriptan 100mg develops URTI starts azithromycin + phenylephrine (nasal decongestant) & suddenly develops with central chest pain diaphoresis dyspnea. ECG: OMI hs-cTn. Cath: no plaque induced stenosis LAD vasospasm seen. Dx" [X Link](https://x.com/Dr_Shiv_kumar_/status/2009983910575484934) 2026-01-10T13:41Z [---] followers, [----] engagements "@IhabFathiSulima Methanol isnt toxic until metabolized. Alcohol dehydrogenase converts it to formic acid 👉🏻metabolic acidosis & blindness. Ethanol has higher affinity for ADH competitively blocking methanol metabolism and buying time for excretion/dialysis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010018454817092024) 2026-01-10T15:58Z [---] followers, [----] engagements "@IhabFathiSulima Myasthenia gravis (MG): Autoimmune disorder of the neuromuscular junction. Path: Abs vs ACh receptors. Features: Fluctuating fatigable weakness ptosis diplopia bulbar/limb muscles; normal sensation reflexes. Tx: AChE inhibitors immunosuppression thymectomy" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010032076213588095) 2026-01-10T16:52Z [---] followers, [---] engagements "@mednomics Takotsubo cardiomyopathy: Stress-induced transient LV systolic dysfunction. Trigger: Emotional/physical stress leads catecholamine surge. Features: ACS-like chest pain ST-T changes modest troponin rise. Echo: Apical ballooning. Coronaries: Normal" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010032754835239043) 2026-01-10T16:55Z [---] followers, [----] engagements "@medcrux Takotsubo cardiomyopathy: Stress-induced transient LV systolic dysfunction. Trigger: Emotional/physical stress leads catecholamine surge. Features: ACS-like chest pain ST-T changes modest troponin rise. Echo: Apical ballooning. Coronaries: Normal" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010062885561741514) 2026-01-10T18:55Z [---] followers, [---] engagements "@Doctors_GUILD Metabolic alkalosis Vomiting ➡loss of H & Cl 👉🏻 HCO. Volume loss ➡ RAAS/aldosterone 👉🏻 distal Na reabsorption with K & H secretion. Alkalosis shifts K into cells + renal K wasting ➡ hypokalemia. Ecg- U wave appears" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010213755070886130) 2026-01-11T04:54Z [---] followers, [---] engagements "@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @RavikantBh99255 I feel answer is A my explanation TB resulted RCM👉🏻 Rigid pericardium in constrictive pericarditis blocks RV expansion. On inspiration venous return shifts septum left( seen on the x ray) LV filling & stroke volume ➡ [--] mm Hg fall in SBP (pulsus paradoxus👉🏻(80 ➡ 60)" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010258090034376864) 2026-01-11T07:50Z [---] followers, [---] engagements "@Doctors_GUILD Ans- D Violaceous indurated plaques on nose/cheeks involving nasolabial folds 👉🏻sarcoidosis (lupus pernio) = chronic disease poor prognosis. Photosensitive butterfly rash sparing folds 👉🏻SLE malar rash" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010324677147972016) 2026-01-11T12:15Z [---] followers, [----] engagements "@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrRajeshG1 @DrYdv_hitesh01 @RavikantBh99255 @VikramMShahpura Ans- B- Arrow marks marginal mandibular nerve (CN VII). It runs along lower border of mandible superficial to submandibular gland. Supplies depressor anguli oris depressor labii inf mentalis. Injury 👉🏻asymmetric smile" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010600932447592528) 2026-01-12T06:33Z [---] followers, [--] engagements "@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @RavikantBh99255 @DrRajeshG1 Ans- B : Meralgia paresthetica = entrapment of the lateral femoral cutaneous nerve ( LFCN) under the inguinal ligament Symptoms- Burning pain tingling numbness over anterolateral thigh. Purely sensory nerve. Root value L2L3. No weakness no reflex loss" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010610374295666868) 2026-01-12T07:10Z [---] followers, [--] engagements "@dr_manish_ydv Ans- D capillary filtration across the capillaries= [--] Use Starling force formula. Net = (Pc Pi) (c i) = [--] [--] Pi (27 7) = [--] [--] Pi [--] = [--] Pi = [--] mmHg Interstitial pressure is negative to prevent edema" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010652460176785776) 2026-01-12T09:57Z [---] followers, [--] engagements "@dr_manish_ydv Ans- A Child ( genetic predisposition) + Father had similar condition ( AD) Lab- isolated LDL predominantly This is classic hyperlipoproteinemia 2A" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010655403944956234) 2026-01-12T10:09Z [---] followers, [--] engagements "@dr_manish_ydv Cause : LDL receptor defect (Apo B mutation)" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010655648992866386) 2026-01-12T10:10Z [---] followers, [--] engagements "Case alert🚨 : 75M with OA chronic HTN on enalapril [--] mg + HCTZ [--] mg. Started ibuprofen [---] mg TID [--] mo for his symptoms. Now C/O chest pain palpitations dizziness N/V/D+ weakness cramps confusion. urine output deranged KFT. ABG labs ECG done 👇🏻🔖 Dx" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010709387288121470) 2026-01-12T13:44Z [---] followers, [----] engagements "@dr_manish_ydv MPS I (Hurler syndrome) -L-iduronidase deficiency 👉🏻 lysosomal accumulation of dermatan sulfate + heparan sulfate. Clues: developmental delay organomegaly corneal clouding weakness" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010721920954896479) 2026-01-12T14:33Z [---] followers, [--] engagements "@SameerYogi14 @DrAkhilX @dr_manish_ydv @IlliasulK @DrNoumory Galant reflex: primitive neonatal reflex. Stroking paraspinal skin 👉🏻trunk flexes toward stimulus. Present at birth disappears by [--] months. Persistence or asymmetry suggests neurological or spinal pathology" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010758264573821246) 2026-01-12T16:58Z [---] followers, [--] engagements "@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrRajeshG1 @DrYdv_hitesh01 @RavikantBh99255 @VikramMShahpura Badiya doc saab aaj tho MCQ ki barish ho rhi h keep up sir 👍🏻" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010758767273783626) 2026-01-12T17:00Z [---] followers, [--] engagements "@dr_manish_ydv Ans- IL5a : Benralizumab is a humanized MCAB that targets the alpha subunit of the interleukin-5 receptor (IL-5R) on the surface of eosinophils and basophils. Uses- severe eosinophilic Asthma EGPA. Route- S/C Dose- Initial dose 30mg every [--] wks for the first [--] dose then 8wks" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010770136253288677) 2026-01-12T17:45Z [---] followers, [--] engagements "@drsthanus Pulmonary nodule = rounded lung opacity [--] cm surrounded by parenchyma (3 cm = mass). DDx: granuloma hamartoma cancer" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010778614376382774) 2026-01-12T18:19Z [----] followers, [----] engagements "@DrAkhilX Commonly abused anabolic steroids in bodybuilding: Testosterone Nandrolone Trenbolone Dianabol Anadrol Winstrol Anavar. Gains come at a cost cardiomyopathy MI infertility & liver injury" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010904070928871497) 2026-01-13T02:37Z [---] followers, [----] engagements "@dr_manish_ydv @Alarmeddd @daoo100 @Doctors__squad @Doctors_GUILD @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @SameerYogi14 @RavikantBh99255 Ans- Histoplasmosis Chronic cavitary lung lesions + hilar lymphadenopathy mimicking TB = Histoplasmosis Key clue: tiny [--] m yeast with narrow-based budding( microconidia) on HPE/SDA culture 👉🏻 Histoplasma capsulatum. Seen on HPE &culture on SDAz" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010973136603529441) 2026-01-13T07:12Z [---] followers, [---] engagements "@MuhammadZa96288 @dr_manish_ydv @Alarmeddd @albertoortegana @Chakravart70006 @daoo100 @DrAkhilX @rajin13a1 @VikramMShahpura @DrYdv_hitesh01 @SameerYogi14 Ans B- severe Leptospirosis or weil disease Jaundice + AKI + bleeding after water exposure = Weil disease" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010973552695263325) 2026-01-13T07:13Z [---] followers, [--] engagements "@dr_manish_ydv @albertoortegana @Alarmeddd @daoo100 @Doctors__squad @DrAkhilX @DrYdv_hitesh01 @SameerYogi14 @VikramMShahpura 45-yo with hearing loss + gait ataxia + CPA mass. HPE shows Antoni A & B areas with Verocay bodies 👉🏻 Vestibular schwannoma" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010992903645257733) 2026-01-13T08:30Z [---] followers, [--] engagements "@DrAkhilX Child with severe photosensitivity blistering scars red/cola-colored urine & reddish teeth (erythrodontia) 👉🏻Congenital erythropoietic porphyria (Gunther disease). AR defect of uroporphyrinogen III synthase 👉🏻porphyrins hemolysis splenomegaly" [X Link](https://x.com/Dr_Shiv_kumar_/status/2011012046360555630) 2026-01-13T09:46Z [---] followers, [---] engagements "Large-volume ascitic tap (paracentesis) Done to relieve tense ascites & dyspnea and to diagnose cause. 👉🏻Site: LLQ USG-guided aseptic drain slowly. 👉🏻Causes: cirrhosis (MC) malignancy TB CHF nephrotic syndrome pancreatitis. 👉🏻Precautions: check INR/platelets empty bladder albumin replacement (5 L) monitor BP renal function & leaks post-tap. Indications : New onset ascites At the time of each admission to the hospital Clinical deterioration either inpatient or outpatient Fever Abdominal pain Abdominal tenderness Mental status change Ileus Hypotension Laboratory abnormalities that may" [X Link](https://x.com/Dr_Shiv_kumar_/status/2011859486324244561) 2026-01-15T17:54Z [---] followers, [---] engagements "@doctors_squad Mask-like facies seen in Parkinsonism 🧠 Due to dopamine in the nigrostriatal pathway 👉🏻facial bradykinesia + rigidity. Automatic facial expressions are lost blink rate falls emotions are felt but not shown. Not weakness the movement is slow" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012037153501692012) 2026-01-16T05:40Z [---] followers, [----] engagements "Faget sign classically seen in Typhoid fever. But also seen in other conditions -Yellow fever -Brucellosis -Legionnaires disease In most infections fever 👉🏻 pulse . Faget sign = fever without expected tachycardia due to altered autonomic or cytokine-mediated cardiac response. https://twitter.com/i/web/status/2012041081052151966 https://twitter.com/i/web/status/2012041081052151966" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012041081052151966) 2026-01-16T05:55Z [---] followers, [----] engagements "@IhabFathiSulima Modified Valsalva Maneuver (for SVT) In stable SVT strain hard for [--] sec (like blowing into a syringe) 👉🏻 then immediately lie flat & raise legs to [--] for [--] sec 👉🏻 relax. Postural change boosts vagal tone venous return baroreceptor firing 👉🏻 terminates AVNRT safely" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012071137824686219) 2026-01-16T07:55Z [---] followers, [---] engagements "Tinea versicolor: Superficial fungal infection by Malassezia furfur. Causes hypo/hyper-pigmented fine scaly macules on trunk/neck. Worse with heat & sweating. KOH: spaghetti & meatballs 👉🏻Spaghetti short curved hyphae 👉🏻Meatballs round yeast cells (spores) This mixed pattern is characteristic of Malassezia infection and helps confirm the diagnosis quickly. Tx: topical selenium sulfide/azoles; oral azoles if extensive. https://twitter.com/i/web/status/2012145823275159556 https://twitter.com/i/web/status/2012145823275159556" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012145823275159556) 2026-01-16T12:52Z [---] followers, [---] engagements "Case alert 🚨 A middle-aged obese man (BMI 31) presents to the ED. K/C/O - DM HTN dyslipidemia compliant with meds. Past history: biliary stone disease managed conservatively. He was stable until [--] days ago when he developed vague uneasiness poor appetite and fatigue. Last night he woke suddenly with: Repeated vomiting Palpitations (heart racing) Mild dyspnea High-grade fever with chills Unable to speak during the episode No chest pain. No cough. No diarrhea. On arrival Temp 38.5C HR 62/min BP 90/60 mmHg Toxic icteric cold peripheries Mild confusion O/E - Abdomen: RUQ tenderness with guarding" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012174490181288066) 2026-01-16T14:45Z [---] followers, [----] engagements "@Charanreddy246 @ecgandrhythmRoe @Ecgloverr @Frances98392343 @Tayfun_demir1 @EcgOxford @ecgrhythms @KostekMilan ECG shows left ventricular hypertrophy with high QRS voltage (deep S in V1V3 tall R in V5V6/aVL). Lateral downsloping ST depression with asymmetric T-wave inversion represents LVH strain secondary repolarization not acute ischemia serial ecg+ hsCTn recommended" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012418950366380256) 2026-01-17T06:57Z [---] followers, [---] engagements "Phenytoin-induced gingival hyperplasia Pathophysiology: [--] Drug effect: Phenytoin acts on gingival fibroblasts [--] Fibrosis: collagen & ECM production [--] Impaired breakdown: MMPs ( Matrix Metalloproteinases ) TIMPs ( Tissue Inhibitors of Metalloproteinases) collagen not degraded [--] Folate effect: folate uptake collagenase activity 👉🏻 collagen accumulates gingival overgrowth Similar drugs: Cyclosporine Nifedipine (CCBs) https://twitter.com/i/web/status/2012477599570919934 https://twitter.com/i/web/status/2012477599570919934" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012477599570919934) 2026-01-17T10:50Z [---] followers, [----] engagements "@dr_manish_ydv @DrAkhilX @albertoortegana @DrArslan480 @DrYdv_hitesh01 @MissNyra__ @RavikantBh99255 @Sabster01 @VikramMShahpura Ans- A Cremasteric reflex root value - L1 L2 Afferent limb: Ilioinguinal nerve 👉🏻L1 Efferent limb: Genitofemoral nerve (genital branch) 👉🏻 L1L2" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012481244542685185) 2026-01-17T11:04Z [---] followers, [---] engagements "INSULIN RESISTANCE: FACTS vs FICTION Insulin resistance isnt caused by one food one oil or one meal-timing trick. Lets separate science from social-media myths 👇 [--] Insulin isnt bad ✅ Insulin rises after all meals carbs protein mixed foods. Thats normal physiology. The problem is chronic hyperinsulinemia not a single spike. [--] Protein & dairy can raise insulin and thats OK ✅ Some proteins (esp. whey) stimulate insulin. But protein also raises glucagon preventing hyperglycemia. ➡ Insulin rise insulin resistance. [--] Insulin resistance starts years before diabetes ✅ Glucose may look normal while" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012487247711580231) 2026-01-17T11:28Z [---] followers, [--] engagements "@DrAkhilX Antibiotic + NSAID + Steroid for sore throat" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012491032559030502) 2026-01-17T11:43Z [---] followers, [--] engagements "@_AYO234 @Medzonetv OP poisoning ➡ bronchorrhea + bronchospasm + respiratory muscle weakness. This causes hypoxia which is the immediate cause of death Atropine dries secretions but does NOT correct hypoxia instantly" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012642695282364842) 2026-01-17T21:46Z [---] followers, [---] engagements "@albertoortegana @DrAkhilX @dr_manish_ydv 1st ecg- Regular complex narrow supra ventricular tachycardia (HR [---] ) P waves hidden or retrograde. 2nd ecg : Give adenosine transient AV nodal block brief asystole/AV block unmasks atrial activity & terminates AVNRT/AVRT restoring sinus rhythm" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012738673960509860) 2026-01-18T04:07Z [---] followers, [---] engagements "OSSIFYING FIBROMA slow progressive facial bony expansion with smooth contour intact skin & no facial nerve deficit suggests a benign fibro-osseous tumor. Imaging shows a well-circumscribed expansile lesion with mixed density classic for ossifying fibroma. Why not cancer Malignancy causes rapid growth pain ulceration nerve palsy ill-defined destructive margins & nodes OF is neoplastic not infective. Definitive treatment = complete surgical excision. https://twitter.com/i/web/status/2012812040562483616 https://twitter.com/i/web/status/2012812040562483616" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012812040562483616) 2026-01-18T08:59Z [---] followers, [---] engagements "Alcoholic + Abdominal pain+ Cullen sign Cullen sign (bluish periumbilical ecchymosis) in a chronic alcoholic classically points to acute hemorrhagic pancreatitis. Alcohol pancreatic acinar injury enzyme activation vascular necrosis retroperitoneal bleeding tracking via falciform ligament to umbilicus. Seen in severe pancreatitis / retroperitoneal hemorrhage. Indicates high severity systemic inflammation mortality poor prognosis. https://twitter.com/i/web/status/2012843746220712010 https://twitter.com/i/web/status/2012843746220712010" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012843746220712010) 2026-01-18T11:05Z [----] followers, [---] engagements "100% agree. That discipline is exactly what helped Virat Kohli endure pressure stay consistent and push through every obstacle cricket threw at him. Talent got him noticed but fitness routine and mindset kept him at the top. When others fade with age workload or setbacks he adapted evolved and stayed hungry. Thats real greatness not just stats. https://twitter.com/i/web/status/2012947003123376311 https://twitter.com/i/web/status/2012947003123376311" [X Link](https://x.com/Dr_Shiv_kumar_/status/2012947003123376311) 2026-01-18T17:55Z [---] followers, [--] engagements "Ans C - Here is my justification ECG shows sinus tachycardia with diffuse STD and STE in aVR 👉🏻 global subendocardial ischemia. After epidural ephedrine (+ b agonist) caused HR contractility BP 👉🏻 sudden myocardial O demand 👉🏻 Type [--] (demand) ischemia. Not plaque rupture (no focal STEMI) not coronary spasm (would cause focal STE) not endothelial dysfunction (chronic not acute drug-triggered)" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013089426562511322) 2026-01-19T03:21Z [---] followers, [---] engagements "Ecg shows : STE in inferior leads ( IIIII aVF) & STE in lateral precordial leads - (V4 V5 V6) + Reciprocal STD in (I aVL) + ( V1 V2 - Suggests posterior wall involvement as well) Correct answer is- [--]. Acute Inferiolateral infarction. Artery likely to be occluded - LCX ( Left circumflex) https://twitter.com/i/web/status/2013106196279066948 https://twitter.com/i/web/status/2013106196279066948" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013106196279066948) 2026-01-19T04:28Z [----] followers, [---] engagements "Patient likely to be suffering from DKA 1.Diabetic Ketoacidosis (DKA) 🥇 2.Hyperosmolar Hyperglycemic State (HHS) less likely. 3.Sepsis precipitating DKA ( Pneumonia TB UTI Catheterised patients appendiciti cholecystitis peritonitis septic shock infective endocarditis Etc can lead to sepsis and precipitate DKA) 👉 Immediate priorities: ABG serum ketones electrolytes (esp. K+ ) IV fluids insulin infusion infection work-up. https://twitter.com/i/web/status/2013120476735004931 https://twitter.com/i/web/status/2013120476735004931" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013120476735004931) 2026-01-19T05:24Z [----] followers, [----] engagements "Dx : Whipples disease Rare systemic infection Caused by Tropheryma whipplei Classic triad: Chronic diarrhea + weight loss + migratory arthralgia Also CNS cardiac & ocular involvement Dx: PAS+ macrophages / PCR Rx: prolonged antibiotics ( [--] months or above) initial therapy ➡ IV Ceftriaxone (or IV Penicillin G) for [--] weeks Chosen for good CNS penetration (important because CNS involvement is common even if asymptomatic) [--] Maintenance (long-term therapy) ➡ TrimethoprimSulfamethoxazole (TMP-SMX) Tropheryma whipplei is intracellular High relapse risk especially CNS relapse Short courses =" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013149322502980020) 2026-01-19T07:19Z [---] followers, [---] engagements "@DocPriyamMD @DrAkhilX @dr_manish_ydv @MedLearnHub @Doctors__squad @anupsoans @ecgandrhythmRoe @gianmauror63676 @DrYdv_hitesh01 @albertoortegana Yes doc. The patients BP meds were quite inconsistent. What are your thoughts on the possible trigger Patient mentioned that this was his first episode with this. I appreciate your insights" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013230011067871299) 2026-01-19T12:40Z [---] followers, [---] engagements "@Frances98392343 @DrAkhilX @dr_manish_ydv @MedLearnHub @Doctors__squad @anupsoans @ecgandrhythmRoe @gianmauror63676 @DrYdv_hitesh01 @DocPriyamMD @albertoortegana Doc Im still skeptical about those slurry R waves. Do they indicate anything significant" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013231848890253531) 2026-01-19T12:47Z [---] followers, [--] engagements "@dr_manish_ydv @IhabFathiSulima @DrAkhilX Ans- D Why Colposuspension elevates the bladder neck and proximal urethra by suturing paravaginal tissue to Coopers ligaments" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013233536028004737) 2026-01-19T12:54Z [---] followers, [--] engagements "Dx- Acute early proximal LAD OMI ST-elevation in I aVL V1V2 localizes injury to the high-lateral and anteroseptal walls 👉🏻 proximal LAD territory. Reciprocal ST-depression in II III aVF supports transmural anterior injury. ST-depression in V4V6 + Tall T waves reflects subendocardial ischemia of the lateral wall in early proximal LAD OMI. Needs urgent reperfusion ( PCI) https://twitter.com/i/web/status/2013262405833490627 https://twitter.com/i/web/status/2013262405833490627" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013262405833490627) 2026-01-19T14:48Z [---] followers, [--] engagements "Coronary angio shows patent LM & LAD with good distal runoff while LCX fills proximally but distal vessel is poorly visualised suggesting posterior/lateral territory involvement. LCX OMI often causes posterior MI 👉🏻 mirror changes on ECG. Hence ST depression in V2V5 (Option 3) fits best not obvious STE. https://twitter.com/i/web/status/2013361828089471364 https://twitter.com/i/web/status/2013361828089471364" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013361828089471364) 2026-01-19T21:24Z [---] followers, [--] engagements "@albertoortegana I cant see distal LCX🥹 correct me if am wrong doc Thanks" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013363332787380284) 2026-01-19T21:29Z [---] followers, [--] engagements "@albertoortegana Yes makes sense i didnt see LCX & i jumped into the conclusion of LCX OMI thanks for the description" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013367368043425919) 2026-01-19T21:46Z [----] followers, [--] engagements "@albertoortegana Ans- [--]. Coagulation of the lesion with endoscopic treatment 👉🏻Presentation: Elderly patient painless bright red blood per rectum 👉🏻 classic for lower GI bleeding Colonoscopy finding: Multiple diverticula Active oozing from a sigmoid diverticulum 👉🏻bleeding source is identified" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013515008974692845) 2026-01-20T07:32Z [---] followers, [--] engagements "Whats really happening here Prolonged fasting + stress 👉🏻 blood glucose( depleted glycogen stores + additional stress induced catecholamine surge) glucose supply to the brain transient cerebral dysfunction ( Neuroglycopenia) syncope Why Postural worsening (dizziness on standing) can occur because hypoglycemia impairs cerebral perfusion responses. https://twitter.com/i/web/status/2013526329338277893 https://twitter.com/i/web/status/2013526329338277893" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013526329338277893) 2026-01-20T08:17Z [---] followers, [----] engagements "Green nail syndrome Green-black nail discoloration due to Pseudomonas aeruginosa. Due to moisture + onycholysis. Why green color Pigment is pyocyanin / pyoverdine produced by Pseudomonas Common in frequent hand washers/healthcare workers. Treat by keeping nails dry trimming nail topical antibiotics in severe cases. https://twitter.com/i/web/status/2013614621467517400 https://twitter.com/i/web/status/2013614621467517400" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013614621467517400) 2026-01-20T14:08Z [---] followers, [---] engagements "STE in aVL & V1V5 with reciprocal STD in III aVF 👉🏻 True acute ischemia. Left axis deviation suggests new LAFB a high-risk ACS sign (LAD septal ischemia). Tall symmetric hyperacute T waves in V2V4 and straight/convex STE favor transmural MI. Pattern localizes to proximal LAD occlusion large anterior territory. Do not wait for the CTn activate cath lab immediately. https://twitter.com/i/web/status/2013832689166770377 https://twitter.com/i/web/status/2013832689166770377" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013832689166770377) 2026-01-21T04:35Z [----] followers, [---] engagements "Milk production starts only after delivery. During pregnancy estrogen & progesterone prepare the breast but inhibit secretion. Estrogen : growth of ducts Progesterone : development of lobules & alveoli Prolactin : primes milk synthesis 👉 Actual milk secretion is inhibited because estrogen & progesterone are high After placental delivery👉🏻 prolactin acts. Suckling increases prolactin (milk synthesis) & oxytocin (let-down). Frequent feeding empties breast overcomes Feedback inhibitior of prolocatin and increases supply. https://twitter.com/i/web/status/2013888430435115241" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013888430435115241) 2026-01-21T08:16Z [----] followers, [---] engagements "Dx- Filigree burn: A superficial electrical skin injury with delicate branching (fern-like) erythema. Caused by surface arcing of high-voltage current it reflects transient dermal capillary dilation not true tissue necrosis. Typically painless non-blistering appears early and fades within hoursdays without scarring. It is also seen in following conditions Lightning strike victims most classic association 👉🏻High-voltage electrical exposure (surface arcing) 👉🏻Static electricity discharge (rare mild forms) https://twitter.com/i/web/status/2014025318705799258" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014025318705799258) 2026-01-21T17:20Z [----] followers, [---] engagements "Dx- Meningocele It is a form of spina bifida cystica caused by failure of neural tube closure. The meninges herniate through a vertebral defect forming a cystic sac on the back usually midline. The sac contains CSF without neural tissue so neurological deficits are minimal or absent. Management is early surgical repair to prevent rupture and infection. https://twitter.com/i/web/status/2014290542700659157 https://twitter.com/i/web/status/2014290542700659157" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014290542700659157) 2026-01-22T10:54Z [----] followers, [----] engagements "10-year parotid swelling pleomorphic adenoma Long-standing slow-growing painless cheek/parotid mass Firm lobulated usually from superficial lobe of parotid Facial nerve intact favors benign lesion Most common salivary gland tumor Work-up: USG +- FNAC Tx: Superficial parotidectomy (nerve preservation) ⚠ Long duration risk of malignant transformation https://twitter.com/i/web/status/2014309825044471812 https://twitter.com/i/web/status/2014309825044471812" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014309825044471812) 2026-01-22T12:11Z [----] followers, [----] engagements "Post-TAVI ECG: Regular wide-QRS escape rhythm with visible P waves marching independently true AV dissociation = complete heart block. QRS is broad with LBBB pattern. Right axis deviation suggests infra-Hisian ventricular escape +/- associated LPFB. Even if asymptomatic this mandates pacing. https://twitter.com/i/web/status/2014312985947455721 https://twitter.com/i/web/status/2014312985947455721" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014312985947455721) 2026-01-22T12:23Z [----] followers, [---] engagements "@Medzonetv Open NTDs (meningocele myelomeningocele) 👉🏻 Increased maternal serum AFP ( Alpha feto protein) Closed NTDs 👉🏻AFP may be normal" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014328202307707277) 2026-01-22T13:24Z [----] followers, [---] engagements "Lymphocutaneous sporotrichosis Rose-gardeners disease caused by Sporothrix schenckii. Inoculation via thorn/soil painless papule linear nodulo-ulcerative lesions spreading along lymphatics (sporotrichoid pattern). Dimorphic fungus Mold form at [--] C (environment) Yeast form at [--] C (human tissue) Tissue: cigar-shaped yeast Dx: culture cigar-shaped yeast. Tx: Itraconazole / SSKI. Amphotericin B severe/disseminated disease https://twitter.com/i/web/status/2014338625325187388 https://twitter.com/i/web/status/2014338625325187388" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014338625325187388) 2026-01-22T14:05Z [----] followers, [---] engagements "Painless slow-growing lobulated mass at the angle of mandible with preserved facial nerve function points to pleomorphic adenoma of parotid. Imaging :- MRI shows a well-circumscribed heterogeneous lesion (epithelial + myxoid elements). Commonest salivary tumor treat with parotidectomy preserve facial nerve during the sx. https://twitter.com/i/web/status/2014509830330061156 https://twitter.com/i/web/status/2014509830330061156" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014509830330061156) 2026-01-23T01:25Z [----] followers, [----] engagements "Ans- : Central pontine myelinosis (ODS): Occurs after rapid correction of chronic hyponatremia Brain adapts by losing osmolytes sudden Na rise causes cellular dehydration Oligodendrocyte injury pontine demyelination Delayed onset (26 days): dysarthria dysphagia quadriparesis Prevent: Na correction [--] mEq/L/day https://twitter.com/i/web/status/2014511013010542859 https://twitter.com/i/web/status/2014511013010542859" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014511013010542859) 2026-01-23T01:30Z [----] followers, [---] engagements "Black dusky non-glistening bowel with hemorrhagic edematous mesentery and a sharp transition zone of ischemic bowel. Venous congestion ( SMA embolus Mesenteric venous thrombosis ) hypoxia transmural necrosis. Atonic thickened loops = non-viable gut. Surgical emergency resection. https://twitter.com/i/web/status/2014512096743182825 https://twitter.com/i/web/status/2014512096743182825" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014512096743182825) 2026-01-23T01:34Z [----] followers, [----] engagements "Dx : - Aortic dissection A tear in the aortic intima lets blood track into media false lumen( like shown in the video) Risks: HTN connective tissue disease. Symptoms: Sudden tearing chest/back pain. O/E : Pulse/BP differential +/- AR murmur. Dx: CT angiography. Rx: Stanford A surgery; Stanford B medical (Medical mx)" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014572061600186634) 2026-01-23T05:33Z [----] followers, [---] engagements "Dx- AML-M3 (Acute Promyelocytic Leukemia) Why it is AML M3 30-yr pt with fatigue gum bleeding epistaxis It is DIC-driven leukemia. Pathogenesis: t(15;17) PML-RARA fusion block in promyelocyte differentiation + procoagulant release. Clinical features: pancytopenia mucocutaneous gum bleeding petechiae; infection less prominent initially. Peripheral smear: abnormal hypergranular promyelocytes multiple Auer rods (faggot cells above picture ) MPO+. Labs: anemia thrombocytopenia fibrinogen PT/aPTT D-dimer. Diagnosis: morphology + cytogenetics (PML-RARA). Pearl: start ATRA immediately." [X Link](https://x.com/Dr_Shiv_kumar_/status/2014655217158258823) 2026-01-23T11:03Z [----] followers, [---] engagements "Bat wing (butterfly) appearance on CXR Seen as B/L symmetric perihilar alveolar opacities radiating outward with relative peripheral lung sparing. Why it appears rapid alveolar fluid accumulation classically cardiogenic pulmonary edema due to increased pulmonary capillary hydrostatic pressure. Central lungs fill first because of richer blood flow & lymphatic drainage patterns. How it appears fluffy ill-defined perihilar shadows often with cardiomegaly Kerley B lines pleural effusions. Diagnosis: CXR + clinical context (acute dyspnea orthopnea) echo BNP response to diuretics. Differentials:" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014671122189713543) 2026-01-23T12:06Z [----] followers, [--] engagements "Ans- Sarcoidosis Why Eye involvement (uveitis) Granulomatous inflammation of uveal tract 👉🏻 red painful eye photophobia. Common extra-pulmonary feature. Lupus pernio (face) Violaceous indurated plaques over nose & cheeks 👉🏻highly specific for chronic sarcoidosis. Erythema nodosum (legs) Tender red subcutaneous nodules on shins due to panniculitis 👉🏻marker of active systemic inflammation Biopsy finding Non-caseating granulomas (tight epithelioid cell clusters no central necrosis) 👉🏻 histologic hallmark. https://twitter.com/i/web/status/2014684534001041637" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014684534001041637) 2026-01-23T12:59Z [----] followers, [---] engagements "A 4-year-old child presents with a high fever that has lasted for [--] days. The child has "strawberry tongue" (bright red bumpy tongue) red eyes without discharge a rash and swollen lymph nodes in the neck. What is the most serious complication of this condition (Kawasaki Disease) that doctors must monitor for using an Echocardiogram A) Aortic dissection B) Coronary artery aneurysms C) Mitral valve prolapse D) Pulmonary embolism #neetpg2026 #MedTwitter https://twitter.com/i/web/status/2014720308331303225 https://twitter.com/i/web/status/2014720308331303225" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014720308331303225) 2026-01-23T15:22Z [----] followers, [---] engagements "Dx: Meningomyelocele Congenital midline lumbosacral cystic swelling with a large tense translucent sac. Contents include meninges + CSF + neural tissue 👉🏻unlike meningocele. Often associated with lower-limb weakness bladder/bowel dysfunction & hydrocephalus (Chiari II). Needs early neurosurgical repair. https://twitter.com/i/web/status/2014776595433796046 https://twitter.com/i/web/status/2014776595433796046" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014776595433796046) 2026-01-23T19:05Z [----] followers, [---] engagements "@Interventi47477 @ecgandrhythmRoe @albertoortegana @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan LAD & LCX stenosis approx 80% " [X Link](https://x.com/Dr_Shiv_kumar_/status/2014784462660485229) 2026-01-23T19:37Z [----] followers, [--] engagements "@albertoortegana @ecgandrhythmRoe @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan Yes doc CAG showed LCX & LAD occlusion. cTn was significantly elevated. Thanks for the detailed analysis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014785143446372506) 2026-01-23T19:39Z [----] followers, [---] engagements "@PeterItebimien @albertoortegana @ChefKarim02 @IhabFathiSulima @elidyynwa @MEmwanta @mendietaalex1 @TSM_Humanist @DrAkhilX @drkeithsiau @modernHealthMe @BrownJHM @the_beardedsina @rkalyes1 @Doctors__squad @NicoGagelmann @ChiomaDPatrick Necrolytic migratory erythema + diabetes + weight loss 👉🏻 Glucagonoma Characteristic rash 👉🏻Necrolytic migratory erythema (erythematous scaly erosive plaques often on limbs/perineum) New-onset diabetes mellitus Recurrent diarrhea Progressive weight loss" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014813407913152787) 2026-01-23T21:32Z [----] followers, [---] engagements "Dx- Melanoma Why Melanoma screening made simple the ABCDE rule 🧠🩺 A: Asymmetry one half unlike the other B: Border irregular notched poorly defined edges C: Color multiple shades (brown black blue red white) D: Diameter [--] mm (but small melanomas exist) E: Evolution Any change in size shape color or symptoms (most important) https://twitter.com/i/web/status/2014924658345451684 https://twitter.com/i/web/status/2014924658345451684" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014924658345451684) 2026-01-24T04:54Z [----] followers, [---] engagements "This video points to situational syncope due to a Valsalva-type manoeuvre most commonly stretch syncope. Whats happening: forceful muscle flexion/straining intrathoracic pressure venous return transient cerebral perfusion syncope. Related bucket: situational reflex syncope (cough micturition defecation weight-lifting stretching) brief LOC rapid recovery no post-ictal confusion. https://twitter.com/i/web/status/2015022321439060363 https://twitter.com/i/web/status/2015022321439060363" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015022321439060363) 2026-01-24T11:22Z [----] followers, [----] engagements "Patients with Sjgrens Syndrome have a 44-fold higher risk of developing which type of malignancy compared to the general population A) Lung Cancer B) B-cell Lymphoma C) Osteosarcoma D) Melanoma #MedTwitter #neetpg2026 @albertoortegana @SameerYogi14 @dr_manish_ydv @DrYdv_hitesh01 @DrAkhilX @IhabFathiSulima https://twitter.com/i/web/status/2015068714249617605 https://twitter.com/i/web/status/2015068714249617605" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015068714249617605) 2026-01-24T14:26Z [----] followers, [----] engagements "In The Pitt a crash victim arrives labeled quadriplegic. Dr. Robby pauses checks the history walks to the lab and the picture changes: Hypokalemic Periodic Paralysis. What looked like permanent paralysis was actually reversible. A quiet diagnostic pivot and suddenly the whole case makes sense. #MedTwitter #ThePittSpoilers Case alert 🚨:- 28yo Indian M Graves presents 2AM w/ acute ascending flaccid paralysis after late-night high-carb dinner & workout. Proximal legs arms profound hyporeflexia preserved sensation/cranial nerves K+ [---] mmol/L CK mildly up. ECG: U waves Dx#MedTwitter" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015088935916155179) 2026-01-24T15:46Z [----] followers, [---] engagements "Thats what made The Pitt click for me. It actually feels like the ER fast decisions uncertainty pattern recognition course correction. No forced love arcs. No melodrama hijacking the medicine. Just cases chaos and thinking under pressure. So far its holding its ground and thats rare. https://twitter.com/i/web/status/2015090705786630161 https://twitter.com/i/web/status/2015090705786630161" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015090705786630161) 2026-01-24T15:53Z [----] followers, [--] engagements "Regular wide-complex tachycardia (180/min). QRS shows RBBB morphology: dominant R / rSR-like pattern in V1 with deep broad S in I & V6. Axis is leftward (I positive II/III/aVF negative) consistent with LAFB. No beat-to-beat QRS variation suggesting organized conduction rather than polymorphic VT. Taken together this fits bifascicular block (RBBB + LAFB) @Frances98392343 doc what do you think https://twitter.com/i/web/status/2015098366473245063 https://twitter.com/i/web/status/2015098366473245063" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015098366473245063) 2026-01-24T16:24Z [----] followers, [---] engagements "All the statements are true actually. Why The fetal adrenal cortex grows massively in utero (for placental estrogen synthesis) and regresses after birth✅ Both fetal & definitive cortex arise from mesoderm while the definitive cortex matures postnatally✅ The adrenal medulla is a neural crest derivative✅ https://twitter.com/i/web/status/2015126927502434569 https://twitter.com/i/web/status/2015126927502434569" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015126927502434569) 2026-01-24T18:17Z [----] followers, [--] engagements "Hair-on-end skull in thalassemia major: Why it happens Severe ineffective erythropoiesis chronic anemia erythropoietin marked bone marrow hyperplasia. Marrow expansion widens diploic space thins outer table and forms vertical trabeculae perpendicular to skull seen on X-ray as radiating hair-on-end striations. https://twitter.com/i/web/status/2015280577038131382 https://twitter.com/i/web/status/2015280577038131382" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015280577038131382) 2026-01-25T04:28Z [----] followers, 29.9K engagements "Squamous cell carcinoma Why Firm indurated growth on the lateral border of the tongue with a keratinized white surface is classic for oral squamous cell carcinoma. The lateral tongue is a high-risk site keratinization reflects malignant epithelial change and firmness suggests invasion. SCC until proven otherwise biopsy is mandatory. Ddx Leukoplakia Oral lichen planus Traumatic ulcer / frictional keratosis https://twitter.com/i/web/status/2015331627485045129 https://twitter.com/i/web/status/2015331627485045129" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015331627485045129) 2026-01-25T07:51Z [----] followers, [---] engagements "ECG alert 🚨 A 45-year-old man presented to the emergency room with central chest pain. An electrocardiogram (ECG) was obtained and I would like to know your thoughts on this ECG #MedTwitter #Cardiology #ER" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015337321760260336) 2026-01-25T08:13Z [----] followers, [----] engagements "Ans- Infereriolateral wall MI Why LCX supplies the lateral LV (V5V6) and in left-dominant hearts the inferior wall via PDA. In the given CAG proximal LCX occlusion cuts flow to both territories producing 👉🏻Inferolateral MI If LCX is dominant & gives rise to PDA- STE in II III aVF with V5V6often with reciprocal aVL depression and possible posterior changes. If not STE in I aVL V5 V6 is seen with subtle reciprocal changes( not obligatory) https://twitter.com/i/web/status/2015349940827173302 https://twitter.com/i/web/status/2015349940827173302" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015349940827173302) 2026-01-25T09:04Z [----] followers, [----] engagements "Ans- Ritodrine Ritodrine is a selective b2 -adrenergic agonist. Why is is preferred [--] Stimulates b2 receptors on uterine smooth muscle [--] Activates adenylate cyclase [--] cAMP inside myometrial cells [--] cAMP reduces intracellular Calcium availability [--] Actinmyosin interaction [--] Uterine relaxation 👉🏻 inhibition of contractions. https://twitter.com/i/web/status/2015400134079811617 https://twitter.com/i/web/status/2015400134079811617" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015400134079811617) 2026-01-25T12:23Z [----] followers, [----] engagements "@SameerYogi14 @DrAkhilX @dr_manish_ydv @dranuj_k Medical science never fails to amaze me. Good post doc👍🏻" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015449426505187361) 2026-01-25T15:39Z [----] followers, [--] engagements "Dx- Rectal foreign body (RFB) Appearance: - Well-defined radiopaque oval/cylindrical object in rectum/sigmoid on pelvic X-ray +/-free air Presentation: - Delayed vague history inability to pass stool/flatus Sx/Signs: - Rectal pain bleeding tenesmus abd pain peritonitis if perforated Dx: Pelvic X-ray first; CT if perforation; DRE after imaging Tx: Transanal removal +/- endoscopy; surgery 👉🏻perforation/sepsis. https://twitter.com/i/web/status/2015492282339008954 https://twitter.com/i/web/status/2015492282339008954" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015492282339008954) 2026-01-25T18:29Z [----] followers, [---] engagements "@medcrux Boutonniere deformity : Why in RA occurs due to chronic synovitis causing rupture of the central slip of extensor tendon at PIP joint PIP flexion with compensatory DIP hyperextension. Reflects longstanding inflammatory damage to extensor mechanism" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015665749906624689) 2026-01-26T05:58Z [----] followers, [---] engagements "Why TMT + hypoglycemia can show hyperkalemia-like ECG changes Exercise-induced hypoglycemia triggers a massive catecholamine surge 👉🏻 beta-adrenergic mediated K+ shift from cells to plasma + impaired Na/K-ATPase (low glucose). Result: functional hyperkalemia 👉🏻tall tented T waves on ECG. Reversible with glucose. Ecg shows :- Tall tented T waves 👉🏻P waves disappear👉🏻 Slow heart rate👉🏻 Finally: Cardiac arrest https://twitter.com/i/web/status/2015747875708482031 https://twitter.com/i/web/status/2015747875708482031" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015747875708482031) 2026-01-26T11:25Z [----] followers, [--] engagements "Dx- Choriocarcinoma: It is highly malignant gestational trophoblastic tumor from syncytio & cytotrophoblasts. Seen after molar pregnancy abortion or term gestation. Age: reproductive years. Sx: PV bleeding early lung/brain mets. Dx: very increased beta-hCG. Associations : complete mole. https://twitter.com/i/web/status/2015843284250460190 https://twitter.com/i/web/status/2015843284250460190" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015843284250460190) 2026-01-26T17:44Z [----] followers, [---] engagements "@albertoortegana @IhabFathiSulima @DrAkhilX @DrArslan480 @DrNikhilMD ✅ Answer: B) Trisomy [--] (Edwards syndrome) Why 👇 Classic features of Edwards syndrome: Microcephaly Clenched fists with overlapping fingers Rocker-bottom feet Congenital heart defects (VSD PDA common) Severe growth restriction low-set ears prominent occiput" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015994716198973468) 2026-01-27T03:46Z [----] followers, [---] engagements "@KSRTC_Journeys Traveling on the Airavat from Mangalore to Bangalore whats the point of providing charging ports no human can access And even if you manage to reach them they dont work. Paying a premium fare yet passengers are treated like trash" [X Link](https://x.com/Dr_Shiv_kumar_/status/2010982748463514086) 2026-01-13T07:50Z [----] followers, [---] engagements "Pruritic erythematous scaly plaques in groin that typically spare scrotum = tinea cruris. First-line: topical anti fungals prefer terbinafine 1% once daily [--] wks (fungicidal faster cure). Alternatives: azoles (clotrimazole/ketoconazole) [--] wks. Apply to lesion + [--] cm margin and continue [--] wk after clearance. Systemic therapy (terbinafine/itraconazole) if extensive recurrent or failed topical. ❌ Avoid steroidantifungal combos tinea incognito & recurrence. Adjuncts: keep area dry loose cotton clothing treat coexisting tinea pedis hygiene is key." [X Link](https://x.com/Dr_Shiv_kumar_/status/2012855824331501819) 2026-01-18T11:53Z [----] followers, [---] engagements "Dx- Pneumonia ( CAP) I see the hyperlucent parenchymal opacity is likely a lobar consolidation on the right side of the lung. Additionally there is a tracheal shift to the opposite side of the affected lung which could be due to the consolidation and mass effect causing the shift. https://twitter.com/i/web/status/2013677101183099258 https://twitter.com/i/web/status/2013677101183099258" [X Link](https://x.com/Dr_Shiv_kumar_/status/2013677101183099258) 2026-01-20T18:16Z [----] followers, [----] engagements "A 55-year-old man known case of hypertension and dyslipidemia on treatment presents to the ER with acute onset severe retrosternal chest pain for [--] hours radiating to the jaw and both shoulders associated with dyspnea palpitations nausea and profuse diaphoresis. Pain is persistent and not relieved by rest. ECG obtained is shown. Whats your thoughts on this ecg #MedTwitter #Cardiology" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014690465472512473) 2026-01-23T13:23Z [----] followers, [----] engagements "@cardiogutierrez @ecgandrhythmRoe @albertoortegana @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan Yes doc it was multi vessel disease. Critical LAD/LCX occlusion. Thanks for your analysis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014785497365938259) 2026-01-23T19:41Z [----] followers, [---] engagements "Ans- B Why Why Calcium Channel Blockers (CCBs) are FIRST LINE (Dihydropyridines: nifedipine amlodipine) Mechanism Block L-type Ca channels in vascular smooth muscle Intracellular Ca arteriolar vasodilation Why they fit Raynauds perfectly Directly counteract vasospasm Strong effect on small peripheral arteries Proven decreases attack frequency & severity Rapid symptomatic benefit 👉 They target the primary pathology unlike beta blockers aspirin ACEI. https://twitter.com/i/web/status/2014935065936248928 https://twitter.com/i/web/status/2014935065936248928" [X Link](https://x.com/Dr_Shiv_kumar_/status/2014935065936248928) 2026-01-24T05:35Z [----] followers, 20.8K engagements "Nephrotic syndrome likely Minimal Change Disease Why Peri-orbital swelling in a child classic early sign of nephrotic syndrome Blood sample appears milky / lipemic 👉🏻due to severe hyperlipidemia Pathophysiology: Heavy proteinuria 👉🏻 plasma oncotic pressure Liver compensates by lipoprotein synthesis 👉🏻 lipemia https://twitter.com/i/web/status/2015441901441417642 https://twitter.com/i/web/status/2015441901441417642" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015441901441417642) 2026-01-25T15:09Z [----] followers, [---] engagements "Dx:- Raynaud phenomenon: episodic digital ischemia due to exaggerated vasospasm of small arteries triggered by cold or stress. Pathogenesis: endothelial dysfunction 👉🏻Increased -adrenergic vasoconstriction. Symptoms : triphasic color change (white-blue-red) pain numbness. Assoc: SSc SLE RA. Tx: avoid cold CCBs (nifedipine) PDE-5 inhibitors sympathectomy (severe). https://twitter.com/i/web/status/2015844136700805409 https://twitter.com/i/web/status/2015844136700805409" [X Link](https://x.com/Dr_Shiv_kumar_/status/2015844136700805409) 2026-01-26T17:47Z [----] followers, [---] engagements "@dr_manish_ydv @IhabFathiSulima ✅ Answer: C Why Age [----] years is the common age group where torsion occurs due to testicular growth at puberty but age is not a predisposing abnormality" [X Link](https://x.com/Dr_Shiv_kumar_/status/2016171317490549132) 2026-01-27T15:27Z [----] followers, [---] engagements "Vigorous muscle flexing 👉🏻 syncope Whats the physiology behind this Sustained isometric contraction ( Chap is flexing in the video ) Increases intrathoracic & intra-abdominal pressure (Valsalva-like) IVC/SVC compression venous return (preload) stroke volume & cardiac output arterial BP cerebral perfusion +/- vagal surge (bradycardia)👉🏻 This results syncope https://twitter.com/i/web/status/2016763509301006748 https://twitter.com/i/web/status/2016763509301006748" [X Link](https://x.com/Dr_Shiv_kumar_/status/2016763509301006748) 2026-01-29T06:41Z [----] followers, [---] engagements "@DrAkhilX Ocular pentastomiasis" [X Link](https://x.com/Dr_Shiv_kumar_/status/2016780938211115053) 2026-01-29T07:50Z [----] followers, 30.6K engagements "ECG alert 🚨 A 56-year-old patient presents with [--] hours of severe retrosternal chest pain diaphoresis and nausea. BP 108/68 mmHg HR 96/min SpO 98% (RA) Investigations: ECG as shown hs-cTn I :- [---] ng/mL CK-MB :- [--] U/L Total CK :- [---] U/L Serum K :- [---] mmol/L Serum Mg :- [---] mg/dL Serum creatinine :- [---] mg/dL ABG :- No acidosis Which coronary artery is occluded Whats your thoughts on this ECG #MedTwitter #cardiology #ECG https://twitter.com/i/web/status/2016825037983273132 https://twitter.com/i/web/status/2016825037983273132" [X Link](https://x.com/Dr_Shiv_kumar_/status/2016825037983273132) 2026-01-29T10:45Z [----] followers, [----] engagements Limited data mode. Full metrics available with subscription: lunarcrush.com/pricing
@docrustic Dr shiv Kumar
Dr shiv Kumar posts on X about dr, what is, in the, the most the most. They currently have [-----] followers and [---] posts still getting attention that total [-------] engagements in the last [--] hours.
Engagements: [-------] #
- [--] Week [-------] -29%
- [--] Month [-------] +423%
- [--] Months [-------] +3,787%
Mentions: [---] #
- [--] Month [--] -90%
- [--] Months [--] +200%
Followers: [-----] #
- [--] Week [-----] +15%
- [--] Month [-----] +131%
- [--] Months [-----] +18,722%
CreatorRank: [-------] #
Social Influence
Social category influence cryptocurrencies finance countries automotive brands currencies technology brands stocks travel destinations musicians nfl
Social topic influence dr, what is #1315, in the, the most, history, ans #1255, skin, sir, transient, lcx #5
Top accounts mentioned or mentioned by @albertoortegana @sameeryogi14 @drakhilx @drmanishydv @shakiled @medlearnhub @daoo100 @docpriyammd @miguelp23970914 @chshafiullah15 @drydvhitesh01 @dr_manish_ydv @fzn733 @frances98392343 @ihabfathisulima @drarslan480 @drmedica13 @khannaa @esanum @vikrammshahpura
Top assets mentioned LCX (LCX) General Motors Company (GM) GrokCoin (GROKCOIN)
Top Social Posts
Top posts by engagements in the last [--] hours
"@Rainmaker1973 @grok why"
X Link 2025-04-28T20:13Z [--] followers, [--] engagements
"I never wish any son to go through the pain this gentleman is going through i wish india would be a better place without Pro pakistani boot lickers & double face Hindus who recite the prayers of secularism I am proud of my country #PahalgamTerrorAttack They asked my father to recite the Kalma. He didn't know it so they shot him. -Son of Dinesh Mirania who was killed by MusIim Terrorist in Pahalgam This Video should go Viral https://t.co/SevmwU0Ptg They asked my father to recite the Kalma. He didn't know it so they shot him. -Son of Dinesh Mirania who was killed by MusIim Terrorist in Pahalgam"
X Link 2025-05-05T20:12Z [--] followers, [--] engagements
"@Nikhilsingh21_ Jai hind to our brave armed forces ♥"
X Link 2025-05-08T08:06Z [--] followers, [----] engagements
"@mountain_rats Work from home eh"
X Link 2025-05-11T18:47Z [--] followers, [--] engagements
"@Warlock_Shubh Breaking news- I saw a pakistani nuclear submarine in the Bangalore port"
X Link 2025-05-11T20:44Z [--] followers, [--] engagements
"@IndiaWarZone Inka alag hi work from home chal rha h bhai"
X Link 2025-05-11T20:54Z [--] followers, [--] engagements
"@mountain_rats Inka alag hi work from home chal rha h bhai"
X Link 2025-05-13T09:49Z [--] followers, [---] engagements
"@miryar_baloch Brother how can we contribute you As in money wise I would love to donate you i am sure there are so many indians like me would like to contribute baloch folks"
X Link 2025-05-14T19:54Z [--] followers, [--] engagements
"@Freeblochistan I would definitely visit Republic of Balochistan"
X Link 2025-05-14T21:45Z [--] followers, [---] engagements
"@TheSkandar @UN @UNHumanRights Congratulations Republic of Balochistan people"
X Link 2025-05-14T22:07Z [--] followers, [--] engagements
"@IndianTechGuide @grok @AskPerplexity whats the forex reserve of terrorist harbouring country Pakistan"
X Link 2025-05-16T15:51Z [--] followers, [--] engagements
"@Ssriwastav30 @grok whos in the video When was it"
X Link 2025-05-17T09:58Z [--] followers, [----] engagements
"@RussiaIsntEnemy @grok whats happening here"
X Link 2025-05-17T17:33Z [--] followers, [--] engagements
"@BreathForBharat @grok what does the maroon hat means in army"
X Link 2025-05-17T22:39Z [--] followers, [---] engagements
"@ReviewVayu @grok tell me about this missile"
X Link 2025-05-18T18:20Z [--] followers, [---] engagements
"@MeghUpdates Only sane thing i have ever heard from supreme court lately"
X Link 2025-05-19T10:39Z [--] followers, [--] engagements
"@vanshkumar421 @arunpudur AMCA Engine from General motors"
X Link 2025-05-21T20:24Z [--] followers, [--] engagements
"@Noumanarshad746 @MeghUpdates This is your country this is your culture stfu"
X Link 2025-05-22T13:03Z [--] followers, [---] engagements
"@vladimirputiniu London will not survive even a day😭 they think they are in british era Russia would sweep em off lol"
X Link 2025-06-03T04:16Z [--] followers, [--] engagements
"@realMaalouf Disgusting creatures resides in pakistan you all will rot in hell man This is so sad Poor kid"
X Link 2025-06-05T06:40Z [--] followers, [--] engagements
"@Madan_Chikna @grok whats the name of this product & where can i buy this"
X Link 2025-06-08T06:04Z [--] followers, [---] engagements
"Just visit the hospital once again like you did yesterday with your Land rover & you can bring your photographer with you & ask for the apologies why so much of ego Nothing wrong in asking for apologies from a a doctor whos academically much superior to you #GoaMedicalCollege During the broadcast with Prudent Media last night I openly extended my heartfelt apology to Dr. Rudresh Kuttikar for the harsh words spoken by me during my visit to GMC. In the heat of the moment my emotions overtook my expression and I deeply regret the manner in which I During the broadcast with Prudent Media last"
X Link 2025-06-09T11:13Z [--] followers, [--] engagements
"@visrane drive your land rover to the hospital and apologise to the doctor with the same intensity you terrorised the doctor you hooligan"
X Link 2025-06-09T13:14Z [--] followers, [--] engagements
"@AugadhBhudeva @grok tell me the content of this video in a nutshell"
X Link 2025-06-14T07:08Z [--] followers, [----] engagements
"@Indian_Analyzer @grok where to do this"
X Link 2025-06-17T13:00Z [--] followers, [--] engagements
"@RVCJ_FB @grok what is the name of the channel of this prank"
X Link 2025-06-18T15:22Z [--] followers, [----] engagements
"@ShivAroor @RoyalNavy @grok add donald trumps dance steps to this pic"
X Link 2025-06-19T05:54Z [--] followers, [--] engagements
"@RanadheeraGowda Get your blood checked once Especially your vitamin B2 B3 B12 vitamin D & iron levels"
X Link 2025-06-23T06:09Z [--] followers, [--] engagements
"@RajeshB18566468 Try reading full article and post the verdict too why are you posting half baking story for your engagement forming"
X Link 2025-07-04T19:27Z [--] followers, [--] engagements
"@_phoenix_fire @grok tell me about this"
X Link 2025-05-19T17:47Z [--] followers, [----] engagements
"@DrAkhilX @grok give me the link of this article"
X Link 2025-11-12T06:06Z [--] followers, 52.6K engagements
"@BaluGorade Tata Sierras NA engine power train is impressive compared to its rivals including the Creta Seltos Hyundai and MS. If it manages to deliver good mileage & reliability nothing will stop it from capturing the market. What they are providing is a class apart"
X Link 2025-12-01T06:11Z [--] followers, [---] engagements
"@neha_basic Why would a doctor prescribe azithromycin just for a simple cold Thats unethical practice. Most colds are viral & resolve on their own with rest and hydration no need to load up on unnecessary antibiotics"
X Link 2025-12-08T12:57Z [--] followers, [--] engagements
"@Rightanglenews Wherever terror strikes its roots trace back to one rotten source Pakistan. #BondiBeachTerrorAttack is no different from #PahalgamTerroristAttack of kashmir . Deport these parasites back to where they belong"
X Link 2025-12-16T02:47Z [--] followers, [--] engagements
"@Doctors__squad Blunt trauma or repeated force to the ear. Separation of perichondrium from auricular cartilage( commonly seen in combat sport athletes) Bleeding into the subperichondrial space auricular hematoma. Rx- Needle aspiration or I&D"
X Link 2025-12-24T10:58Z [--] followers, [----] engagements
"@Tayfun_demir1 @Frances98392343 @ecgandrhythmRoe @Charanreddy246 ECG: Sinus rhythm with LBBB STT elevation in V1-V3 with deep s wave. ST depression & T wave inversion in lateral leads ( I aVL V5 V6) These ST changes are discordant to QTS complexes. No Sgarbossa-positive STEMI"
X Link 2025-12-24T17:15Z [---] followers, [---] engagements
"@MTD_MED @IhabFathiSulima @medcrux @Sage_medics @modernHealthMe ACEIs: Bradykinin breakdown Bradykinin capillary leakage angioedema *ARBs: No ACE block but Ang II bradykinin & substance P (much rarer) CCBs: Arteriolar vasodilation with unchanged venous tone capillary hydrostatic pressure fluid extravasation"
X Link 2025-12-25T11:26Z [---] followers, [--] engagements
"@TrackYourHeart Delayed ankle jerk (hung-up reflex) Most sensitive clinical sign of hypothyroidism Characteristic delay in relaxation phase (not contraction) Constipation- Due to reduced gut motility due to low T3/T4. Both result from reduced metabolic & N.muscular activity caused by low T3/T4"
X Link 2025-12-25T11:50Z [---] followers, 22.1K engagements
"@Charanreddy246 @ecgandrhythmRoe @Frances98392343 @Tayfun_demir1 @ECGWeekly @josecruz2102 Deep symmetric T-wave inversions in V2V4 (V5) with resolution of prior ST elevation classic reperfusion pattern. After successful PTCA restored flow causes transient myocardial stunning altering repolarization & inverting T waves in the infarct territory"
X Link 2025-12-25T12:50Z [--] followers, [---] engagements
"@ManualOMedicine ST elevation in II III aVF Inferior wall STEMI Reciprocal ST depression in I and aVL ST depression in V1V3 with tall R waves posterior wall involvement So this is not just inferior MI it is an: Infero-posterior STEMI. Culprit artery- RCA. Could be LCx involvement"
X Link 2025-12-25T15:40Z [---] followers, [---] engagements
"@DrAkhilX Body packers syndrome-On plain abdominal X-ray each packet shows: Central uniform opacity drug material Surrounding thin radiolucent rim air trapped between multiple layers of condom wrapping ➡This creates the appearance of one condom inside another = double condom sign"
X Link 2025-12-26T03:10Z [---] followers, [---] engagements
"@DrNikhilMD Dx- Kawasaki Bilateral non-purulent conjunctival injection Strawberry tongue Erythema of palms Polymorphous rash / facial changes Classic CRASH features: Conjunctivitis Rash Adenopathy (cervical) Strawberry tongue / oral mucosal changes Hand & foot changes"
X Link 2025-12-26T03:42Z [--] followers, [---] engagements
"@DrAkhilX Electric shock ⚡Rosette cataract Electrical/thermal injury denatures lens proteins Star/flower-shaped (stellate) opacity Often bilateral delayed onset Classic lens finding after Blunt ocular trauma electrocution ionising radiation exposure"
X Link 2025-12-26T06:01Z [---] followers, [----] engagements
"@DrRajeshG1 Regular narrow-complex tachycardia rate 150/min Saw-tooth flutter waves (V1 II III aVF) 2:1 AV conduction Diagnosis: Atrial flutter with 2:1 AV block Correct me if i wrong sir"
X Link 2025-12-26T06:16Z [--] followers, [---] engagements
"@DrRajeshG1 Adenosine does not terminate atrial flutter. It transiently blocks the AV node but the flutter circuit is atrial macro-reentry and AV-node independent. Diltiazem slows AV conduction converting 2:1 to 3:1 or 4:1 block revealing flutter waves best seen in II III aVF"
X Link 2025-12-26T07:04Z [--] followers, [---] engagements
"@Doctors_GUILD Giant Cell Tumor (GCT) of bone 🦴 Young adults (2040 yrs) Site: epiphysis of long bones (knee most common) X-ray: eccentric lytic soap-bubble lesion Benign but locally aggressive Tx: curettage adjuvant Recurrence can occur"
X Link 2025-12-26T11:44Z [--] followers, [---] engagements
"@IrmaMDv Sinus rhythm with frequent premature ventricular complexes occurring as a ventricular couplet with wide QRS morphology and compensatory pause. Please correct if am wrong"
X Link 2025-12-26T12:25Z [--] followers, [---] engagements
"@IhabFathiSulima Methanol poisoning toxic metabolites (formaldehyde formic acid). Ethanol drip works as an antidote because ethanol has higher affinity for alcohol dehydrogenase blocks methanol metabolism less acidosis & optic injury while methanol is excreted"
X Link 2025-12-26T17:12Z [---] followers, [---] engagements
"@Doctors__squad Tunneled double-lumen hemodialysis catheter (Permcath): Inserted via internal jugular vein exits on chest. Subcutaneously tunneled to reduce infection. Two lumens 🔴 red (arterial blood out) & 🔵 blue (venous blood in). Dacron cuff anchors catheter & limits infection"
X Link 2025-12-27T03:58Z [---] followers, [----] engagements
"@Charanreddy246 @ecgandrhythmRoe @Frances98392343 @Tayfun_demir1 @josecruz2102 Post-RTA syncope with deep symmetric T-wave inversion (V2V5) + QT prolongation = Cerebral T waves. Cause: acute brain injury massive sympathetic (catecholamine) surge myocardial repolarization abnormality"
X Link 2025-12-28T16:06Z [---] followers, [---] engagements
"@KakkamKrishna @KostekMilan Regular narrow-complex tachycardia 150/min due to typical atrial flutter with 2:1 AV conduction. Flutter waves are best seen in inferior leads with one wave buried in the ST segment causing a post-QRS negative notch. Normal axis no acute ischemia"
X Link 2025-12-29T04:18Z [---] followers, [--] engagements
"@Abhilasha21822 Pseudomembranous candidiasis White curd like plaques on oral mucosa that scrape off leaving an erythematous / bleeding base. Seen in diabetes HIV steroid use immunosuppression. * Caused by Candida albicans"
X Link 2025-12-29T05:27Z [---] followers, [---] engagements
"@Doctors__squad Corrigan (water-hammer) pulse in Aortic regurgitation: A bounding pulse with rapid upstroke and sudden collapse. AR stroke volume (high systolic BP) + diastolic backflow into LV (low diastolic BP) wide pulse pressure"
X Link 2025-12-29T14:06Z [---] followers, [---] engagements
"@DrNikhilMD Atrial fibrillation + bioprosthetic mitral valve👉🏻 Warfarin for first [--] months ( INR level- 2.0-3.0) after that DOACs are acceptable"
X Link 2025-12-30T03:53Z [---] followers, [----] engagements
"@mednomics Severe hypertriglyceridemia (1000 mg/dL) 👉🏻 chylomicrons clog pancreatic capillaries. Pancreatic lipase breaks TGs into toxic free fatty acids 👉🏻 ischemia fat necrosis & enzyme activation 👉🏻acute pancreatitis"
X Link 2025-12-30T03:56Z [---] followers, [---] engagements
"@DrNikhilMD Its for warfarin sir. NOAC point noted thanks"
X Link 2025-12-30T06:31Z [---] followers, [---] engagements
"@TrackYourHeart 🔺 Triangle of safety- ICD placement done here safe. Chest tube goes in the triangle of safety 4th5th ICS just anterior to mid-axillary line above the rib. This spot avoids the VAN structures heart diaphragm & abdominal organs 👉🏻 safest pleural access fewer complications"
X Link 2025-12-30T07:03Z [---] followers, [----] engagements
"@modernHealthMe Bauer (Crawling) Reflex Its a primitive spinal reflex. When a newborn is placed prone (on the abdomen) & gentle support/pressure is given to the soles the baby makes forward crawling movements with the back facing upward. Disappears by 3-4 months"
X Link 2025-12-30T07:32Z [---] followers, [---] engagements
"@DrAkhilX Pudendal neuropathy aka toilet-seat neuropathy Prolonged sitting on a toilet seat can cause pudendal neuropathy. Constant pressure compresses the pudendal nerve (S2S4) 👉🏻 perineal-genital numbness or burning pain. Clue: pain worsens on sitting improves on standing"
X Link 2025-12-30T11:09Z [---] followers, 18K engagements
"@DrSharadMutalik StevensJohnson syndrome (SJS) Triggered by drugs (antibiotics anticonvulsants NSAIDs). Starts with fever sore throat 👉🏻painful red rash 👉🏻blisters skin peeling & severe oral/eye/genital erosions. Ddx- TEN"
X Link 2025-12-30T13:19Z [---] followers, [---] engagements
"@dr_manish_ydv @Doctors__squad @doctors_squad @DrAkhilX @DrNikhilMD Answer- A : Comminuted intra-articular distal tibial fracture = Pilon fracture"
X Link 2025-12-31T08:29Z [---] followers, [---] engagements
"@nervemed C. Clavicle Cleidocranial dysostosis: AD RUNX2 mutation 👉🏻 defective intramembranous ossification. Hallmarks: absent/hypoplastic clavicles (shoulders meet like the video above) delayed fontanelle closure frontal bossing & multiple supernumerary teeth. Dx - clinical + X-ray"
X Link 2025-12-31T09:36Z [---] followers, [----] engagements
"@dr_manish_ydv D. All of the above Mainly used for fibrinogen deficiency its the fastest way to increase fibrinogen. Indications *Hypofibrinogenemia *DIC- if bleeding + low fibrinogen *Congenital deficiencies- Factor XIII deficiency *von Willebrand disease / Hemophilia A"
X Link 2025-12-31T11:22Z [---] followers, [---] engagements
"@dr_manish_ydv Ans- B - Lateral femoral cutaneous nerve Entrapment causes purely sensory neuropathy ( nerve passed through inguinal ligament ) 👉🏻burning pain numbness tingling over the anterolateral thigh with no motor weakness"
X Link 2025-12-31T12:49Z [---] followers, [---] engagements
"@dr_manish_ydv @daoo100 @Doctors__squad @doctors_squad @ArvindaJAP @DrAkhilX @DrArslan480 @MoarSahitoPTI @Rania_22100 Ans- Acute pancreatitis. This can become so severe that leaked enzymes digest surrounding tissue causing fat necrosis & retroperitoneal bleeding. Blood tracks along fascial planes to the flanks producing ecchymosis a rare sign that indicates severe disease"
X Link 2025-12-31T15:00Z [---] followers, [--] engagements
"@TrackYourHeart Sustained polymorphic ventricular tachycardia (likely torsades de pointes morphology) causing near syncope. Wide QRS complex beat to beat QRS morphology. Check Mg+/ K+ /Ca+"
X Link 2026-01-01T06:44Z [---] followers, [----] engagements
"@dr_manish_ydv @DrAkhilX @albertoortegana @daoo100 @MedEd_Cases @RavikantBh99255 @Amhar_47 @DrYdv_hitesh01 Thank you doc saab🙏🏼"
X Link 2026-01-01T13:05Z [---] followers, [---] engagements
"@sohrab1104 @Frances98392343 @ecgandrhythmRoe @Ecgloverr @ecgrhythms @DrRazi4 @DrRajeshG1 Acute anterior wall myocardial infarction primary ventricular fibrillation Pathophysiology: Acute LAD occlusion Severe transmural ischemia 👉🏻 Chaotic irregular waveform. No identifiable P waves (2nd ecg) 1st ecg- Hyperacute T waves in anterior precordial leads"
X Link 2026-01-02T09:45Z [---] followers, [---] engagements
"@albertoortegana Mobitz I (Wenckebach) AV block Progressive PR interval prolongation on each beat until a P wave fails to conduct 👉🏻dropped QRS. Then the cycle repeats. 👉 Key point: pathology usually involves the AV node not the His-Purkinje system"
X Link 2026-01-03T02:50Z [---] followers, [--] engagements
"@docxusofficial Long-term PPI use benign. Chronic acid suppression 👉🏻 hypergastrinemia decreased B12/Fe/Ca/Mg absorption fractures C. diff AIN 👉🏻CKD & rebound acid hypersecretion on stopping"
X Link 2026-01-03T12:17Z [---] followers, [----] engagements
"@TheECGMedic Suspected pericardial effusion with electrical alternans on ECG (notably lead II) low QRS voltage + beattobeat height shift fits tamponade. Needs urgent echo to confirm plus hemodynamic assessment & possible pericardiocentesis"
X Link 2026-01-04T04:48Z [---] followers, [---] engagements
"@TrackYourHeart Ans- C Verapamil is contraindicated in VT because VT is Na channel mediated not AV-node dependent ( verapamil block ca+ channel in the AVN so terminate SVTs) It wont terminate VT & its negative inotropy + vasodilation can crash BP 👉🏻cardiogenic shock pulseless VT or VF"
X Link 2026-01-04T06:10Z [---] followers, [----] engagements
"Case alert 🚨 72-y man T2DM on metformin [--] yrs + daily PPI [--] yrs presents with numb feet gait imbalance exertional dyspnea. Hb [----] g/dL MCV [---] fL B12 [---] pg/mL MMA & homocysteine. Anemia absent earlier whats the link"
X Link 2026-01-04T12:30Z [---] followers, [----] engagements
"@dr_manish_ydv @daoo100 @angna_86 @VikramMShahpura @DrYdv_hitesh01 Very nice chart doc saab thanks for sharing"
X Link 2026-01-05T11:02Z [---] followers, [--] engagements
"@ECGWeekly Severe bradycardia with complete AV dissociation narrow QRS (junctional escape (20-30bpm) & ST elevation in III & aVF & reciprocal STD in I & aVL 👉🏻inferior wall STEMI (RCA)👉🏻 AV nodal ischemia causes transient complete AV block"
X Link 2026-01-05T13:18Z [---] followers, [---] engagements
"@dr_manish_ydv Ans- B - katG Mutation Isoniazid is a prodrug meaning it needs activation by the KatG enzyme mutation in katG enzyme prevent proper activation of isoniazid & drug becomes ineffective"
X Link 2026-01-05T13:51Z [---] followers, [--] engagements
"@dr_manish_ydv @daoo100 @VikramMShahpura @DrYdv_hitesh01 @DrAkhilX Ans C : HCM myocardium shows: ➡Myocyte hypertrophy. Myofibrillar disarray. Patchy interstitial fibrosis ➡ This creates electrical heterogeneity ➡ Leads to VT/VF especially during exertion Death is usually arrhythmic not pump failure"
X Link 2026-01-05T13:58Z [---] followers, [--] engagements
"@dr_manish_ydv @DrAkhilX @VikramMShahpura @DrYdv_hitesh01 @daoo100 Ans- C : PTU PTU and methimazole block thyroid hormone synthesis in the thyroid gland. However PTU has dual action which acutely inhibits the enzyme 5-deiodinase in peripheral tissues which is responsible for converting thyroxine (T4) to the (T3)"
X Link 2026-01-05T14:06Z [---] followers, [---] engagements
"@FibrilloFlutter @ecgandrhythmRoe @KostekMilan @makkyecg @ecgrhythms @Frances98392343 @Charanreddy246 @capuzzi_luciano @koggelnoggel @DrAkhilX Wandering Atrial Pacemaker (WAP/MAR) Irregular rhythm with [--] P wave morphologies with each beat variable PR narrow QRS HR [---]. Also shows marked sinus arrhythmia with phasic RR variation"
X Link 2026-01-05T18:55Z [---] followers, [---] engagements
"@TrackYourHeart ST elevation in I aVL V5V6 with reciprocal STD in II III aVF = High-lateral STEMI ( culprit vessel likely to be LCX) + ST depression in V1V2V3 + Tall R wave in the anterior leads suggestive of posterior involvement"
X Link 2026-01-06T12:31Z [---] followers, [----] engagements
"@joeroganhq Its astonishing how he believed ivermectin and Fenbendazole cure cancer. You dont need to be a doctor to understand the natural course of a disease"
X Link 2026-01-07T03:14Z [---] followers, [----] engagements
"@dr_manish_ydv Dissection = intimal tear with fragile aortic wall. Thrombolytics dissolve stabilizing clots 👉🏻massive bleeding aortic rupture"
X Link 2026-01-07T18:05Z [---] followers, [--] engagements
"@drsthanus Multiple Sclerosis periventricular hyperintense plaques 👉🏻CNS demyelination👉🏻 Results in limbs paresthesia paresis general weakness"
X Link 2026-01-08T12:38Z [---] followers, [---] engagements
"@IhabFathiSulima [--] degree AV block (Complete heart block): More P waves than QRS (atrial rate ventricular). Regular PP & RR but no fixed PR. P waves march through independently. AV dissociation atria (sinus [-----] bpm) & ventricles (escape [----] bpm) beat independent of each other"
X Link 2026-01-08T13:22Z [---] followers, [---] engagements
"@Doctors_GUILD Pelvic X-ray shows a well defined radiopaque object shaped like a firearm projected over the rectum 👉🏻 Rectal foreign body. Key risks: perforation bleeding sepsis. Removal: endoscopic or surgical based on stability & shape"
X Link 2026-01-08T16:33Z [---] followers, [---] engagements
"@albertoortegana Long standing Raynauds now presents with painful fingertip ulcers/necrosis 👉🏻 critical digital ischemia. This is a vascular emergency. Treat first Start IV prostaglandins (e.g. iloprost) to restore flow. Autoantibodies & imaging come later come later"
X Link 2026-01-08T20:00Z [---] followers, [--] engagements
"@Doctors__squad Corrigan sign (Water-hammer pulse) 👉🏻Aortic Regurgitation A forceful bounding pulse with rapid rise and sudden collapse felt best in the carotid or radial artery. Stroke volume (LV ejects a large volume) Diastolic pressure (blood leaks back into LV) ➡ wide pulse pressure"
X Link 2026-01-09T04:06Z [---] followers, [--] engagements
"@Tayfun_demir1 Bradyarrhythmia with advanced AV block I can see RAD ( degenerative His purkinje disease ) + T wave inversion in II III aVF + anterior precordial leads it could be secondary to brady arrhythmia & conduction abnormality suggestive of demand ischemia"
X Link 2026-01-09T07:42Z [---] followers, [---] engagements
"@Doctors__squad Flat wart (Verruca plana): HPV types: [--] [--] Sites: Face forehead dorsum of hands shins Look: Small flat-topped skin coloured papules"
X Link 2026-01-09T09:44Z [---] followers, [---] engagements
"@ManualOMedicine Hb [----] g/dL MCV [----] fL ( microcytic) RDW 18.9% Platelets 410k RBC histogram: left-shifted High RDW + reactive thrombocytosis 👉🏻Iron deficiency anemia in pregnancy"
X Link 2026-01-09T18:03Z [---] followers, [---] engagements
"@DrAkhilX Facioscapulohumeral Muscular Dystrophy (FSHD) AD disorder 🙂 Facial weakness (cant whistle) 🪽 Scapular winging 👉🏻Asymmetric slowly progressive 👉🏻Beevor sign 👉🏻CK normal/mild"
X Link 2026-01-10T03:56Z [---] followers, [----] engagements
"I still think about it when bro just casually dropped [---] carcinogens [---] cancer agents [--] COPD like it was Harrison's page number. No source. No pause. No shame Evidence based medicine ❌ Evidence based screenplay ✅ Doctors watching this scene: 😐"
X Link 2026-01-10T04:13Z [---] followers, [---] engagements
"@dr_manish_ydv @Doctors__squad @Doctors_GUILD @DrYdv_hitesh01 @DrAkhilX @VikramMShahpura HRCT chest: classically shows multiple nodules with surrounding ground-glass opacity (halo sign) Fever+ neutropenia +no response to antibiotics + sterile culture ( pro cal is low ) i am learning towards Invasive fungal infection most commonly Aspergillus"
X Link 2026-01-10T04:21Z [---] followers, [--] engagements
"@medcrux Rapid vomiting after eating pastry Think Bacillus cereus ➡ Spores survive baking ➡ Improper storage 👉🏻pre-formed heat-stable toxin (cereulide) Incubation: [--] hrs 🤢 Predominant nausea & vomiting no fever Treatment: supportive only"
X Link 2026-01-10T07:12Z [---] followers, [---] engagements
"@DrAkhilX Dermatology and orthopedics the never ending saga 🤣"
X Link 2026-01-10T08:03Z [---] followers, [----] engagements
"@TrackYourHeart Addison disease (Primary adrenal insufficiency) Destruction of adrenal glands 👉🏻 Cortisol & aldosterone 👉🏻 ACTH. Clues: diffuse hyperpigmentation (skin/mucosa/scars) hypotension weight loss GI symptoms weakness vitiligo. Labs: Na K"
X Link 2026-01-10T09:18Z [---] followers, [----] engagements
"Case alert 🚨 40F with chronic migraine on sumatriptan 100mg develops URTI starts azithromycin + phenylephrine (nasal decongestant) & suddenly develops with central chest pain diaphoresis dyspnea. ECG: OMI hs-cTn. Cath: no plaque induced stenosis LAD vasospasm seen. Dx"
X Link 2026-01-10T13:41Z [---] followers, [----] engagements
"@IhabFathiSulima Methanol isnt toxic until metabolized. Alcohol dehydrogenase converts it to formic acid 👉🏻metabolic acidosis & blindness. Ethanol has higher affinity for ADH competitively blocking methanol metabolism and buying time for excretion/dialysis"
X Link 2026-01-10T15:58Z [---] followers, [----] engagements
"@IhabFathiSulima Myasthenia gravis (MG): Autoimmune disorder of the neuromuscular junction. Path: Abs vs ACh receptors. Features: Fluctuating fatigable weakness ptosis diplopia bulbar/limb muscles; normal sensation reflexes. Tx: AChE inhibitors immunosuppression thymectomy"
X Link 2026-01-10T16:52Z [---] followers, [---] engagements
"@mednomics Takotsubo cardiomyopathy: Stress-induced transient LV systolic dysfunction. Trigger: Emotional/physical stress leads catecholamine surge. Features: ACS-like chest pain ST-T changes modest troponin rise. Echo: Apical ballooning. Coronaries: Normal"
X Link 2026-01-10T16:55Z [---] followers, [----] engagements
"@medcrux Takotsubo cardiomyopathy: Stress-induced transient LV systolic dysfunction. Trigger: Emotional/physical stress leads catecholamine surge. Features: ACS-like chest pain ST-T changes modest troponin rise. Echo: Apical ballooning. Coronaries: Normal"
X Link 2026-01-10T18:55Z [---] followers, [---] engagements
"@Doctors_GUILD Metabolic alkalosis Vomiting ➡loss of H & Cl 👉🏻 HCO. Volume loss ➡ RAAS/aldosterone 👉🏻 distal Na reabsorption with K & H secretion. Alkalosis shifts K into cells + renal K wasting ➡ hypokalemia. Ecg- U wave appears"
X Link 2026-01-11T04:54Z [---] followers, [---] engagements
"@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @RavikantBh99255 I feel answer is A my explanation TB resulted RCM👉🏻 Rigid pericardium in constrictive pericarditis blocks RV expansion. On inspiration venous return shifts septum left( seen on the x ray) LV filling & stroke volume ➡ [--] mm Hg fall in SBP (pulsus paradoxus👉🏻(80 ➡ 60)"
X Link 2026-01-11T07:50Z [---] followers, [---] engagements
"@Doctors_GUILD Ans- D Violaceous indurated plaques on nose/cheeks involving nasolabial folds 👉🏻sarcoidosis (lupus pernio) = chronic disease poor prognosis. Photosensitive butterfly rash sparing folds 👉🏻SLE malar rash"
X Link 2026-01-11T12:15Z [---] followers, [----] engagements
"@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrRajeshG1 @DrYdv_hitesh01 @RavikantBh99255 @VikramMShahpura Ans- B- Arrow marks marginal mandibular nerve (CN VII). It runs along lower border of mandible superficial to submandibular gland. Supplies depressor anguli oris depressor labii inf mentalis. Injury 👉🏻asymmetric smile"
X Link 2026-01-12T06:33Z [---] followers, [--] engagements
"@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @RavikantBh99255 @DrRajeshG1 Ans- B : Meralgia paresthetica = entrapment of the lateral femoral cutaneous nerve ( LFCN) under the inguinal ligament Symptoms- Burning pain tingling numbness over anterolateral thigh. Purely sensory nerve. Root value L2L3. No weakness no reflex loss"
X Link 2026-01-12T07:10Z [---] followers, [--] engagements
"@dr_manish_ydv Ans- D capillary filtration across the capillaries= [--] Use Starling force formula. Net = (Pc Pi) (c i) = [--] [--] Pi (27 7) = [--] [--] Pi [--] = [--] Pi = [--] mmHg Interstitial pressure is negative to prevent edema"
X Link 2026-01-12T09:57Z [---] followers, [--] engagements
"@dr_manish_ydv Ans- A Child ( genetic predisposition) + Father had similar condition ( AD) Lab- isolated LDL predominantly This is classic hyperlipoproteinemia 2A"
X Link 2026-01-12T10:09Z [---] followers, [--] engagements
"@dr_manish_ydv Cause : LDL receptor defect (Apo B mutation)"
X Link 2026-01-12T10:10Z [---] followers, [--] engagements
"Case alert🚨 : 75M with OA chronic HTN on enalapril [--] mg + HCTZ [--] mg. Started ibuprofen [---] mg TID [--] mo for his symptoms. Now C/O chest pain palpitations dizziness N/V/D+ weakness cramps confusion. urine output deranged KFT. ABG labs ECG done 👇🏻🔖 Dx"
X Link 2026-01-12T13:44Z [---] followers, [----] engagements
"@dr_manish_ydv MPS I (Hurler syndrome) -L-iduronidase deficiency 👉🏻 lysosomal accumulation of dermatan sulfate + heparan sulfate. Clues: developmental delay organomegaly corneal clouding weakness"
X Link 2026-01-12T14:33Z [---] followers, [--] engagements
"@SameerYogi14 @DrAkhilX @dr_manish_ydv @IlliasulK @DrNoumory Galant reflex: primitive neonatal reflex. Stroking paraspinal skin 👉🏻trunk flexes toward stimulus. Present at birth disappears by [--] months. Persistence or asymmetry suggests neurological or spinal pathology"
X Link 2026-01-12T16:58Z [---] followers, [--] engagements
"@dr_manish_ydv @daoo100 @Doctors__squad @Doctors_GUILD @doctors_squad @DrAkhilX @DrRajeshG1 @DrYdv_hitesh01 @RavikantBh99255 @VikramMShahpura Badiya doc saab aaj tho MCQ ki barish ho rhi h keep up sir 👍🏻"
X Link 2026-01-12T17:00Z [---] followers, [--] engagements
"@dr_manish_ydv Ans- IL5a : Benralizumab is a humanized MCAB that targets the alpha subunit of the interleukin-5 receptor (IL-5R) on the surface of eosinophils and basophils. Uses- severe eosinophilic Asthma EGPA. Route- S/C Dose- Initial dose 30mg every [--] wks for the first [--] dose then 8wks"
X Link 2026-01-12T17:45Z [---] followers, [--] engagements
"@drsthanus Pulmonary nodule = rounded lung opacity [--] cm surrounded by parenchyma (3 cm = mass). DDx: granuloma hamartoma cancer"
X Link 2026-01-12T18:19Z [----] followers, [----] engagements
"@DrAkhilX Commonly abused anabolic steroids in bodybuilding: Testosterone Nandrolone Trenbolone Dianabol Anadrol Winstrol Anavar. Gains come at a cost cardiomyopathy MI infertility & liver injury"
X Link 2026-01-13T02:37Z [---] followers, [----] engagements
"@dr_manish_ydv @Alarmeddd @daoo100 @Doctors__squad @Doctors_GUILD @DrAkhilX @DrYdv_hitesh01 @VikramMShahpura @SameerYogi14 @RavikantBh99255 Ans- Histoplasmosis Chronic cavitary lung lesions + hilar lymphadenopathy mimicking TB = Histoplasmosis Key clue: tiny [--] m yeast with narrow-based budding( microconidia) on HPE/SDA culture 👉🏻 Histoplasma capsulatum. Seen on HPE &culture on SDAz"
X Link 2026-01-13T07:12Z [---] followers, [---] engagements
"@MuhammadZa96288 @dr_manish_ydv @Alarmeddd @albertoortegana @Chakravart70006 @daoo100 @DrAkhilX @rajin13a1 @VikramMShahpura @DrYdv_hitesh01 @SameerYogi14 Ans B- severe Leptospirosis or weil disease Jaundice + AKI + bleeding after water exposure = Weil disease"
X Link 2026-01-13T07:13Z [---] followers, [--] engagements
"@dr_manish_ydv @albertoortegana @Alarmeddd @daoo100 @Doctors__squad @DrAkhilX @DrYdv_hitesh01 @SameerYogi14 @VikramMShahpura 45-yo with hearing loss + gait ataxia + CPA mass. HPE shows Antoni A & B areas with Verocay bodies 👉🏻 Vestibular schwannoma"
X Link 2026-01-13T08:30Z [---] followers, [--] engagements
"@DrAkhilX Child with severe photosensitivity blistering scars red/cola-colored urine & reddish teeth (erythrodontia) 👉🏻Congenital erythropoietic porphyria (Gunther disease). AR defect of uroporphyrinogen III synthase 👉🏻porphyrins hemolysis splenomegaly"
X Link 2026-01-13T09:46Z [---] followers, [---] engagements
"Large-volume ascitic tap (paracentesis) Done to relieve tense ascites & dyspnea and to diagnose cause. 👉🏻Site: LLQ USG-guided aseptic drain slowly. 👉🏻Causes: cirrhosis (MC) malignancy TB CHF nephrotic syndrome pancreatitis. 👉🏻Precautions: check INR/platelets empty bladder albumin replacement (5 L) monitor BP renal function & leaks post-tap. Indications : New onset ascites At the time of each admission to the hospital Clinical deterioration either inpatient or outpatient Fever Abdominal pain Abdominal tenderness Mental status change Ileus Hypotension Laboratory abnormalities that may"
X Link 2026-01-15T17:54Z [---] followers, [---] engagements
"@doctors_squad Mask-like facies seen in Parkinsonism 🧠 Due to dopamine in the nigrostriatal pathway 👉🏻facial bradykinesia + rigidity. Automatic facial expressions are lost blink rate falls emotions are felt but not shown. Not weakness the movement is slow"
X Link 2026-01-16T05:40Z [---] followers, [----] engagements
"Faget sign classically seen in Typhoid fever. But also seen in other conditions -Yellow fever -Brucellosis -Legionnaires disease In most infections fever 👉🏻 pulse . Faget sign = fever without expected tachycardia due to altered autonomic or cytokine-mediated cardiac response. https://twitter.com/i/web/status/2012041081052151966 https://twitter.com/i/web/status/2012041081052151966"
X Link 2026-01-16T05:55Z [---] followers, [----] engagements
"@IhabFathiSulima Modified Valsalva Maneuver (for SVT) In stable SVT strain hard for [--] sec (like blowing into a syringe) 👉🏻 then immediately lie flat & raise legs to [--] for [--] sec 👉🏻 relax. Postural change boosts vagal tone venous return baroreceptor firing 👉🏻 terminates AVNRT safely"
X Link 2026-01-16T07:55Z [---] followers, [---] engagements
"Tinea versicolor: Superficial fungal infection by Malassezia furfur. Causes hypo/hyper-pigmented fine scaly macules on trunk/neck. Worse with heat & sweating. KOH: spaghetti & meatballs 👉🏻Spaghetti short curved hyphae 👉🏻Meatballs round yeast cells (spores) This mixed pattern is characteristic of Malassezia infection and helps confirm the diagnosis quickly. Tx: topical selenium sulfide/azoles; oral azoles if extensive. https://twitter.com/i/web/status/2012145823275159556 https://twitter.com/i/web/status/2012145823275159556"
X Link 2026-01-16T12:52Z [---] followers, [---] engagements
"Case alert 🚨 A middle-aged obese man (BMI 31) presents to the ED. K/C/O - DM HTN dyslipidemia compliant with meds. Past history: biliary stone disease managed conservatively. He was stable until [--] days ago when he developed vague uneasiness poor appetite and fatigue. Last night he woke suddenly with: Repeated vomiting Palpitations (heart racing) Mild dyspnea High-grade fever with chills Unable to speak during the episode No chest pain. No cough. No diarrhea. On arrival Temp 38.5C HR 62/min BP 90/60 mmHg Toxic icteric cold peripheries Mild confusion O/E - Abdomen: RUQ tenderness with guarding"
X Link 2026-01-16T14:45Z [---] followers, [----] engagements
"@Charanreddy246 @ecgandrhythmRoe @Ecgloverr @Frances98392343 @Tayfun_demir1 @EcgOxford @ecgrhythms @KostekMilan ECG shows left ventricular hypertrophy with high QRS voltage (deep S in V1V3 tall R in V5V6/aVL). Lateral downsloping ST depression with asymmetric T-wave inversion represents LVH strain secondary repolarization not acute ischemia serial ecg+ hsCTn recommended"
X Link 2026-01-17T06:57Z [---] followers, [---] engagements
"Phenytoin-induced gingival hyperplasia Pathophysiology: [--] Drug effect: Phenytoin acts on gingival fibroblasts [--] Fibrosis: collagen & ECM production [--] Impaired breakdown: MMPs ( Matrix Metalloproteinases ) TIMPs ( Tissue Inhibitors of Metalloproteinases) collagen not degraded [--] Folate effect: folate uptake collagenase activity 👉🏻 collagen accumulates gingival overgrowth Similar drugs: Cyclosporine Nifedipine (CCBs) https://twitter.com/i/web/status/2012477599570919934 https://twitter.com/i/web/status/2012477599570919934"
X Link 2026-01-17T10:50Z [---] followers, [----] engagements
"@dr_manish_ydv @DrAkhilX @albertoortegana @DrArslan480 @DrYdv_hitesh01 @MissNyra__ @RavikantBh99255 @Sabster01 @VikramMShahpura Ans- A Cremasteric reflex root value - L1 L2 Afferent limb: Ilioinguinal nerve 👉🏻L1 Efferent limb: Genitofemoral nerve (genital branch) 👉🏻 L1L2"
X Link 2026-01-17T11:04Z [---] followers, [---] engagements
"INSULIN RESISTANCE: FACTS vs FICTION Insulin resistance isnt caused by one food one oil or one meal-timing trick. Lets separate science from social-media myths 👇 [--] Insulin isnt bad ✅ Insulin rises after all meals carbs protein mixed foods. Thats normal physiology. The problem is chronic hyperinsulinemia not a single spike. [--] Protein & dairy can raise insulin and thats OK ✅ Some proteins (esp. whey) stimulate insulin. But protein also raises glucagon preventing hyperglycemia. ➡ Insulin rise insulin resistance. [--] Insulin resistance starts years before diabetes ✅ Glucose may look normal while"
X Link 2026-01-17T11:28Z [---] followers, [--] engagements
"@DrAkhilX Antibiotic + NSAID + Steroid for sore throat"
X Link 2026-01-17T11:43Z [---] followers, [--] engagements
"@_AYO234 @Medzonetv OP poisoning ➡ bronchorrhea + bronchospasm + respiratory muscle weakness. This causes hypoxia which is the immediate cause of death Atropine dries secretions but does NOT correct hypoxia instantly"
X Link 2026-01-17T21:46Z [---] followers, [---] engagements
"@albertoortegana @DrAkhilX @dr_manish_ydv 1st ecg- Regular complex narrow supra ventricular tachycardia (HR [---] ) P waves hidden or retrograde. 2nd ecg : Give adenosine transient AV nodal block brief asystole/AV block unmasks atrial activity & terminates AVNRT/AVRT restoring sinus rhythm"
X Link 2026-01-18T04:07Z [---] followers, [---] engagements
"OSSIFYING FIBROMA slow progressive facial bony expansion with smooth contour intact skin & no facial nerve deficit suggests a benign fibro-osseous tumor. Imaging shows a well-circumscribed expansile lesion with mixed density classic for ossifying fibroma. Why not cancer Malignancy causes rapid growth pain ulceration nerve palsy ill-defined destructive margins & nodes OF is neoplastic not infective. Definitive treatment = complete surgical excision. https://twitter.com/i/web/status/2012812040562483616 https://twitter.com/i/web/status/2012812040562483616"
X Link 2026-01-18T08:59Z [---] followers, [---] engagements
"Alcoholic + Abdominal pain+ Cullen sign Cullen sign (bluish periumbilical ecchymosis) in a chronic alcoholic classically points to acute hemorrhagic pancreatitis. Alcohol pancreatic acinar injury enzyme activation vascular necrosis retroperitoneal bleeding tracking via falciform ligament to umbilicus. Seen in severe pancreatitis / retroperitoneal hemorrhage. Indicates high severity systemic inflammation mortality poor prognosis. https://twitter.com/i/web/status/2012843746220712010 https://twitter.com/i/web/status/2012843746220712010"
X Link 2026-01-18T11:05Z [----] followers, [---] engagements
"100% agree. That discipline is exactly what helped Virat Kohli endure pressure stay consistent and push through every obstacle cricket threw at him. Talent got him noticed but fitness routine and mindset kept him at the top. When others fade with age workload or setbacks he adapted evolved and stayed hungry. Thats real greatness not just stats. https://twitter.com/i/web/status/2012947003123376311 https://twitter.com/i/web/status/2012947003123376311"
X Link 2026-01-18T17:55Z [---] followers, [--] engagements
"Ans C - Here is my justification ECG shows sinus tachycardia with diffuse STD and STE in aVR 👉🏻 global subendocardial ischemia. After epidural ephedrine (+ b agonist) caused HR contractility BP 👉🏻 sudden myocardial O demand 👉🏻 Type [--] (demand) ischemia. Not plaque rupture (no focal STEMI) not coronary spasm (would cause focal STE) not endothelial dysfunction (chronic not acute drug-triggered)"
X Link 2026-01-19T03:21Z [---] followers, [---] engagements
"Ecg shows : STE in inferior leads ( IIIII aVF) & STE in lateral precordial leads - (V4 V5 V6) + Reciprocal STD in (I aVL) + ( V1 V2 - Suggests posterior wall involvement as well) Correct answer is- [--]. Acute Inferiolateral infarction. Artery likely to be occluded - LCX ( Left circumflex) https://twitter.com/i/web/status/2013106196279066948 https://twitter.com/i/web/status/2013106196279066948"
X Link 2026-01-19T04:28Z [----] followers, [---] engagements
"Patient likely to be suffering from DKA 1.Diabetic Ketoacidosis (DKA) 🥇 2.Hyperosmolar Hyperglycemic State (HHS) less likely. 3.Sepsis precipitating DKA ( Pneumonia TB UTI Catheterised patients appendiciti cholecystitis peritonitis septic shock infective endocarditis Etc can lead to sepsis and precipitate DKA) 👉 Immediate priorities: ABG serum ketones electrolytes (esp. K+ ) IV fluids insulin infusion infection work-up. https://twitter.com/i/web/status/2013120476735004931 https://twitter.com/i/web/status/2013120476735004931"
X Link 2026-01-19T05:24Z [----] followers, [----] engagements
"Dx : Whipples disease Rare systemic infection Caused by Tropheryma whipplei Classic triad: Chronic diarrhea + weight loss + migratory arthralgia Also CNS cardiac & ocular involvement Dx: PAS+ macrophages / PCR Rx: prolonged antibiotics ( [--] months or above) initial therapy ➡ IV Ceftriaxone (or IV Penicillin G) for [--] weeks Chosen for good CNS penetration (important because CNS involvement is common even if asymptomatic) [--] Maintenance (long-term therapy) ➡ TrimethoprimSulfamethoxazole (TMP-SMX) Tropheryma whipplei is intracellular High relapse risk especially CNS relapse Short courses ="
X Link 2026-01-19T07:19Z [---] followers, [---] engagements
"@DocPriyamMD @DrAkhilX @dr_manish_ydv @MedLearnHub @Doctors__squad @anupsoans @ecgandrhythmRoe @gianmauror63676 @DrYdv_hitesh01 @albertoortegana Yes doc. The patients BP meds were quite inconsistent. What are your thoughts on the possible trigger Patient mentioned that this was his first episode with this. I appreciate your insights"
X Link 2026-01-19T12:40Z [---] followers, [---] engagements
"@Frances98392343 @DrAkhilX @dr_manish_ydv @MedLearnHub @Doctors__squad @anupsoans @ecgandrhythmRoe @gianmauror63676 @DrYdv_hitesh01 @DocPriyamMD @albertoortegana Doc Im still skeptical about those slurry R waves. Do they indicate anything significant"
X Link 2026-01-19T12:47Z [---] followers, [--] engagements
"@dr_manish_ydv @IhabFathiSulima @DrAkhilX Ans- D Why Colposuspension elevates the bladder neck and proximal urethra by suturing paravaginal tissue to Coopers ligaments"
X Link 2026-01-19T12:54Z [---] followers, [--] engagements
"Dx- Acute early proximal LAD OMI ST-elevation in I aVL V1V2 localizes injury to the high-lateral and anteroseptal walls 👉🏻 proximal LAD territory. Reciprocal ST-depression in II III aVF supports transmural anterior injury. ST-depression in V4V6 + Tall T waves reflects subendocardial ischemia of the lateral wall in early proximal LAD OMI. Needs urgent reperfusion ( PCI) https://twitter.com/i/web/status/2013262405833490627 https://twitter.com/i/web/status/2013262405833490627"
X Link 2026-01-19T14:48Z [---] followers, [--] engagements
"Coronary angio shows patent LM & LAD with good distal runoff while LCX fills proximally but distal vessel is poorly visualised suggesting posterior/lateral territory involvement. LCX OMI often causes posterior MI 👉🏻 mirror changes on ECG. Hence ST depression in V2V5 (Option 3) fits best not obvious STE. https://twitter.com/i/web/status/2013361828089471364 https://twitter.com/i/web/status/2013361828089471364"
X Link 2026-01-19T21:24Z [---] followers, [--] engagements
"@albertoortegana I cant see distal LCX🥹 correct me if am wrong doc Thanks"
X Link 2026-01-19T21:29Z [---] followers, [--] engagements
"@albertoortegana Yes makes sense i didnt see LCX & i jumped into the conclusion of LCX OMI thanks for the description"
X Link 2026-01-19T21:46Z [----] followers, [--] engagements
"@albertoortegana Ans- [--]. Coagulation of the lesion with endoscopic treatment 👉🏻Presentation: Elderly patient painless bright red blood per rectum 👉🏻 classic for lower GI bleeding Colonoscopy finding: Multiple diverticula Active oozing from a sigmoid diverticulum 👉🏻bleeding source is identified"
X Link 2026-01-20T07:32Z [---] followers, [--] engagements
"Whats really happening here Prolonged fasting + stress 👉🏻 blood glucose( depleted glycogen stores + additional stress induced catecholamine surge) glucose supply to the brain transient cerebral dysfunction ( Neuroglycopenia) syncope Why Postural worsening (dizziness on standing) can occur because hypoglycemia impairs cerebral perfusion responses. https://twitter.com/i/web/status/2013526329338277893 https://twitter.com/i/web/status/2013526329338277893"
X Link 2026-01-20T08:17Z [---] followers, [----] engagements
"Green nail syndrome Green-black nail discoloration due to Pseudomonas aeruginosa. Due to moisture + onycholysis. Why green color Pigment is pyocyanin / pyoverdine produced by Pseudomonas Common in frequent hand washers/healthcare workers. Treat by keeping nails dry trimming nail topical antibiotics in severe cases. https://twitter.com/i/web/status/2013614621467517400 https://twitter.com/i/web/status/2013614621467517400"
X Link 2026-01-20T14:08Z [---] followers, [---] engagements
"STE in aVL & V1V5 with reciprocal STD in III aVF 👉🏻 True acute ischemia. Left axis deviation suggests new LAFB a high-risk ACS sign (LAD septal ischemia). Tall symmetric hyperacute T waves in V2V4 and straight/convex STE favor transmural MI. Pattern localizes to proximal LAD occlusion large anterior territory. Do not wait for the CTn activate cath lab immediately. https://twitter.com/i/web/status/2013832689166770377 https://twitter.com/i/web/status/2013832689166770377"
X Link 2026-01-21T04:35Z [----] followers, [---] engagements
"Milk production starts only after delivery. During pregnancy estrogen & progesterone prepare the breast but inhibit secretion. Estrogen : growth of ducts Progesterone : development of lobules & alveoli Prolactin : primes milk synthesis 👉 Actual milk secretion is inhibited because estrogen & progesterone are high After placental delivery👉🏻 prolactin acts. Suckling increases prolactin (milk synthesis) & oxytocin (let-down). Frequent feeding empties breast overcomes Feedback inhibitior of prolocatin and increases supply. https://twitter.com/i/web/status/2013888430435115241"
X Link 2026-01-21T08:16Z [----] followers, [---] engagements
"Dx- Filigree burn: A superficial electrical skin injury with delicate branching (fern-like) erythema. Caused by surface arcing of high-voltage current it reflects transient dermal capillary dilation not true tissue necrosis. Typically painless non-blistering appears early and fades within hoursdays without scarring. It is also seen in following conditions Lightning strike victims most classic association 👉🏻High-voltage electrical exposure (surface arcing) 👉🏻Static electricity discharge (rare mild forms) https://twitter.com/i/web/status/2014025318705799258"
X Link 2026-01-21T17:20Z [----] followers, [---] engagements
"Dx- Meningocele It is a form of spina bifida cystica caused by failure of neural tube closure. The meninges herniate through a vertebral defect forming a cystic sac on the back usually midline. The sac contains CSF without neural tissue so neurological deficits are minimal or absent. Management is early surgical repair to prevent rupture and infection. https://twitter.com/i/web/status/2014290542700659157 https://twitter.com/i/web/status/2014290542700659157"
X Link 2026-01-22T10:54Z [----] followers, [----] engagements
"10-year parotid swelling pleomorphic adenoma Long-standing slow-growing painless cheek/parotid mass Firm lobulated usually from superficial lobe of parotid Facial nerve intact favors benign lesion Most common salivary gland tumor Work-up: USG +- FNAC Tx: Superficial parotidectomy (nerve preservation) ⚠ Long duration risk of malignant transformation https://twitter.com/i/web/status/2014309825044471812 https://twitter.com/i/web/status/2014309825044471812"
X Link 2026-01-22T12:11Z [----] followers, [----] engagements
"Post-TAVI ECG: Regular wide-QRS escape rhythm with visible P waves marching independently true AV dissociation = complete heart block. QRS is broad with LBBB pattern. Right axis deviation suggests infra-Hisian ventricular escape +/- associated LPFB. Even if asymptomatic this mandates pacing. https://twitter.com/i/web/status/2014312985947455721 https://twitter.com/i/web/status/2014312985947455721"
X Link 2026-01-22T12:23Z [----] followers, [---] engagements
"@Medzonetv Open NTDs (meningocele myelomeningocele) 👉🏻 Increased maternal serum AFP ( Alpha feto protein) Closed NTDs 👉🏻AFP may be normal"
X Link 2026-01-22T13:24Z [----] followers, [---] engagements
"Lymphocutaneous sporotrichosis Rose-gardeners disease caused by Sporothrix schenckii. Inoculation via thorn/soil painless papule linear nodulo-ulcerative lesions spreading along lymphatics (sporotrichoid pattern). Dimorphic fungus Mold form at [--] C (environment) Yeast form at [--] C (human tissue) Tissue: cigar-shaped yeast Dx: culture cigar-shaped yeast. Tx: Itraconazole / SSKI. Amphotericin B severe/disseminated disease https://twitter.com/i/web/status/2014338625325187388 https://twitter.com/i/web/status/2014338625325187388"
X Link 2026-01-22T14:05Z [----] followers, [---] engagements
"Painless slow-growing lobulated mass at the angle of mandible with preserved facial nerve function points to pleomorphic adenoma of parotid. Imaging :- MRI shows a well-circumscribed heterogeneous lesion (epithelial + myxoid elements). Commonest salivary tumor treat with parotidectomy preserve facial nerve during the sx. https://twitter.com/i/web/status/2014509830330061156 https://twitter.com/i/web/status/2014509830330061156"
X Link 2026-01-23T01:25Z [----] followers, [----] engagements
"Ans- : Central pontine myelinosis (ODS): Occurs after rapid correction of chronic hyponatremia Brain adapts by losing osmolytes sudden Na rise causes cellular dehydration Oligodendrocyte injury pontine demyelination Delayed onset (26 days): dysarthria dysphagia quadriparesis Prevent: Na correction [--] mEq/L/day https://twitter.com/i/web/status/2014511013010542859 https://twitter.com/i/web/status/2014511013010542859"
X Link 2026-01-23T01:30Z [----] followers, [---] engagements
"Black dusky non-glistening bowel with hemorrhagic edematous mesentery and a sharp transition zone of ischemic bowel. Venous congestion ( SMA embolus Mesenteric venous thrombosis ) hypoxia transmural necrosis. Atonic thickened loops = non-viable gut. Surgical emergency resection. https://twitter.com/i/web/status/2014512096743182825 https://twitter.com/i/web/status/2014512096743182825"
X Link 2026-01-23T01:34Z [----] followers, [----] engagements
"Dx : - Aortic dissection A tear in the aortic intima lets blood track into media false lumen( like shown in the video) Risks: HTN connective tissue disease. Symptoms: Sudden tearing chest/back pain. O/E : Pulse/BP differential +/- AR murmur. Dx: CT angiography. Rx: Stanford A surgery; Stanford B medical (Medical mx)"
X Link 2026-01-23T05:33Z [----] followers, [---] engagements
"Dx- AML-M3 (Acute Promyelocytic Leukemia) Why it is AML M3 30-yr pt with fatigue gum bleeding epistaxis It is DIC-driven leukemia. Pathogenesis: t(15;17) PML-RARA fusion block in promyelocyte differentiation + procoagulant release. Clinical features: pancytopenia mucocutaneous gum bleeding petechiae; infection less prominent initially. Peripheral smear: abnormal hypergranular promyelocytes multiple Auer rods (faggot cells above picture ) MPO+. Labs: anemia thrombocytopenia fibrinogen PT/aPTT D-dimer. Diagnosis: morphology + cytogenetics (PML-RARA). Pearl: start ATRA immediately."
X Link 2026-01-23T11:03Z [----] followers, [---] engagements
"Bat wing (butterfly) appearance on CXR Seen as B/L symmetric perihilar alveolar opacities radiating outward with relative peripheral lung sparing. Why it appears rapid alveolar fluid accumulation classically cardiogenic pulmonary edema due to increased pulmonary capillary hydrostatic pressure. Central lungs fill first because of richer blood flow & lymphatic drainage patterns. How it appears fluffy ill-defined perihilar shadows often with cardiomegaly Kerley B lines pleural effusions. Diagnosis: CXR + clinical context (acute dyspnea orthopnea) echo BNP response to diuretics. Differentials:"
X Link 2026-01-23T12:06Z [----] followers, [--] engagements
"Ans- Sarcoidosis Why Eye involvement (uveitis) Granulomatous inflammation of uveal tract 👉🏻 red painful eye photophobia. Common extra-pulmonary feature. Lupus pernio (face) Violaceous indurated plaques over nose & cheeks 👉🏻highly specific for chronic sarcoidosis. Erythema nodosum (legs) Tender red subcutaneous nodules on shins due to panniculitis 👉🏻marker of active systemic inflammation Biopsy finding Non-caseating granulomas (tight epithelioid cell clusters no central necrosis) 👉🏻 histologic hallmark. https://twitter.com/i/web/status/2014684534001041637"
X Link 2026-01-23T12:59Z [----] followers, [---] engagements
"A 4-year-old child presents with a high fever that has lasted for [--] days. The child has "strawberry tongue" (bright red bumpy tongue) red eyes without discharge a rash and swollen lymph nodes in the neck. What is the most serious complication of this condition (Kawasaki Disease) that doctors must monitor for using an Echocardiogram A) Aortic dissection B) Coronary artery aneurysms C) Mitral valve prolapse D) Pulmonary embolism #neetpg2026 #MedTwitter https://twitter.com/i/web/status/2014720308331303225 https://twitter.com/i/web/status/2014720308331303225"
X Link 2026-01-23T15:22Z [----] followers, [---] engagements
"Dx: Meningomyelocele Congenital midline lumbosacral cystic swelling with a large tense translucent sac. Contents include meninges + CSF + neural tissue 👉🏻unlike meningocele. Often associated with lower-limb weakness bladder/bowel dysfunction & hydrocephalus (Chiari II). Needs early neurosurgical repair. https://twitter.com/i/web/status/2014776595433796046 https://twitter.com/i/web/status/2014776595433796046"
X Link 2026-01-23T19:05Z [----] followers, [---] engagements
"@Interventi47477 @ecgandrhythmRoe @albertoortegana @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan LAD & LCX stenosis approx 80% "
X Link 2026-01-23T19:37Z [----] followers, [--] engagements
"@albertoortegana @ecgandrhythmRoe @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan Yes doc CAG showed LCX & LAD occlusion. cTn was significantly elevated. Thanks for the detailed analysis"
X Link 2026-01-23T19:39Z [----] followers, [---] engagements
"@PeterItebimien @albertoortegana @ChefKarim02 @IhabFathiSulima @elidyynwa @MEmwanta @mendietaalex1 @TSM_Humanist @DrAkhilX @drkeithsiau @modernHealthMe @BrownJHM @the_beardedsina @rkalyes1 @Doctors__squad @NicoGagelmann @ChiomaDPatrick Necrolytic migratory erythema + diabetes + weight loss 👉🏻 Glucagonoma Characteristic rash 👉🏻Necrolytic migratory erythema (erythematous scaly erosive plaques often on limbs/perineum) New-onset diabetes mellitus Recurrent diarrhea Progressive weight loss"
X Link 2026-01-23T21:32Z [----] followers, [---] engagements
"Dx- Melanoma Why Melanoma screening made simple the ABCDE rule 🧠🩺 A: Asymmetry one half unlike the other B: Border irregular notched poorly defined edges C: Color multiple shades (brown black blue red white) D: Diameter [--] mm (but small melanomas exist) E: Evolution Any change in size shape color or symptoms (most important) https://twitter.com/i/web/status/2014924658345451684 https://twitter.com/i/web/status/2014924658345451684"
X Link 2026-01-24T04:54Z [----] followers, [---] engagements
"This video points to situational syncope due to a Valsalva-type manoeuvre most commonly stretch syncope. Whats happening: forceful muscle flexion/straining intrathoracic pressure venous return transient cerebral perfusion syncope. Related bucket: situational reflex syncope (cough micturition defecation weight-lifting stretching) brief LOC rapid recovery no post-ictal confusion. https://twitter.com/i/web/status/2015022321439060363 https://twitter.com/i/web/status/2015022321439060363"
X Link 2026-01-24T11:22Z [----] followers, [----] engagements
"Patients with Sjgrens Syndrome have a 44-fold higher risk of developing which type of malignancy compared to the general population A) Lung Cancer B) B-cell Lymphoma C) Osteosarcoma D) Melanoma #MedTwitter #neetpg2026 @albertoortegana @SameerYogi14 @dr_manish_ydv @DrYdv_hitesh01 @DrAkhilX @IhabFathiSulima https://twitter.com/i/web/status/2015068714249617605 https://twitter.com/i/web/status/2015068714249617605"
X Link 2026-01-24T14:26Z [----] followers, [----] engagements
"In The Pitt a crash victim arrives labeled quadriplegic. Dr. Robby pauses checks the history walks to the lab and the picture changes: Hypokalemic Periodic Paralysis. What looked like permanent paralysis was actually reversible. A quiet diagnostic pivot and suddenly the whole case makes sense. #MedTwitter #ThePittSpoilers Case alert 🚨:- 28yo Indian M Graves presents 2AM w/ acute ascending flaccid paralysis after late-night high-carb dinner & workout. Proximal legs arms profound hyporeflexia preserved sensation/cranial nerves K+ [---] mmol/L CK mildly up. ECG: U waves Dx#MedTwitter"
X Link 2026-01-24T15:46Z [----] followers, [---] engagements
"Thats what made The Pitt click for me. It actually feels like the ER fast decisions uncertainty pattern recognition course correction. No forced love arcs. No melodrama hijacking the medicine. Just cases chaos and thinking under pressure. So far its holding its ground and thats rare. https://twitter.com/i/web/status/2015090705786630161 https://twitter.com/i/web/status/2015090705786630161"
X Link 2026-01-24T15:53Z [----] followers, [--] engagements
"Regular wide-complex tachycardia (180/min). QRS shows RBBB morphology: dominant R / rSR-like pattern in V1 with deep broad S in I & V6. Axis is leftward (I positive II/III/aVF negative) consistent with LAFB. No beat-to-beat QRS variation suggesting organized conduction rather than polymorphic VT. Taken together this fits bifascicular block (RBBB + LAFB) @Frances98392343 doc what do you think https://twitter.com/i/web/status/2015098366473245063 https://twitter.com/i/web/status/2015098366473245063"
X Link 2026-01-24T16:24Z [----] followers, [---] engagements
"All the statements are true actually. Why The fetal adrenal cortex grows massively in utero (for placental estrogen synthesis) and regresses after birth✅ Both fetal & definitive cortex arise from mesoderm while the definitive cortex matures postnatally✅ The adrenal medulla is a neural crest derivative✅ https://twitter.com/i/web/status/2015126927502434569 https://twitter.com/i/web/status/2015126927502434569"
X Link 2026-01-24T18:17Z [----] followers, [--] engagements
"Hair-on-end skull in thalassemia major: Why it happens Severe ineffective erythropoiesis chronic anemia erythropoietin marked bone marrow hyperplasia. Marrow expansion widens diploic space thins outer table and forms vertical trabeculae perpendicular to skull seen on X-ray as radiating hair-on-end striations. https://twitter.com/i/web/status/2015280577038131382 https://twitter.com/i/web/status/2015280577038131382"
X Link 2026-01-25T04:28Z [----] followers, 29.9K engagements
"Squamous cell carcinoma Why Firm indurated growth on the lateral border of the tongue with a keratinized white surface is classic for oral squamous cell carcinoma. The lateral tongue is a high-risk site keratinization reflects malignant epithelial change and firmness suggests invasion. SCC until proven otherwise biopsy is mandatory. Ddx Leukoplakia Oral lichen planus Traumatic ulcer / frictional keratosis https://twitter.com/i/web/status/2015331627485045129 https://twitter.com/i/web/status/2015331627485045129"
X Link 2026-01-25T07:51Z [----] followers, [---] engagements
"ECG alert 🚨 A 45-year-old man presented to the emergency room with central chest pain. An electrocardiogram (ECG) was obtained and I would like to know your thoughts on this ECG #MedTwitter #Cardiology #ER"
X Link 2026-01-25T08:13Z [----] followers, [----] engagements
"Ans- Infereriolateral wall MI Why LCX supplies the lateral LV (V5V6) and in left-dominant hearts the inferior wall via PDA. In the given CAG proximal LCX occlusion cuts flow to both territories producing 👉🏻Inferolateral MI If LCX is dominant & gives rise to PDA- STE in II III aVF with V5V6often with reciprocal aVL depression and possible posterior changes. If not STE in I aVL V5 V6 is seen with subtle reciprocal changes( not obligatory) https://twitter.com/i/web/status/2015349940827173302 https://twitter.com/i/web/status/2015349940827173302"
X Link 2026-01-25T09:04Z [----] followers, [----] engagements
"Ans- Ritodrine Ritodrine is a selective b2 -adrenergic agonist. Why is is preferred [--] Stimulates b2 receptors on uterine smooth muscle [--] Activates adenylate cyclase [--] cAMP inside myometrial cells [--] cAMP reduces intracellular Calcium availability [--] Actinmyosin interaction [--] Uterine relaxation 👉🏻 inhibition of contractions. https://twitter.com/i/web/status/2015400134079811617 https://twitter.com/i/web/status/2015400134079811617"
X Link 2026-01-25T12:23Z [----] followers, [----] engagements
"@SameerYogi14 @DrAkhilX @dr_manish_ydv @dranuj_k Medical science never fails to amaze me. Good post doc👍🏻"
X Link 2026-01-25T15:39Z [----] followers, [--] engagements
"Dx- Rectal foreign body (RFB) Appearance: - Well-defined radiopaque oval/cylindrical object in rectum/sigmoid on pelvic X-ray +/-free air Presentation: - Delayed vague history inability to pass stool/flatus Sx/Signs: - Rectal pain bleeding tenesmus abd pain peritonitis if perforated Dx: Pelvic X-ray first; CT if perforation; DRE after imaging Tx: Transanal removal +/- endoscopy; surgery 👉🏻perforation/sepsis. https://twitter.com/i/web/status/2015492282339008954 https://twitter.com/i/web/status/2015492282339008954"
X Link 2026-01-25T18:29Z [----] followers, [---] engagements
"@medcrux Boutonniere deformity : Why in RA occurs due to chronic synovitis causing rupture of the central slip of extensor tendon at PIP joint PIP flexion with compensatory DIP hyperextension. Reflects longstanding inflammatory damage to extensor mechanism"
X Link 2026-01-26T05:58Z [----] followers, [---] engagements
"Why TMT + hypoglycemia can show hyperkalemia-like ECG changes Exercise-induced hypoglycemia triggers a massive catecholamine surge 👉🏻 beta-adrenergic mediated K+ shift from cells to plasma + impaired Na/K-ATPase (low glucose). Result: functional hyperkalemia 👉🏻tall tented T waves on ECG. Reversible with glucose. Ecg shows :- Tall tented T waves 👉🏻P waves disappear👉🏻 Slow heart rate👉🏻 Finally: Cardiac arrest https://twitter.com/i/web/status/2015747875708482031 https://twitter.com/i/web/status/2015747875708482031"
X Link 2026-01-26T11:25Z [----] followers, [--] engagements
"Dx- Choriocarcinoma: It is highly malignant gestational trophoblastic tumor from syncytio & cytotrophoblasts. Seen after molar pregnancy abortion or term gestation. Age: reproductive years. Sx: PV bleeding early lung/brain mets. Dx: very increased beta-hCG. Associations : complete mole. https://twitter.com/i/web/status/2015843284250460190 https://twitter.com/i/web/status/2015843284250460190"
X Link 2026-01-26T17:44Z [----] followers, [---] engagements
"@albertoortegana @IhabFathiSulima @DrAkhilX @DrArslan480 @DrNikhilMD ✅ Answer: B) Trisomy [--] (Edwards syndrome) Why 👇 Classic features of Edwards syndrome: Microcephaly Clenched fists with overlapping fingers Rocker-bottom feet Congenital heart defects (VSD PDA common) Severe growth restriction low-set ears prominent occiput"
X Link 2026-01-27T03:46Z [----] followers, [---] engagements
"@KSRTC_Journeys Traveling on the Airavat from Mangalore to Bangalore whats the point of providing charging ports no human can access And even if you manage to reach them they dont work. Paying a premium fare yet passengers are treated like trash"
X Link 2026-01-13T07:50Z [----] followers, [---] engagements
"Pruritic erythematous scaly plaques in groin that typically spare scrotum = tinea cruris. First-line: topical anti fungals prefer terbinafine 1% once daily [--] wks (fungicidal faster cure). Alternatives: azoles (clotrimazole/ketoconazole) [--] wks. Apply to lesion + [--] cm margin and continue [--] wk after clearance. Systemic therapy (terbinafine/itraconazole) if extensive recurrent or failed topical. ❌ Avoid steroidantifungal combos tinea incognito & recurrence. Adjuncts: keep area dry loose cotton clothing treat coexisting tinea pedis hygiene is key."
X Link 2026-01-18T11:53Z [----] followers, [---] engagements
"Dx- Pneumonia ( CAP) I see the hyperlucent parenchymal opacity is likely a lobar consolidation on the right side of the lung. Additionally there is a tracheal shift to the opposite side of the affected lung which could be due to the consolidation and mass effect causing the shift. https://twitter.com/i/web/status/2013677101183099258 https://twitter.com/i/web/status/2013677101183099258"
X Link 2026-01-20T18:16Z [----] followers, [----] engagements
"A 55-year-old man known case of hypertension and dyslipidemia on treatment presents to the ER with acute onset severe retrosternal chest pain for [--] hours radiating to the jaw and both shoulders associated with dyspnea palpitations nausea and profuse diaphoresis. Pain is persistent and not relieved by rest. ECG obtained is shown. Whats your thoughts on this ecg #MedTwitter #Cardiology"
X Link 2026-01-23T13:23Z [----] followers, [----] engagements
"@cardiogutierrez @ecgandrhythmRoe @albertoortegana @Charanreddy246 @VikramMShahpura @DrYdv_hitesh01 @dr_manish_ydv @MedLearnHub @anupsoans @Amhar_47 @KostekMilan Yes doc it was multi vessel disease. Critical LAD/LCX occlusion. Thanks for your analysis"
X Link 2026-01-23T19:41Z [----] followers, [---] engagements
"Ans- B Why Why Calcium Channel Blockers (CCBs) are FIRST LINE (Dihydropyridines: nifedipine amlodipine) Mechanism Block L-type Ca channels in vascular smooth muscle Intracellular Ca arteriolar vasodilation Why they fit Raynauds perfectly Directly counteract vasospasm Strong effect on small peripheral arteries Proven decreases attack frequency & severity Rapid symptomatic benefit 👉 They target the primary pathology unlike beta blockers aspirin ACEI. https://twitter.com/i/web/status/2014935065936248928 https://twitter.com/i/web/status/2014935065936248928"
X Link 2026-01-24T05:35Z [----] followers, 20.8K engagements
"Nephrotic syndrome likely Minimal Change Disease Why Peri-orbital swelling in a child classic early sign of nephrotic syndrome Blood sample appears milky / lipemic 👉🏻due to severe hyperlipidemia Pathophysiology: Heavy proteinuria 👉🏻 plasma oncotic pressure Liver compensates by lipoprotein synthesis 👉🏻 lipemia https://twitter.com/i/web/status/2015441901441417642 https://twitter.com/i/web/status/2015441901441417642"
X Link 2026-01-25T15:09Z [----] followers, [---] engagements
"Dx:- Raynaud phenomenon: episodic digital ischemia due to exaggerated vasospasm of small arteries triggered by cold or stress. Pathogenesis: endothelial dysfunction 👉🏻Increased -adrenergic vasoconstriction. Symptoms : triphasic color change (white-blue-red) pain numbness. Assoc: SSc SLE RA. Tx: avoid cold CCBs (nifedipine) PDE-5 inhibitors sympathectomy (severe). https://twitter.com/i/web/status/2015844136700805409 https://twitter.com/i/web/status/2015844136700805409"
X Link 2026-01-26T17:47Z [----] followers, [---] engagements
"@dr_manish_ydv @IhabFathiSulima ✅ Answer: C Why Age [----] years is the common age group where torsion occurs due to testicular growth at puberty but age is not a predisposing abnormality"
X Link 2026-01-27T15:27Z [----] followers, [---] engagements
"Vigorous muscle flexing 👉🏻 syncope Whats the physiology behind this Sustained isometric contraction ( Chap is flexing in the video ) Increases intrathoracic & intra-abdominal pressure (Valsalva-like) IVC/SVC compression venous return (preload) stroke volume & cardiac output arterial BP cerebral perfusion +/- vagal surge (bradycardia)👉🏻 This results syncope https://twitter.com/i/web/status/2016763509301006748 https://twitter.com/i/web/status/2016763509301006748"
X Link 2026-01-29T06:41Z [----] followers, [---] engagements
"@DrAkhilX Ocular pentastomiasis"
X Link 2026-01-29T07:50Z [----] followers, 30.6K engagements
"ECG alert 🚨 A 56-year-old patient presents with [--] hours of severe retrosternal chest pain diaphoresis and nausea. BP 108/68 mmHg HR 96/min SpO 98% (RA) Investigations: ECG as shown hs-cTn I :- [---] ng/mL CK-MB :- [--] U/L Total CK :- [---] U/L Serum K :- [---] mmol/L Serum Mg :- [---] mg/dL Serum creatinine :- [---] mg/dL ABG :- No acidosis Which coronary artery is occluded Whats your thoughts on this ECG #MedTwitter #cardiology #ECG https://twitter.com/i/web/status/2016825037983273132 https://twitter.com/i/web/status/2016825037983273132"
X Link 2026-01-29T10:45Z [----] followers, [----] engagements
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