@nileshnolkha Indian women pride themselves about their low Hb sad but true. A doctor friend with 7 Hb was so proud that inspite of low Hb she could work in hectic schedule of residency. 🤦
1 in 2-3 Indian females (or even more) have hair loss issues cyclically. They also end up in rheumatology opds with fatigue and non specific pains. At least 30-40 percent of these patients can improve by improving iron deficiency alone.
It’s amazing how even affluent Indian females have accepted hemoglobin of 9-10 as normal. That’s like having 2-3 packets of less blood than what is considered normal. Many get better and understand what they were missing after iron infusion 😅
Dark circles make you look 5 years older, permanently exhausted, and unwell, even on your best days.
And all you hear is “Just sleep more”. And I know you’ve tried that.
Dark circles have 6 different causes and sleep is only one of them. Here's how to find yours. 🧵
@DrAmbrishMithal When I did scope obesity course in 2021-22 my own colleagues laughed at me but I always believed obesity is a disease and needs medical treatment not only exercise and diet. Before glps I use to always remove time and talk to patient about obesity and also bariatric.
In more four decades of studying and practising endocrinology, I have never seen such excitement in the media about a new therapy.
A year ago when I started talking/ writing about #GLP1 in the public space, there were very few takers outside of the endocrine fraternity.
Amidst all the noise- if you want to learn about the science, the good and the bad, of using these medications I have penned my thoughts in
"The Weight Loss Revolution" -easily available on Amazon and other sites.
amzn.in/d/005Sui0k
@DoctorShiva007@KamathGurudutt And at times if ecg is normal but you know it's abnormal somewhere then u ask them to be in hospital for 24 hr observation,u will be labelled as money making doctor and if he goes home and dies then u are bad with ur knowledge. Irony of we doctors
He came to casualty thinking it was just gastritis.
Burning chest discomfort, little uneasiness. Nothing serious.
But ECG showed anterior wall MI.
The difficult part was not diagnosis.
Convincing patient and family that it was a heart attack.
It took me 10 minutes to make them understand.
10 minutes that could have cost heart muscle.
In our country, many heart attacks look like:
• Gastritis
• Acidity
• Indigestion
If symptoms are new or not settling, please get an ECG.
Time lost is heart muscle lost.
🚨 The 2026 dyslipidemia guideline just dropped, and it quietly changes how we think about cholesterol risk.
Here are 10 takeaways clinicians shouldn’t ignore 🧵
🧵 The "Acidity Pill" Trap: A Silent Health Crisis?
That daily antacid you pop for "gas" or heartburn might be doing more than just stopping the burn. As a neurologist, I see the long-term fallout of over-the-counter (OTC) drug misuse every day.
Let's talk about the hidden risks of PPIs (Omeprazole, Pantoprazole, etc.). 👇
How Energy Drinks Destroy the Heart
Energy drinks are marketed as quick fixes for fatigue promising focus, stamina, and “instant energy.” But behind the flashy branding lies a serious health concern
Let’s break down how they can silently damage your cardiovascular system. 👇🧵
@DRARN93 Azithromycin is otc after Covid. Recently lost young patient 38 yr old who popped Azithromycin as and when had simple cold cough sore throat. Approx 6 times in last 8 mts Landed with torsades de point and ventricular arrhythmia and death.unfortunte
Always check ongoing drugs before prescribing Azithromycin. Recently a patient of mine got admitted in ICU for atrial fibrillation with heart failure. She was taking quetiapine as well( not disclosed) . Niv , diuresis and what not. Be careful guys
2026 Stroke Guideline: 10 Updates You MUST Know
The 2026 AHA/ASA Acute Ischemic Stroke Guideline just dropped and it changes practice.
Here are the 10 most important updates 🧵⬇️
@hyderabaddoctor often as primary care physician it's evident there is breathlessness fatigue pallor try to get their attention it's dismissed as stress or came running no sleep didn't eat well etc atleast get basic test ecg bpmaybe normal but if something abnormal will prevent catastrophe
Paatal Lok star Prashant Tamang’s sudden death raises alarm: Neurologist reveals warning signs we should not ignore
theweek.in/news/health/20…
Many life-threatening conditions, including heart problems, severe infections, and neurological events, may start with subtle symptoms that people often dismiss due to their busy work schedules, stress, or the assumption that they are immune to serious illness, considering their age.
Breathlessness, especially during rest or minimal activity, is a red flag that should never be ignored. Extreme fatigue is another important signal. While feeling tired after a long day is normal, persistent, unexplained exhaustion that does not get better with rest may indicate serious conditions that should be examined by an expert. Similarly, dizziness, fainting, or sudden weakness can point to problems as well.
"In cases of sudden death at a young age, whether due to cardiac arrest or stroke, symptoms are often present days to weeks earlier, but are dismissed as stress, acidity, or fatigue. Early cardiac warning signs may include new or unusual chest discomfort or heaviness, breathlessness, reduced exercise capacity, unexplained fatigue, palpitations, dizziness or fainting," said Dr Sudhir Kumar, a neurologist based in Hyderabad.
Changes in heart rhythm, such as palpitations, rapid heartbeat, or irregular pulses, are also important warning signs.
@TheWeekLive@tisha_jaco
One of the biggest scams of the modern consumer world is the idea that your skin needs a long, step-by-step daily skincare routine.
This belief is deliberately manufactured by the beauty industry to create dependency, turning perfectly normal skin features like pores, texture, oiliness, and aging into “problems” that conveniently require a new product at every step.
Social media and influencers amplify this fear of missing out, selling the illusion that skipping a toner, essence, or serum is sabotaging your skin, when in reality most of these steps add little beyond irritation and marketing claims.
Human skin evolved to protect itself; it does not collapse without a 10-step ritual. What actually works is boring and unprofitable to hype: sunscreen to prevent damage and a moisturizer to maintain the barrier. Everything else is optional, problem-specific, and pushed less by science and more by sales targets.
Residents, fellows and physicians you ll regret if you miss this tweet.
🩸 Hematology Cheat Sheet: Acute Phase Reactants (APRs)
Understanding APRs & Their Clinical Use
#MedTwitter#MedEd#MedX
2️⃣0️⃣ Final message 🌟
Chronic diarrhoea is a diagnostic puzzle.
If you classify it into watery, fatty and inflammatory
Ask about medications
Look for red flags
Use calprotectin wisely
Do a biopsy even when colon looks normal
You will solve almost every case.
#MedTwitter#FOAMed#Gastroenterology#InternalMedicine
@nileshnolkha It's futile to even get into this. We know what we do why and how. We have to answer ourselves at the end. In india people believe doctors only loot not salon spa wedding planners etc no one. Eventually they need us that time we treat them and leave rest to their karma. 😊
💉 I’m pro-vaccine and I don’t want to get into this twitter war…
But let’s clear a few things about this “pharma lobby” nonsense.
Doctors don’t lose business because of vaccines or medicines.
If anything, post-COVID we’re busier and richer because people refuse preventive care, skip vaccines, and experiment with “alternative” nonsense.
Take rheumatoid arthritis for example 👇
🦴 Early on, it’s treatable with simple, affordable drugs and a rheumatologist’s guidance.
But many patients waste months or years on home remedies, oils, or “natural detox.”
When they finally come:
•Their joints are already deformed,
•Muscles wasted,
•Need multi-drug therapy, rehab, sometimes joint replacement,
•And lifelong disability that could’ve been avoided.
💸 The irony?
They end up spending 10–20× more than what early treatment would’ve cost, all because someone told them “medicines are poison.”
So no, we aren’t in a pharma lobby.
We’re just fixing the mess that pseudoscience and poor judgment create.
And trust me, ‘business’ (you call it business, we call it medical care or healing) isn’t going down because of anti-vaxxers / herbal treatments / ayurveda / homeopathy or alternative therapies, it’s booming because of them. 😅
@Chulbulpanda420 High literacy sometimes is a problem where few lines from Google chatgpt are trusted more. These city bred literate PPL are not so educated and so need to push them more. Village PPL trust you and follow everything far better.
I saw a case of obsessive-compulsive disorder (OCD) that had been misdiagnosed by an alternative medicine doctor as an allergy to water.
The lady washed her hands after touching any object she thought was contaminated and also had hand dermatitis. She spent approximately 1–3 hours per day washing her hands and bathing, and it took her 4–8 hours to cook food(obsessive slowness).
Her family first took her to a baba/ojha, suspecting possession by a ghost!
When there was no improvement, they consulted alternative medicine practitioners and general physicians.
At least one baba ji referred her to me (due to family relations).
Her total illness had lasted 6 years!
The lady and her family never considered consulting a psychiatrist because some doctor had told her husband, "Psychiatrists always prescribe sleep medicine, and you will never recover."
Her Yale-Brown Obsessive Compulsive Scale (YBOCS) score showed marked improvement.
The lady is fine now, but why did she have to wait 6 damn years to enter a psychiatrist's clinic???
Then-some people make jokes on Mental health.