Vishal Chandra Sharma

Hello Twitterverse! This space is for: Clinical Pearls Neuro Myth-Busting Patient Friendly Brain insights Follow the path of the #NeuroJediMaster May the neurons be with you #MedTwitter #MedEd #MindTips

When you spot superficial siderosis-especially involving the superior cerebellum-always do a spine screening and check for a spinal epidural collection. ​This can be a key indicator of a chronic ventral CSF leak resulting in extensive superficial siderosis. Keep this on your radar! ​#NeuroTwitter #Neurology #SpinalCSFleak

@PJaseja Vibrant illustrations too

@NeuroJediMaster Very cool kinda language of explaining

Here is the thread of the books I explored, along with standard books #MedTwitter #MBBS Some are fun to read, some give beautiful insight into a topic, and some might help with an exam or a quiz 🧵

@PJaseja Immune. I have a copy too. Loved it

3/n Immune - A journey into the mysterious system that keeps you alive I read this during the post-COVID era, when the immune system was much in the news, with discussions about immunity boosters and the whole vaccine debate. Covers the basic concept beautifully and debunks various myths; however, it is not a core informative book. But it's fun to read from Kurzgesagt creators ... their way of explaining things!! For example, the description of NK cells (image) Buy a hard copy if you like their illustrations #Medtwitter #Immunity @Kurz_Gesagt

@aditya_gan3500 Maybe delay the inevitable, curse or boon is the question

Neurodegeneration is the culmination of a lifelong process that begins from when you are a zygote. To prevent that you have to have everything in your life go right. Everything. From proper neural development to good education and upbringing, stable job with good income and good family life, plenty of time to workout etc etc. No medication can do that. Hence neurodegeneration cannot be stopped.

#MedTwitter #NeuroTwitter #SundayRead Talk of the Town- GLP1 R agonist. Neurological effects have been studied, but clinical translation needs to be established. Central mechanisms in Neurodegeneration: 1.Regulation of protein aggregation and proteostasis 2.Modulate autophagy and improve mitochondrial function 3.Regulate Glial activation and Neuroinflammation 4.Restore synaptic function and network integrity 5.Restore Gut-Immune-Brain homeostasis Potential Role in Neurological disorders like Alzheimer disease, Parkinson disease, ALS, MS, Stroke, IIH, TBI. #GLP1Agonist #Semaglutide #Neuroinflammation #Neurodegeneration #NeuroJediMaster jci.org/articles/view/…

@aditya_gan3500 I agree.

@NeuroJediMaster GLP1-RA lead to loss of fat but we already have a system for that and its called muscles. People will lose muscle mass. Then the question of rebound comes in since no Indian patient takes any drug forever.

The mechanisms are interesting but whether it translates to clinical improvements is a big question. Neurodegenerative disorders, catching them in the initial onset phase is difficult , till that is solved just treating the downstream effects may not be very beneficial. Only time will tell

@NeuroJediMaster Big words. Outcomes will be minimal. Please mark my words.

@PJaseja @claudeai Integrate it with other AI tools , gives great results.

Made the WHO step ladder approach using @claudeai This is cool 🔥...

#MedTwitter #NeuroTwitter Interesting read. The need for spiritual assessment in Neurology. Not to be confused with religion. Especially relevant in disorders where treatment options are limited. Not an easy step for both clinicians and patients, and initiating the conversation can be tough. Even tougher questions follow Meaning → “Why is this happening to me?” Purpose → “What is left for me now?” Identity → “Who am I if I lose function?” Connection → “What keeps me going?” We cannot always answer these questions, but we need to acknowledge and support . doi.org/10.1212/CPJ.00…

@ganeshsonawane Should help a lot of patients with neurological disabilities. Really good

Making movement easier with Frido Patient Transfer Lift. Designed and Made in 🇮🇳

Today’s chatter at the OPD coffee break was all about LPG, induction cooker , insta pot and cooking rice. Changing times #LPG

VERY IMPORTANT ANNOUNCEMENT. Dear friends, we have published the largest analytical study of Ayurveda, Homeopathy, Siddha, Unani and Folk-Traditional Medicinal products that have harmed patients - presenting with liver damage - to our department. This is the most exhaustive analytical study that correlated clinical outcomes in such patients. Interestingly, one of the Reviewers who peer-reviewed our paper (notification after paper publication) and cleared it for publication is a senior professor of Ayurveda (Rasashastra and Bhaishajya Kalpana) at All India Institute of Ayurveda. This makes our paper even more impactful. Here is a plain language summary of the study's major findings, highlighting what patients and the public need to know about the safety of alternative medicines: Severe Liver Damage is a Major Risk: The study looked at 386 alternative and complementary medicines taken by patients who experienced liver damage. It found that these products frequently triggered a severe, life-threatening form of liver failure, called Acute-on-chronic liver failure (or ACLF) which resulted in death for nearly 40% of the patients who developed it. Unlabeled Products Can Be Deadly: Taking "unlabeled" products—those sold without proper ingredient lists, manufacturer details, or batch numbers—was a strong predictor of death. The risk of dying increased the more unlabeled products a patient consumed, showing how dangerous an unregulated supply chain can be. Data revealed a dose-response relationship where death rates escalated progressively, reaching 42.9% among patients who consumed three or more unlabeled products. Dangerous Levels of Heavy Metals: A shocking number of the tested products were heavily contaminated with toxic metals like mercury, lead, arsenic, and cadmium, often at levels far above safety limits. Exposure to cadmium, in particular, was strongly linked to patients developing the most severe form of liver failure. Exposure to cadmium was strongly and significantly associated with the development of ACLF (75.9% in exposed versus 22.6% in unexposed patients). Hidden Prescription Drugs: Almost one-third of the products secretly contained modern pharmaceutical drugs, meaning patients were taking them without knowing. These hidden drugs included steroids, antibiotics, and painkillers, and some were even banned or well-known to cause liver damage. "Natural" Doesn't Always Mean Safe: Over 40% of the products contained plant ingredients that are medically documented to be toxic to the liver. Well-known herbs like Giloy (Tinospora cordifolia) and Ashwagandha were among the most common potentially harmful plants found in the products. Secret Animal Ingredients: Testing revealed that nearly a third of the products contained undisclosed animal ingredients (such as dairy, marine products, or animal extracts). This is a major concern for vegans, vegetarians, and people with religious dietary restrictions who believe they are taking plant-based medicines. Risks from Concentrated Plant Extracts: The study discovered that high concentrations of certain common plant fats and compounds (called phytosterols) were tied to higher rates of severe liver failure. This shows that highly concentrated "natural" extracts can act differently in the body and become harmful, even if they come from everyday plants. Lead Reseacher: @arifhussaintm FULL PAPER (free to read): frontiersin.org/journals/gastr…

#MedTwitter #NeuroTwitter #MOG #OCT Key interesting points: 🔬 OCT Acute pRNFL >118 μm → think MOGAD/NMOSD, not MS. Inter-eye difference >20 μm = red flag for MOG/AQP4 disease 🧲 Advanced MRI ≥6 CVS+ lesions OR ≥1 PRL lesion can rescue MS diagnosis when only ONE topography is involved. PRL = chronic active inflammation, poor prognosis, half-life 7–10 yrs MOGAD- It's bigger than optic neuritis: Seizures in 10–19% (may precede demyelination!) . Isolated cranial neuropathy is noted, CN V involvement most common cranial neuropathy IIH with MOGAD has been described. So expanding spectrum of MOGAD @aditya_gan3500 you were telling me about this. 💧 Biomarkers sNfL → relapse activity marker in MS; always correct for age & BMI sGFAP → progression in MS & NMOSD relapse predictor κ-FLC → automated, quantitative , better alternative to OCB

#MedTwitter #NeuroTwitter At the International Clinical Neuroimmunology Workshop 2026 at K.S. Hegde Hospital, Mangalore. With the new MS criteria introducing the optic nerve as the 5th topographic domain, the workshop is focused on optic nerve, and the diagnostic tools and biomarkers used to evaluate . Truly informative and delightful talks. When meetings focus deeply on a few themes, the discussions become far richer and far more rewarding. Looking forward to the final day of talks tomorrow. Will share some key takeaways soon #NeuroImmunology #Multiplesclerosis #NMO #MOGAD

@Neuroptimist23 @sanofi @SanofiUS I don’t think it’s been approved still for the treatment, still undergoing trials. They have shown some benefit in progressive MS, the data on relapses is still not prominent. Just because patient is keen , I don’t think we can really offer it at the moment

Hello #Neurotwitter, Anybody with the experience of treating MS with Tolebrutinib here? Please get in touch with me. One of my patient is keen on having it but not available in India. #MultipleSclerosis @sanofi @SanofiUS

@ALAM_ABDULA It may not be just stress. She probably needs a proper assessment for underlying cardiomyopathy, channel disorders.

A fellow Pg collapsed on round today and upon investigation her Ejection Fraction was 25%. All the hardwork and stress for this. YE PARI HAI ZINDAGI.

@drpradeepck There is also a bloomy rind sign sir. And adenocarcinoma , signet ring especially seems to be notorious to spread to the leptomeninges.

Zuckerguss Sign : Sugar-coated appearance of cerebellum due to leptomeningeal metastasis. Patient had gastric adenocarcinoma. #MedTwitter #MedX #NeuroTwitter

The Media also taking a Star Wars approach . @firstpost