Dr. Farhan Ansari, MD. DM

@usamasyedMD Haven't heard of a bigger crap story today than this. Examination is absolutely essential in neurology and I'm sure in other specialties as well

The dirty secret of healthcare is that MOST physical exams are a relic of an older time. We still learn them. We still bill for them (main reason they're done still). But they RARELY change management. Clinical suspicion --> confirmatory tests or empirical treatment most times.

@kev712004 Until JB came on the pitch RM was silent. Don't see this team will be able to get a trophy this season but they are definitely the team that prove all these claims wrong

Here’s my take on the last game against Bayern Munich. Firstly, Thiago Pitarch needs to get back to Castilla. Same mistakes in two big games, and it nearly cost us again. Secondly, Vinicius was solid last night until that big chance miss, it ruined everything for real. At this point, he needs an individual finishing coach, it’s getting too much. Thirdly, we’ve been seeing the worst version of Carreras since the start of the game. Bro has been poor, and even Trent kept losing possession with those useless crosses. The only thing saved Trent from noise is that assist, nothing else. And I think Jude Bellingham is back. He changed the game in the 20 minutes he played. Arda Güler deserves his flowers too, what a game! Pedri needs to learn. Another thing we saw was the partnership between Mbappé and Vinicius. Both missed chances, but at least they tried to connect and work together. Lastly, Neuer made us feel what others feel against Courtois. Bro was everywhere, he just wouldn’t let us see the net. And please, I don’t want to see anyone comparing Olise to Lamine Yamal again. Not a debate.

@hyderabaddoctor Tremors have a jerky character with slight posturing of fingers in the right hand. Tremors also asymmetric. Should check for mirror movements. Likely it is dystonic tremor

Teaching video for doctors 🔸Watch this video carefully and describe the findings. What is your diagnosis? 🔸It is of 44 year old man, who has had symptoms for 10 years. Symptoms have more or less remained non-progressive over this period. 🔸He has no slowness of movements or tightness of hands/legs, and his gait is normal. #MedTwitter #NeuroTwitter

@ObsoleteSony Prince of Persia: Sands of Time

Which game defined PlayStation 2 in your opinion?

@aditya_gan3500 I have a different observation. Many of my friends chose not to anything beyond MBBS because they wanted to work at a community level and some of them had familial responsibilities that restricted their progress

Another common debate in Indian #MedTwitter You can find diamonds in a pile a of shit and you can find specks of carbon in the finest diamonds It all depends on the student If he or she is average with no curiosity and no desire to improve I doubt more lectures or better hands on training will do anything Most good academic programmes - MD or DNB - tend to attract the 'best and the brightest' These people will learn well in a cowshed under candlelight and will perform well in exams with minimum preparation They are just that smart, intelligent and resourceful So its heavily skewed towards producing well trained doctors If you really want to see how good a programme is - MD or DNB Take a group of really average and unmotivated students We will see how well the programme works Off topic My opinion is that MD or DNB Chest Medicine degrees should be phased out like several diploma programmes since pulmonology is a subspecialist subject now Narrow broad specialties restrict choices in SS for people with these postgraduate degrees #MedTwitter #NeuroTwitter

@losblancoswrld You forgot to add MS Dhoni

Players with number 7 on their back are just too iconic.

@aditya_gan3500 Maybe the person recording the video doubles up as a chaperone 🤣

A male doctor should not be examining a female patient without a chaperone If I was an examiner This test would have been over before it had even started #MedTwitter #NeuroTwitter #NEJM #Ethics

@ShishirShelke1 Apple music because it's lossless and I being in the ecosystem get it's at a cheaper rate. So basically the second reason 🤣

Which one do you prefer?

@nirmalregency Yes sir by definition lacunar infarcts have a lesion size of 15-20mm supplied by the artery of 1-2mm diameter

NADA. It is NOT a lacunar infarct, strictly speaking from a radiologic and pathological standpoint. We have this itch or rather a nomadic nuance to call anything micro as a lacune (lacuna by definition is a missing part of a story or write up) irrespective of its location. While the size (1–2 mm) certainly fits the dimension of a lacune, the location and the underlying mechanism typically disqualify it from being labeled a lacunar infarct. Lacunar infarcts are small (<15 - 20 mm) ischemic strokes located in the DEEP gray or white matter and are traditionally applied for areas supplied by deep perforating arteries, such as:  • Basal ganglia • Thalamus • Internal capsule  • Pons And are Usually caused by lipohyalinosis or microatheroma of deep penetrating arteries (Small Vessel Disease). It perhaps should have been labelled as an old microinfarct of the corona radiata or to play it safer a minute subcortical WMH of presumed vascular origin, or as per older radiological literature when we trained an 👻UBO.

@whitfieldlewis6 @fananatoly It's like AI drops these easter eggs for everyone to note it's not real

@fananatoly Got him! Not initially the plate is absent (first pic). All of a sudden a plate appears in the scene (second pic). It’s AI!

Morning routine 350 kg, Anatoly

@Grandsoncr7 The winning streak before the last match was largely because there was no start for Mbappe because of injury. But again Mbappe is returning after an injury and will need some time to get to his best.

Uncomfortable truth Real Madrid fans need to accept: No coach will be able to get the best out of this team as long as Kylian Mbappé is our striker. So he needs to leave. Kylian Mbappé scores goals but breaks the team system. Vinícius carries the team on his shoulders and doesn’t need goals to play well for the team. That’s the difference. Mbappé needs the team to play for him so he can perform. Vinícius Júnior plays for the team. Simple. Kylian Mbappé doesn’t press and never will even if the team is two men down. He cares more about the Pichichi than getting three points. Kylian Mbappé = stats. Vinícius Júnior = sacrifice + impact. True Madrid fans know the truth. Goals won’t hide it, Kylian Mbappé disrupts more than he delivers. Vinícius Júnior holds the team together. You can build around Vinícius. You have to adjust for Kylian Mbappé and at that he still won’t press. Kylian Mbappé wants freedom. Vinícius Júnior gives everything. That’s why one fits Madrid, the other doesn’t. Take Kylian Mbappé out, the system still works. Take Vinícius out, everything collapses. Vinícius jr has faced racism, boos, and criticism but he still gives everything for Madrid every game.

@aditya_gan3500 @DocPriyamMD @venkat_id @ShreerajT Multiple infarct like I would say at best if only CT is performed specially in IC host

@aditya_gan3500 @DocPriyamMD @venkat_id @ShreerajT Neuromediodosis usually presents as stroke mimic. MRI classically shows enhancement along corticospinal tracts

Last night in our ICU, we admitted a 25-year-old male with a clinical picture that is a diagnostic minefield....! The patient, an IV drug user, came in with a high-grade fever, chills and altered sensorium. While he has a positive Kernig’s sign, there is no neck rigidity. Things got even more complex when his HIV status came back positive and the CT scan showed multiple cerebral infarcts. Check out these CSF results: 🔹 CSF Sugar: <20 mg/dL 🔹 CSF Protein: 280 mg/dL 🔹 Cytology: Neutrophilic predominance This is the ultimate "Heart vs. Brain" detective work. Are we looking at Infective Endocarditis sending septic emboli to the brain or is this Tuberculous Meningitis causing severe vasculitis and strokes? In an HIV-positive patient, the "Great Mimickers" are always at play. Started him on empirical therapy while we wait for the Echo and GeneXpert results tomorrow. Cases like this are why Internal Medicine is both exhausting and exhilarating

@DocNavarrow This level of disrespect for a live human body

😢Old case, but it’s still a brutal reminder of what you should never do in an operating room: dancing, rapping, and twirling a scalpel while the patient is under anesthesia.

@MedYushi That's the worst kind of toxic

Residency me professors/seniors toxic hote hain Mere co pgs toxic hain 😭😭

@topskillsportuk Before you guys complain any further The last comment was made so that the refs could avoid this controversy. If a player is anyways going to be sent off why intervene for subsequent punishment

🚨💣 Criticism is exploding after Atlético Madrid vs Barcelona over major refereeing inconsistencies 😳 Gerard Martín was shown a straight red card for a reckless tackle on an Atlético player — only for VAR to downgrade it to a yellow. Meanwhile, Atlético’s Nico González was sent off in the same game. The clear double standard has now prompted Real Madrid media to call on La Liga authorities to review the red card given to Federico Valverde in their recent derby. ⚽

@Jds1870354 @topskillsportuk Last man but that wasn't a clear goal scoring chance

@docfarhan88 @topskillsportuk You have no clue. Nico was straight red as last man.

@whitfieldlewis6 Avoid jerky lifts and relax slowly

Guys, you don’t need to lift super heavy to get results. Lifting too heavy can increase your risk of injury by placing excessive stress on your joints, tendons, ligaments, spine, and overall structure. What I focus on is lifting smarter while getting the same or better results. This comes down to two power modes of muscle contraction: ⬇️ Eccentric contraction ⬆️ Concentric contraction Eccentric contraction (lowering phase): This is when the muscle is lengthening under tension. Instead of dropping the weight, I slowly lower it. Even as the muscles are lengthening, they are still under load from gravity and the weight. This is where most people lose tension. Concentric contraction (lifting phase): This is when the muscle is shortening to produce force. I contract to bring the weight back up. Here’s the problem: Most people eliminate the eccentric phase. They drop the weight, lose tension, and miss half the stimulus. If you’re missing half of the movement, you’re significantly reducing your results for the same time spent in the gym. What I’m doing instead: • Controlling the descent • Keeping constant tension • Letting the muscle work while lengthening Translation: You don’t need heavier weight. You need better control. Better control, even with lighter weights, will translate into better results. Try it. Now watch closely in the video below. I never drop the weight. I control the entire movement, keeping constant tension on the muscles from start to finish. 👇👇

@aditya_gan3500 Technically yes. But neurology is all about timeline. Not all features are present in a given patient at a time. They usually develop over time

@docfarhan88 Technically that would make VaP and NPH both unusual I think sir

I love gait analysis A great teaching video from Dr Kumar that I will attempt to analyse The patient is standing on a slightly wide base with feet pointed outwards He starts walking with some start hesitation Step height is very reduced Step length is reduced Cadence is low The arms are not swinging properly No festination as far as I could see Prominent turn hesitation with en bloc turning Tandem gait and pull test are not shown I would like to think of a middle level gait disorder or higher level gait disorder My differentials are 1. Vascular PD 2. PIGD variant of IPD 3. MSA-P 4. NPH (technically needs imaging) Great teaching case sir Could you please post the imaging? #MedTwitter #NeuroTwitter #MovementDisorder