Rajesh Samota

@ambesh__ @ManualOMedicine @medcrux No. Lofgren Syndrome. Acute Sarcoidosis

Fever 🔥 Polyarthralgia 🦴 Erythema nodosum 🩸 BHL on CXR 🫁 ACE elevated 📈 Diagnosis? #MedTwitter #ClinicalReasoning @ManualOMedicine @medcrux

@DrNikhilMD I rely on a STRIDE BP–approved instrument based on the oscillometric method.

In daily practice, which BP apparatus do you rely on more?

Vitamin B6 (Pyridoxine): a NARROW THERAPEUTIC WINDOW ⚠️ ❌ Deficiency → peripheral neuropathy, seizures, depression, confusion, microcytic hypochromic anemia ❌ Excess (chronic high dose) → severe sensory neuropathy, ataxia, gait loss 🧠 Same vitamin. Same target. 👉 Both extremes injure nerves. #MedTwitter @medcrux

What do you see here? 👀 3 days of fever 2 days of profuse diarrhoea BP 60/40 HR 150/min ABG: pH 6.8 Lactate 16.5 What’s your diagnosis? What’s your first 10-minute plan? Fluids or vasopressors first? When do you secure the airway? ⏱️ EVERY MINUTE COUNTS. MISS IT — AND YOU MISS THE PATIENT. #medtwitter

Hb was 4, TLCs 1320, Platelets 38000

🚨 OPD MYSTERY! You notice a peculiar finding on the patient’s hands. What’s the diagnosis? 👀🔥 Clue — She has Pancytopenia. @medcrux @DrAkhilX #MedTwitter

Hyperpigmented Knuckles— sign of Vitamin B12 deficiency.

@DrAkhilX Total T4

Doctors — tell me one medical test you would never order for a patient, even if you were put in this situation. Why?

@manish__aman Even CHCs across Rajasthan provide Anti-rabies Immunoglobulins FREE of cost — along with vaccines. Timely care matters. Let everyone know! 🐾💉

A 2 yr child has been bitten on face by a Street Dog and admitted in my ward, This one vaccine costs ₹400 and ₹1600 for 4 doses and all other surgical expenses just because one species wants to live in Human society, Removing street dogs was the best solution ever.

@DrAkhilX Amitriptyline

Tell me the one medication that truly impressed you.

What’s the lowest Hb you’ve ever seen in a stable patient?🩸 Hb 2.9 g/dL with concurrent Pancytopenia. Patient walked into OPD, fully conscious. Sometimes physiology outperforms pathology. #MedTwitter #Hematology @medcrux @DrAkhilX

🧬 67-year-old male with chronic cough & weight loss. GeneXpert (sputum): ✅ MTB Detected ⚠️ Rifampicin Resistance Detected What’s your next move? A) Start standard ATT B) Send for LPA & DST C) Start MDR-TB regimen D) Repeat GeneXpert for confirmation #MedTwitter #InfectiousDiseases #Microbiology #TB @medcrux @1min_IDconsult

1st year: Clueless 2nd year: IPS 3rd year: IPS Final year: IPS Next 5 years: IPS Ended up as a Physician. Life had other plans — and I’m loving it. 😄

🚨 Ever heard of Empty Ventricle Syndrome? In anaphylaxis, if the patient sits upright — the heart can literally run out of blood! 😱 👉 Sudden drop in venous return → “empty” ventricles → cardiac arrest. 💡 Always lie them flat with legs up BEFORE giving epinephrine! #FOAMed #MedTwitter #Anaphylaxis #CriticalCare @medcrux

A creeping, serpiginous, erythematous rash on the leg — pruritic and migratory, advancing a few mm per day. What’s your top differential? #MedTwitter #DermTwitter #TropicalMedicine #Parasitology @1min_IDconsult @medcrux

How has LDL-C treatment changed? It is National #CholesterolEducationMonth and there’s no better way to refresh your knowledge of LDL-C treatment than through #ACCEd! Start the course now ➡️ bit.ly/429BH8P

@SikandarAdwani Yes Sir! Responds very well to Duloxetine and TCAs.

Many clinicians meet patients with pain everywhere. As neurologists, we often see OPD cases where pain is the only symptom. Here’s the CWP/Fibromyalgia — OPD Pocket Map I use in my OPD • Recognise fast (pattern + ACR 2016) • One-time labs (CBC, CRP, Ca, CK, TSH, Vit D) • Don’t miss mimics (meds, hypermobility, Parkinson’s) • Start non-pharm Day 1 (activity, sleep, CBT, yoga) • Meds like duloxetine/milnacipran/pregabalin/low-dose TCA • Avoid opioids in nociplastic pain • 10-minute clinic flow you can run today #Neurotwitter #Medtwitter #Pain #Fibromyalgia

@hunnykumar1908 Funny thing — you’ll never see MDs chasing supers for cases. But supers line up for MD referrals daily.

MD Medicine is basically a referral machine & glorified co-ordinators: • Admit • Stabilize • Then call every other speciality • Refer

🚨 Hypoproliferative Anaemia Alert 🚨 🩸 Hb crashing 📉 MCV ↓, MCH ↓ ⬆️ RDW, ⬇️ Iron, ⬆️ TIBC, 🚫 Transferrin saturation 👉 Microcytic, Hypochromic RBCs screaming IRON DEFICIENCY! Cause? 🩸 Blood loss | Poor diet | Malabsorption 💊 Rx: Iron + Identify the cause #Medicine #Haematology #IDA #MedTwitter @medcrux