ramram

Syncope is defined as transient loss of consciousness due to cerebral hypoperfusion. Most syncope is not cardiac in aetiology, but cardiac syncope is a high risk subgroup. This Practice article looks at how to identify cardiac syncope #MedEd bmj.com/content/393/bm…

New ACC/AHA Lipid Guidelines 2026 — Practice-Changing Insights:At a glance.. 📌 Core Philosophy “Lower LDL-C, earlier and for longer → better lifetime ASCVD reduction.” 🔬 1. Start Early – Think Lifetime Risk Lipid screening should begin at ≥19 years, with repeat every 5 years or earlier in high-risk individuals. Statin therapy can be initiated as early as 30 years if LDL-C ≥160 mg/dL, strong family history, or high 30-year risk—even if 10-year risk is low. 🎙️Key shift: Move from “10-year risk” to lifetime cumulative exposure model 🧮 2. PREVENT Risk Calculator Replaces PCE New AHA PREVENT tool improves ASCVD risk prediction and starts risk estimation from age 30. Includes 30-year risk estimation, crucial for younger patients. 📊 3. Recalibrated Risk Categories Low: <3% Borderline: 3–5% Intermediate: 5–10% High: ≥10% 👉 Clinical implication: Statins now justified at lower thresholds (≥5%) 🎯 4. LDL-C Targets Are Back <100 mg/dL → Low/intermediate risk <70 mg/dL → High risk <55 mg/dL → Established ASCVD 👉 Shift: From % reduction → absolute target-driven therapy 🧬 5. Universal Lp(a) Testing One-time Lp(a) measurement for ALL patients is now recommended. ≥125 nmol/L → ↑ ASCVD risk ≥250 nmol/L → ~2× risk ≥430 nmol/L → ~4× risk 👉 Intensify LDL lowering even if Lp(a) cannot yet be directly treated 🧪 6. ApoB & CAC — Precision Risk Tools ApoB reflects total atherogenic particle burden and helps detect residual risk. CAC score acts as “tiebreaker” in borderline/intermediate risk. ⚠️ 7. Expanded Risk Enhancers Now includes: PCOS, early menopause, adverse pregnancy outcomes South Asian and Filipino ethnicity CKM syndrome, inflammation markers 👉 Clinical message: Take detailed reproductive & ethnic history seriously 🩺 8. Special Populations – Stronger Statin Mandate All patients (40–75 yrs) with: CKD stage 3–4 HIV infection → Should receive statins irrespective of LDL-C 🍔 9. Triglycerides – Lifestyle First Statins remain foundational even in hypertriglyceridemia. Refer to dietitians if TG ≥150–1000 mg/dL with CKM features. 💊 10. Supplements – Clear Negative Recommendation Non-prescription supplements (e.g., fish oil) are NOT recommended for ASCVD risk reduction due to lack of benefit. 🔥 CME INDIA Take-Home Messages Atherosclerosis begins early → intervene early LDL exposure = cumulative toxin → duration matters as much as level Lp(a) is now a universal risk marker, not optional Risk assessment is shifting from short-term to lifetime biology Precision lipidology = LDL-C + ApoB + Lp(a) + CAC 🏷️ “From numbers to lifetime exposure: Lipidology has entered the era of precision prevention.” jamanetwork.com/journals/jama/…

Whether you’re training for your first 5k, trying to improve your mile time or just looking to become a well-rounded athlete, learning how to run faster involves consistently focusing on three main components: 🏃‍♂️Perfecting your form 🏃‍♂️Improving your agility 🏃‍♂️Strengthening your power Running faster takes more than just pushing harder once. It’s about keeping a consistent week-to-week structure that focuses on: Aerobic exercise Strength training Flexibility The way you breathe The way your heart is conditioned

@Pathfinder2mars @Aadi18_3 To participate in an election rally for Maharashtra Ex-Gov CH VidyaSagar Rao

April 17th will be remembered as your incompetent govt killed Soundary garu. She was coming to Karimnagar that day, but you people gave her a failed helicopter. Shame on the BJP

🧠 Approach to Spinal Cord Lesions ⸻ 1️⃣ Anterior Horn Cell Lesions 🔸 Key concept • Damage to the anterior horn cells causes LMN signs • Leads to flaccid weakness, atrophy, and fasciculations ⸻ ➊ Poliomyelitis 🔹 Cause • Enterovirus infection • Spread via fecal–oral route 🔹 Pathology • Selective destruction of anterior horn motor neurons 🔹 Clinical Features • Flaccid paralysis • Reduced reflexes • No sensory loss 🔹 CSF Findings • Pleocytosis • Mildly elevated protein • Normal glucose 🔹 Treatment • Supportive care • Rehabilitation ⸻ ➋ Spinal Muscular Atrophy (SMA) 🔹 Cause • Mutation in SMN1 gene 🔹 Clinical Features • Progressive proximal weakness • Muscle wasting • Respiratory muscle involvement 🔹 Diagnosis • Genetic testing confirms diagnosis 🔹 Treatment • Supportive therapy • Disease-modifying agents (e.g. nusinersen) ⸻ 2️⃣ Demyelinating Cord Lesions ➊ Multiple Sclerosis (MS) 🔹 Pathology • Immune-mediated CNS demyelination • Common in brainstem, subcortical white matter, cervical cord 🔹 Risk Factors • EBV infection • Vitamin D deficiency • Genetic predisposition 🔹 Clinical Features • Optic neuritis • Sensory symptoms • Weakness • Lesions disseminated in time and space 🔹 Diagnosis • MRI brain/spine • CSF oligoclonal bands 🔹 Treatment • Acute relapse → IV methylprednisolone • Disease-modifying therapy for prevention ⸻ 3️⃣ Transverse Myelitis 🔸 Definition • Acute inflammatory lesion of the spinal cord • Can occur alone or with MS 🔹 Common Causes • Autoimmune disease • Viral infection • Post-infectious inflammation 🔹 Clinical Features • Paraplegia • Sensory level • Bladder/bowel dysfunction • Mixed UMN + LMN signs 🔹 Diagnosis • MRI spine to exclude compression • Lumbar puncture 🔹 Treatment • High-dose IV steroids • Supportive management ⸻ 📚 Get our high-yield neurology book from our website at: 🔗 mediconotes.com ⸻ #Neurology #usmle #medicine #doctor #meded

⚜️ A serene yet powerful Yoga Narasimha, seated in a meditative yogic posture. Casted in bronze during the late Chola era (12th–13th CE), the statue beautifully captures the divine union of ferocity and tranquility. Narasimha is shown with his characteristic lion face, crowned with an elaborate headdress, holding the chakra in his upper right hand, while his other hands display graceful mudras. The crossed legs and relaxed yet regal pose symbolize deep spiritual equilibrium.

This infographic on Bempedoic Acid 👇 explores the importance of LDL-C in #ASCVD prevention. Learn about the evolving role of bempedoic acid & its utilization, including clinical trial data, & more w/ ACC's online course: bit.ly/43eRlyP #ACCEd #ACCAsia @DrEugeneYang

⚜️This exquisite 5th–6th CE sandstone relief from the Dashavatara Temple in Deogarh, Uttar Pradesh, depicts Lord Vishnu in his Anantasayana (or Sheshashayi) form — reclining serenely on the coils of the multi-headed serpent Shesha (Ananta), whose seven hoods form a protective canopy above him. In this cosmic scene of divine repose: 🔹️Goddess Lakshmi sits devotedly at Vishnu’s feet, gently caressing his right leg. 🔹️Above, a four-headed Brahma is seated on a lotus (a miniature form, not emerging from the navel as in later iconography), flanked by other deities including Shiva-Parvati, Indra, and Kartikeya. 🔹️The lower panel features elegant attendants and figures from the divine entourage. ⚜️Carved around c. 500 CE during the Gupta period, the Dashavatara Temple is one of the earliest surviving structural stone temples in North India. It marks a pivotal transition in Hindu temple architecture from flat-roofed shrines toward the towering shikhara style and showcases the refined, graceful sculptural idiom of the era. ⚜️The fluidity of form, intricate detailing, and profound symbolism of preservation and cosmic renewal make this panel truly breathtaking.

Isn't it an interesting fact that a state like Karnataka, which has sent stalwarts like Sushma Swaraj to parliament, who often identified herself as "Telangana Chinnamma" has also sent @Tejasvi_Surya What a down fall!

@dkg334 @Tejasvi_Surya Southern states drive India. You better listen to them

@Tejasvi_Surya Literally screwing over every state for tamil nadu and Kerala. Do it based on population only.

Where does the 50% increase come from when it is not mentioned in the Bill? What is the guarantee? The answer lies in Article 81 of the Constitution. Article 81 lays down how seats are to be distributed across states based on population. Once the total number of seats is increased, this provision determines the method of apportionment. A plain reading of Article 81 makes this clear. The problem is the Opposition either comes unprepared, or chooses not to engage with the substance, opposing for the sake of opposing. Watch my explanation.

Access a 🆕 infographic showcasing clear, actionable strategies to help teams deliver smarter, more coordinated #HFrEF care. Explore more with ACC’s Managing HF Across the Spectrum online course ➡️ bit.ly/3O8JvDp #ACCAsia #ACCEd #HeartFailure

ACC's Concise Clinical Guidance report provides a framework for clinicians to medically manage obesity using the "ever-expanding set of tools to assist patients in diagnosis, weight reduction, & #CVD risk mitigation." More: bit.ly/4vAqzii #ACCAsia #cvPrev @JACCJournals

@TeluguScribe @Infi67 This guy is a state president? 😅 what is he talking

ఇండియా, పాకిస్తాన్ విభజన జరిగినప్పుడు ఎంత మంది చనిపోయారో దాన్ని తెలుపుతూ తెలంగాణ, ఆంధ్రా విభజన సమయంలో కూడా అలాగే జరిగింది అన్నట్లు మా ఎంపీ తేజస్వి సూర్య మాట్లాడాడు దాన్ని పట్టుకొని బీఆర్ఎస్ పార్టీ వాళ్లు కోతికి బెల్లం చిప్ప దొరికినట్లు మాట్లాడుతున్నారు బీజేపీ పార్టీ లేకపోతే తెలంగాణ వచ్చేదే కాదు - టీబీజేపీ అధ్యక్షుడు రాంచందర్ రావు

¿El HDL-C alto es siempre sinónimo de "colesterol bueno" y protección cardiovascular? Una revisión reciente de Parini y Pedrelli (2026) desmiente este mito y redefine nuestra interpretación clínica. 👇 DOI:10.1097/MOL.0000000000001041 @anymzcs @drpablocorral @MaximaMendez15 @society_eas @gt_rcv @LipidoSeen @preventiva_SEC @maciejbanach @BrezanSimonMD @PuigJove @SABOURETCardio

Uterine cancer is the fourth most common cancer in women in the US, with an estimated 68 270 new cases and 14 450 cancer deaths projected to occur in 2026. 📄 This Review summarizes the epidemiology, clinical presentation, and diagnosis of endometrial cancer. ja.ma/4dU90DD

@PranitaRavi @CPHydCity @HYDTP @GHMCOnline No civic sense. Uncivilized behavior. Must have made money by corruption or in real estate

Casually dropping beer cans on the road in broad daylight 🙊 First of all littering is shitty. And then it’s beer cans. 😒 P.S: observe white car on the right. @CPHydCity @HYDTP @GHMCOnline

At Chennakesava Temple Beluru Karnataka, a masterpiece of the Hoysala Empire ✨ Every inch tells a story in stone. The detail, the emotion, the craftsmanship… unmatched. People may debate, but Hoysala sculptures stand in a league of their own in South India. 🖤

Combined oral contraceptives and hormone-replacement therapy increase the risk of venous thromboembolism, although the absolute risk is low. Transdermal estradiol and micronized progesterone carry lower risk. Learn more in the Review Article “Sex Hormone Influences on Venous Thrombotic and Cardiovascular Risk” by Leslie Skeith, MD, MHPE, and Shannon M. Bates, MDCM, from @ucalgary and @mcmasteru: nejm.org/doi/full/10.10…

#MustRead ‼️ Every generation of Indians had one constitutional moment that defined their future. For South India, this is it. Not the Emergency. Not liberalisation. Not even the 1971 freeze. THIS Bill. THIS delimitation. THIS Commission. Bill No. 107 of 2026, 131st Amendment Bill. What’s buried inside those 5 pages will affect South India’s political future for the next 50 years. Let’s see exactly what’s written & more importantly, what’s deliberately NOT written. (1/8)