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Thread for Doctors (a thread to be updated time to time)

I will write here about,
What doctors can do to protect themselves, against complaints under SC/ST Act, complaints in police for medical negligence, complaints for medical negligence in

#Doctors #MedTwitter #India
2/ police station, complaints filed in criminal courts, summons by court to private doctors to appear as a witness with medical record of a patient, cases in civil court for damages, steps a doctor can take if he perceives threats from a patient, etc.

#doctors #MedTwitter
3/ First basic principles : An error in diagnosis (or Judgement) is not by itself a negligence. If a patient dies during an operation or immediately after surgery, is by itself not a medical negligence.
Read 37 tweets
Exactly 7 years ago, I spent #StrokeAwarenessDay undergoing emergency #thrombectomy for #basilar artery occlusion. #BAO

Today, I'm still in awe and celebrating how #modern #medicine saved me from locked-in syndrome and enabled me to live a normal life, against all odds.

1/ 🧵
2/ So far, I have avoided sharing this information as part of my professional life, fearing it would somehow disqualify me as a credible clinician-scientist. Finally, I realize that the experience only strengthened my resolve to give future patients the second chance I was given.
3/ What happened in brief:

I was a healthy, 25yo medical student, all excited to have finished the first 10K run of my life not even 5 hours before my family reacted #FAST and called 911.
Read 20 tweets
Duration of Antibiotic Therapy
Deciding on the duration of antimicrobial therapy for an infection is neither straightforward nor simple. 👇
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
#medschool #MedStudentTwitter #medstudent #TwitterRx
🔽👇🔽🔽👇

/1
Most ID guidelines are based- either expert opinions or evidence-based medicine. Historically, duration of ABX Rx were based on arbitrary extension of days(magic numbers like 7, 10 & 14 days) rather than on reliable evidence with the main aim to ⬇️ failures & avoid underRx.

/2
There is growing evidence to support for shorter courses. It is important for prescribers to be up to date with best practices. Duration of therapy plays a pivotal role in antimicrobial stewardship programme within the global effort to optimize antibiotic use &⬇️resistance.

/3
Read 26 tweets
LASIX and HF
👇👇👇👇
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor

👇👇👇

/1
4-chloro-N-(2-furyl-methyl)-5-sulfamoyl-anthranilic acid, member of the sulfa’s. Potent natriuretic drug, inhibits Na+-K+-2Cl− cotransporter in the ascending limb of the loop of Henle.
Direct Vd effects results in its therapeutic effectiveness in the Rx of acute pulm edema.

/2
Vasodilation leads to reduced responsiveness to vasoconstrictors, such as angiotensin II and noradrenaline, and decreased production of endogenous natriuretic hormones with vasoconstricting properties.

/3
Read 15 tweets
Angioedema:

Edema of the deep dermis & subcutaneous tissues.

Etiology, types and treatments👇👇👇👇⬇️⬇️⬇️⬇️👇👇👇👇

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#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
👇⬇️⬇️⬇️⬇️👇👇👇👇
Mast cell–derived mediators tend to affect layers superficial to subcutaneous tissue, including the dermal-epidermal junction. These mediators cause urticaria & pruritus.

In bradykinin-mediated angioedema, the dermis is usually spared, so urticaria & pruritus are absent.
 
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Read 7 tweets
Pseudomonas aeruginosa (PA):

Gram-negative bacillus found widely in nature, in soil and water.
/1


#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor @ImproveDX
The genus Pseudomonas >140 species,> saprophytic & >25 species are associated with humans. Most known to cause disease in humans are associated with opportunistic infections.

⬆️ MR : ⬇️ host defenses, resistance to ABX & production of extracellular enzymes & toxins.
/2
Often found in water in sinks & can contaminate respiratory equipment, which can serve as an environmental reservoir, especially in ICUs. Is the most serious pathogen causing ventilator-associated pneumonia & remains the most important pathogen in patients with CF.
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Read 15 tweets
Dementia
Acute cognition change with altered consciousness & impaired attention that fluctuates over time. Often unrecognized & unRx. May be preventable & early detec/ facilitates urgent assessment &Rx 1/16
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
The criteria for delirium listed in the Diagnostic and Statistical Manual of Mental Disorders vs Confusion Assessment Method (CAM) 👇👇. CAM has a sensitivity of 94% to 100% and a specificity of 90% to 95%.
2/16 Image
Features:
disturbances of sleep, altered psychomotor activity, and changes in emotion (eg, anxiety, apathy, lability, irritability, or anger). Subtypes of delirium are hyperactive, hypoactive & mixed. Hypoactive form >> hyperactive form. Inattention is hallmark. 3/16
Read 17 tweets
The HPA Axis and Adrenal Fxn.
Typical excretion of cortisol ➡️diurnal pattern with peaking in the a.m, ⬇️toward the afternoon, & ⬆️ in the early p.m. The basal adrenal production of cortisol is 10-15 mg daily. #MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
Physiologic & psychological stress can boost daily production of cortisol to 3 or more times typical levels.
Adrenal insufficiency: caused by a disease involving the adrenal gland itself (primary AI) or one altering its regulation by the hypothalamus and pituitary (secondary AI)
Primary AI results from destruction or replacement of the adrenal cortex. Addison’s disease (autoimmune destruction of the adrenal cortex) accounts for 80% to 90% of primary AI. Image
Read 13 tweets
In case anyone is wondering how we NHS Nurses are doing out here- read this.
Because you need a subscription to read the full article I’ve added screenshots tothisThread
#NHS
#LongCovid

Nurses with long-COVID: NHS urges trusts to redeploy,not dismiss. rcni.com/nursing-standa…
Read 4 tweets
#AIMART storytime 🧵
This just in: Boom💥
So, I’m getting ready for work today, tying up the ol’ scrubs and peek at my phone - I see a message, sent last night from the ER doc stating that one of my patients, a young Black man admitted for Sickle cell pain crisis...

1/
..., wanted to leave and the doc was okay with discharging because the patient’s pain seemed to have resolved. Ok, I get to the 🏥and my team informs me the patient is still in-house (in the ED – No beds on the floors.

2/
The ED is overflowing, so we have patients admitted and waiting in the ED for a bed for daaaays on end. Coupled with the ED being short-staffed - yeah…not good) and didn’t leave, after my wonderful senior resident convinced him to stay and receive more analgesia (pain meds)

3/
Read 24 tweets
💣 This one is going to be a mine-field... Here's why I decided to pursue a medical career in the US 🇺🇸 rather than the UK 🇬🇧. NOTE: this is not me saying what OTHER people should do, simply giving my own thinking. You are free to disagree, there's no 'right answer'. 🧵 1/
🤩 New Experience: I'd spent the majority of my life in the UK, dad was a doctor, I went to a 'good school', got into a 'good uni', and became a doctor. Felt like if I stayed in UK, best case scenario, my life would just be on repeat, now through dad's eyes. Felt too safe. 2/
💵 Money: bet you didn't think I'd go there this quickly, right? (That's the sound of 100 keyboard warriors pressing delete on their "OBVS JUST FOR THE MONEY!!!!" tweets.) Yep, I didn't think being a doctor in the UK was a well-compensated job for how stressful and long... 3/
Read 16 tweets
Here goes the thread..

My Favourite Top 15 Tamil films of 2021 👇🏻. #Karthicdm #Karthicdm_Reviews #Tamilcinema #Kollywood
15. #KamalifromNadukaveri
Sincere attempt of feel good film with a good message. Casting and performance were good. But cliched scenes and weak screenplay in second half were let downs. more like a educational movie. High school students and their parents can watch.
14. #Teddy New attempt for tamil cinema. Decent songs and good acting. lack of creativity and weak script were major cons. Decent fantasy comedy entertainer. one time watchable.
Read 20 tweets
“Given #Omicron's lower severity, the negative cost of lockdowns and school closures—including financial turmoil, isolation, and lost learning time—far outweigh the benefits.” write @AliHMokdad and @kleachkemon in @ThinkGlobalHlth👇
thinkglobalhealth.org/article/sensib…
Estimates suggest that #Omicron is just 3% as deadly as #Delta and 1/10 as likely to cause hospitalization while simultaneously spreading at “stunning” speeds and will likely infect as many people in the next 2 months as SARS-CoV-2 has infected people in the past 2 years
📍The good news is that in most countries, the death toll will be nowhere near as extreme as it was last winter.
Read 11 tweets
Sadly, #MedicareForAll will not help #healthcare costs until the underlying problem with MEDICARE and the ENTIRE HEALTH SYSTEM is FIXED, a LONG 🧵 1 of 24 #Medtwitter @somedocs @AmerMedicalAssn @WCMSSM @MichStateMedSoc References: bit.ly/3rBcvGP bit.ly/3lE3nxf
2/ b/c @SenateFloor @HouseFloor & @CMSGov are yet again not fixing the true problem & instead are again targeting #Physicians by decreasing payments by another 9.75% on top of the fact that reimbursements to providers has already been decreased by 22% over the past 2 decades
3/ On average only 40% of the what your #insurance , including #Medicare , pays your doctor actually goes to the doctor as #income . The overhead costs to be a doctor takes at least 60% of the payment a doctor gets from Medicare or Insurance equivalent. bit.ly/3ptDX6B
Read 25 tweets
#Thread

"दुभंगलेल्या ओठांना, मोफत सुंदर हास्य देणारे - 'देवरुपी डॉक्टर सुबोध कुमार सिंग'!"

एक-दोन दिवसांपूर्वी @thakkar_sameet समितभाऊ यांनी एक न्यूज आर्टिकल शेयर केले होते आणि ते वाचल्यावर वाटले की, हे आणखी लोकांपर्यंत पोहोचले पाहिजे म्हणून हा लेख.

#Doctor
एखाद्याने जर आपलं लहानपण गरीबीत घालविले असेल आणि संघर्षातून तो डॉक्टर बनला असेल तर तो नक्कीच जनमाणसाचे दुःख समजू शकतो, हे त्रिकालबाधित सत्य आहे.

असेच एक डॉक्टर आहेत 'सुबोध कुमारसिंग' जे प्लास्टिक सर्जन आहेत. डॉक्टर बनण्यासाठी त्यांनी त्यांच्या लहानपणी खूप संघर्ष केला आहे.
त्यामुळेच आता ते cleft lip/palate या व्यंगासह जन्मलेल्या बालकांची मोफत शस्त्रक्रिया करतात. आजपर्यंत त्यांनी 37000 शस्त्रक्रिया केलेल्या आहेत.

शालेय जीवनात ते एक मेरिटमध्ये येणारे विद्यार्थी होते आणि वाराणसी येथे 1979 शाळा/कॉलेज शिकताना ते चष्मा आणि हात धुवायचा साबण विकून आपल्या
Read 29 tweets
HD Updates :

#Doctor (தமிழ் | SUNNXT)(தமிழ் - తెలుగు - മലയാളം - ಕನ್ನಡ | Netflix)

#MeenakshiSundareshwar (தமிழ் - తెలుగు - हिन्दी | Netflix)(12:30pm)

#MGRMagan (தமிழ் - తెలుగు - മലയാളം - ಕನ್ನಡ | Disnep+hotstar)

#JaiBhim (தமிழ் - తెలుగు - हिन्दी - മലയാളം - ಕನ್ನಡ | Prime Video) ImageImageImageImage
November 7th Release :

#Mughizh (தமிழ் | Netflix)

Telugu Tamil Dubbed Movies :

#ShesuYaar

#Ruler (Bhavani HD Movies YouTube)(Out Side India)

#VakkeelSaar
#VakeelSir ImageImageImageImage
Read 6 tweets
#BombayHighCourt bench of Chief Justice Dipankar Datta and Justice Girish Kulkarni hearing a decade old PIL pertaining to the deaths of children, pregnant, lactating mothers in #Melghat region of #Maharashtra due to malnutrition.
CJ is informed that from September 13 till date there are over seven plus deaths of children in #Chikhaldhara and #Dharni areas, which are tribal regions.

#BombayHighCourt
#Malnutrition
#ChildDeaths
Advocate General Ashutosh Kumbhakoni for @CMOMaharashtra submits an affidavit before the bench. Says that meetings have been conducted to appoint officials to implement all the schemes and policies at the ground level.

#BombayHighCourt
Read 23 tweets
Playing today with #metahuman solution🔥from @UnrealEngine to provide #healthcare #AI Doctor for @inservissapp consumers with #GPT3 API integration.
Which AI Doctor you trust more?
Dr. Edward Polinsky
Dr. Cooper
Dr. Susan
Leave in a comments below 👇
Read 3 tweets
Beyond thrilled to have been awarded a *renewal* for my @NIH_LRP award!!!!!! Story time (on #privilege and #perseverance)

#medtwitter #academictwitter #blackinSTEM 1/
As a first-generation #Kenyan American, raised in #Kenya and very much an #African child (if you know you know), a #doctor is very much what I was going to be from the time I was born. 😋 (thankfully, also a marrying of my love of science and taking care of people!) 2/
So it was to my parents’ incredible delight when I got accepted to #medicalschool, never having... basically... known someone who had done so, in the US anyway. #firstgen #firstgeneration (yes, this story has a comical peak, wait for it...) 3/
Read 10 tweets
The only feelings to center on are those of black community
Wrong use of this quote during the week of #DerekChauvinTrial

Some people “feel” things if a white male faces accountability
Amy Cooper’s feelings: call cops
Racism & racism lite has always focused on “feelings” #BLM
When @ayshakhoury or @uche_blackstock were authentic in their feelings: ended careers

Black female physician #DrSusanMoore having “knowledge” or a “voice”
while DYING
made others
*feel* “intimidated.”

This is part of a known pattern for WOC
@COCoQC
#BLM #BlackintheIvory
This is a repeating pattern of “feelings” used against tellers of uncomfortable truths that #MLK described in the letter from the Birmingham jail.

Seeking order > justice or overpolicing are all to protect only certain “feelings” of “security” while those like #adamtoledo die.
Read 13 tweets
#MedTwitter influencers show hypocrisy (advice vs actions on masks). Agree:

“unpleasant comments are ‘the nature of social media’ and holding public figures accountable is critical when they are setting an example for their ‘millions of followers.’”

insider.com/coronavirus-sh…
#tweetiatrician have even gotten death threats for pro-#vaccine #SciComm - most #MedTwitter influencers did nothing to protect vs these personal safety threats to #clinician & #doctor colleagues

@ZDoggMD & @DrToddWo did step up to help @NicoleB_MD

medpagetoday.com/special-report…
Compare above to Dr. Mike:
when medical influencers are “caught”

adds to public perception:
“doctors cannot be trusted”

“Another fan posted on Reddit: ‘I know it's your life and you can do what you want, but you have chosen to be a public figure.’”

mirror.co.uk/news/uk-news/w…
Read 11 tweets
When the #ACA was implemented: there was no mandate established to ensure that #emr #ehr electronic medical records could communicate and physicians could obtain medical records from #doctors caring for the same patients at other offices or hospitals. 1/
What ensued was that the government forces practices to an incur most of the cost of buying expensive electronic medical records and forced them to use them or incur more financial penalties. In retrospect those who did not use #emr and #ehr benefitted 2/
It became impossible to afford an #emr #ehr in a private practice
costs include:
1. Computers
2. Network maintenance
3. Wi-Fi
4. Back-up systems
5. #emr #ehr Licenses
6. Cost of repairs
7. Reduction of time with patients
8. Increase typing-dictating time
9. Longer notes 3/
Read 6 tweets
The farce that is #facecoverings & #facemasks against #COVID19 , a thread.
First up, #WHO, in latest ‘interim guidance’ of 1 Dec, on ‘potential benefits & harms’ of #masks: apps.who.int/iris/bitstream…. (note 1st ‘potential benefit’ is ‘reduced spread of respiratory droplets’ - which is not actually the same as reducing transmission, is it?) Image
But you’re convinced the benefits outweigh the harms and go for masking. I mean, forcing people to keep a piece of fabric/paper and plastic on their faces, how hard can that be, eh? Well, here’s the WHO’s most recent interim guidance again. It’s not as simple as it looks, is it? Image
Read 23 tweets

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