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Jul 9 • 10 tweets • 3 min read
1) I was reading a bit of neurology today, for exams and general knowledge.

I have always maintained a lively interest in medical history and the development of this great profession of ours.
2) I was also influenced by the fact that we have a patient admitted at present, with generalized chorea under evaluation.

Common differentials have been ruled out but we haven't made the elusive diagnosis yet.

So a bit of reading was in order.
3) Neurogenetics is one such topic which has grown by leaps and bounds within the last few decades.

Clinical diagnoses of yesteryears can now be confirmed by genetic tests --> thanks to the work of certain stalwarts like Prof. Anita Harding.
4) Anita Harding (1952-1995) was one of the pioneers of this field --> she discovered the etiologies and clarified diagnoses in fields as diverse as the mitochondrial cytopathies, dystonias and familial amyloid neuropathy!
5) I have a wonderful account of her life and times by one of her students @Stephen_Cummins

medium.com/understanding-…
6) A woman in a man's world at that time and despite colon cancer that claimed her too soon, she had a career and achievements that few can dream of --> that too within barely a decade.
7) A fitting tribute.
8) The story of medicine is the story of humanity and as we delve deeper into the human biology with its complex genetics and intricate mechanisms --> it is important to rest and dwell on the human beings who have made these discoveries possible.
9) As Newton said, if we have seen further, it is only by standing on the shoulders of giants.

An appropriate quote, for the present time, when we grapple with this explosion of knowledge, for the betterment of our patients!
10) Please retweet if you find this informative! Thank you!

#MedTwitter
#NeuroTwitter
#WomenInMedicine

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More from @AdiG1993

Aditya Ganguly MD I Internist Profile picture
Jul 11
1) Unpopular opinion here --> but something you should check out.

If you are planning on doing MD gen med residency, it might be worthwhile to do it somewhere with a relatively smaller subspecialty/gen med ratio.
2) A large and very well equipped subspecialty dept will usually directly admit all the unusual/teaching cases. Gen med can't do much here.

A smaller dept usually does not have enough staff to cover 24×7 on call and is less enthusiastic about situations like this.
3) So you get all the input that you need while managing to take care of patients directly.

This is very important --> you can't fire a rifle after placing it on someone else's shoulder.
Read 4 tweets
Aditya Ganguly MD I Internist Profile picture
Jul 8
Since there are lots of MBBS students are asking me how to approach Harrison in UG,

Here is my approach -->

DON'T.

#MedTwitter
#Cardiotwitter
#NephTwitter
#NeuroTwitter
Etc etc
The latest Harrison is a giant encyclopedia of molecular data. Clinical medicine has been reduced to a bare minimum. I am talking about the 20th ed.
In fact, the Oxford Textbook of Med 6th ed is relatively better clinically but it comes in 4 giant volumes.
Read 4 tweets
Aditya Ganguly MD I Internist Profile picture
Jul 5
1) It must be hard being an MBBS student nowadays with everybody criticizing you for not having enough clinical knowledge/not going to the wards etc etc.

I don't think we should blame them for circumstances beyond their control.
2) Medical science has expanded so rapidly that you must now run, just to stay in the same place. Basic knowledge has also changed with along with our ideas of complications. Its no longer 'a simple case of anything'.
3) You will need an MBBS course lasting at least a decade if you need people to master all the skills that MBBS students of decades earlier could master. Medical science has far outpaced our capacity to learn.
Read 9 tweets
Aditya Ganguly MD I Internist Profile picture
Jul 3
1) A terrible crash at the Grand Prix today, but thankfully no lives were lost --> and it is all thanks to this man.
2) Who was he?

Dr Eric Sidney Watkins |(1928-2012) , commonly known in Formula 1 (F1) as Professor or Prof Watkins was an English neurosurgeon.

He was the FIA F1 Safety and Medical delegate, head of the F1 medical on track team and first responder for a period nearly 26 years.
3) He is most famous for treating Ayrton Senna, the Brazilian three-time F1 champion who died in 1994 in a crash at the San Marino Grand Prix in Italy. He was only 34 at that time.

Here is a pic of the two together!
Read 9 tweets
Aditya Ganguly MD I Internist Profile picture
Jul 3
1) Gen med residents are taught to think of secondary hypertension, especially primary hyperaldosteronism, if the following conditions are met.

- young onset HTN (age < 40)
- family history
- resistant HTN
- hypokalemia
2) First of all, young onset HTN is a controversial term nowadays --> with the rise of fast food and sedentary lifestyles with pediatric obesity and metabolic syndrome --> it is entirely possible that the age may need to be shifted even lower!
3) This study, done in AIIMS with @DrSarahAlam as the lead author looked at PA epidemiologically.

202 patients with young onset HTN (YH) were evaluated.

Surprisingly the mean age was 43.9+/- 10.9 years!
pubmed.ncbi.nlm.nih.gov/33393127/
Read 12 tweets
Aditya Ganguly MD I Internist Profile picture
Jul 2
1) Another case of the silent killer.

A middle aged relative of mine has been forgetting things recently --> he doesn't remember where he put his keys, his assistant's name or what he had for lunch that day.
2) His daughter calls me up and schedules a meeting.

Its borderline Alzheimers --> she worries!

What will happen to him? Is there anything to be afraid of? Should we consult a neurologist?
3) First things first --> I say.

Let me evaluate him and see what needs to be done.

Turns out he is HTNsive on meds for more than a decade, since the time he had his first stroke --> no documents available from that time.
Read 8 tweets

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