Its a beautiful Monday morning and its also time for a reality check.

The vast majority of all media that humans consume are focused on the small percentage of winners.

Nobody thinks about the ones who have lost.

This is called survivorship bias.
Its statistically unlikely that you will be a winner even if you work hard or make all the right moves.

Many situations in life are zero sum games
My job here is not to demotivate you.

I am only the devil's advocate here.

A lot of 'inspiration' on social media is a marketing ploy which must be balanced with reality --> this is true for every sphere of life.

You will not be a winner always --> make your peace with this.
PS. I wish to pay due credit to the sources for these pictures.

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More from @AdiG1993

Nov 20
Simple to understand, difficult to implement.

Lack of sleep is dangerous.

This is how much you should be getting across age groups.

#MedTwitter
#sleepmedicine
#sleep
#insomnia
Reference

thensf.org
The study of science must be wedded to knowledge of the great personalities that have advanced its cause.

Sleep medicine is incomplete without knowing its father --> Dr William C. Dement

Here is his obituary.

science.org/doi/10.1126/sc…
Read 5 tweets
Nov 19
1) The clinical exam receives a lot of flak everyday but we forget one very simple thing.

Many investigations like the USG or echo are highly operator dependent.
2) Secondly, the cornerstone of all investigations is basically clinical correlation.

Imaging or lab findings by themselves are not to be taken too seriously --> without a clear clinical issue.

This is what we have been taught and it works!
3) This is important for all residents.

Don't order investigations blindly without understanding the reasoning and defining a clinical question that needs to be answered.

You need concordance btw all three --> hx, findings and labs!
Read 6 tweets
Nov 15
1) If a medical college has 'mandatory' lectures, its most likely because the lectures are terrible and no sane person would spend hours there.
2) If you are a high brow academic institution and yet provide horrible slide based lectures that I can watch in a 10 min Marrow video --> I am not going to class.
3) Time is money and there is more to life than medicine.

Lets be real, most coaching institutes today rule the roost when it comes to medical education because they retain the best teachers.

Its as simple as that.
Read 7 tweets
Nov 14
1) A relatively poor quality digital CXR - PA view.

But this often the best that you get.

Hx --> Middle aged man with passage of reddish urine

What do you see? Image
Choose your answer
Read 11 tweets
Nov 14
I am anti PPI unless its for documented ulcers or H. pylori.

Unexplained dyspepsia +/- alarm symptoms should ALWAYS be evaluated.

PPI without a specific reason qnd for long term --> DANGER

#MedTwitter
#PPI
#dyspepsia
#pepticulcerdisease
Thanks to @MedRewind for the table!
*and
Read 4 tweets
Nov 13
1) The commonest factor that puts people off a healthier lifestyle is the 'all or none' principle.

This is what I have learnt after dealing with lifestyle diseases for over 5 years and having faced certain issues of my own.

I will explain this in my tweet.
2) What is the 'all or none' aka AON principle?

It is the presumption that you have to follow the diet/gym/morning walk schedule EXACTLY as it is.

If you don't complete it, there is no benefit.
3) This AON principle, in my humble opinion, pertains to medication only.

Why?

If you are taking meds for lifestyle diseases (LD) --> you are in the 2ndary prevention phase where you aim to prevent COMPLICATIONS! Image
Read 13 tweets

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