A 2012 batch MBBS doctor has been working as a Medical Officer in Bihar for the last 6 years. During his career, he has managed thousands of OPD patients, issued countless medico legal certificates, and conducted numerous postmortem examinations.

One day, the police bring the body of a 35 year old man who was allegedly murdered during a village rivalry. According to the police, the deceased had been shot by his enemies.

What happened next is very interesting. A thread 🧵 During postmortem examination, the Medical Officer finds a penetrating wound over the left side of the chest. While dissecting the wound track, he recovers a metallic bullet. Seeing the bullet, he feels the case is obvious.

He concludes that the injury is a firearm injury. His postmortem report states that death occurred due to hemorrhagic shock resulting from firearm injury to the chest.

The police investigation proceeds on that basis. Charges are framed. The accused are arrested. Everyone believes the case has been solved.

Breaking 🚨

Apollo Hospitals has released shocking data from a 2024 survey involving over 2.5 million people across its ecosystem and the numbers shows a disturbing picture of India's health.

Key findings are:

1. 65% of 257,199 screened had fatty liver out of which 85% were non-alcoholic. 2. 46% of asymptomatic individuals had signs of early atherosclerosis which can cause silent heart attacks.

3. In post menopausal women, Diabetes jumped from 14% to 40%; Obesity rose from 76% to 86%.

4. 28% of college students are overweight or obese and 19% are pre-hypertensive.

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“How a Fish Bone Caused a Fatal Internal Bleed”

This is a case of a 53-year-old woman who was admitted to a rural hospital due to unexpected dizzy over the course of 2 days.

The medical history review demonstrated that she was a hypertensive patient with intermittent medication therapy. She was pale in appearance during the physical examination, and her blood pressure was 110/ 76 mmHg.

Blood examination revealed severe anemia, hemoglobin level was 9.0 g/dL (11.0-15.0 g/dL).

As it was a rural hospital, no extra auxiliary examinations were performed except the electrocardiogram examination which showed no abnormalities.

A shocking scam in Gujarat has exposed how doctors and hospital officials allegedly manipulated healthy villagers into undergoing unnecessary angioplasty procedures to profit from insurance claims under the Ayushman Bharat scheme.

This tragic incident, involving fake diagnoses and invasive surgeries, has not only shaken the trust in the doctor-patient relationship but also contributes to the rising violence against doctors. #MEDTwitter

Here’s how the scam unfolded and why it impacts the entire medical community - A thread🧵 Step 1: Organise free medical camps: Medical camps were organized in Gujarat villages, offering free cardiac check-ups under the guise of identifying health issues among villagers. These camps were supposedly a part of the Ayushman Bharat PM-JAY initiative, aimed at providing affordable healthcare.

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This is a case of a 30 year old female who was found dead after a 6-hour history of difficulty in breathing. She had no prior significant medical history and she lived alone.

Neighbours reported that she had attributed her symptoms to air pollution and refused medical attention. She was declared brought dead to the hospital.

This was recovered from the heart of the deceased. #MedTwitter External Findings:
The body showed no signs of peripheral edema, cyanosis, or trauma. There was normal hypostasis and rigor mortis.

Internal Findings:
Autopsy revealed multiple well defined, bubble shaped cysts covered by shiny white membrane which were present in the liver, lungs, and heart. The lungs were congested, and several cysts formed saddle emboli in the pulmonary artery.

Cysts were extracted from the inferior vena cava and the right heart chambers. Other organs were mostly normal, except for a prior surgery scar on the right kidney.

Cause of Death: Cardiac arrest due to massive emboli from multiple hydatid cysts.

List of toxic medical colleges and their toxic departments. Feel free to share your experiences as well.
Save future doctors from these colleges and departments. Do your part. Share it as much as possible.

#MedTwitter #NEETPG #neetug





Another list.

Long post alert 🚨

What is psycho-analysis test- A thread 🧵

#MedTwitter #rgkarincident #kolkatahorror #KolkataDeathCase #RGKarCollege What is Psycho-Analysis?

Psycho-analysis is a deep psychological assessment to understand the mental state, personality traits, and behavioral patterns of an individual. In legal contexts, it's used to assess the accused's mental condition, often impacting the judicial process.

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“Death due to idiopathic urinary bladder rupture under the influence of alcohol”

This is a case of a 32-year-old male who was found dead in his bathroom, slumped onto the floor, with blood stains noted in his under-wear.

Earlier on the previous evening he had been out drinking at bars with a friend. While at a bar, his friend found his drunk friend on his knees, with a vague history of having been "hit;" but no further details ever materialized. #MedTwitter Following that episode, the two of them went to another bar, where the deceased went into the bathroom and vomited.

They came home around 2:30 am, and his friend found him dead the following afternoon. The case was referred to the coroner, who ordered a medicolegal autopsy.

How an Ophthalmologist and an RTI Activist @drbabukv from Kerela fought against the giant Patanjali and brought this Company and his owner Baba Ramdev to his knees.

A thread 🧵 The complaint against Patanjali's ads was sparked by his friend's mom, who got hit hard by glaucoma and nearly went blind after trying their ayurvedic stuff.

He realized how messed up those misleading ads could be for people's health, so he decided to do something about it.

Patanjali's been pumping out those tricky ads for ages, even before he dropped his first complaint in Feb 2022.

He complained of profuse rectal bleeding and severe abdominal pain. He explained that the sustained injury had been caused by a silly experiment with the central distribution pressurized air facility at the factory.

He repeatedly stressed that the incident was his own fault. During transportation to the hospital by a helicopter, the man became unresponsive and developed signs of hemorrhagic shock. Despite resuscitation efforts, he died before admission to the hospital.

Because of the strange characteristics of the case and unusual circumstances at the location of the incident, the police ordered a medicolegal autopsy.

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“Sudden death due to ruptured oesophageal varices”

This is a case of a 46-year-old man who suddenly experienced vomiting of a large amount of blood.

He was taken to the emergency department of a tertiary care hospital gasping for air, but during treatment, he was declared dead.

The body was taken to the mortuary for medico-legal autopsy.

Based on information taken from previous medical reports and a police inquest, it was revealed that the deceased had a history of chronic alcohol consumption.

He had experienced many similar episodes previously and was not following his treatment plan regularly.
#MedTwitter #ForensicX On external examination, bloodstains were present on the body surface resulting from haematemesis. At the death scene, bloodstains were found on the road as well.

The abdomen was distended due to free fluid. Yellowish discoloration of both the conjunctiva was seen. Dried blood clots were present in the nostrils and the oral cavity. No evidence of external injury was seen anywhere on the body.

In the GI system, two varices were observed in the posterior wall of the middle third of the oesophagus.

Grossly ruptured varices were bluish discoloured, making bumps and protruding into the lumen with blood clots.

Tortuous, prominent, sub mucosal dilated veins were also observed in the wall of the middle-lower part of the oesophagus.

Clotted blood weighing 370 g was found in the stomach. The liver weighed 2365g. The whole of the external surface of the liver showed the presence of macro and micronodularity. Both the outer and cut surface of the liver showed yellow discoloration and was firm to touch.

Cause of death was opined as haemorrhage subsequent to rupture of oesophageal varices.

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“An Unexpected Cause of Sudden Death Reported as a Case of Adverse Event Following Immunization (AEFI)”

This is a case of a 20-year-old male who took second dose of Covishield vaccine, and then was taken to hospital following complaints of fever, vomiting and abdominal pain.

He was given symptomatic treatment and sent home, and advised to consult surgery outpatient department on the next day.

Early morning on the next day, he collapsed in bathroom at home and was brought dead to the casualty.

His body was kept for medicolegal autopsy as an alleged case of death following vaccination.

RTPCR test for COVID-19 was done prior to autopsy and found to be negative. #MedX #MedTwitter #forensicX
Autopsy: Externally white froth was seen at mouth and nostrils.

On opening abdominal cavity: Loops of small intestine were distended, dark red in color and friable.

A portion of small bowel loops were seen twisted along the axis of its mesentery such that a tight constricting ring was formed at the base of those loops.

(Photographs are posted in the last post)

Peritoneal cavity contained 600ml of blood-stained fluid and emitted a disagreeable smell.

Stomach and proximal part of small intestine contained bile-stained mucoid fluid emitting feculent smell, mucosa was pale.

All other internal organs were congested.

Segments of affected bowel, whole of dissected heart and tissue bits from all other major organs were subjected to pathological study.

Histopathology report revealed: (a) Sections of small intestine - necrosis, extensive areas of hemorrhage and congested vessels, (b) Kidney - acute tubular necrosis, (c) Brain, Lungs- congestion and (d) All other organs - normal morphology.

Cause of death was thus concluded as, death due to gangrene and peritonitis following volvulus of small intestine.

NMC has issued social media guidelines for 1st time for Indian doctors which lay down 11 important points to govern the conduct of doctors on social media under the Registered Medical Practitioner RMP (Professional Conduct) Regulations, 2023.
Every doctor must know about them: 1. RMPs can provide information and announcement on social media.

However, the information should be factual and can be verified.

The information should not be misleading or deceptive, nor should it exploit the patient's vulnerability or lack of knowledge.

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This is a case of a 4yr, F who became suddenly ill with c/o abdominal pain and vomiting. O/E, her abdomen was severely distended and hard, pronounced gastric dilatation was evident on plain abdominal X-ray. A nasogastric tube was inserted, and decompression was achieved with the aspiration of 1400ml of pale brownish, watery fluid. The girl’s condition subsequently stabilized, and she returned home. But after few hours, her condition deteriorated and she was brought dead to hospital.

The cause of death was given as death due to haemorrhagic shock due to an arteroesophageal fistula resulting from button battery ingestion. Disk batteries in particular carry a high risk for corrosive injury to the GI tract, including esophageal burns, fistula formation, and perforation.

High-efficiency disk batteries can produce currents that cause liquefaction necrosis and thermal injury to the esophagus.

If I were a drug, I would be called Humorolol. If @chhayasoni120 were a drug, she would be called pyaricetamol.

Internal examination: On dissection of neck, subcutaneous tissue underlying the ligature mark was found ecchymosed with muscle hemorrhages.
Hyoid bone, thyroid cartilage, laryngeal and tracheal cartilages are found intact. Depressed fracture of size 4.0 × 1.0cm was present over the left side of the frontal bone.
Multiple contusions were present on the inner border of labia minora with fresh tear of hymen.

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This is a case of 47 year old, M who was brought dead to casualty with sudden onset chest pain and breathlessness.
The deceased was a known case of hypertension with on and off medication since last 5 years. twitter.com/i/web/status/1… On autopsy, upon opening pericardial cavity there was e/o blood clot in pericardium. On further exploration, there was e/o rupture of ascending aorta with aortic dissection. Final opinion regarding cause of death was given as cardiac tamponade due to rupture of aortic dissection.

This is a case of of 69 year old male who was brought to our hospital in disoriented state with c/o fever since 4 days, headache, giddiness, altered sensorium with few episodes of convulsions. He was a known case of Diabetes Mellitus and Hypertension. CT-Brain showed diffuse age related cerebral atrophy and small vessel Ischemic changes.
Provisional diagnosis made by the doctors was ?febrile encephalopathy ? Meningitis.

This is a case of an unknown, M, who was brought dead. On autopsy, there was e/o massive bilateral pleural effusion with pulmonary consolidation. On further dissection, there was e/o thickening of pericardium with adhesions to heart which is suggestive of fibrinous pericarditis. Pericardium is a fibrous sac that encloses the heart and great vessels. It keeps the heart in a stable location in the mediastinum.

Pericarditis is the inflammatory process involving the pericardium as a result of a systemic disease or a primary pericardium disorder.

Do you know an autopsy surgeon can determine your age just by looking at some X-rays of your shoulders, hands, hips, wrist.

To determine age a medical jurist uses 4 parameters:
1. General physical examination
2. Secondary sexual characters
3. Dentition
4. Radiographic findings Out of these 4 parameters, radiological examination is most important of them all. In the above x-rays, the findings are :

1. AP view of right shoulder joint is showing appearance of lateral end of clavicle and fusion of
epiphysis of humerus which usually occurs at 18-19 years.