Let me recount a story, bit long but bear with me:

Back in PGY3 MD Medicine at Manipal KMC, we had a patient admitted to the ICU that none of us residents could figure out.
Like no resident (there were quite a few of us) had the slightest clue what he might b suffering from 1/n

https://twitter.com/siddhant_k11/status/1963962297405116764

He had a long history of recurrent fevers with lower abdominal pain seen by multiple docs & surgeons, some even opened him up and did an appendectomy but he kept having the same symptoms periodically. Multiple tests and scans yielded nothing exc for raised inflamm markers 2/n

Q for #medtwitter #cardiotwitter :

How many have noticed ECG being taken by nurses/students with this chest lead placement?

I see it so often but still gets on my nerves everytime!

Just curious if this is a common phenomenon? @anunay_cardio @AdiG1993 @abadkhan2002 @suheildhanse @Hragy @drjatinanand @DrGJustinPaul1 @DrRajeshG1 @ashwinrajenesh @djc795 @rallamee @just1doctorwala @meshaljoseph

Unfortunately the most inaccurate reading taken in a hospital is often the blood pressure. Nearly always guaranteed to be off.

Shown here are a few common errors made during BP measurement:

Can you spot them all?

There are at least 6 errors shown here.. answers in 2 hours. Answers:
1. Back unsupported
2. Feet not planted on the floor
3. Cuff over shirt
4. Cuff too small for arm
5. Patient talking on phone
6. Patient's legs are crossed
7. Arm should be supported with cuff at heart level

Short thread on what evidence means to us in medical field and why real doctors don't promote unproven and pseudoscientific Rx

Below is a classic example of a pseudoscience apologist who uses circular reasoning and appeals to ignorance to justify his stand against evidence 👇1/n Let's break down his reasoning one-by-one and show why modern medicine gives so much importance to trials.

1) He states: "Absence of evidence is not evidence of absence" > This might be true except if after 1000s of years of tall claims, there is still absence of evidence 2/n

So Dr. Reddy's has revealed the actual primary end point of their Phase 3 #2DG trial. They claim this was pre-specified and I guess we'll have to take their word 4 it.

But, wait a minute.. what was the +ve outcome they presented to DCGI? Was it time to 2 point improvement? 1/n Umm, this sounds very different - they presented only proportion of patients with 1 point improvement at Day 3. Which if u recheck the last tweet, wasn't even one of their secondary end points! 2/n

So, I suspect most don't really get what the big deal is in not reporting the primary outcome of a trial before commencing the trial, so here's a short #tweetorial..

https://twitter.com/PriyankaPulla/status/1390993088886173697

So, let's say you're a competitor in a shooting contest, how do you measure your success? That's right - a target

Just leaving this here:
AYUSH 64 is an old formulation that was first tried in malaria and failed to show benefit compared to standard treatment. It was commercialised in 2014 by selling rights to Dabur and is being heavily promoted without any scientific evidence..

https://twitter.com/moayush/status/1390374085276823553

Abstract for the phase 2 trial in patients with Vivax malaria. No subsequent larger trials done..

To those who have recovered from covid and are eager to share their experience:

PLEASE try not to make it into a promotion for a particular drug or treatment regimen

I've seen too many tweets that read "Doctor gave me this drug and in 5 days I was fine!"
This can be dangerous.. Your individual experience may mislead others to think that it's a simple matter of "what worked for him should work for everyone" which is not how medical science works..
As doctors we determine what works via clinical trials which have to be well designed and conducted

Why do we need to correctly count all covid deaths?

To spread doom and gloom for the sake of it? No.
Coz it's an important tool for epidemiologists? Not only that.

To deal with a problem we must first understand how bad it is..

And because it's vital for our collective memory. It has become more and more apparent with each passing day, that the number of deaths is not only being grossly undercounted (which may be unavoidable in many cases) but that it is being SYSTEMATICALLY undercounted.

https://twitter.com/jburnmurdoch/status/1384782984138694658?s=19

Anyone else notice that neither the Cowin portal nor the Aarogya Setu app store displaying the 30 day trend in vaccinations across India?

Wonder what they don't want us to see.. 🤔 Thankfully there are other transparent sources for data 👇

Tactics used by quacks to sell their pseudoscientific concepts and 🐍 oil:
1. Modern medicine has no cure for your condition.
- Ignores the fact that some disease is incurable/beyond cure. They advertise cure but though it's been around for centuries the claims are mostly bogus. 2. No side effects! Natural is better!
- Commonly used. My prof used to say: no side effect means no effect! If it does have any effect then there must be some side effect! Biggest myth that can easily be busted, numerous examples in threads by @drabbyphilips

Ok, took me a few days to properly process the stunning results of the Delhi serosurvey. Unfortunately we only have a press conference with a few slides telling us that 22.86% of 20,000 people sampled tested positive for antibodies to Sars-cov2: timesofindia.indiatimes.com/india/almost-1… This was done from June 27 to July 10 and they did a randomised sampling of every nth household and also sampled minors, they used the Kavach ELISA developed by ICMR (sens 92.3 and spec 97.9). The results were only recently released in the July 21st PC.