Dr Vikram Sakaleshpur Kumar 🇮🇳 Profile picture
I learn by sharing as much medical information as possible... Certain non-medical(esp geo-politics), academic RTs don't mean endorsement.
Mar 18, 2023 10 tweets 4 min read
An otherwise healthy 8 yr girl presents with a 2wk h/o asympt skin eruption. A wk before the onset, she had experienced mild fever, sore throat, & coryza for which she received symp Tx without any significant sequelae.
Guess what folks..!
#MedTwitter #idtwitter #MedEd #FOAMed ImageImageImageImage -A h/o similar complaints was also elicited in some of her school friends
-The lesions were not associated with any atopic diathesis, preceding inflammatory dermatoses, drug intake, or suggestive systemic finding.
Mar 17, 2023 11 tweets 4 min read
Ibuprofen is commonly used in #neonates with PDA, but its benefit is uncertain.
this is a multicenter, noninferiority trial, PDA (dia, >1.5 mm, with L-R shunting) who were extr preterm (<28 weeks’ GA) to receive either expectant management or early ibuprofen Tx
#MedEd #MedTwitter The noninferiority of expectant Mx as compared with early ibuprofen Tx was defined as an abs risk diff with an upper boundary of the one-sided 95% CI of < 10 %ge pts.
Mar 15, 2023 7 tweets 3 min read
Some very interesting dev in the Tx regimens for #TB especially the common rifampicin susceptible TB
@MoHFW_INDIA @DHFWKA @ICMRDELHI @StopTB @UNICEF @paimadhu
#MedTwitter #idtwitter
The imp points 👇 Image There were 4strategy groups with diff initial regimens; noninferiority was assessed in the 2 strategy groups with complete enrollment, which had initial regimens of high-dose RIF–linezolid & bedaquiline–linezolid (each with INH, PZA,& ETH).
Feb 3, 2023 14 tweets 3 min read
Folks....!
A 4 month -old girl infant
▶️of consanguineous parents
▶️one of her brothers died at the age of 2 mth due to #SIDS with the other brothers being normal; presents with
▶️Dysmorphic features
▶️growth faltering
#MedTwitter #FOAMed #TipsForNewDocs ▶️Delivered by LSCS section at 38 wk gest due to intrauterine growth retardation.
▶️birth weight 1240 g, length was 37.3 cm , head circumference was 30.5 cm
▶️At the age of 12 days, she was admitted for suspected sepsis for a week and discharged in good general condition.
Feb 3, 2023 14 tweets 4 min read
Folks...
Have you all seen anything like this before..!?
What could this be?

#MedTwitter #FOAMed #TipsForNewDocs #MedEd Chest X-ray with posteroanterior and lateral view shows a pa ▶️A 57-year-old man of Javanese ethnicity, Indonesia, with a 12-year history of progressive shortness of breath on exertion
▶️there were inspiratory coarse crackles & occasional wheezing with⏬vesicular sound across all thoracic areas, more in the bilateral base of the lungs.
Feb 2, 2023 9 tweets 4 min read
A 4-week-old male infant born at 33 weeks of gestation presented with this. Observe the child's 👀 carefully ... what is happening to the eyes while its mouth opens and closes?
#MedTwitter #MedEd #TipsForNewDocs #Pediatrics #FOAMed
@Sthanu5 @AvrahamCooperMD @PaediatricFOAM ▶️The mother's pregnancy was complicated by maternal syphilis and methamphetamine exposure.
▶️The baby subsequently was found to have a positive serum RPR (1:4) & positive VDRL in CSF (1:1)
▶️GE - hepatomegaly & syphilitic rhinitis (snuffles)-
▶️Diag: Neurosyphillis
Feb 2, 2023 11 tweets 3 min read
A 2 m old infant , born at 35 1/7 weeks of gestation via LSCS with BW 2610 g due to preterm PROM, came with sudden-onset bilateral buccal protrusions. NO trauma history previously, nor were any congenital disorders found.
What is this...!?
#MedTwitter #TipsForNewDocs #Pediatrics ▶️physical examination revealed bilateral protrusions that were normal in color & texture without bleeding, pus, or ulcer.
▶️With crying, the protrusions became more obvious..!
Feb 2, 2023 5 tweets 2 min read
What is this?
A tattoo? Mehendi?

#MedTwitter #MedEd #TipsForNewDocs #FOAMed It is called as "Lichtenberg figures", fernlike or featherlike transient skin injury induced by lightning. The girl was struck through the arm by which she was holding the rope.
Lichtenberg figures are pathognomonic of lightning injuries.
Jan 31, 2023 5 tweets 1 min read
*** A typical case of Sodium valproate-induced Fanconi type proximal RTA.
*** The most important diagnostic features of this syndrome include polyuria, polydipsia,hypophosphataemia,hypocalcemia glycosuria & proteinuria *** clinical fractures representing an underlying osteopaenia may provide an opportunity for early intervention as it ⏫ the suspicion of Fanconi's syndrome.
*** Many case reports suggest there is a subpopulation of individuals who are at risk of developing this condition.
Jan 6, 2022 5 tweets 3 min read
Some imp insights into #omicron by Dr Jacob John , 🧵@naveenthacker & @vipintukur
🚨Probably #Delta plus 🦠 is t last major mutation that occurred at human level
🚨Delta plus caused syncytia formation in 🫁 that resulted in multinucleated cell which incited more damage of 🫁 3.this mutant is going to remain for ⬆️ period & in turn may be an endemic 🦠 .
4. Newborns may not hv immunity like influenza 🦠 & ‘may’ req regular 💉 .
5.#Omicron is not a variant (probably) but a deviant. In t sense it is antigenic shift , probably derived frm infected 🐀
Nov 26, 2021 8 tweets 4 min read
Such a well written editorial this in @Open_HeartBMJ Superb..!! openheart.bmj.com/content/8/2/e0…
a must read for everyone... #MedTwitter #Cardiology
interesting points a 🧵👇 Metabolic acidosis is a chronic condition that
many people in the Western world have but
do not realize it... It occurs when there is
retention of acid in the body, which leads to
a depletion in the bicarbonate stores of the
body. Ways to test for low-grade metabolic acidosis👇
Nov 26, 2021 6 tweets 3 min read
pn.bmj.com/content/21/6/4… a superb article with many many learning points..#neurotwitter #MedTwitter #AcademicTwitter #scicomm
key points in the review article "Localization in focal epilepsy"👇 Cortical zones defined in presurgical evaluation
Nov 26, 2021 12 tweets 7 min read
B.1.1.529 seems to have gone from 0.1% to 50% in just a couple of weeks, when it took Delta several months to achieve that..!!

Brace up folks..!!
#NuVariant
Things are getting worrisome folks..!! Read and understand this thread..!!
Nov 25, 2021 5 tweets 4 min read
#Covid outbreak in SDM Med college, Dharwad, #Karnataka after a student college festival.. many infected… @MoHFW_INDIA @DHFWKA @ICMRDELHI #news Yesterday Day 1
URTI like symptoms !
Contact tracing done
Around 100 tests positive inc staff, students n other primary contacts !

All stable till now..!!
Jun 7, 2021 4 tweets 3 min read
Residual #SARS-CoV-2 🦠 ags detected in GI and liver tissues from 5 recovered pts with #COVID-19. gut.bmj.com/content/early/… @vipintukur @AskDrShashank @VirusesImmunity #SARS-CoV-2 nucleocapsid protein (NP) was detected in the colon, appendix, ileum, haemorrhoid, liver, gall- bladder and lymph nodes from 5 pts who recovered from COVID-19, ranging from 9 to 180 days after testing -ve for SARS-CoV-2. #MedTwitter Image
Jun 3, 2021 14 tweets 9 min read
Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier.. @vipintukur @ProfSomashekhar @naveenthacker @iapindia @INDIANJOURNALO4 @VirusesImmunity @EditorIndPed @ICMRDELHI @MoHFW_INDIA @iiscbangalore Image Weeks after #SARS-CoV-2 inf or exposure, some children develop a severe, life-threatening illness called Multisystem Inflammatory Syndrome in Children (#MIS-C). GI symptoms are common in MIS-C pts & severe hyperinflammatory response ensues with potential for ❤️ complications.
May 30, 2021 11 tweets 13 min read
This gentle man is Sir William Osler.. He has frequently been described as the “Father of Modern Medicine” and one of the "greatest diagnosticians ever to wield a stethoscope". What did he hv to say about #India ? @sanjeevsanyal @vipintukur @naveenthacker @EricTopol @mvankerkhove Image His fascination for #India, The land of #Vishnu had no bounds..!! At each & every intellectual commentary he mentions about his interest in the values #India was known for @ProfSomashekhar @iapindia @IndianMedicalAs @MoHFW_INDIA @VirusesImmunity Image
May 29, 2021 6 tweets 5 min read
#Mucormycosis and children...! What info do we have? After Covid-19, 16-Yr-Old Fights Mucormycosis, Pancreatitis, Stroke..!! ahmedabadmirror.com/after-covid-19… look at the confidence in this boy..!! Way to go boy..! @iapindia @naveenthacker @vipintukur @ProfSomashekhar @AskDrShashank “He was operated on for it, his right-side palate and teeth had to be removed, and he is now on medication,” a 13 year old child..!! indiatoday.in/amp/india/stor… @ICMRDELHI @PedCritCareMed @INDIANJOURNALO4
May 22, 2021 7 tweets 8 min read
Inadvertent Pumping in too much of Zinc!could this also be contributing to this epidemic of #mucormycosis #blackfungus in association with other risk factors...!? @MoHFW_INDIA @ProfSomashekhar @BagaiDr @iiscbangalore @ShamikaRavi @ICMRDELHI @ARanganathan72
ncbi.nlm.nih.gov/pmc/articles/P… ipen.br/biblioteca/200… is this coincidental...!! Image
May 19, 2021 5 tweets 6 min read
#Covid19 is probably the greatest debunker in #medicine we have seen...

Read this ... 👇🏾 🧵 *** The researchers found no evidence of a difference in response in biochemical markers of #inflammation between patients with #MIS-C/PIMS-TS who were treated with #IVIG, #steroids, or #biologics, compared with those who were not.