Prerna

resident in internal medicine. stoic. kind. tenacious

[Prerna @EvanescentMiss]

Surreal. Bedazzling. The skyline at dusk today 🌤

[Prerna @EvanescentMiss]

Heavy traffic influx on the road opposite Ahalya Nagar,Patia. Large number of vehicles coming from Nandankanan side and Infocity chowk creating accident probe situations. Traffic policing is the need of the hour at this junction. @DCP_TRAFFIC

[The Heart @ZHeart11768530]

The cardiac Chambers on Chest X-Ray :
https://t.co/t3lnowvNdZ
#CardioTwitter #CardioEd #cardiology

[Dr. AK 🇮🇳 @docakx]

💥 𝗡𝗘𝗪: November 2023

💥 Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in
𝗖𝗜𝗥𝗥𝗛𝗢𝗦𝗜𝗦 : Expert Review

💥 American Gastroenterological Association ( AGA)

💥 A 🧵 on
12 BEST PRACTICE ADVICE STATEMENTS 👇

#MedTwitter #MedEd #MedX

[Mohammed ALnashri @mohamadanashri]

Atrioventricular blocks in 60 seconds:
- First degree block
- Mobitz type I second degree block
- Mobitz type II second degree block
- Third degree (complete) block

[Prerna @EvanescentMiss]

@thedarkrebel Bhitarkanika in Odisha is a designated Ramsar site, with the largest number of saltwater crocodiles, the mighty Brahmani and Baitarani and other small rivers forming miles and miles of pristine waters. Migratory birds flock and transform the panorama. 2nd largest mangrove.

[Lea Alhilali, MD @teachplaygrub]

1/”I LOVE spinal cord syndromes!” is a phrase that has NEVER, EVER been said by anyone.

Do you become paralyzed when you see cord signal abnormality?

Never fear—here is a thread on all the incomplete spinal cord syndromes to get you moving again!

[Prerna @EvanescentMiss]

@baxirahul The Anatomy of Mumbai.

[PharmaFactz @PharmaFactz]

🔴FLUOROQUINOLONES REVIEW.

EXAMPLES

🔸 ciprofloxacin
🔹 ofloxacin
🔸 levofloxacin
🔹 gatifloxacin
🔸 norfloxacin
🔹 gemifloxacin
🔸 nalidixic acid
🔹 moxifloxacin
🔸 delafloxacin

INDICATIONS

👉 urinary tract infections
👉 GI infections eg. with Shigella, Campylobacter
👉 lower RTIs; pneumonia
👉 Pseudomonas aeruginosa infection
👉 gonorrhea

MECHANISM OF ACTION

Fluoroquinolones kill bacteria by inhibiting DNA synthesis.

Fluoroquinolones inhibit the ligase activity of:

🧬 type II topoisomerases
🧬 DNA gyrase
🧬 topoisomerase IV

With ligase activity disrupted, these enzymes release DNA with single- and double-strand breaks that lead to cell death.

They are particularly active against aerobic Gram-negative bacteria, which explains their use in urinary and GI infections etc. Some fluoroquinolones - such as moxifloxacin and levofloxacin - have enhanced activity against Gram-positive organisms.

SIDE EFFECTS

◾️ GI upset - nausea, diarrhea
◾️ immediate / delayed hypersensitivity reactions
◾️ they lower the seizure threshold
◾️ increase risk of tendon damage / rupture (rare)
◾️ prolong the QT interval / arrhythmia risk
◾️ increased risk of C. difficile colitis

DRUG INTERACTIONS

☑️ multivalent ions (calcium, iron etc.) reduce the absorption and efficacy of fluoroquinolones.

☑️ NSAIDs increase the risk of seizures.

☑️ with prednisolone, tendon rupture risk increases.

☑️ arrhythmia risk increases with other drugs that prolong the QT interval (macrolides, quinine, amiodarone, SSRIs, some antipsychotics etc.).

[Lea Alhilali, MD @teachplaygrub]

1/Asking “How old are you?” can be dicey—both in real life & on MRI!

Do you know how to tell the age of blood on MRI?

Here’s a thread on how to date blood on MRI!

Read this so next time you see a hemorrhage, your guess on when it happened will always be in the right vein!

[Michael Okun @MichaelOkun]

What are the 3 safest drugs you can use to treat psychosis in Parkinson's and not worsen motor symptoms. Greg Pontone shows us the guidelines from 2019 and perhaps they need to be updated; however the 3 drugs clozapine, quetiapine, and pimavanserin would remain unchanged until we get another therapy. @FixelInstitute @UFNeuroRes

[Prerna @EvanescentMiss]

@Sucharitasahu10 https://t.co/dORwafSJ9x

[The Cultural Tutor @culturaltutor]

Exactly 170 years ago today Vincent van Gogh was born.

But he didn't just paint sunflowers and starry skies. Van Gogh made over 2,000 works of art in less than ten years - one every 36 hours.

So here are some of his less famous masterpieces:

[Emma Woolf @EJWoolf]

Virginia Woolf took her own life 82 years ago on this day. Here is the beautiful final letter she left for her husband, my great-uncle Leonard Woolf 💜

[Gaia Giannone @gaia_giannone]

Changing the treatment algorithm of Endometrial cancer...It is time for IO also in first-line!
Jaw-dropping results from ENGOT-EN6-NSGO/GOG-3031/RUBY #endometrialcancer #ESMOVirtualPlenary #gyncsm @myESMO @AACR
https://t.co/ZrMqdZrh9u

[Prerna @EvanescentMiss]

@veda_padma Jibhi. Tirthan Valley. :)

[Prerna @EvanescentMiss]

Is delhivery reliable and accountable ? I have tagged you with relevant information and still there is no response and no means to contact anyone as well. You people shamelessly ripped off 4 packages and sent only one package. @help_delhivery

[Prerna @EvanescentMiss]

@help_delhivery this is the screengrab of the consignment from the mehrauli centre. 5 boxes are clearly visible.
The video shows only one was brought for delivery, which my brother refused to collect. @delhivery

[Prerna @EvanescentMiss]

Where are the other 4 boxes @help_delhivery ?

[Prerna @EvanescentMiss]

@help_delhivery Will the consignment reach me or not ? Atleast have the sincerity to respond. I have sent all the details with video footage. The consignment contains valuable wedding paraphernalia. And the package was booked last saturday.

[Prerna @EvanescentMiss]

@delhivery @help_delhivery A Consignment weighing around 5-10 kgs with 5 boxes containing wedding paraphernalia was dispatched from Vasant Kunj to Bhubaneswar on 4/2/2023.Today only one box was delivered in bbsr.AWB 2827722251750. Is this a practical joke ?

[Prerna @EvanescentMiss]

All the boxes were numbered from 1 to 5 and the numbers were encircled. @delhivery @help_delhivery awb no 2827722251750

[Prerna @EvanescentMiss]

My estimation is that the remaining 4 boxes were deliberately misplaced at bilaspur haryana. @delhivery @help_delhivery my wedding is next week. And it is criminal on your part to misplace 4 large boxes awb no 2827722251750