Dr Muhammad Saad

#Internal_Medicine_Resident
Your only chance is the element of surprise.
#Medicine
#MedEd

[Dr Muhammad Saad @Muhammad_saad10]

Initial approach to asthma exacerbation:
• Assess severity (talking, RR, accessory muscles, SpO₂)
• Give O₂ (target ≥94%)
• Nebulized SABA (salbutamol) ± ipratropium
• Early systemic steroids
• Reassess frequently — don’t wait for deterioration
#pulmonology
#asthma

[Dr Muhammad Saad @Muhammad_saad10]

Bradycardia with hypotension? Don’t miss hyperkalemia — ECG before atropine.
#MedEd
#cardiology

[Dr Sudhir Kumar MD DM @hyderabaddoctor]

The Night-Time Mystery: When an Uncomfortable Urge to Move the Legs Reveals a Hidden Deficiency

For six months, 35-year-old Kailash (name changed) had been struggling with a peculiar problem.

Every evening, as he tried to relax or go to sleep, an unpleasant sensation would begin deep inside his legs. It was difficult to describe: Not exactly pain, not cramps, not numbness. But it produced an irresistible urge to move his legs.

He would walk around the room, stretch, or shake his legs. The relief would come briefly, only to return again when he lay down.

Sleep became fragmented. Nights were restless. Days were tiring.

A frustrating search for answers
Kailash had already consulted a local physician. Because the symptoms were vague and difficult to describe, he was prescribed analgesics and nutritional supplements.

But the problem persisted.

When he came to my clinic, what struck me was the pattern of his symptoms.
As we discussed his history in detail, a few clues became apparent:
🔸Symptoms were worse in the evening and at night
🔸They occurred mainly during rest or while lying down
🔸Movement temporarily relieved the sensation
🔸Sleep had been significantly disturbed

✅These features immediately suggested a neurological condition called Restless Legs Syndrome (RLS).

▶️A simple blood test provides the answer
Restless Legs Syndrome is sometimes associated with low iron stores in the body, even when haemoglobin levels appear normal.
Therefore, I advised a serum ferritin test, which measures iron storage.
The result provided the missing piece of the puzzle.

✅His serum ferritin was 11 ng/mL, well below the normal range for adult men.
This meant that his iron stores were depleted.

▶️Why iron matters for the brain
Iron is not only important for haemoglobin and blood. It also plays a crucial role in brain dopamine pathways, which regulate movement and sensory processing.

Low iron levels can disturb these pathways and produce the uncomfortable sensations characteristic of Restless Legs Syndrome.

In many patients, correcting the iron deficiency significantly improves symptoms.

▶️Treatment and recovery
After counselling, Kailash was started on iron supplementation along with dietary advice.
🔸Over the following weeks, his symptoms began to improve gradually. His nights became more restful, and the distressing urge to move his legs diminished.
🔸For him, the solution turned out to be a simple diagnosis supported by a simple test.
✅But reaching that diagnosis required careful listening to the patient’s story.

Dr Sudhir Kumar
Neurologist, Hyderabad
@hyderabaddoctor

(Note: Image is AI-generated)

[Dr Muhammad Saad @Muhammad_saad10]

@NEJM We see them very often in Pakistan

[Dr Muhammad Saad @Muhammad_saad10]

@baranidharan73 @Rampradeep470 @yajadev @DoctorBhavsar @drmohansai 2)to acidosis and RL contains potassium which can also be raised with it, so the best fluid for resuscitation is normal saline in DKA, start with normal saline and insulin, incase the potassium goes down below the normal add accordingly to the solution

[Dr Muhammad Saad @Muhammad_saad10]

@baranidharan73 @Rampradeep470 @yajadev @DoctorBhavsar @drmohansai 1)The preferred solution in DKA is normal saline for resuscitation, in RL the lactate is not only converted to bicarbonate but also to glucose by gluconeogenesis which can exaggerate hyperglycemia, furthermore in DKA the potassium is also high initially as a compensation

[Dr Muhammad Saad @Muhammad_saad10]

@teachplaygrub This is the reason i open twitter, the best thread so far . There is always something to learn from your posts and that too explained in the most easiest way

[Dr Muhammad Saad @Muhammad_saad10]

If your patient has ⬇️Oxygen saturation with more than 60mmHg of PaO2 on ABGs, do rule out acidosis as ⬆️Acidosis causes hemoglobin desaturation.

[Dr Muhammad Saad @Muhammad_saad10]

@dr_asadnaveed I would like to get that list..TIA

[Dr Muhammad Saad @Muhammad_saad10]

@BrownJHM Cutis verticis gyrata

[Mounir Basalus (Ⲃⲁⲥⲓⲗⲓⲟⲥ) @Basalus]

An educational #ECG

[MCU - The Direct @MCU_Direct]

Martin Freeman says #MarvelStudios hasn't yet given him a "definitive" answer to whether Everett Ross was secretly a Skrull in #WakandaForever:

"I wasn’t playing anything as a Skrull..." Full quote: https://t.co/2olSoarD0G

[Dr Joshua Walinjom @walinjom]

STEMI in paced rhythm or LBBB:

Sgarbossa Criteria

1. Concordant ST elevation ≥ 1mm in a lead with a positive QRS (5pts)

2. ST depression ≥ 1 mm in V1, V2 or V3 (3pts)

3. Discordant ST elevation ≥ 5 mm in a lead with a negative QRS (2pts)

≥3points = 98% specific for ACS

#MedTwitter
#cardiotwitter

[Dr Muhammad Saad @Muhammad_saad10]

@RizwanSayz Bravo 👏 well researched and brilliantly pointed out the main problem of hepatitis in pregnant women. This may go a long way in taregetting the issue of hepatitis and educating women from rural areas to prioritize screening for hepatitis to be treated in due time.Proud of you Bro

[• @Alhamdhulillaah]

Do not wish to be like anyone except in two cases;

1) A person, whom Allah has given wealth and he spends it righteously

2) The one whom Allah has given wisdom (the Holy Quran) and he acts according to it and teaches it to others.

[Bukhari]

[Dr Muhammad Saad @Muhammad_saad10]

@alikeskin_tr Dirlis Ertugrul and Kurulus Osman,the legendary ones❤❤❤❤

[Dr Muhammad Saad @Muhammad_saad10]

A well determined step to change the future of nation.Pivotal for students who are shy and need teachers essential attention.

[Boğaçhan Göksu @bogachangoksu]

Bu Çin’deki okul, 30 saniyede bir öğrencilerin yüzünü tarıyor;

1) Yüz ifadelerini analiz ediyor (mutlu, kızgın, üzgün vs.)
2) Davranışları ölçüyor (parmak kaldırdı, yazdı, okudu vs.)
3) Öğretmenler bu analizle öğretme tarzlarını değiştiriyor…