🩺Clinical & neuroimaging 🧠 clues to differentiate 🧩autoimmune encephalitis & its mimics🔎
Current opinions in Neurology 📖
10.1097/WCO.0000000000001489.
62% of Indian resident doctors work more than 36 hours at a stretch. 86% report severe sleep deprivation. 97% earn less than an entry level civil servant. 76% are assaulted while on duty.
We can call ourselves civilised only when we learn to treat our doctors like they treat us.
@ANI Politicians have no fear anymore, they know there is a cctv, they know doctors will strike, they know there will be a case, they also know that nothing will happen to them because they are in power
This this nothing but to show that you general public are beneath our feet.
@narendramodi * Healthcare expenses can be substantial without adequate insurance.
* Inflation in everyday services, eating out, travel, and lifestyle spending has reduced disposable income.
* Job security is less certain in some sectors due to automation and economic changes.
@narendramodi No sir you cant take credit for this, middle class pathetic situation now.
What is becoming harder
* Housing prices in major cities have increased faster than incomes for many people
* Education costs (especially private schools and colleges) have risen sharply.
Which bulbar muscle do you choose for EMG in ALS?
I started off with genioglossus , but have shifted almost completely to the trapezius
EMG of the tongue is uncomfortable and contaminated with numerous movement artefacts
The traps are easier to access and movement artefacts are not a problem
What about the literature on this ?
🚀Trapezius is the best bulbar surrogate. 67% abnormality rate vs sternocleidomastoid (SCM )41.9% and genioglossus 40.4%
If patient can't tolerate genioglossus, trapezius is definitely a better option.
SCM correlates with bulbar LMN but misses ~23% of bulbar cases
The upper bulbar muscles (genioglossus, masseter, facial) are most specific but least tolerated in patients
Will you change your muscle preference after this?
Ref ; (Zhao et al, 2025).
An office test for POTS, OH and OI
The 10-minute NASA Lean Test (NLT)
•Steps-
•[1] Make the pt rest and lie down for 10 minutes
•[2] Then stand up for 10 minutes, and with her/his heels 6-8 inches from the wall, and shoulder blades touching it