puloriasumit@24

Former Non Academic Senior Resident (RHEUMATOLOGY)

[Anand Ranganathan @ARanganathan72]

Starting tomorrow, Supreme court of India is on a six-week summer vacation and will be operating at just 19% of its capacity. There are 53 million cases pending in Indian courts - 93,143 of them are pending in the Supreme Court.

A judge can go on a vacation, a judiciary cannot.

[Anuradha Tiwari @talk2anuradha]

Dear @PMOIndia

A few days ago, you urged people not to spend Indian money abroad.

So, kindly bring a law mandating that kids of ministers & bureaucrats study only in India.

Their children should also experience the policies & infrastructure their parents create for our kids.

[NEJM @NEJM]

Case Record of the Massachusetts General Hospital: A 76-year-old woman, who had a history of treated hepatitis C virus infection, presented with rapidly progressive kidney failure and a stroke. Palpable purpura on the legs was noted.

A bone marrow core biopsy revealed a moderately hypercellular marrow characterized by maturing trilineage hematopoiesis with myeloid predominance and rare nonparatrabecular lymphoid aggregates. These aggregates were composed mainly of B cells with few plasma cells (Panels A and B) and predominantly expressed IgM (Panel C) and kappa (Panels D and E). Flow cytometry of the bone marrow aspirate identified a small population of B cells (CD19+ and CD10−) with an excess of kappa light chains (kappa:lambda ratio in bone marrow aspirate, 3.6; reference range, 1.0 to 3.0). Plasma cells accounted for 8% of the total cellularity and had kappa predominance (kappa:lambda ratio, 4.4). Flow cytometry of the peripheral blood revealed a concordant population of B cells with monotypic kappa expression (Panel F). These findings are consistent with low-level involvement by a small mature B-cell lymphoma with plasmacytic differentiation — either a marginal-zone lymphoma or lymphoplasmacytic lymphoma. The MYD88 c.794T→C (p.L265P) mutation, which is present in the vast majority of cases of lymphoplasmacytic lymphoma, was not detected.

Read the full case details in “A 76-Year-Old Woman with Fatigue, Rash, and Kidney Failure,” a Case Record of the Massachusetts General Hospital, by F.B. Cortazar et al., from St. Peter’s Hospital (@sphpnews), Massachusetts General Hospital (@MassGeneralNews), and @harvardmed: https://t.co/tDCHGN00I7

[Abhishek G P @Abhishek_joints]

Had the privilege to listen to some of the stories in person, now the whole world will read the path of this GOAT.. Congratulations to Lancet! Many more to come. #padmashri @IndianRheum @nileshnolkha @DurgaPrasannaM1 @Rheumat_Aravind @IlliasulK

[puloriasumit@24 @lupusdoc24]

@IlliasulK @DrAkhilX @IhabFathiSulima @CelestinoGutirr @Urchilla01 Scleritis

[Shesh Paul Vaid @spvaid]

Abolishing the reservation system in India, especially in life-critical professions such as medicine, is an idea that deserves serious debate. Reservation was introduced at the time of framing the Constitution, initially for a period of 10 years. It has now continued for over 75 years and, in many ways, has turned into a competitive vote-bank issue. In the interest of fairness and merit, the Supreme Court of India should consider reviewing the system and take cues from the Supreme Court of the United States while re-examining its future.

[Dr. Neha Das @neha_laldas]

Today Supreme Court is hearing the 73% reservation case in Madhyapradesh.

BJP govt has requested to lift the stay on the appointments & give an interim relief by allowing 73% reservation.

GC students + YFE are fighting for equality.

Hope justice prevails 🙏

#SaveEqualityInMP

[Anuradha Tiwari @talk2anuradha]

Huge Embarrassment for Mohan Yadav in Supreme Court today

Supreme Court refused MP Government plea to remove the stay on 73% Reservations.

For now, a small win for General Category !

[puloriasumit@24 @lupusdoc24]

@IlliasulK @DrAkhilX @IhabFathiSulima @Urchilla01 @CelestinoGutirr Psoriasis, nail changes also seen - oil drop right middle and ring finger

[puloriasumit@24 @lupusdoc24]

@RheumattDoc PAN

[puloriasumit@24 @lupusdoc24]

@IlliasulK @IhabFathiSulima @hemo_shk @MoarSahitoPTI @MRCEMPREP @DrBassemKurdi @mohammadalmogbi @Dr_Alhatlani @osemagnum @DrAkhilX ? Palmar psoriasis, neck pain - psoraitic arthritis axial spA

[puloriasumit@24 @lupusdoc24]

@Abhilasha21822 Combination of folitrax plus folic acid 🤣, they should be avoided on the same day , yaha toh combo dediyaa

[puloriasumit@24 @lupusdoc24]

@Janetbirdope MDA 5

[Anuradha Tiwari @talk2anuradha]

You stayed silent when Reservation increased to 70%.
You stayed silent when SC/ST Act got more draconian.
You stayed silent when Caste Census was announced.

This Republic Day, don't be silent.

SAY NO TO UGC REGULATIONS.

[puloriasumit@24 @lupusdoc24]

@Abhilasha21822 DISH

[puloriasumit@24 @lupusdoc24]

@DrRachit1994 Old age male with anemia , first want to rule out GI causes , though gut feeling says his bone marrow will give the final result possibly MDS

[puloriasumit@24 @lupusdoc24]

@DrRachit1994 Option 1 and 5 are out as he is having iron supplements and blood transfusion

[puloriasumit@24 @lupusdoc24]

@IlliasulK @DrAkhilX @IhabFathiSulima @CelestinoGutirr @Urchilla01 @Janetbirdope @NEJM GCA with tounge infarct

[Dr. Nikhil Agrawal @DrNikhilMD]

Many patients and even relatives often say that doctors from earlier generations were better, that they did not need so many tests and could just look at the patient and write medicines.

I always smile when I hear this because medicine has never been about guessing, it has always been about precision.

If you were a shooter and your relative stood in front of you with an apple on their head, would you shoot blindfolded or use a laser guided system?
Of course, you would choose the laser, not because you doubt your skill but because accuracy matters when a life is at stake.

That is exactly what modern doctors do. Tests are our laser guidance system. They help us confirm what we suspect, rule out what we must not miss and plan the right treatment for the person sitting in front of us.

Medicine has evolved. We now understand that two diseases can look identical but need completely different treatments. We know that one abnormal test can change the entire course of management. We know that guessing, no matter how experienced the doctor, can cost a life.

Older doctors practiced in a very different era. There were fewer known diseases, fewer available drugs and patients often came at later stages when diagnoses were obvious. Today, illnesses appear earlier, there are many lookalikes and treatments are far more specific. That is why evidence matters.

So when we order tests, it is not about chasing reports, it is about chasing the truth.
We do not test to make money, we test to make sure your treatment is right, safe and complete.

Medicine is not about being old school or new school.
It is about being right. 🎯