Omer

Physician/Rheumatologist. Interested in MSK ultrasound, CTD/Vasculitis and Immunology.

[Aravind Palraj @Rheumat_Aravind]

🧵 1/10

Sulfasalazine (SSZ) is an old drug.

But it is still one of the most useful—and misunderstood—DMARDs in rheumatology.

Where does it work?
Where does it NOT work?
And when should you worry about cytopenias?

A high-yield SSZ thread 🧵

#Rheumatology #MedTwitter @docakx @IhabFathiSulima @drkeithsiau

[Tony Breu @tony_breu]

1/15
🤔Does end-stage renal disease (ESRD) make diabetes disappear?

No, but in some patients with ESRD, insulin needs fall. A1c drops. Diabetes medications can be stopped.

This has been called “burnt-out diabetes.”

Let's examine why.

[Ahsan Memon @DrAhsanMemon]

Post COVID, I did Saturday clinics for 10 consecutive weeks to reduce NHS patient waiting list. After end of financial year, I received a bill of around £2800 by HMRC, saying I’ve worked more !
There should be perks not punishments if GOVT wants the NHS waiting list down.

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

TLDR: ACP courses are less rigorous with lower entry criteria than PA courses - yet claim ACPs are ST3 equivalent- when @lengreview said PAs were less than F1

Another anon on X doing the analysis that @gmcuk and Royal Colleges don’t want to address

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

Substitution of doctors with nurses and AHPs - badged as ST3 equivalent after a Masters and no exams - is a pillar of the NHS 10 year plan

It’s an experiment on the public by @NHSEngland without ethical approval or informed consent by @CMO_England

Are the Royal Colleges and @AoMRC complicit? They can’t say they haven’t been warned

[Omer @omersharif9]

@RheumatologyUK Hi, I have emailed as well. Please would you look at it? My membership record has disappeared altogether. I have not been able to access the journal either and contacted for that. Following that, my membership (subscription paid last month) record has disappeared.

[Omer @omersharif9]

@DrAsifQasim @RCPhysicians Congratulations:) So happy for you!

[Ahmad Farhad @AhmadFarhadReal]

یہ وہی نسل ہے جو کربلا میں امام حسین کو باغی کہہ کر یزید کی فتح کے شادیانے بجاتی تھی اور قتل کا جواز اور تاویلیں گھڑتی تھی۔یہ وہی خون ہے جو کل خاندان رسالت کے خلاف جھوٹی کہانیاں بناتا تھا اور آج غلامان آل محمد کے خلاف۔ان کی ولدیت کے خانے میں کل یزید بن معاویہ کا نام تھا اور آج ٹرمپ اور نیتن یاہو کا۔
نہ ان کی رسم نئی ہے نہ اپنی ریت نئی

[Furkan Ufuk @drfurkanufuk]

New paper out!

Radiologic patterns of ILD — a pictorial review aligned with the 2025 ERS/ATS classification.

Highlights CT features of key ILD entities and the updated framework for pattern recognition in clinical practice.

https://t.co/8dbKlVvHfF

[Iqrar Alee Ameer @IqrarAlee112]

On this day in Feb 2013, Dr Syed Ali Haider & his 12yo son Murtaza a Grade 7 student were brutally martyred in Lahore after attackers discovered his sectarian identity.
Dr. Ali was one of Pakistan’s leading eye surgeons & was counted among the top100 eye surgeons in the world.

[Omer @omersharif9]

@KDAO2011 For ESR in women it is Age+10 / 2. This looks a typing error.

[Ghassan Abu Sitta, Chair of Conflict Medicine AUB @GhassanAbuSitt1]

The General Medical Council has just informed my lawyers that they intend to appeal to the High Court against the decision of the Medical Practitioners Tribunal to clear me of misconduct charges that it had brought.
Under its current leadership, the GMC has been weaponised as a tool of political repression in the service of Israel’s genocidal project.
This will be the third legal action the GMC has brought against me, and I’m quite certain it is the result of political pressure from this Labour Government.

[Dr Sandeep Bansal @iDrSunny]

Frankly this sort of consultant has sadly helped enable the demise of the NHS

They may still not see it

But they have

[Milan Koštek @KostekMilan]

The best paper on how to correlate cardiac anatomy with ECG findings.
Kudos to all the authors.
https://t.co/utPHRn3N5N

[Rheuma Doc @LastManStand85]

The Differential diagnosis of the 4 Classic Monogenic Autoinflammatory syndromes, their specific Fever patterns 🌡️ and clinical features [Textbook of #Rheumatology, G.Firestein et al] #MedTwitter

[ILLIASUL IBAD @IlliasulK]

Tweet 13 (Final Takeaways)

📌 JAK-STAT is a key cytokine signaling pathway
📌 JAKs form specific heterodimeric pairs to mediate cytokine action
📌 JAK inhibitors have revolutionized autoimmune disease treatment
📌 Selectivity matters – balancing efficacy & safety is crucial!

🔁 Retweet & share with fellow immunologists & rheumatologists!

#JAKSTAT #Rheumatology #Autoimmune #JAKinhibitors #Sullysrounds

[Rheuma Doc @LastManStand85]

The risk of Osteonecrosis of the jaw and atypical fractures illustrated in the wider grand scheme of things. Put simply it’s rare! & you’re more likely to get run over in the street [in America] than get ONJ🦴😬🦷
[Prof Alex Comninos] #Osteoporosis #Rheumtology #MedTwitter

[Dr hanady manasfi @hanadymanasfi]

#Immunosuppressive medication management at the time of live-attenuated virus #vaccine administration

[Dr.Mukesh , MD , DM @dr_immuno29]

🔥 Scleromyositis – a distinct autoimmune entity!
•🧩 Not just an overlap – sits between systemic sclerosis (SSc) & autoimmune myositis (AIM).
•💪 Muscle weakness: proximal > distal, sometimes axial (→ head drop, camptocormia).
•🫁🫀 Extra-muscular hits: ILD (up to 68%), heart (arrhythmias, fibrosis), kidney crisis, GI & skin.
•🧪 Unique antibody profiles: anti-PM/Scl, anti-Ku, anti-U1RNP, anti-RuvBL1/2 🔑.
•🔎 Biopsy shows vasculopathy & fibrosis → hallmark clues.
•⚠️ Prognosis: worse than SSc alone; cardiopulmonary disease = top killer.
•💊 High CK → better steroid response; fibrosing myopathy = poor drug response.
•🚀 Push for new diagnostic criteria & targeted therapies!

DOI: 10.3389/fimmu.2022.974078

#Autoimmune #Scleromyositis #Myositis #SystemicSclerosis #Rheumatology #Immunology #MedTwitter

[Dr.Mukesh , MD , DM @dr_immuno29]

MMF+MTX Outshines CYC/AZA in Takayasu Arteritis RCT! 🚀
•111 adults with active TAK randomized 2:1 to MMF+MTX vs. CYC/AZA + glucocorticoids.
•Primary win: Overall response at 52 weeks higher with MMF+MTX (55.4%) vs. CYC/AZA (32.4%) – P=0.022!
•Better CR/PR rates at 28 & 52 weeks; fewer relapses (4 vs. 2 patients).
•CYC/AZA downsides: Higher relapse risk (16.7% at wk 52) & more side effects like bone marrow suppression (10.8%) and hair loss (8.1%).
•CYC concerns: Reproductive toxicity key issue for young women; only 32.4% response at both 28 & 52 wks.
•Safety edge: MMF+MTX well-tolerated, avoids CYC’s risks; only 1 serious AE (neutropenia/fever) in CYC/AZA.
•Verdict: MMF+MTX superior for remission – affordable, effective alternative!
#TakayasuArteritis #Vasculitis #Rheumatology #ClinicalTrial #MedTwitter
https://t.co/mLyIwL9aTi