prasad

doctor 👨‍⚕️

[Simon Maechling @simonmaechling]

Ciprofloxacin didn’t come from nature.

It came from relentless iteration and one critical question: What happens if we change just one atom?

In the 1960s, we had early quinolone antibiotics.

They worked… but barely:
Narrow spectrum.
Weak penetration.
Easy resistance.

Good start. Not good enough.

At Bayer, chemists led by Klaus Grohe got to work.

Not guessing.
Testing.

This is medicinal chemistry.
Change the molecule →
Test on bacteria →
Measure →
Repeat →

Again.
Again.
Again.

Hundreds of times.

Then came the breakthrough:
Add a fluorine atom.
One tiny modification.

That single atom:
Increased bacterial penetration.
Strengthened enzyme binding.
Expanded the spectrum.

A new class was born: fluoroquinolones.

But they didn’t stop there.

They optimized the molecule further:
Added a piperazine group.

Now it wasn’t just active - it was clinically powerful.

Out of hundreds of candidates, one stood out:

Ciprofloxacin

Potent.
Balanced.
Usable in real patients.

And here’s the part people miss:

This molecule doesn’t just treat infections.

It helps stop outbreaks - including those leading to Meningitis.

One dose.

Interrupt transmission.
Protect the group.

From lab bench → to public health tool.

No miracle.
No magic.

Just: Data. Chemistry. Persistence.

We didn’t get here by “going natural.”

We got here by asking:
What if we make it better?

[prasad @prasadpendker2]

@NicoGagelmann @MedTweetorials @BrownHospMed @DrGauravNarula @Sthanu5 @AbbasiMuqtadir @nihardesai7 @AvrahamCooperMD @DrCindyCooper Tof

[prasad @prasadpendker2]

@DrTejaswini07 suspicious isn't it 🧐

[Afaq Nawaz 🇵🇰 @sociophobic21]

Texted a lawyer friend (school friend) for some legal advice and he said his charges are 11k, but he'll only take 5k from me.
So much to learn from these people. So many of us have been giving medical advice absolutely free of cost to friends/family/acquaintances.

[Sam Ghali, M.D. @EM_RESUS]

Watch this AMAZING video of a brain aneurysm getting clipped

This is why they call them “berry” aneurysms!

Courtesy: @JasonEllis_MD
#MedTwitter #FOAMed

[Slava Bobrov @slava__bobrov]

Bacteria exploding due to exposure to penicillin:

#biology by Bernhardt Lab

[XRP Ledger Announces @XRPL__A]

Clinical oddity; A mountain of a clot! A young post partum 👩‍🦰 20 days after LSCS with worsening headache and quadriparesis. MRI- right > left hemispheric edema. MRA- shows complete occlusion of the SSS and TS

[Abhishek @absk_yadav]

A patient 30 year old came with alleged history of foreign body ingestion.
What came next was quite a surprise for us.
On history pt said he has ingested arround 15 coins..
So endoscopy removal in the presence of anaesthetist was planned.
Upper GI done ✅
👇

[Dr Rajath Athreya @DrRajathAthreya]

#monkeypox
1. Simply put, a milder version of smallpox, caused by a virus of the same family
2. Was endemic (low level regular occurrence) in some African countries, we now have a global spread but no known epidemiological source
3. Self limiting illness with low CFR (3-6%)

[XRP Ledger Announces @XRPL__A]

Clinical pearl; Unilateral asterixis is almost always associated with a structural contralateral cerebral or an ipsilateral cerebellar pathology. Bilateral asterixis is metabolic/toxic in origin.

[PharmaFactz @PharmaFactz]

🍬HbA1c in Diabetes Diagnosis

✅Normal

👉< 42 mmol/mol (< 6.0%)

⚠️Prediabetes

👉42 - 47 mmol/mol (6.0% - 6.4%)

🚫Diabetes

👉> 48 mmol/mol (> 6.5%)

[PharmaFactz @PharmaFactz]

⚠️Phenytoin can induce vitamin D metabolism and so can cause osteomalacia.

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

This hierarchical phase CT literally zooms into the brain 🤯

#MedTwitter

[prasad @prasadpendker2]

@Shivam_1331 Yeah transitional cell carcinoma

[prasad @prasadpendker2]

Prostaglandin inhibitors - ibuprofen

[@X @MoreXGrok]

Sign?

Image: Radiopedia

[Josh Trebach, MD @jtrebach]

politicians proteinuria,
saying things edema, and
need to change hyperlipidemia
🤝
minimal change

[@X @MoreXGrok]

72-year-old man
♦️
unstable angina
♦️
urgent cardiac catheterization
♦️
significant disease in the right coronary artery, which was stented.
♦️
Twelve hours later👇

[Devpriyo Pal @drdevrad]

In third year MBBS, I had low back pain and so I convinced myself I had Ankylosis Spondylitis. It took blood tests, X-rays, MRIs & two VERY irritated ortho guys to finally convince me I was overweight w bad posture.
What was/is your worst third year syndrome story?
#Medtwitter