AUGUSTINE SSEBALU, MD

official account, Alumnus of MUST

[Dr. Nikhil Agrawal @DrNikhilMD]

Pulmonary embolism management just changed dramatically.

The new 2026 AHA/ACC Multisociety PE Guideline introduces:
• A completely new PE classification system
• Stronger role for PERT teams
• More clarity on thrombectomy/thrombolysis
• Early discharge for selected patients
• Long term follow up recommendations

This is probably the biggest PE guideline shift in years.

[Dr RP Singh, MD @rpsingh1894]

🧠 HOW TO READ A BRAIN MRI — EASY STEPWISE GUIDE FOR BEGINNERS

Many students and junior doctors feel brain MRI is difficult.
The key is simple:

👉 Follow the SAME ORDER every time.

Here’s an easy systematic approach 👇

━━━━━━━━━━━━━━━

1️⃣ DWI = Diffusion Weighted Imaging

📌 Best sequence for detecting:
✅ Acute ischemic stroke

Look for:
🔹 Bright (white) areas

Then ALWAYS confirm on:

➡️ ADC = Apparent Diffusion Coefficient map

✔ Bright on DWI + dark on ADC = TRUE restricted diffusion = acute infarction

⚠ Sometimes lesions only look bright because of “T2 shine-through”.

━━━━━━━━━━━━━━━

2️⃣ FLAIR = Fluid Attenuated Inversion Recovery

📌 Best for:
✅ Edema
✅ White matter disease
✅ Multiple sclerosis
✅ Encephalitis
✅ Meningitis
✅ Gliosis

Look carefully at:
🔹 Brain tissue
🔹 Sulci
🔹 Periventricular regions

💡 CSF (cerebrospinal fluid) becomes dark on FLAIR, making pathology easier to see.

━━━━━━━━━━━━━━━

3️⃣ T2WI = T2 Weighted Imaging

📌 “Water is WHITE on T2”

Best for:
✅ Edema
✅ Tumors
✅ Infection
✅ Hydrocephalus

Check:
🔹 Ventricles
🔹 Midline shift
🔹 Flow voids
🔹 Sinuses
🔹 Mastoid air cells

━━━━━━━━━━━━━━━

4️⃣ T1WI = T1 Weighted Imaging

📌 “Fat is BRIGHT on T1”

Best for anatomy.

Look for:
✅ Fat
✅ Subacute hemorrhage
✅ Melanin
✅ Protein-rich lesions
✅ Bone marrow abnormalities

T1 helps understand NORMAL anatomy clearly.

━━━━━━━━━━━━━━━

5️⃣ SWI = Susceptibility Weighted Imaging
or
T2* GRE = Gradient Echo

📌 Best for detecting BLOOD products.

Look for:
✅ Microbleeds
✅ Hemosiderin
✅ Calcification
✅ Diffuse axonal injury
✅ Cavernoma

💡 Blood products usually appear DARK here.

━━━━���━━━━━━━━━━

6️⃣ Sagittal Images

Never skip midline structures.

Check:
✅ Corpus callosum
✅ Pituitary gland
✅ Brainstem
✅ Cerebellar tonsils
✅ Cervicomedullary junction

━━━━━━━━━━━━━━━

7️⃣ MRA = Magnetic Resonance Angiography

Used to assess BLOOD VESSELS.

Look for:
✅ Aneurysm
✅ Arterial stenosis
✅ Occlusion
✅ Arteriovenous malformation (AVM)

⚠ Don’t rely only on reconstructed images (MIP = Maximum Intensity Projection).
Always review source images too.

━━━━━━━━━━━━━━━

🩺 GOLDEN RULE:
Follow the SAME SEARCH PATTERN every single time.

This reduces missed diagnoses and improves confidence dramatically.

#BrainMRI #Radiology #Neuroradiology #MedTwitter #FOAMed #Me

[𝗝𝗮𝗺𝗲𝘀 𝗘¹ @iam_jamesE1]

It's kaawa man😂

[AUGUSTINE SSEBALU, MD @sebaAugustine]

@UOXUganda @AugustineErima

[Elorm Daniel @elormkdaniel]

For those of you who don’t know, VLC also allows you to watch 150–300 live sports channels plus over 1,800 free TV channels worldwide

Here’s how (using safe and public links only):

Install VLC (Free)
Windows / Mac / Linux: videolan .org
Android / iOS: Search VLC in your store

Get a public playlist
Sports-only: https://t.co/ABAhZgOv2O
Full TV (News, Movies, Kids, Music): https://t.co/JvWFFSE7ik

Open VLC → Network Stream → Paste URL → Play
Use Playlist view to switch channels
Some streams take a few seconds, VPN may be needed for geo-blocked content

Channels are public & community-maintained and availability can change.

Enjoy free TV & sports safely

cc: Rollandex

[Robert Kalyesubula,MD, FISN(USA), PhD-FRCP(London) @rkalyes1]

🔥 Yesterday I just buried my nephew of 25 years. He died from Lupus Nephritis - a rare kidney disease in men.
Our family is devastated by this loss!
Some members believe he was bewitched. I didn't help much because the whole village had never heard of Lupus -no local name for it

[Simple Shamim. @simple_shamim]

For those who know these pants you know . Others Blessed new week ahead . 🙏

[パラノーマルちゃんねる @paranormal_2ch]

天才は3秒で気づくらしい https://t.co/F9nqqGDNPU

[Dr Joshua Walinjom @walinjom]

Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction:

Conclusions =

Treatment with digitoxin led to a lower combined risk of death from any cause or hospital admission for worsening heart failure
than
placebo among patients with heart failure and reduced ejection fraction who received guideline-directed medical therapy.

https://t.co/b6WjshlXJA

#Cardiology
#cardiotwitter
#MedTwitter

[Manifest_Lord @Manifest_Lord]

5 photos rich people don't want you to see

[ILLIASUL IBAD @IlliasulK]

What if saving a pneumonia patient was as simple as adding one cheap pill?

A new NEJM RCT from Kenya just showed exactly that. 👇

2,180 adults with community-acquired pneumonia were randomized within 48 hrs to:

🅰️ Standard Care (WHO regimen)

β-lactam (penicillin/cephalosporin) + macrolide (erythro/azithro)

🅱️ Standard Care + 10 days of low-dose steroids

Dexamethasone 6 mg or
Hydrocortisone 160 mg or
Methylpred 30 mg or
Prednisolone 50 mg or
Prednisone 50 mg (bioequivalent dosages)

30-day mortality:

22.6% with steroids vs 26.0% with standard care

➡️ HR 0.84 (95% CI 0.73–0.97), P = 0.02

Adverse events similar. Steroid-related serious AEs: 0.5%.

💡 One low-dose steroid… in hospitals with almost no ICU support… saved lives.
Global pneumonia care may never be the same.

#NEJM #Pneumonia #RCT #GlobalHealth #MedTwitter #EvidenceBasedMedicine #InternalMedicine #CriticalCare #IDTwitter @DrAkhilX @IhabFathiSulima @CelestinoGutirr @Urchilla01 @drkeithsiau

[komugisha Peace @KomugishaPeace]

When we tell you to marry in your own tribes you say we are tribalistic😂😂 now ue making your fathers walk like cows😂�

[Henry Eziefule Nwankwo @Dr_NHenryE]

You can upload your undergraduate thesis as a grey literature on sites like Zenodo, and then obtain a url and DOI.
You can list this as part of your publications for applications that are not strict about listing only peer reviewed articles.

You are welcome 🙏

[JAMA Neurology @JAMANeuro]

Viewpoint: The updated 2024 McDonald criteria enable MS diagnosis in asymptomatic individuals by incorporating imaging and CSF biomarkers, such as CVS and κ-FLC index, while promoting a single standardized framework. https://t.co/7xElt5zqIp

[Xabi Alonso @XabiAlonso]

Lived it. Loved it.

Farewell beautiful game.

[Siim Land @siimland]

Neurotransmitter cheat sheet🧠:
- Acetylcholine: attention, memory
- Dopamine: salience, motivation
- Glutamate: excitement, learning, memory
- Serotonin: calmness, mood
- Norepinephrine: arousal, vigilance, stress
- GABA: relaxation, inhibition
- Glycine: inhibition, sensory processing
- Histamine: wakefulness, excitement
- Endorphins: pain relief, mood
- Neuropeptide Y: food intake, stress

[Manual Of Medicine @ManualOMedicine]

Dysphagia - Causes

#medtwitter #foamed #usmle

[Phiona Kyeru @kyeruphiona]

When we say 900k
We mean this 😎
8th Gen
Intel core i5
8GB RAM
256 GB SSD

[Ndagije Richard II.0👑 @ndagijerichie]

We celebrate Zohran Mamdani’s win with his tune 'Kanda' from 10 years ago.

Uganda stand up!🇺🇬