Dr Avinash S A
@AAlashetty
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MD(int.medicine) DM (Neurology), Neurologist,
Karnataka, India
Joined July 2009
You haven't seen poverty unless you've worked as a resident doctor in a government hospital in India 🙏🏽
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Optical Coherence Tomography (OCT) is slowly entering rheumatology - not as a guideline tool yet, but as an exciting research adjunct. From subclinical synovial changes to SSc skin imaging and psoriatic nail microstructure, OCT is opening new windows into disease biology. Here’s
👁️ OCT in Rheumatology: A Quick Clinical Primer Optical Coherence Tomography (OCT) is a noninvasive, high-resolution retinal imaging tool that has become essential in rheumatology. Here’s how OCT helps detect rheumatologic eye disease early: 👇 #Rheumatology #Ophthalmology
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Here are 4 dangerous interactions every rheumatology clinician should avoid: • MTX + TMP-SMX → severe marrow suppression • NSAIDs + steroids → GI bleed • Allopurinol + AZA/6-MP → myelotoxicity • Biologics + live vaccines → disseminated infection Safety is also treatment.
🧵 Drug Combinations That Can Kill — Interactions You Must Never Miss We prescribe these daily. Get the combination wrong → bleeding, rhabdomyolysis, bone marrow suppression, cardiac arrest. Here are the 10 combinations you must always check for 👇 @DrAkhilX @IhabFathiSulima
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My latest: The ICH Checklist! This is a nifty 7-point ABCDEFG checklist to guide all of the essential steps in managing your acute #ICH patients, from BP control, emergency reversal, to evaluation for surgery. A ANTICOAGULATION REVERSAL Complete anticoagulation reversal
link.springer.com
Journal of Neurology -
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🚨 New alert for #axSpA! The ASAS-SPARTAN criteria posted a sensitivity ~79.5 % and specificity ~90.4 % in the CLASSIC cohort. 💥 Imaging now weighted highest (MRI = 8 pts / Radiographic SIJ = 7 pts) plus HLA-B27, inflammatory back pain, IBD, uveitis, heel enthesitis,
🧵 “Axial Spondyloarthritis: 10 Updated Guideline Pearls (ASAS–EULAR 2022–2023)” Treatment keeps evolving—here are the most important evidence-based recommendations 👇 #Rheumatology #MedTwitter #ClinicalPearls #Spondyloarthritis @IhabFathiSulima
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Just off the hot plate: CREST-2 quietly reshapes carotid practice. Stent = benefit. CEA = no clear win. Medical therapy = impressively effective. The real question now: Are we intervening on the right patients? #NeuroCommunity #EvidenceBased
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Small Fibre Neuropathy is easy to miss in Rheumatology. Burning feet, dysautonomia, normal NCS — and the cause is often autoimmune. 🧩 Sjögren’s 🧩 SLE 🧩 RA 🧩 Sarcoidosis 🧩 Vasculitis 🧩 Post-COVID immune dysregulation If symptoms don’t match the NCS, think small fibres.
Small fibre neuropathy is easy to miss because routine NCS is normal — but the symptoms are often unmistakable. Here are the key rheumatology-related clues every clinician should know. Infographic below 👇 #MedTwitter #Rheumatology #Neurology @DrAkhilX @IhabFathiSulima
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A Will doesn't need to be registered but registration strengthens it. Sometimes it needs probate. Eg: If you have property in Mumbai/Chennai/Kolkata. Story by @BhushanOnX. We at @thefynprint help with Will creation + registration. Reply Will or reach us: https://t.co/3no45rE0zO
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1 in 3 dementia patients will have emotional lability. Almost all will be mislabelled as agitated. Let’s stop that diagnostic blindness today. #neurotwitter #Medtwitter #Dementia #emotionallability
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Absolutely cracking article on peripheral neuropathy AKA polyneuropathy. One to save & return too. A related podcast too.
Peripheral neuropathy, defined as damage to the peripheral nerves, affects approximately 1% of adults worldwide. This Review summarizes the pathophysiology, clinical presentation, diagnosis, and treatment of length-dependent peripheral neuropathy. 🧵 https://t.co/tgk8h7SdEL
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The difference between a good examination and an exceptional one is often found in the details. Beyond the Babinski and Pronator Drift, there are deeper, more sensitive markers of pathology that deserve our attention. 7 lesser-known neurological signs for the modern clinician.
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Peripheral neuropathy, defined as damage to the peripheral nerves, affects approximately 1% of adults worldwide. This Review summarizes the pathophysiology, clinical presentation, diagnosis, and treatment of length-dependent peripheral neuropathy. 🧵 https://t.co/tgk8h7SdEL
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For MCA stroke, time is not only brain in the emergency room. Time is also brain in rehab. 0–3 months = gold, 3–12 months = silver, >12 months = still not zero. Map the phases, sharpen your therapy. Lets understand how it improves #neurotwitter #Medtwitter #Stroke
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Stop Relying on “Serum Iron” Alone; It Often Misleads. Here's What Truly Matters ▶️Most people (and many lab panels) still focus on serum iron to assess iron deficiency. But here is the truth: 🚫 Serum iron is unreliable. ▶️It fluctuates through the day, varies with food
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Want to transfer your shares from one broker to another? It’s easier than you think in 2025 Here’s a simple step-by-step guide using CDSL Easiest 🧵👇
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🧠 Autoimmune Encephalitis — Recognize the Red Flags Subacute confusion, seizures, or psychiatric symptoms may signal an immune-mediated process. Early MRI and antibody testing are critical for diagnosis and outcome. #NeuroImmunology #MedTwitter #RheumRounds @IhabFathiSulima
4/ 🧠 Seizures + psychosis → Could be neuro-Behçet’s, CNS vasculitis, viral encephalitis 📌 MRI + CSF + APLA panel + infection screen essential
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Stopping Blood Thinners Before Surgery? Most people STILL get it wrong. Here’s the cleanest peri-op cheat-sheet you’ll read today 👇 1️⃣ VKA (Warfarin / Acenocoumarol) • Stop 5 days before • Bridge only if very high thrombotic risk • Restart: Day +1 (low-bleed) or Day +2
Pre-surgery blood thinner cheat sheet (made simple): •Warfarin → Stop 3–5 days before; bridge if needed; restart 24–72 h after •DOACs (Apixaban/Rivaroxaban/Dabigatran) → Stop 1–2 days before (earlier if renal disease); restart 24–48 h after •Aspirin → Usually continued
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Pre-surgery blood thinner cheat sheet (made simple): •Warfarin → Stop 3–5 days before; bridge if needed; restart 24–72 h after •DOACs (Apixaban/Rivaroxaban/Dabigatran) → Stop 1–2 days before (earlier if renal disease); restart 24–48 h after •Aspirin → Usually continued
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