It is a common misconception that the plantar response is THE sign of UMN pathology. The plantar is a polysynaptic reflex and a flexor response requires an intact corticospinal tract. But you can easily have significant UMN pathology without a plantar response. Secondly,

🧵 “ANA Positive ≠ Lupus: The Art of Interpreting Autoantibodies” ANA positivity is one of the most misunderstood findings in medicine. Here’s how to approach an ANA report systematically, clinically, and with confidence. 👇 #Rheumatology #ANA #Autoimmunity #MedEd Dr. Akhil 🇮🇳

🧵 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 👇 Dr. Akhil 🇮🇳 Dr Ihab Suliman

Clinical Rheumatology Thread for Busy GPs: Post 1 Early inflammatory arthritis(IA): the 3–3–3 rule •Onset ≤3 months •Morning stiffness ≥30–60 minutes •≥3 swollen joints (MCP/MTP common) If present, manage as IA: urgent rheum referral; NSAIDs if no contraindications.

The gut-brain axis is a bidirectional communication network between the gastrointestinal tract and the central nervous system. This dynamic system integrates neural, endocrine, immune, and metabolic signals, many of which are modulated by the gut microbiota. 🧠 1. Neural Pathway

🧵 Management of Scleroderma (Systemic Sclerosis) – 2025 Update 1/ Scleroderma (Systemic Sclerosis, SSc) is a chronic autoimmune connective tissue disease with fibrosis, vasculopathy, and autoimmunity at its core. Management is organ-specific and evolving with new evidence.

🧵Thread: Why Some Diseases Vanish in Pregnancy? Tweet 1 (Hook): Some diseases magically improve in pregnancy (like Rheumatoid Arthritis)… Others worsen (like Lupus). It’s one of the strangest puzzles of the immune system. Here’s the fascinating story 🧵👇 Dr. Akhil 🇮🇳

If you lack purpose, watch this:

Hard truth Very few people understand HINTS. #MedTwitter #NeuroTwitter

😬 Not quite. The reality: “If we repeated the trial indefinitely, and each time computed a 95% confidence interval in the same way, then 95% of those *varying* intervals would contain the true effect”

The things they don’t teach you at Harvard ⁦Alok Jain ⚡⁩

📝 The 2025 EULAR update on lupus nephritis management is out! ✅ 4 overarching principles ✅ 13 recommendations for clinical practice 🔗 ard.eular.org/article/S0003-…

🧴 Tight skin, salt-and-pepper pigmentation, and tapering fingers? These are classic skin clues to Systemic Sclerosis (SSc) — and the mnemonic “SCLERODERMA” helps you remember them all. 👇 See the full infographic to master it. #SystemicSclerosis #Rheumatology #DermRheum #MedEd

🚨EULAR recommendations for the management of SLE with kidney involvement: 2025 update ⏩Early biopsy - multidisciplinary care ⏩GC taper target: ≤5 mg/day by 4–6 months ⏩Mycophenolate or low-dose CYC + Belimumab or Voclosporin or Obinutuzumab ard.eular.org/article/S0003-…

🧵 Enteric (Typhoid) Fever — A Complete Clinical Update for Indian Doctors Still one of the biggest public health challenges in India. Let’s break down what every clinician should know — from pathogenesis to vaccination.

😀🇦🇹 multisociety (gastroenterology & hepatology, diabetology & obesity) consensus on MASLD (& MetALD!) 🤝Well-aligned with EASLnews CPGs 😟Reimbursement currently restricted to semaglutide for T2DM 🤔Reimbursement in our country? 🖇️: rdcu.be/eLAde #LiverTwitter

💡 2025 EULAR Lupus Nephritis Updates – Key Changes 1️⃣ Steroid Minimization 💊 • Strong emphasis on low-dose, short-taper corticosteroid regimens during induction to reduce toxicity. 2️⃣ Targeted / Novel Therapies 🧬 • Voclosporin added for induction with MMF in active LN. •

👇🏻✨ bit.ly/4njE0hq

⚡EULAR 2025 Update: Lupus Nephritis (SLE Kidney Involvement) 1️⃣ New Structure: 4 principles + 13 recommendations (evidence-graded). 2️⃣ Core Approach: 🔹 Early biopsy, expert care, & HCQ for all. 🔹 Rheumatology–nephrology team care. 🔹 Aim: prevent CKD, reduce flares, improve

🔹 Lupus Nephritis updates - 2025 snapshot: 1️⃣ MPAA now preferred over CYC for induction 2️⃣ Add BEL to MPAA for higher remission & fewer flares 3️⃣ Voclosporin joins CNIs as an approved option 4️⃣ Focus on steroid-sparing regimens 5️⃣ Taper steroids ≤5 mg/day by 6 months 6️⃣