Shreya Bhat retweeted
Can't wait for our first ever FDA-approved drug for #Sjogrens! before end of year???? Before Convergence, Orlando?
In two trials involving patients with active Sjögren’s disease, decreases in disease activity at 48 weeks were greater with monthly ianalumab than with placebo, but differences in response rates and symptom scores were not significant. Full results of the phase 3 NEPTUNUS-1 and NEPTUNUS-2 trials: nej.md/3VU4TAp
Editorial: Ianalumab in Sjögren’s Disease — A First Step nej.md/4ivvs7E

ALT Two graphs from an Original Article published in the New England Journal of Medicine article titled “Ianalumab for the Treatment of Patients with Sjögren’s Disease.” The graphs show the change in ESSDAI score over time (full analysis population) for both trials, NEPTUNUS-1 and NEPTUNUS-2. The NEJM identity sits at the bottom.
Shreya Bhat retweeted
What is the optimal duration of antibiotics after ERCP decompression for cholangitis?
The #UEGWeek 2026 top abstract prize goes to Anouk Overdevest for her work on the COBRA trial, which shows that 1 day of antibiotic is non-inferior to 4-7 day courses 👏🏆
🤖 Made with AI
Shreya Bhat retweeted
🫀 CardioNugget™ |
PCE is OUT → PREVENT is IN!
The 2026 Dyslipidemia Guideline recommends AHA PREVENT-ASCVD instead of the Pooled Cohort Equations (PCE) for primary prevention risk assessment.
What changed? 👇
PCE → PREVENT
👤 Age: 40–79 → 30–79 years
⏳ Prediction: 10-year → 10 + 30-year risk
🌎 Race: Race-specific → Race-free
🫀 Focus: Traditional ASCVD factors → Cardio-Kidney-Metabolic health
PREVENT incorporates:
🔹 BMI
🔹 Kidney function (eGFR)
🔹 Lipid-lowering therapy
🔹 + optional HbA1c, UACR & social deprivation index
🧠 Remember: PREVENT =
Younger + Longer + CKM + Race-free
#CardioNuggets #PreventiveCardiology #ASCVD #Lipidology #PREVENT
Shreya Bhat retweeted
Underrated life advice: Keep proof that good things happen to you. Old photos. Kind messages. Positive feedback. Notes from great days. Whatever. Store them in a single place. Call it a Rainy Day Folder. Pop it open on a bad day and watch your mood turn. It's a free reset button.
Shreya Bhat retweeted
Nueva nomenclatura para los anticuerpos anti-Ro 🧬
Consenso internacional 🗺️ propone estandarizar su denominación
🔹 anti-Ro60 → anti-TROVE2/Ro60
🔹 anti-Ro52 → anti-TRIM21/Ro52
Acceso abierto 🔑 pubmed.ncbi.nlm.nih.gov/4213…
Shreya Bhat retweeted
من أجمل الخوارزميات العملية في إرشادات الجمعية الأوروبية لأمراض القلب ESC 2026👌
تختصر STAMP on CKD التعامل في 5 خطوات: الفحص بـ eGFR وuACR، تحديد الخطورة، العلاج الوقائي، تعديل علاج القلب، والمتابعة
والجدول الثاني يوضح العلاج الأنسب حسب وجود السكري والحالة القلبية وقوة التوصية
Shreya Bhat retweeted
He spent his life teaching surgeons how to repair the aorta.
Then, at 97, his own aorta began to tear.
On New Year’s Eve 2005, Michael DeBakey was alone in his Houston study when a tearing pain ripped through his chest and into his back. He knew instantly what it was: an acute aortic dissection — the catastrophic condition he had classified, studied, and taught others to treat for decades.
At 97, he first refused surgery. He understood the odds. But his condition worsened. On February 9, 2006, after an ethics-committee debate and with his family pressing forward, surgeons opened his chest. They replaced the damaged segment of his aorta with a Dacron graft — the same kind of synthetic vessel he had pioneered in the 1950s.
There was a quiet full-circle detail in that graft. DeBakey had learned to sew from his mother. When department-store nylon ran out, he bought Dacron instead and stitched the first experimental tubes on his wife’s sewing machine.
Decades later, that material helped save his own life.
The operation lasted about seven hours. He survived. After a long recovery he returned to work, lectured, and wrote. In April 2008 he received the Congressional Gold Medal. He died on July 11, 2008, at 99 — weeks short of his 100th birthday.
He studied the disease. He built the tools. He trained the surgeons. Then he became the patient. The man who gave other people more time was given a little more time himself — and spent it in the hands of the people he had taught. ❤️
🤖 Made with AI
Shreya Bhat retweeted
Acute Tubular Necrosis (ATN) vs Acute Interstitial Nephritis (AIN)
Both sit in the intrinsic box (kidney), both give you FENa above 2, and that's roughly where the similarity ends.
ATN is a dead tubule. Ischaemia or a toxin kills the cell, it peels off the basement membrane and floats down the nephron.
That's the whole reason you see muddy brown granular casts.
You're literally looking at the debris of the tubule that failed.
Casues: Sepsis, hypotension, contrast, aminoglycosides, rhabdo.
AIN is a drug allergy that happens to be occurring inside the kidney.
Nothing dies.
The interstitium fills up with T cells and eosinophils and the tubules get compressed by the crowd around them.
White cell casts, sterile pyuria.
Causes: NSAIDs, PPIs, beta lactams, rifampicin, allopurinol.
So the sediment usually tells you before anything else does.
Shreya Bhat retweeted
Hepatitis C used to mean cirrhosis, cancer, liver transplant.
Now it's 8–12 weeks of tablets and a cure rate over 95%.
Science did that.
Shreya Bhat retweeted
A 56-year-old man with palindromic rheumatism and high-titre RF positivity was started on hydroxychloroquine 300 mg/day with low-dose prednisolone. Crystal arthritis had been excluded by imaging and synovial-fluid analysis.
Five days later, he returned with unilateral tinnitus and ear fullness. Audiometry showed mild sensorineural hearing loss.
Was this HCQ ototoxicity and should HCQ be stopped immediately? 🧵
@docakx @IhabFathiSulima
Shreya Bhat retweeted
The FDA has approved brepocitinib (LISRAYA), the first oral therapy for adults with DM.
But what can we use in India until it becomes available?
1-Tofacitinib has the strongest off-label evidence, especially for refractory skin disease and anti-MDA5 DM-ILD
2-Upadacitinib has promising emerging data across skin, muscle and lung involvement
Practical alternatives, but not proven equivalents. Careful screening for TB, herpes zoster, CMV and other infections remains crucial. @docakx @IhabFathiSulima
Shreya Bhat retweeted
Whenever an elderly patient with dementia falls, the family becomes scared.
And rightly so.
The next instruction at home is often:
Ab inko akele chalne mat dena.
But sometimes I see the patient again after a month or two.
He has not fallen.
But he has also almost stopped walking.
Now he needs help to get up from the chair. His legs are weaker. His confidence is gone. The family has to hold him even for a few steps.
We prevented the fall, but somewhere we also reduced his mobility.
This is why after a fall in dementia, I first try to find what changed.
Any new sleeping tablet?
BP falling on standing?
Vision poor?
Walking becoming slower or unsteady?
Difficulty reaching the toilet?
Wrong footwear?
Poor lighting at night?
Or was it really a fall, or did he briefly lose consciousness?
Correct whatever can be corrected.
Give supervision where it is needed.
Strengthen the legs. Make the house safer. Use the right walking aid if required.
But don't stop walking simply because walking carries some risk.
In dementia care, complete safety is rarely possible.
The aim is to keep the person safe enough to continue living.
A fall can take away independence.
Sometimes our fear of the next fall can do the same thing.
Don't just prevent the next fall.
Try to preserve the next walk. #NeuroX #MedX #Falls #Dementia
Shreya Bhat retweeted
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.
Mucor are particularly fast growing, however during the process of tissue homogenisation, the broad aseptate hyphae get disrupted, so the viable fungal elements may be lost, hence culture sensitivity drops. (Not because they don't grow fast)
Interesting concept. ✨ #Med
ICU Stories:
An 80 yo woman is about to go home when she suddenly develops profound shock
SBP: 40s–50s mmHg
Cold. Clammy. Diaphoretic. Weak
The ECG is interpreted as:
“Anterolateral and septal infarct”
iv fluids + norepinephrine aren't working...
What would you do next?
Shreya Bhat retweeted
You are consulted for a 30 yr old male patient with high INR , planned for a biopsy of liver for suspected liver lesions. Current INR is 2 and radiology wants an INR or <1.5 . You prescribe FFPs to correct INR and proceed for biopsy, however......
The no of H1N1 cases I've seen in the past 2 weeks especially among the elderly with extreme variability in severity of symptoms, most of them landing in ICU, sickest of the sick with other comorbidities, dying. Disheartening during counselling.
#Med























