Dr Mujahid

17/05/2026

Nature Reviews Neurology: This Review explores how reciprocal brain–heart interactions can cause dysfunction in one of these organs to adversely affect the other. The authors discuss clinical conditions, such as Takotsubo syndrome and stroke–heart syndrome, in which these interactions are particularly prominent and address s*x and gender differences in brain–heart interactions.

Link to the Review in the comments.

17/05/2026

Keep your blood pressure under control. 💙

🥗 Eat healthy meals
🏃 Stay physically active
🚭 Quit/avoid to***co
💊 Take medicines as prescribed
⚖️ Maintain a healthy body weight
👩🏾‍⚕️ Follow your doctor’s advice

When was the last time you checked your blood pressure? 🤔

17/05/2026

𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁 𝗼𝗳 𝗟𝗶𝘃𝗲𝗿 𝗔𝗯𝘀𝗰𝗲𝘀𝘀

Definition

Localized collection of pus within the liver caused by infection

Main Types

➤ Pyogenic liver abscess (bacterial) → most common
➤ Amoebic liver abscess → due to Entamoeba histolytica
➤ Fungal abscess → usually in immunocompromised patients

Investigations

Blood Tests

➤ FBC → leukocytosis
➤ CRP / ESR elevated
➤ LFTs → often raised ALP
➤ Blood cultures before antibiotics

Imaging

➤ Ultrasound abdomen → initial imaging
➤ CT abdomen → more sensitive and defines size/number

Microbiology

➤ Aspirate culture if drainage performed
➤ Amoebic serology if suspected

Core Management Principles

➤ Early antibiotics
➤ Drain abscess when indicated
➤ Treat underlying source
➤ Supportive care & sepsis management

Antibiotics

Empirical therapy should cover:
➤ Gram-negative organisms
➤ Anaerobes
➤ Streptococci

Common regimens:
➤ Piperacillin-tazobactam
OR
➤ Ceftriaxone + metronidazole

Adjust antibiotics according to cultures

Duration:
➤ Usually 2–6 weeks depending on response

Amoebic Liver Abscess

Treatment:
➤ Metronidazole is first-line

Then give luminal agent to eradicate cysts:
➤ Paromomycin or diloxanide furoate

Drainage usually NOT required unless:
➤ Large abscess
➤ Risk of rupture
➤ Poor response to therapy
➤ Diagnostic uncertainty

Drainage

Indications

➤ Large abscess (commonly >5 cm)
➤ Multiloculated abscess
➤ Failure of medical therapy
➤ Impending rupture
➤ Diagnostic uncertainty

Methods

➤ Percutaneous needle aspiration
➤ Percutaneous catheter drainage
➤ Surgical drainage → if percutaneous drainage fails

Supportive Management

➤ IV fluids
➤ Analgesia
➤ Monitor sepsis parameters
➤ Glycemic control in diabetics
➤ Nutritional support

Treat Underlying Cause

Examples:
➤ Cholangitis / biliary obstruction
➤ Appendicitis or diverticulitis
➤ Colorectal malignancy
➤ Portal vein infection source

Complications

➤ Sepsis / septic shock
➤ Rupture into peritoneum or pleura
➤ Empyema
➤ Peritonitis
➤ Multiple liver abscesses
➤ Death if untreated

17/05/2026

Uncontrolled hypertension can damage your heart, kidneys, eyes and more.

But high blood pressure can be prevented, detected and managed. 💙

Check your blood pressure regularly. Know your numbers today and take steps to protect your health.

17/05/2026

Stepwise Approach to Suspected Cushing Syndrome
---
1. Initial Screening (Confirm Hypercortisolism)

Any patient with clinical suspicion of Cushing’s syndrome should undergo one of the following first-line tests:

✔️ Overnight 1 mg Dexamethasone Suppression Test (DST)

Normal: Cortisol < 50 nmol/L

Failure of suppression → suggests Cushing’s syndrome

✔️ 24-hour Urinary Free Cortisol (UFC)

> 3× upper limit of normal → diagnostic of hypercortisolism

✔️ Late-night salivary cortisol (if available)

Loss of circadian rhythm supports diagnosis

➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖

2. Confirm ACTH Dependence

After confirming hypercortisolism → measure Plasma ACTH

Interpretation:

ACTH high/normal (>15 pg/mL) → ACTH-dependent Cushing

ACTH suppressed (

17/05/2026

Mucormycosis is associated with:

Poorly controlled diabetes
Diabetic ketoacidosis (DKA)
Immunosuppression
Steroid use
Iron overload

16/05/2026

Women with PCOS-related anovulatory infertility may achieve better live birth outcomes with Clomiphene Citrate + Metformin compared with metformin alone.

✅ Improved ovulation rates
✅ Higher clinical pregnancy rates
✅ Better live birth outcomes

📚 JCEM 2023, Vol. 108, No. 10

16/05/2026

⚠️ 𝗠𝘂𝗰𝗼𝗿𝗺𝘆𝗰𝗼𝘀𝗶𝘀 (“Black Fungus”)

Associated with:

➤ Poorly controlled diabetes
➤ Diabetic ketoacidosis (DKA)
➤ Immunosuppression
➤ Steroid use
➤ Iron overload

🚨 Early diagnosis saves lives.

16/05/2026

08/05/2026

Painful Raynaud’s is not “just vasospasm.”

A 29-year-old woman with:
• Puffy fingers
• Skin tightening
• Exertional breathlessness
• Anti-Scl-70 positivity
• Reduced DLCO + ILD pattern on HRCT

This is a classic systemic sclerosis spectrum presentation.

The real danger is often not the skin.
It’s the lungs and pulmonary vasculature.

Always screen early for:
• Interstitial lung disease (ILD)
• Pulmonary hypertension

Early recognition changes outcomes.

— Dr. Aravind Palraj