Jay Savla
@JaySavla15
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PGY - 2 MD General Medicine @SJHDELHI MBBS-GSMC KEMH | SportsEnthusiast | PADI Certified Scuba Diver | Fide Rated Chess player | Black Belt 🥋 | Skating |
New Delhi, India
Joined November 2019
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Pinned Tweet
What an emergency day today! So many cases! Medicine at its very best💯
Here is the case which made it even more special!
So a 19/M brought with c/o altered sensorium since 3 hrs by his friends.
They left as soon as the mother arrived and hence there was no proper history. 1/
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To be bullied is one of the worst thing, one can ever experience.
To be told that you didn't do any work, when after 36hrs, when every inch of your body is paining, is the worst insult you can bear.
To be told to always say yes to the seniors despite whatever..
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114
811
It is 8pm in the night. This is the
queue for tomorrow's limited offline registrations for OPD
@aiims_newdelhi
. These relatives/patients will stand in the queue the entire night until the counters open in the morning.
Have heard it before, witnessed first time.
#MedTwitter
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616
This is Medicine in India especially in Post Graduation. My tweet is nothing but a plea to anyone who might become senior some day. Don't do it please, even if it happened with you !
Someone somewhere has to break the chain. It is very easy to bully. That is the worst part.
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Patient suddenly collapsed.
What is that one thing which we can't miss and not treat?
As emphasized by
@EM_RESUS
many times!
#MedTwitter
#CardioTwitter
#emergencymedicine
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PG life lessons
#1
In these 50days, the one thing i have learnt and which, i would like to share.
Everyone likes to work with happy, enthusiastic and polite people. No matter how harsh your life is, no matter how tired you are. If you do your work with a smile on your face,
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Starting internship? Aiming to get a decent rank in NEET PG/NEXT 2023?
Congratulations on passing one of the toughest exams i have ever given in my life.
Keep one thing in mind - the movie begins now!
The internship/1st attempt is usually the best attempt!
A thread 1/n
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@ankit9doshi
@varungrover
I am currently working in the Emergency Medical Services of the KEM Hospital as a intern. I can fully understand what your friend has gone through. Have seen it day in and out.
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Hope he makes good use of his second life🤞
We try our best always, fail so many times, but on days like these it is all worth it! All these years of hardwork, sacrifices, everything is worth it! There is no greater joy than the joy of saving a life!
#MedTwitter
6/6
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Fed up of listening to senior doctors continuously saying that the new doctors and students of today are worse than ever.
I can vouch for a lot of things..
A thread - 1/n
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Janeway Lesions🤯 and Splinter Hemorrhages in a case of TOF with Fever.
#MedTwitter
#CardioTwitter
#clinicalmedicine
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PG life lesson
#2
1. The senior PGs, SRs and consultants are always right.
2. In the event of any of them being wrong, refer to point number 1.
3. The best answer is always - yes sir and sorry sir🙏
#MedTwitter
#medicine
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With AIQ R1 done and majority state rounds also done, many doctors across India will join their residency on 20th October. These are the lessons i learnt after 8months of PG 1 and some mistakes i made, which you shouldn't!
1/n
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1st Bone Marrow Aspiration and Biopsy🦴✅
Thank you Chiranth sir for your guidance!
#MedTwitter
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Neurology has always been exciting and stimulating since UG!
Especially Stroke Localisation!
50/F
Sudden onset transient LOC
Followed by
Difficulty in balancing
Binocular Diplopia
Known diabetic since 15yrs - often uncontrolled
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PG life lesson
#3
Treat every patient with dignity, politeness and with confidence. Be firm but gentle.
In these long OPDs and longer ward shifts the last thing you want is to waste energy by screaming or getting frustrated!
Use that energy instead to do your work faster!
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@sardesairajdeep
vs
@rahulkanwal
is always a delight to watch!!
And today's
@sardesairajdeep
post 9pm show was another level of debating!!! Superb!! Very insightful!!
News without noise!!!
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All
#NEETPG2022
aspirants! 75days to go! Here is one thing I want to share.
One month into this hectic residency, i have never felt more satisfied and content with what I am doing.
Once you get into the your dream branch and into a good college, trust me it is like meditation.
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I have been blessed to have great teachers during my MBBS days and this line from one of the greatest has stayed with me since, told during the lecture on DKA,
@drsushantshinde
@Quest_Medicine
had emphasised "Acidosis can Kill"
A thread 1/n
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Known case of Hypothyroidism controlled on 150microgram Levothyroxine, decides to take Homeopathic Medicines as she is promised a cure within 3months.
Comes due to weakness, decreased blood pressure & cold extremities with these reports👇
#Ayush
Nice alcohol content 👌
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Finally after such a long wait, it's
#internalmedicine
at
#VMMC
and
@SJHDELHI
!
So grateful to everyone who has been part of this journey!
Can't wait to start this new exciting chapter of my life :)
#neetpgcounselling
#neetpg2021
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105 new admissions this emergency. Quite a few interesting cases for the upcoming week 🙂
PG 1 is tough but i have never felt more satisfied in life 😇
#generalmedicine
#residency
#MedTwitter
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Had an interesting case recently which left me with a lot of things to ponder on!
A 50yr old Male, brother of a sanitary worker of our ward, a worker himself visited the OPD with complaints of increased fatigue & shortness of breath even with mild exertion since a month.
1/N
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Saw patients for 13hrs in the OPD and Emergency with a half hour lunch break
@SJHDELHI
.Notable ones were :
SLE
Hyperthyroidism
Cor Pulmonale
Silicosis
Ca Lung with Brain Mets
MS ( RHD )
Lung Abscess
Liver Abscess
VUR causing CKD
Pancytopenia with HSM
Pneumothorax
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Thank you Sergeant Major🤝
1st Central Venous Catheterization in the Right IJV ✔️
#medicine
#residency
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After doctors had told him that he will require b/l amputation upto the wrist joint, this man went home and decided to cut off the tips of his own fingers. Has been totally fine since.
Whenever I feel done and want to give up, i will look at this picture.
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What a nice end to a tiring day, some experience that was!
50/M pt complaining of palpitations
ECG - Classical PSVT
Conscious oriented, vitally stable!
Inj. Adenosine 6mg rapidly f/b NS bolus!
And then we see the magic😍
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JVP is one of the most important part of the general examination. It tells you a lot about the patient. Also it is always stressed upon by senior physicians !
And yet, it is elusive, if not checked properly!
A thread 1/n
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2 conditions which present with Hypertension, Hypokalemia and Hypoaldosteronism.
One is responsive to Amiloride & not to Spironolactone and the other is responsive to Spironolactone.
Identify 1 and 2.
#MedTwitter
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Guide to crack apart Final MBBS
Why?
The most crucial year - both in terms of theory and practical.
The quantity and quality of knowledge you assimilate in final year, and the time you spend bedside in the wards will decide how good a clinician you will become. 1/n
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The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.”
- Sir William Osler
I don't know if I ever dreamt any of this.
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It is sad that 'The Consumption Disease' is still consuming humans☹️
Nothing but bones left...
#Tuberculosis
#MedTwitter
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The biggest limiting factor in giving good quality care to the thousands of patients that come to
@SJHDELHI
is Radiology.
This is waiting time for a CE MRI Brain, for a patient who is admitted in the ward. More than 175days for a 15 min investigation.
@mansukhmandviya
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Many sincere FMG externs have worked with us this year
@SJHDELHI
and it pains me to see the way our government is treating them. Not only because it is totally unfair but also the fact that these students have already cleared FMGE (which isn't a cakewalk) 1/2
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Happy Diwali from Ward 11
@SJHDELHI
@RDA_SJH
, have a safe and a prosperous year ahead everyone😃
Remember that when the entire country celebrates many like us will be on our toes far away from family, a special thank you to all such people out there🙏
#HappyDiwali
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Tonight let me tell you, how a patient is referred in Delhi and why does
@SJHDELHI
Medicine wards end up having 100+ admissions every emergency.
So this patient a k/c/o Ischemic Cardiomyopathy and with a history of Koch's in 2018 has had fever, cough with expectoration
1/
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30/M with chronic progressive weakness of b/l hands and clawing. Most common cause in India?
#MedTwitter
#ClinicalPearl
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All the resources, i used to do well in
#NEETPG2021
& develop good clinical skills expected out of a MBBS graduate. Obviously the most important role has been of GSMC and the sea of patients that come there everyday. They are the best teachers. For NEET though here it is..1/
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Reservation is a complex issue and since listening and reading a lot on this topic, my earlier one sided partial view has given way to a more accommodating opinion but the recent introduction of 20% In Service Quota in Maharashtra where the reservation was already
1/
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India ideally needs thousand more
#aiims
&
#nimhans
& this is never going to be possible. It is time, the central govt starts funding existing grand old state medical colleges & bring them to AIIMS levels instead of trying to make newer & newer AIIMS!
@mansukhmandviya
#Thought
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Mr. Prime Minister
@narendramodi
and Mr.
@mansukhmandviya
talk big things about TB Mukt Bharat by 2025.
At
@SJHDELHI
apparently the biggest central government hospital, still haven't got reports of 3 CSF CBNAAT for M. Tuberculosis submitted on Saturday.
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Once you start wearing good classy clothes to work, there is no going back.
Have a good day folks 🤘💪
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Hey Dog lovers need your help!
What should I do to prevent being chased by street dogs in an isolated street on the way home every other night on my bicycle?
It is scary. There is no alternate route.
What if someday i am not able to speed up like I usually do?
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I am tired and i see him. Those eyes, i will never forget. This is India. This is her innocence.
#MedTwitter
#wardrounds
#India
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Tomorrow is the joining day for majority of JR1/PG1s across India.
No matter what we say there are going to be a lot of turbulent times and things will not always be fair. Once post a double emergency one kind YT subscriber commented this on a video.
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45/M Tanzanian National, based on Intel inputs was scanned in an Airport and brought to us in the emergency. Xray abdomen is shown. And the things he has been excreting in stools since.
He is asymptomatic, vitally stable.
PA - Soft NT.
Dx?
Mx?
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An intern is paid - 11k/month
(After 6yrs of training and clearing 20 exams)
A PGresident or SR in Mumbai is paid - 60k/month after working for >100hrs/week.
Sir it's time you are better informed. Because of such blanket statements from people like you, the public is fooled.
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with an energy that is contagious, everyone around you also starts working in the same manner. Greets you, talks to you, about you, in the same manner. Suddenly, despite all the sufferings, it becomes a little easier, if not easy.
#residency
#medicine
#medtwitter
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For all the hate i received and still getting, this is what I meant by classy. Thank you for adding fuel to the fire🤘 Have a good day!
Once you start wearing good classy clothes to work, there is no going back.
Have a good day folks 🤘💪
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No offence to anyone whatsoever but from whatever responses i am getting to my Clinical Questions since a week from good young MBBS students, i sadly feel
#COVID19
has impacted Clinical Learning like anything. These students haven't been to wards since 2years.
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130
So
#INICET2022
is done & dusted. Congratulations to all who did well & r getting branch of their choice!
A gentle reminder to all not in top 20. Don't compromise on branch bcoz of tag/bond/
A branch is something you marry permanently (no divorce)
#NEETPG2022
is d real deal
1/
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GSMC and KEMH😍🙏
Only if the Medicine there would be more humane. Only if...😔🥲
It has few of the best medicine residents of our country! Even the world..
#almamater
@AccountKem
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16/F
Fever with chills since 1 month
ECHO shown below
Spot Dx?
#MedTwitter
#Cardiotwitter
#Cardiology
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So i just now realise that come this September 2022, all government hospitals will finally have 3 batches of PGs probably for the first time after May 2020. So many things have suffered in these last 28 months. Is there anyone in the GOAT Government to take responsibility?
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Was never allowed as a child to have a gaming device by parents! Dad always wanted me to play outdoor sports! I owe all my fitness, energy and skills in those sports to him. We have played for hours and hours!
But finally today i have a
#gaming
laptop!
Fire in the hole🤘
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1
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Every week there is this patient or relative who observes your presence or absence each day in the ward!
And every time you go after a day or two, they ask, sir aap kal aaye nahi?
It is always a nice feeling to hear that, isn't it?
#MedTwitter
#gratitude
#residency
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3
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45/F who has had long standing multiple joint pain and was being treated by a local BAMS physician, recommended by her friends as he offers a very quick solution to all illnesses!
He has a magic pill which he prescribes to most of his patients. Guess?
☹️
#MedX
#MedTwitter
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High time there is a General OPD
@SJHDELHI
which is run by the Community Medicine Department. As Medicine resident have to see more than 90 patients alone in Medicine OPDs. We can never do justice that way apart from it being extremely tiring.
19
2
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All good things come to an end, and today is the end of one of the most special things of my life.
Yes i bid goodbye to Seth GSMC and KEM Hospital, an institute which is also celebrating its 96th Birthday today !
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One of the many many perks of doing PG in India. Nothing beats, having family close to you.
Grateful 🙏
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1
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A long night today in the emergency. But the moon will be there for company.
Happy Holi :)
Will celebrate it in the wards, helping the patients who come after celebrating their Holi with alcohol binge🙏
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A month ago, I asked a simple question to our respected central government in the aftermath of its grand success. What was the expenditure incurred in organising the G20 Summit?
As honest tax paying citizens, do we deserve to know?
Our government thinks otherwise.
#RTI
11
18
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Have you heard of PNES?
At 3am in the night in a heavy emergency, a distressed husband comes running.
Sir meri wife ko continue daure (seizures) aa rahe hai
Sab try kar liya hai - levera, valproate, carbaz...
Me - video liya hai aapne?
Him - ha sir! Yeh dekho
1/N
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18
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CXR clear, ECG - Sinus Tachy
NCCT Head - WNL
Among the probability of so many things, the foremost was Opioid Toxicity(overdose)!
We give him Injection Naloxone 0.4mg and within 5mins he regains consciousness, becomes E4VtM6
from E1VtM1!
4/
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2
100
We welcome all the awareness about
#COVID19
and the change it has brought in the way masses give importance to healthcare. But what is silently eating poor people of India? It's much more morbid than COVID, it's
#tuberculosis
!
Sharing a recent case that broke me😕 1/n
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The common man opinion about private healthcare in India is extremely biased. Every emergency 8 out of 10 patient's relatives say that - "sir aapko toh pata hi hai, private mein kaise loot dete hai, isliye hum yaha laaye hai"
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@narendramodi
@PMOIndia
You may have a vision of creating 100 new AIIMS, but what about such gigantic hospitals like
@SJHDELHI
which currently has only 1 CT and 1MRI machine?
#MedTwitter
3
6
92
Lorazepam overdose
DKA
Disseminated Koch's
CVA, CLD, CKD, COPD..
I tried to do my best right from history, examination and putting notes. The real task starts from tomorrow !
Can any other job in this world have more variety ?
#InternalMedicine
at its very best!
🙏
3
1
91
Majority doctors will start their residency from tomorrow!
Do have a read before you start!
Do share if you find it useful 😃
#MedTwitter
With AIQ R1 done and majority state rounds also done, many doctors across India will join their residency on 20th October. These are the lessons i learnt after 8months of PG 1 and some mistakes i made, which you shouldn't!
1/n
7
50
285
3
11
89
50/F
Sudden onset Headache, LOC and inability to move Rt. UL and LL
Not a known Hypertensive
Not on any medication
NCCT Head - It had to be a Left GC Bleed with IVE
What is the highest blood pressure you have seen?
#MedTwitter
#hypertension
#silentkillers
20
2
92
India is full of such people. People who fight against all atrocities thrown at them. Working in a government hospital, we come across such stories so often.
Yeh jo desh hai tera, swadesh hai tera, tuje hai pukaara, yeh vo bandhan hai jo kabhi tut nahi sakta.
Have a good day.
1
1
90
For starters the entry in Government Medical Colleges now is tougher than ever. There is no room for only talent, it requires a lot and a lot of hardwork to score well in
#NEETUG
and despite lakhs of students working hard, only the cream out of them get in government colleges. 2/
2
3
86
A thing as simple as water also tastes sweeter at home - straight from the earthen pot! No purifier nothing. So much better than the Bisleri that i otherwise drink everyday in my PG room.
Last 25years in Mumbai, the water quality has always been upto the mark!
3
0
85
Maintains saturation on T piece and RR is >12 and in 1hr is extubated! Is perfectly fine now under close monitoring!
What an Adrenaline rush it was!
The mother couldn't stop thanking us!
On asking him, he says he had taken Brown (Heroin)!
5/
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If you compare the levels of competition say 30 years back, it was way too low.
If you look at the most successful doctors at present, both merit and in practise, majority of their children now study in private because they fail to do well to enter in government colleges. 3/
2
5
84
Such a wonderful day today! My brother Pranav, finally shifted to his hostel room in the prestigious
@iitbombay
and it's magnificent campus, maybe the best in the country!
I have seen him burn the midnight oil since 5years for this day & he his finally there😍🤩
#proudfamily
2
0
85
Sad, unacceptable and inhumane.
Strict action should be taken against all those involved and all those higher up who keep quiet.
@SJHDELHI
@RDA_SJH
Rise above the daily photo-ops. The on-ground realities of this hospital and college are really harsh and best not told.
VMMC ,Safdarjung hospital horror :
“I was abused , made to work for 110 hours of continuous duty till cellulitis developed in my feet and yet were not allowed to sleep and bullied on daily basis by my seniors”
These are the words of an All india rank 1300 Female surgery
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761
2K
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6
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Happy Holi from Ward 11. Didn't ever imagine that all the staff would be so amazing. Each day is fun, each day is possible because of them 🙏
1
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While we talk about big things like hundreds of AIIMS, digital health card etc. The on ground situation for the poor even in the capital city of this country is quite grave.
Eventually the value of human life is too small here 😞
8/8
#MedTwitter
@mansukhmandviya
@MoHFW_INDIA
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84
And the cherry on the cake is that luckily his condition has a pretty good prognosis now - thanks to the cutting edge science! But to reach that science, we will always need the basics!
13/13
3
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They were offering money, i just obliged for a photo. Just sitting there, i felt all the bashings i have got, all the efforts i try to put. Everything is worth it. There is no bigger satisfaction than saving a life. I am grateful 🙏
Yes many of you got it bang on correct. It's most probably a c/o TBM, considering the prevalence in India.
Long history - kochs , examination suggesting meningitis, high proteins in the csf, low sugar and lymphocytes all suggest TBM as the cause.
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Someday we all be victims of such vicious decisions, laws and processes and then we will look around with no one for support.
"Our lives begin to end the day we become silent about things that matter." - Dr. Martin Luther King, Jr.
6/6
1
4
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All the best to all the exam going young
#MBBS
students all across India. I know these are tough and uncertain times, but our life revolves around exams. Take care of your physical and mental health. Don't abuse on any substance whatsoever.
1
4
80
It was such a refreshing and peaceful evening away from the chaos of the ward!
Central Vista, India Gate and War Memorial in all its glory! Hats off to
@narendramodi
and this resolute government for executing it!
The weather was totally Lonavala like😍
#indiagate
1
0
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The new trend we keep seeing nowadays in the wards!
Organisms sensitive to old, out of fashion drugs and resistant to the newer stronger ones!
#antimicrobialresistance
0
1
78
Visited my alma mater GSMC today!
UG at times was pretty brutal! Have endured a lot of hardships in those 6years but eventually everything came together well & was worth it! It had a crucial role in preparing me for PG! Was reading a book, & i think this para fits perfect.
1
3
79
These countries produce a uniformly high standard of doctors because of 3 reasons.
1. The licensing exams which requires one to have the things mentioned above.
2. There are no reservations.
3. There are no colleges where you can buy your seat and buy your degree. 7/
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@Famdoc17
@EmilyCuster38
@camsghassemi
Because S4 is produced during the atrial contraction phase when the blood bangs against the walls of the ventricle. In A fib that contraction synchrony of the atrial musculature is lost.
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1
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the pattern of McQs is totally clinical and analytical and it is impossible to rote learn mcqs and do well in the exams. You look at apps like Marrow and their content. It is so useful in building a strong foundation and accessible to the remotest place. 5/
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