𝙳𝚛 𝚁𝚊𝚏𝚒

𝙳𝚛 𝚁𝚊𝚏𝚒 Medicine & Surgery with a critical lens 📸| Health & Research insights | Rational takes on Politics & History | Hospital & Beyond | 🏥 🥼🩺☄️

The U.S. is losing its competitive advantage in scientific research.This new working paper uses 44 million publications ...
20/01/2026

The U.S. is losing its competitive advantage in scientific research.

This new working paper uses 44 million publications and shows a massive global shift:

-Since 1980, the U.S. share of scientific output has fallen from ~40% to 15%.

-In that time period, China has risen from near 0 to ~32% overall.

-This is also true in top-journal papers.

-This isn’t just more scientists; it's higher per-researcher productivity.

The U.S. still leads in biomedical science.

China now dominates engineering & physical sciences.

Bottom line: Global science is democratizing. U.S. scientific dominance is no longer guaranteed.

A English woman in 2020 consulted general physicians around 20 times. She was not diagnosed correctly and was repeatedly...
20/01/2026

A English woman in 2020 consulted general physicians around 20 times. She was not diagnosed correctly and was repeatedly brushed off as having long COVID. She died from advanced stage four cancer aged just 27.

She was Jessica Brady, and her case led to a new rule for doctors called “Jess’s Rule.” It urges clinicians to “think again” if they are unable to pin down a diagnosis after seeing a patient three times, following a “three strikes and rethink” approach.

The Jess’s Rule initiative asks general practitioners to reconsider a patient’s condition if, after three appointments, there is still no clear diagnosis or the symptoms are worsening. It encourages face-to-face assessment, further tests, second opinions, and timely referrals.

It’s a genetic "hiccup" causing extra vessels in the skin and brain.Fix: Laser for the stain, meds for the seizures.Stur...
19/01/2026

It’s a genetic "hiccup" causing extra vessels in the skin and brain.

Fix: Laser for the stain, meds for the seizures.

Sturge-Weber Syndrome (SWS) - GNAQ gene mutation (random!).

A 39 year old man was brought with repeated seizures. No vitals. No sugar checked. Just a referral note.He had diabetes ...
17/01/2026

A 39 year old man was brought with repeated seizures. No vitals. No sugar checked. Just a referral note.

He had diabetes on glimepiride, chronic alcoholism, poor intake. Last drink 2 days ago.

On arrival he seized again. Glucometer said one word. ‘Low’

Dextrose went in. He woke up. Later he developed pneumonia due to aspiration.

History after recovery was simple. He took his medicines. Skipped his meals due to work.

This was not epilepsy. Not stroke. Not something rare.

This was hypoglycemia.

To every doctor at primary and secondary centers
In any new onset seizure, always check blood sugar and electrolytes before referral.

It saves brains. It saves lungs. It saves lives.

One of Einstein’s students asked him: “What does logic mean?”Einstein said: “I will answer you with a question.”“Suppose...
17/01/2026

One of Einstein’s students asked him: “What does logic mean?”

Einstein said: “I will answer you with a question.”

“Suppose two workers enter a chimney to clean it. One comes out with a dirty face and the other with a clean face. Who will go wash their face?”

The student immediately and without hesitation replied, “Of course, the one with the dirty face.”

Einstein said: “Your answer is incorrect. The one who will wash their face is the one with the clean face, because he looked at his colleague’s face and assumed that his own face was as dirty as his colleague’s. The one with the dirty face will not wash his face, thinking it is clean like his colleague’s.”

The student said: “That is correct and logical.”

Einstein replied: “No, it is not correct, because the question itself is illogical. It is not logical for two men to enter the same chimney at the same time and for one to come out clean and the other dirty.”

In a few words, logic itself can collapse, so sometimes the problem is not in the answer but in the flawed question itself.

🚨 CRASH CART CHEAT SHEET 🚨​Nursing students, paramedics, and new grads—SAVE THIS POST! Here is your quick breakdown of t...
15/01/2026

🚨 CRASH CART CHEAT SHEET 🚨

​Nursing students, paramedics, and new grads—SAVE THIS POST!

Here is your quick breakdown of the 14 essential emergency drugs you need to know by heart. ❤️‍🩹

​👇 THE LIFE SAVERS:

​💉 Epinephrine (Adrenaline): The big gun. Used for cardiac arrest & severe anaphylaxis.
​🐢 Atropine: For Bradycardia (gets that slow heart pumping!).
​💓 Amiodarone: The anti-arrhythmic for stabilizing rhythm.
​⚡ Lidocaine: Specifically for ventricular arrhythmias.
​🥨 Magnesium Sulfate: The fix for Torsades de pointes (twisted ECG waves) & Eclampsia.
​🧪 Sodium Bicarbonate: Reverses metabolic acidosis.
​🦴 Calcium Gluconate: Stabilizes the heart in hyperkalemia & treats hypocalcemia.
​🚑 Naloxone (Narcan): The reversal agent for opioid overdoses.
​🍬 Dextrose 50%: Immediate fix for severe hypoglycemia.
​⚡ Dopamine: For shock states & heart failure.
​💪 Dobutamine: Pump support for heart failure.
​💥 Nitroglycerin: The go-to for chest pain (Angina).
​😴 Midazolam (Versed): For conscious sedation.
​🐝 Hydrocortisone: For severe allergic reactions & adrenal insufficiency.

​Tag a study buddy who needs to review this! 👇👩‍⚕️👨‍⚕️
​

A 5★ new review of the GLP-1 drugs, what they have achieved, and where the field is headed with so many new molecules a...
15/01/2026

A 5★ new review of the GLP-1 drugs, what they have achieved, and where the field is headed with so many new molecules and combinations.

Obesity medicine is no longer about weight loss. It is about End-Organ Preservation.​2026 ADA Guidelines distilled:​1. I...
14/01/2026

Obesity medicine is no longer about weight loss. It is about End-Organ Preservation.

​2026 ADA Guidelines distilled:

​1. Is the heart failing? Tirzepatide.
2. Are the arteries clogged? Semaglutide.
3. Is the liver fatty? Tirzepatide.

​These are hemodynamic drugs with a weight loss side effect.

​Stopping the drug because they "hit their goal" is malpractice. You wouldn't stop an antihypertensive because the BP is normal.

​Treat the physiology. The weight is just a bonus.

Black eyes on BOTH sides (no punch to the face) = Raccoon eyesRaccoon eyes almost always means → basal skull fracture( b...
14/01/2026

Black eyes on BOTH sides (no punch to the face) = Raccoon eyes

Raccoon eyes almost always means → basal skull fracture( blood leaks from inside the skull and paints around the eyes like a raccoon mask )

Most common cause = bad head trauma

Look for Battle’s sign (bruising behind the ear) + CSF leak from nose/ear.

Thyroid & Parathyroid High-Yield ​Master the basics in 30 seconds. ​1. MC Thyroid Malignancy: Papillary Carcinoma2. Hoar...
12/01/2026

Thyroid & Parathyroid High-Yield

​Master the basics in 30 seconds.

​1. MC Thyroid Malignancy: Papillary Carcinoma
2. Hoarseness after surgery: Recurrent Laryngeal Nerve injury
3. Loss of high-pitch voice: External branch of Superior Laryngeal Nerve injury
4. Hypocalcemia post-op: Accidental parathyroid removal
5. Brown tumor of bone: Hyperparathyroidism

​Start your week with high-yield pearls.

Follow for daily & tips! 🩺✨

​

Breast Surgery High-Yield ​Master the basics in 30 seconds. ​1. MC Benign Tumor: Fibroadenoma2. MC Carcinoma: Invasive D...
12/01/2026

Breast Surgery High-Yield

​Master the basics in 30 seconds.
​1. MC Benign Tumor: Fibroadenoma
2. MC Carcinoma: Invasive Ductal
3. Peau d'orange: = Lymphatic obstruction 🍊
4. MC Location: Upper Outer Quadrant
5. Skin Fixation: Suggests Malignancy 🚩
6. Paget’s Disease: = Underlying Ductal Ca
7. Sentinel Node: First draining node
8. Triple Assessment: Clinical + Imaging + Biopsy

​Start your week with high-yield pearls.

Follow for daily & tips! 🩺✨
​

10/01/2026

IV iron

• Initiate if: Ferritin ≤ 500 ng/ml and TSAT ≤ 30%.
• Upper limit: Withhold if Ferritin > 700 ng/ml or TSAT ≥ 40%.

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