Vishal Peshattiwar

Asso Professor & Head of Spine Surgery, Kokilaben Dhirubhai Ambani Hospital Mumbai.
GSMC & TNMC Mumbai /NUH Singapore

[Vishal Peshattiwar @DPeshattiwar]

@BoschHomeIn 6170378010

[Vishal Peshattiwar @DPeshattiwar]

@boschindia @boschhomeindia 1 month since we have raised a ticket for refrigerator repairs. Your person changed the fan charged us 9000 rupees for it refused to leave the so called damaged fan behind. The refrigerator still not working and now been asked for different repairs! 👏🏽

[Vishal Peshattiwar @DPeshattiwar]

@theliverdoc @d_s_thakur 🫡🐐

[Vishal Peshattiwar @DPeshattiwar]

S2 Iliac screws navigated have so much less radiation! @KDAHMumbai @Medtronic_Spine @S8navigation @OArm

[Vishal Peshattiwar @DPeshattiwar]

Cervical pedicle screw at C2, navigation makes it less stressful. #S8, #Oarm

[Vishal Peshattiwar @DPeshattiwar]

@pprao @TataAIGMotor @irdaindia Looks like regulations are for common man and run for benefit of the businesses.

[Vishal Peshattiwar @DPeshattiwar]

@pprao @bookingcom @bookingcom will avoid booking via you looking at this.

[Vishal Peshattiwar @DPeshattiwar]

@gauravsabnis You can take an indian out of India but cannot take the entitled and dirty indian out of him

[Vishal Peshattiwar @DPeshattiwar]

@ankitanarang @MasalaBai She can cover the ground with her grandkids ! Let those who have erred repent and correct

[Vishal Peshattiwar @DPeshattiwar]

Our latest article

[Vishal Peshattiwar @DPeshattiwar]

@TheKoshurDoc @drBMJ1 The reason complex surgeries get done better now a days is because anaesthesia has got better. The single most important person in a surgery is the anaesthetist.

[Vishal Peshattiwar @DPeshattiwar]

Generics work.

[TheLiverDoc™ @theliverdoc]

STAY WITH ME.

A few years ago, a patient was referred to me because he was diagnosed with complicated cirrhosis. He had an infection which led to a condition called hepatic encephalopathy (brain failure due to high ammonia levels). The treatment largely involved ammonia reducing therapies. One drug was central to this - Rifaximin - a non-absorbable antibiotic that reduced ammonia in the body. I prescribed him Rifaximin for 6 weeks and advised him follow-up.

He came back to me, not after six weeks, but in 4 weeks, this time, in liver coma (worst stage of brain failure - due to very high ammonia). He spent two days in the ICU and six days in total in the hospital. His hospital bill was close to INR 80,000. He had no insurance and his wife borrowed the money from neighbors and friends to clear hospital dues.

Upon questioning, I found that he was not taking the Rifaximin drug I had prescribed. He was only on the other two drugs (one, a syrup called lactulose for improving ammonia clearance in gut). I was furious, because the patient spent a whole week unecessarily in the ICU and wasted so much money that he never had - just because he was "not compliant" to my orders. I decided it was time for me to school him a bit.

But I was wrong. He was compliant. He had purchased Rifaximin and was on it. For 15 days. Thereafter, he could not afford it. He was an autorickshaw driver who shuttled school children every morning and evening. He could hardly make ends meet. He had two children of his own. The Rifaximin brand I prescribed him was 42 rupees per tablet. He had to consume two a day - which would mean 2520 rupees a month. He just did not have that money - so he skipped it - to not compromise on other important matters - childrens education and food.

He was confused and scared about opting for a cheaper version of Rifaximin because one, he was unsure about the quality of Rifaximin that was not prescribed by me and two, he was "scared" that I would scold him for buying a cheaper Rifaximin and if that got him into trouble.

I was confused and scared about prescribing a cheaper version of Rifaximin because one, I was unsure about the quality of Rifaximin that was not "a good promoted brand" and two, I was "scared" that his family would scold me for prescribing a cheaper Rifaximin and if that got him into trouble.

It is heartbreaking that many doctors still simply don’t trust generic medicines. Too often, they worry that these cheaper options are lower quality or might cause more problems than the big, famous brands. This fear leads them to prescribe expensive drugs instead, and the real tragedy is that it pushes vital healthcare out of reach for the ordinary people who need it most - like my patient.

This narrative, that generic drugs 'are never good' and that only big pharmaceutical marketed drugs are what works has been deeply ingrained into doctors and patients alike - I do not know by whom and since when. Looking back, these strong emotions were based on either opinions, testimonials or second- and third-hand information. Not evidence.

Like I said. Stay with me. This is life changing and will disrupt the drug market in India. Here are the results of The Citizens Generic vs. Brand Drugs Quality Project.
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[Manisha Pande @MnshaP]

PTI clicked the picture, NDTV deleted it — it went viral online. But who's the boy in it and why was he at India Gate? Akshay E R, a third-year LLB student at Delhi University, from Kerala. His father is a daily wage labourer; his mother is a homemaker.
https://t.co/lhIiW3wMRt

[Vishal Peshattiwar @DPeshattiwar]

@atmghn Angio ct to plan

[Vishal Peshattiwar @DPeshattiwar]

@atmghn @virtualspine He is indeed a great teacher!

[hemant morparia @hemantmorparia]

'Aitrogenic' - word whose time has come

[Vishal Peshattiwar @DPeshattiwar]

@atmghn C arm of Siemens?

[Vishal Peshattiwar @DPeshattiwar]

@abhijitkadle Have you tried a cold compress?