Dr Anjani Arihant MD

[Vincent Rajkumar @VincentRK]

Updated FAQs on newly diagnosed multiple myeloma for 2026!

1. Which frontline regimen to use?
Quad regimen, either Dara-VRd or Isa-VRd

2. How long to give the Quad regimen?

4 months and then transplant, or
6 months if transplant ineligible or deferred

3. What maintenance after initial therapy?

Standard risk: Dara or Isa plus Lenalidomide

High Risk: Dara or Isa plus Lenalidomide; or bortezomib plus Lenalidomide

4. How long to give maintenance?

Standard risk: Lenalidomide for 2 years and stop; Dara or Isa till progression.

High risk: Till progression.

5. Is transplant still recommended in eligible patients?

High risk myeloma: Yes.
Standard risk: Early vs delayed- Shared decision making based on age and patient preference.

6. Definition of High risk myeloma?

Del 17p is high risk by itself
All the others (4;14, 1q, 1p, etc) all need two abnormalities together to call as high risk.
(P53 mutation and bi-allelic del 1p also high risk; but small numbers)

Check out https://t.co/qeXZaqzOpV to make this assessment easily.

7. What about CART or bispecifics in newly diagnosed myeloma.

Totally Investigational. Done only on approved clinical trials

8. What about frail patients who cannot tolerate quadruplet?

Triplet: DaraRd or IsaRd; if that’s not possible or safe: Rd or even single agent Dara may sometimes be needed at least initially till performance status improves.

9. What about patients with acute renal failure?

Prefer Dara-VCd rather than Dara-VRd

10. How long to give the Dex?

Keep Dex only for initial 4-6 months. No dex in maintenance.

[PK FOR CM @PK_for_CM]

7वीं फेल को बिहार का मुख्यमंत्री बनाने के बाद BJP ने एक और कारनामा किया है। BJP ने बांकीपुर से अभिषेक कुमार को टिकट दिया है जो मध्यमा बोर्ड (संस्कृत बोर्ड) से 10वीं पास हैं। बिहार में हर कोई ये बात जानता है कि जो लोग बिहार बोर्ड से परीक्षा पास नहीं कर पाते हैं वे ही मध्यमा बोर्ड से केवल डिग्री के लिये परीक्षा देते हैं। इसमें सबसे दिलचस्प बात ये है कि अभिषेक कुमार 1999 में BJP से जुड़े थे और 2000 में उन्होंने मध्यमा की परीक्षा देकर पढ़ाई छोड़ दी क्योंकि BJP से जुड़ने के तुरंत बाद उन्हें इस बात का अहसास हो गया कि BJP में करियर बनाना है तो पढ़ाई छोड़नी होगी। यहां 7वीं फेल होने पर ही मुख्यमंत्री बना जा सकता है, गलती से उन्होंने 10वीं पास कर ली इसलिये उन्हें विधायक प्रत्याशी तक ही सीमित रहना पड़ रहा है।

बांकीपुर में BJP के पास 35 साल का शासन रहा है, यहां उसके पास हज़ारों पढ़े लिखे कार्यकर्ता हैं लेकिन BJP ने एक मैट्रिक पास आदमी को टिकट देकर फिर से यह साबित कर दिया कि उसकी नज़र में शिक्षा की क्या अहमियत है।

खैर, बांकीपुर की जनता के लिये इस चुनाव में अब वोट डालना और आसान हो गया है। एक तरफ प्रशांत किशोर जी हैं जिन्होंने पोस्ट ग्रैजुएशन तक पढ़ाई की है, संयुक्त राष्ट्र में जाकर अमेरिका समेत कई देशों में नौकरी की है। पब्लिक और हेल्थ पॉलिसी बनाने में जिन्हें महारथ हासिल है। ऐसे में जनता के लिये शिक्षित और सुयोग्य उम्मीदवार केवल प्रशांत किशोर जी ही है। बांकीपुर की जनता को अब एक दूरदर्शी और शिक्षित विधायक ही चाहिये। बांकीपुर में बदलाव तय है क्योंकि प्रशांत आएंगे, बदलाव लाएंगे।

[Dr Anjani Arihant MD @Factualerrr]

@DhruvMundhraYT Can u connect me with endocrinology resident at Goa medical college ??

[Bhooshan Shukla @docbhooshan]

I have seen countless doctors standing up for patients' rights, better treatment, affordable healthcare and ethics. Many whistleblowers suffer for life.

I have yet to see a member of public fighting for doctors' basic right of safe workplace.

All half hearted attempts by such people always contain words like - "most/some doctors" , "but..."

Basic principle of public life in India - play helpless/victim card. Then you are absolved of ALL responsibility and crimes.

By law it is a "consumer-service provider" relationship. Do not mistake it for your life's calling.

[Dr. Anuj @anujtiwari11]

No outrage on things that are actually needed!! Increase NICU BEDS, better infrastructure in govt hospitals, better pay so that vacancies are filled in and doctors are enough in numbers to manage that system, but but but, itni Maturity wali baat kaun samjhega!
#Doctor #India

[Nachiket Bhatia @bhatia_nachiket]

If this policy is ever implemented, it will be one of the most dangerous experiments in healthcare.

You’re telling hospitals: “If the patient dies, you don’t get paid.”

If a lawyer loses a case, do you refuse to pay the lawyer?

If a firefighter can’t save every house, do you stop paying the fire department?

Congratulations. You just created a financial incentive to avoid the sickest patients.

Trauma. Septic shock. Massive heart attacks. Terminal cancer. Every high-risk emergency becomes a liability.
Hospitals will stop admitting patients needing emergency care and who is going to suffer the most: THE COMMON PEOPLE OF THE STATE.

Hospitals don’t guarantee life. They fight for it.

Don’t punish doctors and hospitals for death. Fix insurance. Strengthen public healthcare. Stop making disastrous policies that sound compassionate but can cost even more lives.

#Healthcare #HealthPolicy #Doctors #Hospitals #EmergencyCare #ICU #CriticalCare #MedicalEthics #HealthcareReform #PatientCare #India #TamilNadu #HealthcareCrisis #PublicPolicy #SaveHealthcare #MedicalCommunity #DoctorLife #Medicine #HealthcareSystem #PolicyMatters

[Dr Anjani Arihant MD @Factualerrr]

@DhruvMundhraYT How is endocrinology at Goa medical college ??

[Dr Sudhir Kumar MD DM @hyderabaddoctor]

This simple headache log helped me treat a teenager with migraine better than memory ever could.

(Personal and drug details have been removed.)

🔸The first instinct of many patients is to say:
"Doctor, the headaches are better."

🔸But how much better?
A headache diary answers that objectively.

▶️In just 2 months, this log showed:
✅ Headache frequency reduced
✅ There were more headache-free days
✅ Duration of headache shortened
✅ Headache intensity remained stable.

▶️Most importantly, it showed how the patient was responding over time, allowing us to decide whether to:
🔸continue the same dose,
🔸increase it,
🔸taper it,
🔸or change the medicine altogether.

Why is this important?
▶️Migraine treatment is not just about prescribing a drug. It is about measuring treatment response.
▶️International headache guidelines recommend that patients keep a headache diary because it helps:
🔸confirm the diagnosis,
🔸identify triggers,
🔸detect medication-overuse headache,
🔸monitor response to preventive therapy,
🔸and make evidence-based decisions about drug choice and dosage.

A good headache diary should record:
📝 Number of headache days
📝 Severity (0–10)
📝 Duration
📝 Medicines taken
📝 Possible triggers
📝 Effect on school/work and daily activities

✅A headache diary is a valuable tool assisting a neurologist managing migraine.

[Aarkey Gupta M.S DNB . @DrRAHULKUMARGU1]

5–6 goons reportedly entered AIIMS Bhubaneswar, one of Odisha's premier healthcare institutions.The situation highlights the vulnerability of doctors and healthcare workers,and raises serious questions about hospital security and emergency .
@JPNadda
@CMO_Odisha
@aiimsbbsrrda

[Dr Anjani Arihant MD @Factualerrr]

@reallyrudi91 @LiveLawIndia So true.

[Rudrarpan Chatterjee @reallyrudi91]

@LiveLawIndia Sometimes our courts feel so detached from reality. It's medicine at the post MD level, everyone is preparing for exams while serving the public under extreme stress. No one is sitting at home and studying. This is not UPSC.

[Jerry George @JerryGeorgeM]

NEET SS aspirants have been waiting for the 2nd round of counselling since April 10. The prolonged delay has left thousands of doctors in limbo—unable to plan careers, join jobsor make financial decisions. We need clarity, transparency, and a timeline. #NEETSS #NEETSSCounselling

[Dr Anjani Arihant MD @Factualerrr]

@rimpy97 Can also guide neet ug aspirants ??

[Dr Anjani Arihant MD @Factualerrr]

@rimpy97 Can do mba/ upsc cms ??

[Vikram Mathews @MathewsVikram]

Congratulations to Manju Sengar on being the recipient of the "International Women Who Conquer Cancer Mentorship Award"
https://t.co/RNz0LgURJg
@HCC_HemeCancer @jayastuMD @NitinJainMD

[Dr Anjani Arihant MD @Factualerrr]

@Manoj_Ingalagi Depends on reservation

[Dr Anjani Arihant MD @Factualerrr]

@drram90 Congrats sir...

[Dr Anjani Arihant MD @Factualerrr]

@Papa_Heme I am big fan of urs. Kindly share podcast link.

[Dr Anjani Arihant MD @Factualerrr]

@derekobrienmp Should be more. People are fearing ur goons. I witnessed that.

[Dr Anjani Arihant MD @Factualerrr]

@TheKoshurDoc @docakx It is caused by methylene blue, a dye frequently administered during urological procedures to evaluate anastomotic integrity or identify leaks.