Sethi Ram

[Sethi Ram @Sethi30Ram]

@theliverdoc Hello doc, there is an urgency and need for ur consultation and guidance in a case of liver cirrhosis. I have shared some docs on ur whatsapp. Pls help!

[Sethi Ram @Sethi30Ram]

@Phogat_Vinesh 🫡

[Sethi Ram @Sethi30Ram]

@theliverdoc Hey doc I wanna share one of my society uncle's medical reports for ur suggestions and consultation, can I DM u the documents or pls give me ur email/contact. BTW he has been advised to go for lever transplant and that he can't afford! Pls🙏

[Sethi Ram @Sethi30Ram]

@aaditsh Business

[Sethi Ram @Sethi30Ram]

@hemantrajora_ भाई जी बड़ी दुविधा वाली स्तिथि पैदा हो गई है ये तो और डर अलग से लग रहा है। समझ भी नही आ रहा है कि कौन झूठ बोल रहा है और कौन सच, आपसे निवेदन है कि एक्सपर्ट की सहायता से इस दुविधा को दूर करें

[Sethi Ram @Sethi30Ram]

@theliverdoc pathetic situation of public health system!!

[Sethi Ram @Sethi30Ram]

@Wegiveyouhealt1 many congratulations 🎉

[Sethi Ram @Sethi30Ram]

@MrPerfect0538 @amazonIN aise hi hota h bhai...bear with it

[Sethi Ram @Sethi30Ram]

what do u say about this @Wegiveyouhealt1 dr sahab??

[TheLiverDoc™ @theliverdoc]

Intermittent Fasting: linked to a 91% higher risk of death due to heart related complications.

https://t.co/Rf4JoH4H2w

[Sethi Ram @Sethi30Ram]

@IndiaToday Ohh.. Yes ofcourse not u guys!!
by the way as per @harari_yuval book #sapiens journalists are those who inform society about and thus protect it from cheats and freeloaders.
m i right @sardesairajdeep sir??

[Sethi Ram @Sethi30Ram]

मैं ये सोच रहा हूं कि अपने कर्मचारियों की सेलरी में १ रु रो रो कर बढ़ाने वाली ये मुनाफाखोर कंपनियां अपने कर्मचारियों और ग्राहकों का खून चूसकर कमाए गए मुनाफे में से राजनीतिक पार्टियों को करोड़ों रुपए चंदे में क्यों...क्यों...क्यों दे रही हैं?
#ElectoralBondsCase
#ElectoralBonds

[Sethi Ram @Sethi30Ram]

@thevirdas 🤣🤣

[Sethi Ram @Sethi30Ram]

@theliverdoc Aahh... reading it again but it get me as it got me first time...it is wonderful and the way you tell it doc...wow❤️🙏🙏

[Sethi Ram @Sethi30Ram]

@theliverdoc it's look like all of the above😜🤣

[Sethi Ram @Sethi30Ram]

ये नाम समझ आ जाये तो...कितनी दिक्कत होगी अगर 'राम' समझ आ जाये तो...जय सिया राम।।

https://t.co/m6P556nfpy

[Sethi Ram @Sethi30Ram]

@theliverdoc we have seen that evey person who tries to do good for masses is targeted...but still there r lots of people who got benefitted by people like u doc and admire ur work and support u...more power to you!!

[Sethi Ram @Sethi30Ram]

@Memeghnad hahahaha

[Sethi Ram @Sethi30Ram]

#INDvSA #WorldCup2023
a very Happy Bday and Congratulations to @imVkohli for the record 49th 💯 🎉🎊🎂
but it wasn't a selfless knock...it seems mostly for the record and a less little for the team!!
well played @ImRo45 @ShreyasIyer15 and @surya_14kumar

[Sethi Ram @Sethi30Ram]

Must read...!!

[TheLiverDoc™ @theliverdoc]

🚨Breaking🚨

We have a new paper published on something very important and I would like to simplify it for you. But before that, you have to understand something bittersweet about this strange but devastating, not so uncommon disease.

A few years ago, two young women came to my OPD and told me that their father was not "a mad person" like everyone else was claiming. Over the course of few months, he was home-bound, then bed-bound and people around him finally realized that he had gone "full cuckoo" and let him be. Except his daughters. They knew their father so well, to understand that there was no way he could behave like a bipolar-maniac like the psychiatrists they were showing him to claimed. According to them, he was a sweet, brilliant man, and he could not have a psychiatric disorder in a years time that incapaciated him. I believed them, and took his case up.

This was not an isolated incident. A young graduate from Bangalore visited me because his father was unable to make calculations and kept forgetting things around the house and would burst into anger spells with the mother and son. Neurologists and psychiatrists diagnosed him with dementia disorder with psychotic symptoms. He worsened rapidly. He was a maths teacher at a prominent university and there was no way he could get his calculations wrong.
I believed the son and took his case up.

Another man, a son, rushed his father into the emergency one day. He was behaving strangely and he defecated in front of his family on the dinner table. He suddenly became abusive and then went into a state of confusion, progressing to coma. Elsewhere, they told him it was a stroke and he could not get better. But the son could not believe it. I believed him, and took his case up.

In 2020, a group of researchers across the world, saw many children with autistic symptoms, managed as autism, and various psychiatric illnesses - depression, anxiety, hyperactive disorders. But their parents believed that there was something more to it and the diagnosis of autism in their children was more than meets the eye. So they took them to various doctors, finally ending with liver specialists. The parents believed that their children were not autistic. The doctors believed them and took their cases up.

All these patients had one common disease. It was called portosystemic shunt syndrome or PSS - a condition that causes blood from the portal circulation (intestines, spleen and liver) to bypass the liver and flow directly into the systemic circulation, through a large, abnormally developed vein, called as shunt, leading to high ammonia levels in the body, that affects brain functions and lead to a host of neuro-psychiatric symptoms leading to various misdiagnoses.

It may or may not be associated with cirrhosis. In the group of children with "supposed" autistic disorder, there was no cirrhosis and it was a congential disease (from birth) - called Abernathy Malformation.
https://t.co/vNbZZ2fyqB

The treatment is simple. Close/block that damn shunt - through a simple, angiographic/radiological procedure called "shunt embolization". And we did.

The two daughters got their father back. He was not a "looney" anymore. They went for family trips together and attended weddings of their cousins. The father of the young man from Bangalore went back to getting his calculations correct. He was never angry. The man who defecated in front of his family and came in a coma to my ER, went back home walking after two weeks. He was never told what he went through, but his family is still trying to forget that which they witnessed [https://t.co/b6yUDPgE6x].

And all the kids, diagnosed with "autism" and "psychiatric diseases" woke up the next day as different little people, seeing the world differently. They were not autistic anymore. This is what timely diagnosis and shunt block does, in this dreadful disease...

- a reminder to doctors: "The good physician treats the disease; the great physician treats the patient who has the disease." - Sir William Osler.

Our unit, arguably performs the maximum number of shunt blocks in India, which is life changing for many patients. And @SRajesh_IR is the expert in it. We also have the largest number of publications on this from the country.

We did the largest series first [https://t.co/9xS6YOsMSY], followed by a larger series on early vs late shunt block [https://t.co/jS1IBV9qEw] and now we have this new paper that shows how to predict clinical outcomes in those undergoing shunt block in cirrhosis based on liver pressure variables - something very novel and new in medical literature.

Thank you for reading. Please share this so that other (especially doctors) will know about this disease entity that hides in plain sight.

Please read the new full paper here: https://t.co/CkuzagOv7P

#livertwitter #MedTwitter

[Sethi Ram @Sethi30Ram]

@theliverdoc absolutely right doc...many a times I also got in arguments with these sympathizers of alternate medicines & its your posts that come in as reinforcement for my side of facts and point of view...& slowly making progress in proving that ur point is right & actually good fr them.