Social_VadaPav

gutted by a brutally unjust world...

[Social_VadaPav @SocialHawker]

@DearthOfSid @AnimalTheFilm https://t.co/GSLKuuKNpa

[Social_VadaPav @SocialHawker]

@AnimalTheFilm https://t.co/GSLKuuKNpa

[Social_VadaPav @SocialHawker]

@imvangasandeep https://t.co/7BK3ZOt1QJ

[Advocate Antara Jayant @adv_antara]

https://t.co/9bkuWkzg4o

#AnimalTheMovie #MovieReview #RuleofLaw #PrivateRevenge

[Arnab Ray @greatbong]

In today’s Times of India

Suhana Khan, daughter of Shahrukh Khan, recently, at a public event, praised Alia Bhatt, daughter of Mahesh Bhatt, for being a role model for environmental sustainability by destigmatizing wearing the same ensemble multiple times through her repeating an outfit for a public event. Of course, this made me realize how much I, son of the generation that is bequeathing to its next-generation a climate crisis, have done for sustainable living by wearing not just the same clothes twice, but many times, but also underwear without washing during student days, conserving water in the process.

No, I kid. While this display of privilege from a superstar kid is funny and worth making fun of, as I just did, it still obscures a more significant point: privilege. Just as Suhana Khan's perspective on virtue might seem absurd to us, it's worth remembering that if we were public figures and our conversations were public domain, we would appear as out-of-touch with reality by those lower on the totem pole of privilege. If someone who struggles to put two square meals for their family heard us complain about lousy service at a restaurant or someone who has to walk miles to get drinking water heard us having a conversation about how awful flying has become, we would be as meme-worthy.

Just as Donald Trump thinks he built his own business after being given millions of dollars (in the seventies) by his father, many of us feel we got to where we are by dint of our "own hard work," being similarly blind to things we take for granted.

In an actor's roundtable, Ananya Pandey, daughter of Chunkey Pandey, wanted the audience to believe her life had not been easy because her father was not Bollywood royalty, as evidenced by him not being a guest on Karan Johar's show, to which Siddhanth Chaturvedi, an actor in the same program and with not her privilege, had quipped that where other people's dreams end, Ananya Pandey's struggle begins there. Game, set, and match, except that Chaturvedi, son of a Chartered Accountant, is as unaware of his privilege as Ananya Pandey is. Sure, his privilege is less than that of Ananya Pandey in Bollywood, but that does not mean that the starting point of his struggle isn't also the terminus of the dreams of millions of others.

And yes, the same applies to us.

[Social_VadaPav @SocialHawker]

It is time they provide disposable vomit/sickness bags in the movie theatres. #AnimalTheMovie

[Social_VadaPav @SocialHawker]

#AnimalTheMovie is tone deaf to so many things that must matter to the makers of a film (producer, director, writers, actors) in 2023. But, no! They all are smugly oblivious. The movie is mind-bogglingly wrong on so many levels. Triggering for all for so many reasons #garbage

[زماں @Delhiite_]

Real Heros of this operation are those 12 Rat Miners who risked their lives and made impossible task possible, completed the final 15 metres, which no machine could do.

1. Vakeel 2. Munna 3. Feroz
4. Monu 5. Naseem 6. Irshad
7. Ankur 8. Rashid 9. Jatin
10. Nasir 11. Saurabh 12. Devendra

Finished task in 26 Hours what latest technology failed to do in 18 days!

When sophisticated auger machine broke down in the ongoing rescue operation, They toiled relentlessly for 26 hours.

[Martina Navratilova @Martina]

Women’s sports is not the place for mediocre male athletes who compete as women. Period.

[TheLiverDoc™ @theliverdoc]

Things that your liver will love you to do*

1⃣Brisk walk at least 150 minutes a week
2⃣Run at least once a week
3⃣ Black coffee, no sugar, 3 cups a day
4⃣Avoid alcohol (including Homeopathy) & tobacco
5⃣Sleep for at least 7 hours in a day
6⃣Avoid herbal supplements
7⃣Get your hepatitis B vaccine shot/booster
8⃣Limit added sugars & ultraprocessed food
9⃣Avoid sugar sweetened beverages
1⃣0⃣Lose weight
1⃣1⃣Follow a Mediteranean diet (sans alcohol)
1⃣2⃣ Whole eggs - 5/wk in cardio-metabolic disease
1⃣3⃣Whole eggs - 7/wk if no cardio-metabolic disease
1⃣4⃣ Include fermented food portions in daily diet
1⃣5⃣Listen to real clinical doctors

*based on published scientific evidence

[Social_VadaPav @SocialHawker]

@SouthINDGoogly Creation
Gratitude
Change
#twitter

[Social_VadaPav @SocialHawker]

@TheCinesthetic Dharmendra

[TheLiverDoc™ @theliverdoc]

Dear friends, my sincere request is that you do not follow health advice, especially from those who are not science-based healthcare providers or clinical medicine practitioners.

Sean here, is an entrepreneur in eCommerce, SaaS & B2B service categories. He has not seen the inside of a biology text book in school and has no clue about human anatomy, physiology, pharmacology, toxicology and clinical levels of evidence.
https://t.co/PCmIHzDLSu

Please do not consume herbal and dietary supplements in the belief that you will "age slower," or improve your "biological age," or "increase your VO2max," or "get your metabolic health comparable to your toddler," or "increase your sperm count to beat your stable horses," or "increase testosterone to make The Hulk look dumb." It is absurd.

Just be you. Nothing beats a balanced diet, daily physical activity (aerobics/weight training), avoiding alcohol and tobacco and embracing healthy work hours and adequate sleep. Do not forget to cater to your mental health in between all of this. It is also important.

Most of these posts, like Sean's here, are for engagement farming to promote a sales pitch. The supplements description section features a lot of brand names that he has endorsed for a possible commission. None of those supplements work. It is a fact. And many of those supplements can actually harm.
Please see (take your time) this exhaustive database from the US Government's National Institutes of Health, Office of Dietary Supplements for clarity on which supplements work and in conditions they are recommended and which supplements dont.
https://t.co/iXUouw0yLE

Herbal and dietary supplements are now now the biggest cause for increasing liver transplants in the USA, (no) thanks to sales pitchers like Sean and other tech bros who do it for the business of healthcare.
https://t.co/D4r8kqYhSf

And that is not all. Herbal and dietary supplements related liver injury is far more severe and serious than standard prescription drugs related liver injury. Meaning, the chances of dying or receiving a liver transplant is higher with supplements-related liver failure.
https://t.co/2pKSrlF0NS

Tech bros and other medically-illiterates use "science-sounding" jargons to confuse people into thinking they are "credible."
For example, Sean mentions that albumin level is a "function of the liver" - it is not. Albumin provides an idea of the biosynthetic function of the liver and not the whole liver function. The liver performs more than 500 vital functions - metabolic, synthetic, secretory, excretory, immunity, digestive and many more.
https://t.co/Hb2M0HUKsG

Alkaline phosphatase is also not actually liver function as Sean mentions. Alkaline phosphatase is present in the placenta, ileal mucosa, kidney, bone, and liver - and not only in the liver.
https://t.co/TXWTrqUaq0

Creatinine is also not realistically kidney function related. Serum creatinine is widely interpreted as a measure only of renal function; however, the serum level reflects not only renal excretion, but also the generation, intake, and metabolism of creatinine which are dependent on many other factors other than kidneys.
https://t.co/VqMzOovVcL

Glucose as a the singular marker of metabolism is utter nonsense, as Sean mentions and many blood parameters mentioned are an exaggeration of the claims made, such as immune system function (immune system has innate and adaptive components and a simple blood count tests does not provide any clear data on it)
https://t.co/AqW75yrTfS

Sean's post is a masterclass on both misinformation and disinformation. Misinformation is false or inaccurate information—getting the facts wrong. Disinformation is false information which is deliberately intended to mislead—intentionally misstating the facts.

Be wary of such handles and stay FAR away from them, for your own good.

[Douglas Farrar @DouglasLFarrar]

🧵Thanks to FTC staff, previously redacted info on why Amazon is an illegal monopolist is now out! Here’s some of what’s new in a big thread 👇🏻 1/15

[The Tennis Letter @TheTennisLetter]

Ons Jabeur says she’s donating a portion of her prize money to Palestine:

“I am very happy with the win but I haven't been very happy lately. The situation in the world doesn't make me happy... I feel like… I am sorry. It’s very tough seeing children & babies dying every day. It’s heartbreaking. I have decided to donate part of my prize money to help the Palestinians. I can't be happy with this win. It is not a political message, it is humanity. I want peace in this world. That’s it.” ❤️

[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

[Ashok Khemka @AshokKhemka_IAS]

@SUJEET_200 Lowest pay in Govt (Group D) is 18,000. Highest pay is 250,000 (Cabinet Secretary), less than 14 times. Chief Justice of India's pay is 280,000.
Companies facing resolution before NCLT and wiping 98% of depositors' money pay in Crores to their CEOs.
What sayeth?

[namita 🪡✍️ @namitaj68]

Cooking, cleaning, laundry, ironing, childcare, eldercare, sundry household chores?
Ever accompanied elders to clinic? Or gone to PTMs? Or taken kids to coaching? Or hosted guests?
The problem is clueless 'motivators' living in their ivory towers.

[TheLiverDoc™ @theliverdoc]

Let me tell you how a private clinician-researcher and the team work to publish an important study in India.

We think of a study that would be eye-opening and be of great public health education.

We design the study, setup methods and finalize the protocol - takes about a month to get this done.

For a study like this, no one would fund us because a lot of stakeholders will be affected. But this is a public health concern study, so we are forced to self-fund it.

We review the market, purchase multiple products and sent them out for chemical and toxicology analysis
- INR 6,36,888/- ($7635)

The results come, we spend three months collating it, re-analyzing data, looking for errors, confirming final results with the lab - during weekends and late into the night, making us lose time with family, friends, and of course, sometimes forgeting about ourselves.

Once results are completed, we write up the study. This takes about two-three months, again spending late nights after work, and also on weekends, eating into family time. It is usually a 4000-5000 word manuscript. We make tables, figures, supplementary documents. Many journals need infographics, so we subscribe to an online software to create one.
- INR 10,000/- (annual, $120)

Manuscript writing is completed and we look for journals to submit for peer-review and publication. Since this paper is of great public health concern, we want everyone to access it and read it. So we cant use high impact subscription journals. So we go for good impact open access journals, where authors have to pay, so that everyone else can read the paper once published.

Peer review is on. Other doctors and scientists review our paper FOR FREE for the journal and publisher and we receive reviewer comments for revision.

Peer-review is complete, but Reviewer 2 wants us, "authors from India" who are not "native English speakers" to edit the paper by a "native English speaker." And they give options for English editing services. We pay again for those.
- INR 50,048/- ($600)

We submit the revisions and the editor reviews all changes and the reviewers review our responses and they accept it for publication. Now the publisher wants us to pay open access fees to make it free for everyone to read. And so we pay the publisher who scientifically reviewed the paper for free without paying peer reviewers/ doctors/ scientists involved.
- INR 2,50,240/- ($3000)

Paper is published in final form online and everyone gets to see the eye-opening data we produced for the good of the public.

We put up the paper on social media and online to educate the public about what is right by them in the context of healthcare seeking behaviour and treatments available, only to be called "big pharma agent," "anti-national propagandist," "anti-Hindu," "pharma shill," and other colorful word choices.

Cost of publishing a paper from India by a group of private researchers who wants to do good by the public?

- INR 6,36,888 + INR 10,000 + INR 50,048 + INR 2,50,240 = INR 9,47,176/-

or $7635 + $120 + $600 + $3000 = $11,355/-

Sometimes I wonder why we do this. Could we not use that money for so many other things? Like a family trip and make memories with children or invest in our own children's future?

Clinician-scientists are a curse to their own family and boon to the public, because we are trained to give and never take - a core principle in the humanistic practice of clinical medicine.

Please take note, next time when you harrass, troll or abuse a clinical researcher/doctor online.