Pranjal Agrawal, MD, MPH

Physician, GIM, Interested in Healthcare efficiency and Real quality!!

[Pranjal Agrawal, MD, MPH @agrawalpm]

@hyderabaddoctor The nails were response to an acute illness, and will recover on their own in typically about 3 to 6 months. The cycle for nail and hair growth is delayed by 3 to 6 months

[Michael Osterholm PhD, MPH @mtosterholm]

Science just got sidelined. This isn’t about vaccine safety or restoring confidence —it’s about political agendas endangering public health. We should all be alarmed.

[TheLiverDoc™ @theliverdoc]

In India, doctor bashing is a political sport because doctors are considered "rich looters" since the public feel that increasing general consultation fees by 100 rupees is catastrophic...

...when this so-called health minister arrived in a ₹10000000 Range Rover along with the media to fire the CMO of a public hospital...

...all because the senior doctor who I was told is a gentleman and highly efficient, asked a patient to get a vitamin B12 injection from the outpatient day care service and not emergency services because a vitamin B12 injection was never an emergency.

If there is a species that can be considered scum of the universe, it's politicians of India who dehumanise doctors in front of the public for optics. And the joke is on us because we elect these buffoons to serve us.

[Pranjal Agrawal, MD, MPH @agrawalpm]

@DGlaucomflecken You do real Ophthalmology too!! I thought you were just a comedian.
J/k, I love your personality

[Vincent Rajkumar @VincentRK]

ABIM must wake up to the realization that doctors carry a smart phone computer with them. We work in teams. We have colleagues who we can consult for rare disorders and when doubts arise

End MOC. It’s useless.
CME, maintenance of licensure & credentialing is enough.

[TheLiverDoc™ @theliverdoc]

This is the craziest report you will read today.

Last year, a professor and dean at a university in Spain suddenly began publishing papers with a multitude of far-flung researchers. His coauthors, until then exclusively national, now came from places like India, China, Nepal, South Korea, Georgia, Austria, and the United States.

A company called iTrilon run by [Dr.] Sarath Ranganathan from Chennai, India created multiple research papers based on faked and plagiarized data and sold author positions to many senior clinicians and researchers across the globe.

Based on these publications, many clinicians and researchers procured promotions in their respective universities and institutes.

A 6 month investigation by @RetractionWatch has uncovered this large "Paper Mill" from India catering to struggling clinical researchers on a pay per article for author position basis. First and corresponding author positions were most expensive.

Paper Mills also bribe editors of middle level and dubious journals to clear peer review without scrutiny.

India is now becoming a shady place for the business of research and healthcare and it is just shameful that this is happening in a country which has a great good to contribute towards clinical research.

https://t.co/3ompMYoCCz

https://t.co/2xwiUZEmwQ

[Narendra Modi @narendramodi]

The Cabinet has approved the construction of a new 6-lane bridge across River Ganga, connecting Digha and Sonepur in Bihar. This project will boost connectivity, spur economic growth and benefit lakhs of people across Bihar. https://t.co/MiivGjPXBK

[Eric Topol @EricTopol]

US Covid hospitalizations are on the rise, now >20,000 new admits/week, and this wave is just getting started as the JN.1 variant becomes dominant and wastewater levels surging in the Midwest with other regions to follow.
The booster protects vs JN.1!

[TheLiverDoc™ @theliverdoc]

Dear general physicians in India,

If you really love your patients, please stop abusing antibiotics for every sore throat and cough you see in your outpatient department.

Blanket use of antibiotics for every patient with respiratory symptoms will only create more challenges for our patients, especially those with high risk of multidrug resistance such as chronic liver disease as well as cancer patients.

No patient has ever had a deficiency of Azithromycin and Amoxicillin + Clavulanic acid for you to prescribe them like candies. Every purposeless action will have grave reactions.

[Visegrád 24 @visegrad24]

18-year-old Natalie Raanan from Chicago is one of the U.S. citizens taken to Gaza and held hostage by Hamas.

She and her mother Judith were both kidnapped while visiting family members.

🇺🇸🇮🇱

[TheLiverDoc™ @theliverdoc]

We need to talk about this

☠️Azithromycin and Amoxyclav for every run-of-the-mill viral sore throat

☠️Cefuroxime for every viral cold and cough

☠️Upgrading to Meropenam from Ceftrixone when a single fever spike persists in the wards

☠️Upgrading to Colistin with a single fever spike on Meropenam in the ICU

☠️Starting Ceftazidime and avibactam when patient enters the ICU

☠️Not stopping previous antibiotics but adding on more antibiotics in the ward and ICUs like a domino effect

☠️Not de-esclating or stopping antibiotics on time when body fluid cultures come back sterile

☠️Over-the-counter antibiotic sales without prescriptions

💀Alternative medicine practitioners prescribing antibiotics and antifungals without a clue, when Ayurveda or Homeopathy never had a germ theory

☠️People taking antibiotics unnecessarily and for the wrong indications AND stopping after 2 or 3 pills, that too taken erratically

☠️Irrational and illogical antibiotic use domesticated/ farmed-for-food animals and in veterinary practice

☠️Medical representatives asking doctors to prescribe a new antibiotic because it is better than the rest and more "powerful" without knowing recommendations for use - and ill-informed doctors learning medicine from medical representatives on antibiotics use.

🚨This depressing list is endless🚨

This is a complete human-made disaster that needs reflection from every treating doctor to follow what is necessary to reverse the damage done and to prevent irreversible damage in patients who will one day require life-saving antibiotics.

Patients with liver disease and cancer will be the worst hit because of this foolish and irrational antibiotic use. Brace yourselves.

[Pranjal Agrawal, MD, MPH @agrawalpm]

@BijoyTelivala Januvia is the least useful of them all.... the weakest diabetic med!!

[David Steensma, MD @DavidSteensma]

@VincentRK @ABIMcert @Rfonsi1 I’m increasingly frustrated with it. Last LKA block I wrote them about 3 questions one of which was obviously blatantly wrong and 2 others which were worded incorrectly. Time to just give up on the ABIM MOC sham, it is a relic of another era.

[Vincent Rajkumar @VincentRK]

I’m at the point where I will rather quit than do @ABIMcert Longitudinal Knowledge Assessment (LKA) and try to keep ABIM certification active.

It’s interfering with patient care and research for me. And I’m getting the myeloma questions wrong. Useless.
@Rfonsi1 #MedTwitter

[TheLiverDoc™ @theliverdoc]

3 cases of Amoxycillin+Clavulanic acid antibiotic related severe drug induced liver injury the last week & all on plasma exchange therapy for severe jaundice

All 3 had viral influenza fever & NONE needed antibiotics in the first place

When will doctors stop creating patients?

[TheLiverDoc™ @theliverdoc]

Please stop prescribing

Antibiotics for every fever
Antibiotics for viral fever
Azithromycin for every sore throat
Ivermectin for viral infections, esp Covid*
B-complex vitamins ALONG WITH antibiotics
Probiotics with every antibiotic course**
Zinc & Vit.C during flu season***

[TheLiverDoc™ @theliverdoc]

I think my lab partners may stop taking up my Ayush analysis projects

Just received news that their ICP-MS machine's standard column got stressed, had to be sent for maintenance after analyzing Siddha meds

Machine went bonkers with the amount of Lead detected in Siddha med 🫤

[Pranjal Agrawal, MD, MPH @agrawalpm]

@BijoyTelivala Unfortunately, common sense has been wrong equally, if not more often than data as well. The best physicians are the ones who use both🙂

[Bijoy Telivala @BijoyTelivala]

It is impossible for any doctor to have all the right answers all of the time

If you dont know the #answer just tell the patient so

tell them that you will try and look it up or direct them to some one who you think might have the answer

#MedTwitter

[Elon Musk @elonmusk]

@BillFOXLA @FoxNews Seems bizarre that it’s so easy enter illegally, but so hard to get a legal work visa