Ashok Kumar Singh, ARS

Tweets are Personal | RTs r not Endorsement I Researcher | Social Thinker | Non-Political and Optimistic

[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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[SciCommIndia 🇮🇳 @SciComm_India]

Congratulations to all the Rashtriya Vigyan Puraskar 2025 Awardees..!!!

[Ashok Kumar Singh, ARS @aks_iari]

Congratulations Dr. G. P. Singh sir for this milestone.

[ICAR-NBPGR @INbpgr]

Heartiest congratulations to Dr G. P. Singh, Director, ICAR–NBPGR and a prominent wheat Scientist, on receiving the Vigyan Shree Award under the Rashtriya Vigyan Purushkar 2025.👏🇮🇳
@GYANENDRAPSIN11
#RVP2025 #VigyanShree #Agrobiodiversity #IndianScience

[Lekshmy Sathee @lekshmysnair]

Proud moment as an alumni and as a faculty👏

[Ashok Kumar Singh, ARS @aks_iari]

@theliverdoc Really inspiring. Great Job @liverdr

[V. Ramgopal Rao, Ph.D. @ramgopal_rao]

Sad that @fssaiindia isn't doing anything about this. By now these products must have all been banned for misleading public.

[Dr Rajendra Singh Paroda @ParodaDr]

Agri research needs big boost, has to be more focused, say experts
@icarindia @AgriGoI

[B Kumar @iamBrajesh487]

@BPSC_Network I am trying since noon. There are several issues in form submission.

Kindly help.

@BIHAR_CM
@NitishKumar

[Saurav Gupta @SauravG04993709]

Trying to fill BPSC CSE form from but the server is down from many days, I even got this message but still no option for fee payment. thousands of students are facing similar issues since days we sincerely request CM Shri @NitishKumar to please extend application filling date

[Ankit Dev Arpan @nationalistAKD]

#BPSC की वेबसाइट के सर्वर डाउन पर कोई मीडिया डिबेट नहीं
कोई चर्चा नहीं
सरकार का कोई ठोस कदम नहीं, किसी अधिवक्ता की पहल नहीं, किसी नेता का बयान नहीं
और इन्हें वोट चाहिए युवाओं से
@Live_Hindustan @KashishBihar @ZeeBiharNews @ETVBharatBR @news4nations
@BJP4Bihar @Jduonline
#bpsccse

[TheLiverDoc™ @theliverdoc]

"For a nation to progress it is important for people to spend time on science, mathematics and literature instead of spending time showing that 5000 years ago their ancestors did science, mathematics and literature."

J J Thomson won the 1906 (not 1907 as claimed) Nobel Prize in Physics "in recognition of the great merits of his theoretical and experimental investigations on the conduction of electricity by gases."

His son, G P Thomson (not P J Thomson) won the Nobel Prize in Physics in 1937 for showing "diffraction properties" of electrons.

Erwin Schrodinger never called electrons wavicles and it was not in 1932, but 1926, and Nobel Prize in 1933, for the Schrodinger wave equation describing the behaviour of a particle in a field of force or the change of a physical quantity over time. The equation showed that electrons can have the properties of either waves or particles, and their state can only be calculated with probability This discovery settled the dispute over whether quantum objects such as electrons, atoms, or molecules were waves or particles.

Werner Heisenberg never said "we don't know what an electron is. He was awarded the Nobel Prize in Physics in 1932 (not 1956) for his theory of quantum mechanics and its applications, including the discovery of allotropic forms of hydrogen.

The original concept of the photon was developed by Albert Einstein. In 1926 the optical physicist Frithiof Wolfers and the chemist Gilbert N. Lewis coined the name photon for these particles. Photons have nothing to do with electrons that was the point of discussion until now.

The Hindu scriptures have nothing scientific in them. Absolutely nothing. Like all other Holy scriptures, it's fiction.

B M Hegde was a reputable Cardiologist. But now he's an Ayurveda sympathizing quack who has rented out his brain in memory of ancient Sages who wrote fictionalized observations from primal theories.

B M Hegde is now a shell of his former self mostly guided by spinal level thinking, brought on by senility and loss of logic.

Stop circulating his videos on social media. He's merely the remnant of an intelligence from a bygone era.

[ICAR-National Institute for Plant Biotechnology @ICAR_NIPB]

The International Conference on Biochemical and Biotechnological Approaches for Crop Improvement (IBBACI)-2023 kicked-off today at Bharat Ratna C. Subramaniam Auditorium, NAS Complex, New Delhi, being organized by SPBB, IARI, NIPB and NBRI.

[A @ANOKHE_ARCHANA]

Pleasure to listen!!

[Dr Rajendra Singh Paroda @ParodaDr]

Fondly Remembering the Contributions of Dr Monkombu Sambasivan Swaminathan to the Indian and the Global Agriculture (Agricultural World, Volume 9 Issue 10 October 2023)

[Anish Kundu @biok_anish]

If someone is interested and motivated for a post-doctoral research in Plant growth and defense metabolism through high throughput 'omics' approach may apply to my lab as a DBT-RA.

[suryakant kumar @prem_surya]

जद यू के राष्ट्रीय अध्यक्ष श्री ललन बाबू जिनका लोक सभा चुनाव क्षेत्र मुंगेर के अंतर्गत बड़हिया प्रखंड का यह रेल अंडरपास का दृश्य है जो की एकमात्र रास्ता है टाल के लोगों का प्रखंड मुख्यालय तक पहुंचने का कृपया इस पर विचार करें @NitishKumar @LalanSingh_1 @ECRlyHJP @AshwiniVaishnaw

[rajani maurya @rajanimaurya9]

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[Akshay B.G. @AkshayG36492696]

Seeding Prosperity, Not Increasing Financial Hardships! #RollBackIARIHostelFeeHike
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@icarindia
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[Yogesh b m Yogesh b m @Yogeshbm9380]

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"Education is a right, not a privilege! Say no to fee hikes at IARI!"

[rajani maurya @rajanimaurya9]

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