Dr Anoob അനൂബ്

medico, muslim, malayali | He/him | Public Health, Social Justice, Food, Humor, Travel |

[Dr Anoob അനൂബ് @anoobrazak]

DEMOCRACY AS MEDICINE!

Upper Silesia was an area dominated by Polish speaking population, but it was under the Kingdom of Prussia, a German kingdom. There were many famines and in the winter of 1847-48, a typhus epidemic broke out in Upper Silesia, causing many deaths

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[TheLiverDoc™ @theliverdoc]

Today is World Liver Day 2026.
Here are 8 things your liver actually wants you to know.

1
There is no such thing as a "liver detox."
Your liver runs phase I and II detoxification 24/7 on its own.
No juice cleanse, no milk thistle, no herbal detox speeds this up.

In fact several have caused liver injury - the opposite of the claim.

2
Alcohol has no safe dose.
Liver harm begins from the first drink.
The old "moderate drinking is protective" myth came from flawed studies contaminated by abstainer bias - now debunked by Mendelian randomization.

Zero ml is best.

3
"Natural" supplements are now a leading cause of acute liver failure.
Ashwagandha. Green tea extract. Garcinia. Kratom. High-dose turmeric. Giloy/Tinospora.
They dominate drug-induced liver injury registries across India, the US, and Europe.

Natural ≠ safe.

4
Coffee is genuinely liver-protective.
2–3 cups/day (caffeinated or decaf) lowers the risk of fibrosis, cirrhosis, and liver cancer.

One of the very few dietary interventions with real, replicated evidence.

5
Fatty liver (MASLD) now affects ~1 in 3 adults worldwide.
A 7–10% body-weight loss:
• clears Liver fat
• reduces inflammation
• can regress early fibrosis

No approved drug currently beats this. Your plate and feet are the first-line therapy.

6
Sugar-sweetened drinks independently cause fatty liver.
Fructose is metabolized almost entirely by the liver - straight into fat.
One daily soda raises MASLD risk even after adjusting for total calories.
Lesser is better.

7
Get vaccinated against hepatitis B. Get screened for HBV and HCV at least once in your lifetime.
HBV vaccine prevents >95% of chronic infection, cirrhosis, and liver cancer.
Hepatitis C is curable in 8-12 weeks with >95% success - but most carriers don't know they have it.

8
Exercise protects the liver independent of weight loss.
150 min/week moderate OR 75 min vigorous activity reduces liver fat and stiffness - even when the scale doesn't move.

Movement is "medicine".

🫂

PS: we also need a liver emoji

[Dr Anoob അനൂബ് @anoobrazak]

@chiragbarjatya Maybe we should consider not being so polite to AI, because potential environmental costs!

[Oloye Akin Alabi @akinalabi]

You are 30 so don't want to go for a 5 yr course because when you finish you will be 35. Whether you go back or not, you will be 35 in 5 yrs

[Lokendra Singh @HYDTrafficMan]

How to get hoardings removed as per law:

1. Do not complain to @GHMCOnline as GHMC Act is not deterrent and officials do not enforce it fully.
2. Instead, call to local police station and ask them the official email id of police station.
3. Write the brief facts of the complaint like place, type of risk etc. Mention that you want to get it removed under section 152 BNSS and 168 BNSS.
4. While sending email, at last line write that "Please acknowledge the receipt of this email (electronic record) u/s 12(1) of IT Act"
5. It becomes a official record.

If action is not taken, then you can file an RTI for Action Taken Report of your complaint sent via email under life/liberty case (Right to Safety & Security) and authority has to respond within 48 hours.

[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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[Dr Anoob അനൂബ് @anoobrazak]

@manas_muduli Giving an instruction to all Govt staff and every other individual in the state to wear traditional Odisha Handloom dress April 1, Odisha State Day will itself help in promoting and advertising.

[Dr Anoob അനൂബ് @anoobrazak]

@discountsdeck OnePlus Nord CE4 (8GB, 128 GB) or CMF Phone 2 Pro (8GB, 128 GB)??

[Dr Anoob അനൂബ് @anoobrazak]

@antonystanley09 Is there really a WHO recommendation of 1:1000 doctor-population ratio?

@kikumbhar has examined this topic in this article.

https://t.co/z5wEWDEfSh

An excellent read.

[Natalie hamilton @Nataliehamil4]

In 2004, we saw a person aged 27 with bamboo spine. In a month or so saw another. Our hospital staff picked the fact that they belonged to same village but were not related (Kurkutia in Mayurbhanj dt, Odisha).
Discussed the case with Prof Samuel Chittaranjan, spine surgeon of CMC Vellore. He said Ankylosing Spondylitis is likely but Skelletal Flourosis is a DD.
We decided to visit the village and did a health camp. We did the Shoeber's Test for all who attended. More than 80% had restriction.
I collected water samples from all the wells in the village (n=12). I also collected water from wells in neighboring villages. Sent these to CMC Vellore for analysis. This village had very high fluoride content. Some wells had dangerously high.
The village leadership took our report and asked district admin. The Govt arranged a tanker to supply water to this village everyday.
I had an eye for research but was not trained adequately as an MBBS student. We didn't publish this in any medical journal. However, it gives me great joy that we had impact from a simple clinic, with some field work, lab support and expert counsel.
Thanks Dr Akhil for bringing nostalgia. Here is a pic of those times.

[Dr Anoob അനൂബ് @anoobrazak]

@nothingindia @grok phone three, me too want one!

[Dr Anoob അനൂബ് @anoobrazak]

Pretty sure (at least hopeful) that #Djokovic has a lot left to offer and entertain us.

But yes, the #Sincaraz era is upon us!

#Alcaraz #Sinner #AlcarazVsSinner

[Dr Anoob അനൂബ് @anoobrazak]

@patralekha2011 It has been a feature of mainstream newspapers, since many many years

[Dr Anoob അനൂബ് @anoobrazak]

@iMehreenAlam This is the guy they have put in charge!
https://t.co/1GmZU3T88I

[ישראל כ”ץ Israel Katz @Israel_katz]

Indeed, Madam Congresswoman.

We have to draw a line.

We will Not tolerate murdering children and burning families.

The line has been crossed. We will fight the terrorist organization Hamas and destroy it. All the civilian population in gaza is ordered to leave immediately.

We will win. They will not receive a drop of water or a single battery until they leave the world.
@AOC

[Dr Anoob അനൂബ് @anoobrazak]

@cricketingview Washington Sundar clean bowled 5 Kiwis in the first innings and Mitchell Santner trapped 4 Indians trapped in front of wicket in the first innings.

Does this happen frequently, where one bowler gets so many bowled outs or another gets so many LBWs in one single innings?

[Dr Anoob അനൂബ് @anoobrazak]

@__try__catch__ @mynameswatik You didn't get the point about nutrition, did you?
https://t.co/AVyevO4nle

[Ministry of Health @MoHFW_INDIA]

Incorporate iron-rich foods into your daily diet to improve iron levels.

From this National Nutrition Month, let's focus on building a Suposhit, Sakshar, and Sashakt Bharat by addressing iron deficiency anaemia, especially among women of reproductive age.
.
.
#NationalNutritionMonth

[Dr Anoob അനൂബ് @anoobrazak]

A.M.M.A so high in the air,
That they are feeling a lack of oxygen!
#MalayalamCinema #AMMA #MeToo

[cinesthetic. @TheCinesthetic]

what’s a movie that had the BIGGEST PLOT TWIST EVER and it still blows your mind just thinking about it ????

[Dr Anoob അനൂബ് @anoobrazak]

@theliverdoc There is something I haven't really understood as long as I have been on Twitter.

That someone tweets their new profile pic or a random pic of themselves is common and understandable.

BUT WHY DO PEOPLE RETWEET SUCH PICS?
BUT WHY?

[Dr Anoob അനൂബ് @anoobrazak]

@zoo_bear @ShefVaidya @MahuaMoitra @ShashiTharoor @supriya_sule @ShatruganSinha Dear Lok Sabha TV, whenever @ShefVaidya is watching, please make sure to not show the faces of these 10 persons, all of whom got elected.