Rahul Chawla

Neurologist. MBBS, MD, DM Neurology (AIIMS Delhi)
Founder, HealthPil Teleconsultation and Second Opinion.
NEET Mentor. Public Health Educator

[Rahul Chawla @docrahulchawla]

A 38 year old corporate employee came to the emergency with sudden left-side paralysis. Brain imaging confirmed a stroke.
Blood tests showed severely uncontrolled blood sugar. He never thought diabetes could happen to him.

But for the past 10 years, he had this dark, thick pigmentation on the back of his neck. (1/2)

[Rahul Chawla @docrahulchawla]

@DocPriyamMD Very well explained doc! Examining end-organ involvement is crucial

[Dr.Sivaranjini @dr_sivaranjani]

Thank you @ForbesIndia for the recognition! More power to all the women out there!

[Rahul Chawla @docrahulchawla]

Very common scenario. By the time patient reaches hospital, he is already out of window period of stroke thrombolysis. These are the state of affairs sadly.

[Robin Zaccheus @RobinZaccheus]

Is Telangana’s Health Care at the brink of collapse? A must read & share.

I had first-hand experience of how Telangana’s government healthcare system functions during a real medical emergency yesterday.

When my family member suffered a sudden stroke, I immediately called the 108 Emergency Ambulance Service.

It took nearly 40 minutes for the ambulance to reach us in the Malkajgiri area, despite multiple calls to explain the location. The driver eventually had to be guided via WhatsApp location pin because he couldn’t find the place.

Even after arriving, the driver was unwilling to wait even five minutes to help shift the stroke-affected senior citizen. We somehow managed to rush her to the nearest District Medical Hospital in Malkajgiri (just 4–5 km away).

The doctor there checked her vitals, took a brief history, and immediately referred her to Gandhi Hospital, saying they couldn’t treat her there.

The same 108 ambulance driver, who was still waiting for my signature, refused to take us to Gandhi. He insisted I call 108 again so the system could formally allocate the vehicle. I called the helpline, explained the emergency, and even had the hospital nurse speak to them.

The customer care responded that they were sending an ambulance and put me on conference call with a vehicle near Uppal nearly one hour away. When I asked why they couldn’t simply use the ambulance already present at the hospital, I was told, “It doesn’t work that way. The system allocates.”
After waiting for over an hour, the second 108 ambulance finally arrived to shift the patient (who had a mild brain stroke with high BP and sugar levels) to Gandhi Hospital.

At Gandhi Hospital’s Emergency Ward entrance, two private ambulances were already waiting to unload patients. I overheard security staff saying, “Beds anni full unnai kada… ekkada pedataru vellani?” (All beds are full, where will we keep them?), only to be immediately hushed by another staff member.

When I asked if beds were available, they told me to check for myself. The Emergency Ward was completely overcrowded — not a single bed was free — yet somehow space was made for my patient. We were then asked to get an OP card from a counter a few metres away, which was issued quickly.
The ward was in total chaos. Doctors were handling 4–5 critical patients at a time with no time to even drink water.

The entire overcrowded emergency ward had zero air conditioning.
The doctor we finally met was polite and asked for a CT Brain scan. Getting the requisition form itself involved manual paperwork and stamps. There were no stretchers or wheelchairs available. When I requested one, the nurse said all were in use and suggested checking the storeroom. Luckily, I managed to get one from a helper. (Normally, patients have to deposit their mobile phone as security for the stretcher, but the nurse kindly allowed me to return it later.)
We waited another 30 minutes at Room 131 for the CT scan.

This entire ordeal highlighted the serious gaps in our emergency medical response system.

@GVKEMRIOnline @revanth_anumula @TelanganaCMO @TelanganaHealth

[Rahul Chawla @docrahulchawla]

https://t.co/qFsyJ6KGNn

[Rahul Chawla @docrahulchawla]

@kh505043 Vagitus is the first cry of a newborn baby

[Rahul Chawla @docrahulchawla]

@kh505043 Mannitol. It shrinks cerebral endothelial cells which temporarily widens tight junctions of the blood brain barrier to allow better delivery of certain drugs.

[Rahul Chawla @docrahulchawla]

@Doctors_GUILD Iron deficiency. It's pagophagia, a subtype of Pica

[Rahul Chawla @docrahulchawla]

@Doctors__squad I don't even know what to say🤦

[Rahul Chawla @docrahulchawla]

@DocPriyamMD Liver is the most well known answer but it absolutely affects all of the above, even the reproductive system, oral health and the intestinal lining

[Rahul Chawla @docrahulchawla]

@docakx Bitot's spot - caused by vitamin A deficiency

[Dr.Sivaranjini @dr_sivaranjani]

Dear IAPians

I am shocked and traumatized by the misinformation being fed to you in various groups. I am not in any groups to even give you my version.

1. You are being told that I am expecting IAP to support me in the defamation case. NO. I AM NOT. I AM PERFECTLY CAPABLE OF DEFENDING MYSELF.
I ASKED IAP TO CONDEMN THE NOTICE LIKE HOW OTHER ORGANISATIONS CONDEMNED THE NOTICE SO THAT COMPANIES DO NOT BULLY DOCTORS SPEAKING UP FOR PUBLIC HEALTH.
I HAVE ASKED IAP TO CONDEMN KENVUE'S PUBLIC NOTICE SAYING IT'S SCIENTIFIC PRODUCTS WERE PRESENTED AT PEDICON. I ASKED IAP TO DO THIS SO THAT IAP'S RESPECT AND DIGNITY ARE PROTECTED. NO COMPANY WHICH PUTS UP A STALL IN PEDICON AFTER PAYING FOR THE CONFERENCE, SHOULD GO PUBLIC SAYING ITS PRODUCTS ARE SCIENTIFICALLY PRESENTED AT PEDICON!

I ASKED PRESIDENT DR NEELAM MOHAN TO ASK KENVUE TO REBRAND eRZL TO NOT LOOK LIKE ORSL WHICH WAS EQUAL TO ORS FOR ALL THE PARENTS FOR 2 DECADES. INSTEAD, THE COMMITTEE CAME UP WITH A POSITION STATEMENT WITH CLEAR EMPHASIS ON SUCRALOSE BEING SAFE(eRZL USES SUCRALOSE) WITHOUT TALKING ABOUT OTHER ARTIFICIAL SWEETENERS AND WITHOUT WARNING THE PARENTS ABOUT THE POTENTIAL RISKS OF DAILY AND LONG TERM CONSUMPTION OF SUCRALOSE.

PLEASE NOTE THAT eRZL IS BEING MARKETED AS THE NEW FORM OF ORSL (THE SUGARY ONE) VIOLATING THE FSSAI ORDER AND IS BEING HANDED OUT AS ORS AT THE GROUND LEVEL. I HAVE PROOFS FOR THAT TOO.

2. You are being told that I earn money through my social media channels.

A BIG LIE. MY YOUTUBE CHANNEL IS NOT A COMMERCIAL CHANNEL AND I HARDLY GET TIME TO POST, ANY WAY. THE ONLY WAY YOU EARN MONEY ON INSTAGRAM IS THROUGH ENDORSEMENTS, WHICH I DO NOT DO.

3. You are being told that I am doing what I am doing, for public attention.
IF YOU ASK YOUR CONSCIENCE, YOU WILL KNOW THAT NO ONE WILL WRITE TO THE AUTHORITIES AND IAP FOR YEARS, FILE A PIL WITH THE GOVERNMENT AND THE MULTINATIONAL COMPANIES BEING THE RESPONDENTS, AND CALL OUT THE GOVERNMENT, MULTINATIONAL COMPANIES, AND IAP LEADERSHIP ON SOCIAL MEDIA, IF SHE/HE WASN'T PASSIONATE ABOUT THE CASE. PUBLICITY CAN BE GOT IN MANY OTHER WAYS. I DIDN'T HAVE TO GO AGAINST THE GOVERNMENT ON SOCIAL MEDIA, LEAVE ALONE GOING AGAINST IAP LEADERSHIP.

4. You are being told that I am abusive and make derogatory comments.
I AM NOT ABUSIVE. I HAVE CALLED OUT IAP LEADERSHIP FOR THEIR INDIFFERENCE TO MY MAILS ASKING THEM TO ASK JOHNSON&JOHNSON/KENVUE TO REBRAND ORSL SO AS NOT TO CONFUSE PARENTS, AND TO NOT ALLOW FUNDS FROM THOSE COMPANIES FOR PEDICON TILL THEY DID SO. I STAND BY WHAT I SAID. IF THAT'S ABUSIVE, I LEAVE IT AGAIN TO YOUR CONSCIENCE.

5. You are being told that I have not attended EB meetings in IAP TCB. I DID ATTEND A COUPLE OF MEETINGS. I REALIZED I COULD NOT SURVIVE THERE. EVERY TIME I BROUGHT UP THE TOPIC OF MISBRANDED SUGARY LIQUIDS(MISBRANDED AS ORS), THE TOPIC WOULD BE DIVERTED. ONE OF THEM EVEN HAD GONE ON TO SAY, " IT IS PARENT'S CHOICE". IT WAS SUFFOCATING. I RESIGNED FROM THE MEMBERSHIP IN THE VERY BEGINNING ITSELF.

I am really shocked by the way some of you are trying to run this smear campaign instead of feeling heartened that one of the paediatricians has stood up against the pharma and ensured the children are protected from the sugary drinks misbranded as ORS.
I have written to the IAP, to the authorities, filed a PIL, raised awareness through social media, and I have sent so much evidence(including videos) to the Central Government for the FSSAI order of Oct 14th and 15th to happen. Even in the Delhi High Court arguments, the videos had apparently helped the FSSAI in it's arguments against Kenvue(JNTL).

If you listen to your conscience, you will understand the truth! Attaching instagram link of a video where I called out the Government too (this was blocked after it had gone to millions, and I have reposted it). https://t.co/6tahFW7nwV

Dr Sivaranjani Santosh

#smearcampaign #IAPleadership #ORS #misbranding #misleadingmarketing #diarrhoea #diabetes #deaths

[Rahul Chawla @docrahulchawla]

What is the point of living long when you have to live like a lab rat?

[Bryan Johnson @bryan_johnson]

This is her vaginal microbiome report. 100/100 score.

Top 1% of all vaginas.

Her sample is dominated by the single most protective bacterial species a vagina can host (Lactobacillus crispatus).

Only about 25-30% of reproductive age women globally are L. crispatus-dominant, and “dominant” usually means above 50%. Kate is at 98.7%.

The lab found nothing bad to report. (no gardnerella, Candida, STIs, opportunistic pathogens, aerobic vaginitis markers, etc.)

This is linked to lower risk of BV, UTIs, yeast infections, HPV persistence, HSV-2 and HIV acquisition, preterm birth, and improved IVF outcomes.

A vaginal microbiome is downstream of everything: sleep, glucose control, stress, gut health, sexual health, immune function, what you eat, and what you put in it.

[Rahul Chawla @docrahulchawla]

@AnujaJaiswalTOI About time but standards on paper doesn't mean anything if compliance isn't implemented

[Rahul Chawla @docrahulchawla]

No student should have to go through this kind of situation. They should be focusing on their studies and their careers rather than going through these things.
This is shameful.

[Rahul Chawla @docrahulchawla]

Taking Ashwagandha for stress, sleep, anxiety or “hormonal imbalance”? But do you know FSSAI and AYUSH ministry have flagged the use of ashwagandha leaves due to its higher withanolide (withaferin-A) content and potential liver damage risk?

Most people taking Ashwagandha don’t know what exactly they’re consuming. The part that’s usually studied is the root extract, but many products don’t clearly mention this, and some may contain leaf extracts or mixed formulations.

On top of that, dose, strength, and duration are all unsupervised. Some take it for stress, anxiety or sleep issues and just continue for months or years without any monitoring.

Now, what does actual clinical data show?
Ashwagandha contains multiple active compounds, mainly withanolides, and these are suspected to be responsible for both its effects and side effects.

In reported cases, liver injury due to ashwagandha-containing supplements (most commonly root extracts, though exact composition is often unclear) typically develops within 2–12 weeks of starting the supplement, often presenting with a cholestatic or mixed pattern — meaning bile flow gets affected along with liver cells.

A recent case series (2023) by Dr. Cyriac Abby et al. looked at patients with ashwagandha-related liver injury — most were taking it for stress or sleep. Some had very high bilirubin levels, and a few with pre-existing liver disease progressed to acute-on-chronic liver failure and even death.

Even in otherwise healthy individuals, cases have shown jaundice, itching, fatigue, and raised liver enzymes, which gradually improved after stopping the supplement, sometimes taking weeks or months to settle.

Many of these cases involved commercially available products that were tested.

Before you buy that OTC ashwagandha - first know which part is being used, how much dose you’re actually getting, or what else is mixed in and most importantly, what does the evidence say?

Something that sounds “natural” does not mean safe.

@theliverdoc @dr_sivaranjani #MedX #MedTwitter

[Rahul Chawla @docrahulchawla]

A patient came to me with
SGPT- 122, which is clearly too high. On asking further, there was no history of alcohol or hepatitis, nothing that usually explains it.
But, he had been taking this one supplement for years, something that’s been in the news recently and BANNED by FSSAI over safety concerns.
Could his condition be induced by ‘ASHWAGANDHA’?

[Dr.Sivaranjini @dr_sivaranjani]

Do not get misled by advertisements!
It's unfortunate that some doctors, dentists, dietitians are also promoting them in addition to scores of mom influencers. They gain money, and your child loses in the process!

#gummies #caries #obesity #poorabsorption #unregulated

[Rahul Chawla @docrahulchawla]

In such cases, the nervous system eventually integrates the structure as self.

The forearm's subdermal vascularity allows neovascularization of the graft before transfer. Peripheral nerve ingrowth and gradual sensory remapping is handled by the nervous system.

[Dr Abdul Hameed 🩺 @drabdulhameed07]

The fascinating journey of growing the ear!

🧬 An Ear… Grown on an Arm!
This isn’t science fiction-it’s real surgical innovation.

After losing her ear and part of her skull to aggressive skin cancer, one patient became the center of an extraordinary medical breakthrough. Instead of using artificial implants, surgeons turned to the body’s own biology.

🦴 They carefully sculpted a new ear from her own rib cartilage ,then did something remarkable…

👉 They implanted it beneath the skin of her forearm.

Why the arm?

Because it acts like a natural bioreactor rich in blood supply, allowing the new ear to develop its own living vascular network. Over time, the structure matured, survived, and became fully viable.

⏳ And then the final step.

Once ready, the ear was surgically transferred to its rightful place on her head, restoring both form and function.
💡 Why this matters:

• Uses the patient’s own tissue so minimal rejection risk
• Creates a living, natural structure
• Showcases the power of

reconstructive and regenerative surgery
Medicine isn’t just healing ,it’s rebuilding.

[Rahul Chawla @docrahulchawla]

There’s so much NOISE on social media about AI replacing doctors - from Radiologists to Dermatologists and even Neurologists.

Why not start replacing RESIDENTS in government hospitals with AI?

They are working 80-100 hours per week! Let AI do its job and prove to the world doctors are useless.
#MedTwitter #MedX

[Rahul Chawla @docrahulchawla]

Limb transplants aren’t just about attaching prosthetic limbs. Nerve regeneration is a major part and it can sometimes take months to years for motor control to return. This is a miracle in medicine.

[Dr. AK 🇮🇳 @docakx]

A miracle of modern medicine!

This was the world’s first proximal bilateral upper-extremity transplant including shoulder reconstruction. This was done at Hôpital Édouard-Herriot in Lyon, France, on January 13, 2021.

This is how the patient performed after recovery👇

PMCID: PMC11163999
PMID: 38859807