Shankar Gadwal

Nephrology Resident,
Nizams Institute Medical Sciences, Hyderabad

[Dr Sree Bhushan Raju @sreebhushan]

Obesity in Renal Transplantation : Indian Journal of Transplantation https://t.co/kiTGNrHLiG

[Payal Gaggar @DocGaggar]

💥Honoured to share an excellent editorial written by my mentor Dr.Sree Bhushan Raju @bhushan_sree highlighting interesting case reports in nephrology. @manirath
@sreebhushan @HydNephForum @gadwal_sg @AVarmudy @mukeshgoyalneph @sonu_manuel
💥https://t.co/kHxwGbmfDq

[TheLiverDoc™ @theliverdoc]

Between February 2023 and June 2023 kidney doctors at Aster MIMS Hospital, Kottakkal, in Kerala started getting a series of patients with a rare and strange type of kidney disease. They were baffled.

They called it Neural epidermal growth factor-like 1 protein (NELL-1) associated membranous nephropathy - a weird disease where the the body's immune system was attacking the filtering membranes of the kidney.

The disease was characterized by massive loss of protein in urine (>3.5 g/day) and clinically presented with severe leg and face swelling, high blood pressure, frothy urine, and clot formation in blood vessels of legs or lungs and sometimes strokes.

The first patient was a 14 year old girl, followed by her relative. Both their kidney biopsies were positive for NELL-1 kidney disease.

Then came a completely unrelated 29 year old man. The doctors were alarmed. And they looked at their records. There were five more such patients within the past 4 months.

They looked at published literature and found a common culprit among most NELL-1 cases recorded.

Mercury.

Blood levels of mercury in patients were checked and the doctors were stunned. Levels were 100 times more than normal limits of detection.

But what was common to all these mercury poisoned unrelated patients?

And a thorough clinical history in retrospect found the culprit.

Fairness creams.

All patients were using locally made fairness creams to lighten their "naturally-beautiful dark skin."

Fairness creams contaminated with mercury, causing chronic mercury poisoning and NELL-1 kidney disease is well known.

See this report from Akola and Mumbai - https://t.co/Z9zCZOIg7e

Another cause for Nell-1 kidney damage is presence of lipoic acid which can by itself cause membranous nephropathy. Lipoic acid is a common constituent of fairness creams and many oral antioxidant supplements - be wary of this.
Check your supplements.
See here https://t.co/hhyIPn15nP

Not only fairness creams, but traditional herbal medicines, especially Ayurveda & Siddha formulations which Indian "wellness gurus" such as Sadhguru so passionately promote, have been implicated in multiple cases of mercury-induced severe Nell-1 kidney disease.

See here https://t.co/QhSSU9pFji here https://t.co/0H3lWJcFUQ and here https://t.co/CR0Wzf7UKh

Be wary of locally made cosmetics, lipoic acid based oral supplements and Ayurvedic and Siddha herbal products. Know what is good for you. And more importantly, know what is not.

Avoid unwanted troubles. Use the knowledge from medical science as a shield to defend yourself against unscientific practices and bad science.

Sources:
2023 Kerala: Want To Become Fair? Beware Of MN Syndrome - https://t.co/GQzHOC29YN

2022 Mumbai: Mumbai doctors link fairness cream to kidney illness in family - https://t.co/o16zqVIcGN

[Indian Journal of Nephrology @indianjnephrol]

🔷Original Article: Rituximab, Use and B Cell Depletion in Patients with Membranous Nephropathy– A Retrospective, Observational Study

✅ Acceptable remission rates with Rtx in both Rx naïve and Rx resistant pts
✅No significant association btw B-cell depletion and remission

[Vincent Rajkumar @VincentRK]

The serum free light chain FLC assay. Tutorial. #MedTwitter #MyelomaVR

Frequently ordered and frequently abnormal. This thread will reduce unnecessary headaches and referrals.

1/ Don’t order it unless you are suspecting myeloma, amyloid or related disorder

[Sundar Sankaran @sundar_s1955]

Perils of dialysis with out proper Nephrologist supervision

[Dr P S Vali @DrPSVali]

💫 Prof @sreebhushan 's lecture on "ABMR - Rejection to recovery" was highly impactful

🎓His in-depth analysis shed light on approaches to overcome rejection

Thank you, sir

#TransplantConclave. 🌟 @ainuindia @ainunephrology

[Payal Gaggar @DocGaggar]

💥Glad to share our experience on "Rituximab and B cell depletion in MN"
🌟 500mg Rtx, 2 doses.
🌟66.7% Remission rates.
🌟No association between B cell depletion and remission.
@bhushan_sree @SwarnalathaGud2 @GangadharTaduri @Shankurology @gadwal_sg @Vijay100912

[TheLiverDoc™ @theliverdoc]

If you know sugar is the new alcohol, and protein is the building block of muscle and immunity, then you'll know how you have been taken for a ride, at least now:

Bournvita
100g contain 37g of sugar (sucrose)
100g contain 7g of protein

Boost
100g contain 35g sugar of which 9.5g is added sugar
100g contains 7.5g protein

Ovaltine
100g contain 40.4g sugar
100g contain 11.5g protein

Horlicks
100g contain 79g carbs of which 13.5g is table sugar
100g contain 11g protein

Complan
100g contain 62g carbs of which sugar is 21.8g
100g contain 18g protein

Ensure Protein
57g contain 13g sugar
57g contain 9g protein

Pediasure
100g contain 67.7 carbs of which sugar is 17.1g
100g contain 14g of protein

All of the above, advertised as muscle growth, increased height, immunity building and better overall health In comparison🔽
100ml of Coca cola contains 10.6g sugar
100ml of Fanta contains 10.9g sugar
100ml Ginger Beer contains 10.8g sugar
100g of Five Star chocolate 48g sugar
100g McDonald's Cheeseburger 6g of sugar
100g KFC Chicken 0g sugar

Sucrose and fructose are the worst causes for non-alcoholic fatty liver and fatty liver disease in children. Open your minds to advertised "healthy" food products!

[Sree Bhushan Raju @bhushan_sree]

At WCN 2023 with ISN president Prof Fogo

[Hyderabad Nephrology Forum @HydNephForum]

Hyderabad Nephrology Forum is pleased to announce
“Workshop on Nuclear Medicine in Nephrology”

🗓️ Friday 24th Feb 2023, 10 AM Onwards

@SwarnalathaGud2 @drmanishasahay @myadla @DrPSVali

[Shankar Gadwal @gadwal_sg]

"Nephrology and SoMething More" an eloquent article on SoMe by my guide prof @bhushan_sree @sreebhushan sir in ISNSCCON 2023 souvenir 📝
@faizansari88 @Shashikirankb @mukeshgoyalneph @AVarmudy @Vijay100912 @DocGaggar @isnsccon23

[Shashi Tharoor @ShashiTharoor]

My plea in the Lok Sabha today urging the Government to reintroduce comprehensive legislation to outlaw violence against healthcare professionals. No one knows why they withdrew their 2019 Bill, but it’s needed more than ever. IMA says 75% of doctors have suffered assault!

[Harish Rao Thanneeru @BRSHarish]

In a rare feat at NIMS Hospital, doctors performed 4 Kidney Transplants in 24 hours providing a new lease of life to 4 patients suffering from end stage kidney failure.

Congratulations to the doctors at NIMS for their services poor and needy patients.
1/2

[Dr Faizan Ahmed Ansari 🇮🇳 @faizansari88]

Thank you & Congratulations all seniors/teachers/mentors 💐💐💐 all of us will be indebted for lifelong for your teachings, guidance & support 🙏🏿🙏🏿🙏🏿 #isncon22 @bhushan_sree @isn_india @vjha126 @sgulati2002

[Vineet Behera @BeheraVineet]

Dr Shreebhusan Raju @bhushan_sree, speaks on " Ultrafiltration in PD"

UF Failure - Definition
Rule of 4s
Failure of 400ml UF after 4hrs with 4.25% Dextrose

@isncon22 #isncon22 @bhushan_sree @tjeloka @drprabhunephro @iSPD @InformNephro @isn_india @ISPD1 @PDI_Journal

[Dr Faizan Ahmed Ansari 🇮🇳 @faizansari88]

Wonderful Talk by @bhushan_sree #isncon22 "UF in PD" @isncon22

[Sree Bhushan Raju @bhushan_sree]

Words of wisdom - dr Fogo President of ISN

[Int Society of Nephrology @ISNkidneycare]

𝗜𝗦𝗡 𝗩𝗜𝗗𝗘𝗢 𝗔𝗕𝗦𝗧𝗥𝗔𝗖𝗧 𝗦𝗘𝗥𝗜𝗘𝗦: Efficacy of corticosteroids in infection-related glomerulonephritis – A randomized controlled trial. From 2022 @KIReports https://t.co/5moOJ2wB56

#VideoAbstract by @Gawad_Nephro and @acssjr

[Dr Faizan Ahmed Ansari 🇮🇳 @faizansari88]

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Like and Share with your friends & colleagues 🔢 #isncon22 @bhushan_sree @gollaanvesh @gadwal_sg @sindhu_kaza @dwivedi03_rohan @Shashikirankb @muzamilkidney @abidkuchay @NephPrasad @dr_sourabha