soham trivedi

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[soham trivedi @Name_Soham]

@chiragbarjatya Congratulations man! Happy to see your growth. Keep growing! 🎉🎉

[soham trivedi @Name_Soham]

@chiragbarjatya Great going man! 👍🏻

[TheLiverDoc™ @theliverdoc]

This is the saddest thing I have read in a very long time.

As a doctor, speaking with families about death and seeing people die is a routine for me.

We like to believe that people who die, are off to a place where things are better. It's a nice thought. But reality is that they just cease to exist.

After they die, everything goes back to being exactly the same before their birth. Except for memories.

Inside memories of those who could experience life with you, until they die and live as memories inside those who were close to them.

Live in the present to the fullest. Do good for others. Keep your family close. Do things that make you happy. Give back to your community.

So that you'll live and prosper inside memories after you pass away.

[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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[soham trivedi @Name_Soham]

@theliverdoc Thank you doctor for this great work. My father is a CKD patient and i was resistant to buying generic drugs fearing quality issues. This data boosts my confidence with generic drugs. This is amazing work. I really appreciate it.

[soham trivedi @Name_Soham]

@realsohamparekh What have you done bro to our name 😂

[soham trivedi @Name_Soham]

@chiragbarjatya Take care. happy to know everything is good at your end.

[soham trivedi @Name_Soham]

@PuneCityTraffic @PuneCityPolice extremely heavy traffic on nagar road, more than usual. No signals are working and no traffic police at chandan nagar crossing and wadgaon sheri crossing. Kindly do the needful

[Gabbar @GabbbarSingh]

Your idea of luxury is not the same as your parents’ idea of luxury. A lot of kids when they start earning well, tend to impose their own ideas, on their parents. Who out of courtesy bear with it, and don’t complain.

They don’t like a secluded Five star hotel, they like a place where they can access a bustling market after just stepping out. That’s how they did tourism all their lives. They have been value conscious all their lives. Sure, you can afford a Rs 600 ka Masala Dosa on the in-house restaurant menu, but they can never appreciate the taste after knowing the price.

Unclench your butt, you don’t have to prove a point, let them live, just be a facilitator. :)

[soham trivedi @Name_Soham]

@theliverdoc Indeed. He was losing muscles due to kidneys not working and always feeling pain here and there. So he suggested him to have some protein along with eating food that is protein rich.

[Nalini Unagar @NalinisKitchen]

ANOTHER SCAM BY JIO!

If you buy the ₹448 voice-only plan and think you can add the ₹69 data booster plan for UPI payments, you can’t. You need an active data plan to use booster plans. There are data-only plans, but none with 84 days validity. Even a 28-day plan will cost you ₹175 extra.

TRAI, wake up! Don’t stay silent.

[Siddharth's Echelon @SiddharthKG7]

Sanjiv Khanna will be 51st Chief Justice of India.

His father Dev Raj Khanna was a judge in Delhi High Court. His uncle Hans Raj Khanna was judge in Supreme Court.

I wanted to make a thread of Nepotism, but an ounce of integrity stopped me.

Rather, it is a 🧵 of good Karma. Why?

Read how Sanjiv Khanna’s appointment will be a penance of a historical injustice.

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[soham trivedi @Name_Soham]

@chiragbarjatya Congratulations 🎉🎉

[Giorgia Meloni @GiorgiaMeloni]

Hi friends, from #Melodi

[soham trivedi @Name_Soham]

@vineet_tropmet Kharadi today

[soham trivedi @Name_Soham]

@chiragbarjatya Yes Ahmedabad. I had been there for 7 years, not a single power cut.

[soham trivedi @Name_Soham]

@vineet_tropmet raining in wadgaon sheri, full monsoon vibes!

[soham trivedi @Name_Soham]

@chiragbarjatya Bhai kya weather he, my friends living in Gujarat in 43° envying me 😀

[soham trivedi @Name_Soham]

@vineet_tropmet Raining heavily in wadgaon sheri