nischal neupane

Pediatrician/jipmerite🇳🇵NonUSIMGPedsMatch 2023 applicant /ECFMG certified

[Seth Abramson @SethAbramson]

This video is incredible.

Everyone should RETWEET it so the whole *world* sees it.

[nischal neupane @nischal70]

I am happy to share that I will be starting my Pediatrics journey at Tulane Pediatric Residency program.
@LCMCHealthEdu

[TheLiverDoc™ @theliverdoc]

Yoga and improved skin health and hair growth?

India’s pseudoscience poster boy, Ranveer, aka Beerbiceps gets it embarrassingly wrong.

Let us break it down.

I am sorry this is lengthy, because – as per Brandolini's Law (aka the Bullshit Asymmetry Principle): It takes a lot more energy to refute bullshit than to produce it.

Check out this video. In it, Ranveer “pseudoscience peddler” Allahbadia with over 8 million followers on YouTube and Instagram bullshits everyone in just 35 seconds.

He showcases some major female movie celebrities and tells the viewers that the secret to their skin and hair is that they perform Yoga every day, especially a Yoga pose called the “Sarvangasana” or shoulder-stand or candle pose.

His “scientific” explanation? The stance increases blood flow the scalp and head, and improves skin health and hair growth.

This is utter nonsense.

What happens to the blood flow, heart, head, and brain region when someone takes an upside-down stance?

For that, you must know the meaning of one word – Homeostasis.

Homeostasis is a self-regulating process by which human body maintains internal stability in its organ functions while adjusting to changing external conditions. This is also consists of “autoregulation,” the method by which an organ or tissue maintains blood flow despite a change in perfusion due to external (eg: body position changes) or internal (block in blood vessels) conditions.

For example, we are normally supposed to walk on two legs or rest by sitting down or lying down. The heart rate, blood flow to all organs including scalp and brain is all maintained depending on the importance and metabolic activity of that organ. For example, at rest, highest proportion of blood flow is received by the liver (nearly 25% of cardiac output) which is 100ml/min per 100g liver weight. The brain receives 50ml/min per 100g weight, while the skin receives 1 to 3ml per 100g per minute. https://t.co/YsQxLGHvmb

Organ tissues are usually considered as blood supply-dependent (e.g., heart and brain) and blood supply-independent (e.g., abdominal organs, kidneys, skin, and resting muscle) for oxygen delivery – meaning the latter WILL receive fixed amounts to maintain its functioning while the former requires changes to blood flow depending on various unusual situations. For example, in massive blood loss, the body will try to maintain blood flow into heart and brain rather than skin and muscle to maintain life. https://t.co/uBBl3B23Zc

The blood flow is set in the body for proper functioning of organs and every time we try to change that flow, a healthy body will re-align that flow depending on the importance of the organ systems functions. https://t.co/N9YpLIQPvX

So, when you do a shoulder stand or candle pose, the initial sudden change to the body position will be caught by the receptors in the blood vessels and heart which will re-align the flow to organs of importance, thereby maintaining critical functions that are required for health. Which means, the blood flow to the skin including the scalp, will be re-aligned to its required flow and DOES NOT increase to face and scalp or brain as India’s pseudoscience peddler mentions.
https://t.co/f3EUp5gFcd

In heavy aerobic exercise and changes to temperature related sweating or certain disease conditions, the skin blood can increase. Yoga is not a proper exercise as it is not an aerobic activity.

Now Sarvangasana and blood flow – a study showed that heart and blood flow responses were NOT AFFECTED with this pose in healthy people. https://t.co/OrVhey6Zn0

Even a complete head stand, called Sirsasana does not increase blood flow to the brain, forget the scalp skin, because of blood delivery homeostasis due to autoregulatory mechanisms. https://t.co/3xP3eX63ZF

The claims for effects of Yoga on specific organs are complete bluff – a public duping started by B K S Iyengar who took Yoga to the international stage.

Even in his authoritative books, he does not mention shoulder stand or candle pose to be useful for hair growth. In fact, he [nonsensically] mentions that shoulder stand will improve “thyroid health” (it does not), controls asthma (it does not), reduces disease of the throat (it does not) and prevents common cold (it does not, because common cold is caused by a virus, and not dependent on whether you stand, sit, lie down, and hang yourself upside down).

Also, note that Sarvangasana (shoulder stand), Sirsasana (head stand) and Padmasana (lotus position) are the most common Yoga poses reported to cause an injury. In those with high blood pressure or heart disease, these poses may become life threatening.
You can see those here https://t.co/1yjKkIMmwf, here https://t.co/Wm3xqfvZJ6 and here https://t.co/ew9Kz5nbnH

Yoga, especially shoulder or head stands do not improve skin health or increase hair growth by increasing blood flow.

In fact, Yoga does nothing specific for organ systems functions since such evidence does not exist. A lot of pseudoscience peddlers who sympathize with Yoga will mislead you with many such magical benefits.

So then, what specific exercise or action improves hair growth?

We do not really know. There is some evidence, even though weak, for standardized scalp massages: https://t.co/b3jloyQEwH good evidence for scalp cooling (prevents hair loss, may promote regrowth especially in chemotherapy patients) https://t.co/6BpDLQs3J6

Speak with your Dermatologist on skin and hair health queries and not National-level baby-face poster boys of misinformation.

[Roshan Rai @RoshanKrRaii]

BJP now at just 66 seats in Karnataka

This is after the Prime Minister of India

Held 33 rallies
Held 28 Roadshows
Brought Pakistan
Brought Bajrang Bali
Cried and played the victim card

This is the defeat of Modi's shamelessness and arrogance.

#KarnatakaElectionResults2023

[Pediatric Nephrology @Ped_Neph]

Acute post-streptococcal glomerulonephritis (APSGN) is common in developing countries. Read this Original Article on clinical features & complications in children diagnosed w/APSGN at presentation & after 4 & 12 weeks, in a resource-limited setting.
https://t.co/duEvKhn9QZ

[TheLiverDoc™ @theliverdoc]

This is important 📣

I'm sure most doctors do not know about this, and patients need to be aware.

Montelukast is a drug commonly prescribed long term for allergic rhinitis (seasonal runny nose) and bronchial asthma alone or with antihistamines like cetirizine.

The US FDA has issued black box warnings for this drug which many may not have known.
https://t.co/mYiCl9m1Ad

I know a lot of people who use montelukast and levocetirizine combination for months to years for allergies and asthma in India.

This drug is now strongly implicated as a cause for negative mental health such as anxiety, major depression and insomnia. This can happen in children too. The longer the use, the higher the risk of mental health disorder. Up to one year use is most significantly associated with adverse mental health.
https://t.co/iEB5TJKRQR

Children can also suffer from depression, insomnia and nightmares that negatively impact their interactions with peers and family.

Even though side effects are rare, the common use of this drug in India could probably see (if looked into) higher adverse events due to sheer numbers of people using it.

If you are on montelukast for months on and have been experiencing new onset mental health issues or worsening of preexisting mental health issues, please speak with you doctor. If your children show adverse mental health symptoms especially insomnia, anxiety after start of montelukast, notify your doctor.
https://t.co/Blpl1sLs4c

Montelukast is a great drug for management of allergic rhinitis and control of asthma. But there are safer drugs that be used in its place.

DO NOT STOP YOUR OR YOUR CHILD'S DRUG BY YOUR SELF. SPEAK WITH YOUR ALLERGY SPECIALIST, GENERAL PRACTITIONER OR PULMONOLOGIST.

I hope this was useful for you and your children who are on this drug.

[Barack Obama @BarackObama]

This nation was built on peaceful protest. No elected official should lose their job simply for raising their voice – especially when they’re doing it on behalf of our children.

[𝙎𝙞𝙧 𝘿𝙚𝙫𝙚𝙣 @36xxx69]

कान्तिपुर टेलिभिजनको करिब ३० मिनेटको समाचारमा यीनि नानीलाई ठ्याक्कै १३ मिनेट देखाउने रैछ। बाँकीसमयमा अन्य भिडियो सामाग्री देखाइने रैछ। उक्तसमयमा यीनले ८२३ पटक दुबैआँखा झिम्क्याउँदी रैछिन भने १३७ पटक टाउको हल्लाउने,१८ पटक पाना पल्टाऊने र१२ पटक दाँत सबै देखिनेगरी मुस्कुराऊने रैछिन।

[nischal neupane @nischal70]

@LFC @MoSalah Congratulations king

[Ali Abdaal @AliAbdaal]

I've read pretty much every book on productivity and time management - here are my top time management tips that I genuinely use 👇

[American Academy of Pediatrics @AmerAcadPeds]

We mourn the lives of the children and families affected by yet another school shooting today in Nashville. Gun violence is a threat to children everywhere. As pediatricians, we will continue to advocate for policies to keep kids safe and to #EndGunViolence.

[TheLiverDoc™ @theliverdoc]

People taking probiotic and prebiotic supplements daily, would you care to look back at the amount of money wasted?

Me and a patient recently calculated the money he spend on daily probiotic use since one year for fatty liver and "gut health." Took us a good 1 hour to go through his invoices on the app.

He spent 1,24,568 INR ($1514) for nothing.

[Ashwasena (अश्‍वसेन) @Renaltubules]

Renal biopsy:
When to stop and restart Aspirin ?

[Ashwasena (अश्‍वसेन) @Renaltubules]

Supportive management of glomerular disease @goKDIGO

[Keith Siau @drkeithsiau]

Stomach full of crayons. How would you manage this? More importantly, what title would you give this case report?

[Ashwasena (अश्‍वसेन) @Renaltubules]

A child with nephrotic syndrome.
Off steroid for 4 months with no proteinuria in this period.
Now since two weeks,
Persistent proteinuria with spot PCR 1, urine protein - 3+ three samples.
Serum albumin -normal.
No edema. Rest inves- normal.

Management?

[TheLiverDoc™ @theliverdoc]

This would be the biggest comedy of errors in Indian media in last few months.

The Indian Express puts out a news title claiming that Ayurveda advises consuming jalebi+rabri (type of Indian sweet) for management of migraine.

BUT, the actual content of the news deals with debunking this misinformation which was initially put up on Instagram by an Ayurvedic practitioner.

Now, the apex pseudoscience authority in India, Ayush, does a "fact check" on the pseudoscientific news piece and warns people and The Indian Express NOT to print such claims - when the news content was actually fact-checking and debunking the very pseudoscientific claim.

But the real comedy comes when Ayush themselves start patronizing Ayurveda by misinforming the public that migraine is well described in Ayurvedic texts and MANY STUDIES on benefits of Ayurveda on migraine is published in literature (there is none actually)

Ayurvedic texts do not describe migraine but mentions "headache" in general in the chapter on "Diseases of the Head" and talks about treatments that include putting cow and goat urine in the nose, burning the patient's skin, making the patient consume fats+sugars (probably where the idea of Indian sweets came in) and more importantly, instilling blood of animals in the nose and making patient smell fumes of rotten fish to drive away bacteria and worms causing headache.

This is real Ayurveda.

Do not, for ONCE believe what AYUSH is telling you. It is the biggest disinformation campaign on Indian public health.

[nischal neupane @nischal70]

@Princy_shrest @TulPeds Thank you 😊

[nischal neupane @nischal70]

I matched @TulPeds. #pedsmatch2023 #futurefaap #ipickedpeds