Vishnu Rao

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Travel 🧭
Foodie 🍱

[Vishnu Rao @oarunshiv]

@kbalakumar Sorry my bad then. I just read the headlines and and your reaction to it

[കാസർകോടൻ മലയാളി @NuraaruN88]

😂 Journalism these days!

[Zito @_Zeets]

Arteta and Arsenal shielding this man for so long has to remain part of the legacy and stain of this era. Players are kept out of the team or released for a variety of reasons, yet when it came to this, every excuse was brought up to defend his inclusion.

[MFWitches @MFWitches]

If you don’t yet understand how it’s nearly always only white people who can afford to train at expensive ski resorts, bear the costs of hugely expensive equipment and clothes, and have the free time to pursue their passions in places they’re unlikely to also be able to earn a living, you aren’t really adult enough for a Twitter account, are you?

[Carl Anka @Ankaman616]

His middle name is Chinazaekpere.

In Igbo that is "God answers prayers."

[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.
1/11

[Sachin Tendulkar @sachin_rt]

Must say, today was a 10/10 day Leo Messi 😉

[Philip Proudfoot @PhilipProudfoot]

This is who they’re referring to as “two suspects”

[Vishnu Rao @oarunshiv]

@Megatron_ron Hi @tobi . I saw you had retweeted quite a few tweets that were praising the conservative president. Hope you retweet this as well

[Vishnu Rao @oarunshiv]

@FootieWriter Maresca couldn't use half time because he had already used up 2 out of 3 sub windows. If he had used that as well your would been in trouble if you had further injuries

[Zohran Kwame Mamdani @ZohranKMamdani]

The biggest sporting event in the world is happening in our backyard. But most New Yorkers will be priced out of watching it live.

Sign our petition calling on @FIFAWorldCup to put game over greed.

[Maheshwer Peri @maheshperi]

CIAN Agro is not traditionally an ethanol producer but entered the space in Feb 2024. India started pushing for ethanol usage.
The revenues mutliplied 28X. The profits shot up 100X
The share went up from Rs.41 a year back to Rs.668 today, locked at upper circuit.
PS: CIAN is owned by Nikhil Gadkari, son of Nitin Gadkari.

[Deepak Shenoy @deepakshenoy]

Oh it's going to be accepted, the same way the world has accepted large arms manufacturers benefiting from the wars in Iraq, Ukraine, Gaza etc.

In the long run, India should realize it has no friends, just acquaintances that decide we should be subservient to their whims and fancies. And because we won't be, they won't be friends.

[Nathan J Robinson @NathanJRobinson]

What a pathetic, spineless, bullshitting coward.

Pete Buttigieg is everything wrong with the Democratic Party and until it gets rid of every soulless, amoral McKinseyite, the party has no future.

[Rahul Gandhi @RahulGandhi]

#VoteChori हमारे लोकतंत्र पर Atom Bomb है।

[Vishnu Rao @oarunshiv]

@7Erzil @whosgenrul @grok what is the context?

[Vishnu Rao @oarunshiv]

@StatmanDave Is there a way to get the number of wins EtH had before international breaks vs Amorin?

I remember being in a gloom for extended period of time because United always used to lose just before going on International break.