Prashant Singh

Patriotism is the last refuge of the scoundrel
~ Samuel Johnson
Hypocrisy is the homage that vice pays to virtue.

[Prashant Singh @prashants0777]

Today I saw this bird in the fields of Pratapgarh Uttar Pradesh. Can anyone identify this bird? @prakashraaj

[Grok @grok]

Menstrual blood isn’t inherently unhygienic—it’s a natural fluid like saliva or sweat. Disease spread in public is unlikely, needing direct contact with wounds or mucous membranes, which is rare. HIV or hepatitis transmission is possible only under specific conditions, not casual settings. Hygiene products further lower risk. Cultural bans, like avoiding temples, lack medical backing—evidence shows minimal public health threat.

[Prashant Singh @prashants0777]

@grok best president of the world as of today?

[Prashant Singh @prashants0777]

@_booktrovert Aap ye soch rahi hongi ki , ek mahine ke liye calendar kaun badle.

[Prashant Singh @prashants0777]

@hvgoenka Nonsense

[iamOnir @IamOnir]

Human lives are less Valuable than blind faith and the power games that come with it . No wonder “ Religion is the Opium of the people “

[Prashant Singh @prashants0777]

@_booktrovert Any marriage without pomp and show is good. However marriage under special marriage act has presumption of equity and fairness to both.

[Prashant Singh @prashants0777]

@_booktrovert Aapka to khandani pesha nikla......

[Prashant Singh @prashants0777]

@_booktrovert This happened with almost half of the people I know.

[Prashant Singh @prashants0777]

@_booktrovert Have you read Hindi literature?

[Prashant Singh @prashants0777]

@_booktrovert But why movies, actors.....etc.

[Prashant Singh @prashants0777]

@_booktrovert Bechara "tum" Book nahi padhta........

[TheLiverDoc™ @theliverdoc]

Please read till end.

In 2020, a middle aged woman came to me for a routine liver health check up. She was based in the UK and she used to drink alcohol, more than occassionally. She was overweight and without any other chronic illnesses. Her husband, who has been following me on social media, was always fascinated by the way I campaigned against alcohol use and how even the lowest doses can increase development of various types of cancers.

They were going to leave India in a weeks time, and so, before they left, wanted a quick check up and a consult with me. I examined the woman and saw that her liver was firm and bumpy. Something was amiss. The liver function and other blood tests were normal. I ordered an AFP (alfafetofprotein) test and sent the patient for a quick ultrasound screening. The AFP came back 28,000 ng/ml (normal <10 ng/ml) and the ultrasound liver showed a 6 cm lesion which had extensively invaded the main blood vessel of the liver, the portal vein. She had highly, locally advanced aggressive primary liver cancer. A CECT scan also confirmed the same, but there were more smaller cancer lesions on other parts of the liver too.

Their whole life turned upside down with that one consult with me. I broke the news in the most empathetic way and told them that this was stage C (BCLC-C: https://t.co/yiAiong7f9). They did not speak much. Angry and sad, they left my outpatient without discussing their decisions with me. They went to other doctors asking for help. Most of them discussed death with them and the lack of option for curative liver transplant surgery because the tumor was locally advanced. They offered them various medications, some radiotherapy, even some surgeons offered to adventorous and gave them option for a liver transplant.

Distressed with the lack of consensus from many doctors, they came back to me. They had two days left to return to the UK. The husband told me, "Sir, you diagnosed my wife. We are hopeless now. You only please guide us, because we were wrong in meeting many doctors and she has become depressed."

Since there was nothing I could do at the point, as they were leaving for the UK, I wrote two well-meaning, detailed empathetic letters - one to the woman's GP at their place of stay and one to the specialist oncologist (I did not know their names, wrote in general) asking them to please consider this patient for immunotherapy if it was available as a protocol their. I decided that immunotherapy with Atelolizumab-Bevacizumab, based the landmark IMBRAVE150 trial (https://t.co/Olr6SctY6e) was their best option. I made that decision for them because they were not in s state to make decisions. Their children were young.

Early 2021, I was informed by the husband that they got into the NHS oncology program very quickly because the GP escalated my letter and the diagnosis for the immunotherapy. And it was all for free. They did not have to pay any money and an ambulance and medical personnel for come and pick her up and give her the injections under close monitoring and send her back home. She was given close 2 years or may a bit more than to survive.

Last week, I saw the patient and her husband again in my outpatient. After almost more than 3.5 years. She was well. Her cancer disappeared. NHS protocol showed that there was no recurrence and all the big cancer in the liver and the smaller ones and the ones in the liver vein melted away. They asked me to evaluate them, for their satisfaction. I did a contrast MRI on her liver. No tumor. Nothing. Just old features of chronic liver disease. Her AFP was 1.8 ng/ml now.

They were just so happy that the kids got their mother to be around, when they were growing up. She was cancer free, but in remission and ready for a life saving transplant whent the time came. Almost 4 years now.

As gratitude, they got me this IPAD 10th Generation as a gift. "But I do not accept gifts," I told her. "My patients well-being is the greatest gift that I can receive. You are here in front of me, after nearly 4 years, alive and well, because of a decision I made for you. This is the greatest gift," I told them.

But they were adamant and kept the box on my table, bid me goodbye to journey back to the UK.

I was happy, but also sad. I see hundreds of patients in my outpatient who are candidates for this drug treatment but cannot afford it. I send most of them to palliation and they die within a year. And here was a patient, who was destined to die in my care if she was where I was. But instead, she found freedom from a devastating illness because treatments were made affordable where she was. I was happy for her, but also sad for the many I had to let go here.

But here is the reason why I wrote this post.

I do not have personal use for this new IPAD. I have my phone and my computer and I am happy using them. I do not require additional gadgets and do not want to keep them in a corner and waste them. So if you know any NGO or childrens educational/teaching programs that use IPADs and would like to have this IPAD, please tag them in the responses to this post. I will gladly send this IPAD to their official address for free for them to use. Please make sure you do not not lie to me to get this for your personal use or for your children to play Candy Crush. Let us find someone or some group who can genuinely find use for this because I have no use for this at present.

IPad, 10th Generation, Wi-Fi only, 64GB, Blue color (brand new).

Thanks for your time reading this far.
Take care.

[Baba MaChuvera 💫 Parody of Parody @indian_armada]

कोई भाभीजी की बात मोदीजी तक पहुंचा दो भाई 🌝

[Prashant Singh @prashants0777]

@h_331__ Ok