Dr Rishi A Bhargava

Cardiologist-interventional and clinical! Twitter for science/cricket/politics/Movies/Lifeskills/spirituality/Literature.

[Dr Rishi A Bhargava @rishib01]

A neonate was brought in this thermacol box for echo. Was surprised at first but later found that's it's an innovative and affordable solution with scientific basis as an incubator and means of transport for babies! Wonderful!

[Dr Rishi A Bhargava @rishib01]

@NishithChandra @Hragy @mirvatalasnag @mmamas1973 @ShariqShamimMD @drjohnm @PCRonline @TCTMD Amazing case. Thanks for recording and sharing ☺️👍

[Bhooshan Shukla @docbhooshan]

If you are 15yr old student in India, contemplating medicine as your career, there are a few things to consider -
1. Why do you want to be a doctor?
2. What is your track record for sustained study to the exclusion of "normal life" ?
3. What are your financial aims in life ?
4. Is at least one of your parents a practicing doctor ?

I will elaborate each in the following discussion -

1. Why be a doctor - only reason should be " कामये दुःखतप्तानां प्राणिनाम् आर्तिनाशनम् l " ( i desire destruction of affliction of the ones in pain/suffering )
This may appear lofty but this is a moment-to-moment reward of practice of medicine. And this is the only thing that sustains you over 4-5 decades of work.

2. Your track record for sustained study -
You need 2-3 years of preparation for medical entrance exam
Another 5.5yr for MBBS
Additional 3 for MD
And beyond that 2-5 years of superspecialization if you choose.

All these years daily you need at least 10-12 hr of classroom / lab / ward time and self study. Gets a lot worse in 3 years of MD/MS residency.

If you look forward to this cognitive, physical and emotional challenge then medicine is meant for you.

3. Financial Aim - by the time you enter practice (12 years from now) - medicine is going to be very different from what it looks now. Earnings of most doctors will slip from being in top 3% earners to being in top 10-15% earners and falling.

And that brings us to the last point - your family

4. If your parents are in medical profession, you will have a head start in almost all areas over those who dont. But it ends there. In the new world with oversupply of doctors, parents reputation can not hide your shortcomings. If they help you set up and run a hospital where other doctors work for you, then it is a good run.

So think carefully before you stake your life. Mid life change of career is impossible. Especially for a male doctor.

Your parents, teachers, society are enamoured by bygone days of prestige, honour and money in medicine. Your future is different. Think for your self. Fulfilling others' dream always ends up bad.

It is a nobel profession. Joy comes in small and large packages everyday.
Poverty line will be far below you. So life will be good if you know how to really live it.

So think well and take the plunge. Then it is all worth it.

I am a practicing postgraduate doctor since 27 years and i love my work and its rewards. I would do this again if i get a second chance.

But thats me. You must decide for yourself. Good luck.

DocBhooshan

[Dr Rishi A Bhargava @rishib01]

Hilarious!!

[R @AlphaWizarDD]

Every Indian retail investor has an Abhishek Kalra inside them.

Owns 1 share of GKB Lenses.

Shows up to the AGM. Lectures the management for 3 minutes straight like he's the largest shareholder.

We've all wanted to do this at least once.

[Dr Rishi A Bhargava @rishib01]

@GabbbarSingh “It's a timeline against which we measure our own lives” so true!

[Dr Rishi A Bhargava @rishib01]

Thanks, @IndiGo6E and Ms Joyeeta for the wonderful hospitality and this sweet gesture ☺️

[Bilal Iqbal @DrBIqbal]

Here is my algorithm:

1) Vasodilator therapy (if hemodynamic allow and pull)

2) Pull Rotawire. This works very effectively, 90% of times. It is frequently overlooked. The 0.014 tip works as a great way to bring back the stuck burr. Make sure wire is free with brake off for maximal efficiency. Pulling the driveshaft is less effective, as it is made of 3 coiled wires which gives some elasticity to the driveshaft.

3) If burr is free beyond lesion, can use short dynaglide runs and then pull. Prinicple is that dynamic friction is lower. Don’t overdo this and also with skipping rope technique, there is risk of driveshaft breakage and burr loss due to torsional forces with a fix s immobile burr!

4) Cut driveshaft and remove teflon sheath

5) Deliver GE over driveshaft to the burr and pull.

6) Intimal/subintimal wire and ballooning to dislodge burr and pull.

7) Re-deliver GE over driveshaft and pull.

8) Obtain second access and adding a ping-pong guide. Remember a ping-pong guide is not required in most cases. Once Teflon sheath is removed, a 6F guide can accommodate: Driveshaft + coronary wire, Driveshaft + Caravel microcatheter, Driveshaft + Corsair/Turnpike LP microcatheters, Driveshaft + 2.5-4mm balloons

9) Combine subintimal ballooning and GE over driveshaft and pull. Only these maneuvers requires ping-pong guides.

10) Call surgeons.

[Dr Rishi A Bhargava @rishib01]

🙏🙏

[RAHUL @RahulSeeker]

She, Kanchan Bai Meghwal (40yrs) an anganwadi cook in Madavada Panchayat, MP and she is a Hero. A Martyr of humanity.

This Monday around noon, kids at the Anganwadi centre were playing outside the facility as part of their daily routine when a swarm of bees suddenly attacked. Kanchan Bai placed herself between the bees and the kids. She saved 20 children.

Kanchan Bai quickly wrapped them one by one in Tarpaulin and mats available there, shielding them with her own body, and rushed them inside the centre.

She absorbed the full force of the attack, protecting those children who were not even her own. By the time the local villagers arrived she had collapsed. She was rushed to a hospital for treatment but did not survive.

Hero Kanchan Bai leaves behind a son, two daughters and a paralysed husband. She was the sole breadwinner of the family. In MP an Anganwadi cook earns Rs 4250/ month. Will the govt now stand by the family she left behind?

To me Kanchan Bai Meghwal is a Hero of Humanity, who laid down her life saving 20 innocent children. A Martyr who sacrificed her life for others.

[Salman Arain @realarainmd]

When PCI Does/Does Not Work for Stable CAD - 🧵

In PCI RCTs, we often use the terms severe stenosis, ischemia, and angina interchangeably.

However, they are not entirely synonymous. 🤔

🔑 Each entity responds differently to OMT and PCI and has a unique impact on outcomes.

[Dr Rishi A Bhargava @rishib01]

A good one 👍

[Shezi @__Shezi]

I bought a book because I liked the illustration, and it’s turned out to be a good read 😂. They keep asking the question: if you could go back in time, to a moment you’d like to change or improve, but knowing that it won’t change the present, would you do it? I’m so thrilled.

[Dr Rishi A Bhargava @rishib01]

🎯

[Tyler Olson, EA @olsonplanner]

Before You Even Tour Homes

☐ I expect to stay in this city at least 5 years
☐ My job is stable and not dependent on bonuses or RVUs to feel safe
☐ My partner and I agree on timeline, budget, and lifestyle expectations

Income & Cash Flow Reality Check

☐ The mortgage works on one income
☐ Housing costs are ≤ 25% of gross income (30% is a red flag, not a goal)
☐ I can still max retirement accounts
☐ I can still save meaningfully in taxable accounts
☐ I can take time off without financial stress

Student Loan Integration

☐ My home choice does not derail PSLF strategy, if applicable
☐ I am not counting on future refinancing to make this affordable
☐ I understand how higher fixed costs lock in higher loan payments
☐ I have a written loan plan that still works after buying

Down Payment & Liquidity

☐ I will still have 3+ months of expenses in cash after closing
☐ My down payment is not draining emergency or opportunity funds
☐ I am not using “doctor loans” as an excuse to overbuy
☐ I can handle repairs, taxes, and insurance without building up credit card debt

The House Itself

☐ The home is easy to resell
☐ The layout and size fit my current life, not a hypothetical future
☐ I am not paying a premium for “dream home” features
☐ HOA fees and rules are fully understood and acceptable
☐ Property taxes and insurance are sustainable long term

Lifestyle Creep Defense

☐ This purchase does not set an uncomfortably high baseline lifestyle
☐ I could live here happily even if income growth slows
☐ Future upgrades would be a choice, not a necessity
☐ I am not buying to “feel successful”

Final Gut Check

☐ Renting for another year would not feel like failure
☐ I would make the same decision if housing appreciation were zero
☐ I am choosing flexibility over optics
☐ This house protects future options instead of shrinking them

Hard rule:

If buying the house makes you say, “It’ll be fine once I’m making more,” tread very very carefully.

[Dr Rishi A Bhargava @rishib01]

Model Code of Conduct at work—our city finally free of large, ugly political hoardings. A welcome sight.

[Dr Rishi A Bhargava @rishib01]

Did MD med at LTMMC. Saw KEM med too while doing DM card there.
LTMMC definitely over KEM for MD medicine. Faculty is good at both the places, but Sion is better with regard to clinical exposure, unit wise super speciality teaching and well organised academics including allied postings.

[Dr Rishi A Bhargava @rishib01]

@Houseof_Cricket Sanath Jayasuriya
Brian Lara
Sourav Ganguly

[Sachin Tendulkar Fan Club 🏏 @CrickeTendulkar]

How do I explain this to a non cricket fan this is the most beautiful thing .. 🩷🫴🏼
Sachin Tendulkar

[Mounir Basalus (Ⲃⲁⲥⲓⲗⲓⲟⲥ) @Basalus]

Let’s talk about the Top 10 cardiology papers of 2024 that shook up the field!
Hard science, no BS, 🚀 and yes — some practices WILL change.
🫀 Let’s dive in: a tweetorial thread!
#CardioTwitter #MedEd #Cardiology

[Dr Rishi A Bhargava @rishib01]

It’s difficult to compress with the sheath insitu and there are chances of recurrence. Take opposite side access followed by culprit sheath removal and then apply compression. Check with a JR from the other side. It’s also useful for balloon compression and stent deployment if needed.

[Dr Rishi A Bhargava @rishib01]

@DegenMacro @Meta @Apple Thanks bro 😀

[Dr Rishi A Bhargava @rishib01]

Why is WhatsApp erratic on iPhones? Just me or a common observation? 🤔 @Meta @Apple

[Dr Rishi A Bhargava @rishib01]

@nainaverse Amazing thread. Feeling nostalgic. Visited some 6 years back. Srilanka is rightly called an untouched gem. Serene. We had a short trip. Yala national park, and stay at Jetwing Yala I liked the most.

[Imtiaz Mahmood @ImtiazMadmood]

Dad admires a car he sees parked in a restaurant parking lot. It reminds him of his old car, which he had to sell to help raise kids. He's reminiscing and telling stories, and then the daughter hands him the keys.