Rishikesh Behere

Psychiatrist, Director-Manoshanti, Mental health researcher. Passionate about PG training, Suicide prevention, Mental health awareness

[Rishikesh Behere @rvbehere]

@docbhooshan Neurologists and neurosurgeons prescribe more psychotropics than psychiatrists!

[Rishikesh Behere @rvbehere]

Sound advice. I have suffered when doing my mbbs internship. Developed hepatitis A from a juice vendor. Lost one month of medicine rotation. Took 6 months to recover completely. Impacted my PG entrance preparation.

[Dr. AK 🇮🇳 @docakx]

Never buy freshly made juice from a vendor whose eyes look yellowish.

[Rishikesh Behere @rvbehere]

@docbhooshan @vishnu_agni @thelonghol ESI hospitals is a sort of cooperative model. But with increasing sophistication and gadget heavy medicine practice it is difficult to sustain.

[Rishikesh Behere @rvbehere]

@docbhooshan Conference of medical societies are not meant for academics. They are social events

[Dr. Brahma Chellaney @Chellaney]

Trump says the U.S. will “run” (that is, occupy) Venezuela for the time being, tightening its grip on the world’s largest proven oil reserves. Europe’s ex-colonial powers, meanwhile, have welcomed the U.S. kidnapping of a sitting president. So much for the idea that colonialism is dead.

[Rishikesh Behere @rvbehere]

Punekars knew this all along!

[Nicholas Fabiano, MD @NTFabiano]

Daytime napping is associated with a larger total brain volume.

[Rishikesh Behere @rvbehere]

@aparanjape @flyspicejet @airindia @AkasaAir @IndiGo6E Govt needs to realise importance of train network and track capacity. Distances within 600km can easily be covered in 4hrs by 160km/hr trains(equal to checkin plus flying time). Eg Pune hyderabad/ Indore

[Rishikesh Behere @rvbehere]

Important discovery and an interesting read!

[Navin Kabra @NGKabra]

Scientists from NCRA Pune have made a discovery with the potential to shake up science's understanding of how early galaxies were formed after the Big Bang

They have discovered a galaxy which they've named Alaknanda. It is a fairly basic galaxy, so why is it such a big deal? 🧵

[Rishikesh Behere @rvbehere]

@yoonshabnami 1. ARR
2. ARR
3. ARR
4. ARR
SEL
Vishal Shekhar
Pritam ( very high plagiarism)

[Rishikesh Behere @rvbehere]

@arrahman Rockstar is still on 14th!
My listens on apple music this year

[Rishikesh Behere @rvbehere]

@DocDevavrat @NGKabra I don’t think it’s a consultation. Just clerical work of issuing prescription for online orders. But if something goes wrong liability is entirely the doctors

[Rishikesh Behere @rvbehere]

Chasing gravity as cause of aging is going down a rabbits hole. Large effort small returns. Unless we are looking at human race leaving earth and living in space

[Rishikesh Behere @rvbehere]

Important clinical dictum-if you think rare causes you will be rarely correct. Common causes of brain aging are diabetes hypertension atherosclerosis. Cracking these have greater public health benefits.

[Deepinder Goyal @deepigoyal]

Just came up with a more visual explanation of how gravity could interact with human aging across the gravitational spectrum.

(Again, this is part of the hypothesis, not proven yet).

[Rishikesh Behere @rvbehere]

This is how AI should be used in Health care… not to diagnose but to screen out negative conditions @NGKabra @kmr_dilip

[AIIMS, New Delhi 🇮🇳 @aiims_newdelhi]

We manage very high volumes, up to 1,000 radiographs a day, and AI helps manage this load efficiently. The algorithm is tuned for a high negative predictive value (NPV), which reduces the chance of missing abnormalities while maintaining patient safety.

[Rishikesh Behere @rvbehere]

@docbhooshan @aparanjape And now Lemborexant!

[Rishikesh Behere @rvbehere]

Absurd regressive illogical reasoning. Public health policy is based on statistical observations made on representative population minimising confounding and bias. This is to ensure greater public good. Policy based on anecdotal experiences is bad science!

[Sridhar Vembu @svembu]

To understand why medicine is so complex, let's make a crude simplifying assumption that there are only 100 biomarkers that are important (in reality there are vastly more). Let's also crudely assume each market is allowed only two values. That gives us 2^100 possibilities, which is about 10^30. That is vastly more than humans that ever lived. And this is with the extremely over-simplified model. We face a practical infinity of possibilities.

In reality, no two patients are ever really alike. No statistical model can give you very high confidence on how to treat. That is why AI can never treat patients, because human doctors exercise something called "clinical judgment".

That judgment is what enables a doctor to tell us "this is not a serious issue, get good sleep" vs "this definitely needs deeper investigation". That judgment is hard. Often they cannot even explain why they arrived at this but great doctors have that intuition. The entire Big Medicine is about systematically dismantling clinical judgment and convert doctors to mere "protocol pushers". Great doctors resist this.

Now on top of the measurable biomarkers, there is the unmeasurable factor called "mental state". Every good doctor knows a positive mental state in a patient leads to far better clinical outcomes. That is why good doctors practise compassionate medicine, not just numbers based medicine. I know an outstanding skin doctor in Chennai who prescribed me medicine for my very-itchy Eczema that I had endured for months, and he also told me "try to avoid stress and it may go away, and you may not even need the medicines I prescribed". I consciously reduced my stress level and the problem went away without medicine. That is a truly great doctor.

What does it have to do with autism-vaccine connection? As my crude numerical analysis showed, we have the problem of N=1 way too often in medicine and that is even more true for autism where each kid is truly unique, and that is why statistics are mostly useless and clinical judgment is mostly all we have. We cannot have broad sweeping mandates, definitely not broad vaccine mandates. Each doctor has to exercise their judgment with their patient. And they have to listen to the patient concerns first.

What Big Medicine is about is to try to reduce medicine to be a pure statistical science and it is not. Conditions like autism do not fit that paradigm at all.

That is the battle here. At its core it is not just an autism battle, it is a philosophy of medicine battle.

I pledge to keep fighting this fight because I nearly wanted to commit suicide at one one point in my life. Just this morning, a depressed parent approached me for advice and that started my X thread today.

I urge intelligent doctors to debate this philosophy of medicine issue. I will not respond to the arrogant "stay in your lane" types.

[Rishikesh Behere @rvbehere]

Men from science technology fields seem to lose their rationality and scientific temper when it comes to health and medicine topics… Inexplicable phenomenon!

[Sridhar Vembu @svembu]

Parents should take this analysis seriously. I believe there is increasing evidence that we are giving way too many vaccines to very young children. This is spreading in India too and we are seeing a rapid increase in autism in India.

[Rishikesh Behere @rvbehere]

The book gives a detailed account of the procedure done by a group of ‘Brahmins of Indostan’. Involves collecting exudates from previous years outbreak, diluted with water from Ganges, and innoculated on arm using iron lancets

[Rishikesh Behere @rvbehere]

https://t.co/D3QjxtU6Hh

Amazing initiative to digitise and preserve such rare literature
@Guten

[Rishikesh Behere @rvbehere]

https://t.co/D3QjxtU6Hh

Amazing initiative to digitise and preserve such rare literature