Olivia
Online
Dr Sajith K Satheesh
@sajith1729
Senior Consultant Pathologist, Oncopathology,
Dr Lal Pathlabs, Bangalore
Kerala, India
Joined January 2008
608 Following
270 Followers
696 Posts
M P Parameswaran: The Nuclear Scientist Who Taught Kerala to Question Development and Power https://t.co/QsATgUdinW
Cockroach Democracy: Unarmed and Dangerous https://t.co/mvXfv8jvUk
https://t.co/CqvowmfPnF
Ministry of AYUSH will receive ₹44,000,000,000 (Forty-four thousand million / Forty-four billion Indian Rupees) this year for promoting pseudoscience, creating more stethoscope-wearing Instagram quacks, building more unscientific institutions, and endangering peoples liver and kidneys.
Good morning.
The weekend witnessed a massive hate campaign directed against me by the pseudoscientific Ayurveda community as well as large account Indian right-wing influencers including "fellow doctor colleagues."
They doxed my work place, threw religious slurs at me, morphed my images, made vulgar racist comments, defamed my family, called us organ traffickers, and named my public health awareness efforts "rabid."
By doing that, they have exposed themselves more. My work and it's importance have become even more valuable.
I appreciate and thank my follower-friends (you know who you are🫶) and doctor colleagues (you know who you are 🫶) here on Twitter for supporting me and helping my voice echo longer and stronger. The public support against pseudoscientific alternative medicine was even stronger and it gladdened me.
ONE event, and now everyone knows how dangerous alternative medicine such as Ayurveda and Homeopathy are. Everyone knows how the practitioners and their supporters are the real rabid cultists.
Why do I strongly oppose Ayurveda and Homeopathy and such alternative medicine practices? Because it has real world outcomes.
Shown in the image below are the various alternative medicines, herbal and dietary supplements that many people took because of advertisements, promotions on anecdotes and health misinformation on social media. They came to me with severe liver injury and some in liver failure for treatments. My team painstakingly retrieved these products from them. Sadly and to my terrible sorrow, most of these patients did not make it. They are survived by their young children or spouses, or aging parents only.
You think your massive hate campaign will deter me? It only makes me stronger. Keep 'em coming. You have no idea of the gargantuan beast you have created with so much hate. I'll keep educating people and public as long as I can, as much as I can. Jai Hind.
The wife gets the husband to our outpatient for liver health check up. He's a daily drinker. He's been drinking for 15 years. His friends too. They are all doing fine. Him too. He does the tests. Just a bit of fatty liver. He says he's doing alright. We (me and my senior RMO) educate him how alcohol harms beyond the liver. He's not interested. We advised a psychiatrist review. He ignores it. Goes home. Drinks at night. Probably to teach the wife a lesson. In the morning he's back. This time on the ventilator. The ICU doctor sent me this. This guy is in for a long stay in the ICU and longer stay in the hospital. This can happen to anyone who drinks.
Anyone. Anytime. Anywhere.
I could not say no, when this young news agency, managed by students, primarily high schoolers, from the Wesean region asked me for a gruelling interview on matters of medical and health, specifically for students. The questions were so good and significant for our times, I gave them exhaustive answers which I feel can really help students and those interested in the medical field. #MustSee #Read
Thank you to Estelle Kipgen and David Gurung!
Please make this your must read for today:
A Special Q&A for "Students", with The Liver Doc
https://t.co/BFQWXSHZo9
I want to make a clear statement regarding cough syrup use in children and in general. This is especially for those idiotic physicians who still prescribe cough syrups for children even in 2025.
Please stop prescribing cough syrups to children, especially in a country like India where public healthcare is not evidence based and proper vigilance and scrutiny of over-the-counter (OTC) medicines is zero.
The routine use of conventional cough syrups is not recommended due to limited benefit and safety concerns. Most guidelines advise supportive care and highlight that cough in children is usually self-limiting. Overall, major guidelines suggest against routine OTC cough/cold meds for common-cold cough in kids. Honey (>1 yr.) is reasonable; otherwise supportive care.
Age related recommendations:
Under 4: skip cough syrups.
4–6: avoid, especially opioid cough syrups.
6–11: can be used cautiously, but evidence is very limited. Again never use opioids; avoid benzonatate.
12–17: no opioids; even dextromethorphan use should be cautious because abuse risk of this is high in this group.
Adults: routine cough syrups aren’t recommended.
≥65: avoid sedating/anticholinergic combos; check interactions; always favour non-drug options.
What actually helps
Honey (for anyone >1 year) for a few days at night time can modestly ease cough.
For those thinking that "natural" options are better, please avid OTC Ayurvedic and Herbal cough syrups because [1] they contain multiple herbs that can interact in the body and cause organ damage or interact with other medicines to cause harm and [2] they are not adequately tested for safety or benefits and are directly marketed without evidence and [3] the doses mentioned in those Ayurvedic bottles are not scientifically identified, but the company's arbitrary doses, which may not be safe for all, or all ages. Read the label!
And for those thinking herbal is unsafe, so lets go with Homeopathy cough syrups, please don't even tough those with a 10ft pole because not only they have multiple herbs, but also high levels of alcohol which is never safe for children or adults and will have high chances of misuse/ addiction later on. Read the label!
![theliverdoc's tweet photo. I want to make a clear statement regarding cough syrup use in children and in general. This is especially for those idiotic physicians who still prescribe cough syrups for children even in 2025.
Please stop prescribing cough syrups to children, especially in a country like India where public healthcare is not evidence based and proper vigilance and scrutiny of over-the-counter (OTC) medicines is zero.
The routine use of conventional cough syrups is not recommended due to limited benefit and safety concerns. Most guidelines advise supportive care and highlight that cough in children is usually self-limiting. Overall, major guidelines suggest against routine OTC cough/cold meds for common-cold cough in kids. Honey (>1 yr.) is reasonable; otherwise supportive care.
Age related recommendations:
Under 4: skip cough syrups.
4–6: avoid, especially opioid cough syrups.
6–11: can be used cautiously, but evidence is very limited. Again never use opioids; avoid benzonatate.
12–17: no opioids; even dextromethorphan use should be cautious because abuse risk of this is high in this group.
Adults: routine cough syrups aren’t recommended.
≥65: avoid sedating/anticholinergic combos; check interactions; always favour non-drug options.
What actually helps
Honey (for anyone >1 year) for a few days at night time can modestly ease cough.
For those thinking that "natural" options are better, please avid OTC Ayurvedic and Herbal cough syrups because [1] they contain multiple herbs that can interact in the body and cause organ damage or interact with other medicines to cause harm and [2] they are not adequately tested for safety or benefits and are directly marketed without evidence and [3] the doses mentioned in those Ayurvedic bottles are not scientifically identified, but the company's arbitrary doses, which may not be safe for all, or all ages. Read the label!
And for those thinking herbal is unsafe, so lets go with Homeopathy cough syrups, please don't even tough those with a 10ft pole because not only they have multiple herbs, but also high levels of alcohol which is never safe for children or adults and will have high chances of misuse/ addiction later on. Read the label!](https://pbs.twimg.com/media/G2YryXHbMAIg7CE.png)
"Treating the root cause" is a trope abused in alternative/integrative/functional medicine to sow distrust in mainstream medicine.
Ironically, a scientifically implausible “root cause��� is often treated with pseudoscientific approaches (e.g., spine subluxations for all diseases; past life regressions for PTSD; balancing energy for back pain, etc.).
H/t @DGlaucomflecken
Breaking news of the day:
A Kerala State Transport bus driver failed the breath analyser test because it detected significant alcohol content in his body.
He was suspended from his job.
But the driver maintains that he is a teetotaller, never drank alcohol his entire life.
Investigators finally found the reason for detectable alcohol in his blood - Homeopathic formulations which he had take a day before, prescribed by Homeopathy practitioner for his vague symptoms/ailment.
It is high time these alcoholic quack products sold in the name of medicine within the Homeopathy industry be banned from shelves. The Kerala government themselves have a State-public funded Homeopathy manufacturing unit called HOMCO which should be demolished as soon as possible and the money from that used for making proper roads.
Homeopathy practitioners believe that substances potentized (diluted) in alcohol gives it additional magic energy that prevents or cures various diseases.
This was the original delusion that the inventor of Homeopathy had centuries ago when science had not evolved yet. The same delusion is taught as a subject in colleges in India even now, for a period of 5 years as a Bachelors degree course and the Government legalize and unleash these group of "doctors" on the public, who ultimately sell either distilled water, or milk sugar or sucrose globules or hard liquor with or without herbs or dangerous heavy metals in the name of medicine.
The utter nonsense is going on in this country is beyond my understanding. Even if there was a God, he would just flush this scientifically illiterate nation and its pseudoscience peddling and dogma loving populace down a large celestial toilet and be done with it. Cannot educate these people on rationalism and logic.
No poverty, zero hunger, good health and well being, quality education and decent work and economic growth- these are the key components of Sustainable Development Goals (SDG) index released by Niti Aayog regularly.
Look at how Tamil Nadu and Kerala leads.
Tamil Nadu and Kerala are the most criticised states by BJP. The same Tamil Nadu and Kerala are the best performers on SDG parameters as per centre's own Niti Aayog.
If only centre can fulfill genuine needs of Tamil Nadu by being impartial, how much more the state would grow?
Two very contrasting matters happened today that saddened me and angered me.
The lady with multi herbal supplements related liver failure died. A family lost their loved one. A void. Just their lonely cries. The alternative medicine practitioner who prescribed the product is scott free to harm others.
On the other side, I received yet another summons from the Chief Judicial Magistrate, Thrissur district asking me to come for a hearing, based on a criminal defamation complaint filed against me by SNA Thaikatmooss Ayurveda Private limited because I educated people on the lack of benefits and potential dangers with these untested and highly promoted fraud products.
Patients die due to fraud practices and medical science communicator get harassed for educating the public on healthcare. This is new India.
Pay: This is the price. Die: This is the hill. I'll be here as long as I can.
How an electric motor works
[🎞️ Jared Owen Animations]
Every point in this absolutely nonsense report by the Times of India is inaccurate. Black coffee is the only dietary supplement that has been consistently shown to have health benefits.
Here is a rebuttal of all inaccurate points by Times of India
"Avoid black coffee if you have digestive issues"
Wrong. Black coffee does not lead to any "digestive issues".
✅No Association of Coffee Consumption with Gastric Ulcer, Duodenal Ulcer, Reflux Esophagitis, and Non-Erosive Reflux Disease: A Cross-Sectional Study of 8,013 Healthy Subjects in Japan https://t.co/xODPXalOVA
"Black coffee can affect the sleep cycle"
Wrong. It is not black coffee, but caffeine that affects the sleep cycle. Even tea has caffeine in it. ✅Caffeine consumption reduced total sleep time by 45 min and sleep efficiency by 7%, with an increase in sleep onset latency of 9 min and wake after sleep onset of 12 min.
https://t.co/0U0z0E82uo
Have decaf. It has all the benefits without any sleep issues.
"Black coffee can cause anxiety"
Wrong. It is not black coffee, but caffeine that affects anxiety.
✅Caffeine consumption may have a detrimental effect on anxiety and may increase the risk of anxiety. This association was more pronounced at caffeine intake doses above 400 mg.
https://t.co/b8SvKmLJqW
Just so you know this: Green tea contains a relatively small amount of caffeine, approximately 29 milligrams (mg) per 8-ounce cup, compared with black tea, which has around 47 mg per cup, and coffee, which has about 95 mg per cup.
"Black coffee can affect bone health"
No it doesn't.
✅Our meta-analysis results suggest that daily coffee or tea consumption is not associated with BMD or hip fracture risk.
https://t.co/WlTolaOM2F
"Black coffee can cause palpitations"
No it does not.
✅In fact, habitual consumption of moderate amounts of coffee lead to LESS heart rate and rhythm abnormalities, which is reflected in the results of many clinical trials and meta-analyzes.
https://t.co/nDCXXs9Zqo
"Black coffee can dehydate the body"
Not correct.
✅No evidence of dehydration with moderate daily coffee intake: a counterbalanced cross-over study in a free-living population.
https://t.co/yROdF28FXF
Probably it's time, Times of India fired the person who wrote this garbage?
Do better.
Read this carefully.
It says cancer is curable when diagnosed early and advanced cancers can go into remission when treated properly with medical, surgical and interventional management which includes chemotherapy, radiation and surgery.
Your beliefs and personal anecdotes are not evidence.
Ayurveda, Homeopathy, Yoga, Naturopathy, Siddha and Unani and those lovely plants and flowers in your grandma's garden and the lemon your grocer sells and that turmeric in your backyard or neem from your neighbor's tree does nothing to cancer - from preventive and treatment aspects.
Please get this inside your nationalistic, religious drivel loving, cultural dogmatism embracing, health illiteracy skulls. It's a request.
All because some cricketer-turned-politician put emotions and politics before science, facts and evidence.
@kmfnandinimilk @krishnabgowda @cubbonparkblr @cubbonparkps
This Nandini parlour charges ₹5 extra per item for packaged Nandini products. Is this allowed or even legal? This is next to the toy train inside Cubbon Park, Bengaluru.
@theliverdoc Hi sir, this has come up in my son's class 2 EVS textbook. I'm appalled that kids are taught such rubbish in the name of science. How to deal with this when textbooks in reputed schools follow no basic scientific temper?
Today is Uthradom. It is the penultimate day before the main Onam festival day in Kerala.
I received a message from a patient of mine this morning. I will call him Sandeep. He remembered me this day as I remember him every year this day. In the message, he wrote that he was thinking about me and my family in his prayers and he thanked me for helping him and treating him.
He is 32 years old. I met him when he was 30 years old, exactly on Uthradom day, two years back. During our first meeting, we did not speak, shake hands or even make eye contact. He was on the ventilator and breathing with the help of a tube hooked to a machine. His hospital bed was stained with blood, as he lay in his own pool of defecated blood clots and foul smelling digested blood (melena in medical term). He collapsed because he nearly vomited half of his body's blood volume in the morning after an Onam party with his friends. They were all binge drinking. He drank close to 1.5 L of alcohol within 10 hours. His liver pressure rose, his blood pressure went haywire...and because alcohol messed up his brain, all that blood that burst out of his engorged veins in the food pipe due to his preexisting liver disease did not come out. Much of it went into his lungs, he aspirated, choked on his own blood clots as his lung, brain and body shut down in minutes.
He was rushed to a nearby clinic where they put him on a ventilator and stabilized his blood pressure and breathing and transferred him to us for expert care. I thought he would die. In a day. He was that bad. But he was young and he fought on the ventilator. He had a young child who was waiting for him. So he fought on the ventilator. His wife said she would kill herself and the child if she lost him, because theirs was a love marriage and she had no one if he passed. So he fought on the ventilator. And we fought for him. After a marathon endoscopy session, we controlled his bleed. We pushed in enough medications that prevented a life threatening infection and reduced ammonia burden on his brain so that he could get out of the brain failure the bleed brought on. After a week on the ventilator, he woke up. We rehabilitated him. He could not speak for a few weeks because his voice box was damaged in the rush to save his life, courtesy the breathing tube. But speech therapy did him a lot of good.
He drank close to 2000 rupees worth alcohol that day before the main Onam festival, but paid close to 450,000 rupees to get his life back. To get a chance to see his kid and his loving wife.
We took him through de-addiction and he was alcohol free for 2 years. Even now.
In 2023, Kerala recorded liquor sales of Rs 665 crore in the first nine days of Onam season till Uthradom which is an increase of Rs 41 crore compared to last year's figure of Rs 624 crore for the same period.
This year, it will break records again.
And I'll see more "Sandeeps" even if I do not want to.
Alcohol kills. It's a fact. How much ever you romanticize it. And there are only a few who care. I hope you, reading this, will also care, so that me and other doctors, will have eternal days where we do not see Sandeeps.
In a country like India where the majority of people are science illiterates who trust cinema and media more than the doctors when it comes to healthcare choices, it is imperative to put out public health information and disclaimers and censor movies that misinterpret and misrepresent life saving organ donation based on cooked up conspiracy theories.
There is absolutely no shred of evidence that people are kidnapped and killed for organs in India, but disgusting movies like these misinform the public and prevent valuable organ donations that help save many lives.
The Indian Government must focus more on correcting these realistic healthcare challenges and hold these media misnformation sources accountable, rather than wasting time and resources on punishing filmmakers and streaming platforms, based on complaints from insecure snowflakes who bring up Hindu-Muslim names issues on OTT that benefits no one.
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