Shibu V Ignatious

Chief Healthcare Architect @arca_a_i| Medical Oncology Resident, RCC, Trivandrum| Internal Med Faculty @OffCMCVellore| Husband, 🐾 dad, son, brother n more

[Zu-Grama @zugramadotorg]

🚀 Challenges in Healthcare & AI: Insights from Dr. Shibu Ignatious (CMC Vellore) 🏥🤖

The current healthcare system reacts to disease rather than preventing it. How do we shift from treatment to proactive health alignment? 🧵👇

1/ Patients feel unheard & neglected.

Healthcare focuses on post-disease solutions, but prevention & awareness are missing.

Dr. Shibu identifies 3 key personas 👇

🔹 Health-conscious people → How to align them better?
🔹 Unhealthy individuals → How to improve their habits?
🔹 Those unaware of health risks → How to create awareness?

2/ Priorities in Healthcare:
Cardiometabolic health, cancer risk & prevention 🫀
Need Lifestyle Wellness Clinics as pillars of well-being
Educate people on nutrition, stress, & daily health practices

3/ The Core Problems 🏥:
🔸 Lack of high-quality clinical metadata
🔸 Segmented/demographic data (North vs South India) missing
🔸 No health education in schools & colleges
🔸 No ecosystem for everyday health tracking

4/ The Need for Data & AI in Healthcare 🤖📊

🩺 Capture quality health data at home → Chatbots/tools that track vitals
📍 Personalized recommendations based on location & lifestyle
💡 Agentic AI → Autofilled datasets to reduce manual data entry
👩‍⚕️ Counseling & AI-powered diagnostics
🧬 Epigenetic studies for risk prediction

5/ Supply-Demand Mismatch & Solution Pathways

💰 Affordable nutrition & lifestyle intervention
📊 ROI-driven solutions that give direct value to patients
🌎 Frameworks like FHI & NR7 for healthcare data standardization

6/ Bridging Rural & Urban Gaps 🏡🏙️

Rural India provides better quality health data due to trust & connection
Need community-driven non-invasive data collection → e.g., Happy Mothers Program (TN & CMC)

7/ Future of Healthcare Tech 🏥🤖
🔹 AI-powered frameworks for disease risk scoring
🔹 Non-invasive health tracking (Hb levels, vascular data, sleep quality, snore episodes, etc.)
🔹 Integrating legacy healthcare systems with modern AI-driven solutions

8/ Dr. Shibu's Key Message:
"If the problem is big, we need more hands to solve it."
AI & tech should give doctors more time to focus on patients, not paperwork.

9/ Next Steps?
📌 How can we build AI-driven preventive healthcare ecosystems?
📌 What role can public & private sectors play in this?
📌 Who’s building in this space? Let’s collaborate!

Drop your thoughts below! 👇
#AIinHealthcare #PreventiveHealth #DeSci #Zugrama

[Praveen Kumar Marimuthu @drmpk91]

⚠️OPEN FOR TRIAL RECRUITMENT⚠️

We, from Medical Oncology @OffCMCVellore, are recruiting eligible patients for our phase 2 trial Carboplatin, Pemetrexed with Cetuximab for advanced NSCLC with EGFR exon 20 insertion (CATCH20)'. Registered in
CTRI/2024/08/072275
PI: @todrashish 🧵

[JAMA Oncology @JAMAOnc]

Progression-free survival and overall survival benefits of adding chemotherapy to gefitinib were sustained at 5 years, confirming earlier results reported at median follow-up of 17 months. https://t.co/T1v8xcXD2V

[Vincent Rajkumar @VincentRK]

On being a good doctor.

The number of research publications don’t tell you how good a doctor is at being a doctor.

Neither do the number of book chapters or grants. Or academic rank.

It’s a different skill set.
Good doctors have stellar clinical acumen & empathy.
#MedTwitter

[CMC Vellore @OffCMCVellore]

Prestigious 2024 John Dirks Canada Gairdner Global Health Award for @GKangInd retired Professor, CMC Vellore, for research on enteric diseases in children and their effects on life course "with significant impact on vaccine development & health policy in India & internationally".

[President of India @rashtrapatibhvn]

India’s first CAR-T cell therapy is developed through collaboration between the Indian Institute of Technology, Bombay and Tata Memorial Hospital in association with industry partner ImmunoACT. So, we have two of India’s pioneering research institutes in their respective fields, joining hands with industry for a humanitarian cause.

[Jame Abraham, MD, FACP @jamecancerdoc]

“I am not entitled to my patients trust- I need to earn that each time” beautiful essay by @TimGilliganMD @JCO_ASCO Knuckleheads | @OncoAlert @MosheOrnsteinMD @shilpaonc https://t.co/z3oJT2LliB

[Dr Amol Akhade @SuyogCancer]

It is open secret that there is always a difference between approved dose of drug and optimal dose of drug. And it is this gap that if bridged can lead to better access of costly drugs to many more patients across the world.
Great article in @NatureMedicine by @sofiamoutinhoBR
What are the issues to implement this ?
1 - Getting real world evidence of such low dose is very difficult as pharma won't sponsor such studies for obvious reasons .
2 - sometimes , pharma keeps pricing in such way that cost of less dose and full dose is same .
Cost of pill is not less as per strength of the pill .
Eg. Cost of 100 mg of Lorlatinib and 75 mg of Lorlatinib in India is SAME.

3 - All this reaserch comes into picture only after several years of drug use in real world and not when drug is new and we are always catching up .
This should be done when drug is in its prime .
IO drugs are in market for more than 10 years and low dose IO movement is gaining traction in last few years .
Now it is the ADC era .
Eg . Any one working on low dose of ADC Trastuzumab deruxtecan? It may work same at 2 to 3 mg per kg ( with only 2 vials) ( instead of 5.4 mg per kg which needs 4 to 5 vials for 80 kg patient )

We will get this data after 10 years when ADC era is over and we have moved on to Newer class of drugs .

4 - The dose approved and vial made is always in such way that there is almost always a wastage of drug and patient has to buy more vials .

Dose of Tdx1 is 5.4 mg per kg and so for 60 to 7O kg percent the dose will always be above multiples of 100 and there is no 50 mg vial .
Why ? So that u end up using one 100 mg vial extra and waste a lot of drug.
Pembrolizumab 50 vial was withdrawn from market after initial few years.
Same is rituximab 375 mg per m2 dose.
How phase 1 dose finding studies always lead to such dose in fractions ( 5.4 or 375 , instead of round figures like 5 or 300 , is beyond my understanding)

5 - Can drug vials be stored after opened and reused late ? Yes, for multi dose vials . But such vials are never introduced upfront . Eg trastuzumab when first came , it was not a multiple dose vial . Only after several years, now we have a mutli dose vial which can be used for 4 weeks.

Why such vials can not come for all drugs and at the beginning?

( how many of u know that nivolumab vial can be used upto 4 to 6 weeks , after opening, if kept at proper temperature? ) @dr_yakupergun @5_utr @VPrasadMDMPH @Alfdoc2 @JackWestMD @agrothey @csoncol @OCCA_Cancer

[American College of Rheumatology @ACRheum]

We, the American College of Rheumatology (ACR), the European Alliance of Associations for Rheumatology (EULAR), and the International League of Associations for Rheumatology (ILAR) are deeply saddened by the passing of Debashish Danda, MBBS, MD, DM, FRCP. Professor Danda was a highly respected member of the global rheumatology community. His contributions to the field were immense and his passion for improving patient care was unparalleled. As an educator, Professor Danda nurtured a new generation of rheumatology providers across the Asia Pacific region. He was a beacon of knowledge, compassion, and dedication, and his loss will be felt deeply within our community. We extend our heartfelt condolences to Professor Danda’s family, friends, and colleagues. His legacy will continue to inspire us and guide our efforts in advancing the field of rheumatology. @eular_org @DandaDebashish

[Mittal Ankit 👨‍⚕️ @IDDoc_Mittal]

Always teach on rounds. Even if it's a very basic concept. Teach.

#MedEd #MedTwitter #IDtwitter

[JCO Global Oncology @JCOGO_ASCO]

Dexamethasone-free anti-emetic prophylaxis proves effective and safe for highly emetogenic #chemotherapy. A step towards minimizing side effects and improving patient experience. 👉 https://t.co/JVHDendt5R #GlobalOnc #QoL @venkymd

[TheLiverDoc™ @theliverdoc]

Today I went to three pharmacies and asked for over the counter Amoxycillin antibiotic. All three pharmacists refused because I did not have a prescription. I told them I am a doctor. They still refused, because I did not have a prescription.

I was really happy.

This is Operation Amrith by Kerala Government and it's already in full force.

The Kerala State Health department plans to completely stop over-the-counter sale of antibiotics without prescriptions by the end of 2024. The State Drugs Control department launched Operation Amrith (Antimicrobial Resistance Intervention for Total Health) to check antibiotics abuse in the State.

I wish all the very best for this life saving endeavor.

[Indian Association of Palliative Care @iapcsecretary]

Ida B Scudder Hospice, a joint project of CMC Vellore & Sneha Deepam Society, inaugurated in January at #Vellore, #Tamilnadu.

The 15-bedded #hospice will care for patients with both #cancer & non-cancer.

For further information: [email protected] / 0416-2283159.

[Josh Thomas Georgy @jtgeorgy]

🌟 We are glad to share our study on the mutational landscape in TNBC pre vs. post neoadjuvant therapy. Led by @todrashish Sir and Dr Rekha Pai, @rajutchacko @ajoel_84 @divyathumaty @ajoyojohn @sethenral @OffCMCVellore #TNBC #bcsm #LMICresearch
https://t.co/62VxZYsqlL
👇details

[Vikram Mathews @MathewsVikram]

https://t.co/pYFNDmKkKz

[The Nobel Prize @NobelPrize]

"I refuse to accept that world is so poor, when just one week of global military expenditure can bring all our children into classrooms."

On International Day of Education, we honour @k_satyarthi who has dedicated his life for children's right to education.

#CommitToEducation

[Anand D Jeyasekharan @adj_23]

#medtwitter. Pet peeve of a medical oncologist. Stop inserting pleural drains in patients with small effusions and hypoxia! 1/10

[Dr. Meet Ghonia @DrMeet_Ghonia]

Updates in PGMER Regulations published on 1/1/24 :

1) Stipend :
In all the institutes, Stipend for PG Students will be at par with State/Central Government Institute's Stipend.
(Students can inform NMC if Private Institutes aren't following same)

2) Leave Rules :
- Minimum 20 days of CL for every PG Students. (Plus 5 Days of Academic Leaves)
- One weekly holiday will be allowed.
- Maternity and Paternity Leave as per existing Government Rules

3) Accomodation :
It is mandatory for all the institutes to provide appropriate residential accommodation to PG Students.

Team @FordaIndia submitted many points for PGMER and these points are very well taken for solution. Thankful to @OfficeOf_MM for consideration.

Hope that @NMC_IND will strictly monitor implementation of this.

[Adam Grant @AdamMGrant]

Being a lifelong learner isn’t about taking pride in your knowledge. It's about having the humility to know what you don’t know.

My top 23 insights from 2023 🧵

[Vincent Rajkumar @VincentRK]

Bookmark: mSMART guidelines for myeloma are now available to download as PowerPoint slides.

For over 15 years mSMART guidelines have been used by thousands of clinicians around the world.

@myelomaMD @Rfonsi1 @MayoMyeloma #MedTwitter

https://t.co/R4hz7umwEJ