Olivia
Online
Chetan Phadke MD, DM
@steth_talks
Doctor (MBBS, MD, DM (Nephrology))/ National medallist Swimmer/ Football/ Hardwork, Discipline/ Motivate, Elevate
Joined October 2012
219 Following
364 Followers
891 Posts
Pinned Tweet
Anything you spend or invest: money, time, etc. it all just comes down to whether you will regret doing that in the future.
If the answer is yes, don’t. If the answer is no, do.
From the @hubermanlab podcast with @morganhousel; idea of D. Kahnemann.
Cheers! 😇
🇮🇳 PRAGGNANANDHAA IS THE NORWAY CHESS CHAMPION 2026 👏👏👏
#NorwayChess
📷 Norway Chess / Tor Nilssen & Kjetil V. Tveito
If bad luck was a person, It was Krishna.
Born in a prison cell.
With chains.
Cold walls.
And fear.
The West writes self-help books after one breakup and a weekend depression.
Krishna was born with a death warrant.
His own uncle wanted him dead.
He never drank his mother's milk.
Hours after birth,
his father carried him across a mad river at midnight.
Rain above.
Death behind.
Darkness ahead.
No burning bush.
No sea parting.
No miracle announcing salvation.
No therapist with scented candles.
Just survival.
Born a prince.
Raised a cowherd.
Before he could speak,
they sent Putana.
Then Shakatasura.
Trinavarta.
Kaliya.
One after another.
As if destiny hated him personally.
And he still smiled.
People today collapse over an unfollow.
He lost everything early.
His parents.
His childhood.
His home.
And Radha.
Ah, Radha.
The part Bollywood never understands.
His closest friend Sudama lived in poverty.
Krishna could not protect everyone he loved.
Shishupala insulted him publicly.
Again and again.
Before assembled kings.
Krishna listened calmly.
Then came Jarasandha.
17 invasions.
Mathura burned again and again.
Then came the greatest tragedy.
The Mahabharata.
Krishna tried to stop it.
He went himself.
He sat before Duryodhana.
Pleaded for peace.
Just 5 villages.
Duryodhana refused.
And humanity walked into hell smiling.
18 days later, rivers carried blood.
1.66 billion dead.
Think about that.
An entire civilisation collapsing into dust.
And Krishna carried that silence.
No lamentation carved into scripture.
No prophet demanding heaven explain itself.
Just silence.
Then Gandhari cursed him.
A grieving mother blamed him for everything.
Krishna accepted it.
That is spiritual strength.
Then came the final collapse.
His own clan destroyed itself.
Drunk. Violent. Mad.
The Yadavas killed each other.
His own son died in that chaos.
Krishna watched.
Because some endings cannot be stopped.
Then Dwarka sank.
His city.
His dream.
His life's work.
Gone beneath the waves.
And finally...
The man who was greatest strategist.
The man kings feared.
The man sages worshipped.
Died alone in a forest.
One arrow.
A hunter's mistake.
No throne.
No army.
No grand farewell.
No Resurrection.
Just silence beneath the trees.
And yet...
He is called the complete being.
Not because life was kind.
But because pain never poisoned him.
That is Krishna's greatness.
Not miracles.
Not powers.
Not mythology.
Life gave him suffering.
He gave life wisdom.
Life gave him betrayal.
He gave humanity the Gita.
Life gave him war.
He gave the world detachment.
And in the middle of chaos,
he left us one terrifying truth:
"You control your actions.
Never the outcome."
Krishna did not teach escapism.
He taught endurance.
He did not teach positivity.
He taught responsibility.
He taught how to stand inside hell,
without becoming hell yourself.
That is why he still smiles.
And maybe...
That is why Bharat still survives.
41 deg C
What stops Indian men from dressing up like this?
Frame of reference.
I remember the example of a housefly in a train from my Jr college physics lessons.
Explain using physics: Is the drone stationary or moving at 50 kph?
@hyderabaddoctor @ashrafazam17425 HbA1c sensitivity will vary with the stage of CKD. Other similar tests exist but are not superior to HbA1c. Fasting and PP BSL will help evaluate diabetic status.
Colonoscopy gone too far. 🤭
Found on colonoscopy in a patient with diarrhoea. What’s the diagnosis?
Avoid NSAIDs/ nephrotoxic drugs.
Which ones though specifically? Good question. Good answer.
Which painkiller is considered the SAFEST for the kidneys when used in normal doses?
A) Ibuprofen
B) Diclofenac
C) Paracetamol
D) Naproxen
Most people think all painkillers affect the kidneys equally but one is usually preferred specifically because of renal safety.
Haha. Awesome. 😇
@NephRodby Nephrology carries enormous cognitive load, cares for extraordinarily complex, increasingly fragile patients; yet struggles with visibility, prestige, & compensation…inevitably affecting morale & recruitment.
It’s time nephrology stopped being medicine’s best-kept secret!
@aditya_gan3500 @SridattaPawar It’s a good account for diagnosis and management of hypertension and considerations for Kidney as a primary organ. Authored, I think by Dr. Bakris, one of the best authorities on Hypertension management.
Not the physician. Not the cardiologist.
Most of the patients I see have already been seen by them.
Hypertension is often assumed to be the cause of renal failure, while significant proteinuria is dismissed as if it carries no value.
In my own institution, cardiologist was interviewed about hypertension the same cardiologist I mentioned in Case 1. Repeated echocardiograms are ordered for pedal edema, while the renal cause remains overlooked.
Patients keep moving from physician to cardiologist in circles.
Many still think hypertension management is simply about prescribing BP tablets and sending the patient home.
The evaluation of proteinuria, volume status, secondary causes, renal parenchymal disease, CKD progression, and target organ involvement is frequently ignored.
That is why nephrology referrals happen late and only the lucky patients eventually reach a nephrologist early
@aditya_gan3500 @SridattaPawar A few decades ago, there was a boom “Hypertension and The Kidney”. Idk if it still is around. Speaks volumes. 🤷🏻♂️
🚨 BREAKING: Xabi Alonso has accepted to become Chelsea next manager, HERE WE GO! 🔵🔜
The agreement is set to be completed.
#CFC prepare official announcement for the upcoming days, but Xabi said YES. 💣
@abeejuice @nihardesai89 @aditya_gan3500 @docakx @drkeithsiau @DrRishabhOnco @drsthanus @MostafaFaisal14 Standard CrCl equations online are based on CG.
Technically these are CKD equations and not to be used in AKI.
CKD EPI Cys- Cr is the best to estimate eGFR (ONLY in CKD ofc).
So for AKI it’s alright to use CG for drug dose modification. And CKD EPI for CKD staging.
@DrNikhilMD Previously used in prophylaxis for CA AKI. It’s been removed from that too, same has been published in the latest “Comprehensive Nephrology”.
A 30% rise from baseline is a threshold, beyond which one needs to look into RAS.
HyperK+ should be managed medically and RAASi stopped only if it cannot be controlled with diet/ medication. The risk/benefit is low for one to stop only because of HyperK+.
You started Telmisartan for hypertension.
A week later, creatinine doubled.
The kidney just gave you a clue about the real diagnosis. 👀
Let it grow
pay solid attention;
an average millionaire is 40 not 23
an average billionaire is 55 not 35
the average age to buy a house is 35 not 25
most men hit their peak confidence at 32 not in their 20s
it takes the average person 66 days to build a habit not 7
the average ceo is 57 not 30
most people meet their life partner after 27 not 18
the average successful business takes 5-7 years not 6 months
most people don’t know what they want until they’re 30 not at graduation
stop letting social media brainwash you. you are not behind, you’re on your own track. live it ❤️
That’s some way to look at it. Immediate gratification and dopamine waves are the difference.
Addiction is proof that you are capable of intense devotion. You just have a false god
Unforgettable character.
He was paid millions to play a miserable man — and couldn't tell where the character ended and he began.
When the creators of House M.D. were casting in 2004, they wanted someone quintessentially American. British actors, they believed, couldn’t pull off the accent convincingly. They weren’t even looking overseas.
Thousands of miles away in Namibia, Hugh Laurie was filming a movie and heard about the role. He couldn’t fly to Los Angeles. He couldn’t walk into a polished audition room. So he went into his hotel bathroom — the only space with enough light — propped up a camera, grabbed an umbrella as a cane, and recorded two scenes.
He sent the tape, apologizing for how rough it looked. Executive producer Bryan Singer watched it and was captivated. He had no idea Laurie was British.
That tape changed everything.
The pilot drew seven million viewers. Respectable. Not earth-shattering. But over the following seasons, House became a global phenomenon. Laurie became the most-watched leading man on television, according to Guinness World Records.
What nobody saw was the weight he carried.
For eight seasons, Laurie worked sixteen-hour days. He was in nearly every scene. Los Angeles on set, London with his wife and three children — six thousand miles apart for nine months each year.
The isolation crept in slowly. Laurie had battled depression since his youth, seeking help in 1996. The relentless schedule made it worse. He described “very, very black days” on set, a feeling of being exposed and trapped.
The irony was impossible to ignore. Here was a man grappling with darkness, praised for playing a character defined by misery. The line between Hugh and House blurred with every episode.
He kept his American accent between takes. Rode his Triumph Bonneville at dawn, finding brief freedom in speed and air rushing over him.
But he never walked away. Eight seasons, 177 episodes. He stayed because it was the role of a lifetime.
When House ended in 2012, Laurie stepped back. Music called. He released blues albums, toured with a band, and returned to acting on his terms — smaller, stranger roles, a Golden Globe-winning turn in The Night Manager.
He didn’t disappear. He just stopped running on someone else’s clock.
Playing House was like carrying a heavy, beautiful stone. You can’t set it down. But you can’t ignore its weight.
Sometimes the greatest performances come from people who have lived the pain they portray. Laurie didn’t act misery. He understood it.
Watched Hail Mary today.
Even if we assume life is fairly common in the universe, that doesn't mean intelligence is. Life on Earth was strictly microbial for the first three billion years that it existed, then it took another 600 million years for something smart enough to make fire to emerge. And keep in mind that intelligence simply isn't necessary to survive in most ecological niches. Actually, a large brain can be a hindrance due to high calorie demands, which is why most animals are only smart enough to survive long enough to reproduce. Evolution doesn't care about the survival of the individual, which is why so many species persist by reproducing really fast. It doesn't matter if 90% of your babies die before adulthood if two members of your species can produce hundreds of offspring, and you don't need to be smart to do this. Intelligence just doesn't provide much benefit to a species until it crosses a certain threshold, and until it does, the large brain it requires is a liability for an investment that may not pay off.
And even if intelligence is fairly common, that doesn't mean technology is. What a species can accomplish is limited by their biology and biome. A purely aquatic species with no ability to manipulate tools will never discover fire, and so will never master metallurgy or any other technology fire is a prerequisite to. Being land-dwelling (or at least being able to survive outside of water for long stretches of time) is a minimum requirement to becoming technological.
And even if an intelligent species discovers fire, that doesn't mean they will advance beyond stone age technology. That species has to be social and cooperative. If you're forced to spend every waking moment looking for food and avoiding predators, then it doesn't matter how smart you are, you will never develop space travel on your own.
And even if that species is cooperative, that doesn't mean they will advance. Humans had to decide to give up a nomadic hunter-gather lifestyle and form permanent settlements and start farming despite the obvious disadvantages, such as crowding and proximity to animals enabling the spread of disease, putting themselves at the mercy of the weather, making themselves an obvious target for raiders, and so on, before the first cities could develop. This is what led to organized warfare and the precipitating technological arms races that eventually gave rise to the bronze and iron ages. An intelligent and cooperative species that never settles down won't accomplish this.
Then even if an intelligent, cooperative species manages to develop technology, they have to survive long enough to figure out space travel.
Now, consider how long it took life on Earth to go from microbial to something capable of building rockets, and realize how long of a lucky stretch we needed to last for billions of years without some natural disaster resetting the clock on evolution. All it would have taken was one gamma ray burst, one nearby supernova, or one really big asteroid impact (I'm talking much bigger than the one that killed the dinosaurs) to set everything back to square one.
And then, after all that, even if an intelligent, cooperative, technological species manages to get into space, there's no guarantee they will explore outside of their own solar system. It takes an extremely long time to travel between stars, so any interstellar journey would take decades or centuries, and would cost a huge amount of resources and concerted effort, and would come at a huge risk to the explorers who most likely wouldn't be able to make it back home. Unless their species happens to live a really long time, they would need multiple generations to be born, grow up, and die on a voyage of questionable profitability.
By the time a species is able to attempt an interstellar journey, they might lose any interest in doing so because they will have mastered using materials from local asteroids to construct artificial habitats in orbit around their parent star. Why go through the effort and risk of colonizing other solar systems when you can just build a Dyson swarm around your own sun and support quadrillions of people indefinitely? They might even figure out how to digitize their minds and live in a virtual paradise, and forsake reality altogether.
Lastly, consider the fact that the universe is only about fourteen billion years old. That sounds like a long time to us, but the Earth has been around for about a third of that time, and it took nearly all that time for us to evolve. Also consider that the star-forming era of the universe is expected to last another hundred trillion years. We probably live at the earliest time that it's even possible for a technological civilization to exist. The reason we don't see aliens might simply be because we're too early. There may come a time in the distant future when every star and every galaxy has been claimed by some galactic or intergalactic empire, and we will be the ancient forerunners to them, but that won't happen anytime soon.
Last Seen Users on Sotwe
Most Popular Users
Elon Musk 
@elonmusk
240.2M followers
Barack Obama
@barackobama
119.3M followers
Donald J. Trump
@realdonaldtrump
111.6M followers
Cristiano Ronaldo
@cristiano
109.2M followers
Narendra Modi
@narendramodi
106.9M followers
Rihanna
@rihanna
97.3M followers
NASA
@nasa
92.1M followers
Justin Bieber
@justinbieber
90.6M followers
KATY PERRY
@katyperry
87M followers
Taylor Swift
@taylorswift13
80.8M followers
Lady Gaga
@ladygaga
72.3M followers
Kim Kardashian
@kimkardashian
69.5M followers
Virat Kohli
@imvkohli
68.8M followers
YouTube
@youtube
68.6M followers
Bill Gates
@billgates
63.5M followers
The Ellen Show
@theellenshow
62.5M followers
CNN
@cnn
61.9M followers
Neymar Jr
@neymarjr
61.4M followers
X
@x
60.9M followers
Selena Gomez
@selenagomez
60.1M followers