Joshua I.R. Jeyakumar

Wayfaring stranger. Immigrant.

[Garry Kasparov @Kasparov63]

My thanks to everyone expressing their outrage and concern. Of course there are millions of people whose lives are threatened by Russia every day in Ukraine, and Ukrainian victory remains the best form of security for me, my colleagues, and all of Europe.

[Eby G @strawmaggot]

What story is it this time @Swiggy @SwiggyCares #lies

[TheLiverDoc™ @theliverdoc]

Good morning. Please take your time to read this. It is important. I worry for my children and yours too. I waited for a while to tell you the story about this liver.

I wanted to make sure it ended well. This is was the liver of a teenager we took out a month back. He was flown in from another State because of an unidentifiable jaundice + hepatitis that was making him sick. Hardly a few days in, he went into a coma because of liver failure and we put him on a ventilator. To help him survive, a parent donated part of the liver. This was the quickest emergency liver transplantation we ever did. Everything happened in less than 24 hours.

On the outside the liver looks pretty normal, just a bit swollen from the hepatitis (liver inflammation). But when we looked at it under the microscope, there was nothing left. Almost all the liver cells were wiped out (a finding known as massive hepatocellular necrosis) with deep inflammation.

The cause remained unknown. We call it indeterminate hepatitis - meaning, something we did not know, caused it.

You may remember post Covid-19 era. There were multiple cases of unknown hepatitis among children which either led to them dying or receiving a transplant. At the time, scientists thought it was due to another virus - Adenovirus, that had changed the way it attacked us due to Covid-19 era restrictions and immune changes. But that theory fell apart because not every kid with indeterminate hepatitis had adenovirus positive.

In the 1980s, some doctors in few hospitals across the world described a handful of single-center cases that first documented liver cell loss and inflammatory infiltrates in unexplained pediatric liver failure. And they kept seeing such cases, here and there, and forgot about it. Some died. Some lived after a liver transplant.

In 1999, with the establishment of the Pediatric Acute Liver Failure (PALF) study group allowed for systematic tracking and larger-scale retrospective and prospective analysis of immune functionand dysfunction in such kids with unknown hepatitis.

In 2022, medical scientists were armed with better technology and more impressive analysis methods. And global attention surged, in the post-Covid-19 era on outbreaks of severe acute hepatitis of unknown origin in children.
https://t.co/ktKVaLQjcQ

They figured it out. Just like we did.

A special stain and a technical advancement known as immunohistochemistry, a lab test that used antibodies to find specific proteins in a tissue sample was deployed. A special type of immune cell, supposed to defend us, was going crazy. Cytotoxic T cells act as the body's security guards to find and destroy cells infected by viruses or those that turned cancerous. There was no cancer in our teenager. And teenagers and children with this disease before him. The most likely culprit was a previous viral infection.
https://t.co/JicKah98a4

Covid-19 probably increased this. The little fcker wrecks havoc on the immune system like no other. It makes the body go wild and attack itself. It has done this before in other other organs too. It is called molecular mimicry.

When you get infected with COVID-19, your immune system creates defenses—like antibodies—to target and destroy the virus. To do this, it memorizes the physical shapes and protein sequences of the virus. However, because some building blocks of the COVID-19 spike protein mimic the shapes of our own healthy human proteins, the immune system can experience "cross-reactivity". Your newly trained antibodies end up attacking both the invading virus and your own healthy organs because they cannot tell the difference.
https://t.co/8baDr9nvJa

Large numbers of children with indeterminate hepatitis have cytotoxic T-cell mediated hepatitis. And it can only be diagnosed through a liver biopsy before the kid got really sick or after a liver transplant when the kid was going to die.

The liver that you see below, is far from normal. Deep within these tissues was a horde of cytotoxic T-cells that were picking of large areas of liver cells, pushing the child towards death.

As a doctor, I was only able to give them a diagnosis, after the liver came out and because they were convinced about this hidden killer of children, we did it in the nick of time. The teenager survived and we found what nearly killed the patient.

Any viral infection can lead to this. Not immediately, but even later on in life. It happens mostly in children, teenagers and young adults. Vaccines prevent/ reduce severity of various viral infections. Please make sure you and your children are vaccinated for age.

I hope Governments everywhere promote annual vaccinations for Covid-19 too along with the flu-shot. Because there is a strong possibility that this is the one virus that can cause this type of damage on the liver, many months after the initial infection and we may never know - becuase Covid-19 can come and go silently.

[ravish kumar @ravish_journo]

हम उम्मीद तो नहीं करते कि आप हिन्दी पढ़ सकते हैं मगर इस त्रासदी में नेपाल के पत्रकारों ने शानदार काम किया है। हिमाल ख़बर, हिमालय टीवी, कांतिपुर, काठमांडु पोस्ट। आपदा की रिपोर्टिंग में नए मानक स्थापित किए हैं। मैंने कई सारी नेपाली भाषा में लिखी रिपोर्ट देखी, वीडियो रिपोर्ट देखा, अंग्रेज़ी में लिखी गई रिपोर्ट पढ़ी। किसी में बढ़ा-चढ़ा कर हांफते हुए रिपोर्टिंग नहीं दिखी। यह हम सबके लिए भी ख़ुद को रि-सेट करने का सबक रहा। आपदा के दो-तीन दिनों के भीतर हिमालय टीवी ने हेलिकॉप्टर हायर किया और अपने दो रिपोर्टर को भेजा। हिमालय टीवी ने अपना पूरा फुटेज मुझे दे दिया। बदले में कुछ नहीं माँगा। हेलिकॉप्टर उस रूट पर उड़ान भर रहा था जिसके रास्ते ग्लेशियर फटने के बाद मलबे की सुनामी आई थी। रिपोर्टर ने कुछ भी बढ़ा-चढ़ा कर या हाँफती हुई आवाज़ में नहीं बताया। न ही दावा किया कि हिमालय टीवी दुनिया का पहला टीवी है, जो हेलिकाप्टर से आपको आपदा का रूट का हाल दिखा रहा है। दोनों रिपोर्टर अपना प्रचार करने के फिराक में भी नहीं थे, न उन पर कैमरा था कि हम वो हैं जो इस हाल में आपको ये दिखा रहे हैं। यह तभी होता है जब मीडिया संस्थान, पत्रकारों को अपने काम पर भरोसा होता है। नेपाल के पत्रकारों ने इस त्रासदी के मामले में काफी प्रभावित किया है। नेपाली, अंग्रेज़ी में कई सारी अच्छी रिपोर्ट पढ़ने को मिली है। आप चाहें तो इस दौरान नेपाली प्रेस की बेहतरीन रिपोर्टर का संकलन भी तैयार कर सकते हैं। यह अच्छा दस्तावेज़ भी होगा और पत्रकारों के लिए गाइडलाइन का भी काम करेगा। आपके अख़बार का भी काम शानदार रहा है।

[TheLiverDoc™ @theliverdoc]

Hello Sir, happy to see you have recovered well. Could you tell us more about the Ayush specialists who took care of you while you were admitted to AIIMS? If none, then why is your Government promoting quackery in the name of nationalism and destroying the reputation of an apex Institute? Public funds are embezzled on Ayush in multiple such institutes. If you were not treated by Ayush for your illness, then please do not promote it for the majority who elected you to power. Isn't that what real leaders should be doing instead of promoting double standards?

[Joshua I.R. Jeyakumar @zzjosh12]

@BBCWorld @rdfrs @RichardDawkins @LRosenblood @center4inquiry @cficanada - one potential candidate for the Richard Dawkins Award is @theliverdoc Please check out his work

[Joshua I.R. Jeyakumar @zzjosh12]

One of these days, I think @theliverdoc might win the Richard Dawkins award from @rdfrs . Worthy candidate in my opinion.

Would also be wonderful if he can be invited as a guest on the Podcast For inquiry with @LRosenblood @cficanada

[HarperCollins @HarperCollinsIN]

Behind the viral posts, sharp takedowns and unapologetic advocacy is a far more personal story.

@BBCWorld’s profile of India’s “Liver Doc,” Dr. Cyriac Abby Philips, explores the struggles that shaped him, the compassion that drives his work, and his unwavering commitment to evidence-based medicine.
Read more: https://t.co/sRJmL5WGSh
@theliverdoc
To discover why his latest book, The Liver Doctor, is a must-read, expand the thread👇

[TheLiverDoc™ @theliverdoc]

Today is National Doctors Day in India. And the best day for me to discuss this very important paper. I will tell you why, at the end of this post.

The BMJ invited me to lead and write an invited editorial with a niche group of medical science communicators on an important topic.
https://t.co/kWPdRNSUbp

One of the most common arguments from the traditional medicine industry to prove the "legitimacy" of their (untested) products and (unscientific) practices in healthcare was that they had been "recognised" by WHO.

Large scale global meetings were conducted by WHO. And countries with emotional appeal towards traditional medical care, while others with political, religious and cultural stakes in the form of business oppurtunities were all part of these WHO-driven meetings were public funds were utilized to plan strategies to justify alternative medicine and promote it.

In this invited review, me, along with fantastic and brilliant medical science communicators - @CaulfieldTim , @Cath77777 , Prof. Xingshun Qi - and a patient-partner discuss, how, some WHO-related strategies, policies and endoresements are not science-related, but mostly politically and culturally motivated.

Please read here: https://t.co/kWPdRNSUbp

4 major points about the risks of rushing alternative medicine:

Lowered scientific tandards: The WHO is pushing to include traditional and alternative medicines into standard healthcare systems. However, they are dangerously lowering the scientific standards needed to prove these treatments actually work, allowing them to be endorsed before standard safety data exists.

Real risks to patients: Rushing to use unproven traditional remedies can lead to serious patient harm, including dangerous interactions with standard medications. Globally, herbal remedies are actually a more common cause of severe liver failure than prescription drugs.

Driven by politics, not science: The growing acceptance of alternative medicine is often driven by politics, nationalism, and economic interests rather than reliable science. Promoting these unproven practices risks spreading health misinformation and commercially exploiting vulnerable patients.

Safety must come first: While traditional practices are heavily relied upon globally, all patients deserve treatments that are fundamentally safe and effective. We must ensure alternative medicines pass the exact same rigorous scientific tests as conventional healthcare before endorsing them.

Today is National Doctors Day in India. Whether is is WHO or any such "legit" monolithic organization directly promoting misinformation and indirectly driving disinformation that can cause public health harm, as doctors, we do not look at the size of different Goliaths we meet. We fight like David, to protect - because that is what doctors who are really teachers swore - took an oath - that Primum non nocere...

..."first, do no harm."

We hope the WHO is listening. And so are the public.
Editorial: WHO’s misguided push for complementary and alternative medicine
https://t.co/kWPdRNSUbp

[TheLiverDoc™ @theliverdoc]

Drop everything you are doing and watch and share this "zabardast" original documentary on Ayush and Ayurveda in India.

https://t.co/CJW7ZItQyJ
Featuring the narration by Ravish Kumar
And on-ground report by Basant Kumar
#MustWatch

Basant met me at my workplace in Kochi and we had a very long talk and recording session (in Hindi!) on my experiences with treating and publishing on the largest numbers of cases of Ayush-liver injury in the country at our referral center. I wish I could have given him more time, but clinical work was damning at the time. But I am happy how this turned out.

He has also interviewed my patients (and many such patients across India), especially my young-girl patient who turned out to have severe alcohol-related liver injury and arsenic poisoning from Ayurvedic treatment for seizure disorder (that segment will make your feel really sad). #MustSee

It is the most important video you will watch this year and please share it maximum. This is a huge effort from Basant and the NL team, and I am proud to be part of this.

PS: Ayurveda practitioners feature time and again in the video. That's your loo break or comic relief - whichever way you want to see it. Listen to their incompetence and ignorance. And the Govt. is hell bent on creating more such incompetent fools.

[S Sebag Montefiore @simonmontefiore]

The Islamic Republic has sentenced surgeon Dr. Alireza Golchini to death after arresting him during Iran's national uprising. His "crime" was treating protesters wounded by the regime.

[Masih Alinejad @AlinejadMasih]

How dare you?
Millions of us Iranians are in total darkness.
The internet is shut down.
People being killed and from the safety of the free world, you go on international media to repeat accusations the regime uses to kill them.
That’s not analysis.
That’s fuel.
@piersmorgan

[Steven Pinker @sapinker]

Bombshell: Oliver Sacks (a humane man & a fine essayist) made up many of the details in his famous case studies, deluding neuroscientists, psychologists, & general readers for decades. The man who mistook his wife for a hat? The autistic twins who generated multi-digit prime numbers? The institutionalized, paralyzed man who tapped out allusions to Rilke? Made up to embellish the stories. Probably also: the aphasic patients who detected lies better than neurologically intact people, including Ronald Reagan's insincerity. https://t.co/77nQRF8kp6

[Joshua I.R. Jeyakumar @zzjosh12]

@RichardDawkins @strawmaggot - anyone in your network who might know if any Tamil copies of the other books are available?

[Masih Alinejad @AlinejadMasih]

Right after two Russian hitmen got 25 years in U.S. federal court for trying to kill me in Brooklyn, I spoke with @jaketapper on CNN about how dictators hunt their opponents beyond their borders.
When the hitman came to my porch in New York with an AK-47,
I was on a Zoom call with @leopoldolopez, fighting Maduro,
and @Kasparov63, fighting Putin. If I’d opened the door, I’d be dead.
Before that, Tehran had planned to kidnap me from Brooklyn and fly me to Caracas because Venezuela was the safe house for Iran’s agents.
The FBI stopped them just in time.
They had the boat, the route, the silence arranged.

This is transnational repression dictators outsourcing murder. And this is how dictators are working together.

[TheLiverDoc™ @theliverdoc]

I would like to highlight certain points:

1. No infant requires a cough syrup. It is not recommended, nor approved.

2. Indian-made cough syrups have huge quality control issues. All the more reasons to NOT give children cough syrups.

3. Just because modern medicine cough syrups have quality control issues, it does not automatically mean that alternative medicine options such as Ayurveda are safer. They are not. In fact they may be more harmful, because a) they are wholly unregulated, b) they do not conduct safety studies, c) adulteration and contamination are issues along with, d) toxic herbals that can cause a variety of organ injuries and most importantly, e) there is literally zero evidence that alternative medicine and supplements work for anything, even for a symptom like cough, let alone and actual disease.

4. Don't want your child to have infection-related cough? Then vaccinate them - influenza vaccine, DTaP for pertussis (whooping cough), MMR to prevent measles (high risk of pneumonia) and pneumococcal vaccine.

What India really needs further is an RSV (Respiratory Syncytial Virus) vaccine (given to mothers to protect babies in early life) and the updated combined Influenza+COVID vaccine.

Prevention is always better than cure. Don't let anyone tell you otherwise.

[Joshua I.R. Jeyakumar @zzjosh12]

@theliverdoc Congrats @theliverdoc ! Well deserved. Thank you for doing what you do.

[S Sebag Montefiore @simonmontefiore]

This is amazing. There is another wondrous and admirable Iran waiting to blossom
@arash_tehran

[TheLiverDoc™ @theliverdoc]

Here is a video on it: We Made Medical History Together: India’s First Blood Group-Incompatible Liver Transplant for a Rare Genetic Disorder - Methyl Malonic Acidemia...
...done free of cost to save this child.

[Sara Wahedi @SaraWahedi]

A colleague in Afghanistan shared a terrifying realization with me today:

“Nearly 4 years without school, learning is a thing of the past. Some girls say they feel too depressed to study. Or they are busy with housework. We may struggle to find girls ready, or able, to learn.”

[Ahmed Fouad Alkhatib @afalkhatib]

As negotiations for the end of the war in Gaza pick up steam again, following the ceasefire between Israel and Iran, Hamas’s demands during preliminary talks have focused on some pretty revealing priorities, according to some on the periphery of these conversations with whom I’ve spoken. The group is seeking guarantees that its finances and resources abroad, especially in Qatar, are secure from seizure and forfeiture; it wants guarantees that its leaders abroad are not assassinated; it wants a role in the future of Gaza’s affairs even if it does not govern directly; and it does not want the introduction of an international peacekeeping mission that it views would be another form of “occupation.”

This clearly shows that the most crucial priority for Hamas in the ceasefire negotiations was and will always be its political survival and maintaining a grip on power. October 7, or the so-called “Operation Al-Aqsa Flood,” was launched under the guise of "protecting Jerusalem and addressing settler aggression" in the West Bank. However, after Gaza has been fully annihilated, and Hamas so utterly defeated, the only thing that the terror group is thinking to accomplish now is to ensure its survival, even if the entirety of the Palestinian people in Gaza are destroyed.

This fascist death cult must never again be allowed anywhere near power or control in Gaza. All of its finances have to be immediately seized and the entirety of its leadership arrested and detained. This will be the beginning of the end of Hamas’s reign as a cohesive political entity.