TheLiverDocā„¢ Profile picture
Sep 25, 2020 • 14 tweets • 17 min read • Read on X
Here is an example of exactly HOW NOT to design a study and publish.
A grp of #ayurveda vaidyas published:šŸ’”Clinical Improvement In #COVID19 #patients With Timely Intervention Of Panchagavya: Preliminary Finding
šŸ’µInternational Journal of Pharmacological Research
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#MedTwitter Image
First, choice of #journal. Choose one indexed in valid scientific databases - eg @Scopus, Medline @NCBI, @embase, @EBSCO, @webofscience. International Journal of Pharmacological Research is indexedšŸ‘‡šŸ˜¶
Just bcoz its on Google doesn't mean its quality. #pseudoscience #fake
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There R indexed and impactful journals charging #openaccess fee (eg @JHEP_Reports) if the institute can afford it. Most quality indexed, impactful journals (eg @HEP_Journal) dont have open access fee to publish, but #Subscription fee for persons to read #published study.
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The current journal, The International Journal of Pharmacological Research - isnt indexed, doesn't have an impact factor, no valid presence in scientific repositories, has a blurry editorial board charging an open access fee - the making of a #PredatoryPublishing STAY AWAY.
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Now the study and obnoxious results:
#Gomutra or distilled #cow urine was given, along with prescribed medications to three very mild COVID-19 positive patients. All three recovered from #COVID19 with no #complications. That's it. That's the study and its conclusions.
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So what is wrong?
First, case study/series must have an intro section providing insight, references 2 previous work which made possibl current work. In this study, authors hav written non-structured BACKGROUND (with study conclusions!) followed by INTRODUCTION which is nuts.
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Methodology is quite hilarious.
All 3 patients wit #coronavirus (patient+2 fam members) were treated 'telephonically' - i.e, they were told over the phone to take distilled cow urine 'while they are at home'. This means, tat #Covid infection was very mild at outset #science
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Once they were confirmed #SARSCoV2 , underwent admission to a Covid hospital at Nagpur and underwent ultra-proper treatment (they got every thing undr the sun along wit cowurine). After gov hospital based treatment they were deemed #Covid -ve & send home
All medications šŸ‘‡šŸ˜±
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Finally, authors conclude that cowurine improved immunity (how it did is up2 readers fantasy) and all patients recovered wit cow urine. They then dive into the imaginary reasons why this is so, in the process, stretching readers imagination and then, sudenly discus #Cancer!
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Im not sure why cow urine was used, and not human urine. Both hav similar composition, properties. Human urine easily available, people can donate free. Collection jars at public urinals ensure steady flow 4 clinical use. This discussion is missing from limitation section😵
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The authors finally call 4 population study on cow urine FOLLOWED BY in-vitro study. Interesting reverse science. They conclude that comorbidly ill patients with #coronavirus recover with cow urine, based on family study of 3 who received all treatments under the Sun.
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So wat is conclusion!? If you hav #COVID19, esp mild #Disease, call #cowurine #Ayurveda helpline, buy distilled cowurine packs, go 2 nearby modern hospital, get treated, get well. Witout drinking, jus holding on2 urine pack in a proper hospital promotes wellness as well.
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But let us not belittle urine so much. It has potential, as another study shows (Sreedevi et al , IJPP 2016)
When human urine used wit farmyard manure, mazie crops grew better than wit cow urine. Its time for another #ayush team to look into this combo therapy in #COVID19
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More from @theliverdoc

Jan 4
STAY WITH ME.

A few years ago, a patient was referred to me because he was diagnosed with complicated cirrhosis. He had an infection which led to a condition called hepatic encephalopathy (brain failure due to high ammonia levels). The treatment largely involved ammonia reducing therapies. One drug was central to this - Rifaximin - a non-absorbable antibiotic that reduced ammonia in the body. I prescribed him Rifaximin for 6 weeks and advised him follow-up.

He came back to me, not after six weeks, but in 4 weeks, this time, in liver coma (worst stage of brain failure - due to very high ammonia). He spent two days in the ICU and six days in total in the hospital. His hospital bill was close to INR 80,000. He had no insurance and his wife borrowed the money from neighbors and friends to clear hospital dues.

Upon questioning, I found that he was not taking the Rifaximin drug I had prescribed. He was only on the other two drugs (one, a syrup called lactulose for improving ammonia clearance in gut). I was furious, because the patient spent a whole week unecessarily in the ICU and wasted so much money that he never had - just because he was "not compliant" to my orders. I decided it was time for me to school him a bit.

But I was wrong. He was compliant. He had purchased Rifaximin and was on it. For 15 days. Thereafter, he could not afford it. He was an autorickshaw driver who shuttled school children every morning and evening. He could hardly make ends meet. He had two children of his own. The Rifaximin brand I prescribed him was 42 rupees per tablet. He had to consume two a day - which would mean 2520 rupees a month. He just did not have that money - so he skipped it - to not compromise on other important matters - childrens education and food.

He was confused and scared about opting for a cheaper version of Rifaximin because one, he was unsure about the quality of Rifaximin that was not prescribed by me and two, he was "scared" that I would scold him for buying a cheaper Rifaximin and if that got him into trouble.

I was confused and scared about prescribing a cheaper version of Rifaximin because one, I was unsure about the quality of Rifaximin that was not "a good promoted brand" and two, I was "scared" that his family would scold me for prescribing a cheaper Rifaximin and if that got him into trouble.

It is heartbreaking that many doctors still simply don’t trust generic medicines. Too often, they worry that these cheaper options are lower quality or might cause more problems than the big, famous brands. This fear leads them to prescribe expensive drugs instead, and the real tragedy is that it pushes vital healthcare out of reach for the ordinary people who need it most - like my patient.

This narrative, that generic drugs 'are never good' and that only big pharmaceutical marketed drugs are what works has been deeply ingrained into doctors and patients alike - I do not know by whom and since when. Looking back, these strong emotions were based on either opinions, testimonials or second- and third-hand information. Not evidence.

Like I said. Stay with me. This is life changing and will disrupt the drug market in India. Here are the results of The Citizens Generic vs. Brand Drugs Quality Project.
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With your help, we analyzed 131 different medicine samples from pharmacies - ranging from expensive top brands to "free" government generics.

This included the highest prescribed and selling (most expensive) branded drugs, generics marketed by the same big brands (branded and local pharma generics), government supplied generics [Central Govt. - Jan Aushadi and State Government - Kerala Medical Services Corporation Limited (KMSCL)], and trade generics [sold at hospital pharmacies and special generic pharmacies - Dava India, Generic Aadhar)

The question: Is the expensive stuff actually better?
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The Test
We took 22 types of common (essential) medicines (for heart, pain, antibiotics, liver, sugar) from these 7 different sources, and sent them to an accredited lab - Eureka Analytical Services Pvt. Ltd. in Kundli, Sonipat, an FSSAI-notified and US-FDA and NABL/ISO 17025 accredited laboratory providing comprehensive pharmaceutical, API, and drug testing services.

We tested 5 quality parameters according to standards of Indian Pharmacopeia:
āœ… Drug content or assay
āœ… Dissolution
āœ… Uniformity
āœ… Impurities
āœ… Physical appearance
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Read 12 tweets
Nov 16, 2025
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Our important work, The Citizens Protein Project 2 that analysed "hospital/doctor" prescribed whey protein vs. nutraceutical/fitness industry marketed whey protein is now peer-reviewed and published. Please share with your doctor!

Full paper: journals.lww.com/md-journal/ful…Image
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Read 14 tweets
Oct 20, 2025
Please read this and don't take medical advise from so-called health influencers.
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Read 5 tweets
Sep 10, 2025
Good morning. Eli Lilly did not pay me for this post.
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Read 9 tweets
Jul 27, 2025
We recently published our independent analysis of Homeopathic practitioner commonly prescribed and popular over-the-counter 134 Homeopathy products marketed and sold as "medicine."

The Placebo Project: An observational study and comprehensive analysis of 134 commonly prescribed homeopathic remedies in India uncovers potential for hepatotoxicity: journals.lww.com/md-journal/ful…

Here is our plain language and visual abstract summary of what these Homeopathy products are and what we found in them.

1/3 - Classical (Diluted) Homeopathy ProductsImage
2/3 - Homeopathic Mother Tinctures Image
3/3 - Homeopathic Proprietary Products Image
Read 4 tweets
Jul 19, 2025
Ok. Let's properly study Ayurveda.
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Read 16 tweets

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