TheLiverDoc Profile picture
Sep 25, 2020 14 tweets 17 min read
Here is an example of exactly HOW NOT to design a study and publish.
A grp of #ayurveda vaidyas published:💡Clinical Improvement In #COVID19 #patients With Timely Intervention Of Panchagavya: Preliminary Finding
💵International Journal of Pharmacological Research
1/n
#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 indexed👇😶
Just bcoz its on Google doesn't mean its quality. #pseudoscience #fake
2/n Image
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.
3/n Image
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.
4/n Image
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.
5/n #ayush Image
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.
6/n Image
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
7/n Image
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 👇😱
8/n Image
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!
9/n Image
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😵
10/n Image
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.
11/n Image
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.
12/n Image
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
13/n Image

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More from @theliverdr

May 19
My staff ushers in a man & his mother cradling a 5y old boy into OPD

I luk at my list & ask, Mr Ram?

But the staff tells me, Ram is next on list
But this boy looked very sick & was given priority

One look at the boy & I knew what this was

A race against my worst enemy

Time.. Image
The boy's name is Dheeraj

which in Sanskrit means 'patience'

- but this was not a time to be patient becoz

"If we lose time, we lose the little patient"

Dheeraj was diagnosed with a dreaded liver condition a few weeks after birth

called biliary atresia... Image
Biliary atresia is a blockage in the tubes (ducts) that carry bile from the liver to the gallbladder

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I asked the son, who was flustered and trembling, looking at his father lying on the green sheet ER bed

"What happened?"

Trying to cover his shame, but not the disgust, he replies, "This has never happened before"

"What?" I ask him

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..."in front of us, in front of my cousins"

"& then what did u do?", I ask him

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"My dad's never been abusive, he's the sweetest person"

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& he says, "Ammonia"...
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Read 25 tweets
May 16
28 y old young mother is referred for evaluation of progressive jaundice

Docs are mind-boggled

Patient is getting sicker - increasing jaundice/persistent itching 2 mo after delivering healthy baby girl

She's scared, of the possibility that she wont get to see her baby girl...
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Their diagnosis - post delivery unknown cholestatic viral hepatitis, possibly hepatitis E infection

But it didnt seem right...
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This young mother had no obstructive features to bile flow, but her liver tests had shown...
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May 15
I received these samples for analysis

Formula 1
Batch: A221752B04
Mfg:date-DEC2021
Exp:date-NOV2023

Personalized Protein
Batch: A221726G21
Mfg:date-NOV2021
Exp:date-OCT2023

Afresh Energy Drink
Batch: E821712A27
Mfg:date-NOV2021
Exp:date-OCT2023

Here are results, discussion...
...Analysis was done by an independent lab approved by the central and state government for food analysis and NABL accredited for general testing in chemical and biological parameters

Gas Chromatography/Mass Spectrometry, method was used to identify different substances...
...rather than conclude based on analytical findings, I wud like to know whether these findings r NORMAL for a protein supplement?

Herbalife supplements unlike other pure proteins, use herbal components 2, mayb this would have led to complex results...
@minicnair @PriyankaPulla
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May 14
Grateful to @AASLDFoundation,@AASLDtweets for recognizing our work @DDWMeeting & choosing us as one among ten to receive the prized Foundation Fellow Award globally

AASLD's recognition has been instrumental in progression of our clinical research in our State & Nation+
#DDW2022
Our featured works to be presented at the @DDWMeeting, San Diego May 21-24 include:

A. Use of high dose probiotics in patients with severe alcohol-liver disease where we discuss novel findings associated with intestinal microbiome and their interactions after probiotic therapy +
& B. The changes in fungal communities in intestines of patients with severe alcohol-liver disease treated with high dose probiotics (Poster of Distinction)

Were the changes beneficial?
How did bacterial communities interact with fungal communities?

#medtwitter #livertwitter +
Read 4 tweets
May 14
58y old man with chronic liver disease is rushed to ER very early morning after multiple seizures, loss of consciousness

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Bilirubin 4.8
AST 346
ALT 228
ALP 444
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Even though abnormal liver tests are common after seizures, jaundice is unexpected, very rare

Which meant, this was more than just a hypoglycemic seizure...
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In early cirrhosis, controlling or treating cause(s) of cirrhosis helps prevent disease progression...
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