vishnu v y Profile picture
May 9, 2021 26 tweets 12 min read Read on X
Health Vs Politics: Should science or medical journals comment on political decisions affecting health? YES Because Politics affects everything including health. Let’s see some eg. of medical journals critical of establishment (1/n) @AnantBhan @TheLancet
Lancet Oncology on Trump adminstration (2/n) @TheLancetOncol
Science journal going hard at Trump (3/n) @ScienceMagazine
Nature journal taking it further and supporting a presidential candidate. Can anyone imagine it in India- even 10 years before? (4/n) @nature
JAMA discussing health policy of two presidential candidates- Have we ever seen any medical journal in India discussing the health policies of various parties during an election? (5/n) @JAMANetwork
Lancet on Brazilian Government.(6/n) @TheLancet
Lancet on Trump, who no one spared (7/n) @TheLancet
Finally NEJM editorial on Trump administration “Dying In a Leadership Vacuum” (8/n) @NEJM
Pls post here if anyone finds more examples. The point is one improves with criticism. There is no shame in accepting mistakes and taking course correction. Instead of hyper nationalistic jingoism, let’s all work together to improve our system
Hard to find medical journals critical of China- something I could find👇
This one is Interesting as it came for an Indian author in China- journals.sagepub.com/doi/pdf/10.117…
Another one on China from the same author link.springer.com/content/pdf/10…
An example of Lancet criticising a left leaning government. Venezuela is like Mamta Bannerje of Bengal- more left than the left that left became irrelevant
Lancet on the Lebanese Health Crisis and criticising “atrocious failure of the US and UK’s weak, evasive, and ultimately disastrous foreign policy towards the Middle East”
A piece critical of Cuba’s health system. One will find lot of articles praising Cuban health care. But since we are focusing on articles critical of establishment, putting this here tandfonline.com/doi/pdf/10.108…
JAMA piece criticising the Cuban Governments mandatory quarantine policy for people with HIV in 2003
“Politics of Medicine”- the other side of the argument- which I personally don’t agree with- ‘The major medical journals of the western world badly need their own glasnost and perestroika” academic.oup.com/qjmed/article/…
Lancet had a Health Policy Review on ‘Weaponisation of health care in Syria’ thelancet.com/action/showPdf…
BMJ usually plays safe with “Yes/No” debates. For example the Head to head on ‘Should we consider a boycott of Israeli academic institutions?”. More interesting than the article are the correspondences on these pieces
A medical crisis in Syria- “Being caught with medical supplies or treating injured protesters is worse than being caught with weapons: one doctor told Amnesty” Since it’s an editorial on ‘some’ conflict zone in Middle East- no body here would have noticed
Lancet editorial critical of large aid agencies and humanitarian organisations. “We have repeatedly drawn attention to the fact that when viewed through the distorted lens of politics, economics, religion, and history, some lives are judged more important than others”
Ebola used as a political tool in Congo? This editorial could also be written in a similar way on India- replace Ebola with COVID, add more elections, add more political parties and increase the complexity of the country
Lancet has published many editorials on India. Thanks to @sainimmm In 2004 editorial on “Political Neglect in India’s health”
2009 Special Report in Lancet on Sidelining of health issues in India’s general elections @sainimmm
And the most controversial piece by Lancet on Kashmir
There was a strong view point against mixing politics and medicine by @RogueRad TBH it was a great read! kevinmd.com/blog/2019/08/w…

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More from @vishnuvy

Apr 25, 2022
VOR-POD9: Laboratory diagnosis of CJD @NEJM
Main diagnostic strategy of CJD involved:
🛑EEG
🛑MRI Brain
🛑Brain biopsy or autopsy samples
✳️ Characteristic changes in brains of CJD pts are: ⏺Aggregates of abnormal host-derived PrP
⏺Histopathological triad of
🛑spongiform changes (small, round or oval, vacuolated empty spaces in the neuropil surrounding neurons)
🛑neuronal loss
🛑gliosis without inflammation
Read 20 tweets
Apr 24, 2022
VR-POD8: Spontaneous Intracranial hypotension @NEJM
❇️SIH is characterized by a lower-than-normal volume of CSF because of leakage of CSF through the dural membrane at one or multiple sites

❇️‘Non-spontaneous’: CSF leaks of known cause:
⏺craniospinal trauma
⏺spinal surgery
⏺LP or spinal anesthesia- MC
Normal CSF pressure: 6-25 cm of water
SIH: CSF pressure may be normal, and it is often lower than normal
Read 32 tweets
Apr 23, 2022
VR-POD7: Approach to Adult Onset Neurometabolic diseases @JNNP_BMJ
Inborn errors of metabolism with neurological manifestations (neurometabolic diseases)
✳️ Group of heterogeneous genetic disorders due to alteration of specific aspects of the cellular metabolism- leading to disease

✳️In adults, it may be difficult to diagnose
List of all adult-onset neurometabolic diseases
Read 50 tweets
Jun 4, 2021
Feed is full of violence on doctors in India. It’s a reflection of the society, a twitter hashtag trend is not going to change it. Protect and take care of yourself. Never skip a lunch or family commitment for any non-emergency. Few practices I followed in Precovid era: (1/n)
Skipping lunch: Have argued with my faculty during residency for taking rounds beyond lunch time without a lunch break. When joined as contract faculty in PGI, have stopped a grand round for lunch break- and it was received in the right spirit by senior faculty. (2/n)
During residency and as a faculty now- I take a lunch break in OPD at 1pm for half an hour. Patients who have taken appt are informed so that they can also have lunch. Residents are always told to have lunch. Don’t starve yourself and FYI doing so is not social service. (3/n)
Read 9 tweets
May 23, 2021
An editorial from ‘Indian Medical Sciences’ journal. Read and enlighten yourself.
Other similar academic pieces “Misplaced outrage on India’s new citizenship laws: Opinions of healthcare professionals”
Read 4 tweets
May 23, 2021
Every speciality who is on (or wants to be) the ‘Mucor’ team- how many are willing to admit a patient with Mucor under their care and manage (even after surgical debridement). How many were admitting before and will admit after the pandemic? (1/n)#Mucormycosis #COVID19India
Some hypothetical consultations in the emergency before and after the pandemic:

#ENT : We will operate and transfer back

#Ophthalmology : Call us during the Surgey, we will coordinate with ENT in the OT, if needed

#Neurology : Continue Amphotericin (2/n)
#Endocrinology : Send us a consultation after admission under primary, we will control sugars

#Neurosurgery :No active neurosurgical intervention required

#Nephrology :We will do renal modification of Amphotericin

#Medicine/ #Infectiousdisease Admit under any of the above
Read 4 tweets

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