This is an SOS. The #AssamFloods have wreaked havoc. The Cachar Cancer Centre in Silchar has faced enormous challenges in continuing with cancer care amidst very difficult situations. This thread is an entreaty to all of you to support them (donation link at end of the thread)1/n There is a severe shortage of all supplies – food, water (yes, safe water is an essential commodity during floods), diesel, life-jackets, and many more. Repair and rehabilitation is urgently required. 2/n

Cancer vanishes from every patient’s body in drug trial “miraculously”; Shocked doctors’ say ‘First time in history’ financialexpress.com/healthcare/new… What miracle are we talking about?

A drug called dostarlimab, an anti–PD-1 monoclonal antibody (immunotherapy), was given every 3 weeks for 6 months in patients with a subgroup of patients with rectal cancer (stage II or III, mismatch repair–deficient or MMR-deficient). (2/9)

#SriLanka is going through one of their worst economic crises ever. The acute shortage of medical supplies will be catastrophic for the country if help doesn’t come fast. They may lose more lives during this crisis than during the #COVID_19 pandemic. How can you help? Thread The Ministry of Health in Sri Lanka, with whom we are in touch with regularly, have shared a list of essential drugs and consumables that they are running out of critically.

#MerryChristmas2021! If I had one wish from #SantaClaus, what would it be? With the #OmicronVariant, there’s a lot of chat on what countries should do with #COVID_19 vaccinations – start boosters or complete the first round of the recommended two doses for everyone? If boosters, should it be for all, or select populations? My take.

A couple of days back saw the inauguration ceremony of "Asha Nivas" at @ACTREC_TMC by Hon'ble CM of Maharashtra @OfficeofUT @CMOMaharashtra and @sudhamurty in the presence of Shri K N Vyas @DAEIndia and Prof R A Badwe, Director, Tata Memorial Centre. Why is this such a big deal? Let me explain-Asha Nivas is a place where patients treated at @TataMemorial and @ACTREC_TMC can stay during their cancer treatment. Consider that 86% of patients being treated by us come from outside Mumbai, 60% from outside Maharashtra, 65% hailing from low socioeconomic strata

This is such an important concept to understand. Very often, the public & even a lot of physicians equate the success of a screening test to detecting cancers early when patients are asymptomatic / improved survival amongst those detected to have cancer. This is inherently flawed

https://twitter.com/NCIprevention/status/1418604378374684675

Why are early detection & improved survival not sufficient to proclaim success of a screening test?
While it seems intuitive, these two do not actually translate into lives saved
This doesn't seem logical, but it's true

A group led by @drsabita & @docpriyar set out to look at the impact of COVID_19 on physicians in India from a gender perspective, our hypothesis being that a greater burden of familial/domestic responsibilities fell on women. Full paper: ascopubs.org/doi/pdf/10.120… 1/n The #COVID_19 pandemic had realigned our lives, and for many, especially in healthcare, increased their work considerably. Healthcare workers globally found themselves working overtime to handle the pandemic, while their domestic work increased thanks to the lockdown 2/n

#SARSCov_2 viral variants / mutants and vaccination seem to be consuming most discussions on #COVID_19 these days. We’ve let incomplete data and general knowledge create misinformation and confusion amongst us all. An explanatory thread... We’ve heard of the #Delta, the #DeltaPlus & unknown future variants which may be either more transmissible or more lethal than previous ones. This has either created panic, or worse, a sense of futility about both vaccines and precautionary measures to avoid the infection

The worst of the second wave of #COVID_19 seems to be behind us in India. Here are some random thoughts… Let’s face it – the second wave caught all of us by surprise by the sheer ferocity with which it unleashed itself. The inadequacies and frailties of our healthcare systems lay exposed. After nearly three months of helplessness, we are limping back to some semblance of control.

We had some interesting findings from our study on the impact of COVID-19 on cancer care. What we did was pretty simple…

Impact of COVID-19 on cancer care in India: a cohort study thelancet.com/journals/lanon… We looked at volumes of services in 41 cancer centres that were part of the @CancerGridIndia over a 3 month period during the pandemic in 2020 and the same 3 months in 2019.

There has been a lot of panic in India about the “black fungus” which has caused substantial concern, morbidity and even deaths in patients with COVID. This is a short thread to explain what we know about it The truth is that we don’t know everything about it, but let’s start by calling it what it is – “Mucor”. And anybody who claims that they know all about it is hmm…., let's say, “factually incorrect”

This thread is directed to all of you searching for plasma donors and/or amplifying requests for plasma donation, but most importantly, for physicians suggesting plasma donation, or patients’ families demanding #ConvalescentPlasma treatment for their loved ones. Over the past year and more, we have had #ConvalescentPlasma dominating conversations about #COVID_19 treatment. Families have run from pillar to post trying to find a compatible donor. We’ve had celebrities urging people to donate.

Today, our usual "Thursday morning meeting" at @TataMemorial was anything other than usual...
0.4%. This number becomes significant in the last tweet of this thread.
Follow on. The topic for today's meeting was "How have nurses contributed to the @TataMemorial #COVID_19 response? This was planned to coincide with the #InternationalNursesDay2021 and the #InternationalNursesWeek

I know the #COVID-19 numbers in India are not looking good, but here are my (not so) random thoughts on it We have 2 options – one, rant & rail against the ‘system’ and lament how it has let us down; second, do whatever we can to avoid getting infected & if infected, minimize adverse consequences to ourselves & others. If you belong to the first, you can stop reading now

Why is there a shortage of Remdesivir, with family members desperately trying to procure it when it has been proven that it is no better than routine care? #EvidenceBasedMedicine There are two living meta analysis and systematic reviews that show it is not better than routine care. Close to 4000 patients in randomized trials showing no benefit, and patients & families desperate and buying in the black market because they believe it will save their patient

Let me tell you an amazing story... In the 1990s, a maverick breast surgeon at @TataMemorial (fresh from his return from the UK) stepped up to do research. Now, to understand the situation, you should go back 30 years, when research was not as big as it is now, and certainly not from surgeons.

Great work by Connor Wells & Shubham Sharma @QueensUHealth asking two important #GlobalHealth questions
1. Is there a #publicationbias against papers from #LMICs?
2. Do oncology RCTs match the global disease burden?
Confirms something we always knew
What we did was this... We identified 3 problems and 2 facts
We looked at all phase 3 studies in oncology from 2014 to 2017; classified origin of these RCTs based on #WorldBank economic classification of countries. We compared RCT designs and results from HICs and LMICs. The findings were striking…

The WHO’s chief scientist on a year of loss and learning nature.com/articles/d4158…
For anyone remotely involved in healthcare, these are life lessons from @doctorsoumya. A must read.
For those of you who want a quick analysis, thread. Disclaimer: I’m just breaking this up & annotating them with my own comments. Between quotes are her exact words (with some poetic license)

The preprints of the #SOLIDARITY trial are out on MedRxiv. While many may lament that all four drugs tested did not show benefit, this is a remarkable trial for many reasons. Thread First, this was another #MultiArmMultiStage #MAMS study design; @MRCCTU made this highly efficient trial design globally acclaimed with #STAMPEDE. The more recent #RECOVERY trial was another example of this.
@MaxParmarMRCUCL @Prof_Nick_James @PeterHorby @MartinLandray

I’ve been watching with increasing concern at the trend of new daily diagnoses of COVID-19 in India over the past two weeks. To me, this reflects general public mood which seems to have begun to ignore the threat this virus poses. Thread While the good news is that our death rates haven’t been as bad as some of the other countries (we might debate the accuracy of death reporting), but with a population of 1.35 billion people, the absolute numbers are still sobering. And rural India is just beginning to get hit

I can't believe the @US_FDA Commissioner @SteveFDA announced that 35 out of 100 patients treated with #ConvalescentPlasma will benefit from it. This demonstrates either a lack of understanding of basic statistics (relative risk vs absolute risk) or external pressures. (1/n) There are several problems with this - first, this is not based on randomized evidence. This is based on "data obtained from the ongoing National Expanded Access Treatment Protocol (EAP) sponsored by the Mayo Clinic". The preprint is available on medrxiv.org/content/10.110… (2/n)