Varun C. MD, DM Profile picture
Crossword lover, truth seeker, free thinker, grunge fan. Cardiologist at Medical Trust Hospital, Kochi. Trained at AIIMS, Delhi. All tweets personal opinion.
1 Aug
Another day, another tragic story of organ damage from #herbals:

27/F with #psoriasis of her face, trunk and limbs for 10 yrs. Now this is a tough disease to get, especially for a young woman. Appearance affected, social stigma attached, no easy cure but can be controlled..
Initially consults dermatologist, counselled, started on topical agents, but visible change takes time. Not satisfied and seeking "cure" without "side effects" they approach local practitioner who prescribes herbal formulation to take daily - which she dutifully does for 10 yrs
During a routine evaluation for unrelated back pain, a serum creatinine done is 8.1 mg/dl- shockingly high! Further evaluation and a kidney biopsy reveals interstitial fibrosis in the renal cortex s/o Aristolochic acid nephropathy!
Here is the cheeky little culprit 👇
Read 10 tweets
23 Jul
Ok, took me a few days to properly process the stunning results of the Delhi serosurvey. Unfortunately we only have a press conference with a few slides telling us that 22.86% of 20,000 people sampled tested positive for antibodies to Sars-cov2: timesofindia.indiatimes.com/india/almost-1…
This was done from June 27 to July 10 and they did a randomised sampling of every nth household and also sampled minors, they used the Kavach ELISA developed by ICMR (sens 92.3 and spec 97.9). The results were only recently released in the July 21st PC.
So why r these results stunning? Well, for one they imply 46 lakh infections, whereas the official count is only 1.2 lakh to date. Meaning only 1 in 38 were actually detected by antigen testing! Either implies pathetic testing or huge percentage of asymptomatics?
Read 15 tweets
13 Jul
Just want to put this out there for more discerning readers not easily swayed by @Bioconlimited hype on #Itolizumab.. two huge issues with their pivotal trial. First a very small sample size of 21 Rx arm and 10 control arm is underpowered to detect any significant effect size.1/3
A 'power' calculation is a basic step prior to any study to make sure you enrol enough subjects to actually statistically prove that a drug is effective. For showing a 50% benefit for example, assuming a 30% mortality, and a power of 80% you wld need a sample size of 100. 2/4
2nd, thanks to this their reported outcomes are going to have wide confidence intervals for their effect estimates. Here is my calculation for their press release reported mortality benefit (no deaths in 21 rxed Vs 3 deaths in 10 control). Gr8 RR (93% reduction in death) but 3/4
Read 7 tweets
29 Jun
This is a general info tweet:
If you see or hear the phrase "boost your immunity" just run in the opposite direction.
Your immunity is not a battery that you can charge, or a dial that you turn up or down.. it's a multitude of complex interconnected systems with multiple levels..
Your body has an innate immunity, active immunity, passive immunity, first line defense (skin, membranes), local immunity (mucosal, IgA), humoral and cell mediated immunity. It's built up over time based on all the pathogens and organisms you've been exposed to your entire life!
Stress, illness and poor nutrition can affect your immunity short term, and your genes play a role too. Reliable immunity from covid needs a need a specific type of immunity that is best achieved with a vaccine. So don't fall for BS advertising magic 'boosts' 4 a complex system!
Read 4 tweets
16 Jun
Saw a very sick patient today with fulminant liver failure on ventilator who previously doing well and had no liver problems. After extensive work up the only history we could get was that he had taken a herbal concoction that claimed to prevent #covid.
Please, do not take unproven mixture that make tall but bogus claims. False advertising is rampant and it is damaging people's health. Herbal remedies are not "harmless" and "natural" as my friend @drabbyphilips will attest.
Gonna link to this research if you want to read more..
Read 4 tweets