Montelukast is widely prescribed in India, and sales appear to be rising. This is despite several reported adverse effects, including nightmares, depression, death by suicide. Sanjitha Muneeswaran and I make a case for stricter regulations @the_hindu 1/n As doctors, we need to ask our patients about adverse effects, and advise to watch for the same. My prescribing practice changed dramatically once I started asking.Not knowing is not the same as “I’ve been prescribing it forever and my patients are fine” 2/n

The antibody cocktail against SARS-CoV-2 is now available in India, and is being touted as “life-saving”. We need to spread the right kind of information before this expensive cocktail goes down the same route of drug shortages, desperate pleas and black market sales 1/n REGEN-COV (Casirivimab and Imdevimab) is a mixture of antibodies against the spike protein of SARS-CoV-2. The two antibodies work on different parts of the spike protein and this potentially enhances the effectiveness of the cocktail 2/n

Nicotine is a highly addictive substance, and on “World No Tobacco Day”, a few links to help understand why giving up tobacco is so difficult, and why we need to have a scientific, evidence-based approach 1/n This is an easy-to-understand dartboard we created to elucidate the difficulty in giving up nicotine, and how rational pharmacotherapy can improve the odds onlinelibrary.wiley.com/doi/epdf/10.11… 2/n

Thank you, @SachinKalbag @RupsaChak @htTweets for helping spread awareness, it is truly the need of the hour! Here’s a thread for those who want a deeper dive 1/n Inhaled steroids (not oral or intravenous) may have a role in the first week of the disease, especially in high-risk individuals, and those who have a cough. See thread for details 2/n

https://twitter.com/lancelot_pinto/status/1387864333477056513

I’ve often been asked about whether/when one should take the second dose of the vaccine when one gets infected after the first dose. Here is my understanding of the literature 1/n A second dose is advisable even after infection because the immune boost provided by natural infection is variable, while that provided with vaccination is robust. Also, the proof of 2-dose vaccination might become an important document to have. 2/n

1/4 Saw this at Bandstand today. As a chest physician, this made me very happy! Pigeons are responsible for an interstitial lung disease (ILD) called hypersensitivity pneumonitis or extrinsic allergic alveolitis. 2/4 Most chest physicians and radiologists in the city will tell you how the number of patients with the disease has consistently increased over the years, paralleling the increase in the pigeon population of the city.