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Dr. Raghuraj Hegde Profile picture
Dr. Raghuraj Hegde
@raghurajs_hegde
Consultant, Ophthalmic Plastic Surgery Service, Manipal Hospitals, Bangalore. Free thinker| Poet| Writer| Ophthalmic Plastic Surgeon| Passionately curious|
May 1, 2022 • 9 tweets • 3 min read
It is not often that an eye surgeon is able to awe a room full of medical students and residents in a busy Ophthalmology clinic.
👀.
So I'll take this opportunity to write a thread 🧵 about this extra-ordinary accomplishment. 🤩 1/ An 18yr old male patient was referred to me. He came in with complaints of a swelling on his left eyebrow since last 3 mts. He had gone to several doctors of different specialties before me & had several differentials ranging from “Sebaceous Cyst” to “Dermoid cyst”! 🤷 2/
Jan 27, 2022 • 5 tweets • 2 min read
There is no difference between getting a cab or getting a cataract surgery done.

Agregator start ups are reaching every nook and corner now.

It is high time there is regulation and laws governing these type of businesses especially concerning healthcare. Image These agregators do not take of any risks of surgeries and costs of running hospitals but take a lion's share of the revenues (read "Comission"), exponentially increase valuations & sell off the business at high profits to the highest bidder.
Dec 28, 2021 • 6 tweets • 2 min read
This NEET counselling fiasco is what happens when you make laws without debate and without considering the stakeholders into account.

Those affected by the laws will take any of the legal recourses available to them to challenge- courts and protests. 1/ Don't paint the disaffected as the cause of the pain like the govt is doing now. It is on the govt's duty to plan for laws being in effect and to protect those fall between the cracks because of it. 2/
May 16, 2021 • 6 tweets • 2 min read
The only controllable factor in the prevention of #Mucormycosis is the close monitoring of blood sugars during & post COVID-19 and it's appropriate control

The extra-ordinary focus on steroid usage in #COVID19 and the use of O2 delivery mechanisms is diluting a simple message. 1 We are seeing Mucormycosis even in home quarantined patients who had mild disease and even in those who had no history of hospitalisation, steroids or other immunomodulatory drugs.

Steroids, equipment non-sterility and diabetes might be contributory but not the main cause. 2/
May 6, 2021 • 4 tweets • 3 min read
This second wave of Covid associated Mucormycosis has been a brutal bloodbath

Have seen 18 cases in the last 10 days in Bangalore. If there's anything lose to black death, this fungal disease should be it

A pandemic within a pandemic

#MucorMycosis #COVID19 #India #MedTwitter This tweet was just a week back and now the situation is pretty bad.

May 2, 2021 • 4 tweets • 2 min read
The 2nd wave of COVID-19 related Mucormycosis is already here while we have still not quite reached the peak.

This time patients are presenting earlier and some of them even while still being I'll with covid-19 (2nd week of illness) This wave, I've already seen 5 in the last week. 4/5 were still positive for virus.
Patient profile:
Younger patients, more aggressive disease. I do think that covid itself is responsible for disease not just immuno-supression as a 2/5 patients were not even diabetic in 20s.
May 1, 2021 • 5 tweets • 2 min read
I'm part of an NGO called The Vision Mission. We are mainly into eye care in remote areas. In this crisis we are trying to help one of our partner eye hospitals, Trilochan Nethralaya to run 2 covid care centres in Sambalpur Odisha. The cases are skyrocketing in Sambalpur area. It's a tribal belt in western Odisha and very few resources are available. People there are dying for want of basic care. We urgently need funds.

Please try to share this thread in your networks and this is a personal appeal requesting donation.
Apr 19, 2021 • 6 tweets • 1 min read
A friend asked me why do you have such strong opinions about C-19 treatments & rampant poly-pharmacy being practiced while being an Ophthalmologist.

Why indeed?

Because "Science, data and critical analysis". I don't have to be treating C-19 to know what works and what does not. Reading has been my coping mechanism to stay sane during this whole year since the pandemic started. Too much information can be paralyzing for many people. I would however prefer to sift through it all and process it. An alternative is not acceptable.
Mar 10, 2021 • 10 tweets • 3 min read
An infection and a silent epidemic few people are talking about!

Rhino-Orbito-cerebral Mucormycosis in the background of recovered Covid-19 patients.

#Thread #COVID19 #MucorMycosis #SinoOrbitalDisease

Read the thread and finally the article to know more about it. 1/ Image As the peak of the Covid-19 pandemic was ebbing down slowly in Bangalore around Sept/Oct -ENT surgeons, CMF surgeons, Oculoplastic Surgeons & Neurosurgeons suddenly had a surge of cases diagnosed with Mucormycosis presenting a few weeks after recovering from covid-19 infection
Nov 22, 2020 • 11 tweets • 2 min read
Ayurveda is not science. It is a belief system like religion. People including doctors should stop calling it science because any traditional medicine which has been shown to be effective as per modern EBM standards becomes modern medicine. Ayurveda has no scientific rationale. Same goes for Homeopathy/Unani/Siddha/_____any traditional medicine.

Qinghaosu became the antimalarial drug Artemisinin through evidence collected by YouYou Tu. It doesn't mean Chinese medicine is scientific.
Sep 27, 2020 • 7 tweets • 2 min read
Yesterday my patient on the operating table bled buckets. He wasn't on blood thinners-no explanations.🤷‍♂️

After surgery he told me he was taking a herbal concoction of Ginger, Garlic, Turmeric & Asafoetida thrice daily to prevent covid.

Need to change my Pre-op instructions. 🤦‍♂️ Since many are asking.

Pre op bloods were done 3 weeks back. BT, CT, PT, aPTT, INR were all within normal limits. Considering no co-morbidities the blood work wasn't repeated just before surgery. Hadn't considered this history.
Sep 25, 2020 • 5 tweets • 2 min read
Quietly, NMC has replaced MCI. While I'm happy that a corrupt body like MCI is out, I'm not sure NMC is make it any better.

Several people have had concerns regarding the mandate, centralisation tendencies and scope of NMC and I have written about those concerns earlier. 1/n Now that we have no choice but to accept the new reform I hope they progress upon the opportunities available. The above article raises several such issues and it is important to keep the eye on the target over a long period of time. 2/n
Sep 23, 2020 • 7 tweets • 2 min read
I've been fortunate to have found incredible mentors in residency & Fellowship. They treated me like colleagues not sub-ordinates/slaves. I was lucky but anyone entering residency shouldn't need to be lucky.

This culture of bullying in medicine doesn't stop just at residency. 1/ Though I have only good things to say about my own residency, I've heard enough of the experiences of my friends/ Srs/Jrs who've come through the various medical college residencies around India. Toxic culture in an average Indian medical college residency is almost a given. 2/
Aug 23, 2020 • 4 tweets • 1 min read
When we speak of lack of access to healthcare we don't speak of equitable spread of resources state-wise. Kerala has 70,000 doctors Vs Jharkhand having 6,000 (all specialities). Kerala and Jharkhand have around the same population to serve. More than 60% of doctors are in 6/28 states-MH, TN, KA, KL, AP, UP. States with highest shortfall-UP, CH, OD, MP has 60% of population. 2/n
Aug 12, 2020 • 6 tweets • 2 min read
There's a myth that our ancestors lived more healthier and longer lives because of Ayurveda and that modern medicine is killing people.India's life expectancy has improved from 22 yrs in 1920 to nearly 70 yrs in 2020- that's 100 years of modern medicine. Ayurveda is >2500 yrs old Source of data: statista.com/statistics/104…
Jul 21, 2020 • 22 tweets • 5 min read
Long Thread
Contrarian view on #vaccines for #Covid-19.

I argue that vaccines might not be the best answer for managing this pandemic. I'm putting my money on anti-virals and other treatment protocols. Hear me out as I make my case and decide if it makes sense. 1/n 2/n Vaccines are tough business. From all the decades of collective knowledge in vaccine development we have, it is very rare that we will get a successful vaccine for any disease. Vaccine development takes years and for good reason.
Jul 10, 2020 • 5 tweets • 1 min read
We will just move on from here because non one is interested in justice. Systemic problems can't be solved by encounters. Encounters are just one gang member being eliminated by the rival gang members No point gloryfying police for these encounters. They will tomorrow kill an innocent person and falsely paint him as a terrorist or goonda to justify it
Jun 4, 2020 • 18 tweets • 5 min read
The HCQ saga proves why politicizing science and research is a very bad idea. In a state of panic, even doctors and scientists can become polarised. Bias creeps in even if unintentional.

This is the latest evidence with a properly conducted randomized controlled trial (RCT) which was even double blinded. An RCT is the most robust form of evidence available in science. It didn't show any benefit of HCQ as a prophylaxis for covid-19!

nejm.org/doi/full/10.10…
Mar 22, 2020 • 7 tweets • 2 min read
If HCQ+ Azythromycin worked so well, why are Italy and Spain, not able to contain both new cases nor deaths? For all the chloroquine enthusiasts. Long read. But the gist of it was that data was manipulated in that sensational paper, it wasn't an RCT and the primary author has a long history of faking data in his papers and has been banned from publishing in certain journals.
Mar 16, 2020 • 6 tweets • 2 min read
What this coronavirus episode has taught us in India is that in times of a public health crisis, what is going to save us is the robust public health infrastructure. COVID-19 has shown precisely why healthcare can't be a completely free market enterprise. The very people who were cheering the privatisation of healthcare in India a few weeks ago are now cheering India's credible and effective response to the global pandemic which has been much better than many developed countries including the US.
Mar 13, 2020 • 6 tweets • 1 min read
I do have to commend how India is handling the COVID-19 situation despite our poor systems. I think it is down to having great individuals in these poor systems who rise to the occasion in times of crisis We have great individuals but very poor systems in every aspect in the country. This is the reason why individuals have to substitute for systems in India.