Dr Kunal Jobanputra MD, DM

@grok @Atulya_99 @Ashish_4vedi Which are reputable sellers

Ratol (zinc phosphide-based rat poison paste) is misused by some vendors to deter rats from damaging fruits overnight—illegal and highly toxic if ingested, causing severe poisoning. To remove: Rinse fruits under running water 1-2 min, scrub with baking soda/vinegar solution (1 tbsp per liter), then rinse again. Peel if possible. Best: Buy from reputable sellers; vendors here were arrested.

Just saw a video: Fruit seller in Mumbai’s Malad applying ‘Ratol’ (rat poison) on fruits.

@BuskerClothing @grok pls explain

This isn’t a good chart $COPX #copper #GME #silver #btc $HOOD

@ccg33k 1:1 miles trasnfer is for baseline variants too?

Equitas PowerMiles Credit Card – applications are now live online with no bank account requirements & high approval rates - Instant approval and card issuance happening 🚀🚀 selfeloans-web.equitas.bank.in/cc?Tpp=EQINTMK… This is one of those cards that looks average today, but could quietly become a very strong default card if (and when) 1:1 miles transfer finally goes live. Let’s break it down 👇 1️⃣ Fees & Waivers • Joining fee: ₹5,000 • 100% fee waiver if you spend ₹1.2L in 90 days (ex-GST) • Renewal fee waived at ₹4.8L annual spend Solid fee structure for a miles-oriented card. 2️⃣ Reward Structure • 3% base rewards on regular spends • 9% rewards on forex spends • Rewards can be redeemed for flights, hotels, vouchers & bill payments The interesting part? 👀 👉 Points are supposed to be transferable at 1:1 to 10+ airline miles partners like JAL, FInnair, Aeroplan, Air India etc.. If this actually works smoothly, the card instantly moves into serious miles territory. 4️⃣ The BIG caveat (read this before applying ⚠️) • Miles transfer feature has been getting postponed for ~1 year • Latest communicated ETA: July 2026 • 1:1 is NOT default — needs sustained high spends • My personal experience: – Used mainly for forex / gold – Faced multiple declines in Vietnam (likely needs manual whitelisting) 5️⃣ Not into miles? There’s an alternative 👇 Equitas SELFE Card (First Year Free) • 5× rewards (~10%) on any 2 categories – Apparel – Dining – Grocery – Utilities – Taxis Much simpler, less “future promise”, more day-to-day value. Apply here: selfeloans-web.equitas.bank.in/cc?Tpp=EQINTMK…

@MTPHereToHelp Everyday same story. Citizens suffer @MTPHereToHelp

@KNJobanputra We have informed Dadar Traffic Division for the necessary action.

@MTPHereToHelp absolutely static traffic at Dadar West - Plaza - Tilak Bridge! Situation getting worse day by day. What are you doing?

@UberIN_Support @UberIN_Support waiting for response on DM

@KNJobanputra Hey there, we’re happy to assist you. Could you please confirm the amount, and please share the screenshot of the transaction for reference. We’ll look into this and follow up soon. Appreciate your cooperation. twitter.com/messages/compo…

@UberIN_Support money got deducted from my card but uberone membership not reflecting - says error. Please get me refund

@UberIN_Support Replied Pls check DM

@CardMavenIn Does it have annual charges if I a apply fot Rewards DC while I have Easyshop Platinum?

Closing out 2025 with a bang! 💥 Yes, Rewards DC issuances are still live and active. 5% drop is loading... ⏳

Stillness that sings of the ages gone by.. #Varanasi #Ghats

@airindia pls respond to my DM

Ready to chase the moon 🌔✈️ @IndiGo6E #AvGeek

One of the main goals of our review article in @NEJM on MGUS was to provide clear clarifications on the concept of “monoclonal gammopathy of clinical significance” (MGCS). It’s all very confusing in the literature and can cause problems for patients if we are not totally clear of the concepts. Read on to be 100% sure of the concepts so you can take care of your patients correctly! 1) First key concept: MGUS is a clinically indolent condition that usually remains quiet for an entire lifetime. The problem with MGUS is that it can progress to symptomatic malignancy (like multiple myeloma), or cause a variety of non-malignant, serious, and clinically important diseases that are collectively referred to as “monoclonal gammopathy of clinical significance” (MGCS). 2) Second key concept: MGCS is like the title of chapter in a textbook. It is NOT the name of a disease. Within the term “MGCS” are several distinct diseases, each of which has its own diagnostic criteria, clinical manifestations, and treatment strategies. So you simply cannot diagnose “MGCS” and treat but need to identify the specific disease. All that the term MGCS does is to alert you that MGUS can cause serious non-malignant diseases besides progression to malignancy. 3) Third key concept is: Some of the MGCS conditions are multi-system disorders like light chain amyloidosis and light chain deposition disease. Some MGCS disorders on the other hand are restricted to one organ leading to more confusing terms like “monoclonal gammopathy of renal significance” (MGRS), “monoclonal gammopathy of dermatologic significance” (MGDS), monoclonal gammopathy of neurological significance” (MGNS), and so on. These are also like titles of book chapters NOT the names of a disease. Within each term are specific unique diseases. 4) Fourth key concept is: For taking care of the patient you need to know the name of the exact disease. Not just add an umbrella term like “MGCS” or “MGRS”. So for example instead of diagnosing “MGRS” you need to be clear exactly which kidney disease the monoclonal protein is accused of causing! MGUS is so common and so many people can have a MGUS and a completely unrelated kidney disease. MGUS plus kidney disease doesn’t mean “MGRS”. Most of the time the two have nothing to do with each other. There are specific kidney diseases that are casually related to the monoclonal protein and if we suspect MGRS for some reason we need to work up and make the specific diagnosis which needs a kidney biopsy: proliferative glomerulonephritis with immunoglobulin deposits (PGNMID), C3 glomerulonephritis, and so on. Each of these disease have their unique clinical and lab manifestations, and treatment strategies. 5) Fifth key concept is: with more and more sensitive tests for MGUS and more and more testing done for MGUS we are all going to find M proteins associated with a variety of clinical problems, 99% of which are NOT caused by the M protein. I am hugely concerned with labels like MGCS and MGRS wrongly applied. And the last thing we want is Dara-VRd for a DVT just because there is a paper that says M proteins can cause blood clots! This Review will be a good place to start for getting all the key concepts straight. nejm.org/doi/abs/10.105…

Why do some patients with #ProstateCancer on Androgen deprivation therapy (ADT) develop arthritis? Androgens suppress thymic function ADT --> 🔼 thymus regeneration --> 🔼 thymic derived T-cells --> ⏫ INFLAMMATION ADT also reduces estrogen --> BMD loss and sarcopenia

Dose of Olaparib tablet in renal impairment ? 🟢CrCl >50 : no adjustment 🔻CrCl 31-50 : 200 mg BD 🔻CrCl < 30 : not studied, few case reports used 100 mg BD with close monitoring. CYP3A4 (🔍drug interactions) 44% renal excretion Olaparib can cause pseudo-AKI #Oncology

PARP inhibitors & PHOTOSENSITIVITY 🌞 💊Rucaparib/talazoparib/niraparib > olaparib 🖊️Advise sunscreen, hats, moisturizers, avoid tanning beds, manicure lights 📊Other cutaneous AEs : Rash 12%, pruritus 13%, peripheral edema 10%, PPDE. Mostly Gr 1-2. Gr3 <1%. #Oncology

Could spot a few contrails today. Very rare for Mumbai sky.

@BijoyTelivala @OncBrothers It has already started happening and worse when it is out of pocket expenditure in LMICs

@OncBrothers This is what i suspect will happen in real life Once approved it shall be used in > 75 % of pts with a low score Look at gastric and adj Nivo.. Data best for CPS > 5 but used left right and center

Winner winner, chicken dinner!! Clear as mud! Will wait to see what the approval label will say #MATTERHORN #gism #OncTwitter

Bright sunny day. Last few days of the iconic Elphinstone Bridge.

Late repost but it was great to meet @brunolarvol last week. Exciting times ahead for AI in oncology! And it was a lovely place to see the busy runway!