MANISH SHETTY

@ianmiles Savages

Absolute insanity. A migrant mob assaulted an Australian football supporter in Melbourne because they thought he was insulting them by being ignorant to their cause. This is what happens when you let economic migrants into your country by the bushel.

@ianmiles Boycott oxygen,will be better for the world!!!

Boycott everything.

Jai Jagannath Prabhu🙏🙏

Trudeau is trying to crush free speech in Canada. Shameful.

If these managers had any sense, they'd just take Romero and Jorginho off the pitch and play 10 v 10.

India wins the race 🔥🙏🏻#isrochandrayaan3mission

😂😂😂

Difficult to come to terms with @D_DeGea ,not being a united player anymore #DeGea #ManchesterUnited

@GautamGambhir 🤫

@GautamGambhir 🤫🤫🤫🤫🤫

The long wait continues….Forever RCB ❤️ @RCBTweets #RCBvGT

Today I was visited by a man who introduced himself as the cousin of a patient I treated in 2018. The patient Satish, died of progressive liver failure under my care without a timely liver transplant. His wife did not match and his children were young and he did not receive an organ from the "deceased donor" pool in time. He died from multiple organ failure alone on the ventilator with only me and the ICU staff by his side, because his wife did not want the last memory of her husband to be one where he was hooked to machines and lines and deep in coma. I remember him because his was one of the nightmarish cases I had to manage when I was just getting to learn the ropes on management of critically-ill liver disease patients. He was also one of the first of my patients whom I saw leave behind very little children and a deeply confused and grieving wife. I did not have the words to comfort them then. I did not know what loss meant and how to comfort meaningfully. We spoke through silence. I have learned how to communicate with the family when a patient was dying, by caring for many such patients & their families the hard way thereafter. Initially, I thought his diagnosis was pretty straightforward - a case of severe alcohol-associated hepatitis - because Satish suffered from alcohol-use disorder and was a binge drinker [Binge drinking: if a woman has four or more drinks, or a man has five or more drinks, within about 2 hours]. But the way his disease progressed confused me. In matter of days, his jaundice was skyrocketing, bilirubin levels reaching upto 40mg/dl at one point. His fluid collection in the abdomen had to be drained multiple times in a week. A risky liver biopsy was performed to confirm the diagnosis of alcohol-associated hepatitis, but the liver tissue under the microscope had another story to tell. There were classical features of alcohol-related liver injury, but something sinister, that was not meant to be part of alcohol-liver injury stood out. Large areas of necrosis (complete loss of liver cells) with hemorrhage (or bloody areas) were unexpected. Large chunks of liver cells were lost, the viable liver cells were swollen and damaged. There was something more, along with the alcohol that was eating up his liver from the inside. Energy drinks. Caffeine and taurine based energy drinks. He used to mix alcohol with energy drinks and consume them. A few days before he developed liver disease, he had a binge session where he consumed large amounts of alcohol mixed with energy drinks. Energy drinks independently, are rarely implicated in liver injury. But instances of severe liver injury leading to liver failure with consumption of large amounts (in healthy people) or modest amounts (in those with underlying diseases) of energy drinks are well documented. pubmed.ncbi.nlm.nih.gov/31992329/ pubmed.ncbi.nlm.nih.gov/31625396/ pubmed.ncbi.nlm.nih.gov/31543103/ The combination of energy drinks with alcohol is quite precarious. The damage caused by the combination and the chances of liver failure is more than noticed with either alone. In those with alcohol-use disorder and with binge alcohol use, energy drink use could lead to severe liver injury. ncbi.nlm.nih.gov/pmc/articles/P… In fact, a rat study showed that when alcohol vs. energy drink vs. energy drink+alcohol was given to the small animals, severe liver injury and kidney injury occured the combination group. Energy drink and alcohol combination leads to kidney and liver alterations in rats sciencedirect.com/science/articl… An occasional energy drink use may not be associated with major adverse events, but the type of drink, contents, amount of specific substances such as high caffeine, presence of herbal ingredients and such could pose serious health risks. Beware of energy drinks containing "guarana" - it contains caffeine 4 to 6 times more than coffee beans. The American Academy of Pediatrics recommends that adolescents do not consume energy drinks. nccih.nih.gov/health/energy-… cdc.gov/healthyschools…

Conte was spot on about spurs!!!This is just hilarious!!!!

K L Rahul will go down as the most hyped overrated batsman in the history of world cricket!!! #IPL2023

Leclerc does way too many mistakes for a championship contender!!! #AustralianGP

Kerala blasters being sore losers here!!!Disgraceful!!! #BengaluruFC #ISL

Manchester United Back to the Business of winning 🔥🔥🔥 #CarabaoCup

Instead of showing highlights of Crystal Palace v Liverpool on MOTD, they should just play this on repeat. twitter.com/behaveirene___…

When Barca gets knocked out of Europe (again) and you couldn’t do it yourself