Dr Bivek Kumar, Mch (URO.)

🧵 Fish Oil & Heart Health in Dialysis Patients: A Game-Changer? 1/ A major new study (PISCES trial) shows that daily fish oil supplements can cut serious heart risks by 43% in patients on hemodialysis. That’s huge. Let’s break it down 👇

Other case

Will President Trump do NUCLEAR tonight

Reporter: “You called the Iranians ‘crazy bastards…’” Trump: “True.” Reporter: “What is your response to critics who say” Trump: “I don’t care about critics.” Zero apologies. Absolute legend

@gaurav_kochar Everything is just fine , 🙂 pls stop fear mongering, we're chill bro. Thanks for your attention on the matter 🙂

🚨🇮🇳 SURAT IS FLASHING A WARNING TO INDIA. Thousands of migrant workers are now leaving the city as the global war begins hitting India’s economy in real time. Not because jobs disappeared first—because LPG shortages made survival impossible. No gas to cook. Prices exploding. Textile units slowing. Families heading back to villages. Surat is India’s textile engine. When workers flee here, it’s not a local story. It’s the first visible crack in the supply chain → labor → production → inflation cycle. First fuel. Then factories. Then freight. Then food and clothing prices. This is how a distant war quietly enters every Indian household.

This recent video has 19 million views & 1.2 million likes! But who will answer?

200 helium containers are stranded in the Persian Gulf right now. Each one holds 41,000 liters cooled to -269°C. The containers have no refrigeration. No compressor, no cooling loop. Insulation is all that stands between the cargo and ambient heat, and it buys 35 to 48 days. After that, the liquid boils, the pressure valve opens, and the helium vents to atmosphere. Re-liquefying it requires a specialized plant. Most ports do not have one. Qatar's North Field supplied 33% of the world's helium as a byproduct of cryogenic separation at its LNG plants. On March 2, Iran closed the Strait of Hormuz. Spot prices surged 70 to 100 percent. EUV lithography requires 99.9999% purity helium for wafer cooling and no current substitute exists. The fifth helium shortage since 2006 has just begun.

DECLARATION OF INTENT 🧔 ALTERNATE HORMUZ STRAIT

VOLUME CONTROL FOR VIDEOS IS MISSING #NewXAndroidFeedback

Ethanol blending is adulteration. Plain and simple. And more the ethanol in your petrol, the more 'adulterated' it is. A 'high octane rating' is just a smokescreen. Street cars/motorcycles don't need 100 octane. What they need is more energy content. Picture this: Ethanol is like asking your vehicle's engine to eat dal (for protein) and lift heavy weights. Petrol, otoh, is real meat. And this is why mileage dips. Ethanol blending's main objective is to enrich the sugar mill lobby (not farmers) at the expense of everyone else including the farmers. Most sugar mills are controlled by politicians and their affiliates. The rot begins at the top. And the ethanol lobby is doing its best to push more ethanol into your petrol by using the Iran war as an excuse. Multiple statements: 1. cartoq.com/car-news/grain… 2. cartoq.com/car-news/india… 3. cartoq.com/car-news/india…

🚨 Day 7 Update: Crossing this river while travelling for my internship is full of struggles. My shoes get dirty daily and most of the time water is so much that I have to book an auto just to cross it.🥲

🧠 EAU 2026: What’s New in Upper Tract Urothelial Carcinoma (UTUC)? 📍 Practice-changing updates for smarter diagnosis, safer surgery, and personalized follow-up 🔹 1. Risk Stratification Refined 📊 High-risk UTUC now defined by: - Tumor size >2 cm - High-grade cytology or biopsy - Multifocality - Radiologic invasion → Clearer thresholds for kidney-sparing vs radical surgery 🔹 2. Kidney-Sparing Management Expanded 🛡️ Conservative treatment now preferred for low-risk UTUC → More patients eligible for ureteroscopic ablation or segmental resection 📅 Second-look ureteroscopy recommended within 1–3 months 🔹 3. RNU Technique Standardized 🔪 Surgical approach to radical nephroureterectomy (RNU) clarified → More consistent technique across centers; better oncologic outcomes 🔹 4. Perioperative Systemic Therapy Guidance 💊 Adjuvant chemotherapy and IO now integrated for high-risk UTUC → MDT planning becomes essential 🔹 5. Molecular Surveillance Tools Emerging 🧬 Liquid biopsy (ctDNA/utDNA) shows promise for detecting minimal residual disease → May predict recurrence months before imaging 🔹 6. Lynch Syndrome Screening Formalized 🧬 Modified Amsterdam II criteria now embedded in UTUC work-up → Germline DNA testing recommended for suspected hereditary cases 📌 What Changes in Practice? ✅ stratify risk with clearer criteria ✅ preserve kidneys in low-risk UTUC ✅ standardize RNU technique ✅ screen for Lynch syndrome ✅ personalize follow-up with molecular tools

🧠 EAU 2026: What’s New in Bladder Cancer Care? 📍 Practice-changing updates for smarter, safer, and more personalized treatment 🔹 1. Perioperative Immunotherapy Gains Ground 💉 Immune checkpoint inhibitors (ICIs) now play a stronger role around cystectomy → More patients eligible for neoadjuvant or adjuvant IO in high-risk muscle-invasive bladder cancer (MIBC) 🔹 2. Metastatic Therapy Pathways Updated 🧬 Clearer sequencing of systemic therapy for metastatic bladder cancer → Better guidance for cisplatin-ineligible patients and IO-exposed cases 🔹 3. Non-Muscle Invasive Bladder Cancer (NMIBC) 🔍 Risk stratification refined — especially for high-risk and BCG-unresponsive disease → More structured decisions on intravesical therapy, early cystectomy, and surveillance 🔹 4. Bladder-Sparing Strategies Clarified 🛡️ Trimodal therapy (TMT) and partial cystectomy now have updated indications → More patients can be considered for bladder preservation with guideline support 🔹 5. Imaging & Diagnostics Modernized 🧠 Enhanced role for MRI and molecular markers in staging and risk assessment → Smarter, less invasive diagnostic pathways 🔹 6. Follow-Up Protocols Refined 📅 Surveillance intervals now risk-based → Reduces over-imaging and improves patient experience 📌 What Changes in Practice? ✅ offer IO perioperatively ✅ personalize metastatic therapy sequencing ✅ rethink bladder-sparing eligibility ✅ stage smarter with MRI ✅ follow-up more precisely Dr Bivek Kumar - Urologist practo.com/bangalore/doct… Let’s make bladder cancer care smarter, safer, and more patient-centered.

🧠 EAU 2026: What’s New in Prostate Cancer Care? 📍 Practice-changing updates every clinician should know 🔹 1. Risk Stratification Reboot 🧭 Intermediate BCR risk now split into favourable vs unfavourable → Alters adjuvant therapy decisions & follow-up intensity 🔹 2. Imaging Gets Smarter 🧠 PSMA-PET/CT now recommended for staging intermediate-risk PCa 🧠 MRI-first endorsed for screening & biopsy targeting → Earlier, more accurate staging becomes standard 🔹 3. Biopsy Strategy Updated 💉 Transperineal biopsy preferred over transrectal → Safer, cleaner, more precise sampling 📊 New flowchart for biopsy & imaging in BCR 🔹 4. Systemic Therapy in mHSPC 💊 Triplet therapy (ADT + docetaxel + ARPI) now formally recommended 💊 ADT + ARPI preferred in low-volume metachronous mHSPC → Intensified systemic care, MDT discussion now mandatory 🔹 5. CRPC & Neuroendocrine PCa 🧬 Tailored sequencing after ARPI/chemo 🧬 Neuroendocrine PCa treated as distinct entity → Less extrapolation, more precision 🔹 6. Supportive Care Matters 🦴 Bone-protective agents now standard with long-term ADT ± ARPI → Bone health is no longer optional 📌 What Changes ? ✅ re-label BCR risk groups ✅ stage smarter with PSMA-PET ✅ biopsy transperineally ✅ intensify systemic therapy ✅ embed bone health & MDT into routine care Dr Bivek Kumar - Urologist

@GuidoGiusti Perhaps substitution with vascularizated appendix or ileal ureter

Yet another present generated by a misconducted #RIRS elsewhere: 5cm proximal ureteric stenosis … big problem to solve. Being a referral center, a concern is also why do I have to use my limited OR slots with non remunerative surgeries to fix complications of others? The only answer is because we all are good doctors but I’m not sure that the managers of my hospital are happy with this choice! #ETCE

Happy Holi! May the colours of this beautiful festival bring renewed energy, harmony, and joy into your life. Wishing you and your loved ones a season filled with warmth, good health, and vibrant celebrations. Warm regards, Dr. Bivek Kumar Urology, Sparsh Hospitals Sarjapur Road, Bengaluru

OIL THE NEW OLD GOLD 😌

Cytoreductive nephrectomy in metastatic RCC has evolved. Not routine anymore. Start immunotherapy first. Restage. Operate only on responders. It’s no longer dogma — it’s biology-driven strategy. #RCC #KidneyCancer #Immunotherapy #MVOnco

@DrRishabhOnco Very informative 👏

🚨 ASCO GU 2026: Bladder Cancer’s “Cisplatin-Replacement” Era 🚨 The #ASCOGU26 data confirm it. Urothelial carcinoma has entered its most transformative phase in 20 years. Here are the 10 trials redefining practice 👇 1️⃣ KEYNOTE-B15 (EV-304) Perioperative EV + Pembro vs Gem/Cis Significant EFS and pCR benefit Curative setting now ADC + IO driven 🥊 2️⃣ IMvigor011 Atezolizumab improved DFS and OS in ctDNA-positive patients True MRD-guided adjuvant therapy 🧬 3️⃣ EV-302 (30-mo update) EV + Pembro OS 33.8 mo vs 15.9 mo chemo The new metastatic backbone ⏳ 4️⃣ CORE-001 Cretostimogene + Pembro 83% CR in BCG-unresponsive NMIBC Major bladder-sparing signal 🛡️ 5️⃣ NIAGARA biomarker data Urine tumor DNA detects relapse months before imaging Dynamic monitoring era 🧪 6️⃣ KEYNOTE-905 EV + Pembro in cisplatin-ineligible MIBC Platinum eligibility becoming less decisive 📉 7️⃣ Sac-TMT + Pembro Next-gen Trop-2 ADC entering advanced UC landscape 🧬 8️⃣ SunRISe-2 TAR-200 + Cetrelimab A serious bladder-preservation contender ✋ 9️⃣ KEYMAKER-U04 Triplet exploration Can we surpass EV + Pembro? 🧪 🔟 RETAIN-1 ctDNA-negative patients safely avoided consolidation surgery Risk-adapted care validated 🎯 🧠 The Big Shift Chemo-first → Biomarker-guided Platinum-defined → ADC + IO backbone Static staging → Molecular surveillance Bladder cancer management has fundamentally changed. #ASCOGU26 #GU26 #OncoTwitter #MedTwitter #BladderCancer #UrothelialCancer @myESMO @OncoAlert @Larvol @ASCO

ASCO GU 2026 – Top 15 Trials with Potential Practice Impact @ASCO #GU26