Dr Nikhil Sharma 🇮🇳 retweeted
I love how real the Jaipur Nagar Nigam website is.
Yes. This is the official website.
Dr Nikhil Sharma 🇮🇳 retweeted
No matter how many times Shri Nitin Gadkari ji sir targets me: my accusation remains he is running a BETA BADHAO YOJNA! Secondly TEAM BHARAT is not against E20 blended petrol we are just asking for E10 & all documents wrt E20 policy in public domain!
#EthanolScam
BETA BADHAO YOJNA
Dr Nikhil Sharma 🇮🇳 retweeted
Shri Nitin Gadkari ji has just admitted that E20 blended petrol can harm your vehicles washers!
Shri Hardeep Puri ji has said your gasket may have to be changed in 30,000 kms instead of 50,000. Are our vehicles their ministries ke "Baap ka Maal"!
Till yesterday Nitin Gadkari ji was challenging us get one person just one who is affected by E20-blended petrol ? What if the vehicle has aged parents, young kids or a pregnant women or just you & it breaks down! What about the inconvenience?
#EthanolScam
Dr Nikhil Sharma 🇮🇳 retweeted
🏆 Celebrating Excellence at VSI Mid Term 2026! 🏆
We are proud to recognize the outstanding achievements of our Poster Presentation Award Winners at VSI Mid Term 2026, held from 5th–7th June 2026 at Novotel Goa Candolim.
#VSIMidTerm2026 #VSI #VascularSocietyOfIndia
Dr Nikhil Sharma 🇮🇳 retweeted
Today is the perfect day to expose this Haryana man @iPradeepSangwan and @healinghimalaya . Absolute menace for garbage industry , bro keeps entering remote areas of Himachal and Uttarakhand and cleaning all the waste people worked so hard to spread there.
Tons of plastic removed from the Himalayas already and still this man refuses to stop. Don’t understand what problem he has with bottles, chips packets and garbage peacefully existing in nature.
When everyone else is busy fighting online, this guy is busy destroying the littering system built over years.
Amid all the noise online, this heartwarming video from Kasar Devi near Almora stands out for the right reasons.
A tourist from London was seen collecting plastic and garbage scattered along the trail instead of ignoring it like most people do.
Sometimes outsiders end up respecting the mountains more than those living around them.
Uttarakhand is not just a tourist destination. It is Devbhoomi, and keeping it clean is everyone’s responsibility.
Dr Nikhil Sharma 🇮🇳 retweeted
Concluded my four-day maiden visit to Kargil, marked by the roll out of a series of development works and witnessing an abundance of natural splendour, peculiar to the rugged terrains of Kargil.
Towering glacial peaks, rolling meadows, wild blooms and meandering streams amidst the multi-hued vistas - Kargil offers more than enough to satisfy every traveller’s soul.
Visit Ladakh to immerse in its timeless spirit, rich traditions, vibrant culture and captivating beauty.
𝐋𝐚𝐝𝐚𝐤𝐡 𝐢𝐬 𝐭𝐫𝐮𝐥𝐲 𝐌𝐲𝐬𝐭𝐢𝐜𝐚𝐥, 𝐌𝐚𝐠𝐢𝐜𝐚𝐥 𝐚𝐧𝐝 𝐒𝐩𝐢𝐫𝐢𝐭𝐮𝐚𝐥.
Dr Nikhil Sharma 🇮🇳 retweeted
13 Apr 1984 - A trail of endurance and fortitude was carved on the ice of the highest battle field. Greetings on Op Meghdoot Day🙏🏼
Dr Nikhil Sharma 🇮🇳 retweeted
🩻Contrast-induced AKI:
one of the biggest myths still shaping clinical decisions
For decades we were taught:
👉 “Contrast damages the kidneys”
👉 “Avoid CT with contrast in CKD”
👉 “Hydrate, protect, delay imaging if needed”
But what if… most of this is wrong?🤔
->The uncomfortable reality
Modern evidence shows:
👉 Low-osmolar contrast rarely causes true nephrotoxicity
👉 Even in CKD, AKI, and ICU patients
👉 The risk is often overestimated—or nonexistent
So where did the fear come from?
📍 1950s high-osmolar contrast (actually toxic)
📍 Poorly controlled observational studies
📍 “Creatinine rise = contrast injury” assumption
👉 Correlation became causation
👉 And the dogma stayed
⚠️What recent data tells us
✔ No difference in AKI rates with vs without contrast
✔ No benefit from bicarbonate, NAC, or aggressive hydration
✔ Even ICU and AKI patients show no worsening outcomes
->Translation to real life
👉 The patient was going to develop AKI anyway...Not because of contrast!!
->The real problem: “Renalism”
👉 Avoiding necessary imaging
👉 Delaying diagnosis
👉 Choosing inferior tests
And that leads to:
❌ Missed PE
❌ Delayed sepsis source control
❌ Worse outcomes
->Clinical mindset shift
Instead of asking:
👉 “Will contrast harm the kidneys?”
We should ask:
👉 “Will NOT doing the scan harm the patient?”
->Who still deserves caution?
✔ eGFR <30
✔ Severe hemodynamic instability
✔ Multiple nephrotoxins
Even then:
👉 Optimize volume
👉 Minimize dose
👉 Don’t delay critical imaging
🤓Bottom line
✔ Contrast nephrotoxicity exists… but is rare
✔ The fear is bigger than the risk
✔ The harm of NOT imaging is often greater
In critical care
👉 We don’t treat creatinine
👉 We treat patients
And sometimes…
👉 The most dangerous thing is NOT the contrast
👉 It’s hesitation.
📃Reference
Florens N, Demiselle J.
Kidney360 7: 445–449, 2026. doi: doi.org/10.34067/KID.0000001…
Dr Nikhil Sharma 🇮🇳 retweeted
(Meant for my younger colleagues)
32 Years in Medicine: Lessons Beyond Guidelines
I saw my first OPD patient on 1st Feb 1994, during internship. This is my 33rd year as a doctor.
Over the years, I have followed the guidelines laid down by regulatory bodies. But some of the most valuable lessons in patient care are not written in any manual. They are learned, observed, and practiced daily.
Sharing a few principles that have consistently improved my doctor–patient interactions, especially for younger colleagues:
1. Respect time.
Keeping appointments on schedule builds trust. If delayed, inform early. If delay is due to an emergency, explain honestly.
2. Start with a smile.
Patients often walk in anxious. A warm greeting can ease half their stress.
3. Speak their language.
Even a few words in the patient’s language can instantly build rapport.
4. Listen; truly listen.
A missed detail in history can lead to a missed diagnosis. Good listening is good medicine.
5. Be fully present and avoid distractions. The patient in front of you deserves your complete attention.
6. Be fair.
If a patient has come to the wrong specialty, guide them appropriately and consider refunding the fee.
7. Know your limits.
If someone else can offer better expertise, don’t hesitate to suggest a second opinion.
8. Respect colleagues.
When a patient comes to you for second opinion and you find that prior treatment was appropriate, say so. There is no need to undermine another doctor.
9. Think from the patient’s perspective.
If they have traveled far to consult you, help them find care closer to home or consider teleconsultation when feasible.
10. Communicate clearly.
Explain diagnosis, treatment options, duration of treatment, possible side effects of medications, and follow-up plans in simple terms.
11. Promote healthy living.
Never miss the chance to reinforce lifestyle measures. Healthy diet, exercise, and sleep matter more than most prescriptions.
Medicine is both a science and an art. Guidelines teach us the science. These small, human touches define the art.
To the younger doctors:
Your knowledge will earn respect, but your empathy will earn trust.
Dr Sudhir Kumar @hyderabaddoctor
#MedTwitter
In an international, randomized trial involving patients with acute venous thromboembolism, the risk of clinically relevant bleeding was significantly lower with apixaban than with rivaroxaban during the 3-month treatment period.
Full COBRRA trial results: nejm.org/doi/full/10.1056/NE…
Dr Nikhil Sharma 🇮🇳 retweeted
🕯️ Obituary
*Dr. Sandeep Agarwal*
The Vascular Society of India expresses its profound grief and heartfelt condolences on the sad demise of Dr. Sandeep Agarwal, who passed away on 25 February 2026.
May his soul rest in peace.
— Vascular Society of India
Dr Nikhil Sharma 🇮🇳 retweeted
In 1980, DeBakey operated on the Shah of Iran. He declares success. Soon, the patient is dead. Reoperation is psychologically brutal: how bias delay truth & what might save us from the same trap. leezhaomd.org/post/the-secon… #MedTwitter #Surgery #MedEd
Dr Nikhil Sharma 🇮🇳 retweeted
That's Mushkoh Valley. Being bombed by IAF jets during Kargil, 1999. Photo taken from a Chetak Helicopter of 132 FAC Flt, which turns 40 today.
To understand why this unit matters, you need to understand a problem that plagued air forces since the WWI. As aircraft got faster, pilots had less and less time to identify targets on the ground. Pre-flight briefings on enemy positions were often obsolete by the time jets arrived as front lines shifted too quickly. And last-minute inputs from ground troops were of limited use, because soldiers and pilots simply didn't speak the same language. At those speeds, precision was everything.
The answer was to place trained pilots on the ground, and later in the air, to guide strike aircraft during Close Air Support missions. "Forward Air Controllers". It was a game changer. CAS missions grew from fewer than 10% in WW2, to 20-30% in Vietnam, to over 30% in Afghanistan and Iraq. India felt this difference acutely. FACs transformed CAS effectiveness in 1971, and the contrast with 1965 was impossible to ignore.
Post-1971, the IAF formalised the FAC role, establishing airborne FAC flights using Cheetak/Chetah helicopters through regular joint exercises with the Army. 131 FAC Flt was the first, raised in 1974 on Bell Helicopters, later moving to Chetak and to Udhampur. 132 FAC Flt followed on 24 Feb 1986, eventually replacing 131 at Udhampur and it was from there that this unit went to war in Kargil.
Their methods were innovative and their courage remarkable. Flying within enemy missile range, they used coloured smoke from artillery fire to mark targets, carrying Air Observation Post pilots onboard to direct fire. Their airborne FAC operations in Drass, Batalik and Mushkoh were instrumental in directing the fighter strikes on Tololing and Tiger Hill. Every mission demanded meticulous planning just to minimise exposure to enemy fire. The unit earned 1 Vayu Sena Medal and 4 Mentions-in-Despatches for their efforts.
132 FAC Flt is also where Flying Officers Gunjan Saxena and Sreevidya Ranjan made history becoming the first two female pilots to operate in a combat zone in the IAF.
The IAF did go on to raise 133, 134 and 135 FAC Flts in the years that followed, but all were merged or disbanded by 1997. The use case for dedicated FAC flights has diminished in the modern era, and these units have since been repurposed to other roles. An era, quietly closed.
But on this day, it's worth remembering what these units built and what 132 FAC Flt, in particular, achieved over the peaks of Kargil.
Happy Raising Day.
Pic Credits: Gp Capt Arjun Sen
#IAFHistory @IAF_MCC
Dr Nikhil Sharma 🇮🇳 retweeted
🇮🇳 ⚔️ 🇵🇰 Siachen Glacier: World's highest battlefield. How 🇵🇰 QAID Post became 🇮🇳 BANA TOP in June 1987!
Rare picture included.
It's been 39 yrs since, under the able leadership of Lt Gen Satish Dua, the QAID POST, on the Siachen Glacier, was captured by his Battalion, later renamed as BANA TOP, is where the world's highest military operation was executed by the Indian Army (Operation Rajiv) at 21153 ft.
Naib Subedar Bana Singh was awarded the Param Vir Chakra, India's highest gallantry award.🇮🇳🪖🫡
Dr Nikhil Sharma 🇮🇳 retweeted
This is the drive up to Tanglang. Nothing quite describes what a solo bike trip does to you. So I’ve done Ladakh every year for five years. I’ve got a window in February. Where to go? Got to be safe enough to ride alone. Weathers gotta be decent enough to do long hours.
Dr Nikhil Sharma 🇮🇳 retweeted
As a vascular surgeon taking an aggressive coronary evaluation for patients with CLI I am discovering a huge burden of advanced coronary disease with the use of coronary CTA. I think it’s a huge game changer for potentially improving long term survival for this group
Dr Nikhil Sharma 🇮🇳 retweeted
Replying to @farkomd
You will be so very missed Dr Fogarty. I will never forget your kindness or genius. Thank you for everything you have done for this world
Dr Nikhil Sharma 🇮🇳 retweeted
Farmers are not burning less stubble, but burning it at a different time. This is what NASA says, with data collected by @hjethva05. While some are quick to give the farmers a free pass, the reality is something else. Strikingly different.
science.nasa.gov/earth/earth…









































