Sreejith Parameswaran @sreejithdr.bsky.social · 29/08/2026Saturday Morning 10K Run (and Walk) in the hilly terrains of Kodungoor. The terrain is such that it is either uphill or downhill. Even the 'flat' sections in between are also either gently slopping up or down. I walked the uphill sections and ran the downhill & relatively flat sections. 030
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026Why Haemoadsorption is Not Standard of Care —Part II 14/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026Why Haemoadsorption Is Not Standard of Care —Part I. 13/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026Should Haemoadsorption Be Routine? No. In Selected Cases? Perhaps. The problem right now is that we don't have reliable & accessible means to identify the 'niche' population who may benefit! 12/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026And what do you get? Mortality Benefit: Inconsistent at Best, Absent at Worst! When the effect estimate depends on which studies you include and who funded the analysis, it is not evidence of benefit —it is evidence of uncertainty. 11/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026The cost: Need TDM for safe use of antibiotics, clearance of beneficial mediators, hormones, etc. This competes directly with proven interventions: early antibiotics, source control, and fluid stewardship. 10/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026What We Get: There are indeed proven physiological benefits. The debate is not whether haemoadsorption changes physiology —it clearly does. The debate is whether changes in physiology have translated into survival among patients. 9/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026For those who point to the TIGRIS trial - it was nicely 'taken apart' at the @NephJC : tinyurl.com/49n4d3s6 8/15 @hswapnil.medsky.social @kidneyboy.bsky.social 110
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026The “Positive” Meta-Analysis Does Not Survive Scrutiny. Not surprising that no major international guideline endorses routine haemoadsorption in septic shock. 7/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026Five Meta-Analyses, Five Different Verdicts. Only the analysis restricted to randomised trials shows a statistically significant effect —and it points toward harm! 6/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026The Randomised Evidence Does Not Hold Up the argument for Haemoadsorption as SOC. 5/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026Selected Landmark Trials Behind the Case for Haemoadsorption. 4/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026“Haemoadsorption” Is Not One Device —But the Pattern Repeats. The most extensively randomised-trial-tested devices in the class are CytoSorb & Toraymyxin, which the review focused on. 3/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026There is a complex, time-varying biology, making a single non-selective filter applied at one fixed point in the timeline a fragile premise for a therapy—the target it needs to hit keeps moving. 2/15 100
Sreejith Parameswaran @sreejithdr.bsky.social · 09/08/2026The (lack of) Evidence Behind Haemoadsorption in Septic Shock: I was asked to argue the CON position at the Debate "Hemoadsorption in Septic Shock Standard of Care in 2026, or Expensive Placebo?" at CCNA3.0 in Pune & I conducted a literature review. A short 🧵1/15 111
Reposted by Sreejith ParameswaranSwapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 31/07/2026Guidance on nutrition supplementation in dialysis www.kireports.org/article/S246... In @kireports.bsky.social Increasing protein intake once dialysis begins is important! 1119
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026The first half is done and dusted. Onward to the next — leaner, meaner, more focused academically. Looking forward to exciting, productive, meaningful years ahead. 🙏 (10/10) 010
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026Building from scratch and constant public-sector firefighting took a toll on research output. I owe it to those who've been the wind beneath my wings to make amends: Prof Vivekanand Jha @vjha.bsky.social, Prof Jai Radhakrishnan @jradnephro.bsky.social, Prof Vinay Sakhuja & Prof A Vimala. (9/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/202616.5 years have flown by like 16.5 months. I always believed there was enough time — but closing in on 50, I realise it's running out. Time to pick up the pace. (8/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026I focused on process over outcome — went with the flow, but never passively: saw opportunity where others saw burden, chose order over drift, and defined the dept by its scope, not a clock. And yes, I was lucky. (7/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026I never chased a fixed outcome — but that didn't mean there was no plan. There was always a method to the madness inherent to public institutions like JIPMER. (6/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026I built the Nephrology dept at JIPMER from scratch. It's come a long way — some of it far beyond what I imagined. Looking back, it was all worth it. I'd do it again. (5/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026"कर्मण्येवाधिकारस्ते मा फलेषु कदाचन। मा कर्मफलहेतुर्भूर्मा ते सङ्गोऽस्त्वकर्मणि॥" — You have a right to your duty, not to its fruits. Never see yourself as the cause of outcomes, nor be attached to inaction. (Bhagavad Gita 2.47) (4/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026Could I do everything I wanted? No. Should I have done more? Probably. Any regrets? None — I gave it my all. (3/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026I joined as an Asst. Professor of Nephrology at JIPMER in Jan 2010, 14 days after finishing training at PGIMER Chandigarh. If I stay till retirement, I'm exactly at the midpoint today. (2/10) 100
Sreejith Parameswaran @sreejithdr.bsky.social · 24/07/2026Exactly 16.5 years (6,035 days) ago, I joined JIPMER as faculty in Nephrology. I'm now at the exact midpoint of my academic career here — a good time to take stock. A thread 🧵 (1/10) 210
Sreejith Parameswaran @sreejithdr.bsky.social · 20/07/2026I have followed the CKM literature closely from the time the ACC/AHA Presidential advisory came out in '23. The 'CKM Framework' is useful in patient care, public health and academic contexts. I don't make a diagnosis of the syndrome for individuals, but I think the framework does help our approach. 030
Sreejith Parameswaran @sreejithdr.bsky.social · 19/07/2026Sunday Morning 10K Run 🏃🏽♂️ Still struggling to stay in Zone 2 010
Sreejith Parameswaran @sreejithdr.bsky.social · 14/06/2026Sunday Morning 10K 🏃🏽♂️ Stayed in Zone 2 for almost the whole run. 000
Sreejith Parameswaran @sreejithdr.bsky.social · 03/05/2026Sunday Morning 10K Run 🏃🏽♂️ With the onset of summer, weather conditions here are not great for running 🥵, so went out earlier than usual & stuck to a lower pace. Ended up woth my best 'zone 2' run so far! 😃 000
Reposted by Sreejith ParameswaranNephrology Journal Club @nephjc.bsky.social · 22/04/2026Still ordering hydralazine? 🤔 Beyond case reports, this large cohort compares hydralazine vs ACEi/ARB to estimate real-world vasculitis risk, will this 📉 bias & clarify the answer Read more 👇 pubmed.ncbi.nlm.nih.... #TenPostNephJC #NephJC #NephSky #MedSky 168
Sreejith Parameswaran @sreejithdr.bsky.social · 19/04/2026In Hyderabad to participate at a conference. Ran to the Durgam Chevuru park near by and did two laps (almost) at the park. Walked back to the hotel. 000
Sreejith Parameswaran @sreejithdr.bsky.social · 22/03/2026Sunday Morning 15K Run 🏃🏽♂️ The run was marred by stray dogs coming after me at the Irumbai village (the destination). 051
Sreejith Parameswaran @sreejithdr.bsky.social · 15/02/2026I am sure this is the ‘lived experience’ of many - aerobic exercise doesn’t help weight loss. Combining it with diet restrictions seems even worse. www.newscientist.com/article/2514...newscientist.comWhy exercise isn't much help if you are trying to lose weightWhen we exercise more, our bodies may compensate by using less energy for other things – especially if we eat less too 000
Sreejith Parameswaran @sreejithdr.bsky.social · 15/02/2026BMI has long been used to determine someone's health, but it is deeply flawed. Better measures of body fat exist – and they are finally catching on, finds Starre Vartan www.sciencedirect.com/science/arti... 010
Sreejith Parameswaran @sreejithdr.bsky.social · 08/02/2026My first #HalfMarathon done and dusted! At the Annual Auroville Marathon 2026 (Ran 21km, but my watch tracked only 20.5km). 020
Sreejith Parameswaran @sreejithdr.bsky.social · 01/02/2026Apparently Time is an Illusion! This is supposed to be Physics (Quantum Physics) but has no resemblance to the Physics I learned at school (admittedly 30 yrs back). This reads more like philosophy or science fiction! www.newscientist.com/article/2511...newscientist.comThe daring idea that time is an illusion and how we could prove itThe way time ticks forward in our universe has long stumped physicists. Now, a new set of tools from entangled atoms to black holes promises to reveal time’s true nature 020
Reposted by Sreejith ParameswaranNature @nature.com · 25/01/2026After turning off ChatGPT’s ‘data consent’ option, Marcel Bucher lost the work behind grant applications, teaching materials and publication drafts go.nature.com/4r2ateigo.nature.comWhen two years of academic work vanished with a single clickNature - After turning off ChatGPT’s ‘data consent’ option, Marcel Bucher lost the work behind grant applications, teaching materials and publication drafts. Here’s what happened next. 33211
Sreejith Parameswaran @sreejithdr.bsky.social · 02/01/2026Right now I am on a 30 week streak of activities (at least one run or walk a week). Hope I will be able to sustain the streak! 000
Sreejith Parameswaran @sreejithdr.bsky.social · 02/01/2026Made an effort to be more physically active in 2025 and this is how it turned out. Ran 701 out of 838 km and walked 134 km. I stopped going on bike rides in 2025 & that explains the lower distance (despite days active being more) Vs 2024. 110
Sreejith Parameswaran @sreejithdr.bsky.social · 28/12/2025Sunday Morning 15K 🏃🏽♂️ to the ancient Irumbai Mahakaleshwar Temple premises temple.dinamalar.com/en/new_en.ph... 030
