what if bilirubin direct is high - #23469

I am Dr. Surbhi Agrawal, a consultant physician & diabetologist, and yeah—it’s kinda hard to sum up everything in one go, but here’s where I’ll start. I work out of Newlife Hospital in Nagpur right now, and most of my time goes into caring for patients both in-person and online (which honestly has its own rhythm). I try to keep my consultations rooted in science but also real-life practical. Everyone’s got different bodies, lifestyles, worries—your treatment should reflect that, not be copy-pasted. My key focus is diabetes care—managing sugars, guiding on insulin or meds, helping people understand their bodies better. But it doesn’t stop there. I deal a lot with obesity, hormonal things like thyroid problems, infections (including COVID-related ones), plus skin and hair concerns that sneak into the picture more often than you’d think. I’ve also worked quite a bit around allergies, nutrition imbalances, and issues around sexual wellness which patients usually hesitate to talk about, but shouldn’t have to. I’ve always felt like just giving prescriptions isn’t enough—sometimes you gotta talk it out, decode the symptoms behind the silence. That’s where I try to lean in with my patients. Listen more, speak clearly, and not throw complicated jargon unless I need to (and when I do, I break it down). Whether you're dealing with a long-term condition or something that cropped up suddenly, I want you to feel like there’s space to ask and be heard. I stay updated—digging through research, listening to patient stories, and adapting. There’s new stuff all the time, especially in areas like endocrinology and internal medicine. But to me, empathy’s still the thing that holds it all together. If you’re struggling with symptoms or just confused about what’s going on with your health—reach out. I’m here for support, science & solutions... in whatever mix that works for you.

I am a periodontist with a background in clinical dentistry, and tbh my journey into the field kinda started back when I was a Jr Resident at Dr. R. Ahmed Dental College in Kolkata. That phase was super intense—rotational training in three major departments: Endodontics, Oral Surgery, and Periodontics. Each rotation was like six months long, and ngl that grind really shaped my clinical instincts, especially when it came to diagnostics and surgical stuff. Things weren’t always smooth but those months taught me loads. Later I went ahead and did a 3-year postgrad residency in Periodontics and Oral Implantology at SCB Government Dental College, Cuttack. That phase honestly deepened everything for me—like flap surgeries, mucogingival procedures, regenerative therapies, and full-on implant treatment planning. Was dealing with chronic perio cases pretty much on a daily basis and learning how to customise care based on specific patient profiles.. I kinda leaned more into evidence-based protocols and surgical precision—while still keeping things practical and personal with the patient. Right now what drives me is combining those skills in a way that doesn’t just “fix the gums” but really helps people regain confidence in their oral health long-term. Like, for me, it’s not just about how perfect a flap turns out—it’s also about making sure someone understands what’s going on, why we’re doing it, and how they can stay healthy way past the surgery day. That kinda patient education and maintenance is huge in my book. I try to keep things updated, reading new studies and adapting to better implant techniques—doesn't mean jumping on every shiny trend, tho. My approach is super tailored; I mean every mouth, every patient’s gum profile is diff and I respect that. My aim? Safe, sustainable, clear-headed periodontal and implant care—without unnecessary drama or guesswork.

I am someone who kinda grew into emergency medicine not just by choice, but honestly by seeing how critical that first few mins can be for any patient. Over the last 5 yrs, I’ve worked across ERs, ICUs, step-down units, and even small community setups where you’re the only doc on floor managing multiple things all at once. My work usually involves handling acute medical emergencies, starting ventilatory support when needed (both invasive and non), managing Hemodialysis sessions, and even doing temporary pacings if required. I’ve also had fair exposure to giving general and regional anesthesia during critical procedures—those moments can get tense real quick. Admissions to nursing homes for continued care is something I handle directly too, acting as a solo consultant at times, where I take over complete patient management once stabilized from ER. It’s tough sometimes tbh, you're constantly juggling—interpreting unstable vitals, responding to collapsing airways, thinking of 3-4 differential diagnoses at once while also explaining things to relatives who are scared and confused. But that’s kind of the thing I like about emergency care... it demands fast thinking, calm hands and clear judgement. Working in high-pressure environments helped me understand how different every patient is. No one protocol works for all, and reading between the lines of clincial signs—like that subtle drop in consciousness or lab value that just doesn’t “fit”—can make or break outcomes. My goal’s always been to stabilize fast but also plan smart. Not just act but act right for long-term safety. Even outside hospitals, I’ve kept learning. The field moves fast—new evidence, new ventilator modes, even how anesthesia interacts with dialysis now gets updated. Staying current is part of the job. And yea, I’ve had my share of nights where decisions had to be made in seconds, no second opinions, just gut and training. Those moments stay with you. Honestly? Emergency medicine isn't just a branch for me, it’s kind of my zone. The rush, the decisions, the unpredictability—it’s hard but it fits how I think and work. And if I can make it a little easier or safer for just that one patient in crisis, I’d say the day was worth it.

I am Dr. Avantika Tiwari and honestly—working with kids is something I didn’t just choose, it kinda chose me. I'm a Pediatric Surgeon with a little over 7 years of hands-on experience dealing with everything from newborn emergencies to complex surgeries in adolescents. Whether it's neonatal surgeries, hernias, undescended testes, or even something more rare, I focus on making sure the treatment isn’t just effective—but also gentle, thoughtful, & right for the child and family. I really try to listen—like really listen—to what parents are scared about, what confuses them, and even what the kid isn't saying. That’s where care starts, isn’t it? I don’t rush consults and I try my best to talk to kids at their level—sometimes it’s a stuffed toy in one hand, sometimes a story. Whatever makes it feel less scary. Clinical work is one part of it. I do stay pretty updated with the latest in pediatric surgical care... I’m always reading or attending something—can't afford not to, right? I mean, families deserve the best possible surgical techniques and safer outcomes. From minimally invasive procedures to post-op pain control, I try to bring in whatever is most current and evidence-backed into my practice. Peers and teams I work with often say they like how I bring people together—nurses, anesthetists, fellow docs, parents. I guess I just think healing needs everyone to pull in the same direction. And yeah, leadership comes into play there, but more importantly it’s about building trust and respect across the board. Some days are tough—kids in pain, anxious parents, decisions that can’t be delayed. But even then I try to stay calm, explain clearly, and move quick when it matters. The weight of it is real, but so is the joy when a child heals and smiles again. That’s the part that stays with you. I’m always open to second opinions, follow-ups, weird questions—nothing’s too small or silly when it comes to your kid.

I’ve had the privilege of working across some of Delhi’s most respected government hospitals—Safdarjung, Dr. RML, Lady Hardinge, Charak Palika, and even a brief stint at AIIMS. Each one brought its own pace, pressure, and people, and honestly, nothing can quite prepare you for that kind of real-world clinical exposure until you’re right in the thick of it. In these hospitals, I learned not just about diseases—but about patients. From managing emergency trauma cases at Safdarjung to assisting in maternal and child care at Lady Hardinge, I was thrown into scenarios where both speed and sensitivity mattered. There were nights with barely any sleep, days that blurred into the next, and moments that challenged everything I thought I knew. At RML, I was lucky to work closely with experienced consultants who helped refine my diagnostic skills and decision-making, especially in time-critical cases. AIIMS, of course, was on a whole other level in terms of learning—from rare presentations to multidisciplinary teamwork. It was intense, but it shaped me. I don’t pretend to have it all figured out—honestly, no real doctor should. What I do know comes from real-world experience, not just reading. These days, I focus on being accurate, honest, and treating people like people, not problems. I’m still learning but always trying to show up better than the day before.

Hello, I’m Dr. Sandeep Gupta, a practicing physiotherapist with national and international exposure in the field of sports rehabilitation and manual therapy. Over the years, I've been fortunate to work in dynamic, high-performance environments, including serving as a physiotherapist for the All India Football Federation’s National Sports Team and representing India as part of the medical support staff at the U-20 World Wrestling Championship 2024 in Spain. These experiences have not only sharpened my clinical skills but also given me insight into the unique needs of elite athletes. I work mainly in sports physiotherapy, manual therapy, and musculoskeletal rehab. Along the way, I’ve picked up certifications in cupping therapy, IASTM (which is basically a tool-based technique for soft tissue), myofascial dry needling, and advanced manual therapy. My approach is a mix of evidence-based methods and real, hands-on care that comes from genuinely wanting to help. Whether I’m treating a pro athlete or someone who's been living with pain for years, my goal stays the same—get them moving better, feeling stronger, and living well. I believe therapy is never one-size-fits-all. Each case is different, and I take time to understand the root cause of the issue, rather than just addressing symptoms. I work closely with patients to develop realistic, effective treatment plans that are both progressive and easy to follow. I’ve learned over time that catching things early, understanding body mechanics, and sticking to the right rehab plan can really stop problems from turning into something long-term. What drives me is helping people understand their own bodies so they feel more in control of their healing. I’m very hands-on in my work—literally—whether that means easing tight muscles, using cupping therapy, or helping someone correct their posture and movement, step by step. Honestly, working with international teams taught me that communication and trust are just as important as clinical skill. So I always try to create a space where patients feel heard, respected, and motivated to heal. If you're dealing with pain, injury, or just looking to move better and live pain-free—I'm here to help.

I'm currently working as an Assistant Professor at the Government Dental College and Hospital in Aurangabad, where I also completed my MDS in Orthodontics in 2024 with distinction (76%). Teaching gives me a chance to stay closely connected with both the academic and clinical side of dentistry, and honestly—I learn as much from my students and patients as I try to offer them. My core area of interest lies in orthodontics, especially early intervention and esthetic correction for functional bite issues. Whether it's braces, aligners, or space management, I believe a well-planned smile correction can really change how someone feels about themselves. I try to keep my treatment approach practical and conservative, wherever possible—less discomfort, more efficiency. Besides my clinical and teaching duties, I’ve written and published a few papers in both national and international dental journals. Two of them got pretty good response from peers, which honestly meant a lot to me. Research and writing kind of push me to slow down and think more deeply about the issues we face in dentistry today. It also helps me tweak the way I approach both teaching and treatment, you learn stuff as you go. I’m constantly exploring newer techniques in orthodontic care while keeping the basics strong. Patient comfort, treatment stability, and facial harmony are some of the things I pay attention to—because every case is unique, and one-size-fits-all just doesn’t work in orthodontics. Being in a teaching hospital also means I get to treat a diverse population with a wide range of malocclusions and skeletal patterns. That clinical variety, combined with academic exposure, keeps me sharp and grounded. I don’t claim to have all the answers, but I’m always listening, learning, and refining my work—because that's what good dental care should be about.

With over 18 years of clinical experience, I’ve dedicated my practice to the care and management of outdoor ophthalmic patients across varied settings. I have done my Diploma in Ophthalmology from the National Board of Examinations (NBE), and since then, I’ve focused on providing accessible, empathetic, and evidence-based eye treatments. I deal with a wide spectrum of eye conditions—ranging from routine vision complaints to more complex concerns like infections, trauma-related injuries, and chronic conditions affecting ocular health. Whether it's diagnosing early signs of cataract or managing long-term visual issues, my approach always begins with listening carefully to each patient. No two eyes are the same—and neither are the people behind them. I’ve worked extensively in outpatient settings, where timely diagnosis and clear patient communication are absolutely key. I try my best to keep things simple for the patient—eye care shouldn't feel like a maze of medical terms and rushed appointments. Instead, I focus on making every consultation practical, collaborative, and comfortable. I still attend occasional clinical meets or training modules to refine my practice wherever needed. I may not always have fancy words, but I know how to take care of the eyes that walk into my clinic. That’s what matters most to me.

I’m a practicing general surgeon with hands-on experience across a pretty wide range of surgical cases, especially ones related to oncology and gut issues. What I’ve learned over the years is that doing a good surgery isn’t only about being precise with your hands—it’s also about seeing the person behind the scans, hearing what they’re really worried about, and keeping your head clear when things get tense. That balance matters more than people often realise. I handle a mix of elective and emergency surgeries pretty often—ranging from tricky abdominal operations to trauma cases and even those more regular, day-to-day procedures. What I focus on most is safety... making sure pre-op planning is solid, the surgery itself is clean and precise, and follow-up care is always thorough. Over time I’ve realised, honestly, every patient’s story is different, and the way you treat them should be too. Compassion matters. During my surgical training and clinical practice, I’ve developed a solid hand in diagnostics, operative procedures, and managing critical post-surgical scenarios. Whether it’s a challenging oncologic resection or a straightforward hernia repair, I treat each case with the same level of focus and responsibility. I also try to stay up to date with surgical advancements—laparoscopic techniques, better suturing methods, evolving anesthetic protocols—because medicine doesn’t stand still, and neither should we. At the end of the day, what matters most to me is that the patient feels safe, informed, and cared for—not just before the surgery, but every step through recovery. Outside the OR, I really try to keep things simple and honest when I talk with patients and their families. Surgery can be felt scary, confusing, and full of unknowns. So I make it a point to slow down, explain things in a way that actually makes sense, and just listen when they need to talk. I’ve seen how much that kind of connection helps people feel calmer and more in control, which I think really does make a difference in how they recover. No matter how many surgeries I’ve done, I never take it lightly. Every incision, every decision—it all counts. And I make sure it’s done with purpose.

I am working in the field of Sexual Medicine & Male Infertility for 40+ years now, and honestly it’s still a space that’s not talked about enough. Whether it’s a man dealing with ED or a woman struggling with hormonal ups & downs, I try to look at the whole picture. Not just symptoms. Like, what’s actually causing it and what can we do that’ll actually work long-term—not just patch things up for a moment. I deal a lot with male infertility issues like low sperm count, poor motility, hormonal issues, you name it. I try to not just run tests but also explain what's happening in simple terms. ED and premature ejaculation are common but man, the mental impact is huge! I work on those cases from all angles—medical, lifestyle, even psychosexual support if needed. Anejaculation’s another one people don’t talk about much, but yeah, I've handled several of those too. On the women’s side—there’s PCOS, ovulatory issues, arousal disorders, painful intercourse. These aren't easy to talk about but once patients open up, they want real answers, not vague promises. Sometimes it’s hormonal, sometimes past trauma, and sometimes just no one ever asked them the right questions. I try to make that space for them. My approach blends detailed diagnostics with tailored plans that might include meds, hormone regulation, or even just fixing sleep, stress & diet patterns that mess up the whole system. I believe sexual health isn’t separate from general health, and treating it that way—holistically—is where things actually shift. I work with both men & women, often couples too. What really matters to me is getting people past shame and confusion and into solutions that stick. And yeah sometimes that just starts with a really honest conversation.

I am a practicing physician with more than 35 years in clinical medicine, though honestly sometimes it still feels like I just started. I graduated from Lady Hardinge Medical College back in 1986—those early years, especially at Sir Ganga Ram Hospital, kind of shaped everything that came after. Since 1990, I’ve been running my own private setup, and I’ve seen thousands of patients across all age groups and conditions... but the one thing I keep circling back to is preventive health. It’s where change really begins. Over the past 15-ish years, my focus has been shifting more and more toward lifestyle medicine—especially around weight management and chronic disease reversal. Not everyone believes that diabetes or hypertension can improve without increasing meds, but I’ve seen real outcomes using therapeutic weight loss, dietary shifts, behavior tweaks... all rooted in clinical logic, not hype. I took formal training in this area too—wanted to go beyond just theory and actually offer patients plans that work. I’m currently attached to multiple clinics and nursing homes across Delhi and Gurgaon. My style’s pretty hands-on—I like to sit with people, understand what they’re really going through, and help them find small steps that feel doable. No crash diets or overnight promises. If you’ve tried and failed before, I totally get it. We start again. Teaching is something I also enjoy—currently visiting faculty at Baba Farid University of Health Sciences where I talk to students about integrating wellness with clinical science. It’s interesting how younger minds bring fresh questions. Oh and I wrote a book—The Ultimate Weight Loss Formula—it’s not a self-help fluff piece but more a tool-kit kind of thing, drawn straight from cases I’ve worked on. To me, health isn’t just about avoiding illness—it’s about building the kind of energy and balance that lets you live fully. Whether you're looking to reverse diabetes, lose weight sustainably, or just feel better overall, I’m here to help you take back control without judgment or gimmicks. Just real support, real goals, and real change.