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DR JAGADISH J HIREMATH Profile picture
@Kaalateetham
Sep 22, 2020 • 7 tweets • 2 min read • Read on X
What is happening regarding Covid?

Well it is mostly good news. Slowly understanding is dawning on many issues hitherto not understood.

Fear of Covid is gone. Currently case fatality rate of less than 1.6 ; however in my understanding it should be much less

Why?
Read on
Early on contact tracing was inefficient & ineffective due to various factors biggest contribution was from sloppy work of authorities. This allowed Covid to spread horizontally across communities across cities across states.

Thankfully many in public did not manifest symptoms
Here in lies the fallacy of CFR, it estimates fatalities based on patients who were diagnosed positive while many primary & secondary contacts did not show symptoms, did not get checked & were not included in CFR

According to few this could be additional 100-150% of +ve cases
So in CFR; if all infected were included & calculated it would probably be in the region of 0.7 to 0.9 in India & less than 1.5 globally.

Is it a pandemic? Yes
Does virus transmit fast? Yes

However, it is not scary anymore due to various reasons. Initial ignorance & fear gone!
2nd point

The number of positive cases has shown de-growth for the first time in India since the pandemic started. It shows either we hit a plateau state or in down hill state.

The recovery rate is growing steadily, active cases not piling like before

This is really good news.
Few weeks ago in a #bbcradio interview i had expressed my concern that India might become biggest contributor to global deaths but now I am confident we will not. Deaths per day are stabilizing & not increasing anymore.

All hotspots are slowly turning warm to cold.

Good news
The only worry for me has been Namma Bengaluru, which continues to remain a hotspot. Hopefully the IAS officers who have been given "Jahagir" of our city, will burn more night oil & come up with better solutions for Namma ooru.

We definitely want to see a rapid decline soon.

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More from @Kaalateetham

DR JAGADISH J HIREMATH Profile picture
Jul 9, 2023
A reluctant 40 yr old male walked into our emergency with burning sensation in his chest at 5 AM.

First question by ER doctor: Did it wake you up? He said, he was uncomfortable through the night & did not sleep.

He came in the morning as he did not want to disturb his family.
He had diagnosed himself as suffering from gastric problem. He used to get pain mostly after dinner or heavy lunch & used to take tablet Pan 40 himself as it was available over the counter in many medical shops. It used to relieve his pain

But this time, it did not.

Reason 👇
He & his family members were reluctant to believe he had a heart attack.

He is so strong, was their reason. Only after ER consultant, Cardiologist & Cardiac Intensivist yours truly repeated the same, they understood the gravity of the problem.

Finally they agreed for Angiogram
Read 8 tweets
DR JAGADISH J HIREMATH Profile picture
Feb 16, 2023
In men, there is a small gland called prostate situated just below the bladder surrounding the proximal part of the urethra (tube which drains the bladder). Its job is to secrete seminal fluid that nourishes sperm.

In most men, it gets enlarged with age due to hormonal factors.
This increase in the size of the prostate with age is called Benign Prostate Enlargement or Hypertrophy (BPH).

It is distinct from prostate cancer & is not associated with increased incidence of cancer.

Sometimes it gets large enough to cause severe trouble requiring treatment
TURP: Trans Urethral Resection of prostate, where the urologist creates a tunnel for easy passage of urine is a common surgery today.

Newer modifications of the above are:

Plasma TURP: Different set of instruments & solution used to give same result with lesser complications.
Read 7 tweets
DR JAGADISH J HIREMATH Profile picture
Feb 15, 2023
What happens to your gastro intestinal system at sleep?

A set of neurons in GI tract get activated during sleep. It starts what's called "migrating motor complex" it helps to move digested food & waste through the tract.

Net effect: You get constipated if you do not sleep well.
Inadequate sleep can affect production of digestive hormones ghrelin & leptin. These regulate hunger & satiety, when sleep is affected, leptin is not secreted adequately by our fat cells.

Decrease in leptin keeps the hunger centre in the brain active making the person eat more.
When you are not sleeping enough, your stomach secretes more ghrelin which stimulates the hunger centre & you eat more leading to obesity.

Sleep has a direct relationship with obesity as explained above.

Apart from inadequate sleep causes leaky gut which leads to dry skin.
Read 5 tweets
DR JAGADISH J HIREMATH Profile picture
Feb 14, 2023
The dignified looking lady here is another eminent physician who changed the way we practice medicine.

Dr Virginia Apgar created “Apgar” score with 10 markers, which is used to assess newborns in labour rooms immediately after delivery & in 5 minutes.

This is used even today.
Dr Virginia Apgar was the first woman to head a speciality in medical colleges of America.

She was a teacher & administrator par excellence.

The introduction of Apgar score in 1940s & its wide use in the US by 60s, reduced infant mortality rate significantly in 24 hrs of birth.
Dr Apgar was among the first to bring the attention of medical world to the problem of “premature births”.

She was also among the advocates of use of Rh testing to identify women at risk.

Though she started as a Anesthesiologist she ended her career as professor of Pediatrics.
Read 5 tweets
DR JAGADISH J HIREMATH Profile picture
Feb 12, 2023
I came across lithium in 1991 during pharmacology semester 2nd MBBS.

I saw its use during my psychiatry postings. Its most common use was in mania & in bipolar disorder.

Lithium regulates certain neurotransmitters in the brain stabilizing the mood of the patient completely.
It prevents further episodes of mania/depression when patient is compliant & actually improves the patient's performance in all walks of life.

It is very well tolerated by most patients. However, regular monitoring of blood levels & follow up with the doctor is most important.
#Lithium is a very valuable tool in #psychiatry

It has saved more patients than all the help lines across the world have done.

We should thank Dr John Cade an Australian doctor who found the use of lithium & published it in 1949.

He used it on himself to check if it was safe.
Read 5 tweets
DR JAGADISH J HIREMATH Profile picture
Oct 9, 2021
In my final MBBS year at a famous Govt Medical College in Karnataka; you will be surprised to know the examiner had loads of bias in favour of fair sex. They just had to show up in practicals to pass. However it is a different matter that they had to clear theory themselves.
I was young & had an idea of this because our seniors had told us this is how exams are!!

I got thyroid MNG as my major case & cervical lymphadenopathy as my minor.

At the end of a gruelling session of 4 hours despite answering most questions I could feel something amiss.
On that day there were 4 girls & 3 boys for morning session.

You guessed it right, 4 girls passed along with 1 boy & I was not that.

I was left depressed, disheartened & felt damned for life.

However, life has to go on. I was in the infamous odd batch now & had to reappear.
Read 6 tweets

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