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 👇

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

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.

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.

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.

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.

I am informed that now there is a Taliban Air Force.

Thanks to US, which created the air fields & other necessary infrastructure. US also has left lot of Blackhawks, mid range fighter jets & a complete set of airforce equipment needed worth billions of dollars. Afghan Air Force trained by US did not act against Taliban when they captured Afghanistan in a short span. Now this trained team of men are joining Taliban and also training the selected ones.

The question is; with this infrastructure how long will it take Taliban to attack pak?

#InternationalDayOfYoga

Many have asked me how I overcame Covid so fast; the answer is "I used Yoga"

Here it is: the moment symptoms started treatment was on, although I had high fever for 3 days it did not bother me much as I knew my body was working against the Chinese virus My intention was not to allow the virus to colonise my lungs 🫁. So I started "Basti Kriya" or "Bastrika" pranayama as soon as throat irritation started.

This Pranayama brings air out of lungs at high speed & is known to clean the lungs. I used to perform it atleast 20 times/day

Dear Prime Minister @narendramodi ji

ACE Suhas hospital Jigani is a registered CVC, we have done Vaccination for thousands before end of March 2021.

Once it was thrown open & Pvt Hospitals were asked to procure directly from manufacturing companies, we have not been able to buy Our Emails & phone calls to both @BharatBiotech & @SerumInstIndia have not been answered by them

We are unable to procure even one single dose while Corporate Hospitals are able to buy millions of doses

This stinks of cartelization & profiteering by these companies + hospitals.

#Mucormycosis
#BlackFungus

Self medication & procedures like steaming have played a big role in increasing numbers of patients getting infected with fungal infections.

Indiscriminate antibiotic use has killed the normal flora allowing opportunistic infections like fungi to grow The normal flora has also been destroyed by the indiscriminate steaming which patients & people have done, thinking that will kill the virus.

People have taken zinc supplements indiscriminately & this has allowed fungus to grow as zinc is prerequisite for its growth.

Lessons learnt this Pandemic

A country like US which spends 10% of GDP on healthcare could not manage the pandemic

Whereas NZ & Australia did a good job. It helped that they are islands & put in strict SOPs to quarantine people who tested +ve, also allowed in only after testing Non pharmacological measures for prevention worked better than trying to find cure & vaccination. It is nightmare to manage a otherwise healthy adult struggling to breathe in ICU

60K ventilators of GOI could not save as much as what N95 mask could do but we never implemented it

Guidelines to prevent Mucormycosis in Covid recovery

1) Never enter damp spaces, especially if walls already has mold or mold like growth

2) If median Sr ferritin values were high during hospital stay, you are high risk as immune dysregulation is high, wear N95 mask all times 3) Cover your face with a shield & close your nose & mouth with N95 mask if you are out in the open especially dusty areas. Since dust is ubiquitous in India never come out without protection

4) Ask your doctor if you need any prophylaxis, chances are that you will not need it

So many assumptions & confusion

The solution is simple

1) Covid Appropriate Behaviour

2) Vaccination The question is about those who already are positive now & are suffering the illness.

Solution:

1) 81% do not require hospital visit

2) 14% require oxygen only

3) 5% require additional care

In that 5% only 1% require ICU care, NIV, HFNC, Ventilator & other organ failure care

Normally nobody likes to talk about their home loans; they are personal.

Decided to talk about ours. Those taking home loans need to be very careful with banks as they overcharge you while you go on with your life.

In our case @syndicatebank & @canarabank are the culprit banks. Ours is a high value home loan by any normal Indian standards. @syndicatebank treated it like one when we were given the home construction loan through their Syndnivas scheme.

It was sanctioned in 2015 at 10.5% floating rate of interest. In time @RBI reduced interest rates

Dear friends, I have been mining to find studies which are relevant to us.

CDC has recently published one such study of 150000 subjects who suffered from #Covid

Obesity as expected is "the biggest Risk factor"

Also those patients who had very low unhealthy BMI suffered more. BMI 23 - 25 has least morbidity & mortality
BMI 30 - 35 hospitalisation increases to 7%, ICU admissions of less than 1%
BMI > 35 associated with increased hospitalisation, ICU admissions & increased mortality.
BMI of 45+ is associated with very high ICU admissions & mortality

Met a young guy yesterday, he had hitchhiked & trekked his way back to work from Chhattisgarh.

Came to see me b'coz he had fever & was terribly scared that I will get Corona test done on him. He was worried that his employer will throw him out of job

If you care : mask up now ! There are a lot of people who have survived the virus but are not able to survive the loss of income.

They cannot afford to lose even one day's wages. It is what keeps them "alive". They need to feed their families & it is our responsibility to ensure they are not starved.

A 21 yr young girl came to me with severe pain abdomen. She was diagnosed with PCOD (quite common USG finding now) & taking treatment for the same.

The pain was unusually severe was associated with lot of belching by the girl. She jumped in agony when her abdomen was touched With good history taking it was clear that she had inhaled chemicals while working in a R&D facility of a drug major. While she was told by a doctor the previous day that her problem was aggravated PCOD we did not agree with it.

Asked our Industrial Health Expert to investigate

Thread on #AyurvedicSurgeons

I have been quiet on this issue because I have read history of medicine in India & written about it in my published articles. You can check them out on my blog

Ayurveda got stoned by the British during the period they ruled India. Let us agree that+ Let us also agree that the tradition of Guru Shishya Parampare was lost during this period in Ayurveda.

Creation of Medical Register & Registered Medical Practitioners where traditional medicine doctors including Ayurveda were not registered literally killed Ayurveda practices+

So slowly we are talking about Infection Fatality Rate

According to CDC of US it is 0.65% for Americans

32 million Americans less than 10% population has been infected by Covid

Regional Antibody studies show that it varies from place to place also varies dramatically with age. For example only 0.003% of people less than 19 years of age showed antibodies to Covid virus whereas 5.4% were positive for antibodies among 70+ age group.

Why was not answered convincingly. We do not know why susceptible are infected more.

550 that is the number of Doctors dead due to Covid contracting it while treating Covid patients & in India

67 doctors are dead in similar fashion in Karnataka. Case Fatality Rate for Covid among doctors treating Covid patients & non Covid patients is 36.4.

This is more than 22 times the the CFR of non doctor population of India which is 1.6.

Post Covid Syndrome is also more seen among doctors.

Doctors running OPDs are worst affected.

#COVID19India

Are we entering a phase of "Pathological Science"?

Is there a big factor of wishful thinking in analysis of Chinese Virus?

Are we in N Ray mode?

Tough questions to answer but who will do it?

We have bureaucratic nincompoops running the show busy in corruption The vaccine manufacturing guy wants Rs 80000 crores to provide vaccine to Indians.
Q
1) Is is vaccine safe?
2) Is it efficient?
3) How long does immunity last?
4) What is the cost of production per dose?
5) What is the price for end user?
6) Will CFR go below 1.5% on vaccination?