On a journey, the destination of which I know not; but the road, the menagerie of travellers, the pitstops, the potholes, the experiences are what make me, Me.
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Oct 1, 2022 • 8 tweets • 2 min read
India is staring at a massive, massive Antimicrobial Resistance (AMR) problem; however we are refusing to take this up as a a serious & urgent health policy issue and address it.
Both Private & Public sector health establishment are equal contributors to this menace.
The factors that worsen it -
1) Irrational Antimicrobial prescriptions both in urban & rural areas 2) Lack of understanding of formulation of Antimicrobial policy & its implementation 3) Inadequate number of qualified Infectious diseases professionals
Oct 1, 2022 • 8 tweets • 2 min read
My problem with Indian’s Drug regulatory body and the implementation of processes & laws is that it is so hopelessly & blatantly & obviously flawed even at the very basic & essential pre-requisite level that one doesn’t know where to even begin critiquing the entire exercise.
In one sentence if I were to say - Criticism of Indian Drug Regulatory body & process is a an endless mine hole.
And, there is hardly any intent to address these issues by Govt or the incentive to do so which is surprising because it affects Human health, life & safety.
Sep 30, 2022 • 5 tweets • 1 min read
So @MoCA_GoI why is it that as a rule Disability assistance provided by Indian airlines is not seamless? Airlines will say their disability assistance will begin from counter or inside airport, then what is the point of disability assistance if it doesn’t begin from car door?
Families especially on large airports are left foraging for wheelchair assistance and which btw is a huge rip off in terms of cost & services by the private parties that have put up kiosks outside airports?
Jun 29, 2022 • 8 tweets • 2 min read
GST council wants to tax hospital room rents and no one has any problems with this is how disconnected average Indian is from the realities that directly impact them.
I am aware that this is for room rents above 5k, however what is mind boggling is that most people think that a room rent of 5k is relatively rare rent in Metros even for that matter in Tier 1 & Tier 2 cities where even if not room rate, ICU rates will be higher.
Jun 28, 2022 • 4 tweets • 1 min read
Some lawyers on my TL are talking about legitimate national interest or let law take its own course , to all of you -
It is in the interest of the nation to follow due process as laid by the law of the land. And to apply that process equally and impartially to all.
Problem is that on a daily basis due process as laid by law is trampled upon the executive. Problem is that judiciary no longer holds to its own set precedents in similar situations.
Problem is that none of this breach of established & codified law is considered a problem.
Jun 1, 2022 • 6 tweets • 2 min read
Everytime I come across such news be it this or the Salmonella poisoning with the Belgian chocolates in Europe recently, the public health person in me is reminded of the pathetic state of affairs that would be in case something similar were to happen in India because +
because of absolutely non-existent coordination among Food & drug safety & Infectious diseases reporting mechanisms & infrastructure or effort to even pin point such sources through a source investigation
We don’t even have the necessary infrastructures or awareness in place +
May 30, 2022 • 5 tweets • 1 min read
I am not sure if Indian elite (who are Infact largely responsible for this) realise that the road which this country is fast tumbling down with the gyanvapi & Muslim hate rubbish, is going to destroy them faster than they will realise & that time is not far off.
More businesses are seeking an alternative or divesting out of India than WA university forwards give you an idea, market sentiment for Indian investments is a huge +/- ball game & our ruling politicians are unwilling to help this scenario.
Mar 7, 2022 • 26 tweets • 8 min read
Allow me to introduce you to the two Poisons of our time, with which are poisoning ourselves and also our children on a daily basis -
Uncontrolled
Salt/Sodium
Sugar
In our daily diet which we consume without any mindfulness.
This thread began cuz last week I diagnosed a 20 yr old with Hypertension.
On evaluation we could not find any of the routine organic culprit for hypertension in such a young person. Patient was a non-smoker, slightly overweight but not obese.
I found the culprit in their Diet.
Mar 4, 2022 • 13 tweets • 3 min read
Why do students leave India for #MedEd is not a simple answer - Seat mismatch to lay persons seems like the most plausible issue which can be addressed by increasing number of hospitals or seats.
IMHO this won’t change the scenario
The reason being - Cost of education in private med schools is elitist & is unaffordable by commoners, so unless seats in public institutions increase students will prefer affordability.
Feb 10, 2022 • 4 tweets • 1 min read
It doesn’t matter - Whether or not viruses mutate to become less pathogenic over time is correct or incorrect (A lot of people are referring to this hypothesis in context of Omicron & to push through that this means end of the pandemic) - because as I see it
Omicron is able to infect despite boosters or natural infection+ full vaccination dose and is highly infectious, which means now it has the advantage to reach hosts (immunocompromised or non-vaccinated) that can aid further mutations faster than its predecessors.
Feb 8, 2022 • 5 tweets • 1 min read
Gupta ji, there are many sides to this debate and there are too many associated takes, however justifying it by nullifying the right of choice of women by garbing it under modernity or liberalism is the worst of all.
Your take especially in the backdrop of surrounding circumstances, involvement of rogue elements and the constitutionality involved demonstrates your lack of understanding of both modernism & liberalism apart from displaying how little you understand feminism.
Feb 8, 2022 • 4 tweets • 1 min read
I used to commute for work, every single day during the peak of heat I would see young children, old men & women walking under the scorching sun many a times without even a slipper, when we would stop the car. I would carry juice & water bottles & food & hand them out
Never once did I have anyone of these migrants stop to beg or even ask for money when we stopped, they would keep walking, because that walk was their only chance at surviving.
Jan 24, 2022 • 7 tweets • 2 min read
It urgent and imperative that Indian medical community from top to bottom & bottom to top realise that they are in the process of creating a monster called “Anti-microbial resistance” with their irrational antibiotics prescription approach.
And, Even Now is pretty late.
But seriously if we are going to use antibiotics Which should be last in the line of defence like Tazobactum, Levoflox, Meropenem as first line then we are inviting bugs that we have no ammunition against.
Jan 9, 2022 • 20 tweets • 4 min read
Just thinking this out aloud & I will delete it later, I have been following Omicron growth very closely since SA & now having experienced patients in India I know that it is extremely transmissible & it infects rapidly, 24-48 hrs if exposed, extrapolating this
To my observations in India, our infection control practices in India are really pathetic across all healthcare set ups, equally pathetic is personal protection by HCWs & in hospital patients & attendants & so is our in-hospital air ventilation.
Jan 7, 2022 • 5 tweets • 1 min read
Govt’s & policy makers - Omicron is mild because our deaths are low & ventilators needs are low.
Chickengunya is a disease with high grade fever, debilitating body ache. However debilitating pain requires hospitalisation.
It is mild but in season it overruns hospital capacity
Common Symptoms so far in present wave are - Highgrade fever that many times is not breaking with oral antipyretic even for 2 days, severe fatigue, headache, severe vomitting & diarrhoea, cough & breathing difficulty.
These may seem mild to read but most of my patients are
Jan 7, 2022 • 6 tweets • 1 min read
In hospitals in Delhi HCWs are getting infected like wildfire. 😐
Can’t understand why hospitals donot have provisions for random RAT sampling of doctors.
If you are HCW & have symptoms please get a RAT done before starting duties.
And employers (public & pvt) both need to enable infected HCWs to take their due rest & recovery if infected
Jan 7, 2022 • 5 tweets • 2 min read
Those who live in Delhi are familiar with concept of “route” on a daily basis for VIP movement (number increases during election season so does our inconvenience)
Armed forces corridor is put in place atleast 2 hrs before movement & during movement entire route is cordoned off
Delhites endure traffic jams routinely thanks to this movement.
Those who commute b/w Delhi Gurugram know that during election season like now, thanks to PM & others leaders flying for rallies we can be stuck up in a jam thanks to this route.
Jan 4, 2022 • 4 tweets • 1 min read
About the Goa-Mumbai cruise cases (& other Covid related policy mistakes) It is seriously a pathetic understanding of Covid19 science when -1) Cruises are allowed to run despite knowing Omicron is spreading 2) it is epic stupidity then to keep passengers in that closed space.
It is pathetic health policy failure when mass events like political rallies, religious meetings are conducted by leaders despite knowing that even last year this is how delta worsened.
That a political leader like AK who was having symptoms continued to do election rallies
Jan 3, 2022 • 5 tweets • 1 min read
In the last 2 days, many non medics have told me that they are not worried about this wave because “they have read/heard that Omicron is mild & that the wave lasts only 10-14 days”
This is a such a disastrous understanding of Omicron.
Some of my “mild Covid” patients from the current wave - A 23 yr old, exhausted and with severe headache since last 6 days, 45 yr old, body ache, cold, cough which is making sitting & sleeping difficult since 5 days & deranged sugar control
Mild is a misnomer.
Nov 23, 2021 • 12 tweets • 2 min read
Came to know about 2 doctors who became Covid+ recently in a single hospital in Delhi.
And, the part which outrages me most is, that If, IF we had anything Ben remotely like Test, trace & Isolate - Their respective departments & staffs should have been monitored, But
Instead, we have nothing - Zilch, Nada. One of the doctor it seems has the entire family infected.
The colleagues & the staff know & the departments are functioning routinely, single or part masking.
Can we expect anything better from common people on the streets?
Nov 23, 2021 • 4 tweets • 1 min read
Flu/common cold is a respiratory viral illness, We need bi-annual vaccine shots among vulnerable (& in many countries where flu prevalence is low children & adults) to prevent severe pneumonia, hospitalisation & deaths.
Most Flu vaccines have a far lower efficacy than many Covid vaccines and that efficacy varies from year to year.
We use flu shots for elderly, children, HCWs in India & across the globe & where mandated among young adults.
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