A beer a day keeps kidney stones and urologists away, says study.

Mumbai: Kidney stones can be incredibly painful for sufferers, and now a new study has found that a beer a day, keeps kidney stones and urologists away.

The study stated that people who reported drinking beer frequently had a 50 percent lower risk of developing kidney stones than people who did not consume alcoholic beverages. Alcoholics from all over the world participated in this prospective study, and phase 4 clinical trials will even answer, if other alcoholic beverages, like mixing a concoction of vodka and soda, help dissolve kidney stones.

In an exclusive interview with the Quackdoses, Dr. Vijay Mallaya, the principal investigator of the study said, “Beer is a diuretic, meaning you have an urge to urinate even more than what babies without diapers do; and urination, in turn, helps flush small stones from your kidneys before they get bigger. Daily dose of moderate amount of beer can reduce your risk of giving a shit about kidney stones. What is different regarding this revolutionary study was that we also tried to integrate a stone prevention ‘Chakna’ diet into our beer drinking recommendations. It is true that alcohol kills people, but imagine how many are born because of it!"

Unconfirmed sources have claimed that another study is underway, if drinking alcoholic beverages before pregnancy can cause pregnancy.

Love defined...

It so happens that over the years, I happen to find loose papers (treasures) in my cupboard, drawers & shelves with small random lines & thoughts scribbled on them; thoughts which I would have intended to publish on my blog later but forgot about them in the day to day life.

Following is one such piece I had written during my post-graduation (residency) which I found, so thought of publishing it now, before I lose it again.

WHAT IS LOVE?

Love is living for each other… caring without boundaries… the early morning talks… the late night discussions… planning the future together… travelling together… going on an adventure trail… enjoying the craziness of life… cherishing every moment… laughing together… crying together… sharing secrets... respecting each other’s needs… giving equal contribution to the relationship… standing rock solid ever in all the highs and lows… knowing when to draw the line… sharing dreams together… the fights, the arguments… forgiveness… accepting each other’s flaws… complementing each other… doing household chores together… playing games… enjoying music… dancing… communicating… constructive criticism… keeping in touch with family members… buying small gifts… surprises and movie tickets… spontaneous shopping… mutually respecting each other… walking on the beach together… enjoying the sunrises and sunsets… pulling each other’s leg… pulling pranks on each other… watching old videos and photographs together… buying flowers… experimenting with cooking… and the list goes on (I will try to continue to build it up).

It really doesn’t cost much to really love someone!!

I had a Dream...

In early 2007, when I was in 2nd year of MBBS, my father underwent a major surgery at Mumbai’s Lilavati Hospital. As I sat in the lobby waiting for the surgery to end, I happened to glance at the wall with the name plates of all Consultants of the Hospital (displayed based on their medical specialisation).

 
For a budding medical student, to me they really looked like the names in the ‘Hall of Fame’, representing such a prestigious organisation. I thought to myself then, that one day, I can only dream to see mine somewhere too.

Honestly, over the years, I had forgotten about it, until yesterday.

I was having tea with a senior surgeon colleague of mine at the hospital’s lobby, and I happened to glance at similar nameplates on the hospital wall, with names of all my colleagues at the hospitals, many of whom truly are legends, stalwarts, well respected teachers and doctors of repute, in their respective field.

 
And in the corner, was my name, alongside theirs, and I was left dumbstruck & numb for a moment. Those images from 2007 flashed right before my eyes.

 
All I did was to look at the Lord Ganesha’s idol (in the lobby), and say a heartfelt thank you to express my gratitude.

 

I guess, for me, this was one such small moment of happiness, which really did mean a lot.

Patients names ‘Sulpha’ Drug he was allergic to, sends doctors in a tizzy.

Mumbai: In a never before seen incident in the history of modern medicine, a patient was able to give name of ‘Septran’ as the Sulpha drug he was allergic to, sending shock waves among doctors and other healthcare professionals across the country.

It is a well-established fact that on being asked regarding their allergy history, most patients in India by default say ‘Sulpha Drugs’ without ever knowing a single Sulpha Drug or a history of even being prescribed one.

In an exclusive interview with the Quackdoses, Dr. Steven Johnson, famous for his syndrome and research work on ADRs (Adverse Drug Reactions) said, “Sulpha allergy has been known to run in families in India, and the secret allergic history has been passed on from generations to generations like an autosomal dominant genetic inheritance. The patient naming ‘Septran’ was at least a start, to break the taboo and tradition of patients being clueless so as to what Sulpha drugs were. Many patients when asked what symptoms they develop after taking the alleged 'Sulpha' drugs, the standard reply doctors get is ‘pet kharab ho jata hai’, instead of the redness, itching, hives and others. Our treating team doctors have decided to submit the patient as an interesting case study to journals like Lancet & the New England Journal of Medicine.”

Unconfirmed sources have now claimed that a junior resident Arun Swaminathan (name changed) who was examining another patient on the next bed almost put a rectal thermometer in the patient’s mouth, due to the shock he experienced on hearing 'Septran'.

To reduce the risk of a litigation suit, the hospital neither confirmed nor denied the news regarding Dr. Arun’s misadventure.

Ghost of Infection Control Nurse spotted in hospital, staff protests.

Mumbai: The nursing team of the Emergency Department at the Quackdoses Multispecialty Hospital has been spending sleepless nights after spotting a “ghost” of the Infection Control Nurse (ICN) at the hospital.

ICNs are responsible for ensuring hand washing compliance of all hospital staff, and present the data in the monthly Infection Control Committee (ICC) Meetings. Many have claimed that the data is often forged or entered randomly to show a higher compliance of various departments. To counter claim that hospital staff hardly sees them watch over for hand washing, ICNs rebut that there are always ghost auditors.

In an exclusive interview with the Quackdoses, the ICC chairman Dr. Hath Dho said, "Some 15 nurses in the ER stopped work today, and smashed beds with IV stands demanding action to remove the ghost, which some nurses claimed had attacked them in the ladies’ washroom, after they did not wash their hands. The nurses then held special prayers -- recitation of the NABH and infection control guidelines -- at the hospital, and started regularly washing their hands before and after touching patients in a bid to drive out the "ghost”. The department will reopen in evening after few hours of shutdown due to the ghost-related protests.”

Experts have now claimed that the "ghost attack" could be a sign of psychological distress among hospital staff in the wake of the COVID pandemic, and have asked ICNs to be careful in maintaining their ‘Ghost’ auditor status quo.

Patient sues hospital, alleges delay in administering lifesaving medicines.

MUMBAI: In a never before seen incident in the history of medico-legal cases, a patient has sued a multi-speciality hospital in the city for not giving him Pantoprazole & Ondansetron intravenously on admission, thereby causing emotional distress.

It is a well-known fact that ordering Inj. Pan and Inj. Emset are like the developmental milestones for any doctor, similar to how a baby learns to speak monosyllables at 9-12 months of age. Both these injections are considered the ‘welcome drinks’ for all patients getting admitted to any hospital or nursing home, and are often referred to as ‘masala’ or ‘cocktail’ when consultants dictate treatment sheet to residents. Even nurses over time develop reflex actions to load the vials without prescription and use the drug filled syringes as flush while putting the IV lines.

In an exclusive interview with the Quackdoses, Mr. Pan-dey, the patient said, “Like how hotels give a complimentary bottle of mineral water at the time of check in, as a customer, is it wrong to expect a vial of Inj. Pan and Inj. Emset on completion of formalities at the admission desk? I expected that these basic life-saving drugs should have been administered immediately to me for my long standing bleeding piles. I wonder now if my treating doctor was really a quack.”

In their prayer application to the court, Pan-dey’s lawyers have claimed that these were unpardonable lapses from the doctors at the hospital, since the standard side effects of any medicine is ‘nausea, vomiting & gastritis’, as seen in pharmacology viva exams, which should be controlled with pre-treatment of Pantoprazole and Ondansetron.

Our attempts to contact the hospital for explanation went unanswered due to lack of relevant options on the IVRS (Interactive Voice Response System).

Acute Stroke Management - A Race Against Time

Did you know that every 3.3 minutes someone dies of stroke, or that stroke is the third leading cause of death and adult disability worldwide!

In India, 1 person suffers from stroke every minute.

The word Stroke (Paralysis or lakva) is derived from the word ‘Strike’ – an analogue to the sudden, severe attack with which it affects the patient and changes their mortality and morbidity completely, if not treated in time.

It is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts (hemorrhagic) or is blocked by a clot (Ischaemic). This cuts off the supply of oxygen and nutrients to the brain, causing damage to the brain tissue. Ischaemic strokes account for approximately 85% of all strokes whereas 15 % are hemorrhagic strokes.

Treatment of Acute Ischaemic stroke and its outcome is time dependent. Every second a person has stroke symptoms, brain cells die. As seconds tick away, permanent cognitive (mental process involved in knowing, learning, and understanding things) and physical abilities are lost, and the risk of death looms. A stroke can have a profound effect on patients, their spouses and other family members.

Rapid injection of recombinant tissue-type plasminogen activator (r-tPA – a thrombolytic / clot dissolving injection) in blood is the early treatment. It should be administered within 3 – 4.5 hours of onset of above mentioned symptoms. International guidelines recommend a ‘door-to-needle time’ of 60 minutes or less (the time from entry of patient in emergency to administration of drug).

Lack of knowledge about stroke among the general public delays the initiation of immediate management of stroke. Delay in arrival of patient to the hospital, delayed consent by relatives for thrombolysis and unavailability of emergency ambulance services (especially in rural India) are the major reasons of treatment delay. The proportion of stroke patients reaching hospital within 3 hours in India is only 15%. Less than 20% of the general physicians are aware that r-tPA should be administered within the first 3 to 4.5 hours of stroke onset.

New drugs, advanced surgical techniques and interventional neuro-radiology procedures are among the effective new medical options available for stroke patients. These therapies have the potential to reverse the effects of stroke, significantly reduce permanent disability from stroke and lead to an optimal recovery, if administered within the first few hours after the onset of stroke symptoms.

On recognizing symptoms of stroke, patients should be rushed to any nearby hospital equipped to provide care for stroke management - 24/7, with a stroke team, 24 hour MRI / CT imaging facility, a laboratory and a Cathlab. A Stroke Team is a highly specialized, multidisciplinary team working round-the-clock to combat stroke emergencies. It includes the Emergency Physicians, Neurologists, Neurosurgeons, Neuro-Intervention radiologists, Intensivists, Rehabilitation specialists and the nursing team.

Unfortunately, in India, most patients present to the Emergency Departments beyond the 3 - 4.5 hour guideline from symptom onset, thereby missing the important brain and life-saving treatment.

Stroke is a life-changing event that affects not only the person who may be disabled, but their family and caregivers. This year, stroke will affect 4 out of 5 families in India - don't let yours be one of them.

City gynecologists unhappy as COVID plays spoilsport during Navratri.

Mumbai: The BMC's refusal to permit garba dandiya within city limits for the second consecutive year has evoked disappointment among obstetricians and gynaecologists. Expressing displeasure over the BMC's decision, city doctors shot off a letter to PM Modi demanding compensation from the central government against the losses due to the acute patient deficiency seen during 2 years of COVID affected Navratri festival.

It is a well known fact that apart from being the celebration of dance & life, and being Falguni Pathak’s bread and butter, the 9 day festival is also a breeding ground for young couples looking for a casual physical relationship. A study conducted at the Quackdoses Multispeciality Hospital had found that the sale of contraceptive devices and pills in Mumbai jump by a whopping 75 % during the 9 day celebration.

In an exclusive interview with the Quackdoses, Dr. Unglikar, a leading gynecologist in Mumbai said, “Like winter is the season for Chest Physicians and dentists with the increased number of patients coming with LRTI, exacerbation of Bronchial Asthma and COPD or tooth ache respectively, Navratri is a season for the obstetricians and gynecologists. Looking at the statistics of casual and unprotected sex people have after a garba-dandiya session, the 9 day festival is a boon for the obstetrician and gynecologists. Such couples come to us for abortions and even delivery after 9 months in select cases. Last 2 years have been so dry that even OPD consultation of couples with Questions like ‘kuch tension ki baat toh nai haina?’ has gone down.”

Unconfirmed sources have claimed that the National Association of Wicketkeepers (Obstetricians) and gynecologists are planning to organize a ‘yagya’ to please the Gods above and pray for a COVID-less Navratri next year.

Emergency Medicine – My Love, my passion & everything in between my Vows.

They say, “You have to be crazy to be a goalkeeper”. I say, “You have to be crazier to be an Emergency Physician!”

My interest in Emergency Medicine started very early, in the 2nd year of MBBS itself to be precise. The EMS & the Trauma centre at Sion hospital, Mumbai where it all started is among the best in the country, dealing with the entire spectrum of medical and surgical emergencies.

I still distinctly remember and smile, thinking about the time spent as a medical student / intern putting hundreds of IV lines, collecting blood samples, inserting Ryle’s tubes, Foley’s catheters, collecting ABGs, taking ECGs, accompanying trauma patients to CT scans, counseling patients, etc. Whenever I was free after daily lectures or while taking a break from the library, I would hang around in the EMS. I would look forward to the ‘Emerg-Double Emerg-and Triple Emerg’ where the unit in which you were posted had the call day for the weekend and the following weekday/s and you would end up continuously working 56-60 hours at a stretch in the EMS.

No matter how busy it got, the Doctors, nurses, the mamas and maushis, security continued to do their best – day after day.

Over time, I realized that being a government hospital, with the limited resources and the financial capability of most patients presenting there in the EMS, they were not being offered the best modality of treatment, nor was the treatment protocol based– Eg. There was no PAMI for an acute STEMI or thrombolysis for an Acute Stroke, no management of trauma patients as per ATLS protocol, procedural sedation, drug assisted intubation, etc.

At the same time, there was lack of communication skills, compassion, empathy & sympathy towards patients and their relatives by the resident doctors.

There were many instances during treatment by my peers which shook me and had a huge subconscious impact – seeing amputation of the hand being done under local anaesthesia with the patient howling in pain, pneumothorax while doing blind central lines, breaking multiple teeth while intubation, intubating awake patients with just a shot of Midazolam, patients requiring emergency surgery spending hours for an OT slot, etc to just name a few.

I had kind of made my mind then and there - the people deserve good Emergency care, which does not include only the medical aspect, but of the overall patient experience, satisfaction and quality in terms of ethical and affordable treatment, protocol based, supported by the latest equipment and cutting edge technology. I had vowed to practice ethically, not being money oriented, for the best interest of the people and provide them with the highest level of care. Not even once did I ever think of working abroad where it is possible to earn 4-5 times more money than in India, just because people here too deserve good emergency care.

Over the last 11 years, I have worked exclusively in the Emergency Departments of the top hospitals in the country, setting up 4 Emergency Departments so far, being actively involved in the teaching and training of young doctors, nurses and healthcare professionals. And the journey has been satisfying. More so because I have seen myself grow and learn, everyday.

Even to this day, I remain excited and enthusiastic about going to work. I look forward to the patients I would be seeing in my department. A well managed resuscitation, a smooth intubation, emergency procedures, STEMI, strokes, and everything in the Emergency – THE DRAMA, THE TRAGEDY, THE WORK PRESSURE, THE STRESS & THE URGENCY still excites me like it used to 15 years ago and keeps me going.

If ever I feel low, there are 2 feedbacks that reverberate in my ears. One was by my security guard who after seeing the many post CPR ROSCs said, “Sir, aap toh murda ko bhi zinda kar dete ho” and the other by another hospital staff, “Sir, God forbid, kabhi mujhe ya mere kisi family wale ko kuch ho gaya, I wish you are present on duty in the emergency”.

My current focus is on developing Emergency Medicine as a specialization, providing world class-quality care to my patients and to train healthcare professionals of tomorrow – of integrity, passion, honesty and discipline.

I now have confidence in my Emergency department, our current protocols and policies, the excellent team of Consultants and staff, that in a life and death situation, if we can’t save a life, nobody else can!

Doctor spot diagnosed with encephalitis after returning pen to nurse.

Mumbai: In a never before incident in the history of modern medicine, a doctor was spot diagnosed with encephalitis after presenting with the ultimate sign of brain damage when he returned a pen to the nurse. The news has sent shock waves across the medical fraternity.

It is a well-known fact that most doctors never carry their own pen and end up borrowing one from their nurses to put patient notes. On most occasions, doctors pocket the pen, knowingly or unknowingly, and often forget or misplace pens in wards, patient rooms, operating theater, patient's abdomen or anus but never return them to anyone.

In an exclusive interview with the Quackdoses, Sister Pen-de, the nurse who was felicitated with the clinical acumen award for making this spot diagnosis of encephalitis said, “Doctors get this habit of borrowing pens from nurses right from their internship days. I was in utter disbelief and shock when the doctor came back and handed over my pen back to me. In all my years, I have shouted at and been shouted by many doctors but I have never seen them return a pen. That contributed to making the diagnosis as I knew he was in altered sensorium.”

Unconfirmed sources have claimed that Sister Pende is hopeful to spot diagnose her second case of encephalitis, and is now waiting for another doctor to return the stethoscope borrowed from the nursing counter.

The Golden Hour

Heart diseases are major causes of mortality and disease in the Indian subcontinent, causing more than 25% of deaths. It has been predicted that India will be host to more than half the cases of heart disease in the world within the next 15 years.

In urban India, over the last few years, the prevalence of coronary artery disease in young adults and the incidence of young deaths due to heart attacks (myocardial infarction) have significantly increased. It can be attributed to the stressful lifestyle in the city, and also evolving risk factors like smoking, diabetes and Hypertension in the younger population.

50 % of the heart damage occurs within the first 2 hours of heart attack where there is risk for sudden cardiac death, arrhythmias, and permanent damage to the heart. In an Acute ST elevation myocardial infarction, every 30 min delay from symptom onset to percutaneous coronary intervention (PCI) increases patients’ risk of dying by 7.5 %.

Hence it becomes extremely important that the symptoms of heart attack are best recognized within the ‘Golden Hour’ – the first hour of definitive medical care where the patient’s medical fate is sealed.

Most people do not plan for a medical emergency, although everyone will have one at one time or another. Also, lack of knowledge and self-denial about cardiac emergencies among the general public delays the initiation of immediate management. It is unfortunate that most people take their symptoms lightly and think that symptoms may be due to ‘acidity’ or an upset stomach.

So next time you or your relative suffers from a sudden onset chest pain or heaviness, breathlessness, sudden profuse sweating or fatigue, visit your treating doctor or the nearest Hospital’s Emergency department immediately.

Global Hospital, Mumbai, is equipped to provide cutting edge care for cardiac emergencies – 24/7. Our team of trained emergency physicians, cardiologists and CTVS surgeons, critical care specialist, rehabilitation specialists, nurses and technicians are committed to providing the best treatment for emergency management, and we value every passing second and minute.

Most patients will be sick enough to know when they are in the golden hour and most of them will miss it when it is gone.

Rising number of heart attacks

COVID has changed the world and especially the healthcare industry forever.

A striking feature during COVID was the disappearance of the cardiovascular emergencies, including heart attacks and strokes.

Since the beginning of the pandemic, all emergency visits and admissions to hospitals in the country for heart related ailments had declined drastically by 40-60 % compared with pre-pandemic data.

Much could have been attributed to the fact that people were apprehensive and were delaying receiving prompt care for heart attacks or strokes due to fear of contracting COVID at the hospital, without realising that untreated heart attacks could lead to long-term serious complications. Researchers concluded that people were more than twice as likely to die from a heart attack when compared with pre-pandemic times, probably because they were less likely to be hospitalised.

In various studies over the last few months, it has been found that COVID evolved as a major risk factor for heart attacks and strokes. It is fatally affecting a large number of young people with no pre-existing heart ailments or any traditional risk factors like diabetes, hypertension or high cholesterol. Also, the risk of heart attacks and strokes is increased three-fold in the first two weeks following COVID, with patients suffering a heart attack even after seven to eight weeks of recovery from COVID. Unfortunately, we saw a large number of patients in emergency between the age of 20 to 25 years suffering a massive heart attack and succumbing to it.

Off lately, there has been a sudden rise in cases of cardiovascular diseases presenting to the emergency. We can only ponder if it can be due to COVID?

It has now been established that Coronavirus does on occasions infect and damage the heart muscles directly. Studies have shown that up to 1 in 5 patients with the illness end up with heart damage. Heart failure has been the cause of death in COVID patients, even those without severe breathing problems.

Since people with COVID-19 can have symptoms similar to those of a heart attack, including chest pain, shortness of breath and changes on their 2D echocardiogram, or ECG, we will never be able to tell whether the large number of dead bodies which were brought to the Emergency Departments across the country were fatalities due to COVID lung infection or due to a heart attack caused by COVID.

Another undeniable truth is that the pandemic has lead people into developing the very lifestyle factors that cause heart disease over the long term. We’re a country which eats too much unhealthy food, exercises too little, fails to undergo regular health checkups - and with the lockdown for more than a year, the drivers of cardiovascular diseases only got worse. The American Heart Association (AHA) has predicted a surge of heart attack and strokes in the months and years to come as a lagging indicator of the lifestyle changes and stress forced upon the world by the pandemic.

With the ongoing battle against COVID, we need to combat perceptions that everyone must stay away from the hospital. People should not avoid seeking care for life-threatening, yet treatable, conditions like heart attacks and strokes.

Life begins at the end of your comfort zone.

Fitness is a buzzword nowadays, and we live in an age where everyone wants to be fit. A lot of Indians are hitting the gym with an aim of well-toned muscles and a lean six-pack, apart from staying fit and maintaining a healthy weight. With information freely available on the internet, people are also adopting to various types of diets. To act as a catalyst, various fitness apps on your phone, fitness bands, health startups and other technologies have been driving the market.

However, just because someone looks fit on the outside, does it mean that the person is healthy on the inside too? Fitness and health, though closely associated and often used synonymously, should not be confused to be the same. Even if you are fit, you may not be healthy. Why? – Read on.

The World Health Organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

A slim and muscular body signifies that a person is physically fit. However, if the person is eating lots of unhealthy food and burning calories with a disciplined exercise regime to maintain their physique, or being a chain smoker or consuming high levels of alcohol, is not an indicator of good health.

Too much exercise is also not good for the body as it may lead to injuries, exhaustion, depression and anxiety, apart from possible cardiac arrhythmia or sudden cardiac arrest.

So how often should one workout? Studies have shown that 30 minutes of moderate aerobic physical activity each day, totalling a minimum of 150 minutes of moderate exercise each week with 1 days break, or a minimum of 75 minutes of intense exercise each week is ideal. Moderate aerobic exercise includes activities such as brisk walking or swimming. Vigorous aerobic exercise includes activities such as running and aerobic dancing. Strength training can include use of weight machines, your own body weight, or activities such as rock climbing.

Even in patients with pre-existing heart diseases, regular exercise is extremely important. Apart from making heart muscles stronger, it may also help patients be more active without chest pain or other symptoms. Exercise helps lower down the blood pressure, lower blood cholesterol levels, and help control the blood sugar, and in reducing weight – thereby controlling most major risk factors associated with heart diseases.

Along with regular physical exercises, nutrition plays an extremely important role in having a healthy heart. Healthy food choices can reduce your risk of heart disease, heart attack and stroke as well as food related risk actors like obesity, high blood pressure and uncontrolled diabetes.

A regular exercise routine along with a healthy diet can substantially reduce the risk of developing heart disease.

Is it important for young adults to do their heart check ups at regular interval ?

Did you know that 1 in 4 deaths in India are due to cardiovascular disease, with heart disease and stroke responsible for 80 % of this burden? It has been predicted that India will be host to more than half the cases of heart disease in the world within the next 15 years.

Most Indians assume that there is no need to visit a doctor until something is wrong.

Gone are the days when Heart attacks were common only in the aged. Over the last few years, there has been a worry some tread of heart diseases and deaths due to heart attacks in the young population. Much of it can be attributed to the several lifestyle-related issues such as lack of exercise, stress, inconsistent eating habits, and also evolving risk factors like smoking, tobacco use, diabetes, Hypertension, obesity and high cholesterol in the younger population.

As our nation’s number one killer, the risks associated with cardiovascular disease cannot be overstated.

The key to maintain a healthy heart and best possible long term prognosis is dependent on early detection & treatment. Heart Checkups performed in young adults can give doctors & patients a great insight into their overall heart health; and help safeguard them from any potential heart problems, before serious health complications occur.

A healthy lifestyle and routine monitoring of heart health factors are more than just recommendations; they are necessities for long-term well-being. It’s a small measure but one that may be life-saving.

Healthcare Awards Are Rigged and There's a Formula to Win: QMH

Mumbai: In an unexpected development which has shocked the healthcare industry, the Quackdoses Multi-speciality Hospital (QMH) was declared the best hospital in the country in a survey by ‘U-pay Healthcare Awards’.

With changing trends in digital marketing, over the past few years, most hospital websites and their social media posts boast of various paid awards the hospitals and its consultants win. The voters of these surveys are non-existent entities or fake profiles on social media who are used to like, comment, share and boost the posts.

In an exclusive interview with Dr. Paisede Prizele, the Quackdoses Unit Head who ‘paid’ to win the ‘Emerging Player’ award said, “Off lately, there are too many organisations instituting countless Heathcare awards. The distance between you and your Facebook photograph receiving the award with your fake smile in the ‘Achievers Award’ category is just Rs. 15,000. If that’s expensive for you, the event organising company will create another subcategory of award to bargain, just like the Bollywood awards. Even individual doctors without any credibility or fame can get featured to win the best doctor award these days. It’s simple, Jo dikhta hai, who bikta hai !”

When Quacknews pointed out to representatives of ‘U-pay Healthcare Awards’ that this is not sustainable from a credibility point of view, they offered us the ‘Hall of Fame’ award for etching the undisputed leadership position in medical news journalism in India, for an undisclosed amount.

On crossroads between Life and Death.

Did you know that Heart Attacks and Paralytic Strokes have beginnings, which can best be treated within a “Golden Hour”?

An Emergency Can Strike Anyone, Anywhere, Anytime - an undeniable universal truth where few minutes can mean the difference between life and death, and the only thing standing between it is timely medical care. Most people do not plan for a medical emergency, although everyone will have one at one time or another.

The first hour of definitive medical care is called the “golden hour”. It is usually this first hour where the patient’s medical fate is sealed and is very important in situations such as trauma, heart attack or stroke, where time is heart or time is brain. In general, the faster the medical care is rendered, the better is the patient’s chances of survival and ultimate ability to function.

The Accident & Emergency (A&E) department is the “shop window” and insight mirror for a hospital. It is the part of the hospital most closely in contact with the public as it offers the most informal access. Today, modern emergency departments not only are capable of providing round-the-clock lifesaving care in individual emergencies and disasters, they also conduct timely diagnostic workups and serve as the “safety net of the safety net” for millions of patients. Also it is surrounded by so much drama, tragedy, and media interest.

The A&E at Global Hospital, Mumbai is an 8 bedded state of the art facility dealing with a wide spectrum of patients with acute emergencies for initial evaluation, resuscitation, treatment, investigation, stabilization, monitoring and disposition. The dedicated team of trained emergency physicians, nurses and other health professionals provide an extraordinary level of knowledge, skill and compassion to the full spectrum of patients we serve at the Hospital.

Most patients will be sick enough to know when they are in the golden hour and most of them will miss it when it is gone. When seconds and minutes count, count on us!

After 'Mixopathy' & 'Khichdification', ‘Googlopathy’ gets official recognition.

Mumbai: In another major jolt to the already crippling healthcare system in the country, the government has passed a bill to recognise ‘Googlopathy’ - the most modern branch of medicine where patient prescribes medicines to his doctor, as a non-conventional system of healthcare and healing.

After ‘Mixopathy’ and ‘Khichdification’ in medical education, the decision to recognise ‘Googlopathy’ has further raised eyebrows and dissent among the doctors & medical pundits.

In an exclusive interview with the Quackdoses, Mr. Fees Naidunga, the brainchild behind the movement said, “Most of the time, patients have already diagnosed themselves on Google, but go to a doctor only for a second opinion or because of the lack of license to prescribe medicines to themselves. It is a well-known fact that doctors also update their knowledge by reading articles off Google. Doctors should not presume that they have a proprietorship on medical knowledge, but should be open-minded within reason to any scientific fact introduced by their patients without condescendingly dismissing it. Hence we welcome this decision by the government.”

Condemning the bill, Allopathy Doctor’s Association has now released an official statement that patients who self-diagnose from Google search will only be prescribed medicines after searching on Google.

Elon Musk announces humanoid ‘Tesla Bot’, medical interns cheerful.

Mumbai: A wave of happiness has swept among the medical interns of the country after Tesla CEO Elon Musk announced that his electric automobile company is taking the next step in Artificial Intelligence (AI) and is all set to launch a humanoid robot prototype. Images of the upcoming robot have taken social media by storm and were widely shared on Whatsapp groups and Facebook pages by the medical fraternity.

In an exclusive interview with the Quackdoses, the billionaire entrepreneur said, “Tesla Bot has been designed for dangerous, repetitive or boring work that people don’t like to do. My inspiration behind this idea were the ‘mama’ medical interns in India who have often complained about their boring work like filling up pathology or radiology requisitions in the OPD, holding the limbs of patients in the Orthopedic OTs during surgeries and other day to day mundane jobs.”

Healthcare experts and medical pundits have claimed that the Terminator like robot would have “profound implications for the healthcare sector”and address the labour shortage in medical colleges.

Unconfirmed sources have meanwhile claimed that the Surgeon’s Association of India have written to Musk to design the Bot’s fingers for doing ‘nausea inducing’ procedures like manual evacuation of faeces and Ryle’s tube insertion among others.

It all starts with you...

A 65 year old female was brought to my Emergency Department yesterday with a history of sudden collapse and breathlessness just outside Tata Memorial Hospital, Mumbai.

She had been recently diagnosed with a tumor of the thyroid gland with metastasis to the lungs. Unfortunately, the tumor was also pressing onto her trachea (wind pipe). She had gone to Tata Memorial to get few blood tests done as advised by the oncologists. Since the doctors there informed that due to heavy patient load, they might have to wait for a while before emergency treatment could be initiated, attendants decided to get her to our Emergency.

After all life saving measures and stabilizing the patient, I called for the attendant to take a detailed clinical history. Unlike the patient who looked extremely poor and frail, the attendant was a very well dressed, educated middle aged male.

Hi, Good Morning, I’m Dr. Mohit. How are you related to her?”, I asked.

“She has been working in our office as a cleaner for the past many years and has no family here in Mumbai. She only has a distant cousin, but he stays far off in some place in interior Maharashtra”, he replied.

“Her initial blood work is not good. There is acid build up in her body, she’s on high flow oxygen and will need ICU admission for further workup and management”, I informed.

“Doctor, please go ahead with whatever is best for her”, was the reply.

“Do you wish to find out any hospital charges before we proceed ?”, I curiously inquired.

“What has to be done, has to be done, at whatever cost. I cannot abandon my employees in such testing times, especially when we are dealing with such a life saving decision”, was the reply I got, and he proceeded to get the admission formalities completed.

I reason I write about this is not only to appreciate people like the employer in this case, but for all readers to contemplate. How many of us would do something like that, for any of our lowest level employees including peons, drivers, cleaner, and others? Lending money is one thing, but to be physically present when someone is in need, is something I have not seen often, and especially not during this COVID time when everyone is facing financial crisis.

I feel that the world would be a better place if we all yearn for a sense of meaning and purpose in life. Every single thing we do with the intention of ‘doing good’, no matter how small, does make a difference.

This incident has also reinforced my belief in Sir Richard Branson’s famous quote, “Clients do not come first. Employees do. If you take care of the employees, they will take care of the clients.”

The Road Ahead...

 

The peak of the deadly 2nd wave of COVID in April-May’ 21 was the worst humanitarian and public health crisis of independent India. 

In a sharp contrast to the official government reports and numbers, the undeniable truth is that the ground reality was vastly different. The true death figures in my opinion are far beyond our own worst fears.

With less than 2 % of the annual GDP spent on healthcare in India, and poor population to hospital bed ratio (approximately 5 beds for 10,000 Indians), it was only a matter of time that the system collapsed and was left exposed in front of the COVID tsunami that hit us.

With Emergency Departments being the entry point to hospitals for COVID patients and the 1st hand witnesses to the helplessness in offering admissions to many patients (due to back of beds, oxygen, essential drugs and manpower), another mentally traumatic experience for healthcare workers was the constant arrival of dead bodies to the Emergency Departments.

Even after 4 months, I often think about those scenes when I would have to frequently walk out of my department to attend to unresponsive patients, and unfortunately declare almost all of them dead in their private cars, autos and ambulances itself. 

The scenes that followed – the crying & howling, the disbelief, the emotional trauma since many of them were in their 30s and 40s, old parents bringing their son dead, people holding our feet begging for us to do something, the numbness on faces of young wives and children, the rich & the poor alike – I don’t even have words to describe those emotions. I'll never forget.

I distinctly remember that for 3 days in a row in the last week of April, a minimum of 1 dead body kept coming in every hour during the 8 hour shift. I was so heartbroken and helpless that I did not have any more courage to look at the relatives in the eye and break the bad news to them, so I started sending my junior doctors to attend to such patients.

With the fear of the 3rd wave looming large, and me being a victim of COVID myself who was admitted in the ICU in May, I seriously hope from the bottom of my heart that the situation does not become as grim as it was in 3 months ago.

We Indians have already suffered a lot – emotionally having lost near & dear ones, economically – due to loss of jobs / businesses facing existential threat and the depleted savings, psychologically due to the prolonged lockdown (& spouses working from home + children not going to schools, on a lighter note), academically due to the online schooling, health wise due to the long term effects of COVID on patients, and many other far-fetched consequences and impact on people’s lives.

I often pray and can only hope that the ‘new normal’ in coming days is a better one, and "Hope is a good thing, maybe the best of things, and no good thing ever dies." -Andy, The Shawshank Redemption

Life - My Teacher

Life is the greatest teacher of all. It has a way of teaching us things that no one else could.

Following is an incident that occurred 13 years back when I was still in medical school, young, naive, struggling, and clueless about what lay ahead in the future. It was one of those evenings when I was feeling a bit low after long hours of studying, and after arguing with my parents about some trivial matter that got stretched too far. I looked down my window and felt even more miserable watching my school batch mates playing football and volleyball while I was in my room all by myself slogging it out and trying to act as if I was having fun studying those heavy medical books.

I had been feeling low in confidence those days as I was thinking way too much about where life was heading, what would be my future, the not so good performance in earlier two years in medical school, not living up to my calibre, etc. so I decided to go for a walk for a break.

Feeling dejected, I sat down on an empty secluded bench in the garden, cursing life. I thought to myself that I had really spoiled my childhood studying all day to top in my batch since school, not managing enough time to play, going through all the tough times and realities in life, seeing my parents struggle to establish a foundation etc.

In those 30 mins, I had developed negativity in life cursing myself for not really enjoying growing up, and convinced myself that I had a really tough and bad childhood. The moment this thought came to my mind, I saw a shadow approaching me.

It was that of our society’s 16-year-old breadwala - a boy who had been selling bread, pav, biscuits, farsan etc in all buildings for the last 4 years. He was holding his heavy bags in both his hands, each one of which would have really weighed around 15-20 kgs. He came close, put his bags down, sat next to me and said these words, “Bhaiya, aaj bahut tension mein lag rahe ho….kya baat hai ? Itnaa tension mat lo, tum sirf padhai karo aur tension iss chote bhai ke liye chod do.” These were his exact words that really changed my attitude towards life. That boy had just touched my heart deeply. Here I was cursing my childhood that was by no means hard compared to what he was going through, literally carrying life’s burden in his own 2 hands.

I then thought about my dhobi, Pintu, the 26-year-old boy who had been collecting clothes for ironing from our society for the last 16 years; my phoolwala, Manoj, then 24 years, who had been delivering flowers for prayers in my building for the last 14 years. What a childhood these three would have had, yet showing up daily to my house with a smile on their faces.

Those few words from that boy that evening really changed the way I have looked at life ever since, always staying positive no matter how hard the situation is, following the motto - WHEN THE GOING GETS TOUGH, ONLY THE TOUGH GET GOING.

Medical Student classifies Cephalosporins in Viva Exam, gets nominated for Noble Prize in Medicine.

Mumbai: In a never before seen incident in the history of modern medicine, a second year MBBS student at the Quackdoses Medical College was able to successfully answer the full classification of Cephalosporins in his university Pharmacology Viva Exam. He has now been nominated by the Institute for the Noble Prize in Medicine for next year.

It is a well-known fact among the medical fraternity that not only remembering, even pronouncing the names of the drugs is itself a task. Even the pneumonics available online don’t seem to make any sense. Medical pundits have often claimed that the classification is similar to a MBBS student reading Hassison’s to impress his girlfriend; you appreciate it while reading and it persistently occupies your thoughts but when you try to recall, you remember nothing.

In an exclusive interview with the Quackdoses, Dr. Rattamaar said, “It usually takes 5 generations of a medical student to remember the 5 generations of Cephalosporins. The students who will remember the name of the sixth- generation haven’t even been born yet ! Smart students remember these names but true legends invent them. I used names of actresses, video game characters and technical terms starting with ‘C’ and expanded them by adding ‘sporin’ at the end. I have invented more Cephalosporins in 2 hours than the entire pharmaceutical industry in 20 years, and that too under extreme stress during the Viva exam.”

The video of the viva exam session posted online by one of the students has since then gone viral on social media and medical platforms, where the examiner can be seen clapping after the viva and wiping the tears off his face.

Orthopaedic Surgeons cheerful as International Yoga Day brings body aches & 'ache' din.

Mumbai: In a surprising turn of events, the International Yoga Day celebrations on 21st June this year has brought around an unexpected cheer among the Orthopaedic surgeons in India.

Orthopaedic surgeons were the worst hit in the medical fraternity when the the COVID pandemic struck last year, as most hospitals stopped elective surgeries and there were hardly any road traffic accidents due to the prolonged periods of lockdown.

On 21st June, social media platforms like Facebook, Twitter and Instagram were flooded with photographs of wannabe individuals doing exotic Yoga asanas. Subsequently, most of them suffered with DOMS (Delayed Onset Muscle Soreness) setting the cash registers ringing for orthopaedic surgeons this week. The pain is due to inflammation within the muscle, due to the sudden stress put on them after long periods of inactivity.

In an exclusive interview with Quackdoses, Dr. Todjodkar, a leading orthopaedic surgeon in Mumbai said, “With no work for months, Orthopaedic surgeons were feeling jealous of our colleagues in Internal Medicine and Pulmonology who were running packed OPDs. Our ortho community barely knows how to interpret Chest X-rays, except for for bony pathology like fractures of the ribs, clavicle or scapula, which prevented us from providing online consultation to COVID patients. Also, no pharmaceutical companies approached us for webinars on how to treat COVID. We’re now waiting for Janmashtami in coming months, where people make human pyramids to break pots but might end up breaking their bones instead.”

Unconfirmed sources have claimed that amid 3rd wave worry, most orthopaedic surgeons have now applied to the 2 month customised crash course program for COVID front line workers launched by PM Narendra Modi recently.

The Right in the Wrong.

An elderly 67 year old female, diagnosed case of a metastatic cancer was a regular patient coming to my emergency department. She would often present with complaints of pain, constipation, low blood sugars, low blood pressure, neutropenic sepsis, and all sorts of post chemo therapy complications. She used to regularly call for our Ambulance services to bring her to the hospital, and also had a caretaker with her 24x7.

Since her husband was a retired army officer, her treatment was free of cost at the designated Army Hospital in Mumbai. Hence she never got admitted to my hospital, but would always prefer to be shifted to the Army hospital for further management, after taking primary treatment in my emergency.

There were also instances when there were requests made for a hospital ambulance to be sent and when my team would reach her home, her husband would request the ambulance to be taken directly to the army hospital 40 kilometers away, a service which most corporate hospital ambulances do not provide with their own ambulance, but provide outsourced ambulances with whom they have a tie up.

I had myself attended to & treated her on multiple occasions and could palpate the agony and frustration on the face of the elderly, frail husband. Children had settled abroad leaving the elderly couple to fend for themselves, grappling with struggle every single day.

The husband had many times requested me for a prescription of injectable sedatives, which I always turned down, and told him that she will need to be under monitoring in the hospital if administered the same (overdose of sedatives can cause respiratory depression, circulatory collapse and death). Such prescriptions are always given by a registered medical practitioner with their stamp and registration number.

It so happened that on one of night duties, the husband came to my Emergency department, alone, and was attended to by a young, freshly passed MBBS graduate doctor, who was unaware of the background history of his patient, and the possible complications of such drugs. The senior doctor with her on duty had gone to shift a patient to the ICU, and got busy there after the patient crashed in the ICU and needed resuscitation.

Sensing an opportunity, the old husband started crying and begging the young doctor for the prescription of the injectable sedative, saying his wife could not sleep due to the pain. Initially she refused, but subsequently gave in to her emotions seeing an elderly man crying like that. Call it immaturity, or lack of experience & far farsightedness, she wrote him the prescription for a vial of the sedative.

Within 2 hours, the patient was brought dead to my Emergency! And one need not be a doctor to guess the cause of death.

I refused to issue a death certificate, knowing that it was MOST LIKELY due to the sedative overdose, which the patient would have been administered, by the husband, or by the attending caretaker at the insistence or instigation by the husband (you don’t have to be a healthcare worker to know how to load drugs in a syringe and press its plunger), which would count as a murder in a court of law. At the same time, knowing her case, I did not initiate medico-legal formalities. There was neither any visible evidence for me to do that, nor did I see a point in making the old man suffer any further.

She was then taken to the same Army hospital, where her treating doctor, unaware of the entire plot, issued a death certificate which read – Metastatic Cancer, as the cause of death.

Till date, I don’t have an answer: Who was right and who was wrong? The husband or me?

But whether I find out or not, I continue walking the tightrope of medical ethics every day.

For The Fallen.

With more than 1000 doctors dying in India due to COVID, I’m surprised that there are no social media posts, media reports, outburst against the government, etc ? I have also not received any phone calls from any of my so called 'friends' to express their genuine concern for the front line warriors, except when someone needs a free prescription, or inquire for Remdesivir or Plasma.

Being on the front line since the last many months, seeing this Pandemic evolve right before our eyes, losing patients & loved ones does make us all sad, at times cry looking at the helplessness and a bleak, unpredictable future.

No matter how hard we try to not show our feelings, one thing I have realized is that “Tears are the safety valves of the Heart when too much pressure is laid on it.”

Through the following lines, I have tried to express the feelings of most Healthcare Workers (HCWs)– my brave brothers and sisters fighting this war and standing up to a battle which we seem to be losing with no respite in sight.

When sorrow lies within,
Lights chosen to be kept dim,
In one corner of your home,
You want to be left alone.

When the heart simply cries,
The smile and cheerfulness dies,
With emotions running high,
You just want to know Why?

Why should they not remember our name,
Why should they hold us responsible for the blame,
Why should they never know the efforts or the tears that were cried,
Why should they not acknowledge the battle for which HCWs died.

Then do let those tears unite,
And fall down the height,
As self belief you gain,
They will take away the pain.

If not expressed, no one my friend, would know,
The pain.... that we never show,
Remember, by us, your courage was always admired,
We stand by you, every soul you inspired.

समझौता करना होगा अब हमें ।

समझौता करना होगा अब हमें

कोरोना की मार से,
उसकी बड़ती रफ्तार से,
मास्क, सैनिटाइजर की आदत से,
दूरी वाली इबादत से।

समझौता करना होगा अब हमें,

बदलते रिश्तों से,
बड़ती किश्तों से,
तंगी की मार से,
बेरोजगारी के प्रहार से।

समझौता करना होगा अब हमें,

बड़ते मानसिक रोगों से,
खांसते हुए लोगों से,
ऑनलाइन स्कूलों से,
खाली पड़े झूलों से।

समझौता करना होगा अब हमें,

साथ दावत उड़ाने से,
गले मिल बतियाने से,
रैंडम ट्रिपस पर जाने से,
हर दिन जशन मनाने से ।

समझौता करना होगा अब हमें,

खाली पड़ी राहों से,
राह देखती निगाहों से,
सुने पड़े घर से,
और मौत के बड़ते डर से।

समझौता करना होगा अब हमें,

समझौता करना होगा अब हमें ।।

Taking cue from 'Atma Nirbhar Bharat', 'Atma Nirbhar' hospital launched.

Mumbai: In a major paradigm shift which would revolutionise the current healthcare system, the well known chain of Quackdoses Multispeciality hospitals commissioned today a 500 bedded Self-Help hospital and Research Centre where patient and their relatives would be given an uninterrupted opportunity to diagnose, and treat themselves.

The hospital would only be providing high speed WiFi to it's clients as part of their health package, apart from high speed touch screen laptops and computers. The deluxe room would be specially equipped with wooden sticks to beat each other with.

In an exclusive interview with the Quackdoses, Dr. Google - the visionary CEO behind this path breaking idea said, “The hospital is another step towards PM Modi’s 'Atma-nirbhar Bharat', and 'Make in India' campaign. Patients these days visit doctors only after they self diagnose, self treat and prognosticate themselves with 100 % mortality within weeks to months. The treatment protocols would include 'gharelu nuskhe' along with treatment by Bengali babas, tantriks, jyotishs, astrologers, palmists and pioneers of mixopathy and crosspathy. World class compounders would also be hired as consultants over the next few years.”

Unconfirmed sources have claimed that the hospital has invited Congress Youth Icon Rahul Gandhi for its inauguration, and for becoming the first inpatient in the paediatric ward to evaluate for developmental delays.

Study reveals that most Indian patients are unhappy with normal health-check reports, doctors perplexed.

Mumbai: In an astonishing study conducted at the Quackdoses Multispecialty hospital which has left the medical fraternity perplexed, it was found that most Indian patients are unhappy when their health-check package report comes normal, and all their parameters are within normal limits.

With clinical medicine now becoming diagnostically driven and increased health awareness among the general population, people often avail the comprehensive health packages. These packages are marketed by hospitals and labs in such a manner that all the various parameters of a particular test are shown as separate standalone tests, so that the patients can be fooled to believe that they are getting report of 50 tests for the cost of 5.

In an exclusive interview with the Quackdoses, patient Kanjus Wasooli said, “After fasting for 10 hours and coming early morning to get the tests done, is it wrong to expect at least 1 abnormal report, highlighted in bold - be it raised ESR, vitamin deficiency or size of the RBCs? I was waiting to send the 21 page PDF report to my doctor on Whatsapp, so that he could search and brief me for the abnormal parameters. I’m an optimist, and I look for the positive in the negatives, be it in life or in medical reports, except COVID PCR report.”

Doctors have meanwhile complained that they prescribe only 3-4 tests as clinically indicated, but patients bring pages of random reports on follow up OPD visit, mixed with medical bills, and also question them on the reference interpretations written below each page. When the reports come normal, patients often allege that the doctor has tie up with the labs and receives kickbacks.

Unconfirmed sources have now claimed that hospitals and labs have unanimously decided to give reports with deficiency of multi-Vitamins, so that patients can then be started on the placebo of ‘takat ki goliyan’ for few days, leading to better patient satisfaction.

COVID Vaccine - All is Well Jingle.

Jab Covid out of control, 
Vaccine ka vial khol, 

Vaccine ka vial khol, 
Syringe mein kar le tu load, 

All is well… 
Doctor hain jane vaccine se kya hoga, 
Infection rukega, tansmission ko bye hoga, 
Covid na jane uska future kya hoga… 

Deltoid (shoulder joint muscle) dikha, 

Injection laga, 
Photo khicha ke bol, 
Bhaiya all is well, 
Arre Bhaiya all is well, 
Arre Chachu all is well, 
Arre Bhaiya all is well… (Chorus) 

Dil jo tera rumours se ghabraye, 
Dil pe rakh ke hath use tu batlade, 
Safe hai vaccine pyar se usko samjhade… 

(Chorus) 

Patients le jaan unki jaan ka kya hoga, 
Vaccine lagegi life ka beema hoga, 
Covid na jane uska future kya hoga… 

(Chorus)