Editorials 2008-2009

January 29th, 2010 Leave a comment Go to comments

Dr Deepak K Jumani has been appointed as the Editor of General Practitioners Association Greater Bombay Bulletin for the second consequtive year since July 2008.

December 2009

Pranaam to all my teachers and all the members of GPA.

I believe in the eternal importance of the Family Practice as the fundamental institution for the benefit of community health. I believe in the trust, hopes and ideals of every Primary care giver who dwells in the hearts of their patients.  I believe in the beauty and the art of General Practice. I believe in the satisfaction of duty in General Practice. I  believe that every GP have the capacity to adventure, the more he adventures more he is successful.

Life of a Primary care giver presents a never ending series of opportunities to perform acts of caring, and we shouldn’t miss even one. Every moment is a marvellous eureka moment The world thus is a  glorious gorgeous glitterball.

We have many examples cited where  patients with non cardiac chest pain have been hospitalized, investigated and traumatized to end up as Cardiac neurotics. On the other hand many cases of cardiac ischaemia with normal ECG  have been sent home only to collapse and die at home. Patients with Acute Myocardial Infarction often waste time in reaching medical facilities or their treatment is delayed due to variety of reasons To lighten this burden Every Primary Care giver can have a set up of  a Chest pain unit, where he can take a ECG, do troponin test, and administer tablets of  Disprin & clopidogril, Oxygen etc .

Healthy heart is a matter of Choice and avoiding hurry, worry and curry is essential. Once a clinical diagnosis has been made, a ECG  which shows ST changes, administration of antiplatelets, antithrombotics, use of tenectalase IV bolus and transferring the patient to a nearest ICCU and PCI centre can save hearts said  renown Interventional Cardiologist Dr Lekha Adik Pathak speaking at the Annual Medical Conference  here in the city.

Every 10 seconds one person dies of Diabetes and every 10 seconds two persons develop Diabetes, inspite of several awareness programmes and events held on November the 14th World Diabetes Day nothing is stopping  India for  marching towards being the World Capital of Diabetes.

Israel has a innovative method to treat painful knee arthritis. Israeli custom made shoes, costing around 2.5 lacs, now available in Dubai, which is the nearest for us, have created euphoria in some patients almost getting rid of their painfull knee arthritis. If found successful they may make knee replacement surgeons find more time for their families.

A novel tumor marker,  not in the blood but in stools, have been innovated and now a stool test which is Stool DNA test have been used to diagnose Cancer of Colon. So a great Good bye to Colonoscopy and use of Peglec, which drained every patient completely.

The organs that  can now be used  for transplant  are cornea, teeth, eardrum, skin and bones, heart,  lungs, kidney, liver, intestines,  pancreas and bone marrow. Society expects  from Doctors for prolongation of life and a good quality of life at an affordable cost. Doctors expect in turn  from Society Voluntary Altruistic organ donation in life and death, accept brain death concept and realize that the life after transplant  is the borrowed time. Today transplants have been possible because rejection have been prevented  by drugs, immunosuppressive agents, various special fluids to store organs, surgical technology etc.brilliantly explained renowned Nephrologist of Mumbai ,Dr Ashok Kirpalani

There are four necessary components for successful and healthy relationships and they are Non judgemental attitude, Objectivity, Communication, Realistic thinking and Rational Behaviour said Dr Sujata Chavan while  delivering her keynoate address at Seminar held on Future of Families in Metros by Bombay Psychiatric Society and Association of Marriage Counsellors in Maharashtra

Two new pnemonics which explain the problems of today’s youth  and poverty are DINK and NIMK. DINK is Double Income No Kids, & NIMK is No Income Many Kids.

There are three lives of an individual in Modern era, The real life, The reel life and the Virtual Net life. There are new terms  like weekend husbands, Sunday uncle, Office spouse & Net nanny.

There is outsourcing of family  functions e.g. outsourcing mothering is common these days,  The elders are taken care in the home for aged and nursing homes. The future family will also include gay marriages and single parent. And are we prepared for surrogate motherhood and rent a womb culture. These  are some mind-boggling  issues which  shall need to be addressed  in future said Dr Shreekant Joshi a renowned Psychiatrist.

A blind boy sat on a footpath with a hat by his feet and a slate on which he wrote

“ I am Blind Please help me “

At the end of the day there were only few coins in his hat.

A wise man walking by took some coins from his pocket and put in his hat, then he took his slate and wrote some words and placed the slate back at its place so all could read.

Soon the hat began to fill up. A lot more people were giving money to the blind boy. That afternoon the man who had changed the sign came to see how things were. The boy recognized his footsteps and asked, “Were you the one who changed my sign this morning? What did you write?”

The man said, “I only wrote the truth. I said what you said but in a different way.”

What he had written was:   “Today is a beautiful day and I cannot see it”

So Be creative,  Be innovative, Think differently and positively in your practice, update yourself by attending the useful CME’s get all the essential hathiyaars like, ECG machine, Pulse oxmimeter, ophthalmoscope, Computer  and experience a world of difference.

I never teach but I only create conditions in which students can learn and Nothing can be taught but  Everything can be learnt.

Merry Christmas and Welcome 2010 with open arms.

Dr Deepak K Jumani

November  2009.

Pranaam to all my teachers and all the members of GPA, GB.

Life gave me more than I have asked for  and  I  am what my teachers made me said  the renowned Neuro-Physician, Dr B S Singhal, on  receiving  the coveted Dhanvantari Award,  conferred upon him by The 38th Dhanvantari Medical Foundation  recently.  Dr B S Singhal has been a teacher par excellence since four decades, he is loved by one and all  for his innate gentleness,  soft speech, unassuming nature and undying passion to teach.

Dhanvantari Medical Foundation has been fostering a feeling of cordiality amongst the practitioners of different systems of medicine, as it’s a fact  that every system of medicine has some good remedies as well as pitfalls and if a proper scientific evaluation is done a great sense of  equanimity amongst medical practitioners can be attained. The Foundation has been recognising the immense contribution of medical  hero’s of all systems of medicine and conferring them with this most prestigious and coveted Dhanvantari Award annually since last 38 years.

Padmashri, Padma Bhushan and Padma Vibhushan Shri Dr B K Goyal, also the Founder President of Dhanvantari Medical Foundation said that we must warn our patients  to refrain from  some self crowned scientist who have been advertising cures for every ailments from Diabetes,  Heart diseases, Kidney  Diseases, All Cancers, Strokes etc  by giving just a small fake medication and he emphasised that if these quacks were able to cure even one of these  a Nobel Prize would have conferred on Him. One such Scientist who claims cure for all ailments under the sun without even seeing any reports and giving the same syrup for every ailment at a fee of Rs 15,000.00  for 3 months, advertising daily on a major TV Channel is Mr Munir Khan. Is Medical Council of India sleeping or shying away  from this day light medical eyewash  or is there a terror group operating ?

True Courage is not the brutal force of heros, but a firm resolve of virtue and reason. This was manifested by this tall classified interventional cardiologist and Dean of Bombay Hospital  Dr B K Goyal, The only mother son of this soil who had the guts to  bridge the gap between Indian Medical Association Mumbai Branch and GPA and has autopiloted the most important educational activities of CMEs  which today are jointly organized and held since  last two years at  Bombay Hospital. I wish that IMA and GPA jointly organize their annual conferences too. Dr B K Goyal also is the only Indian Cardiologist to have been appointed on the Academic Council of Cardiology at the University of Texas in USA. His immense contribution to the field of medical teaching,   has rightly conferred him  the most prestigious Master Teacher 2009  award by the Association of Physicians of India.  GPA  is very proud of this doyen of medical fraternity  and congratulates him for this unique achievement.

In India, Obesity is more seen in women than in men and hence women are more at serious health hazards and Obesity today also has affected over 30 percent of children  and thus has become a chronic progressive disease of all ages. Though Bar iatric Surgery seems to be a therapeutic promise, we must warn our aspiring patients who wish to cure obesity of the mushrooming of fake evolving spas and clinics. However persistent Diet and Exercise still are the best remedial actions to retard obesity.

3000 people die every month  in Mumbai of stroke, the common reason being the link of stroke between stress and strain of living in the city said Dr Sangeeta Ravat Head Neurology Dept of KEM Hospital . To add  to this is  a sad fact that 90 percent of stroke patients do not reach hospital during the golden period of three hours  said  Dr Shirish Hastak Neurologist at the Kokilaben Dhirubhai Ambani Hospital  who also lamented to the fact that of the  80 patients admitted at KDA hospital only five could be salvaged.  So The dire need of time is awareness  this was stressed by the all speaking at a symposium held on the World stroke day

Lasers have now been successfully used in performing circumcision said  Laser Surgeon Dr Rusi Bhalla at CME held at PD Hinduja Hospital. He also stressed the fact that this new technique of treatment is bloodless and free of any complications.

Todays Family Physicians are updating themselves by all possible means , Like CME’s Seminars, Conferences, internet, journals etc and have become enlightened, and these medical messiahs  not only cure but heal.

Friends, The family physician today  is looked upon as a  skilled clinician. They are skilled at providing information to patients in a manner that respects their autonomy and empowers them to “take charge” of their own health care and make decisions in their best interests. They demonstrate an understanding of patients’ experience of illness (particularly their ideas, feelings, and expectations) and of the impact of illness on patients’ lives. So a Family Physician is much more skilled than a Consultant in a hospital who has assistants to take histories, examine them and also has all the supports like pathlabs, imaging etc available, trained Nurses and paramedics to administer drugs etc.   The family physician is also a  resource to his patients. They can use repeated contacts with patients to build on the patient-physician relationship and to promote the healing power of interactions. Over time, the relationship takes on special importance to patients, their families, and the physician. As a result, the family physician becomes an advocate for the patient.

Our Great General Practice is splendid and very resourceful to Primary Care givers too, every day we learn new vagaries of every disease, every drug, every investigations etc.  Its rightly said that  Life is a  splendid and resourceful beach to be explored and we gather wisdom there like shells swept by the tide.

Sadness ambushes us, but happiness embraces us. General practice  or Primary care is happiness  and being happy to the best of our ability is possible by way of giving thanks and praise. Lets thank Family Practice and believe me this happiness shall invite you all  into the ice-cream parlour of life, in all its sundae glory.

Our world has enough for each person’s need but not for his greed. There must be more to life than having everything.  I can say there can be no more love, service, joy and truth than in  being a Family Doctor today.

I slept and dreamed  that Family practice was Joy, I woke up and saw that Family Practice was Duty,

I acted and realized My Duty was My Joy.

With loads of love and light,

Dr Deepak K Jumani

October 2009

On an occasion when Gautam Buddha was teaching a group of people, he found himself on the receiving end of a fierce outburst of abuse from a bystander, who was for some reason very angry.

Gautam  Buddha listened patiently while the stranger vented his rage, and then the Buddha said to the group and to the stranger, “If someone gives a gift to another person, who then chooses to decline it, tell me, who would then own the gift? The giver or the person who refuses to accept the gift?”

“The giver,” said the group after a little thought. “Any fool can see that,” added the angry stranger.

“Then it follows, does it not,” said the Buddha, “Whenever a person tries to abuse us, or to unload their anger on us, we can each choose to decline or to accept the abuse; whether to make it ours or not. By our personal response to the abuse from another, we can choose who owns and keeps the bad feelings.”

Hence we all should prevent getting infected from  emotional metastazing cancers like Criticism  & Complaining instead if possible encourage and share wisdom.  Two men looked through the prison bars, One saw the mud other saw the stars.

To my mind bravery is a forethought and a  stitch in time saves nine, this was magnificently demonstrated by our Dear teacher Dr Suchitra Pandit, at the ObGyn department of Kokilaben Dhirubhai Ambani Hospital, while delivering the first case of successful quintuplets in India where all the five babies of a 24 year old, Sabeera Khan, delivered have survived. Though a premature delivery her brilliant plan in place could make this marathon delivery procedure a La grand Success.

An experimental vaccine has been found to successfully cut the risk of HIV infection, raising hopes of a “breakthrough” in the battle against the virus that causes Aids, and trials of this AIDS vaccine on more than 16,000 volunteers in Thailand found that it reduced the risk of infection by almost one-third. This is a very important scientific advance and gives us hope that a globally effective vaccine may be possible in the future. It is the first demonstration that a vaccine against HIV can protect against infection. The vaccine was effectively a combination of two older vaccines that had not cut infection on their own.

NASA in their historic press conference globally applauded the brilliant efforts of Indian Space Scientists who launched India’s maiden lunar mission Chandrayan 1, and this could help discover water molecules on the surface of the moon which was previously thought to be a dry surface with lot of rocks. Similarly the world shall surely applaud the Family Physicians of India, when they discover that now a Primary Care giver of India is a multifaceted, well updated & skilled healer. NASA thanked ISRO of India, for this discovery and so shall humanity thank we all Primary Care Givers for our humane potential.

This Deepavali festival I urge all the primary care givers not to spend any money or time on crackers, instead choose to purchase a Ophthalmoscope, Pulse Oximeter or a ECG  machine for your clinic this shall bring more light to your life ahead and your joy to work be doubled.

The occcurunces of swine flu has taken a slower pace and the panics have reduced with the peace of mind that the tests for swine flu are done at almost all the hospitals of Mumbai and Tamiflu has been made available at several chemists.. The cost is Rs 470.00 for 10 tablets and a prescription in triplicate is a must.

Light bandh to sab Hema Malini lage, Light bandh to sab John Abrahm lage, this has been My Best  Mantra, hilariously explained  Dr Vasant Mundra and this was told to him by his patient who came for counselling for sexual dysfunction.  Most people do not listen with the intent to understand, they listen with the intent to reply. They have their own agenda and they come out with their own autobiography. Listen first to understand than to be understood is the essence of good communication and key to human influence. This was the jist of the successfully completed Certificate Course on Art of Counselling held at PD Hindjuja recently.

Every Family Physician should be transparent in their communications with patients,  keep a high profile, be a ideal role model for all their  patients and also do some medico social activity of  helping the poor and the under privileged said  Dr Bakulesh Mehta, former President and grass root worker  of GPA,  We congratulate our dearest  Dr Bakulesh  Mehta for being elected as President of IMA  Maharashtra State, with a thumping majority at  the recently held Presidential elections of The IMA Maharashtra State.

Family medicine is the natural evolution of historical medical practice. But today though the family physician is rooted in the historical generalist tradition. This  specialty is three dimensional, combining knowledge and skill with a unique process. The patient-physician relationship in the context of the family is central to this process and distinguishes family medicine from other specialties. Hence, the scope of family medicine is dynamic, expanding, and evolutionary.

Family physicians are rated as “excellent” or “very good” by a clear majority of survey respondents on the top 5 relationship-related attributes identified by patients: being non-judgemental, understanding, and supportive; being honest and direct; acting as a partner in maintaining health; listening effectively; and attending to patient’s emotional and physical health. This speciality of Medicine  thus shall remain  on the top and the crux of whole medical fraternity.

Just as there is a latent fire in the wood and by rubbing the wood fire  is invoked, lets update ourselves with meaningful CME’s and Courses to invoke in us the fire of our own potential commitment and wisdom.  After all  We are, and we shall  always be Great Practitioners.

With loads of love and light, I wish all the members of GPA , My Pranaam with  a very enlightening Deepavali &  a ECG machine , Ophthalmoscope and a pulse Oximeter  in your clinic this  New Year.

Dr Deepak K Jumani

September 2009

Pranaam to all …

We are born in this world, so let us make it a beautiful place to live in.

The panic endemic of swine flu has really given insomnia to the state and national authorities all across the globe and this is the nature’s best call for them to make them be healthy nation conscious. The Global scenario is not alarming but not to be slept over . As of August 18, there were more than 235,000 laboratory confirmed cases, though the actual number of infections is probably much higher. Global swine flu deaths have passed 2,150. In the last seven days, cases reported globally have increased by 10% and the number of deaths by 24%. Looking at the emerging need to avoid confusion, commotion and streamline the strategies for testing for this flu its been mandatory for we all medical personnel to check on the following facts.

Some people are more at risk than others of serious illness if they catch swine flu. They will need to start taking antivirals as soon as they are confirmed with the illness. On occasions, we can advise some high risk patients to take antivirals before they have symptoms if someone close to them has swine flu.

The risk profile of the virus is still being studied but now it is already known that certain groups of people are particularly vulnerable. These include:

  • Patients who have had drug treatment for asthma in the past three years
  • Pregnant women
  • People aged 65 years and older
  • Children under five years old
  • People with chronic lung disease
  • People with chronic heart disease
  • People with chronic kidney disease
  • People with chronic liver disease
  • People with chronic neurological disease
  • People with immunosuppression (whether caused by disease or treatment)
  • People with diabetes mellitus

I have enclosed the list of hospitals in our city and let us assure our patients that there are no charges for the treatment of Swine flu medications (Tamiflu tabs and Syrups) anywhere in our city, but the private hospitals who have now been allowed to test for this virus, thanks heaven to the wisdom which dawned on the authorities, shall charge for admissions if any, charges of any consultant visiting the patients as per their norms and also if the swine flu test kit if provided free to the private hospitals this tests shall be done free of costs for all.

The best thing we as Primary Care givers can spread is move to a preventive phase for swine flu. It’s important that people continue to do everything they can to stop the virus from spreading. The most important way to stop it spreading is to have good respiratory hygiene (i.e. sneezing and coughing into a tissue) and hand hygiene (keeping your hands clean).

The phrase Catch it Bin it, Kill it, explains the importance of catching your sneeze in a tissue, or a sterile napkin, placing it quickly in a bin and washing your hands regularly to kill the virus.

We shall by spreading this message that Swine flu is curable and not deadly if one is monitoring the patient well, along with Catch it, Bin it and Kill it we shall bring a premature end to this swine. I wish we had done the same practices when mycobacterium had just taken its first steps in our country. Lets now be consciously active and not resign ourselves to fate.

Unless you change how you are, you will always have what you have got and Knowledge is the eye of desire and can become the pilot of your spirits. We all have enough opportunities to quench our constant deepest thirst and hunger for knowledge, by attending the awesome practical CME’s , short courses etc arranged by our association all the year long so we must grab these opportunities to have an edge over our own previous best and that’s being successful said Dr Pankaj Mehta a Senior Family Physician of Mumbai.

The most precious gift we can offer our patients and our children is our mindful presence stressed Father Godfrey D’souza at the Art of Counselling Certificate Course organized by Bombay Psychiatry Society, PD Hinduja Hospital and GPA. The nuggets of wisdom which we all are swallowing during this ongoing 20 hour, 9 lectures long course are amazing beyond words and time. You can learn new things anytime in your life. If you are willing to be a beginner and If you learn to like being a beginner the whole world opens up to you.

Life may be short in duration but could be magnanimous if you live, love, learn and leave a legacy and have a vision in your mind, disciplined body, a passion and conviction in heart and a conscious spirit.

The four assumptions which can always make you effective, keep you smile and keep your chin high are as follows:

The first is Assume you have had a heart attack, now live accordingly.

The Second is Assume anything you say about others they can overhear , now speak accordingly,

The Third is Assume half life of your profession is two years, now prepare accordingly

The Fourth is Assume you have one on one communication with Almighty The Creator, now live accordingly. These assumptions are more useful to me than my stethoscope.

All my teachers have a dauntless dedication to teaching and have been exemplary in their work. They have given me undying hope, highest dignity and zestful positivity. This teachers day, September the 5th, I on behalf of all we Primary Care givers, humbly bow down, with joined hands to all my teachers and pray to Almighty for their continuous supreme health and beseech them to continue blessing we all students, as we can never ever reciprocate the gifts of wisdom which our teachers have so selflessly showered on us and whatever we are today are truly because of our teachers. Thank you all my dear teachers.

GP’s are becoming rare and a rarer community , They are becoming the most precious to some but useful and blessing for all. Sometimes they are not given any importance and dumped. A General Practitioner has never been a short term luxury as the modern hi fi cosmetologist or smile specialist etc but Undoubtedly Time shall prove that in every patient’s heart and conscious, his/her conscious GP is truly a permanent, dearest and precious necessity.

Afterall The GPs are The Grand Parents of Medical fraternity.

With loads of love and light,

Dr Deepak K Jumani

August 2009.

My Pranaam to All…

I express my wholehearted thanks to all my guiding guides, collegues and the members of Managing Committee of GPA GB, for entrusting me with this awesome role of being The Editor for second consequtive year . I am acutely aware of the responsibilities of this position and the work that is ahead of us and I am sure together we all shall spend our choices for working to further the achievements of GPA and to create a refurbished feeling of pride and honor for our truly being Great Practitioners. I believe that collectively we have a breadth and depth of expertise and talent. The summation of individual contributions is vital. Friends, Don’t leave it to just a handful of members of GPA – this is YOUR organisation, help us make it worthy of YOU!

It was one of the blessed days of my life when I witnessed US Secretary of State Hilary Clinton in conversation with Bollywood actor Aamir Khan, at St Xaviers College. She was sharp and shining, everything she said was sparkling brilliance, whatever she meant personified her steel nerve and to me She is The Sky. It takes a teacher to change a child, a nation. I believe every child can learn, I do not believe that children regardless of their background, have limited or no capacity, but I believe they don’t have equal oppurtunity, I think talent is distributed universally but oppurtunity is limited said Hilary Clinton..

My dear friends we have a Golden Godly teacher whose magnanimity is beyond skies.He is Dr O P Kapoor. At 77, he walks his talks on hard core practical modern medicine, Every word of his is a ton of gold , every joke of his is a mighty lesson, every monoact of his is a difficult chapter. He is the one who can change us, he is the one who can change our medical community beyond words and space. We all do not lack in oppurtunities to learn as he is still continuing to teach Medicine, now in his 25th year at Birla Matushri , but what we all lack is in the attitude to learn. When I met Hilary and listened to her enthralling discussions at Teach India and Teach for India’s maiden inaugural event, the only person whom I could perceive in my naïve mind as a True Indian Teacher, who has really taught and enlightened our medical fraternity was none other than My Best Teacher Dr O P Kapoor… We are truly proud of this Saint of Medicine and The Medical Ambassador of India.

If you want to change the fruits, you will first have to change the roots. i.e., If you want more revenue in your practice, if you want more job satisfaction, start seeing your patients from top to bottom and increase the deposits of your hathiyaar bank, but do not forget that the best and most useful hathiyaar of your practice is your own tounge. If you want to change the visible, you must first change the invisible., i.e. if you want to earn a name and fame for yourself, you must tap your hidden potential of something unique in you and start practicing what you loved and dreamt of by changing your stubborn mindset and stale attitudes. Be flexible as Stiffness is the sign of Rigor Mortis.

Health is the greatest gift, contentment the greatest wealth, faithfulness the best relationship. Every human being is the author of his/her own health or disease. As Simple Conscious Primary Care givers we never do Bypass Surgeries,Laproscopies,Appendicectomies,Angioplasties or Ceasarian sections which may or may not be necessasry and can produce complications but what we do with great love and compassion are the small but timely first-aid treatments, give right guidances counselling, which is essential to prevent complications and surely brings smiles beyond miles.

Adult Vaccination Center can be a good avenue for additional revenue. Vacination for Tetanus, Hepatitis A, Hepatitis B, Chicken Pox, Rabies, Influenza, Pneumococcal, HPV, etc and many more now in the pipeline could easily be administered by we Primary Care Givers.

The recent MARD strike for wants of increase in stipends, salaries etc made a huge impact and hit the Democrazy attitude of the government authorities and forced them to come to terms. GPA took a humble stand of appreciating the crusade of MARD and its objectives, but lent a helping hand to the patients attending the municipal hospitals and extended every help to the Municipal Corporation during the strike, as such strikes have always been against the sentiments of our esteemed organization.

We live, not as we wish to, but as we can and life is just not being alive but being well. Brand Guru Jagdeep Kapoor in his awesome oneday Brain Circulation Session brilliantly elaborated his copyrighted Mantras, Shastras and Ashtras and stressed on ethics, planning, commitment and continued communication with your patients as a master key for becoming a Brand. There is a difference in Advertizing and Marketing. Medical personnel cannot advertize but can surely market their varied expertise explained by Jagdep Kapoor.

We welcome the landmark judgement of the High Court of India in that the 140 year law against homosexuality is unconstitutional. In the light of this, The Indian Government annulled the law that criminalizes homosexuality because Scientific evidence indicates that homosexual orientation is not a matter of choice and that in all populations there is a minority, but significant, number of people who have this natural expression of human sexuality. Everyone has the right to a happy, healthy and consensual, adult relationship. The right to lead one’s life free from discrimination on the grounds of race, ethnicity, religious beliefs, gender, economic status or sexual orientation is fundamental. Hence It is every government’s duty to protect all their citizens, without exception. We appreciate the governments decision to ensure equal rights for all their citizens through dismantling discriminatory laws and establishing protective legislation.

So While advocating Ideal Sexual Health or practicing successfully Primay Care Medicine isn’t it true to say that “Rakho Sambandh verna Sab bandh. ”?

With loads of love and light,

Dr Deepak K Jumani.

August 2008

My Pranaam to all the Office bearers and members of GPA, GB,

I thank Almighty, My Parents, My Beloved teachers and my great guiding colleagues for having the faith and trust in me to rekindle the fire of Family Practice in the hearts and minds of every Primary Care Physician.

We all Primary care physicians choose to enter family practice because we felt the advantages outweigh those of other specialties. We value interpersonal relationships, independence, the Godly image for generations in the families, treat variety of ailments involving all the systems, of every individual in the family of any age, consulted for any matters other than health and public service, earn loyalty & prestige over just wealth. But today the central value of family medicine i.e .forming a lasting relationship with a core set of patients is slowly dissolving, patients are forced to find new doctors, With the quality relationships and independence eroding, many of us feel that we are not receiving what we bargained for when we choose our career, besides this we also lack the monetary rewards and prestige other specialties enjoy and hence its no wonder many of us are dissatisfied.

The result is we blame the external forces like insurers, specialists, hospital policies,

Chemists, Corporate, etc This is negative thinking. While this is true that some external forces contribute to our sense of dissatisfaction and pose a threat, we too have made critical errors that have amplified our current discontent.

Let us solve this problem and make every primary care physician contented…

To begin with look at our self. Let us Redesign our academic personality. Update ourself, Please do not forget to attend My Best teacher Dr O P Kapoor’s lectures, who has now over 5 decades of experience and teaches us still every nuances of Family practice. and each word he says is worth a loaf of Gold. Spend some more time with your patients with renewed energy to take a detailed history, examine them from top to bottom, record your findings, take the help of technology in issuing prescriptions. Take a feedback by calling up your patients. and most important of all Please start charging Consultation fees, let it be a small amount but please begin charging for the services you give. This shall go in a long way in maintaining your relationships with your patients. This is the USP of Successful family practice and if we don’t we are risking nothing less than the future of our speciality and the health of our patients. I salute my seniors and mentors Dr Gunvant Sheth, Dr Vijay Panjabi, Dr B K Punamiya, Dr Vibhakar Advaryu, Dr Pankaj Mehta, Dr Mehmood Merchant, Dr Hozie Kapadia, Dr Bakulesh Mehta, Dr R J Jimulia, Dr Akil Contractor, Dr Suryakant Pandit, Dr Anil Pachnekar,Dr B K Dholakia, Dr Satish Naik, Dr Suhas Pingle, Dr Melmane, Dr Vora and many others for their spirits and unending passion to keep the Great Practice of family Practice alive and thank them for being a great role models for all of us.

In the next issues I shall be providing you with several pearls of wisdom from Dr O P Kapoor….CD’s of all prescriptions of various ailments seen in Family Practice with dosage guidelines, side effects. This shall also accompany a user friendly software only for making prescriptions, referral letters, Bills, & Certificates.

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September 2008

My Pranaam to all my Respected teachers and all Dear members of GPA, GB.

I do not know how long I shall live., which is surely not in my hands. And It matters not how long we live, but How ??
I always preferred to having wings than to having things ,as for me Time is a very precious gift, so precious that its given to us moment by moment….
The amazing gifts of time to all of us, what gives our lives a meaning,
a heart and mind to our body of life, a resource, which inspires and motivates us every day, are our teachers our gurus.. And on this Sepember 5th , Teacher’s Day
Let us pay our tribute, a humble salute and a Service of love to our Heroes of Life….

I want to reach the hearts of every right thinking individual and softly knock
on their souls to whisper my heart felt wish about my Heroes who are known to all, we see them, we have learnt from them, they have made a great impact in our life and work. But its really not easy to thank them.. How can I adequately thank these
God send noble angelic souls, who often do so much for us and continue to do so…
They are not wanting for fame or acclaim.. Their aim and love of life is caring and giving.
They aren’t those who wished to make a fortune, but they passionately try hard to teach us and make a difference. These heroes might have their names in Who’s Who, but the light of the wisdom, which they have so selflessly showered on us, is lit in all of us to brighten our path of life…

These heroes have enlightened and brightened our lives and seldom have we turned back to them to say Thank you My teacher….
I on behalf of all my colleagues, all the members of GPA, GB, and friends in the medical fraternity, wholeheartedly thank all the teachers who shall remain cherished in us as our
spirits and iota of enthuse in all of us and beseech all my teachers to continue blessing us all, As what we today are is all

BECAUSE OF YOU…

If I was to bring down the rainbow from the sky I would do so, and I would write the names of all my teachers on it and place the rainbow back in the sky.

Let me tell you how our teachers have made a difference in our lives either by being what they are or by designing our academic personality. I wish I could emulate all…

Examine every patient from top to bottom says my best teacher Dr O P Kapoor… Many a times stopping all the medicines and counseling parents almost cure the children was taught to me by Father of Paediatrics, Dr Y K Amdekar… What has age got to do with learning and using computers emphasizes octogenarian Dr R D lele. Even today every heart ailment can be diagnosed clinically and without the help of any machines stresses Reverend teacher and Cardiologist Dr K G Nair…Do not forget thyroid and Drug Fever in any case of PUO taught renowned Physician Dr K Ramamorthy.. Be good and do good is my religion says Father of Rheumatology Dr V R Joshi… Never refuse any patient and Diabetes is to be treated by Family Physicians says Endocrine Debonair Dr Shashank Joshi . Maintain records for your benefit and Master tropical diseases says Director of Medical Education and Health Services, & Dean of KEM Hosp. Dr M E Yeolekar. Literature, Trials, Experiences are true but trust your sixth sense and what you see in a patient and don’t treat the reports treat your patient says Classified intensivist Dr Farhad Kapadia…Compassion and Courage always personified the renowned microbiologist Dr Cameila Rodrigues..

ECG machine is a must in every Primary Care Giver’s Clinic stresses Senior Family Physician Dr Mehmood Merchant, Give every patient a file with all their reports it costs nothing but yields are splendid told our favorite senior Family Physician Dr Gunvant Seth, Every thing one does in life is due to only two emotions either Fear or Love.. and Love heals says One of My best teacher RJ Archana Pania of Radio City 91.1FM..

There are many many useful lessons which our teachers have taught us and we are fortunate to have them and lastly let me tell you that I would be very happy if dozens of quacks came and started their practices near my clinic.. and I would never ever be affected, After all how they can match our splendid clinical acumen, which is the core requisite & our USP for a trust and long term relationship between a family physician and a patient So ignore the quacks, You are a lotus and a diamond you shall never loose your sanctity and sparkle, wherever you may be. Raise yourself with a positive attitude and a changed mindset…

The pearls of Wisdom by Dr O P Kapoor and the most useful CD for we all, is under making… Please send us your feedbacks and suggestions , You can make a difference…

With loads of love and light,

Dr Deepak K Jumani

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October 2008

My Pranaam to all my Respected teachers and all the members of GPA, GB…

The noblest pleasure in my life has been the joy of understanding.

Let it be a complex CBC, ABG report, a MRI, a USG, a X-ray plate or even a complicated case or even any new therapy. and even understanding human beings. This joy to understand gave me tremendous job satisfaction and peace. Like a mother understands what a child doesn’t say we ought to understand what patients don’t say which means dig in the history as much as possible, search for signs by examining the from top to bottom, The rewards of this are simply amazing beyond words and time.

Last month I was a appraiser for DNB Family Medicine examination held at Jaslok Hospital conducting the exams along with Dr H G Desai, our reverend teacher and gastroeneterologist.of four DNB students who have been working at Jaslok Hospital for more than a year now. To my dismay I found no student examining the patient by seeing them from top to bottom. The DNB guidelines for their theory exams is ten short notes, which is ridiculous, The strategy needs to be revised..

I talk to my Sindhi patients in Sindhi, Maharashtrian patients in marathi, Tamilians in their Tamil, talking to patients in their own matrubhasha works wonders, why does it work ?.. coz the patients feel that Doctor apna hi hai.. So if we have to write our names on our signboards in Marathi also, what’s wrong, write it have a win win situation The positive side is that if someone who understands Marathi can also now read your name, so what’s wrong.. Infact make your signboard multilingual, This will increase your practice.. Thank you Raj…for enlightening us.

Dr R D Lele, Noted Nulear Medicine Chief at Lilavati Hospital, who has now lived his life with grace and dignity and has still so much to offer to all of us through the HMO project .which he has worked with TTK Singapore, a TPA company, . and has given me a splendid offer….He says Give me 100 GP’s who can each work dedicatedly for taking care of 1000 families in a particular locality I shall pay them a lump sum amount of 1 lakh rupees per month.

Are we willing to be dedicatedly working with strict protocols and guidelines ? If yes please Stand up ! Come forward ! Accept this challenge…The path is laid..

There is again a good news for academically sound doctors who wish to get a International recognized qualification within a year and a half here in India This is MRCGP from England..

Recently I laid my hands on a beautiful hathiyaar.. which is a multifunctional stethoscope which has a built in ECG, heart rate and a Pulse oximeter…

The Ideal Primary Care Physicians prevent diseases, or detects them in early stages before they become expensive to the patients, to the insurance company or to the nation at large…But the flip side is Are we Primary Care Physicians responsible or Are the Five star Nursing Homes and hospitals responsible for the skyrocketing costs of medicare ? ? ?

The new mantra which the nursing homes adopt is that every patient is asked by the treating doctor therein “mediclaim hai kya” ?? If you have medicalim and if you affirm, finish… This question has its own mysterious answers and implications…..

Sometimes in some cashless cases neither the patient nor the referring doctor comes to know what the exact bill of his treatment was ? My best suggestion is motivate all your patients to get their mediclaim policies..

For any patient you do good or if you have any opportunity to do good is your real talent. Try to remove the myth amongst your patients that everything can be cured by taking some magic pills and impress upon them that medical care should be considered as a continuum with good health and stress on prevention and wellness practices… But no one should be denied medical care in your clinics at any time, Please take a vow on this with your conscious, irrespective of you being paid for or not ….Whatever you can give even as first aid or even some guidance etc…after all we have earned and learned from our own patient’s illnesses, pains & discomforts and its our moral duty towards our own conscious to give the patient something more than they ask for…

Look at your patients problems in totality, the so called holistic approach, integrate evidence based pathies, gear up your mind to comparing and seeing the trends and patterns of diseases, study the responses of various treatments available, thus study the connections and this is where our clinical acumen excels…

The sun sets to rise again. If you have a cancer patient Don’t give him the diagnosis as a death sentence, but lets approach this patient to help him make the remaining time of life more meaningful…If you will, you can…

It’s my hope that my experiences may inspire others to tackle the obstacles they face in life and to achieve their full potential. It seems to me that our greatest limitations are the ones we impose on ourselves. I want to encourage others to throw out these misconceptions and unhealthy attitudes, and to be all they can be. Afterall nothing is impossible & we all are still learning….….

Remember everyone’s body is a temple only if the patient and we treat it as one. My head falls down in shame when I realize that We have Bill of rights but what is the need of hour is Bill of Responsibilities.

With loads of love and light,

Dr Deepak K Jumani

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November 2008

My Pranaam to all my Respected teachers, my guiding friends and all the Dear members of GPA, GB.

“Every human soul is teaching something to someone nearly every minute here in mortality” I followed the footsteps of my teachers and gave my best and whatever honours I receive I owe it to those great teachers of mine .. said Reverend Dr K Ramamoorthy who was rightly felicitated as the Teacher of teachers at the Eureka 2008, The annual medical conference of IMA Chembur Branch held recently.

A fresh and fantastic gift to the medical fraternity is Our Dearest and dynamic Paediatric Surgeon Dr Sanjay Oak, who has been appointed as the Dean and Director of Medical and Health Services at KEM Hospital and Seth G S Medical College.. Dr Ravi Rananavre, a very sincere, humble and very friendly Radiologist has been appointed as the Dean of BYL Nair Hospital and Topiwala National Medical College.and Lastly Dr Sandhya Kamath a Senior Physician who has been no less than a Goddess of medicine has been appointed as the Dean of Sion Hospital and Lokmanya Tilak Municipal General Hospital… This team of New Deans, trust me shall change the entire scenario of health care delivery at the Municipal Hospitals and the medical schools in our city.. They are a boon to all the medical students, doctors, consultants and more so God send for the poor and needy patients.. They are the staunch believers of We must not only give what we have, but we must also give what we are. On behalf of all the members of GPA GB, I congratulate all the three Captains of Medicine and wish them the essence of all the choicest things they dream in life. Truly BMC hospitals and medical schools are now in healthy hands.

I really feel proud of all the hundreds of Family Physicians and salute them, who turned up at the Protest march on the 10th of October 2009 to join the Association of Medical Consultants, and other organisations to show our solidarity… for voicing for the Violence against Doctors and Medicare Institutes..

The truth about the bandh was ….

All the Nursing homes were open and tell me honestly whether they were open only to emergency patients ? All the hospitals were open…, but we Family Physicians who see the emergencies primarily were asked to keep our clinics closed and did anyone care about the emergencies which might have been left unattended to in a family physician’s clinic which were kept closed… Although we are in different boats Consultants in their boat and we in our canoe, We share the same river of life. So We joined the Big Brothers in this bandh in bigger way and as a result of this The Cabinet approved the Ordinance to be passed and soon a bill which shall protect the rights of a medico shall be introduced.. This is a victory of solidarity and justice ….

In giving one gathers.. This has been the guiding principle of Endocrine Debonair Dr Shashank Joshi, who has arranged the Eight International Diabetes Symposium in the month of January 2009, with the faculty from Mayo Clinic and American Diabetes Association coming here in Mumbai to educate and share with we Primary Care givers the newer advances in DM…A cherished feast for all of us….

“I am not what happened to me, I am what I choose to become.” Dr Satish Naik, a senior family physician and a passionate writer declares that I now have been attending to my patients in the clinic only in the evenings and I use my morning hours most creatively as I am fulfilling my dream project of writing a epic on Democrazy, and am enjoying doing this and trust me this change hasn’t affected my practice at all in any way.

So We are not forced to work late nights nor are we forced to work all through the week, its always been our choice to choose the life style or the work style and face the music…

Every morning a Family Physician enters his clinic after finishing a couple of house calls, which may be giving insulin or may be checking BP of a geriatric patient, or any other medical emergency then he in his clinic examines kids, ladies, young adolescents, old patients, does a couple of CLW repairs, or a auroplasty or removal of a cyst, takes some ECG or Glucose check, or pregnancy tests, HIV tests, or gives vaccines to some… does some consults and counsels some…and have some referrals and so on, but in doing all this he has a variety in his practice and is a multispecialist which is such a joy and he gets the first hand information of the patients complains, which is truth and now during the day he may see variety of patients and follows them up every day thus increases his clinical competence and trust me every Family Physician today is a Clinical Scientist. This is the gift to only primary care givers and not to any specialists….

Hence In a day to day life every Primary care physician experiences a magic of diversity in his work and if updated adequately with a positive mindset and love to heal, he has the grandest feeling of joy and truth with a infinite scope to increase as much joy in his wok and life as one can….

This art of Family Medicine Practice is alive till date and shall always remain evergreen with a refurbished and renewed energy, to be the pillar of health care delivery in our country and world over till infinity

We must build in us a new Family Physician , a far better updated technosavy Primary Care Physician, one in whom the eternal dignity of Family Doctor is respected. Remember that when we leave this earth, we can take with us nothing that we have received, but only what we have given with a true heart, enriched by honest service, love, sacrifice and courage. What more can be a better cherished gift to your child than your own Goodwill ?

I am only one,
But still I am one.
I cannot do everything,
But still I can do something;
And because I cannot do everything
I will not refuse to do the something that I can do.

Give your patients the best you can and surely you will gather the best you can dream of… As the purpose of life is … a life of purpose.

With loads of love and light,

Dr Deepak K Jumani

ACS (USA), MBBS (Bom), FCGP, Ph D Candidate.

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December 2008,

My Pranaam to all my respected teachers, all great guiding colleagues and all the members of GPA GB.

Mahatma Gandhi use to get not only fan mails but a lot of hate mails too. One day he received a long abusive slurry letter from a man he hardly knew. The letter ran into five pages, put together with a pin. When Gandhiji finished reading that letter, he took out the pin carefully kept it on his table and threw the pages into the waste paper basket.

A visitor who was sitting there asked him why he had taken out the pin ?

“It was the only useful thing in the letter “, replied Gandhiji quietly.

We all in our lives get choices and options, and the great thing about Great Practice {General Practice} is that we can accept what we cannot change and change what we can’t accept. So we cannot deny accepting the changing and vagaries in disease patterns, changing investigation and treatment modalities, changing working hours etc, And the change we have accepted is the changing attitude and mindset of patients. The best way we do this is by updating ourselves, placing ourselves in the learnosphere, being scientific, ethical, transparent and evidence based in our work style and raise our traditional image of a Miracle man, the best God on earth , etc to a Clinical Scientist. We are proud to say that all of the CME Centres organized under the auspices of GPA, GB at various hospitals have large attendance, there has been great interaction and the lectures have been more of clinical substance. Every time we attend any CME there is always something very useful to take home and this is the true change, investment and love to heal seen in all the Family Physicians. Today’s Doctor Saheb doesn’t want to die a unlived life.

Today we see more and more Primary Care givers becoming more technosavy, progressing not only intellectually but even spiritually as was seen at the Dr B K Iyengar’s Workshop on Yoga organized at Bombay hospital, where we had contributions from cardiologists, nephrologists and neurologists who immaculately demonstrated with all their equipments the immediate advantages of this amazing art of Yogic Science. GPA GB shall remain indebted to Noted Neurophysician Dr B S Singhal for giving us a opportunity to interact with Guru Iyengar ji and have a first hand experience of the wonderful therapeutic effects of this science. Surely yogapathy has a great promising future.

We all Primary Care Physicians are having infinite potential, the variety of medical problems we can handle individually, the numerous hathiyaars we can use, the splendid research we can do in our community, like drag and drop we can learn any new procedure or take any speciality & sort of specialize and more so aren’t we giving the primary treatment to the ailments of all branches of medicine and we surely can call ourselves as a like a broad spectrum physician. But for this we should have a mindset of continuum of learning every aspect of medicine all the time for which we may have to spend time at hospitals, conferences, workshops, symposias, internet, journals etc..

On the keyboard of our life let’s not keep our finger always on the Escape key and instead remember that the true wisdom can never be seen if we deliver our knowledge without character and your work cannot be a worship if its without sacrifice.

Noted Onco Surgeon, Prof & Chief of Surgical Oncology at Tata Memorial Hospital. Dr Rajendra Badwe, while speaking at the Mahim Dharavi Medical Practitioner’s Association’s Annual Medical Conference urged Family physician to be vigilant and not worried about Cancer and beautifully described the do’s and don’ts in life for having a satisfied life. He said at the age of 10 Stop holding mother’s fingers, at 20 stop playing with toys, at 30 stop looking around here and there, at 40 stop eating dinner, at 50 stop outside food, at 60 stop starting all new businesses, at 70 stop sour things, at 80 don’t avoid hard bed, at 90 stop the will to live and at 100 have a full stop to life. Surely a simple useful message to harp on for all.

In today’s convulsive financial market scenarios, the unstable property bazaar, infracted law and order, and with shameless , religious biased, political fanatics what can save us is our own learning and this can never ever show any fluctuations as more we learn more we shall earn.

We shall all keep learning as we do even if we have to take some time off our practice for we know that we cannot undo a single act we performed nor can we erase a single word we said but after learning from the oceans of recourses available, our reality cheque shall never ever bounce.

“If the student is ready the teacher shall appear” ….. Gautam Buddha.

Thank you all for the profuse love and affections which you all have showered on me for the last few months after reading the editorials as I get numerous calls and letters from many and I humbly apologize to all whom I may have hurt through my emotions. For all the ill feelings which might have transpired in any or may in future, I with head bowed, joined hands and with all my heart prayerfully urge “ Michhami Dukhadam”.

With loads of love and light,

Dr Deepak K jumani

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January 2009

My Pranaam to all my Respected teachers, and I wish them all and all our members warmest thoughts of love, support, a recession free and a terror free 2009.

At the fag end of 2008 after every Mumbaikar suffered from severe terroritis of 26/11, and forced us to ask Mr Politician, We want our India back !!!!

Over every successive election, you’ve taken it away from us in painful installments. And now we want it back. We want back the country the Mahatma died for. The country, our parents made their home when they fled across the border in 1947. The India we chose to live in and work for. And pay taxes too. Don’t make us give up on India, Mr Politician. Because you’ve had your chance and you’ve botched it up. Big time. Come on, Mr Polititcian! You’ve built your future and that of your progenies by systematically destroying ours. So, give us back my India. Give it to me now. Allow me and a billion others to defend themselves because you are incapable of it. Give me the India we set out to be; not what you are making it to be.

You showed us a false dream of making Mumbai into Shanghai, but turned her into a Jalianwala Baug…. Don’t tempt we angry Indian anymore, Mr Politician. Today, we are angry. Tomorrow we will be uncontrollable and will rebel. A set of rulers tried it and failed a century ago. We’ll do it again – only this time, the enemy lies within.

But one thing let us make the unscrupulous elements of India and outside very clear that What so ever dirty and nasty they try, they will always loose, Mumbai will rise up again as much stronger and smarter, as India is more plural than any country on this planet, and India’s signature is peace and tolerance.

Lets learn from 2008: “ Be Strong and Smart ”.

And resolve for 2009 something very essential for our workplace and our patients.

A Good Record Keeping! So what if you are not a computer geek, keep a hard copy, have case papers for individual patients ..Please write the personal details , presenting complains, your findings and a provisional diagnosis along with the treatment which you dish out so easily. This change, once you start writing a working diagnosis before your treatment on the case sheets, will help you and make a world of difference.

The bad news is that time flies and the good news is that you are the pilot. So get your record keeping straightened without any excuse. This is a also a requisite of Medical Council of India and not keeping the same is today an offence. I always believe in digging a well before I become thirsty.

Our 39th Annual GPA Conference was a grandest feast of knowledge and it rightly began paying our humble homage to the brave martyrs of Mumbai, Shri Henant Karkare, Shri Ashok Kamte and Shri Vijay Salaskar and many others whose sacrifices have given us this day to witness the sunshines

Dr Taral Nagda, a Noted Pediatric Orthopedic Surgeon in his brilliant teachings funded me with love, kindness and understanding…

LaproHero of Heroines, Dr Rakesh Sinha who always walks his talk introduced us to a fantastic ultrasonic, noninvasive treatment for uterine fibroids and Kudos to him to pioneer this unique treatment modality in our motherland.

Dr Jamsehd Dalal, Director Cardiac Services of Kokilaben Dhirubhai Ambani Hospital enlightened us brilliantly with his splendid talk on Hypertension. Dr Jamshed Dalal is a teacher whose eyes shine with calmness, his voice contains a undercurrent of sweetness and joy. He really is a true teacher.

Steel hearted, Plastic Surgeon Dr Sunil Keswani gave us superb tips on dressings on Burns. Ace Radiologist Dr Bhavin Jankharia gave us a great insight on PET Scan. A Genius of our times Dr Aparna Jairam,from Dr Avinash Phadke’s Piramal Diagnostic, a eagle eyed Pathologist gave us a complete perspective of newer tests for autoimmune disorders. Dr Ravi Bapat, Vice Chancellor of MUHS who graced the Conference as our Hon’ble Chief Guest splendidly explained us the facts of medical health in our country and gave us a shocking eye opener on the present pathetic scenario of medical industry. Hyperbaric Oxygen has tremendous therapeutic Applications endorsed our darling Interventional Cardiologist Dr Shoaib Padaria.

Dr Gunvant Sheth a pillar of General Practice in India, was as sparkling as ever, I must say that the light he emits through his talks can even light a star. Dr Mehmood Merchant and Dr Subodh Kedia Senior Family Physicians contributed a lot to our wisdom through their eduinformative talks. Dr Udit Thakker a Senior Family Physician, said I presented the case because I wanted to share the thrill he had and in turn he proved that, To share knowledge is a way to achieve immortality. Dr Jyothi Parekh’s talk did touch the deepest chord of our psyche.

Words fail me to thank Dr G N Patel, Chief Medical Insurance Officer from Rajkot, who showed his immaculate, spine chilling, too touchy, and a masterpiece of his Grand work of multimedia, on Save the Girl Child. This was a real great feast to our senses beyond words and time. In fact this presentation was the most befitting and a poignant tale,

Truly the best part of our conference as the message of Save the Girl Child shall haunt in our minds and hearts for ages.

Life has too many unanswered questions and issues, and the flip side is not to put them under microscope and magnify them, and if you are wrinkled of the burden of General Practice Please come to attend the CME’s arranged by GPA, Get your record keeping straightened, and in turn gift yourself a magical facelift. Why should we be worried about terror, slack season, struggles and problems of worldly life? They shall always come and go. We must continue to attend CME’s & update ourselves. As life is not about waiting for the storms to pass, but its all about learning to dance in rain.

With loads of love and light,

Dr Deepak K Jumani.

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February 2009

Editorial

My Pranaam to all my respected teachers, great guiding colleagues and all the members of General Practitoners’ Assonciation, Greater Bombay.

Welcome to 2009 and more importantly welcome to your great positive mindset, a refurbished spirit,a strong and smart attitude and an undying urge to be learned and updated.

Public Private Partnerships can work wonders provided all the energies, expertise and resources are Chanellised in the direction of service to humanity at large and not to individual gains said Dr Jayraj Phatak, Our Dearest Municipal Commissioner, while inaugurating the 39th Annual Medical Conference of the Indian Medical Association, Mumbai Branch, which was courageously held at the Trident, Oberoi a venue which was in shambles just few weeks back due to terror strikes of 26/11. Kudo’s to the team of the dynamic President of IMA Mumbai Br., Dr Anil Pachnekar, Dr Vijay Panjabi & Dr. Shivkumar Utture for their splendid efforts and resilience.

We are in the rat race. The trouble with being in rat race is that even if you win, you’re still a rat. Instead we should be demanding the best of one own self, living with honour and devoting our talents to the benefit of all our patients religiously, and the race we should be endeavouring on is to try to better our past best, in every aspects of our work ethics, this will surely lead us live with greater job satisfaction, peace and live life like a Lion and not a rat…

Stressing the role of Medical Nutrition therapy and Physical Activity, ripping the deadliest devil-Smoking, Controlling Diabetes, Hypertension, Dyslipidaemia & stress, Relaxation exercises like Yoga, Avoiding The Idiot Box and shunning negative behaviour, are the pre-requisites to live a good quality of life and the onus of imploring this awareness in humanity at large lies on we Family Physicians explained Internationally renowned and Ace Interventional Cardiologist Dr Ashwin Mehta in his oration. Afterall, Think for a moment…Should we not address these issues with our patients early in their 20s or 30s ? Should we wait till they all suffer and succumb ? Is it not cost-effective and safe to take action now ? What for are we waiting? Whose permission is needed? Who will bell the cat to motivate for CAD prevention ? It will never be a priority for our rulers ! It is we – the answerable ones for all – should take steps, Take a pledge now to screen all above 30 years.

Ask for history of Erectile Dysfunction which is the earliest marker for Coronary Ischemia. Initiate them into preventive action persuade them persistently.

Hippocrates Centuries ago rightly said:

“Let your FOOD be your Medicine –Lest,

Your Medicines will replace your Food.!!”

Addressing the Family Physicians, on newer Investigations in Rheumatologic disorders, Goddess of Microbiology , One of my best teachers, Dr Camela Rodrigues emphasized elegantly that the use & interpretation of lab tests depends on how they relate to a clinical illness, A positive test is not an illness in the absence of disease.

She said increase in ESR, indicates rise in Plasma Fibrinogen. ESR more than 100 reminded me of the teachings of my best teacher, Dr O P Kapoor, who 28 years back told us three common causes of ESR over 100 are Extra Pulmonary Tuberculosis, Connective tissue disorders or Malignancy.. which holds true even today. Dr Camela enlightened us with another new investigation which clinches Rheumatoid arthritis i.e. Anti CCP antibody test (anti-cyclic citrullinated peptide antibody,)as this is Diagnostic marker of RA & can be detected very early even before joint erosion begins. Anti-CCP +ve patients are at risk of a more erosive disease and Anti CCP has 95% specificity- can differentiate RA from other disorders

Another interesting talk was by renowned Interventional Cardiologist from Cleveland Clinic Dr Pradip Nambiar,now attached to Kokilaben Dhirubhai Ambani Hospital elaborated the role of Minimal Invasive Surgery and shall be pioneering Robotic Coronary Artery Surgery here in Mumbai and emphasized the importance of this unique Dia Vinci Robotic System which shall give highest precision and make difficult MIS easier, faster and with less human errors. These procedures shall revolutionize the trends of surgical therapies in future. Surely a boon and happiness. But what about the costs and complications ? Amazingly though newer advances dawn, they accompany newer complications, escalating costs and how long will they sustain?… Your guess is as good as mine !

Well !! All these changes shouldn’t worry us, because though the haunts of happiness are varied, every Family Physician finds happiness on the faces of their ethically treated patients, in the thrill of they clinically diagnosing a disease of their patients with no or minimum investigations, counselling them on prevention and wellness aspects of lifestyle disorders. conviction, continuously updating , learning all the time and being available in their clinic giving primary care to all the needy, with gifted sixth sense and the fine art of General Practice.

Undoubtedly the Great Practice of General Practice shall always be the Best, Evergreen, full of variety, and affordable, surely loved by our patients at large for generations now. Truly, the backbone of Medical Fraternity, even today are updated, motivated, daring and caring Primary Care Physicians.

If the only prayer we ever say in our life is Thank you God for making me a Good Family Doctor, this shall be enough to affirm a total life of joyful prosperity.

Thank you all my fellow colleagues, my angels for being the love and light of my life.

Dr Deepak K Jumani

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March 2009

My Pranaam to all my Respected teachers , great guiding colleagues and all the members of GPA GB.

We cannot become what we need to be by remaining what we are, we can do more than we promise, & right now is the good time to start living the life we’ve imagined, and If we believe we can do it , We shall surely acquire the capacity to do it as Success is not the key to happiness. Happiness is the key to success. If we love and enjoy what we are doing, and always put our patients first undoubtedly success is never far.

As the Global recession bites, and thoughts of doom and despair abound, there are many uncertainties which have attempted to gel in our minds, Instead of thinking of solutions of coming out of this mess, we should focus on improving our own image.

By keeping all the necessary equipments like Pulse oximeter, ECG, Spirometer, Ophthalmoscope, we shall Experience Excellence, beyond the thrill of achievement, By Attending to every emergency all day and night we Experience Resilience, beyond the fear of challenges, By attending meaning full CME’s, Symposia we Experience Knowledge beyond the fathoms of depth, By learning newer office procedures, we Experience diversity beyond the limits of horizons, By being techno savvy, we Experience innovation beyond the constrains of possibilities. And thus we experience Certainty, where limitations don’t hold you back, you break free your shackles, the crisis of confidence don’t cripple you and lets you go beyond boundaries in Family Practice which is the most joyous and gratifying art of humane service at each moment of your life for sure. This Healthatitude philosophy can touch a future of every Primary Care Physician to heights beyond space and time.

Karela (Momordia Charantia-Bitter Gourd) may be containing Osmotin, which is a protein found in various fruits and vegetables and is proven to up regulate adiponectin receptors, can become a newer therapeutic approach to treat DM. More light can be thrown If some Family Physician could study the results of Karela juice and Metformin said Octogenarian and Nuclear Medicine Chief Dr R D lele at the 8th International Symposium on Diabetes held here recently. Questionable adaptation to the changes in environment, Higher Insulin resistance and Increased mitochondrial activity to produce more ATP are the key issues why Asian Indians are more prone to Diabetes explained to Prof Sreekumar Nair, of Mayo Clinic USA. Dr Amit Ghosh, Dr Usha Shriram, Dr Undurti Das, Dr Yogesh Kudva, Dr Joseph Tibaldi , Dr Anuj Bhargava, Dr Gundu Rao all from USA along with crème de la crème of Endocrinologists of India shared their wisdom and enlightened us on various aspects of Diabetes during the 8th International Symposium of Diabetes.

A loads of Books cannot equal the think tank of Endocrine Debonair Dr Shashank Joshi, who brilliantly brought the world of Diabetologists here in to the capital of Diabetes to make all of us at par in toto in wisdom by enlightening us on the newer advances in Diabetes across the globe. Surely The 8th International Symposium on Diabetes was a feast of knowledge and the most needed celebration of 2009

Obesity is a Chronic Progressive incurable disease said Dr Arya Sharma Professor of Medicine & Chair for Cardiovascular Obesity Research and Management at the ,University of Alberta, Canada, at the 5th Asia Oceanic Conference on Obesity. The medical line of treatment with Fat Burners, appetite suppressors etc, have a limited role and beyond this the promising treatment which can instantly reduce the load of adipose tissue is Bariatric Surgery. However the costs, complications and cure rate in a long run are being closely watched. Governments should be regulating the commercial weight-loss industry to prevent innocent public, desperate to shed weight from being taken in by products and programs promoting scientifically unproven therapies, said Dr Arya Sharma.

Although experts agreed that obesity management requires long-term behavioral, medical or surgical intervention, the majority of commercial weight-loss providers manipulate vulnerable consumers with impunity, cultivating unrealistic expectations and false beliefs. Dr Arya Sharma, said successful weight loss and maintenance depend on a number of factors, including calorie reduction, healthy food choices, regular exercise and addressing psychosocial or physiological factors that lead to overeating.

“Obesity treatment is not about weight loss. Losing weight is easy. Treatment is keeping it off.” After losing 40 kgms myself by just walk and cutting down on SOS (Salts, Oils and Sugars) and maintaining the same for over a year now, I feel its all about mindset which at that moment has to win over the temptation of always available sumptuous, atherogenic and diabetogenic food, to abstinence of the same.

The Budget this year was nothing less than senile ejaculations of our Finance Pundits, It was like a coitus interruptus as country’s financial libido is flagging.. The only aphrodisiac which is desperately needed by these pundits is money. As usual we medical practitioners cannot truly decode the so called Great Indian Budget. All I feel is that despite all promises and projections the pundits make, the bottom line remains the same every year after year, since this year its just before the election we can call it as electile dysfunction.

I have laid my hands on a amazingly simple, and a highly user friendly software of practice management for Family Physicians which shall be a boon and gift to all tech savy medicos from Vital Health Software, a US Dutch based IT firm, and now having a base in Mumbai, who are experts in health care domains all across the globe including Mayo Clinic.

A Unique Combo of Ginseng, Gingko Biloba, French Maritime Pine bark and L-Arginine branded by the name Enlarge has proven to be restoring natural sexual energy without any side effects, unlike Sildenafil Citrate which is being used today with unpardonable side effects. Enlarge was timely launched on Valentine day as a promise to ensure a fulfilling healthy sexual relationships.

Let us put a sense of optimism about tomorrow and future, without underestimating the same with a strong hope and no fear, shame or guilt and enjoy our work to its fullest, as we all understand that Life is not a problem to be solved, but a reality to be experienced..

I am indebted to my parents for living, but to my teachers for living well. I thank my teachers at this dawn of 2009 as we all ordinary students whom they taught, no longer shall remain ordinary and with the wisdom they have so selflessly showered on us, we are walking through the world with a firmer step.

“All my life, I had a choice of hate and love, I choose love and I’m here” said Musical Maestro A R Rahman while receiving the coveted Oscar for his music in Slumdog Millionaire. We all love our Family practice and shall always win every heart. Jai Ho !

With loads of love and light,

Dr Deepak K Jumani

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April 2009

I wish all my fellow colleagues all the best in their journey of healing, self discovery and pray a greater fellowship amongst all for ever.

“See the world and it’s people with your heart not your eyes, the image will be more authentic”.

So many of us are too hard on ourselves for what we didn’t accomplish or what we should have done. The first step is to forgive yourself for all the things you didn’t do that you should have, and all the things that you did do that you shouldn’t have. Hence Every day do something that will inch you closer to a better tomorrow. We Primary Care givers can give a lot to our community with our skills, devotion and commitment and with our default image of a traditional Miracle God, as a Family doctor trust me you can make a difference in every patients life every time and for ever.

It’s good to have money and the things that money can buy, but it’s equally good to check once in a while and make sure that you haven’t lost the things that money can’t buy. Try to work but also give time to your spouse and children, they too need you.

I am humbled and feel rejoiced to complete six years of CME programme at PD Hinduja Hospital and this April the 6th Monday we are glad to have Reverend Dr V R Joshi, Father of Rheumatology who shall deliver a extempore talk on Romance with Rheuatology.

Kudos to all the Medical Associations for the Ordinance which was submitted by Govt of Maharashtra, We appreciate the untiring efforts of PadmaShri Prof T P lahane who spearheaded the team of leaders from medical fraternity and inititated the Ministry to take stern immediate action and got the bill submitted which shall be approved soon..
Dr T P lahane a gem of a human being and a brilliant ophthalmic surgeon who has with his immense contribution in the field of ophthalmic care, for well over a decade, led the UPA government to grant the status of “regional institute’’ to JJ Hospital’s ophthalmology department led by our darling ophthalmic maestero. “It’s the biggest milestone for us so far. Now C J Ophthalmic department will be rechristened as the regional institute of ophthalmology, and for the first time a private Government hospital shall be equipped with every ultramodern equipment required in the field of ophthalmology. A great boon to humanity. When Dr T P Lahane with his sheer devotion and passion to serve can bring this change why others cannot ?

Dr R A Badwe, Director Tata Memorial Center, has introduced uniform guidelines for family physicians and specialists providing assistance to cancer patients living in rural areas. This will surely help doctors across the country provide treatment to cancer patients at their doorstep instead making them travel long distances. A copy of these guidelines can be obtained from him.

Dystonia: The monster like movement disorder, which had practically not cure in our country till date now has a fantastic treatment right here in our city. Renowned NeuroSurgeon attached to P D Hinduja Hospital, Dr Milind Sankhe proved with his impeccable skill, finesse & precision that a surgically implanted brain pace makers, similar to cardiac pacemakers, delivers controlled electrical stimulus to certain areas of Globus Pallidium and helps patients regain voluntary control over abnormal postures and muscle movements. However the implant is imported and expensive, Dr Sankhe has now formed a NGO “Aastha Foundation”, aiming to make the implant more affordable.

Longevity is a matter of choice. Seven lifestyle factors are vital to determining how well we age: Avoiding alcohol, avoiding smoking, having a stable marriage, exercising regularly, maintaining a healthy weight through optimal diet, developing good coping mechanisms, and pursuing education. Successful ageing isn’t simply a matter of gene or fate, Its making healthy choices which can pave way for a long vital life. Life does not end as one grows old but merely changes gear said Dr Vihang Vahia a noted psychiatrist at a recently held Symposium on Ageing.

A tree’s best fruits are those which receive the most sunlight, not those which cluster densely together in leafy shades. So we must try and learn as much as possible as many skills in medicine all the time to be skilled so much to do justice to our own conscious and be a no limit Primary Care Giver.

The Maharashtra Polls this year are a real test to the zest of the pests(politicians) April 30 (Thursday) –Holiday declared for elections, May 1st (Friday) Holiday as its Maharasthtra Day, May 2nd Saturday and then of course May 3rd Sunday.. Four days is more tempting for taking off from our nest to rest away.

Is Politics today worth it ?

This little boy goes to his dad and asks, “What is politics?”

Dad says, “Well son, let me try to explain it this way: I’m the breadwinner of the family, so let’s call me Capitalism. Your Mom, she’s the administrator of the money, so we’ll call her the Government. We’re here to take care of your needs, so we’ll call you the People. The nanny [babysitter], we’ll consider her the Working Class. And your baby brother, we’ll call him the Future. Now, think about that and see if that makes sense.”

So the little boy goes off to bed thinking about what Dad has said.

Later that night, he hears his baby brother crying, so he gets up to check on him. He finds that the baby has severely soiled his diaper. So the little boy goes to his parents’ room and finds his mother sound asleep. Not wanting to wake her, he goes to the nanny’s room. Finding the door locked, he peeks in the keyhole and sees his father in bed with the nanny. He gives up and goes back to bed.

The next morning, the little boy says to his father, “Dad, I think I understand the concept of politics now.” The father says, “Good son, tell me in your own words what you think politics is all about.”

The little boy replies, “Well, while Capitalism is screwing the Working Class, the Government is sound asleep, the People are being ignored and the future is in deep shit.”

In three words I can sum up everything I’ve learned about life: “It goes on”.

But one thing is sure that Learning is the beginning of wealth. Learning is the beginning of health. and learning is where the miracle process begins.

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May 2009

We all are deeply saddened to understand that one of our dearest teacher Rev. Dr K Ramamoorthy who bid adieu to heaven and I am sure he is still watching me and all of us and when I think of him He whispers to me in my minds eyes and this is what he says to me:

My Dear students,

When you are content to be simply yourself and don’t compare or compete, everybody will respect you.

Let your light shine. Shine within you so that it can shine on someone else.

Gratitude is riches. Complaint is poverty.

You must first have a lot of patience to learn to have patience.

Everything he said and taught me is a worth every unperishable thing. All the members of GPA fondly remember him as our best teacher, our pride and our mentor and all of us join me in praying, May his soul rest in peace.

Any fool can criticize, condemn, and complain — and most do. Let it be functioning of GPA, IMA, MMC, etc or writing or even a perspective, but I discovered I always have choices and sometimes it’s only a choice of attitude. I keep learning and so do today almost all Primary Care Physicians, as that’s the most joyful thing any human can do.

I am so happy to understand that now doctors will not be treated as street dogs, their nests shall not be damaged as the Govt. of Maharashtra has passed the much awaited ordinance. of attack & atrocities on Doctors. This should not be considered as Immunity or vaccination for being negligent at work.

In a shocking incident of illegal ragging, at Dr Rajendra Prasad Medical College of Himachal Pradesh recently, claimed a life of a young First MBBS student. Death of just 19 years old medico Amann Kachroo, proved that despite Anti-Ragging Ordinance present in our country, ragging is still rampant in medical, engineering and other technical colleges. It is beyond one’s imagination that how the practice of making joke of new entrant at College will take a shape of draconian practice of beating a young boy to death. While seeing the crying parents, who have lost their aspiring son, on every TV Channel was heart rendering. This raises several questions. While authorities swung into action and arrested the four senior third year students of the college, who had allegedly beaten up Amaan Kachroo to death, the question still remains; Are we really serious about the ragging issues ? All I can say till date we lack the conviction that ragging should be stopped. I urge all the parents of aspiring medical students to counsel them adequately and burr in their grey matter, that ragging is a unnecessary evil.

The medical students who are a part of our learned fraternity do not fear the anti ragging ordinance which is passed by the Govt. long time back, and it’s a truth that we see ragging being rampant today even in several colleges of Mumbai, So, Is there a joy to understand that the Ordinance which is recently passed by the Govt of Maharashtra in lieu of Atrocities and attacks on Doctors, will the ill informed public fear this ordinance…? Your guess is as good as mine.

You don’t have to be great to start- but you have to start to be great explained Eminent Rheumatologist Dr V R Joshi while he spoke of his Romance with Rheumatology, To ignite a ongoing passion, love and joy for any thing you are doing is to be romantic with the same on a continuum. The more you admire, more you inspire to aspire. That’s the secret. So inspire to aspire before you expire.

Our Best teacher Dr O P Kapoor, whose philosophy has been Simplicity with Variety till date now being over 75 has undying passion to teach, and feels that teaching is his learning, his way of making miracles a reality. Sir Dr O P Kapoor is one such reverend teacher of our mother soil whose teachings shall never ever be erased from our remotest memories. Infact If we had some more Dr O P Kapoors which can never ever happen, Indian Medical Fraternity could have been the most adorable community at large. In fact if we still genuinely follow what he teaches, every Clinic could be a temple and a pilgrim.

There has never been a good war or a bad peace, Every election today either political or non political has almost become a internal war.?

Is it really worth it.? Kudos to GPA whose committee members are elected every year without any elections and with amazing mutual understandings and respect for each other. We must raise ourselves so much that this dirty, stinking game of elections should be washed out of our systems and I am sure that we Doctors can show to the world that ,

when the power of love overcomes the love of power the world will know what is peace.

Dr Renuka Bradoo, a brilliant ENT Surgeon, heading the ENT department at LTMMC and Sion Hospital, delivered a awesome lecture on Vertigo and enriched us with every nuances of this common symptom. We all felt refurbished with renewed energy as we know we can’t turn back the clock. but we can wind it up again. Everyone experienced a unique joy which is more than acquiring any wealth or property as this gift from our teachers shall be our treasure beyond measure.

Endocrine Debonair Dr Shashank Joshi, whose zeal to teach is no less than a volcano, let it be teaching anything from General Medicine to Endocrinology to HIV, pleads all Primary Care Physicians to Master Diabetes and has planned to conduct series of Diabetes Educator Programmes in collaboration with International Diabetes Association and WHO, which shall enable all Primary Care Givers to be innovative and skilfully confident in treating Diabetes which is a need of this hour, as tomorrow every fifth Indian shall be a Diabetic.

In the book of my life’s questions, the answers are not in the back and It’s not the hours I put in my work that counts, it’s the work I put in the hours. Learning through CMEs is a creative activity and Creativity is a drug, I cannot live without.

No seed has ever seen its flower, but with all the hope and faith in the wisdom which our teachers have so selflessly showered on us, and our continued zeal to learn we all experience a courage, hence life shall always flower as a amazing beauty. Nothing on this earth can ever reciprocate the wisdom our teachers have gifted us with and still continue to do so, in every CME, Symposia or Conference etc, all I can say is My teachers have been my priceless time, my most precious phase of life and hence I can say “ Time is the best Doctor ”.

Thank you and Bless me.

With loads of love and light,

Dr Deepak K Jumani.

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June 2009

We wish all the members of our Association, our teachers, guides and all our colleagues

a splendid journey of healing and happiness.

What we see today around us is economic downturn, political blackmail, environmental degradation, moral decay and now add swine flu in the ills of globalization.

Swine flu outbreak became very popular, thanks to its rude name, the current pandemic could become a worse panic-demic than what SARS was. This time’s viral terror got the normally better mannered doctor community use the same crude word without shame or guilt., and why forget swine is not a word native to ethos of medical labs and wards, Though swine flu didn’t affect our country much as yet, our fat friend pig is irredeemably reviled. But in Indian Epidemics as in Politics, a swine is nothing to be sneezed at.

We would all love to vote for the best man in any elections of our medical fraternity, but till date there was never a candidate till we had Dr Suhas Pingle our own member, who. we all know so well and rightly thus won the Maharashtra Medical Council Election with thumping majority. We hope and urge the newly elect Maharashtra Medical Council team to have a heart for our, hard working Doctor community and treat all of us with a sense of Compassion and show that Maharashtra Medical Council is worth it.

Atherosclerotic Cardiovascular diseases have become the leading cause of death globally and hence in our country the widespread negligence and unacceptability, poor compliance of the general population towards the preventive measures is because of the apathy of the health care providers in our country which needs to be addressed seriously and . Surely there has to be a paradigm shift from getting the disease and providing timely treatment to spend on prevention of diseases and promote wellness which will make a world of difference in the health scenarios of our nation said Dr R R Kasliwal Director Cardiology at Indraprastha Apollo Hospital said at the 4th International Symposia on Diabetes along with the faculty from Joslin Diabetes Center USA, held in Mumbai recently.

Dr Sanjay Agarwal,Eminent Endocrinologist of Pune and the Programme Director of the Joslin Diabetes Meet, called Hypoglycaemia as the devil which shall always lurk around and stressed about Wipple’s triad which is (a)Symptoms and signs of hypoglycaemia, (b)Low plasma glucose which corresponds to symptoms and (c)resolution of symptoms on corrections of plasma glucose., Dr A Enrique Caballero of Harvard Medical School showed us the Good, the Bad and the Ugly side of Current Pharmacological therapies of Type 2 DM. Dr Osama Hamdy of Joslin Diabetes Center USA gave us the practical implications of total calories and Nutrients in Diabetics. Dr Arturo Raul Rolla and Dr Robert Shanton of Harvard School gave a fantastic comprehensive guidelines to all the important practical aspects of Diabetes. This was a sumptuous feast to our senses.

Every ill had a pill, but today every pill has a ill. Recently I was amazed while reading a case of a 6 year old child of Nephrotic Syndrome admitted at a hospital in Pune who had allergy to prednisolone. How Amazing but true..

My teacher once told me that If one gets bored of the monotony of Family Practice, which it never is, (unlike all the other branches of medicine), one can opt for some greener avenues like starting a Complete Backache Center, which includes providing all the various treatments allopathic and alternative, under one roof, Stem Cell Company, Sperm Banking, Genetic Counseling etc etc.

Not ignorance, but ignorance of ignorance is the death of knowledge. We all are aware of all the eduinformative CME’s on in our city, and we must grab these opportunities and humbly accept the wisdom as gifts or blessings from our teachers and be smart and richer.

Nothing on this earth can be as pure, true and as innocent as the love for teaching and the teachings of all our great teachers. They are like Sun giving sunshine, tree giving shade and a mother loving her new born. In teaching they guard us and in turn guard the civilization..Everything they taught is priceless

All my teachers and to name some whom I and whole medical fraternity shall always cherish for their selfless contribution to we Family physicians are late Rev Dr K Ramamoorthy, Dr O P Kappor, Dr Y K Amdekar, Dr K G Nair, Dr R D lele, Dr V R Joshi, Dr B K Goyal, Dr R A Bhalerao, Dr F D Dastur, Dr B S Singhal, Dr Philip Abraham, Dr Cameila Rodrigues, Dr Ashwin Mehta, Dr H G Desai,Dr Jamshed Dalal, Dr P M Dalal, Dr Milind Kirtane, Dr Udwadia F E, Dr S M Sapatnekar, Dr Renuka Bradoo, Dr R P Soonawala, Dr Indu Khosla, Dr Nergis Motashaw, Dr Shashank Joshi, Dr Khusrav Bajan, Dr Sandhya Kamath, Dr Gustad Daver, Dr Bhavin Jhankaria, Dr V T Shah, Dr Prakash Kothari, Dr Paresh Navalkar, Dr Mehmood Merchant, Dr Gunvant Sheth, Dr Vinod Parikh, Dr Satish Naik, Dr Sanjay Oak, Dr Ravi Ramakantan, Dr Vishwanath Billa, Dr K N Shah Dr Ashok Kirpalani, Archanaa Pania and many more are truly my Magnets of Cheer and Peace. I look upon them as my mentors. Infact these gems not only are the Kohinoors of our society but are the Medical Ambassadors of our city who have made our stay on this earth worth staying. In a world where the big things make little difference — it’s the little things that make a big difference. I salute you all my life and Thank you my dearest teachers, you have been the light of my life.

Bless me.

Dr Deepak K Jumani

July 2009

My Pranaam to all my Respected teachers, all my guiding colleagues and all the members of General Practitioners Association.

Myths are public dreams and Dreams are public myths.

If you have found your own dream and following it through will lead you to the myth world in which you live. This is true as I dream of a Primary Care Physician being one of the most

important and rarest of the medical personnel and in the highest of demands in this pressing microfocussed super specialists era. Every Primary Care giver is blessed with an authority to treat all the diverse and varied ailments from all the systems of human body. All the Primary care giver needs is regular updates and a positive mind set.

Dr Sanjay Oak, Our most dynamic and classified Paediatric Surgeon of our city, also the Dean of Seth GS Medical College and Medical Director of Health Services, welcomed GPA with open arms for CME’s at KEM Hospital and appreciated humbly the efforts of GPA in giving him a opportunity to bridge the gap between GP’s and Doctors at KEM hosp. to increase the health standards of our city by regularly arranging CME’s at KEM hospital on common issues related to benefit our community. Never to chase TSH while treating patients with thyroid dysfunctions was brilliantly explained by Dr Nalini Shah, Head of Endocrinology Department of Seth GS Medical College and KEM hospital at the CME.

Most of the exercises for various ailments of shoulders, neck, knee, hips and ankles do not require a need to visit a gym and can be conveniently done at home demonstrated

Dr Bhavna Mhatre HOD of the Physiotherapy Dept. of KEM hospital. GPA shall for ever remain indebted to Dr Milind Tullu, Dr Vinay Thapar, Dr Tushar Bandgar, Dr Milind Nadkar Dr Kshitij Choudhary, Dr Sandeep Sonone, Dr Mohan Desai and all other faculty of KEM Hospital for enlightening us on various common medical problems with immense passion and love. This CME was a first step of laying the foundation of a Pilgrimage of wisdom by sharing and learning the experiences of Primary care givers and teachers of Seth GS Medical College. Kudos to Dr B K Dholakia and Dr Vijay Panjabi for reaching this noble milestone.

Practicing Professionalism and ethics are two essential requisites for every successful doctor said World renown and Pioneer of Total Knee replacement Surgery, Dr C S Ranawat, while inaugurating the State of Art Spine Operation Theater of the KEM Hospital recently. It was brain drain in the past but today we see a brain Circulation, explained Dr J M Phatak, Our Municipal Commisioner commending the will of Dr Ranawat who inspite of his busy schedules at prestigious Ranawat Ortho Center at New York, comes to India to share his expertise in Knee Replacement Surgery and also offer fellowship to aspiring Orthopaedic Surgeons of our country.

Minimum Invasive Surgery is the buzz word today, Laproscopic thoracic sympathetectomy

Is the Gold standard treatment for sweaty palms explained Dr Avinash Katara , a Classified Laproscopic Surgeon attached to P D Hinduja Hospital and he has successfully treated over 30 patients of sweaty palms having promising results.

The much awaited software of Vital Health for General Practitioners has now being tested finally and the pilot study was done at various clinics of Mumbai , Dr Vijay Panjabi, Dr Udit Thakker, Dr Vithalani and many others were the part of this study which was a la Grand Success.

Co Enzyme Q in the dose of 300 mg per day given for a period of three months showed astounding improvement in sperm counts in patients with oligospermia. CoQ 300mg marketed by Universal Medicare is truly a miracle life drug.

The happiest people are not those who have the best of all, but are those who simply appreciate what they find on their way. We can always learn to write the sad times of our profession on sand and all the good times on stone. But what we do in life surely echoes in eternity. No one can go back and make a brand new start, but anyone can start from now and make a Brand which can never have any end. In today’s fast pace of life, info plays a vital role, time is a constraint and promptness expected. So we ought to gear up to feed the need to lead.

Instead of avoiding challenges of Family practice, jump into them and beat the heck out of it..

Enjoy the amazing art of family practice and never ever give up, reorganize, find more determination, procure more knowledge, skills and surely your life shall have a promising future. Worry is the darkroom in which negatives can develop. Pessimism, Confidence Crisis are heart stirring questions, which needs to be answered with ignited minds and keep the fire burning inside you. Keep updating and deliver the best any physician can, to every patient who asked for help. Always remember Family Practice is more plural than any other branch of medical speciality.

You are not responsible for what people think about you, but you are responsible for what you give them to think about you. Show your concern, finesse and precision in every thing you do for all your patients at your clinic. Do your Best and God does the rest.

All my teachers and to name some whom I and whole medical fraternity shall always cherish for their selfless contribution to we Family physicians are late Rev Dr K Ramamoorthy,

Dr OP Kappor, Dr Y K Amdekar, Dr K G Nair, Dr R D lele, Dr V R Joshi, Dr B K Goyal,

Dr R A Bhalerao, Dr F D Dastur, Dr B S Singhal, Dr Philip Abraham, Dr Cameila Rodrigues, Dr Ashwin Mehta, Dr Jamshed Dalal, Dr P M Dalal, Dr Milind Kirtane, Dr Udwadia F E,

Dr S M Sapatnekar, Dr Renuka Bradoo, Dr R P Soonawala, Dr Indu Khosla, Dr Sonu Udani, Dr Nergis Motashaw, Dr Shashank Joshi, Dr Khusrav Bajan, Dr Asha Kapadia,

Dr Gustad Daver, Dr Bhavin Jhankaria, Dr V T Shah, Dr Prakash Kothari, Dr Rupin Shah, Dr Uma Ali, Dr Vasant Mundra, Dr H G Desai, Dr Dilip Karnad, Dr Manu Kothari,

Dr Ashok Mahashur, Dr Pralhad Prabhudesai, Dr Jayant Barve, Dr Chetan Oberoi, Dr Roy Patankar, Dr Paresh Navalkar, Dr Mehmood Merchant, Dr Gunvant Sheth, Dr Sanjay Oak, Dr Ravi Ramakantan, Dr Vishwanath Billa, Dr K N Shah Dr Ashok Kirpalani, Dr Jayant Barve , Archanaa Pania and many more are truly my Magnets of Cheer and Peace. Infact these gems are the Medical Ambassadors of our country who have made our stay on this earth worth staying. Thank you all my dearest teachers, you have been the light of my life.

There is no cure for Life and Death , so enjoy the interval. Life is not a problem to be solved, but a reality to be experienced and Happiness is the absence of striving for happiness.

When you enjoy and love your practice, all fear disappears,

When you fear your practice all the joy and love disappears.

With loads of light and love,

I remain,

Dr Deepak K Jumani.

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