Editorials 2010

Editorial for July 2010

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

Everyone wants to be successful, Everyone wants to be happy and healthy, do meaning ful  work, achieve financial independence. Everyone wants to make a difference in the world, be significant and have a positive impact on those around  him or her. Everyone wants to do something wonderful with his or her life. Its also said that Success is not a matter of background, intelligence, or native ability. Its not our family, friends or contacts who enable us to do extraordinary things. Instead its our ability to get the very best out of ourselves under all conditions and circumstances. Its our ability to do what you can with what you have, right where you are. 

Everyone has a Sahara to cross, You and I move in and out of crisis on regular basis. The turbulence and turmoil of life are inevitable and unavoidable. The only part of the equation you control is how you respond. Circumstances do not make the man, they merely reveal him to himself. A Updated Primary Care Physician of today in whatever area he is a grand example of successful healers.

A mediocre physician tries to cure his patient, the enlightened one heals him. A mediocre physician focuses on removal of disease, enlightened one restores health. There is no magic wand but creation of health is more important than removal of disease said our best teacher Dr Y K Amdekar while giving a inaugural talk during the Diploma in Clinical Paediatrics: A certificate Course on Paediatrics which started off at P D Hinduja Hospital recently. He also said that the changing face of infections is a constant reality. Humans, microbes and environment will continue to change. Physicians need to change as well. Constant updating of self knowledge, spending quality time for patient care and documentation of actions for introspection are prerequisites to match the changing situation. We have to run twice as fast if we want to remain where we are. If you have not done so yet, please check your pulse, you may be dead.

Shri Pramod Lele, CEO of the P D Hinduja Hospital and Medical Research Center lauded the seven year trek of CME’s conducted by GPA and reinforced that Primary Care Physicians shall always remain the main soldiers of medical warfront and as he still showed his unflinching faith in his own family doctor for getting himself treated for any ailments wished every Primary Care Physician be updated and heartily felt that the nobility of the medical profession is even today  seen in a Primary Care Physician.

Prof Barbara Starfield Head Priamry Care at John Hopkins, USA  in her awesome keynote address at the WONCA Conference  for Family Physicians, held recently in Mexico, irrefutably declared that the future of a Updated Primary Care Physician is the brightest amongst all branches of Medicine. Over 3000 delegates from all across the globe, attended, the Wonca Conference for Family Physicians held in Mexico last month. The highlight of the conference was  over six simultaneous sessions , six hundred topics,   spanning from anaemia to disaster management, leadership, communication skills , over six hundred poster exhibits and countless splendid workshops added colour to the conference. The best part was for the first time 18 members of our association, from Mumbai attended this international Family Physicians meet. Our esteemed  Dr Ramnik Parekh was elected for the coveted posts of South Asia Pacific Wonca. Dr Vinod Parikh our CEO fabulously organized this meet  and this was a great gesture to build bridge amongst our own brethren across the globe and increase brotherhood.

Kudos to Dr Kumud Nagral our member brilliantly revealed the relevance of our Ancient Indian Medicine, “Ayurveda” and how a holistic approach can give a better health care today  to our patients in her two volumes of Ayurved for Modern Medical Practitioners.

The human brain is built for learning by example and experience and adolescents today believe much more in what we do than what we tell them to. In fact it there is anything parents can take away from all the scientific research in development of adolescents is that their influence, patience, understanding and guidance are necessary, even if a teen ager grunts, slams doors, blasts music, rolls eyes, breaks house rules. Adolescents today need appropriate amounts of independence and responsibility. They may drive the family car, move away from home, go to college and spend their early twentys wrestling with life decisions, all while growing up, but all said and done just because adolescents have left their childhood behind, “parents shouldn’t  say, ‘My work is done’.”

A fabulous breakthrough in the treatment of Schizophrenia or schizoaffective disorder in young individuals  is Amisulpride. This is a new drug tried globally with promising clinical improvement of symptoms and illness severity.

Tow vaccines which I recommend every Primary Care Physician must keep and lavishly administer are Hepatitis B vaccine and HPV vaccine. We cannot do everything at once, but we can do something at once.

Multistix SG of Miles India Ltd is a splendid uristick and it costs just Rs 3, and this should always be kept in a visit bag of a Primary Care Physician who can diagnose the cause of severe vomiting either due to viral hepatitis or due to diabetic ketoacidosis. This little thing can save life.

Every Primary Care Physician of our association has within him or her , right now, deep reserves of potential and ability which if  properly harnessed and channelled, will enable them to accomplish every extraordinary things in  their life. The only real limits on what you can do, have, or be are self imposed. They do not exist outside of you.  We all have a fabulous opportunity  every day to learn newer avenues & learn something from the vast  panorama of skills required to cure and heal all who come to us. So once you make a clear unequivocal decision to cast off all your mental limitations and throw whole heart into the accomplishment of anything new you want to start in your practice, your ultimate success is virtually guaranteed as long as you don’t stop .

There are many things in life that will catch your eye. But only a few will catch your heart. The worst prison would be a closed heart.  The secret to achieve  whatever you aim for  in life is to enjoy every moment you are in, as each day is little life and Do all things you do with all your love and commitment  as  Commitment is a line you must cross….it is the difference between dreaming and doing.  Its noble to dare to commit .  After all Life is either a daring adventure or nothing.

With loads of love and light,

Dr Deepak K Jumani

EDITORIAL June 2010

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

One day Akbar drew a line with his royal hand on the floor of the open court and told his wise men that if they wanted to keep their jobs they must make the line shorter without touching any part of it. Wise man after wise man approached and stood staring at the puzzle, but they were unable to solve the problem. Finally Birbal stepped forward and drew a longer line next to the first one, without touching the first line. Everyone in the court look at it and agreed. The first line was definitely shorter. This is what we (bribals)family physicians can do by updating ourselves  and have the Akbars (Consultants) in every awe.

We live on an island surrounded by a sea of ignorance. As our island of knowledge grows, so do the shores of our ignorance.  We turn not older with years, but newer every day. Its never too late to seek a newer world. What you need to know about the past is that no matter what has happened, it has all worked together to bring you to this very moment. And this is the moment you can choose to make everything new. Right now. This month onwards we Family Physicians are in for a feast  as we have My Best Teacher Dr O P Kapoor starting his golden lecture series at Birla Matushri every Sunday morning.. These lectures are the gifts of loads of Gold for all those who attend them and the wisdom earned  have been   the ideals which have lighted my way, and time after time have given me new courage to face the challenges of  life cheerfully.  The roots of education are bitter, but the fruit is sweet.

My head falls down in  shame and I feel so small when I think of the parent body of our fraternity, our Medical Council of India being dissolved and may be politicians are eyeing to grab the same, which shall be the most pathetic and disaster for the  medical professionals and humanity at large. As we know Politics is nothing but Poly tricks and Politicians know nothing except victory, defeat and revenge.  

At no point in history has a generation been so satisfied with material comforts as ours. We have supersonic jets that take us to various parts of the world in the blink of an eye, and cars that not only move at agreat speeds but offer untold luxury. We have iphones, ipads, Black berrys and before we learn to use them there are new models in the market. Ther are endless sources of entertainment : from over 200 tv channels, digitally enhanced movies in the multiplexes, music personalized on ipods that we can tune into our wills and whims and fancy. But with all this comfort and entertainment we are still angst ridden, in the need of therapy and counselling and drug induced sleep and drug einduced daefecations. A restlessness has siezzed our lives. We have to constantly update not only our fancy phones and music systems but our personal hard drives too. Even happiness seems to be a goal which we have to strive for. We Primary Care physicians have all the potential to be always happy because we are the first to see the changes in everything in our lives may be symptoms of our patients, prognosis of diseases, patterns of the diseases  and more so attitudes and mindsets of patients too. But one thing which haunts me all the while and keeps me going is that we have to change with the flow of change.

Scientists at Santa Barbara and University of Michigan USA, have developed synthetic particles that closely mimic the characterstic key functions of natural red blood cells, including flexibility, softness and the ability to carry oxygen. They have coined these particles as sRBC.  The s RBC’s also have been shown to deliver therapeutic drugs effectively and with controlled release. These have also been proven to carry well distributed contrast agents for enhanced resolution in diagnostic imaging. The ability to create flexible biomimetic carriers of therapeutic and diagniostic agents really opens up a whole new realm of possibilities in drug delievery and similar applications. What is more fulfilling to me is that these Scientists who have done this innovative engineering are  Dr Nishit Doshi and Samir Mitragotri both are Indians. What a fantastic discovery.!

A new drug in the treatment of hyperuricamia associated with gout is Febuxostat a Xanthine oxidase inhibitor  gioven in the dose of 40 mg to 80 mg have shown a great promise in reducing recurrent episodes of gout. A good option in the narrow basket of drugs available to treat gout.

There was a wise man who lived up in the mountains and all these people wanted him to drop into the mosque and give them the word on Sunday, so he said all right. He showed up on Sunday and there was this huge crowd of people and he says : Good people, do you know what I’m going to talk to you about?,  and they all shouted back  “No” and he says “Ignorant People”, and he turns around and he leaves. And so they go back up and say , Wait a minute, man, you came through too fast for us, drop in again next Sunday…and he says all right. So next Sunday he’s down there and he starts, Good people, do you know what I’m going to talk to you about? and this time they’re ready for him and they all yell Yes  and he says  Good! and he turns around and he leaves. And so finally they say, Look, man, just one more time, cause somehow it’s slipping past us. So he comes down the third time and starts up there, Good people, and this time they’re ready for him…Some of us do and some of us don’t. Good!, he says. Let those who do communicate their knowledge with those who do not.

So its rightly said our thoughts are our destiny.  Thus  the thoughts which make we family physicians creative and innovative are  those that bring in feeling of unconditional love, of doing something good without expectation of getting something in return., whether name or fame or money, and regularly updating ourselves. This creativity needs to be developed and explored.  We all can and We all will. Because I know my teachers  always blessed me and said our love for you is a journey; Starting at forever, And ending at never . Thank you all my teachers for enlightening us and making our lives worth living.

Dr Deepak K Jumani

EDITORIAL May 2010

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

To learn for we practicing physicians should have a undying passion. When work, commitment, and pleasure all become one and you reach that deep well where passion lives, nothing is impossible. If there is no passion in your life, then have you really lived? Find your passion, whatever it may be. Become it, and let it become you and you will find great things happen for you, to you and because of you. In fact passion is the genesis of genius.

Passion and purpose go hand in hand. When you discover your purpose, you will normally find it’s something you’re tremendously passionate about. Follow your passion, and success will follow you Develop a passion for learning. If you do, you will never cease to grow. Never underestimate the power of passion.  A passion to learn is LIFE. Thats why I find a tremendous rise in the number of Family Physicians attending CME’s. Once again we have a great opportunity to be wise and rich through rekindling our passion to learn.. Lets attend our best teacher  Dr O P Kapoor’s lecture series which shall begin next month at Birla Matushri Sabhagriha.

We Family Physicians should counsel all our diabetes patients of what is called Metabolic Memory.. Large-scale clinical trials have demonstrated that metabolic control achieved early in the course of diabetes substantially reduces development and progression of diabetes and the associated microvascular complications. Additionally, prospective observational studies have demonstrated that atherogenic and inflammatory mediators are elevated even prior to the onset of diabetes and significantly contribute to subsequent development of macrovascular complications. Collectively, these data suggest that metabolic memories are stored early in the course of diabetes. We believe that insulin suppresses inflammation and also suppresses glucotoxicity and lipotoxicity (and the consequences thereof, such as the formation of advanced glycation end products and epigenetic phenomena), and thus has a pivotal and beneficial role. Comprehensive metabolic control, especially when instituted early, may alter the natural history of diabetic complications by affecting this metabolic memory. Thus, our overall goal is to understand in more detail the molecular mechanisms involved in these changes, thereby affording us opportunities to reduce the long-term effects of diabetes..

Researchers at Boston Medical Center  examined several fast food items from McDonald’s. They spectrophotometrically measured the iodine content of each homogenized item and It was surprising for them to find out that these fast food products, which are supposed to contain a lot of salt, did not really have high iodine content at all. Although there has been a decrease in iodine intake,  Such a diet is not a ideal diet for children and pregnant women. This should be a warning signal for we Indians who have been following the west and all they get is be obese.. after all your stomach should not be a waist basket.

Well, spring is in the air and summer’s on a whisper of a cloud coming our way. Not to make light of those horrific clouds from Iceland’s spewing that cost the airlines billions and grounded the whole planet almost for a week, but let’s always remember that Mother Nature is always in charge. Such new phenomenons shall be seen very often and these climatic dramas are nothing but a right reply to mankind’s teasing Mother Nature.

Common causes of  Red eyes in Children are FB / Corneal abrasion,  Allergic conjunctivitis, Infective conjunctivitis either bacterial or viral,  Uveitis , Glaucoma & Blocked tear duct in newborns explained Dr Ashwin Sainani a promising Paediatric Ophthalmic Surgeon attached to P D Hinduja Hospital. Many of these conditions can be silent and can be diagnosed by  Poor performance at school,  Watery eyes, eye rubbing ,Recurrent headaches or eye strain,  Complaints of blurry vision, Head position,  Seeing objects from close said Dr Sainani.

Dr S M Sapatnekar, Medical Director of Karmic Lifesciences,  & Ex Chairman of Haffkeines at a Workshop on Code of Medical Ethics conducted by Medical Council of India and Indian Medical Association Maharashtra State, said  that Medical Council of India’s  Code of Ethics is a document drafted very shoddily,  there are many escape routes  glaring and MCI lacks enforcement mechanism and hence theInevitables are Pharma Co.s will find it difficult to make provisions in their budget for “Marketing expenses”, their Proxy transactions will increase, There will be ‘Benami’ or ‘Hawala’ transactions .

Potential patient safety impact of informed consent needs to be understood and necessasary corrections must be made in the formation of Informed Consent said Ace Cardiothoraci Surgeon PadmaShri Dr Ramakant Panda at the Workshop on Code of Medical Ethics.  He also said Improving missed, incomplete or poorly understood informed consent is a significant patient safety opportunity and `Better informed patients “ are less likely to experience medical errors by acting as another layer of protection”

A awesome journal launched  by  Dr Ashok Agarwal , our member, could be a  atlas for Family Physicians is GP Clinics. It is a worth reading material for all GP’s  as its simple and useful. It has a fantastic collection of articles from various peer reviewed journals and is very economically priced.

Congratulations and  Kudo’s to Dr Ramnik Parekh, Dr Jyoti Parekh, Dr Vinod Parekh, Dr Mehmood Merchant and over 2 dozen dedicated  stalwarts of Family Medicine and our members who shall be attending the World Conference of Family Medicine at Cancun Mexico  this May. This endorses their  genuine academic  thirst,  touch and brotherhood which we Family Physicians of our city manifest.

Every CME you attend  can be useful in your day to day practice. Every new avenue you take up can fetch you rich dividends. Be more service oriented, be well informed about all the latest investigations, newer therapies, investigations and treatment  modalities available in the city and be aware of who’s who in the medical fraternity. Do what you love and love what you do,  Don’t judge each day by the harvest you reap, but by the seeds you plant,  Problems in the clinics are not stop signs, they are guidelines.

It is once again a great victory to Medical fraternity’s solidarity and unity in voicing the  crusade to stop the  menace of violence against doctors. The Bill to this effect was legalized  in the Vidhan Parishad on 23rd April 2010 and now it’s a permanent Law. I believe that Society is a hospital of incurables and we must be ethical and transparent in every act of ours in our clinic. As The ornament of a clinic or a hospital is the patient  who frequent it, &  its our moral duty towards our own conscious to give them more than asked for. We must make your life a mission – not an intermission.

With Loads of Love and Light,

Dr Deepak K Jumani

EDITORIAL  April 2010

Pranaam to all my Respected teachers, guiding guides and all  our esteemed members of GPA.

The medical profession is probably the only profession where the professional cannot tell the client (patient) that “It was good doing business with you, please come again!” as that does not bode well for the patient.  Its true that MCI  has new resolutions not  to let medical fraternity accept any handshake with  any pharma companies  and this has been a total paradox to the reality. We Family Physicians have started receiving  sms’s from affected Consultants not to prescribe the drugs from MNC’s who abide by MCI’s  sentiments.  This  war is an eyewash and soon shall sadly commit suicide. Truly  He who wants the rose must respect the thorn.

I do not believe in generation gap. I believe in regeneration gaps. Each day a Family Physician can regenerate. Creative  experience foreshadows a new Heaven and a new Earth. So many Avenues exist today for we Primary Care Givers to earn revenues.

We know now that just as our medical science can coax stem cells to take on the form of any cell in the body, creating heart tissue, bones and even brain tissue to replace the damaged body parts, so, too,   we  can coax our mindset to do a variety of things as Primary Care Physician in our clinics, which can bring in your life the  romance of a Great General Practice.

Once you have opened up your doors of  innovation you will find a plethora of opportunities waiting for you to walk in your life to give you all what you wanted in life.  And we all truly believe that our real ultimate purpose in life is growth and peace. You really are the creator of your own reality.

Keep your hand and your heart in the Right direction and you’ll not have to worry about your feet. Don’t  sit back and take what comes.. Go after what you want. & Remember you are Unique, just like everyone else.  We should give meaning to life and not wait for life to give us meaning. This is the Unspoken truth spoken fully.

Common reversible causes of premature aging are  Oxidative stress and impaired mitochondrial function, Glycation (dysglycemia) and insulin resistance, Chronic inflammation, Altered methylation reactions, Lipid atherogenesis , Compromised detoxification capacity, Poor immune function, Chronic stress response, Hormone imbalance &  Physical and mental inactivity explained  Endcrine Debonair Dr Shashank Joshi

What can we do to slow the aging process : Daily stress reduction practices,  Daily physical activity , 8 to 10 servings of fruits and vegetables daily ,8-10 glasses of water daily ,10 servings of cooked tomatoes weekly,  Reinforcement of childlike experiences of life ,At least 8 hours of sleep every day ,  Continued social connection with family and friends of different generations,  Meaningful communication with family and friends, especially sharing wisdom with young people Maintenance of optimism and a positive outlook  Routine cancer and CVD screening , Supplementation with B  vitamins and antioxidants,  Conscious enjoyment of living with meaning and purpose, Maintenance of physical, mental, emotional, and spiritual balance with a relatively stable and disciplined daily regimen can slow the aging process  said Dr Niharika Suchak  Head of Division of Geriatric Medicine, Hackensack University Medical Center, USA.

Exercise may minimize or reverse the syndrome of physical frailty, which is so prevalent among the most elderly. Because of their low functional status and high incidence of chronic disease, there is no segment of the population that can benefit more from exercise than the elderly said Dr Vatsal Kothari who heads the Intensive Care Unit of the Kokilaben Dhirubhai Ambani Hospital speaking at the Gericon 2010 held in Mumbai recently.

Young people are not healthy as they seem  this was brilliantly described by Robert Blum in the Lancet  2009; 374-853-54. Today almost a third of worlds population is aged 10-24 years, and in many developing countries 30% , or more of the population fall into this group. In Industrialized nations young men are two or four times more likely to die  than  are  young women, and homicide, suicide and injury account for between 50% and 80% of adolescent mortality. Also WHO estimates that more than 250, 000 pregnancy related deaths happen world wide.  Looking at this frighting fact one must understand that we have a geriatric population surge  which shall be a challenge in future. Are we prepared to accept this challenge  voiced  Dr Bakulesh Mehta President  of IMA MS.

I came across some Miracle Humans in my three decades of practicing medicine. These angelic souls paralysed my fears, gave me booster doses of wisdom and  all the light with unconditional love to fill my life with amazing delight, peace and truest job satisfaction. These Miracle humans are all my awesome teachers, who are and shall be my greatest awe for ever.  These teachers who were born with every breath to give and to teach gave me  all the  coolest happiness the rewards of which are my real Oscars of life .  There can be no second OP Kapoor, Second K Ramamoorthy, Second YK Amdekar, Second VR Joshi, Second KG Nair, Second Jamshed Dalal, Second Manu Kothari, Second Shashank Joshi, Second Gunvant Sheth, Second Mehmood Merchant, Second N Motashaw, Second Pratiksha  and many more teachers who shall never ever be second but always cherished as numero uno . Fortunate are those who have been touched by these Kohinoors of Medicine.

We do not have to be good at everything. It was Einstein who said, “Do not worry about your difficulties in Mathematics, I assure you that mine are greater” Every Primary care physician is a superman or a super woman and can make difference in the life of every patient, whom they see. Serenity comes from  rejoicing what we can do and doing it for every patient  with all our heart and soul. Don’t agonize, Organize your clinics with all hathiyaars & your splendid positive  thoughts.

Thoughts are like data programmed into a computer, registered on the screen of your life. If you don’t like what you see on the screen, there’s no point  going up to the screen and trying to erase it. Thought is Cause & Experience is  Effect. If you don’t like the effects in your life, you have to change the nature of your thinking.

Keep your thoughts positive, because positive thoughts become your words, Keep your words positive, because your words become your behaviour. Keep your behaviour positive because your behaviour becomes your habits, Keep  your habits positive, because your habits become your values. Keep your values positive, because your values become your destiny. In short your thoughts are your destiny.  Do not forget,  if you want to succeed, you got to start from scratch and keep scratching.

With loads of love and light,

Dr Deepak K Jumani

EDITORIAL

Pranaam to all my Respected teachers, guiding guides and all  our esteemed members of GPA.

The medical profession is probably the only profession where the professional cannot tell the client (patient) that “It was good doing business with you, please come again!” as that does not bode well for the patient.  Its true that MCI  has new resolutions not  to let medical fraternity accept any handshake with  any pharma companies  and this has been a total paradox to the reality. We Family Physicians have started receiving  sms’s from affected Consultants not to prescribe the drugs from MNC’s who abide by MCI’s  sentiments.  This  war is an eyewash and soon shall sadly commit suicide. Truly  He who wants the rose must respect the thorn.

I do not believe in generation gap. I believe in regeneration gaps. Each day a Family Physician can regenerate. Creative  experience foreshadows a new Heaven and a new Earth. So many Avenues exist today for we Primary Care Givers to earn revenues.

We know now that just as our medical science can coax stem cells to take on the form of any cell in the body, creating heart tissue, bones and even brain tissue to replace the damaged body parts, so, too,   we  can coax our mindset to do a variety of things as Primary Care Physician in our clinics, which can bring in your life the  romance of a Great General Practice.

Once you have opened up your doors of  innovation you will find a plethora of opportunities waiting for you to walk in your life to give you all what you wanted in life.  And we all truly believe that our real ultimate purpose in life is growth and peace. You really are the creator of your own reality.

Keep your hand and your heart in the Right direction and you’ll not have to worry about your feet. Don’t  sit back and take what comes.. Go after what you want. & Remember you are Unique, just like everyone else.  We should give meaning to life and not wait for life to give us meaning. This is the Unspoken truth spoken fully.

Common reversible causes of premature aging are  Oxidative stress and impaired mitochondrial function, Glycation (dysglycemia) and insulin resistance, Chronic inflammation, Altered methylation reactions, Lipid atherogenesis , Compromised detoxification capacity, Poor immune function, Chronic stress response, Hormone imbalance &  Physical and mental inactivity explained  Endcrine Debonair Dr Shashank Joshi

What can we do to slow the aging process : Daily stress reduction practices,  Daily physical activity , 8 to 10 servings of fruits and vegetables daily ,8-10 glasses of water daily ,10 servings of cooked tomatoes weekly,  Reinforcement of childlike experiences of life ,At least 8 hours of sleep every day ,  Continued social connection with family and friends of different generations,  Meaningful communication with family and friends, especially sharing wisdom with young people Maintenance of optimism and a positive outlook  Routine cancer and CVD screening , Supplementation with B  vitamins and antioxidants,  Conscious enjoyment of living with meaning and purpose, Maintenance of physical, mental, emotional, and spiritual balance with a relatively stable and disciplined daily regimen can slow the aging process  said Dr Niharika Suchak  Head of Division of Geriatric Medicine, Hackensack University Medical Center, USA.

Exercise may minimize or reverse the syndrome of physical frailty, which is so prevalent among the most elderly. Because of their low functional status and high incidence of chronic disease, there is no segment of the population that can benefit more from exercise than the elderly said Dr Vatsal Kothari who heads the Intensive Care Unit of the Kokilaben Dhirubhai Ambani Hospital speaking at the Gericon 2010 held in Mumbai recently.

Young people are not healthy as they seem  this was brilliantly described by Robert Blum in the Lancet  2009; 374-853-54. Today almost a third of worlds population is aged 10-24 years, and in many developing countries 30% , or more of the population fall into this group. In Industrialized nations young men are two or four times more likely to die  than  are  young women, and homicide, suicide and injury account for between 50% and 80% of adolescent mortality. Also WHO estimates that more than 250, 000 pregnancy related deaths happen world wide.  Looking at this frighting fact one must understand that we have a geriatric population surge  which shall be a challenge in future. Are we prepared to accept this challenge  voiced  Dr Bakulesh Mehta President  of IMA MS.

I came across some Miracle Humans in my three decades of practicing medicine. These angelic souls paralysed my fears, gave me booster doses of wisdom and  all the light with unconditional love to fill my life with amazing delight, peace and truest job satisfaction. These Miracle humans are all my awesome teachers, who are and shall be my greatest awe for ever.  These teachers who were born with every breath to give and to teach gave me  all the  coolest happiness the rewards of which are my real Oscars of life .  There can be no second OP Kapoor, Second K Ramamoorthy, Second YK Amdekar, Second VR Joshi, Second KG Nair, Second Jamshed Dalal, Second Manu Kothari, Second Shashank Joshi, Second Gunvant Sheth, Second Mehmood Merchant, Second N Motashaw, Second Pratiksha  and many more teachers who shall never ever be second but always cherished as numero uno . Fortunate are those who have been touched by these Kohinoors of Medicine.

We do not have to be good at everything. It was Einstein who said, “Do not worry about your difficulties in Mathematics, I assure you that mine are greater” Every Primary care physician is a superman or a super woman and can make difference in the life of every patient, whom they see. Serenity comes from  rejoicing what we can do and doing it for every patient  with all our heart and soul. Don’t agonize, Organize your clinics with all hathiyaars & your splendid positive  thoughts.

Thoughts are like data programmed into a computer, registered on the screen of your life. If you don’t like what you see on the screen, there’s no point  going up to the screen and trying to erase it. Thought is Cause & Experience is  Effect. If you don’t like the effects in your life, you have to change the nature of your thinking.

Keep your thoughts positive, because positive thoughts become your words, Keep your words positive, because your words become your behaviour. Keep your behaviour positive because your behaviour becomes your habits, Keep  your habits positive, because your habits become your values. Keep your values positive, because your values become your destiny. In short your thoughts are your destiny.  Do not forget,  if you want to succeed, you got to start from scratch and keep scratching.

With loads of love and light,

Dr Deepak K Jumani

March 2010 There was no Editorial printed due to lack of space

February  2010

Pranaam to all my respected teachers, and all the members of GPA…

Atharva veda (2500 BC)  mentions “Aham  Annam” which means  We Are ,What We Eat. Today what is killing Indians  is  Lifestyle Disorders  like CAD, DM and due to what ? its Obesity-Tummy Fat   and Oxidative Stress. The  incidence of cardiovascular disease  can be lowered due to  inhibition of LDL, oxidation by antioxidants  & also by antioxidants found in fruits & vegetables  So  Vegetarian diets and Rice bran oil which is a heart friendly oil due to its innate composition and being combined with tocopherols and Oryzanol act as Powerful antioxidants, Cholesterol reducing agent,Anti-cancer,Anti-thrombotic and Anti-ageing is a boon  said  Endocrine debonair Dr Shashank Joshi at our  40th Annual Medical Conference held recently.

The more we become, the more we are capable of becoming, and the more we are capable of becoming the more we become.  This was personified  in Dr Prateeksha Das the first woman Preventive Cardiologist of India &  Founder & Director of Institute Of Preventive Cardiology , the first of its kind in India who has trained over 1,00,000 normal individuals till date for Prevention of Heart Diseases through Lifestyle Managements at various centers of the Institute in Mumbai and treated over 5000 heart patients who had been advised bypass surgery or angioplasty through her Cardiac Rehabilitation Programs with 90% success rate of avoiding Bypass surgery.

It is amazing how complete is the delusion that beauty is goodness, explained  Plastic  Surgeon Dr Mohan Thomas in his talks on ABC of looking good at the Conference.  He does amazing makeovers , fillings, breast augmentation, fat reductions etc. Really the mystery of the world is the visible, not the invisible.

Congratulations to  Dr Udit Thakker for presenting a case of Child in Distress  &  Dr Mehmood Merchant for his case on Syncope. Both  the cases  were winners of  GP  Paper Presentation and  were eye openers and brilliantly managed.

Viruses are a great challenge to mankind  and in future we must be vigilant in diagnosing them clinically  & In general wide spread practice of prescribing antibiotics as a kneejerk response to any infection is bad medicine. There are hundreds of antibiotics available to fight bacteria but none of them are effective against viruses. In viral infections antibiotics should be reserved for serious super infections with bacteria or to prevent likely bacterial infections post viral infections was explained  brilliantly by Senior Family Physician by Dr Ramesh Bansode reciting his invitation paper at the Conference.

To fly we have to have resistance and we need to work hard said Dr Satish Naik who claimed and explained to have done blunders for  two and half decades of his practice as a GP, by doing  Ct all. As a Primary Care Physician,  I feel  Ct all  is not “Continue all “, but with the variety of things we can do as GP’s , its  a  “Creative tall” acts of  service  and joy, and the only limits are, as always  those of our vision.

Common medical illnesses that often present as psychiatric emergencies  are: hypo & hyperthyroidism, diabetic ketoacidosis,hypoglycaemia, uti, alcohol intoxication, alcohol withdrawal,  acute liver disease, steroid induced psychosis, hypokalaemia, hypocalcaemia, epidural & sub arachanoid haemorrhage, pulmonary embolism & even myocardial infarction. said Dr Yusuf Matcheeswala  delivering his brilliant talk at the conference. He stressed that  A must in a GP’s bag should be drugs like  Ether, Injections of Haloperidol, Lorazepam, Chlorpromazine, Promethazine, a rope, and certain help line numbers  HELP LINE:   64537070 / 64537171. Psychiatric Ambulance 9821119603 / 9819533496/ 9869422592 / 9320520899

Dr Vishwanath Billa a classified Urologist  said that Heart is a  Monofunctional organ, whereas the Kidney is Polyfunctional organ Hypertension is a kidney disease,Anemia is a kidney disease, Metabolic bone disease is a kidney disease, Dysnatremias and dyskalemias are kidney diseases,  Acid Base imbalance is a kidney disease, Renal failureis  also a kidney disease, mediated by solutes, hormones, channels, signals, second messengers etc, all controlled by the kidney.  Diagnosis of heart diseases can bedone by clinical examination, ECG, Echo, Thallium &  Angio , Whereas in Diagnosis of Kidney diseases  Interpretation is everything.

Our attitude towards life determines life’s attitude towards us. Dr B K Dholakia our senior family physician and  a grass root support of GPA in strengthening the academic  stem of our Association was rightly honoured with the coveted Life time Achievement Award  for his undying passion to work for updating the Family Physicians in every walk of medicine. Dr B K Dholakia is a  person who is always so unassuming, gentle and pure at heart. GPA is proud of him and his massive contributions to the fraternity of Primary Care physicians.

Dr B K Misra, a renowned NeuroSurgeon attached to P D Hinduja Hospital  while delivering the prestigious Dr L U Kirpalani Oration at the Conference  enlightened us on amazing newer advances in neurosurgery  and made us feel as though every sick or abnormal  nerve or  neurone can today be healed. Really The only limit to our realization of tomorrow  will be our doubts of today, and its our duty to proceed as though limits to our abilities  do not exist.

WHO , in its World Health Report of 2008 emphasized the importance of laying stress on primary health care , right opportune time for general practitioners to show their colours & the  Primary Care Givers are the most important stake holders in primary health care system  of the nation said  Dr Preethi  Wijee gonoawardanee President Wonca-Mesar while delivering his key note address at the Conference. He was impressed with the work done by GPA and also said that Every Primary Care Physician should  continue  professional development,  be proud, hold your head high, be closest to the community, shower all the empathy, love and caring to all your patients and show the world that monetary gains is not your motto, but healing and caring for the sick, honestly and rationally is our USP.  He admitted that GP’s of Mumbai  are truly the best clinicians to innovate to excel.

Onco Surgeon Dr Anandh Balasubramanium, Radio Onco Surgeon Dr Kaustav Talapatra, Interventional Radiologist Dr Vimal Someshwar, Vascular Surgeon Dr Ibrahim Riza, Paediatric Cardiac Surgeon Dr Suresh Rao and Orthopaedic Surgeon Dr Dinshaw Pardiwala all from Kokilaben Dhirubhai Ambani Hospital  showed us awesome newer endeavours they do  in their respective field with amazing results. Undoubtedly Kokilaben Dhirubhai Ambani Hospital with its whole bunch of skilled brain tanks is a boon to our patients .

Dr Niteen Dedhia, ophthalmic Surgeon took us through a panorama of newer advances in Ophthalmology and Dr Aashish Arbat enlightened us on Newer advances in therapies by Arthroscopy.  Dr Taral Nagda, witty and brilliant as ever demonstrated the gratifying results of  limb surgeries. Dr Amita Nene in her tinkling style  refurbished our grey matter with the newer advances in treatment of Pneumonias. Ace Interventional Cardiologist Dr VT Shah  brilliantly convinced why  Diabetes  should be treated by Cardiologists & Dr Raghunath Pathak, Diabetologist at  Raheja Hospital gave us useful tips on use of insulin in Primary Care. Dr Ira Shah Editor of Paediatric on call  simplified the whole theory and practicals of Respiratory tract infections , Diarrhoea, and Fevers in children with her genuine passionate and simple style. The simple things are often the truest and making the complicated  simple, awesomely simple that’s creativity. GPA wholeheartedly thanks Dr Ira Shah for her mighty contributions to Primary Care. In fact 40th Annual GPA Conference was a great feast.

I wish this New Year, a newness in you all  which shall be full of Peace, Wisdom, Happiness & Love. This is possible with the attitude to keep updating, changing with the tides  and move on. No mirror ever became iron again, No bread ever became wheat, No ripened grape ever became a sour fruit,  So Mature yourself and be secure.  Become Light…. After all life is like riding a bicycle and to keep your balance  you must keep moving.

With loads of love and light.

Dr Deepak K Jumani

January 2010

A warm welcome and pranaam to all my respected teachers, all members of GPA to a very energetic, peaceful and creative  2010.

One of the cornerstones of family medicine is the tenured relationship that develops over time with the patients and as a Primary care physician helps them deal with life shaping issues right from conception, birth, first steps, first teeth, starting school, puberty, marriage, parenting, striving to succeed, changes such as climacteric and menopause, accepting the ticking of the clock, coping with acute and chronic illnesses, loss of dear ones. These are the fabric of Family medicine and the elements that bond Primary Care Physicians  and their patients. Today one thing which is striking about  dedicated Primary Care Physicians is that they are flowing, flexible, dynamic, composed of information and energy, have  a network of intelligence and are trying to  do everything to make them timeless and ageless.

Activism is all about 100% listening and adopting a doctrine or policy advocating pro-active steps in every field of medicine said Renowned Psychiatrist, Dr Yusuf Matcheeswala and every Primary Care Physician  can do so wonderfully. If we strive to preserve this spontaneity and  this expectation unconditionally  in our  day to day practice we can create power and light. Life can thus be a fascinating journey with full of changes, challenges, choices and yes a full life.

Inch by Inch Life is a cinch ( Certainty),  Yard by Yard Life is hard. This is a beautiful time management concept for every busy Primary Care Physician who have lots to do. All one can do is write down the list of every thing he needs to do during the day and then keep sincerely doing each thing one at a time.  Working in haste and cutting corners are the quickest routes to disasters.

You cant help getting older, but you don’t have to get OLD, Growing OLD is inevitable, Growing up is optional, & its important to have a twinkle in your wrinkle, said Shri Pramod Lele, CEO of P D Hinduja Hospital and Research Center on his 60th Birthday. GPA and all the members wish Shri Pramod lele a long, creative and healthy life ahead.

Stem Cell Therapy has been a approved therapy in patients having spinal cord injuries and is also tried in numerous other  neurological disorders with promising results said Professor of Neuro Surgery at LTMMC & Sion Hospital Dr Alok Sharma  and though this is a team work,we all can learn this newer skill, a sure avenue for enthusiastic Physicians who love to match with future. Do not wait to strike till the iron is hot, but make it hot by striking.

The Ninth International Diabetes Symposium in collaboration with Mayo Clinic, USA to be held in January 2010,is a unique opportunity for all the Primary Care Physicians to be Certified Diabetes Educators and be instrumental in  participating in the crusade to help our patients understand Diabetes and reduce the complications of Diabetes Mellitus. GPA wholeheartedly thanks Endocrine Debonair Dr Shashank Joshi for inviting Primary Care Physicians to this much awaited festival of knowledge. Dr Joshi believes that as in England all the motivated Primary Care Physicians in our country will in near future manage the treatment of  Diabetes. Dr Shashank Joshi is today’s Sir William Osler who once said “ One of the first duties of the physician is to educate the masses.”

POEM and DOE are two types of evidences:  POEM ( Patient Oriented Evidence that Matters) is a study addressing the quality of life issues, mortality and morbidity. These studies deal with patient outcomes and may lead physicians to alter their patterns of practice.

DOE(Disease Oriented Evidence) A study addressing factors such as organ functions, or biochemical levels in the blood & also deals with investigative procedures Our knowledge and understanding of aetiology, prevalence and pathophysiology is enhanced by DOE. Dr V R Joshi, Director of Research at P D Hinduja Hospital and Father of Rheumatology brilliantly encouraged we Primary Care Physician to be proactive and do case control studies in their community which shall enable them to formulate  practice guidelines and then have Evidence based practices.

As I look ahead to the twenty-first century, it is apparent that there are more specialists, superspecialists and not enough dedicated Primary Care Physicians. More mushrooming of Corporate hospital Malls luring the devoted teachers from the teaching institutes and thus letting the teaching institute loose its reverence. There is increase in development of newer, costly  treatment options leading to rationing of health care. The population of our country is aging and geriatric problems like management of Chronic ailments, terminal diseases, patients with multiple problems,  patients with immunocompromised states, recurrent infections which will surely rise.

Primary Care Physician shall become techsavy and have his computerised health record system and may even do better decision analysis and may even do some computer assisted laser surgeries in their clinics. Primary care physician shall  be academically recognised with a splendid knowledge base by regularly updating, and instead of managing health of a certain pocket will evolve beyond managed care to its next major stage of population based health care and manage issues related to community health persons, environment hazards, lifestyles etc. Primary Care Physicians of India shall expand its leadership role by enriching international community of Family Physicians by communicating across borders and oceans not because of a philosophic epiphany in the house of medicine, but because the politics of health care place vital resource decisions in the hands of Primary Care Physicians. WONCA Conference this year to Mexico is  a fantastic platform to pave the roots of Family Medicine practice blossom to a unique  Supermulti-speciality.

We must lean to come out of limiting our assumptions, not be addicted to status quo, improve our tunnel vision, and over come hyperrationality  because Not everything that counts can be counted and not everything that can be counted counts.

Family Medicine practice is an ocean. I have a living immovable faith in my teacher Dr O P Kapoor, who for over 5 decades has been continuously educating the medical fraternity just to help all of us learn to sail through the tides and Dr O P Kapoor’s  lectures  today is the spinal cord of our Education and our powerful oar to sail our lifeboat. Sir Dr O P Kapoor is the Gift of our life. I learnt all the common sense from him but believe me Common sense is not so common.

Some are born happy, Some achieve happiness, but the essential, joyous thing is that everyone can be happy. We don’t need to pass exams, we don’t need to have a model’s figure, or win a competition. This healing, restorative, rejuvenating and energizing emotion which can make us reach stars, is nothing else but a brave decision of ours. Lets look for positive in every situation, listen to every patient with genuine intent, keep learning, bag all the hathiyaars like ECG, pulseoximeter, Ophthalmoscope, computer in our clinics this year and experience this 2010 as the most  wonderful world.

A wise man washes his hands after he pees, A wiser man doesn’t pee on his hands.

Wishing you a wiser 2010.

Dr Deepak K Jumani

  1. shailesh doshi
    July 3rd, 2010 at 08:56 | #1

    DR DEEPAK YOUR THOUGHTS ARE REALLY GREAT.CONGRATULATIONS ,THANKS A LOT FOR YOUR COMMENT ON SRB, NISHIT DOSHII IS MY SON AND I STAY IN KANDIVALI N WILL TRY TO GET YOUR PHONE NO AND GET IN TOUCH IF POSSIBLE.THANKS AGAIN

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