SP Kalantri

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Evidence-based Medicine Medical Education

Doing away with MD thesis

I must admit that I, too, was—and still am—a medical teacher who guided—or is misguided the more appropriate word?—over three dozen postgraduates in writing their MD theses. I do not wish to stand on a pedestal or adopt a “holier than thou” posture. I have erred, misjudged, behaved badly, mishandled situations, and at times, been …

Evidence-based Medicine Research

Scrub Typhus: Two is better than One!

𝗦𝗰𝗿𝘂𝗯 𝘁𝘆𝗽𝗵𝘂𝘀 is a devastating disease. At Sevagram, our healthcare providers regularly care for hundreds of patients with severe scrub typhus in the ICU. Unfortunately, around 15% of these patients do not survive. A study from India published a day before in the 𝗡𝗲𝘄 𝗘𝗻𝗴𝗹𝗮𝗻𝗱 𝗝 𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲 caught my attention. CMC Vellore, PGI Chandigarh and …

Evidence-based Medicine

Low Bach Ache

The Lancet (http://www.thelancet.com/series/low-back-pain) this week has published three papers on low back pain, which should be read by everyone with a back. Authored by an international group of authors, who examine the current evidence and offer recommendations that are based on solid science, these papers make one sit up and take notice.  The Lancet says …

Evidence-based Medicine

More is not always better

Atul Gawande, the surgeon-researcher-public health activist in his recent essay describes the current medical practice so succinctly : “Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.” Once a  test or a …

Evidence-based Medicine

Surgical Pathology in the Kalyug

Dr. Anita Borges at her best! I was glued to her hour-long talk—and could hardly take my eyes off her histopathology and IHC slides—as she explained in her inimitable style how pathology is rapidly evolving. For over 150 years, histopathology—focused on organs, tissues, and cells held sway in pathology. But over the last two decades, …

Evidence-based Medicine

Angioplasty

One way to see the chorus of emergency angioplasty treatment of acute heart attack is with awe. Another is with utter frustration—because in most cases it is unnecessary- John Mandrola recently summed up beautifully. A 2014 population based study from Sweden (J Am Coll Cardiol 2014; 64:1299-1306) shows that if people eat less, walk more, …