Science, Stories and Sevagram: A Physician-Teacher's Reflections
Clinical stories and reflections on evidence-based medicine, research, and patient care.
How do we deal with Covid-19 in Indian villages? We must empower primary health centres, where people are familiar with the doctors and healthcare workers; provide adequate training and resources; and weed out unnecessary drugs and investigations. Also, make vaccinations available close to people’s homes. I speak to Indiaspend.
I couldn’t believe my eyes. So I asked my colleague to read to me the recent COVID-19 guidelines from the Directorate General of Health Services (DGHS), in the Union health ministry. I couldn’t believe my ears either. The nine-page PDF document talks about how to treat, investigate and monitor patients with a COVID-19 infection. What are the … Read more
Remdesivir. Hydroxychloroquine apart, no drug during the current pandemic created as much controversy, generated as much hope, led to as much black marketing and eniced as many physicians and people as Remdesivir did. I was not sure if remdesivir indeed reduced the chances of dying in hospitalised patients and wondered if the hype and hope … Read more
Exactly a year ago, on this very date, a 64-year-old person arrived in the repurposed Covid block of Sevagram. He hailed from Washim—a town 225 km south-west of Sevagram—tested positive in the neighbouring medical school and was admitted to what was once a Medicine ICU. He was the first patient in our Covid ICU, the … Read more
Beginning May 2020, we admitted hundreds of patients with COVID. But in the middle of last month, something changed. Patients arrived with problems we had not yet seen in the pandemic: people were not only breathless and feverish but also had pain and pressure behind their cheekbones and around their eyes. Some lost their vision. … Read more
Rural India. A third of our population lives in rural India. The COVID-19 pandemic has now entered rural parts of our country and these areas are now carrying twice as much as disease burden as the urban and semi-urban areas. The hospitals in our cities are towns are overloaded and overwhelmed. Our rural infrastructure is … Read more
Covid associated mucormycosis has hit the country. The fungus has also made its way in Covid wards and ICU in Sevagram. The fungus is fast and furious, it destroys the skin, soft tissue and bones as it invades the blood vessels and causes infarction and necrosis of tissues. It enters into paranasal sinuses, quickly spreads … Read more
I designed an evidence-based management protocol for managing patients admitted to our teaching hospital with Covid19. The concept was minimalist: excluding irrational, untested, unproven therapies and focusing only on those which have been shown to work in large randomised trials. Here is a YouTube link to the powerpoint presentation:
The novel anti-Covid medicines look promising and appealing, but I’d urge caution in interpreting the study results…
The novel anti-Covid medicines look promising and appealing, but I’d urge caution in interpreting the study results…