Chairman. Fortis CDOC Hospital for Diabetes, Former Professor, Medicine, AIIMS, New Delhi, Editor-in-Chief, Diab Metab Syndr
Padam Shree and BC Roy Awardee
Promote
#doublemask
. If you wear two masks, one disposable and over which a cloth mask, you have 95% protection for
#coronavirus
Wish more people do it.
promote
#doublemask
Why create panic about "
#blackfungus
" to patients? (name seems to suggest something like black death; Bubonic plague). It is still sufficiently rare. Patients cannot control it. It is physicians who should use steroids judiciously, and use insulin aggressively to control sugar. .
Why should vaccination be free for all individuals? Those who can pay, should pay. Govt. should pay for vaccine for people with low socio-economic stratum only. I am willing to pay for vaccine.
The bedlam you are seeing today, is because of decades of neglect to strengthen primary and secondary medical care and supply chains. There is no point of making all these AIIMS, when oxygen cannot be provided. All we need is good civil hospitals with adequate facilities!!
In a busy OPD, I deal with at least 1000 data points (clinical, biochemical) and make more than 100 decisions daily. Some of those will save/prolong lives. I don't need any AI, I just need a good computer & a good assistant/nutritionist. Knowledge and experience assist me.
Punishing
#doctors
for not writing
#generics
is unfair. A patient can take generic if he wants. Quality of generics anyway is suspect. Why not first punish
#quacks
and those
#babas
who say they can cure all diseases with their concoctions? Or drug companies who make false claims?
While at Chennai airport today, i saw i man trying to make is small son walk. That kid had difficulty in walking, and i noticed bowing of legs. Diagnosis rickets. I counselled father to go see pediatrician with this diagnosis. Pleased that i have not lost AIIMS trained acumen
Front of package labelling (food articles), if done in a simple and effective manner, could help in curbing
#obesity
,
#diabetes
and
#heartdisease
.
See this interesting discussion.
Total fatigue (mental/physical) has set in doctors, paramedics, and frontline workers. And crowd gathering events continue?? Why were election rallies allowed at all, or Kumbh?? You can see results; mortuaries and shamshans full. We all have a lot of frustration and anger!!
Winter of
#Omicron
-2: In my estimate 7-10 days to go when this
#wave
will be appreciably down. Be strict with your
#masks
and tell others. Be holed up in your favorite place. Watch some movies. Relax. And do on the spot
#exercises
. Buy and eat a lot of
#fruits
and
#vegetables
.
The problem that plagues Indian
#science
is very few original studies. Most are duplication of previous, or small descriptive studies. Basic sciences are in shambles. Even top
#medical
institutions have no publications in high impact journals. Salaries of researchers are terrible
Dr KK Agarwal: An irrecoverable loss. The man who made education of doctors and population an institution outside the medical institutions. A man admired and followed by many. Extremely intelligent and quick-thinking. Far ahead of others. Did more to public health than many.
7 ladies in morning walk I can't get across! They never wear
#mask
despite many reminders from me/others. They walk in 3 groups so I have to pass them three times. Now I wear 2 masks on and upon seeing them make a new path 20 feet away. Don't lower guard now with BA.2 around
As Editor-in-Chief, I am pleased to announce that our
#Journal
has achieved an impressive impact factor of 10, catapulting us into the league of premier international diabetes publications. This milestone is a testament to the tireless efforts of our exceptional team.
Physicians who should use steroids judiciously, and use insulin aggressively to control sugar. Once that is done,
#blackfungus
will not occur.
As such panic/anxiety is airborne now-a-days. We are adding "black fungus" to make it a swirling witches black brew of intense panic.
Why create panic about "
#blackfungus
" to patients? (name seems to suggest something like black death; Bubonic plague). It is still sufficiently rare. Patients cannot control it. It is physicians who should use steroids judiciously, and use insulin aggressively to control sugar. .
Many patients with
#diabetes
come to me with "full body check" and say, doc these all look fine. This means many unnecessary checks (
#chestxray
, gives radiation), and miss out on simple informative tests. One such is
#microalbumin
test, which is an early test for
#kidney
damage.
Most of my co-workers are down with
#COVID19
first time in two years. But, fortunately, they received all
#vaccine
doses including
#boosters
. They are all fine except first 3 d of mild symptoms. If booster was given in December, maybe even this would not have happened.
Steroids rule India. Out of 3736648 active cases of COVID19 today, 25 L must be on steroids (best guess). 80% of these (20 L) would have high or very high sugars (if diabetic), or would have become diabetic if at risk. So rapid addition of new diabetes/majorly high sugars (1/2)
Honored to be listed in the top 2% of global researchers' list, across all subject fields. Result of lots of efforts, sweat and time. Nothing was possible without my excellent research team and collaborators.
It is happening again. Delhi increasingly unmasked. This morning about 30% people in park had
#masks
down. Good article by
@durgeshjhaTOI
in which I wrote; unless most of Delhi is vaccinated, we should have full compliance with masks.
#COVID19
Only people who can tell preliminary story of
#omicron
are clinicians who have seen patients (mostly in S Africa) and geneticists who have sequenced. The rest of us are just stating hearsay, conjectures, cut and paste story, guesses or generalizations. real story will emerge.
I have now a number of cases where
#COVID
-19 is occurring in those who have received one or two doses of vaccine. These are people where a younger person in family is affected, or they have not taken precautions.
wear
#doublemask
. Please promote this hashtag
Dr. Anoop Misra's medical prowess have merited him a spot in the list of 18 notable alumni of All India Institute of Medical Sciences, New Delhi (AIIMS).
We thank him for his constant dedication and congratulate him on achieving this honour.
@docanoopmisra
#AtFortisWeCare
In times of great pestilence, misery,
#poverty
, wasting and
#death
; the only thing i will build (given a chance) is huge
#publichealth
institute, only issue I will celebrate is when all Indians get basic health, and I will light lamp only when poor people get healthy food.
Two dangerous things are happening, vaccination rates are down, and likely delays in vaccinations for at least two weeks in many private facilities. 99% people with infections after vaccinations have mild symptoms. Vaccine is our second shield (after masks).
When I walk, I see a lot of people without mask/mask below chin. When I object, many get angry. After failure of lock down, this is only defense. If people dont do it, all of us will suffer.
Let us all start a movement, to be "Mask-Warriors". Everybody tell those who dont wear.
This decision is welcome. A suggestion is to delete tag of "on doctors advice" and instead allow all above 60 years to take
#booster
. It will save time, money and going around chasing doctors for writing "advice". Lastly, doctors advice will always be for vaccine, not against.
Precautionary vaccines will be available for frontline and medical workers from 10 January’22. Precautionary dose also for those 60 years of age and above with co-morbidities (on doctor’s advice).
@PMOIndia
#MaskUp
#Omicron
Ok I am not going into whether
#IPL
should be held here, or stopped, or shifted out of India. But BCCI has capability of taking care of whole of Delhi's
#oxygen
needs. They should pitch in, I think. What do you think?
@BCCI
Non compliance to a routine, diet, exercise, medical checks is frequently seen in all of us, and patients with
#diabetes
. Those with good
#compliance
will do well, and bad compliance will not, whichever 'new drugs/insulin' we throw in. Patients health is 50% on his/her own hands.
In this literal Kalyug in India; we should do whatever we can to help others; we doctors with our correct advice even if we are not treating directly (i try to reply to all messages and give some direction); others in little ways, provide information, relief, words of succor...
Terrible situation. In Delhi situation was bound to worsen. First, people are going around with abandon, without
#masks
, having parties. Second, people returning from other places have brought
#covid19
. No point harping on "excellent recovery and low mortality" (1/1).
It is terrible that because of this so many patients are misled, then some are admitted with life threatening glucose and ketone levels. Such misinformation should be banned.
Today's newspaper-
Most statements in this ad are blatantly false.
#misinformation
But some are downright dangerous
Curing type 1
#diabetes
? Leaving insulin??
Request all type 1 DM NOT to give up
#INSULIN
It can be fatal
#DiabetesAwareness
Many doctors are attending conferences physically. Be careful, look at
#omicron
positive doctor who attended the Bengaluru cardiology conference (?
#superspreader
). So the brief reign of "hybrid (tele plus physical)" conferences should be over.
This
@Coronavirus
is a chameleon, it can change genetic material but CANNOT change size. The lesson to all of us, while
#vaccine
may fail against variants, masks (which stop particles depending on size), will never fail.
So double mask up!!!
#COVID19
#covidvariant
When it comes to
#life
-saving drugs with narrow therapeutic windows, the stakes are high. Errors in quality can mean
#organ
loss,
#heartattacks
, or worse,
#death
. Given the choice, would you trust non-
#USFDA
approved
#generics
when your health is on the line? I wont!
Shortage of
#amphotericin
B is of similar importance to oxygen shortage, and of more importance to remdesivir shortage. Without it patient with
#mucormycosis
will surely die. We have patients where
#BlackFungus
is seriously eroding bones, and very little amphotericin!!
We are increasingly seeing new-onset
#diabetes
(most do not have symptoms)in our employees. Any high
#sugar
increases risk of complications due to
#Covid
-19 several times. Diabetes detection/awareness camps should be held in all organizations.BP can be measured at same time too.
Interesting observations on morning walk. I passed by 52 people. 30 were wearing masks correctly, 22 were not. Out of 22, 16 were girls or women from well-to-do families. I interjected in 7 people, 6 complied, 7th said I cant breath with masks!
Support
#WearAMaskBeAMaskWarrior
#Diabetes
and
#MetabolicSyndrome
: Clinical
#Research
and
#Reviews
an international journal run by Diabetes India/
#NDOC
has outstanding cite score of 15, better than all journals in this subject in Asia. I am proud that as Editor i have been able to accomplish this in three years.
There is indiscriminate accusations against doctors and hospitals; fleecing patients, looters etc., without proper facts. They are already disheartened and at personal risk. Residents are leaving already. So attacked by virus, government & patients; doctors are in terrible state.
Essential criteria for starting
#molnupiravir
(as per
#CDSCO
, India):
>18 y age, non-pregnant, Spo2 >93% (and not hospitalised), Having >one risk factor for progression severe
#covid
-19
No dose adjustment in
#CKD
,
#CLD
I have taken over as Editor of International Journal: Diabetes and Metabolic Syndrome: Clinical Research and Reviews. Editorial Board will appreciate good articles with solid science. My first Editorial is on Dietary proteins and Sarcopenia.
Symptoms that may not interest following clinicians; headache for a
#gastro
, joint pains for a
#cardiologist
, skin itching for a
#neurologist
, etc.
But a general practitioner listens to them all. That is his skill & expertise. He should retain primacy in universe of diseases.
One increases
#vaccine
dose interval (poor science there, more convenience due to vaccine shortage?), other decreases vaccine intervals (Science still robust, to fight B1.167). One goes up, other goes down, and many of us fall down! And
#B1
.167 has a demonic laugh!!
One important lesson that
#diabetes
teaches us, lifetime of
#discipline
. If are undisciplined, no matter what you do (bariatric surg, "diabetes reversal" programs, etc.) diabetes will come back & haunt you. If you tread middle of road sensible disciplined path, troubles are away
For those who have oxygen levels going down, intermittent prone position for upto one hour will improve oxygen levels. All those who have
#covid19
#Pneumonia
and are at home should try this.
It was a rare honour to serve this great man as his physician and closely see him over 3 years while accompanying him in india/several countries. I have not known a more cerebral, humble and greater statesman than him through his good days, bad times, happiness and extreme pain.
How do you make a U-turn without anybody seeing you make a U-turn?
On his 99th Anniv, this 36-second masterclass from PV Narasimha Rao on how he moved from socialism to reform..
Thank you GD Thirumalavasan for flagging this...
#AIIMS
needs two types of directors, one who takes care of discipline and patient care, and second, importantly, who takes stuttering research to a better level. The research there is at the lowest ebb since its inception.
@docanoopmisra
To be fair the rest of the breakfast menu had lots of diabetic friendly options much to my delight. Ragi Kool for instance . A salted ragi porridge . Sprouts of all kinds, boiled peanuts , sauteeed vegerables .
#Cardiologists
/
#nephrologists
, request do not base your judgements on
#HbA1C
alone, since most of these patients will have
#anemia
due to illness/drugs. Always look at self-monitoring of blood glucose values/CGM. Discrepancy between HbA1C and daily blood glucose values is common.
Just published:
#Diabetes
and
#COVID19
. A bidirectional relationship. In Nature Portfolio on
@ejcneditor
. Thanks Ranjit Unnikrishnan for constructing the article.
Today, the U.S.
#FDA
approved
#Farxiga
(
#dapagliflozin
) oral tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease. Good news!
@bishnoikuldeep
@SheilaDikshit
Mrs Dikshit, was a wonderful human being & an excellent leader. It was a privilege to know her & receive affection from her
Many patients with
#diabetes
and
#hypertension
, both well controlled, are coming with marked fatigue after
#COVID19
. No other cause was found after investigations. I am sure Post COVID19 syndrome will be added as one of the causes of
#ChronicFatigueSyndrome
.
Why
#covid19
is severe in some people, especially young? In a case series (included 4 young males with severe COVID-19, 2 families), loss-of-function variants of the X-chromosomal TLR7 were identified, with defects in interferon production (essential to fight COVID19).
#covid19
Data emerging from India henceforth will be faulty and unworthy to quote in any lay press or in scientific publications. It should not be taken to project trends or for 'mathematical modelling of
#COVID19
in India. Our
#epidemiologist
friends can, finally, take a deserving break
As Editor-in-Chief, I am pleased to announce that our
#Journal
has achieved an impressive impact factor of 10, catapulting us into the league of premier international diabetes publications. This milestone is a testament to the tireless efforts of our exceptional team.
Those who are dealing with public; doctors, frontline workers etc. should always wear
#doublemask
(or one n-95). I hand over new masks to patients to wear over the existing mask (unless n-95) before I see them. Others in public dealing should have the same practice.
There are people in medicine who do research only, there are others who see patients only, and finally, there are those, like me, who do both, a more difficult and consistently demanding job given poor research funding situation and facilities.
Many
#doctors
and
#nutritionists
, who have a office based practice, have periods when they are confined to chair; hence remain
#sedentary
. They should give advice to patients when standing so that activity increases. I now remain standing when giving assessment/advice to patients
The authors say, "The survival benefit is clear/large in sick patients who require oxygen, so it should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide".
Bravo!! First great steps!!
The Hippocratic Oath is sworn by doctors the world over. It is insane to replace it with some dodgy variant - where doctors swear they will not treat women patients. Glad you intervened
@ptrmadurai
Super successful Ahuja Bajaj Symposium-10. Six hours, 24 lectures. Short, crisp, and clear. New data. New drugs. Plenty of nutrition. No chairpersons. No mementos. No time wastage. 45 Q and As. 350 attendees. Packed hall.
This "baba" is clearly spreading falsehood in this video. Type 1 diabetes CANNOT be cured. If fact, if these patients leave insulin therapy, they are in grave danger.
PLEASE DON'T BELIEVE THIS VIDEO
There are 2 major types of
#diabetes
Type 2-common, lifestyle related, seen in adults
Type 1-
#insulin
dependent, seen in children
Nobody can cure type 1 diabetes
DON'T STOP YOUR INSULIN, it's life saving
#misinformation
I believe print media in India has greater credibility than visual. Visual narrative plays to the gallery, while print is more fact oriented. In health writing, most writers take two expert opinions, just to be sure. Graphics add to the effect. Your opinion?
Destroying an economic asset like the twin towers is stupid. Since the builders had no clearances the punishment should be to take the towers away from.The towers are safe should have been used for a hospital or given to destitute people
If (and when) third wave of
#covid19
comes, it will not target children majorly, but those who have not been
#vaccinated
, or weak
#immunity
, or leaving all precautions to (toxic) wind. A new
#variant
may arise!
There are reports of "Double COVID" (second
#Covid19
infection), some after previous infection and vaccine. It means previous infection induced immunity is not working, like in multiple flu infections. To my mind, this is COVID21 or Covid19.version2. New vaccines needed?
During
#Covid19
pandemic,
#doctors
have stopped doing physical exam of patients. It was understandable. Our team always did it with due precautions. There is simply no replacement to pulse,
#heart
,
#lungs
,
#liver
and
#feet
exam in patients with
#diabetes
. Takes a few mins time.
With faster transmission of
#covid19
, it is scientific that we have double mask protection; 2 masks, one disposable mask first, close to face (if possible shave beard), and over this a cloth mask to make surgical mass closer to face. Good fit is needed
I believe that
#COVID19
will stay in and simmer in India for quite some time. Indiscipline is distancing and wearing of masks are increasing as lockdown measures open up. This morning walk, out of 47 people, 25 did not wear masks; 10 were construction workers (1/2)
It is becoming clearer that we all will need a booster shot of
#vaccine
. For that timing is important. A one year study of evaluation of
#antibodies
will tells us when to take. It will then add to the list of annual or biannual adult
#vaccinations
.
@covid19