Price for becoming a doctor money wise.

Money wise how much a doctor lags behind his friends who chose other than or could not pursue medicine. This question is asked by doctors worldwide. Though I along with many Indians have been fortunate to have become doctors with hardly any money spent as the Government of India and our state governments bear the cost. But in rest of the world and in private medical colleges this is not the case. The tuition fee and the capitation fees are very high.

We all know this angle. The medicine study is very costly. But what are the outcomes? Asav Patel an ophthalmologist from India discusses the cost of becoming a doctor in terms of money.

  1. Are we at a better situation when we start earning 10 years after our friends start earning?
  2. Did they have been blessed in disguise for not gaining entry in to the medical profession?

Well I certainly do not believe in such a way. I on one hand accept that the cost is huge, but I believe certainly that we are at the best place possible.

As Morpheus in Matrix says

You are not here to make choices, you are here to understand why you have made them

We have already made the choice to become doctors. We need not worry about why it took us so much time. We have to find out what was the divine force wanted us to achieve by becoming doctors.

In a way we are the chosen ones.

Wealth one can build being in any profession. take the example of Dr. Mani. This Cardiothoracic surgeon from Madras India is a big internet entrepreneur. With the money raise from his internet marketing he is financing Children Heart  Foundation that helps in funding surgery in children with Congenital Heart Diseases.

Is not that great?

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Kali Prasad Patra Gets BMGF funds for malaria vaccine

Malaria has been a health problem all over the world. Most cases and case fatalities occur in Africa and Asia. Traditionally the medicines available target to kill the parasite in blood of human beings. Other measures are directed towards vector control. The vector being the female Anopheles mosquito.
Kali Prasad Patra is working currently as a post doctoral scientist and principal investigator at the University of California, San Diego. His
research project aims at checking the development of malarial parasite inside the mosquito. The vaccine that Patra wants to make in a year with the help of $100,000 funding by BMGF (Bill and Melinda Gates Foundation).

The procedure will be to vaccinate human beings once. From this I guess the immunity that will develop in humans will not directly save the people
from malaria, but will infect the mosquitoes instead and thereby render mosquitoes’ internal environment not suitable for parasite propagation.

This possible mechanism of the vaccine is just my conjecture from different news articles. But anyways I am happy that people (like Kali
Prasad Patra) are working for the people who need it the most (As for centuries malaria has been a great problem for people of India and
Orissa in particular) rather than any European or American Peter J. Weina doing the job for Asian people.

If the above paragraph sounds racial then pardon me of wrong communication and pardon yourself of selective reading. My concern has

been the importance of participation in research oriented fields by indigenous people. Some time ago I made a post where an American pharmacologist gave us (doctors in India) some insight about malaria treatment. I have no problem if an American doctor is my teacher. My problem is that we Indians are lagging behind in research.
So when I find news like this it makes me very happy that we are also contributing towards the medical knowledge it makes me a lot happy
and proud.

Kali Prasad Patra completed his degree from Vikram Dev College, Jeypore and Post Graduation from Berehmpur University. Then he did his Ph.D from Pondicherry University. In 1987 he joined Vector Control Research Centre (VCRC) as a research assistant at Koraput and Malkangiri districts. Then he went to Pondicherry and USA in 2005 where he completed his 2 year post-doctoral training on malaria vaccine at University of Texas. Now he got BMGF funding.

Congratulations and Godspeed.

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License to heal at last

At last I have the license to heal (practice) anywhere in India. Today I got my Permanent Registration Number 17002/2009 dated 9 November 2009. I need not apply to MCI separately. I can practice in all over India as an MBBS.

Let me describe the incident. Today i.e. on 12th November I went OCMR office near Pump House Square, BBSR. I went via Barang. Just after crossing Jayadev Vihar Square it rained. I managed to get to the OCMR Office. Got the license for which I have applied after my completion of internship on 28th October 2009. Actually it was due on 23rd of October 2009. But due to DMET, Dr PK Das’s orders we had to repeat 5days of duty as earlier this year we had gone on a strike to increase our stipend from a meager Rs5000 ($100) to Rs8640 ($175) per month.

Well then I went to I.M.S. & SUM Hospital to apply for the post of Junior Resident / Tutor. From there I returned via RasulGarh.

So that is how I became a Registered Medical Practitioner. My name is in the IMR (Indian Medical Register). But it is getting updated so you can not find my name in there. But from 1960 onwards one can find doctors from their name or registration number. Till now it has been updated up to 2007.

Hopefully when it updates 2009 we can see my name in the MCI Online database.

Have a God day

Dr Bikash

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Relevance and Acceptance of Artemisinin Combined Therapy against Malaria in Orissa, India

Today I went to IMA House for a talk. It started 3 days back. Ipca a large pharmaceutical company of India invited specialists in Medicine, Pediatrics, Gynaecology and General practitioners of Orissa to IMA house at Cuttack for a talk on Atremisinin and Malaria. I got the invitation too. The event was on May 4th 2009. Some Peter J. Weina from US was going to give the talk. Now that was funny.

A single physician in India treats more malaria cases in a year than the total number of malaria cases in any US state. Well the talk turned out to be even more funny. The US FDA has yet not cleared Artesunate. This drug has been saving lives for thousand years in China. We in India have been using it for quite some year now. And here comes a pharmacologist from US who says we need to use artesunate. Come on give me a break. We already are using it.
So what is the point? Well the point was there of course. WHO has recently published a paper regarding ACT. Artemisinin Combined Therapy, according to WHO is the way to go in combating Malaria in near future. So in order to create awareness about the combined blister packages of ACT, Ipca has arranged these talks by Peter J. Weina. So at the end of the talk, we got the message of use of combined therapy of Artemisinins, but the question still remained. In Orissa and in India no resistance has developed against Artesunate. So is it justified to give so much burden to th patient to bear the extra cost of combined therapy?

So at the end of the day, we knew the guideline by WHO. But as doctors we might think otherwise as we have to do what is best for the patient.

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How to know if you have Lupus?

As you know that I am a practising doctor and during my practice patients of autoimmune diseases are the most difficult to manage. They are of a chronic variety and due to autoimmune nature of the disease their own body is fighting is fighting against them. So continuous medication and earliest diagnosis is the cornerstone to control this disease. Rheumatoid arthritis, S. L. E.,ankylosing spondylitis are one of those few diseases that require proper diagnosis and timely management so that the disease can be checked before it causes serious damage. So I am going to describe some of the symptoms that we find in the OPD.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease which is quite prevalent among women. Though men also get Lupus but the frequency is very less. Many authorities claim the ratio to be nine to one. Systemic Lupus is the commonest variety of Lupus which is a chronic inflammatory disease of autoimmune origin. The professional bodies around the world have led down certain criteria for the physicians to diagnose Lupus.

But there are certain common signs and symptoms that can easily be identified a common person to suspect that if a person is suffering from Systemic Lupus Erythematosus.

When the patient goes out in the sun reddish spots are found in a butterfly pattern over the nose and the cheeks. This is characteristically known as “butterfly rash”. Butterfly rash is characteristic of systemic Lupus. But patients with Discoid Lupus devil of circular patches of rash or scaly skin lesions after sun exposure.

The patient may have joint pain and maybe stiffness in multiple joins that is lasting for more than three months. Chest pain after exercise can indicate towards lungs involvement. Mental disorders can also be a key factor in finding out whether the person is suffering from CNS involvement of systemic Lupus. The CNS involvement can be manifested as hallucinations depression, confusion, loss of memory or even seizures.

In cold the person’s fingers maybe becoming pale,numb due to Raynaud’s phenomenon. Protein in urine suggests proteinuria. Anaemia with low blood cell counts leading to fatigue and frequent infections is an indicator of chronic inflammatory autoimmune disease.

Hair loss can be the first marker of Lupus.

Though these symptoms can indicate that the patient might be suffering from systemic Lupus, still then it is prudent to consult your doctor for the diagnosis and proper management of this dreaded multisystemic disease.

In my next instalment I’ll be providing information about other multisystemic diseases and autoimmune diseases. Till then goodbye.

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