Hyperlipidemia- Bad cholesterol (LDL) and plaque in an artery

Hyperlipidemia

Hyperlipidemia (high cholesterol) means your blood has too many lipids (fats) in it. These can add up and lead to blockages in your blood vessels. This is why high cholesterol can put you at risk for a stroke or heart attack. But you can make lifestyle changes like eating healthier and exercising to lower your cholesterol. Medicine can help, too.

Hyperlipidemia, or high cholesterol, can let plaque collect inside your blood vessels and put you at risk of a heart attack or stroke. The good news is that you have the power to reduce your risk of heart attack and stroke. Exercising more and eating healthier are just two of the ways you can improve your cholesterol numbers. Taking medicine your provider orders makes a difference, too.

OVERVIEW

Bad cholesterol (LDL) and plaque in an artery

What is hyperlipidemia?

Hyperlipidemia, also known as dyslipidemia or high cholesterol, means you have too many lipids (fats) in your blood. Your liver creates cholesterol to help you digest food and make things like hormones. But you also eat cholesterol in foods from the meat and dairy aisles. Since your liver can make as much cholesterol as you need, the cholesterol in foods you eat is extra.

Too much cholesterol (200 to 239 mg/dL is borderline high and 240 mg/dL is high) is not healthy because it can create roadblocks in your artery highways where blood travels around to your body. This damages your organs. Bad cholesterol (LDL) is the most dangerous type because it causes hardened cholesterol deposits (plaque) to collect inside of your blood vessels. This makes it harder for your blood to get through, which puts you at risk for a stroke or heart attack.

Think of cholesterol, a kind of fat, as traveling in lipoprotein cars through your blood.

Low-density lipoprotein (LDL) is known as bad cholesterol because it can clog your arteries like a large truck that broke down and is blocking a traffic lane. (Borderline high number: 130 to 159 mg/dL. High: 160 to 189 mg/dL.)
Very low density lipoprotein (VLDL) is also called bad because it carries triglycerides that add to artery plaque. This is another type of traffic blocker.
High-density lipoprotein (HDL) is known as good cholesterol because it brings cholesterol to your liver, which gets rid of it. This is like the tow truck that removes the broken down vehicles from the traffic lanes so vehicles can move. In this case, it’s clearing the way for your blood to get through your blood vessels. For your HDL, you don’t want to have a number lower than 40 mg/dL.

It’s important to know that providers consider other factors in addition to your cholesterol numbers when they make treatment decisions.

Is hyperlipidemia the same as high cholesterol?

Yes, hyperlipidemia is another name for high cholesterol, and so is hypercholesterolemia.

What is dyslipidemia vs. hyperlipidemia?

They are mostly interchangeable terms for abnormalities in cholesterol. Your cholesterol can be “dysfunctional” (cholesterol particles that are very inflammatory or an abnormal balance between bad and good cholesterol levels) without being high. Both a high level of cholesterol and increased inflammation in “normal” cholesterol levels put you at increased risk for heart disease.

What are the risk factors for hyperlipidemia?

Several things can put you at a higher risk of hyperlipidemia, including:

Having a family history of high cholesterol.
Having hypothyroidism.
Having obesity.
Not eating a nutritious diet.
Drinking too much alcohol.
Having diabetes.
Smoking.

How common is hyperlipidemia?

Hyperlipidemia is very common. Ninety-three million American adults (age 20 and older) have a total cholesterol count above the recommended limit of 200 mg/dL.

How serious is hyperlipidemia?

Hyperlipidemia can be very serious if it’s not controlled. As long as high cholesterol is untreated, you’re letting plaque accumulate inside your blood vessels. This can lead to a heart attack or stroke because your blood has a hard time getting through your blood vessels. This deprives your brain and heart of the nutrients and oxygen they need to function. Cardiovascular disease is the leading cause of death in Americans.

How does hyperlipidemia affect my body?

Hyperlipidemia (high cholesterol) that’s not treated can allow plaque to collect inside your body’s blood vessels (atherosclerosis). This can bring on hyperlipidemia complications that include:

Heart attack.
Stroke.
Coronary heart disease.
Carotid artery disease.
Sudden cardiac arrest.
Peripheral artery disease.
Microvascular disease.

SYMPTOMS AND CAUSES

What are the symptoms of hyperlipidemia?

Most people don’t have symptoms when their cholesterol is high. People who have a genetic problem with cholesterol clearance that causes very high cholesterol levels may get xanthomas (waxy, fatty plaques on the skin) or corneal arcus (cholesterol rings around the iris of the eye).

What causes hyperlipidemia?

Various hyperlipidemia causes include:

Smoking.
Drinking a lot of alcohol.
Eating foods that have a lot of saturated fats or trans fats.
Sitting too much instead of being active.
Being stressed.
Inheriting genes that make your cholesterol levels unhealthy.
Being overweight.

Medications that are helpful for some problems can make your cholesterol levels fluctuate, such as:

Beta blockers.
Diuretics.
Hormonal birth control.
Steroids.
Antiretrovirals for HIV.

Medical problems can also affect how much cholesterol you have. These include:

Multiple myeloma.
Polycystic ovary syndrome (PCOS).
Hypothyroidism.
Primary biliary cirrhosis.
Chronic kidney disease.
Diabetes.
Lupus.
Sleep apnea.
HIV.

DIAGNOSIS AND TESTS

How is hyperlipidemia diagnosed?

Your provider will want:

A physical exam.
Your medical history.
Your family’s medical history.
To calculate your 10 year Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score.

A blood test called a lipid panel will tell you these numbers:

Type of cholesterol	Best number to have

Total cholesterol	Less than 200 mg/dL
Bad (LDL) cholesterol	Less than 100 mg/dL
Good (HDL) cholesterol	At least 60 mg/dL
Triglycerides	Less than 150 mg/dL

What tests will be done to diagnose hyperlipidemia?

Your provider may also do these tests:

High sensitivity C-reactive protein (hs-CRP).
Lipoprotein (a).
Apolipoprotein B.
Coronary calcium scan.

MANAGEMENT AND TREATMENT

How is hyperlipidemia treated?

Changing their lifestyles may be all some people need to do to improve their cholesterol numbers. For other people, that’s not enough and they need medication.

Things you can do include:

Exercising.
Quitting smoking.
Sleeping at least seven hours each night.
Keeping your stress level under control.
Eating healthier foods.
Limiting how much alcohol you drink.
Losing a few pounds to reach a healthy weight.

What medications are used for hyperlipidemia?

People who need medicine to treat their high cholesterol usually take statins. Your provider may order a different type of medicine if:

You can’t take a statin.
You need another medicine in addition to a statin.
You have familial hypercholesterolemia, a genetic problem that makes your bad (LDL) cholesterol number extremely high.

Are there side effects of hyperlipidemia treatment?

Any medication can have side effects, but the benefits of statins far outweigh the risks of minor side effects. Let your provider know if you aren’t doing well on your medicine so they can develop a plan to manage your symptoms.

How soon will the hyperlipidemia treatment start working?

Your provider will order another blood test about two or three months after you start taking hyperlipidemia medication. The test results will show if your cholesterol levels have improved, which means the medicine and/or lifestyle changes are working.

PREVENTION

How can I reduce my risk of hyperlipidemia?

Even children can get their blood checked for high cholesterol, especially if someone in the child’s family had a heart attack, stroke or high cholesterol. Children and young adults can get checked every five years.

Once you reach middle age, you should have your cholesterol checked every year or two. Your healthcare provider can help you decide how often you should have a hyperlipidemia screening.

How can I prevent hyperlipidemia?

Changes you make in your life can keep you from getting hyperlipidemia. Things you can do include:

Stop smoking.
Stay active instead of sitting too much.
Keep your stress level down.
Get the right amount of sleep.
Eat healthy foods.
Cut back on eating fatty meats.

Don’t buy snacks that have “trans fat” on the label.
Stay at a healthy weight.

OUTLOOK / PROGNOSIS

What can I expect if I have hyperlipidemia?

If you have hyperlipidemia, you’ll need to keep using healthy lifestyle habits for years to come. You’ll also need to keep follow-up appointments with your provider and continue to take your medicine.

How long will you have hyperlipidemia?

Hyperlipidemia is a condition you’ll need to manage for the rest of your life.

What is the outlook for hyperlipidemia?

Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.

LIVING WITH

How do I take care of myself with hyperlipidemia?

Be sure to follow your provider’s instructions for making your lifestyle healthier.

Here are things you can do yourself:

Exercise.
Stop smoking.
Sleep at least seven hours each night.
Control your stress level.
Eat healthier foods.
Limit how much alcohol you drink.
Stay at a healthy weight.

Other things you can do:

If your provider ordered medicine for you, be sure to keep taking it as the label tells you to do.
Keep your follow-up appointments.

When should I see my healthcare provider?

You should see your provider if you have:

High blood sugar.
High blood pressure.
High cholesterol.

What questions should I ask my doctor?

Do I need to make lifestyle changes, take medication or both?
If I do what you tell me to do, how quickly can my numbers improve?
How often do I need to check in with you?

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April 21, 2022 0

Why buying a medical college seat & paying millions may be a blunder?

The painful incident of Dr Archana Sharma’s Suicide unmasks the everyday struggle of the doctors in the present era. Her supreme sacrifice depicts the plight of doctors- being undervalued and demonized, forced to work as a sub-servant to bureaucrats, irresponsible policing, blackmail by goons and vulture journalism-all have become an accepted form of harassment. Her suicide has unveiled the despondency, moral burden of mistrust that doctors carry. Her death is the result of the apathy of fair justice that eludes medical community. Sadly, the society is unable to realize its loss.

Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment. It may not be a good idea to opt for a medical career any more. In the present circumstances, when doctors themselves are doubtful about the advice for choosing medical career, some people are naïve enough to spend millions on securing an expensive medical college seat. Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

Disadvantages of being a doctor, Drawbacks of Medical profession:

Choosing medical career or being a medical professional a disadvantage to doctor in comparison to other professions?

Medical courses are comparatively lengthy and expansive study course and difficult training with slave like duties. “enslavement of doctors”.
Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post-graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice. They have to just flow with system ultimately.

3.Hostile environment for doctors to begin: Suddenly young and bright children complete training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

Difficult start of career: After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
Blamed for all malaise: The society gets biased because of the media reports and some celebrity talking glib against medical profession. The blame for inept medical system, administrative failure and complexity of medical industry is conveniently loaded on doctors. These lead to formation of generalised sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
Personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
Risk to doctor himself: Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include tuberculosis and other bacterial and viral illnesses. Radiologists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.
Unrealistic expectations of society: Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative every day is enough to spoil the mood for the day.
Retrospective analysis of doctor’s every action continues all the life: It could be by patients and relatives every day in the form of “Why this was not done before?” Every day irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. If unfortunately there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.

The decision taken in split seconds will be questioned, which in retrospect may not turn out to be the best one. But later retrospective analysis along with wisdom of hindsight with luxury of time (in courts) may be labelled as wrong if a fault-finding approach is used. This along with general sentiment and sympathy with patients makes medical profession a sitting duck for lawsuit and punishments. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation would be full and almost permanent.

Physical assault, routine instances of verbal abuse and threat are common for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. Recently, even female doctors have not been spared by mobs. Silence of prominent people, celebrities and society icons on this issue is a pointer towards increasing uncivilized mind-set of society.
Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: It is heart-breaking to watch zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations. This encouragement and instigations of lawsuit against doctors is a major disadvantage for medical profession.
Overall, a complex scenario for doctors: There is increasing discontentment amongst doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic Oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients. They are also supposed to maintain meticulous documentation and also supposed to work under norms of medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, which use pressure tactics to get their own way.

It may be a naïve idea or just a blunder to pay millions to be a doctor.

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April 20, 2022 0

‘Doctor- Save Yourself’: Court Convicts Doctors For Operating Woman Without Ventilator

Merely having a ventilator does not solve the problem and is not enough . The hospital requires much more arrangements to keep a patient on ventilator. Do all Govt hospitals where surgeries are being done have ventilator and trained doctors and support staff to operate those ventilators? It needs round the clock trained doctors and nurses, ABG machine, portable X-ray , bed side Echo dialysis etc. Doctors in ill-equipped Govt centres are forced to conduct deliveries. What should be the SOP in such circumstances? A real and honest data would be an eye opener and interesting. Doctor need to ponder over the issue of saving themselves before they save the patient.

A Judicial Magistrate First Class court in Bidar district of Karnataka recently convicted three doctors for causing the death of a woman who was operated on by them without having a ventilator facility in the hospital and other lifesaving equipment. This was despite the fact that the committee constituted by the District Surgeon to verify the allegation of medical negligence in its final report has said there is no negligence on the part of the accused during the performance of the LAVH surgery and also shows *how the accused have tried to save the deceased.”*

What is worrying for the doctors is that every death during medical treatment can be a blame against the doctors. If the courts were to impose criminal liability on the hospital and doctors for everything that goes wrong, the doctors now should be more worried about their own safety than giving all the best treatment to their patients. Both Government and Private small hospitals carry out thousands of routine surgeries every day. Occasionally complications may arise in simplest looking procedures – for example even in normal deliveries; what to say about routine surgeries. How many hospitals (Government and private) in districts, town in peripheries are equipped with a ventilatory support system? Perhaps they are too less, although an honest count would be some interesting data. Still, surgeries of the type mentioned are conducted routinely in almost all of these small centres.

So based on one incident of this kind, the thousands of surgeries done in such areas are going to be affected. In other words, doctors will not dare to conduct surgeries in peripheries. As per the verdict of the court, many of the surgical speciality’s doctors in periphery are indulging in blameworthy activities every day in their routine work. Why should they risk their lives and profession in such circumstances? That raises another question , as many Government Hospitals are also without ventilators in the periphery. Should Govt doctors also refuse surgeries without an ICU setup? Any Surgery or even normal delivery in rare circumstances can get complicated and the patient may require ventilator. Usually anaesthetist use Ambu-bag for an emergency situation and transport the patient to other facility. So absence of a ventilator is not life threatening in a real sense. In peripheries, a large number of deliveries are conducted by ANMs, and nurses, and complications may arise occasionally. So what are the facilities expected and available at a sub-centre? In reality almost nothing is available. Merely having a ventilator does not solve the problem and is not enough . The hospital requires much more arrangements to keep a patient on ventilator. Do all Govt hospitals where surgeries are being done have ventilator and trained doctors and support staff to operate those ventilators? It needs round the clock trained doctors and nurses, ABG machine, portable X-ray , bed side Echo dialysis etc. Doctors in ill-equipped Govt centres are forced to conduct deliveries. What should be the SOP in such circumstances? A real and honest data would be an eye opener and interesting.

Doctor need to ponder over the issue of saving themselves before they save the patient.

Medical Negligence: Karnataka Court Convicts Three Doctors For Death Of Woman Operated Without Ventilator Facility & Other Life Saving Equipment* “A Judicial Magistrate First Class court in Bidar district of Karnataka recently convicted three doctors for causing the death of a woman who was operated on by them without having a ventilator facility in the hospital and other life saving equipment. BIDAR: Four people, including three doctors, have been handed jail terms and slapped with fines by a local court for a botched surgery which claimed the life of a woman.The II Civil (senior) and JMFC Court judge Abdul Khadar sentenced well-known medical practitioners Dr Rajshree Biradar and Dr Vaijinath Biradar, and Saibanna, to two years imprisonment and fined them Rs 10,000 each. If they fail to pay the fine, they will have to serve an additional six months in prison. Dr Rajshekar Patil was sentenced to six months imprisonment and fined Rs 5,000. He will have to serve additional imprisonment of one month if he fails to pay the fine.The case dates back to October 12, 2014, when Sampavati, wife of Ghaleppa Auradakar, got herself admitted to Sushrut Nursing Home in the city for a hysterectomy procedure. But after a five-hour surgery, she died due to alleged medical negligence.However, without disclosing her condition to the family, she was shifted to Dr Rajshekhar Patil’s Shree Hospital in an ambulance. Dr Patil continued the treatment without disclosing her condition, it was alleged in the chargesheet.

Nursing home was negligent in not having ventilator: Court

Later, it was revealed that Sampavati had died at Sushrut Nursing Home itself due to the lack of ventilator facility. The court, while convicting the accused, observed that the nursing home authorities were negligent in not having a ventilator facility for such a risky procedure.

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April 15, 2022 0

Typical Story of Blackmail by Goons &Vulture journalism #Dr-Archana-Sharma-Suicide

Painful story of Dr Archana Sharma Suicide unmasks the everyday struggle of the doctors in present era. Although not ideal but being undervalued, dis-empowered and demonized, forced to work as sub-servant to bureaucrats are considered new normal and is an accepted form of harassment. Fatigue and burnout are thought to be routine side effects of being a doctor or nurse. Venomous media, celebrities, film stars and prominent personalities have left no stone unturned in spreading hatred and creating an environment of mistrust against the medical profession. They project single stray incident as an example and portray poor image of medical profession as generalization just to earn money and fame for themselves. Doctors have become prone to the verbal, physical as well as legal assaults. Dr Archana Suicide unmasked an organised crime and propagators were local goons, politicians and vulture journalist, who usually managed an orchestrated racket to blackmail the doctors and extort money. Doctors being soft targets because of their nature of work as they deal with life and death. Any death gives them opportunity to all to blackmail the doctors on the pretext of negligence, a legal weapon used by law-enforcers.

Dead doctor’s husband demands action against ‘vultures’ and ‘blackmailers’

JAIPUR: The husband of gynaecologist Dr Archana Sharma, who committed suicide on Tuesday, lodged an FIR against one Shiv Shankar Ballya Joshi for exerting pressure on the doctor and organising protests in her hospital. Hours before his transfer, Dausa SP Anil Kumar said police have seen the CCTV footage wherein Joshi was belting out abusive slogans against the doctor in the hospital. Police said they were investigating Joshi’s role in the case. The entire incident began when a 22-year-old woman was brought to Sharma’s Anand Hospital on Sunday night with labour pain. Though she was taken to the labour room, her condition deteriorated allegedly due to excessive bleeding and she died on Monday. On the same day, Dausa police registered an FIR under Section 302 (Murder) of the IPC which names Dr Archana Sharma and her husband Dr Suneet Upadhyay. The FIR put Rajasthan police in a tight spot because several doctors alleged that cops could have filed the FIR under Section 304A (causing death by negligence) of the IPC, instead of slapping murder charges on doctors. 4/1/22, 3:20 PM Rajasthan: Dead doctor’s husband demands action against ‘vultures’ and ‘blackmailers’. Kumar, however, said the police only registered the FIR on the basis of the complaint filed by the patient’s family. In an emotional video message, Dr Upadhyay alleged that Joshi had promised the family a hefty compensation and brought them back with the body to the hospital. “Joshi called other BJP leaders to the hospital too. Joshi has been trying extortion and blackmailing in the hospital,” he said, adding that the police have been shielding Joshi due to a senior BJP leader of Dausa. Sharma’s husband Dr Suneet Upadhyay in his FIR said that some “vultures” played politics on the patient’s body as they gheraoed the hospital and forced the local administration to file a case of murder against the doctor. Upadhyay alleged that Joshi played a key role in this entire affair. He has been accused in the FIR of threatening the hospital multiple times in the past. As per the FIR, many complaints were filed against Joshi at the police station, but cops took no action against him, which further emboldened the accused. Upadhyay said Joshi was hurling invectives during the protest at the hospital and his wife could not tolerate such insults because she was a reputed surgeon who had saved the lives of several women and children. He said she was stalked by fears that Joshi could send her to jail even though she was innocent. The complaint also mentions that Sharma read a report of the incident in a local newspaper, but there was no mention of the hospital’s version there.

According to Upadhyay, the family members of the deceased patient had returned from the hospital with complete satisfaction because they had witnessed the doctors struggling for nearly two hours to save her life. He said the family of the deceased patient were preparing for her last rites when Joshi stepped in and brought the body back to the hospital. Joshi allegedly called up people over the phone and gathered a large crowd at the hospital. He wanted to file a case of murder against the doctor even though the family of the patient had not given any complaint. The FIR states that vultures like them have made the lives of doctors in the country very difficult and told cops to act against such blackmailers. Dausa police said they have booked Joshi under Section 306 (abetment of suicide), 304 (extortion) and 384 (extortion by threat of accusation of an offence punishable with death or imprisonment for life, etc) of the IPC. Police said Joshi is a local leader, whereas, they are probing the journalist’s involvement.

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April 1, 2022 1

The Book-‘At the Horizon of Life & Death’:Blackmail of Doctors by opportunist goons, legal industry, Vulture Journalism

While doctors are usually blamed for any mishap, be it natural poor prognosis or genuine complications, rarely people get to know their side of the story — how a dying patient affects their psyche, how they deal with these patients and their kith and kin, what are the kinds of abuse and threats made when they are not able to save a life despite their best efforts. Book describes stories the blackmail doctors face from opportunist goons, legal industry and vulture kind of journalism. Every day blackmail by legal industry, journalist and local goons, similar to what Dr Archana Sharma went through and others doctors are facing have been described.

Dr Pankaj Kumar, Director Critical Care at a Delhi Hospital, India has come out with an insightful account of these very aspects of a doctor’s life.

The 300-page book (English) contains 20 stories divided into three parts viz – Larva & Pupa Syndrome, Hope & Fear & Medical Lawsuits. The book is available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive etc.

His book ‘At the Horizon of Life & Death’ is a Reality Fiction that reflects the sensitivity involved in dealing with patients facing death.

Through the eyes of its protagonist Dr Anand, the book captures significant moments in the treatment trajectory of critical patients. The book tries to create awareness regarding pertinent issues faced by the medical professionals like demoralisation, expensive medical education, the extreme pressure and suicidal ideation, the plight of the nurses and support staff, assaults and violence and the medico-legal intricacies involved in day-to-day practice among others. The author has also taken care to guide aspiring doctors to make well-informed career decisions.

Part One (Larva & Pupa Syndrome)- talks about the expensive medical education, and the issues students face in medical college.

Part Two (Hope & Fears) talks about the beginning of doctors’ professional journey, the disease demons they face while dealing with critical patients, dilemmas of doctors and patients near death situations.

Part Three (Medical Lawsuits) is about how doctors are always working under the threat of medico-legal lawsuits.

While stories are fictional, the scenarios and the problems in them are very real — things that he faced or saw his colleagues facing.

Medical profession has become victim of mistrust generation and blame culture. Everyone keeps harping about the few black sheep in the community, while larger good work of doctors is not highlighted enough.

The stories span from Dr Anand’s initial days in the emergency room and capture his struggles in complex medico-legal scenarios over the next four decades. This book is an effort to bring back focus on the treatment of the patient as opposed to the mistrust, legal frameworks and policies surrounding the healthcare practice.

More naïve would be to pay millions to be a doctor.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

March 31, 2022 0

Sitting Ducks for Blackmail- May be Unwise to Become a Doctor

Suicide by Dr Archana Sharma has exposed the blackmail; medical professionals are going through in current era. Doctors have become sitting ducks for punishments complaints, blackmail, and legal complexities besides every day harassment. Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment. It may not be a good idea to opt for a medical career any more. In the present circumstances, when doctors themselves are doubtful about the advice for choosing medical career, some are naïve enough to spend millions on securing an expensive medical college seat. Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

More naïve would be to pay millions to be a doctor.

Stark reality of complex medical scenario hits the studious and meritorious medical students on the face when they come out of college and start working in present environment. After a difficult time at medical college with slave like duties, an unsettled family life and with no money, these brilliant doctors begin their struggle. They work at various hospitals to gain more experience and slowly acclimatize themselves to the real problems of this profession. They realize that the actual medical world is far different than what was apparent from inside the medical college. Suddenly they find that their lives undergo a sea change. The goals that were taught in the medical college are now just not enough and they actually constitute only smaller part of a much larger system. And the scenario seems to getting worse for doctors with each passing day.
There is increasing discontentment amongst doctors because of complex and punishing system in addition to the unrealistic expectations of society which takes the enthusiasm out of these young bright doctors. Every day now, the informal discussions with colleagues regularly dwell more on problems faced by doctors, rather than real goals. There are routinely instances of verbal abuse and threat for no fault of theirs. Some unlucky ones get physically assaulted as well. Sometimes there are threats of dragging the doctor into a lawsuit which sometimes do really happen. Even if court, after years of deliberation, does decide in favour of the doctor, the harm to the doctor in the form of mental harassment and tarnished reputation is already done and that is something which cannot be undone even after he has been proved innocent.
Even if such events don’t happen to everyone, the very fear of such possible scenarios and their possible complications always lurks in the back of the mind and affects the treatment because the doctor tries to be doubly safe. The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient always colours the final decision in treatment. Many become punching bags in place of inept medical system and invisible medical industry. Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment.
And if these were not enough, these problems have been further compounded by unnecessary utterances by celebrities against doctors, negative projections by media who never acknowledge the great work done day and night by doctors. Stray mistakes by some doctor, or treatment failure due to a poor prognosis and sometimes due to system failure are projected and widely highlighted by media and celebrities to tarnish image of all doctors .Though these do sensationalise their news and promotes their business, but the repercussions are heavy and it breaks the trust of the public in their doctors. This eventually does harm to innocent public in the long run but has also done enough irreparable damage to the medical profession.
If children of current generation do not hold the profession in high esteem, then obviously they wouldn’t want to be part of this profession. And if brilliant students shun this profession, then how would society get good doctors? If there is always fear in their mind, no one can do justice to his job and this you’ll all agree, applies to all professions

Disadvantages of being a doctor, Drawbacks of Medical profession: Choosing medical career or being a medical professional a disadvantage to doctor in comparison to other professions?

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March 30, 2022 0

Any Fine Morning can be Harbinger of Doomsday for doctors #lady-doctor-suicide

Working of a doctor and nurses is not free from risk to themselves which can be verbal, physical as well as legal assaults. Everyday globally, the doctors and the nurses greet the new day and return to their work of taking care of their patients, knowing well the risk involved. None of the doctors can guess which one fine morning becomes a harbinger to their doomsday, especially when serving an anarchic and hostile society. No doctor can anticipate which one patient can cause deadly harm to health care workers, while trying to save the one. Unfortunate incident of PPH (Post-partum Bleeding – a natural complication of pregnancy) and subsequent agitation by mob and over-reactive FIR by hostile Police was enough for a brilliant Obstetrician to commit suicide in Jaipur. Possibly doctors are not assured of getting justice anymore from our system.

Jaipur- A woman doctor booked for death of a pregnant woman in Rajasthan committed suicide

Jaipur- A woman doctor booked for death of a pregnant woman in Rajasthan committed suicide

Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. According to police, the pregnant woman died at the hospital run by Dr Archana Sharma and her husband on Tuesday. An FIR was registered against Archana at the Lalsot Police Station after family members of the pregnant woman held a demonstration outside the hospital and demanded immediate action against the erring doctor. Stressed over the FIR, Archana hanged herself to death, police said. “The doctor was booked for the death of the pregnant woman due to negligence in treatment. Today afternoon, the doctor hanged herself to death at her residence above the hospital,” Additional SP (Dausa) Lal Chand Kayal said.

The risk is generally underestimated, although often it may be major risk to life. Majority of people, society and governing bodies and even doctors themselves do not perceive or acknowledge the possible harms to health care workers in present era. But since these risks are increasing exponentially, they should be known to students, who want to take medicine as a profession. There are lesser set procedures, lack of awareness, not protective equipment or hostile society, lack of governance and laws and doctors continue to work in dangerous environment.

Doctors have become punching bags for all the malaise prevalent in the system. A failing system which is unable to provide health to the people and security to doctors. The rickety system hides behind their hard working doctors and presents them as punching bags. The impunity with which attendant easily and brutally assault doctors is really appalling, should be shameful to law enforcing agencies.

Role of media, celebrities, film stars and prominent personalities in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable. They project single stray incident as an example and portray poor image of medical profession as generalization just to earn money and fame for themselves. Doctors need to be careful and remain careful about saving themselves from verbal, physical as well as legal assaults.

Doctor- ‘save the patient but to save themselves also’.

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March 29, 2022 0

Man Jailed for Abusing Lady Doctor

In present era, most of the time, a lenient view is taken against assault of doctors on the grounds of emotional circumstances of relatives and sympathy towards patients, even in cases of blatant injustice imparted towards doctors and nurses. Not infrequently, assaults of doctors are taken as routine incidents committed under disguise of perceived negligence and sympathy towards patients. The culprits are able to commonly get away with it.

But this businessman who abused a lady doctor has not been proved to be lucky, at least till this time. He was handed over a jail term of 6 months. Rightly so, courts need to aim at imparting justice and not judge on the basis of projected disturbed emotional state.

Man gets six-month jail for abusing lady doctor

The incident had taken place on 23 Nov 2017 when Rohinton Umarigar, who was at the Parsi General Hospital for his mother’s treatment used abusive language with the woman doctor who was in charge of the ICU

A Girgaum magistrate court refused leniency to a 52-year-old who used foul language with a woman doctor in 2017 and sentenced him to six months of simple imprisonment. It stated that unwarranted leniency to him would send a wrong signal to society and that he had used unparliamentary language to insult the dignity of a woman.

The incident had taken place on November 23, 2017, when the man, Rohington Umarigar, was at the Parsi General Hospital where his mother was undergoing treatment. He used abusive language with the woman doctor who was in charge of the ICU.

The Nepean Sea Road resident had sought leniency and requested that the court release him by imposing a minimum fine and on a bond of good behaviour. He told the court that he was the only breadwinner of his family. Umarigar’s advocate told the court that the incident occurred at the spur of the moment when his mother was ill. The court said the punishment under Sec 509 of the IPC (word, gesture, act intended to outrage modesty of a woman) was enhanced by the legislation in 2013 looking at the time and seriousness of offences committed against the modesty of women. The court noted that Umarigar had misbehaved a second time with the doctor, which means it was intentional.

“Whenever such type of offence is committed against women, it is against their right to sexual integrity, dignity. It is linked to their right to privacy…in the present matter also, the accused has used unparliamentary words to insult the dignity of woman. He is in his 50s and knows the consequences of his act,” Magistrate Nadeem A Patel said. The court further said that while enhancing the punishment, it was the intention of the legislature to penalize the offence of outraging a woman’s dignity, either physically or verbally. Therefore, in such cases, unwarranted leniency shown will send a wrong message to society. It also imposed a fine of Rs 1,000 on the man.

The man had claimed that he had made a complaint to the hospital management against the doctor for negligence and that this was a counter-complaint. The court refused to accept this defence. It said that even for the sake of argument if it were to be assumed that she had been negligent in her own duty, it did not give him the right to abuse a lady doctor. It relied on the testimony of the victim, as well as her three colleagues at the hospital who testified about the incident.

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March 28, 2022 0

Sow Muskmelon-Deserve/Expect Apple? #NEET-Medical-seats filled with rock-bottom scores

MBBS aspirants who missed out in the initial rounds of seat allotment and pinned their hopes on vacant NRI quota seats have been bested by students at the tail end of the NEET qualifying list helped by NRI sponsors. Overnight, close to 152 aspirants, many of them with ranks in six digits, have submitted documents, including a certificate from the consulate concerned, to prove that their education will be sponsored by an Indian based abroad. Aspirants with much higher scores, who were banking on the addition of vacant NRI seats to the relatively cheaper management quota — the fee differential can be as much as Rs 25 lakh-35 lakh — have been done in by a minor clause in the fingerprint. A medical college in Maharashtra has, in fact, already

Doctors are just as offshoots of a tree called as society. They essentially are the same as rest of the society. It is a specialized branch of tree which helps other offshoots of tree to save others. As part of same tree, they resemble the parent society, of which they are part. Society needs to choose and nurture a force of doctors carefully with an aim to combat for safety of its own people.

Apple tree will have apples and musk melons plant will grow muskmelons only. One should not expect apples to grow on muskmelon stem. If society has failed to demand for a good and robust system, failed to save them, it should not rue scarcity of good doctors. Merit based cheap good medical education system is the need of the society. This is in interest of society to nurture good doctors for its own safety.

Therefore the quality of doctors who survive and flourish in such system will be a natural consequence of how society chooses and nurtures the best for themselves.

Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college. Even an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. So that a candidate who scores 15-20 % marks also becomes eligible to become a doctor. What is the need to dilute and shortlist around half a million for few thousand seats? Answer to that is simple. To select and find only those students from millions, who can pay millions to become doctors?

If the society continues to accept such below par practices, it has to introspect, whether it actually deserves to get good doctors. Paying the irrational fee of medical colleges may be unwise idea for the candidates, who are not from strong financial backgrounds. But at the same time unfortunately, it may be a compulsion and entrapment for students, who have entered the profession and there is no way forward. So children have to be careful while choosing medical careers from the beginning.

NEET Tail-Enders Jump Queue, Grab Medical Seats

NEET Tail-enders Jump Queue, Grab Medical Seats

MUMBAI: MBBS aspirants who missed out in the initial rounds of seat allotment and pinned their hopes on vacant NRI quota seats have been bested by students at the tail end of the NEET qualifying list helped by NRI sponsors. Overnight, close to 152 aspirants, many of them with ranks in six digits, have submitted documents, including a certificate from the consulate concerned, to prove that their education will be sponsored by an Indian based abroad. Aspirants with much higher scores, who were banking on the addition of vacant NRI seats to the relatively cheaper management quota — the fee differential can be as much as Rs 25 lakh-35 lakh — have been done in by a minor clause in the fingerprint. A medical college in Maharashtra has, in fact, already allotted a seat to a NEET qualifier placed 267th from the bottom in a list stretching into several lakhs. When registration for the all-India mop-up round began on March 10, several Indian candidates had applied to convert to NRI status. The medical counselling committee gave such students time from noon on March 11 to 6pm the next day to change their nationality from Indian to NRI. However, candidates wrote to the NMC asking for their nationality to be converted in the last leg of the admission process, presumably after all other options to secure a seat had been exhausted. “The NMC was forced to open that window. According to a 2017 Supreme Court judgment, a candidate can change his or her nationality at any point,” said Dr Pravin Shingare, former head of the Directorate of Medical Education and Research. NRI seats, which cost Rs 40 lakh-60 lakh per year — 4-5 times more than those in the management quota — and had no takers until last week, were now suddenly in demand and filled by candidates with rock-bottom scores. At Pravara Institute of Medical Sciences, Loni (Maharashtra), the last management seat was filled by rank 83,817 while the last NRI seat went to rank 8,72,911. At Sri Devaraj Urs Medical College, Kolar, the last management seat was allotted to rank 86,416 and its last NRI seat to rank 8,76,357. This scenario has played out in medical institutes across the country. Rank holder 71,474 had named MGM College as his first choice in the mop-up round. He didn’t get a seat, but a candidate more than 8 lakh ranks below at 8,73,286 has got lucky, thanks to the clause which allows a student to abruptly change his/her nationality in the midst of the admission process. Hence, of the 19 vacant NRI seats at MGM that should have been converted to the general category, according to the NMC notification, not a single one eventually remained vacant.

Our society fails to develops a robust system of choosing and nurturing good doctors and therefore itself responsible for decline in standards of medical profession. A famous axiom “as you sow so shall you reap” has an application to health system, Government and Public as well in this scenario, so people should not rue scarcity of good doctors.

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March 27, 2022 0

Lowering NEET Percentile- an Illusion of Merit

Govt cuts NEET-PG cutoff by 15 percentile In a move that is likely to boost uptake in vacant post-graduate medical seats and also improve availability of specialists in future, the health ministry has slashed the cutoff for NEET-PG 2021 by 15 percentile across all categories. The ministry issued a letter to the National Medical Commission on Saturday giving a go-ahead to the proposal. The revised qualifying cutoff now stands at 35 percentile for the general category, 30 percentile for persons with disabilities (PwD) general, 25 for SC/ST and OBC and 25 for PwD (SC/ST/OBC), the letter said. The reduction in the cut off percentile is expected to allow more MBBS passouts to apply for post-graduate courses, an official said. “The move aims to prevent seat wastage. With this reduction in percentile, approximately 25

Overplayed narrative of fewer doctors in the country, rather than a system for proper utilization is an effort to increase numbers of doctors. But this goal needs to be achieved with preserving quality of medical education. Almost all efforts to increase the number of doctors are associated on dilution of merit. Selling the medical seats is heading towards bubble burst, when despite declining demand for poor quality and expensive medical education, new private colleges being approved along with lowering merit to a dismal percentage.

Future doctors getting admissions by scoring just 10-20 percent of marks, poor teacher student ratio, seats being awarded to highest bidder are few pointers to the poor quality of medical education. Few years back NEET percent system was changed to percentile and now the bar is lowered further, just to accommodate more ‘bidders’ with less marks, to be able to buy medical seats.

This potpourri portends to be a travesty of quality, not just of medical education but more seriously, of the quality of doctors. Allotment of medical seats is being left to the vagaries of populism and commercialism, through a false sense ‘the illusion of merit’ secured via NEET. Admission criteria whittled down to mere 10-20 percent, will result in an irreversible and regressive compromise with quality of doctors. Will patients approve such dizzying choice and at what cost?

Going by selection of candidates as doctors, if given a choice, by which a patient will like to get treated? A candidate who scored 20 % marks or a person getting 60% or 80% marks. NEET eligibility getting lower and a candidate getting around 20 % of marks may be able to secure a degree to treat patients. What will be the deciding factor? The criteria as to why a person with 60% marks not getting a seat and another with 20% marks will be able to secure. It will depend upon, whether a candidate is able to pay the exorbitant fee or not. Present system and mechanism of admission permit and accept such huge variation! That strange equation is acceptable in lieu of money paid!