CME INDIA Presentation by Admin.

ॐ  न ही ज्ञानेन सदृश्यं पवित्रिमिह विद्यते

इस संसार में ज्ञान के समान पवित्र कुछ भी नहीं है

CME INDIA wishes a very happy New Year to you. We present the unique scenarios our physicians had in 2020 – the year of doom and desperation. But, hope and will power to tide the troubled sea will the best tribute to 2020…

Illuminating Messages from CME INDIA fraternity

Dr H D Sharan, Sr Cardiologist, Ranchi:

• Let us ask ourselves? Have we ever waited so eagerly for any year to end? I do not know how it happened but everyone feels that the moment clock strikes midnight on 31st December, the Virus will disappear. That it had something to do with the digits 2020 and the moment the last zero turns into one, our problems will be gone too.
• The human race has entered into a long-term relationship with a bio-terrorist called the SARS CoV2. Vaccination is probably going to be an annual affair and some people are going to get very rich.
• So, let us hope that the New Year gives us more wisdom, brings new knowledge and newer and affordable therapies so that we can start enjoying life once again.
• There is always a silver lining to the dark clouds. So many people, out there, were looking for someone to seek some help or other and it was nice to know that, God willing, I could do something for them. There were people with 3 members of the family admitted to 3 different hospitals as I could not find them beds at the same place. Talking to my sources in those hospitals at least twice a day to know the status of the patients and then briefing the poor family member who was running from one hospital to the other, gave me a lot of satisfaction.
• In the initial part of the pandemic, I kept away from direct contact with the patients. The expression on the faces of my family members made me take that decision. Age of 70 and multiple comorbidities were the cause of their anxiety.
• The people succumbing to the disease were just names till then. But then, it had to happen. All 10 members in the family of one of my close friend got infected. Within no time, his wife and younger brother had to be admitted to a hospital. The rest were being treated at home by me. The wife died of multi-organ failure in August. His brother has been discharged from the hospital but is still dependent on oxygen. There was no doubt in my mind what was expected of me.
• Friends in Raipur, Ahmedabad, Gwalior started getting infected one after the other and for them, I was the only doctor in the world.
• Let us try to help those who need help in the New Year. A smile on their face will make our lives worthwhile. This is the lesson 2020 taught us.
• I wish my family and all my friends a very healthy, happy, peaceful and safe 2021. खूब खुश रहो, मस्त रहो। हंसो भी और हंसाओ भी।

Dr Akash Kumar Singh, Diabetologist, Vadodara, Ahmedabad:

• The year 2020 – As I perceived. New learnings, new failures.
• Could we have avoided spreading it worldwide?
• Probably, yes, if WHO would have declared pandemic earlier, flights might have been stopped a little earlier.
• Lots of drugs were promoted initially without much evidence. I agree, that there was not much time for proper evidence, but it was more politicized!! (Like HCQS).
• The biggest success we got was the RECOVERY trial, which gave us evidence for use of steroids and this saved so many lives.
• There were so many unproven therapies, which were also promoted to a large extent. I believe, media also played a greater role in spreading wrong messages in society as many such therapies were promoted in social media and relatives were upfront asking for such therapy. Like, many demanded them. To give you an example, Remdesivir/Tocilizumab/Convalescent Plasma therapies were demanded by relatives of patients as they were much publicized in media. We really didn’t know whether they would have helped the patients in that particular situation in which they were demanded.
• Some positive aspects of the pandemic are as follows:
• We can say that people are now much more aware of personal hygiene (Hand hygiene, mask), which may decrease many diseases like contagious diseases like influenza, COPD, etc. An indeed we have seen less respiratory tract infections this year in our predisposed patients.
• I would say, the biggest thing we achieved in this pandemic is to develop a vaccine in the shortest possible time ever in the history of mankind.
• Hope it will end the pandemic.
• On the personal front the year has had a silver lining for doctors. We have organised ourselves well through the social medial platforms like Whatsapp, Zoom, Google meets. We have had lots of knowledge dissemination through the digital platform. We have come to know of each other across India. We are associated with our colleagues across India, a situation which we could never have imagined in 2019. And fortunately, the digital platform is here to stay.
• On the social front, although we are faced with isolation from our friends, relatives, and local and international conferences and travels, we have enjoyed our interactions on digital platforms which earlier was seen as an addiction has become a reality now.
• And I think the year 2020 has been a real boon for our CME group with hundreds of colleagues joining in and the platform now becoming the largest CME platform of India with the addition of many new features!!

Dr Ripun Borpuzari, MD GCDC FICP, Joint Director of Health Service at Govt. of Assam, India:

Will it fade away or just change numerically from 2020 to 2021?

• In the bludgeons of time, everything in this Mother Earth fades away except time itself. Time maintains its vicious cycle ever since the existence of this planet along with life. The 2020 is just a part of the time clock; the question is ‘will it fade away or just change numerically from 2020 to 2021? Whatever the answer, the reality is that the four-letter word HOPE will always be there amidst all odds to drive the mankind ahead to think ahead, to look ahead always for a better tomorrow…. that’s the divine spring of life!

Except few words of solace and mental boosts you do not have any more to offer

• The last few months were a really difficult time my family came across. My sister along with her husband (a recent post-operative case of Ca Tongue) and son; my sister in law’s (herself being the HOD of Ophthalmology in Assam Medical College) whole family along with her octogenarian hubby, son and daughter in law; my own daughter’s in laws family (her father in laws being a diabetic) and few other close friends suffered terribly from this pandemic of the century. By the grace of the Almighty no untoward happened though. But the situation, the mere feeling of their panic minds, the words of sheer desperation…. might not easily fade away from my mind! Just imagine when you cannot even do anything you being the only doctor in your family and you are not in a position to describe all probabilities because you do not even know much! Except few words of solace and mental boosts you do not have any more to offer…

Time is a great teacher

• Time is a great teacher. The year 2020 taught me that belief and reality are the two sides of the same coin of ‘Confidence.’ Reality is the scientifically proved version of belief or hypothesis. So long a belief is not proved scientifically we call it a myth. But sometimes even a strong evidence against fails to fade away a belief. All the drugs that have been in use in this pandemic are still in the tug between faith and reality! I did take HCQ for a pretty long time of two months weekly and I find it tough to remove it from my mind as a mere placebo only. Had there been no Big Pharma theory, the belief would have been different. The drug Remdesivir failed to show any curative effect. But all my friends and relatives who were treated with this medicine came out well even from a stage of SPO2 as low as 90-92% in spite of the fact that seven of them were above 66 years of age with some comorbidities.

The ladder step on which the science goes forward

• So, controversies and difference of opinion shall remain and it must because this is the ladder to step on with which the science goes forward. One thing is clear: the pandemic revealed a total lapse in preparedness and some politically motivated erroneous decisions by the country of origin, China. If we go by the history, even after three weeks of the first case detected in Wuhan, the district authority suppressed the news to be out. Secondly on 18th Jan, 20, they allowed a traditional banquet in the district attended by 40000 families! The result was that more than 28000 people got affected followed by 560 deaths (red: Ind J of Ophthalmology May 2020; 68(5)-703-710). In contrast look at Singapore: it started screening of temperature of all passengers right from 3rd January ‘20 onwards with all measures of quarantine etc., even before the virus was isolated. That is called a perfect preparedness. We need such a global preparedness.

Four letter word ‘hope’ is always there

• Yet, the four-letter word ‘hope’ is always there to decorate our expectations…the black cloud shall go away; the evil crown must fall and be destroyed. As a doctor, we need to portrait a realistic image of the vaccination policy taken up by the GOI and encourage public to go for it.

First defence for some time in years to come

• And the last but not the least, thought to ponder upon is that more than 60% of all killer infectious diseases are zoonotic. But how much effort we have put to save the animal kingdom from being infected by these organisms? Along with giving priority to shielding the human race, an ongoing research should be strengthened to parallelly salvaging them too. Secondly it seems SMS (the three principles of protection) is going to stay as the sign of first defence for some time in years to come

Dr Sanjeev R Pathak, Founder, Vijayratna Diabetes Diagnosis & Treatment Centre, Ahmedabad.

• The year 2020 has been a standout year indeed, but for all the wrong reasons. Ranging from numerous wildfires and tropical cyclones to locust attacks and the news of the possibility of existence of alien life, this year has proven to be a roller coaster that only goes down.
• While all these natural disasters loom in the background, the COVID-19 pandemic has definitely been the showstopper for the year 2020. The Coronavirus disease which started in late 2019 wreaked havoc upon the entire world this year. 2020 is almost over and yet, the virus seems to be here to stay, with repeated waves of infection and newer strains constantly appearing, the virus seems to be adjusting to our world too quickly.
• The Coronavirus has not only put an end to a large number of lives, old and young alike, but has led to decimation of entire businesses, healthcare systems and many communities. The psychological and social damage it has caused is only secondary to its long-lasting effects on the physical health of the patients and their families who have succumbed to the ill effects of this virus.
• This disease has been so unpredictable at times, that it has been difficult for the doctors to come up with a standard treatment. Every case, every patient is different in the terms of presentation of the illness and response to treatment. In some families, one infected person has not transmitted the disease to his close contacts and on the other hand, entire households have also been affected even after taking ideal precautions to avoid contact. Elderly people with co morbid conditions are believed to be at a higher risk of complications from this disease, and yet there have been many cases that have defied this norm, with this group having fought the disease with almost no symptoms, while young and healthy adults have become severely ill with prolonged fever and hypoxia, sometimes losing their lives to this dreadful disease.
• It is a generalization that patients who demonstrate loss of smell and taste as symptoms will likely have a mild form of the illness, but a couple of patients have developed moderate to severe symptoms, thus proving that there are exceptions to this conception.
• On the personal front, a lot of my close friends and family members suffered from the disease. It was a difficult time for them. I observed that my doctor friends were much more anxious, probably because they know the impacts of this grim disease while non-medicos generally disregarded even some serious signs. As someone has very correctly said, ‘A little knowledge is a dangerous thing, so is a lot.’
• Coming to the highly-debated antibodies, some patients developed large amounts of antibodies even without having faced any symptoms, particularly those who had contact with a family member who had COVID, whereas some patients had almost no antibody response even after facing moderate to severe symptoms for 7-10 days.
• We noted a more severe form of the illness in male patients when compared to females. Moreover, patients with blood groups A+ and AB+, uncontrolled diabetics and obese, patients with history of heart failure and Vitamin D deficiency were found to be more susceptible.
• Treatment wise, among the antiviral drugs, Remdesivir when given early in the course of the disease, preferably during the first week, appeared to reduce the severity and need for hospitalization while also simultaneously shortening the duration of illness, all this with no safety concerns.
• With the news of vaccine approvals in India doing the rounds, and with some countries already administering it, 2021 surely seems to be beginning on a much happier note. However, this virus is not one to completely disappear out of thin air, especially with newer strains developing very rapidly. The basic principles of SMS will still apply in the foreseeable future, but here’s hoping that 2021 will bring with its better health and safety for the world.

Dr Raj Kamal Chaudhary, Asso. Prof of Medicine, JLNMCH, Bhagalpur:

Lessons learned from Corona in 2020: –

Danger of ignoring our interdependence

• The Covid-19 pandemic highlights the danger of ignoring our interdependence and the importance of global cooperation.
• The Covid-19 pandemic demonstrates to us that our economic, political and social systems can serve our needs and purposes only when they induce us to cooperate at the appropriate scale – Since the Coronavirus does not respect national boundaries.
• But it is just as much a challenge on the national level, where many of the policy decisions in response to the pandemic are made, and at the local levels, where people decide on whether to comply with government guidelines and whether to support one another in times of need. Everyone one of us – from heads of state to ordinary citizens to refugees – bears great responsibility for the health and wellbeing of others.

Billions of people were in lockdown

• Billions of people were in lockdown, unable to visit one another, unable go to work, unable to attend school, unable to meet one another in public places. People around the world were in desperate straits, struggling at home, in care homes and intensive care units, dying of the same cause, separated from their loved ones in their hours of need.
• At times of existential danger, we instinctively desire to be close to our family and friends, hold their hands and embrace them – but now we are forbidden to do so, for every act of physical contact – every expression of physical loving-kindness and compassion – could bring illness and death.

Ignored the uncertainty of our existence

• We are confronted with the true uncertainty of human existence and the true vulnerability of human life. How often have so many of us believed that we are supreme masters of the world around us.
• How often have we as researchers ignored the uncertainty of our existence, mistaking it for probabilities generated by our statistical models? How often have we ignored our vulnerability by pretending that we are in control of our destinies? The Covid-19 pandemic shows us how wrong we were.
• We are brought face to face with the most basic questions of life. What are we here for? What have we done with our lives? What do we yet wish to do if given the opportunity? Who is truly important on our lives? What is it that we truly cherish? The pandemic leads us to some painful insights: If we know who is truly important to us and what we truly cherish, then why have we spent so little of our lives pursuing these things?

How terrible it really is to waste our lives

• The Coronavirus shows us how terrible it really is to waste our lives, embroiled in endless battles for wealth and status and power. How terrible it really is not to recognize the value in the people around us – not just our family and friends, not just colleagues and fellow citizens, but also complete strangers. How terrible it is not to give our lives meaning – every hour of every day – by honoring the sacredness of life and according all living things the respect, sensitivity and care that they deserve.
• The Covid-19 pandemic demonstrates to us the value of freedom – the freedom to move, to be with those we love, to live in dignity and security – for ourselves and for those around us, from our loved ones to the refugees and the downtrodden.
• Above all, it shows us the importance of recognizing the true purpose of all our businesses and economies, our political parties and governments, our local civic associations and our international organizations, our conventions and ideologies, and all our other systems: namely, to serve human needs and purposes.
• The pandemic to end must end somewhere and then we will be sure that the pandemic has come to an end, May be India this time.

 Covid & 2021 :-

• I see a much brighter year ahead. India has done a very good job in the last few months. Around the mid-2021, vaccinations should start, the vaccines will effectively calm down the Corona pandemic, these vaccines will be better than Remedesvir and other Antibiotics which was a water loo for the infection and weren’t hundred per cent effective despite their claim. The pandemic won’t end immediately but life will be much, much better. Provided the people of India remains conscious and especially to the new variants entry to the mutated virus .

Dr Hem Shankar Sharma, Asso.Prof of Medicine, JLNMCH,Bhagalpur

Strong Impact in my Life

• The pandemic era, starting in my place in the month of April 2020, had a strong impact in my life. For months together, after being the Nodal Officer of our medical college hospital, busy round the clock, hardly any time to have a break whether days or nights, went by, without a stop… Ideas, planning, execution, allaying the fear psychosis of the Fraternity, friends, and the community people on different levels, with the help of my Superintendent, Dr R C Mandal, Dr. K. Gaurav and Dr A K Bhagat, went all out to tackle the issue. Press and Electronic media friends supported completely and helped us in this War!!!

Team Work was unique

• Administration, both General and Police, collectively fought, under the leadership of the DM Bhagalpur, Mr. Pranav Kumar. I would like to thank specially two young officers – IAS Dipak Mishra, and IPS, Bharat Soni, undergoing training, joined hands with me, for a 24-hour working. Tough times started challenging us, managing patients of 12 adjoining districts, losing some close friends, mostly because of late reporting of them, and non-availability of some drugs!! Psychological counseling was very important for all those involved in the management, as well as patients and their families. Losing the physical support of some administrative and health officers, as they started getting Covid themselves, and seeing my cricket team, losing some quick wickets!!

Mixed feelings of losses and wins!!

• My team of Young doctors went on a rampant strike while one of their colleagues was positive. It appeared that system will collapse! But we sat together with remaining friends to gear up and a comeback, fighting on many fronts, with determination. The days went by, gradually, with mixed feelings of losses and wins!! The visit by a person, at the helm of affairs, Pratyay Amrit, who had taken the charge of affairs in our state, was a strong help to our work and determination with a more intense, target oriented goals, with a very sympathetic attitude to all groups. A coordinated discussion started taking place of all friends, Nodal Officers of Bihar, friends from all over the country, particular mention of Dr Shashank Joshi of Mumbai and my friend, Dr Sanjiv Kumar Sinha of AIIMS, Patna and Dr. Ajay Sinha, of NMCH, Patna, who has already started a crusade against this fight… Collectively we took many decisions in the management, updating ourselves with discussion on different platforms, specifically mention, run by my friend Dr. N K Singh ,under CME INDIA, with an upgraded discussion round the clock. Things went on, moving towards better controls, but we were always on alert modes…achieving a recovery rate of 97 plus, currently, in our state.

That day, I will never forget

• The day of 2nd December, afternoon, while returning from hospital, I noticed that some discomfort in abdomen, alerted my wife, who insisted for a test for Covid, which came positive. The next few days of mixed reactions, remembering those who fought and lost in these fights, were cooled by a clear HRCT Chest, and only slightly deranged other markers. Was helped by my music system, Pandit Jasraj, Pt. Bhimsen Joshi and Bhagwat Gita…Days went by and I was comforted by my friends. Continued attending patients and Webinars, even during this, on video calls. Finally got a relief with a negative test of RTPCR.

Life back to normal, Don’t forget the year,as it has given us many lessons

• Lessons, we got, not to undermine the importance of Social distancing Masking and Sanitization, despite the wait for availability of vaccine. Don’t forget the year, as it has given us many lessons. How to live with limited resources. Taking good care of oneself, families, community and patients.
• Wish and pray the easy availability of vaccine for all in 2021. Despite this depend more on Distancing, Masking and Sanitization…

 Dr A K Virmani, Jamshedpur:

• From today, now we are all going into a new decade 2021 – 2030.
• A decade in which many of us would be retiring from our jobs, passing on our businesses & completing our family duties.
• Our kids would be completing their studies, getting settled in their respective professions, businesses, marrying and becoming parents and we as grand parents.
• Some of us will also be losing our dear loved ones.
• We will be facing more and more of life’s challenges and health issues as we age.
• Life will be tougher for some ( def. not forgetting The Unforgettable 2020 we all have had 😀)
• Yeah, the coming decade will be the end of most of our duties and also a start of duty towards ourselves.
• Let us all promise to indulge with our friends and take care of ourselves more in the coming years ‘coz-
• कुछ हिस्सा इस ज़िंदगी का तो अपने लिए भी बनता है।
• In the last week of December 2020, I went to Khajuraho for first physical conference this year for two days, stayed at Kolkata since last four days and now am in Goa for New Year.
• Taking all precautions but not afraid. I have lived life the army way as if there is no tomorrow. I’ve a strong family history of dyslipidemia and CAD from my maternal side. I believe I can take only adequate precautions, rest God will take care. COVID vaccination is needed but nothing is certain at present. No one can outrun his/her destiny.
• Here’s wishing all my friends and near and dears a decade and more, full of fantabulous moments with family and friends 🌹.

Dr Raju Sharma, Internist, Jamshedpur:

Work is important but we shouldn’t leave living “life.”

• Enjoy the relationship we have with our near and dear ones.
• Enjoy our hobbies.
• Enjoy staying healthy and at home!!
• Talk to others, reach out.
• Avoid show offs either by self or those who do.
• Make a list of “to do things” and do them😁
• 👍🏾Best of luck to everyone one for 2021 & Happy New Year.

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