The Antiretroviral Combination story

The news about the combination pill containing generic version of three antiretroviral drugs being as effective as their expensive counterparts is all over the internet. For me, this is not at all a surprise. Back in the days of the Anthrax scare, the prophylactic drug of those times Ciprofloxacin used to be upto 10 times cheaper and as effective when it came in the generic form from manufacturers in India. Besides, the BBC has been reiterating the claims of the Indian companies in it's programs about the AIDS situation in Africa.

The facts are staring at you. The US administration should take notice. I hope the people concerned will forget whatever has happened and help the needy in the epidemic stricken nations in Africa and Asia.

In addition to that, I've been wondering what the actual combination is.

In addition to being cheaper, drugs like Triomune -- which contains GlaxoSmithKline's lamivudine, Bristol-Myers Squibb's stavudine and Boehringer Ingelheim's nevirapine -- are simpler to use since patients need to take only two pills a day.

FDA Drug and Device Approvals: July 1, 2004

The U.S. Food and Drug Administration (FDA) has approved leeches as a device for skin grafts and reattachment surgery, an oral HIV-2 antibody test with results in 20 minutes, generic dimenhydrinate injection for motion sickness, and a new device for the treatment of heart failure. The European Commission has granted the CE mark of approval for cetuximab in the treatment of metastatic colorectal cancer in the European Union (EU).

Very interesting reading indeed! The leeches might be very interesting to work with in a case of DVT! And the Oral HIV tests would mean a lot in the third world countries.

Commitment to patients or oneself?

Today I got a call from my friend informing that he might have contracted Leptospirosis, which is fondly known by the names of 'Weil's Disease' and 'Weil's Syndrome in this part of the world. Shocked as I was, I asked him how it had happened. He said he thought he got it from a patient in the hospital he was doing residency. The patient, a known case, was spitting blood out and needed resuscitation. My friend had to do his duties despite of the fact that gloves weren't available at that time. In spite of the fact that the resuscitation was in vain, my friend had his hands smeared with blood and unluckily for him, he had some fresh abrasions to help the spirochetes on their quest over another human body. There are two points that I wish to discuss about this issue. One is the lack of proper facilities in Government hospitals in India. This kind of scenes are going on in hospitals all over the world in developing countries. The Government fails to provide enough gloves, syringes, needles, drip sets, IV fluids, sutre material to suit even baseline needs. Therefore, there are times when, being committed residents/interns, we would have to put ourselves to risks in dealing with such infectious disease and even more deadlier ones - HIV/AIDS. Having said this, I must also admit I have seen countless interns/residents who won't use the facilities when they are available. The reason - One of these days you are going to have to do something without gloves. So why waste a pair now? I totally condemn both the aspects of the story. Wait a minute. Who am I to comment? I am, for the benefit of the readers, just a would-be-resident in a Government hospital in India. I don't have any voice when it comes to such issues except for this blog. If I raise the issue in my hospital, chances are that most people (including patients) would consider me as a nerd. From professional aspects to sports - I don't know how many of you are interested in Euro 2004. The fact is that my favorite team is out of the tournament as of yesterday. They were outdone by the fantastic tactics of the Greek. I am not taking any credit of the Greeks but have to admit that using the same tactic over a period of 105 minutes was a tactical error from the Czechs. It's fine if you have a forward in Koller who is taller than anyone in the opposition. If you put aerial balls in from anywhere else on the field into the opponents half aiming Koller, chances are that he will win the ball for you. But if this masterplan doesn't work, why not try something else? That's what they didn't. And that's probably why they lost. They could have substituted the lack-lusture Poborsky in the second half to improve the 'service' to the box. And if you think I'm not geeky enough - I'm a resident doc in India who's into computers, running a website, has a four Gmail accounts, blogging, poetry - dig this! I'm going to try and learn computer programming for upgrading my website. It might be hard to find a more ambitious project anywhere else. But still, I'm going to try my hand at ASP/PHP etc. Wish me luck everyone!

Happy Doctor's Day!

First of all, I wish all of my colleagues and fellow doctors a very happy Doctor's day! But the Doctor's day hasn't started in an intellectually stimulating fashion for me - I read on the Malayala Manorama that the residents/workers in the Kerala House in Delhi were facing epidemic 'jaundice' which was attributed to excess Coliforms in the water. Now, as far as my theory goes, Coliforms don't cause epidemic hepatitis which is what the paper meant by epidemic 'jaundice'. The only thing that Coliforms are known to cause, in this context of course, is cholangitis, the signs and symptoms of which are quite different from this 'jaundice'. There must be a species of staff in the paper's editorial team called - Medical Professionals? Can't they run the story through them before it appears in print? Another thing that I'm dying to bitch about is the Government's idea of uplifting the historical landmarks in Kerala, particularly in Thiruvananthapuram, with ideas that are as teeny as it gets. For example, the City Corporation of Thiruvananthapuram spent a lump of money to renovate and 'decorate' the East Fort, the city's most prominent landmark. The final picture, which I'm unable to show you at the moment, is something like a kinky Vegas casino - the walls are lighted by lamps of the colors pink, green etc. Oh by the way, this is not Texas and we are certainly not in the 70's hippie era! Even though I didn't understand the whole process of "Legal Handover" of Saddam to the Iraqi administration thing, I could clearly make out the idea behind this cartoon on The Hindu which was about Bush's upcoming best seller autobiography! *winks*
Back to my life - My mother retired voluntarily from serving the Central Government for over 40 years yesterday. She was an employee of Department of Posts. There was an official sending off function at the office and a lot of her colleagues gave her a farewell accompanying her home. She, as I can understand very well, was very touchy about this. This was probably one of the moments in her humble career-one in which she had to sacrifice promotions for staying with her family. She used to be considered as a trust-worthy, reliable, efficient person at her office; almost the exact opposite to what she was in her family's eyes. Apart from this, I know how a work environment can liberate oneself from the limitations imposed by the family structure. I knew my mother enjoyed working immensely. But as she was tiring, she had to compromise on that to enjoy a quiet retired life. Anyway, the point that I'm trying to make is that I knew how important this was to her. And that is why I did my level best to get everything ready for the guests. I spent almost all day doing that hoping to make her feel really good about it all. And it worked! And I'm happy; maybe even proud! Apart from her colleagues, almost everyone from my father's side of the family came for the function. Some even got her gifts! You should have seen the thrilled look on her face when she opened up the package with the Mysore Silk Saree, an expensive one, which my sister and in-laws had sent! Everything was so bright and happy! One any other day, this kind of get-together could have been one of my nightmares-I would get stuck in these pointless arguments with my relatives about topics such as religion and marriage. But it wasn't in the end! It was actually fun! I enjoyed being the "nu" Me; somone who is mature enough, and matured enough in the eyes of others, to not be tampered with in his concepts about various issues. Would you believe that I actually enjoyed recording the new mallu hit "Lajjavathiye" with me on the guitar and my cousins on vocals?! This remarkable step in my musical career can be looked at as a deterioration in the quality of music that I play. Or maybe just expanding one's own horizons. I take the second.

Today, I came across an article on Medscape.com about Physicians and their blogs. Very interesting indeed! I had time to go throug a few of those. It's worth the read. I'm amazed to see the kind of topics being discussed in those. These are the kind that I would like to discuss as well.
-- Web Logs Offer Viewers a Rare Glimpse Into the World of Medicine : a Medscape.com article -- MedLogs.com : This should be the aggregated version of a lot of medical blogs. I'll let you know more later. -- Family Medicine Notes : Docnotes - Occasional Notes from a family physician - since 1999 -- A Chance to Cut is a Chance to Cure by Bard-Parker.
I'll review some more next time.

Welcome to South India's Leading News Site: "A female leopard, which was trapped by forest officials on Tuesday morning, looks out from her cage at the Sanjay Gandhi National Park on the outskirts of Mumbai. Several leopard attacks this year has struck terror in the city of nearly 13 million, killing ten people in June alone. Reuters"

Whew, another reason for my choice for studying in Mumbai! I hope I get to see leopards in action!