Monthly Archives: July 2020


Evidence is accumulating to suggest that preoccupation with Covid-19 is resulting in collateral damage to persons with other health conditions. What has been the impact of Covid-19 on pregnancy? This question was examined by Khalil et al (2020) at St George’s University Hospital, London, UK. These authors extracted data for pregnancy outcomes during 2 periods: […]


When the Covid-19 vaccine is ready, it would be interesting to see how it is distributed. One expects that the vaccine would reach citizens in the country of development first, in the rich countries next, and in the poorest countries last. Within a country, political and administrative leaders, the ultra rich, healthcare workers, and the […]

Vaccine freeloaders

Vaccine freeloaders are persons who do not get vaccinated but who nevertheless reap the benefits of vaccination. The benefits of freeloading arise when the rest of the population is vaccinated and immune; then, the disease does not spread, and so the freeloaders do not contract the disease (Rashid et al, 2012). The desire to reap […]


TAKE-HOME MESSAGE This article corrects two misconceptions: that herd immunity can be represented by a single number, and that achieving herd immunity assures safety. ======================== THE SYNERGY TIMES ======================== Jul 30, 2020: Vol 20 No 90 It is popularly believed that herd immunity is a fixed number for a disease. It is also believed that […]


Jul 21, 2020: Vol 20 No 88 Every other day, somebody, somewhere in the world, presents a new mathematical model of how much worse the pandemic is going to get, or perhaps when the pandemic will end. Nobody can see into the future. So why should we believe these models any more than we believe […]


Jul 31, 2020: Vol 20 No 91 For how long does immunity against Covid-19 last in a person who has suffered and recovered from the disease? Experts say that nobody knows. This is actually untrue because it is now possible to make an educated guess. Consider: The disease originated in China in December 2019. It […]


• VERY INTERESTING OBSERVATIONS • • Covid-19 was first considered to be a viral pneumonia, but now it is known as a mysterious virus, which is predictably unpredictable. • It spares joints and larynx, so no joint involvement or hoarseness of voice; also, no lymph nodes involvement. • Covid-19 was earlier believed to be non-inflammatory, […]

What Is Gender Dysphoria?

Gender Dysphoria Gender dysphoria involves a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of […]

Career in medicine

Visit HealthEd Alternative Career Paths for Med Students (Organized By Personality Type) Hafsa Omer Published on Jul 28, 2020. Updated on Jul 28, 2020. Ever wonder if a career in medicine is really right for you? Today on the Osmosis blog, OMEF Hafsa Sulaiman shares a humorous account of career prospects outside the clinic, […]

Review Article Psychopharmacology of COVID-19

 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19. The COVID-19 resource centre is hosted on Elsevier Connect, the company’s public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the […]

Alzheimer’s Disease

 Ll BRARYI ONL OXFORD NEUROLOGY LIBRARY Alzheimer’s Disease  ONL OXFORD NEUROLOGY LIBRARY Second edition Edited by Gunhild Waldemar Professor of Clinical Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Director, The Danish Dementia Research Centre, Copenhagen, Denmark and Alistair Burns Professor of Old-Age Psychiatry, University of Manchester, Manchester, UK; […]

Essential features of a biosafety level 4 (BSL-4) laboratory[1]

A biosafety level (BSL), or pathogen/protection level, is a set of biocontainment precautions required to isolate dangerous biological agents in an enclosed laboratory facility. The levels of containment range from the lowest biosafety level 1 (BSL-1) to the highest at level 4 (BSL-4). In the United States, the Centers for Disease Control and Prevention (CDC) […]


*TrueNAT* TrueNat is a chip-based, portable RT-PCR machine, originally developed as a portable diagnostic tool for tuberculosis by Goa-based startup Molbio Diagnostics. TrueNat machine can detect an enzyme (called RdRp) found in the RNA of the coronavirus SARS-CoV-2. On 19 May, the ICMR revised its testing guidelines to allow the use of the TrueNAT system […]


Reporting on diagnostic imaging studies revolves around being able to accurately describe what we are seeing on the images. There are a number of terms that we commonly use in our reports that you should understand, and that you should be able to use when asked to describe an image. Radiographs The formation of an […]


Dear Doctors, Interleukin 6 has been an analyte which till recently was rarely used in general clinical practice. IN these days of COVID 19 it is being widely used to detect IL storm and helps in deciding whether Tocilizumab therapy ought to be given. It has come to our notice that when tested immediately after […]

Unlock 2

Sanjiv Agarwal Founder, Good Governance India Foundation Mumbai, India Hon’ble Prime Minister, Jay Bhattacharya, MD, PhD Professor of Medicine Stanford University Stanford, California USA   Thank you for inviting suggestions regarding Unlock 2.0 in your recent speech. In response to your invitation we are writing our suggestions in the form of this […]

These are the 4 effects COVID-19 can have on your brain

< Research has shown how coronavirus is affecting the brain of those infected. Image: REUTERS/Callaghan O’Hare This article is published in collaboration with The Conversation 16 Jul 2020 Michael Zandi Consultant Neurologist and Honorary Associate Professor in Neurology, UCL • COVID-19 is known as a respiratory disease, causing damage to a patient’s lungs. • However, […]

Neurology signs

It’s a Tuesday morning at 11.30 am. You are already 45 minutes behind. A 35 year old woman is referred to your neurology clinic with a nine month history of fatigue, dizziness, back pain, left sided weakness, and reduced mobility. Her general practitioner documents a hysterectomy at the age of 25, subsequent division of adhesions […]

Few Observations from covid wards

Hydroxychloroquin is useful in prophylaxis of covid. It’s found that Those who are on Hydroxychloroquin either don’t get covid or even if they get the disease runs a milder course in them. Proper PPE kit is must in covid ward .Also poper Donning & Doffing is required. Good infection control protocol should be in place. […]

X ray

Human medical trials have begun on severely ill COVID-19 patients using low-doses of radiation. The first results on a very small group were published this week in a non-peer-reviewed journal that exists to get critical results out quickly to the scientific and medical community. The results were quite extraordinary. Researchers at Emory University Hospital, led […]

The Clinical Diagnosis and Treatment for New Coronavirus Pneumonia

The Clinical Diagnosis and Treatment for New Coronavirus Pneumonia Fanjun Cheng Yu Zhang Editors  1 3                                       […]


All the doctors here, please believe that you have no less brain than a lawyer. Consider the following facts: 1. CPA 1986 did not have healthcare included in the Letter (text) of the law. The text of the law in terms of definition of services remains same in CPA 2019. 2. SC interpreted CPA 1986 […]

why did I choose this profession?

There will be days when you wake up in the morning and ask the universe – why did I choose this profession? Most people who’re doctors are those who start reading for the highly competitive medical entrance after their 10th boards (some start earlier but I believe one should enjoy their childhood instead of running […]

219 virus

There are 219 virus species that are known to be able to infect humans. The first of these to be discovered was yellow fever virus in 1901, and three to four new species are still being found every year. Extrapolation of the discovery curve suggests that there is still a substantial pool of undiscovered human […]

How to increase opd

 History of professional etiquette Hospitals as we know them didn’t exist until the first Muslim-built “bimaristan” was established in Baghdad in 9th AD. Till late 19th century AD, doctors occupied a fairly low status in the society. From Roman times and throughout the European middle ages, doctors were subjected to and endured any indignity […]

For Kolkata / Bengal only:

I am a person who has returned home after recovering from corona. After returning home, I see in the news that corona affected patient cannot be admitted to hospital and is leaving this world at last. It is a very sad and tragic event. So I would like to share my experience with hospitalization. I […]

Goodbye, Doctor

�© Dr. Rajas Deshpande “Screw this satisfaction. Dump this happiness. Can you try to understand that I am fed up of both?” said Dr. Sahil. He was one of the busiest and most respected specialist in our town. Surprised at a superspecialist friend speaking this, still impressed by his ability to identify and speak the […]


Technical Bulletin May, 2020 Revision 4 Comparison of FFP2, KN95, and N95 and Other Filtering Facepiece Respirator Classes                          Description Filtering facepiece respirators (FFR), which are sometimes called disposable respirators, are […]


(VERSION 3.0) DISCLAIMER: This Recommendation is derived from the prevailing trials published and collation of various guidelines. These guidelines would change with the evolving evidences DEFINITIONS: • ILI is defined as one with acute respiratory infection –  with fever ≥ 380 C (100.40F) and –  cough –  with onset within last 10 days • SARI […]

Consumer Protection Act – 2019 and Rule – 2020

From 20/07/2020 it is to be implemented by Notification in Gazette After this news I have received almost 500 messages from different parts of India. A few were congratulating for removal of medical professionals from the ambit of CPA-2020 now on. I felt that rather than replying all individually I should put forward my stand […]

Comparison on Consumer Protection Act 1986 with the New Consumer Protection Act 2019 notified on 20.07.2020 for implementation.

By N.Naresh Kumar, HRO, NICL. In exercise of the powers conferred by sub-section (3) of section 1 of the Consumer Protection Act, 2019 (35 of 2019), the Central Government hereby appoints the 20th day of July, 2020 as the date on which the following provisions of the said Act shall come into force. Objective of […]


Doctor Patricio Avendaño, a cardiologist at U. De Chile who attends the German clinic, points out the tips to avoid contagion: * The virus is not a living organism, but a protein molecule (DNA) covered by a protective layer of lipids (fat) that, when absorbed by the cells of the ocular, nasal or oral mucosa, […]

*COVID Treatment Protocol : simplified*. 29/ 05/20

1) *All covid positive patients* * *Tab HCQ* 400 twice a day for 1 day Then 200 twice a day for 4- 9 days * *Tab Oseltamivir* 1-0-1 for 5 days * *Tab Ivermectin* 12mg twice a day for 2 days * *Tab Doxy* 100 twice a day for 5 days. ( In case of […]

“Covid Straight Drives”

*Salient points *1.* Having symptoms, fever high grade, cold, sore throat, cough, malaise at this time of Pandemic should be taken as suspected covid. *2.* Day 2 to Day 5 of symptoms to get the Real Time PCR and more likely to come positive. (at present so called gold standard) No Antigen test. *3.* HRCT […]

Lessons learned from 108 doctor deaths in India:

Dr Rajeev Jayadevan, 16 July (Link to original paper and other references are embedded/hyperlinked in the text below) 1. No age group appears to be immune to the pandemic. Unlike western countries where most of the deaths are among older age groups, published mortality data from Maharashtra and UP show that over 60% of deaths […]

*From Dr. Fauci…*

“Chickenpox is a virus. Lots of people have had it, and probably don’t think about it much once the initial illness has passed. But it stays in your body and lives there forever, and maybe when you’re older, you have debilitatingly painful outbreaks of shingles. You don’t just get over this virus in a few […]


 When will the Covid-19 Pandemic End ? Levitt’s Metric on Indian Data Bhaskaran Raman, Dept of CSE, IIT Bombay 13 July 2020   Opening Remarks, Disclaimers ●  What you will see is childishly simple (high school math) [and hence blindingly brilliant] ●  It is nothing new: it has been known since Mar/Apr ● […]

Bacillus Calmette–Guérin vaccine, antimalarial, age and gender relation to COVID-19 spread and mortality

Vaccine 38 (2020) 5564–5568    Contents lists available at ScienceDirect Vaccine journal homepage:  Commentary Ahmed Osama El-Gendy a, Haitham Saeed b, Ahmed M.A. Ali c,d, Hossam M. Zawbaa e, Dina Gomaa f,g, Hadeer S. Harb b, Yasmin M. Madney b, Hasnaa Osama b, Mona A. Abdelrahman b, Mohamed E.A. Abdelrahim b,⇑ […]

Covid-19 symptoms: What we know now and what to do

(CNN)It may feel like years, but the world has only been battling the deadly novel coronavirus for months. As scientists feverishly work around the clock to unravel the mysteries of this deadly invader, they have gained interesting insights into the virus and the disease it causes: Covid-19. “We know more now about how it makes […]


Docs!  Wear a mask scientifically. Nothing else will save you !!!!!  Dr Mahesh Holeyannavar MD FPCC   Wearing a STANDARD mask properly is of utmost importance in today’s situation.   Here are some key observations in scientific studies 1. N95 MASK ( STANDARD ONE) SEEMS TO DO THE JOB EFFECTIVELY. AGAINST […]

Usefulness of Ivermectin in COVID-19 Illness

Amit N. Patel MD, MS1,2; Sapan S. Desai MD PhD Usefulness of Ivermectin in COVID-19 Illness Amit N. Patel MD, MS1,2; Sapan S. Desai MD PhD MBA3; David W. Grainger PhD1; Mandeep R. Mehra,MD, MSc4 1Department of Bioengineering, University of Utah, Salt Lake City, UT; 2HCA Research Institute, Florida; 3Surgisphere Corporation, Chicago, Illinois; 4Brigham and […]

physicians’ lounge

I recently read an article about how the physicians’ lounge, which was once present in every hospital and an important congregating area for doctors during the day, is now mostly a thing of the past. Although the article was not a new one, it peaked my interest because I’ve witnessed the demise of the physicians’ lounge at […]

Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial

 HHS Public Access Author manuscript Am J Geriatr Psychiatry. Author manuscript; available in PMC 2019 March 01.   Published in final edited form as: Am J Geriatr Psychiatry. 2018 October ; 26(10): 1050–1060. doi:10.1016/j.jagp.2018.05.008. Davangere P. Devanand, M.D., Gregory H. Pelton, M.D., Kristina D’Antonio, M.S.W., Adam Ciarleglio, Ph.D., Jennifer Scodes, M.S., Howard Andrews, […]

Fever, Chills, and Night Sweats

Chapter Dall L, Stanford JF. In health, body temperature is regulated around a set point of 37 ± 1°C, and a circadian temperature rhythm exists in which the highest temperature of each day occurs around 6 p.m. The variance between the highest and lowest core temperature in a given day is usually no more than […]


Compiled by Dr. Narendra Malhotra, Dr. Neharika Malhotra, Dr. Jaideep Malhotra, Dr. Keshav Malhotra Special Inputs CORONA INDIA IN JULY by Prof. K. K. Aggarwal SARS-COV-2 pandemic is still on the way of spreading. The curve has not flattened and the disease has not shown any signs of regression in numbers. The pandemic is predicted […]

Gender and Mental Health Combining Theory and Practice

Gender and Mental Health Meenu Anand Editor 1 3 Editor Meenu Anand Department of Social Work University of Delhi New Delhi, Delhi, India ISBN 978-981-15-5392-9 ISBN 978-981-15-5393-6 (eBook) © Springer Nature Singapore Pte Ltd. 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of […]

Tracking changes in SARS-CoV-2 Spike: evidence that D614G increases infectivity of the COVID-19 virus

Journal Pre-proof Tracking changes in SARS-CoV-2 Spike: evidence that D614G increases infectivity of the COVID-19 virus B. Korber, W.M. Fischer, S. Gnanakaran, H. Yoon, J. Theiler, W. Abfalterer, N. Hengartner, E.E. Giorgi, T. Bhattacharya, B. Foley, K.M. Hastie, M.D. Parker, D.G. Partridge, C.M. Evans, T.M. Freeman, T.I. de Silva, C. McDanal, L.G. Perez, H. Tang, […]

Corona Virus Infection

Precautions & Treatment Pbn. Dr.(Prof.) Manju Kaushal ABVIMS, Dr. RML Hospital, New Delhi    COVID – 19   • Corona virus disease (COVID-19) is an infectious disease caused by a newly discovered virus. • Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment. […]


HOW TO INTERPRET HRCT REPORT WHAT IS CO-RADS ? WHAT IS CT SEVERITY SCORE ?  HRCT REPORT TEMPLATE LOW DOSE H.R.C.T. CHEST SCREENING (L.D.C.T.S.): IMPRESSION: Findings are suggestive of atypical viral pneumonia, possibility of COVID-19 infection. (CO-RADS V). CT severity score 9 / 25 (Moderate)       What is CO-RADS??? […]