. COVID medical literature – the Good, the Bad and the Ugly . I
In a very rare gesture of appreciation, the EDITOR of the journal published the following note at the end of my article:
“ From the Editor........
The Editor wishes to inform the Readers of ‘The Antiseptic’ who are interested in having correct, complete and comprehensive knowledge of the current literature on Covid, to read the above article by Dr. T. Rama Prasad, written as is usual, in beautiful, flawless and inimitable English, with numerous apt quotations.
He further wishes to thank Dr. T. Rama Prasad profusely for choosing to publish all his ‘very interesting to read’ articles on Covid in ‘The Antiseptic’ and hopes that he (Dr. T. Rama Prasad) continues his benevolence. ”
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“I am greatly honoured and recognised, indeed, by this special ‘editorial comment’ of inspiring appreciation by the distinguished, scholarly and erudite editor of the premier journal, The Antiseptic, which itself is a rare treasure of documentation from the eclecticism of India’s diverse medical systems, including the dominant ‘modern medicine’. My articles were published in this long-standing and reputed journal even more than forty years ago.”
-- T. Rama Prasad
The article is reprinted below
COVID world: 28 of my articles on the single subject of ‘COVID’ were published in 30 months in the monthly medical journal, ‘THE ANTISEPTIC’, which is a WORLD RECORD in Medical Journalism.
This article titled “COVID medical literature – the Good, the Bad and the Ugly” is one of them.
The last 15 pages in this file ‘about me’ and my ‘PAY WHAT YOU CAN’ Clinic are not part of the article.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
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. COVID medical literature – the Good, the Bad and the Ugly .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu, India.
Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com WhatsApp +91 98427 20393 BLOG https://drtramaprasad.blogspot.com
WEBSITE www.rama-scribbles.in Twitter @DrRamaprasadt Facebook T Rama Prasad
Telegram Dr T Rama Prasad
`
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 9 September 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
. COVID medical literature – the Good, the Bad and the Ugly .
RAMA PRASAD T.
.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052.
Specially Contributed to “The Antiseptic” Vol. 119, No. 9
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ABSTRACT
Even as COVID-19 entered the third year of the pandemic, the world is no closer to know the authenticity of the huge volume of ‘COVID medical literature’ that was published for over two years. Due to lack of incontrovertible evidence for the varied conclusions drawn from various studies, both the professionals and the public are in a state of confusion. The subject has become too much of a conundrum to arrive at decisions on prevention and treatment of COVID-19. There have been good and bad studies and publications. The subject has attracted a phenomenal debate all over the world, mixed with vested interests – personal, academic, political, business, prestige, etc. Some of the aspects and perspectives of the situation are briefly mentioned in this article.
Key words: Covid-19 medical literature, Covid-19 drugs and vaccines, Covid-19 pandemic
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“We go through the Good, the Bad, and the Ugly all together.”
-- Emily Robison
Introduction
‘The Good, the Bad and the Ugly’, the title of the ‘1966 Italian epic spaghetti Western genre film’ directed by Sergio Leone, has over a period of time become a famous phrase to mean that ‘Good is good, bad is bad, but bad doesn’t necessarily have to be ugly’. In the ‘Covid medical literature’, we have been going through ‘the Good, the Bad and the Ugly’ all together. But the human trait of magnifying the bad is very evident. And ego-clashes dogged the claims of superiority of documentations.
In this context, a peep into my informal blog article titled “MODERN MEDICINE – the Good, the Bad and the Ugly” may give a general perspective on this subject. Excerpts from a couple of articles published in The Antiseptic are also in this document (https://drtramaprasad.blogspot.com/2017/04/modern-medicine-good-bad-and-ugly_30.html ). 31
COVID (SARS-CoV-2 / COVID-19) has transported us all into a different world altogether. We feel captured in an unpleasant time warp. The COVID pandemic has had an unparalleled impact on every facet of our lives. The impact has been extensively modified by the ‘COVID medical literature’ which played a paramount role, as most of the activity in all the fields all over the world during the long Covid pandemic period has been critically based on the conclusions drawn from the ‘COVID medical literature’ generated through studies and research. Even the morbidity and mortality are modified by it. Globally, so far, there are around six million deaths out of around 500 million recorded cases of Covid. The numbers might have been stupendously higher if not for the interventions guided by the research and documentation on Covid. But controversial views are expressed. Good literature did good for global health. Bad publications put the authorities on wrong paths, leading to undesirable consequences.
There has been ‘the Good’, ‘the Bad’ and ‘the Ugly’ in Covid research and the related scientific papers. Some of the aspects of this subject are briefly mentioned in this article. More related details may be found in the 24 articles published in 24 months, written by a single author (T. Rama Prasad) on a single subject (Covid), and published by a single establishment (Professional Publications (P) Ltd.), in The Antiseptic, a journal of Medicine and Surgery (indexed in IndMED), and in Health, a journal devoted to healthful living. 1 to 24 (which is a world record in medical journalism). Some more references of importance, related to COVID, are provided. 25 to 58
Historical perception
There is the ancient medical literature on epidemics and pandemics like Homer’s epic The lliad (eighth century BCE) which begins with a plague ravaging the Greek army camp at Troy, and the biblical book of Exodus which describes the ‘10 plagues’ of Egypt. When plague struck France in 1722, an old novel of 1665 plague of London, titled ‘A Journal of the Plague Year’ was rushed for reprinting. The old accounts of epidemics relied on anecdotes, witnessing and testimony, rather than on scientific studies. An example of this is the 1958 essay on London’s Great Plague of 1665 by Percival Hunt which relied on the first-hand account of The Diary of Samuel Pepys (1660 – 1669) for details about the progression of the disease and its effect on daily life. A well-written perspective on the effect of pandemic literature on responses to pestilence in the contemporary world with a focus on many themes of the genre may be found in a recently published (2021) source – Contemporary Literary Criticism, Volume 483; Gale, a Cengage company. At the start of the COVID pandemic, numerous media outlets ran stories about the Spanish flu pandemic of 1918 – 1919, drawing parallels to COVID.
COVID literature conundrum
Before the identification of the ‘new virus’ we had nothing significant on record about the COVID (SARS-CoV-2 / COVID-19). Further, this disease started killing a huge number of people very quickly in 2020 and 2021, causing a global alarm and panic. This made all the researchers to focus on this subject, and a deluge of literature, good and bad, inundated the field as quickly as the spread of the ‘novel virus’.
Never in the history of medicine was there such a stupendous volume of literature on a single disease in such a short period of time of just around two years between January 1, 2020 and March 10, 2022. I myself wrote 24 articles in 24 months on COVID. Over 125,000 articles were published or released on the subjects related to COVID in the first 10 months of the COVID pandemic globally in various languages together with a surge in flawed scientific literature. Most of the ‘COVID medical literature’ has been from the ‘evidence-based-Modern Medicine (Allopathy)’ system of medicine. Some are on familiar themes and some are unfamiliar like ‘Nanoparticles vs COVID-19’. The quality of the literature falls into ‘the Good’, ‘the Bad’ and ‘the Ugly’ categories depending upon the quality of evidence. Though not very much, there has been a good amount of increase in ‘COVID medical literature’ in other systems of medicine, listed under ‘Alternative Medicine’.
Peculiarities of the COVID literature
The genesis and evolution of COVID medical literature is quite glaringly different from that connected with other diseases. There are a lot of ramifications with politics, commerce, vested interests and policy matters at global, national and local levels. No other disease had elicited so much debate, discussion and diverse views on medical reporting, both in medical press and lay press; and in various systems of medicine. Some of the peculiarities of the COVID medical literature are:
(1) The ‘COVID medical literature’ picked up the speed of the top gear within a very short span of time due to the ‘emergency’ to break the tsunami speed of the infections and deaths. (2) There has been the opportunity and urgency to speedup research trials; and this promoted the ‘me-first’ investigator and the ‘me-first’ seller competition. (3) Consequently, some manufacturers went over the top to ‘manufacture’ COVID medical literature to ‘scientifically’ backup their claims to be made for marketing their products. (4) Based on the existing medical literature, various drugs of unproven value were given ‘emergency use’ authorization which included ‘repurposing’ of drugs. (4) The ‘emergency use’ authorization has been a boon to the pharmaceutical companies. (5) The results of the clinical trials have been announced through press releases, influencing the authorities and the public. (6) The people have been eagerly looking into COVID news and medical literature for over two years continuously to decide for themselves the validity of the various controversial results of the research studies and the advisories. (6) Shifting strategies in COVID control and treatment, based on evolving ‘COVID medical literature’, have become commonplace, undermining the confidence of the public in the COVID programs. (7) There has been a free access to most of the COVID scientific papers published in medical journals. (8) A sharp increase in the number of ‘preprints’ before ‘peer review’occurred. (9) There was a ‘fast tracking’ of ‘peer reviews’ and the publication process. (10) An enormous number of papers was retracted and withdrawn quickly. (11) Significant fraud and misconduct in the COVID research and literature was reported. (12) There has been a huge spurt in ‘COVID medical literature’ in the fields of ‘Alternative Medicine’ systems like ‘AYUSH’also. (13) Some ‘COVID medical literature’ from some countries is not viewed as transparent because of their governmental policies on research and publication. (14) The quality of ‘Covid medical literature’ remained multi-dimensionally poor in some countries. (15) COVID triggered a massive scientific fracas in the ‘COVID medical literature’, including angry outbursts and rage from scientists. (16) Medical literature from ‘Alternative Medicine’ (AYUSH, etc.) has gained tremendous importance during the pandemic.
A treasure of information
The World Health Organization (WHO) had done a lot of good to let the world know of the literature published on Covid through its Global Research Database (SearchCOVID19DatabaseNews/Updates/Help). 59 “The WHO gathers latest international multilingual scientific findings and knowledge on COVID-19. The global literature cited in the ‘WHO COVID-19 database’ is updated almost daily from searches of bibliographic databases, hand searching, and the addition of other expert-referred scientific articles. This database represents a comprehensive multilingual source of current literature on the topic. While it may not be exhaustive, new research is added regularly. In this endeavour, the WHO brings scientists and global health professionals together to accelerate research and development process, and develop new norms and standards to contain the spread of the coronavirus pandemic and help those affected. The R&D Blueprint has been activated to accelerate diagnostics, vaccines and therapeutics for this novel coronavirus.
The solidarity of all countries will be essential to ensure equitable access to COVID-19 literature and health products. The database is built by BIREME, the Specialized Center of PAHO/AMRO and part of the Regional Office’s Department of Evidence and Intelligence for Action in Health. The ‘WHO evidence retrieval sub-group’ collaborates with key partners to enrich the citations and build a more comprehensive database with inclusion of more content.” Apart from this, there are many other ‘databases’ and medical journals which contributed to build up a huge source of information which can easily be accessed through the Internet.
Belief and disbelief in literature
The unrelenting spread of COVID-19 has set off a lot of ‘COVID medical literature’ based on ‘emergency’ and ‘experimental’ initiatives in ‘Modern Medicine’ (Allopathy) which has been the most accepted scientific system of ‘evidence-based medicine’ all over the world. While people believed in the robust foundation of science, logic, rationale and wisdom, alas, many scientific calculations, research findings and experiences related to COVID went on unexpected lines over the past two years, making people stare at the ‘modern medicine’ with a sliver of suspicion, especially because of the growing shade of commercialism in the application of COVID medical literature globally. This situation, indirectly, enhanced the belief in the literature and practice in the various systems of ‘Alternative Medicine’. In this connection, it is gratifying to note that the premier journal The Antiseptic, established in 1904, devotes half of its pages for ‘Alternative Medicine’ which include subjects related to COVID.
And it is believed that some countries ‘controlled’ and ‘doctored’ COVID research publications for political or prestige or economic reasons. This has been one of the glaring characteristics of the ‘COVID medical literature’. During the 'Corona period', various drugs and vaccines were permitted for 'emergency use / experimental use / compassionate use' by various authorities across the world, not necessarily with robust evidence of benefit. The strength of the earlier belief that Covid vaccines would put an end to the pandemic quickly is also weakened by the ‘breakthrough’ and ‘rebound’ infections after multiple vaccinations – American President Joe Biden, British Queen Elizabeth II, and the US Surgeon-General Dr. Vivek Murthy are some of the famous examples. The world-famous Novak Djokovic preferred to forgo French Open and Wimbledon titles rather than to get vaccinated against COVID.
The rigid regulatory checks and balances of ‘normal times’ have become flexible and arbitrary in many countries. Some pharmaceutical companies and some hospitals had taken advantage of this to promote certain drugs for profiteering. Fear among the public paves the way for profiteers. South Africa halted the AstraZeneca vaccine in the belief that it gave only minimal protection against mild-to-moderate COVID-19 disease caused by the country’s dominant coronavirus variant, according to a study. India continues to use the AstraZeneca vaccine under the name ‘Covishield’ in the belief that it is effective and safe. It's a see-saw like situation with evidence for and against, coupled with shifting advisories which have promoted belief and disbelief as well.
False belief may lead to another aberration and danger to those countries which are splurging on excessive vaccination (‘booster’ doses and vaccinations in very young children, without scientific validation) may be haunted by a recoil by new vaccine-defying variants or even the remote possibility of ‘Antibody Dependent Enhancement (ADE)’ because of which Philippines suspended the use of a Dengue vaccine called DENGVAXIA on December 5, 2017. 31
The belief in medical literature is so unflinching that, about a year before the COVID struck humans, on January 25, 2019, when I started speaking about the bad of medical literature published in reputed journals, at a ‘get-together celebration’ of our classmates, the microphone in my hand was taken away by the event organizing classmate, on the pretext that talking ill of medical matters at that function was not appropriate. He even asked me whether I had any of my papers published in the BMJ, implying that one who had no documentation in the BMJ had no right to talk bad about such journals !
‘The Good’, ‘the Bad’ and ‘the Ugly’
The scientific literature on COVID is a wide spectrum of ‘the Good’, ‘the Bad’, and ‘the Ugly’. Examples of ‘the Good’ are in the vast number of praiseworthy articles which speedily identified the ‘novel virus’ and contributed to make vaccines in a short period of time. At the other end, are a few examples of ‘the Ugly’ like those of the infamous articles (which were published and retracted) in famous medical journals like The Lancet and The New England Journal of Medicine using allegedly fraudulent and fabricated data generated by the Surgisphere. 29 In between these two categories are articles of myriad shades which projected useful and dubious information as well.
“It takes many good deeds to build a good reputation, and only one bad one to lose it.” -- Benjamin Franklin. ‘The Bad’ also taught us many useful and good lessons. “There is nothing either good or bad, but thinking makes it so.” -- William Shakespeare.
The Good
Volumes can be written on the good done by the enormous medical documentation during the COVID pandemic. But, many of the papers based on ‘emergency’ treatment trials suffer from lack of robustness of validity due to the small number of the cases, the short periods of trials and the inadequacy of ‘control’ subjects, for obvious reasons. The inevitable ‘emergency authorisation’ to use certain drugs and vaccines was inevitable. The ‘emergency authorisation’ to use drugs and vaccines, based on the available COVID medical literature, might have saved many lives and facilitated to restart the normal human life on the planet after about two years. We should say ‘hallelujah’.
There has been a voluminous literature which did good for the humans during the pandemic. Some of the references to the earlier literature in the article by Zimmer ( Zimmer C; 26 February 2021; "The Secret Life of a Coronavirus - An oily, 100-nanometer-wide bubble of genes has killed more than two million people and reshaped the world. Scientists don't quite know what to make of it". Archived from the original on 27 February 2021. Retrieved 28 February 2021.) 60 indicate how vague our ideas on “life” of the virus are. And through a lot of literature in the early phase of the pandemic, we came to know about Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) and its effects. Then, followed more than 100,000 articles, some of them having a ‘roller-coaster ride’ of validity. There has been a continuous shifting of the percentages of efficacy and safety of drugs and vaccines – a highly heterogeneous phenomenon. The limitations and failures piqued the interest of researchers to find better solutions, expanding the melting pot of medical literature across the globe.
There can’t be space to travel through the vast literature here. Let’s fast forward to one of the latest. There is an editorialin The New England Journal of Medicine (May 4, 2022) by Hanna Nohynek and Annelies Wilder-Smith mentioning about two articles (based on a plant-based coronavirus-like particle vaccine, and a receptor-binding domain-dimer-based vaccine) in that issue dealing with the need for newer vaccines as the presently available vaccines may not be ideal to suit the varied requirements globally to cover geographical variations in the virus strains, racial susceptibilities, cost factors, logistics in cold-chain transportation and storage, efficacy, side-effects, ‘breakthrough’ infections, long-term benefits, etc. Interestingly, the editorial gives a glimpse into the voluminous literature on COVID vaccines. Here is an excerpt from the editorial: “ … A total of 344 Covid-19 vaccine candidates have been developed or are still in development. Of these, 31 vaccine products are already in large-scale use after conditional approval by national regulatory authorities or under the WHO Emergency Use Listing. At least five different technology platforms have been used (i.e., messenger RNA [mRNA], viral-vectored, inactivated whole-virus, protein subunit, and plasmid DNA approaches). Several of the inactivated whole-virus and protein subunit vaccines need adjuvants to potentiate the immune response. …” ( https://www.nejm.org/doi/full/10.1056/NEJMe2204695 ). 61
One more recent documentation of interest could be the ‘supervaccine’, against COVID, that is related to ‘smallpox-monkeypox’ vaccines the literature on which may play a bigger role in our armamentarium against COVID. It is the ‘Modified Vaccinia Virus Ankara (MVA)’ vector expressing a stabilized SARS-CoV-2 spike protein (S). The MVA/S vaccine, as it is called, produced strong neutralising antibodies and cellular immunity against the Covid virus. 62 More interestingly, this vaccine may be effective against both COVID and monkeypox (The WHO declared monkeypox, on July 23, 2022, a Public Health Emergency of International Concern – PHEIC) – two birds in one shot (https://www.clinicaltrials.gov/ct2/show/NCT04895449 ). 62
The medical literature that began with battling smallpox on May 14, 1796 when Edward Jenner used pus from a cowpox pustule on the hand of a milkmaid Sarah Nelmes to inoculate an 8-year-old James Phipps and protect him from smallpox seems to have graduated now to protect us against both COVID and monkeypox by a single shot. 62 What a goodness ! The remote link to small pox is evident from the fact that the current (2022) ‘international monkey pox outbreak’ is largely restricted to those below 40 years of age, born after smallpox vaccination ended in 1980.
According to a study published recently (August 2022) in Science Translational Medicine, researchers from Scripps Research Institute found a different type of antibodies that may pave the way to produce a vaccine which would be effective against all COVID strains (https://timesofindia.indiatimes.com/india/antibodies-that-can-lead-to-vaccination-for-all-covid-strains-found/articleshow/93509631.cms ). 63 Based on credible literature, from August 12, 2022, the Covid vaccine Corbevax, of a ‘traditional recombinant protein-based technology’, will be used in India as a ‘heterologous booster (precaution)’ dose though the WHO has not yet approved the vaccine for use under ‘emergency use listing (EUL)’.
At the time of writing this (August 16, 2022), the latest and the most welcome documentation is that of ‘the very positive ‘phase III clinical trial data’, of the INTRANASAL Covid-19 vaccine (BBV154) developed by the Bharat Biotech International Limited, which is just submitted to the Indian ‘regulatory authorities’ for approval. Being a vaccine which can be just put into the nose without needle, this would be the most acceptable Covid vaccine – perhaps, a game changer. This vaccine can be used as a ‘primary’ as well as a ‘heterologous booster’, and can be developed as a ‘targeted vaccine’ quickly against emerging ‘variants of concern’. This is ‘the Very Good’ of the ‘Covid medical literature’.
All are not ‘Good’
All this doesn’t mean that all the published literature can be rated as good. There are ‘grey areas’ on which the literature is not definitive. The WHO itself in its ‘Disclaimer’ (of its Global Research Database -- SearchCOVID19DatabaseNews/Updates/Help) 59 mentioned: “ … By listing publications in this database and providing links to external sites does not mean that WHO endorses or recommends those publications or sites, or has verified the content contained within them. The mention of specific companies or of certain manufacturers’ products in publications listed in the database does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. The responsibility for the interpretation and use of publications included in this database lies with the reader. In no event shall WHO be liable for damages arising from its use. …”
The Bad
Naturally, bad is often seen through magnifying glasses. But its truth is very bitter, however small it is. The ‘emergency situation’ perforce made scientists cut the corners leading to fallacious and controversial publication of results which are frowned upon by puritans of science. In the mess of the medical confusion, countless medical practitioners, independent and attached to institutions, took ad hoc decisions, based on misleading conclusions in the published literature, which proved to be hazardous. The COVID-19 claptrap has been only growing. This has become a matter of huge public concern and debate because of the scale of the crisis and the ubiquity of the misinformation. The abnormal behaviour of the virus and the selfish nature of the human being may be the causative factors.
Critical opprobrium and public uproar
An editorial in The Hindu newspaper of June 6, 2020 mentioned: “The scientific process must be protected from those seeking power and riches . … Two weeks ago, a study in The Lancet, perhaps the most influential medical journal in the world, found no benefit from the use of hydroxychloroquine (HCQ), a well-known antimalarial, to treat sick COVID-19 patients. Today, that study stands retracted. As it had relied on a huge dataset of about 96,000 patients sourced from 671 hospitals in six continents, the World Health Organization, citing a ‘do no harm’ principle, suspended drug trials pending a safety review. This led to some countries in Europe withdrawing the drug from their own trials. Another study involving some of the same authors and relying on the same data published in The New England Journal of Medicine, which sought to answer questions on the associations between cardiovascular disease, COVID-19 and drugs that target the enzymes that play a role in facilitating the virus in attacking a host, has also been retracted. The Lancet study triggered a backlash from scientists who found problems with the methodology and, more importantly, the dataset. … The key lesson is that it is a mistake to assume the scientific process as one divorced from the influence of power, privilege, finance and politics. The means and methods to a scientific result matter more than results — only achieved through global scrutiny. Openness, more than blame game, is what the post-COVID world needs now.”64 (https://www.thehindu.com/opinion/editorial/shine-a-light-the-hindu-editorial-on-retraction-of-the-lancets-research-paper-on-hydroxychloroquine-use/article31761420.ece ) 64
The ‘Ugly’ Hydroxychloroquine fiasco
Touting of the drug Hydroxychloroquine (HCQ) by Donald Trump, the former President of the US, and his outbursts at the WHO about the 'Virus-China-Origin' issue may be a different story, as also the story that the motive of discrediting the low-cost HCQ is to make profits to manufacturers of costly alternative molecules like Remdesivir. Trump was derisively called ‘booster’ of HCQ ! Expectedly, 'politico-medico-commercial links' had been making rounds. The profound interest of the ex-POTUS in HCQ surprised everybody. He had also stated that he doesn’t own a company that produces HCQ. HCQ is unique -- no other drug enjoyed this much of global publicity and the strong patronage by none less than the POTUS. 29
Publication of a study on HCQ in the highly reputed journal The Lancet kicked up a storm of criticism. A huge number of scientists and researchers alleged that the methodology and the data cited in the study are flawed, fraudulent and fabricated. 29 “An Open Letter posted online, is addressed to the authors of the report: Mandeep R Mehra, MD, Sapan S Desai, MD, Frank Ruschitzka, MD, Amit N Patel, MD, and to the editor, Dr. Richard Horton. The letter was signed by more than 200 prominent scientists across the world, including 17 from institutions in Africa.” ‘Modern Medicine’ is getting a taste of its own medicine !
In addition, another study, published in The New England Journal of Medicine (another highly reputed journal), by some of the same authors on the subject of HCQ and cardiovascular diseases met with the same criticism. An APOLOGY was tendered by the authors, and the articles in The Lancet and The New England Journal of Medicine were RETRACTED on June 4 / 5, 2020. A worldwide debate went on and millions of pages were written in the medical and general press on this matter. No other drug kicked up such a ‘scientific Covid storm’ with a great interplay of science, politics, money, publicity and personalities. The media blitz created panic among the public and sullied the image of ‘modern medicine’ which faced ignominy and wrath. The shockwaves reverberated around the world after the fraud was revealed. 29
Mainly three doctors are involved in these fraudulent publications and the Surgisphere scam -- 1. Dr. Sapan Desai, a vascular surgeon and the founder of 'Surgisphere QuartzClinical Global Database' which supplied the questionable data, 2. Dr. Mandeep Mehra, a renowned Harvard University vascular surgeon and professor, at Brigham Women's Hospital who was the lead author of the paper. 3. Dr. Amit Patel, a cardiac surgeon. All the three are Americans of Indian origin. Dr. Desai and the Surgisphere (a tiny Chicago-based 'global database' with just a handful of employees with very limited expertise) are involved also in another retracted publication connected with another molecule, Ivermectin, in the treatment of COVID-19. 29
It was reported that Dr. Philippe Douste-Blazy, a cardiologist and former French Health Minister, revealed that “the editors of both The Lancet and The New England Journal of Medicine expressed their exasperation, citing the pressures put on them by pharmaceutical companies which are so financially powerful to pressure the editors to accept papers that are apparently methodologically perfect, but their conclusion is what pharmaceutical companies want.” 65 ( https://healthimpactnews.com/2020/editors-of-the-lancet-and-the-new-england-journal-of-medicine-pharmaceutical-companies-are-so-financially-powerful-they-pressure-us-to-accept-papers/ ) 65
Shock and consternation followed among researchers, scientists and the public as well. The shocking revelations may only be the tip of ‘the Ugly’ iceberg. There may be political ramifications, the invisible strong hand of the pharmaceutical industry, various personalities, politicians, researchers, institutions, research bodies, the peers who review articles, drug control authorities, academic bodies, publishers and international organisations behind the good and bad of the ‘COVID medical literature’. The erring doctor is ‘docter’ !
And the WHO seemed to be abundantly cautious about continuing its HCQ drug evaluation trial. The Director-General of the WHO, Tedros Adhanom Ghebreyesus said on May 25, 2020: "In the light of a paper published in The Lancet that showed people taking HCQ were at higher risk of death and heart problems, there would be a temporary pause on the HCQ arm of its global clinical trial." In yet another fiasco, the WHO made a U-turn and announced on June 4, 2020, consideration of resumption of the HCQ arm of the 'Solidarity' drug trial ! And, yet in another twist, on July 4, 2020, the WHO announced ending of HCQ trial in hospitalised patients with COVID-19, as there was no evidence of benefit – a strong ‘forward-backward’ history of flip-flops.
The Indian Council of Medical Research (ICMR) seems to have based its recommendations of ‘preventive HCQ’ among high-risk frontline workers in the battle against COVID-19 on the evidence of some observational studies. Two observational studies in France and South Korea found some benefit of treatment and prevention. The Director-General of the ICMR, Balram Bhargava said on May 26, 2020: “We’ve weighed the risks and benefits and concluded that we can’t as of now deny this (preventive HCQ) to our frontline workers battling COVID-19.” The ICMR made a small observational study on its own. The study said that four or more doses of HCQ reduced the risk of getting COVID-19 among frontline healthcare workers. But it had drawn a flak. Dr. Amar Jesani, editor of Indian Journal of Medical Ethics said "The ICMR Director-General Dr. Balram Bhargava and Dr. Gangakhedkar were involved in the decision making on HCQ use. So, they should not have been involved in a research project to collect evidence in support or against their policy." It's a ‘conflict of interest’. Dr. Anant Than, a bioethics expert, pointed out that since the senior ICMR leaders are co-authors, it would have been a good practice to have a 'Conflict of Interest' statement. (TNIE, 02.06.2020). Belatedly and ultimately, most authorities around the world had dropped HCQ as a preventive or curative medicine.
Flawed and fabricated publications and their retractions later, in reputed medical journals, the World Health Organization (WHO)’s U-turns on studies and advisories, the Indian Council of Medical Research (ICMR)’s recommendations and de-recommendations, of course based on some studies and literature, made the science stand in front of multiple questions.
Fraud and misconduct
The ‘misinformation’ might have been planted intentionally (called fraud) or unintentionally (called misconduct). Fraud and misconduct in clinical research has become more widespread with the advent of COVID. It seems that scientific fraud pops out with alarming consistency from paleontology to nanotechnology. Editors of biomedical journals of India insist on clinical trial registration as a precondition for considering publication of trial results and so do several ethics committees. One important reason for the enormous increase in publications is the growing tendency to measure the merit of applicants in academics for employment or promotion by the yardstick of the number of papers published by individuals.
Commercial motivation may be the most important one. Pre-planned vested interests peep through them to promote products ranging from masks to medicines; sanitizers to ventilators. Some of the fraudulent published scientific literature might have been fabricated to meet the needs of the ‘Big Pharma’. The ‘Big Pharma’ has huge resources to sponsor research, and even to bend the norms, and influence scientists, publishers and even the WHO, especially in the pandemic emergency. It is difficult to go to the grassroots and dig out the true evidence. Such so-called ‘authentic’ literature, naturally, influences the authorising agencies, world health bodies and the governments on taking policy decisions simply because of the EMERGENCY and the lack of an ALTERNATIVE. By the time an ‘emergency use’ drug is proved to be of no value, the manufacturers would have already laughed all the way to the bank. All the same, it is to be acknowledged that most of the advancements in medicine happened because of the huge financial support by the ‘Big Pharma’.
The takeaway from the outcome of the fraud or misconduct is that the publishers must ponder as to whether this strategy of ‘speedy’ publication in the name of ‘emergency’ information does any good to scientific research. A few clinically important examples of hasty inferences / emergency applications / genuine misjudgements / bad policy decisions, based on the not so good COVID medical literature are briefly mentioned below:
Famotidine farce
A huge amount of $21 million was granted for an emergency contract to researchers in the US for a scientific study to try Famotidine (Pepcid) in sick Covid patients. Scientists laughed at the idea as there were no published scientific studies to justify it and as the proposed daily injections of high doses of Famotidine for the already sick patients pushed safety “to the limits.” Considered as a casual disregard for science and anti-corruption rules, the deal was said to have been pushed through without the scientific oversight necessary for such a federal award. The United States Food and Drug Administration (USFDA) gave the clinical trial a speedy approval. Dr. Steven Nissan, an adviser to the USFDA, said that this approach is like throwing spaghetti at a wall to see how much sticks ! Can this be called ‘the Good’ ? 29
Ivermectin imbroglio
Ivermectin had grabbed headlines for wrong reasons. Based on the ‘study data’ of Surgisphere, the company behind some discredited research studies (including those of HCQ), officials of Latin American countries recommended ivermectin as a possible coronavirus drug. 29 The drug had been very extensively used in Latin American countries and India too.
One Professor Thomas Borody from Centre for Digestive Diseases in Australia 'believes' that ivermectin with zinc and doxycycline is a cure for COVID-19. Professor Ian Musgrave, a molecular pharmacologist from the University of Adelaidesaid: "Professor Borody's 'belief' is to be taken with a grain of salt as ivermectin acts only in test tubes." Professor Borody wondered why Australia didn't consider his recommendation to include ivermectin in its COVID-19 treatment protocol while the '"HUGE INDIA" approved it ! (Uttar Pradesh government approved it in August 2020) 29
On April 10, 2020, the USFDA issued a guidance not to use ivermectin for COVID-19, and The Pan American Health Organization, a regional office of the WHO, had issued a statement warning against the use of ivermectin to treat COVID-19. The statement noted that the anti-parasitic drug was being investigated in clinical trials, and that “ivermectin was incorrectly being used for the treatment of COVID-19, without any scientific evidence of its efficacy and safety for the treatment of this disease.”
Despite lack of robust evidence in medical literature, many doctors had been prescribing Ivermectin as a routine in India, even now. They may be endorsing the famous quote of the cosmologist Martin Rees: “Absence of evidence is not evidence of absence” !!! This ‘succinct, elegant and logical’ quote is widely used during the COVID pandemic to promote a myriad of medicaments of unproven value. The ICMR had, rather belatedly, dropped Ivermectin from its Covid treatment protocol in August 2021. All this was, of course, based on varied ‘COVID medical literature’.
Remdesivir conundrum
Earlier, the literature generated by the Giliad and the US National Institute of Allergy and Infectious Diseases (NIAID)had shown that Remdesivir significantly reduced the time to recovery of those who were hospitalised with COVID-19. Later, a huge global trial of the WHO, SOLIDARITY TRIAL, showed that Remdesivir did not have any beneficial effect on the length of hospital stay or the mortality rate of the COVID-19 patients. 29 This, of course, was challenged by Giliad pointing out some deficiencies in the study.
Remdesivir had been selling like hotcakes (even in the black market – Rs.60,000 and more per dose) in India during the ‘second Covid wave’. 15 According to IQVIA numbers, Remdesivir recorded a sale of Rs. 593 crore from June to December 2020 in India. Where were so many ‘scientifically eligible’ patients for this quantity of the drug ? Patients couldn’t have bought the drug and injected it into themselves. Hospitals claim to have used the drug based on some medical literature.
In their anxiety to save life, hospitals might have set aside the protocols and injected drugs injudiciously. Even doctors got themselves injected with remdesivir with no ‘official’ indication according to protocols. Relatives of some serious patients might have ‘pressurised’ the hospitals to administer the ‘costly’ drug out of desperation. And, in their anxiety to save their kith and kin, some poor people sold their cattle and houses to pay for the exorbitant medical bills, only to mourn at the crowded burial grounds during the ‘second wave’ in India. In this process, some might have quoted ‘COVID medical literature’ and exploited the desperate.15 One Covid patient was charged Rs.16 lakh in India and one Covid patient in the US was billed $1.1 million for Covid treatment – it’s a global phenomenon, not just local.10 The justification is the application of some ‘COVID medical literature’ in the prevailing circumstances of uncertainty of outcomes of treatment. 6
Plasma therapy cauldron
A mosaic of evidence from ‘COVID medical literature’ of varying epistemic levels worldwide indicates that Convalescent Plasma Therapy (CPT) is safe and has a survival benefit when transfused early in the course of the disease.29 But, individual Randomised Control Trials (RCTs) provided divergent evidence. In fact, some experts think that the use of CPT may have even played a role in facilitating new worrisome mutations to the virus. The ICMR’s PLACID trial and a study (May 14, 2021) published in The Lancet found no benefit in reducing mortality or improving patient outcomes. 26,29 The ICMR had dropped the CPT from the recommended treatment guidelines for COVID-19 in May 2021. The latest revelation about the ‘plasma therapy’ is that the CONCOR-1 trial results published on September 9, 2021 in Nature Medicine journal by Canadian researchers showed that ‘plasma therapy’ is ineffective and associated with worse clinical outcomes and serious side effects. Nearly 36,000 people were treated in Maharashtra with ‘convalescent plasma’ which was sold at the rate of Rs. 60,000 per dose. 29
In spite of lack of evidence, hospitals had been putting the onus on the relatives of the Covid patients to source the plasma which often led to fraught attempts by the desperate kith and kin. Science of healing seems to be bereft of sense, though supported by medical literature. 10
Tocilizumab tumble
The ‘recombinant humanised monoclonal antibody’ drug known as Tocilizumab gained conflicting results from heterogeneous and underpowered scientific studies. 26 However, the largest trial, the WHO’s RECOVERY, showed that the all-cause mortality among the ‘Tocilizumab group’ was 31% and that among the ‘usual care group’ was 35%. Humongous amounts of money were spent on this drug for that indefinite slim gain. Does the science of economics find sense in making the poor much poorer ? 10 The WHO trial, which also studied the effect of hydroxychloroquine, a combination of HIV drugs lopinavir and ritonavir, as well as a combination of lopinavir and interferon, showed that none of the drugs showed any beneficial effect on the length of hospital stay or the mortality rate of those infected. All India Institute of Medical Sciences (AIIMS) and the Health Ministry, on September 2, 2020, advised not to use favipiravir, pirfenidone, methylene blue, itolizumab, tocilizumab, et cetera ‘too enthusiastically’ as sufficient evidence is lacking to support their use. 26
The ‘fashion’ now is to crave for a ‘cocktail’ of monoclonal antibody combination of ‘Casirivimab’ and ‘Imdevimab’ (Regeneron / REGEN-COV) which comes with a warning that it may be associated with worse clinical outcomes when administered to hospitalised patients with COVID-19 requiring high-flow oxygen or mechanical ventilation. 26
Masks, ventilators, lockdowns, vaccines, steroids, etc.
Opinion on documentations even by specialists is divided, and there were even amusing interpretations by world leaders and politicians.26 Did not the Brazilian President Jair Bolsonaro tell his countrymen that Covid vaccines would convert them into crocodiles ? 28 Did not the ex-POTUS Donald Trump thought aloud about injecting disinfectants to control COVID ? 29 There had been huge protests around the globe against ‘lockdowns’, ‘face masks’, ‘Covid vaccination’, etc. backed by some scientific literature and by some world leaders. 26 Due to the ‘pressure’, the US relaxed precautions, for example the disastrous guidance supplied by the Centers for Disease Control and Prevention (CDC) on May 13, 2021 to the effect that people need not wear masks if they had been vaccinated. This advisory, of course, was later reversed.
In the first few months of 2020, ventilators were extensively used, unnecessarily with fatal outcomes. Later on, it was realised that the deaths were mostly due to micro-thromboembolism, disseminated intravascular coagulation, vasculitis in lungs, etc. Further later, it was documented that steroids were ‘lifesaving’ in COVID cases. The easily available cheap steroids flooded into the bodies of COVID patients waking up another monster called ‘Mucormycosis’ which horribly killed hundreds of Covid patients in India. 14
Disinfectant tunnels
Studies are still going on to find the impact of disinfectants on this new virus. Based on some documentation, even governments used them wrongly by forcing people to go through “disinfectant tunnels” during the ‘corona crisis’. 20 The Supreme Court of India also found fault with the authorities in this matter. In some places, disinfectants were sprayed on the fleeing poor migrant workers during the ‘national lockdown’ which is unscientific, barbarous and very hazardous to health. Most disinfectants, by nature, are potentially harmful and even toxic to humans and animals. 20 The science needs to be applied with some mind and some sense.
Retractions and withdrawals
While the COVID pandemic has generated an unprecedented volume of research documentation, there have been an unusual number of retractions and withdrawals of articles far earlier than the usual period of two to three years. 66,67,68,69 An average of 39.5 COVID preprints were posted each day during the ‘Covid pandemic’ compared with just 10.5 per day during the ‘Ebola virus epidemic’ of 2014 , according to a writing in The Lancet.
Another curious fact is that a study from the All India Institute of Medical Sciences (AIIMS), Delhi found that there were more retractions of papers from journals than those from preprints – 143 against 40. “The skullduggery had not been met with shock, surprise or righteous disdain by the researchers. It was, as if, the scientists had come to expect it. The frequency with which unreliable data were rolled out is unprecedented. Reporting of non-robust data seem no longer an exception; it seems to have become a routine. But more interestingly, this perversion of the research process through rushing information, true and false, and blatant use of vested interests is not met with disapproval. Moreover, some of them are celebrated by pharmaceutical industry. Also, endorsement of such cynical machinations by the publishers of such papers is welcomed by some unscrupulous researchers.” Quite contrary to this ‘permissiveness’ in publication, runs the story of a recent (August 2022) episode. Twenty-four astronomers and physicists from 10 countries protested the denial of papers critical of the ‘Big Bang’ hypothesis of the origin of the Universe, by the open PREPRINT website arXiv.
Nationalism in COVID literature
Certain nations took pride in their own publications and framed their own protocols for prevention and treatment of COVID. The West has its own, China has its own, India has its own, and so on. There have been too many variables to make any sense in comparison. There has been ‘the Good’, ‘the Bad’ and ‘the Ugly’ in every sense. Covid medical literature has been an eclectic potpourri of facts and falsifications. It is for the readers and the countries to draw their own conclusions. Examples are too many to make a mention of them here.
Emergency publications
In the recent decades, there has been an exponential growth of medical journals and so the volume of literature. The journals are of varied standards, defined by their editorial policies. Articles published in journals of long existence, good reputation and premier status are generally considered to be good and reliable. There has been a ‘peer-review’ system through which the articles are judged and filtered. During this pandemic period, for reasons of providing ‘emergency information’, many ‘peer reviews’ were rushed through without much verification. This made many papers of dubious value pass through for publication even in internationally reputed journals. Secondly, the usual timelines of ‘clinical trials’ for drugs and vaccines were compressed for reasons of ‘emergency’, and conclusions drawn with questionable validity. Thirdly, adequate number of cases could not be enrolled in the short window of the studies to draw acceptable conclusions.
Manufacturers making mischief in the conduct of trials of their prospective molecules is another story. Vested interests played a great role in the scientific research during the pandemic. It is difficult to prove either way, as ‘service to humanity’and ‘business interests’ are inextricably mingled in the research. There is ‘the Good’, ‘the Bad’ and ‘the Ugly’ in the research and publication field. It is difficult to segregate the good from the bad. Shortcuts and cutting the corners in the COVID research have been rampant, and applying their results on populations could be hazardous. ‘Covid vaccines’ literature is an example. Ten years of a ‘standard study’ to evaluate the efficacy and safety of a vaccine was compressed into ten months.
The ‘interim’ results were applied to declare ‘emergency authorisations’ across the globe. The justification is to save lives on an ‘emergency basis’. So also, is the hurried publication of papers on the efficacy and safety of medicines in treating or preventing COVID-19. As a result, many drugs were authorised to be used as ‘emergency’ medicines, and also were later included in advisories against their use. All this happened in the Covid pandemic due to ‘emergency publication of research literature’. Actions in health and medical practice were approved based on the conclusions of the studies which were even at the ‘preprint’ stage of the publications, even before ‘peer review’.
COVID pseudoscience literature
COVID generated too much of ‘pseudoscientific literature’ due to paucity of definitive conclusions from short-term studies. Honestly speaking, we don't have much of proven facts about this disease. While the ‘true-scientific world’ is struggling to find facts about this new problem, innumerable ‘pseudo-scientific writings’ were printed. The poppycock is transformed into science by using the language of real science, language of stem cell research, language of quantum physics and the language of double-blind randomized control trials – a phenomenon called ‘scienceploitation’. The myriad uncertainties in the ‘Covid science’ had brought to the fore the pseudoscience, both in allopathy (‘modern medicine’) and other systems of medicine.
It’s but natural that people embrace anything when ‘modern medicine’ says it has no guaranteed specific medicine against COVID-19. It comes even from political heads in the form of touting for Hydroxychloroquine or ‘paapads’ (‘appalams’).29 Countless wellness gurus, holistic healers, herbalists, naturopaths, chiropractors, potions, ‘kashayams’, pills and practices had promptly stepped in, many of them not without some sort of studies and literature. Of course, donkey milk, cow urine, bleach, cocaine, zinc, vitamin D, vitamin C and a host of other immune-boosters to prevent or cure COVID-19 had also enjoyed a great patronage, many of them not without some kind of documentation. Many of these which were considered ineffective to prevent a disease in the pre-Covid times are now being religiously consumed. Uncertainties and vicissitudes in life make one vulnerable. People are tuned by tragedies to hobble through them with the crutches of unproved medicaments.
Millions of dollars are being spent globally on ‘pseudoscience’ and its products of unproved efficacy and safety. Sometimes, we realise the hazards of a very popular and most commonly used product after using it for decades – one example is in the announcement in this month (August 2022) that “Johnson & Johnson will stop selling talc-based baby powder globally in 2023, after the product drew thousands of consumer safety lawsuits.”
People have come to trust this pseudoscience as real science, especially when all this guff is tacitly recognized by integrative health centres in some countries including Canada, Singapore and the UK, and at universities and reputed institutions such as the Cleveland Clinic in Ohio which offers ‘Reiki’ – a method of treatment by using hands without even touching the patient to balance the “vital life force energy that flows through all living things.” And, there is no dearth of documentation on some of the unbelievable ones.
Devils and literature
As Arthur Conan Doyle in his ‘Sherlock Holmes’ said, “It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.” The statistics deployed and the conclusions drawn about the potential benefits or risks in the ‘COVID medical literature’ seem to be hazy. As seen during the past two years, the benefits of decentralized access to ‘COVID medical literature’ came with the cost of promoting incorrect, invalid, or untrustworthy conclusions. A solution to this problem may lie in automated methods to deliver status updates to readers. As it is a new disease in evolution, medical standards couldn’t be set yet. The evolving medical literature would be the foundation for future studies and actions. The new academic chessboard provides both opportunities and threats to research.
Finally, is the question: “Is the COVID pandemic over, as of August 2022 ?” Now, 29 months after the WHO declared COVID-19 a pandemic, considerable number of new cases are still continuing to be reported from different parts of the world. The peregrination seems to be still going on. Considering the current COVID medical data and documentation, the WHO may not declare a transition to the stage of endemicity in the near future.
But, going against the grain of medical literature, people and many countries have already ‘declared for themselves’ that the pandemic is over, and returned to ‘business as usual’, unmindful of potential new devils on the horizon. On balance, common sense prevailed. Let’s hope that yesterday’s frightening spectres are not exorcised by even more fearsome apparitionswhich may get our full, horrified attention to the exclusion of past hauntings. May a fortunate stroke of serendipity put a stop to the COVID pandemic without the manifestation of another strange quirk of fate. Monkeypox virus seems to have made a beginning in many countries, and Henipavirus (Langya) has just set its foot in China. Reminiscing “The Brook” by Alfred Lord Tennyson, I may say that “Viruses may come and viruses may go, but the medical literature goes on expanding forever – good, bad or ugly.”
While we wishfully take comfort in the thought of winning the COVID battle, we have to refocus on the old devils which have been killing more than 25,000 people every day in India – 1,400 due to tuberculosis, 500 due to road accidents, 120 due to pregnancy-related problems, 2,000 young children due to illness, 4,000 due to tobacco use, etc. As millions of lives everyday have been saved due to the goodness of medical literature during the past one century, the few bad reports in the ‘COVID medical literature’ during the past two years (mostly due to the newness of the devil) should not make one to dismiss research documentation as a devilish claptrap. As ‘the Good’ replaces ‘the Bad’, we have to still learn on the go !
Whatever it is, some of the ‘COVID medical literature’ cited above may make one think that the world and the medicine have been blindly following what two eminent persons said, perhaps, jokingly: (1) “Money is not everything. But make sure you earn a lot before speaking such nonsense.” -- Warren Buffett; (2) “Money is not everything, but it ranks up there with oxygen.” -- Rita Davenport. In my experience of over half-a-century in the field of medicine, I noticed that “Mother Nobleness” has been regretfully giving way to “Mother Money” in the noble profession, across the globe, including some well-developed countries. The ‘devil’ of venality seems to have gained respect. In this context, the text in the following link about my “PAY WHAT YOU CAN Clinic” may be of some interest:
https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html
‘The Bad’ medicine !
Is the medicine itself bad ? William Osler’s quote seems to be relevant even today, notwithstanding the tremendously beneficial strides made on the medical, scientific and technological front. The risk of being harmed during medical treatment is one in 300, while it is one in 1,000,000 in aeroplane travel ! Every day in America alone, 750 older adults are hospitalised due to side effects of medicines, and Lown Institute predicted premature death of 150,000 older adults due to ‘medication-overload’ in the US in the next 10 years (https://www.webmd.com/healthy-aging/medication-overload ). 70 Most of the people in the world are taking medicines or vitamins (even vitamins are not without side effects) routinely, based on the evidence in the medical literature generated over the past 100 years. Are you not taking ?
( According to a recent study by Johns Hopkins, more than 250,000 people in the United States die every year because of medical mistakes, making it the third leading cause of death after heart disease and cancer.)
“The person who takes medicine must recover twice, once from the disease, and once from the medicine.” -- William Osler
From the Editor........
The Editor wishes to inform the Readers of ‘The Antiseptic’ who are interested in having correct, complete and comprehensive knowledge of the current literature on Covid, to read the above article by Dr. T. Rama Prasad, written as is usual, in beautiful, flawless and inimitable English, with numerous apt quotations.
He further wishes to thank Dr. T. Rama Prasad profusely for choosing to publish all his ‘very interesting to read’ articles on Covid in ‘The Antiseptic’ and hopes that he (Dr. T. Rama Prasad) continues his benevolence.
REFERENCES
1. Rama Prasad. T., Origin of COVID. The Antiseptic, 2022 August; Vol. 119; No. 8; P: 09-17; Indexed in IndMED – www.antiseptic.in
2. Rama Prasad. T., COVID Deaths. The Antiseptic, 2022 July; Vol. 119; No. 7; P: 14-22; Indexed in IndMED – www.antiseptic.in
3. Rama Prasad. T., The long and the short of COVID in India. The Antiseptic, 2022 June; Vol. 119; No. 6; P: 14-27; Indexed in IndMED – www.antiseptic.in
4. Rama Prasad. T., COVID Fear and Paranoia. The Antiseptic, 2022 May; Vol. 119; No. 5; P: 09-17; Indexed in IndMED – www.antiseptic.in
5. Rama Prasad, T., Post-OMICRON Peregrination. The Antiseptic, 2022 April; Vol. 119; No. 4; P: 06-14; Indexed in IndMED – www.antiseptic.in
6. Rama Prasad, T., COVID – still an enigma. The Antiseptic, 2022 March; Vol. 119; No. 3; P: 20-25; Indexed in IndMED -- www.antiseptic.in
7. Rama Prasad, T., OMICRON – A Paper Tiger. The Antiseptic, 2022 February; Vol. 119; No. 2; P:12-21; Indexed in IndMED – www.antiseptic.in
8. Rama Prasad, T., Ominous Omicron of COVID. The Antiseptic, 2022 January; Vol. 119; No. 1; P:25 – 29; Indexed in IndMED – www.antiseptic.in
9. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December; Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in
10. Rama Prasad, T. The Science and Nonsense around COVID. The Antiseptic, 2021 November; Vol. 118; No. 11; P: 8-14; Indexed in IndMED -- www.antiseptic.in
11. Rama Prasad, T. COVID, Children and Schools. The Antiseptic. 2021 October; Vol.118; No.10; P: 08-18; Indexed in IndMED -- www.antiseptic.in
12. Rama Prasad, T. India’s Third COVID Wave. The Antiseptic. 2021 September; Vol.118; No.9; P: 14-20; Indexed in IndMED – www.antiseptic.in
13. Rama Prasad, T. Vagaries of India’s COVID Vaccination Policy. The Antiseptic. 2021 August; Vol.118; No.8; P: 10-16; Indexed in IndMED – www.antiseptic.in
14. Rama Prasad, T. Mucormycosis and COVID-19 in India. The Antiseptic. 2021 July; Vol.118; No.7; P: 21-26; Indexed in IndMED -- www.antiseptic.in
15. Rama Prasad, T. Disastrous Second COVID Wave in India. The Antiseptic. 2021 June; Vol.118; No.6; P: 20-27; Indexed in IndMED – www.antiseptic.in
16. Rama Prasad, T. COVID Variants. The Antiseptic. 2021 May; Vol.118; No.5; P: 11-14; Indexed in IndMED -- www.theantiseptic.in
17. Rama Prasad, T. Covishield or Covaxin ? The Antiseptic. 2021 April; Vol. 118; No. 4; P: 12-16; Indexed in IndMED – www.theantiseptic.in
18. Rama Prasad, T., Versha Rajeev. The Conundrum of COVID-19 Vaccines. The Antiseptic. 2021 January; Vol.118; No.1; P: 10-17; Indexed in IndMED – www.theantiseptic.in
19. Rama Prasad, T. 40+15 Hypoxia Test in COVID-19. The Antiseptic. 2020 December; Vol. 117; No. 12; P: 13-17; Indexed in IndMED – www.antiseptic.in
20. Rama Prasad, T., Versha Rajeev. Antiseptics, Disinfectants and COVID-19. The Antiseptic. 2020 November; Vol.117; No.11; P: 26-28; Indexed in IndMED – www.antiseptic.in
21. Versha Rajeev., Rama Prasad, T. Fear and COVID. Health. 2020 November; Vol.98; No.11; P:31-32
22. Rama Prasad, T., Versha Rajeev. Tea and COVID. Health. 2020 October; Vol.98; No.10; P: 4-6.
23. Rama Prasad, T. Is the “Lockdown Medicine” too toxic ? The Antiseptic. 2020 October; Vol. 117; No. 10; P: 13-15; Indexed in IndMED – www.theantiseptic.in
24. Rama Prasad, T., Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy. The Antiseptic, 1979 April, Vol. 76; P: 213-215
25. https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html
26. https://drtramaprasad.blogspot.com/2020/06/coronavirus-covid-19-sars-cov-2_43.html
27. https://drtramaprasad.blogspot.com/2020/
28. Rama Prasad, T., Versha Rajeev. https://drtramaprasad.blogspot.com/2017/04/covid-crocodiles.html
29. https://drtramaprasad.blogspot.com/2017/04/hydroxychloroquine-hcq-and-coronavirus_29.html
30. https://drtramaprasad.blogspot.com/2017/04/corona-and-charles-darwin.html
31. https://drtramaprasad.blogspot.com/2017/04/modern-medicine-good-bad-and-ugly_30.html
32. https://drtramaprasad.blogspot.com/2017/04/yellow-nail-syndrome_28.html
33. https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
35. http://drtramaprasad.blogspot.com/2017/04/what-you-can-clinic_30.html
36. https://www.maxhealthcare.in/blogs/long-covid
38. -- https://nypost.com/2020/04/18/americas-junk-food-diet-makes-us-more-vulnerable-to-coronavirus/
40. https://www.nejm.org/doi/full/10.1056/NEJMoa2201300
44.
45. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239175/
46. https://gh.bmj.com/content/5/12/e003097
47. https://www.aljazeera.com/news/2021/10/22/who-says-covid-may-have-killed-180000-health-workers
49. http://ircamera.as.arizona.edu/NatSci102/NatSci102/images/exthoyle.html
50. Corman VM, Muth D, Niemeyer D, Drosten C, 2018. Hosts and sources of endemic human coronaviruses. Adv Virus Res100: 163–188. [PMC free article] [PubMed] [Google Scholar]
51. Hu B, et al. 2017. Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus. PLoS Pathog 13: e1006698. [PMC free article] [PubMed] [Google Scholar]
52. Latinne A, et al. 2020. Origin and cross-species transmission of bat coronaviruses in China. Nat Commun (In press). [PMC free article] [PubMed] [Google Scholar]
53. Menachery VD, et al. 2016. SARS-like WIV1-CoV poised for human emergence. Proc Natl Acad Sci U S A 113: 3048–3053. [PMC free article] [PubMed] [Google Scholar]
54. Anderson KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF, 2020. The proximal origin of SARS-CoV-2. Nat Med 26: 450–452. [PMC free article] [PubMed] [Google Scholar]
55. Zhang Y-Z, Holmes EC, 2020. A genomic perspective on the origin and emergence of SARS-CoV-2. Cell 181: 223–226. [PMC free article] [PubMed] [Google Scholar]
56. Zhou P, et al. 2020. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 579: 270–2734. [PMC free article] [PubMed] [Google Scholar]
57. Allen T, Murray KA, Zambtana-Torrelio C, Morse SS, Rondinini C, Marco MD, Breit N, Olival NJ, Daszak P, 2017. Global hotspots and correlates of emerging zoonotic diseases. Nat Comm 8: 1124. [PMC free article] [PubMed] [Google Scholar]
58. Wang N, et al. 2018. Serological evidence of bat SARS-related coronavirus infection in humans, China. Virol Sin 33: 104–107. [PMC free article] [PubMed] [Google Scholar]
59. https://www.who.int/publications/m/item/quick-search-guide-who-covid-19-database
61. https://www.nejm.org/doi/full/10.1056/NEJMe2204695
62. https://www.clinicaltrials.gov/ct2/show/NCT04895449
66. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550405/
68. https://journals.sagepub.com/doi/full/10.1177/21501327211015592
69. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809656/
70. https://www.webmd.com/healthy-aging/medication-overload
There are only 10 faces in the above drawing, but the COVID has many more !
The face of COVID would be remembered for a longer time than any of the faces in the ‘tree’ above. Of course, everybody would be forgotten in course of time. And the ‘time’ is a very relative thing. Just see the ‘timeline’ below:
'Age' of the Sun -- 4.54 billion years. Expected lifespan. -- 7 billion years more
'Age' of the Earth -- 4.54 billion years. Expected lifespan -- 1 billion years more
'Age' of Himalayas -- 50 million years
'Age' of Humans. -- 3 lakh years
'Age' of Religions -- 4 thousand years
'Age' of Temples. -- 3 thousand years
‘Age’ of viruses -- 3.5 billion years
‘Age’ of viral epidemics -- 12,000 years
‘Age’ of COVID – about 3 years as in 2022
We have around 380 trillion viruses (mostly harmless) on or inside our bodies !!!
“Computer Virus” is a “Mechanical Organism”, such as a computer code, which may damage computers, ‘copy’ itself and ‘infect’ other computers, just like a “Biological Virus.”
Dr. T. Rama Prasad
A BLOG ARTICLE in : http://drtramaprasad.blogspot.com or www.rama-scribbles.in
A brief introduction
In the words of Prof C H Sivaraman, FRCP (London):
“ ... Dr. T. Rama Prasad belongs to a distinctly different and unconventional species of doctors. He speaks sparingly and does not even display his qualifications or merits, but his innumerable published writings (he calls them ‘scribblings’ though they are ‘pearls of wisdom and knowledge’, sprinkled with a bit of humour and sarcasm) which received wide acclaim talk eloquently for him. The ‘PAY WHAT YOU CAN’ Clinic where services are available for which one may pay whatever one can is a facility run by Dr. Prasad for a very long time which could be a world record. Dr. Prasad is called a “god” by his patients, and many of them named their children after his name “Prasad” -- that is the height of recognition of goodness of a human being.."
Service to Humanity is service to God; Kindness costs nothing
This is not an ad, it’s about an odd service.
GREETINGS from
‘PAY WHAT YOU CAN’ Clinic
“Thena thyakthena bhoojithaha”– Ishopanishad
( Translated by Prof. B.M. Hegde as: “Rejoice in giving.”)
True to this quote, I have been rejoicing at what little I could give. Defying stereotypes, this clinic has been in existence for a very long time, sans glitz, blitz, ads, microphones, speeches and noise. As a matter of my policy, publicity is shunned. The reason is simple. Good work needs no noise and nonsense. My ‘SCRIBBLINGS’ on related topics may be accessed at: http://drtramaprasad.blogspot.com or www.rama-scribbles.in
My consultation fee is not decided by me. It is the patient’s pleasure. The patient may pay (donate) whatever he can and what he wishes. If one is short of money, he or she need not pay anything. And the money thus received is used for charity to help the needy, the poor and the less fortunate. If interested to know more about this facility, go to: http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html
"We need not run after money. If we are meritorious and compassionate, money would run after us, and it eludes us if we run after it.” -- T. Rama Prasad
“Richness is not having lots of money. It is the feeling that one has enough of it. Contentment sans comparison is what makes one really rich.” -- T. Rama Prasad.
Dr. T. Rama Prasad, Director, ‘PAY WHAT YOU CAN’ Clinic, PERUNDURAI, Erode Dt., TN, India. Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Website: www.rama-scribbles.in , Blog: https://drtramaprasad.blogspot.com, Email:drtramaprasad@gmail.com, Facebook: T Rama Prasad, Twitter: @DrRamaprasadt, WhatsApp: +91 98427 20393
Dear Dr. Rama Prasad
I am sure the world will be a better place, if people understand your writings ... ‘EXCELLENT’ is the word. I cannot find any other word in this language to describe what you have written without any pretensions. You have brought out some home truths to those who care to read your website ... You are a great thinker, writer and crusader ... As usual, your messages are incisive, to the point and make lots of sense, much better than my articles …
... You are not only GREAT, but are a true missionary in medicine. May your tribe increase for the good of mankind. ….
Love,
-- Padma Bhushan Prof. B. M. Hegde, (awarded Padma Vibhushan in 2021)
MD, FRCP (Lond), FRCP (Edin), FRCP (Glas), FRCP (Dub), FACC (USA), FAMS, Former Professor of Cardiology, Middlesex Hospital Medical School, University of London, UK, Former Vice-Chancellor, Manipal University, India, Affiliate Professor of Human Health, Northern Colorado University, USA, Editor-in-Chief, The Journal of the Science of Healing Outcomes, Chairman, State Health Society’s Expert Committee, Govt of Bihar, India and Padma Bhushan awardee of 2010. www.bmhegde.com
CLICK ON THE HEADINGS BELOW TO ACCESS THE “SCRIBBLINGS”
· ABOUT ME and MY SCRIBBLINGS (2) 'PAY WHAT YOU CAN' Clinic
· MY LOVE STORY & good old days (4) BETTER HALF (4) SHIVA, KRISHNA, Ramanuja & Ramanujan (5) MOTHER-IN-LAW (6) YOU ARE NOT OLD (7) MODERN MEDICINE -- the Good, the Bad and th... (8) Dr. Peon, PhD (9) MEDICAL CONFERENCES & Clinical meetings (10) RUN ON MONEY (11) MEDICINE IN RURAL INDIA (12) RURAL ARE THE REAL (13) INTERNET EFFECT (14) MARKETING TRICKS & INNOVATIONS (15) INCREDIBLE INDIA ! (16) SCHOOL EDUCATION (17) DEVALUED DEGREES (18) TEA, COFFEE and COMMERCE (19) SEX. and MARRIAGE (20) THE CHANGING WORLD (21) RAPE (22) SEXUAL HARASSMENT (23) DRESS SENSE (24) OPEN AIR DEFECATION (25) ONAM 2017 (26) TEST-TUBE BABIES and TERMINATION BABIES (27) TEST-TUBE PUPPIES (28) ASTHMA, ALLERGY & COPD (29) GIRL CHILD : GOLDEN CHILD (30) MY REAL AWARDS (31) TREES and PLANTS (32) PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus (33) SOPHISTICATED CHEATING (34) NIPAH & ZIKA viruses (35) SWINE FLU -- A (H1 N1) influenza (36) INDIAN SUPERBUG (37) HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS (38) YOGA (39) CORONA and CHARLES DARWIN (40) GOD, RELIGION & UNIVERSE (41) LOCKDOWN MEDICINE (42) CODUP (43) GOD-MEN (44) DOGS (45) CANCER (46) SMILE and STRESS (47) CIVIC SENSE & MANNERS (48) MY ART (49) TUBERCULOSIS in India (50) DIABETES (51) FOOLED TO BELIEVE (52) DENGUE, ZIKA and MOSQUITO (53) COMPLEXION (54) BAHUBALI (55) VINAYAKA chathurdhi 2017 (56) SUNDAY LUNCH ... Dec 3, 2017 (57) ABDUL KALAM (58) BIRDS and DRUGS (59) YELLOW NAIL SYNDROME (60) RICHNESS and HAPPINESS (61) FISHES (62) KMCH (63) MY 'SCRIBBLES' IN NEWSPAPERS (64) To live in INDIA or ABROAD ? (65) SILENT, ISOLATED and INSULATED (66) PONGAL FESTIVAL (67) SPB (68) CESAREAN DELIVERY (69) POLLUTION, Disease and Deepaavali (70) HAPPY 2018 (71) BRINGING UP CHILDREN (72) SINGAPORE (73) STAFF & STUDENTS. -- photos (74) "AHIMSA" (75) GRADUATION DAY -- 2018, Perundurai Medical Col... (76) PERUNDURAI is the GEM (77) WORLD CANCER DAY ..February 4, 2017 (78) INDIAN ENGLISH (79) FOOD, EXERCISE and SLEEP (80) Nurses Day 2017 (81) DEEPAAVALI (82) PUTHAANDU -- Tamil New Year Day - 2018 & 2017 (83) COMPUTER. ILLITERATE (84) SMILE and LAUGHTER (85) REMOTE ANCESTORS (86) ODD things ... wow, whacky & weird ! (87) FACEBOOK 'scribbles' (88) HANDWRITING (89) MY QUOTES
GREAT HOLY SOUL
16.10.2017
" ... I always wonder that we both seem to be identical in our thoughts, deeds and actions. ... I always cherish your friendship and appreciate your humanitarian attitude towards life, poor rural people and the needy. ... I went through your articles ... especially, the 'PAY WHAT YOU CAN Clinic' touched my heart, and after studying, I wondered: "What a great holy soul you are !" You are a living example of Swami Vivekananda. ... "
Dr. J.K.K. Munirajahh, M.Tech (Bolton)
Chairman, JKKM Group of Institutions & Industries
Komarapalayam, Tamil Nadu, India
"...A study of your work reveals how fertile is your brain and how facile is your pen. Your command of English is breathtaking. One cannot help being astounded by your encyclopaedic range of knowledge and its depth is unfathomable......Your sense of humour is very much to be appreciated. Your invaluable treasure "SCRIBBLINGS" is to be preserved for posterity....."
05.08.1999 -- Prof. P. Lakshmi, MA,
Principal, Vellalar College for Women,
Thindal, Erode, Tamil Nadu, India
Dear Dr. Rama Prasad, 20 Jan 1999
“..When I saw a copy (of your book titled "Some of my SCRIBBLINGS") in the medical college library, curiosity got the better of me and I borrowed it. As I went through it, curiosity turned into admiration. What struck me first and the most was your command over the language. I appreciated your interest in widely varied subjects, from pornography to piano, as the saying goes. I also realised that the interest was not just superficial, but substantial as evidenced by the statistics quoted to emphasise a point. When I finished with it, it left me wondering how you continued to sustain your interest despite having spent more than 3 decades in this place, well isolated and insulated from academic and intellectual environment...”
--- Group Captain (Retd) Prof. N. Ramachandran, MD,
Professor of Paediatrics, Perundurai Medical College Perundurai, Erode District, Tamil Nadu, India
“… I am amazed to find how the book (Some of my “Scribblings”) mirrors your multifaceted personality – the sterling qualities of head and heart. It reflects the encyclopedic range of your mind. I am struck by the fact that there was no subject that is untouched – from physical to metaphysical, sacred to secular, all under the sun have been dealt with quite thoroughly, authenticated and well-documented to reveal a genuine humanist at work. … Combined with the art of healing is your art of drawing and painting. … We are amazed to see your paintings and to learn that the illustrations in the “Scribblings” are your own. …”
-- Prof. V. Prafulla,
M.A., Ph.D. (Eng.), M.A. (Hindi), P.G.T.E., Former Principal, Erode Arts College for Women, Erode, Tamil Nadu, India; Former Professor of English, Visalakshi College, Udamalpet, Tamil Nadu, India.
April 12, 2020
The following is the comment written by the internationally renowned scholar, Pritam Bhattacharyya (Editor-at-Large of Pentasect and Founder and Chief of Wordsmith at Wordsmith Communication, Chairman of Freelance Foundation, ) on the blog article on Coronavirus and COVID-19
(1) https://wordsmithofbengal.wordpress.com/2012/01/16/health-un-heath-and-fear-of-un-health/
(2) https://wordsmithofbengal.wordpress.com/2012/04/23/google-effect-and-kali-yuga-prophecies/
wordsmithApril 12, 2020 at 10:42 PM
“One of the best articles I have read on this theme and having balance, measure and proportion. Miss Corona in hindsight is really kind and benign in a sense - Nature has rolled a dice with fatality of 2-3%. She is under no obligation not to roll a dice of fatality 40,50,60% with Ms. Corona being "size zero" and "air-borne". Consider what would have happened ?
Dr. Prasad is one of the few doctors whom I know who fall into the rare category of "healers". A healer knows the art, science and commerce of healing, i.e. allowing the innate immunity of the body to manifest itself.
One should be very careful and critical about three things in the world : Big Pharma, Big Government, Big Science. In the proverbial Kali-Yuga, all three converge with overlapped agendas and sometimes not with the best interest in mind of the end users : patients, citizens, learners.
Finally, this pandemic will also pass. The system will come to a new equilibrium. But I think a whole generation will carry this impression forward and may become saner with this.
I nurture another hope : just like pivotal events propel a whole generation (Apollo Mission and interest in space science), this may inspire many young Indians to shift their focus into public healthcare, virology, immunology, public immunity, psychological counselling and learning the art and science of healing.
Again, it was very nice to find an article of this time in the avalanche of printed words in this theme.
Continue your good work.”
COVID world: 24 of my articles on ‘COVID’ were published in 24 months in Medical Journals which is a WORLD RECORD in Medical Journalism.
This article titled “Origin of COVID” is the 24th one.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
---------------------------------------------------------------------------------------------
. Origin of COVID .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu, India.
Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com WhatsApp +91 98427 20393 BLOG https://drtramaprasad.blogspot.com
WEBSITE www.rama-scribbles.in Twitter @DrRamaprasadt Facebook T Rama Prasad
Telegram Dr T Rama Prasad
`
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 8 August 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
COVID
articles authored by
Dr. T. Rama Prasad
and published in MEDICAL JOURNALS, making a WORLD RECORD
1. Rama Prasad. T., Origin of COVID. The Antiseptic, 2022 August; Vol. 119; No. 8; P: 09-17; Indexed in IndMED – www.antiseptic.in
2. Rama Prasad. T., COVID Deaths. The Antiseptic, 2022 July; Vol. 119; No. 7; P: 14-22; Indexed in IndMED – www.antiseptic.in
3. Rama Prasad. T., The long and the short of COVID in India. The Antiseptic, 2022 June; Vol. 119; No. 6; P: 14-27; Indexed in IndMED – www.antiseptic.in
4. Rama Prasad. T., COVID Fear and Paranoia. The Antiseptic, 2022 May; Vol. 119; No. 5; P: 09-17; Indexed in IndMED – www.antiseptic.in
5. Rama Prasad, T., Post-OMICRON Peregrination. The Antiseptic, 2022 April; Vol. 119; No. 4;
P: 06-14; Indexed in IndMED – www.antiseptic.in
6. Rama Prasad, T., COVID – still an enigma. The Antiseptic, 2022 March; Vol. 119; No. 3; P: 20-25; Indexed in IndMED -- www.antiseptic.in
7. Rama Prasad, T., OMICRON – A Paper Tiger. The Antiseptic, 2022 February; Vol. 119; No. 2; P:12-21; Indexed in IndMED – www.antiseptic.in
8. Rama Prasad, T., Ominous Omicron of COVID. The Antiseptic, 2022 January; Vol. 119; No. 1;
P:25 – 29; Indexed in IndMED – www.antiseptic.in
9. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December; Vol. 118; No.12;
P: 11-17; Indexed in IndMED -- www.antiseptic.in
10. Rama Prasad, T. The Science and Nonsense around COVID. The Antiseptic, 2021 November; Vol. 118; No. 11; P: 8-14; Indexed in IndMED -- www.antiseptic.in
11. Rama Prasad, T. COVID, Children and Schools. The Antiseptic. 2021 October; Vol.118; No.10; P: 08-18; Indexed in IndMED -- www.antiseptic.in
12. Rama Prasad, T. India’s Third COVID Wave. The Antiseptic. 2021 September; Vol.118;
No.9; P: 14-20; Indexed in IndMED – www.antiseptic.in
13. Rama Prasad, T. Vagaries of India’s COVID Vaccination Policy. The Antiseptic. 2021 August; Vol.118; No.8; P: 10-16; Indexed in IndMED – www.antiseptic.in
14. Rama Prasad, T. Mucormycosis and COVID-19 in India. The Antiseptic. 2021 July; Vol.118; No.7; P: 21-26; Indexed in IndMED -- www.antiseptic.in
15. Rama Prasad, T. Disastrous Second COVID Wave in India. The Antiseptic. 2021 June; Vol.118; No.6; P: 20-27; Indexed in IndMED – www.antiseptic.in
16. Rama Prasad, T. COVID Variants. The Antiseptic. 2021 May; Vol.118; No.5; P: 11-14; Indexed in IndMED -- www.theantiseptic.in
17. Rama Prasad, T. Covishield or Covaxin ? The Antiseptic. 2021 April; Vol. 118; No. 4; P: 12-16; Indexed in IndMED – www.theantiseptic.in
18. Rama Prasad, T., Versha Rajeev. The Conundrum of COVID-19 Vaccines. The Antiseptic. 2021 January; Vol.118; No.1; P: 10-17; Indexed in IndMED – www.theantiseptic.in
19. Rama Prasad, T. 40+15 Hypoxia Test in COVID-19. The Antiseptic. 2020 December; Vol. 117; No. 12; P: 13-17; Indexed in IndMED – www.antiseptic.in
20. Rama Prasad, T., Versha Rajeev. Antiseptics, Disinfectants and COVID-19. The Antiseptic. 2020 November; Vol.117; No.11; P: 26-28; Indexed in IndMED – www.antiseptic.in
21. Versha Rajeev., Rama Prasad, T. Fear and COVID. Health. 2020 November; Vol.98; No.11; P:31-32
22. Rama Prasad, T., Versha Rajeev. Tea and COVID. Health. 2020 October; Vol.98; No.10; P: 4-6.
23. Rama Prasad, T. Is the “Lockdown Medicine” too toxic ? The Antiseptic. 2020 October; Vol. 117; No. 10; P: 13-15; Indexed in IndMED – www.theantiseptic.in
The articles may be accessed at IndMED – www.antiseptic.in
WRITINGS AND TALKS of Dr. T. Rama Prasad
List No. 1
1. Drug Resistance in Tuberculosis - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
2. Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy - Pathogenesis - The Antiseptic, Vol. 76. pp.
213- 215, 1979.
3. Childhood Tuberculosis - Part I - The Antiseptic, Vol. 76, pp. 449-504,1979
4. Childhood Tuberculosis - Part II - The Antiseptic, Vol. 76. pp. 567-574, 1979
5. Yellow Nail Syndrome - Chest (U.S.A.), Vol. 77, p.580, 1980 –
http://journal.chestnet.org/article/S0012-3692(16)40458- 7/fulltext
6. Short-course Chemotherapy - The recent Advances in the Treatment of Respiratory Tuberculosis - Current Medical Practice,
Vol.24, pp. 41- 46, 1980.
7. Stevens-Johnson Syndrome and Thioacetazone - The Antiseptic, Vol. 77, pp. 99-102, 1980.
8. Yellow Nail Syndrome - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
9. Highly Purified Insulins - An Assessment - The Antiseptic, Vol. 77, pp. 3455-347, 1980.
10. Diabetes and Tuberculosis - The Medicine and Surgery, Vol. 21, pp. 10-12, 1981.
11. Tuberculosis Control in India - In Press
12. Tuberculin Test - Relevance to diagnosis in India today - In Press
13. Toxic Epidermal Necrolysis - The Antiseptic, Vol. 75, p. 194, 1978.
14. Drugs in the treatment of Tuberculosis - The Antiseptic, Vol. 75, p.678, 1978
15. Chemotherapy of Tuberculosis - The Antiseptic, Vol. 76, p.248, 1979.
16. Streptomycin in Tuberculosis - The Antiseptic, Vol. 76, p.516, 1979.
17. Health of the citizen (Special article) - The Hindu, Vol.99 A, No.198, p.8, 1976
18. How effective is the TB control programme ? (Special Article) - The Hindu, Vol.100, No. 274, p.8, 1977.
19. Five years Plans and TB Control Programme (Special Article) - The Hindu, Vol.101, No. 275,
20. BCG vaccination - The Antiseptic, Vol. 76, p. 726, 1979.
21. Genetic Selection - The Antiseptic, Vol. 77, p.258, 1980.
22. National Tuberculosis Control Programme - views presented, on invitation by the Tuberculosis Association of India,
at the 32nd National Conference on Tuberculosis and Chest Diseases, 1977.
23. Correlation between Geomagnetic Activity and Haemoptysis - paper presented at the II Tamil Nadu State Conference
on Tuberculosis & Chest Diseases, 1980.
24. Snakes.
25. AIDS - the disease of the decade - Radio Talk - All India Radio, Coimbatore, Feb. 1, 1986.
26. AIDS - What next ? - Radio Talk - All India Radio, Coimbatore, May 24, 1986
27. BRAIN FEVER (Encephalitis): taming the scourge - Radio Talk - All India Radio, Coimbatore, February 14, 1987.
28. HEALTH OF THE HIGH RISK GROUPS: Mothers, Children and elderly - Innovative Health Care Programmes,
Paper submitted for Scientific Session of the National Annual Conference of the Indian Society of Health administrators.
29. SAVING THE YOUNG - healthcare of the children in developing countries - Radio Talk -
All India Radio, Coimbatore, January, 1988.
30. MEDICINE and MONEY - Co-Chamber Journal, Vol. 5, Issue 8, p.8, 2010,
31. THE INDIAN SUPERBUG - Co-Chamber Journal, Vol. 5, Issue 9, p.15, 2010
32. SWINE FLU - Co-Chamber Journal, Vol. 5, Issue 10, p. 13
33. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, Jan. 15, 2012 -
……http://www.thehindu.com/opinion/open page/article2801701.ece
34. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012
...http://www.thehindu.com/opinion/open-page/article3340116.ece
35. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 …
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
36. A BAD PATCH - The Hindu, OPEN PAGE, March 15, 2020 ...
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
37. MODERN MEDICINE: how good is it in India ? - Co-Chamber Journal, Vol. 11, Issue 5, p. 23, June 2016 & Vol. 11,
Issue 6, p. 18, July 2016
38. WORLD TB DAY: March 24, 2016 - Health, Vol. 94, No. 5, p. 20, May 2016
39. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
40. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
41. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
42. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
43. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
44. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
List No. 2 contains references to about 1000 writings which may be found on my Website -- T. Rama Prasad
“Education is the most powerful weapon we can use to change the world.” --- Nelson Mandela
AUTHOR Dr. T. Rama Prasad
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
‘The Hindu’ (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy -
Pathogenesis -- The Antiseptic, Vol. 76. pp. 213-215, 1979
2. Childhood Tuberculosis - Part I -- The Antiseptic, Vol. 76, pp. 449-504,1979
3. Childhood Tuberculosis - Part II -- The Antiseptic, Vol. 76. pp. 567-574, 1979
4. Stevens-Johnson Syndrome and Thioacetazone -- The Antiseptic, Vol. 77, pp. 99-102, 1980
5. Highly Purified Insulins - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. Is the "Lockdown Medicine" too toxic ? -- The Antiseptic, Vol.117, No.10, pp. 13 - 15, 2020
7. Antiseptics, Disinfectants and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. Disastrous Second Covid Wave in India -- The Antiseptic, Vol.118, No. 6, pp. 20-27, 2021
9. Covid Variants -- The Antiseptic, Vol. 118, No.5, pp. 11-14, 2021
10. The Conundrum of COVID-19 Vaccines -- The Antiseptic, Vol.118, No. 1, pp. 10-17, 2021
11. Covishield or Covaxin ? -- The Antiseptic, Vol.118, No. 4, pp. 12-16, 2021
12. 40+15 Hypoxia Test in COVID-19 -- The Antiseptic, Vol. 117, No.12, pp. 13-17, 2020
13. Mucormycosis and COVID-19 in India -- The Antiseptic, Vol. 118, No. 7, pp. 21-26, 2021
14. Vagaries of India’s Covid Vaccination Policy – The Antiseptic, Vol. 118, No. 8, pp. 10-16, 2021
15. India’s Third Covid Wave -- The Antiseptic, Vol. 118, No. 9, pp. 14-20, 2021
16. Covid, Children and Schools -- The Antiseptic, Vol. 118, No. 10, pp. 08-18, 2021
17. The Science and Nonsense around COVID -- The Antiseptic, Vol.118, No.11, pp. 08-14, 2021
18. Covid and Tuberculosis – The Antiseptic, Vol.118, No.12, 2021
19. Tea and Covid -- Health, Vol. 98, No.10, pp. 4-6, 2021
20. Fear and Covid -- Health, Vol. 98, No. 11, pp. 31-32
21. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 –
https://www.thehindu.com/opinion/open-page/Health-check-up-how-healthy-is-it/article13379235.ece
22. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012
23. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 …
https://www.thehindu.com/opinion/open-page/of-tea-coffee-and-commerce/article5567951.ece
24. A BAD PATCH - The Hindu, Open Page, March 15, 2020 ...
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
25. Yellow Nail Syndrome - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
26. Yellow Nail Syndrome - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
27. Drug Resistance in Tuberculosis - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
Dr. T. Rama Prasad www.rama-scribbles.in
LOVABLE RURAL FOLK ... February 10, 2018
Yes, rural are really lovable folk. Most of them have a refreshingly rural and innocent background. They have blind faith in gods, and doctors as well.
After a few decades, we may see no more of such good plain-hearted rural folk. And, even now, we rarely see the good old grand grandmother of ‘topless’ (‘blouseless’) era ! The women of that generation cover their upper bodies with a piece of a cloth only (end piece of saree) wrapped around without any underclothing like bra or blouse.
Today (February 10, 2018), one frail-looking grandmother in that 'topless' attire (see the attached photo) walked into my consultation chamber, accompanied by her grandson, but not needed to be assisted by him to walk in. She (Gowandayamml) fluently talked in the grand old style ... said she got the appointment with great difficulty (limited consultations today, as I had to spare some time to attend my granddaughter's 'food court bonanza' at her school). At the end of the consultation, she wanted a 'cough syrup' (most of the 'cough syrups' are used unnecessarily and for psychological satisfaction, and to the great delightfulness of drug industry !). I gave her a sample bottle of a cough syrup, free of cost, of course ... and lo and behold, her face was lit up with happiness. Little pleasures ... little things matter in life ... read the 'Scribbling' titled 'Richness & Happiness' on my blog. She narrated at length of her previous visits over decades and profusely thanked me for keeping her fit (in fact, it is her good old lifestyle and her constitution that kept her fit, not me !). I asked her whether I may have a photo with her. She was amused and laughed. I called the receptionist to take a photo. The lady of the old school put up a serious pose for the photo. Receptionist, Nandhini, asked her to smile ... in vain ... perhaps, the grandma thought that one should not move or smile when the camera clicks (In our school days, photographers used to instruct us not to move or smile when they take group photos in the school, with those bulky 'plate' cameras with a long exposure time !). I shall give her a print of the photo when she visits me again ... curiously, we both are of the same age group by the calendar, though seem not to be by the images ! Finally, the plain, simple, candid and 'topless' granny left my chamber. After a while, she came back with money (hundred rupees notes) in her hand to put into my tiny 'Pay what you can' hundi, as consultation fee. I had to persuade her a lot not to give any consultation fee, saying that it's a great pleasure for me to treat her free of cost ... again there was a flash of a cheerful smile across her face. This is the most pleasant reward we get in medical practice -- the cheerful smile of satisfaction.
If you wish to read more about the good rural folk, click on http://drtramaprasad.blogspot.in/2017/08/rural-are-real.html
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Dr. T. Rama Prasad, www.rama-scribbles.in http://drtramaprasad.blogspot.in
'PAY WHAT YOU CAN’ Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre, Perundurai.
WORLD HEART DAY … September 29
Various writings and ads (with commercial colour of discounts) appeared today across the globe scaring the public about their heart health. Some of them, purported to be of educative value to the public, may have a hidden agenda of vested interests. And, some normal persons may be converted into patients ! People are confused on knowing about needless tests, medicines and even surgeries.
Much of the modern treatment may be like cutting some of the branches of an evil tree without tackling the roots. ‘Modernity’ in lifestyle brought in its wake all the adverse factors, STRESS & ECOLOGICAL IMBALANCE (destruction of Nature) being the important ones, associated with money, materialism, competition, comparison, ego, hubris, hegemony, selfishness, greed, arrogance, anger, miserliness, manipulability, vanity, vengeance, etc. MODERNITY may be the root cause for the arrival of COVID. Moderns may have to mend their ways to prevent emergence of more novel viruses. Should we celebrate March 11 (March 11, 2020 was the day on which the WHO declared ‘Covid’ as a pandemic) as the ‘WORLD COVID DAY’ ? Or, should it be December 31 when the first outbreak in the world was reported in China in 2019 ?
Cell phones arrived, we forgot writing letters;
Automobiles arrived, we forgot walking;
Computers arrived, we forgot spellings;
Calculators arrived, we forgot mathematics;
Modern jobs arrived, we forgot families;
TVs arrived, we forgot cinema theatres;
Digital games arrived, we forgot playgrounds;
Modern pharma arrived, we forgot grannies’ remedies;
Speciality hospitals arrived, we forgot ‘MBBS clinics’;
Super-specialists arrived, we forgot family doctors;
Nuclear families arrived, we forgot relationships;
Junk food arrived, we forgot healthy meals;
Food courts arrived, we forgot cooking;
HEART specialists arrived, we forgot HEARTY meals !
COVID has arrived, we forgot everything else !
(In 24 months, 24 of my articles on COVID were published – a WORLD RECORD !)
Dr. T. Rama Prasad,
https://drtramaprasad.blogspot.com www.rama-scribbles.in
drtramaprasad@gmail.com, Director, 'PAY WHAT YOU CAN' Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.
The first outbreak of COVID in the world was reported in China on the very next day (31.12.2019) of taking the above photo on 30.12.2019 !!!
“We are sometimes praised and sometimes pilloried. We should neither bask in the glory of success nor sulk in the shadows of defeat.”
