Dr. T. Rama Prasad's QUOTES
1. "You had learnt to live with your wife / husband.
Now learn to live with Mrs. / Mr. Corona also.
Because you are wedded to both and can't divorce !" -- T. Rama Prasad
"Anything is OK so long as you are not near the 'corona infected', known or unknown. But the problem is how to know the unknown -- so take precautions, but don't be obsessive and theoretical." -- T. Rama Prasad
Strict implementation of 'hygiene advisory' would have been sufficient."
-----------------------------------------------------------------------------------------------------------------
"Going forward, the COVID-19 could become a 'viral/bacterial syndemic' posing to kill many more synergistically by joining hands with other microbes, what with the antibiotic resistance across the world and the weakened immunity."
-- T. Rama Prasad
-------------------------------------------------------------------------------------------------------------------
 |
| Under the 'cytokine storm' of corona, under the umbrella of ICU |
2. "FASHION is blind, more blind with
these fashionable spectacles !"
wise grandmas, traditional recipe, ... and rarely ill.
always ill."
aberrant though," say the doting parents
of modern, trendy children !
instead of a simple family doctor ! "
his pound of flesh, the nearly empty wallet is
passed on to the psychiatrist ! Dear ones, take it
in a lighter vein ... there is only half truth in this."
barred unless you have deep pockets."
'treat' lab reports, scan reports and endo
reports rather than the patient."
"What fever is it ?"
"What is the sudden death due to ?"
"Why did not the patient come alive out of the
These oft-repeated ready-made answers
12. "The most effective and least toxic drug of
today may be banned after sometime.
Vioxx, Zeinorm, Baycol, Redux -- were they
not banned ?"
13. "OLD DRUGS -- known devils;
 |
| Think positively -- the glass is half full. |
at things
matters most in life -- whatever it is -- food,
shelter, job, facilities, family, friends, place,
ambience, dress, customs, religion, spirituality,
service, society, sex, or whatever."
but only to exist."
to agree that all dogs have three legs."
the feeling that one has enough of it.
Contentment is the real wealth."
20. "Think positively. The more you think of
your disability, the more disabled would you be."
21. "Pampering is a shortcut to be in good books."
22. "Life is full of presumptions and compromises.
We presume that car brakes won't fail, and that
we shall wake up next morning. When things
go against these presumptions, we compromise."
23. "The best way of responding to a pig-headed
arguer is to say 'I totally agree with you'."
24. "It all depends on the way you look at it. The
glass is half full or half empty. Think positively
-- it is half full."
28. "Stress sarts at LKG and ends only
to your life."
30. "Age is a fast engine that runs without fuel.
Slow it down by smiling at it."
31. "Humility and humbleness readily earn one's
respect and reverence."
32. "Successful people leave their ego behind, at least,
until they succeed."
33. "Ego and arrogance readily makes one
detestable and despicable."
34. "Money is the main fuel to launch ego
and arrogance."
35. "Our ego is our frontline enemy. And,
our humbleness is our sound foundation."
36. "Society is good or bad depending on what
we are. It is a mirror, just reflects us."
37. "Your attitude is what finally makes you,
not your achievements.
38. "If your attitude is not praiseworthy,
your praiseworthy achievements pale
into insignificance."
39. "Truculent attitude at once qualifies you to be
stared with total contempt."
40. "Attitude matters a lot. It may make or mar."
bed, and irons it on waking up is physically
fit and economically viable."
(I do it quite often, but it is more out of an obsession towards sartorial
perfection -- T. Rama Prasad.).
42. "Be wise. Agree, if it's futile to argue."
43. "Be wise. Learn to tolerate, if you can't correct."
44. "If your worthiness is doubted, be proud
of it, because people doubt the purity of gold
but not of iron."
45. "Love your religion;
Hate not other religions;
At least, tolerate them."
46. "The combine of a little aesthetic sense and a
little time every day is what makes a home
tidy, healthy and beautiful. Results are better
when all the family members have that sense
and a little time rather than entrusting the job
to servants."
47. "You are mature when you can
differentiate flattering from praising."
48. "To get a work done well, you should know how
to do it. A servant's work is as good
as the master's knowledge about it."
49. "Earning a lot of money is not the be-all and
end-all, but these days, money is ranked next
to oxygen."
50. "Side effects of AFFLUENCE:
Arrogance
Adamance
Ego
One-upmanship
Vices
Treatment:
Help the poor."
51. "Why are you so happy and stress-free, man ?"
The man sitting on the roadside replied:
"Because, I don't have a credit card and bank
loans now. I had them previously which brought
me to this level."
The rest of the 100 quotes are yet to be uploaded
United States’ pharmaceutical giant Eli Lilly has launched its weight-loss and diabetes drug, Mounjaro, in India. Known chemically as tirzepatide, the once-weekly injectable medication arrives amid soaring global demand and rising concern over obesity-related complications in the country. However, the price point may still make it out of reach for most Indian patients. Mounjaro is priced at Rs 3,500 for a 2.5 mg vial and Rs 4,375 for a 5 mg vial, translating to Rs 17,500 per month for a patient on a 5 mg weekly dose — raising affordability questions in India’s cost-sensitive healthcare market. The prescription-only weekly injectable drug is designed primarily for people with type 2 diabetes or those with obesity and related health issues like hypertension or heart disease."
It may be interesting to know how companies struggle to make new drugs and market them. Of late, there has been a growing suspicion about the veracity of some of the rolled out statistics and the validity of conclusions of some research studies. Read my writing titled "MEDICAL LITERATURE" Go to https://drtramaprasad.blogspot.com/2017/03/medical-literature.html to know the unknown ! -- read it, it's only a click away. You may be surprised. And, read my writing titled "MEDICAL CONFERENCES" to know of the ingeneous ways of promoting their products at https://drtramaprasad.blogspot.com/2017/04/medical-conferences-clinical-meetings_30.html .
We can't find fault with either the manufacturers or the doctors, as they all struggle in this competitive 'Kaliyuga' to thrive !!! If interested to know more, read my writing titled "THE NOBLE PROFESSION ..." at
COVID medical literature – the Good, the Bad and the Ugly
Author : Dr. T. Rama Prasad
Rama Prasad. T., COVID medical literature – the Good, the Bad and the Ugly. The Antiseptic, 2022 September;
Vol. 119; No. 9; P: 07-19; Indexed in IndMED – www.antiseptic.in
https://drtramaprasad.blogspot.com/2017/03/medical-literature.html
AA
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 suggest to 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. ”
Tall claims are often made of the benefits of numerous things which may gain entry into medical journals which doesn't automatically mean authenticity and robust evidence. About the frauds in research and publication, go through my article titled "COVID Medical Literature -- the Good, the Bad and the Ugly" in the link below -- https://drtramaprasad.blogspot.com/2017/03/medical-literature.html
"Are there any type 2 diabetes medicines that can help people lose weight and lower their blood sugar? Are there side effects?"
Read further down below the answer from M. Regina Castro, M.D.ABOUT THE AUTHOR,
ABOUT THE AUTHOR,
Dr. T. Rama Prasad
Dr. T. Rama Prasad is the WORLD RECORD holder of authoring 28 articles related to COVID-19 in 30 months, published in a medical journal (The Antiseptic – www.theantiseptic.in -- Indexed in IndMED), and reporting in the same journal the WORLD’s FIRST CASE of ‘Yellow Nail Syndrome’ (YNS) associated with COVID-19, PT & DM (https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html ). Interestingly, he reported the first case of YNS from India in an American medical journal, CHEST, long ago in 1980. He wrote his first article in the premier journal, The Antiseptic, four decades ago. Many of his thousands of articles written over half-a-century may be accessed at https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html & https://drtramaprasad.blogspot.com/2017/04/my-in-newspapers_28.html & https://drtramaprasad.blogspot.com .
He is the former MEDICAL SUPERINTENDENT (Special) of R.T. Sanatorium & Perundurai Medical College and Research Centre. Presently, he is the Senior Consultant in TB & Lung Diseases, and the Director at ‘PAY WHAT YOU CAN’ Clinic, Perundurai, He is the recipient of the “Lifetime Achievement Award” of the ‘Coimbatore Respiratory Society’, and the honorific title “Perundurai Rathinam” from the body of ‘Perundurai Public’.
Apart from these 'type2 diabetes medicines(GLP-1 receptor agonists)', there are some other drugs known to reduce excessive body weight -- Benzphetamine, Bupropion, Naltrexone, Liraglutide, Oristat, Phendimetrazine, Phentermine, Topiramate, etc. Obesity is a very complex phenomenon, and most of the non-pharmaceutical and pharmaceutical measures didn't stand the test of time.
FATTY HAPPY MAN
The 'obesity drugs' market is expected to cross $100 billion in the next decade ! They would definitely reduce the weight in the pocket !!! What's WRONG ? And what's RIGHT ?
The buzz around the expensive injectable weight-reducing anti-diabetic drugs has got louder with the announcement that TIRZEPATIDE (Mounjaro) and SEMAGLUTIDE (WEGOVY / OZEMPIC) injections will be available in the Indian market by 2025 / 26. The usual dose is one injection every week. Semaglutide is also available as tablets for weight reduction. One tablet a day of ORFORGLIPRON may become very popular. And there are other brands like Liraglutide, Orliistat, etc.
It makes good business sense for the 'pharma-medical' industry to amplify the buzz as India has eight crores of obese people, including one crore in the age group of 5 to 19 years. And also because India is the 'Diabetes Capital' of the world, having more than 20 crores of diabetics. Let alone the prohibitive cost of the injections (the cost would come down with increased usage), would it be WRONG to think that they also won't stand the test of time ? In the US, around 60% of the patients stopped taking these 'injectable weight-loss drugs' after taking for one year (Journal of Managed Care and Specialty Pharmacy').
The 'FATTY HAPPY MAN' is the one who sells all these drugs and laughs his way to the bank !!!
FATTY LEAN MAN !!!
High fat means high cholesterol; high cholesterol means high heart attacks. Right or wrong ? Lean body means low fat; low fat means no heart attacks. Right or wrong ?
FATTY LEAN PERSON !!! How can a lean-looking person be fatty ? In recent years, it is found that some of the people who look normal are loaded with a lot of fat inside their chests and abdomens which makes them vulnerable to metabolic diseases. We used to assess the fat content of a person by just looking at him / her.
Then came the 'Body Mass Index (BMI)' as a standard to estimate the "fattiness" (mass) of the body (calculated by dividing the weight in kilograms by the height in metres squared -- for a weight of 70 kg and a height of 170 cm, the BMI would be 24.22 -- less than 18.5 is considered as underweight, 18.5 to 24.9 is normal, then up to 29.9 is overweight, then up to 34.9 is obesity class I, then up to 39.9 is obesity class II, then over 40 is obesity class III).
It should be noted that body fatness (which is generally equated to bad cholesterol levels) is just one of the various factors that determine the overall health. In fact, certain amount of cholesterol is necessary for maintaining good health. Maintenance of normal body functions is a highly complex one which involves trillions of cells functioning in sync. One disruption may lead to a cascading effect of a disaster.
BMI, WC, WHR, WHtR, BRI, BCA
For about half-a-century, BMI alone has been recommended as the metric to measure obesity. But, BMI does not indicate how much of the weight is fat and where the fat is distributed in the body. Fat in the abdomen particularly ( something that Indians are GENETICALLY predisposed to accumulate ) contributes to metabolic syndrome, a group of risk factors that iincreases the chances of developing type 2 diabetes, bad cholesterols, stroke and heart disease. In recent years, it has come to the knowledge that BMI alone can't give an idea of the fat inside the body (visceral fat), and that a simple measurement of "Waist Circumference (WC)" and "Waist / Height Ratio" gives a better assessment.
Until recently, a person, apparently looking physically normal with normal BMI, normal height and weight, normal lifestyle and doing normal work was considered not to have a risk associated with excessive weight, bad cholesterol, diabetes, high blood pressure, heart diseases, etc. as he was supposed not to have excessive fat. Today, it's supposed to be a WRONG assumption, as he may be having a lot of VISCERAL FAT inside his chest and abdomen which can't be assessed by BMI test.
A person of “normal” weight and “normal” BMI may have a lot of VISCERAL FAT (of large organs inside the body), around the heart, lungs, liver, pancreas, etc. !!! And they are at the risk of developing diabetes, cardiovascular disease and ‘metabolic syndrome’.
The RIGHT assumption now is that measurement of "Waist Circumference" gives a better indication than BMI about 'visceral fat load' and the attendant metabolic and cardio-vascular diseases. As such, a set of new measurements to quantify the VISCERAL FAT are coming into vogue which are recommended to be used in addition to BMI.
https://www.nature.com/articles/s41574-019-0310-7 (Waist Circumference as a Vital Sign in Clinical Practice : a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity)
‘Waist Circumference (WC)’ measurement at the level of umbilicus may give an idea of visceral fat deposition better than the BMI (below 90 cm / 35.4 inches for men and below 80 cm / 31.4 inches for women is normal). The 'Waist to Hip Ratio (WHR)' parameter (below 0.9 for men and below 0.85, and more than 1 is linked to increased risk of heart disease) may be a better option. These two tests, as indicators of good health, require just a measuring tape to do. A couple of other similar tests may give more information -- 'Body Roundness Index (BRI)' to assess abdominal fat content (below 4.5 is normal, above 6.91 is high); 'Body Composition Analysis (BCA)' test gives the percentage of fat (10 to 30 % is normal) , bone and muscle in the body. These two tests can be done by simple machines. Will all this be a WRONG assessment of the risk after sometime !!!
"The National Heart, Lung and Blood Institute (NHLBI), International Diabetes Federation (IDF), and American Heart Institute (AHI) consider only waist measurement. The NHLBI and AHI define a healthy waist size as: 35 inches or less for women. 40 inches or less for men.19 Jul 2024 " Can these measurements be RIGHT for Indians ?
"WAIST to HEIGHT Ratio (WHtR) : In general, having a WAIST CIRCUMFERENCE of less than half of the HEIGHT of an individual is healthy. This may be taken as a 'VITAL SIGN' in clinical practice.
WHtR of 0.4 to 0.49 is healthy; 0.5 to 0.59 indicates increased risk; 0.6 or more means high risk. This measurement may be made as a routine check-up for the patients, or even by people at home to know their 'fat status'. It requires only a measuring tape." -- T. Rama Prasad
INDIAN POTBELLY
South Asians, particularly Indians, tend to accumulate excessive visceral fat. It may start while still in the wombs of malnourished Indian mothers. Excess fat gets deposited, especially in the liver and pancreas. Fat metabolism seems to play as important a role as carbohydrate metabolism. Excess fat in the liver leads to insulin resistance. A fat-loaded pancreas produces less insulin. Curiously, some babies born in India are found to be small in size though they have more fat than a normal proportion --- "Thin Fat Indian Child." When they grow up, they may become TOFIs (Thin Outside and Fat Inside) !!! Some attribute the "Thin-fatty phenomenon" to a "Thrifty Gene" evolved during famines in the past, to build up reserves in the form of visceral fat. If it is genetic, is it modifiable ?
One may say, citing the mythological figures in the epics, that potbelly is a racial characteristic and that efforts to melt it would be an exercise in futility. RIGHT or WRONG ? "Potbelly sculptures' have been associated with FAT GOD of Mesoamerican mythology. Mahabali, Buddha, Kubera, Ganesha and others are visualised as potbellied deities.
Obesity is a major public health problem worldwide which could not be brought down in spite of a tremendous build up of knowledge and its application. What's WRONG ? Can the new drug TIRZEPATIDE set it RIGHT ? This drug under the brand name MOUNJARO of Eli Lilly company costs around 1,000 US dollars per fill. It is expected to be available in the Indian market by 2025. The 'obesity drugs' market is expected to cross $100 billion in the next decade ! They would definitely reduce the weight in the pocket !!!
There are some other drugs known to reduce excessive body weight -- Benzphetamine, Bupropion, Naltrexone, Liraglutide, Oristat, Phendimetrazine, Phentermine, Topiramate, etc. Obesity is a very complex phenomenon, and most of the non-pharmaceutical and pharmaceutical measures didn't stand the test of time.
Interestingly, some recently introduced 'type2 diabetes medicines' (GLP-1 receptor agonists) like SEMAGLUTIDE (Wegovy / Ozempic) and TIRZEPATIDE (Mounjaro) are being used to reduce excessive body weight even in non-diabetics.
As food is inseparably associated with body fat, you may be interested to go through : https://drtramaprasad.blogspot.com/2017/04/food-exercise-and-sleep_25.html which is just a click away. And, it has become a fashion to blame everything on JUNK FOOD and DIGITAL SCREENS !!! And, food and body fat are part of the Diabetes problem. You may read my 'Scribbling' on DIABETES at : https://drtramaprasad.blogspot.com/2017/04/diabetes_29.html
DIABETES
-- Dr. T. Rama Prasad
Obesity is a major public health problem worldwide which could not be brought down in spite of a tremendous build up of knowledge and its application. What's WRONG ? Can the new ANTI-DIABETIC drug TIRZEPATIDE set it RIGHT ? This injectable drug under the brand name MOUNJARO of Eli Lilly company costs around 1,000 US dollars per fill. It is available in the Indian market from March 2025 at a price of Rs. 4,375. The 'obesity drugs' market is expected to cross $100 billion in the next decade ! They would definitely reduce the weight in the pocket !!! In addition, TIRZEPATIDE is approved by the US FDA to treat OBSTRUCTIVE SLEEP APNEA (OSA) also.
 |
BLUE CIRCLE is the 'Universal Symbol' for Diabetes |
But there’s hope! Advances in diabetes management and healthcare have significantly improved mortality rates.
We have developed a number of drugs and devices to control diabetes, but we couldn't find the exact cause which makes one a diabetic, except blaming the imperfect lifestyle or the genes. Perhaps, multiple factors are involved -- some known and some unknown ... even the toothpaste may be the one ! Researchers from the University of Texas found (2018) that crystalline particles of titanium dioxide were found in pancreas specimens from Type 2 diabetics. Titanium dioxide has become the commonly used white pigment in paints, food items, toothpaste, cosmetics, plastics and paper.
Are there any type 2 diabetes medicines that can help people lose weight and lower their blood sugar? Are there side effects?
Answer From M. Regina Castro, M.D. :There are two main groups of type 2 diabetes medicines that lower blood sugar and also may lead to weight loss. The first group is glucagon-like peptide 1 (GLP-1) agonists. The second is sodium glucose cotransporter 2 (SGLT-2) inhibitors.
GLP-1 agonists
GLP-1 agonists for type 2 diabetes are generally taken by a shot, also called an injection. Most are taken once a day or once a week. GLP-1 agonists include the following medicines.
Taken once a day by a shot:
- Liraglutide (Victoza, Saxenda).
- Lixisenatide (Adlyxin).
Taken twice a day by a shot:
- Exenatide (Byetta).
Taken once a week by a shot:
- Dulaglutide (Trulicity).
- Exenatide extended release (Bydureon BCise).
- Semaglutide (Ozempic).
Another form of semaglutide is available in a pill that's taken by mouth once a day. The brand name of that medicine is Rybelsus.
Tirzepatide (Mounjaro) is a similar kind of medicine called a dual-acting GLP-1/GIP agonist. It's also used to control blood sugar and can support weight loss. It is taken once a week by a shot.
All GLP-1 agonists can help with weight loss. But the amount of weight loss depends on the type of medicine and the dose. In general, studies have found that tirzepatide and semaglutide are the most effective for weight loss. Dulaglutide and liraglutide also have been found to be very effective. Other GLP-1 agonists appear to be somewhat less effective for weight loss. But people who take them still have better weight loss results than those who do not take the medicine.
GLP-1 agonists mimic the way a hormone called glucagon-like peptide 1 works in the body. When blood sugar starts to rise after a person eats, these medicines cause the body to make more insulin. The extra insulin helps lower blood sugar.
Lower blood sugar helps control type 2 diabetes. But it's not clear exactly how GLP-1 agonists lead to weight loss. They appear to curb hunger. They also slow the movement of food from the stomach into the small intestine. That means you may feel full faster and longer, so you eat less.
As with any medicine, there is a risk of side effects when taking a GLP-1 agonist. Some side effects can be serious. More common side effects often improve after taking the medicine for a while.
Common side effects include:
- Nausea.
- Vomiting.
- Diarrhea.
- Headache.
Low blood sugar is a more serious risk linked to GLP-1 agonists. The medical term for that condition is hypoglycemia. But the risk of low blood sugar typically only goes up when a person also is taking another medicine that's known to lower blood sugar. Examples include sulfonylureas and insulin.
GLP-1 agonists aren't recommended for people who:
- Have had medullary thyroid cancer or who have a family history of the disease.
- Have had multiple endocrine neoplasia or who have a family history of the disease.
- Have had pancreatitis.
- Are pregnant or are actively trying to get pregnant.
- Are breastfeeding.
Certain GLP-1 agonists may not be appropriate for people who have a health condition that affects the intestines, such as gastroparesis, or for people who have some types of kidney disease.
Studies have linked GLP-1 agonists with certain thyroid tumors in rats. But until more long-term studies are done, the risk to humans isn't known.
SGLT-2 inhibitors
SGLT-2 inhibitors come in a pill that's taken once a day. They include the following medicines:
- Canagliflozin (Invokana).
- Dapagliflozin (Farxiga).
- Empagliflozin (Jardiance).
- Ertugliflozin (Steglatro).
- Bexagliflozin (Brenzavvy).
These medicines work in the kidneys where they help take extra sugar out of the blood that then goes out of the body in urine. This lowers blood sugar. It also can help with weight loss. The weight loss benefits of SGLT-2 inhibitors typically are less than those of GLP-1 agonists.
Side effects of SGLT-2 inhibitors may include:
- Genital yeast infections.
- Urinary tract infections.
- Lightheadedness.
- Dizziness.
- Nausea.
- Kidney injury.
- Weaker bones and a higher risk of broken bones.
- A higher risk of diabetic ketoacidosis.
Rarely, SGLT-2 may be linked to a higher risk of infection in the feet and lower legs. If an infection is serious, it could lead to the need for amputation. People who have had wounds on their feet or other problems with their feet or lower legs should talk with their healthcare professionals about the possible risks before taking an SGLT-2.
SGLT-2 inhibitors aren't recommended for people who have had diabetic ketoacidosis. They also may not be a good choice for people with certain types of kidney disease.
Benefits beyond weight loss
Along with helping to control blood sugar and boosting weight loss, GLP-1 agonists and SGLT-2 inhibitors seem to have other health benefits.
Research has found that some of these medicines may lower the risk of certain serious health conditions, such as kidney disease, heart disease, heart failure and stroke. Many people who take these medicines also see their blood pressure improve. But it's not clear whether these benefits are from the medicine or a result of weight loss.
If you have type 2 diabetes and you want to find out if these medicines might be useful for you to lose weight, talk with your diabetes care team. They can help you decide what's best for your situation.
Even in those days, I used to 'scribble' something for publication. Hereunder are a few reprints of the published writings which are of 'archaic knowledge and of historical interest' at this point of time -- 2017 - 2024. They may hardly have any relevance to the present scenario.
-- T. Rama Prasad
 | |
|
 | |
|
 |
| NEW DRUGS in DIABETES in 1998 |
“ … It is a refreshing experience to learn more about the age-old and important problem of ‘Diabetic Foot’. Thank you very much Dr. E. Thangavelu for enlightening us. This subject takes me down memory lane kindling nostalgic thoughts. It was half-a-century ago ( in 1967 -- most of you who are here now were yet to be born at that point of time ! ) when I joined as a Medical Officer at the ‘Perundurai Sanatorium’, and the first case I saw was a patient with ‘diabetic foot’ with gangrene and lung TB. There were no big corporate hospitals or diabetologists here around and there were not many alternative drugs to diabetes or TB. And today we are talking about ‘new’ anti-diabetic drugs while the incidence of diabetes and TB has been increasing enormously over the decades.
There are many DPP-4 inhibitors; some are in various stages of clinical development. The first approved DPP-4 was sitagliptin in 2006. Later, vildagliptin, saxagliptin, alogliptine, linagliptine, anagliptin and teneligliptin were introduced. Phase III studies are in progress with regard to more gliptins like denagliptin. The incretin agents (GLP-1 receptor agonists and the DPP-4 inhibitors) belong to a unique class of anti-diabetic agents.
“Unless the thief decides to transform himself,
it is never possible to eradicate stealing.” (“ thirudanai parthu thirunthavital thirutai olika mudiyathu.”)
drtramaprasad@gmail.com, 'PAY WHAT YOU CAN’ Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.
I had asked one of the speakers, in a lighter vein, as to whether diabetic foot problems are more in the right foot or the left. He couldn't cite any data. Traditionally, we are advised to put the right foot first, while entering a house or going up the steps. I was wondering whether the practice of always 'starting off on the right foot' makes the right foot more vulnerable to injuries and infection ! 
Raghu Rangaswamy Hi Dr. I do accept your comments. It’s sad to say many drugs which are banned abroad citing various proven evidences are still marketed in India, which clearly indicates money can do anything in this country. I have no idea who will tie the bell to these mafias. I appreciate the recent Govt's action on bringing down the cardiac stent prices by 80% lower, the same thing should be brought on medicines too. Being in medical research I would say every medicine you take is a chemical and it’s not going to give you miracle. They bind to certain receptors which are responsible for a disease, but one can't assure the same chemical will not bind to other receptors and block the natural body function. The reason is body produces few chemicals which interacts with many receptors. For example ATP binds to nearly 300+ kinases which are involved in different body functions, when you design a kinase inhibitor even though your molecule binds to your desired kinase but it will also bind to other kinases because of the protein structural similarity. The best way one should do is to have control on the food, to change life style and to prefer natural remedies. Being in modern medicine profession, I will still give my vote to ayurveda and naturopathy. I still vouch that our ancestors were more knowledgeable than today’s technologically advanced scientists. I wonder how they identified certain herbs and plants for diseases.
Now, can we hope to get the desired results through stem cell therapy enhancing Beta cells of Islets of Langerhans which produce chiefly insulin. This can help overcome insulin resistance.
Our native herbal medicines should be encouraged on scientific lines.
********************************************************************************************************
=====================================================================
The following is a list of some of my 'scribblings', including a few from the 28 articles on COVID published in a monthly medical journal in 30 months (a world record). To open them, click on any of the titles. -- T. Rama Prasad
These are only scribbles for the general audience to pass some time, not for experts. The expressions may be biased and the narration may be a crashing bore on negative aspects. Taste a bit of the bitterness before leaving. -- T. Rama Prasad
Blog Archive
· ▼ 2017 (115)
o ▼ March (1)
o ▼ April (112)
§ OREIKLE
§ Science and Nonsense about COVID
§ WORLD CANCER DAY ..February 4, 2017
§ GRADUATION DAY -- 2018, Perundurai Medical Col...
§ "AHIMSA"
§ OMICRON
§ QUOTES
§ POLLUTION, Disease and Deepaavali
§ DOCTORS' HANDWRITING MATTERS
§ To live in INDIA or ABROAD ?
§ KMCH
§ FISHES
§ SUNDAY LUNCH ... Dec 3, 2017
§ BAHUBALI
§ DIABETES
§ MY ART
§ CANCER
§ DOGS
§ GOD-MEN
§ CODUP
§ LOCKDOWN MEDICINE -- too toxic ?
§ YOGA
§ HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS
§ SWINE FLU -- A (H1 N1) influenza
§ PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus
§ RAJYALAKSHMI RAMAPRASAD and PLANTS
§ GIRL CHILD : GOLDEN CHILD ; WOMEN POWER
§ ALLERGY, ASTHMA, COPD and ILD
§ RAPE
§ MARKETING TRICKS & INNOVATIONS
§ MODERN MEDICINE -- the Good, the Bad and th...
§ RAJYALAKSHMI & International Women's Day 2024
§ SHIVA, KRISHNA, Ramanuja & Ramanujan
§ OUR LOVE STORY & good old days
o ▼ May (2)
· ▼ 2019 (1)
o ▼ January (1)
· ▼ 2020 (3)
o ▼ February (1)
o ▼ April (1)
§ RAJYALAKSHMI RAMAPRASAD and RADIOGRAM
o ▼ June (1)
§ CORONAVIRUS COVID-19 (SARS-CoV-2)
· ▼ 2022 (1)
o ▼ October (1)
· ▼ 2023 (17)
o ▼ January (15)
§ TUBERCULOSIS -- drug-resistant
§ HEART
§ INDIAN IMMUNITY, BCG and COVID
§ WOW !!!
§ COVID vaccines -- Safe or Unsafe ?
o ▼ August (1)
§ RAMAYAAN
o ▼ October (1)
· ▼ 2024 (1)
o ▼ May (1)
Blog Archive
· ▼ 2017 (115)
o ▼ March (1)
o ▼ April (112)
§ OREIKLE
§ Science and Nonsense about COVID
§ WORLD CANCER DAY ..February 4, 2017
§ GRADUATION DAY -- 2018, Perundurai Medical Col...
§ "AHIMSA"
§ OMICRON
§ QUOTES
§ POLLUTION, Disease and Deepaavali
§ DOCTORS' HANDWRITING MATTERS
§ To live in INDIA or ABROAD ?
§ KMCH
§ FISHES
§ SUNDAY LUNCH ... Dec 3, 2017
§ BAHUBALI
§ DIABETES
§ MY ART
§ CANCER
§ DOGS
§ GOD-MEN
§ CODUP
§ LOCKDOWN MEDICINE -- too toxic ?
§ YOGA
§ HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS
§ SWINE FLU -- A (H1 N1) influenza
§ PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus
§ RAJYALAKSHMI RAMAPRASAD and PLANTS
§ GIRL CHILD : GOLDEN CHILD ; WOMEN POWER
§ ALLERGY, ASTHMA, COPD and ILD
§ RAPE
§ MARKETING TRICKS & INNOVATIONS
§ MODERN MEDICINE -- the Good, the Bad and th...
§ RAJYALAKSHMI & International Women's Day 2024
§ SHIVA, KRISHNA, Ramanuja & Ramanujan
§ OUR LOVE STORY & good old days
o ▼ May (2)
· ▼ 2019 (1)
o ▼ January (1)
· ▼ 2020 (3)
o ▼ February (1)
o ▼ April (1)
§ RAJYALAKSHMI RAMAPRASAD and RADIOGRAM
o ▼ June (1)
§ CORONAVIRUS COVID-19 (SARS-CoV-2)
· ▼ 2022 (1)
o ▼ October (1)
· ▼ 2023 (17)
o ▼ January (15)
§ TUBERCULOSIS -- drug-resistant
§ HEART
§ INDIAN IMMUNITY, BCG and COVID
§ WOW !!!
§ COVID vaccines -- Safe or Unsafe ?
o ▼ August (1)
§ RAMAYAAN
o ▼ October (1)
· ▼ 2024 (1)
o ▼ May (1)
An anecdote about “GORU”
During my childhood, one of my schoolmates had huge nails. Her name was Gowri. We nicknamed her as ‘Goru’ (‘goru’ in Telugu means nail of a finger or toe ). They used to say that her huge nails caused a problem in her heart. It might be a case of ‘Digital Clubbing’ (abnormal nails present in some ‘Congenital Heart Diseases’). After one summer vacation, ‘Goru’ didn’t come back to the school. It was learnt that she died due to the nail / heart problem, and that treatment could not be availed as they didn’t have money to pay for it.
Perhaps, this incident prompted me to look at everyone’s nails from that time which might have led me to report the first case from India of ‘Yellow Nail Syndrome (YNS)’ from India in 1980 (published in an American journal, CHEST) and the first case in the world of ‘Yellow nails & Covid’ in 2023, published in an Indian journal, THE ANTISEPTIC - https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html
And perhaps, the preventable death of ‘Goru’ due to the inability to pay for the treatment motivated me to start my ‘PAY WHAT YOU CAN’ Clinic (PWYCC) half-a-century ago where patients may pay whatever they can. No fixed fee ( http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html ). The credit for these case reports on YNS and the starting of my PWYCC should go to ‘Goru’. Thanks to “Goru”.
-- T. Rama Prasad
More at : https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html
***************************************************
This is not an ad, it’s about an odd service.
Dr. T. Rama Prasad’s
‘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
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. The money may just be put into the ‘hundi’ box kept outside the consultation room. 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 . And, if you wish, you may also 'contribute what you can' through bank (Dr. RAMA PRASAD T, A/C No. 451075868, INDIAN BANK, IFS CODE IDIB000P155, PERUNDURAI, Erode District, Tamil Nadu - 638052 ).
"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.
Facebook: T Rama Prasad Twitter: @DrRamaprasadt
Telegram : Dr T Rama Prasad
Consult your local doctor before rushing to me
Most ailments can be cured at local level
Doctor . This s true words of mankind.
ReplyDelete