Tuesday, September 15, 2009

Dr. R.K.Gadgil, our most affectionate Dean

Last week , I got a call from Dr. Pravin Gupte, a senior pathologist . ' Make yourself free this Sunday night as our Grant Medical College Alumni Club Thane is having a get together to felicitate Dr. Gadgil, our ex Dean ' he said.

Oh !! what a pleasant thing to hear. I was looking forward to the Sunday to see this 87 year old great person, who had won international awards for his pioneering research work in 1952 for human infection of schistosomiasis in the remote villages of south Konkan.

When I was admitted to the college, our Dean was Dr.Karandikar . After him, I think it was Dr. Gadgil and then Dr. Lele. At that time I was not aware of his great personal charm, as there was no chance of interacting with him as a student.

The speakers that day had interacted with him very often in respect of some college activity or some problems in the hostel or resident quarters. GMC is always full of problems and that creates the liveliness in the campus.

Dr. G.B.Kulkarni welcomed Dr.Gadgil, Mr.Ramesh Gadgil of Medreich SaiMirra, the sponsors of the evening, Dr.Gupte, the chief architect and convener of this function and the committee members of the club, to the dais.

On behalf of the sponsors Mr. Ramesh Gadgil of Medreich SaiMirra was asked to say a few words before the programme started.

He is a very popular figure amongst Thane doctors. He is always ready to come forward for any program organized, especially if it is in Thane.

Dr. Kolge welcomed the guest and Dr Gupte gave a brief introduction of him. It was great to have Dr. Vijay Panikar, my batch mate and a very close friend, amongst us that evening .

He had come all the way from Dadar, from his busy schedule He did not want to miss this function, being very closely associated with Sir, as Vijay was the CS at that time and had a lot to share in his address.

It was decided to have an interacting session involving doctors to narrate their experiences and asking Sir questions related to that incident. This turned out to be a great success than having only the guest to speak and then have a question answer session.

Dr.Gupte took us down memory lane to an era more than 30 years ago. We were junior students when he was a post grad in pathology and so associated more with Dr. Gadgil in addition to his cultural activities of Marathi Vangmay mandal. He told of how he saw the test matches at Brabourne stadium for the entire 5 days from Sir's residence balcony over cups of tea. He also made Sir tell in detail about the story of Joshua, a Malaysian student who was an addict and wanted to reform. Sir had taken him home to stay with his family, dine with them, study along with Sir's children and travel to and fro with Sir.

Another story was narrated by Dr. Chhaya. She had come home for a short break and when she returned to the hostel, she found her belongings thrown out by an arrogant room partner. She went to the Dean's office, which was always open to all, at all times. When she entered there were already two groups of people narrating their problems and so Chhaya stood there not knowing when to begin. Sir looked at her and asked ' What the problem '. She said ' All others are talking.' ' You also start ' Sir said, ' I can hear you all !!! ' Her problem got solved in sometime.

Dr. Benny narrated about the day of admission to the college.

Sir congratulated her on getting the admission and asked her ' Do you know any other meaning to your name Benedicta ? ' She said no , to which he replied it also stands for the Benedict Test for sugar --- sweet.

Next was the presentation of the Citation in the traditional ' Shawl and Sreephal ' way, by the Alumni Club Thane.

Dr. Pawar told about the rowdy parties that used to go in the next room and how his balcony and room was literally messed about as on one such party the boys had used it as a toilet, when he was out on duty. He went to Sir to narrate the incident.

He was given a sweeper to clean up the mess and had summoned the other students, who returned and profusely appologised to Dr.Pawar. Sir might have given them the dose of a lifetime in a typical GMCite way.

Dr. Tambe was the other speaker.

Dr. Sushil Shah of the famous Metropolis Chain of Laboratories, spoke about the casual remark that Sir had made to him, that has taken him to these heights.

' Do something different than a routine pathology work. Endocrine Pathology is the future .' This was a chance remark that has made Dr. Sushil so famous and successful.

After a vote of thanks the session ended with the ' always looked forward to ' coctails and dinner.

Sunday, September 13, 2009


Last night I attended the launch of a poly-pill for the treatment of cardiovascular diseases. The talk was organized by Cadilla Pharmaceuticals at Satkar residency and the speaker was the eminent cardiologist Dr. Dayanand Kumbla.

Most of the patients require multi drug therapy for the control of various problems and they get fed up of popping in many pills in a day. The concept of a poly-pill is to put together many drugs in a single pill for convenience. That is an advantage but I personally have reservations. It is fine for a patient taking these drugs in that particular doses in a fixed combination, but may be incorrect for a generalized thoughtless prescription. It may put an additional burden on a physician to think correctly at the very short time available of writing down a prescription in a busy schedule.

This pill known as Polycap contains Symvastatin 20mg, Ramipril 5mg, Atenolol 50mg, HCTZ 12.5mg, Aspirin 100mg.

Here comes the problem for me and may be for a few fellow practitioners.

Though many studies have been published on symvastatin, it is atorvastatin that has mostly been in use over the past few years. Now rosuvastatin is gaining popularity and will be the future popular statin.

Ramipril is mostly used post episode, more for secondary prevention than for a primary prevention. Ramipril with HCTZ will be beneficial for hypertension control in this polypill.

Atenolol has had its good time and is on retirement. Other beta blockers are more favoured in practice. Due to the side effects of impotency and adverse lipids highlighted during the promotion of Atenolol as a first line treatment for young hypertensives, I never used it for HT control in young people and preferred the other molecules instead. Role of B-blockers post episode is non debatable. Hence use will be mostly for secondary prevention

Aspirin 100mg is fine, but should be used with close monitoring.

All the molecules being in a fixed dose, there is no scope for titration. In a busy schedule, a larger than required dose may go to some patients. When each drug is written separately, we can give a thought to each doses. Secondly, if many companies come out with this concept, there should be a standard drug list in each polypill, or else there will be a great strain on a prescribing physician to remember what drug and in what doses the various pills contain and probability of error increases.

The only positive thing is a convenience for the patient, but a great responsibility on the doctor, hence the use will be very restricted.

Well, only time will tell about the success of a Polypill.