Pictures of what I call 'living walls' of old houses in Mangalore. The region is known for its laterite soil and the use of laterite bricks in construction. Unlike walls of concrete, these can support luxuriant vegetation including ferns. Alas, concrete is taking over the city.

Colleagues at NIE have published a qualitative study of the Direct Benefit scheme of Nikshay Poshan Yojana accessible at rdcu.be/dKhez. The study highlights that the scheme is beneficial, but could do with simplification, timely disbursal & revision of benefit amounts.

Irrational use of antibiotics like azithromycin for viral URIs in India increases AMR. A patient treated outside for a LRTI with azithromycin, presented with septic shock. Blood culture grew S.pneumoniae resistant to macrolides but sensitive to penicillins. we walk on v.thin ice!

A high-risk behavior urban docs may not be aware when seeing a rural livestock-rearing patient. In one such patient with puo of 4 mo, i asked- How many goats have delivered in last 6 mo? 3. Did you bury the placenta barehanded? Yes. Blood culture positive for brucellosis. Q.E.D!

The top graphic is the cumulative CO2 emissions for countries between 1950-2000 and the bottom graphic is the distribution of 4 climate sensitive health effects. Those who contributed the least will suffer the most-a catastrophic health inequity. 10.1007/s10393-007-0141-1

We cannot get the hepatitis B vaccine for healthcare workers or dialysis patients who need protection. This shortage of an essential vaccine is a serious issue endangering public health. newindianexpress.com/states/kerala/…

Classic books on TB from 1940s recently purchased by me online. Still valuable insights on pathogenesis and epidemiology of TB." ..from too much zeal for the new, and contempt for what is old, from putting knowledge before wisdom,..Good Lord deliver us"- Robert Hutchison's Litany

In the current predicament that aspiring medical students in India face , a letter from seniors, based on personal experience of the deeply meaningful possibilities that the profession of medicine still offers in India. I wholly agree too. scroll.in/article/106998…

thelancet.com/journals/langl… . An important study for predictors of dengue in acute febrile illness in endemic areas. Blood counts on day 2-5 of illness useful with low WBC, and low platelets predictive of dengue. 25% of dengue patients can have resp symptoms. NS1 < 70%sens after3 d.

thelancet.com/journals/langl…. An accompanying edit. Dengue is now presenting with GI symptoms with diarrhea with jaundice too in severe dengue. Trends in pulse pressure and hematocrit help to detect capillary leakage and should be focussed on rather than platelet counts alone.

Zika is also transmitted by Aedes vectors. The fever is lower grade than in dengue, there may be a pruritic rash, arthralgia, and non-purulent conjunctivitis (not seen in dengue). 2 of these 4 features are suggestive. Platelet counts are normal. Testing largely ltd to ref. labs

Acute undifferentiated fevers are a dilemma and challenge for clinicians in low-resource settings. IN 2018, I with colleagues published an approach based on epidemiology, clinical features & results of simple tests in the BMJ. There were nice infographics too. Still relevant.

Have we learned anything? - thelancet.com/journals/lanin… This is a call to apply the lessons of COVID to the outbreak of avian influenza in dairy herds in US and monkeypox in DRC. Cows were considered resistant to avian flu but it is multiplying in milk glands & milking can spread it

Bedaquiline has been a game-changer for drug-resistant TB. Was a privilege to be part of an international collab to review how best to preserve the drug and make it more accessible. The Lancet Madhu Pai, MD, PhD SP Kalantri Anurag Bhargava Madhavi Bhargava Survivors Against TB Malathy Iyer Anant Bhan

Letter from Mangalore nmji.in/letter-from-ma… Deficiencies in clinical skills is a growing problem. This is a light-hearted piece on the situation where some can't pick up lymph nodes and others fail to look for them. The terms coined are pure neologisms!@spkalantri@abe_verghese

I am speechless! Anurag Bhargava Bharati Kulkarni Rema Nagarajan Center for Nutrition Studies yogesh jain Parth | पार्थ Fabian Panthaki Neha Faruqui Anant Bhan Dr Arun Gupta MD (Pediatrics-1976) FIAP Vani Sethi Khyati Tiwari indiaretailing.com/2024/09/04/mcd…