Physician Scientist - American Association of Physicians of Indian ...

• Physician Scientist: Participation by International 

Medical Graduates 

• The Time For Health Care Reform Is Now 

• Larger Your Waistline Shorter Is Your Life Span! 

• Memories of an AAPI Foot Soldier 

• How Not To Invest 

• Our Parent Trap: The Importance of Not Getting Caught

AAPI Journal • June 2009 

• AMERICAN ASSOCIATION OF 

P H YSICIANS OF 

INDIAN ORIGI N 

AAPI (American Association 

of Physicians of Indian Origin) 

Sanku Rao, M.D., President 

600 Enterprise Drive, Suite 108 

Oakbrook, IL 60523 

Phone: 630-990-2277 

Fax: 630-990-2281 

www.aapiusa.org 

AAPI Journal Editor 

Sivaprasad Madduri, M.D. 

2817 Charlton Lane 

Poplar Bluff, MO 63901 

O: 573-778-7158 

H: 573-686-3632 

F: 573-686-1298 

madduri@semo.net 

The AAPI Journal is published 

quarterly by the American 

Association of Physicians of Indian 

Origin (AAPI). This publication 

may not be reproduced in whole 

or in part without the express 

written permission of the AAPI. 

All articles published including 

editorials, letters and book reviews 

represent the opinions of the 

authors and do not reflect the 

official policy of AAPI. 

Copyright© 2009 AAPI. 

All rights reserved. 

Designed & Printed by: 

GR Marketing & Graphic Design 

Tampa, Florida 

(813) 886-4500 

www.grgraphics.net 

• 

CONTENT 

Executives 

• Presidential Message Sanku Rao, M.D. ..........................4 

• Editor’s Desk 

Sivaprasad Madduri, M.D.............8 

• President-Elect’s Report Vinod Shah, M.D. ........................9 

• Vice President’s Report Ajeet R. Singhvi, M.D ................10 

• Secretary’s Report 

Prasad Srinivasan, M.D...............12 

• AAPI Charitable Foundation Krishan Agrawal, M.D.................12 

• Treasurer’s Report Narendra R. Kumar, M.D. ..........13 

• Letter To The Editor ..................................................14 

Feature 

• Turmeric and Breast Cancer Hari Sharma, M.D. ....................15 

• Vision Correction Surgeries Arun Gulani, M.D.......................16 

• Physician Scientist: Participation 

by International Medical Graduates 

Jayesh Shah, M.D. 

Dharmapuri Vidyasagar, M.D. ....17 

• Akshaya Patra’s Hunger Struggle 

A Ray of Hope for Underprivileged 

Children In India Vijaya L. Appareddy, M.D. ..........19 

• The Time for Health Care 

Reform is Now Sanku Rao, M.D. ........................21 

Special Articles 

• Join IMANE/AAPI Meeting is 

a Resounding Success Nasir Khan, M.D. ......................22 

• Larger Your Waistline Shorter 

Is Your Life Span! Purushotham Kotha, M.D. ........24 

• Memories of an AAPI 

Foot Soldier 

Onaly Kapasi, M.D.....................27 

• Perinatal Outcomes Among 

Mothers of Indian Origin 

and Prenatal Testing in The US Neeraja Kambham, M.D.............28 

• Cross Country Biking And 

Campaigning For Chronic 

Disease Prevention 

Rajan Dewar, M.D. 

Ramar Kannan, M.D...................29 

• How Not To Invest 

Monita Soni, M.D.......................31 

• Our Parent Trap: The Importance 

of Not Getting Caught Niru Madduri, M.D. ..................35 

• Fast Track in Memorial Hermann 

Emergency Department 

Swati Choudhary, M.D. 

Yashwant Chathampally, M.D. ....37 

Depatments 

• Poems 

I Made Sandwiches on 26/11 Vijay Kulkarni, M.D.....................43 

Slow Dance 

Arun Pramanik, M.D...................43 

Changing Venues Interdependence Chander M. Kapasi, M.D. ..........45 

Life Without Kidneys 

Sivaprasad Madduri, M.D...........45 

• Member In The News Arun Gulani ..........................39,41 

• Book Review Ravindra Nathan, M.D. ..................46 

About the Cover 

Bah'i Temple, New Delhi, India. 


3


President’s Message 

by Sanku Rao, M.D. 

Dear members, it’s my privilege to 

present the President’s report. 

Finances: 

Financially, AAPI is stable and 

strong. Weekly teleconferences with 

our Treasurer Dr. Narendra Kumar 

are being scheduled and the finances 

are being monitored very closely. We 

are following all the guidelines and 

paying bills very promptly. Checks 

above $2000 are being signed by the 

Treasurer and me. We filed all the 

relevant tax returns as of June 2008. 

Teleconferences: 

The monthly Executive Committee 

teleconferences are being held with 

an active participation from the 

Officers with useful discussions and 

exchange of ideas. 

Activities of past eleven months: 

• Orlando, FL: Met with Chair and 

Co-chairs of 2009 Convention 

Committee. 

• Tampa, FL: Keynote speaker at a 

conference held by Federation of 

Greater Tampa 

• Fall Governing Body Meeting in 

Oklahoma City, OK from 

October 24-26, 2008. 

• New York: Attended the annual 

meeting of Federation of AAPI of 

Greater NY and NJ and Long 

Island and Queens Chapter on 

October 18, 2008 

• Cleveland, OH: Attended the 

25th Silver Jubilee meeting of 

APINO as a keynote speaker on 

November 1, 2008 

• Grenada: Attended St. George 

University, Grenada Conference 

on November 13, 2008 and met 

with Dr. Charles Modeca, 

Chancellor of SGU. 

The university has set up 

scholarships amounting to 

$500,000 which will be issued 

to students of Indian origin every 

year and AAPI will select the 

awardees. 

• Anaheim, CA: Attended the 

annual meeting held jointly by 

Indian Medical Association of 

Greater Los Angeles and Indian 

Medical Association of Southern 

California on November 22, 

2008. 

• Wichita, KS: Attended the annual 

meeting held by AAPI Wichita 

Kansas Chapter on December 

12, 2008. 

• Atlanta, GA, Attended the CME 

on March 7th organized in 

association with Georgia 

Association of Physicians of 

Indian Origin (GAPI) 

• Orlando, FL: Attended meeting 

organized by Convention 

Committee on March 8th where 

175+ physicians from Florida 

attended. 

• Melbourne, FL: Keynote speaker 

at Brevard Indian Medical & 

Dental Association (BIMDA) 

annual meeting held on March 

28th. 

• Spring Governing Body Meeting 

at Boston, MA from April 10-12, 

2009 

• Visited Indian Embassy and met 

with Indian Ambassador Mrs. 

Meera Shanker on April 27th. 

• Legislative Day in Washington 

DC on April 28th. 

Second Indo-US Healthcare Summit, 

Delhi, India: 

The second Indo-US summit held 

from January 2-4, 2009 at La 

Meridien Hotel in New Delhi along 

with BAPIO was a huge success. 

More than 175 delegates from India, 

USA and 

Britain 

attended the 

Summit. Meeting which 

Sanku Rao, M.D. 

AAPI President 

started on 2nd afternoon with the 

press conference arranged by AAPI 

media consultant Prakash Swamy. 

Around 50 reporters attended the 

press conference where the media 

was updated with AAPI healthcare 

projects in India. The current 

healthcare status in India was 

presented by the Mackenzie 

Corporation as well as the CEOs 

from major hospitals in Delhi. This 

set the stage for a plan of action for 

the Strategic Planning committee for 

the next 5 years. Healthcare 

landscape of India which was looked 

into at length. An expert panel 

shared their thoughts and answered 

questions from the international 

delegates. The session was very 

knowledgeable and informative and 

most of the questions from the 

audience were answered. Johnson & 

Johnson sponsored dinner that 

evening. 

The summit was inaugurated by 

Honorable Minister for Overseas 

Indian Affairs, Mr. Vayalar Ravi, on 

January 3rd morning. In his 

inaugural speech, Mr. Ravi said that 

AAPI is in a position to play a 

leading role in the healthcare arena 

given its vast expertise and skill and 

informed that the Government of 

India would soon initiate talks with 

the Medical Council of India to 

enable physicians living abroad to 

practice in India. Dr. Ramesh Mehta, 

President of British Association of 

Physicians of Indian Origin (BAPIO) 

informed that the BAPIO will partner 

with AAPI from next year in the rural 

healthcare projects in India. 

Continued on page 5 

4 www.aapiusa.org



Continued from page 4 

The meeting’s aim was bringing 

together caring and dedicated 

physicians from all the three 

countries to focus on six disease 

states – Asthma and Allergy, Heart 

Diseases, Diabetes, Infectious 

Diseases, Maternal & Child Health 

and Mental Health. All 6 break-out 

sessions were done where the US & 

British Delegates working with their 

Indian counterparts on six disease 

states. The summit concluded with 

the summary of recommendations 

from each of the disease states. 

Follow up with the chairs and cochairs 

are being planned so that our 

goals are achieved. Chairs & cochairs 

are all working to present 

their recommendations at the June 

annual convention. 

The strategic planning committee 

had its own session and will draw its 

action plan for the next five years 

and give recommendations on 

which AAPI will act. 

AAPI delegation met the Chief 

Minister of New Delhi, Honorable 

Mrs. Sheila Dixit and was informed 

about our activities and goals. The 

Chief Minister was very gracious to 

offer office space in New Delhi for 

AAPI to have a local presence in 

Delhi. 

On January 5th, I met with Chief 

Minister of Andhra Pradesh Dr. Y.S. 

Rajasekhara Reddy and updated him 

regarding the Health Summit and 

the need to implement the rural 

health care initiative. At the press 

conference on the afternoon of the 

5th, AAPI, along with Andhra 

Pradesh Medical Graduates (APMG), 

outlined our vision in implementing 

the rural healthcare in Andhra 

Pradesh. 

Pravasi Bharatiya Divas: 

The Ministry of Overseas Indian 

Affairs (MOIA) in partnership with 

the State Government of Tamil Nadu 

and the Confederation of Indian 

Industry, (CII) organized the Pravasi 

Bharatiya Divas at Chennai Trade 

Center, Chennai, India from January 

7-9, 2009. AAPI delegation was 

invited for the event. I was one of 

the panelists for the session ‘Health 

for All: Role of Diaspora’ chaired by 

Dr. Anbumani Ramdoss, Union 

Health Minister of India. During my 

talk I highlighted about AAPI goals 

and its role in improving healthcare 

in India through 17 free health 

clinics which are funded by AAPICF. 

I also met with Chief Minister of 

Gujarat, Mr. Narendra Modi. Mr. 

Modi requested to send a proposal 

on AAPI’s rural healthcare project in 

the State of Gujarat. 

Global Association of Physicians of 

Indian Origin (GAPIO): 

The world’s first comprehensive 

healthcare organization is named 

Global Association of Physicians of 

Indian Origin (GAPIO) and was 

launched by Government of India at 

the Pravasi Bharatiya Divas in 

Chennai, India. This global 

consortium of healthcare 

professionals consists of 

international medical practicing 

physicians including AAPI, CAPIH 

and BAPIO. The consortium will 

promote the contribution of 

approximately 1.2 million physicians 

and dentists of Indian origin to 

global health and to harness their 

skills and expertise to address 

healthcare issues in India. 

Enrollment is free of charge. 

Chair: Dr. Pratap Reddy 

Vice Chairs: Dr. Sanku Rao (AAPI) 

and Dr. Ramesh Mehta (BAPIO) 

Advisers: Anwar Feroz & Haresh 

Kaneriya. 

Trip to Israel: 

I visited Israel at the invitation of 

the AJC (American Jewish 

Committee) and had the opportunity 

to see first hand their National 

disaster management program, MDA 

(Magen David Adom), which is one 

of the best in the world. The 

Director of MDA was able to 

interact one on one and he extended 

his support to AAPI to help develop 

a similar program for disaster 

management in India. I also visited 

the children’s hospital in Tel Aviv 

where they were performing cardiac 

surgery for children from around the 

world at almost no cost. 

AAPI CME: 

This year’s first CME program was 

held on a Greek Islands cruise from 

September 21 to 28, 2008. Three 

sessions were organized with 

speakers of high caliber and topics 

and were well chosen. The CME was 

well done and everyone enjoyed the 

visit to Greek Islands. 

The second CME program was 

held in Goa from December 28th – 

January 1st. The CME was very well 

done with interesting sessions on 

‘Hypertension and Cardio Metabolic 

Syndrome’, ‘Impaired Medical 

Students and Physicians’, ‘Neglected 

Bladder’ etc. Dr. Nasir Khan did a 

phenomenal job in putting the CME 

together. Dr. Ram Gopal is also 

instrumental in this well organized 

CME. The participants enjoyed the 

visit to Goa. 



5




The third CME was held in 

Atlanta, GA by GAPI on March 7, 

2009. The speakers were dynamic 

and the CME was of high caliber. All 

but one of the speakers were faculty 

at Emory University. Thanks to Dr. 

P.K. Natrajan and Dr. Naresh Parikh, 

for arranging a phenomenal CME 

program. 

The final CME Convention in 

Orlando is being finalized. We have 

up-to-date topics with diversified 

speaker’s bureau. Looking forward to 

a top-notch CME program. CME 

committee under the Chairmanship 

of Dr. P.K. Natrajan did a fabulous 

job in conducting CME’s. I would 

like to thank Dr. Natrajan for the 

excellent work done. 

AAPI Academic Affairs: 

• Develop a directory of 

Academic Notables 

• Assist CME Committee in 

development of agenda with 

topics and speakers. 

AAPI Observership Program: 

The AAPI Observership Committee 

headed by Chair Dr. Jayesh Shah has 

successfully begun the first phase of 

the AAPI Observership Program. We 

have selected the first batch of 

candidates and they have already 

begun their observerships. The 

Oklahoma Chapter Externship 

Program has been reorganized and 

is currently selecting candidates. The 

candidates will begin their rotations 

starting on June 15th, 2009. 

AAPI Women s Forum: 

The Women’s Healthcare Summit 

and Leadership Development was 

held March 14th, 2009 in New 

Jersey. The event was well organized 

by the Women’s Physicians 

Committee and the Federation of 

AAPI NY/NJ and they did an 

excellent job. They had excellent 

speakers during the Summit. I want 

to thank Dr. Seema Jain, Dr. Tarun 

Shah and Dr. Thomas Alapatt for the 

successful event. 

AAPI Spring Governing Body 

Meeting: 

The Spring Governing Body 

Meeting held in Boston went very 

well. I would like to thank The 

Indian Medical Association of New 

England (IMANE), and President Dr. 

Nasir Khan for hosting the event. 

The Special Ad Hoc Audit 

Committee chaired by Dr. Surendra 

Purohit presented their report which 

was discussed and unanimously 

approved by the Governing Body. 

The newly elected Officers of AAPI 

were also announced. 

AAPI Legislative Day: 

The Spring Legislative Day on 

Wednesday, April 29th, 2009 went 

very well and was attended by many 

prominent Congressmen and 

Senators as well as a representative 

from the Executive Branch, Mr. 

Nicholas Rathod, Director of the 

White House Office of 

Intergovernmental Affairs. We also 

had the unique opportunity to meet 

with the Indian Ambassador- 

Designate Meera Shankar, who 

graciously attended the sessions on 

Capitol Hill. Physician Senator Tom 

Coburn, MD and U.S. Congressman 

Bill Cassidy, MD were in attendance 

as well. The importance of our 

presence on Capitol Hill is needed 

now more than ever as President 

Obama has pledged to reform the 

national healthcare system in the 

coming year. Please continue to visit 

our website for future updates and 

to learn more about how you can 

take part in AAPI’s Legislative efforts. 

We would like to thank AAPI’s new 

Legislative Director, Mr. Dino 

Teppara, Esq., who was instrumental 

in making the arrangements for 

Legislative Day. 

AAPI Annual Convention: 

The 27th Annual Convention is 

scheduled from June 10-14, 2009 in 

Orlando, FL. The Convention 

Chairman Dr. Ravi Jahagirdar and 

his Committee have been working 

tirelessly to create a memorable 

convention featuring state-of-the-art 

CME with renowned keynote 

speakers. Convention Chair Dr. Ravi 

Jahagirdar and his four co-chairs are 

working closely to make this event 

successful. Dr. Jahagirdar Appointed 

16 committee chairs who will be 

directly responsible for their 

division. I met with all of them on 

one-to-one and their enthusiasm is 

applaudable. This is the first time 

FICCI is coming with a delegation to 

this convention and they opted to 

purchase six booths. Principal 

Health Secretary and possibly the 

Health Minister of India will attend 

the Convention. Friday’s Cultural 

Entertainment Program will feature 

Krishna Kumar Kunnath (K.K.) and 

Sunidhi Chauhan on Saturday. We 

are also planning a Classical Music 

Program for Thursday evening by 

Pandit Jashraj. Member registration 

and hotel reservation at the Dolphin 

Hotel is now available online at 

www.aapiconvention.com. Please 

be sure to complete your registration 

early for discounted pricing and 

premium table selection. Early Bird 

registration ended on May 8, 2009. 

Exhibition booth registration is 

online and several booths were sold. 


6 www.aapiusa.org




I invite you all to attend the 

annual convention in Orlando, FL 

from June 10-14, 2009. 

AAPI Election Reforms: 

I have appointed the Election 

Reforms Committee with Dr. Anand 

Sahu as Chairman. The committee 

will come up with recommendations 

that will be presented to the Bylaws 

Committee. 

AAPI Elections: 

The AAPI elections for 2009-10 

were concluded and the results 

were announced. The Election 

Officer Dr. Arun Pramanik along 

with his to co-election officers did 

an excellent job in conducting the 

elections smoothly. 

AAPI IT Committee: 

We are excited to announce the 

launch of the completely redesigned 

new AAPI website, 

www.aapiusa.org. The IT Committee 

under the Chairmanship of Dr. Anil 

Gupta worked very hard for several 

months in creating a modern, 

professional, user friendly and 

interactive website which an 

organization our size badly needed. 

Members will now be able to log in 

to their member profiles and edit 

their information as well as access 

members only areas of the site. This 

new website will be updated on a 

regular basis with upcoming AAPI 

events in addition to local chapter 

events. Please visit the completely 

redesigned new AAPI website. 

Special Ad Hoc Committee: 

The Chair of BOT was at the AAPI 

office at Oak Brook, IL in January, 

2009 and looked into the accounts 

and subsequently he found issues in 

spending. He wrote an email to the 

Secretary of AAPI and subsequently 

he sent an email to the Past 

Presidents and the past Chairs of the 

BOT. At this juncture I selected a 

special AdHoc committee to look 

into the issues raised by Dr.Rajendra 

Gupta, Chair BOT. The Committee 

consisted of Dr. Surendra Purohit 

(Chair), Dr. V Haranath Reddy and 

Dr. Anand Sahu. All of them were 

past BOT Chairs and well respected 

and experienced individuals. The 

AAPI Office sent the requested 

information to the committee and 

they formally presented their 

findings at the Boston Governing 

Body Meeting on Saturday, April 

11th 2009. 

AAPI Journal: 

AAPI Publications committee 

under the editorship of Dr. 

Sivaprasad Madduri did a fabulous 

job in bringing the AAPI Journal on 

time. The latest Journal was sent out 

to 14,000 members on March 10, 

2009. I would like to thank Dr. 

Narendra Kumar, Chair of Journal 

Resource Committee and his team 

for doing a tremendous job in raising 

funds through advertisements and 

making the journal self sufficient. 

Scholarships: 

As you are aware, St. George 

University allocated a merit 

scholarship for an amount of 

$500,000 for students of Indian 

Origin. I was invited by St. George 

University, Grenada, from 

November 13-16, 2008, along with 

Dr. Sharad Lakhanpal to finalize the 

details of the scholarships. 

Also, one candidate was selected 

for the scholarship at American 

University at Antigua (KMC). 

Appointments: 

One of our members, Dr. Ram 

Krishna, from Arizona was elected 

to The Board of Directors of The 

Federation of the State Medical 

Boards (FSMB). The FSMB represents 

all the 50 Medical Licensing and 

Regulatory Boards in addition to the 

20 Osteopathy Boards. Dr. Ram 

Krishna has also been elected to the 

Executive Committee of the 

Educational Commission for Foreign 

Medical Graduates (ECFMG). 

AAPI Charitable Foundation: 

At the Fall Governing Body 

meeting held at Oklahoma City, the 

AAPI Charitable Foundation 

fundraiser dinner event was held in 

association with the AAPI-Oklahoma 

Chapter on Friday, October 24th, 

2008 and raised $37,000. We will 

help AAPI Charitable Foundation to 

continue its mission in India. 

AAPI Legal Issue: 

The legal issue regarding our AAPI 

Office condo was settled in a 

compromise. AAPI was able to get 

an amount of $12,005.58 after 

paying the legal fee. 

AAPI Office: 

There are currently three staff 

members working at the 

headquarters in Oak Brook, IL and 

Ms. Vijaya Kodali and Mr. Sam 

Fulambarker have been managing 

the office very well. The search for 

an Executive Director is on. 

I would like to express my sincere 

thanks to the AAPI Officers and the 

Executive Committee for their help 

and support they gave me 

throughout the year. 


7


From The Editor’s Desk 

by Sivaprasad Madduri, M.D. 

“I could not write nor could I read, and so 

I became an Editor.” —Anonymous 


Editor-in-Chief 

With feelings of honor and 

humility, I accepted to take charge 

of the AAPI Journal editorship one 

year ago. It has been a learning 

experience endowed with 

satisfaction and a milestone I will 

cherish for a long time. AAPI Journal 

is the official voice and the main 

source of communication amongst 

its 50,000 members, the largest 

medical organization next only to 

AMA. I was skeptical initially, to take 

the responsibility of the editorship as 

I was practicing in a rural 

community away from civilization, 

technical, as well as, secretarial 

help. Thanks to the Internet, I could 

communicate with the Executive 

Committee, Editorial Board, writers 

and the printers with ease. 

Though there was a significant 

debate to develop the journal into a 

‘scientific’ publication with peerreviewed 

articles worthy enough to 

be ‘indexed’, most of the Editorial 

Committee members echoed 

differently. They felt the journal 

should be reader-friendly, with a 

healthy mix of scientific and real-life 

stories. We wanted the journal to 

adorn the coffee tables and 

bookshelves, and be source of 

conversation rather than a throwaway 

journal. We sincerely hope that 

we succeeded in achieving that goal. 

Many events made headlines 

during the last year: Massacre in 

Mumbai, Presidential Election in the 

United States and Hurricane Ike, to 

name a few. AAPI Journal gave 

proper recognition by timely 

publication of those events. Health 

Care topics related to the Indian 

community in the U.S. and 

charitable organizations sponsored 

by AAPI membership were 

prioritized and given deserving 

place. Young physicians and 

residents and medical students who 

will be torch carriers of the future 

were encouraged to participate and 

I am glad to report that the response 

was beyond our expectations. 

Ayurvadic Medicine, Probiotic 

Therapy, raising children in a foreign 

country with different cultural and 

social environment, investment 

pitfalls; diverse topics made their 

way into the journal and made it 

interesting to read. 

I owe a deep debt of gratitude and 

would like to thank a host of 

persons that helped the journal: Dr. 

Sanku Rao, the President of AAPI, 

for his help and guidance, Dr. 

Narendra Kumar, AAPI Treasurer, for 

helping the journal to be self 

supportive with the advertisements, 

the members of the Editorial Board 

for their unrelenting assistance, 

G.R. Graphic Designs for the dressup 

and the attractive look of the 

journal. Our sincerest thanks go to 

the readership for their continuous 

support and ‘good words’ which 

made us feel that the hard work was 

richly rewarded. 

Committee and the new Editorial 

Board of the AAPI Journal ready to 

take over, we would like to wish 

them good luck and in closing, I 

would like to say, 

"Thanks for the memories". 

8 www.aapiusa.org


President-Elect’s Report 

by Vinod K. Shah, M.D. 

I would like to express my 

profound gratitude to the entire 

membership for giving me the 

opportunity to serve our 

organization as President-Elect for 

the year 2008-09. The year started 

on a very positive note and I am 

honored to represent you during 

these exciting years. 

After a long tenure, Ambassador 

Ronan Sen left Washington D.C. He 

was gracious to invite us for a 

farewell party that was held on 

March 28th. It was my pleasure to 

represent AAPI at this occasion. We 

have been closely in touch with the 

Embassy of India who has always 

been supportive of Indian Diaspora 

and we recently met our new 

Ambassador – Madam Meera 

Shanker. Our meeting was attended 

by President Sanku Rao, Past 

President Navin Shah, Suvas Desai 

and our incoming secretary, 

Narendra Kumar. The Ambassador 

was complimentary of AAPI’s 

contribution for the betterment of 

Indo-US relationship. 

As a special guest of House 

Majority Leader, Honorable Steny 

Hoyer, it was my pleasure to attend 

the Democratic National 

Convention. The Convention gave 

me an opportunity to network with 

many senior members of the 

Democratic Party and I learned a lot 

about the healthcare agenda which 

will be an extremely important issue 

during this administration. It was 

also my pleasure to participate in 

the swearing in ceremony of our 

new president, President Obama, a 

historic event which was a 

breathtaking experience which I will 

cherish for years to come. 

Recently we completed our 

Legislative Conference which was 

very well attended, and many 

Congressmen and Senators 

participated in our event. During the 

conference, we addressed the issues 

that are extremely important for our 

organization such as: 

A. Healthcare initiative of the new 

administration. 

B. Physician shortage and role of 

international medical graduates. 

C. Physician reimbursement and 

impact of the current economic 

climate on physician practices. 

D. J1 Visa Waiver program. 

E. TORT Reform. 

Association with other Organizations: 

1. Attended the Legislative 

Conference held by Asian 

American Hotel Owner’s 

Association (AAHOA) on 

Wednesday, September 10th at 

Capitol Hill. It was also my 

pleasure to attend the annual 

conference of AAHOA on April 

24 & 25, 2009. 

2. Attended the annual meeting 

held by Indian Medical 

Association of Central Florida. 

AAPI Events: 

1. Participated in the CME 

program conducted in the last 

week of September, 2008 under 

the leadership of Dr. Sanku Rao 

on a cruise to the Greek 

Islands. Members who 

participated in the CME 

enjoyed the visit to the Greek 

Islands and the entire event was 

very exciting. 

2. Attended the Fall Governing 

Body meeting at Oklahoma City 

on October 25th. 

3. Attended the Ohio Chapter 

annual meeting. The group in 

Columbus is dedicated, 

energetic and focused. I was 

impressed with their event and 

friendship. 

4. Also participated in Women’s 

Forum in New Jersey, and 

Spring 

Governing 

Body meeting 

in Boston. 

Constitution & 

Bylaws Committee: 

As a Chair of the Constitution & 

Bylaws Committee, the first Bylaw 

committee meeting was held on 

October 8, 2008. Existing revision of 

the Bylaws was reviewed which was 

proposed and approved at the 

Spring Governing Body meeting 

held in Michigan in March 2008 

and subsequently forwarded to the 

General Body. No objections were 

received from any members. We 

also discussed extensively how 

modifications to the Bylaws can be 

made to improve membership, to 

create a strong and positive image 

and to develop member satisfaction. 

I have worked very closely with Dr. 

Ajeet Singhvi, our new incoming 

President-Elect, to work diligently to 

propose a revision to the Bylaws to 

achieve those objectives. 

Orlando Convention: 

Vinod K. Shah, M.D. 

President-Elect, AAPI 

I had several meetings with the 

Chair of the Orlando Convention, 

Dr. Ravi Jahagirdar and his team. 

Under his leadership we will have a 

fantastic convention. I would like to 

compliment the entire convention 

team who is working so hard to 

make the annual event a big 

success. 

I would like to express my 

gratitude to our President Dr. Sanku 

Rao for his leadership and tireless 

work. I also would like to 

compliment his wife, Dr. Sanku 

Rohini for her generosity and 

support for this entire year. I am sure 

that the entire Executive Committee 

shares my sentiments. 



9


Vice-President’s Report 

by Ajeet R. Singhvi, M.D. 

As the Vice President of the 

American Association of Physicians 

of Indian Origin (AAPI), it is my 

privilege to present the year-end Vice 

President’s Report. 

As your Vice President I have been 

assisting the President, the President- 

Elect, the Secretary, and the Treasurer 

in whatever capacity they have asked 

for my services. Dr. Sanku Rao has 

been working very hard, along with 

the Executive Committee to move 

our organization forward. 

One of the major responsibility, as 

the Chair of Membership Committee 

is to increase our current membership. 

Ajeet R. Singhvi, M.D. 

Vice President, AAPI 

An organization is only as 

strong as its membership. Our 

current membership as of May 20, 

2009 is as follows: 

As of June 30, 2008 As of May 20, 2009 From July 1 to May 31, 2009 

a. Patron – Life member 6,311 6,496 185 

b. MSRF – Our Future 6,721 7,499 778 

c. YPS - Our Youth 193 230 37 

d. Annual – Our Strength 473* 620 147 

Total 13,698 14,845 1,147 

* Annual members renewed their dues from July 1, 2007 to June 30, 2008 

Considering the total strength of 

45,000+ physicians and over 

10,000+ MSRF & YPS, we have a 

long way to go. We had set a 

modest goal to increase our total 

membership at least by 5% at the 

beginning of the fiscal year. We 

have already achieved that goal. The 

MSRF section has seen the greatest 

increase which is very heartening 

and needs to be commended. 

However, the Annual membership 

and YPS membership growth has 

been dismal. A case needs to be 

made to reduce membership to 

MSRF, YPS, retired physicians 

wanting to join as a Patron Member 

($250 – same as spouse of MD). 

Patron Membership usually sees two 

peaks during the year. First one just 

before the General Election (January 

31st of each year is the cutoff date 

to be eligible to vote for the General 

Election) and the other peak is 

before the convention (patron 

members get their registration fee 

waived). With the Orlando 

Convention preparation is in full 

swing, the membership and 

convention committees will be 

working hard to increase the 

numbers. You can apply online or 

ask for an application by 

fax/mail/email from the AAPI office. 

Recruiting new members is 

challenging in any organization, 

especially with physicians. They are 

not only busy in their profession, but 

also do not perceive it to be crucial. 

To be able to wield influence in 

Washington (for professional issues 

and legislative concerns) as well as 

with the pharmaceutical industry 

and other vendors (for CMEs, 

charitable activities, conference, and 

raising funds) membership number 

matters. 

AAPI’s strength and image 

continues to grow, yet a great many 

physicians who are well reputed and 

widely known nationally and 

internationally are not members of 

our organization. We need to bring 

them into fold and tap their 

resources. I seek your help and 

guidance in this regard. If we can 

somehow convince our colleagues 

to become members and attend one 

or two AAPI events, they will be 

very happy and will feel good being 

part of our organization. Let’s try to 

make one member each year. We 

will be twice as strong instantly. 

I hope, those of you joining the 

convention will have a wonderful 

time, make new friends and will 

take good memories with you. I 

thank you all for being part of our 

organization and also for giving me 

the opportunity to serve you as your 

next President Elect. 

I will be happy to receive and 

respond to your comments. 

Respecfully submitted, 

Ajeet R. Singhvi, M.D. 

10 www.aapiusa.org


President-Elect’s Report 


We are united as a team and we 

have enormous support of our entire 

membership. I am looking forward 

to working with you all in the years 

to come. 

Editorial Committe 

Chair: 

Members: 


Urologist, Poplar Bluff, MO 

madduri@semo.net 

I hope that you will call me with 

your suggestions to make AAPI a 

stronger and more formidable 

organization. Thank You very much 

for your friendship and trust. 

Purvi Parikh, M.D. 

MSRF Representative for Publications Committee 

purviparikh7@hotmail.com 

Monita Soni, M.D. 

President, PrimePath, P.C. 

Decatur, AL 

M. P. Ravindra Nathan, M.D. 

Cardiologist, Brooksville, FL 

ravinath@tampabay.rr.com 

Subruto Kundu, M.D. 

Neurologist, San Leandro, CA 

virtualme2@comcast.net 

Venkit S. Iyer, M.D. 

Palm Harbor, FL 


Regional Director, SW ( 2006-2008), 

AAPI Vice Chair, AMA- IMG Section 

Medical Director 

Rita Frenchman, M.D. 

Hendersonville, TN 

AAPI Executive Officers 

President 

Sanku Rao, MD 

(580) 234-0285 

sankuraook@sbcglobal.net 

President Elect 

Vinod K. Shah, MD 

(301) 373-7416 

vinnyshah@hotmail.com 

Vice President 

Ajeet R. Singhvi, MD 

(951) 929-0124 

asinghvi@aol.com 

Janine Saldahna, M.D. 

Anesthesiologist, Mass. Eye and Ear Infirmary and 

Mass. General Hospital 

jansaldanha@gmail.com 

Niruma Madduri, M.D. 

Dept. of Developmental Pediatrics 

nsmadduri@texaschildrenshospital.org 

Julie Y. Patel, M.D. 

Assistant Professor 

Texas A & M Health Science Center 

Pooja Voria, M.D. 

Radiology Resident, University of Washington 

AAPI MSRF Executive Committee 

img.aapimsrf@gmail.com 

VenuGopal K. Menon, M.D. 

Allergy and Immunology, Pearland, Texas 

doctorvmenon@hotmail.com 

Secretary 

Prasad Srinivasan, MD 

(860) 246-7273 

prasads268@yahoo.com 

Treasurer 

Narendra Kumar, MD 

(989) 793-1040 

kum73@aol.com 

Past President 

Hemant Patel, MD 

(973) 373-7700 

drhemantpatel@gmail.com 

600 Enterprise Drive, Suite 108 • Oak Brook, IL 60523 • Phone: (630) 990-2277 Fax: (630) 990-2281 


11


Secretary’s Report 

by Prasad Srinivasan, M.D. 

My Reflections on the Year Gone By. 

It is time to say “Au Revoir”. 

My term as the secretary is coming 

to an end and it has been both 

challenging and fulfilling. I will 

continue to contribute to AAPI’s 

growth to the best of my capacity. 

The office in Chicago continues to 

be short staffed and over worked. 

Both Ms. Vijaya Kodali and Mr. Sam 

Fulambarker are great assets to the 

organization. They work tirelessly 

and with a cheery disposition, and it 

has been a pleasure working with 

them. I want to thank them in their 

continued efforts in ensuring that we 

have an efficient office. 

I have been a spokesperson for 

AAPI at numerous events both in the 

United States and in India. 

Discussing our multiple platforms 

and our accomplishments as an 

organization has been the subject of 

my presentations. 

I am deeply touched and honored 

by the resolution made by the 

Governing Body in Boston to 

Prasad Srinivasan, M.D. 

Secretary, AAPI 

commend 

me for my 

objective and transparent 

report throughout the year. 

I sincerely thank the multi faceted 

AAPI leadership for their 

cooperation throughout the year. I 

want to thank the AAPI membership 

at large for giving me the 

opportunity to serve the organization 

as Secretary. 

AAPI Charitable Foundation 

by Krishan Aggarwal, M.D. 

Everyone can be great because 

everyone can serve. 

Martin Luther King 

For the last two decades AAPI-CF 

has been continuously taking care of 

the health care needs of poor, sick 

and forgotten people in remote 

areas of India. During this period it 

has served virtually millions of 

people and contributed almost 

$3 million.This all could be possible 

only with your generosity year after 

year. Charitable Foundation is ever 

so grateful for your help. 

This noble work is facilitated 

through 17 hospitals and clinics in 

different regions of the country. 

Every year we serve hundreds of 

thousands patients at the base and 

those who can’t come many of these 

have outreach programs. Engaging 

in prevention, education and 

immunization, these clinics has 

become integral part of those areas. 

12 www.aapiusa.org 

Started as small outpatient clinic 

many of them have become 

hospitals doing surgery, inpatient 

admission, maternity service etc. To 

see this expansion is gratifying. This 

is possible only with the efforts of 

local dedicated people. 

The Foundation has been in the 

forefront during many calamities 

striking Indian masses like Tsunami, 

earthquakes and floods of Gujarat, 

Maharashtra and famine of Orissa. 

We have been in these situations 

with physical, financial and other 

medical help. 

Also we have joined hands with 

Ngo like the Naandi Foundation to 

provide clean and pure water to 

villages of Andhra, Punjab, 

Rajasthan and working with Gujarat. 

It has been slow but is making a 

difference to prevent water born 

diseases. With a commitment of 

$170,000 annually we are making 

Krishan Aggarwal, M.D. 

some 

difference in 

the life of deprived people. 

Chairman, AAPI Charitable Foundation 

All this needs fundraisers at 

different places. Pittsburgh has 

arranged its 19th annual fund raiser 

on 20th September and San Antonio 

is doing a function in October. In 

addition we are grateful to 

leadership and Convention Chair Dr. 

Jahagirdar for arranging a musical 

evening on behalf of the 

Foundation. To ensure that this 

noble work can continue without 

interruption we have over a $1 

million in the endowment fund. We 

wish to grow this over $2 million so 

that this noble work continues to 

flow like Ganga serving all without 

caste and creed. It has been a 

gratifying experience to be part of 

this effort for over 10 years. I AM 

SURE EACH OF US CAN CHANGE 

THE WORLD if we so decide.


Treasurer’s Report 

by Narendra Kumar, M.D. 

It is my privilege to report that the 

state of our AAPI finances continues 

to be reasonably strong, and we are 

making every effort to maintain and 

improve the current financial status. 

As your AAPI Treasurer, I have tried 

to fulfill my promise to keep AAPI 

finances in proper order by 

maintaining fiscal stability, accountability 

and transparency. This 

required cautious spending and 

enhanced revenues especially 

during this current economic 

climate. I have closely monitored 

financial activities at the AAPI 

National Executive Office, and I 

have kept our President appraised 

on the financial status at regular 

intervals, and the Executive 

Committee at our monthly 

Narendra Kumar, M.D. 

Treasurer, AAPI 

teleconferences. A 

detailed report will 

be presented at the Governing Body 

and General Body meetings in 

Orlando. Let me also take this 

opportunity to thank you all for your 

confidence in choosing me as your 

next AAPI Secretary. 

Major Income/Expenses As of May 17, 2009 

Major Income 

Balance From Previous Year (6/30/08)................$122,459.87 

Patron Fund Allocation (from BOT)....................$122,795.25 

Las Vegas Convention Balance ..........................$170,019.30 

Total Membership Dues ......................................$82,450.00 

AAPI Emergency Relief Fund ....................................$652.00 

Interest from Money Marker Fund ............................$665.80 

CME ......................................................................$7,974.14 

Observership Fee......................................................$600.00 

Journal Ads..........................................................$54,675.00 

Website Ads ..........................................................$2,100.00 

Nomination Filing Fee ........................................$10,000.00 

Royalties................................................................$8,223.96 

Resource Directory Sponsorship............................$7,500.00 

2005 Convention - Closing balance ......................$3,049.97 

Philadelphia 07 Convention ................................$24,984.67 

Refund from 2008 LV Conv. (Advance refunded) $52,049.80 

June 2008 Year-in Review Ads Income ................$10,333.00 

Money Market Account Balance..........................$11,768.16 

Refund from the settlement of Office Condo ......$12,005.58 

Uncleared Checks from July 1 to Nov 14, 08 ......$42,371.51 

Accounts Payable ..................................................$5,111.61 

Total Income ....................................................$751,789.62 

Citi Bank Operating Acctount Balance 5/17................$140,256.89 

Indo-US Healthcare Summit Account Balance 4/09......$36,506.89 

Women s Healthcare Summit Account Balance 4/09 ......$2,768.72 

AAPI Orlando Convention Account 5/17 ....................$349,267.16 

AAPI-Charitable Foundation Account as of 4/09 ......$1,073,544.94 

AAPI-CF Elite Account (Current) 4/09 ..........................$67,767.94 

BOT Account (Smith Barney) as of 4/09 ..................$2,154,220.46 

Major Expenses 

AAPI MSRF Support ........................$15,000.00 

AAPI YPS Support..............................$2,500.00 

Accountant Fee ................................$4,800.00 

Computer Related ..........................$25,859.14 

Constant Contact (Email) ..................$1,150.69 

Copy Machine lease..........................$3,930.54 

Pitney Bowes Machine Lease ............$1,188.00 

Media Consultant............................$31,700.00 

Condo Association Fee......................$6,656.70 

Office Expenses ................................$5,413.05 

Insurance ..........................................$6,455.00 

Postage..............................................$2,484.65 

AAPI Journal–June 08 Issue ............$29,249.00 

AAPI Journal (3 issues) ....................$68,873.93 

2008 Resource Directory ..................$7,600.00 

Printing – Other ................................$4,216.65 

Governing Body Expenses ................$1,840.35 

Employee Wages & Misc...............$172,325.52 

Telephone/Storage/Bank Fees etc.......$8,846.83 

Travel ................................................$8,854.15 

Promotions, AMA..............................$4,429.74 

2009 Orlando Convention Advance$44,742.30 

2010 Convention Advance ................$5,000.00 

2007 Real Estate Taxes ......................$3,535.90 

2008 Real Estate Taxes ......................$1,727.04 

Election Expenses............................$18,797.61 

Legislative Day Expenses ................$13,499.54 

Advertisements................................$10,900.00 

Patron Membership Refund ............$62,500.00 

Canon Copier Purchase ....................$7,187.89 

Other office Equipment ....................$2,873.73 

Women’s Forum ................................$2,101.00 

Total Expenses ..............................$586,238.95 


13


Letter To The Editor: 

Dear Dr. Madduri, 

I enjoyed reading the March issue 

of the AAPI journal which has 

several good articles written by your 

excellent Editorial Committee (I am 

also happy to see them all with their 

respective Photographs!) I must 

congratulate you for writing an 

excellent article about the problems 

facing US healthcare and asking Mr. 

Obama to start working towards real 


A few days ago, I received the 

AAPI journal and noticed that it 

does not have a place for the “letters 

to the editor“ perhaps you would 

consider having such a column in 

the journal. If you do then, I would 

like to comment on the article by 

Dr. Desai: Great Equalization – Is 

MBBS from India equal to M.D. in 

India? Of course it is but that is not 

the question, the real question is “Is 

the American M.D. really a doctoral 

degree?” The answer is that it is 

NOT. 

The doctoral degrees all over the 

world require a thesis and as we all 

know the doctors who obtain an 

reform. I particularly liked the idea 

of writing about making safe 

drinking water available to many of 

the poor in India. This could be the 

best solution to so may of the GI 

infections in India. But I could not 

tell if this was an Ad for Naandi or a 

real article written by an unknown 

author? This needs attention of the 

Indian Physicians and support from 

AAPI. What do you think? Finally I 

loved reading about the article on 

American M.D. do not write a 

thesis. 

Contrary to that, those of us who 

have M.D. degrees from India 

(myself included) did have to write a 

thesis. 

For years, a former professor at 

Michigan State University (I believe 

he was a professor of Sociology) 

complained that the American M.D. 

was not really a doctoral degree and 

that the designation should be 

changed to a bachelor degree. 

However, as we know nothing 

happened and he eventually gave up. 

MBBS = MD, something I had 

always wondered about since I 

came to the US but did not know or 

read about it till now. Please congratulate 

your team on my behalf. 

Best wishes, 

Sewa S. Legha, MD 

Houston, Texas 

Along the same lines, I do not 

expect that this small letter will 

change anything, but it will educate 

our members and the public that the 

sought after M.D. degree is merely a 

bachelor degree and not a doctoral 

one. It will not change the legal 

status but we also know that the 

lawyers and the academics 

frequently do not agree. 

Thanks for your consideration. 

Ved V. Gossain, M.D. 

Swartz Professor of Medicine 

Chief, Division of Endocrinology & 

Metabolism 

Michigan State University 

East Lansing, MI 


I have just received and read the 

Journal – congratulations. The 

articles are wide-ranging, interesting 

and well written. I particularly liked 

the ones on Probiotic Therapy and 

the Behaviorally Disruptive 

Physician – very timely. It is always 

great to read about AAPI members' 

awards and recognitions. (And, Ravi, 

I'm glad you were not sued after 

your compassionate and dedicated 

care of Sally over the years!) 

By increasing the number of 

authors, especially young ones, you 

make the Journal more inclusive. I 

would suggest that you include 

where the author lives or practices 

eg Gopal Lalmalani, M.D., Chicago. 

IL. It would be nice to see articles 

from diverse regions, especially 

smaller towns. The guidelines you 

set forth will hopefully result in 

many articles. 

I believe "From the Editor’s Desk" 

should take precedence over the 

President’s Report, as in any journal 

or magazine. I hope President 

Obama reads your editorial. Why 

don’t you send him a copy of the 

Journal? At the very least, he will 

learn (or learn more) about AAPI. 

Was AAPI invited to his recent 

healthcare summit? 

Great work! 

Best regards, 

Janine Saldanha 

14 www.aapiusa.org

FEATURE 


Turmeric and Breast Cancer 

by Hari Sharma, M.D. 

Hari Sharma, M.D. 

Columbus, Ohio 

Breast cancer continues to be a 

leading cause of cancer-related 

death among women worldwide. An 

estimated 182,460 new cases of 

invasive breast cancer occurred in 

the United States alone in 2008. 

Turmeric (Curcuma longa), a spice 

that is widely used in South Asian 

cooking, has long been utilized in 

Ayurveda for the treatment of a wide 

variety of disorders and diseases 

involving the skin, liver, pulmonary 

and gastrointestinal systems, as well 

as wounds, sprains, aches and pains. 

Curcumin, the pigment that gives 

turmeric its orange-yellow color, has 

been referred to as an ‘age-old 

NSAID’ (nonsteroidal antiinflammatory 

drug). The antiinflammatory 

properties of turmeric 

and curcumin have been extensively 

researched over the last 20 years in 

relation to a multitude of disease 

processes including neurodegenerative, 

cardiovascular, 

pulmonary, metabolic, autoimmune, 

and neoplastic. Curcumin modulates 

multiple cell-signaling pathways 

known to be involved in the 

pathogenesis of various chronic 

diseases. It downregulates 

inflammatory transcription factors 

such as nuclear factor kappa B (NF- 

_B), enzymes such as 

cyclooxygenase-2 (COX-2), and 

inflammatory cytokines. 

Curcumin’s inhibition of multiple 

proinflammatory pathways has been 

heavily researched in relation to 

cancer. More than 800 studies have 

been published to date 

demonstrating the anticancer 

potential of curcumin. With regard 

to breast cancer, curcumin exerts 

multiple suppressive effects on 

human breast tumor cell lines, 

including hormone-dependent, 

hormone-independent, and multidrug 

resistant lines. Effects of 

curcumin include the inhibition of 

growth, as well as inhibition of 

invasion and angiogenesis. 

Curcumin induces apoptosis in 

breast cancer cells by regulating 

multiple signaling pathways. In an 

animal study, curcumin inhibited 

7,12-dimethylbenz[a]anthracene 

(DMBA)-induced mammary 

tumorigenesis. This inhibition was 

associated with a significant 

decrease in formation of DMBA- 

DNA adducts in the animals 

administered curcumin. 

Curcumin suppresses activation of 

the transcription factor NF-_B, 

which is involved in inflammation, 

tumor promotion and progression, 

angiogenesis, invasion, and 

metastasis. NF-_B is constitutively 

activated in breast cancer cells and 

correlates with the metastatic 

potential of breast tumors. It has 

been proposed as both a prognostic 

marker and a molecular target in 

breast cancer therapy. In an animal 

model, curcumin reduced NF-_B 

activity resulting in the prevention of 

hematogenous breast cancer 

metastases. There was a significantly 

lower number of lung metastases in 

the animals treated with curcumin; 

68% of curcumin-treated animals vs. 

17% of untreated animals had no or 

very few lung metastases. A study 

utilizing curcumin and paclitaxel 

(Taxol) showed that curcumin 

improves the therapeutic outcome of 

paclitaxel treatment. Paclitaxel has 

been used as a front-line 

chemotherapeutic agent for breast 

cancer; however, it can induce drug 

resistance, possibly through the 

activation of NF-_B, and therefore is 

not useful in treating advanced 

breast cancer. In breast cancer cells, 

curcumin blocked paclitaxelinduced 

NF-_B activation. In an 

animal model used in this study, 

curcumin inhibited human breast 

cancer metastasis to the lung. 

Treatment with paclitaxel modestly 

reduced the incidence of metastasis, 

however curcumin alone and 

curcumin plus paclitaxel 

significantly reduced the incidence 

and number of lung metastases. 

To further elucidate the 

mechanism of action for curcumin’s 

strong antimetastatic effect, an 

analysis was carried out on the 

complete range of curcumin’s effects 

on gene transcription in a metastatic 

breast cancer cell line. It was 

discovered that curcumin alters the 

expression of multiple genes, 

including downregulating two 

inflammatory cytokines known as 

CXCL1 and CXCL2. The genes for 

these cytokines are regulated by 

NF-_B. CXCL1 and 2 are both 

associated with tumor progression, 

and CXCL1 is overexpressed by 

breast cancer cells with an 

increased potential to metastasize to 

the lung. The downregulation of 

these cytokines in turn leads to 

downregulation of several 

metastasis-promoting genes, 

including the cytokine receptor 

CXCR4, which has been implicated 

in the promotion of metastasis in 

breast cancer. 



15


FEATURE 

Vision Correction Surgeries: 

From Memory Lanes of the Past to the Vision 

Super Highways of the Future 

by Arun Gulani, M.D. 

Arun C. Gulani, M.D. 

Jacksonville, FL 

Since its inception in the past 

century, Vision Corrective Surgeries 

(Refractive eye surgeries) have 

undergone radical and revolutionary 

refinement, with technological 

advancement catapulting it into the 

21st century as one of the most 

sought-after elective procedures. 

Cryo Lathes, Crude Blades and 

Sutures have been replaced by 

Lasers, Diamond instruments and 

Glue. Add to this, accessories like 

human placenta, contour-modifiable 

bio gels and plastic inserts and we 

have the present day eye surgical 

trends with a goal for Super Vision. 

My personal involvement in the 

advancement of Lasik and related 

Refractive surgeries and the privilege 

to have learnt from the very pioneers 

all over the world, fuels a relentless 

endeavor to perfect vision. 

Blast from the Past 

Since early 19th century, pioneers 

in eye surgery have pursued the 

impact of corneal shape on vision. 

Procedures like keratophakia and the 

very famous Russian, Radial 

Keratotomy (RK) surgeries were a 

result of those concepts. Dr. José 

Barraquer in Columbia, South 

America, used a mechanical 

capenter’s blade - like instrument 

called microkeratome to make a 

corneal flap followed by reshaping 

the cornea using a cryolathe and 

gave birth to LASIK. Rightly so, Dr. 

Jose I. Barraquer is called the father 

of LASIK surgery. 


The Arrival of the Excimer Laser 

Originally designed to work on 

computer chips, this laser involves 

surface ablation in order to achieve a 

corneal flattening effect for myopic 

correction. By 1990 and 1991, 

Lamellar splitting (using a 

microkeratome to make a corneal 

flap, based on Barraquer’s pioneering 

work of forty years earlier) was 

combined with Excimer laser 

ablation to give birth to modern 

LASIK (laser in-situ keratomileusis). 

This has been further improved 

following the application of a Laser 

instead of the microkeratome to 

modern day “Blade-less” Lasik.. 

Intraocular Lenses (IOLs) 

Phakic IOLs 

Until recently, high degrees of 

refractive errors (extreme 

nearsightedness or farsightedness) 

could not be treated by Lasik. With 

the advent of implantable contact 

lens or ICL, a miniature contact lens 

is surgically implanted inside the eye 

in front of the eye’s natural lens. This 

can further be combined with LASIK 

to treat even higher refractive errors 

or eyes with astigmatism. This 

coupling is termed BIOPTIC. 

Intraocular Lenses (IOLs) 

In 1948, Dr. Harold Ridley, a 

physician to Royal Air Force pilots in 

World War II, discovered that the 

material of cockpit "glass" (following 

bombshell injuries) could be 

tolerated inside the human eye. 

Cataract surgery always came with 

the downside of “Coke bottle” 

glasses. Following Dr. Ridley’s work 

in the 1940s, IOLs were designed to 

replace the extracted cataract and to 

provide refractive correction. 

Reading was still an issue. The new 

presbyopia-correcting (multifocal/ 

progressive) lens technology now 

allows cataract surgery patients to 

see distance and near without any 

glasses. 

Present and Future Diagnostic 

Technologies 

In addition to all the current trends 

in surgical procedures, the diagnostic 

arena is also growing to include 

wavefront aberrometry — initially 

developed to improve visibility of 

distant objects in space through 

high-powered telescopes, this has 

since been applied to laser vision 

correction, in order to map and 

quantify imperfections in the eye 

never before measured using 

standard methods for glasses and 

contact lenses. 

Topography and imaging for Lasik 

patient screenings are at new heights 

with the development of Pentacam 

Scheimpflug technology as well as 

optical coherence tomography to 

study the eye in 3D. We can now 

aim for vision beyond 20/20 by 

addressing quality of vision too. 

Reversing the Past 

Also, with millions of elective 

refractive surgeries being done we 

Continued on page 20

FEATURE 


Physician Scientist: 

Participation By International Medical Graduates 

by Jayesh Shah, M.D. and Dharmapuri Vidyasagar, M.D. 


San Antonio, TX 

“Despite considerable progress in 

new treatments and therapies, too 

many people continue to struggle 

daily with diseases that have no 

cure, like diabetes, mental illness, 

and Alzheimer's disease," said 

Edward D. Miller, M.D., dean and 

CEO of Johns Hopkins Medicine. 

"Medical research is the beginning 

of hope for millions of Americans, 

and one of the best investments we 

can make in our future." There is 

little debate that the frontiers of 

medicine should march forward. 

There is enormous concern that the 

economic forces are deterring 

physicians from seeking a carrier in 

scientific research. 

There are serious concerns in the 

academic circles that the pool of 

physician scientists in US is steadily 

decreasing. The Association of 

American Medical Colleges 

conducts a survey of all graduating 

medical students in the country. In 

1989, 14 percent expressed a strong 

interest in research as a career; that 

fraction fell to 9.4% percent in 

2007. The Pipe-line of physicianscientists 

is emptying at its source, 

the young physician .There are 

several reasons for this trend, 

economics being in the forefront. US 

medical graduates are burdened 

with heavy loans by the time they 

graduate from medical school. The 

trend is to recover the economic 

losses of long years of schooling and 

training. There is a 25% decrease in 

physician scientists on medical 

school faulty today than a decade 

ago. The institutions could draw 

from the IMG physician pool to fill 

this gap in much the same way as 

they are utilizing them to serve the 

medically underserved areas. 

There is limited information on 

IMG Physician Scientists. In a study 

in 1998 Aranha (1) reported that 

88% of the medical schools had at 

least one IMG faculty member. In 

the country 13.2 % of faculty is of 

Asian origin second to white who 

constitute 70% of the total. Up 

until recently a vast majority of the 

faculty of Asian origin were IMG 

physicians. In recent years the 

second generation Asians is seen in 

increasing numbers on the faculty 

rosters. Similar data on IMGs in 

different specialties should be 

gathered to better understand the 

critical role of IMGs in meeting the 

academic workforce needs. AAMC 

recognizes this gap in information. 

Although a few IMGs with J-1 

visas have managed to pursue 

research interests, there is no data 

on their numbers. They are also not 

eligible to compete for training 

grants (T16/T32). Currently there are 

very few options for the IMG 

candidates engaged in research or 

academic work to change their visa 

status to H1-B, EB or O visas. The EB 

visas and O visas are given to an 

established researcher. Any federal 

agency may ask for a J-1 visa waiver 

for a person of exceptional merit. A 

resident just completing the graduate 

medical education training will not 

have such credentials at this early 

stage in their carrier. 

People of Indian Origin have 

contributed greatly to the brain pool 

of US. The 2007 census shows that 

there are 2.8 million (0.9% of US) 

people of Indian Origin in the US. 

They comprise 16.4% of the Asian 

pool and are the third largest group. 

A third of the engineers in the 

Silicon Valley are of Indian Origin 

and 7% of the high - Tec companies 

are run by Indian CEO’s. Seventy 

two percent participate in the US 

workforce and 58% are in 

managerial positions. There is ample 

precedence to expect great 

contributions from Indian physicians 

in the scientific world. 

There is a large pool of potential 

physician scientists to draw from. 

For the seventh consecutive year, the 

number of first-year (PGY-1) 

residency positions offered through 

the residency matching program has 

increased. A total of 22,427 firstyear 

positions were offered an 

increase of 187 positions compared 

to last year. Of the 10,980 IMGs 

who participated in the 2009 Match, 

4,796 (43.7%) matched. Of the 

7,484 IMG participants who were 

not U.S. citizens, 3,112 (41.6%) 

obtained first-year positions. In order 

to make this carrier path attractive 

and available to the IMG physician 

several steps have to be taken. 

Vidyasagar (2) has outlined these in 

a recent article. 

1) The IMG’s in US on J-1 visa 

should be mentored to seek 

physician scientist career and be 

able to compete for T series NIH 

grants. 



17


FEATURE 

Turmeric and Breast Cancer 


Several Phase I clinical trials have 

demonstrated that there is no doselimiting 

toxicity associated with oral 

curcumin administration. 

However, according to Ayurveda 

turmeric should be taken with warm 

milk or aloe vera juice as it may 

cause gastric irritation in sensitive 

individuals. One of the clinical trials 

investigated the systemic effects of 

curcumin consumption and found 

that curcumin significantly inhibited 

prostaglandin E2 production in 

blood samples of the study 

participants. This study investigated 

several pharmacokinetic and 

pharmacodynamic parameters to 

help optimize the clinical evaluation 

of curcumin in Phase II 

chemoprevention or chemotherapy 

trials. 

The Ayurvedic pharmacopeia is 

extensive, with more than 700 herbs 

described in detail in the ancient 

texts. Compared to pharmaceutical 

drugs, herbs and herbal mixtures are 

cost-effective and lack toxic side 

effects. Over the last several 

decades, researchers have 

extensively investigated turmeric and 

its chemical constituents and are 

elucidating the mechanisms 

involved in the clinical benefits that 

have been experienced with this 

herb for thousands of years. 

Physician Scientist: 

Participation By International Medical Graduates 


2) A J-1 Visa waiver program for 

physician scientist should be created 

similar to the Conrad 30 program. 

The AMA IMG section has sent a 

resolution to AMA House of 

Delegates to pursue this. 

Facilitating bilateral exchange 

(Brain Circulation) of interested 

scientists between the countries will 

contribute to rapid scientific growth 

and minimize the 10/90 gap. 

The lack of sustainable funding 

and programs to encourage all 

young physicians leads to loss of an 

entire generation of potential 

researchers. This is magnified for the 

physician who returns to a country 

with even poorer resources. The loss 

of a mind is a loss to the entire 

world. In a 1999 address to the 

National Institute of Health, Leon 

Rosenberg sums it up eloquently, 

“heroes are not enough. We must 

act now to create a national 

environment conducive to creating a 

new generation of physicianscientists 

— rigorous in their 

training, confident in their ability to 

compete and succeed, and, above 

all, imbued with the belief that their 

efforts are essential if we are to 

improve the lives of people 

everywhere — young and old, 

woman and man, sick and well.” 

Rajam Ramamurthy, Rita and 

Williams Head Distinguished 

Professor Of Environmental and 

Developmental Neonatology. 

UTHSCSA, San Antonio, Tx 

18 www.aapiusa.org

Vijaya L. Appareddy, M.D. 

FEATURE 


Akshaya Patra’s Hunger Struggle A Ray of 

Hope for Underprivileged Children In India 

Vijaya L Appareddy, M.D. 

Not withstanding the tremendous 

progress India has made in recent 

years on all fronts; there are more 

than 45 million hungry children. At 

a time when they should be in 

schools, they are mostly on the 

streets begging or doing menial jobs 

to eke out a living. Hunger is the 

culprit, which prevents these 

children from enjoying the joys of a 

carefree life in childhood. This is not 

the kind of hunger that makes 

headlines, as in a famine, but a 

silent holocaust that continues 

everyday for these children. 

A recent UNICEF 2005 report on 

the state of the world’s children 

under the title “Childhood Under 

Threat” says that over one billion 

children, half of the world’s 

population of children, have been 

denied their childhood. It is reported 

that some 640 million children lack 

adequate shelter; 400 million have 

no access to safe drinking water; 

270 million lack health care 

amenities and 140 million — mostly 

girls — have never been to school. It 

was earlier reported that more than 

150 million children are 

malnourished worldwide. 

The UNICEF 2005 report also says 

millions of Indian children are 

equally deprived of their rights to 

survival, health, nutrition, education 

and safe drinking water. It is 

reported that 63 per cent of them go 

to bed hungry and 53 per cent suffer 

from chronic malnutrition. 

Malnutrition in early childhood 

has serious, long-term consequences 

because it impedes motor, sensory, 

cognitive, social and emotional 

development. Malnourished children 

are less likely to perform well in 

school and more likely to grow into 

malnourished adults, at greater risk 

of disease and early death. Medical 

science has proven that most of the 

cognitive developments occur 

between the age group of 6 and 12 

years. Hunger and malnutrition 

during these years impairs cognitive 

development, thus permanently 

crippling an individual for life. 

Iron deficiency in infancy may 

cause a permanent loss of IQ later in 

life. Iron deficiency and anemia lead 

to shortened attention span, 

irritability, fatigue, and difficulty in 

concentration. Consequently, 

anemic children tend to do poorly in 

vocabulary, reading, and other tests 

(Parker, 1989). 

A laboratory study that involved 

healthy, well-nourished school-aged 

children found a negative effect of 

morning fasting on cognitive 

performance. A test of the speed and 

accuracy of response on problemsolving 

tasks given to children who 

did or did not eat breakfast found 

that skipping breakfast had an 

adverse influence on their 

performance on the tests (Pollitt et 

al., 1991). 

The Akshaya Patra Foundation is a 

philanthropic endeavor, striving to 

eradicate hunger among the 

underprivileged children in India 

since the year 2000. By providing 

unlimited, wholesome food in 

schools, The Foundation addresses 

the challenges of hunger and 

education, as mid-day meals served 

in school is known to be the most 

powerful incentive to attract children 

to schools. 

With a clear vision “No child in 

India should be hungry and hunger 

should not be an obstacle to 

education,’’ they have been offering 

nutrition-rich food everyday to 

973,147 underprivileged school 

children across six states in India. 

They are Karnataka, Andhra Pradesh, 

Orissa, Rajasthan, Uttar Pradesh and 

Gujarat. 

This program is unique in 

magnitude, complexity, method of 

delivery and approach and uses 

technology extensively for 

minimizing cost, time and labor. The 

entire program is managed in the 

most cost effective manner by 

spending only Rs 1,200 per annum 

per child, to provide nutritious & 

hygienic food, cooked in automated 

kitchens in each city and distributed 

through custom built vehicles. 

Akshaya Aroghya: During a survey, 

doctors found that typically, 85 per 

cent of children from slums suffered 

from worm infestations because of 

unhygienic living conditions. Added 

to it, they were deficient in vitamins, 

particularly vitamin-A. To counteract 

these problems, Akshaya Patra offers 

medical assistance in the form of deworming 

and vitamin supplements 

to the children in these schools, in 

partnership with other charitable 

organizations. 

Yardstick for Measuring Program 

Success 

Past Chair, AAPI Board of Trustees 

Several studies conducted by 

independent, third-party 

organizations reiterate the 

effectiveness of wholesome mid-day 



19


FEATURE 

Vision Correction Surgeries: 

From Memory Lanes of the Past to the Vision Super 

Highways of the Future 


shall see a number of patients 

seeking “Fine tuning of their 

previous surgeries”. 

In this direction, I have introduced 

the concept of Corneoplastique, a 

new super speciality of the future 

wherein Lasik and refractive eye 

surgery itself can be performed in a 

wide spectrum of techniques as well 

as provide help to those patients 

who have had surgeries in the past 

that can be fine tuned or corrected 

to present day expectations. 

Other fields of pursuit are 

presbyopia, gene engineering, 

synthetic eyes and neural networks. 

All of these are being pursued 

relentlessly everyday 

The above detailed choices of 

refractive surgery options 

neccessitates a dialogue with 

virtually every patient. These choices 

provide a wide selection for each 

and every patient whether 

contemplating a glass-free lifestyle or 

looking for improving their previous 

eye surgery (these previously 

performed eye surgeries could be 

Radial Keratotomy (RK), Astigmatic 

keratotomy, Lasik, PRK, cataract 

surgery, transplant, keratoconus etc). 

Having successfully performed 

Laser vision surgery on a 90 year old 

patient, I can clearly state that age is 

surely not a barrier. 

As, I look into the crystal bowl of 

the future, refractive surgery shall 

become the birthright of every 

individual and eye surgeons will 

have to provide the whole spectrum 

of surgical choices for patients to 

cater to their needs throughout their 

lifetime with changes of age and life 

style requirements. 

I predict anecdotally that one day 

a patient will walk into the eye 

doctor’s office and say “Doctor, I see 

20/20”, the eye doctor will stand up 

with a solemn look on his/her face 

and say “I can help you”. 

Arun C. Gulani, M.D. 

Gulani Vision Institute, 

Jacksonville, Florida. 

Akshaya Patra’s Hunger Struggle A Ray of Hope 

for Underprivileged Children In India 


meals in enhancing school 

participation, particularly of girl 

children, increasing attendance, 

eliminating classroom hunger, 

fostering social equity and 

improving children’s health. 

A study conducted by M S 

Ramaiah Medical College Hospital, 

Bangalore in one of the rural schools 

receiving the benefits of Akshaya 

Patra program reports: 

• Skin infections in the children 

decreased from 80% to almost nil. 

• Anemia reduced from 40% to 

less than 5% of the children. 

• Children below optimal 

nutrition level reduced from 

60% to almost nil. 

• Children developed better 

resistance to diseases. 

• Children showed significant 

improvement in height and weight. 

The above report is just one 

indication of how the program has 

made a significant difference to 

children from economically weaker 

sections of the society. 

www.akshayapatra.org 

20 www.aapiusa.org

FEATURE 


The Time For Health Care Reform is Now! 

by Sanku Rao, M.D. 

Sanku Rao, M.D. 

AAPI President 

When Barack Obama was running 

for President, he made universal 

health care a major platform of his 

campaign. It is unacceptable that 

more than forty million people 

remain without health insurance in 

our nation, which arguably has the 

most advanced health care system in 

the world. Now that President 

Obama is in the White House, he is 

focused on signing a major health 

care reform bill into law by the end 

of the year. In fact, as I write this, 

House and Senate committees are 

drafting legislation that will provide 

universal health care for all 

Americans. 

While this is a positive fact, the 

details have yet to be ironed out. 

Various stakeholders have met the 

President and Congressional leaders 

to lobby and advocate for their 

priorities. These groups include 

pharmaceutical and medical device 

companies, medical specialty trade 

associations, hospital executives, 

think tanks, physicians, and nurses. 

This is where our organization 

comes into play. We cannot rely 

solely on medical specialty groups 

to speak on our community’s behalf. 

As Indian American physicians, we 

have unique concerns and must 

ensure our voice is heard in this 

debate. Our issues are diverse and 

include: providing more residency 

slots for recent medical school 

graduates; ensuring fairness for 

International Medical Graduates; 

making the J-1 visa program 

permanent; reforming medical 

liability lawsuits; ensuring ACGME 

guidelines establishing medical 

resident work hours are followed; 

and permanently fixing the formula 

for Medicare reimbursements. 

We, as doctors, have spent years 

and expended enormous personal 

funds to have the honor of 

becoming a physician. We must 

ensure the profession we love is not 

compromised in this debate, no 

matter how badly we want to do the 

right thing by providing health 

insurance for all Americans. The 

next few months will be critical in 

making our voices heard. If we don’t 

mobilize now, we may regret our 

inaction for years to come. Don’t 

forget, we also have an obligation to 

future Indian Americans who will 

seek the honorable profession of 

physician. 

AAPI members must wage a 

nationwide, grassroots advocacy 

effort to meet their Member of 

Congress and discuss the pending 

reforms. We must educate Members 

of Congress, most of whom are not 

physicians, about our profession, 

and the best way to preserve our 

innovative health care system. A 

system that rations health care, 

does not provide the latest 

pharmaceuticals to patients, and 

moves the power of decision-making 

from the hands of patients to 

government-run commissions, is not 

the direction we should take. 

Instead, we need an innovative way 

to provide universal health care by 

reforming the insurance industry, 

ensuring patients control the 

decision-making process over their 

own health care, and by allowing 

the latest pharmaceuticals to 

improve the quality of life for our 

patients. 

The time for action is now! Please 

engage your federal lawmakers on 

this issue. For assistance, please 

contact our new Director of 

Legislative Affairs, Dino Teppara in 

Washington, D.C. at 

legislativeaffairs@aapiusa.net. 


21


SPECIAL ARTICLE 

Joint IMANE/AAPI Meeting 

Is A Resounding Success 

by Nasir A. Khan, M.D. 

Nasir A. Khan, M.D. 

President, IMANE 

By all accounts, the joint Indian 

Medical Association of New 

England/American Association of 

Physicians of Indian Origin meetings 

held on April 10 – 12, 2009 at the 

Marriott Renaissance Boston 

Waterfront Hotel were a resounding 

success, with close to 100 people 

from both groups attending. 

The weekend kicked off with a 

dinner Friday evening in the hotel 

restaurant for AAPI members. More 

than 50 AAPI guests, most of whom 

came from around the country, 

participated and listened to an 

excellent talk by Dr. Lawrence 

DuBuske of Brigham & Women’s 

Hospital on Treating Asthma, 

Including an Update on New NIH 

Guidelines. 

The activities continued the next 

morning with a 7 a.m. breakfast for 

the APPI Board of Directors and the 

Executive Committee members. This 

was followed by concurrent 

meetings of the AAPI Governing 

Body and the IMANE Continuing 

Medical Education program. 

The IMANE CME program, which 

was also open to AAPI members, 

was extremely well received and 

included talks by Sajani Shah, 

M.D., minimal invasive surgeon at 

Tufts Medical Center who spoke on 

Morbid Obesity: Predisposing 

Factors, Co-Morbidities and Surgical 

Management; Sumer Verma, M.D., 

geriatric psychiatrist at McLean 

Hospital who spoke on Depression 

and Medical Illness: A Two-Way 

Street; and Luis Sanchez, M.D., 

Director, Physician Health Services, 


Massachusetts Medical Society who 

spoke on Doctors Who Get into 

Trouble with the Board of 

Registration: A Review of the 

Problems and the Role of Physician 

Health Services. 

The individual talks were followed 

by a panel discussion that allowed 

participants to ask questions of the 

speakers. The format and content of 

the educational program received 

high marks from attendees, with a 

combined approval rating score of 

4.86 out of a possible 5. Further, 98 

percent of participants indicated that 

all objectives were met. 

The lunch was a combined 

IMANE/AAPI event. Dr. Sanku Rao, 

President of AAPI, was asked to 

present the 2008 IMANE 

Community Service award to Dr. 

Chander Kapasi, a distinguished 

member of both IMANE and AAPI. 

Dr. Kapasi invited women who were 

active in both groups to join her at 

the podium, and an impressive 

group of more than a dozen highly 

accomplished women responded. 

The luncheon speaker was Dr. 

Alireza Atri, neurologist in the 

Memory Disorders Unit, Mass 

General Hospital and GRECC, 

Bedford VA Medical Center who 

spoke on New Thinking on an Old 

Disease: Alzheimer s Disease, 

Current Thinking and Future 

Directions. Since this disease is 

coming into more prominence due 

to the longevity of those around us, 

having the latest research findings 

was pertinent and welcomed. 

The AAPI Governing Body 

Meeting spanned most of the day, 

allowing ample time for many issues 

to be discussed frankly and 

forthrightly, with numerous 

comments from the floor. Present 

were current officers, Governing 

Body members and those who were 

recently elected who will take office 




Joint IMANE/AAPI Meeting Is A Resounding Success 


at the annual meeting to be held in 

June 2009 in Orlando, FL. 

The finale of the weekend was the 

Harbor Cruise with a 3-course 

dinner and music on the Spirit of 

Boston. It was a five-minute walk 

from the hotel along the waterfront 

to the boat dock and this distance 

provided a welcomed opportunity 

for participants to get fresh air and 

stretch their legs. IMANE secured 

the entire third deck for a delicious 

buffet and bar with absolutely no 

speeches or talks! It was truly “R & 

R” and the most pleasant aspect was 

the chance to eat, walk around and 

socialize. It was also a picturesque 

setting for IMANE and AAPI 

members to renew old acquaintances 

and make new friends. This was a 

perfect ending to a great weekend. 

This was the second joint 

IMANE/AAPI meeting held recently 

with equal success. The first was in 

Goa, India in December 2008, 

which was also very well-received. 

Such occasions to bring members 

from both IMANE and AAPI together 

offer very valuable opportunities for 

sharing information and ideas. Both 

groups have so much in common 

including similar goals and missions; 

both welcome professionals from all 

medical and dental disciplines; both 

have a charitable focus; and both 

support educational activities to 

benefit people of all backgrounds. 

Further, the two groups have 

sponsored fundraising drives at 

times of national disasters. Finally, 

both organizations provide a 

valuable forum for networking, 

mentoring and socializing. 

I want to thank the members of 

IMANE and AAPI for their support, 

guidance and efforts in helping to 

make another joint event a true 

success. 

• AMERICAN ASSOCIATION OF 

• 

P H YSICIANS OF 

INDIAN ORIGI N 

American Association of Physicians of Indian Origin 

2009 AAPI Election Results 

President Elect - Dr. Ajeet Singhvi 

Vice President - Dr. Sunita Kanumury 

Treasurer - Dr. Jayesh Shah 

Board of Trustees 

Dr. Satish Anand 

Dr. Shobha Gupta 

Dr. Anil Khosla 

Regional Directors 

Mid-Atlantic Region 8 - Dr. Sanjay Jain 

South Region 10 - Dr. Ravi Jahagirdar 

Congratulations to all the winners 

www.aapiconvention.com 


23



Larger Your Waistline Shorter Is Your Life Span! 

Indian Diaspora In The U.S. and 

Cardio-Metabolic Syndrome 

by Purushotham Kotha, M.D. 

Purushotham Kotha, M.D. 

FACC 

The IDEA study did it! 

International Day for Evaluating 

Abdominal obesity study looked at 

168,000 patients in 67 countries all 

around the World and reconfirmed 

the previous observations that 

abdominal obesity (visceral fat) is 

convincingly the most important, 

independent and universal predictor 

of cardiometabolic risk in men and 

women of all ages, nationality and 

ethnicity. Many studies over the last 

half century reported higher 

cardiovascular and all cause 

mortality in people with Cardio- 

Metabolic syndrome and its high 

prevalence in Asian Indians. 

Why Indians should be Concerned? 

Because we are in the midst of a 

Cardiometabolic Epidemic! 

High incidence of Cardio/Metabolic 

Syndrome with larger waistline 

(visceral fat), with or without Diabetes 

and with underlying excess of Insulin 

(Insulin Resistance), small dense LDL, 

remnant particles, proinflammatory, 

procoagulant factors contributes to 

the very high incidence of heart 

disease and all cause mortality in 

Indians. 

Coronary Heart Disease is 3-4 

times more common in Asian 

Indians compared to other 

populations. 

The NIH program ‘Healthy People 

2010’ designated the Asian Indian 

Immigrant Population in the United 

States as a “high risk group for heart 

disease”. 


The World Health Report of 2002 

projects Cardio Vascular Disease 

(CVD=heart disease and stroke) to be 

the largest cause of death and 

disability in India by 2020. 

The World Health Organization 

estimates that about 60% of the 

World’s heart disease patients will be 

Indian by year 2010. 

CVD is the largest cause of death 

in women. Compared to Whites, 

Blacks and Latinos Indian women 

suffered the highest all cause 

mortality and highest cardiovascular 

mortality in the U.S. 

AAPI/RICADIA sponsored first 

randomized National DIA (Diabetes 

in Indian Americans) study showed 

that the prevalence of Metabolic 

Syndrome and Diabetes in Indian 

Americans is even higher than that 

reported by earlier, non-randomized, 

smaller studies. 

What is CardioMetabolic Syndrome! 

Metabolic syndrome is considered 

a "multiplex" cardiovascular risk 

factor, in that each component of 

the cluster of abnormalities is a risk 

factor in its own right. Introduced as 

Syndrome X by Reaven in 1988 and 

also termed insulin resistance 

syndrome, metabolic syndrome is 

recognized clinically by the findings 

of abdominal obesity, elevated 

triglycerides, atherogenic 

dyslipidemia – ie, low levels of highdensity 

lipoprotein cholesterol 

(HDL-C), elevated blood pressure, 

high blood glucose and/or insulin 

resistance. Metabolic syndrome is 

also characterized by a 

prothromobotic state and a 

proinflammatory state. 




Larger Your Waistline Shorter Is Your Life Span! Indian 

Diaspora In The U.S. and Cardio-Metabolic Syndrome 


With regard to the increase in 

cardiovascular risk associated with 

metabolic syndrome, the whole far 

exceeds the sum of its parts. For 

instance, the 4-year risk of incident 

myocardial infarction (MI) among 

men ages 40-65 in the Prospective 

Cardiovascular Münster (PROCAM) 

study was increased 2.5 times in the 

presence of either type 2 diabetes or 

hypertension; 8 times in the 

presence of both factors; and 19 

times in the presence of both factors 

plus an abnormal lipid profile. 

Both the proinflammatory and 

prothrombotic states of metabolic 

syndrome derive largely from the 

secretory activity of adipose tissue, 

particularly intra-abdominal or 

visceral fat. Contrary to the former 

concept of fat as an inert tissue 

mass, adipocytes are increasingly 

being recognized as secretory 

entities. Cytokines and other 

inflammatory markers or signaling 

molecules released by adipocytes -- 

termed "adipokines"--include leptin, 

tumor necrosis factor alpha (TNFalpha), 

interleukin-6, resistin, and 

adiponectin. Adiponectin levels are 

inversely related to fasting plasma 

insulin and glucose levels. Weight 

loss by obese individuals has been 

associated with increased 

adiponectin levels. 

Populations that are genetically 

susceptible to metabolic syndrome 

include South Asians (Indian 

subcontinent), Southeast Asians (eg, 

Polynesian, Japanese), African- 

Americans (particularly African- 

American women), Mexicans, and 

Native Americans (eg, Pima Indians). 

The age-adjusted prevalence of 

CHD in Caucasians is highest in 

patients with both type 2 diabetes 

and metabolic syndrome (19.2%), 

Cardiovascular disease mortality in the metabolic syndrome. 

followed by patients with metabolic 

syndrome but not type 2 diabetes 

(13.9%). Notably, the prevalence of 

CHD is no higher in patients with 

type 2 diabetes but without 

metabolic syndrome than in 

individuals who have neither type 2 

diabetes nor metabolic syndrome. 

The Diabetes in Indian Americans 

study showed much higher ageadjusted 

prevalence of Metabolic 

Syndrome of 26.9% by the original 

ATP III criteria, 32.7% by the 

modified ATP III criteria and 38.2% 

by the IDF criteria. 

Life habits-Diet, Exercise or their 

lack of play a major role in 

unmasking the genetic 

predisposition to CardioMetabolic 

Syndrome in Indians. 

Life Habit factors unique to Asian 

Indians contributing to higher 

CardioMetabolic risk! 

• Being sedentary- Couch Potato! 

• Meager consumption of fresh 

fruits and fresh vegetables 

• Excess consumption of sweets, 

jaggery, dairy products and fried 

foods 

• Re-heating edible oils for 

cooking over and over! 

• High carbohydrate and low fiber 

diets. 

Remedies to prevent and reverse 

Cardio- Metabolic Syndrome! 

EXERCISE for at LEAST 30 minutes 

everyday; children need to exercise 

60 to 90 minutes a day! 

In general 10% weight loss is 

associated with 30% loss in adipose 

tissue. 

Nutrition 

Restrict total calories, especially 

from simple carbohydrates and 

consume more calories from mono, 

poly and Omega 3 fats. 

Bake and Boil! Minimize frying; 

Stop deep frying, Stop re-heating the 

edible oils for cooking. 



25



Larger Your Waistline Shorter Is Your Life Span! Indian 

Diaspora In The U.S. and Cardio-Metabolic Syndrome 


Eat at least five servings (cups) 

each of fresh fruits and vegetables a 

day. Whole/multi grains, legumes, 

lentils, variety of nuts, low fat milk 

products, soy milk and tofu. 

Balance your Omega 3 and 

Omega 6 Oils! 

Olive oil, Canola oil, Nuts and 

Avocado are rich in Monounsaturated 

(good) fats 

Flax seed, oily fish like wild 

salmon are rich in Omega 3 (heart 

protection) 

Sun flower oil, safflower oil and 

soy bean oil are rich in healthy 

polyunsaturated fatty acids. When 

hydrogenated become Trans Fats 

which are highly atherogenic. 

Avoid sugars, white flour, polished 

rice, Colas 

Avoid Trans Fats crispy and 

crunchy, fried and fast foods, 

desserts; cookies, cakes, pastries! 

Lower Salt intake (pickles, chips, 

pretzels!) 

Practice Yoga, meditation 

Know Your Numbers! 

Consensus Target Numbers to 

prevent CAD in Indians developed 

by CAD Committee of AAPI 

Waist circumference (most 

significant component of MetS) < 35 

inches in men; in women



Memories of an AAPI Foot Soldier 

by Onaly A. Kapasi, M.D. 

“The farther backwards you can look, the farther forward you are likely to see” 

— Winston Churchill 

Onaly Kapasi, M.D. 

Newton, MA 

It seems just yesterday when I 

joined the AAPI but in reality it was 

the summer of 1986. The 

proceedings of that AAPI annual 

meeting made an indelible mark in 

the string of memories that were yet 

to come. I was enchanted by the 

large turnout of Indian physicians, by 

the emotion-churning speeches and I 

was equally excited with the prospect 

of having a premier ethnic medical 

organization carry my voice all the 

way to the United States Congress. 

During those years we were 

referred to as ‘foreign medical 

graduates - FMGs’ in short and 

referred to as ‘aliens’ even though we 

were all citizens of planet earth and 

not from an alien planetary system. A 

change seemed eminent but the task 

was daunting. The prospect of having 

a united voice representing our 

common medical interest was not 

only welcome but also timely. The 

FMGs had awakened. 

It was in Atlantic City that I 

reconnected with my professor, Dr. 

Sunder Mansukhani who without 

hesitation gave me his hotel room 

when I told him that I was unable to 

find an accommodation in the hotel. 

I was equally amazed that he 

THE TASK 

WAS DAUNTING 

MEDICAL 

BEAURACRACY 

remembered my name and treated 

me with the love and affection of a 

long-lost relative. I heard and listened 

to the AAPI trendsetters who gave 

vision to my voice and theirs that 

resonated demanding equality. When 

I returned to Boston I carried with me 

a comforting thought that AAPI was 

there to safeguard my future medical 

interest. That feeling of comfort and 

camaraderie has kept me returning 

home to AAPI each year. 

At a subsequent meeting in 

Orlando I was somewhat shaken by 

the lack of cordiality and also by the 

discord and lack of continuity. The 

proceedings definitely took away the 

feeling of camaraderie that AAPI had 

espoused in me the previous year in 

Atlantic City. Had I gambled and lost 

in the casino town the previous year? 

There was fierce infighting between 

two groups and each group had 

brought with them their private 

attorney to represent their collective 

interest. What followed the Orlando 

meeting was a succession of 

presidential selection mostly from the 

group that had successfully taken 

over the AAPI reins at the Orlando 

convention. Somehow, the 

organization lost some of its gusto 

and the race for leadership 

overshadowed much of the 

organizational goals. Two or more 

factions were formed and the same 

people that held hands at the Atlantic 

City convention were now unable to 

resolve their differences. Some of the 

past leaders and their entourage 

stopped coming to the AAPI meetings 

for some years to follow. Over time, 

thankfully the divide was forgotten 

and AAPI resumed its important 

mission of representing the Indian 

physician practicing in the United 

States of America. 

Some leaders meanwhile remained 

a legend in their own minds whilst 

others such as Dr. Satya Ahuja 

brought great leadership, finesse and 

cohesiveness to AAPI. During the 

earlier days the AAPI leadership was 

a boy’s club in spite of the fact that 

more than 40 percent of its members 

were female physicians. Dr. Chander 

Kapasi broke that mold when she 

was elected a chairperson of the 

Board of trustees. This bold and 

appropriately forward move opened 

APPI leadership to the female Indian 

physicians who later followed her 

lead. These female physicians tempered 

the leadership with class, and 

finesse of an Indian mother who 

single-handedly juggled busy practices, 

cared for the family and home. 

In the past two decades I served on 

several committees and enjoyed the 

privilege of taking a CME conference 

on Sports Medicine to the National 



27



Perinatal Outcomes Among Mothers of Indian 

Origin and Prenatal Testing In The United States 

by Neeraja Kambham 1 , Vinita Parkash 2 , Shenbagam Dewar 3 , Meenakshi Singh 4- 

Neeraja Kambham, M.D. 

Stanford, CA 

In 2002, Dr. Ashima Madan from 

Stanford University reported on the 

increased incidence of Low Birth 

Weight (LBW) infants in Asian 

Indian women (Madan et al., J. 

Perinatol. 2002). A subsequent study 

reviewed the birth records of 

1,622,324 babies born in California 

from 1995-97 and further 

corroborated these findings (Gould 

et al., Pediatrics. 2003). Perinatal 

outcomes in Asian Indian women 

were compared to Hispanic and 

Caucasian women, and the data 

showed that Indian mothers were 

more likely to have an adverse 

pregnancy outcome. Termed as a 

‘dual epidemiologic paradox’, this 

paper suggested that despite an 

improved socio-economic profile as 

measured by education and income, 

Indian mothers more frequently gave 

birth to LBW babies than Caucasian 

or even foreign born Hispanic 

mothers. In a follow up study 

examining the U.S Perinatal 

Mortality Data Files, the 

investigators showed that these 

findings persisted in the second 

generation Asian Indian women 

(Madan et al., J. Pedaitr 2006). In 

other words, both foreign born and 

U.S. born Asian Indian women 

remain at high risk for delivering 

LBW infants. Although the 

incidence of maternal diabetes was 

higher in Indian women in one of 

the studies, the other suspected risk 

factors such as pregnancy induced 

hypertension, pre-eclampsia or 

maternal anemia were not observed. 

The investigators then went on to 

examine morbidity in these infants. 

The data from this small, 

retrospective study showed that 

Asian Indian infants also have a 

higher incidence of admissions to 

the intensive care nursery (abstract – 

Society for Ped Res. 2009). 

These studies suggest that perhaps 

genetic and /or environmental 

factors compromise perinatal 

outcomes in Asian Indian women 

living in the US. Identification of 

these factors is essential to design 

directed testing and perinatal care 

programs to reduce such negative 

outcomes in these infants. 

Prenatal care and tests for carrier 

screening among Indian mothers 

The mothers of Indian descent get 

adequate and in fact, better prenatal 

care in comparison to their ethnic 

peers. However, current prenatal 

care protocols, developed largely 

based on studies conducted in 

predominantly Caucasian/African 

American and occasionally Hispanic 

groups, may not focus on the 

distinct susceptibilities and risks of 

this population subgroup. 

The current guidelines of the 

American College of Obstetrics and 

Gynecology recommend a prenatal 

care program, to monitor the well 

being of mother and baby, and to 

screen for genetic abnormalities. 

The latter include a variety of blood 

tests and ultrasound screenings to 

rule out genetic syndromes that 

occur sufficiently commonly in the 

general population. In high-risk 

settings, additional testing such as 

amniocentesis or chorionic villous 

sampling is advocated. The ACOG 

recommends genetic carrier 

screening for Cystic Fibrosis in ALL 

pregnant women, because of its 

relatively high prevalence in 

Caucasians. Additional tests are 

recommended in the setting of a 

strong family history of genetic 

disease or certain ethnic 

backgrounds (eg. Ashkenazi Jews). 

These genetic screening guidelines 

are invaluable in that they 

standardize protocols over different 

areas of the country and ensure a 

uniform level of care. However, by 

their very nature, these (broad and 

all encompassing) guidelines tend to 

disregard small population subgroups 

that may have different 

genetic profiles. For example, ACOG 

recommendations would subject 

Indian mothers to screening for 

Cystic Fibrosis, a disease that is 

very rare among Indians (



Cross Country Biking and Campaigning for 

Chronic Disease Prevention 

by Rajan Dewar, M.D., PhD and Ramar Kannan, M.D. 

As already well highlighted in 

several articles, published books, 

forums and previous issues of the 

AAPI Journal, chronic diseases due 

to preventable lifestyle factors, are 

among the leading and rapidly rising 

causes for increased morbidity and 

mortality among Indian adults. 

Seen more in this era of 

globalization, sedentary lifestyles, 

unhealthy food and other yet 

unidentified factors has raised an 

alarming trend in these diseases that 

include hypertension, coronary 

artery disease, dyslipidemia, obesity 

and diabetes mellitus. These sets of 

diseases and their resulting 

complications are serious enough to 

merit immediate and urgent 

interventions in India. 

Consider the following statistics 

regarding the Indian population (in 

India) at risk: The prevalence of 

Coronary Heart Disease (CHD) is 

11% among urban adults. The 

overall prevalence of hypertension is 

28% in the 20-69 age group. 

Overall prevalence of 

overweight/obesity is 31%. 

Diabetics in India are expected to 

increase from 30 to 57 million by 

2025. Death from chronic diseases 

is set to increase from 53 to 67 % by 

2025. Accumulated loss in revenue 

as a result of chronic diseases from 

2005 to 2015 is predicted to be US$ 

236 billion. 

Screening measures by the AAPI 

and a few other organizations are 

highly commendable and go a long 

way in disease prevention and 

health education. We wanted to 

highlight yet another unique effort in 

this direction, to the attention of the 

AAPI readership. 

Sanjeevini trust is a relatively new 

organization formed by a practising 

Urologist in the United Kingdom. 

Members of this trust combine a 

direct public education campaign 

along with screening camps for 

these chronic diseases in selected 

communities. 

Dr. T.V. Seshagiri and his 

colleagues have been organizing 

cross-country bicycle trips mostly in 

South India educating the lay public 

about these chronic diseases and 

discussing simple ways of lifestyle 

modifications that can help with 

chronic disease prevention. These 

bicycle trips are typically long 

distance rallies. For example, the 

2008 campaign covered 1100 kms 

in Northern districts of Tamil Nadu; 

this year the organisers have plans 

for a Bangalore-Pondicherry rally 

that is approximately 300 kms and 

lasts 3-4 days. The physicians start 

biking by 5:30 AM, bike for 2-3 

hours, stop for breakfast, and bike 

again till about 10:30 AM. After a 

noon break to beat the heat, they restart 

by 3:30 or 4 and bike till 

sundown. The biking trip is 

punctuated by frequent stops – 

almost every 25-30 minutes: if they 

see a crowd of 5 people or so, say 

in a tea shop, they stop their bikes, 

introduce themselves and talk about 

chronic diseases, how sedentary life 

styles, smoking and malnourishment 

due to a carbohydrate or fat rich diet 

can cause diabetes, hypertension or 

heart disease. They explain the 

impact of these diseases on the 

individuals’ family, jobs, or their 

well being. The organisers feel that 

this direct health education, though 

targeting only a microscopic 

population is still very effective – 

people listen when they are visited 

by “foreign doctors”, those are 

biking for the public’s good. 

Through this ‘bottom’s-up’ approach 

and other publicity measures these 

‘docs on bikes’ are able to reach out 

to many communities. 

The screening camps are 

organised as day long clinics with a 

point of care testing laboratory 

screening for diabetes and kidney 

diseases. They also screen for 

hypertension and cardiac symptoms. 

They target rural or suburban 

population with poor access to a 

low cost health clinic. The intent is 

to promote or work with a local 

doctor who will continue to care for 

the newly diagnosed patients. 

Identifying local doctors is possibly 

the most challenging aspect of these 

screening camps. Dr. T.V. Seshagiri 

is promoting the idea of “adopting 

communities by non-resident 

physicians”. Physicians can therefore 

identify a small village that they 

have been associated with, and 

arrange a screening camp, invite the 

‘docs on bikes’, and co-ordinate 

continued care of the patients 

through local resources. Through a 

combination of education, local 

community involvement and charity, 

Dr. Seshagiri is able to reach out to 

the masses. 


29 

www.aapiusa.org



Perinatal Outcomes Among Mothers 

of Indian Origin and Prenatal Testing 

in the United States 


the average Indian mother would 

seek such tests is not certain. 

As the Indian population grows 

within the continental United States, 

is there a need to identify ethnic 

specific testing strategies, especially if 

there is selective morbidity as 

highlighted earlier? Associations 

such as AAPI would provide an 

appropriate forum to support 

discussions and studies about the 

specific susceptibilities and risks in 

persons of Indian descent and 

possibly to form task groups to 

investigate the same. We invite 

readers of AAPI Journal to contact the 

authors with suggestions and 

comments on this issue. In addition, 

we are also looking for collaborators 

at other institutions to participate in 

studies to further investigate the ‘dual 

epidemiologic paradox’. 

Note: The authors wish to thank 

Drs. Ashima Madan of Stanford 

University Medical Center and Rajan 

Dewar of Harvard Medical School 

for critically reviewing this article. 

Dr. Usha Chitkara, Obstetrician at 

Stanford University Medical Center 

participated in a group discussion 

which led to this manuscript. 

Memories of an AAPI Foot Soldier 


1 

Neeraja Kambham, Department of 

Pathology; Stanford University 

Medical Center, Stanford, CA., 

2 

Vinita Parkash, Yale University 

School of Medicine, New Haven, 

CT. 

3 

Shenbagam Dewar, Department of 

Family Medicine, Boston University 

Medical Center, Boston, MA. 

4 

Meenakshi Singh, Department of 

Pathology, Stony Brook University 

Medical Center, Stony Brook, NY. 

Sports Institute of India. Sir Winston 

Churchill said, The farther 

backwards you can look, the farther 

forward you are likely to see . And in 

that spirit I have looked far into our 

past to predict the future. Like most 

organizations we have gone through 

growing pains, infighting, ego trips, 

and we have virtually been to the 

moon and back (Orlando annual 

meeting), and much, much more but 

all in all AAPI has achieved 

unparalleled successes in 

representing the Indian physician in 

the medical arena. I distinctly 

remember the successes of the ethics 

and grievance committee during my 

years as its chair. We stood toe to toe 

with medical goliaths and won. It 

was a first for an ethnic organization 

to confront injustice and inequality 

with successful outcomes. The years 

were so successful that three years 

later an Ethics Committee chairman 

staked his claim in an AAPI resource 

book to a ‘complaint-responsealgorithm’ 

that my committee had 

proposed, adopted and used to 

successfully investigate issues of 

grievances. 

I am hopeful that we will continue 

to return to our constitution and 

bylaws in time of duress and doubt. 

The constitution must always be our 

moral compass. I believe that we 

have a long way to go and the road 

may be an uphill climb at times, and 

the destination may not be in sight 

but we must remember that the road 

is never long between friends. 

Onaly A. Kapasi, MD, FAAOS - 

Orthopedics 

www.MassOrtho.com, 

www.orthodoc.aaos.org/KapasiAssociates 

30 www.aapiusa.org



How Not To Invest 

by Monita Soni, M.D. 

Monita Soni, M.D. 

Decatur, AL 

I am a typical physician like many 

of you. I love my work, and am 

extremely busy taking care of 

patients. We all try to pack 48 hours 

in a twenty four hour day and then 

steal some more minutes to take 

care of family, community 

obligations, exercise and of course 

“hobbies”. I have no knowledge of 

financial investments. I just keep my 

savings at the bank, or at least I DID 

till the June 2006 AAPI convention 

in Atlanta. That was perhaps the 

most UNLUCKY weekend of my life. 

I met a young man who sold “safe 

investments” under the façade of a 

God-fearing Sai-Baba devotee. This 

boy who touched my feet and was 

like a ”son” took me to the cleaners 

with not an iota of remorse. For the 

last one year I have been struggling 

to extricate myself from multiple 

very convoluted products which 

have earned him and a carload of 

his cronies hundreds of thousands of 

dollars. I on the other hand have lost 

most of my savings! 

Now I am very war. Needless to 

say, all my waking time has been 

spent in reading, collecting 

documents, endless phone calls and 

sleepless nights. I have lost the 

ability to trust people. I am not an 

authority on financial matters but I 

consider it my responsibility as a 

human being and executive 

committee member of AAPI to 

caution other members. I will just 

highlight a few points that you must 

take into consideration when 

investing your hard earned money. 

1. We as physicians are vulnerable 

to fraud and scams because we 

are very busy, we do not have 

time to read documents 

carefully. Please do not SIGN 

anything without reading it till 

you understand all the fine print. 

2. We do not make time to seek 

out the best adviser; we just 

agree to invest with someone 

we meet at a convention, dinner 

talk etc. Please recognize that 

anyone who is sponsoring your 

meal, advertisement, CME 

meeting, and convention has an 

AGENDA. The bigger the favor, 

the PRICIER the agenda. 

3. We believe in people because 

our vocation is based on trust. 

There are many products with 

EXCLUSIVE names like “Golden 

Select“, “Elite index”, 

“Universal Life”, “Executive 

bonus”, “Premium financing 

plan”, etc. These are all 

advertisement gimmicks. The 

more esoteric the name of 

the product, the agent is 

guaranteed to get a BUMPER 

COMMISSION. As much as 

100%. You might not get any 

return after age 73-75. Please 

take out your policies, look at 

your signed illustrations and see 

if they are valid. 

4. We rely on ESTABLISHED 

company names but how many 

of us actually read the company 

profiles and see what their 

investment strategies are. Please 

take time to investigate 

everything before you WRITE 

a check. 

5. We do not use our accountant 

effectively. Please spend 

adequate time before the TAX 

week. Discuss all your 

investments with your CPA. If 

you are not satisfied with the 

consultation, do not hesitate to 

ask as many questions as you 

like and also feel free to take a 

SECOND opinion. 

6. We all do not have a proper 

TAX ATTORNEY. Please bring all 

the investment papers to your 

attorney and make sure that 

your investments are going to 

protect your estate. Always have 

witnesses present while signing 

any financial document. NEVER 

sign anything not completely 

filled out by the agent. Never 

sign FAXED documents. 

7. We do not know that all 

products/annuities and insurance 

policies have a FREE LOOK 

PERIOD. We do not know the 

difference between variable and 

fixed annuities. What is the price 

you pay for minimum income 

guarantee rider? What is meant 

by annuitization? Always ask for 

the risk of losing your investment 

and penalties on withdrawal. 

8. We do not present a united 

front. This makes our association 

very open to fraudulent vendors. 

Remember NOTHING IN LIFE 

IS FREE. Cheats often have a 

very innocent façade. Please 

make it a point to exercise 

extreme caution while dealing 

with vendors and immediately 

inform other members if you are 

concerned. I have received a 



31



Cross Country Biking and Campaigning for 

Chronic Disease Prevention 


This unique effort was highlighted 

in an NDTV interview last year, and 

is evoking a lot of interest among 

physicians, non-governmental 

organizations (NGOs) and health 

care industry. We invite further 

comments from the AAPI readers on 

this approach and to provide advice 

on how these efforts can be further 

improved and improvised. We 

would also like to take this 

opportunity to encourage the AAPI 

members to participate and arrange 

screening camps in their local 

communities. Please write to the 

authors or contact Sanjeevini Trust 

(www.sanjeevinitrust.com) directly 

for further information. 

Author affiliations: 

Dr. Rajan Dewar 

(rmariapp@bidmc.harvard.edu) 

Department of Pathology, 

Harvard Medical School and Beth 

Israel Deaconess Medical Center, 

330 Brookline Ave, YA 309 

Boston, MA 02215. 

Dr. Ramar Kannan 

(ramar.kannan@mayo.edu) 

Division of Pulmonary, Sleep and 

Critical Care Medicine 

Mayo Clinic 

200 First Street SW 

Rochester, MN 55901 

DR MOHAN DURVE PRESENTS CME PROGRAMS FOR YEAR 2009-2010 

*trips Dr. Durve will be escorting. 

Australia/New Zealand Aug 3 - 17or Oct 7 – 21 or Oct 26 – Nov 9, 2009 $4199w/air from LA 

Maan Sarovar & Kailash (by helicopter) Aug 31 - Sept 9, 2009 From $3900 

China w/ Yangtze River Cruise Sept 18 – Oct 3, 2009 From $2149 

Iceland Sept 6 - 13, 2009 From $1749 

*Scotland & Ireland Aug 8 — 20, 2009 From $3099 

Croatia & Slovenia Sept 28 – Oct 8, 2009 From $2199 

Egypt & Jordan Sept 17 – Oct 1, 2009 From $2999 

South Africa Oct 8 – 20, 2009 From $2199 

S. America Oct 13 – 27, 2009 From $2699 

Egypt Dec 2 – 13, 2009 From $2099 

Antarctica Dec 3-16, 2009 or Feb 13 – 26, 2010 As low as $6799 

*Morocco Dec 20 — 29, 2009 From $1750 

*Jordan w/opt pre- Syria Jan 2 - 9, 2010 From $1520 

*Namibia w/optional Botswana Safari Jan 30 - Feb 9, 2010 Approx $6799 

*Mediterranean Cruise Aug 24 — Sept 6, 2010 As low as $1549 

Call For Air Prices for the above trips except Australia 

Call for 2009 Discounted Prices for Exotic countries like Italy, Spain, Portugal, Greece, Turkey, Egypt Jordan, 

Israel, Morocco, Malta, Sicily, Tunisia and the United Arab Emirates. WEBsite: www.CMETravels.com 

Call Dr. Mohan Durve at 888-794-1995 or 440-845-7272 

E-mail at: mjdurve@yahoo.com or mjdurve@sbcglobal.net. 

We will also organize Family or group vacations to your dream destinations on your dates of choice! 

32 www.aapiusa.org



How Not To Invest 


few emails from some of you 

and I will sleep a little better if 

even one person is helped by 

my example. 

9. We do not understand different 

insurance products. I think some 

of us do partially understand car 

insurance but we do not 

understand the different life 

insurance products. Please take 

time to differentiate Term Life, 

Whole Life and NEVER buy 

UNIVERSAL LIFE because it is 

linked to the market. There are 

certain insurance policies and 

long-term care plans with “return 

of principle” but these products 

have small honest commissions, 

so the agents don’t push them. 

Ask for them. It is perfectly okay 

to ask upfront how much 

commission the agent is making. 

10. We do not spend enough 

money on educating 

ourselves. I would encourage 

everyone to take a course with 

your own money (NOT 

SPONSORED by anyone) to 

comprehend money 

management. Please make 

yourself and your family 

members aware of government 

agencies that regulate 

investments and insurance 

companies because there is 

wealth of information on their 

websites. 

In closing I would like to thank all 

of you for being a member of AAPI. 

Please be involved, please be 

responsive. PLEASE SAFEGUARD 

YOUR ORGANIZATION. Your 

feedback is crucial to make AAPI a 

coherent, dynamic, and successful 

organization. DO NOT INVEST LIKE 

ME but do send a little prayer into 

the cosmos because I strongly believe 

in creating good VIBRATIONS. 

Join AAPI for a Family Cruise August 6-10, 2009 

on the CARNIVAL TRIUMPH 

4 day Canada/New England cruises from New York, NY 

This cruise from New York City is the ideal summer getaway. In Addition to 

pampering “Fun Days” at Sea cruising along the scenic coast of New 

England, you’ll visit Saint John, New Brunswick. From this historic and 

scenic town, you’ll marvel at the beautiful Bay of Fundy which has the 

highest tides in the world and features a natural phenomenon called 

Reversing Falls. On this cruise, you’ll enjoy one fun adventure after another. 

AAPI President: Dr. Sanku Rao 

President Elect: Dr. Vinod Shah 

For CME inof, please contact Dr. Jayesh Shah 

at (210) 289-5946 

ELITE TRAVEL 

PHONE: 210-340-2555 

800-209-6951 

vasu@elitetravel.info 

www.elitetravel.info 


33



Our Parent Trap: 

The Importance of Not Getting Caught 

by Niru Madduri, M.D. 

Parenting consists of a multidimensional, 

emotional roller 

coaster, with peaks, valleys, twists, 

and turns for which we are never 

prepared. Upon witnessing others’ 

parenting mishaps and vowing to 

avoid them, we still encounter the 

unexpected events that cause anxiety 

and doubt in our own choices. South 

Asians face unique challenges, 

particularly when raising children in 

a Western culture. Like the parents in 

“Bend it Like Beckham”, there is a 

conflict between the sacred 

traditions of generations and the 

desire for empowered youth to 

assimilate with their peers. Thus, the 

struggle continues to prevail in the 

lives of South Asian young adults, in 

this epic battle with the people who 

raise them. 

Growing up in the United States 

can be a blessing and a curse for 

youngsters who are striving to blend 

into a progressive culture while 

maintaining the ancient customs of 

their parents. Usually, there is an 

understanding that children will 

follow the advice given by their 

parents, without significant dispute. 

Kavya, an eleven-year-old girl who 

participates in her traditional Indian 

dance as well as a gifted and 

talented class, feels, “If I tell them 

(my parents) a problem, I want them 

to look at a kid’s perspective.” 

Communication barriers grow into 

walls, dividing the generations. 

Researchers previously demonstrated 

that South Asian families enforce 

strong disciplinary tactics, such as 

humility, which is considered to 

result in positive outcomes. 

However, such intense rigidity may 

have consequences. Anne Deepak 

surveyed a group of South Asian 

women in 2005, and found that 

many of the women had excellent 

and very open relationships with 

their mothers. However, when they 

embarked upon their independence 

and moved out of their parents’ 

homes, they engaged in activities 

about which they could not inform 

their mothers. Many South Asian 

children experience difficulty sharing 

intimate details of their lives with 

their parents. Fear and uncertainty of 

their parents’ reaction triggers an 

initial fabrication that can escalate. 

Encouraging open dialogues from a 

young age is extremely important in 

cultivating a healthy relationship 

between children and their parents. 

South Asians as a group 

established high standards of 

achievement. Deepak’s report noted 

that South Asians are four times more 

likely than the general population to 

have a postgraduate degree. They 

also have higher incomes per capita 

compared to other ethnic groups. As 

first generation South Asians 

exemplified the values of hard work, 

determination, and sacrifice, they 

anticipate the same success in their 

children. Second generation 

youngsters are expected to be more 

successful than their parents, given 

the abundance of resources and 

support. As one father notes, “Here, 

the level of involvement in our 

children’s lives is far more than my 

parents did in India.” He continues, 

“I am involved in every project the 

kids do, every activity, and we are 

always present. My parents never 

really knew what I did.” Parental 

involvement at this level also carries 

high expectations for success in 

education and careers. Youngsters 

are hopeful that they will be able to 

fulfill their parents’ dreams by 

excelling in school, winning 

academic awards, and being 

recognized for their talents. As 

Pranavi, a fourteen-year-old 

mentions, there 

is, “pressure to be perfect”. It is 

vital for parents to allow realistic 

expectations and also respecting 

the autonomy of their children. 

Nirupama Madduri, M.D. 

Houston, TX 

Ultimately, the most sensitive area 

of conflict between South Asian 

parents and their children is dating 

and relationships. Parents prefer that 

their children do not date in high 

school, college, or even afterwards. 

They feel a sense of responsibility for 

assuring that their children marry 

partners from good families, with 

successful careers, and, preferably, 

with similar ethnic background. As 

in “Bend it Like Beckham”, there is 

a significant dilemma when that 

potential partner is not South Asian. 

Many South Asian youth choose not 

to inform their parents if they want to 

cultivate a relationship with someone 

of a different ethnicity. Furthermore, 

parents advise their children not to 

date independently, and wait until 

an acceptable age to “look” for a 

suitable spouse. Researchers report 

varying degrees of parental 

involvement and support in regards 

to dating. 

Respect and honor of one’s mother 

and father comprise the foundation 

of the long-established ideals of 

South Asian culture. Learning to live 

in the Western world, where progress 

and industrial success are primary 

goals, the traditions of the homeland 

can be tested. As generations of 

South Asians become more active in 

society and successful in various 

facets of education and industry, the 

pressure to assimilate grows. Parents 

and children must communicate 

openly, providing a bridge between 

generations, thus strengthening the 

precious bond formed in the womb. 


35



Fast Track In Memorial 

Hermann Emergency Department 

by Swati Choudhary, M.D. 

Swati Choudhary, M.D. 

Houston, TX 

Emergency Department (ED) 

waiting periods have increased from 

1997-2004 by 4.1% 1 with resulting 

patient frustration causing loss of 

patient satisfaction. To reduce the 

waiting time a pilot Fast Track 

service labeled “Chair Project” was 

started in Emergency Department of 

Memorial Hermann Hospital at 

University of Texas (UT), Houston 

during September 2008. 

A separate Fast Track stream was 

started where patients were treated 

on chairs under supervision of an 

attending physician, a resident 

physician and two nurses. Less 

emergent conditions including 

extremity fractures or sprains, minor 

injuries, headaches, abdominal 

pains, nausea and vomiting, abscess, 

etc., not requiring couch for 

examination or urgent interventions 

were included. All patients were 

assessed and triaged by an 

experienced ED Nurse or a 

Physician and were fast tracked to 

an Emergency Room (ER) chair. Time 

spent by the patients in ER was 

reduced without compromising the 

health care standards. 

The Fast Track unit was run on 5 

random dates in September 2008 

from 1300 hrs-1700 hrs. 70 patients 

were fast tracked. Patient’s age 

varied from 3-67 years (mean 35 

years). The following medical 

conditions were treated; urinary 

tract infection(4), headaches(2), 

diarrhea(1), dehydration(1), back 

pain(4), abdominal pain(2), rectal 

bleeding(1), shingles(1), skin 

infections(8), ear pain(1), 

syncope(1), anxiety(1), dizziness(2), 

viral syndrome(3), bronchitis(1), 

asthma(1), anemia(1), otitis 

media(1), gynecological 

problems(3), obstetric problems(3), 

minor surgical problems like 

abscesses(5), cyst(1), cellulites(3), 

lacerations(4), burns(2), trauma(4), 

and orthopedic problems like 

contusions(3), sprains(3), pain in 

extremities(1) and fractures of 

extremities(4). 

The study compared time spent 

waiting for treatment on days with 

and without Fast Track in ED. 

Patient’s time from arrival to care 

complete for discharge averaged 90 

minutes (range 10-300 minutes) on 

fast track days. On non-fast track 

days average turn around time for 

September 2008 was 5.2 hours. 

Patient’s time spent in ER was 

reduced from 310 minutes to about 

90 minutes, an 82.7% reduction. 

Patient’s response was graded as 

Satisfactory, Unsatisfactory or 

Neutral. In patient satisfaction 61 

patient’s response was positive, 4 

patient’s response was negative and 

5 patients had a neutral response, an 

87% patient satisfaction 

The introduction of a separate Fast 

Track stream for minor injuries can 

lead to a significant decrease in time 

spent by patients in ED while 

maintaining the standards of care. 

The experience gained by the 

Chair Project led us to use this 

method during the strike of 

Hurricane Ike at Houston and 

proved to be of considerable benefit. 

References: 

(1) White Coat Notes, Cambridge 

Health, Harvard University. 

Swati Choudhary, MD., Research 

Observer, Dept. of Emergency 

Medicine, University of Texas, 

Houston, TX 

Yashwant Chathampally, MD., 

Attending Physician, Dept. of 

Emergency Medicine, University of 

Texas, Houston, TX 


37


Members In The News 

Dr. R.R. Vijaynagar 

Dr. R. R. Vijaynagar, “Dr. Vijay”, 

was recently honored in New Delhi 

by the Hon. Prime Minister of India, 

Dr. Manmohan Singh. The PM in a 

meeting with a group of Indian- 

American leaders congratulated the 

community on behalf of the 

Government of India for delivery on 

the Indian-American nuclear deal. 

In a personal letter to Dr. Vijay, the 

PM wrote, “I would like to convey 

my appreciation for your efforts in 

working for the successful 

conclusion of the Indo-US civil 

nuclear initiatives.” Dr. Vijay has 

served AAPI in many capacities – 

Vice President, Chair of Board of 

Trustees, Chair of AAPI Charitable 

Foundation and Chair of 1988 

Orlando Convention. Dr. Vijay also 

has the distinct honor of being the 

first surgeon who did a successful 

cardiac transplantation in Florida. 

Recently, he was appointed as a 

Member of Board of Directors, 

Tampa Bay Chapter or American 

Dr. Vijay (2nd from left) being congratulated 

by PM. Man Mohan Singh. 

Red Cross. AAPI congratulates Dr. 

Vijay for his many achievements. 

Dr. Bhagvan Bang 

In October 2008 American 

Academy of Pediatrics launched a 

campaign to find stories of the every 

day unsung pediatric heroes. After 

receiving hundreds of entries and 

MUCH deliberation, four individuals 

were selected by the NCE Planning 

Group Executive Committee. Dr. 

Bhagvan Bang was one of them. 

“Watching children suffer and die 

of preventable diseases in the small 

Indian town where I grew up 

inspired me to become a 

pediatrician. I graduated in 1982 

from Osmania University as an 

Indian Council of Medical Research 

Scholar and later received a gold 

medal for best graduating 

pediatrician of Niloufer Hospital in 

Hyderabad, the largest hospital in 

southern India. 

Before migrating to the United 

States, I worked as a neonatologist 

at Government Hospital in Riyadh 

for 5 years. On completion of my 

residency at Kansas University 

Medical Center, I moved to a 

medically underserved area in rural 

Dr. Bhagvan Bang 

Alabama to fulfill my immigration 

requirements in 1997.” 

Dr. Arun C. Gulani 

Dr. Arun C. Gulani, founding 

director of The Gulani Vision Institute 

in Jacksonville, Florida was awarded 

the Science Achiever of the Year 

Award for his innovative, world 

leadership in the field of eye surgery, 

LASIK in particular. With numerous 

inventions, techniques, protocols 

and classification systems named 

after him, Dr. Gulani has developed 

a reputation of being the Surgeon’s 

Surgeon. Often called the “ Da Vinci 

of eye surgery ” by peers worldwide, 

Dr. Gulani has raised the bar to 

deliver results beyond 20/20. 

Having invented the super 

specialty of Corneoplastique ȚM 

Dr. Gulani has turned vision corrective 

eye surgery like cataract and 

Lasik into an ART. With an ability to 

treat most levels of near-sightedness, 

farsightedness and astigmatism using 

a full range of techniques including 

the capacity to correct complications 

of other surgeons, helping patients 

who were told they are not Lasik 

candidates and even combining 

surgical tech-niques; Dr. Gulani’s 

practice attracts second opinion 

patients from reputed universities in 

the country and provides a training 

ground for the creme de la creme of 

eye surgeons worldwide. 

This combination of surgical 

innovation, professional leadership, 

revolutionary business entrepreneurship 

and personalized compassionate 

care, qualified him as an 

unparalleled choice among aspiring 

contestants nationwide. 

Dr. Gulani receives Science Achiever 

of the Year Award at Sony, South 

Asian Excellence Awards ceremony 

held in New York recently. 


39


Members In The News 

Dr. T. R. Shantha 

Nominated to receive Nobel Prize 

in Physiology and Medicine 

T.R. Shantha, MD, PhD, F.A.C.A 

was nominated for receiving Nobel 

Prize in physiology and medicine for 

the year 2007 for his research work 

on the membranes (PERINEURAL 

EPITHELIUM) of the peripheral 

nervous system and their role in 

health and disease. This research 

was conducted at the Emory 

University School of Medicine, 

spanning over a period of 15 years 

in collaboration with Late Profs. G. 

H. Bourne. The research work 

resulted in publication of his work 

in numerous research papers in 

every prestigious journal all over the 

world including, British journal 

Nature (7 papers), Science, NEJM, 

Journal of cell biology etc. Nobel 

laureates such as Dr's. Peter 

Medawar, Ellison, George Palade 

recognized the work decades back 

stating â??this fundamental 

discoveries of T. R. Shantha and Dr. 

Bourne deserves Nobel Prize in 

Medicineâ?? 

Dr. Shantha was also awarded 

Distinguished Physician Award from 

AAPI at their 23 Annual meeting at 

Houston Texas on June 19th of , 

2005 for his contribution to research 

and Medicine spanning 50 year. He 

was awarded Professional 

Achievement Award from 

Veerashaiva Samaj of North America 

(VSNA) at their annual meeting held 

in Maryland on July 3rd of 2005. In 

the year 2007, he played an 

important role in withdrawl of 

Exubera- a form of inhalation insulin 

to treat diabetes form the market 

due to his research findings 

publication â??that it causes lung 

canerâ??. At present he is involved 

in development of treatment for 

Autism, Alzheimerâ?s, periodontal 

diseases, hair 

loss, cancers, 

BPH, 

Meniereâ?s 

disease besides 

submitting 3 

patents on the 

energy and 

environmentally 

friendly electric bulbs and 2 patents 

on diabetes. 

AAPI Has New Legislative Director 

Dino Teppara has joined AAPI as 

the new Director of Legislative 

Affairs. He recently concluded a 

successful seven-year career on 

Capitol Hill working for U.S. 

Congressman Joe Wilson (SC-02), 

where he was the only Chief of Staff 

and Counsel in the U.S. Congress. 

He has a long list of legislative 

achievements, including writing the 

first-ever congressional resolution 

commending India’s Republic Day, 

the resolution celebrating the festival 

of Diwali, and the congressional 

resolution calling on Congress to 

commission an official portrait of 

the first Indian American ever 

elected to Congress, Dalip Singh 

Saund. He served as a liaison for 

State Department and White House 

officials to secure passage of the 

U.S.-India Civilian Nuclear 

Cooperation Agreement through the 

House Foreign Affairs Committee 

and full House of Representatives. 

He has extensive fundraising and 

political experience, and is a veteran 

of ten political campaigns around 

the country, including in Iowa, 

Kentucky, South Carolina, California, 

Virginia, Louisiana, and Ohio. Prior 

to working in Congress, he served as 

a law clerk to Judge H. Samuel 

Stilwell on the South Carolina Court 

of Appeals from 2000-2001. Dino is 

a licensed attorney and received his 

law degree from Indiana University’s 

School of Law in Bloomington in 

2000. He received his B.A. from the 

University of Nebraska-Lincoln in 

1997, majoring in Philosophy with a 

minor in English. 

He attended 

Nebraska on an 

athletic 

scholarship, 

playing Division 

One NCAA 

tennis, where he 

was a three-year 

letterwinner and three-time All- 

Academic conference selection. 


41


Poem’s 

I Made Sandwiches On 26/11 

I was on night shift at Taj on 26/11 

Paying no attention to the noise upstairs 

Or the burst of firecrackers frequently. 

Sounds of night in the neighborhood! 

I was making sandwiches in the kitchen. 

Someone said it is a gang war 

I looked up and saw CCTV was out 

Police sirens were getting louder 

They will take care of the goons 

I must make sandwiches for the guest. 

Cell phone rang in my pocket 

Dad was calling from Pune 

“What is going on over there”? 

“Nothing much, Dad. Some kids fighting 

I have to make sandwiches. 

Hour later Dad called again, 

“There are terrorists in Taj. 

It is all over the TV. Get out of there” 

“There is nothing happening here, Dad? 

I must make sandwiches.” 

I called my friend 

“Come and help me. I got hit in the leg” 

He came and dragged me to the lift 

We waited for lift door to open 

I had to stop making sandwiches. 

A young boy came downstairs 

In army fatigues, laughing, having fun 

I smiled back saying,” Oh! Help is here” 

My smile froze on my lips, as 

The boy emptied his A/K 47 into us. 

18 Terrorists came to Mumbai by sea 

They killed 179 innocent people 

And damaged historical sites 

8 died in combat and one was captured 

Rest escaped in glory of their evil act. 

I did not finish making sandwiches!!! 

VIJAY KULKARNI 

Pune, December 12 2008 

(Chef was a 28 year old son of an acquaintance in 

Pune) 

Slow Dance 

Have you ever watched the children 

Having a blast on a merry-go-round? 

Or listened to the rain 

Making music on the leaves and the ground? 

Ever followed a butterfly's erratic flight? 

Or gazed at a full moon on a starry night? 

Did you feel that their life was at its best? 

You better slow down. 

Step back, don't dance so fast. 

Our life is too short 

And its music won't last. 

Do you run through each day? 

You often seem to be on the fly! 

When you ask “How are you”? 

Do you hear the reply? 

When your day is done, 

And you lie in your bed 

With the next hundred chores 

Running through your head 



Our life is too short. 


Ever told your child, 

We will do it tomorrow? 

And in your haste, 

You do not see his sorrow? 

Ever lost touch, 

Let a good friendship die, 

because you did not have time 

To call and say, "Hi, I love and care for you” 



Our life is too short. 


When you run so fast to get somewhere! 

You miss half the fun of getting there. 

When you worry and hurry through your day 

It is like an unopened gift.... 

Thrown away. 

Life is not a race. 

Do take it slower 

Hear the music --- 

Before the song is over. 

ARUN PRAMANIK 


43


Poem’s 

Life without Kidneys 

Blood filled tangled web of tubes 

Readings too many on the big 

machine 

AV fistula that pulsates with the heart 

Anemic and tired looks 

Long hours at dialysis 

Kidneys, God given cleansing machines 

Filter poisons day and night 

Keep the host fit and trim 

Nephritis attacks insidious, yet with vengeance 

Fails the kidneys, leads host’s life down the hill 

Connected to the machine tight 

Three times a week and four hours each session 

Life hard to live tied up 

No where to go; no sun sets or vacations with kids 

No salt, no carbs, Diets hard and tight 

Fluids restricted, to live by the book every minute 

Kidneys matching and compatible 

Embryonic Stem Cells with their promises 

Replace lost kidneys sweet and loud 

Cure is so close, and 

Yet God, so far away 

SIVAPRASAD D. MADDURIMD 

Poplar Bluff, Missouri 

(After watching a friend going through dialysis — 

author) 

Changing Venues, Interdependence 

As I first stood up to walk my parents 

held my hand 

As I walked waddling at best they 

walked by my side 

As I walked to school they worried but 

let go 

As I returned they waited to hear of my adventures 

As I sought independence my teachers held my hand 

As I faltered they gently brought me back on track 

As I learned more they taught me even more 

As I left the school they wished me well 

As I grew up my friends held my hand 

As I worried they lessened my load 

As I walked ahead they walked behind 

As I accomplished they celebrated my success 

As I had my children my family held my hand 

As I marched on they spelled my future 

As I worried they rallied to my support 

As I matured they shared my wisdom 

Life is all about interdependence 

CHANDER M. KAPASI, M.D., MHP 


45


Book Review 

Cutting For Stone 

By Abraham Verghese, M.D. 

Published by Alfred A Knopf, Random House, 560 pages, $26.95 

There are two essential requirements 

for the success of any writing, 

fiction or non-fiction: knowledge of 

the subject matter and the art of 

conveying it to the readers. Dr. 

Abraham Verghese certainly is 

blessed with both, as is obvious in 

his highly successful and truly 

compelling work of medical fiction, 

‘Cutting for Stone.’ 

This fascinating novel, set mostly 

in Ethiopia, but also in the USA, is 

about a set of twins – Marion and 

Shiva, born out of the secret union 

between Sister Mary Joseph Praise, a 

beautiful Indian nun/nurse, and 

Thomas Stone, a British surgeon 

raised in India. Both are working in 

‘Missing Hospital’ – a Mission 

Hospital in Adis Ababa, Ethiopia – a 

word that came out with a ‘hiss’ on 

the Ethiopian tongues. 

Unfortunately, the mother dies 

during child birth and the orphaned 

twins are saved by Hema, the 

Obstetrician from India in that 

hospital. Dr. Stone absconds, unable 

to take responsibility for his actions 

and cope with the enormous reality. 

The twins are adopted by Hema and 

Abhi Ghosh, an internist, who is the 

third doctor at that hospital. 

Marion and Siva grow up with 

entirely different personalities. 

Marion, a sensitive, introspective 

young man, is in love with Genet, 

whereas Shiva, the outgoing, fun 

loving person dating many and 

learning Bharatha Natyam, spoils 

Marion’s love interest. While they 

drift apart because of a deep 

misunderstanding, they still share a 

love for medicine, instilled by Dr. 

Ghosh. With the political turmoil of 


Ehtiopia under the dictatorship of 

Emperor Haile Selassie and the 

Eritrean revolution, Marion is forced 

to run away to America where he 

joins a surgical residency in a New 

York City hospital. Shiva too pursues 

a career in surgery in Ethiopia. The 

twins are finally reunited in America 

under somewhat dramatic, yet tragic 

circumstances through the 

intervention of their long- vanished 

father Dr. Stone, now working at the 

“Mecca of Medicine” in Boston. 

The story told through the voice of 

Marion has all the elements of a 

riveting read. Vivid descriptions of 

surgical procedures could perhaps 

be a bit disturbing for the nonmedical 

readers. The author’s 

sensitive mind deeply touched by 

the poverty, political turmoil, 

sufferings of women in Ethiopia as 

well as the plight of the hardworking 

residents in a New York City hospital 

uncannily reaches out to the 

readers. In spite of some overly 

dramatic situations and the familiar 

theme of long-suffering, abandoned, 

adopted twins eventually reuniting 

in USA after a brief separation, it is 

the development of the plot in 

settings unknown to most that 

intently grasps our attention. 

I was thrilled to see that bed side 

clinical teaching, a marvelous, but 

dying art in these days of high- tech 

medicine, is much emphasized. The 

author himself is a reputed clinician 

and a master bedside teacher. If one 

wonders about the title, Stone being 

the surname of three key characters, 

it is an epigraph from the Hippocratic 

Oath, I will not cut for stone, 

even for patients in whom the 

disease is 

manifest; I 

will leave this operation to 

be performed by practitioners, 

specialists in this art. 

Dr. Verghese captured the 

attention of the public through his 

very first work ‘My Own Country,’ 

depicting the arrival of AIDS in rural 

Tennessee (a 1994 NBCC Finalist 

and a Times Best Book of the Year) 

which introduced him to the best 

selling authors’ list. This was 

followed by The Tennis Partner , a 

New York Times notable book. And 

writing is only his second love – he 

is Professor and Senior Associate 

Chair of the Theory and Practice of 

Medicine at Stanford University 

School of Medicine! As one writer 

put it, “Dr. Verghese is one of those 

part-time writers who make full-time 

writers and journalists jealous.” 

When I met this renowned author 

in New Port Beach, CA, in July 

2008, he had promised me to send 

his new book as soon as it is 

released for review in AAPI Journal. 

He was a key note speaker for the 

2004 AAPI Convention in Houston. 

With his debut novel, Dr Verghese, 

already a respected non-fiction 

writer, has earned his wings as a 

much-admired fiction writer. This is 

a must read for all of us, there is a 

lot to learn from this powerful, 

enduring work. I have just started rereading 

it to relish it even more. 

Reviewed by M.P. Ravindra Nathan, 

MD, FACP, FRCP, FACC 

Cardiologist, Brooksville, FL

AAPI Executive Office 

600 Enterprise Drive, Suite 108 

Oakbrook, IL 60523 

PRSRT STD 

U.S. POSTAGE 

PAID 

Tampa, FL 

PERMIT # 4309

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