SPRING - American Association of Physicians of Indian Origin

SPRING 2011 

AAPI 

Journal 

F O C U S O N T H E Y O U N G E R G E N E R A T I O N 

“Investing in... 

...the Future” 

1 2 

MSRF/YPS PHOTO 

CONTEST WINNERS 

3 3 

INSIDE: • MSRF/YPS Contest Winners • Reports from the Committee on Medical Rotations to India, 

Committee on Medical Missions and Community Service • Project Pacemaker International • In Giving is 

Receiving • Heart Disease Epidemic Among Asian Indians • Heart Disease in South Asians

2011 Capitol Hill Legislative Conference 

Wednesday, June 1, 2011 

B-369 Rayburn 

House Office Building Washington, D.C. 20515 

8:00 a.m. - 1:30 p.m. 

Evening receptionn 

B-354 Rayburn 

House Office Building 

5:30 p.m. - 7:30 p.m. 

Also to be attended by community leaders from AAHOA, GOPIO, NFIA, etc. 

AAPI will initiate a discussion on issues affecting the Indiann American community during the reception 

Dinner at the Embassy of India Hosted by Indian Ambassador Meera Shankar - 8:00 p.m. onwards 

2107 Massachusetts Avenue, N.W. Washington, D.C. 20008 

Speakers 

U.S. Congressmann Andy Harris, MD (R‐MD) 

U.S. Congressmann Phil Gingrey, MD (R‐GA) 

U.S. Congresswoman Zoe Lofgren (D‐CA) 

U.S. . Congressman Bill Cassidy, MD (R‐LA) 

U.S. Congressman Phil Roe, MD (R‐TN) 

U.S. Congressman Joe Heck, , MD (R‐NV) 

U.S. Congressman Paul C. Broun, Jr., MD (R‐GA) 

U.S. Congressmann John Fleming, MD (R‐LA) 

U.S. Congressman Frank Pallone (D‐NJ) 

Neil Chatterjee, Esquire – 

Legislative Assistant to U.S. Senator Mitch McConnell (R-KY) 

Dr. Robert Moffitt, Ph.D. – 

Senior Fellow, Center for Policy Innovation, The Heritage Foundationn 

Vivek Murthy, MD, MBA – 

President and Co-Founder, Doctors for America 

Nicholas Rathod, Esquire – 

Deputy Director, White House Office of Intergovernmental Affairs 

Thomas C. Roberge, Jr. – 

Senior Assistantt Director, Division of Congressional Affairs, American Medical Association 

Mike Stinson, Esquire – 

Director of Government Relations, Physicians Insurers Association of America (PIAA) 

Neera Tanden, Esquire – 

Chief Operating Officer, Center for American Progress 

Ajeet AAPI R. Singhvi, Director MD, of President Legislative • Affa Krishan airs Dino Aggarwal, Teppara, MD, Esqui Leg. ire Chair will serve • Dino e as the Teppara, conference Esq., moder Leg. rator. Director 

Conference registration is limited to the first 100 50 people to RSVP 

Reception registration is limited to the first 150 people to RSVP 

To RSVP, please provide name, email address, cell phone numberr and city/state 

to: 

info@aapiusa.o 

org or call 630-990-2277 

Please visit the Legislative Affairs Page on the AAPI Website for more information. 

* While all speakers are currently confirmed, speakers and topics are subject to change *

aapi content 

President 

Ajeet R. Singhvi, MD, FACG 

600 Enterprise Drive, Suite #108 

Oakbrook, IL 60523 

Phone: (630) 990-2277 

Fax: (630) 990-2281 

president@aapiusa.org 

www.aapiusa.org 

AAPI Journal Editor 

M. P. Ravindra Nathan, 

MD, FACC, FACP, FRCP (Lond & Can) 

Hernando Heart Clinic 

Brooksville, FL 34613 

Phone: (352) 597-3353 

Fax: (352) 597-3368 

ravinath@tampabay.rr.com 

Office Manager 

Vijaya Kodali 

vkodali@aapiusa.org 

Marketing Communications 

& Ad Sales 

Sam Fulambarker 

sam@aapiusa.org 

Designed & Printed by 

GR Marketing & Graphic Design 

Phone: (813) 886-4500 

Fax: (813) 886-4501 

Copyright©2011 by 

American Association 

of Physicians 

of Indian Origin. 

All rights reserved. 

4 Message from the President – Ajeet R. Singhvi, MD 

7 From the Editor’s Desk – M. P. Ravindra Nathan, MD 

8 MSRF President’s Report – Mamta Singhvi, MD 

9 YPS President’s Report – Priya Kundra, MD 

11 Readers Respond 

MSRF/YPS competition 

12 Cover Story - The First Ever AAPI MSR/F/YPS Contest in: 

Creative Writing, Poetry & Amateur Photography – M. P. Ravindra Nathan, MD 

14 - 21 Creative Writing Winners 

22 - 23 Poetry Winners 

24 - 27 Photo Competition Participants 

MSRF/YPS JOURNAL 

28 Networking Beats Not Working – Pooja Voria, MD 

29 Medical Rotation to India: Vinod Sancheti, MD, Swarup S. Swaminathan, MD, 

Neil Krishan Aggarwal, MD & Kinjal Shah 

aapi charitable activities 

32 Report from the Committee on Medical Missions & 

Community Service – Ram Upadhyay, MD 

34 Project Pacemaker International Inc. – Salil Midha, MD, Susan DeTurk 

and V.K. Saini, MD 

36 In Giving is Receiving – Gopal Badlami, MD 

Featured Articles 

38 Heart Disease in South Asians: “Facts we should know as Indian Americans to help 

reduce our risk.” – Pravien K. Khanna MD 

40 Heart Disease Epidemic among Asian Indians and Low Threshold of 

Intervention – Enas A. Enas, MD 

21 Members in the News - Dr. Reddy Receives Award 

42 - 43 AAPI News 

44 “My Battlefield” – Vijay Kulkarni, MD 

45 MSRF/YPS New Members 

about the cover 

AAPI President Dr. Ajeet R. Singhvi addressing at AAPI Convention in Washington, D.C. 

MSRF/YPS Board Members-left to right: Maneesh Kumar, Dr. Vinita Bhagia, Dr. Priya Kundra, Dr. Pooja Voria, 

Dr. Mamta Singhvi and Dr. Julie Patel 

1st Prize - Imran Shaik ‘Solitude’ • 2nd Prize - Kinjal Shah ‘There is Hope... is there a Future?’ 

3rd Prize - Rahul Wadke ‘Reflection’ • 3rd Prize - Sriram Eleswarapu ‘Nothing to Fear’ 

DISCLAIMER: 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 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. Please note that the acceptance of advertising in this journal does not constitute or imply endorsement by AAPI of any product or service nor 

does AAPI accept any responsibility for any claims made in any advertisement, unless otherwise stated by AAPI. In addition individual advertisers are solely responsible for the 

content of their advertising material which they submit to us, including ensuring that it complies with relevant legislation.

President’s 

REPORT 

Ajeet R. Singhvi, MD, FACG 

As the President of the American 

Association of Physicians of 

Indian Origin (AAPI), it is my 

privilege to present the President’s 

report. 

Focus on Younger Generation 

We have always mentioned that MSRF and YPS are our 

future. All that we have achieved towards this goal, so far this 

year and hopefully during coming years is a culmination of the 

efforts of present and past leaders. We have made a sincere effort 

and tried very hard to put that focus into action. Our leadership 

development program has been a great success. We have had five 

such programs, beginning with Newport Beach, CA onto Long 

Island, NY, Dallas, TX, Chicago, IL and Detroit, MI. I thank 

the YPS President Dr. Priya Kundra and MSRF President Dr. 

Mamta Singhvi along with Dr. Smita Tandon, Dr. Mukul Arya, 

Dr. Arti Gupta, Dr. Pratap Kumar and Dr. VJ Desai for making 

these programs successful. Our legal counsel Mr. Andy Schlafly, 

Mr. Bob Miglani and Dr. Jayesh Shah also need credit for this 

success. 

Medical Rotations to India 

Several Medical Students and Residents have completed 

their 4-weeks rotation and have shared their experiences with 

their colleagues and in AAPI Journal and website as well. I 

expect this program to be very popular in coming years. I urge 

you to please sponsor one Medical Student or Resident for only 

$1,500. Please make your check payable to “AAPI Charitable 

Foundation” and send it to AAPI office. 

Medical Missions and Community 

Service 

Several projects are ongoing in India and elsewhere. Dr. 

Sudeep Kukreja’s mission to China was very successful. Please 

contact Dr. Ram Upadhyay, Chair of the Committee, Dr. Nitin 

Shah, Co-Chair as well as AAPI office for current as well as and 

future missions and community service projects. 

4 Spring 2011 • AAPI Journal 

Other Programs 

Our Observership program under the leadership of 

Dr. Bhoja Reddy has helped secure residency for quite a few 

International Medical Graduates. I thank all the Physicians who 

have participated in the program and invite other physicians to 

join to be a mentor. MSRF President Dr. Mamta Singhvi along 

with Ms. Sangita Sancheti are working together for a mentorship 

program for High school and early college students. 

The Capitol Hill Internship Scholarships for Young 

Medical Students and Physicians is a great opportunity to serve 

and learn healthcare policy making with senior Legislators. 

Please contact our Legislative Director Mr. Dino Teppera (dino. 

teppara@gmail.com) or AAPI office (info@aapiusa.org) for the 

same. 

This year we have had a record number of Residents/ 

Fellows/Young Physicians joined our Organization as Patron 

members. Once reluctant to be part of AAPI, these young 

physicians are very happy to join the organization and I see 

definite interest and pride in them to have become part of the 

organization. I see a very strong future for the Organization 

in their leadership. Thanks to the leadership of Dr. Narendra 

Kumar, Chair, Membership Committee that we will recruit over 

1500 physicians this year alone, as Patron (life) members. 

AAPI GOVERNING BODY 

Spring Governing Body in Chicago, IL was extremely 

successful. This was perhaps the most attended meeting 

where all the 10 current AAPI Board of Trustees, all 7 AAPI 

Officers, 6 current Regional Directors, all three past Presidents 

from Chicago and several past AAPI and local leaders were in 

attendance. Before the hard work on Saturday, the delegates had 

wonderful cruise on Lake Michigan along with good food and 

entertainment. The Governing Body awarded 2013 and 2014 

AAPI Conventions to Chicago and San Antonio respectively. 

It also unanimously approved the formation of first ever Health 

India Think Tank. It appointed Dr. Pawan Rattan to Chair this 

Think Tank. It will be an autonomous body with partners from 

India, USA and other countries to deliberate on healthcare issues

Left: Youngest AAPI 

fan Anokha Jana 

Nathan dancing 

during Friday night 

cruise. 

Below: Congressman 

Jessie L. Jackson 

Jr. dancing with Dr. 

Manju Sachdev on 

Saturday evening 

gala. 

president’s report 

improve Women’s healthcare in this Country and to help them 

live longer and healthier lives. 

AAPI Charitable Foundation 

This has been our flagship arm. Dr. Shashi S. Shah is 

helping us not only in Medical Missions, Medical Rotations etc., 

he has been busy raising funds. He attended AAPI-Alabama 

Chapter meeting on May 7th, 2011, where he presented a check 

of $5000 on behalf of the AAPI-CF to the Governor Robert 

Bentley for the people affected by the nature’s wrath. AAPI- 

CF is holding a fundraiser on May 21st to continue to fund 

the worthy causes. Our ambitious program to install Automatic 

External Defibrillators in each and every Indo-American 

community center in the Country to improve the survivability 

of sudden cardiac arrest victims was recently launched. The first 

Automatic External Defibrillator was presented to install at the 

Indian Consulate in New York. Honorable Counsel General 

Mr. Prabhu Dayal was very appreciative of AAPI-CF efforts. 

We hope to expand the program to several community 

centers around the country in next several months. Please 

support the AAPI-CF activities generously. 

Legislative Agenda 

Drs. Ajeet, Mamta and Gaurav Singhvi with Congressman 

Jessie L. Jackson Jr. at the Governing Body in Chicago 

and healthcare policy and create a forum for public debate and 

Government policy. At the gala banquet dinner, Congressman 

Jessie L. Jackson Jr. gave a very motivational speech. He 

interacted with the crowd till late and danced as well to the 

Indian music and live numbers by Babul Supriyo. 

AAPI Women’s Health Forum 

Dr. Manju Sachdev, Chairperson of the Women Physicians 

Committee along with TIIPS local president Dr. Arati Gupta 

held a very successful Women’s Health Forum in Dallas, TX on 

March 5th. It was attended by record number of delegates. The 

forum clearly demonstrated the unwavering mission of AAPI to 

Dr. Krishan Aggarwal as Legislative Chair and Dino 

Teppara, JD, Esq as the Legislative Director have been very 

busy working to put together a Legislative Day planned for 

June 1, 2011 in Washington D.C. We have a very busy morning 

session, beginning with healthcare issues. We plan to continue 

to work with the Congress towards increasing the Residency 

slots, which are desperately needed. J1 visa waiver, permanent fix 

of SGR, loan forgiveness and adjustment for Medical Students 

and Young Physicians and increased salary for them are some 

of the issues we are going to address. We have also invited 

later in the day, the leaders of various organizations including 

AAHOA, GOPIO, NFIA and others to join and interact with 

the legislators and address the concerns of the community. They 

will also join us at the reception in the evening at the Capitol 

Hill as well as join in the interaction with Madam Ambassador, 

officials and staff at the Indian Embassy during the dinner. 

CME 

I am happy to report that for the first time after years of 

hard work by past leaders, AAPI has become a CME provider 

with ACCME. I thank Dr. Sri Iyengar and his team for the 

hard work. We should be able to (continued on page 6) 

www.aapiusa.org 5

(continued from page 5) 

provide CME not only for AAPI programs but for the umbrella 

organizations as well. The Regional CME programs and CME 

in India were extremely successful under the leadership of Dr. 

Sunder Mudaliar. Dr. Sunder Mudaliar, Dr. Jagat Narula and 

Dr. Rakesh Gupta along with Convention CME Chair Dr. 

Praveen Singhal are working diligently to provide outstanding 

CME of over 12 hours at the New York Convention. 

Membership Benefits 

The Membership Benefits Committee under the leadership 

of Dr. Lakhu Rohra and Dr. Hemant Dhingra have done a great 

job this year. A comprehensive benefit package is available to 

all the members and we are adding benefits frequently. We are 

working on providing a membership Identification card to our 

Patron Members. We want to provide a welcome kit for the 

Medical Students joining AAPI as new members. 

AAPI Annual Convention 

We are getting wide-ranging support from all the past 

leaders, AAPI members and community-at-large for our New 

York Convention. The Convention Committee under the 

leadership of Dr. Ajay Lodha is working round the clock to 

give us a memorable convention. Please register now to take 

advantage of the early bird pricing and book your hotel to avoid 

disappointment. 

I have been regularly attending the Board of Trustees 

meetings. Dr. Ashok Fulambarker and his entire team have been 

addressing several important issues including financial stability. 

Dr. Satish Anand, our current Board of Trustee was elected at 

the Chicago Governing Body meeting to be the next Chair, 

Board of Trustees 

I am very thankful to my entire Executive Committee, 

various chairs and AAPI leadership for their steadfast support. 

I am particularly grateful to Dr. Ravi Nathan, editor of AAPI-J 

and Dr. Pooja Voria-Borde, Chair, MSRF publications for 

bringing out special issue dedicated exclusively to MSRF & 

YPS. I congratulate all the participants including the winners of 

various competitions and we are proud of their talents. 

I have been travelling and have attended several Alumni, 

regional and various organizational meetings during the year. I 

would like to thank Ms. Vijaya Kodali, Mr. Sam Fulambarker 

and Ms. Harshita Mukunda at AAPI office who have been a 

great asset to the organization. We welcome the new addition 

Ms. Anam Arshad. The Executive Director Search team will 

hopefully find the right candidate soon. 

I will be happy to receive and respond to your comments 

and suggestions. 

Respectfully Submitted. 

Ajeet R. Singhvi, M.D., F.A.C.G 

president@aapiusa.org 

editorial committee 

Sagar Galwankar 

MBBS, DNB, MD, MPH, Diplomat ABEM 

Chief of Academics 

INDO-US Emergency & Trauma Collaborative 

M P Ravindra Nathan MD, 

Cardiology 

Chair – ravinath@tampabay.rr.com 

Shivprasad Madduri MD, 

Urology 

Vice Chair – madduri@semo.net 

Sagar Galwankar MD, 

Emergency Medicine 

Vice Chair – scsagar@yahoo.com 

Naresh Parikh MD, 

Cardiology 

nparikh1950@gmail.com 

Radha Menon MD, 

Internal Medicine 

menon@aol.com 

Priya Kundra MD, 

Endocrinology Diabetes Mellitus 

kundrapk@yahoo.com 

Chakrapani Prakash, MD, 

Gastroenterologist 

chak811@yahoo.com 

Nirupama Madduri MD, 

Developmental Pediatrics 

nirumad108@hotmail.com 

Mamta Singhvi, MD, MSR 

President, MSR 

mamtasinghvi@gmail.com 

Snehal Desai, MD, 

Radiation Oncology Chair, 

IT Section AAPI snebcm@gmail.com 

Pooja Voria Borde, MD, M.B.A. 

Chair, MSR Publications 

pvoria@gmail.com 

Anil K Gupta, MD, FACC, 

Cardiology 

anil.gupta@oceanheartcenter.com 

Ujwala Dixit MD, Psychiatry 

udixitmd@gmail.com 

Sam Fulambarker, Ex officio 

sam@aapiusa.org 

6 Spring 2011 • AAPI Journal

from the editor’s desk 

To the Poets, Writers & Photographers of 

Young AAPI: WELCOME! 

M. P. Ravindra Nathan, MD 

This issue of AAPI Journal 

is dedicated to the youth of 

AAPI - Medical Students, 

Residents, Fellows and Young 

Physicians (MSR/ F/ YPS). Every year, we earmark one 

issue to showcase the talents and activities of our younger 

colleagues. And for the first time in the history of AAPI, 

we organized a contest in Creative Writing, Poetry and 

Amateur Photography for the MSR/F/YPS. Please 

read the cover story and the special section regarding 

the details of the competitions with the prize-winning 

articles and poems and look at the center spread of their 

photographs. All the judges certainly enjoyed going 

through their creative offerings and you will, too. 

I must thank Dr. Ajeet Singhvi, our President, and 

the Executive Committee for making all these possible 

– finding the resources and entrusting this awesome 

responsibility with the Editorial Committee. It was 

indeed a challenge to pore over the many submissions in 

each category, catalogue them properly, transmit them 

to the judges, tabulate the results and decide the final 

winners. The last part was the most difficult since all the 

submissions were of high caliber and difficult to separate 

from each other. Although we had only a short time to 

work with, we did our best to complete the project on 

time. Dr. Pooja Voria Borde was quite instrumental in 

getting the word out through her periodic e-mail blasts 

and personal communications. It was, indeed, a very 

time consuming and effort intense project but it was all 

worthwhile. 

Some of the other articles in this issue highlight the 

many charitable projects our members are doing globally. 

A few are from the MSR/ F/ YPS ranks. It is nice to 

know more and more AAPI Members are into helping 

others, a very commendable act. These are the people who 

veritably embody the spirit underlying, “Manava seva is 

Madhava seva.” AAPI appreciates everything you do to 

make another person‘s life better. 

The recent Governing Body meeting in Chicago 

was well attended and we achieved a lot without getting 

mired in too much controversy. The Friday night cruise 

in Lake Michigan was very enjoyable with good food, 

great dancing and plenty of camaraderie. My five year 

old granddaughter Anokha said later: “Grandpa, it was 

exciting to dance with the uncles and aunties. May be I’ll 

join AAPI too!” 

On April 30, 2011, I travelled to Melbourne, 

FL to participate in the 9th Annual Medical Expo & 

CME Conference of Brevard Indo American Medial & 

Dental Association (BIMDA), a very successful chapter 

association of AAPI, as an invited guest. The entire 

program including the gala ceremonies in the evening was 

outstanding. Our chapters are our strength and it is always 

nice to see their growth as they uphold and propagate the 

mission and goals of AAPI. 

Congratulations to all the newly elected officers 

of AAPI for their well deserved wins! They will carry 

the mission of AAPI and take our association to 

greater heights. And thanks to all the contributors and 

those readers who took the time to send their valuable 

opinions about the journal, some of which appear in 

“The Readers Respond” column. It is very gratifying 

that other magazines are willing to quote or reprint the 

articles published in AAPI Journal - the true testament 

of approval by our peers. 

www.aapiusa.org 7

MSRF President’s Report 

Mamta Singhvi, MD * 

Hello, and welcome to the 

3rd edition of our AAPI 

Journal! I would like to 

start by thanking Dr. Ravi 

Nathan and Dr. Ajeet R. Singhvi for dedicating 

this issue to MSRF/YPS. I am truly excited by 

the impressive submissions and grateful for the 

opportunity to showcase our talent 

In terms of our achievements until this point 

in the year, we continue to work hard to provide 

our members with new and exciting opportunities. 

Our board has been hosting charitable socials 

throughout the country benefiting various nonprofit 

organizations. Recent events in Chicago, 

Washington, D.C. and New York City were 

successful and more are in the works. Leadership 

seminars in Chicago and Detroit were heavily 

attended, as we strive to improve presentation 

caliber and tailor material to our audience. We 

continue to send MSRF members on one month 

rotations to India, and every experience has been 

truly unforgettable. We hope that this tradition will 

continue for years to come, as the potential to learn 

and give back to our native country is unparallel. 

Our one month Washington, D.C. legislative 

internship is a unique chance for our members to learn 

of political intricacies as they relate to healthcare 

professionals. If interested in applying, please visit 

our website at www.aapimsr.org. Additionally, 

I invite each and every one of you to our annual 

AAPI Legislative Day on June 1, 2011. We will 

be meeting with several bipartisan Congressmen to 

express our collective stance on issues such as the 

need to increase national residency slots, waive J1 

visas, loan forgiveness, and increasing resident/ 

fellow salary. We must realize that the only way to 

impact change is to become involved in the process. 

As June looms in sight, I look forward with 

great enthusiasm to our Annual Convention, to be 

hosted at the NYC Manhattan Hilton from June 

22nd-26th. Early Bird registration will be ending 

on May 23rd, and I urge all of you to take advantage 

of the heavily discounted MSRF rate of $285, A-Z 

package. This includes evening events held at such 

exclusive venues as 230 5th Rooftop Lounge and 

Cipriani’s Wall Street; stimulating CME series, 

research competitions, speaker panels, mindful yoga 

sessions, a world class fashion show, and more. Not 

to mention that we will be in the heart of the Big 

Apple, and walking distance to Radio City Music 

Hall, Central Park, MOMA, Times Square, etc! 

Register at www.aapiconvention.com 

I look forward to seeing you all in June, and 

as always, please do not hesitate to contact me with 

any questions, concerns, or suggestions. Thank you 

for giving me the opportunity to serve you. 

AAPI-MSRF President 

*president@aapimsr.org 


YPS President’s Report 

Physicians should embrace the arts as well 

Priya Kundra, MD * 

Being a physician can at 

times require you to be a 

“superhero.” For example, 

you must remain calm and, 

at times, emotionless when 

faced with difficulties such as breaking bad news, 

coping with death, and handling excessive stress or 

tragedy. It is important to recognize that the same 

types of support networks that are available for patients 

and others are also available for physicians: namely, 

family, friends, and religious/spiritual networks. 

However, it is equally important to embrace the 

arts such as creative writing, poetry, and painting-- 

all of which are excellent ways to express oneself in 

a form that can lead to more empathy and a better 

understanding of the intangible human experience 

between patients and colleagues. Indeed, the arts 

allow a form of expression that often leads to greater 

self-awareness and less of an “emotionless” superhero 

approach. 

I am thrilled to see so many of our young 

physicians, fellows, residents, and medical students 

embrace the arts in this month’s edition. I hope we 

will continue this tradition for years to come. 

YPS Section President 

* Endocrinologist: Washington Hospital Center 

Assistant professor of Medicine: Georgetown University 

Hospital 

email: kundrapk@yahoo.com 

‘Still Life’ 

Oil on canvas 

Abdul Karim, MD, FACC 

Merritt Island, FL 

www.aapiusa.org 9

aapi executive officers 

Ajeet R. Singhvi, 

MD, FACG 

President 

Sunita Kanumury, MD 

President-Elect 

Narendra Kumar, MD 

Vice President 

Jayesh B. Shah, MD 

Secretary 

Ravindra R. Jahagirdar, MD 

Treasurer 

Vinod K. Shah, MD 

Immediate Past President 

Ashok M. Fulambarker, 

MD, FCCP 

Chair, BOT 

Priya Kundra, MD 

YPS President 

Mamta Singhvi, MD 

MSRF President 

REGIONAL DIRECTORS 

Radha Menon, MD 

Pacific Regional Director 

Prem Rupani, MD 

NE Central-I Regional Director 

Sharwan Bagla, MD 

Mid Atlantic-I Regional Director 

Vishweshwar R. Ranga, MD 

Mountain Regional Director 

Gautam Samadder, MD 

NE Central-II Regional Director 

Anil K. Gupta, MD 

Mid Atlantic-II Regional Director 

Vimal Goyle, MD 

NW Central Regional Director 

M.S. Arun, MD 

SE Central Regional Director 

Suresh K. Gupta, MD 

South Atlantic Regional Director 

Tarakumar B. Reddy, MD 

SW Central Regional Director 

Onaly A. Kapasi, MD 

New England Regional Director 

Vibhuti N. Singh, MD 

South Regional Director 

board of trustees 

Ashok M. Fulambarker, MD, FCCP 

Trustee 

Satish K. Anand, MBBS 

Trustee 

Naresh Parikh, MD 

Trustee 

Muttathil P. Ravindra Nathan 

Trustee 

Seema Jain, MD 

Trustee 

Anil Khosla, MD 

Trustee 

Shobha Gupta, MD 

Trustee 

Suresh C. Gupta, MD 

Trustee 

Sanku Surender Rao, MD 

Trustee (Past President) 

Durgesh P. Mankikar, MD 

Trustee 


eaders respond 

Readers Respond 

Congratulations Dr. Nathan, on a job well done. I 

apologize for the delayed response, but I did not get my copy 

of last AAPI Journal on time. I see that many doctors have 

expressed interest in having a ‘peer review medical journal’ 

from AAPI, modeled on JAMA. Great idea! Needs a lot of 

work and commitment from everyone involved. 

What do you think about the idea of having a section 

‘Original Theory’ similar to the one in Lancet. As far as I 

am aware, Lancet is the only journal which is open to new 

ideas, without the need to substantiate. A section on ‘Being 

an Indian Doctor’, similar to the one in Annals of Internal 

Medicine, will encourage people to write; I want to share 

with you my own ‘original idea’ if you are interested , to see 

what your thoughts are. My last GI chief thought it will 

need lab support and funding. 

Chak Prakash, MD 

substance and more participation from members. 

Hello Ujwala (Editorial Member) 

Satish Anand, MD 

I enjoyed your article “It’s our problem too” in this 

month’s AAPI Journal and would like permission from you 

and the journal to reproduce it in our newsletter. 

If you could send me either a pdf or a word file, I would 

appreciate it. Of course, we will give appropriate credit to 

you and AAPI We have quite a few physician members/ 

non-members on our mailing list and I believe it will help 

them assist DV victims I am Secretary of the board of 

ASHA RAY OF HOPE a DV organization in Columbus. 

See www.asharayofhope.org 

Thanks Chak. May be we can introduce the idea of 

“Original Theory.” I patterned “A Glimpse of My Life” after 

JAMA. But we can have another column “On being an Indian 

Doctor.” I would like to hear from the members — Editor 

Dear Dr. Nathan, 

Bhagwan Satiani, MD 

Dear Dr. Nathan, 

I must congratulate you for coming out with such a 

good journal, in spite of time restraints and technical 

situations. I like your idea in the Editorial to publish on 

the website some articles for members who would like 

to see the other side of medicine and not necessarily day 

today medicine as we know. Also personal experiences in 

different aspects of the art of clinical medicine and this 

way, you get more participation. One suggestion: for each 

article printed the authors and participants can bring some 

sponsorship to mitigate the cost of production. Your team of 

Editorial committee should pick one article as the best one 

and highlighted in the convention. Among the ones I liked, 

were ‘Healthcare Reform,’ by Dr. Pramod Wasudev, ‘Why 

join AAPI’ by Dr. Anil Gupta and ‘American Guru by Dr. 

Satish Verma. If you can cut back on numerous pictures, 

perhaps more space can be given to the good articles with 

This is Neelaxi Arora, I write for IANS (Indo Asian 

News Service), India’s largest Independent News Service 

and am based in the US. I am doing a story on Medical 

Tourism and seek your permission to quote from the AAPI 

Journal dated Winter 2010-2011, from features written by 

Pramod B. Wasudev, MD in particular and the Indo-US 

Health Summit in general. Thank you 

Neelaxi Arora 

www.ians.in 

I am glad many are reading our journal and want to 

either reprint an article or quote from the journal. We are 

indeed happy to be of service to others — Editor 

Kudos to AAPI for providing a channel to display latent 

creativity. 

Akshay Jain 

www.aapiusa.org 11

cover story 

The First Ever AAPI MSR/F/YPS Contest in: 

Creative Writing, Poetry & Amateur Photography 

M. P. Ravindra Nathan, MD 

A few weeks ago Dr. Ajeet R. 

Singhvi, our president, called 

me and said, “It will be great 

if we can organize a contest in 

Creative Writing/ Poetry and 

Photography for our young 

AAPI Members – MSR/ F/ YPS and give them cash 

awards and recognition plaques.” I couldn’t have agreed 

more. Many magazines like Medical Economics do this 

annually and it almost always stimulates the members to 

respond with their best effort. 

Details of the competitions: 

We decided to include 3 categories: Creative Writing, 

Poetry and Photography with cash awards of $500, $400 

and $300 for the first, second and third prizes respectively. 

The topic for creative writing was ‘a medically related 

narrative based on real life experiences, not exceeding 1000 

words. Original poems reflecting one’s medical experience, 

either from the point of view of a health care worker, a 

patient or just an observer, were considered. Photographs 

capturing an interesting scene, mood, or moment in life 

were accepted. 

Submissions for the various competitions started 

pouring in as soon as the e-mail blast went out announcing 

the details of the competition. In spite of all the demands 

imposed by the stringent on call schedules, patient care 

and family responsibilities, our young students and doctors 

found time to stop, listen, touch, feel and above all, think 

and then express their ideas into words. They clicked their 

cameras at interesting scenes. 

Altogether, there were 36 submissions for photography, 

10 for creative writing and 9 for poetry. The articles 

and poems were of high caliber, some very emotionally 

charged, evoking one’s inner sensibilities and others, more 

philosophical, reflecting on career changes or work place 

conundrums. Most seem to have an instinctive, natural 

gift for artistic expressions, be it creative writing, poetry 


or photography. Some told their stories in an easy, readable 

fashion touching on small details and spanning different 

worlds. The photos they submitted captured that truly 

magical moment in one’s life and often didn’t even need 

any formal caption. The judges unanimously agreed it was 

not easy to pick the winners. 

What has this done for AAPI? Plenty, I would say. For 

starters, this has brought MSR/ F/ YPS closer to AAPI 

by acting as a ‘connector.’ Suddenly, there is a buzz about 

AAPI among their ranks. Secondly, the contest has helped 

to discover and promote their talents. Thirdly, this may 

become the ‘tipping point’ leading to a surge in membership 

from the junior ranks of AAPI. As one of our editorial 

members, Dr Sivaprasad Madduri, said, “It is a great idea to 

have the contests and I am sure it will improve the image of 

the Journal. This is a real bench-mark for future journals.” 

In this issue we are publishing the articles and poems 

that have won the top 3 prizes. Some of the consolation 

prize winning pieces will be considered in future issues. 

Also, you will note that the center spread is composed of the 

photos submitted by the contestants. From all these, you 

will get a very good feel about the outstanding talents of our 

youngsters. For me, this will have to be rated as a high point 

in the history of the journal. And to our young generation 

of physicians, I offer my congratulations and best wishes; 

we are proud of you. But remember, “Success is a journey, 

not a destination.” So, don’t rest on your laurels; we like to 

see more of your work in future. And I sincerely hope this 

will become an annual event. 

A word about the Judges: 

The following experts judged and ranked the entries 

and before we selected the winners, I personally talked at 

length to all of them and got a consensus. I also acted as the 

co-ordinator and assisted in judging in all the categories. 

We discussed the many aspects of each entry in detail and 

graded them and then only the final selection was made. 

(continued on next page)

Creative Writing poetry photography 

Dr. Sivaprasad Dr. Ujwala Dixit 

Madduri 

They are already members of the Editorial 

committee well versed with writing, with 

numerous publications to their credit. 

Dr.Vijay Kulkarni, 

a past President 

of AAPI and well 

recognized poet 

whose works have 

appeared in many 

magazines. 

Dr. Susheela 

Ravindra Nathan, 

with two books of 

poetry as well as 

several articles and 

stories to her credit, 

was the second judge. 

Dr. U. B. Vasudev, 

an excellent 

photographer 

well versed in 

photography, whose 

photos regularly 

appear in 

St. Petersburg Times, 

Florida’s premier 

newspaper. 

And the winners are: 

Creative Writing: 

First Prizes: Sanya V. Hede for ‘The Blessing’ 

Second Prize: Akshat Jain, MD for ‘The Elephant in the Room’ 

Third Prize: Sunit Baga for ‘Two years in India’ & Rajiv Sharma, MD for ‘Pursuit of Happiness’ 

Special Prize for Outstanding Article: Pooja Voria Borde, MD for ‘Music Ma’mm’ 

Poetry: 

First Prize: Smitha Bhatt for ‘The Special Child’ 

Second Prize: Anuj Gupta for ‘Ten Minutes’ 

Third Prize: Vaseem Ahmed for ‘Some Say’ & Jai Gandhi for ‘I feel like falling’ 

Photography: 

First Prize: Imran Shaik for ‘Solitude’ 

Second prize: Kinjal Shah for ‘There is Hope.. is there a Future?’ 

Third Prizes: Sriram Eleswarapu for ‘Have no fear’ & Rahul Wadke for ‘Still reflection’ 

I sincerely thank all the judges for doing an excellent job spending a lot of their personal time for this first ever 

venture of AAPI. Please enjoy the creative efforts of our young members as they unfold in the next several pages. 

www.aapiusa.org 13

MSRF/YPS AAPI Journal 

“The Blessing” 

MSRF/YPS Competition Creative Writing 

1 st 

Sanya V. Hede * 

As I walked through the grey, 

double-doors at the entrance of 

the Intensive Care Unit, the heart 

monitor seemed to beep in fourfour 

time. Stiff, lifeless silence 

hung heavily in the air, save the 

diligent nurses who sat scribbling medication orders. All the 

beds held advanced machinery, smelled strongly of latex, and 

cradled me in cold blasts of air, but the one at the end of the 

hall particularly felt drained of energy. 

As a first year medical student and a mere volunteer, 

I knew my significance would be small, but my hopeful 

enthusiasm drew me forwards. Peering behind the floral 

curtains, I looked upon a stout, sun-burned man in a tight, 

faded T-shirt, sitting apprehensively at his father’s bedside. 

He gave me a tired smile and stood up to introduce me to his 

wife, mother, and father, sick in bed—a Methodist minister 

at the local church in town. After several painful coughs, 

he repeated my name and softly whispered, “Thank you, my 

child.” Whether it was from the sincerity of his tone, the 

helplessness of his condition or simply the spontaneity of 

my musical intuition, I do not know—all I remember is that 

within a few minutes, I was singing my favorite German art 

song. 

There, in the last room of the MICU, I psychologically 

morphed into Schumann’s fervent lover from Widmung. 

As the heart monitor beeped in four-four time, the words 

began to ascend from my heart, carrying more weight as they 

reached my mind. They spoke of devotion and joy for the 

one person that makes life worthwhile. Suddenly, something 

inside of me began to pour outwards. Tears fled my eyes 

spilling emotions that I could not understand and all for an 

old man who I had met only minutes before, who for all I 

knew might have had only had a few more seconds of life to 

spare. Standing at the foot of his bed however, I saw in his 

eyes a faint sparkle—the kind that reaches out and says, “I 

know you—I understand.” Nothing held me back. I gave all 

that I could... 

Even as the lingering vibrato of my final note faded into 

the air, my priest friend still sat motionless, lost in meditative 

peace. Trying to wipe the tears from my eyes inconspicuously, 

I looked up to find all eyes on me, in an appreciative trance. 

Finally, my attentive listener opened his eyes and gazed at 

me. Struggling to a sitting position, he held my hands as 

if he were holding the Scripture. His eyes scanned my Om 

chain, and he smiled as he peered into my soul. “May I bless 

you, my child?” he inquired softly. I don’t think I had the 

ability to speak as emotions flooded my throat; I just bowed 

my head. Placing his bony, but firm hands on my head, he 

recited a prayer for my well-being and happiness, while I 

closed my eyes to keep my tears of joy from falling on his 

knees. I related his blessing to my Indian family’s tradition 

for hard and fast healing, a jadu gali, or simply put, a magical 

hug. We both erupted into laughter and as I embraced him, I 

felt the magic rub off on both of us. 

I will never forget that lazy Saturday afternoon, when the 

joy of spreading music beckoned me into the hidden corners 

of the third floor ICU. In truth, I had come with nothing 

but a song in my heart—no stethescope to check a heartbeat, 

no morphine to ease the pain, and certainly no idea of how 

I could ever help a patient who would probably forget me 

after I left. Walking out of the room that day however, I was 

a different individual, stronger, wiser, better—for I carried 

with me the assurance of my Methodist friend that I had 

healed him more than anything ever could and witnessed 

the healing of my own well-being. He opened my eyes to a 

power within me that I never knew existed—the power of 

compassion and sincerity, of a deeper human understanding 

that transcends the barriers of race and religion, age and 

position. 

Medicine was no longer just a science—that day, it 

held hands with music and somehow linked the mind and 

the heart. We said little, but gained much. Truthfully, I 

cannot say how much of an impact my performance had on 

his recovery. Looking back in this decision however, I have 

realized that the true birth of new perspectives, of my multidimensional 

perspective, begins by taking a stab in the dark, 

as I did the day I dared to bring music to the I.C.U. I go 

back to the I.C.U. sometimes, on lazy Saturday afternoons, 

serenade those who wish to hear the sound of music and 

quietly leave through the grey double-doors, feeling better 

than I did when I came in. I am in search of happiness, 

smiles, and jadu galis: the true substance of any life—and 

sometimes, if I’m lucky, I will hear the sound of my blessing, 

the heart monitor in four-four time reminding me of my dear 

friend and his impact on my life. 

* Class of 2014 M.D. Candidate 

Baylor College of Medicine, Houston, TX hede@bcm.tmc.edu 




“Elephant in the Room-Euthanasia” 

2 nd 

Akshat Jain, MD * 

“I will give no deadly medicine 

to any one if asked, nor suggest 

any such counsel” 

The Hippocratic Oath 

My 6 month old patient who 

was born pre mature, under circumstances that would 

make even the gravest works of fiction and widest extent of 

imagination shudder in shock, is suffering. 

I m sitting next to his crib and writing this piece 

.Believe me I wish no parent in my NICU should come and 

look at him . They are not prepared for this horror. You 

will have to carve up the selective deafness and blindness 

I have developed over the past few months watching this 

baby, and believe me they will suffer. 

The medical surgical and theological aspects of his 

care have been exhausted. God seems to have given up and 

the cruel mockery is staring at me in the face. There will 

be no change from this point on, other than worse, despite 

heroic efforts at worship and practice to salvage whatever 

little life that is left in him. 

I have seen babies die and I have faced the horrific 

terror of breaking such news to parents, and believe me 

it was tough, but I found solace through material of the 

likes of Joel Osteen. May be it was “gods wish”, the “divine 

intervention” and we meager specks of little nothings have 

no say , in meddling with this “business”. 

But no Joel Osteen, Deepak Chopra, Eckhart Tolle 

could help me reconcile with this pain of suffering deep 

down inside. Debilitation is painful to watch and even 

more-so when you see the parents losing hope. 

I have sought comfort in situations when parents have 

accepted the ill stroke of fate and are glad to have love 

vested even in a debilitated child. But what do I do when 

I know this little one is going to have to fight the battle of 

his remaining life alone. 

Memories of my editorial in the college magazine on 

Euthanasia comes rambling back to consciousness. The 

theoretical discussion of pros and cons of Physician assisted 

suicide seemed very “literary” at that time. But today I am 

facing the dilemma in person; I am at crossroads, bound by 

complexities of law and morality. 

When is it appropriate for a doctor to play God? 

Putting an end to this insurmountable suffering, the 

continuous flow of tears, the rigid body, the seemingly 

never aborting seizures, and the continuous frothing … 

seems to be a valid option. Where the ever loving maternal 

instinct has fatigued, the medical science has exhausted 

all options, even the doors of heaven seem slam shut, one 

wonders was this fate written by the same hand of God that 

wrote mine, or was this a rare glitch. 

The critics of physician assisted suicide would argue, 

putting forth a solid argument, of morality. But if you 

qualify to be alive while being dependent on feeding and 

breathing tubes, undergoing constant trauma of pain that 

is immeasurable, but clearly visible, I bet you this, if God 

himself granted this baby one wish, he would unflinchingly 

ask for a vial of sweet death. 

It’s a dilemma not just faced by me, but anyone who 

has shared the pain of Aruna Shanbaug and many others 

like her would pray mercy killing would be made legal. 

I cannot help but think of the implications of the 

power any loosely passed legislation in favor of euthanasia, 

will have. It would not take too long before the argument 

of “right” to die, be twisted into a “duty” to kill. Suddenly 

I recall the chilling lines of conversation between the judge 

and a condemned German from the movie—“Judgment at 

Nuremberg” and I shudder. 

Condemned German –“But we didn’t think it would go that 

far.” American judge- “it went that far the very first time you 

condemned an innocent human being.” 

* New York Medical College , Metropolitan Hospital , 

Manhattan , NY 

www.aapiusa.org 15



“Two Years in India, The Rest to Reflect” 

3 rd 

Sumit Baga, MD * 

There is a saying, “I complained of no shoes, until I 

met a man with no feet.” This quote definitely describes 

my first two years of medical school, which were in India. 

My parents came from India with hopes of the American 

dream. For two years, I did quite the opposite. As a 

Punjabi born and raised in the United States, I embarked 

on a two year journey to study medicine in India. The 

four semesters of medical school in Manipal, India 

changed my perception of what it means to be a health 

care provider. After my experience at Kasturba Medical 

College – International Center, it was apparent to me that 

I had grown both academically and spiritually. 

Every Saturday my class would take a bus to the clinic 

and venture to Dr. T. M. A. Pai hospital in Udupi. On the 

way there, we would pass a large smoky landfill filled with 

the dark smoky stench of burning plastic. The air had a 

brownish tinge from all the burning plastic and paper. 

The smell was putrid and the hawks circled above in the 

sweltering jungle heat. What surprised me the most was 

that the impoverished literally dug out their huts in these 

heaps of smoking lumps of debris. Most of the time, I was 

sitting in an air conditioned room studying medical books 

and enjoying the luxury of American junk food. While 

the poor suffered from easily treatable and rare conditions 

such as iron deficiency and tuberculosis. 

The diseases we encountered clinically in India are 

situations I am unlikely to encounter again practicing in 

the United States. An elderly professor of mine, Dr. Bhatt, 

once told our class that there are two major class systems 

in India, the very rich and the very poor. He emphasized 

that there is a very large rural population that will always 

be present in India despite advances in technology and 

growth of the Indian economy. These farmers and 


villagers, undoubtedly the hardest working group of 

India, are unfortunately the large part of India that are 

uneducated about health care and have less access because 

of their financial disadvantage. It was hard to hear about 

one patient in Karnataka who unfortunately took all of 

the potential treatments based on his symptoms because it 

was his cheapest option – he simply could not afford the 

one diagnostic test which would determine what disease 

he had and it’s specific treatment. 

What also surprised me was the number of patients 

with pulmonary tuberculosis in the Udupi hospital as well 

as the Kasturba Hospital in Manipal. Though the patients 

were being treated with the correct anti-tubercular 

antibiotics, there was no use of face masks. These patients 

weren’t isolated either, which is unfortunately the reason 

that tuberculosis still spreads from patient to patient 

through air droplets. Another factor that assisted in 

the tuberculosis situation in India was that many of the 

patients had poor immune systems due to lack of proper 

nutrition. It was as if the sweltering jungle heat was a 

cesspool for rare infectious diseases like dengue, malaria, 

cholera, tuberculosis, filariarsis and others. 

Another difference in the Indian medical system that 

really surprised me was the fact that the sex of fetus in 

India can never be revealed to the parents for fear that 

certain parents are likely to commit infanticide if they 

find out that the child is a female. Many poor in India 

cannot afford to pay for the dowry of a female, and it is 

also considered by many to be socially and economically 

beneficial for the family if the child is male. Although 

this rule has been mandated by the Indian government, 

it was unusual to hear from my female classmate on the 

OBGYN floor that most if not all of (continued on next page)

the newborns in the nursery were males. 

Though India is different from the United States 

in many ways, two major differences stuck with me 

with most: the vast culture of India and the general 

attitude of its people. Spirituality is a very important 

aspect in the daily lives of most, if not all Indians. It 

has a major impact on the reason that they often carry 

such an easy-going demeanor. I got the general sense 

from most Indians that everything would be alright. 

This is something the fast-paced American life style 

truly lacks. It may be due to the strong presence of 

spirituality and religion in the Indian culture. Though 

Indians may live life more simply, they appear to be 

much more comfortable with what little they have. 

Many of the local Indian students would call us 

non-resident Indians because we were of Indian origin 

but had been brought up in the United States. From 

their perspective, I definitely saw how Americans 

could often act brash and show lack of modesty. Some 

of the younger students who had been living in India 

for the first time would often get noisy. And the facial 

expression from the locals was usually, “You aren’t 

from around here, are you?” The calm and collected 

demeanor was definitely something I respected about 

the native Indians; I truly got a sense that whether rich 

or poor or whether they had troubles or not, they were 

satisfied with taking each day at a time. 

I often find myself not being satisfied with how 

much I have, and I always try to return to my days in 

Manipal when life was simpler, but I was still content. 

I don’t think I value how much opportunity I had in 

India until now. Looking back, I miss the people and 

culture I came across in India. I learned a great deal in 

the basics of medicine and on the rare tropical diseases 

present in India, but I got a life lesson on all the small 

things of my Indian heritage. Someday when I find time 

to escape from my busy life in US hospitals, I believe 

I’ll return to India and really appreciate once again how 

beautiful it is there. 

* Sumit Bagga American University of Antigua 

Fourth Year Medical Student • sumitmed@gmail.com



Pursuit of Happiness: 

To Be or Not To Be — That is the Question! 

3 rd 

Rajiv Sharma, MD * 

Knock! Knock! My mother banged on my room 

door. The premedical test result was out. I got into the 

most prestigious medical school in Punjab. I ran to my 

dad who was working in our front yard. His eyes were 

moist as he patted my back…but he didn’t say anything. I 

could see the joy and pride on his face. 

I come from a very modest background. My father 

was from a poor family but ambitious to rise above his 

limitations. He had left his village barefoot as he had no 

money to buy shoes. He joined the police force which was 

the only job he could get. 

He was a dreamer and I am a dreamer just like him. 

He wanted the best for me and my brother, so he sent us 

to private English school, and took out heavy loans for 

our studies. 

I inherited the same vigor as my father. I constantly 

pushed myself to perform well, always aiming to be the 

best I can at everything I did. Time flew by and I cruised 

through the 5 1/2 years of medical school. Then I decided 

to relocate to greener pastures. I felt it would be hard for 

a man of my background to reach my full potential in 

India. 

I got married to a girl from USA and emigrated. 

Initially worked at a full time job to pay for USMLE exam 

fee. But back home things got tough. My father suffered 

from severe vertigo and needed frequent admissions to 

the hospital. The Police Department forced him to retire 

early with a meager pension. However, my father never 

asked me for help but I could feel his desperation over the 

other end of the phone, every time he made a transatlantic 

call. He tried to be strong and not put pressure on me. 

And I started sending some money to India every month. 

Luckily, I matched in Internal medicine. So, I 

started planning my next move to be even better. I chose 

Gastroenterology since it paid well and I can pay off my 

debts, well, my dad’s debts! 

I spent 4-6 hours a day writing research papers/ 

protocols and worked on my projects unfailingly - on 

call, post call or whenever I had some time. I used my 

vacation for research and I know my family life suffered 

during these periods. I worked like a maniac and gave 

my best shot at everything. Due to my confidence some 

“key people” at my residency program were turned off by 

me- envy perhaps? I am not sure. I was stunned that my 

clarity of goal, dedication and motivation was labeled as 

“aggression”, “abrasiveness”. 

I had 8 active research projects, 15 poster 

presentations, 2 national oral presentations, 2 paper 

publications and 4 awards for Excellence in Research and 

Academics. My competitors for fellowship were guys who 

barely had any research, leave alone publications. They 

were “friendly” just because they were good at faking it 

with the attending physicians and the “key people.” I was 

not “good enough.” 

“Was this because I was a “Foreign Medical 

Graduate?” I constantly asked myself. (continued on next page) 


I applied for fellowship in the same institution and did not 

match the first time, so I had to re-apply. I was told that I 

had a good chance matching at some “outside” program. I 

was not sure if I would ever get a GI spot. I had one year 

of residency left. I applied for Chief Resident position 

to better my chances of getting into a GI Fellowship. 

Interviews went well and now I was waiting for the match 

day-highly nervous. 

About three weeks before the match I got an 

unexpected phone call from an outside area code. It 

was one of the program directors in NY whom I had 

interviewed with. “Your application is very strong. We 

have a sudden opening for a position starting 6 weeks 

from now. We would like to offer you that spot,” he said. 

My body went numb and hands frozen. I have never 

felt like this before. At least someone thought, “I was good 

enough.” I started crying…tears of joy but I could see 

clearly where this is headed to. Since I was contractually 

obligated to be Chief resident for 1 year, I would have to 

cancel that contract. My dream was so close that I could 

literally touch it now. On the other hand I was scared 

about losing it if I couldn’t get out of the contract. What 

if they say NO? What if they hurt my career? What if 

they feel disrespected? Chief Resident is a big respectful 

position in the academic world. 

I paged my Medicine program director. He was a 

ruthless administrator with zero tolerance for “trouble 

makers.” He answered my page right away. My heart 

was in my throat, my voice shaky and eyes… wet with 

happiness and apprehension. 

I explained to him the scenario; he paused for a few 

seconds…my heart was racing, my hands trembling. Then 

he started talking... my heart stopped. He sensed the 

happiness, anxiety in my voice. He said “Rajiv… I would 

love for you to stay here. I personally would like to work 

with you but sometimes you just have to do what’s best for 

you and move on. Go ahead, follow your dream”. 

at such a short notice, this is disrespectful!” 

I stayed quiet and explained my point of view. There 

was silence. He said, “ I have nothing else to say to you”. 

I walked out. 

I couldn’t believe my ears... But I had to fulfill my 

dreams…my parents’ dream! 

I signed the fellowship contract and resigned from 

the chief resident position. My parent’s prayers and 

sacrifices have paid off. I graduated and moved to NY for 

fellowship. I have reached my goal. I am the happiest man 

alive. 

There comes a point in your life where you have to 

make a choice. Should you follow your own goals and 

dreams or honor others’ expectations of you? It’s a tough 

choice. But that’s how life is...unpredictable! 

This reminds me of the Shakespeare’s play Hamlet, 

“To be, or not to be--that is the question.” Whether ‘tis 

nobler in the mind to suffer. The slings and arrows of 

the outrageous fortune! Or, to take arms against a sea of 

troubles? 

* 2nd year G I Fellow, University of Rochester Medical Center, 

Rochester, N Y. 

Einstein said: “I am thankful to all those who 

said NO to me. It’s because of them I did it myself.” 

Abraham Lincoln said: “If friendship is your 

weakest point then you are the strongest person in 

the world.” 

Shakespeare said: “In times of crisis, I was not hurt by 

the harsh words of my enemies, but by the 

silence of my friends.” 

The next day the Chief of Medicine wanted to see 

me right away. I was terrified. He was furious! He wanted 

me to honor my contract and was hinting towards not 

taking the GI fellowship spot. 

“How are we going to fill the chief resident position 

www.aapiusa.org 19



“The Music Ma’mm” 

Pooja Voria, MD, MBA * 

Special 

Prize 

Outstanding 

Article 

It was the first time we had music in the department. 

No, there wasn’t a new surround sound system. I didn’t 

have my iPod playing. To my surprise, it was my patient 

singing to me as I was doing a breast biopsy on her. 

A few months ago, Judith Brown* came to the breast 

imaging department of my hospital because she felt a new 

lump in her breast. I did a complete work up, including 

a mammogram and ultrasound. I couldn’t rule out cancer, 

so I proceeded to explain to her that she needed a biopsy. 

Judith normally had pep and pizzazz, but I could see that 

she was scared. She asked for her husband, Rick, to be in 

the room. I tried to be empathetic and reassuring, but the 

biopsy still needed to be done. I explained each step of the 

procedure. Eventually, she nodded and signed the consent 

form. 

It was clear that Judith was nervous. She lay on the 

bed with her arm above her head. I tried to make her as 

comfortable as possible, but she was still shifty. 

I told her, “I’m going to give you the lidocaine now. 

It’s going to sting and burn a little bit, but then the area 

will be numb.” 

“OK. I think I’m ready. What are you giving me 

again?” she replied with angst. 

“Lidocaine.” 

“Lidocaine. What a funny word. It sounds like 

‘Lida Rose’ from the musical, The Music Man.” I was 

concentrating on my hands, but I saw her smile from the 

corner of my eye. 

“Hmm. I’ve never seen The Music Man. Nor have I 

heard the song, ‘Lida Rose.’ ” 

“Oh, it’s one of my favorites! Rick and I love musicals. 

I’m going to sing it for you.” 


Lida Rose, I’m home again, Rose 

To get the sun back in the sky. 


About a thousand kisses shy. 

Ding dong ding 

I can hear the chapel bell chime. 

Ding dong ding 

At the least suggestion I’ll pop the question. 


Without a sweetheart to my name. 

Lida Rose, now everyone knows 

That I am hoping you’re the same 

So here is my love song, not fancy or fine 

Lida Rose, oh won’t you be mine 

Lida Rose, oh Lida Rose oh Lida Rose. 

And she did. While she sang, her body relaxed a 

little bit. Her husband didn’t chime in. We both knew 

that singing was comforting to her. 

“We’re all done with the biopsy.” 

“It’s over? That wasn’t too bad.” 

During my breast imaging fellowship, I’ve learned 

that comforting a patient is one of the most important 

parts of any doctor’s job. Sometimes all it takes is a smile 

and a warm blanket to calm the nerves. With others, it 

may take much more, a reassuring voice, a listening ear, 

or a heart-to-heart in depth discussion. And once in a 

while, patients learn to comfort themselves with their 

own version of ‘Lida Rose.’ 

I’m happy to say that I had good news for Judith. 

The biopsy was benign and she did not have cancer. 


But not all the news I give is positive. Giving bad 

news is one of the most challenging things a doctor has to 

do, especially over the phone, where the empathy in our 

voice is all we can offer. Some patients take the bad news 

in stride while others become hysterical. It’s a tough job 

for us, and comforting a patient is not something we can 

learn from a book. It takes time, experience, and good 

mentors to learn the art of communication in medicine. 

That evening after Judith’s biopsy, I went home and 

listened to ‘Lida Rose’ online. It’s sung as a quartlet in 

a cappella format. No bells, no whistles, just vocals. It 

was catchy, yet soothing. Listening to the song helped 

me understand why it put her at ease, bridging the gap 

between something as unfamiliar and invasive as a biopsy 

with something warm and reassuring. 

Judith’s ability to build her inner-strength through 

something as simple as singing a proverbial song helped 

me to realize that the best way a doctor can comfort a 

patient is not always through conventional techniques 

like walking a patient through the facts of a procedure 

or answering technical medical questions. Through Judith 

and other patients, I have learned that fostering an honest 

and strong doctor-patient relationship stretches beyond 

these typical forms of communication and can require 

more comforting, personal, and simple approaches, like 

singing a song or simply holding a patient’s hand. 

Judith’s singing was a memorable part of my fellowship 

experience this year. The fact that she found her strength 

to endure in a song opened my eyes to an alternative form 

of comforting a patient, and I’ll always remember her as 

the “The Music Ma’mm.” 

________________________________ 

*All names changed 

* MSRF Communications Chair 

Breast Imaging Fellow in the Department of Radiology 

University of Washington pvoria@hotmail.com 

members in the news 

Dr. Reddy Receives the Prestigious Bharat Gaurav 

Award at Annual “Global Friendship Day” 

Dr. E. Shyam P Reddy, GCC Distinguished 

Cancer Scholar, Professor and Co Director, Morehouse 

School of Medicine, is honored with the globally reputed 

Bharat Gaurav Award and a Certificate of Excellence 

for Meritorious Services, Outstanding Performance and 

Remarkable Role on January 6th 2011, in New Delhi 

during the India International Friendship Society’s (IIFS) 

Global Friendship Day. 

The Society confers the “Bharat Gaurav Award” to 

luminous personalities in India and abroad, who have made 

outstanding contributions in their personalized fields, 

including science & technology, education, politics and 

social work, services providers industry, etc. Past recipients 

of this most coveted award include late Mother Teresa, 

Noble Laureate Late B.D. Jatti, Former Vice President of 

India Dr. Bishma Narain Singh, Cricketer Sunil Gavaskar, 

Veteran Actors Shammi Kapoor and Rajesh Khanna, Lord 

Bikhu Parekh, Lord Navnit Dholakia, Mr. Harinder S. 

Takhar (Minister of the Crown of Province of Ontario, 

Canada), NRI business-magnate Vijay Mallya, Dr. Sampat 

Shivangi, Dr. Bhagwan T. Sahni, Dr. Sudhir Shrivastava, 

Dr. Jayanti Singh, Omie Singh (MP South Africa), and 

Sukh Daliwal (MP Vancouver, Canada). 

The award was 

presented jointly by 

Mr. Pawan Kumar 

Bansal, Minister 

of Parliamentary 

Affairs & Water 

Resources Government 

of India, and 

Dr. Bhishma Narain 

Singh, Former Union 

Minister & Governor 

Tamilnadu, at the 

2011 Parvasi Bharatiya 

Divas national seminar on Global Participation in 

India’s Economic Development. 

Other dignitaries present at the award giving ceremony 

include Honorable Baroness Sandeep Verma (Minister 

in waiting Govt. of UK), Ms. Ruby Dhalla (Member of 

Parliament from Canada), Mr. Rohit Kochhar (Chairman 

& Managing Director Kochhar & Co.) and Gurmeet 

Singh (Secretary General, India International Friendship 

Society). 

www.aapiusa.org 21


“The Special Child” 

MSRF/YPS Competition Poetry 

“Ten Minutes” 

Smita V. Bhatt, MD * 

Anuj Gupta, MD * 

1 st 

2 nd 

He knows what to say 

But cannot say it 

He wishes to be friendly 

But only shows it with personal uniqueness 

He is startled by bells and whistles 

But easily calmed by a favorite tune 

He is not perfect 

But strives to get perfection time and time again 

He dislikes changing environments 

But finds beauty and peace and the sameness of life 

He does not like lots of things 

But what few things he likes he loves oh so much 

He knows not when to stop 

But will not start something he cannot finish 

He likes to be alone 

But detests the loneliness of it 

He is unpredictable by nature 

But desires life to be predictable 

He is challenged by everyday things 

But has a remarkable ease for the extraordinary 

He remains blind to the evils around him 

But has a sixth sense for what is good 

There are no smiles to be seen. 

Seems like only forms to glean. 

No introductions to be made. 

No pleasantries to exchange. 

Just enough time to be seen. 

To Be Seen 

To be seen with no eye contact made? 

Electronic health records may aid 

Only if they provide me quality 

Is this the meaningful measure charade? 

* FACC, FSCAI 

Assistant Professor of Medicine, Director of 

Peripheral Interventions 

University of Maryland School of Medicine, 

22 South Greene Street S3B08 

Baltimore, Maryland 21201, 

Phone (410) 328-9098 Fax (410) 328-3826 

agupta@medicine.umaryland.edu 

He represents one of many 

But is incomparably individualistic 

He needs numerous examples to learn 

But is a model example to teach the simple pleasures of life. 

He is an Autistic 

But a precious, priceless life full of love 

This Poem is dedicated to all mothers of Autistic children for 

Autism Awareness Month. 

* PGY-1 Psychiatry Resident, Department of Psychiatry, Nassau 

University Medical Center, East Meadow, NY 

smitabhatt9@hotmail.com 


MSRF/YPS Competition Poetry 

“I Feel Like I’m Falling” 


“Some Say” 

Jai Gandhi 

Vaseem Ahmed * 

3 rd 

3 rd 

I’ll be the last to know 

When my sanity flees. 

My grasp is being loosened, 

My fingers beginning to lose their grip, 

And I try, and I try, and I dig into that bag of chalk, 

My sweaty palms, desperate to increase the friction, 

To give me a shot at climbing back over this abyss, 

But I keep slipping. 

And the irony isn’t lost on me. Not yet. 

The comparison, my lost grip on reality as equivalent 

To my death. 

Society casts me out for my abnormality. 

And in fleeting moments of lucidity, 

I think, I think how 

If this was a broken bone, 

A seeping, disgusting wound, 

I would cover it up; no one would have been the wiser. 

But this disease eats away at me, until the disease 

has consumed me, 

And there is no me but the disease. 

I become a pestering reminder, 

The personification of why ignorance is bliss. 

And my lost grip won’t result in plummeting to the ground, 

There will be no splatter. 

No, the mess I make will be reflected in the psyche 

Of those who continue to love me unconditionally. 

Who are forced to care for me, and watch me, 

As “me” loses all meaning. 

Some say I tick, others say I thump, 

But we can all agree it’s important that I pump. 

My 4 chambers fill with blood on every beat, 

My valves help oxygen reach the ends of your feet. 

Exercise keeps my muscles healthy and strong, 

Without it, I wouldn’t be able to keep you alive for very long. 

It’s important to eat healthy and exercise, 

Eat more salads, but avoid those fries. 

Every so often, the doctor has to check me out, 

You’ll have to run on the treadmill ‘til you scream and shout. 

One way to keep me healthy is to stop smoking, 

It will make you prettier and stronger, I’m not joking. 

If you think you are having coronary attack, 

Take an aspirin; be sure to keep them in your knapsack. 

Today my problems are the leading cause of death, 

But I am the final organ to go until your very last breath. 

Take care of me and don’t let my vessels clog, 

Eat an apple a day and don’t forget to jog. 

Some say I am filled with blood, others say with love, 

But I am the heart of hearts when push comes to shove. 

*Medical Student, 3rd Year 

American University of Antigua, 

vahmed729@gmail.com 

www.aapiusa.org 23

MSRF/YPS 

PHOTO CONTEST 

Sara Venkat “Sunbird on Flower” 

Verma Varun “Window to the Soul” 

Ami Shah “Sculpture” 

Uzma Choudhary “Desert Mountains” 

Riddhi Shah “Sunset” 

Joseph Marin “In his Steps” 


Vickas Dangyach “Sowing Seeds” 

Sandip Patel “Dogged Persistence” 

Sheila Krishna “Tokyo at Play” 

Serena Jain “Self Discipline” 

Subhasis Misra “Endless Possibilities” 

Jaya Padmanabhan “Selling Flowers in Jaipur” 

www.aapiusa.org 25

Niru Madduri “Purity of Aging” Deepak Pahuja “Solitary Boat” 

Amit Momaya “Balance” 

Morargi Pesai “Birth of a Storm” 

Hetal Bhingradia “Endless Serenity” 

Sunita Nathan “Look What I Found ” 


Sirkar Kumkum “Medical School Begins in Paradise” 

Ankita Sagar “Tranquil Twilight” 

Madhuri Saligrama “Fortitude” 

Vidya Pai “A Midsummer’s Night” 

Shashank Jain “Ephemeral” Rajiv Bhal “The Chase” 

Rippal Shah “Vadodara” 

www.aapiusa.org 27


Networking Beats Not Working 

Pooja Voria, MD, MBA * 

going to hire me? 

Now that you’re completing 

residency/fellowship, what 

next? You must be thinking 

- How do I find a job? Who’s 

Many of us have been in school/training for most of 

our lives. We’ve always had specific goals to achieve and 

have known exactly what steps to take. In college, our goal 

was to get into a medical school so we took the MCAT 

and filled out the AMCAS application. In medical school, 

our goal was to get into a residency so we filled out the 

ERAS application and waited for the dreaded match. But 

there is no structured method of finding a job. So what 

can you do to improve your chances of getting your dream 

job? 

Here’s a little secret. The best jobs are found by wordof-mouth, 

networking, and referrals. So during residency 

and fellowship, you’re not working just to impress your 

attendings and studying just to pass your boards, you’re 

networking with people who have been immersed in the 

marketplace for many years. This includes attendings, 

nurses, technologists, and administrators. All of these 

people have more experience in the workplace and may 

know some “gossip” that could land you a job. If they like 

you enough, they may even make a phone call on your 

behalf to help you out. 

It’s also important to be actively networking when 

you can. Go to your specialty’s annual meetings, especially 

locally. It’s rare for residents to go to these meetings, 

because most feel that they could be using their time 

doing something else, i.e. studying, sleeping, or having 

fun. But spending even a few hours at these events can 

be worth it. You’ll stand out since you’ll be one of the 

few residents there. And you never know who will be 

sitting at your table. It could be the CEO of a group in the 

area. And of course, don’t forget AAPI. AAPI has many 

different events thoughout the year, including the annual 

convention, all of which are great avenues to meet people 

as well as have fun. 

If you don’t live in the area you want to work, you can 

use a physician recruiter. Recruiters are hired by hospitals 

and groups. But not all groups use recruiters. Groups with 

good jobs in popular markets and groups in major cities 

typically don’t use recruiters because it’s expensive and 

they don’t need to (word of mouth or referrals). 

You can also look on the website of your specialty’s 

professional association. There is usually a job posting 

section. 

Start early, but don’t dismay if you can’t find 

anything. If jobs are tight in the area you’re looking, then 

they may only open up if a group acquires a new contract 

with a hospital or if someone retires. Something may be 

available just a few months before you need to start. It’s a 

very fluid market right now, and people aren’t hiring like 

they used to. 

Remember, it’s in your best interest to find all the 

available jobs in the market. So, during residency, set 

yourself up a little bit. Network when you can. And don’t 

be scared to stand out, especially in today’s job market. 

*MSRF Communications Chair 

Breast Imaging Fellow in the Department of Radiology 

University of Washington pvoria@hotmail.com 


Medical Rotation to India: 

First Hand Experience 


With much interest, enthusiasm and support, AAPI has launched a new endeavor under 

the leadership of the President Ajeet R. Singhvi, MD. The purpose of this program is to 

send American Medical Students and Residents of Indian origin from accredited medical 

schools or Residency program for four weeks rotation to India. This would expose them to 

the Indian Medical System, have them learn clinical skills as well as have them experience 

of working in suboptimal conditions. Few weeks of work experience is expected to be a life 

time of learning through this program. This program is sponsored by AAPI members and other sponsors. We 

would like to thank all the committee members for raising the funds for the program and participating in the 

candidate selection process. Four candidates have completed their rotation and 4 are currently in India. With the 

support of our members we hope to send about 10 candidates this year. 

Here are experiences of some of the four candidates who have completed a clinical rotation in India 

through this program. 

Sincerely, 

Vinod Sancheti, MD 

Vinod Sancheti, MD 

Chair 

MedicalRotations@aapiusa.org 

Mamta Singhvi, MD 

President, AAPI MSRF 

mamtasinghvi@gmail.com 

Shashi Shah, MD 

Advisor & Chair, AAPI-CF 

shashimd@gmail.com 

Amit Bhakoo, MD 

Community Service Chair, MSRF 

communserv@aapimsr.org 

The Aravind Eye Care System: 

An Analysis and An Experience 

Swarup S. Swaminathan * 

As a young medical student interested in ophthalmology, I was enamored by the opportunity to 

conduct a study at the Aravind Eye Hospital thru the AAPI medical rotation to India program. 

The postgraduate residents to let me examine patients with unique ocular conditions, which are uncommon in the US. 

I was thus able to examine patients with fungal keratitis, complete ophthalmoplegia, and Loa loa filariasis to name a few. 

I was also able to attend grand rounds at the base hospital on a weekly basis, which was a wonderful way to learn more 

about ophthalmology and interact with the local residents. I was also able to observe several surgeries in the OR, spend 

time in the subspecialty clinics, and visit the free hospital clinic, all which were incredibly valuable learning opportunities. 

I am extremely grateful to AAPI-MSRF for supporting me in this endeavor and allowing me to gain first-hand 

experience in ophthalmology. 

*MS2 – Harvard Medical School 

swarups@gmail.com 

(continued on page 34) 

www.aapiusa.org 29


Global and Cross-Cultural Mental Health in India 

Neil Krishan Aggarwal, MD, MBA, MA * 

I travelled to Sri Guru Ram Das Institute of Medical 

Sciences Throughout my residency, I have explored 

issues in cross-cultural and global mental health, specifically 

among South Asian populations. The AAPI 

MSRF International Externship program supplemented 

additional funding from the American Psychiatric Association 

and the Substance Abuse and Mental Health 

Services Administration to provide me with field experiences. 

I worked with Drs. Vikram Patel and Neerja 

Chowdhury in summarizing all of the published academic 

literature on mood and anxiety disorders among 

South Asians. Everyday, I met with a team of researchers 

to debate the findings of latest studies and to spend 

the next nine hours considering research design and 

implementation for a future randomized controlled 

trial of psychotherapeutic treatments in resource-challenged 

settings. The work was difficult, but stimulating, 

as we struggled to apply the latest scientific findings 

to real world problems. Hopefully, our efforts will 

be rewarded with the publication of a systematic literature 

review. 

After a month of intense research, I spent two 

weeks working at a public outpatient clinic in Amritsar 

affiliated with Sri Guru Ram Das Institute of Medical 

Sciences and Research. For a population of four 

million people, there are only twelve psychiatrists in 

the city of whom five work in the government sector. 

Everyday, I saw between fifty and eighty patients 

in seven hours, conducting evaluations and consultations 

in Hindi and Punjabi under the supervision of an 

attending physician. A number of fascinating crosscultural 

differences emerged. Patients controlled their 

medical charts which they brought to each visit. Given 

the constraints on time and the refreshing lack of a 

malpractice culture, physicians wrote the bare minimum 

defending their diagnoses and justifications for 

choosing a particular medication. In terms of clinical 

presentation, we saw patients mostly with depressive, 


bipolar, anxiety, psychotic, and substance abuse disorders. 

Interestingly, psychiatrists manage epilepsy in 

India, a disorder commonly referred to neurologists in 

the United States. Finally, psychiatrists and patients often 

collaborated to devise innovative clinical solutions 

regarding the immense expenses of transportation and 

medications: psychiatrists often started medications at 

higher doses and patients preferred brief directive recommendations 

rather than exploratory psychotherapy. 

Such international experiences are invaluable for 

future clinical researchers. Next year, I will start a fellowship 

at Columbia University designed specifically 

to learn how to research the prevalence and treatment 

of mood and anxiety disorders among South Asians in 

the United States. These rotations were indispensable 

in helping me understand how to conduct research on 

the expectations of treatment among South Asian patients. 

I am grateful to AAPI MSRF for generously underwriting 

a portion of my visit which exposed me to 

the Indian academic environment and to Indian community 

psychiatry. 

*Psychiatry Resident, Yale University 

neil.k.aggarwal@gmail.com 



Chai Time: with an International Focus 

Kinjal Shah * 

We live in an increasingly mobile society, which 

lends to the transfer of disease across oceans. I want to 

be competent in providing care for my patients, weather 

it is treating the neighbor next door or a patient half 

way across the world. To that end, I wanted to see how 

healthcare is delivered in India and decided to spend a 

month there this January. 

This trip was….inspiring, refreshing, and served 

as a reminder for why I wanted to enter medicine in 

the first place. 

*UTHSC, Memphis, TN 

I embarked on this journey under the mentorship 

of Dr.Nitin Shah, professor of Anesthesiology at 

Loma Linda University, California. Our trip itinerary 

in Jaipur; Pravasi Bhartiya Divas conference 2011 

in Delhi; 37th Annual Medical highlights included 

attending the: 4th Annual AAPI Indo-US Healthcare 

summit & Surgical camp in Bidada, Kutch; Kalidas 

Hospital Surgical Camp, Vyara, Gujarat; Bardoli Surgical 

Camp, Bardoli, Gujarat. The Bidada camp was the 

highlight of my trip- we had camps in various specialties, 

from general surgery to Urology, Dermatology, 

and even Vision and Dental Care; a similar panel existed 

for the pediatric population. This 20 day camp in 

January at Bidada provided health care related services 

to thousands of patients! Bidada satisfied my intellectual 

curiosity as I saw “zebra” cases such as Duchene’s 

Muscular Dystrophy, Pustular Psoriasis, and Rubella 

associated Congenital Cataracts and Heart Disease. 

Without a doubt, I can say this was one of the 

most educational endeavors I have embarked on. 

Where else will I get to negotiate with the rickshaw 

driver, drink fresh coconut water in the surgeon’s 

lounge, diagnose Duchene’s Dystrophy, visit 72 

jinalaya(a Jain tirth) and watch a breathtaking sunset 

at the Mandavi beach—all in the same day! 

In addition to honing my clinical skills, I encountered 

and have gained an appreciation for medical problems 

uncommon in the US. I would like to thank AAPI for 

giving me this opportunity and encourage the AAPI 

community to support the AAPI Scholarship for International 

Electives. I come out of this elective with a 

broader perspective on the practice of medicine. 

www.aapiusa.org 31

AAPI charitable activities 

Report from the Committee on Medical 

Missions & Community Service 

Ram Upadhyay, MD * 

Most of us, as volunteers, are 

individually involved in various 

philanthropic and charitable 

projects. It will not be an exaggeration to say that, due to 

our upbringing in India, it is a kind of second nature to us, 

to do some ‘seva’ or extend the helping hands to others. We 

have been taught that ‘Vasudhaiva Kutumbakam,’ i.e., this 

whole world is my family. In order to be happy, we need to 

try to make this family happy. 

• As our AAPI members have expressed their keen 

desire to serve the underserved, needy and poor, both 

in USA and abroad as volunteers….. 

• As our medical students/ residents expressed their 

interest to work as volunteers. To serve & learn 

globally…. 

• As many of our AAPI members and their families 

have shown interest to work with various NGOS in 

India and other countries in Medical as well as non 

medical social projects. 

With great admiration and gratitude for AAPI 

member’s noble desire to serve, our current AAPI 

leadership, President Dr. Ajeet R. Singhvi and Executive 

committee along the BOTs, established an Ad Hoc 

committee known as the COMMITTEE ON MEDICAL 

MISSIONS & COMMUNITY SERVICE. 

Activities of the Committee include: 

1. Preparation of appropriate Forms for potential 

Volunteers including Release of Liability form. 

2. Dr. Sudeep Kukreja’ Trip to Egypt from Sept. 17 to 

October 2nd, 2010 (published in Winter 2011 AAPI 

Journal) 

3. Haiti Project: this is an ongoing activity. 

4. Contacting Various NGOs for working together. 

5. Placement of Volunteers in India. 

6. Collection of old working equipment and supplies to be 

distributed to needy institutions. 

7. Storage space for supplies being established with the help 

of other charities. 

8. Contacting various agencies for transportation of 

supplies to target sites. 

9. Preparing pertinent Travel information about target 

site, including Political stability etc. 

10. Collecting the necessary funds. Of course this is a real 

challenge! 

11. Periodic Tele Conferences, the last one was on 3/10/11 

So far our Committee Members have put in a lot 

of work. Currently they are involved in very extensive 

Community Services with other organizations. We are 

collecting all the information and will present to the 

AAPI Membership in the near future. Our Heartiest 

appreciations and congratulations to the following 

members: 

Dr. Kukreja who is taking a team to China in a few months. 

Dr. Nitin Shah. 

Dr. Gopal Badlani and 

Dr. V.K. Raju. 

They are planning to give more information to our 

membership about their activities. 

Our Challenges: 

This committee needs funding as there are no specials 

funds allotted from AAPI. This creates a big hurdle. 

As other NGOs who give logistic support expects some 

sharing of their expenses. 

Our sites need supplies and other resources for which 

financial support is needed. Also, we need to make our 


AAPI Charitable clinics potential sites for volunteers 

to stay and provide the medical care. They need to have 

an ongoing relationship with the adjacent hospitals for 

appropriate referral. Our Charitable Foundation needs to 

take lead towards this goal. 

This committee needs to be upgraded to the status 

of a full permanent committee. It’s Chair should be a 

voting member of the Governing Body, so that they can 

participate in the discussion, since the decision in the Fall 

Governing Body in 10/10, in California, unfortunately 

has effectively taken off the right to express the views of 

non voting members even if they are present during the 

meeting. The healthy tradition practiced before need to be 

restored. 

On March 11, 2011, the whole world was shocked at 

the massive tsunami and earthquake that struck Japan. We 

had numerous calls and emails from our AAPI members 

to help and participate in relief efforts. We immediately 

contacted Japanese Consulate. After hearing all details 

about our organizations, about numbers and doctors of all 

the specialty, they agreed to put AAPI’s name, along with 

Doctors without Borders and International Medical Corp 

as a potential Medical Relief providers. This is a great 

recognition of our organization. I am proud to say that 

there were 15 volunteers, from primary care to orthopedics 

physicians, were ready to go on 48 hours notice. As the 

alert was taken off by Japanese Emergency management 

Administration, we were informed that they do not need 

Medical Teams from outside. They will accept monetary 

help thru Red cross, either American Red Cross or Japanese 

Red Cross. 

Our donations can be send to AAPI- CF with the 

memo: Japanese Relief Fund. Yes, we are ready, if they 

need us. 

It is wonderful to see the overwhelming response from 

our membership during these critical times. May everyone 

be happy and healthy, May no body suffers” 

Sarve Bhavatu Sukhina, Sarve santu Niramaya 

*Chair Committee on Mecical Missions & 

Community Services, Boston MA. 

Faculty of Emergency Medicine and Global Health 

University of South Florida, Tampa, Florida, USA 

Regional Director for AAPI Region 10 

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www.aapiusa.org 33


Project Pacer International, Inc. 

Salil Midha, MD, FACC, * 

Susan DeTurk and V.K. Saini, MD 

Project Pacer 

International 

(PPI) is a non-profit organization with 

the single purpose of bringing medical 

technologies and services to less developed 

countries around the world. Originally 

founded by Dr. V.K. Saini, MD, a 

retired cardiothoracic surgeon from the 

South Shore & Carney Hospitals, and 

Dr. Thomas Piemonte, from Lahey 

Clinic, PPI is currently supported by a 

large network of highly dedicated and 

motivated individuals. In addition to the 

tireless efforts of the PPI team, generous 

donations from pacemaker companies 

such as Medtronic, Guidant, and St. Jude 

Medical make the program possible. 

2011 marks the 21st visit to India 

by Dr. Salil Midha, Chief of Cardiology at the Melrose 

Wakefield Hospital, and Ms. Susan DeTurk of the 

Dartmouth Hitchcock Medical Center. Their PPI team, 

made up of physicians, nurses, and technologists, has been 

performing cardiac procedures such as pacemaker surgery 

free of charge for patients who can’t afford the lifesaving 

treatment. Most of the patients treated have a high degree 

AV block and bradycardia and without the pacemakers 

would have little hope of survival. Since Project Pacer 

began in 1989, over 350 devices have been in implanted in 

India alone. 

This year, the team led by Dr. Midha, Dr. John 

Omara, Jessica Jordan, RN and Ms. DeTurk implanted 

24 new pacemaker devices. Most of these recent efforts in 

India have taken place at the Sitaram Bhartiya Institute in 

New Delhi and Jaswant Rai Specialty Hospital in Meerut, 

Uttar Pradesh, India. Both the hospital administration 

and local staff, most notably Dr. Rajeev Agarwala and Mr. 

Tara Phulara, have been absolutely (continued on next page) 

Top: Project Pacer Team in Meerut India. (Dr. Rajeev 

Agarwala, Dr. Salil Midha, Ms. Susan DeTurk, Dr. 

S. Kumar, Mike Ford from Medtronic and Dr. Suneet 

Mittal) 

Above: Dr. John Omara and Dr. Salil Midha performing 

surgery 


essential in making the program possible. 

In addition, several other area hospitals 

have participated including: Mool Chand 

Hospital (New Delhi), All India Institute 

of Medical Sciences (New Delhi), 

Ganga Ram Hospital (New Delhi), 

PGI (Chandigarh), Fortis Hospital 

(Chandigarh), Sai Sathya Sai Institute of 

Higher Medical Sciences (Puttaparthi, 

AP), as well as hospitals in Kerala. 

One of their most memorable patients 

is Vandana Maini. When the team met her, 

she was a 17 year old high school student 

who had been repeatedly accused of faking 

blackout spells by her peers and teachers. In 

reality, she lacked proper medical care and 

was suffering from a complete heart block 

and frequent episodes of asystole. Thanks 

to the PPI team, she had her first life-saving 

pacemaker surgery 19 years ago and has had 2 successful 

battery changes since then. Not only was Vandana able to 

graduate from high school and college, she got married and 

teaches children in a local school. 

Since the PPI team began visiting India, many 

others have joined the effort by volunteering their time and 

resources to help support the program. New physicians have 

been trained in India and pacemaker surgery has become 

a routine procedure in the state of UP. Several 

local cardiologists dedicate their time to help care 

for patients when the team is on site. And, other 

charities such as the Ladies Club in Meerut have 

donated funds to purchase new devices from Indian 

companies, allowing the team to help a larger 

number of patients. 

“Being able to help those who wouldn’t 

survive without these devices and procedures has 

been one of the most rewarding experiences of my 

life” says Dr. Midha. “It is very moving to see how 

many lives we can touch when we lend a hand”. 

If you would like to get involved to help 

those less fortunate, please contact Dr. Salil Midha 

at 781-662-6404. For more information please visit: 

melrosecardiology.com/projectpacer.aspx 

* Salil Midha, MD, FACC is Chief of Cardiology at Melrose 

Wakefield Hospital 

Melrose, MA 02176 salilmidha@gmail.com 

Clockwise: Dr. V. K. Saini, Dr. Salil Midha, Ms. Susan 

DeTurk, Dr. S. Kumar, Ms. Bhavana Gandhi, Dr. Suneet 

Mittal 

Ms. Susan DeTurk, Dr. V. K. Saini, Dr. Salil Midha and 

Dr. Suneet Mittal 

Staff at SitaRam Bhartiya Hospital in Delhi with the PPI 

team 

www.aapiusa.org 35


In giving is receiving 

Gopal Badlani, MD * 

When I was leaving my home 

in Bombay for the USA, my 

father said, “this country gave 

you education, now that you 

are a doctor you are leaving 

without giving anything in return?” I was young and 

naïve and in my excitement of migrating to the USA, 

I chalked it up to parental separation anxiety. Fast 

forward to 1994 - I had by then achieved my professional 

goals in academic urology. I had the incredible fortune 

of being introduced to an individual who opened my eyes 

to “karma” as the path to happiness. 

Swamiji at Bairagarh (now known as Sant 

Hirdaramnagri) near Bhopal, through his disciple 

in NYC, asked for my help to obtain some urological 

instruments for “Urology Camps”. Obtaining instruments 

was an easy task for me through my friends in the industry 

as I was doing a lot of trials, but my curiosity took me 

to Bairagarh to take part in one of the camps. Imagine 

a small village in India with not one building more than 

one floor. I am introduced to an individual living in a 

Kutiya, in his eighties. They tell me he is different, he 

does not preach, he shuns meeting people. Then they 

show me a most modern gymnasium in this village built 

with his inspiration, with money earmarked to build the 

umpteenth temple. Swamiji said “the youth in this village 

need a place to go to after school, we don’t need another 

temple”. I was so impressed with this out of the box 

thinking. He told me “The old, the children & the infirm 

are the God’s favorites, if you serve them well, he will be 

your guide through this world.” 

During my first experience in the camp I cannot 

explain the phenomenon, but I was mesmerized with the 

whole set up after operating there in the most primitive 

set up of a primary care center. The 19 year old with the 

fistula shunned by her family, a young spinal cord injury 

patient with a giant decubitus begging for a diversion, 

were challenging cases without my fancy retractors and 

automated instruments, but when I saw the same two 

individuals a year later, the smile of gratitude on their 

faces was the best payment I have ever received. 

Patients awaiting surgery in a camp organized by Jeev 

Sewa Sansthan in Bairagarh MP 

Once you decide to start on this path it is unbelievable 

how many people join you and want to help. My fellow 

urologists (Sakti Das, Raju Thomas, BhushanKhashu, 

Mantu Gupta, ShibanWarikoo, Shashi Shah), my nurses 

in the OR, the residents, the airline employees, the 

shipping people, the drug reps, the instrument companies 

and on and on. My wife Charu has been my backbone. I 

learned to “ask for donations” from my friends and family. 

My sweet and talented daughter Pooja with the help of my 

son Chirag, put on many art auction parties. All of this 

effort however pales in comparison to the efforts of the 

volunteers of “JeevSewaSansthan (JSS)” & the “Mother 

Theresa” of urology, Dr. Catherine DeVries from the 

International Volunteers in Urology. These individuals do 

this volunteering year round; I do this for 2 or 3 weeks 

a year. The JSS volunteers are candy store owners, bank 

clerks, shop keepers, yet on the weekends or during the 

camps they become the most knowledgeable assistants in 

the operating room or in patient care. Through my position 

at the American Urological Association we have been able 

to partner with Indian American Urology Association to 

extend an educational bridge to the Urological Society of 

India. 



Current Status: 

This is a capsule of what we have done 

Medical missions: 

Available throughout the world through International 

Volunteers in Urology. IVUmed.org. 

In India organized through Jeevsewasansthan. 

Jeevsewa@gmail.com. http://jeevsewa.org. 

In Africa through International Organization for 

Women and Development. ba.margolies@verizon.net. 

http://www.iowd.org/ 

Team leader accompanied by residents and fellows and 

supported locally in India by a fellowship trained urologist 

who screens patients for surgery. Locations are in rural 

India (mostly north). 

- 10 day mission, 125 to 150 cases done 

- 1 pediatric urology camp per year at Christian 

Medical College, Vellore 

- Equipment and supplies are donated to local 

hospitals 

- 2 urology centers built and equipped (Ajmer, 

Rajasthan and Bairagarh, Madhya Pradesh) 

- Equipment donated to many free care hospitals 

(e.g.: Mahua in Saurashtra, Nair Hospital 

Mumbai) 

- 4 to 6 missions per year since 1994 

- Each year 12 to 15 residents receive a scholarship 

of up to $3000 each from IVU 

- Report of all urology missions in India on website 

http://jeevsewa.org/ 

Education: 

Through India American Urology Organization 

(IAUA), American Urology Association (AUA) coordinated 

with Urological Association (USI) in India. 

- 2 post graduate courses done in India with US 

faculty, including board review course 

- 2 faculty and 4 residents supported to come for 

AUA meeting annually in the USA 

- 2 andrology fellowships recently funded in India 

- 2 “chakraborty” fellowships in USA, for young 

faculty from India (3 month observer ship) 

- 2 junior faculty supported from USA to go to India 

- Leadership of USI hosted at AUA annual meeting 

- IRB approved multicenter RCT trials with 

urology programs in Nadiad,SGPGI in Lucknow 

- Many individual student rotations arranged to 

various locations in India 

- International Education through AUA to China, 

Brazil and Japan 

* Professor/Vice Chair, Department of Urology, Wake Forest Baptist 

Hospital, Winston-Salem, NC. 

Dr. Gopal Badlani is the Secretary – Elect of the 

American Urological Association, Linthicum, MD 

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feature 

Heart Disease in South Asians: 

“Facts we should know as Indian Americans to 

help reduce our risk.” 

Pravien K. Khanna, MD, MPH * 

Coronary artery disease (CAD) 

is the number one killer in 

developed nations. While death 

rates of CAD have been declining 

over the past three decades for 

developed nations, a disturbing 

trend has been noted among the persons of South Asian 

origin, whether living on the sub-continent or abroad. In this 

article I would like to take a moment and explain why heart 

disease in the South Asian population is unique and deserves 

greater awareness and preventive efforts from every South 

Asian either living in the United States or abroad. 

Studies indicate that people of South Asian descent, 

particularly Indians, experience a disproportionately large 

burden of CAD. Reports vary from having two to five fold 

higher risk of heart attack and death compared with other 

ethnic groups. (1) (See Table #1). Strikingly, one study 

among Indian males showed that just over half of heart 

attacks occurred at less than 55 years of age, and up to 25% 

of heart attacks occurred at less than 40 years of age. (2) 

Another study showed that compared with whites, South 

Asians presented to the hospital later in the course of their 

heart attack, and were more likely to have their heart attack 

in the anterior region of their heart muscle. (3) This location 

can be potentially more harmful as it does not have adequate 

collateral blood supply. Those South Asians diagnosed with 

CAD before having a heart attack, are found to have more 

severe narrowing or plaque build up in their coronary arteries 

than seen in whites. (4) In 2001, California, hospitalization 

for CAD among Asian Indians was 4-fold higher than in 

Whites, Japanese, and Filipinos and 6-fold higher than 

Chinese. In many countries, hospitalization for MI in Asian 

Indians compared to other ethnic groups is 2 to 4-fold higher 

overall and 5 to 10-fold higher in those under 40 years of 

age. (See Figure #1). In short my fellow South Asians, 

while we are a kind and gentle hearted people, our hearts 

need closer and more preventative healthcare than Caucasian 

Americans. 

So what explains this higher risk of early heart disease? 

The search for various pathogenic factors and mechanisms 

has attracted great interest among scientists. Researchers at 

Yale and other academic medical centers have been looking 

for such answers. Evidence currently suggests there is a 

genetic predisposition for early plaque buildup in coronary 

blood vessels, which may be accelerated when superimposed 

with certain risk factors such as obesity, early diabetes, 

high blood pressure and abnormal cholesterol levels 

(higher triglycerides, higher low-density lipoprotein (LDL), 

increased lipoprotein (a), and lower high-density lipoprotein 

(HDL) in particular). 

Since the Asian Indian population is not significantly 

represented in major clinical trials, evidence based 

management strategies for treatment and prevention of CAD 

in South Asians are simply insufficient at the present time. 

Fortunately, in India a number of randomized trials of anticholesterol 

therapy and risk reduction have been launched. 

While we cannot change our own genes or DNA, we can 

minimize our risk by taking action to prevent or treat the 

factors mentioned above whether through lifestyle changes 

or prescription medication. Preliminary data suggests 

a need for lower goals for our cholesterol levels through 

institution of much more aggressive therapy than is currently 

recommended. (5) Another risk factor that as individuals we 

have control over is our weight. Abdominal obesity has been 

established as an important cause of both early diabetes and 

CAD. 

English BMI Formula 

BMI = ( Weight in Pounds / ( Height in inches ) x 

( Height in inches ) ) x 703 

Metric BMI Formula 

BMI = ( Weight in Kilograms / ( Height in Meters ) x 

( Height in Meters ) ) 

The World Health Organization has recognized the 

need for definitions of obesity that are specific to individual 

populations. (6) Compared with European populations, South 

Asians tend to have more abdominal or “visceral fat”, which 

is type of fat beneath the abdominal wall. Consequently, the 

NHLBI Obesity Task Force in 2000 stated that the obesity 

range in Asians should be lower than for non-Asians, and 

effectively moved the obesity cutoff from a BMI >30 kg/m2 

to a BMI >25 kg/m2. (7) 

So what can Indian Americans do to prevent heart 

disease? The best treatment is education and prevention. 

Once turning 30 years of age, we should strongly encourage 

every south Asian to establish care with a primary care 

physician to evaluate their risk factor profile and develop 


a strategy that is best for each individual. Periodic routine 

blood tests will monitor various blood markers on a routine 

basis that will guide how best to reduce your individual 

risk of heart disease, perhaps though medication if needed. 

Dietary and lifestyle modifications are extremely important 

to staying healthy, not only do South Asians take on the 

cholesterol-rich diet of the Western world upon migration, 

but the traditional diet of South Asians also contains foods 

rich with saturated and clarified fat (ghee). We as South 

Asians must be aware of our increased risk of heart disease, 

so we can play an active role in its prevention to live longer 

and healthier lives. 

Table 1: Interesting Facts of CAD in South Asians versus other populations. 

Higher rates 

-2 to 4- fold higher prevalence, incidence, hospitalization, and mortality 

Greater prematurity 

-5 to 10 years earlier onset of first MI 

-5 to 10- fold higher rate of MI and death in those 2-fold higher rates after adjusting for conventional risk factors 

-Underscores the need for lower threshold for intervention 

Higher prevalence of emerging risk factors 

-High levels of lipoprotein(a), homocysteine, apo B, triglycerides, fibrinogen, P.A.I.-1 

-Low levels of HDL and HDL 2b 

-Small dense LDL, small HDL, large VLDL 

Higher rates of clinical CAD events for a given degree of atherosclerosis 

-2-fold higher than Whites 

-4-fold higher than Chinese 

Higher proportions of unstable or vulnerable plaques 

Source: 

Enas EA. Arresting 

and reversing the 

epidemic of CAD 

among Indians. 

In: Kumar A, ed. 

Current Perspectives in 

Cardiology. Chennai: 

Cardiological Society of 

India, 2000:109-128. 

Figure 1: 2001 California hospitalization for CAD among Asian 

Indians was 4-fold higher than in Whites, Japanese, and Filipinos 

and 6-fold higher than Chinese . 

Source: E. A. Enas & A. Senthilkumar : Coronary Artery Disease In 

Asian Indians: An Update And Review . The Internet Journal of Cardiology. 

2001 Volume 1 Number 

*Fellow, Section of Cardiovascular Medicine 

Department of Internal Medicine Yale University School of Medicine 

pravien.khanna@yale.edu 

Sources: 

1. Gupta M et al. “South Asians and Cardiovascular 

Risk: What Clinicians Should Know.” Circulation. 

2006;113;e924-e929. 

2. Singh RB, Niaz MA. Coronary risk factors in 

Indians. Lancet 1995; 346: 778–779 

3. Deedwania P, Singh V, Coronary artery disease 

in South Asians: evolving strategies for treatment 

and prevention. Indian Heart J. 2005 Nov- 

Dec;57(6):617-31. 

4. Deedwania P, Singh V, Coronary artery disease 

in South Asians: evolving strategies for treatment 

and prevention. Indian Heart J. 2005 Nov- 

Dec;57(6):617-31. 

5. Gupta M, Singh N. South Asians and 

cardiovascular risk: what clinicians should know. 

Circulation. 2006 Jun 27;113(25):e924-9. 

6. Lee J, Heng D, Chia KS, Chew SK, Tan BY, 

Hughes K. Risk factors and incident coronary heart 

disease in Chinese, Malay and Asian Indian males: 

the Singapore Cardiovascular Cohort Study. Int J 

Epidemiol 2001; 30: 983–988 

7. NHLBI Obesity Task Force, 199859 & diabetes. 

com.au/research/report_obesity.htm Feb 2000 

www.aapiusa.org 39

feature 

Heart Disease Epidemic Among Asian 

Indians and Low Threshold of Intervention 

Enas A. Enas, MD, FACC * 

Numerous studies over the 

past 50 years, involving several 

generations in countries as 

diverse as the US, Canada, the 

UK, South Africa, Singapore, 

Malaysia, Trinidad, Fiji, and Mauritius have shown a 

50% to 400% higher risk of dying from heart disease 

(coronary artery disease) among Asian Indians 

compared to, blacks, whites, Chinese, Malays and other 

populations. This indicates that Asian Indians have a 

genetic predisposition to heart disease that also applies 

to all South Asians. 1 

Over the past 4 decades, the prevalence of 

heart disease has doubled to 3-6% in rural India and 

quadrupled to 10-12% in urban India. This marked 

difference in heart disease rates between urban and rural 

areas and the dramatic increases over such a short period 

strongly indicate the powerful role of lifestyle related 

risk factors associated with economic development and 

urbanization. 

Many Asian Indians are in double jeopardy 

from nature and nurture — nature being geneticallydetermined 

lipoprotin (a) excess, and nurture being 

an unhealthy lifestyle associated with affluence, 

urbanization, and mechanization. The adverse effects 

of the modifiable risk factors related to lifestyle are 

markedly magnified in those with lipoprotein (a) 

excess — a genetic risk factor found in 4 in 10 Indians. 

Lipoprotein(a) can magnify the risk from traditional 

risk factors by a factor of 2-10. 2 This synergy between 

the nature and nurture best explains the excess burden 

of heart disease among Indians worldwide. 

Millions of Indians die even before the prime of 

their lives. By 2015, the projected annual death from 

heart disease is 2.95 million; of these 1.5 million (50%) 

will be younger than 50 years of age, 920,000 (31%) will 

be younger than 40 years of age and 420,000 (14%) will 

be younger than 30 years of age (1,150/day). In sharp 

contrast, most of the deaths from heart disease occur in 

the elderly (more than 65 years of age) and very elderly 

(more than 85 years of age) in Western populations. 

For example, elderly account for 83% and very elderly 

accounts for 35-50% of the 400,000 Americans dying 

annually from heart disease in the US. 

Fortunately, heart disease has now become the 

most predictable, preventable, and treatable of all 

chronic diseases. Over the last 30 years, heart disease 

death rates have decreased by 50-70 % in the US and 

several other countries and is decreasing by 2-3% per 

year. In sharp contrast, during the same period, CAD 

rates (prevalence) has increased 300% and is now 

increasing by 5-6% per year in India. 

We now have the knowledge to combat this 

epidemic and we need to act now. But the Indian medical 

community in the US has stubbornly refused to address 

this greatest public health challenge affecting Indians 

apart from paying lip service to prevention, proposing 

grandiose unworkable alliances with Indian bureaucracy 

and publishing photos with Indian leaders in Indian 

newspapers. It has been next to impossible to include 

this topic in the CME programs at AAPI convention 

as well as local chapters, except for a few instances that 

were initiated and funded by pharmaceutical companies. 

Furthermore, many “pseudo experts” have challenged 

the excess burden of heart disease in Asian Indians and 

the need for any modifications to intervention specific 

to Indians. 

So it is indeed a welcome change to see Pravien 

Khanna young cardiology fellow from Yale, pursue the 

science and set the record straight, 21 years after I first 

sounded the alarm on this topic in the pages of this 

Journal. 3 He has addressed both the prematurity and 

severity of heart disease among Indians adequately but 

the lower threshold of intervention and modifications to 

treatment guidelines deserve greater emphasis. 

Although major modifiable cardiovascular 

risk factors (obesity, diabetes smoking, high blood 

pressure, high cholesterol, low physical activity, and 

unhealthy diet) do not fully explain the excess burden 

of heart disease in Indians, these risk factors are doubly 

important and remain the foundation of preventive and 

therapeutic strategies in the Indian population. A diet 

is considered unhealthy when it is low 

(continued on next page) 


in fruits, vegetables and fiber, and high in salt, calories, 

glycemic load (too much starchy food), saturated fat 

(full-fat dairy products), and trans fat (fried or crispy 

food). 

The focus on Indian heart disease has shifted 

from high rates of heart disease to high risk of heart 

disease. For example, at any given level of cholesterol, 

blood pressure and other major risk factors, the risk 

of developing and dying from heart disease is at least 

double among Indians compared to whites (even in 

countries with free comprehensive advanced medical 

care). 4 This appears to be due to a high prevalence of 

emerging risk factors such as lipoprotein (a) which are 

not included in the heart disease risk prediction models. 

The European and Australian Guidelines have 

specific modifications that qualify Asian Indians for 

pharmacologic treatment of high cholesterol and high 

blood pressure, substantially ahead of whites at an 

earlier age and at a lower risk threshold. This is the 

ultimate proof of the recognition of underestimation 

of heart disease risk among Indians in Europe and 

Australia, where people receive free medications when 

they reach a certain risk threshold. Unfortunately, this 

recognition remains dismally poor among physicians in 

North American and India. 

The Indo-US Health Summit Held in New Delhi 

India in 2009 has published (Indian Heart Journal 

2009; 61:265-274) specific lower cut offs and stricter 

goals of treatment for major risk factors for Indians, 

than is recommended for Western populations. 4 The 5 

key recommendations for Indians include: 1) desirable 

waist size of less than 80 cm for women and less than 

90 cm for men; 2) a desirable body mass index (BMI) 

of less than 23 (BMI more than 25 is obese among 

Indians as opposed to more than 30 among Europids); 

3) desirable LDL cholesterol (bad cholesterol) of less 

than 100 mg/dl (2.5mmol/l) for all Indians; 4) LDL 

cholesterol of less than 70 mg/dl (1.8 mmol/l) for 

those with heart disease, stroke, diabetes, metabolic 

syndrome, and chronic kidney disease (very high 

risk-category); 5) Because most Indians have high 

triglycerides that spuriously lowers LDL cholesterol 

levels, the summit also recommends a secondary target 

of non-HDL cholesterol, which is set as 30 mg/dl (0.8 

mmol/l) higher than the LDL cholesterol target in each 

risk category. 

those with family history of early heart attacks. This is 

consistent with the Australian guidelines, which call for 

screening evaluation of Asian Indians 10 years ahead of 

Europids. 

In short, we now have the knowledge and 

medications to prevent, reduce and even reverse heart 

disease that applies equally well to Indians. Lifestyle 

modification should begin at 2 years of age, to prevent 

heart attacks in young adulthood and beyond. For those 

who fail to achieve the cholesterol goals with aggressive 

lifestyle modification, statin therapy offers the best hope 

of preventing a heart attack and other complications 

of heart disease. Many statins are approved for use in 

children older than 8 years of age. Recently, the price 

of statins has come down drastically daily cost of 11 

cent for pravastatin 40 mg/d in the US and less than Rs 

5/- for atorvastatin (Lipitor) 20 mg/d and rosuvastain 

(Crestor) 10 mg/d in India. At these prices, most 

Indians would be able to afford a statin and control the 

bad cholesterol to its Indian specific targets. 

* Enas A Enas, MD, FACC 

President and CEO, CADI Research Foundation. 

www.cadiresearch.com 

Sources 

1. Enas EA. How to Beat the Heart Disease Epidemic among South 

Asians: A Prevention and Management Guide for Asian Indians and 

their Doctors. Downers Grove: Advanced Heart Lipid Clinic USA; 

2010. 

2. Enas EA, Chacko V, Senthilkumar A, Puthumana N, Mohan V. 

Elevated lipoprotein(a)--a genetic risk factor for premature vascular 

disease in people with and without standard risk factors: a review. 

Dis Mon. Jan 2006;52(1):5-50. 

3. Enas EA, Thomas I. Immigrant Indian Males - Sitting Ducks for 

Heart Attacks; A Cause for Alarm - And Call for Action. J Am Assoc 

Phys India 1990;2:5-8. 

4. Enas EA, Singh V, Gupta R, Patel R, et al. Recommendations of 

the Second Indo-US Health Summit for the prevention and control of 

cardiovascular disease among Asian Indians. Indian heart journal. 

2009;61:265-74. 

The Indo-US health summit guidelines calls 

for universal screening including blood sugar and 

lipid profile of all Indians at age 18 (paid for by the 

individual). Screening should also be done in children 

who are obese (waist girth more than half of height) and 

www.aapiusa.org 41

AAPI news 

AAPI Charitable Foundation presenting Automatic 

External Difibrilator to be installed at the 

Indian Consulate. 

AAPI President at Indian Doctors Association Gala 

with IDA President Dr. Ashok Tripathy and Dr. Guru 

Reddy. 

AAPI-CF Chair Dr. Shashi Shah presenting a check to 

Alabama Governor Robert Bentley for disaster relief. 

AAPI Regional Director Dr. M. S. Arun with volunteers 

at a medical camp in Alabama. 

AAPI President-Elect Dr. Sunita Kanumury with AAPI 

past leadership at TAPI meeting in PA. 


AAPI Vice President Dr. Narendra Kumar and past 

AAPI leaders with former President of India, 

Dr. A. P. J. Abdul Kalam at a meeting in Chicago.

AAPI news 

Dr. Samin K. Sharma honored with 

prestigious NECO/Ellis Island award. 

Dr. Nitin Doshi honored with 

prestigious NECO/Ellis Island award. 

Dr. Zac Zacharaiah appointed to 

Board of Medicine, Florida 

Dr. Pawan Rattan with ACOG President Dr. Richard 

Waldman. 

New Jersey State Assembly honors Dr. Sudhir Parikh. 

AAPI-QLI honors Nassau County Chief Executive, 

Honorable Edward Mangano on May 11, 2011 

BIMDA Expo Committee & Spouses during Medical 

Expo Gala. 

www.aapiusa.org 43

AAPI & poetry 

“My Battlefield” 

Vijay Kulkarni, MD * 

You got cancer! 

No one likes to hear it. Yet 

Some have to. Asking, ‘ why me’? 

No; It just happened to be you. 

When surgeons find cancer 

They grab it, excise it, and repair it 

All the collateral damage left 

On this Battlefield-My Body. 

Suddenly I know my body is invaded 

By a killer disease, growing unseen, 

Little known, asymptomatic, relentless 

Killer for sure unless fought against. 

And yet there is a Hope 

In healing body, retreating cancer 

Hope for a normal life, albeit with 

Cancer lurking in the background. 

Who are the warriors? –The Physicians 

What do they fight with? 

Chemo, radiation, chemo, 

Surgery, chemo, chemo till end. 

Will cancer come back? 

That depends! 

Not on what was done 

But on what cancer decides to do next? 

Where do they fight? 

On the battlefield-My precious Body 

They turn it upside down, inside out 

Destroy good with bad tissue. 

Who says, I fought the cancer? 

I was only a suffering bystander. 

*Dr Vijay Kulkarni is a past president of AAPI and has published his poems in AAPI Journal and many 

other reputed magazines. Glendale, Wisconsin 


MSRF/YPS new members 

Patron Members from July 1, 2010 

Anjaneyulu Alapati, AL 

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Rama Maganti, AZ 

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Suman Agarwal, CA 

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Sujatha Ramamurthy, VA 

Nikhil Rao, VA 

Amy Reddy, VA 

Manoj Reddy, VA 

Sameer Rohatgi, VA 

Pooja Sabharwal, VA 

Amit Shah, VA 

Renu Shah, VA 

Taral Sharma, VA 

Pooja Singhal, VA 

Sabrena Tangri, VA 

Anjali Varandani, VA 

Vikrant Virupannavar, VA 

Sonali Vora, VA 

Padmaja Yalamanchili, VA 

Shashi Kumar, WA 

Shilpen Patel, WA 

Ganesh Elangovan, WI 

Sweeta Gandhi, WI 

Parameswaran Hari, WI 

Kailas Laxman, WI 

Asha Mehta, WI 

Shibani Munshi, WI 

Annmarie Sundareson, WI 

Prasad Devabhaktuni, WV 

Manu Kaushik, WV 

Venkata Moningi, WV 

Narendra Patel, WV 

Kumaraswamy Sivakumaran, WV 

Vipul Thakkar, WV 

Regular Members 

Dual Membership & others 

Dibyajiban Mahapatra, AL 

Ravindra Mailapur, AL 

Vinod Bansal, AL 

Dheerendranath Raikhelkar, AZ 

Meenakshi Goyal-khemka, AZ 

Param Dedhia, AZ 

Anitha Mullangi, CA 

Gunvantray Mehta, CA 

Mohammed Mollah, CA 

Nayana Patel, CA 

Pravin Kansagra, CA 

Rakesh Dixit, CA 

Smita Tandon, CA 

Sunny Shah, CA 

Uday Shah, CA 

Vikram Kamdar, CA 

Jessie Singh, FL 

Subash Rege, FL 

Vishnu Prasad Yelamanchi, FL 

Manel Nayak, GA 

Shyam Shah, GA 

Sima Pandey, GA 

Gopal Madhav, IL 

Joshua Mammen, KS 

Rajesh Kotecha, MI 

Rakesh Alva, NC 

Ajai Goyal, NJ 

Anil Sharma, NJ 

Chakrapani Prakash, NJ 

Dharam Pal Mann, NJ 

Kausalya Chennapragada, NJ 

Krishna Bhaskarabhatla, NJ 

Manoj Trivedi, NJ 

Rajesh Mohan, NJ 

Sandhya Patil, NJ 

Vineeta Pathak, NJ 

Akhaya Das, NY 

Anil Kapoor, NY 

Anil Maheshwari, NY 

Chitranjan Ranawat, NY 

Dayanand Huded, NY 

Kishor Zinzuvadia, NY 

Meenakshi Jhaveri, NY 

Rohit Bhojo Shahani, NY 

Samir Desai, NY 

Samuel Mark, NY 

Sukhvinder Ranu, NY 

Sunil Dutt Aggarwal, NY 

Dharmesh Gandhi, OH 

Mukesh Rangwani, OH 

Ravindra Pawar, OH 

Shwetal Desai, OH 

Suresh Yadav, OH 

Atul Kalanuria, PA 

Ashok Tripathy, TX 

Kalidindi Vishnu, TX 

Madhavi Muppidi, TX 

Sunil Sahai, TX 

Rajendra Rathour, WI 

Rajiv Varma, WI 

Yoganand Gundamraj, WI 

Prasuna Jami, WV 


If you need help finding a sponsor, please contact AAPI Office at (630) 990-2277 

American Association of Physicians of Indian Origin 

Executive Office: 600 Enterprise Drive Suite 108, Oak Brook, IL 60523 

Telephone: (630) 990-2277, Fax: (630) 990-2281, www.aapiusa.org 

AAPI Tax ID: 38-2532505 

NOMINATION FORM FOR PATRON MEMBERSHIP 

The American Association of Physicians of Indian Origin extends a one time opportunity to its Patron/ 

Life members to nominate only one family member/friend as a new Patron Member at a one time fee of 

$100. The offer expires on June 30, 2012. Please fill in the application and fax/mail it to AAPI Office. 

This offer is extended only to the Patron/Life members as of October 30, 2009 who did not utilize this 

opportunity earlier. 

NOMINATED MEMBER PERSONAL Information 

Last Name: First Name: Middle Initial: 

Degree: 

Other degrees: 

(DO, BDS, MBA, PhD etc): 

Male ____ Female ____ Private Practice ___ Academics ___ Industry ___ Other(specify) __________ 

Primary Specialty: 

Secondary Specialty: 

Current address: 

City: State: ZIP Code: 

Phone: Fax: Email: 

Medical/Dental School: 

Year of Graduation: Residency Completion Year: Fellowship Completion Year: 

nOMINATED BY 

Last Name: First Name: Middle Initial: 

AAPI Membership Number: 

Current address: 


Phone: Fax: Email: 

Medical/Dental School: 

Private Practice ___ Academics ___ Retired ____ Other(specify) __________ 

Payment information 

Visa _____ American Express _____ Master Card ____ Check_____ Charge Amount: $100.00 

Credit Card Number: Exp Date: Security Code: 

Name of Cardholder: 

Credit Card billing address: 


Signature 

I agree to pay the total amount according to card issuer agreement. All credit card transactions are processed in 

U.S. dollars and are subject to the current exchange rates. Membership dues may be tax deductible as an ordinary 

business expense. Consult your tax advisor. AAPI Tax ID # 38-2532505. 

Signature of Applicant: 

Date:

AAPI Executive Office 

600 Enterprise Drive, Suite 108 

Oakbrook, IL 60523 

prsrtd std 

u.s. postage 

paid 

tampa, fl 

permit no. 4309 

American Association of 

Physicians of Indian Origin 

More Convention 

Information Inside 

Back Cover 

Ajeet R. Singhvi, MD, President • Shashi Shah, MD, Host City President • Ajay K. Lodha, MD, Convention Chairman 

www.aapiconvention.com • convention@aapiusa.org

SPRING - American Association of Physicians of Indian Origin

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