Tag Archives: Medico

The “Cheap Competition” among Doctors: a Hidden Cancer.

The “Cheap Competition” among Doctors: a Hidden Cancer.
©Dr. Rajas Deshpande
Neurologist, Pune.

A majority of medical students in India are actually from poor or middle class background. Most students come in this profession for service to the suffering and also for social respect. Every doctor passing out in India does not pay crores of rupees for education. This is a system created and maintained by all governments for their strongmen as a source of huge earnings. Many of these “paying” students also work hard and earn their degree. However some few look at the amount spent as an investment and try to earn it back by unfair means. This is NOT the fault of the majority of good doctors (both non-paying and paying) who work hard to acquire their skills and help the society. © Dr. Rajas Deshpande

As the society expects “cheapest” advice even for most complicated health issues, some newcomers, those who are under qualified, those who do not have a good number, and some who don’t have the confidence keep their “Consultation fees” quite low, and rely upon alternate income: through tests, procedures and surgeries, through percentage in hospital bills. Thus, though the ‘entry ticket’ is low, the ‘hidden charges’ compensate for the doctor’s (genuine) hard work and skill.
However, not all ‘low fees’ doctors are bad, but keep their rates low to be able to compete, no one wants to criticise those who have low fees for ulterior motives. This competition to keep the consultation fees low to attract patients has generated most evils in the medical practice. Unfortunately, this is unlikely to change soon, as most people prefer this.© Dr. Rajas Deshpande

The low “Consultation fees“ model works best for even good, skilled and experienced surgeons and branches with procedures (plasty/ scopy etc.), where the patient usually does not question the charges for the procedures or surgery, just because every patient prefers best skilled doctor. There is also a recent trend to offer even “procedures and surgeries” at a competitive low cost by some hospitals, who employ the inexperienced or inadequately qualified/ trained doctors, beginners, lowest skilled nurses, technicians and other staff and instrumentation, catheters, joints, other prostheses. The whole show will be put up for “short term goals”, risking patient’s life and compromising many aspects of good care. In many “cheap packages”, the long term outcomes may be at risk.

Those who run hospitals have many profit sources: right from the tea sold inside the hospital campus to the room charges, pathology and radiology, nursing, drugs and everything used, they earn profits under multiple headings. This is also why they can afford to keep their consultation fees extremely low. However, most doctors employed at such hospitals are not paid anything besides their own low consultation fees, while they remain the face of the “total-bill” for all patients. This system encourages rich doctors who invest in alternative sources of income than the consultation fees alone. © Dr. Rajas Deshpande

Physicians / specialists must rely only upon their OPD consultation and IPD visits. If a proper examination is to be done in each case, and all questions of every patient are to be addressed, one cannot see more than 20-25 patients in a day. Thus if he / she keeps low fees, it becomes difficult to sustain in any Indian city. So they must see as many patients as they can, only addressing the immediate medical issue, and unable to answer many queries of the patient and relatives. If a good doctor decides to spend more time with each patient, and gives up relying upon the “hidden income”, he must charge a much higher consultation fees to just sustain in a good city.

The social anger against doctors mostly comes from increased expenditures on health and unrealistic expectations. Although there are greedy doctors, a majority are just doing their best to make a good name by offering the best service at a low price. Quality healthcare will always come with a higher price-tag, a good doctor will have a higher fees, and that if one wants the “backdoor / cut / referral practice “ to end, one must be prepared to pay higher fees.

In a country where loud and sweet talk, deception and lies are preferred by majority over genuine service, honesty and truth, it is difficult to change the basic attitudes: on both sides..

There indeed are some honourable doctors and hospitals who know the value of their own service, and offer the best to their patient. But even they are usually considered “Greedy” by the very patients whose miseries they end. There are senior / skilled doctors who charge from three to ten thousand or more per consultation, and most of our powerful and ministers go to these doctors too. Although this consultation fees appears high, the accuracy of the opinion and advice often save the patients lacs of rupees. If a surgeon advises a surgery, he/ she can earn many thousands, but if the same surgeon with his skills and experience treats the patient conservatively, avoids surgery and gets good results, the patient is unwilling to pay even half the price of that surgery for the same result. What would anyone do in such a case? The concept that “A Right Opinion by the Right Specialist” saves the patient huge amounts of money and discomfort is yet to dawn upon the Indian society.

The market of cheap has always survived, but in the long run, cheap options always come with a greater final price tag upon health: often your life.

It is my sincere appeal to all my fellow practitioners from the newer generations to please change this structure. See a moderate number of patients per day, charge according to your skill, experience and time, do not undercharge or bargain, then alone this system of backdoor incomes will gradually change. Of course you must consider concessions for the really poor, and accommodate those who cannot pay by keeping a separate time/ OPD for them.

© Dr. Rajas Deshpande
Neurologist, Pune.

PS:
Many city-based imbeciles without any doctor in their family will immediately say that all doctors should go to villages. Those who suggest that, please make your own children (if you have) doctors (if they have the caliber) and send them to villages. Why doesn’t the government make it compulsory for every mla and mp who draws lifelong financial benefits from the country’s exchequer, to send their kids to medical schools and serve in rural India compulsorily? Why is it not compulsory for the elected members to take all treatment in their own electorate? Every law is bent every which way possible to accommodate the healthcare requirements of all the rich and powerful, whether it is kidney transplant or joint replacement, but when extending healthcare to the poor and unaffording, the same people from various ruling parties conveniently point fingers at the medical professionals!

Please share unedited.

The Cult of Good Blood: Superhero Medical Students

The Cult of Good Blood:
Superhero Medical Students
© Dr. Rajas Deshpande

He grew up selling vegetables and fruits grown by his mother. He went door to door and in the village market to sell those. He also walked for two miles every day to catch a bus to a school over 20 miles away. He then enrolled in a private class that waived off his fees, because he had a passion: He desperately wanted to become a doctor.

Atul Dhakne, son of a school teacher Mr. Nivruttirao Dhakne and farmer Mrs. Mandabai Dhakne, with his hard work and merit, got admission in the prestigious B.J. Medical College in Pune.

But he wasn’t satisfied. “What about those like me who are from the poor rural background, those who have no access to good classes and education, but want to become doctors?” he worried.

Good Blood speaks, whichever soul it flows in. Young medical students of different origins, studying with him, decided to resolve this. Ketan, son of a lawyer Mr. Avinash Deshmukh (who mostly handles cases for the non-affording,) wanted to do charity like his father. Farooque Faras, whose father raised a family in one small room, was burning with the desire to give. Many others joined in (names below), and the Cult of Good Blood multiplied. They all wanted to uplift the deserving.

“Lift For Upliftment” was born, formed by the superheroes among medical students.

They printed posters and went to almost all junior colleges in Pune, appealing students from poor backgrounds to join their free tuitions / classes, to prepare for the CET /NEET. In the first round, over 40 students joined. After the medical college hours, Atul and his friends took turns to teach these poor students, give them notes, set question papers, conduct exams, assess and counsel for improvement. All expenses were borne from their own puny pocket-money.

There was no fixed place for the class. One local bakery owner, Mr. Dinesh Konde, decided to help these students. He planned the logistics and took them to the corporator Mr. Avinash Shinde, who asked for only one thing in return of his help: commitment to continue this good work. The Cult agreed whole-heartedly. With him, they approached Mrs. Meenakshi Raut, Asst. Director in the education department in Pune, who helped them get two classrooms in a Municipal school after the school hours. The classes thus became regular, every day, from 6-9 PM.

The cult lacked stationery, the huge backup of notes and question paper sets for 40 students, so they approached Mr. Sanjeevkumar Sonavne from Latur, who runs many educational institutes, helps poor students, and even pays the fees of some who cannot afford college. Mr. Shelke and Dr. Harish from Sassoon Hospitals also joined hands to help.

The results were impressive: from the first such batch, 6 students qualified for MBBS, 3 for BDS, 11 for BAMS and 2 for BHMS.

No one had earned anything, but Good Blood flowed forward. Many medical students from subsequent batches came forward to teach free, imparting their fresh acquired knowledge and skills to those who could otherwise have no access to it.

There is no discrimination while accepting junior college students for their class. They have two batches now with 60 students in each. They have also started weekend classes for poor students preparing for NEET in the extremely backward area of Maharashtra, named Melghat. These medical students go to Melghat with their own expenses, teach the rural junior college students over the weekend, and return to attend the tough schedules of medical college again!

“I learned helping others from my mother. We don’t earn anything, but we learn something precious every day” tells Atul, who has now passed MBBS. Ketan Deshmukh, Abhiraj Matre and Farooque Faras help him supervise the group. Their endless enthusiasm only reminded me of how much more I can do. I came to know of this group “LFU” during the recent “Quest Medical Academy” event arranged by Dr. Sushant Shinde.

They are naturally, perpetually short of funds.
I am not rich, but I won’t feel right about myself if I didn’t contribute. They graciously accepted.

When these students came to meet me today, I offered them dinner at a good restaurant (knowing that they stay in hostels). Farooque said “Sir, we will rather use that money to print some more question paper sets”. Farooque’s father has stopped all celebrations in the family, and sends all the money he can, from his one small room home, for the torch of humanity that his son carries forward!

When they asked for an advice, I had but one small request for them: that a Doctor should be completely free of all political and religious influence at work, in teaching, and especially while treating a patient. They assured me that “Lift For Upliftment” has decided to never be affiliated to a political or religious organization, keeping humanity as their highest ideal.

There is no better lamp than the one which carries the light from soul to soul. There is no better definition of humanity than holding hands of those who need it most. I feel very happy today, that I could contribute to this beautiful, divine cause.

Long Live the Cult Of Good Blood, and may we all find it in abundance within ourselves!
© Dr. Rajas Deshpande

The group “LFU” also includes: Esha Agarwal, Shivkumar Thorat, Satyender, Tanvi Modi, Mayank Tripathi, Nikhil Nagpal, Sitanshu, Arvind Kumar, Nagesh Pimpre, all from the B. J. Medical College Pune.

PS: My heartfelt appeal to all medical students and doctors to contribute by starting similar activity in your region, by teaching poor students who want to become doctors, by joining this group and / or by donating for this cause.

Please share unedited.

Essentials Of Being A Smart Doctor

“Essentials Of Being A Smart Doctor”FB_IMG_1470417314264
Guest Lecture at National Undergraduate Students Conference ‘RESPIRARE’ at the
BJ Medical College
August 3 in B. J. Medical College
© Dr. Rajas Deshpande

My dear friends,
If you are sitting in this hall today, you have already proven that you are smarter human beings, but that alone is not enough for becoming a smart doctor. However intelligent or smart anyone else may be in the outside world, your ability to save their life, help them in illness gives you an upper hand, hence the perpetual tag “Doctor sahab” bestowed upon you by the world. To be able to gracefully deserve that tag is a difficult task.
Like success, riches and many other achievements in the world, medical smartness too is not an accident. One has to earn it with a great effort.
There are really smart and good doctors, and there are also those who pretend so. Most patients can tell the difference. So if you plan to be a really smart doctor, you will have to imbibe the essential qualities in your very subconscious, so they become your basic self, a part of your personality. You will have to force yourself to change certain habits, traits of your behaviour and thinking, and allow the inception of newer, better methods within your being. I am very happy that I can speak this to you at this budding stage, while you still have ample time to modify the DNAs of your medical smartness. Once you accept to change for better, never go back or compromise. © Dr. Rajas Deshpande
Let us consider a small question: What quality is universally liked in a human being by almost everyone, including their enemy?
Genius?
Looks? Money?
Muscle power? Political Connections?
No.
Compassion. Kindness.
It is irresistible. Even when a patient has come to you with a prejudice or suspicion, the first thing that will change his / her attitude is your kind words, your compassionate attitude. It is not very easy to be kind and compassionate to everyone, especially the ill-behaved. This is where you will need to train yourself to be smart: by avoiding use of bad words, not raising your voice and not being aggressive. Keep your words to a minimum, and do not use negative, accusing words. Do not speak arrogantly with the relatives. You don’t know when things may take a bad turn.
However, the first few steps that you take to be kind to the patient will get you the biggest reward that this field has to offer: your patient’s trust, and if you care for it, it is usually lifelong. © Dr. Rajas Deshpande
When the patients come in, they are not willingly entering the hospital in most cases, but out of desperation. They are scared, angry and often extremely worried that something bad will turn up as their diagnosis. Add to this the resentment caused by having to be questioned and touched by a total stranger, whom they have to tell private information. This has already made them jittery.
A smart doctor understands this mental state of the patient completely, and makes the best effort to ease out the patient by welcoming them, wishing them, and initiating a genuinely friendly chat. Such simple sentences like “Good Morning, How are you?”, “Hope you are not very tired”, “I am sorry that you had to wait” reassure the patient that they are dealing with a nice human being, and put them at ease.
Whether the patient comes from rich or poor, educated or illiterate background, the doctor must have utmost respect for their privacy and dignity. Asking private questions, undressing and examination should never embarrass the patient. Standing up and wishing the patient while they enter and leave your room makes the patient feel respected, and adds flair to your smartness. © Dr. Rajas Deshpande

FB_IMG_1470417305344
How should a doctor dress?
It is common to see few doctors, both junior and senior, wearing short sleeves and open collars, sometimes even low rise jeans, trying to show off their physique. One can only imagine what kind of reaction they will generate if things go wrong.
There have been many scientific studies about this. If you yourself want to be treated, you will never prefer a shabby looking, ungroomed, unclean person with a stink. You will want someone who looks healthy and positive to make health choices for you. The patient always wants to see a neat, clean and reassuring doctor. Your demeanour should not be frivolous: unnecessary excessive laughing, smiling, joking, bad language are not welcome to be used in front of a worried patient. © Dr. Rajas Deshpande

It is wise to dress up as good as one can, without too much show and fashion. A very richly dressed doctor in a suit may turn off an already nervous patient from lower socioeconomic classes. The best attire is formal, simple, clean and ironed clothes which cover you well, apron, shoes, and no jewellery. Fortunately, tattoos and piercings have not yet much entered this field. One must avoid religious clues, and refrain from religious and political talk while practicing as an allopath.
A smart doctor cannot forget that our field deals with people from different socio-economic strata. He / she should be able to irradiate the feeling of being a trustworthy person and invoke positive, peaceful feelings in those who come to see him / her.
Personal hygiene is an indicator of a doctor’s smartness, and such simple things as hand-washing after every case, using sanitizers, wearing gloves etc. speak a lot about a doctor’s dedication towards good health. Best clinical practices must be learnt and complied with voluntarily by everyone who wants to be a smart doctor. © Dr. Rajas Deshpande
Humility, manners and etiquette
A Spanish TV anchor who follows up with me for Multiple Sclerosis told me once: that many patients travelling to India complain about the doctors being very good clinically, but worst in manners. “I was amazed that you actually offered me a glass of water when I was crying during my first consult” she said. Such simple manners affect the patients so much!
Many doctors, as they ascend the merit scales in this profession, develop a complex that they are unbeatably smart. They end up becoming ego-balls disliked by almost everyone, because of their high handedness. A smart doctor will never let that happen to himself / herself. There are far more smarter people than most doctors in almost every other field, even some illiterates are sometimes smarter than the most literate. One must never shed humility, whatever one’s achievements. We often see students smarter than teachers, juniors smarter than seniors and we all know what happens in those cases. The best policy is to never presume oneself better than the other. A smart doctor always knows his manners and etiquettes very well. © Dr. Rajas Deshpande
Language and communication:
“What do you mean by dizziness?” my teacher asked a tired female patient once.
“Oh I feel abnormal noise in my ears” she replied. Dizziness, in patient’s language, may mean anything from imbalance, blackout, vertigo, to heavy-headedness or blurring of vision. It is always wise to dig into what they actually mean. A knowledge of regional language often helps resolve misunderstandings. Similarly, the patient may also misunderstand the words that a doctor uses.
A smart doctor will learn to communicate so as to make the patients from different streams understand exactly what is being conveyed. We do not always have too much time, hence it is necessary to develop the skill of using minimum words. One must use simple words, and know the colloquial alternatives (e.g. use “Heart” instead of “Cardiac”, use “Brain infection” instead of “Encephalitis” etc.). If the patient does not understand, one must encourage him / her to ask questions. Use pictures if necessary. Many patients / relatives do not stick to time or subject, often asking irrelevant questions based upon their googling, but a smart doctor must be able to steer them on to the right path with a smile and a gentle reminder of time limitation.
The most difficult part of being a doctor is conveying the bad news. There is no good way, one has to be very careful and diligent. On one hand one must offer sympathy and readiness to help further, while on the other hand, one must also be aware of aggressive, impulsive and shocked reactions, making sure not to risk one’s safety.
While conveying the bad news, surgical risk or complications, a doctor must have the patient / relatives sit down, have witnesses around, and speak compassionately but confidently, offering all possible help to ease out their suffering. A hesitant doctor invokes suspicion even if correct. However, an overconfident liar will invite more trouble, so be careful that you speak what is the exact truth. That never fails in long run. © Dr. Rajas Deshpande
Professional Smartness
Friends, as you become more and more specialised, you will unfortunately face rivalry and jealousy. Doctors are the most ingenious professionals in their ability of pulling legs or sabotaging careers, and you may sometimes be facing your own teachers in such situations. A smart doctor will never compromise his / her own grace or the dignity of our noble profession. Fight all that you must, and I will stand by you if you are correct, but always use the best language, think about and mention the best things about your competitor, and always keep the door for direct discussion open. Refrain from allegations, cheap comments, mockery and defamation. If you feel that a colleague is wrong in some clinical decision, please reach out to them and talk, before you discuss it with others. Everyone usually has a reason for their decisions, one must respect it. If your reaching out is unwelcome, then alone mention on paper what you think about the case. A smart professional will have no friends or enemies, no senior or juniors, but only colleagues. Immediate reporting of any adverse clinical events to the authorities, and correct documentation are essential. © Dr. Rajas Deshpande
Medico legal Smartness
We live in a country with too much poverty and illiteracy. If there is a chance that a doctor’s mistake can be proven, there is every chance that the relatives will drag that doctor into the courts of law, demanding millions in compensation.
In these days of exponential medico legal cases, where patients, relatives, authorities and even some colleagues are usually unforgiving if you commit a mistake, real smartness is to document everything perfectly. Just as an example, a young patient of mine recently had a stroke, without any known risk factor. Upon repeated questioning, he reported that he was taking some unknown herbal medicine since three months, in a mixture of some oils, to improve memory. One must mention every such detail on the paper, including poor known history, delayed admission and alternative treatments. Every interaction with the patient and relatives must be recorded on paper. Recording the date, time and your name and designation at the beginning of every note is an indication of you basic smartness. A proper written consent must be obtained for every procedure, however trivial. Information about dangerous medicine being given to the patient / relative should be recorded, a consent for the same signed by the relatives. © Dr. Rajas Deshpande
Academic Smartness
I do not know if I am enough qualified to talk about this, because I was often beaten up by my primary school teachers for not doing my home work and some other curiosities which I cannot mention here.
A doctor is expected to be on top of the pyramid of scientific advances, and there is nothing more pathetic than a doctor who quotes medical knowledge from decades ago. While we respect the past, we cannot disrespect what every standard medical textbook mentions on its first page: Medicine is an ever-changing science. A smart doctor, therefore, will still study on a daily basis even after achieving the highest degrees, and keep himself / herself updated with the most recent medical knowledge relevant to his / her field. Studying on a daily basis, I feel, is the most important basic quality every smart doctor must inculcate. One must register on smart medical sites like up-to-date, emedicine or many others, to stay updated about one’s medical interests. Yours is a lucky generation, having all information at your fingertips, thanks to your smartphones. Check drug interactions every time you use new medicines. Cross check your differential diagnoses. © Dr. Rajas Deshpande
Digital Smartness
Everyone is semi-addicted to their smartphones. However, they are also a great hindrance to the super-essential concentration required of a smart doctor while interacting with patients or making medical decisions. Smartphones can be wisely used to record data and expedite certain protocols, accessing information etc., but they should be switched off while with a patient. It is very humiliating and irritating for a patient when the doctor is occupied with a cellphone during a consult.
Social Smartness
There is a competition now among some doctors to post everything they do on the social media. A colleague of mine recently posted a video of a huge tumor that she removed from the abdomen of a patient. She is now under an enquiry for compromising patient privacy. One must refrain from posting any information that discloses patient’s identity on the social media.
Most of you google your crush, actor or actress you like, don’t you? Well, some of you will honestly agree.
Patients are as curious and inquisitive as you are, and may google you. So please refrain from posting undignified pictures / matter / vulgar jokes, etc. and pictures while drinking / smoking, hugging etc. on social media. Also refrain from posting stuff that maligns your own profession or colleagues. You can improve things from within, not by publicising them.
A smart doctor will learn over time to refrain from giving out personal number to the patients / relatives, as this may lead to many disadvantages later, including unwanted calls, messages, advertisements and other misuse.
While patronising should be avoided completely, (“You are my brother, sister, mother, father etc.), in some cases it may reassure a frightened patient, hence it may only rarely be used. © Dr. Rajas Deshpande
It is not at all uncommon for a doctor or a patient to get a crush upon the other. In case you sense a love interest blossoming within your patient or yourself, immediately rethink about your life’s choices and refrain from any further progress in that direction, as this could turn disastrous for your career. Do not encourage meaningless chats, messaging or personal comments when dealing with patients. An allegation of molestation, sexual harassment or mal-intention can ruin you.
Most doctors feel proud of their excess hard work, and often mention that they work without proper food or sleep for days together. While this is really commendable, it is also a granted feature of this career. One must learn not to milk a pardon for one’s ill behaviour or mistakes by quoting excess work. A mistake is a mistake and the best policy about a medical mistake is being completely honest about it. © Dr. Rajas Deshpande
Moral Smartness
My recently published book, “The Doctor Gene” ends with the words “A good doctor is the best a human being can be”.
You belong to a community that practices the highest of morals not just because the society expects it, but because you have voluntarily sworn to. You have chosen this career yourself. Right from now, please imbibe the best of morals and truthful attitudes in your blood. Believe me, every human being has the hidden sense to perceive a genuinely good person, make sure that your patients get this feeling about you. © Dr. Rajas Deshpande
Serenity Smartness
One important art in medicine is almost on the verge of extinction: that of immense concentration. What with the hustle-bustle and digital exposure that every medico must work with, we are fast losing the ability to switch off the world and concentrate, think or meditate. These things bring the serenity, so essential an ingredient of medical smartness. Learn to find time, preferably on a daily basis, to be with yourself, and sort out the tangles in your mind before they strangulate you.
Higher education
I get atleast one question everyday from some or other medical student on my facebook page:
Which branch is best? What PG should I do?
You will eventually realise what you like. You may seek opinions, but not decisions from others. Be smart enough to identify what you want and respect your own inclinations. Keep a list of alternative options, as PG seats are limited. Don’t waste too much time in pursuing a particular branch, there are so many advances happening that every PG branch offers you good futures if you are dedicated enough. There are umpteen examples on the other side: doctors who got their desired specialties but never did anything significant after that, other than customary routine. © Dr. Rajas Deshpande
De-stressing
I am sure that in this very hall, there are beautiful dancers, painters, far better authors than myself, speakers, and artists of infinite ability. I think I should also say some potential models. But you will give up all that art and beauty within yourself, lost in the heavy duty career of being a doctor.
One absolute essential for every medico is a sure-shot de-stressing mechanism. We are all destined to face suffering, poverty, struggle, pain and death on a daily basis, and this takes a toll upon our minds. We tend to grow mentally old very soon. Many think that alcohol or smoking is a respite, but this is ridiculously stupid. A smart doctor knows to find his / her escape in arts, literature, family, travel and other hobbies. It is extremely essential to de-stress as your performance may be affected if you accumulate stress for long. © Dr. Rajas Deshpande
What do patients want?
The best compliment for a doctor is a happy patient, and the best feeling in the world is knowing that your efforts saved a life.
A smart doctor is the one who has the reputation of making the correct diagnosis in majority of cases. A smart doctor is the one who invokes trust in a patient by being genuinely honest and compassionate. A smart doctor is the one, most of whose patients are happy, not only because their health issues are well attended, but also because they met a caring, well behaved human being.
Never think about money or anything else when consulting a patient. Think of every case as an exam case, get the most correct history, do the best clinical examination and give the patient the best treatment options. You will make enough happy money with such practice, if you are smart enough to understand what that means. © Dr. Rajas Deshpande
Dear friends, one thing about smartness which I learnt early in my medical career is that a senior doctor should not give very long lectures, and should end up his speech before time.
I have written many more things about the essentials of being a truly good doctor, and the glorious traditions of our noble, almost divine profession, in my book “The Doctor Gene’. If you did not get a copy outside, please email thedoctorgene@gmail.com to get your copy.
I am sure that you will all be very successful doctors, and I will be very happy if my words today help you deal with your medical life smartly. I thank you for patiently listening to me today.

FB_IMG_1470417301427
Love to you all and I wish you all the best, always!
© Dr. Rajas Deshpande
03.08.2016
Thank you, Mr. Yashodhan Morye and BJMC UG Student’s Council