Kamal Shah

Kamal Shah

Hello, I'm Kamal from Hyderabad, India. I have been on dialysis for the last 13 years, six of them on PD, the rest on hemo. I have been on daily nocturnal home hemodialysis for the last four and half years. I can do pretty much everything myself. I love to travel and do short weekend trips or longer trips to places which have dialysis centers. Goa in India is a personal favorite. It is a great holiday destination and has two very good dialysis centers.

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Thursday, 21 October 2010 20:13

A good IDE goes a long way

An IDE, or an Integrated Development Environment is the tool that you use to create software. A lot of the credit for the success of any development software goes to the IDE. Who would develop using Dot Net if it weren't for Visual Studio?

I primarily use two IDEs for my day to day development - Eclipse for all my WebObjects and Java work and Xcode for all my iPhone and Cocoa work. Eclipse is definitely the better of the two.

Eclipse is Open Source while Xcode is Apple's product (see, I am not biased!).

These days, an IDE does a lot more than just give you text editing capabilities. Code completion, refactoring, inline documentation, templates and more, all these make life much easier.

Code completion is one of the most important features for me and Xcode simply does a bad job. Let's say I type the first few characters of a variable or a method. Now, when I hit the key for code completion (Esc for Xcode and Control+Space for Eclipse), while Eclipse will show me a list of options, Xcode often fills the first available option which, most often is not what I want!

File organization is another area where Eclipse beats Xcode hands down. Eclipse simply mirrors the disk file system of your project folder. Xcode, on the other hand has no connection between the two. You could have all your files in one folder on the file system whereas the project could have everything organized in folders. This becomes a problem as you manually need to go and move things around when the number of files becomes large.

Of course, Apple fanbois will still swear by Xcode (as with anything that has an Apple logo on it), but I really hope Eclipse starts supporting Cocoa and Cocoa Touch! Or that Xcode 4, touted as the next best thing since the iPhone 4 lives up to its promise.

... http://www.kamaldshah.com/2010/10/good-ide-goes-long-way.html

Saturday, 23 October 2010 09:30

CFH/CFHR1 hybrid

I got an email from Dr. Tim Goodship from the University of Newcastle upon Tyne in the UK this morning.

I had sent my blood samples to this lab in 2006 for genetic testing for atypical HUS. They had sent me initial results saying they could not find any mutations of Factor H, Factor I or MCP, the three most commonly implicated genes in aHUS.

Apparently, they did more tests subsequently and a very specialized set of tests revealed that I did have an abnormal form of the Factor H gene called CFH/CFHR1 hybrid. The chance of recurrence of atypical HUS after a transplant with this abnormal gene is 80%.

So, that pretty much rules out me getting a transplant using the current protocols. Even plasmapheresis may not help.

My only hope now is Soliris (Eculizumab) from Alexion Pharmaceuticals. They have just recently completed a set of Phase 2 clinical trials in patients who were resistant to plasma therapy and patients who were on chronic plasma therapy. The clinical trials have met the objectives, they say. I have myself seen scores of papers on the results of the use of this drug and the rate of aHUS remission has been 100%.

Though daily nocturnal hemodialysis has shown outcomes comparable to that of a deceased donor transplant, I still think I want a transplant. The hassle of undergoing dialysis every day and the restrictions on travel (portable machines are not yet available in India) make a transplant seem like complete freedom. So, I really hope Soliris becomes available for use in renal transplants soon. That, as I said, is my only hope.

... http://www.kamaldshah.com/2010/10/cfhcfhr1-hybrid.html

Sunday, 31 October 2010 06:06

A hectic fortnight

The last couple of weeks have been really hectic. There was this new project we started at Grene for which a prototype had to be completed asap. This resulted in some late nights and working weekends, something unheard of in my career at Grene!

The work culture at Grene is generally very healthy. You do your work. As long as you are reasonably productive and work responsibly, no one bothers you.

In addition to this, I was busy with things at Nephroplus too. We had a stall to manage at the TiE-ISB Connect event that was held at the Hyderabad International Convention Center. This was basically an event for budding entrepreneurs to meet people who had already taken the plunge and started businesses on their own. There were panel discussions on various topics (one of which was healthcare) where people from different backgrounds would discuss the topic and then there would be an open Q&A.

Initially I thought that these discussions serve no real purpose other than giving people an opportunity to network. I was probably wrong. I could sense the encouragement wannabe-entrepreneurs got by simply seeing people who have taken risks succeed in a field close to their heart!

Well, I also heard more jargon than I have in quite some time. Value proposition, stakeholders, tier x cities, strategic investments. Gosh, I did not even understand many of those terms! I wonder if the speakers themselves were just bandying them about without really meaning anything. In one answer to an audience question, the speaker used so much jargon that I got totally lost. In fact, I thought he answered yes to the question when I realized, to my utter horror, that he actually meant no!

Today, Sunday, I decided to take it totally easy. So, apart from my weekly pilgrimage to Poorna Tiffins (while on the topic, I might as well mention a joke I put together - Q. What is K Rosaiah's main contribution to the city of Hyderabad? A. He inaugurated Poorna Tiffins! hehehe... He really did, you know! When he was a simple MLA), so, apart from my weekly pilgrimage to Poorna Tiffins, I did not do ANYTHING. I practically was on my bed the whole day, watching TV and browsing using my iPad.

It's 4:30 now and I am feeling so much better. Rested. My body was actually aching last evening due to all the strain of the past two weeks. I am really glad I rested totally today. I even skipped a family lunch at an uncle's house.

I must really control the time I spend at work. This is totally not sustainable. It is good to say you are leading a normal life despite kidney disease. It is however important to not overdo it!

... http://www.kamaldshah.com/2010/10/hectic-fortnight.html

Monday, 01 November 2010 22:44

One hospital versus best doctors

Kidney disease often ends up being a multi-disciplinary thing. A nephrologist is not the only person you need to consult. With long term kidney disease, there are some conditions that could need you to consult a cardiologist, a neurologist, a hepatologist, an orthopedician, a dermatologist, a urologist and a vascular surgeon among others!

Most of these referrals will be by your primary nephrologist. Now there are often two choices in front of a nephrologist. He could either refer you to someone from the hospital you see him in or where he primarily works or he could refer you to who he thinks is the best (or at least very good) in the city.

Both these approaches have their pros and cons.

Referring you to the best in the city may be good because obviously you are seeing someone who is likely to advise the best course of treatment. However, as is almost always likely, there will be a need to consult the nephrologist because these kinds of things are not always black and white. In these cases, it could be better for both to be a part of the same team, in the same hospital. Things becomes much easier to discuss.

I see my nephrologist mostly at his clinic and rarely at his primary hospital. He inevitably refers me to the best in the city or to someone he thinks is very capable. He initially leaves the choice to me. And I invariably ask him to recommend someone.

As a result, I now see specialists in about five hospitals in the city! This might, at some point, becomes a logistical nightmare as it will be impossible to get these doctors to come together to discuss anything!

... http://www.kamaldshah.com/2010/11/one-hospital-versus-best-doctors.html

Tuesday, 02 November 2010 22:18

Dissent is ok

Many organizations are managed by a group of people. This is true of companies, non-profit organizations and social communities among others. In these organizations, among the management, I feel it is all right, even healthy, to have dissent.

Let me explain. Let's say, a decision about some important issue is to be made. Among the multiple managers of the organizations, it is not always necessary (or desirable) for all of them to hold the same views. It is natural for them to have differing opinions.

The important thing to do is to hear everyone out and then take a decision that the majority supports. I believe that consensus should never be the objective.

Many people believe that Sardar Patel would have made a better first Prime Minister of India. This did not happen due to Gandhiji's obsession with consensus. He wanted the Prime Minster to be chosen unanimously. So, even though Patel had the backing of a majority of the Congress committee, Nehru stayed silent when Gandhiji asked one of them to step down in favor of the other. Patel, despite having majority support, stepped down. So, had Gandhiji not insisted on unanimity, the course that India would have taken would have been very different!

I believe that consensus is not good always. It is important to have dissenting notes provided they are healthy and do not result in acrimony and jeopardize the functioning of the organization.

... http://www.kamaldshah.com/2010/11/dissent-is-ok.html

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