Background: COVID 19 infection caused by SARS-CoV2 virus is causing high mortality all over the world. This causes asymptomatic, mildly symptomatic , moderate, and severe illness. In severe illness, mortality is remarkably high as drugs are not effective enough to avert cytokine storm, stroke, myocarditis, or myocardial infarction. COVID-19 is a positive sense virus that directly enters the ACE2 cell and starts replication after encountering the host protein. Effective treatment has been limited to only mild and sometimes moderate cases but there is a high mortality in severe cases. Case Presentation: Severe COVID-19 cases with different comorbities were assessed and treated in the first wave as well as the second wave of the pandemic in North India.. A total number of 305 patients were assessed for severity with their symptoms and abnormal blood parameters , out of which 109 patients severe patients were given the drugs and their symptoms and vitals were monitored along with therapy. In both the single SARS CoV 2 and the double mutant virus strain in the second wave. We measured their severity through their blood parameters by calculating high Neutrophil lymphocyte ratio, Platelet lymphocyte ratio after getting their complete blood count, diabetes, and other inflammatory markers like high LDH, CRP, Serum Ferritin, D Dimer, or IL 6 in critically ill patients as studied in previous studies. Hence, we designed this combination therapy drug protocol which was home based oral therapy with hundred percent recovery rate if initiated early. Wherever required oxygen therapy had also been recommended along with diet modification, low fatty acid diet and low carbohydrates for more effectivity. The combination of Azithromycin , Pentoxifylline and Dexamethasone had shown to be highly effective in controlling the inflammation and viral replication with dose modification. Intravenous Ceftriaxone was given as infusion in patients having viral Pnemonia .Conclusions: This combination therapy of drugs has shown to decrease TLR mediated cytokine production. This therapy has shown full success in all high-risk patients especially in the elderly having comorbidities like Diabetes, heart diseases, cancer, autoimmune diseases.

India is the only country in the world running two different doctoral courses for doctors, i.e., Doctor of Medicine (MD) and Diplomate of National Board (DNB). DNB course was introduced in 1975 to overcome shortage of specialist doctors and medical teachers. Both courses have centralized entry examination, similar tenure period, academic and clinical activities, and research exposure and exit examination (in the host institute in MD examination and in designated exit exam centre in institute other than poarent institute in case of DNB examination). Initially, the Ministry of Health and Family Welfare and Medical Council of India (MCI) established the equivalence between two. Discrimination started since October 2012 through MCI gazette notification for DNB trainees from non-MCI recognized institutes with regards to teacher appointment. DNB doctors were united to raise their voice against this. While the Government of India (GOI) is in favor of equivalence between two, MCI is against the same. Recently, MCI is dissolved and is going to be replaced by the National Medical Commission and positive outcome is expected for the DNB side. A recent notification is issued toward equivalence of two courses provided candidate completed DNB course from hospitals with minimum 500 beds. Evaluating quality of education on the basis of number of beds seems unjustifiable as there are many better indicators of quality of medical education. The NMC act also retained the same 500 bed criteria. Taking into account the view point of benefit of population and improvement in medical education in India, it is desirable to reconsider the issue by the Government of India (GOI) and to act accordingly. To enhance the standard of current medical education, higher standards should be imposed in curriculum and centralized exit examination to be made compulsory for both the courses.

Background: COVID 19 infection caused by SARS-CoV2 virus is causing high mortality all over the world. This causes asymptomatic, mildly symptomatic , moderate, and severe illness. In severe illness, mortality is remarkably high as drugs are not effective enough to avert cytokine storm, stroke, myocarditis, or myocardial infarction. COVID-19 is a positive sense virus that directly enters the ACE2 cell and starts replication after encountering the host protein. Effective treatment has been limited to only mild and sometimes moderate cases but there is a high mortality in severe cases. Case Presentation: Severe COVID-19 cases with different comorbities were assessed and treated in the first wave as well as the second wave of the pandemic in North India.. A total number of 305 patients were assessed for severity with their symptoms and abnormal blood parameters , out of which 109 patients severe patients were given the drugs and their symptoms and vitals were monitored along with therapy. In both the single SARS CoV 2 and the double mutant virus strain in the second wave. We measured their severity through their blood parameters by calculating high Neutrophil lymphocyte ratio, Platelet lymphocyte ratio after getting their complete blood count, diabetes, and other inflammatory markers like high LDH, CRP, Serum Ferritin, D Dimer, or IL 6 in critically ill patients as studied in previous studies. Hence, we designed this combination therapy drug protocol which was home based oral therapy with hundred percent recovery rate if initiated early. Wherever required oxygen therapy had also been recommended along with diet modification, low fatty acid diet and low carbohydrates for more effectivity. The combination of Azithromycin , Pentoxifylline and Dexamethasone had shown to be highly effective in controlling the inflammation and viral replication with dose modification. Intravenous Ceftriaxone was given as infusion in patients having viral Pnemonia .Conclusions: This combination therapy of drugs has shown to decrease TLR mediated cytokine production. This therapy has shown full success in all high-risk patients especially in the elderly having comorbidities like Diabetes, heart diseases, cancer, autoimmune diseases.