December 11   2015, Friday
emedinexus emedinexus
Dr KK AggarwalDr KK Aggarwal Inter-ministerial committee headed by Add. Secretary for health on issues raised by IMA

Dear Leaders

The first meeting of this committee was held at Nirman Bhavan on 8th December 2015, where apart from IMA representatives, representatives of MCI, Joint Secretaries of departments of Health, home affairs, law ministry and consumer affairs ministry participated. The discussion went on for four hours.

IMA could very strongly put forward our demands to a convincing level on

1. Central act for prevention of assault on doctors and health institutions: There was general agreement that when so many avenues for redressal of grievance of patients and relatives are available like consumer courts, civil courts, criminal courts, human rights commission, women’s commission, Medical Council of India and others, taking law into one’s own hand and assaulting medical men and their institutions cannot be tolerated. For the question as to the need for a central act, we could convince the committee that unless there is amendment to the CrPC and police manual through a central act, the state acts could still be weak and ineffective. A draft act on prevention of attack on doctors and clinical establishments was also submitted.

2. Capping of compensation: IMA put forward the view that capping is not a new concept, this is existing in countries like United States, UK, Australia and others. Even in India there is capping as far as compensation is concerned in sterilisation failures and related deaths, deaths due to natural calamities, plane crash/ train accidents, death occurring in the course of clinical trials etc. On many instances the compensation is awarded on emotional grounds, sometimes using multiplier method. Even the multiplier method used in MACT compensation cannot be applied on the medical field because the earning capacity of a patient definitely will be gradually less and less because of his illness, even his longevity of life will be affected; hence instead of multiplier method a calculation on the basis of diminishing earning capacity can only be used.

IMA also demanded that a legal audit has to be done just like medical audit is being done so that mistakes once committed by the judiciary is not being repeated. An arbitration in deciding the compensation will be a better solution in terms of deciding the quantum of compensation and faster justice (even in consumer commission, it takes years for a final verdict). Although the provision for penalty for frivolous complaints exists, it is never awarded and amount also is very inadequate. The penalty amount should be proportionate to the claim.

3. BSc Community Health/ Posting of AYUSH Doctors in modern medicine institutions or Prescription of modern medicine drugs by other systems: IMA put forward the strong argument that health parameters are better in countries where the ratio of total health workers including doctors to population is higher. In India, the proportion of doctors per population is higher than in most developing countries. But the total health manpower is less. This definitely points to the need to have more nurses, health workers and field staffs rather than doctors. So the government move to post AYUSH doctors in sub centres and PHCs will be counter-productive. The responsibility of the doctor at the primary health centre is 70% preventive and only 30% curative. He is a team leader to oversee health awareness education, implementation of immunisation, sanitation, nutrition, personal hygiene etc. This cannot be done by AYUSH doctors who do not have exposure to modern medicine. Moreover the role of modern medical doctors cannot begin at community health centre or taluk hospital level. The best opportunity to prevent diseases and also early detection of disease for better cure is lost by this move. Hence, IMA strongly put forward the view that posting AYUSH doctors at PHC and sub centres would be injurious to public health.

Many court verdicts are available, which ban modern medicine drug prescription and practise of modern medicine by AYUSH doctors. The MCI Act also prevents doctors of other systems of medicine from prescribing modern medicine. A short course or bridge course to facilitate AYUSH doctors to prescribe modern medicine can only lead to more of iatrogenic complications.

4. PCPNDT Act: While IMA strongly supports the government in punishing doctors who do/aid/abet female foeticide, at the same time, IMA is equally strong in opposing award of same criminal punishment for non-compliance like mistakes in filling the forms, non-display of registration certificate, not keeping copy of the PCPNDT Act in the diagnostic centre etc. IMA could convince the committee that noncompliance should only attract penalty.

Specialists like cardiologists, neurologists, emergency medicine doctors who use ultrasound should not be harassed and compelled to fill and maintain so many forms and registers, which has to be done only by those who are doing obstetrical sonography.

5. Clinical Establishment Act: IMA strongly demanded exclusion of single man clinic, family doctors and general practitioners from the purview of the CEA. IMA quoted the recent NSS survey 2014 which pointed out that 40% of health care is being done by small and medium level hospitals. A promotive clause should be included in the act to sustain these hospitals even to the extent of having aided hospitals. IMA demanded that those hospitals, which have entry level accreditation or above by NABH need only register under the act and need not undergo the entire accreditation process under the CEA. IMA demanded that clauses like stabilisation, having police personnel in the district level committee, fixation and display of professional fees and procedural charges and the government itself coming out with treatment protocols, should be removed.

The representative of MCI strongly supported IMA's demands. Team IMA anticipates a favourable outcome in a time-bound manner on all these issues, but at the same time our preparedness for a national agitation at any time should continue.

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Breaking News

Mexico to get world's first dengue fever vaccine

The Mexican health ministry has approved the use of the world's first vaccine against dengue fever. The vaccine, Dengvaxia has been developed by Sanofi and prevents four types of dengue virus. Some 40,000 people will receive the treatment in Mexico in an initial phase. In a statement, the Health ministry said, "With this decision, Mexico moves ahead of all other countries, including France, to tackle the spread of this virus." The vaccine will be available only to children over the age of nine, and adults under 49 who live in endemic areas. (BBC)

State drug controllers to report blood transfusion adverse reactions

The Drug Controller General of India (DCGI) has asked all state drug controllers to direct all licensed blood banks to uplink transfusion adverse reactions with the National Institute of Biologicals (NIB) under the Haemovigilance Programme of India (HvPI). After uplinking, data in transfusion reaction reporting form (TRRF) would be collected by NIB online through a software named Haemovigil indigenously developed by IT division of NIB. The user ID and password may be obtained from NIB by sending an email to member secretary, HvPI at This will enable Central Drugs Standard Control Organisation (CDSCO) to take safety related regulatory decisions in blood safety… (Pharmabiz - Shardul Nautiyal)
IMA MS /610/ 2015 10th December, 2015

Report about Agitation of Sonologist’ strike

On 2nd December 2015, a city based senior radiologist, who runs a XRAY and SONOGRAPHY clinic in Yeravda, was sentenced to 1 year jail under PCPNDT ACT for not maintenance of records and lapses in submitting monyhly reports. Judicial Magistrate first class S.C Kharinar awarded this punishment along with a collective fine of Rs 32000/- failing which he would have to undergo an additional imprisonment of 2 and a half months . A criminal case was registered against him in February 2012 and the Court made a statement saying lapses in record keeping about obstetric USG only showed his ulterior motives. Dr. S. T. Pardeshi., PMC medical officer of Health has said that still 61 cases are pending in the court for flouting the norms of PCPNDT ACT and that he hoped that this conviction will act as a deterrent for those who indulge in such sex determination.

On 3rd of December, Dr Viren Kulkarni,..President of Indian Radiological Association, PUNE Chapter had approached, Dr. Avinash Bhondwe, Sr. Vice-president IMA-MS, Dr. Bhutker, President PUNE IMA, Dr. Navrange and Dr. Meenakshi Deshpande for support from PUNE IMA for the agitation the radiologists were planning to take up against such inhuman and incapacitating judgements for minor clerical mistakes and non maintenance of records.

In that meeting the decision about THREE DAYS FULL USG CLOSE DOWN FOR PUNE DISTRICT with 400 ODD SONOLOGY CENTRES.. FROM 7 TH DECEMBER TO 9 TH DECEMBER 2015. 9 TH DECEMBER IS PLANNED TO BE A COMPLETE RADIOLOGY SERVICES SHUT DOWN DAY [which includes Xray, Mammography, CT, MRI. Vasculography ]. All Emergency radiology services will be continued unhampered in selected hospitals. Inconvenience to referring doctors and consultants is regretted.

I called up Dr. Jayesh Lele, President IMA-MS on 5th December 2015. I informed him the situation and discussed the IMA- M-S stand for this strike. Since PCPNDT act is one of our 5 points agenda about the National Satyagraha and the most of the Sonologists are active members of IMA, we decided to support the agitation.

We also assured the Sonologists to offer the support for the discussion with the State & Central level with the help of IM MS & HQ.

On 7th December we participated in the Rally in the morning to PMC.

On 7th December, Monday a Press meet was arranged at IMA, Pune Office, which was attended by Dr. Avinash Bhondwe, Dr. Bhutker, Dr. Navrange, Dr,Viren kulkarni, Dr. Deoker, Dr. Machave and Dr. Meenakshi Deshpande and we informed the media regarding our stand.

As Vice president of IMA M-S, I was daily in touch with the office bearers of Sonologists Association, on phone and in person. We discussed every move to be taken during their strike.

On 9th December 2015, we had discussions about the Further actions to be taken by Sonologists. We appeal them to participate IMA activities about PCPNDT at National level.

Thanking You,
Yours Sincerely,

Dr. Jayesh Lele                                                               Dr Parthiv Sanghvi
President                                                                      Hon. State Secretary
cell + 91 981 981 2996                                                     + 91 9820304284

IMA Maharashtra State

Dr RVS Surendran
President, IMA Tamil Nadu State


At this moment of natural fury, Indian Medical Association stands with you to support and help. Indian Medical Association HQ Disaster Management Cell has appealed to its members for generous donation for the needy people affected by the flood.

Please inform us about the need and requirements to carry out the rehabilitation and Medical help to the affected people. IMA HQs will try to provide help in its best ability.

We also request you to inform us regularly about the activities done by IMA Tamil Nadu with regards current floods in the state.

Dr A Marthanda Pillai                                           Dr KK Aggarwal                                                  Dr Chetan N Patel
President                                                                Hon Sec General                                                         Chairman
IMA HQ                                                                           IMA HQ                                                             IMA HQ DMC
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Specialty Updates
• Patients with hemophilia had almost twice the risk of developing alloantibodies when treated with recombinant factor VIII instead of plasma-derived factor, suggested a randomized trial presented at the American Society of Hematology (ASH) meeting.

• There are many side effects linked to overuse of ibuprofen. However, a new ibuprofen patch has been developed that can deliver the drug at a consistent dose rate without the side effects linked to the oral form. The transparent patch adheres well to skin, even when the drug load reaches levels as high as 30% of the patch weight.

• An FDA advisory committee has voted in favor of approval of reslizumab for the treatment of eosinophilic asthma in patients aged 18 years and above despite the emergence of two safety signals, anaphylaxis and muscle toxicity, during pivotal clinical trials. However, the committee voted unanimously against approval in children aged 12 to 17, due to lack of efficacy and uncertainties about safety.

• Long-term survival rates are about two-thirds higher for patients in their 50s who undergo aortic-valve replacement with mechanical prostheses compared with bioprostheses, but no such significant survival advantage for mechanical valves was seen for patients in their 60s, reported a population-based study published in the European Heart Journal. Still, survival with mechanical valves was significantly increased for the overall cohort aged 50 to 69 years.

• A dexamethasone intravitreal implant provides sustained improvement over three years for patients with diabetic macular edema, suggests a new analysis published online in the British Journal of Ophthalmology.

• Premenopausal women with Luminal A breast cancer, a common, intrinsic subtype, can consider skipping chemotherapy altogether and still expect a good prognosis, even when they are node positive, suggests a new analysis of an old Danish study presented at the San Antonio Breast Cancer Symposium (SABCS).

• New data, presented at the American Epilepsy Society (AES) 69th Annual Meeting, suggest that patients with long-term treatment-resistant epilepsy have a brain that appears older on brain imaging than their chronologic age.

• Babies born to mothers who did not finish high school, possibly due to socioeconomic stress, are more likely to be born with decreased chromosome protection, thus making them vulnerable to additional health risks, suggested new research published in the Journal of Perinatology.
Desire, Hatred and Ignorance

According to Buddhism, the three negative emotions that cause disease are ignorance, hatred and desire. Accordingly physical sickness are classified into three main types.

• Disorders of desire (Ayurvedic equivalent of Vata imbalance): These are due to disharmony of the wind or energy. The seed of these disorders are located in the lower part of the body. It has cold preferences and is affected by mental desires. In this, the person mainly suffers from the disorders of movement functions.

• Disorders of hatred (Ayurveda equivalent of Pitta imbalance): It is due to disharmony of the bile. The seed of these disorders is centered in the middle and upper part of the body and is caused by the mental emotion of hate. The person suffers from metabolic and digestive abnormalities.

• Disorders of ignorance (Ayurveda equivalent of Kapha imbalance): It is due to the disharmony of phlegm, the seed of which is generally centered in the chest or in the head and the disorder is cold in nature. It is caused by the mental emotion of ignorance.

Desire, hatred and ignorance are the main negativities mentioned in Buddha’s philosophy. They are all produced in the mind, and once produced they behave like a slow poison. The Udanavarga once said, “From iron appears rust, and rust eats the iron”, “Likewise, the careless actions (karma) that we perform lead us to hellish lives.

According to the other scriptures, six afflictions are most troublesome, namely ignorance, hatred, desire, miserliness, jealousy and arrogance. Patience is the most potent virtue a person can acquire. According to the Shanti Deva, “There is no evil like hatred, and there is no fortitude like patience. Therefore, dedicate your life to the practice of patience.” Bhagvad Gita classifies the enemies as Kama, Krodha, Lobha, Moha and Ahankara; of these, Kama, Lobha and Ahankara, are the three gateways to hell.
The Year in Medicine 2015: News That Made a Difference
SPRINT: More intensive management of BP saves lives

A more intensive strategy of blood pressure management reduces the risk for death and cardiovascular events when compared with a strategy that lowers systolic blood pressure to the conventional target of 140 mm Hg. The Systolic Blood Pressure Intervention Trial (SPRINT) reported that treating high-risk hypertensive adults aged 50 years and older to a target of 120 mm Hg significantly reduced cardiovascular events by 30% and all-cause mortality by nearly 25%. Though the study was stopped early due to the benefit of the intensive strategy, the absolute risk reductions were small and some adverse effects were higher in the intensive-treatment group. The SPRINT investigators suggest review of data and updated guidelines incorporating the results still need to be written. (Medscape)
Legal Quote
Ayesha Begum vs All India Institute of Medical Sciences on 9 May, 2007, Complaint No. 155/2000,

“A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.”
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IMA White Paper on Live Surgeries

IMA Check List

Surgeon selection

1. The surgeon is of sufficient proficiency, with a high annual volume of similar cases.
2. The surgeon holds operating privileges in a hospital in his or her country of origin.
3. The surgeon is granted operating privileges in the host unit.
4. Personal and hospital indemnity insurance is arranged prior to the event.
5. It is explicit whether the guest surgeon is the primary surgeon.
6. The guest surgeon is named on the patient consent addendum and ideally has significant experience in LSEs.

Patient selection

1. Standard cases rather than extremes are preferable and recommended.
2. Patient selection must reflect the submitted educational objectives of the event.
3. Patients must be asked well in advance for their permission to undergo live surgery and experience no disadvantage, including scheduling if they decline.
4. There must be no delay in the patient's treatment as a consequence of agreement to an LSE. 5. Reserve patients should be available and appropriately counselled.

Theatre team preparation

1. The operating surgeon must submit in advance a detailed list of preferences, including instruments, disposables, and devices; patient, surgeon, and scrub nurse positioning; and preferred assistants.
2. Any language difficulties should be foreseen and avoided, where possible.
3. Nominated assistants should be appropriately registered and suitably experienced.
4. Anaesthesiologists must be involved in planning the procedure.

Preoperative planning

1. Full clinical details, test results, and images of the case should be sent to the guest surgeon for review well in advance, allowing time for discussion with the host surgical team.

2. The guest surgeon reserves the right to decline to operate, and contingency plans should be in place for this eventuality.
3. The surgeon must be invited to arrive at the host unit the day before the surgery.
4. The standard consent for surgery used by the hospital must be signed.
5. Patients should give specific consent to a live link during the operation (Patient Consent Addendum).
6. Patients should have the opportunity to withdraw at any stage preoperatively. If there is a guest surgeon, patients must meet the visiting surgeon in a calm environment the day before surgery for consent.

Preoperative checks

1. The WHO surgical checklist (or a local adaptation) must be used and involve all personnel in the operating room, who must also be briefed about the event.
2. Unnecessary personnel and equipment should not be present in the operating room.
3. Representatives from industry should be in the operating room only if their presence is mandatory, and they should be appropriately registered and certified by the host hospital.

LSE Overview

1. Cases should be digitally recorded.
2. Delays purely for the conduct of the live
proceedings must be avoided. 3. The presence of an experienced urologist, acting as the patient's advocate in the theatre, is a mandatory requisite.
4. The use of one or more moderators is recommended.
5. The role of the moderators is critical for filtering irrelevant audience questions, explaining critical steps, helping the surgeon in teaching, raising interesting issues, assessing the tension in the operating theatre, minimising distractions to the surgeon, recognising difficult moments of surgery, and interrupting the teleconference to quietly handle any arising complications.
6. The presence of one moderator in the operating room and one or more moderators (a panel) in the auditorium is recommended.

Postoperative care

1. There must be dedicated and appropriate on-call personnel throughout the patient's hospital stay.
2. Postoperative follow-up is under the direction of the local surgeon and team, and it must comply with the standard protocol of the host hospital.
3. The guest surgeon must be informed of and, where possible, involved in all decisions about postoperative patient care, even if he or she is not still in the unit.
4. Regular postoperative ward rounds are mandatory, and the visiting surgeon must be kept informed of all deviations from the care plan.
5. All complications must be documented using the revised Martin criteria, and outcomes and complications must be submitted to the EAU Live Surgery Registry.

(To be contd.)
IMA Satyagraha
IMA Poll
22nd MTNL Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India

The Secretary General
IMA UP State

In August 2014, I was diagnosed with carcinoma urinary bladder for which I took treatment (TURP was done at Pushpanjali Hospital at Ghaziabad). Then I went to Medanta Hospital Gurgaon for radical cystectomy. After that I was okay and led a normal life. I was even able to organize the state annual conference along with my dedicated team of Doctors which proved to be successful and admired by delegates. Unfortunately in October 2015 during routine investigation I received the bad news of having a lump of 3” in my left lung and few small patches on the right lung. FNAC and biopsy confirmed the diagnosis of squamous cell carcinoma, so I was advised to have chemotherapy with the schedule of six cycles each comprising of three doses of Ambaxine 1.5 gm and Carbaplatin 1.5 gm. I have taken two cycles comprising of six doses of chemo that comes to be 18 rounds of chemotherapy. I was advised to undergo further evaluation if it is satisfactory, then Radiotherapy will be considered.

I am very senior member of IMA for 40 years and have been Past President UP State IMA 20 years back. The purpose of writing this letter is many folds.

• I suggest that instead of hiding the disease, one should come forward boldly to let every member of IMA know about the problems so that they can boost their morale and come close to their family members to give the idea that IMA is like a family who is always ready to help each and every one besides arranging meetings etc.
• I strongly wish that IMA members should send their best wishes and prayers as it gives immense power to heal the sufferings.
• I further suggest, based on my experiences of the corporate Hospitals, that our ailing Doctors should be given proper respect and priority in the course of their treatment.
• Our photo ID card issued by the HQs should be recognized by these hospitals.
• Last but not the least our HQ leaders should convince the corporate hospital to give them financial aid of at least 20% concession (if you are convinced, please send these suggestions to the State and central leaders).

Dr VK Jain
Past President UP State IMA
Aligarh (UP)
Gavi to give $500 mn to India for immunization program

Gavi, a global vaccine alliance funded by Bill and Melinda Gates Foundation has pledged $500 million to the Indian government over the next five years for supporting immunization program in the country. The major vaccines to be supported are rotavirus, measles-rubella, PCV vaccine and HPV when it is introduced. Government has also taken over the task of implementing Pentavalent vaccine in its immunization programme at a cost of Rs 750 crore annually from next year which was earlier being taken care of by the Gavi Board… (ET Healthworld)
WHO releases guidelines for reducing maternal, newborn deaths

WHO has identified ‘Four Critical Pause Points’ when maternal and newborn deaths are most likely to occur in health facilities; when the mother is admitted to the labor and delivery unit, just before the woman begins to push or undergoes a cesarean delivery, within 1 hour after birth and shortly before the mother and infant are discharged from the hospital. Checklists have been developed for each of these periods, with critical actions to be taken outlined as essential care standards for every birth to avoid maternal and neonatal deaths. The WHO's new Safe Childbirth Checklist and Implementation Guide address the major causes of maternal and neonatal complications and deaths, including infection, postpartum hemorrhage, preeclampsia, obstructed labor and birth asphyxia… (Medscape)
Children with common allergies at high risk of heart disease

A study of 13,275 children published in the Journal of Allergy & Clinical Immunology has found that children who have allergic diseases such as asthma, eczema and hay fever double their risk of high cholesterol levels and high blood pressure making them prone to heart disease at early age. Asthma, hay fever and eczema had higher associations with overweight or obesity. Inflammation occurring in asthma and hay fever might contribute to the higher rates of heart disease. Also, children with profound asthma are typically more sedentary, which may increase BP and cholesterol … (Times of India)
New WHO report signals progress in malaria elimination

New estimates from WHO show a significant increase in the number of countries moving towards malaria elimination. Across sub-Saharan Africa, the prevention of new cases of malaria has resulted in major cost savings for endemic countries. New estimates presented in the WHO report show that reductions in malaria cases attributable to malaria control activities saved an estimated US$ 900 million in case management costs in the region between 2001 and 2014. Insecticide-treated mosquito nets contributed the largest savings, followed by artemisinin-based combination therapies and indoor residual spraying. According to the "World Malaria Report 2015", 57 of the 106 countries with malaria in 2000 had achieved reductions in new malaria cases of at least 75% by 2015 and 18 countries reduced their malaria cases by 50-75%... (WHO)
Inflammation plays a big role in worsening knee OA pain

The Multicenter Osteoarthritis Study (MOST) published in the journal Arthritis & Rheumatology, suggests that knee osteoarthritis (OA) should no longer be thought of as a "noninflammatory" condition. Inflammation associated with synovitis or effusion plays a bigger role in worsening OA pain than mechanical load. The study found an association between baseline presence of synovitis or effusion and pain threshold 2 years later (a marker of central pain sensitization), but not between baseline presence of bone marrow lesions (BMLs; a marker of mechanical load) and pain... (Medscape)
Kidney patients more at risk for future heart attacks

Chronic kidney disease patients with kidney function less than 60% are included in the list of criteria for defining people at highest risk for future heart attacks. In a large cohort Canadian study published in The Lancet led by Dr Marcello Tonelli at University of Alberta, patients with only chronic kidney disease had a significantly higher rate of heart attacks than those who only had diabetes. Those who had already had a heart attack had the highest overall rate of heart attacks.

Chronic kidney disease should be regarded as a coronary heart disease risk equivalent, similar to diabetes, as patients with the condition have high rates of cardiovascular events, particularly when they also have proteinuria. When chronic kidney disease was defined more stringently with kidney function less than 45% and increased proteinuria, the rate of first heart attack was higher in those with both chronic kidney disease and diabetes than in those with either disorder alone
Provisional programme for the ensuing meeting of the Central Council

Dear Colleague

The provisional programme for the ensuing meeting of the Central Council to be held from 27th (Sunday) to 28th (Monday) December, 2015 at Hotel Le Meridien, New Delhi is as below.

This year, the Central Council will not only have issues related to IMA but also have interactions with top luminaries of the country connected with issues related to health.

Kindly send your names, suggestions with questions related to the Agenda, in advance to us so that the same can be incorporated in the various discussions during the Central Council Meeting, as this CC Meeting is absolutely packed minute by minute. To conduct Central Council smoothly, we request your cooperation.

Please note that the whole meeting of the Central Council will be live webcast.

Dr A Marthanda Pillai                                                                                                                             Dr KK Aggarwal
National President                                                                                                                              Hony Secretary General

27-12-2015 (Sunday)
08:00 - 08:10 AM
Inviting of leaders to the Dais
Adornment of National President with the Presidential Medallion
08.10 – 08:20 AM
Invocation of the IMA Prayer
Flag Salutation
Homage to departed souls
Approval of Minutes of the 135th Ordinary Meeting of IMA Central Council
08:30 - 09:00 AM
Dr A Marthanda Pillai
Presidential Address
09:00 - 09:30 AM
Shri Ashok Chakradhar, Padma Shri Awardee
Laughter the best medicine
09:30 - 10:00 AM
Sh Rajat Sharma, Editor, India News
How media perceives the doctors
10:00 – 10:30 AM
Dr K K Aggarwal
Address by Honorary Secretary General
10:30 – 11:00 AM
Sidharth Luthra, Former ASG
CPA vs Council vs IPC vs specific laws
11:00 – 11:30 AM
CC Continues
Satyagraha Update
11:30 – 12:00 NOON
Sh D K Jain (invited)
National Consumer Dispute Redressal Commission
12:00 – 12:30 PM
IMA Update
Membership, Miscellaneous
12:30 – 01:00 PM
Justice Vipin Sanghi, Justice G S Sistani, High Court Judges (invited)
Duties of a medical professional
01:00 – 02:00 PM
02:00 – 02:30 PM
IMA Update
RNTCP, Child Sexual abuse, UNESCO
02:30 – 03:00 PM
Sh. Sushil Chandra, Member CBDT
Income tax and medical profession
03:00 – 03:30 PM
IMA Update
IMA Accreditation Council, CME Hours
03:30 – 04:00 PM
Sh. Maninder Singh, ASG
Legal open house
04:00 – 05:00 PM
Shri JP Nadda, Hon’ble Minister of Health
05.00 – 07.00 PM
Sh. Satyendra Kumar Jain, Health Minister, Delhi
Reception at 2 Raj Niwas Road
07.00 PM onwards
Banquet hosted by IMA HQs at Asiad Tower Garden (Asian Complex adjacent to Sri Fort Auditorium, New Delhi)
28-12-2015 (Monday)
08:30 - 09:00 AM
Dr Ved Prakash Mishra, MCI
Medical education
09:00 - 09:30 AM
CGP, AMS, AKN, JIMA, NPPS, NSSS, Health Scheme, Pension Scheme, HBI, International wing
Reports by wings of IMA
09:30 – 10:00 AM
10:00 – 10:30 AM
VP, FSC, BSC, YD wing, students wing, Disaster Management
IMA reports
10:30 – 11:00 AM
Shri B S Bassi, Police Commissioner, Delhi
Violence against doctors
11:00 – 11:30 AM
IMA Lybrate, IMA Kent, IMA USV Initiatives
New Initiatives
11:30 – 12:00 NOON
Shri Nalin Kohli, Media Personality
How to face a TV Debate
12:00 – 12:30 PM
Mental health, MMR, IMR, RTA, BMW disposal, Elderly care, safe sound, diabetic blindness, Mediation Cell
New initiatives
12:30 – 01:00 PM
01:00 – 02:00 PM
02:00 – 02:30 PM
Guest lecture
Pediatric Update
02:30 – 03:00 PM
Dr Harsh Vardhan, Minister of Science and Technology, GOI (invited)
Medical Research
03:00 – 03:30 PM
Mental health, MMR, IMR, RTA, BMW disposal, Elderly care, safe sound, diabetic blindness, Mediation Cell
New initiatives
03:30 – 04:00 PM
Shri Sanjay Jaiswal, Member of Parliament
Rural Health options
04:00 – 04:30 PM
CC Meeting
Other issues
04:30 – 05:00 PM
Shri G N Singh, DCGI
Pharmacovigilance Program
05:00 – 07:00 PM
IMA National Awards Function

Dr Jitendra Singh, Hon’ble Minister of State of Science & Technology, as Chief Guest

Shri Rajyawardhan Rathore, Minister of State of Information & Broadcasting as Co-Chief Guest (Invited)
07.00 - 08.00 PM
Dr S S Agrawal

Shri Mukul Rohatgi, Attorney General of India

Dr Mahesh Sharma, Minister of State for Culture, Tourism & Civil Aviation
Installation of Team IMA – 2015-2016, followed by 136th Ordinary Meeting of Central Council of IMA

Chief Guest

Co-Chief Guest
08.00 PM onwards
WP(C) No.8706/2015 titled “Indian Medical Association Vs. Union of India & Anr (NCERT)” Delhi High Court, New Delhi

Click here to read the proposed changes
IMA Live Webcast

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Bioethical issues in medical practice
Protecting the privacy and confidentiality of patients

Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

You are a member of an informal discussion group of doctors who meet regularly to discuss difficult cases. At all these discussions, the conversation is frank and detailed, with all details of the patients, social situation, family issues etc. are discussed threadbare. Sometimes this discussion spills over into the hospital lifts, corridors and canteens. When these issues are really interesting, you discuss them at home with your spouse- a doctor- as well. Many times the name, address, and other details of patients are discussed as well.

a) Do such discussions breach medical confidentiality?
b) At which places should medical cases be discussed?
c) Should interesting medical cases be discussed at home?

Any suggestions? Do write in!

Adapted from: Bioethics Case Studies (AUSN and EEI, November 2013):

Responses received

Medical discussions of difficult cases are very important from the doctor’s point of view and also from the patient’s point of view. They should definitely be discussed at home, in medical get-togethers, but not in lifts, hotels and public places. Medical science is based on discussions and exploration of the knowledge what one has. Dr BR Bhatnagar
Inspirational Story
The 12 Gifts of Birth

Once upon a time, a long time ago, when princes and princesses lived in faraway kingdoms, royal children were given 12 special gifts when they were born. Twelve wise women of the kingdom, or fairy godmothers as they were often called, traveled swiftly to the castle whenever a new prince or princess came into the world. Each fairy godmother pronounced a noble gift upon the royal baby.

As time went on, the wise women came to understand that the 12 royal gifts of birth belong to every child, born anywhere at any time. They yearned to proclaim the gifts to all children, but the customs of the land did not allow that. One day when the wise women gathered together they made this prophecy: Someday, all the children of the world will learn the truth about their noble inheritance…when that happens a miracle will unfold on the kingdom of Earth.

Here is the secret they want you to know.

At the wondrous moment you were born, as you took your first breath, a great celebration was held in the heavens and twelve magnificent gifts were granted to you.

1. Strength is the first gift. May you remember to call upon it whenever you need it.
2. Beauty is the second gift. May your deeds reflect its depth.
3. Courage is the third gift. May you speak and act with confidence and use courage to follow your own path.
4. Compassion is the fourth gift. May you be gentle with yourself and others. May you forgive those who hurt you and yourself when you make mistakes.
5. Hope is the fifth gift. Through each passage and season, may you trust the goodness of life.
6. Joy is the sixth gift. May it keep your heart open and filled with light.
7. Talent is the seventh gift. May you discover your own special abilities and contribute them toward a better world.
8. Imagination is the eighth gift. May it nourish your visions and dreams.
9. Reverence is the ninth gift. May you appreciate the wonder that you are and the miracle of all creation.
10. Wisdom is the tenth gift. Guiding your way, wisdom will lead you through knowledge to understanding. May you hear its soft voice.
11. Love is the eleventh gift. It will grow each time you give it away.
12. Faith is the twelfth gift. May you believe.

Now you know about your 12 gifts of birth. But there is more to the secret that the wise women knew. Use your gifts well and you will discover others, among them a gift that is uniquely you. See these noble gifts in other people.
Which of the following are true about Campylobacter?

1. C enteritis is an important cause of acute diarrhea
2. It is never seen in India
3. It is typically caused by Campylobacter jejuni or Campylobacter coli, and is largely a foodborne disease.
4. Campylobacter infection can also be transmitted via water-borne outbreaks and direct contact with animals or animal products.

Yesterday’s Mind Teaser: Complete the mnemonic for muscarinic signs and symptoms.


_Urination, Miosis, Bronchorrhea/Bronchospasm/Bradycardia, Emesis, Lacrimation, Salivation

Answer for Yesterday’s Mind Teaser: A: D: Defecation

Answers received from: Dr Purushottam, Dr Kailash Chandra Sharma, Dr Jainendra Upadhyay, Dr KV Sarma, Dr Avtar Krishan

Answer for 9A: U: Urinationth December Mind Teaser: 4. All of the above

Answers received from: Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr Avtar Krishan
A housewife goes to an optometrist and says: “Lately I’m seeing grocery items smaller than they appeared till recently. I think I need a change of my eyeglasses.”

The optometrist after examining her eyes for refraction and finding no change in dioptric values observes: “Manufacturers of grocery items, rather than increasing the prices, have made the packings smaller; and there’s no need for you to change your eyewear.”

(By Dr Narendra Kumar, Ophthacare Eye Centre)
Readers column
Very good initiative taken up by IMA HQs. I am interested to serve the affected area. If you inform about Bank A/c No. & other bank details, we can deposit the amount through netbanking. Dr Shekhar S Galinde, Vice President, IMA Chembur, Mumbai
Press Release
One third of cancer patients in high-income countries are smokers

Recent research indicates that more than 50% of cancers can be prevented if people simply change their lifestyle. Every year nearly one million new cancer cases are diagnosed in India, the prevalence being 2.5 million. With mortalities of 6,00,000-7,00,000 a year, cancer causes six per cent of all adult deaths in the country.

One of the leading causes of cancer in the world and India is tobacco consumption accounting for about 40 percent of all cancers in India. About 275 million Indians (35 per cent of adult population and 14.1 per cent of children aged 13-15 years) are tobacco users.

Being overweight or obese causes approximately 20% of cancers across the globe today. If people could maintain a healthy body mass index (BMI), the incidence of cancer could be reduced by approximately 50% in 2 to 20 years.

Poor diet and lack of exercise are each associated with about 5% of all cancers. Improvement in diet could reduce cancer incidence by 50% and increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide by implementing widespread infant and childhood immunization programs targeting three viruses — human papillomavirus and hepatitis B and C — could lead to a 100% reduction in viral-related cancer incidence in 20 to 40 years.

Speaking about this, Padma Shri Awardee Dr. A Marthanda Pillai – National President and Padma Shri Awardee Dr. K K Aggarwal, Honorary Secretary General IMA in a joint statement said, “The number of deaths due to cancer in our country continues to increase due to lifestyle irregularities. Urgent steps must be taken to raise awareness about the ill effects of tobacco consumption, obesity, increased harm caused by exposure to harmful radiation emitted from mobile phones and other electronic gadgets as well as the result of ozone layer depletion. People must also be encouraged to make changes in their lifestyle as a step towards cancer prevention. They can do this by quitting smoking, reducing alcohol consumption, eating a healthy and balanced diet and exercising regularly. The government must also take adequate steps towards reducing the environmental pollution as well as enforcing stricter laws against smoking in public places."

It has also been found that:

• Tamoxifen reduces the rate of both invasive and noninvasive breast cancer by 50% or more, compared with placebo, at 5 years. Raloxifene has been shown to reduce the risk for invasive breast cancer by about 50% at 5 years.
• Bilateral oophorectomy in women carrying the BRCA1 or BRCA2 gene, although rare, has been associated with a 50% reduction in breast cancer risk among high-risk women.
• Aspirin is associated with a 40% reduction in mortality from colon cancer.
• Screening for colorectal cancer has a similar magnitude of mortality reduction (30% to 40%).

Prevention is always better than cure and awareness generation is the first step in this direction