January 12 2015, Monday
editorial
 

(…Contd.)
The Ethics Committee and Grievance Redressal Forums…
Dr Ethics is a dynamic concept varying in time and space. A new perspective on medical ethics is warranted. With the medical profession switching over from clinical medicine to evidence based medicine and the patient care shifting from family doctor based care to hospital based care this has become a necessity. Any institution offering patient care should practice medical ethics. Appropriate privileges should be conferred on hospitals and other institutions to facilitate this. An Ethics committee of IMA with a dedicated Grievance Redressal Forum will be formed at the National level.
(…Contd.) Read More ...
eMedipics
IMA,IJCP,HCFI
Health Check Up and CPR 10 Camp
at G B S S School, No-2, Ambedkar Nagar
on 19th December 2014
editorial
Heart Attack Symptoms in Women and elderly are Different
Dr KK AggarwalWinter is the month for heart attacks and the symptoms in women and the elderly may be different.
  • Chest pain is still the most common sign of a heart attack for most women but women are more likely than men to have symptoms other than chest pain or discomfort when experiencing a heart pain. In a study published in Archives of Internal Medicine researchers examined 35 years of research that yielded 69 studies and found that, between 30 and 37 percent of women did not have chest discomfort during a heart attack. In contrast, 17 to 27 percent of men did not experience chest discomfort.
  • Older people are also more likely to have heart attack without chest discomfort. Absence of chest discomfort is a strong predictor for missed diagnosis and treatment delays.
  • Women are also more likely than men to experience other forms of cardiac chest pain syndromes, such as unstable angina, and they appear to report a wider range of symptoms associated with acute coronary syndrome (ACS). They are more likely to report pain in the middle or upper back, neck, or jaw; shortness of breath; nausea or vomiting; indigestion; loss of appetite; weakness or fatigue; cough; dizziness; and palpitations.
  • Women are, on an average, nearly a decade older than men at the time of their initial heart attack. Coronary heart disease is the leading cause of death among U.S. women, and affects one in 10 women over the age of 18.
IMA,IJCP,HCFI
 
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IMA to develop a Model Health Village – Dr. A. Marthanda Pillai

New Delhi: Addressing his first Press Conference, Padma Shri Awardee, Dr. A. Marthanda Pillai, National President, IMA said that under Aao Gaon Chalen Project of IMA, IMA will come out with a Model IMA Health Village in the coming year, which can be replicated at a national level, both by the Govt as well as NGOs including IMA branches. Explaining further, Dr. Pillai said that the Model Health Village will have all parameters met within a year as defined by Millennium Development Goals. The Conference was co-addressed by Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA. In a joint statement, Dr. Pillai and Dr. Aggarwal said that IMA has written to all its 1700 branches to follow Hon’ble Prime Minister, Shri Narendra Modi’s initiative of Swachh Bharat, Swasth Bharat movement. The IMA officials feel that 20% of the disease burden can be reduced if all the doctors in our country are sensitized to have their medical establishments follow hygienic principles and they in turn motivate their patients to follow the principals of respiratory, food, water and hand hygiene. The IMA officials said that they have requested each of its 1700 branches in the country to nominate 9 Medical Icons of their area to lead this campaign in the coming year. IMA also showed concern about the inclusion of Cross pathy in the National Health Policy, which has been put by the MoHFW, Govt. of India on its website. Under this National Health Policy, the Govt is envisaging training AYUSH doctors for a limited period of time and allowing them to become midcare health providers.
http://www.countryandpolitics.in/2015/01/09/ima-to-develop-a-model-health-village-dr-a-marthanda-pillai/
'Code of conduct chalked out by Centre will break doc-pharma nexus'
HT Correspondent, Hindustan Times; Chandigarh, January 10, 2015

The code of conduct charted out by the central government would break the nexus between doctors and pharmaceutical companies, Dr KK Aggarwal, national general secretary of the Indian Medical Association (IMA), said on Saturday.

Dr Aggarwal said this while he was attending annual conference of the Global Association of Physicians of Indian Origin which started at a city hotel on Saturday.

He said so far the guidelines were applicable only on doctors and there were no such rules for pharmaceutical companies.

"It was an incomplete code of conduct to check the nexus," he said. The government had introduced a code of conduct for pharmaceutical industry instructing them to stop luring doctors to prescribe unnecessary medicines.

Hailing the Swachh Bharat Abhiyan, Dr Aggarwal said if it was implemented in word and spirit, it would help in reducing the disease burden by at least 20%.

Besides, the IMA officials also spoke on drug menace in Punjab. IMA national president Dr A Marthanda Pillai said if the problem was so big then there should be a standard protocol for the doctors to deal with such cases. "These protocols should be made available to general physicians also so that each person suffering from drug abuse could be taken care of," he said.
Reducing burden on hospitals need of the hour, says IMA general secretary
Jan 11 2015, The Tribune, Chandigarh

The Indian Medical Association (IMA), is deliberating upon reducing the burden on hospitals with decreased hospitalisation and has taken up the battle with medical insurance companies. Disclosing this today, Dr KK Aggarwal, secretary general of the IMA, said, “We are holding meetings with insurance companies and stressing on introducing changes in their policies.”

Dr Aggarwal, who is a Padma Shri awardee, was in the city to attend the 5th Annual Conference of the Global Association of Physicians of Indian Origin (GAPIO).

“Reducing hospital burden with lessening the number of patients is the need of the hour. This can be done with more focus on day care or care at home. We are creating awareness among doctors to not admit a patient unless it is absolutely necessary. Insurance companies should be more patient-friendly so that doctors don’t have to necessarily keep patients at the hospital even when a simple drip is required and no procedures are involved,” said Dr Aggarwal.

“At present, insurance companies provide claim only if the patient is admitted in a hospital for at least 24 hours. Why? Can’t an alternative be found out so that less critical patients can have hospital-like facilities at home and companies can reimburse the cost,” he said.

“The modern system is toxic. Five percent of infections are caught by visitors and persons other than patients during hospitalisation. We are stressing that the hospital industry is not a hotel industry. If a person requires a simple IV (intravenous) drip, then why admit him in a hospital for the entire day while the same bed can be provided to a needier patient,” he said.
Treat swine flu like ordinary flu, but avoid self–treatment
NEW DELHI, January 10, 2015: Three persons have died within 72 hours in the city due to complications arising out of swine flu. Delhi on Friday reported the death of its third swine flu victim this season. A 38-year-old woman from Uttam Nagar succumbed at Ram Manohar Lohia Hospital in the early hours of the day.

Health Department Additional Director In-charge (Public Health) Charan Singh said: "We received five new cases of swine flu on Friday, taking the total number of cases this season to 35. The second death was that of a young adult in a private hospital in East Delhi on Thursday, while a woman died earlier while undergoing treatment at a private hospital."

Over 20 fresh cases of swine flu have been reported from across the city, including Madangir, Sangam Vihar, Greater Kailash–I, JNU campus, Laxmi Nagar, Rajouri Garden, Masjid Moth of South Delhi and Chhatarpur.

Meanwhile, the Indian Medical Association (IMA) has cautioned against self–medication. Advocating immediate medical consultation for those suspecting to be suffering from swine flu, it has released a set of public guideline to create awareness about the virus.

IMA honorary secretary–general K. K. Aggarwal said: "We endorse the views of the World Health Organization and Ministry of Health, which clearly states that there is no need to panic and that swine flu should be treated like any other normal flu." Dr. Aggarwal added that swine flu has not taken any epidemic shape this year. "Delhi had reported 16 deaths in 2013. Swine flu cases have gone up in the past two to three weeks."

Swine flu symptoms include fever, cough, sore throat, body aches, and malaise. Occasionally, nausea, vomiting, diarrhoea and rash may also be present. Severe breathlessness and blood on coughing are ominous signs and need investigation and/or hospitalisation. Symptoms ordinarily last for one to two weeks.

The IMA has noted that cases of fever with breathlessness should not be neglected, and the need admission in isolation and investigation for influenza (swine or otherwise). The government has designated both government and private labs for testing. Positive tests only through these laboratories will be considered confirmed.

Swine flu can be prevented by adhering to cough and respiratory hygiene. One should not cough in the hands or a handkerchief. Instead, cough on the sleeves of a shirt or in a tissue paper.
Medicolegal
IMA,IJCP,HCFI
IMA to create awareness on organic farming
Is hydrophobia a sign of rabies in dogs?

With drug addiction and rising cancer instances in the state, the IMA has planned to initiate a programme in Punjab to create awareness about organic farming where the use of pesticides and insecticides is far less. “Another problem crippling the state is mental health. We are focusing on these two issues in the state,” said Dr Aggarwal.
THE DRUGS AND COSMETICS (AMENDMENT) BILL, 2015
(q) "investigational new drug" means new chemical entity or substance which is under investigation in a clinical trial regarding its safety and efficacy;

(r) "investigational new medical device" means a new device which is an object of a clinical investigation or research or development involving one or more human participants to determine the safety and the effectiveness of a device;

(s) "investigator" means a person permitted to conduct clinical trial by the Central Licensing Authority under section 4A; (t) "manufacture"–
(i) in relation to any drug, or any cosmetic, except human blood and its components, includes any process for making, altering, ornamenting, finishing, labeling, packing, breaking up or otherwise treating or adapting any drug or cosmetic with a view to sell, stock or distribute or market but does not include the compounding or dispensing of any drug, or the packing of any drug or cosmetic in the ordinary course of retail business;

(ii) in relation to human blood and its components includes any process of collection, processing, storage, labeling, packing and testing for its use or distribution for transfusion in human beings;

(iii) in relation to medical device, includes any process for designing, making, assembling, configuring, finishing, packing, sterilising, labeling, refurbishing, or adapting with a view to sell, stock or distribute or market but does not include assembling or adapting by Registered Medical Practitioner, a device already approved for use, for an individual patient;

(u) "manufacturer" means a person who himself or through any other person on his behalf manufactures drug, cosmetic or medical device;

(v) "medical device" includes–

(i)any instrument, apparatus, appliance, implant, material or other article, whether used alone or in combination, including the software, intended by its manufacturer to be used specially for human beings or animals for one or more of the specific purposes of,–

(A) diagnosis, prevention, monitoring, treatment or alleviation of any disease or disorder;
(B) diagnosis, monitoring, treatment, alleviation or assistance for, any injury or disability;
(C) investigation, replacement or modification or support of the anatomy or of a physiological process;
(D) supporting or sustaining life;
(E) disinfection of medical devices;
(F) control of conception; which does not achieve primary intended action in or on the human body or animals by any pharmacological or immunological or metabolic means, but which may be assisted in its intended function by such means;

(ii) an accessory to such an instrument, apparatus, appliance, material or other article;

(iii) in vitro diagnostic medical device including a reagent, reagent product, calibrator, control material, kit, instrument, apparatus, equipment or system, whether used alone or in combination;
 
THE DRUGS AND COSMETICS (AMENDMENT) BILL, 2015
(f) "Central Licensing Authority" for the purposes of this Act means the Drugs Controller General of India;

(g) "clinical trial" means –
(i) in respect of drugs, any systematic study of new drug or investigational new drug or bioavailability or bioequivalence study of any new drug in human participants to generate data for discovering or verifying its clinical, pharmacological, including pharmacodynamic and pharmacokinetic, or adverse effects with the objective of determining safety, efficacy or tolerance of the drug;

(ii) in respect of cosmetics, the systematic study, including dermatological study of any new cosmetic on human participants to generate data for discovering or verifying its adverse effects with the objective of determining safety, efficacy or tolerance of the cosmetic;

(iii) in respect of medical devices, the systematic clinical investigation or study of an investigational medical device or a new medical device in, or on human participants to assess the safety or performance or effectiveness of the medical device;

(h) "clinical trial protocol" means a document containing background, objective, rationale, design, methodology including performance, management, adverse event, withdrawal and statistical consideration of a clinical trial;

(i) "Cosmetic" means any article intended to be rubbed, poured, sprinkled or sprayed on, or introduced into, or otherwise applied to, the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance, and includes any article intended for use as a component of cosmetic or new cosmetic;
The Year in Medicine 2014: News That Made a Difference
3. World’s First Baby Born After Uterine Transplant

A 36–year–old woman who received a uterus transplant from a live donor in 2013 gave birth to a healthy baby boy in September 2014, according to an article published online October 6 in The Lancet. "Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility," said lead author Mats Brãnnström, MD, professor of obstetrics and gynecology at the University of Gothenburg, Sweden. The report raises several important medical and ethical questions. (Source: Medscape)
News around the Globe
  • Pharmacokinetic data indicate that rifampicin and rifapentine significantly reduce concentrations of the new anti–tuberculosis (TB) drug bedaquiline. The data are published online in the Journal of Antimicrobial Chemotherapy.
  • In combination with steroids, tacrolimus seems to have similar efficacy and safety as mycophenolate mofetil (MMF) as induction therapy for lupus nephritis, suggests new research published in Annals of the Rheumatic Diseases.
  • Primary screening for human papilloma virus (HPV) using a DNA test can be considered as an alternative to current US cytology–based cervical cancer screening strategies, suggests new interim guidance from multiple societies published online January 7 in Gynecologic Oncology.
  • Scientists at National Taiwan University have produced a new biocompatible material that potentially rebuilds worn enamel, reduces tooth sensitivity and is much longer–lasting than current treatments. The report is published in the journal ACS Nano.
  • Alternatives to hysterectomy are underused in women with abnormal uterine bleeding and other benign conditions, suggests an analysis of perioperative hysterectomy data published online in the Journal of Obstetrics and Gynecology.
Media
IMA,IJCP,HCFI
Cardiology eMedinewS
  • Older Medicare patients with heart failure and reduced ejection fraction (HFrEF) who were hospitalized for acute decompensation and were started on beta–blockers when they were discharged did not have worse 30–day readmission rates than those who were not given these drugs, suggests a new study published online in the American Journal of Medicine.
  • Chronic heart–failure patients who have accepted their disease are more likely to have a better quality of life when compared with heart failure patients who have not accepted their illness, suggests a new study published online January 8 in the European Journal of Cardiovascular Nursing.
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh,
SM Heart Care Foundation Fund, Post CAG
https://www.youtube.com/watch?v=Mc3kKDXKWvs
Kishan, SM Heart Care Foundation Fund,
Post CHD Repair
https://www.youtube.com/watch?v=OTEG7toVkAQ
Deepak, SM Heart Care Foundation Fund,
CHD TOF https://www.youtube.com/watch?v=rjOel0aaqt0
‘Treat swine flu like ordinary flu, but avoid self-treatment’
Three persons have died within 72 hours in the city due to complications arising out of swine flu. Delhi on Friday reported the death of its third swine flu victim this season. A 38-year-old woman from Uttam Nagar succumbed at Ram Manohar Lohia Hospital in the early hours of the day.

Health Department Additional Director In-charge (Public Health) Charan Singh said: “We received five new cases of swine flu on Friday, taking the total number of cases this season to 35. The second death was that of a young adult in a private hospital in East Delhi on Thursday, while a woman died earlier while undergoing treatment at a private hospital.”

Over 20 fresh cases of swine flu have been reported from across the city, including Madangir, Sangam Vihar, Greater Kailash-I, JNU campus, Laxmi Nagar, Rajouri Garden, Masjid Moth of South Delhi and Chhatarpur.

Meanwhile, the Indian Medical Association (IMA) has cautioned against self-medication. Advocating immediate medical consultation for those suspecting to be suffering from swine flu, it has released a set of public guideline to create awareness about the virus.

IMA honorary secretary-general K. K. Aggarwal said: “We endorse the views of the World Health Organization and Ministry of Health, which clearly states that there is no need to panic and that swine flu should be treated like any other normal flu.”Dr. Aggarwal added that swine flu has not taken any epidemic shape this year. “Delhi had reported 16 deaths in 2013. Swine flu cases have gone up in the past two to three weeks.”

Swine flu symptoms include fever, cough, sore throat, body aches, and malaise. Occasionally, nausea, vomiting, diarrhoea and rash may also be present. Severe breathlessness and blood on coughing are ominous signs and need investigation and/or hospitalisation. Symptoms ordinarily last for one to two weeks. The IMA has noted that cases of fever with breathlessness should not be neglected, and the need admission in isolation and investigation for influenza (swine or otherwise). The government has designated both government and private labs for testing. Positive tests only through these laboratories will be considered confirmed.

Swine flu can be prevented by adhering to cough and respiratory hygiene.
Video of the Day
Dr K K Aggarwal head on with Arnab Goswami of Times Now on MCI Issues
h t t p : / / w w w . t i m e s n o w . t v / D e b a t e -
WhistleblowerDumped/videoshow/4468283.cms
Heart Care Foundation of India announces the Mrs Abheeta Khanna Oration on Excellence in Sports and Health
https://www.youtube.com/watch?v=6Ktz5-iUINE
Betiyan Hain Anmol, Bachao Dil Se, Medanta joins hands with Heart Care Foundation of India
https://www.youtube.com/watch?v=TGEGauzE0kg
Rabies News (Dr A K Gupta)
Is hydrophobia a sign of rabies in dogs?

Hydrophobia is not a sign of rabies in dogs. Rabid dogs can drink water and even swim in water. If a rabid dog is not able to drink water, it is because of paralysis of jaw muscles and not due to hydrophobia.
Twitter of the Day
Dr KK Aggarwal: Do not eat more than 5 grams of salt in a day

Dr Deepak Chopra: In order to achieve the impossible you don’t need motivation; you need to connect with your true self & unleash its potential
IMA in the News
  • Treat swine flu like ordinary flu, but avoid self – treatment: The Hindu
  • IMA to develop a Model Health Village: Dr. A. Marthanda Pillai: Focus News
  • IMA wants state–of–the–art forensic labs in every state: Virat Vaibhav
  • IMA wants state-of-the-art forensic labs in every state: Vir Arjun
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Events
IMA,IJCP,HCFI
IMA to develop model health village
NEW DELHI, The Indian Medical Association (IMA) Thursday said it will develop a model health village with all parameters defined in the UN Millennium Development Goals.

"Under the Aao Gaon Chalen (lets go to village) project of the IMA, the organisation will come out with a model health village, which can be replicated at a national level, both by the government as well as NGOs," IMA national president A. Marthanda Pillai told reporters here.

Pillai said the model health village will have all parameters met within a year as defined by the UN Millennium Development Goals.

In a joint statement, Pillai and IMA secretary general K.K. Aggarwal said the IMA has written to all its 1,700 branches to follow Prime Minister Narendra Modi's initiative of clean India movement.

The IMA feels that 20 percent of disease burden can be reduced if all doctors in the country are sensitised to have their medical establishments follow hygienic principles and they in turn motivate their patients to follow the principles of respiratory, food, water and hand hygiene, it said.

The IMA will also launch many projects like care of elderly, trauma care and waste disposal.
http://health.economictimes.indiatimes.com/news/industry/ima-to-develop-model-health-village/45822516
Country needs latest labs: IMA
Jan 10, 2015 | Age Correspondent| New Delhi

Citing the forensic report submitted by the three-member AIIMS medical board, which suggested further examination of her viscera in a foreign lab, the Indian Medical Association has written to the Union health ministry to set up state-of-the-art forensic labs in every part of the country.

On Friday, the IMA wrote to Union health secretary Luv Verma and urged the government to set up state-of-the-art forensic labs in every district in the country. IMA secretary general Dr K.K. Aggarwal said that due to absence of a state-of-the-art forensic lab it took over a year after the incident for the Delhi police to file a murder case in the Sunanda Pushkar death. The medical board headed by the chief of AIIMS forensic department, Dr Sudhir Gupta, pointed to the possibility of the use of a few poisons which could not be detected easily by forensic laboratories in the country.

IMA president Dr A. Marthanda Pillai also asked the Union health ministry to treat this matter on priority and let the association know what steps were being taken in this regard. “With a soaring crime rate in the country, every state has a right to have a state-of-the-art forensic lab. Why should there be a need to send samples to other states or countries?” he asked. Pointing to the medical board report, the IMA said that the report of the medical board had said that they did not have all the facilities for forensic examination and the viscera needs to be sent abroad for further testing.

“Observation made by the medical board consisting doctors from AIIMS means that the country does not have a single lab for complete forensic examination and if it would not have been a high profile case, the matter could have been closed as a case of suicide. Thousands of such cases of murder today might be getting closed as suicidal cases,” added Dr Aggarwal.
IMA slams Delhi Police for delay in Sunanda case
January 10, 2015, The Hindu

Senior physicians in the country have criticised the delay on the part of the Delhi Police in registering a case of murder in Sunanda Pushkar’s death. They have demanded that the Central Government work at establishing state-of-the-art forensic labs in every district in the country.

The Indian Medical Association (IMA), the country’s largest non-government organisation of doctors with a membership of more than 2.5 lakh physicians, have expressed concern about the state of forensic lab facilities available in the country and has written to the Prime Minister and Union Health Minister.

In their letter, the IMA office bearers have noted that “it has taken over a year after the incident for the police to file a case of murder”.

Also the report of the medical board of All India Institute of Medical Sciences (AIIMS) said they do not have all the facilities for forensic examination and the viscera samples need to be sent abroad for further testing.

IMA president Dr. A. Marthanda Pillai said: “We have asked the health ministry to treat this matter on priority and let the Association know what steps are being taken in this regard.” AIIMS in its subsequent report in September named a few poisons, which could not be detected easily by forensic laboratories in the country.
‘Treat swine flu like ordinary flu, but avoid self-treatment’
January 11, 201, The Hindu

Three persons have died within 72 hours in the city due to complications arising out of swine flu.

Delhi on Friday reported the death of its third swine flu victim this season. A 38-year-old woman from Uttam Nagar succumbed at Ram Manohar Lohia Hospital in the early hours of the day.

Health Department Additional Director In-charge (Public Health) Charan Singh said: “We received five new cases of swine flu on Friday, taking the total number of cases this season to 35. The second death was that of a young adult in a private hospital in East Delhi on Thursday, while a woman died earlier while undergoing treatment at a private hospital.”

Over 20 fresh cases of swine flu have been reported from across the city, including Madangir, Sangam Vihar, Greater Kailash-I, JNU campus, Laxmi Nagar, Rajouri Garden, Masjid Moth of South Delhi and Chhatarpur.

Meanwhile, the Indian Medical Association (IMA) has cautioned against self-medication. Advocating immediate medical consultation for those suspecting to be suffering from swine flu, it has released a set of public guideline to create awareness about the virus. IMA honorary secretary-general K. K. Aggarwal said: “We endorse the views of the World Health Organization and Ministry of Health, which clearly states that there is no need to panic and that swine flu should be treated like any other normal flu.”Dr. Aggarwal added that swine flu has not taken any epidemic shape this year. “Delhi had reported 16 deaths in 2013. Swine flu cases have gone up in the past two to three weeks.”

Swine flu symptoms include fever, cough, sore throat, body aches, and malaise. Occasionally, nausea, vomiting, diarrhoea and rash may also be present. Severe breathlessness and blood on coughing are ominous signs and need investigation and/or hospitalisation. Symptoms ordinarily last for one to two weeks. The IMA has noted that cases of fever with breathlessness should not be neglected, and the need admission in isolation and investigation for influenza (swine or otherwise). The government has designated both government and private labs for testing. Positive tests only through these laboratories will be considered confirmed.

Swine flu can be prevented by adhering to cough and respiratory hygiene.
IMA vows to develop model health village: Dr A Marthanda Pillai
DTMT NETWORK, NEW DELHI 8/1/2014

Indian Medical Association (IMA) will be providing free medical facilities and create awareness about good health practices in the villages adopted by it under the Aao Gaon Chalen Project. Addressing his first press conference after taking charge as National President of the IMA, Dr A Marthanda Pillai said under the project, IMA will soon come up with a Model IMA Health Village, which can be replicated at national level, both by the Government and NGOs including IMA branches. "Free medical facilities will be provided to the villagers and a cleanliness campaign will be launched to make them aware of best health practices. People suffering from ailments will be admitted in the hospitals," Dr Pillai added.

Honorary Secretary General of the association, Dr KK Aggarwal, said IMA has written to all its 1,700 branches to follow Prime Minister Narendra Modi’s initiative for Swachh Bharat, Swasth Bharat Movement. Informing that IMA doctors will meet district officials soon to adopt a village within every 25 kilometers in the city, he said. “We are hopeful that the plan will be implemented within a month.”

IMA officials feel that 20 per cent of the disease burden can be cut if all the doctors in our country are sensitised to have their medical establishments follow hygienic principles and they in turn motivate their patients to follow the principles of respiratory, food, water and hand hygiene.

IMA expressed concern over inclusion of cross-pathy in the National Health Policy, which the Ministry of Health and Family Welfare (MoHFW) put on its website. Under the National Health Policy, the Government is planning to train AYUSH doctors for a limited period of time and allowing them to become midcare health providers.

IMA holds the view that it is not against AYUSH as a branch taking the front position and wants it to progress in their respective fields. However, IMA is against AYUSH doctors practicing modern system of medicine, as it will cause more harm than good to the patients.
Dr Good Dr Bad
IMA,IJCP,HCFI
The Year in Medicine 2014: News That Made a Difference
5. Medicare Billing Data Released

The Centers for Medicare & Medicaid Services (CMS) in April released, for the first time, data detailing about $77 billion in payments to more than 880,000 healthcare professionals under its Medicare Part B Fee–For–Service program. Almost 4000 physicians were paid more than $1 million each in 2012 by Medicare, and the average payment per physician was $77,000 for that year, according to multiple media reports. (Source: Medscape)
10 Innovations in Medicines
8. New Antibiotics

Referring to the recent approval of three antibiotics effective against methicillin-resistant Staphylococcus aureus, John G. Bartlett, MD, professor emeritus at Johns Hopkins University School of Medicine said that the pipeline for new antibiotics is slow but not dry. The drugs are tedizolid, an oral agent with activity similar to linezolid but with less frequent dosing and a lower price tag; dalbavancin, an IV preparation with a 6–day half–life; and oritavancin, another IV agent with sustained activity for weeks. (Source: Medscape)
Dr KK Spiritual Blog
You look at people the same way as you are

Honest people regard everybody as honest and dishonest people regard everybody as dishonest. It all depends on the type of people you interact with. If you do not take bribe, nobody will come and offer bribe to you and you will feel everybody is honest. If you take bribe then everybody will come to you to offer bribe and you will feel that everybody in the society is dishonest.

Never judge people with you personal experience. I recall one of the doctors saying that every doctor takes and gives bribe because he was running an imaging centre and every doctor who approached him asked for a bribe. But he did not take into consideration the doctors who did not approach him.
Wellness Blog
Heart disease starts in youth

Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing

The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese.

The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat.

Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increases in the boys and drops in the girls. Levels of HDL cholesterol, the "good" kind that helps keep arteries clear, go down in boys but rise in girls.

Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years.

Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.
Pediatrics eMedinewS
  • A new study of twins has suggested that insomnia in childhood and adolescence is partially explained by genetic factors. Results exhibited that clinically significant insomnia was moderately heritable at all stages of the longitudinal study. The study is published in the January issue of the journal Sleep.
  • Exercise habits of expecting mothers can lower a child's chances of high blood pressure, even though they may weigh less at birth, suggests a new study published in the Journal of Sports Medicine and Physical Fitness.
Make Sure
Situation: A patient with 3 hour of developing chest pain went into acute cardiac arrest.
Reaction: Oh my God! Why was water–soluble aspirin not given at the time of chest pain?
Lesson: Make sure that all patients with suspected MI are given water–soluble aspirin to reduce chances of death.
eMedinewS Humor
A Friendly Honest Neighbor

A man received the following text from his neighbor:

I am so sorry Bob. I’ve been riddled with guilt and I have to confess.

I have been tapping your wife, day and night when you’re not around.

In fact, more than you.

I’m not getting it at home, but that’s no excuse.

I can no longer live with the guilt and I hope you will accept my sincerest apology with my promise that it won’t happen again.

Bob, anguished and betrayed, went into his bedroom, grabbed his gun, and without a word, shot his wife and killed her.

A few moments later, a second text came in: Damn autocorrect. I meant "wifi", not "wife".
Inspirational Story
Our Time in History

The paradox of our time in history is that we have taller buildings, but shorter tempers; wider freeways, but narrower viewpoints. We spend more, but have less; we buy more, but enjoy it less. We have bigger houses and smaller families; more conveniences, but less time.

We have more degrees, but less sense; more knowledge, but less judgment; more experts, but less solutions; more medicine, but less wellness. We have multiplied our possessions, but reduced our values. We talk too much, love too seldom, and hate too often.

We’ve learned how to make a living, but not a life. We’ve added years to life, not life to years. We've been all the way to the moon and back, but have trouble crossing the street to meet the new neighbor. We've conquered outer space, but not inner space.

We’ve cleaned up the air, but polluted the soul. We’ve split the atom, but not our prejudice. We have higher incomes, but lower morals. We've become long on quantity, but short on quality.

These are the times of tall men, and short character; steep profits, and shallow relationships. These are the times of world peace, but domestic warfare; more leisure, but less fun; more kinds of food, but less nutrition.

These are days of two incomes, but more divorce; of fancier houses, but broken homes. It is a time when there is much in the show window and nothing in the stockroom.
eMedi Quiz
A 64–year–old hypertensive obese female was undergoing surgery for fracture femur under general anaesthesia. Intra operatively her end–tidal carbon–dioxide decreased to 20 from 40mm of Hg. followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?

1.Fat embolism.
2.Hypovolemia.
3.Bronchospasm.
4.Myocradial infarction.

Yesterday’s Mind Teaser: At the end of a balanced anaesthesia technique with non-depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?

1.Pancuronium.
2.Gallamine.
3.Atracurium.
4.Vecuronium.

Answer for yesterday’s Mind Teaser: 3.Atracurium.

Correct Answers received from: Dr Avtar Krishan.

Answer for 10th Jan Dec Mind Teaser: 4. Oxygen affinity of hemoglobin.

Correct Answers receives: Dr K V Sarma, Daivadheenam Jella, Dr Avtar Krishan.
Press Release of the Day
Weight gain precedes the onset of diabetes

Weight gain after age 18 years in women and after age 20 years in men also increases the risk of type 2 diabetes. This was stated by Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

The Nurses’ Health Study, compared women with stable weight (those who gained or lost <5 kg) after the age of 18 years to women who gained weight. Those who had gained 5–8 kg had a relative risk of diabetes of 1.9; this risk increased to 2.7 for women who gained 8–11 kg. Similar findings were noted in men in the Health Professionals Study. Thus, the excess risk for diabetes with even modest weight gain is substantial.

Weight gain precedes the onset of diabetes. Among Pima Indians (a group with a particularly high incidence of type 2 Diabetes), body weight gradually increased 30 kg (from 60 kg to 90 kg) in the years preceding the diagnosis of diabetes.
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Reader Response
The warning is a good decision sir. But they are leading glorious practices with all allopathic drugs. They use 3rd generation cephalosporins and amoxiclav for cold and cough for example. I request you to stop or inform someone in power to stop this. Heard PHC doctors can give notice about unauthorized allopathic drug use. But as IMA members we should have meeting involving PHC doctors and encourage them to take action against these people. Kumaragoud Patil
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