June 18  2015, Thursday
eMedinewS
editorial
Natural foods and not supplements prevent heart disease
Dr KK Aggarwal One should take seasonal and locally grown natural food and vegetables grown out of organic farms. Eat less, dinner lighter then lunch, eat natural and in moderation – are few of the mantras.

Eating food supplements may be harmful. According to the American Heart Association (AHA), supplementation with beta carotene, vitamin C and vitamin E, either alone or in combination with each other or other antioxidant vitamins does not prevent heart disease.

High dose vitamin E supplementation (400 IU/day) may be associated with an increase in all–cause mortality.

Supplementation with vitamin C does not prevent a second heart attack.

Beta carotene supplementation may be dangerous and should be discouraged.

Vitamin E supplementation may be of benefit for only secondary prevention in heart patients with chronic renal failure who are undergoing hemodialysis.

The AHA concluded that current data do not justify the use of antioxidant supplements for the prevention or treatment of cardiovascular disease risk.

The above recommendations apply to supplementation only. Diets that are rich in natural antioxidants are associated with lower cardiovascular mortality.
IMA,IJCP,HCFI
eMedipics IMA,IJCP,HCFI
17th May 2015: Netradeep Camp was held at Avedem, Quepem, Goa with active participation of IMA Student Wing members
IMA,IJCP,HCFI
News
  • Eating more protein might help control weight in people older than 45 years, suggests a new study presented at the American College of Sports Medicine 62nd Annual Meeting.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) might inhibit ovulation and reduce progesterone levels in young women, which could seriously undermine fertility, reported new research presented at the European League Against Rheumatism Congress 2015.
  • The dietary supplement citicoline seems promising in the treatment of cocaine dependence in patients with bipolar disorder (BD); however, the benefits appear to decline over time, suggests new research published online in the American Journal of Psychiatry.
  • Perimenopausal women may have increased sensitivity to the normal hormone fluctuations of the menstrual cycle when it comes to getting a good night's sleep, suggests a cohort study published online June 16 in the Journal of Clinical Endocrinology and Metabolism.
  • Individuals with celiac disease who follow their gluten-free diet more closely are more likely to show complete mucosal recovery one year after diagnosis, suggested new research published online in the American Journal of Gastroenterology.
IMA,IJCP,HCFI
Cardiology eMedinewS
  • Analysis of almost 21,000 adults from the UK's EPIC-Norfolk study showed that those who ate the most chocolate had an 11% lower risk of developing coronary heart disease (CHD) and a 25% lower risk of CV-related death over 12 years of follow-up when compared with those who ate no chocolate. In addition, the highest-consumption group had a 23% lower risk of stroke. The findings were published online June 15 in Heart.
  • A new study suggests that poor sleep can significantly increase the risk of heart attack and stroke, thus prompting researchers to consider it as a risk factor for cardiovascular disease in prevention guidelines for the condition. The findings were presented at EuroHeartCare 2015 - the annual conference of the European Society of Cardiology.
Pediatrics eMedinewS
  • Exclusive breast-feeding for the first 3 months of life did not modify children's risk of becoming overweight by age 5 to 6 years, reported a population-based prospective birth cohort study published online in the Archives of Disease in Childhood.
  • Children who sustain traumatic brain injury (TBI) are more likely to experience greater daytime sleepiness, sleep disturbances, and poorer overall sleep quality, and to have impaired emotional, physical, and social functioning, in comparison with children without TBI, suggests a study presented at SLEEP 2015: the Annual Meeting of the Associated Professional Sleep Societies.
Dr KK Spiritual Blog
Understanding exact speech

Upanishads, Yogasutras of Patanjali and teachings of Gautam Buddha, all talk about "the right speech". As per Gautam Buddha, the right speech has three components:
  • It should be based on truthfulness.
  • It should be necessary.
  • It should be kind.
All three have to be in the same sequence with truthfulness taking the top ranking. For example, when a patient asks a doctor, "Am I going to die in the next few weeks or will I survive longer?" The truth may be that he is serious enough and may not survive but it is not necessary to speak the truth and also it is not kind. Therefore, that truth should not be spoken.

Lord Krishna in Mahabharata explained when not to speak the truth and when to speak a lie. The truth which is going to harm the society may not be spoken and a lie which can save the life of a person without harming others may be spoken.
  • A truth which is necessary and kind may be spoken.
  • A truth which is not necessary but kind may not be spoken.
  • A truth which is necessary but not kind may not be spoken.
  • A truth which is neither necessary and nor kind may not be spoken.
Inspirational Story
Blue Hummingbird

Once, long ago, there was a young boy who lived in a distant land called Tandow. He was a cheerful lad with not a care in the world. He had a special friend, the little blue hummingbird. Now this little boy didn’t have a lot of great friends, but the little bird and the boy were inseparable friends. The boy loved the little humming bird, so he built him a home. The bird also loved the boy and would follow him wherever he would go. As time went by their love grew and grew.

Then one day the young lad met a pretty young girl in school. The girl had long blonde hair, blue eyes, and a cute little smile. This was about the time of the biggest dance of the year. All the boy could think about was how he would love to take the girl to the dance. He gathered his courage all day and at the end of school confronted the girl and asked her to go with him to the dance.

Now this young girl was very popular and felt she did not want to be seen with the boy who cared for her so, but she did not want to hurt his feelings and so figured out a way to avoid saying no or yes. She told the boy if he brought her a red rose she would allow him to escort her to the dance.

This hurt the little boy because he knew that in the land of Tandow there had never been a red rose. In fact, the only roses in the land Tandow were white. On the way home the boy kept mumbling to himself why couldn’t she have asked for a white rose. There were hundreds of them in his front yard.

Feeling sorry for himself the boy didn’t even notice his friend the hummingbird fluttering above him. Now the bird loved him so, that it could tell instantly the boy was troubled. The bird hovered closer as the boy mumbled on home. Now the bird knew why the boy was so troubled. The bird could not rest all the night long, it pondered all night, a solution to the boy’s problem.

Finally as the sun began to rise the answer to how the bird could help his best friend entered his mind. The little blue hummingbird flew to a rose bush and searched for a large rose with a stem bearing thorns directly above it. Now the bird chose a thorn and with all the power in his wings cast his small body against the sharp thorn. It entered with great pain, as the tear drops of blood fell upon the white petals of the rose.

Now as the boy was ready for school, as he left the house he saw a red rose, he could hardly believe it, he ran to the bush and plucked the red rose. In his excitement he failed to notice the lifeless little body that lay below the bush in a puddle of blood. Happy as could be, he began with his red rose on his way to school. Before he got there some other boys playing football in a field called to him and asked him to come and play.

His first thought was, no, he had something more important to do. But they begged him and said they really needed him to even the teams. He looked at the rose, then them, then back at the rose. He said to himself. Ah!!! She didn’t really want to go with me anyway. Then, throwing the rose down, the boy went and played football.

You’ve probably already figured out the allegory…
  • The boy is each of us.
  • The humming bird is Jesus Christ.
  • The girl is eternal life.
  • The rose is the atonement.
  • The football game is the worldly things we sometimes feel are so important.
Make Sure
Situation: A 28–year–old pregnant woman was advised erythromycin estolate for her upper respiratory tract infection. A week later she developed jaundice.
Reaction: Oh my God! You should have prescribed erythromycin stearate instead!
Lesson: Make sure to remember that there is a higher incidence of hepatitis with cholestatic jaundice in pregnancy with erythromycin estolate.
Dr Good Dr Bad
Situation: You have NAFLD
Dr Bad: It is rare in India
Dr Good: It is common in India
Lesson: Nonalcoholic fatty liver disease (NAFLD), the hepatic manifestation of insulin resistance (IR), is a growing cause of chronic liver disease worldwide with a prevalence of about 20–30% in the general population (Dig Liver Dis. 2009 Sep;41(9):615-25).

(Copyright IJCP)
Wellness Blog
Eating Out Tips
  • Curb portions: Always order for one if you are two people and if you are alone set aside some of what is on your plate to bring home.
  • Resist refined carbohydrates.
  • Load your plate with colorful choices at the salad bar with vegetables, fruits and small amounts of lean protein. Skip the creamy and ranch dressings.
  • Choose dishes that are grilled, roasted, steamed, or sautéed.
  • Don’t be afraid to request a salad, vegetables, or fruit instead of starchy side dishes.
  • If you are a non–vegetarian, order only fish or seafood.
  • If you decide to have dessert, share it with your dining companion(s).
eMedinewS Humor
My Grades

A high–school student came home one night rather depressed.
"What’s the matter, Son?" asked his mother.
"Aw, gee," said the boy, "It’s my grades. They’re all wet."
"What do you mean ‘all wet?’"
"You know," he replied, "…below C–level."
Events
IMA,IJCP,HCFI
eMedi Quiz
The buffering capacity of a buffer is maximum at pH equal to:

1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

Yesterday’s Mind Teaser: In a patient with a tumor in superior mediastinum compressing the superior vena cava, all the following veins would serve as alternate pathways for the blood to return to the right atrium, except:

1. Lateral thoracic vein.
2. Internal thoracic vein.
3. Hemiazygos vein.
4. Vertebral venous plexus.

Answer for yesterday’s Mind Teaser: 4. Vertebral venous plexus.
Correct Answers received from: Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr K Raju, Dr K V Sarma, Dr G Madhusudhan, Daivadheenam Jella, Dr Avtar Krishan.
Answer for 16th June Mind Teaser: 2. Propionyl CoA.
Correct Answers received: Dr Sharavana.
IMA,IJCP,HCFI
Rabies News (Dr A K Gupta)
What are the initial (prodromal) symptoms of rabies?
  • Pain or paresthesia at the site of the bite is well–known as a diagnostically useful prodromal symptom occurring in one–third to two–thirds of cases. In Thailand, however, a specific type of paresthesia–itching–was the earliest symptom in more than 40% of cases. Itching occurred at the site of the healed bite wound or involved the whole bitten limb and was sometimes so intense as to provoke frenzied scratching and excoriation of the skin. The explanation for local paresthesia may be the multiplication of virus in the dorsal root ganglion of the sensory nerve supplying the area of the bite.
  • Pain behind the grafted eye was an early symptom in 3 of the 4 patients who developed rabies following corneal transplants.
  • Priapism with frequent spontaneous orgasms was the first symptom in one Thai patient.
  • Fever, malaise, nausea and vomiting.
  • Increased sensitivity of the skin to changes of temperature, especially air currents.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
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
Kishan, SM Heart Care Foundation Fund, Post CHD Repair
Deepak, SM Heart Care Foundation Fund, CHD TOF
Press Release
Over 200 people were trained in CPR in Geeta Colony (Rajghat Colony)

Heart Care Foundation of India trained over 200 people in compression only CPR at Geeta Colony (Rajghat Colony) here.

Giving the details Padma Shri Awardee, Dr K K Aggarwal, Honorary Secretary General, IMA and Dr V K Monga, Dean (Elect) IMACGP in a joint statement said that every member of the public should learn compression only CPR. They said that public should remember the sub-formula of CPR 10.

The CPR 10 Mantra is :-

Within 10 Minutes (as early as possible) of death, compress the centre of the chest of the dead person effectively and continuously with a speed of 10X10=100 compressions per minute atleast for another 10 Minutes (as longer as possible).

Marney ke 10 minute ke andar kam se kam dus minute tak 10X10 prati minute ki speed se apni chhati peetne ki bajaye marrey huye aadmi ki chhati peeto.

By learning CPR, 50%-70% of the people whose heart has stopped can be revived. The foundation has trained over 1 lac people so far and after training many lives have been saved by the people who had learnt CPR
eIMA News
  • The American Geriatrics Society is removing its recommendation to avoid nitrofurantoin in patients with a creatinine clearance level under 60 mL/min.
  • Vitamin D deficiency is highly prevalent in RA patients and is associated with higher disease activity and worse QoL indices. Regular PA correlates with higher vitamin D titers and better QoL in RA (Medscape).
  • Acute severe ulcerative colitis (ASUC), the most aggressive presentation of UC, occurs in 15% of adults and children with UC. First line therapy with intravenous corticosteroids is ineffective in half of adults and one-third of children. Therapeutic monoclonal antibodies against TNF (anti-TNF therapy) are emerging as a common treatment for ASUC due to their similar efficacy to calcineurin inhibitors and more favorable adverse effect profile (Medscape).
  • Chennai: They don the white coats and have a 'Dr' prefixed to their names, but they aren't allowed to practice medicine - a norm that is increasingly being violated by the growing number of physiotherapy centres in the city. With no regulatory body in the state to monitor them, physiotherapists are increasingly prescribing medicines to patients (TOI).
From Reuters, for comments
Special Report: Why India's medical schools are plagued with fraud
Muzaffarnagar, India | By Andrew Macaskill, Steve Stecklow and Sanjeev Miglani: Reuters

Last December, Dilshad Chaudhry travelled with about 100 of his fellow villagers by bus to a local Indian medical-school hospital. They’d been told that foreign doctors were coming to tour the facility, and check-ups would be free.

There was nothing wrong with Chaudhry; he was accompanying his brother, who had a back problem. But “every person was told to lie in a bed even if they’re not sick,” he said. The 20-year-old electrician said he never saw any foreign physicians that day, but the hospital’s Indian doctors kept checking that the phony patients were in bed. “They wanted to make sure no one escaped,” he said.

That was the same month government inspectors visited the hospital, which is at Muzaffarnagar Medical College, 80 miles northeast of New Delhi. The inspectors checked, among other things, whether there were enough patients to provide students with adequate clinical experience. They determined there were.

But a year earlier, inspectors had found that most of the college hospital’s outpatients “were fake and dummy and seems to be hired from nearby slum area,” according to the official report. “In paediatric ward all children were admitted ... without any medical problem and were hired from nearby area!!!!!”

“I am not very keen to reply,” said Dr. Anil Agarwal, the school’s principal, when asked about the episode with Chaudhry.

India’s system for training doctors is broken. It is plagued by rampant fraud and unprofessional teaching practices, exacerbating the public health challenge facing this fast-growing but still poor nation of about 1.25 billion people.

The ramifications spread beyond the country’s borders: India is the world’s largest exporter of doctors, with about 47,000 currently practicing in the United States and about 25,000 in the United Kingdom.

Schools and scandals
In a four-month investigation, Reuters has documented the full extent of the fraud in India’s medical-education system. It found, among other things, that more than one out of every six of the country’s 398 medical schools has been accused of cheating, according to Indian government records and court filings.

The Reuters probe also found that recruiting companies routinely provide medical colleges with doctors to pose as full-time faculty members to pass government inspections. To demonstrate that teaching hospitals have enough patients to provide students with clinical experience, colleges round up healthy people to pretend they are sick.

Government records show that since 2010, at least 69 Indian medical colleges and teaching hospitals have been accused of such transgressions or other significant failings, including rigging entrance exams or accepting bribes to admit students. Two dozen of the schools have been recommended for outright closure by the regulator.

Paying bribes – often in the guise of “donations” – to gain admission to Indian medical schools is widespread, according to India’s health ministry, doctors and college officials.

“The next generation of doctors is being taught to cheat and deceive before they even enter the classroom,” said Dr. Anand Rai. He exposed a massive cheating ring involving medical school entrance exams in the central Indian state of Madhya Pradesh in 2013. Rai was given police protection after he received death threats following the bust.

The poor state of India’s medical education reflects a health system in crisis. The country has the highest rates of mortality from diarrhea, pneumonia and tuberculosis, creating pressure to train more physicians. Patients are regularly denied treatment at public hospitals that are so overcrowded, often the only way to see a doctor is to pay a bribe.

The causes of the crisis are manifold: Too few doctors. A government-backed surge in private medical schools which, to boost revenue, frequently charge under-the-table fees for admission. Outdated government regulations that, for example, require college libraries to keep paper copies of medical journals and penalize those that subscribe instead to online editions.

Charged with maintaining “excellence in medical education” is the Medical Council of India (MCI). But this government body is itself mired in controversy. Its prior president currently faces bribery allegations. The council is the subject of a mountain of lawsuits, many of them pitting it against medical schools challenging its findings. The cases often drag on for years.

“The best medical schools in India are absolutely world class,” said David Gordon, president of the World Federation for Medical Education. But, he added, the Indian government’s process of accrediting a “huge” number of recently opened, private medical schools “has at times been highly dubious.”

India has been rocked by a series of recent medical scandals, including doctors accused of serious crimes. In November, a group of junior doctors at a medical college in the eastern city of Kolkata allegedly tied a suspected mobile phone thief to a pillar, slashed him with a razor and beat him to death with bamboo sticks, according to local police. Nine of the accused men remain in jail; they deny murder charges, say lawyers involved in the case. Three suspects remain at large.

The scalpel thrower
The system’s problems are felt abroad, too. Tens of thousands of India’s medical graduates practice overseas, particularly in the United States, Britain, Australia and Canada. All of these countries require additional training before graduates of Indian medical schools can practice, and the vast majority of the doctors have unblemished records.

But regulatory documents show that in both Britain and Australia, more graduates of Indian medical schools lost their right to practice medicine in the past five years than did doctors from any other foreign country.

In the United Kingdom, between 2008 and 2014, Indian trained doctors were four times more likely to lose their right to practice than British trained doctors, according to records of Britain’s General Medical Council. (The U.S. and Canada lack publicly available centralized databases of disciplined doctors.)

The British cases include that of Dr. Tajeshwar Singh Aulakh, who received his medical degree in 1999 from Punjabi University in Patiala, India, according to Indian government records. He was assisting during a hip operation in 2008 in Shropshire, England, when he allegedly grabbed a scalpel, slashed the patient’s stitches and threw it toward a nurse, according to British government records. The United Kingdom later struck him off its list of approved physicians. He could not be reached for comment.

The Australian cases include that of Dr. Suhail Durani, who graduated from an Indian government medical college in the northern city of Jammu in 2003. He was imprisoned in Perth for more than 18 months after being convicted in 2011 of sexually assaulting a female diabetic patient who had shown up in the emergency room with symptoms of a potentially serious illness.

In an interview, Durani maintained his innocence and described his medical training in India as excellent. He currently is not practicing medicine.

Dr. Ramesh Mehta, vice president of the Global Association of Physicians of Indian Origin, said there are “major problems” with some private Indian medical schools. But he added that a doctor’s success depends as much on “personality and attitude” as on his or her college training.

Fake degrees
About 45 percent of the people in India who practice medicine have no formal training, according to the Indian Medical Association. These 700,000 unqualified doctors have been found practicing at some of India’s biggest hospitals, giving diagnoses, prescribing medicines and even conducting surgery.

Balwant Rai Arora, a Delhi resident in his 90s, said in an interview that he issued more than 50,000 fake medical degrees from his home until his forgery ring was broken up by the police in 2011. Each buyer paid about $100 for a degree from fictitious colleges. Arora was twice convicted and jailed for forgery.

“There is a shortage of doctors in India. I am just helping people with some medical experience get jobs,’’ said Arora. “I haven’t done anything wrong.”

India currently has about 840,000 doctors – or about seven physicians for every 10,000 people. That compares with about 25 in the United States and 32 in Europe, according to the World Health Organization.

The shortfall has persisted despite India having the most medical schools of any nation. That’s because the size of graduating classes is small – typically 100 to 150 students.

Indeed, gaining admission to India’s top medical schools is akin to winning the lottery. The All India Institute of Medical Sciences in New Delhi has been rated the best medical school in India Today magazine’s past five annual surveys. According to the registrar’s office, it takes in only 72 students for its undergraduate course each year out of about 80,000 to 90,000 who apply – an acceptance rate of less than one tenth of one percent. As in the United Kingdom, most medical school students attend an undergraduate program.

Similarly, Christian Medical College, a top ranked school in the southern city of Vellore, received 39,974 applications this year for 100 places, according to a school official – an acceptance rate of 0.25 percent. By contrast, the acceptance rate at Harvard Medical School for its entering class in 2014 was 3.5 percent.

Health ministry officials and doctors say India’s medical education system began to falter following a surge in new, private medical colleges that opened across the country during the past few decades, often in remote areas.

In 1980, there were 100 government run medical schools and 11 private medical colleges. Thirty-five years later, the number of government medical colleges has nearly doubled. The number of private medical schools, meanwhile, has risen nearly twenty-fold, according to the Medical Council of India. There are now 183 government medical colleges and 215 private ones.

'Little better than quacks'
Many of the private colleges have been set up by businessmen and politicians who have no experience operating medical or educational institutions, said MCI officials. Sujatha Rao, who served as India’s health secretary from 2009 to 2010, said the boom in private colleges was driven by a change in the law in the early 1990s to make it easier to open new schools because the government was struggling to find the money to build public medical schools.

“The market has been flooded with doctors so poorly trained they are little better than quacks,” Rao told Reuters.

Not that a legitimate degree necessarily makes a difference.

A study in India published in 2012 compared doctors holding medical degrees with untrained practitioners. It found “no differences in the likelihood of providers’ giving a diagnosis or providing the correct treatment.” The study, funded by the Bill & Melinda Gates Foundation, concluded that in India, “training in and of itself is not a guarantor of high quality.”

Last year, an individual described as a “concerned” student at a rural government medical college in Ambajogai, in western India, posted a letter online with a litany of allegations about the school, Swami Ramanand Teerth Rural Medical College.

There were professors who existed only on paper, he alleged, and “no clinics and no lectures” for students in the medicine and surgery departments. Conditions were unsanitary at the hospital, and pigs and donkeys roamed the campus, he wrote. The writer also alleged that students had to pay bribes to pass exams.

“We are not taught in this medical college,” the letter stated. Students have graduated “without even attending a single day.” The writer said the letter had been sent to various government agencies and health officials.

Records from the Medical Council of India, the body charged with maintaining the country’s medical education standards, show that an inspection of the college this January found numerous deficiencies, including a shortage of faculty, residents and lecture theaters.

Dr. Nareshkumar S. Dhaniwala, who served as the principal of the college between 2011 and 2013, said “there is some truth in the letter.” Animals, such as pigs and cows, do roam the campus, teachers and students don’t turn up for lessons, and there is a scarcity of running water in the dormitories, he said. And before he joined, he said, he heard students had to pay to pass final exams.

“I found the students were not very interested in studying, they don’t come to classes, they don’t come to clinics,” Dhaniwala said. “Medical education has gone downhill all over the country because the teachers are not as devoted as they used to be.”

Sudhir Deshmukh, the college’s current principal, did not respond to requests for comment.

The Medical Council of India, which was established by the government in 1934 and oversees medical education, has itself been swirling in controversy. Dr. Ketan Desai, the council’s former president, faces criminal charges related to his arrest in 2010 for allegedly conspiring to receive a bribe to recommend authorizing a private medical college to accept more students. The case is still pending; Desai has denied the charges.

'Junk body'
In interviews, medical school officials complained that the MCI had onerous inspection requirements that were outdated and arbitrary.

“The Medical Council of India is a junk body,” said Dr. A. K. Asthana, principal and dean of Subharti Medical College in the northern city of Meerut, which has been accused of demanding illegal fees for admission. Asthana denies the allegations. The council has tried – unsuccessfully so far – to close the school. “I’m totally frustrated with the MCI. Totally frustrated,” he said.

Dr. Vedprakash Mishra, the head of MCI’s academic committee, told Reuters that the agency has created “discipline and accountability” among medical colleges by imposing fines and, in several cases, prohibiting schools from admitting students for up to two years. “We don’t compromise and mitigate on the requirements,” he said.

Asked about allegations of corruption within MCI itself, Mishra abruptly ended the interview. “This is not what I want to be discussing,” he said.

Under the government’s current regulations, private medical colleges generally must have campuses on at least 20 acres of land. Because urban real estate in India is expensive, many schools open in rural areas where recruiting qualified, full time doctors to teach is difficult because pay scales are low and living conditions are tough.

Interviews and MCI records show that some private colleges solve the problem by cheating – they recruit doctors to pose as full time faculty members during government inspections. The physicians work there for just a few days or weeks. Two MCI officials estimated that there are several hundred Indian companies involved in recruiting them.

In October, a doctor in New Delhi received an email from a local company called Hi Impact Consultants with the subject line: “Urgent requirement of doctors for MCI Inspection in Ghaziabad”

The email offered up to 20,000 rupees a day (about $310) if the doctor appeared for an inspection at Saraswathi Institute of Medical Sciences in Hapur, east of New Delhi. The doctor, who requested anonymity, has no connection with the college.

“If interested please revert back ASAP,” the email concluded. The sender described itself as “a Medical Executive Search firm.”

In an interview, Sanjeev Priyadershi, Hi Impact’s executive director, confirmed that the firm had tried to recruit doctors to appear during government inspections at medical colleges where they don’t normally work.

“My client wanted to hire full time faculty members for inspection purposes,” he said.

Dr. Shailendra K. Vajpeyee, the principal of Saraswathi, said the college is constantly struggling to recruit qualified professors. Vajpeyee said he knew of Hi Impact Consultants, but denied he had employed them during his 18 month tenure.

“I don’t know why that email was sent” by the company, he said. He declined to comment further about the matter.

'Biased' inspectors
At Muzaffarnagar Medical College, where electrician Dilshad Chaudhry was taken in December, students can read medical journals and books in a sprawling, circular library and take classes in clean and modern lecture halls.

But finding enough patients to provide students with clinical experience at rural, private teaching hospitals like Muzaffarnagar is a challenge. Many people in rural India simply can’t afford the cost of treatment.

School principal Agarwal denied the allegations by MCI inspectors that the college’s hospital had inflated its number of patients during a 2013 inspection. “Sometimes the inspectors are biased, that is for sure,” he said. He also denied the hospital had ever recruited local villagers to pose as patients.

But Dr. Vaibhav Jain, a former student at the college, told Reuters that the hospital would conduct “free check-up camps,” to lure rural villagers to the facility on inspection days. He said the hospital sometimes would promise free ultrasounds, but only a small number of people would be tested. Villagers often later complained about it to students at a clinic in Bilaspur where he worked, he said.

“We used to say we can’t do anything, the machine was not working,” he said.

Medical education is in trouble across India, said Jain. “The truth is that many medical students aren’t prepared to be doctors when they finish” college. “And the result is the patient suffers.”

(Edited by Peter Hirschberg)
What's worth reading
  • Rising incidence of atrial fibrillation over the last 50 years. (Schnabel et al., The Lancet, May 2015)
  • Transcatheter aortic valves versus surgically implanted valves in low-risk patients with aortic stenosis. (Thyregod et al, JACC, May 2015)
  • Clopidogrel of 6 weeks vs. 6 months in patients who are already on anticoagulation and aspirin following stent implantation. (Fiedler et al, JACC, April 2015)
Celiac Disease: Beware of probiotics: Columbia University has shown widespread contamination of probiotics with gluten. Dr Green and colleagues looked at the gluten component using liquid chromatography. They looked at a composite of 22 probiotics, and a little more than two thirds of these were listed as gluten-free. They found that 55% contained gluten and two of them contained an incredibly high amount of gluten. Of the 15 probiotics that were labeled gluten-free, eight (53%) tested positive for gluten, including two that contained gluten levels more than 20 parts per million.

Elderly care: Any medication, even an over-the-counter medication, could increase your risk of falling. Common medications that can cause these kinds of side effects include blood pressure, heart, pain, and sleep medications, and antidepressants.
Aao Gaon Chalen Abhiyan
Netradeep Camp was held at Avedem, Quepem, Goa on 17th May 2015, with active participation of IMA Student Wing members. It was graced by the presence of IMA State Secretary, Dr. Francisco Couto, in addition to Mr. Kishore and his team from Mukta Opticians, Dr. Kaushik Dhume, branch members Dr KR Kamath and Dr Jagadish Cacodcar and Sarpanch and members of Avedem Panchayat. A total of 246 patients attended the camp; 197 persons were found to have refractive errors and will be provided spectacles. Fifteen cases of cataract were detected and will be taken up for surgery at the Ophthalmology Department of GMC at a later date.
IMA Rise & Shine - Indore CME
IMA,IJCP,HCFI
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Quote of the Day
You have to forget about what other people say, when you’re supposed to die, or when you’re supposed to love. You have to forget about all these things. Jimi Hendrix
Reader Response
To, Dr K K Aggarwal, Dear Sir, You deserve compliments for publishing the judgment of Patna High Court on the death of a patient after hernia operation. I feel every branch of IMA and Association of Surgeons of India must get the copy and preserve it as the contents of the judgment are vital to every member while facing litigations in the court and it will help the lawyers too to bring out the details of various Acts of CrPC and their interpretations. Thank you for the judgment details. Dr Jaya Prakash Reddy, Nalgonda, Telangana.
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