April 25 2015, Saturday
editorial
25 points that all doctors should know about malaria
Dr AC Dhariwal and Dr K K Aggarwal
Dr KK Aggarwal
  1. Malaria is endemic throughout India except in areas located 5000 ft above sea level.
  2. It is largely prevalent in 16 states of India including the 7 North-Eastern states. These are Odisha, Jharkhand, Chhattisgarh, Madhya Pradesh, Assam, Tripura, Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Andhra Pradesh, Gujarat, Maharashtra, West Bengal and Karnataka.
  3. Intensity of transmission varies from area to area. The areas, which have conducive geo-ecological and climatic conditions, inaccessible terrains, poor infrastructure, lack of health seeking behavior, poor availability of health services and high vector load have high disease burden and high mortality rates.
  4. Districts with predominant tribal population are the most affected due to poor availability of health services and lack of health seeking behavior.
  5. Main plasmodium species causing malaria in India are P. vivax and P. falciparum; each is responsible for 50% of the cases in the country.
  6. The incidence of malaria has been brought down from 2 million cases annually during the last decade to around 1 million cases annually during the beginning of current decade and it has been contained at that level for the last 3 years. Similarly, annual deaths due to malaria have also declined during this period.
  7. 152 districts have been identified as high endemic.
  8. During the year 2014, there was an increase in total cases and deaths due to malaria as compared to the year 2013. A total of 11 States/ UTs reported case rise in 2014 as compared to the previous year. The major states, which reported increase in malaria cases include Odisha, Madhya Pradesh, Chhattisgarh, Maharashtra, Andhra Pradesh, Tripura, Meghalaya and Mizoram.
  9. Some of the main reasons identified for this upsurge are increased surveillance since the introduction of Bivalent Rapid Diagnostic Test (RDT) in 2013 and focal outbreaks such as in the states of Tripura, Madhya Pradesh, Maharashtra, and Meghalaya.
  10. National Vector Borne Disease Control Programme is taking intensive malaria control measures with the ultimate goal of bringing down malaria incidence to the level that it is no more a public health problem.
  11. To achieve effective control of malaria, the program aims at early case detection through active, passive and sentinel surveillance along with prompt and complete treatment of all the detected cases.
  12. As per National Drug Policy for Treatment of Malaria- 2013, all fever cases suspected of malaria are to be investigated by microscopy or Rapid Diagnostic Test (RDT) for malaria.
  13. Although microscopy is the Gold standard test for malaria, bivalent RDTs are being recommended and used to detect malaria in remote, inaccessible areas, during malaria epidemic, for travelers and military forces.
  14. NVBDCP recommends only antigen-based bivalent RDTs (Pf and Pv) for diagnosis of malaria.
  15. As per the National Drug Policy (2013), P. vivax cases are to be treated with chloroquine for 3 days and primaquine for 14 days.
  16. As per the National Drug Policy (2013), P. falciparum cases are to be treated with Artemisinin Combination Therapy (ACT) i.e. Artesunate 3 days + Sulphadoxine-Pyrimethamine 1 day and single dose Primaquine on day 2.
  17. However, in North Eastern states, all Pf cases are to be treated with ACT-AL (Artemether-Lumefantrine combination) + Primaquine on day 2.
  18. All severe cases should be treated with injection Artesunate followed by complete oral ACT course i.e. of 3 days.
  19. The referral services are being strengthened for the management of severe cases. The referral mechanism under NHM is being used for referring cases.
  20. Special measures are being taken for epidemic preparedness and rapid response, through co-ordination with IDSP.
  21. To reduce the risk of transmission, Integrated Vector Management is being done through Indoor Residual Spraying (IRS) in selected high risk areas with API >2 (~80 million pop/annually), use of Long Lasting Insecticidal Nets (LLINs) and use of larvivorous fish and source reduction.
  22. Other important supporting interventions of the program include Behaviour Change Communication/ Information, Education & Communication (BCC/IEC), capacity building and inter-sectoral collaboration and NGO or Public Private Partnerships.
  23. In urban areas, more than 60% of the population seeks health services from private sector and other public undertaking and organized sectors. Their involvement in the programme is of paramount importance.
  24. To ensure timely action, actual disease burden, reporting from all the sectors needs to be captured and monitored.
  25. Any confirmed malaria case not responding to treatment within 72hours may be suspected for resistance. Such cases should be given alternative antimalarial and should be reported to the program for detailed investigation.
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IMA & AIMED sign MoU to promote India manufactured medical devices
News
Guidelines for Social Media Use Released by ACOG: The American Congress of Obstetricians and Gynecologists (ACOG) has become one of the first medical specialty societies to issue guidelines on physicians' use of social media. Other guidelines are available from state medical boards, and the American Medical Association released a statement on the topic in 2010. The ACOG report, published in the February issue of Obstetrics & Gynecology, was written by the society's committee on professional liability
  • The report points out that some physicians may give medical advice on Facebook to people who are not their patients. Although they might feel comfortable about doing that in a face-to-face conversation with an acquaintance, providing medical advice online might establish a physician–patient relationship.
  • ACOG recommends that physicians not give medical advice online to nonpatients.
  • All online and digital communications between physicians and patients, should conform with the Health Insurance Portability and Accountability Act (HIPAA) and the standards of professional behavior. ACOG reminds physicians that such communications may be included in the patient's electronic record and would therefore be discoverable in a lawsuit.
  • HIPAA rules prohibit physicians from disclosing protected health information on a social media site. However, there is nothing to prevent physicians from directing patients to an educational site or a forum that might be able to answer their questions.
  • Medical advice is different from medical information.
  • Clinicians should avoid social media posts about patients or clinical events, even if the patients are not identified by name. The event can be traced back through public statistics data to a specific patient or hospital. Therefore, posting or blogging about specific events or cases is strongly discouraged.
  • Many societies have recommended that physicians not "friend" their patients on Facebook or other social media sites, ACOG did not take that step because many obstetrician/gynecologists opposed it. In some practices, doctors are friends with their patients outside the doctor–patient relationship. So it's perfectly natural for them to be Facebook friends, and even social acquaintances.
  • Physicians should not become too friendly with patients on social media, because to do so might lessen their ability to offer good medical advice offline.
  • When physicians post pictures on their social media personal page, they may appear to show themselves drinking or celebrating something. That may lead people to wonder about their capability (as physicians).
  • There is a difference between professional and personal social media profiles. For some practices, Facebook or Twitter "may serve as a substitute for a professional web page or as an auxiliary platform for other original content, such as a blog." In that case, the physician can adjust security settings to prevent undesired content from being posted on the site and to prevent a professional profile from being "tagged" by other users. This is more difficult to control in the context of a personal profile, which can expose personal information to a larger audience.
  • Twitter is less of a challenge in this respect. Physicians can have both social "handles" for their personal interactions and professional handles that they use in their practices. This professional aspect can sometimes be valuable. When one practice temporarily lost its telephone service, he recalled, it sent out tweets to all of the patients who "followed" the practice to let them know the office was still open.
  • Medical societies, including the American Medical Association and the Wisconsin Medical Society, encourage physicians to maintain separate professional and personal identities to minimize the risks for social media.
  • Physicians should use the privacy settings available on personal Facebook pages.
  • Think carefully about what you post and what kind of reaction might occur. At the end of the day, anything you post on the Internet may be public, and it could paint you in a bad light. (Obstet Gynecol. 2015;125:516-520)
4 ways to put off joint replacement
  • Tip #1: Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half.
  • Tip #2: Take care when using your joints: Poor posture and using the wrong techniques during your daily activities add more stress to damaged joints. By standing up straight instead of slouching, you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away.
  • Tip #3: Try nonsurgical approaches before turning to surgery: Treatment with steroids is one approach. Benefits can last anywhere from four to six months. However, this doesn't work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis
  • Tip #4: Get pain relief: Instead of heading straight to your doctor to treat sore joints, try taking an over-the-counter pain reliever. Take them for the shortest possible time to relieve your discomfort. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain.
(Source: Harvard Health)

Zoonosis: Dog hygiene
  • Risk of transmission from contact with dogs is low and may be further reduced by simple precautions.
  • Dogs should be seen by a veterinarian on a regular basis.
  • Dogs should be treated promptly for diarrhea.
  • Dogs should be vaccinated for rabies.
  • Dogs should be treated to prevent heartworm disease (Dirofilaria immitis).
  • Effective flea control requires treatment of affected dogs, their environment, and other animals they contact.
  • Dogs should be fed high quality commercial food.
  • Dogs should not eat raw meat or eggs. Raw meat may have higher rates of Campylobacter and Salmonella in their stools
  • Dogs should not be allowed to eat garbage, feces, or hunt.
  • Dogs should not be allowed to drink non-potable water (e.g., surface water or toilet water).
  • Dogs should be inspected for ticks regularly.
  • Dog owners should wash their hands following contact with or cleaning up dog feces.
  • Groups at high risk for serious infection from pets include: Persons with waning immunity (e.g., older adults); children less than five years old; pregnant women and immunocompromised patients with AIDS, those without a functioning spleen or taking immunosuppressive therapy
  • To avoid infections, people at higher risk should take particular precautions with any animal contact.
  • They should do thorough and frequent hand wash
  • They should avoid contact with animals and their environment (e.g., pens, bedding and manure).
HIV positive patients should carry following precautions
  • When obtaining a new pet, they should avoid animals aged <6 months (or <1 year for cats)
  • They should be cautious when obtaining a pet from pet-breeding facilities, pet stores, and animal shelters, because of highly variable hygienic and sanitary conditions.
  • They should avoid stray animals.
  • They should avoid contact with any animal that has diarrhea.
  • They should seek veterinary care for animals with diarrheal illness, and a fecal sample from such animals should be examined for Cryptosporidium, Salmonella and Campylobacter.
  • They should wash their hands after handling pets, including before eating, and should avoid contact with pets' feces.
  • They should avoid contact with reptiles (e.g., snakes, lizards, iguanas, and turtles) as well as chicks and ducklings because of the risk for salmonellosis.
  • They should wear gloves during aquarium cleaning to reduce the risk for infection with Mycobacterium marinum.
  • They should avoid contact with exotic pets (e.g., nonhuman primates)
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Dr KK Spiritual Blog
Why do we Offer Food to God in Every Pooja?

We follow a ritual of offering ‘bhog’ to the deity we worship. The ritual also involves sprinkling water all around the place where we sit down to eat food. Many people have advocated that the sprinkling of water is related to preventing ants and insects from approaching the food. But in spiritual language there is a deeper meaning to these rituals.

Bhagwad Gita and Yoga Shastras categorize food into three types corresponding to their properties termed as gunas. Depending upon satoguna, rajoguna and tamoguna, the food items are categorized as satwik, rajsik or tamsik.

Satwik foods provide calmness, purity and promote longevity, intelligence, strength, health, happiness and delight. Examples of satwik food items are fruits, vegetables, leaves, grains, cereals, milk, honey, etc. These items can be consumed as they are. One can also live on satwik food for life.

Rajsik food items possess attributes of negativity, passion and restlessness. Hot, spicy and salty food items with pungent, sour and salt taste promote rajas qualities.

Tamsik food has attributes of inducing sleep, ignorance, dullness and inertia. The examples of tamsik food are meat, onions, garlic, left–over food, etc.

Only satwik food is offered to God. Rajsik and tamsik food is never offered as Bhog. The only persons who were offered tamsik and rajsik food in Ramayana are Ahi Ravana and Kumbhkaran. Both of them were of an evil nature. Kumbhkaran signified tamas and Ahi Ravana, rajas or aggression. Tamsik and rajsik food can be converted into satwik by slow heating, sprouting or keeping them in water overnight. The examples are sprouted wheat and chana (chickpeas), etc.

A mixture of honey, milk, ghee, curd and sugar is called panchamrut and is a routine offering to the God. All the five components have satwik properties and their consumption promotes health.

In Ayurveda, there is a saying that any food item, which grows under the ground, is tamsik in nature and one, which comes from the top of the tree or plant like leaves, flower and fruits are satwik in nature. Satwik food is usually fresh, seasonal and locally grown.

Human beings are made up of body, mind and soul and soul is equated to consciousness or God. Whatever offered to external God if is offered to the internal God or consciousness leads to inner happiness. The ritual, therefore, of offering food to God before eating forces us to either eat only satwik food or to include a substantial portion of satwik food in our meals. It helps a person convert his meal into a pure satwik one or at least adding satwik items.

Sprinkling water around the plate is considered an act of purification.

Many people confuse bhog with chadhava or offerings to the deity. While bhog is shared with God, chadhava is the offering of your illness or negative thoughts to the God and you go back with prasada of inner happiness. Many people counter the above argument by saying that alcohol is offered to Bhairon, viewed as a demon God, which means alcohol, is good for health. I personally feel that alcohol is offered to Bhairon not as a bhog but as an offering which means that people who are addicted to alcohol go to Bhairon and give their share of alcohol to him so they can de–addict themselves.
Cardiology eMedinewS
  • Studies in patients with Marfan syndrome and aortic root dilation have suggested that angiotensin II receptor blocker therapy may be more effective than beta blocker therapy for prevention of further dilation. A randomized trial in N Engl J Med 2014; 371:2061 comparing losartan with atenolol in 608 children and adults with MFS and aortic root dilation found no significant difference in the rate of dilation between the two treatment groups over a three-year period. Give beta blocker therapy for patients with MFS with aortic root dilation and add an angiotensin II receptor blocker as tolerated. (Uptodate)
  • Use of continuous positive airway pressure (CPAP) is associated with a significant decrease in atrial fibrillation in patients with both recurrent AF and obstructive sleep apnea (OSA), suggests a new analysis published in JACC: Clinical Electrophysiology.
Pediatrics eMedinewS
  • For acute otorrhea in children with tympanostomy tubes, antibiotic-glucocorticoid eardrops are not only clinically superior to oral antibiotics and initial observation, they also cost less, suggests a study published online in Pediatrics.
  • For children 4 to 7 years old, a required daily nap of more than an hour at school or daycare may lastingly reduce sleep time at night, suggests a new study published online in the Journal of Developmental and Behavioral Pediatrics.
Inspirational Story
Helping Yourself

Well my story starts 3 years ago. I was working in a retail store; I like to talk to everybody and know what’s going on in their lives. I remember this one girl who started working there a few months after me. I remember always seeing her. I don’t know why but for a weird reason we would never talk. We would just see each other and smile.

She would always smile in a really happy way until one day when we got to work in the same department again. She smiled as if she was the happiest girl in the world. I went up to her and asked "What’s wrong with you?" She answered "Why?" I said, "I could feel you’re very sad and you’re always trying to hide it."

Her mouth just dropped as if I had discovered her deepest secret, so we started talking. She told me why she was feeling like that and why she was trying to hide it. Time went by and we became good friends. She’d always tell me I had changed her life in so many ways. I could not imagine. I would just smile, not really understanding what she meant by that.

Today this girl is one of my best friends. I really don’t know what I would do without her. She has been there for me in every possible way a friend could be. I guess what I’m trying to say is you never know when you’re helping yourself. I helped this girl never knowing that at the same time I was helping myself by finding a truthful friend.

So the next time you see a stranger and they look like they need someone who will listen to them, listen to what they have to say. You never know, you might just end up helping yourself.
Wellness Blog
About thyroid gland
  • Low functioning thyroid is a new epidemic of the society affecting more than 3% of people. If thyroid function is low, it causes weight gain, loss of energy, cold intolerance and menstrual irregularities in women.
  • All people who are aged 50 and above should have their thyroid profile (TSH test) done to look for thyroid deficiency.
  • In younger people, or in cases of infertility, menstrual irregularity, pregnancy, weight gain, one should check for thyroid deficiency.
  • Iodized salt should be used to prevent thyroid deficiency.
  • Non–iodized salt is only used in two conditions: firstly in patient with thyroid inflammation and secondly, while doing Jalneti in naturopathy, a yoga–related nasal wash technique.
  • In pregnancy, even mild thyroid deficiency can affect the growth of fetus hence dose requirement of thyroid medicine is much higher in pregnancy than in non–pregnancy.
  • In the elderly, the dose of thyroid medicine to be started is always low as compared to one in the adults.
  • If thyroid deficiency is untreated, osteoporosis (thickening of bone) and/or atrial fibrillation (irregular and fast heart rate) may result. Osteoporosis can cause recurrent fractures and atrial fibrillation may cause brain paralysis.
  • In Allopathic medicine, thyroid deficiency is treated by synthetic T4 hormone replacement. In TFSP, thyroid extracts are available, which contain both T4 and T3 potential drugs.
  • In Ayurveda, thyroid stimulant drugs are available but they are effective only if some amount of thyroid gland is available.
  • As per Ayurveda, eating soya and drinking water from copper vessel is good for thyroid.
Make Sure
Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.

Reaction: Oh by God! Why was additional insulin given?

Lesson: Make sure that the insulin dose is correctly calculated. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.
Dr Good Dr Bad
Situation: Embolization occurs in how many patient of DVT? (JR to SR).
Dr Bad: It is rare!
Dr Good: It is quite common!
Lesson: Embolization occurs in about 50% of patients with proximal vein DVT.

(Copyright IJCP)
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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
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Gender Determination
In Writ Petition (Civil) No. 349 of 2006, Voluntary Health Association of Punjab Vs. Union of India & Others, the Hon’ble Supreme Court on 4th March, 2013, gave following directions for effective implementation of provisions of PC & PNDT Act.

……….11. The various courts in this country should take steps to dispose of all pending cases under the Act, within a period of six months. Communicate this order to the Registrars of various High Court, who will take appropriate follow up action with due intimation to the concerned Courts.

The Hon’ble Supreme Court, in Writ Petition (Civil) No. 349 of 2006, Voluntary Health Association of Punjab Vs. Union of India & Others, reiterated its directive in order passed on 16.09.2014.

…….ii. For an order directing all courts where proceedings under this Act are instituted to fast track the proceedings to be completed within 6 months from today.

Details of State/ UT- wise cases under PC & PNDT Act disposed in last two years are at Annexure-I. The data is based on the Quarterly Progress Reports (QPR) submitted by States/ UTs.

In Writ Petition (Civil) No. 349 of 2006, Voluntary Health Association of Punjab Vs. Union of India & Others, the Hon’ble Supreme Court on 13.01.2015 and 20.01.2015, passed State-specific orders for Haryana & Uttar Pradesh Governments respectively wherein States have been directed to impart adequate training to the judiciary through State Judiciary training and Research Institutes.

In view of the above mentioned order of Hon’ble Supreme Court, The Govt. of Uttar Pradesh organised a training workshop on 24th Feb. 2015 in which about 100 officers were trained including Prosecuting Officers, District Magistrates, Sub-District Magistrates. A State level training workshop was also organised by Govt. of Haryana on 31.03.2015, which was attended 110 officials including District Attorneys, Director (Prosecution), State Appropriate Authority, District Appropriate Authorities, Deputy Superintendent of Police and other State level implementing Officers. A Judicial Colloquium was organised by Govt. of Rajasthan on 10th January, 2015 at Jaipur. The participants were Hon’ble Judges from High Court, Session Courts, District Courts, Special Magistrates of PNDT Courts etc.

State/ UT- wise cases disposed off under PC & PNDT Act
Cases disposed off in last two years
S. No.
States/UTs
2013
2014
1.
Andhra Pradesh
0
0
2.
Arunachal Pradesh
0
0
3.
Assam
7
0
4.
Bihar
0
0
5.
Chhattisgarh
0
0
6.
Goa
0
20
7.
Gujarat
0
0
8.
Haryana
0
85
9.
Himachal Pradesh
0
0
10.
Jammu & Kashmir
0
0
11.
Jharkhand
0
0
12.
Karnataka
0
0
13.
Kerala
0
0
14.
Madhya Pradesh
1
1
15.
Maharashtra
33
33
16.
Manipur
0
0
17.
Meghalaya
0
0
18.
Mizoram
0
0
19.
Nagaland
0
0
20.
Odisha
0
0
21.
Punjab
30
6
22.
Rajasthan
124
44
23.
Sikkim
0
0
24.
Tamil Nadu
7
0
25.
Tripura
0
0
26.
Uttarakhand
2
3
27.
Uttar Pradesh
0
2
28.
West Bengal
4
1
29.
A & N. Island
0
0
30.
Chandigarh
0
2
31.
D. & N. Haveli
0
0
32.
Daman & Diu
4
0
33.
Delhi
5
0
34.
Lakshadweep
0
0
35.
Puducherry
0
0
Total
167
190

This information was given by Union Minister of Law & Justice Shri D. V. Sadananda Gowda in a written reply in Lok Sabha today.
Toll free number for TB patients soon, Health Ministry launches ‘Call to Action for TB Free India’
The Union Minister for Health & Family Welfare Shri J. P. Nadda today announced that a toll-free number will be launched soon to reach out to all suspected TB patients for counseling and treatment. Sh. Nadda made this announcement after launching ‘Call to Action for TB Free India’, here today.

“In addition to this number, we will use mobile and other telecommunication tools in an innovative manner in this programme,” added Sh. Nadda.

“We are working on getting the toll free number launched as soon as possible. Currently preparations and training is going on at the state level in this regard,” informed Sh. Nadda. He said the patients would be able to call on this toll free number for any support and information they seek regarding TB. Even a missed call will suffice, the Health Minister informed. Based on the call received, the Ministry team will reach the person who had made the call, check his or her status of TB and ensure the person is covered in the programme to get correct diagnosis, free drugs, treatment and follow-up.

The Health Minister stated that one of the biggest challenges faced by the TB Control Programme is in reaching out to the TB patients. The toll-free services will help the patients to be incorporated in the TB Control Programme. The Health Minister also informed that a massive mass awareness campaign through multi-media campaign will be taken up as part of the Call to Action for a TB Free India. He appealed to various stakeholders across the private sector, civil society members, experts, doctors, patients and caregivers to be part of the movement to make India TB free. The Call to Action is not merely a slogan, Shri Nadda said. It is a movement to galvanise all stakeholders for a common shared commitment.

The Health Minister stated that to achieve the vision of TB Free India, the Ministry will ensure 90% coverage of BCG under the Mission Indradhanush; reach out to the unreached; diagnose all TB cases within two weeks of symptoms and refer to the nearest public health center; employ extensive use of rapid diagnostic kits and active screening of high risk population; and ensure treatment completion. The Minister added that efforts will be made to match international cure rates for MDR and XDR TB. It is important to have a rigorous follow up of treatment and ensure free treatment at the doorsteps, he stated. “We will also encourage research in new drugs and new drug regimes in order to achieve better regimens with shorter duration”, Shri Nadda stated, in addition to promoting indigenous development and manufacturing of diagnostic tests under the “Make in India” programme. Emphasis will be laid on provision of comprehensive healthcare to TB patients. The Ministry will also work out schemes to incentivize patients to help complete therapy, coordinate with other ministries to ensure linking of TB patients and their families to various welfare schemes of the Government so that the earning of these families increase to enable them to have nutritional support which will enhance the immunity status of each member of the family.

Secretary (H&FW) Shri B P Sharma stated that despite the challenges, India has achieved significant success in its TB Control Programme- nearly 2 crore patients have been cured and about 3.2 million lives have been saved. He stated that the “Call to Action” will prove to be catalytic in synergizing efforts of various stakeholders towards a common shared goal.

Also present at the launch function were representatives of WHO, USAID, The Union, STOP TB Partnership, Global TB Program of WHO, the US Embassy and other stakeholders.
MCD gears up to fight malaria
New Delhi, April 23, 2015, DHNS: North Corpn to Begin Weekly Anti-Larvae Drive

Over 5,000 houses were found to be positive for mosquito breeding in the capital, according to a report by the North Delhi Municipal?Corporation. So far, the corporation has served 5,720 legal notices to buildings which were found to be breeding ground for mosquitoes.

The administrative heads of all government offices, educational institutions, commercial establishments and market associations need to be proactive to prevent mosquito breeding, said Praveen Gupta, North Corporation commissioner. The corporation urged people to take extra care in checking of mosquito breeding in offices and residential areas for prevention of dengue and malaria. Breeding of mosquitoes in offices is a serious concern, Gupta said.

Six cases of dengue and three cases of malaria have been reported in the capital this season. No deaths have been reported so far. Last year, there were three dengue deaths here.

The corporation has drawn up a programme of a weekly anti-larvae programme in open where there is stagnant water and through 1,300 engaged domestic breeding checkers in houses. In 90 spots where there was stagnant water, fishes were found by the corporation. To avoid falling prey to malaria, dengue and chikungunya, the corporation has advised citizens to follow basic guidelines.

Coolers are often the greatest breeding ground for mosquitoes in summer. It’s important that coolers be cleaned once a week and mopped dry, petrol or kerosene be put in all coolers that cannot be emptied, water tanks be covered and empty containers be not left in the open.

The corporation is planning to intensify the checks at both official and residential houses.

IMA to sensitise docs

The Indian Medical Association (IMA) will sensitise over 2 lakh doctors on vector-borne diseases like malaria, dengue to spread awareness on the issue.

“All doctors should be equipped with the basic knowledge on how to diagnose malaria and dengue at the earliest. We will send across SMSes and e-mails to sensitise doctors,” said Dr K K Aggarwal, Honorary General Secretary, IMA.
Doctor’s Day Celebrations
Dear Colleagues

1st July is organized every year as DOCTOR’S DAY. In the recently convened 213th meeting of Central Working Committee of IMA, it was resolved that every year IMA would organize mega Blood Donation Camps on 1st July, pan India.

This year also, IMA Hqrs. would request all State/Local Branches to do the following:-
  1. Organize Blood Donation Camps with focus on collecting components so that multiple lives can be saved with each blood donation.
  2. Those who do not want / are unable to donate blood on that day, can be asked to take a pledge regarding their commitment to donate the blood within the next six months. Their name, Blood Group, mobile number and email id can be uploaded on the website of IMA as a committed donor.
  3. To collect data of all patients of Rare Blood Group and post the same on the website of IMA at http://www.ima-india.org/e- connect
IMA intends to cross the mark of 1 lakh blood donation, 1 lakh Pledges, 45 thousand Rare Blood Group Data by 1st July, 2015.

Over a period of time, IMA will be sending all of you standard press releases which can be released periodically in the local press.

We will also be sending you slogans on Blood donation which can be incorporated in your campaigns. Any other Slogan created or selected by the Branch, may be forwarded to IMA Hqrs. for circulation among the other members.

We will also be writing to Limca Book of Records to cover our event in their records.

For details you can contact, Dr. Niranjan Vaidya, Chairman, IMA Blood Donation Standing Committee (Mobile No. 9320442122) or Dr. Rajeev Ardey, Senior Honorary Joint Secretary, IMA HQ (Mobile No. 9810053338) Thanking you and with kind regards,

Yours Sincerely,

Prof Dr A Marthanda Pillai
Padma Shri Awardee
National President, IMA

Prof Dr K K Aggarwal
Padma Shri, Dr BC Roy &
National Science Communication Awardee
President, Heart Care Foundation of India
Honorary Secretary General, IMA
Sonal Namaste
Preventive measures for acute diarrhea among children in resource– limited settings include breastfeeding, consumption of safefood and water, adherence to hygienic practices, and vaccination against rotavirus infection.
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Quote of the Day
Men talk of killing time, while time quietly kills them. Dion Boucicault
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Reader Response
Dear Dr Aggarwal, The anatomical 3rd eye is the pineal gland, and is actually situated centrally in brain. It, too, 'opens' / works only when both regular eyes close! It is the conductor of the body-clock and all body rhythms. Previously thought to be effete, its importance is now supreme, with its melatonin secretion being a life-saver. Dr Hemang D Koppikar, M S Ophthalmology
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eMedi Quiz
Epidermodysplasia veruniciformis is caused by which of the following HPV serotypes:

a.1
b.3
c.5
d.11

Yesterday’s Mind Teaser: During rapid sequence induction of anesthesia:

1. Slick’s maneuver is not required.
2. Pre-oxygenation is mandatory.
3. Suxamethonium is contraindicated.
4. Patient is mechanically ventilated before end tracheal incubation.

Answer for yesterday’s Mind Teaser: 2. Pre-oxygenation is mandatory.

Correct Answers received from: Dr Jainendra Upadhyay, Tukaram Pagad, Dr G Madhusudhan, Dr Avtar Krishan.

Answer for 23rd April Mind Teaser: D. Unusual geographic clustering of disease

Correct Answers received: Daivadheenam Jella, Dr Shangarpawar, Dr Pandit Hantodkar, Dr Poonam Chablani, Dr KV Sarma, Dr K Raju, Dr Madhusudhan G.
IMA Humor
Get me a Battleship

After lunching at the Algonquin Hotel, Robert walked through the lobby, out the front door, and said to the uniformed man on the sidewalk, "My good man, would you please get me a taxi?"

The man immediately took offense and replied indignantly, "I’m not a doorman! I happen to be a rear admiral in the United States Navy."

Robert instantly quipped: "All right then, get me a battleship."
IMA & AIMED sign MoU to promote India manufactured medical devices
  • Under IMA ‘Cure in India’ and “Buy Indian” initiatives, focus on building product credibility, affordability and to enhance user confidence both domestically and internationally
  • MoU to give big push to manufacturing & innovation within India
In an initiative which could be a game changer for India manufactured medical devices while giving a big push to their export, Indian Medical Association (IMA) and Association of Indian Medical device Industry (AIMED) have signed an MoU to promote ‘Cure in India’ and “Buy Indian” initiatives, to encourage use of India manufactured devices in healthcare sector along with Indian medical expertise.

Under the scheme of things, IMA will encourage medical fraternity to go ‘One Step beyond Endorsement’ for India manufactured medical devices which would be approved by IMA based on stringent internationally accepted quality parameters.

As per the MoU, IMA and AIMED will establish joint mechanism to promote Indian medical device industry and under their ‘Cure in India’ and “Buy Indian” initiatives will give users and consumers access to ‘IMA preferred Brands of Safe Indian Medical Devices’ that are affordable.

The move is likely to have a huge positive impact on ‘Make in India’ program while giving a big shot to manufacturing of medical devices within the country.

“This MoU will give a big push to manufacturing and innovation in Indian medical device industry while promoting Indian healthcare sector as a whole,” said Mr Rajiv Nath, forum Coordinator of AIMED. “This initiative will also help reduce the country’s huge import dependency in medical device sector while encouraging exports,” added Mr Nath.

“IMA is committed to providing cost-effective quality health care to the community,” said Padma Shri Awardee Dr A Marthanda Pillai, National President IMA.

"IMA is of the view that for those consumables and devices which are manufactured in India and approved by appropriate authorities, no reimbursement should be given to foreign devices”, said Padma Shri awardee, Dr K K Aggarwal Honorary Secretary General IMA.

Under the joint mechanism, both Associations will soon roll out promotional campaigns to achieve the objectives of this MoU.
Rabies News (Dr A K Gupta)
How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.