November 3   2015, Tuesday
EDITORIAL
Dr KK AggarwalDr KK Aggarwal Laws applicable on Quacks (Part 2)

Allopathic medicine / Modern medicine
Indian Medical Council Act, 1956


Indian Medical Council Act, 1956 (hereinafter referred to as IMC Act) is an act to provide for the reconstitution of the Medical Council of India and the maintenance of a Medical Register for India and for matters connected therewith.

According to Section 2(c) of IMC Act, "council" means the Medical Council of India constituted under this Act.

According to Section 2 (e) of IMC Act, "Indian Medical Register" means the medical register maintained by the Council.

According to Section 2 (g) of IMC Act, "medicine" means modern scientific medicine in all its branches and includes surgery and obstetrics, but does not include veterinary medicine and surgery.

According to Section 2(i) of IMC Act, "recognised medical qualification" means any of the medical qualifications included in the Schedules.

According to Section 2(k) of IMC Act, "State Medical Council" means a medical council constituted under any law for the time being in force in any State regulating the registration of practitioners of medicine.

According to Section 2 (l) of IMC Act, "State Medical Register" means a register maintained under any law for the time being in force in any State regulating the registration of practitioners of medicine.

Section 15 of IMC Act deals with right of persons possessing qualifications in the schedules to be enrolled:

(1) Subject to the other provisions contained in this Act, the medical qualifications included in the Schedules shall be sufficient qualification for enrolment on any State Medical Register.

(2) Save as provided in section 25, no person other than a medical practitioner enrolled on a State Medical Register:-
(a) shall hold office as physician or surgeon or any other office (by whatever designation called) in Government or in any institution maintained by a local or other authority;

(b) shall practice medicine in any State;
(c) shall be entitled to sign or authenticate a medical or fitness certificate or any other certificate required by any law to be signed or authenticated by a duly qualified medical practitioner:
(d) shall be entitled to give evidence at any inquest or in any court of law as an expert under section 45 of the Indian Evidence Act, 1872 on any matter relating to medicine.

(3) Any person who acts in contravention of any provision of sub-section (2) shall be punished with imprisonment for a term which may extend to one year or with fine which may extend to one thousand rupees, or with both.

Section 21 of IMC Act deals with Indian Medical Register:

(1) The Council shall cause to be maintained in the prescribed manner a register of medical practitioners to be known as the Indian Medical Register, which shall contain the names of all persons who are for the time being enrolled on any State Medical Register and who possess any of the recognised medical qualifications.

(2) It shall be the duty of the Registrar of the Council to keep the Indian Medical Register in accordance with the provisions of this Act and of any orders made by the Council, and from time to time to revise the register and publish it in the Gazette of India and in such other manner as may be prescribed.

(3) Such register shall be deemed to be public document within the meaning of the Indian Evidence Act, 1872 and may be proved by a copy published in the Gazette of India.

Section 25 of IMC Act deals with provisional registration which is reproduced hereunder:

(1) A citizen of India possessing a medical qualification granted by a medical institution outside India included in part II of the Third Schedule, who is required to undergo practical training as prescribed under sub section (3) of Section 13, shall, on production of proper evidence that he has been selected for such practical training in an approved institution be entitled to be registered provisionally in a State Medical Register and shall be entitled to practise medicine in the approved institution for the purposes of such training and for no other purpose.

(2) A person who has passed the qualifying examination of any university or Medical Institution in India for the grant of a recognized medical qualification shall be entitled to be registered provisionally in a State Medical Register for the purpose of enabling him to be engaged in employment in a resident medical capacity in any approved institution, or in the Medical Service of the Armed Forces of the Union, and for no other purpose, on production of proper evidence that he has been selected for such employment.

(3) The names of all persons provisionally registered under sub-section (1) or sub-section (2) in the State Medical Register shall be entered therein separately from the names of other persons registered therein.

(4) A person registered provisionally as aforesaid who has completed practical training referred to in sub section (1) or who has been engaged for the prescribed period in employment in a resident medical capacity in any approved institution or in the Medical service of the Armed Forces of the Union, as the case may be, shall be entitled to registration in the State Medical Register under Section 15.

According to Section 27 of IMC Act, subject to the conditions and restrictions laid down in this Act, regarding medical practice by persons possessing certain recognised medical qualifications, every person whose name is for the time being borne on the Indian Medical Register shall be entitled according to his qualifications to practice as a medical practitioner in any part of India and to recover in due course of law in respect of such practice any expenses, charges in respect of medicaments or other appliances, or any fees to which he may be entitled.

In exercise of powers conferred by Sections 4 and 32 of the Indian Medical Council Act, 1956, the Central Government has made Indian Medical Council Rules, 1957.

In exercise of powers conferred by section 33 of the Indian Medical Council Act, 1956, the Medical Council of India with the previous sanction of the Central Government has made the Medical Council of India Regulations, 2002.

Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002

In exercise of powers conferred under Section 20A read with Section 33(m) of the Indian Medical Council Act, 1956, the Medical Council of India, with the previous approval of the Central Government has made the regulations relating to the Professional Conduct, Etiquette and Ethics for registered medical practitioners known as “Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002".

Clause 1 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 deals with Code of Medical Ethics.

According to Clause 1.1.3 of the said Regulations, 2002, no person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council (s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine is not allowed to practice Modern system of Medicine in any form.

According to Clause 7 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 which deals with Misconduct, the following acts of commission or omission on the part of a physician shall constitute professional misconduct rendering him/her liable for disciplinary action:

7.1 Violation of the Regulations: If he/she commits any violation of these Regulations

7.7 Signing Professional Certificates, Reports and other Documents: Registered medical practitioners are in certain cases bound by law to give, or may from time to time be called upon or requested to give certificates, notification, reports and other documents of similar character signed by them in their professional capacity for subsequent use in the courts or for administrative purposes etc. Such documents, among others, include the ones given at Appendix –4. Any registered practitioner who is shown to have signed or given under his name and authority any such certificate, notification, report or document of a similar character which is untrue, misleading or improper, is liable to have his name deleted from the Register.

7.8 A registered medical practitioner shall not contravene the provisions of the Drugs and Cosmetics Act and regulations made there under. Accordingly,
a) Prescribing steroids/ psychotropic drugs when there is no absolute medical indication;
b) Selling Schedule ‘H’ & ‘L’ drugs and poisons to the public except to his patient;

in contravention of the above provisions shall constitute gross professional misconduct on the part of the physician.

Clause 8 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 deals with Punishment and Disciplinary Action.

8.1 It must be clearly understood that the instances of offences and of Professional misconduct which are given above do not constitute and are not intended to constitute a complete list of the infamous acts which calls for disciplinary action, and that by issuing this notice the Medical Council of India and or State Medical Councils are in no way precluded from considering and dealing with any other form of professional misconduct on the part of a registered practitioner. Circumstances may and do arise from time to time in relation to which there may occur questions of professional misconduct which do not come within any of these categories. Every care should be taken that the code is not violated in letter or spirit. In such instances as in all others, the Medical Council of India and/or State Medical Councils have to consider and decide upon the facts brought before the Medical Council of India and/or State Medical Councils.

8.2 It is made clear that any complaint with regard to professional misconduct can be brought before the appropriate Medical Council for Disciplinary action. Upon receipt of any complaint of professional misconduct, the appropriate Medical Council would hold an enquiry and give opportunity to the registered medical practitioner to be heard in person or by pleader. If the medical practitioner is found to be guilty of committing professional misconduct, the appropriate Medical Council may award such punishment as deemed necessary or may direct the removal altogether or for a specified period, from the register of the name of the delinquent registered practitioner. Deletion from the Register shall be widely publicized in local press as well as in the publications of different Medical Associations/ Societies/Bodies.

8.3 In case the punishment of removal from the register is for a limited period, the appropriate Council may also direct that the name so removed shall be restored in the register after the expiry of the period for which the name was ordered to be removed.

8.4 Decision on complaint against delinquent physician shall be taken within a time limit of 6 months.

8.5 During the pendency of the complaint the appropriate Council may restrain the physician from performing the procedure or practice which is under scrutiny.

8.6 Professional incompetence shall be judged by peer group as per guidelines prescribed by Medical Council of India.

Indian Medical Degrees Act, 1916

Indian Medical Degrees Act, 1916 has been enacted to regulate the grant of titles implying qualification in Western medical Science and the assumption and use by unqualified persons of such title.

According to Section 2 of Indian Medical Degrees Act, 1916 “Western medical science” means the western methods of Allopathic Medicine, Obstetrics and Surgery, but does not include the Homeopathic or Ayurvedic or Unani system of medicine and states means all the territories which immediately before the 1st November 1956, were comprised within Part A State, Part C States.

According to Section 3 of Indian Medical Degrees Act, 1961, the right of conferring granting or issuing in the States degrees diplomas, licenses certificates or other documents stating or implying that the holder grantee or recipient thereof qualified to practices western medical science, shall exercise able only by the authorities specified in the schedule and such other authority as the State Government may, by notification in the Office Gazette and subject to such conditions and restrictions as it thinks fit to impose authorize in this behalf.

According to Section 4 of the Indian Medical Degrees Act, 1916, save as provided by section 3 no person in the States shall confer grant or issue or hold himself out as entitled to confer grant or issue any degree, diploma licence certificate or other document, stating or implying that the holder grantee or recipients qualified to practice western medical science.

According to Section 5 of Indian Medical Degrees Act, 1916, whoever contravenes the provisions of section 4 shall be punishable with fine which may extend to one thousand rupees; and if the person so contravening is an association, every member of such association, who knowingly and willfully authorizes or permits the contravention shall be punishable with fine which may extend to five hundred rupees.

According to Section 6 of the Indian Medical Degrees Act, 1916, whoever voluntarily and falsely assume or uses any title or description or any addition to his name implying that he holds a degree, diploma, license or certificate conferred granted for issued by any authority referred to in section 3 or recognized the General Councils of Medical Education of the United Kingdom or that he is qualified to practice western medical science, shall be punishable with fine which may extend to two hundred and fifty rupees, or if the subsequently commits and is convicted of an offence punishable under this section with fine which may extend to five hundred rupees.

Provided that nothing in this section shall apply to the use by any person of any title, description or addition in which Prior to commencement of this Act he used in virtue of any degree, diploma licence or certificate conferred upon or granted or issued to him.

As per the provisions of Indian Medical Council Act, 1956, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 it is opined that only the person who has obtained recognized qualification as per the Schedule appended to the Indian Medical Council Act, 1956 and who has been enrolled in the State Medical Register or Central Medical Register is entitled to practice the modern system of medicine. Any other person who practices modern system of medicine who does not possesses the recognized qualification and who is not enrolled on either State or Central Medical Register shall be punishment with imprisonment and / or with fine…(To be continued)
Breaking news
1st lab-in-a-briefcase for faster cancer detection

Scientists have developed the world's first portable lab-in-a-briefcase that can operate even at high temperatures, to boost early detection of cancer in developing countries. Believed to be the first kit of its kind dedicated to the portable measurement of cancer biomarkers, the concept is the brainchild of Dr Nuno Reis, a lecturer at the Loughborough University in UK, who developed it keeping in mind the lack of adequate technology to support a full laboratory in developing countries.

The lab-in-a-briefcase comprises of four components; a manually driven multi-syringe device capable of performing up to 80 simultaneous tests from whole blood samples at any one time; microwell plates pre-loaded with assay reagents; a portable USB-powered film scanner to image the test strips; and a portable computer for real-time data analysis. The system requires just one operator with minimal training to conduct the test within 15 minutes. One of the remarkable features of the product is that it uses whole blood without the need for any sample preparation —a previously challenging task outside a laboratory... (TOI - PTI)
Dr Good Dr Bad
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Specialty Updates
• People working in well-ventilated offices with below-average levels of indoor pollutants and carbon dioxide function significantly better than those working in offices with typical levels, suggested a new study published in Environmental Health Perspectives. Researchers stated that indoor working environments could adversely affect cognitive function.

• The more insulin there is in the brain, the more dopamine will be released, and this may affect what we choose to eat, suggests new research published in Nature Communications.

• While high-fat diets are considered a primary cause of weight gain, a new study suggests a diet low in soluble fiber may also be a significant culprit. The findings are published in the American Journal of Physiology-Gastrointestinal and Liver Physiology.

• Macrolide antibiotic use during pregnancy does not negatively influence the unborn child's development, suggested a recent study.

• Both traditional cardiovascular (CV) risk factors and elevated disease activity explain the increased incidence of CV events in patients with psoriatic arthritis (PsA), suggests new research published online in Annals of the Rheumatic Diseases.

• Patients with diabetes who underwent surgery were more likely to get infections from the procedures than nondiabetic patients, reported a meta-analysis published in Infection Control & Hospital Epidemiology.

• A subset of patients with chronic obstructive pulmonary disease (COPD) with emphysema appeared to benefit from treatment with an angiotensin receptor blocker - losartan, supporting preclinical evidence of efficacy, suggested a randomized clinical study presented at CHEST 2015.

• New research at the University of Warwick found that cognitive behavioral therapies (CBT) were either moderately or strongly effective in tackling insomnia in patients with long-term pain. Further, chronic pain sufferers reported improved sleep and also experienced a wider positive impact on pain, fatigue and depression. The study was published in the journal Sleep.

•The White House has issued a 187-page report addressed to top officials at 16 federal agencies designed to improve biosafety following a series of safety breaches at federal laboratories charged with handling dangerous pathogens such as anthrax, bird flu, and smallpox.
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Media
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eSPIRITUAL
I want to live after my death

In my workshops, whenever I ask the delegates as to how long they want to live. The answer I get from most of them is 60, 70 or 80 years. While answering they forget that they are only talking about the death of the physical body but what about the mental, social, intellectual and spiritual bodies. It is well known that the soul never dies and so is your Sanskars and good work done. The aim of life should be that one should live even after the death of his or her physical body. It is your good Karmas which keep your memories alive even after your physical death. It is equally true that even your bad Karmas can make you be remembered after death but that is not the purpose of life. We would like to be remembered as Rama and not like Ravana after death.

In Vedic language your present is decided by your past and your future is decided by your present. To improve your future you need to work positive in your present.

When you start working positive in your present moment, you will start neutralizing your bad karmas. It is like washing a dirty shirt which will not become stain free in one washing. With repeated washings only it can become stain free. Similarly washing your bad karmas with good karmas will take time.

It is possible that when one start good Karmas one may still suffer as the sum total of past karmas may not have got neutralized by that time. For example if a dacoit surrenders and wants to live a civilian life he may be pardoned to some extent but may still be jailed for a duration of time. In other word he may be pardoned from death sentence and given life sentence. As per Bhagavad Gita whatever are your thoughts at the time of death will decide the atmosphere you will get in your rebirth. It also says that whatever will be your thoughts throughout your life will be your thoughts at the time of your death. So do not expect that you can acquire positive thoughts at the time of death if you have been thinking negative throughout your life The gist is to start doing good actions in the present.
Legal Quote
Samira Kohli vs Dr. Prabha Manchanda and Anr, SCI, Civil Appeal No. 1949 of 2004, 16.01.2008

“A doctor has to seek and secure the consent of the patient before commencing a ‘treatment’ (the term ‘treatment’ includes surgery also). The consent so obtained should be real and valid, which means that: the patient should have the capacity and competence to consent; his consent should be voluntary; and his consent should be on the basis of adequate information concerning the nature of the treatment procedure, so that he knows what he is consenting to.”
Medicofinance
Estate Planning: Insurance

Insurance policies, such as whole life covers, can be valuable assets that one leaves behind for legal heirs. Whole life insurance plans provide insurance throughout one’s life or up to specified predetermine age. The maximum age of coverage differs from insurer to insurer. The maximum age of expiry for a whole-life policy could be up to 100 years of age. The sum assured is paid out to the nominee on death of insured or to insured the predetermined age. Whole life policy payouts include the death benefits and bonus accrued. As a measure of estate planning, the whole life insurance policy is the best in the insurance stable.

(Source: IJCP)
Industry News
Tech start-ups go for multiple apps to engage users better: Indian technology start-ups are replicating a model that Facebook has successfully built to allow users and partners to engage on multiple apps in order to retain customers within its environment. E-commerce company Snapdeal has five apps, each targeted at a different set of users but interconnected with its marketplace. Similarly, hotel room aggregator Oyo Rooms and realty portal Commonfloor have four apps each. Facebook has multiple apps such as Messenger, Pages and Groups which break away functionalities from its social network... (Business Standard- Anita Babu and Alnoor Peermohamed)

Why start-ups are partnering with rivals for non-core activities: Not long ago, most HR departments handled all activities from recruitment to training and handling concerns about employee benefits, salary and more. Most companies handled it in-house. But things have changed over the years. For instance, with the IT revolution, companies have started to outsource non-core activities like HR and payroll, to remain focused on their core areas of IT infrastructure and product innovations. It is critical for companies to concentrate on their core competency and identify non-core activities which can be handled by a third party. (The Financial Express- Prabhu Mallikarjunan)

India world's 7th most valued 'nation brand': India has moved up one position to become the world's seventh most valued 'nation brand', with an increase of 32 per cent in its brand value to USD 2.1 billion. The US remains on the top with a valuation of USD 19.7 billion, followed by China and Germany at the second and the third positions respectively, as per the annual report on world's most valuable nation brands compiled by Brand Finance. However, the surge of 32 per cent in India's 'nation brand value' is the highest among all the top-20 countries on the list (Deccan herald – PTI)

T-Hub promises to assist start-ups: ‘Catalyst’, the first building in the city to house Telangana Hub or T-Hub on IIIT-Hyderabad campus, is a sprawling 70,000 square-foot structure. It promises to provide assistance to 400 entities at various stages of incubation. Those start-ups screened by the T-Hub committee will be allowed to use the space and amenities like high-speed internet, at a nominal cost, IT Minister K.T. Rama Rao said on Friday, a week before industrialist Ratan Tata inaugurates it. (The Hindu)
Inspirational Story
Mother’s Day

A man stopped at a flower shop to order some flowers to be wired to his mother who lived two hundred miles away. As he got out of his car he noticed a young girl sitting on the curb sobbing. He asked her what was wrong and she replied, “I wanted to buy a red rose for my mother and I don’t have enough money.” The man smiled and said, “Come on in with me. I’ll buy you a rose.” He bought the little girl her rose and ordered his own mother’s flowers. As they were leaving he offered the girl a ride home. She said, “Yes, please! You can take me to my mother.” She directed him to a cemetery, where she placed the rose on a freshly dug grave. The man returned to the flower shop, canceled the wire order, picked up a bouquet and drove the two hundred miles to his mother’s house.
eWELLNESS
Have Leg Artery Blockages? Walk on a Treadmill

A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD). Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with PAD published in JAMA showed that regular six-minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six-minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet.

There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it.

Such exercise leads to improvement in "collateral circulation" i.e. growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program.

Walking is a standard recommendation for people with PAD. A recommended regimen is a 40-minute walk three times a week for at least six months. Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm
eMEDIPICS
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Cardiology - Yesterday, Today & Tomorrow - A CME was organized by IMA HQs on World Heart Day at IMA House, New Delhi
eMEDI QUIZ
A 30-year-old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:

1. Medial rectus and superior division of oculomotor nerve.
2. Inferior oblique and inferior division of oculomotor nerve.
3. Lateral rectus and abducent nerve.
4. Superior rectus and trochlear nerve

Yesterday’s Mind Teaser: A lesion of ventrolateral part of spinal cord will lead to loss (below the level of lesion) of:

1. Pain sensation on the ipsilateral side.
2. Proprioception on the contralateral side.
3. Pain sensation on the contralateral side.
4. Propriception on the ipsilateral side.

Answer for Yesterday’s Mind Teaser: 3. Pain sensation on the contralateral side.

Answers received from: Dr Arvind jain, Dr Bitaan Sen & Dr Jayashree Sen, Dr Poonam Chablani, Dr Jainendra Upadhyay, Raju Kuppusamy, Daivadheenam Jella, Dr Avtar Krishan, Dr Jainendra Upadhyay.

Answer for 1st November Mind Teaser: 2.Hypovolemia.

Answers received from: Dr Poonam Chablani, Dr Thakor Hitendrsinh G, Dr Avtar Krishan.
MTNL Perfect Health Mela 2015.
Pls click here for details
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Humor
There was this man driving along in his car when he suddenly got a flat tire. When he pulled over he was at the fence of a mental hospital. When he got out of the car one of the patients came to the fence and asked "Can I help you?" And the man said "No, I need to figure out how to make it home with only 2 lugs on this wheel." The patient asked again "Are you sure you do not need any help?" And the man said "No." The man tried to figure it out when all of a sudden the patient said "If I were you I would take one lug off the other 3 wheels and put them on that wheel and you should be able to get home." The man asked "How did you think of that?" The patient replied "I am in here because I'm crazy not because I'm stupid."
BIOETHICAL ISSUES IN MEDICAL PRACTICE
Right to refuse treatment

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

In India, going on protest fasts is a recognized method of registering opposition to several public issues- from AFSPA to reservations and pensions. Indian law permits force feeding of protesters.

a) While correct in law, is this ethically proper?

b) What alternatives should the State follow, if force feeding is not permissible?

Do write in with views and your solutions!
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Breaking news
NPPA caps prices of 18 formulations packs

Pharmaceutical pricing authority National Pharmaceutical Pricing Authority (NPPA) has capped prices of 18 formulations packs, including anti-diabetic Metformin HCl tablets, anti-bacterial Ceftriaxone Sodium injection packs and devices among others. The prices have also been fixed/revised for hormone releasing IUD, ondansetron HCl orally disintegrating strip, Metformin HCl tablets, Cefaclass injection pack among others.

The prices of the 18 formulation packs have been fixed/revised under the Drug Price Control Order (DPCO), 2013, the NPPA said in a statement. Drug firms such as Cipla Ltd, Alembic Pharmaceuticals Ltd and Unichem Laboratories Ltd will be impacted by the government’s move for prices fixation and revision. At present, the government caps prices of essential drugs based on the simple average of all medicines in a particular therapeutic segment with sales of more than 1%. In case of nonscheduled formulations companies are allowed to hike prices of medicines by only up to 10% in a year. The government had notified DPCO, 2013, which covers 680 formulations, effective 15 May 2014, replacing the 1995 order that regulated only 74 bulk drugs. (PTI)
MAKE SURE
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Indian Medical Association National Satyagraha for a Healthy India
IMA Digital TV
IMA Satyagraha, suggested slogans
• Writing prescription drugs by a non-MBBS is injurious to health of the community.
• Writing prescription drugs by unqualified people can be dangerous.
• Allow doctors to treat patients irrespective of patients’ income. (If compensation is not capped, we can't do this)
• When there is capping of Rs 2 lakh for a sterilization death, why not for other procedures?
• When there is a compensation of Rs 30,000/- for a sterilization failure, why not for other procedures?
• Allow us to treat poor and rich equally.
• Non pelvic ultrasound providers should be out of PCPNDT Act.
• Unless caught doing sex determination, no criminal offence shall be registered.
• If any prospective parent asks for sex determination, they should be booked under a non bailable offense.
• More patients will die if doctors are not provided protection during duty hours.
• Death does not mean negligence.
• Money spent does not mean you will get a cure.
• Including single clinic and small establishments under Clinical Establishment Act will make treatment costly.
• How can we treat patients using outdated standard treatment guidelines made by government?
• How can government decide the charges of a clinical establishment?
75 major cities and state capitals to be rated for sanitation with focus on solid waste management

Ministry of Urban Development has commissioned a survey of sanitation scenario in 75 major cities including 53 with a population of above 10 lakhs each and state capitals. This is the first such survey since the launch of Swachh Bharat Mission in October, 2014. The survey parameters have been aligned with the objectives of Swachh Bharat Mission with more focus on solid waste management which is adversely impacting cleanliness in urban areas, as per the direction of Minister of Urban Development Shri M.Venkaiah Naidu. The proposed survey and subsequent ratings to be completed in January next year is aimed at fostering a spirit of competition among the major cities and state capitals in 29 states and Chandigarh to ensure sanitation in urban areas.

In the proposed survey for rating of 75 major cities accounting for over 50% of country’s total urban population, solid waste management is being given 60% weightage followed by 15% each for availability and use of household individual toilets and public and community toilets besides 5% each for city level sanitation plans and Information, Education and Behaviour Change Communication (IEBC) activities. Under Swachh Bharat Mission, about Rs.37,000 cr of the project cost of Rs.62,009 cr is to be incurred on solid waste management. In the last survey for ranking of 476 cities with a population of above one lakh each which was commissioned before the launch of Swachh Bharat Mission across the country, solid waste management had a weightage of only 13%. Swachh Bharat Mission is aimed at ensuring door-to-door collection, transportation and scientific disposal of municipal solid waste in all the 83,000 wards in urban areas by 2019 besides construction of one crore household individual toilets and over five lakh public and community toilet seats…(PIB)
Environment ministry launches new website on national clean development mechanism authority

A new website - http://www.ncdmaindia.gov.in has been launched by the National Clean Development Mechanism Authority (NCDMA) in the Ministry of Environment, Forests and Climate Change. The new website, launched last Friday, will capture the entire life cycle of CDM Projects. With step, the Ministry has taken another step in applying the principles of e-governance. The on-line uploading of project related information in a module wise pattern will help to capture the entire life cycle of CDM projects. It will also enable monitoring of the projects at different stages. This web-based application will promote transparency in operation and monitor sustainable development activities relating to the CDM projects in the country. It will be the first such web-based application developed globally in this direction… (PIB)
Existing cuts not enough to curb rising temperature

UN report seeks emission reduction effort by 2025- 30

The voluntary emission cuts promised by the world could be insufficient to keep the temperature rise by two degree Celsius as recommended by the Inter-Governmental Panel on Climate Change, a new UN report suggested. The report on intended national determined contributions (INDC) – released on Thursday – will trigger backroom negotiations to decide further cuts in the run up to the Paris climate summit… (Deccan Herald)
PEP treatment given within 8 hours, can help prevent HIV contraction in rape victims

Rape victims can be prevented from contracting an HIV infection if a ‘post-exposure prophylaxis’ (PEP) treatment is given to them within eight hours of the sexual assault, a medical expert has claimed. However, the treatment, which can prove to be life-saving for victims of sexual assault, is neither mandated nor is provided in India due to lack of awareness, AIDS Society of India (ASI) President Dr Ishwar Gilada told PTI. “In cases of rape, along with legal aid a treatment of post-exposure prophylaxis should be immediately given to sexual assault victims. This will cut down the chances of infection to 100 per cent,” Gilada said. (Indian Express – PTI)
Indian medical tourism industry to touch $8 billion by 2020

New Delhi: As healthcare turns costlier in developed countries, India's medical tourism market is expected to more than double in size from USD 3 billion at present to around USD 8 billion by 2020, a report says. According to a CII - Grant Thornton white paper, cost is a major driver for nearly 80 per cent of medical tourists across the globe. The cost-consciousness factor and availability of accredited facilities have led to emergence of several global medical tourism corridors - Singapore, Thailand, India, Malaysia, Taiwan, Mexico and Costa Rica. "Amongst these corridors of health, India has the second largest number of accredited facilities (after Thailand). The Indian Medical Tourism market is expected to grow from its current size of USD 3 billion to USD 7-8 billion by 2020," Grant Thornton India's National Managing Partner Vishesh C Chandiok said… (ET Healthworld – PTI)
India ranks 103rd in the list of healthiest countries of the world

Singapore has been declared as the world's healthiest country in a recent reports with India securing the 103rd position. The list ranked the countries with the help of the data from the United Nations, the World Bank and the World Health Organization. In order to identify the healthiest countries in the world the Bloomberg Rankings created health score and health risk scores with populations of at least 1 million, reports the Independent. The ratings were given depending on factors such as birth, mortality rates and cause of death. Health risks are based on factors such as number of young people who smoke, people suffering from high cholesterol and number of immunization Singapore receives an overall grade of 89.45%. Italy is in second place with 89.07%, while Australia comes third with 88.33%. India ranked 103rd with an overall score of 22.17%... (India Today)
ISB to launch one-year program for doctors, healthcare professionals

The Indian School of Business (ISB), with campuses in Mohali and Hyderabad, is all set to launch a healthcare management programme (HMP) for doctors and healthcare professionals. The one year part-time programme, which will commence in January 2016, has been designed and developed by the Max Institute of Healthcare Management and the Centre for Executive Education at the ISB, it said in a statement… (ET Healthworld – PTI)
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GP Tip: Tremor in Graves’ disease

Placing a sheet of paper on the patient’s outstretched palms provides helpful information. This “paper shaker” phenomenon illustrates tremor more clearly than does viewing the hands alone

(Source: IJCP)
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Experts have noted that medical ethics and human rights subjects should be taught as obligatory and examined parts of the curriculum

Medical professionals from all across the globe insisted during the General Assembly of the World Medical Association last month on the immediate need to revise medical school curricula to include subjects on medical ethics and human rights.Given that medical school curriculum plays an intrinsicrole in determining what kind of doctors the students will be in the future, an extra emphasis on ethics and human rights must be made.

Towards this aim, the Indian Medical Association will also be holding a training workshop for the 5000 medical students expected to attend Heart Care Foundation of India’s annual flagship event, the 22nd MTNL Perfect Health Mela. The five day event will take place from November 4-8, 2015 at the Talkatora Indoor Stadium in New Delhi.

Speaking on this, Padma Shri Awardee Dr. A Marthanda Pillai – National President IMA and Padma Shri Awardee Dr. KK Aggarwal, President HCFI & Honorary General Secretary of IMA said,“As opposed to hardcore medical knowledge of the human body and its functioning, physicians should also understand the social, cultural and environmental contexts whithin which they will practice. This requiresa solid understanding of the social determinants of health. Broadly speaking, medical ethics include the social contract made between the health care professions and the societies they serve. These ethics are based upon established principles governingthe limits that apply to medical practice. Medical ethics, the duties of physicians to patients, and the rights patients enjoy as citizens make up for a complex structure.“

“Physicians are looked up to as idols and this places a responsibility on them for improving the wellbeing and health of patients and the population. But they will only be able to fulfill their role effectively and efficiently if they considerfactors like social and societal change, including legislation and regulation. A holistic view, which encompasses clinical and ethical parameters, will be able to support the doctors’ role in the society. And for this, physicians should appeal government to ensure that the existing legislations support the principled medical practice, " Dr. KK Aggarwal added.

Health care ethics should be fined tuned in accordance with the standards that are acceptable to the society, ones that do not violate civil,political and other human rights. To achieve coherence, it is essential that all physicians be trained to perform an ethics evaluation of every clinical scenario they may encounter. It doesn’t matter what the situation maybe,they should never sideline understanding the prominence of their role in protecting the rights of individuals.

A few changes that need to be made in this direction are that medical ethics and human rights be taught at every medical school as obligatory and examined parts of the curriculum. Secondly, medical schools should seek to ensure that they have sufficient faculty skilled at teaching ethical enquiry and human rights to make these courses sustainable. These two essentials will help the physicians to understand their profession better and grow in a holistic learning environment.
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