February 6  2015, Friday
editorial
To screen or not to screen all young athletes with ECG to discover problems hiding within the heart
Dr KK Aggarwal Guidelines from the American Heart Association (AHA) (endorsed by the American College of Cardiology) and the European Society of Cardiology (ESC), both recommend a screening before sports participation, but the Americans favor a detailed medical history combined with a physical examination only, while the Europeans favor the addition of the 12–lead ECG.

The controversy was evident in the results of a poll conducted during a debate session at the AHA meeting last year, which were published this week in the New England Journal of Medicine by James Colbert, MD, of Harvard Medical School.

Of the audience members who voted –– an unscientific sample, to be sure –– 70% favored some type of screening for cardiac disease in young athletes. And in a scenario where screening was already a foregone conclusion, 60% said it should include an ECG. A similar online poll on the NEJM website was even more informative, showing that the differences in opinion exist on both sides of the Atlantic.

Of the 1,266 people who voted on the site –– again, not a scientific sample –– 18% did not want any mandatory screening, 24% wanted screening with a medical history and physical exam and 58% favored screening that included an ECG. The percentage of voters who endorsed an ECG was higher among Europeans than among Americans (66% versus 45%), but that still indicates a substantial amount of controversy regardless of geography.
eMedipics

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IMA White Paper on Cancer Prevention
News Around the Globe
  • Paramedics may be first line of treatment for stroke: A study from NIH designed to test the benefits of early administration of magnesium sulfate suggests that stroke patients may not have to wait until they get to the hospital for treatment — paramedics may be able to start therapy as soon as stroke is suspected. Although the drug did not improve outcome in stroke patients, the study demonstrated the feasibility of early therapy in the ambulance. The results were published in the New England Journal of Medicine.
  • In December 2014, visitors to Disneyland and the Disney California Adventure in Anaheim were exposed to measles, also known as rubeola. One of the most infectious diseases in humans, the airborne illness spread to 102 people across 14 states between Jan. 1 and Jan. 30, 2015. Once an “eliminated” disease, measles is making a comeback due in part to declining vaccination rates. Health officials continue to recommend that children, unless immunocompromised, get vaccinated, and that adults check with their doctor if they're unsure about whether they are vaccinated for measles. Anne S MD director of the CDC's National Center for Immunization and Respiratory Diseases, told reporters on a conference call that 84 people in 14 states have been diagnosed with measles so far in 2015 and, of them, 67 are linked to the Disneyland outbreak.
  • Clinicians should treat allergic rhinitis with intranasal steroids when patients' symptoms impair their quality of life, suggest clinical practice guidelines published February 2 in Otolaryngology–Head and Neck Surgery. The guidelines also suggest that clinicians should recommend second-generation oral antihistamines for patients complaining primarily of sneezing and itching.
  • For patients with severe trauma and major bleeding, transfusion of plasma, platelets and red blood cells in a balanced 1:1:1 ratio seems superior to a 1:1:2 ratio for reducing death due to hemorrhage, reported a new trial sponsored by the U.S. Department of Defense and the National Institutes of Health. The report is published February 3 in JAMA.
  • The US Food and Drug Administration (FDA) has granted accelerated approval to palbociclib, a new drug for the treatment of breast cancer with a novel mechanism of action. The drug is indicated for use with the aromatase inhibitor letrozole as first-line treatment in postmenopausal women with metastatic breast cancer that is estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative.
  • Antiviral prophylaxis with valganciclovir in living kidney donors may reduce transmission of cytomegalovirus (CMV) and Epstein-Barr virus (EBV), suggests a pilot study published online in Transplantation.
Dr KK Spiritual Blog
What do you mean by ‘food is Brahman’?

‘Food is Brahman’ is a Vedic Upanishad and Bhagavad Gita saying.

Brahma is consciousness, therefore, food is consciousness. Though the traditional Vedic teaching has been that consciousness is present in everything and yet only food is considered Brahman. It is never said that a stone is Brahman or a dog is Brahman.

As per Chandogya Upanishad (6.15.1) at the time of death, our Vak Vritti (motor senses) merges into Karm Indriyas or manovritti (sensory senses, mind, intellect, ego and memory) and that now merges with Prana (Udana Vayu) and finally this merges into Tejas which leaves the body to merge into the Sat.
Vak Vritti, Manovritti and Prana Vritti, in the form of vibrations in the atmosphere, come back through rain and are taken by the plants to become plant consciousness.

Therefore, as per Chandogya Upanishad, the consciousness of the Brahman moves from human to plants and plants to human.

The plant food once eaten and absorbed enters into the human body and ultimately makes Prana, Tejas, Ojas, Sperms and Ova. Through Sperm and Ova, it enters into the next life.

If this theory is correct, then food makes the consciousness and consciousness makes food. This also further proves that vegetarian food, as it is full of Brahman creating a satvik mind and takes one towards spirituality.

Tamsik food, which is dead and devoid of consciousness does not lead to a healthy mind as it may produce Mal (waste) or make flesh but will not make essence.

As per Chandogya Upanishad, fiery food makes Karma Indriyas, earthy food makes Gnan Indriyas and Water in food makes Prana.

It further emphasizes on the fact that one should eat freshly cut fruits and vegetables as far as possible as life or consciousness in them can only stay for some time (as per Jainism up to 48 minutes).
IMA,IJCP,HCFI
Cardiology eMedinewS
  • Baseline and serial measures of high-sensitivity cardiac troponin T (hs-TnT) predict incident atrial fibrillation independently of traditional risk factors, suggests a new analysis from the Cardiovascular Health Study (CHS), published online in Heart Rhythm.
  • A large study reports that one in nine patients hospitalized with heart failure received not only diuretics in their first 2 days of hospitalization but also IV fluids. Additionally, patients who received IV fluids were more likely to later be admitted to critical care, be intubated, have renal-replacement therapy, or die in the hospital. The study is published in the February 2015 issue of JACC: Heart Failure.
Pediatrics eMedinewS
  • In children with comorbid conditions, invasive pneumococcal disease causes higher morbidity and mortality, reported a surveillance study published online in Pediatrics.
  • Pregnancy outcomes for kidney recipients are similar whether the transplant was done in childhood or adulthood, suggests a new study published online in JAMA Pediatrics.
Make Sure
Situation: A patient with rheumatoid arthritis was not responding.
Reaction: Oh my God! Why was smoking not stopped?
Lesson: Make sure that all patients of RA stop smoking. It is a major preventable factor contributing to the development of antibody–positive rheumatoid arthritis in genetically susceptible individuals.
Event
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Media
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Medicolegal
(Contributed by Dr MC Gupta, Advocate)

Q: I had a query and then I saw you who knows about the law. Would you mind telling me few rules about Govt. jobs? I have applied for job in medical college. But I am confused if I can resign from it easily if I don’t feel like continuing with it. Few of my colleagues have told me that it’s tough to get into Govt. job and even tougher to get out of it as the Govt. does not let you go even if you want to resign. Can you tell me how far this is true?

A.
Rules about government jobs are as follows:
  • Just as "God helps those who help themselves", the Govt. tends to give jobs to those who can write good English.
  • Getting in is difficult. Many people would gain by preventing the entry. Getting out is easy. Many people would gain by facilitating the exit.
  • Bonded labour is unconstitutional. Nobody can be made to work forcibly. I have resigned five jobs, including that of an army officer.
  • It is better (and more sensible) to get a job and then resign rather than not get a job because it would be difficult to resign. Of course, the more sensible thing would be to seek a job that one likes and to not think of resigning even before getting the job.
Dr Good Dr Bad

Situation: A patient came with classical benign postural vertigo.
Dr Bad: Take these drugs
Dr Good: Do Epley maneuver.
Lesson: Epley maneuver in most situations can cure benign postural vertigo.

(Copyright IJCP)
IJCP Book of Medical Records
IJCP’s ejournals
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Inspirational Story
The Brilliance of Mahatma Gandhi

When Mahatma Gandhi was studying law at the University College of London, there was a professor, whose last name was Peters, who felt an animosity for Gandhi, and because Gandhi never lowered his head towards him, their "arguments" were very common.

One day, Mr. Peters was having lunch at the dining room of the University and Gandhi came along with his tray and sat next to the professor. The professor, in his arrogance, said, "Mr Gandhi: you do not understand… a pig and a bird do not sit together to eat", to which Gandhi replies, "You do not worry professor, I’ll fly away", and he went and sat at another table.

Mr. Peters, green of rage, decides to take revenge on the next test, but Gandhi responds brilliantly to all questions. Then, Mr. Peters asked him the following question, "Mr Gandhi, if you are walking down the street and find a package, and within it there is a bag of wisdom and another bag with a lot of money; which one will you take?"

Without hesitating, Gandhi responded, "the one with the money, of course".

Mr. Peters, smiling, said, "I, in your place, would have taken the wisdom, don’t you think?"

"Each one take what one doesn’t have", responded Gandhi indifferently.

Mr. Peters, already hysterical, writes on the exam sheet the word "idiot" and gives it to Gandhi. Gandhi takes the exam sheet and sits down. A few minutes later, Gandhi goes to the professor and says, "Mr. Peters, you signed the sheet, but you did not give me my grade".
eMedinewS Humor
Visiting a barber

A man enters a barber shop for a shave. While the barber is foaming him up, he mentions the problems he has getting a close shave around the cheeks.

"I have just the thing," says the barber taking a small wooden ball from a nearby drawer. "Just place this between your cheek and gum."

The client places the ball in his mouth and the barber proceeds with the closest shave the man has ever experienced. After a few strokes the client asks in garbled speech.

"And what if I swallow it?"

"No problem," says the barber. "Just bring it back tomorrow like everyone else does."
Wellness Blog
Low cholesterol linked to anxiety, depression, suicide, hemorrhagic stroke and cancers

People with very low cholesterol levels are at increased risk of developing stomach cancer, according to a study published in the International Journal of Cancer.

The study involved 2,600 residents of Hisayama, Japan, who were followed for 14 years. Gastric cancers developed in 97 subjects. After accounting for age and gender, stomach cancer rates rose significantly with descending cholesterol level. For example, among subjects with the highest cholesterol levels, the gastric cancer rate was the equivalent of 2.1 cases per 1000 persons per year; among those with the lowest cholesterol, the rate was 3.9 per 1000 persons per year.

Patients with low serum cholesterol should consider periodic gastrointestinal examination for the prevention of stomach cancer.

Low cholesterol has been earlier linked to depression, anxiety and suicide in both men and women. Another earlier report has also shown that people with cholesterol level below 180 had twice the risk of brain hemorrhage as compared to those with cholesterol levels of 230.
Twitter of the Day
Dr KK Aggarwal: Diabetic drug metformin may have anti cancer effects http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Your subjective world of thoughts emotions memories & desires is as real as the world outside with stars & galaxies http://bit.ly/15QdVeB #Health
CPR 10
Total CPR since 1st November 2012 – 101090 trained
eMedi Quiz
An anxious mother brought her 4 year old daughter to the pediatrician. The girl was passing loose bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered the stool examination which showed the following organisms. Identify the organism:

1. Entamoeba histolytica
2. Giardia lamblia
3. Cryptosporidium
4. E. coli

Yesterday’s Mind Teaser: Haemorrhage secondary to heparin administration can be best corrected by administration of:

1. Vitamin K.
2. Whole blood.
3. Protamine.
4. Ascorbic acid.

Answer for yesterday’s Mind Teaser: 2. Whole blood.
Correct Answers received from: Dr Jayshree, Dr Mirnal, Dr Kartik, Dr Shrey.
Answer for 4th Feb Mind Teaser: 3. Atherosclerosis.
Correct Answers receives: Daivadheenam Jella, Dr Jainendra Upadhyay.
Quote of the Day
It does not matter how slowly you go as long as you do not stop. Confucius
Reader Response
Dear Sir, Very informative newspaper. Regards: Dr Kapila
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
ESIC to close medical colleges, fate of 1379 medicos at stake
Economics Times: The Joint Action Committee of ESIC Chapter of Young Doctors and Student wing of IMA said that no political party has given any assurance or commitment to solve this problem, so, they along with their well wishers will be forced to press NOTA (none of the above) in the coming Delhi Election.

New Delhi, 5th Feb: The future of 1,379 medical, dental and nursing students studying in ESIC (Employee's State Insurance Corporation) colleges all over the country is in the dark in view of the ESIC's unilateral decision of closing medical, dental and nursing colleges run by them.

" On one hand, the Govt. of India is concerned about the shortage of medical, dental and nursing colleges in the country but on the other hand, it is turning a deaf ear and allowing ESIC administration to close these colleges" said Dr A. Marthanda Pillai, National President and Dr K K Aggarwal, Hony. Secretary General IMA in a press statement here today.

Dr. M. C. Prabhakar, Chairman, Young Doctors' Wing and Dr. Yathu Thulaseedharan Pillai, Chairman, IMA Students' Wing of IMA in a joint statement said that "our appeal to Hon'ble President of India, Prime Minister of India, Health Minister of India and Labour Minister of India has not been reverted."

The Joint Action Committee of ESIC Chapter of Young Doctors and Student wing of IMA said that no political party has given any assurance or commitment to solve this problem, so they along with their well wishers will be forced to press NOTA (none of the above) in the coming Delhi Election to be held on 7th Feb' 2015 and also in subsequent elections due in the country.

It is unfortunate that none of the political parties have raised this issue in their election manifesto so far. If no assurance is received, over 5000 well wishers of ESIC students will start a "Satyagrah" in New Delhi, said Chander Mohan, Dr Sameeksha Chand, Dr Wasim Ahmad, Vanga Ashwita Siri and Priyanjali, of the Joint Action Committee.
Rabies News (Dr A K Gupta)
What is the potency requirement of IDRV?

Only three countries are practicing IDRV in regular patients attending regular anti–rabies clinics (ARCs) for more than 10 years. These countries are Thailand, Philippines and Sri Lanka.

In Thailand and Sri Lanka, the potency requirement is 0.7 IU/ID dose and in Philippines it is 0.5 IU/ID dose.
IMA NEWS
Drug Today Medical Times: IMA releases white paper on cancer prevention

BS Rawat: New Delhi 4 Feb 2015

To mark World Cancer Day today, the Indian Medical Association (IMA) released a white paper on the incidence of cancer in the country and the preventive measures it has taken to counter the deadly disease.

The white paper compiled by Dr KK Aggarwal, the IMA Secretary General, explains what the disease is and what preventive measures should be taken to check it. An advisory issued on the occasion termed cancer as preventable and curable provided it is detected an early stage. As per the white paper, most cancers can be prevented with healthy lifestyle.

India reports about one million new cases of cancer every year, which is 15 per cent less than that of the US. The disturbing fact is the number of cases is predicted to double in 20 years, IMA said.

Speaking to DTMT, Delhi State Cancer Institutes, director Prof RK Grover said, “A majority of India's cancer patients are between 30 and 69 years of age. Something else seems to be at work that is adding to lifestyle habit like smoking. But we do know the disease affects everybody." Honorary secretary general Dr KK Aggarwal said, “With early detection and better therapies, more and more cancer will be cured or better managed. The costs, however, are not easy to manage.”

The white paper lists nine warning signals of cancer including unusual bleeding, lump, nodule or swelling, ulcer or wound anywhere in the body that does not heal, obviously change in shape, size or appearance of a wart or mole etc. IMA claimed that tobacco is responsible for 90 per cent of all lung cancer deaths, red meat consumption may promote colorectal cancer, high intake of tomatoes probably decreases prostate cancer risk.
About the Editor

Padma Shri, National Science Communication and Dr B C Roy National Awardee, Honorary Secretary General IMA, Immediate Past Senior National Vice President IMA, Professor of Bioethics SRM University, Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand, President Heart Care Foundation of India, Chairman Legal Cell Indian Academy of Echocardiography, Editor in Chief IJCP Group of Publications & eMedinewS, Member Ethics Committee Medical Council of India (2013-14), Chairman Ethical Committee Delhi Medical Council (2009-14), Elected Member Delhi Medical Council (2004-2009), Chairman IMSA Delhi Chapter (March 10- March13), Director IMA AKN Sinha Institute (08-09), Finance Secretary IMA (07-08), Chairman IMAAMS (06-07), President Delhi Medical Association (05-06)
IMA NEWS
IMA Cure in India Initiative

‘Cure in India’: An Integrated Effort to make India a Preferred Healthcare Destination

India as a medical tourism destination has been in though and action for almost a decade now and has even created a few pockets of success. While all the providers are busy creating their own niche, there a need for an integrated and uniform approach at national level for the world to acknowledge India as a more economical and trusted healthcare delivery destination.

‘Cure in India’ aims to be an international movement which gathers momentum by unidirectional channelization of efforts currently being made by several clinical care institutions and government and non-government institutions. ‘Cure in India’ initiative aims to place India in a leadership position with best comparable international standard clinical outcomes for medical care and best suited tropical destinations of India for wellness and rejuvenation.

Cure in India positions itself uniquely with a winning edge for both, India as well as the other participating nations by helping them benefit through:
  1. Economising medical insurance claim ratio for nations with high healthcare costs
  2. Reducing waiting time for advanced surgical treatments
  3. Opportunity to establish care delivery centres in India to leverage lower operating costs
It is not only cost*(Annexure-1) that makes India a lucrative medical tourism destination. Many Indian doctors have studied or worked abroad, and most hospitals are accredited by the National Accreditation Board for Hospitals (NABH) or the Joint Commission International (JCI), ensuring that they are safe and follow international standards.

Moreover, India’s medical tourism industry benefits from government support. Foreign tourists availing medical treatments in the country are now exempted from its standard two-month gap before re-entry. The only requirement is that the patients supply a detailed itinerary and proper supporting documentation.

A large number of healthcare facilities focused on medical tourism are being established. The Kerala state government is establishing a medical-education city, in association with private developers. This will feature a super-specialty hospital, a diagnostic center and a wellness center, offering treatment in traditional systems of medical care, to cater to foreign patients. - KPMG

The initiative would need support from government by creating an apex body and bring supporting regulatory changes. While India would have to offer sops to international healthcare delivery and wellness organisations and professional, the participating nations will have to ease medical insurance norms and allow claims to be settled for treatment in approved provider organisations. Wellness, however should be actively be offered as part of tourism to India.

The initiative has the potential to rope in the international medical equipment manufacturers through ‘Make in India’ initiative. Tax benefits to international manufacturers of medical and diagnostic equipments can encourage production in India, thereby easing out a major challenge of adoption of newer technologies by reducing costs.

The essential IT support required to build this bridge among the participating nations is already available in India and come at a decent cost advantage compared to Americas and Europe.

A joint action from government and the medical fraternity leadership would be the key to make ‘Cure in India’ a globally recognised initiative for people and governments around the world.

The medical tourism market in India is projected to hit US$ 3.9 billion mark this year having grown at a compounded annual growth rate (CAGR) of 27 per cent over the last three years, according to a joint report by consultancy firm KPMG and an industry body. The report says inflow of medical tourists is expected to cross 320 million by 2015 (Source: http://indiainbusiness.nic.in)

While the trends have been encouraging so far, a special effort like ‘Cure in India’ would be required to build competitive edge over countries like Thailand, Singapore, South Africa, South Korea, Dubai and Taiwan to remain, and become most preferred healing destination.

ANNEXURE-I
Cost Comparison - India Vs Other Countries
 
 
 
 
 
 
 
Sr. No
 
Procedure
 
India
U. S
U.K
Singa-
pore
Mala-
ysia
Thail-
and
In US $
In US $
In US $
In US $
In US $
In US $
1
Coronary Angioplasty
8000
+
stent
57000
52000
13000
12000
13000
2
CABG Package
8900
70000 to 1,33,000
90000
17000
13100
23500
3
MVR
(Mitral Valve
Replace-
ment)
Surgery
10000
+
Valve
75,000 to 1,40,000
95000
23500
15000
25000
4
Total 'Knee
Replace-
ment
6700
+
implants
45000
37000
10500
13000
12000
5
Hip Replace-
ment
6700
+
implants
45000
35000
13000
9000
12700
6
Kidney Transplant
19000
65000
76000
38000
32000
37000
7
Shoulder Replace-
ment
6700
+
implants
45000
37000
13000
10000
12700
8
Spine
Surgery
10500
40000
37000
18500
14000
15000
9
Bone
Marrow
Transplant
40000
200000
200000
75000
67000
70000
10
Prostate surgery (TURP
procedure)
4500
15000
12000
6000
5500
5300
11
Gastric
bypass
12000
45000
42000
17000
13500
14100
12
Cataract
Surgery
1200
2500
2500
1800
1450
1500
13
Face Lift
5000
16000
13500
7500
7000
6500
14
Breast
Reduction
3500
11000
13000
8000
7500
5000
15
Breast
Augme-ntation
3500
11000
12000
8000
7500
5000

Source: http://www.rubyhall.com/cost-comparison

Cost Comparisons on some major procedure between India and US
Procedure
US ($) approx.
India ($) approx.
Bone Marrow Transplant
$2,50,000
$69,200
Liver Transplant
$3,00,000
$69,350
Heart Surgery
$30,000
$8,700
Orthopedic Surgery
$20,000
$6,300
Cataract Surgery
$2,000
$1,350
Smile Designing
$8,000
$1,100
Metal Free Bridge
$5,500
$600
Dental Implants
$3,500
$900
Porcelain Metal Bridge
$3,000
$600
Porcelain Metal Crown
$1,000
$100
Tooth Impactions
$2,000
$125
Root Canal Treatment
$1,000
$110
Tooth Whitening
$800
$125
Tooth Colored Composite
$500
$30
Fillings / Tooth Cleaning
$300
$90
Breast
 
 
Mastopexy
Reduction Mammoplasty
Mammoplasty Augmentation
Replacement Of Implants
$7,500 $8,000 $8,000 $6,500
$2,800 $3,300 $2,750 $3,000
Face
 
 
Blepharoplasty (Upper & Lower) Facelift
Dermabrasion Total face)
Canthopexy w/Orbicularis suspension
Hair Transplant
Endoscopic Brow lift
Neck lift
Otoplasty(For prominent Ears)
$6,000 $6,500 $5,500 $6,000
$50 Per graft
$5,800 $6,100 $4,700
$2,000 $2,800 $2,150 $2,200
$3 Per graft
$2,300 $2,400 $1,500
Nose
 
 
Primary Rhinoplasty
Tip Rhinoplasty
$7,300 $6,300
$2,900
$1,300
Body Contouring:
 
 
Abdominoplasty
Thigh Lift (Bilateral)
Total Lower Body Lift(Belt Lipectomy)
Liposuction (One Region)
$7,700 $7,200 $9,500 $6,100
$3,200 $3,150 $6,000 $1,750
Non – Surgical Procedures:
 
 
Laser Hair Removal
Laser Resurfacing/ Wrinkle Reduction
Laser Acne Treatment
Laser Scar Treatment
Botox
$550
$550
$575
$500
$70 Per Unit
$225
$225
$230
$210
$8 Per Unit
Cost Comparison - India vs. United Kingdom
Accompanied with the cost are waiting times which exist in U.K. for patients which range from 3 months to over months. India is not only cheaper but the waiting time is almost nil. This is due to the outburst of the private sector which comprises of hospitals and clinics with the latest technology and best practitioners.
Procedure
UK ($) Approx
India ($) Approx
Open Heart Surgery
$18,000
$4800
Facial Surgery and Skull base
$13,000
$4500
Neurosurgery with Hypothermia
$21,000
$6800
Complex spine surgery with implants
$13,000
$4600
Hip Replacement
$13,000
$4500
Simple Spine Surgery
$6500
$2300
Simple Brain Tumor
Biopsy
Surgery
$4,300
$10,000
$1200
$4600
Parkinson’s
Lesion
DBS
$6500
$26,000
$2300
$17,800
* These costs are an average and may not be the actual cost to be incurred.

http://www.indian-medical-tourism.com/medical-tourism-india-price-benefits.html

Dr A Marthanda Pillai                  Dr K K Aggarwal
Padma Shri Awardee                 Padma Shri Awardee
National President IMA      Honorary Secretary General IMA

Dr Mahipal S Sachdev
Padma Shri Awardee
CMD Centre for Sight

IMA NATIONAL LEADERS MEET PROGRAM
7TH FEB
 
 
2:00 - 2:15
Flag Salutation, IMA Prayer
 
2:15 - 2:30
Presidential Address
Dr A Marthanda Pillai
2:30 - 2:45
IMA So Far
Dr K K Aggarwal
2:45 - 3:00
IMA pension Scheme
Dr K V Devadas
3:00 - 3:15
IMA health scheme
Dr Alex Franklin
3:00 - 3:30
IMA Waste Management scheme
Dr K Jayaram
3:30 - 3:45
IMA Elderly Initiative
Dr V U Seethi
3:45 - 04:00
IMA RTA Initiative
Dr M Balasubramanian
4:00 - 4:15
IMA Safe Sound Initiative
Dr John Panikker
4:15 - 4:30
IMA blindness prevention in DM
Dr N S D Raju
4:30 - 4:45
IMA welcome the girl child
Dr Ashok Adhao
4:45 - 5:00
IMA e university
Dr Arul Rhaj
5:00 - 5:15
IMA CPA Initiative
Dr Appa Rao
5:15 - 5: 30
IMA Health & Law Program
Dr Jayakrishna AV
5:30 - 5:45
IMA IMR reduction
Dr Vasudevan Panikker
5:45 - 06:00
IMA Mental Health
Dr Roy Abrahm Kallivayalil
6:00 - 6:15
IMA Grievance Mediation & Reconciliation Cell
DR V C P Pillai
6:15 - 6:30
Disaster Management
Dr Chetan Patel
6:30 - 7.00
IMA Vitamin D Initiative
Dr Ambrish Mithal
7:15 - 7:30
IMA Leadership
Dr Naresh Trehan
7:30- 7:45
Nutrition and Public Health, 33 Public Health Directors
Dr Rajiv Tandon
7:45-8:00
Sum Up
Dr A M Pillai
 
Sentinel events reporting
Dr C M Bhagat
 
 
 
8TH FEB
 
 
08:00: - 08:15
Presidential Remarks
Dr A M Pillai
08:15  - 08:30
IMACGP: what’s new
Dean
08:30  - 08:45
IMAAMS: New skill courses
Chairman
08:45 - 09:00
IMAAKN: New Courses
Director
09:00 - 09:15
HBI what’s new
Dr R Asokan
09:15 - 09:30
IMA Publications
Open House
09:30 - 09:45
Anti Quackery and other PIL
IMA Lawyers
10.00 - 10.30
Child Sexual Abuse
Dr Rajiv Seth
10:30- 11.00
TB Notification
Dr Suresh Gutta
11:00 - 12.00
Leadership Qualities
Dr Prathap Reddy
12:00 - 12:15
Students and young doctors wing
Wing Chairmen
12.15 -1.00
National Health Policy
Dr A M Pillai
01: 00- 01:30
Pain Management
Panel Discussion
1.30 2.30
Lunch and Networking
 
2.30- 3.00 PM
Spurious Drugs
Dr Pradeep Sharma
3:00 - 3:15
Website/ rare blood group directory/ Choose Wisely
Dr K K Aggarwal
3:15 - 3:45
Ethics and Behavior
Sh A R Kohli
3:45 - 4:00
Girls and Adolescent Care, Weekly Clinics
Dr Ashok Adhao
4:00 - 4:15
Swacchh Bharat Abhiyan
open house
4:15 - 4:30
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open house
4:30 - 4:45
Jan Aushidhi Scheme
Open house
4:45 - 5:00
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Dr Vinay Aggarwal
5:00 - 5:15
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Open House
5:15 - 5:30
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open house
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IMA SAFE MEDICAL PRACTICE
Dr Anupam Sibal
5:45 - 06:00
Stroke Prevention
Dr Balbir Singh
sum up
 
 
 
NABH Update
 
Wellness interventions are those interventions that do not require overnight stay at the Wellness Centre for medical reasons; leaving the treatment after any stage should not cause any harm to the individual.
Tip of the day for safe and effective strength training
 
Don't lock your joints; always leave a slight bend in your knees and elbows when straightening out your legs and arms.
10 Worst Medical Treatment Dangers 2015
 
Robotic Surgery Dangers

Robot-assisted surgery changes the surgical process for all involved. Adverse events can occur if surgeons and associated staff are not sufficiently trained. ECRI Institute has investigated several cases in which situations unique to robot-assisted surgery probably contributed to patient harm. These events occurred because of factors such as the need to reposition team members or equipment to accommodate the size of the robot, repositioning of the patient or accidental movement of the OR table during the procedure, and lapses in common safety practices and team communication.
(Source: Medscape)
Medscape Family Physician Lifestyle Report 2015
Family Physicians Burnout and Volunteering

Volunteer activity associated with religious organizations pulled in the largest number of responses, but non–burned-out family physicians did more of this work (31%) than their burned-out peers (24%). Another large difference between the groups was seen in whether they volunteered at all: 22% of the non–burned-out group and 31% of the burned-out group never volunteer. IMA,IJCP,HCFI
White paper on Nimesulide
Pharmacologic Category: Analgesic, Nonsteroidal Anti-inflammatory Drug; Nonsteroidal Anti-inflammatory Drug (NSAID)
Indications: Treatment of all painful inflammatory conditions , dysmenorrhea, migraine
Dosage Range: Duration should be limited to 15 days
Adults: Oral: 100 mg two to three times daily
Children below 12 years: Not to be used
Product Availability: Product available in various countries; not currently available in the U.S.
Dosage Forms: Tablet: 100 mg
  1. Nimesulide has preferential selectivity for COX-2 over COX-1 in vivo at full therapeutic doses and induces less gastrointestinal damage than that seen with naproxen in the short term. (Uptodate: Gut. 2001;48(3):339.)
  2. Atopy is a risk factor for non-steroidal anti-inflammatory drug sensitivity. The prevalence of atopy is increased in challenge-proven NSAID-intolerant patients. The atopic condition may represent an important risk factor for developing reactions to these drugs. Paracetamol and nimesulide are relatively safe alternative choices in those patients. (Uptodate: Ann Allergy Asthma Immunol. 2000;84(1):101.)
  3. Topical NSAIDs that are effective for chronic musculoskeletal pain in adults include diclofenac, ketoprofen (level 1 likely reliable evidence), ibuprofen, felbinac, and nimesulide (level 2 mid-level evidence) (DynaMed)
  4. nimesulide may be associated with better efficacy than diclofenac for acute gout (level 2 (mid-level) evidence) (Ter Arkh 2007;79(5):35)
  5. Nimesulide is safe in Crohn's disease (DynaMed: Clin Gastroenterol Hepatol 2006 Feb;4(2):196)
  6. It is safe in ulcerative colitis {DynaMed Clin Gastroenterol Hepatol 2006 Feb;4(2):196, commentary can be found in Clin Gastroenterol Hepatol 2006 Feb;4(2):157)
  7. International Brand Names: Agudol (PY); Ainex (CO); Aldoron (AR); Algimesil (IT); Algolider (IT); AllDone (BG); Antalgo (IT); Antiflogil (BR); Antifloxil (ES); Apolide (MX); Aponil (TR); Arflex Retard (BR); Arslide (PK); Aulin (AR, BG, CH, CZ, GR, HR, IE, IT, PL, PT, RO, VE); Auronim (IN, RU); BangNi (CN); Biosal (IT); Blunid (PK); Coxtral (PL, RU); Defam (MX); Deflogen (BR); Delfos (IT); Doloc (CL); Doloctaprin (AR); Dolonime (CO); Domes (IT); Donulide (PT); Drexel (VE); Efridol (IT); Elinap (TR); Emdon (TH); Enetra (BG); Eskaflam (MX); Fansidol (IT); Fasulide (BR); Flamide (MX); Flogovital N.F. (AR); Flolid (IT); Gravx (PK); Guaxan (ES); Inflalid (BR); Isodol (IT); Jabasulide (PT); Laidor (IT); Ledoren (IT); Li Nuo Ke (CN); Manaslu (KP); Mesid (IT); Mesulid (BE, CZ, GR, HK, HU, IL, IN, IT, LU, MX, PY); Metaflex (AR); MF/110 (IT); Molden (KP); Nerelid (IT); Nexen (FR); Nide (IT); Nidol (HK, HU, PK, TH); Nidolid (PH); Nimax (KP); Nimed (BG, CZ, ID, PT); Nimel (IN); Nimelid (VE); Nimepast (CL); Nimesil (IT, PL); Nimesol (PY); Nimesulene (IT); Nimesulide Dorom (IT); Nimesulide GNR (IT); Nimesulide UCB (IT); Nimind (IN); Nimm (HK, TR); Nimotop (PT); Nims (IT); Nimulid (IN); Nisal (IT); Nise (PE); Nisulid (BR, CH); Nisural (CL); Noalgos (IT); Nodo (UY); Noxalide (IT); Octaprin (AR); Pacisulide (HK); Penalgin (CO); Precoxi (MY); Prolid (RU); Pu Wei (CN); Quimoral Plus (PE); Redaflam (MX); Remov (IT); Resulin (IT); RuiLi (CN); Scaflam (BR, CO, VE); Scalid (BR); Severin (MX); Sharonim (HK); Sintalgin (BR); Solving (IT); Sulidamor (IT); Sulide (IT); Sulidene vet. (FR); Sulidin (PH); Sulidor (PT); Sulimed (ES); Tenesmin (UY); Teonim (IT); Veedol (TH); Ventor (GR); Virobron (AR); Xilox (HU); Ximede (ID)
Note:
  • In February 2011 Nimesulide was banned in India by DCGI for use in children below 12 years of age. Nimesulide was never banned in India or any other country for use in adults.
  • DCGI approved Nimesulide on 13th January 1995 for painful & inflammatory conditions as well as fever.
  • The European Medicines Agency has completed a review of the safety and effectiveness of systemic medicines containing nimesulide (capsules, tablets, suppositories and powder or granules for oral suspension). The Agency’s Committee for Medicinal Products for Human Use (CHMP) concluded that the benefits of nimesulide used systemically continue to outweigh its risks but that its use should be restricted to the treatment of acute pain and primary dysmenorrhoea. The Committee noted that the studies looking into the effectiveness of nimesulide in acute pain relief have shown that it is as effective as other NSAID pain killers such as diclofenac, ibuprofen and naproxen. In terms of safety, the Committee noted that nimesulide has the same risk of causing stomach and gut problems as other NSAIDs. To current recommendation is use of lowest effective doses for the shortest possible duration, and a maximum duration of treatment for acute pain. Its approved for use upto 15 days.
  • In US the drug is not available as being an European drug the permission was never applied.
  • Even aspirin is not safe in children. Aspirin has been linked with Reye's syndrome. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin.
  • Even Paracetamol is not safe. around 82,000-90,000 patients present with toxcity per annum in UK alone with 150 –250 deaths. Bateman N et al (2014) Br J Clin Pharmacol 78:610). Concerns with paracetamol in USA and EU; new dosage restrictions (325mg) in USA has been set.

IMA,IJCP,HCFI
IMA in the News
  1. Amar Ujala published a story headlined " IMA White Paper on Cancer Prevention " on page 05 of its National edition.
  2. Navodaya Times published a story headlined "IMA White Paper on Cancer Prevention" on page 07 of its National edition.
  3. Deshabndhu published a story headlined "IMA White Paper on Cancer Prevention" on page 04 of its National edition.
  4. Loksatya published a story headlined "IMA White Paper on Cancer Prevention" on page 03 of its National edition.
  5. Mahamedha published a story headlined "IMA White Paper on Cancer Prevention" on page 03 of its National edition
IMA in Social Media
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The Year in Medicine 2014: News That Made a Difference
Readers Respond: Most Frustrating
The event or news that most frustrated members this year was trying to meet meaningful use requirements for electronic health records (EHRs), at 26% of respondents. About 18% of respondents said that Dr. Oz defending his tactics for touting weight-loss products before a US Senate panel was most frustrating. Cyber-attacks on EHRs and California wanting to drug test doctors tied, at 10%. And about 9% of respondents said Affordable Care Act health grace period rule was most frustrating. Among the write-in votes, most respondents mentioned MOC or the ACA (promotion of or opposition to) as most frustrating. Others mentioned the states that refused to expand Medicaid and Ebola fear or "hysteria."(Source: Medscape)
Press Release of the Day
Indian Medical Association: Student’s Wing & Young Doctors’ Wing to go on SATYAGRAH and Press NOTA

The future of 1,379 medical, dental and nursing students studying in ESIC colleges all over the country is in the dark in view of the ESIC’s unilateral decision of closing medical, dental and nursing colleges run by them.

" On one hand, the Govt. of India is concerned about the shortage of medical, dental and nursing colleges in the country but on the other hand, it is turning a deaf ear and allowing ESIC administration to close these colleges" said Padma Shri Awardee Dr A. Marthanda Pillai, National President and Padma Shri Awardee Dr K K Aggarwal, Hony. Secretary General IMA in a press statement here today.

Dr. M. C. Prabhakar, Chairman, Young Doctors’ Wing and Dr. Yathu Thulaseedharan Pillai, Chairman, IMA Students’ Wing of IMA in a joint statement said that "our appeal to Hon’ble President of India, Prime Minister of India, Health Minister of India and Labour Minister of India has not been reverted".

The Joint Action Committee of ESIC Chapter of Young Doctors and Student wing of IMA said that no political party has given any assurance or commitment to solve this problem so, they along with their well wishers will be forced to press NOTA (none of the above) in the coming Delhi Elections to be held on 7th Feb’ 2015 and also in subsequent elections due in the country.

It is unfortunate that none of the political parties have raised this issue in their election manifesto so far. If no assurance is received, over 5000 well wishers of ESIC students will start a “Satyagrah” in New Delhi, said Chander Mohan, Dr Sameeksha Chand, Dr Wasim Ahmad, Vanga Ashwita Siri and Priyanjali, of the joint action committee.