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EDITORIAL

A new platform for complaints against doctors who are public servants - IMA's View

An interstate (Maharashtra, Gujarat, and Rajasthan) public hearing was held over two days on January 6-7, 2016  in collaboration with Jan Swasthya Abhiyan and the National Human Rights Commission (NHRC), with representation from the Ministry of Health and Family Welfare.

During its first day 88/106 cases were taken up, and compensation of Rs. 4.25 lakhs was issued in five cases relating to medical negligence, delay of treatment, incorrect HIV testing reports, lack of consent for private referral, and absence of doctors at a PHC resulting in denial of availability of services.

State Governments have been asked to conduct inquiries in a number of cases.

To Read More or Comment, Click Here
 
 

BREAKING NEWS

 

Adult asthmatics are at a higher risk of shingles

A study published in the Journal of Allergy and Clinical Immunology has suggested asthma to be an unrecognized risk factor for herpes zoster (shingles) in adults. It also suggests that clinicians should consider vaccinating asthmatics at least 50 years old as a target group. In the study, of the 371 shingles cases, 23% had asthma vs 15% from the control group. Adults with asthma were at about a 70% greater risk of developing shingles vs those without asthma (odds ratio [OR], 1.73; 95% confidence interval (CI), 1.26 – 2.39; P < .001). The population-attributable risk percentage for asthma was about 10%… (Medscape)

1 in 7 Indians is at risk of malaria: WHO

According to the WHO, one in seven people in India are at risk of contracting malaria. The report based on the data collated by the National Vector Borne Disease Control Programme (NVBDCP) states that India, along with Ethiopia, Pakistan and Indonesia accounts for 80% of all malaria cases worldwide, but it allocates the lowest funding for malaria control in the world. Of the 138 million people suspected to have malaria in India, 1.102 million were confirmed cases. Even though this figure is 15% lower than the 1.31 million cases in 2011, it is higher than in 2013 (.88 million) and 2012 (1.06 million). Deaths from malaria have also increased from 519 in 2012 to 562 in 2014… (Times of India – Ekatha Ann John)

 

 
IMA JIMA 

http://module.ima-india.org/ima/jima/2015/September/
 

SPECIALTY UPDATES 

  • Two thirds of women receiving medication for osteoporosis potentially did not need treatment, reported a retrospective cohort study published online January 4 in JAMA Internal Medicine. Researchers noted that half of these women with possibly inappropriate prescriptions were younger and without risk factors that would have pointed towards screening.
  • Ambulatory heart–rate (HR) range as captured on 24–hour Holter monitoring predicts all–cause mortality in patients with chronic heart failure and left-ventricular systolic dysfunction, suggested a prospective, observational cohort study published in the journal Heart.
  • Eating processed foods may weaken the intestines, thus increasing the risk for autoimmune diseases, such as type 1 diabetes, celiac disease and multiple sclerosis, suggests a new study published in the journal Autoimmunity Reviews.
  • The American College of Prosthodontists has come up with clinical practice guidelines for caring for patients with teeth restorations such as crowns, bridges, veneers and implants. The guidelines are published in the January issue of the Journal of Prosthodontics.
  • More than 90% of Crohn’s disease patients experience long-term resolution of symptoms after side–to–side isoperistaltic strictureplasty (SSIS), suggests new research published online in JAMA Surgery.
  • An Asian study, published online in Arthritis Care & Research, revealed that smoking reduces the risk of gout, though only among men. The overall risk of gout among individuals who reported current smoking was 20% lower than for those who never smoked.
  • A review of medical literature suggests that older age at menopause may be associated with a lower risk of depression for women in later life. The findings were published online 6 January in JAMA Psychiatry.
  • Scientists have discovered a molecule – called AH peptide – with broad–spectrum antiviral activity inside the hepatitis C virus that kills viruses but does not harm host cells, by discriminating between the molecular make–up and size of their membranes. The report is published in the Biophysical Journal.
  • Lateral ankle injuries without radiographic evidence of a fracture are common injuries for children and rarely result in Salter–Harris I fractures of the distal fibula (SH1DF), suggested a prospective cohort study published online January 4 in JAMA Pediatrics.
  • People have evolved to have subconscious urges to over–eat, and limited ability to avoid becoming obese, especially in winter, suggests new research published in Proceedings of the Royal Society B.
 

eSPIRITUAL

What is the difference between smile, hug and laugh?

Smile is a sign of joy while hug is a sign of love. Laughter on the other hand is a sign of inner happiness.
None of them are at the level of mind or intellect. All come from within the heart. They are only the gradations of your expressions of your happiness. It is said you are incomplete in your dress if you are not wearing a smile on your face.… Hug comes next… and laughter the last. Laughter is like an internal jogging and has benefits like that of doing meditation.
But be careful we must know when not to laugh. The most difficult is to laugh on oneself.

 

LEGAL QUOTE

National Consumer Disputes Redressal Commission New Delhi Original Petition No.214 of 1997

"As laid down by Apex Court in the above case (Jacob Mathew case), we feel that it is high time that hospital authorities realize that the practice of employing non–medical practitioners such as Doctors specialized in Unani system and who do not possess the required skill and competence to give allopathic treatment and to let an emergency patient be treated in their hands is a gross negligence.

 

 

THE YEAR IN MEDICINE 2015: NEWS THAT MADE A DIFFERENCE   

Medical Teams Respond to Nepal Earthquake

Surgeons, nurses, and other healthcare professionals from around the world responded to earthquake in Nepal, which struck near Kathmandu on April 25 with a magnitude of 7.8. More than 6000 people were killed, and at least 14,000 were injured. The quake caused widespread destruction across a huge geographic area. Some of the worst–hit communities were remote mountainside villages. Access to these hard–to–reach areas remained the single biggest hurdle to providing critical services. In many places, medical teams had to be flown in by helicopter or walk in by foot, according to Margaret Traub, head of Global Initiatives, International Medical Corps… (Medscape)

 

1. IMA Rare Blood Group Online Blood Bank Directory: ima-india.org/Rare
2. IMA Online TB Notification initiative: ima-india.org/tbnotify
3. IMA Online Events Reporting initiative: http://www.ima-india.org/ima/left-side-bar.php?scid=228
4. Proforma for Hypertension Screening: http://module.ima-india.org/
5. IMA Online Sentinel Events Reporting Initiative: ima-india.org/sentinel
6. IMA Disease Notification: http://disnotif.ima-india.org/
7. IMA RISE and SHINE: http://imariseandshine.com/
12. IMA Slide Share: http://www.ima-india.org/ima/free-way-page.php?scid=287
13. I Pledge My Organ: http://module.ima-india.org/ipmo/
14. IMA Weekly Live: http://www.ima-india.org/imalive/
17. IMA ART: http://ima-india.org/artbill
18. IMA Satyagraha: http://ima-india.org/satyagraha
19. IMA Daily Webcast: http://ima-india.org/ima/
20. CC Slides: http://www.ima-india.org/ima/left-side-bar.php?scid=417
21. NATCON Photos: IMA Natcon 2015 - Day 2 - Camera 1, IMA Natcon 2015 - Day 2 - Camera 2, 

 

IMA SATYAGRAHA

https://www.youtube.com/watch?v=UV1zCH33BlU

IMA POLL

http://www.ima-india.org/ima/ima-poll.php

 

SAMMPRIS Trial

In the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial, a handful of risk factors predicted who did worse with aggressive medical therapy alone for preventing recurrent ischemic stroke in intracranial stenosis. Those factors include having an old infarct in the territory of the stenosis, initially presenting with stroke, and not using a statin at enrolment (JAMA Neurology)

 

Intensive therapy may reduce new HIV MSM infections

A study published online January 6 in Science Translational Medicine observed that 71% of HIV transmissions were from undiagnosed men, 22% from diagnosed but not yet treated men, 6% from men who had started ART, and 1% from men with no link to care for at least 18 months. Some 43% of transmissions were from men in their first year of infection. The researchers conclude that the lack of decline in new HIV cases among MSM was not coming from ineffective ART provision or inadequate retention in care. According to the researchers, frequent testing of men who have sex with men (MSM) followed by treatment with available antiretroviral therapy (ART) may cut infections by 66%… (Medscape)

 

Ministry of Health proposes steep fee hike for drugs licences, registration & manufacturing

The Ministry of Health and Family Welfare has proposed multifold fee increases for product registrations, manufacturing and product licences and clinical trials. A December 29 gazette notification said the Central government is of the opinion that circumstances have arisen that render it necessary to make the rules without consulting the Drugs Technical Advisory Board, which advises it on important policy decisions… (ET Healthworld – Vikas Dandekar) 

 

Indian Council for Medical Research (ICMR) Director General Dr Soumya Swaminathan said out of $1 billion that the country has been spending annually, just 1% is for healthcare and it is 0.06% of GDP. Of the total amount, only 16% is by not–for–profit institutions and 83% by pharmaceutical industry… (ET Healthworld)

 

India needs to build a safety net around the consumers prior to the sale of medicines on internet to ensure safety, efficacy and quality of health. The country is already the third largest online market with over 167.2 million internet users, ranked only behind China and the US, said Dr BR Jagashetty, former National Adviser (Drugs Control) to the CDSCO and former Karnataka Drugs Controller… (Pharmabiz – Nandita Vijay)

 

India will collaborate with UK to conduct ‘Add–Aspirin’ global drug clinical trials to investigate whether the use of widely–used medicine, aspirin prevents recurrence of the most common cancers, like breast and gastric or esophagus. The UK trials have already started, while trials in India will start as soon as the approval comes in. Dr Manju Sengar medical oncologist at the Tata Memorial Hospital said that researchers at Tata Memorial Hospital have submitted the research application to the ethics committee and plan to conduct these trials on over 1600 subjects in the first quarter this year… (ET Healthworld)

 
 
Media
eMediPics

IMA PVPI Programme 

 

WP(C) No.8706/2015 titled "Indian Medical Association Vs. Union of India & Anr (NCERT)" Delhi High Court, New Delhi 

Click here to read the proposed changes

 

BIOETHICAL ISSUES IN MEDICAL PRACTICE

Parent’s dilemma in choosing sex of their intersex child

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

A and S have one child. The second, born three months ago, had indeterminate sexual genitalia. He doctor opines that the child will need one operation so that sex is clear. The operation can be done in the future once the child grows up and decides which sex s/he wants to belong to. They are worried because they feel that growing up with a confusing sexual identity will not be good for the child. Moreover the other sibling may face stigma. Finally the child does not even need to know about the operation. As their doctor what should you advise?

  1. What would you do, as a parent?
  2. Is such a surgery necessary at all? Can the child not go through life with indeterminate sex if s/he wants?
  3. What other social issues would such a child face?

Any suggestions? Do write in!

Adapted from: Bioethics Case Studies (AUSN and EEI, November 2013):  http://www.eubios.info/

 

eWELLNESS 

Focus only on upper blood pressure if over 50 years of age

For patients aged over 50, doctors only need to monitor the upper systolic blood pressure, and can ignore the lower diastolic blood pressure reading. As per a report published in the journal The Lancet, patients are not getting their systolic blood pressures adequately controlled because there is such an emphasis on diastolic pressure. The fact is that people over the age of 50 probably do not even need to measure diastolic – it’s only the systolic blood pressure that should be the focus.

Generally, systolic blood pressure continues to increase with age, while diastolic pressure starts to drop after age 50, which is the same time when cardiovascular risk begins to rise. Therefore, there is an increased prevalence of systolic hypertension past age 50, whereas diastolic hypertension is practically nonexistent. Rising systolic pressure is the most significant factor in causing stroke and heart disease.

For people under 50, the scenario may be different. About 40 percent of adults under 40 years of age have diastolic hypertension, and about a third of those between 40 and 50 have the problem. For these patients, a continued emphasis on both systolic and diastolic blood pressures is needed. However, controlling systolic blood pressure, even among these younger patients, almost always results in adequate control of diastolic blood pressure, too. For people 50 or older, systolic pressure is high if it is 140 mmHg or above.

 

IMA Live Webcast 

Click here

 

INSPIRATIONAL STORY

Live and work

Father was a hardworking man who delivered bread as a living to support his wife and three children. He spent all his evenings after work attending classes, hoping to improve himself so that he could one day find a better paying job. Except for Sundays, Father hardly ate a meal together with his family. He worked and studied very hard because he wanted to provide his family with the best money could buy. Whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family. The day came when the examination results were announced. To his joy, Father passed, and with distinctions too! Soon after, he was offered a good job as a senior supervisor which paid handsomely. Like a dream come true, Father could now afford to provide his family with life’s little luxuries like nice clothing, fine food and vacation abroad.

However, the family still did not get to see father for most of the week. He continued to work very hard, hoping to be promoted to the position of manager. In fact, to make himself a worthily candidate for the promotion, he enrolled for another course in the Open University. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

Father’s hard work paid off and he was promoted. Jubilantly, he decided to hire a maid to relieve his wife from her domestic tasks. He also felt that their three–room flat was no longer big enough; it would be nice for his family to be able to enjoy the facilities and comfort of a condominium. Having experienced the rewards of his hard work many times before, Father resolved to further his studies and work at being promoted again. The family still did not get to see much of him. In fact, sometimes Father had to work on Sundays entertaining clients. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family. As expected, Father’s hard work paid off again and he bought a beautiful condominium overlooking the coast of Singapore. On the first Sunday evening at their new home, Father declared to his family that he decided not to take anymore courses or pursue any more promotions. From then on he was going to devote more time to his family… Father did not wake up the next day.

 

eMEDI QUIZ

Preservation is:
1. Persistent and inappropriate repletion of the same thoughts.
2. When a patient feels very distressed about it.
3. Characteristic of schizophrenia.
4. Characteristic of obsessive compulsive disorder (OCD).

Yesterday’s Mind Teaser:  Cinnarizine is known to perform which of these functions?
a. Improve labyrinthine blood flow
b. Vestibular sedation
c. Reduction in irritability of vestibular labyrinth
d. All of above

Answer for Yesterday’s Mind Teaser: c. Reduction in irritability of vestibular labyrinth
Answers received from: Dr Poonam Chablani, Dr K Raju, Dr K V Sarma, Dr Avtar Krishan, Daivadheenam Jella.
Answer for 6th January Mind Teaser: 1. The sample should be kept at 4°C.
Answers received from: Dr Rakesh, Dr S Raju, Dr Jainendra Upadhyay, Dr Neelam. 

 

READER’S COLUMN

Dear Dr KK Aggarwal, Happy New Year. Congratulation on the NATCON Conference where you able to mix the Doctors, Politicians and Senior Civil Servants which was great. I am quite sure this will help in the growth of IMA. Dr JC Sobti, Past Honorary General Secretary IMA

 

HUMOR

The bride, upon her engagement, went to her mother and said, "I’ve found a man just like father!" Mother replied, "So what do you want from me, sympathy?"

 

PRESS RELEASE

IMA, IPC and NCC – PvPI sign an MoU to work towards encouraging the medical fraternity to report the occurance of all adverse drug reactions in the country

The Indian Pharmacopoeia Commission (IPC), National Coordination Centre (NCC) for Pharmacovigilance Programme of India (PvPI) and Indian Medical Association (IMA) today signed a letter of intent to enhance their mutual understanding and device ways to promote Adverse Drug Reactions (ADRs) reporting in the country.

The Indian Pharmacopoeia Commission (IPC) is an autonomous institution of the Ministry of Health and Family Welfare, Govt. of India which was created to set standards of medicines commonly used for treatment of diseases prevailing in our country. The IPC has been functioning as the NCC for PvPI since 15th April 2011 to monitor all adverse drug reactions taking place in the country. The mission of PvPI is to safeguard the health and welfare of the Indian population by monitoring drug safety and ensuring that the benefits of use of medicine outweigh the associated risks. IMA is the only representative, national voluntary organization of doctors of modern scientific system of medicine, which looks after the interest of doctors as well as the well–being of the community at large.

Speaking about the partnership, Dr. S.S Agarwal – National President and Padma Shri Awardee Dr. KK Aggarwal, Honorary Secretary General of IMA in a joint statement said, "We are extremely pleased to sign this memorandum of understanding with the IPC, NCC & PvPI. Together we will work towards promoting the cause of drug safety in our country. We will be sensitizing all our 2.5 lakh IMA members about the importance of reporting all adverse drug reactions in their day–to–day practices to help improve their standards."

Together these bodies will work towards promoting patient safety in the country. They have agreed to cooperate and work together on the following:

  • PvPI–IMA patient safety monitoring cell to be started at the IMA Head Quarters in New Delhi
  • Organizing Continuing Medical Educations (CMEs), 
  • Disseminating PvPI information/concept of Pharmacovigilance (PV) to all IMA members through its journals, news portals
  • IMA to identify the nodal centers for education/advocacy and ADR monitoring and recommend to NCC–PvPI for recognition
  • Providing training to the nodal coordinators and medical officers
  • Development and up-gradation of a mobile app. for ADR monitoring
  • To propagate the concept of drug safety to patients.
 
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