eMediNews
(incorporating eIMA News)
9th March 2016
Editorial (Dr S S Agarwal, Dr K K Aggarwal)
IMA White paper on Antibiotics​
 
A survey by IMA showed that 50% of the healthcare providers feel that expensive medicines are stronger and better; 70% feel that newer drugs are better and stronger; 87% feel that minimum two antibiotics are required for fever; 80% correlate cough with necessity of antibiotics; 90% use Levofloxacin for Respiratory Tract infections; 50% are not aware about the term healthcare associated infections and 70% of them feel that it is cheaper to give an antibiotic than to investigate a patient in an overcrowded OPD.
 
Most practitioners are also afraid of legal and Consumer Protection Act implications.  
 
Central Government Act
  • Section 269 Indian Penal Code: Negligent act likely to spread infection of disease danger¬ous to life. Whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both.
  • Section 270 Indian Penal Code: Malignant act likely to spread infection of disease danger¬ous to life.—Whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.”
MCI Ethics Regulations 2.4 says that a patient should not be neglected. Also, MCI Regulation 3.1.2 warns that diagnostic lab investigations should be done judiciously and not in a routine manner. But, on the contrary, a judgement of Supreme Court by Justice M. Katju in 2002 said that one should not rely only on clinical history but also go for investigations when indicated.
 
“A doctor should not merely go by the version of the patient regarding his symptoms, but should also make his own analysis including tests and investigations where necessary.” SCI: 3541 of 2002, dated 17.02.2009, Martin F. D'Souza vs Mohd. Ishfaq: Markandey Katzu and G S Singhvi, JJ.
We have not come across on any legal case against a doctor for using Antibiotics. Mostly cases are filed for not using antibiotics. 
 
Medical profession is often blamed of overprescribing, writing newer drugs when older drugs are equally effective. British Media, especially BMJ & Lancet, have been writing that development of bacterial resistance in India is because of corruption and overuse of antibiotics. 
 
Most doctors in India work in adverse situations.
 
Drugs Controller General of India (DCGI) does not inform each and every doctor when a drug has been banned for use or a new drug is introduced on a regular basis. Simply putting the information in a newspaper or on the website is not the answer, as 50% of the doctors even today are not digital-friendly.
 
As per MCI 1.2.3 Regulation, medical graduates need to update their knowledge on a regular basis but the Council has not made it mandatory for the medical colleges to hold annual review programme on a yearly basis.  Most medical updates are pharma-sponsored and so the information, a practitioner gets, is often biased.
 
1.2.3 A Physician should participate in professional meetings as part of Continuing Medical Education programmes, for at least 30 hours every five years, organized by reputed professional academic bodies or any other authorized organisations. The compliance of this requirement shall be informed regularly to Medical Council of India or the State Medical Councils as the case may be.
 
Drug price variations are allowed in the country. Multiple brands in the country with huge price variations will invariably allow pharma companies to lure doctors. The list of drug prices is also not available on a centralized Govt. website.
 
A General practitioner has no access to antibiogram or recommendations from Infection Control committee. Even NABH does not enlist that information for general use.  
 
The Govt. policy of intermittent regimen for treatment for TB and the shift now to a daily regimen has created more confusion than right answer. Govt. has opened Jan Aushadhi Kendras but most of the essential drugs are not available there.
 
Most doctors fear prescribing Penicillin though penicillin still has no resistance to any antibiotics.
 
No regulation against quacks, Ayush doctors, chemists and Nurses on prescribing allopathic antibiotics also results in over and irrational prescriptions.
 
Unchecked use of antibiotics in animal husbandry and agriculture adds to the existing problems.
 
IMA Policy
  • IMA is compiling 10 points that every doctor must know about antibiotics to prevent resistance.
  • IMA will be appointing an Independent Infection Control Committees at National/State and Branch level.
  • IMA is conceptualizing Trade tendering for vaccines so that they are available at a cheaper cost to the patients.
  • IMA is compiling a book on “When Not to Use Antibiotics”.
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American Family Physician - MOUTH PAIN WITH RED GUMS 

Press Release
Indian Medical Association announces the winners of the IMA National Women Achievers Award
 
 Dr. Jayshree Pranshankar Mehta – President MCI, Dr. Soumya Swaminathan – Director General ICMR recognized for their contribution to the medical fraternity
 
New Delhi, March 08, 2016: The Indian Medical Association today announced the names of the two women who will be honoured with the IMA Women Achievers Award for the year 2016.  Dr. Jayshree Pranshankar Mehta, President of the Medical Council of India and Dr. Soumya Swaminathan – Director-General of the Indian Council for Medical Research will receive the award which carries a citation, trophy and shawl for their outstanding contribution towards the advancement of the medical profession during IMA’s annual Central Council Meeting in December.

Congratulating the awardees, Dr. S S Agarwal, National President & Padma Shri Awardee Dr K K Aggarwal, Honorary Secretary General IMA said, “Dr Jayshree Pranshankar Mehta, President of the Medical Council of India and Dr. Soumya Swaminathan –Director-General of the Indian Council for Medical Research have helped bring in efficiency and transparency in the medical system through their leadership and we are proud to honour them as IMA’s Women Achievers for the year 2016. They are the ideal example of how woman are and must be treated as equals and they can without any doubt effectively run the topmost offices in the country. We wish all the wonderful women a very Happy Women’s Day and urge them to take preventive measures to safeguard their health and take inspiration from women like Dr. Mehta and Dr. Swaminathan to become leaders in their field.”
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IMA Updates
IMA Polio Dates
  • April 1st: tOPV would not be available after this date.
  • April 11th: bOPV would be available in private market but it is not to be opened or used before 25th April.
  • April 25: IMA Polio Switch Day, when tOPV would be completely withdrawn and replaced by bOPV in both routine immunization and polio campaigns.
  • 9th May: IMA National Validation Day when India would be declared free of tOPV. 

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