Anti fever drugs will not reduce fever in patient with heat stroke

Anti fever drugs will not reduce fever in patient with heat stroke

Over 1,000 people have died across India because of heat stroke. Heat stroke is a medical emergency and deaths can be prevented if treatment is started early. The commonest mistake done in treating patient with high fever due to heat stroke is giving anti fever medicine and waiting for it to respond, said Padma Shri Awardee, Dr A Marthanda Pillai, National President, IMA and Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.

The only treatment of very high fever in cases of heat stroke is rapid reduction of body temperature by physical means.

Rapid reduction in body temperature can be accomplished by cool or tepid ( 20 degree centigrade) , no cold, bathing preferably using damp sponges. Submersion should be avoided so that body heat loss by evaporation can occur.

Alcohol aids nothing to tepid water sponges. Cooling blankets should also be avoided.

In heat stroke the core body temperature is usually more than 40 degree centigrade and patient rapidly developed altered mental status. If not treated in time most patient died of multi organ failure.

The difference between heat exhaustion and heat stroke is presence of sweating in heat exhaustion, added Dr Aggarwal. Till the armpits are wet patient is in heat exhaustion and not heat stroke.

IMA & HCFI for increase in size of pictorial health warnings on tobacco products

IMA & HCFI for increase in size of pictorial health warnings on tobacco products

A survey conducted by the Indian Medical Association (IMA) and Heart Care Foundation of India (HCFI) amongst the youth found that the two most important facts, which youth fear about tobacco usage are: “Tobacco products can lead to erectile dysfunction in men” and “Tobacco consumption  can lead to early aging of skin in women leading to wrinkles.”

Addressing a Press Conference in Delhi, Padma Shri Awardee Dr A Marthanda Pillai, National President IMA and Padma Shri Awardee Dr KK Aggarwal, Hony Secretary General, IMA and President HCFI said that IMA is for increasing the size of the pictorial health warnings on tobacco products, covering up to 60 to 80% of the front part of the product. According to the IMA, besides the cancer warnings, the government should also include pictorial warning messages about early aging and erectile dysfunction.

Dr Aggarwal further said that they support increase in taxes on tobacco products and hailed the order of Punjab Government, Haryana Government and Chandigarh Administration that banned complete use of nicotine under the Provisions of Poison Act 1919 and their Sale Rule 2015.  These three States have placed nicotine in the category of poison.  IMA wants this to be implemented in all other States and Union Territories too. IMA has written to the Health Minister demanding this ban at a National level also.

IMA will also be training all General Practitioners in tobacco cessation so that tobacco quit facilities are available to those who want to quit.  IMA has already advised their 2.5 lakh members to ask every patient at every visit whether he or she smokes and if yes, offer help for quitting.

IMA has also sent communication to all its 1700 branches and 2.5 lakh members not to allow smoking in their organizational meetings and their clinics and hospitals should be strictly no smoking zones. No doctor shall smoke in public place and in public view.

Following points, as IMA Stand, were released.

·                Beedi and Hukkah smoking is in fact more dangerous than cigarette smoking.

·                Secondhand smoke is equally dangerous to health as tobacco smoking.

·                Quitting means 3 years of not consuming tobacco

·                Electronic cigarettes are not safe option to quit smoking.

·                Putting nicotine water over herbal products and selling them for a kick, needs to be banned.

·                There should be complete ban of smoking in films. The caption below the scene that smoking is injurious to health does not stop people emulating the smoking character depicted in the film.  There is enough data available to prove the point.


IMA & HCFI support banning oral tobacco products all over the country. Selective ban in few States is encouraging the illicit trade of tobacco products from non ban states to ban states e.g. from UP to Delhi.

The Press Conference was co-addressed by Dr NV Kamat and Dr RP Vashist, Principal Advisors, IMA.

Abundant sunshine available in the Capital during peak summer months, yet 80 – 90% of the city’s population remains Vitamin D deficient

Abundant sunshine available in the Capital during peak summer months, yet 80 – 90% of the city’s population remains Vitamin D deficient

Indian Medical Association trains doctors in New Delhi on the urgent need to raise awareness about Vitamin D deficiency under its Rise & Shine campaign

New Delhi 26th May 2015: A CME was organized in New Delhi today by the Indian Medical Association to discuss the growing concern about the rise of Vitamin D deficiency cases amongst the Indian population. Lately, studies have revealed that in addition to the known skeletal effects of Vitamin D deficiency, it can also have serious long-term impact on the health of people making them vulnerable to diseases such as heart attacks, cognitive disorders, type 2 diabetes and cancer. The CME was an initiative under IMA’s Rise and Shine campaign and was attended by around 70 doctors.

The IMA Rise and Shine campaign is a National movement initiated by the Indian Medical Association under an unconditional educational grant from leading pharmaceutical company USV. It is aimed at sensitizing its 2.5-lakh members across 30 states and 1700 branches over the next two years about the need to raise awareness of Vitamin D deficiency. The campaign also aims to provide essential soft skills training to all doctors on topics such as public speaking, managing patient records online, adapting to the new mobile app culture, how to break the news of death to a patient's family.

Addressing the media, Padma Shri Awardees Dr. A Marthanda Pillai – National President and Dr. KK Aggarwal – Honorary Secretary General of the Indian Medical Association in a joint statement said, “For the next two years, the IMA Rise & Shine campaign will raise awareness about Vitamin D deficiency and address the skill gap that exists in the healthcare sector. A serious concern for the medical fraternity is that most people in our country are unaware that they are Vitamin D deficient. The onus lies on the doctors to recognize common signs of vitamin D deficiency in their patients such as tiredness, vague aches, and pains and advise them the right diet plans and supplementation to cure it. In the long run, a National policy on Vitamin D food fortification similar to that being practiced in the US and some European countries is needed to help eradicate the problem from its root itself.”

Adding to this, Dr. Ambrish Mithal, Chairman, Division of Endocrinology & Diabetes, Medanta – The Medicity and Dr. Ajay K Ajmani, Senior Consultant Endocrinologist, BLK Super Specialty Hospital in a joint statement said, “Vitamin D deficiency is rapidly gaining epidemic proportions yet it is the most under diagnosed and under treated nutritional deficiency in the world. Vitamin D, which can be synthesized in the body by sun exposure, is essential to maintain calcium homeostasis in the body for good bone health and for overall disease prevention. Supplementation is required when adequate levels are not met from natural sources. Indians are more prone to Vitamin D deficiency for several reasons including long and stressful working hours in a closed office space, consumption of a predominantly vegetarian diet and obesity amongst others. The need of the hour is to raise awareness about this problem and possible prevention measures.”

The IMA Rise and Shine campaign, in addition to conducting CMEs and soft skill training workshops across 128 cities, also comprises of a National daily SMS campaign for doctors, awareness through an active Facebook page, regular State and National Body meetings and public sensitization events.

IMA released certain guidelines for doctors during the CME. These include:
·         Indians require higher levels of vitamin D supplementation than their Western counterparts.
·         The typical dose of Vitamin D supplementation in Indian adults is about 2000 International units per day.
·         Doses up to 4000 IU daily are considered safe and do not require monitoring. Toxicity has not been reported below intakes of 10000 IU/day.
·         The optimum serum 25(OH)D level for patients with bone disorders like osteoporosis is 30 ng/dL (International Osteoporosis Foundation 2010, Endocrine Society 2011)
·         A serum 25(OH)D level of 30 ng/ml is also preferable for older adults (>50 years),  who are at risk for osteoporosis (IOF). For other patient groups or population, 25(OH)D values of  20 ng/ml may be considered adequate. Most Indians may require supplementation to achieve this level (International Osteoporosis Foundation 2010)
·         Vitamin D toxicity is most commonly caused by overdose of vitamin D supplements
·         There is no specific antidote for vitamin D toxicity. Hydration, judicious use of loop diuretics, calcitonin, bisphosphonates, and glucocorticoids are mainstay of management

IMA congratulates Union Health Minister Shri JP Nadda on taking over as President of 68th World Health Assembly

IMA congratulates Union Health Minister Shri JP Nadda on taking over as President of 68^th World Health Assembly

The Indian Medical Association (IMA) congratulates Union Health and Family Welfare Minister Shri JP Nadda on taking over as the President of the 68^th Session of the World Health Assembly being held from May 18 to May 26 at Geneva.

IMA believes that it is a matter of great honour for our country, and IMA in particular, to assume presidency of this prestigious global health event that plays a decisive role in context of global health initiatives to prevent and cure various diseases. The health minister’s projection of India’s position on various global health issues has drawn positive response globally which is a matter of great pride.

The Presidential Address articulated India’s stand aptly by highlighting the importance of Yoga and emphasising the need to adopt a healthy lifestyle to improve health globally.

The contribution of 2.1 million US dollars to the World Health Organization (WHO) reflects India’s commitment to WHO and has helped to establish the role of India as a global leader in health.

India has assumed presidency of the prestigious World Health Assembly, the decision making body of the WHO, after a gap of 19 years.

A special photo exhibition on Yoga - “Yoga for All, Yoga for Health” was also organised at Geneva on the initiative of the Union health Ministry. Such an event on Yoga, an ancient Indian tradition, has happened for the first time at a prestigious global platform creating history.

Last year in December, the UN General Assembly adopted a resolution led by India, with co-sponsorship from 177 countries, to observe 21st June as the International day of Yoga.

Prof Dr A Marthanda Pillai                                                                  Dr KK Aggarwal

National President, IMA                                                                      Hony Secy Gen, IMA

Best age to stop smoking is after 40

Best age to stop smoking is after  40

Cigarette smoking is a leading preventable cause of mortality.  It kills more than 60 lacs people worldwide every year.  More than 50% of regular smokers would invariably die from tobacco related illnesses which includes Heart Attack, Cancer or Asthmatic Lungs diseases.

31st May is "NO Tobacco Day" & IMA will come out with a weeklong health education activities for the public said Padma Shri Awardee Dr. M.Marthanda Pillai, National President and Padma Shri Awardee Dr K K Aggarwal, Hony. Secretary General, IMA.

Stopping smoking before age of 40 is associated with larger decline in pre mature death than stopping it at a later date.

However, quitting smoking even after the age of 50 is still associated with lower risk of death  as compared to those who continue.

Even in smokers, over age of 80 quitting smoking appears to reduce mortality.

Cigarette is responsible for more than 10% of all cardiac deaths.

Medical Profession and Strike: IMA Stand

Medical Profession and Strike: IMA Stand

Right of the Medical profession to protest and even to go on strike is a right which IMA will not compromise.  Every citizen has the right to protest and even go on strike in rare situations and this right is ingrained in Article 19 of our constitution.

IMA has a sense of satisfaction that the Supreme Court refused to ban strike by Doctors and opined that MCI is the body to receive complaints on ethical issues related to Doctors strike.

But it is unfortunate that MCI which should look after the interest of the Modern Medical Profession and rise voice in favour of the Medical Profession whenever there are issues which affect smooth medical practice, preferred to do the job of policing the medical profession by wrongly interpreting the Supreme Court verdict and instructed State Councils to take action against striking doctors.

IMA strongly protest against the MCI circular.  IMA want to inform MCI and State Councils that IMA and Medical Profession reserve the right to strike whenever necessary inspite of the MCI circular. 

Doctors rarely resort to strike when there is no alternative to make the authorities to listen to our just demands.  It is the responsibility of MCI to see that the just demands of the doctors are considered by the Government.

Vide circular dated 22-04-2015 MCI has written to all State Councils, referring to SC judgment and also to 2002 Regulations to take action against doctors going on strike. There is nothing in the said judgment and Regulations to hold that it is against law on the part of doctors to go on strike. 

Regulations nowhere even contain the word "strike". The MCI circular does not advise the SMCs as to which regulation restrains a doctor from striking work in pursuance of just demands that remain unaddressed by the authorities. The circular has created an unnecessary confusion and scare among doctors all over India because, coming from the MCI, an ordinary person feels intimidated by it. The circular can be misused by the SMC's. SMCs, feeling dictated by the MCI, are likely to pass adverse and illegal decisions against the accused doctors.

Article 19 in The Constitution Of India 1949:  talks about protection of certain rights regarding freedom of speech etc: (1) All citizens shall have the right; (a) to freedom of speech and expression; (b) to assemble peaceably and without arms; (c) to form associations or unions; (d) to move freely throughout the territory of India;

Doctors rarely resort to strike when there is no alternative to make the authorities listen to their just demands. Strike is a fundamental right of workers and, till today, there is no ban on strikes in India.

The scheme of the Industrial Disputes Act, 1947 implies a right to strike (vii) in industries. A wide interpretation of the term 'industry' (viii) by the courts includes hospitals, educational institutions, clubs and government departments.

 SC judgment has drawn a parallel with the Bar Council of India and has suggested that all professionals, whether medical or legal, should be treated alike and should be judged by the respective professional council and not by the Hon'ble SC in a matter concerning strike.  A continuous 22 day strike was held by all lawyers in all district courts of Delhi, paralyzing court work and harming the interest of clients, but the bar Council has not taken any action against striking lawyers this time or even earlier occasions.

Doctors' strike are not peculiar to India but have taken place in other countries also, including USA and UK.

The question of striking work arises usually in case of doctors in service. It is best to let the employer deal with strike by employees. For those not in service, it is up to the private practitioners to decide for themselves about when they want to open their clinic and for how long. No restrictions can be placed upon private practitioners except under law.

 Pertaining Laws of MCI: Basic norms are not to neglect emergencies

 MCI Ethics regulation 2.4 The Patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving adequate notice to the patient and his family. Provisionally or fully registered medical practitioner shall not willfully commit an act of negligence that may deprive his patient or patients from necessary medical care.

 Regulation 2.4 mandates, not ignoring emergencies and giving adequate notice to non emergent patients

MCI Ethics Regulation 2.1 Obligations to the Sick: 2.1.1 Though a physician is not bound to treat each and every person asking his services, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he discharges in the course of his professional duties. In his treatment, he should never forget that the health and the lives of those entrusted to his care depend on his skill and attention. A physician should endeavour to add to the comfort of the sick by making his visits at the hour indicated to the patients. A physician advising a patient to seek service of another physician is acceptable, however, in case of emergency a physician must treat the patient. No physician shall arbitrarily refuse treatment to a patient. However for good reason, when a patient is suffering from an ailment which is not within the range of experience of the treating physician, the physician may refuse treatment and refer the patient to another physician.

 The above regulation again indicates that strike should be the last resort

 The Essential Services Maintenance Act (ESMA) 1968 is an act of Parliament of India which was established to ensure the delivery of certain services, which if obstructed would affect the normal life of the people. 2. (1) Definitions. In this Act,- (a) " essential service" means- (i) any postal, telegraph or telephone service; (ii) any railway service or any other transport service for the carriage of passengers or goods by land, water or air with respect to which Parliament has power to make laws; (iii) any service connected with the operation or maintenance of aerodromes, or with the operation, repair or maintenance of aircraft; (iv) any service connected with the loading, unloading, movement or storage of goods in any port; (v) any service connected with the clearance of goods or passengers through the customs or with the prevention of smuggling; (vi) any service in any mint or security press; (vii) any service in any defence establishment of the Government of India; (viii) any service in connection with the affairs of the Union, not being a service specified in any of the foregoing sub- clauses; (ix) any other service connected with matters with respect to which Parliament has power to make laws and which the Central Government being of opinion that strikes therein would prejudicially affect the maintenance of any public utility service, the public safety or the maintenance of supplies and services necessary for the life of the community or would result in the infliction of grave hardship on the community, may, by notification in the Official Gazette, declare to be an essential service for the purposes of this Act;

Recently in South Africa Portfolio Committee on Labour, the ANC unanimously rejected the Labour Relations Amendment Bill 2014, which seeks to prevent the high incidence of violent strikes in South Africa

Finally MCI has not banned strikes and even if there is a BAN by MCI  on Doctor's strike, IMA will go for it, If the situation warrants.

In a recent news published in THE TRIBUNE it was stated that IMA headquarters endorses the decision of MCI regarding the actions to be taken against striking doctors. This was never communicated ort said by IMA.

IMA want to reiterate and conclude that the right to protest and even to strike is a fundamental right of the Medical Profession and we will safe guard this right.

Prof. Dr. A. Marthanda Pillai                                         Prof. Dr. K. K. Aggarwal

National President, IMA.                                                Honorary Secretary General, IMA.

Secondhand exposure to smoking in the first trimester of pregnancy is hazardous to fetal health

Secondhand exposure to smoking in the first trimester of pregnancy is hazardous to fetal health

Smoking in pregnancy is harmful to both the mother as well as her unborn child. Women who smoke or are exposed to secondhand smoke during pregnancy are at greater risk for spontaneous pregnancy losses, preterm births, preterm premature rupture of membranes, placenta previa, abruptio placentae and still births.

Most of these risks can be reduced by avoiding secondhand smoking, said Padma Shri Awardee, Prof (Dr.) A. Marthanda Pillai, National President Indian Medical Association (IMA) and Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.

The IMA campaign on Tobacco cessation will continue till 31st May, 2015 with a Tableau, which will go around Delhi/NCR to create awareness on how to quit smoking.

Quitting smoking during pregnancy has beneficial aspects but most benefits occur if one quits smoking or avoids exposure to secondhand smoke during the first three months of pregnancy.

In pregnancy, there is nothing like reducing or cutting down on smoking.  It has to be a “Zero Smoking Policy.” For women who cannot quit, drugs are not contraindicated.

About 50% of women who quit, restart within 2 months. Therefore, continuing counselling is required.

IMA sends Legal Notice to Sanjay Leela Bhansali and Akshay Kumar

IMA sends Legal Notice to Sanjay Leela Bhansali and Akshay Kumar

IMA today sent a Legal Notice calling for removal of objectionable scenes from the movie ‘Gabber is Back’ released on 1st May, 2015.

Padma Shri Awardee Dr A Marthanda Pillai, National President, Indian Medical Association (IMA), Dr S S Aggarwal, National President-Elect and Padma Shri Awardee Dr K K Aggarwal, Hony Secretary General, IMA, in a joint statement said that in accordance with the Cinematograph Act, 1952 and other provisions of law, the Director, Producer and Actor are under the obligation and have a responsibility to ensure that no movie or scene of the movie would incite or likely to incite of commission of any offence.

The said movie scene shows doctors intentionally treating a dead patient to make money. The said intentional scene in the movie has not only lowered the dignity of the medical profession, but has also provoked the public at large against the noble profession of the doctors.

The legal notice says that the Producers, Directors and Actors in order to make money create false sensations in the public, so that the movie becomes a hit, which has caused immense loss to the reputation of the doctors.

The Medical Association has demanded to immediately remove the objectionable scene from the movie ‘Gabber is Back’.

IMA has also sent a notice to the Central Board of Certification, Censor Board to ban the movie with immediate effect till objectionable scenes from the movie are removed.

The Association has also called upon the addressees to tender a written apology in national newspapers to the doctors and pay Rs. 5 crore as compensation for damaging the image of the medical profession.

Hypertension in children: Never ignore high blood pressure in children younger than 10 years

Hypertension in children: Never ignore high blood pressure in children younger than 10 years

17th May is World Hypertension Day

Hypertension or high blood pressure is a condition that is usually prevalent in adults. However, hypertension is now becoming common in children too.

Speaking on the occasion of World Hypertension Day, Padma Shri Awardee Dr A Marthanda Pillai National President Indian Medical Association (IMA) and Padma Shri Awardee Dr KK Aggarwal Honorary Secretary General IMA and President Heart Care Foundation of India said that hypertension in childhood and adolescence contributes to the early development of heart disease, but all high BP in children is not benign. Curable blood pressure in children should always be ruled out, especially in children when they develop blood pressure below the age of 10.

World Hypertension Day is celebrated on 17th of May every year in order to create awareness about hypertension amongst the public around the world. The theme for 2015 is ‘Know your Numbers’.

IMA released some facts on high BP in children on the occasion.

·         First blood pressure should be checked at age of 4 years.

·         Hypertension in childhood and adolescence contributes to premature heart disease.

·         Childhood hypertension is divided into two categories: primary hypertension (no identifiable cause is found) and secondary hypertension (an underlying cause is identified).

·         Always identify a child with secondary hypertension, who may have a curable disease.

·         Always identify other comorbid risk factors like obesity, abnormal lipids, diabetes.

·         It has become clear that hypertension begins in childhood and adolescence, and that it contributes to the early development of heart disease. 

·         Secondary hypertension should be suspected in children with one or more of the following findings:

o  Pre-pubertal, particularly younger than 10 years of age.

o  A thin child with a negative family history for high BP

o  An acute rise in blood pressure above a previously stable baseline.

o  Severe HT defined as stage 2 HT (BP >5 mmHg above the 99th percentile)

o  Past history of urinary tract infection, especially pyelonephritis, or underlying congenital kidney or urologic anomalies raises the possibility of renal scarring.

o  Symptoms suggestive of excess levels of catecholamines include headache, sweating, and tachycardia in addition to high BP

o  Ambiguous genitalia

o  Swelling feet

o  Blood in urine

o  Family history of chronic or congenital kidney disease (such as polycystic kidney disease)

o  Drugs history (steroids, or oral contraceptives)

o  History of umbilical arterial catheterization as a neonate.

o  Presence of an abdominal bruit

o  High BP in upper limbs and low BP in lower limbs. 

Women should quit smoking to lower their risk of heart disease

Women should quit smoking to lower their risk of heart disease

Smoking is still the leading preventable cause of death. Not only does tobacco smoke cause lung cancer, it is also implicated in heart disease, other cancers and respiratory diseases. As per WHO, an estimated 3 million people in industrialized countries will have died as a result of tobacco use by 2030, and an additional 7 million people in developing countries face the same fate.

The harms of smoking are reversible and can decline to the level of nonsmokers, as per a report in Journal  of the American Medical Association, said Padma Shri, Dr A Marthanda Pillai National President IMA and  Padma Shri, Dr BC Roy National Awardee & DST National Science Communication Awardee, Dr KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA.

Women who quit smoking have a 21 percent lower risk of dying from coronary heart disease within five years of quitting their last cigarette. The risk of dying from other conditions also declines after quitting, although the time frame varies depending on the disease. For chronic obstructive pulmonary disease, it may take up to 20 years. It's never too early to stop, and it's never too late to stop.

Women who are current smokers have almost triple their risk of overall death compared with nonsmoker women. Current smokers also have a 63 percent increased risk for colon cancer compared with never-smokers, while former smokers have a 23 percent increased risk. There was no significant association between smoking and ovarian cancer.

Women who started smoking early in life are at a higher risk for overall mortality i.e. of dying from respiratory disease and from any smoking-related disease. However, a smoker's overall risk of dying returns to the level of a never-smoker 20 years after quitting. The overall risk declines by 13 percent within the first five years of abstaining. Most of the excess risk of dying from coronary heart disease vanishes within five years of quitting.

For chronic obstructive pulmonary disease, the return to normal takes 20 years, although there is an 18 percent reduction in the risk of death seen within five to 10 years after quitting.  And the risk for lung cancer does not return to normal for 30 years after quitting, although there is a 21 percent reduction in risk within the first five years.

Over 50 focus only on upper blood pressure

Over 50 focus only on upper blood pressure

For patients over 50, doctors only need to monitor the upper systolic blood pressure, and can ignore the lower diastolic blood pressure reading, said Padma Shri, Dr A Marthanda Pillai National President IMA and  Padma Shri, Dr BC Roy National Awardee & DST National Science Communication Awardee, Dr KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA.

Systolic blood pressure – the top number in a blood pressure reading – is the pressure exerted at the beginning of the heart's pumping cycle, while diastolic pressure records the lowest pressure during the resting cycle of the heart. Both pressures are routinely measured when recording the blood pressure.

As per a report published in the journal The Lancet, there is such an emphasis on diastolic pressure that the patients are not getting their systolic blood pressures adequately controlled. 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 Relief work at NEPAL

                              IMA HQ   MEDICAL RELIEF ACTIVITY

             IN A COUNTRY --FEDERAL DEMOCRATIC REPUBLIC OF NEPAL

Nature’s fury, no forecasting system combined with poor preparedness has left Nepal battling its worst earthquake.

On April 25^th  severe   earthquake caused havoc in Nepal. Many people have died. Property and infrastructure worth billions of rupees have been damaged.

The earthquake fury has overtaken the community of Nepal especially of interior parts of it and left them numbs. There are huge losses of human life as well as properties and need to help. It is our social responsibility towards our neighboring   country to help in all ways.

Indian Medical Association HQ .,  immediately came into action under the guidance of our Hon. Secretary  General  Dr. K. K. Aggarwal. A line of action was prepared immediately and sent to all IMA members along with” DO & DON’T During   Earthquake”.

A monitoring cell was established at IMA HQ.  An appeal was sent to all Working Committee Members , State Branch Presidents and  Hon. Secretaries of local branches and IMA  members to volunteer their services reaching  Nepal for help and to contribute for medicines and financial contribution  to the IMA President  Disaster Relief  Fund.

A request was done to Indigo airlines to provide free tickets to go to Kathmandu.  We received a positive response. We received many request from our IMA members to go to Nepal at the service of affected victims. 

IMA HQ’s unique initiative started to help the needy brethren of our neighboring   country, which was affected by disaster, the natural calamity of earthquake. The important aspect of this activity was that all the doctors went voluntarily. Doctors were sent from different states like Chhattisgarh , Gujarat, Maharashtra  and Punjab.

Dr. Ahok Gupta, Dr. Kanchan Gupta, Dr. Shashank shrigarpure, Dr. Sujit Adsol, Dr. Mansukh Kanani , Dr. Anoop Verma, Dr. Roohi  Deol & Dr. Dilip Sheth along with few paramedical attended from 30^th April to 9^th May 2015.

Our IMA Team worked together with the doctors of Vayodha Hospital,  B.K. Eye Foundation Hospital and Bhaktipur Civil Hospital. Along with seeing the patients in OPD ,  they assisted  the hospital doctors in debridement of wounds, dressings, anesthesia procedure , emergency cesarean section  and emergency resuscitation of new born also.  Along with hospital doctors our team rendered services in the periphery area of Kathmandu to the interior part of Nepal.

Our team examined about 300 patients of Charagadh village of Kirtipura Dist., about 250 patients at village Ranitar of Sindupalchok district     ( at a distance of around 100 k.m. from Kathmandu ) and 60 patients in Karyabinayak Municipality area in a temporary OPD erected in tent.  In the Hospital OPD of Bhaktipur Civil Hospital Dist. Bhaktipur, our team had examined about 500 patients including pediatric patients in three days. Around 1100 patients were examined from pediatric to geriatrics patients by our team in 10 days.

The whole relief activity was carried out with the support of Heart Care Foundation of India.

Long Live IMA

Dr. Marthanda Pillai  , National President IMA

Dr. KK Aggarwal     Honorary Secretary General IMA

Dr Chetan N  Patel, Chairman IMA HQ DMC

Indian Medical Association condemns the movie ‘Gabbar is Back’ for its derogatory portrayal of the Medical Profession

Indian Medical Association condemns the movie ‘Gabbar is Back’ for its derogatory portrayal of the Medical Profession

New Delhi May 8, 2015: Last week saw the National release of the much-awaited film ‘Gabbar is Back’ produced by none other Sanjay Leela Bansali and Viacom 18 Motion pictures. The star cast of the film includes Akshay Kumar and Shruti Hassan. The director is Mr Krish and scriptwriter Mr A R Murugadoss.

The film has however come into controversy with the Indian Medical Association - one of the oldest National voluntary organizations representing doctors of modern medicine around the world having as its members 2.5 lakh doctors spread over 29 States and 1700 local branches.

Speaking on the issue, Padma Shri Awardees and the present National President - Dr A Marthanda Pillai and Honorary Secretary General of the IMA - Dr K K Aggarwal in a joint statement said, “The Indian Medical Association is in deep anguish about the way the medical profession has been projected in the Movie “Gabbar is Back. It’s portrayal is derogatory and unrealistic and we together stand against it.”

‘Gabbar is Back’ showcases doctors in a hospital setting carrying out the fraudulent act of providing medical treatment to a person who was already “dead” before arriving at the hospital. Akshay Kumar who plays the role of the doctor is shown to be aware of the patient’s death however he makes everyone at the hospital believe that he is critical but still alive.

With cases of violence against doctors on the rise, a totally unjustified message such as this one as shown in the movie will only add fuel to the fire and further provoke public outrage against the medical profession. The IMA wants the above-referred scene to be withdrawn from the movie immediately. Till such time that this is done, the movie should be boycotted and banned.

The video clipping of the scene has been sent by the IMA to its 2.5 lakh doctor members to create awareness about the issue and to request all of them to boycott the film.

The IMA feels that if the Censor Board, Ministry of Information & Broadcasting, Health Ministry or the Home Ministry do not take any immediate action against this, IMA will be forced to start a public protest against the movie.

One can view a snapshot of the movie by clicking the following link: http://tinyurl.com/kzkg48o

All asthmatics should check level of pollution

IMA observes World Asthma Day today

In a joint statement, Dr Bipul Mishra, Asthma Specialist from Pushpanjali Crosslay Hospital and Dr K K Aggarwal, Hony Secretary General, Indian Medical Association (IMA) said that both allergic and non-allergic asthma including chronic bronchitis are on the rise. Most asthmatics also suffer because of the rising pollution in the cities. Dr Bipul Mishra and Dr K K Aggarwal were interacting with doctors on the occasion of World Asthma Day.

Addressing a gathering of doctors, Dr Vinay Aggarwal, Past National President, IMA said that all asthmatics should check level of pollution from the website of Pollution Control Board and restrict their outdoor activities if the level of pollution is high.

Schools located in areas with high pollution level also need to take steps to prevent exposure of their students to environmental pollutants, which may aggravate symptoms of asthma.

One should not ignore first attack of asthma after the age of forty

IMA Releases Asthma White Paper:

One should not ignore first attack of asthma after the age of forty and only cough or acidity may be signs of asthma says the asthma white paper released by IMA on the occasion of world asthma day.
Giving the details Padma Shri Awardees, Dr A Marthanda Pillai National President and Dr KK Aggarwal Honorary Secretary General IMA, said that if not controlled asthma can even be fatal. Following 20 points were released.

1. Do not ignore first attack of asthma after the age of 40, it may be heart in origin

2. All wheeze is not asthma and all asthmatics do not wheeze

3. Only cough may be a sign of asthma

4. If during an attack of asthma you can speak a sentence you do not have  severe asthma

5. If you get an attack of asthma more than twice in night in am month or more than twice in day time in a week you need continuous asthma treatment

6. All asthmatics should be questioned about symptoms triggered by common inhaled allergens, at home, daycare, school, or work

7. Indoor allergens, such as dust mites, animal danders, molds, mice, and cockroaches, are of particular importance.

8. Food allergy rarely causes isolated asthma symptoms, although wheezing and cough can be symptoms of food-induced anaphylaxis.

9. Aspirin and non-steroidal anti-inflammatory drugs can trigger asthma symptoms in approximately 3 to 5 percent of adult asthmatic patients.  The incidence of aspirin-exacerbated respiratory disease is higher among asthmatic patients with nasal polyps. Aspirin-sensitive asthma is uncommon in children.

10. Non-selective beta-blockers can trigger severe asthmatic attacks, even in the minuscule amounts that are absorbed systemically from topical eye drops. Selective beta-1 blockers can also aggravate asthma in some patients, especially at higher doses.
 
11. Gastric reflux is common among patients with asthma. Estimates of the prevalence of GE reflux among patients with asthma have varied from 30 to 90 percent. Look for  asthma symptoms after eating certain foods (eg, high fat food, chocolate, peppermint, caffeine, alcohol).

12. Well-controlled asthma is characterized by daytime symptoms no more than twice per week and nighttime symptoms no more than twice per month.

13. Exercise-induced asthma refers to asthma that follows exercise in many asthmatic patients. All patients with asthma should have a rapid-acting beta agonist available when exercising for relief of asthma symptoms. In patients who have well-controlled asthma, but who frequently have asthma symptoms with exercise, we recommend prophylactic use of a rapid-acting beta agonist approximately 10 minutes prior to exercise.  Avoiding exercise in cold, dry air can also reduce the stimulus for exercise-induced asthma. Oral theophylline and oral beta agonists are minimally effective or ineffective for exercise induced asthma.

14. All asthmatics should buy asthma meter ( peak flow meter ) and keep ir above 60% of normal range

15. Inhalers are better than oral drugs

16. Inhaled irritants include tobacco smoke, wood smoke from stoves or fireplaces, strong perfumes and odors, chlorine-based cleaning products, and air pollutants. Patients should be cognizant of avoiding irritants, and avoid exertion outdoors on days when levels of air pollution are elevated

17. Annual administration of influenza vaccine is recommended for patients with asthma because they are particularly at risk for complications of influenza infection. However, vaccination does not reduce the number or severity of asthma exacerbations during the influenza season, and providers should ensure that patients understand this distinction
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18. Administration of pneumococcal vaccination is recommended for adults whose asthma is severe enough to require controller medication and for children with asthma who require chronic oral glucocorticoid therapy

19. Sulfite compounds are used in the food industry to prevent discoloration. As many as 5 percent of patients with asthma may note significant and reproducible exacerbations following ingestion of sulfite-treated foods and beverages, such as beer, wine, processed potatoes, dried fruit, sauerkraut, or shrimp.

20. Near-fatal and fatal asthma exacerbations may occur in patients with mild, moderate, or severe asthma and the course may be either slow or rapid in onset.Recent history suggestive of poor asthma control or any prior history of endotracheal intubation and mechanical ventilation for asthma should alert the asthma care provider that the patient is at high-risk for near-fatal asthma exacerbations.Other factors are long duration of asthma, poor adherence to medical therapy, systemic glucocorticoid dependence, psychosocial problems, aspirin/NSAID sensitivity, cigarette smoke exposure, prior hospitalization for asthma, and aeroallergen exposure in sensitized individuals. 

Cure-in-India Initiative to boost innovation in Indian healthcare and medical device industry

Cure-in-India Initiative to boost innovation in Indian healthcare and medical device industry

New Delhi: A Summit on ‘India the Future Global Healthcare Hub’ was held at PHD House. Moderating a Session in the Summit, Padma Shri Awardee, Dr K K Aggarwal, Hony Secretary General, IMA said that IMA and PHD Chamber of Commerce shoudl join hands and promote the concept of Cure-in-India.

Once approved by the Govt. of India, any indigenous medical product is of good quality and should be promoted.

No reimbursement should be given for foreign devices for those drugs and devices, which are available from indigenous reliable sources.

The Govt. should not allow price variation in drugs of more than 10%. During epidemics, there should be a cap on medical facilities.

The cost of treatment should be transparent and there should be no hidden charges.

The Panel Discussion was organized by PHD Chamber of Commerce to promote medical tourism in India.  The panelists included Dr Himangi Bhardwaj, Dr Harsh Wardhan, Mr Nitin Mahajan, Dr Harvinder Popli and Mr Pradeep Multani.

Cure-in-India Initiative to boost innovation in Indian healthcare and medical device industry

Cure-in-India Initiative to boost innovation in Indian healthcare and medical device industry

New Delhi: A Summit on ‘India the Future Global Healthcare Hub’ was held today at PHD House. Moderating a Session in the Summit, Padma Shri Awardee, Dr K K Aggarwal, Hony Secretary General, IMA said that IMA and PHD Chamber of Commerce have co-organized the Panel Discussion to come forward and promote a concept of Cure-in-India.

Once approved by the Govt. of India, any indigenous medical product is of good quality and should be promoted.

 No reimbursement should be given for foreign devices for those drugs and devices, which are available from indigenous reliable sources.

The Govt. should not allow price variation in drugs of more than 10%. During epidemics, there should be a cap on pricing of medical facilities.

The cost of treatment should be transparent and there should be no hidden charges.

The Panel Discussion was organized by PHD Chamber of Commerce to promote medical tourism in India.  The panelists included Dr Himangi Bhardwaj, Dr Harsh Wardhan, Mr Nitin Mahajan, Dr Harvinder Popli and Mr Pradeep Multani.