Thursday 30 June 2016

Indian Medical Association appeals to its 2.5-lakh members to provide free consultation to all on Doctors Day

Indian Medical Association appeals to its 2.5-lakh members to provide free consultation to all on Doctors Day New Delhi, June 29, 2016: Indian Medical Association (IMA), the only representative, National voluntary organisation of doctors of the modern scientific system of medicine in our country has appealed to its 2.5 lakh doctors to commemorate Doctors Day by providing free medical consultation to all patients on that day. “Medical profession is a noble profession and will always remain so despite the violence and negative criticism against doctors. IMA has written to our 2.5-lakh members to observe Doctors day as IMA community service day and provide free consultation to over one crore people in one day. We strongly believe that each and every person deserves quality medical care irrespective of his or her economic background. This will help make health care more accessible to all”, said Dr SS Agarwal – National President IMA & Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA and President Heart Care Foundation of India. In addition to waiving their consultation fees for one day, IMA has also written to its 2.5-lakh members urging them to organise seminars on patient safety, conduct blood donation camps and adopt a girl child. IMA through Sameer Malik Heart Care Foundation Fund an initiative of Heart Care Foundation of India will also be supporting girl children from economically weaker sections of the society and approach them for free congenital heart surgery.

Clinical Establishment Act Update (Part 1)

Clinical Establishment Act Update (Part 1) In the 8th Meeting of National Council for Clinical Establishment, which was chaired by Dr Jagdish Prasad, DGHS, the Indian Medical Association (IMA) submitted a list of issues and objections related to Clinical Establishment Acts and Rules and persuaded the Council to discuss these issues separately in a special meeting under the Chairmanship of DGHS, which followed and IMA has been able to make following points/recommendations. 1. MA has demanded that the District Appropriate Authority must be headed by a medical person. DGHS informed the IMA members that as District Collector is the administrative head of the District, the change may not be necessary. (not agreed) 2. Exclusion of the police officer from the District Registering Committee has been agreed by the inter-ministerial Committee 3. It was recommended that single doctor clinical establishment (Husband & Wife should be taken as one unit/OAE Own Account Entrepreneur) who are providing only consultation services, may be exempted from the purview of Clinical Establishment Act. The IMA argued that single doctors are already covered under the Medical Council of India Act and are regulated by the Medical Council of India or State Medical Council. 4. Allowing Medical Establishment, which has entry level accreditation or above under NABH, need only registration under the Act and should automatically be registered under CEA without any other formalities has been referred to Ministry for decision whether this is permissible under the Act. 5. IMA raised objections to the other conditions of registration as included in Rule 9 of Central Govt. Rules, 2012. It was agreed that these conditions may be reviewed by DGHS and suggestions in this regard sent to Ministry for further action.

Wednesday 29 June 2016

Ways to lower your cholesterol

Ways to lower your cholesterol
New Delhi, June 28, 2016: High blood cholesterol is one of the major risk factors for heart disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. When there is too much cholesterol in your blood, it builds up in the walls of your arteries. Over time, this buildup causes hardening of the arteries so that they become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack. Speaking about the same, Padma Shri Awardee Dr KK Aggarwal – President Hear Care Foundation of India (HCFI) and Honorary Secretary General IMA said, “High blood cholesterol itself does not cause symptoms; so many people are unaware that their cholesterol level is too high. Lifestyle changes are imperative given the increasing incidence of high cholesterol in people in the 21st century. There are many ways in which lifestyle diseases can be averted including living an active and healthy life, eating healthy food, staying away from cigarettes and alcohol and finding effective means of stress management. Here are a few steps for using your diet to lower your cholesterol. 1. Consume unsaturated fats and avoid saturated and trans fats. Most vegetable fats (oils) are made up of unsaturated fats that are healthy for your heart. Foods that contain healthy fats include oily fish, nuts, seeds, and some vegetables. At the same time, limit your intake of foods high in saturated fat, which is found in many meat and dairy products, and stay away from trans fats. 2. Get more soluble fiber. Eat more soluble fiber, such as that found in oatmeal and fruits. This type of fiber can lower blood cholesterol levels when eaten as part of a healthy-fat diet. 3. Include plant sterols and stanols in your diet. These naturally occurring plant compounds are similar in structure to cholesterol. When you eat them, they help limit the amount of cholesterol your body can absorb. Plant sterols and stanols are found in an increasing number of food products such as spreads, juices, and yogurts. 4. Find a diet that works for you. When a friend or relative tells you how much his or her cholesterol level dropped after trying a particular diet, you may be tempted to try it yourself. If you do, and after a few months you discover that you're not getting the same benefits, you may need to chalk it up to genetic and physiological differences. There is no one-size-fits-all diet for cholesterol control. You may need to try several approaches to find one that works for you. Although diet can be a simple and powerful way to improve cholesterol levels, its results may differ from one person to another.

Service to the society and county is the best way to give back

Service to the society and county is the best way to give back Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Prof Dr C V Harinarayan, Director, Institute of Endocrinology, Diabetes, Thyroid and Osteoporosis Disorders, Sakra World Hospitals, Bangalore, Karnataka. Dr CV Harinarayan has been honored with Dr BC Roy National Award for the year 2009 under the category of ‘Oration’'. How does it feel being conferred one of the most prestigious awards in the medical field? I feel humbled and the society expects more dedicated work from me. Tell us about your journey so far. I was the first to document low vitamin D status in Indian population as a part of my DM (endocrinology) project thesis. Our studies showed that low vitamin D status of Indian population is the cause of bone disease in patients with primary hyperparathyroidism. This work on primary hyperparathyroidism is quoted in many textbooks of metabolic bone disease. It is hard to believe that in a sun drenched country like India we have vitamin D deficiency. Later this fact was confirmed by many scientific workers across the country. Our landmark population study from south India is the FIRST and ONLY study till date to document the low dietary calcium intake and low vitamin D status in agricultural laborers residing in villages. Subsequently we documented by in vitro studies on ampoule model of previtamin D synthesis and showed that we as Indians can synthesize enough vitamin D on exposure to sunlight from 11 am to 2 pm, by exposing 10 to 15% of body surface area for 15 to 30 minutes. Our studies documented that correction of vitamin D deficiency and calcium supplementation can improve the pancreatic beta cell secretory function. Our work was the first to show that renal tubular damage is the major cause of metabolic bone diseases in patients with fluorosis (Ranked top 10 publications - year 2006 by Internet). The work with BARC, Mumbai helped to indigenously develop intact IRMA radioimmunoassay for parathyroid hormone in India (make in India concept). With all this background, we were instrumental in developing the “Clinical Practice Guidelines on management of Postmenopausal osteoporosis (2012-13) – Executive summary and Recommendations” for Indian Menopause society. We developed the Department of Endocrinology, SVIMS, Tirupati, (for nearly two decades) with a good dedicated endocrine laboratory infrastructure and now we have MCI recognized seats (two) for DM endocrinology. What were the early challenges faced by you in your career? How did you manage to overcome them? To convince the scientific community about low vitamin D status in Indian population was a major challenge. We conducted population studies in villages in and around Tirupati (Tirupati is nearer the equator and sun drenched most of the year) and showed low dietary calcium intake along with low vitamin D status in agricultural population. It is the first and only study (till date) of dietary calcium intake and vitamin D status from rural India. It would not have been possible but for the dedicated team work of students and staff of the department of Endocrinology, and support of the administration of SVIMS, Tirupati, Andhra Pradesh. Tell us about your family. How important has been the role of your family in your journey? Family has been always supportive and encouraging in my academic work. What would be your message to the community? Service to society and community should be kept in mind of all health care professionals, so that it benefits a larger segment of the society. Given a chance, what changes would you like to bring about in health policies? India being a vast country with diverse cultural habits and limited resources, I would aim to provide adequate dietary calcium and vitamin D to all ages groups and both genders using available resources. What advice would you give to youngsters? Society and our country has given you the opportunity to get knowledge, the best way to return that is service to the society and county.

Tuesday 28 June 2016

HCFI raises awareness about essential first aid skills

HCFI raises awareness about essential first aid skills
New Delhi, June 27, 2016: It is not uncommon for each one of us to face a situation where we are required to administer emergency first aid, and we have absolutely no idea what to do. There always exists potential for injury, illness, or sudden health emergency around us making basic first aid knowledge essential. While many situations may require no more than a Band-Aid, others are more serious and may even be life-threatening. Knowing what to do when an accident happens or when someone becomes suddenly ill can help ensure that minor injuries don’t develop into major medical conditions. More importantly, it can save a life. “Each and every person must learn basic and easy to follow first aid techniques for it can help save lives. Most people remain unaware that life-saving techniques such as hands-only CPR can bring a person back to life after suffering from a sudden cardiac arrest if performed up to 10 minutes after their death. Every minute counts and can reduce the chances of a person’s survival so acting swiftly is key. The technique can be learnt by anyone. People also often make injuries worse because they are not aware of how to deal with them. For instance, ice should never be applied on a burn. We at HCFI urge every person to undergo a basic first aid training course,” said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. Common First Aid Situations Bleeding - If possible, cover wounds with clean bandages, and then apply direct pressure to the wound to control bleeding. Continue to put pressure on the wound till help arrives. In the case of minor wounds, the cut can be washed to remove dirt. However if the wound is bleeding heavily, do not wash it for if you do, all the clotting agents will get washed away making the wound bleed more. Head injury - If a person suffers a blow to the head, the brain can be shaken inside the skull. This is called a concussion. It tends to result in a short loss of consciousness (a few seconds to a few minutes). Most people make a full recovery from a concussion, but occasionally it may become more serious. If you think someone has a concussion, call an ambulance immediately. Do not also administer pain killers immediately for it may diminish the seriousness of the injury. In the case of a minor injury apply a cold press that will help reduce the swelling and reduce the pain. Burns – In a case of burns the most common mistake that people make is using ice on them. Ice, in fact, can make the burns worse. It is important to put the burnt part under running water till the burning stops. It is also important to never cover the burnt area. In cases of severe burns, the person should be rushed to the nearest medical facility. Ice, lotions, oil and butter, should not be applied to the burn. Shock - Symptoms of shock typically include pale, bluish skin that is cold to the touch, vomiting, and thirst. You cannot reverse shock with first aid, but you can prevent it from getting worse. Help maintain an open airway by keeping the victim on their back with their mouth slightly open, control obvious bleeding, and elevate the victim's legs about 12 inches if possible. Prevent loss of body heat by covering the victim in blankets. Do not administer any food or liquids, as this increases the risk of vomiting. Loss of Consciousness and Breathing Issues - If the victim appears to be unconscious, tap or shake them and ask loudly “Are you okay?” If the victim is breathing but unconscious, gently roll them onto their side (if possible) while keeping the head and neck aligned. If the victim is not breathing, perform cardiopulmonary resuscitation (CPR) until help arrives. Nosebleed – One should not panic and should make the patient sit in an upright position with his head slightly forward. With one's thumb and index finger, pressure should be applied to the soft part of nostrils below the nose bridge until the bleeding stops. If bleeding persists for over ten minutes, then it is important to seek medical aid Choking Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible. If choking is occurring, first, deliver five back blows between the person's shoulder blades with the heel of your hand. Then Perform five abdominal thrusts. Continue to alternate between 5 blows and five thrusts until the blockage is dislodged. Poisoning – Call for medical help at the earliest Sudden cardiac arrest - The HCFI hands only CPR 10 mantra is extremely simple to remember and can help save a person's life. It does not require mouth-to-mouth breathing unless the victim has died due to drowning or is a small child. What each of us needs to remember is that within 10 minutes of death (earlier the better), for a minimum of 10 minutes (the longer, the better), compress the centre of the chest of the deceased person continuously and effectively with a speed of 10×10 = 100 per minute. Chest compression should be stopped only when the person starts breathing, or the ambulance arrives.

Study links health Benefits from nature to frequency and duration of visits to green spaces

Study links health Benefits from nature to frequency and duration of visits to green spaces Yet another study has corroborated the positive health outcomes of communing with nature. Researchers from Australia have shown that people who made long visits to green spaces had lower rates of depression and high blood pressure, and those who visited more frequently had greater social cohesion. Higher levels of physical activity were linked to both duration and frequency of green space visits. The results further suggested that up to a further 7% of depression cases and 9% of high blood pressure cases could be prevented if all city residents were to visit green spaces at least once a week for an average duration of 30 minutes or more. For the first time, the researchers quantified the link between health outcomes and experiences of nature, as measured by intensity (i.e. the quality or quantity of nature itself), and the frequency and duration of a city resident’s experiences. The participants’ experiences of nature were measured by three factors: The average frequency of visits to outdoor 'green spaces’ during a year, the average duration of visits to these spaces across a week and the intensity of nature in these spaces - measured by the amount and complexity of greenery in that space. The researchers concluded that higher levels of physical activity were linked to both duration and frequency of visits to green spaces. The study is published online June 23, 2016 in the journal Scientific Reports

Monday 27 June 2016

Do not give Aspirin still wrongly given to lower AF stroke risk: IMA

Do not give Aspirin still wrongly given to lower AF stroke risk: IMA
New Delhi, 25th June, 2016: Over one-third of patients with atrial fibrillation (AF), who have a moderate to high risk for stroke are prescribed aspirin to lower this risk instead of oral anticoagulants, even though aspirin has no benefit for the prevention of thromboembolism related to AF. A newly published analysis of data from the American College of Cardiology's PINNACLE registry involving AF patients has found that almost 40% of patients were treated with aspirin alone instead of an oral anticoagulant. After multivariable adjustment, patients prescribed aspirin were found to be also more likely to have other risk factors for cardiovascular disease than those prescribed an oral anticoagulant. “There is good evidence now that aspirin is not an anticoagulant, and that it does not prevent stroke due to AF. Understanding the risks involved of wrong treatment, IMA sent out a circular educating its 2.5 lakh members about how Aspirin should not be given to lower AF stroke risk” said Dr SS Agarwal – National President IMA & Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA & President Heart Care Foundation of India. While the American College of Cardiology/American Heart Association (ACC/AHA) still "give tepid support" to the use of aspirin in patients with a low risk for stroke (CHA2DS2-VASc ≤1), other guidelines, including those from the European Society of Cardiology (ESC) and NICE in the United Kingdom, no longer recommend aspirin for AF-related thromboembolism prevention.

Honor the dignity of patients and treat them with respect

Honor the dignity of patients and treat them with respect Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Dr OP Kalra, Vice-Chancellor. Pt. B.D. Sharma University of Health Science, Rohtak (Haryana), India. Dr OP Kalra has been honored with Dr BC Roy National Award for the year 2010 under the category of ‘Eminent Medical Teacher’. How does it feel being conferred one of the most prestigious awards in the medical field? I feel humbled. It re-enforces my belief that hard work, dedication, perseverance and clarity of goal help you achieve your targets and finally get rewarded. Institutional support by University College of Medical Sciences (UCMS), University of Delhi, University Grants Commission and lately Pt. B.D. Sharma University of Health Sciences, Rohtak and Haryana Govt. have played a major role in this achievement. Tell us about your journey so far? I am an alumnus of JN Medical College, Aligarh Muslim University and Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. I did my MD (Medicine) followed by DM (Nephrology) from PGIMER, Chandigarh. In pursuit of higher learning in the field of Nephrology, I got the opportunity to work as Visiting Scholar at University of Missourie, Columbia and Veterans Administration Hospital, Columbia, Missourie, USA under the aegis of International Society for Peritoneal Dialysis. Thereafter, I got the opportunity to work at the University Hospitals of Leicester, United Kingdom under Commonwealth Academic Staff Fellowship Program. After completing my initial training at PGIMER, Chandigarh in 1984, I joined as a faculty member at Medical College and Hospital, Rohtak, Haryana, where I upgraded the Dialysis Unit; however I moved to UCMS (University of Delhi) in 1988, where I have been working for more than 27 years until 2015. During my long stint at Delhi, I got rich experience of working with distinguished faculty members, researchers and trained several undergraduates and postgraduates in Medicine. During the last nearly 9 years, I got the opportunity to work as Principal of UCMS and GTB Hospital. It was an exciting experience to witness the remarkable all round growth of quality medical education, research and tertiary level patient care facilities in the College, which made its mark among the top three Medical Institutions in the country. I developed the Division of Nephrology at GTB Hospital, Delhi and subsequently under the aegis of Government of NCT of Delhi, established Hemodialysis Centers at various Delhi Government Hospitals under Public Private Partnership. During this period, I also got an opportunity to work at BP Koirala Institute of Health Sciences, Nepal for a period of 2 years on deputation from Government of India, where I established the Dialysis Unit. Mid-year in 2015, I was given the opportunity to return to Rohtak and serve as the Vice Chancellor at the prestigious Pt BD Sharma University of Health Sciences. During my current position at the University of Health Sciences, Rohtak, I am involved with several major projects such as operationalization of Trauma Centre and Maternal and Child Care Hospital, establishment of Imaging and Hemodialysis facilities under Public Private Partnership, modernization of Intensive Care Units (ICUs) and Emergency Department, upgradation of Regional Cancer Centre establishment of facilities for Kidney Transplantation, establishment of DNB Training Centers in various District Hospitals in Haryana, etc. What were the early challenges faced by you in your career? How did you manage to overcome them? I faced some difficulties for seeking permission for higher training in Nephrology and starting hemodialysis centers in various hospitals; however, persistence and single minded approach helped me achieve my goals in the interest of patient care to the underprivileged strata of society. Tell us about your family. How important has been the role of your family in your journey? My family has provided me all-round support in my pursuit for excellence in medical education and establishment of various patient care services especially for patients with kidney disease. My parents have been a constant source of encouragement throughout my medical education and subsequently all the years. My wife, son and daughter have always provided me rock-like support and stood by me throughout to help me realize my dreams in medical education and healthcare services. What would be your message to the community? For the general community, I would like to convey that today we are in the midst of an epidemic of non-communicable diseases such as diabetes mellitus, hypertension, heart disease, kidney disease, cancer, stroke, etc. These diseases are responsible for nearly two-thirds of the deaths in our country. The root cause of these medical ailments is sedentary life style and obesity. By simple methods, such as cessation of smoking, regular physical exercise, healthy eating habits, avoidance of stress and strain in life and periodic physical check up and simple laboratory investigations, we can prevent majority of these ailments and if the illness has already started, it can be controlled in the early stages and various complications can be prevented. Given a chance, what changes would you like to bring about in health policies? In order to pursue the goal of Health for All and Millennium Development Goal, we need to strengthen our medical education and healthcare delivery system at the grass route level. There is need for overall restructuring of medical education to make it more relevant to the contemporary needs of the country and inclusion of quality parameters for assessment of medical colleges. A greater emphasis needs to be given for preventive and promotive health at all levels, especially Primary Health Centers. An effective referral system needs to be developed, so that patients with minor ailments can be treated at Primary Health Centers. There is need to strengthen emergency treatment and tertiary care facilities at referral hospitals to provide subsidized healthcare for one and all and health insurance system needs to be very effective. What advice would you give to youngsters? I would like to convey a message to the young aspiring medical students that our medical profession is different from all other professions. This involves caring for human life with a sense of compassion, sympathy and we must follow the basic principles of bioethics while dealing with the patients. We have to honor the dignity of our patients and treat them with respect. While delivering healthcare, we must attend to all patients without differentiating on the basis of their caste, creed, socioeconomic status or religious leaning. We must regularly update our knowledge and skills to keep abreast with the recent advances in medical sciences, so that best medical care may be provided to the suffering humanity.

Art therapy, regardless of skill level, reduces stress

Art therapy, regardless of skill level, reduces stress A new study provides preliminary evidence that creating art can reduce stress levels, regardless of the artistic skill of the person. The study included 39 healthy adults aged 18-59 years, who were provided with a selection of art materials, such as modeling clay, marker pens, and paper, and were told they could use them to create anything they wanted to. Researchers found that just 45 minutes of art creation - such as making clay models or drawing – significantly lowered levels of the stress hormone, cortisol in 75% of the study participants indicating a reduction in stress. This finding remained even after accounting for participants' experience of art-making. Participants' written responses indicated that they found the art-making session to be relaxing, enjoyable, helpful for learning about new aspects of self, freeing from constraints, an evolving process of initial struggle to later resolution, and about flow/losing themselves in the work. The study led by Girija Kaimal, assistant professor of creative arts therapies at Drexel University in Philadelphia, PA, and colleagues is published in Art Therapy, Journal of the American Art Therapy Association

The need to reduce the social stigma around eating disorders

The need to reduce the social stigma around eating disorders
New Delhi, June 26, 2016: A person who has a preoccupation with what they eat, how much they weight and how they look in the eyes of others are often said to be suffering from an eating disorder. This condition is often so serious that the person with the eating disorder may starve themselves, throw up the food that they eat or inflict on different forms of self-harm just to reach a certain ideal body weight. “The incidence of eating disorders is on the rise in India especially amongst the younger generation, given with population’s sudden obsession with size zero. However given the social stigma and societal pressures attached to eating disorders, those suffering from it hardly ever get any actual medical help. It is the duty of the medical fraternity to keep a watch out for eating disorders amongst their patients and counsel them effectively on how eating a healthy and diet is necessary and the serious complications that eating disorders can cause on one’s overall health and well-being. Parents must also be counselled to reduce stigma and encourage acceptance. They must be made to realise that they are a key support system to their child” said Padma Shri Awardee Dr. KK Aggarwal – President Heart Care Foundation of India and Honorary Secretary General IMA. The path from a normal, healthy diet to an eating disorder is sometimes a very perplexing one. While the exact cause is unknown, certain factors may play a role in the development of an eating disorder. This could include emotional issues like low self-esteem or impulsive behaviour. Traumatic events, abuse, or pressure to conform to society’s definition of beauty may also trigger a shift toward unhealthy behaviours Eating disorders may begin slowly, with crash diets or overindulging from time to time and then spiral out of control. There are several types of eating disorders that exist: • Anorexia nervosa: People with anorexia nervosa have an irrational fear of gaining weight. Many of these people see themselves as overweight or obese, even when confronted with evidence that they are underweight and malnourished. They continue to weigh themselves several times in a day and eat in bare minimal quantities. Anorexia nervosa may cause side effects or additional health problems including anaemia, brittle hair and nails, constipation, feeling lethargic or tired frequently, infertility, low blood pressure amongst others. • Bulimia nervosa - People with bulimia nervosa frequently eat large amounts of food at one time, often in private. This is called binge eating. People with this disorder feel as if they have no control over their eating behaviours. To compensate, the person will then engage in excessive exercise, self-induced vomiting, or fasting. He or she may even use diuretics, laxatives, or an enema. The side effects of bulimia nervosa include acid reflux disorder, chronically sore or inflamed throat, dehydration from purging fluids and vomiting, electrolyte imbalance, gastrointestinal problems amongst others. • Binge-eating disorder - People with a binge-eating disorder do not have control over how much they eat. A person with a binge-eating disorder consumes excessive amounts of food on a regular basis, often to the point of discomfort and pain. People who binge may eat when they’re not hungry, and they will often continue eating long after they’re full. People with a binge-eating disorder are often obese or overweight. For that reason, these people are often at a higher risk for developing cardiovascular disease and high blood pressure. Healthy diet tips • An ideal diet should also be low in sodium and no person should consume more than 6 gm of sodium chloride in a day. • The consumption of trans fat, which is found in hydrogenated oils or vanaspati ghee, should be minimal as it is bad for the heart and reduces the good HDL cholesterol levels and increases the bad LDL cholesterol. • A person should avoid eating out as much as possible since the food in most restaurants and hotels is high on trans fat and usually will be bad for the heart • Refined carbohydrates like white bread, white flour, white rice and refined sweetened cereals and white sugar should be avoided and replaced with options like whole grain flour, healthy green cereals and oat meal • Any sweet item containing more than 10% sugar should be limited. On an average the sugar content in soft drinks is 10%, Indian sweets is 30-50% sugar

Saturday 25 June 2016

IMA raises awareness amongst its 2.5-lakh members about safe surgery practices in light of the recent medical mishap

IMA raises awareness amongst its 2.5-lakh members about safe surgery practices in light of the recent medical mishap

In light of the recent medical mishap where a 24 year old man’s wrong foot was operated upon at Fortis Hospital Shalimar Bagh, the Indian Medical Association raised awareness amongst its 2.5 lakh members about safe surgery practices and how such a case is a never event and must not happen again.

“Never events are situations where deficiency of service and or negligence is presumed and no trial of expert’s evidence is necessary. Uttermost care must be taken during a surgery so as to ensure that such an incident never happens again”, said Dr SS Agarwal – National President IMA & Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA.

Following are examples rectified by various court judgments. 

a.    Removal of the wrong limb or performance of an operation on the wrong patient.
b.    The issues arising in the complaints in such cases can be speedily disposed of by the procedure that is being followed by the Consumer Disputes Redressal Agencies and there is no reason why complaints regarding deficiency in service in such cases should not be adjudicated by the Agencies under the Act.” 

Case References
1.    IMA vs VP Shantha 1995 (6) SCC 651 (37)
2.    SC/4119 of 1999 and 3126 of 2000, 14.05.2009, Nizam Institute of Medical Sciences vs. Prasanth S. Dhananka and Ors: B.N. Agrawal, Harjit Singh Bedi and G. S. Singhvi, JJ. 

The recommendations shared by IMA include:
·      Definition: Near misses -- when surgeons started to operate on the wrong site or patient
·      Operations on the wrong site or the wrong patient should never happen
·      Surgeons shall mark the surgical site before going to the operating room. 
·      Also mark the site that should not be touched. 
·      Reasons for errors include similar sounding names, failure to check patient names on medical records and reversing the sides of X-rays and scans placed on viewing boxes in the operating room.
·       In the operating room before starting surgery, all members of the surgical team should confirm that they have the correct patient, surgical site and procedure. 
·      The operating room team should take ''a timeout'' to check medical records and X-rays, discuss among themselves what they are about to do, and corroborate information with the patient.

Friday 24 June 2016

Common myths and facts about heart surgery

Common myths and facts about heart surgery
Dr OP Yadava and Padma Shri Awardee Dr KK Aggarwal educate the public and the medical fraternity about the urgent need to raise awareness about the reversal of heart disease New Delhi, June 23, 2016: Cardiovascular disease (CVD) is one of the leading causes of morbidity and premature mortality in the world contributing to over 17.5 million deaths every year. The disease poses a great risk in a developing country like India, which is not only one of the most densely populated nations but is also beset with extreme differences in terms of the social, economic and regional divisions. India already holds the title of the diabetic capital of the world. Estimates indicate that by 2025, we will also be the CVD capital of the world with estimation of 69.8 million disease cases. The most common type of heart disease in India is coronary artery disease that is caused due to the narrowing and choking of the heart artery walls over a period due to the deposit of plaque. The primary cause of this is irregularities in one’s lifestyle. Recognising the need to raise awareness and reduce the increasing incidence of heart disease in the young (people below the age of 40), the Indian Medical Association (IMA) and Heart Care Foundation of India (HCFI) today hosted a webcast that was attended by over 3000 doctors and patients. The expert faculty for the webcast included Dr OP Yadava Chief Cardio Thoracic Surgeon, National Heart Institute and Padma Shri Awardee Dr KK Aggarwal – President HCFI & Honorary Secretary General IMA. Speaking about the webcast, Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA said, “Congenital heart disease affects 3-5 children per 1000 population. If diagnosed and treated in a timely manner, almost 99% of the children and live healthy and long-lives. Rheumatic heart disease is easily preventable by maintaining adequate hygiene. In case of any fever with joint pains and a sore throat, parents must take their child to the doctor without any delay. In the 21st century with more and more people being diagnosed with coronary heart disease at an early age given their irregular lifestyles, it is crucial that awareness is raised about the long-term implications of living high stressed sedentary lives. Tobacco consumption increases a person’s chances of developing heart disease by two folds. Living a healthy and balanced life is key. People must also be educated about how it is not required to take second opinions from doctors abroad. Cardiac treatment in India is as advanced as it is outside.” Adding to this, Dr OP Yadava said, “It is important that heart patients should never ignore mild symptoms by finding some explanation for it. They must report it to their doctor, as it could be a hidden sign of an upcoming heart attack. It is also important to remember that after a heart surgery, constant monitoring of the heart and lifestyle modifications preventing further damage are critical. The decision to go in for a bypass or an angioplasty must be a team including the cardiologist, cardiac surgeon, family physician as well as the patient and his/her family members”. Though heart surgery is a costly affair, there are organizations that come to the aid of poor people. Heart Care Foundation of India through its partnership with the National Heart Institute has been helping save lives of those in need of heart surgery but are unable to afford treatment because of their financial background over the past two years. Any person can apply for the benefits of the project the Sameer Malik Heart Care Foundation Fund by calling on its helpline number +919958771177. An expert committee comprising of notable individuals would assess all applications received by the fund. Once sanctioned, the funds would be directly deposited in the bank account of the medical establishments treating the patient.

Another medical mishap: wrong foot operated

Another medical mishap: wrong foot operated
It’s a never event: Never events are situations where deficiency of service and or negligence is presumed and no trial of expert’s evidence is necessary. Following are examples rectified by various court judgements.
a.            Removal of the wrong limb (1,6) or performance of an operation on the wrong patient  (1,6)
b.            “……The issues arising in the complaints in such cases can be speedily disposed of by the procedure that is being followed by the Consumer Disputes Redressal Agencies and there is no reason why complaints regarding deficiency in service in such cases should not be adjudicated by the Agencies under the Act.” (6)
References
1.            IMA vs VP Shantha 1995 (6) SCC 651 (37)
2.            SC/4119 of 1999 and 3126 of 2000, 14.05.2009, Nizam Institute of Medical Sciences vs. Prasanth S. Dhananka and Ors: B.N. Agrawal, Harjit Singh Bedi and G. S. Singhvi, JJ.


IMA Recommendations
1.            Definition: Near misses -- when surgeons started to operate on the wrong site or patient
2.            Operations on the wrong site or the wrong patient should never happen
3.            Surgeons shall mark the surgical site before going to the operating room.
4.            One should also mark the site should not be touched.
5.            Reasons for the errors include similar sounding names, failure to check patient names on medical records and reversing the sides of X-rays and scans placed on viewing boxes in the operating room.
6.            In the operating room before starting surgery, all members of the surgical team should confirm that they have the correct patient, surgical site and procedure.
7.            The operating room team should take ''a timeout'' to check medical records and X-rays, discuss among themselves what they are about to do, and corroborate information with the patient.

The Universal IMA Protocol  based on JCI recommendations for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery


Conduct a pre-procedure verification process


1.            Address missing information or discrepancies before starting the procedure.
2.            Verify the correct procedure, for the correct patient, at the correct site.
3.            Try to involve the patient in the verification process.
4.            Identify the items that must be available for the procedure.
5.            Use a standardized list to verify the availability of items for the procedure.
6.            At a minimum, these items include: relevant documentation (history and physical, signed consent form, preanesthesia assessment); labeled diagnostic and radiology test results that are properly displayed and any required blood products, implants, devices, special equipment
7.            Match the items that are to be available in the procedure area to the patient.



Mark the procedure site

1.            Mark the site when there is more than one possible location for the procedure and when performing the procedure in a different location could harm the patient.
2.            The site does not need to be marked for bilateral structures. Examples: tonsils, ovaries
3.            For spinal procedures: Mark the general spinal region on the skin. Special intraoperative imaging techniques may be used to locate and mark the exact vertebral level.
4.            Mark the site before the procedure is performed. Try to involve the patient in the site marking process.
5.            The site is marked by the doctor who is ultimately accountable for the procedure and will be present when the procedure is performed.
6.            In limited circumstances, site marking may be delegated to some medical residents
7.            The mark is unambiguous and is used consistently throughout the organization.
8.            The mark is made at or near the procedure site.
9.            The mark is sufficiently permanent to be visible after skin preparation and draping.
10.          Adhesive markers are not the sole means of marking the site.
11.          For patients who refuse site marking or when it is technically or anatomically impossible or impractical to mark the site (see examples below): Use your organization’s written, alternative process to ensure that the correct site is operated on. Examples of situations that involve alternative processes: mucosal surfaces or perineum, minimal access procedures treating a lateralized internal organ, whether percutaneous or through a natural orifice, interventional procedure cases for which the catheter or instrument insertion site is not predetermined [Examples: cardiac catheterization, pacemaker insertion], teeth and premature infants, for whom the mark may cause a permanent tattoo.


Perform a time-out

1.            The procedure is not started until all questions or concerns are resolved.
2.            Conduct a time-out immediately before starting the invasive procedure or making the incision.
3.            A designated member of the team starts the time-out.
4.            The time-out is standardized.
5.            The time-out involves the immediate members of the procedure team: the individual performing the procedure, anesthesia providers, circulating nurse, operating room technician, and other active participants who will be participating in the procedure from the beginning.
6.            All relevant members of the procedure team actively communicate during the time-out.
7.            During the time-out, the team members agree, at a minimum, on the following: correct patient identity, correct site, procedure to be done
8.            When the same patient has two or more procedures: If the person performing the procedure changes, another time-out needs to be performed before starting each procedure.
9.            Document the completion of the time-out. The organization determines the amount and type of documentation.



[Source JCI]

Thursday 23 June 2016

IMA & HCFI hold public and GP awareness webcast the advancements in heart surgery over the past decade

IMA & HCFI hold public and GP awareness webcast the advancements in heart surgery over the past decade
Dr. OP Yadava and Padma Shri Awardee Dr KK Aggarwal stress on how timely diagnosis and intervention is key to saving lives Anyone can log on to www.ima-india.org/imalive or www.heartcarefoundation.org to watch the webcast live between 3-4pm on June 23, 2016 New Delhi, June 22 2016: Heart disease in the young is on the rise. More and more people under the age of 40 years require cardiac intervention because of defused blockages in the heart arteries due to a faulty lifestyle. If timely awareness is not raised in ways to reverse the increasing incidence of heart disease from its very onset, most people will end up in need of stenting or a bypass surgery in 15-20 years. Aimed at raising awareness amongst the medical fraternity as well as the general public about the need to understand the risks and benefits of heart surgery and to raise awareness about reducing the incidence of coronary artery disease; a webcast will be organized by the Indian Medical Association and Heart Care Foundation of India between 3-4pm tomorrow. The expert faculty for the webcast will include of Dr. OP Yadava Chief Cardio Thoracic Surgeon, National Heart Institute and Padma Shri Awardee Dr KK Aggarwal – President HCFI & Honorary Secretary General IMA. High-stress levels characterize the lifestyle of the 21st century Indians. The spend less time engaging in outdoor sports & activities and more time in front of the television, laptop, and iPad. They sleep less, eat mostly unhealthy junk food and are addicted to evils such as smoking and drinking from a fairly young age. They are also extremely competitive making them more stressed than happy. All these factors make them more vulnerable to heart diseases than their ancestors. Coronary artery disease a lifestyle induced disease and therefore is preventable. It is a well-known fact, that jungle animals never need stenting or a bypass surgery because they live in accordance with the laws of nature. Speaking about the webcast, Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA said, “Though advancements in cardiac surgery have been dramatic in the past two decade, efforts must be made to control the growing prevalence of heart disease and control symptoms using lifestyle changes and other non-surgical methods till surgery becomes essential. When surgery is a must, it is lifesaving and can add quality and years to one’s life. But surgery is not a license to practice a faulty lifestyle. If after surgery lifestyle modifications are not made, it can be fatal for the patient”. In addition to stenting and bypass surgery for the correction of coronary artery disease, people may also need surgical intervention for valve damage and congenital heart disease. Though heart surgery is a costly affair, there are organizations that come to the aid of poor people. Heart Care Foundation of India through its partnership with the National Heart Institute has been helping save lives of those in need of heart surgery but are unable to afford treatment because of their financial background over the past two years. Any person can apply for the benefits of the project the Sameer Malik Heart Care Foundation Fund by calling on its helpline number +919958771177. An expert committee comprising of notable individuals would assess all applications received by the fund. Once sanctioned, the funds would be directly deposited in the bank account of the medical establishments treating the patient. Anyone can log on to the live webcast by visiting www.ima-india.org/imalive or www.heartcarefoundation.org between 3-4 pm tomorrow. To get one’s questions answered live, they can call on 9811090206 during that time. The webcast is free for all.

Aspirin still wrongly given to lower AF stroke risk

Aspirin still wrongly given to lower AF stroke risk

Dr SS Agarwal, Dr KK Aggarwal Over one-third of patients with atrial fibrillation (AF), who have a moderate to high risk for stroke are prescribed aspirin to lower this risk instead of oral anticoagulants, even though aspirin has no benefit for the prevention of thromboembolism related to AF. A newly published analysis of data from the American College of Cardiology's PINNACLE registry involving AF patients has found that almost 40% of patients were treated with aspirin alone instead of an oral anticoagulant. After multivariable adjustment, patients prescribed aspirin were found to be also more likely to have other risk factors for cardiovascular disease than those prescribed an oral anticoagulant. There is good evidence now that aspirin is not an anticoagulant, and that it does not prevent stroke due to AF. While the American College of Cardiology/American Heart Association (ACC/AHA) still "give tepid support" to the use of aspirin in patients with a low risk for stroke (CHA2DS2-VASc ≤1), other guidelines, including those from the European Society of Cardiology (ESC) and NICE in the United Kingdom, no longer recommend aspirin for AF-related thromboembolism prevention. Aspirin administration places a patient at significant risk for bleeding, while offering virtually no protection from stroke. “Take two aspirin and call me in the morning” is not an appropriate treatment for a patient with AF at risk for thromboembolism, the clot only thickens. (MedPage Today)

Wednesday 22 June 2016

Yoga can play a key role in the long-term management of lifestyle diseases

Yoga can play a key role in the long-term management of lifestyle diseases
On International Yoga Day, Heart Care Foundation of India raises awareness about the effectiveness of yoga in helping manage diseases such as hypertension, diabetes, and cardiovascular irregularities New Delhi, June 21, 2016: The United Nations General Assembly declared June 21st as the International Day of Yoga in December 2014. With Indian origins, yoga is a 5000-year-old physical, mental and spiritual practice aimed at the transformation of the mind, body and soul. Over the past few decades, Yoga has been widely accepted by people globally as a holistic approach to well-being and health. With established health benefits, yoga is also increasingly being prescribed by doctors as an add-on treatment with allopathic drugs to patients suffering from both psychosomatic and chronic degenerative diseases. Over the past two decades chronic diseases, such as chronic obstructive pulmonary disease (COPD), cancer, cardiovascular diseases (CVD), obesity and diabetes mellitus, have emerged as serious problems worldwide, and it has become important for older adults to maintain or improve their immune functions. Yoga has been reported to have positive effects on distress and functional performance in patients with chronic diseases and improves several immunological indicators. Speaking about the benefits of yoga, Padma Shri Awardee Dr KK Aggarwal - President Heart Care Foundation of India and Honorary Secretary General IMA said, “Yoga helps patients fight lifestyle disease by reducing stress and building the body’s immunity. Yoga also helps slow down the deterioration of body organs. Pranayam and meditation if practiced regularly can help control high blood pressure. On International Yoga Day it is important to raise awareness about how while patients must continue to use allopethic medicines as recommended by their doctor, performing regular yoga can help them further fight dieases. It is important to note that yoga is generally low-impact and safe for healthy people when practiced appropriately under the guidance of a well-trained instructor. It is important that patients suffering from lifestyle diseases consult their doctor before starting a regular yoga routine.“ A few health benefits of yoga include: 1. Improves your flexibility Yoga helps us improve our flexibility thereby helping reduce or eliminate common aches and pains, helping improve blood circulation and thereby also boosting immunity 2. Builds muscle strength Strong muscles do more than look good. They also protect us from conditions like arthritis and back pain, and help prevent falls in elderly people. 3. Drains your lymphs and boosts immunity When you contract and stretch muscles, move organs around, and come in and out of yoga postures, you increase the drainage of lymph (a viscous fluid rich in immune cells). This helps the lymphatic system fight infection, destroy cancerous cells, and dispose of the toxic waste products of cellular functioning. 4. Increases your heart function Yoga and meditation that follows every yoga session reduces hypertension, improves blood circulation and relieves depression. It helps reduce extra pressure on one’s heart caused due to added stress thereby improving its functioning and helping protect us against future heart attacks 5 Lowers blood sugar Yoga lowers blood sugar and LDL (“bad”) cholesterol and boosts HDL (“good”) cholesterol. In people with diabetes, yoga has been found to lower blood sugar in several ways: by lowering cortisol and adrenaline levels, encouraging weight loss, and improving sensitivity to the effects of insulin. It is important to keep in mind that people who are suffering from some disease or are obese should seek professional help while performing yoga. The yoga routine should be designed by the yoga instructor in consultation with the treating doctor for best results and to avoid injury.

IMA Soft Skills CME Series

IMA Soft Skills CME Series

Dr K K Aggarwal On an average an IMA leader sends or receives more than 100 emails every day. We need to train our staff, who respond to emails addressed to us, in basic email etiquettes so that the receiver does get annoyed but feels happy. Train your IMA staff who handles your email in the following manner. Let me confess, even I learnt a lot after I attended a similar workshop. If you write an email to someone you don’t know “Might I take a minute of your time?” If it is someone you know “I’m just emailing to ask…” If you have sent an email and haven’t got any feedback “When you get a minute, could you please drop me a line regarding my last email?” or “I would like to follow up making sure you got my previous email.” Instead of writing “Meeting” in the subject matter Write: “Tomorrow, 5 am, super-important discussion!” Instead of writing “Asking for a favor”. “Life or death matter that requires your intervention”. Always write “I am attaching the file” Or he may not notice it Always introduce yourself, if you writing the mail for the first time Say “Let me introduce myself…” or “My name is Dr KK and I am addressing you because…” Be polite even while complaining “I wish to complain about the services I got yesterday. I would like to get some explanations (refund, replacements, etc.)” Do not write your services were bad. Let people know that you realize why they are angry and offer a solution. “I understand your frustration...” How to reject a CV “You are great, but unfortunately...” “You did very well at the job interview, but I regret to inform you that we picked someone else”. “ASAP” vs “As soon as possible” Acronyms are very cool to use in texting. They are not for emails, thought. So, unless you are writing to a close friend, try not to use them. If you can put the same information in shorter sentences and paragraphs, then you should better do it. Show people that you value their time. Start every new idea with a new paragraph. “Hello X I got your reports yesterday after the meeting with our partners, and I have a few questions and remarks concerning them. Did you collect the information only for two months? I needed the data for at least four. By the way, you need to be careful with the numbers there were several miscalculations. I also noticed that the figures dropped last month; we need to inform the marketing department about it so that they start dealing with the problem. The guy from the second flow told me that their sales increased two times this month; we should start doing something to top that. Respectfully Y” This letter is easier to read because it is structured in a more logical way and has no unnecessary information. “Hello X Thank you for your reports from yesterday. I have a few things to discuss. Did you collect the information only for two months? I needed the data for at least four. By the way, you need to be careful with the numbers there were several miscalculations. I also noticed that the numbers dropped last month; we need to inform the marketing department about this matter. Respectfully, Y” Always write your name at the end of the letter Unless you are writing to your mom or a best friend Give a personal touch “I hope you are doing great...” For example, if your business partner was on vacation (you might have gotten an auto-email notifying about that), you can ask how it went. If you write to your doctor, for example, ask how his or her family is. If it is a business mail, write a nice comment about a person’s company, site, service, etc. “Hello X I hope you and your family are doing great. Have you finished those cooking classes you were so thrilled about? Well, I actually writing you with a question…” Always thank It is always nice to know that your time and effort are appreciated. “I really appreciate you finding some time to answer my email”, or Simply “Thanks a lot for writing back.” Use would or could If you are asking someone to do you a favor, to read your article, to mention your business, to take a look at your product, etc., you need to be very polite and use “would” or “could” sentences. “Would you be so kind…?” Apologize for the delay “I’m very sorry it took me this long to answer…” Or “I apologize for the delayed reply…” Never apologize with a reasoning Apology is an apology. Never give a reason. You shouldn’t make excuses saying that you were sick, out of town or your cat died. Just politely apologize; you don’t have to explain yourself (unless you do because you missed some deadlines, etc.) Be careful with the titles before names You should be very careful with the titles before names. Many people get offended when they are addressed by the wrong titles. “Dear Mr Aggarwal” Always be correct in your spellings The names may be different: Agarwal, Aggarwal, Agrawal How you end the mail matters The way you close an email may influence whether you get a response or not; or how fast you will get it. Seeing some gratitude or a nice wish at the end of an email can dispose people to answer right away. “Have a great weekend and I hope to hear from you soon!” or “Enjoy the evening! Looking forward to hearing from you”. Essential components of writing Before writing any word ask yourself • Is it necessary? • Is it based on facts? • Is it kind? Do not write if the answer is to any one of them is ‘No’. Whether you write emails on a regular basis or not, it is necessary to know how to do it right. You always need to understand what results you want to get and write appropriate phrases to get those results. If you write complaints and want to get your money back, you need to be convincing and reasonable, but not rude. If you write a business email, you need to be formal and respectful. And if you write to a friend or good acquaintance, you can be personal, but still respect their time. Always think of the feedback you want to receive and then write!

Monday 20 June 2016

Medicine is the most rewarding and satisfying career

Medicine is the most rewarding and satisfying career Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Prof Dr Kanan Yelikar, Prof & Head, Dept. of Obs/Gyn, Govt. Medical College & Hospital, Aurangabad. Dr Yelikar is Dean of Govt. Medical College- 2016. She has been elected as president of AMOGS – Association of Maharashtra Obstetrics and Gynaecological Societies 2016-1018. Earlier, Dr Yelikar has served as Vice President FOGSI (2007) and Chairperson Clinical Research Committee FOGSI (2004- 2008). Dr Kanan Yelikar has been honored with Dr BC Roy National Award for the year 2009 under the category of ‘Eminent Medical Teacher’. How does it feel being conferred one of the most prestigious awards in the medical field? It was a dream come true for me. I am very happy, overwhelmed, excited and at the same time very, very humbled to accept it. I thank the almighty for having considered me to be worthy of it. Tell us about your journey so far. I completed my MD in Obstetrics and Gynecology with a meritorious career, in the year 1983 from Govt. Medical College Nagpur, a reputed institute. Teaching was my passion and hence I joined as assistant professor in the Dept. of Obs/Gyn in Govt. Medical College, Aurangabad. Presently, I am Prof and Head of the Dept. of Obstetrics and Gynecology, Government Medical College and Hospital, Aurangabad, (MS) and have a teaching experience of more than 30 years. I have been selected as Dean of Govt. Medical College. I undertook special training in advanced Laparoscopic Surgery, Ultrasound, Infertility, High Risk Pregnancy, Colposcopy and Research Methodology. Maternal health is an area that is of special interest to me. I successfully established a state of the art delivery room and a High Dependency Unit (HDU), the first of its kind in the state of Maharashtra, for I received the Safe Motherhood Award on 11th July, 2014, World Population Day from the Govt. of Maharashtra. I have had the privilege of being conferred Life membership of more than 8 national professional organizations of repute and been elected as chairperson and member of different statutory bodies of the State Medical University, like Senate, Board of studies – undergraduate and postgraduate and faculty of medicine since 2002. I run several skill enhancement training programs in my institute - Basic Emergency Obstetric Care, Comprehensive Abortion Care and Comprehensive Emergency Obstetric care, which train Medical Officers and nurses, a joint project in collaboration with NRHM and FOGSI, funded by the Bill & Melinda Gates Foundation. I am also a Nodal officer for Maharashtra Breast Feeding Promotion Initiative (MBPI) since 1994 and in that capacity have conducted more than 50 workshops on Correct Breast Feeding Practices, which has helped thousands of newborns to survive. As chairperson of District MTP Committee and District PCPNDT committee, I have conducted counselling programs of doctors who had a borderline mind-set regarding sex determination. This has helped to curb down the child sex ratio of Aurangabad district over a period of 5 years. The Directorate of Medical Education and Research, Govt. of Maharashtra appointed me as the Member of Scientific Advisory Board of Medical Research Council of Maharashtra (MRCM). I have a huge list of Publications, both in national and international journals. I have delivered more than 300 Guest Lectures as National Faculty, 50 keynote addresses and five orations; also, I have been an invited national faculty for the First National Satellite FOGSI conference, the first of its kind, in 2004 and an Invited faculty at FIGO congress 2000 at Washington DC, USA. I have also successfully organized more than 50 workshops on different subjects and more than 30 post graduate CMEs at different medical colleges in the country. I received the President’s Rotating Trophy for Aurangabad Obstetrics and Gynecological Society for the year 1998. This award is given by FOGSI to the best obs/gyn society of the year. I was honored as the Best Woman Doctor on International Women’s Day by Giants Aurangabad, Best Baby Friendly Hospital award by Breast Feeding Promotion Network of India and Govt. of Maharashtra Safe Motherhood Award July 2014. What were the early challenges faced by you in your career? How did you manage to overcome them? The early challenges in my career were the non availability of advanced technology like USG and Laparoscopy in the govt. sector. To overcome this I personally paid the USG training fee at Wadia Maternity Hospital and underwent training during my vacation period in 1987. Similarly in 1994, I underwent advanced laparoscopy training during my summer vacation. Consequently, I could establish both USG and laparoscopy as early as 1987 and 1994, respectively, in my Dept. Thousands of poor patients benefited as a result. Similarly, thousands of medical students and hundreds of post graduate students are getting an opportunity to learn about these medical technical tools. Tell us about your family. How important has been the role of your family in your journey? My father Dr Wamanrao Korpe, pre-independence era medical practitioner and my mother Dr Kusumtai Korpe were keen to have five of their six children opt for medical career. My father was my role model. At the end of the day all human beings need a warm family. My husband Dr Avinash Yelikar, a consultant Plastic Surgeon, is a constant source of inspiration for me. My daughter, Dr Ashwini, who is now an IVF consultant and my son Dr Aditya who is pursuing superspeciality in urology, accepted my long absences from home whenever I was busy with my projects. The backup support to the home sweet home is my mother-in-law Smt Laxmibai Yelikar, who is equally active even today. What would be your message to the community? Indian medicine has been globally accepted. Believe that Indian doctors are the best and doctors always try to provide the best services to the best of their knowledge and ability. Some complications and morbidity and mortality are inherent with the disease itself. So doctors are not always to be blamed for mishaps which occur in hospitals. Given a chance, what changes would you like to bring about in health policies? Medical education system is changing at a fast pace and we need to keep up with the changing trends. The first thing I would like to do is sanction sabbaticals to medical teachers in the Govt. sector in order to enable them to train themselves in the latest technology, which will help them impart updated knowledge to the students. This will definitely help Indian medical colleges to produce world class doctors capable of competing globally. What advice would you give to youngsters? Believe in hard work and perseverance. The combination definitely fetches you success. Doctor is next to God. Teacher is next to the “Guru”. Combination of the two, doctor and teacher i.e. a medical- teacher is above all and hence all medical teachers should prove themselves. Indian medical science has a very bright future. Newer researches are going to help serve the human illnesses. Do understand medicine is a noble profession concerned with human services, though it is a lengthy career as compared to other careers, it is the most rewarding and satisfying career as I understand today. Jai Hind! Jai Medical Fraternity!!

Prevent India from becoming the heart disease capital of the world

Prevent India from becoming the heart disease capital of the world
New Delhi, June 20, 2016: Cardiovascular disease (CVD) is one of the leading causes of morbidity and premature mortality in the world contributing to over 17.5 million deaths every year. The disease poses a great risk in a developing country like India, which is not only one of the most densely populated nations in the world but is also beset with extreme differences in terms of the social, economic and regional divisions. Given the high economic burden of cardiovascular disease on the patient and his family; the increase in disease incidence runs the risk of the rich becoming poor and the poor dying just because they could not afford the treatment. India already holds the title of the diabetic capital of the world. Estimates indicate that by 2025, we will also be the CVD capital of the world with estimation of 69.8 million disease cases. While there exist various types of cardiovascular diseases plaguing the Indian society, the most rapidly growing form coronary artery disease. Speaking about this, Padma Shri Awardee Dr. KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA, said, “Coronary artery disease (CAD) is caused due to the narrowing and choking of the heart artery walls over a period due to the deposit of plaque. The primary cause of this is irregularities in lifestyle. People in today's day and age are faced with high levels of stress causing them to eat an unhealthy diet, sleepless, are more dependent on toxic substances such as alcohol and cigarettes and exercise less. All these lead to an increase in the incidence of CAD.” Indians due to their genetic predisposition are anyways at a high risk of premature coronary artery disease due to the presence of high levels of lipoprotein. They further add to their misery by living an extremely unhealthy lifestyle. The risk of CAD in Indians is 3–4 times higher than Americans, six times higher than Chinese and 20 times higher than Japanese. CAD affects Indians 5–10 years earlier than any other community in the world. One can take the following steps to reduce their chances of suffering from cardiac diseases in the future · Eat healthily, sleep right: A healthy and balanced diet is key for a healthy heart. An over-dependence on junk food, consumption of saturated and trans fats, food containing high salt and sugar levels - lead an increased incidence of obesity, high cholesterol, hypertension and diabetes, all key risk factors of heart disease. A healthy diet must consist of items, which have low levels of saturated fats, fresh fruits and vegetables. · Exercise Regularly – Regular exercise is important to strengthen one's, heart, lower blood pressure, keep obesity under control, burn off stress, boost your self-esteem and help you sleep better. By regularly exercising for at least 30 minutes three to four times a week, one can keep their heart healthy. Aerobic exercise particularly is beneficial for patients with a tendency to get heart disease. · Kick the butt – Smoking damages the lining of your arteries, leading to a build-up of fatty material (atheroma), which narrows the artery. This can cause angina, heart attack or a stroke. The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. Thus, smoking is extremely dangerous for a heart and is a leading cause of heart attacks amongst the young. · Limit the intake of alcohol - If you have to consume alcohol, drink in moderation. Drinking excessive amounts of alcohol causes raised blood pressure, which is one of the most important risk factors for having a heart attack or a stroke. Increases in your blood pressure can also be caused by weight gain from excessive drinking. Obesity too leads to cardiovascular ailments · De-stress - High levels of stress make other risk factors for heart disease such as high cholesterol or high blood pressure worse and push you to lead an unhealthy lifestyle. For instance, if you are under stress, your blood pressure goes up, you may overeat, you may exercise less, and you may be more likely to smoke. Engaging in deep breathing exercises, doing yoga all help decrease stress and the temptation to indulge in bad habits. · Get regular health check-ups - Lastly, one must get regular health check-ups to ensure that their blood pressure, hypertension, cholesterol are all under control and to rule out the risk of heart disease in the future. If at risk, necessary lifestyle changes must be made

Prevent India from becoming the heart disease capital of the world

Prevent India from becoming the heart disease capital of the world
New Delhi, June 20, 2016: Cardiovascular disease (CVD) is one of the leading causes of morbidity and premature mortality in the world contributing to over 17.5 million deaths every year. The disease poses a great risk in a developing country like India, which is not only one of the most densely populated nations in the world but is also beset with extreme differences in terms of the social, economic and regional divisions. Given the high economic burden of cardiovascular disease on the patient and his family; the increase in disease incidence runs the risk of the rich becoming poor and the poor dying just because they could not afford the treatment. India already holds the title of the diabetic capital of the world. Estimates indicate that by 2025, we will also be the CVD capital of the world with estimation of 69.8 million disease cases. While there exist various types of cardiovascular diseases plaguing the Indian society, the most rapidly growing form coronary artery disease. Speaking about this, Padma Shri Awardee Dr. KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA, said, “Coronary artery disease (CAD) is caused due to the narrowing and choking of the heart artery walls over a period due to the deposit of plaque. The primary cause of this is irregularities in lifestyle. People in today's day and age are faced with high levels of stress causing them to eat an unhealthy diet, sleepless, are more dependent on toxic substances such as alcohol and cigarettes and exercise less. All these lead to an increase in the incidence of CAD.” Indians due to their genetic predisposition are anyways at a high risk of premature coronary artery disease due to the presence of high levels of lipoprotein. They further add to their misery by living an extremely unhealthy lifestyle. The risk of CAD in Indians is 3–4 times higher than Americans, six times higher than Chinese and 20 times higher than Japanese. CAD affects Indians 5–10 years earlier than any other community in the world. One can take the following steps to reduce their chances of suffering from cardiac diseases in the future · Eat healthily, sleep right: A healthy and balanced diet is key for a healthy heart. An over-dependence on junk food, consumption of saturated and trans fats, food containing high salt and sugar levels - lead an increased incidence of obesity, high cholesterol, hypertension and diabetes, all key risk factors of heart disease. A healthy diet must consist of items, which have low levels of saturated fats, fresh fruits and vegetables. · Exercise Regularly – Regular exercise is important to strengthen one's, heart, lower blood pressure, keep obesity under control, burn off stress, boost your self-esteem and help you sleep better. By regularly exercising for at least 30 minutes three to four times a week, one can keep their heart healthy. Aerobic exercise particularly is beneficial for patients with a tendency to get heart disease. · Kick the butt – Smoking damages the lining of your arteries, leading to a build-up of fatty material (atheroma), which narrows the artery. This can cause angina, heart attack or a stroke. The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. Thus, smoking is extremely dangerous for a heart and is a leading cause of heart attacks amongst the young. · Limit the intake of alcohol - If you have to consume alcohol, drink in moderation. Drinking excessive amounts of alcohol causes raised blood pressure, which is one of the most important risk factors for having a heart attack or a stroke. Increases in your blood pressure can also be caused by weight gain from excessive drinking. Obesity too leads to cardiovascular ailments · De-stress - High levels of stress make other risk factors for heart disease such as high cholesterol or high blood pressure worse and push you to lead an unhealthy lifestyle. For instance, if you are under stress, your blood pressure goes up, you may overeat, you may exercise less, and you may be more likely to smoke. Engaging in deep breathing exercises, doing yoga all help decrease stress and the temptation to indulge in bad habits. · Get regular health check-ups - Lastly, one must get regular health check-ups to ensure that their blood pressure, hypertension, cholesterol are all under control and to rule out the risk of heart disease in the future. If at risk, necessary lifestyle changes must be made

Sunday 19 June 2016

First of its kind e-meet on Tuberculosis held between 1000 IMA doctors from across 28 of its State branches and the Association leadership

First of its kind e-meet on Tuberculosis held between 1000 IMA doctors from across 28 of its State branches and the Association leadership
The interactive webcast was an initiative under IMA Digital, a program in line with the Prime Minister’s Digital India initaitve

New Delhi, July 23 2015: Bridging the vast geographical gap that exists in our country, the Indian Medical Association has launched several digital initiatives aimed at more efficient implementation of its programs. As a part of this, a first of its kind e-meet was held between 2-3pm today which connected over 100 doctor members of IMA from across States with the leadership on the subject, “Why notifying tuberculosis cases was important”.  The overall aim of the Indian Medical Association is to use the digital medium to amplify important healthcare messages to both its 2.5-lakh doctor members and to the public at large.

Interacting with over 1000 IMA doctors from across the country, Padma Shri Awardee, Dr A Marthanda Pilliai, National President, IMA and Padma Shri Awardee, Dr KK Aggarwal, Honorary Secretary General, IMA in a joint statement said, “In May, 2012 the Ministry of Health & Family Welfare declared Tuberculosis as a notifiable disease. Most Municipal Corporation Acts also include Tuberculosis under the section of dangerous diseases, which mandate reporting. The Medical Council of India in its ethics for doctors clearly states under regulations 5.2 and 7.14 that it is mandatory for all practicing doctors of modern medicine to notify communicable diseases, which includes Tuberculosis. It further states that once Tuberculosis is notifiable disease as per the IMA guidelines, there is no question of confidentiality or privacy.”

There are provisions of Negligent Act likely to spread infection under Indian Penal Code Section 269-270. Section 270 specially applicable to MDR Tuberculosis. If spread of Tuberculosis is allow to continue  in the society by not taking treatment or not advising treatment may amount to negligence under Indian Penal Code.

The IMA further said that each person who gets exposed to a patient suffering from Tuberculosis must traced and treated. One undetected Tuberculosis patient can spread the disease to 20 additional people on an average and can continue to do so for up to 2-3 years. 10-14% of the total cases where the patient receives only half the treatment can take more serious forms and develop into MDR TB. MDR Tuberculosis is highly contagious and can cause the infection to spread to healthy people at a rapid speed.

In addition to the e-meet, IMA has already created a digital group called Team IMA, which will make daily communication between over over 2000 Central Council Members possible. Since the beginning of this year, over 2 lakh doctor members of the IMA are being sent daily updates on the organization and key health matters through the medium of text messages and emails.  

IMA will also be launching a first of its kind Tele Medicine Rural Health Consultation service on 16th August, 2015 where the IMA Dhule Branch will connect with the IMA headquarters through video conferencing.