Thursday, 14 December 2017

Seasonal flu to hit India hard in the coming year

Seasonal flu to hit India hard in the coming year
 
It is imperative to get vaccinated in a timely manner to avoid getting infected

New Delhi, 13 December 2017: Seasonal influenza outbreaks each year cause 3 million to 5 million severe cases and 300,000 to 500,000 deaths globally, estimates the WHO. Recent predictions by flu-trackers have indicated that seasonal flu will hit India and the rest of the northern hemisphere hard next year. This prediction is based on outbreak trends in the winter of the southern hemisphere, where Australia has reported record-high numbers of cases, hospitalizations and deaths.

Seasonal flu shows a minor peak from December to February in India. It causes symptoms of fever, cough, breathlessness, lethargy, headache and nausea. Most people recover within a week without ill-effects, but complications such as pneumonia and multi-organ failure can kill people at risk, such as young children with respiratory problems, pregnant women, older adults above age 65 years, and those with chronic disorders such as asthma, lung diseases, heart disease and diabetes.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Most flu outbreaks happen in late fall and winter. The symptoms may not show up for a couple of days and thus, it is possible for a person to pass on the flu to someone even before this. Flu is usually caused by influenza viruses A and B. The strains vary each year. One may often confuse flu with a common cold as the symptoms are very similar. It is imperative to get a shot of the flu vaccine every year to prevent any incidence particularly in children, pregnant women, and older citizens.”

As viruses adapt and change, so do those contained within the vaccines – what is included in them is based on international surveillance and scientists’ calculations about which virus types and strains will circulate in a given year.

Adding further, Dr Aggarwal, said, “Flu is primarily treated with rest and fluid intake to allow the body to fight the infection on its own. Paracetamol may help cure the symptoms but NSAIDs should be avoided. An annual vaccine can help prevent the flu and limit its complications.”

Here are some tips to prevent spreading of seasonal flu.

Those who are not sick should avoid close contact with people who are sick.
People with flu should cover their mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
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Straight from the Heart: Some Facts on Max-Fortis Cases

 Straight from the Heart: Some Facts on Max-Fortis Cases

IMA got an access to part inquiry reports in the Fortis and the Max case, respectively. Here are some excerpts which should also be known to the medical fraternity

Fortis case: IMA Notes Based on inquiry report

·         “The committee found that the patient was suffering from Dengue Shock Syndrome, not mere dengue fever”.
·         “The mortality is high ranging from 6 to 30%. Most deaths occur in children”.
·         “The Committee found that the family had to spent Rs. 15.00 lakh for emergency ICU treatment for 15 days, not for dengue fever”
·         “There is prima facie no evidence of negligence in the management of the child during her stay in the PICU.”
·         “It is unlikely that conducting MRI earlier would have affected the course of treatment.”
·         “There are no guidelines on how many consumables are to be used per day in a PICU patient. However, general guidelines state that a liberal use of consumables for example syringes, gloves etc. must be made to decrease the risk of hospital acquired infections in these patients.”
·         “After perusal of above statements, I am of opinion that the father of the baby Adya was well informed about the consequences of LAMA.”
·         “However, at the end of the complete documents in all cases, one original signature of the parents is there.”
·         “It is again reiterated, the consent for so-called LAMA was obtained from the parents of the victim at the strong insistence of the treating doctors who gave a professional opinion stating that the MRI Scan Report revealed irreparable brain damages. It is again repeated that the "cost of the treatment" was never a consideration or deterrent for the parents.”

IMA Comments

IMA is developing a LAMA policy so that these types of disputes do not occur when a case reaches a state of no recovery.

Max Case: Some excerpts from the government report

·         “.. report concluded that the hospital have not kept any proper temperature and vital sign monitor record of the period of comfort care provided to the live male newborn”

IMA Comments: Not keeping record is a misconduct and not a criminal offence.

·         “….committee also concluded that the staff nurses on duty were also at fault as they handed over the bodies of the newborns without any written direction from the pediatrician and they also missed the signs of life in the male newborn while handing over the 'body' to the attendants”

IMA Comments: The very fact they also missed signs of life confirms the newborn was clinically dead (when the brain is alive and heart can get revived later when the body temperature increases due to warmth. Clinical death period is 10 minutes in every death and up to 4 hours in hypothermia)

·         “WHEREAS, the committee also concluded that the hospital has entered the name of live male newborn baby in the still birth register.”


IMA Comments: This is a record keeping mistake and not criminal negligence.

Wednesday, 13 December 2017

India has the highest number of TB patients across the world

India has the highest number of TB patients across the world
Missing doses can defeat the purpose of DOTS therapy

New Delhi, 12 December 2017: According to recent reports, with 2.79 million cases, 4.23 lakh deaths, and an average of 211 new infections diagnosed per 100,000 people, India currently has the highest number of tuberculosis (TB) patients across the globe. India also has the most number of MDR-TB patients in the world as well as the largest number of ‘missing’ TB patients. There are several million who have not been identified, notified, or treated and these people remain off radar.

TB is a highly infectious disease cured by providing proper medication at the right time for the full duration of the treatment. The drug regimen is called DOTS and is provided free under the Revised National TB Control Programme (RNTCP). It is based on the principle that a regular and uninterrupted supply of high-quality anti-TB drugs must be administered to cure the disease and prevent the occurrence of the MDR-TB.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “TB is a major public health concern in India. Not only is it a major cause of morbidity and mortality but also poses a huge economic burden on the country. Elimination, which is defined as restricting new infections to less than one case per 100,000 people, is possible only when patients get diagnosed and cured without any break in treatment. Any interruption in treatment can exponentially raise the patient’s risk of developing MDR-TB, which is harder to treat. Missing doses defeats the very purpose of DOTS therapy, which is meant to ensure strict compliance through supervised consumption of medicines. As many as 900,000 people with TB do not have access to proper treatment, which means they risk developing drug-resistant TB and infecting others.”

Reporting is important to trace contacts of the person with infectious TB. All contacts of the patient should be screened for TB and put on treatment if required. This cascade of screening of contacts, at home and workplace, identifies individuals at risk and prevents further spread of TB, including MDR TB.

Adding further, Dr Aggarwal, said, “The approach to all notifiable diseases should be based on DTR: Diagnose, Treat, and Report. Diagnose early, using sputum Gene Xpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”

Here are some tips that can help avoid TB infection from spreading.

Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
Do not attend work or school.
Avoid close contact with others.
Sleep in a room away from other family members.
Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria. 

Straight from the Heart: IMA-FOMA Resolutions

Straight from the Heart: IMA-FOMA Resolutions

Members: Indian Medical Association, All India Ophthalmological Society, Urological Society of India, Geriatric Society of India, Indian Radiology & Imaging Association, Indian Academy of Echocardiography, Heart Care Foundation of India, Cardiological Society of India, Association of Surgeons of India, Indian Psychiatric Society, Delhi Psychiatrist Society, Indian Orthopaedic Association, The Federation of Obstetric & Gynaecological Societies of India, Indian Association of Dermatologists, Venereologists and Leprologists, Association of Physicians of India, Indian Academy of Echocardiography, FFPAIA, Indian Society of Hospital waste Management,  Academy of Hospital Administration,

IMA- FOMA (Federation of Medical Associations) Resolutions

April 6, 2017

  • IMA will be the mother NGO for FOMA (Federation of Medical Associations).
  • All Major-Medical Associations in India will be invited to become Hony. Member of FOMA through their President/Secretary or their nominee.
  • IMA FOMA members will physically meet at least twice in a year and through e-connect as and when required.
  • National President of IMA or its nominee (one of the past Presidents) shall be the President of IMA-FOMA.
  • Hony. Secretary General of IMA or its nominee (one of the past HSGs) shall be the Secretary of IMA-FOMA.
  •  Presidents and Secretary Generals of various Organizations/Associations shall be the member of Management Board of IMA-FOMA.
  • IMA will provide local hospitality for all the meetings and the travel arrangements shall be made by the respective Organizations/Associations, unless a meeting is hosted by one of the member association.
  • IMA-FOMA will have IMA FOMA Action committee with representatives of all member Organizations/Associations.
  • IMA-FOMA shall work on national issues of importance to medical profession.
  • IMA-FOMA shall come out with Declarations/Statements/White Papers/Policies, Standard Treatment Guidelines etc. on regular basis endorsed by all member Organizations/Associations.
  • IMA-FOMA Action Committee will interact with Govt. of India, Ministry of Health on regular basis on subject of common interest.
  • IMA-FOMA shall create a local Google group to communicate on daily basis with all its members.
  • IMA-FOMA will come out with joint initiatives with individual Organizations/ Associations and also group of organizations under IMA-FOMA on various health issues.

IMA-FOMA Delhi Resolutions

Prescription of Generic Name of the Drugs by Medical Professionals

IMA and FOMA appreciate the concern of the Hon’ble Prime Minister, Shri Narendra Modi about the availability, accessibility and affordability of quality economical drugs to the society.



  • The judgement to choose a rational drug and its format vests only with the Registered Medical Practitioners. This right of the medical profession is sacrosanct.
  • IMA-FOMA also wants the Government to strengthen Quality control mechanisms to ensure adherence to Good Manufacturing Practices (GMP) for patient safety.
  • For a rational prescription, doctors should choose drugs generic-generic or generic - brand based on quality, efficacy and economy and write legibly and preferably in capital letters.
  • IMA-FOMA recommends that Government should ban differential pricing of a drug under different brand names (generic-generic, generic- trade or generic- brand) by one company. (one chemical drug, one company, one price)
  • IMA-FOMA will be meeting the President of MCI, Union Health Minister and Prime Minister of India about the views of the medical fraternity on this issue. All the constituent members of IMA-FOMA shall communicate these IMA-FOMA Delhi Resolutions to its members.

Reference

MCI Ethics Regulations Clause No. 1.5 states “All physicians SHOULD prescribe medicines with generic names, legibly and preferably in capital letters and he or she SHALL ensure rational prescription and use of drugs."

IMA- FOMA Delhi Declaration 2017

  • IMA- IMA-FOMA stands for ethical practice of medicine and has zero tolerance for unethical practices. Any payment where a service is not involved is deemed unethical.
  • Sex selection and female feticide leading to conviction will invite disciplinary action by IMA- FOMA members. Any members, so convicted, will forfeit the membership of all IMA-FOMA organisations.
  • IMA- FOMA advocates decriminalisation of medical practice. All legislations from IPC to POCSO should recognise absence of mens rea in medical practice or an intention to harm and jurisdiction of criminal prosecution of medical practice and medical negligence has to be discontinued.
  • Doctors should be provided a single accountability window withdrawing the jurisdiction of multiple forums. Similarly medical establishment s should have single window registration facility.
  • Practice of modern medicine and prescription of modern medicine scheduled drugs shall vest only with doctors of modern medicine.
  • IMA-FOMA demands that Central legislation against violence on doctors, staff and hospitals be enacted.
  • IMA-FOMA reiterates that the professional autonomy of MCI has to be retained. While amendments to the IMC Act are essential, NMC is unacceptable.
  • IMA-FOMA endorses a common All India Final MBBS Exam and rejects NEXT.
  • Standard Treatment Guidelines will emanate from the professional organisations led by IMA-FOMA.
  • Clinical Establishments Act (CEA) has to be hospital-friendly eschewing License Raj for accreditation.

Tuesday, 12 December 2017

The Indian Medical Association announces bold steps aimed at restoring faith in doctors and the medical profession

The Indian Medical Association announces bold steps aimed at restoring faith in doctors and the medical profession
Proposes certain self-regulatory procedures for doctors and hospitals to adopt

New Delhi, 11 December 2017: The Indian Medical Association (IMA), the largest voluntary organization of Doctors of Modern Scientific Medicine today announced certain self-regulation procedures for hospitals and doctors. This comes in light of the recent incidents involving the lives of a pair of twins, and a 7-year-old girl. The doctor-patient trust in the country, which was already experiencing a downward spiral, has deteriorated further. Doctors, hospitals, the health industry, patients, media, and politicians all are unhappy. Doctors do not have the intent to be the cause for public unrest or loss of public trust. At the same time patients must understand that to err is human and one incident does not mean that there will be more such cases in future as well.

Trust is the foundation of a doctor and patient relationship. The medical profession is undergoing certain changes. While violence against doctors is on the rise and they are being held accountable, at times, for deeds not committed, it is also true that there is some introspection needed on the part of doctors and hospitals, failing which this trust may take a long time to reestablish. Today, the private sector looks after 80% of the patients that too with highest quality. In the absence of state subsidy private sector providing quality care  invariably will come at a cost which is still at fraction of a cost compared to that in advanced countries.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "We represent the collective consciousness of the largest medical association of modern doctors of the country, the IMA. A profession, which has been considered as second to none, & it will remain noble is today, being looked at with suspicion. However, the medical profession is the noblest profession. It is disheartening to see the erosion in trust and we want to make it more transparent. IMA is and will continue to work towards improving doctor-patient relationship. IMA is committed to practicing with humility and pledges to reform the existing system. We will also take the opportunity to say here that the doctor to patient ratio in India is skewed due to which doctors are under a lot of stress. Doctors are also human beings and not healing angels. Once treatment is administered, the recuperation of a patient depends upon physical and organic factors. It is unacceptable and absurd to victimize the medical practitioner if the patient does not respond to treatment.”

All doctors shall practice with compassion and follow IMA ALERT policy (Acknowledge, Listen in detail, Explain, Review and Thank you). The IMA has also announced formation of an IMA Medical Redressal Commission at the state level (in each state) to engage in social, financial, and quality audits of health care (Suo moto or on demand). The commission will have a public man, an IMA office bearer, one former state medical council representative, and two subject experts. The commission shall consider every grievance in a time bound manner. An appeal to the state commission will be heard by the "Head-quarters IMA Medical Redressal Commission" which will have the powers to take suo moto cases also. The headquarters shall also suggest reforms in healthcare on periodic basis.

Adding further, Dr Aggarwal, said, “What happened was most unfortunate. However, not all doctors are wrong, and the public must have faith in them. Such errors happen by accident and not intentionally. Having said this, it is also time for the medical profession to introspect and come out with self-regulation procedures. We are often blamed for prescribing costly drugs. From today onwards, all doctors in the country shall choose affordable drugs. We also appeal to the government to come out with an urgent ordinance for one drug-one company-one price policy. Doctors should actively participate in ensuring that no hospital sells any item priced higher than the MRP. No service charges should be added to procure drugs from outside. MRP shall not be dictated by the purchaser.”

The other points announced by IMA are as follows.
  • IMA recommends that all doctors should prescribe preferably NLEM drugs.
  • All doctors shall promote Janaushidhi Kendras.
  • We appeal to the government to classify all disposables under both NLEM and non-NLEM categories and cap the price of essential ones. Till then all medical establishments should sell the disposables at procurement prize after adding a predefined fixed margin.
  • Hospitals and doctors are often blamed of overcharging and over investigations. Billing should be transparent, and all special investigations should be well informed & explained.
  • Every doctor should ensure that it becomes mandatory on the part of the hospital administrator to give options at the time of admission to choose cost-effective treatment room and treatment (single room, sharing room, and general-ward) and explain the difference in total bill estimates.
  • All doctors should ensure that hospital estimates at the time of admission are near to actual.
  • The treating doctor must explain the chances of death and unexpected complications and resultant financial implication at the time of admission.
  • Once doctors take charge of a patient, the patient should not be neglected. They should look after the patient till discharge.
  • Emergency care is the responsibility of the state government and the government should subsidize the costs of all emergencies in private sector & create a mechanism for reimbursement.
  • Every medical prescription must include counseling on the cost of drugs and investigations.
  • IMA has zero tolerance to doctors indulging in female feticide.
  • IMA has zero tolerance to cuts and commissions. Medical establishment should revisit their referral fee system. Billing paid to doctors should be transparent and reflected in the bill.
  • No hospital can force their consultants to work on targets. Contractual agreements should be in such way in which of both parties that is consultant and the hospital is equally protected. All hospitals should consider not charging service charges from the consultants.
  • Choice of drugs and devices rests with the doctors based on the affordability of the patient and not on the profitability.
  • All hospitals must comply to the commitment towards EWS, BPL, and poor patients without any discrimination.
  • All patient complaints should be addressed in a timely manner through an internal redressal mechanism with a chairman from outside the hospital.
  • All medical establishments must ensure that their business ethics comply with the MCI ETHICS.
  • IMA LAMA policy is being developed as there are no clear guidelines at present.
  • Every dead body needs to be treated with respect and dignity.
  • All charitable hospitals should do their free work as assigned.
  • All needy patients must be routed through the social worker of the establishment and guided and directed to the appropriate place.
  • At least one more equally experienced but unrelated surgeon should be involved in the consent form during elective LSCS.
  • The patient has a right to get medical records within 72 hours of request. Acknowledge their request.
  • The patient has the right to go for a second opinion from an appropriately qualified medical doctor. The primary doctors have should not  get offended.
  • A hospital has no right to stop life-saving investigations or treatment for non-payment of bills if the patient is still admitted in the hospital. The government should make a mechanism for the reimbursement for the above for poor patients.
  • Ensure for us all are equal. BPL, APL, EWS, rich, or poor all should get the same attention and treatment.
  • IMA policy: With no National Guidelines on viability of fetus issue ,it is being looked upon by IMA, FOGSI, IAP and NNF.
  • We are not against any regulations and accountability, but we should all ask for a single window accountability at the state level. The state medical council should be proactive and take timely decisions. We should also ensure a single window registration.
  • We must ensure that our establishment has a transgender policy.
  • All government hospitals should be upgraded and have facilities like those in the private hospitals. All public, private or charitable hospitals should have quality accreditation.
  • No doctors should issue false certificates.
“All the above will & should be implemented with immediate effect”, said Dr Ravi Wankhedkar, National President Elect IMA, in his message.
The above have approval from most stakeholders. A copy of this is being sent to the Health Secretary, Govt of India and Health Minister, Govt of Delhi. Both President and Registrar, Delhi Medical Council, are requested to help in circulating this message to all doctors in Delhi.

We are thankful to the society for raising the issues and will request them to work with the medical fraternity to make IMAs project "Cure in India" a success. 

Straight from the Heart: Team IMA Initiatives with MCI

Straight from the Heart: Team IMA Initiatives with MCI  

Dr KK Aggarwal
National President IMA


1.       Finalized Indian Medical Services draft suggestions to the Govt. of India passed by CWC IMA and GBM of MCI.
2.       As per MCI Ethic Regulations 8.6, professional incompetence shall be judged by peer group as per guidelines prescribed by the MCI.  But these guidelines were never made. IMA and MCI finalized these guidelines, passed by CWC IMA and GBM of MCI.
3.       In its judgment in Jacob Mathew vs State of Punjab & Anr on 5 August, 2005, the Hon’ble Supreme Court of India directed Statutory Rules or Executive Instructions incorporating certain guidelines to be framed and issued by the Government of India and/or the State Governments in consultation with the MCI regarding prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient. MOH wrote to MCI to make a task force to make recommendations involving IMA. IMA and MCI has framed these guidelines and passed by CWC IMA and GBM of MCI.
4.       In Parmanand Kataria vs Union of India clarification in MCI General Body Meeting, it was submitted that Evidence Act should also be so amended as to provide that the Doctor's diary maintained in regular course by him in respect of the accident cases would be accepted by the courts in evidence without insisting the doctors being present to prove the same or subject himself to cross-examination/harassment for long period of time.”  MCI-IMA task force has framed these guidelines, which have been passed by CWC IMA and GBM of MCI.
5.       With regard to NEET, IMA wrote to MCI to relax the norms for age and number of attempts and the same was done
6.       The extended list of disabilities now has been accepted by MCI for MBS admissions and 5% of the seats are now reserved for the same
7.       We wrote to MCI regarding non-payment of stipends to interns in many private colleges. MCI is looking into t.
8.       MCI changed the professor: student ratio.
9.       IMA Grievance Cell wrote to MCI about two cases to expedite their enquiry process
10.    IMA offered CPR training after tragic death of Smt. Premlata on 16th November, 2017 at MCI premises.
11.    May 10: Sub: imposing the condition of Good Standing Certificate for those who are Registered with registering authorities in other countries [Any Graduate or Post Graduate from our country whenever intends to register with registering authorities for practicing modern medicine in the concerned countries, he/she is required to furnish a Good Standing Certificate for their verification issued by the Medical Council of India. This is solely to ensure that the concerned registered medical practitioner has a good track record and there is nothing against him/her, especially with reference to ethical breech and/or violates. In the same breath and vein, it is necessary that a similar condition needs to be imposed for Indian doctors who are practicing in other countries after getting registered in that country and intends to come back to India. Imposition of similar conditions would be required for Indian students getting their MBBS or equivalent course outside India and coming back for registration in India; foreigners to India and asking for temporary license to practice and also for Indian doctors seeking multiple registrations in different states.  This would mean that before they are registered or re-registered with the registering authorities in India, they will have to furnish the similar Good Standing Certificate as a condition precedent. This will serve a similar purpose as the Good Standing Certificate issued by the MCI serves in respect of Indian Doctors seeking registration to the competent registering authority practicing modern medicine in foreign countries. Hence the suggestion.  We are sure that the required decision will be taken, in this regard for the enforcement by all concerned.
12.    June 20: IMA wrote about Female Genital Mutilation and hysterectomy of mentally unstable females to maintain the women's hygiene during menstruation and avoidance of pregnancy in sexual abuse. As per IMA, doing so is violation of women's fundamental rights. IMA requested to clarify the position of MCI as regards to these two practices so that we can put it as IMA policy.
13.    MCI restarted Dr B C Roy National Awards on persistent reminders by IMA.
14.    Response from MCI: “This has reference to your email dated 22nd January, 2017, wherein you have forwarded a representation pertaining to permissible filling up of non-medical teachers in pre and para clinical departments in medical colleges under the ambit of the Medical Council of India.  

It may be noted that in the context of unavailability of the medical teachers (possessing medical qualifications) in the pre and para clinical subjects, the regulation as provided for a permissible percentage of non-medical teachers in the subject of Biochemistry up to the extent of 50% and physiology, microbiology, pharmacology up to the extent of 30% with a rider that the same shall be filled up in case the teachers with medical qualifications are not available. This by no stretch means that the said percentage is earmarked for non-medical teachers. Ideally speaking medical college should have teachers possessing medical qualifications, but as there is paucity hence the provision in the regulation.”
15.    MCI raised the issue regarding ESIC: DACP guidelines, Govt of India, has not been implemented for promotion of Assistant professors to Associate Professors in ESIC Medical Colleges, though assured in the recruitment Advertisements.
16.    IMA opposed introduction of NMC.
17.    IMA opposed NEXT exam, which MCI supported.
18.    IMA opposed and wrote to MCI not to support post BDS bridge course to MBBS.
19.    IMA support amendments to IMC act and say no to NMC. IMA drafted a study group report to this aspect.
20.    IMA won the PCPNDT act case in Delhi High Court. Matter is in Supreme Court now.
21.    Both IMA and MCI were part of Inter-Ministerial Committee formed by Ministry of Health.
22.    IMA supported the UPRN circular issued by MCI.
23.    In NATCON 2017, MCI has been given a slot by IMA to introduce UPRN (Unique Permanent Registration Number).
24.    MCI: “…proposed change of the MODE OF EXECUTION of persons awarded capital punishment from HANDING TO LETHAL INJECTION as proposed by the Law Commission. “The Ethical Committee of Medical Council of India has deliberated on the subject of the mode of execution of death sentence as prepared by the Law Commission and has come to the unanimous view that in order to uphold the highest moral and ethical values of humanity, the Death Penalty (capital punishment) should be abolished altogether in our country.”

1. “The members of the Adhoc Committee appointed by the Hon’ble Supreme Court and of the Executive Committee of the Council considered the recommendation of the Ethical Committee with regard to law panel for execution by Lethal injection and decided that this matter does not come under the purview of the Council.” However, the Ethics Committee strongly feels that the matter should be reexamined by the Executive Committee afresh and the Ethics Committee decision be placed before the General Body………….”


25.    Three attempts for UG MBBS admission were shifted from retrospective to prospective. IMA was flooded with students calls after the Central Board of Secondary Education (CBSE) said that AIPMT attempts will be included in the proposed NEET exam (UG) starting this year. IMA immediately took up the cause. I spoke to MCI and also to Dr Ketan Desai, then President World Medical Association (WMA). Immediate action was taken. The Health Ministry has now clarified that "since any new regulation takes effect prospectively, NEET-2017 shall be counted as the first attempt for this purpose irrespective of the previous attempts in AIPMT/NEET, subject to the upper age limit. CBSE has been advised to make necessary corrections in the information bulletin and on their website cbseneet.nic.in, so that any application is not rejected on this ground. Data pertaining to applications already rejected will be erased so that rejected applications can be filed afresh" (Press Information Bureau, 3.2.17) …

Monday, 11 December 2017

Long-term use of statins can exacerbate the risk of developing Type 2 diabetes

Long-term use of statins can exacerbate the risk of developing Type 2 diabetes
Healthy diet and lifestyle changes can prevent complications

New Delhi, 10 December 2017:A recent study has indicated that those indulging in the long-term use of cholesterol-lowering drug, statin, are at 30% more at risk of developing Type-2 diabetes. It mentions that taking statin is associated with a 36% heightened risk of subsequently being diagnosed with Type-2 diabetes. Research also indicates that statins may impair the production of insulin, the hormone needed to lower the body’s levels of blood glucose.
Estimates place the number of people living with diabetes at 60 million in India, of which 95% have Type 2 diabetes. Type 2 diabetes is typically brought on by poor eating habits, too much weight and too little exercise. This condition, when poorly controlled, can increase the risk of cardiovascular disease, blindness, and even kidney failure.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “In a person with Type 2 diabetes, the body does not utilize insulin properly and this condition is called as insulin resistance. The pancreas first makes extra insulin to make up for this. However, over time, it cannot make enough to keep the blood glucose at normal levels. While the exact trigger for this condition is not known, Type 2 diabetes could be a result of a combination of factors. Some may be genetically predisposed to the condition. People with a family history of obesity are also at an increased risk of developing insulin resistance and diabetes. Those who are obese have added pressure on their body’s ability to use insulin in controlling blood sugar levels. This can lead to Type 2 diabetes. The more fatty tissue a person has, the more resistant their cells become to insulin. Lifestyle factors also have a major role to play.”
The symptoms of Type 2 diabetes develop slowly, over a period of time. Some of them include increased thirst and hunger, frequent urination, weight loss, fatigue, blurred vision, slow healing of infections and wounds, and skin darkening in certain areas.
Adding further, Dr Aggarwal, said, “A healthy diet is, more expensive than an unhealthy one. The wide availability of cheap energy dense low-nutrient food is contributing to the global epidemic of type 2 diabetes. Foods which reduce the risk of type 2 diabetes such as vegetables, fresh fruit, whole grains and unsaturated fats need to be more affordable and more widely available.”
The following preventive measures can help prevent the onset of Type 2 diabetes in people.
·          Exercise more Exercise has various benefits including preventing weight gain, controlling blood sugar levels, and other conditions. A minimum of 30 minutes of physical activity every day is very beneficial.
·          Eat healthy A diet rich in whole grain, fruits, and vegetables is very good for the body. Fibrous food will ensure that you feel fuller for a longer period and prevent any cravings. Avoid processed and refined food as much as possible.
·          Limit your alcohol intake and quit smoking Too much alcohol leads to weight gain and can increase your blood pressure and triglyceride levels. Men should limit drinks to two per day and women to one per day. Smokers are twice as likely to develop diabetes as non-smokers and therefore, it is a good idea to quit this habit.

·          Understand your risk factors Doing so can help you in taking preventive measures at the earliest and avoid complications.

Straight from the Heart: IMA Grievances Cell

Straight from the Heart: IMA Grievances Cell

IMA HQs Mediation, Conciliation & Grievances Redressal Cell (IMA-MCGRC)

·            Total number of complaints Received- 162
·            Total number of complaints referred to State /Local Branches – 88
·            Total number of complaints resolved at IMA HQ - 55
·            Total Number of complaint Pending - 19

IMA Nagpur Mediation, Conciliation & Grievances Redressal Cell

  • Total complaints received so far: 235
  • Complaints disposed of: 233
  • Complaint pending for investigations: 2
  • Mutual agreement reached between complainant and doctor: 176 (74.4%)
  • Left cases where IMA is unaware about what happened to these cases: 41 (17.4%)
  • Cases of negligence referred to MMC/ State Ayush Medical council for action: 18 (8.2%) (unfortunately, except in three cases IMA did not receive any communication or feed-back from respective state medical/ ayush council)

Positive indications

  • Complaints lodged directly to police are now referred to IMA for technical advice.

  • Hon. Chief Minister of Maharashtra is from Nagpur and has a chief minister’s secretariat at Nagpur. Complaints received are forwarded to IMA Nagpur branch for investigation and technical advice.

  • Of late IMA is also receiving requests from Nagpur District Consumer Redressal Forum, to provide technical opinion on the complaint cases directly received by the forum.

  • During interaction, Dean, Government Medical College has informed that the medical board is constituted by the order of the government. And, therefore, officially representatives of grievance cell of IMA Nagpur branch cannot be invited during official meetings of medical board, whenever, a case of private practitioner comes before the medical board for hearing. However, he assured that, in such a case of private practitioner, he would invite informally, representatives of IMA to discuss with him ahead of the meeting whenever a case against private service provider comes up before the medical board for discussion.


  • IMA Nagpur had discussed this issue with Secretary Medical Education during his visit to Nagpur. He has promised to induct IMA representative with representative of a concerned specialist’s organization, as special invitee for meeting of medical board when a case against a private service provider comes for hearing before the medical board. IMA has already submitted a proposal to Secretary Medical Education in this regard, and hopefully waiting to receive favorable orders in this regard.

Sunday, 10 December 2017

Straight from the Heart: CC Reporting

Straight from the Heart: CC Reporting
We have tried to compile the important meetings held during the year. Following is a list of meetings with government including stakeholders as well as international meetings that IMA participated in. All states branches can attempt to compile a similar list of meetings that your state participated in.

Meetings with government/stakeholder’s/ officials

  • Inter-ministerial meetings
  • Monthly meeting of IMA with MoH
  • Shri JP Nadda on 20th January 2017
  • Shri CK Mishra on 3rd March 2017
  • Member of Parliament Doctors meeting on 17th May 2017
  • Addl. Secretary (Health) Shri Sanjeeva Kumar with IMA 19th May 2017
  • Shri Satyender Jain, Health Minster, Delhi Govt.
  • Shri JP Nadda on 6th June 2017
  • Dr Jagdish Prasad on 6th June 2017
  • Shri CK Mishra on 6th June 2017
  • Shri Jitendra Singh on 6th June 2017
  • Shri JP Nadda on 23rd June 2017
  • Dr CP Thakur, Dr Mahesh Sharma, Dr Sanjay Jaiswal and Dr Vikas Mahatme on 24th May 2017
  • FOMA meeting on 6th April 2017 at Hotel Lalit, New Delhi
  • 23rd May meeting with FOMA stakeholders regarding plan organization of Dilli Chalo Movement on 6th June 2017
  • IMA Meeting with WHO Officials on 17th June 2017
  • Meeting with President-Elect Govt. of India on 21st July 2017
  • Meeting with Dr Sanjeeva Kumar, Addl. Secretary, MoHFW on 16th August, 2017
  • Meeting Shri GP Samanta, Under Secy, GOI  to discuss the issues raised by IMA during the meeting with Hon’ble HFM on 19th September 2017 at 3.00 pm under the chairmanship of Addl. Secy. (Health) in Nirman Bhawan, New Delhi
  • Meeting with Shri Sunil Kumar Gupta, Under Secy., GOI, MoHFW, Meeting to discuss the issue raised by IMA on 27th September 2017 , Nirman Bhawan, ND
  • Meeting with Dr Anil Kumar, Addl. DDG (AK) reg. Meeting of sub-committee to finalize the draft notification in respect of medical diagnostic laboratories including signatory authority/Technical head of medical diagnostic laboratory on 1st November, 2017 under the chairmanship of Dr B D Athani, Spl. DGHS Nirman Bhawan, ND
  • Shri GC Dobhal, Deputy Secretary, Petition Committee reg. Meeting of the Parliamentary Committee on petitions, Lok Sabha, w. r. t. Medical Reforms in the country on 20.11.2017 Parliament House Annexe, New Delhi

Other meetings

  • NABH Board Sub-Committee Meeting on 13th January 2017, New Delhi
  • 2nd Meeting of National Core Group on Elimination of Mother to Child Transmission (EMTC) on 6th February 2017
  • Stakeholder Consultation meeting for preparation of Concept Note (2018-20) for Global Fund Grant reg. on 13th February 2017 at New Delhi.
  • NABH Board Sub-Committee Meeting on 17th February 2017, New Delhi
  • 26th Board Meeting of NABH on 24th March, 2017, New Delhi
  • 2nd Meeting of National Medical Wellness Tourism on 28th March 2017 at New Delhi
  • Meeting of Working Group Environment Health on 30th March 2017 at Indira Paryavaran Bhawan, New Delhi
  • Meeting of World Malaria Day on 25th April 2017 at New Delhi
  • Meeting regarding setting up of Facilitation Counters for visitors arriving on e-Medical Visa at International Airport on 25th April 2017 at New Delhi.
  • Meeting Of Governing Body-NBE on 28th April, 2017 New Delhi
  • Meeting of Signal Review Panel Meeting at CDSCO (PvPI) on 16th May 2017
  • Meeting of Expert Group to review self assessment report for patient safety for India & capacity development on patient safety on 30th May 2017 at New Delhi.
  • Meeting of the Expert Committee constituted to draft comprehensive FAQs related to the PC & PNDT Act, 1994 reg. on 30th May 2017 at Nirman Bhawan, New Delhi.
  • National Workshop on “Parivar Niyojan-Sashakt Samaj, Rashtra Ka Vikas on 11th  July 2017 at Vigyan Bhawan, New Delhi
  • Launch of National Strategic Plan (2017-22) by Hon’ble HFM on 12th July 2017 at 5.30 PM at Sovereign Hall, Le Meridien, New Delhi
  • Stakeholders Consultation for MTAB-Reg. on 27th July 2017 at New Delhi
  • National Board of Examination governing council meeting on 7th September, 2017, New Delhi
  • NBQP QCI 12th Nation Quality Conclave on 21-22 September, 2017
  • Inauguration of Pharmacovigilance Programme of India as a WHO collaborating centre on 30th October 2017
  • NABH Board Meeting on 3rd November, 2017
  • NBE Board Meeting on 9th November, New Delhi
  • National Steering Committee PCPNDT Act on 3rd November, 2017

International Meetings


  • Annual Scientific Meeting of Chinese Medical Association held on 14-15 January, 2016 at Nanjing (China)
  • International Summit on Air Pollution - Health Advisories held at New Delhi on March 10, 2017
  • Cyprus to attend and participate in the UNESCO Chair in Bioethics – 12th World Conference on Bioethics, Medical Ethics & Health Law to be held from March 19-24, 2017 at St. Raphael Hotel Resort & Congress Center, Limassoi, Cyprus.
  • 206th World Medical Association (WMA) Council Meeting to be held from April 15th to 22nd April, 2017 at the Avani Victoria Falls Resort in Livingstone, Zambia
  • Annual Meeting of Swedish Medical Association in Stockholm from 29th May to 31st May 2017 at Hotel Scandic Continental Vasagatan 22, Stockholm, Sweden.
  • The Annual Meeting of the American Medical Association on June 10-14, 2017 at Hyatt Regency Hotel, Chicago, Illinois, USA.
  • BMA Annual Representative Meeting on Sunday 25 June- Thursday 29 June 2017 at the Bournemouth International Centre, Exeter Road, Bournemouth BH2 5BH,
  • 32nd CMAAO General Assembly in September 13-15, 2017
  • WMA General Assembly on October 11-14, 2017 at Renaissance Downtown Hotel, Chicago
  • WMA European Region Meeting on End-of-Life Questions on November 16-17, 2017 at Vatican