Aging is not bad -- even for blood

Aging is not bad -- even for blood

Dr KK Aggarwal

The view that “when blood transfusions are needed, it may be best to use the freshest blood” is no more true as per McMaster University researchers.

A study of 31,497 patients published in the New England Journal of Medicine of almost 31,500 patients at six hospitals in four countries (Australia, Canada, Israel and the U.S) has shown that having a transfusion with the freshest blood did not reduce the proportion of patients who died in hospital. 

"our study finally puts an end to the question about whether stored blood could be harmful and fresher blood would be better," said Nancy Heddle, lead author and a professor emeritus of medicine for McMaster's Michael G. DeGroote School of Medicine. "Our study provides strong evidence that transfusion of fresh blood does not improve patient outcomes, and this should reassure clinicians that fresher is not better."

Having a supply of stored blood helps to ensure that blood is available when a patient needs it.

The mortality rate was 9.1 per cent with people receiving the freshest blood, and 8.7 per cent among those receiving the oldest blood. 

Advances in blood storage now allow blood to be stored up to 42 days before transfusion and the usual practice is to use up the blood that has been in storage the longest. But, because there are biochemical, structural and functional changes in the blood during storage, there had been concerns about the use of 'older' blood. [source science daily]

Heart Care Foundation of India's (HCFI) annual flagship event, the MTNL Perfect Health Mela, to focus on the global concept of ‘One Health.'

Heart Care Foundation of India's (HCFI) annual flagship event, the MTNL Perfect Health Mela, to focus on the global concept of ‘One Health.' To raise mass health awareness about new age health epidemics like Bird Flu, Swine Flu, Dengue, Zika & Chikungunya The event will be inaugurated tomorrow at the Talkatora Indoor Stadium by none other than Shri Satyendar Jain – Honorable Minister of Health & Family Welfare, Govt. of NCT of Delhi & Dr SY Quraishi – Former Election Commissioner
New Delhi, 24th October 2016 - Heart Care Foundation of India, a leading national non-profit organisation committed to making India a healthier and disease-free nation is all set to roll out its annual flagship event – the 23rd MTNL Perfect Health Mela from Oct 25 – 29 at the Talkatora Indoor Stadium New Delhi.
The global concept of ‘One Health’ recognises that the health of humans is connected to the health of animals and the environment. With this as the event’s theme, a primary focus of the 23rd edition of the Perfect Health Mela is to deliberate, debate and deliver a comprehensive strategy for the National management of new age health epidemics such as bird, flu, chikungunya, zika, malaria, dengue and swine flu.
The Health Mela is a confluence of tradition and modernity and has successfully since the past two and a half decades been working towards creating mass awareness on all aspects of health; using a consumer-driven model as the medium. It is being co-organized in association with the IMA, MTNL, MCD and NDMC, Ministry of Science & Technology and Handicraft, Coca Cola, LIC, AYUSH GOI, DCW, Women & Child Dev., Govt. of Delhi, DTTDC, Johnson & Johnson, Dept. of Environment Delhi Govt., DSACS, DHS, Drugs Control, Family Welfare Delhi Govt. & Delhi AIDS Cancer Society. The five-day event will showcase seminars, on-ground checkups, entertainment programs, lectures, workshops, and competitions all centred around preventive health issues. For the first time ever, the entire Mela will offer a free Wi-Fi zone for all visitors. It will also feature regular webcasts on important preventive health issues. A special webcast on bird flu will be held on Thursday, Oct 27, 2016. A special IMA Godhbharai event will also be organised with a focus on antenatal health. Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President HCFI and President Elect IMA said, "Over the past decade we have seen a drastic rise in diseases closely associated with the environment, humans and animals. For this reason, the focus of this year's MTNL Perfect Health Mela will be ‘One Health'. The most recent scare has been that of Bird Flu, a virus that is rapidly killing birds in the city. While it is a contagious virus that can affect birds and humans alike, there is no need to worry as of yet since this version is a milder one and is unlikely to spread to humans. We thank all our partners and look forward to having large audiences at the event”. Adding to this, Sh Sunil Kumar Director EB & HR, MTNL & Sh N K Joshi ED Delhi, MTNL in a joint statement said, “Mass health awareness programmes such as the Perfect Health Mela are much needed in a country like India where chronic lifestyle diseases and other acquired infections like Swine Flu and Dengue plague the society. Preventive health education is key for a healthy society. We are happy to be associated with the event and will continue to support it in the future as well.” "Initial symptoms of bird flu include high fever, sore throat, abdominal pain, chest pain and diarrhoea. But it can manifest into severe symptoms like respiratory distress and pneumonia leading to death. HCFI & IMA will be coming up with guidelines for health providers and the public on early identification of bird flu cases and ways to avoid the spread of infection through a consensus meeting held at the Perfect Health Mela,” added Dr Aggarwal.
The entry to the MTNL Perfect Health Mela is free for all. To know more about the event, please call on the NGO's helpline number +919958771177.

WMA proposes a comprehensive program to prevent childhood obesity

WMA proposes a comprehensive program to prevent childhood obesity The World Medical Association (WMA) has published a comprehensive program to prevent childhood obesity including consideration of a tax on non-nutritious foods and sugary drinks. WMA has also called on governments to regulate availability of food and beverages of poor nutritional value, particularly in the vicinity of schools by way of regulating price, advertising and labeling of unhealthy foods to combat obesity. According to the WMA, a sedentary lifestyle, unhealthy diets, and lack of exercise are contributing to childhood obesity. In view of this, the WMA Assembly adopted a new statement on ‘Obesity in Children’ at its recent annual Assembly in Taiwan which recommends that schools should incorporate daily physical activity into their daily routine and all children should be encouraged to participate regardless of their economic status. The National Medical Associations should work to raise public awareness about childhood obesity. Physicians should educate parents and children in how to live healthy lives and emphasize the importance of doing so. It’s not only parents and children who need to be educated about childhood obesity, the WMA statement also recognizes that physicians and health professionals should be educated in nutrition assessment, obesity prevention and treatment by strengthening CME activities focused on nutritional medicine. WMA President Dr. Ketan Desai, said: ‘We know there is a link between the extent of advertising and childhood obesity, and so we are recommending that the advertising of non-nutritious products on television be restricted during programmes that appeal to children. Children frequently watch programmes designed for adults, so regulators must ensure that legislation and regulation also limits marketing associated with such programs. ‘We are also urging governments to consider imposing a tax on non-nutritious foods and sugary drinks and to use the additional revenue to fund research into preventing childhood obesity and reducing the resulting disease risk.' IMA Viewpoint • The incidence of metabolic syndrome is rising in urban school children. • This high incidence of metabolic syndrome is contributing to childhood obesity. • Increased consumption of refined carbohydrates – white rice, white sugar, white maida – several times in a day is fuelling the increase in metabolic syndrome. If not checked in time, this will lead to an epidemic of diabetes, hypertension and heart attacks precipitated by obesity. • Avoid replacing saturated fats with refined carbohydrates. • Avoid eating highly refined and processed grains and carbohydrates. • Eat more fresh fruits and vegetables and whole grains. • Stay active.

A proud moment for IMA: Dr Ketan Desai takes over the reins of World Medical Association

A proud moment for IMA: Dr Ketan Desai takes over the reins of World Medical Association

Dr K K Aggarwal and Dr Ved Prakash Mishra

Taipei Taiwan: Indeed a historical moment of which every Indian would feel proud was when Dr Ketan Desai took over the reins of World Medical Association as its President at 10 am on Friday 21^stOctober 2016 at Hotel Grand Hyatt to a thundering applause by the world 

professional fraternity.  

It was a diligent recognition which came way of an illustrious leader who always with passion rendered himself to the cause of medical profession and medical education alike.

His initiatives on several counts got converted into policy frame and have catered to the public interest in a very substantial manner.

Be it National entrance examination test, doctor pharma relationship, enforceable punishment on those who were committing frauds and misrepresentations and rationalizing minimum standards requirements facilitating development of medical schools in the country, he was the torch bearer and the front runner as well.

It was under his initiative that the Government run medical schools in the country were granted a onetime increase in post graduate seats without any onsite verification exclusively based on furnishing of information by increasing the permissible ratio of registered students against a professor post graduate teacher to 1:2. This in one stroke resulted in an increase of well over 2500 post graduate seats in the Government colleges in the country which were and are open and available for meritorious students within their affordable reach.

His stint as President MCI for two terms is known for his steering roles in shaping the face, facet and future of medical education in the country. It was his initiative to put into place competency based post graduate curriculum and also structure out National faculty development program for the full time teaching faculty in medical schools.

It was under his guidance that the National faculty development program resulted in training and orienting full time medical teachers in medical colleges across the country numbering now to well over 30,000 which makes the MCI as the only regulator of medical education to have taken the onus of such a program on its shoulders in an exemplary and emulative manner.

The efforts initiated by him in the Year 2009 to bring transparency in the process of medical admissions ensuring that merit alone turns out to be the sole criteria for admission to the medical courses in the country that the NEET was conceived and structured which ultimately saw the light of the day as an operational reality in the academic year 2016-17 setting to rest all the speculations that came to be raised on the very issue from time to time.

His ascendancy to the highest office of presidency of World Medical Education is neither an accident nor a conjuncture. IMA is an integral part of WMA and is recognized as a valuable member and a partner because of the significant role it has played on wide and varied issues pertaining to medical professionals within and outside the country.

The inputs furnished by IMA on the various issues at the WMA forum have not only been well appreciated but also have resulted in shaping its global perceptive on vital issues pertaining to the medical education, health care delivery systems and practicing of the profession judiciously and ethically.

In his speech Dr Desai rightly evoked the core issue of professional autonomy which in countries like Turkey, UK and India is under threat of subjugation and marginalization as well. This in his opinion was inconsistent with the well set out democratic norms which mandate participative decision making in an accountable manner. Such attempts for whatever reasons and from which ever quarter need to be dealt by an iron hand.

His observations on this count evoked huge cheers from the professional fraternity around the globe present at the installation ceremony.

He equally emphasized the need of making the world terror free. He observed that be it bruised Brussels, traumatized Paris, school children bombarded in Pakistan or deeply injured Uri all are slur in the name of humanity. Terrorism neither has a color, religion, caste or a creed. It is only terrorism alone. There is nothing like good or bad terrorism. In reality it dehumanizes mankind and traumatizes humanity. It has to be abandoned at all costs in the interest of bringing peace and tranquility to this planet in order to make it worthy of living for all times to come.

He strongly brought to fore the ill tendency of resorting to kickbacks for various reasons by the health professionals which on every count is unbecoming on their part. Profession has to be practiced within the tenets of ethicality, morality and judiciousness its sanctity is paramount and needs to be upheld at all costs and independent of consequence.

In the same breath he also emphasized that there is an urgent necessity to protect the health professional from unprovoked assaults and hurts on any and every count.  They need to be accorded required protection and desired insulation.

He categorically stated that those professional who trespass ethical conduct and take recourse to the sex determination resulting in female feticide should be dealt by the penalty of permeant removal of their names from the medical register  and delisting them from practicing the profession for life.

It is such deterrent measures alone which in his opinion could set the otherwise disturbed house in order.

Bringing to fore the importance of Yoga he recorded his appreciation gratitude to Sh Narendra Modi the Honorable Prime Minister of India for bringing Yoga, a parasympathetic lifestyle, on the global platform as a result of which 21^st June has been declared as the World Yoga day by united national organization.

It is only Yogic approach which could be the most cost effective modality for putting into place the preventive and promotive aspects of global health in an affordable and handy manner.

His suggestion to the global partners under the umbrella of WMA  to the effect that time has come where by a serious thought is necessary to structure out a world health keeping force on the lines on which world peace keeping force came to be created.

National Medical Associations across the world that have substantial and huge professional memberships can substantially contribute towards actualization of these perceived realistic needs. This suggestion was very well received by all present there.

World Medical Association President Dr Ketan Desai alarms over political onslaught on medical autonomy

World Medical Association President Dr Ketan Desai alarms over political onslaught on medical autonomy

A strong warning about continued political attempts around the world to marginalise the autonomy and self-governance of the medical profession has been given by the new President of the World Medical Association.

Dr. Ketan Desai, a former President of the Indian Medical Association, was delivering his inaugural speech as President of the WMA at the Association’s annual Assembly in Taiwan.

He told delegates from more than 40 national medical associations: ‘In many countries like Turkey, India, and the United Kingdom, there are continued political attempts to undo or marginalize autonomy and self-governance of the medical profession, including mauling and trampling on the trinity of professional autonomy, clinical independence and self-governance.’

‘Yet professional autonomy is not limited to asking for the privilege to do what we want to do. It is less about physicians and more about patients’ rights. It is the assurance that individual physicians have the freedom to exercise their professional judgment in the care and treatment of their patients without undue influence of any type from any quarter how so powerful and mighty they be’.

‘Regulation of clinical practice, framing evidence-based standard treatment guidelines, defining and checking professional malpractice and medical education all need vital professional independence and a democratic system based on meaningful participative decision making. The WMA has been, is and must continue to be against government attempts to usurp professional independence through bureaucrats and politicians and making the same ‘subservient’, as a part of their calculated nefarious designs.’

He said that in a democratic society, self-governance is an element of horizontal power-sharing and an important pillar of civil society and democracy itself. ‘Doing away with the vital concept of self-governance will not only amount to subverting a valuable element of democracy but end up in devouring the very soul of it.’

Dr. Desai, a urologist and a former President of the Medical Council of India, will serve as President of the WMA for 2016/17.

He emphatically brought out that cross border terrorism anywhere and everywhere needs to be stopped at all costs. Be it the 9/11 terrorist attack in the USA ( twin tower), Mumbai terror attack, traumatized Brussels, victimized Paris, school children massacred in Pakistan, bruised Uri or any other attack Globally disrupts the tranquillity and harmony of the society in an irreparable manner. Terrorism by any name and for any reason is terrorism and terrorism alone.  There is nothing like “good” or “bad” terrorism.  It is a slur on civilization of mankind and hence needs to be dealt with an iron hand and commensurate political will by all the countries in the world.

In his speech, Dr. Desai also called for physicians to receive more protection, whether in war or civil conflict situations. He said physicians were under constant threat throughout the world.

‘They are risking their lives while treating their patients in a committed manner. While on one hand in some parts of the world hospitals are being bombarded, ambulances hijacked, nurses and doctors kidnapped or killed and physicians pressured, threatened and tortured, on the other hand in other parts of the world, especially Asian Countries, doctors are being assaulted and medical establishments attacked and damaged’.

‘The Geneva Convention is practiced more in breach than observance, invariably ending up in flagrant violation of the inviolate human rights’.

‘It is a core commitment of physicians as a part of their basic duty to help patients by their professional knowledge without any distinction or discrimination of any type and magnitude. To a physician, a patient is neither a friend nor an enemy. They legitimately need protection from violence while at work, whether in war or civil conflict situations’.

In a wide-ranging speech, Dr. Desai also warned that professional honesty and integrity were at risk in many countries because physicians were prescribing and referring patients based on pecuniary self-interest or ‘kick backs’. He said the profession should be practices transparently. Physicians should not receive any financial or other consideration for referring patients to laboratories, pharmacies or opticians.

He has emphasised in his speech that perhaps the time has come to seriously think about the need to create a “World Health Keeping Force” on the lines of “World Peace Keeping Force”. By virtue of the fact that National Medical Associations that have substantial membership of Health professionals with them together can jointly go in for creation of such an ‘international health keeping force’ under the aegis of the WMA.

He ended his speech by extolling the virtues of yoga. With the expense of medical care rising and the need for preventive medicine, yoga was a proven way to prevent illness and preserve health. It was totally non-invasive, gentle and soothing and was cost effective. In diligent recognition of the same since last year the United Nations had adopted 21st June as the International Yoga Day.

“IMA National leaders and its 2.7 lakh members congratulate Dr Desai on taking over as the President of the World Medical Association. This is an extremely prestigious post and will allow key issues affecting the Indian healthcare system to be addressed at a global platform”, said Padma Shri Awardee Dr KK Aggarwal – President Elect Indian Medical Association.

All Website Link - http://www.ima-india.org/drdesai/

e-book - http://module.ima-india.org/15102016d/espeech/index.html

Video - http://module.ima-india.org/15102016d/Video.html

Audio - http://module.ima-india.org/15102016d/Audio.html

Photos - http://module.ima-india.org/15102016d/photo/default.htm

Happy Dussehra: Fighting your health demons for a healthy life!

Happy Dussehra: Fighting your health demons for a healthy life! This Vijaydashmi, people should find ways to beat key lifestyle evils like stress, depression, insomnia, obesity, smoking, alcohol and drugs New Delhi, 11th October 2016: Dussehra is one of the most important Hindu festivals, which marks the triumph of good over evil. During the festival, devotees worship Lord Rama, who ended the rule of Ravana thereby reinstating goodness in the World. Likewise, this Dusshera, each one of us should try and fight the evils within us for a healthy and long life. A balanced state of mind and a healthy lifestyle can go a long way in preventing lifestyle diseases such as diabetes, hypertension, cardiac ailments and obesity. The life of the 21st century Indian is found plagued with evils such as unhealthy eating habits, a sedentary lifestyle, excessive stress, consumption of tobacco and alcohol. The time has come to reverse this trend and make necessary lifestyle changes. Simple everyday lifestyle modifications can do the trick. Speaking about these, Padam Shri Awardee Dr. K K Aggarwal – President Elect IMA and President HCFI said, “This Dusshera, we must take a pledge to eliminate evils like smoking and drinking from our lives. To restrict the consumption of food containing high levels of trans fat, sodium and refined sugar. We must deal with stress through a holistic approach and to do away with anger and negativity from our lives. Most lifestyle diseases are preventable and manageable, only when necessary precautionary measures are taken. We must work towards beating obesity, heart disease, hypertension and diabetes. Only when we do, will the true meaning of a victory of good over evil can be achieved.” Some healthy alterations that one can make: · To avoid stress, you should start taking short breaks at regular intervals whenever working at the office or even at home. Eat foods like brown bread for carbohydrates instead of white bread, oranges and lemons for vitamin C and spinach for magnesium. A healthy diet and sufficient sleep help release chemicals like serotonin, which helps to reduce stress · More often than not, people think that smoking helps in reducing stress, which is nothing more but a myth. Excessive smoking aggravates blood pressure, increases heart rate and reduces the supply of the oxygen to the brain. You should immediately quit smoking for a disease free life · Alcohol is one of the most dangerous evils prevailing in our society; it is responsible for a plethora of medical ailments. Alcohol can worsen heart problems and cause cirrhosis of the liver. It triggers obesity and depression. · The majority of lifestyle diseases stem from our irregular and unhealthy eating habits. People who indulge in overeating and consume primarily junk food can develop long-term chronic diseases like diabetes, high blood pressure, heart issues due to increased cholesterol and obesity. A balanced diet is a key; consume healthy meals, which have the required nutritional meals you body needs to function efficiently. Consuming small but frequent meals, which contain a sufficient quantity of fruits and vegetables, is key. One should reduce the intake of high trans fat, sugar and sodium laden food. · Exercise daily; include a 5-minute brisk walk and a 10-minute stretching in your things to do list whenever you get time. Regularly exercising also helps keep a check on hypertension and obesity.

Bechara Mein: I want to be a mental care provider but……….?

Bechara Mein: I want to be a mental care provider but……….? IMA represent the collective consciousness of over three lakh medical practitioners in the country. During our MBBS, we were not taught any subject like mental health or mental well-being. Psychiatry was taught in a few lectures. During internship, psychiatry was less than a week posting with no psychiatrist in the faculty. During my MD medicine, psychiatry was just a touch-and-go subject. But we were still taught that health is not mere absence of disease but a state of physical and mental well- being. As per the WHO, 1 in 4 persons will suffer from mental disorder in their life time and 10% of us at any given time suffer from mental disease. About 800,000 people commit suicide worldwide every year, of these 135,000 (17%) are in India. Every 40 seconds a life is lost through suicide worldwide. The suicide rate in India is 11.5 % per lakh and every 3 seconds a person attempts to die. Suicide is one of the top three causes of death among the young in the age group of 15-35 years. A large percentage of them try to seek help from friends or doctors just before they commit suicide. But I am helpless as a doctor • We are now being informed that depression is no more a stigma or a social issue. That depression is treatable and a manageable disease and it needs to be diagnosed early. Then why does it not have insurance cover? • Our patients do not want to disclose ‘depression’ when getting admitted so that their claim does not get rejected. Often we are socially bound not to divulge the history of depression when we fill Mediclaim form even though we know it is unethical and we can be prosecuted under Indian Penal Code 191 and 193 or our license to practice can get cancelled under MCI Ethics regulation 7.7 • Once we admit such patients we cannot prescribe them anti depressant drugs on the file for the same reason. We cannot call psychiatrists or counselors as their billing would surely reflect that the patient had a mental problem. • Suicidal ideation is a medical emergency as we all are aware and such patient needs emergent admission. But we often do not admit them for fear of insurance rejection. • Government runs social campaigns and special free clinics for substance abuse disorders, smoking cessation clinics, then why can’t they allow treatment of depression under insurance reimbursement. Government can charge extra premium to those who smoke, drink or take drugs. • Smoking cessation, obesity reduction, alcohol cessation, and drug de-addiction should all be covered under insurance. • The proposed new mental care health bill may have some answers in clause (4) - every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness. Also under the new bill, suicide has been treated as a form of severe stress, which will not be punishable under section 309 of the Indian Penal Code (IPC). But till the bill is passed in Lok Sabha we all are worried about handling suicidal attempt cases. Under Section 309 of the IPC, whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both]. Though one can be let off with a simple fine but once the case has been made as a medicolegal case and the police is called, the patient and the family is always in a difficulty. Such patients are at risk for future suicidal attempts and hence needs tender and immediate care and counseling. • We face a similar problem while dealing with substance abusers. Under Narcotic Drugs and Psychotropic Substances Act, 1985, Section 27 there is a punishment for illegal possession of any narcotic drug or psychotropic substance or consumption of such drug or substance. All substance abusers invariably will be in possession of such drugs. Do we call the police when a substance abuser comes for counseling? • But it is also true that under section 39 of the act the courts have the power to release certain offenders on probation for detoxification or de-addiction from a pre-defined institution and to report back within a year that they have been de-addicted. However, ‘Court’ means that we need to inform the police first. • There are less than 6500 psychiatrists in the country with over 150 million mental health patients. Billing by Psychiatrist is not reimbursable under any claim. The answer is to mandate mental health as a subject in family practice. MCI has already mandated 10% credit hours in mental health and IMA has mandated mental health aspects in every medical education class. • Amongst professionals number one suicides are amongst doctors. Over one lakh doctors as per the statistics also need mental counseling. The numbers of psychiatrists are not enough even to manage them. • We are supposed to take mental history in every patient. As per a finance ministry document, average time available with a patient is 4 minutes. In these 4 minutes, we are required to wash our hands twice, greet and acknowledge our patient, brief about our credentials, take detailed history incorporating mental health maintaining privacy and confidentiality, read all the documents, make up our mind and explain investigations and line of management and counsel about rehab, side effects, warning signals and future plan. This is impossible in today’s era. • In Bhagavad Gita, in the first chapter, Krishna only listened to Arjuna when he was in acute depression? Do we have so much time to listen? Will our patents be able to pay us for the extra time spent? May be we need to have mental health counselors, dieticians and pharmacist as our employees in our practice. • Due to paucity of time and in search of giving instant relief, we end up prescribing short-acting benzodiazepines like lorazepam to patients making it the number one addiction drug in the country. • Should we call depression a depression? We have changed the nomenclature of all stigma-related terms then why not depression. We can call it as a mood disorder. We now call impotence as erectile dysfunction, prostitutes as female Sex workers, homosexuals as males havin • g sex with male, penis as male sex organ, vagina as female sex organ, child sexual abuse as sexual violence against children, drug abuse as substance abuse and IV drug addicts as IV substance user.