Paradigm shift in blood donation

Paradigm shift in blood donation India has huge population of more than 1.3 billion, but is still short of blood by 20-25%. Blood donation is a requirement of the society. All donations should be voluntary. Blood donation camps are often organized by hospitals and NGOs. But these are whole blood donation camps. But, now no camp should be organized for ‘whole blood donation’. Instead components-only blood donation camps should be organised. One unit of blood collected can be used to help 3 to 4 patients, instead it is being wasted as whole blood depriving another patient in need. And, voluntary blood donation camps should be now called “blood component donation” camp and not just blood donation camp. So, if the blood being donated is collected in a single bag, do not give blood. Usually two component bags are used. 100 ml bags should be promoted for pediatric use. People with rare blood groups should not donate in camps. They should instead donate only when needed. Under the new National Blood Transfusion Council regulations, no blood is to be wasted. The surplus left over plasma is fractionated to manufacture products like albumin and intravenous immunoglobulins (IVIG). The blood that is donated in voluntary blood donation should be maximally utilized. The tests done are for blood groups (A, B, O) and Rh factor and five transfusion-transmitted infections namely hepatitis B and C viruses, HIV 1 & 2, VDRL and malaria. Tests with the shortest window should be chosen as per affordability. For safe blood transfusion, tests other than those prescribed by the government should also be available such as minor blood groups, nucleic acid amplification testing (NAT). NAT detects very low levels of viral RNA or DNA that may be present in donated blood and reduces the window period of detection of viruses like hepatitis C, hepatitis B, HIV, which may otherwise be undetected by 3rd generation or even 4th generation ELISA-based tests. The prevalence of hepatitis B, C and HIV is very high in India. The doctor has a duty to inform the donor that facilities for these other tests are also available and the donor or the recipient should have the right to ask for extra tests. Till they a national policy is formulated in this regard, a doctor can help the donor or the recipient to decide. An informed consent must be taken from the donor or the recipient explaining the risks by not doing these tests, however small and rare they might be. These tests may add to the cost of the blood transfusion, but patient safety is foremost. The donor’s blood should also be tested for lipids, liver enzymes (SGOT, SGPT), kidney function (creatinine); a complete hemogram can be done, so that the donor gets a comprehensive panel of tests done, when he/she volunteers to donate blood. Rational blood transfusion is safe blood transfusion… Transfuse blood only when necessary. If only one unit is required, don’t transfuse blood; if two units are required, transfuse one. If hemoglobin is more than 7, give a trial of intravenous iron first. This is also a very important way by which the transfusion-transmitted infections can be reduced. Dr KK Aggarwal National President IMA & HCFI Recipient of Padma Shri, Dr BC Roy National Award,Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO) Past Honorary Secretary General IMA Past Senior National Vice President IMA President Heart Care Foundation of India Gold Medallist Nagpur University Limca Book of Record Holder in CPR 10 Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand Editor in Chief IJCP Group of Publications & eMedinewS Member Ethics Committee Medical Council of India (2013-14) Chairman Ethics Committee Delhi Medical Council (2009-15) Elected Member Delhi Medical Council (2004-2009) Chairman IMSA Delhi Chapter (March 10- March 13) Director IMA AKN Sinha Institute (08-09) Finance Secretary IMA (07-08) Chairman IMAAMS (06-07) President Delhi Medical Association (05-06)

IMA and HCFI propose the Rule of 20 in identifying factors associated with hypertension

IMA and HCFI propose the Rule of 20 in identifying factors associated with hypertension On World Hypertension Day, IMA and HCFI call for understanding the numbers, and also taking a step forward in identifying and managing the symptoms New Delhi, 17 May 2017: About one-third of India's urban population and one-fourth of the rural population are hypertensive, according to a recent study published in the Journal of Hypertension. It has been found that high blood pressure is responsible for almost half the ischemic strokes that are also called brain attacks, akin to a heart attack. It also increases the chances of hemorrhagic strokes. Hypertension often goes unnoticed as it attacks the body without showing any symptoms at all. The 17th of May every year marks the World Hypertension Day, with the theme this year being 'Know your numbers'. Experts opine that early detection of blood pressure and its management may reduce the complications of hypertension as also the risk of death. 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, "High blood pressure is one of the leading causes for stroke contributing to over 50% in blockages (ischemic stroke) and leads to bleeding in the brain. This condition can damage arteries throughout the body, creating conditions where they can burst or clog more easily. Weakened arteries in the brain, resulting from high blood pressure, put people at a much higher risk of stroke. There are many factors and conditions which can lead to high blood pressure, for example, smoking, lack of physical activity, excess salt in the diet, consumption of alcohol, stress, and genetic history of high blood pressure." The IMA recently conducted a national study on ambulatory blood pressure measurement amongst doctors in partnership with HCFI and Eris Lifesciences. The study revealed that 21% of the doctors surveyed had masked hypertension or isolated ambulatory hypertension. In simple terms, their BP readings were normal when evaluated through the conventional clinic measurement technique but high when checked through the ABPM technique. Masked hypertension is associated with an increased long-term risk of sustained hypertension and cardiovascular morbidity. "Ambulatory Blood Pressure Monitoring is globally accepted as the gold-standard method towards detecting hypertension. It evaluates a patient's BP continuously over a period of 24 hours and helps diagnose masked or white coat hypertension, conditions in which a patient's BP readings are inaccurate due to certain environments. It is important to increase your intake of fresh fruits, vegetables, olive oil, and omega-3 foods to help lower high BP levels. Apart from this, it is a good idea to consume sprouted or 100% whole grains as also reduce your sodium intake. The real culprits behind increased sodium intake include processed and ultra-processed foods," opined Dr Aggarwal. Understanding the Rule of 20 in Hypertension can go a long way in identifying and managing the causes and symptoms of hypertension. • Prevalence of hypertension is 20% in the society • Only 20% of people are aware about Hypertension at any given time. • The morbidity and mortality due to hypertension is 20%. • Only 20% people get treated for hypertension and at any given time. • Only 20% of hypertensives are well controlled at any given time. • The risk of CAD and heart attack in hypertension is 20% • Risk of peripheral vascular disease in hypertension is 20% • Risk of paralysis in hypertension is 20%. • The severity of hypertension is decided by increments of 20 mm Hg each • In white coat hypertension, a person can have rise of more than 20 mm systolic blood pressure. • 20 mm Hg systolic blood pressure can be reduced by life style management alone. • 20 mm Hg systolic blood pressure can be reduced by one drug intervention. • Up to 20 ML of 80 proof 40% whisky is safe in hypertension. • 10 KG weight reduction can reduce systolic blood pressure by 20 mm Hg • Reduction of salt to 6 grams and intake of DASH diet can reduce systolic blood pressure by 20 Mm Hg • Look for a cause of hypertension, if blood pressure first time appears before the age of 20 • Each and every IMA member should monitor BP of at least 20 patients per day. • 20 Cores people are seen by IMA member every year • In last 20 years, the community systolic blood pressure has gone up by 20 mm hg. • IMA has more than 20,000 office bearers.

Inform, educate, and make people aware of Thalassemia this year

Inform, educate, and make people aware of Thalassemia this year 1 in every 25 Indians is a carrier of Thalassemia New Delhi, May 07 2017: With a prevalence of 288,000 with 60,000 live births each year, Thalassemia is the world's largest rare disease community. Due to its heavy prevalence in the Mediterranean region (Italy, Greece), it is also called Mediterranean anemia. Statistics indicate that approximately 15 million people suffer from thalassemic disorders worldwide. Apart from this, there are about 240 million carriers of β-thalassemia worldwide, which is 1.5% of the world population. One in every 25 Indians is a carrier of thalassemia. A genetic blood disorder where the bone marrow fails to produce the required red blood cells for the body to thrive, Thalassemia requires lifelong blood transfusions and other therapies. Thalassemia minor people are carriers and can lead normal lives without any clinical interventions. Every year, 8th of May is marked as the World Thalassemia Day. 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, " India has about 35 lakh plus thalassemia majors. This day should be used to inform, educate, and make people aware of this disorder and how to prevent it. One important thing to consider today is making genetic counseling for prenatal testing a must so that other children in the family do not carry this disorder. There is also a need to dispel the myths surrounding this condition and ensure inclusion." Thalassemia is the most common genetic disorder genetically passed on to children. Its symptoms include weakness, fatigue, slow growth, pale appearance, abnormal swelling, abnormal bone structure (especially on the face and skull), heart problems, and iron overload. On World Thalassemia Day, it is imperative to raise awareness on this disorder, its causes, symptoms, and possible treatment options. Adding further, Dr K K Aggarwal, said, "As is the case of any other disease or health condition, there is an immediate need for policy changes with regard to Thalassemia to ensure health equity and justice. Many individuals including children In India succumb to this disease due to lack of access to drugs and treatment. We need a policy which will help enable free delivery of treatment and drugs to every nook and corner of the country." Thalassemia is a hereditary disease and can be prevented but not cured with medicines. To ascertain whether one is a carrier, a blood test is important. In pregnant women, prenatal tests help detect this condition before birth. In case one or both the parents have this condition, it is a good idea to consult the doctor to reduce the risk of passing it on to the children.

Eating fruits and vegetables may lower risk of dementia in older adults

Eating fruits and vegetables may lower risk of dementia in older adults A population-based observational study published February 10, 2017 in the journal Age and Ageing has yet again provided evidence for the benefits of eating fruits and vegetables. The study says that at eating least three servings of vegetables and two servings of fruits daily might help prevent dementia in older adults. Researchers examined the diet of more than 17,000 Chinese older adults who attended the Elderly Health Centres in Hong Kong who did not have at study baseline. Their cognitive status was followed up for 6 years. The cut-off for minimal intake of vegetables and fruits was defined as that recommended by the WHO as at least three and two servings per day, respectively Compared with adults who did not adhere to WHO recommendations for fruit and vegetable intake, adults who consumed three servings of vegetables and two servings of fruits daily were found to be at lower risk of dementia development over 6 years. Dementia risk was further reduced for adults who consumed an additional three portions of vegetables each day, the team reports. According to the authors, the study also highlights the importance of daily intake of fruits and vegetables for cognitive maintenance. (Source: Medical News Today) Dr KK Aggarwal National President IMA & HCFI