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)

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!

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

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.