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Archive for August, 2011

90-minute TB test not a game changer for India

August 30, 2011 Leave a comment

By IANS,

New Delhi : A new diagnostic technique that detects tuberculosis in 90 minutes instead of three months using the conventional method may not be effective in India as the heat and humidity would affect the equipment, experts said.

TB kills two people every three minutes in India, accounting for over three million (30 lakh) deaths a year.

The diagnostic technique, Gene Xpert MTB/RIF, was launched in the US in 2007 and is supported by the World Health Organisation. It was launched in India last year.

However, a health ministry official said the technique may not be a game changer in India due to the staggering burden of tuberculosis the country is currently facing.

The technique enables rapid diagnosis of tuberculosis, multi-drug resistant TB (MDR-TB) and TB in HIV-infected individuals in a span of 90 minutes compared to the conventional test.

“The technique cannot be used for routine testing. We have pilot projects at 18 sites going on to test its feasibility in the Indian situation where the climate and temperature conditions are different from the western countries,” said Ashok Kumar, deputy director general of the central TB control division under the ministry of health and family welfare, at a conference by Stop TB partnership.

When the technique was launched September 2010, health experts pinned their hopes on the test promising a quicker diagnosis of Multi-Drug Resistant TB by looking for bacterial DNA in a person’s sputum.

“The pilot projects are in consultation with the WHO. The idea is to take the test near to the districts and remote areas where the conditions under which TB originates could be different,” Kumar explained.

According to experts, high humidity and high temperature may affect the equipment and cartridges used in the test. Invariable temperature can also lead to inconsistency in the results.

“Solid culture/sputum testing remains the golden standard for Indian conditions. Xpert test can be used for HIV positive patients, but not in routine testing,” Kumar said.

According to officials from the TB control division in the health ministry, the cost would be incurred by the ministry. The test costs around Rs.900 ($20) per sputum sample.

Blessi Kumar, a TB prevention activist and vice chairperson of Stop TB partnership coordinating board, said thought should be given to the technique to make it effective.

“The Indian research community and pharma industry should take on the task of going deeper into the 90-minute test. It can be a scientific advancement or a stepping stone that India needs to reduce TB cases,” Kumar said.

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Every district in India will have a medical college within next five years

August 30, 2011 Leave a comment

In order to bring down the shortage of doctors and improve healthcare services at the minutest level, the government is planning to have medical colleges in each district.

It has plans to convert district hospitals into training institute the paramedical personnel as well.

Besides, the government also plans to integrate AYUSH doctors and have capacity building programmes for other traditional healthcare providers such as Registered Medical Practitioners (RMPs) and Traditional Birth Attendants (TBA) so that traditional care practices and local remedies are encouraged.

Health ministry sources indicated that the AYUSH doctors may be trained further to handle normal chidbirth cases in remote areas.

They will also be trained to take care of serious medical cases so that the patient is stabilised before he/she is sent to bigger hospital. Ministry officials said that this help will bring down maternal and infant mortalities.

Expressing concerns over the low density of doctors and paramedical staff in India the Planning Commission’s approach paper for the 12th Five Year Plan, has prescribed drastic reforms to improve healthcare.

As of now medical colleges are concentrated in only 193 districts of the country that have 640 medical colleges among them. The rest 447 districts do not have any medical college.

Against 335 colleges, there are about 319 Auxiliary nurses and midwives (ANM) training schools, 49 health and family welfare training schools and only 34 LHV (Lady Health Visitor) schools.

The present doctor patient ratio 0.6 per 1000 while the ratio of health workers (including midwives, nurses etc) is 2.5 per 1000.

“To fill the gap in training needs of paramedical professionals, the 12th Plan proposes to develop each of the district hospitals into knowledge centres, and 4,535 CHCs into training institutions,” says the Planning Commission report.

The government has already begun work on six All India Institute of Medical Sciences (AIIMS) -like medical institutions in different states.

The government has so far released Rs847 crore for the purpose. These AIIMS like institutions are coming up in Bihar (Patna), Chhattisgarh (Raipur), Madhya Pradesh (Bhopal), Orissa (Bhubaneswar), Rajasthan (Jodhpur) and Uttarakhand (Rishikesh) under the first phase of Pradhan Mantri Swasthya Suraksha Yojana .

Over the last three years, Ministry of Health and Family Welfare had announced to increase about 5,000 post graduate seats in medical colleges across the country in order to increase in the number of specialist doctors.

Sources:- DNA

Recruitment of 233 doctors

August 29, 2011 Leave a comment

IMPHAL, Aug 27: The state cabinet meeting convened this evening under the chair of Chief Minister Okram Ibobi has approved recruitment of 233 doctors under the state health department.

According to an official source, the 233 doctors will include 25 for dental and 21 for Ayush. Out of these 233 posts, 75 will also be reserved for scheduled tribes.

Sources:- Imphal Free Press

Moirang CHC shifted

August 29, 2011 Leave a comment

IMPHAL, Aug 28: The community health centre (CHC) of Moirang has been shifted temporarily to the premises of District Institute of Education and Training (DIET) due to inundation of the CHC complex for the last many days.

The CHC has remained defunct due to inundation of the complex. The arrangement came into force after Moirang MLA M Prithiviraj raised the issue to the Assembly and after which Chief Minister accepted the proposal for shifting the CHC in the interests of the general public.

Sources:- Imphal Free Press

Accessible, affordable healthcare in the offing

August 25, 2011 Leave a comment

New Delhi : India’s Twelfth Five Year Plan (2012-2017) will give more teeth to healthcare by emphasising on accessibility and affordability, a member of the plan panel said here Wednesday.

“Health and manufacturing affordable means of healthcare will be priority areas. The medical technology industry needs to understand the demands of the Indian market for innovation in the health sector,” Planning Commission member Arun Maira said at the fourth conference on medical technology organised by the Confederation of Indian Industry (CII).

“With over 80 percent of healthcare services met by corporations, a large part of the populace still finds itself outside the ambit of delivery mechanisms,” he noted.

While Prime Minister Manmohan Singh, in his Independence Day speech, announced that health would be deemed a priority area, experts said indigenous players in the health sector will have to be given more suport to achieve the target.

“With a population of 1.2 billion, support should be given to indigenous manufacturers in addressing the issues of quality and narrowing the technology gap we have in healthcare,” said Naresh Trehan, chairman of the CII National Committee on Healthcare.

What Really Happens on a Hospital Night Shift?

August 20, 2011 Leave a comment

Hospital Night Shift
Research and design by Nursing Schools Site

Categories: Articles, health

Doctor rounds

August 18, 2011 Leave a comment

By Chitra Ahanthem
Once upon a time, a trip to a doctor meant a pretty decent time interval where the doctor would take patient history and then follow it up only with required medication instructions. Looking at those times, it is also a matter of great irony that though there were lesser doctors then and few private clinics, there would never be a rush of people waiting for their turns to be medically examined. But they say changes are the only constant of life and the scene has changed and how! For one, the number of doctors and specialized ones has increased and so has the number of private clinics and hospitals and doctors on private service. But along with the number of doctors increasing (and we are talking mainly of urban centers), there is also an ever growing number of people who are becoming inclined towards seeking health services.

There are interesting insights into the phenomenon of seeking health care. There is of course, the fact that people are becoming more aware about the need to be concerned about their health and to take medical opinion. But on the other end of the spectrum is also the fact that urban life styles have added to new medical ailments. Over and above these areas, there is a disquieting tendency for doctors to treat their patients like money spinning enterprises. There is rarely any doctor (doing private practice) in Imphal or for that matter, in the district headquarters who do not charge a set patient consultation fee. Most of these doctors have a family member or a relative manning a sort of ticket table. They allocate serial numbers and take the consultation charge. The going rate at present is Rs. 200 on the first consultation and Rs. 100 for every follow up medical check up. 99.99 per cent of the time, the doctor will give a list of medicines that you have to buy and the ticket attendant will lead you to the in house pharmacy. Chances are also that you will find free doctor samples of medicines being sold.

This piece today is certainly not a chest beating or vitriolic rant against the medical community in Imphal but a mere mirror image of the practices that has become totally normal. It is certainly not a stand-alone practice for the same situation exists in urban areas and cities. But one wishes that there was a standard set of rules or code of conduct and ethics that the medical fraternity here would stick to. Most private clinics that I have seen functioning outside the state have a social responsibility program where they give subsidized health care to senior citizens and people with poor economic backgrounds. I happened to take my son for a surgery for plugging his leaking tear sac at the Nethralaya Eye Institute and was very impressed by the standard of health care and quality that justified with the amount of money they were charging. They had a patient counseling session where they explained the operation and what would follow later on. But what impressed me most was the fact that they had free surgery and medication policy for senior citizens and people from poor backgrounds. For the later, they checked with BPL cards and when I asked what would happen in cases where people do not come with any official documentation specifying that so and so is poor, I was told that the one thumb rule to check such cases was the desperation of people seeking services and the state of their appearance. I was told that it was as simple as that!

Personally, I have nothing against doctors on private practice so long as they are not shirking their Government work timings. It is I as a consumer, and customer and patient party who is aware that I can also seek his service at a subsidized rate at the government hospital where he/she is practicing. And if this “I” feel that waiting at a hospital is not in the order of things, it is only fair that “I” pay for the time that the doctor has devoted to me. But having said that, there are many areas that need to be considered from the doctor’s viewpoint that justifies the money that is being charged for his consultation. For one, it would do well to have a strict order of who gets in first. Very often, doctors have a set consultation time, which is known or announced. Patients troop in and an attendant, who allocates a serial number, takes down their names. But mostly, the serial numbers do not matter because someone they know or some one in their social circle drops in unannounced for a check up. Also, there are certain doctors who will give first priority towards the patients they have been administering at his/her government hospital set up but who follow up with him later on a private consultation basis. This would mean that they would jump the waiting list and ruffle up a few feathers.

End-point:
They say that an apple a day keeps the doctor away but either, something is wrong with the apples or the doctors have become indispensible for on an average basis, about 4 people out of 10 would most definitely be seeking medical attention or consultation at any given time: if not for his own self, for a family member, for a child etc.