Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                            Dated:7th September,2019

Emergency department openings and closures impact resources for heart attack patients
(NIH): A new study published in the September issue of Health Affairs has found that hospital emergency room closures can adversely affect health outcomes for heart attack patients at neighboring hospitals that are near or at full capacity. Conversely, when a new emergency department opens, health outcomes for patients at those so-called “bystander” hospitals improve. The study, believed to be the first to evaluate the impact of emergency department openings and closures on bystander emergency departments, looked specifically at outcomes for heart attack patients. But researchers said the findings have implications for all patients, particularly in communities where inadequate health resources contribute to disproportionately poor health outcomes.

   When the closure of an emergency department resulted in an increased travel time of 30 minutes or more to get to another
   hospital, health outcomes for patients in the bystander hospitals were negative. The one-year mortality rate for patients in those
   hospitals increased by 8% and the 30-day readmission rate increased by 6%. The likelihood of the same patients receiving the
   cardiac procedure declined by 4%.

   When an emergency department opened and reduced that driving time by at least 30 minutes, the patients in the bystander
   hospitals experienced a reduction in one-year mortality by 5%. The likelihood of these patients receiving the cardiac procedure
   improved by 12%.

The Path to Wellness
Dr Ketan Desai delivered the “Taro Takemi Memorial Oration” at the 34rd CMAAO General Assembly of CMAAO in Goa. Here are excerpts from the Oration.

“Ladies and Gentleman

It gives me immense pleasure to record my committed sense of appreciation for the Indian Medical Association and its office bearers who have taken this historically notable initiative of organizing the 34th CMAAO General Assembly and 55th Council Meeting in the midst of the scenic beauty of Goa, which is bound to the memorable by all yardsticks.

I also consider it a privilege conferred on me to deliver this prestigious oration on a theme which is very apt, timely, relevant and of vital and significant need in the context of contemporary and long term challenges that the health systems in vogue across the Globe are plagued by. ....read more

Mera Bharat Mahan 23: Self-Manifest
Swayambhu or ???????? (Sanskrit "self-manifested", "self-existing") means "that is created by its own accord". In Sikh prayer, it is called Ajuni Saibham. In Tibetan, this word appears as "Rangjung".

The word Swayambhu is used to describe a self-manifested image of a deity, otr ku (Tibetan) which was not made by human hands, but instead is naturally arisen, or generated by nature.

The word etymology of swayambhu is 'Svayam' (??????) which means 'self' or 'on its own' and 'bhu' (??) which means 'to take birth' or 'arising'. The idol of Venkateshwara at Tirumala is one such example.

In Sikh prayer, the word ‘Ajuni’ makes God to be unborn. Saibham (saibhang) explains God as self-manifested, self-existent or self-effulgent. ....read more

Healthcare News Monitor

Government nutrition survey highlights deficiency of anaemia, micronutrient, prevalence of NCDs in country
Pharmabiz India

Union government’s national nutrition survey has revealed that there is prevalence of anaemia, micronutrient levels, vitamin A, D and Iodine deficiency in the country. It also goes on to highlight the incidence of non communicable diseases (NCDs). The Union health ministry recently concluded its first ever comprehensive national micronutrient survey (CNNS) with the comprehensive nutritional assessment from birth to adolescence between 0-19 years. The survey and design protocol was devised by the National Statistical Commission (NSC). The survey implementation was by UNICEF with help from multiple agencies in close supervision and technical support from the Technical Advisory Group (TAG) constituted by the Union health ministry. The data quality assurance was done by multiple government organisations including the All India Institute of Medical Sciences (AIIMS), New Delhi, National Institute of Nutrition (NIN), Hyderabad and PGI, Chandigarh. The purpose CNNS was to measure the malnutrition in children and adolescents. The biological samples were transported in insulated bags maintained a temperature between 2 to 8 degree centigrade. The time and temperature was recorded by data loggers and real-time short message service (SMS) reports.

Operation Modicare: Some hospitals don't care about Modicare, refuse to treat patients
IndiaToday- Nitin Jain

Ayushman Bharat -- also known as Modicare -- seems to have been contaminated by infectious greed, with some hospitals on its panel refusing treatment to patients entitled to the scheme, an India Today investigation has found.Billed as a game-changer for the most vulnerable, Ayushman Bharat was launched by Prime Minister Narendra Modi in September last year, targeting 50 crore beneficiaries. India Today's Special Investigation Team (SIT) found that the project could be running up against non-compliance in terms of its implementation on the ground. So far, around 16,000 hospital have been empanelled for the programme. But, the probe discovered some of them shying away from treating the patients entitled to Ayushman Bharat scheme. Of the target 50-crore beneficiaries, more than 40 lakh have already been enrolled in the PM Modi's flagship healthcare project. The cashless and paperless scheme promises an annual cover of Rs 5 lakh per family, with no cap on family size. The assurance covers surgery, daycare, medicine, diagnostics and transport costs.

Experts urge DCGI to make B Pharm the qualification for Drug Inspector-Medical Devices
Pharmabiz India - Peethaambaran Kunnathoor

A clause in Medical Devices (Regulations) Rules 2017 stating a degree in pharmacy as one of the basic educational requirements for the post of Drug Inspector - Medical Devices (Medical Devices Officer) needs to be incorporated by making an amendment to Rule 18 (2) of the MDR Rules 2017, academic to experts. While hailing the efforts took by the Union health ministry and the pharmacy council of India (PCI) to boost employment opportunities for pharmacy graduates, the academic community appealed to the drugs controller general of India (DCGI) to amend the Rule 18(2) of the MDR Rules 2017. In a letter sent to the DCGI, an academic expert in Jharkhand, Dr. RN Gupta from Birla Institute of Pharmaceutical Sciences in Ranchi, said that the central recruitment agency (UPSC) considers graduates and post-graduates in engineering and technology for the post of Medical Devices Officers, but the most appropriate qualification for the post is graduation in pharmacy. He has written the letter, on behalf of the academic community, in the wake of reported news that the union government is gearing up to increase the manpower of the central drugs standard control organisation (CDSCO) for regulation of medical devices and enforcement of the Rules 2017. According to him, the union public services commission may soon recruit 754 medical devices officers for regulation of manufacturing and sale of medical devices along with filling up of vacancies of other technical staff. As suggestion to the central drug regulator, the academic community feels that qualified persons with pharmacy background must be considered for first preference while recruitment is done. B Pharm should be included in the list of educational qualifications for the post in the first position.

Doctors in Assam stage protest against 73-year-old colleague’s killing
The New Indian Express- Prasanta Mazumdar

Doctors across Assam resorted to a 24-hour “withdrawal of non-emergency medical services” on Tuesday in protest against the killing of a 73-year-old colleague by a mob of tea garden workers in Jorhat district on Saturday. During the protest which began at 6 am, the doctors took out rallies and held sit-in stirs. They demanded security for medical practitioners at their workplace. Some organisations of the doctors, led by the Assam branch of Indian Medical Association (IMA), had taken a decision on the withdrawal of non-emergency medical services. The doctors, including junior medical practitioners, attended to only emergency cases in the state’s six government-run medical college and hospitals, civil hospitals, family referral units and primary health centres. Earlier, the IMA demanded exemplary punishment for the perpetrators of the crime and stepping up of security in all health establishments including those in tea gardens.

Jamnagar: Govt hospital doctor tests positive for Congo fever
The Indian Express

A resident doctor of Guru Gobind Singh Government Hospital in Jamnagar has been diagnosed with Crimean-Congo Haemorrhagic Fever (CCHF) on Monday, hospital authorities said.Dr Nandini Desai, superintendent of the hospital, said that one of the resident doctors was suffering from high-grade fever for nine days. As the fever persisted, the hospital sent her blood samples to the National Institute of Virology (NIV), Pune on Saturday. The test report returned positive of CCHF and the same were reported to the Guru Gobind Singh Government Hospital (GG) Hospital on Monday evening, the superintendent added. “The doctor had attended to a patient with high-grade fever in the emergency ward on August 22. That patient died within four to five hours and therefore we couldn’t collect his samples for testing at NIV. This is the only suspected source of infection for this doctor as no CCHF cases have been reported in Jamnagar so far. But since the patient died immediately, we could not investigate much. The doctor also complained of fever on August 22. She was having symptoms similar to CCHF. Therefore, we sent her samples to Pune and we received results yesterday (Monday) evening, saying they were positive for CCHF,” the superintendent said.