Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                                  Dated:12 October,2019

Dengue in India

Odishadengue outbreak: 28 patients tested positive for dengue in the last two days daily at SCB Medical College and Hospital, Cuttack. Of the 67 blood samples examined on Tuesday, as many as 23 blood samples have been tested positive for Dengue virus. Similarly, a total of 155 samples examined on Wednesday out of which as many as 34 tested positive for the vector-borne disease.

After floods, Bihar recorded 1,184 cases till October 9, 2019. Of these, Patna, which is the worst hit, registered 823 cases and 140 of them in just the last 48 hours. In 2018, around 2,100 people had tested positive for the disease and of these, 1,176 were from Patna.

Factors influencing disease severity

  Most dengue virus infections produce mild, nonspecific symptoms or classic dengue fever.

  Severe dengue, dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS), occurs in less than 1 percent of all dengue virus infections.

  Risk of severe dengue is highest with dengue-2 viruses.

  Genetic analyses of dengue virus isolates from the Western hemisphere strongly suggest that DHF only occurs during infection with viruses that fall into specific genotypes within each dengue serotype

  Risk of severe disease (DHF and DSS) is significantly higher during a secondary dengue virus infection than during a primary infection

  The risk for DHF appears to decline with age, especially after age 11 years.

  A specific population at higher risk for DHF in endemic areas is infants, particularly those between 6 and 12 months of age.

   DHF and DSS are less common in malnourished children than in well-nourished children.

#MainFitToHiIndiaFit: Join the Fit Delhi-Fit India movement
The six-minute walk test, the easiest first-line test to assess cardiac fitness

The six-minute walk test (6MWT) is the easiest test to assess cardiac fitness. It measures the distance (recorded in meters) a person can walk on a hard, flat surface in 6 minutes. While the test is primarily used to assess exercise tolerance in chronic respiratory disease and heart failure, it may also be used to measure exercise capacity in healthy older adults.

6MWT is an inexpensive, simple to do and easy to administer test, requires no special equipment or specially trained technician/s, well-tolerated and acceptable to patients. These features make it a reliable first-line test to quantify exercise intolerance. ....read more

Work-family conflict not heart friendly
(AHA): When family demands affect work performance or work demands undermine family obligations, the resulting stress may contribute to decreased heart health, particularly among women.

Work-family conflict is classically defined as “a form of inter-role conflict in which the role pressures from the work and family domains are mutually incompatible in some respect.”

A new study published in the Journal of the American Heart Association, adds another factor for doctors and patients to evaluate in treating cardiovascular problems, said the study's senior author, Dr. Itamar Santos, a professor at the University of São Paulo and a researcher in the Brazilian Longitudinal Study of Adult Health. Santos and his colleagues studied more than 11,000 workers in Brazil between ages 35 and 74. The workers filled out questionnaires based on a model that measures the impact of work on family life, and vice versa. Their heart health was scored using questionnaires, clinical exams and laboratory results for health metrics, including smoking, body mass index, diet, physical activity, cholesterol, blood pressure and blood sugar level.....read more

An empty mind is the devil’s house
It is an old saying that "Khali dimag shaitan ka ghar".

Empty mind means when you are doing nothing and Shaitan means negative thoughts. In terms of Vedic science, negative thoughts mean absence of positive thoughts and they are often equated to darkness, which is absence of light.

Positive thoughts always need efforts and exertions, while negative thoughts are spontaneous and without exertion. It is recommended that one should think differently and positive otherwise there will be spontaneous appearance of negative thoughts. ....read more

Healthcare News Monitor

Raise healthcare spending to at least 8% of budget: Harsh Vardhan asks states

New Delhi: Union Health Minister Harsh Vardhan on Thursday urged states to increase their healthcare spending to a minimum 8% of their budget, with an aim to meet the goals of National Health Policy 2017. This would increase the health spending to 2.5% of GDP by 2025, the health minister said. While inaugurating the 13th conference of the Central Council of Health and Family Welfare, an apex advisory body to consider and recommend broad lines of policy in matters concerning health and family welfare, Harsh Vardhan said, “Health needs to become a social movement in every state and union territory and the "Eat Right" and "Fit India" movements need to be taken up by States and UTs in a synergized manner, to ensure a healthy and robust India."
The CCHFW meeting was aimed at building consensus on national health priorities i.e. Universal Health Coverage (UHC) through Ayushman Bharat, eliminating TB and other priority agenda such as strengthening medical infrastructure. Besides increasing health budget, the government deliberated on engaging the private sector in healthcare. “For augmenting the efforts of the public sector to bring in equity to increase the number of beds and hospitals to meet the global standards of health infrastructure, we need to engage the private sector as well," said Vinod K. Paul, member, NITI Aayog.

CDSCO soon to notify list of OTC drugs to prevent misuse of medicines

In order to promote self-care without compromising patient safety, the Central Drugs Standard Control Organisation (CDSCO) will soon notify list of over-the-counter (OTC) drugs and lay down specific provisions for its regulation in the country. As per the recent drug consultative committee (DCC) recommendations, the definition for OTC drug must be laid down in the Drugs and Cosmetics (D&C) Rules, 1945. The DCC recommendation comes in the wake of a subcommittee of experts proposal for adequate labeling in the drug packaging, so that consumers can “self-diagnose,” “self-elect,” “self-administer” and know when to stop using OTC drugs. The CDSCO is also considering introducing a “unit dose packaging” for non-prescription medicines to lower chances of misuse or an overdose. Contraceptive pills and analgesics such as paracetamol also qualify as over-the-counter medicines. The subcommittee, which is looking into over-the-counter drugs, has suggested packaging for medicines that can be sold “without prescription, have a proven safety profile, therapeutic index and (are) used for common ailments”. The experts have suggested two separate categories– OTC1 for those sold at retail outlets and OTC2 for those sold at pharmacies. India does not have a definition for OTC drugs. The subcommittee has suggested that a formulation should have been sold for at least four years for it to be considered as an OTC medicine. The experts have also proposed “labelling requirements”, which include a logo specifying whether a medicine is an OTC drug or an “OTC drug to be specified”.

Chennai: Doctors turn CT scan room into operation theatre to remove tumour
ET Healthworld

CHENNAI: In a novel method, doctors at MGM Healthcare turned a CT scan room into an operation theatre on September 25 and performed a CT-guided precision surgery on Sridhar S. The 30-year-old software professional was diagnosed with osteoid osteoma - a non-cancerous bone tumour. Sridhar, who suffered excruciation pain in his elbow for several months because of this, told reporters, "I am pain-free after a long time." More than a year ago, the techie complained of pain in the elbow and approached orthopedicians at MGM Healthcare. Tests showed that the tumour was in the joint capsule of his elbow and caused intense pain. "Such tumours are first treated with pain killers because they eventually fade. But in cases where there is no pain relief, we suggest surgical removal," said senior orthopaedician Dr AB Govindaraj. During the surgery, a significant portion of the bone is removed along with the tumour and a graft is placed to fill the hole. "But in this case there was risk of joint damage. So we thought we should use the help of interventional radiologists to remove the tumour," he said.

Kochi: General Hospital gets stroke-ready hospital tag
ET Healthworld

Kochi: General Hospital (GH) has become the first stroke-ready hospital in government sector in Ernakulam. A dedicated team for stroke treatment is being formed for offering immediate and efficient medical care for patients who are brought to the hospital with symptoms of stroke. Once a patient with cerebral thrombosis is brought to the hospital within four-and-a-half hours of showing the symptoms, physical defects can be avoided in 33% of the cases. “We have already started to offer the services. But, patients are being brought to the hospital after two or three days of showing symptoms. We will be able to provide thrombolysis only if the patient is brought here within the window period of four-and-a-half hours since showing the symptoms,” said Dr M Sreedeepan, neurologist, who leads the stroke treatment team in the hospital. Of the stroke cases found here, around 80% is thrombosis while the remaining cases are haemorrhage. In vast majority of these cases, thrombolysis — the treatment offered at the hospital — can ensure that the patient’s condition doesn’t deteriorate while there are chances for worsening the condition in 4-5% of the patients. The injection as part of thrombolysis, which is charged up to Rs 50,000 in private hospitals, is administered to the patients free of cost at the GH. “In many of the hospitals, including government hospitals, bystanders will have to purchase the medicine from outside. It will cause delay. In our hospital, we always store 10 vials,” Sreedeepan said.

KIMS collaborates with CLINEA (France) for advanced rehabilitation services
ET Healthworld

Bahrain, 10 Oct: KIMS Bahrain Healthcare (KBH), a unit of KIMS Healthcare Group based in Trivandrum, has come together with France-based CLINEA to provide long-term rehabilitation and post-acute care in Bahrain and then to extend its services to other KIMS units in India. KIMS has completed 15 years in Bahrain and the agreement is part of its expansion plans in the Kingdom. The services will be provided through a new facility alongside the upcoming KIMS Bahrain Hospital in Umm Al Hassam. The 10-storey facility will have 110 rehabilitation beds. In addition, the facility will provide rehabilitation day care for 30 outpatients (ambulatory). Talking about the significance of this association, Dr. Sheriff Sahadulla, Chief Executive Officer, KIMS Healthcare Group, says: “Rehabilitation centres form an essential part of healthcare infrastructure and are often associated with goals of getting patients rehabilitated to the point where they can live on their own. For KIMS, the association with a major European healthcare Group forms an important part of its expansion in Bahrain. KIMS goal in Bahrain is to provide the spectrum of Healthcare delivery; to include primary, secondary, tertiary, post acute and home care.” "The collaboration for advanced rehabilitation will be extended to all the KIMS units in India as part of its tertiary and quaternary care service departments. KIMS is further expanding in Bahrain with medical centres in Askar and Saar and hospital in Umm Al Hassam", said Dr M I Sahadulla, Chairman and Managing Director, KIMS Healthcare Group.