Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 13th July, 2019

MCI makes 8-week research methods course must for PG

(The Tribune, July 11, 2019): In a significant step that acknowledges the importance of research in learning along the lines of western countries, the Medical Council of India (MCI) Board of Governors introduced a compulsory online course in basic research methods for all postgraduate students in the country and for faculty with no prior research training. The 8-week course will be mandatory for medical PG students being admitted from academic year 2019-20 onwards. The course would have to be completed by the end of the 2nd semester.

The National Institute of Epidemiology of the Indian Council of Medical Research will conduct the course, and students will have to register on NIE portal. An online certificate will be generated on successful completion of the course and examination. This will work as the proof of completion of the course. Sources said there will be no fee for the online course, but students will have to pay exam fee, details of which will be available once they register…

Budget Highlights: Goods and Services Tax

1. A Proviso has been inserted to clarify that interest for late payment of tax shall be levied only on that portion of tax which has been paid by debiting the electronic cash ledger. Earlier there was a confusion among taxpayers on this issue whether such interest would be charged on gross tax liability or only on net tax liability. However, there is one exception to this rule wherein interest shall be levied on gross tax liability. Where returns are filed subsequent to initiation of any proceedings under GST Act, the interest shall be levied on the gross tax liability.

2. Every registered person shall authenticate, or furnish proof of possession of Aadhaar number. If an Aadhaar number is not assigned to the registered person, such person shall be offered an alternate and viable means of identification. In case of failure to undergo authentication or furnish proof of possession of Aadhaar number or furnish alternate and viable means of identification, registration allotted to such person shall be deemed to be invalid.

3. Now a registered person can transfer any amount of tax, interest, penalty, fee or any other amount available in the electronic cash ledger to the electronic cash ledger for Integrated Tax, Central Tax, State Tax, Union Territory Tax or Cess through a new form PMT-09 subject to the conditions and restrictions prescribed under GST Act. Such transfer shall be deemed to be a refund from the electronic cash ledger.

4. The Central Government has been authorized to pay the amount of refund towards State taxes to the taxpayers.

5. The Government shall constitute an Authority 'National Appellate Authority for Advance Ruling (NAAAR)' for hearing appeals. It shall pass an order within 90 days from the date of filing of appeal.

6. The value of exempt supply of services provided by way of extending deposits, loans or advances (where consideration is received in form of interest or discount) shall not be considered for determining turnover under Composition Scheme.

7. Simplified return forms to be implemented soon. Composition registered dealers are required to pay tax quarterly and file return on annual basis.

Cardiac arrest and death during elective stenting

No surgery is safe. In every so-called safe surgery, one should take consent about unexpected complications and chances of death on the table or proximal optimization technique (POT) stenting.

A new European registry analysis presented at the Congress of the European Association of Percutaneous Cardiovascular Intervention (EuroPCR) 2019 has identified high rates of unexpected cardiac arrest and death in patients undergoing elective percutaneous coronary intervention (PCI).

An analysis of more than 113,000 elective cases performed at high-volume PCI centers shows that 330 patients arrested during PCI, or one per 344 procedures......read more

Botulinum toxin, a new treatment for endometriosis-associated chronic pelvic pain?

(NIH): According to results published in Regional Anesthesia & Pain Medicine, treating pelvic floor muscle spasm with botulinum toxin may relieve pain and improve quality of life. The study was conducted by scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.

In the study, women with surgically treated endometriosis who were generally taking hormones to suppress menses, but who continued to experience pain and had pelvic floor muscle spasm, initially received injections of botulinum toxin or saline as part of a placebo-controlled clinical trial, targeting areas of spasm. At least one month after the masked study injection, 13 participants chose to receive open-label botulinum toxin injections in areas that remained in spasm and were then followed for at least four months. These patients were described in the current study at the NIH Clinical Center......read more

Healthcare News Monitor

Dedicate one month to stabilise population: Health Minister

The Times of India- PTI

Union Health Minister Harsh Vardhan Thursday urged NGOs to dedicate one month every year to work to stabilise the country's population, saying it is necessary to improve the quality of life and achieve universal health coverage. "Let us work towards not losing any pregnant woman and child to preventable causes," Vardhan said, adding this requires everyone to work together. "The development partners, civil society, private and corporate sector, community leaders and the media, all have critical roles to play," he said. At an event on World Population Day, the minister said the government is committed to addressing health issues, improving the scale and ensuring accessibility of quality services for everyone. But for that to happen, he stressed, population stabilisation is a crucial determinant. "We need to position health as a component of all public policies. The occasion also provides a valuable and potent platform to discuss issues related to gender equality, maternal and child health, human rights, poverty and other development determinants," he said. Citing the success of polio eradication programme, he said it taught the government that desired results can be achieved by involving society. "We have experience of the success stories and learnings from our challenges. We need to leverage on this knowledge and resources to achieve what we have set out for." Vardhan said his ministry's increased budget this year reflects the importance given to the health sector, including the flagship Ayushman Bharat scheme. Launching a new awareness campaign on family planning, he stressed on the importance of information and communication to share knowledge with people.

Health ministry revives oral contraceptives as condoms fail to attract Indians

Mint- Neetu Chandra Sharma

After major push for injectible contraceptives and professing usage of condoms, that still witness a nominal uptake for family planning by Indians, union ministry of health and family welfare is now going back to revive the category of oral contraceptives. On world population day on 11 July, the ministry released at least three television commercials to promote oral contraceptives and debunking the myths surrounding them. “The Government has increased focus on spacing at birth to achieve improved maternal and child health outcomes. Keeping this in mind, new communication and Information, Education and Communication (IEC) material were designed this year and launched today," said Harsh Vardhan, union health minister. “This focuses on improving the uptake of spacing methods by addressing myths and misconceptions prevailing around these methods and reviving the category of oral contraceptive pills and improving the uptake of Condoms and Injectable Contraceptives," he said adding that population stabilisation is a crucial determinant of quality of life and achievement of universal health coverage goals.

Health ministry sets up committee to consider central law against attacks on doctors


The Union Ministry of Health and Family Welfare has constituted a 10-member committee to assess the aspects of enacting a central law against attacks on doctors and medical establishments, The Indian Express reported on Wednesday. The move came after junior doctors at NRS Hospital in Kolkata went on strike on June 11 along with their colleagues across the state after a patient’s family allegedly attacked two interns. Doctors in Delhi, Rajasthan, Assam, Gujarat, Tripura, Madhya Pradesh, Uttar Pradesh, Odisha, Karnataka and Kerala joined the strike, which was called off June 17. The committee held its first meeting on Wednesday. The panel comprises representatives from the health ministry, the legal affairs department, hospital administrators, members of Medical Council of India and Federation of Resident Doctors’ Association, and medical superintendents of All India Institute of Medical Sciences and Ram Manohar Lohia Hospital in New Delhi. “In the meeting of the stakeholders, there was a broad consensus that a central law is needed,” Hindustan Times quoted an unidentified senior health ministry official as saying. “The committee will now look into the specific provisions.” The Indian Medical Association had submitted a draft bill on the matter to Union Health Minister Dr Harsh Vardhan last month. The bill proposed a 10-year jail term and Rs 5 lakh fine for violence against doctors.

IPC identifies 17 medical device monitoring centres pan India to analyse SAEs exclusively

Pharmabiz India- Shardul Nautiyal

To develop the culture of reporting of adverse events in healthcare institutions in the country, the Ghaziabad-based Indian Pharmacopoeia Commission (IPC) has identified 17 medical device monitoring centres pan India to analyse serious adverse events (SAEs) exclusively as part of Materiovigilance Programme of India (MvPI). MvPI is meant to enable safety data collection in a systematic manner so that regulatory decisions and recommendations on safe use of medical devices for India could be based on data generated in India. This is a welcome change for the consumers and patients who are administered high risk medical devices like stents and implants as part of therapy in cardiac and orthopaedic disorders. Government has also been contemplating to introduce a high risk medical device registry to track SAEs due to faulty medical devices. Uptil now SAEs have been reported through the Pharmacovigilance Programme of India (PvPI). Central Drugs Standard Control Organisation (CDSCO) had launched PvPI in July 2010 with Ghaziabad-based IPC as the National Co-ordinating Centre (NCC) to track adverse drug reactions (ADRs).

Hospitals witness negative impact of input GST on their business under NPPA price control regime

Pharmabiz India- Shardul Nautiyal

Though healthcare services have been exempted from the Goods and Services Tax (GST) regime, hospitals are witnessing negative impact of input GST under the National Pharmaceutical Pricing Authority (NPPA) price notifications with reference to out patient department (OPD) and in patient department (IPD) patients, according to experts. Drug pricing regulator in India has been fixing prices of drugs or formulations and implants on a priority basis under the provisions of the Drugs Prices Control Order- 2013 (DPCO).“To understand the impact of GST on healthcare operations, it has been observed that in case of OPD patients, drugs are supplied separately for a charge along with applicable GST in which case the healthcare services are GST exempted. In case of IPD patients, patients are administered different drugs, consumables, implants etc. as per medical requirement and finally no GST is paid on the composite supply of healthcare services,” explains Surbhi Premi, joint director, Lakshmikumaran & Sridharan Attorneys. The irony is that the input GST on procurement of drugs forms part of overall cost which is finally borne by the hospital, Premi further adds. For instance, in case a drug costs Rs.20,000+GST, the ceiling price is Rs.22,000, the rate of GST being 10 per cent, the amount recovered for the services by the hospital during IPD would be even lower than its procurement cost.

NABH to conduct sensitisation workshops for nursing management staff on certification

Pharmabiz India - Shardul Nautiyal

In order to guide hospitals on nursing staff certification, National Accreditation Board for Hospitals and Healthcare Providers (NABH) will conduct series of sensitization workshops for Nursing management staff across the country as part of its newly launched certification programme for nursing excellence. The workshops will start from August and conclude in December in Coimbatore, Vijayawada and Patna. Participation to workshops across the country is open for nursing superintendents and nursing supervisors from both private and public hospitals. NABH is a constituent board of Quality Council of India (QCI), which establishes and operates accreditation and certification programmes for healthcare organizations. NABH has been successfully running various accreditation and certification programmes for hospitals, small health care organisations (SHCO), allopathic clinics, Ayush hospitals, blood banks, blood storage centres, dental hospitals, dental clinics, medical laboratories etc. Total 40 seats are available and registration will be done on first come first serve basis. Not more than two participants will be accepted from the same organisation.

Poor doctor-patient contact root of hospital brawls, opine experts

The Hans India

Lack of communication between patient's family members and doctors and hospital staff attending them is one of the main causes for abuse and physical attacks on doctors that have increased in recent times, according to experts. This is why Public Relations and Managerial Skills are becoming very important in smooth running of hospitals without any untoward incidents, they said. The Administrative Staff College of India, Hyderabad held an inaugural programme at Banjara Hills campus, for the new batch of PGDHM (PG Diploma in Hospital Management) and it was graced by eminent personalities including Dr Kakarla Subba Rao (founder director, NIMS), Dr K Padmanabhaiah (Retd IAS), Chairman, Court of Governors, ASCI and Dr Mudit Saxena, CEO, Ovum Hospitals, Bengaluru among others.