Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                                  Dated:31 October,2019

Rehabilitating stroke survivors

Most stroke survivors reach a plateau after about three months, say doctors, but don’t be discouraged by that

Reproduced from: http://www.newindianexpress.com/lifestyle/health/2019/oct/29/rehabilitating-stroke-survivors-2054104.html, published Oct. 29, 2019

One of the leading causes of disability and death globally is a stroke. The incidence of stroke is high in India as well – more than 18 lakh cases of stroke are reported in India every year. Despite this, there is little awareness about stroke due to which both treatment and rehabilitation is a challenge for many patients.

“The suddenness of the attack and the absence of clear symptoms makes it a deadly event as it allows only a small ‘window period’ where a patient can be treated successfully without any major disability,” says Dr Vishal Sehgal, Medical Director, Portea Medical, a home healthcare management organisation.

“We need a strong, centralised stroke action plan and a comprehensive written stroke management protocol in case of emergencies at all hospitals... an emergency transport service with an easy 24x7 access helpline that can reduce door-to-needle time to less than one hour... a stroke-specific diagnostic setup, including emergency neuro-imaging systems such as MRI and CT-scan facilities... readily accessible medical expertise for quick diagnosis as well as cost-effective post-stroke physiotherapy and rehab facilities,” says Dr KK Aggarwal, President, Confederation of Medical Associations of Asia and Oceania

“Since recovery from stroke takes a long time many patients often drop out from rehabilitation programmes as a result of which a survivor’s responsibility falls on the family. Further, the cost of treatment, hospital admission and post-stroke rehab are high,” says Dr Sehgal. On the occasion of World Stroke Day, healthcare experts tell us how to best manage a stroke survivor.

Regular movement is must

Encourage a stroke survivor to be as much physically active as possible. Make a daily exercise routine in consultation with the doctor and see to it that the patient follows it. In case the patient is struggling with a task, offer help. But don’t be overbearing. Just be around so that you can step in when the situation demands.

Modify your house a bit

Stroke patients often have a problem of balancing their body which increases the risk of falling. Make certain changes in your home like install grab bars, place anti-slip mats to minimise the chances of falling.

Avoid OTC supplements

Don’t fall for OTC (Over The Counter) supplements that promise the moon. Do not take any over the counter drug. Always consult your doctor before going in for any supplement. Carefully monitor the side-effects of prescribed medicines. Contact your doctor immediately in case you notice any adverse change.

Motivate and encourage

Most stroke survivors reach a plateau after about three months, say doctors, but don’t be discouraged by that. The human brain has amazing powers and keeping a positive attitude will help a great deal. Tackle emotional outbursts with love and care.

Manage risk factors

Check all body parameters like blood pressure and blood sugar regularly. If you notice any fluctuations, consult a doctor immediately

Understanding crime test, criminal test and comparative proportionality test

Three tests form the basic principles when sentencing for crimes has to be analysed. These tests are: crime test, criminal test and comparative proportionality test.

In a recent decision in the matter of State of Madhya Pradesh vs Udham and Others, Criminal Appeal No. 690 of 2014, Supreme Court of India, October 22, 2019, Justice NV Ramana, Justice Mohan M. Shanthanagoudar and Justice Ajay Rastogi briefly explained the three tests to be applied while sentencing in a criminal case ....read more

Air pollution is man-made and does not affect the soul
The Bhagavad Gita, in shlokas 2.23 and 2.24, has defined the characteristics of soul as omnipresent, omniscient and omnipotent. Fire cannot burn it, air cannot dry it, water cannot wet it and weapons cannot cut it. The same also implies to the air pollution levels. Pollution cannot affect the soul status. It can only affect the physical and subtle body and not the causal body.

Bhagavad Gita 3.14 shloka further says “All living bodies subsist on food grains, which are produced from rain. Rains are produced by performance of yajna [sacrifice], and yajna is born of prescribed duties.” ....read more

Sewa the best dharma
Offering help is the best service to the humanity. As per Sikhism, Sewa (unconditional service), Simran (meditation) and Satsang (company of good people) constitute the trio to acquire happiness and spiritual health. In Sikhism, Sewa is the main path for acquiring spiritualism. In Gurudwara, one even offers sewa by cleaning the shoes of others or by cleaning the entry paths to any Gurudwara. ....read more

Healthcare News Monitor

MGM Hospital gets first sliver certificate under PMJAY for healthcare quality
ET Healthworld-ANI

New Delhi: After awarding gold certificate to hospitals for maintaining quality culture, the Quality Council of India (QCI) on Tuesday issued its first silver category certificate to Mohanlal Gupta Memorial (MGM) Hospital and Research Centre based in Madhya Pradesh's Katni for its optimum healthcare facilities. MGM hospital is one of the empanelled healthcare institutions among 18,097 hospitals on board with Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). "We are happy to announce that Mohanlal Gupta Memorial (MGM) Hospital and Research Centre has received sliver certificate for maintaining quality in healthcare services. It is the first AB-PMJAY Silver Quality certificate issued to MGM hospital till date," said Dr J L Meena, General Manager, Hospital Networking and Quality Assurance at AB-PMJAY. AB-PMJAY, the world's biggest healthcare scheme, aims to cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalisation. National Health Authority (NHA), which is the implementing body of AB-PMJAY, has framed comprehensive guidelines for empanelled hospitals to apply for the quality certificate in three categories- Gold, Silver and Bronze.

Govt working on policy to allow OTC drugs sale on retail outlets
Mint - Leroy Leo

The government’s top advisory board for pharmaceutical policy will soon consider allowing sale of certain over-the-counter (OTC) medicines at retail outlets, a senior government official said. Last month, the Drug Consultative Committee (DCC) recommended that the government should define OTC drugs in the Drugs and Cosmetics Rules, as well as make regulations on their distribution, sale and advertisements. “The Sub-Committee (of DCC) is of the opinion that there is an urgent need for defining the over-the-counter (OTC) drugs and to lay down specific provisions for the regulation of OTC drugs in the country," as per the minutes of the meeting. The consultative panel had also suggested that the government create two lists of over-the-counter drugs, based on evidence of their safety, availability, non-habit forming nature, among other factors. Now, the proposal will move to the Drug Technical Advisory Board (DTAB), the government’s highest advisory board on pharmaceutical matters, and following its approval, the Ministry of Health and Family Welfare will take a final call, the official said. “After the DCC’s approval for the OTC policy, it now goes to DTAB. So there will be a panel looking at it. It’s all work in progress right now," the official said, on condition of anonymity.

Medical devices are not drugs, they need a separate legislation
LiveMint - Rajiv Nath

A comprehensive regulatory framework is nearly in sight 30 years after the first medical device was regulated as a drug but the big question being asked is, why not under a separate law? India currently imports 80-90% of medical devices of the $15 billion market, the vast majority of which are unregulated for quality and safety. The ministry of health and family welfare is surprisingly unsure about ushering in a ‘Patient Safety Medical Devices Law’ to protect patients, even after the recent publication of implant files by the International Consortium of Investigative Journalists or the Johnson & Johnson (J&J) incident, or the recent ban on pelvic mesh by the US Food and Drug Administration. Industry watchers are anxiously awaiting the details of a draft biomedical devices bill that the Niti Aayog is reportedly working on to address the regulatory vacuum and the national concerns. The four draft notifications issued by the health ministry on 18 October has notified all medical devices as ‘medicines’ under the Drugs Act from December 2019 but the roadmap being defined in the cover note by the under secretary does not entail migrating these to a separate ‘Medical Devices Act’ in due course. This is causing huge confusion and apprehension among domestic manufacturers. At present only 24 out of over 6,000 devices are regulated. We need to understand that devices are not drugs.

Industry wary as govt charts plan to regulate all medical devices
LiveMint - Neetu Chandra Sharma

As the government continues to chart plans to regulate the production, sale and import of all medical devices, clouds of confusion hover over the need for regulation, on whether to enact separate laws and the possible impact on the medical device industry. The ministry of health and family welfare recently proposed to notify or include all medical devices under the Drugs and Cosmetics Act, 1940, to regulate them as per the provisions of that Act and the Medical Devices Rules, 2017. According to the draft notification, devices intended for use on human beings or animals should be treated as drugs with effect from 1 December 2019. “We have proposed to include all devices, including an instrument, apparatus, appliance, implant, material or other article; whether used alone or in combination, including software or an accessory," said a senior official at the Central Drugs Standard Control Organisation (CDSCO) under the ministry of health and family welfare. The government notification pointed out that any device that has a purpose of “diagnosis, prevention, monitoring, treatment or alleviation of any disease or disorder; diagnosis, monitoring, treatment, alleviation or assistance for, any injury or disability; investigation, replacement or modification or support of the anatomy or of a physiological process; supporting or sustaining life; disinfection of medical devices; and control of conception" will be regulated.

Health Minister urges stakeholders to timely implement NDHB
BioSpectrum India

Urging the stakeholders to work towards implementing the National Digital Health Blueprint (NDHB) in a time bound manner, Union Minister of Health and Family Welfare Dr. Harsh Vardhan said that “Government of India is committed to ensuring high quality healthcare, accessible to all upto the last mile. The digital health interventions are accelerating this transformation and have a huge potential for supporting Universal Health care.” J. Satyanarayana, Former Chairman, UIDAI and Chairman of the National Digital Health Blueprint (NDHB) Committee has submitted the final NDHB report to Dr. Harsh Vardhan. J. Satyanarayana provided a brief overview of the efforts that have gone into preparation of NDHB report and made a brief presentation on the overall framework as proposed in NDHB. He said that the priorities of Government of India in health care were included in the National Health Policy 2017 and this recommendation report by Ministry of Health and Family Welfare has shown the implementation angle for achieving the same. He further added that this may be considered as the biggest leap of GoI towards achieving the goal of Universal Healthcare Coverage (UHC) with impetus on Digital Healthcare component. Dr. Harsh Vardhan said that “The need of the hour is to create an ecosystem which can integrate the existing disparate health information systems and show clear path for upcoming programmes. There is a need to ensure convergence across these IT systems to monitor and provide health services in a robust and efficient manner. Ministry of Health and Family Welfare has initiated efforts in the direction of a comprehensive, nationwide integrated e-Health system under National Digital Health Blueprint.”