Health

Health minister A Ramadoss told the Rajya Sabha during question hour that the 50-year-old institute's infrastructure was facing tremendous pressure as on an average 8,000 to 9,000 patients visited the institute every day from all over the country for treatment. He said the new campus would help lessen the load on main AIIMS campus.

Asked about the recent death of children in clinical trials at AIIMS, he said an inquiry into the incident has revealed that the deaths were not due to negligence by doctors.

The children were in a critical stage and even if the drugs were not given, there was very slim chance of their survival, he said adding the clinical trials followed the stringent laid down procedure that included taking the consent of parents or relatives before administering the drugs.

In reply to another question about medical facilities in the north-eastern states, the minister said the government is in the process of upgrading several medical institutions in the area to ensure that people from the region do not have to go to other parts of the country for treatment.

Known plastic surgeon Anup Dhir has launched a 24-hour helpline to provide ready and quick tips on how to treat burn injuries during the festival of lights.

The helpline will be functional from Oct 23. Diwali is on Oct 28.

Dhir, who is a senior consultant cosmetic surgeon in the Indraprastha Apollo Hospital and has been running the helpline since 1998, said people have no clue of how to tend to cracker burns.

'A small tip can help ease the person's pain. I am not treating but advising them what should be done and what should be avoided if one gets burns,' he added.

For assistance, call 09312377554, he said. It will be functional till Oct 30 and the doctor will pick up the phone himself.

'The most important thing regarding burn injuries is that 95 percent of them are accidental and can be prevented with care and precautions. People try their own home remedies which wouldn't help. One needs professional help,' Dhir told IANS.

The doctor said he started the concept 10 years ago after he saw in the hospital that maximum number of patients after Diwali were those who had burnt themselves while bursting crackers.

'People don't know how and in which situation to pour water. I will simply guide them and then they could go to their nearest hospital. People panic and act foolishly, which worsens the situation. Some people even apply toothpaste. It is not the solution,' he said.

He said he gets dozens of phone calls before and after Diwali and these peak on Diwali.

Dhir said statistics show that 38 percent of injuries involve hands and fingers and 19 percent eyes.

About half of the injuries are burns, especially in the face, hand, wrist or arm, he said. 'Contusions and lacerations are the next most common kind of injuries.'

Forty percent of those who suffered such injuries are children below the age of 14, and it is mostly boys in the age group of 10 to 14, the expert said.

'Diwali is the festival of lights and happiness and that is what it should be. Playing with firecrackers, especially the big ones, should be avoided,' he advised.

He suggested that firecrackers should be lit in an open area and a bucket of water should always be kept nearby.

'The best is to say no to firecrackers. This would surely mean a happy and safe Diwali,' Dhir said.

Agents at rural IT kiosks run diagnostic units, data from which can be viewed by doctors elsewhere

Like most doctors, Radha Srinivasan's day starts early, which is hardly surprising, given the steady stream of patients waiting to meet her. Unlike other doctors though, Radha begins her workday by logging on to Yahoo Messenger. No, she isn't a chat addict; it's just part of her job, which also involves treating patients who live in remote locations. By logging on to the messenger service, Radha is merely indicating to the person manning the rural information technology kiosk miles away that she is ready to diagnose her first patient.

On the day we met her, it was 41-year-old Vijaya C, who had logged on from Iraniyur, some 15 km from Tirupattur (near Madurai). Because Vijaya's medical parameters are already fed into the system, it takes only a few minutes for the doctor to pronounce her diagnosis--viral infection. Quickly, Radha moves on to her next patient, while we are left wondering about the technology that helps her in this endeavour. It is tele-medicine alright, but with a difference. It's affordable and has an in-built diagnostic solution. And, the company that has pioneered this innovation is a little-known boutique firm based out of Bangalore, Neurosynaptic Communications.

Neurosynaptic's journey began in 2002 when founders Sameer Sawarkar (currently its CEO) and Rajeev Kumar (Director) quit their salaried jobs, and decided to turn entrepreneurs. Sawarkar and Kumar were communication and signal processing engineers with a passion--to explore opportunities involving the central nervous system (brain waves, in particular) and combine that with electronics.

"We knew that next-generation solutions would be inter-disciplinary in nature--the era of one domain or one technology is passe," Sawarkar says. "The future is all about different domains and the technologies available in those domains coming together to create new solutions. We wanted to be a part of this movement." Soon, the duo got in touch with Professor Vijay Raghavan of the National Centre for Biological Sciences. He, in turn, referred them to Ashok Jhunjhunwala and his TeNet Group at IIT Madras, which was working towards transforming rural areas through the use of technology.

It was during their numerous visits to the TeNet centres that the duo decided to shift track and focus on the huge untapped opportunity in rural healthcare delivery.

They wondered if tele-medicine could bridge the gap between what was needed and what was available. Was it possible to bring patients and doctors together on a single platform even if they were physically apart? Some work was going on in this field in a few rural IT kiosks--like basic video-conferencing and remote imaging for cataract patients--but it was inadequate in terms of helping a doctor get relevant information to make a proper diagnosis.

For instance, the doctor had no way of checking a patient's blood pressure, pulse rate or temperature--such things could not be done remotely. That was what prompted Sawarkar and Kumar to develop the idea of building a diagnostic capability. They also realised that there was a need to build a full-fledged solution that would allow connectivity with a doctor if required.

After speaking to a cross-section of doctors, they identified a basic set of parameters that could be built into an easy-to-use diagnostic unit. These included body temperature, blood pressure, heart sound, height and weight measurement, electro cardiogram and some basic imaging. The idea was to capture this data, both for current use as well as for subsequent visits to the doctor. Agents at rural IT kiosks would be trained to operate the unit and store the data, which could then be viewed by the doctor remotely.

The institute has proposed to open a campus 'AIIMS II' either in Noida or in any other place in Haryana adjoining the capital, including Gurgaon.

A proposal has been approved by the governing body of the institution headed by Union Health Minister Anbumani Ramadoss.

"We are facing a constraint of infrastructure for our new expansions as our existing 166 acre campus cannot provide enough space for increasing demands of the institution," Shailesh Yadav, Deputy Director (Administration) said.

In its proposal sent to the government, the AIIMS has demanded 300 acres of land either in Noida or  NCR in Haryana, keeping in view easy accessibility from the main campus, Yadav said.

Over 400 people have died of viral fever, malaria, diarrhoea, encephalitis, gastro-enteritis and measles. With runoff of water receding following a lull in rainfall, a fresh outbreak of water and vector-borne diseases has not been ruled out.

According to health officials, there is a likelihood of a 25 per cent increase in the cases of viral fever and malaria, as also the dreaded encephalitis.

"As the run off of rain and flood waters would be reduced to a considerable extent, the density of mosquitoes and viruses would increase in the stagnant water," said R.R. Bharti, Director of Vector-Borne Diseases in the State Medical and Health Directorate here.

This year, the maximum casualties are caused by diarrhoea and encephalitis, with diarrhoea accounting for 120 deaths and encephalitis 185. The 10,391 diarrhoea cases and deaths in 2008 (figures updated till September 2, 2008) have outstripped the 10,287 cases reported in 2007 and the 55 deaths caused by the disease.

The Director-General, Medical and Health Services, Uttar Pradesh, I.S. Srivastava said 115 fresh cases of diarrhoea were reported on Tuesday, with no casualties. Of the 24 new cases of Acute Encephalitis Syndrome (AES), four victims died, Dr. Srivastava said.

"The dengue testing kit will be provided by the Union Ministry of Health and Family Welfare and the selected hospital will be have to bear processing cost and provide human resource," said Dr BK Singh, Additional Chief Medical Officer (ACMO) of Noida.

A three member team under the leadership of Dr Kalpana Barua, Dy Director (Vector Borne Diseases) surveyed major private hospitals of the city - Fortis Hospital, Kailash Hospital, Max Hospital, Vinayak Hospital, Metro Hospital and Bhardwaj Hospital but Fortis Hospital at Sector-62 is likely to win the race.

The hospital has already submitted its consent to the terms and conditions of the project. This unit in Fortis Hospital would be developed as Centinal Lab for dengue confirmation test in this region and the tests would be free of cost.

"Presently, we have to send blood samples of suspected patients of dengue to National Institution of Communicable Diseases (NICD), New Delhi for confirmation test. Generally it takes three to four days to get the report but after establishment of this lab in Noida the patients will get the report on the same day," added Singh.

This lab would provide free testing facility for dengue to referred cases of district Government hospital of Noida and also will act as a reference lab for private hospitals on nominal charges that would be decided soon.

District Chief Medical Officer M.P.S. Verma confirmed this. "Diarrhoea and gastroenteritis cases have shot up. At the outpatient department of three community health centres and 18 primary health centers in Gautam Buddha Nagar district daily about 600 diarrhoea and gastro cases are being reported. At Noida district hospital, about 200 such cases are being reported daily," said Verma.

The 167 nursing homes in the district are getting five cases of diarrhoea. The nursing homes report about 800 cases each day, said Verma.

Verma said another 200 cases are being reported from big hospitals every day .

"Majority of the cases are of mild diarrhoea or gastro. They do not need hospitalisation. In only 10 per cent cases, hospitalisation was needed," said Verma.

Verma said the district health authorities have been directed to take random samples from water supply reservoirs and get them tested. Authorities have also been directed to use chlorine at water sources and clean water supply tanks.

Noida residents said the outbreak was not surprising given the fact that the area continued to get dirty and foul-smelling water.

Federation of Noida Residents Welfare Association president N.P Singh said: "Residents .

from various sectors have complained of foul smelling tap water supply for the first 15 to 20 minutes. Several residents have complained of sand and dust particles in the tap water supply .

Some even complained of small insects." Noida Authority's Chief Maintenance Engineer (water) Yadav Singh said: "Underground water reservoirs were cleaned wherever we received individual complaints. These are cleaned periodically even if there is no complaint. Water samples from reservoirs are regularly tested for E-Coli and other parameters."

The UP supremo's directions are to establish two state of the art multi-specialty Dr. Ambedkar Hospitals at Noida and Greater Noida. As per sources, an expenditure of Rs.150 crore will be made for establishing the multi-specialty Dr. Ambedkar Hospital at Greater Noida. On the other hand, an amount of Rs.378 crore has been invested into turning the Noida 100-bed hospital into a 300-bed multi-specialty hospital. The renovation work is being carried out by the NA to whom its management was handed over in February this year. The hospital is coming up in two wings. The first wing, with facilities for 100-beds would be thrown open to public by March 2009. This one will come up in the place of the existing hospital.

Also, any experience or reviews about Noida Apollo's delivery and maternity facilities, would also be very helpful.

"The management plans to attract foreign travellers coming here for medical purposes as the promoters are both into hotels and hospitals," informs Mohinder Pal, General Manager, Rockland. He also informed that the group was expanding in a big way and would be coming up with more hospitals and hotels. "Three more hospitals will be opened at Manesar, Dwarka and Greater Noida by 2010. The plan for a five-star hotel at Sohna -Gurgaon is still under process and we are awaiting a decision for our request for change in land use from the concerned authorities," adds Pal.

Rockland Hotels offer all the modern facilities for their guests, including a valet for 24 hours, buffet breakfast, 24-hour room service, fax and internet facilities, besides well-furnished and spacious rooms.

The Richmond Fellowship is working in the field of mental health care for nearly five decades. It was founded in 1959 in Richmond, U.K. by Elly Jansen. The activities of Richmond Fellowship subsequently spread to 30 countries.

The facility was inaugurated by famous economist Dr. Kaushik Basu, C. Marks Professor of International Studies and Professor of Economics and Director, Centre for Analytic Economics, Cornell University, USA. He is a Padma Bhushan awardee and has written many books on economics.
Speaking on the occasion, he narrated about his meeting with John Nash, a mathematical genius who suffered from schizophrenia at the age of 30 and spent the next three decades in and out of mental hospitals.

In 1994, Nash showed signs of emerging from his illness and was awarded a Nobel Prize in economics for his dissertation, 'Non-Cooperative Games' written in 1950, when he was 21. Nash was also the subject of the Hollywood movie 'A Beautiful Mind'. Dr. Kaushik praised The Richmond Fellowship for working for the cause of rehabilitation of people suffering from schizophrenia.
The function also had two eminent persons as guests of honour - V.P. Agrawal, member (planning), Airports Authority of India and Muzzafar Ali, noted film maker, fashion designer and social worker.
Besides running Halfway Home, Long Stay Homes and Day Care Centres, Richmond Fellowship is actively involved in rural areas for taking mental health help to the door-step of poor people who have meagre resources.

According to Health Committee estimates of the ASSOCHAM, most of the migrant workers, engaged in Noida's construction, real estate and large infrastructure projects earn their livelihood in aforesaid places and are dependent on AIDS detection facilities provided in Delhi and Meerut since, neither Noida, Gurgaon, Faridabad and Ghaziabad has a single AIDS detection centers which in medical terminology is called Anti Retroviral Therapy (ART) Centers.
The proposal which would be shortly submitted to Union Health Ministry and National AIDS Control Organization (NACO) by the President of ASSOCHAM, Sajjan Jindal and its secretary general, D. S Rawat, however, also reveals that Noida which is well connected from Delhi have been facing unregulated movements of migrant workers, street children and women from various parts of the country, particularly Eastern UP, Bihar, Orissa, North-East, Jharkhand, Chattisgarh and even Nepal, majority of whom are suspected to be suffering from AIDS.

According to Chamber estimates, approx. 4 lakhs laborers are believed to be settled in Noida's scattered slums, approximately 30-40 per cent of them are suspected to be quietly enduring syndromes of dreaded diseases like AIDS as they cannot easily access AIDS detection centers in Delhi and Meerut as their capacities are over utilized, said Rawat. Rawat said that Noida has over 15,000 industrial units most of its workforce lacked awareness campaign about AIDS, still they slog and do not get themselves examined in the absence of AIDS detection centers.

The secretary general ASSOCHAM pointed out that the chamber is taking this cause with relevant authorities as part of its corporate social responsibility and even willing to earmark a significant part of its earnings for setting up of proposed centers with whosoever comes forward for this noble cause.

To spread awareness in Delhi and NCR's rural areas, ASSOCHAM stressed the need to work closely with districts, panchayati Raj, nagarpalikas and schools which have wide ranging network to access the rural poor to make a difference to the epidemic situation in India as well as improve the quality of life of those living with HIV.

The campaign aims to bring down chronic ailments like heart disease, diabetes, cancers and stroke, which caused 53% of deaths in India in 2005.

Set up by the health ministry and the Public Health Fotmdation of India, the sites - www.healthy-india.org and www.foodpyramidindia.org - possib1y give the best nutritional advice based on the traditional lndian diet.

"Cancers apart, major risk factors for other diseases are high blood pressure, high cholesterol, not eating enough fresh fruits and vegetables, obesity and tobacco use. Five of these risk factors are caused by unhealthy diets and being physically inactive, which we hope to change through the campaign," says Health Minister An- bumani Ramadoss. "A third of all cancers, too, can be prevented by eating healthy and staying active."

Diet advice apart, foodpyramidindia.org has a calorie calculator to figure out how many calories your body needs - based on your age, height and activity level. It also categorises 'physical activity' as moderate or vigorous, in addition to a daily routine like walking, climbing stairs, doing household chores or playing outdoor games.

The helpline number (9958771177), was jointly released by noted model Priyanka Sharma and eminent designer Rahul Jain.

The helpline would focus on weight reduction and heart-friendly diet.

Dr K.K Aggarwal, president, Heart Care Foundation of India, informed that experts would answer queries from 8 a.m. to 8 p.m. on all working days.

Aggarwal said that most heart diseases are self-inflicted and can be prevented by proper lifestyle management. Reducing weight by 10 per cent can reduce the risk of a heart attack substantially.

It will give consumers information on essential medicines and their prices, and also help them locate a cheaper generic version if an expensive, branded version has been prescribed. The helpline will be run by a consumer organization,VOICE,and initially funded by the government. A toll-free number, which can be accessed from anywhere in the country, is likely to be introduced soon.

Helpline will prevent overpricing of drugs
A helpline to be launched by consumer organization, VOICE, and initially funded by the government is likely to be introduced soon. The helpline will also tell you prices of scheduled drugs, which are under government control.

In another move to benefit the "aam admi", the government has decided to promote sale of non-branded generic drugs (cheaper versions of branded medicines) by setting up drug stores in each district. These stores -- to be run by non-governmental organizations and agencies like Red Cross -- will sell drugs at reduced prices. Doctors at government hospitals will be asked to prescribe generic drugs.

The dispensary has been opened in association with Ambey Vridhashram Society It started functioning last week at the sector's community centre.

It will be opened for two hours daily from 10 a.m. to 12 noon. Consultation and medicines will be provided free of cost. Dr Dipti Bhagat, Bachelor of Homeopathic Medicine and Surgery (BAMS), from Maharashtra University of Health Sciences, Nashik, will be stationed at the dispensary

FACT FILE

• The dispensary has boon opened in association with Amboy Vridhashram Society.
  
• It started functioning from last week at the community contre in the sector

"The homoeopathic system of medicine has no side effects and should be adopted in preference to allopathic," he remarked. Addressing the gathering, RWA president, A. N. Dhawan, said that the RWA had always wanted to open such a dispensary for a long time, but the job couldn't be accomplished for want of adequate accommodation.

"Once the FONRWA building, that is being constructed by the Noida Authority, is ready, this dispensary will be shifted there," said Dhawan.

Listing the benefits of alternative systems of medicine, Dhawan gave an instance in which a patient's life was saved by homoeopathic medicines even while allopathic doctors had thrown up their hands in despair.

Also present on the occasion was Bharat Vikas Parishad president, Vipin Ma1han, who assured all possible cooperation for the noble cause.

"We will arrange for providing requisite facilities for setting up dispensaries in other sectors as well wherever accommodation is available," said RWA genera1secretary B. S. Gulati. FONRWA president, N. E Singh, and secretary general, M. K. Sharma, called upon all the RWAs to provide space for such a noble cause.

The National Urban Health Mission (NUHM), to be launched in a couple of months, would cater to a population of around 22 crore in 429 cities and towns of the country, Union Health Minister Anbumani Ramadoss said.

"Out of this nearly six crore of the slum population would be insured," he said.

The premium for the insurance scheme with a coverage of around Rs 40,000-50,000 would be paid by the government to the hospitals directly.

"The beneficiaries of this scheme can approach both government and private hospitals," the minister added.

According to Ramadoss, this will help in ensuring a huge inflow of funds into the government hospitals as the Centre will pay the amount directly to the hospitals.

The beneficiaries might have to pay a premium of Rs 600 annually later.

The insurance will cover maternal benefits, Out Patient Department (OPD) facilities and other general diseases.

I recently happened to have my father as a patient in the metro multispeciality hospital,noida. And was shocked to see the waythe staff deals in patient care and management, which seemed to me as a possible threat to the other patients as well.
? As a protocol and practise, the patients room is cleaned before the patient arrives in the room.But the moment we entered it was a mess and the rest room was untidy at the highest level expected. And we had to request to get the room clean.
? My father was being monitored with the same thermometer orally which was being used for other inpatients. This occurred in gastroenterology ward, which has hepatitis and infectious patients as well. This happens to be the protocol in the leading hospitals to indent a new thermometer for each patient. Finally I bought thermometer myself.
? Same pair of gloves is being used for all patients, it is clear that the nurses are using gloves to protect themselves rather than protecting the patient.
Upon requesting above to the nurses I was told this is their normal practice they cannot change the hospital policy for any individual. And in spite of repeated requests to indent a box of gloves, the attending nurses did not acknowledge the same. There was nothing like infection control as not even hand washing before touching the patient was practiced. When we brought this fact into their notice they refuted saying that this is not under the hospitals policy guidance provided by the management. They were rude enough to confidently say that we can complain it to the treating doctor or the management or the administration. The consultant had the same attitude and passed a verdict that we cannot follow this protocol. It is absolutely all right if the hospital staff doesn't use gloves.
? The patient went into a hypoglycemic episode on 9th but there was apparently no 25% or 50% Dextrose available in the ward. And we had to run to get it from the pharmacy
? We were astonished to here that Dr Anurag Tandon completely approved the policy practiced by nurses here. He told us that you can not expect BMW services at Maruti type hospital. According to him hand washing or any other procedures are fads and showoffs and he specifically said such are useless procedures and this is the way this hospital works. Take it or leave it. He said that nurses are not supposed to take order from attendant even if it is a request for simply sterilizing hands before touching immune no compromised pt.
? when Dr. Anurag Tandon was on rounds, entered in our room with his subordinates. Asked me in harsh voice that does he need to sanitize his hand? For his respect we were silent. He asked again. When this is a question to the doctor, now I have no complains against the nurses since they are following their leader. I guess the leader needs to trained first. I am shocked with the doctor's question. He walked out from my room without cleaning his hands to see the next patient.

I am sure Padm Bhushan Dr BN Tandon work standards are not aligned with Dr. anurag tondon. We come to see Dr. BN Tandon and seek his services; instead Dr. Anurag Tandon is rendering and forcing his services to us for no reason.

We still believe that Metro is the BMW type hospital (Language of Dr. Anurag Tandon) where you have doctors like Hon. Dr BN Tandon. Dr Anurag Tandon is maligning the work standard and ethic.

At last we were told today to move out of the hospital, since patient has multi problems. Misnomer is that Metro hospital happens to be Multi specialty hospital.

For four-year-old Rahul Arya, the onset of winter is a painful time. An asthma patient, he lives in constant fear of falling prey to influenza, a common ailment during winter. Even a slight cold and fever makes his breathing difficult and he has to be on a nebuliser for days after that. An attack of influenza can make things more complicated. The only hope that he has is a shot of the flu vaccine. Sadly, his parents have not heard about it.

``Influenza is a serious threat in the country, especially among people who have a lung disease. The flu vaccine can save people from falling victim to serious complications but unfortunately, the awareness is very low,'' says Dr Sanjay Lalwani, HOD, paediatrics, Bharati Vidyapeeth University Medical College, Pune.

It's particularly tough for asthmatic children. ``At our nursery care centre, we get at least 40-50 admissions of children suffering from influenza during the flu months, which are from October to March. Things wouldn't be so bad if they had been given the vaccine,'' he adds.

The flu vaccine is the most effective prevention for high risk patients. Its given before the onset of flu months. But in a tropical country like India, where the virus circulates round the year and not necessarily during winter, it can be given any time.

Children between the ages 6 months to five years, and adults above 65 years, should ideally take the vaccine. But it's essential for those suffering from diabetes, pulmonary or cardiovascular illness, renal dysfunction and even pregnant women --i.e. all those in the highrisk group.

PAY HEED

• Heart patients should avoid exercises involving rapid breathing exercises.
  
• Wrong breathing techniques could lead to an asthma attack.
  
• Correct exercises relieves pain, but a wrong move could leave an arthritis patient in terrible pain.

According to experts, before starting any exercise or taking ayurvedic medicine, a person's physical examination and history charting is a must. "What may be good for everyone else might not suit your body type," said Sudha Malik, a yoga expert.

Sudha said one wrong move could leave the person in a lot of pain.