Nail Hygiene

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Nails can harbor dirt and germs and contribute to the spread of many infections.
Keep nails short.
Trim nails often.
Scrub the underside of nails with soap or water each time you wash your hands.
Clean any nail grooming tools before use.
Nail grooming tools should be sterilized before use in saloon.
Avoid biting nails.
Avoid chewing nails.
Avoid cutting cuticles as they act as barriers to prevent infection.
Never rip or bite a hang nail, instead clip it with a clear sterilized nail trimmer (a hang nail is small torn piece of skin next to finger nail or toe nail).
Infections of the finger nails or toe nails are often characterized by swelling of the skin or thickening of the nail. In some cases these infections may be serious and need to be treated by a doctor.

Financial health advice is also our responsibility while dealing with patients.

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Dear Colleague,

Financial health advice is also our responsibility while dealing with patients.

We must explain to our patients

To get insurance done
To wrote a will
About reverse mortgage policies
About railway concessions
about income tax benefits for patients etc

From time to time we will sensitize our members in these issues. The first in the series is on deduction under 80DDB.
Kindly circulate these in your correspondence, bulletins, website etc.

Dr A M Pillai and Dr K K Aggarwal

(Deduction in respect of medical treatment, etc.
80DDB. Where an assessee who is resident in India has, during the previous year, actually paid any amount for the medical treatment of such disease or ailment as may be specified in the rules made in this behalf by the Board—

For himself or a dependant, in case the assessee is an individual; or
For any member of a Hindu undivided family, in case the assessee is a Hindu undivided family, the assesses shall be allowed a deduction of the amount actually paid or a sum of forty thousand rupees, whichever is less, in respect of that previous year in which such amount was actually paid:

Provided that no such deduction shall be allowed unless the assessee furnishes with the return of income, a certificate in such form, as may be prescribed, from a neurologist, an oncologist, a urologist, a hematologist, an immunologist or such other specialist, as may be prescribed, working in a Government hospital:
Provided further that the deduction under this section shall be reduced by the amount received, if any, under an insurance from an insurer, or reimbursed by an employer, for the medical treatment of the person referred to in clause (a) or clause (b):
Provided also that where the amount actually paid is in respect of the assessee or his dependant or any member of a Hindu undivided family of the assessee and who is a senior citizen, the provisions of this section shall have effect as if for the words “forty thousand rupees”, the words “sixty thousand rupees” had been substituted.
Explanation.—For the purposes of this section,—

“Dependant” means—
in the case of an individual, the spouse, children, parents, brothers and sisters of the individual or any of them,
in the case of a Hindu undivided family, a member of the Hindu undivided family, dependant wholly or mainly on such individual or Hindu undivided family for his support and maintenance;
“Government hospital” includes a departmental dispensary whether full-time or part-time established and run by a Department of the Government for the medical attendance and treatment of a class or classes of Government servants and members of their families, a hospital maintained by a local authority and any other hospital with which arrangements have been made by the Government for the treatment of Government servants;
“Insurer” shall have the meaning assigned to it in clause (9) of section 2 of the Insurance Act, 1938 (4 of 1938);
“Senior citizen” means an individual resident in India who is of the age of (sixty years) or more at any time during the relevant previous year.)

(Specified diseases and ailments for the purpose of deduction under section 80DDB.
11DD. (1) For the purposes of section 80DDB, the following shall be the eligible diseases or ailments:

Neurological Diseases where the disability level has been certified to be of 40% and above,—
Dystonia Musculorum Deformans;
Motor Neuron Disease;
Parkinson’s Disease
Malignant Cancers
Full Blown Acquired Immuno-Deficiency Syndrome (AIDS)
Chronic Renal failure
Hematological disorders

(2) The certificate in respect of the diseases or ailments specified in sub-rule (1) shall be issued by the following specialists working in a Government hospital—

for diseases or ailments mentioned in clause (i) of sub-rule (1) – a Neurologist having a Doctorate of Medicine (D.M.) degree in Neurology or any equivalent degree, which is recognized by the Medical Council of India;
for diseases or ailments mentioned in clause (ii) of sub-rule (1) – an Oncologist having a Doctorate of Medicine (D.M.) degree in Oncology or any equivalent degree which is recognized by the Medical Council of India;
for diseases or ailments mentioned in clause (iv) of sub-rule (1) – a Nephrologist having a Doctorate of Medicine (D.M.) degree in Nephrology or a Urologist having a Master of Chirurgiae (M.Ch.) degree in Urology or any equivalent degree, which is recognized by the Medical Council of India;
for diseases or ailments mentioned in clause (v) of sub-rule (1) – a specialist having a Doctorate of Medicine (D.M.) degree in Hematology or any equivalent degree, which is recognized by the Medical Council of India:

Provided that where in respect of any diseases or ailments specified in sub-rule (1), no specialist has been specified or where the specialist specified is not posted in the Government hospital in which the patient is receiving the treatment, such certificate, with prior approval of the Head of that hospital, may be issued by any other specialist working full-time in that hospital and having a post-graduate degree in General or Internal Medicine, which is recognized by the Medical Council of India.
(3) The certificate from the prescribed authority to be furnished along with the return of income shall be in Form No. 10-I.)

Medical certificate format:

(See rule 11DD)
Certificate of prescribed authority for the purposes of section 80DDB

Name of the Patient
Father’s name
Name and address of the person on whom the patient is dependent and his relationship with the patient.
Name of the disease or ailment (please see rule 11DD)
For diseases or ailments mentioned in item (i) of clause (a) of sub-rule (1), whether the disability is 40% or more (Please specify the extent).
Name, address, registration number and qualification of the specialist issuing the certificate, along with the name and address of the Government hospital (see rule11DD(2))


This is to verify that I, Dr.___________________________________ s/o (w/o) Shri_____________________, in the case of the patient Shri/Smt./Ms._____________________________, after considering the entire history of illness, careful examination and appropriate investigations, am of the opinion that the patient is suffering from________________________disease/ailment during the previous year ending on 31st March,____________________________

I also certify (only in case of neurological disease) that the extent of disability is more than 40%) (Strike off, if not applicable).
I certify that the information furnished above is true to the best of my knowledge.

Date ______________ Signature
Place ______________ (Name and Address)

To be countersigned by the Head of the Government hospital, where the prescribed authority is a specialist with post-graduate degree in General or Internal Medicine.

Date ______________ Signature
Place ______________ (Name and Address)

27th February: Rare Disease Day

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Dear Colleague

Observe 27th February as Rare Disease day and create awareness about the subject.

Some background material is enclosed.
Dr A M Pillai and   DR K K Aggarwal
27th February: Rare Disease Day

Rare Diseases day Is observed on 27th February to raise awareness for rare diseases and improve access to treatment and medical representation for individuals with rare diseases and their families.

It was established in 2008 because, according to the European Organization for Rare Diseases (EURORDIS), treatment for many rare diseases is insufficient, as are the social networks to support individuals with rare diseases and their families.

In 2009 Rare Disease Day went global as NORD (National Organization for Rare Disorders) mobilized 200 rare disease patient advocacy organizations.

Some Court Judgments

    • “….on account of lack of Government planning, there is ‘pricing out’ of orphan drugs for rare and chronic diseases, like Gaucher. The enzyme replacement therapy is so expensive that there is a breach of constitutional obligation of the Government to provide medical aid on fair, reasonable, equitable and affordable basis. By their inaction, the Central and the State Governments have violated Articles 14 and 21 of the Constitution.
    • “… Just because someone is poor, the State cannot allow him to die. In fact, Government is bound to ensure that poor and vulnerable sections of society have access to treatment for rare and chronic diseases……..”
    • “………….After all, health is not a luxury and should not be the sole possession of a privileged few.”
  2. IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO.2867 OF 2012 “Finally, we hope and believe that the institutions and individuals providing medical services to the public at large educate and update themselves about any new medical discipline and rare diseases so as to avoid tragedies such as the instant case where a valuable life could have been saved with a little more awareness and wisdom from the part of the doctors and the Hospital. “
  3. Delhi High Court “New Delhi: In a significant development for the right to health in India, Justice Manmohan of the Delhi High Court took serious note of the limited availability of affordable treatment for persons with neglected diseases like Haemophillia and ensured that the State Government provide treatment free of cost, as part of its obligation under Article 21 of the Constitution of India.”

IMA stand

IMA has asked the government to fix budget for the care of rare diseases.
Rare Diseases (Some may not be rare in India) Acrocephalosyndactylia, Acrodermatitis, Addison Disease, Adie Syndrome, Alagille Syndrome, Amylose, Amyotrophic Lateral Sclerosis, Angelman Syndrome, Angiolymphoid Hyperplasia with Eosinophilia, Arnold-Chiari Malformation, Arthritis, Juvenile Rheumatoid, Asperger Syndrome, Bardet-Biedl Syndrome, Barrett Esophagus, Beckwith-Wiedemann Syndrome, Behcet Syndrome, Bloom Syndrome, Bowen’s Disease, Brachial Plexus Neuropathies, Brown-Sequard Syndrome, Budd-Chiari Syndrome, Burkitt Lymphoma, Carcinoma 256, Walker, Caroli Disease, Charcot-Marie-Tooth Disease, Chediak-Higashi Syndrome, Chiari-Frommel Syndrome, Chondrodysplasia Punctata, Colonic Pseudo-Obstruction, Colorectal Neoplasms, Hereditary Nonpolyposis, Craniofacial Dysostosis, Creutzfeldt-Jakob Syndrome, Crohn Disease, Cushing Syndrome, Cystic Fibrosis, Dandy-Walker Syndrome, De Lange Syndrome, Dementia, Vascular Dermatitis Herpetiformis, DiGeorge Syndrome, Diffuse Cerebral Sclerosis of Schilder, Duane Retraction Syndrome, Dupuytren Contracture, Ebstein Anomaly, Eisenmenger Complex, Ellis-Van Creveld Syndrome, Encephalitis, Enchondromatosis, Epidermal Necrolysis, Toxic, Facial Hemiatrophy, Factor XII Deficiency, Fanconi Anemia, Felty’s Syndrome Fibrous Dysplasia, Polyostotic, Fox-Fordyce Disease, Friedreich Ataxia, Fusobacterium, Gardner Syndrome, Gaucher Disease, Gerstmann Syndrome Giant Lymph Node Hyperplasia, Glycogen Storage Disease Type I, Glycogen Storage Disease Type II,Glycogen Storage Disease Type IV, Glycogen Storage Disease Type V, Glycogen Storage Disease Type VII, Goldenhar Syndrome Guillain-Barre Syndrome, Hallermann’s Syndrome, Hamartoma Syndrome, Multiple Hartnup Disease, Hepatolenticular Degeneration, Hepatolenticular Degeneration, Hereditary Sensory and Motor Neuropathy, Hirschsprung Disease, Histiocytic Necrotizing Lymphadenitis, Histiocytosis, Langerhans-Cell, Hodgkin Disease, Horner Syndrome, Huntington Disease, Hyperaldosteronism, Hyperostosis, Diffuse Idiopathic Skeletal, Hypopituitarism, Inappropriate ADH Syndrome, Intestinal Polyps, Isaacs Syndrome, Kartagener Syndrome, Kearns-Sayre Syndrome, Klippel-Feil Syndrome, Klippel-Trenaunay-Weber Syndrome, Kluver-Bucy Syndrome, Korsakoff Syndrome, Lafora Disease, Lambert-Eaton Myasthenic Syndrome, Landau-Kleffner Syndrome, Langer-Giedion Syndrome, Leigh Disease, Lesch-Nyhan Syndrome, Leukodystrophy, Globoid Cell, Li-Fraumeni Syndrome, Long QT Syndrome, Machado-Joseph Disease, Mallory-Weiss Syndrome, Marek Disease, Marfan Syndrome, Meckel Diverticulum, Meige Syndrome, Melkersson-Rosenthal Syndrome, Meniere Disease, Mikulicz’ Disease, Miller Fisher Syndrome, Mobius Syndrome, Moyamoya Disease, Mucocutaneous Lymph Node Syndrome, Mucopolysaccharidosis I,Mucopolysaccharidosis II, Mucopolysaccharidosis III, Mucopolysaccharidosis IV, Mucopolysaccharidosis VI, Multiple Endocrine Neoplasia Type 1, Munchausen Syndrome by Proxy, Muscular Atrophy, Spinal, Neuroaxonal Dystrophies, Neuromyelitis Optica, Neuronal Ceroid-Lipofuscinoses, Niemann-Pick Diseases, Noonan Syndrome, Optic Atrophies, Hereditary, Osteitis Deformans, Osteochondritis, Osteochondrodysplasias, Osteolysis, Essential Paget Disease, Extramammary Paget’s Disease, Mammary Panniculitis, Nodular Nonsuppurative Papillon-Lefevre Disease, Paralysis, Pelizaeus-Merzbacher Disease, Pemphigus, Benign Familial, Penile Induration, Pericarditis, Constrictive, Peroxisomal Disorders, Peutz-Jeghers Syndrome, Pick Disease of the Brain, Pierre Robin Syndrome, Pigmentation Disorders, Pityriasis Lichenoides Polycystic Ovary Syndrome, Polyendocrinopathies, Autoimmune, Prader-Willi Syndrome, Pupil Disorders, Rett Syndrome, Reye Syndrome, Rubinstein-Taybi Syndrome, Sandhoff Disease, Sarcoma, Ewing’s,Schnitzler Syndrome,Sjogren’s Syndrome, Sjogren-Larsson Syndrome, Smith-Lemli-Opitz Syndrome,Spinal Muscular Atrophies of Childhood, Sturge-Weber Syndrome, Sweating, Gustatory Takayasu Arteritis, Tangier Disease, Tay-Sachs Disease, Thromboangiitis Obliterans Thyroiditis, Autoimmune Tietze’s Syndrome, Togaviridae Infections,Tolosa-Hunt Syndrome, Tourette Syndrome, Uveomeningoencephalitic Syndrome, Waardenburg’s Syndrome, Wegener Granulomatosis, Weil Disease, Werner Syndrome, Williams Syndrome, Wilms Tumor, Wolff-Parkinson-White Syndrome, Wolfram Syndrome, Wolman Disease, Zellweger Syndrome, Zollinger-Ellison Syndrome, von Willebrand Diseases

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