People with Darier’s disease can go into depression

Health Care, Heart Care Foundation of India, Medicine Comments Off

It is a rare disorder, inherited in an autosomal dominant pattern
New Delhi, 04 December 2017: Recently, a case of Darier’s disease was reported from a city in North India. So far, about 15 cases have occurred in India, with this being the first in Uttar Pradesh. The disease is so rare that it affects only one out of one lakh people. Although the disease does not kill, it can be potentially debilitating for the person in question and put them on lifelong precautionary treatment.
Darier disease is a skin condition characterized by wart-like blemishes on the body. The blemishes are usually yellowish in color, hard to the touch, mildly greasy, and can emit a strong odor. The most common sites for blemishes are the scalp, forehead, upper arms, chest, back, knees, elbows, and behind the ear. The mucous membranes can also be affected, with blemishes on the roof of the mouth (palate), tongue, inside of the cheek, gums, and throat.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “The wart-like blemishes in this disease usually appear in late childhood to early adulthood. Without precautionary measures, it can become more severe over time with the affected people experiencing flare-ups alternating with periods when they have fewer blemishes. The appearance of the blemishes is influenced by environmental factors such as heat and humidity; UV light; minor injury or friction; and ingestion of certain medications. At times, people with Darier disease may have neurological disorders; and issues with learning and behavior as well. This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.”
Itching is very common in those with this condition.  The affected skin may smell unpleasant, particularly in moist areas. This is probably caused by increased numbers of ordinary skin bacteria growing in the affected skin.
Adding further, Dr Aggarwal, said, “The diagnosis of Darier’s disease can often be made on the appearance of the rash and the fact that it runs in families.  To confirm it, a small sample of skin (a biopsy) can be removed under a local anesthetic and examined under the microscope in the laboratory. Genetic testing to identify a mutation in the ATP2A2 gene can be used to confirm the diagnosis as well.”
Some precautions to be taken for those with this disease include the following.
•    Avoid stress, excessive humidity, heat and tight clothes and use moisturizers, sun block and wear the right type of clothes which absorb sweat and keep the body cool.
•    For localized lesions, dermabrasion can be done. Topical retinoids are also prescribed and are beneficial.
•    If the patient has secondary bacterial infection, then antibiotics are prescribed. Antiviral medications are prescribed if the patient has herpes simplex.
•    For severe symptoms, oral retinoids  can be prescribed, but these medications have serious side effects and need to be used with caution. Topical or oral antibiotics can be prescribed during flare ups.
•    Using sunscreen and taking vitamin C tablets helps in preventing flare ups in some patients.
•    Patients should also maintain good hygiene to prevent flare ups.

Straight from the Heart: IMA-HBI Initiative

Health Care Comments Off

Thank you to Team HBI led by Dr RV Asokan for the wonderful work being done and for winning the Best Wing Award for the year 2017.

Here are some of my views about IMA HBI to be implemented by 28th December and put in the HBI agenda book.

Thanks for initiating over 768 pre entry level NABH accreditation certification process launching a HBI portal bringing out 12 HBI e Connect newsletters and a practical guide on hospital start ups conducting GST and insurance summits digital Team HBI and aiming for 10 000 affiliated memberships.

Hospital Board of India may consider re naming itself as IMA Clinical Establishment Board of India. This will give it a better branding and broader scope in working.

As per the last CWC resolution all state IMA branches having nursing home wings have already become part of HBI and the same should be implemented as early as possible HBI adopted medical emblem. NABH will not be able to cope up with numbers required by IRDA regarding pre accreditation entry level certification of clinical establishments. Today NABH requires a 3 month period of self certification prior to application.

This period may be certified by IMA. IMA certified clinical establishments means they are ready for entry level NABH certification. IRDA is being approached so that IMA certified establishments may be recognized by them for insurance purposes.

Medical tourism ministry has allowed IMA to run Mumbai airport facilitation centre. The same is to be coordinated by IMA HBI.

IMA HBI should tie up with IMA Insurance web page and IMA SBI card policy

Why NABH IMA white paper should be promoted to all?

IMA HBI should adopt IMA Aao Gaon Chale wing

HBI issues

  • Can technicians sign lab reports?
  • CEA Karnataka issue to be put in full page advt in one of the national dailies.
  • IMA HBI costing department to come out with its recommendation part 1 by the 2nd week of December . The aim of IMAHBI costing department should also be how to reduce the cost. The IMA sanctioned budget of six lakh to be used by IMA HBI for this purpose.
  • IMAHBI to implement one price one drug one company policy
  • IMAHBI Transgender Policy to have toilets for disable people to be used as toilets for transgenders

IMAHBI to come out with minimal requirement for ICU facility in small health care establishments in view of the Supreme Court judgment.

Small health care organizations should be promoted as they are the only cost effective setups. HBI to have a separate agenda book this year in central council.

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