India has the highest number of TB patients across the world

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

Missing doses can defeat the purpose of DOTS therapy

New Delhi, 12 December 2017: According to recent reports, with 2.79 million cases, 4.23 lakh deaths, and an average of 211 new infections diagnosed per 100,000 people, India currently has the highest number of tuberculosis (TB) patients across the globe. India also has the most number of MDR-TB patients in the world as well as the largest number of ‘missing’ TB patients. There are several million who have not been identified, notified, or treated and these people remain off radar.

TB is a highly infectious disease cured by providing proper medication at the right time for the full duration of the treatment. The drug regimen is called DOTS and is provided free under the Revised National TB Control Programme (RNTCP). It is based on the principle that a regular and uninterrupted supply of high-quality anti-TB drugs must be administered to cure the disease and prevent the occurrence of the MDR-TB.

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, “TB is a major public health concern in India. Not only is it a major cause of morbidity and mortality but also poses a huge economic burden on the country. Elimination, which is defined as restricting new infections to less than one case per 100,000 people, is possible only when patients get diagnosed and cured without any break in treatment. Any interruption in treatment can exponentially raise the patient’s risk of developing MDR-TB, which is harder to treat. Missing doses defeats the very purpose of DOTS therapy, which is meant to ensure strict compliance through supervised consumption of medicines. As many as 900,000 people with TB do not have access to proper treatment, which means they risk developing drug-resistant TB and infecting others.”

Reporting is important to trace contacts of the person with infectious TB. All contacts of the patient should be screened for TB and put on treatment if required. This cascade of screening of contacts, at home and workplace, identifies individuals at risk and prevents further spread of TB, including MDR TB.

Adding further, Dr Aggarwal, said, “The approach to all notifiable diseases should be based on DTR: Diagnose, Treat, and Report. Diagnose early, using sputum Gene Xpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”

Here are some tips that can help avoid TB infection from spreading.

  • Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
  • Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
  • Do not attend work or school.
  • Avoid close contact with others.
  • Sleep in a room away from other family members.
  • Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria.

Straight from the Heart: Team IMA Initiatives with MCI

Health Care Comments Off

1. Finalized Indian Medical Services draft suggestions to the Govt. of India passed by CWC IMA and GBM of MCI.
2. As per MCI Ethic Regulations 8.6, professional incompetence shall be judged by peer group as per guidelines prescribed by the MCI. But these guidelines were never made. IMA and MCI finalized these guidelines, passed by CWC IMA and GBM of MCI.
3. In its judgment in Jacob Mathew vs State of Punjab & Anr on 5 August, 2005, the Hon’ble Supreme Court of India directed Statutory Rules or Executive Instructions incorporating certain guidelines to be framed and issued by the Government of India and/or the State Governments in consultation with the MCI regarding prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient. MOH wrote to MCI to make a task force to make recommendations involving IMA. IMA and MCI has framed these guidelines and passed by CWC IMA and GBM of MCI.
4. In Parmanand Kataria vs Union of India clarification in MCI General Body Meeting, it was submitted that Evidence Act should also be so amended as to provide that the Doctors diary maintained in regular course by him in respect of the accident cases would be accepted by the courts in evidence without insisting the doctors being present to prove the same or subject himself to cross-examination/harassment for long period of time.” MCI-IMA task force has framed these guidelines, which have been passed by CWC IMA and GBM of MCI.
5. With regard to NEET, IMA wrote to MCI to relax the norms for age and number of attempts and the same was done
6. The extended list of disabilities now has been accepted by MCI for MBS admissions and 5% of the seats are now reserved for the same
7. We wrote to MCI regarding non-payment of stipends to interns in many private colleges. MCI is looking into t.
8. MCI changed the professor: student ratio.
9. IMA Grievance Cell wrote to MCI about two cases to expedite their enquiry process
10. IMA offered CPR training after tragic death of Smt. Premlata on 16th November, 2017 at MCI premises.
11. May 10: Sub: imposing the condition of Good Standing Certificate for those who are Registered with registering authorities in other countries [Any Graduate or Post Graduate from our country whenever intends to register with registering authorities for practicing modern medicine in the concerned countries, he/she is required to furnish a Good Standing Certificate for their verification issued by the Medical Council of India. This is solely to ensure that the concerned registered medical practitioner has a good track record and there is nothing against him/her, especially with reference to ethical breech and/or violates. In the same breath and vein, it is necessary that a similar condition needs to be imposed for Indian doctors who are practicing in other countries after getting registered in that country and intends to come back to India. Imposition of similar conditions would be required for Indian students getting their MBBS or equivalent course outside India and coming back for registration in India; foreigners to India and asking for temporary license to practice and also for Indian doctors seeking multiple registrations in different states. This would mean that before they are registered or re-registered with the registering authorities in India, they will have to furnish the similar Good Standing Certificate as a condition precedent. This will serve a similar purpose as the Good Standing Certificate issued by the MCI serves in respect of Indian Doctors seeking registration to the competent registering authority practicing modern medicine in foreign countries. Hence the suggestion. We are sure that the required decision will be taken, in this regard for the enforcement by all concerned.
12. June 20: IMA wrote about Female Genital Mutilation and hysterectomy of mentally unstable females to maintain the womens hygiene during menstruation and avoidance of pregnancy in sexual abuse. As per IMA, doing so is violation of womens fundamental rights. IMA requested to clarify the position of MCI as regards to these two practices so that we can put it as IMA policy.
13. MCI restarted Dr B C Roy National Awards on persistent reminders by IMA.
14. Response from MCI: “This has reference to your email dated 22nd January, 2017, wherein you have forwarded a representation pertaining to permissible filling up of non-medical teachers in pre and para clinical departments in medical colleges under the ambit of the Medical Council of India.

It may be noted that in the context of unavailability of the medical teachers (possessing medical qualifications) in the pre and para clinical subjects, the regulation as provided for a permissible percentage of non-medical teachers in the subject of Biochemistry up to the extent of 50% and physiology, microbiology, pharmacology up to the extent of 30% with a rider that the same shall be filled up in case the teachers with medical qualifications are not available. This by no stretch means that the said percentage is earmarked for non-medical teachers. Ideally speaking medical college should have teachers possessing medical qualifications, but as there is paucity hence the provision in the regulation.”
15. MCI raised the issue regarding ESIC: DACP guidelines, Govt of India, has not been implemented for promotion of Assistant professors to Associate Professors in ESIC Medical Colleges, though assured in the recruitment Advertisements.
16. IMA opposed introduction of NMC.
17. IMA opposed NEXT exam, which MCI supported.
18. IMA opposed and wrote to MCI not to support post BDS bridge course to MBBS.
19. IMA support amendments to IMC act and say no to NMC. IMA drafted a study group report to this aspect.
20. IMA won the PCPNDT act case in Delhi High Court. Matter is in Supreme Court now.
21. Both IMA and MCI were part of Inter-Ministerial Committee formed by Ministry of Health.
22. IMA supported the UPRN circular issued by MCI.
23. In NATCON 2017, MCI has been given a slot by IMA to introduce UPRN (Unique Permanent Registration Number).
24. MCI: “…proposed change of the MODE OF EXECUTION of persons awarded capital punishment from HANDING TO LETHAL INJECTION as proposed by the Law Commission. “The Ethical Committee of Medical Council of India has deliberated on the subject of the mode of execution of death sentence as prepared by the Law Commission and has come to the unanimous view that in order to uphold the highest moral and ethical values of humanity, the Death Penalty (capital punishment) should be abolished altogether in our country.”

1. “The members of the Adhoc Committee appointed by the Hon’ble Supreme Court and of the Executive Committee of the Council considered the recommendation of the Ethical Committee with regard to law panel for execution by Lethal injection and decided that this matter does not come under the purview of the Council.” However, the Ethics Committee strongly feels that the matter should be reexamined by the Executive Committee afresh and the Ethics Committee decision be placed before the General Body………….”

25. Three attempts for UG MBBS admission were shifted from retrospective to prospective. IMA was flooded with students calls after the Central Board of Secondary Education (CBSE) said that AIPMT attempts will be included in the proposed NEET exam (UG) starting this year. IMA immediately took up the cause. I spoke to MCI and also to Dr Ketan Desai, then President World Medical Association (WMA). Immediate action was taken. The Health Ministry has now clarified that “since any new regulation takes effect prospectively, NEET-2017 shall be counted as the first attempt for this purpose irrespective of the previous attempts in AIPMT/NEET, subject to the upper age limit. CBSE has been advised to make necessary corrections in the information bulletin and on their website cbseneet.nic.in, so that any application is not rejected on this ground. Data pertaining to applications already rejected will be erased so that rejected applications can be filed afresh” (Press Information Bureau, 3.2.17) …