Stethoscopes can harbor harmful bacteria and cause hospital-acquired infections

Health Care, Heart Care Foundation of India, Medicine No Comments

Imperative to put in place control guidelines and educate clinicians on the outcomes of not ensuring safety

New Delhi, 19 December 2018: Recent research has indicated that stethoscopes used in an intensive care unit (ICU) are loaded with bacteria, including those that may be associated with hospital-acquired infections (HAIs). Moreover, standard cleaning methods do not eliminate the problems. Practitioner stethoscopes are contaminated by a plethora of bacteria, including organisms that may be associated with nosocomial infections.

The researchers found that all stethoscopes used in the ICU were significantly contaminated with a variety of pathogens. The highest bacterial contamination levels were found on practitioner stethoscopes, followed by patient-room stethoscopes. Bacterial contamination levels on clean stethoscopes and background controls were indistinguishable from each other.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Given that the stethoscope is seen universally as a healing instrument, both patients and healthcare workers may not take it as a transmitter of bloodborne pathogens or a vector of infection. However, the truth is far from this. Some of these pathogens include Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium difficile, and vancomycin-resistant enterococci. These are responsible for many diseases such as pneumonia, urinary tract infections (UTIs), and skin infections, some of which can be life threatening. Patients and at times, even hospital staff, fail to follow certain basic hygiene protocols which can go a long way in preventing these infections. This is further exacerbated by the fact that there is no specific documentation of HAI incidence in India, at least in the major cities.”

Studies have also concluded that the diaphragm of the stethoscope is more contaminated than other regions of the hand, including the skin around the base of the thumb and little finger, or the back of the hand.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “In light of all this, it becomes imperative to educate clinicians on the importance of stethoscope hygiene. They should conduct a cleanliness check between each patient encounter. Cleaning hands and ensuring other forms of hygiene is also an important part of avoiding HAIs.”

Some tips from HCFI

Stethoscopes can be cleaned using a combination of 90% ethanol, isopropyl alcohol (IPA), and chlorhexidine. This will help in reducing the bacterial contamination of diaphragm of stethoscope.

  • If your stethoscope needs to be disinfected, wipe with a 70% isopropyl alcohol solution.
  • Do not use hand sanitizer as a cleaning agent as there are additives that may damage parts of the stethoscope.
  • Do not immerse your stethoscope in any liquid, or subject it to any sterilization process.
  • Keep your stethoscope away from extreme heat, cold, solvents and oils.
  • Tunable diaphragms can be removed from the chest piece and their surfaces wiped with alcohol or soapy water. Dry all parts thoroughly before reassembly.
  • Ear tips can be removed from the ear tubes for thorough cleaning. For safety, snap ear tips firmly back onto the ribbed ends of the ear tubes.

Understanding food labels may lead to healthier eating choices

Health Care, Heart Care Foundation of India, Medicine No Comments

One should check for the fat and sugar content in labels specifically

New Delhi, 18th December 2018: New research has indicated that labels on packaged foods such as nutrition facts, “low-sodium” or “fat-free” as well as calorie counts on restaurant menus, have to some extent encouraged healthier eating choices in people. It also found that labelling reduced consumers’ intake of calories by 6.6%, total fat by 10.6%, and other unhealthy food options by 13%. Labelling also increased consumers’ vegetable consumption by 13.5%.

Obesity is on the rise in India, particularly among children. Overweight and obese children are predisposed to lifestyle diseases later in life. It is thus important to encourage healthy eating habits at a younger age. A change in food labeling policy may discourage the public from choosing such foods products not only for themselves, but most importantly for their children.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “The health ministry has made it mandatory for some medicines to have a red vertical line on their strips to sensitize the public to the fact that these medicines are meant to be consumed only with the doctor’s prescription. Along these lines, packages of all food products that contain high levels of sugar, calories, salt and saturated fats should also carry a ‘red dot’ or a ‘red arrow pointing upwards’ on the food label, which carries the nutritional content of that particular food product as a symbol warning the consumer that the food product contains unhealthy amounts of fats, sugar and salt. This will perhaps encourage people to opt for healthier alternatives.”

One example to understand food labels could be: any food label which end with ‘ose’ is sugar. Some examples are glucose, maltose, sucrose, fructose, galactose etc.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “For people with diabetes, obesity and metabolic syndromes, eating sugar needs to be restricted. Therefore, every patient must know the food labels where sugar is present. Most people confuse sugar with only glucose. Malta contains maltose, table sugar contains sucrose, fruits contain fructose, and glucose available in the pharmacy contains glucose. If eaten in excess, all forms of sugar can increase blood sugar in the body. They also can cause insulin resistance if the sugar is taken in the form of refined sugar or is rapidly absorbable form.”

Some tips from HCFI

  • Na in label means salt
  • ‘ose’ ina label means sugar ( fructose, glucose, maltose etc)
  • · The top contents in the label contains the maximum contents of that substance
  • · Check both the serving size and the number of servings found in a package or container.
  • · Foods containing 5% of the daily value (DV) or less of a nutrient are low in that nutrient, and those that contain 20% of the DV or more are high in that nutrient.
  • · Avoid foods that list multiple types of sugars near the beginning of the list. When choosing products containing grains, opt for those that contain a whole grain near the beginning of the list rather than refined grains.
  • · Food labels can also help you become more familiar with standard serving sizes and help with portion control. Measure out one serving of a food at a time, so you can become familiar with what that looks like.

Jammu & Kashmir becomes the first state in the country to have law against “sextortion”

Health Care No Comments

In a Public Interest Litigation (PIL) titled as “Court on its Own Motion versus State of Jammu and Kashmir” vide judgement dated 15.10.2018, the Hon’ble Chief Justice of Jammu and Kashmir had directed the State of Jammu and Kashmir to examine the concept of “Sextortion” in the context of applicable laws and to amend the existing penal laws so that illegal acts, unwarranted demands for sexual favors and inappropriate contacts by the persons in authority are made punishable.

The said issue relating to “Sextortion” was examined by the Governor and it was found that in order to prevent misuse of authority for unwanted sexual favors, it is expedient to amend the existing penal laws so as to curb this menace and prevent and check such misuse of position by persons in authority, fiduciary relationship or by a public servant.

Accordingly, a Bill to this effect i.e. the Jammu and Kashmir Criminal Laws (Sexual Offences) (Amendment Bill), 2018, has been signed off by the State Administrative Council headed by Governor Satya Pal Malik.

Now, the State of Jammu and Kashmir has become the first State in the country to recognize Sextortion as a separate criminal offence, punishable with 3-5 years of imprisonment in addition to fine.

The Jammu and Kashmir Criminal Laws (Sexual Offences) Amendment Act, 2018 makes amendment in the State Ranbir Penal Code, Samvat, 1989, Code of Criminal Procedure, 1989 and Evidence Act.

As per the amendment Act, 2018 term “Sextortion” is any person who being in a position of authority or in a fiduciary relationship or being a public servant abuses such authority, or fiduciary relationship or misuses his official position to employ physical or nonphysical forms of coercion to extort or demand sexual favors from any woman in exchange of some benefits or other favors that such person is empowered to grant or withhold shall be guilty of offence of sextortion.

Sexual favors mean and include any kind of unwanted sexual activity ranging from sexually suggestive conduct, sexually explicit actions such as touching, exposure of private body parts to sexual intercourse including exposure over the electronic mode of communication.

The person who commits the offence of sextortion shall be punished with rigorous imprisonment for a term which shall not be less than 3 years and may extend to 5 years and with fine.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

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