Getting adequate nutrient supplementation through natural food is harm reduction

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

Vitamin D is essential for several body functions and 40 minutes of absorbing this from sunlight is a must

New Delhi, 23rd February 2019: A new study published in the Journal of Bone and Mineral Research confirms that vitamin D supplementation is less effective in the presence of obesity, and it uncovers a biological mechanism to explain this observation. It indicates that it may be more useful to treat vitamin D insufficiency in obese individuals with calcidiol rather than with other forms of vitamin D. Obesity reduces the ability of the liver to convert vitamin D into 25-hydroxyvitamin D.

A recent report by the ASSOCHAM Healthcare Committee has revealed that about 8 in 10 people in Delhi suffer from Vitamin D deficiency. Such a deficiency can cause chronic muscle pain, spasms, low energy levels, and depression. About 88% of Delhi’s population has a Vitamin D level that is less than normal. The need of the hour is to create awareness about the consequences of being deficient in this vitamin.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “A deficiency of Vitamin D deficiency can lead to bone mineralization, and bone softening diseases such as rickets in children and osteomalacia and osteoporosis in adults. The prime reason for this deficiency among people in urban cities such as Delhi could be insufficiency or non-exposure to sunlight, staying in air-conditioned rooms for long hours during the day. Vitamin D deficiency has also been associated with metabolic syndrome, heart diseases and even fertility. Five to 30 minutes of sunlight twice a week to your face, arms, legs, or back without sunscreen will enable you to make enough of the vitamin. Food and sun exposure should suffice, but if not, get 2,000 IU of vitamin D daily from a supplement.”

The current vitamin D mantra is that 40 days in a year for at least 40 minutes. One should expose 40% of the body to the sunlight either after sunrise or just before sunset.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Vitamin D2 ergocalciferol is found in food items and our body makes Vitamin D3 cholecalciferol in the presence of sunlight. While both are extremely important, if D2 can be obtained from food, even little exposure to sun can help the body produce D3.”

Some tips from HCFI

The following foods are good sources of Vitamin D.

  • Cod liver oil This oil comes from the liver of the cod fish and is considered extremely healthy. It helps ease joint pains and can be taken in capsule form or oil form.
  • Mushrooms If you love mushrooms, you are covered. Dried shitake mushrooms are a brilliant source of Vitamin D3 as well as Vitamin B. It is low in calorie and can be consumed daily.
  • Salmon This is another good source of D3, Omega 3 and protein.
  • Sunflowers seeds This seed not only have Vitamin D3 but also comes with monounsaturated fats and protein.

US hospital and doctors settle malpractice suit for 142.35 crores: Could this become a real possibility in India?

Health Care Comments Off

A Midwest hospital system and several doctors will pay a total of $20.6 million to settle a man’s claims that he is permanently disabled because the physicians failed to diagnose and treat a ruptured aneurysm in his abdomen, as per the patient’s lawyers.

The patient had filed a claim that Indiana-based Franciscan Health and its doctors missed a bleeding aneurysm on a CT scan when he visited St. James Hospital in Chicago Heights complaining of abdominal pain, nausea and vomiting.

The initial CT scan during his 2013 hospital visit had shown the bleeding aneurysm with several other large aneurysms in his pelvic and abdominal areas. However, two radiologists failed to notice the bleeding when they reviewed the scan, and a vascular surgeon missed the bleeding when he reviewed it the next morning, according to the statement of the lawyers.

The patient did not have any issues with ambulation when he arrived at the hospital and could perform all activities of daily living without assistance. But his condition worsened as he began to experience symptoms including weakness in his legs, dropping blood pressure and increased abdominal pain. The next morning, the hospital’s daytime attending doctor ordered a “routine MRI” to look for spinal abscesses as a potential source of Baldridge’s lower extremity weakness, according to the statement. But the MRI was never conducted, Baldridge’s condition worsened and an X-ray the hospital ordered later that day showed his large bowel was dilated, the statement said. He was then transferred to a sister hospital, where he underwent emergency surgery after another CT scan revealed bleeding from an aneurysm in his right iliac artery. The patient is now permanently paralyzed at 64. He has received several toe amputations, struggles with deep pressure ulcers and experiences “chronic and unrelenting pain,” the statement said.

The lawsuit alleged that the bleeding aneurysm should have been spotted in his first CT scan. He also claimed he would have received emergency surgery much sooner if it had been. “When this acute change occurred, the health care providers failed to coordinate care to get appropriate diagnostic tests and consultation with specialists. All signs were pointing towards internal bleeding, and because of a failure in communication, this was not acted upon in a timely fashion.”

The hospital and doctors denied negligence, claiming his preexisting end-stage kidney disease had severely limited his life expectancy. They also claimed the ailments Baldridge suffered were known complications to the type of surgery he received, which he would have needed regardless.

The parties reached an agreement, which requires Franciscan to pay $13.5 million on behalf of the hospital while the doctors will contribute $7.1 million collectively, making it a total of $20.6 million.

(Source: Law360)

20.6 million US dollars amounts to Rs 142 crore, 35 lakh rupees.

This was an out of court settlement and although it did not happen in India, the day is not far off when this exorbitant sum of money awarded could become a real possibility in India.

Award of compensation in medical negligence cases in India is already moving along this path, albeit gradually.

Compensations amounting to more than one crore have been awarded by the Supreme Court of India and National Consumer Disputes Redressal Commission (NCDRC) in three judgements.

In its judgment in “Dr. Balram Prasad versus Dr. Kunal Saha & Others”, the Hon’ble Supreme Court of India awarded Rs. 6.08 crores as compensation for medical negligence. After addition of interest, this figure increased to a staggering amount of Rs 11 crores.

Rs one crore each was also awarded as compensation in the judgements in Nizam Institute of Medical Sciences vs Prasanth S Dhananka and Ors and Dr. (Mrs.) Indu Sharma vs Indraprastha Apollo Hospital.

As a result, litigations against doctors have seen a huge increase; some of these are on frivolous grounds. Premiums paid to insurance companies have increased.

This means that doctors now have to be conversant with the law as it applies to medicine. This is no longer optional but an urgent need of the hour. They have to be more vigilant now than before.

We have wealth management consultants, who provide financial, tax and investment advice. Almost all of us are assigned a Relationship Manager by the bank to help us with our banking needs.

Similarly, the time has now come for doctors to have legal consultants on “retainership” to help them safely navigate the complexities of law.

Informed consent has now become an absolute legal necessity and it is the only safeguard available to the doctor as protection from malpractice claims.

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

Past National President IMA