When will we stop fighting?

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When will we stop fighting?

Delhi Medical Association elections over many years have become a dirty game with contestants carrying out a negative SMS campaign.

This year the election had three contestants for the post of the President, with Dr. Sharad Lakhotia contesting as an independent candidate, besides Dr Anil Goyal from the Karma group and Dr Ramesh Dutta from previous Faith group. Dr Dutta had earlier served as a DMA President. This was for the first time after many decades that somebody wanted to re-contest as President for DMA.

While Dr. Goyal was contesting with his background of being a specialist and a Chairman of the CME Committee of the Delhi Medical Council, Dr. Dutta’s, also a specialist, basic contention was that earlier when he was the President of DMA, he had not been allowed to work to his expectations by the then Secretary DMA. Dr. Lakhotia, again a specialist, started on the right wicket but soon ended up with a sustained negative camp, which apparently annoyed many people.

As doctors, we always teach people to talk transparent and positive and that too in the interest of the medical fraternity.

One of the points raised in the elections was that a doctor, who wants to become the President of DMA, spends about Rs. 50 lakhs and after becoming the President, he has to recover back that amount and for that he has to indulge into corruption.

I personally feel that both the statements are without scientific facts. Firstly, the finances of the Delhi Medical Association are not in the hands of the President. When I was President DMA, I did not sign a single cheque that year. It is the Secretary and the Treasurer, who have the authority to sign checks and their elections are not held the way the elections for the President are held. The Secretary and Treasurer are chosen from amongst the Executive Members elected by various branches. The accounts are further controlled by a Finance Committee, which along with its chairman is chosen by the General Body Meeting held on 31st March every year. Accounts passed by the Finance Committee are then approved by the Executive Meeting and later finally by the General House.

In a system like this, it is impossible for anybody to be a part of corruption or indulge into corruption. If someone does so, then the executive members have a right to raise the point in the monthly Executive Meetings.

Another point raised was that the candidate has to spend about Rs. 50 lakhs to win the election. This also does not seem to be true. The elections of President are held along with two Vice Presidents and the voting is done in five zones.

DMA is controlled by its Executive Members. One person represents 150 members of the branch. These executive members are the backbone of DMA politics.

The average number of voters is 4000, which means 27 voters per executive member. It is not difficult for executive member to campaign, convince and motivate 40 members each to come and vote. This does not require any finances.

It was said that candidates throw parties to lure the voters. I know that in my branch, no party has ever been hosted in the last five years.

I am aware of the South Delhi branch of DMA where all the hardcore DMA workers meet and plan for the DMA elections and contribute for their meetings.

Every branch has 40 to 50 committed workers who meet and decide the strategy of winning an election.

All the branches of DMA have to complete their elections before 22nd of February and hence most of them will have their annual elections by the first week of February.

Indirectly, these branch elections are linked to DMA elections as DMA executive members are to be elected by Branches. To hold branch elections, the contestants pool allowable finances to win the branch elections and DMA executive posts and IMA central council posts.

Annual meetings of the branches are also held near the election days. For example, the South Delhi Annual Convention was held on 3rd February this year and DMA elections on 12th February. Every branch annual meet will have some CME fund raised to hold scientific meets. The DMA candidates have an opportunity to project themselves during these meetings.

In DMA bylaws, once the code of conduct is enforced, any type of campaign is prohibited and sponsoring of dinners is also prohibited.

Friends and well-wishers of the candidate do host smaller meetings but these have nothing to do with the funding from the contestants.

As of today, there is nothing in the constitution as to how much a person can spend on election in SMS, emails, door to door campaigning, leaflets, pamphlets or posting. Till that happens, these election expenses will be borne by the candidates.

Another point raised was that illegal annual members are made at the time of election.

Most of the young non members become members of IMA only after knowing its activities. Every branch has to have a membership drive for which they have to designate specific months for the same. In DMA most branches have membership drive from September to December.

At a national level in IMA, awards are given to members who make maximum new members. People who become members in November, December will have to pay an annual membership fee of only six months.

Branches are allowed to bring schemes to attract new memberships.  During the 6-month membership, new members get to know of the IMA activities and other members and most of them subsequently become life members of IMA.

Most branches choose membership months so that they coincide with the annual elections so that new members get an opportunity to participate in the annual DMA elections as this is the only time when approximately 1000 people gather in each of the zones (south, east, west and north). The new members get to know the strength of the IMA only at these gatherings.

I personally feel the people should not fight in the organization and work together in the interest of the medical profession. Already at a national level, all the States work in a cohesive manner and decide the national working. I recall in 1991 when I was the Vice President of DMA, there was a group of 8-10 doctors who used to sit together and decide the working of DMA. The time has come for that to happen again. All the stakeholders should sit together.

Politics is a hardcore honorary profession and requires devotion and commitment by people who are into it. When I was President DMA in 2005 and President (Elect) DMA in 2004, I literally spent six honorary hours every day for two full years. Even now, when I am Vice President (Elect) of IMA, I spend 2-3 honorary hours every day either at home or at IMA office doing the IMA work.

It is because of IMA that Clinical Establishment Act till today has not been passed by the government; doctors’ establishments are not being harassed by the MCD; under the PNDT Act, doctors are not being harassed and relations of patients can no more break medical establishments on disputes.

Today, IMA has over 2.2 lakh members, 1768 branches and 29 State branches. Let us all do our bit and work in the interest of the medical profession. I personally feel that everybody should become a member of medical association and people who do not vote for five consecutive years should be debarred from IMA membership. Even the MCI regulations endorses that everyone should become a member of an association.

Remember IMA is not just the four walls of a building. It is WE who make IMA. Let us all start contributing to IMA and make it one of the strongest bodies in the country.

Azharuddin’s son Ayazuddin a victim of missed resuscitation during the Golden Hour?

Health Care, Medicine, Social Health Community 558 Comments

Ayazuddin (19), son of former cricketer and Moradabad MP Mohammad Azharuddin, died on 16th September (2011) five days after being critically injured in a road accident in Hyderabad. He was critically injured when his 1000 CC Suzuki skidded on the Outer Ring Road at Puppalguda on Sunday. His cousin died on the same day.

Ayazuddin suffered a cardiac arrest on his way to the hospital. He responded to resuscitation and was later operated on to stop the bleeding from his lung and kidney. His kidneys were also damaged. Commuters on the route alerted the police and a patrol vehicle from a nearby police station arrived soon. The police team failed to get an ambulance and had to take the profusely bleeding cousins in their patrol vehicle to the hospital, losing an hour in the process.

Medically the lesson is that opportunity to save him was list as the precious first hour was missed of resuscitation.  The “Golden Hour” concept emphasizes the increased risk of death and the need for rapid intervention during the first hour of care following major trauma. Rapid intervention improves the outcome of injured patients (obstructed airway, tension pneumothorax, severe hemorrhage).

Death in road traffic accident can be a part of trimodal distribution of mortality (death at the scene; death 1 to 4 hours after injury; and death weeks later, generally in an intensive care setting) or bimodal distribution (death at the scene or within the first 4 hours).

The current thinking is that relatively few patients die after the first 24 hours following injury. The large majority of deaths occurs either at the scene or within the first four hours after the patient reaches a trauma center. This is true only when the patient gets medical care within the first hour. The care involves fluid resuscitation and control of the bleeding.

Is sex an exercise and is it hard on the heart?

Health Care, Medicine 1,021 Comments

This is a piece taken from HealthBeat to share with our readers. At some time in his life, nearly every man gets exercised about sex. And as many men get older, they wonder if sex is a good form of exercise or if it’s too strenuous for the heart.

Treadmill vs. mattress

To evaluate the cardiovascular effects of sexual activity, researchers monitored volunteers while they walked on a treadmill in the lab and during private sexual activity at home. In addition to 13 women, the volunteers included 19 men with an average age of 55. About three-quarters of the men were married, and nearly 70% had some form of cardiovascular disease; 53% were taking beta blockers. Despite their cardiac histories, the men reported exercising about four times a week, and they reported having sexual activity about six times a month on average.

Researchers monitored heart rate and blood pressure during standard treadmill exercise tests and during “usual” sexual activity with a familiar partner at home. All the sex acts concluded with vaginal intercourse and male orgasm. Disappointingly perhaps, the treadmill proved more strenuous. On an intensity scale of 1 to 5, with 5 being the highest, men evaluated treadmill exercise as 4.6 and sex as 2.7. Sex was even less strenuous for women in terms of heart rate, blood pressure, and perceived intensity of exertion.

Sex as exercise

Men seem to spend more energy thinking and talking about sex than on the act itself. During sexual intercourse, a man’s heart rate rarely gets above 130 beats a minute, and his systolic blood pressure nearly always stays under 170. All in all, average sexual activity ranks as mild to moderate in terms of exercise intensity. As for oxygen consumption, it comes in at about 3.5 METS (metabolic equivalents), which is about the same as doing the foxtrot, raking leaves, or playing ping pong. Sex burns about five calories a minute; that’s four more than a man uses watching TV but it’s about the same as walking the course to play golf. If a man can walk up two or three flights of stairs without difficulty, he should be in shape for sex.

Sex as sex

Raking leaves may increase a man’s oxygen consumption, but it probably won’t get his motor running. Sex, of course, is different, and the excitement and stress might well pump out extra adrenaline. Both mental excitement and physical exercise increase adrenaline levels and can trigger heart attacks and arrhythmias, abnormalities of the heart’s pumping rhythm. Can sex do the same? In theory, it can. But in practice, it’s really very uncommon, at least during conventional sex with a familiar partner.

Careful studies show that fewer than one of every 100 heart attacks is related to sexual activity, and for fatal arrhythmias the rate is just one in 200. Put another way, for a healthy 50-year-old man, the risk of having a heart attack in any given hour is about one in a million; sex doubles the risk, but it’s still just two in a million. For men with heart disease, the risk is 10 times higher — but even for them, the chance of suffering a heart attack during sex is just 20 in a million. Those are pretty good odds.

How about Viagra?

Until recently, human biology has provided unintentional (and perhaps unwanted) protection for men with heart disease. That’s because many of the things that cause heart disease, such as smoking, diabetes, high blood pressure, and abnormal cholesterol levels, also cause erectile dysfunction. The common link is atherosclerosis, which can damage arteries in the penis as well as in the heart.

Sildenafil, vardenafil, and tadalafil  have changed that. About 70% of men with erectile dysfunction (ED) respond to the ED pills well enough to enable sexual intercourse. Sex may be safe for most men with heart disease, but are ED pills a safe way to have sex?

For men with stable coronary artery disease and well-controlled hypertension, the answer is yes — with one very, very important qualification. Men who are taking nitrate medications in any form cannot use ED pills. This restriction covers all preparations of nitroglycerin, including long-acting nitrates; nitroglycerin sprays, patches, and pastes; and amyl nitrate. Fortunately, other treatments for erectile function are safe for men with heart disease, even if they are using nitrates.

Safe sex

Sex is a normal part of human life. For all men, whether they have heart disease or not, the best way to keep sex safe is to stay in shape by avoiding tobacco, exercising regularly, eating a good diet, staying lean, and avoiding too much (or too little) alcohol. Needless to say, men should not initiate sexual activity if they are not feeling well, and men who experience possible cardiac symptoms during sex should interrupt the sexual activity at once.

With these simple guidelines and precautions, sex is safe for the heart — but it should be safe for the rest of the body, too. Sexually transmitted diseases pose a greater threat than sexually induced heart problems. When it comes to sex, men should use their brains as well as their hearts.

[Source HealthBeat: Harvard]

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