IMA-No Incentive Initiative

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During the Central Council Meeting in Amritsar, I had said in my presidential speech that IMA will have zero tolerance for unethical practices including sex selective abortions for non-medical purposes and cuts and commissions. And that IMA and the medical profession will boycott any person indulging in unethical sex selective practices.

I am happy to note that IMA Bagalkot Branch in Karnataka, under the Presidentship of Dr Shekhar Mane has taken up the “IMA-No Incentive Initiative”.

The draft undertaking by the branch states “INCENTIVES in any form cash, cheque, gifts, articles, parties etc. will NOT be given to or taken from any of our colleagues, referring doctors, RMP, quacks, ASHA workers, ambulances, laboratories etc.” Incentive means where no service is attached.

The branch also nominated an Ethical & Vigilance Committee comprising of 15 doctors with President and Secretary as ex officio member.

If any doctor or hospital violates this model code of conduct, then the complaint can be investigated by this ethical committee. The committee will discuss and counsel the doctor/s involved and send a notice to them directing compliance. The matter will also be brought to the notice of the Executive Committee or General Body for warning. The punitive action includes suspension from the local IMA branch and report to the MCI, KMC and other govt. regulatory authorities for necessary action.

In order to discourage crosspathy, the branch further resolved that all modern scientific medicine (allopathic) doctors must stop going to hospitals owned by practicing non allopathic doctors as visiting consultants.

Dr KK Aggarwal
National President IMA and HCFI

Healthcare for all not possible with the present budget

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In his speech when presenting the budget, the Finance Minister said that health for all and education for all is his priority but the budget allocation is only Rs. 37330 crores, which is an increase of only 7.5% in the last years allocation (planned and non-planned budget together). Medical fraternity expected it to be at least 2-3% of the GDP. Even allocation to AYUSH is only 1069 crores against 1650 crores allocated to six AIIMS-like institutions. If the Government really wanted to do something for promoting healthcare, they could have allocated for six AIIMS-like AYUSH institutions whose purpose should have been prevention so that people do not require allopathic tertiary care.

There are no tax holidays or tax exemptions for doctors living in rural areas in the present budge. Also, there was no relief for making VISA easy for medical tourism.

The Rs. 110 crores allocated for disability is not sufficient. Rs. 6000 crores should have been allocated for providing free generic drugs for people coming to government hospitals. This announcement was lacking in the budget.

Rs. 150 crores have been allocated for the care of the elderly, who constitute 8% of the total population. Elderly people usually do not have insurance as insurance companies do not give them a cover. At least 8% of the total health budget should have been allocated for the elderly.

Allocations to National Health Mission (NHM) (which covers both rural and urban population budget) is only Rs. 21200 crores, which is less than the amount used last year for which rural mission. It aims to provide urban mission money from the money received from the rural mission project. Separate budget should have been allocated for the urban mission.

Rs. 4727 crores allocated for training, education and research is also inadequate as unless you patent your own equipments and drugs, you are going to be dependent on foreign market.

India Medical Association in its recent meeting with Economic Advisor, Ministry of Health, Government of India had offered that every private doctor should be incorporated for providing healthcare facilities across the country, where the Government only had to invest on the human resource.

The government can start MD in Rural Medicine with a curriculum that teaches the art of treating the patients in limited resources. After that people can choose and do their respective post graduation. This way the doctors will not feel that it is a burden on them. There will be additional degree in MD in Rural Medicine Surgery. Such doctors serving in rural areas should be given income tax-free income.

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

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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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