About 15% to 30% of medical students and residents suffer from depression

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Doctors are not healing angels and should not be blamed for patient deaths unduly

New Delhi, 11 October 2018: A study conducted by the Indian Medical Association (IMA) last year found that in Kerala doctors die approximately 10 to 12 years before the average person – in India, overall, this number stands at seven years before the average person. In early 2018, about six doctors checked into the psychiatric ward at AIIMS at the same time, even as the IMA has declared physician suicides ‘a public health crisis’.

Most doctors follow a 12-hour shift including teaching, mentoring, attending to patients, and doing research work. Some attend to about 400 patients a day in healthcare facilities, some of which lack even the basic amenities and infrastructure. All this and the guilt of not being able to give enough time to patients can result in burnout, alienation, diseases, and depression over time, all of which can lead to suicides.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Medical students often suffer from depression. Their training is extremely taxing and can take a toll on their mental and physical health. A student may have been a topper in school, but things change when they enter medical college. Not being able to score as well can also lead to depression after a point. It is estimated that about 15% to 30% of the medical students and residents suffer from depression. In a study, it was found that many students either contemplated suicide or attempted it! Many students resort to non-prescription drug use such as eating painkillers or antidepressants. For senior doctors, there is work stress, reputation at stake, and the inability to recognize the symptoms of depression or fatigue.”

Increasing physical assault on doctors by patients and their families is also on the rise. People hold doctors responsible for any eventuality without realizing that they are not healing angels. Lack of trust between patients and doctors is another major reason for suicides.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The cases of burnout are likely higher in female doctors due to the demands at both work and home. The number of specialists is limited, and hence they are subjected to more working hours and the nature of the jobs is demanding. With such a punishing workload, they may also end up taking the blame if something goes wrong or even become frustrated with the changing work culture. Addressing the doctor-patient ratio in India is, therefore, an urgent need of the hour.”

Here are some tips for doctors to avoid a possible burnout.

  • Practice smart work scheduling
  • Start a hobby which will help you distract yourself from the regular workload
  • Make time for relaxing techniques such as yoga and meditation, as these will prove to be stressbusters.
  • Make time for family and friends
  • Delegate tasks and try to manage your time effectively.

People working in irregular shifts at a higher risk of acquiring Type 2 diabetes

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Inculcating healthy eating habits at the outset can help in averting this condition

New Delhi, 15 February 2018: According to a recent study, people working irregular or rotating shifts with usual night shifts were 44% more likely to have Type 2 diabetes. In addition, compared to day workers, all shift workers were more likely to have Type 2 diabetes, except for permanent night shift workers. WHO statistics indicate that the global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. The majority of people with diabetes are affected by Type 2 diabetes.

Type 2 diabetes is typically brought on by poor eating habits, too much weight and too little exercise. In this condition, the cells cannot use blood sugar (glucose) efficiently for energy. This happens when the cells become insensitive to insulin and the blood sugar gradually gets too high.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, it is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide. One of the primary reasons for this is the lifestyle people lead today. On-the-go and fast-paced lives mean people skip their breakfast and end up eating unhealthy, quick-fix meals through the remainder of a day. Type 2 diabetes is closely linked to obesity and it’s well–known that maintaining a healthy weight through diet and exercise reduces the risk of developing the disease. Diet affects diabetes risk independent of a person’s weight.”

Type 2 diabetes is also known as the silent killer. This is because by the time people are diagnosed with the condition, the other health complications of diabetes may already be present.

Adding further, Dr Aggarwal, who is also Group Editor of IJCP, said, “Foods which reduce the risk of Type 2 diabetes such as vegetables, fresh fruit, whole grains and unsaturated fats need to be more affordable and more widely available. Most of all, it is important to start the day with a healthy breakfast as this can help prevent the onset of type 2 diabetes and effectively manage all other types of this condition as well. This will be an important topic of discussion at the 25th Perfect Health Mela to be held this year by the HCFI.”

Here are some tips to manage Type 2 diabetes in young adults.

  • Maintain a healthy weight by exercising every day and consuming a healthy diet.
  • Get your blood glucose levels monitored at regular intervals.
  • Do not consume refined sugar in any form as this can get absorbed into the blood stream more easily and cause further complications.
  • Reduce stress through activities such as meditation and yoga.

Essential medicines should be perennially available

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Only a small fraction of these is available in private pharmacies, says study

New Delhi, 6th February 2018: A recent research has revealed that India lacks access to essential medicines, despite the approval of thousands in an attempt to generate wider availability. It has found that the policy to open up the market has generated a large number of brands of medicines, but there are still not enough available in the pharmacies.

Although multiple brands of selected medicines are listed in professional and commercial databases — running into thousands — only a small fraction is available in private pharmacies. Apart from this, the medicines are also available in fixed dose combinations (FDCs), where two or more drugs are combined in a set ratio in a single dose form, usually a tablet or capsule. There are concerns in India over the safety and effectiveness of these products.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “Essential medicines are those that satisfy the priority health care needs of the population. These should be available at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford. Essential drugs satisfy the priority healthcare needs of a majority of the community. The NLEM assumes importance in India where out-of-pocket expenditure on health care is quite high and only a few have health insurance.”

The Alma Ata Declaration adopted by the World Health Assembly in 1978 was the first international declaration, a milestone, which brought primary health care to the forefront. It outlined provision of essential drugs as one of the essential components of primary health care. In the same year, the World Health Assembly passed a Resolution urging Member States to establish national lists of essential medicines and adequate procurement systems.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Of the thousands of drugs in the market, as many as 70% are duplicative or ‘me-too’ drugs and hence nonessential. Therefore, it is important to derive a system to facilitate selection of fewer drugs from the numerous that are available. Essential medicines are selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost-effectiveness.”

Many criteria are considered to include a drug in the NLEM.

  • The medicine should be approved/licensed in India.
  • The medicine should be useful in disease which is a public health problem in India.
  • The medicine should have proven efficacy and safety profile based on valid scientific evidence.
  • The medicine should be cost effective.
  • The medicine should be aligned with the current treatment guidelines for the disease.
  • The medicine should be stable under the storage conditions in India.
  • When more than one medicine is available from the same therapeutic class, preferably one prototype/ medically best suited medicine of that class to be included after due deliberation and careful evaluation of their relative safety, efficacy, cost-effectiveness.
  • Price of total treatment to be considered and not the unit price of a medicine.
  • Fixed Dose Combinations (FDCs) are generally not included unless the combination has unequivocally proven advantage over individual ingredients administered separately, in terms of increasing efficacy, reducing adverse effects and/or improving compliance

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