Indian Health Care Sector

csubash · Post by **csubash** » 21 Apr 2009 03:48

Hi Sridhar,

The question of asking a relative to hold the plate itself is unethical. There should radiation exposure trained/certified personnel to take X-rays. There are procedures like image intensifiers which need continuos exposure to X-rays are helped by radiographers(technicians) with proper protective clothing. X-rays/ CT-scans are done without any manual help however awkward the positioning could be with proper equipment. Agree that single exposure wouldn't do a lot of harm, but that's not the point.

CSubash

SSridhar · Post by **SSridhar** » 21 Apr 2009 17:26

CSubash, exactly. That was my point with the Chief of Radiology of that very reputed hospital. But he said that WHO standards allow the attenders of patients to hold the plate. I was confused. I am unable to Google and get the details.

SSridhar · Post by **SSridhar** » 21 Apr 2009 17:33

George J, thanks for your efforts in getting an answer. It is not my intention to proceed legally with in this matter. Far from it. I just want good practices implemented in a hospital of that reputation.

If it may help, in this case, the patient was conscious and the x-ray was taken two days after a knee surgery. I was asked first to hold the leg in a particular way for one view and later hold the plate for a different view. In the first case, the plate was below the knee while the x-rays came from above and in the second case, the plate was placed between the two knees while the x-ray source was from the side. I think these were called bilateral x-rays of the knee. I am not sure, though.

Bade · Post by **Bade** » 21 Apr 2009 20:51

SSridhar,

I went through a similar experience for my kid in massa. It was for X-ray of the feet. To make sure that he remain still, I was requested to help. As I recall I was given the lead jacket to wear at that time. To avoid taking multiple exposures if the child moved was good enough reason to me. Besides, I have worked in more dangerous radiation environments near 'hot' beam pipes with radiation monitoring devices in hand, so did not think twice.

SSridhar · Post by **SSridhar** » 22 Apr 2009 06:15

Bade, thanks for the info.

negi · Post by **negi** » 22 Apr 2009 06:49

I do not wish to nukkadise this thread but have a personal experience regarding the 'misdiagnosis' of an ailment.

In my case during my second year of Engg all of a sudden I developed this excruciating pain in my right hip (used to be worse during mornings), after a couple of weeks of procrastination I finally visited a well known orthopedic surgeon (He was the head of Dept of MC).The gentleman first diagnosed it as some sort of a physical trauma and administered some painkillers and even a shot of some unknown medicine (it even caused rashes on my body).

After a couple of weeks when my condition worsened and I even found it difficult to get up from the bed , the Doc. asked me to get a TB test done (it was a regular Mantaux test with some circle drawn around the spot where stuff was injected). Doc. concluded that I had contracted a form of TB which affected bones (in my case SI joints were affected ) so I was put on a complete course of TB antibiotics .However after 1 week of starting the treatment the pain shifted to the left hip region and it was then the Doc. conceded that he had mis-diagnosed the ailment he then suggested that it might be spondolysis of lower SI joint

.

However my parents decided to get a second opinion and we went to KMC Manipal , the docs too confirmed the possibility of spondolysis (after MRI tests ) and suggested I be admitted as an in-patient for traction,ultrasound and radiation therapy . The treatment was of little help (same as a hot water bag or some home remedy ). We did few more rounds of Apollos and even a local 'Hakim'

(but the condition did not improve). After 1 year of ordeal one fine day pain finally disappeared .

;I have since then never experienced the same pain again .

SSridhar · Post by **SSridhar** » 24 Apr 2009 09:02

Hyderabad to host Cardiology Meet

“By 2015, India would be home to 60 per cent of all cardiac patients in the world,” he said.

SSridhar · Post by **SSridhar** » 30 Apr 2009 06:21

Surgery Olympics: Silver medal for gastroenterologist from Coimbatore

SSridhar · Post by **SSridhar** » 01 May 2009 19:38

Newborn with rare heart disease operated upon using new procedure

CHENNAI: Doctors at a city hospital, using a new procedure, have operated on a seven-day-old baby who was flown here with a rare heart disease. The Kozhikode-based baby, according to the doctors, was recovering well and was discharged on Thursday. . . .it was diagnosed as having Hypoplastic left heart syndrome (HLHS) a rare congenital defect in which the left side of the heart is severely underdeveloped. . . In children with HLHs, the left side of the heart including the ventricles, valves and vessels is malformed and unproductive. It does not perform its natural function of pumping oxygen-rich blood out to the rest of the body. "The aorta was also under-developed. The blood flow to the whole body is reduced and there is flooding of the lungs with excessive flow. Normally, these children are offered a palliative operation through three open-heart surgeries. The first stage surgery regulates the excessive blood flow to the lungs and provides adequate blood supply to the whole body," he said.

A newer technique, called the Hybrid Norwoor Procedure, achieves this without connecting the circulation to a heart-lung machine.

SSridhar · Post by **SSridhar** » 05 May 2009 11:11

Chennai hospitals plan bowel, ovarian and pancreatic transplantations

Currently, the state has 52 kidney transplant centres, 18 eye transplant centres, 5 heart transplant centres and three centres for liver and pancreas transplant.

SSridhar · Post by **SSridhar** » 07 May 2009 17:35

Infant gets new life after rare surgery

"The acidity of her blood was so high that it damaged the mitral valve of the heart. She was hardly breathing and her lung pressure was very high," said interventional cardiologist Dr R Ravikumar, who first attended on her. While the normal Ph level in blood 7.36 - 7.4, Sriya's blood showed a ph level of 6.9. Her lung pressure, which should have been 30 mmHg, was 85 mmHg.

She was given drugs intravenously and put on a ventilator. Medical experts then met to strategise her treatment plan. "It was a rare condition. I browsed the internet to see if I can get some inputs from the medical literature. I did not find any," said chief cardiac surgeon Dr K R Balakrishnan. "That's when we decided to be a little innovate," he said.

Dr Balakrishnan performed a 3-hour surgery to repair the leaking mitral valve. "We couldn't replace the valve with an artificial one since those available in the market are meant for adults. Even if we tailored one, it would not grow with the child," he said. Therefore, the doctors used an improvised ring of a synthetic material (gore-tex) along with heart tissues to replace the heart valve. Sriya showed remarkable improvement after the surgery. "Her valve is completely normal now and will grow with the child," the surgeon said.

Vipul · Post by **Vipul** » 10 May 2009 18:43

Rare surgery lets woman see son’s sixth birthday.

In a first-of-its-kind surgery in the country, a 28-year-old woman suffering from a critical medical problem, got a new shot at life. And the timing couldn’t have been better. Till a week ago, Jyoti Soni and her husband Santosh didn’t think she’d be around to celebrate their six-year-old son, Arpit’s birthday, today.

It was three years ago that Jyoti, a resident of Goregaon, was diagnosed with Nonspecific Aortoarteritis or Takayasu disease. Both her arteries supplying blood to her brain were 95% blocked. That meant, Jyoti was under a constant threat of suffering a stroke or ‘brain attack’. Jyoti visited innumerable doctors but the answer was always the same - her condition was too critical for a bypass surgery.

Just when the family had given up hope, a doctor at the Asian Heart Institute recommended she visit the Interventional Radiologist at the hospital, Dr Hemant Deshmukh. And to the family’s delight, he agreed to take up her case. “I realised cutting balloon angioplasty was the only option for Jyoti, even though there was a risk of life-threatening complications,” explained Dr Deshmukh. The surgery was conducted on May 5.

It’s been a few days since the surgery but Jyoti still can’t stop smiling. “I can’t express how happy I feel. The constant blackouts and giddiness I felt have gone. I will be able to lead a normal life again,” she said.

Jyoti’s beaming husband, Santosh, added, “In the last three years, we had met innumerable doctors and had given up hope. But now we’ll celebrate Arpit’s birthday together.”

Members of the medical fraternity confirmed the surgery was a critical one and the first in the country. Dr Rohini Samant, Consulting Rheumatologist at Hinduja Hospital who had examined Jyoti, said, “Her condition had been critical and the procedure performed on her is certainly an unusual one.”

Similarly, Dr Anil Karapurkar, Endovascular Neurosurgeon at Harkisandas Hospital said, “A bypass surgery could not have been performed on Jyoti as her arteries were 95% blocked. In my opinion, the procedure is the first in the country.”

SSridhar · Post by **SSridhar** » 13 May 2009 08:55

Drop in infant mortality rate in the country

The infant mortality rate (IMR) in the country went down by two percentage points from 57 to 55 per 1,000 live births between 2006 and 2007.

SSridhar · Post by **SSridhar** » 15 May 2009 08:50

Sick Neonatal Care Unit saves lives in Guna, MP

Until two years ago, Guna district in Madhya Pradesh was identified with poverty, malnutrition, high infant and maternal mortality rate. Now, it is a model to be replicated across the country for high rates of institutional deliveries and infant survival.

Singha · Post by **Singha** » 15 May 2009 09:32

GE healthcare has designed and built a infant incubator out of their blr facility for indian conditions.
skips some fancy chi-chi features found in bideshi incubators to save on the cost.

these kind of products and good operation theaters and pediatric units in each small town could
save a lot of lives.

upendora · Post by **upendora** » 15 May 2009 11:07

We need to a health care system which helps in reducing population.

SSridhar · Post by **SSridhar** » 24 May 2009 19:53

India will be rid of lethal P-1 Polio virus by year end: WHO

Vriksh · Post by **Vriksh** » 25 May 2009 02:09

upendora wrote:We need to a health care system which helps in reducing population.

You mean we need to have a well educated population... population control is simply a function of the average education levels of the citizens. Better schools will achieve that objective.

IndraD · Post by **IndraD** » 26 May 2009 21:06

http://timesofindia.indiatimes.com/Why- ... 580547.cms

AIIMs, however, maintained that it had its own experts to conduct the surgery and such operations were being conducted at the premier institute for the last three decades. It added that the decision to invite Panda was taken "jointly by the PMO and family members of the Prime Minister".

Jetli contended before the CIC that "The public has the right to know why a premier institute such as the AIIMS, which is staffed by the best doctors in the country and with the best of medical facilities, had to invite a doctor from outside to conduct the operation in its premises. This is a matter of great concern to the public and inviting a doctor from another institute has eroded the reputation of AIIMS

A country where PM himself breaks law and over rides the system..!

shiv · Post by **shiv** » 27 May 2009 08:55

Macaulay ki Jai!
http://www.indianexpress.com/news/caugh ... gn/465842/
Caught speaking Malayalam, Apollo nurses asked to resign

Indraprastha Apollo Hospitals on Monday asked two nurses to submit their resignations for speaking in their “native tongue” inside the hospital premises.

< snip >

Menon said they arrived for the afternoon shift at 1.45 pm. “We greeted each other in the lift lobby in Malayalam and did not realise that the nursing superintendent was standing behind us,” Joseph said.”
Menon added, “We spent the entire day apologising but we were not allowed to enter the ward after that.”

The hospital’s nursing superintendent, Usha Banerjee, said employees were encouraged to speak only in English within the premises. “We cater to an international clientele,” Banerjee said. “In any case, speaking in native languages might jeopardise patient safety; we avoid talking in any language other than English while inside the hospital premises.”

AjayKK · Post by **AjayKK** » 27 May 2009 13:28

In any case, speaking in native languages might jeopardise patient safety; we avoid talking in any language other than English while inside the hospital premises.”

89 % indians are jeopardising something or the other

Nurses approach NHRC, Labour Ministry; Apollo says not fired yet

http://www.indianexpress.com/news/Nurse ... et/466388/

Asked to resign for speaking in their native language, two nurses of the Indraprastha Apollo Hospital have approached the National Human Rights Commission (NHRC) and the Labour Ministry.

“We want this harassment to end. The hospital should not have such a clause. This is the second such incident reported from the hospital,” Usha Krishna Kumar, president of the Malyalee Nurses Association and wife of former Union Minister S Krishna Kumar, said.

“Yesterday, the authorities were not willing to listen to anything the nurses had to say. Today, after the matter has snowballed, they maintain that the nurses have not been terminated,” she said.

Sanjay M · Post by **Sanjay M** » 02 Jun 2009 18:06

Businessweek:

India's Growing Healthcare Burden

Avinash R · Post by **Avinash R** » 05 Jun 2009 14:45

Eating curry can prevent dementia: Researcher
http://www.hindu.com/thehindu/holnus/09 ... 041180.htm
--
The gist of the article is turmeric is good for mental health by preventing acculumation of toxins in the brain.

IndraD · Post by **IndraD** » 06 Jun 2009 10:42

http://timesofindia.indiatimes.com/Is-M ... 623398.cms

MBBS & MD SEATS FOR SALE IN COLLABORATION WITH MCI

Incidentally, Desai was asked to step down from the MCI president’s post in 2001 following corruption charges, but was re-elected in March.

Rampant corruption, right from MCI to Health minister is involved. It is a huge mafia. Ketan Desai (MCI President) is a product of BJMC Ahmedabad and one time he was so powerful (while still a MS student) that MCh seat in urology was created for him.

The colleges themselves are, of course, directly responsible for the scam, but it now appears so is the so-called regulator, Medical Council of India. The MCI boss Ketan Desai is himself on the board of one of the colleges that has been caught asking for lakhs of rupees for admission. According to the Delhi High Court, MCI is a ``den of corruption'', and yet the government has done nothing to clean it up and add moral fibre to the regulator.

Actually, the government is possibly more culpable than just being negligent. It has granted ``deemed university'' status to unproven and at times questionable educational bodies. The status of ``deemed university'' is usually given to an institution which has been attached to a university, and over a period of time, proved to be sufficiently efficient, mature and responsible to be able to work autonomously. There are now instances of educational institutions starting off as deemed universities! This makes sarkari recklessness, if not complicity, pretty apparent

Vipul · Post by **Vipul** » 08 Jun 2009 18:38

Bangalore hospital claims successful stemcell transplant for traumatic brain injury.

A team of neurosurgeons led by NK Venkataramana, chief neurosurgeon and vice-chairman of superspeciality hospital BGS Global, is reported to have successfully completed brain stem cell transplant on a 27-year old woman - the first such brain transplant in the country.

The woman, Madhu Mallika, who sustained severe brain injury in an accident last year, has been suffering from severe disability for the past one year following an accident, the report said.

"The patient was suffering from altered sensorium, severe cognitive dysfunction and lack of movement in limbs. Following the surgery, she has now regained full consciousness, memory, communication abilities and purposive movements in limbs," Venkataramana said.

He said the doctors had initially given the patient, admitted in an unconscious state with severe injury, only 20 per cent chances for survival.

"It was perplexing that the woman did not show any improvement despite all available treatment in the last one year and ultimately the possibility of stemcell therapy was considered after discussions with her family and it proved successful," the chief neurosurgeon said.

"This is an eye opener that there is a possibility of reactivating brain cells following injury with very gratifying clinical results. To our knowledge such attempts were made only in China. This is the first attempt in the country and India is the second country in the world to use such therapy," he said.

Sanjay M · Post by **Sanjay M** » 09 Jun 2009 17:00

Personal Genetic Testing Comes of Age

http://www.technologyreview.com/biomedicine/22765/

Is there a market for this in India, a country where prospective spouses are evaluated for arranged marriages, and where some families even seek out gender tests to decide on whether to abort fetuses?

Personally, I think India could become the eugenics capital of the world

rohitvats · Post by **rohitvats** » 09 Jun 2009 17:54

Posting a query to the learned jirga:

1. What is the correlation between the size of the population and requirement for health services?
2. When I say requirement for health services, the same can be broken down into the requirement for hospitalization and OPD services. I know the WHO standard says requirement of 4 beds per 1000 people. What I want to know is how does this ratio come about? Is there any statistical reference as in a given population X no of people will fall ill and require hospital beds?
3. Any reference to sources/studies etc are welcome.

Thanx in Advance

IndraD · Post by **IndraD** » 16 Jun 2009 11:11

Fleeing patients prove hospitals are sick

If suspected H1N1 patients are doing so – a man allegedly absconded from RML Hospital within hours of being admitted in the wee hours of Saturday with flu-like symptoms – then it is high time to look at the facilities these hospitals provide.
The supreme irony of the situation is that while government hospitals are funded with tax-payers’ money yet the facilities they offer are good enough only for people who have nowhere else to go and are frequently outside the tax-paying bracket. And it takes an ``elitist’’ disease like H1N1 infection – most people who contracted it have just come back from abroad – to expose the pathetic conditions in government hospitals.

putnanja · Post by **putnanja** » 25 Jun 2009 04:10

Pentavalent vaccine likely to be introduced in India soon

The long-pending proposal to introduce pentavalent vaccine in the National Immunisation Programme is likely to take off soon. The plan has already been cleared by the Expenditure Finance Committee (EFC) and will be put up before the Cabinet soon.
...
A single shot of the vaccine has antigens of five diseases —Diphtheria, Pertussis, Tetanus, Hepatitis B and HIB. Its introduction in India was recommended by the National Technical Advisory Group on Immunisation (NTAGI) two years ago.
...

Jamal K. Malik · Post by **Jamal K. Malik** » 25 Jun 2009 22:05

Drug patent pool proposal gets a push
http://www.thehindubusinessline.com/200 ... 380100.htm

Concerned over the changing intellectual property (IP) environment, where medicines are getting patented across the world, UNITAID had proposed a “patent pool” to make drugs more accessible.

suryag · Post by **suryag** » 27 Jun 2009 12:19

Do the INC guys mean business by any chance ?

Massive pay hike for doctors serving in rural areas
http://ibnlive.in.com/news/massive-pay- ... 771-3.html

IndraD · Post by **IndraD** » 27 Jun 2009 12:44

suryag wrote:Do the INC guys mean business by any chance ?

Massive pay hike for doctors serving in rural areas
http://ibnlive.in.com/news/massive-pay- ... 771-3.html

That was a fantastic input suryag. But working in these naxal infested areas is not easy many at times doctors get abducted for removal of bullets/sharpnels etc, but this is a welcome change in a country where rural health care is non existent. I recommend fixed tenure posting of doctors plus improvement of law and order and infrastructure in these areas. I hope medicines/drugs/antisnake venoms/minor operation theatres et are made available in these primary health centres.

these are areas of concern...!! I hope docs get insurance for life as well.

The most difficult areas have been identified as Naxal-affected districts of Jharkhand, Chhattisgarh, Madhya Pradesh and Bihar, remote areas in the North-East, interiors of Jammu and Kashmir, the Thar Desert stretch of Rajasthan, Lakshwadeep and the Andaman and Nicobar Islands.

IndraD · Post by **IndraD** » 27 Jun 2009 13:02

http://linkinghub.elsevier.com/retrieve ... 8303001633

Non existent trauma care system in India

Trauma-care systems in India are at a nascent stage of development. Industrialised cities, rural towns and villages coexist, with almost complete lack of organised trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints and lack of appropriate health infrastructure. There is no national lead agency to co-ordinate various components of a trauma system. No mechanism for accreditation of trauma centres and professionals exists. Education in trauma life-support (TLS) skills has only recently become available. A nation-wide survey encompassing various facilities has demonstrated significant deficiencies in current trauma systems.

Although injury is a major public-health problem, the Government of India has failed to recognise it as a priority. Significant efforts to develop trauma-care systems across the country are seen mainly in the private sector. New initiatives under National Health Policy 2002 are expected to result in improvement in the systems, but the allocation of funds remains grossly inadequate for any significant impact on the outcome.

Infant mortality doubles in Delhi

But there is a rider. Only women from reserved categories and those below the poverty line can benefit from these schemes as the urban poor women are excluded. The schemes also don't cover young mothers who are below 19 years of age

Jamal K. Malik · Post by **Jamal K. Malik** » 30 Jun 2009 22:21

Bharat's unit to manufacture 100 mn doses of animal vaccine
http://www.ddinews.gov.in/Health/animal+vaccines.htm

Bharat Biotech International Ltd, vaccines manufacturer, on Tuesday said it is in the process of setting up a Rs 100-crore unit near Bangalore that will manufacture 100 million doses of animal vaccines.

Jamal K. Malik · Post by **Jamal K. Malik** » 02 Jul 2009 00:10

Higher incentives to doctors working in rural areas: Azad
http://www.ddinews.gov.in/National/Nati ... satyam.htm

In a bid to shore up health facilities in rural areas, the govt has said doctors and medical practitioners working in such areas would be given significantly higher incentives "sometimes even double" than their counterparts in urban localities.

Ameet · Post by **Ameet** » 06 Jul 2009 10:54

PBS Special on Aravind Hospital

http://www.pbs.org/wnet/religionandethi ... ital/3449/

IndraD · Post by **IndraD** » 27 Jul 2009 12:50

Who will heal the doctors. PG residents in Gujarat are on strike since many days demanding a rise in stipend. Today when stipend for PG residents in Delhi and NCT is Rs 55 ooo a month, doctors are paid in penny at other places because govt knows PG degree is a must. Unless there is centralization of postgraduate training this situation will not improve. During my MD training I also got meagre stipend while my engg counterpart friends were firmly establising in software and management etc. No wonder aspirants for medicine has come down while that for IIT has increase 3 fold

Gujarat Global News Network, Ahmedabad

Two more babies died in Vadodara as the indefinite strike by junior doctors in Gujarat entered the third day today. This has taken toll in the Vadodara hospital to seven as five babies had died yesterday. However, agitating doctors claim that they were not responsible for the deaths. The babies died in the neo natal intensive care unit of SSG hospital of Vadodara.

Junior doctors across the state are on strike demanding increase in their stipend. They had gone on strike earlier last year, but withdrew it after the government assured them further increase. They want the stipend to be increased from Rs 11,400 to Rs 27,000. The doctors have been organizing blood donation camps and leading silent rallies in different cities.

Meanwhile, the Family welfare department says that a committee was formed to look into the problem two months ago and it was expected to submit its report within two months.

Pranav · Post by **Pranav** » 31 Jul 2009 12:14

Swine flu vaccines to contain mercury, which causes neurological damage, in addition to squalene, which causes auto-immune disorders:

http://www.prisonplanet.com/washington- ... rcury.html

http://blogs.mercola.com/sites/vitalvot ... posed.aspx

Omar · Post by **Omar** » 01 Aug 2009 08:44

Two more babies died in Vadodara as the indefinite strike by junior doctors in Gujarat entered the third day today. This has taken toll in the Vadodara hospital to seven as five babies had died yesterday. However, agitating doctors claim that they were not responsible for the deaths. The babies died in the neo natal intensive care unit of SSG hospital of Vadodara.

A frightening scenario. Couldn't these premies be evacuated to another center that could care for them? For example, before Hurricane Ike hit Galveston, TX; the NICU and other ICU patients were transferred to hospital throughout Texas thus a repeat of the Hurricane Katria fiasco was avoided.

Omar · Post by **Omar** » 01 Aug 2009 09:03

IndraD:

I found my answer in a paper published by the same author of the review you posted earlier on the thread. However, I disagree with author's assertion that trauma care should be a central government directed effort. It needs to be an effort spearheaded by relevant medical societies analogous to how the American College of Surgeons publishes and updates ATLS guidelines in the US, designates which hospitals can be level 1,2,3 trauma centers etc.etc. Central government involvment has the potential to make a huge mess of the system especially if it tries to incentivize construction of, conversion of, or classification of trauma centers.