Healthcare in India

The Indian Air Force  has launched a mobile health (mhealth) app to provide health information to the users, including first-aid and other health and nutritional topics

The 'MedWatch' was launched on 8 October on the occasion of IAF's 85th anniversary and was conceived by the doctors of IAF and developed in-house by Directorate of Information Technology (DIT)

"'MedWatch' will provide correct, Scientific and authentic health information to air warriors and all citizens of India.

The app comprises a host of features like information on basic First Aid, health topics and nutritional facts; reminders for timely Medical Review, vaccination and utility tools like Health Record Card, BMI calculator, helpline numbers and web links

The 'MedWatch' is first such health app to be built by any of the three armed forces.

check out the press release : http://pib.nic.in/newsite/PrintRelease.aspx?relid=171664

check out the original unedited article : https://www.firstpost.com/tech/science/indian-air-force-launches-medwatch-a-mobile-health-app-on-its-85th-anniversary-5349871.html

The World Bank came forward to fund for the development of 7,500 health sub-centres as electronic sub-centres (e-sub-centres). As part of the programme, e-health records would be maintained in all the e-sub-centres apart from extending telemedicine facility.

The e-health centres include 1,147 Primary Health Centres (PHCs), 192 Community Health Centres (CHCs), 31 area hospitals, 13 district hospitals and 23 teaching hospitals.

The World Bank (WB) team comprising Programme Leader (Human Development) Jorge Coarasa, Senior Operations Officer Kari Hurt and health specialist Mohini Kak met Chief Minister N. Chandrababu Naidu on Tuesday.

Explaining the government’s efforts in improving health services in the State, Mr. Naidu suggested the visiting team to provide expertise to fill the gaps in medical and health services. The government has introduced IT-enabled health services. However, introduction of some more global practices was required to further improve the services.

The government has been releasing health bulletin every month and sufficient data was available, he said, adding, the WB can extend its cooperation in research and innovation.

Electronic records to be maintained apart from extending telemedicine facility

Read the whole story at https://www.thehindu.com/news/national/andhra-pradesh/world-bank-to-assist-state-in-transforming-health/article25106584.ece

"We have finalised fresh guidelines to promote and market medical tourism by sufficiently incentivising tour operators and market facilitators to cash in on its hidden potential that hitherto stays untapped and unexplored," tourism secretary Parvez Dewan said.

He was speaking at the inauguration of "Medical and Wellness Tourism Summit -2014" here that was organised by PHD Chamber of Commerce and Industry.

According to Dewan, these incentives would also be extended to NGOs for the promotion of eco-tourism.

Without elaborating much, he said these incentives would comprise "part reimbursement of expenses, undertaken by tour operators and market facilitators to propagate medical tourism in India and overseas".

more at http://www.indiatimes.com/lifestyle/travel/centre-to-promote-medical-tourism-164146.html

Promising ‘extraordinary’ steps in the health sector by the Modi government, Union Minister Harsh Vardhan today said a mass movement will be built for implementing various policies and programmes in the coming months. ‘I can say with confidence that our government under the leadership of Narendra Modi is committed to health sector in the country and intends to do extraordinary work in this field,’ the Health Minister said. 

In this regard, he called for building a ‘mass-movement’ involving everyone in the policies and programmes so as to make India a healthy society. The Minister said everyone should take pride in the fact that India today is a polio-free country.

The government has earmarked Rs 39,237.82 crore for the health sector in this year’s general budget. Finance Minister Arun Jaitley had also promised that the government would take up on priority basis initiatives such as providing free drugs and diagnostic services while aiming to ensure ‘Health for All’.

He had also announced earmarking of Rs 500 crore to set up four more AIIMS-like institutes. Both Vardhan and Lok Sabha Speaker Sumitra Mahajan were attending the foundation day celebration of International Vaish Federation which was inaugurated by Tamil Nadu Governor K Rosaiah. The Speaker called upon the Vaish community to work for the welfare of the citizens. Men and women should commit themselves to the betterment of society, she said.

Improve healthcare services in rural areas

The former minister Ghulam Nabi Azad tried hard to convince docs to spend some time in rural areas without much success and Dr Harsh Vardhan is walking down the same road, perhaps convinced that it’ll improve healthcare services. Replying in Question Hour in the Rajya Sabha, he said the central government would create a mechanism to ensure docs are available in rural dispensaries and centres.  ‘One way to do it, which will be feasible and acceptable to all, is that during the PG courses, medical students can be asked to spend a fixed duration in rural health centres,’ Harsh Vardhan said.

Malaria and dengue prevention

The minister asked all states to take malaria and dengue prevention measures on a war footing and hoped to make a new beginning in battling these ailments.  ‘Dengue and malaria strikes with sickening regularity every year resulting in many deaths. Prevention of this tragedy is easy only if the prevention protocol is implemented with commitment,’ he said. ‘Let us make a new beginning. Let us not be complacent if the number of victims this year is less than last year’s. We must aim for zero incidences within two to three years,’ he said. He believes that 80% success rate is feasible if well-known preventive measures are implemented. 

more at http://www.thehealthsite.com/news/harsh-vardhan-promises-better-healthcare-under-namo-government/

Heart diseases are one of the leading causes of death in India. 80 per cent of the Indian population succumbs to a heart problem. If you are running helter-skelter for the best heart hospitals in India, ‘check-in’ either of these top cardiac care hospitals in India.

more at http://www.indiatimes.com/lifestyle/health-and-fitness/top-5-cardiac-care-hospitals-in-india-154043.html

Do you still have a family physician? - In the time of super-specialisation in medicine and healthcare, patients seem to bemoan the scarcity of the family doctor who cured their sniffles without making them undergo a battery of tests. Where is the general physician now?

Sorry situation

India produces nearly 42,000 MBBS doctors every year. But of these, only 8,000 to 10,000 take up general medical practice as a profession

India does not offer an MD in family medicine. Of close to 8,000 seats that are reserved for a 3-year PG course offered by the Diplomate of National Board, only 5–6% of seats are allotted to family medicine

Another reason general practice is on the decline is that fresh MBBS graduates avoid practicing family medicine as a career because it pays less

Read the whole story at http://www.dnaindia.com/health/report-do-you-still-have-a-family-physician-1964306

The days of doctors’ prescriptions being parallel lines of illegible scrawls punctuated by the odd circle to indicate dosage, may soon be a thing of the past.

The executive committee of the Medical Council of India has decided that doctors should only write prescriptions in capital letters.

If the prescription also includes other remarks such as dietary advice or recommended tests, then at least the drug names and dosages should be written clearly in capitals, the committee has ruled.

Letters to this effect will soon be sent to all medical colleges, MCI chairperson Dr Jayshreeben Mehta told The Indian Express Monday.

“The executive committee has just passed this proposal. The committee unanimously felt that drug names and dosages are at times not clearly written in prescriptions causing a lot of confusion among both chemists and patients. That is why we have decided that all prescriptions should be in capital letters. Once the order comes out, it will be sent to all medical colleges,” Mehta said.

Committee members, sources said, made a strong pitch for all-caps prescriptions on the ground that misreading even a single letter can alter the name of a drug dramatically and lead to disastrous consequences for the patient. 

Doctors have welcomed the move but health ministry sources said they had no information about the decision.

more at http://indianexpress.com/article/india/india-others/mci-tells-doctors-use-block-letters-when-you-write-prescriptions/

Millions of Indians suffering chronic pain will get better access to pain medicines following changes in India’s drug law, Human Rights Watch said today. On February 21, 2014, the Rajya Sabha, the upper house of parliament, approved amendments to the Narcotic Drugs and Psychotropic Substances Act (the Drug Act) that  the lower house had approved a day earlier.

The amendments eliminate archaic rules that obligated hospitals and pharmacies to obtain four or five licenses, each from a different government agency, every time they wanted to purchase strong pain medicines. As Human Rights Watch documented in a 2009 report, “Unbearable Pain: India's Obligation to Ensure Palliative Care,” this resulted in the virtual disappearance of morphine, an essential medicine for strong pain, from Indian hospitals, including from most specialized cancer centers.

“The revised Drug Act is very good news for people with pain in India,” said Diederik Lohman, senior health researcher at Human Rights Watch. “These changes will help spare millions of people the indignity of suffering needlessly from severe pain.”

Patients who experience severe pain without access to adequate treatment face enormous suffering. Like victims of torture, these patients have often told Human Rights Watch that the pain was intolerable and that they would do anything to make it stop. Many said that they saw death as the only way out and some said they had become suicidal.

The amendments to the Drug Act give the central government authority to regulate so-called “narcotic drugs,” require a single license to procure morphine and other strong opioid medications, and charge one government agency, the state drug controller, with enforcement. The government introduced the amendments to the Drug Act in 2012.

more at http://www.hrw.org/news/2014/02/21/india-major-breakthrough-pain-patients

The couple, unaware that Hiranandani did not allow any other service provider to collect stem cells, had made an arrangement with LifeCell International. They had paid an advance of Rs 60,000 for the banking, that lasts up to 21 years. A complaint was lodged in June 2012, after which a probe was ordered by the Competition Commission of India (CCI). 

Hiranandani's refusal came when the couple went to seek permission to allow the LifeCell representative to collect the stem cell on the day the baby was born. Stem cells must be collected shortly after a baby is born. Hiranandani cited its tie-up with Cryobank for denying entry to another company representative on its premises. The couple tried to reason with the hospital and then decided to shift to SevenHills Hospital, Marol, for the delivery. 

The body, while penalizing the company 4% of its annual turnover of the last three years, said the hospital should behave ethically towards patients. It said the hospital's arrangement was based more on a commission model rather than competition and that was "against the spirit of health services". CCI found that Cryobank was paying the hospital Rs 20,000 for every patient who opted for stem cell banking. This practice is common in the industry. 

The industry hailed CCI's decision. "Patients deserve to be given a fair choice. The industry is new and such pacts can hamper its growth," said Meghnath Roy Chowdhry, secretary, Association ofStem Cell Banks of India (ASBI). Gynecologists said most city hospitals affiliate more than one player though the practice may be different for nursing homes. "Each company may have something better to offer. As doctors we only explain the benefits and disadvantages of storing stem cells, but beyond that the choice is with the patients," said Dr Suchitra Pandit, president, Federation of Obstetric and Gynecological Societies of India. 

more at http://timesofindia.indiatimes.com/city/mumbai/Hospital-warned-against-deal-with-stem-cell-banks/articleshow/30817366.cms

Kerela Health Department’s ambitious e-health project has managed to complete a tumultuous pilot phase with “significant achievements” on one side and much valuable lessons learnt on the other.

However, scaling up of the project across the State could remain a far-fetched dream, as the financial investment it entails is huge and the technical challenges immense, it is feared.

The ₹96-crore project envisages the development of an electronic demographic data base, electronic health records (EHRs) of a population and end-to-end automation of all government hospitals.

With less than ₹30 crore Central funds remaining to be secured, finding funds to sustain the project in the long term is a challenge that the Health Department will have to face head on.

read more at https://www.thehindu.com/news/national/kerala/funds-crunch-may-hit-e-health-project/article25215358.ece

The doctors writing prescriptions in illegible handwritings are under the scrutiny of law in Uttar Pradesh now. The Lucknow bench of Allahabad court set an example by imposing fine of Rs 5,000 each on doctors writing in “poor handwriting”.

Three different cases of doctors writing in running handwriting were reported from Unnao, Sitapur and Gonda district hospitals. The injury reports of the patients were said to be “not readable”

curated from  https://timesofindia.indiatimes.com/city/lucknow/court-fines-doctors-rs-5000-for-poor-handwriting/articleshow/66061795.cms

and   https://www.news18.com/news/india/up-court-fumes-over-shabby-handwriting-of-doctors-slaps-rs-5000-fine-1898123.html

On October 3, 1978, due to the pioneering effort of Dr Subhash Mukhopadhyay and his team in Calcutta, a girl—Durga—was born through IVF. It was the second such attempt in the world, a repeat of what his English counterparts Robert G Edwards and Patrick Steptoe had achieved barely days ago, on July 25. The news boded well for thousands of infertile couples, but there was no noise around the achievement. Perhaps because the couple chose to keep mum and didn’t want themselves or the child’s image to be shaped by the manner of conception. Battling ignominy and failure to be recognised for his monumental work led him to take his life on June 19, 1981. But recognition did come his way, posthumously, and 25 years after the birth of Durga, the physician was “officially” regarded as the first doctor to perform IVF in India. Later on August 6, 1986, Dr Indira Hinduja and Dr Kusum Zaveri helped deliver—Harsha—India’s first test tube baby.

Now, State-of-the-art-technologies are making their parenthood dream of many come true

A latest Ernst & Young (E&Y) report records high prevalence of infertility affecting nearly 10-15 percent of married couples in India, of which women account for 40-50 percent. Infertility attributable to male factors is on the rise and constitutes 30-40 percent of the segment.

Only 1 percent of infertile couples in India seek treatment, says the E&Y report. It highlights the rise in the population of women in reproductive age (20-44). This proportion could go up by 14 percent between 2010 and 2020. The climb is skewed towards women aged between 30 and 44 (20 percent increase estimated between 2010 and 2020), who typically display lower fertility rates. This shifting demographic trend coupled with rising contraceptive use is likely to scale up infertility rates in India.
Age has an important part to play in conception.

Tech to Rescue

The fertility treatment landscape has drastically improved over the years. The services at a fertility centre range from the simplest that involves IUI to the most advanced ones such as IVF,
IMSI (intracytoplasmic morphologically selected sperm injection), ICSI (intra-cytoplasmic sperm injection) and PICSI (a new method of sperm selection for ICSI).Today any IVF specialist is lucky to possess the latest techniques to combat the disadvantage of advanced maternal age, prevent unnecessary transfer of embryos, prevent and reduce implantation failure and give quick results. 

Performing genetic diagnosis prior to embryo implantation could prevent abnormal pregnancies. Various categories of hopeful mothers are advised this screening method. They are:

1. Women who suffered repeated implantation failure or recurrent pregnancy loss while undergoing IVF
2. Patients aged 35 years
3. Women with recurrent miscarriages after IVF
4. Women with a positive history of chromosomal aneuploidies in the family or are diagnosed carriers of chromosomal abnormalities
5. Or have a combination of some of the above factors

read more at http://www.newindianexpress.com/magazine/2018/sep/30/the-great-baby-race-1878013.html

The Internet is creating new-age hypochondriacs, an all-India doctors’ survey reveals

A recent survey, conducted across 27 cities including Mumbai, Pune, Delhi, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad revealed that doctors have been struggling to deal with patients who use the internet to find out what ails them.

Making matters worse are hundreds of thousands of online forums where people discuss their ailments and symptoms, which often result in patients indulging in self-medication, and also end up arguing with doctors upon being told that their ailmentisnotevenclosetotheworsediseasestheyhad imagined, said majority of the 650 doctors who participated in the survey.

The doctors, including specialists and super specialists, termed people's increasing dependence on the internet to find medical cures and search for symptoms as a "major strain on the doctor-patient relationship".

Overloaded with information 
Forty-four per cent of the 650 doctors surveyed said that most of their patients were "overloaded with information", while 37 per cent doctors were of the opinion that their patients considered themselves "medical experts" after reading about the ailments on the internet.

As many as 38 per cent of the doctors surveyed said that majority of their patients who participated in online forums to discuss their ailments were "grossly misinformed" about the symptoms.

Dr Pratit Samdani, a general physician at the Breach Candy Hospital said he often comes across patients who imagine the worst after an online search of the ailments.

"One of my patients, a woman in her 30s, was convinced she was suffering from lung cancer. She had been coughing incessantly, and obviously the internet search said it was the most basic symptom of lung cancer. She assumed the worst, but it turned out to be a very minor infection," he said.

Dr Bharat Shivdasani, a cardiologist at Jaslok Hospital, said that it becomes difficult to convince patients who are loaded with "internet information". He said,"A few weeks ago,a man in his 40s visited me for consultation. He was convinced that he suffered from a heart ailment only because he was experiencing pain in left arm. When I told him that was not the case, he ended up arguing with me."

Samdani termed the internet a "medical menace", saying the woman who had assumed she was suffering from cancer insisted on undergoing a series of tests. "I spent an hour trying to convince her that she didn't need to undergo the tests. Internet cannot diagnose ailments or treat anyone," he said.

The survey, conducted by Ipsos Healthcare and Ruder Finn, an international public relations firm, aims to educate people on the dangers of 'over-information' when it comes to ailments. One such victim of medical overload, Dahisar resident Vikas Vyas, said he recently spent sleepless nights assuming the worst of diseases after searching the causes of throat pain on the internet.

The curse of internet 
Out of the 650 doctors surveyed, 44% said their patients were "overloaded with medical info gathered online". Thirty-seven per cent doctors said that many of their patients think of themselves as medical experts.

Fifty per cent of the doctors surveyed said internet has made their interaction with patients "difficult".

more at http://timesofindia.indiatimes.com/life-style/health-fitness/health/Doc-the-internet-says-I-have-cancer/articleshow/33815433.cms

In a bizarre move, the Medical Council of India(MCI) — the apex regulatory body of doctors and the medical practice in the country — has decided to shrink its own jurisdiction. It has reinterpreted its code of ethics regulations as being applicable only to individual doctors and not doctors' associations. 

Clause 6.8 of the Code of Medical Ethics Regulation 2002 clearly states that it pertains to "code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry". However, the executive committee of the new MCI in its meeting on February 18 decided that the term "association of doctors" be deleted from the clause. It went on to add that any action it took it against any association of doctors by virtue of clause 6.8 shall be nullified and that such proceedings would stand annulled. 

In effect, the MCI has stated that the action it took against the Indian Medical Association (IMA) for endorsing products of Pepsi and Dabur in exchanges for crores of rupees or against the Indian Academy of Paediatrics for accepting funding from pharmaceutical companies will no longer be valid. 

"It is a ridiculous position. The MCI itself had argued in an affidavit filed in the Delhi high court that what is prohibited for an individual doctor cannot be done by the doctor along with another bunch of doctors by forming an association," said Dr K V Babu, who had filed the original complaint against the IMA for endorsing products. 

Endorsement is expressly forbidden by the code of ethics, which says that no doctor ought to endorse any commercial product or drug or therapeutic article. In November 2010, the MCI had initiated action against officer bearers of the IMA on the endorsement issue. When one of the office bearers challenged the removal of his name from the medical register for six months before the high court, the MCI had argued in its affidavit that "...what is not allowed to be done directly cannot be permitted to be done indirectly".

more at http://timesofindia.indiatimes.com/india/MCI-shrinks-own-ambit-doctor-bodies-out-of-ethics-code/articleshow/30873980.cms

FDA Commissioner Margaret A. Hamburg, M.D., contrasted the craftsmanship and beauty of India’s Taj Mahal with recent lapses in quality by “a handful” of the country’s drug manufacturers during a recent visit there. If the comparison was meant to flatter the domestic pharma executives and regulators with whom she met, they didn’t appear to think so.

Dr. Hamburg and officials from India’s Ministry of Health and Family Welfare pledged cooperation in data sharing and even “medical and cosmetic product and inspections conducted by the other Participant.” That’s no small promise since India is the world’s second largest exporter of prescription and over-the-counter drugs. Yet their formal Statement of Intent conditioned such cooperation “as time and resources allow” and didn’t set specific terms.

In a conference call with reporters today, Dr. Hamburg said implementing the statement was a five-year commitment “already under way” as both countries “have already embarked upon some cross-training activities and started to identify some critical areas for future activities together, so I think progress will be made.”

Indian drugmaker Ranbaxy has come under repeated FDA scrutiny. It agreed last year to pay a $500 million fine for safety and record-keeping violations. More recently, it urged Dr. Hamburg to lift the FDA’s consent decree. Extended as of January, this decree effectively bans four of Ranbaxy’s Indian plants from exporting active pharmaceutical ingredients to the United States. Although Ranbaxy contended that it needed the export activity to fund FDA-sought quality improvements, Dr. Hamburg declined the company’s request.

According to the All India Chemists and Druggists Association data reported by Indian newspaper The Economic Times, Mumbai-based Glenmark Pharmaceuticals impacted the Rs 3,000 crore ($483.7 million) Indian diabetes drug market long dominated by multinationals last year. Glenmark racked up Rs 16 crore ($2.58 million) in eight months for its Zitamed and Zita generic versions of sitagliptin

These generics sold 30% cheaper than the Januvia and Janumet branded drugs of market leader Merck & Co., which generated more than $5.8 billion in combined global 2013 sales for Merck and are the subject of a patent dispute between the companies.

Through court decisions and regulatory actions, Indian officials have pressed foreign-based multinationals for lower-cost drugs. These multinationals, however, have argued that Indian actions hinder their ability to do business selling innovative if costlier drugs.

As part of its plans to propagate the benefits of traditional Indian form of medicine, leading Ayurvedic healthcare company Dabur India Ltd today launched 'Ayurveda Samvad', India's first Ayurvedic Medical Journal. 

The quarterly journal was unveiled by Shailaja Chandra, General Secretary, AYUSH, Government of India. 

The quarterly publication will cover detailed information on various clinical trials being conducted on Ayurvedic medicines.

Announcing the launch, Dabur India Ltd Ayurveda R&D Head Dr J L N Sastry said the journal would cover the holistic approach on Ayurveda. It would popularise Ayurveda and reach out to the doctor fraternity to propagate messages on the Ayurvedic way of life to manage health and diseases. 

The journal will feature articles covering original scientific studies in the field of Ayurvedic medicines with direct clinical significance, addressing health care issues and public health policy. 

more at http://www.business-standard.com/article/pti-stories/dabur-launches-india-s-first-ayurvedic-medical-journal-114022200250_1.html