Vitamin C improves the efficacy of TB drugs

Adding vitamin C as a nutritional supplement while treating drug-sensitive tuberculosis patients with first-line TB drugs will boost the efficiency of treatment, a study by Indian researchers shows. The increase in efficiency is not because vitamin C has antibacterial activity, as was suggested by a few researchers in 2013 from in vitro studies, but by doing the complete opposite — inducing dormancy in TB bacteria.

A team led by Prof. Jaya Sivaswami Tyagi from the Department of Biotechnology at AIIMS, New Delhi had first proposed the dormancy-inducing ability of vitamin C in TB bacilli in 2010 and has now reconfirmed it in a comprehensive study published in the journal Redox Biology.

The team found that vitamin C imposes multiple stresses on TB bacteria such as hypoxia, acid stress (where the pH is reduced to around 5.5), oxidative stress (through the generation of H2O2 and reactive oxygen species), reductive stress (due to cessation of aerobic respiration) and metabolic stress. “As a result of these stresses, there is slowing down of metabolism leading to dormancy and further progression to viable but non-culturable (VBNC) state,” says Prof. Tyagi. “Together, these stresses remarkably resemble the host environment that the bacteria would face.”

In the lab, TB bacteria already exposed to vitamin C displayed resistance to two first-line drugs — isoniazid and rifampicin — as it progressed to a dormant state. Unlike these two drugs, pyrazinamide drug is capable of killing TB bacteria even in a dormant state. “The addition of vitamin C increased the population of dormant bacteria and this led to an eight-fold increase in pyrazinamide’s ability to kill the bacteria. There was also a four-fold decrease in the minimum concentration (MIC) of pyrazinamide required to kill the bacteria even in an infection model,” says Dr. Kriti Sikri from the Department of Biotechnology, AIIMS and first author of the paper.

In the presence of pyrazinamide alone nearly 90% of the bacteria survived but when combined with vitamin C, the survival rate in vitro dropped sharply to less than 3%. “Vitamin C induces dormancy and enhances the population of slowly growing bacteria or bacteria that are not growing. And pyrazinamide drug targets these bacteria bringing about sharp reduction in the survival rate,” explains Prof. Tyagi. “The effect of vitamin C combined with TB drugs was reproduced in an intracellular model, which is akin to human infection. So, our findings acquire clinical relevance. When used along with other first-line drugs, vitamin C has the potential to shorten the treatment time.”

Screening novel drugs

Besides improving the efficacy of existing TB regimen, vitamin C can help in producing subclasses of bacteria to test new drugs. For instance, due to hypoxia, the metabolism gets slowed down leading to reductive stress. Lipids are formed as a compensatory mechanism and the breakdown of lipids produces energy. The AIIMS team used novel inhibitors to prevent the breakdown of lipids for energy purpose and this led to the death of TB bacteria.

Similarly, dormancy can be induced by adding vitamin C. Dormant bacteria are able to reduce the effectiveness of isoniazid and rifampicin by pumping them out using efflux pumps. The use of vitamin C can help in producing a population of dormant bacteria which can be used for screening drugs that inhibit efflux pumps, which the researchers were able to do. “We were able to reverse the tolerance and restore the bacterial sensitivity to these drugs by treating the bacteria with either of two efflux pump inhibitors — verapamil and piperine,” Prof. Tyagi says.

Likewise, vitamin C can be used for producing viable but non-culturable (VBNC) TB bacteria. Though VBNC bacteria are present in sputum samples they cannot be cultured and hence never identified leading to misdiagnosis. The VBNC bacteria can always reverse and cause disease. “Unlike reports that 100 days are required to produce VBNC bacteria, our model can generate them in just eight days, which can be used for screening drugs,” Prof. Tyagi says.

When used with first-line drugs, vitamin C can shorten the treatment time

Cancer hits more women in India than men, but more men die of it

Image result for Cancer hits more women in India than men, but more men die of it

Estrogen, the female sex hormone that shields young women against cardiovascular diseases, plays a role in her battle with cancer as well. It not only increases her chances of getting the disease, but also increases her chances of survival, say doctors. Statistics prove this. The World Health Organisation-developed statistical tool Globocan 2012 shows the Big C has afflicted more Indian women than men. But more Indian men died due to cancer than women, said the World Cancer Report 2014.
Doctors in Chandigarh’s Postgraduate Institute of Medical Education and Research (PGI-MER) surmise women are subjected to more medical attention in their lifespan, allowing cancers to be picked at an early stage and hence improving life expectancy.

Image result for Cancer hits more women in India than men, but more men die of it

In all, 5.37 lakh Indian women got cancer in 2012 as against 4.77 lakh men, said the World Cancer Report. But 75% of the men affected with cancer have low life expectancy, while the mortality rate of cancer in women is 60%. In 2012, 3.56 lakh men died of the disease in comparison to 3.26 lakh women.

Among all cancers in both sexes, incidence of breast cancer is highest at 1,44,937, while the cervix uteri is the second most frequently occurring one with 1,22,844 cases. The third most common cancer is of the lip and oral cavity with 53,842 men affected.

This gender bias in cancer is noticeable. Dr Rakesh Kapoor, department of radiotherapy at PGIMER, Chandigarh, said, “Women are subjected to more medical attention in their lifespan as compared to men. From antenatal checkup, menopause problems and menstrual disorder, women get investigated and, by default, screened for cancer. Therefore, cancers are picked up at an earlier stage and mortality is less.” He said most national policies for screening are directed more towards cancers that hit women such as breast cancer and cervix cancer, as they are non-invasive. “Also, men have prolonged exposure to lifestyle risk factors that cause cancer such as tobacco use, substance abuse and alcohol consumption,” Dr Kapoor added.

Why is cancer mortality higher among men? Doctors say this could be because the lung and oral cavity cancers that are the leading cancers among men are usually detected at a late stage. “95% of these cancers are due to tobacco consumption, and 40% of all cancers in India are due to tobacco abuse. Mortality is high as it is hard to detect these cancers. We come across patients during an advanced stage of the disease, so they are tough to treat,” said Dr Ravi Mehrotra, director of ICMR-affiliated National Institute of Cancer Prevention and Research.

The World Cancer Report estimates that of the 1,589,925 lung cancer deaths worldwide in 2012, 30.90% were of women and 69.10% of men. “Breast cancer is detected early, particularly in the western world. There is no screening of cancers in men,” said Dr Rajesh Dixit, professor of epidemiology at the Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai. As per ICMR’s latest cancer registry, breast cancer, with an estimated 1.5 lakh (over 10% of all cancers) new cases during 2016, is the number one cancer.

Not just lifestyle, geography too plays crucial role in mapping of cancer incidences

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Over two decades back, doctors at Tata Memorial Hospital, Mumbai, noticed that most gall bladder cancer patients were from the Gangetic belt states of Bihar, Uttar Pradesh or West Bengal. This led to a series of studies that found high concentration of heavy metals in the soil and ground water in this belt — a likely factor for high incidence of gall bladder cancer.
It is now well known that the incidence of gall bladder cancer is highest in the country’s eastern side while south India registers the lowest.

Environment and lifestyle are among the leading risks. The incidence of lung cancer is registering a rise in metros, be it Bengaluru or Delhi. Women in urban India are more likely to get breast cancer than those in rural areas.

The Indian government’s Million Death Study released in 2012 for the first time showed that that the area an Indian lives in, his economic and educational status and religion contribute to the malady’s outcome. A youngster from India’s northeast is four times more likely to develop and succumb to cancer than one from Bihar.

“There is growing evidence that environment and lifestyle can cause cancer in younger people as well,” said former director-general of ICMR, Dr Vishwa Mohan Katoch. “While some cancers are common, others are specific to a region,” he said, adding that in the Gangetic plains the risk of gall bladder cancer is very high due to polluted water, sediments in water and high consumption of animal protein and fish.

Every day, 1,500 people die of cancer in India, making it the second most common cause of death in India after cardiovascular disease. And nearly 2,000 new cancer cases are detected in the country daily, according to National Institute of Cancer Prevention and Research. Projections put the number of new cases by 2020 at 17.3 lakh.

In eastern India, rise in tobacco use has led to an increase in lung cancer among men, and rapid changes in food habits have made women more vulnerable to breast cancer, said Kolkata-based oncologist Gautam Mukhopadhyay.
 Common cancers in the north-east are oesophagus, stomach and hypopharynx. Registries in the north-east have also recorded the country’s highest incidence of nasopharynx and gall bladder in Nagaland and Kamrup in Assam.
In Bengaluru and Chennai more than a quarter of the total number of cancers in women are of the breast. Bengaluru-based Dr PP Bapsy said mass screening is most important to detect cancer early. “We need low cost, accessible treatment,” Dr Bapsy said.

Most oncologists insist that lifestyle changes will by itself bring down incidence. “By some magic, if everyone stopped using tobacco in India, we will have at 50% lesser cancer cases,” said Dr Rakesh Jalali, medical director of Apollo Proton Cancer Centre.

India’s cancer cases far lower than those in the West, yet death rate higher

Image result for India’s cancer cases far lower than those in the West, yet death rate higher

India’s cancer graphs tell two distinct stories. The first holds out hope as India’s cancer incidence is far lower than developed nations such as Denmark and the US. If cancer strikes over 300 out of every 100,000 population in Denmark, the corresponding number in India hovers around 80. But the second Indian cancer story is worrisome: cancer manages to get the upper hand in almost 70% of cases in India. A study in medical journal, The Lancet, in 2014 indicated only 30% of India’s cancer patients survive for over five years.
So while India has lower cancer rates than many other countries, it has a high death rate. Check the World Health Organisation’s Globocan 2012 report’s analysis for breast cancer: only 1 out every 5 or 6 women newly diagnosed with breast cancer died in the US, but corresponding figures in India stood at 1out of every 2 patients.

Experts said early detection could go a long way in reducing the high death rate caused due to illiteracy, fear and taboos. “In India, almost 50% of all cancers are seen in late stages. This is the reason our death rate is higher than western countries,” said senior medical oncologist Shona Nag.

Maximum cancer patients succumb to lung, head and neck and breast cancers. “We lose almost 80% of all patients detected with lung cancer. The death rate due to breast cancer world over is 20%, but we lose over 50% of our breast cancer patients,” Nag said.

Almost 80% of cervical cancer patients are diagnosed in stage 3-4 in India, but the West has almost eradicated this cancer due to regular pap smear tests. Given India’s population, it is impossible to scan everybody. “Self-breast exams and clinical exams involving community workers or ancillary health professionals are hence crucial,” she added.

Lack of awareness is the main cause for late detection. “In the western world, the culture is openness and they are more aware. Though we have facilities, we cannot reach out to such a huge population. Almost all cancers are detected at late stage in India mainly because of lack of awareness and social stigma,” said medical oncologist Anantbhushan Ranade.

Cancer surgeon Anupama Mane said, “We have women with 10 cm lumps who come to us late because the lump didn’t hurt or cause pain so they did not think a check was needed.” Moreover, men don’t discuss women’s health. “So a blood stain or excessive bleeding is dismissed and not taken up as cause for worry,” Mane said. Early detection is key to reduce mortality. “It is important to diagnose cancer early because then you have a chance at curing it. The spread and extent of it make it harder to control,” said oncosurgeon Snita Sinukumar. Lack of a dedicated health care system is one of the big reasons for higher deaths. “Just like Aadhar, we need to make it compulsory to invest in one’s own healthcare,” Sinukumar added.

A red alert for women

It is common to think of heart disease as a ‘man’s problem,’ but you could be in for a surprise. The last two decades in India have seen a steady rise in incidences of heart attack among women, especially those in the reproductive age.

A recent study in the United Kingdom published in Heart, an international peer-reviewed cardiology journal, has shown that women who started menstruating at age 11 or earlier, or entered menopause before 47 had a higher risk of heart disease and stroke. The findings of the team, led by Sanne A.E. Peters a research fellow at the George Institute for Global Health, University of Oxford, suggest that women who have premature reproductive cycles or a history of adverse events should get themselves checked for heart problems.

While there are no studies of a similar kind in India, cardiologists say a low level of oestrogen — on account of changing lifestyle and other co-morbid conditions — is among the key reasons why younger women develop cardiovascular disease (CVD).

Indian survey

In 2013, a survey conducted by a team of senior doctors, titled “Visualising the Extent of Heart Disease in Indian Women” (VEDNA), mapped the trends of cardiovascular diseases among women based on interviews with 577 cardiologists from across the country. They found that 54% of doctors had observed a 16%-20% rise in CVDs among women since 2009. An estimated 65% of the doctors surveyed also showed that they had found insufficient oestrogen to be one of the main causes for younger women developing heart diseases.

Dr. C.N. Manjunath, Director, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, who was part of the survey, says, “The most worrying factor is that it is affecting more women in the reproductive age group now, unlike in the past when women got it mostly after menopause.”

This, along with risk factors such as a higher prevalence of diabetes, obesity and related ailments and physical inactivity, have worsened the problem, he adds.

Another study at the institute last November, which involved 750 patients below the age of 40 with premature coronary heart disease, found that 16% of them were women.

“At least three of the women patients (two were aged 25 and one was 26) did not have any conventional risk factors, indirectly indicating that low levels of oestrogen could be the cause,” says Dr. Manjunath.

Dr. K.K. Aggarwal, President of the Heart Care Foundation of India and immediate past national president of Indian Medical Association says what is worrying is that women exhibit atypical symptoms that delay diagnosis.

“The warning signs of this disease are different from those seen in men. For example, women do not have the characteristic chest pain but may have a jaw pain. This is one of the reasons why women do not get diagnosed in time, thus exacerbating the condition further,” he says.

Traditionally, heart disease has never been thought to be a woman’s disease. Thus, when a woman complains of symptoms such as breathlessness, it is very often mistaken to be some other problem, he adds.

“The classic pattern of angina with pain on the left side of the chest may be absent in women. They are more likely to have atypical angina, in which they could experience discomfort in the shoulders, back, and neck. Apart from this, shortness of breath is often the first and only presenting symptom. All of this can make the diagnosis tricky,” Dr. Aggarwal explains.

Risk factors

The risk factors for heart disease in women include the regular ones such as smoking, high cholesterol, high blood pressure, lack of physical activity, and an unhealthy diet. There are also some specific ones which include the use of birth control and other hormone pills.

Doctors say the need of the hour is to create awareness about the fact that heart diseases can affect anyone irrespective of age or gender. Only early and corrective lifestyle changes and preventive measures can help in combating the risk factors and avoiding heart diseases. Women in particular need to be aware of the signs and symptoms and take adequate care of their health.

Prescription for the future

The National Medical Commission Bill, aimed at reforming Indian medical education and practice, is in trouble. After countrywide protests by the Indian Medical Association, the Bill was referred by the Lok Sabha to a Parliamentary Standing Committee for a re-look. Whatever be the outcome of this exercise, the altered Bill is unlikely to please everyone.

This is because the questions it seeks to address are knotty, with no straightforward answers. First, how can India produce enough competent doctors to meet its evolving health-care challenges? Second, how can it minimise opportunities for rent-seeking in medical education and practice? So poorly did India’s current medical regulator, the Medical Council of India (MCI), perform on both counts that policymakers believed the only way to redeem the body was to replace it.

MCI’s failures

The MCI’s failures are well known. For years, it was mired in allegations of bribery and going soft on unethical doctors. Under its stewardship, the medical curriculum grew obsolete, resulting in a cadre of MBBS doctors who frequently couldn’t perform basic procedures. This led to a rush among MBBS doctors to specialise, competing for a small number of post-graduation seats. Today, India neither has enough basic doctors, nor specialists.

Enter the National Medical Commission (NMC), intended by policymakers to be a dynamic regulator responsive to India’s needs, unlike the opaque MCI. In contrast with the MCI, which does everything from advising universities on curriculum to disciplining errant doctors, the NMC distributes powers among four autonomous boards — those for undergraduate education, postgraduate education, medical assessment and rating, and ethics and registration. Also, unlike the MCI, the commission includes non-doctors like patient-rights advocates and ethicists, in line with the medical regulators of the U.K., Australia and Canada. These are all steps in the right direction.

Where the NMC bill trips up is in how it chooses the members of the new regulator. The authors of the NMC bill, a committee headed by ex-vice chairman of Niti Aayog, Arvind Panagariya, argued that the electoral process through which MCI members were picked was fundamentally flawed, because conscientious doctors tended to avoid such elections. Because there was no bar on re-elections, this had created a revolving door through which the same group of members controlled the MCI for years. Sometime around 2008, Gujarati urologist Ketan Desai was elected MCI president, even though he had been prosecuted in the Delhi High Court for abusing power as president in 2001. Further, corruption charges against Dr. Desai and his team led to the MCI being disbanded in 2010.

The NMC Bill’s solution to the pitfalls of the electoral process is for the central government to select most of the commission’s members. But this would tip the scales towards bureaucracy, say experts. “The babudom is now extreme,” says Rama Baru, a health-policy researcher who served on the ethics committee of the MCI between 2012 and 2014. Such political hold on the commission is especially problematic, she adds, given the close ties that private medical colleges in southern India have with politicians. Ms. Baru is in favour of more elected members in the commission, but with limited terms of office, so that corrupt members aren’t re-elected.

Another option to keep the NMC free from political influence is for an independent body like the Union Public Service Commission to select its members, says Sujatha K. Rao, a former Union Health Secretary. Such a model is followed in the U.K., where the Professional Standards Authority oversees the selection of members to the General Medical Council. Whatever route the NMC takes, it is critical that its members are professionals of high integrity, something that isn’t ensured in the current Bill. “Any law will succeed if it is implemented by good people. The best law, if implemented by corrupt people, can fail,” says Ms. Rao.

Shortage of doctors

The NMC Bill also misses an opportunity to plan for India’s rural health- care needs in the coming decades. While it eases regulations to set up private medical colleges, a move that will hopefully produce more doctors, this measure isn’t enough. As of today, India has one doctor for 1,700 people, compared to the WHO norm of 1:1,000. Most of these doctors are in urban regions, while close to 70% of Indians live in rural provinces. This gap isn’t going to close any time soon. A 2015 Parliamentary Standing Committee report mentioned that even if India were to add 100 medical colleges per year for five years, it would take till 2029 to achieve the WHO prescribed ratio.

Even in States like Tamil Nadu, which has successfully attracted doctors to rural primary health centres (PHCs), tribal regions like Sittilingi are underserved and rely heavily on informal health-care providers, says Meenakshi Gautham, a health policy researcher at the London School of Hygiene and Tropical medicine. This is why India must think of quicker fixes to the doctor shortage instead of waiting for MBBS doctors to fill the gap. “We can’t ask populations here to wait for ten years till we produce enough doctors. Neither can we wait for rural areas to become urbanised,” she reasons.

Training non-doctors

Several sub-Saharan countries have successfully addressed this problem by training non-doctors in basic medicine and even surgery. Such non-doctors include nurses, or even informal health-care providers, often referred to as quacks. A 2016 study published in Science magazine showed that nine months of training led to a marked improvement in the ability of informal providers in West Bengal to correctly manage chest-pain, respiratory distress and childhood diarrhoea. International organisations like Médecins Sans Frontières and Red Cross have endorsed training programmes for non-doctors to carry out critical surgical procedures like caesarians and intestinal resections. Evidence from countries like Mozambique and Thailand shows that such training can be a safe, effective and cheap way to provide life-saving health care when no doctors are available. This is why even Chhattisgarh attempted to create a cadre of rural doctors in 2001, through a three-year programme. Even though the Indian Medical Association has strongly opposed such ideas, they cannot be off the table, given the evidence backing them. Ms. Gautham says it is time to recognise that MBBS doctors may not be the best means of health-care delivery in isolated parts of rural India. The NMC Bill should, at the very least, include a provision to debate this idea.

The 1956 Indian Medical Council Act, under which the MCI in its current form came to life, set the agenda for nearly 60 years of medical education and practice. The NMC Bill could do the same for the next few decades. If policymakers do not address the many questions that health-care experts have raised over the Bill today, they will miss their chance at truly game-changing reform.

Govt needs to increase healthcare outlay in budget: Report

Govt needs to increase healthcare outlay in budget: Report

Public sector accounts for only 30 per cent of the total healthcare expenditure in the country and investment in building and maintaining public health infrastructure needs priority in the forthcoming budget for FY 2018-19, a report says.

Public sector investment on healthcare accounts for less than 1.5 per cent of GDP, which is one of the lowest globally, and the government intends to increase the expenditure to 2.5 per cent of GDP by 2025.

The outlay on healthcare increased by a healthy 28 per cent in the last budget and the allocation is likely to see a similar increase in the forthcoming budget as well, according to a report by rating agency Icra.

In line with National Health Policy (NHP) 2017, the expenditure is expected to be directed towards setting up of new hospitals to increase the number of beds in the country, and for transformation of existing district and town level health centres to provide better healthcare facilities across geographies while using the existing infrastructure.

Public sector accounts for only 30 per cent of the total healthcare expenditure in the country, as compared to 42-58 per cent in Brazil, 58 per cent in China, 52 per cent in Russia, 50 per cent in South Africa, 48 per cent in USA and 83 per cent in UK as per the WHO reports.

ICRA believes that investing in building and maintaining public health infrastructure should be given priority in the budget as these facilities are lagging and vast majority of the population has to bear their own healthcare costs due to low penetration of health insurance.

Besides, along with the setting up of new hospitals, the report recommends setting up of medical colleges and nursing academies to address the shortage of beds and skilled medical professionals in the country, it said.

The budget is also likely to increase the allocation for addressing the increasing burden of non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, hypertension and to increase the outlay for providing free drugs, diagnostics and emergency services across all public hospitals, in line with NHP 2017.

Icra suggested that new infrastructure developed through incentives can also be utilised for catering to the growing medical tourism in the country, which is expected to continue to grow by 20 per cent over the next five years generating export revenues and employment.

Not for medical science to profiteer from society: President Kovind


Highlighting the health gaps in the country while speaking at the 45th convocation of the All India Institute of Medical Sciences (AIIMS), President Ram Nath Kovind said it is not for medical science to “profiteer” from society and asked the graduating doctors to give back to those who are less fortunate.

“This institution is the national centre of excellence. You have joined an illustrious list of medical graduates and postgraduates from AIIMS. As you go into the world, a world that needs your services more than ever before, please remember that you need to give back to society. It is true that you need to be legitimately rewarded for your academic excellence, your medical skills and your expertise. Yet, as doctors, your services must be available both to those who can afford your fees and also to those who are less fortunate and cannot afford (it). It is for society to profit from medical science, it is not for medical science to profiteer from society,” Kovind said.

The President also expressed concern over the “highly inadequate” number of medical education seats in the country and said various regulatory impediments that had prevented growth would have to be overcome.

“Currently, our medical colleges have only 67,000 undergraduate seats and 31,000 postgraduate seats. In a country of 1.3 billion people, this is highly inadequate. We have to overcome the regulatory bottlenecks and interest groups that have prevented the growth of quality medical education in the country,” Kovind said.

He lauded the students and faculty of AIIMS, saying that the institute has become “a byword for quality, commitment and rich experience”. However, Kovind added, “Despite our progress, gaps remain. Indian companies are among the world’s biggest manufacturers of vaccines and these vaccines are supplied across the globe. Even then, our own immunisation record remains below desirable levels.”

New regulatory system must to tackle shortage of doctors, says Ram Nath Kovind

The restructuring the Medical Council of India (MCI) is one of the reforms needed to address the acute shortage of doctors in India, President Ram Nath Kovind said on Tuesday.

“We need a new regulatory system to enhance availability of doctors and medical professionals in our society. We have to overcome regulatory bottlenecks and interest groups that have prevented the growth of quality medical education in our country. This gives us far fewer medical graduates and postgraduates every year than our people need,” Kovind told the 45th convocation of the All India Institute of Medical Sciences (AIIMS).

According to the ministry of health and family welfare, a total 1.02 million allopathic doctors were registered with the MCI or with state medical councils as of 31 March 2017. Going by these figures, India barely has seven allopathic doctors per 10,000 population.

Indian medical colleges, whether run by the government or private institutions, have only about 67,000 undergraduate seats and 31,000 postgraduate seats. “In a country of 1.3 billion people this is highly inadequate,” Kovind said.

Till now, MCI has been country’s sole medical regulatory body.

“It’s a great challenge to produce high quality healthcare providers at all levels. To address these challenges, we have undertaken reforms such as setting up of more medical and nursing schools, introduction of National Eligibility-cum Entrance Test (Neet) to get rid of multiple entrance exams and ensure greater transparency and better standard, reforms in MCI and National Board of Examinations (DNB) regulations have helped in taking the total number of postgraduate (PG) and DNB seats to more than 37,000,” said J.P. Nadda, Union minister of health and family welfare at the same event in New Delhi.

The Indian Medical Association (IMA) has been up in arms against a proposed bill that seeks to replace the MCI with a National Medical Commission (NMC). The apex medical body earlier this month called a one-day strike in hospitals across the country, shutting down outpatient services claiming the bill sas “anti-poor, anti-people, non-representative, undemocratic and anti-federal”. However, Nadda called it “beneficial” to the medical profession while addressing the Parliament in earlier this month. The bill was later referred to a parliamentary standing committee following nationwide protests.

Odisha govt hikes stipend of pre and para-clinical PG students

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The State Government on Tuesday hiked the stipend for doctors pursuing Pre and Para-Clinical Post Graduation courses in Government-run Medical College and Hospitals.

As per the decision, stipend has been increased to Rs 48,302 from Rs 39,950 for first year students, Rs 50,658 for second year and Rs 53,014 for third year, respectively.

“The CM has approved financial incentive of Rs 18,000 per month for doctors pursuing Pre and Para-Clinical Post Graduation courses in Govt Medical Colleges. Both In-service& Direct PG students will get incentive over & above their salary & stipend respectively,” said Health and Family Welfare Minister Pratap Jena in a press release.

“Incentive will encourage more students to take up Pre and Para Clinical disciplines as Anatomy, Physiology, Biochemistry, Pharmacology, FMT, Pathology, Microbiology & Community Medicine and lead to filling up of vacant posts in Government services,” the Minister added.

The State Government had earlier announced a hike in stipend of house surgeons from Rs 15,000 to Rs 20,000. Besides, the Government has decided to provide an additional monthly stipend to Rs 18,000 for post graduate students undertaking pre and para-clinical courses at State-run medical colleges.

Both in-service and post graduate doctors will be entitled for the monthly stipend which has been introduced for the first time by the Odisha Government, informed Health Minister Pratap Jena.

The State Government had earlier announced a hike in stipend of house surgeons from Rs 15,000 to Rs 20,000 on January 1.

Gurugram Fortis hospital stares at license cancellation

The Haryana government has recommended cancellation of recognition to Gurugram’s Fortis Memorial and Research Institute (FMRI) following the death of seven-year-old Adya Singh due to alleged medical negligence.

A letter in this regard was sent to chairman of National Accreditation Board for Hospitals and Healthcare Providers (NABHHP) by the director general of Haryana health services on December 9. MAIL TODAY has accessed a copy of the letter, in which the DG has pointed out negligence found during an investigation by a three-member committee headed by the additional director of the health department.

The panel’s report accuses the hospital of removing Adya from ventilators without any substitute arrangements and sending her in an ordinary ambulance despite the fact that her condition was very critical.

“Removing Adya from ventilator was a serious lapse done by hospital,” the letter said. The institute is also accused of overcharging by using expensive medicines.

“The hospital could have used generic medicines for the treatment of Adya instead of expensive allopathic medicine,” the letter also said. The DG also urged presidents of the Indian Medical Association and Medical Council of India to act against the hospital.

He has also written a letter to the Haryana Urban Development Authority (HUDA) for cancellation of the hospital’s land lease over violation of terms and conditions of allotment. According to health department guidelines, if any hospital is found guilty of flouting norms and negligence leading to death, there is a provision for licence cancellation.

When contacted, HUDA administrator Yashpal Yadav said did not receive any official copy from the state health department regarding the cancellation of land lease, assuring that once he receives the same, action will be taken accordingly.