RAKSHA

Swine Flu Update- 15th July, 2010

2010-07-20T17:19:00.004+05:30

As of 12 July, worldwide more than 214 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 18337deaths.

Vaccines- Governments, foundations and manufacturers have offered contributions of vaccines, ancillary products (such as syringes and safety boxes) and finances to support the donation initiative

Current Status of Vaccine Supply by the WHO and Partners (PDF)

Emerging data on Oseltamivir resistance of the virus is also worrying. Geographical distribution of oseltamivir resistance by the WHO regions (as of 14 July 2010) shows high prevalence of resistant virus strains in European, Western Pacific and North American regions (PDF)

Interestingly, 24% of the resistant cases were seen in patients who had taken post exposure prophylaxis.

Faking Orgasms

2010-07-02T18:06:00.001+05:30

Faking orgasm refers to the act of pretending to have an orgasm without actually experiencing one. It usually means simulating or acting out behaviors, such as body movements, vocal sounds, and sequences of apparent intensification followed by apparent release, typically associated with orgasm. It can also include giving verbal indications that orgasm occurred.- Wikipedia

Bhopal gas leak: Medical data suppressed

2010-06-11T17:34:00.001+05:30

The Bhopal disaster or Bhopal Gas Tragedy was an industrial catastrophe that occurred on the night of December 3, 1984 at the Union Carbide India Limited (UCIL) pesticide plant in Bhopal, Madhya Pradesh, India. At that time, UCIL was the Indian subsidiary of the U.S. company Union Carbide Corporation (UCC), which is now a subsidiary of Dow Chemical Company. Around midnight on the intervening night of December 2–3, 1984, there was a leak of methyl isocyanate (MIC) gas and other toxins from the plant, resulting in the exposure of over 500,000 people. Estimates vary on the death toll. The official immediate death toll was 2,259 and the government of Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release. Other government agencies estimate 15,000 deaths.

Since the day they were hit by the deadly Methyl Isocynate (MIC) gas, the victims of the Bhopal gas tragedy have been suffering with various health problems. Rayeesa Bi has had breathing problems. She has lost her eyesight and is bed-ridden; 14-year-old Suraj was born with congenital deformities, so was Kartikey and Khushi living in the same neighbourhood. Their parents are all gas victims.

Swine Flu Update- 15 th May 2010

2010-06-07T13:16:00.004+05:30

http://www.who.int/csr/disease/swineflu/FluTransmissionZones_2010_05_28.png

See original Image here.

Clean hands can prevent the spread of disease

2010-05-17T11:21:00.002+05:30

Clean hands can prevent the spread of disease: "The WHO 'Save lives: clean your hands' campaign invites healthcare workers, hospitals and organizations around the world to actively promote improved hand hygiene to reduce infections."

Clean Hands Podcast

40% of cancers are preventable

2010-02-04T17:47:00.001+05:30

About two out of five cancers can be prevented: "As we mark World Cancer Day, this episode focuses on cancer prevention. Each year, over 12 million people are diagnosed with cancer. Cancer kills more people than AIDS, malaria, and TB combined but the good news is that approximately two out of five cancers are potentially preventable."

http://terrance.who.int/mediacentre/podcasts/WHO_podcast_089.mp3

WHO and Pharma team up to fool the people ?

2010-01-12T15:29:00.001+05:30

via thefirstpost.co.uk

Eminent doctors are now coming out openly with comments on the alleged "Swine-Flu-pandemic conspiracy". Dr Wolfgang Wodarg, an epidemiologist, claims the WHO was persuaded to change the definition of 'pandemic' by scientists linked to pharmaceutical companies in order to trigger lucrative 'sleeping' vaccination contracts. The accusations are to be investigated by the Council of Europe after Dr Wodarg, the chairman of the body's health committee, tabled a damning resolution. Dr Wodarg claims the WHO "in cooperation with some big pharmaceutical companies and their scientists re-defined pandemics and lowered the alarm threshold" so that governments would begin to order vaccines. In fact, at one time , the WHO warned against preventive anti-virals thus leaving a free field for Vaccines.

GlaxoSmithKlein is estimated to have made $1.7 billion from sales of H1N1 vaccine sales in the fourth quarter of 2009 alone. Lower than expected uptake of the vaccine has led to a huge oversupply, to the extent that France, Britain, Germany and the Netherlands are all attempting to sell or give away surplus shots - or cancel orders, where possible.

Quite apart from the cost implications to already stretched national health budgets, if Dr Wodarg is right, then millions of healthy people have been, as he puts it, "unnecessarily" exposed to "the risk of poorly tested vaccines" for a flu strain that is "vastly less harmful" than all previous flu epidemics.

Community participation in Right to Health

2010-01-07T13:12:00.002+05:30

The power of community in advancing the right to health: A conversation with Anand Grover

Anand Grover was recently appointed by the UN Human Rights Council as Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Special Rapporteurs hold an honorary position as independent experts appointed by the Human Rights Council to examine and report on a country situation or a specific human rights theme. This interview with Mr. Grover was conducted by Alec Irwin, Co-Managing Editor of Health and Human Rights, at the XVII International AIDS Conference in Mexico City in August 2008.

Health and Human Rights: What aspects of your background do you feel have especially prepared you to take on the role of Special Rapporteur on the right to health?

Anand Grover: What is very important for me is to bring to the Special Rapporteur’s role the strengths I have from my work with communities of HIV-positive people and with other marginalized groups. I’ve done a lot of work in India around HIV, discrimination, access to treatment, and also the rights of marginalized groups like men who have sex with men, sex workers, and injection drug users. What the HIV movement has shown is that it’s community empowerment which changes the paradigm.

We need to pay more attention to the content of the right to health as it is experienced by communities. This right is not only an abstraction to be argued about by academics or clever lawyers. It’s a vital part, a living part of people who actually enforce it themselves. In that sense, it’s crucial to respond to people, not just to make your own decisions. I have experiences in my work where the community has corrected me and told me, “Anand, you’re wrong.” And they proved to be right in the final analysis. I’m proud to say that the community has the right to correct me, so I’m committed to continuing the exchange with affected communities on critical health issues.

HHR: Could you give an example of a situation in which the community challenged you and changed your views?

AG: One instance was recently, when we were working on an amendment to Indian law that included, for the first time, punishing clients of sex workers. As their legal advisor, I had accompanied the representatives of the sex workers to the Office of Women and Children, which was in charge of drafting the amending law. When I looked at the law that was being proposed I remarked, “They’re punishing the clients; why should we be worried about that?” I didn’t see a problem. I explained to the sex workers what the law was about. They replied: “Let us go back to the office and you translate the text to us in Hindi.” So we went back to my office and I translated the documents for them. The sex workers said, “Anand, you have to oppose this law on our behalf.” I asked why, and they said, “We won’t be able to have clients, and we’ll starve to death.” So, the community corrected me there. Our intellectual faculties are abstract. We come to our conclusions by intellectual discourse. We don’t have the experience of oppression and discrimination. The community has that experience. If we don’t marry our intellectual analysis with the community’s experience, we can’t make the right decisions.

HHR: In these early stages of your work as Special Rapporteur, what do you see as the main challenges and opportunities?

AG: Well, I think we have a strong foundation to build on. There is a recognized right, which is established in international law and is also understood by countries, though of course it’s interpreted differently. This shows the importance of dialogue that includes all points of view. I’m a great believer in dissent and opposition of ideas. I’m a leftist, and people often think that leftists don’t believe much in dialogue! But I’ve always been a part of the “New Left,” which encourages a very strong element of dissent, which believes that effective strategies and policies can only be formulated after rigorous discussion. And I think that’s what is required. There are different ways of looking at the right to health that are entirely legitimate. So we need an ongoing process of dialogue.

That’s on the conceptual level. The second issue, then, is how this is implemented concretely, at the local level. The large majority of countries recognize a right to health, whether this is formally written into their constitutions or otherwise. So how the right is implemented becomes critical. Courts have issued judgments — are they actually translated into practice? The classical model of implementation is top-down. Well, I think the community, again, plays a very important role in transparency, accountability and effective implementation of the right to health. That’s the lesson again from HIV, which I want to impress upon Member States and other constituencies. That’s also a process of dialogue, which has to include both human rights activists and people who don’t necessarily believe in the human rights framework.

HHR: Do you see opportunities to advance this dialogue on specific issues?

AG: Two areas where I want to concentrate initially are access to treatment and health systems, including the whole area of budgeting and finance in the health sector. There are very different views on questions like the proper role of insurance — for example, whether we should have community health insurance or social insurance. And whether the focus should be on state-funded, tax-based health systems or on a greater role for the private sector. All these models may be legitimate, and the practical realization may be different in different countries. But any solution has to be premised on the idea that everyone, without exception, is entitled to the right to health.

Again, I do think there are many fundamental issues countries have agreed upon. And then there are civil society and health activists, affected and infected, who get engaged in these issues and exert pressure, for example, for access to AIDS treatment. Already there is great mobilization in the community about these issues, so I want to take that further. This will help governments to realize the rights of their citizens. I firmly believe in dialogue between civil society and government, like we have a dialogue with our government [in India] is critical. The government now sees the value of the community organizing itself, lots of people organizing. Communities can make sure that the government and the different agencies are delivering, that they are accountable.

The community is the most effective tool that we have: an organic tool, not a tool in the abstract or purely instrumental sense, but a living, organic tool which can see to it that the right to health is actually delivered. You just have to compare the efficiencies of the Global Fund, in terms of actual delivery, to the traditional systems of financing, and you see a vast difference. This suggests how we have to shift the paradigm across the sectors, not only in HIV. And HIV activists are very clear that health systems must respond to the needs of all people who suffer disadvantage in health — whether it’s because of poverty, as Paul Farmer has discussed, or because of other forms of discrimination and marginalization, for example the discrimination that affects indigenous peoples or other ethnic minorities. Now we must deliver, and those communities must be part of the process of decision-making, implementation, monitoring, and accountability. That’s what HIV has shown as a living reality, and that’s what we want to translate into other areas of health.

HHR: Why might the mandate of the Special Rapporteur be especially important right now?

AG: The economic crisis shows the importance of systematic action to protect rights, including the right to health, especially for poor and marginalized groups. In the 1990s, we had economic liberalization, which usually meant only privatization. The poor were pushed into deeper poverty, while the rich became richer. In this context, it’s all the more important to insist that the right to health is universal. But this isn’t just a philosophical principle. It’s about budgeting. As I said, we can’t ignore budgeting anymore. And budgeting doesn’t mean that governments in low-income countries must pay for everything from their own resources. The right to the highest attainable standard of health, and the responsibility to protect the right, have to be seen in international terms. This means you look at international systems of financing. If a country’s resources aren’t adequate, then money has to come from abroad, also. That financing commitment has to be part of the international rights agenda.

HHR: How do you plan to build on the contributions of Paul Hunt during his tenure as Special Rapporteur?

AG: That’s an important question. Paul Hunt has done tremendous work, and I’m glad to say I’m in regular communication with him. I’ve got a lot to learn from him, not only about the procedures, which are but a tiny part of the work, but also because he laid down the basic foundations and the contours of the work of the Special Rapporteur. And he’s been prolific in his writings, which I don’t think I’ll ever be able to match. If I can produce even half the number of reports he has generated, I’ll be happy!

Specifically I will try to see that what Paul did in terms of country missions are followed up by me, so that the progress or lack of it can be monitored. This will reinforce what Paul has done. Also on issues like indicators, he has made a good beginning. We need to explore that further.

Building on Paul Hunt’s achievements requires learning from him, seeking advice from him. I don’t believe that any person is better than another person; you only become better by learning from others, with humility. So I want to build on that previous work not with my own native intelligence, but drawing on what I described earlier, the experience of the community and the marrying of that experience with a nuanced understanding of the right to health.

A full description of the mandate of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health is available at http://www2.ohchr.org/english/issues/health/right/overview.htm.

Copyright © 2009 Grover. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Revisiting Child Rights after 20 years

2009-12-15T18:53:00.009+05:30

Modern contraceptives in India

2009-12-09T12:07:00.001+05:30

Recently, Birth control ring NuvaRing was recently (December2009) launched in India by Organon (India).

Organon (India), incorporated in the year 1967, is a global biopharmaceutical company. Earlier known as Infar (India), it got its present name on Dec. 31, 2002. The company is part of the American pharmaceutical company Schering-Plough, which is a world class provider of human healthcare prescription, consumer and animal health products. It is among the leaders in the areas of gynecology, fertility, neuroscience and anesthesia."NuvaRing heralds a new era in contraception in the Indian market,” said KG Anathakrishnan, managing director of Organon (India) Limited

NuvaRing is a flexible, transparent ring containing hormones that are dispersed throughout the ring’s core and absorbed through the vaginal lining directly into the bloodstream, when inserted. The exact positioning of the ring is not critical for it to work. Additionally, the ring works, like ‘the Pill’, by inhibiting ovulation. In order to prevent pregnancy for a full month, NuvaRing must be inserted and left in place for three consecutive weeks. After a one week ring-free interval, a new ring must then be inserted in order to have continued contraceptive effect.

Introduction of Nuvaring(r) in India allows another flexible choice for female contraception.According to recent National Family Health Survey (NFHS-3) survey (India), despite availability of various modern contraceptive methods, modern contraceptive usage is limited to less than 50 per cent of women under age 50 years.

Social Media in Public Health

2009-12-08T10:31:00.001+05:30

A slidedeck describing how social media can be used for Public Health.

To tweet or not to tweet? : Exploring the use of Social Media for [public] health

View more presentations from Francisco J Grajales III.

Empathy in Medical Education

2009-11-29T16:42:00.001+05:30

This "Mendley" created by Anne Marie Cunningham of Cardiff, United Kingdom

It lets you create an online collection of research papers

Organize, share, and discover research papers! Mendeley is a research management tool for desktop & web. You can also explore research trends and connect to other academics in your discipline.

Bibliography created using Mendeley

Patients Rights- India

2009-11-16T12:03:00.000+05:30

Patients Rights, Patients, Hospital Patient Rights, Hospital

Healthcare reform supporters from Rural Medical center

2009-11-13T17:14:00.002+05:30

After all the "interested parties" have had their say, i came across a much more balanced view of the healthcare reform scenario and the House Bill 3962 in the United States, and What a Rural Medical Center in the US thinks of it.

The following are the thoughts of Austin Medical Center, a 99 bed licensed hospital with a multiple specialty associated clinic. AMC is a rural facility located in a service area of ~45,000 people in southern Minnesota.

They start clear and loud.

We are supportive of health reform and this bill is a step in the right direction.

Some of their statements i liked are-

The proposed insurance reforms are long overdue. All people regardless of health status deserve fair coverage.

Shared responsibility is critical to the success of meaningful reform. Younger adults with lower health risk should not be able to opt out without a penalty.

Two more detailed and insider viewpoints were about legal reforms and state controlled options.

Assistance to small business is a big plus. Especially in smaller communities like Austin and our surrounding area where future economic growth is highly dependent upon entrepreneurs. When these new businesses grow to a self-sustaining size, they’ll be able to pay their fair share of health costs. Giving them an exemption during the early years is the right thing to do.
We do not support a public option modeled after Medicare. Today, government-run insurance programs can be heavy-handed, bureaucratic, inefficient systems that penalize medical systems (like AMC) that offer high value care. We cannot assume this public option will be any different. Our fear is that this plan will morph into a federal fixed fee schedule that is priced below our costs. This could drive all private insurance out of the market and we could end up with a government-run system like Great Britain and Canada. While these systems handle public health well, those that are very sick get rationed care. Most Americans will find rationing intolerable. We prefer to see expanded coverage through an insurance exchange like the Federal Employees Health Benefit Plan model, which Members of Congress and all federal employees have. This exchange offers multiple private plan choices and is the best “public option” for offering insurance for all.

Will the americans get rid of their fear of anything faintly RED or "socialist" ?

Tough question.

Introduction to medical ethics

2009-10-09T17:57:00.002+05:30

I thought i might as well keep a primer ready for the primaries.

Here are notes on "Introduction to Medical ethics"

Healthy lifestyle benefits-

2009-10-05T15:07:00.000+05:30

PODCAST from MedlinePlus

Previously, most research focused on the impact of one or two lifestyle choices on hypertension, heart failure, and other diseases. Here are 2 studies which assess the impact of a cluster of modifiable lifestyle choices on the onset of hypertension and heart failure.

1) The risk of the onset of hypertension was prevented or delayed by 78 percent if study participants:

* Kept their body mass index under 25 (within a normal weight range)

* Exercised vigorously daily

* Maintained a diet designed to stop hypertension

* Drank alcohol moderately

* Used a non-narcotic analgesic less than once a week. Non-narcotic analgesics include pain relief medications, such as acetaminophen, or Tylenol

* And took recommended doses of a folic acid supplement

2) A 21 percent lifetime risk of heart failure was reduced to 10 percent if male participants followed four of the following lifestyle recommendations:

* maintaining normal weight

* not smoking

* regular exercise

* moderate alcohol intake

* consumption of breakfast cereal

* and eating fruits and vegetables

Change in Health education apparatus in India

2009-09-16T14:10:00.001+05:30

Task Force Report on setting up NCHR in Health

To overcome the acute shortage and uneven distribution of human resources in public health delivery system, the Ministry of Health & Family Welfare aims at overhauling the current regulatory framework. Toward this end, it is proposed to set up a National Council for Human Resources in Health as an overarching regulatory body to achieve the objective of enhancing the supply of skilled personnel in the health sector.

http://www.mohfw.nic.in/nchrc-health.htm

Here is the draft report for initiating Positive changes in our medical education system.

Some of the ideas mentioned are revolutionary scrapping multiple levels of control and having a standardised post graduation level exam) whereas some are half-assed (like the umpteen administrative functions concentrated in a select few).

The general public is invited to go through the report of the Task Force and the draft bill and sent their comments / observations on the suggested provisions by the 15th October, 2009.

http://www.mohfw.nic.in/nchrc-health.htm

The Draft Report and The Draft Bill- .

Kindly mail your views to make a difference

Swine Flu Update: Single-Dose Vaccine Appears to Work

2009-09-11T11:14:00.000+05:30

Swine Flu Update: - We have all been waiting for the ideal swine flu vaccine, and lo, its POSSIBLY Here now.

A Single-Dose Vaccine Appears to Work, Study Shows: "

The first clinical trial data on new vaccines being developed to treat the H1N1 pandemic flu virus in the U.S. suggest that one dose will work to immunize most people, according to a preliminary report in the New England Journal of Medicine.

Researchers studied two vaccines, one which had a substance added to improve immune response, called an adjuvant, and one that didn’t, for 21 days. Both showed the vaccines elicited immune responses with single shot. One big question for public health officials was whether a single dose would be sufficient.

Full results will be published after patients have been followed for 42 days, the journal said.

An accompanying editorial, written by Kathleen Neuzil of the University of Washington, calls the findings “welcome and reassuring” and suggests that it would be “appropriate” to start vaccination using one regular dose of non-adjuvanted vaccine. Two doses might be needed in children, she writes, but if supplies are short, the vaccine shouldn’t be held in reserve to give a second dose.

The nonadjuvant vaccine is being developed by CSL Ltd. of Australia.

The adjuvant version is from Novartis. Both are expected to be available in the fall.

Side effects, including pain at the injection site and headaches, were reasonably tolerated, Neuzil noted.

Chinese vaccine marker Sinovac Biotech and Novartis have both said recently that their swine-flu vaccines showed positive results.

WHO: Impact on healthcare services

2009-09-05T19:27:00.000+05:30

Swine flu has now been around for about 6 months.It has caused an alarming impact on health services trying to cope with all thr panicked populations, more so in Developing countries.

Mexico, India, and Central and Southern American countries have born the brunt.

Check the image.

Using Cellphones to diagnose Malaria and Blood disorders

2009-08-27T18:26:00.001+05:30

Microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases.It is an essential tool in disease diagnosis and widely used all over the world. Unfortunately, the EXPERTISE required to use the tool, and to evaluate the findings is not very common. One requires a pathologist with many years of experience to make sense of those seemingly random and confused pixels. (I know, i am a pathologist :-)

It takes a lot of effort, and money to train a pathologist, equip him/her with all the instruments required, and then use the skills in a backward area without proper facilities. But the advent of digital imaging has solved many of our troubles. Telepathology made sure that we do not need a pathologist physically present at the site, to render a diagnosis.

But microscopy and digital imaging of the biopsy/tissue fragment was still a hassle. Now we have done better. You don't even need a microscope to send a microscopic image over the network!! Researchers from the Univ. of California worked with high-powered LED – which retails for just a few dollars – coupled with a typical camera phone to produce a clinical quality image sufficient for detecting in a field setting some of the most common diseases in the developing world.

The newly developed technology, CellScope, allows for average cell cameras to be retrofitted with powerful microscopes, able to detect malaria parasites, and even fluorescent marker-stained tuberculosis bacteria.
Thus you have your humble cell-phone transformed into the sherlockian "cell-scope".

“The images can either be analyzed on site or wirelessly transmitted to clinical centers for remote diagnosis. The system could be used to help provide early warning of outbreaks by shortening the time needed to screen, diagnose and treat infectious diseases,” University of California in San Francisco (UCSF)/UCB Bioengineering Graduate Group graduate student David Breslauer adds. CellScope could also provide remote access to digitized health records, and would be amenable to epidemiological studies, using triangulation or global positioning system location data, such that outbreaks could be monitored as they happen.

So maybe i could click a photomicrograph of that mole on my friend"s forearm, twitter it to my onco-pathologist friends, who view it on their smartphones and twitter / message their diagnosis back to me. Simple and fast, especially with my own group of pathologists on the network.

Labels: cell, Imaging, Pathology

Personal mobile slide viewers for Pathologists. (neeleshbhandari.blogspot.com)

Posted via email from drneelesh's posterous

Kindle in Medicine

2009-08-27T16:29:00.001+05:30

Kindle is a new device that is changing the face of reading. The best of the current lot of e-book readers, Kindle is a boon for medical students and professionals, allowing them access to hundreds of books on the go!. The basic functions of Kindle can be seen here.Kindle, now in its third avatar, the Kindle Dx (Deluxe) boasts of more advanced features, like PDF support (experimental) , longer battery life, 5-way Controller and sleeker design.

Check out more features here.. You can view it from all angles, zoom into any area and look at its features.

Using Kindle in Medicine

Easy for medical students to keep up with all their scheduled reading. You can download and read reference materials that you have read previously to refresh your memory.You can seek out new textbooks to look for answers too.
Seeking out symptoms, conditions, and other relevant information is easy.You can view photos on the Kindle if you need to see pictures of various signs and symptoms conditions.
Study medical texts and highlight portions of texts / make notes on the Kindle as you go. Zoom into images for micro details.Bookmark and annotate important portions.
Research can be done on its built-in web browser ( experimental feature) , no need to carry a laptop to access the internet.It offers free Wireless access to Wikipedia
.Multiple books can be read at once, no need to carry a JUMBO Grey"s anatomy or Robbin"s Pathology encyclopedias !! It boasts of storage capacity of 1500 / 3500 books, depending on the Model.
You can listen to music while you read.
Inbuilt Text-to-Speech feature lets you listen to your favorite books.

It has a clear policy for returning the instrument or any content bought ( within 7 days of purchase) and also One year limited warranty. The kindle library boasts of more than 300,000 books for download, and many more added regularly. Priced at 300 and 500 $$ , and weighing approx. 300 and 500 grams (depending on the model) it is still too pricey for open embracing of this technology. Some libraries have started lending out Kindles ( with preloaded content) to its patrons.

Personally speaking , i can see a lot of content being adapted for Kindle, provided the machine becomes less expensive.
Also , many more wireless features ( like chat, email, videos etc) need to be added. If more such functionality is added to justify its high prices, i expect a LARGE number of medical students turning to Kindle.

Related articles

Posted via email from Medical Communications

New Swine Flu Guidelines

2009-08-18T13:56:00.000+05:30

On 14 th august, Friday night, after facing flake for the past two weeks on the bungled handling of Swine Flu epidemic in India, the government has come up with a better set of guidelines.The new guidelines allow ALL doctors to treat for Swine Flu ( earlier only designated hospitals and doctors could treat Swine flu!!)The guidelines were finalized after a five-hour meeting chaired by Health and Family Welfare Minister Ghulam Nabi Azad.

The patients have been categorized as follows:

Category A: Patients with mild fever plus cough/sore throat with or without body ache, headache, diarrhoea and vomiting. They do not require Oseltamivir and should be treated for the symptoms mentioned above. The patients should be monitored for their progress and reassessed after 24 to 48 hours by the doctor. No testing of the patient for H1N1 is required. Patients should confine themselves at home and avoid mixing with the public and high risk members in the family.( I agree with this)

Category B: (i) In addition to all the signs and symptoms of Category A, if the patient has high grade fever and severe sore throat, he/she may require home isolation and Oseltamivir; (ii) In addition to all the signs and symptoms of Category A, individuals having one or more of the following high risk conditions shall be treated with Oseltamivir: children under five, pregnant women, those above 65 years, those with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS; Patients on long term cortisone therapy. No H1N1 tests are required for Category-B (i) and (ii). Such patients should confine themselves at home and avoid mixing with the public and high-risk members in the family.( I think all such cases be tested for H1N1, and antiviral therapy started without delay)

Category C: In addition to the symptoms of Categories A and B, if the patient has one or more of the following: breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails; irritability among small children, refusal to accept feed; worsening of underlying chronic conditions. Such patients require testing, immediate hospitalisation and treatment.( All such patients should be started on antivirals without even waiting for test results!!, its already late!!)

During the meeting, various guidelines and protocols developed by the World Health Organisation, Geneva, the Centre for Disease Prevention and Control, Atlanta, United States, and the National Health Service, United Kingdom, were also discusse

Medical consultation on the Move

2009-07-30T17:48:00.000+05:30

A new mobile handheld technology developed by mVisum of Cedar Brook, NJ, is been tested. This communication tool boasts of providing off-site cardiologists access to EKGs that can then be used to prescribe immediate treatment.

The Department of Veterans Affairs is testing this new system which seemingly enables fast transfer of clinical data to a smartphone for review within minutes. The mVisum Medical Communication System is stated to be a communication tool which permits health-care personnel to securely receive, review and respond to a patient"s medical data recorded at the point of care. This transfer of information notably takes place through secure HIPAA compliant internet servers, later transmitting it via mobile technology to the smartphone of the physician. More so, this system is also loaded with the ability to be availability aware, so that the patient can refer to another physician in the absence of the original intended physician. The various types of medical data that can be sent through this technique include DICOM images, EKGs, CT scans, MRIs, X-rays, etc. Along with this, textual information relating to the patient may also be included in the message for the purpose of getting a broader idea about the condition of the patient.

View more news videos at: http://www.nbcwashington.com/video.

The process begins with the recording of patient data at the point of care. Point of Care can include the physician's office, medical center, hospital, or anywhere the patient is located and an system is installed.Data is transmitted securely and reliably to the physician's mobile handheld device. The system has advanced technology that allows the system to be availability aware,so that another physician can immediately be contacted if the original intended physician is unavailable.Once received, the physician can review data and securely respond with medical opinion, prescription or other critical orders.

Mobile phones for public health

2009-07-29T18:28:00.000+05:30

Video: Nokia & mHealth in emerging markets | mobihealthnews

Here’s a video (via MobileActive.org) that showcases Nokia’s Data Gathering application for the E71. The video shows the Amazonas’ State Health Department in Brazil using the devices and application to monitor and treat outbreaks of dengue fever. In developing markets one of the key problems for caregivers and public health workers is recording and managing data collection on health issues for large populations. The application featured below shows the type of technology replacing the clipboard abroad, but similar technologies are being deployed across hospitals in the U.S. like mobile clinical assistants (MCA) that sync up to a hospital’s EMR.

Have Sex every day, Doctors advice.

2009-06-30T19:34:00.000+05:30

Daily sex makes for healthier sperm | Health | Reuters

LONDON (Reuters) - Having sex every day improves the quality of men's sperm and is recommended for couples trying to conceive, according to new research.

Until now doctors have debated whether or not men should refrain from sex for a few days before attempting to conceive with their partner to improve the chance of pregnancy.But a new study by Dr David Greening of Sydney IVF, an Australian center for infertility and in vitro fertilisation (IVF) treatment, suggests abstinence is not the right approach.

He studied 118 men with above-average sperm DNA damage and found the quality of their sperm increased significantly after they were told to ejaculate daily for seven days.

On average, their DNA fragmentation index -- a measure of sperm damage -- fell to 26 percent from 34 percent, Greening told the European Society of Human Reproduction and Embryology in Amsterdam on Tuesday.

Frequent sex does decrease semen volume but for most men this is not a problem.

"It seems safe to conclude that couples with relatively normal semen parameters should have sex daily for up to a week before the ovulation date," he said in a statement."In the context of assisted reproduction, this simple treatment may assist in improving sperm quality and ultimately achieving a pregnancy."
Greening said it was likely frequent ejaculation improved the quality of sperm by reducing the length of time they were exposed to potentially damaging molecules called reactive oxygen species in the testicular ducts.

India needs IT based health delivery system

2009-06-25T20:21:00.000+05:30

The National Rural Health Mission (NRHM) International Advisory Panel Chairperson Jeffrey Sachs has called upon India to implement IT based health delivery system in the country.

The Columbia University Professor, while praising India's effort for closing gap on the health mission under the Millennium Development Goals (MDG) with the other countries, however, said that the country needs to make more investment in the sector. "India should step up the budgetary allocation in health sector to four to five per cent of the GDP," Sachs said adding that a higher investment in the health sector will give great social returns.Calling the NRHM as one of the most remarkable achievements in public health sector, he said that India's dramatic improvement in the health sector have been made possible due to enhanced partnership between the centre, state and local units.

Sachs, who is also the advisor to UN Secretary General Ban Ki Moon, said that the increase in institutional delivery and drop in mortality is especially impressive.

Arguing for an IT-based health delivery system, Sachs added that India can serve as a role model for other countries in the health sector.Having traveled to a few Indian states, he also said that there is, however, a need for more human resources and logistical support.

Health care reforms in the US.

2009-04-26T14:11:00.000+05:30

By Sanch Panza on Flickr

Health care reform is a hot topic these days. What is health care reform? The President, Congress and people like you are talking about it. The simple answer is well, there is no simple answer.

Most Americans i know are not even sure if Healthcare is a fundamental human right?! So talking about "Health care for all" seems too far fetched for them.The argument i hear commonly says that only taxpayers should be given health care assistance and the 46 million or so people without Health insurance can go to Hell ! It seems like a weeding out plan for poverty. " You don't have money to buy insurance? Too bad, go sit there and die".

A few ways to reduce healthcare costs include

More Use of Technology
Empower people with More information
Payment to care providers to be based on Quality rather than the number of investigations performed. ( This is very basic actually)
Promote healthier Lifestyle.

Medical Animations - WebSlides

2009-04-02T16:35:00.001+05:30

Check out this website I created at slides.diigo.com
A clickable list of my favorite 3D animation sites in Medicine.

The male foreskin is dangerous- Circumcision protects .

2009-03-28T15:07:00.003+05:30

Health information politicized

Doesn't the public have the right to know that male circumcision protects against HIV?

In 2007, the ethical landscape surrounding medical male circumcision (MC) suddenly lurched and shifted when the World Health Organization and UNAIDS declared unequivocally that the `efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt.The male foreskin has been shown to have a high number of cells that were targeted by the HIV virus

Interestingly, evidence that MC had medical benefits has been mounting for more than 20 years. Not only does the procedure reduce the risk of HIV infection, it also has been shown to prevent urinary tract infections, sexually transmitted diseases, and penile and prostate cancers.

Researchers have even found that MC reduces the risk of cervical cancer in current female partners . In spite of that growing list of medical benefits, the issue has hovered just below the radar screen until several large randomised controlled studies from Africa showed that circumcision offered a 60% to 70% protective effect against the heterosexual acquisition of HIV. The evidence was so compelling that three of the studies were stopped early, on the recommendation of Data Safety and Monitoring Boards

The Government of India has been reluctant to approach an issue that promises to be controversial among conservative Hindus. MC is considered a marker of religious identity since Muslims routinely circumcise their male children, and Hindus do not. It has been suggested that at times, circumcision status may even have been used to identify people`s religious affiliation during communal riots. Popular wisdom holds that even the mention of MC in some communities will trigger sectarian violence. Predictably, some opponents have argued that the greater good of society must be protected by withholding information about MC from the population.

This is a joke, surely?
They wont tell the benefits of circumcision because they want to use it to identify Muslims?

The benefits of circumcision include:

• Decrease in physical problems involving a tight foreskin [Ohjimi et al., 1995].

• Lower incidence of inflammation of the head of the penis [Escala & Rickwood, 1989; Fakjian et al., 1990; Edwards, 1996].

• Reduced urinary tract infections.

• Fewer problems with erections, especially at puberty.

• Decrease in certain sexually transmitted infections (STIs) such as HIV, HPV, genital herpes, syphilis and other micro-organisms in men and their partner(s).

• Almost complete elimination of invasive penile cancer.

• Decrease in urological problems generally.

Other proofs of advantages of circumcision

Removal of the foreskin of the penis (male circumcision, MC, C) is known to significantly reduce female-to-male HIV transmission through sex, which then decreases male-to-female transmission. Three recent randomized controlled studies from Africa have shown that circumcision offers a 60% to 70% protective effect against heterosexual acquisition of HIV. The protective effect of circumcision against HIV, known since the 1980s, has been confirmed by more than 30 studies before these three famous randomized controlled trials, which are the criterion standard of clinical research.

-Distance education in Medical and paramedical sciences

2009-03-09T19:14:00.000+05:30

Image by interplast via Flickr

In a developing country such as India, where an optimal level of health service is a dream to many, there are far too few health workers in training and the number of training institutions is far too few. To understand the gravity of the situation, ther r r re are more than 365,000 doctors, 264,000 nurses and 350,000 allied health professionals which includes Multipurpose Health Workers, Village Health Guide, etc. Whereas, proper training facilities exist only at a few institutions like National Institute of Health and Family Welfare (NIHFW), State Health and Family Welfare Training Centers. With a limited number of available training institutions, it is nearly impossible to train large numbers of medical officers and paramedical workers. Nearly 47 Health and Family Training Centers (HFWTC's) and seven Central Training Institutes (CTIS) provide health and family welfare training to all categories of health functionaries in the country. These long-duration training programs attract a limited number of clients, and hence most of the institutions also organize in-house short-term training programs which has less than the desired impact on their functionaries.

Distance education is a relatively new concept which not only has the ability to train a large number of health care workers in a short time in a cost effective way but can also attend to skills of health care without diluting the quality.Distance teaching-learning often involves a multi-media approach to design, develop and implement independent learning programs through self-instructional materials, both in print and electronic media forms. Distance study allows self pacing for convenience and also facilitates learners having control over their learning. The various media used for distance education delivery include among others, print materials, audio and video programs, radio and television programs, tutoring and counseling, field visits, laboratory practicals, extended contact programs, and teleconferencing.

The following issues need to be addressed and considered for successful application of distance education programs for health professions:

1. Since health sciences deal with life and death and are therefore are more skill-oriented (rather than more knowledge-based), it is felt that providing basic beginning or early training in the field of health may not be feasible through distance learning. Being an innovative and flexible system, and having the ability to respond to emerging training and educational needs, distance education is more appropriate for inservice training of health personnel.

2. The academic programs have been confined to a limited area of health education and training. In order to meet the diversified and emerging needs of health workers, the programs and courses have to go beyond medical graduates to include a wide variety of need-based functional areas ranging from simple awareness programs to more complicated skill-oriented courses on epidemiology and health economics.

3. Application of sophisticated communication technology has to be done cautiously, keeping in view clients needs, cost, media behavior and infrastructure and facilities at the receiving end. In the developing countries including India, audio and television programs seem to be more feasible and promising. Furthermore, multi-media packages need to include a large amount of hands-on and field experience.

4. An issue to be deliberated is the provision of student support services for health workers and professionals. While compulsory counseling and extended contact increase the effectiveness of programs, these on the other hand pose problems to both providers as well as the receivers of health education. More practical-oriented courses need to have compulsory built-in face-to-face components; and work centers or practice centers at grassroots level with required instructional provisions would be more feasible than regular study centers.

In conclusion, it is worth noting that distance education has tremendous potential for providing education and training programs to different categories of medical and paramedical personnel as a means of helping achieve the goals of HFA. In addition to the national agencies such as the Ministry of Human Resources Development, the Ministry of Health & Family Welfare and Indira Gandhi National Open University, international agencies such as WHO and UNICEF need to play increasingly prominent roles in facilitating the achievement of national and institutional targets. Proper use of ISRO provided satellite communication facilities can make distance education courses an important aspect of ongoing medical education.

-New test to say if dengue vaccine is safe

2009-02-17T17:50:00.000+05:30

Image via Wikipedia

Researchers have developed a test to determine whether vaccines against dengue virus would really protect patients from infection, or would make it more dangerous for them.

"Our stNew test to say if dengue vaccine is safeudy shows that the new test is likely superior to the standard test in its ability to tell whether a patient's response to a vaccine is safe," Associate Professor of Medicine at the University of Rochester Medical Centre (URMC) and co-author of the study Xia Jin said.

Cases of tropical, mosquito-borne dengue fever have been expanding globally for more than 50 years, with nearly a third of the human population in 100 countries now at risk of infection with the four types of dengue virus.

Infection with the dengue flavivirus, which is related to West Nile Virus and Yellow Fever, annually results in an estimated half a million hospitalisations and 22,000 deaths, mostly among infants, according to World Health Organisation (WHO).

After decades of absence in the US, the disease is causing illness again along the Texas-Mexico border, experts say and add that widespread dengue infection in the continental US is a real possibility, reports IANS.

A typical dengue infection confines a patient to bed for more than a week with fever and severe limb pains, but most recover. In less than five per cent of cases, however, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), often deadly complications, develop just as the fever breaks.

Mostly affecting babies between five and eight months, DHF causes victims to vomit and pass blood in their feces and urine. If diagnosed quickly, patients respond to intensive hospital treatment and fluids, but mortality can reach 15 per cent when undiagnosed.

DSS comes when the infection has caused so much fluid to leak out of capillaries that there is not enough blood to supply organs. As of 2008, there were no antiviral drugs designed to treat dengue and no drug candidates in late-stage development, an URMC release said.

-Mobile healthcare in Punjab

2009-02-09T17:36:00.000+05:30

Image via Wikipedia

Mobile healthcare unit launched

Chandigarh: In a bid to increase accessibility of the rural people for getting better healthcare, the Chandigarh Administration has started a Mobile Medical Unit (MMU) to provide healthcare services at the door steps of the rural people.

MMU not only facilitates access to basic services of healthcare, but also provides essential knowledge and information on the kind of services under the umbrella of National Rural Health Mission (NRHM).

The Unit, a hospital on wheel under the flagship programme of NHRM, has been pressed into service in the union territory (UT) as joint venture with the Guru Granth Sahib Sewa Society.

A team consisting of eye specialist, gynaecologist and dentist will provide specialist services from within the van. Two doctors of Health Department along with RCH staff will provide primary health care facilities including MCH and immunisation services.

Initially, 10 villages have been identified which will be visited by the team fortnightly.

Information, education and communication (IEC) material on health education including personal hygiene, proper nutrition, hazards of tobacco consumption would be displayed and health awareness about various ongoing national programmes will be imparted.

-Prozac- Things to know before you use it.

2009-02-04T14:57:00.000+05:30

Prozac What You Should Know Before You Use
Prozac or ( Fluoxetine Hydrochloride ) is a commonly used antidepressant in clinical practice. It has shown excellent results and is often used by people/patients even without proper prescriptions. Is that safe??

Below is a slideshow i have prepared detailing a few important facts about Prozac use. Also incorporated is a video which will further enhance comprehension about this widely used drug.

View more presentations from Neelesh Bhandari. (tags: bhandari neelesh)

-Human rights abuses contribute to Malaria

2009-01-02T00:35:00.001+05:30

Human rights abuses contribute to malaria

Medecins Sans Frontieres recently listed 10 top crisis areas that highlight in many instances the interrelation between human rights abuses and poor health. Recent news on two of these areas, Zimbabwe and Burma, shows even stronger links to malaria.ZWNews quotes an IRIN report: “‘There is no food, we have malnutrition, there is cholera, now we are expecting a malaria outbreak,’ said an exasperated Amanda Weisbaum, the emergency manager for Save theChildren, UK, in Zimbabwe.” After suffering cholera and malnutrition, “With the onset of rain, there are mounting concerns of a possible malaria outbreak ravaging immune systems weakened by cholera and malnutrition, ‘especially among those aged under five,’ said Weisbaum.”The government even recognizes the threat of the rainy season. The Herald reports that …

HARARE City Council has embarked on a programme to
clear stormwater drains with the assistance of residents under the
food-for-work programme at a time the United Nations Children’s Fund
has contracted trucks to speed up the removal of refuse in the city as
a measure to curb the spread of malaria and cholera.Under the
programme, residents in high-density suburbs are paid for clearing the
drainage systems in their respective areas.

A BBC reporter notes that, “The country that was once the jewel in Africa’s crown, able to feed itself, heal its sick and educate its people to the highest standards on the continent, is now in a pitiful state.” The BBC has been showing the link between Zimbabwe’s current problems and its
human rights violations that contributed to the present economic, political and health crises.

In eastern Burma “Access to maternal health-care is extremely limited and poor nutrition, anemia and malaria are widespread in eastern Burma, which increases the risk of pregnancy complications,” was a finding of researchers from the Johns Hopkins University, as reported in Medical News Today. The full article in PLoS Medicine reported that, “Few women had received iron supplements or had used insecticide-treated bednets to avoid malaria-carrying mosquitos.
Consequently, more than half the women were anemic and 7.2% were infected with malaria parasites.”

The Burma situation results from “Human rights violations - such as displacement and forced labor - (that) are also widely present, and in some communities forced relocation doubled the risk of women developing anemia and greatly decreased their chances of

receiving any antenatal care.”

A disregard for human rights and a breakdown of health services, especially for the most vulnerable, appear to go hand in hand. Another call for peace in 2009 is urgent.

- The best medical blogs of 2008.

2009-01-01T23:33:00.001+05:30

Medgadget.com is sponsoring "The Best Medical Weblog Awards of 2008.".

My blog drneelesh@Raksha has made it to the Final list of Nominees as Best NEW Medical blog of 2008.. At stake is the title and a PDA. In all, Fifteen entries were chosen as the final nominees in this category..Other categories include Best Clinical sciences,Image by drneelesh via Flickr Health policies,Best blog on Medical ethics, Best Literary Medical, Health IT, Patient centered, e.t.c. Now the final "awardees" will be chosen via an internet voting system. All you have to do to vote is scroll to the bottom of the nomination-list page and write in a comment here about my blog or simply second my blogs nomination.

My Blog looks at Medical issues from the eyes of a pathologist , e.learning enthusiast and a Health Rights pro-activist. My page may take some time to load ( the left half of the page is slightly data heavy, but be patient. The wait will be worth it!).There are a number of ways to interact with me. You can also search my virtual library (my references, bookmarks,images,articles,blogs, etc). via this website.

So do check out my blog and don't forget to comment on Medgadget.com. I would love to get my hands on this piece of electronics.

Dr.Neelesh Bhandari
M.B.B.S (AFMC),M.D (Path)
P.G.P in Human Rights

Chief Mentor ( RAKSHA)
Registered society for knowledge and health activities.

Chat: Google Talk: neeleshbhandari

Contact Me:

--- @ WiseStamp Signature. Get it now

-Why American healthcare is so expensive?

2008-12-04T02:07:00.000+05:30

Image via Wikipedia

drneelesh@Raksha: -Why American healthcare is so expensive?
That the American healthcare delivery system is out of control and wasteful is a no-brainer.

Needless battery of investigations and over diagnosis, branded drugs, impractical insurance laws, free-markets approach to health care and sedentary lifestyle are all major factors in creating the current scenario.Its like a bad spiraling black hole which only sucks you into unnecessary and wasteful consumption of health services.

Keeping the whole machinery ticking seems to be the raison d'itre de patient existence.

This video below touches on a few reasons on why health care is so expensive in America. Features like this convince that India must be doing something right in its public health policy. I have been a member of Public health delivery system for about 10 years, in a wide range of positions and institutions. I fully appreciate Indian obstacles (population) and limitations (poverty) in public health delivery. A good step has been taken with the Swasthya bima (govt. sponsored health insurance with private partners). This Indian central govt scheme for BPL (Below poverty line) families is built on sound understanding of indian conditions and mindset. Eighteen states, including Rajasthan, have already launched this scheme. What is needed now is to make sure ALL BPL families OBTAIN an insurance smartcard. NGOs need to come forward to ensure all BPL families get their smartcards. The cost of the insurance is Ruppees 750/- annualy, 75% paid by central govt. and 25% state govt. The consumer would have to pay an annual Ruppees (Thirty) 30/- as registration/renewal fees. Then they would be able to use services at all public hospitals, many private hospitals and most specialist health care institutions all over the country with the help of a single smartcard!! The claims section of the scheme still has to show efficiency. But all in all, its a very well thought out scheme and should work wonders in more ways than one.

----------------------------

------------------------

Evangelizing Swathya Beema Yogana in Rajasthan

2008-12-02T18:39:00.000+05:30

RAKSHA (Registered society for knowledge and health activities) is a Rajasthan based non-profit organization working for democratization of knowledge and health. It is headed by 1)Dr.Neelesh Bhandari, a Armed forces Medical College passout, a pathologist, post graduate in Human Rights and a medical multimedia consultant. Dr.Neelesh has more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. 2) Dr. Preeti Lodha, a psychiatrist and health rights activist with more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. Additionally, Dr. Preeti has previous experience of One year as a Project Manager in Operation Veerni. ( A maternal and child health project run by Apollo Rajdadiji Hospital, Jodhpur with international assistance).

The Swasthya Beema Yogana is an ambitious programme meant to provide cashless health care services to the poor in Rajasthan and India.

-Health Raksha Campaign, Rajasthan-

The main aims of the Project-

1) Creating New multimedia/video content for public awareness
2) Displaying multimedia content at important rural junctions using Audio-visual equipment and via local cable and news channels.Permanent IEC Boards ( 4 feet by 2 feet) to be erected at more than one thousand sites.
3) Explaining the benefits of the scheme to Doctors and health workers.
4) Screening BPL families and referring appropriate cases to public hospitals.
5) Collect data on baseline health status and scheme usage trends amongst the BPL families.

Broadly, the project would consist of

1) Four vehicles, armed with Audio-visual equipment ( Television and CD player) to be leased for One year.
2) Each vehicle manned by one driver, one paramedical staff and one Technician, ie 3 personnel.( Total Twelve employees in four vehicles). Supervision over Four vehicles by Two doctors ( Dr.Neelesh Bhandari,Pathologist and Dr.Preeti Lodha, Psychiatrist).
3) Each vehicle entrusted with carrying out IEC activities in Six ( or seven) Districts.( Total 25 districts)
4) Each vehicle makes a minimum of twenty (20) visits per month.( Total approx. One thousand visits over 25 districts in one year) These visits would be prefixed in consultation with local authorities and would consist of rural junctions with high BPL population/attendees ( like Tehsil offices, hospitals, panchayat bhawan, Bus stops, subordinate courts etc.)
5) Dr.Neelesh Bhandari and Dr.Preeti Lodha to make regular monthly visits to various district hospitals, CHCs etc. to give multimedia presentations on the Scheme to the medical and paramedical staff. These visits shall coincide with monthly block/CHC meetings and achieve the dual purpose of training and sensitization of health workers and Doctors. All District hospitals and medical staff at CHCs in all 25 districts to be covered over one year.

Creating New Multimedia

1) For this campaign original video content shall be produced . Promotional content shot in TV studios ( Surya Cine vision, Mumbai and MEdRC, Hyderabad), Interviews with BPL families and officials on site, health education videos and other such content shall be produced. RAKSHA expects to produce original video content of Tens of hours over One year. All intellectual property rights to the multimedia content will be equally shared between RAKSHA and Controlling agency / ICICI Lombard.All the content shall be branded and provided to local cable channels, TV stations and also published on our youtube channel on medical education.
2) Each visit shall be recorded via Still photographs which shall be posted on a dedicated Flickr channel created for this purpose.Copies of photographs shall be distributed to all the local newspapers. Close to five thousand photographs ( Five photographs per visit X approx. 1000 visits) shall be published on the internet.
3) All the events shall be chronicled ( updated every three days) on a new blogspot/wordpress blog created for this purpose.
Such extensive self publication via youtube, blogs and Flickr.com shall also assist in Remote Monitoring of the campaign by state and central authorities at ICICI Lombard.

During each visit by the mobile team, the activities carried out would include

1) Set up the TV and the CD player
2) Give short talks on the Bima Yojana to the gathering
3) Distribute pamphlets and other brochures.
4) Provide OTC medication only to BPL families. This will be done primarily to attract the Target audience.The seriously ill amongst these families to be referred to nearby hospitals with instructions to avail the Bima Yojana. Data regarding total number of patients seen and referred to be conveyed monthly to ICICI Lombard.

This is the skeleton sketch of the proposed Project to conduct IEC and other Promotional activities in the state of Rajasthan over one year. Initially, the four vehicles shall concentrate on the four districts of Jhalawad, Rajsamand, Barmer and Bikaner ( as recommended by you). Later, all the remaining districts shall be covered in equal proportions during the year. RAKSHA shall operate locally in conjunction with public health authorities and local NGOs like Bharat Vikas Parishad., Manav sewa sansthan and others.RAKSHA shall strive to create new partnerships with national and international organizations by using United Nations platforms like solution exchange.to furthur extend the reach of this campaign.

Copies of all the multimedia content along with analysis of before-after data accumulated over the year shall be handed over to Controlling agency / ICICI Lombard at the end of the year.

Kindly email me for receiving a detailed project report. If approved, RAKSHA can initiate the project from the First of January, 2009.

Dr. Neelesh Bhandari
MBBS(AFMC), MD(Path.)
P.G.P. in Human Rights
www.geocities.com/neeleshbhandari

My blogs and original widgets ecosystem
www.neeleshbhandari.blogspot.com
www.netvibes.com/drneelesh
My slides
www.slideshare.net/drneelesh
My presentations
www.authorstream.com/User-Presentations/drneelesh/
My videos
www.youtube.com/medicaleducation

Chief Mentor- RAKSHA
Registered society for knowledge and health activities.
c/o Suncity Hospital and Research Center, Paota, Jodhpur 342006
Phone- 02912701970

Email- neeleshbhandari@gmail.com, onlineraksha@gmail.com

-Non existent healthcare facilities in Jalpaiguri-

2008-11-09T14:30:00.001+05:30

The Statesman
JALPAIGURI, West Bengal, India

The State Legislative
Assembly’s health standing committee has expressed dissatisfaction
today over the dismal heath service of the Jalpaiguri Sadar Hospital.

After visiting the hospital today, Mrs. Tapati Saha, the chairman of
the committee said that the service seemed to have broken down in spite
of several lakhs of rupees having been sanctioned for the
infrastructure development for the district hospital. “We are wondering
how the sanctioned amount has been spent. No initiative to improve the
health infrastructure is in sight. There is no burn unit. Besides, the
condition of the other wards in the hospital is very bad. The seem not
to care and indifferent to the multitude of patients coming from far
and near for treatment,” she said adding that the team would submit a
special report on the fast worsening condition in the hospital on the
floor of the Assembly in the coming session.

The chairman also expressed concern over the plight of the HIV positive
patients of the district. “The doctors are not following the special
counseling programme for the HIV patients as ordered by the state
government.” Mrs. Saha said. '

Commenting on the charge the medical superintendent of the Jalpaiguri
Sadar Hospital, Mr.Suresh Chandra Bhoumick, said that the separate burn
unit proposal was yet to be sanctioned by the state government.
“Besides, we are under staffed. The special counseling program for the
HIV positive patients would start soon in our district,” he said.

- Preventing Mother-to-Child transmission of HIV-

2008-11-04T11:11:00.001+05:30

Guidelines Address HIV Testing, Prophylaxis to Mother-to-Child Transmission

Below I am quoting some of the guidelines for dealing with Pregnancy in High HIV risk pregnancies, during and after labour.
You can view all the guidelines here

When the mother's HIV serostatus is unknown, the newborn infant's healthcare professional should order rapid HIV antibody testing for the mother or the newborn, with appropriate consent as required by state or local law.
To facilitate appropriate care and testing of the newborn infant, maternal HIV serostatus should promptly be disclosed to the healthcare professional for that infant.
When results of HIV rapid antibody test are positive, the mother and newborn infant should receive antiretroviral prophylaxis without waiting for results of confirmatory HIV testing.
Although women with positive results of HIV rapid antibody test should not breast-feed, they should be offered assistance with immediate initiation of hand and pump expression to stimulate milk production, in the event that confirmatory test results may be negative. If this proves to be the case, prophylaxis should be stopped and breast-feeding may be started.
All facilities with an obstetric unit and/or newborn nursery of any level should have rapid HIV antibody testing available on a 24-hour basis.
Infant medical records should document maternal HIV-infection status, and this documentation should be a standard measure of the adequacy of hospital care for the mother and infant.
Although prophylaxis is most effective within 12 hours of birth, it may still be effective when started as late as 48 hours of life.
Before hospital discharge, the full 6-week course of infant antiretroviral prophylaxis should be arranged and the family should be carefully instructed regarding administration. All third-party payers should pay for the prophylaxis.
Infants should not breast-feed if either the mother or the infant has a positive test result for HIV antibody.
The newborn infant should be tested for HIV antibody, preferably within the first 12 hours of life, in the absence of parental availability for consent. State and local jurisdictions should develop policies to ensure rapid assessment and testing of the infant.
To guide appropriate care and follow-up testing if indicated, infants of unknown HIV exposure status at the first health supervision visit should undergo HIV antibody testing with appropriate consent.
Specialists in obstetric and pediatric HIV infection should be consulted regarding care of the mother, fetus, newborn, and child with perinatal exposure to HIV.

-Achieving Millennium Development Goals, India-

2008-10-22T22:19:00.001+05:30

India forms parliamentary panel to meet MDGs : iGovernment ( 22nd October,2008)
New Delhi: A parliamentary committee comprising 30 MPs was formed on Wednesday to ensure that the Millennium Development Goals (MDG), which India aims to achieve along with the rest of the world, are met by 2015, reports IANS.

"The main aim behind formation of the Parliamentary Group on the MDGs (PG-MDGs) is to sensitise the MPs about the MDGs and the issues that plague India, and indeed the rest of the world today," Lok Sabha MP and a core member of the committee on MDGs Raman Senthil said.

"Only when they are aware, will the various government policies be influenced in the direction of realisation of the goals," Senthil said on the sidelines of a meet on MDGs in the capital on Wednesday.

In 2000, leaders of 189 countries including India signed the Millennium Declaration, agreeing to do everything in their power to end poverty. They promised to do this by achieving the MDGs, a roadmap set by the UN to end extreme poverty by 2015.

"To begin with we are launching the committee with 30 MPs including a bright and upcoming woman MP, Supriya Sule, who is the chairperson of the group. There maybe more members in the future," Senthil said.

Two handbooks were also released for the benefit of the MPs on this occasion. "The handbooks give details about the eight MDGs, what our present government programmes are doing to achieve these and recommendations about what else needs to be done," he said.

For instance, the first goal is eradication of poverty. The current policies towards this common goal include the National Rural Employment Guarantee Scheme (NREGS) and the Public Distribution System (PDS).

Policy recommendations state that NREGS should be made more mission focussed, wage payments should be made on time and transportation to the area of work and child care should be included.

To achieve the MDG of universal primary education, the policy recommendations include more public investment in education, making education a justifiable right and making it more relevant to the present times.

Besides these two, the other six MDGs are promotion of gender equality and women's empowerment, reduction of child mortality, improvement of maternal health, combating HIV/malaria and other diseases, ensuring environmental sustainability and development of global partnership.

HMIS for India

2008-10-22T01:16:00.007+05:30

Proper Health management requires the monitoring of the health status of the population, the provision of services as to the coverage and utility, drugs stocks and consumption patterns, equipment status and availability, Finances, personnel on a regular basis.India has a large population living in widespread far flung areas. Because of this, Data collection and streamlining of public health services has always been a very tough task.

http://www.nrhm-mis.nic.in/

The Government of India has launched the Health Management Information System (HMIS) portal to convert local health data into real time useful information, management indicators and trends which could be displayed graphically in the reports.The new system envisages enhancing the information flow at various levels and providing useful and timely inputs for programme development, monitoring and midcourse interventions in the policies.

The HMIS portal captures data to be collected as per the revised HMIS formats on a web-based system at the District level so that the primary data can be easily aggregated and the information and reports flow quickly to the state head quarters and the Ministry.

The application has been developed by the Ministry in technical collaboration with iBILT Technologies who will also be providing maintenance and support to the application for the next five years.

The portal will be generating unique intelligence reports using the advanced SAS Data Warehousing platform and explore and establish new linkages and advanced analysis for policy initiatives.

`-Radio for health education-

2008-10-19T22:38:00.001+05:30

The Hindu : Kerala / Thiruvananthapuram News : Health capsules on the air

THIRUVANANTHAPURAM: A major campaign utilising the mass media to disseminate health education and public health messages took off here on Monday with the launch of Radio Health, an initiative by the National Rural Health Mission (NRHM-Arogyakeralam).

Inaugurating the campaign at a function here, Health Minister P.K. Sreemathy said Radio Health would make it possible to disseminate information about the increasing incidence of lifestyle- induced diseases and the importance of health in everyday life.

She said the project, to be aired on the Ananthapuri FM platform initially, would be extended to other parts of the State soon.

NRHM Director Dinesh Arora, who participated in the function, said moves were afoot to utilise Ham radio operators for the network.

Radio Health is envisaged as a vehicle for providing information on health-related activities in the State and for giving health education to the community, especially rural women.

-No passive smoking for Indians-

2008-10-17T18:02:00.001+05:30

INDIA BUSINESS WORLD - SUPREME COURT APPROVES SMOKING BAN IN PUBLIC PLACES

THE Supreme Court has refused to stay the Central government's notification imposing a ban on smoking in public places from October 2. A bench headed by Justice B N Agarwal, while refusing to stay the notification dated May 30, 2008, also transferred the four petitions, including one each filed by the ITC and the Indian Hotels Association, against it in the Delhi High Court.

�We are of the view that it is not a fit case for grant of interim relief. The prayer staying implementation of prohibition of smoking in public places is rejected...let transfer cases be heard on November 18", court said. The court also clarified that �no court in the country shall pass any order in derogation of this order." The Centre's plea seeking permission to implement a ban on smoking in public places from October 2�the birth anniversary of Mahatma Gandhi�was part of an application seeking transfer of all the petitions, challenging the ban on smoking in private offices, pending before various high courts. Additional Solicitor Generals Gopal Subramanium and Mohan Prasaran, on behalf of the centre, sought stay on Madras high court order. The high court, in its interim order, had put on hold the centre�s law banning smoking in public places. The people would suffer immensely and an irreparable loss and injury would be caused in case the notification was not implemented, said government's law officer. "The Act would not only discourage smoking in public places but would curtail passive smoking, which is the cause of lung cancer...around one billion deaths are reported every year due to smoking," said centre's law officers. Supporting him, Indra Jaisingh, appearing for health organisations, said that the petitioners should comply with the ban as such rules were being followed all over the world in public interest. However, the tobacco manufacturers and hoteliers earlier strongly opposed the notification saying such a ban on smoking at workplace was unjustified as it would include private offices. Stating that "the Rules go way beyond the Act," senior counsel Harish Salve, appearing for ITC, said that the hotels were already complying with the earlier rules that made it mandatory for the hotels, having a seating capacity of 30 or more, should have separate smoking zones. While partially supporting the ban, Salve said that the petitioners don't have any objection to such ban but the same should be applied discreetly. They alleged that the notification made no distinction between private space and public space and the �Inspector Raj� is what that may create the problem. However, he objected to the enforcement of such ban in private offices like that of lawyers, architects, private clinics, etc and the imposition of fine on persons in charge of these offices. Pointing out that the present Rules amounted to "Inspector Raj,, Salve said that now the hotels and restaurants cannot have any service in the smoking area. "Such place without any service can�t function as a restaurant. No ashtray (can be provided) or a candle can be lit in a restaurant," he added. When the court pointed out that why it took petitioners so much time to approach the court against the ban, Salve said that the petitioners had made various representations to the government and had received a reply only on September 22. �We were trying to evolve a method by which we are able to resolve the problem rather than fighting in court,� The ITC counsel said. Telling the court about the places where such a ban would be imposed, he said that not only work places, shopping malls, cinema halls, airports, hotels and restaurants�which have public access�will have to abide by the notification but a public place would also include open space surrounding such premises such as refreshment rooms, discotheques, canteen etc. It also says that smoking areas or spaces should be used only for the purpose of smoking and that too, at the entrance or exits and no other service shall be allowed. The notification also stipulates that the owner, proprietor, manager, supervisor or incharge of the affairs of a public place shall ensure that no person smokes in the public place and no ashtrays, match boxes, lighters or any other thing designed to facilitate smoking should be kept. Besides, if the owner or any incharge or authorised officer of a public place fails to act on the report of such violation, he shall be liable to pay fine.

- Hindi video for sanitation-

2008-10-17T15:02:00.001+05:30

A hindi language video to promote hand washing.

New tools in public health

2008-10-08T21:33:00.001+05:30

New tool to analyse maternal mortality in India : iGovernment

The United Nations Children's Fund (Unicef) has unveiled a new tool that is designed to help health-care experts, policymakers and local communities across India understand the root causes of its high rates of maternal mortality.

The tool—Maternal and Perinatal Death Inquiry and Response (MAPEDIR)—has collected data and analysed the cases of some 1,600 women across six states within India to show the underlying medical and social reasons behind maternal deaths, a Unicef release said.

An estimated 80,000 Indian women, either pregnant or new mothers, die each year from preventable causes, including haemorrhage, eclampsia, sepsis and anaemia, according to MAPEDIR.

Haemorrhage after delivery is the most common cause of death, the new tool pointed out.

Many other deaths go unrecorded because they occur in the anonymity of a women's homes or when the woman is on the way to seek help at a medical facility. In total, an average of 301 women die annually for every one lakh live births across India.

Chris Hirabayashi, the Deputy Director of Unicef's programmes in India, said the agency was working with health authorities in selected districts in the six states—Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and West Bengal—to promote surveillance as a crucial strategy to cut both maternal and child mortality.

"The tragic reality is that too often maternal deaths are not visible. They don't leave any trace behind, and their deaths are not accounted for," Hirabayashi said

"If India is to achieve the Millennium Development Goal (MDG) of slashing maternal mortality figures by three quarters by 2015, it must tackle critical social and economic factors, such as the low status of women, the poor understanding of many families about health care, the cost of such care, and also the low standard of roads and other forms of transport," Unicef said.

Last month a broader UNICEF report found that at least five women die unnecessarily around the world each year because of complications from pregnancy or childbirth, with the vast majority occurring in the developing world.

MAPEDIR is being funded by the United Kingdom's Department of International Development, and Unicef is providing technical support to the initiative.
—iGovernment Bureau

Mistakes that kill !

2008-10-08T09:17:00.001+05:30

AdelaideNow... Seven die from health system 'mistakes'

SEVEN people have died and dozens more have been left disabled or traumatised by mistakes within the health system, a survey has found.

A consumer watchdog group's snapshot of the public and private health systems also found only six in 10 people affected had filed official complaints, with people citing a fear of retribution and a lack of trust in the system as reasons for staying silent.

Of those surveyed by Health Rights and Community Action, few complainants received apologies and only one respondent felt the system had subsequently changed.

HRCA spokeswoman Pam Moore said the results pointed to the need for an urgent overhaul of complaints processes, with changes to the Health and Community Services Complaints Act and the resourcing of an independent consumer advocacy organisation.

"We are of the strong belief that sweeping changes are needed to health complaints processes generally, within SA, and nationally," she said. Most of the 70 respondents were unhappy with the standard of care, communication, misdiagnoses or waiting times.

In one example, a man's aorta was fatally severed during a triple bypass and when they told his wife, she had a heart attack and died three days later. In another case a GP ignored a woman's complaint of breast pain. She had an independent scan and two days later had to have a total mastectomy.

Other respondents told of threats, bullying and abuse when they tried to complain about their treatment.

Health Minister John Hill said some of the complaints referred to were 30 years old and most were about the private sector. Private hospitals and GPs have separate complaints processes, but unhappy patients can still complain to the HCSC commissioner.

"The State Government has set up a clear process which lets people make complaints about public health services (and) we established the HCSC commissioner to investigate complaints about all health and community services - private and public," he said.

What are health rights?

2008-10-01T12:20:00.001+05:30

A short power point presentation by me trying to explain the basic concepts of health rights.

Uploaded on authorSTREAM by drneelesh

Health rights unit launched

2008-10-01T11:10:00.001+05:30

Health rights unit launched
Tuesday, 30th September, 2008
By Conan Businge THE Uganda Human Rights Commission (UHRC) has set up an office to sensitise and offer legal aid to citizens whose rights to health are abused. UHRC launched the health rights unit on Monday at its head office in Kampala. “The right to health should not be understood as the right to be healthy. It simply contains both freedoms and entitlements to health. The freedom includes the right to control one’s health and body, including sexual and reproductive issues,” an official said. It also includes the right to conditions vital to being healthy, she added. The unit has been operational since 2006. It is funded by the United Nations Development Programme (UNDP), under its country programme, Action Plan. According to the UHRC chairperson, Margaret Sekaggya, one has a right to be free from torture, non-consensual medical treatment and experimentation. “This right stipulates that every human being is entitled to the enjoyment of the highest attainable standard of physical and mental health conducive to living a life of dignity,” Sekaggya explained. She was flanked by Sam Ibanda of UNDP and the assistant commissioner for planning in the ministry of health, Dr. John Bagambisa. The right to health is contained in the Universal Declaration of Human Rights promulgated in 1948. Bagambisa said the unit would help “people realise what they are entitled to in the health units and empower them to demand for the services.” He added that they were planning to secure $100m (about sh1.7b) to support the health sector next year.

Innovative uses of easy-to-use technology

2008-09-25T12:48:00.001+05:30

YouTube - Assignment Rwanda: Using Mobiles to Combat AIDS

Google.org's new initiative, Predict and Prevent.

2008-09-25T12:39:00.002+05:30

Its goal is to identify "hot spots" and enable rapid response to emerging threats, such as infectious disease and climate risk.

Internet audio broadcasting free.

2008-09-24T12:46:00.001+05:30

Juice, the cross-platform podcast receiver.
Want to listen to internet audio programs (podcasts), music and shows but can't when they are scheduled? Juice is for you.

Juice lets users select and download shows and music and play whenever they want on their iPods, portable digital media players, or computers automatically.

I like the idea of democratization of knowledge by widely distributed audio and video snippets. Short, sweet and sticky knols.

Miro - free, open source internet tv and video player

Dance for health rights- This i must share :)

2008-09-24T03:01:00.001+05:30

VietNamNet - Dance for Life to come in November2008

Dance4Life
will attract the attention of youth and encourage them to learn about
HIV/AIDS, productive health rights through dance, music and messages
sent through their idols.

Dance4life
is held every two years globally when participating countries hold the
same event, at the same moment, and is aired globally.

In
Vietnam, the programme is being conducted by the World Population Fund
(WPF), the Vietnamese HIV/AIDS Prevention Agency, the Ministry of
Health, the Hanoi Department of Education and Training, Hands in Hands,
and the Central Ho Chi Minh Communist Youth Union. Vietnam is the second Asian country taking part in this global project.

Dance4Life
will take place on November 29, 2008, with the presence of famous
artists, 3,000 students and representatives of donors and international
non-governmental organisations.

Students and HIV carriers will gather in groups to deliver the message: We are the same, no discrimination.

Dance4Life was founded
in 2003 by Dennis Karpes and Ilco van der Linde in Amsterdam, the
Netherlands, with the message: Start Dancing, Stop Aids. Dance4Life.

Search for any human rights document

2008-09-24T02:55:00.001+05:30

Neccesary Drug information for all!

2008-09-24T02:29:00.001+05:30

RxList - The Internet Drug Index for prescription drugs and medications