RAKSHA

04 February, 2009

-Prozac- Things to know before you use it.

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)

02 January, 2009

-Human rights abuses contribute to Malaria

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.

01 January, 2009

- The best medical blogs of 2008.

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:

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04 December, 2008

-Why American healthcare is so expensive?

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.

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02 December, 2008

Evangelizing Swathya Beema Yogana in Rajasthan

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

09 November, 2008

-Non existent healthcare facilities in Jalpaiguri-

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.

04 November, 2008

- Preventing Mother-to-Child transmission of HIV-

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.