Sunday, December 12, 2010

Time Magazine releases list of Top 10 Medical Breakthroughs of 2010

1. AIDS Drugs Lower the Risk of HIV Infection Antiretroviral drugs have turned the AIDS epidemic around, by thwarting the virus in HIV–positive patients. But new research suggests that this powerful treatment may have another benefit — as a weapon against infection in healthy individuals. In a trial involving nearly 2,500 HIV–negative, but high risk, gay men in six countries, researchers found that a combination antiretroviral pill called Truvada reduced the risk of HIV infection by 44%, compared with placebo. When scientists looked more carefully at the study volunteers who took the medication most faithfully, on a daily basis, they found that the risk of contracting HIV was even lower — 73% lower than the placebo group. More studies will need to confirm the benefit of antiretrovirals in the prevention of HIV, and public health experts warn that even if the results hold up, it would not replace the best method of prophylaxis: safe sex and consistent use of condom That’s because the way so–called pre–exposure prophylaxis, or PrEP, works is to load up high–risk people with HIV–disabling antiretroviral drugs before exposure to the virus, which allows the medication to hit HIV as early as possible. But the drugs do not work as a vaccine would, by priming the immune system to actually prevent infection.
2. Synthetic Cell Move over, Dr. Frankenstein, and make room for your 21st–century counterpart, Dr. Venter. That’s J. Craig Venter, co–mapper of the human genome, who this year took another step toward creating life in the lab. Generated from a painstaking process of stitching together the chemicals that compose DNA, Venter synthesized the entire genome of a bacterium, which was inserted into a cell and was able to replicate. Granted, Venter’s "synthetic cell" had hardly the personality of Mary Shelley’s angst–fueled monster, but it’s man–made life nonetheless. Venter hopes his findings will be the first of a long line of lab–made creatures in synthetic biology. By mixing and matching genetic material into viable combinations, Venter is already generating organisms that may serve as new types of biofuel, or even speed up flu vaccine production by allowing researchers to keep ready–made versions of different viral strai s of influenza on lab shelves.
3. Blood Test for Alzheimer’s The degenerative illness can be definitively diagnosed only at autopsy, when pathologists can confirm the presence of hallmark plaques and tangles in the brain. But a promising new blood test may help confirm a diagnosis early in the disease's progression, which opens the possibility for prevention of dementia and mental decline even before the earliest onset of symptoms. The new test analyzes more than two dozen proteins in the blood, and is 80% accurate in identifying patients with the disease. It is only the latest in a series of new methods, including tests of spinal fluid, aimed at detecting and confirming Alzheimer’s earlier in patients’ lives. Quicker diagnoses could help patients take advantage of behavioral interventions — such as keeping the mind active by maintaining social contacts and learning new things — that may slow the mental deterioration of Alzheimer’s.
4. FDA Approves Botox for Migraines Who knew that vanity could yield a new treatment for pain? After some patients who received Botox injections to prevent wrinkles in their forehead reported that their migraines also seemed to diminish. Based on data from two large trials involving more than 1,000 patients, the company convinced the FDA that patients receiving Botox in the facial area experienced fewer days of migraine pain each month than those who did not get the muscle paralyzing injections. It’s still difficult to predict which headache patients will benefit the most.
5. Taking the Resuscitation Out of CPR For 50 years, rescuers have been saving lives the same way, by combining mouth–to–mouth resuscitation with chest compressions to revive unresponsive victims. But after new data showed that chest compressions alone were just as effective as traditional CPR in rescuing victims of cardiac arrest, the American Heart Association (AHA) decided to update the decades–old process. The new rules for CPR put more emphasis on the chest compressions, and in some cases do away with resuscitating breaths altogether. Several studies have found that untrained bystanders are more comfortable performing chest compressions, without mouth–to–mouth and that victims who receive only compressions are as likely to survive as those who receive full CPR. These results, coupled with the fact that only 30% of those in need of CPR actually get it — in large part because of untrained bystanders’ reluctance to perform what they view as a c mplex procedure — forced the AHA to revise its CPR guidelines. The new recommendations advise all rescuers, to reverse the current protocol for CPR and begin with 30 firm chest compressions, then turn to resuscitating breaths. The priority for those whose hearts may be in distress, is to get the heart pumping again, and starting off with chest compressions may keep damage from a stopped heart to a minimum.
6. The FDA Restricts rosiglitazone Eleven years after it hit the market and became a worldwide blockbuster, the diabetes medication rosiglitazon) was slapped with the FDA’s most stringent drug restrictions yet. Now, the medication that helps control blood sugar in patients with Type II diabetes can be prescribed only by physicians who are part of a registry certifying that they are aware of the increased risk of heart attack associated with the drug. These doctors may dispense rosiglitazone only if their patients have exhausted all other treatment options, and patients must sign off on these risks as well. The FDA’s decision, according to some experts, was long overdue, considering that researchers first reported increased heart risks among rosiglitazone users in 2007. At that time, the FDA instituted its first warning on the drug’s label. And yet a government review of the drug’s safety revealed that its manufacturer, GlaxoSmithKline, was aware of the heightened isks associated with its product not long after it hit the market in 1999. The good news for patients who respond well to rosiglitazone but are finding it difficult to keep their prescription filled under the new restrictions is that a similar drug, pioglitazone, does not seem to pose the same risks to the heart.
7. Blood Test for Heart Attack A heart attack starts with blockages in the blood vessels, so where better to look for predictors of heart trouble than in the blood? At the moment, the most reliable way to check the status of the heart’s vessels is by angiogram, an invasive procedure that involves snaking a thin tube into the vessels from an artery in the leg. But researchers have now identified a preliminary panel of 23 genes that code for blood proteins, which was 83% accurate in detecting blood–vessel obstructions typical of heart disease. When doctors added this blood test to existing measures of heart attack risk — including symptoms of chest pain and family history of health problems — it improved by 16% their ability to classify patients as being at high or low risk, compared with traditional methods alone. It’s too much to expect that the blood test by itself can predict heart attack, at least for now, but it could serve as an early warning call for p tients who register as high risk. Perhaps by prompting changes in diet and lifestyle habits in these patients, it can help prevent them from ever having a heart attack at all.
8. Predicting IVF Success For couples choosing to start a family with in vitro fertilization (IVF), the odds are not always in their favor. The procedure, even under the best circumstances, has a 30% chance of resulting in a live birth on average. So it was welcome news indeed when Stanford University researchers reported on a new method for selecting the strongest embryos, which would most likely result in a pregnancy and live birth. By filming the first few hours of an embryo’s activity after fertilization, the scientists were able to come up with a profile of characteristics of embryos that were most likely to continue developing and survive for several days, instead of dying off. Among other things, the criteria included the time that the embryos took to make their first division from one cell into two, as well as the time that this division itself took to unfold. The next step will be to put this video–based assessment to the test in an IVF clinic, and determine whether he analysis can actually improve pregnancy and live birth rates.
9. Artificial Ovary Scientists reported success in creating an artificial ovary that could one day nurture immature human eggs outside the body. Researchers led by a team at Brown University managed to coax three primary ovary cells donated by patients into a 3–D structure resembling an ovary. In the lab, the cell types interacted with one another and functioned for all intents and purposes like a real ovary, even successfully maturing a human egg from its earliest stages in the follicle to a fully developed form. Most immediately, the structure could help IVF technicians improve success rates. Currently when women donte eggs for a cycle of IVF, they provide a range of both mature and immature eggs; the less developed ones are less likely to be fertilized to become embryos. But by allowing technicians to mature these eggs in the lab, researchers might be able to help each IVF cycle become more efficient in leading to a pregnancy and eventual life birth. In addition, the artificial vary could help women with ovarian disease, who are unable to produce mature eggs, take advantage of IVF to have children of their own.
10. Creating iPS Cells Safer and Faster Working with the groundbreaking type of stem cell known as induced pluripotent stem (iPS) cells — which can be generated from a skin cell, completely bypassing the need for embryos — researchers at Children’s Hospital Boston have overcome a critical hurdle in making the technology safe for human patients. Until now, to create iPS cells from skin cells, researchers needed to expose the skin cells to both viruses and cancer–causing genes to reprogram them to an embryo–like state. Now the Boston scientists report success in using another form of the added genes, known as RNA, that eliminates the danger posed by the insertion of the viruses and cancer-promoting genes. And as an unexpected bonus, the technique is about 100 times more efficient in making iPS cells than the older method. The new findings mark a significant advance toward someday using stem cells as a source of new and healthy cells to replace those that have been destroyed by disease.

Saturday, September 4, 2010

Friday, August 20, 2010

ESI SAG PROMOTION.pdf

Message from gomarwah@gmail.com:
ESI SAG PROMOTION order is  posted on google document. Link is given as follows. https://docs.google.com/fileview?id=0B4IulQCpDTIYYTA3OTU2ZDAtM  Thanks. Dr Marwah
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Friday, August 13, 2010

C.A.T. DECLINES STAY IN OA No.2395/2010( "Dr. Manisha Malhotra & Ors. Vs. UOI & ors.) ON 12-8-2010

C.A.T. DECLINES STAY IN OA No.2395/2010( "Dr. Manisha Malhotra & Ors. Vs. UOI & ors.) ON 12-8-2010

DOCTORS APPROACH C.A.T. AFTER DENIAL OF BENEFITS OF DACP BY MOHFW
Please read the message board at www.dadwa.com

Wednesday, August 11, 2010

Message from -Dr. Vijay Rai, Secretary :-DADWA DOCTORS RESORT TO LITIGATION

Dear All,

DOCTORS RESORT TO LITIGATION : THANKS TO DIVISIVE POLICIES OF GOVT

Message from -Dr. Vijay Rai, Secretary DADWA from www.dadwa.com

Dr Marwah


Message Update 10-8-2010

DOCTORS RESORT TO LITIGATION : THANKS TO DIVISIVE POLICIES OF GOVT.

DADWA had stated earlier on this column that benefits of DACP committed by the MOHFW in Oct. 2008 could be used to divide the members of CHS further. Hundreds of CHS Officers from various sub-cadres of CHS missed inclusion in the list of those who got SAG following DACP. The root cause was change of R/R’s from 3 ‘very good’ grade our of 5 ACR’s to 5 such grades out of 5. Ideally such changes should have been implemented prospectively and not retrospectively but that was not to be.

Now please see the situation. First hundreds of ACR’s pertaining to several years were found missing and the members of CHS were asked to get their ACR’s to the MOHFW. Then was the change of bench mark grades and then delay in DPC’s and then inability of the DPC’s to take cognizance of overall performance of the officers whose were found below the bench mark grades and then inability to communicate the crucial lower grades to the officers concerned and so on. The process of such communication and inviting representations has started but it is too little and too late.

Who has been at the receiving end due to such errors of omission and commission? Any one can guess and as expected, affected doctors (almost 33%) are angry and some have approached the court. DADWA fully supports proactive actions by all such CHS Officers whether in Delhi Govt. or not. One such OA has been filed by about 20 aggrieved doctors in CAT wherein in additions to the remedy to their grievance, reportedly they have sought a stay on the ongoing exercise by MOHFW wherein lists are being finalized to give benefits of DACP to doctors of CHS and some lists are already out. The said OA is listed for 12-8-10.

The core committee of DADWA has deliberated on the issues involved. It understands that the grievance of affected doctors is genuine and deserves remedy, but there is a need to assess the impact of a possible stay if sought by the applicant doctors. MOHFW would be responding to the OA but is may not be surprising if it may lukewarm in contesting the prayer for a stay by Hon’ble CAT. For example there is no reason for the MOHFW to apprise the court of the delay of almost 2 years in reaching to this stage and consequent loss financial loss to hundreds of doctors. Further stay would entitle it to stop the work altogether while senior doctors would continue to retire.

View of DADWA on the Subject: The core committee of DADWA is of the view that,
First facts are to be ascertained as to whether stay has really been sought in the OA coming on 12-8-10? If yes, what are the grounds.
Seek a legal opinion about an ideal course of action so as to protect the interest of both the groups viz. Promoted and not promoted. The view that emerged is that DADWA while supporting the plea of applicants seeking justice viz, promotion and financial benefits of DACP from retrospect (Oct. 2008) without loss of seniority DADWA should request the court to give it an opportunity to present the case of those CHS Officers who are likely to be affected in case Hon’ble CAT grants a stay.
Act decisively and fast so as to meet the deadline of 12-8-10.
It is true that DADWA came to know of these developments late, but it believes that remedy is possible. We seek your full support of that of all groups of doctors and associations. Please give send your views on email to secretarydadwa@rediffmail.com or through views section of this website. -Dr. Vijay Rai, Secretary DADWA

Tuesday, June 22, 2010

Follow-up Treatment of CGHS Beneficiaries in Recognized Hospitals

MONDAY, JUNE 21, 2010

Follow-up Treatment of CGHS Beneficiaries in Recognized Hospitals


The undersigned is directed to refer office memodum No. S.11017/1/95-CGHS (P), dated September 20, 1995 and to say that it has been decided to modify the order in view of difficulties being faced by Central Government Health Scheme beneficiaries.

It has now been decided that the CGHS beneficiaries will beeligible for follow-up treatment relating to Neuro Surgery, Cardiac Surgery (including Coronary Angioplasty & implants), Cancer Surgery/Chemotherapy/Radiotherapy, Kidney transplantation, Hip/Knee replacement Surgery and Accident cases in the same Institutions/Hospitals where the treatment was earlier carried out with prior permission of competent authority. The follow-up treatment will however, be subject to the following conditions :


  1. The reimbursement of expenditure for Consultation/Treatment including hospitalization if required/Investigations will be limited to rates as fixedunder Central Government Health Scheme.
  2. The beneficiary should collect all the OPD medicinesprescribed in connection with the treatment from the dispensary concerned in normal timing. In emergency these could be procured from market.
  3. In case there is no approved CGHS rates for any procedure, or test, reimbursement will be made as per All India Institute of Medical Sciences rates, if any, or actual whichever is less or as per actual in case there is no AIIMS rates also.
  4. Reimbursement in respect of Central Government Employees and other working employees and pensioners of autonomous bodies which were covered under CGHS will be made by respective departments from Service Head; from Rajya Sabha/Lok Sabha Secretariat as the case may be in case of Member of Parliament and EX-Member of Parliament. In respect of Central Government Pensioners, Freedom fighters etc. covered under Central Government Health Scheme, the reimbursement will be made by respective Additional/Joint/Deputy Director of CGHS of concerned City from CGHS head.
  5. Permission for follow-up treatment may be granted by the Head of the Department in case of Central Government Employees, working employees and pensioners of Autonomous Bodies admitted under the scheme and by Rajya Sabha Secretariat/Lok Sabha Secretariat as the case may be in case of Members of Parliament and Ex-MPs and by CMO Incharge of concerned CGHS Dispensary in case of Pensioners, Freedom Fighters etc. for 3-6 months at a time, which may be extended if required on the bases of medical record.
  6. In case of other conditions 9other than those mentioned earlier) where prior permission for treatment in a private hospital recognized under CGHS is granted, regular follow-up treatment is to be obtained from CGHS Dispensary/CGHS/Govt. specialist only. However the OPD medicines prescribed on discharge summary may be issued by concerned CGHS dispensary up to a maximum period of one month.
  7. Permission for follow-up treatment in case of accidents, where patients were admitted under emergency without prior permission in recognized hospitals under CGHS may be considered by Head of CGHS Organization of city concerned subject to Ex-post facto sanction for initial treatment based on discharge summary and possession of a valid CGHS card. In such cases Medical reimbursement claim may be accompanied by a copy of the Permission letter.
  8. In exceptional cases where permission for treatment of the above mentioned conditions in a private un-recognized hospital was granted by Ministry of Health and Family Welfare, permission for follow-up treatment may be considered by Head of CGHS organization of concerned city on a case to case basis and HOD in respective cities.
  9. This issues with the concurrence of Finance Division vide Dy. No. 2266/JS (FA) dated 4/4/2001.
Dr Marwah

CGHS-Hospitals-Delhi as on 10 06 2010

https://docs.google.com/fileview?id=0B4IulQCpDTIYNDliYzdjYTAtMWIwOS00OThmLWJkM2YtYmU0OWQwZWI0MjM4&hl=en_GB
Dr Marwah