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



Sunday, August 9, 2009

Link to InteractiveTutorial on Swine Flu published by Patient Education Institute at Medline Plus




http://www.nlm.nih.gov/medlineplus/tutorials/h1n1flu/htm/index.htm
Dr Marwah

Admissibility / Entitlement for traveling by Shatabadl Express


Admissibility / Entitlement for traveling by Shatabadl Express

No.19030/3/2008-E.IV
Government of India
Ministry of Finance
Department of Expenditure
.........
NewDelhi,Dated 29th June,2009.


OFFICE MEMORANDUM


Subject:- Admissibility / entitlement for traveling by Shatabadl Express.


.........


The undersigned is directed to refer to para 2 A of Annexure to this Department's OM of even number dilled 23.9.2008 and to clarify that for the purpose of journeys on tour, officers drawing Grade Pay of Rs.7600 and above are entitled to travel by Executive Class in Shatabadi trains and AC First Class In Rajdhani trains.
--
Dr Marwah

Sunday, July 26, 2009

Fwd: CENTRAL GOVERNMENT EMPLOYEES NEWS



---------- Forwarded message ----------
From: CENTRAL GOVERNMENT EMPLOYEES NEWS <ushanandhinite@gmail.com>
Date: 2009/7/25
Subject: CENTRAL GOVERNMENT EMPLOYEES NEWS
To: gomarwah@gmail.com


CENTRAL GOVERNMENT EMPLOYEES NEWS


Enhancement of Child Adoption Leave from 135 days to 180 days and extension of the facility of Paternity Leave to adoptive fathers

Posted: 24 Jul 2009 07:31 PM PDT



No. 13018/1/2009-Estt.(L)

GOVERNMENT OF INDIA

Ministry of Personnel, Public Grievances & Pensions

(Department of Pension & Pensioners'Welfare)

Lok Nayak Bhawan,New Delhi-110003
dated the 22nd July, 2009

OFFICE MEMORANDUM


Sub: Enhancement of Child Adoption Leave from 135 days to 180 days and extension of the facility of Paternity Leave to adoptive fathers.



The undersigned is directed to refer to this Department's O.M. No.13018/4/2004-Estt.(L) dated 31st March, 2006 regarding grant of Child Adoption Leave for 135 days to female Government servant on adoption of a child upto the age of one year, on the lines of maternity leave admissible to natural mothers. After implementation of the Sixth Central Pay Commission recommendations, the period of maternity leave was enhanced from 135 days to 180 days. Subsequently, this Department has received representations requesting for enhancement of the period of Child Adoption Leave from 135 days to 180 days in line with the maternity leave. The matter has been examined in this Department and it has been decided to enhance the period of Child Adoption Leave from 135 days to 180 days.


2. A female Government servant in whose case the period of 135 days of Child Adoption Leave has not expired on the date of issue of these orders shall also be eligible for Child Adoption Leave of 180 days.


3. It has also been decided that a male Government servant (including an apprentice) with less than two surviving children, on valid adoption of a child below the age of one year, may be sanctioned Paternity Leave for a period of 15 days within a period of six months from the date of valid adoption.


4. These orders shall take effect from the date of issue.


5. In so far as persons serving in the Indian Audit and Accounts Department are conceded, these orders issue in consultation with the Comptroller and Auditor General of India.

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--
Dr Marwah

Monday, July 20, 2009

Vitamer EA is benfotiamine a dietary supplement


https://www.benfotiamine.net/ShoppingCart.aspx?Category=0

Vitamer EA is benfotiamine a dietary supplement 
 

1. WHAT IS BENFOTIAMINE?

2. IS BENFOTIAMINE SAFE?

3. HAVE THERE BEEN RECENT CLINICAL TRIALS USING BENFOTIAMINE?

4. HOW ABOUT INTERACTIONS WITH OTHER MEDICATIONS?

5. WHAT TYPE OF CONDITIONS MAY RESPOND WELL TO BENFOTIAMINE?

6. HOW MUCH BENFOTIAMINE SHOULD I USE DAILY?

7. WHAT IS THE FDA POSITION ON BENFOTIAMINE?

8. WHY HAVEN'T I HEARD OF BENFOTIAMINE BEFORE?

9. WHAT DOES "PHARMACEUTICAL GRADE" MEAN?

10. HAVE YOU RECEIVED ANY TESTIMONIALS?

11. WHERE CAN I BUY BENFOTIAMINE? 

1.  WHAT IS BENFOTIAMINE?

Benfotiamine is a lipid-soluble form of thiamine (vitamin B-1).  It is perhaps the most effective of the allithiamine group of naturally occurring, thiamine-derived compounds, found in trace quantities in roasted crushed garlic and other vegetables from the Allium genus (such as onions, shallots, and leeks).  The best description of benfotiamine I have found was assembled by AOR, a Canadian nutriceutical company:  Abstracts & Summary Description of Benfotiamine.  If you are interested in the benfotiamine molecule, you may view it here:  Benfotiamine Molecule You may also view the original U.S. patent for benfotiamine here:  Adobe Version of Benfotiamine Patent.

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2.  IS BENFOTIAMINE SAFE?

Though benfotiamine is lipid-soluble, it metabolizes quickly, producing high levels of thiamine pyrophosphate (TPP, the active form of thiamine), which then continues to metabolize in the body as usual.  Benfotiamine itself does not accumulate in the body.  The original patent filed in the United States on benfotiamine, Adobe Version of Benfotiamine Patent, included data from LD-50 tests on lab mice (Table III) indicating that benfotiamine is significantly less toxic than common vitamin B-1 (typically, thiamine hydrochloride).  Thiamine hydrochloride has been the subject of much research.  To quote from the European Commission Health and Consumer Protection Directorate General study on the tolerable upper intake level of vitamin B-1, paragraph 3. Hazard Identification:

"3.1. Evidence of adverse effects in humans. Orally ingested vitamin B1 has a long history of use as an oral supplement without reported adverse effects. Due to its therapeutic action in some frequently observed clinical syndromes, thiamine hydrochloride has been advised and used over a long period of time. There are no reports of adverse effects of oral thiamine, even at dosages of several hundred milligrams a day (SCOGS, 1978; DHEW, 1979; Marks, 1989)."

The entire EC study is available at:  Tolerability of Thiamine (Vitamin B-1).  Again, vitamin-B-1 has proven safe after decades of public use and benfotiamine has been found to be significantly more tolerable than common vitamin B-1.  Also, there are no known negative interactions between benfotiamine and other supplements or medications.  However, there is information published by Ohio State University in 1996 and by the European Journal of Biochemistry in 2001 indicating thiamine supplementation should be carefully considered in patients undergoing therapy for tumorous forms of CANCER.  These articles address thiamine in general (not specifically benfotiamine) but I find them relevant since benfotiamine is essentially a very effective form of thiamine.  You may access that information here:  OSU Article, EJB Abstract.

Otherwise, I believe there is minimal to nil downside in trying benfotiamine and the individual results have the potential to be quite significant.  Still, it is wise and prudent to consult your health care provider before beginning a benfotiamine regimen.  Also, if you have a known sensitivity to thiamine, you should check with your health care provider before using benfotiamine.

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3.  HAVE THERE BEEN RECENT CLINICAL TRIALS USING BENFOTIAMINE?

Yes, in the past couple of years interest in this compound has grown significantly.  You may link to some of the recent clinical trial abstracts here: Clinical Trials.

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4.  HOW ABOUT INTERACTIONS WITH OTHER MEDICATIONS?

Benfotiamine has no known negative interactions with any medications.  In fact, the use of some medications may cause a thiamine deficiency which benfotiamine would likely correct:  Interactions.

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5.  WHAT TYPE OF CONDITIONS MAY RESPOND WELL TO BENFOTIAMINE?

While the recent clinical trials have concentrated on conditions such as neuropathy, retinopathy and nephropathy, there is an expectation among those studying this compound that its beneficial effects may be far more wide-ranging, to include:  sciatica, vascular health, general nerve health, improved blood pressure, general cellular protection, anti-aging, fibromyalgia, prevention of lactic acidosis, and treatment for Alzheimer's disease.  A most informative link on this topic is:  Abstracts & Summary Description of Benfotiamine.

Benfotiamine is not just for diabetics.  Any condition that is the result of a thiamine deficiency will likely respond quite well to benfotiamine.  Of course, any bodily function that is improved by a therapeutic level of thiamine would most likely be enhanced by benfotiamine, since benfotiamine is perhaps the most effective form of thiamine.  Some interesting facts regarding thiamine can be found at this link:  Thiamine Facts.   More on thiamine can be found here:  More Thiamine Facts.

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6.  HOW MUCH BENFOTIAMINE SHOULD I USE DAILY?

Though the body cannot use more than about 10mg. of common, water-soluble vitamin B-1 per day, benfotiamine is lipid-soluble and can safely be used at much higher levels than common vitamin B-1.

Most people get excellent results in 14-21 days time using two 150mg. capsules twice per day (two in the morning and two in the evening). Benfotiamine need not be taken with meals. Some people get better results increasing the dosage to 900mg. or 1200mg. per day after the first two weeks. The point here is that benfotiamine is safe at any reasonable daily usage level. An individual should merely find the level that produces the maximum beneficial effect without reaching a point of diminishing return beyond which the excess amount is wasted.

Dr. Brownlee participated in a clinical trial using 600mg./day:  Clinical Trial Using 600mg. Daily. As for me, I noted dramatic results after increasing daily usage to 600mg.  My neuropathy symptoms ceased progression and began to reverse and I experienced a complete cessation of sciatica episodes.  Also, my average blood pressure dropped from a persistent 145/90 to 120/80, without the use of other blood pressure medications.  I now take two capsules in the morning and two in the evening, everyday. 

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7. WHAT IS THE FDA POSITION ON BENFOTIAMINE?

At first I was curious as to whether benfotiamine is considered a drug or a supplement.  I have established to my satisfaction (and based on the expert opinion of others in the industry) that benfotiamine, a synthetic derivative of vitamin B-1, is a dietary supplement under the Dietary Supplement Health and Education Act (DSHEA) of 1994.  During 2003 I have successfully imported to the U.S. both bottled tablets as well as bulk benfotiamine, with full disclosure and full FDA and U.S. Customs review and approval at the respective U.S. ports of entry.  Let me emphasize that.  The FDA did a hands-on review and inspection of my imported benfotiamine, with full disclosure as to contents by both name and chemical formula, and approved all items for import.  Benfotiamine may be imported under Tariff Number:  2936.22.00.00, (thiamine and its derivatives).   

For those curious as to the current FDA stance on dietary supplements, I offer the following quote from their website:

"Under DSHEA, a firm is responsible for determining that the dietary supplements it manufactures or distributes are safe and that any representations or claims made about them are substantiated by adequate evidence to show that they are not false or misleading. This means that dietary supplements do not need approval from FDA before they are marketed."  See:  http://www.cfsan.fda.gov/~dms/ds-oview.html.   As to the safety of benfotiamine, please see the data provided above in this document. 

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8. WHY HAVEN'T I HEARD OF BENFOTIAMINE BEFORE?

Though attempts were made by the Japanese pharmaceutical manufacturer Sankyo to market benfotiamine in the U.S. decades ago, there was little interest until the recent article published in the U.S. by Dr. Brownlee.  Since that time, interest in benfotiamine has increased dramatically.  I have heard some speculation that since the patent on benfotiamine expired years ago, no large company is interested in investing in its promotion.  I personally remain mystified as to why this very beneficial compound has languished in obscurity in this country until now.

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9. WHAT DOES "PHARMACEUTICAL GRADE" MEAN?

"Pharmaceutical grade" means that the product has been manufactured under GMP conditions and is safe, pure and effective.  Under GMP (Good Manufacturing Practices) every step of the process is documented by using established SOPs (Standard Operating Procedures).  This includes training, equipment, raw materials, facilities, and final release criteria.  Everything can be traced back to the date, time, person, lot number, and piece of equipment used.

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10.  HAVE YOU RECEIVED ANY TESTIMONIALS?

Yes, I am very gratified that, like me, many others are getting good results with benfotiamine.  You may read the testimonials I have received to date at this link:  TESTIMONIALS.

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11.  WHERE CAN I BUY BENFOTIAMINE?

Please follow THIS LINK to be redirected to a website where you may order benfotiamine.

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Note:  If you have other questions you would like to see answered here, please email us at:  info@benfotiamine.org.

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(Note:  Since benfotiamine is classified as a dietary supplement and not a drug, the U.S. FDA has not evaluated its effectiveness.  Benfotiamine therefore cannot be represented to diagnose, treat, cure or prevent any disease.  Also, the information above was assembled by a lay-person, not a medical professional nor practitioner.  For medical advice, please consult your health care professional.)


--
Dr Marwah

Saturday, July 18, 2009

General cancer information, including causes and screening ( www.cancerbackup.org.uk)


Cancerbackup merged with Macmillan Cancer Support in April 2008. It provide the same high quality, expertly developed information about cancer, and now it can make it available to everyone who needs it. The vision is for all people affected by cancer to have the information they want, when they want it - find out more on the main Macmillan website.
www.cancerbackup.org.uk/QAs/TreatmentsQAs/ChemotherapyQAs/All