Morning MEDtalks with Dr K K Aggarwal 1^st August 2018

Lok Sabha passes The Homoeopathy Central Council (Amendment) Bill, 2018

A bill seeking to replace the Central Council of Homoeopathy (CCH) with a board of governors and aimed at bringing accountability and quality in homoeopathy education system was passed by the Lok Sabha today. The government, will reconstitute the CCH within a year and restore the democratic process. As per the bill, the members of the board of governor will replace the existing functionaries of the CCH and comprise seven eminent homeopathy practitioners and administrators who will be appointed by the government.

Bill: (a) to constitute a Board of Governors by superseding the Central Council of Homoeopathy till a new Central Council is duly reconstituted within a period of one year from the date of supersession of the Central Council; (b) to make provision for obtaining prior permission of the Central Government by all Homoeopathy Medical Colleges.

It amends the Homoeopathy Central Council Act, 1973 which sets up the Central Council of Homoeopathy. The Central Council regulates homoeopathic education and practice. As Parliament was not in session and immediate action was required to be taken, the President promulgated the Homoeopathy Central Council (Amendment) Ordinance, 2018 on the 18th day of May, 2018.

The Board of Governors will consist of up to seven members including: (i) persons of eminence in the field of homoeopathy education, and (ii) eminent administrators, appointed by the central government. The central government will select one of these members as the Chairperson of the Board.  With regard to policy decisions, the directions of the central government will be final.

Permission for existing homoeopathy colleges: The Ordinance states that: (i) if any person has established a homoeopathy medical college, or (ii) if an established homoeopathy medical college has opened new courses or increased its admission capacity before the Ordinance was promulgated, it will have to seek permission from the central government within one year. If the person or homoeopathy medical college fails to seek such permission, then any medical qualification granted to a student from such medical college will not be recognised under the Act.

A new surveillance report released by the CDC analyses causes of foodborne disease outbreaks between 2009 and 2015

The researchers found 5,760 outbreaks that caused 100,939 illnesses, 5,699 hospitalizations, and 145 deaths in the U.S. during that time. All 50 states, the District of Columbia, and Puerto Rico reported outbreaks. (An outbreak is defined as two or more cases of a similar illness that happens after people eat a common food, the CDC says. So if you get sick after leaving your plate of potato salad out in the heat for too long, it doesn’t qualify.)

The foods that were most often implicated in outbreaks were:

1. Fish (17 percent of all outbreaks)
2. Dairy (11 percent of all outbreaks)
3. Chicken (10 percent of all outbreaks)

But some foods were more likely to cause outbreak-related illnesses. Those were:

1. Chicken (12 percent of cases)
2. Pork (10 percent of cases)
3. Seeded vegetables (10 percent of cases)

The researchers also found that norovirus was responsible for 38 percent of the outbreaks, salmonella was responsible for another 30 percent, and shiga toxin-producing escherichia coli (STEC) was implicated in 6 percent. Other causes (including campylobacter, clostridium perfringens, scombroid toxin, ciguatoxin, staphylococcus aureus, vibrio parahaemolyticus, and listeria monocytogenes) were all responsible for 5 percent or fewer outbreaks.

World Medical Association condemns killing of medic

The killing of a medical student in Nicaragua has been condemned by the World Medical Association (WMA). Brazilian student Rayneia Lima was shot this week while driving home from her hospital shift in Managua, Nicaragua’s capital city. 

WMA President Dr Yoshitake Yokokura said this was a tragic death and illustrated the high risks that doctors in Nicaragua are taking every day in coping with the breakdown of the country’s public health care system.

‘We repeat our warning about the rapidly deteriorating situation in the country. Attacks on health workers, medical vehicles and hospitals are unacceptable’. 

He went on: ‘We repeat our call to the Nicaraguan Government to immediately end this state of affairs. The breakdown of law and order has undermined basic health care in the country and is endangering all those medical staff who are striving to deliver health care in the midst of this crisis. It is the duty of all of us to do what we can to bring this appalling situation to an end’.

Health consequences of floods

Flooded ICU at Patna’s Nalanda hospital has patients, and fish also; Delhi Haryana under flood danger (https://www.youtube.com/watch?v=RdDlzi9bwvc)

Immediate health effects 

1. Drownings are the leading cause of death from floods and are more likely to occur from flash flooding. Most fatalities occur when using a motor vehicle and attempting to cross flooded roads or from crashes on wet roadways. Drownings also occur during evacuation and rescue. 
2. Injuries can occur during the flood or upon return to an unstable structure.
3. Water close to electrical lines, circuits, or equipment can cause an electrical hazard.
4. Floodwaters may disrupt gas lines and chemical storage tanks leading to burns and explosions.
5. Hypothermia can occur in any season as most flood water is well below human core body temperature.
6. Health services can be impacted resulting in limited access to care for patients.

Secondary health effects

1. Floodwaters may increase the potential for infectious diseases. Contaminated water can result in waterborne disease transmission (E. coli, Shigella, Salmonella, and Hepatitis A virus). Fecal contamination of livestock and crops may lead to infectious diseases. Temporary shelters may result in crowded and unsanitary living conditions. Vector-borne disease may increase during flooding. 
2. Chemical contamination can result from the unintended spread of fertilizers, pesticides, and industrial chemicals. An awareness of local land-use is important for assessing this risk. 
3. Carbon monoxide poisoning is a common risk due to unventilated gas- powered electrical generators, pressure washers, cooking tanks and house fires. 
4. Respiratory problems account for high morbidity due to mold and other materials that can be inhaled.
5. Animal displacement increases the risk of bites and transmission of diseases to humans by rodents and sick animals.

Long-term health consequences

1. Exacerbation of chronic diseases such as asthma, allergies, or ear, nose or throat conditions can occur during the flood and clean-up stages due to poor outdoor and indoor air quality.
2. Mental health problems are common occurrences after disasters, including floods, especially in children.
3. Management of mental health problems in children have not been fully addressed in many disaster plans resulting in poor accessibility for this population.
4. Suicides are 14% higher in adults compared to pre-disaster rates and can increase the mental health consequences in children.
5. Social disruption can result in significant health consequences. Antisocial/violent behavior (e.g. assaults, gunshots, rape). Destruction of public health infrastructure. Poor nutrition due to decreased food supplies and livelihood.

Bombay High Court asks state govt. to encourage private doctors to assist in civil hospitals by way of charity for benefit of poor patients

Hon’ble Bombay High Court Bench comprising of Justice NH Patil and Justice G S Kulkarni said that Government’s exercise of getting such doctors to serve at the Malegaon Civil Hospital (in Nashik district) should be followed as a ‘model’ in other districts.

Hon’ble Bench was hearing a PIL filed by a resident of Malegaon town, alleging inaction on part of Public Health Department and local civic body in filling the vacancies for the doctors and Assistant Medical staff at the Malegaon Civic Hospital for years.

Petitioner, Rakesh Bhamare, cited replies to his Right to Information (RTI) queries to inform Court that Authorities had failed to sanction and fill such vacancies since 2012.

Earlier this month, Advocate General Ashutosh Kumbhakoni submitted a report to High Court showing work carried out by medical experts attached to the Malegaon civil hospital and doctors practising privately in June this year.

As per the report, apart from three gynaecologists working with the Malegaon civil hospital, 12 gynaecologists and as many anaesthetists working with private hospitals have also contributed there.

To this, Hon’ble High Court Bench remarked that, “The report is encouraging. It has informed that private doctors have shown their willingness to extend co-operation as and when required by the administration”.

Hon’ble Bombay High Court Bench added that, “We appreciate the gesture. We further expect the administration to encourage private doctors to get them involved in such an exercise, which would be a step in the larger public interest”. (Source: PTI)

NGT on ‘holy’ river Ganga pollution: If cigarette packets can carry injurious to health warning, why not the water from river Ganga?

NGT expressed its displeasure over the quality of water in the river Ganga. National Green Tribunal stated that water of the Ganga river, between Haridwar and Unnao in Uttar Pradesh, was unfit for the drinking and bathing, and expressed anguish over the situation.

NGT Bench directed National Mission for Clean Ganga (NMCG) to install display boards at a gap of 100 kilometres, indicating whether the water was fit for bathing or drinking.

Bench directed NMCG and Central Pollution Control Board to place on their website, within two weeks, a prominent map showing safe spots for bathing and drinking.

NGT added that innocent people drank and bathed in the river with reverence, without knowing that it may adversely affect their health.

NGT Chairperson AK Goel stated that, “We are of the view that on account of great reverence to great Ganga, innocent persons may drink and bathe without knowing that the water is unfit for consumption. It is of utmost necessity to comply with the right to live of persons using Ganga water and they are put to notice about the fitness of water.” (Source HT)

Video to watch: https://www.facebook.com/drkkaggarwal/videos/1934225719932055/

Participate in survey on inflammatory bowel disease:

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Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI