Morning MEDtalks with Dr KK Aggarwal 6th October 2018Dear ColleagueHere are two links for videos to watch. Share them with your colleagues and friends.Vedic Health - A Dialogue with Shri Ashwini Kumar Choubey
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Allahabad High Court fined doctors for illegible handwriting in medical records. When the Lucknow Bench of the Allahabad High Court struggled to read the injury remarks of victims in 3 Separate Criminal Cases Medical Reports, because of poor handwriting, it reprimanded and penalized the Doctors who had authored them. Judges considered poor handwriting an obstruction to court work and summoned Dr TP Jaiswal of Unnao, Dr PK Goel of Sitapur and Dr Ashish Saxena of Gonda and imposed a fine of Rs. 5000/- each on them. Court further directed Principal Secretary (home), Principal Secretary (medical & health) and Director General (medical & health) of the State to ensure that in the future, medical reports are prepared in Easy Language & Legible Handwriting. Fine amount needs to be deposited at the library of Oudh Bar Association’. On failure, the amount will be deducted from the Doctors salaries. Court also suggested that the reports should be computer-typed rather than handwritten in order to avoid encountering such problems in the future.
A circular was issued by UP Director General (Medical & Health) in 2012 to Doctors, asking them to present Medical Reports in readable form. Judges remarked that the guidelines have been ignored with impunity. However, the Doctors cited a heavy workload as the cause and pled negligence (Source: The Quint).
The Drug Controller General of India (DCGI) on Wednesday asked the Central Drug Laboratory (CDL) at Kasauli to test all batches of polio vaccines for type 2 strain to rule out any possibility of contamination.
A systematic review of health effects of electronic cigarettes: “A conventional cigarette is the most harmful legal product that exists and everything will seem “harmless” compared with it. Also, by searching for harmful ingredients found in conventional cigarettes we may neglect or overlook other ingredients of potential harm (e.g. glycols, flavours, metals, rubber, silicone, ceramics and yet unknown ingredients), as the e-cigarette is a radically different product. Are we comparing apples with pears?” (WHO, p.38)
When mothers used household disinfectants (most commonly multi-surface cleaners, hand soap, and spray air fresheners), their children were more likely to be overweight or obese at age 3. Researchers from Canada used data from the Canadian Healthy Infant Longitudinal Development (CHILD) study to see if there was a connection between the use of household disinfectants by mothers and the weight of their children. By looking at stool samples from the children when they were infants, they found that this increased risk seemed to be related to a change in the bacteria in the digestive tract. The children whose mothers used disinfectants had less of the “healthier” bacteria.
The benefits of exercise cant be overstated for people who have diabetes or almost any other disease, for that matter. Exercise helps control weight, lower blood pressure, lower harmful LDL cholesterol and triglycerides, raise healthy HDL cholesterol, strengthen muscles and bones, reduce anxiety, and improve your general well-being. There are added benefits for people with diabetes: exercise lowers blood glucose levels and boosts your bodys sensitivity to insulin, countering insulin resistance.
Different strains of probiotics offer different health benefits. For example, L. acidophilus has been shown to support healthy digestion and immune function, while B. longum blocks unfriendly bacteria and yeast.
Foods naturally loaded with probiotics are yogurt, kombucha, tempeh, miso, and sauerkraut. These are all fermented foods; it’s the fermentation process that creates probiotics.
Can a registered medical practitioner compel or force his patient to purchase the drug / medicine from him only? (Dr KK Aggarwal & Advocate Ira Gupta) No, the registered medical practitioner cannot compel or force his patient to purchase the drug/medicine from him only.
Though as per Item No. 5 of the Schedule K of the Drugs and Cosmetics Rules, 1945 and Clause 6.3 of the Code of Medical Ethics, the registered medical practitioner is entitled to supply the drugs to his patients which have been prescribed by him.
However, the registered medical practitioner cannot compel or force the patients or his relatives / friends to purchase or take the medicine from the said registered medical practitioner as held by the Hon’ble National Consumer Disputes Redressal Commission in its landmark judgment dated 22.07.2014 titled as Fortis Health Management (North) Ltd. VS Meenu Jain & Anr.
In the case titled as Fortis Health Management (North) Ltd. VS Meenu Jain & Anr., on 25.05.2009, Meenu Jain was admitted to Fortis Escort Hospital, Jaipur, Rajasthan (OP) for treatment of Guillain Barre Syndrome. The Complainant signed a general consent for admission. On 25.06.2009, the patient was on ventilator and administered lifesaving drug injection Iviglob-Ex, five doses daily, for five days. The cost of each injection-M.R.P. was Rs.18,990/-. Those injections were provided by hospital pharmacy and the Complainant was successfully treated and discharged on 13.06.2009. The total sum of Rs.6,82,965/- as hospitalisation charges were paid by the Complainant without any protest.
The Complainant alleges that, he was told that the cost per injection was Rs.9,000/-.The Complainant-2 requested the hospital authorities that the injection Iviglob-Ex was available at Rs.30% - 40% discount in the other medical shops in the market and he may be permitted to purchase the injections from outside, but his request was not considered and he was forced to purchase the injections from the hospital itself.
The Hon’ble Commission held that:
“8. We find that, the complainant singed the consent and the counselling form, but it is also important to understand the state of mind of the complainant-2 as his wife Meenu Jain was in a critical condition in OP hospital. The OP was in a dominating position over the Complainants. Also, the Complainants agreed to pay the expenses of drugs and medicines and other consumables as per rates of the hospital, but it is also an admitted fact that the hospital authorities did not permit the Complainant to purchase the injection “IVIGLOBEX” from outside, despite repeated verbal requests. Those injections were allegedly available in the market at lesser price and he was forced to buy the injections from the hospital itself. Thus, the hospital authorities indirectly imposed unjustified and unreasonable conditions on the Complainant to purchase the injections from the hospital, for the treatment of the patient. The counsel for OP argued that, to ensure quality and genuineness of the drugs, the OP did not permit the patients to buy the drugs from outside which is not at all convincing and reasonable. The OP sold the injections at the maximum retail price (MRP), and not charged any excess amount.
We have given a thoughtful consideration and feel that the patient was suffering from GBS, a serious disease, and was in a critical condition. No doubt, the OP hospital has treated her and cured her. We know that, the corporate hospitals purchase the medicines, surgical items, consumables, in bulk. Certainly huge margin is available, while procurement. OP has not produced it’s purchase bills of those injections. In the open market, certainly the distributors or Pharmacy shops offer discounts on the medicines. The inj. IVIGLOBEX is a very expensive drug, which will be available at discounted price in open market, hence the OP should have allowed at least marginal discount of about 10 to 20%. The corporate hospitals should not be a commercial/business centres for profiteering from the exploitation of such critical patients, who have to pay sky rocketing hospital bills. Regarding contention of OP about spurious drugs, the OP was at liberty to explain the pros and cons of drugs brought from outside market, and after due consent from the complainants, they could have administered the injections.”