Month: March 2014

High Court directs MCI to review forensic medicine curriculum in MBBS course

current practice in forensic medicine cover

The Nagpur bench of Bombay High Court has directed the Medical Council of India (MCI) to review the curriculum of forensic medicine in the MBBS course and find out if any revision of the curriculum is needed.

Peeved by the “inadequate and irrational” curriculum of forensic medicine in the MBBS course, a Sevagram-based doctor Indrajit Khandekar had approached the judiciary seeking its immediate revamp.

Dr Khandekar, who is in-charge of Clinical Forensic Medicine Unit (CFMU) and associate professor at Mahatma Gandhi Institute of Medical Sciences (MGIMS) in Sevagram (Wardha), had challenged the existing syllabus before the Nagpur bench of Bombay High Court on the ground that it has no provision for bedside practical teaching of clinical forensic work and forensic postmortem (FPM) work like other clinical subjects. The plea was based on a 464-page study report of the petitioner.

In an order issued on March 13, a division bench comprising Justice B P Dharmadhikari and Justice P R Bora directed the MCI that they shall look into the suggestions given in representation made by the petitioner for revamping the curriculum of forensic medicine in accordance with law and to proceed further and find out whether any revision of the curriculum is necessary or not.

The petitioner’s counsel Anil Kilor had contended that because of lack of bedside practical teaching of medico-legal aspects half-baked and inadequately trained MBBS doctors are being produced in the country.

“Government expects all types of medico-legal work (MLW) from such doctors when they join as Casualty Medical officer (CMO) or Medical Officer after completion of MBBS degree. A quality medico-legal work cannot be expected from such pseudo-experts. That’s why at present quality of medico-legal work in the country is very poor and abysmal which helps in acquittal of accused in majority of cases and also leads to miscarriage of justice,” the counsel argued.

According to the petitioner, there are instances where judiciary has passed strictures against doctors and even government has taken serious actions against doctors for poor quality of medico-legal work.

“But, unfortunately all concerned agencies including government never tried to correct the actual reason — i.e., only theoretical teaching of forensic medicine and lack of bedside practical teaching — behind this. Till the curriculum is amended and properly implemented no one should expect good quality of medico-legal work from the doctors,” said Dr Khandekar.

Kilor further pointed out shortcomings in medico-legal examination in assault cases, recording of dying declaration, sexual violence exam, injury report preparation, age estimation, alcoholic and weapon exams, burn and dowry cases including postmortem exam etc.

According to Dr Khandekar, the key reasons for the poor quality of medico-legal work are production of half-baked and untrained doctors by the MCI; allowing such untrained doctors by the government to do medico-legal work; and private medical colleges not allowed to do postmortem exam.

Dr Khandekar suggested that functional forensic autopsy and clinical forensic medicine units (CFMU) should be set up in every private and govt medical college; clinical forensic and forensic autopsy posting schedule should be provisioned in the syllabus itself for bedside practical teaching like other 15 clinical specialties and all medico-legal work of casualty, trauma centre and hospital should be handed over to the department of forensic medicine under CFMU.

He further suggested compulsory internship in CFMU and autopsy units for a period of one month; optimum teacher student ratio for bedside practical teaching; provision for court visits for MBBS students in batches; and teaching of the subject should be taken up in the later part of the clinical years.

Source: India Medical Times

Spices and herbs helps adults reduce salt intake

Teaching people how to flavor food with spices and herbs is considerably more effective at lowering salt intake than having them do it on their own, according to research presented on Wednesday at the American Heart Association’s Epidemiology & Prevention/Nutrition, Physical Activity & Metabolism Scientific Sessions 2014.In the first phase of the study, 55 volunteers ate a low-sodium diet for four weeks. Researchers provided all foods and calorie-containing drinks. Salt is the main source of sodium in food.

In the second phase, half of the study volunteers participated in a 20-week behavioral intervention aimed at reducing their sodium intake to 1,500 mg/day by using spices and herbs. The other half reduced sodium on their own.
More than 60 percent of the participants in the study had high blood pressure, 18 percent had diabetes and they were overweight.

The researchers found:
In the first phase, sodium intake decreased from an average 3,450 mg/day to an average 1,656 mg/day.

In the second phase, sodium intake increased in both groups. But those who received the behavioral intervention consumed an average 966 mg/day of sodium less than the group that didn’t receive the intervention.

“People in the intervention group learned problem-solving strategies, use of herbs and spices in recipes, how culture influences spice choices, how to monitor diet, overcoming the barriers to making dietary changes, how to choose and order foods when eating out and how to make low-sodium intake permanent,” said Cheryl A. M. Anderson, Ph.D., M.P.H., lead author of the study and associate professor in the Department of Family and Preventive Medicine at the University of California San Diego.

Those assigned to the behavioral intervention group had cooking demonstrations and had a chance to share how they were changing traditional recipes to remove salt and include spices. The researchers didn’t emphasize specific spices, and encouraged participants to try different things to find out what they liked most.

“Salt is abundant in the food supply and the average sodium level for Americans is very high — much higher than what is recommended for healthy living,” Anderson said. “We studied the use of a behavioral intervention where people learn how to use spices and herbs and less salt in their daily lives.”

“Given the challenges of lowering salt in the American diet, we need a public health approach aimed at making it possible for consumers to
The McCormick Science Institute funded the study.

Source: Science daily

Cerebrospinal fluid test may detect Alzheimer’s

Researchers at the University of Texas, in Houston, analysed CSF samples from 50 people with Alzheimer’s disease, 37 people with other neurodegenerative diseases such as Parkinson’s disease, and 39 people with other brain diseases who had normal memory and thinking abilities. They set out to discover whether small fragments of the protein amyloid, which accumulates into clumps in the brain during Alzheimer’s, were present in the CSF of people with the disease.

Their results showed more of these fragments of protein in the CSF of people with Alzheimer’s compared to those with other diseases. The researchers suggest that more research is needed to explore whether the method could detect the disease at its earliest stages.

Dr Simon Ridley, Head of Research at Alzheimer’s Research UK, the UK’s leading dementia research charity, said:
“This very small study suggests a potential way to identify people with Alzheimer’s disease, but it’s too early to tell how accurate this method might be or whether it can distinguish people with the disease from healthy people. We need to see further research in much larger groups of people before we can know whether this approach will be successful.

“Diagnosing Alzheimer’s can be difficult, and the ability to give an accurate diagnosis would be a real boost, allowing people access to the right care and existing treatments. The ability to detect Alzheimer’s accurately is also a key goal for research, as it’s important to be able to test potential new treatments in the right people. Investment in research is vital to develop better diagnosis tools and, crucially, for better treatments to be made available to those who desperately need them.”

Source: alzheimers Research

 

44-pound baby rescued from family by Colombian charity

Eight-month-old Santiago Mendoza might look like a happy, cuddly little tot – but the reality is that he is very sick.

Santiago, who weighs around 44 pounds — the equivalent of a 6-year-old child — has been ‘rescued’ from his family by Colombian health charity Chubby Hearts.

Volunteers from the foundation took the grossly obese infant away from his home in the north east city of Valledupar to a hospital in Bogota for urgent medical treatment.

The intervention came after his mother Eunice Fandino wrote to Chubby Hearts for help after Santiago became too heavy to take outside. Fandino blamed her own ‘‘ignorance’’ for Santiago’s weight gain and admitted she fed him every time he cried.

Santiago’s weight has landed him in the hospital on several occasions in the past. He is now being assessed by specialists.

Source: Fox news

 

Poor diagnosis driving global multidrug-resistant TB, WHO warns

Half a million people fell sick with dangerous superbug strains of tuberculosis (TB) in 2012, but fewer than one in four were diagnosed, putting the rest at risk of dying due to the wrong medicines or no treatment at all.

Latest data from the World Health Organisation (WHO), which says drug-resistant TB is a “global health security risk”, showed a third of the estimated 9 million people who contract TB in any form each year do not get the care they need.

This has led to drug resistance spreading around the world at an alarming rate and has given rise to incurable strains of the bacterial infection – known as totally drug-resistant TB – which cannot be treated with any known medicines.

“Earlier and faster diagnosis of all forms of TB is vital,” said WHO director general Margaret Chan as the U.N. health agency published new TB data on Thursday. “It improves the chances of people getting the right treatment and being cured, and it helps stop spread of drug-resistant disease.”

Last year the WHO called for multidrug-resistant tuberculosis (MDR-TB) to be recognized as a public health crisis. It says the contagious, deadly superbug forms of the disease carry “grave consequences for those affected”.

Treating even regular TB is a long process. Patients need to take a cocktail of antibiotics for six months and many fail to complete the treatment.

This in turn has fuelled the emergence of drug-resistant TB – a man-made problem that has grown in the past decade because people sick with regular TB were either being given the wrong medicines or wrong doses or did not complete their treatment.

HURDLES

Experts say one of the major hurdles to tackling drug-resistant strains effectively is that so many patients who have contracted them do not know it and so continue with the wrong treatments or are not treated at all.

Some of the poorest and most ill-equipped countries have only one central laboratory, which often has limited capacity to diagnose MDR-TB. In other cases, patient samples have to be sent to other countries for testing.

Traditional diagnostic tests can take more than two months to get results, leaving a dangerous gap in which the patient is not getting the right treatment and is putting others at risk of catching the contagious disease.

The WHO says up to 2 million people worldwide may be infected with drug-resistant TB by 2015.

Newer, speedier diagnostic tests have been developed in recent years, but the problem has been getting the technology and know-how to the countries where they are needed most.

However, Chan cited encouraging signs from an international project known as EXPAND-TB (Expanding Access to New Diagnostics for TB), financed by UNITAID, which has helped to triple the number of MDR-TB cases diagnosed in participating countries.

In 2009, UNITAID backed the EXPAND project with $87 million to new TB diagnostic technologies in 27 low- and middle-income countries, which together account for around 40 percent of the global MDR-TB burden.

“The gap in access to TB diagnostics and care is far from filled, but it is narrowing,” said Mario Raviglione, director of WHO’s global TB program. “Increased capacity and reduced prices mean that we can reach more people.”

UNITAID was launched in 2006 by the governments of Britain, Brazil, Chile, France and Norway to give sustainable funding for the fight against HIV/AIDS, malaria and tuberculosis. About 70 percent of its funds come from a levy on airline tickets.

Source: Reuters

Mindfulness Meditation May Reduce Drug User Relapse

Many people who undergo treatment for addiction will relapse and begin using drugs again soon after their therapy ends, but a new study suggests that meditation techniques may help prevent such relapses.

In the study, 286 people who had been treated for substance abuse were assigned to receive one of three therapies after their initial treatment: a program that involved only group discussions, a “relapse- prevention” therapy that involved learning to avoid situations where they might be tempted to use drugs, and a mindfulness-based program that involved meditation sessions to improve self-awareness.

Six months later, participants in the both the relapse prevention and mindfulness group had a reduced risk of relapsing to using drugs or heavy drinking compared with participants in the group discussions group.And after one year, participants in the mindfulness group reported fewer days of drug use, and were at reduced risk of heavy drinking compared with those in the relapse prevention group. This result suggests that the mindfulness-based program may have a more enduring effect, the researchers said.

The researchers emphasized that mindfulness-based programs are not intended to replace standard programs for preventing drug relapse.

“We need to consider many different approaches to addiction treatment. It’s a tough problem,” said study researcher Sarah Bowen, an assistant professor at the University of Washington’s department of psychiatry and behavioral sciences. Mindfulness therapy is “another possibility for people to explore,” she said.

More research is needed to identify which groups of people benefit most from the approach, Bowen said.

Meditation for addiction

About 40 to 60 percent of people who undergo addiction treatment relapse within one year after their treatment ends, the researchers said.

Although 12-step and traditional relapse-prevention programs have value in preventing relapse, “we still have a lot of work to do,” Bowen said.

Mindfulness-based relapse prevention, a program developed by Bowen and colleagues, is essentially a “training in awareness,” Bowen said.

In this program, each session is about two hours, with 30 minutes of guided meditation followed by discussions about what people experienced during meditation and how it relates to addiction or relapse, Bowen said. The meditation sessions are intended to bring heightened attention to things that patients usually ignore, such as how it feels to eat a bite of food, or other bodily sensations, as well as thoughts and feelings.

The mindfulness program may work to prevent relapse in part because it makes people more aware of what happens when they have cravings.

“If you’re not aware of what’s going on, you don’t have a choice, you just react,” Bowen said.

The program also teaches people how to “be with” or accept uncomfortable feelings, such as cravings, rather than fight them, Bowen said. In this way, people learn skills that they can apply to their everyday lives, and not just situations in which they feel tempted, which is usually the focus of other prevention programs, she said.

Addiction and emotions

Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., who was not involved in the study, said people with addiction often suffer from other conditions that involve problems regulating emotions, such as depression, anxiety or self-harm.

Emotional problems, such as feelings of numbness with depression, can be a reason people turn to drugs, he said.

The mindfulness program helps teach people to “tolerate feelings of emotional distress, so when they feel like they’re going to use [drugs], they don’t,” Krakowe said.

Krakower noted that mindfulness meditation programs have already been shown to be useful for depression.

Future studies are needed to examine the effectiveness of the therapy for substance abuse over longer periods, Krakower said. But at the very least, it seems that the program can be helpful for people with emotional dysregulation, which is the majority of the substance abuse population, Krakower said.

The study is published online today (March 19) in the journal JAMA Psychiatry.

Source: Live science

Labour in tub OK but childbirth in water unproven

Sitting in a tub of warm water can relieve a mom-to-be’s pain during the early stages of labour, but actually giving birth under water has no proven benefit and may be risky, say recommendations for U.S. obstetricians.

There’s no count of how many babies in the U.S. are delivered in water, but it is increasingly common for hospitals to offer birthing pools or tubs to help pregnant women relax during labour.

In a report released Thursday, a distinction is made between the two uses, saying that early on immersion may be helpful, as long as some basic precautions are taken.

But there has been little scientific study of underwater delivery, along with a handful of reports over the past decade or so of near-drownings and other risks to the infant, said the joint opinion from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Although complications appear to be rare, the report urges that underwater deliveries be performed only in research studies to settle the questions.

“Labouring in water is not the same as delivering under water,” said co-author Dr. Jeffrey Ecker of Harvard University, adding that he’s cared for numerous women comforted by immersion during labour.

As for delivery, “We want people to do more research,” added ACOG committee member Dr. Aaron Caughey of Oregon Health & Science University.

In fact, midwives at Caughey’s hospital perform several dozen underwater deliveries a year and are collecting data on how mothers and babies fare, said Cathy Emeis, a certified nurse-midwife at the Oregon university. She cautioned that the numbers are small but so far don’t show increased risks.

Pregnant women interested in a water birth at the Oregon facility are required to take a special class and sign a consent form, Emeis said.

“We always acknowledge to our patients that there is not a lot of high-quality evidence that shows there’s a benefit to birthing under water,” she said.

Thursday’s recommendations aren’t binding. Birthing in warm water, which proponents say simulates the uterine environment, has been an option for several decades, although more women use it for early labour than delivery, said Tina Johnson of the American College of Nurse-Midwives.

“I don’t know that this statement will necessarily change women’s desire for that option,” said Johnson, whose organization is drafting its own guidelines.

The Canadian Association of Midwives told CBC News it is standard practice for midwives in Canada to offer underwater deliveries.

“In our experience and our understanding of the research to date, there’s no major concern around the safety of water birth for healthy, normal pregnancies and healthy, normal labour and birth,” Elizabeth Brandeis of the Ontario Association of Midwives said in an interview.

“The majority of women I work with gravitate towards water at some point during their labours.” Brandeis called the U.S. appeal for more research “a laudable impulse.”

The U.S. report recommends that hospitals or birth centres choose low-risk candidates for immersion during labour, keep tubs clean, monitor women appropriately and be able to move them out of the water quickly if a problem occurs.

It says potential risks of underwater delivery include infection, difficulty regulating the baby’s body temperature and respiratory distress if the baby inhales water.

Source: cbc

Diabetes in Middle Age May Cause Memory Problems

People who develop type 2 diabetes or high blood pressure in middle age appear more likely to suffer brain damage that can contribute to dementia as they grow older, a new study finds.

Diabetes might actually shrink the brain over a long period of time, reducing the size of crucial areas like the hippocampus, which plays an important role in short- and long-term memory, according to the study.

Additionally, diabetes and high blood pressure both seem to increase a person’s risk of micro-strokes and other damage to the blood vessels that feed the brain, the study authors said.

“People who had diabetes earlier in life had much worse brain [structure] than those who had it later in life,” said lead author Dr. Rosebud Roberts, a Mayo Clinic researcher. “These scans are showing us that cognitive impairment happens over a long period of time. The earlier you develop type 2 diabetes, the more likely you are to have damage.”

Diabetes has long been linked to problems with thinking and memory later in life, but this study is the first to provide solid evidence explaining why that occurs, said Keith Fargo, director of scientific programs and outreach for the Alzheimer’s Association.

“We are very excited about this study,” Fargo said. “It has been known for quite some time that there is some kind of link between diabetes and cognitive ability later in life. What has not been known yet is why this link exists and how it develops over time.”

The study involved more than 1,400 people with an average age of 80, according to the report published online March 19 in the journal Neurology. The study participants had at most slight memory and thinking problems called mild cognitive impairment. The researchers assessed the participants’ thinking and memory skills, noting any signs of mild impairment.

The study participants then underwent MRI brain scans to look for signs of brain damage that can be an early indication of dementia.

Finally, the researchers reviewed the participants’ medical records to see whether they had been diagnosed with diabetes or high blood pressure in middle age, which, for the purposes of this study, ran from 40 to 64.

The study authors found that people who developed diabetes in middle age had brains that were on average 2.9 percent smaller than people who didn’t have diabetes. And their hippocampi were even smaller — an average of 4 percent smaller than those of non-diabetics.

“When your hippocampus begins to shrink, you begin to lose your long-term memory and your ability to remember recent events,” said Roberts, who also is a member of the American Academy of Neurology.

Source: web md

Parents save premature baby’s life by keeping him in icebox

On the advice of a doctor, a premature baby boy’s life was saved after his parents incubated him inside a polystyrene icebox for five months

In October 2013, Mithilesh Chauhan was born two months premature at Alliance Hospital in Mumbai, India. At birth, he weighed just 3 pounds 3 ounces and was in need of constant monitoring as he was prone to infections.

However, Mithilesh’s parents, Aruna and Ramseh Chauhan, could not afford to keep their son in the hospital’s intensive care unit (ICU). They initially paid for their son’s hospital stay by borrowing money from relatives, but they soon ran out of people to ask for help. The new parents then tried reaching out to other government-run hospitals, but all the ICU waiting lists were too long.

Knowing the baby would have to be discharged soon, doctors at Alliance Hospital suggested a cheap – and unconventional – alternative.

“One doctor told us that if we couldn’t afford to keep our baby in hospital we should try a Thermocol icebox with holes for ventilation and a 60-watt bulb to provide the right amount of warmth,” Aruna Chauhan, 34, told Cover Asia Press. “He advised it was better than nothing and might save our baby. My husband bought the box from a nearby fish market and cut holes in it.”

After 20 days in the ICU, Mithilesh was released from the hospital – leaving the icebox as the Chauhan’s only option. Aruna and Ramseh said they would take him out every two hours to take his temperature.

“It was awful,” Aruna told Cover Asia Press. “We had no idea if it was the right thing to do, but we had to try something. We were terrified if we did nothing he’d die, but we were also aware that what we were doing wasn’t exactly safe either. It was a very distressing time.”

Mithilesh survived after spending five months in the icebox – but he remained severely underweight. He is now receiving 24-hour medical care at the Wadia Hospital for Children, who heard about his condition and offered to treat him for free.

Source: Fox news

7 Spices for super health benefits!

How often do we sprinkle cinnamon powder into the porridge or add a dash of oregano to pizza to pamper our taste buds! It may come as a surprise to many that our favorite herbs and spices not only add a twist of color, flavor and taste to our breakfasts, lunches, and dinners but also pack a nutritional punch.

From keeping our heart healthy and arteries clear to easing pain and warding off cancer, spices used extensively in cooking carry infinite health benefits and contribute towards a healthy life.

spices that not only turn bland dishes into mouth watering delicacies but contribute towards a healthy life.

1. Ginger: This gnarly looking tree root is a good source of magnesium, potassium, copper and vitamin B. The underground stem gives specific flavour to food and has many medicinal uses. It works wonders in alleviating nausea, motion sickness, helps treat upset stomachs, gas and bloating, is beneficial for coping with sore throats and colds. In addition, it is good for arthritis, hinders the growth of certain cancer cells, boosts immunity and promotes sweating.

2. Garlic: Some profess to love garlic while others hate it! Whatever may be the case, there is no denying that garlic is good for you! It has antibacterial, anti-fungal and antiviral properties. Research has established that garlic improves cardiovascular health and helps the body metabolize iron. Just incorporate the spice in your daily diet whether in sauces, pizzas, roasted in veggies or finely chopped in regular meals.

3. Cinnamon: We love cinnamon, the common kitchen spice prized for its unique aroma in pie, rolls, raisin bread, stirred in coffee and sprinkled on yoghurt because it brings out the flavors of the food it is paired with. However, few know that cinnamon tames nausea and stomach ulcers, is a proven anti-inflammatory, keeps arteries healthy increases metabolic rate, helps alleviate arthritis pain, regulates blood sugar and lowers cholesterol. Moreover, it is a natural food preservative.

4. Saffron: The “golden spice” is truly a wonder herb. Prized for adding color and a unique aroma to a dish, this expensive and exotic spice is known to treat nearly 90 ailments. Saffron is a purifier and has a cooling effect. It works wonders as therapy for kidney, bladder and liver disorders. It is heart healthy, and is known to lower blood cholesterol and triglycerides. Saffron is touted as an enhancer of skin tone.

5. Turmeric: This bright orange-yellow spice has some solid gold health benefits. Turmeric paste speeds healing process of injuries and provides pain relief of arthritis. Turmeric can relieve colds, respiratory problems, improve liver function and help to digest fats quickly. Curcumin, a compound in turmeric contains anti-inflammatory and anti-bacterial properties. The spice is also being investigated for its potential benefits in Alzheimer’s disease, managing heart disease and inhibiting cancerous cell growth.

6. Chilies: Believe it or not but chilies which create sensations of heat also help trigger the body’s natural cooling system. Research has established that capsaicin, a pungent compound found in hot chilies, revs up the body’s metabolism and may help burn fat. Capsaicin may also lower risk of ulcers and shield the heart by keeping “bad” LDL cholesterol from turning into a more lethal, artery-clogging form. Moreover, chilies improve circulation, clear congestion, fight inflammation, enhance immunity, aid in weight loss and lower the risk of diabetes.

7. Cardamom: Enriched with dietary fiber, iron, magnesium, zinc, calcium, Vitamin C and potassium, cardamom flushes out toxins from the body, perks up kidney, bladder and digestive function as well as circulation. Commonly known as choti elaichi, this spice alleviates gas and symptoms of asthma, stimulates appetite, aid acid reflux while the fragrant seeds rectify foul breath.

source: the med guru