If poor don’t get free treatment at Apollo, will hand it over to AIIMS, warns Supreme Court

If poor don’t get free treatment at Apollo, will hand it over to AIIMS, warns Supreme Court

The Supreme Court asked the Central and Delhi governments to set up a joint inspection team to “find out if poor people are being treated there or this land has been grabbed for private interest”.

By: Express News Service

New Delhi | Updated: March 27, 2025 05:58 IST

The bench also asked them to inform it of the existing total bed strength of the hospital and sought records of OPD patients for the past five years.

The Supreme Court has warned the Indraprastha Apollo Hospital in Delhi that it will ask the All India Institute of Medical Sciences (AIIMS) to take over its management if it does not fulfill its commitment in the lease agreement to provide free treatment to poor patients. “If we find out that poor people are not provided free treatment, we will hand over the hospital to AIIMS,” a bench of Justices Surya Kant and N K Singh cautioned on Tuesday.

The Supreme Court asked the Central and Delhi governments to set up a joint inspection team to “find out if poor people are being treated there or this land has been grabbed for private interest”.

“Discuss the matter at the highest level, and if need be, we will ask AIIMS to run the hospital,” the court said. The hospital has been given four weeks to submit a report.

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The bench was hearing an appeal filed by Indraprastha Medical Corporation Limited (IMCL), which runs the hospital, challenging an order dated September 22, 2009, by the Delhi High Court, which said that “there has been hardly any implementation of the conditions of the agreement providing for free treatment to indoor and outdoor patients” as it cited “reports which clearly show that the IMCL has flouted the conditions with impunity”.

As per the agreement establishing the hospital, it was stipulated that it shall provide free facilities of medical diagnostic and other necessary care to not less than 1/3rd of the total capacity of 600 beds and to provide free of cost full medical diagnostic and other necessary facilities to 40% of the patients attending OPD of the hospital.

The All India Lawyers Union had approached the High Court alleging that this was being flouted.

The High Court asked the hospital “to provide one-third of the free beds i.e. 200 beds with adequate space and necessary facilities to the indoor patients and also to make necessary arrangements for free facilities to 40% of the outdoor patients.”

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Hearing the appeal against the High Court order on Tuesday, the Supreme Court orally remarked that the hospital — built on 15 acres of land given on a symbolic lease of just Re 1 — was to be run on a ‘no profit and no loss’ formula but has instead turned into a purely commercial venture where the poor can hardly afford treatment.

The IMCL counsel told the bench that it was being run as a joint venture and the government of NCT of Delhi has 26% shareholding and had also benefited from the earnings.

“If the Delhi government is earning profit from the hospital instead of taking care of the poor patients, it is the most unfortunate thing,” Justice Kant said. The Supreme Court noted that the land on which the hospital was built was given on a 30-year lease, which was to expire in 2023, and asked the Centre and Union Health Ministry to find out if the same had been renewed and to explain “if the lease deed has not been renewed, what lawful recourse has been initiated for restoration of government land”.

The bench also asked them to inform it of the existing total bed strength of the hospital and sought records of OPD patients for the past five years.

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“The affidavit will explain how many poor patients on the recommendation of the state authorities were provided indoor and outdoor treatment in the last five years,” the court said, allowing the hospital to explain its stand in an affidavit.

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Students demand safety after medical intern is left injured in clash

Students demand safety after medical intern is left injured in clash 

TIMES NEWS NETWORK 23.03.2025

Chennai : Two days after a medical intern at the ESIC Medical College and Hospital in KK Nagar was injured in a clash with the housekeeping and security staff, students —undergraduates and postgraduates — went on a protest on Saturday, demanding safety on campus. The protest, which began at 8am, lasted more than four hours. Students ended it after the management issued a four-page circular promising further inquiry into the incident and enhanced security for students. On Friday, the MGR Nagar police registered a case and arrested housekeeping staff member A P Balajeevagan, who was produced before a magistrate court and remanded in judicial custody. Hospital sources said the security and housekeeping staff stopped a food delivery agent from entering the campus at 11:30pm on Thursday as it was beyond “permitted hours”.

Following this, the intern who had ordered the food, Alfred, argued with Balajeevagan and five other security staff as one of the students recorded them. In the video sent to media, Alfred is seen asking who ordered them to prevent students from ordering food late at night. The arguments turned into a fistfight, and Balajeevagan was seen beating Alfred. Alfred was not available for comment. “Alfred has blunt injuries on his shoulder. He is being treated at the hospital,” hospital dean Dr Kalidas Chavan said. “Preliminary enquiries revealed the intern was beaten. We terminated the housekeeping and security staff. The agencies that employed them gave us a copy of the termination letters. We also filed a police complaint and initiated an internal enquiry into the incident. 

A three-member committee headed by the medical superintendent will inquire into the incident,” he said. The college had asked the security to not permit outsiders, including food delivery agents, on campus after 10:30pm for security reasons, he said. Senior professors said they counselled students and promised legal action against those who hurt Alfred. Meanwhile, students said the management gave them a copy of the letters from two agencies — Urekha Security Agency Private Limited, which terminated H Anwer Basha, R Durai Raj, S Uthirapathy, N Ramamoorthy, and S Durai from services, and from Alert Security Services, which relieved Balajeevagan due to “administrative reasons.”

Govt faces scrutiny over purchase of medicines without issuing tenders

Govt faces scrutiny over purchase of medicines without issuing tenders

 Min Says All Procedures Duly Followed

TIMES NEWS NETWORK 21.03.2025

Jaipur : Govt’s response to a starred question by Congress MLA Rafeek Khan Thursday showed that SN Medical College in Jodhpur purchased medicines worth Rs 5 crore in 2024-25 without going through the mandatory tendering process while medicine supplies worth Rs 28.5 crore were obtained through tenders. 

Responding to Khan’s question on the methods deployed to purchase medicines and healthcare equipment, health minister Gajendra Singh Khimsar said medical colleges and departments follow established regulations for purchases. He said that due to emergency reasons, purchases are sometimes made without tenders. Khimsar assured Khan that any complaints regarding irregularity will be thoroughly investigated. He promised to forward detailed information on this to Khan.

Khimsar’s written response clarified that some medicines were purchased without tenders from cooperative consumer centres and Pradhan Mantri Jan Aushadhi centres, and also locally for amounts under Rs 10,000. Urgent requirements necessitated some equipment purchases without tenders, he added. The medical department’s tender-based procurement for 2024-25 (until Feb 28) included medicines worth Rs 1,366.7 crore and equipment worth Rs 110.9 crore (until March 3). Khimsar announced that the IPD Tower at SMS Hospital in Jaipur will be completed and ready for commissioning by 2028, while the Cardiac Tower is expected to become operational in 3-4 months. The cardiac building at SMS Hospital will be operational within three to four months and offer cardiac services. The 28-storey IPD tower’s completion is scheduled for 2028

‘Prolonged use of steroids linked to risk of glaucoma’

‘Prolonged use of steroids linked to risk of glaucoma’ 

Anuja.Jaiswal@timesofindia.com 16.03.2025

New Delhi : Prolonged use of steroid-based inhalers for respiratory conditions like asthma and bronchitis, continuous application of nasal sprays for allergies, and steroid-containing skin creams for allergic reactions and cosmetic purposes may lead to glaucoma, doctors at AIIMS have observed. They have highlighted the issue and advised regular eye check-ups, indicating that early identification significantly improves the chances of vision preservation. Glaucoma is a persistent eye condition that can damage the optic nerve, potentially causing vision loss or blindness. Dr Tanuj Dada, professorin-charge of the glaucoma unit, emphasised the significance of timely detection. “Glaucoma is known as the thief of vision because it has no symptoms until significant damage occurs. 

After 40, regular check-ups every 1-2 years are essential, even if your vision seems fine.” Dr Dada also cautioned against steroid misuse for children who are often prescribed steroid eye drops by unqualified persons, resulting in glaucoma. He explained that they frequently encountered young children with eye allergies, particularly those from Rajasthan affected by sand-related allergic reactions. These children, when experiencing eye irritation and redness, often get medicines from chemists or seek assistance from unqualified practitioners. Although the immediate allergy symptoms and redness may subside, some children later develop glaucoma. Students sustaining eye injuries from sports equipment such as balls or shuttlecocks during playground activities should also undergo regular eye examinations as these injuries could progress to glaucoma after 10-20 years. The doctor also warned against the use of skin whitening creams that mostly contain steroids. According to doctors, the research also linked stress to glaucoma, with meditation and breathing exercises showing potential benefits.

Chicken bone costs Mumbai mom ₹4 lakh, 21 days in hosp

Chicken bone costs Mumbai mom ₹4 lakh, 21 days in hosp 

3.2CM BONE DAMAGED RUBY’S OESOPHAGUS 

TIMES NEWS NETWORK 07.03.2025

Mumbai : A dinner treat turned into a misadventure for Kurla’s Shaikh family. On Feb 3, Ruby Shaikh (name changed), a 34-year-old woman juggling a seven-year-old daughter, a six-monthold son and four in-laws, was enjoying a rare treat — chicken biryani from a local restaurant. Little did she know that a chicken bone would take her on a month-long medical journey that would baffle doctors. The modestly priced biryani left Ruby’s husband, a supervisor in a local factory, with an ₹8 lakh bill, though the hospital later halved it through donations. The 3.2cm chicken bone that damaged Ruby’s oesophagus was extracted on Feb 8. But when doctors at Criticare Asia Hospital began the throat procedure, it vanished from its initial position (C4-C5 vertebral discs). X-ray and ultrasound examinations couldn’t find it in the chest or abdomen. A CT scan, performed while the patient was intubated, revealed its unexpected upward movement to the nasopharynx, the topmost part of the throat. 

The operation lasted eight hours instead of two hours. Immediately after choking on Feb 3, Ruby arrived at the hospital where an X-ray scan showed a foreign object in her neck. Moved upwards, 

 Due to effect of anaesthesia, bone moved upwards: Doc 

Ruby refused CT scans and admission but returned two days later with fever, high blood pressure, and oral infection. This time, through endoscopy and CT scans, doctors found the foreign body in the cervical oesophagus, having caused bilateral perforations. ENT surgeon Dr Sanjay Helale said, “Scans carried out before the surgery revealed the bone was still in the earlier position.” He chose an open surgery as the bone was close to the carotid artery to the brain and the patient’s perforated food pipe needed repair. “Perhaps due to manipulations of the oesophagus during dissection or due to the effect of anaesthesia, the bone moved upwards,” said Dr Helale, who plans to send the case to a medical journal for publication. Dr Ajay Bhandarwar, head of the surgery department at J J Hospital, Byculla, said the movement from the food pipe back to the throat was unusual. 

Ruby, who was fed through a tube for weeks, has meanwhile told her husband that she will not eat biryani or cook it.

84 drug batches fail quality test, commonly used antacids, diabetes meds among them

84 drug batches fail quality test, commonly used antacids, diabetes meds among them 

24.02.2025

New Delhi : As many as 84 batches of drugs, including some commonly-prescribed steroids and cholesterol-lowering drugs, were found to be ‘not-of-standard quality’ in the latest round of inspections carried out by the drug control authorities across country. CDSCO, which is the apex body responsible for approval of new drugs & clinical trials, has issued an alert regarding this.

 It issues alerts about nonstandard quality drugs being sold in the market monthly. According to its latest data, for Dec 2024, they found 84 batches of drugs manufactured by various firms to be of ‘not-of-standard quality’ (NSQ). This includes some of the drugs prescribed for common conditions such as acidity, high levels of cholesterol, diabetes and bacterial infections among others. Identification of drug samples as NSQ is done based on failure of the drug sample in one or the other specified quality parameters. 

The failure is specific to the drug products of the batch tested by govt, officials said. “This action of identifying NSQ and spurious medicines is taken on a regular basis in collaboration with state regulators to ensure that these drugs are identified & removed from the market,” they added. Recently, CDSCO introduced new guidelines for inspections. It stated all drug inspectors in the country should collect at least 10 samples in a month; nine samples of drugs and one sample of cosmetics/ medical device. TNN

HC notices to govt over lack of quality for patho tests, labs

HC notices to govt over lack of quality for patho tests, labs 

TIMES NEWS NETWORK 24.02.2025

Bhopal/Jabalpur : A division bench of the MP high court issued notices to the central and state govt in response to a petition seeking quality standards for chemicals used in pathological tests. The petitioner stated that there are no standards fixed regarding the chemicals used in pathological tests, and the test results could be erratic if the quality of chemicals used is not proper. 

The petitioner in the case, Advocate Amitabh Gupta, said that different chemicals are used in various pathological tests to obtain results, and if the quality of chemicals is not good, the test results would not be accurate. 

In 2009, a commission formed in this connection was asked to fix standards for chemicals to be used to obtain pathological test results, but after a lapse of so many years, the standards have not yet been deci- ded and practised. This makes the credibility of the tests results suspect.

 Besides, only a few pathological labs have affiliation with NABL. Gupta, arguing the case himself, said that he filed the petition in 2015 and requested the court to find out from NABL regarding steps it has taken to make pathological test reports more credible, fix standards for chemicals to be used, and ensure pathology labs obtain NABL affiliation. After preliminary arguments, the bench of Chief Justice S K Kait and Justice Vivek Jain issued notices to the state and central govt.

Device to treat pain in cancer patients AT RGGGH

Device to treat pain in cancer patients AT RGGGH 

TIMES NEWS NETWORK  16.02.2025

Chennai : A radiofrequency ablation (RFA) device, used to treat chronic pain in the neck, back, and joints, particularly in cancer patients, was inaugurated at Rajiv Gandhi Govt General Hospital. Funded by a donation from the administrator general and official trustee (AGOT), it was dedicated to the public by Justice S S Sundar. 

RFA therapy uses heat to destroy nerve tissue, thereby interrupting pain signals to the brain. “RFA is considered when other methods of treatment, such as pain medication and physical therapy, are not successful,” said health minister Ma Subramanian. The procedure involves inserting a needle-like probe into the target area, where radiofrequency waves generate heat to destroy the nerve tissue. “This therapy can cost up to ₹1 lakh in private hospitals. Patients at RGGH who found no relief from drugs such as morphine will now benefit from this,” he added. 

RGGH dean Dr E Thera-nirajan said the hospital submitted a request and made a presentation to the govt seeking funds for the RFA device. The AGOT board granted ₹42 lakh for the purchase. “RFA is a minimally invasive medical procedure used to treat a variety of conditions. Patients are likely to be pain-free for at least one year,” he said. The equipment can also be used to shrink or destroy tumours in vital organs such as the liver, lungs, and kidneys. Additionally, i t is used to treat irregular heartbeats (arrhythmias) by destroying small areas of heart tissue-causing the irregularities. “It is performed under local anaesthesia, and patients can usually go home the same day,” he said.

Oncologists discuss latest developments in cancer care at Wellness Series webinar

Oncologists discuss latest developments  in cancer care at Wellness Series webinar

The Hindu Bureau

CHENNAI

To mark World Cancer Day, The Hindu Wellness Series, in association with Kauvery Hospitals organised a webinar on ‘Advancements in Cancer Care’.

Three experts — A.N. Vaidhyswaran, senior consultant and director of radiation oncology at Kauvery Hospital, Chennai; Indhuja M.V., consultant medical oncologist at Kauvery Hospital, Tirunelveli, and B. Anis, consultant surgical oncologist at Kauvery Hospital, Tiruchi — spoke about the latest developments in radiation, medical, and surgical oncology. Dr. Vaidhyswaran, who spoke about the cancer trends in the country, said breast cancer is the most common cancer in India and that lung cancer is more widespread in the west.

He also elaborated on the radiation therapy and spoke about the advancements in it, a press release said.

Dr. Indhuja said: “Cancer is caused by genetic mutations, and this method helps analyse those changes.” She also spoke about immunotherapy, Adoptive T-Cell Therapy and Targeted Therapy, which greatly help in improving cancer treatment.

Dr. Anis said, traditionally, during the cancer surgeries, removal of the affected organs, surrounding tissues and lymph nodes, and this often resulted in complications.

“While surgery remains a cornerstone of cancer treatment, medical interventions such as chemotherapy play an equally crucial role,” he said.

Watch the full video here: bit.ly/40Htg35

Eight patients at govt. hospital develop allergic reactions, one dies

Eight patients at govt. hospital develop allergic reactions, one dies

The Hindu Bureau

Salem 01.02.2025

Eight patients admitted to the Salem Government Mohan Kumaramangalam Medical College Hospital (GMKMCH) developed allergicreactions after they were administered salineto the patients on Thursday night.

While one patient died, hospital authorities denied that the death was caused by the saline.

Doctors injected saline into the patients at around 9 p.m. on Thursday night at the male surgery ward.

By around 11 p.m., eight patients developed allergic reactions and their relatives alerted the doctors.

The hospital’s dean, Dr. J. Devi Meenal, along with a medical team, transferred the affected patients to the Hybrid Intensive Care Unit (ICU) in the super-specialty building for treatment.

The affected patients are Venugopal (40), a resident of Mangalapuram in Namakkal district, Manoj (28), a resident of Nagalur in Dharmapuri district; Manoharan (64), a resident of Erode district, Ramesh (45), a resident of Deevattipatti in Salem district, Rajaram (27), a migrant worker, Anbalagan (40), a resident of Kamalapuram in Salem district, and Murugaesan (54), a resident of Vazhapadi in Salem district.

At midnight, Venugopal died at the hospital.

However, hospital authorities denied that his death was caused by the allergic reaction, stating that he had multiple underlying health conditions.

‘Others stable’

Dr. Devi Meenal assured that the same saline solution had been used on several patients across the hospital and that all other affected individuals remained stable.

Sources at GMKMCH reported that Health Minister Ma. Subramanian inquired about the incident, and doctors were instructed to cease using that specific batch of saline. A pharmacovigilance team will investigate the saline.

Mystery illness kills 17 in J&K, Centre sends team

Mystery illness kills 17 in J&K, Centre sends team 

Members To Ascertain Causes Of Mass Deaths 

Sanjay Khajuria | TNN 20.01.2024

Jammu : The spectre of the “mystery illness” continued to haunt residents of Badhaal village in J&K’s Rajouri, with the sixth child of Mohammad Aslam succumbing to the disease at a hospital in Jammu on Sunday, taking the total toll to 17 since Dec 2024, even as an inter-ministerial team from Delhi reached Rajouri to take stock. 

Aslam, who had lost five of his children till Friday, witnessed the death of his sixth and last child, Yasmeena Akhtar Jan (16). She was admitted to a hospital in Rajouri last Sunday from where she was referred to Jammu on Monday. Principal of Govt Medical College and Associated Hospital (GMC&AH) in Jammu, Ashutosh Gupta, told mediapersons that her condition was critical from Day 1 . With this, Aslam has lost four daughters, two sons and his maternal uncle and aunt in a span of a week after they had taken meal at a ‘fatiha’ — a memorial ceremony — organised in memory of Fazal Hussain and Robia Kousar (both 14), Farhana Kousar (9) Raftar (5) and Rukhsar (11) who died on Dec 7 during treatment after being affected by this mysterious dis ease. Earlier, in the wake of deaths in two families in the month of Dec 2024, the directorate of health services under the Union health ministry had sent a team of experts from premier medical institutions, including a team from Indian Council of Medical Research. Equipped with a Mobile Laboratory Vehicle, the team had camped at Kote-ranka to investigate the cases and deaths in Badhaal. 

On Saturday, Union home minister Amit Shah ordered the constitution of an inter-ministerial high-level team to visit a village in Rajouri district to ascertain the causes of mass deaths in the past six weeks. On Friday, J&K CM Omar Abdullah had reviewed the situation in Badhaal village. He had directed the state health department to expedite investigations. During the probe, health teams conducted door-to-door surveys of over 3,000 residents in the affected area, collecting and testing samples of water, food, and other materials. However, all test results, including those for influenza, came negative. Police have constituted a special investigation team (SIT) to probe the mass deaths after neurotoxins were found in samples. Authorities have sealed three houses belonging to the affected families and shifted 21 of their close relatives to a govt accommodation and are being kept under strict monitoring. Official sources said police have questioned around 20 people from the village, some related to the victims’ families

WB suspends 12 docs over C-section death, orders CID probe

 WB suspends 12 docs over C-section death, orders CID probe 

Dwaipayan Ghosh & Debashis Konar | TNN 17.01.2025

Kolkata : Bengal govt suspended Thursday 12 doctors of Midnapore Medical College and Hospital and ordered a CID probe into allegations that their criminal negligence caused the death of a 32-year-old woman within a few hours of giving birth by caesarean section. The suspensions came eight days after Mamoni Ruidas’s death 12 hours after giving birth. She was among five new mothers whose health deteriorated after C-section procedures. Mamoni allegedly died of septic shock while three others were shifted to a Kolkata hospital. 

The suspended doctors include vice principal of MMCH, head of obstetrics and gynaecology, and three colleagues. CM Mamata Banerjee termed Mamoni’s death due to suspected medical negligence “shocking, unacceptable and avoidable”. She said the kin of the deceased had every reason “to question us”. The CM announced a state govt job for one member of the bereaved family and compensation of Rs 5 lakh

Initial probe suggested that a senior doctor who was supposed to be at the OT during the allegedly botched caesarean was working in a private nursing home. “Those who were negligent, those who left C-sections to trainees, must be booked. I am sympathetic to doctors. But I must also consider people’s well-being when there is wrongdoing,” the CM said 

‘Why wasn’t banned IV fluid stocks withdrawn? Following the death of a woman during childbirth at a Bengal hospital, allegedly after administration of intravenous fluid Ringer’s lactate, Calcutta HC on Thursday questioned Bengal health dept, asking it why it had not taken steps to withdraw existing stocks of Ringer’s lactate made by Paschim Banga Pharmaceutical as soon as Directorate of Drugs Control ordered the pharma company to stop manufacturing it on Dec 10, 2024....the high court said.

‘High oxytocin doses one of the reasons for mom death’

‘High oxytocin doses one of the reasons for mom death’

 Three Still In Critical Condition

 Sarthak Ganguly & Sujoy Khanra 

TNN  15.01.2025

Kolkata/Midnapore : A five-and-a-half-page report submitted to the health department by the 13- member probe committee, formed to investigate the death of a woman at Midnapore Medical College and Hospital following a C-section delivery, indicated that high doses of oxytocin were administered to five patients without following any protocol. 

While 22-year-old Mamoni Ruidas died after a C-section on Jan 8, the condition of three others — Nasrin Khatun, Mampi Singh and Minara Bibi — who underwent C-section deliveries on the same day at the hospital, was stated to be serious. They were shifted to SSKM in critical condition. The fourth mother, Rekha Sau, was in stable condition at Midnapore hospital and was supposed to be discharged on Tuesday. However, her condition worsened in the afternoon, and her blood sample was collected for testing, according to her husband Santosh Sau. 

According to a health department official, the patients’ blood was not clotting properly due to infection, and their lungs and kidneys were not functioning well. Nasrin Khatun and Mampi Singh are on ventilation. The report allegedly states that instead of the prescribed 10 units, 15 to 25 units were administered, causing a rapid drop in the patients' blood pressure. 

Oxytocin is used to prevent excessive bleeding. "It appears that the women were given excessive doses of oxytocin, which worsened their conditions," sources said. Additionally, the report mentions that an RMO was on duty in the maternity department's OT at Medinipur Medical College that night. Being the senior doctor, he was expected to perform the surgeries. It is believed he was not present there. The matter will be further investigated. 

Meanwhile, it was observed that family members were being given small notes to buy medicines from outside, which they brought to the hospital. Hospital sources stated that the use of bupivacaine, ranitidine, ceftriaxone, ondansetron, metoclopramide, fentanyl citrate, oxytocin and regallacted injections has been halted. Hospital superintendent Jayanta Raut stated that some injections and RL had been temporarily suspended, and alternatives were being provided. 

On Jan 2, when placing an online order for medicines, 'Ringer's Lactate' was found to be blocked, so it was not purchased from outside but was brought from the Tamluk Hospital stock in East Medinipur. However, it is unclear how the saline that was supposed to be set aside came up at the medical college. A senior health department official said, “Everything is being thoroughly investigated.” 

Saline supplier blacklisted The state Directorate of Health Services Central Medical Stores (CMS) has issued a notice on Tuesday, informing the MSVPs of medical college and hospitals as well as chief medical officer health of districts that all the items, including Ringer’s Lactate (RL) solutions, procured through state management information system (SMIS) from Paschim Banga Pharmaceuticals, should not be used. The notice also stated that “all existing stock of the items supplied by Paschim Banga Pharmaceuticals Pvt Ltd should be withdrawn from wards/hospitals until further orders, if not done already.” However, the notice stated that 'paracetamol infusion and sodium chloride injection may be procured from Pharma Impex laboratories Pvt Ltd through SMIS and other items can be procured as NON CAT (drugs which are not available in the catalog of the supplier) as per the existing policies.” TNN

BMI isn’t an accurate tool to diagnose obesity: Study

BMI isn’t an accurate tool to diagnose obesity: Study

DurgeshNandan.Jha@timesofindia.com 15.01.2025

New Delhi : Do you think you are not obese according to your Body Mass Index? You may be mistaken, as a global commission convened by The Lancet Diabetes & Endocrinology, a reputed medical journal, has now argued that BMI provides inaccurate results in assessing obesity. Doctors should confirm whether a person is obese using at least one other body measurement — such as waist circumference or by directly measuring body fat, it has suggested. 

BMI is a medical screening tool that measures ratio of a person’s height to her or his weight to estimate amount of body fat she or he has. Current definition says a person with a BMI of 30 kg/m2 and above can be considered obese. According to Lancet Commission’s report, released Tuesday, people with excess body fat do not always have a BMI above 30, meaning that their health risk can go unnoticed. Similarly, it says, individuals with high muscle mass (for example, athletes) tend to have high BMIs despite normal fat mass and diagnosing them as having obesity or adisease was inappropriate.

 “Relying on BMI alone to diagnose obesity is problematic as some people tend to store excess fat at the waist or in and around their organs, such as the liver, heart or muscles, and this is associated with a higher health risk compared to when excess fat is stored just beneath the skin in the arms, legs or in other body areas. But people with excess body fat do not always have a BMI that in dicates they are living with obesity, meaning their health problems can go unnoticed. Additionally, some people have a high BMI and high body fat but maintain normal organ and body functions, with no signs or symptoms of ongoing illness.” 

Robert Eckel, a professor at the University of Colorado Anschutz Medical Campus, who was part of the expert group, said. Dr Anoop Misra, a doctor from India who was in the expert committee, added: “Abdominal obesity is common in India. Existing criteria based on BMI measurement often fails to classify them as obesity. The new classification will help remove this hurdle.” The Lancet Commission says not all persons having obesity need medical or surgical intervention. It has, for the first time, recommended subdividing obesity into two groups: clinical obesity and pre-clinical obesity, based on the presence or absence, respectively, of objective clinical manifestations (i.e., signs and symptoms) of altered organ function or impairment of an individual’s ability to conduct daily activities. Preclinical obesity often needs only monitoring and counseling, while clinical obesity may require treatment to prevent severe complications like heart attack, the Commission suggests.

Shape, size of retina veins can predict stroke risk: Study

Shape, size of retina veins can predict stroke risk: Study

DurgeshNandan.Jha@timesofindia.com 15.01.2025

New Delhi : The shape and size of veins and arteries on your retina can predict stroke risk almost as accurately as traditional risk factors, but without the need for invasive tests, according to a new study. Published in international journal Heart, the study claims that the vascular network of the retina, the layer of cells lining the back wall inside the eye that senses light and sends signals to the brain so you can see, is very similar to that of the brain. Therefore, it says, one can use a simple retinal scan to assess the health of these veins and arteries of the retina to predict potential damage to the brain’s blood vessels. 

This includes examining the calibre (length, diameter, ratio) density, twistedness, branching angle and complexity of the veins and arteries. In the Heart study, researchers looked at the health data of 45,161 people aged above 55, collected as part of the UK biobank study. Of them, 749 people developed stroke over a period of 12.5 years. These people tended to be significantly older, male, current smokers, and to have diabetes. They also weighed more, had higher blood pressure, and lower levels of ‘good’ cholesterol, all of which are known risk factors for stroke.

AI-driven software enhances TB detection in Chennai

AI-driven software enhances TB detection in Chennai

Pushpa.Narayan@timesofindia.com 15.01.2024

Chennai : A computer-aided detection software can detect patients with tuberculosis from their X-ray reports using algorithms with high accuracy, a city-based study by doctors from two medical colleges has shown. AI could speed up and streamline the TB screening process in India, which exhibits 27% of all TB cases worldwide with an estimated 2.82 million cases and a 12% fatality rate in 2022, they concluded. 

For the study, the software -called Genki -was connected to an X-ray machine on four mobile diagnostic vans in low-resource areas of Chennai. These vans were used to screen patients who were suggestive of TB. The patients visited the van, completed registration and chest X-ray. The reports were triaged for suggestive findings within one minute -as TB suggestive or TB not suggestive. Scans and AI outputs were then reviewed by an expert radiologist for further interpretation. Patients with suggestive TB were referred for sputum or swab collection to confirm the diagnosis, said the study’s first author, Dr Prabakaran Jayaraman from the department of community medicine at Madha Medical College. Out of 25,598 X-rays screened between January and December 2022, Genki demonstrated an aggregated sensitivity (true positive rate) of 98%, specificity (true negative rate) of 96.9%, and accuracy of 96.9% in detec ting TB from chest X-ray scans, based on expert radiologist annotations. The study was published in the Japanese Association of Rural Medicine Journal of Rural Medicine. Of the 25,598 chest radiographs, radiologists reported TB in 1,029 (4.02%) scans, whereas Genki suggested TB in 1,802 (7.03%) scans. The software predicted 1,029 true positives, 23,775 true negatives, 773 false positives and 21 false negatives, Dr Prabhakaran said. The study included a significant number of participants from remote areas with high TB prevalence. Participants included both asymptomatic and symptomatic individuals. "Both these reflect real-world con ditions.

The software was not trained on any of the study participants' data and hence it minimized bias and provided a more objective assessment of its performance. We found Genki demonstrated consistent performance across different age groups and sexes," said Dr S Sangeetha from the department of community medicine at Vinayaka Mission’s Kirupananda Variyar Medical College and Hospitals. However, there were limitations as the study relied on human reader annotations for performance evaluation. While expert opinions are valuable, biological confirmation through sputum smears or NAATs would provide a more definitive reference standard.

NMC to reduce workload of resident doctors by lowering NEET PG cut-off

NMC to reduce workload of resident doctors by lowering NEET PG cut-off 

To utilise the workforce efficiently, pre-clinical and para-clinical residents will receive training for OPDs

 Ayushi.Gupta1@timesofindia.com 13.01.2025

The medical fraternity is divided over the Union Health Ministry and the National Medical Commission’s (NMC) recent decision to lower the admission cut-off for the NEET-PG 2024 exam. Professionals argue that lowering the cut-off will compromise the quality of medical professionals and will benefit private institutions by allowing them to fill their seats and earn profits by admitting underqualified aspirants. Refuting these claims, the NMC states that the move aims to increase the number of practicing resident doctors and reduce stress caused by excessive workloads. Additionally, it seeks to address the issue of seat wastage in non-clinical medical specialisations such as Pharmacology, Anatomy, Physiology, Biochemistry, and Microbiology. The cut-off for PG medical aspirants has been reduced to the 15 percentile for General and EWS candidates and the 10 percentile for SC, ST, OBC, and PwD candidates. 

Dr B Srinivas, secretary, NMC, says, “Lowering the percentile will not impact the quality of medical professionals, as all candidates are already qualified MBBS doctors with first-hand experience in treating patients. After enrolling in PG courses, these doctors will undergo further training needed in the course. Moreover, every postgraduate student must clear their final exams to earn their PG degree. Those who fail can only continue practicing as MBBS doctors.” 

Sharing the workload 

By lowering the cut-off, the NMC aims to address the issues of burnout in doctors and overworked resident doctors. According to a survey conducted by the NMC’s Mental Health Task Force in 2024, prolonged hospital duties have been a significant risk factor for mental health issues among medical students. Dr Srinivas says, “This step is both patient and resident doctor-friendly, as it will increase the number of resident doctors in all hospital OPDs, where staff shortages often overburden the existing workforce.” Meanwhile, clinical specialisations remain the most preferred choice for NEETPG aspirants, leaving pre-clinical and para-clinical specialisations with vacant seats. Both government and private colleges face significant resource loss due to seat vacancies.

 “The government incurs a setup cost of Rs 1 to Rs 1.5 crore per seat. When these seats remain vacant for all three years, the resources are wasted, benefiting no one. Allowing students with lower scores to fill these seats will reduce wastage helping colleges operate efficiently,” adds Dr Srinivas. Many private colleges reduce fees for non-clinical branches after the first two rounds of MCC counselling, making these courses more affordable, he adds. 

Creating more jobs 

A prominent reason for student disinterest following low enrolment in nonclinical PG courses is the lack of job prospects and financial stability, which has resulted in vacant seats. To counter this, the NMC plans to integrate non-clinical specialisations into roles with clinical exposure, leveraging the existing workforce, as was used during the Covid pandemic. “We are working to involve pre-clinical and para-clinical residents in OPD duties and use their skills in nursing homes, community services, and hospitals. This is a more effective use of manpower compared to many AYUSH doctors working in such roles in allopathic hospitals.

 Pre-clinical and paraclinical students have comparable skills and can be trained for clinical duties, expanding their job opportunities,” says Dr Srinivas. Previously, many NEETPG aspirants had appealed to the NMC to lower the cutoff, enabling them to enrol in non-clinical courses. “MBBS doctors have written letters requesting NMC to absorb them into pre-clinical and para-clinical courses, which will help them save time and further enhance their careers,” adds Dr Srinivas

State govt bans 10 intravenous fluids

State govt bans 10 intravenous fluids

 MOVE AFTER WOMAN’S DEATH 

Sujoy Khanra TNN  12.01.2025

Kolkata : The state health department on Saturday prohibited the use of 10 intravenous fluids to ensure patient safety. The banned fluids include Ringer Lactate, Ringer Solution, dextrose injection, ofloxacin, and sodium chloride irrigation solution among others. The order was sent to all state medical colleges and hospitals and to all senior health officials across the state. The directive came a day after the death of a pregnant woman, Mamoni Ruidas (22), at Midnapore Medical College, after being administered an intravenous fluid. Four other women — Mampi Singh, Nasrin Khatun, Minara Bibi and Rekha Sau — also receiving treatment at Midnapore Medical College are in critical conditions, too. Among the four, two women are on ventilation and one is in the ICU. The women were responding well to the treatment, said hospital superintendent Jayanta Raut. 

On Saturday morning, members of the hospital’s medical board visited the ICU and spoke with the patients’ families. A 13-member committee formed by the state govt is investigating the cause of the illness of these four women and the death of Ruidas. The patients’ families alleged the problem started with the saline. A large number of police presence had been deployed at the hospital. The probe committee, led by OSD (ME) Ashish Biswas, willexamine various aspects, including medications and saline, to determine if there was any laxity. The team visited the hospital and inspected the ICU unit after meeting the principal. Local Congress leaders entered the maternity ward , demanding CM’s resignation. DYFI supporters also protested in front of the hospital superintendent’s office, leading to a scuffle with the police. BJP also held a protest.

Govt. doctors do critical brain surgery to treat aneurysm

Govt. doctors do critical brain surgery to treat aneurysm

The Hindu Bureau

TIRUCHI 10.01.2025

A team from the Department of Neurosurgery, K.A.P. Viswanatham Medical College and Mahatma Gandhi Memorial Government Hospital, conducted its first endovascular ‘coiling’ of an aneurysm (a bulge or ballooning in a blood vessel wall) found in the brain of a 56-year-old man recently.

According to an official statement, the patient had complained of severe headache. Diagnostic tests confirmed the presence of a bi-lobed aneurysm, situated at the anterior communicating artery, which connects the left and right anterior cerebral arteries in the brain.

These aneurysms are particularly challenging because of their complex anatomy and the critical vascular territories they involve. With the guidance of S. Kumaravel, dean, K.A.P. Viswantham Medical College, MGMGH medical superintendent Udhaya Aruna and deputy superintendent Arun Raj, the surgical team carried out the ‘coiling’ operation on the affected area.

An aneurysm coil is a device made of platinum that can stop a ruptured aneurysm from continuing to bleed or prevent an unruptured aneurysm from bleeding. It is usually inserted via catheter.

Patient stable

After the procedure, the patient was shifted to the intensive care unit and his condition was reported to be stable.

The Department of Neurosurgery has performed around 50 diagnostic cerebral angiograms in the past six months, said the statement.

Born without uterus, vaginal procedure gives 28 year old hope of motherhood

Born without uterus, vaginal procedure gives 28 year old hope of motherhood

Yashaswini.Sri@timesofindia.com 08.01.2025

Bengaluru : For Aparna (name changed), a 28-year-old working professional in Bengaluru, unbearable abdominal pain led to a rare diagnosis. Born without a uterus and vagina but with two functional ovaries, Aparna's condition puzzled several doctors. “At 14, I visited a rural hospital for a checkup, where the doctor told me that I won't get periods and advised me to focus on my studies. At 15, another doctor explained my condition to me and my sister, suggesting surgery before marriage. By 16, I began experiencing severe monthly stomach pain, which worsened over time. Despite visiting multiple hospitals, the only answer I got was surgery, without proper explanation,” 

Aparna told TOI. Last year when Aparna suffered unbearable abdominal pain, she visited Dr Nisha Buchade, obstetrics & gynaecologist, gynac-oncologist & minimal access surgeon (laparoscopy and robotic surgeon), Vasavi Hospitals. Aparna was diagnosed with Mayer Rokitansky-KüsterHauser (MRKH) syndrome, which affects about 1 in 5,000 women. “This condition arises from a rare autosomal dominant genetic anomaly, but it is not always inherited. It can also result from sporadic mutations. It is not typically detected in advance, even with genetic testing. Like other congenital abnormalities, it occurs during embryonic development, often due to factors like the absence of Müllerian hormone, which is crucial for the development of the uterus and vagina. Some women may lack a uterus, vagina or cervix due to congenital anomalies caused by sporadic mutations or embryonic developmental factors,” Dr Nisha explained. 

An MRI revealed an enlarged rudimentary uterine horn causing severe pain, while her ovaries remained healthy. Given these findings, a surgical approach was deemed necessary, noted the doctor. Aparna underwent laparoscopic surgery to remove the left rudimentary horn. Additionally, a vaginal reconstruction was performed using a groin muscle flap, successfully creating a functional and anatomically appropriate vaginal structure. By Dec, Aparna had recovered well with a normal-appearing vagina and restored sensation. “During follow-up consultations, she was informed that while she cannot carry a child due to congenital absence of uterus, her healthy ovaries make it possible for her to have biological children via surrogacy. Currently, she is doing exceptionally well and looks forward to a promising future,” Dr Nisha said.