AIIMS doctors set an example by operating on an AIDS patient

NEW DELHI: Doctors in the Department of Urology at AIIMS successfully operated on a 65-year-old man on August 24 this year for a kidney tumour.

Yes, it was a routine surgery, but by announcing that the patient was HIV positive and if not operated would have died due to the cancer than the AIDS virus, the doctors want to lead by example.

``This is the first surgery on an AIDS patient at the institute,'' and can send positive signals to the medical fraternity which has been shying away from conducting operations on AIDS patients,'' said Dr N P Gupta, Professor and Head of Department of Urology, who conducted the surgery.

``Usually everyone is scared of HIV patients and tries to stay away from them whereas this man was operated on to give him a new lease of life despite the risk involved in the operation. So, we decided to go public with the case,'' he said.

Dr Gupta is also treating Raj Bahadur, the AIDS patient who was refused treatment by five hospitals in the capital last year. Bahadur was admitted to LNJP after the court took suo motu action. Dr Gupta says Bahadur's case is complicated and surgery would not be possible as the blockage in urethra might return.

Raj Bahadur was, in fact, at AIIMS today, buoyed by a recent Delhi HC order directing the institute to provide him specialised medical treatment. He was given a monthly estimate of the cost of anti-retroviral drugs _ between Rs 8,500 and Rs 14,000 per month. The cost will be borne by the Delhi government.

In the present case, though the patient was HIV positive, he had good general health. His CD count was not very low and he hadn't developed full-fledged AIDS as yet. He had good immunity status and had not developed any probability infection as yet. ``The delay in the operation would have meant cutting down on his life as he would survive the virus for long but the tumour would have killed him,'' the doctor added.

According to him, the patient had smooth post-operative recovery and is progressing well. He is likely to be discharged from the hospital and the doctors hope he will be leading a near-normal life.

``We want to tell people that patients with HIV/AIDS can be safely operated upon. All one needs to do is take universal precautions like using special masks, gowns and shoes for the surgery. The doctors also have to wear double gloves as a precaution,'' he said.

Quality norms for drinking water too

By Our Special Correspondent

NEW DELHI AUG. 27. The Union Health Ministry has initiated a move to set norms for ordinary drinking water for which there are no standards currently.

As a first step, the Ministry has proposed to bring an ordinance to include drinking water as a food item under the Prevention of Food Adulteration Act. Bottled water and mineral water were brought under the purview of the legislation a few years ago. But drinking water was left out on the ground that it would impose a heavy burden on civic bodies.

Announcing the new move, the Union Health Minister, Sushma Swaraj, said the ordinance would be followed by the constitution of a group of experts, to recommend on the quality norms. An ordinance was being issued since inclusion of drinking water as a food item required an amendment to the PFA Act.

Addressing a conference of social sector editors, she announced that the full details of the results of tests conducted on 12 soft drink brands would be made public tomorrow. It would also be placed in the Ministry's website. "We have nothing to hide," she shot back, when a reporter charged that Ministry was trying to keep the report of the test results confidential. The samples that were tested were collected from the market place and belonged to the same bottling units from which the Centre for Science and Environment had collected its samples. Ms. Swaraj announced that the Ministry would launch its first mobile emergency unit, Sanjivani, on December 25. It would carry the latest medical equipment and be able to conduct even intricate surgeries on the spot.

Emergency heart care at SCTIMST

By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 26. The Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) here has set up a round-the-clock intensive care unit (ICU) to admit heart patients requiring emergency treatment.

An institution press note said here today that patients developing acute chest pain or associated symptoms of a heart attack could be brought without any reference to the SCTIMST after checking the availability of beds at the intensive care unit.

Those who need emergency service should contact phone numbers 2524524 or 2443152, the release said.

Ray of hope for filaria patients

KASARGOD: Here is good news for filariasis patients!

A new treatment method for the disease evolved by integrating the systems of modern medicine, ayurveda and yoga has been found effective in reducing the swellings on the bloated legs of the patients leading a hellish life.

The findings will be a topic of discussion at the six-day International Congress of Lymphology beginning in Frieiburg in Germany from September 1. The objective of the conference is global elimination of filariasis.

There are 2.8 crore filariasis patients in India, which is 40 per cent of the global patient population for the disease. As much as ninety-five per cent of the patients are in Kerala, Tamil Nadu, Andhra, Gujarat, West Bengal and Bihar. The highest concentration of the disease in Kerala is in Alappuzha, according to the figures released by the Indian Council of Medical Research.

The new treatment was developed by the Institute of Applied Dermatology (IAD), a Non-Governmental Organisation here. The unique method, which is regarded as the first in the world, is likely to be adopted at the international congress in Germany and could be recommended to the WHO for adoption all over the world as an effective treatment of filariasis.

Dr S R Narahari, a dermatologist here and director of the IAD who has been selected to attend the Germany meet, says the system developed by a team of experts of the IAD has been proved effective in reducing the swellings of patients.

The experts are: Dr P E Mahadevan (Ayurveda), Dr K S Bose (Homoeo), Dr K S Prasanna (Dermatologist), Vivekananda (Head of medicinal plants programme of IAD) and Madhuri S Bose (Botanist).

According to Dr Narahari, the IAD had made a case study of a 68- year-old patient who has been suffering from filariasis for the past 34 years. She was subjected to the treatment, which cost only Rs 1200, for six months.

The girth of her swollen leg was found to be reduced by 21 per cent after the period. Besides, the patient had no symptom of fever during the treatment period nor did she take her periodic penicillin injection.

The entire treatment was recorded on CD, which would be shown to the international audience.

``We evolved the system by integrating three systems _ Modern Medicine, Ayurveda and Yoga,'' says Dr Narahari.

The system of treatment was daily oil massage (Ayurveda system) and deep breathing (Yoga system) while undergoing the massage. The theory of Modern Medicine was applied in diagnosing the disease, which is caused by worms with mosquitoes as carriers.

The lymphatic system which carries lymph from the tissues back to the main blood stream gets blocked gradually once the filaria worms (W. bancrofti) enter the body system. The function of lymph is to nourish the tissues of the body.

According to Dr Narahari, there is no system in Modern Medicine by which the lymphatic system of the patient could be revived by eliminating the block. But it could be revived through Ayurvedic oil massage and the deep breathing could draw the lymph from legs to the chest.

``There is no common method to reduce the lymph size even though high pressure yielding machines are available. Even the reconstruction surgery in Modern Medicine is not effective,'' explains Dr Narahari. He adds that he would argue for the integrated system developed by the IAD since it was cheap, could be practised in homes was effective even for chronic patients.

The IAD would train the relatives of patients on conducting the massage while the patients would be trained in breathing practices, he says.

(Details about the project can be had from www.lymph-congress and www.indian dermatology.org)

Kerala leads in suicide rate

By M. Harish Govind

THIRUVANANTHAPURAM AUG. 24. Kerala has the dubious distinction of being the State with the highest suicide rate in the country, with 28.8 suicides per one lakh population, which is more than twice the national average of 10.8, according to the latest report of National Crime Records Bureau (NCRB).

According to the report, `Accidental deaths and suicides in India', a total of 9,304 suicides was reported from Kerala in 2000. The tiny State contributed 8.57 per cent of the total number of suicides in the country during that year and was ranked only behind the Union Territories of Pondicherry and Andaman & Nicobar Islands as far as the suicide rate was concerned.

The rate of suicide or suicides per one lakh population, has been widely accepted as the yardstick for such ranking. The other southern States like Tamil Nadu (17.72), Karnataka (23.66) and Andhra Pradesh (13.06) have a significantly lower suicide rate.

There has been a steady increase in the incidence of suicide in Kerala over the years, with 25.8 suicides per one lakh population being reported in 1996, 28.5 in 1997, 29.3 in 1998 and 30.5 in 1999. The suicide rate in Kerala was the highest among the States in 1998 and 1999 as well.

Some of the major causes for the suicides were unemployment, family problems, illness, non-settlement or cancellation of marriage, dowry dispute, drug abuse/ addiction, fall in social reputation, failed love affairs, poverty and property disputes. As many as 6,609 victims were males.

Unknown causes contributed to a sizeable chunk of 1,024 suicides in the State. Kerala did not furnish information to the NCRB on the number of cases in which family members committed suicide jointly under a "common pact''.

Out of the suicide victims, 2,049 were unemployed, 1,547 were housewives, 162 were Government employees, 505 were employed in the private sector, 200 in public sector undertakings, 258 were students, 2,192 were self-employed and 1,295 were farmers.

While 3,899 hanged themselves, 579 chose self-immolation as the means of suicide and 623 drowned themselves. The consumption of insecticides and other poisons (3,608), jumping from buildings and from moving vehicles (128), consuming an overdose of sleeping pills (72) and coming under running vehicles and trains (179) were the other means employed by the victims.

‘Check growth of unlicenced nursing schools’

KOZHIKODE: The Kerala chapter of the Trained Nurses’ Association of India (TNAI) on Monday demanded the reconstitution of the Kerala Nurses and Midwives Council and measures to tackle the growth of unlicensed nursing schools in the State.

Addressing a news conference here, TNAI State secretary Sr. Rose Vypana said the State Government is yet to take seriously, the reconstitution of the council, which was last reconstituted two decades back.

When the council was formed, only a few diploma courses were in offer. Over the years, the number of training institutions and programmes have gone up considerably. Yet, the council is not headed by a Nurse Registrar, despite the stipulation of the Indian Nursing Council that the State council should be headed by such a person, she said.

She also said the Government should bridle unlicensed nursing institutions that have mushroomed in the name of nursing schools. ‘‘Employing hands trained from such unprofessional institutes in private hospitals should be stopped for the safety of the public, she said.

The TNAI also demanded the constitution of a Nursing Directorate, as recommended by the Central Government.

If the State is not in a position to form the full body of the directorate due to financial constraints, the posts of the Joint Director of Nursing and Additional Director of Nursing should be filled. Such a move would go a long way in reorganising the nursing sector in the State.

The 39th annual conference of the Kerala branch of the TNAI will be held at the Baby Memorial Hospital here on Tuesday.

Medi Week begins at British Library

THIRUVANANTHAPURAM: A Medi Week book exhibition and a seminar on public health education began at the British Library here on Sunday .

The week-long programme, being conducted jointly by the Indian Medical Association and the British Council, was inaugurated by Mayor J Chandra.

Health Secretary Ramamoorthy delivered the keynote address. IMA’s former president V C Velayudhan Pillai, Residents’ Association president John, British Library Manager T K Subramoni and Indian Medical Association secretary Sreejith N Kumar spoke.

Over 500 new medical books are on display at the exhibition.

GO on 50 per cent merit seats AIMS in a quandary

THIRUVANANTHAPURAM: The Government Order directing the Amritha Institute of Medical Sciences (AIMS), Kochi, to admit candidates from the Government merit list to 50 percent seats in the MBBS course this academic year has put the management in a quandary.

According to AIMS sources, admissions to all the 100 seats had been completed in its capacity as a deemed university and the classes had begun in the medical college.

The college management had conveyed to the Government its inability to admit students from the list of the Commissioner for Entrance Examinations this year.

However, it was ready to follow the Government directive from next year onwards.

When contacted, Higher Education Principal Secretary K.Mohandas said that the Government order was in tune with the Supreme Court verdict and the policy of the State Government.

Since the AIMS had completed the admissions, a solution would have to be worked out after holding discussions with the college management, he said.

Entrance Examination Commissioner C.K.Viswanathan said that he was yet to see the Government order directing the AIMS to admit merit students to 50 percent seats.

‘‘If a Government order has been issued in this regard, the AIMS will have to abide by it,’’ he said.

More private medical colleges may come up

By Our Staff Reporter

THIRUVANANTHAPURAM AUG. 22. The Government of Kerala has issued Essentiality Certificate to 17 private managements to set up self- financing medical colleges in the State.

These agencies will be granted permission to set up the colleges only after they satisfy all the conditions laid down by the Government.

Each management has to remit a sum of Rs. 50,000 as application fee and Rs. 5 lakhs towards processing fee. The colleges will have to function strictly within the framework of the Medical Council of India and will be required to give a written undertaking to the effect that in the event of failing to do so, all the financial commitments would be met by them.

As much as 50 per cent of the seats should be filled from the list to be provided by the Commissioner for Entrance Examinations. And with regard to the fees, the decision of the Government will be binding on the managements.

The maximum number (five) of applicants are from Palakkad district. There are three agencies from Thiruvananthapuram and two each from the districts of Kannur and Kollam. From Pathanamthitta, Alappuzha, Malappuram, Kozhikode and Kasaragod districts, there is one applicant each.

Govt sactions essentiality certificates for 17 medical colleges

THIRUVANANTHAPURAM: The Government has sanctioned essentiality certificates for starting 17 more self-financing medical colleges in the State subject to conditions.
The institutions which were given essentially certificates are the following: Vandematharam Medical Research Centre (Palakkad), T S Arunachalam Pillai Memorial Educational and Charitable Trust (Thiruvananthapuram), Saikrishna Educational Society (Palakkad), Century Educational Trust (Kannur), V N Public Health and Educational Trust (Palakkad), P G R Foundation (Alappuzha), Ravindranath Tagore Educational Charitable Trust (Palakkad), Century Educational Trust (Kasargod), Prestige Educational Trust (Kannur), Quilon Medical Trust (Kollam), Society of Sisters of the Holy Cross (Kollam), Rugmini Memorial Charitable Educational Health Trust (Thiruvananthapuram), Al-Ameen Educational and Charitable Trust (Thiruvananthapuram), Sri Anjaneya Medical Trust (Palakkad), Archana Hospital (Pathanamthitta), The Muslim educational Trust (renewal of essentiality certificate, Malappuram), Kunjitharuvai Memorial Charitable Trust (renewal of essentiality certificate, Kozhikode).

The institutions will have to remit Rs 50,000 as application fee and Rs 5 lakh as processing fees with the Government. They should also submit an undertaking that the institutions will be run according to the guidelines prescribed by the Indian Medical Council and they will own up any loss which the institutions may meet while running the institutions according to the guidelines.
The colleges will have to set apart 50 percent of the seats for the candidates recommended by the Commissioner of Entrance Examinations. Another condition is that the colleges should not collect fees more than what the Government decides.

Cancer Care for Life scheme revived

THIRUVANANTHAPURAM: The Regional Cancer Centre (RCC) here has revived the `Cancer Care for Life' scheme following public demand.

The third phase of the scheme, which was recently launched, has two kinds of membership programmes, one with a membership fee of Rs 500 and the other for Rs 10,000. The membership fee was just Rs 100 when the scheme was introduced in 1986, but it was later raised to Rs 500 due to escalation in the cost of medicines. The scheme is open to all Indian citizens who are not cancer patients now.

RCC additional director Dr B.Rajan said that there were both individual and family schemes. ``When you take a membership for Rs 500, you get treatment facilities up to hundred times the value of the membership fee, that is Rs 50,000. A family of three persons needs to pay a membership fee of Rs 1,400, a family of four Rs 1,700 and a family of five Rs 2,000,'' he said. Those who take a membership of Rs 10,000 get free treatment for Rs 5 lakh.

The facilities offered include out-patient treatment, in-patient treatment, case investigation, radiation therapy, chemotherapy, surgery, reimbursement of expenses for stay during treatment in Thiruvananthapuram as per the rules of the Regional Cancer Centre, and psychological, social and vocational counselling.
However, members will have to report with a referral letter from a registered allopathic practitioner. ``You will get the benefits of the scheme after two years from the date of joining. But the cost of treatment in other hospitals before reporting to the RCC will not be reimbursed,'' he said.

While the application forms are available at the RCC, interested persons can become members of the scheme by paying the membership fee at the designated banks. A membership card with a number will be issued to each member for identification. The membership fee, which is non-refundable and non-transferable, will be a once-in-a-lifetime payment with no annual premium.

Hospitals expect influx of patients from U.K.

By M. Dinesh Varma

THIRUVANANTHAPURAM Aug. 21. Hospitals in Kerala which deliver state-of-the-art health care in various specialities can expect to attract a share of British patients, following the recent relaxation of rules by the U.K. Government allowing Britons to undergo treatment in other countries.

The rules had been relaxed in a bid to clear the steadily mounting backlog of patients enlisted in Britain's National Health Services (NHS) who were waiting for extended periods to undergo treatment for procedures ranging from cardiac operations to cataract surgeries.

``The relatively low cost factor could be a strong incentive for patients in Britain to opt for treatment at centres in India rather than, say, hospitals in Europe,'' says M.I. Sahadulla, who is the only delegate from the State representing a high-level team of the Healthcare Mission to the U.K. of the Confederation of Indian Industry.

It is pointed out that undergoing a cardiac surgery would cost only around 3,000 pounds, which would cover to and fro flight costs. The expenses are almost half of what it would cost to undergo a similar procedure in the U.K.

In fact, it is estimated that patients in the U.K. suffering from heart, orthopaedic, ophthalmic or lung ailments could be flown in for undergoing surgery in India at virtually half of what a similar procedure would cost elsewhere.

Dr. Sahadulla, chairman and managing director of the Kerala Institute of Medical Sciences (KIMS), joins a team of around 20 executives of corporate hospitals in the CII's Healthcare Mission. The delegation leaves later this month for discussions with representatives of the British High Commission and officials of the NHS and insurance firms.

According to current estimates, over a million patients requiring treatment for a range of ailments are on the wait-list of the NHS in the U.K. While the wait-period of undergoing a cardiac operation is as long as six months, patients requiring cataract surgery have to wait for nearly nine months. The facility is also expected to be made available for a fairly large constituency of Indian expatriates in the U.K.

Given the presence of several state-of-the-art hospitals in the country, the CII is anticipating an influx of Britons visiting India for a medical reason.

In fact, the CII had earlier sent a delegation to the U.K. to discuss the possibilities of engaging select Indian hospitals to reduce the backlog of patients in the NHS.

The new delegation would carry forward the discussions in a bid to convince high-ranking British officials about the competency of select Indian hospitals in rendering tertiary-level treatment for patients in the NHS backlog. The talks are slated to be held between September 1 and 4 at London.

According to Dr. Sahadulla, the British Government is also expected to send a multi-disciplinary inspection team to India for evaluating medical facilities of hospitals and evolving a grading system before allowing these institutions to undertake treatment of patients from the country.

Medical PG admission

By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 21. The provisional select and waiting lists of candidates eligible for admission to the post-graduate super speciality courses, 2002, in the medical colleges in the State have been published.

The lists have been prepared on the basis of the entrance examination conducted at Thiruvananthapuram, on August 2 and 3, 2003.

The Director of Medical Education will make the admission as per the conditions laid down in the prospectus.

The lists will be available for reference at the offices of the Commissioner for Entrance Examinations and the Director of Public Relations and also on the Web site "cee-kerala.org''. The lists will also be available at all the district information centres from August 25 onwards.

Govt to collect provisional fee from MBBS candidates

THIRUVANANTHAPURAM: The Supreme Court verdict earmarking 50 percent seats in self-financing medical colleges for Government will help 250 more candidates get admission to MBBS course in the merit quota this year. However, compared to last year, the effective increase this time will be only 90.

This year, the Commissioner for Entrance Examinations could admit students to 50 seats each in Pushpagiri Institute of Medical Sciences and Research, Tiruvalla, Malankara Orthodox Syrian Christian Medical College, Kolencherry, Dr Somervell Memorial CSI Medical College, Karakonam, as well as the newly-sanctioned Jubilee Memorial and Amala Medical Colleges, both in Thrissur, on the basis of the Supreme Court verdict.

With this, the total number of merit quota seats in medical colleges in the State this year would go up from 750 to 1,000. Since the fee structure is yet to be finalised by the Cabinet sub-committee, the Government plan is to collect a provisional fee from candidates who are admitted in the merit quota in self-financing medical colleges.

Last year, the Commissioner for Entrance Examinations could fill 910 seats in the merit quota. This included 700 seats in five Government Medical Colleges. Apart from this, Amritha Institute of Medical Sciences, Kochi, had admitted 75 students and Pariyaram Medical college 85 students last year through counselling conducted by the Commissioner for Entrance Examinations.

However, Amritha Institute of Medical Sciences, which had been given the status of a deemed university, will admit students to all the seats on its own this time. In the case of Academy of Medical Sciences, Pariyaram, only 50 percent seats could be filled under the merit quota this year. This would mean that 110 seats would not be available from the 910 merit seats filled under the merit quota last time.

Karakonam Medical College which agreed to the Government decision on merit quota seats had admitted students to 50 percent seats last year. However, Pushpagiri and Kolencherry colleges had admitted students to all the seats on their own last year.

Joint Commissioner for Entrance Examinations Raju Krishnan told this website's newspaper that the Academy of Medical Sciences, Pariyaram, a self-financing medical college in the co-operative sector, had already admitted 50 per cent students to merit quota seats through the counselling conducted by the Commissioner for Entrance Examinations.

Admissions have also been completed to 100 seats each in Kottayam, Thrissur and Alappuzha Medical colleges and 200 seats each in Thiruvananthapuram and Kozhikode Medical Colleges through the counselling conducted by the Commissioner for Entrance Examinations.
Sanctioning of two new medical colleges in the State had increased the total number of medical seats from 1,200 to 1,400. This include 700 seats in the Government medical colleges and 700 seats in self-financing medical colleges.

Higher Education Principal Secretary K. Mohandas told this website's newspaper that the Commissioner for Entrance Examinations had been asked to initiate action to admit students to merit quota in self-financing colleges. The commissioner would notify the date for the counselling to these seats soon, he said.

Under construction medical college building roof caves in

KOCHI: The roof of the power station building of the Kochi Cooperative Medical College (CMC), Kalamassery, being constructed, caved in on Tuesday night, allegedly after some outside elements removed supporting poles at the site.

Work on the roof was completed at around 5 p.m. on Monday and it collapsed at around 1 a.m. on Tuesday. It is alleged that an ongoing dispute between the construction company and some outside forces over the awarding of a sub-contract had led to the `sabotage'.

The construction company has now registered a complaint with the Kalamassery police for arresting those behind the antisocial act. Cooperation Minister M V Raghavan, however, has issued directions to continue with the works so as to complete them before September.

Co-operative Academy of Professional Education project engineer, P J Jose Maria, who is in charge of the construction activities at CMC, said that there is no possibility of an accident occurring due to technical problems. He refuted allegations that the supporting poles did not have the sufficient strength to hold the concrete mixture. If the poles did not have sufficient capacity, they would have collapsed when several workers were carrying out the works on top of the ceiling, he said.

``It takes around two hours for the concrete mixture to settle initially and eight hours to settle finally. During this time, the weight decreases and there is no possibility of roof collapse due to technical reasons,'' he added.

Several persons, with the backing of various political leaders, had approached the college authorities requesting to award them sub-contract for the works. The construction company had to turn away several people as they could not meet the eligibility criteria.

Kalamassery Municipal councillor, P P Ramakrishnan, who represents the ward where the medical college is coming up, expressed doubts over the whole episode. ``The contractor removed the debris soon after the roof collapsed. If there was any foul-play, they would have conducted an investigation,'' he said.
Shilpy Constructions Managing Director F Edision said that the works have to be completed by September and here was not much time to wait for an investigation.

There were several attempts from `outside forces' to disrupt the works. Someone might have purposefully removed the poles of the ceiling to tarnish the image of the construction company and delay the works, he said.

According to the present plan, work on the four blocks, including the administrative block, would be completed by September. The construction company will concentrate on two out-patient departments and a teaching block after that.

The Rs 50-crore construction work is expected to be completed by the end of this academic year and the medical college with 500-bed capacity will become operational by that time.
Meanwhile, the dispute between the Co-operative Medical College and the Kalamassery Municipality over the permit fee for the construction is still continuing. Earlier, Kalamassery Municipal Chairman had stayed the construction and later allowed to resume the work, till a final decision is taken by the Local Administration Ministry.

SECURITY TIGHTENED: Following the collapse of the roof, the medical college authorities have decided to strengthen the security arrangements at the spot, especially during night. At present there is only one security guard and two more persons will be deployed with immediate effect. Steps would also be taken to complete the compound wall immediately, they said.

One more cholera case confirmed

By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 7. One more case of cholera was confirmed in a 27-year-old patient who was under treatment at the Medical College on Wednesday.

According to health officials, it was not clear whether the infection was an indigenously acquired one as the patient had a travel history of visiting Bangalore recently.

So far, five patients had been infected with `Ogawa' strain of vibriocholera.

Meanwhile, 25 suspected cholera cases were under observation at the General Hospital. As many as 12 cases had been referred from Tiruvallam alone. The other cases were sourced from Vazhithadam (2), Vellayani (3), and one each from Vizhinjam, Karickakam, Kuttichal, Pangappara, Poonthura and Malayinkeezh.

The stool samples of the patients were being investigated at the Microbiological Department of the Medical College.

District health officials had also collected nine water samples, which included water from the Vellayani lake, a borewell, stored water and pipe water from affected areas.

The samples had been handed over to the Public Health Laboratory for identifying the pathogen.

A team comprising K. Ramamoorthi, Health Secretary, V.K. Rajan, Director of Health Services, and E.K. Madhavan, District Medical Officer, is scheduled to visit Tiruvallam on Thursday as the bulk of the suspected cholera cases have been reported from there.

Eli Lilly-Pfizer-Novo developing oral insulin

By Our Staff Reporter

BANGALORE AUG. 6. Eli Lilly and Company (ELC), Pfizer, and Novo Nordisk are jointly developing a `delivery system' to administer insulin orally, in a method similar to the inhaler used by asthma patients.

Brand named Oralin, the system was in global phase three trials, and the earliest it would hit markets would be 2007, Rajiv Gulati, Chairman and Managing Director, ELC India, a wholly owned subsidiary of ELC, said.

Mr. Gulati was addressing a press conference to announce the company's value added service, Huma Care Junior, for children with diabetes Type I, which was launched here on Wednesday, two days after its launch in Delhi.

Oralin was likely to be `at least six to seven times' as expensive as the vial from which insulin is injected, today. That would make it cost Rs. 1000 or more per unit. One vial of Oralin would last from `five days to a week', Mr. Gulati said.

The estimated 32 million diabetics (Types I and II) in the country represent a market of about Rs. 250 crores for companies selling human insulin, preferred as safer as compared to the protein derived from animals, he said.

Last year ELC India sold five million vials of U 40, a vial with 40 ml of insulin. It ended last year with a market share of 19 per cent, he said.

The multinationals are now facing competition from Wockhardt, an Indian company manufacturing recombinant DNA human insulin crystals and bottling them, within the country..

Lupin strategy for advanced markets

By Our Staff Correspondent

MUMBAI AUG. 6. Lupin expects a shift in its business, therapeutic and geographic mix, in the coming years in favour of other segments even as anti-TB continues to be important. Addressing shareholders at the annual meeting here, Desh Bandhu Gupta, CMD, Lupin, said cephalosporins and cardiovasculars were gaining in importance.

The company has developed a three-pronged strategy to increase its presence in advanced markets. Lupin will expand its API business by establishing partnerships with niche players, being already among the most successful manufactures of APIs in its therapeutic segments.

While the pillar would be expanding the API business, the second strategy is marketing of finished dosages in the advanced markets through marketing alliances. Already, the company has launched cefuroxime axetil in partnership with Watson Pharmaceuticals.

The third part of the strategy involved marketing of branded finished dosages, Dr. Gupta said.

V-sat facility for `Onconet'

By Our Staff Reporter

THIRUVANANTHAPURAM AUG. 5. The telemedicine project, `Onconet', pursued by the Regional Cancer Centre (RCC), has got a major fillip with the ISRO offering its V-sat facility for online networking with other nodal centres in the State.

A broad bandwidth would be provided along with the V-sat facility to the RCC this month to ensure uninterrupted and qualitative online interaction between oncologists at the RCC and doctors/patients using any of the five nodal centres set up across the State, the VSSC group director told RCC officials.

The nodal centres have been established at Kollam, Kozhencherry, Kochi, Palakkad and Kannur.

The ISRO's technological assistance is expected to iron out several teething problems associated with the telemedicine project. It was launched in April 2001, with technical assistance from the ER&DC on a fund of Rs. 50 lakhs from the IT Department.

But the reliance on telephone lines to run teleclinics at the nodal centres had rolled back the quality of online interaction. Attempts at video-conferencing had also failed due to the poor quality of the pictures.

These drawbacks had hampered the initiative to offer online consultation for patients on follow-up lists, so that they could save money by avoiding visits to the hospital. The facility was particularly useful for the roughly 700 patients from the northern districts of Kannur and Kasaragod, who had to travel all the way to the RCC for follow-up care.

The ISRO's extension of satellite technology for the project is expected to remove communication hassles, improve connectivity and enhance the quality of tele-consultation.

It will now be possible to carry out cancer diagnosis, follow-up examination and palliative care for patients at these nodal centres. Apart from RCC patients, the public as well as doctors of other institutions can also avail themselves of `Onconet' services, on a real-time basis.

Patients returning home after treatment at the RCC can now communicate post-treatment problems, discuss results of laboratory investigations or seek suggestions from the Internet-enabled personal computers set up at the nodal centres.

The RCC doctors would also be able to render advice on a real-time basis for terminally-ill patients who require only palliative care.

The RCC officials say that besides helping patients save money by avoiding hospital visits, the online facility to clarify doubts with doctors at the RCC would boost the confidence of the cancer patients.

KU for study on new medical colleges

By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 5. The University of Kerala has suggested that new medical colleges be sanctioned in the State only after conducting an exhaustive study of human resources.

Such a study would be required to ascertain whether more medical colleges were needed in Kerala, it was suggested by the university at a meeting convened here today by the Minister for Health, P. Sankaran.

The meeting was held mainly to discuss the issue of granting No Objection Certificates for setting up medical institutions in the State.

Comprehensive guidelines regarding location, buildings and other infrastructure facilities should be published. Only those managements who agree to abide by these guidelines should be granted NOCs.

In the case of medical colleges, before NOC was granted, an agreement had to be signed by the management on issues such as fee structure, admission, seat allocation and management quota.

It should also be binding on the managements that at least 50 per cent of seats would be filled on the basis of merit, it was suggested.

The admissions to these institutions should be conducted through the Commissionerate of Entrance Examinations and only after the university has granted affiliation to them.

The examinations and evaluation should be held only with the involvement of teachers of government colleges.

The proliferation of professional colleges has made the conduct of examinations highly difficult, it was pointed out.

Common waste disposal system for hospitals mooted

By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 4. A recent seminar on bio-medical waste management for hospitals organised by the Kerala State Pollution Control Board (PCB) has mooted the idea of a common waste disposal system for hospitals in the State.

Participants in the seminars stressed the need for implementing the Biomedical Waste (Management and Handling) Rules, 1998 keeping in mind public health and the security of hospital personnel. The establishment of a common waste disposal system is much better than seeking to install individual systems in each hospital, various speakers said.

It was pointed out that about 85 per cent of the waste generated by hospitals comprised leftover food and other commonly found waste material. Only the rest was the waste that could be dangerous and infectious. If it was isolated at the point of origin, the extent of damage caused by it could be minimised and contained.

Experts pointed out that the policy of using incinerators as a panacea for hospital waste management should be done away with. The fact was that only about 2 per cent of waste generated in a hospital was fit to be burned in an incinerator. Therefore the alternative methods of waste management and disposal suggested by the 1998 rules should be implemented.

AIDS lobby group to sue S.A. Govt.

Durban Aug. 3 . A South African AIDS lobby group said today it would take the Government to court for its failure to provide anti-AIDS drugs in a country where nearly 1,000 people die every day from the disease.

``Treatment Action Campaign (TAC) will pursue litigation for a national treatment and prevention programme,'' a TAC spokeswoman said. — AFP

MCH: Patients gasp for lifeline

By M. Dinesh Varma

THIRUVANANTHAPURAM Aug. 3. Shortage of ventilators for critical care and poorly equipped operation theatres at the Medical College is thinning the dividing line between life and death for patients, even as surgery schedules have gone haywire owing to the inordinate delay in completing the renovation of one of the twin operation theatres at the premier institution.

The shutdown of the `B' theatre since March 27, ostensibly for refurbishment purposes, has only served to acutely expose the shortage of ventilators and other routine life-saving facilities for patients who develop a medical or post-surgical emergency.

It is estimated that annually, the Thiruvananthapuram Medical College handles over 22,000 medical and 14,000 surgical admissions with less than a handful of ventilators whereas a similar institution with a tertiary status and which conducts one-third of the volume of work at the Medical College has as many as 40 ventilators.

The closure of the `B' theatre has already led to massive cancellations and reschedulements of elective surgeries at the departments of cardiology, orthopaedics, urology and general surgeries, apart from leaving these units totally unequipped to resuscitate patients developing an emergency.

In a glaring instance recently that exposes the post-surgical inadequacies in the prevailing circumstances, a patient who required ventilatory support after a six-hour major surgery had to be sustained on ambu-bag support for hours together until he was referred to a nearby private hospital when a ventilator became available.

The six general surgery units which had two operation days a week now have only one operating day at the space available allocated at the `A' theatre, which is always overburdened with elective cases from the general surgery, gastrointestinal, plastic surgery and thoracic surgery units.

Though the annual maintenance of the two theatres by turn is usually undertaken in December-January, the modernisation of the `B' theatre had been taken up four months ago as a priority measure.

Among the worst affected are cardiology patients referred for a surgery and many of them have had to turn to private hospitals in desperation, sources said. While some 90 per cent of the cases are elective in nature, the rest are emergency bypass referrals.

It is estimated that the `B' theatre performs an average of 10 open-heart surgeries a week and 30 cases a month. The other operating tables in the theatre are allotted to general surgery, urology and casualty emergencies. Even at a normal rate, the Cardio-thoracic Department usually runs a one-month backlog. And, with the total disruption in open-heart procedures, the backlog has mounted to about five months, it is feared.

In effect, the number of surgeries undertaken by general surgery units now averages around five per day in place of the 15 surgeries that were being conducted before the closure of the `B' theatre. A senior general surgeon told The Hindu that the wait-list of elective cases on his list had burgeoned to 157 cases between March and August.

According to sources, barring the Cardio-thoracic and the Surgical Neurology Departments, none of the general surgery or other surgical specialties has even one ventilator. The surgical ICU located near ward 7 has no ventilator or centralised oxygen supply, where ideally there should be at least two life support equipment to provide backup if one develops a snag. The three-bedded critical care unit inside the now dysfunctional `B' theatre has to suffice with one ventilator.

According to sources, the scant number of hydraulic operating tables are not in proper working condition due to poor maintenance. The central suction system is also not functional and surgeons have to rely on portable tubes to remove deep-seated pus collections. According to sources, at least half of the six operating lamps have blown the fuse and have been neither repaired nor replaced.

Aggravating the hardships for patients are indications that the modernisation of the `B' operation theatre might take a few more weeks to complete. Authorities plan to shut down the `A' theatre as soon as the `B' theatre resumes functioning.

When contacted, the Medical College Superintendent, Mathew Thomas, said the Rs. 60-lakh revamp of the 30-year-old air-conditioning system of the operation theatres had become inevitable as it formed part of a long-term plan to provide better services. Though conceding that the completion of the work had taken more time than initially expected, the Superintendent said the reworking on the `A' theatre would be completed quickly.

According to Dr. Thomas, there were plans to acquire more ventilators for the institution. The new Medical ICU was equipped with three ventilators and the institution expected to increase its fleet of ventilators to at least 10, he said, while conceding that even this was not proportionate to the volume of patients taken under the fold of the institution.

The emergency unit at the relocated Casualty was now equipped to handle a spectrum of emergencies and poly-trauma cases, he said.

However, even at the newly relocated Casualty, there are two operating tables for emergencies though only one is currently functional due to lack of staff, sources said.

August 3 to be Heart Transplantation Day

By Our Special Correspondent

NEW DELHI AUG. 3. The Prime Minister, Atal Behari Vajpayee, today declared that August 3 would be observed every year as Heart Transplantation Day. He also announced that the Organ Retrieval Banking Organisation at the All-India Institute of Medical Sciences (AIIMS) would now be a national facility.

At a function held at his Race Course Road residence to mark the first heart transplant carried out nine years ago, Mr. Vajpayee said: "The two decisions would go a long way in promoting heart transplantation in the country". The Health and Family Welfare Minister, Sushma Swaraj, said it was a matter of pride that India was the third country after the United States and the United Kingdom to perform such an operation.

Dr. Venugopal, Director, AIIMS — who was described by the Prime Minister as the pioneer of heart transplant surgery in the country — said that heart diseases were growing rapidly in the country and predicted that there would be an estimated 4 million deaths a year due to them by 2020.

Nurses have vast scope for job in US

THRISSUR: Professionally qualified nurses have vast scope for employment in the US at present and, according to studies conducted in America, in the next 20 years, the situation is unlikely to change, according to Tom Edwards, director of US-based placement agency Consultancy Solutions International.

He told reporters here on Tuesday that, being attracted to more lucrative employment opportunities, Americans are reluctant to take up nursing profession. This has resulted in a serious shortage of nurses in almost all the hospitals in that country.

According to an assessment made by hospitals in the US, the present requirement of nurses in the US is about one million. In the next 20 years, the situation is most likely to worsen. Indian nurses are preferred by many hospitals in the US because of the better training they have compared to their counterparts in other countries.

The demand is for both diploma and degree holders. The facilities available in the US are better than in India and the annual remuneration of a nurse ranges between US $ 35,000 and 45,000. Usually the initial contract is for a period of two years.

Edwards said that, following pressure by hospitals facing shortage of nurses, the US Government is in the process of easing the immigration procedures for nurses. At present, after passing the qualifying examinations, the immigration procedures take about 12 months. The proposed changes are expected to reduce the period to six months.

He said his organisation has entered into a tie-up with the Kottayam-based Manjurans Charitable Society for conducting coaching to nurses for passing the eligibility examinations conducted by the US Government. Under the tie-up, the society will provide free coaching to those securing over 75 per cent marks in the screening test conducted by the society.