Use of antibiotics worsening swine flu patients' condition: Expert

New Delhi: Amid swine flu spreading to different parts of the country, experts have witnessed a rise in new cases as well as deaths every day and have cautioned that misuse of antibiotics could worsen the condition of patients suffering from the disease.

Dr Kamlesh Upadhyay, swine flu director of Gujarat and who is also in-charge of swine flu department in Civil Hospital said that taking antibiotics instead of anti-virals is leading the condition of H1N1 patients critical, reported an English Daily.

He asked pregnant women, who are in high risk group with high mortality rates of the disease to take swine flu vaccination.

He also said that family members of pregnant women should take vaccination as a preventive measure.

Dr Upadhyay said that they found most of the patients admitted, with serious complications due to either the delay in getting treatment or doctors putting them on antibiotics which would not help in viral fever.

He further added that there is a tradition of misusing antibiotics and instead using anti-viral medicines will be of greater help.

The state of Gujarat is among the worst affected by swine flu with as many as 81 people having lost their lives due to the disease since January this year.

The national capital on Sunday recorded the sixth death due to swine flu after a 55-year-old man succumbed to H1N1 virus at a private hospital in New Delhi.

India needs 3.5 mn hospital beds, 3 mn doctors by 2034: Report

Mumbai: The Indian healthcare delivery system, which suffers from acute problem of limited resources, will need an investment of around USD 245 billion through traditional means to deliver desired outcome in next two decades, according to a PricewaterhouseCoopers (PwC) report.

The requirement will be for 3.5 million beds, 3 million doctors and 6 million nurses over a period of 20 years, it added.

The report said the huge investment would not only put fiscal pressure, but, would be difficult to implement considering the nature and scale of new additions.

For instance, over the last decade roughly 100,000 hospital beds have been added annually. If India continues to maintain this rate, it will fall short of the winning leap target by 1.6 million beds by 2034.

It further said the ratio of doctors per 1,000 people is just 0.6 while in Brazil and China it is 1.8. India has only 1.3 hospital beds per 1,000 people-significantly lower than the guideline of 3.5 beds defined by World Health Organisation.

Several factors have resulted in poor health outcomes such as low life expectancy, high infant and maternal mortality rates. To bring about a winning leap in healthcare, India must increase life expectancy at birth from 66 years in 2012 to 71 years by 2024 and to 80 years by 2034.

By adopting non-traditional solutions, infant mortality rate (number of infant deaths per 1000 live births), could decrease from 44 to 31 in 2024 and to 12 in 2034.

Similarly, the maternal mortality rate (number of maternal deaths per 100,000 live births), which is at 190 today, could decrease to 124 in 2024 to 27 in 2034.

To achieve these targets, healthcare-sector players must focus on improving the reach, quality, and affordability of healthcare.

India can also leverage its strength as a world leader in vaccine manufacturing (it contributes 60 per cent of global production) to sharpen its focus on preventive care.

Indian vaccine manufacturers such as Serum Institute of India, Bharat Biotech, and Biological E are known worldwide for their contribution to reducing the cost of vaccines to about USD 1 per dose.

Enabling universal access to healthcare through the adoption of Winning Leap solutions could help save USD 90 billion in capital costs in India's healthcare delivery infrastructure, the report said.

Do You Sleep on Your Stomach? Beware, Say Doctors

People with epilepsy who sleep on their stomach may be at higher risk of sudden unexpected death, scientists have warned.     

Epilepsy is a brain disorder that causes repeated seizures and affects an estimated 50 million people worldwide.

"Sudden unexpected death is the main cause of death in uncontrolled epilepsy and usually occurs unwitnessed during sleep," said study author James Tao, from the University of Chicago in Illinois.

People with tonic clonic seizures (formerly known as grand mal seizures) that affect the entire brain are more likely to die suddenly than people with partial seizures that affect an area of the brain.

Researchers reviewed 25 studies that included 253 sudden unexpected death cases where body position was recorded.

They found that 73 per cent of the cases died in the stomach sleep position, whereas 27 per cent died in other sleep positions.

Looking at a subgroup of 88 people, researchers found that people younger than 40 were four times more likely to be found on their stomachs at the time of sudden death than people over 40.

A total of 86 per cent of those under 40 were sleeping on their stomachs, compared to 60 per cent for those over the age of 40.   

"We're not sure why this was more common in younger people. It may be that they are more likely to be single and not have anyone with them during a seizure while sleeping," Tao said.

He noted that a person sleeping with someone who has a generalised tonic clonic seizure while on their stomach should help them turn over or on the side during or after the seizure.

"Similar to infant SIDS cases, adults often have an impaired ability to wake up after a seizure, especially a general seizure," Tao said.        

"Our findings highlight an important strategy for  preventing sudden unexpected death in epilepsy - that 'back is best,'" Tao said.

"Using wrist watches and bed alarms designed to detect seizures during sleep may also help prevent these deaths," Tao added.

Call to bar doctors from capitation fee colleges

NEW DELHI: The British Medical Journal (BMJ) has called for action over illegal payments to India's private medical colleges. The latest issue of the journal has an article on capitation fees in India's private medical colleges which talks of fundamental reforms needed to tackle corruption in the admission process. 

Action is urgently needed to tackle the illegal but seemingly common practice of paying huge fees for admission to India's private medical colleges, warns the special report in the BMJ. Yet another article in the journal suggests that the international community might be able to help tackle the problem by barring Indian students of private medical colleges that allow admission through capitation fee from training jobs abroad. 

Speaking to TOI, Dr Samiran Nundy, chairman of the department of surgical gastroenterology and organ transplantation at Sir Ganga Ram Hospital says that with increasing number of candidates paying to get into medicine the quality of graduates was being compromised. He adds that he knows candidates who believed that if they could pay to get a seat, they could also pay to get through the course. 

Dr Nundy feels that a common entrance test for admission, as is happening for engineering colleges, combined with an exit exam like the US Medical Licensing Examination (USMLE) conducted by an independent body could at least ensure a minimum standard for students who become doctors. The USMLE website describes the licensing exam as a three part examination meant to assess a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. 

In a personal view article in the journal, Dr Sanjay Nagral of the Department of Surgical Gastroenterology in Jaslok Hospital & Research Centre, Mumbai,blames the government for the malaise of corrupt private medical colleges. "The state, by not opening more colleges, has created a space for private colleges," says Dr Nagral in his article titled, 'We need to discuss India's reliance on private medical colleges'. He goes on to state that India's medical profession was too entangled in these institutions to offer substantial resistance to their growth and sleaze. Dr Nagral says it might be possible for the international medical community to help by barring students from such colleges from taking training jobs abroad. Whether such a move, which may hurt students more than the institutions, is feasible or effective remains to be seen, he adds. 

According to the BMJ article a recent report in the National Institute of Public Finance and Policy ranked the education sector second in a list of black money generators in India. It is estimated that capitation fees paid to professional colleges last year amounted to more than Rs 6000 crore. Despite several judgements of the Supreme Court declaring that charging capitation fees is illegal, the practice continues unabated.