MedWorm: Surgeons

Sorry, no woo for you today. or: cancer isn't just for humans

Respectful Insolence — Fri, 04 Jul 2008 15:49:50 +0100

Today is Friday, which has normally meant for the last two years that it's the time every week when I poke fun at some particularly outrageous woo. Indeed. I even had a great idea for a 4th of July-themed post today that (I hope) would have been hilarious. I had even started to write a bit of it a couple of nights ago. Then real life intervened, and I didn't feel the least bit like humor last night. I still don't feel capable of humor this morning, either. Those of you who don't have pets may want just to skip the rest of this; you may not understand why I'm feeling so down and may view this post as nothing more than self-indulgent whiny twaddle. But what is the purpose of a blog if not to be an outlet for self-indulgent twaddle from time to time? Of course, those of you who do understand (which, I hope, is the vast majority) won't view it that way. Yesterday afternoon, eight years to the day after the day we first picked her up from the shelter, my wife and I learned that our dog Echo, the sweetest, most even-tempered dog in the world (unless you're a bunny), has terminal cancer. There will be no more bunny carnage in our yard. Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

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The 90th meeting of the skeptics' circle: coming at you from down under

Respectful Insolence — Fri, 04 Jul 2008 12:55:21 +0100

Better late than never (for me to announce it, I mean), the 90th Meeting of the Skeptics' Circle has descended upon the blogosphere from Down Under, this time brought to you by prominent Australian skeptic and battler against woo, a guy who's even harsher on antivaccinationists than I am, Peter Bowditch. Go forth and enjoy! Next up on July 17 is Sorting Out Science. Start getting your best skeptical writing together and join us back here in two weeks for a little summer skepticism. Guidelines for submissions and the schedule can be found here, and if you want to host one of these check out the guidelines for hosts and drop me a line. Read the comments on this post... (Source: Respectful Insolence)

Australia develops bird flu vaccine for humans

"Reflections" - Doctor Bruno's Blog — Fri, 04 Jul 2008 04:00:00 +0100

Asia and the rest of the world may not need to worry about the bird flu infection in human beings anymore, thanks to the vaccine developed by Australia.Announcing the breakthrough development, Australia’s Health Minister Nicola Roxon said, here, Tuesday that the country has developed a vaccine to protect humans against infection by the avian influenza virus.“The first Australian-made vaccine to protect humans from future bird flu pandemics has been granted approval for use in the event, of course, of an avian influenza outbreak,” Roxon told reporters.The vaccine, developed by CSL Biotherapies Australia, is expected to protect humans against the H5N1 strain of influenza responsible for outbreaks of bird flu in Asia, the Middle East, Europe and Africa, reports Xinhua.“We know, of course, that if there is an outbreak that affects Australians, we need to make sure that we are properly prepared,” Roxon said.Australia has earmarked US $150 million in this year’s federal budget to replenish the country’s vaccine stockpile, the report said. (Source: "Reflections" - Doctor Bruno's Blog)

India to promote electric vehicles

"Reflections" - Doctor Bruno's Blog — Fri, 04 Jul 2008 04:00:00 +0100

With the crude oil prices hovering around US $140 per barrel and vehicle population increasing rapidly, the Government of India is planning to initiate a rigorous marketing strategy for battery-operated vehicles in the country.Addressing a meeting with major battery-operated vehicle manufacturers on Tuesday, the Ministry of New and Renewable Energy Secretary V Subramanian stressed the need for opening of dealers’ network and charging stations for leasing batteries in major cities for these vehicles by the manufacturers.With a view to work out a policy conducive for large use of battery-operated vehicles in the country, Subramanian said that the existing scheme will be changed to accommodate two-wheelers, which are also in its purview.“At present only three and four-wheelers of institutions are eligible for this scheme. Besides this, the Ministry will give subsidy to a large network of charging stations established by the companies,” the Secretary said.The Ministry informed that several battery-operated models of two-wheelers, three-wheelers and four-wheelers are manufactured by a number of industries; however, the number of such vehicles is quite small in comparison to conventional fuel vehicles.During the discussion, it was felt that while the running cost of battery-operated vehicles is cheaper than the petrol and diesel run vehicles, the replacement of batteries of battery-operated vehicles is quite costly.The aspects of leasing of batteries and central charging facility for battery-operated vehicles were also considered as a step-forward for promotion of battery-operated vehicles.Battery-operated vehicles manufacturers have assured all efforts for expanding their marketing network and creating awareness about these vehicles.Delhi has already announced supporting 30 per cent of battery-operated vehicles costs and procedures for availing the incentives. (Source: "Reflections" - Doctor Bruno's Blog)

« nhai to build 6-lane highway in andhra tk alex is now isac director » ‘e-nivaran’ to monitor grievances in himachal

"Reflections" - Doctor Bruno's Blog — Fri, 04 Jul 2008 04:00:00 +0100

The Government of Himachal Pradesh has designed and developed a web-based ‘e-Nivaran’ system for grievance monitoring.Inaugurating a one day MIS Workshop on the online grievance monitoring system, the state Food, Civil Supplies and Consumer Affairs Secretary BK Aggarwal directed all the officers of the department to start this system within a week so that the public may get benefit of the system.A grievance can be entered into the system using the Internet, at any office of the concerned department, at the Deputy Commissioner Office, at the Chief Minister office and by the concerned Minister and MLAs.The Secretary said login ID and password are required for all stakeholders to access the new system except the public which can submit the grievance and view its status without any login and password.He further said a grievance detail entered into the system instantly becomes visible not only to the concerned office but also to the public and the line of higher authorities including concerned ministers, MLAs and the Chief Minister.The Secretary said that concerned office would be bound to take necessary action against each grievance, and report the progress by entering the actions taken into the E-Nivaran system as various stakeholders would be monitoring the grievances and sending direction and orders using the new system.Aggarwal said that in this system an advice against the grievance may be taken online from the higher authority and added that at the click of button, the department-wise pendancy summary could also be viewed and drilled down to the lower offices.The new system offers various search criteria to find to monitor the grievances and there is provision for analysis of various categories of grievances from their occurrence in different areas.“The advantages of the E-Nivaran would be transparency, instant availability of grievances and to make accountability of officials and concerned officers. The system would reduce the paper work considerably,” Food, Civil Supplies and Consumer Affairs Director RS Gupta said. (Source: "Reflections" - Doctor Bruno's Blog)

Balancing

Cut On The Dotted Line — Thu, 03 Jul 2008 23:40:40 +0100

So far, not too bad. I’ve always been involved in tutoring the students a year or two behind me, so showing the interns the ropes isn’t much out of the way. So yes, I’m the one actually doing most of the work, but then I’m used to doing intern’s work - that’s nothing to complain about. Today I got myself a little bit stumped. There was a problem, and I knew what it was, and I knew what to do to fix it. Except I wasn’t sure about one piece of equipment; and the whole thing wasn’t technically my responsibility. So I opted for the low-resistance route of notifying the people who were responsible, hanging around to make sure nothing happened till they got there, and then leaving. But what’s going to happen tomorrow, when I am the one responsible - for everything - and I don’t know which of two pieces to use? Am I going to stand there wringing my hands until I find an attending to figure it out for me? Or am I going to rush into something, end up using the wrong thing, and maybe having things worse than they were to start with? Enough decisions already. It doesn’t help that the guys are all teasing me about being too aggressive. Early on, I thought I would establish a reputation for being willing to do anything, anytime; I’d start off doing the most minor procedures, the dirtiest cases, and earn the right to be offered any loose cases that weren’t yet assigned to a specific resident, by demonstrating my willingness to be available at all times for all things. Well, I don’t know what the attendings think of me, but the guys latest joke is, “Stay away from Alice. She’ll put a line in you when you’re not looking. I saw her the other day, there was this guy walking down the hall, and she just stuck a chest tube into him.” I think they’re not disturbed about it, otherwise one of the senior ones would tell me seriously to settle down, but their joking makes me second-guess myself even more, when I think a procedure is indicated: am I doing this because it’s right, or because I’m trying to be a cowboy? These guys seem to be born with a cowboy sense; they know when to push and when not; when to be aggressive, and when to back off. I try to imitate them, but I can’t seem to make it natural. (Source: Cut On The Dotted Line)

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What was that about not being "antivaccine" again?

Respectful Insolence — Thu, 03 Jul 2008 17:30:00 +0100

I've written time and time again about how antivaccinationists go out of their way to try to reassure us that they really, truly are not "antivaccine" or even that they support vaccination. Of course, such disclaimers are often nothing more than a prelude to a tirade of blatantly antivaccination rhetoric and misinformation about "toxins" in vaccines and the like, and if you try to pin an antivaccinationist down and ask her if there was any evidence that would ever change her mind or persuade her that it's safe to vaccinate, you'll either get a lot of hemming and hawing of the "Green Our Vaccines" variety or, if the antivaccinationist is Jenny McCarthy, you'll get a response along the line that if she had another child she "wouldn't vaccinate at all, never, ever." The same is true, of course, of the merry band of ignorant antivaccinationists making up the know-nothing crew at Age of Autism. However, occasionally the mask slips and the lie that they aren't antivaccine is made obvious. Here's one such occasion, in which Dan Olmsted attacks Bill Gates for the work his foundation is doing in promoting vaccination. The stupid, it burns as agonizingly as the flames in the illustration of the Gates of Hell that graces his post would if they were real. Fortunately, the flames are not real, but unfortunately the rampant stupidity is all too painfully real. Get a load of this: Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

Why would a woman withhold chemotherapy from her child with lymphoma?

Respectful Insolence — Thu, 03 Jul 2008 13:46:15 +0100

One of the main issues that I've written about quite a bit is the issue of what the state should have the power to do when a child has cancer or another life-threatening disease and the parents choose quackery over scientific medicine when the disease is potentially (or even highly) treatable or curable with standard treatment. Most of the time, this has come in the context of patients like Abraham Cherrix, who, with his parents support chose the quackery that is the Hoxsey therapy over chemotherapy, or Katie Wernecke, whose parents chose high dose vitamin C and other woo, over effective anticancer therapy. In this case, Abraham's doing pretty well thus far, thanks to his willingness to accept low dose radiation therapy as part of his "alternative" therapy regimen, while when last I checked Katie was not doing well at all, and I now wonder if she is even still alive anymore. (I do know that a year ago her parents were suing the State of Texas for trying to save her life.) I also tend to write about cases where a family's religious beliefs lead them to favor prayer over medicine and thereby deny their children life-saving treatment, letting them die in most unpleasant ways. Such cases disturb me more than any others. This case has nothing to do with quackery or extreme religious beliefs, but it brings up the same issues. It's also an instructive comparison to cases in which religion or faith in "alternative" medicine leads a parent to rely on prayer or quackery instead of scientific medicine. In that it may even be more disturbing in a way than the cases mentioned above: Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

Sterilised monkeys in himachal become pregnant

"Reflections" - Doctor Bruno's Blog — Thu, 03 Jul 2008 04:00:00 +0100

Everything is possible in love and war. Even monkeys sterilised can reproduce again if they are in love with their mates. The Himachal Pradesh Wildlife Department is ready to prove it.To control the monkey menace in areas like Shimla, Kufri and Rampur, the Wildlife Department sterilised about 1,300 simians last year. The males were sterilised using laser technology while tubectomy was performed on females using the laparoscopic technique.But now the animals are breeding again, reports IANS.“Most of the monkeys sterilised by the wildlife department are pregnant again,” said a wildlife official at the Himalayan Nature Park in Kufri.He said 60 monkeys were caught from Kufri, about 25 km from here, and taken to the Tuti Kandi rescue centre on the outskirts of Shimla. After sterilisation, they were released in the same area.At that time, male and female monkeys were tagged. But now the tags have also disappeared.Conservator of Forests (Wildlife), Lalit Mohan admits that there were some flaws in the sterilisation programme.The drive hit several road blocks due to the shortage of expert monkey catchers. Now the department is training its own staff.“The monkeys might be pregnant again as all animals could not be trapped at that time. Those that had been left out at that time might be breeding now,” he said.The wildlife department had also initiated mass translocation of simians to remote forest areas from cities and towns to control the menace.But this process was not successful as the territory vacated by the animals was occupied by more aggressive troops of monkeys from surrounding areas.According to a census conducted by the Wildlife department, the state has 319,000 monkeys. (Source: "Reflections" - Doctor Bruno's Blog)

Hp intros fault-tolerant blade server

"Reflections" - Doctor Bruno's Blog — Thu, 03 Jul 2008 04:00:00 +0100

Hewlett Packard (HP) has introduced its fault-tolerant blade server that supports high transaction volumes and provides real-time response capabilities in a cost-effective design.The new HP Integrity NonStop NB50000c BladeSystem is an ideal replacement platform for mainframe applications in industries such as finance, public sector and telecommunications.Using the same amount of power as existing NonStop server offerings, the NB50000c delivers twice the performance and occupies half the data center space, besides offering 35 per cent lower total cost of ownership than competing offerings and up to a 50 per cent decrease in cost per transaction.“The new Integrity NonStop BladeSystem provides 24/7 business availability and scalability to our customers through the economies of a bladed form factor,” HP’s Technology Solutions Group Executive VP Ann Livermore said.Supporting high volumes of mission-critical transaction processing, the new BladeSystem offers a new way to transition customers’ most-demanding applications onto a highly efficient and modular form factor.The NonStop operating environment offered on a standards-based blade design ensures the highest levels of reliability, while its fault-containment design protects data while error-recovery features eliminate downtime.The new system features double the processing power in half the physical footprint through multi-core technology and HP BladeSystem.It comes with a patented 24/7 fault-tolerant software built on standard components for reduced cost of ownership, HP said in statement. (Source: "Reflections" - Doctor Bruno's Blog)

Indo-bhutan health corridor soon

"Reflections" - Doctor Bruno's Blog — Thu, 03 Jul 2008 04:00:00 +0100

The Governments of India and Bhutan are working on a draft proposal to facilitate people living along the Assam-Bhutan border avail best of medical services.“The draft Standard Operating Procedure (SOP) will be a ticket of sort that would help poor patients from both the countries to cross the borders to access medical benefits,” Nedan Foundation Director Digambar Narzary said.To prepare the draft, Nedan is working in coordination with the immigration officials, police forces and various civil society organisations of India and Bhutan.Nedan Foundation is an Assam-based non governmental organisation (NGO), which is preparing the draft proposal to be signed by border commissioners of the two countries in August.The border areas falling in this health corridor are the Bodo Territorial Autonomous District (BTAD) in Assam and Samdrup Jongkhar in Bhutan.The opening of the corridor holds immense importance for the Bodo tribals who live in areas with negligible healthcare centres.“Bhutan has some of the best medical health centres. The corridor would greatly benefit Bodo people, who will only have to cross the border to get themselves treated,” Narzary said.An official of Assam’s Health Department said that the state government will extend all sort of facilities to the Bhutanese who are on the lookout for medical benefits in Assam and neighbouring states.Out of the four districts of BTAD, three—Kokrajhar, Baska and Chirang—share the 700-km border with Bhutan. The fourth district is Udalguri. (Source: "Reflections" - Doctor Bruno's Blog)

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“cafeteria approach” to offer patients treatment options in hospitals

"Reflections" - Doctor Bruno's Blog — Thu, 03 Jul 2008 04:00:00 +0100

http://www.hindu.com/2008/07/03/stories/2008070353070500.htmSpeciality clinics will be established in 134 primary health centres in the State To be funded by Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and HomeopathyEach PHC allotted Rs.10 lakh for constructing buildings and providing equipment and medicines CHENNAI/MADURAI: Imagine going to a hospital and being able to choose the system of medicine you want to be treated with. It may just be possible in the near future in Tamil Nadu, with the State government trying to adopt a “cafeteria approach” to healthcare. Besides allopathy, speciality clinics will be set up in 134 primary health centres in the State to provide patients with a range of treatment options in the Indian Systems of Medicine (ISM). The project will be funded by the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH). A sum of Rs. 13.40 crore has been allotted for establishing the clinics that will provide a one-stop shop for Siddha, Ayurveda, Unani, Yoga and Naturopathy and Homeopathy treatment. “The idea is to mainstream the AYUSH system. We intend giving the patient a choice in treatment options, as the same hospital that provides allopathy treatment will now have specialists in each of the traditional systems of medicines. The patient can prefer the system he has faith in,” G.A. Rajkumar, Special Commissioner, Indian Medicine and Homeopathy, told The Hindu. He terms this the “cafeteria approach” to public health. Of the 1,434 primary health centres in the State, 469 have an Indian system of medicine wing, Mr. Rajkumar said, and from among them, 134 have been chosen to set up speciality clinics. The Indian system of medicine wings are also functioning in four major hospitals, 19 medical college hospitals and 61 district headquarters hospitals. Each primary health centre has been allotted an average of Rs.10 lakh for constructing buildings and providing equipment and medicines, and for general expenditure. The districts that will benefit include Nagapattinam, Coimbatore, Vellore, Thanjavur, Kanyakumari, Dindigul, Virudhunagar, Sivaganga and Tiruvarur. “This is just the beginning. By 2014, all PHCs and taluk and district hospitals will be equipped with speciality clinics,” Mr. Rajkumar said. “The cafeteria model is accepted internationally as a public health delivery system. The idea is to offer all services in one place,” S. Elango, Director of Public Health, said. Siddha, which had its origins in Tamil Nadu, seemed popular in the State. Going by the figures thrown up by the Varumun Kappom Thittam or preventive health camps, 6,56,110 patients had chosen Siddha treatment, and the total amount spent on Siddha medicines alone in these camps stood at Rs. 61,58,907 till June 13. (Source: "Reflections" - Doctor Bruno's Blog)

Battle heating up for medical seats

"Reflections" - Doctor Bruno's Blog — Thu, 03 Jul 2008 04:00:00 +0100

http://www.hindu.com/2008/07/03/stories/2008070353080500.htmAs per the reservation rule, 31 per cent of the total 1,831 seats will be available for open competition With the battle heating up for 1,831 medical seats (under the government quota), students are now busy calculating the number of seats allotted to each community, going by the rule of reservation followed in Tamil Nadu. As per the rule, 31 per cent of the total seats will be available for open competition; 30 per cent of the seats have been allotted for BCs, 20 per cent for MBCs, 18 per cent for SCs and 1 per cent for STs. This year, however, the 30 per cent available to the BCs have been divided into two: 23 per cent and 7 per cent. The 7 per cent is meant to be split equally between the Backward Class Christians and Muslims at 3.5 per cent each. Cut-off mark jumps Health Secretary V.K. Subburaj said the cut-off mark for the open competition had jumped by 0.5 points from last year to touch 197.25. The Secretary, Selection Committee, Directorate of Medical Education, told The Hindu that the rest of the cut-off marks had not been announced, but it might be almost the same as last year, with a 0.5 mark increase across the board. Last year, the cut-off for BC candidates was 194.50, 191.75 for MBCs, 187.25 for SCs and 179 for STs. Applying the rule of reservation strictly, 569 seats are technically available for the open competition in both government medical colleges, and under the government quota in five self-financing institutions. Similarly, for the BCs, the number is 421, and for BC (Christians) and BC (Muslims) it is 64 each. MBCs get 365 seats, SCs, 330 and STs 18 seats in all. BDS seatsAs for BDS, 85 seats are available in the Government Dental College and 783 seats under the government quota in 17 self-financing colleges. Of these, 269 seats are available for open competition, 201 for BC, 30 each for BC Christians and BC Muslims, 173 for MBCs, 156 for SCs and 9 for STs. (Source: "Reflections" - Doctor Bruno's Blog)

A little at sea

Cut On The Dotted Line — Thu, 03 Jul 2008 01:40:42 +0100

It feels so strange to sign out with the third year residents. Last year they were my juniors, I tried to do everything the way they wanted it, and looked up to them so much. Now, we’re almost equals, the way this hierarchy works. Of course the attendings have a higher regard for them than for the new 2nd years, but we’re nearly equal when it comes to the authority structure and case distribution. And they generously treat us as true colleagues, as well. Still strange. I’ve lost my sense of time. For the last year, I was waiting for the end of internship. Every week or so, I’d count up again how many months were left. Lately, I was counting the days. I would have been counting hours, but by the end of trauma, I didn’t have enough brain cells left to be able to multiply by 24. And now here I am. Simply by virtue of having survived, it seems, I’ve moved on to the next level. I’ve hoped for this for so long, right now I have no ambition left. This was the height of my dreams, to be really a surgery resident, not just an intern on probation. Rounding now is a breeze. By the end of June, I was rounding on nearly twenty ICU patients in less than two hours. Now, two ICU patients and a handful of floor patients seems like nothing. A note here, a note there, no rush. June was a baptism by fire, but it worked. (Source: Cut On The Dotted Line)

Science is irrelevant. resistance is futile, part 2: another domino falls

Respectful Insolence — Wed, 02 Jul 2008 20:10:39 +0100

I've written extensively before about how advocates of non-science-based "medical" treatments, such as naturopathy, homeopathy, and all the woo that follows have been waging a war on all fronts against science- and evidence-based medicine in their effort to have their so-called "complementary and alternative medicine" (or the newer, brighter, shinier name "integrative medicine") be perceived as co-equal with scientific medicine. They've infiltrated academia. They've insinuated their agenda into medical school curricula. They've even managed to have the teaching of woo become a mandatory part of the family medicine residency in several residency programs. But one victory has always eluded them. One victory that would cement their appearance of legitimacy. That victory is to have insurance companies pay for their unscientific modalities. Say what you will about them (and there is certainly a lot bad to say), insurance companies are very hard-nosed. Even if a modality is cheap, they will not pay for it if there is no good evidence that it works. It's all about the bottom line. Of course, sometimes if customers demand it, an insurance company here or there might agree to pay for acupuncture or chiropractic adjustments. It's a business decision meant to keep woo-loving customers from deserting them. But such decisions were haphazard and in no way mandated by anything other than an assessment of the harm done by annoying customers versus the relatively small cost of paying for some woo. I hadn't realized that this isn't the case any more. Apparently, Vermont passed a law last year requiring insurers and third party payers to cover the cost of naturopathy. Apparently there are other states that mandate coverage for naturopathy as well, including Washington. I don't know about you, but if I were paying into an insurance plan, and the company administering that plan were wasting money paying for woo, I'd be mightily pissed. This can only serve to drive up the costs for everyone, as patients with non-self-limiting diseases pursue non-science-based modalities, think they feel better for a while, and then find that their disease is progressing, at which point they seek out science-based medical care--which their insurance companies will have to pay for, too. Of course, this is just one more reason to oppose the licensure of naturopaths. Licensure confers the legitimacy of the state upon a profession. Never mind that legislating the licensure and regulation of a profession is a political and policy decision and has little or nothing to do with whether science supports the efficacy of that profession's methods. Once that legitimacy is conferred it's very easy for those holding the licenses to make the argument that they are a legally regulated profession and that there should therefore be no reason why they are not treated as legitimate health care providers for purposes of reimbursement. After all, they're licensed and regulated by the state! That appears to be exactly what happened in Vermont and Washington. Is Minnesota next? Read the comments on this post... (Source: Respectful Insolence)

Recall bias, vaccines, and illness

Respectful Insolence — Wed, 02 Jul 2008 14:00:00 +0100

In the eyes, of anti-vaccine advocates, vaccines bear the brunt of blame for a variety of conditions, including autism, asthma, neurodevelopmental disorders, autoimmune disorders and a wide variety others. Often this link is based on retrospective data, in which parents or patients recall and self-report how many vaccines they've had and which ones. This self-recall is then correlated with the health condition under study, and sometimes correlations are found. However, it's long been known that self-reporting has a tendency to be unreliable, with a tendency to conflate incidents that may or may not be related. That's why a study in which a patient's recall is cross-referenced as much as possible with objective and concrete records, such as the study participants' medical records. Human memory is very fallible, but we human beings often have a very hard time realizing that, admitting it, or accepting it. Each of us tends to think that his or her memory is far above average, at least when it comes to issues like this. Combine the fallibility of human memory with the natural human tendency to find correlations and relations where none exist, and it's not too surprising that the myth that vaccines cause autism, for instance, is so persistent, all science refuting notwithstanding. Published just this week in the British Medical Journal is a study that demonstrates how relying on self-reporting can result in investigators finding correlations that are probably not there, particularly when it comes to relating vaccines to health problems. What's interesting about this study is that it's not about vaccines and autism. Rather it looks at the relationship between vaccines given to British soldiers serving in Iraq between 2004 and 2006. That no correlation between vaccination status (specifically multiple vaccines) and various health complaints was not particularly surprising, but there was a twist. The authors analyzed the data both using self-reported data and actual medical records about vaccination: Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

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Rajasthan bill for weaker section quota soon

"Reflections" - Doctor Bruno's Blog — Wed, 02 Jul 2008 04:00:00 +0100

The Government of Rajasthan on Thursday decided to convene a session of the state legislature to pass a Bill to provide 14 per cent reservation to the economically backward among the upper castes.Chief Minister Vasundhara Raje had on Wednesday announced job and education quota benefits for the economically backward category (EBC).“Rajasthan has become the first state in the country to announce reservation to EBC,” state Law Minister Ghanshyam Tiwari said.According to a decision taken by the cabinet today, the government proposes to bring a bill on reservation for the new category in the state assembly soon, reports IANS.“We are working out the parameters of economic backwardness,” Tiwari said adding that the state government has sought legal opinion on the issue. Different caste organisations have also been invited to submit their representations on the matter, he said.He clarified that this reservation would only be available to those who are not entitled to any reservation in any category at present.The Government of Rajasthan had on Wednesday offered a five per cent special reservation to the Gujjar, Banjara, Gadia Lohar and Raika communities, bringing an end to a nearly month-old stand-off over the Gujjar community’s demand for inclusion in the Scheduled Tribes category.While announcing the special reservation, the government has not tampered with the existing Scheduled Castes and Scheduled Tribes or Other Backward Classes (OBC) list.So far, Rajasthan has had total quotas of 49 per cent—16 per cent for the Scheduled Castes, 12 per cent for the Scheduled Tribes and 21 per cent for OBCs.The newly announced quotas of five per cent and 14 per cent exclude the existing reservation, taking the reservation tally in Rajasthan to 68 per cent which is highest amongst any state in the country. (Source: "Reflections" - Doctor Bruno's Blog)

Up move to check new born swapping

"Reflections" - Doctor Bruno's Blog — Wed, 02 Jul 2008 04:00:00 +0100

In a bid to check the growing number of child-swapping complaints the Health Department in the northern Indian state of Uttar Pradesh has come up with a novel idea.The draft proposal of the policy makes it mandatory for all hospitals to keep photographs of newborns in their records. “We would soon come up with a policy to prevent child swapping it will be mandatory for all hospitals to photograph the newborn along with the mother,” Uttar Pradesh Director General (Medical and Health) I S Srivastava said.The photograph will be kept in the hospital’s records, he added. Moreover, every hospital will have to attach an identity tag to the newborn.In the last one year, over half a dozen complaints of child swapping have been reported from various hospitals in the state, reports IANSThe latest came on Saturday when a woman, Phoolmati, admitted to the Ram Manohar Lohia (RML) Hospital here, alleged that its administration changed her baby boy with a girl. (Source: "Reflections" - Doctor Bruno's Blog)

Solar plants in tn via ppp mode

"Reflections" - Doctor Bruno's Blog — Wed, 02 Jul 2008 04:00:00 +0100

The Government of Tamil Nadu is planning to establish solar power plants through private sector participation, based on guidelines laid down by India’s Ministry of New and Renewable Energy guidelines.Announcing this at the conference on renewable sector organised by Confederation of Indian Industry (CII) here on Wednesday, the state’s Minister for Electricity Arcot N Veerasamy said the solar plants would have capacities up to 10 MW.Veerasamy said that there were as many as 41 sites where wind power could be generated in Tamil Nadu.The installed capacity of wind mills in the state, including the 19 MW under public sector, was 3,711 MW. The estimated power generation from biomass was 4,087 MW, reports IANS.“We do not have enough hydel resources, solar energy is still too expensive and we are still waiting for a technology breakthrough,” CII’s Renewable Energy Council Chairman Ramesh Kymal said.He said wind energy was at present the best renewable option, and that large wind farms generating over a 1,000 MW each were the solution to India’s power shortage in the future.“In view of the escalating oil prices globally, it is the right time to focus on renewable sources and reduce dependence on fossil fuels,” Tamil Nadu Energy Development Agency CMD Mohan Verghese Chunkath said. (Source: "Reflections" - Doctor Bruno's Blog)

Multi-drug resistant tb to be diagnosed in 2 days

"Reflections" - Doctor Bruno's Blog — Wed, 02 Jul 2008 04:00:00 +0100

The diagnosis of multidrug-resistant TB (MDR-TB) will now take only two days instead of the standard two to three months.Geneva: The diagnosis of multidrug-resistant TB (MDR-TB) will now take only two days instead of the standard two to three months, according to World Health Organisation.WHO has decided to make available a rapid molecular diagnostic tool that will generate TB results in two days. MDR-TB is a form of TB that responds poorly to standard treatment because of resistance to the first-line drugs isoniazid and rifampicin.At present it is estimated that only two percent of MDR-TB cases worldwide are being diagnosed and treated appropriately, mainly because of inadequate laboratory services.However, the initiatives announced on Monday should increase that proportion at least seven-fold over the next four years, to 15 per cent or more."This initiative will improve both the technology needed to diagnose TB quickly, and increase the availability of drugs to treat highly resistant TB," British Prime Minister Gordon Brown said.In developing countries most TB patients are tested for MDR-TB only after they fail to respond to standard treatments. Even then, it takes two months or more to confirm the diagnosis.Patients have to wait for the test results before they can receive life-saving second-line drugs, thereby increasing the possibility of spreading the multidrug-resistant disease to others.The initiative comes just one week after WHO recommended â€˜line probe assays' for rapid MDR-TB diagnosis worldwide."Five months ago, WHO renewed its call to make MDR-TB an urgent public health priority," WHO Director-General Margaret Chan said."And today we have evidence to guide our response. Based on that evidence, we are launching these promising initiatives," he added.The first, made possible through US $26.1 million in funding from UNITAID, will introduce a molecular method to diagnose MDR-TB, which will produce an answer in less than two days.Over the next four years 16 countries will begin using rapid methods to diagnose MDR-TB, including the molecular tests. The countries will receive the tests through the Stop TB Partnership's Global Drug Facility, which provides countries with both drugs and diagnostic supplies, WHO said.As part of the project, WHO's Global Laboratory Initiative and the Foundation for Innovative New Diagnostics (FIND) will help countries prepare for installation and use of the new rapid diagnostic tests, ensuring necessary technical standards for biosafety and the capacity to accurately perform DNA-based tests.Under a second, complementary agreement with UNITAID for US $33.7 million, the Global Drug Facility will boost the supply of drugs needed to treat MDR-TB in 54 countries, including those receiving the new diagnostic tests.This project is also expected to achieve price reductions of up to 20 per cent for second-line anti-TB drugs by 2010."Through the US $60-million support provided by UNITAID, these projects are expected to produce significant results in diagnosing and treating patients as well as reducing drug prices and the costs of diagnosis," UNITAID's Executive Board Chairman Philippe Douste-Blazy said. (Source: "Reflections" - Doctor Bruno's Blog)

Secure firewall to help cos block ip addresses

"Reflections" - Doctor Bruno's Blog — Wed, 02 Jul 2008 04:00:00 +0100

Now organisation will be able to create policies that block connections by an Internet protocol (IP) address based on country code information with the launch of Secure Computing Corporation’s Firewall Geo-Location service on Thursday.The Secure Firewall, formerly known as Sidewinder, is the first and only firewall to provide organisations with the ability to reduce their exposure to attack by essentially shrinking the size of the Internet.Geo-Location does this by blocking or allowing the organisation to apply additional in-depth application filtering on all traffic from countries that they do not do business with, or that are known originators of malicious hacking.Geo-Location, in conjunction with Secure Computing’s TrustedSource reputation-based filtering, further reduces an organisation’s threat exposure by defining policies that rely on a combination of IP address reputation as well as country code. Besides preventing employees from visiting malware infected websites hosted in countries, the Secure Firewall and Geo-Location policy reduces traffic volume and therefore bandwidth requirements on public-facing web, application and remote access servers, which do not have to process these unwanted connections from countries which the organisation has disallowed.The firewall is setting a new standard for proactive threat detection by integrating TrustedSource and the new Geo-Location technology into every firewall. The combination can be used with existing firewall policies such as anti-virus, IPS signatures, and application layer filtering to further reduce the company’s exposure and prevent attacks.“The Secure Firewall’s ability to filter connections based on the country code of an IP address enables our clients to significantly reduce virus and malware threats from high risk areas they would normally not be doing business with,” Network Computing Architects Chief Security Officer Preston Hogue said.IDC Research Director Charles Kolodgy said that Geo-Location technology potentially provides benefits by allowing enterprises to filter connections at the firewall perimeter based on the country location. (Source: "Reflections" - Doctor Bruno's Blog)

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Surgexperiences 201 to go to monash medical student

SurgeXperiences — Wed, 02 Jul 2008 00:46:29 +0100

The 1st edition of the 2nd season of SurgeXperiences will kick off at monash medical student. The call for submissions is here. Please submit via this form and get writing! (Source: SurgeXperiences)

New faces

Cut On The Dotted Line — Wed, 02 Jul 2008 00:06:26 +0100

July 1 - a very good day for staying out of the hospital. Actually I don’t know why everyone repeats that, because nothing very bad happened. The attendings and seniors were practically breathing down the juniors’ and interns’ necks, and there was not much opportunity for error. My service was relatively light, so I wasn’t called on to do anything out of the ordinary, which was just fine with me. I mainly babysat the intern all day. At first it was fun, because I wanted to help them and smooth the transition. By the end of the day, though, I was rather annoyed, and am trying to figure out whether all the interns are that infuriating, or mine was special. I’m going to try to keep giving them the benefit of the doubt for at least another week, and try to remember that I must have some of the same mannerisms, and must have been annoying my seniors in a very similar way through the last year. But hmmph, he/she/it is going to get in some trouble if they carry on at this rate. Friday, on call, if the rest of the interns are like this, is going to be quite a nuisance. I guess I’m mainly used to my intern class, for the last several months, being able to do all kinds of work; which it isn’t fair to expect of the new guys at first here, so I need to adjust my expectations of “having an intern to do work with me” to “having an intern whose work I need to do as well as my own.” Ah well, a few weeks should straighten them all out. It is funny, though, to see the new interns in the halls. Even the ones I didn’t know as medical students wear their new long coats so stiffly that they look out of place, as though they picked up someone else’s coat by mistake. Now if I could just find my new coat (supposedly somewhere in the hospital) so I can stop looking as though I’ve been sleeping in mine. Welcome to the gang. (Source: Cut On The Dotted Line)

This is depressing: barack obama promises to expand the office of faith-based initiatives

Respectful Insolence — Tue, 01 Jul 2008 17:00:00 +0100

(Note Addendum before commenting, please.) Is there any candidate who still supports the separation of church and state anymore? Heck, even Barack Obama seems to be pandering to the religious base these days: CHICAGO -- Reaching out to evangelical voters, Democratic presidential candidate Barack Obama is announcing plans to expand President Bush's program steering federal social service dollars to religious groups and -- in a move sure to cause controversy -- support some ability to hire and fire based on faith. Obama was unveiling his approach to getting religious charities more involved in government anti-poverty programs during a tour and remarks Tuesday in Zanesville, Ohio, at Eastside Community Ministry, which provides food, clothes, youth ministry and other services. "The challenges we face today ... are simply too big for government to solve alone," Obama was to say, according to a prepared text of his remarks obtained by The Associated Press. "We need all hands on deck." Obama's announcement is part of a series of events leading up to Friday's Fourth of July holiday that are focused on American values. Worse, not only does he plan on making this program the "moral center" of his administration and renaming it the Council for Faith-Based and Neighborhood Partnerships, he's even favoring giving funds to groups that fire and hire based on religion: Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

Teaching overenthusiastic cam advocates a little bit about gene expression profiling

Respectful Insolence — Tue, 01 Jul 2008 14:00:00 +0100

Yesterday, I was depressed. Today I'm a little irritated. I'm irritated because I came across a study from a couple of weeks ago that's actually a really cool study that applies actual science to the question of how diet and lifestyle changes might alter biology to improve health. It's exactly the sort of study that can apply help understand how diet affects health. It's a study by Dean Ornish, who's widely known for his advocacy of a lifestyle-driven approach to treating atherosclerotic coronary artery disease and producing evidence in the early 1990s that such a lifestyle alteration could not only halt disease progression but actually partially reverse it. This lifestyle intervention included a low-fat vegetarian diet, smoking cessation, regular exercise, and meditation. Although his approach is interesting, attempts to replicate it have been mixed. For example, Dr. Frank Sacks, a nutrition professor at Harvard Medical School and the Harvard School of Public Health. Dr. Sacks, tried to replicate Dr. Ornish's results with a grant from the NIH but found it difficult to recruit patients because few could stick it out for the whole program. In other words, Dr. Ornish's treatment is very difficult to follow and not suitable for many, if not most people. A couple of weeks ago, Dr. Ornish published a study in the Proceedings of the National Academy of Sciences of the USA that examined the effect of his particular set of dietary and lifestyle interventions on the development of prostate cancer. The study, entitled Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. As I've discussed before, prostate cancer is in most men a relatively indolent cancer. Indeed, in autopsy series, most men who die after the age of 80 of something other than prostate cancer have evidence of cancer in their prostate glands. Many prostate cancers never progresses fast enough to endanger a man's life, especially when it's detected through PSA screening. The problem is, we don't know how to differentiate between dangerous prostate cancer that needs to be treated and indolent cancer that does not, nor do we yet have any good treatment strategies to keep such tumors in check. Before I give you my take on this study and its findings, let me first show you a quote.This one is by our favorite advocate of a "more fluid" concept of evidence, Dr. David Katz: Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

Delhi to get evening courts from july

"Reflections" - Doctor Bruno's Blog — Tue, 01 Jul 2008 04:00:00 +0100

Now common man can seek justice without wasting his working hours during the day. The eight magistrates’ courts of India’s national capital New Delhi will begin functioning for two hours every evening from July 1 in an attempt to clear the staggering 897,373 pending cases.The sittings will be held in all the four district courts at Tis Hazari, Patiala House, Rohini and Karkardooma and officials hope this will lead to the quick disposal of around three lakh cases in the initial phase.“Initially two metropolitan magistrates in each of the courts will hear cases in the evening but the number will soon be increased. The system will work on a rotational basis,” an official involved with the project said.The official informed that the courts will operate from 5:30 pm to 7:30 pm on all working days and there will be no added burden on the exchequer given that the existing infrastructure will be utilised. The concept of evening courts was first mooted at the conference of chief ministers and chief justices of high courts here last year, with Gujarat and Tamil Nadu having already taken the lead in the matter. The legal community is, however, divided on the issue.“If we attend court proceedings in morning as well as in evening, then when we will get the time to prepare for our cases?” Advocate KK Jha said.He pointed out that the court staff would work on a shift basis but this luxury would not be available to lawyers.Earlier this year, India’s Law Minister HR Bhardwaj in written reply in the Lok Sabha, had stated that apart from setting up evening courts, his Ministry had also requested the High Courts to increase their working hours by 30 minutes or to reduce the number of holidays.“It is up to the respective chief justices to take action in this regard,” he added.Gujarat was the first to introduce evening courts in November 2006 and the response was overwhelming. (Source: "Reflections" - Doctor Bruno's Blog)

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Kec to electrify 1,454 jharkhand villages

"Reflections" - Doctor Bruno's Blog — Tue, 01 Jul 2008 04:00:00 +0100

Over 1,454 villages in Jharkhand’s Dumka district will be electrified by December next year. The rural electrification project worth Rs 160 crore has been awarded to KEC International, a subsidiary of RPG group.Confirming the work allotted to them by the National Thermal Power Corporation’s Electric Supply Company (NESCL), the KEC International Managing Director and CEO Ramesh Chandak said the award of contract to the KEC was a compliment for the strides the company has made in the field of rural electrification.The work awarded involves rural electrification on turnkey basis in Dumka district of Jharkhand state. This is the largest single value order awarded under the Rajiv Gandhi Gramin Vidyutikaran Yojana (RGGVY) scheme till date.In terms of scale, KEC’s scope of work covers electrification of 1,454 villages, providing capproximately two lakh Below Poverty Line (BPL) service connections and fourteen 33/11KV new and augmentation substations.KEC, an RPG Group company, is one of the largest power transmission engineering procurement and construction (EPC) companies in the world with an established reputation in over 40 countries. The company presently operates in more than 25 countries across South and Central Asia, the Middle East Africa and North America. (Source: "Reflections" - Doctor Bruno's Blog)

E-database launched in hungary

"Reflections" - Doctor Bruno's Blog — Tue, 01 Jul 2008 04:00:00 +0100

A regional interactive space information system has been established in Hungary to provide demographic data of the country including data pertaining to the regions at national, regional and settlement levels.The new online database will support the work of the politicians, decision makers and scientific experts dealing economic and infrastructural indicators and the main demographical data of the Carpathian Basin, reports ePractice.It provides information regarding the Hungarian population, its age group breakdown, the unemployment rate, the infrastructural data, important Hungarian institutions operating in the area, as well as the amount and main sources of the foreign and domestic support to the region.With the help of Google, the searched data can be depicted so that their spatial distribution becomes visible.Besides helping in locating mistakes in political development measures, the system is expected to facilitate cooperation among the Hungarian counties, as well as with the neighbouring countries, for participating in calls for applications.—iGovernment Bureau (Source: "Reflections" - Doctor Bruno's Blog)

Un award for mumbai-based sex workers collective

"Reflections" - Doctor Bruno's Blog — Tue, 01 Jul 2008 04:00:00 +0100

Mumbai-based organisation Sanghamitra, working with female sex workers in the city’s red light area of Kamathipura, has bagged the prestigious UN Red Ribbon Award 2008.Presented every two years at the International AIDS Conference by the United Nations Development Programme (UNDP), the award seeks to recognise community initiatives that help in reducing the spread and impact of AIDS.The award, given to only 25 from a pool of over 560 organisations, will be presented during the UN general assembly special session for HIV/AIDS, scheduled June 11, reports IANS.Sanghamitra was formed in 2005 with support from Population Services International (PSI) and has been working in Mumbai with over 6,500 female sex workers, their husbands as well as clients.“The prime aim was to provide sex workers with a platform for expressing their angst, dissent, anger—both independently as well as collectively,” PSI head Shilpa Merchant said.“The main goal of Sanghamitra was to bring about a change within as well as in society at large. The women hoped to alleviate daily oppression and stigmatisation and the collective has helped them to quite an extent to fight the exploitative power structures,” she added. (Source: "Reflections" - Doctor Bruno's Blog)

Kerala gets ‘school of mathematics’

"Reflections" - Doctor Bruno's Blog — Tue, 01 Jul 2008 04:00:00 +0100

The Kerala School of Mathematics, a joint venture between the Kerala State Council for Science, Technology and Environment (KSCSTE) and the Department of Atomic Energy (DAE), was inaugurated here Tuesday.The School of Mathematics, in its first phase, will conduct research activities at doctoral and post-doctoral levels, workshops in frontier areas of mathematics and will hold national and international conferences, IANS reports.“This is the second institution in the country dedicated to research in mathematics,” KSCSTE Executive Vice President E P Yesodharan said, adding that once the institute becomes fully operational, it would also offer postgraduate and special courses at the centre.Inaugurating the research institute, Kerala Chief Minister V S Achuthanandan said that studies have shown that the standard of mathematics education has gone down in the state.“The School of Mathematics has a great responsibility to improve the standards of research and studies in the subject in the state,” he said.The state government, which is setting up a research institute after a gap of 25 years plans to speed up the initiative over the next three years.“In the next three years, the government will set up more research facilities to improve the state’s standing in the field of science and technology,” the Chief Minister said. (Source: "Reflections" - Doctor Bruno's Blog)

Gastric ulcer

Buckeye Surgeon — Mon, 30 Jun 2008 23:01:00 +0100

In this day and age of everyone and their brother being on protonix or nexium or some variant thereof, we rarely see patients present with peptic ulcer disease to such a degree that surgical intervention is necessary. The glory days of general surgery had to be back in the late seventies when guys like Phil Donahue MD (not Marlo Thomas' husband) were snipping vagus nerves in a highly selective fashion left and right. The old surgical textbooks had throngs of chapters on all the permutations of ulcer surgery. Vagotomies and Billroth I and Billroth II and roux-en-Y gatrojejunostomies and all the post-gastrectomy complications like dumping syndrome and gastroparesis and roux stasis. My god, I killed myself trying to memorize everything as a junior resident. And then.... I find out no one ever does surgery like that anymore except for the occasional graham patch for a perforated duodenal ulcer. Looking through the old Cameron and Schwartz textbook chapters on peptic ulcer diease is like reading an old scroll from Galen or Hippocrates. Interesting but not particularly relevant to modern surgical practice.But every once in a while we see someone like Patient X. 50 years old, alcoholic, non-compliant with previous medical interventions. He smokes 2 packs a day and said that whenever he would "cough up blood" he could usually treat it by running out to Walgreens and scarfing down a bunch of Tagamet and/or Pepcid. He was admitted for weakness and his hemoglobin in the ER was noted to be 4.6. The upper endoscopy confirmed a large gastric ulcer (3x6cm) on the lesser curve of the stomach that was not actively bleeding. Further questioning found that he had a first degree relative who had died from a "stomach tumor". So he got transfused up to a normal level and was placed on a Protonix IV drip. Then what?Peptic ulcer disease (PUD) encompasses ulcers in two distinct locations: duodenal and gastric. Duodenal ulcers are much more common. 95% of duodenal ulcers are associated with chronic H Pylori infection and nearly all are observed in the setting of acid hypersecretion. Gastric ulcers are a slightly different animal. Gastric ulcers are further broken down into 4 categories:Type I- Most common type, usually a single ulcer on the lesser curve, not typically associated with hypersecretion of acid, seen in patients infected with H Pylori or NSAID abusers.Type II- Two ulcers present (duodenal and lesser curve of stomach), strong association with hypersecretion of acid.Type III- Prepyloric ulcers, also have an association with hypersecretion of acidType IV- ulcers near the gastroesophageal junction, not associated with acid hypersecretion.The classic indications for surgery for gastric ulcers are similar to those for duodenal ulcers: perforation, bleeding, obstruction, and intractability. In addition, gastric ulcers are a risk factor for the development of gastric adenocarcinoma. Therefore, all gastric ulcers need to be biopsied and followed over the course of time. Giant gastric ulcers (>3cm) have a 30% incidence of harboring a cancer.Back to my patient. Non compliant borderline alcoholic male. Giant gastric ulcer. Strong family history of stomach cancer. Presents with significant blood loss and massive transfusion requirements....what would you do?Well I did a distal gastrectomy with Billroth II reconstruction. No need for vagotomy because his was a true Type I ulcer (non-dependent on acid hypersecretion). He's doing well so far. The ulcer seemed smooth and rounded (more consistent with a benign etiology) but we'll have to see what the pathology shows in a few days. Surgery on the stomach is actually quite fun. You feel like a goddam surgeon when you're in there doing it. Sometimes futzing around with laparoscopes and tiny instruments all the time can be tiresome. Good to get your hands dirty every now and then.... (Source: Buckeye Surgeon)

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Now there's a presidential candidate for this age!

Respectful Insolence — Mon, 30 Jun 2008 22:05:00 +0100

I realize my post earlier today was a bit of a downer, but what can I say? Lately, there doesn't seem to be much good news on the ever-growing front in the war against quackery. However, in researching that piece I did come across something that made me smile. I found the campaign website for what to me appears to be the perfect embodiment of politics these days, for a leader who represents an exact fit with the mood of the times: Locutus for President You will be assimilated! Read the comments on this post... (Source: Respectful Insolence)

June 30, 2008

Inside Surgery — Mon, 30 Jun 2008 21:01:47 +0100

Surgeon For Donda West Arrested For DUI Dr. Jan Adams was arrested recently for allegedly driving while intoxicated in Solano County, California. Copyright 2008 InsideSurgery.com (Source: Inside Surgery)

Science is irrelevant. resistance is futile.

Respectful Insolence — Mon, 30 Jun 2008 14:00:00 +0100

"I am Locutus of Borg. Resistance is futile. Your life as it has been is over. From this time forward, you will service us." - Locutus of Borg. "Strength is irrelevant. Resistance is futile...Your culture will adapt to service ours." -- The Borg. I'm a bit depressed these days. Maybe a better term for it would be pessimistic, as I'm not really depressed about the state of my life per se. More precisely, I'm becoming increasingly pessimistic about the state of science- and evidence-based medicine in this country. What brought this pessimism to the forefront was last Thursday's post, which referenced a droll and spot-on post by Dr. Wallace Sampson asking why medical schools would associate with quackery, about how scientific medicine appears to have lost the linguistic high ground to unscientific and pseudoscientific nostrums going by the brilliantly Orwellian monikers of either "complementary and alternative medicine (CAM) or "integrative medicine" (IM). Pile on top of this the most recent of a series of posts by Dr. Atwood about how the mish-mash of a little valid herbal medicine mixed with a whole lot of woo (otherwise known as the "profession" of naturopathy) is pushing for--and achieving--greater legal legitimacy, and there is truly reason to wonder if the golden age of scientific medicine is over and we are now drifting towards a new Dark Age of pseudoscience. Perhaps I exaggerate, but, I fear, not that much. Of course, I've written about this before on this very blog, including my (in)famous Academic Woo Aggregator, a list of medical schools that have embraced CAM, and my lament about a medical school that has even gone so far as to "integrate" so-called "integrative" medicine into every aspect of its curriculum from day one of the first year. These disheartening trends accompany and draw succor from the $120 million a year budget of that center of woo in the heart of the National Institutes of Health, the National Center for Complementary and Alternative Medicine, the equal amount of money coming yearly from, alas, the National Cancer Institute, and, of course, the financial clout of the Bravewell Collaborative. No, unfortunately things are not looking good for science-based medicine in academia right now. I say this in particular because I just learned of a press release issued three weeks ago by Andrew Weil and his University of Arizona Program in Integrative Medicine that, as Emeril Lagasse would say, "Kicks it up a notch," but not for the better. Indeed, it shows that the forces arrayed against scientific medicine are indeed kicking it up far more than just a notch. Read the rest of this post... | Read the comments on this post... (Source: Respectful Insolence)

Cuba intros performance-based salary

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

The Government of Cuba has introduced performance-based salary for its employees, ending the system of equal pay for its workers.The country’s President Raul Castro has given all state enterprises a deadline of August 1, 2008 to comply with the new system, reports IANS.“The correct implementation of the new policy would enable Cuba to conform to the socialist principle of distribution, wherein each person receives according to his or her contribution,” Deputy Labour Minister Carlos Mateu Pereira said.Raul Castro, who became Cuba’s President in February after holding the job on a provisional basis since older brother Fidel fell ill in July 2006, says performance-linked pay will boost efficiency and productivity.“The overhaul of the compensation package for the employees is part of the improvement model that Raul as the then Armed Forces Minister had established in the military and defence-related activities 20 years ago,” Pereira said.Earlier the President, while relaxing restrictions on Cuban citizens on buying consumer goods like computers and mobile phone, acknowledged the need to increase the average pay of the workers who earned the equivalent of US $17 a month. (Source: "Reflections" - Doctor Bruno's Blog)

What is the community wise compositionof top 500 rankers in tamil nadu

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

Counseling for Admission to MBBS / BDS in Tamil Nadu starts from 04.07.2008 and Director of Medical Education, 162, Periyar Road, Chennai has releasted the counselling schedule The Community of the Top 500 Rankers can be seen from thatOf the Top 500 Rankers in Tamil NaduForward Community - FC - 55 Students - 11 %Backward Community - BC - 293 Students - 58.6 %Christians - BCC - 29 Students - 5.8 %Muslims - BCM - 20 Students - 4 %Most Backward Community - MBC - 70 Students - 14 %Scheduled Castes - SC - 32 Students - 6.4 %Scheduled Tribes - ST - 1 Student - 0.2 %Opinion Welcome :) :) (Source: "Reflections" - Doctor Bruno's Blog)

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Aids bomb ticking in asia - india accounts for roughly half the hiv-infected population of asia

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

About 10 million Asians are expected to be infected with HIV by 2020, an independent commission on AIDS in Asia warned on Monday.The commission comprising nine of Asia's leading development economists, scientists and policymakers working on AIDS, urged Asian countries to chart a new response to AIDS. India accounts for roughly half the HIV-infected population of Asia. About 2.5 million Indians were estimated to be living with HIV in 2006. Its 236-page report on â€˜Redefining AIDS in Asia, crafting an effective response' was released by India's Prime Minister Manmohan Singh here today, reports IANS.“Many Asian countries are lagging behind in their response to AIDS. At current levels of response, 10 million Asians are expected to be infected with HIV by 2020. By then, AIDS is also expected to claim an estimated five lakh lives annually if governments do not change policies,” the report sponsored by UNAIDS, Unicef and UNDP said.India accounts for roughly half the HIV-infected population of Asia. About 2.5 million Indians were estimated to be living with HIV in 2006.Twenty-six countries have been covered by the report.Almost five million Asians are currently infected with HIV, some 4.4 lakh people got infected with HIV and three lakh people died of AIDS-related diseases in 2007.Regionally, AIDS is estimated to be the single largest cause of death and morbidity due to disease for adults aged 15-44 years.“AIDS has emerged as the single-largest cause of disease-related deaths and work days lost among 15-44-year-old adults in Asia,” the report said.Expressing concern over the alarming situation, the Commission Chairman and PM's Economic Advisory Council Chirman said that these numbers indicate the seriousness of the problem the region faces.The report noted that India has managed to slow down the epidemic in some states like Tamil Nadu, which provides an effective and focused HIV response.“Asian leaders in places such as Thailand, Hong Kong, Cambodia and Tamil Nadu in India has the foresight to recognise the threat of AIDS early on; they provided leadership that proves vital for reversing their epidemics,” it said.Noting that Asia's response approach neither matched nor kept pace with the unfolding realities of the HIV epidemic, it recommends that policies must prioritise on focused and scaled-up interventions towards unprotected commercial sex, unprotected sex between men and the sharing of contaminated needles and syringes.With an estimated 10 male clients for every sex worker in Asia, the commission noted that men who go for unprotected commercial sex are probably the single most important determinant of the size of HIV epidemics in most of Asia.By pragmatically focusing prevention programmes to the sex trade and on drug use, it suggested that governments would make considerable progress in halting and reversing the epidemic.Experts found that existing resources are not only inadequate but are also currently not being spent on priority interventions that produce an impact.Rangarajan emphasised that countries which are at the early stages of the epidemic needed to spend an average of 50 cents per capita to reverse the epidemic.Every US $1 spent on early prevention would save US $8 in treatment costs later. Yet, the money spent on HIV programmes from national budgets decreased over the past decade in countries surveyed by the Commission, the only exceptions being India and China.The commission has estimated the resource need of the region to halt and reverse the epidemic at US $3.1 billion per annum. For a long-lasting and comprehensive response, however, the resource need would be US $6.4 billion a year.Noting that stigma against HIV patients remains a major issue in Asia's health care systems, including in India, the commission has recommended a more meaningful role for civil society and community-based initiatives.It emphasises the need for strong political will across Asia. If leaders implement a largely scaled-up priority response right away they could save more than two lakh lives each year and succeed in reversing the epidemic. (Source: "Reflections" - Doctor Bruno's Blog)

West bengal to introduce insurance for bus passengers

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

The state government has taken this initiative to make long-distance bus travel much more safer in the state.In an effort to make long-distance bus travel much more safer in West Bengal, the state government is planning to introduce insurance benefits for the passengers of long-distance state transport buses.“We have decided to take Rs 5 from the passengers travelling within 300 km and Rs 10 for those travelling more than 300 km by the state transport buses,” the state Transport Minister Subhas Chakraborty said.He added that the surplus would be charged on the tickets of the passengers who would avail long-distance government buses.The Minister said the money will be used to provide them with insurance benefits worth Rs 50,000 in case they meet with fatal accidents during travel. The amount would be handed over to their nearest relatives.Chakraborty said that if anyone is killed in a road accident by government buses, the nearest relative of the deceased will get the same insurance benefit.“The amount collected from every long-distance passenger would be deposited to a state government-owned corporation,” he said, adding the facility would come into effect from September.Initially, the state government is implementing this facility only for the long-distance buses, and later plans to introduce the scheme in all government-run buses in the state, he said.Following the fuel price rise, fares of buses, mini-buses and taxis in the state have also been hiked, reports IANS.The minimum bus and mini-bus fare has been increased by 50 paisa and the taxi fare by Rs 2. The new fare structure is likely to come into effect from July 11. (Source: "Reflections" - Doctor Bruno's Blog)

Ibm deploys supercomp to boost cancer research

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

The new system will aid in the search for more effective cancer treatments and facilitates analysis of millions of images of proteins.IBM has announced the deployment of Canada's fastest research supercomputer at the Ontario Cancer Institute in the University Health Network.The new system will aid in the search for more effective cancer treatments and facilitates analysis of millions of images of proteins.Through automation, high resolution imaging and sophisticated computer-based image classification, researchers are attempting to more quickly identify the structure of disease-related proteins, and thus improve our ability to design new treatments for cancer. The new IBM System Cluster 1350 supercomputer incorporates its recently announced DCS9550 disk storage system, as well as deep computing visualisation to create high-resolution images required for the research analysis.The system includes 1,344 processor cores in the Linux cluster running at 12.5 teraflops (trillion calculations per second) with 150 TB of storage, making it one of the fastest research clusters in Canada.“We need to better understand the specific function and interactions of proteins that cause cancer,” Igor Jurisica of Ontario Cancer Institute said, adding that this research will enable to diagnose cancer earlier, before symptoms appear, to have the best chance of treating disease.The supercomputer was made possible by grants from the Canada Foundation for Innovation and the Ontario Ministry of Research and Innovation and an in-kind donation by IBM for the hardware, software and services.The computing complex also houses a custom-built data centre, which has been adapted to fit into Toronto's historic MaRS research building.In November 2007, Jurisica's research was added to the World Community Grid as a Help Conquer Cancer project. The grid works on a network of approximately one million PCs and laptops using donated processing time.The Ontario Cancer Institute's new supercomputer will allow data to get on the Grid for complex analysis, and enable faster and more detailed analysis of results from the Grid computation.In simple terms, this supercomputer can do more calculations in one second than every Canadian doing one calculation per second for four days without stopping. (Source: "Reflections" - Doctor Bruno's Blog)

Hc stays g.os on new health insurance scheme for transport staff

"Reflections" - Doctor Bruno's Blog — Mon, 30 Jun 2008 04:00:00 +0100

Madras High Court today stayed operation of three Tamil Nadu Government Orders (GOs) pertaining to new health insurance scheme for employees of state transport corporations in the state. Justice N Paul Vasanthakumar granted the stay on a petition filed by Tamilnadu State Transport Employees Federation seeking to restrain the government from altering, annulling or modifying the existing Special Medical Assistance Scheme in any manner and from implementing the new Health Insurance Scheme announced and introduced by the government by GO Ms No 430, GO Rt No 65 and GO No 174. The petitioner submitted that the transport corporations had introduced the Special Medical Assistance Scheme for the employees based on a settlement reached under Section 12 (3) of the Industrial Dispute Act on September 28, 1995.As per Clause 79 of the minutes of the settlement, every workman had to contribute Rs five every month towards the scheme and the corporations have to make an equal contribution.The petitioner contended that the Special Medical Assistance was a better scheme than the new scheme introduced by the state government. The government has no power to do away with the existing scheme framed under the settlement, the petitioner added.The state government had recently introduced the new health insurance scheme for government employees in collaboration with a private insurance company. (Source: "Reflections" - Doctor Bruno's Blog)

Poetry

Cut On The Dotted Line — Mon, 30 Jun 2008 01:10:35 +0100

I have a Cherish the Ladies CD I’ve been listening to on the drive home from work for the past few days, Threads of Time. They set a poem by William Yeats to music. It’s a perfect arrangement, and the song is hauntingly beautiful; the only problem is it tempts me strongly to play hooky, and disappear off into the mountains. The Lake Isle of Innisfree I will arise and go now, and go to Innisfree, And a small cabin build there, of clay and wattles made; Nine bean-rows will I have there, a hive for the honey-bee, And live alone in the bee-loud glade. And I shall have some peace there, for peace comes dropping slow, Dropping from the veils of the morning to where the cricket sings; There midnight’s all a glimmer, and noon a purple glow, And evening full of the linnet’s wings. I will arise and go now, for always night and day I hear lake water lapping with low sounds by the shore; While I stand on the roadway, or on the pavements gray, I hear it in the deep heart’s core. [Except I'd really rather be by an ocean than by a lake; but generally speaking. . .] (Source: Cut On The Dotted Line)

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Imitation is flattery

Cut On The Dotted Line — Mon, 30 Jun 2008 00:58:13 +0100

One more day of internship left. It’s a little hard to believe. I’m making a couple of notes for myself about what I most admired in the junior residents I worked with over the last year, because I know that within a month, if not less, I’ll have completely forgotten what it was like to be an intern. (The same way that I’ve forgotten what it was like to be a medical student. For the med students out there wondering, “How can the residents treat us like this? Don’t they remember what it was like?” the answer is, no, we don’t remember, because things change so fast in just a few years. I remember third year of medical school about as much as I remember college, unless I concentrate. Even my own blog from back then seems foreign. I’m a different person now, immeasurably more cynical, skeptical, overbearing, determined, confident - hardened. For instance, when people ask for pain medicine, I have no problem saying flatly to the nurse, “That patient has been told that they will have no more iv pain medication. Tell them those are the rules that the attending discussed with them, and please try not to have to call me about it again.” The other day, as we were setting up the trauma bay for a gunshot victim, one of the residents told me, “You can put in the chest tube, but you have to really throw it in. No time for lidocaine, no dissection - cut and push. It doesn’t matter if the patient feels it. In fact, if he feels it, that’s good [because it would mean he was alive enough to care].” I told him, “It doesn’t matter to me what the patient thinks. You watch, I’ll throw it in.” And I did, because by this time I care a lot more about the technical affair of getting the tube in fast, and the overall implications of getting it in fast enough to prevent a tension pneumothorax or overwhelming hemothorax from killing the patient, than I do about whether it hurts him for a short time.) Getting back to the stated topic: There were some residents I worked with for whom I would do absolutely anything, from something I simply could barely get up the willpower to do, like calling family members with bad news, to pure scut errands, like running to the other end of the hospital to get a paper they should have remembered to bring with them in the first place. Other residents (the minority) could make me silently furious simply by reminding me to do a job which was clearly my responsibility, and which I had been planning to do. I think the biggest difference between these two groups was that the first kind of resident acted as though we were on a team, together; working toward the same goal, taking care of the same patients; they knew as much or more than I did about our patients, and didn’t have to have the whole story told to them fresh when I came to ask question. They routinely helped get all the work done, no matter whether it was “intern-level” or not; and if they didn’t help, I knew it was because they were overwhelmed with their own work. They cared about whether I got to sit down or eat, what time I came in and left. (Speaking of which, all year, all the seniors seemed to work at getting the interns home at a very decent time, no matter what that meant for themselves. I think now that I’m ready to commit to the longer hours the seniors worked; I need to remember to think about the interns’ hours.) Since I knew they cared about me and my patients, I would do pretty much anything for them, and still will, as we both advance in seniority. The second kind of resident clearly regarded me as a working machine, who existed to save them from having to do any work, and preferably from having to know much about my patients. That is purely bad leadership, and bad medicine. So my primary resolution is, not to enjoy having an intern to do the scut work so much that I stop caring about the intern’s patients, or stop sharing in the general work of the team. (Although after these last two weeks, desperately short-staffed, without even medical students to help out, having someone junior to me, to do work, when I haven’t even had a senior to help out, will be an unbelievable luxury. I’m not sure what I’ll do with it.) The other thing that I know I loved about seniors was when they let me do procedures, or enabled me to scrub in on cases. That may be a little more challenging, since I know I’ll be grasping to do every case that comes my way, now that I’m finally allowed/expected to do more, and as for procedures, I’ll still be gaining confidence at doing them on my own - let alone supervising someone else. Many juniors, who seem to have ice in their veins, taught me how to place lines in coding patients, by standing back and forcing me to try myself, before they would take over. I don’t know if I can be that cool. (Source: Cut On The Dotted Line)

Up from down under: the skeptics' circle is on its way

Respectful Insolence — Sun, 29 Jun 2008 17:23:58 +0100

Lest I forget my obligations here, I have to post a reminder that the 90th Edition of the Skeptics' Circle is fast approaching and will be here on Thursday, July 3. In fact, because it's being hosted by prominent Australian skeptic Peter Bowditch at the Millenium Project, it may well be earlier than that given the rather large time difference. (Of course, if you're in Asia or Australia you won't notice.) That means there's less time than usual to get your submissions to Peter before July 2 for inclusion in the Circle. So get cracking while there's still time! The contact information and instructions are here. The schedule and guidelines are here. This is also a good time to mention that the 100th Meeting of the Skeptics' Circle will be arriving here in November. (Can it really be that there have been almost 100 of these things? Time flies...) There is not as yet a host, although hosts are lined up all the way through the 99th Meeting and there's one already lined up for the 101st Meeting. I haven't decided how to handle this milestone yet, whether to host it myself or to find one of our best hosts from the past to do it--or even to take a chance and have a newcomer do it. So, basically what I'm saying is: Give me some ideas, or even take the opportunity to make the case that you should be the host. I'll try to decide just what the heck to do and announce it when I post my usual plug for this upcoming Skeptics' Circle. Read the comments on this post... (Source: Respectful Insolence)

Say it ain't so, sid!

Respectful Insolence — Sun, 29 Jun 2008 15:00:25 +0100

I have some bad news for the medical blogosphere. Well, actually Sid Schwab does. Apparently, he's decided to drop out of the blogosphere, at least for now. Sid's grown enormously as a blogger since he first started hawking his book a couple of years ago in the comments here. He got on my nerves at first, but I quickly took a liking to him and his blog, realizing that his early self-promotion came from his being new to the blogosphere and not realizing that too much of that sort of stuff is generally frowned upon. Now he's a well-respected medical blogger, and definitely one of the best. The evidence is in his Sampler of some of his best posts. He does mention that he might go back into practice. If that happens, his community will only benefit from his surgical expertise. Fortunately, he may not be gone forever. He leaves open the possibility of coming back. Personally, I hope he does. The blogging bug, once it bites, often won't let go for long. A few months to recharge his batteries, and Sid may well find himself hearing the siren call of the blogosphere, luring him back. Read the comments on this post... (Source: Respectful Insolence)

Industrial growth slows down in india

"Reflections" - Doctor Bruno's Blog — Sun, 29 Jun 2008 04:00:00 +0100

The sluggish expansion in the manufacturing sector has led to the slower growth of industrial production at seven per cent in April 2008 as against 11.3 per cent in the same month of last fiscal.The growth in manufacturing was just 7.5 per cent in April, as compared to 12.4 per cent in the corresponding month of 2007, as per data on Index of Industrial Production (IIP) released at the Planning Commission here.For the year as a whole, industrial production was 8.3 per cent higher for fiscal 2007-08, as against 11.6 per cent in the previous fiscal.The worrisome news came against the backdrop of India’s central bank hiking its short-term interest rates to eight per cent on Wednesday in a bid to tame inflation—a move that experts feel could, in turn, trigger interest rate hikes by commercial banks.“Monetary policy has to respond proactively to immediate concerns,” the Reserve Bank of India said.The central bank was forced to take the monetary measure as India’s annual rate of inflation jumped to a 45-month high of 8.24 per cent for the week ended May 24, against 8.1 per cent for the previous week.Rating agencies like Moody’s predict that India’s central bank may hike interest rates further to keep a check on spiralling prices, while predicting an economic slowdown.“Amid tight monetary policy conditions which weigh on household consumption and business investment, the Indian economy looks set to slow this year,” Moody’s Economy said in a report.The biggest challenge facing central banks across Asia is to cool inflation without hurting economic growth; the RBI is no exception, the agency’s report said. (Source: "Reflections" - Doctor Bruno's Blog)

Reach govt officials via online: austria

"Reflections" - Doctor Bruno's Blog — Sun, 29 Jun 2008 04:00:00 +0100

The Government of Austria has added ‘Help’ feature in its e-Government site, which is a directory of the names, addresses and phone numbers of officials throughout the federal administration.The new directory covers the Presidential Chancery, the Federal Chancellor’s Office and four federal ministries, reports ePractice.Users would be able to search people of the federal government by entering any of the search criteria which include providing surname, organisation or telephone number in the ‘search by person’ function.Furthermore, in order to narrow down the search, more criteria can be entered in one single go.In the new feature, for each official, an e-mail address is given, together with clickable links to the institution concerned and the department or sub-department within that institution. In most cases, a phone number is also shown.It also comes with ‘extended search by person’ option, which will produce further details, notably about their functions, but there is a greater range of possible identifiers.The third search function is ‘organisational units’, which can be used to find out which unit of which ministry is responsible for a particular issue. (Source: "Reflections" - Doctor Bruno's Blog)

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Chinese president goes online

"Reflections" - Doctor Bruno's Blog — Sun, 29 Jun 2008 04:00:00 +0100

Now citizens of China can directly interact with their President without taking the pain to meet him. The Chinese President Hu Jintao has become online to chat with citizens through a major news portal of the Communist Party of China (CPC).The ‘Qiangguo Forum’, launched by the mouthpiece of the CPC, has been a big hit since the news of the President going online surfaced.The news has led thousands of people post their queries and write-ins on the forum.“The Internet is a major channel for public opinion,” Hu said during the chat, and added that he has squeezed his time to go online, though he would not be able to surf the net daily due his busy schedule.The President logs on to the website to view domestic and foreign news, to learn what interests people on the Internet and to solicit their advice and opinions about the work of our government.The Qiangguo Forum, meaning ‘powering the nation’, has more than 23,000 daily postings and the highest simultaneous web page visits exceeding 1.4 million. (Source: "Reflections" - Doctor Bruno's Blog)

Backwards and forwards

Cut On The Dotted Line — Sun, 29 Jun 2008 00:28:22 +0100

Now that we’re getting down to the wire, I’m having the same butterflies I did last year at this time. The butterflies are riding a rollercoaster - first excitement at moving on then, and then fear at the prospect of having even more responsibility than I have now. There’s also the vertigo-inducing exercise of turning around, as it were, and remembering how the second-year residents looked to me when I started last year. I revered them nearly as much as I revered the chiefs - and them I nearly worshipped (which is just as well, because the executive chief is the direct manifestation of the program’s control over your life). And then to turn back, and realize how lost I’m going to feel, and the interns are going to be looking at me with - hopefully not reverence, but a little respect. And looking ahead, the increasing certainty that the new chiefs don’t feel any more confident with their role than I do with mine. . . We all perform for each other. The unit has stopped whirling a little bit, and settled down to more straightforward feverpaced activity. I had my first patient go into a grand mal seizure in front of me - actually the first real seizure I ever witnessed, and she had to go and be in status epilepticus for nearly forever. The seniors were all off elsewhere, in traumas, so I was left rummaging through my memory of the neurology rotation in medical school, and telling the nurses, “Since this patient has been in status for the last 30 minutes, her neurons are seriously burning out now; and we’ve already tried multiple doses of three different medications, so at this point I don’t particularly care what medication that we have to get from the other end of the hospital that the neurosurgeons do in these circumstances, iv valium is the handiest thing we haven’t tried yet, go ahead and push it.” And it actually worked. After we stopped the seizures, then the neurologists, neurosurgeons, and seniors turned up, and of course all looked at me skeptically: “Who’s seizing? I don’t see the patient moving at all.” No, because she’s had high-dose ativan, dilantin, valium, and propofol, she better not be seizing. So I was reduced to imitating the seizure for them, and the EEG confirmed my diagnosis. But I can hardly feel pleased about handling it, because it makes this patient’s prognosis so bad, and the family doesn’t seem to understand yet how bad things are. I’ve also spent too much time in the last week talking to doctors about their relatives in the unit. Something funny is up, there are so many doctors’ mother/grandfathers/aunts/cousins through here lately. It’s a tricky conversation. You have to show courtesy between professionals, and also deference, since they’re all attendings a long way into private practice, and you’re just an intern. On the other hand, mostly they’ve been in very non-surgical specialties (pediatrics, heme/onc, family medicine), so in all honesty, between their nonsurgical mindset, and how far they are from medical school and internship, I may be (and my attending definitely is) a little more familiar with the management of critically ill trauma patients than they are. I’m still trying to figure out the exact phrases to use for telling them something that they may or may not already know or remember. But they are certainly the most wonderful historians; they can tell you all the medical history, medications, allergies, and surgical history of the family member; it’s like having a walking medical record. And then there’s the concern that if I use a technical term incorrectly, they’ll walk away thinking, “What kind of incompetent residents do they have working here, they can’t even name the fractures correctly?” Mostly, though, it goes ok. Just as I would be in such circumstances, they’re very glad to get some definite information in medicalese - the guild language. (Source: Cut On The Dotted Line)

A chiropractor for president?

Respectful Insolence — Sat, 28 Jun 2008 15:00:33 +0100

Apparently there's a chiropracter named Billy Sticker running for President. His platform: My platform: To increase your patient count by 200% during my first term To increase your income by 200% Pass legislation designating Chiropractic the Official Health Care of America Reduce our dependency on pharmaceuticals (because Chiropractic would be the official health care!) He even has his own video coverage: Say it ain't so! A woo-meister for President. That'd be a step down even from our current President! It's even worse than that, though. He's apparently a guy who sells marketing plans to other chiropractors to help them increase their profits! Indeed, his entire website is called Chiropractic Marketing University, and if there's one thing worse than chiropractic woo it's chiropractic business woo. It's a joke, right? Talk about my breathing a sigh of relief! Read the comments on this post... (Source: Respectful Insolence)

Shortage of doctors hits india’s health mission

"Reflections" - Doctor Bruno's Blog — Sat, 28 Jun 2008 04:00:00 +0100

The ambitious National Rural Health Mission (NRHM) launched by the Government of India to provide medicare facilities in villages has failed to yield results due to shortage of doctors and paramedics. “The multi-billion-dollar NRHM was launched three years ago, but India’s 6.5 lakh villages continue to face a shortage of doctors and paramedics,” the Planning Commission said. An assessment report of the commission revealed that there was still a yawning gap between the requirement and availability of human resources in the rural health units at various levels. The report said against the requirement for 21,490, there were only 5,910 specialist doctors were available at community health centres across the country. The plan panel will shortly review the flagship rural health scheme, which was launched April 12, 2005 to provide effective healthcare facilities to the rural population. The union Health and Family Welfare Ministry, the nodal agency for NRHM, has earmarked over Rs 120 billion for the mission in the current fiscal. The country’s primary health centres (PHCs) are also understaffed. The plan panel said there were 31,381 doctors at these centres by the end of December 2007 as against 20,308 doctors engaged there before the flagship scheme was launched. “There is a need to accelerate the process of appointment of doctors and nurses at a greater pace. Against the requirement of 66,059 nurses and midwives for the health centres, only 41,313 appointments have been made as against 29,139 such nurses already on the rolls,” the commission said. As per details with the plan panel, 159,181 auxiliary nurse midwives (ANMs) have been appointed under the mission for sub-centres in rural areas against the need of 197,488. There were 133,194 ANMs when the NRHM was launched. The health mission puts special emphasis on 18 states with weak public health indicators and infrastructure. Some of them are Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura and Uttar Pradesh. However, health and family welfare ministry officials are satisfied with the progress made under the NRHM so far. Some of the key goals of the mission are reducing infant mortality rate to 30 per 1,000 live births and maternal mortality rate to 100 per one lakh against 450 per one lakh live births by 2012 through promoting institutional delivery in the countryside. An official estimate says half of India’s women still deliver babies at home and accounts for the world’s 20 per cent child mortality. The mission has several projects—Janani Suraksha Yojana (save the mother project) and accredited social health activists (ASHAs)—to promote safe delivery and newborn safety. (Source: "Reflections" - Doctor Bruno's Blog)