Author: Dr Sumit Ghoshal

Medical Refrigeration Possible Despite Power Outages

  India is a country with extremes of climate, with the temperature varying from winters near zero in Himachal Pradesh and Uttarakhand to sizzling 50o Celsius summers in Rajasthan, Madhya Pradesh and so on. Under these circumstances, maintaining the quality of blood for transfusion, blood components, vaccines and other biological substances becomes a challenging task. Because these substances, blood in particular, has to be stored within the temperature range of 2-8oC at all times, despite variations in weather, power outages and others hazards. This problem is not unique to India but also applies to Africa, the Gulf countries, Latin America and other parts of the world. According to one estimate, almost half of all the vaccines for all diseases that are sent to the various tropical countries are weakened or destroyed because of failure to maintain proper temperature and humidity conditions. Another recent study from Duke University showed that as many as 151 million vaccines, doses valued at approximately $750 million, are lost annually due to improper refrigeration in developing countries. The consequence of this in terms of large swathes of the population who remain exposed to various preventable infections is quite difficult to calculate! So what is the remedy? The only way to avoid this massive wastage of vaccines and other materials, as well as the consequent vulnerability of people is to install refrigeration devices in their thousands...

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Surgery Avoidable In Knee Meniscus Injury

  Injury to the meniscus of the knee joint is one of the commonest forms of knee injury observed worldwide with an incidence of about 66 per 100,000 people. A large proportion of these are sports related injury in young people under the age of 40 years, often due to sports-related activities or in people required to lift heavy weights, such as construction workers or railway porters. The latter are more common in developing economies in Asia, Africa, Latin America, etc. However, as more and more people grow older each year, an increasing number of these patients would belong to the Senior Citizens category, in which the meniscus damage is more on account of degenerative changes rather than an acute strain. Globally, about two million of these patients are subjected to arthroscopic surgery, at an immense but expense, whether it is publicly funded or out of pocket for the patients’ families. But a number of studies are now showing that if the meniscal damage is partial or not very severe, conservative therapy with a medically supervised exercise regimen is as effective as surgery. The latest of these is a report from the British Medical Journal (BMJ), according to which “arthroscopic knee surgery offers little benefit (additional) benefit in comparison with arthroscopic surgery.” The findings published last week were based on research conducted in Norway and Denmark, in which the...

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Fresh WHO appeal on antibiotic resistance

Earlier this week, Marc Sprenger, the Director of the WHO (World Health Organisation) Secretariat for Antibiotic Resistance sent out a fresh appeal to both prescribing doctors and antibiotic users across the world. “The advent of antibiotics introduced a new era in medicine. But now, I fear we are moving backwards – to the world in which my parents lived, when bacterial infections were often lethal because there were no specific treatments available,” he said at the start of a lengthy article on what can be done to control antimicrobial resistance. Those interested to read the full article may click...

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Surgery for Diabetes: Limited Usefulness

Is gastric by-pass surgery a recommended course of action in the treatment of uncontrolled diabetes? Two studies, the COSMID study published at this year’s annual conference of the American Diabetes Association (ADA) and the STAMPEDE study published at the same conference last year, seem to suggest so. A number of physicians however hold a contrary opinion. COSMID stands for Comparison of Surgery Vs Medicines in Indian Diabetes, and is making waves in this country for two reasons. Firstly, it was conducted entirely on Indian patients, mostly Mumbai and Pune, and secondly, the lead author of the study, Dr Shashank...

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Passive Euthanasia Bill: Work in progress

The Union Ministry of Health and Family Welfare (MOHFW) has recently published a draft Bill to provide legal sanction to a process known all over the world as “Passive Euthanasia” and has invited comments from members of the public. The Bill is the result of a lengthy debate over the past many years, arising from two important cases. One was the case of Aruna Shanbagh, a nurse in Mumbai’s KEM Hospital, who remained in a vegetative state for over three decades, and went all the way to the Supreme Court. The other was Gian Kaur Vs State of Punjab,...

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