Community medicine training consists of a bit of family medicine and a bit of public health- with no advanced competencies on either. Family medicine is now an established discipline with its own scholarly niche, a clear generalist approach towards clinical care rooted in the philosophy of primary care. Public health developed outside medical universities, and global scholarly work has meant it has a strong but continually evolving philosophical basis. Both family medicine and public health have some commonalities – they do not shy away from integrating concepts from various disciplines; are collaborative in nature; and its post-graduates are job-ready. Community medicine on the other end has been not able to move away from the clinical lens and has no clear philosophical leanings. Surely teaching medical students alone cannot be an enough justification for continued investment on community medicine.
The full article in Journal of Family Medicine & Primary Care is available open access here .
Surgeons and health activists have called on the Indian government to make the practice of unbanked direct blood transfusion legal again to meet the needs of people living in rural areas.
The Association of Rural Surgeons of India, Jan Swasthya Sahyog (JSS), a non-governmental organisation serving in rural and tribal areas, and the Christian Coalition for Health in India say that unbanked direct blood transfusions (UDBTs) are vital in some parts of India. UDBT involves testing potential donors for blood type and screening the blood for infections and then transfusing directly to the patient without any banking or storage.
The much deliberated and long awaited Mental Healthcare Bill was introduced to the Rajya Sabha, the upper house of India’s parliament, in the third week of August.
The bill, intended to replace 1987 legislation, includes provisions to decriminalise attempts at suicide and supports advanced directives to allow people to express how they would like to be treated should they lose the mental capacity to make decisions for themselves.
India has been a pioneer among developing nations in identifying mental health as an important issue. It launched the National Mental Health Programme in 1982 to increase accessibility to “minimum healthcare for all” …
Read the full article by Dr. Soumyadeep B at the British Medical Journal here
The Indian Academy of Pediatrics has called for doctors working in the private sector to report adverse events after immunisations to the national surveillance system to ensure more complete vaccine safety data.
In a position paper published in Indian Pediatrics, the academy said that the adverse event following immunization (AEFI) surveillance system run by the government needed to be strengthened by including reports from the private sector.1
India has one of the largest universal immunisation programmes in the world, with 26 million babies born every year. Approximately …Read the full article by Dr. Soumyadeep B at British Medical Journal
“More than 50% of all medicines are prescribed, dispensed or sold inappropriately, and half of all patients fail to take medicines correctly.” WHO Fact Sheet 2012
So why do half of all patients fail to take medicines correctly?
Issues of adherence are different depending on whether the condition in acute chronic. For example, it is extremely common for patients to fail to take the complete course of antibiotics for an acute infection, thereby predisposing to antibiotic resistance. For background on adherence in relation to chronic conditions, you can freely download the WHO publication ‘Adherence to Long-term Therapies’ (1.5Mb): (Open Access)
Here are the “Take-home messages” (reproduced from the report):
1. Poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude
Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. In developing countries, the rates are even lower. It is undeniable that many patients experience difficulty in following treatment recommendations.
2. The impact of poor adherence grows as the burden of chronic disease grows worldwide
Noncommunicable diseases and mental disorders, human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis, together represented 54% of the burden of all diseases worldwide
in 2001 and will exceed 65% worldwide in 2020.The poor are disproportionately affected. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs
3. Poor adherence to long-term therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Interventions aimed at improving adherence would provide a significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes.
With a shift in disease epidemiology trends, non-communicable diseases (NCDs) are fast becoming leaders in the global burden of disease. NCDs are estimated to cause 36 million deaths annually and have become the focal point of concern for global public health. To meet the increasing challenge, WHO plans to rope in innovative technologies to aid its fight against NCDs.
Dr. Soumyadeep B’s response to His Royal Highness, The Prince of Wale’s “Integrated health and post modern medicine” plan has been published in the Journal of The Royal Society of Medicine in its latest issue.
Prospective registration of clinical trials has been made mandatory by various government regulations. The ICMJE guidelines require a clinical trial to be registered as a prerequisite for publication while the revised CONSORT Statement requires the authors to submit the trial registration number and name of registry while reporting of clinical trials.
A short study of ‘instructions for authors’ of MEDLINE indexed Indian medical and dental journals publishing clinical trials to assess their editorial policies on trial registration was done by Dr. Soumyadeep B and his colleague .
They identified 30 journals from the National Library of Medicine Catalog meeting our study criteria. From the websites of these journals, they accessed the ‘instructions for authors’ and extracted information on requirement of trial registration number during submission of clinical trials, mention about any eligible trial registry, endorsement of CONSORT Statement in reporting of trials and mention about the ICMJE Guidelines.
Results :Trial registration number was required in only 30 % journals (9/30, 30%). Only 16 journals (16/30, 53.33%) encouraged adherence to the CONSORT Statement in reporting of trials, while 22 journals (22/30, 73.33%) mentioned about ICMJE Guidelines in their instructions.
The study shows an urgent need of uniform endorsement of international standards in registration and reporting of clinical trials by the journals and identifies a major issue in the medical publishing arena in India. Read the full study titled ” Editorial Policies of MEDLINE Indexed Indian Journals on Clinical Trial Registration ” published in the esteemed medical journal IndianPediatricshere. (OPEN ACCESS)
For more than two decades mankind has been dreaming of a “polio-free world.” However the dream is yet to be realized owing to various problems related to transmission of wild polio virus transmission as well as vaccine-derived polio virus. These problems are as much scientific as human. The article briefly discusses the current status of polio control across the globe, and various challenges associated with it in a nation-wise manner.