Do Sex Test By USG To Save Girl Child, Maharashtra Parliamentary Panel

To correct Indian Male to female ratio and to check female foeticide or girl child abortion while PNDT Act and FOGSI and Central and State government do not allow sex determination of the foetus at all by USG or blood test or amniotic fluid assay, recommendation was made by a Maharashtra assembly committee, the Public Accounts Committee (PAC), towards making pre-natal sex determination mandatory in order to prevent female foeticide.
They say as it is a law where only doctors are regulated and patients are not booked so many illegal abortions took place as patient once knowing illegally that she is carrying female child goes to many quacks to get it aborted and as sex can't be determined so initially too they move to illegal sex clinic where even proper diagnosis is not made, if sex of child will be told to parent on the first USG by an expert and they will be labelled and now monitoring them carefully and even home visits will control killing of girl child better.
The panel was led by MLA, calling for parents to be brought under the PCPDNT Act (1994).
Monitoring by local health officials of pregnant women was also called for to ascertain if abortion of fetus was in the case of discrimination against the girl child.
Sex determination tests are also prescribed when parents reach for sonography and that they must be tracked regularly, noting ‘when parents come for sonography, compulsory sex determination must be followed and follow-ups must be done at the local level to ensure the couples come for further check-ups. It is necessary to visit these couples at home if they stop check-ups.
Since the law only provides for action against doctors (for carrying out sex selection tests), there is no fear of the law among parents. But this fear of law among parents is necessary to increase the sex ratio. Doctors, parents, district health officers (DHOs) and NGOs must be involved in the tracking system.

Acute-Onset, Severe Hypertension During Pregnancy

April 10, 2017, Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension, severe diastolic hypertension, or both, require urgent antihypertensive therapy. The American College of Obstetricians and Gynecologists (ACOG) has issued a committee opinion on this topic, offering both recommendations and conclusions, including:

• Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes.

• Close maternal and fetal monitoring by a physician and nursing staff are advised during the treatment of acute-onset, severe hypertension.
• After initial stabilization, the team should monitor blood pressure closely and institute maintenance therapy as needed.
• Intravenous (IV) labetalol and hydralazine have long been considered first-line medications for the management of acute-onset, severe hypertension in pregnant women and women in the postpartum period.
• Immediate release oral nifedipine also may be considered as a first-line therapy, particularly when IV access is not available.
• The use of IV labetalol, IV hydralazine, or immediate release oral nifedipine for the treatment of acute-onset, severe hypertension for pregnant or postpartum patients does not require cardiac monitoring.                                                                                                          Obstet Gynecol; ePub 2017 Mar 24; O’Neil Eckert, et al.

License Renewal Exam, Mandatory For Medical Degree Holders

From now onward, the doctors with MBBS and MD degrees have to appear for re-validation exam in every three to five years. According to sources close to Health Minister, this re-validation exercise will be implemented from the beginning of next year by the Union Health Ministry as this is a part of a slew of health sector reforms.
As per the plan, it will be implemented for CGHS and ESI first followed by all doctors. The government has sought for IMA views on the matter. Eliminating quacks has been told as one of its objectives.
Source: Aaj Tak

Heat exhaustion and heat stroke should be differentiated promptly

Most parts of the country are experiencing high temperatures. With the ongoing heat wave, cases of heat–related disorders are also bound to increase. Heat cramps, heat exhaustion and heat stroke are the three forms of heat-related disorders that occur with prolonged exposure to heat and differ in their severity. Hence, it is important to differentiate between the three conditions. Clinically, both heat exhaustion and heat stroke may manifest as fever, dehydration and other symptoms such as headache, thirst, malaise, nausea or vomiting, rapid pulse etc. The main difference between heat exhaustion and heat stroke is the presence of sweat in the former and absence in the latter.' Normally, the axillae will always be wet even if a person has severe dehydration. If the axillae are dry and the person has high fever, this invariably means that the person has progressed from heat exhaustion to heat stroke and this should be treated as a medical emergency. In heat exhaustion, the core temperature is between 37°C and 40°C. While in heat stroke, the core temperature is very high, > 40°C and needs to be lowered within minutes and not hours. Rapid reduction in body temperature can be accomplished by cool or tepid bathing preferably using damp sponges. Submersion should be avoided so that body heat loss by evaporation can occur. Cooling blankets should also be avoided. The absence of sweating, dry armpit, non-passage of urine for 8 hours or presence of high grade fever in summer season are ‘red flags’ and medical attention should be sought immediately. Heat cramps are muscle spasms in the arms, legs, or abdomen that result from loss of large amount of salt and water through exercise. The treatment is replacing fluid and salt orally.

God help us all ! We Doctors At Risk

Most doctors are trained to do everything possible to help their patients get better. We’re used to spending sleepless nights monitoring our patients; running around to arrange blood when the patient is bleeding; being sleep deprived ; and skipping meals, so that we can keep our dying patients alive .

We don’t think about personal comfort and duty hours when our patients need us. We don’t look at the clock, and we don't think about the fact that we haven't eaten for hours, or that there is no one senior who can guide us when we are out of our depth in the middle of the night, because our focus is on helping our patients to recover. Even when we are unsure what to do , we persevere and do our best with whatever resources are available to us, to make sure our patients do not die on our watch.

We’ve been taught that good doctors always put their patients first, and will sacrifice their personal well being to do whatever is needed to help them to heal. This credo is deeply embedded in the culture of medicine , and this is why the role model for doctors are heroic surgeons who will move heaven and earth to help their patients fight death. They are our role models; we share their stories, and try to follow in their footsteps.

However , given all the episodes of doctor bashing which have started occurring recently, I don’t think doctors will be willing to stick their neck out for their patients anymore. In the past, when they had a critically ill patient, they would slog through the night; mobilize resources; get help; donate blood; organize medicines and disposable supplies even if nothing was available in the hospital - do whatever was needed to snatch their patients from the jaws of death.

They didn’t complain about inadequate facilities; under-staffing ; or that they were overworked. They did whatever they had to , and they took pride in their ability to function under completely adverse conditions.

Most young doctors are idealistic, and they want to save lives, which is why they choose to become doctors. This is the medical tradition and culture, which has been passed on from generation to generation. This is why doctors revere medical heroes such as Albert Schweitzer , who sacrificed so much in order to help their patients.

However, thanks to the way we ill-treat our doctors and allow them to get beaten up by not being able to provide them even basic security, I think this tradition is going to sadly die out. Doctors are going to start thinking of protecting themselves first, and when they are confronted with a critically ill patient, their self-preservation instinct will kick in. Their first priority will be to protect themselves from ungrateful and unappreciative relatives, rather than try to battle massive odds in order to try to save the life of a critically ill patient. God help us all !