Mosquito borne virus causing microcephaly

A mosquito-borne virus is being blamed after more than 3,500 babies in Brazil were born with microcephaly #ViralDisease

Zika virus is a member of the Flaviviridae, transmitted by Aedes mosquitoes

In 2015, Zika virus RNA was detected in the amniotic fluid of two fetuses, indicating that it crossed the placenta and could cause fetal infection. On 20 January 2016, scientists from the state of ParanĂ¡, Brazil, detected genetic material of Zika virus in the placenta of a woman, who had undergone an abortion due to the fetus' microcephaly, which confirmed that the virus is able to pass the placenta.

Babies in Brazil Suffer as Zika Virus SpreadsA mosquito-borne virus is being blamed after more than 3,500 babies in Brazil were born with deformed heads and brain damage.
Posted by AJ+ on Monday, January 18, 2016

The torture of being "Just MBBS"

The average salary of a fresh medical graduate (MBBS) at private hospitals in sizzling cities like Bangalore,
Hyderabad, Chennai and Mumbai is much lower than an entry level call center employee. At most cities this income cannot support a lower middle class living.

Even when we talk about employability in small towns, rural setups and government setups, there is a big dearth of vacancies. In under-developed states like Bihar, for every available post for a salary of USD 400 per month public sector medical officer job there are hundreds of applicants for every district.

The health system clearly does not have necessary capacity to employ the existing workforce of fresh medical doctors passing out every year.

So where exactly the newly qualified doctors are disappearing to? Interestingly majority of the medical graduates are engaged in postgraduate entrance test for the first 5-10 years of their career and youthful lives instead of fruitful engagement with the health system.

I am sure that all of you who have been through the "Just MBBS" phase wouldn't agree more.

While having an interesting discussion with one of my friends Dr Nitiraj Gandhi (Clinical Services Manager with a prominent Corporate hospital in Bangalore), on the pathetic conditions being faced by Junior doctors in India, one of his statements really gave me an insight on healthcare industry's perception towards fresh MBBS graduates.

"Today's MBBS has little to offer in addition to Web MD or such sites. They themselves (more than 90%),are apprehensive at making a diagnosis. In contrast MD and MS are extremely well equipped in terms of knowledge and expertise and at par with the best in world. Its a pity that post MBBS, few are equipped to practice while most are busy preparing for pg and memorizing stuff. The art of apprenticeship is a lost one today."

Is it that something is wrong with the Medical education system or is it something else?

In India, most fresh graduates are involved in majority of nursing and clerical activities like giving injections, indenting medicines for the ward, doing dressings, putting IV fluids, drawing blood for investigations, transporting them to the lab and collecting results, carrying blood bags from the blood bank to the ward and collecting X rays. This work has to be done 365 days without a single leave, and duty hours extending upto 28-32 hours at a stretch!

This kind of work and work schedule will definitely suck out any left over knowledge, capability to analyze, capability to innovate and above all the capability to diagnose and prescribe medicines in a manner which is optimum for the patient.

There is a widespread resistance to change in the above situation because in a teaching hospital they are a cheap resource available with no prescribed rules on the nature of work, work hours, work days and holidays by the government.

Then you have our so called professional leaders in MCI and senior professors in Medical colleges who think that all of this is fine because that is what they have also been through. This notion that "You got to do it because we did it", is what is taking the standard of Indian clinicians on a downward spiral.

For all categories of employees in India, we have some rules and laws laid down to prevent human resource exploitation. But to this date nobody bothers to take care of this under paid, over worked and underutilized brilliance we know as CRRIs, "Just MBBS", "Junior doctors" or "Duty doctors".  

Let's Support Thiruvarur Interns:First batch interns in Thiruvarur medical college are threatened by the Dean that he...
Posted by SLAVE CRRI on Thursday, April 9, 2015


Kumar R. The leadership crisis of medical profession in India: ongoing impact on the health system. J Fam Med Primary Care [serial online] 2015 [cited 2015 Apr 10];4:159-61. Available from:

Sorry state of Emergency Departments of Indian Government Hospitals

The origin of this post comes from the concerns over the deficient universal precaution practices and instrument sterilization in emergency departments at government hospitals. In the course of my education and career, I have worked/ observed the practices in quite a few government hospitals across India.

I am currently working at a government hospital in Tamil Nadu. As a part of my job I am regularly posted in the emergency department of the  hospital where we are supposed to see the trauma patients.

My hospital is a mid sized tertiary care government hospital. Our emergency department gets around 50-100 patients/day with varying degrees of trauma. The majority of cases(50-60%) come with minor lacerations which need to be sutured, after doing the math it comes to around 25-50 patients per day of cases for whom we do suturing and dressing. Whereas there are larger hospitals which get 3-4 times of the above numbers daily. So you can just get an idea of the big number of patients that visit the emergency departments of government hospitals for outpatient emergency care everyday.

But speaking of the supplies of few basic things required for suturing wounds like sterile gloves, suture materials, sterile suturing instruments and dressing materials; many a times we are forced to follow practices which may possibly directly contribute to spread of communicable diseases such as HIV and Hepatitis B.

I am sure if you have ever worked in a government hospital emergency department/ casualty in India you will agree that sterile gloves, sterile instruments and sterile dressing materials are considered a luxury and are always in short supply. Ever heard somebody asking you to complete 6 debridements /dressings with 3 gloves? This is a common argument given for not wasting the [disposable] sterile gloves!

Being publicly funded and providing crucial healthcare free of cost, I am aware that there is not much you can ask for in a government setup. But cutting upon the basics is definitely a thing to worry about, both from patient and healthcare provider perspective. On one hand, the patients come to the hospital to be cured and not to get infected with another unrelated disease. While on the other hand, it is the front line healthcare providers who put their life at risk just because of unavailability of basic supplies such as soap for hand wash and gloves for  patient/ self protection.

Will end this blog post with a question: Is your hospital emergency department actually one of the factors contributing to the incidence of HIV and other blood borne communicable diseases?

If you are an administrator or a decision maker in any of the government hospital in India, it is the time for a little introspection and action.

11 reasons why the current Indian caste based reservation system is out rightly illogical and should have no place in the modern Indian society

Recently the ruling Congress-NCP government in Maharashtra decided to accord 16% reservation for Marathas and 5% for Muslims in government jobs and educational institutions in a last-ditch attempt to woo these two categories of people following the parties' pathetic performance in Lok Sabha elections. This again raises the same question which we have been choosing to ignore until now, when will this spiraling trend of increasing proportion of caste based reservations end?

Coming from a very moderate background, I have managed to achieve a lot in the prevailing adversity of the Indian caste based reservation system. Until now I have not complained but there has to be a point where you have to say ‘enough is enough’.These type of politically motivated actions are really demotivating and it makes me feel that our coming generation will really have to struggle hard to get quality education and rightful opportunities, if such actions don’t face a strong opposition right now. I am sure that majority of people reading this blog will also resonate with my concerns.

The whole logic of caste based reservations is wrong at so many levels. Below I discuss a few reasons why a caste based reservation system is out rightly illogical and should be discarded.

What are the problems with the Indian healthcare system which the Modi government will have to tackle?

After a strong mandate the Modi government has received in general elections, everybody is having a lot
of hopes from the government.  They are hoping and waiting for transformatory changes and  strong steps to be taken in direction of revival of the Indian economy. Very soon we will be having a draft of intention of the Modi government in our hands in the form of the union budget. What kind of changes are we going to expect for the healthcare sector?

We have a Prime Minister who seems to be pro reforms and above all we have a new Health Minister, who is a doctor himself. Will this combination add up to some bold steps translating into results or are we going to have the same run of the mill actions which would lead to no substantial changes in the long run?

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