Mycobacteriun leprae incidence in INDIA

LEPROSY - INDIA (05): (ANDHRA PRADESH) INCREASED INCIDENCE ********************************************************** A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases Date: Sat 21 Dec 2013 Source: The Times of India Times News Network (TNN) [edited] Leprosy is increasing alarmingly in Andhra Pradesh with the government doing little to check the bacterial infection from spreading, experts said as a staggering 8285 cases were reported in the state during 2012-13. As many as 239 new cases were detected in Hyderabad in the same period. Health department officials said Andhra Pradesh now figures among the top 12 states with the highest caseloads of leprosy in the country. The proportion of new paediatric cases in the state was also among the highest in the country, experts said. Data from the National Leprosy Eradication Programme shows that out of the total new cases, a substantial 911 cases (11.34 per cent) are of children, officials said. Experts said the numbers have gone up particularly in the last 2 years. During 2011-12, 7820 cases were detected, they pointed out and attributed the situation to the state government's apathy towards the health issue, so much so that it is now regaining ground. "We could not identify these cases well in time," said Dr Michael Sukumar, a WHO consultant who is working with the state leprosy cell [in Hyderabad], underscoring a situation when agencies are sometimes helpless when local governments fail to read health warnings.

UK DAILY MAIL:: ERROR in "NIL BY MOUTH" at ROYAL BOURNEMOUTH HOSPITAL

Elderly patient starved because a 'nil by mouth' sign meant for the previous occupant of her bed had not been removed Royal Bournemouth Hospital in Dorset under attack from hospital inspector Care Quality Commission inspection found alarming care of elderly patients One was left naked on top of a soiled sheet and other forced to wet the bed Another left on the verge of malnutrition because they couldn't reach food By Anna Hodgekiss PUBLISHED: 11:49 GMT, 19 December 2013 | UPDATED: 11:53 GMT, 19 December 2013 An elderly patient starved because a ‘nil by mouth’ sign meant for the previous occupant of her bed had not been removed. A damning report into care at the Royal Bournemouth Hospital also found that another elderly patient was left completely naked on top of a soiled sheet, while others were forced to wet the bed after their repeated calls for assistance went unanswered. A dementia patient was also left on the verge of malnutition because they were unable to reach food or drink left for them. The Royal Bournemouth Hospital in Dorset has received a damning hospital inspection report. Patients were found to have had fluids and food restricted by mistake while others were left lying in soiled or wet beds The Royal Bournemouth Hospital in Dorset has received a damning hospital inspection report. Patients were found to have had fluids and food restricted by mistake while others were left lying in soiled or wet beds The terrible treatment came to light after the Care Quality Commission, which inspects hospitals, visited in October. The two-day inspection singled out wards three and 26 for being particularly bad and understaffed. The report states the family of an elderly woman were surprised to find the ‘nil by mouth’ sign on her bed and were shocked when it was realised it wasn’t meant for her. Yet it took another five hours for the patient to be given water, such was the lack of staff on the ward. The report states: 'One person on ward 3 told us they had come to visit their relative and had been surprised to find they had a sign above their bed saying "nil by mouth", which told staff not to offer this patient food or fluids orally. More... How was NHS surgeon allowed to carry out controversial breast cancer surgery even AFTER colleagues raised concerns? Report published today as victims sue 'Bully' chief of cancer scandal hospital quits: £165,000-a-year executive accused of fiddling cancer waiting times 'The relative had questioned this with a nurse, who told them that their relative was due to undergo an investigation, which meant that they couldn’t eat or drink. 'They then asked the nurse to find out what this investigation was. When the nurse returned they said that the patient was not in fact meant to be ‘nil by mouth’ but that the sign had been left on the bed from a previous patient. 'This meant that the patient had missed breakfast and lunch, and had not received fluids since their admission to the ward. 'The concerned relative went on to say that although this mistake was discovered at 2pm, when they returned to the ward at 7pm their relative had still not been given water to drink.' The report also highlights the case of a dementia patient who lost a significant amount of weight because they were unable to reach their food just inches away. Professor Sir Mike Richards, the Chief Inspector of Hospitals Royal Bournemouth Chief Executive Tony Spotswood Despite the scathing report from the chief inspector of hospitals, Professor Sir Mike Richards (left), Bournemouth chief executive Tony Spotswood (right) said there was no reason for him to resign It reads: 'Despite them being able to eat independently, food and drinks had been left out of their reach and left to go cold. 'As a result, their relative had lost a significant amount of weight on the ward. 'When they asked about the weight loss they were told that staff had weighed their relative that morning and they had weighed 90 kilograms. 'As they felt that this did not seem correct, they asked staff to weigh them again. On that occasion they weighed 69 kilograms. 'They said that the ward had given their relative a Malnutrition Universal Screening Tool (MUST) score of zero after the first weight was recorded, which needed to be changed to a three after the second weight was recorded. Dorothy Simpson, 84, telephoned her family from the hospital because she could not breathe, and died 20 minutes later Dorothy Simpson, 84, telephoned her family from the hospital because she could not breathe, and died 20 minutes later 'This score of three showed that their relative was at risk of malnutrition.' The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire scandal, following complaints about the level of care there. The inspection found that nurses on ward three accepted staffing levels were ‘horrendous’. The chief inspector, Sir Mike Richards, concluded: 'The trust did not employ enough staff, even though it was fully aware that nearly all its beds were occupied all the time. Professor Sir Mike Richards, the Chief Inspector of Hospitals, said: 'Whenever we inspect we will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people's needs? Is it well-led? 'At Royal Bournemouth Hospital, we were told about basic nursing care which was not being given to patients on two medical care wards. We heard from five patients who told us they had been left to wet or soil their beds. 'The hospital had a high occupancy rate and there had been ongoing use of escalation beds when a ward or unit was full - even though these beds could not meet patients' needs properly. The 64-page document also said that stroke victims were 'not always given the urgent care they needed'. Surgical services and outpatient departments also came under the microscope at the hospital managed by The Royal Bournemouth and Christchurch Hospitals NHS Trust, which serves 550,000 people. 'A number of services were not always safe, effective, responsive, caring or well-led,' stated the CQC report. 'In particular we found that medical care (including care older people's care) was inadequate. 'There were widespread and significant negative views from patients and staff.' The outpatients' department was found to have infection control risks. The main outpatient reception, the floor sinks and the waste bins in the female toilets were not clean. The sluice room - a specially designed cleaning room - was cluttered with 'obsolete equipment' and stacked with used clinical dressing packs. The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire (pictured) scandal, following complaints about the level of care there The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire (pictured) scandal, following complaints about the level of care there The report said: 'Staff entered the sluice with dirty packs, adding to the pile, and left without washing their hands.' Despite the report beign scathing of the leadership of the hospital, chief executive Tony Spotswood said there was no reason for him to resign. He added: 'We accept the broad findings of the report and would like to apologise to those patients who received poor care. 'Clearly it is unacceptable but many of these issues have now been set right. 'We have put in place a number of changes in relation to staffing and care of the elderly and we have already seen a number of improvements within the last six weeks. Paula Shobbrook, director of nursing at the Royal Bournemouth, added: 'I don’t want patients to be frightened about coming to hospital. 'We have recruited more nurses; 57 newly qualified nurses are now working on our wards and we have new ward sisters who are committed to raising standards.' Read more: http://www.dailymail.co.uk/health/article-2526334/Patients-left-soiled-sheets-locums-poor-nursing-Hospital-chief-inspector-slams-two-leading-hospitals-unsafe.html#ixzz2nvdpTWcw Follow us: @MailOnline on Twitter | DailyMail on Facebook

Switzerland: PRESERVATIVE-FREE EYE DROPS.

Consider using preservative-free topical medication in patients with ocular surface disease Publishing date: December 2013 The Science behind the Tip Many glaucoma drops contain a preservative agent to minimise the risk of microbial contamination. Benzalconium chloride, a cationic surfactant, is the most widely used preservative, but even in doses of 0.002% to 0.004% can result in toxic effects on the surface of the eye and ocular inflammation. (1) Symptoms and signs of ocular surface disease (OSD) are found in 48-60% of patients on topical glaucoma medication (2) (3). This is a multifactorial condition which leads to adverse local reactions, reduced visual acuity, reduced quality of life and reduced compliance with prescribed therapy. (1). Risk factors associated with OSD include the number of preserved drops used and duration of therapy. (4) An improvement of symptoms is found if these patients are switched to preservative-free topical medication. (1) Contributor: Frances Meier-Gibbons, Switzerland References 1. Baudouin C, Labbé A, Liang H et al Preservatives in eyedrops: the good, the bad and the ugly. Prog Retin Eye Res 2010; 29 (4) 312-334. 2. Leung EW, Medeiros FA, Weinreb RN. Prevalance of ocular surface disease in glaucoma patients. J Glaucoma 2008; 17 (5) 350-355. 3. Fechtner RD, Godfrey DG, Budenz D et al. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure lowering medications. Cornea 2010;? 29: 618-621. 4. Rossi GC, Pasinetti GM, Scudeller L et al. Risk factors to develop ocular surface disease in treated glaucoma or ocular hypertension patients. Eur J Ophthalmol 2013; 23 (3) 296-302. Tip Editors: John Salmon and John Thygesen Reviewers: Roger Hitchings and Anders Heijl

OMA TORONTO STREET ADS

ASTRAL TTC STOP ADS. $3787 (inc 13% tax) per face for 4 weeks (central core area).

UK PRIVATE MED.SCHOOL: University of BUCKINGHAM

Accredited by UK Gen Med.Council www.buckingham.ac.uk/medicine Tuition:$70,000/year for 4.5 years (short vacations) NO SCHOLARSHIPS Living expenses: circa $30,000/yr Entry: Int.Baccalaureate(36+)for Canadian students.

Dr.GERHARD MANN PHARMA, Berlin ( a Bausch & Lomb company ) CARBOMER, MYRITOL 318 "LIPOSIC" eye drops.

OMA had an EYE CME @ WESTIN PRINCE HOTEL. BAUSCH & LOMB presented LIPOSIC combination of Ophthalmic drops & night use Liposic gel for xerophthalmia.

TORONTO: MEDICAL ADVICE FOR VISITORS

FROM PHYSICIAN CONTRIBUTOR. AVOID LOCAL ER. WAITING TIME 4-6 hrs. ADVISE LIMO RIDE ($400) 1.5 - 2 hr. to Mount St.Mary Hospital,Lewiston, NY. Quick access to Specialists, MRI etc. For general medical advice CLEVELAND CLINIC CANADA, (30,000 sq.ft.)@ BROOKFIELD PLACE, 181 BAY ST. (also entrance YONGE ST.) 416-507-6600 Same building as Hockey Hall of Fame & MARCHE Swiss Restaurant. Connected to USA Cleveland clinics. (Near Fairmont ROYAL YORK Hotel.) MEDCAN Private clinic 150 YORK St.(@ Adelaide)416-350-5900 (Mid-Town location)Near to HILTON & SHERATON Hotels.) No Private Hospitals in Ontario (Quebec has Private Medicine)