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There are many Pharmceuticals marketing anti TB drug combination packs under various brand names.. The srenghth of individual drugs varies from brand to brand and leads to lot of confusion while prescribing ATT for children. The following table highlights this fact:
3 Drugs combinations
Brand Rifamp. INH PZA Ethamb.
{In mgs.}
Montorip
Kid 100 50 300 - - -
Rifacept
kid 100 75 250
Rifater 120 80 250
Coxter
3 FD 150 100 500
Montorip
forte 225 150 750
Rifcept-3
forte 225 150 500
Monitor
3 225 150 750
Rifinex
plus 150 100 500
Rimcure
3 FDC 150 300 400
Rinizide
forte DT 150 100 500
4 Drugs combinations
Monitor
4 225 150 750 275
Xeed
4 150 75 400 275
Caviter
FD 225 150 750 400
2 Drugs combinations
Rimactazid
disped 100 50 - - -
Ipacin
kid 100 100
Rcinex
kid 100 50
Binex
kid 150 100
Tibrium
INH 100 100
The above table reflects a scenario akin to that of a jumbled mass of confusion. Conventionally the forte strength of a drug is double the normal one. It is extremely difficult to memorize the various strengths of ATBDs in different brands. It can lead to pre ion errors ,underdosage or overdosge. Underdosage can help emergence of MDR TB and overdosage to drug toxicity in a child. The drug controller, IAP and pharma companies must put their heads together and try to remove this ambiguity. The various brands must have identical strength of different ATBDs.
Dr. Jasbir S. Chugh, Ludhiana
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Hi, just a thought to ponder........ if all we paediatricians join up and give free medical advice to school children and the necessary medication {whatever possible}, i mean in the govt schools , then we can bring down the under 5 yr mortality. Its no point in sitting and expecting the Govt to do everything.
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The sad demise of Star Voice of India, Ishmeet Singh has created an irreparable void for his family and a pall of gloom for his fans.
The tragedy could have been averted if he himself or his friends knew how to swim.
This sad event should be an eye opener for the parents of young children. The kids must learn swimming at a young age. They can be life saviors for themselves and many others during similar situations.
Another thing which youngsters must learn at home and schools is "First Aid". Knowing CPR {Cardio-Pulmonary resuscitation} is a must for them and the technique can be handy to save lives during life threatening conditions leading to choking and suffocation before the proper medical aid arrives. The Pediatricians should take up this matter with the authorities of schools in their vicinity. They must spare some time to teach First-Aid to school children.
The youth need council ling and must avoid unnecessary risks to their lives.
Dr. Jasbir S. Chugh, Ludhiana
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govt is recognizing foreign degrees nopw .. but not recognizing the DNB for medical colleges...... and even DNB results ... last time only 8 Percent in theory exams.... very horrible experience. for results to come it will take six months, if once failed then it will take one year .
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Ethical and unethical practices are either at personal level, which canot be big but institutional or industry level malpractices are phenomenal. . We feel our pharma industry is an institution of unethical practices.
Science is mixed with marketing very cleverly. Young smart graduate boys brief you regarding so called latest drugs, try to imprint on your brain odd spellings of many drugs and lastly give you gifts, samples under the disguise of trial on patients. These marketing people feel they help in improving doctor’s knowledge. Thank god they do not teach medical students in our medical colleges.
Sir I have mentioned only a fraction of whole system. We must adapt a new system of direct marketing to a retailer under generic name. We believe our academic journals, CMEs, workshops and conferences are too good to teach us. It is humanly impossible to remember the odd spellings and names of thousand of drugs. Drug companies can put their names in bracket under the generic names. If a prescribing doctor prefers certain companies for certain products, he can do so.
One way to ensure a good knowledge for the doctor is yearly refresher’s course for all the practioners of modern medicine. Specialist and super specialist should also undergo the refresher’s course suitable for them. This will eliminate the need for medical representatives particularly in rural areas. Certain ethically accepted measures must be implemented if physicians want to retain the public trust that they still enjoy...
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It is with great interest that I read the article in Times of India about private medical colleges charging a huge amount of money for reserving payment seats for students who wish to do medicine. I then had a talk with my resident doctors and realised that most of them have come through these so called "payment seats". With almost half seats being reserved for backward classes, the remaining half open merit seats are divided into 2 parts: payment and non payment seats. Payment seats charge about 8-9 lakhs fees for total MBBS course officially but over 12-15 lakhs may be taken to get the seat. The scenario for post graduation is even worse and apparently radiology and orthopedics are the 2 most common sort after branches with price as high as 50 lakh rupees. I asked my resident how much he had paid for MBBS and he told me since he had some influence, he could manage with 5 lakhs additional. Also CET marks do not make a difference, it is money that matters.
To think all this is happening in the name of education and charity. Now-a-days starting a medical college seems to be the most lucrative business where you can make money in crores.
This doctors then when they practice are so tempted to do malpractice to "recover" the money they spend in education and so called education.
I think now when one goes to a doctor, it will be necessary for a patient to not only know the degree and qualification but also the medical school from which the doctor passed out.
Where is the conscience of the medical college trustees- who play in the name of health_?_?
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In andhra pradesh,certain p.g.courses are recognised in pvt.medical colleges whereas the same courses are not recognised in govt.colleges with superior infrastructure and faculty. Why_? Am I mistaken_?
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I quote an incidence which happened about 35 years ago.
when I was doing my P.G. My room-mate`s dad had sent somebody to see him regarding his matrimonial proposal.
The girl`s father asked me about my friend`s pay package. ` He must be getting about 4000 p.m.` he inquired. `Oh yes uncle the pay is good but you must delete the last zero from the figure you have quoted`, I answered. `You mean just Rs. 400-, Phir to nanga nahaye ga kiya aur nichore ga kiya_?` Fuming and fretting the man barged out of our room leaving us aghast.
Things are no better even today also. After spending heaps of money as fee in medical colleges especially private ones, a fresh medical graduate hardly manages to get more than 10,000-12,000 p.m. when he joins a nursing home or a charitable hospital as E.M.O. Even the specialists are also drawing meager salaries as compared to their degrees and experience. They are rather being exploited. Not every body can indulge in immoral practices of cuts and commissions to run a roaring practice.
As compared to other professions, doctors are highly underpaid. Young graduates with commerce or business management degrees easily get placements with pay packages starting from 25,000plus. But doctors are treated as beasts of burden, paid poorly and sort of taken for a ride as they have to work day and night.
In this context the MCI and I.M.A have a serious role to play. They must put their foot down and insist upon higher salaries for doctors as per their qualifications and experience.The hospitals and nursing homes which try to exploit doctors must be blacklisted or firmly warned against such trends. In fact medicos should unite and boycott such institutes by refusing job assignments in them.
A better option for young doctors is to gain a few year`s experience and set up practice in small towns and even in rural areas. Not only they can earn handsomely, it is a way of social service also as these areas have scarcity of qualified doctors. Moreover they will help curb the practices of unscrupulous elements and quacks who play havoc with the life of innocent people of small towns and villages.
Dr. Jasbir S. Chugh
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Dear Friends medico,s non medicos
The modern life style and materializm has made the present generation emotionless. Evey day we hear cases of accident victims lying on the road with no help coming for anywhere.The result the victim dies for want of medical care.
We don,t stop to look at the victim.Everyone wants to reach at his workplace and to avoid delays.Are we so much insensitive_?
Remeber it could be you,your family member and your distant realtive who is in need of urgent medical attention.
Sometimes I feel why it is happening_? Is it we don,t want any situation where we are asked to come as witness or police questioning us_?
or there are some other reasons.
Even I don,t feel like looking at a place where there is a crowd - it may be accidnet victim or any case of criminal striking an innocent person
The judicial system in India is so time consuming that you don,t want to loose you sleep for helping some one.Many of us have read a story- Baba Bharti and his horse` and dacoit Kharag singh_?
Baba Bharti - pleading to dacoit Kharag singh that he should not tell this incident of dacoity to any one one - So that people don,t stop trusting the lepers and sick is coming true_?
I wish that medical community can do something. I intend to take an initiative in this regard. So dear friends come out with some incidences in your life where u wanted to help some one but did not_?
The reason why and your suggestions `How can we do it _?
I will look forward to your experiences
With regards
Dr.Bajaj
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With all due respect to my fellows countrywide, there are increasing incidents of doctors, intensivists, physically abused ,two of them in a month in gujarat..one of them, a20year old ,post op. deteriorated boy,ventilated, prognosis told, consents taken, expired, and relatives damage the whole intensive unit, take the qualified intensivist on the road ,beat him up brutally untill he becomes critical,nobody on the gathering comes to his rescue..his CCTV catches up all live.. and no media highlights it.....
Another incident in which the pediatrician admits a Severe Birth Asphyxia neonate ,explains prognosis,risk-one the day of holi a relative of the pt.is drunk and enters the NICU,is advised to go outside, and three days later he enters the doctors OPD, and brutally beats him....and poor doc.gets a humerous fracure and scapula fracture.....
what are we doing all this intensive care for...we go and update ourselves every year so that we benefit our pts..we spend sleepless nights when we ventilate our babies...we keep ourselves in tremendous stress when they are critical,sometimes are questioned by our family about being irregular and workoholics...
And worse, we play the blamegame amongst eachother even when we know that both of us are right in treating...of which the relatives of the patient take full advantage......
summarizing,,KEEP ETHICS INTACT,BE UNITED AS COLLEAGUES, AND COME TO EACHOTHERS HELP ...........
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