Pediatric Neurology Conference

Salient points from Pediatric Neuro Conference today at Chennai Rain tree hotel

Epilepsy diagnosis is purely clinical and doesn't need a EEG.. As a normal eeg doesn't rule out epilepsy and an abnormal eeg doesn't  conclude epilepsy..

If you are in doubt if it is epilepsy or syncope ask the history properly and EEG is not needed here to rule out epilepsy as we usually think

MRI is the investigation of choice and never a CT as radiation is soon high to cause leukemia s..

Treating epilepsy is not an emergency.. Only if you are sure about the diagnosis start AED s.. If u r in doubt wait for another episode to occur and then start .. If possible ask them to video record the event.. Though its practically tough insist the patient to do so as it is the best way to conclude seizure event.

Pseudo refractory seizures means trying 2 inappropriate combination of AED s and concluding that its a case of refractory seizures.. Always use the appropriate combinations..

Don't do MRI for Autism ADHD cases.. No need if MRI for absence seizures..

No role of Neuroimaging and EEG even in atypical febrile seizures.. No need of AED prophylaxis in any febrile seizure typical or atypical as it doesn't alter long term seizure occurrence.. Teaching parents to use midazolam nasal spray is all that is needed in most cases..

Don't increase AED s dose with increasing weight of child as we usually think .. If child is seizure free with that particular dose that's enough and continue with that alone..and don't increase dose for decreased serum drug levels of the drug.. Mostly serum drug levels don't have a role

No role of cannabinoid oil or L carnitine.. No use..in seizures

For Infantile spasms oral prednisone (40 mg per day for all )  is as good as ACTH .. ACTH has more complications..Prednisone can be combined with vigabatrin too..

Valproate causes asymptomatic increase in transaminase levels.. Not to be taken seriously until the AST ALT levels are increased more than 5 times the normal..

Epileptic surgery is not a last option as we think some epilepsy disorders improve well with surgery.. They are decided based on MRI.. Lesions which are predominantly on one side like mesial temporal sclerosis, heterotopia hemi megalencephaly, tuberous sclerosis sturge weber syndrome improve well with surgery..like lesionectomy lobectomy,hemispherectomy.

In certain rare MRI negative epilepsy usually cortical dysplasia s stereo EEG explorations could be done.. And the lesion causing seizure could be removed..

EEG machines made in India are of poor calibration and quality which gives you wrong diagnosis.. A EEG report should have the diagnosis and not merely cortical seizure activity or subcortical seizure activity ..

In all cases of acute transverse myelitis,, mri brain is a must along with spine so as not to miss a demyelination

Headaches in children.. First line of treatment is paracetamol and Ibubrufen( better option) .. Second line is triptans ( sumatriptan nasal spray)  For a severe headache iv anti emetics are very useful.. Prophylaxis is for those with more than 3 attack s per month for past 3 months.. Propanolol is very good.. Flunarizine and Amitriptyline are good too but more side effects..Sodium valproate can also be used..good results.. Cyproheptadine is good for less than 6 years old children..

NCC and Tuberculoma.. How to differentiate❓..

NCC rule of 6 S.. Supratentorial, single,some edema, scolex, seizure only presentation, stage of lesion variable..

Tuberculoma can have features other than seizures like prolonged fever cough TB contact positive mantoux positivity.. Focal neurological deficit s, midline shift in MRI.. Multiple lesions..

Rarely both NCC and tuberculoma can coexist in the same patient..

Rarely multiple neurocysticercosis cysts can be seen in MRI disseminated ones... Called as  starry sky appearance...can present with fever vomiting headache etc..

No role of MRI spectroscopy with lipid peak and lactate peaks in differentiating both..

Duchene muscular dystrophy.. Treatment is Prednisone 0.75 mg per kg per day...or Deflazocort 0.9 mg per kg per day.. Prednisone has high risk of obesity.. Deflazocort has high risk of cataract..

Two drugs with same mechanism of action is an inappropriate combination egs. Phenytoin and Carbamazepine , Phenytoin and valproate...

Those with different mechanism of action is a good combination.. E.g.Valproate and Lamotrigine, Valproate and leviteracetam, Leviteracetam and clobazam, Valproate and clobazam, ..

Nowadays neurologists prescriptions have Valproate+ clobazam or Leviteracetam+ clobazam.. This combination works well I guess😊

Few points to add to pearls:
Levitiractetam - not much effective in continuous , daily, multiple seizures. Lamotrigine, topiramate are better options.
2. Clobazam - best first add on drug in seizures not controlled with a single drug.
3.valproate not effective in focal seizures.
4.clobazam and PBT need a slow tapering

15 Facts about Vitamin D

*15 FACTS ABOUT VITAMIN D*

Vitamin D is perhaps the single most *underrated nutrient* in the world of nutrition. 

That's probably because it's free....

Your body makes it when sunlight touches your skin !

The truth is, most people don't know the real story on  *vitamin D and health.*

 So here's an overview taken from an interview between Mike Adams and *Dr.Michael Holick*.

◆ 1. Vitamin D is *produced by your skin* in response to exposure to ultraviolet radiation *from natural sunlight*. 

◆ 2. The healing rays of natural sunlight (that generate vitamin D in your skin) *cannot penetrate glass*. 

So you don't generate vitamin D when sitting in your car or home. 

◆ 3. It is nearly impossible to get adequate amounts of vitamin D from your diet. *Sunlight exposure is the only reliable way* to generate vitamin D in your own body. 

◆ 4. A person would have to drink *ten tall glasses* of vitamin D fortified milk each day just to get minimum levels of vitamin D into their diet. 

◆ 5. The further you live from the equator, the longer exposure you need to the sun in order to generate vitamin D. Canada, the UK and most U.S. States are far from the equator. 

◆ 6. People with dark skin pigmentation may need 20 - 30 times as much exposure to sunlight as fair-skinned people to generate the same amount of vitamin D. 

That's why prostate cancer is epidemic among black men -- it's a simple, but widespread, sunlight deficiency. 

◆ 7. Sufficient levels of vitamin D are *crucial for calcium absorption* in your intestines. Without sufficient vitamin D, your body cannot absorb calcium, rendering calcium supplements useless. 

◆ 8. Chronic vitamin D *deficiency cannot be reversed overnight*: it takes months of vitamin D supplementation and sunlight exposure to rebuild the body's bones and nervous system. 

◆ 9. Even weak *sunscreens (SPF=8) block* your body's ability to generate vitamin D by 95%. This is how sunscreen products actually cause disease -by creating a critical vitamin deficiency in the body. 

◆ 10. It is impossible to generate too much vitamin D in your body from sunlight exposure: your body will self-regulate and only generate what it needs. 

◆ 11. If it hurts to press firmly on your sternum(chest/breast bone), you may be suffering from chronic vitamin D deficiency right now. 

◆ 12. Vitamin D is "activated" in your body by your *kidneys and liver* before it can be used. 

◆ 13. Having kidney disease or liver damage can greatly impair your body's ability to activate circulating vitamin D. 

◆ 14. The sunscreen industry doesn't want you to know that your body actually needs sunlight exposure because that realization would mean lower sales of sunscreen products. 

◆ 15. Even though vitamin D is one of the *most powerful healing chemicals in your body*, your body makes it absolutely free. No prescription required. 

~ Other powerful *antioxidants* with this ability include the 

super fruits like Pomegranates (POM Wonderful juice), 

Acai, Blueberries, etc. 

~ Diseases and conditions cause by vitamin D deficiency:

● Osteoporosis is commonly caused by a lack of vitamin D, which greatly impairs calcium absorption. 

● Sufficient vitamin D prevents 

prostate cancer, 

breast cancer, 

ovarian cancer,

depression, 

colon cancer and

schizophrenia..

● "Rickets" is the name of a bone-wasting disease caused by vitamin D deficiency. 

● Vitamin D deficiency may *exacerbate* type 2 diabetes and impair insulin production in the pancreas.

 

● Obesity impairs vitamin D utilization in the body, meaning obese people *need twice* as much vitamin D. 

● Vitamin D is used around the world to treat *Psoriasis*(a chronic skin disease).

 

● Vitamin D deficiency can cause ~

schizophrenia. 

● Seasonal Affective Disorder is caused by a melatonin imbalance initiated by lack of exposure to sunlight. 

● Chronic vitamin D deficiency is often misdiagnosed as *fibromyalgia* because its symptoms are so similar: *muscle weakness, aches and pains*. 

● Your risk of developing serious diseases like diabetes and cancer is *reduced 50% - 80%*  through simple, sensible exposure to natural *sunlight 2-3 times each week*. 

● Infants who receive vitamin D supplementation (2000 units daily) have an *80% reduced risk* of developing *type 1 diabetes* over the next twenty years*

  ° Exposure to direct sunlight between 1PM to 3 PM is more beneficial.

💥 Shocking Vitamin D deficiency statistics:

¶ 32% of doctors and med school students are vitamin D deficient. 

¶ 40% of the U.S. population is vitamin D deficient. 

¶ 42% of African American women of childbearing age are deficient in vitamin D. 

¶ 48% of young girls (9-11 years old) are vitamin D deficient. 

¶ Up to 60% of all hospital patients are vitamin D deficient.

¶ 76% of pregnant mothers are severely vitamin D deficient, causing widespread vitamin D deficiencies in their unborn children, which predisposes them to type 1 diabetes, arthritis, multiple sclerosis and schizophrenia later in life. 81% of the children born to these mothers were deficient. 

¶ Up to 80% of nursing home patients are

vitamin D deficient❗❗

Date with my father

એક વાર પપ્પા સાથે ડેટ પર જવું છે... ડૉ. નિમિત્ત ઓઝા

થોડા સિક્રેટ્સ
શેર કરવા છે,
થોડી
કબૂલાતો કરવી છે,
એમણે આપેલી જિંદગીના બદલામાં,
એમને એક સાંજ ધરવી છે.

બાળપણમાં જે હાથ તેડીને ખભા પર બેસાડતો,
એ જ હાથને
વ્હાલ કરવું છે,
એક વાર
પપ્પા સાથે
ડેટ પર જવું છે...

કોલેજમાં ગમતી છોકરીથી લઈને,
એમની જાણબહાર પીધેલી સિગરેટનું,
કેટલું વજન લાગતું હોય છે યાર,
એક નહિ કીધેલા સિક્રેટનું.

કેન્ડલ લાઈટ ડિનર પર લઈ જઈને,
પપ્પાને એક ગુલાબ આપવું છે.
આટલું વિશાળ હ્રદય સાચવીને,
ચૂપચાપ બેઠેલી છાતીનું મારે ક્ષેત્રફળ માપવું છે.

એમણે મમ્મીને પ્રેમ કર્યો છે,
એમનું નામ ઓસ્કાર માટે નોમીનેટ કરવું છે.
એક વાર
પપ્પા સાથે
ડેટ પર જવું છે....

થોડો ટાઈમ કાઢીને મારે,
એમના જીવતરમાં રહેલા અભાવ ગણવા છે.

અજવાળામાં જઈને,
એમના શરીર પર થયેલા એક એક ઘાવ ગણવા છે...

કાયમ સાથે રહેવા માટે,
ગીતા પર હાથ રાખીને એમને પ્રપોઝ કરવા છે.

ખાબોચિયા જેવી જાત લઈને મારી અંદર,
મારે સમંદર જેવા પપ્પાને ભરવા છે.

હાથ પકડીને,
આંખોમાં આંખો નાખીને
એકવાર
‘આઈ લવ યુ’ કહેવું છે,

એક વાર
પપ્પા સાથે
ડેટ પર જવું છે...!!

Health of a doctor

आजकल चिकित्सकों में ..
psychological disorders ,
Stress , B.P. , M.I. , Stroke  आदि की..
मुख्य वजह –
" ये दिल मांगे मोर है "
अपने आप में व्यस्त रहें ,
मस्त रहें !
देश विदेश घूमने जाएँ !
साल में दो बार ..
क्लिनिक / अस्पताल / नौकरी को ,
एक-एक हफ्ते के लिए अवश्य बंद रखें !
दारु और स्मोकिंग कम से कम रखें !
काम चलाऊ भर का राजनीति में भी दखल रखें !
कभी कोई अच्छा अफसर टकराए ..
तो उनसे दोस्ती कर लें !
बैलेंस सीट भारी रखें ,
इनकम टैक्स ज्यादा से ज्यादा दें !
ज्यादा HEROIC EFFORTS के चक्कर में न पड़ें ,
भगवान का अवतार कतई न बनें ,
लेकिन ,
अपने पेशे के प्रति घनघोर ईमानदार रहें !
अपने साथी चिकित्सकों के प्रति ..
ईर्ष्या व घृणा न रखें !
अपने दोस्तों व साथियों की ..
आमदनी के बारे में कभी भी ,
अपने आप से भी चर्चा न करें !
कितनी भी मेहनत करें ..
तो भी आप ..
अपनी आज की ORBIT को CHANGE नहीं कर सकते ..
अपने सेट अप की लिमिट से ज्यादा नहीं कमा सकते ,
इस उम्र में ..
जो आप की आज की आमदनी है !
वो भी सारी जरूरतों व शौक को ,
मजे में पूरा करने से कुछ ज्यादा ही है !
किन्तु कैरियर की शुरुआत में ,
जबरदस्त मेहनत करें व गजब की इमेज बनाएं !
फिर उसी को मेन्टेन करने में ही ..
आपके पसीने छूट जायेंगें !
अपने पुराने दिनों को भी याद किया करें ,
हमेशा ध्यान रखें कि ..
कौन पेशेंट आपकी सामर्थ्य का है ,
और ,
कौन सा मरीज आपको बाहर भेजना है !
अपनी खुद की व अपने परिवार की ,
मानसिक व शारीरिक सेहत के लिए सजग रहें !
रेगुलर थोड़ा सा व्यायाम अवश्य करें !
अपनी बैलेंस सीट के साथ तालमेल बनाकर ..
एक लक्जरी कार अवश्य लें ,
उसको लेकर कभी कभी ..
बिला वजह घूमने जाएँ !
याद रखें कि ...
यदि आप स्वस्थ हैं व ज़िंदा हैं ,
तभी पैसे  का उपयोग / उपभोग है ,
तभी क्लिनिक है -अस्पताल है !
तभी मरीज हैं ! तभी सेवा है !
एवं ....
आप मरीजों से भी कहीं ज्यादा ..
अपने परिवार के लिए जरूरी हैं !
एक बार अवश्य सोचना कि ,
इतनी मेहनत इस उम्र में ..
“ जरूरत है – जरूरी है – सनक है या मजबूरी है ” 

A truth from Dr. Tuteja sir

We, as a society, really have no idea how *suffocated* people are in their emotions. Most people have *nobody* to express themselves entirely to. Everyone is holding back their *vulnerabilities* to maintain the *social image* of a confident and happy person.

Heart-to-heart conversations have become *rare, artificial and shallow*. Most hearts are filled with *empty defences*. 

Most people can't even talk to their *life-partners openly* for the fear of being judged or rejected. Emotions await just a release. Social images make sure that weakness is not glorified. 

Children have *bottled up* stress. Young people suffer from anxiety and depression. 

It is just lack of social support. It is *lack of non-judgmental* friendships. It is a result of *fast and busy lives* where nobody has time to just sit and watch someone cry.. 

It is a result of *instant and impatient lifestyle* practices, that *emotions have started feeling like a waste of time*. 

We have *Whats App, Facetime and social media* - and we also have *stress, anxiety and depression*.

Our forefathers had neither.... Because they talked to each other...... Because talking helps.....
The *face-to-face* type talking, the *just-listen-to-me* type talking, the *hold-my-hand-and-let-me-cry* type talking, the *sit-next-to-me-and-listen-to-my-silence* type talking... the talking where *persons can be themselves and say anything they feel without the fear of any judgement or loss or rejection*. 

Today, we don't like that type of talking! In fact we *avoid people*. Naturally, it has led to mental illnesses....which are becoming an epidemic.

There is not much we can do but we can offer *listening* !

Let's let people talk without any fear. Let's create conversations. 

*Let's Start Talking Again*.

बॉते गिरॉ देती है फॉसलों की दीवारें 

आप अभी भी सोच रहे है शॉयद?

How to win the game of life

This is one of the best answer which i read because it explains the science behind the most important thing which makes our life good : (HAPPINESS)

Question was :

I am rich, fit, and I have mastered almost everything I wanted to master. Why am I still not happy and still not satisfied?

It starts like this

“Human happiness (as we know it) is caused by 4 basic chemicals:

Dopamine

Endorphins

Serotonin

Oxytocin

On your journey to become fit, your body released endorphins to cope with the pain of physical exercise.

You probably began to enjoy exercise as you got more into it, and the endorphins made you happy - temporarily.

On your journey to become rich, you probably completed many tasks and goals.

You probably bought all the things you’ve ever wanted. Nice cars, beautiful clothes, and a perfect home.

This released dopamine in your brain when you achieved your goals and bought these things, which once again contributed to your happiness - temporarily.

So what about the other two chemicals?

It turns out that human happiness is incomplete without all 4 chemicals constantly being released in the brain.

So now you need to work on releasing serotonin and oxytocin.

“How do I do that, Karim?”

Serotonin is released when we act in a way that benefits others. When we give to causes beyond ourselves and our own benefit. When we connect with people on a deep, human level.

Writing this Quora answer is releasing serotonin in my brain right now because I’m using my precious time on the weekend to give back to others for free.

Hopefully I’m providing useful information that can help other people, like yourself.

That’s why you often see billionaires turning to charity when they have already bought everything they wanted to, and experienced everything they wanted to in life.

They’ve had enough dopamine from material pleasures, now they need the serotonin.

Oxytocin on the other hand, is released when we become close to another human being.

When we hug a friend,or shake someone’s hand, oxytocin is released in varying amounts.

Oxytocin is easy to release. It’s all about becoming more social!

Share your wealth with your friends and family to create amazing experiences.

Laugh, love, cooperate, and play with others.

That’s it my friend!

I think it all comes down to the likelihood that you are missing two things: contribution and social connection”

Its written by : Karim Elsheikh

This answer teaches use about an important aspect which helps us to win the game of life. And this is the best answer which i read in 2017.

Answer link :Karim Elsheikh's answer to I am rich, fit, and I have mastered almost everything I wanted to master. Why am I still not happy and still not satisfied?

14 points for good health

1. *Take the stairs and always carry your own stuff*
This represents firm proponent of doctor Hinohara, he still takes two steps at a time climbing the stairs.

2. *Do not believe everything your doctor recommends or says*
Explore, read and educated yourself. You do not have to believe in everything your doctor says.

3. *Share what you know*
Dr. Hinohara gives 150 lectures on an annual basis in schools, business communities etc. He often shares lessons on war and peace. Do not forget that most of the lessons (90 min) are done standing up.

4. *You do not have to retire*
If you love the work you do, you do not have to retire.

5. *Plan ahead*
If you want to enjoy your life better, you have to have busy schedule fill with different appointments, lectures, work, etc. Dr. Hinohara is planning to attend the 2020 Tokyo Olympics.

6. *Don’t be overweight*
Dr. Hinohara consumes a tbsp of olive oil, orange juice and coffee for breakfast. Cookies and milk for lunch and rice, fish and veggies for dinner. He consumes 100g of lean meat two times a week.

7. *Energy does not come from sleeping a lot or eating well, it comes from feeling good*
You will be more happy and energetic if you eliminate strict time-regulated rules, be like children – have a lots of fun until you feel sleepy or hungry.

8. *It is wonderful to live long*
He continues serving society, he volunteers, works 18h per day, 7 days a week and he also enjoy every single moment of his life.

9. *Find a role model*
The doctor usually asks himself what his father would do when he faces with some issue.

10. *Do not worry too much, life is unpredictable and full of incidents*
The doctor was hijacked by the communist Red Army when he has 59 years old. He spent 4 days under 40 degree heat and handcuffed to his seat. He is also amazed how his body slowed down to adapt to deprivation.

11. *Science alone can not help or cure people*
The doctor believes that every illness can be cured with liberal and visual arts. He also believes in the uniqueness of every single individual.

12. *Do not be crazy for money*
The doctor is more than aware that he can not take anything when he goes!

13. *Pain is mysterious*
You have to do something fun if you want to forget about pain. The doctor found that music and animals can really help you to get rid of and mange your pain.

14. *Be inspired*
You must find inspiration in the World in order to motivate yourself. For ex: he finds motivation in the poem “Abt Vogler” by Robert Browning.

Senior citizen take care

*Tomorrow is sr citizens day         Advice to seniors.*👍

*A study in United States shows over 51% of old people fall down from climbing stairs. Every year, many Americans are killed by climbing stairs.*

*Experts Reminder:*

*After 60 years, these 10 actions should be avoided:*

*1, do not climb staircase. If must climb, hold on firmly to staircase railings.*💐

*2, do not rapidly twist your head. Warm up your whole body first.*😇

*3, do not bend your body to touch your toe. Warm up your whole body first.*

*4, do not stand to wear your pants. Wear your pants while sitting down*🙏

*5, do not sit up when lying face up. Sit up from one side (left hand side, or right hand side) of your body.*🙌

*6, do not twist your body before exercise. Warm up whole first.*

*7, do not walk backwards. Falling backwards can result in serious injury.*
❤

*8, do not bend waist to lift heavy weight. Bend your knees and lift up heavy object while half squatting.*😎

*9, do not get up fast from bed. Wait a few minutes before getting up from bed.*🚩

*10, do not over force defecation. Let it come naturally.* 😇

*Please forward to all seniors.* *And to others, who will  take care and guide senior citizens.*

                         ❤

BHAGWAD Gita. One sentence per chapter

*One sentence per chapter gist of Bhagavat Gita*

🕉

              *BHAGWAD GITA*
                _*in one sentence*_
                   _*per chapter...*_

*Chapter 1*

_Wrong thinking is the only problem in life_

*Chapter 2*

_Right knowledge is the ultimate solution to all our problems_

*Chapter 3*

_Selflessness is the only way to progress & prosperity_

*Chapter 4*

_Every act can be an act of prayer_

*Chapter 5*

_Renounce the ego of individuality & rejoice in the bliss of infinity_

*Chapter 6*

_Connect to the Higher consciousness daily_

*Chapter 7*

_Live what you learn_

*Chapter 8*

_Never give up on yourself_

*Chapter 9*

_Value your blessings_

*Chapter 10*

_See divinity all around_

*Chapter 11*

_Have enough surrender to see the Truth as it is_

*Chapter 12*

_Absorb your mind in the Higher_

*Chapter 13*

_Detach from Maya & attach to Divine_

*Chapter 14*

_Live a lifestyle that matches your vision_

*Chapter 15*

_Give priority to Divinity_

*Chapter 16*

_Being good is a reward in itself_

*Chapter 17*

_Choosing the right over the pleasant is a sign of power_

*Chapter 18*

_Let Go, Lets move to union with God_

Who is your life partner?

Who is your life partner...???

Mom..?
Dad..?
Husband /wife...?
Best friend..?
Son..?
Daughter...??

Or someone else... ????

Your real life partner
is Your *Body*

You and your body
stay together from
the beginning of your
life till your last
breath.

You enjoy each
relationship in this
world that you feel
is good for you..
But you also play an
important role with
your body.

What you do to your
body is your
responsibility and
that will come back
to You.
The more you care
for your body, the
more your body will
care for You.

What you eat,
What you do for being Fit,
How u deal with
stress (physical/mental/emotional),
How much rest you
give to it..
Will decide how your body gonna respond
in your day to day
life.

Remember your
body is the only
permanent address
where You live.

What your body
wants is...,
Love
Care
Respect
Politeness
Honesty

Your body is your
responsibility.
Because...
You are Your real
life partner.

*Fitness forever*

Pathologist Vs Technician

*Red-flagging the consequences of the Supreme Court’s recent orders mandating only pathology postgraduates to sign medical laboratory reports, healthcare providers today urged the government to seek immediate review of the apex court directions*.

The Association of Healthcare Providers, representing a majority of those in the field in India, said the *orders would create an impossible situation* considering the country had a few professionals with MD pathology degrees and their availability for report signing would become a challenge.

The SC pronounced the orders in the matter of North Gujarat unit of the Association of Self-employed Owners (Paramedical) of Private Pathology Laboratories of Gujarat versus North Gujarat Pathologist Association.

“We dispose of all the special leave petitions and other pending applications, if any, by taking a view that the stand of MCI that the (medical) laboratory reports can be countersigned only by a registered medical practitioner with postgraduate qualification in pathology is correct,” the court said.

*Until recently,* medical laboratory reports were reviewed and signed by MD-pathology, MD-microbiology, MD-biochemistry and MSc/PhD in microbiology and biochemistry.

This ended when the Medical Council of India (MCI) in June 2017 debarred MSc/PhD in biochemistry and microbiology for signing test reports. 

The MCI order was challenged in courts, but the latest SC order has closed the matter agreeing with MCI.

Healthcare providers now feel the judgment will have serious repercussions for the sector with numbers of *MD-pathology being only 5,500*. 

“We have around 9,500 professionals with MD-microbiology and MD-biochemistry qualification. Postgraduate degree holders in microbiology and biochemistry are around 20,000. Then we have about 1,500 Ph.D in biochemistry, microbiology, genetics and molecular biology. All put together, we have *36,500 qualified personnel,* who have been *till now the authorised signatories* for various medical test reports. *By virtue of the SC order, we will be left with only 5,500 persons to sign the report*,” reasons Dr Girdhar Gyani, Director General, AHPI.

There are around *three lakh medical testing laboratories in the country* and it could become *humanly impossible* for 5,500 MD-pathology persons to handle the workload. This, healthcare providers say, could breed corruption.

“These professionals will be pushed to become *visiting signatory* authorities covering many cities. Pathologists may begin lending electronic signatures from one central office to hundreds of test reports. All this will hamper the authenticity of test reports, which are the sole basis for physicians to prescribe treatment. The current pool of MD-pathology in the country will hardly be enough even for major tier-I and tier-II cities. This will adversely affect the availability of signatories in *smaller towns and rural areas would be worst sufferers*,”
Dr Gyani said

Indian Judiciary

Let us don’t forget to thank God for keeping us safe through the night and every time we awaken to see a beautiful new day!

Father

પપ્પા 1લી એપ્રિલે જ એપ્રિલફુલ બનાવે એવું થોડું હોય છે ? એ તો આપણને હંમેશાં એપ્રિલફુલ બનાવતા જ રહે છે.

કેવી રીતે ?

1. મારે અત્યારે નવાં કપડાંની શી જરૂર છે, એવું ખોટું કહીને સંતાનો માટે નવાં કપડાં ખરીદતા રહીને…

2. પોતાને કેટલું દુઃખ થશે એ છુપાવી રાખીને સાસરે જતી દીકરીને સુખી થવાના આશીર્વાદ આપતી વખતે…

3. પોતાને બસ કે ટ્રેનમાં મિત્રો સાથે ઓફિસે જવાની બહુ મજા પડે છે, એવું કહીને દીકરાને કોલેજ જવા માટે હપતેથી બાઇક અપાવતી વખતે…

4. પોતાને ફિલ્મો કે નાટકો જોવાનો શોખ જ નથી એવું કહીને સંતાનોને પોકેટમની આપતા રહીને…

5. પોતાની બગડેલી તબિયત વિશે મૌન રહીને ફેમિલી માટે ઓવર ટાઈમ કરતા રહીને…

6. હોટલમાં જઈએ ત્યારે મને તો કોઈ પણ વાનગી ભાવશે એમ કહીને સંતાનના હાથમાં મેન્યુ આપીને વાનગી પસંદ કરવાનું કહીને…

7. પોતાને થાક લાગ્યો હોય કે ઊંઘ આવતી હોય એ છુપાવીને સાસરેથી આવેલી દીકરી સાથે મોડે સુધી વાતો કરીને કે પત્તાં રમતા રહીને…

8. દીકરો-વહુ અલગ રહેવા જવાની વાત કરે ત્યારે પોતાની પીડા અને વ્યથા દબાવી રાખીને એમને સંમતિ આપતી વખતે…

9. પોતાના તૂટેલા ચશ્મા હજી ખાસ્સો સમય ચાલે એવા છે, એમ કહીને સંતાનને ગોગલ્સ અપાવતી વખતે…

10. આર્થિક સંકડાશ છુપાવી રાખીને સંતાનનાં ધામધૂમથી લગ્ન કરતી વખતે…

11. દરવાજા પાછળ છુપાઈને પપ્પાને ‘હાઉ’ કહીને ડરાવતા સંતાનથી ખોટેખોટું ડરતા રહીને…

12. પોતાનો બર્થડે ઉજવવાની હંમેશાં ના પડે અને ફેમિલીમાં સૌનો બર્થડે ઉજવવા તૈયાર રહીને…

– પપ્પા, હવે અમારેય તમને, તમારી સ્ટાઈલથી એપ્રિલફુલ બનાવવા છે, થોડા ચાન્સ અમનેય આપોને !

🙏🙏🙏🙏🙏