COVID-related loss of smell tied to changes in the brain, finds study

According to researchers, the common symptom of anosmia in COVID-19 is connected to certain cognitive alterations and changes within the brain, thus making it a potential risk factor for identifying patients in need of follow-up care upon recovery from COVID-19. A recent study conducted on patients with mild to moderate SARS-CoV-2 infection revealed that people suffering from anosmia were characterized by impulsive decision-making behaviors and brain changes such as reduced functional activity and cortical thinning. A study published in Scientific Reports by Leonie Kausel and colleagues has found that individuals without the sense of smell after COVID-19 are at increased risk of cognitive impairment. The results further support the need for monitoring anosmia in post-COVID patients for risks to their long-term cognitive and neurological health.

Cognitive function and the health of the brain may be impaired due to COVID-19, even after mild or moderate infection. Given its global prevalence, affecting tens of millions, understanding which patients are at the greatest risk for cognitive and neurological complications is paramount. While cognitive impairments and brain abnormalities have been described, mechanisms and risk factors are poorly understood. Anosmia has been suggested as a marker of these complications. Here, the study assessed the cognitive and neurological sequelae in relation to anosmia and the requirement for hospitalization in 73 adults with mild-to-moderate COVID-19 in comparison with 27 controls.

In the present study, 100 individuals were assessed: 73 recovered adults from mild-to-moderate COVID-19 and 27 infected with other agents, with no history of COVID-19. Patients did not present respiratory failure. Cognitive screening was performed, a decision-making task was evaluated, and structural MRI was performed in all participants. The occurrence of anosmia and the need for hospitalization for the study were evaluated as possible risk factors related to cognitive and brain changes.

There were no significant differences in cognitive performance and age across groups. The study was designed to relate anosmia, impulsive decision-making, and brain structural changes.

Key Findings

  • Anosmic patients presented even a greater number of impulsive decision-making behaviors, especially to changes in probability while performing decision-making tasks.

  • The correlation between anosmia and impulsive shifts was significant:(r = -0.26, p = 0.001). Those having anosmia were more likely to make impulsive decisions when the scenarios changed.

  • A higher prevalence of perseverative choices was found in hospitalized patients.

  • A statistically significant correlation was identified regarding hospitalizations and the patients’ perseverative behavior (r = 0.25, p = 0.003).

  • MRI and anosmia were correlated with abnormal reduction in functional activity during the choice phase of decision-making, reduced thinning of cortical thickness in parietal regions, and reduced loss of white matter integrity.

  • Such results indicate that olfactory function has to be considered not as a narrow sensory function but possibly in the context of wide-ranging brain changes likely to affect cognitive function.

  • This study, therefore, highlights the importance of anosmia being included in any workup approach directed toward identification of patients who are likely to experience late sequelae in cognitive and brain health after COVID-19. Such information might help practicing clinicians guide relevant rehabilitation for these patients.

These findings further underscore the role of anosmia as a harbinger of potential cognitive and neurological sequelae in COVID-19 recovery. The interaction between anosmia, impulsivity, and brain changes explains the overall impact of COVID-19 on brain function. This finding can suggest that anosmia could be of greater usefulness as a marker in the selection of subjects who should be offered further controls or very early interventions to prevent complications of long-term cognitive decline.

Anosmia, one of the common symptoms of COVID-19, is related to cognitive and brain changes, thereby making it a major risk factor for follow-up care. Notably, these findings of this study have shown that patients with anosmia link impulsive decision-making behavior to brain changes featured by reduced functional activity together with structural integrity. Identification of anosmia in post-COVID patients may help in prioritizing those needing closer follow-ups in cognitive and neurological terms, finally aiding better long-term outcomes.

Reference:

Kausel, L., Figueroa-Vargas, A., Zamorano, F., Stecher, X., Aspé-Sánchez, M., Carvajal-Paredes, P., Márquez-Rodríguez, V., Martínez-Molina, M. P., Román, C., Soto-Fernández, P., Valdebenito-Oyarzo, G., Manterola, C., Uribe-San-Martín, R., Silva, C., Henríquez-Ch, R., Aboitiz, F., Polania, R., Guevara, P., Muñoz-Venturelli, P., … Billeke, P. (2024). Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations. Scientific Reports, 14(1), 1–14. https://doi.org/10.1038/s41598-024-69772-y

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AI-Enhanced CV MRI Predicts Heart Failure Risk, Study Finds Fivefold Increased Risk with High Heart Pressure

UK: Research published on August 12 in the journal European Society of Cardiology Heart Failure reveals that combining cardiovascular MRI with an AI model can effectively predict heart failure (HF) risk in the general population by estimating heart pressure.

The study, led by Ross Thomson from Queen Mary University of London and senior author Pankaj Garg, MD, from the University of East Anglia in Norwich, found that individuals with elevated heart pressure, as measured by MRI, faced a fivefold increased risk of developing heart failure within six years.

Garg highlighted in a statement from the University of East Anglia that a key finding of the study is the ability of MRI-derived pressure measurements to accurately predict the likelihood of developing heart failure.

The group explained that the rising prevalence of HF is partly attributed to an aging population. A common indicator of this condition is elevated left ventricular filling pressure, which is typically assessed through pulmonary capillary wedge pressure (PCWP) via cardiac catheterization. Cardiovascular magnetic resonance (CMR) imaging holds potential for non-invasive estimation of PCWP. However, its prognostic value at the population level is still uncertain. Additionally, the connection between CMR-modelled PCWP and well-established cardiovascular risk factors has yet to be thoroughly defined.

To fill this knowledge gap, the researchers aimed to investigate the prognostic value of CMR-modelled PCWP at the population level.

For this purpose, data from the imaging substudy of the UK Biobank—a substantial prospective population-based cohort study—were utilized. CMR-modelled PCWP was calculated using a model that includes left atrial volume, left ventricular mass, and sex.

Logistic regression was employed to investigate the relationships between conventional cardiovascular risk factors and elevated CMR-modelled PCWP (≥15 mmHg). Additionally, Cox regression was used to assess the effects of standard risk factors and CMR-modelled PCWP on heart failure and major adverse cardiovascular events (MACE).

The following were the key findings of the study:

  • Data from 39,163 participants were included in the study. The median age of all participants was 64 years, and 47% were males.
  • Clinical characteristics independently associated with raised CMR-modelled PCWP included hypertension [odds ratio (OR) 1.57], body mass index (BMI) [OR 1.57], male sex (OR 1.37), age (OR 1.33) and regular alcohol consumption (OR 1.10).
  • After adjusting for potential confounders, CMR-modelled PCWP was independently associated with incident HF [hazard ratio (HR) 2.91] and MACE (HR 1.48).

“The findings showed that elevated CMR-modelled PCWP is an independent predictor of incident heart failure and MACE. It is recommended to include CMR-modelled PCWP in routine CMR reports to aid in HF diagnosis and management,” the researchers concluded.

Reference:

Thomson, R. J., Grafton-Clarke, C., Matthews, G., Swoboda, P. P., Swift, A. J., Frangi, A., Petersen, S. E., Aung, N., & Garg, P. Risk factors for raised left ventricular filling pressure by cardiovascular magnetic resonance: Prognostic insights. ESC Heart Failure. https://doi.org/10.1002/ehf2.15011

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Olanzapine may prevent vomiting among patients with moderately emetogenic chemotherapy: JAMA

A new study published in the Journal of American Medical Association suggests that in patients receiving mildly emetogenic chemotherapy, olanzapine added to the usual dose of dexamethasone, palonosetron, and aprepitant greatly improved the management of nausea and vomiting. In regimens of moderately emetogenic chemotherapy (MEC), either with or without neurokinin-1 receptor antagonists, the function of olanzapine has not been well assessed. Thereby, this study by Vikas Ostwal and colleagues wanted to determine if adding olanzapine to a maintenance of consciousness regimen lowers nausea, vomiting, and the need for nausea rescue drugs in patients with hard malignant tumors.

The patients undergoing treatment with oxaliplatin, carboplatin, or irinotecan-based solid malignant tumors who were 18 years of age or older were enrolled in this randomized clinical research. From March 26, 2019 to August 26, 2023, 3 institutes in India performed the experiment and the patients were randomized 1:1 to receive either olanzapine-free (observation group) or olanzapine-containing (experimental group) dexamethasone, aprepitant, and palonosetron. On days 1 through 3 of the chemotherapeutic treatment, the experimental group was given 10 mg of olanzapine orally once at night. Complete response (CR) is the percentage of patients who did not vomit, did not have severe nausea, and did not require rescue medicine for nausea, was the primary outcome measured. 

A total of 560 individuals in all were randomized. There were 544 patients having evaluable data in the analysis where the two baseline characteristics of the groups matched exactly. Throughout the course of the 120-hour treatment period, the percentage of patients with CR was substantially higher in the group taking olanzapine (248 [91%]) than in the group not taking it (222 [82%]).

The proportion of patients receiving rescue medications increased significantly in the observation group (30 [11%]) when compared with the olanzapine group (11 [4%]), and there were also significant differences for nausea control between the observation and olanzapine groups during the entire assessment period. Grade 1 somnolence was recorded by 27 patients (10%) after receiving chemotherapy plus olanzapine, but no individuals in the observation group. Overall, the findings of this study imply that one of the standards of treatment in these chemotherapy regimens should be the use of olanzapine.

Source:

Ostwal, V., Ramaswamy, A., Mandavkar, S., Bhargava, P., Naughane, D., Sunn, S. F., Srinivas, S., Kapoor, A., Mishra, B. K., Gupta, A., Sansar, B., Pal, V., Pandey, A., Bonda, A., Siripurapu, I., Muddu, V. K., Kannan, S., Chaugule, D., Patil, R., … Olver, I. (2024). Olanzapine as Antiemetic Prophylaxis in Moderately Emetogenic Chemotherapy. In JAMA Network Open (Vol. 7, Issue 8, p. e2426076). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.26076

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Camu-camu fruit extract may reduce liver fat in Hepatic disease, suggests study

A research team from Université Laval has shown the benefits of camu-camu on non-alcoholic fatty liver disease, which affects over seven million people in Canada. This exotic fruit reduces liver fat levels.

Over 12 weeks, thirty participants took either camu-camu extract or a placebo at different times in this randomized clinical trial. Participants underwent magnetic resonance imaging (MRI) to determine fat levels in the liver. Scientists observed a 7.43% reduction in liver lipids when study participants took camu-camu extract. With the placebo, they noted an 8.42% increase in liver fat.

“That’s a significant 15.85% difference,” says André Marette, a professor in the Faculty of Medicine and researcher at the Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-ULaval), who led the study.

Polyphenols and the microbiota

This effect stems from the polyphenols contained in camu-camu and their relationship with the intestinal microbiota. “The microbiota metabolizes the large polyphenol molecules that cannot be absorbed by the intestine, transforming them into smaller molecules that the body can assimilate to decrease liver fat,” explains André Marette.

His team has identified two potential mechanisms of action for these small polyphenols. “They could reduce lipogenesis, i.e., the formation of lipid droplets in the liver. They could also stimulate lipid degradation by oxidation. A combination of the two mechanisms probably explains the high efficacy of the extract, as we’re playing on both sides of the coin,” reports Professor Marette, who collaborated with scientists at the Institute of Nutrition and Functional Foods (INAF).

However, the team noted a wide variability in response to camu-camu. “We hypothesize that the initial intestinal microbiota influences the response to polyphenols. If we find the factors involved, we may be able to modify the microbiota and increase the extract efficacy,” explains Professor Marette.

Although camu-camu is an exotic fruit, the extract is readily available in capsule form. However, Professor Marette stresses the importance of checking the content of certain polyphenols, as not all commercial products are equivalent. 

Cranberries, which also contain a number of partially different polyphenols, could also have a protective effect. In the future, Professor Marette hopes to investigate whether combining camu-camu and cranberry could have a synergistic effect.  

Reference:

Anne-Laure Agrinier, Arianne Morissette, Laurence Daoust, Anne-Marie Carreau, Marie-Claude Vohl, André Marette, Camu-camu decreases hepatic steatosis and liver injury markers in overweight, hypertriglyceridemic individuals: A randomized crossover trial, Cell Reports Medicine, https://doi.org/10.1016/j.xcrm.2024.101682.

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Marriage strongly associated with optimal health and well-being in men as they age, reports study

A new study that followed over 7,000 Canadians, middle-aged and older, for approximately three years found that married men or men who became married during the study period were twice as likely to age optimally compared to their never-married male peers.

Among women, those who had never married were twice as likely to age optimally compared to married respondents who became widowed or divorced during the study period. Married women did not differ significantly from never-married women with respect to optimal aging.

“Little is known about the relationship between marital trajectories in old age and successful aging. Our goal was to see whether different marital trajectories were associated with physical health and well-being, and whether these relationships varied for men and women,” says first author Mabel Ho, a recent doctoral graduate at the University of Toronto’s Factor-Inwentash Faculty of Social Work (FIFSW) and the Institute of Life Course and Aging.

The researchers defined optimal aging as freedom from any serious physical, cognitive, mental, or emotional conditions that prevent daily activities, as well as high levels of self-reported happiness, good physical health, and mental health. The sample for the current study was restricted to the 40% of participants who were deemed to be successfully aging at the start of the study.

“Previous studies have shown that marriage is associated with better health outcomes for both men and women, while men who were never married generally had the poorest health outcomes,” says David Burnes, Professor and Canada Research Chair at the University of Toronto’s Factor-Inwentash Faculty of Social Work. “It may be that married people encourage each other to adopt or maintain positive health behaviors such as quitting smoking or exercising regularly.”

Older adults who were not socially isolated were more likely to maintain optimal health in old age. Those who had regular contact with relatives, friends and neighbors were more likely to age optimally compared to older adults who were socially isolated.

“Being socially connected with others is important, especially in later life. Having regular contact with relatives, friends and neighbours can help older adults feel connected, reduce their sense of loneliness, and improve their overall well-being,” says Eleanor Pullenayegum, a ​Senior Scientist at The Hospital for Sick Children (SickKids) and professor at the University of Toronto.

The study also found that lifestyle factors such as maintaining a healthy body weight, being physically active, not having insomnia and not smoking were important in maintaining optimal health in later life.

“It is so important to maintain a healthy lifestyle, no matter how old we are. For example, it is never too late to quit smoking,” says senior author Esme Fuller-Thomson, Director of the Institute for Life Course & Aging and Professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work. “In our study those who were former smokers were much more likely to be aging optimally than those who continued to smoke.”

“Our study underlines the importance of understanding sex-specific differences in aging so that we can better support older men and women to continue to thrive in later life,” concluded Ho. “Our findings can inform the development of programs and services to engage and support older adults, particularly those who were never married or experienced widowhood, separation, and divorce in later life.”

This study entitled “The association between trajectories of marital status and successful aging varies by sex: Findings from the Canadian Longitudinal Study on Aging (CLSA)” was published online this week in the journal International Social Work. It uses longitudinal data from the baseline wave (2011-2015) and the first follow-up wave (2015-2018) of data from the Canadian Longitudinal Study on Aging (CLSA) to examine factors associated with successful aging. The CLSA included 7,641 respondents aged 60 years or older at wave 2 and in excellent health during the baseline wave of data collection. 

Reference:

Ho, M., Pullenayegum, E., Burnes, D., & Fuller-Thomson, E. (2024). The association between trajectories of marital status and successful aging varies by sex: Findings from the Canadian Longitudinal Study on Aging (CLSA). International Social Work, 0(0). https://doi.org/10.1177/00208728241267791

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Oral Nutritional Supplements Effective in Managing Endometriosis Pain, New Review Finds

Brazil: In recent years, the search for effective management strategies for endometriosis—a chronic condition characterized by painful, often debilitating symptoms—has led researchers to explore various adjunctive therapies. A new narrative review of clinical studies suggests that oral nutritional supplements may offer significant benefits in alleviating pain associated with endometriosis, potentially enhancing overall treatment outcomes.

“These nutritional supplements demonstrated a range of beneficial biological activities, including antioxidant, anti-inflammatory, antiproliferative, and antiangiogenic effects, all pertinent to managing endometriosis,” the researchers reported in the Journal of Gynecology Obstetrics and Human Reproduction.

“Consequently, incorporating these supplements into a comprehensive treatment plan could potentially reduce pain and improve overall medical care for individuals with endometriosis.”

Endometriosis affects approximately 1 in 10 women of reproductive age, causing tissue similar to the lining of the uterus to grow outside it, leading to severe pain, infertility, and other complications. Traditional treatments typically include hormone therapy and surgical interventions; however, these options are not always effective or suitable for all patients. This has spurred interest in complementary approaches to improve symptom management.

To facilitate clinical decision-making in managing patients with endometriosis, Tamiris Julio, Institute of Health Sciences, Paulista University, Ribeirão Preto, São Paulo, Brazil, and colleagues conducted a narrative review of clinical studies to investigate the effects of oral nutritional supplements on endometriosis-related pain.

“Our goal is to offer valuable insights to guide clinical decision-making in endometriosis management, paving the way for potential non-pharmacological interventions to enhance patient outcomes,” they wrote.

For this purpose, the researchers conducted a comprehensive literature search of the English-language PubMed/MEDLINE database using relevant keywords to identify clinical studies on oral nutritional supplements and their impact on endometriosis-related pain. The narrative review encompasses 20 studies published between 2013 and 2023, including 12 randomized controlled trials, six non-comparative trials, and two observational studies.

The selected research explored the effects of various nutritional supplements on endometriosis pain, investigating a range of supplements such as vitamins, fatty acids, probiotics, medicinal plants, and bioactive compounds.

The researchers observed a notable reduction in endometriosis-related pain in three out of five studies examining vitamins, four out of six studies on fatty acids, one study involving probiotics, two studies on medicinal plants, and five out of six studies on bioactive compounds.

“Several oral nutritional supplements demonstrate anti-inflammatory, antioxidant, antiproliferative, and antiangiogenic properties. The positive outcomes observed thus far support their potential use as therapeutic strategies for managing endometriosis-related symptoms, including pain, alone or in combination with other treatments,” the researchers concluded.

Reference:

Julio, T., Fenerich, B. A., Halpern, G., Carrera-Bastos, P., Schor, E., & Kopelman, A. (2024). The effects of oral nutritional supplements on endometriosis-related pain: A narrative review of clinical studies. Journal of Gynecology Obstetrics and Human Reproduction, 53(10), 102830. https://doi.org/10.1016/j.jogoh.2024.102830

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AIIMS Bhubaneswar releases Instructions for Round 1 MBBS Counselling for candidates, check details

Bhubaneswar- Through a recent notice, the All India Institute of Medical Sciences (AIIMS), Bhubaneswar released instructions for 1st Round Counselling of MBBS 2024 Candidates.

As per the notice, the Orientation is on August 30, 2024, and the  Academic Programme is commencing from August 31, 2024.

All the concerned candidates seeking MBBS Admissions in All India Institute of Medical Sciences (AIIMS), Bhubaneswar college are advised to take note of the following schedule:-

All India Institute of Medical Sciences
(AIIMS), Bhubaneswar Admission & Reporting in Hostel August 24, 2024 . It is advised to read the following
instructions carefully before Admission.

Programme for Admission Process of MBBS, Batch 2024 (1st Round Counselling) & MBBS classes:

Date, Time and Venue

· Admission &
Reporting in Hostel: 24-08-2024 to 29-08-2024(Time: 09:30 A.M. to 05:00 P.M.)

· Venue: Ground Floor,
Lecture Theatre(LT)-1, Administrative Building.

· Orientation Programme:
30-08-2024, 3 PM Onwards (Main Auditorium)

· Beginning of Academic
Programme: 31-08-2024 onwards

*Admission Programme as per information available in MCC
website.

Also Read:AIIMS Bhubaneswar announces stray round counselling to fill up vacant PG medical seats, details

Mandatory
requirement of documents (in original) during admission:

  • Laboratory
    Tests: Reports of X-Ray chest (PA view) as Random Blood Sugar, Urine Analysis,
    Blood Group and Rh factor done from a Government/ NABL accredited laboratory.
  • NTA
    Rank letter from Medical Counselling Committee (MCC).
  • Provisional
    Allotment Letter from Medical Counselling Committee (MCC).
  • Original
    Bank Draft worth Rs. 5856/- (Five thousand, eight hundred fifty-six only) in
    favor of AIIMS, Bhubaneswar Academic Fund (A/c No. 557810110001482). (Please
    write your Name, Mobile No., All India Rank and e-mail ID (IN CAPITAL LETTERS)
    at the reverse of the Bank Draft.)
  • Date
    of birth Certificate OR certificate from the board from which you passed the
    high school / higher secondary examination showing date of birth.
  • Certificate
    of having passed the 10+2 examination showing the subjects in the examination.
  • Mark
    sheet of 10+2 examination from the Board from which you passed the same.
  • Caste
    Certificate showing that you belong to Schedule Caste/ Scheduled Tribe/ OBC
    (NCL)/ EWS category (Applicable only if have claimed in your application that
    you belong to that category) as per the prescribed format issued by the
    Government of India (for validity period of OBC-NCL/EWS certificates candidates
    are advised to visit MCC website regularly) as attached at Appendix G, H & I.
  • PwD
    Certificate from designated Disability Centers as per MCC guidelines. (Format
    of Disability certificate as per Appendix J from the Institutes as per Appendix K)
  • 2
    (two) sets of photocopies of the above documents (self-attested).
  • Current
    Passport size photograph (front facing) 2 copies.
To view the Instructions click the link below

https://medicaldialogues.in/pdf_upload/aimmsb-bhubneshwar-249057.pdf

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156 FDCs banned with immediate effect, declared irrational: Ministry of Health and Family Welfare

New Delhi: Citing that there is no therapeutic justification for the ingredients contained in fixed dose combinations (FDC) and that the FDC may involve risk to human beings, the Ministry of Health and Family Welfare has prohibited the manufacture for sale, sale and distribution for human use of 156 fixed dose combinations indicated for common cold, fever, bacterial and fungal infections, duodenal ulcers, nausea, and vomiting, fatty liver with diabetes, with immediate effect.

The list of FDCs banned includes Mefenamic Acid plus Paracetamol Injection, Omeprazole Magnesium + Dicyclomine HCl, Sucralfate + Acelofenac, Ursodeoxycholic Acid + Metformin HCl, Sucralfate + Domperidone, Minoxidil +Aminexil, Tetracycline + Colistin Sulphate, Clindamycin Phosphate + Zinc acetate, Norfloxacin + Tinidazole (with Betacyclodextrin) Eye ointment, Cetirizine HCl + Paracetamol + Phenylephrine HCl, Levocetirizine + Phenylephrine HCl, Aceclofenac 50mg + Paracetamol 125mg oral liquid, Paracetamol + Pentazocin and others.

The fixed dose combinations that are currently prohibited include a number of products marketed by pharmaceutical giants such as Sun Pharmaceuticals, Dr. Reddy’s Laboratories, Cipla, Alkem Laboratories, Mankind Pharma, Torrent Pharmaceuticals.

The notice claimed that safer alternatives to the medicine in question are available, and the Central Government concluded that using the Fixed Dose Combinations specified below is likely to include risk to human health.

Furthermore, regarding the use of FDCs, the notice stated, “The matter was examined by an Expert Committee appointed by the Central Government and the said Expert Committee considered this FDC as irrational.”

In addition to the above, the Drugs Technical Advisory Board also examined the said FDC and recommended that

“There is no therapeutic justification for the ingredients contained in this FDC. The FDC may involve risk to human beings. Hence in the larger public interest, it is necessary to prohibit the manufacture, sale or distribution of this FDC under section 26 A of Drugs and Cosmetics Act 1940. In view of above, any kind of regulation or restriction to allow for any use in patients is not justifiable. Therefore, only prohibition under section 26A is recommended”

Section 26 A of Drugs and Cosmetics Act 1940 is concerned about power of Central Government to prohibit manufacture, etc., of drug and cosmetic in public interest. It states,

“Without prejudice to any other provision contained in this Chapter, if the Central Government is satisfied, that the use of any drug or cosmetic is likely to involve any risk to human beings or animals or that any drug does not have the therapeutic value claimed or purported to be claimed for it or contains ingredients and in such quantity for which there is no therapeutic justification and that in the public interest it is necessary or expedient so to do, then, that Government may, by notification in the Official Gazette,[regulate, restrict or prohibit] the manufacture, sale or distribution of such drug or cosmetic.”

On the basis of the recommendations of the said Drugs Technical Advisory Board, the Central Government is satisfied that it is necessary and expedient in public interest to prohibit the manufacture for sale, sale and distribution for human use of the said drug in the country.

Therefore, in exercise of powers conferred by section 26A of the Drugs and Cosmetics Act, 1940 (23 of 1940), the Central Government hereby prohibits the manufacture for sale, sale and distribution for human use of 156 fixed dose combinations with immediate effect.

LIST OF BANNED FIXED DOSE COMBINATIONS (FDC)

SN

FIXED DOSE COMBINATION( FDC)

ORDER NO.

DATED

1

Amylase + Protease + Glucoamylase + Pectinase + Alpha Galactosidase + Lactase + Beta-Gluconase + Cellulase + Lipase + Bromelain + Xylanase + Hemicellulase + Malt diastase + Invertase + Papain

S.O.3285 (E)

12.08.2024

2

Antimony Potassium Tartrate + Dried Ferrous Sulphate

S.O.3286 (E)

12.08.2024

3

Benfotiamine + Silymarin + L-Ornithine L-aspartate + Sodium Selenite + Folic acid + Pyridoxine hydrochloride

S.O.3287 (E)

12.08.2024

4

Bismuth Ammonium Citrate + Papain

S.O.3288 (E)

12.08.2024

5

Cyproheptadine HCl + Thiamine HCl + Riboflavine + Pyridoxine HCl + Niacinamide

S.O.3289 (E)

12.08.2024

6

Cyproheptadine Hydrochloride + Tricholine Citrate + Thiamine Hydrochloride + Riboflavine + Pyridoxine

Hydrochloride

S.O.3290 (E)

12.08.2024

7

Rabeprazole Sodium (As enteric coated tablet) + Clidinium Bromide + Dicyclomine HCl + Chlordiazepoxide

S.O.3291 (E)

12.08.2024

8

Fungal Diastase + Papain + Nux vomica Tincture + Cardamom Tincture + Casein Hydrolysed + Alcohol

S.O.3292 (E)

12.08.2024

9

Mefenamic Acid + Paracetamol Injection

S.O.3293 (E)

12.08.2024

10

Omeprazole Magnesium + Dicyclomine HCl

S.O.3294 (E)

12.08.2024

11

S-adenosyl methionine + Metadoxine + Ursodeoxycholicacid BP + L-Methylfolate Calcium eq. to L- Methylfolate + Choline bitartratee + Silymarin + L-ornithine Laspartate + Inositol + Taurine

S.O.3295 (E)

12.08.2024

12

Silymarin + Thiamine Mononitrate + Riboflavin + Pyridoxine HCl + Niacinamide + Calcium pantothenate +

Vitamin B12

S.O.3296 (E)

12.08.2024

13

Silymarin + Pyridoxine HCl + Cyanocobalamin + Niacinamide + Folic Acid

S.O.3297 (E)

12.08.2024

14

Silymarin + Vitamin B6 + Vitamin B12 + Niacinamide + Folic acid + Tricholine Citrate

S.O.3298 (E)

12.08.2024

15

Sodium Citrate + Citric Acid Monohydrate Flavored with Cardamom Oil, Caraway Oil, Cinnamon Oil, Clove

Oil, Ginger Oil + Alcohol

S.O.3299 (E)

12.08.2024

16

Sucralfate + Acelofenac

S.O.3300 (E)

12.08.2024

17

Sucralfate + Domperidone + Dimethicone

S.O.3301 (E)

12.08.2024

18

Sucralfate + Domperidone

S.O.3302 (E)

12.08.2024

19

Tincture Ipecacuanha + Tincture Urgenia + Camphorated Opium Tincture + Aromatic Spirit of Ammonia +

Chloroform + Alcohol

S.O.3303 (E)

12.08.2024

20

Ursodeoxycholic Acid + Metformin HCl

S.O.3304 (E)

12.08.2024

Weak Ginger tincture + Aromatic Spirit of Ammonia + Peppermint Spirit + Chloroform + Sodium

Bicarbonate + Compound Cardamom + Alcohol i

S.O.3305(E)

12.08.2024

22

Sucralfate + Pantoprazole Sodium + Zinc Gluconate + Light Magnesium Carbonate

S.O.3306 (E)

12.08.2024

23

Aloe + Vitamin E Soap

S.O.3307 (E)

12.08.2024

24

Povidone Iodine+ Metronidazole + Aloe

S.O.3308 (E)

12.08.2024

25

Azelaic acid + Tea Tree Oil + Salicylic acid + Allantoin + Zinc oxide + Aloe vera + Jojoba oil + Vitamin E +

Soap noodles

S.O.3309 (E)

12.08.2024

26

Azithromycin + Adapalene

S.O.3310 (E)

12.08.2024

27

Calamine + Aloes + Allantoin

S.O.3311 (E)

12.08.2024

28

Calamine + Diphenhydramine Hydrochloride + Aloe + Glycerine + Camphor

S.O.3312 (E)

12.08.2024

29

Chlorphenesin + Zinc oxide + Starch

S.O.3313 (E)

12.08.2024

30

Clindamycin Phosphate + Zinc acetate

S.O.3314 (E)

12.08.2024

31

Gamma Benzene Hexachloride + Benzocaine

S.O.3315 (E)

12.08.2024

32

Glucosamine hydrochloride + Diacerein + Menthol + Camphor + Capsaicin

S.O.3316 (E)

12.08.2024

33

Hydroxyquinone 2.0%w/w + Octyl Methoxycinnamate 5.0% w/w + Oxybenzone 30 % w/w

S.O.3317 (E)

12.08.2024

34

Ketoconazole +Zinc Pyrithione +D-Panthenol +Tea Tree Oil +Aloes

S.O.3318 (E)

12.08.2024

35

Ketoconazole +Aloe vera+ Vitamin A Acetate

S.O.3319 (E)

12.08.2024

36

Ketoconazole +Aloes + ZPTO

S.O.3320 (E)

12.08.2024

37

Kojic Acid +Arbutin +Octinoxate +Vitamin E + Mulberry

S.O.3321 (E)

12.08.2024

38

Lornoxicam +capsaicin +menthol+ camphor

S.O.3322 (E)

12.08.2024

39

Lornoxicam + Thiocolchicoside +Oleum Lini +Menthol + Methyl salicylate

S.O.3323 (E)

12.08.2024

40

Menthol + Aloe vera Topical Spray

S.O.3324 (E)

12.08.2024

41

Menthol +Lignocaine HCl +Aloe vera gel +Clotrimazole +Diphenhydramine

S.O.3325 (E)

12.08.2024

42

Miconazole nitrate + Gentamicin + Fluocinolone Acetonide +Zinc Sulphate

S.O.3326 (E)

12.08.2024

43

Miconazole +Tinidazole

S.O.3327 (E)

12.08.2024

44

Minoxidil +Aminexil+ Alcohol

S.O.3328 (E)

12.08.2024

45

Minoxidil +Azelaic acid + saw palmetto

S.O.3329 (E)

12.08.2024

46

Minoxidil +Aminexil

S.O.3330 (E)

12.08.2024

47

Pine Bark extract+ Kojic acid +Sodium Ascorbyl Phosphate

S.O.3331 (E)

12.08.2024

48

Povidone Iodine +Tinidazole +Zinc sulphate

S.O.3332 (E)

12.08.2024

49

Povidone Iodine + Ornidazole + Dexpanthenol

S.O.3333 (E)

12.08.2024

50

Salicyclic acid +Aloe vera+ Allantoin +D-Panthenol

S.O.3334 (E)

12.08.2024

51

Silver sulphadiazine +Chlorhexidine Gluconate solution +Allantoin + Aloe vera gel +Vitamin E acetate

S.O.3335 (E)

12.08.2024

52

Sodium salicylate + Zinc gluconate + Pyridoxine HCl

S.O.3336 (E)

12.08.2024

53

Tetracycline + Colistin Sulphate

S.O.3337 (E)

12.08.2024

54

Clomiphene +Ubidecarenone

S.O.3338 (E)

12.08.2024

55

Combikit of Clomiphene Citrate + Estradiol Valerate

S.O.3339 (E)

12.08.2024

56

Flavoxate HCl +Ofloxacin

S.O.3340 (E)

12.08.2024

57

Clomiphene Citrate +N-Acetylcysteine

S.O.3341 (E)

12.08.2024

58

Primerose Oil +Cod liver oil

S.O.3342 (E)

12.08.2024

59

Sildenafil Citrate +Papaverine +L-Arginine

S.O.3343 (E)

12.08.2024

60

Tranexamic acid +Mefenamic acid + Vitamin K1

S.O.3344 (E)

12.08.2024

61

Divalproex Sodium +Oxcarbazepine

S.O.3345 (E)

12.08.2024

62

Divalproex Sodium + Levetiracitam

S.O.3346 (E)

12.08.2024

63

Ergotamine tartrate +Caffeine + Paracetamol +Prochlorperazine maleate

S.O.3347 (E)

12.08.2024

64

Piracetam + Ginkgo biloba extracts + Vinpocetin

S.O.3348 (E)

12.08.2024

65

Ginkgo biloba + methylcobalamin

S.O.3349 (E)

12.08.2024

66

Ginkgo biloba + methylcobalamin + Alpha lipoic acid +Pyridoxine HCl

S.O.3350 (E)

12.08.2024

67

Ginseng Extract +Dried extract of Ginkgo Biloba

S.O.3351 (E)

12.08.2024

68

Meclizine HCl+ Paracetamol + Caffeine

S.O.3352 (E)

12.08.2024

69

Nicergoline + Vinpocetine

S.O.3353 (E)

12.08.2024

70

Gamma Linolenic Acid + Methylcobalamin

S.O.3354 (E)

12.08.2024

71

Beclomethasone Dipropionate + Neomycin Sulphate + Clotrimazole + Lignocaine HCl

S.O.3355 (E)

12.08.2024

72

Boric acid+ Phenylephrine HCl + Naphazoline Nitrate + Menthol + Camphor

S.O.3356 (E)

12.08.2024

73

Naphazoline HCl + Chlorpheniramine Maleate + Zinc Sulphate + Hydroxy Propyl Methyl Cellulose

S.O.3357 (E)

12.08.2024

74

Chlorpheniramine Maleate + Naphazoline HCl + Zinc Sulphate + Sodium Chloride + Hydroxy Propyl Methyl

Cellulose

S.O.3358 (E)

12.08.2024

75

Chlorpheniramine Maleate + Naphazoline HCl + Hydroxy Propyl Methyl Cellulose

S.O.3359 (E)

12.08.2024

76

Chlorpheniramine Maleate + Sodium Chloride + Boric Acid + Tetrahydrozoline HCl

S.O.3360 (E)

12.08.2024

77

Chlorpheniramine Maleate + Phenylephrine HCl + Antipyrine

S.O.3361 (E)

12.08.2024

78

Ketorolac Tromethamine + Chlorpheniramine Maleate + Phenylephrine HCl + Hydroxy Propyl Methyl

Cellulose

S.O.3362 (E)

12.08.2024

79

Ketorolac Tromethamine + Flurometholone

S.O.3363 (E)

12.08.2024

80

Naphazoline HCl + Zinc Sulphate + Boric Acid + Sodium Chloride+ Chlorpheniramine Maleate

S.O.3364 (E)

12.08.2024

81

Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Boric Acid + Borax + Menthol + Camphor

S.O.3365 (E)

12.08.2024

82

Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate +Boric Acid + Sodium

Chloride + Zinc Sulphate

S.O.3366 (E)

12.08.2024

83

Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate +Boric Acid

S.O.3367 (E)

12.08.2024

84

Naphazoline HCl + Chlorpheniramine Maleate + Methyl Cellulose

S.O.3368 (E)

12.08.2024

85

Naphazoline HCl + Hydroxy Methyl Cellulose + Boric Acid + Menthol + Camphor

S.O.3369 (E)

12.08.2024

86

Naphazoline HCl + Boric Acid+Menthol+Camphor +Methyl Cellulose + Chlorpheniramine Maleate + Zinc

Sulphate + Sodium Chloride

S.O.3370(E)

12.08.2024

87

Naphazoline HCl + Phenylephrine HCl+ HPMC + Chlorpheniramine Maleate + Menthol+ Camphor

S.O.3371 (E)

12.08.2024

88

Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate + Boric Acid + Sodium

Chloride + Zinc Sulphate + Menthol + Camphor

S.O.3372 (E)

12.08.2024

89

Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate + Boric Acid +Zinc

Sulphate

S.O.3373 (E)

12.08.2024

90

Naphazoline HCl + Azelastine HCl+ Sodium Carboxy Methyl Cellulose + Menthol + Camphor + Stabilized

Oxychlorocomplex

S.O.3374 (E)

12.08.2024

91

Naphazoline HCl + Sodium Carboxy Methyl Cellulose + Menthol + Camphor + Stabilized Oxychloro

complex

S.O.3375 (E)

12.08.2024

92

Naphazoline Nitrate + Chlorpheniramine Maleate + Phenylephrine HCl + Hydroxy Methyl Cellulose + Boric

Acid+ Menthol+ Camphor

S.O.3376 (E)

12.08.2024

93

Naphazoline Nitrate + Chlorpheniramine Maleate + Zinc Sulphate + Boric Acid + Sodium Chloride

S.O.3377 (E)

12.08.2024

94

Norfloxacin + Tinidazole (with Betacyclodextrin) Eye ointment

S.O.3378 (E)

12.08.2024

95

Ofloxacin + Beclomethasone Dipropionate + Lignocaine HCl

S.O.3379 (E)

12.08.2024

96

Naphazoline HCl + Chlorpheniramine Maleate + Phenylephrine HCl + Menthol + Camphor

S.O.3380 (E)

12.08.2024

97

Phenylephrine HCl + Naphazoline HCl +Menthol+ Camphor + Hydroxy Propyl Methyl Cellulose

S.O.3381 (E)

12.08.2024

98

Phenylephrine HCl + Naphazoline HCl + Menthol + Camphor

S.O.3382 (E)

12.08.2024

99

Sulphacetamide Sodium + Zinc Sulphate + Chlorpheniramine Maleate + Boric acid + Sodium Chloride

S.O.3383 (E)

12.08.2024

100

Zinc Sulphate + Boric acid + Naphazoline HCl + Sodium Chloride + Phenyl Ethyl Alcohol

S.O.3384 (E)

12.08.2024

101

Cetirizine HCl + Paracetamol + Phenylephrine HCl

S.O.3385 (E)

12.08.2024

102

Cetirizine HCl + Phenylephrine HCl

S.O.3386 (E)

12.08.2024

103

Levocetirizine + Phenylephrine HCl

S.O.3387 (E)

12.08.2024

104

Levocetirizine + Phenylephrine HCl + Paracetamol

S.O.3388 (E)

12.08.2024

105

Phenylephrine HCl + Paracetamol + Levocetirizine HCl + Menthol

S.O.3389 (E)

12.08.2024

106

Levocetirizine HCl + Ambroxol HCl + Paracetamol

S.O.3390 (E)

12.08.2024

107

Levocetirizine HCl + Ambroxol HCl + Phenylephrine HCl

S.O.3391 (E)

12.08.2024

108

Diethylcarbamazine Citrate + Chlorpheniramine maleate

S.O.3392 (E)

12.08.2024

109

Diethylcarbamazine Citrate + Levocetirizine HCl

S.O.3393 (E)

12.08.2024

110

Ambroxol HCl + Phenylephrine HCl + Guaiphenesin

S.O.3394 (E)

12.08.2024

111

Bromhexine HCl + Phenylephrine HCl

S.O.3395 (E)

12.08.2024

112

Etofylline + Theophylline anhydrous eq. to Theophylline hydrate + Ambroxol HCl

S.O.3396 (E)

12.08.2024

113

Etofylline + Theophylline anhydrous eq. to Theophylline hydrate+ Montelukast

S.O.3397 (E)

12.08.2024

114

Ambroxol HCl + Terbutaline Sulphate + Ammonium Chloride + Guaiphenesin + Menthol

S.O.3398 (E)

12.08.2024

115

Ambroxol HCl + Salbutamol Sulphate + Ammonium Chloride + Guaiphenesin + Menthol

S.O.3399 (E)

12.08.2024

116

Cetirizine HCl + Terbutaline Sulphate + Ambroxol HCl + Guaiphenesin

S.O.3400(E)

12.08.2024

117

Dextromethorphan Hydrobromide + Chlorpheniramine Maleate + Ammonium Chloride + Sodium Citrate

+ Menthol

S.O.3401 (E)

12.08.2024

118

Salbutamol Sulphate + Bromhexine HCl + Guaiphenesin + Ammonium Chloride + Menthol

S.O.3402 (E)

12.08.2024

119

Terbutaline Sulphate + Bromhexine HCl + Chlorpheniramine Maleate

S.O.3403 (E)

12.08.2024

120

Chlorpheniramine Maleate + P.G Sulphonate + Ammonium Chloride + Sodium Citrate + Menthol

S.O.3404 (E)

12.08.2024

121

Aminophylline + Ammonium Chloride + Sodium Citrate

S.O.3405 (E)

12.08.2024

122

Paracetamol + Chlorpheniramine Maleate + Phenyl Propanolamine

S.O.3406 (E)

12.08.2024

123

Trithioparamethoxyphenyl Propene + Chlorpheniramine Maleate

S.O.3407 (E)

12.08.2024

124

Aceclofenac 50mg + Paracetamol 125mg oral liquid

S.O.3408 (E)

12.08.2024

125

Aceclofenac 50mg + Paracetamol 125mg tablet

S.O.3409 (E)

12.08.2024

126

Adenosine triphosphate diphosphate + Magnesium Orotate

S.O.3410 (E)

12.08.2024

127

Amoxicillin Trihydrate + Dicloxacillin Sodium + Lactobacillus

S.O.3411 (E)

12.08.2024

128

Camylofin Dihydrochloride 25 mg + Paracetamol 300mg

S.O.3412 (E)

12.08.2024

129

Cefixime+ Acetyl Cysteine

S.O.3413 (E)

12.08.2024

130

Cephalexin Monohydrate + Serratiopeptidase

S.O.3414 (E)

12.08.2024

131

Cetyl Myristoleate + glucosamine Sulphate Potassium +Methyl Sulfonyl methane

S.O.3415 (E)

12.08.2024

132

Diacerin IP + Glucosamine Sulphate Potassium Chloride USP + MSM (Methylsulphonyl Methane) + Cetyl

Myristoleate

S.O.3416 (E)

12.08.2024

133

Paracetamol+ Diclofenac Potassium + Caffeine Anhydrous

S.O.3417 (E)

12.08.2024

134

Diclofenac sodium + Thiocolchicoside Injection

S.O.3418 (E)

12.08.2024

135

Doxycycline + Ornidazole + Bromelain + Lactobacillus Rhamnosus + Lactobacillus Reuteri RC

S.O.3419 (E)

12.08.2024

136

Doxycycline HCl + Betacyclodextrin + Serratiopeptidase

S.O.3420 (E)

12.08.2024

137

Erythromycin stearate eq.to Erythromycin + Lactic acid Bacillus

S.O.3421 (E)

12.08.2024

138

Etodolac + Paracetamol +Serratiopeptidase

S.O.3422 (E)

12.08.2024

139

Flupirtine Maleate 400 mg + Paracetamol 325 mg tablet

S.O.3423 (E)

12.08.2024

140

Glucosamine sulphate potassium chloride 410 mg + Chondroitin Sulphate 100 mg

S.O.3424 (E)

12.08.2024

141

Glucosamine sulphate potassium chloride+ Methyl Sulphonyl Methane (MSM) + Sodium Borate + Copper

Sulphate pentahydrate+ Manganese Sulphate + Vitamin D3

S.O.3425 (E)

12.08.2024

142

Glucosamine Sulphate + Sodium chloride+ Manganese +Boron + Zinc + Copper

S.O.3426 (E)

12.08.2024

143

Glucosamine sulphate + Chondroitin sulphate + Methylsulfonylmethane +Vitamin D3 + Vitamin E + Vitamin C + Selenium +Elemental Zinc +Elemental Manganese + Elemental Chromium + Elemental Copper

+Elemental Boron

S.O.3427 (E)

12.08.2024

144

Glucosamine sulphate + Methyl sufonyl methane + manganese sulphate +Vit E acetate +calcium

Carbonate

S.O.3428 (E)

12.08.2024

145

Glucosamine Sulphate + Vitamin E acetate + Calcium Pantothenate + Vitamin D3

S.O.3429 (E)

12.08.2024

146

Glucosamine Sulphate Potassium chloride + Calcium Carbonate from an organic source (oyster shell) eq. to

S.O.3430 (E)

12.08.2024

147

Cetyl Myristoleate + Glucosamine Sulphate Potassium chloride + Methyl sulfonyl methane

S.O.3431 (E)

12.08.2024

148

Glucosamine Sulphate Potassium chloride + Methyl sulfonyl methane +Calcium carbonate +Vitamin E+

Manganese

S.O.3432 (E)

12.08.2024

149

Glucosamine Sulphate Potassium chloride + Calcium carbonate + Methyl sulfonyl methane +Vit D3

S.O.3433 (E)

12.08.2024

150

Glucosamine Sulphate Potassium + Methyl sulphate Sodium+ Sulphonyl Methane +Chondroitin Sulphate Sodium+ Calcium Carbonate +Vitamin D3+Sodium Borate+ Cupric Oxide+ Colloidal Silicon Dioxide+

Manganese Chloride

S.O.3434 (E)

12.08.2024

151

Methocarbamol + Diclofenac Sodium Injection

S.O.3435 (E)

12.08.2024

152

Paracetamol + Pentazocin

S.O.3436 (E)

12.08.2024

153

Sucralfate +Domperidone+ Simethicone

S.O.3437 (E)

12.08.2024

154

Sulfaquinoxaline +Diaveridine HCl+ Vitamin K

S.O.3438 (E)

12.08.2024

155

Tramadol HCl +Dicyclomine HCl + Domperidone

S.O.3439 (E)

12.08.2024

156

Tramadol HCl +Paracetamol +Caffeine +Taurine

S.O.3440 (E)

12.08.2024
Also Read:Govt bans 14 fixed-dose combination drugs

To view the official notice, click the link below:

https://medicaldialogues.in/pdf_upload/fdc-prohibited-249121.pdf

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Clinical Establishments Act came as Central Law, so Can Doctors Protection Law: IMA Tells Health Minister

New Delhi: Reiterating their case and appealing to the authorities to bring a Central Act for the protection of doctors in the country, the Indian Medical Association (IMA) has recently written to the Union Health Minister Jagat Prakash Nadda.

In the letter, IMA cited the example of the Clinical Establishments (Registration and Regulation) Act, 2010, and argued that even though hospitals and dispensaries come under the State list of the Constitution of India, this Act was enacted by the Parliament of India at the request of 4 States. 

Referring to this, the association argued that a similar provision can be made for the protection of doctors as well. 

Central Law to ensure the safety of doctors and put a stop to instances of violence against them has been a long pending demand of medical professionals across the country.

The doctors across the country, who are sitting on the streets in protest of the brutal rape and murder of their colleague, a PG resident doctor at Kolkata-based RG Kar Medical College and Hospital, have also been demanding implementation of the Central Protection Act to ensure their safety in future.

While various other demands of the doctors are in the process of being addressed, the issue of the Central Protection Act remains illusive as the Government has stated that Health being a state subject, this aspect will be governed by the State.

Also Read: Breaking News on RG Kar Case: Supreme Court Constitutes National Task Force to draft Action plan for Safety of Doctors

Last year, reiterating its previous stand, the former Union Health Minister Mansukh Mandaviya informed the Rajya Sabha about the Central Government’s decision of not enacting separate legislation to prohibit violence against doctors and other healthcare professionals.

Former Health Minister Mandaviya had informed that even though the Draft of “The Healthcare Services Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019” was prepared by the Ministry of Health and Family Welfare, it was decided not to enact a separate Legislation for prohibiting violence against doctors and other health care professionals. Consequently, an ordinance namely “The Epidemic Diseases (Amendment) Ordinance, 2020” was promulgated on April 22, 2020.

“Since, law and order is a State Subject, State/Union Territory (UT) Governments also take appropriate steps to protect healthcare professionals / institutions under provisions in Indian Penal Code (IPC) / Code of Criminal Procedure (Cr.PC),” the former Union Health Minister had earlier informed.

However, the necessity of a Central Act on Violence on Doctors and Hospitals has again been highlighted by the IMA in its recent letter addressed to the Union Health Minister J.P Nadda.

“Indian Medical Association is grateful to your goodself for receiving the delegation of IMA on 13th August 2024 regarding the issue of Central Act on Violence on Doctors and Hospitals, Safety and Security in workplaces of healthcare personnel and the working and living conditions of the Resident doctors. IMA also thanks you for accepting the suggestions for the National Medical Commission insisting on security measures as a pre-condition for giving recognition to new medical colleges. The advisory of the National Medical Commission in this regard was released an hour after the meeting,” IMA mentioned in the letter.

The association also pointed out that it had withdrawn service of the Medical Fraternity except casualties and emergencies across the country on 17.08.2024. Further, it referred to the fact that the Supreme Court has intervened into the alleged rape and murder incident of a trainee doctor in RG Kar Medical College and Hospital and related issues. Consequently, the Apex Court constituted a National Task Force, which will not draft an action plan to ensure safety and security of healthcare professional including doctors the working and living conditions of the resident doctors and also the matters relating to the crime at R.G. Kar Medical College & Hospital.

IMA Demands Central Act for Protection of Healthcare Professionals: 

However, the association pointed out that the issue of promulgating an ordinance for the Central Act for the protection of Healthcare Professionals remains to be addressed. Submitting that IMA is keen on a Central Act, the association submitted several facts before the Union Minister for consideration.

1. Clinical Establishments (Registration and Regulation) Act, 2010 was enacted by the Parliament of India at the request of 4 states even though hospitals and dispensaries come under the state list of the Constitution of India.

2. The Ministry of Health & Family Welfare, GoI under your watch has documented an Office Memorandum with the IMA where the Ministry has said that “it shall explore the possibility to initiate the process to bring a Central Act in line with those in vogue in the state”.

3. A draft legislation “The Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019” was placed in public domain after due consultation with all the stake holders. The Union Home and Law Ministry were involved alongwith the Union Health Ministry in drafting this Bill.

4. The Epidemic Diseases Amendment Ordinance, 2020 was proclaimed on 22nd April 2020 amending the Epidemic Diseases Act of 1897 during the Covid Settings. The same was approved and passed by the Parliament as the Epidemic Diseases Amendment Act, 2020 and received the assent of the President on 28th September 2020.

Referring to these previously implemented Acts and rules, IMA argued that there is constitutional validity in enacting a Central Act for the protection of doctors.

“All the above proceedings show the sensitivity of the Union Health Ministry regarding violence on doctors and hospitals. That the Government went through all the above exercises shows that there is a constitutional validity which is implicitly acknowledged. Similarly, the enactment of CEA brings out the constitutional provisions under which a Central Act could be enacted on Hospitals and Healthcare personnel,” it mentioned.

Citing examples of four doctors, including the PG doctor at RG Kar, who were killed in the line of their duty, IMA referred to the Supreme Court order in the case of Jacob Mathew vs State of Punjab & Anr and argued that doctors stand as a separate class by the nature of their professional services. 

“There are special laws enacted for specific exigencies like the POCSO Act as well. We, the Indian Medical Association appeal to you that a special exigency exists in relation to the violence on doctors and hospitals,” wrote the association. 

“The doctors are vulnerable in their workplace. The State has a bounden duty to provide safety and security to the doctors and other healthcare personnel. “Right to Life” is a fundamental right,” it further added.

State Laws Failed to Prevent Violence against Doctors: IMA 

Referring to the rules implemented by the State Governments, IMA argued that 25 State legislations in this regard have not prevented violence across the country. It further pointed out that very few FIRs have been lodged and very few convictions have happened. Therefore, as per IMA, there is an urgent need to bring in a Central Act on violence on Doctors and Hospitals. 

“We demand that the draft bill 2019 incorporating the amendment clauses of the Epidemic Diseases Amendment Act, 2020 and the Code Grey Protocol of Kerala Government “Prevention Management of Violence against Healthcare workers” be proclaimed as an ordinance to instill confidence into the minds of the Doctors of India,” IMA added in the letter.

Also Read: Doctors denied protection: Govt says No to bringing uniform law for violence against doctors

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Kolkata Rape-Murder Case: AIIMS doctors call off strike after Supreme Court appeal

New Delhi: The resident doctors at the All India Institutes of Medical Sciences (AIIMS), New Delhi, on Thursday called off their 11-day strike after the Supreme Court asked healthcare workers to resume their duties and asked the Centre to provide security to all health professionals across the country.

In a statement, the Resident Doctors Association made the announcement and said, “In the interest of the nation and in the spirit of public service, the RDA, AIIMS, New Delhi, has decided to call off 11-day strike. This decision comes in response to the appeal and direction of the Supreme Court. We extend our sincere appreciation to the Supreme Court for taking cognizance of the RG Kar Medical College incident and addressing the broader issue of safety and security for healthcare workers across the country”, news agency ANI reported. 

Earlier, the Supreme Court, while commencing its hearing on the Kolkata doctor rape-murder case, said that health professionals must return to work and that once they resume their duties, the court will prevail upon authorities to not take adverse action against them.

Also Read:Kolkata doctor death case: AIIMS Doctors demand Central Protection Act, Strike continues

According to an ANI report, the court said, “Let the health professionals return to work and once they return to duties, the court will prevail upon authorities to not take adverse action. How would the public health infrastructure function if doctors did not return to work”.

On Thursday, the Supreme Court continued its hearings into the alleged rape and murder of a junior doctor at RG Kar Medical College and Hospital in Kolkata. Chief Justice of India (CJ) DY Chandrachud shared a personal experience of staying overnight in a public hospital, underscoring the challenges faced by healthcare workers.

Medical Dialogues team had earlier reported that while considering the case of the horrific incident of rape and murder of a PG medical doctor at Kolkata-based RG Kar Medical College and Hospital, the Supreme Court has set up a National Task Force to give recommendations on the modalities to be followed across India to ensure safety of senior and junior doctors employed across the medical colleges/hospitals in the country.

The development comes days after the rape and murder of a junior doctor in Kolkata sparked nationwide protests, the apex court suo motu took up the case and directed the task force to submit an interim report within three weeks and a final report within two months.

The top court also asked the Central Bureau of Investigation (CBI) to file a status report on the status of the investigation in the rape case. Also, the court asked the West Bengal government to file a status report on the mob attack incident that took place at the RG Kar hospital on August 15.

Also Read:Kolkata doctor rape-murder case: PGI doctors continue to protest, start OPDs at protest site

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