Archive for month: August, 2024

New Delhi: Announcing the details of this year’s list of best pharmacy institutes across the country, the Union Education Minister Dharmendra Pradhan has released the National Institutional Ranking Framework (NIRF) 2024. Besides pharmacy, the rankings have been released under various categories including Overall, Medical, Engineering, Management, Pharmacy, Colleges, Architecture, Law, Dental and Research.

According to the National Institutional Ranking Framework, the Jamia Hamdard , New Delhi (JHU, New Delhi) maintains its record and ranks first in the pharmacy colleges list. The score of Jamia Hamdard has been increased from 78.74 in 2023 to 84.01 in 2024. 

The rank of National Institute of Pharmaceutical Education and Research Hyderabad (NIPER, Hyderabad) has come down from rank Ist to rank 2nd in 2024 with a score of 80.29.

The Birla Institute of Technology and Science, Pilani Rajasthan has ranked 3rd in the pharmacy colleges list with a score of 78.95.

The 4th, 5th and 6th positions have been reserved by JSS College of Pharmacy, Tamilnadu and Institute of Chemical Technology Maharashtra, JSS College of Pharmacy Karnataka respectively.

The list of Top 100 pharmacy colleges as per NIRF 2024 has been given below:

Union Minister for Education Shri Dharmendra Pradhan recently released the India Rankings 2024, which implements the National Institutional Ranking Framework (NIRF) drafted for this purpose by the Ministry of Education in 2015. Secretary, Higher Education, Shri K. Sanjay Murthy; UGC, Prof. M Jagadesh Kumar; Chairman, AICTE, Prof. T.G. Sitharam; Chairman, NETF, Prof. Anil Sahasrabuddhe; Member Secretary, NBA, Dr. Anil Kumar Nassa, Additional Secretary, Department of Higher Education, Shri Sunil Kumar Barnwal; Joint Secretary, Shri Govind Jaiswal; Chairman, and other academicians, heads of the institutions, etc. were present on this occasion.

Cambridge: AstraZeneca and Daiichi Sankyo’s Enhertu (trastuzumab deruxtecan) has received conditional approval in China as a monotherapy for the treatment of adult patients with locally advanced or metastatic HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma who have received two or more prior treatment regimens.

New Delhi: India has altogether 31053 Primary Health Centres (PHCs), 6064 Community Health Centres (CHCs), 1275 Sub Divisional Hospitals, 767 District Hospitals, and 315 Government Medical Colleges, the Union Minister of State for Health Smt. Anupriya Patel recently informed the Lok Sabha.

The MoS Health also provided the details regarding the availability of health workers, AYUSH doctors, Allopathic practitioners, Pharmacists, Laboratory Technicians, and Nursing Staff at the PHCs and CHCs across the country. 

This data was shared by the Union Health Ministry while responding to a question raised by Parliament member Shri Rajesh Verma, who sought to know the number of PHCs, CHCs, SDHs, DHs, and Union Government hospitals in the States/UTs as uploaded on the HMIS portal. He also questioned about the number of doctors, nurses, Health workers, and allied health professionals employed in Central Government operated hospitals and in other medical establishments and sought to know about the data regarding the vacant posts.

Apart from this, Shri Rajesh Verma also asked the Ministry about the steps taken/proposed to improve the number and quality of medical professionals in the public health system.

In response to these questions, the Union MoS Health provided the State/UT wise break up of PHCs, CHCs, SDHs, DHs, and MCs including Central Government Hospitals as per the Rural Health Statistics 2021-2022.

Availabiliity of PHCs: 

As per the data provided by the Health Ministry, the maximum number of PHCs are in Uttar Pradesh, where 3513 PHCs are catering to the Public Health Sector. 

Further, there are more than 1000 PHCs in States including Andhra Pradesh (1689), Assam (1010), Bihar (1760), Gujarat (1804), Karnataka (2521), Madhya Pradesh (1572), Maharashtra (2539), Odisha (1393), Rajasthan (2409), Tamil Nadu (1886), and West Bengal (1371).

Apart from these, there are 131 PHCs in Arunachal Pradesh, 822 in Chhatisgarh, 497 PHCs in Haryana, 570 in Himachal Pradesh, 361 PHCs in Jharkhand, 944 in Kerala, 147 in Meghalaya, 136 PHCs in Nagaland, 522 in Punjab, 834 PHCs in Telangana, 117 PHCs in Tripura, 607 in Uttarakhand, 550 PHCs in Delhi, and 973 in Jammu and Kashmir.

Less than 100 PHCs are available in States/UTs including Goa (28), Manipur (95), Mizoram (66), Sikkim (26), Andaman & Nicobar Islands (27), Chandigarh (43), Dadra & Nagar Haveli and Daman & Diu (14), Ladakh (33), Lakshadweep (4) and Puducherry (39).

Availabiliity of CHCs:

Among 6064 CHCs the maximum number of CHCs are available in Uttar Pradesh, where there are 841 Community Health Centres. Apart from this, there are 181 CHCs in Andhra Pradesh, 201 CHCs in Assam, 301 CHCs in Bihar, 170 CHCs in Chhattisgarh, 361 CHCs in Gujarat, 131 CHCs in Haryana, 178 CHCs in Jharkhand, 212 CHCs in Karnataka, 230 in Kerala, 356 in Madhya Pradesh, 398 in Maharashtra, 384 in Odisha, 160 in Punjab, 685 in Rajasthan, 400 in Tamil Nadu, and 348 in West Bengal.

States/UTs that have less than 100 CHCs include, Arunachal Pradesh (57), Goa (6), Himachal Pradesh (97), Manipur (17), Meghalaya (28), Mizoram (9), Nagaland (23), Sikkim (2), Telangana (82), Tripura (23), Uttarakhand (80), Andaman and Nicobar Islands (4), Chandigarh (2), Dadra & Nagar Haveli (4), Jammu & Kashmir (79), Ladakh (7), Lakshadweep), and Puducherry (4). There are no CHCs in Delhi.

Availability of Sub Divisional Hospitals: 

The data revealed that among the 1275 Sub Divisional Hospitals, the maximum number i.e. 282 SDHs are available in Tamil Nadu. More than 100 SDHs are available in States/UTs including Karnataka (147), Madhya Pradesh (119). There are more than 50 SDHs available in Andhra Pradesh (51), Gujarat (54), Himachal Pradesh (84), Kerala (87), Maharashtra (93), and West Bengal (60).

Further, there are 14 SDHs in Assam, 45 in Bihar, 12 in Chhatisgarh, 24 in Haryana, 13 in Jharkhand, 33 in Odisha, 41 in Punjab, 22 in Rajasthan, 41 in Telangana, 12 in Tripura, and 19 SDHs n Uttarakhand.

States/UTs that have 10 or less than 10 SDHs include Goa (2), Manipur (1), Meghalaya (2), Mizoram (2), Sikkim (1), Chandigarh (1), Dadra & Nagar Haveli and Daman & Diu (1), Delhi (10), Lakshadweep (2).

Arunachal Pradesh, Nagaland, Uttar Pradesh, Andaman & Nicobar Islands, Jammu and Kashmir, Ladakh and Puducherry do not have Sub Divisional Hospitals.

Availability of District Hospitals: 

As per the data shared by MoS Health, India has altogether 767 District Hospitals. Among these, the highest number i.e. 169 District Hospitals are available in Uttar Pradesh. 

Apart from this, more than 30 District Hospitals are available in Kerala (48), Madhya Pradesh (52), Delhi (40), Bihar (36), Odisha (32), Rajasthan (30). Further, there are 25 District Hospitals in Assam, 27 in Chhattisgarh, 22 in Haryana, 21 in Jharkhand, 23 in Maharashtra, 23 in Punjab, 

Less than 20 District Hospitals are in States/UTs including Goa (2), Himachal Pradesh (9), Manipur (7), Andhra Pradesh (17), Arunachal Pradesh (19), Gujarat (20), Meghalaya (11), Mizoram (12), Nagaland (12), Sikkim (4), Tamil Nadu (20), Telangana (5), Tripura (7), Uttarakhand (13), West Bengal (18), Andaman & Nicobar Islands (2), Chandigarh (1), Dadra & Nagar Haveli and Daman & Diu (2), Jammu and Kashmir (15), Ladakh (2), Lakshadweep (1), Puducherry (4).

More than 100 SDHs are available in States/UTs including Karnataka (147), Madhya Pradesh (119).

Availability of Medical Colleges: 

Among the 315 medical colleges including central government hospitals available in India, the highest number of colleges i.e. 41 colleges are available in Tamil Nadu, followed by 40 medical colleges in Rajasthan.

More than 10 medical colleges are available in States/UTs including Andhra Pradesh (12), Bihar (11), Gujarat (20), Karnataka (19), Madhya Pradesh (13), Maharashtra (23), Uttar Pradesh (20), West Bengal (18), and Delhi (13).

States/UTs that have less than 10 medical colleges include Arunchal Pradesh (1), Assam (8), Chhattisgarh (8), Goa (1), Haryana (5), Himachal Pradesh (6), Jharkhand (7), Kerala (8), Manipur (2), Meghalaya (1), Mizoram (1), Odisha (7), Punjab (3), Telangana (9), Tripura (1), Uttarakhand (3), Andaman & Nicobar Islands (1), Chandigarh (2), Dadra & Nagar Haveli and Daman & Diu (1), Jammu and Kashmir (8), and Puducherry (2).

Availability of Doctors, Nurses & Health Workers and Other Health Professionals in PHCs & CHCs: 

The MoS Health also provided the State/ UT wise details of in-positions of doctors, nurses, health workers and other health professionals as per Rural Health Statistics (RHS) 2021-2022.

As per the data, altogether 26818 Health Workers (Female)/ANM are available in rural PHCs and 21501 are available in the urban areas. Further, there are 11329 Health Assistants, 8473 Ayush doctors are available in the rural PHCs.

The data revealed that the rural PHCs have 30640 doctors, 19359 pharmacists, 14565 laboratory technicians, and 36079 nursing staff in position. On the other hand, the urban PHCs have 7315 doctors, 5029 pharmacists, 4361 laboratory technicians, and 9467 nursing staff in position. 

In the case of CHCs, the rural areas have 661 Ayush specialists, 4485 Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians], 17348 General Duty Medical officers, 2448 Radiographers, 7776 Pharmacists, 8207 Laboratory Technicians, and 43854 nursing staff in positions.

On the other hand, the urban CHCs have 1278 Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians], 1568 GDMOs, 358 Radiographers, 840 pharmacists, 4361 Laboratory Technicians, and 6121 Nursing Staff.

Vacant Positions: 

In the PHCs, 5863 Health Workers (Female)/ANM are vacant in rural areas and 3228 are vacant in urban areas. Further, there are 6580 positions of Health Assistants and 2917 posts of Ayush doctors are vacant in rural areas. 

Further the data revealed that the rural PHCs have 9451 vacant positions of doctors, 5766 posts of pharmacists, 6394 laboratory technicians, and 10776 vacant nursing staff. On the other hand, the urban PHCs have 1680 doctors, 1008 pharmacists, 870 laboratory technicians, and 2203 nursing staff posts vacant.

In the case of CHCs, the rural areas have 605 Ayush specialists, 9343 Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians], 5159 General Duty Medical officers, 1628 Radiographers, 1723 Pharmacists, 1752 Laboratory Technicians, and 12174 nursing staff posts vacant.

On the other hand, the urban CHCs have 764 Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians], 528 GDMOs, 164 Radiographers, 179 pharmacists, 870 Laboratory Technicians, and 1433 Nursing Staff posts vacant.

“Public Health and Hospitals is a State Subject and all the administrative and personnel matters, including support for outsourcing or engagement of doctors and other health human resources lies with the respective State Government/UT Administration. Further, under National Health Mission (NHM), Government of India provides financial and technical support to States/UTs to strengthen their healthcare systems,” informed the MoS Health.

As per the Minister, the Government of India has taken the following initiatives in the form of incentives and honorarium to the medical professionals for encouraging better service delivery in rural and remote areas in the country,

 Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.

 Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors to increase availability of specialists for conducting Cesarean sections in rural & remote area.

 Incentives like special incentives for doctors, incentive for ANM for ensuring timely ANC checkup and recording, incentives for conducting Adolescent Reproductive and Sexual Health activities.

 States are also allowed to offer negotiable salary to attract specialist including flexibility in strategies such as “You Quote We Pay”.

 Non-Monetary incentives such as preferential admission in post graduate courses for staff serving in difficult areas and improving accommodation arrangement in rural areas have also been introduced under NHM.

 Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.

Also Read: 80% Shortfall of Specialist Doctors in CHCs: Health Ministry Report

Transesophageal echocardiography (TEE) is extensively utilized in cardiac surgery to provide real-time, high-resolution images of the heart and its surrounding structures, contributing significantly to surgical decision-making, procedural monitoring, and postoperative outcome assessment. Recent study investigated factors predictive of difficult transesophageal echocardiography (TEE) probe insertion in adult cardiac surgery patients. The observational study involved 119 adult patients undergoing cardiac surgery, analyzing demographic variables (age, gender, BMI) and airway factors (modified Mallampati classification, modified Cormack-Lehane grading, and thyromental distance). The difficulty of TEE probe insertion was categorized into three grades, and various maneuvers were assessed for difficult insertions.

Results and Key Findings

Results showed that 30.3% of insertions were difficult, and male gender, BMI ≥30 kg/m2, Mallampati class III-IV, Cormack-Lehane grade IIb-IV, and thyromental distance <6.5 cm were significantly associated with difficult insertion. Jaw thrust was the most effective maneuver for difficult cases, used in 58.3% of instances. The study highlighted the potential complications associated with difficult TEE probe insertion, such as oropharyngeal injuries and esophageal perforation, particularly with larger 3D TEE probes. The findings emphasized the importance of identifying predictive factors to anticipate challenges and reduce complications.

Patient Characteristics and Airway Factors

The study involved ethical approval and excluded patients with contraindications to TEE probe placement. The age of participants ranged from 18 to 75 years, with a higher proportion of males. The BMI distribution showed a significant portion of overweight and obese patients. Airway characteristics, including Mallampati scores and Cormack-Lehane grading, indicated potential difficulties with TEE probe insertion. While the majority of insertions were performed without difficulty, 30.3% required intervention, with jaw thrust being the most commonly used and effective technique.

Statistical Associations

The study found statistical associations between demographic and airway factors and difficult TEE probe insertion, with Mallampati class III-IV showing the strongest association. Men, individuals with high BMI, and unfavorable airway characteristics were also significantly associated with difficulty. The use of video laryngoscopy was not required in any case, suggesting that simpler techniques were sufficient. The study provided valuable insights into the predictive factors associated with difficult TEE probe insertion, highlighting the importance of comprehensive preoperative airway assessment and the value of simple, effective maneuvers in managing insertion difficulties. The findings emphasized the need for further research to validate the results in larger, multi-center studies and explore additional predictive tools to enhance patient safety during TEE probe insertion.

Key Points

– The study aimed to identify factors predictive of difficult transesophageal echocardiography (TEE) probe insertion in adult cardiac surgery patients. It involved 119 adult patients undergoing cardiac surgery and analyzed demographic variables (age, gender, BMI) and airway factors (modified Mallampati classification, modified Cormack-Lehane grading, and thyromental distance). – Results indicated that 30.3% of insertions were difficult, with male gender, BMI ≥30 kg/m2, Mallampati class III-IV, Cormack-Lehane grade IIb-IV, and thyromental distance <6.5 cm being significantly associated with difficult insertion. Jaw thrust was the most effective maneuver for difficult cases, used in 58.3% of instances. – The study highlighted potential complications associated with difficult TEE probe insertion, such as oropharyngeal injuries and esophageal perforation, particularly with larger 3D TEE probes. It stressed the importance of identifying predictive factors to anticipate challenges and reduce complications. – Statistical associations were found between demographic and airway factors and difficult TEE probe insertion, with Mallampati class III-IV showing the strongest association. Men, individuals with high BMI, and unfavorable airway characteristics were also significantly associated with difficulty. Video laryngoscopy was not required in any case, suggesting that simpler techniques were sufficient. – The study emphasized the importance of comprehensive preoperative airway assessment and the value of simple, effective maneuvers in managing insertion difficulties. It also called for further research to validate the results in larger, multi-center studies and explore additional predictive tools to enhance patient safety during TEE probe insertion.

Reference –

Hasnain S, Shenava A, Garg I (July 10, 2024) A Study of Factors Predicting Difficulties in Transesophageal Echocardiography (TEE) Probe Insertion in Adult Patients Undergoing Cardiac Surgery. Cureus 16(7): e64256. DOI 10.7759/cureus.64256.