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YOUNG AT FIFTY, BUT MUCH WISER
Here,
hands cure better than machines
Some
core concerns & nagging troubles
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A
Tribune Exclusive
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first: K’taka to get bio-fuel outlet
6
get life term for custodial deaths
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relieved Maya thanks partymen, lawyers
Krishna
to attend Tokyo meet on Afghanistan
SC
rejects plea against Pranab
CBI
officer who probed Adarsh scam shifted
MoEF
halts Akhilesh’s Lion Safari project High
Court tells Bengal to file affidavit in Pinki case
Incentives
for Central govt staff posted to Valley extended UP
mango grower names a variety after Delhi CM
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As PGI, Chandigarh, celebrates its Golden Jubilee today, The Tribune takes a look at the premier institute’s rapid strides
In its golden jubilee year, the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, or PGI as it is simply known, has much to cheer about.
Christened an institute of national importance under the Act of Parliament on April 1, 1967, the PGI was assigned three main goals – provision of high quality patient care, attainment of self sufficiency of postgraduate medical education and production of medical specialists to help India meet its public health goals. On each of these, it has done fairly well, starting from June 23, 1962, when the first patient was admitted here followed by April 15, 1963, when the first batch of PG students was inducted. The Institute's legendary wing — Nehru Hospital — was thrown open on July 7, 1963 by Prime Minister Pandit Jawahar Lal Nehru. It is this occasion, the country will celebrate tomorrow. But more than that, it would be the celebration of the hope of recovery which the PGI offers to lakhs every year – from the poorest to the richest patients across northwestern India, and now even in the northeastern region. “The PGI has met regional aspirations outstandingly well. The excellence it has achieved is splendid, and not easy for a public health institute to attain. I salute its achievements,” says Vinod Paul, acclaimed pediatrician, currently, head, pediatrics, at AIIMS. He makes a special mention of the PGI’s Advanced Pediatric Centre, India’s best critical care centre for children today. “In pediatric super specialties of neonatology, gastroenterology and emergency medicine, the PGI leads the way. The tradition continues from the times of Dr BNS Walia, who left AIIMS to join PGI as the first pediatrics head,” Paul recalls. The Specialists’ Nursery PGI’s contribution to the national human resource pool is also outstanding. It has produced the maximum number of specialists – 4,500 – for the all India pool and 1,500 super specialists. Several top super specialties first started here. “We started DM in Pulmonary Medicine in 1989 while AIIMS is starting it now. DM Gastroenterology and Hepatology started here much earlier than at AIIMS. We are also frontrunners in the super specialty of nuclear medicine and nephrology,” says Dr SK Jindal, Department Head, Pulmonary Medicine, PGI. The institute has the best departments in India in hepatology, pathology, pediatric gastroenterology and pediatric oncology, which recently created history with the first stem cell transplant on a three-year-old Taran Taran boy suffering from rare cancer of the eye — neuroblastoma. Importantly, the PGI has maintained excellence in teaching despite its mounting patient load. People flock its tertiary care facilities even for common ailments, courtesy poor public health care in Punjab, Haryana, Himachal and J&K. “We get scores of requests weekly for transfer of patients from private hospitals to our critical care units. We have just about 1,900 beds” Dr Jindal says. Deluge of patients Data shows that at inception in 1962, PGI doctors saw 1.25 lakh OPD patients and had 3,328 admissions. Last year, OPD and IPD figures stood at a whopping 18 lakh and 70,000 respectively, marking an increase of 14.4 times and 21 times, respectively, over 1962. By contrast, the budgets didn’t increase. This year, the PGI got Rs 576 crore against Rs 1,000 crore it had sought. Big brother AIIMS The PGI has 470 faculty members but needs three times more. In the 12th Plan, it has sought 2,000 posts across disciplines. In the face of 35% average annual increase in admission rate, it’s natural for research at any institute to suffer. But the PGI has done fairly well on this front, contributing 600 research papers last year, a marked improvement from the past. AIIMS, contrastingly, contributed 1,500 papers with Pediatrics faculty alone contributing 110. Annual extra mural research funding was also higher — Rs 55 crore for AIIMS as against Rs 14 crore for the PGI. But experts feel it’s not fair to compare the two institutes of national importance. “We are smaller and younger than the AIIMS which came up in 1956. They have double our faculty and more funds,” reasons Dr Rajesh Kumar, Head, School of Public Health, PGI and an acclaimed community medicine man known globally for his 2003 study which showed for the first time that HIV/AIDS prevalence in India was declining. The research changed the global response to AIDS. Other groundbreaking work at the PGI includes – the concept of verbal autopsy to determine causes of death; Dr Vijay Kumar’s (former head, pediatrics) work on Acute Respiratory Infection in children, which shaped national policy and community medicine department’s model of asphyxia management in the community and care of low birth babies. That apart, PGI’s research output can get better. Although second only to the AIIMS in the national ranking of Indian medical colleges for their research performance in allied sciences, PGI’s publications have lower impact value (average citations per paper) than many other institutes like AIIMS, Sanjay Gandhi Institute of Medical Sciences, Lucknow and NIMHANS, Bangalore. On impact value, PGI is a distant ninth among the top 30 medical institutes of India. “Impact is critical. It reflects the quality of research. Patient load is taking a toll on research in the PGI,” says ex-PGI Director SK Sharma. Some PGI brains in top global positions are Patrick Kamat, Head, Hepatology, Mayo Clinic, US; Nageshwar Reddy, Chief, Asian Institute of Gastroenterology, Hyderabad; Randeep Guleria, HOD, pediatrics, AIIMS; SK Sharma, HOD, Medicine, AIIMS and Suresh Sharma, HOD, ENT, AIIIMS. Scope of improvement The PGI has some catching up to do considering AIIMS research has shaped national health policy more formidably than other institutes. Though the PGI contributed to TB control DOTS programme; calculation of national Asthma and non communicable disease burden, AIIMS pioneered the advocacy of iodine fortification of salt for goiter cure (Dr Ramalinga Swamy’s Kangra study which led to national iodine deficiency control programme); improved ORS anti-diarrhoeal solution for children (MK Bhan’s work); anti tobacco programme (K. Srinath Reddy’s advocacy on risk factors for heart diseases) and Integrated Child Development Services, whose concept was shaped by Dr DN Tandon in the late 1970s.
Experts Speak
I joined the institute in 1972 as a junior resident. Things were very different then. The doctors had the time to interact in length with patients. Teachers had sufficient time for students. |
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Here, hands cure better than machines
Chandigarh, July 6 Now in its golden jubilee year, the PGI has never allowed its shortages — of manpower, machinery and medicines — and controversies to come in its way of serving the suffering humanity. A brainchild of the then Punjab Chief Minister Partap Singh Kairon, PGI was one of several institutions of excellence — Punjab Engineering College being the other one — that attracted the then best available talent in the country. Some of the great names in health care, including Dr Tulsi Das, Dr SS Anand, Dr PN Chhuttani, Dr BK Aikat, Dr BNS Walia, Dr IC Pathak, Dr BK Sharma, Dr JS Chopra, Dr KS Chugh, Dr VK Kak, Dr PL Wahi, Dr JS Gujral, Dr RVS Yadav and many others, are identified with the PGI. Interestingly, the PGI drew majority of its initial faculty from Government Medical College, Amritsar, one of the oldest in the region, followed by medical colleges in Shimla, Patiala and other places. Being in public sector, it could not immune itself from resource crunch. When the Total Body scans arrived in 1980s, patients of the PGI had to be brought to a private diagnostic center in Sector 17 for CT scans. PGI got
its own Total Body scan much later. There is a long and unending list of eminent personalities who were treated at the PGI over the years. One major controversy that rocked this premier institute was during 1975 Emergency in the country when spearhead of the campaign against emergency, JP Narayan, was kept in the PGI. His room in Nehru Hospital room was notified as "jail". It was here his kidney ailment turned serious and the PGI was blamed for improper diagnose. Ultimately JP was taken to Jaslok Hospital in Mumbai for treatment. Former President Giani Zail Singh, who was injured in a road accident near Anandpur Sahib, perhaps had one of the longest stays in the Intensive Care Unit of the institute before he passed away.
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Some core concerns & nagging troubles
Overload turns it into a 'civil hospital' The deluge of routine patients is hitting the faculty and research work hard. Dean, Dr Amod Gupta says: "This place has become a civil hospital". Dr SK Jindal, chairman of the celebration committee, seconds the opinion. 'Patients are what a hospital needs, but it must be remembered that the PGI is an institute for education and referral cases. But routine ;patients flood this institute, as a result ihas turned into a civil hospital," says Dr Gupta. "Seeing routine cases is a sheer waste of expert manpower," asserts Dr Jindal. The institute witnesses more than 7,000 patients daily. The average annual growth rate of patients coming to the PGI is 25 per cent. PGI Director Dr Yogesh Chawla says: "Upgrading hospitals in the neighboring states would greatly help us." Former directors - Dr IC Pathak, Dr BK Sharma and Dr SK Sharma — also feel that the load on the tertiary facility can greatly be reduced. Staff crunch The hospital staff is definitely not consummate with the growing rush. A communication seeking 2,200 staff members, including doctors and nurses, has already been forwarded to the Ministry of Health. Dr Jindal says, "The super specialty wings are reeling under 50 per cent shortage". Space woes Due to the increased patient rush, parking woes have worsened on the campus. Dr Chawla says, "Besides alternate arrangements for parking, we need an area for expansion of core work - medical research. More super specialties are coming up." High mortality rate The PGI has a high mortality rate of 7.2% The hospital recorded 3,474 deaths in different departments of the hospital last year. The Gross Death Rate in the AIIMS is five per cent and the institute. The PGI has faced criticism over infections because of poor cleanliness. "We are aware about the hospital infection and formed a special committee to work out a permanent solution," says Dr AK Gupta, medical superintendent. No proper help desk An ordinary patient coming to the PGI finds himself at sea. Visitors at the enquiry counters inside the building complain of unsatisfactory answers. Manoj Tewana of Jind says: "The hospital needs to appreciate the fact that a sizable number of patients are illiterate. We need desks instituted at the entrance gate." Long procedures Patients complain about long admission procedures before being able to see a doctor. Says Randhir Singh, a resident of Kathua in J&K: "Despite having a reference slip of my doctor back home for my kidney problem, I had to stand here in a queue for getting an admission slip.
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‘We need three times the faculty we have’
On the eve of Golden Jubilee of the PGI, Director Yogesh Chawla spoke to The Tribune about past achievements and future challenges. Excerpts:
Are you satisfied with the progress in the past
50 years? We have by and large carried out our mandate of patient care, research and medical education. Patients come to us from as far as Andamans and Nicobar Islands. We are getting a lot of cases of renal transplant from the northeast now. What is your edge in
medical science? We have been the frontrunners in offering super specialty courses like DM in pulmonary medicine and hepatology. We offer 30 super specialty courses. What have you sought in the 12th Plan? We have to start advanced centres in neurology and neurosurgery. We have requested for 2,000 posts across medical specialties and paramedical areas. We need three times the faculty we have. We are also hopeful of setting up a PGI campus in Punjab. How long will it take for PGI to offer online services ? We have completed detailed software requirements for the project. The facility would help us maintain online patient records, online ordering of laboratory investigations, patients billing and support services. What are your future plans? We will soon start courses in clinical and biomedical engineering, multi organ transplant and translational medicine centre. We hope to start heart transplant very soon.
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RENAL TRANSPLANT
The institute introduced minimally invasive method for retrieval of kidney from living donors. This procedure is performed at select global centres IMMUNOPATHOLOGY Started opt-out screening for HIV in emergency and pre-surgery patients demonstrating that such an effort was necessary to sustain control over the HIV/AIDS epidemic Cytology department ran a population-based screening of women in Chandigarh for cancer cervix and breast cancer. Will be scaled up nationally PEDIATRIC ONCOLOGY Recently the institute conducted the first stem cell transplant on a three-year- old Taran Taran boy suffering from rare cancer of the eye - neuroblastoma Virology department started functioning as the Influenza A (H1N1) testing center from August 17, 2009, after nominaiton by Health Ministry HIV TESTING Transfusion Medicine started offering Nucleic acid testing (NAT) is the most sensitive testing for improving blood safety from transfusion transmissible viral infections like HIV, Hepatitis B and Hepatitis C. It detects DNA/RNA presence of virus unlike currently used ELISA tests which detect either antibodies or antigens. Much faster results ENDOBRONCHIAL ULTRASOUND Pulmonary Medicine started endobronchial ultrasound (EBUS) service in 2011 to help in the diagnosis of intrathoracic lymph nodes and masses without use of invasive procedures. Only government department in India offering this service TELEMEDICINE PGI is the first centre in India to provide telemedicine facility to SAARC countries like Bhutan, Sri Lanka, Afghanistan and Nepal CHILDLINE PGI's pediatric centre is running toll-free child helpline and responded to 7,000 calls last year In Chandigarh, institutional deliveries increased from 60% to 76.5% in last three years; In rural Haryana, nutrition counseling by anganwadi workers was more cost effective than health education by health workers on immunization days; in Punjab, incidence of dengue outbreak was 75.6 per 100,000 population
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Tribune Exclusive Drops 11 spots in the assessment of research impact Aditi Tandon/TNS
New Delhi, July 6 In the field of medicine research, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, outranks PGI, Chandigarh. But between them, AIIMS; PGI, Chandigarh; SGPIMS, Lucknow; the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore; and Christian Medical College, Vellore, have got the first five positions in both the rankings (overall and medicine) published by two CSIR scientists. PGI has fallen to the eleventh position when only the impact factor of research is assessed. Impact factor is the average number of citations per paper. For the study, the authors considered citations received for the first three years since the date of publication. PGI’s low impact factor points to its focus on spread rather than the depth of work. PGI director Yogesh Chawla had recently issued a circular to the faculty members asking them to concentrate on not more than two areas of research. “Focus on quantity stems from the fact that number of published papers matter for better faculty positions at every level. The circular will help us focus better on the quality of research," said SK Jindal, head, Pulmonary Medicine, PGI. The first-ever rankings of Indian medical schools were published in the Annals of Library and Information Studies recently. Study data came from the international bibliographical database SCOPUS and top 30 Indian colleges with higher research output during 10 years were ranked. In 10 years, India’s medical research output was 3,34,476 papers. The top 30 colleges published 33,001, 9.87 pc of the national share. AIIMS published 8,021 papers (2.4 pc share in Indian output) and PGI published 4,791 papers (1.43 pc share). In medicine, India contributed 65,436 papers; the top 30 colleges has 42.69 pc share in the national output. AIIMS with 6,742 publications has 10 pc share; PGI made up 6.16 pc with 4,036 publications but fell behind SGPIMS, Lucknow, which came second despite a mere 2.9 pc share in national publications due to better quality of research. On the research impact, NIMHANS with impact factor of 3 tops the list. Next come the Institute of Postgraduate Medical Education and Research, Kolkata, has 3.15; SGPIMS, Lucknow, with 2.77; King George Medical College, Lucknow, with 2.5; AIIMS with 2.54; CMC Vellore, with 2.27; BHU Medical Science Institute with 2.2; St John's Medical College, Bangalore, with 2.14; Nizam's Institute of Medical Sciences, Hyderabad with 2.04; GMC, Nagpur, with 1.99. PGI, Chandigarh is a remote 11th with 1.97.
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Laila Khan was last seen near Mumbai
Mumbai, July 6 According to sources, the police has so far traced Laila's last location by tracking her mobile phone to Igatpuri. She was last seen there more than a year ago. Earlier this week, her step-father Parvez Tak reportedly confessed to having murdered the family after the Jammu and Kashmir police arrested him. Following information provided by Tak, the police has arrested another person, Asif Shaikh, who had accompanied Laila, her mother Saleena, her elder sister and twin siblings. The police here says it is still trying to verify whether Shaikh was married to Saleena. "We are waiting to question both of them," Joint Commissioner of Police (Crime) Himanshu Roy told reporters here. Shaikh is a resident of Juhu Galli in suburban Mumbai and had been on the run ever since Laila was reported missing. Laila’ biological father Nadir Shah Patel, who filed a missing person's complaint following the disappearance of the starlet and her siblings, has provided important information to the police, sources said here. Patel had told the police about a fire in the Igatpuri bungalow around the time of the family's disappearance. Apart from Tak and Shaikh, Patel has also named one Shadgir from Kishtwar in Kashmir as a suspect, the police said.
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A first: K’taka to get bio-fuel outlet
Bangalore, July 6 The “bio-fuel bunk”, on the Hassan-Channarayapatna highway, would get supplies from the nearby bio-fuel park with a capacity of producing 300 litres per day, he said. Karnataka government plans to open 20 such bio-diesel outlets over a period of one year. As many as 70 institutions had been identified to aid bio-fuel research and a total of 746 seed centres would be opened in the next one year to cultivate and supply bio-fuel, Ramakrishna said. He said Karnataka would strive to dislodge Maharashtra from the second spot in the production of bio-fuel in the country by increasing its production to 200 million litres by the end of the year. At present Uttar Pradesh and Maharashtra occupy the top two slots in bio-fuel production. The KSBDB executive chairman said bio-fuel related plantations (neem and honge) were now spread over 1.35 lakh hectares in Karnataka. There is scope to expand the area, he said. Karnataka would invest Rs 200 crore under various schemes to give a boost to the sector, he added. He said a private company had set up a bio-fuel production unit in Bangalore with a capacity of producing 3,000 litres a day. It has tied up with the Bangalore International Airport Limited (BIAL) and is supplying fuel for 20 per cent of the ground transport vehicles there. Ramakrishna said the government was in talks with BIAL to ply 1,400 taxis attached to the airport on bio-fuel.
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Good news for diabetics
Hyderabad, July 6 The scientists found that “knocking out” a gene in mice led to higher insulin production and better glucose tolerance. The malfunction of the beta cells leads to non-production of insulin or production of ineffective insulin. In either case, the problem is manifested in the form of diabetes. The CCMB team could regulate the mass of beta cells in pancreas in the mouse model. There are several significant medical implications of this research, the most important being the successful management and control of diabetes. The quantity of pancreatic beta cells determines whether a person is diabetic or normal. The team, comprising Satish Kumar, D Partha Sarathi, Shalu Singh and Vijay Pratap, genetically engineered a knockout strain of mice which lacks the gene 'Wdr13'. The scientists inactivated or 'knocked out' an existing gene in the mice by replacing or disrupting it with an artificial piece of DNA in the embryonic stem cells. “We have found that without Wdr13, the mice had higher pancreatic islet mass and blood serum insulin levels. As a result of the increased islet mass, the knockout mice had better ‘glucose clearance’ as compared to their counterparts with the Wdr13 gene. In other words, knocking off the gene WDr13 will help diabetics to clear blood glucose quite effectively,” the team leader Dr Kumar said.
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6 get life term for custodial deaths
Mumbai, July 6 In a case dating to 1998, Munishwar, an accused of a small time theft at Umarkhed in Yavatmal district was badly beaten up by a police officer while he was being questioned in custody. Four police officers have been awarded life imprisonment. In another case dating to 2003, Tarachand received similar treatment after he was nabbed for a minor theft. Two policemen have been awarded life imprisonment in the case. — IANS
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The PGI has provided highest quality of patient care, produced best medicos and educationists, who have established their names in international arena, and set up landmarks in research activities.
The best talent joined PGI since its inception. Rich people have many options. But this is the only institute on which the poor and middle-class patients rely for best treatment
The teaching standards at PGIMER are recognised all over the world. Still the ever-increasing patient load and frequent strikes by the employees have affected the quality
of patient care.
PGI has many feathers in its cap. The facility of dialysis started here in 1963 and the institute was the first medical centre in country to set up a separate Department
of Nephrology
Chandigarh, July 6
CANCER SCREENING
H1N1 TESTING
COMMUNITY MEDICINE RESEARCH