Wednesday, August 26, 2009

Localism: The future of mass communication

Sounds quite interesting an idea and one that is worth to think about seriously


Am attaching the complete text here for my personal use.
The way forward for local television would be to engage citizens in debates on prominent problems of their city and make them part of the solution, Rajiv N. Lulla, CEO, NDTV MetroNation said on Wednesday.

In his keynote address on “Localism: The future of mass communication and what it means to you” hosted by the Chennai chapter of the Public Relations Society of India, Mr. Lulla said the key was in increasing citizen’s involvement in evolving solutions to common problems in everyday life.

Local television had the unique advantage of providing local content that was relevant to residents of a particular city that a national television channel with its limited “shelf-space” could accommodate, Mr. Lulla said.

For instance, a programme that invited viewer contributed videos would be impossible to undertake on a national scale but could be a great way to encourage citizen’s participation on local television, he said.

Accountable metrics

At the same time, local television needed to evolve an accountable metrics for advertisers who sought an alternative way to reach out to regional consumer segments, he added.

Preetha Reddy, Managing Director, Apollo Hospitals, said public relations was in essence all about the skill of communication and played a vital role in every organisation. However, the term was not always used in a complimentary manner, she said.

The Chennai chapter of PRSI also kickstarted its activities for the 2009-2010.

Sunday, August 23, 2009

Naresh Trehan, brain behind ‘Medicity’: Interview and few thoughts on it

Naresh Trehan, an eminent cardiologist and the brain behind the Medanta Medicity project has answered questioned from a variety of people in the Indian Express this sunday. Following is the short summary on a few items that he has talked about along with my personal views on them.
  • On the motivation behind creation of medicity:
Creation of a healthcare facility that is patient driven, than target driven. A health care set-up which maintains a high level of transparency, in its governing practices, billing systems and patient outcomes. Also, on top a health care facility that is world standards but still accesible to the possible widest strata of the society and not just a select few.
  1. His mention about publicizing patient outcomes and maintaining atmost transparency on this is a very important thing. Infact, he also mentioned that the outcome studies needed to be presented with a local context. Let me share a personal experience of mine, to better understand this point.
Once an aunt of mine had fractured her leg and there was a blood cot in the knee. We initially took her to a hospital to get the diagnosis, but for a variety of reasons we did not want her to be treated there and decided to move her to a bigger hospital in another city. Trying to hold us in the same hospital, the doctor told us about the risk involved with clots, that they have a tendency to move and can lead to brain stroke or cardiac arrest. We were scared of moving her from that places due to the risk. I then called up our family doctor and enquired about the risk involved in moving her. He said, there is definitely a small% risk involved, but I have not experinced in my medical carrer a patient where the clot due to hurting the leg has moved and led to a cardiac arrest, but you cannot come and blame me tomorrow if such a thing happens in your case because there definitely is a chance, but a chance event that I have not come across in my 15years of medical practice. So putting a statistical data into a context was re-assuring for us to evaluate the risk vs benefit that we gain by taking that risk.

Also on the target driven health care, unfortunately due to the heavy corporatization of the health care facilities in our country, doctors are functioning based on set target of having to accomplish a certain number of surgeries and whole lot per month to show corporate results. I hope this motivation as outlined in this inititaive will set a role model for other hospitals.

  • On the issue of affordable health care:
On a related note, he states that many of the medicinal practices that are followed in the country(on diagnosis, treatment approaches) are blindfoldedly followed based on the data available in the west. This is also an area where he states that MediCity would standout of the rest. I do not know whether use of indigineorus technology, and integrating other indian medicine practices also fir into his goal on affordable health care.

He says lot of health care cost burden can be brought down through dealing with it in the prevention phase. And the use of mobile health disbursal system to adress the rural health care needs.

I think his suggestion that satellite mobile medical mission with the help of qualified doctors instead of rural posting makes a lot of sense.

As regards the accountablity of the doctors his opinion was that doctors should be included in the professional regulatory body.

Thursday, August 20, 2009

"Crazy" Venkatesh: one more post

‘If Venkatesh knows you are here, he might sit up even now,’ we told Kamal. However crazy and wishful the thought, only if it had come true!” Balaji sighs.

Link to a tribute column in The Hindu

Monday, August 17, 2009


‘Possession’ is still very common, especially in rural areas. Even in Tamil Nadu, there are some temples such as Hanumanthapuram where I have observed a group of young women who used to remain in a so-called trance state for about 30 minutes around noon almost everyday. Even if considered a cry for help or attention, this practice gets social sanction and not perceived as a deviant behaviour.

Book Review in The Hindu

Crazy Venkatesh

க்ரேஸி குழுவின் முக்கிய நடிகராக இருந்த வெங்கடேஷ் நேற்று காலமானார். தி.நகர் நானா தெருவில் அவர் வீட்டுக்குக் காலையில் போனபோது க்ரேஸி, பாலாஜி, அப்பா ரமேஷ் இன்னும் நிறைய நண்பர்கள். மௌலியோடு அவசர அறிமுகம் செய்து கொண்டபடி வீட்டுக்குள் நுழைந்தேன் மோகனோடு.

வெங்கட் ஆறு அடி உயர நெடியமால். அவரை இனி எப்போதும் எழுந்திருக்க முடியாத படுத்த கோலத்தில் பார்க்க மனதுக்கு கஷ்டமாக இருந்தது. க்ரேஸி குழுவினர் எல்லோரிடமும் அலாதியான டைமிங் சென்ஸ் உண்டு. வெங்கட்டிடம் இது கொஞ்சம் அதிகம். வங்கியில் விருப்ப ஓய்வு வாங்கி ஒரு ரவுண்ட் சினிமாவில் கலக்க திட்டமிட்டுக் கொண்டிருந்தவரோடு விதி விளையாடிய பலன் - இரண்டு ஆண்டாகப் படுத்த படுக்கை. மைக்கேல் மதன காமராஜனைத் தொடர்ந்து அவரைத் தொடர்ந்திருக்க வேண்டிய வெற்றி ஏனோ விலகிப் போய்விட்டது.

கமல் சார் காலையில் தொலைபேசியபோது வெங்கட் பற்றிச் சொன்னேன். அவர் நேற்றைக்கு சேதி தெரிந்ததுமே போய் வந்ததாகச் சொன்னார். சக கலைஞரை மதிப்பதில் அவருக்கு இருக்கும் அக்கறை தனியானது.

Link from Era.Murukan's web page

Influenza A (H1N1) Revised Guidelines as on 14.8.2009

In order to prevent and contain outbreak of Influenza-A H1N1 virus for screening, testing and isolation following guidelines are to be followed:

At first all individuals seeking consultations for flu like symptoms should be screened at healthcare facilities both Government and private or examined by a doctor and these will be categorized as under:

Category- A

• Patients with mild fever plus cough / sore throat with or without body ache, headache, diarrhoea and vomiting will be categorised as Category-A. They do not require Oseltamivir and should be treated for the symptoms mentioned above. The patients should be monitored for their progress and reassessed at 24 to 48 hours by the doctor.

• No testing of the patient for H1N1 is required.

• Patients should confine themselves at home and avoid mixing up with public and high risk members in the family.


(i) In addition to all the signs and symptoms mentioned under Category-A, if the patient has high grade fever and severe sore throat, may require home isolation and Oseltamivir;
(ii) In addition to all the signs and symptoms mentioned under Category-A, individuals having one or more of the following high risk conditions shall be treated with Oseltamivir:

• Children less than 5 years old;
• Pregnant women;
• Persons aged 65 years or older;
• Patients with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS;
• Patients on long term cortisone therapy.

• No tests for H1N1 is required for Category-B (i) and (ii).

• All patients of Category-B (i) and (ii) should confine themselves at home and avoid mixing with public and high risk members in the family.


In addition to the above signs and symptoms of Category-A and B, if the patient has one or more of the following:

• Breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails;

• Irritability among small children, refusal to accept feed;

• Worsening of underlying chronic conditions.

All these patients mentioned above in Category-C require testing, immediate hospitalization and treatment.

Sunday, August 16, 2009

Beta: The Hindu

இது என்ன Beta(as in Englisha) இல்லை Beta(as in Hindia)..
புளிய பாத்து பூனை சூடு போட்டுண்ட கதை கேள்விப்பட்டிருக்கோம்
இங்க பூனை நெருப்பிலையே குதிச்ச effect வரது..
இதெலாம் வேற நெறைய பேர் 50 வருஷமா படிக்கறவங்க letters to editorku எழுதுவாங்க..

Thursday, August 13, 2009

திரும்பி பார்க்கிறேன்: இந்த வாரம் சித்ராலயா கோபு

Thirumbi Paarkiraen
(Jaya TV, Monday-Friday, 10 p.m.)
The channel’s much watched show will feature writer-director Chitralaya Gopu, from August 17-21. Beginning as an assistant dialogue writer to veteran director Sridhar, Gopu, whose comedies are ever popular, went on to direct more than 20 films. Catch him recount his experiences in cinema!

Good initiative, but unfortunately by wrong people

குரங்கு கையில் பூமாலை..வேற என்ன சொல்வது..சினிமா current commercial ambience மோசமாக இருப்பதால் தான் பாலசந்தர் சினிமா எடுப்பது இல்லையாம் இப்பல்லாம்..சிரிப்பதா இல்லை அழுகறதா தெரிலே..

Link to the sad story

Wednesday, August 12, 2009

Guidelines for diagnostic laboratories: Swine Flu Testing

Guidelines for diagnostic laboratories pertaining to requirements of infrastructure for testing of specimens for Pandemic Influenza A (H1N1) virus infection (based on CDC/WHO guidelines1)

General Bio-safety measures: Gloves (latex), shoe cover, head cover, goggles, triple layered mask, mask with N-95 specification, front closed full length apron, puncture resistant autoclavable yellow coloured bio-safety bag with bio-safety symbols, hypochlorite solution. (As per bio-safety manual attached as Document 2).

Civil Infrastructure: Separate dedicated areas for sample handling and PCR testing as per recommended guidelines (Document 3).

Sample collection kit: Throat/Nasal swab with synthetic up (polyester or Dacron) and aluminium or plastic shaft sample collection vials or tubes (leak proof and autoclavable) containing 1-3 ml. virus transport media (with protein stabilizer and antibiotics) as primary container.

Sample storage: Refrigerator (4-80 C) for storage up to 48 hrs. Deep freeze (-700C) for longer storage.

Back up sample for future testing etc. should be kept at -700 C.

Sample Transport: Absorbent cotton, tissue paper or waste newspaper for wrapping primary container. Secondary container to hold the primary container i.e. bigger tube or sealed plastic bag. Insulated ice box with ice pack, sample proforma fastened on to the secondary container.

Sample handling and testing:

Handling: In BSL-3 Bio-safety or BSL-2+ facility with BSL-3 precautions.

Testing: Real time RT-PCR test, by Real Time PCR machine using validated reagents accessories and protocol as per CDC/WHO guidelines/testing protocols3 and subsequent amendments published from time to time.

Reporting of Results: Standardized uniform reporting proforma. PC with internet facilities, fax machine.


1. collection.htm
2. WHO¬¬¬_CDS_ CSR_LYO_2004_ 11/en/
3 . dated 28th April 2009 and 30th April,2009

Tuesday, August 11, 2009

Press release from Jan Arogya Abhiyan on Swine Flu

Lack of clear-cut swine flu guidelines, to citizens and private doctors, by Municipal Corporation and health officials resulted in unnecessarily long queues in Naidu Hospital. Moreover a lot of confusion continues amongst lay people and doctors about specific steps to be taken.

There are two criteria for throat swab collection and its testing at National Institute of Virology (NIV) and those are: only those patients with cough, cold, fever who had been a) to foreign countries in last eight days or b) in contact with swine flu patients. However this was not made sufficiently clear through newspaper, radio and TV by Municipal Authorities leading to overcrowding at Naidu Hospital.

Even persons not fitting in above two criteria are also getting swine flu infection. Hence there is need to change these criteria and new ones should be properly publicized through media. Even today, there is no clear guideline for private practitioners and doctors. On the contrary on 6th August, government issued a threat of registration cancellation to doctors, through newspaper if they did not take proper care of patients, without making it clear what does it mean to take proper care!

Municipal Corporation printed more than one lakh information pamphlets. But it contains some incomplete and faulty instructions. E.g. ‘wash hands continuously’, ‘avoid congested places’. What does it mean to citizens? Some instructions have been taken from ‘Centre for Disease Control’,USA website. However CDC website says keep 6 feet distance from swine flu patient, PMC pamphlet says only 3 feet! Despite conveying these corrections to concerned health officials, there is no response from them.

No clear publicized information is provided to public and doctors on why only Naidu Hospital is collecting samples and only NIV is testing them, why only Naidu Hospital is providing required medicines.

Directorate of Maharashtra Health services has issued impracticable and vague instructions to doctors in today’s Indian Express.

Jan Arogya Abhiyan demands an immediate end to this indifference by Municipal and Health authorities. There is need to issue proper, scientific instructions for public and doctors through all newspapers and display them frequently on all television, radio channels.

Who one should visit doctors and when? When to directly approach Naidu Hospital and other 15 screening centres? What kind of congested places should be avoided? Who is at greater risk of infection? Who should use mask? What is exact meaning of ‘contact with swine flu patient’? Does it mean spending whole day with such patient or just brief time? Is it necessary to sterilize entire class or office if there is any swine flu patient? People should get proper scientific and specific answers to all such questions.

Private medical practitioners and civil society experts should be consulted while preparing guidelines for public and doctors.

Sunday, August 9, 2009

Swine Flu update: Revised Guidelines from Health Minstry

Revised Guidelines for testing of persons with flu like symptoms reporting at hospitals notified for influenza H1N1

So far, the present guidelines stipulate that a person suspected of influenza A H1N1 need to be referred to an identified govt. health facility. He/she needs to be kept in an isolation facility in that hospital and if found positive, is treated accordingly.
In order to make the testing facility for H1N1 more accessible at large and due to the onset of the Influenza season in the country, it has been decided to revise the existing guidelines.
Under the new guidelines, any person with flu like symptoms such as fever, cough, sore throat, cold, running nose etc. should go to a designated Government facility for giving his/her sample for testing for the H1N1 virus. After clinical assessment, the designated medical officer would decide on the need for testing. Except for cases that are severe, the patient would be allowed to go home (This was not allowed under the existing guidelines).
The sample of the suspect case would be collected and sent to the notified laboratory for testing. If tested as positive for H1N1 and in case the symptoms are mild, the patient would be informed and given the option of admission into the hospital or isolation and treatment at his own home.
In case the patient opts for home isolation and treatment, he/she would be provided with detailed guidelines / safety measures to be strictly adhered to by the entire household of the patient. He/ she would have to provide full contact details of his entire household. The house hold and social contacts would be provided with the preventive treatment.
Notwithstanding the above guidelines, the decision of the doctor of the notified hospital about admitting the patient would be final.

In case the test is negative, the patient will accordingly be informed.
These guidelines have been issued by the Government in public interest and shall be reviewed from time to time depending on the spread of the pandemic and its severity in the country. These guidelines would however not apply to passengers who are identified through screening at the points of entry. The existing policy of isolating passengers with flu like symptoms would continue.

Swine Flu Scenario in Pune

The number of death victims associated to Swine Flu has touched 6(it was 5 when I started typing this) and the scare is quite palpable amongst the citizens of Pune. I have been carefully observing the developments in the last couple of days and wanted to register some of my thoughts on this issue.

First and foremost of the concerns is that it has been more than a week and the government is yet to come with the defined protocol to follow while dealing with Swine Flu. It is understandable in a situation like this, the government cannot work with some pre-set guidelines and needs to condition their strategy and evolve different protocols as the situation demands.

Just the day after the first victim had died, the government attributed it to not approaching the designated health care facilities in time and losing valuable time by consulting the private medical practitioners. In-fact, one of the health department official(I think it is the health minister of Maharashtra) went as far as telling that licensing of the private doctors will be cancelled if they treat someone showing swine flu symptoms.

Just a day or two after that, government is suggesting that private doctors needs to treat them and should not send them away. The ambiguity and dilemma in defining the strategy to deal with how situation evolve is understandable. But should not they deal with some forethought. I mean if within a couple of days, one imagines a scenario of engaging private medical professional in handling the crisis, what is the need to take such an aggressive posture.

And the information also seems going back and forth on all the issues associated, like administering Tamiflu to suspected individuals and everything. The teacher who lost his life in pune was asked to go back and told that he is not a possible suspect by the same government doctors when he has approached them. Such cases are in the rise, so the diagnosing doctors decision whether to send the sample for testing or not is still very ambiguous.

Even for simple things like procuring the masks to protect against the virus, the special protection masks, which are not so easily available at-least needs to be made available to the high risk people such as the pregnant women or other ailing people who are more risk prone and are under medical care and more susceptible to medical infection.

Also with the number of death counts increasing, it is a issue of serious concern, whether the government has any strategy on how intensive and critical care departments will cope with high patient numbers.

It is not just enough to request people not to panic, without making adequate actions that would make them feel confident of the situation.

As regards to spreading the awareness and establishing the proper information to communicate, the fundamental issue as stated in the earlier paras are to establish and define, clearly what needs to be communicated.

One of the doctors on TV, suggested that information spread through radio does not seem to be happening at all, I think all media tools like SMS, FM radio channels all need to be channelized for the information spread. Fortunately it is reported that the spread of the Flu is not large in rural areas, in the event of such a spread, the information spread through Radio needs to be effectively used.

I will keep posting on whatever that in the course of time thoughts I have on this issue that needs to be shared with.