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Review article by Dr Michelle Fernandes et all

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Smoking during pregnancy and vision difficulties in children: a systematic review

Image result for dr micheel fernandesCover image for Vol. 93 Issue 2


Cigarette smoking during pregnancy is a major public health concern. Intra-uterine exposure to maternal cigarette smoking is associated with increased risks of growth and neurodevelopmental problems during childhood and later life. Few studies have focussed on visual difficulties in children in the context of maternal smoking during pregnancy. A systematic search of online databases was carried out between February and May 2013 to examine the trend in visual outcomes in children exposed to maternal cigarette smoking during intra-uterine life. Twenty-four non-randomized studies were identified. Each study was rated for quality using the Newcastle-Ottawa Scale. Most studies (n = 18) reported fetal exposure to active or passive maternal cigarette smoking to be associated with an increased risk of adverse visual outcomes in children. In particular, there were higher rates of strabismus, refractive errors and retinopathy among children of women who smoked during pregnancy. These findings suggest that fetal exposure to cigarette smoke is a significant risk factor for visual problems during later life and that certain visual faculties, such as the intraocular muscles and retinal neurons, are more affected than others. The findings provide evidence in support of public health policies aimed at reducing fetal exposure to smoking by advising both women and their partners to quit smoking during pregnancy.

We gratefully acknowledge the contributions of Emma Plugge at the Nuffield Department of Population Health and Karine Barker at the Radcliffe Science Library, University of Oxford. We are grateful to the Nuffield Department of Obstetrics and Gynaecology and the Li Ka Shing Foundation for supporting this work.

  1. Dr Michelle Fernandes had primary responsibility for research design, designing of the analytical framework of the study, database searching, evaluation of studies and performance of the final analysis, and in the writing of the manuscript. Dr Xiao Yang had primary responsibility for database searching, review of the papers, data collection and analysis, quality assessment and writing of the manuscript. Dr Jinying Li provided professional advice on the aspects of the study relating to paediatric ophthalmology. Dr Leila Cheikh Ismail supervised the design and execution of this work.

    There are no conflict of interests. Dr Yang is funded by the Li Ka Shing Scholarship from the Nuffield Department of Population Health, University of Oxford. Dr Fernandes and Dr. Cheikh Ismail are funded by the Bill and Melinda Gates Foundation via the INTERGROWTH-21st Project and the Nuffield Department of Obstetrics and Gynaecology, University of Oxford.




Dr Joseph Vettukattil's invention could benefit certain heart conditions

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All Things Considered

Spectrum doctor's invention could benefit certain heart conditions

Hilary Farrell
February 9, 2015 | WGVU Pulmonary arterial hypertension is a relatively rare disease of the lung arteries.

“And when this happens, the right [side of the] heart starts struggling because it is under high pressure. It’s not able to send the blood into the lung.”

“And the heart starts failing.”

That’s Dr. Joseph Vettukattil of Spectrum Health.

“So, this device is basically intended to decompress one chamber by making a small hole in the heart to a defined size.”

Dr. Vettukattil is the inventor of the atrial flow regulator.

He’s also the surgeon who performed the first placement of the device in the world.

“My biggest challenge was to make a device which may not have much economic benefit, but a patient may enormously benefit from it."

"That was the most rewarding point for me – to make sure that I could [implant] this device and help a patient.”

Dr. Vettukattil says the idea came from his work with congenital heart disease in children.

And he says it may also be beneficial for other heart conditions – such as left heart failure, with an estimated 3.2 million patients in the U.S. alone.

Spectrum Health received special permission from the U.S. Food and Drug Administration to perform the surgery.

The device needs more study, testing and research before entering the larger market.

Dr. Vettukattil says they’re currently looking at what the next steps may be – including the possibility of partnerships with other interested entities.

She is an angel for under privileged people

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Meet Dr. Sylvia Karpagam who has been visiting slums in Ejipura and Devara Jeevana Halli to help people suffering from health issues.
In 2007, Dr. Sylvia Karpagam returned to India from UK to work for slum-dwellers. She realised that there were a few doctors working for the slum-dwellers.  She had to stop higher studies in South Hopton in United Kingdom in 2007 and return to Bengaluru to serve patients from economically poor families.
Dr. Sylvia Karpagam was like an angel for slum dwellers of Ejipura and DJ Halli. She took an initiative in DJ Halli to draw attention of not only government officials and service providers but also elected representatives, NGOs and social organisations to build pressure from various quarters and make the state government to discharge its duties.
In 1989 she graduated from St. John’s Medical College in MD (community medicine). Her first job at Asha Kirana Hospital in Mysore gave her a chance to experience the emotions and behaviour of HIV positive patients who came from different walks of life.
Few years later she moved to Delhi for her research work at Center for Social Development.  She returned to the city and was a consultant for many NGOs that work for community health.
In 2013, the Bruhat Bengaluru Mahanagara Palike (BBMP) evicted people residing at EWS quarters. The residents were not only deprived of shelter but also food and other basic amenities. Dr. Sylvia was a great help for around 50 families who were dwelling on the road. Many NGOs and multinational companies supporter her endeavour to help the slum-dwellers by providing free medicines and financial assistance.
Parveen Taj, a slum dweller said, “At the time of demolition, I was suffering from a fractured leg and was rushed to Bowring and Lady Curzon Hospital. Dr. Sylvia ensured financial help, medical support post discharge and also helped my daughter’s education.”
She also helped a number of slum-dwellers to avail treatment at the Primary Health Centre situated at Vannarpet.
Expressing same opinion, another slum dweller, Esther Lakshmi, said, “My grandson was admitted to a school by Dr. Sylvia.  She and friends paid the school fee. When my daughter Suganthi suffered burn injuries in a fire accident, she arranged funds for treatment and also advised the government officials to issue disability certificate.”
Arun Selva, a member of PUCL said, “Dr. Sylvia and team of volunteers helped in chipping with the basic health care. People living in slums could not afford a square meal post demolition and health checkup like blood pressure, diabetes and anemia became a primary concern. Thanks to Sylvia that she served the people without any expectations in return. She also ensured that frequent health check-up of slum-dwellers takes place and children get education at schools.”
Venkatraman Iyer, a resident of Koramnagala 3rd Block said, “I have not met Dr. Sylvia personally but have heard a lot about her contribution towards community health. Severe cold and open drains added to the woes of people dwelling on the roads. She is like an angel for them.’’ Dr. Sylvia has a family. She manages to spend time with her family in spite of her busy schedule in serving the community. She said, “My inspiration was my father who was an investigation officer at Indian Air Force. He involved in community service and then I realized that I too have to contribute to society.”
Her policy is to help poor and under privileged to become independent from being dependent.

She is a writer and a cartoonist. Her Blog ‘Random Thoughts’ has her writings that are thought provoking largely based on the current issues prevailing in the country. Her paintings express the various issues concerning women. This story of Sylvia is soul searching for those who can serve the community and still throw up their hands in the air and continue to be silent spectators.

--Rashmi Patil


Rest in peace Dr S A Chinnappa

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Dr S A Chinnappa was from batch 1975.His classmates just came to know of his demise recently, even though his passing was more than a year ago .

Chinnappa passed away on 24th April 2013.He is survived by his wife and three children.His wife is a teacher in a school in Harihar, his eldest son is a dentist, second one dong his Medicine in a East European country and his daughter has just finished her MBBS final year exams.

He worked at Vijaya Marie Hospital, Siruguppa [1987- August 1991] after which he was at Employees State Insurance [E.S.I] Hospital, Harihar for 22 yrs till he passed away on 24th April 2013. Chinnappa also worked part time at Our Lady of Health Hospital, Harihar as his service to the Church.

He is  sadly missed by his family ,friends and classmates.He was much fun and at the same time scholarly and hard working while he was in medical school.

May his soul rest in peace.

Condolences messages

Chinnappa was a really wonderful person.  Very quiet.   Had a good bit of time together for various classes.  Never saw him annoyed.  Had  a brief contact through Facebook about two years ago.  Well difficult to come to terms with the fact that he is no more with us.  My condolences to his family.  May his soul rest in Peace. Mathew Sebastian

He was our source for the weekly phantom and mandrake comics. George Dsouza

I am sad to hear the sad demise of Dear Chinnappa long ago with out any one of us knowing about it. Thanks to Dr.Chinnppa who worked in our hospital of jmj in Vijaya Marie in Siruguppa which is a rural hospital. May God reward him with His eternal bliss for the good work he has done on this earth for the rural and poor. Belated heartfelt condolences to his wife and family with love and prayers Mary Thomas

So sad to hear this news. about 2 or 3 years ago Salais had asked me to add Chinnappa to my Facebook friend list. I did so and also asked Carol to add him to the SJMC Facebook group. I also asked Meenakshi to add him to her friend list.It was so sweet of him to thank me especially for these small things. Gone too soon.
Will miss you Chinnappa.Will pray for repose of his soul.Good to see that his family is well situated Johny Allencherry.
Sad  to hear the news. Remember the quiet guy next to our dissection table. RIP my friend.
Deepest condolences to his family. Chou

Chinnappa's friendship was the ultimate 'home-comfort' I enjoyed in D- block. On a quiet holiday afternoon, he was always there with a comic to lend. Quiet, unassuming and extremely friendly.........
He was a loner like Phantom and like the latter he has no end in our hearts....Sasikumar Louis

Yes , Chinappa was a quiet guy. He could always smile and say hello when ever you met him. Jayan Thomas

albeit late, my condolence to his family. Although I did not know him much, he has a history and legacy known by God and unknown by us .  A quite simple guy , never caused trouble to anyone or harmed anyone. Anotonio Ferrao

Hadn't seen him since the 80s, He was a good soul, My condolences to his family..May his soul Rest In Peace CM


Govt can't force St John's to part with seats: HC

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BENGALURU,Feb 11, 2015, DHNS:

The High Court said on Wednesday that the state government cannot force City-based St John's Medical College, an unaided religious minority institution, to surrender 25 per cent of its medical seats to the government in lieu of granting approval to the college to increase seat intake. DH file photo

The High Court said on Wednesday that the state government “cannot force” City-based St John’s Medical College, an unaided religious minority institution, to surrender 25 per cent of its medical seats to the government in lieu of granting approval to the college to increase seat intake.

Justice B V Nagarathna directed the state government to consider its application for essentiality and feasibility certificate within two weeks.

The court disposed of a petition filed by Catholic Bishops' Conference of India Society for Medical Education and St John’s Medical College.

The petitioners approached the Rajiv Gandhi University of Health Sciences (RGUHS) in March 2014 to increase their medical seats from the existing 60 to 150 for the 2015-2016 academic year .

The RGUHS had inspected the medical college and hospital and recommended increasing the seat intake. The state government, which had to provide approval to the college with essentiality and feasibility certificate, however  laid down a condition that the institution should surrender 25 per cent of its seats.

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