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Top Ten Rankings Of The Medical Schools In India

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Top 10 Medical Colleges 2007
By Top Institute Research

111All India Institute of Medical Sciences, Delhi
233Armed Forces Medical College, Pune
322Christian Medical College, Vellore
444JIPMER, Puducherry
569Kasturba Medical College, Manipal
65-Lady Hardinge Medical College, Delhi
776Maulana Azad Medical College, Delhi
887Grants Medical College, Mumbai
998St John's Medical College, Bangalore
10--Madras Medical College, Chennai

Bio Medical Innovations Programme

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St. John's entry for the Piramal Prize

The Team
Ravi Nayar, This e-mail address is being protected from spambots. You need JavaScript enabled to view it  
S Venkatesh, This e-mail address is being protected from spambots. You need JavaScript enabled to view it


The Problem

  • What are the area(s) of intervention that best represent your innovation? Please select all that apply.

    Technology-Enabled Innovations, Other

  • What specific problem(s) in the Indian health context does your innovation address?

    1) Innovations are the need of the hour.Innovations are not part of core curriculum of either Medical or Engineering studies. India needs as many innovators as it has problems , otherwise we will forever be waiting for western solutions to our problems.
    2) Technical innovations in health care need to based on real time problems. These could be generic or patient specific.They also need to be cost effective , and generate enough revenue to make each person in the development chain feel that it is worth his while.
    3) The need is to expose students of medicine, engineering and teachers of both fields to the process of innovations addressing real needs .

  • What community will your initiative serve?

    The target community will be initially students of engineering, medicine , their teachers.
    The products developed will then be introduced into the market , utilising skills of management trainees, and law students .
    The ultimate beneficiaries of the innovations will be patients and doctors. and the society at large

The Innovation

  • What is your solution?

    1) The problem is addressed by the setting up of a formal programme between our two institutions, A medical College and and engineering college.
    2) Real time problems are sourced from the doctors in all departments of the hospital .
    3) These are vetted and forwarded to the Engineering college , which in turn hands it to the students as projects , a requirement for the fulfillment of their courses.
    4) Close interaction is maintained with the doctors who originally gave the problems.
    5) Prototypes are tested after an ethical board approval
    6) The next stage will be the design modification on ergonomic principles
    7) Patency and other issues will be discussed with lawyers or a law college will be involved in this scheme
    7) A managment school will be contacted for market surveys and other such preliminaries to production
    8) the industry will be involved at the end of the exercise.
    the aim is to ensure that all the participants in the chain ,teachers, students of engineering , medicine, law students and management students see the chain of technical enterpreneurship in its entirety , in a real time setting and thereby learn the positive benefits of collaboration between specialities , and the process involved.
    The educational benefit is the primary goal..if India is to learn to help itself and not to perpetually rely on charity from within or without .

  • What makes your enterprise innovative?

    1) Bio Medical Innovations are the very basis of bio medical engineering.
    2)The innovation in this programme is in its attempt to include it in the training phase of engineering and medical students.
    3) Its is hoped that it will induce a mindset change in students .
    4) The programme is already underway for over a year now, 5 projects were selected and 2 have reached prototype stage , these have been presented in conferences and well recieved in their peer groups. The positive impact on the teachers is heartening . The students too are enthused , as their skills are challenged in real time situations , not bookish problems.
    I am personally convinced that if this continues, soon some products will reach the market , further providing a fillip to the students..and this can only be a positive developement in the Indian context. I see most Indian research and project developement as aping the west, either because our role models are western , or we believe the money is there for innovations not in India.

  • How does your initiative “democratize” healthcare?

    Democracy is not only in delivery of a service , it lies also in providing a channel to continously modify the service in the light of real time problems. This is as true in politics as it is in health care.
    This I believe is the main aim of the programme.
    It utilises our vast manpower of engineers and doctors, encourages them to interact early in their respective careers, shows the way by which their education can be put to direct benefit of patients in our settings , and suggests ways and means to make the effort financially viable in the real world.
    Education of this sort is the backbone of any democratic process.

The Enterprise

  • Leadership team and organizational structure.

    Dr Ravi C Nayar - Team leader , in charge of Bio Medical Innovations programme. Heads the ENT Department of St John's Medical College Hospital. Identified the projects and was instrumental in setting up this programme a year ago , which began after a formal Memorandum of Understanding was signed between the two institutions .
    Dr Venkatesh, Assistant Professor , Department of Bio Medical Instrumentation RV College of Engineering. co ordinates the Engineering students and their activities.

    The core team utilises the services of Dr Maruthi , MBBS, MD, Diploma in Engineering, Assistant Professor of Physiology , and Ranjit Kumar, Bio Medical engineer in St John's Medical college Hospital ... and Dr Padmaja Professor and Head of Bio Medical Instrumentation and staff in RV College of Engineering

    The current programme is run on a voluntary basis , with like minded individuals contributing time and effort to help students .

  • Provide a summary of your implementation plan. How do will you turn this idea into action (or how have you already)?

    1) The programme was discussed with the authorities in the two institutes , St John's National Academy of Medical Sciences, and RV College of Engineering.
    2) A memorandum of understanding was signed between the director and Principal of the two institutions respectively.
    3) Projects were sourced from the Medical professionals , discussed with the M tech engineering students
    4)Seed capital was provided from respective departments , and prototypes developed for 2 projects.
    5) Academic discussion in peer groups were encouraged , as was publication in peer reviewed journals.
    6) Now ethical board approval for patient trials is being sought before ergonomic modification and further steps for market feasibility, patenting etc before industry interaction is contemplated.

  • Discuss the current market conditions for your innovation.

    1) Frankly the market size is limitless , because the projects are as many , as there are needs.. and needs in India mimic needs in the vast majority of developing nations
    2) If the programme is given a firm definition and adequate projection , similar programmes can be set up all over the country ./
    3) Hopefully India can take its rightfull place in the community of scientific and technological users . Currently we are so reliant on borrowed technology in most scientific fields that our students are not exposed to the innovative side of science.

  • Please describe your basic financial model.

    1) The need for funding is in two main categories.
    a) Concept funding - This involves basically setting up an office , a lab and other such paraphernalia for administrative efficiency . A budget of 1- 1.5 lakh for running expenses is necessary . The set up costs of a laboratory can be large, but if approached in a step wise manner , using available laboratories in the engineering college, it need not be a limiting factor. ( Rs 3-5 lakhs a year will be ideal at the outset )
    b) Individual project funding - if seed capital of Rs 25,000 - to Rs 50,000/- is assured this monies will be recovered by applying to funding agencies like ICMR, DST or CSIR. Ts 3- 5 lakhs for seed money per year, recoverable.

  • What is your five-year objective for this innovation? Be BOLD.

    1) Establish the concept of innovations for solutions of real time needs firmly in the minds of medical students and engineering students.
    2) The benefit of this approach , in terms of showing the profit of technical learning , both emotionally by benefitting patients, and financially by income generation through patents and product sales, will be demonstrated.
    3) Similar programmes will be established in every state , thereby ensuring that real time needs in far flung areas will be addressed whereever there is an engineering college and medical college together .

  • What is the minimum size of the market required for your enterprise to be sustainable?

    1) At first the model will focus on the two institutions specified.
    2) Attempts will be made to obtain a centre of excellence status from the department of Bio Technology.
    3) The paradigm of Engineering college and medical College collaboration will be propagated in every state thereafter using this as a model.
    4) Financial viability will be demonstrated within 2-3 years .

  • How will you measure the impact of your enterprise?

    1) The impact of the scheme , will initally be on the basis of the number of prototypes developed
    2) The next impact will be on the success of securing individual project funding from conventional funders of such projects
    3) The next assessment will be on the basis of number of patents secured , and industry acceptance of projects
    4) Obtaining centre of excellence certification from the DST is a primary goal
    5) Ability to develope such schemes in other states will be the secondarly goal

  • What is the origin of your idea?

    1) The initiative came through a felt need on the part of doctors during discussions.
    2) It is a truism, that healthcare in India is rendered needlessly expensive because we are forced to buy western solutions for western problems and modify them for our situation .. instead of developing solutions directly for our problems using our enormously talented workforce.
    3)Doctors feel that engineering solutions are too often targetted at making the life of an average western citizen comfortable ( Witness the fact that the main focus of our software industry is providing solutions abroad )


The Lancet | Patient-centred treaments for type 2 diabetes

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Editorial in the Lancet by Dr.Yogish C Kudva | Vol 371 March 29, 2008 1047

Type 2 diabetes mellitus is a common, chronic, heterogeneous disorder that is difficult to control adequately with pharmacotherapy and is associated with other vascular risk factors, target organ complications, and increased mortality.1–3 Today’s Lancet includes a report of APOLLO, a randomised trial that tested insulin-based approaches to improve glycaemic control in patients with type 2 diabetes.

Many drugs, including several forms of insulin, are available to treat type 2 diabetes.5 Experts have recently provided an algorithm to choose among these options largely on the basis of action and cost. Many experts have debated the relative importance of fasting glucose and postprandial glucose as targets of therapy, assessing their association with surrogate measures of control, such as concentration of haemoglobin A1c (HbA1c) and organ damage. APOLLO was done to address this issue.4 A similar study is the Treating to Target in Type 2 Diabetes (4-T) trial that includes an additional group of patients given premixed insulin twice daily. These studies differ in location, study design, and therapeutic targets.

APOLLO randomised patients who were inadequately controlled (7·5–10% HbA1c) with sulphonylurea and metformin to receive either basal insulin (insulin glargine) or prandial insulin (insulin lispro) for 44 weeks. This was a non-inferiority study funded and done by the makers of the basal insulin under evaluation. Both approaches led to similar reductions in concentrations of HbA1c, although patients receiving basal insulin had 78% fewer hypoglycaemic events, less weight gain, and greater satisfaction with treatment than did those given prandial insulin.

To our knowledge, there are no head-to-head comparisons of the basal insulin regimens used in APOLLO and 4-T. There was a larger decrease in HbA1c and fewer hypoglycaemic events with insulin glargine in APOLLO than with the basal insulin regimen in 4-T. In 4-T, the basal insulin was insulin detemir and 34% of patients required two daily doses. Neither trial reported adherence to therapy. We await further results from 4-T, which is scheduled to conclude in July, 2009. Whether targeting of fasting glucose or postprandial glycaemia or both is best to improve diabetes outcomes is unclear and will remain so until evidence emerges that links these to improvements in outcomes that matter to patients.9 The fi nding in APOLLO of greater treatment satisfaction with a less burdensome regimen that achieves similar goals with fewer side-eff ects contributes to this knowledge.

Results of modern trials in type 2 diabetes, however, are diffi cult to apply in practice. APOLLO suggests that insulin glargine should be considered after metformin and sulphonylureas fail; patients might consider this approach consistent with their preferences or may want to try exenatide, an injectable drug that might help with weight loss. The availability of these options will diff er across health-care systems with some limiting patients’ access to the diff erent agents or forcing a particular treatment algorithm that limits access to expensive treatments. Whether this algorithm is sensitive to patients’ preferences and whether patients’ participation in the choice of drugs can aff ect adherence to therapy remains unclear. This issue is important given recent research showing that, for some patients, treatment burden can be worse than the burden of diabetes complications.

Finally, efforts to control glycaemia and improve diabetes outcomes should also consider the effect of the approach on the overall health and risk profile for diabetic complications. In this sense, bariatric surgery has emerged as an increasingly effective option to treat type 2 diabetes and other cardiovascular risk factors. The dearth of independent trials comparing treatment strategies and measuring outcomes important to patients hinders efforts of clinicians and patients to improve the safety and efficacy of treatments for type 2 diabetes.

*Yogish C Kudva, Victor M Montori
Division of Endocrinology and Metabolism, Mayo Clinic,
Rochester, MN 55905, USA
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

YCK has received funding for a research trial from Sanofi -Aventis. VMM declares that he has no confl ict of interest.


Hauling the moving truck Updated Regularly

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Sharon Doss Mascarenhas  from 1988 batch has moved to a group practice in Chicago Illinois from Milwaukee in March 2008. She is board certified in Internal Medicine and hopes to be board certified in Lipidology soon.

Sunil Babu from batch 1990 will be completing a fellowship in Heamatology and Oncology and will be moving to Fort Wayne Indiana in June 2008 to join a private practice group.

Rajeev Fernando from batch 1997 has matched into the Internal Medicine Residency programme at UT Houston and will be joining the programme in July 2008.


Anju Anna Oommen from batch 1999 has matched into internal medicine residency programme  at Morehouse SOM Atlanta starting July 2008 .She and her husband Joseph are based in Atlanta.

 Niraj James from 1998 batch is looking for a residency position .If any one can help him please contact Ivan Chou or Ragaven.


Announcing the marriage of Cardilogist Sanjay Doddamani Johnite from 1990 batch to Arpitha in New York USA.

Sr Mary Thomas Johnite from batch 1975 has been posted to Africa and will be there for a peroid of two years serving patients of different needs.


Dr Ravi Nayar: Innovator,Teacher,Researcher and Surgeon

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A teacher is someone who helps a student learn, a teacher who in addition to instructing  the students challenges  them to  become innovators are uncommon and to be admired. One such teacher is Dr Ravi Nayar Professor and HOD ENT at Saint Johns.He is forward thinking and enterprising .He has through his creativity and help of senior colleagues achieved a tremendous amount  for the Department ENT  in the past few years.What he has done so far is featured here for:

1: Undergraduates: Multi media presentations to make ENT vivid. Taught undergraduates to write case reports with a fair  success.
2: Post Graduates: a nationally recognised certified - DNBE programme to make up for the lack of the MS ( stuck due to politics at State Govt level)- A fully equipped seminar room with multimedia projector, lap top etc..
3. Consultants: Equipments for  encouraging niche specialisations in vertigo, Speech ,OSA -  CO2 laser, microdebrider , etc. so now  there is a systematic  vertigo protocol , OSA protocol and Speech protocol in place, and research activities so directed..
4. Audiology: a 6 month certificate course in Audiology, Speech and Vestibular medicine.for post BSc students - the first of its kind in the country to include Vestibular medicine.
5. For Patients: A digital imaged enhanced discharge summary is now the norm for patients admitted in ENT.  For the Department - All patients records are now imaged, digitised for future studies case report or retrospective For the OT - operative imaging and recording digitised with the help of a donation by Dr Trevor Viegas and Dr Charles Farias
6. Institute: revamped the Cochlear Implant programme, Bio Medical Innovations Programme with the RV College of Engineering. He has also encouraged interdepartmental cooperation by involving surgeons in ENT departmental academic discussions and coordinated a joint protocol for PNS Skull base fungal sinusitis..
7. Academics: ENT Pathology, ENT Radiology, ENT Microbiology, and ENT Anatomy . on a monthly basis with a formal didactic and patient discussion format included.
8. Guest Lectures: 3 sessions last year.. with speakers from Belgaum, Bombay, and even a German endoscopist..more planned...
9. As President of Staff Society: Succesfully commenced various co curricular activities for students, such as the Archery Club, Astronomy Club, Photograpy Club, Trekking Club, Salsa Club, Martial Arts Clubs & Yoga Club etc-with the help of Alumunus Trevor Viegas

In the next year he plans to put together a dissection Lab for the department .Dr Nayar is trying to raise  10000$ to fulfill this project. If anyone is looking to help Dr Nayar out with his efforts at St John's either financially or with advice or contacts, please contact Deepak Edwards @ This e-mail address is being protected from spambots. You need JavaScript enabled to view it


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