Brief summary of National Seminar on Research Opportunities in Medical Colleges and Role of Medical Faculties as Researcher at Rajkot
The above title seminar was organized by the Department of Community Medicine, PDU Medical College Rajkot on 17th Jan 2014. There were three faculties form SBKS MIRC and one faculty from Dental College attended.
The seminar started at 10 am with inauguration, Vice-chancellor of Saurastra University has inaugurated the seminar. The technical sessions started at 11 am.
In first technical session was key note address. Dr Sanjay Zodpey, Director, PHFI, New Delhi had delivered first key note address on ‘Facilitating Research in Medical College- Current status, Changing dynamics and Futute Direction’. First he focused on SWOT analysis of current status of research in medical colleges. There are many strengths bur weakness are large. Main areas of weakness are lack of research aptitude, complicated institutional mechanism, no incentive or recognization to active researcher, poor partnership with various stakeholders, interdisciplinary communication gaps, no leadership position in private or government setup, research competencies, teaching research in medical curriculum and poor programme and policy partnership. He also told that what is meaning of active researcher? At present there is no clear definition of ‘active researcher’. But he told that we can say a medical person who is getting one grant per year or publishing one or two publications in a year can be considered as ‘Active Researcher’.
He also told that our all weaknesses can be converted to opportunities. Like we can collaborate interdepartment in college, with government or private, training opportunity to create researchers, create research environment in medical college, develop research skills from undergraduates only so they can become good future researchers and many more.
In changing dynamics of research environment he told that Research is the Tool to create knowledge for scientific community and generated knowledge should translated to action for community benefits. We need to understand the Research- Policy – Programme loop. All policies and programme should have available adequate evidences. All researchers should focus on the knowledge generated out of research. Also we need to see that that knowledge shall use for policy programme.
He rightly said on future direction on Research in Medical College that we need to act on the creation of Research Environment in Department and College, all medical colleges shall develop excellent Institutional Ethics Committee and Institutional Research Board for active researchers, Incentive must for the active researchers, capacity building of researchers, possible create research leadership position in state government or in private, vision mission statement of each college in context to research and be a partner for change.
Second key note address of Dr Manoj Pandey, ICMR, BMHRC, Bhopal spoke on role of medical teacher as researcher. He explained that research is the team work. He gave the recent example of Nobel prize winner Bozone particle history. When scientist is announced as the winner for Bozone particle, they approached the Nobel committee and asked this prize should go to all the team members who work for Bozone particle concept. But the committee rejected the condition and decided to give prize to individual. So it time to think about the team work in research.
He also said that medical teacher can play multiple role while teaching like to act as principle investigator in the research, to teach research design to students, collect data and compiled for registry and contribute to database, write article in journals and teach how to write article and most important one he will conduct responsible research with out compromise the ethics. He strongly focus that research is generating evidences which are use for solving clinical query. He also told that in era of private practice the medical teacher do not have time for research. Clinical practice is more motivational than research for teacher. So need some motivational factor for research. He said one very good statement of Enest Leroy that is Poor Surgeon hurts one person, Poor Teacher hurts 130 but Poor Researcher Hurts Millions??? So it require to focus on researcher. Medical teachers can act as best teacher and best researcher for the students. So we need to focus on this community.
Third key note address was by Dr Nilima Kshirsagar, National Chair, Clinical Pharamcology, ICMR and Dean EIS-PGIMSR MGM Hospital Mumbai. She showed the comparison of publication by USA and India. It was very poor for India. Outcome research is also poor in India. She said that due to non availability of data in country, it is very difficult to withdraw any drugs from the market. She gave example of nemesulide. India dose not have policy for withdrawal of drug. The mine reason is the lack of availability of data. If medical colleges take lead in data base for adverse reaction after drug, india can able to make policy.
In the first plenary session, Dr Ashoo Grover, Scientist, ICMR told about the recently developed Department of Health Research (DHR) and ICMR role in research in upcoming years. Government of India has set up department of health research with nine new function with tent one is ICMR. Theses nine new functions are promotion and coordination for applied and out come research in country; focus on research governance issue; intersectoral coordination; advance training; technical support for epidemics and calamities; investigation of outbreak; support to scientific association and societies and last is coordination with government, institutions and other organizations. DHR is focusing maily on human resource development in research and grant in aid for various projects. For human resource development ICMR is conducting series of research methodology workshops in country. They are motivating medical teachers for project proposal writing and submitting. The responses are very good from various part of country. The DHR is also focusing to develop MRU (Multidisciplinary Research Unit) in medical colleges. At present they are establishing in government medical colleges. This is very good opportunities to grab for medical colleges. The budget for one MRU is 5.5 caror. Only two medical colleges form Gujarat are selected for this year.
Second talk in this planery was from Dr. Nilima Kshirsagar about sharing experience of running research cell in medical college in Mumbai. She told that the medical college authority should have long vision without that research can not develop. She shared her experience to establish malaria research center in college and long battle to get good laboratory support form authority. At last when authority got malaria they got the research center. In research initially we need to invest without immediate gain but surly research will give credit to institute in long run. She also gave example of drug interaction. They had one patient who was on eptoin for epileptic condition. It had good control on seizure with eptoin. But suddenly patient came back with frequent seizures. Initially it thought that patient did not have compliance. But patient was telling he is taking regular drug. They asked detail history and found that patient started Shankhpushpi recently as brain tonic. Later with their very good laboratory support they could identify that shanshpushpi is lowering the blood level of eptoin. So she was insisting that medical college should have good laboratory support to measure all blood chemicals.
Post lunch the second plenary session was on scope and collaboration in research with medical colleges. Dr Sanjay Zodpey had focus on scope and role of clinical epidemiology in advancing research agenda in medical college- experience sharing. He mainly focus in experience of INCLEN, International Clinical Epidemiology Network and IndiaCLEN Indian Clinical Epidemiology Network. These network is working for the epidemiological studies in India and providing very good back up services. Similarly medical colleges can establish such data base and support to the research evidences. Medical colleges can take research leadership for future direction. Dr. Dilip Mavalankar, Dean, IIPH Gndhinagar had focus on the grant and scope of collaboration with various international universities. There are lots of agencies including ICMR and different agencies in government and private are giving various grants for research. Medical college can directly opt these grants. He also told that if not possible to get direct funding, medical college can act as consultant to the other agencies and earn the income. Even there are many private sector and NGO are in search of consultant for the research activities. In this condition medical college can act as consultant and earn money. The management authority can work on earning model so the faculty and institute both can earn the consultancy.
The last plenary session was on pitfalls in research publication and need assessment & feasibility study for establishing research cell in medical college. The first speaker was Dr. Yogesh Marfatia, Professor & Head Skin, Baroda Medical College and Editor of Indian Journal of STD & AIDS. He showed the various weaknesses in research publications. Also he stressed on the writing skill need to develop. Medical College faculties can play major role in skill development of the new researcher for writing paper for journal. This is big scope and return to the scientific community. Dr. Deepak Saxena, Associate professor, IIPH Gandhinagar shared his experience of ICME study on need assessment & feasibility study for establishing research cell in medical college.
Research leadership in medical college –
This is the best time to start Research Cell in each medical college like Medical Education Unit. This leadership need to develop and monitor at state level, regional level and national level. The functions and activities of the research cell are
1. Regular training and capacity building of all the faculties for research and ethical issue
2. Research Development Committee under research cell who can brainstorm every year various topics for research and percolate to each department so there is no difficulty in searching topics for the thesis in department.
3. Fully functional laboratory to measure all chemical levels in blood including drug assay study in central laboratory. With department of pharmacy we can plan animal trial for drugs.
4. Multidisciplinary Research Unit (MRU) under Research cell where all different disciplines come closer and work together for research. Collaborative research and multicentric research
5. ICMR is giving extra-mural grant support for any research work. Research Development Committee can plan the capacity building workshops for faculties and apply for grant support. Research proposal writing workshops can plan and do regular follow up for applying grant for research.
6. Active Researcher will be identified and special incentive form the research cell for doing research.
7. Like Pre-PhD, if feasible incorporate the one section on research methodology in paper -1 of all postgraduate exams.
8. Institute can think to do consultancy on research to external bodies live government and private.
The report is prepared by Dr. Niraj Pandit and views and comments are his personal.
Importance of Periodical Health Check up in Industrial Employees
Author – 1. Dr. Niraj Pandit, Professor, Community Medicine, SBKS MIRC, Sumandeep Vidyapeeth, Piparaia
2. Dr. Hiren Patel, Resident Doctor, Community Medicine, SBKS MIRC, Sumandeep Vidyapeeth, Piparaia
The modernisation and innovation in industries and rapid increase in chemical, hazardous, and polluting industries in recent years has not only resulted in unsafe working conditions but has created problems of occupational health hazards. The incidence of occupational diseases is much higher in developing countries than developed ones. In developing countries the workers most exposed to occupational risks are those employed in agriculture, chemical and primary extraction industries and heavy manufacturing. Quite apart from this poor equipment, heavy workload and even poisoning due to pesticide's and organic dusts take their heavy toll on workers, health and safety. Further, work related hazards are changing with the introduction of new chemical substances which pose a threat to community and workers alike. Moreover, occupational risks such as temperature (excessive heat or cold), humidity of air, dampness inducing chill, low air movements and defective lighting in the work place affect the workers. Further other factors like noise, sustained vibration, excessive uncontrolled ionizing radiation, high voltage electric current and abnormal air pressure produce damaging effects on certain organs of the body. Apart from this certain substances cause poisoning or disease in industry. It is, therefore, essential to take effective measures to protect the workers from such risks and dangers.
Many disease of occupational origin require months or even years for their development. Their slow development, very often leads to their non reorganisation in early stages and that is harmful to worker, that is the reason in addition to pre-employment medical check up, the periodical medical check up of worker is very necessary.
In India various Committees and Commissions were appointed from time to time by the Government of India to inquire into the problems of health of industrial workers. Health monitoring or health surveillance at work site is an integral component of health promotion (HP).As per the amendments in 1987 to the Factories Act, more and more vigilance is required to keep track of the health of the employees working in hazardous operations. Health monitoring is the forerunner of all HP activities. In today’s occupational health practice, factory medical officers have the daunting task of promoting the health of employees in industry. Health promotion concept incorporates programmes of health monitoring of employees exposed to potential hazards, general health screening, hypertension, diabetes control programmes, nutrition surveillance programme, stress management programme, fitness programme, etc. Irrespective of the type of HP programme, its potential benefits are plenty. Improvement in productivity is achieved by reducing absenteeism, improving morale of employees, improvement in the ability of performance and developing higher quality staff. HP concept establishes the fact that the organization has concern for the health and welfare of its employees. The supervision of the health of workers is specifically carried out by means of medical check-up periodically. Such periodic tests have become particularly important today because these tests help us to diagnose the earliest deviations in health and permit prevention of illness. Chronic diseases such as hypertension, diabetes can be detected at an early stage. Thus, occupational health service is able to supervise an important sector of the population but the supervision takes place on the spot, thus making it possible to protect and improve workers health without incurring loss of time or absenteeism which would be the case if they had to go to health centers for that purpose.
When the examination should carried out?
The frequency & content of periodical examination will depend upon the type of occupational exposure. Ordinarily workers are examined once a year. But in certain occupational exposures like lead, toxic dyes, radium monthly examination are indicated. Even daily examinations may be needed such as when irritant chemicals like dichromate. Particular care should be given to workers returning from medical leave, to assess the nature and degree of any disability and to assess suitability or otherwise of returning to the same job.
Who should carry out the periodic health check up?
Ideally the Factory Medical Officer should carry out the check up. But many time the industry is large and large number of employees are working, in such scenario they can out source the work to the agencies. They are many agencies and consultant who are working for the periodic health check up. They have full back up of laboratory, radiological, audiometry and other tests. In small industry the FMO is part-time in such scenario also the management can opt services of such agency.
'Actions for Sustainable Biomedical Waste Management"
“Handle the Waste Only” the very important quote read in the presentation of Almitra H Patel, Mamber of Supreme Court committee on Solid Waste Management. He has very rightly focused on waste only. Sometime mixture of waste is creating major problem rather just waste. We all aware that the biomedical waste is hazardous if not properly handle and manage. Today we are going to see the various scopes and opportunities from the management of biomedical waste management, which helps the sustainable biomedical waste management practices.
There are various sporadic actions are taken at country level and each person has tried level best practices for sustainable BMW management. The first missing link is the common platform which is fulfilled by this National Conference on Urban & Biomedical Waste Management 2013. The proceedings of conference should be followed up by the special group people. Here you have opportunity to make networking in each state and at national level.
There are many other issues and challenges in the BMW management. They are awareness and practices about the various aspects to various groups like doctors, nursing, laboratory people, waste handlers, rag pickers and community at large; poor capacity building support; there are more than 6 lac hospitals bad and 23, 000 PHC, thousands of register nursing homes, countless unregister nursing homes & dispensaries and huge number of quacks practicing in every corner of urban and rural area of country- they need support for BMW management; poor management of generation of very small waste which turn to huge burden, poor regulatory measures, poor green procurement policy, rage pickers and waste reuse issue, lack of committed support from top management of hospitals, poor finance for good practices of waste management, poor research support, poor society support and many more. I am looking as each as scope of opportunity. Today my main focus is on this aspect of business opportunity for Young Turk and how to make sustainable waste management practices.
Prof. Dr. Niraj Pandit
Professor Community Medicine,
SBKS Medical Institute & research Center,
Sumandeep Vidyapeeth, Piparia,
Mobile – 09825371135