Tuesday April 7, 2020

National Cancer Institute at Jhajjar: PMO pushes but ministry delays?

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New Delhi: The Rs 2,035 crore National Cancer Institute (NCI), touted as one of the biggest government-run health projects in the country, has got a nudge from the Prime Minister’s Office (PMO). The project was delayed by almost a year, but the PMO directed that it should be completed before September 2017 deadline. And there lies the catch — a key minister doesn’t have the time for it.

The institute is slated to come up at Jhajjar (Haryana campus) of the All India Institute of Medical Sciences (AIIMS) at about 60 km from Delhi. It will offer tertiary care facilities other than those that are meant for cancer.

However, AIIMS sources say the delays have mainly been because of the inability to hold a meeting of the Institute Body headed by Health Minister JP Nadda to award the tender for the construction work. Such important decisions are taken by the Institute Body that is the apex decision-making panel for AIIMS. The Institute Body also chooses the governing body members. However, after the Narendra Modi government assumed power last May, the new Institute Body has not even been appointed.

After a meeting chaired by principal secretary to the Prime Minister Nripendra Misra, on July 11, 2015, a decision was taken which stated, “The project of NCI should be viewed as a flagship health institute project and the construction should be completed six months before the deadline.” IANS has seen the document.

The meeting was attended by secretary of the union health ministry, the chief secretary of the Haryana government, the AIIMS director, the joint secretary in charge of AIIMS in the health ministry, the AIIMS deputy director (Administration), the chief of the Institute Rotary Cancer Hospital (IRCH) at AIIMS.

A senior health ministry official,  revealed, “The ministry had taken a decision to grant total autonomy to the new AIIMS. Greater powers in terms of administration and financial decisions should be given to the institute bodies. That is why a decision has been taken that the contract for the campus in Jhajjar should be granted by the institute body and not by the ministry. This will give them a sense of empowerment, responsibility and help in expediting the decision making in the long run. The AIIMS Institute Body is all set to be constituted within a fortnight and the contract for the construction will be granted immediately after that by the newly-appointed body. This would make the AIIMS’ project run more efficiently in a particular time frame.”

cancer-390322_640The parliamentary standing committee on health and family welfare, on August 11, had also observed that the development of AIIMS campus-II in Jhajjar, Haryana, was an ambitious project and would require not only massive allocation of funds but also sustained monitoring.

The committee wanted health ministry to ensure that development of the project was executed within the initial estimated project costs and time-frame to avoid any time-overruns and cost escalation.

The cabinet approved the project on December 26, 2013. About 300 acres has been earmarked; out of which 32 acre has been allotted for the National Cancer Institute (NCI), which has been assigned more than 700 beds.

But the question remains whether the project will be accomplished within the targeted date. The proposed date of the start of the project was January 1, 2014, and the duration of the project was 45 months. The target date of completion is September 2017.

“The award of work for the institute block at NCI should have been completed within nine months (September, 2014) of the start of the project (January 1, 2014) and the construction should have started in October, 2014. It’s been more than year-and-a-half now, but still the award of work has not been done. How is it possible to complete the work within the stipulated time-frame,” asked an AIIMS source.

The decision to award the tender to Shapoorji Pallonji & Company Limited was taken in the standing finance committee (SFC) meeting of AIIMS on May 26, but the approval had to come from the highest decision-making bodies of AIIMS. The Institute Body has to convene to constitute the Governing Body of AIIMS. The Institute Body meeting is now likely to take place in October.

“The award of work has been stalled for four months, even if it was decided in the last SFC meeting. The Institute Body meeting which was scheduled on August 6 was cancelled by Health Minister JP Nadda. By doing so, the project is getting delayed further,” the source added.

Reacting to this, the AIIMS deputy director (Administration), V Srinivas said, “Statutory clearances from the Ministry of Environment & Forests, National Board of Wildlife, State Board of Wildlife, Haryana, and the Departments of Town & Country Planning, Fire, Irrigation, Electricity Board, PHED and Labour in the government of Haryana for the National Cancer Institute have been received. All efforts are being made to ensure timely commencement of work and adherence to prescribed timeline.”

The other institutes proposed for the Jhajjar campus are National Cardiovascular Centre, General Purpose Hospital, National Transaction and Training Centre, National Centre for Child Health, Digestive Diseases Centre, National Institute of Geriatrics, Comprehensive Rehabilitation Centre and National Institute of Nursing Research.

(Sidhartha Dutta, IANS)

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All You Need to Know About Parkinson’s Disease

10 early signs of Parkinson's Disease

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parkinson's disease
Parkinson's disease and related disorders is common in people above 60 years of age. Pixabay

While the focus remains on the pandemic its easy to forget that there are many other illnesses which patients are struggling with.

Parkinson’s disease and related disorders is common in people above 60 years of age. Parkinson’s disease is a disorder where most tests including MRI Brain are not very helpful in diagnosis or non-contributory (except dopamine scans). So, an understanding of its clinical symptoms and signs is as vital as a diagnosis.

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Dr. Praveen Gupta, Director & HOD, Fortis Memorial Research Institute, Gurugram shares some early signs to keep a look out for.

parkinson's disease
Parkinson disease responds very well to treatment and response may last up to more than a decade, so it is very useful to diagnose it early to restore a patient’s quality of life. Pixabay

1. A pill rolling type of tremor visible in the resting position usually in one hand which improves intruding to move the hand.

2. There is change in handwriting with the writing becoming small and cramped called micrographia.

3. There is sudden quickening of steps which the patient cannot control called shuffling; it is also accompanied by difficulty in maintaining posture.

4. There is shortening of steps leading to short stepped walk and overall time to cover a small distance increases significantly.

5. There is decreased movement of arms while walking and the arm swing is reduced, a sign of slowing.

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6. There are sleep problems with increased dreaming and enacting dreams called REM Sleep Behaviour disorder.

7. There are abnormal limb movements in sleep called PLMS and current like pain in legs called restless legs syndrome.

parkinson's disease
Parkinson’s disease is a disorder where most tests including MRI Brain are not very helpful in diagnosis or non-contributory (except dopamine scans). Pixabay

8. A gradual loss of smell and difficulty detecting or identifying doors called hyposmia during conversation

9. There is a clear lack of expression on face with significant lack of emotive expressions called mask-like face.

10. There is a forward bending of posture leading to early stooping and bending forward.

These early signs are a feature of decreased dopamine in the brain which interferes with sleep and changes in motor function leading to slowness of activities (Bradykinesia medically), stiffness of muscles (rigidity), loss of posture sense and trembling. These features usually affect one side of the body initially and respond very well to levodopa replacing treatments. There may also be some mental and behaviour changes and some patients there is an unexplained loss of weight.

Also Read- Spreading COVID-19 Awareness in Bollywood Style

If the patient walks in the clinic the physician can often start diagnosing based on these early symptoms. Tests are done to rule out other disorders mimicking Parkinson’s disease. Parkinson disease responds very well to treatment and response may last up to more than a decade, so it is very useful to diagnose it early to restore a patient’s quality of life. (IANS)