Friday November 22, 2019

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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Vaping Can Lead to Chronic Disease in Lungs known as “Popcorn Injury”

This novel disease pattern of airway injury associated with vaping leading to chronic obstruction appears to be distinct from the alveolar injury

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Novel disease pattern of airway injury associated with Vaping leading to chronic obstruction appears to be distinct from the alveolar injury characterizing the EVALI . Pixabay

In yet another serious health alert on e-cigarette use, researchers have documented first-ever case of a new form of damage from Vaping products in a youth which is similar to “popcorn lung,” a condition seen in workers exposed to food flavouring fumes in microwave popcorn factories.

If inhaled, the chemical called diacetyl causes bronchiolitis, which is characterized by the small airways of the lungs becoming inflamed and obstructed.

The 17-year-old patient who narrowly avoided the need for a double lung transplant suffered with this new type of vaping-related injury.

A team from Lawson Health Research Institute in London, Ontario, and University Health Network (UHN) in Toronto described the life-threatening bronchiolitis in a previously healthy 17-year-old male who initially presented for care after a week of persistent and intractable cough and was eventually hospitalized and put on life support.

After ruling out other causes, the team suspected flavoured e-liquids as the cause. The youth’s family reported that he vaped daily using a variety of flavoured cartridges and used tetrahydrocannabinol (THC) regularly. THC is the chemical responsible for most of marijuana’s psychological effects.

“This novel disease pattern of airway injury associated with vaping leading to chronic obstruction appears to be distinct from the alveolar injury characterizing the EVALI (e-cigarette or vaping product use-associated lung injury) have been described cases recently reported in the US, and the seven confirmed or probable cases in Canada, highlighting the need for further research and regulation of e-cigarettes,” elaborated lead author Dr Karen Bosma, Associate Scientist at Lawson.

The case study, published in CMAJ (Canadian Medical Association Journal), provides detailed medical information on the extent and type of injury as well as treatment.

“This case of life-threatening acute bronchiolitis posed a diagnostic and therapeutic challenge,” the authors wrote.

Vaping
In yet another serious health alert on e-cigarette use, researchers have documented first-ever case of a new form of damage from Vaping products in a youth which is similar to “popcorn lung,” a condition seen in workers exposed to food flavouring fumes in microwave popcorn factories. Pixabay

“Given the patient’s intense vaping exposure to flavoured e-liquid and negative workup for other causes of bronchiolitis, we suspected that bronchiolitis obliterans might have been developing in this patient as in microwave popcorn factory workers exposed to occupational inhalation of diacetyl.”

The youth narrowly avoided the need for a double lung transplant, but now has evidence of chronic damage to his airways.

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He is still recovering from his lengthy stay in the intensive care unit, and is abstaining from e-cigarettes, marijuana and tobacco.

“This case may represent the first direct evidence of the lung disease most expected to result from e-cigarette use,” said Dr Matthew Stanbrook, Deputy Editor, CMAJ. (IANS)