Global Update

Indian Pediatrics 2000;37: 1160-1161

News in Brief

Ethics
Separation blues: One wonders at the complexities of the law and the principles of natural justice. Judges in UK are spending sleepless nights pondering over whether a pair of Siamese twins Mary and Jodie should be separated or not. The parents had come from a remote Mediterranean island to UK for the birth when it was discovered that the twins were conjoined. Mary has no heart or lungs and is dependent on Jodie for survival. Left to themselves the twins will not survive beyond 6 months while surgery will save Jodie at the cost of Mary. The Roman Catholic parents do not desire surgery but the hospital appealed to the court that surgery be allowed. A London high court ruled that the surgery be done but Mary’s lawyer has appealed the ruling. In England the law does not allow the death of an individual to save the life of another. It goes back to a famous case in 1884 of Dudley when two seamen who were lost on the high seas, killed and ate the cabin boy. They survived till rescue ships arrived but were subsequently held guilty of murder in the court of law. In the current case the doctrine of neccessity will have to be developed slightly further as while the cabin boy was not harming the seamen, Mary imperils the survival of Jodie (BMJ 16 Sept 2000).

Consumer watch

Patient pleas: For years doctors have enjoyed demi-god status with not many patients daring to question or criticize. But easy access to information has empowered the consumer who no longer fears to complain or expect the best. In 1995 the Supreme Court ruled that doctors could be sued in consumer courts despite all attempts by the Indian Medical Association to disallow this. But the gap between the crime and the court still yawns wide. Recently the Voluntary Organization in Interest of Consumer Education studied redressal mechanisms in 81 hospitals in Delhi, Hyderabad and Lucknow and 86 cases of negligence. In less than 50% of hospitals were any systems to address complaints operational. Further very often doctors refused to certify against other doctors. In other countries like Spain, consumer societies are planning to publish a website listing doctors with negligence cases against them. In Israel the new health minister has transferred the hearing of medical negligence cases to the Justice Department and in the US a bill is pending which will enable consumers to access the information of malpractice suits filed against all doctors. The consumer movement in India is wakening up and it’s time for doctors also to increase their accountability (BMJ 9 Sept 2000).

Return of the rota virus vaccine? The future of the tetravalent rhesus rota virus vaccine is uncertain. The vaccine which was introduced into USA in August 1998, was withheld from July 1999 when a clustering of cases of intussusception were reported following vaccination. The additional risk of intus-suception was calculated as 1 in 10,000. The question at hand is whether trials of this vaccine should continue in developing countries. Not enough numbers have been vaccinated with the Bovine rota virus vaccine to determine whether they also may precipitate intussusception. Those who are enthusiastic about the rhesus vaccine’s continuation feel the lives it will save in poorer countries far outnumber the risk of intussuception. Others are indignant that there should be two standards of care, one for USA and one for the rest of the world (BMJ 2 Sept 2000).

Gouri Rao Passi,
Consultant,
Department of Pediatrics,
Choithram Hospital & Research Center,
Indore, India.
E-mail: [email protected]

Clinical Evidence - www.clinicalevidence.org. The full text of this quarterly journal from the BMJ publishing group is now available free on the internet. This journal contains meta-analysis of controversial issues in various specialities including topics of pediatric interest .

Bronchoscopic Aspects of Human Lung Diseases - www.korb1.sote.hu/broncho/album/album000.htm. The collection of broncho-scopic images from the Koranyi National Institute of Pulmonology, Hungary can be accessed from this site. The description images and notes cover comprehensive bronchoscopic care including normal anatomy, biopsies, malignant tumors, and therapeutic broncho-scopy. The images are of real bronchoscopic quality and will be a useful teaching aid in pediatric pulmonolgy.

Blood gas tutorial - www.neonatology.org/cin/cbg/bkgd01.htm. The blood gas tutorial is a web-based computer tutorial and quiz on umbilical cord blood gas interpretation. It has been designed for pediatric housestaff. This is a part of the neonatology on the Web, a popular neonatology site.

Juvenile Diabetes Foundation International - www.jdf.org/publications/aboutjdf.html. This site presents news, reports of research and clinical trials, publications and fact sheets, related links. Examples of statements include- management of diabets in school. Another feature of the website is the quaterly journal - Countdown. This provides articles on the effects of research on the way people with diabetes must live their lives. The Juvenile Diabetes Foundation International (JDF) is a leading nonprofit, nongovernmental funder of diabetes research in the World and has been founded in 1970 by parents of children with diabetes.

Pediatriclinx - www.pediatriclinx.com. The latest articles in various pediatric journals are listed in this site with abstracts.The journal collection includes most of the international journals.The news can also be customised into various subspecialities. Users can also avail of free email delivery of contents. This site is a convenient way of keeping abreast of the latest happennings in pediatrics. This site has been developed by MDlinx, a network of 34 professional Web sites for physicians and other healthcare professionals.

Apollo life - www.apollolife.com. The apollo-life is a health portal from the Apollo hospitals group, India. This is a very comprehensive health portal launched on 15th August, this year with sections for doctors, corporates and patients. The section for doctors contains a medical encyclopedia, medical news, medline, second opinion, career center and many features. The patients will find information about various diseases, chatrooms,message boards, health flash - containing the latest health news and sections on parenthood and childhealth. A virtual medical record can be created and stored online for retrieval at any place. An online consultation facility with various specialists is another feature. The child health section has been well designed and provides comprehensive information for parents on common problems.

Bug Bytes - www.ccm.lsumc.edu/bugbytes/ Bug bytes as been developed and produced by the Section of Infectious Diseases at Louisiana State University Medical Center. This is a biweekly newletter that presents a single problem in Infectious Diseases in each issue. The format is brief, and contains information concerning the diagnosis, therapy, or biology of an infectious disease.

C. Vidyashankar,
Pediatrician,
Military Hospital, Namkum,
Ranchi 834 010, Bihar.,
India.
E-mail: [email protected]