Gerüchte um eine #Schießerei in der City bekannt. Die Lage ist noch unklar! Bitte meidet öffentliche Plätze sowie U/SBahn #oez #München
Olympia shopping Mall Attack - Catastrophic Alert
Is it a well orchestrated attack by a group of terrorist in Germany?
Cafe shooting report.
One or more than one shooter.
Lage am #OEZ mit #Schießerei ist aktuell noch unübersichtlich. Es gab mehrere Verletzte. Sobald wir mehr haben gibt es weitere Infos.
Staff in the German shopping mall where shooting broke out are still hiding, an employee has told Reuters by telephone.
NTV television reported that German police special forces had arrived at the scene.
“Many shots were fired, I can’t say how many but it’s been a lot,” the employee, who declined to be identified, said from the mall in Munich.
“All the people from outside came streaming into the store and I only saw one person on the ground who was so severely injured that he definitely didn’t survive.
“We have no further information, we’re just staying in the back in the storage rooms. No police have approached us yet.”
Die Mitarbeiter in den deutschen Shopping-Mall , wo Schießen heraus brach verstecken sich immer noch , hat ein Mitarbeiter gegenüber Reuters per Telefon. Fernsehsender NTV berichtete, dass die deutsche Polizei Spezialkräfte am Tatort eingetroffen war. "Viele Schüsse abgefeuert wurden , kann ich nicht sagen, wie viele , aber es ist viel gewesen , " der Mitarbeiter, der abgelehnt identifiziert werden, sagte von der Mall in München. " Alle Leute von außerhalb kam das Geschäft Streaming in und ich sah nur eine Person auf dem Boden , die wurde so schwer verletzt, dass er auf jeden Fall nicht überlebt . "Wir haben keine weiteren Angaben vor , wir gerade in den Rücken in den Lagerräumen zu bleiben. Keine Polizei hat uns noch angefahren . "
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Air Ambulance Germany reported "The Munich transport authorities say they have halted services on multiple train, tram and bus lines after the Munich Mall shooting.
Air Ambulance Germany reported "The Munich transport authorities say they have halted services on multiple train, tram and bus lines after the Munich Mall shooting.
An emergency call was received at 6pm local time after the man opened fire in a drugstore in the Olympia Shopping Centre in the Moosach district of the southern German city.
A police spokeswoman told German media: “We believe this is a big incident”. Police and ambulance crews were on site within minutes of the call.
The man is believed to have fled the shopping centre and headed for a nearby underground station. There was no indication as to the motivation of the attack. But
Germany is on high alert after a man wielding an axe and knife attacked train passengers near the southern city of Würzburg earlier this week.
The Olympia shopping centre is a two-tiered glass covered mall. It was built on the site of the 1972 Summer Olympics. The Munich Olympics was overshadowed by a terrorist attack in which 11 Israeli sportsmen and a German policeman were killed after being taken hostage by Palestinian terrorists.
Shots ay fired sa isang shopping center sa Munich. Narito kung ano ang alam namin sa ngayon: Ulat sabihin ang lugar sa paligid ng shopping center sa distrito ng Moosach ay tinanggal selyadong off, ngunit ang mga detalye ng insidente ay kulang . Ang isang malaking pulis operasyon ay sa ilalim ng paraan . Maraming tao ang namatay , ang Sueddeutsche Zeitung pahayagan quotes pulis bilang sinasabi.
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Die Mitarbeiter in den deutschen Shopping-Mall , wo Schießen heraus brach verstecken sich immer noch , hat ein Mitarbeiter gegenüber Reuters per Telefon. Fernsehsender NTV berichtete, dass die deutsche Polizei Spezialkräfte am Tatort eingetroffen war. "Viele Schüsse abgefeuert wurden , kann ich nicht sagen, wie viele , aber es ist viel gewesen , " der Mitarbeiter, der abgelehnt identifiziert werden, sagte von der Mall in München.
Air Ambulance International
German officials were treating that as the first attack with a jihadi motive by an asylum seeker on German soil.
Over 15 people have reported to have died in a terrorist attack in Munich Mall in Germany.
The situation is being monitored and very tense.
HI Flying has placed its Air Ambulance services in high alert and is willing to transfer injured victims to any hospital of their choice.
Germany’s Muencher Abendzeitung is reporting that up to 15 people have been killed. Again, police have not officially confirmed any casualty figures.
“Many were shots were fired,” an employee inside the Munich shopping centre tells the Reuters news agency.
A police spokesperson as saying several people have been killed and more injured in the shootout at the Olympia shopping mall.
The paper said a large police operation was underway and that the police was “assuming there was just a single perpetrator”.
An employee at the nearby DM drugstore told the paper by phone that she heard “shots and saw injured people ... We can not go outside”.
Air Ambulance International - HI Flying.
Central venous catheters (CVCs) are temporary devices implanted into patients when easy or frequent intravenous access is needed. Doctors often use them. A Hickman line is an example of a CVC. A CVC is used, for instance, for monitoring patients in intensive care, or for giving chemotherapy or intravenous nutrition. However, such catheters can cause blood clots, which can block the line, increase the risk of infection and travel elsewhere in the body such as to the lung (this is called thromboembolism). Heparin is a drug that helps to prevent blood clots and may help prevent these unwanted consequences. But heparin can also cause serious adverse effects (bleeding, allergic reactions, fall in platelet count, etc.). Normal saline solution, a sterile solution of salt in water at a concentration suitable for the blood, is typically used for intravenous infusions. We wanted to know whether heparin helps prevent the unwanted effects of blood clots in CVCs, and if this benefit outweighs its risk of harms.
Six studies with a combined total of 1433 participants were included. The quality of the evidence ranged from very low to moderate for the main outcomes.
Our review found no compelling evidence of a decrease in the rate of blocking of CVCs flushed with heparin compared with CVCs flushed with sterile saline solution, nor of differences in the number of days the catheter lasted, the rate of thrombosis, rate of infection, mortality, bleeding rates or heparin-induced fall in platelet count.
We conclude there is no good evidence that heparin flushing of CVCs is better than flushing with sterile saline solution. As heparin is more expensive, the findings of this review do not support its use except in future clinical trials.
The U.S. State Department said on Friday that it was too early to say who was involved in a hostage situation at a restaurant in the Bangladeshi capital Dhaka or what the motivation might be, but it confirmed that all Americans working at the U.S. mission there had been accounted for.
"We have accounted for all Americans working for the chief of mission authority" in Dhaka, State Department spokesman John Kirby told a press briefing. He said the situation was "very fluid, very live."
11:45pm- Lori Ann Walsh Imdad, principal of American Standard School, wrote on her Facebook page: "Terrorists broke in and shot the Italian baker and his wife and took about 20 foreigners hostage. This is a block from my place so I have a front row seat to the police action."
11:20pm- "We are requesting the ones who are inside the restaurant to talk to us, relay usyour demands," said the RAB DG.
11:20pm- The RAB DG confirms that the gunmen kept the hostages at O'kitchen restaurant, which is a sister concern of the Holey Artisan bakery and operates from the same building at Road-79 in Gulshan 2.
11:20pm- Dubbing the ongoing incident a hostage situation, the RAB Director-General Benazir Ahmed told reporters on site: "We would like to resolve the situation peacefully. And I urge everyone to remain calm and not to panic." He declined to provide further information on the development.
11:10pm- Members of police Dhaka Metropolitan Police (DMP) Bomb Disposal Unit are at the site, confirms police sources.
11:00pm- Three ambulances kept stand-by near the site to move any injured urgently to hospitals, police sources said.
10:55pm- Sumon Reza, superviser at the bakery, who escaped the attack, told reporters that at least 20 people were at the bakery when the attack began and all of them were foreigners. He saw two attackers and both of them were slim and appeared to be under 30. He said they had small firearms and at least one was carrying a sharp weapon. He said the attackers were shouting 'Allahu Akbar' when coming into the bakery. Two of the bakery's staff are also foreigners, he said. One baker, an Italian, had escaped the attack but the other one, an Argentine, could not, according to Reza. His information could not immediately be verified.
10:45pm- Three people were shot at 10:30pm. Of them, two are police personnel, poilce sources confirmed.
10:30pm- An explosion has been heard from the site.
10:20pm- Dhaka Tribune's DMCH correspondent Aminul Islam Babu confirmed the identities of the injured. They are—Abdur Razzak, a driver in profession who took a bullet in throat and police constables Pradip and Alamgir. The police personnel were shot in their right legs.
10:00pm- Assistant Commissioner (AC) of Gulshan Division Police Rafiqul Islam confirmed that three people were shot in an apparent terrorist attack in Gulshan Friday evening. He also said the injured—two police constables and a civilian- have been sent to Dhaka Medical College Hospital (DMCH).
9:50pm- Police is yet to reach the vicinity of the site due to indiscriminate shooting by the unidentified gunmen, Salauddin Ahmed, Gulshan police inspector. A joint team of police, RAB, BGB has been deployed at the site, Salauddin said.
9:30pm- Earlier, Dhaka Tribune received unconfirmed reports of severe gunfire exchanges in several parts of Gulshan and adjacent areas since 8:45pm Friday evening. A Dhaka Tribune reporter received unconfirmed report of the killing of two people at the Holey Artisan bakery in Gulshan-2. Three heavily-armed gunmen entered the bakery and started shooting indiscriminately, leaving the two unidentified people dead. Unconfirmed reports also suggested that the both the chefs of the bakery have been taken into hostage.;
Bangladesh Dhaka Helpline
Gunmen have attacked a restaurant popular with foreigners in the diplomatic quarter of the Bangladeshi capital, and reportedly taken at least one hostage.
Local media reported that a group of up to nine gunmen had entered the Holey Artisan Bakery cafe and opened fire on at around 9.20pm on Friday evening.
Jamuna Television quote a kitchen staff worker at the restaurant who escaped the attack and said that the gunmen chanted “Allahu Akbar” (“God is greatest”) as they launched the attack.
A large contingency of police and security guards cordoned off the area, trading gunfire with the attackers.
Bangladesh has seen a series of attacks, mostly using machetes, targeting bloggers, atheists and religious minorities.
Earlier on Friday, a Hindu temple worker was hacked to death in the south-west of the country in the latest attack blamed on radical Islamists, police said.
At least three assailants on a motorbike fled the scene after hacking Shyamonando Das with sharp weapons, local police chief Hasan Hafizur Rahman said.
The attack happened in Jhenaidah district, 210 km (120 miles) south-west of Dhaka, as the victim was plucking flowers for his morning prayers near the temple, Rahman said. The worker died on the spot.
Gunmen attacked a restaurant popular with foreigners in the diplomatic quarter of the Bangladeshi capital on Friday and the U.S. State department said there was a hostage situation.
Three policemen were wounded by gunfire that erupted as police surrounded the Holey Artisan restaurant in the upscale Gulshan area of Dhaka, a police officer said.
He said there were foreigners inside the restaurant and that police were preparing a plan to enter the premises.
The U.S. State Department said on Twitter that there was a hostage situation in the diplomatic enclave of Dhaka.
Istanbul has been on a high security alert for months after three deadly attacks in the city this year blamed on Islamic State jihadis and the Kurdistan Freedom Hawks (TAK), a radical offshoot of the outlawed Kurdistan Workers’ party (PKK). Less than a month ago a car suicide bomber killed 12 people and wounded several others in the central Istanbul district of Vezneciler.
Globally, terror attacks on the ‘soft’ target of airports are common, and increasingly so. Below is a list, not comprehensive, of the major attacks on airports over the past five years.
June 26, 2016 - Three suspected Islamic State group suicide bombers targeted the international terminal of Istanbul’s Ataturk airport, killing at least 36 people and wounding many others, Turkish officials said.
June 12, 2016 - An explosion at a check-in-area of Shanghai’s main international airport injures four people. The blast at Pudong International Airport, China’s second-busiest, was carried out using fireworks stuffed inside empty beer bottles.
March 22, 2016 - 16 people are killed in two suicide bombings as bombs ripped through check-in counters at Brussels Airport. The Islamic State group claims responsibility for the attack. A subsequent explosion at a Brussels subway station killed 16 more people.
March 7 2016 - A bomb explodes in a piece of luggage at an airport in a central Somali town, wounding three people. Somalia’s Islamic extremist rebels, al-Shabab, claim responsibility for the blast.
December 28, 2015 - A suicide car bomb attack killed at least one civilian near the eastern entrance of the Kabul international airport. Another 13 civilians were wounded. The Taliban claimed responsibility for the attack.
March 21, 2015 - A machete-wielding man attacks TSA officers at New Orleans’ international airport and is shot and killed. Authorities later said he was carrying a bag loaded with Molotov cocktails. One of the TSA officers was slightly injured.
July 18, 2012 - A bomb explodes on a bus carrying Israeli tourists at the airport in Burgas, Bulgaria, killing five of the tourists, the Bulgarian bus driver and the suicide bomber. Another 35 people are hurt. In 2014, Bulgaria’s interior minister says he is convinced the Shiite militant group Hezbollah was behind the bus bombing.
February 27, 2012 - Suicide car bomber struck at the gates of Jalalabad airport in eastern Afghanistan, killing nine people. The Taliban said the attack on the airport, which serves both civilian and international military aircraft, was revenge for the burning of Muslim holy books at an American military base.
January 24, 2011 - Suicide bomber blew himself up in the international arrivals area of Moscow’s Domodedovo airport, killing 37 people and wounded 180 others and was claimed by Chechen rebels. Russia’s Federal Investigative Committee later identified the suicide bomber as a 20-year-old from the North Caucasus region.
Air Ambulance Medevac
Gunmen armed with kalashnikovs and and suicide vests, stormed the entrance to Istanbul’s Atatürk airport shortly after 9pm on Tuesday, killing 36 people and injuring 147.
Turkey’s prime minister has said the attack was carried out by agents of Daesh -using the Arabic term for Isis - but the terror network has not yet claimed responsibility for the attack.
At least two gunmen were involved in the assault, but authorities suspect a third man was also involved. The men caught a taxi to the airport, emerging at the international arrivals terminal where they opened fire.
South African tourist Paul Roos described seeing a gunman shooting at at people indiscriminately.
We came right to international departures and saw the man randomly shooting. He was just firing at anyone coming in front of him.
He was wearing all black. His face was not masked. I was 50 metres away from him.
We ducked behind a counter but I stood up and watched him. Two explosions went off shortly after one another.
By that time he had stopped shooting. He turned around and started coming towards us. He was holding his gun inside his jacket.
He looked around anxiously to see if anyone was going to stop him and then went down the escalator... we heard some more gunfire and then another explosion, and then it was over.
The terrorists were unable to get past the airport’s x-ray security checkpoint, and became involved in a firefight with security and police.
Several video clips circulating online purport to show the gunmen attacking the airport.
Because of their graphic nature, The Guardian has chosen not to show these, and stresses they have not been verified or corroborated. Sources, however, have told The Guardian that the clips seem authentic.
One graphic piece of footage shows people fleeing a man dressed in black and carrying what appears to be a Kalashnikov, who runs into a hall area, before falling, apparently shot, and dropping his weapon, which slides away from him on the floor.
A man, believed to be a policeman or security official, approaches the prone gunman, appearing to point a gun at him for several seconds. The standing man then runs from the prone bomber who, after several seconds, detonates the explosive vest he is wearing.
The attack on Turkey’s largest airport, and the third-busiest in Europe, is yet another ‘soft’ target attack, following on from the attack on Brussels airport in March which killed 32 people and injured more than 300.
It is also the third attack on Turkey’s biggest city this year.
Istanbul has been on a high security alert for months after three deadly attacks in the city blamed on Islamic State jihadis and the Kurdistan Freedom Hawks, a radical offshoot of the outlawed Kurdistan Workers’ party. Less than a month ago a car suicide bomber killed 12 people and wounded several others in the central Istanbul district of Vezneciler.
In the aftermath of the attack, Turkish president Recep Tayyip Erdoğan said the attack showed “the dark face of terror that targets innocent civilians”.
Erdoğan urged the whole world to unite in the fight against terrorism.
“Despite paying a heavy price, Turkey has the power, determination and capacity to continue the fight against terrorism until the end. Today’s attack targeted 79 million Turkish citizens along with 7.5 billion human beings around the world. The bombs that exploded in Istanbul today could have gone off at any airport in any city around the world.
“Make no mistake: For terrorist organizations, there is no difference between Istanbul and London, Ankara and Berlin, Izmir and Chicago, or Antalya and Rome. Unless all governments and the entire[ty of] mankind join forces in the fight against terrorism, much worse things than what we fear to imagine today will come true.”
Speaking at the airport, Turkish prime minister Binali Yildirim said: “our security force’s findings indicate that this terror attack was done by DAESH but we are still working to determine who is behind the attack”.
Yildrim also said it was “noteworthy that this heinous terror attack took place at a time when [Turkey] successfully fights separatist terror and enters a period of normalisation with our neighbours”, an apparent reference to Turkey’s recent rapprochement with Israel and Russia.
Atatürk airport was closed for only a matter of hours before being reopened to flights in and out of the country.
Air Ambulance Medevac Turkey
Gunshots, screams and explosions pierced the air Tuesday at Istanbul Ataturk Airport, as three terrorists armed with bombs and guns attacked passengers at one of the world's busiest travel spots.
Witnesses described deadly carnage and crowds in a panic as the attackers struck.
At least 36 people were killed, Turkish Prime Minister Binali Yildirim said, in the terror attack, one for which there was no immediate claim of responsibility.
Another 147 people were wounded, Turkey's Justice Minister Bekir Bozdag said.
Sue Savage was in the airport to see a friend off when she heard gunshots and then an explosion, which she knew was a bomb. Then more gunshots and another boom, she told "Erin Burnett OutFront."She ducked into a men's prayer room and then into a men's toilet, where she hid in a stall with a young woman. They came out, perhaps 20 or 30 minutes later, and heard more screams and gunshots and ducked into a room where luggage is inspected.
She and about 30 people were herded into a women's prayer room until authorities led them out and down an escalator into the main terminal hall.
"There was a lot of blood," she said. The floor was marked with bloody boot marks and she saw a woman's scarf on the floor. The group was herded around to the other side of the room.
"There was so much glass on the floor they were scuffing it aside so we didn't slip," she said.
Photos: Istanbul airport attacked
Video from inside the airport terminal shows people racing away as fast as they could and the bright orange flash of fire from one of the explosions. Victims stagger and some fall from the now blood-covered, slick floor.
Another video shows a man walking with a gun, which he drops when he apparently is shot by a security officer. The man slumps to the ground and the officer briefly stands over him before running. About 10 seconds later, there is an explosion.
Traveler Laurence Cameron described what he saw after he stepped off a plane.
"It was just a massive crowd of screaming people. Some were falling over themselves. A poor chap in a wheelchair was just left, and everyone just rushed to the back of the building, and then people ran the other way and no one really seemed to know what was going on," he told CNN. "Where you normally hail a taxi, that is where the attack happened. The ground is just kind of shredded. There are bloodstains on the floor as well."
Terrorist attack in Istanbul Ataturk airport
Here’s a summary of what we know so far about missing EgyptAir flight MS804.
Pregnancy and Planned Parenthood news
Parents are standing up against Planned Parenthood infiltrating Iowa schools.
The Obama Administration has put forth more than $5 million towards Planned Parenthood providing sex education to the children, some as young as 5, but pro-lifers and concerned parents are working to keep the abortion giant away from Iowa children, according to One News Now.
According to Ricky A. Rohrig of the Pregnancy Center of Southwest Iowa, Planned Parenthood was already run out of their schools several years ago after the parents realized exactly what they were teaching their young children. One News Now reported that Planned Parenthood was “graphically teaching children about condom use and using stuffed animals to demonstrate sexual positions.” Rohrig went on to say the parents “were not informed prior to their youth being taught this.”
Rohrig explained that three Iowa communities are currently being targeted by the abortion corporation. An informational meeting recently was held by one of these communities with 120 concerned residents in attendance, according to the report.
Iowa Right to Life Executive Director Jenifer Bowen explained more in an email:
This is for the so-called “The President’s Teen Pregnancy Prevention Initiative.” This grant targets children from Kindergarten-12th grade in the following counties: Woodbury, Pottawattamie, Mills and Page Counties in Iowa and Dakota and Douglas Counties in Nebraska.
… Planned Parenthood made national news back in 2010 for getting kicked out of Shenandoah for the obscene things they were teaching in the classroom.
Stanton, Iowa, is one of the targeted cities. Concerned parents, Rod and Tricia Goodemote, became alarmed when they received notice that Stanton kindergartners-3rd graders were supposed to be taught about “sexual abuse” through a program called “Ready Set kNOw.”
Why the alarm? The teacher who plans to lead these classes is none other than Planned Parenthood staffer, Jennifer Horner!! She is the SAME woman who was kicked out of Shenandoah classrooms in 2010.
The class has indefinitely been postponed, as concerned parents continue to request that the Stanton school leadership stand against Planned Parenthood’s efforts to reach children as little as 5!!!
This isn’t the first time this year that Iowa has encountered a Planned Parenthood controversy. In April a measure that would have cut funding to the corporation was killed, LifeNews recently reported on the incident. The defunding measure was part of a health and human services budget bill, which passed the Iowa House. However, the state Senate removed the language to stop tax dollars from going to abortion groups like Planned Parenthood, and then passed the bill in a 27-23 vote, the Associated Press reports.
According to these recent incidents, the people of Iowa are largely against Planned Parenthood infiltrating their state. After the abortion business tried once again to influence their children, parents became rightly upset and are fighting against the new sex education.
About 500 doctors gathered in this Haryana district to discuss advancements in stomach resizing surgery to tackle the problem of obesity in India.
The conference attended by bariatric surgeons from across the country also had a brain-storming session on how morbidly obese women can increase their chances of conceiving without complications.
According to medical statistics, about 70 percent of obese women are not able to conceive.
“Somebody who is overweight by 5-10 kg can manage to shed that extra weight by dieting, exercising, etc. But in cases of women who are obese and are not able to conceive, stomach resizing surgery is a solution,” said Gaurav Srivastava, managing director of IBM hospital, the organisers of the conference.
“A lot of obese women, after weight loss surgery, find that they are more fertile as reproductive system receives a surge of fertility due to the hormonal effects of weight loss on the body,” he said.
Vivek Bindal, a leading bariatric surgeon, said, “The biggest benefit after bariatric surgery is freedom from chronic diseases like diabetes, hypertension, sleep apnea, infertility, migraine, high cholesterol, and arthritis.”
“It has been proven to increase the life expectancy and quality of life in morbidly obese patients. These patients actually regain their lives and confidence after bariatric procedure.”
Bariatrics is the branch of medicine that deals with the causes, prevention and treatment of obesity.
Obstetrics is one of the major areas in medicine requiring blood transfusion. On one hand maternal morbidity and even mortality depends on availability of blood and blood products and on the other hand injudicious use of blood and blood products can cause infection, allergic reaction or antibody production in the mother which can have major impact on the present or future pregnancies . The most common complication of blood transfusion is error in transfusion.
Intravenous iron is indicated when there is poor tolerance to oral iron or a quick response is needed. There are two main preparations: irondextran and iron sucrose. There is evidence that intravenous iron therapy replenishes iron stores faster and more efficiently than oral iron therapy Recombinant human erythropoietin is used when anaemia is caused by renal disease. It is safe to use in pregnancy and there is no reported cases of teratogenicity.
In 2015, National Blood Authority released the Blood Management Guidelines Obstetrics and Maternity
Following are the its main Practice Points:
More information about travel to Mumbai India for Treatment
Euthanasia is a very tricky topic for any person. Whether it is the medical professionals or the lawmakers or a patient’s family or even the patient itself, the thought of euthanasia brings mixed emotions and even mixed logics which can both be correct while being contradictory at the same time.
After years of contemplation and debate, the government seems to be finally coming out with with a stand on the issue of passive euthanasia by legalizing it and giving the patients the right to “withhold or withdraw medical treatment to herself or himself” and “allow nature to take its own course”.
Passive Euthanasia, otherwise known as ‘negative euthanasia’, as opposed to active euthanasia, involves withholding of medical treatment or withholding life support system for continuance of life e.g., withholding of antibiotic where without doing it, the patient is likely to die or removing the heart-lung machine from a patient in coma. Passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained (vide Para 39 of The Judgment Of Hon’ble Supreme Court in WP No. 115 Of 2009- Aruna Ramchandra Shanbaug vs UoI and Others).
The draft bill called Terminally Ill Patients(Protection of Patients and Medical Practitioners ) Bill deals with many aspects of Passive Euthanasia and the concept of Living Will. The relevant provisions for the medical practitioners are as follows
Refusal of Medical Treatment by a Competent Patient and its binding nature on Medical Practitioners
(1) Every competent patient including minor aged above 16 years has a right to take a decision and express the desire to the medical practitioner attending on her or him:-
Provided that the medical practitioner is satisfied that the patient is a competent patient and that the patient has taken an informed decision based upon a free exercise of her or his free will and.
Provided further that in the case of minor above 16 years of age, the consent has also been given by the major spouse and the parents.
(3) Before proceeding further to give effect to the decision of the competent patient, the medical practitioner shall inform the spouse, parent or major son or daughter of the patient or in their absence any relative or other person regularly visiting the patient at the hospital about the need or otherwise of withholding or withdrawing treatment from the patient and shall desist from giving effect to the decision for a period of three days following the intimation given to the said patient’s relations.
Authority to prepare panel of medical experts.
(1) The Director-General of Health Services, Central Government and the Director of Medical Services (or officer holding equivalent post) in each State shall, prepare a panel of medical experts for purposes of this Act and more than one panel may be notified to server the needs of different areas.
(2) The panels referred to in sub-section (1) shall include experienced medical experts in various branches such as medicine, surgery, critical care medicine or any other specialty as decided by the said authority.
(3) The Director General of Health Services may consult the Directors of Medical Services or the equivalent rank officer in regard to the composition of panel in order to ensure uniformity, as far as practicable.
(4) The panels prepared under sub-section (1) shall be published in the respective websites of the said authorities and the panels may be reviewed and modified by the authorities specified in sub-section (1) from time to time and such modifications shall also be published on the websites, as the case may be.
Medical Practitioner to maintain record and inform patient, parent etc.
The medical practitioner attending on the patient shall maintain a record containing personal details of the patient such as age and full address, the nature of illness and the treatment being given and the names of spouse, parent or major son or daughter, the request or decision if any communicated by the patient and his opinion whether it would be in the best interest of the patient to withdraw or withhold the treatment. The medical practitioner shall inform the patient if conscious and the spouse, parent or major son or daughter of patient or in their absence the persons regularly visiting the patient at the hospital about the need or otherwise of withholding or withdrawing treatment from the patient.
Palliative care for competent and incompetent patients.-
Even though medical treatment has been withheld or withdrawn by the medical practitioner in the case of competent patients and incompetent patients in accordance with the foregoing provisions, such medical practitioner is not debarred from administering palliative care
Protection of competent patients from criminal action in certain circumstances.
Where a competent patient refuses medical treatment in circumstances mentioned in section 3, notwithstanding anything contained in the Indian Panel Code (45of 1860), such a patient shall be deemed to be not guilty of any offence under that code or under any other law for the time being in force
Protection of medical practitioners and other acting under their direction, in relation to competent and incompetent patients:
Where a medical practitioner or any other person acting under the direction of medical practitioner withholds or withdraws medical treatment in respect of a competent patient on the basis of the desired expressed by the patient which on the assessment of a medical practitioner is in her or his best interest, then notwithstanding anything contained in any other law, such action of the medical practitioner or those acting under his direction and of the hospital concerned shall deemed to be lawful provided that the medical practitioner has concerned with the requirement of section 3 and 5.
Permission to be obtained from high court and the procedure.
(1) Any near relative, next friend, legal guardian of patient, the medical practitioner or para- medical staff generally attending on the patient or the management of the hospital where the patient has been receiving treatment or any other person obtaining the leave of court, may apply to the high court having territorial jurisdiction for granting permission for withholding or withdrawing medical treatment of an incompetent patient or a competent patient who has not taken informed decision.
(2) Such application shall be treated as original petition and the Chief Justice of High Court shall assign the same to a division bench without any loss of time and the same shall be disposed of by the high court as far as practicable within a month,
Provided that a letter addressed to the registrar- general or judicial registrar of the high court by any of the persons above mentioned containing all the material particulars seeking the permission under sub-section (1) shall be placed before the chief justice without delay and the letter shall be treatedas original petition.
(3) The division bench of the high court may, if deemed necessary, appoint an amicus curiae to assists the court and where a patient is unrepresented, direct legal aid to be provided to such patient.
(4) The high court shall take necessary steps to obtain the expert medical opinion of three medical practitioners drawn from the panel prepared under section 4 and any other expert medical practitioner if considered necessary and issue appropriate directions for the payment to be made towards the remuneration of the experts.
(5) The high court shall, having due regard to the report of panel of experts and the wishes of close relations, namely spouse, parents, major children or in their absence such other persons whom the high court deems fit to put on notice and on consideration of the best interests of the patient , pass orders granting or refusing permission or granting permission subject to any conditions.
(6) The medical practitioner or the hospital management or staff who in accordance with the order of high court, withholds or withdraws medical treatment to the patient concerned shall, notwithstanding any othe law in force, be absolved of any criminal or civil liablility.
Confidentiality for purpose of section9 (previous section)
The division bench of the High Court may, whenever a petition under section 9 is filed, direct that the identity of the patient and of his or her parents or spouse, the identity of the medical practitioner and hospitals, the identity of the medical experts referred to in section 4, or of other experts or witnesses consulted by the court or who have given evidence in the court, shall, during the pendency of the petition, and after its disposal, be kept confidential and shall be referred only by the English alphabets.
Advance Medical Directives as to medical treatment and Medical Power-of-Attorney to be void and not binding on medical practitioners.
Every advance medical directive (called living will) or medical power-of-attorney executed by a person shall be void and of no effect and shall not be binding on any medical practitioner.
Medical council of india to issue guidelines.
(1) Consistent with the provisions of this act, the Medical Council of India may prepare and issue guidelines, from time to time for the guidance of medical practitioners in the matter of withholding or withdrawing of medical treatment to competent or incompetent patients suffering from terminal illness.
(2) The Medical Council of India may review and modify the guidelines from time to time.
(3) the guidelines and modifications thereto, if any shall be published on the website and a press release may be issued to that effect.
Severe turbulence injures 31 on Etihad flight
Severe turbulence on an Etihad Airways flight from Abu Dhabi to Jakarta has injured 31 people, 10 of them taken to hospital.
Flight EY474 hit the unexpected turbulence about 45 minutes before arrival at Soekarno Hatta International Airport earlier today (Wednesday).
Medical and emergency teams met the Airbus A330-200 aircraft on landing.
Nine passengers and one crew member were taken to a nearby hospital and the other 22 were treated by paramedics at the hospital clinic and then released.
Etihad said the turbulence also caused some damage to cabin storage areas.
Flight EY475 from Jakarta to Abu Dhabi today has been cancelled.
"Etihad Airways has sent a support team from its home base in Abu Dhabi, and is assisting passengers scheduled to travel on this flight, by rebooking them on alternate flights or providing hotel accommodation," it added.
Latest debris Malaysian Airlines MH370
Officials confirmed the latest two pieces of debris found near the African coast earlier this year are 'almost certainly from MH370.'
Investigators from the Malaysian International Civil Aviation Organisation are as certain as they can be that debris found off South Africa and Mauritius is from the doomed jetliner.
Malaysian transport minister Liow Tiong Lai announced the findings which follows similar positive identification of debris previously washed ashore in the region.
"This complements the results from the previous examination in March during which the team confirmed that the Mozambique debris were almost certainly from MH370," he said.
A report said both pieces of debris are 'consistent with those found on Malaysia Airlines Boeing 777 aircraft.'
MH370 went missing en route to Beijing from Kuala Lumpur in March 2014 with 239 passengers and crew on board.
Investigators still believe the plane veered wildly off course and went down somewhere in the southern Indian Ocean.
A transport ministry statement said the governments of Malaysia, Australia and China are still 'wholly committed' to the search for MH370.
A team of international tobacco control experts has found that use of e cigarettes can reduce overall smoking as well as potentially decrease the mortality rates particularly arising out of cigarette smoking.
The findings showed that e-cigarettes have the potential to counteract health risks and may do more benefit than harm.
Also, the evidence suggests a strong potential for e-cigarettes use to improve population health by reducing or displacing cigarette use in countries where cigarette prevalence is still high and smokers are interested in quitting.
“While e-cigarettes may act as a gateway to smoking, much of the evidence indicates that e-cigarette use encourages cessation from cigarettes by those people who would have otherwise smoked with or without e-cigarettes,” said lead researcher David Levy, professor at Georgetown University in the US.
However, the experts’ estimated that exclusive e-cigarette use is associated with about five percent of the mortality risks of smoking.
Research shows that cigarette smoking rates have fallen more in the last two years than they have in the previous four or five years in the US, Canada and England, and that this trend has coincided with the increase in e-cigarette use.
“We believe that the discussion to date has been slanted against e-cigarettes, which is unfortunate, because the big picture tells us that these products appear to be used mostly by people who already are or who are likely to become cigarette smokers,” Levy added.
In the study, published online in the journal Addiction, seven top international tobacco control experts have prompted regulators at the US Food and Drug Administration (FDA) to have a broad “open-minded” perspective when it comes to regulating vaporised nicotine products, especially e-cigarettes.
Taking a low-dose of aspirin may increase the chances of survival of cancer treatment patients by up to 20 per cent and help stop the disease from spreading, a new study suggests.
“There is a growing body of evidence that taking aspirin is of significant benefit in reducing some cancers,” said Peter Elwood from Cardiff University in the UK.
“Whilst we know a low-dose of aspirin has been shown to reduce the incidence of cancer, its role in the treatment of cancer remains uncertain. As a result, we set out to conduct a systematic search of all the scientific literature,” Elwood said.
“Our review, based on the available evidence, suggests that low-dose aspirin taken by patients with bowel, breast or prostate cancer, in addition to other treatments, is associated with a reduction in deaths of about 15-20 per cent, together with a reduction in the spread of the cancer,” he added.
For the study, researchers looked at all of the available data including five randomised trials and forty two observational studies of colorectal, breast and prostate cancers.
They found a significant reduction in mortality and cancer spread by patients who took a low-level dose of aspirin in addition to their cancer treatment.
“A mutation known as PIK3CA was present in about 20 per cent of patients, and appeared to explain much of the reduction in colon cancer mortality by aspirin,” said Elwood.
Information about Medical travel for patient with Cancer to Singapore