The South Korean government has warned trainee doctors they could face legal punishment if they don't end their strike. Protests have been taking place over plans to boost medical school enrollments The government in South Korea made a last-ditch appeal to striking doctors on Thursday to end their mass walkout, or face having their medical licenses suspended and prosecution. Thousands of resident and intern doctors have walked off the job for the past 10 days in protest over government plans to raise the number of students enrolling at medical school by 2,000 each year. They argue that the government should first address pay and working conditions before attempting to raise the number of doctors. Return to work ultimatum "We've said that we won't hold them responsible for leaving their worksites if they return by today," Vice Health Minister Park Min-soo told a briefing. "Doctors are there to serve patients, and those patients are anxiously waiting for you. This isn't the way to protest against the government," said Park. South Korea's Health Ministry said that as of Wednesday night, around 9,076 of the country's 13,000 medical interns and residents were confirmed to have walked off the job. Senior Health Ministry official Kim Chung-hwan told a briefing that starting on March 4, doctors who missed the deadline to return to work would be notified of plans to suspend their licenses and that they would be given an opportunity to respond. Government says emergency, critical care stable The walkouts have strained South Korea's health system, leading to postponed surgeries and suspended medical treatments. Health authorities say the handling of emergency cases and those needing critical care is largely stable. Still, in an effort to ease the burden, military medical facilities have been temporarily opened to the public.

Fears grew on Thursday for Queen Elizabeth II after Buckingham Palace said her doctors were "concerned" for her health and recommended that she remain under medical supervision.   The 96-year-old head of state -- Britain's longest-serving monarch -- has been dogged by health problems since last October that have left her struggling to walk and stand.   The queen -- an instantly recognisable figure to billions of people across the world -- is in her Platinum Jubilee year, marking 70 years since she succeeded her father king George VI in 1952.   All her children -- heir to the throne Prince Charles, 73, Princess Anne, 72, Prince Andrew, 62, and Prince Edward, 58, were either at or heading to Balmoral, royal officials said.   On Wednesday, the queen pulled out of a planned meeting with her senior political advisors, after being told to rest.   The previous day she held audiences at her Scottish Highlands retreat, Balmoral, with outgoing prime minister Boris Johnson and appointed his successor, Liz Truss.   "Following further evaluation this morning, the queen's doctors are concerned for Her Majesty's health and have recommended she remain under medical supervision," Buckingham Palace said in a statement.   "The queen remains comfortable and at Balmoral," the palace added.   The palace statement about the queen's health is highly unusual.    "The palace does not issue bulletins on the queen's health unless it's significant," royal commentator and author Robert Hardman told the BBC.   - 'Deeply concerned' -   It comes after she has looked visibly frailer in recent months, and a succession of withdrawals from public engagements.   She has taken to walking with the help of a stick and was also seen earlier this year at the Chelsea Flower Show touring the site in a motorised buggy.    In February she was laid low by a bout of Covid, which she admitted afterwards had left her "exhausted".   Officially, the palace has said only that the queen has been suffering from "episodic mobility problems" but given no further details. She spent an unscheduled night in hospital in central London in October 2021 and was  advised to slow down.   She has pulled out of ceremonial engagements, delegating more to Charles, including the State Opening of Parliament and the Trooping the Colour military parade to mark her official birthday.   Moments before Thursday's announcement, notes were passed to Truss and senior members of her team in parliament, prompting them to leave the chamber.   Truss tweeted almost immediately afterwards: "The whole country will be deeply concerned by the news from Buckingham Palace this lunchtime," she added.   "My thoughts -- and the thoughts of people across our United Kingdom -- are with Her Majesty The Queen and her family at this time." - Global figure -   Archbishop of Canterbury Justin Welby, the highest-ranking cleric in the Church of England that the queen heads, said the queen was in his prayers.   "May God's presence strengthen and comfort Her Majesty, her family, and those who are caring for her at Balmoral," he tweeted.   Political leaders from Britain's devolved nations in Scotland, Wales and Northern Ireland, also sent their best wishes.   Four days of public events were held in June to mark the queen's record-breaking Platinum Jubilee, but she made only two appearances to acknowledge the huge crowds in central London.   As well as the United Kingdom, the queen is also head of state in 14 Commonwealth countries around the world, including Canada, Australia and New Zealand.   She also heads the Commonwealth grouping, which comprises 56 nations and takes in more than a quarter of humanity.   For most of her subjects, she is the only monarch they have ever known, featuring on stamps, banknotes and coins, and immortalised in popular culture.   But Britons were forced to face up to the reality that her reign in her twilight years, when her husband of 73 years, Prince Philip, died in April 2021, just weeks shy of his 100th birthday.   In recent years, she has been forced to face a succession of scandals involving senior royals, including her second son Prince Andrew for links to the convicted paedophile Jeffrey Epstein.   Grandson Prince Harry and his wife, Meghan, also rocked the palace by quitting royal life, and criticising the institution, even accusing it of racism. Source: AFP/BSS AH

The doctors at SKIMS, Soura performed a unique cardiac surgery by replacing the aortic root, aortic valve and transposing the coronary arteries to the newly formed aortic root. This operation is known as Bentall’s operation. A team of doctors headed by Professor Muhammad Akbar Bhat performed the operation on a 52-year-old female, resident of Kupwara, who was suffering from aortic root (origin of largest artery from the heart) dilatation (diameter 6.5 cms). “She had a grossly leaking heart valve (Severe Aortic Regurgitation). The patient had the imminent danger of death due to rupture of the aorta (the largest artery of the heart) or heart failure and was not able to perform daily routine activities due to this heart ailment. The patient was evaluated by Cardiologists at the Department of Cardiology and planned for Surgery after approval,” it added. Dr Mohammed Akbar Bhat, (Professor and Head division III) of the CVTS  department informed the patient was operated and the aortic root and aortic valve was replaced with an aortic Root conduit (Artificial synthetic tube, combined with metallic valve) and transposed both the coronary arteries (blood vessels supplying the heart) in one go. The operation was assisted by Dr Yaqub Khan, Dr M Sahil, and Dr Abid.  “During these operations, the heart is totally bye-passed and no blood goes through it. The function of the Heart and lungs is taken over by the heart Lung machine(CPB) during the operation and the heart is kept standstill (arrested) by instilling drugs till the operation is completed. After the operation the heart starts  beating of its own or is made to beat normally by giving electric shocks,” the hospital said “The Aortic root replacement (Bentall’s Operation) has been performed for the first time in SKIMS. This operation requires extraordinary knowledge and skills for better outcomes. After surgery, the patient was shifted to the cardiac surgery intensive care unit where an expert nursing team managed her postoperative period. The patient is doing well after surgery and has been discharged from the institute,” it said. “Such operations are being performed at very few centres in  India,” said  Dr AG Ahanger, Director and ex-officio secretary to the government, Sheri-Kashmir Institute of Medical Sciences (SKIMS). Source: India Blooms    

A global debate has emerged among doctors treating COVID-19: When should patients who need help breathing be placed on ventilators — and could intubation do some people more harm than good? It’s one of the biggest medical questions of the day, along with how effective the antimalarial hydroxychloroquine really is, a US doctor told AFP. The data is scarce and there aren’t yet formal studies on the subject since the disease itself is so new and we don’t have the benefit of hindsight. It’s also impossible to know for sure whether the patients placed on ventilators would have died anyway because of the severity of their conditions. But a growing number of doctors have said that COVID-19 patients appear to fade rapidly when they are put on ventilators and tubes are placed down their windpipes. In recent weeks, American hospitals have started doing what they can to delay having to use the breathing machines — which the federal government ordered 130,000 of, fearing a shortage. The first warning signs came from Italy, where the vast majority of patients placed on artificial breathing died. The statistics are also bad in the United Kingdom and in New York, where 80 percent of intubated patients die, according to the state’s governor, often after spending a week or two in intensive care in which they are placed in an artificial coma and their muscles atrophy. At the start of the pandemic, patients who were completely out of breath were treated under well established protocols for a severe lung condition called Acute Respiratory Distress Syndrome (ARDS). This condition, which prevents the lungs from taking in enough oxygen to pass on to other organs, can be triggered by infection, such as pneumonia, or by physical injury. It’s very dangerous, with studies placing the overall fatality rate at around 40 percent. The standard procedure for these patients is to intubate relatively early, and this is how COVID-19 patients have generally been treated. Until, that is, doctors began to realize lung complications among COVID-19 patients weren’t quite the same as “typical” ARDS patients, at least not in all cases. The lungs aren’t damaged in the same way — they are less “stiff.” Doctor Luciano Gattinoni and his colleagues in Milan described at the end of February how they had to adjust their procedures. “All we can do (by) ventilating these patients is ‘buying time’ with minimum additional damage,” he wrote in a research letter to the journal of the American Thoracic Society where he argued for lower air pressure settings. “We need to be patient.” – ‘Learning as we go’ – Kevin Wilson, a professor of medicine at Boston University and guideline director for American Thoracic Society guideline, agreed on the need for caution. “Most of the health care community has gone a little nervous by these bad reports about people not doing well on ventilator, and actually is moving towards trying to delay intubation,” he told AFP. “We delay as long as we can, but not to a point where it becomes emergent,” he added. Doctors realized that some patients who had very low blood oxygen levels and would normally be intubated could in fact go without. Instead of going straight to ventilators, doctors are opting to use less invasive methods — like nasal cannulas that feed oxygen up the nose, conventional or more sophisticated breathing masks, or even placing the patients on their stomachs, which helps the lungs. “We’re learning as we go,” said Wilson. Most of the new information is coming from New York, where more than 10,000 people have died from the new coronavirus. “We try to wait a little longer, if possible keep people from even being on the ventilator,” said Daniel Griffin, chief of the infectious disease division of ProHEALTH Care Associates, a network of 1,000 doctors serving hospitals around New York. “If they look like they’re doing okay, we’ll tolerate pretty low oxygen saturations,” he added. Some recover without needing to step up the treatment. And if they do need to be intubated, Griffin says they use different settings on the ventilator with lower air pressure. Medical societies, including international experts from the Surviving Sepsis Campaign, are in the process of writing best practice guidelines. None yet have a definitive answer. Source: AFP (BSS) AH

Health and Family Welfare Minister Zahid Maleque on Saturday said some 4,500 new doctors are going to join different district and upazila hospitals on December 8. “With this, there’ll be no doctor crisis,” he said during a visit to 250-bed Manikganj district hospital at noon. The minister also said in the last four months 2,000 doctors were promoted to the rank of assistant professor. “They’ll provide treatment at different hospitals alongside delivering lectures at medical colleges,” he said. Mentioning that doctors were appointed for rendering services to people, he said action will be taken if anyone remains absent in workplace unlawfully. Zahid also said a 15-storey new hospital will be established in each of the eight divisions at a cost of Tk 2,500 crore. “Cancer patients will be treated in the first six floors of the hospitals and later approval will be given for kidney treatment.”  He said a 10-bed kidney hospital will be constructed in each district to facilitate the treatment of kidney patients. Turning to the dengue outbreak, the minister said the situation now remains under control. He also said the Directorate General of Health Services has all the preparations to face the mosquito-borne disease in the future. Zahid, however, said city corporations and municipalities will have to discharge their duties in time to destroy Aedes mosquito, the vector of dengue. Source: UNB AH

Renowned Indian cardiologist Dr Devi Shetty highly appreciated the Bangladeshi doctors who provided treatment for Awami League General Secretary Obaidul Quader as he paid a courtesy call on Prime Minister Sheikh Hasina Monday afternoon. “The Bangladeshi doctors did an excellent job … you cannot expect more than this even in the developed countries,” PM’s Press Secretary Ihsanul Karim quoted the cardiologist as saying while briefing reporters after the meeting at the Prime Minister’s Office. Reports BSS. Dr Shetty apprised the Prime Minister of the latest health condition of Obaidul Qauder, also the road transport and bridges minister. He suggested sending Obaidul Quader abroad for better treatment, saying that local doctors have to work under tremendous pressure for treating such a celebrity. The premier extended her sincere thanks to Dr Shetty for coming to Bangladesh quickly responding to the call for the treatment of Obaidul Quader. “I was eagerly waiting to hear your opinion about the treatment of Obaidul Quader,” she told the cardiologist. In response, Dr Shetty told the premier, “I will come to Bangladesh, whenever you call me.” The Prime Minister also talked to Dr Shetty about the country’s medical education. Referring to Bangabandhu Sheikh Mujib Medical University, she said her government for the first time in the country established such a medical university so that the medical students do post graduation and carry out research. She said the work on setting up such universities in Chittagong and Rajshahi was almost completed. The Indian cardiologist highly appreciated Bangladesh’s tremendous development under the leadership of Prime Minister Sheikh Hasina. “The socioeconomic progress of the common people of Bangladesh over the last few years is remarkable,” he said. State Minister for Foreign Affairs Md Shahriar Alam, State Minister for Health and Family Welfare Dr Murad Hasan, PM’s Principal Secretary Md Nojibur Rahman and PMO Secretary Sajjadul Hassan were present on the occasion. Obaidul Quader was taken to Singapore this afternoon by an air ambulance after Dr Shetty gave the “go ahead” to move him after examination. Quader’s blood pressure has improved and diabetes is under control, Dr Shetty said at a briefing at the BSMMU Hospital, where the Awami League leader was admitted with blockages in three coronary arteries yesterday. Dr Shetty further said Quader’s condition is better than yesterday but he is not out of danger. The BSMMU doctors have done their best, he added. Earlier, a chartered plane carrying the cardiologist landed at Hazrat Shahjalal International Airport at 12:45 pm, airport sources said. AH

Doctors from Singapore have observed the physical condition of Awami League General Secretary Obaidul Quader. On Sunday evening a team of three expert physicians arrived in Dhaka boarded on an air ambulance. Then they visited Obaidul Quader at Bangabandhu Sheikh Mujib Medical University. Of the physicians one is Indian and the rest two are Singaporean. Meanwhile, at a press conference in the evening the on duty Physicians said that nothing can be said about the condition of Quader if 24 to 72 hours are not passed. BSMMU Cardiology department Chairman Syed Ali Ahsan said, after performing angiogram of Quader three coronary artery blockages were detected. He had uncontrolled diabetes. He was good for two hours after clearing the blockage of one artery. Then again his blood pressure went down. Electrolyte imbalance was created. Some other problems were also seen. After consulting with others the pressure control machine was fixed in his body. Professor Ali Ahsan said, he is opening his eyes at the moment, can speak but the critical stage is still remaining. Whether he needs overseas treatment or not- in response to this question he said, if he is sent in this condition then it may turn unstable. But if the medical team of Mount Elizabeth Hospital thinks that he should be taken abroad then that will be done. Awami League General Secretary and Road Transport and Bridges Minister Obaidul Quader was admitted at the BSMMU hospital at 7:30 am on Sunday with complain of severe chest pain. AH