Legal Aspect of Ayurvedic Proctology Practise w.s.r. to Gujarat State Law

Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

AMD

• Achieved a reference in Bailey & Love’s text book of Surgery.*

• Wildly used by Ayurvedic Proctologist in management of Bhagandara & other ARD

*Bailey & Love’s, Short practice of Surgery, 25th edition- 2008 p. no .1266

Bailey & Love’s, Short practice of Surgery, 26th edition- 2013 p. no .1263

• No need of introduction • Scientifically validated

device by ICMR at PGI Chandigarh, AIIMS New Delhi, CDRI Lucknow along with other Ayurvedic institutions.

• Accepted by Kanazava University of Japan


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Laws & Acts ?

Ayurvedic Proctology ?

Gujarat State Law ?

Quackery in Practice

Any System Practice ?

IPC & Tips of Safe Practice


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• Indian Medicine Central Council Act, 1970 (48 of 1970) – 2{3(e)} :"Indian Medicine" means the system of Indian

medicine commonly known as Ashtang Ayurveda, Siddha or Unani Tibb whether supplemented or not by such modern advances as the Central Council may declare by notification from time to time.

• Practitioners of Indian Medicine (Standards of Professional Conduct, Etiquette and Code of Ethics) Regulations, 1982 – "Practitioner of Indian medicine" means the Physicians and

Surgeons of Indian Medicine who are for the time being enrolled on any State Register of Indian Medicine and who possess any of the recognized medical qualifications;


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• Central Register of Indian Medicine, Regulations, 1979 for registration of qualification

• Clinical Establishment (Registration & Regulations) Act 2010 (23 of 2010)

– Guidelines for minimum set up of Ayurvedic Clinic / dispensary / Hospitals 10/11-25/26-100/> 100 beds

– Mostly effective in HP, Punjab, HR, UP, AP,

– Yet not in Gujarat

Rules


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• THE DRUGS AND COSMETICS ACT, 1940 (23 OF 1940) (As amended up to the 30th June, 2005)

• THE DRUGS AND COSMETICS RULES, 1945 (As amended up to the 30th June, 2005)

Introduction 3 –a – drug [Ayurvedic, Siddha or Unani] ” includes all medicines intended

for internal or external use for or in the diagnosis, treatment, mitigation or prevention of [disease or disorder in human

beings or animals, and manufactured] exclusively in accordance with the formulae described in, the authoritative books of [Ayurvedic, Siddha and Unani Tibb systems of medicine], specified in the First Schedule;]


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• GUJARAT AYURVED UNIVERSITY ACT, 1965

• GUJARAT MEDICAL COUNCIL ACT, 1967 for MBBS or equitant

• The Gujarat Medical Practitioners Act 1963 for Ayurveda or Homeopathy or Unani. – 2(1) b : Ayurvedic system of medicines or Ayurvedic

system means “Asthang Ayurvedic System of Medicines”, whether supplemented or not by such modern advances are consistent with the fundamental principals of Ayurvedic.


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Clinical Establishment (Registration & Regulations) Act 2010 (23 of 2010)

Bio-medical Waste (Management & Handling) Rules 1998 under section 6,8 & 25 of Environment & Pollution control Act, 1986, the Central Govt. of INDIA

Registration of clinic/hospital GPCB if Indoor Facility or Monthly OPD>1000 patients in Clinic/Hospital

The Bombay Nursing Homes Registration Act 1949

Shop Act License & Professional Tax at Local Municipality or Municipal Corporation

NABH Accreditation / ISO Accreditation Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

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What is Ayurvedic Proctology ?

• No definite definitions as per law and/or Government bodies

• In modern parlance

– The medical specialty that deals with the diagnosis and treatment of disorders of the rectum and anus is called proctology

– Ref. Principles of Anatomy and Physiology

12th ed - G. Tortora & B. Derrickson (Wiley, 2009), Page 921, E Edition.


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• The specialty which deals with the anatomy, physiology, pathology, diagnosis and treatment of various disorders of the rectum and anus through Ayurvedic science & its modern parlance may called Ayurvedic Proctology


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M.D. (Ayu.) Shalya-Shalakya Tantra before 2005

• This qualification is recognized as additional qualification as per IMCC Act 1970

M.S. (Ayu.) Shalya Tantra after 2005

• This qualification is not recognized as additional qualification as per IMCC Act 1970

BAMS + Special Courses like from various Gurus / Pvt. Institutes /

• Most of this courses are not recognized as additional qualification as per IMCC Act 1970

But based on Syllabus any BAMS Reg. Graduate can do.

• 3rd Year (Old Syllabus) /

• 4th Year (New Syllabus)


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Yes

No


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CCIM Notification

Syllabus(Old & New)

Madras High Court Judgment

NIMA vrs IMA in MH

Sushrut the Father of Surgery

– World wide accepted as per various texts


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CCIM Notification 96

Original Scan & TOI web


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Right To Practice Any System Of Medicine (THE INDIAN MEDICINE CENTRAL COUNCIL ACT, 1970)

• Chapter I(Preliminary), 2-1-e – "Indian Medicine" means the system of Indian medicine

commonly known as Ashtang Ayurveda, Siddha or Unani Tibb whether supplemented or not by such modern advances as the Central Council may declare by notification from time to time.

• CHAPTER III (Recognition of Medical Qualifications)17 (3) (b) – the privileges (including the right to practise any system of

medicine) conferred by or under any law relating to registration of practitioners of Indian medicine for the time being in force in any State on a practitioner of Indian Medicine enrolled on a State Register of Indian medicine;


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SCHEDULE-I [See regulation 4, sub-regulation (1) of regulation 5, regulation 6, sub-regulations (4) and (7) of regulation 7]

CENTRAL COUNCIL OF INDIAN MEDICINE Notification New Delhi, the 18.07. 2012 No. 28-15/2011-Ay.(Minimum Standards)- In exercise of the powers conferred by clause (j) of section 36 of the Indian Medicine Central Council Act, 1970 (48 of 1970), the Central Council of Indian Medicine, with the previous sanction of the Central Government, hereby makes the following regulations, namely:-


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2.1 DRAVYAGUNA VIJNAN (PHARMACOLOGY & MATERIA MEDICA)

Part 1 –B (II) 30 Marks 18. - Introduction, Definition & scope of Pharmacology and Principles of general Pharmacology. Brief Knowledge about pharmacology of the following - Anaesthetics, Antipyretics, Analgesics ……..Aerosols/ Inhalants, Expectorants, Digestants , Carminatives, Antacids,… Antidiarrhoeals, Antiemetic, …….. Antidiuretic, Lithotriptic, Antiinflammatory, Hormonal therapy, Antidiabetic, Antithyroid, Oxytocic. Galactagogues, Contraceptives, Antihistamines, Antimicrobial, Antibiotics, Antimalarial, Amoebicidal,, Antifungal,Vitamins, Minerals,Water imbalance and IV fluids, Vaccines, antivenom, Local anti septics, drugs in ophthalmic practice, Anti cancer drugs and immunomodulators. Ref. Books • 27 Pharmacological basis of Medical Practice - Goodman & Gillman • 28.Pharmacology and Pharmacotherapeutics - Satoskar Bhandarkar & Ainapure

3.1 ROGA NIDANA Paper 1 Part 1 III. Basic Pathology 30 Marks

3.2 ROGA NIDANA Paper 2 Various modern diseases in details


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3.3 PRASUTI TANTRA & STRIROGA

Paper 1 – Part B

• Normal Labour, ……., Assisted Labour, Caesarian …… Retention of Placenta, ……..Forceps Delivery, Ventouse Delivery.

Paper 2 Part B : Shastra Karma

• Surgical procedures their Indications, Contraindications of cauterization of cervix, …..

• PNDT Act, MTP Act, and importance of current National Programme

• Knowledge of important Commonly used Ayurvedic and Allopathic drugs used in Prasutitantra and Streeroga. Pharmacotherapuetics of allopathic drugs in obstetrics and Gynaecology

• Record keeping,ethical and medicolegal issues in Streeroga and prasutitantra

• DESIRABLE (non detail) Laproscopy,hysteroscopy,hysterosalphingography, USG,X-RAY,Colposcopy, Cervical Biopsy.)

Practical :

• CLINICAL TRAINING-OBSTETRIC SKILLS To observe/assist-D&C, D&E, Caesarean section, Repair operations, Resuscitation of new born. Dr Shreyas Bhalodia Sushrut Proctology

Association Conference 01 Feb. 2015 @ AMD

Paper 1 • Description of Yantra, Shastra, Anushastra: Definition, number, types, uses, Dosha, Guna,

Karma. Relevant modern instruments.

• Nirjantukarana / Sterilization: Methods, types and its role in surgical practice.

• Sangyaharan / Anaesthesia: Definition and Types.

• Kshara and Kshara Karma:

– i. Nirukti, Pradhanyata, Guna, Dosha, Karma, Prakara, Yogya, Ayogya, Procedure, Upadrava and Chikitsa.

– ii. Kshara nirmana vidhi, knowledge of Kshara Varti, Taila and Pichu.

– iii. Kshara Sutra – Preparation, Indications, Contraindications and Method of application, Complications and their Management.

• Fluid, Electrolyte, Acid Base Balance and Nutrition:

• Antibiotics, analgesics, anti-inflammatory and emergency drugs in surgical practice.

– Target – Working knowledge of commonly used drugs.

– Preferable targets - Advanced pharmacological study of the above drugs.

• Diagnostic techniques – X-ray, Imaging techniques, Ultrasonography, CAT Scan, MRI, Biopsy / Cytological study.

PAPER - 2 • Diagnosis & treatment of various Ayurvedic & modern parlance diseases with surgical

managements Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

AMD

Training to develop skills in following Parasurgical and other procedures

i. Kshara Karma ii. Agnikarma iii. Kshara Sutra iv. Raktamokshana v. Application of bandages and splints vi. Catheterization vii. Wound management procedures

like Parisheka and Patradana viii. Ryle’s tube aspiration ix. Injections -Intramuscular /

Intravenous / Subcutaneous / Intradermal

x. Incision and drainage of abscess xi. Suturing of open wounds

Observation of following procedures

i. Circumcision

ii. Hydrocele

iii. Hernial repair

iv. Vasectomy

v. Haemorrhoidectomy

vi. Fistulectomy

vii. Fissurectomy viii. Appendecectomy

ix. Cholecystectomy


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2012


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49.In the light of the above, this court is of the view that the order passed by this court in 2010 (4) CTC 798 is held to be a correct position of law. For the sake of repetition, it is observed as follows:

• "4....it is imperative that no proceedings can be initiated against any of those registered practitioners in Siddha, Ayurveda, Homeopathy and Unani, who are eligible to practice irrespective of the respective system also with Modern Scientific Medicine including Surgery and Gynecology Obstetrics, Anesthesiology, ENT, Opthalmology, etc.

• Such registration of the medical practitioners with Tamil Nadu Siddha Medical Council, Tamil Nadu Board of Indian Medicine and Tamil Nadu Homeopathy Medical Council as well as such of those qualified doctors who were recognised as such by the Madurai Kama raj University and Tamil Nadu Dr. MGR Medical University who have been qualified respectively in the system of bachelor of Siddha Medicine and Surgery. If any action had been taken against such of those medical practitioners referred to above, it is needle ss to state that, such action should be dropped forthwith pending further orders in the Writ Petition."

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED: 11/02/2011 CORAM : THE HONOURBLE MR.JUSTICE K.CHANDRU http://www.ismga.net/uploads/5/4/6/4/5464496/chandru_judgement.pdf


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http://www.ismga.net/uploads/5/4/6/4/5464496/chandru_judgement.pdf

2003


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Dr. Falana Falana AIMS-DHC

2006 Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

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Beware of Fake Documents

Original Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

AMD


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Sec. 29 Deals with documents

Sec. 52 Describes "good faith"

Sec. 90 Related to consent

Sec. 176 Failure to inform police whenever essential

Sec. 269-271 Related to spread of infectious disease and disobedience of a quarantine rule.

Sec. 272-273 Related to adulteration of food and drinks.

Sec. 274-276 Related to adulteration of drugs.

Sec. 304-A Deals with death caused by an negligent act.

Sec. 306-309 Related with abetement of suicide.

Sec. 312-314 Related to causing mis-carriage, abortion and hiding such facts.

Sec. 315-316 Deals with act to prevent child being born alive or to cause it to die after birth.

Sec. 319-322 Related to causing hurt, grievous hurt, loss of vision, loss of hearing or disfigure-ment.

Sec. 336-338 Deals with causing hurt by rash or negligent act.

Sec. 340-342 Related to wrongful confine-ment.

Sec. 491 Related to breech of contract.

Sec. 499 Related to defamation


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Term used in IPC


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NIMA & Ayurvedic Dr various asso. Comes to gather made Amendment in MH-Vidhansabha (Assembly) for practicing any system of medicines with due respect of study-syllabus

IMA made PIL against this in Bombay HC

Recently in Bombay HC had refuse to make stay order against this PIL of IMA - MH


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Pending issue of MS (Ayu.) degree reorganization as additional qualification in CCIM Schedule awarded

by Gujarat Ayurved University - Jamnagar

As per Law any degree holder MS (Ayu.) cant write in their degree

Miss communication between CCIM-AYUSH-GAU-IPGTRA & GBAU leads this issue since 2005.

PG from GAU may get MS (Ayu.) Registration from Karnataka State Board.

But our own GBAU not recognizing same qualification due to lake of Notification by CCIM.


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2010 & 2011, 2 times ….but no further action till date…… Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @

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Proof of Conflict


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OPD & IPD Register

OPD & IPD Case Sheets

BMW Registered

Annual Report of BMW (Submission of report via BMW Service Provider in GPCB)

Auto-Claving & OT Fumigation Register

Daily Case Register Form no 3 C (Rule 6F[3])

Printed Bill & Receipt of Payment Received

Maintain Proper record of purchase & used of modern medicines.

Written Informed consent of Patients and/or guardian (prior any Minor procedure also)

ITR forms as per Rules


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• Displaying of – Dr’s /Clinic/Hospitals

Registration Details in waiting rooms

• In Consent must write Early and/or late

complication of Surgical procedure and anesthesia in local language.

Name of Surgeon, Assi. Surg. Anesthetic and OT Assi.

• Never Forget Anesthetic Note in Surgical Case with Adv Antibiotics &

Analgesics SOS

Procedure Name

Vital Remarks

• Never use guarantee word for any treatment


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Shop Act License Copy

Bio-medical Waste Certificate

GPCB Certificates

Various Notifications From Gov. of Guj., CCIM, AYUSH, Court Decisions etc.

News Papers Cuttings with Date


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Letter Head


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The only clause it has is that the patient should avail treatment in either a government hospital or an institute recognized by the government. Another option for patients is that they may choose to be treated in centers recognized by the QCI (Quality Council of India) or NABH (National Accreditation Board of Health) or any other suitable institution.

As per the notification from IRDA (Insurance Regulatory and Development Authority) , the inclusion of the alternative medical techniques like Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) method of treatment has been added through part 5(1) regulation of the IRDA. The change came into force on the 18th of February this year 2013

http://health.india.com/news/up-to-integrate-yoga-homeopathy-and-other-alternative-therapies-in-its-healthcare-services/

Gujarat Action Committee

CCIM Members, GBAU Board Members & Senet Members helping completely

Still No Concrete decision comes


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• Many time Our graduate face harassments

• SC – Feb. 2009

• Hon. Mr. Markenday Katju Judjements

– Martin F. D. Vs Mohd. Faruk (Dr)

This Law doesn’t include AYUSH Drs


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JOURNAL OF INDIAN ACADEMY OF FORENSIC MEDICINE

JIAFM, 2005 ; 27 (3). ISSN 0971 -0973

Dr. D.S.Bhullar, Registrar & Dr. J. Gargi, Professor & Head,

Department of Forensic Medicine & Toxicology, Guru Gobind Singh Medical College Faridkot (Punjab)

ABSTRACT

In a land mark historical judgment the Hon,ble Supreme Court has ruled that doctors should not be held criminally responsible unless there is prime facie evidence before the Court in the form of a credible opinion from another competent doctor, preferably a Government doctor in the same field of medicine supporting the charges of a rash and negligent act. It is a laudable judgment in the light of criminal procedures filed against the medical professionals in trivial cases under Section 304-A and even 304 IPC where prima-facie there seems to be no neglect in these medical treatments.

On August 05,2005 a Three Judge Bench of Supreme Court of India of Chief Justice R.C.Lahoti, Justice G.P.Mathur and Justice P.K.Balasubramanyam


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A good draft of Answer if any harassment or any MLC issue against our practitioners happens. . .

With help of Lawyer,

My Self &

Dr Bhavin Savaliya


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AYUSH

• Gov. Policy's

CCIM

• Act & Rules

• Various Court case Judgments

GAU

• Act & Rules & Syllabus related

Court HC/SC

• Various Court case Judgments

GBAU

• Registration Details, Ethics & Laws


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http://www.rti.gov.in/

http://www.rti.gov.in/


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http://www.ccimindia.org/actandammendment.html

http://www.indianmedicine.nic.in/index1.asp?lang=1&linkid=19&lid=47#maincont

http://www.ayurveduniversity.com/

http://www.gbau.in/



http://www.indianmedicine.nic.in/index1.asp?lang=1&linkid=19&lid=47

http://www.indianmedicine.nic.in/index1.asp?lang=1&linkid=19&lid=47

http://www.ayurveduniversity.com/

http://www.gbau.in/

• Dr. Mandar Ranade

– Pune

• Dr KL Koradiya

– Junagadh

• Dr Bhavin Savaliya

– Jetpur

• Dr. Nitin Pathak

– Amadavad

• Gujarat Action Committee

• NIMA – Gujarat


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www.aumayurved.com

Dr Shreyas Bhalodia Sushrut Proctology Association Conference 01 Feb. 2015 @ AMD

For Any Assistance on Any MLC /Mediclaim Issues

Contact me 24 X 7

Dr. Shreyas G. Bhalodia

+91 98254 51215 or +91 7878151215

[email protected]

Health & Medicine

Legal Aspect of Ayurvedic Proctology Practise w.s.r. to Gujarat State Law