Sunday, December 31, 2017

Swallowing Problems

Swallowing seems simple, but it's actually pretty complicated. It takes your brain, several nerves and muscles, two muscular valves, and an open, unconstricted esophagus, or swallowing tube to work just right.
Your swallowing tract fgoes from the mouth to the stomach. The act of swallowing normally happens in three phases. In the first phase, food or liquid is contained in the mouth by the tongue and palate (oral cavity). This phase is the only one we can control.
The second phase begins when the brain makes the decision to swallow. At this point, a complex series of reflexes begin. The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other things happen: A muscular valve at the bottom of the pharynx opens, allowing food to enter the esophagus, and other muscles close the airway (trachea) to prevent food from entering the airways. This second phase takes less than half a second.
The third phase starts when food enters the esophagus. The esophagus, which is about nine inches long, is a muscular tube that produces waves of coordinated contractions (peristalsis). As the esophagus contracts, a muscular valve at the end of the esophagus opens and food is propelled into the stomach. The third phase of swallowing takes six to eight seconds to complete.
A wide range of diseases can cause swallowing problems, which your doctor may call "dysphagia." These include:
  • Disturbances of the brain such as those caused by Parkinson's diseasemultiple sclerosis, or ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease)
  • Oral or pharynx muscle dysfunction such as from a stroke
  • Loss of sphincter muscle relaxation (termed "achalasia")
  • Esophageal narrowing such as from acid reflux or tumors

  • How Do I Know If I Have a Swallowing Problem?

    Under normal circumstances, people rarely choke during a meal. Occasionally, food will stick in the esophagus for a few seconds (especially solid foods), but will pass spontaneously or can be washed down easily with liquids. But there are a number of symptoms that you should get checked for a possible swallowing problem, including:
    • Frequent choking on food
    • Hesitancy in food passage for more than a few seconds
    • Pain when swallowing
    • Recurring pneumonia (an indication that food may be going into the lungs rather than the esophagus)
    Immediate medical attention is needed when food becomes lodged in the esophagus for more than 15 minutes and doesn't pass spontaneously or with liquids.
    Some people don't know that they have swallowing problems, because they compensate unconsciously by choosing foods that are easier to eat, or they eat more slowly. However, untreated swallowing problems raises he risk for choking or having large pieces of solid food lodge in the esophagus.

    How Are Swallowing Problems Diagnosed?

    If you think you have a swallowing problem, talk to your health careprovider. You may get tests such as:
    Cineradiography: An imaging test in which a camera is used to film internal body structures. During the test, you will be asked to swallow a barium preparation (liquid or other form that lights up under X-ray). An X-ray machine with videotaping capability will be used to view the barium preparations movement through the esophagus. This is often performed under the guidance of a speech pathologist, an expert in swallowing as well as speech.
    Upper endoscopy: A flexible, narrow tube (endoscope) is passed into the esophagus and projects images of the inside of the pharynx and esophagus on a screen for evaluation.
    Manometry: This test measures the timing and strength of esophageal contractions and muscular valve relaxation.
    Impedance and pH test: This test can determine if acid reflux is causing a swallowing problem.

    How Are Swallowing Problems Treated?

    Treatment depends on the type of swallowing problem you have. Sometimes, a swallowing problem will resolve itself without treatment. On other occasions, swallowing problems can be managed easily. Complex swallowing problems may require treatment by a specialist or several specialists.

    If you have a chewing or swallowing problem there are several things you can do to make eating and drinking easier and safer, including:
    • Sit upright at a 90-degree angle.
    • Tilt your head slightly forward.
    • Remain sitting upright or standing for 15 to 20 minutes after eating a meal.
    Dining environment
    • Minimize distractions in the area where you eat.
    • Stay focused on the tasks of eating and drinking.
    • Do not talk with food in your mouth.
    Amount and rate
    • Eat slowly.
    • Cut food into small pieces and chew it thoroughly. Chew food until it becomes liquid in your mouth before swallowing.
    • Do not try to eat more than 1/2 teaspoon of food at a time.
    • You may need to swallow two or three times per bite or sip.
    • If food or liquid catches in your throat, cough gently or clear your throat, and swallow again before taking a breath. Repeat if necessary.
    • Concentrate on swallowing frequently.
    Saliva management
    • Drink plenty of fluids.
    • Periodically suck on Popsicles, ice chips or lemon ice, or drink lemon-flavored water to increase saliva production, which will increase swallowing frequency.
    Food consistency
    • Minimize or eliminate foods that are tough to chew and eat more soft foods.
    • Puree food in a blender.
    • If thin liquids cause you to cough, thicken them with a liquid thickener (your speech pathologist can recommend one for you). You can also substitute thicker liquids for thin ones, such as nectar for juice and cream soup for plain broth.
    Taking medications
    • Crush pills and mix them with applesauce or pudding.
    • Ask your pharmacist for his or her recommendations on which pills should not be crushed and which medications can be purchased in a liquid form.

‘Denied’ treatment over Aadhaar, Kargil war widow dies, probe on

  • 31 Dec 2017
  • Gurgaon
  • HT Correspondent

‘Denied’ treatment over Aadhaar, Kargil war widow dies, probe on

The hospital insisted to see her Aadhaar card before starting the treatment. I told the administration I did not have the Aadhaar at the time but showed its copy on my mobile... But they did not admit her.
ROHTAK : Haryana CM Manohar Lal Khattar has ordered an inquiry after the son of a Kargil martyr alleged that his 55-yearold mother died after being denied treatment at a Sonepat hospital as she did not have her Aadhaar with her at the time.
The woman’s son, Pavan Kumar, alleged that he had taken his mother Shakuntala Devi to a private hospital. “The hospital insisted to see her Aadhaar card before starting the treatment. I told them I did not have the Aadhaar card at the time but showed its copy to the hospital administration
PAVAN KUMAR, deceased’s son
on my mobile phone and promised to get it within an hour,” Kumar said. “But they did not admit her. I begged them to start my mother’s treatment, but they called the security to manhandle me,” he said.
No wanting to waste anymore time, Kumar said he then took his mother to another hospital, but she passed away on the way.
CM Khattar, said, “I have received information about it. We will conduct an inquiry and punish those found guilty.” However, a doctor at the hospital said: “Aadhaar is mandatory for documentation, but not for treatment. We have never denied treatment to anyone without Aadhaar ”.

Friday, December 29, 2017

Enhancement of gratuity and all retrial benefits to those who made to retired on 30th june & 31.12.

Chronic diseases in relation to Fixed Medical Allowance (FMA) for Railway Pensioners Railway Board Letter No 2006/H/DC/JCM dated 12-10-2006

Chronic diseases in relation to Fixed Medical Allowance (FMA) for Railway Pensioners
Railway Board Letter No
2006/H/DC/JCM dated 12-10-2006
Circular Subject
Clarifications regarding chronic diseases in relation to Fixed Medical Allowance @ Rs.100/- granted to Railway Pensioners.

As per Board’s letter No. PC/V/98/I/7/1/1 dated 21-4-99 a fixed medical allowance @ Rs.100/- per month is granted to the Railway Pensioners/ family Pensioners who are residing beyond 2.5 kms from Railway Hospital /Health Unit / Dispensary.  This fixed medical allowance is given to meet the day to day medical expenses.  They are not entitled to receive outdoor treatment from Health Unit /Railway Hospital etc. except in cases of Chronic Diseases.

Arising out of demand in the DC/JCM September, 2006, the definition of Chronic disease and some illness which are to be treated as Chronic ones are hereby stated.

Any disease which persists for a period of approximately three months or more is defined as a chronic disease.  Some of the common illness, which are treated as chronic diseases are given below:

1. Arthritis and related conditions

2. Cardiovascular disease

3. Cancer of any part of body

4. Diabetes mellitus

5. Epilepsy disorders

6. Obesity / chronic weight loss

7. Tuberculosis


9. Oral Health Problem

10.      Chronic skin disorders

Fixed Medical Allowance (FMA) to Railway pensioners and family pensioners who are members of RELHS
Railway Board Letter No
PC-V/2006/A/Med/1 dated 15.09.09
Circular Subject
Grant of Fixed Medical Allowance @ Rs.100 p.m. to the Railway pensioners/family pensioners – Clarification reg.

          Subsequent to the issue of Board’s letter No. PC-V/98/I/7/1/1 dated 07.02.2008, references were received from pensioners / family pensioners and banks seeking clarification as to whether those pensioners/family pensioners who are members of RELHS and availing OPD facility are also eligible for the Fixed Medical Allowance. 

2.      The matter has been examined and in reference to the Board’s letter dated 07.02.2008 ibid,  it is clarified that since actual enrolment under the Health Scheme is not mandatory, those pensioners/family pensioners who, in terms of Board’s letter No. 97/H/28/1 dated 23.10.97, are eligible to become members of the Scheme but are not actually enrolled are also entitled for grant of Fixed Medical Allowance.  Pensioners/family pensioners who possess RELHS card & avail OPD facility are NOT entitled for Fixed Medical Allowance, whereas those who possess RELHS card but do not avail OPD facility  [except in cases of chronic diseases, as defined in Board’s letter No. 2006/H/DC/JCM dated 12.10.2006] are entitled for Fixed Medical Allowance.

3.      Further, FMA and arrears of FMA would continue to be paid, as earlier, to pensioners /family pensioners only after submission of the enclosed undertaking form to the Pension Disbursing Authority [PDA] thereby implying that fulfillment of the following two conditions is mandatory for becoming admissible for FMA:

 [i]  the pensioner/family pensioner is residing beyond 2.5 kms from the nearest health unit;
[ii]  the pensioner/family pensioner is not availing the facility of OPD [except in cases of chronic diseases as mentioned in para 2 above].         


[To be submitted in DUPLICATE by pensioners/family pensioners to his/her Pension Disbursing  Authority [PDA] one copy to be retained by PDA and other copy to be furnished to Pension Sanctioning Authority by PDA]

I_____________________________________,  a retired employee /family pensioner whose ___________________ [specify relation of Family pensioner with deceased Railway employee] was an employee of [Office address] ____________________ declare that I am residing at [residential address indicated in PPO] _______________, which is beyond 2.5 Kms from the nearest Railway hospital / health unit __________________  [Name of the Hospital /Health Unit as contained in Annexure III to Railway Board’s letter No. PC-V/98/I/7/1/1 dated 21.4.99].

2.    Accordingly, I hereby opt to claim fixed medical allowance of Rs.100/- per month.  Necessary endorsement may please be made in my PPO in this regard.  Simultaneously, I undertake that I will not avail of OPD facilities at Railway hospitals /health units from the day I claim Medical Allowance.  I also understand that grant of Medical Allowance is subject to the terms and conditions specified in Board’s letters No. PC-V/98/I/7/1/1 dated 21.4.99 and 1.3.2004.

3.    I also declare that I have not availed of any treatment as Out Door Patient for the period from _______________________ [indicate here the date of retirement or the date of availing OPD facility on the last occasion or 1.12.1997, whichever is later] to _______________ [indicate here the date on which this declaration is signed].  I may accordingly be paid  arrear of Medical Allowance @ Rs.100/- per month for the period mentioned above. 


                                                                        Name in full………………………..

                                                                                      PPO No…………………………….

                                                                                      Issued by ………………………….

                                                                                      SB A/c No………………………….

                                                                                      Post office /Bank…………………..





FMA to widowed,divorced & unmarried daughters on becoming family pensioner

Enhancement of gratuity and all retiral benefits to similarly placed pensioners in the light & spirit of various Court orders DOPPW replies to Bharat Pensioners Samaj

Thursday, December 28, 2017

Implementation of Govt’s decision on the recommendations of the V CPC-grant of fixed medical allowance @ Rs.108/-P.M. Railway pensioners/family pensioners

Grant of fixed medical Allowance to railway pensioners.

CTSE Registration for Smart card for cashless treatment in emergencies

Clarification on family pension admissible to NPS employees on their death attributable to Govt. service – CPAO OM dated 11.12.2017

Md. Shahid Kamal Ansri, ICAS
Assistant Controller of Accounts
Government of India
Ministry of Finance, Department of Expenditure
Central Pension Accounting Office
Trikoot-II, Bhikaji Cama Place, New Delhi-110066
Tel.:011-26103074, Fax: 011-26167326

dated 11th December 2017

Subject: Clarification on family pension admissible to NPS employees on their death attributable to Govt. service – regarding.
I am to enclose herewith the OM No. 1/5/2017-P&PW (F) dt. 12/09/2017 regarding clarification on family pension admissible to NPS employees on their death attributable to Govt. service for information and further necessary action please.
Encl: As above
(Md. Shahid Kamal Ansari)
(Asstt. Controller of Accounts)
Ph. No. 011-26103074

All Pr CCAs/CCAs/Cas/AGs and Administrators of UTs (As per list)

No. 1/5/2017-P&PW (F)
Ministry of Personnel Public Grievances and Pensions
Department of Pension and Pensioners Welfare
3rd Floor, Lok Nayak Bhawan
Khan Market, New Delhi-110 003
Dated the 12th September, 2017
Subject: Clarification on family pension admissible to NPS employees on their death attributable to Govt. service – regarding.
The undersigned is directed to refer to CPAO d.o. letter No. CPAO/NPS CRPF-BSF/2017-18/89 dated the 24th July 2017 on the above cited subject. As per this Department’s OM No. 38/41/2006-P&PW(A) dated 5 th May 2009, Government servants covered under National Pension System (NPS) on their death, attributable to Government service are provisionally entitled for benefits under CCS(EOP) Rules 1939. 

2. The benefit of family pension under CCS (Pension) Rules and CCS(EOP) Rules has been extended to the employees under NPS, vide OM dated 05.05.2009. On death of an NPS employee, the family is, however not paid the benefit from NPS accumulations. The entitlements of the family on death of an NPS employee, are at par with the employee borne on a pensionable establishment, both under CCS(Pension) Rules and CCS(EOP) Rules. Therefore, in case of death of an NPS employee, the family should be entitled to family pension under EOP Rules at the rate of 60% of the basic pay and not at the rate of 40% of basic pay applicable on death of holder of a non-pensionable post. 

(Sujasha Choudhury)
Tel: 24635979

PCDA circular 177Seventh Central Pay Commission-Revision of pension of pre-2016 pensioners/family pensioners Notional Fixation: Shortcomings and common error/mistakes listed by PDCA (Circular No. 177)

O/o The Principal Controller of Defence Accounts (Pesnion), Draupadighat, Allahabad - 211014 
Important Circular No. C-177
No: G1/C/0199/Vol-II/Tech Dated:19.12.2017
To, ———————————– 
(All Head of Department under Min. of Defence)

Subject: – Implementation of Govt’s decisions on the recommendations of the Seventh Central Pay Commission-Revision of pension of pre-2016 pensioners/family pensioners, etc.
Reference: – This office important circular no. C-164, bearing no.G1/C/0199/Vol-I/Tech, dated 30th May 2017 . 

Attention is invited to above cited circular wherein all HOOs were advised to submit the LPC-Cum-Datasheet to PCDA (P) Allahabad for revision of Pension/ Family Pension of all pre-2016 pensioners with effect from 01.01.2016.

2. Of late, it has come to notice of this office that following common errors/mistakes are being made by the HOOs while initiating/forwarding above said LPC-Cum-Datasheet. These shortcomings are main cause behind avoidable delays in revision of pension causing of hardship to the pensioners.
i. Annexure-A :- Common errors/mistakes in claim(LPC-Cum-Datasheet) for revision of pension/family pension w.e.f. 01.01.2016 in respect of 7th CPC recommendation. 3. In view of the above, you are requested to issue suitable instructions (along with copy of this circular) to all the Head of the Offices under your administrative control to ensure that these Common errors/mistakes may be avoided while initiating/forwarding the LPC-Cum-Datasheet in r/o revision of Pension/ Family Pension to this office.
(Subhash Kumar)
Dy.CDA (P)

1 Hardcopies of claims are being received without softcopy in CD.

2 A number of claims (Hardcopies) are being received alongwith scanned image/pdf of LPC instead of M S Access utility.

3 Few Head of the offices are forwarding M S Access utility alongwith only scanned image/pdf of LPC only. No hardcopies are being received.

4 Hardcopy-softcopy record mismatch- The major problem is being faced in uploading of data into system due to the reasons that softcopy contains more number of records than for which hardcopies received in that particular batch and it is difficult to reconcile records before uploading into the system for processing.

5 CD containing soft-copy are not being received in CD mailer resulting into number of CDs received as broken in this office.
6 M S Access utility containing only single record in each utility and each CD are being received instead of all the records in one/two utility. For example:- One Head of the office has sent 21 claims along with 21 CDs i.e. one CD against each claim.

7 Claims are being received without obtaining HOO code.

8 Last pay and retiring pay scale are not being entered into LPC-Cum-Datasheet corresponding to pay commission when individual retired in Pay Detail portion.

9 Instead of claims in one or two batch; piecemeal batches containing only 10-15 records are being received.

10. During uploading, it has been observed that structure of fields in MS Access Utility provided by this office has been modified by HOOs at their own, which results into in-correct uploading of data into the system, Hence, it is requested to not to temper/modify fields/structure of the Utility provided to you by this office.

11. Claims are being forwarded in piece meal batches, it is therefore requested to forward the batch containing at least100 cases.

(Raj Bahdur)
Sr. Accounts Officer (P.)