Central procurement agency

The union cabinet Friday cleared a proposal to set up a central procurement agency (CPA) for medical goods, making it easier to address shortages and facilitating the health ministry in procuring and distributing quality medicines and medical equipment to states.

The decision to set up a CPA under the health ministry was taken during a cabinet meeting headed by Prime Minister Manmohan Singh.
Aimed at efficient procurement and distribution of health sector goods, the agency will also help the government curb wastage, thus leading to savings.
The idea was also to eliminate shortages in the states of medical goods like vaccines and contraceptives, a statement issued here said.
The cabinet also approved a one-time budgetary support of Rs.50 crore to establish the CPA.
'Thereafter, CPA will charge service fee, which will be well within the overall ceiling of five percent of the value of procurement, to meet its subsequent operational expenses,' the statement said.

Travel Postcard

Got 48 hours to spare in Munich during Oktoberfest, the world's largest fair?

Oktoberfest was first celebrated 201 years ago when Crown Prince Ludwig married Princess Therese and invited Munich's citizens to join the party on the Theresienwiesen ("Wiesn").
These days the festival is held mostly in September as October gets too cold. This year it runs from Sept 17 to Oct 3.
Reuters correspondents with local knowledge help visitors get the most out of a visit to Oktoberfest, where a record amount of beer -- 7.1 million litres -- was consumed last year.
Friday
5 p.m. - Gear up for the Oktoberfest by shopping around for your own Bavarian garb, which has come back into fashion over the past decade.
Try wearing lederhosen (if you're a man) or a dirndl (for women) if you're up for the authentic feel. The regional clothing now exists in a dazzling spectrum of styles from the austere and traditional to modern and mildly pornographic.
You can often lay your hands on the kit anywhere in Munich from the luxury boutiques on Maximilianstrasse to the second hand shops tucked away in side streets, as well as online.
Other regional dress, from Scottish kilts to Dutch dress and clogs, are also warmly welcomed.
Clad in your new outfit, take a first stroll across the "Wiesn" to soak up the atmosphere: the aroma of cotton candy, roasted almonds and the scent of barley and hops of the main protagonist, the beer.
Some 6.4 million visitors from Germany and as far afield as the United States attended the Oktoberfest last year.
7 p.m. - Take it easy tonight if you plan to return for another session tomorrow.
If you're keen to rub shoulders with celebrities, head to the Hippodrom tent where Bayern Munich footballers, former tennis star Boris Becker and German actors are often sighted.
Young locals favour the Schuetzen-Festzelt tent, famous for its suckling pig in maltbeer. Even younger locals head to the Schottenhamel where Oktoberfest's first keg is tapped.
Traditional charm can be found in the Hacker tent -- decked out in white and blue, colours representing Bavaria's skies -- at the Braeurosl or Augustiner tents. The latter is the only brewery that still uses wooden kegs for storage. Its beer is also served in the Fischer Vroni tent.
The Oktoberfest tents serve local delicacies such as oxen, pork knuckles and cunningly thirst-provoking, salty pretzels. But for a less pricey version and possibly more authentic Munich meal, try one of the city's many beer gardens.
The Augustiner near the Central Station is a favourite after-work meeting spot. The Chinese Tower in the English Garden is a classic, but farther away from the main festivities. Hirschgarten is more suited for families.
If the weather is not being kind to you, you could head to the area around Marienplatz to check out the city hall and the cathedral and find a restaurant in the pedestrian zone. The Bratwurst Gloeckl offers good traditional food.
Saturday
11 a.m. - If you want to get into a beer tent but have not made a reservation, be prepared to turn up before noon. Tents open at 9 a.m. on the weekends and while there is seating for some 115,000 people in total, they shut once they are full.
On the final weekend last year, access to the entire Wiesn site had to be shut off for several hours due to overcrowding.
For your first view of the fair, try a turn on the Ferris wheel. For the more adventurous, try one of the stomach-turning rollercoasters now, rather than after sampling the beer.
The Toboggan, offering the sight of punters trying to stay upright on an uphill conveyor belt, is an all-time favourite. Its entertainment value makes up for its lack of gut-churning potential.
Once you are inside a tent, where the oompah of the brass bands mingles with the cheer of merry drinkers and sing-alongs, find a table, order drinks and food, and have fun. Prost!
Be aware though that the beer not only comes in a 1 litre 'mass' glass but at around 6 percent is also stronger than the brew you might be used to. Pace yourself or risk becoming a Bierleiche (literally translated: a beer corpse).
The litre will cost between 8.70 euros ($11.87) and 9.20 euros this year, roughly 35 cents more than last year.
Learn a few key Bavarian phrases to navigate your way around the tents: Biddscheen for please, Bierdimpfe for "tavern potato" for a notorious beer drinker (hint: don't become one) and Heisl for toilet.
11 p.m. - All but a few tents have served their last round now and will close shortly. A few places, like the Schuetzen-Festzelt, have a ritual last song of the night. So if you're into Rainhard Fendrich -- an Austrian pop star who goes down well with the Bavarian crowd too -- head to the Schuetzen for a recital of his love song "Weus'd a Herz host wia a Bergwerk" ("Because you have a heart like a mine". Yes, it works better in German).
You can either go on to Weinzelt (the wine tent) or the Kaefer tent, both of which still serve alcohol after midnight.
Alternatively, there are after-parties all over the city. Follow the locals. Surely, by now you will have befriended some. If you haven't, it may be because you didn't check out Oktoberfest's very own Bavarian dictionary at: www.oktoberfest.de/en/lexikon/.
In Schwanthalerhoehe, the district that lies downtown just beyond the monumental statue of Bavaria, many bars remain open and rowdy all night long.
If clubbing is your thing, however, and you want to dance off some of those beer-calories, try out the stylish -- if a tad pretentious -- P1 club.
Located underneath the Haus der Kunst art museum, a Nazi-built structure which hosted the infamous 1937 exhibition of "degenerate art", P1 is a favourite haunt for Munich's upper class and celebrities.
The doormen are ruthless in their entrance policy, so glam up or you'll be left standing in the cold.
Sunday
9 a.m. (or whenever you can make it out of bed) - To cure your hangover, try a walk around the English Gardens, a rare oasis of tranquility during the Oktoberfest and one of the world's largest urban parks -- more expansive than even New York's Central Park.
Don't be taken by surprise if you wander into the area reserved for naked sunbathers. The Free Body Culture (FKK) movement was founded in the early 20th century and succeeded in taking much of the smut and embarrassment out of nudity.
Another curiosity is the surfers riding the small waves at the mouth of an artificial stream running through the gardens.
An alternative relaxing destination just out of town is Lake Starnberg, formed from ice age glaciers from the Alps and offering stunning mountain views on a clear day.
The hardy can attempt a dip in the 21-km long freshwater lake, go windsurfing or sailing, while the more laid-back can simply stroll along the shore with its brightly painted wooden boathouses or hop on a ferry.
And if you still haven't had enough of the Oktoberfest, return to the Wiesn to check out more beer, rollercoasters and amusement rides.
Look after your belongings, however. So far this year's lost and found's list of curiosities includes: 460 personal identity cards, 130 mobile phones, a Viking helmet, a walking frame and several wedding rings.

Symptoms Headache

Migraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages — prodrome, aura, attack and postdrome — though you may not experience all the stages.

Prodrome
One or two days before a migraine, you may notice subtle changes that may signify an oncoming migraine, including:
Constipation
Depression
Diarrhea
Food cravings
Hyperactivity
Irritability
Neck stiffness
Aura
Most people experience migraine headaches without aura. Auras are usually visual but can also be sensory, motor or verbal disturbances. Each of these symptoms typically begins gradually, builds up over several minutes, then commonly lasts for 10 to 30 minutes. Examples of aura include:
Visual phenomena, such as seeing various shapes, bright spots or flashes of light
Vision loss
Pins and needles sensations in an arm or leg
Speech or language problems
Less commonly, an aura may be associated with aphasia or limb weakness (hemiplegic migraine).
Attack
When untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently. During a migraine, you may experience some of the following symptoms:
Pain on one side of your head
Pain that has a pulsating, throbbing quality
Sensitivity to light, sounds and sometimes smells
Nausea and vomiting
Blurred vision
Diarrhea
Lightheadedness, sometimes followed by fainting
Postdrome
The final phase — known as postdrome — occurs after a migraine attack, when you may feel drained and washed out, though some people report feeling mildly euphoric.
When to see a doctor
Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan.
Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.
See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:
An abrupt, severe headache like a thunderclap
Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
Headache after a head injury, especially if the headache gets worse
A chronic headache that is worse after coughing, exertion, straining or a sudden movement
New headache pain if you're older than 50

TYPES OF MIGRAINE

Symptoms

There are several types of migraine, all share basic features, and each person will suffer this headache in a unique way. Generally, however, migraine often begins as a dull ache and then develops into a constant, throbbing and pulsating pain that you may feel at the temples, as well as the front or back of one side of the head. The pain is usually accompanied by nausea and vomiting, and sensitivity to light and noise.
The two most prevalent types of migraine are migraine with aura (formerly referred to as classic migraine) and migraine without aura (formerly referred to as common migraine).
Migraine without Aura
As we have said, migraine is a vascular headache, which means the headache is associated with changes in the size of the arteries inside and around the skull. During the pre-headache phase, blood vessels constrict; when vascular dilation occurs, the migraine begins. The blood vessels are thought to become inflamed as well as swollen, and it is believed that migraine pain is caused by this inflammation, as well as by the pressure on the swollen walls of the blood vessels.
Most migraine sufferers experience two to four headaches per month; but, some people can get one every few days, and others may only have one or two a year. Most migraine headaches last at least four hours, although very severe ones can last up to a week. Headaches may begin at any time of the day or night; and while a sufferer may wake up with one, a migraine will rarely awaken a person from sleep.
Approximately one-third of migraine sufferers experience an aura prior to the headache pain.
Migraine with Aura
While most migraine sufferers experience visual problems during the headache, you may be someone whose migraine begins with an aura, a manifestation of neurological symptoms. Generally, the aura begins from five to thirty minutes before the actual onset of the headache. You may see wavy or jagged lines, dots or flashing lights; or, you experience tunnel vision or blind spots in one or both eyes. The aura can include vision or hearing hallucinations and disruptions in smell (such as strange odors), taste or touch. It can become even more disconcerting or frightening if it involves feelings of numbness, a "pins-and-needles" sensation or even difficulty in recalling or speaking the correct word. These neurological events may last sixty minutes and will fade as the headache begins.
Hemiplegic Migraine
If you suffer from this rare but severe type of migraine with aura, you probably also have a family history of it. The hemiplegic migraine often begins with temporary motor paralysis and/or sensory disturbances on one side of the body, followed by the headache -- within the hour -- which may be accompanied by numbness or the "pins and needles" sensation. When the headache appears, the initial neurological symptoms may disappear.
Ophthalmoplegic Migraine
Also a rare and severe migraine, the ophthalmoplegic migraine’s pain usually surrounds the eyeball and lasts from a few days to a few months. There may be paralysis in the muscles surrounding the eye. If these symptoms occur, you should seek immediate medical attention because the symptoms can be caused by pressure on the nerves behind the eye.
Retinal Migraine
Another rare migraine, the retinal type starts with a temporary, partial, or complete loss of vision in one eye. It is followed by a dull ache behind that eye that may spread to the rest of the head.
Basilar Artery Migraine
This very rare form of migraine is accompanied by dizziness, confusion or lack of balance. It comes on suddenly and can result in fleeting visual disturbances, the inability to speak properly, ringing in the ears, and vomiting. Throbbing occurs in the back of the head. The basilar artery migraine is strongly related to hormonal influences and primarily strikes young adult women and adolescent girls; as sufferers age, the migraine with aura may replace the basilar artery type.
Abdominal Migraine
It is difficult to diagnose this migraine because the pain is felt in the abdomen. Nausea, vomiting and diarrhea may occur, and the pain usually occurs in the middle of the abdomen. The attack typically lasts hours and occurs mostly in children as a forerunner of migraine.