emedinews
Head Office: 39 Daryacha, Hauz Khas Village, New Delhi, India. e-Mail: drkk@ijcp.com, Website: www.ijcpgroup.com
FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
emedinews is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
Padmashri and Dr. B C Roy National Awardee

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Member Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR


Dear Colleague

1st March 2010, Monday

eMedinewS WISHES ITS READERS A VERY HAPPY AND A SAFE HOLI

Holi Beyond Colors

The story behind the festival, Holi, starts with Holika, the sister of Hiranyakashyap the father of Prahlad. Hiranyakashyap had declared himself as GOD and wanted his own son Prahlad to worship him and not Vishnu. When Prahlad refused to do the same, he was made to sit with Holika in an open fire. Holika had been granted a boon that she could not be burned even if she was on live fire. When she was made to sit with Prahlad on the live fire, the opposite happened. She was burned and lost her life but Prahlad came out unharmed from the fire.

The above story has a deep spiritual and scientific meaning. Hiranyakashyap represents "EGO" which once takes control; we forget about our own consciousness and think ourselves as the supreme power. The same symbolic representation is seen with Ravana in Ramayana and Kansa in Mahabharata.

In the present times, Prahlad represents a person with self realization or one’s consciousness or one’s trueself. The consciousness or soul cannot be burnt, cut, dried or made wet by anything. It is imperishable and everlasting.

All those people who have attained self realization utilizing any of the pathways (bhakti, karma and gyana) are in a state of acquaintance with God and nothing can destroy them.

The obstacles to the pathway of self realization are mentioned as 'attachment, anger, desire, greed and ego'. When all these negative factors overpower any individual, they lead one away from the path of self realization. Holika represents the sum total of the negative forces in the body which can kill you if not controlled in time.

Getting attached to any of the five senses can end in a vicious cycle and one can get burnt in this ‘chakravyuha’ of attachments. If you are truthful, and have attained a state of one–point contemplation on a known truth, all the negative forces will stay away. All such negative forces, if repressed within the body can burn you out over a period of time and that is one reason why all negative emotions should never be suppressed or repressed.

The practice of burning Holi a day before the festival symbolizes burning up of negative thoughts or emotions embedded in the mind and neutralizing all the poison arising due to the negative feelings. As soon as negativity is removed from the mind, one can attain spiritual vision or the knowledge of the consciousness. Once this is done, only the positive thoughts remain, which is celebrated as sharing and loving each other, the next day.

Sharing love is the biggest thing one can do in removing all the above mentioned
obstacles to self–realization. Spreading love reduces anger as well as desires. It detaches one from various attachments; reduces greed, and brings humility in a person. By burning one’s ego and other negative qualities, one also burn the ill feeling amongst each other and make everybody a friend.

During Holi, the practice therefore, is to visit and meet not only your friends but also people with whom you are not friendly. Holi is an opportunity to spread brotherhood and happiness in the society.

WHO defines health as not mere absence of disease but a state of physical, mental, spiritual, social and environmental well-being. Holi is a classical example of a custom to create 'social healthiness' amongst the general society.

The habit of throwing water on each other, also has a deep spiritual meaning. It basically means removing dirt from each others body. Dirt here does not imply bodily dirt but mental dirt which once removed leads to spiritual cleanliness.

The whole meaning is not to play Holi superficially or meet each other at a superficial level but to get rid of the negativity at the level of the mind as well. There is no point in celebrating Holi and meeting people unless you remove your negativity towards them.

When you lovingly smear ‘gulal’ (coloured powder) on others, they reciprocate with doubled love and affection. Similarly, always think of good things about people. Express your positive thoughts loudly about these friends – not only in front of them but also in their absence. Don’t you think your heart will throb with pleasure when they reciprocate?

Dr KK Aggarwal
Chief Editor


News and Views

Presswatch (Dr Vivek Chhabra)

How dynamite could help destroy prostate cancer

A chemical once used as a deadly explosive could be a powerful new treatment for prostate cancer. Patients who took part in a small clinical trial saw their levels of prostate–specific antigen (PSA), a chemical marker in the blood that increases when cancer is present, stabilize when small amounts of nitroglycerine seeped into the bloodstream. The latest trial, carried out at Queen’s University in Belfast, came about after researchers there performed laboratory tests that showed the explosive appeared to slow cancer growth. The results, published in the journal Urology, showed that within six months, PSA levels had stabilized in all but five of the 24 volunteers.

People with significant sleep apnea have much fewer nightmares (Dr G M Singh)

People with significant sleep apnea continue to dream, but they report fewer nightmares, said Dr. Jim Pagel, lead author of a study appearing in the Feb. 15 issue of the Journal of Clinical Sleep Medicine. There has been a question for a long time about the cognitive effects of sleep apnea. . . This is one of the first studies showing a clear cognitive change with sleep apnea and, surprisingly, it’s in a positive direction, he further added.

Antibiotics can actively make bacteria stronger

Current understanding of the way bacteria develop resistance has been challenged. The current thought that resistance is caused by a few bacteria, which by chance had the ability to resist the antibiotic, was initially challenged when it was found that the surviving bacteria were also then more resistant to other subsequent yet different antibiotics. A team at Harvard Medical School has found that some antibiotics actually induce mutations in bacteria. They do this by producing toxic free radicals which then result in mutations incorporated into bacterial DNA by the repair pathways. This process is greatest when drug levels are low and potentially

HIV and women

Nearly six in 10 women (58 percent) say they don’t get tested because they believe they are in a monogamous relationship.

Eye care snippets by Dr. Narendra Kumar (OptometryToday@gmail.com)

Lens Materials and coatings (Part 2)

Coatings: It’s surprising that ‘anti–reflection vs. UV–absorbing coatings is a commonly misunderstood area in ophthalmic dispensing. Let’s consider (a) visible and non–visible light, (b) effect of ultraviolet light, (c) anti–reflection coating, (d) mirror coating, and (e) UV–Protec dye, to understand the subject better.

Visible and non–visible light: Light varies considerably in wavelength; not all wavelengths cause an activation of photoreceptors. Not all light striking the eye is therefore visible. The actual range of wavelengths that reach the retina is between 380 and 1400 nm. It has been estimated that of these only those between 390 and 740 nm are visible. Light of wavelengths down to 300 nm could actually be seen if it were not absorbed by the anterior segment of the eye. And, when the crystalline lens is removed, objects illuminated with light down to 300 nm are reported to be visible. Most light of wavelengths less than 300 nm or greater than 250 nm is screened by the cornea, while light between almost 300 nm to 390 nm passes through the lens. The vitreous allows no light of wavelength longer than 1400 nm to reach the retina.

The effect of Ultraviolet light. Because the cornea absorbs (UV) light below 300 nm, excessive exposure to these UV wavelengths can result in inflammation of the cornea and conjunctiva. Exposure of the eye to large quantities of ultraviolet light between 300 and 400 nm can speed up or contribute to the formation of cataract.

Common sources of UV rays are sunlight at high altitudes, reflected sunlight from a surface such as water or snow, sun or other ultraviolet–type lamps, and welding. Even colour television screens and computer screens emit harmful UV–radiation. An aphakic, having had his crystalline lens removed, can no longer absorb light between 300 and 390 nm but allows it to fall on the retina. Outdoor workers, even on cloudy days, mountaineers, those indulging in water or snow games, users of UV–type lamps, sunbathers, welders, children sitting for long hours before colour television, and those working on computers, therefore, need a lens with UV–absorbing properties. Crown glass transmits 92% of the visible light striking its surface. The 8% not transmitted is lost through reflection. All UV light below 290 nm is absorbed by crown glass. Unfortunately, it is the UV between 290 and 390 nm that can be more disturbing.

Protection from bright sunlight is available through good–quality sunglasses. Normal transmission for sunglasses is generally between 15% and 30%. More than 30% transmission may not help the average wearer sufficiently in sunlight, while less than 15% may not be too dark for normal purposes. Plastic lenses offer greater versatility in tinting, since they may be dyed to almost any color, may be made as light or dark as desired by simply dipping in a solution of heated dye of the desired color, and may be bleached out and retinted again if a tint has proved unsatisfactory. Photochromic lens changes in its transmission when exposed to light, due to the activation of silver halide crystals within the glass by ultraviolet light of wavelengths between 300 and 400 nm, causing darkening of the whole lens.

Anti–reflection coating. An anti–reflection coating is a thin, clear layer of the coating film applied to the surface of a lens for the purpose of (i) reducing unwanted reflections from the lens surface and (ii) increasing the amount of light that actually passes through the lens to the eye. Reflections, including oncoming headlight annoyance at the time of night–driving, are reduced considerably by anti–reflection coatings. Another cosmetic, helpful aspect of AR–coating is reduction of the awareness of lenses.

Mirror coating. A mirror coating can be applied by a vacuum process to the front surface of the lens causing the lens to have the same properties as a two–way mirror. The observer, unable to see the wearer’s eyes, sees his own image reflected from the lens. The wearer is able to look through the lens normally. There is, of course, a reduction in the transmission of the lens because of the high percentage of light reflected. Mirror coatings are often used in combination with a tinted lens to provide more protection from intense sunlight. So, when there is a demand of a UV–dye coating and the optical practitioner provides AR–coating, instead, he not only is just not providing any answer to the blocking of UV–radiation affecting the ocular tissue but may actually also be increasing the UV–light transmission through the spectacles.

UV–Protec dye. The UV–Protec dye penetrates the lens surface. During the long heating process, the pores of the lens open up and the chemical is permanently enclosed. A treated lens absorbs 100% UV from 260 to 400 nm and the absorption does not weaken with time. Insertion in lens tint neutralizer does not affect absorption. The chemical comes in concentrated form. Three times water is added to the concentrate before using the dye (i.e. 750 ml water is added to 250 ml concentrate). Solution is heated to 96° C or 205° F. Cleaned CR–39 lenses are inserted only when temperature is reached. Lens is left in solution for 30 to 60 minutes. It is then removed from solution, allowed to cool off and residue washed off under hot water. Evaporated water is replaced, before next treatment, so that inserted lenses are completely covered by the solution. UV–Protec treated lens can be tinted, bleached and re–tinted, scratch–guard coated and AR coated. And is a viable UV–protection by means of tinted lenses for outdoor use and clear lenses for indoor use. (To be continued)
(To Read Part 1, see eMedinews dated 22.2.10)

Conference Calendar

3rd International Online Medical Conference (IOMC 2010)
Online Conference (including India participants)
Date: March 06–07, 2010
Website: www.iomcworld.com/2010/

Quote of the Day

Prayer is a triumph, in whatever form. (Mirakel Reves)

Diabetes Fact

Sulfonylurea increases pre-formed insulin and not insulin.

Public Forum (Press Release)

Natural foods and not supplements for preventing heart disease

One should consume seasonal and locally grown natural foods and vegetables grown at organic farms. Eat less, dinner lighter then the lunch, eat natural and eat in moderation are few of the mantras. Eating food supplements can be harmful.

Supplementation with beta carotene and vitamin E, either alone or in combination with each other or other antioxidant vitamins does not prevent heart disease.

High dose vitamin E supplementation (400 IU/day) may be associated with an increase in all–cause mortality.

Supplementation with vitamin C does not prevent second heart attack. Beta carotene supplementation may be dangerous and should be discouraged.

Vitamin E supplementation may be of benefit for only secondary prevention of heart patients with chronic renal failure who are undergoing hemodialysis.

The American Heart Association concluded that current data do not justify the use of antioxidant supplements for the prevention or treatment of cardiovascular disease risk.

The above recommendations apply to supplementation only. Diets high in natural antioxidants are associated with lower cardiovascular mortality.

Question of the day

What is the role of mesalazine in ulcerative colitis?

The mesalamine (mesalazine) group of drugs is formed by coating 5–aminosalicylic acid (5–ASA) with acrylic resins or by encapsulation in ethylcellulose microgranules. This results in drug delivery to the distal small bowel and colon.

The acrylic–base resin dissolves at a pH >6, while ethylcellulose serves as a semipermeable membrane allowing the release of 5–ASA, also in a pH–dependent fashion, as it traverses the small bowel.

Oral 5–ASA compounds, mesalamine is effective in inducing remissions in active ulcerative colitis.

The clinical response ranges from 50–71% (2–4 g/day). A trial found that 4.8 g/day of mesalamine were significantly more effective than 2.4 g/day at achieving overall improvement at six weeks (72 vs 59%) in patients with moderately active ulcerative colitis.

The mesalamine compounds are also prescribed at high doses to maintain remission in patients with Crohn’s disease when begun soon after surgical resection.

Because of the favorable safety profile many practitioners attempt treatment with aminosalicylates before treating with corticosteroids or immunosuppressants. Maintenance doses are similar to those used for ulcerative colitis.

Suggested reading

  1. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5–aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med 1987;317:1625.
  2. Hanauer SB, Sandborn WJ, Kornbluth A, et al. Delayed–release oral mesalamine at 4.8 g/day (800 mg tablet) for the treatment of moderately active ulcerative colitis: The ASCEND II Trial. Am J Gastroenterol 2005;100:2478.
eMedinewS Try this it Works

Support for walking

When patients with peripheral neuropathy have suboptimal visual input, they should use a cane. If a cane is used, the patient should have sufficient upper extremity strength to bear 20 - 25% of body weight on the cane; this can be checked with a bathroom spring scale in the office.

Dr Good Dr Bad

Situation: A borderline diabetic came for prescription.
Dr Bad: Start with lifestyle modifications.
Dr Good: Start with metformin and lifestyle interventions.
Lesson: As lifestyle interventions fail to achieve or maintain metabolic goals either due to failure to lose weight, weight regains, progressive disease, or a combination of factors for most individuals with type 2 diabetes, metformin therapy should be initiated concurrently with lifestyle intervention at diagnosis. It is recommended as the initial pharmacological therapy, in the absence of specific contraindications. (Source: Diabetes Care 2009;32(1):193–203.)

Punjab & Sind Bank
 
action
docconnect
 
Central Bank of India
 
Nestle
 
nuspera
 
Docconnect

Make Sure

Situation: A patient of pulmonary Koch’s on antitubercular treatment (ATT) complained of numbness in fingers and toes.
Reaction: Oh my God! I forgot to prescribe vitamin B complex.
Make sure that in patients talking ATT [including isoniazid (INH)], B–complex vitamins (especially vitamin B6) are prescribed to prevent neuropathy. Addition of antioxidants and multivitamins also boost the immune system.

Laughter the best medicine

I worked in surgery for almost 15 years, and we had a cardiac surgeon that was a "good ol’ boy" (well, we are in Fort Worth!). After the surgery was over he would always tell us: "The patient will be okay if he does just fine"

Formulae in Critical Care

Predicted endotracheal tube size for age
Formula: = 4 + (age/4) for pediatric age group.

Milestones in Neurology

Ugo Cerletti (1877 – 1963) was an Italian neurologist who discovered the method of electroconvulsive therapy in psychiatry.

Mistakes in Clinical Practice

A zero should always precede a decimal point if the amount is less than 1 (eg, 0.5 mg and not .5 mg).

Thought for the day

Remove the darkness of the mind and the world will be illuminated (B.K.Sapna)

1–7 April Prostate Disease Awareness Week: Prostate SMS of the Day
(Dr Anil Goyal)

Patients castrated prior to puberty or those affected by genetic disease that diminishes androgen action or production do not develop BPH.

Lab test (Dr Navin Dang)

A single Widal test has minimal value till you see a rising titre.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name Indication Approval Date
Clozapine Tablet 200mg (Addl. Strength)
Indicated in the management of Schizophrenic patients
19.08.2009

(Advertorial section)

ZEN IMMUNE–FACT SHEET

Zen Immune Power – a known immunity booster with ability to help reduce absorption of aluminum from the GI tract and enhance excretion through kidneys and is a key to eliminate aluminum toxicity and the related systemic involvement.

Advertising in eMedinewS

eMedinewS is the first daily emedical newspaper of the country. One can advertise with a single insertion or 30 insertions in a month. Contact: drkk@ijcp.com. emedinews@gmail.com

eMedinewS–PadmaCon 2010 

Will be organized at Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

eMedinewS–revisiting 2010

The second eMedinewS–revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited.

Stress Management Workshop (April 17–18)

A Stress Management Workshop with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized on April 17–18, 2010.

Organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, in association with IMA New Delhi Branch and IMA Janak Puri Branch

Venue: Om Shanti Retreat Center, National Highway 8, Bilaspur Chowk Pataudi Road, Near Manesar.

Timings: On Saturday (2pm onwards) and Sunday (7am–4pm). There will be no registration charges, limited rooms, kindly book in advance, stay and food (satvik) will be provided. For booking e–mail to emedinews@gmail.com or sms to Dr KK Aggarwal 9811090206/ BK Sapna 9811796962

Stroke Update Workshop for GPs (March13–14)

Indian Stroke Association and International Stroke Conference is organizing a Stroke Update Workshop on March 13–14, 2010 at AIIMS Auditorium. eMedinewS has tied up with the conference for free registration for first 200 GPs of NCR. Organizer: Dr Padma, Prof of Neurology, AIIMS, New Delhi. SMS for free registration to 9717298178 or email to isacon2010@gmail.com

Also, if you like emedinews you can FORWARD it to your colleagues and friends. Please send us a copy of your forwards.

Readers Responses

  1. Read the sentence below carefully. This is a sentence where the nth word is ‘n’ letters long. e.g. 3rd word is 3 letters long, 8th word is 8 letters long and so on... ... "I do not know where family doctors acquired illegibly perplexing handwriting, nevertheless, extraordinary pharmaceutical intellectuality counterbalancing indecipherability, transcendentalizes intercommunications incomprehensibleness". [Dr. J.S. Tuteja]

  2. Heartiest congrats for your well deserved award. I am personally very happy. You deserve more that that. Wish you many more: Col. (Dr.) SK Garg

  3. My heartiest congratulations. We are proud of you: Dr. AK Sinha

  4. Congratulations for the award. Your honour makes us proud: Kaushik Dutta, MAMC