emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.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

 

  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri 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; Chairman Ethical Committee 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

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

 
  Editorial …

1st March 2012, Thursday

PPIs may be associated with a higher risk for Clostridium difficile–associated diarrhea

The FDA has announced that use of prescription and OTC PPIs may be associated with a higher risk for CDAD and attendant gastrointestinal complications. Symptoms of Clostridium difficile–associated diarrhea (CDAD) may include persistent watery diarrhea, abdominal pain and/or fever. Clinicians should prescribe the lowest dose of a PPI for the shortest duration that is effective for the condition being treated.

According to an FDA review of AERS reports and published case reports of CDAD in patients being treated with PPIs, many patients had factors predisposing them to the development of CDAD, but the FDA could not definitively exclude the role of PPI use in contributing to the risk for CDAD. The FDA warns that patients with at least one of these predisposing risk factors and concomitant PPI use may have serious outcomes from CDAD. Colectomy and, rarely, death have been reported.

Clinicians should counsel their patients who are taking PPIs to seek immediate care from a healthcare professional if there is development of watery stool that does not go away, abdominal pain, and/or fever. However, patients should not discontinue their prescription PPI drug without medical advice. Patients taking OTC PPIs should be advised to carefully follow package directions.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

PPIs may be associated with a higher risk for
Clostridium difficile–associated diarrhea

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – blood donation

In the 1st Mega Ajmer Health Camp 72 blood donations were collected on the site.

 
Dr K K Aggarwal
 
    National News

MCI gets contempt of court notice for not starting 3–year BRHC course

Delhi High Court on Monday issued a contempt notice to the union government and the MC for failing to comply with the court’s earlier order to start a three–year course for non–MBBS people to practice medicine in rural health centres. Issuing the notice, Justice Vipin Sanghi sought the response of the government and the MCI within four weeks.

Petitioner Meenakshi Gautam, filing the contempt petition through advocate Prashant Bhushan, said that on November 10, 2010, a division bench of this court had ordered the MCI to implement by March 2011 the Bachelor of Rural Health Care (BRHC) course, approved by the health ministry, but no action has been taken so far. She contended that life of people living in rural areas is in risk because of lack of qualified medical practitioners there. "The court had given the MCI two months" time to finalise the curriculum and syllabus of the 3.5–year Primary Healthcare Practitioner Course, the implementation of the introduction of which was approved by the Union of India. The course was named Bachelor of Rural Health Care (BRHC). A further period of two months was given to the ministry of health and family welfare for the enforcement of the same," the petition said. Seeking the court’s direction to implement the course, it said the course should have been introduced by March 2011 as per the timeline stipulated by the court in its order but no such course has been introduced as of February 2012. "The Medical Council of India apparently opposed the course in 2011 and is not willing to notify it," the petition said.

"The continual delays and lack of initiative by the respondents in implementing a proposal which promises a headway in the realisation of our country’s long held dream of providing at least primary health care to all, is extremely worrisome…" the petition said. The petitioner expressed fear that if despite the court’s order specifying the timelines for implementing the course, the ministry is not in a position to introduce it after more than a year from the time directed, then left to itself, it would never do so. (Source: IANS)

Comments: As per the news, the Delhi High Court has only issued a notice to the MCI and the union government to show cause why Contempt of Court proceedings should not be initiated against them for not complying with the orders of the Delhi High Court. I do not feel that the MCI would have committed a gross contempt of the orders of the Delhi High Court. It might be sometimes true that, the MCI has not complied with the orders of the Delhi High Court, but it will be for valid and justifiable legal reasons. The reasons for non compliance of the Delhi high Court order by the MCI and the govt could be substantiated by these bodies before the Delhi High Court. The real matter of concern is, will the issuance of notice to show cause contempt by the Delhi High Court, be used to implement BRHC course by the government. Thanking You: Anil KG Advocate.

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

WHO data on H5N1 prevalence, lethality questioned

The World Health Organization’s H5N1 diagnostic criteria only identify the sickest patients, which has resulted in alarming fatality rates that are inaccurate, according to an article published online February 23 in Science by researchers at Mt. Sinai School of Medicine in New York City. (Source: Medscape Medical News)

For comments and archives

New diabetes drug cuts glycemic risk

A novel agent that activates a free fatty acid receptor successfully increased insulin secretion without raising the risk of hypoglycemia in patients with type 2 diabetes, a randomized study found. (Source: Medpage Today)

For comments and archives

First vaccine against black fever enters clinical trials

Houston, Feb 23: The first–ever vaccine to prevent kala azar, the world’s second largest parasitic killer after malaria, has been developed and clinical trials to test it are being planned in India, the epicentre of the disease, along with the US. Visceral leishmaniasis (VL) or black fever affects 500,000 people each year in India, Nepal, Bangladesh, Sudan, and Brazil and is also called the "parasitic version of HIV." According to the National Vector–borne Disease Control programme, more than 25,000 cases had been reported in 2010 in India with 73 deaths. The vaccine, which took researchers more than two decades to develop, entered Phase I trials in recent weeks, according to the Vaccine’s developer Steve Reed, founder of the Infectious Disease Research Institute (IDRI). The Phase 1 trial is taking place in Washington State, with a companion Phase 1 trial planned in India.
(Source: http://www.thehindubusinessline.com/industry–and–economy/economy/article2923644.ece)

For comments and archives

Naltrexone may lessen chronic pain

Low doses of the opioid antagonist naltrexone (ReVia) may relieve pain associated with fibromyalgia compared with placebo by targeting the immune pathway of pain, researchers said. In a small, randomized crossover trial, fibromyalgia patients reported significantly greater reductions in pain with naltrexone than with placebo, Jarred Younger, PhD, of Stanford University School of Medicine, and colleagues reported at the American Academy of Pain Medicine meeting. (Source: Medpage Today)

For comments and archives

Flavanones in citrus fruit may lower stroke risk

High intake of flavanones, a subclass of flavonoids found in the greatest concentrations in oranges and grapefruit, is associated with a 19% lower risk for ischemic stroke in women, a new analysis from the Nurses’ Health Study has shown. (Source: Medscape Medical News)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: #IJMD Comparison of shear bond strength of three different company composites cured with plasma arc curing light… fb.me/1BLd6RvyI

@DeepakChopra: Your true being is connected to all that exists. It has no limitations. It has infinite creativity. It is fearless.

 
    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Eat less to live more – a new prescription

Eating less calories can delay primary aging. "The less you live the more you live" has been a Vedic saying. Calorie restriction has previously been shown to slow aging and increase lifespan in small mammals.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What should one expect from treatment of hirsutism?

Hormone treatment generally prevents new terminal hairs from developing and may slow the growth rate of existing hairs. Once a hormone treatment has proven to be effective, it may be continued indefinitely. Electrolysis or laser can remove any hair remaining after hormone therapy. Because it is usually not possible to cure the hormonal problem that causes hirsutism, ongoing medical treatment is required to manage.

For comments and archives

 
    Microbial World: The Good and the Bad they do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta The Medicity)

God created us and God also created the microorganisms: Bacteria, viruses, fungi and parasites, the whole microbial world. Some of these microbes are good for us and some are deadly for us. We are starting this column to serve the community by creating awareness amongst the health care providers about microbes, what they do to us, the good and the bad and what we can do to make use of the good the microbes do and protect self and community from the bad the microbes do.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Just listen

I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it’s given from the heart. When people are talking, there’s no need to do anything but receive them. Just take them in. Listen to what they’re saying. Care about it. Most times caring about it is even more important than understanding it. Most of us don’t value ourselves or our love enough to know this. It has taken me along time to believe in the power of simple saying, "I’m so sorry," when someone is in pain. And meaning it.

One of my patients told me that when she tried to tell her story people often interrupted to tell her that they once had something just like that happen to them. Subtly her pain became a story about themselves. Eventually she stopped talking to most people. It was just too lonely. We connect through listening. When we interrupt what someone is saying to let them know that we understand, we move the focus of attention to ourselves. When we listen, they know we care. Many people with cancer can talk about the relief of having someone just listen.

I have even learned to respond to someone crying by just listening. In the old days I used to reach for the tissues, until I realized that passing a person a tissue may be just another way to shut them down, to take them out of their experience of sadness and grief. Now I just listen. When they have cried all they need to cry, they find me there with them.

This simple thing has not been that easy to learn. It certainly went against everything I had been taught since I was very young. I thought people listened only because they were too timid to speak or did not know the answer. A loving silence often has far more power to heal and to connect than the most well intentioned words.

For comments and archives

 
    Cardiology eMedinewS

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Aldosterone inversely linked to mortality and acute ischemic events in CAD with normal EF and no MI – Dr Sameer Srivastava

Read More

Lessons from the RIVAL trial, published in 2011 – Dr Rony Mathew (Kochi)

Read More

Why radial stenting – Dr S Chugh

Read More

RPR cut–off < 230 PRU – Dr Praveen Chandra

Read More

Medina classification for bifurcation lesions – Dr Mantosh Panja (Kolkata)

Read More

 
    Pediatric eMedinewS

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

H. pylori breath test Ok for kids, FDA says

Read More

Protocol may stop infection after cardiac surgery in peds

Read More

Tool spots kids at risk for in hospital cardiac arrest

Read More

Hospital baby beds recalled

Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A 13–year–old diabetic child needed to increase his metformin dose.
Dr Bad: Metformin is not given to children.
Dr Good: You can increase up to 2 gms per day.
Lesson: In pediatric patients, metformin is started as an oral dose of 500 mg, administered once–daily. The dose can be increased by 500 mg increments, initially as 500 mg twice daily, to a maximum daily dose of 2000 mg given as 1000 mg twice daily (Diabetes Care 2002;25:89)

For comments and archives

Make Sure

Situation: A patient with pseudomonas meningitis was not responding.
Reaction: Oh my God! Why was aminoglycoside not added?
Lesson: Make sure that when pseudomonas meningitis is suspected, combination therapy with two antibiotics from different classes to which the isolate is susceptible are given and one antibiotic is an aminoglycoside, unless the use is precluded by nephrotoxicity. The therapy should continue for at least 21 days.

For comments and archives

 
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  Quote of the Day

(Dr GM Singh)

The weak can never forgive. Forgiveness is the attribute of the strong. Mahatma Gandhi

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Treat the patient and not the lab reports. Always correlate with clinical findings.

 
    Legal Questions of the Day

(Dr MC Gupta, Advocate & Medico–legal Consultant)

Q. A 16–year–old unmarried girl is brought to an MTP center by her father for abortion. The mother intervenes and denies consent. What should the doctor do?

Ans. The doctor should do nothing. She should refuse to perform MTP without the consent of the guardian in terms of section 3(4) (a) of the MTP Act, 1971. If the mother refuses, the consent of the guardian cannot be said to be complete.

 
    Mind Teaser

Read this…………………

Overwhelming post–splenectomy infection (OPSI) is commonest in splenectomy done for

a. Thalassemia
b. Trauma
c. Hereditary spherocytosis
d. ITP

Yesterday’s Mind Teaser: Which of the following is not true regarding splenorrhaphy (spleen repair)?

a) Use of Argon Beam coagulator is superior to other techniques.
b) Grade II and III injuries can be managed by suture repair.
c) At least one–third of the spleen should be preserved to maintain immunological function.
d) Mesh wrapping is recommended for Grade IV injuries.

Answer for Yesterday’s Mind Teaser: a) Use of Argon Beam coagulator is superior to other techniques.

Correct answers received from: Dr CP Singh, Raju Kuppusamy, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Anil Bairaria.

Answer for 28th February Mind Teaser
: c) Splenomegaly (enlargement of spleen) is present in most of the patients.
Correct answers received from: Avula Ramadevi, Dr Ankita Kanathia, Sagar.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Teacher: Ellen, give me a sentence starting with "I".
Ellen: I is…
Teacher: No, Ellen. Always say, I am.
Ellen: All right. I am the ninth letter of the alphabet.

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Right coronary artery supplying blood to the electrical area of heart is called artery of sudden death

  • The most common cause of sudden cardiac death in adults over the age of 40 has been coronary artery atheroma seen in postmortem examination in about 100 cases randomly selected by me in the mortuary of AIIMS.
  • The most common finding at postmortem examination is chronic high-grade stenosis of minimum one segment of a major coronary artery, the arteries which supply the heart muscle with its blood supply. A significant number of cases also have an identifiable clot in a major coronary artery which causes transmural occlusion of that vessel.
  • In 75 cases out of hundred cases, the clot was found in the right coronary artery supplying the electrical area of heart. Death in these cases is thought to result from a period of transient or prolonged lack of blood supply in the muscle of the heart wall which induces an ventricular arrhythmia/fibrillation and no changes in the myocardium is seen during postmortem examination.
  • The absence of the histological signs of acute necrosis and a healed infarct are a common finding.
  • Chronic high–grade stenosis causing previous episodes of ischemia and areas of focal fibrosis is seen histologically in the myocardium.
  • Ventricular arrhythmias may arise from a myocardium which has been previously scarred by episodes of ischemia.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Eating fast food can cause liver damage

Eating at least two fast foods meals every day and restricting levels of physical activity to no more than 5,000 steps a day can lead to signs of liver damage or gain weight as per a Swedish study by Dr. Fredrik H. Nystrom of University Hospital of Linkoping, Sweden and colleagues published in the journal Gut, said Padma Shri and Dr B C Roy Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India, while quoting the Swedish study.

At the end of 4 weeks, the fast food eaters had put on an average of 6.5 kgs (14.3 pounds). After just one week on the fast food diet, blood tests showed sharp increases in a liver enzyme called serum glutamic pyruvic transaminase or SGPT. SGPT levels were more than quadrupled over the 4–week study period. Increased SGPT levels are used to diagnose liver disease before symptoms develop. In 11 fast food eaters, SGPT rose to levels suggestive of liver damage. The SGPT increases were linked to weight gain and higher sugar and carbohydrate intake.

 
    Readers Responses
  1. In response to the query published in issue dated …………..Dear emedinews readers, I am suffering from loss of taste. I was advised tests of B 12 + Zinc + Folic Acid. Vit D was lower, the other 2 were within range. You had further suggested Triphala Gargles + Alpha d3 + B complex with Zinc……

    Dear Sir, One of the possibilities: Monosodium Glutamate might be causing or exacerbating symptoms. MonoSodium Glutamate (MSG) which is typically used in Thai, Chinese and a number of spicy Indian foods also as a flavor enhancer. The symptoms are varied and diagnosis is by exclusion of food materials containing MSG. Whilst I can not provide an explanation as to "Whether MSG casuses Taste loss ?" but this point is worth considering. I am enclosing the link for an article regarding MSG for reference http://www.msgmyth.com/deb_s_story.html Best wishes: Dr Jitendra Ingole, MD Internal Medicine.
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

Study Camp on ‘Mind–Body Medicine and Beyond’

16–23 June 2012, Nainital Centre (Van Nivas)

Sri Aurobindo Ashram – Delhi Branch will organize the 5th Study Camp on ‘Mind–Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from 16–23 June 2012. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind–body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of a mind–body medicine clinic at AIIMS, and the author of Back to Health through Yoga and Essays on Yoga. For more details, send an e–mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

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  Pesticides Safely

 
    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta