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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial…

1st March 2013, Friday

Healthcare for all not possible with the present budget

In his speech when presenting the budget, the Finance Minister said that health for all and education for all is his priority but the budget allocation is only Rs. 37330 crores, which is an increase of only 7.5% in the last years allocation (planned and non-planned budget together). Medical fraternity expected it to be at least 2-3% of the GDP. Even allocation to AYUSH is only 1069 crores against 1650 crores allocated to six AIIMS-like institutions. If the Government really wanted to do something for promoting healthcare, they could have allocated for six AIIMS-like AYUSH institutions whose purpose should have been prevention so that people do not require allopathic tertiary care.

There are no tax holidays or tax exemptions for doctors living in rural areas in the present budge. Also, there was no relief for making VISA easy for medical tourism.

The Rs. 110 crores allocated for disability is not sufficient. Rs. 6000 crores should have been allocated for providing free generic drugs for people coming to government hospitals. This announcement was lacking in the budget.

Rs. 150 crores have been allocated for the care of the elderly, who constitute 8% of the total population. Elderly people usually do not have insurance as insurance companies do not give them a cover. At least 8% of the total health budget should have been allocated for the elderly.

Allocations to National Health Mission (NHM) (which covers both rural and urban population budget) is only Rs. 21200 crores, which is less than the amount used last year for which rural mission. It aims to provide urban mission money from the money received from the rural mission project. Separate budget should have been allocated for the urban mission.

Rs. 4727 crores allocated for training, education and research is also inadequate as unless you patent your own equipments and drugs, you are going to be dependent on foreign market.

India Medical Association in its recent meeting with Economic Advisor, Ministry of Health, Government of India had offered that every private doctor should be incorporated for providing healthcare facilities across the country, where the Government only had to invest on the human resource.

The government can start MD in Rural Medicine with a curriculum that teaches the art of treating the patients in limited resources. After that people can choose and do their respective post graduation. This way the doctors will not feel that it is a burden on them. There will be additional degree in MD in Rural Medicine Surgery. Such doctors serving in rural areas should be given income tax-free income.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

How does chronic constipation affect quality of life for a patient?

Chronic constipation has been associated with considerable impairment in quality of life as it can be physically and mentally troublesome for many patients, and can significantly interfere with their daily living and well-being. Individuals with constipation have higher medical care (outpatient and emergency) use, which leads to large individual healthcare costs, and represents a burden to healthcare delivery systems.

For comments and archives

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

H5N1 Bird Flu Pandemic Just
Three Mutations Away

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

Multi-specialty camp in East Delhi

A multispecialty camp was organized by Heart Care Foundation of India in association with East Delhi Walkers’ Association on 17th February 2013.

 
Dr K K Aggarwal
    National News

254 died of swine flu: Health Ministry

New Delhi, Feb 27 (PTI) As many as 254 lives have been lost in the country due to swine flu during the current year till February 24, with Rajasthan reporting maximum of 105 deaths. According to the Union Health Ministry, a total of 2,267 persons have tested positive for the Influenza A (H1N1) virus across the country, with the maximum of 759 reported from Delhi alone.

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    From the Desk of Vice President (Elect) IMA (Dr KK Aggarwal)

Meeting with Dr. Sheela Prasad, Adviser Economy, Ministry of Health, Government of India and Dr. P.K. Abdul Kareem

Dr. Narender Saini, Secretary General, Indian Medical Association, Dr. S. Roy and I met Dr. Sheela Prasad and Dr. PK Abdul Kareem from Ministry of Health, Government of India, Economy Department regarding the suggestions of on health budget given by IMA.

  1. IMA offered Health Ministry services of private doctors under a private-public partnership regarding primary health care. Through IMA, Health Ministry was advised to use the services of 2.2 lakh doctors spread over 1800 branches. Under the PPP module, the Ministry can use individual private doctors’ clinic setups as a part of their health care infrastructure where they will have to invest only on the doctors. The Government will get the infrastructure at no cost. IMA doctors cover 30 crore patients every month.
  2. Concern was shown to allocate more funds for drugs in government sector.
  3. Reimbursement to private hospitals regarding stabilization of a patient was discussed. IMA’s viewpoint was that doctors should be able to provide first-aid but for stabilization of patients, the Government should be able to reimburse at CGHS rates. Tamil Nadu module was discussed.
  4. It was discussed that CGHS, State Government, Mediclaim and other reimbursement bodies should reimburse for drugs and devices, which are cheapest with preference given to indigenous ones. Anybody who wants a device, which is costlier than indigenous, should pay from his own pocket.
  5. It was discussed that health as an infrastructure be notified.
  6. IMA offered that if doctors commit 10% free work, they should be given equivalent incentives in income tax exemptions or the status of a trust.
  7. Government should make all medical equipment, along with reagents, duty-free as amount of duty collected per year is insignificant.
  8. No service tax should be levied on doctors. If this is done, medical consultation charges will increase by 100%.
  9. Health insurance should be made compulsory and for those who cannot afford, Government should pay.
  10. Medical treatment on CGHS rates for a patient should be exempted under tax as expenditure.
  11. Preventive health checkup and health insurance tax rebate should be increased from 10 to 25 thousand.
  12. It has been observed that medical doctors live, on an average, 10 years less than the non-doctors. Risk insurance should be made compulsory and provided by the Government.
  13. MRP of the drugs should be controlled.

For comments and archives

    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Sexual abuse is inappropriate sexual behavior with a child. It includes fondling a child's genitals, making the child fondle an adult's genitals, sexual assault (intercourse, incest, rape and sodomy), exhibitionism and pornography. To be considered child abuse, these acts have to be committed by a person responsible for the care of a child or related to the child (for example a baby-sitter, parent, neighbor, relatives, extended family member, peer, older child, friend, stranger, or a day-care provider).

For comments and archives

 
    Valvular Heart Disease Update

When is bypass surgery indicated during valvular replacement?

The 2006 ACC/AHA guidelines reached the following conclusions about CABG at the time of aortic valve replacement.

  • CABG was recommended in patients with =70 percent stenosis of major coronary arteries.
  • Among patients undergoing CABG, the weight of evidence favored use of a left internal mammary artery graft for =50 to 70 percent stenosis left anterior descending coronary artery.
  • CABG was considered reasonable in patients with 50 to 70 percent stenosis of major coronary arteries.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Increased dietary sugar drives global rise in diabetes

The increasing availability of sugary food and drink — independent of excess calories, excess weight, or a sedentary lifestyle — explains part of the rise in cases of type 2 diabetes worldwide, suggests a new study published online February 27 in PLoS ONE. (Source: Medscape)

New stress echo criteria close gaps

The 2011 updated appropriate use criteria (AUC) for stress echocardiograms represent an improvement over the original version, but the use of "imaging gatekeepers" may need refinement, a single-center study suggested. (Source: Medpage Today)

Common 'Red Flags' are poor indicators of spinal cancer

The identification of spinal cancer in patients with low back pain is not helped much by the "red flag" signs and symptoms that indicate a higher risk for a serious underlying condition, according to a review published online today in the Cochrane Database of Systematic Reviews. (Source: Medscape)

Health IT use lags in infection prevention efforts

As US hospitals increasingly use health information technologies to improve the quality and efficiency of healthcare delivery, many hospital infection preventionists (IPs) lag in awareness and engagement in those activities, according to an article published online February 18 in the American Journal of Infection Control. (Source: Medscape)

Personalized risk info may allow better screening decisions

Patients make better informed choices about undergoing screening tests when given risk information related to their own personal risk rather than average risks, according to findings from a systematic review published online February 28 in the Cochrane Database of Systematic Reviews. (Source: Medscape)

 
   Twitter of the Day

@DrKKAggarwal: Tolvaptan and Liver Damage Warning US FDA has issued warning about liver injury associated with tolvaptan, in a... http://fb.me/10Dj2gmhI

@DeepakChopra: Nature is a balance of evolution and destruction. I discuss the paradox of existence in this week's Rabbit Hole http://tinyurl.com/aokesqy

 
    Spiritual Update

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

What is the importance of Agni in pooja and in the Phera ceremony?

In Hinduism, fire is the symbol of purity, and the fire deity is called Agni Dev who is worshipped in all Hindu rituals, like havans, yagnas, ahutis, sankalp, marriage ceremonies (seven pheras around the fire). Fire destroys impurities without itself being affected.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How does BMI affect fertility?

A BMI of 18.5 or less (underweight) may cause irregular menstrual cycles and may cause ovulation (release of an egg from the ovaries) to stop. A BMI of 17.5 or less may indicate an eating disorder. A BMI in the obesity range may also lead to irregular menstrual cycles and irregular ovulation. Women with a BMI of greater than 29 should see a doctor for an evaluation of hormonal status related to ovulation.

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Who is a healthy donor?

Any person within the age group of 18 – 60 years with minimum body weight 45 kg, and hemoglobin content minimum 12.5 gm% is a healthy donor.

For comments and archives

 
   An Inspirational Story

Cost of a miracle

A little girl went to her bedroom and pulled a glass jelly jar from its hiding place in the closet.

She poured the change out on the floor and counted it carefully. Three times, even. The total had to be exactly perfect. No chance here for mistakes.

Carefully placing the coins back in the jar and twisting on the cap, she slipped out the back door and made her way six blocks to Rexall's Drug Store with the big Red Indian Chief sign above the door. She waited patiently for the pharmacist to give her some attention, but he was too busy at this moment. Tess twisted her feet to make a scuffing noise. Nothing. She cleared her throat with the most disgusting sound she could muster. No good. Finally she took a quarter from her jar and banged it on the glass counter. That did it!

'And what do you want?' the pharmacist asked in an annoyed tone of voice. I'm talking to my brother from Chicago whom I haven't seen in ages,' he said without waiting for a reply to his question.

'Well, I want to talk to you about my brother,' Tess answered back in the same annoyed tone. 'He's really, really sick....and I want to buy a miracle.'

'I beg your pardon?' said the pharmacist.

'His name is Andrew and he has something bad growing inside his head and my Daddy says only a miracle can save him now. So how much does a miracle cost?'

'We don't sell miracles here, little girl. I'm sorry but I can't help you,' the pharmacist said, softening a little.

'Listen, I have the money to pay for it. If it isn't enough, I will get the rest. Just tell me how much it costs.'

The pharmacist's brother was a well dressed man. He stooped down and asked the little girl, 'What kind of a miracle does your brother need?'

'I don't know, 'Tess replied with her eyes welling up I just know he's really sick and Mommy says he needs an operation. But my Daddy can't pay for it, so I want to use my money.'

'How much do you have?' asked the man from Chicago.

'One dollar and eleven cents,' Tess answered barely audible. 'And it's all the money I have, but I can get some more if I need to.'

'Well, what a coincidence,' smiled the man. 'A dollar and eleven cents-the exact price of a miracle for little brothers.'

He took her money in one hand and with the other hand he grasped her mitten and said 'Take me to where you live. I want to see your brother and meet your parents. Let's see if I have the miracle you need.'

That well-dressed man was Dr. Carlton Armstrong, a surgeon, specializing in neurosurgery. The operation was completed free of charge and it wasn't long until Andrew was home again and doing well.

Mom and Dad were happily talking about the chain of events that had led them to this place.

'That surgery,' her Mom whispered. 'was a real miracle. I wonder how much it would have cost?'

Tess smiled. She knew exactly how much a miracle cost.....one dollar and eleven cents...plus the faith of a little child.

In our lives, we never know how many miracles we will need. A miracle is not the suspension of natural law, but the operation of a higher law. I know you'll keep the ball moving!

Here it goes. Throw it back to someone who means something to you!

A ball is a circle, no beginning, no end. It keeps us together like our Circle of Friends. But the treasure inside for you to see is the treasure of friendship you've granted to me.

Today I pass the friendship ball to you.

Pass it on to someone who is a friend to you.

MY OATH TO YOU... When you are sad.....I will dry your tears. When you are scared.......I will comfort your fears.

When you are worried......I will give you hope.

When you are confused.....I will help you cope.

And when you are lost...and can't see the light, I shall be your beacon...shining ever so bright.

This is my oath.....I pledge till the end.

Why you may ask?....Because you're my friend.

Signed: GOD

For comments and archives

 
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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

 
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   Cardiology eMedinewS

Higher risks for patients with secondary AF diagnosis Read More

Large proportion of raised LDL cholesterol in FH caused by multiple genes Read More

 
   Pediatric eMedinewS

Ramadan fasting during pregnancy linked to smaller offspring Read More

First UTI in febrile infants: No ideal workup exists Read More

 
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What is the incubation period of rabies in humans?

The incubation period of rabies that is the time interval between the exposure to virus and the onset of symptoms, is usually from 03 weeks to 03 months (rarely 04 days to 02 years). An incubation period as long as 19 years has been reported. Children are at an increased risk of a shorter incubation period because of their short stature and bites are often closer to CNS. Multiple bites to the head and neck are associated with very short incubation periods less than 1 month.

The incubation period varies with the amount of virus transmitted, virus strain, site of inoculation (bites closer to the head have a shorter incubation period), host immunity and nature of the wound.

During most of the long incubation period of rabies, the virus likely remains close to the site of viral entry. Centripetal spread to the central nervous system and spread within the central nervous system occur by fast axonal transport

People who are immunocompromised will most likely be more susceptible to rabies. Rabies is usually undetectable during the incubation period, and infections can also be difficult to diagnose when the clinical signs first appear.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and stop low–dose aspirin.
Lesson: In dengue, lose–dose aspirin needs to be stopped.

Make Sure

Situation: A patient after receiving 40 units of insulin developed severe hypoglycemia.
Reaction: Oh my God! The order was 4 units.
Lesson: Make sure that 4 unit is not written as 4.0 units as it may be read incorrectly as 40.

 
  Quote of the Day (Dr GM Singh)

If we would see the color of our future, we must look for it in our present; if we would gaze on the star of our destiny, we must look for it in our hearts. Canon Farrar

 
    Mind Teaser

Read this…………………

The pain management nurse notices a male patient grimacing as he moves from the bed to a chair. The patient tells the nurse that he is not experiencing any pain. The nurse's response is to:

1. Clarify the patient's report by reviewing the patient's nonverbal behavior.
2. Confronting the patient's denial of pain.
3. Obtaining an order for pain medication.
4. Supporting the patient's stoic behavior.

Yesterday’s Mind Teaser: Biofeedback is a therapy used to:

1. Develop psycho-physiologic self-regulation.
2. Enhance drug delivery.
3. Increase release of serotonin.
4. Promote neuronal regeneration.

Answer for yesterday’s Mind Teaser: a. Develop psycho-physiologic self-regulation.

Correct answers received from: Dr K Raju, Dr Bharat Bhushan Aggarwal, Dr KV Sarma, Dr Kanta Jain, Dr Arpan Gandhi, Dr (Maj. Gen.) Anil Bairaria, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Jayashree Sen &
Dr Bitaan Sen.

Answer for 27th February Mind Teaser: b. Morning fatigue, widespread body pain, and focal tenderness

Correct answers received from: Dr Parul Chopra, Dr K Raju.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

Psych Treatment

A woman called her insurance company to see if her policy covered psychiatric treatment.

After reviewing her policy, the agent told her, "Yes, there is an insanity clause!"

 
    Medicolegal Update

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

What is an impulse and what is its medicolegal importance?

Impulse is a sudden and irresistible desire or force in a person, compelling him to the conscious performance of some act for which there is no motive; for example, kleptomania means an irresistible desire to steal articles which may be of small value and even, may be of no use to the person stealing the article. A sane person who has self–control and judgment capacity may not finally give shape to his impulsive or compulsive desire. But an insane person, who lacks in self–control and judgment capacity, cannot resist the impulse and may commit any offence. Thus, in connection with commission of an unlawful act, impulse is a good defense for an insane person which is not so for a sane person. Some types of impulses are:

  • Dipsomania: This is found in alcoholics who have an irresistible desire to take alcoholic drinks.
  • Pyromania: Here, there is an irresistible desire to set fire to things, which may be important and valuable. The person is not conscious or careful, at least temporarily, to the possible dangers of his act.
  • Mutilomania: This is an irresistible desire to injure and mutilate animals, commonly the domestic pets.
  • Sexual impulse: The person may feel compulsive urge to perform sexual intercourse, often in a perverted way. There may be some psychic problem concerning the sexual behavior; or the person may be a victim of mental sub normality.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Healthcare for all not possible with the present budget

In his speech when presenting the budget, the Finance Minister said that health for all and education for all is his priority but the budget allocation is only Rs. 37330 crores, which is an increase of only 7.5% in the last years allocation (planned and non-planned budget together).

Expressing his views on the healthcare allocations in the present budget Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA said that the medical fraternity expected it to be at least 2-3% of the GDP. Even allocation to AYUSH is only 1069 crores against 1650 crores allocated to six AIIMS-like institutions. If the Government really wanted to do something for promoting healthcare, they could have allocated for six AIIMS-like AYUSH institutions whose purpose should have been prevention so that people do not require allopathic tertiary care.

There are no tax holidays or tax exemptions for doctors living in rural areas in the present budge. Also, there was no relief for making VISA easy for medical tourism.

The Rs. 110 crores allocated for disability is not sufficient. Rs. 6000 crores should have been allocated for providing free generic drugs for people coming to government hospitals. This announcement was lacking in the budget.

Rs. 150 crores have been allocated for the care of the elderly, who constitute 8% of the total population. Elderly people usually do not have insurance as insurance companies do not give them a cover. At least 8% of the total health budget should have been allocated for the elderly.

Allocations to National Health Mission (NHM) (which covers both rural and urban population budget) is only Rs. 21200 crores, which is less than the amount used last year for which rural mission. It aims to provide urban mission money from the money received from the rural mission project. Separate budget should have been allocated for the urban mission.

Rs. 4727 crores allocated for training, education and research is also inadequate as unless you patent your own equipments and drugs, you are going to be dependent on foreign market.

India Medical Association in its recent meeting with Economic Advisor, Ministry of Health, Government of India had offered that every private doctor should be incorporated for providing healthcare facilities across the country, where the Government only had to invest on the human resource.

The government can start MD in Rural Medicine with a curriculum that teaches the art of treating the patients in limited resources. After that people can choose and do their respective post graduation. This way the doctors will not feel that it is a burden on them. There will be additional degree in MD in Rural Medicine Surgery. Such doctors serving in rural areas should be given income tax-free income.

 
    Readers Response
  1. Dr KK "Basic emergency care” is that, which can be provided by school children, teachers, police and drivers in the absence of advanced medical care. If a school kid is trained in CPR, he can take care of his peers, family members and community at large. Beside CPR and foreign body removal, the course also includes considerations of the cervical spine & avoiding additional injuries through splinting and immobilization. JOIN DR.K.K. STUDY GROUP.
 
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