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  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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

 
  Editorial …

1st July 2011, Friday

eMedinewS Wishes all Doctors "Happy Doctor’s Day"

Respect the prefix ‘Dr.’ before your name

Very few professions have the privilege of prefixing an honor before their name and medical profession is one of them. We, as doctors, are allowed to prefix ‘Dr.’ before our names and so we must respect this honor.

Diwan, Rai Bahadur, Rotaries, Lion, Justice etc. are other sets of prefixes given by the society to distinguished people. Even the Prime Minister of India, President of India, Member of Parliaments, MLAs, Councillors have no such privilege. Likewise, Padma Awardees too have no such privilege. They cannot write Padma Shri Dr. XYZ but can only write Padma Shri Awardee Dr. XYZ.

There is no law in India, which allows us to write prefix ‘Dr.’ before our names. It is a precedence which has been accepted and honored by the society. The prefixes Dr., Diwan, Rai Bahadur etc. distinguish the privileged persons from the rest of the population. These prefixes indicate that the main duty of these people is towards the welfare of the society. For example, people are aware as to whom to contact when in trouble. It can be any one with a ‘prefix’.

It is the Vedantic principle of "welfare of the society" which makes doctors special and different in the society. The day this aspect of welfare is lost, society may not accord us the same respect as they have been doing so till now.

The principles involved in acting towards the welfare of the society includes giving 10% of our time to charity; not charging any fee from those who cannot afford; charging less from the middle class and charging normal from people who can afford and where reimbursements are available. Probably, this is the reason that in every hospital even today we have multiple systems of patients and policies starting from Free Wards, General Wards, Concessional Semi Paying Wards and Fully Paid Wards. Many hospitals have even come out with another category of Deluxe where one can charge more from people where money is not a problem. It is the rich who has to pay for the poor in the welfare system.

Let us resolve to commit some portion of our time for the welfare of the poor this year on Doctor’s Day, July 1, 2011.

Dr KK Aggarwal
Group Editor in Chief

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  Changing Practice – Evidence which has changed practice in last one year

Treatment of HIV and tuberculosis

For patients with a CD4 count <500 cells/mm3, start integrated treatment of tuberculosis and HIV infection rather than sequential therapy.

 
  eMedinewS Audio PostCard

Padma Shri & Dr BC Roy National Awardee
Dr K K Aggarwal on


Audio News of the day

Audio PostCard
 
    Photo Feature (From HCFI Photo Gallery)

Doctor’s Day

Eminent dancer Geeta Chandran along with Dr. KK Aggarwal, President of the Heart Care Foundation of India, and Dr. TS Kler, Director, Cath Lab, Escorts Heart Institute, at a press conference on the eve of Doctor's Day in 2006

 
Dr K K Aggarwal
 
    National News

Bitter ‘lauki’ juice can kill you, says panel

HYDERABAD: Do not drink your bottle gourd (‘lauki’ in Hindi, and ‘sorakaya’ in Telugu) juice if it tastes bitter, it could kill you. This recommendation comes after some investigation by an experts’ committee. The death of 59–year–old scientist, Sushil Kumar Saxena, a deputy secretary in the Council for Scientific and Industrial Research (CSIR) in New Delhi in June 2010, spurred an investigation into the effects of the consumption of bottle gourd juice that is bitter. A spate of other deaths relating to the same were also uncovered. This led to the formation of an experts’ committee on the ‘Safety of consumption of vegetable juices with special reference to ‘lauki.’ The committee was constituted by the Indian Council of Medical Research (ICMR) and held its second meeting in New Delhi on Sunday after it was formed this year in April. (TNN | Jun 28, 2011)

(Suneela Garg )

ASHAs to home deliver contraceptives…… Menstrual hygiene scheme to be taken up in 152 districts

The Union Minister of Health and Family Welfare Shri Ghulam Nabi Azad today chaired the seventh meeting of the Mission Steering Group (MSG) of the National Rural Health Mission (NRHM). The MSG is the highest decision making body of NRHM that takes decisions on the policies and programs under the Mission. Sh Vilasrao Deshmukh, Minister of Rural Development and Panchayati Raj, Shri Kapil Sibal, Minister of Human Resource Development and Telecom, Mrs. Sayeeda Hameed, Member, Planning Commission, Secretaries of various Departments of Government of India, Health Secretaries of State Governments and eminent public health professionals attended the meeting.

Addressing the meeting Shri Azad noted that NRHM has completed six years and has been instrumental in revitalizing a health system across the country. Upgradation of health infrastructure, additional manpower at health facilities, improved skills of health care providers, better availability of drugs and diagnostics and service delivery through the participation of community have been the hallmark of National Rural Health Mission. "As we prepare for the 12th Five Year Plan, it is time to take stock of the progress made and to review the strength and weaknesses" he added. He informed that during the year 2010–11, the number of beneficiaries under Janani Suraksha Yojana has reached 11.3 million as against 7,40,000 in 2005–06. Talking about new initiatives, the Minister particularly mentioned that the Mother and Child name based tracking system have also picked up in different States. The data base for more than 43 lakh mothers and 17 lakh children has already been created. The following important decisions were taken in the meeting:

  • Population stabilization was one of the thrust areas discussed by the MSG. It was decided to utilize ASHAs for delivery of contraceptives at the homes of the beneficiaries and ASHAs are to be allowed to charge Rs. 1.00 for a pack of 3 condoms, Re 1.00 for an Oral Contraceptive Pill (OCP) cycle and Rs. 2.00 for an Emergency Contraceptive Pill (ECP) from the beneficiaries.
  • Global evidence indicates that home visits for neonatal care by community health workers are associated with reduced neonatal mortality. To make an impact on the Infant Mortality Rate, MSG decided to provide performance linked incentive of Rs. 250/ to ASHAs. The proposed schedule of home visit for institutional delivery is 6 home visits on days 3, 7, 14, 21, 28, and 42 in order to assess newborn as well as to ensure post partum care of mother. In the case of home delivery, a total of 7 home visits will be required as ASHA should be present at the birth or visit the mother and baby as soon as possible within the first 24 hours and on days 3, 7, 14, 21, 28 and 42.
  • It was decided to further improve and streamline the scheme to promote menstrual hygiene amongst the adolescent girls in rural areas. For this the MSG decided to revise the existing scheme with following modification: The scheme would be taken up in 152 districts instead of 150; A price of Rs. 7.50 per pack of 6 sanitary napkins was fixed for procurement for which assistance will be provided by the Government of India. Any amount for procurement over and above this norm will be provided through the State budget; A uniform selling price of Rs. 6 per pack was fixed for all the adolescent girls to be covered under the scheme.
  • The criteria for financial allocation to the States were discussed in detail. It was decided that an Expert Group be set up to look into the existing weightage formula to bridge the gap in health systems between the States. The MSG also decided that 10% of the total allocation under flexible pools of NRHM be kept apart at the national level which can be released to different States for specific activities based on their performance against the monitorable targets and implementation of specific reform agenda in the health sector.

    by National Rural Health Mission on Tuesday, June 21, 2011 at 9:47am

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

(Dr Monica and Brahm Vasudev)

ADA: Two tests needed to track diabetes progression

Diagnosing prediabetes with a combination of glycated hemoglobin and impaired fasting glucose may be a more effective predictor of progression to diabetes than either test alone, Japanese researchers found. The hazard ratios for incident diabetes were similar for the two tests –– about a six–fold increased risk compared with normoglycemic patients –– but were increased substantially to almost a 32–fold higher risk when prediabetes was diagnosed using both together, Hirohito Sone, MD, of Toranomon Hospital in Tokyo, and colleagues reported simultaneously in The Lancet and at the American Diabetes Association meeting. (Source: Medpage Today)

ADA: Intensive Tx no better than good routine diabetes care

Screening and early intensive management of type 2 diabetes may hold little benefit beyond usual care, perhaps because of more aggressive routine practice, researchers suggested. Intense management of glucose, lipids, and blood pressure for screen–detected cases in the randomized ADDITION trial modestly reduced cardiovascular events by 12% and raised overall survival by 9% over roughly five years, Simon J. Griffin, MD, of Addenbrooke’s Hospital at the University of Cambridge, England, and colleagues found. (Source: Medpage Today)

ADA: Diet counseling aids glycemic control

Intensive dietary counseling in the year following a diagnosis of diabetes improved glycemic control, but adding exercise to the mix didn't add any extra benefits, researchers said. Newly diagnosed diabetes patients given an extra 6½ hours of dietary counseling had significant reductions in glycated hemoglobin (HbA1c) after six months and a year compared with patients who got the standard advice on diet, according to Rob Andrews, MB, ChB, PhD, of the University of Bristol, and colleagues. (Source: Medpage Today)

Adverse events common with rhBMP–2 device

In stark contrast to published reports from manufacturer–sponsored studies of the Infuse spinal fusion device that incorporates a biologic bone–building drug, a new analysis of FDA documents and other data sources suggests that up to half of patients receiving the device may experience adverse events related to the drug, researchers said. The Infuse device, which delivers recombinant human bone morphogenetic protein–2 (rhBMP–2) to speed vertebral fusion in patients with chronic back pain, has adverse event rates of 10% to 50% depending on the approach, according to Eugene Carragee, MD, of Stanford University’s outpatient clinic in Redwood City, Calif., and colleagues. (Source: Medpage Today)

 
   Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Exercise, inflammation and type 2 diabetes

It is well–known that physical activity reduces type 2 diabetes and cardiovascular disease. As a matter of fact, the American Heart Association lists becoming more active as one of the top lifestyle changes necessary to prevent heart attacks. However, exactly how physical activity does this is still unknown, so researchers performed a study to find out whether a certain type of inflammation caused by C–reactive protein (which is lowered after physical activity) is related to mortality in type 2 diabetes patients. Researchers from the University of Turku in Finland followed 569 type 2 diabetic patients (ages 45–64) who were free of cardiovascular disease at the beginning of the study. They separated patients into groups according to the level of the protein in their blood and by the amount of physical activity they engaged in.

During an 18–year follow–up, 356 patients died, 217 of whom died of cardiovascular disease–related complications. Those who were more physically active had significantly less coronary heart disease. However, researchers found that physical activity had nearly no effect on patients with a low level of inflammation, but that it significantly reduced total cardiovascular disease mortality in type 2 diabetic patients with elevated levels of inflammation. These results suggest that physical activity can have a protective effect against the risks associated with type 2 diabetes and high inflammation.

 
   Twitter of the Day

@DrKKAggarwal: Go and wish your doctor "Happy Doctor’s Day" July 1 is Doctor’s Day. Call your doctor or your doctor friends and… http://fb.me/NebsCzxC

@SanjivChopra: My video response to "Your definition of reality…" #VYou http://vyou.com/a/560078

 
    Spiritual Update

Science behind Hanuman Chalisa

Most spiritual powers can be explained by understanding the concept that soul and spirit are nothing but energized files of information that carry information of not only this birth but also of the past births. When Soul and Spirit are connected with each other, the transfer of data is just a formality.

 
    An Inspirational Story

(Dr Prabha Sanghi)

To Heaven and who was able to compare

A man died and because he had been a good person, he went to Heaven, where Saint Peter greeted him at the door. Welcome! he said. You can enter Heaven right away, but, because you lived such a good life, you can also go and check out Hell first, if you like. The man was rather curious and said – well, why not – and he went down all the stairs to reach the door of Hell, which opened before him. Behind the door, he saw many people sitting around tables with delicious food! But they were all very sad, and suffering, because instead of hands they had long knives and forks as arm extensions and they did not manage to put any of this great food in their mouths.

The man went back up to Heaven and said to Saint Peter: Wow, am I glad that I can go to Heaven. That is really some punishment. Welcome to Heaven, Saint Peter said, as he let the man in.

What did he see there? He saw many people sitting around tables with delicious food, just like in Hell!

And just like in Hell, they also had these long fork and knive extensions on their arms! But in Heaven, the people weren’t crying or cursing, because they were sticking the food in each other’s mouths! "Try this", they laughed. "And this!", and they had lots of fun in the process.

Lesson: Happiness comes from making other people happy. Don’t be selfish but care for other people, and you will be taken care of as well.

 
    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What are the causes of vitamin A deficiency?

The risk of vitamin A deficiency is increased in patients suffering from fat malabsorption, cystic fibrosis, sprue, pancreatic insufficiency, IBD, or cholestasis, as well as in persons who have undergone small–bowel bypass surgery. The risk is also increased in vegans, refugees, recent immigrants, persons with alcoholism, and toddlers and preschool children living below the poverty line. These patients should be advised to consume vitamin A.

 
    eMedinewS Apps

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    Did You Know

(Dr Uday Kakroo)

Drinking water after eating reduces the acid in your mouth by 61 percent.

 
    Legal Question of the Day

(Dr MC Gupta, Advocate)

Q. Should it be acceptable to the medical profession that after the MBBS degree is given to a student by a university, he should be denied registration by the medical council unless he passes an exit exam as proposed by the MCI? If he fails, that means he was not given proper education and the university, the medical college and the MCI failed in their duty to provide proper education. I think the punishment for failing to discharge their responsibility should fall on these entities and not on the medical students who stand to suffer by prolongation, in effect, of their 5–1/2 years’ course by maybe 6 months and deprivation from earning during this period and by general delay in their career prospects. What are your views?

Ans.

1. Your concern is correct.

2. The objective of the exit test is to ensure minimum acceptable standards in a physician before he is licenced by the medical council. The university ought to have exactly the same objective—"to give such education and training as will be required for licencing by the medical council". If the MBBS course and degree granted by the university are themselves certified recognised by the medical council, there should be no reason why the University, the College and the MCI should not work together towards the common aim of giving quality education.

3. One needs to seriously think whether this approach of the MCI can be challenged legally. The following need to think seriously about submitting a legally drafted representation to the government and the MCI in this regard:

a. The IMA
b. Residents’ associations
c. Undergraduate students unions
d. Faculty associations/Teachers’ associations
e. Medical educationists
f. Deans/principals/VC’s

Those who are against it need to move fast in this direction rather than exchanging mails and losing precious time, as happened in the case of the CEA, 2010.

 
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    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim of 2 lakhs of seven years duration needed a claim of Rs. 2.2 lakhs.
Dr. Bad: You will have to pay Rs. 20,000 from your pocket.
Dr. Good: You can claim cumulative bonus.
Lesson: Sum insured under the policy shall be progressively increased by 5% for each claim–free year of insured subject to maximum accumulation of 10 claim–free years of insurance.

Make Sure

Situation: A patient with fever and cough developed complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure that a patient with fever and cough is not given antibiotics as presence of cough mostly signifies viral infection.

 
  SMS of the Day

(Ritu Sinha)

The meaning of life is not an unquestionable answer, it is an unanswerable question.

 
  ENT Update

(Dr. Aru Handa, MS, DNB (Department Co–coordinator and Senior Consultant Dept. of ENT, Moolchand Medcity)

What are the causes of perforation of ear drum ?

  • Trauma: Direct penetrating injury, indirect trauma due to sudden change of air pressure as in forceful blow on ear, blast injury, barotrauma, diving or due to accidents associated with temporal bone fracture.
  • Iatrogenic: Improper wax cleaning; sometimes drum does not heal following myringotomy with or without grommet insertion.
  • Infections: Viral or bacterial infection leading to acute otitis media (AOM). In inadequately treated AOM, the pressure of the pus behind the ear drum weakens the fibrous layer of tympanic membrane thus causing perforation.
 
  GP Pearls

(Dr Pawan Gupta)

According to a study, liraglutide was superior to sitagliptin for glycemic control in metformin–treated diabetic patients and resulted in greater reductions in body weight (Lancet 2010;375(9724):1447–56). But, the gastrointestinal tolerance profile is better with sitagliptin than with liraglutide, and one pill of sitagliptin daily might be judged as easier to administer than one subcutaneous injection of liraglutide daily. The increased cost of liraglutide should be compared with the benefit provided by (its) improved glucose control and weight reduction (Lancet 2010;375(9724):1410–2)

 
    Medicolegal Update

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

What is the accidental suffocation?

  • There have been numerous instances of accidental deaths as a result of children putting things into their mouths and swallowing them, which in turn blocks the airways. This is why it is imperative that small children are never left unattended and are not allowed to put anything in their mouths which may result in their choking.
  • People also die of suffocation in the instance of a house fire where there is a lack of oxygen and they cannot breathe. The postmortem examination provides information whether or not the victim was conscious at the time of the fire starting or if indeed they had already been deceased.
  • This process is measured by the amount of carbon dioxide in the deceased's system at the autopsy stage.
  • Murder is comparatively rare; however, in some cases the assailant has tried to cover his or her tracks by setting fire to the location where the deceased is finally found. This could be a house, an office, a workshop, anywhere.
  • The autopsy surgeon must look for the telltale signs: the bloodshot eyes, the high levels of carbon dioxide in the blood and bruising around the nose and mouth and may even collect trace evidence such as hair and fiber from around the nose and mouth of the deceased.
  • As accidental suffocation or smothering is relatively common; however, until proven otherwise by a forensic surgeon/doctor and subsequent inquest, all cases of suffocation or smothering are treated as potentially suspicious.
 
  Vitamins—Open Secrets revealed

(Dr Jitendra Ingole, MD Internal Medicine)

Vitamin B12 and Homocysteine

Grain fortification with vitamin B12?

Since 1998 it has been mandatory to fortify grain–based foods with folic acid in the United States. Recent reports indicate that this measure has resulted in a 19 per cent decrease in the incidence of neural tube defects. A similar fortification program is being considered in the UK. Irish researchers now suggest that the fortification protocol should include not only folic acid, but also vitamin B12. They point out that folic acid supplementation also lowers the level of homocysteine, a potent risk factor for heart and vascular disease. However, a recent trial carried out by the Dublin researchers clearly showed that as blood levels of folic acid increased through supplementation, blood levels of vitamin–B12 became the limiting factor. In other words, additional folic acid as well as additional vitamin B12 is required in order to attain the maximum reduction in homocysteine levels. Four to five hundred micrograms per day of folic acid were found to increase folic acid levels by 80 to 180 per cent and lower homocysteine levels by about 30 per cent in both men and women. Both folate and homocysteine levels tended to revert to their pre–supplementation levels after 10 weeks of no supplementation; this shows that continuous supplementation is necessary in order to keep homocysteine levels under control.

(Ref: Quinlivan EP, McPartlin J, McNulty H, et al. Importance of both folic acid and vitamin B12 in reduction of risk of vascular disease. Lancet. 2002 Jan 19;359(9302):227–8)

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Electrolytes (Sodium, Potassium, Chloride and Carbon dioxide)

To help detect and evaluate the severity of an existing electrolyte imbalance and to monitor the effectiveness of treatment. Electrolytes may be affected by many conditions. In Addison’s disease, the sodium, chloride, and carbon dioxide levels are often low, while the potassium level may be very high.

 
    Mind Teaser

Read this…………………

Which one of the following is the investigation of choice for evaluation of suspected Perthe’s disease?

1. Plain X–ray
2. Ultrasonography (US)
3. Computed Tomography (CT)
4. Magnetic Resonance Imaging

Yesterday’s Mind Teaser: o2ne

Answer for yesterday’s Mind Teaser:
Two in One

Correct answers received from: Dr BN Ganagdhar, Dr Sandhya, Dr Rakesh Bhasin, Dr K Raju, CMA Sudhir Sharma, Dr Muthumperumal Thirumalpillai, Dr Rashmi Chhibber, Dr Surendra Bahadur Mathur,
Dr Anil Bairaria, Dr Nelam Nath, Dr Chandresh Jardosh, Dr BB Aggarwal, Dr Pramod M Kulkarni, Dr YJ Vasavada.

Answer for 28th June Mind Teaser:1. Persistent and inappropriate repletion of the same thoughts.
Correct answers received from: Dr Jyotsna Verma, Dr Anupama Sethi Malhotra, Dr Keshav,
Dr Priyanshu, Dr Krishna.

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

What is pledging?

If you wish to take a loan from a bank against the security of your physical share, the certificate must be physically lodged with the bank. This action is called a pledge. In electronic holding also you can pledge the shares by making a request with your DP in favor of any bank. You can pledge your shares in a bank which is a DP or a client of a DP.

 
    Laugh a While

(Dr. Prabha Sanghi)

The family of tomatoes

A family of three tomatoes were walking downtown one day when the little baby tomato started lagging behind. The big father tomato walks back to the baby tomato, stomps on her, squashing her into a red paste, and says, "Ketchup!"

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Citicoline 500mg + Piracetam 400mg per 5 ml syrup
Additional dosage form
11.10.10
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Lung cancer screening

A randomized trial of lung cancer screening in over 3,000 high–risk individuals found cumulative probability of a false positive finding of 33 percent for screening by low–dose CT and 15 percent for chest x–ray.

(Ref: Croswell JM, Baker SG, Marcus PM, et al. Cumulative incidence of false–positive test results in lung cancer screening: a randomized trial. Ann Intern Med 2010;152:505)

 
    Public Forum

(Press Release for use by the newspapers)

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

July 1 is Doctor’s Day

Call your doctor or your doctor friends and wish them a Happy Doctor’s Day

Medicine is a noble profession. Among all professions, medicine is the only profession which can be regarded as next to God, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

“Doctors treat, but God heals” is a well-known saying. Doctors thus serve as the messengers of God.

A doctor cannot refuse treatment. It is a doctor’s duty to attend to a patient in emergency regardless of caste, creed, race or the financial status of the person. This principle has been very well–personified in our mythology too. Ramayana cites the story of Vaidya Sushen, who treated Lakshmana with the famed Sanjivani booti. He was called to see the unconscious Lakshmana during the war between Lord Rama and Ravana. Despite the fact that he was a royal physician in the kingdom of Ravana, Sushen made the decision of treating Lakshmana. This illustrates the ethical duties of a physician.

Likewise, if a person sentenced to death by hanging falls ill, it is the duty of a physician to treat him until the day of his hanging.

The concept of Family Physician or the General Practitioner of the olden times is fast vanishing in this age of super specialization. Every day new specialties are coming up. What was once the domain of a family physician has been now divided among different specialties. This has created a gap in communication between patient and doctor often leading to litigations. To avoid this, look for a Family Physician, who will be your guide in all health matters and also coordinate your care when specialists are involved.

 
    Readers Responses

An 18–year–old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be to:

1. Leave him as normal adolescent problem.
2. Rule out depression.
3. Rule out migraine.
4. Rule out an oppositional defiant disorder.

The most appropriate answer would be to "Rule Out Depression" because adolescents present with irritable behavior and somatic symptoms in the presence of depression along with a disinterest in studies. Just to "Leave him as normal adolescent problem" can color his perception of future, about self and world. He deserves a minimum of counseling to detect his issues with parents and the reasons for displeasure with them. The decision to treat him with pharmacotherapy could be made by a psychiatrist but a primary care Pediatrician should definitely rule out depression as it is affecting his functioning style, (lack of interest in studies for more than two weeks). He definitely needs help to handle the change in behavior and falling interest in what he is expected to do (or what he has been having interest all along). Thanking you, Yours Sincerely: Dr S Yamuna, Adolescent Physician, Chennai.

  1. Dear Dr K K Aggarwal, Warm Greetings from Chennai. I have been reading emedinews fairly regularly. I have been learning a lot from this newspaper. Congratulations and Thanks. I read the answer to the 27th June Mind Teaser just now as (1), but (2) is a better option from clinical point of view.
 
    Forthcoming Events

National Conference on "Insight on Medico Legal Issues"
Date: Sunday, 10th July, 2011
Venue: Auditorium, Chinmaya Mission, 89, Lodhi Road, New Delhi–110003

eMedinewS and Heart Care Foundation of India are jointly organizing the first-ever National Conference on "Insight on Medico Legal Issues" to commemorate "Doctors’ Day".
The one–day conference will provide total insight into all the medicolegal and ethical issues concerning the practicing doctors. Both medical and legal experts will interact with the delegates on important issues.
You are requested to kindly register in advance as seats are limited. There will be no registration fee. You can register by sending your request at rekhapapola@gmail.com or at 9899974439.

For Programme Details

Programme Schedule 10th July MEDICO LEGAL CONFERENCE
Time Session Chairperson Moderator Speaker Topic
8 Am–8:30 Am Ethical Issues in Medical Research   Dr KK Aggarwal
Dr Girish Tyagi
   
8 am–8.10 am       Ajay Agrawal Rights of a patient in medical trial
8.10–8.20 am       Dr Ranjit Roy Chaudhury Ethical Issues in a medical trial
8:20–8.30 am       Priya Hingorani Statutory permits required for conducting trials
8.30–9.10 am Medical ethics and organ donations Dr N V Kamat Dr KK Aggarwal    
8.30 am–8.40 am       Dr Anoop Gupta Ethical issues in IVF practice
8.40 am–8.50 am       Dr N K Bhatia 100% voluntary blood donation
8.50 am–9.00 am       Dr Rajesh Chawla Need for do not resuscitate laws in India
9.00 am–9.10 am       Dr Neelam Mohan Ethical issues in organ transplantation
9.10 am–9.30 am Handling cases of death Mr S K Saggar
Dr Arvind Chopra
Dr KK Aggarwal
Dr Girish Tyagi
   
9.10 am–9.20 am       Dr S C Tewari Spiritual considerations in a dying patient
9.20 am–9.30 am       Dr G.K. Sharma Medico legal and ethical issues in post mortem
9.30 am–9.50 am Medical Insurance Mr Vibhu Talwar
Dr H K Chopra
Dr Vinod Khetrapal
Dr KK Aggarwal    
9.30 am–9.40 am       Meenakshi Lekhi Engaging a lawyer
9.40 am–9.50 am       Maninder Acharya Understanding various court procedures
9.50 am–10.20 am How to handle medico legal cases? Dr Anil Goyal
Dr Rajiv Ahuja
Ajay Agrawal
Dr Girish Tyagi
   
9.50 am–10.00 am       Dr M C Gupta When to do the MLC?
10.00 am–10.10 am       Dr Sudhir Gupta Checklist of MLC case
10.10 am –10.20 am       Siddarth Luthra Medico legal record keeping
10.20–10.50 am Medical Consent Dr Vinay Aggarwal
Dr P K Dave
Dr KK Aggarwal
Dr Girish Tyagi
   
10.20 am–10.30 am       Indu Malhotra Types of consent
10.30 am–10.40 am       Dr Manoj Singh Ideal consent
10.40 am–10.50 am       Dr N P Singh Extended consent
10.50 am–11.20 am Fallacies in acts applicable to medical profession Dr Anup Sarya
Dr Sanjiv Malik
     
10.50 am–11.00 am       Dr Kaberi Banerjee MTP, PNDT Act
11.00 am–11.10 am       Dr Anupam Sibbal Organ Transplant Act
11.10 am to 12.00 noon Inauguration Justice A K Sikrai
Justice Vipin Sanghi
Dr A K Agarwal
     
12.00 noon–1.00 PM Professional misconduct and professional ethics Dr A K Agarwal
Dr. D S Rana
Dr H S Rissam
Dr KK Aggarwal
Dr Girish Tyagi
   
12.00–12.10 pm       Dr Sanjiv Malik Doctor-pharma relationship
12.10 pm–12.20 pm       Dr M C Gupta Advertisement and medical practice
12.20 pm –12.30 pm       Dr Navin Dang Rights of a patient
12.30 pm–12.40 pm       Dr Ajay Gambhir Rights of a doctor
12.40 pm– 12.50 pm       Dr Ashok Seth Kickbacks, touts and commercialization in medical practice
1.00 pm to 2.00 pm When it is not a negligence? Dr Prem Kakkar
Dr S K Sama
Dr O P Kalra
Dr KK Aggarwal
Dr Girish Tyagi
  Complaints of a doctor against doctor
1.00 pm–1.10 pm       Dr Girish Tyagi What is medical negligence?
1.10 pm–1.20 pm       Dr Vijay Aggarwal Medical accidents
1.20 pm–1.30 pm       Mukul Rohatgi Professional Misconduct
1.30 pm–1.40 pm       Dr K K Aggarwal How to defend a complaint?

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September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), India

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com

………………………………………………………………

Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at
medifilmfestinhealthmela@gmail.com

………………………………………………………………

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