emedinews
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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 Workshop on Stress Management and How to be Happy and Healthy

 
    Dr KK Aggarwal on Social Media …

ASAR–Aamir Khan & Dr KK Aggarwal on Satyamev Jayate Watch Video
Docs vs Aamir Khan Headlines today 9th June 2012 7.30pm Watch Video
Aamir Khan Workshop with kids on dangerous areas Watch Video
DR KK Aggarwal on Doctor Bhagwan Hai ya Shaitan Watch Video

 
  Editorial …

1st July 2012, Sunday

Norepinephrine in septic shock

Patients on dopamine during septic shock have increased mortality compared with patients who receive norepinephrine. A meta–analysis of six randomized trials (1408 patients) compared dopamine with norepinephrine in septic shock and showed that Patients who received dopamine had a higher 28–day mortality rate than patients who received norepinephrine. Arrhythmic events were two times more common with dopamine than norepinephrine. Norepinephrine is preferable to dopamine as a vasopressor in the management of septic shock (Crit Care Med 2012;40:725).

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Norepinephrine in septic shock

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Ek Shaam Sehat Ke Naam

An interaction involving specialists from all pathies under one roof was organized for the first time by Heart Care Foundation of India in association with All India Radio and India Habitat Centre. The session was organized to mark the occasion of Doctor’s Day on July 1, 2012

 
Dr K K Aggarwal
 
    National News

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 re build the image of the medical profession.

Indians lack awareness about lung diseases

Indians exhibit a "worrying lack of understanding" and concern about lung diseases – that kill nearly four million people globally every year, said a study on Tuesday. "Despite the high incidence of lung disease, research conducted by YouGov across India revealed that people are far more worried about heart disease and cancer. While impact of lung disease is underestimated, the public poll reveals a lack of understanding about how to manage it," says the study by European Lung Foundation and Forum for International Respiratory Societies (FIRS) ahead of world spirometry day Wednesday. Spirometry refers to tests to diagnose any pulmonary, chronic obstructive pulmonary disease (COPD) or breathing disorders in the lungs. "The survey revealed that 62 per cent of respondents have never had their lungs tested. While the other major diseases have been decreasing as a cause of death in the last three decades, death due to COPD has doubled in the same period," said the study. (Source: TOI, Jun 27, 2012)

For comments and archives

Medical Council approves 100 seats for a women college in Haryana

ROHTAK: The medical council of India (MCI) has granted approval for 100 seats of MBBS course to the newly established Bhagat Phool Singh government women medical college in Khanpur village of Sonipat for the academic session 2012–13. This is the first women medical college of north India after Independence. The Haryana government had set up this medical college with a 400 bed hospital. The hospital authorities informed that about 1200 patients visit daily in the OPD and 20 to 25 major surgeries were performed every day in the hospital. In view rush of patients, they had requested the state government to increase the capacity to 800 beds. (Source: TOI, Jun 26, 2012)

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

(Contributed by Dr Monica and Brahm Vasudev)

Immune globulin approved for multifocal motor neuropathy

Immune Globulin Infusion (Human), 10% (Gammagard Liquid, Baxter International, Inc), has been approved by the US Food and Drug Administration (FDA) as a treatment for multifocal motor neuropathy (MMN), making it the first immunoglobulin treatment approved here for this condition. MMN is a "challenging neuromuscular disease to diagnose and manage, and patients have had limited treatment options," noted trial investigator Said R. Beydoun, MD, professor of neurology at the Keck Medical Center, University of Southern California, in Los Angeles, in a statement from Baxter issued June 25. (Source: Medscape)

For comments and archives

Type of fluid resuscitation matters in patients with sepsis

Despite the fact that hydroxyethyl starch (HES) 130/0.4 is used frequently for fluid resuscitation in intensive care units, it is unknown how safe and effective it is for patients with severe sepsis. That is according to Anders Perner, MD, PhD, of the Department of Intensive Care, Center of Clinical Intervention Research at Copenhagen University Hospital in Denmark, and colleagues, in a new study, the results of which are adding to a growing body of research that this type of treatment may do more harm than good. According to the study, published online June 27 by the New England Journal of Medicine, patients who received fluid resuscitation with HES 130/0.4 had an increased risk for death and dependency on renal replacement therapy at 90 days post–resuscitation when compared with patients who received fluid resuscitation with Ringer’s acetate. (Source: Medscape)

For comments and archives

Childhood adversity linked to depression, substance abuse

Childhood maltreatment may be linked to later-life behavioral disorders, new research suggests. A study from New Zealand showed that adult participants who underwent adversity as children, such as experiencing physical or sexual abuse or witnessing parental violence, had a significantly higher risk of developing mood, anxiety, and substance use disorders than their peers who had not experienced maltreatment. (Source: Medscape)

For comments and archives

Chronic fatigue tied to higher risk of non–Hodgkin’s lymphoma

Elderly patients with chronic fatigue syndrome (CFS) had higher rates of non–Hodgkin’s lymphoma (NHL) in a new study of Medicare data. The risk of NHL was increased by 29% among individuals who had been diagnosed with CFS more than a year previously, according to the findings, which were published online May 30 in Cancer. (Source: Medscape)

For comments and archives

Biomarkers track arthritis activity

A group of biomarkers that reflect the various underlying disease processes in rheumatoid arthritis correlates well with conventional disease activity scores and may prove useful in predicting treatment response, researchers found. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Initial dosing of warfarin The initial doses of warfarin should not exceed 5 mg/day except in highly selected,…… http://fb.me/1v7Qvfcjf

@DeepakChopra: Randomness is another word for creativity

 
    Spiritual Update

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

How to remove negative thoughts

Darkness is absence of light and similarly, negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring positive thoughts back. Ideal mind is devils workshop and will always think negative.

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)

4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More

The 4th Asia Pacific Vascular Interventional Course begins Read More

Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More

4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More

Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty
Read More

4th Asia pacific vascular intervention course Read More

4th Asia pacific vascular intervention course paper clippings Read More

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How does ICSI work?

The sperm are mixed with the woman's egg in a laboratory. If ICSI is needed, a small needle is used to inject a sperm into the center of the egg. The fertilized egg grows in a laboratory for 1 to 5 days and then it is placed in the woman's uterus (womb).

For comments and archives

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

(Dr Sanjay Chaudhary, Medical Director, Chaudhary Eye Centre, Dr Pallavi Sugandhi, Consultant Ophthalmologist, Cornea & Refractive surgeon, Chaudhary Eye Centre)

Q. Is there any use of corneas that are for some reason not utilized for surgery?

A. Corneas that are rejected for technical reasons may be used for research or education purposes.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

A cold day in December

An eye witness account from New York City, on a cold day in December, some years ago: A little boy, about 10–years–old, was standing before a shoe store on the roadway, barefooted, peering through the window, and shivering with cold.

A lady approached the young boy and said, ‘My, but you're in such deep thought staring in that window!’

‘I was asking God to give me a pair of shoes,’ was the boy’s reply.

The lady took him by the hand, went into the store, and asked the clerk to get half a dozen pairs of socks for the boy. She then asked if he could give her a basin of water and a towel. He quickly brought them to her.

She took the little fellow to the back part of the store and, removing her gloves, knelt down, washed his little feet, and dried them with the towel.

By this time, the clerk had returned with the socks. Placing a pair upon the boy's feet, she purchased him a pair of shoes.

She tied up the remaining pairs of socks and gave them to him. She patted him on the head and said, ‘No doubt, you will be more comfortable now.’

As she turned to go, the astonished kid caught her by the hand, and looking up into her face, with tears in his eyes, asked her: ‘Are you God’s wife?’

For comments and archives

 
    Cardiology eMedinewS

Coffee vs heart failure: A Few cups per day protects Read More

B6 deficit tied to CV disease risk Read More

 
    Pediatric eMedinewS

Nurse program keeps baby BMI in line Read More

New migraine computer app designed for teens Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic elderly came with low HDL levels.
Dr Bad: In elderly it is of no significance.
Dr Good: It is an important risk factor.
Lesson: Lower HDL cholesterol is an important risk factor for not only IHD but also CVD, especially in diabetic elderly individuals (Diabetes Care 2009;32(7):1221–3).

For comments and archives

Make Sure

Situation: A 28–year–old male presented with increased frequency and occasional blood in urine. Examination of urine showed sterile pyuria.
Reaction: Oh my God! Why didn’t you check for TB?
Lesson: Make Sure to rule out TB in patients with frequency, dysuria, hematuria. Sterile pyuria is the first clue to diagnosis.

For comments and archives

 
    Health News Bulletin

Industry now cites public health of pharma FDI debate

The Hindu Business Line, P.T. Jyothi Datta

Mumbai: It is not just about competition. Public health and medicine security too are being raised as issues in the objections against the "unfettered freedom" of foreign companies to acquire existing domestic drug–makers, says the Indian Pharmaceutical Alliance (IPA), a platform of large domestic pharmaceutical companies. In a letter to the Prime Minister’s Office, the IPA has pointed out that the Foreign Investment Promotion Board (FIPB) is better equipped to be the gate-keeper for foreign investments in domestic drug–makers, especially from the public health point of view. The letter comes against the backdrop of a Planning Commission committee under Mr Arun Maira recommending that the Competition Commission of India (CCI) be the watchdog for foreign investments in existing drug operations. But that recommendation has few supporters. In fact, on the other side of the argument stands a strong contingent, including the Union Health Ministry, Commerce Ministry and several healthcare advocacy groups, rooting for the FIPB as watchdog. "The distinction between greenfield and brownfield foreign direct investment was made to protect public health. "The CCI has made it clear that it cannot be expected to stop an acquisition strictly and solely on the grounds of public health. "Not only does the Competition Act not have such a provision but, even if it had, the CCI does not have the wherewithal to take a call on the grounds of public health," the IPA letter said, casting its lot with the growing number of supporters for the FIPB’s role at the helm of pharmaceutical mergers and acquisitions (M&As).

 
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    Quote of the Day

(Dr GM Singh)

I Promise my Friendship

I Promise you my friend, promise you my life
Promise we’ll never be apart, promise not to hurt you
Promise to never make you cry, promise to always trust you
Promise not to lie, promise you forever
Promise you tonight, promise you my respect
Promise to do things right, promise to always be there
Promise until the end, promise to always love you
Promise to be your best friend, promise you my love
Promise you my life, promise this forever
Promise our friendship is my life

 
    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

ADH

Also known as: Antidiuretic hormone

  • To help detect, diagnose, and determine the cause of ADH deficiency or excess
  • To investigate low blood sodium levels (hyponatremia)
  • To distinguish between the two types of diabetes insipidus
 
    Eye Update

(Dr. SK Verma, Consultant Ophthalmologist, New Delhi)

Development of retina from human embryonic stem cells

Scientists have taken a major step towards restoring vision for blind people with the help of stem cells. Human derived stem cells were encouraged to form a structure of the eye known as optic cup. In normal human eye development the optic cup is derived from the neural ectoderm that ultimately forms the two layers of the retina. First inner layer of the optic cup forms the ten layered neuronal retina comprising photo-receptors rods and cones, bipolar cells and ganglion cells. Second outer layer of the optic cup forms the retinal pigment epithelium which blocks the light to go beyond the retina and that light stimulates the light sensitive rods and cones which is adjacent to it.

In an experiment led by Doctor Yshiki Sasai et al of the RIKEN center for developmental biology in Kobe, Japan, retinal precursor cells (the cells after embryonic stem cells) spontaneously without any guidance formed a ball of epithelial tissue and then bulged outward to form a bubble called an optic vesicle. That vesicle folded back on itself to form a pouch creating the optic cup, about 550 micrometer in diameter, having two layers just like normal fetal development of human eye.

Until recently, stem cell biologists had been able to grow embryonic stem cells only into two dimensional sheet. But over the past four years, Dr. Sasai and his team has used mouse embryonic stem cells two grow well organized, three dimensional cerebral cortex, pituitary gland and optic cup. His latest result marks the first time that any one has managed a similar feat using human embryonic stem cells. Researchers say transplantation of this tissue in the future could help patients with visual impairments see clearly. The cells are controversial as creating them requires the destruction of a human embryo, an eye for an eye, a move opposed by pro–life groups. The findings were published the Journal of stem cells. (Courtesy: Daily Mail UK 13.06.12 and journal Nature 15.06.12)

 
    Mind Teaser

Read this…………………

After surgery, Gina returns from the Post-anesthesia Care Unit (Recovery Room) with a nasogastric tube in place following a gall bladder surgery. She continues to complain of nausea. Which action would the nurse take?

A. Call the physician immediately.
B. Administer the prescribed antiemetic.
C. Check the patency of the nasogastric tube for any obstruction.
D. Change the patient’s position.

Yesterday’s Mind Teaser: Mr. Pablo, diagnosed with Bladder Cancer, is scheduled for a cystectomy with the creation of an ileal conduit in the morning. He is wringing his hands and pacing the floor when the nurse enters his room. What is the best approach?

A. "Good evening, Mr. Pablo. Wasn’t it a pleasant day, today?"
B. "Mr., Pablo, you must be so worried, I’ll leave you alone with your thoughts.
C. "Mr. Pablo, you’ll wear out the hospital floors and yourself at this rate."
D. "Mr. Pablo, you appear anxious to me. How are you feeling about tomorrow’s surgery?"

Answer for Yesterday’s Mind Teaser: D. "Mr. Pablo, you appear anxious to me. How are you feeling about tomorrow’s surgery?"

Correct answers received from: Dr shashi saini, Dr prabha sanghi, Dr. P. C. Das, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr.Chandresh Jardosh, Dr. Thakor Hitendrsinh G, Raju Kuppusamy

Answer for 29th June Mind Teaser: D. Administer Demerol 50mg IM q4h
Correct answers received from: Anil Bairaria, Dr. P. C. Das

Send your answer to ijcp12@gmail.com

 
   Laugh a While

(Dr Prabha Sanghi)

When you discover that you are riding a dead horse, the best strategy is to dismount and get a different horse.

However, in government, education and corporate life, more advanced strategies are often employed, such as:

  1. Buying a stronger whip.
  2. Changing riders.
  3. Appointing a committee to study the horse.
  4. Arranging to visit other countries to see how other cultures ride dead horses.
  5. Lowering the standards so that the dead horse can be included.
  6. Reclassifying the dead horse as ‘living impaired’.
  7. Hiring outside contractors to ride the dead horse.
  8. Harnessing several dead horses together to increase speed.
  9. Providing additional funding and/or training to increase dead horse’s performance.
  10. Doing a productivity study to see if lighter riders would improve the dead horse’s performance.
  11. Declaring that as the dead horse does not have to be fed, it is less costly, carries lower overheads and therefore contributes substantially more to the bottom line of the economy than do some other horses.
  12. Rewriting the expected performance requirements for all horses. And, of course,…
  13. Promoting the dead horse to a higher position!
 
    Medicolegal Update

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

WMA declaration of Malta on hunger strikers

Such difficult ethical situations in medical practice and the guidelines to deal with them have been addressed thoroughly in the revised WMA Declaration of Malta on hunger strikers with principles of Duty to act ethically, in 2006. All physicians are bound by medical ethics in their professional contact with vulnerable people, even when not providing therapy. Whatever their role, physicians must try to prevent coercion or maltreatment of detainees and must protest if it occurs. The other important component is respect for autonomy. Physicians should respect individuals’ autonomy. This can involve difficult assessments as hunger strikers’ true wishes may not be as clear as they appear. Any decisions lack moral force if made involuntarily by use of threats, peer pressure or coercion. Hunger strikers should not be forcibly given treatment they refuse. Forced feeding contrary to an informed and voluntary refusal is unjustifiable. Artificial feeding in form of intravenous fluid/nutrition with the hunger striker’s explicit or implied consent is ethically acceptable.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Too much salt damages blood vessels and cause high BP

Eating a high–salt diet for several years is associated with markers of blood vessel damage like high uric acid and presence of albumin in the urine. People with any of these markers of blood vessel damage, who eat a high–salt diet are more likely to develop high blood pressure, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal president Heart Care Foundation of India. The study published in the American Heart Association journal Circulation analyzed the association between sodium consumption and blood levels of uric acid and albumin in the urine — both markers of blood vessel damage — in participants not taking high blood pressure medicine. Higher sodium intake was associated with increasing levels of uric acid and albumin over time. The higher the levels of these markers, the greater the risk of developing hypertension, if dietary salt intake was high.

Compared with participants eating the least amount of sodium (2.2 grams a day), those eating the most (6.2 grams mg/d) were 21 percent more likely to develop high blood pressure.

Those who had high uric acid levels and ate the most salt were 32 percent more likely to develop high blood pressure while those with high urine albumin levels and highest salt intake were 86 percent more likely to develop high blood pressure.

A high–salt diet is believed to be responsible for 20 percent to 40 percent of all cases of high blood pressure.

 
    Readers Responses
  1. Dear Sir, The CME of Ek Shaam Sehat ke Naam was really very informative.: Regards:Dr Sneha
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal

IYCNCON 2012

All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

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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    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, Dr Usha K Baveja