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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 2nd eMedinewS – Revisiting 2010

 
  Editorial …

2nd February 2012, Thursday

Judicious use of cardiac screening

Unnecessary screening can have a considerable cost beyond that of the test itself, warn members of an ad hoc committee convened by the American College of Physicians.

Screening tests should be performed judiciously, and the committee has assembled a list of common clinical situations in which more testing is unlikely to be helpful and may be harmful, writes Amir Qaseem, MD, PhD, MHA, from the ACP, Philadelphia, Pennsylvania, and colleagues in the January 17, 2012, issue of the Annals of Internal Medicine.

ACP committee has identified 37 clinical scenarios in which screening does not promote patient health, and might even have adverse consequences. Among them cardiac ones are:

  • Performing coronary angiography in patients with chronic stable angina who have well–controlled symptoms on medical therapy, or who lack specific high–risk criteria on exercise testing
  • Routinely repeating echocardiography in asymptomatic patients with mild mitral regurgitation and normal left ventricular size and function
  • Obtaining ECG to screen for cardiac disease in patients at low to average risk for coronary artery disease.
  • Obtaining exercise electrocardiogram for screening low–risk, asymptomatic adults

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

Judicious use of cardiac screening

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

3rd eMedinewS Revisiting 2011

Dr Sujay Shad receiving the eMedinewS Doctor of the year Award 2011 in the 3rd eMedinewS Revsiting 2011 at Maulana Azad Medical College on 22nd January 2012

 
Dr K K Aggarwal
 
    National News

40 lakh children to be de–wormed

In the biggest health initiative of its kind, Delhi government will de–worm 40 lakh children in a single day on February 21. One in six children has worm infestation, which causes childhood malnutrition, anaemia, retarded mental development, slowed physical growth and reduced academic performance. More than 30 lakh school children from nursery to Class 12 in schools run by the Delhi government, Municipal Corporation of Delhi, New Delhi Municipal Council and Delhi Cantonment Board schools, eight lakh pre–school children in anganwadi centres and two lakh school dropout adolescent girls will be given de–worming tablets. (Source: Hindustan Times, January 31, 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

Big BP variation between arms raises red flag

A substantial difference in blood pressure from one arm to the other could be a warning sign for overall cardiovascular and mortality risk, a meta–analysis determined. A systolic pressure difference of 15 mm Hg or more between the right and left arm was linked to a 70% elevated risk of death from cardiovascular causes (P=0.01), Christopher E. Clark, MSc, of the University of Exeter, U.K., and colleagues found. (Source: Medpage Today)

For comments and archives

New clinical trial network for Neurology launched

The US National Institute for Neurological Disorders and Stroke in Bethesda, Maryland, will soon launch its first study funded by a new clinical trial network. The announcement is expected in February and the work will be the first from the National Network for Excellence in Neuroscience Clinical Trials. The new initiative, also known as NeuroNEXT, will cover 400 neurological diseases and offer a centralized institutional review board to help trials move faster. The first study will be an investigation of potential biomarkers to assess treatments for spinal muscular atrophy. This focus will emphasize the capacity of the network to run pediatric, as well as adult, studies. (Source: Medscape Medical News)

For comments and archives

India has the most toxic air: Study

It is official: India has the world’s most toxic air. In a study by Yale and Columbia Universities, India holds the very last rank among 132 nations in terms of air quality with regard to its effect on human health. India scored a miniscule 3.73 out of a possible 100 points in the analysis, lagging far behind the next worst performer, Bangladesh, which scored 13.66. In fact, the entire South Asian region fares badly, with Nepal, Pakistan and China taking up the remaining spots in the bottom five of the rankings. These rankings are part of a wider study to index the nations of the world in terms of their overall environmental performance. The Yale Center for Environmental Law and Policy and Columbia’s Center for International Earth Science Information Network have brought out the Environment Performance Index rankings every two years since 2006. In the overall rankings — which takes 22 policy indicators into account — India fared minimally better, but still stuck in the last ten ranks along with environmental laggards such as Iraq, Turkmenistan and Uzbekistan. The Index report was presented at the World Economic Forum currently taking place in Davos, where it’s being pitched as a means to identify the leaders and the laggards on energy and environmental challenges prior to the iconic Rio+20 summit on sustainable development to be held in Brazil this June.
http://www.thehindu.com/sci–tech/energy–and–environment/article2837739.ece

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on All adolescents who can afford shou…: http://youtu.be/g6lR8pM06d0 via @youtube

@DeepakChopra: Non–judgment quiets the internal dialogue, and this opens once again the doorway to creativity.

 
    Spiritual Update

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

Deepak Chopra on Happiness Formula

According to Deepak Chopra, Happiness = The Brain’s Set–Point (S) + Conditions of Living (C) + Voluntary Actions or Choices (V).

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the economical issues related to multiple pregnancies?

  • The health care cost for delivery and newborn care for twins is 4–times higher when compared to a singleton birth.
  • Companies are not as willing to donate formulas, diapers, etc. to parents of multiples as in the past.
  • The cost of caring for children with lifelong disabilities may be high. Some of your children may have a disability.
  • The total cost of raising multiples is likely higher than the cost of raising the same number of singletons. Cribs, car seats, high chairs, and other items have to be bought all at once, which can be financially difficult.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

A little girl’s prayer

One night I had worked hard to help a mother in the labor ward, but in spite of all we could do she died leaving us with a tiny premature baby and a crying two–year–old daughter. We would have difficulty keeping the baby alive, as we had no incubator (we had no electricity to run an incubator) and no special feeding facilities. Although we lived on the equator, nights were often chilly with treacherous drafts. One student midwife went for the box we had for such babies and the cotton wool the baby would be wrapped in. Another went to stoke up the fire and fill a hot water bottle. She came back shortly in distress to tell me that in filling the bottle, it had burst. Rubber perishes easily in tropical climates. "And it is our last hot water bottle!" she exclaimed.

As in the West it is no good crying over spilled milk, so in Central Africa it might be considered no good crying over burst water bottles. They do not grow on trees, and there are no drugstores down forest pathways.

"All right," I said, "Put the baby as near the fire as you safely can; sleep between the baby and the door to keep it free from drafts. Your job is to keep the baby warm."

The following noon, as I did most days, I went to have prayers with any of the orphanage children who chose to gather with me. I gave the youngsters various suggestions of things to pray about and told them about the tiny baby. I explained our problem about keeping the baby warm enough, mentioning the hot water bottle. The baby could so easily die if it got chills. I also told them of the two–year–old sister, crying because her mother had died.

During the prayer time, one ten–year–old girl, Ruth, prayed with the usual blunt conciseness of our African children. "Please, God," she prayed, "send us a water bottle. It’ll be no good tomorrow, God, as the baby will be dead, so please send it this afternoon." While I gasped inwardly at the audacity of the prayer, she added by way of corollary, "And while you are about it, would you please send a dolly for the little girl so she'll know you really love her?"

As often with children’s prayers, I was put on the spot. Could I honestly say, "Amen"? I just did not believe that God could do this. Oh, yes, I know that He can do everything. The Bible says so. But there are limits, aren’t there? The only way God could answer this particular prayer would be by sending me a parcel from the homeland. I had been in Africa for almost four years at that time, and I had never, ever received a parcel from home. Anyway, if anyone did send me a parcel, who would put in a hot water bottle? I lived on the equator!

Halfway through the afternoon, while I was teaching in the nurses’ training school, a message was sent that there was a car at my front door. By the time I reached home, the car had gone, but there, on the verandah, was a large twenty–two pound parcel! I felt tears pricking my eyes. I could not open the parcel alone, so I sent for the orphanage children. Together we pulled off the string, carefully undoing each knot. We folded the paper, taking care not to tear it unduly. Excitement was mounting. Some thirty or forty pairs of eyes were focused on the large cardboard box.

From the top, I lifted out brightly colored, knitted jerseys. Eyes sparkled as I gave them out. Then there were the knitted bandages for the leprosy patients, and the children looked a little bored. Then came a box of mixed raisins and sultanas – that would make a nice batch of buns for the weekend. Then, as I put my hand in again, I felt the… could it really be? I grasped it and pulled it out – yes! A brand–new, rubber hot water bottle! I cried. I had not asked God to send it; I had not truly believed that He could.

Ruth was in the front row of the children. She rushed forward, crying out, "If God has sent the bottle, He must have sent the dolly, too!"

Rummaging down to the bottom of the box, she pulled out the small, beautifully dressed dolly. Her eyes shone! She had never doubted!

Looking up at me, she asked, "Can I go over with you, Mummy, and give this dolly to that little girl, so she’ll know that Jesus really loves her?"

That parcel had been on the way for five whole months! Packed up by my former Sunday school class, whose leader had heard and obeyed God’s prompting to send a hot water bottle, even to the equator. And one of the girls had put in a dolly for an African child – five months before – in answer to the believing prayer of a ten–year–old to bring it "that afternoon."

When you realize you want to spend the rest of your life with somebody you want the rest of your life to start as soon as possible.

For comments and archives

 
    Cardiology eMedinewS

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

Rheumatic heart disease: Dr. RB Panwar

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People with risk factors should visit cardiologist

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Statins confer a small increased risk of diabetes

Read More

FDA warning against 80 mg simvastatin

Read More

 
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    Pediatric eMedinewS

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

Hospitalized Kids With CVD Who Require CPR Have Worse Outcomes

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Updated AAP Policy Statement Stresses ‘Safe Sleep’

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New ADHD Guidelines Include Broader Age Range

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Delayed Acyclovir Means Longer Hospital Stay

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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Can patients with heart diseases drive?

Drivers are not allowed to drive if they have any disturbance of cardiac rhythm, which is likely to cause disabling, symptoms, especially impairment of cerebral function.

For comments and archives

 
    Legal Question of the Day

(Dr MC Gupta)

Q. What are your comments about the proposed strike by junior doctors in Bihar?

Ans.

  1. Junior doctors in Bihar have announced that they would go on strike from 31st January in furtherance of their demand for higher pay. A report about the proposed strike can be found at
    http://ibnlive.in.com/news/bihar–minister–threatens–to–cut–off–doctors–hands/225305–37-64.html
  2. It is wise of doctors to give advance notice of the proposed strike and not to go on a flash or precipitate strike. An advance notice is meant to give a chance to the government to take remedial and contingency measures thereby avoiding undue harassment of the public.
  3. I hope the doctors have submitted an advance memorandum of demands to the government and that the memorandum and the notice of strike have both been legally drafted. If not, they should urgently consult a good advocate and submit supplementary memorandum and notice drafted by the advocate.
  4. The proposed strike has had a peculiar and unsavoury effect on the state government. The Bihar Health Minister Ashwini Chaube, instead of analysing and resolving the situation, has spoken as per the above link at a function at the launch of a health awareness campaign on 28–1–2012 as follows: "Who dares to stop hospitals from running? I will not allow that, I can take extreme steps, even chop off your hands if you try to obstruct public welfare".
  5. Doctors should not take the above insult lying down. If they do so, it is a disgrace to the youth of India. However, it calls for a cool headed and calculated approach as per the advice of a seasoned advocate so that the usual government actions of the following types may be avoided or managed effectively:
    • Asking them to vacate hostels
    • Threatening or implementing the Essential Services Maintenance Act, 1981
    • Asking the medical council to take action against them
    • Dismissing them from service
    • Imposing no work, no pay rule
    • Approaching the HC directly or through somebody to order withdrawal of the strike
  6. The IMA should rise to the occasion and should immediately provide all legal, moral, political and other help to the doctors in their apparently just cause. It should also raise a demand for uniform pay scales for doctors throughout India. It should immediately appoint a high power group to monitor and assess the situation and take necessary action on a regular basis.
  7. Senior doctors in government hospitals should consider in their own hearts whether the demands of the junior doctors are just. If the answer is yes, they should abide by their conscience and the call of professional unity and should stick out their neck in support of their junior colleagues and not succumb to any divisive tactics of the government.
  8. Private nursing homes and government hospitals which are not covered by the strike (such as, maybe, defence hospitals; railway hospitals; ESI hospitals etc.) should issue advance statements in the media that the public would be free to approach them for services, thereby strengthening the cause of striking doctors.
  9. Rather than chopping the hands of the striking doctors, the health minister should force the private hospitals to provide services to the public as mandated by law.
  10. All private practitioners, through the IMA, should act in such a manner as to support the striking doctors but avoiding undue hardship to the public in case of emergency.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: An elderly male had an A1c of 6.5%.
Dr Bad: This is very good control.
Dr Good: Reduce the dose of drugs.
Lesson: A1c goal should be set somewhat higher for older patients and those with a limited life expectancy. The American Geriatrics Society suggests an A1c target of 8% for frail older adults and individuals with life expectancy of less than five years (Source: Ann Intern Med 2008;149:11).

For comments and archives

Make Sure

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA.
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

There are always three speeches, for every one you actually gave. The one you practiced, the one you gave, and the one you wish you gave. Dale Carnegie

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Protein electrophoresis

Protein electrophoresis (or Immunoelectrophoresis) is a method of analyzing a mixture of proteins by means of gel electrophoresis, mainly in blood serum. Abnormal bands (spikes) are seen in monoclonal gammopathy of undetermined significance and multiple myeloma etc.

 
    Mind Teaser

Read this…………………

What word, when written in capital letters, is the same forwards, backwards and upside down?

Yesterday’s Mind Teaser: I right I

Answer for Yesterday’s Mind Teaser: Right between the eyes

Correct answers received from: Dr KV Sarma, Dr Avtar Krishan, Dr Mrs S Das, Raju Kuppusamy, Dr PC Das, Dr Pramod M Kulkarni, Dr Chandresh Jardosh, Yogindra Vasavada, Muthumperumal Thirumalpillai,
Dr Vijay Kansal, Anil Bairaria, Dr Neelam Nath.

Answer for 30th January Mind Teaser
: Platinum
Correct answers received from: Dr Vijay Kansal, Anil Bairaria, Dr Neelam Nath, Dr Valluri Ramarao, Sudipto Samaddar.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Classical definitions and cool meanings

DICTIONARY: A place where divorce comes before marriage
CONFERENCE ROOM: A place where everybody talks, nobody listen and everybody disagrees later
ECSTASY: A feeling when you feel you are going to feel you have never felt before.
CLASSIC: A book which people praise, but do not read.
SMILE: A curve that can set a lot of things straight.
OFFICE: A place where you can relax after your strenuous home life.
YAWN: The only time some married men ever get to open their mouth.

 
    Medicolegal Update

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

What is a negative postmortem examination?

  • Negative or obscure autopsy is when no significant finding are discovered in autopsy i.e. when in a postmortem examination all efforts i.e. gross, microscopic, chemical and toxicological results are not concluding enough about the cause, manner or other required medicolegal aspects of death
  • Negative autopsy is very useful in cases where there is no adequate history of death
  • Death from fear/fright or shock/cases of post fracture air embolism
  • Death due to lesion in neck as diphtheria, laryngeal bronchitis/swelling of glottis or choking on food
  • Cases like brown atrophy of heart associated with starvation, asthma or cancer
  • Sickle cell disease/lesion of adrenal gland/hemorrhage or destruction by tumor
  • Negative autopsy is also very informative; I have seen such a case in death due to distal coronary artery occlusion or coronary arteries spasm

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)

Even the older should exercise

Research spanning two decades has found that older runners live longer and suffer fewer disabilities than healthy non–runners, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. This observation applies to a variety of aerobic exercises, including walking.

Quoting a study by authors, from Stanford University School of Medicine, whose findings are published in Archives of Internal Medicine. Dr Aggarwal said that being active reduces disability and increases survival.

Late in life, there are benefits of vigorous activity. Earlier many experts believed that vigorous exercise would actually harm older individuals. And running, in particular, would result in an epidemic of joint and bone injuries. But this new study proves otherwise.

Two hundred and eighty–four runners and 156 healthy "controls," or non–runners, in California completed annual questionnaires over a 21–year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period, the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years, just 15 percent of the runners had died, compared with 34 percent of the non-runners. In the study, running delayed the onset of disability by an average of 16 years.

It's so important to be physically active your whole life, not just in your 20s or 40s, but forever. Exercise is like the most potent drug. Exercise is by far the best thing you can do. One should take lessons from Yudhishtir in Mahabharata who walked till his death.

However a word of caution if an elderly is walking or entering into an exercise program, he or she should have a cardiac evaluation to rule out underlying heart blockages.

 
    Readers Responses
  1. Dear Sir, Congratulations on organizing such a wonderful event. It was not only informative but also a very pleasant experience in itself. The whole doctor community will be highly obliged if we can have the opportunity of attending more such events in the future. Thanking you. Best Regards, Dr Nishkarsh Saxena
 
    Forthcoming Events

Ajmer Health Fair: Ajmer’s Largest Ever Super Specialty Health Camp

Date: February 11 and 12, 2012
Venue: Patel Stadium, Ajmer
Organizer: Heart Care Foundation of India

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund, Faridabad. It is a multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of the British Menopause Society and South Asian Federation of Menopause Societies and is an opportunity to hear international faculties.

For information contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048
Download forms at: http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

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

 
    eMedinewS Special

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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