emedinews
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FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA

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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

 
  Editorial …

2nd March, 2011, Wednesday                                 eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Shiva: Neelkanth

The blue neck (Neelkanth) of Lord Shiva represents that one should neither take out the vices (slow poison) or negative emotions nor suppress them; instead one should alter or modify them. The blue color indicates slow poison or the negative thoughts. The same in the neck indicates that the poison is neither to be drunk nor to be spitted out but to be kept in the throat temporarily so that it can be neutralized at appropriate time.

Suppressed anger releases chemicals leading to illnesses like acidity, asthma, angina and diarrhea etc. Similarly, expressed anger will end up into social unhealthiness and future heart disease.

The only way is to mange anger, taking the right and not the convenient action, neutralizing the anger by willful cultivation of opposite positive thoughts. For example the process of silently passing on love to any individual can take away the angry thoughts from the mind (love is opposite of anger).

A high level of anger has a powerful effect on the incidence of preventable cardiovascular death. Anger evokes physiological responses that are potentially life threatening in the setting of CAD. Emotional stress, anger, or worries have a dominant influence on the severity, frequency, and treatment of angina.

The message by Shiva was given to us in our Vedic knowledge and in the different Upanishads. Scientists today are only validating these concepts by way of studying them all over the world. And unless the messages come to us from the west, we do not believe them.

In the modern context, angina is characterized by episodic variations in the frequency and severity of symptoms coincident with periods of emotional stress. When angina is associated with stress or anger, the angina is not usually a result of progressive coronary disease, but rather is due to an increase in oxygen demand. Appreciation of this concept will help to rule out "true" unstable angina due to progressive coronary disease from recurrent angina that results from an increase in oxygen demand related to emotional stress. The former requires aggressive medical or surgical therapy; the latter, a demand–induced angina, responds to beta–adrenergic blockade, a tranquilizer and to stress reducing methodologies.

Anger has many phases. Anger Expression Inventory, assesses anger frequency (trait anger), anger intensity, anger expression (anger–out), anger suppression (anger–in) and anger recall. Both anger–in and anger–out are associated with heart blockades.

Dr. C. Noel Bairey Merz, from Women’s Health at Cedars–Sinai Medical Center has shown that anger and hostility alone are not predictive for coronary artery disease in women, but women who outwardly express anger (anger–out) are at increased risk especially if they also have other risk factors: age, diabetes and high cholesterol levels. He said the overt expression of anger toward other persons or objects is the most "toxic" aspect of hostility in women. The findings are a part of Women’s Ischemia Syndrome Evaluation (WISE) Study, a multi–center, long–term investigation sponsored by the National Heart, Lung and Blood Institute.

Anger–in is also related to severity of blockages. Dr. Dembroski and group have shown that potential for Hostility and Anger–In are significantly and positively associated with the heart blockages disease severity, including angina symptoms and number of heart attacks. Suppressed anger is also associated with increased carotid arterial stiffness in older adults, a condition making them prone to future heart attacks and paralysis. In univariate correlational analysis by Anderson DE and group from National Institute on Aging, Baltimore, Maryland, a significant positive association of anger–in with stiffness was observed (P < 0.01), together with a less significant association of anger–in with carotid artery IMT (P < 0.05). Neither anger–out nor trait anger was significantly associated with carotid artery IMT or stiffness.

Suppressed anger has also been shown to increase blood pressure by Thomas and group from University of Tennessee. Suppressed anger is further dangerous as the recall of anger now has been shown by Dr Jain and group from Yale University to be associated with angina, heart LV dysfunction and rise in upper blood pressure.

Ironson and group from Department of Psychology, University of Miami has shown that anger recall produces more stress than the actual stress in a treadmill. In most studies psychological stressors used are mental arithmetic, recall of an incident that elicited anger, giving a short speech defending oneself against a charge of shoplifting. They also showed that intensity of anger is associated with severity of angina. In their study vasoconstriction only occurred with high levels of anger. There also showed that there was no narrowing of non–narrowed arteries indicating that anger recall produce coronary vasoconstriction in previously narrowed coronary arteries.

References

  1. Krantz DS, Olson MB, Francis JL, et al. Anger, hostility, and cardiac symptoms in women with suspected coronary artery disease: the Women’s Ischemia Syndrome Evaluation (WISE) Study. J Womens Health (Larchmt) 2006 Dec;15(10):121423.
  2. Dembroski TM, MacDougall JM, Williams RB, et al. Components of Type A, hostility, and anger–in: relationship to angiographic findings. Psychosom Med 1985 May–Jun; 47(3): 219–33
  3. Anderson DE, Metter EJ, Hougaku H, et al. Suppressed anger is associated with increased carotid arterial stiffness in older adults. Am J Hypertens 2006 Nov;19(11):1129–34.
  4. Thomas SP. Women’s anger: relationship of suppression to blood pressure. Nurs Res 1997 Nov–Dec;46(6):324–30.
  5. Jain D, Joska T, Lee FA, et al. Day–to–day reproducibility of mental stress–induced abnormal left ventricular function response in patients with coronary artery disease and its relationship to autonomic activation. J Nucl Cardiol 2001 May–Jun;8(3):347–55.
  6. Ironson G, Taylor CB, Boltwood M, et al. Effects of anger on left ventricular ejection fraction in coronary artery disease. Am J Cardiol 1992 Aug 1;70(3):281–5.
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  eMedinewS Audio PostCard

Treating Diabetes Post 2010

Dr Ambrish Mithal speaks on
Weight gain with diabetes treatments
 

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

Genius is the ability to put into effect what is on your mind. F. Scott Fitzgerald

 
    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS: Revisiting 2010: Excellence Awards

Dr Yatin Mehta received the ‘eMedinewS Medical Doctor of the Year 2010’ Award at the 2nd eMedinewS: Revisiting 2010 held on 9th January this year at Maulana Azad Medical College, New Delhi

 
Dr K K Aggarwal
 
    National News

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

Healthcare set to cost more

PUNE: The move in the Union Budget to levy a tax on all services provided by private hospitals with more than 25 beds and diagnostic centres with central air–conditioning is likely to make healthcare costlier, say doctors and experts. "The cost of healthcare would obviously go up by 5–10% due to the service tax on services provided by hospitals and diagnostic centres that have air–conditioning," said Bomi Bhote, CEO of Ruby Hall Clinic. The Union government had imposed a service tax in 2010–11 on health check–ups or treatment. This levy resulted in differential treatment between persons who make payments themselves and others where payments were made by an insurance company or a business entity, finance minister said in his Budget speech. He proposed to replace it with a tax on all services provided by private hospitals with 25 or more beds that have central air–conditioning as well as diagnostic centres. (Source: The Times of India, March 1, 2011)

 
    International News

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

National exercise on the rise

Gallup recently released encouraging data indicating that the message of prevention and exercise is taking hold across America. According to the poll, the percentage of Americans who said they exercised for at least 30 minutes three or more days per week rose to 51.1 percent in 2010, up from 49.6 percent in 2009.

(Dr GM Singh)

Updated guidelines issued for women’s cardiovascular disease prevention

  • There’s been a title change from "Evidence–Based" to "Effectiveness–Based."
  • The guidelines define "high risk" in women as being at a 10% or greater 10–year risk for all cardiovascular disease, not just coronary heart disease.
  • Clinicians should consider the importance of racial, ethnic, and socioeconomic factors and be sensitive to how those factors affect cardiovascular risk.
  • Women with existing cardiovascular disease should be screened for depression, since the condition may affect whether patients adhere to treatment regimens.
  • Women with systemic lupus erythematosus and rheumatoid arthritis should be considered at risk for cardiovascular disease and be screened for other risk factors.
  • Similarly, women who have experienced pregnancy complications, such as preeclampsia, gestational diabetes, or preterm birth, should have those factors taken into account when their risks are evaluated later in their lives.

(Dr Monica and Brahm Vasudev)

Nephron–sparing surgery may offer better long–term kidney function than nephrectomy

Less radical renal tumor surgery (nephron–sparing surgery; NSS) can offer better long–term kidney function than radical nephrectomy (RN) for tumors larger than 4 cm, according to the results of a study reported in the February issue of BJUI.

Strength training may provide benefits beyond increasing muscle

A growing body of research shows that working out with weights has health benefits beyond simply bulking up ones muscles and strengthening bones. Studies are finding that more lean muscle mass may allow kidney dialysis patients to live longer, give older people better cognitive function, reduce depression, boost good cholesterol, lessen the swelling and discomfort of lymphedema after breast cancer and help lower the risk of diabetes. In fact, a 2010 study in the Clinical Journal of the American Society of Nephrology suggested that people on dialysis can benefit from building muscle.

Medication to lower blood pressure may not benefit acute stroke patients

Giving medication to lower blood pressure in hypertensive stroke patients appears to have no benefit and might even be harmful, according to a study published online Feb. 11 in The Lancet.

Physicians may be missing silent strokes in children with severe anemia

Physicians may be missing silent strokes in a small but significant number of children with severe anemia, who may be unfairly labeled as slow learners when in fact they have a medical problem, according to a study presented at an American Stroke Association conference.

 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation, banerjee.kaberi@gmail.com)

Is infertility more common in any particular group? For example, IT industry, BPO sector, highly competitive and career minded people or any other group.

A. People in the cities are definitely more prone to it as the stressful life style and long working hours do not allow them to have contact at the right time with the desired frequency. Most cases are from people working in the BPO industry.

 
    Hepatology Update

(Dr. Neelam Mohan, Dir. Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta–The Medicity, drneelam@yahoo.com)

What is the role of other imaging modalities in the diagnosis of liver abscess?

CECT (Contrast enhanced CT) is more sensitive in detecting small abscesses anywhere in liver. A hypo dense lesion with low attenuation areas and an enhancing rim is a classical CECT image. Small hypo echoic lesions in cluster may suggest a beginning of process of coalescence into a single large abscess later. However it is inconvenient and expensive with risk of contrast nephropathy.
On MRI, liver abscess appear hypo intense on T1 weighted and hyper intense in T2 weighted sequences. On gadolinium enhanced sequences there is early and continued enhancement of wall which persists on delayed images. There is increased peri–abscess tissue enhancement in immediate post–gadolinium images. However, it is very expensive.

 
    Medicolegal Update

(Dr Sudhir Gupta, Asso Professor, Forensic Medicine & Toxicology, AIIMS)

Suicide

The World Health Organization estimates that it is the 13th leading cause of death worldwide. The method varies dramatically amongst countries.

  • Over one million people commit suicide every year across the globe.
  • Suicide is derived from a Latin word suicidium, from Sui caedere, "to kill oneself."
  • Suicide is often committed out of despair, or attributed to some underlying mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism and drug abuse.
  • Financial difficulties, troubles with interpersonal relationships and other undesirable situations play a significant role
  • The leading methods in different regions include hanging, pesticide poisoning, and firearms.
  • In India 30% of suicides are from pesticides. The use of this method however varies markedly from 4% in Europe to more than 50% in the Pacific region.
  • In the United States 52% of suicides involve the use of firearms however asphyxiation and poisoning are fairly common as well. Together they comprised about 40% of U.S. suicides.
  • Other methods of suicide include blunt force trauma means jumping from a building or bridge, self, stepping in front of a train, or car collision, for example).
  • Bloodletting means slitting one's wrist intentional drowning, self-immolation, electrocution, and intentional starvation are other suicide methods.
  • A study found increased rates of suicide following the television news stories regarding suicide.
 
    Legal Question of the Day

(Dr MC Gupta Advocate)

Q. What are your comments regarding the following incident of assault on doctors?

"NG, a surgeon, performed laparoscopic cholecystectomy on a young male on 14th.January 2011 at a private nursing home in Punjab. The patient was discharged on 16th.Janaury 2011 in a satisfactory condition. He reported on 19th.January 2011, with pain abdomen. On investigation, serum amylase was found to be very high. He was diagnosed as having acute pancreatitis with stone in the common bile duct. He was managed conservatively and was discharged on 21.st.Janaury 2011 with the advice to get further treatment at PGI Chandigarh/GMC&H Chandigarh. He was taken to GMC&H, Sector 32, where ERCP with stenting of CBD was done. He expired in the hospital on 23.2.2011. A mob brought the body to the nursing home on 24th.Feb.2011 and ransacked the hospital and physically manhandled the operating surgeon, punching his chest and abdomen amidst slogans to kill him. The hospital staff saved him by locking him in the OT. Police was called and it registered a case against the surgeon under section 304 A and body was sent for Post Mortem Examination. The surgeon has lodged a separate complaint with the police on 24.2.2011, annexing a CD of the CCTV footage. Police have not taken any action on his complaint so far but a case u/s 304 A stands registered against him."

Ans.

My comments are as follows:

A. Immediate action

  • It should immediately constitute a high powered committee including, amongst others, its counsel and also, preferably, a retired judge (and maybe also a police officer), to probe into this incident and submit its report along with the plan of action;
  • It should get published in the newspapers a balanced and correct version of the incident so that the public understands the facts of the situation. This may be by way of a press release or an advertisement.
  • It should approach the police authorities for an immediate registration of an FIR against the accused persons under the Punjab Protection of Medicare Service Persons and Medicare Services Institutions (Prevention of Violence and Damage to Property) Act, 2008, as also under various sections of the IPC. If the police do not register an FIR, the magistrate should be approached to direct the police to do so.
  • It should take direct action within law against the culprits. It should circulate amongst the members the names of those involved in the incident with a request that members may, at their discretion, decline to provide services to them except in emergency unless they submit apology to the surgeon concerned and to the state IMA in writing.
  • This is a clear case of liability under the "The Punjab Protection of Medicare Service Persons and Medicare Services Institutions (Prevention of Violence and Damage to Property) Act, 2008". The doctor concerned has lodged a police complaint. He should not be left alone. The state IMA should provide him all support in the interest of the profession. The support should be on the following lines:

B. Long term action

  • The state IMA and the city/district branches should establish patient grievance redressal cells to look into complaints of medical negligence. These cells, if they function properly, would avoid or minimize the incidents of this type.
  • The state and district IMA branches should organize discussion meetings with the police regarding atrocities and injustice against doctors.
  • The state and district IMA branches should organize regular medico–legal updates for members with focus on medical negligence and grievances of doctors.
 
    ENT Update

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

How do enlarged adenoids cause growth retardation?

Growth hormone is released mainly during slow wave phase of sleep. Children with enlarged adenoids have disturbed sleep, frequent awakenings and apneas due to nasal blockage and this specifically affects slow wave sleep thus leading to decreased growth hormone secretions. Various studies have shown improved growth after adenotonsillectomy in children with adenotonsillar hypertrophy, especially if it is done before the age of five years.

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Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
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  Docconnect Dr. Naveen Dang
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  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
 
    Obesity Update

Dr. Parveen Bhatia: MS, FRCS (Eng.), FICS, FIAGES (Hon.), FMAS, FIMSA, Chairman, Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, Consultant Laparoscopic & Bariatric Surgeon & Medical Director, Global Hospital & Endosurgery Institute, New Delhi

Dr Rama Lakshmi: M.D (Obst and Gynae) Consultant, Global Hospital & Endosurgery Institute, New Delhi

Childhood Obesity

Are we carrying excess baggage?

Obesity is now among the most widespread medical problems affecting children and adolescents living in the United States and other developed countries. Childhood obesity represents one of the greatest health challenges. These overweight adolescents have a 70% chance of becoming overweight or obese adults and without major lifestyle changes, these kids face a 10 to 20 years shorter life span and will develop health problems in their 20s that is typically seen in 40–to–60–year–olds.

About 17% of children and adolescents are affected and the numbers are expected to continue increasing. The percentage of children aged 2 to 5 who are obese has increased to 12.4% in 2006 from 5 percent in 1980. Obesity in teenagers is even higher than that of younger children at 18%. Of these almost 7% of boys and 5% of girls were extremely obese, as were more than 2% of all children under 5 years old.

 
    Useful Website

(Dr Surendernikhil Gupta, drsurendernikhil@yahoo.com)

KidSurvival

Two on measles (Guinea–Bissau, US) http://www.childsurvival.net/?content=com_articles&artid=325

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Transferrin

Increased: Iron deficiency anemia

Decreased: Acute and chronic inflammatory states, poor nutritional status, chronic liver disease

 
    Medi Finance Update

(By Saurabh Aggarwal)

BDO Budget Snapshot 2011–12
Budget 2011– Key Features (General)

  • Indian Economy Overview:
    > Economy – Gross Domestic Product estimated to have grown at 8.6% in 2010–11
    > Exports grown by 29.4% and Imports grown by 17.6%. Further expected to grow at 9%
  • Tax Reforms:
    > Direct tax code (DTC) to be effective from 1st April, 2012
    > Goods and Service Tax been narrowed
  • Investment Environment:
    > Liberalize FDI policy in various sectors under discussion. This area is still not addressed. A real      drawback.
    > Direct investment in Indian Mutual Funds by any foreigner. This is a big positive
    > MFs allowed to raise money from foreign investors. This is a big positive
    > Reforms in Housing Sector Finance Introduced
  • Black Money:
    > Five fold strategy to be put in operation to deal with problem of generation and circulation of      black money
    > Tax Information Exchange Agreements (‘TIEA’) and Double Taxation Avoidance Agreements     concluded.
    > (Recently TIEA was done with British Virgin Islands, Isle of Man, Bermuda, Cayman island,     Gibraltar, Guernsey, Jersey, Macau etc)
    >  GAAR under DTC is based on similar lines.
  • Improving Governance:
    > UID Mission (under the leadership of Nandan Nilekani). Likely generation of 10 Lac Aadhar     numbers per day
 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Lidocaine 2.5% w/w + Prilocaine 2.5% w/w Gel
Additional higher Strength
26/03/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

STAR trial

At 81–month follow–up, the randomized STAR trial found raloxifene to be less effective than tamoxifen in reducing the risk of invasive breast cancer, but maintained its toxicity advantage.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with CKD was prescribed goat intestinal soup.
Dr Bad: Stop it.
Dr Good: It is prescribed in Ayurveda.
Lesson: Different pathies have different treatment.

Make Sure

Situation: A patient who had blood in the urine one month back was found to have large bladder cancer.
Reaction: Oh my God! Why was a cystoscopy not done at that time?
Lesson: Make sure that all painless bleeding in the urine are investigated for cancer at the first diagnosis.

Beware Of These Common Children’s Eye–Care Myths
(Dr. Narendra Kumar)

Myth: You should wait until kids are old enough to read before they undergo an eye test.

Fact: Amblyopia, or lazy eye, and strabismus, or squint, are serious conditions, and the outcome is surely better when these conditions are identified and treated as early as possible.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Anupam Sethi Malhotra)

Never leave the mind vacant

An empty mind is the devil’s workshop. All evil actions start in the vacant mind. Keep your mind occupied in something positive, something worthwhile. Actively follow a hobby. Do something that holds your interest. You must decide what you value more: money or peace of mind. Your hobby, like social work or temple work, may not always earn you more money, but you will have a sense of fulfillment and achievement.
Even when you are resting physically, occupy yourself in healthy reading or mental chanting of God’s name.

………………………………

eQuiz
(Dr Ashish Verma MD)

Read this…………………

An otherwise healthy 60–year–old male presents to your office with several weeks of upper abdominal discomfort that does not respond to over–the–counter ‘Digene’ and Ranitidine. The discomfort is slightly worsened with both exertion and eating. His father had died of an MI at 50 years of age. Physical examination is normal and so is the EKG. What is the best next step?

A. Upper gastrointestinal tract endoscopy
B. Admission to rule out acute coronary syndrome
C. Exercise Stress Treadmill
D. Dobutamine Stress Echo

Yesterday’s Mind Teaser: japmadean
Answer for Yesterday’s Mind Teaser: Made in Japan

Correct answers received from: Dr Anil Bairaria, Dr Muthumperumal Thirumalpillai, Dr Vinay Sakhuja, Dr Neelam Nath, Dr Rashmi Chhibber, Dr K.Raju, Dr Chandresh Jardosh, Dr Rajiv Dhir, Dr Rakesh Bhasin, Dr Rajshree Aggarwal, Dr karani Vishanji, Dr Susheela Gupta, Dr K.P.Rajalakshmi, Dr Ratinder Jhaj, Dr Bina Sawhney, Dr Sivaram Upadhyaya, Dr N C Prajapati, Dr Sudipto Samaddar, Dr Anupam Sethi Malhotra, Dr Rajiv Kohli, Dr Anil Kumar, Dr K V Sarma, Dr M C Kothandaraman

Answer for 28th February Mind Teaser:Toucan
Correct answers received from:Dr.Vinay Kamat, Dr Manjesha

Send your answer to ijcp12@gmail.com

………………………………

Laugh a While
(Dr GM Singh)

A Horoscope For The Workplace

HUMAN RESOURCES: Ironically, given your access to confidential information, you tend to be the biggest gossip within the organization. Possibly the only other person that does less work than marketing, you are unable to return any calls today because you have to get a haircut, have lunch, and mail a letter!

………………………………

Knowledge is amusing

Rats multiply so quickly that in 18 months, two rats could have over million descendants.

 
    Readers Responses
  1. Dear Sir, thank you for sendng the daily eMednewS. Its a daily update for Doctors like us who are working at Primary centres. Thanks & Regards: Dr. Sneh Lata Rewaria, Ex. CMO NDPL.
  2. Dear Dr. KK Aggrawal, Thank you very much for the article–deeper meaning of lord shiva. Regards: Dr A K Saxena
 
    eMedinewS Special

1. eMedinewS audio lectures

2. eMedinewS ebooks

 
    Public Forum

(Press Release for use by the newspapers)

To avoid panic before Board exams, try these

Exam panics are very common in children before the board exams. If not treated properly it can end up with suicides. Instead of taking sleeping drugs one can try simple techniques to relieve panic, said Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee and President, Heart Care Foundation of India.

  • One should try distraction techniques which not only slow down the levels of adrenaline in the body but also re-focus attention away from the stress.
  • The easiest way is to make the panicky child count backwards from 100.
  • Another way is to make the child breathe in to the count of 3, hold to the count of 3, exhale to the count of 3 and hold to the count of 3 again. Repeat as many times till the acute panic attack goes away.
  • Progressive muscular relaxation – much of the discomfort one feels during a panic attack is due to voluntary muscle tensing. Progressive muscle relaxation also called as body mind relaxation is something like shavasana in yoga. With this, one is able to relax the muscles. Children can also be taught to practice this type of muscular relaxation and do it on a daily basis. Two minutes of progressive muscular relaxation can break the cycle of panic attack.
  • Procedure of progressive muscular relaxation: Sit or lie comfortably. Work through the whole body, muscle by muscle, tensing muscle for 10 seconds and then relaxing it for 10-15 seconds. Work from the feet through the body to your scalp. Some background music can help.
    Milk and bananas are the best calming substances. These include mash potatoes, lettuce, etc.
  • White sugar consumption may be harmful as it can increase stress.      
 
    Forthcoming Events

ICC Cricket World Cup 2011

http://www.cricbuzz.com/cricket–schedule/series/228/icc–world–cup–2011

6th Annual Conference of Indian Academy of Nephrology (IANCON–2011)

Date: March 12–13, 2011
Venue: Taj Deccan, Banjara Hills, Hyderabad–34
Faculty: Dr MS Amarsen, Dr KV Jhony, Dr SC Dash, Dr Kashivishweswaran, Dr V Sakhuja, Dr RK Sharma, Dr Girishnarayan, Dr Anuradha, Dr SK Agarwal, Dr P Sundarajan, Dr P Keshivya, Dr Ravi Raju, Dr Dilip Pahari, Dr LC Sharma, Dr Sanjeev Saxena, Dr Sanjay Gupta, Dr Abhijit Tarapdhar, Dr PP Verma, Dr Harun Rashid, Dr Sampath Kumar, Dr Sanjib Sharma, Dr S Padmanabhan.
Topics: CKD Symposium (From India, Nepal, Bangladesh), Newer concepts in the pathogenesis of hypertension, Fluid and Electrolyte & AKI, RAAS in treatment of Diabetic Nephropathy, Primary Prevention of CKD: Trials & tribulation in Indian condition, Vitamin–D andchronic kidney disease, Mycophenolate Vs Cyclyophosphamide in Lupus nephritis, Individual zinganemia therapy, How to monitor Immunosuppression minimization, Obesity Diabetes epidemic, Life Style changes & therapeutics, BKV and CMV Nephropathy, Leptospira and Acute Kidney Injury, HIV Nephropathy, Hypophosphatemia and Renal Disease, Immunosuppressant and risk of Malignancy, Pregnancy ARF, Expanding Dialysis services in Andhra Pradesh,Making kidney transplant easier for less privileged, Cardiovascular risk reduction in CKD

Organizing Secretary: Dr Sree Bhushan Raju, Associate Professor, Dept of Nephrology, NIMS, Hyderabad
Contact: Mob: 09848492951, sreebhushan@hotmail.com
Website: www.ian2011.in
Note: "Prof SC Dash oration in Nephrology" from this year onwards. Three awards each in oral, poster and imaging in Nephrology sessions

Registration for Delegates Amount
Up to 15th February 2011
 
Rs. 1500/–
Up to 5th March 2011
Rs. 2000/–
Spot registration
Rs. 2500/–
Student
Rs. 500/–

DD/Cheque in favor of "IANCON– 2011" payable at Hyderabad. Add Rs 100/– for outstation cheque.

eMedinewS Events: Register at emedinews@gmail.com

Medifinance Conference On Portfolio Management for Doctors and update on Budget 2011

Date: 13th March 2011
Time: 9 Am – 4 Pm
Venue: Auditorium, New Delhi TB Centre, Lodi Institutional Area, Lodhi Road, New Delhi

Speakers: Top of line from finance sector. The speakers to be chosen from the industry will be experts in each field to be covered in this conference

Separate sessions for portfolio management, insurance, mediclaim, banking sector, investments primary market, secondary market, taxation, loans for setting up hospitals, nursing homes, labs, etc. all under one roof.

No entry fee, the number of participants will be limited to 100 on first cum first serve basis. advance registration by mail to hcfi.1986@gmail.com /drkk@ijcp.com or by phone on 9899974439/9873716235 .

World Fellowships of Religions and Perfect Health Parade

First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof
Subject: Global Warming, Ethnic Crises, How to be Healthy
Date: Sunday 3rd April, 2011
Venue: Maulana Azad Medical College Auditorium, New Delhi
Time: 8 AM – 4 PM Parade through tableaus to be flagged off at 10 am from outside MAMC to move till 5 pm on different predefined routes in Delhi to create awareness about health matters.

Parade Route: Vikas Marg – Shahdara – Seemapuri – Guru Tegh Bhadur Hospital – Seelampur Pusta – Gandhinagar, to ISBT Kashmiri Gate – Civil Lines – Delhi University North Campus – Azadpur – Punjabi Bagh – Mayapuri – Raja Garden – Janakpuri – Tilak Nagar – Tihar Jail Road – Delhi Cantt. – R.K Puram – Munirka – IIT Gate – Panchsheel Park – Chirag Delhi Flyover – Nehru Place – Modi Mill Flyover – Ashram – Nizamuddin – Sunder Nagar – Pragati Maidan – ITO – finally culminate at Maulana Azad Medical College at 4pm.

Full day conference on ethnic crisis and global warming. Pre lunch session to be addressed by religious representatives who would talk on what each religion has to say. Post lunch to be addressed by doctors from all streams of medicinal practice (allopathy, ISM)
Register: rekhapapola@gmail.com

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