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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
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; Member 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


2nd May, 2010, Sunday

Arrest of a quack 


This is in response to the story published in Mail Today on March 1, 2010 under the heading – “Medical body’s secretary is a quack” by Dinesh C Sharma.

J.K. Sharma was introduced to the medical profession in early 90s as a freelancer journalist and used to attend DMA called press conferences on a regular basis along with other journalists of the city. He used to pose as a medical doctor shifted to journalism.

Later, he became a bonafide member of National IMA through New Delhi Branch after submitting the registration certificate of Orissa Medical Council. At that time, Delhi Medical Council did not exist and, hence, his credentials were never verified by state DMA. It was for the national IMA to have verified his credentials through the Orissa council or the medical council of India but the same was not done. The role of the local branch which initiated the membership was only to forward the application as it had no locus standi to verify any one’s credentials. Had the national IMA at the time when he was being confirmed as a member got his credentials verified either through Orissa Medical Council or MCI the fraud could have been caught a decade back? 

Over years, J K Sharma became active in medical association activities, joined Lion’s Club, Delhi Diabetic Forum, Delhi Medical Association Executive, became a medical officer to YMCA and even got selected as a medical officer for Commonwealth Games under Boxing category by the Government of Delhi.

Working in an association, there is no way to find whether an office bearer is a quack or not as the medical practice credentials are never checked in the association. An association does not run like a clinic or a hospital and hence any person’s medical credentials and knowledge can never be known to others.

I am also an elected member of Delhi Medical Council and was aware of the inquiry proceedings against J K Sharma and was a silent party to the inquiry. When the matter came to full Delhi Medical Council, the council acted against him and filed an FIR in the Police.

Both at IMA New Delhi Branch and Delhi Medical Association a resolution was passed by which JK Sharma’s primary membership seized to exist. It was also resolved that the association should initiate to get the credentials of all non DMC members practicing in Delhi verified.

Delhi Medical Council already has a policy in which one cannot practice in the city of Delhi without valid DMC registration. Unfortunately, thousands of doctors in the city, especially, from the government sector are still not registered with the council. Even many of the ministry, MCI, major govt. officials and other medical administrators and officials are not registered with DMC.

For becoming a member of National India Medical Association one has to go through a  three-tier system. The candidates credentials needs to be verified at the state level though the medical council and also at the level of National IMA. The very fact that people like J K Sharma become member of IMA shows how easy it is to dodge the so called the three tier system.

The suspicion of JK Sharma being a quack started when I was to fight the DMC member election and being the secretary of the IMA New Delhi Branch he was deputed by the branch as my observer in the election. IMA New Delhi Branch had sponsored my candidature.


With kind regards,

Yours sincerely,


Padamshri and Dr. B.C. Roy Awardee
Dr. K.K.  Aggarwal

 

 

Photo Feature

World Earth Day celebration at DPS School Mathura Road: In the picture (From left to right): Mr. MI Hussain, Principal, Sh R Mehta, Advisor Min. of Env. & Forests, GOI; Sh Pramod Grover, Vice Chairman DPS Society; Padma Shri and Dr BC Roy Awardee Dr KK Aggarwal (For health awareness, involve the people who counts, and select a location and event partner which matters)

Dr k k Aggarwal

International Medical Science Academy Update (IMSA): Practice Changing Updates

Preoperative skin antisepsis

Preoperative skin cleansing with chlorhexidine–alcohol is superior to providone–iodine. Application of antiseptics to the skin immediately prior to surgery is a routine practice in most operating rooms. Preoperative skin cleansing with chlorhexidine–alcohol is superior to providone–iodine; in a trial of 849 patients undergoing clean–contaminated surgery, the overall rate of surgical site infection was significantly lower in the chlorhexidine-alcohol group than in the povidone-iodine group (9.5 versus 16 percent). (Darouiche, RO, Wall, MJ Jr, Itani, KM, et al. Chlorhexidine–Alcohol versus Povidone–Iodine for Surgical–Site Antisepsis. N Engl J Med 2010;362:18.)

News and Views (Dr Brahm and Monica Vasudeva)

FDA approves prostate cancer treatment

FDA has approved Provenge (sipuleucel–T), a vaccine for prostate cancer. It doesn’t prevent the disease, so vaccine is a bit of a misnomer. The vaccine extended lifespan in men with metastatic cancer who did not respond to hormone–deprivation therapy. It did not slow tumor growth. A full treatment will cost $93,000. Dendreon officials defended that price, saying it was in line with those of other cancer drugs in terms of cost per extra month of life provided by the drug. The new approval is limited to ‘the treatment of asymptomatic or minimally symptomatic prostate cancer that has spread to other parts of the body and is resistant to standard hormone treatment.

Study finds increased risk for children whose parents commit suicide

Children whose parents commit suicide are almost twice as likely to kill themselves as those whose parents are still alive, according to a new study published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Lucentis helps with diabetic macular edema vision loss

A study published in Ophthalmology found Lucentis (ranibizumab) can improve eyesight being lost to diabetic macular edema.

Link between food, migraines

For most people, red wine, chocolate, and assorted cheeses mean a good time. But who suffer from migraines it can precipitate headache. Early research focused on migraines as a vascular disease. A chemical called tyramine, found particularly in aged cheeses and fermented meats, emerged as the likely culprit in the debilitating headaches, because it has an effect on blood vessels. It’s possible that tyramine can set a migraine in motion.

Mnemonic of the Day (Dr Prachi Garg): Causes of Jugular venous pressure (JVP) elevation – HOLT

Heart failure
Obstruction of venea cava
Lymphatic enlargement (supraclavicular)
Intra–Thoracic pressure increase

What’s New: Isolated single umbilical artery carries no risk

A prospective study found no difference in the risk of significant clinical renal abnormalities in infants with an isolated single umbilical artery compared to matched controls.(Deshpande SA, Jog S, Watson H, et al. Do babies with isolated single umbilical artery need routine postnatal renal ultrasonography?. Arch Dis Child Fetal Neonatal Ed 2009;94:F265.)

 Quote of the Day

"Asking the right questions takes as much skill as giving the right answers." Robert Half

Diabetes Fact

Emphysematous pyelonephritis is a diabetes complication; due to E. coli;gas around kidney; 80% mortality;, treat with aminoglycosides, and 3rd generation cephalosporins.

DMA Update: 9th May is Mother’s Day

At the first visit, when a woman mentions incontinence, the doctor should set her up with a voiding diary and schedule a follow–up visit in a few weeks. At that next visit, in addition to reviewing the diary, the doctor should do a history and physical, perform a stress test and measure postvoid residual urine.

Question of the Day: Dr GM Singh

What is the usefulness and interpretation of monitoring tests for HIV such as CD4 count and viral load?

Both CD4 count and viral load are surrogate markers of disease progression and correlate well with clinical outcomes. CD4 count is the best indicator of the current risk of AIDS–defining illness and ranges between 500–1500 cells/µl in HIV negative people. HIV–infected patients are at risk of opportunistic infections if the CD4 count is less than 200 cells/µl. As well as starting HAART they will start prophylaxis to prevent opportunistic infections – for example, cotrimoxazole or dapsone for pneumocystis jiroveci pneumonia (PCP) or azithromycin for mycobacterium avium intracellulare. HIV viral load is used as a marker of the effect of antiretroviral treatment. The goal is an almost undetectable plasma HIV viral load of less than 50 copies – the lower limit of detection of most assays. Research using ultra–sensitive HIV RNA assays confirm that virus is still found in the plasma even when HIV viral load is less than 50 copies/ml, so transmission is still possible.

World Asthma Day (May 4, 2010): (Dr Sukanta Sen)

World Asthma Day is a yearly occasion structured by the Global Initiative for Asthma (GINA) to perk up the asthma alertness and concern around the globe. World Asthma Day takes place on the first Tuesday of May. The Global Initiative for Asthma (GINA) works with health care professionals and civic health officials around the world to decrease asthma incidence, morbidity, and deaths. This year World Asthma Day falls on Tuesday, May 4, 2010. The theme for this year is ‘You can Control your Asthma’.

Stupid Question: (drsooneita@gmail.com)

In the bus: A heavy lady wearing pointed high-heeled shoes steps on your feet...
Stupid Question: Sorry, did that hurt?
Answer: No, not at all, I’m on local anesthesia.. ...why don’t you try again.

SMS of the Day (Kavi Chetan)

No one ever said that life would be easy but the 3 ‘B’ factor, Begin ...Believe...Become... are three factors that can change anything anytime.

eMedinewS Try this it Works: A birthday reminder for preventive health

To make sure everyone gets their routine checkups, ask all patients to make an appointment during the month of their birthday for routine care. On this visit focus on preventive care, such as adult immunizations, cancer screening, and health education.

Dr Good Dr Bad

Situation: A patient with carotid occlusion of 72 years duration had a transient episode of unconsciousness.

Dr Bad: You can have frequent episodes of stroke if not treated.

Dr Good: Further events are not likely.

Lesson: If a patient has a sustained carotid occlusion without suffering from a devastating stroke, he or she must have a good collateral supply and further events are unlikely.

Make Sure

Situation: A 23–year–old asymptomatic soldier undergoing routine physical examination was found to be positive for Chlamydia.

Reaction: Oh my God! Why did you not prescribe 1 g single dose of azithromycin.

Lesson: Make sure to remember that azithromycin 1 gm in single dose is highly active against C. trachomatis in a single–dose therapy.

IMANDB Joke of the Day

Intensivist: I have some bad news and some very bad news.
Patient: Well, might as well give me the bad news first.
Intensivist: The lab called with your test results. They said you have 24 hours to live.
Patient: 24 HOURS! That’s terrible!! WHAT could be WORSE? What’s the very bad news?
Intensivist: I've been trying to reach you since yesterday

ECG Formulae: NSR (Normal Sinus Rhythm)

P wave should normally be upright in lead II if there is NSR. The P wave may normally be positive, negative or biphasic in lead V1.

Milestones in Cardiology

1543 AD: Vesalius observed the absence of connection between the two ventricles; blood therefore could not pass from one to the other.

Lab Test (Dr Arpan Gandhi and Dr Navin Dang): Beta–2 Microglobulin

To help identify a mycobacterial infection; to diagnose tuberculosis (TB); to monitor the effectiveness of treatment.

Public Forum (Press Release for use by the newspapers)

Before sports children need to be screened for the heart

Sudden Cardiac Death amongst athletes is a rare but devastating event. Most victims are usually young and, apparently, healthy but many have underlying undiagnosed heart disease, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

As per American Heart Association Guidelines, children and adolescents need medical clearance before undergoing for athletic training. Majority of sudden deaths amongst athletes are due to malignant irregularities in the heart rhythm such as ventricular tachycardia and ventricular fibrillation. The precipitating factors can be prolonged physical training or unaccustomed athletic activities. In athletes under the age of 35, the most common cause of death is underlying congenital heart disease and for those above the age of 35, it is the presence of blockages of the coronary arteries. As per American Heart Association, in every school/college, the attached doctor should evaluate all students with a 12–step history and examination to rule out high risk cases that need further evaluation. The European Society of Cardiology also recommends an additional standard 12 lead ECG before a medical clearance is given for both competitive as well as recreational athletic activities. For those master athletes who are above the age of 35, they will need an additional exercise testing before they can be given a clearance for athletic activity. Diagnostic echocardiography is indicated with clinical, historical and physical findings suggest possibility of structural heart diseases. Athletes on pacemaker should not engage in sports as bodily collision may damage the pacemaker system.

The 12–element AHA recommendations for pre participation cardiovascular screening of competitive athletes:

  1. Exertional chest pain/discomfort
  2. Unexplained syncope/near–syncope
  3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise
  4. Prior recognition of a heart murmur
  5. Elevated systemic blood pressure
  6. Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in one relative
  7. Disability from heart disease in a close relative <50 years of age
  8. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long–QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias
  9. Heart murmur
  10. Femoral pulses examination to exclude aortic coarctation
  11. Physical features of Marfan syndrome
  12. Brachial artery blood pressure (sitting position, both arms)
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   eMedinewS-Padma Con 2010

Will be organized at
Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

 
 

eMedinewS-revisiting 2010

The second eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited.

 
 

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Stop Press: MCI Update:

A Delhi court on Saturday remanded MCI president and three others in judicial custody after their arrest for allegedly taking a bribe to grant licence to a medical college in Punjab. Additional Sessions Judge O P Saini sent them to jail till May 14 after the CBI submitted that their custodial interrogation was not required any longer in the investigations.  Meanwhile, Desai moved his bail application in the court which has been fixed for hearing on May 3. Dr. Desai, alleged middleman J P Singh and doctors Sukhwinder Singh and Kanwaljit Singh of Patiala-based Gyan Sagar Medical College, have been booked under the Prevention of Corruption Act. 

Readers Responses

  1. Heartiest congratulations. I am sure you will get higher laurels. Sunil Prakash
  2. Congratulations. It has strengthened my believe in goodness. KC Gupta
  3. Sir, many congratulations for winning Padma award. You truly deserved it. Nitish

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

Approval Date

Fluvoxamine Maleate100/150mg ER Tablets

For the treatment of obsessive compulsive disorder (OCD)and depression

19.08.2009