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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
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; 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 October 2010, Saturday

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

Gandhi Jayanti is also observed as Anti Quackery
Day by Indian Medical Association

The IMA observes the birth anniversary of Mahatma Gandhi as Anti–Quackery Day to fight quackery. It is a day to recapitulate what has been done in the anti–quackery front in the last one year and plan ahead for the next year. For every one Allopathic Doctor, there are 1.5 quacks. If government is not interested in solving this problem, what can be done?

  • Lobby for a President’s Ordinance clarifying "who can write the word Dr. in front of their names".
  • A new law defining the suffix or prefix in such a way that doctor of different ‘pathies’ can be easily differentiated.
  • Allowing a nurse practitioner to practice in the community.
  • Allowing a registered Paramedical worker to practice in the community as a paramedical worker.

Gandhi Jayanti also teaches us ways of removing negativity in the mind. Mahatma Gandhi believed in fasting and defined it as a way of purification of mind, body and soul using satvik aahaar, satvik vyavahar and satvik vichaar.

Gandhi Ji’s three monkeys depict, "Do not see evil", "Do not listen evil" and "Do not speak evil". In Hindu mythology, monkeys represent ‘thoughts’ and Gandhi Ji’s 3 monkeys represent ‘controlling negative thoughts and action’. Both motor and sensory indriya fast forms the basis of any spiritual fast.

This year 2nd October falls on the eve of the Commonwealth Games. It should remind us to ignore the shortcomings in the Commonwealth Games and appreciate the positive aspects of Commonwealth Games including the newly developed sports facilitates for sportspersons in India.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
  Photo Feature (from the HCFI Photo Gallery)

Perfect Health Mela 2009

In the photo: Dr Kiran Walia, Health Minister, Govt of Delhi at the inaugural function of the 16th PHM, 2009. The focus of the Mela was on Lifestyle disorders.

 
Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Statins and Diabetes mellitus

A meta–analysis of 13 randomized trials has shown that patients treated with statin therapy have a small increased risk of developing diabetes (odds ratio 1.09)

(Reference: Sattar N, et al. Statins and risk of incident diabetes: a collaborative meta–analysis of randomised statin trials. Lancet 2010;375:735).

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

95 new cases take dengue tally to 3,108

The city reported 95 confirmed cases of dengue on Tuesday, taking the total number of people infected with the mosquito-borne disease to 3,108. South Delhi continues to be the worst affected area with 446 cases this season, followed by the Civil Lines zone (401) and Rohini zone (363). MCD officials said fogging operations have been intensified across the city, especially in the Commonwealth Games Village area. (Source: The Times of India)

  International News

(Dr Monica and Brahm Vasudev)

Cook stent more effective than standard therapy for patients with blockages in upper–leg artery

According to research presented at the Transcatheter Cardiovascular Therapeutics meeting, a drug–coated stent from Cook Medical, the maker of devices for minimally invasive medical procedures, was more effective than standard therapy for patients with blockages in an upper–leg artery.

Celiac disease may be showing an increasing presence among the elderly

According to a study in the Annals of Medicine, celiac disease, an autoimmune illness affecting about one in 133 Americans, is showing an increasing presence among the elderly. In the study, more than 3000 volunteers were evaluated between 1974 and 2007.

Autologous chondrocyte implantation may benefit certain patients with knee osteoarthritis

Autologous chondrocyte implantation (ACI) may delay knee replacements for certain patients with osteoarthritis.

Stress may speed tumor metastasis

According to a study published Sept. 15 in the journal Cancer Research, UCLA researchers discovered that breast cancer tumors spread faster inside…mice that were stressed –– because they had to spend part of each day confined to a small space –– than in the mice that were not.

  Hepatology Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

Neonatal cholestasis

What is the need for early diagnosis?

Prompt identification and diagnostic assessment of infant with cholestasis is most essential.

  • For early surgical intervention. The success of surgical correction of biliary atresia (Kasai’s operation) is significantly reduced if it is performed after 6-8 weeks of age.
  • To recognize disorders amenable to specific medical therapy e.g. sepsis / UTI /galactosemia/hypothyroidism etc.
  • To institute early conservative/empiric management.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Why is there so much concern about having twins or triplets after fertility treatment?

Multiple births carry risks to both the health of the mother and to the health of the unborn babies. Twins or triplets are more likely to be premature and to have a below–normal birth for admission. You would need to visit the centre 3–5 times during the monitoring cycle. On the day of egg collection you would need to fast for 6 hours and come to the clinic, the procedure takes about half an hour. You weight. Studies show that the risk of death before birth, or within the first week of life, is more than four times greater for twins than for a single baby. For triplets, the risk is seven times greater than for a single baby.

  Diabetes Update: Question of the Day

What are the beneficial effects of metformin?

Metformin is the first drug of choice in obese type 2 diabetes mellitus to decrease hyperglycemia. Metformin exerts its effect by increasing insulin mediated glucose disposal in visceral adipose tissue and predominantly decreasing the elevated hepatic glucose production.

  • Metformin therapy in United Kingdom Prospective Diabetes Study (UKPDS) was associated with decrease in fasting plasma insulin levels, with no weight gain and no significant incidence of hypoglycemia.1 Metformin monotherapy reduced fasting plasma glucose (FPG) by 52–92 mg/dl and HbA1C by 1.4–2% over the dose range 1,700–3,000 mg daily. Combination therapy of metformin with sulfonylureas (1.7–1.9%) and glitazones (1–1.2%) produces additional reduction in HbA1C. When added to insulin, it reduces insulin dosage by 25-36%.2
  • Metformin is associated with a mean weight loss of 2–3 kg which is primarily due to decrease in adipose tissue. In normoglycemic obese adolescents, the metformin group produces greater weight loss (6.5% ± 0.8% vs 3.8 ± 0.4%, p < 0.01), greater decrease in body fat (p < 0.001) and enhanced insulin sensitivity as compared to placebo.3
  • Metformin also has many beneficial effects on many aspects of insulin resistance syndrome; decrease in central obesity, decrease in plasma insulin levels, decrease in proliferative activation inhibition (PAI)–1 thus improving fibrinolysis, and a small effect on decreasing serum triglyceride and LDL cholesterol. It ay represent a relevant element of an integrated lifestyle modification-pharmacotherapy to prevent not only type 2 diabetes but also CVD.4
  • Metformin has direct effects on fibrin structure/function and stabilizes platelets, two important components of arterial thrombus.5

References

  1. Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UKPDS group. Lancet 1998;352(9131):854–65.
  2. International Textbook of Diabetes Mellitus 3rd edition, Vol 1.
  3. Kay JP, et al. Beneficial effects of metformin in normoglycemic morbidly obese adolescents. Metabolism 2001;50(12):1457–61.
  4. Despres JP. Potential contribution of metformin to the management of cardiovascular disease risk in patients with abdominal obesity, the metabolic syndrome and type 2 diabetes. Diabetes Metab 2003;29(4,Pt. 2):6S53–6S61.
  5. Grant PJ. Beneficial effects of metformin on haemostasis and vascular function in man. Diabetes Metab 2003;29(4, Pt. 2):6S44–6S52.
  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What was the Dr. Sam Sheppard Murder Case? The infamous unsolved murder in the USA

Marilyn Shephard, wife of a handsome 30–year–old doctor, Sam Shephard was brutally murdered in the bedroom of their home on July 4, 1954 in America. Sam Sheppard denied any involvement in the murder and described his own battle with the killer he described as "bushy–haired." The subsequent arrest of Dr. Sam Sheppard led to what became known as the "Trial of the Century" in 1954 followed by the "Re–Trial of the Century" in 1966. Facing two different juries, 12 years apart, Sam Sheppard was pronounced ‘guilty’ by one jury, ‘not guilty’ by the next. Even over the past decade, partisans continued the debate and the case became one of the most infamous unsolved murders in the USA. A third jury in 2000, asked to consider awarding the Sheppard family damages for wrongful imprisonment, sided with county prosecutors. In 2001, a book on the Sheppard case concluded that Sam was clearly innocent. Two years later, another book on the case argued just as forcefully that the first jury got it right: Sam was guilty as charged. Did Sam do it?

  Medi Finance Update

If a doctor wants to employ his son and give salary on the basis of personal skill then can he do so?

Yes, there are no restrictions.

  Drug Update

List of drugs prohibited for manufacture and sale through gazette notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combinations of Atropine in Analgesics and Antipyretics

  Lab Update

Insulin–like Growth Factor – 1 (Dr Arpan Gandhi and Dr Navin Dang)

  • To identify diseases and conditions caused by deficiencies and overproduction of growth hormone (GH)
  • To evaluate pituitary function
  • To monitor the effectiveness of GH treatment
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  IJCP Special

Dr Good Dr Bad

Situation: A 36–year–old female with mitral stenosis and moderate mitral regurgitation came for opinion.
Dr. Bad: Go for Balloon Valvuloplasty.
Dr. Good: Go for surgery.
Lesson: Surgery is indicated when Balloon Valvuloplasty is not available, there is left arterial thrombosis that persists despite anticoagulation, the mitral valve is severely calcified and moderate to severe mitral regurgitation is present.

Make Sure

Situation: A diabetic patient with blood pressure of 130/90 developed acute heart attack.
Reaction: Oh my God! Why was his blood pressure not kept below 120/80?
Lesson: Make sure
that all patients with diabetes should have a goal BP of less than 120/80

Quote of the Day (Dr.G.M.Singh)

"We all make mistakes. But not many are willing to own up and rectify them. Even just a plain – "Sorry, we messed up!" – comes hard to come by."

  eQuiz

Read this…………………

Which of the following patients with atrial fibrillation should be on Coumadin therapy?

A. 50 year old diabetic male whose LDL cholesterol is 200.
B. 76 year old male with no other significant past medical history.
C. 45 year old female with diabetes and hypertension.
D. 64 year old female with congestive heart failure.
E. 49 year old female with HTN and TIA

(Contributed by Ashish Verma MD)

Answer for yesterday’s Mind Teaser: "Sideburns."

Correct answers received from: Dr. Meera Rekhari, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr. Naorem Sharat. Dr.K.P.Rajalakshmi, Dr. Yogesh Kumar.

Answer for 29th Sept Mind Teaser is: "I am bigger than you"
Correct answers received from:
Dr Muthumperumal Thirumalpillai, Dr.A.P.Bhatia, Dr Anurag Jain, Dr Raju Kuppusamy.

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr. GM Singh)
Patient to doctor: I’ve got a terrible backache. Please help me.
“Have you been to any other doctor before you came to see me?” asked the grouchy medic.
“No sir,” replied the meek patient, “I went to a druggist.”
“That shows how much sense some people have!” growled the doctor. “And what sort of idiotic advice did he give you?”
“He told me to come to see you.”

You are an Indian if you (Anuj Goel)
Arrive one or two hours late to a party – and think it’s normal.

  An Inspirational Story

Black and Gold Boxes

I have in my hands two boxes, Which God gave me to hold.
He said, "Put all your sorrows in the black, And all your joys in the gold."
I heeded his words, and in the two boxes, Both my joys and sorrows I store.
But though the gold became heavier each day, The black was as light as before.

With curiosity, I opened the black. I wanted to find out why.
And I saw, in the base of the box, a hole Which my sorrows had fallen out by.
I showed the hole to God, and mused aloud,"I wonder where my sorrows could be.
"He smiled a gentle smile at me."My child, they’re all here with me."

I asked, "God, why give me the boxes,"
"Why the gold, and the black with the hole?""
My child, the gold is for you to count your blessings, The black is for you to let go."

  Readers Responses
  1. Dear Dr Aggarwal, I read the spiritual thought regarding timing of Commonwealth games and negative energy. But I beg to differ regarding the concept and explanation in this article. Don’t you think it will again lead to blind faith in the rituals? We are scientific people and should always believe in science. I do admit there is another dimension of health and that is spiritual wellbeing. But this fourth dimension of health varies from person to person and is not to be propagated. If we blame the Chaturmas and negative energy for the mess and adverse publicity of the Commonwealth Games, we will be justifying the inefficiency, corruption and bureaucracy. Why does it happen in India? European countries do have different weathers and so many obstacles. But their scientific thinking has made them believe in themselves. In India too, there are many religions and communities who do not believe in this explanation. Sikhs, for example, never consult the experts in Vedic thoughts and plan their weddings and other celebrations without worrying about Chaturmas. They are able to celebrate their occasions more happily because these months are not overcrowded and they can book the venues easily. Guru Nanak Says - All these days, months and years are made by God Almighty. It is your Karma that will determine your fate. Kabir Das always took a snide at all these explanations and always emphasized the value of Karma. Positive energy and negative energy is a concept of mind set and our own way of thinking. Dr R.S. Baja
    eMedinewS Responds: We agree with your emotions. But most Indian rituals are based on science. Chanting of vowels produces interleukin-2 and chanting of nasal consonants produces delta activity in brain. Aum is a combination of a vowel and a nasal consonant. Principles of CBT are taken from Bhagwad Gita. Principles of narration exposure therapy are taken from mourning ritual etc. No one can deny that even an educated Hindu will not organize the marriage (arranged marriage) of his or her daughter during the shradhs/chaturmas or in holasthak. Chaturmas marriages are not applicable to love marriages as per the rituals. As far as corruption is concerned, it has to be dealt within the law. If one individual is corrupt he should be tried in the court of Law and if found guilty punished but the image of the country cannot be tarnished on the name of one person.
  Public Forum

(Press Release for use by the newspapers)

Yoga is not just asanas
 
Inaugurating Yoga Diwas, organized by Ramesh Nagar District of Bhartiya Yog Sansthan, Dr. Hedegawar Park, Mansarowar Garden Padma Shri and Dr B C Roy National Awardee Dr. K. K. Aggarwal said that science has recognized that chanting of vowels leads to physical  relaxation and that chanting of nasal consonants provides mental  relaxation to the human body. Aum combines vowels and nasal consonants and therefore is of immense medical value. He laid great emphasis on the links between science and Indian rituals, and explained the scientific reasoning behind various Hindu festivals and religions.
In another Seminar on science and spirituality held at Chandra Arya Vidya Mandir, organized by the Investors Club, Dr  Aggarwal said that Gandhi Ji’s 3 monkeys depict, “Do not see evil”, “Do not listen evil” and “Do not speak evil”. In Hindu Mythology monkeys represent the thoughts and Gandhi Ji’s 3 monkeys represents controlling the negative thoughts and action. Both motor and sensory indriya fast forms the basis of any spiritual fast.
Dr Aggarwal said that Yoga is not just about asanas. It is a complete  8 steps meditation. Dr. Aggarwal demonstrated the correct respiration and breathing procedures. Asserting that most humans utilize only 60 per cent of their lungs for regular breathing, he stressed that the right way to respire is to practice abdominal thoracic breathing, which involves both the stomach region as well as the chest cavity in the process of inhaling and exhaling. From this arose the concept of Pranayama and its relevance as a spiritualistic gesture, he continued. He asked the audience to participate in a deep breathing and meditation exercise for 5 minutes, at the end of which many of those present confessed to feeling both mentally and physically relaxed.

  Forthcoming Events

CPLD 2010: Dept. of Gastroenterology & Human Nutrition, AIIMS and Dept. of Gastroenterology, PGIMER, Chandigarh are jointly organizing a conference on Current Perspective in Liver Diseases (CPLD) on 15th and 16th October at AIIMS, New Delhi.

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi 24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

eMedinews Revisiting 2010

The 2nd 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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