emedinews
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FIRST NATIONAL DAILY 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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

2nd October 2011, Sunday

In US only 25% hypertensive patients gets treatment

If this is the situation in the US, what will the figure be in a country like India? Following are the US statistics.

  • According to Agency for Healthcare Research and Quality (AHRQ) more than 5.5 crore adults over the age of 18 were treated for hypertension in 2008 in USA.
  • According to the American Heart Association (AHA), more than 7.6 crore adults have been diagnosed with high blood pressure, which is the most common cardiovascular disease, the leading cause of stroke and kidney failure, and a major cause of heart attack. This means about 2 crore people who have been diagnosed with hypertension are not being treated for it.
  • As per CDC’s National Health and Nutrition Examination Survey, more than half of 7.6 crore people diagnosed with high blood pressure did not have controlled disease. Most high blood pressure feels fine and think treatment is unnecessary. Symptoms develop only when the organ damage occur.
  • Over 60% of those over 65 were treated for hypertension in 2008.
  • Only 33% of those in the 45 to 64 age group were treated for hypertension.
  • Just 5% of adults younger than 45 were treated for hypertension in 2008.
  • Slightly more women received treatment than men, but the cost of treatment did not differ between the genders.

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Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

In US only 25% hypertensive patients
gets treatment

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Heritage–An Inter Dancing School Health Festival at Perfect Health Mela

Heritage – An Inter Dancing School Health Festival at Perfect Health Mela. Dancing is good for health and classical dance is a mix of exercise and meditation

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

High cholesterol women catch up with men

MUMBAI: City doctors warn that the notion of women being less prone to cardiac problems needs to change fast. Now, a survey by a city–based laboratory has found that the possible underlying cause of rising heart ailments could be alarming cholesterol levels in women. Metropolis laboratories released data on cholesterol levels of 17,379 men and 15,255 women who had got themselves tested between January 2009 and July this year. A whopping 36% men and 33% women were found to have at least one abnormal cholesterol parameter or undesirable cholesterol and triglycerides presence in their blood stream. But what is most worrisome is that women seem to be fast catching up with men in terms of high cholesterol levels. Doctors say this calls for a detailed analysis as to how women are showing higher cholesterol levels despite the protection of estrogen (the primary female hormone). The survey revealed how 55.7% women in the 25–45 age bracket had abnormally high cholesterol in comparison to 43.4% men. Also, out of the 3,586 women found to have abnormal cholesterol levels, around 1,225 had very high cholesterol. Further, the numbers reflected how more women had abysmally high level (56.5%) of bad cholesterol, and an equal percentage were on the verge of tipping over. (TOI, Sep 28, 2011)

For comments and archives

Ban on human placenta extract and its formulations (Placentrex) relaxed

The ban on Human placenta extract (HPE) and its formulations (Placentrex) for human use imposed by Govt of India on the recommendation of DTAB (Drug Technical and Advisory Board) subcommittee based on safety concern along with five other drugs vide gazette notification No. G. S. R 82(E) dated 10th feb’2011 has now been relaxed vide amended Gazette notification No. G.S.R. 418(E) dated 30th May 2011. The manufacturing and marketing of HPE and its formulations (Placentrex) has now been permitted for human use for the following: HPE (Placentrex) topical application for wound healing, HPE (Placentrex) injections for Pelvic inflammatory diseases.

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

(Dr Monica and Brahm Vasudev)

Six enterovirus clusters spark CDC warning

The CDC is warning clinicians that a rare enterovirus caused six clusters of respiratory illness – including several deaths – from 2008 to 2011. Three of the clusters, involving 39 people, occurred in the U.S., the agency said in the Sept. 30 issue of Morbidity and Mortality Weekly Report; another 56 people were affected in Asia and Europe. More than half of the cases in the six clusters occurred in children under age 5. The pathogen is human enterovirus 68 (HEV68), which has epidemiological and biological similarities to human rhinoviruses. It was first isolated in 1962 and has been reported only rarely since then, the CDC said

For comments and archives

Screening ECG still not supported by evidence

No new evidence has surfaced since 2004 to justify screening asymptomatic adults for coronary artery disease (CAD) with resting or exercise ECG, according to a literature review by the U.S. Preventive Services Task Force (USPSTF).

For comments and archives

Cytisine more effective than placebo in a randomized trial in smoking

In a 740–person trial conducted in Poland, 8.4% of those assigned to cytisine, a partial agonist at nicotinic acetylcholine receptors, remained abstinent through the one–year follow–up period compared with 2.4% of the placebo group (P=0.001), reported Robert West, PhD, of University College London in England, and colleagues. It did not help much to define abstinence more loosely as not having smoked during the final week of follow-up, according to their report in the Sept. 29 issue of the New England Journal of Medicine. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Silence and smile are the two powerful tools. smile is the way to solve many problems and silence is the way to avoid many problems…

@DeepakChopra: Everything in the Universe is Within You. Ask All From Yourself – Rumi Secret of Love Deluxe Edition at BN.com:http://bit.ly/qQWrW5

 
    Dr KK Answers

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

What is the absolute risk of acute heart attack after sex?

Sexual act is a transient trigger that increases risk of heart attack for only a two hour period. The absolute increase in risk is very small.

A 50 year–old man with no cardiac disease with an annual baseline risk of heart attack of one percent would increase his annual risk of heart attack to only 1.01 percent from weekly sexual activity.

A person with a high annual risk for a heart attack of 10 percent would increase the annual risk to only 10.1 percent from weekly sexual activity.

For comments and archives

 
    Spiritual Update

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

Science behind 2nd Navratri or Mata Brahmacharini (Sati) Worship (let go your impure thoughts)

Navratri is the detoxification of body, mind and soul. Body detoxification involves Navratri diet containing eating less devoid of cereals. In Navratri diet flour is replaced with Kuttu or Singhara flour; pulses with amaranth or Rajgiri and Rice with Samak rice. Mental and soul detoxification involves practicing Yoga Sadhna as described in nine forms of respective Durga.....

For comments and archives

 
    An Inspirational Story

(Dr Anupam Sethi Malhotra)

Pencil: I’m sorry. Eraser: For what? You didn’t do anything wrong. Pencil: I’m sorry because you get hurt because of me. Whenever I made a mistake, you’re always there to erase it. But as you make my mistakes vanish, you lose a part of yourself. You get smaller and smaller each time.

Eraser: That’s true. But I don’t really mind. You see, I was made to do this. I was made to help you whenever you do something wrong. Even though one day, I know I’ll be gone and you’ll replace me with a new one, I’m actually happy with my assigned job. So please, stop worrying. I hate seeing you sad dear.

This conversation between the pencil and the eraser is very inspirational.

Parents are like the Erasers & Children are the Pencils.

They are always there for their children, cleaning up their mistakes. Sometimes along the way, they get hurt and become smaller/older, and eventually pass on. Though their children will eventually find someone new (spouse) but parents are still happy with what they do for their children and will always hate seeing their precious ones worrying or sad.

May the Erasers live longer & the Pencils write good things.

For comments and archives

 
    Fitness Update

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

Weakness in heart attack therapy identified

Scientists didn’t have a plausible research–based answer until now, according to the UCSF researchers. In a paper published this month in the scientific journal Science Translational Medicine, researchers offer an explanation of why a gap exists been the success of human trials and rodent experiments. Researchers use bone marrow from young, healthy donor rodents to treat mice that had heart attacks. However in humans, bone marrow cells came from the patients themselves –– typically older –– after they suffered heart attacks.

"It’s very important to consider the disease, whenever you think about treatments that involve returning cells into the same person from whom they were taken," said the paper’s senior author Matt Springer, PhD, associate professor of medicine in the UCSF Division of Cardiology and UCSF Cardiovascular Research Institute. "The very disease you’re trying to treat might actually cause a problem for those cells, and that seems to be the case here. "Heart attacks are very complicated, and are hard to treat even with pharmacology and interventional therapies," said Xiaoyin Wang, MD, lead author, and an associate research specialist at the UCSF Cardiovascular Research Institute. "It’s difficult to get reasonable and realistic results to heal heart attacks.

For comments and archives

 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

What are the rights of persons having qualifications registrable under the IMC Act, 1956, and what are the privileges of the persons so registered? Can an RMP claim the following privileges?

a. Exemption from jury service.
b. Right to Prefix Dr. to his name.
c. Right to Suffix MBBS with his name.

Ans.

  1. The rights of a person possessing registrable qualifications are given in section 15 of the Act, reproduced below: "RIGHT OF PERSONS POSSESSING QUALIFICATIONS IN THE SCHEDULES TO BE ENROLLED. (15) (1) Subject to the other provisions contained in this Act, the medical qualifications included in the Schedules shall be sufficient qualification for enrolment on any State Medical Register.
    (2) Save as provided in section 25, no person other than a medical practitioner enrolled on a State Medical Register:–
    (a) shall hold office as physician or surgeon or any other office (by whatever designation called) in Government or in any institution maintained by a local or other authority;
    (b) shall practice medicine in any State;
    (c) shall be entitled to sign or authenticate a medical or fitness certificate or any other certificate required by any law to be signed or authenticated by a duly qualified medical practitioner:
    (d) shall be entitled to give evidence at any inquest or in any court of law as an expert under section 45 of the Indian Evidence Act, 1872 on any matter relating to medicine.
    (3) Any person who acts in contravention of any provision of sub–section (2) shall be punished with imprisonment for a term which may extend to one year or with fine which may extend to one thousand rupees, or with both".
  2. The privileges of an RMP are spelled out in section 27 of the IMC Act, 1956, as follows: "Privileges of persons who are enrolled on the Indian medical register.

    27. Subject to the conditions and restrictions laid down in this Act, regarding medical practice by persons possessing certain recognised medical qualifications, every person whose name is for the time being borne on the Indian Medical Register shall be entitled according to his qualifications to practice as a medical practitioner in any part of India and to recover in due course of law in respect of such practice any expenses, charges in respect of medicaments or other appliances, or any fees to which he may be entitled."
  3. The following privileges cannot be claimed:
    a. Exemption from jury service. ––There is no jury service in India
    b. Right to Prefix Dr. ––This is not an exclusive right of an RMP. Even a PhD or D Litt can do so.
    c. Right to Suffix MBBS with name ––Such a right can come only by virtue of possessing an MBBS degree and not merely by virtue of being an RMP. A person who is registered as an RMP on the basis of a qualification other than MBBS cannot suffix MBBS to his name.

For comments and archives

 
    Malaria Update

AC Dhariwal, Hitendrasinh G Thakor, Directorate of NVBDCP, New Delhi

How is malaria diagnosed?

If a microscopy result cannot be made available within 24 hours in Pf predominant areas, RDT should be used for diagnosis, which is simple and can be done by any healthcare providers in their clinic. If the RDT is found negative, then the slide is to be sent for microscopy. If it is positive, the patient is treated for falciparum malaria. Mixed infection cannot be ruled out in such cases, but the risk is low.

In areas, where the risk of falciparum malaria is very low, it is not cost–effective to do RDT in every patient with fever. To meet this challenge, the country programme is recently planning to introduce bivalent RDT which will not only be useful to detect both Pv and Pf cases at the field level, but also reduce the load of microscopy service. If such tests are available in private set up in any area, the treatment provider should use that service for confirmation of diagnosis and the species–specific treatment should be provided for malaria on confirmation only.

For comments and archives

 
    Medicine Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What are the common causes of acute liver failure in adults?

The common causes of ALF in adults in India are viral hepatitis (Hepatitis E Hepatitis A, Hepatitis B), drug–induced, Wilson’s disease, autoimmune hepatitis, acute fatty liver of pregnancy/HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) syndrome, Budd–Chiari syndrome and malignant infiltration.

For comments and archives

 
    Infertility Update

(Dr. Kaberi Banerjee, Infertility and IVF Specialist)

Infertility is still an enigma to us. The most advanced technique gives a pregnancy rate of at best 50–60% per attempt. Definitely there is lot more to be understood. We are hosting a Conference on 8th–9th of October at Le Meridian, New Delhi on Current Practices and Recent Advances in ART (CUPART 2011). We have invited a very respectable panel of International and National faculty whose experiences will be a wealth of knowledge to us.

Under the aegis on AOGD

Organizing Chairperson–Dr Kaberi Banerjee

Day–1 Interesting Highlights

Session 1–Foundations of Infertility Management


This session will focus on the basics of infertility diagnosis without which successful treatment is not possible. This will also highlight which patients will benefit from IVF treatment sooner rather than later.

Speakers: Dr Neena Malhotra (AIIMS), Dr Sunil Jindal (Meerut), Dr Suneeta Mittal (New Delhi), Dr Anjani K Agarwal (New Delhi), Dr Bishwaranjan Dash (New Delhi)

Inauguration & Welcome Address by Chief ICMR New Delhi at 7.00pm followed by Shaan–e–Hindustan–Sufi Night with Adil Hussaini, Hyderabad & Fellowship Dinner

For Registration Contact: Address: E–23 Ayurvigyan Nagar New Delhi–110049, For details contact +91 9871250235

For comments and archives

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Liver function tests (LFTs)

  • To screen for, detect, evaluate and monitor for liver inflammation and damage.
  • Periodically to evaluate liver function whenever you are at risk for liver injury; when you have a liver disease or when you have symptoms such as jaundice.

For comments and archives

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with inflammatory bowel disease came for deworming prescription.
Dr. Bad: Take it every three months.
Dr. Good: There is no need.
Lesson: Worms in the intestines have protective action against inflammatory bowel diseases.

For comments and archives

Make Sure

Situation: A patient presents with recurrent scaling and itching of the scalp not responding to antikeratolytic agents.
Reaction: Oh my God! I forgot to prescribe antifungal agents.
Lesson: Make sure that patients with dandruff and seborrhoeic dermatitis are prescribed antifungal medications. Recent studies implicate pityrosporium yeast infection as the underlying cause.

For comments and archives

 
    Quote of the Day

(Dr GM Singh)

Champions are made from something they have deep inside them a desire, a dream, a vision.

 
    IDIOMS

Never bite the hand that feeds you: Don’t hurt anyone that helps you.

 
    Sri Chanakya Niti-Sastra: The Political Ethics of Chanakya Pandit

(Dr Anupam Sethi Malhotra)

He who gives up what is imperishable for that which is perishable, loses that which is imperishable; and doubtlessly loses that which is perishable also.

 
    Medicolegal Update

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

Plasma transfusion is beneficial in gravely injured cases

  • The plasma donations can be done much more frequently than whole blood donations even up to twice a week. This is because the red blood cells, which take so much time to replace, are separated from the plasma and injected back into the plasma donor in saline solution.
  • Whole blood refers to blood containing all its components, including red blood cells, white blood cells, platelets, and so on. "Plasma" can refer either to the yellowish fluid of blood in which the cells are suspended, or to the blood after red blood cells have been removed.
  • In the cases of mismatch between Donor and Recipient, the plasma can be given to a recipient with an incompatible group much more safely than red blood cells, since the antibodies in the plasma are quickly diluted when transfused into circulatory system
  • In case of trauma/serious injuries resulting in massive ongoing loss of blood, plasma can be transfused to restore the volume of the recipient’s blood and to stop bleeding because of its high concentration of clotting factors. Hemophiliacs, who do not clot well, are frequent recipients of plasma.
  • Whole blood is rarely used and medically required for transfusions. Rare exceptions are for sickle cell disease and heart surgery, in which the blood loss can be several units.
  • The red blood cells have blood group antigens that cause illness and even death has been known to occur on many occasions when types are mismatched. Plasma contains antibodies for the antigens proteins in red blood cells that trigger an immune response.

For comments and archives

 
    Mind Teaser

Read this…………………

How much dirt is there in a hole that measures two feet by three feet by four feet?

Yesterday’s Mind Teaser: Johnny’s mother had three children. The first child was named April. The second child was named May. What was the third child’s name?

Answer for Yesterday’s Mind Teaser: Johnny of course

Correct answers received from: Dr Rupa Rao, Gita Arora, Sulu E S, Dr Anmol, Neeraj Chaudhary,
Dr Kanu Verma, Dr Anil Kumar Jain, Priyanka Sharma, Dr Pramod M Kulkarni, Dr Rakesh Kalra, Dr HL Kapoor, Dr K Raju, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, YJ Vasavada, Dr Jainendra Upadhyay,
Dr Neelam Nath, Dr S Upadhyaya, Dr Bharat Bhushan Aggarwal, Dr S Upadhyaya, Dr Vinita Naik,
Dr BN Ganagdhar.

Answer for 30th September Mind Teaser: a. Cardiac
Correct answers received from: Dr HL Kapoor, Dr K Raju, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, YJ Vasavada, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai.

Send your answer to ijcp12@gmail.com

 
   Laugh a While

(Dr Veena Aggarwal)

Murphy’s Laws for Humour

In order to get a Loan, you first need to prove that you don’t need it.

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Who should not donate blood?

All cannot donate blood said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Here is an updated list as to who cannot donate blood

  1. People with coronary artery disease, valvular heart disease, arrhythmia, significant cerebrovascular disease, or heart failure
  2. People with any active lung disease impairing gas exchange.
  3. Persons who have undergone recent surgery in the absence of blood transfusion until healing is complete and full activity has been resumed.
  4. Ladies who are pregnant are deferred during pregnancy and for six weeks after delivery.
  5. Persons with seizure disorders are acceptable provided that they have had no seizures within the past 12 months with or without medications.
  6. The minimal age for donation is generally 16 to 18. Most blood centers do not impose an upper age limit for donor eligibility.
  7. Blood is not collected from persons who are febrile at the time of donation, who state that they do not feel well, or who are taking systemic antibiotics.
  8. A donor with a history of a solid organ tumor should be deferred and will be eligible to donate only if he/she has been symptom–free and considered to be clinically cured for a defined time period.
  9. Persons with a history of blood cancer are permanently deferred.
  10. Some drugs may pose a risk due to their demonstrated cancer producing potential at low plasma concentrations. One should not donate blood for one month after taking isotretinoin and finasteride, six months for dutasteride, three years for acitretin, and permanent for etretinate.
  11. Persons should not donate if they have taken bovine insulin (risk of variant Creutzfeldt–Jakob disease (CJD) transmission) or human growth hormone derived from pituitary glands (risk of iatrogenic CJD).
  12. Persons who have received hepatitis B immunoglobulin (HBIG) or an unlicensed vaccine are not allowed to donate for one year.
  13. Most donors are also temporarily deferred if they are taking warfarin, heparin, or another anticoagulant.
  14. Collections of platelets for pheresis should not occur from donors who ingested aspirin, aspirin–containing drugs, or feldene in the previous 48 hours or from donors who have taken clopidogrel or ticlopidine in the previous 14 days.
  15. One should not donate blood if one has HIV infection or AIDS or in case of men having sex with men, IV drug users, commercial sex exchangers, receiving clotting factor concentrates for hemophilia or other clotting disorders.
  16. One should not donate blood for one year if he/she has had sex in the past one year with a person who has HIV infection or AIDS; a prostitute; a person who currently or previously used intravenous drugs; for women: a man who has had sex with another man; a person receiving clotting factor concentrates.
  17. Persons with a history of viral hepatitis after age 10 are permanently deferred.
  18. Persons currently or previously testing positive for HBsAg are permanently deferred.
  19. Persons with a history of close contact with someone who has viral hepatitis are deferred for 12 months following their last potential exposure
  20. Persons who have received a blood transfusion are deferred for 12 months.
  21. Deferral is not required when the donor's history is based solely on a positive serologic test result (i.e, anti–HBc or anti–HBs) that indicates past exposure to HBV.
  22. Receiving a tattoo or body piercing within the last 12 months has also been included on the donor questionnaire, due to concerns about hepatitis transmission. Some blood centers will accept donors with body piercing, provided that the procedure was performed with sterile, single use equipment. Donors with tattoos or permanent makeup are deferred for 12 months after the exposure unless the application was performed in a state that has a regulatory body that licenses tattoo parlors.
  23. Donors with a history of malaria are deferred for three years after becoming asymptomatic.
  24. Travelers to a malaria endemic area are deferred for one year after their return to the United States (provided they have not had malarial symptoms).
  25. Immigrants from or residents of malarial endemic countries, defined as living in that country for more than five years, are deferred for three years after their departure from the endemic country based upon the premise that such individuals may have partial tolerance to malarial parasites, thereby resulting in the delay of malarial symptoms beyond one year.

For comments and archives

 
    Readers Responses
  1. Thnx emedinew team n particularly Dr KK and Dr Anil Jain. The story is sooooo touching that it touched the core of heart n made blood chilled. Farahim Chaudhary
 
    Forthcoming Events

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals

Dr K K Aggarwal

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    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