|Address: 39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: firstname.lastname@example.org , Website: www.ijcpgroup.com|
Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
President, Heart Care
Foundation of India
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)
FIRST NATIONAL DAILY MEDICAL NEWSPAPER OF INDIA
emedinews is now available online on www.emedinews.in and www.emedinews.org
3rd January 2010 Sunday
H1N1 not as communicative as previously thought
When the H1N1 pandemic started we were scared that the disease will spread like wild fire. My first encounter however surprised me. I saw a young 28 year old male with symptoms like swine flu. He was diagnosed positive on 10th day by the blood test. During these ten days his mother and sister were exposed to him in the the same room without any precautions. But none of theme developed the flu symptoms. I even thought that the report was wrong as we were told that every one who comes in contact with flu will develop it if precautions are not taken.
Today I get the answer as a new study has sown that people aged 19 and older show more immunity to H1N1 swine flu than was initially believed.
Researchers from the U.S. Centers for Disease Control tracked the spread of H1N1 influenza in 216 households that included a total of 816 people. In each household, one member of the family had been diagnosed with H1N1.
Only 13% of other household members, came down with the H1N1 flu. In 72% of households in which one person had the swine flu, no other family member came down with it. In 21% of households, one other person got the flu, while in 6 percent, more than one other family member got the flu.
Children and teens aged 18 and under were twice as likely as those aged 19 to 50 to contract the flu. Those who were 51 and older were less likely still than those in the middle aged group to contract the flu,
One of the reasons is that people in the middle age group have some acquired immunity because of prior exposure to another similar virus.
Other strains of H1N1 virus have been circulating for decades, including pre 1957, which explains why older people are resistant to infection.
H1N1 reappeared in the late 1970s, causing significant illness in 1978 through the mid 1980s.
Children are still being hit unusually hard by the flu. Over 1,090 U.S. children have died from H1N1, three to four times as many as during a typical flu season.
In contrast to conventional wisdom, children were no more likely to spread the flu to other family members than people in other age groups.
The average time between the first person in the household showing flu symptoms and someone else in the household having symptoms was 2.6 days in the study.
Dr KK Aggarwal
(Source: Dec. 31 issue of the New England Journal of Medicine/Medline News)
Global Summit (Session in Cardiology) emedinews reports: 2nd Jan, Hotel Maurya New Delhi, India
Chairperson ( Dr. O.P. Yadava); Co-Chairpersons (Dr. Vinod Shah, President, AAPI; Dr. Brahma Sharma from USA; Dr. Vibhuti Singh from Florida, Miami; Dr. F. Crow from Oxford and Dr. Neeeraj Bhalla from London)
The deliberations were held to look into the implementation of the recommendations of the first and the second Global Summit organized by AAPI and IMA in association with other groups. It was impressed that coronary artery disease occurs at a young age in Indians and the current guidelines of the British and American standards underestimate the disease process in India. Therefore, these guidelines need to be modified. The Indians are 2 to 2.5 times more at risk for heart disease as compared to the western counterparts, and almost 8500 crores worth of GDP money will be lost because of disability and disease for cardiac disorders between 2005 and 2-015 i.e. in 10 years. The risk factors were discussed and it was suggested that following recommendations should be followed:
1. Firmingum score should be multiplied by 2 for Indians for calculating the 10 years risk coronary artery disease.
2. There should be low threshold for intervention – 10% lower for risk factors, 20% lower for total cholesterol and 30 mg% lower for LDL and HDL cholesterol.
3. Waist circumference should be less than 80 in Indian woman and less than 90 in Indian males.
4. Body mass index should be less than 23.
5. Blood Pressure should be less than 130/85 and if a person suffering from diabetes and heart failure, it should be less than 120/80 mmHg.
6. Recommendations regarding triglyceride should be less than 150 mg%
7. Total cholesterol should be less than 160 mg, LDL should be less than 80 mg% (less than 70 for diabetic and preexisting CAD). HDL should be more than 40 in males and more than 50 in females.
8. Hemoglobin AIC should be less than 6.5 and Lp(a) less than 20 mg/dl.
9. Polypill role was also discussed. It was felt that introduction of polypills will increase the compliance of medication. Currently, 2 drugs are being taken by 61% of CAD patients and 3 drugs by only 28%. Aspirin compliance is only 4% and statin compliance only 5%. By easy availability of genetic drugs as well as by introduction of polypill these compliances are likely to increase.
10. Tobacco was also debated as a very significant risk factor in India. It is estimated that in 2010 alone, 1 million deaths will take place because of tobacco. 6to 10 years of life are lost in active smokers.
11. The importance of reducing the blood pressure was impressed as 10mmHg increase in systolic blood pressure is likely risk of cardio vascular risk by 30%.
12. Though India is a poor country, its per capita calorie intake has increased significantly from 2083 Kcal in 1979-81 to 2490 Kcal in 1999-2001. This intake of energy specially coming from carbohydrates and saturated fats needs to be curtailed and healthy living habits inculcated.
13. The role of family physicians in dismantling the information was also impressed upon.
International AIDS Society Conference on HIV Pathogenesis and Treatment (Cape Town, South Africa • July 19 22, 2009)
1. Acyclovir failed to prevent transmission of HIV among discordant couples, but it may still have a role in treatment by slowing progression to full blown AIDS. The Partners in Prevention HSV/HIV Transmission Study team found that there was no efficacy in the intention to treat analysis of all transmissions (Dr. Connie Celum, at the University of Washington in Seattle)
2. Starting anti HIV treatment earlier than current WHO guidelines would save lives and reduce opportunistic infections. Such a change in clinical practice would also be cost effective (Dr Rochelle Walensky, of the Massachusetts General Hospital in Boston Aug. 4 issue of the Annals of Internal Medicine).
3. From the female point of view, male circumcision is either no big deal or a positive improvement, Ugandan researchers said. Among women whose partners took part in the landmark circumcision trial in Rakai, Uganda, only a handful reported that the procedure reduced their sexual satisfaction (Dr Godfrey Kigozi, of the Rakai Health Sciences Program). The remaining 97% said their satisfaction was unchanged or improved,
4. Circumcision may exert a protective role among men who have sex with men. Circumcision lowers the risk of infection with HIV for men who practice insertive anal intercourse or receptive anal intercourse nearly exclusively. (Dr Tim Lane at the University of California San Francisco)
5. Patients in an experimental program suppressed HIV to undetectable levels over a full year of taking potent antiretroviral medications on a five day on, two day off (FOTO) schedule. Lead researcher Dr Cal Cohen, medical director of the Community Research Initiative of Boston, suggested that the long half life of the drugs Efavirenz, Tenofovir, and emtricitabine give patients the opportunity to take brief drug holidays without creating virologic rebound.
Letters to the editor
1. Respected Dr K.K. Aggarwal, The govt. decision to start the BRMS course will not serve the purpose rather this will reduce the quality of medical education in this country. I think govt. of India quite ignorant regarding the actual problems. hy Indian Doctors don't want to serve in rural area. If you provide better infrastructure, better salary incentive and better education for their children, everybody want to serve there. Instead of starting new course like BRMS, MCI should think about distant CME Programmes which can be organized at district and Tehsil level along with health camps. Dr Kuldeep Kumar, Assitt. Professor, Medicine, UCMS and Associated GTB Hospital
2. I support the evolving reforms of bringing a new rank of rural doctors as well as shortening of MBBS course provided the recently launched speciality of Emergency Medicine is supported on top priority basis. If our MBBS and Rural Doctors are rotated for 3-6 months giving them good training and exposure to handle clinical emergencies, trauma and disaster medicine practices in austere environments along with mandatory provider certification status for ACLS, ATLS and APLS courses, then I am 100% sure, to feel safe as a patient, in the hands of this new generation medical doctors in case of an emergency. Dr Vivek Chhabra, Sr Consultant, Emergency Medicine, Max Hospital, Saket
Signs of an Asthma Attack in a Child (Dr Prachi Garg)
1. A frightened facial expression and posture that indicates the child can't relax.
2. Restless sleep.
3. Coughing, particularly at night.
4. Sweating, pale skin, rapid breathing and flaring of the nostrils.
5. Labored breathing with the lips pursed.
6. Vomiting and fatigue.
7. Sunken areas between the ribs or in the neck.
Possible reasons for abdominal pain: (Dr. Soni Verma)
1. Inflammation of the gallbladder, pancreas or appendix.
2. Obstructed bowel.
3. Persistent constipation or too much gas.
4. Aneurysm in the abdomen.
6. GERD or heartburn.
8. Food borne illness.
11.Infection, such as mononucleosis or stomach flu.
12.Kidney stones or gallstones.
13.Inflammatory bowel disease.
MCI News: Retirement age for medical professor to become 70 Medical Council of India is envisaging increasing the retirement age of professors in medical colleges to 70 years. This will be applicable to those who will be willing to teach in BRMS medical school. Normal retirement age for MBBS College is 65 years.
Four teachers are required for 100 students and for 25 students only one teacher will be required. This way there will be no shortage of teachers in BRMS courses. Also, MCI is envisaging calling all doctors in district hospitals with 8 years experience as Associate Professors and with 14 years as full fledged Professors. (Source Dr Ketan Desai)
A Nurse Practitioner was examining his patient who happened to be hard of hearing. He put his stethoscope to her chest and said, "Big breaths."
The woman replied, Yes, they used to be bigger!
A man gave an add in Matrimonial column "PATNI CHAHIYE"
He got 1000 replies all saying:- Meri Le Ja.! Meri Le Ja.!
Dr Good Dr Bad
Situation: A patient with hypertension was found to have serum K of 5.
Dr Bad: Get K done after 2 weeks
Dr Good: I need to stop ACE inhibitors
Lesson: ACE inhibitors increases K
SODIUM META SILICATE in ALZEIMER'S Disease
Alzeimer's Disease is one of the Commonest cause of Dementia. Symptoms Include Loss of Memory, Confusion,Irritability and Aggression.The Disease is Associated with Plaques and Tangles in the Brain. In long term, Behavioural and Neuropsychiatric Changes become more Noticeable. The cause could be either Reduced Synthesis of the Neuro Transmitter Acetylcholine or Deposition of Amyloid Plaques in the Brain Tissue.
Management: There is no cure for Alzheimer's disease. However, many health supplements containing Silicic acid as a main constituent are known to help in reducing the absorption of Aluminium, a known factor in Alzeimer's disease, by reducing the uptake through digestive system and by enhancing the elimination of Aluminium through renal excretion.
Mnemonic: Multiple myeloma behaves like a CRAB: Assess the CRAB (Calcium, Renal function, Anemia, Bone disease).
emedinews: revisiting 2009
IJCP Group, Heart care Foundation of India and World Fellowships of Religions are is organizing emedinews: revisiting 2009, day long conference on the top health happenings in the year 2009 on 10th Jan 2010 at Maulana Azad Auditorium. There is no registration fee however advanced information is required. Top experts (Dr KK Aggarwal (revisiting 2009), Dr Naresh Trehan (what's new in cardiac surgery), Dr Anupam Sibal (A decade of successful liver transplants in India), Dr Ajay Kriplani (Current Trends in the Management of Morbid Obesity), Dr Praveen Chandra (The Indications of Interventional Treatment in Cardiology), Dr Kaberi Banerjee (IVF- Where We Stand Today?), Dr N K Bhatia (TTI infections), Dr V Raina ( molecular genetics), Dr Ajit Saxena (ED and male infertility), Dr S C Tewari (Nephroprotection), Dr. Ambrish Mithal (Diabetes), Dr Vanita Arora (ECG arrhythmias), Dr N Subramanium (Current concept in Male infertility ), Dr Neelam Mohan (Coeliac Disease), Dr. Sanjay Chaudhary (Eye Update), Dr Harish Parashar (aluminum toxicity), Dr Praveen Khillani (Whats new in field of critical care in past decade?), Dr Rohina Handa ( Whats new in rheumatology), Dr Ajay Kumar ( Fatty Liver), Dr P K Julka (Whats new in oncology), Mr. B.N.S Ratnakar, will deliver lectures
CME will be followed by lively cultural evening guest performances by Shabani Kashyap, Vipin Aneja and perfomances by medical professional singers Dr Praveen Khilnani, Dr Lalita and Dr N Subramanium, Dr Lata Tandon, Dr Arti Pathak, Dr Sudipto Pakrasi, Dr Harjeet Kaur, Dr Ramni Narsimhan, Dr Sanjay Chugh (on the drum), Dr Yash Gulati (Anchor) Dr Reshma Aggarwal (Anchor), doctors of the year award, dance and dinner. For registration mail email@example.com. We have crossed 1200 registrations.
1. PSB & Aviva is proud to be associated with Emedinews: Revisiting 2009. To know more about us, please visit our stall on day of the conference. http://avivaindia.com/
2. Kindly enjoy not stop tea and coffe from NESTLE ayt the conference
3. Refresh yourself with mineral water, coke and other related drinks, soda from COKE counter.
4. Silicic Acid is available as Sodium Meta Silicate in U.S.A and is being Launched in India During the IJCP Emedinews revisiting 2009 Conference at New Delhi on January 10th,2010.
Advertising in emedinews
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What's the difference between an oral thermometer and a rectal thermometer?
emedinews-revisiting 2009 Program
8.00 AM - 8.30 PM Dr KK Aggarwal Revisiting the year 2009
8.30 AM - 8.45 AM Dr Neelam Mohan, Advances in Paedatric Diseases ( Non Liver)
8.45 AM - 9.00 AM Dr S C Tewari, Nephroprotection
9.00 AM - 9.15 AM B.N.S Ratnakar (GM CBI), Presentation
9.15 AM - 9.45 AM Dr Ambrish Mithal, Newer treatments in diabetes
9.45 AM - 10.00AM Dr Harish Parashar, Aluminium Toxicity
10.00 AM - 10.30AM Dr N K Bhatia, Screening for TTI
10.30 AM - 10.40AM Anshu Gupta, Probiotics Update
10.40 AM - 11.10AM Dr Praveen Chandra, Indications of Cardiac Interventions 11.10 AM - 11.25AM Dr Sanjay Chaudhary, What's new in Lasik
11.25 AM - 11.55AM Dr Naresh Trehan, What's New in Cardiac Surgery
11.55 AM - 12.10PM PSB-AVIVA, Presentation
12.10 PM - 12.40PM Dr Anupam Sibal, A Decade of Succesful Liver Tansplant in India
12.40 PM - 1.10 PM Dr Ajay Kriplani, Current Trends in the Management of Morbid Obesity
1.10 PM - 1.40 PM DR Vanita Arora, Common Arrhythmias
1.40 PM - 2.10 PM Dr N Subramanium, Current Concept in Male Infertility
2.10 PM - 2.40 PM Dr V Raina, Molecular Genetics
2.40 PM - 3.10 PM Dr Kaberi Banerjee, IVF: Where We Stand Today?
3.10. PM - 3.25 PM Anil Chopra (Bajaj Capital), Mutual Funds
3.25 PM - 3.40 PM Dr Praveen Khilnani, Whats New in Critical Care in Past Decade?
3.40 PM - 4.10 PM Dr Ajit Saxena, Erectile Dysfunction and Male Infertility
4.10 PM - 4.20 PM Dr Ajay Kumar, Whats New in Gastroenterology
4.20 PM - 4.30 PM Dr Rohini Handa, Whats New in Rheumatology
4.30 PM - 4.40 PM Dr P K Julka, Whats New in Oncology
5.00 PM Onwards Cultural hangama and awards