emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

 
  Editorial …

3rd April 2012, Tuesday

Carotid neck ultrasound the only way to check regression of heart blockages

In people with type 2 diabetes, intensive drug therapy can significantly lower bad LDL cholesterol and reduce the thickness of the neck carotid arteries supplying oxygen to the brain.

A study published in Journal of the American College of Cardiology has shown that every effort should be made to bring down the bad LDL cholesterol to less than 80mg/dL.

The Stop Atherosclerosis in Native Diabetics Study (SANDS) trial tested the value of aggressively lowering bad LDL cholesterol to 70 mg/dL or lower and non HDL cholesterol to 100 mg/dL.

The standard treatment group had standard goals (100 mg/dL for LDL and less than 130 mg/dL for non HDL Cholesterol).

The study involved 427 type 2 diabetic Native Americans who were aged 40 or older and who had no history of heart attack or other heart–related event. There were 204 people in the standard treatment group and 223 in the aggressive treatment group. Ultrasound tests showed that neck artery thickness got worse, or progressed, in the standard treatment group and regressed in the aggressive treatment groups.

The test called intima media thickness of the carotids is the only cost–effective test to know whether or not the heart blockages are shrinking or progressing as the thickening in carotids goes hand in hand with the thickening in the heart arteries.

For Comments and archives…

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

Carotid neck ultrasound the only way to check regression of heart blockages

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Pathlab Facilities

800 laboratory test were done by Religare and other organizations and over 25,000 free hemoglobin checkups were done.

 
Dr K K Aggarwal
 
    National News

Women take the lead in India’s grey march

NEW DELHI: Now, a majority of India’s elderly are women. The Registrar General of India’s (RGI) latest data from the Sample Registration System (SRS), 2010, has confirmed feminization of India’s elderly. The data sent to the Union health ministry on Saturday shows that the percentage of women in the age group of 60 years and above is higher in 17 out of the 20 large states. It is as high as nearly 12.6% in Kerala, Maharashtra (10%), Himachal Pradesh and Tamil Nadu ((10.3%). Only three states – Assam, Bihar and Jammu & Kashmir – have more elderly men than women. Overall, nearly 7.5% of India’s population is aged 60 years and above. In rural India, 7.5% of the population is above 60, and the corresponding figure is 7% urban areas. (Source: TOI, April 2, 2012)

For comments and archives

Fertility rate in India drops by 19% in 10 yrs

NEW DELHI: India’s total fertility rate (TFR) – the average number of children expected to be born per woman during her reproductive years – has fallen by19% over the past decade. Among bigger states, the percentage decline in TFR during this period the last decade varied from as high as 28% in Punjab to 5.6%in Kerala. Maharashtra saw the second highest dip in TFR between 2000-2010 at 26.9%, followed by Haryana and Andhra Pradesh (25%), Uttar Pradesh (23%), Rajasthan (22%), Himachal Pradesh and West Bengal (21%). The latest Sample Registration System 2010data finalized by the Registrar General of India and sent to the Union health ministry on Saturday says India’s TFR, which had remained stagnant in 2008 and 2009 at 2.6, finally has dropped by 0.1 points in 2010. India’s TFR now stands at 2.5 as against a TFR of 3.2 in 2000. Education has been found to play a major role in determining TFR. (Source: TOI, April 1, 2012)

For comments and archives

eMedinewS extends its best wishes to Dr Veena Aggarwal, Joint MD and Group Executive Editor, IJCP Group on her birthday. Celebrate and enjoy another year of your life.

May all your birthday dreams and wishes come true.

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

Overt hematuria always requires workup

The cause of visible hematuria can be determined in almost half of cases, according to a report from Aberdeen Royal Infirmary in Scotland. "Therefore, all cases of visible hematuria require full standard investigations," the authors advise in the Journal of Urology, in a report online. (Source: Medscape)

For Comments and archives…

FDA OKs anemia drug for kidney disease

The FDA has approved peginesatide (Omontys), a synthetic erythropoiesis–stimulating agent, for treatment of anemia in adult dialysis patients with chronic kidney disease (CKD). The drug is injected once monthly and stimulates bone marrow to produce more red blood cells in patients with CKD, which reduces the need for blood transfusions, the agency said in a statement. Other erythropoiesis–stimulating agents (ESA) require as many as 13 injections each month. (Source: Medpage Today)

For Comments and archives…

Extreme obesity adds more risk in hysterectomy

Increasingly severe obesity drives up complication rates after hysterectomy, and outcomes continually worsen with rising body mass index, according to results from a study reported at the Society of Gynecologic Oncology meeting. (Source: Medpage Today)

For Comments and archives…

Study shows better fit for digital zirconia crowns

Zirconia crowns with veneers made with digital impressions fit better than those made with conventional impressions, researchers reported here at the American Association for Dental Research 2012 Annual Meeting. (Source: Medscape)

For Comments and archives…

 
    Twitter of the Day

@DrKKAggarwal: If needed the doctor must perform CPR even in patients with injury chest When a person is in need of… http://fb.me/1EMB1Kds6

@DeepakChopra: Karma simply means we have to live with the consequences of our actions.

 
    Spiritual Update

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

Say no to temples in residential areas

Most temples have Gods represented in deity located in the temple or mandir situated at the outskirts of the city. The temple spiritual atmosphere is devoid of pollution and any such thing, which promotes Rajasik or Tamsik behavior.

The silence of the spiritual atmosphere reduces the internal noise and helps one move in an inner journey. The inner journey of being in touch with one’s consciousness requires detachment from the worldly pleasures and withdrawal of all the five senses of the body.

For Comments and archives…

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

Are there options for preserving fertility in women who have been newly diagnosed with cancer?

Yes. New technology lets your doctor remove and freeze some cells, tissues, or fertilized eggs (embryos) before treating your cancer. This way you may be able to have children after your treatment. This process is called cryopreservation or freezing. The most common cancers in girls and young women are leukemia, thyroid cancer, breast cancer, melanoma, or gynecologic cancers (cervix, uterus, or ovary). Most of these cancers can be successfully treated with chemotherapy, radiation, or a combination of both. Chemotherapy is effective at treating many cancers, but these drugs are likely to cause infertility. Infertility from using these chemotherapy drugs usually happens because a woman produces fewer or no eggs.

For Comments and archives…

 
    Tat Tvam Asi………and the Life Continues……

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

What is cadaveric and living liver transplantation?

  • Cadaveric liver transplantation: In this, the liver of a brain–dead person, whose family volunteers to donate, is used.
  • Living related liver transplantation: This has been a further step to answer the shortage of organs for children. In living related liver transplantation, a part of the liver from a living related donor is used in the child. In India, the Human Organ Donation Act was passed in 1984. The donor has to be a spouse or first–degree relative or emotionally related to the patient.

In India, presently cadaveric donation has not gained momentum and majority of transplants, whether renal or liver are living related.

For Comments and archives…

 
  Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Withholding tax (TDS)

  • TDS on transfer of certain immovable properties (other than agricultural land)
    TDS @ 1% (Effective from 01. 10. 2012)
    if the consideration on transfer exceeds–
    • Rs.50 lakhs in case such property situated in specified urban agglomeration; or
    • Rs. 20 lakhs in case such property is situated in any other area.
      If consideration is less than value adopted or assessed by stamp duty authorities, such value be deemed as consideration for transfer of such immovable property.
  • TDS on remuneration (other than salary) to a director @ 10%. (Effective from 01.07.2012)
  • For non–deduction of TDS, Payer not to be considered as ‘assessee in default’ where the resident payee discharges the tax liability on such income, files the tax return and furnishes Certificate from accountant in prescribed form. (Effective from 01.07.2012)
  • No disallowance on failure to withhold tax on payments made to resident payee where payer is not considered as an ‘assessee in default’ as discussed above. (Effective from 01.07.2012)

For comments and archives

 
    An Inspirational Story

(Dr. (Prof.) Sandeep Guleria)

Why Doctors Die Differently

By KEN MURRAY

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient’s five–year–survival odds—from 5% to 15%—albeit with a poor quality of life.

Charlie, 68 years old, was uninterested. He went home the next day, closed his practice and never set foot in a hospital again. He focused on spending time with his family. Several months later, he died at home. He got no chemotherapy, radiation or surgical treatment. Medicare didn’t spend much on him.

It's not something that we like to talk about, but doctors die, too. What’s unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently.

Doctors don't want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken. During their last moments, they know, for instance, that they don’t want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).

In a 2003 article, Joseph J. Gallo and others looked at what physicians want when it comes to end–of–life decisions. In a survey of 765 doctors, they found that 64% had created an advanced directive—specifying what steps should and should not be taken to save their lives should they become incapacitated. That compares to only about 20% for the general public. (As one might expect, older doctors are more likely than younger doctors to have made "arrangements," as shown in a study by Paula Lester and others.)

Why such a large gap between the decisions of doctors and patients? The case of CPR is instructive. A study by Susan Diem and others of how CPR is portrayed on TV found that it was successful in 75% of the cases and that 67% of the TV patients went home. In reality, a 2010 study of more than 95,000 cases of CPR found that only 8% of patients survived for more than one month. Of these, only about 3% could lead a mostly normal life.

Unlike previous eras, when doctors simply did what they thought was best, our system is now based on what patients choose. Physicians really try to honor their patients’ wishes, but when patients ask "What would you do?" we often avoid answering. We don’t want to impose our views on the vulnerable.

The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago. Nursing professor Karen Kehl, in an article called "Moving Toward Peace: An Analysis of the Concept of a Good Death," ranked the attributes of a graceful death, among them: being comfortable and in control, having a sense of closure, making the most of relationships and having family involved in care. Hospitals today provide few of these qualities.

Written directives can give patients far more control over how their lives end. But while most of us accept that taxes are inescapable, death is a much harder pill to swallow, which keeps the vast majority of Americans from making proper arrangements.

It doesn’t have to be that way. Several years ago, at age 60, my older cousin Torch (born at home by the light of a flashlight, or torch) had a seizure. It turned out to be the result of lung cancer that had gone to his brain. We learned that with aggressive treatment, including three to five hospital visits a week for chemotherapy, he would live perhaps four months.

Torch was no doctor, but he knew that he wanted a life of quality, not just quantity. Ultimately, he decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months having fun together like we hadn’t had in decades. We went to Disneyland, his first time, and we hung out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He had no serious pain, and he remained high–spirited.

One day, he didn’t wake up. He spent the next three days in a coma–like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

As for me, my doctor has my choices on record. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like so many of my fellow doctors.

—Dr. Murray is retired clinical assistant professor of family medicine at the University of Southern California. Adapted from an article originally published on Zocalo Public Square.

For Comments and archives…

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  Fitness Update

(Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, www.mymonavie.com/sonraj)

Exercise reduces depressive symptoms among cancer survivors

There are over 12 million cancer survivors in the United States, and nearly all of them experience psychological side effects as a result of their cancer diagnosis. In addition, 60% of cancer survivors experience depressive symptoms, which are associated with reduced survival rates.

A recent article reviewed 40 exercise interventions involving 2,929 cancer survivors. Results showed that participants who exercised had reduced depressive symptoms compared to those who did not. A "dose–response" relationship was also found, meaning that as the amount of aerobic exercise performed per week increase, depression symptoms decreased. The greatest decreases in depressive symptoms were seen in people aged 47–62 and participants who exercised with supervision. Cancer survivors could benefit from regular aerobic exercise, and may see further benefits by adding personal training or group classes to their schedule.

For comments and archives

 
  Microbial World: The Good and the Bad they do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity)

Normal flora of genitourinary tract

The microbes which colonize the genitourinary tract constitute the normal flora of this system. Normally the genitourinary tract should not be colonized as any bacteria ascending from perinea are constantly being flushed by urine. Normally urine is sterile. So, even if the microbes reach the urinary system they are not able to establish and colonize. However, the anterior part of urethra is mostly colonized with small numbers of alpha hemolytic streptococci and Staph epidermidis, usually an extension of surrounding normal skin flora. Sometimes enteric bacteria may also be found in anterior part of urethra, these are usually contaminants from skin, vulva and rectum.

An excellent example of how normal bacterial flora benefits us is the "Doderlein’s bacillus" or Lactobacillus acidophilus, colonizing the vagina. The vaginal epithelium is rich in glycogen, which is due to the effect of circulating estrogens. These lactobacilli breakdown glycogen and produce lactic acid and other products resulting in acidic pH in vagina. The acidic pH prevents the growth of other microbes like potentially pathogenic Candida albicans. The other microbes which colonize vagina right after birth include corynebacteria, staphylococci, streptococci, E coli and lactic acid bacilli (Doderlein’s bacillus).

For comments and archives

 
   Cardiology eMedinewS

FDA panel wants cardio studies for weight–loss drugs Read More

Girls with a higher birth weight are at an increased cardiometabolic risk Read More

Post stroke depression not treated Read More

 
   Pediatric eMedinewS

Hepatitis E Infected More Than 20 Million Worldwide Annually Read More

Tenofovir In Pregnancy Has Little Effect On Growth Of Infants Of Hiv–Infected Mothers Read More

Autism Rate Climbs Again Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient had an episode of TIA.
Dr Bad: Start aspirin 150 mg per day.
Dr Good: Start aspirin 300 mg per day.
Lesson: The recommended dose of aspirin for stroke prevention is 300 mg/day as against coronary artery disease prevention where the dose is 150 mg/day.

For comments and archives

Make Sure

Situation: A patient came to ICU with acute GI bleeding.
Reaction: Oh my God! He had also received a painkiller from his dentist.
Lesson: Make sure before prescribing NSAIDs that the patient is not taking any other NSAID for some other illness.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

A loving relationship is one in which the loved one is free to be himself to laugh with me, but never at me; to cry with me, but never because of me; to love life, to love himself, to love being loved. Such a relationship is based upon freedom and can never grow in a jealous heart. Leo Buscaglia

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Osmolality

  • To help evaluate the body’s water and electrolyte balance
  • To investigate hyponatremia and increased or decreased urine production
  • To detect the ingestion of toxins such as methanol
  • To monitor the effectiveness of treatment for conditions affecting osmolality
  • To help determine the cause of chronic diarrhea
 
    Mind Teaser

Read this…………………

Which of the following is not true for malignancy of familial adenomatous polyposis?

a) Adrenals
b) Thyroid
c) Astrocytomas
d) Hepatoblastomas

Yesterday’s Mind Teaser: How can you use the letters in NEW DOOR to make one word?

Answer for Yesterday’s Mind Teaser: ONE WORD

Correct answers received from: Satyanarayana Akupatni, Dr Deepali Chatterjee, Dr Sumit Mehndiratta, Dr PC Das, Raju Kuppusamy, Sudipto Samaddar, Dr Chandresh Jardosh, Anil Bairaria,
Dr krishan lal Jindal, Dr PC Das.

Answer for 1st April Mind Teaser: 12 people

Correct answers received from: Dr Avtar Krishan, Dr Suman Kumar Sinha.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Charles Dickens had a cold and thus described it in a letter to a friend: "I am at this moment deaf in the ears, hoarse in the throat, red in the nose, green in the gills, damp in the eyes, twitchy in the joints and fractious in the temper."

 
  Medicolegal Update

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

The Bird road rapes remain unsolved today

  • During 1977–79, a serial rapist kidnapped and sexually assaulted at least 25 women in the vicinity of Bird Road, outside Coral Gables, Florida. In 1979, police arrested 41–year–old Luis Diaz, charging him with eight of those cases.
  • At the trial in 1980, the eight victims identified Diaz as their attacker, prompting jurors to convict him on four counts of attempted rape, five kidnapping charges, plus various firearms and robbery counts.
  • Diaz received 13 life terms + 55years; virtually ensuring that he would die in prison. Two of the victim witnesses recanted their identifications of Diaz in 2002, under questioning by private investigator Virginia and Florida authorities agreed to void the sentences in those two cases if Diaz would drop his remaining appeals. The bargain’s net result was one life prison term.
  • Despite the agreement, members of the CARDOZO INNOCENCE PROJECT obtained permission for DNA testing on semen recovered from one Bird Road victim – the only biological evidence presented against Diaz’s alleged victims at trail when he was suspected of attacking.
  • Testing of all three samples exonerated Diaz as a suspect, and he was suspected of attacking.
  • Testing of all three samples exonerated Diaz as a suspect, and he was released from prison on August 4, 2005, after serving 26 years for crimes he did not commit.
  • The Bird road rapes remain unsolved today.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Every arthritis is not same

Every arthritis is not the same. While osteoarthritis also called as green arthritis may require only painkillers and rehabilitation exercises, the red inflammation arthritis called rheumatoid arthritis if not treated aggressively and early can end up with serious deforming complications, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Any arthritis in young women of child–bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1–2% of population may have this type of disease.

Osteoarthritis, on the other hand, is a disease of age 50+ and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis. The experts said that another form of joint disorder is due to gout which is never seen in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease and never seen in children.

The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease.

Typical wear and tear of osteoarthritis is caused by sitting cross legged, doing padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc.

Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise.

Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks

 
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  1. Dear Sir, Enjoing reading emedinews. Regards: Dr Prakash
 
    Forthcoming Events
Dr K K Aggarwal


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BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
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