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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

  Editorial ...

3rd December, 2010, Friday

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

Diet and aging: Gaining a nutritional edge

Choose fruits and vegetables wisely

  • Get at least five servings of fruits and vegetables a day.
  • When filling your plate with fruits and vegetables, choose from a full color palette.
  • For even more health benefits, aim for nine servings a day. To get there, choose vegetable soups and vegetable or fruit salads. Sprinkle fruit on breakfast cereal, and select it for snacks or as a sweet end note after meals.

Choose fats wisely

  • Whenever possible, use monounsaturated and polyunsaturated oils. Avoid trans fats entirely. Limit saturated fats to less than 7% of daily calories and total fat to 20% to 30% of daily calories.
  • If you don’t have coronary artery disease, the American Heart Association recommends eating foods rich in omega–3 fatty acids, such as salmon, trout, or mackerel, twice weekly. If you have documented coronary artery disease, consume roughly 1 gram a day of EPA or DHA from oily fish and supplements if your doctor advises this.

Choose carbohydrates wisely

  • Choose whole–grain foods over those made with refined grains, such as white bread. Look beyond popular choices like whole oats and brown rice to lesser–known whole grains like barley, bulgur, kasha, and quinoa. Limit your intake of white potatoes.

Choosing protein wisely

  • Emphasize plant sources of protein, such as beans, nuts, and grains, to help you bypass unhealthy fats predominant in animal sources. Enjoying a wide variety of vegetables and eating beans and grains helps you get a full complement of amino acids over the course of a week. Shy away from protein sources high in saturated fat. Favor fish and well–trimmed poultry. If you do eat beef, pick lean cuts.
  • Don’t char or overcook meat, poultry, or fish — it causes a buildup of carcinogens. Cutting off fat, which causes flames to flare on the grill, can help avoid charring; try gently sautéing, steaming, or braising these foods in liquid instead. Grilling vegetables is safe, however.
Dr KK Aggarwal
Editor in Chief
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  HIV/AIDS Update


1. If a person is diagnosed to have HIV and an opportunistic infection, can the two infections be treated simultaneously?
Ans. Treat opportunistic infection first. For example, if the patient has TB, give ATT for 2 weeks and then start ART.

2. What are the drugs of choice for opportunistic infections?
• Diarrhea: Sulphamethoxazole/Trimethoprim (Septran DS) 1 b.i.d. or Ciprofloxacin 500 mg 1 b.i.d.
• Toxoplasma: Sulfa group of drugs
• PCP pneumonia: Very high dose of Sulphamethoxazole/Trimethoprim (Septran DS) – 6 tablets a day
• Herpes zoster or simplex: No difference in the treatment whether HIV–positive or negative.

3. Is there a role of prophylaxis?

• If the CD4 count is < 200, patients should be put on Sulphamethoxazole/Trimethoprim (Septran DS) one daily till CD4 count is > 200.
• If the CD4 count is < 50, patients should be given MAC prophylaxis with Clarithromycin 500 mg daily or Azithromycin 1250 mg per week. This prophylaxis should continue for minimum three months after CD4 count reaches > 200. If the patient in the past has suffered from Cryptococcus infection, he should be given fluconazole 200 mg daily till CD4 count is > 200.

4. What is the standard drug to be started in a patient who cannot afford much?
Ans: Such a patient should be started on Duovir N or Virocom N (combination of lamivudine, Ziduvidine and Nevirapine). The protocol is
• To start Duovir N one daily in the morning and Duovir one daily in the evening for 14 days and after that Duovir N 1BD to continue.
• The next alternative is to give Duovir E or Virocom E. It is available as a kit and contains lamivudine, Ziduvidine and Efavirenz.
• Efavirenz is not given in pregnancy.
• Nevirapine is not given if a patient has Hepatitis.
• If CD4 count is > 250 in females and > 400 in males, Nevirapine is not given.
• The goals of ART include viral suppression to a viral load <50 copies/mL.

5. What is the role of Stavudine?
Ans. In private sector, this drug is practically not used. Available in 30 mg strength, it has potential side effects. Cachexia may develop after two years of use. The three drug combination is available in the name of Trimune 30 (lamivudine, Stavudine and Nevirapine)

— — — — — — — — — —

HIV–The Rule of 3

Change in CD count
Any change of more than 3 (× 10, 30%), in CD count from baseline is significant.

3 types of AIDS syndrome
WHO classifies AIDS into four groups out of which type 3 is the most important. It is the most commonly encountered situation in criminal practice.

3 Routes of transmission
1. Heterosexual or homosexual sex
2. Mixing of infected blood or blood products with the uninfected blood, blood products or other internal secretions of an uninfected person
3. Transmission of HIV from infected mother to the unborn child.

3 susceptible societies
HIV can spread in all 3 groups of people: Males Females and in the third gender.

3 steps of prevention
1. Adapting to universal precautions by healthcare professionals
2. To evolve a practice involving high index of suspicion
3. To get HIV test done whenever such suspicion arises.

3 principles of counseling
1. To reduce confusion
2. To give SOS support
3. To give continuous guidance.

3 steps of counseling
1. That the disease is not curative and only prolongs life and, therefore, the treatment is life long
2. Drugs are extensive, has side effects, interacts with other drugs
3. Patients still have to continue safe sex.

When counseling a patient, always asks 3 histories
1. Personal history (habits)
2. Present history
3. Past history

3 components of counseling (personal history)
1. Habits
2. Sex behavior including marital status
3. Substance abuse.

3 rules of prevention (ABC)
1. Abstinence
2. Be faithful to your partner
3. Consistent and continuous use of Condom. Out of which it is the third ‘C’, which is most important.

3 S of prevention
1. Safe sex
2. Safe syringe
3. Safe blood

  Quote of the Day

(By Dr GM Singh)

"Friends are kisses blown to us by angels."

    Photo Feature (from the HCFI Photo Gallery)

 Pyramid Meditation Centre Opened

Inaugural function of the Acharya Sadhna Pyramid Meditation Centre was held on 2nd December, 2010 at Acharya Sushil Muni Ashram, C-599, Defence Colony.

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Apollo Hospitals gets 3D Electroanatomical mapping system

Apollo Hospitals on Monday unveiled the latest in the field of electrophysiology mapping, bringing to Chennai the next generation 3D Electroanatomical mapping system. The device would enable accurate localisation and treatment of the electrophysiological disorders of the heart, including complex arrhythmias, atrial fibrillation and ventricular tachycardia (rapid/irregular rhythms in the upper and lower chambers of the heart). (Source: The Hindu, Dec 01, 2010)

Awaaz do!

8 million children in our country are denied their basic right to education. With the Right to Education Act making education free and compulsory, we must now join hands to help these children exercise this right. UNICEF has started a movement Awaaz Do that provides us a platform to ensure that no child in this country is denied his/her basic right to education. I have joined this movement and I urge you to pledge your support to the cause.

To join the cause, SMS AWAAZDO to 53030 or log on to www.AwaazDo.in Together we can make a difference. So let’s get started.

(Contributed by Dr. Surender N. Gupta)

    International News

(Dr Monica and Brahm Vasudev)

Second–hand smoke kills 600,000 a year

One in a hundred deaths worldwide is due to passive smoking, which kills an estimated 600,000 people a year, as per WHO. Children are more heavily exposed to second–hand smoke and around 165,000 of them die each year because of it. Two–thirds of these deaths occur in Africa and south Asia. Children’s exposure to second–hand smoke is most likely to happen at home, and the double blow of infectious diseases and tobacco is a deadly combination. WHO researchers examined data from 192 countries for their study. To get comprehensive data from all 192, they had to go back to 2004. Worldwide, 40% of children, 33% of non–smoking men and 35% non–smoking women were exposed to second–hand smoke in 2004. This exposure was estimated to have caused 379,000 deaths from heart disease, 165,000 from lower respiratory infections, 36,900 from asthma and 21,400 from lung cancer. While deaths due to passive smoking in children were skewed toward poor and middle–income countries, deaths in adults were spread across countries at all income levels.

Way to partially reverse aging in mice

U.S. scientists have partially reversed age–related degeneration in mice, leading to new brain and testes growth, improved fertility and the return of lost cognitive function, or thinking skills. The advance in aging science was achieved by working with telomerase genes in the mice, said the team at the Dana–Farber Cancer Institute in Boston. Telomerase is an enzyme that helps maintain telomeres, the protective caps on the ends of chromosomes. As people age, low telomerase levels lead to progressive erosion and shortening of the telomeres, resulting in physical and mental decline. (Dana–Farber Cancer Institute, news release, Nov. 28, 2010)

Heavy kids become teens with heart risks

Preteens with a high body mass index (BMI) have increased risk factors for coronary artery disease in adolescence. Those with a greater BMI between ages 9 and 12 were more likely to have high blood pressure, high LDL cholesterol and triglycerides, and insulin resistance at ages 15 or 16. (Dr. Debbie Lawlor of the University of Bristol in England in BMJ).

Long–time statin users have lower gallstone risk

People who take statins for at least one to two years appear to be less likely to develop gallstones, a study of nearly two million Danish residents shows. The risk of developing gallstones fell by 11–24%. Study author Dr. Rune Erichsen of Aarhus University Hospital in Denmark said that people are prescribed statins to lower their cholesterol, which is one of the ingredients in gallstones.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

1. What are assisted reproductive techniques?

Assisted reproductive techniques are commonly used for the treatment of the female partner of men with moderate or severe oligospermia and azoospermia.

2. What is intrauterine insemination (IUI)?

The IUI procedure consists of washing an ejaculated semen specimen to remove prostaglandins, concentrating the sperm in a small volume of culture media, and injecting the sperm suspension directly into the upper uterine cavity using a small catheter threaded through the cervix. The insemination is timed to take place just prior to ovulation, typically using home urine luteinizing hormone (LH) measurement. In couples with mild male infertility, IUI does improve pregnancy rates in couples when compared to intracervical insemination or timed natural cycles.

For queries contact: banerjee.kaberi@gmail.com

    Medicine Update

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

Prevention of Pediatric Overweight and Obesity

Prevalence of overweight and its significant commodities in pediatric populations has rapidly increased and reached epidemic proportions.Prevention of overweight is critical, because long-term outcome data for successful treatment approaches are limited.

Genetic, environmental, or combination of risk factors predisposing children to obesity can and should be identified.

Early recognition of excessive weight gain relative to linear growth should become routine in pediatric ambulatory care settings. BMI (kg/m2) should be calculated and plotted periodically.

Families should be educated and empowered through anticipatory guidance to recognize the impact they have on their children’s development of lifelong habits of physical activity and nutritious eating.Dietary practices should be fostered that encourage moderation rather than overconsumption, emphasizing healthful choices rather than restrictive eating patterns.

Regular physical activity should be consciously promoted, prioritized, and protected within families, schools, and communities.

Optimal approaches to prevention need to combine dietary and physical activity interventions.Advocacy is needed in the areas of physical activity and food policy for children; research into pathophysiology, risk factors, and early recognition and management of overweight and obesity; and improved insurance coverage and third-party reimbursement for obesity care.

    Medicolegal Update

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

How should biological samples and medical evidences be collected in a medicolegal case?

The analyst/doctor has a legal responsibility to retain untested biological specimen in legal cases so that another person can test it and come to an independent conclusion as to its origin.

The observation of scenes of crime, collection of human body fluids, weapons of the offence and medical examination of victim, accused, or both is required in any investigation of crime against human body such as injury, rape, murder.

The medical examination is carried out in emergency ward of hospitals and treatment of injured and dying patient remains the major focus of the treating doctor. But, in cases of crime against the human body, the medical examination and collection of biological sample/s, its documentation, packaging, and analysis have an important role and should be done by the doctor very meticulously with the high standards of science and the law in mind. These biological materials include: Blood, seminal stains, vaginal smears/slides gastric lavage, chemical substances, poison, hair, fiber, broken glasses, knives, blunt instruments/objects, fire arms, bullet, live and empty cartridge cases, wads, clothing etc. This scientific biological evidence becomes legal evidence in prosecution/acquittal of case if collected correctly.

    Rabies Update

Dr. AK Gupta, APCRI, Author of "RABIES – the worst death"

Are there any survivors of human rabies?

Rabies is practically 100% fatal even today but easily preventable. Till date only seven survivors have been recorded. These patients survived not due to any specific anti–rabies therapy but following intensive life support and excellent nursing care. These patients survived for variable periods with residual neurological deficits.

    Legal Question of the Day

(Contributed by Dr M C Gupta, Advocate)

Can a doctor appear on behalf of a complainant in an inquiry held by a medical council to look into the complaint against a doctor?

  1. As a basic legal principle, the onus to prove negligence lies on the complainant. It is obvious that a patient/layman cannot present evidence of medical negligence. An expert opinion is often necessary. The medical expert can give such opinion in writing or in person.
  2. The medical council inquiry committee/ethics committee includes 5–6 doctors. If those doctors as well as the complainant can question the defendant doctor about negligence, there is no reason why a doctor cannot do so on behalf of the complainant.
  3. A doctor can appear on behalf of a complainant/patient in two situations:
    • When the doctor is not an advocate: I once went on behalf of a patient to appear in an inquiry. The MCI ethics committee told me I could have been allowed if I were a doctor but not an advocate.
    • When the doctor is an advocate (like me): This is covered by Regulation 8.2 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, the relevant portion of which reads as follows:

      "8.2 It is made clear that any complaint with regard to professional misconduct can be brought before the appropriate Medical Council for Disciplinary action. Upon receipt of any complaint of professional misconduct, the appropriate Medical Council would hold an enquiry and give opportunity to the registered medical practitioner to be heard in person or by pleader…………".
      As a matter of fact, when, in the same case as mentioned above, I quoted the above regulation, they allowed me to argue for my client.
  4. It is clear from section 21(7) (b) of the Delhi Medical Council Act, 1997, reproduced below, that even a non–pleader can appear for a party:
    • "Where an assessor advises the Council, or the Executive Committee, as the case may be, on any question of law as to evidence, procedure or any other matter, he shall do so in the presence of every party or person representing a party to the inquiry who appears thereat or if the advice is tendered after the Council or the Executive Committee has begun to deliberate as to its findings, every such party or person shall also be informed if, in any case, the Council or the Executive Committee does not accept the advice of the assessor on any such question as aforesaid".
  5. Delhi Medical Council allows doctors to appear in the inquiry but does not allow advocates. This is what they told me when I went to appear for my clients. I told my clients about the Regulation 8.2 quoted above and told them that the stand of the medical council is illegal and should be challenged in the High Court.
  6. Refusal to allow a doctor to appear on behalf of a complainant amounts to denial of hearing to the complainant and thereby vitiates the inquiry and renders it null and void. In case of refusal, a writ petition should be filed in the High Court against the medical council.
  7. A very peculiar situation arose in respect of the Karnataka Medical Council recently. A complainant filed a complaint with the Karnataka Medical Council against a hospital for negligence resulting in the death of his wife aged about 26 years. The wife was taken to the OT for Caesarian section but after 2–3 hours, the relatives were told she could not be operated upon and succumbed to drug allergy even before surgery could commence. On autopsy, the sacro–iliac joint and several ribs on the left side were found fractured along with large superficial contusions on the left side. It was apparent that the injuries occurred as a result of a fall while she was being taken to the OT on a trolley by the hospital staff. The complainant wanted a professor of forensic medicine to appear on his behalf for the purpose of proving negligence. The Council sent back the Professor unceremoniously, telling him that they would have heard him if he were a counsel/lawyer but would not hear him because he was appearing as a doctor. This shows clear high–handedness on the part of the Council. I have advised the complainant to challenge the Council in the High Court.

The above instances concerning the MCI and two state councils show clearly the ignorance, arrogance and injustice perpetrated by the councils. It is a pity that the doctors are in unnecessary awe and fear of the medical council and do not challenge them legally. The whole purpose of my Q–A series by e mail is to make the doctors aware about their rights and to embolden them.


"e–patient" … The Impatient Patient

Dr. Parveen Bhatia, MS, FRCS (Eng.), FICS, FIAGES (Hon.), FMAS, FIMSA Chairman, Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, Consultant Laparoscopic & Bariatric Surgeon & Medical Director, Global Hospital & Endosurgery Institute, New Delhi

Dr. Pulkit Nandwani, MD, DMAS (WALS), DMAS (CICE, France)
Associate Consultant Gynaecologist and Laparoscopic surgeon, Bhatia Global Hospital & Endosurgery Institute, New Delhi

Changing Doctor Patient relationship

Traditionally, the doctor–patient was asymmetrical i.e. doctors had significantly more information about medical conditions than their patients. But, this imbalance is increasingly being bypassed by the patients who now have access to both external means of procuring health information as also to their health records.

The information age revolution

Before the information era, knowledge of medicine belonged only to the physician. The patient’s role in his or her physician’s office was simply to listen and comply. The Internet has opened up the doors of information like never before. There are innumerable sites ready to dish out detailed information about the patient’s condition. Not just basic information, the e–patient also has easy access to latest developments, various different treatment modalities available for the condition and can then make an intelligent choice. He approaches the physician with preconceived notions based on the Internet information.

    DMC order

In the order DMC/DC/F.14/Comp.647/2010/ 21st July, 2010

"The medical certificate issued is not in conformity with Regulation 1.3.3 of Indian Medical Council (Professional Conduct, Etiquette and Ethics), Regulations, 2002 which mandates that" A Registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued. When issuing a medical certificate he/she shall always enter the identification marks of the patient and keep a copy of the certificate. He/She shall not omit to record the signature and/or thumb mark, address and at least one identification mark of the patient on the medical certificates or report. The medical certificate shall be prepared in the format prescribed under the aforesaid regulation." The medical certificate in question is retrospective in nature, whereas a medical certificate should generally certify a period of absence from duty prospectively, from the date on which the patient is examined by the doctor i.e. it may state the anticipated period of absence from duty necessitated because of the ailment of the patient. Dr. BSS also erred in issuing a medical certificate for an unreasonably long duration of 52days for an ailment of Enteric fever with peripheral neuritis with injury (Lt) big toe that too without proper investigations.

    Lab Update

(Dr. Naveen Dang and Dr Arpan Gandhi)

Serum chloride

  • Increase in serum chloride is seen in dehydration, renal tubular acidosis, acute renal failure, diabetes insipidus, prolonged diarrhea, salicylate toxicity, respiratory alkalosis, hypothalamic lesions, and adrenocortical hyperfunction.
  • Drugs causing increased chloride: Acetazolamide, androgens, corticosteroids, cholestyramine, diazoxide, estrogens, guanethidine, methyldopa, oxyphenbutazone, phenylbutazone, thiazides, and triamterene.
  • Bromides in serum will not be distinguished from chloride in routine testing, so intoxication may show spuriously increased chloride
    Medi Finance Update

Understanding Mutual Funds

To get started, you need to understand the various types of funds available. The first fund classification is based on asset class. There are six types:

  • Money market funds
  • Bond funds (also known as Fixed income funds)
  • Balanced funds (also known as Diversified funds)
  • Asset allocation funds
  • Index funds
  • Equity funds
    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

List of drugs prohibited for import


    IMSA Update

International Medical Science Academy (IMSA) Update

Immunization pain

A meta–analysis of trials that studied the use of sucrose or glucose for control of pain before immunization in infants found significant reductions in the incidence of crying when compared with water or no treatment.

(Ref: Harrison D, et al. Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review. Arch Dis Child 2010;95:406).

    IJCP Special

Dr Good Dr Bad

Situation: A patient wanted to know if he could buy Vigor-25 from the net.
Dr Bad: Go ahead.
Dr Good: It can be harmful.
Lesson: The US FDA has warned that Vigor–25, a product marketed as a natural dietary supplement to enhance male sexual performance, should not be purchased or used because it contains sildenafil which may interact with nitrates and can dangerously lower blood pressure. Vigor–25, distributed by Piston Corp., is sold on Internet sites.

Make Sure

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1c is very high?
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

    Lighter Side of Reading

An Inspirational Story

The Honesty Diploma

There was a very rich village zamindar who was also a great philanthropist. Everyone liked him. Once he decided that for three days he would give rice, vegetables and money to the poor and only to the poor.

One poor man received a very heavy sack of rice. Because he was such a poor man this made him very happy. When he came home and emptied the sack into storage bins, he found 20 gold coins mixed in with the rice. His wife was delighted. But the husband said, "The zamindar didn’t intend to give me gold. He gave me rice. This is a mistake. I should return the coins." The wife said, "Don’t be a fool! We’re poor. Take the gold to the market and exchange it for money." The husband said, "No, I can’t." And so they fought until the husband reminded his greedy wife that it was he who had brought the rice and gold home in the first place.

The following day he went back to the rich man. "You were so kind to give us things we needed. I found these 20 gold coins in the rice sack. I’ve come to return them. Although I am a beggar, I know this was a mistake and I am an honest man." The rich man was moved by the poor man’s sincerity, He said, "No, keep them. And because of your sincerity, I’ll give you double the amount. You brought me 20 gold coins; you'll leave with 40. 1 give these to you personally so you know there's no mistake."

A greedy businessman happened to overhear the story and he came up with a brilliant idea. He went to the poor man and said, "I heard that you have some gold coins. Do you want to sell a few to me?" The poor man said, "Certainly. How many would you like to buy?" The businessman bought six coins from the poor man. Then he put on beggar’s clothes and went to the rich man’s house. "I will do the same thing the beggar did and I will double my wealth," he thought. "Since over the past three days hundreds and hundreds of beggars have received bags of food from the zamindar, I am sure that he will not remember that I was not one of them."

So the businessman went to the zamindar and said, "Yesterday you gave me three gold coins but magically they have become six gold coins today. I have come to give back the original ones, while I am keeping the other three." The zamindar said, "You are the only person to whom I gave coins whose wealth has increased. One man brought back the same amount I gave him. But in your case the amount increased. I am happy for you. Now, what can I do for you?"

The businessman–beggar said, "If you are impressed with my honesty because I'm returning these three coins, you can give me more. Had I not returned these coins, you would not have known the original three produced three more. If you value honesty, then give me a few more coins." The rich man said, "You really deserve much more. Since from three coins you have got six, let me do one thing. I will give you something much more important that a few more gold coins." The businessman was excited and curious. He said, "Please tell me what it is."

The zamindar asked his servant to write out an "honesty diploma." The servant wrote it out and the zamindar put it on this fellow’s back and signed it. Then he told the businessman–beggar, "With this diploma you can announce to the whole world that you are the most honest man. I have not given an ‘honesty diploma’ to anyone else. But you deserve it."

— — — — — — — — — —


Read this…………………

Which of the following patients presenting to the emergency department with an acute knee injury needs an x–ray?

  • A 20–year–old male who walks in limping on the affected side. He has no tenderness on exam.
  • A 35–year–old obese female who was unable to weight bear immediately after the fall but is limping on the affected side. She has a normal exam.
  • A 60–year–old male with a painful knee but a normal exam.
  • A 30–year–old male with inability to flex knee to 90 degrees but with otherwise normal exam. E. A 45–year–old who has tenderness over the fibular head but otherwise normal exam and limping on the affected leg.

(Contributed by Ashish Verma MD)

Yesterday’s Mind Teaser: "l JJJJOOOOHHHHNNNNSSSS"
Answer for yesterday’s Mind Teaser:
"Long Johns"

Correct answers received from: Dr Sudjha Nayyar, Dr Suman Kumar Sinha, Dr KP Rajalakshni

Answer for 1st December Mind Teaser: "A little on the large side"
Correct answers received from: Dr KV Sarma, Dr Prabha Sanghi

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr Prabha Sanghi)

High Blood Pressure

When a physician remarked on a new patient's extraordinarily ruddy complexion, he said, "High blood pressure, Doc. It comes from my family." "Your mother's side or your father's?" I asked.
"Neither," he replied. "It's from my wife's family." "Oh, come now," I said. "How could your wife's family give you high blood pressure?"
He sighed. "You oughta meet 'em sometime, Doc!"

    Readers Responses
  1. Dear Sir, Very informative Newsletter. Regards: Dr Prachi
    Public Forum

(Press Release for use by the newspapers)

Pyramid Meditation Centre Opened

The premises of the Acharya Sadhna Pyramid Meditation Centre were opened to public today. Located at C–599, Defence Colony, the Centre was inaugurated by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India who also conducted a one–hour meditation session for the public.

Addressing a gathering of over 500 people, Dr. Aggarwal said that Pyramid Meditation involves either meditating inside a pyramid–shaped room or meditating under a pyramid with a small pyramid hanging over the head.

All holy places, whether Temple, Mosque, Gurudwara or Church, are so architecturally designed in order to create an area which can capture more energy from the universe. The triangular–shaped religious place works like an area with concentrated energy.

Pyramid is one such architectural design, which belongs to no religion or dharma. People can sit under a pyramid and do pranayam, relaxation exercises and meditation. Over 60 people at a time can meditate under the Defence Colony pyramid which is now open to public.

Regular sessions will be held

Dr. Aggarwal will be personally conducting pyramid meditation every Monday 7am to 8 am.
Speaking on the occasion, Acharya Dr. Sadhvi Sadhna Ji Maharaj, Chairperson World Fellowship of Religion said that pyramid can only be a place of worship and not for living as the high energy area cannot be used for sleeping purposes.

The high energy zone under a pyramid can keep vegetables, fruits and food fresh for a longer period of time. Pyramid energy can also help to heal many diseases.

Apart from pyramid, the annual flag changing ceremony of Ahimsa Paryavaran Sadhna Mandir was also held. Celebrities who participated in the function were: Shri Sriprakash Jaiswal, Union Minister; Shri Pradeep Jain; Shri Buta Singh, Former Union Home Minister and Former Justice Delhi High Curt, Shri Vijender Jain.

Other prominent personalities who were present were: Shri Dalchand Ji Jain, President, Vishwa Ahimsa Sangh; Shri Arvinder Singh Lovely, Minister of Education, Delhi Govt. and Shri Veer Singh Dhigan, MLA.

    Forthcoming Events

Hospital Infrastructure India (HII) 2010 opens doors on 7 – 9 December 2010 at Bombay Exhibition Centre, Goregaon East, Mumbai. More than 80 exhibitors will be showcasing the latest technologies, products, services and advancements in hospital sector.

  • Hospital planning and design from TAHPI (Australia), HKS (US), Burt Hill (US), AFL (UK)
  • Medical Imaging systems from Sony
  • Wall protection material from InPro Corporation (US). They will be introducing G2, the world’s greenest wall protection material
  • Hospital supplies, OT, LED solutions from Edifice Medical Systems & Dr Mach
  • Floor covering and disinfecting surface solutions from Graboplast, Hungary
  • Electrical safety solutions by Bender – Germany & RR – Eubiq – Singapore
  • Floors and ceilings by Armstrong World, Square Foot, CCIL, Gerflor
  • Clean Room Partitions from GMP Technical
  • Smart Networks International (SNI) – a global consortium of European companies, showcasing hospital infrastructure solutions
  • Hospital project management & consultancy from Medica Synergie
  • Engineering & Project consultancy from Ted Jacob (US), KJWW Engineering (US), ETS – Eastern Services Private Ltd.

Special Features
Exhibition: Leading companies from countries, besides host country India have confirmed their participation at HII 2010

Session themes include:
Hospital Building Design – Basic principles and insights into future trends
Departmental Planning 1 – HBOT, Laminar airflow in operation theatres
Departmental Planning 2 – Healthcare next: A view of next generation healthcare innovations amongst other topics
Developing Healthcare Infrastructure – Case study of PPP models from Australia, UK and India

Product Demonstration Area: A selection of the latest products and services from some of the key exhibitors participating at HII 2010 will be on display at the product demonstration area. There will be interactive workshops as well as detailed briefing on these products and services to help you keep updated on the trends as well as make informed buying decisions.

B2B Meetings: The event is designed to help you make the most of your time at HII 2010 by facilitating business meetings and networking opportunities.

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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