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 DAILY 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

 
  Editorial …

4th March, 2011, Friday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Service Tax in medical profession – will the govt revert?

Medical profession has now been included in the service tax. All hospitals with more than 25 beds which are centrally air conditioned will come under the scope of the Service Tax. Service tax will be applicable only to high end treatments (details need to be declared by the government). It will end up with 5% addition to the bill of medical treatment in the private sector.

Health for all is the fundamental responsibility of the government. One can understand duty and taxes on luxury items or on services where alternatives are available by the government. For example, if Taxi and Auto fares are increased, they are justifiable as people have an alternative to use other modes of transport such as Metro or the Buses. In healthcare setup, where 80% of the treatment is provided by the private health care infrastructure, people will be forced to pay more as they have no other alternatives. The service tax will have no implications on the hospitals as they have nothing to lose; they will pass on the tax to the public. In case of insurance sector again, though the taxes may be paid by the insurance company, but the equivalent limit of reimbursement will be reduced as taxes will be part and parcel of the total limit for which the person is insured.

Apart from the service tax, the private sector will also increase their charges as now they will have to employ more people to take care of the service tax as well as to file regular returns. Money spent in filing the return and getting it cleared without objections will also be pressed on to the patient. For the current year, they have added service tax on 50% of the amount of the bill. It is likely that in the next one or two years, it will be applicable to the whole bill.

It is rather premature for the government to bring medical services under the service tax till they provide adequate medical care.

There are indications that the government may roll back on this issue and withdraw the service tax from medical profession.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
 
  eMedinewS Audio PostCard

 Treating Diabetes Post 2010

Dr Ambrish Mithal speaks on
GI adverse events with metformin

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

I asked GOD to make my handicapped child whole. GOD said no his spirit is whole, his body is only temporary.

 
    Photo Feature (From HCFI Photo Gallery)

Dr. Sadhna Women Empowerment Awards Distributed

Dr. Sadhna Women Empowerment Awards were presented to women of eminence. Mrs. Rashmi Singh, IAS was felicitated with this award on 27th February 2011 at 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

New, Rs. 50-crore HIV vaccine design programme launched

With an estimated 7,100 people getting infected with HIV every day and India home to 2.7 million HIV positive people, the government on Wednesday launched a new HIV vaccine design programme in the country. It was also announced that a new HIV Vaccine Laboratory will now come up in New Delhi. M K Bhan, Secretary, Department of Biotechnology, said that autonomous institute Translational Health Sciences and Technology Institute (THSTI) and the International AIDS Vaccine Initiative (IAVI) have agreed to jointly establish, operate and fund an HIV vaccine design programme in the country. The programme will primarily focus on one of the greatest scientific challenges of AIDS vaccine design and development: the elicitation of antibodies capable of neutralising a broad spectrum of circulating HIV variants — a problem that stems in large part from the almost unparalleled mutability of HIV. The programme will cost Rs. 50 crore over five years. (Source: Indian Express, March 03, 2011)

 
    International News

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

Dairy colostrum could improve athletes’ performance, prevent heat stroke

Scientists investigating natural ways to enhance athletic performance have found that bovine colostrum can massively reduce gut permeability – otherwise known as ‘leaky gut syndrome.’ Their findings, published in the March issue of the American Journal of Physiology–Gastrointestinal and Liver Physiology, could have positive implications not just for athletes but also for sufferers of heatstroke. A research group led by Ray Playford, Professor of Medicine at Barts and The London School of Medicine and Dentistry looked at athletes who were asked to run for 20 minutes at 80 per cent of their aerobic maximum. At the end of the exercise, changes in the subjects gut leakiness were measured using urine sample – also determined were changes in the athletes’ core temperature. Under standard conditions, gut leakiness had increased by 250 per cent and temperature had risen by 2 degrees. However, when the group were given a drink of dairy colostrum for two weeks before the trial, the rise in gut leakiness was reduced by about 80 per cent, despite the same effort and temperature rise.

Gut disorders induced by exercise are common in runners – the body’s response to increased permeability is to clear the gut contents, giving rise to symptoms such as diarrhoea to avoid toxins from gut organisms entering the bloodstream, as these lead to heatstroke which can result in damage to the internal organs. Professor Playford’s research identified changes in gut barrier function in laboratory studies: gut cells were cultured at normal 37 degrees body heat and at 39 degrees to replicate the temperature after exercise. The death rate of gut cells was much increased at the higher temperature yet when colostrum was added to the culture medium the rise in cell death rate was reduced by two thirds. Professor Ray Playford said: "Athletes’ performance can be seriously diminished due to gut symptoms during heavy exercise. We have been looking at natural approaches to reduce this problem as the range of products that athletes can legitimately take is very limited. Our findings suggest colostrum may have real value in helping our athletes perform. This is a research area we are especially interested in given our proximity to the 2012 Olympic site. In addition, extremes of temperature and exercise are often suffered by armed forces in desert war scenarios and can result in heat stroke which is life threatening. Based on our results to date, our research group is also exploring products that may be useful for protecting soldiers in life threatening situations such as these."

(Dr Monica and Brahm Vasudev)

FDA Panel: Menthol increases risk to young smokers

FDA advisory committee is expected to report that menthol cigarettes cause an increase of tobacco addiction in adolescent smokers.

Electronic cigarettes prohibited on airplanes

The US Department of Transportation says the use of smokeless electronic cigarettes on airplanes is prohibited and plans to issue an official ban this spring, according to a letter from Transportation Secretary Ray LaHood obtained by the AP.

Some stroke survivors skipping prescribed medications due to high costs

According to research presented at the American Stroke Associations International Stroke Conference, some stroke survivors skip prescribed medications because the cost is too high –– a situation that may be worsening, particularly among young and uninsured patients.

Physicians may be missing silent strokes in children with severe anemia

Physicians may be missing silent strokes in a small but significant number of children with severe anemia, who may be unfairly labeled as slow learners when in fact they have a medical problem, according to a study presented at an American Stroke Association conference.

Over 200 patient deaths linked to alarm fatigue

With the use of monitors rising, their beeps can become so relentless, and false alarms so numerous, that nurses become desensitized –– sometimes leaving patients to die without anyone rushing to their bedside.

 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation, banerjee.kaberi@gmail.com)

What is unexplained infertility?

Up to 26% of infertile couples have unexplained infertility. In such cases, abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.

 
    Hepatology Update

(Dr. Neelam Mohan, Dir Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity, drneelam@yahoo.com)

What is the cause of UGI bleed in newborns?

In newborn period the common causes are:

  • Swallowed maternal blood
  • Haemorrhagic disease of newborn
  • Stress gastritis
  • Acid- peptic disease
  • Vascular anamoly
  • Coagulopathy
  • CMPI
 
    Medicolegal Update

(Dr Sudhir Gupta, Asso Professor, Forensic Medicine & Toxicology, AIIMS)

Malpractice

Supreme Court of Georgia echoed the Illinois decision, albeit with somewhat different wording

  • Every person who enters into a learned profession undertakes to bring to the exercise of his profession a reasonable degree of care and skill. He does not undertake to use the highest possible degree of skill, for there may be persons who, for having enjoyed a better education and greater advantages, are possessed of greater skill in their profession; but he undertakes that he will bring a fair, reasonable, and competent degree of skill…He is not responsible for an error in judgment…if such error arises from the peculiar circumstance of the case, and not from the want of proper care or competent skill on his part.
  • Nearly a half–century later, a state of New York appeals court issued an opinion as to what constitutes the standard of care of a medical physician. Although the lawsuit did not involve radiology, the court decision could have well applied to radiologic interpretation
  • The law requires a physician to possess the skill and learning which is possessed by the average member of the medical profession…and to apply that skill and learning with ordinary reasonable care. He is not liable for a mere error in judgment, provided he does what he thinks is best after a careful examination. He does not guarantee a good result.
 
    Legal Question of the Day

(Dr M C Gupta, Advocate)

Q. How can the cancer of corruption within the medical profession be cured?

Ans.

  1. Corruption is a worldwide phenomenon and pervades all walks of life. We have reached a stage when the amounts of corruption are counted in lakhs of crores (2G and ISRO scams). Medical scams are negligible in comparison. It is to the credit of the medical profession that ordinary members in a medical group often show concern about corruption in the profession.
  2. Some instances of corruption in the medical profession, as seconded by some doctors themselves) are as follows:
    1. Kick backs
      1. For diagnostic tests: 40–60% kickbacks for lab tests. (That is why labs offer cheaper rates for patients going directly to a lab for blood tests or x–ray etc. The age old advice that patients should not go for tests on their own without a doctor advising them seems to be in need of change in view of the menace of kickbacks). It is obvious that the kick back culture is conducive to advising unnecessary tests.
      2. For specialist referrals: There may be 30–40% kick–backs to a GP for referring patients to a specialist. It is obvious that the kick back culture is conducive to advising unnecessary consultations.
      3. For hospital admissions: 30–40% of total hospital charges. If the GP or consultant recommends hospitalization, he will receive kickback from the private nursing home as a percentage of all charges including ICU, bed, nursing care, surgery etc. It is obvious that the kick back culture is conducive to advising unnecessary hospitalisation. Some patients, especially those having heart related symptoms, are likely to be advised unnecessary hospitalization “for observation".
    2. Unnecessary tests, hospital admissions (including unnecessary ICU transfer) and procedures, such as caesarian section and hysterectomy, cholecystectomy and tonsillectomy.
    3. Unqualified or substandard staff: It is common to find unqualified doctors, nurses and other staff in private nursing homes. This is not really corruption but rather an unavoidable evil because, FIRSTLY, qualified persons are just not available (thanks to the government’s and politicians’ blameful rhetoric against doctors and attempts to produce BRHC/BRMS graduates rather than increase and improve the training facilities for paramedicals); and, SECONDLY, when available, the salary payable to them is so high that nursing homes cannot bear the cut throat competition.
    4. Touts: Some hospitals also engage touts to bring the injured to their casualty for admission.
    5. Price for appointment as consultants: Private hospitals demand price from specialists to be appointed as consultants. This may be in cash or kind. The examples of the latter are commitments to ensure a certain quota of procedures related to their specialty, such as angiographies, cardiac bypass surgeries, caesarians etc.
    6. "Emergency surgery" on dead body, just to inflate the hospital bill.
  3. The root cause of corruption is not that doctors are more greedy but that they find it impossible to make enough money to compensate for:
    1. Cost of medical education: Private medical education can mean about a crore rupees for 5 year MBBS course and 2 crore rupees for coveted specialties like radiology, pathology, orthopedics, ophthalmology etc.
    2. Establishment and running cost of private hospitals which are treated as commercial establishments by the government.
    3. Unfair costs imposed statutorily upon hospitals in the form of free treatment of all emergency patients "up to the stage of stabilization" as provided in the Clinical Establishment Act, 2010.
    4. Unhealthy competition with quacks who are, knowingly, left unchecked by the government. (The term quack includes, among others, the following: Doctors without a recognised degree; doctors having a recognised degree who are registered with a professional council related to one system of medicine but practicing another system of medicine; non–pathologists running pathlabs, etc.)
    5. Unhealthy competition with unscrupulous or substandard doctors: The term unscrupulous or substandard doctors refers to those who get admission to a medical course through means other than fair competition on the basis of level playing field (for example, doctors who get admissions to a medical course through capitation fees or through the system of reservations).
  4. There are also instances of institutionalized corruption in the medical profession such as the following:
    1. Bribes charged for granting approval for new medical colleges or courses etc. The MCI–Ketan Desai episode exemplifies this.
    2. Fees charged for "certifying" cold drinks, fruit juices, antiseptic lotions and water purifiers etc. The recent IMA episode is an example.
    3. Bribes charged by politicians/health ministers for appointment/transfer of doctors in government service.
  5. Corruption cannot be eradicated. It can be minimized by the following measures:
    1. Increasing the number of seats in medical courses so that demand is fully met and the menace of admission of undeserving students through capitation fee is eradicated.
    2. Increasing the fee in government colleges to a level that is similar to private colleges. This will decrease the clamour for reservations which are seen as doling out of free favours. The interests of the economically poor sections can be protected through soft loans and working assistantships as in USA.
    3. Doing away with the system of reservations in medical field.
    4. Strict and quick implementation of laws and disposal of court cases related to corruption and quackery etc. This cannot be possible without law and police reforms including creation of more number of judges and filling the existing vacancies. The judge: population ratio in India is far below the optimum.
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Our Contributors
  Docconnect Dr Veena Aggarwal
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  Docconnect Dr Sudhir Gupta
 
    Obesity Update

Dr. Parveen Bhatia and Dr Rama Lakshmi

Childhood Obesity

Diagnosis of Obesity

Tests to determine obesity include:

  1. Weight–to–height tables define obesity in children as body weight at least 20% higher than a healthy weight for a child of that height. The tables, however, do not take into account the individual characteristics of each child like children gaining weight before a growth spurt.
  2. Body fat percentage This is a good marker of obesity. Boys over 25% fat and girls over 32% fat are considered obese. Body fat percentage is difficult to measure accurately, however. Measuring skin fold thickness is not reliable unless it is done correctly by a trained and experienced technician.
  3. Body mass index (BMI) is defined as weight in kilograms divided by height in meters squared (kg/m 2). BMI is the standard for defining obesity in adults, but its use in children is not accepted universally. The Centers for Disease Control and Prevention (CDC) suggests two levels of concern for children based on the BMI–for–age charts.
    • BMI–for–age between 85th and 94th percentiles: At risk of overweight
    • BMI–for–age 95th percentile or above: Overweight
  4. Waist circumference (WC) This measurement in a child or adolescent correlates closely with the future risk of developing type 2 diabetes mellitus and related complications of the a metabolic syndrome. The assessment is made with a tape measure stretched across the widest abdominal girth and any value over the 90th percentile for age and gender carries the highest risk.
  5. Neck Size: Measuring a child’s neck size is a relatively new method of screening for childhood obesity and is more accurate and easier to obtain than BMI and can be used to identify overweight and obesity in boys and girls ages 6 to 18. The technique isn’t routinely used yet and further research is needed.
 
    Rabies Update

Dr A K Gupta, Author of "RABIES – the worst death"

Can we apply local antibiotics or antimicrobial agents on the site of bite?

After cleansing of the bite wounds, local antimicrobial agents can be applied.

What is a street virus?

Street virus is a type of rabies virus which is virulent and has a long and variable incubation period of about 3 weeks to 3 months.

 
    Useful Website

(Dr Surendernikhil Gupta)

KidSurvival

The Origin Of The Haitian Cholera Outbreak

http://www.childsurvival.net/?content=com_articles&artid=323

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Tests for Coeliac Disease

The best initial laboratory test for diagnosis of celiac disease is anti–tissue transglutaminase antibody (anti–tTG), IgA. If this test is positive, it is likely that the patient has celiac disease.

The doctor may request an

  • Intestinal biopsy to determine whether there is damage to the intestinal villi.
  • CBC (complete blood count) to look for anemia.
  • ESR (erythrocyte sedimentation rate) and CRP (C–Reactive protein) to evaluate inflammation.
  • CMP (complete metabolic panel) to determine electrolyte, protein, and calcium levels and to verify the status of the kidney and liver.
  • Vitamin D, E, and B12 to measure vitamin deficiencies
  • Stool fat, to help evaluate malabsorption.
 
    Medi Finance Update

BDO Budget Snapshot 2011–12
(Saurabh Aggarwal)

Proposed Direct Tax Amendments In Brief

Tax Rates – Individuals

  • Basic exemption limit raised to INR 180,000.
  • Women – Basic exemption limit raised to INR 190,000. (No change.)
  • Senior Citizen – Basic exemption limit raised to INR 250,000. Qualifying age reduced from 65 to 60 years
  • Very Senior Citizen (> 80 years) – Basic exemption limit raised to INR 500,000.
  • Other tax slabs remain the same
 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Difluprednate Opthalmic Emulsion 0.05% w/v
For the treatment of inflammation and pain associated with ocular surgery.
30/03/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Nocturnal leg cramps

A systematic review of treatments for nocturnal leg cramps identified limited data to support the use of several agents, including calcium channel blockers and vitamin B complex.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with COPD developed Herpes zoster.
Dr Bad: They are not related.
Dr Good: They are related.
Lesson: People with chronic obstructive pulmonary disease, or COPD, are more likely than others to develop shingles. (CMAJ: the Canadian Medical Association Journal, news release, Feb. 22, 2011)

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking light breakfast.
Reaction: Oh my God! Why was insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 grams of carbohydrates.

Myth and Fact
(Dr. Narendra Kumar)

Myth: Full spectacle correction should not be given to first–time hypermetropes.

Fact: Uncorrected hypermetropia has clearly been linked to amblyopia or strabismus. Spectacle correction, whether full or partial, is a matter of choice to be decided by the optometrist or the ophthalmologist depending upon the findings of visual acuity for distance and near, and the status of accommodation (ability of the eye to increase the power of the eye lens in order to see near objects clearly). Full spectacle correction of hypermetropia, or hyperopia, is surely going to help, and is a must, in the presence of strabismus. And, a child with moderate amount of hypermetropia, but with adequate distance and near visual acuity and good accommodation with excellent performance at school, and above all with no visual complaints, may not need spectacle correction at all.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr. Anupam Sethi Malhotra)

Existence of God

A man went to barber’s shop to get a haircut and beard trimmed. As the barber began to work, they began to have a good conversation. They talked about so many things and various subjects. When they eventually touched on the subject of God, the barber said: "I don’t believe that God exists." "Why do you say that?" asked the customer. "Well, you just have to go out in the street to realize that God doesn’t exist. Tell me, if God exists,would there be so many sick people? Would there be abandoned children? If God existed, there would be neither suffering nor pain. I can’t imagine loving a God who would allow all of these things." The customer thought for a moment, but didn’t respond because he didn’t want to start an argument.

The barber finished his job and the customer left the shop. Just after he left the barbershop, he saw a man in the street with long, stringy, dirty hair and an untrimmed beard. He looked dirty and unkempt. The customer turned back and entered the barber shop again and he said to the barber: "You know what? Barbers do not exist."

"How can you say that?" asked the surprised barber. "I am here, and I am a barber. And I just worked on you!" "No!" the customer exclaimed. "Barbers don’t exist because if they did, there would be no people with dirty long hair and untrimmed beards, like that man outside."

"Ah, but barbers DO exist! What happens is, people do not come to me." "Exactly!"– affirmed the customer. "That’s the point! God, too, DOES exist! What happens, is, people don’t go to Him and do not look for Him. That’s why there’s so much pain and suffering in the world."

— — — — — — — — — —

Mind Teaser

Read this…………………

(ice) 3

Yesterday’s Mind Teaser: BRIDGE
w t r
a e
Answer for yesterday’s Mind Teaser:
Bridge over troubled water

Correct answers received from: Dr Govil SM, Dr Vinod Khetarpal, Dr T. Samraj, Dr Sudipto Samaddar, Mr karani Vishanji, Dr Susheela Gupta, Dr Rakesh Bhasin, Dr K.Raju, Dr Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr Anil Bairaria, Dr Neelam Nath

Answer for 2nd March Mind Teaser: Exercise Stress Treadmill
Correct answers received from: Dr Anupam

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Dr GM Singh)

A Horoscope For The Workplace

Senior Management: Catty, cut–throat, yet completely spineless, you are destined to remain at your current job for the rest of your life. Unable to make a single decision you tend to measure your worth by the number of meetings you can schedule for yourself. Best suited to marry other "Senior Managers," as everyone in your social circle is a "Senior Manager."

— — — — — — — — — —

Continuing Ed for Doctors
(Dr Dolly Aggarwal)

Diseases described in Bollywood songs……
Dekha jo tujhe yar, dil me baji guitar:– Cardiac Murmur

— — — — — — — — — —

Knowledge is amusing

If you SNEEZE too hard, you can fracture a rib. If you try to suppress a sneeze, you can rupture a blood vessel in your head or neck and die. So good to bless the sneezing person.

— — — — — — — — — —

 
    Readers Responses
  1. The write up on Lord Shiva is really informative and illuminating; but, the line, "The matted hairs of Shiva represents tapas, which signifies that nothing in the universe is impossible without contemplation and repeated practice." near the end of it seems to have some typographical error. May be, I’m unable to make out what it really means. May Shiva bless you! Dr. AK Gupta.
    eMedinewS Responds: Thanks for the correction and the corrected line is "The matted hairs of Shiva represents tapas, which signifies that nothing in the universe is possible without contemplation and repeated practice."
  2. Please note that the answer to the following question (February 23rd, 2011, Legal Question of the Day) is wrongly attributed as (Contributed by Dr Akash Deep)

Q. I joined a private medical college as Faculty without signing an agreement. I want to resign and get experience certificate and relieving order but the employer is not accepting my resignation. How can I resign and get the experience certificate and relieving order?
It was answered by Dr MC Gupta.

 
    Public Forum

(Press Release for use by the newspapers)

Passive smoking can cause dementia

People exposed to secondhand smoke may face as much as a 44 percent increased risk of developing dementia, said Dr. K.K. Aggarwal Padma Shri and Dr B C Roy National Awardee and President Heart Care Foundation of India.

Smoking is already known to increase the risk for dementia and Alzheimer’s disease. A study from Peninsula Medical School in Exeter, England and published in the journal BMJ has shown that there is an association between cognitive function, and exposure to passive smoking. The risk increases with the amount of exposure to secondhand smoke. For people at the highest levels of exposure, the risk is probably higher.

The study collected data on more than 4,800 nonsmokers who were over 50 years old and tested saliva samples from these people for levels of cotinine, a product of nicotine that can be found in saliva for about 25 hours after exposure to smoke. The researchers found that people with the highest cotinine levels had a 44 percent increased risk of cognitive impairment, compared with people with the lowest cotinine levels. And, while the risk of impairment was lower in people with lower cotinine levels, the risk was still significant.

Passive smoking is also associated with an increased risk of stroke and heart disease.

 
   eMedinewS Special

1. eMedinewS audio lectures

2. eMedinewS ebooks

 
    Forthcoming Events

ICC Cricket World Cup 2011

http://www.cricbuzz.com/cricket–schedule/series/228/icc–world–cup–2011

6th Annual Conference of Indian Academy of Nephrology (IANCON–2011)

March 12–13, 2011: Taj Deccan, Banjara Hills, Hyderabad–34
Faculty: Dr MS Amarsen, Dr KV Jhony, Dr SC Dash, Dr Kashivishweswaran, Dr V Sakhuja, Dr RK Sharma, Dr Girishnarayan, Dr Anuradha, Dr SK Agarwal, Dr P Sundarajan, Dr P Keshivya, Dr Ravi Raju, Dr Dilip Pahari, Dr LC Sharma, Dr Sanjeev Saxena, Dr Sanjay Gupta, Dr Abhijit Tarapdhar, Dr PP Verma, Dr Harun Rashid, Dr Sampath Kumar, Dr Sanjib Sharma, Dr S Padmanabhan.
Topics: CKD Symposium (From India, Nepal, Bangladesh), Newer concepts in the pathogenesis of hypertension, Fluid and Electrolyte & AKI, RAAS in treatment of Diabetic Nephropathy, Primary Prevention of CKD: Trials & tribulation in Indian condition, Vitamin–D andchronic kidney disease, Mycophenolate Vs Cyclyophosphamide in Lupus nephritis, Individual zinganemia therapy, How to monitor Immunosuppression minimization, Obesity Diabetes epidemic, Life Style changes & therapeutics, BKV and CMV Nephropathy, Leptospira and Acute Kidney Injury, HIV Nephropathy, Hypophosphatemia and Renal Disease, Immunosuppressant and risk of Malignancy, Pregnancy ARF, Expanding Dialysis services in Andhra Pradesh, Making kidney transplant easier for less privileged, Cardiovascular risk reduction in CKD
Organizing Secretary: Dr Sree Bhushan Raju, Associate Professor, Dept of Nephrology, NIMS, Hyderabad, Mob: 09848492951, sreebhushan@hotmail.com; www.ian2011.in
Note: "Prof SC Dash oration in Nephrology" from this year onwards. Three awards each in oral, poster and imaging in Nephrology sessions

Registration for Delegates Amount
Up to 15th February 2011
 
Rs. 1500/–
Up to 5th March 2011
Rs. 2000/–
Spot registration
Rs. 2500/–
Student
Rs. 500/–

DD/Cheque in favor of "IANCON–2011" payable at Hyderabad. Add Rs 100/– for outstation cheque.

eMedinewS Events: Register at emedinews@gmail.com

Medifinance Conference On Portfolio Management for Doctors and update on Budget 2011

Date: 13th March 2011, Time: 9 Am – 4 Pm, Venue: Auditorium, Delhi TB Association,  9 Institutional Area, Lodhi Road, New Delhi 110003
Speakers: Dr Subhash Lakhotia and other top of line from finance sector. The speakers to be chosen from the industry will be experts in each field to be covered in this conference

Separate sessions for portfolio management, insurance, mediclaim, banking sector, investments primary market, secondary market, taxation, loans for setting up hospitals, nursing homes, labs, etc. all under one roof.

No entry fee, the number of participants will be limited to 100 on first cum first serve basis. advance registration by mail to hcfi.1986@gmail.com/drkk@ijcp.com or by phone on 9899974439/9873716235.

World Fellowships of Religions and Perfect Health Parade

First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof
Subject: Global Warming, Ethnic Crises, How to be Healthy
Date: Sunday 3rd April, 2011;Venue: Maulana Azad Medical College Auditorium, New Delhi;Time: 8 AM – 4 PM

Parade through tableaus to be flagged off at 10 am from outside MAMC to move till 5 pm on different predefined routes in Delhi to create awareness about health matters.

Parade Route: Vikas Marg – Shahdara – Seemapuri – Guru Tegh Bhadur Hospital – Seelampur Pusta – Gandhinagar, to ISBT Kashmiri Gate – Civil Lines – Delhi University North Campus – Azadpur – Punjabi Bagh – Mayapuri – Raja Garden – Janakpuri – Tilak Nagar – Tihar Jail Road – Delhi Cantt. – R.K Puram – Munirka – IIT Gate – Panchsheel Park – Chirag Delhi Flyover – Nehru Place – Modi Mill Flyover – Ashram – Nizamuddin – Sunder Nagar – Pragati Maidan – ITO – finally culminate at Maulana Azad Medical College at 4pm.

Full day conference on ethnic crisis and global warming. Pre lunch session to be addressed by religious representatives who would talk on what each religion has to say. Post lunch to be addressed by doctors from all streams of medicinal practice (allopathy, ISM)
Register: rekhapapola@gmail.com

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