emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
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


4th August, 2010, Wednesday

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

Medical education is not as per Chanakya Neeti

One of the fundamental principles of Chanakya Neeti is to know the strength and weaknesses of your competitors. No business house can run without this principle. Even in politics, we have people who infiltrate into the opposition parties to gather information.

Unfortunately, in medical education, this principle is completely ignored. In India, there are multiple recognized systems of medicine, namely, allopathy, homeopathy, ayurveda, unani, naturopathy etc. But in the MBBS curriculum, there is no single class that teaches us about the strengths and weaknesses of other systems of medicine. In practice, we often end up saying "I don’t know the ABC of Homeopathy or Ayurveda." The new Board of Directors of MCI should seriously think on this issue and include introduction to other pathies in the curriculum. In health, it’s a question of life and death, therefore, every pathy should know what else is available in other pathies.

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

 

Photo Feature (From HCFI file)

 Celebrities can raise public awareness

Famous cricketer Kapil Dev visited the first ever Perfect Health Mela in 1993 and attarcted a large crowd. Celebrity endorsement of helth messages is a known moduole for creating health awareness.

In the photo: Kapil Dev, Famous Former National Cricketer and Padma Shri, Dr B C Roy National Awardee Dr. K K Aggarwal, President HCFI at the mela vanue

Dr k k Aggarwal

 

News and views 

National

Rajya Sabha passes healthcare bill

Rajya Sabha passed the Clinical Establishments Regulation and Accreditation Bill seeks uniformity in healthcare delivery by making registration of all clinical establishments mandatory.

The bill was passed by voice votes. 'Registration of the clinical establishment is the focus of the bill. It will provide data about the number and standard of clinics to the center,' Azad said, adding: 'Registration will be the key to regulation'.

Earlier, participating in the debate Monday, opposition members had objected to the legislation being focused only on registration and ignoring the other aspects like regulation and standardization of prices.

Dispelling their doubts, the minister said the bill will also pave the way for categorizing clinics, which will facilitate their regulation.

'We cannot run into regulation without having an idea of what we have to regulate. Once we have the data of the clinics, we can categorize them for regulation.' Azad said.

He said that the bill will not impeach on the authority of the state governments and it aims to create a national data bank of clinical establishments.

'To identify and rectify flaws in the health system, we need such data,' he said adding: 'Our response to H1N1 (swine flu) would have been better if we had such data.'

Answering the issue of fixing prices for treatment, the minister said this can be done only after categorizing the establishments.

'Once categorization takes place to prescribe minimum standards, we can prescribe a range of costs,' he said.

He also denied that the legislation will lead to a 'license raj', as apprehended by some members as it had a provision for self-declaration.

'Provisional registration will be given to the clinics after  self-declaration,' he said adding that permanent registration will be provided only after the standards are notified.  (Source News Agencies)

Emedinews: invites comments on the act.Write to emedinews@gmail.com 

 

Clinical Establishment Bill (Dr Anil Varshney)

The Clinical Establishment Bill is like PNDT Act where 99% doctors are being harassed for not keeping proper records and establishments are being sealed. A similar fate may soon be seen with clinical establishments of small types i.e. individual clinics, small nursing homes and diagnostic centers which will ultimately help the Corporate set up since these are unlikely to be touched by the officials as has been seen in present day.

International

Frostbite (Dr G M Singh)

According to the U.S. National Safety Council, frostbite occurs upon exposure of the skin to extremely cold temperatures. Symptoms of frostbite include skin that looks waxy, pale white or gray–yellow in color. Affected skin also may feel numb, and very cold to the touch. The top layer of skin may feel stiff. Frostbite can be superficial or deep. Deep frostbite is the more serious form and frequently affects hands and feet. The council suggests wearing many layers of clothing whenever you’re exposed to very cold weather to prevent frostbite, and immediately removing clothing that becomes wet. You should also eat healthy foods and drink plenty of liquids. Avoid alcohol or caffeine

Dr Brahm and Monica Vasudeva

Discontinuing EPO May Be Better Than Dose Reduction For Patients On Hemodialysis

A study in an upcoming issue of the Clinical Journal of the American Society of Nephrology report that stopping the anemia drug epoetin may be more effective than reducing the dose for normalizing potentially dangerous high hemoglobin levels in patients on hemodialysis.

Dietary supplements found to contain prescription drugs

A FDA lab analysis of Joyful Slim Herb Supplement was found to contain desmethyl sibutramine, weight–loss drug. Some batches of Good Health’s Vialipro had been found to contain sulfoaildenafil, a cousin of sildenafil.

 

 

Legal Column

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

Cross–examination debate for standards of medical care (cont…)

The cross–examination format involves eight speeches and four cross–examination sessions. The first four speeches are designated as constructive speeches. These are longer speeches, and are open to new lines of argument at any point in time. The final four speeches are designated as rebuttal speeches. These shorter speeches are reserved for summaries, which mean they are not open to new lines of argument. Interspersed between the constructive speeches are short cross–examination sessions, in which the debater who has just finished speaking is questioned by an opponent. During the course of the medical debate, each debater will deliver a constructive speech, a rebuttal speech, be cross–examined by an opponent, and cross–examine an opponent. The order of speech is arranged to give the affirmative the open and closing speeches in the debate.

 

Experts’ Views

Interesting Tips in Hepatology & Gastroenterology

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


Pancreatitis
Definition: Pancreatitis is defined as inflammation of the pancreas resulting in acinar cell injury caused by the destructive effect of pancreatic enzymes. It is further classified into

  1. Acute,
  2. Chronic and,
  3. Recurrent

Question of the day

What are the risk factors for type 2 diabetes mellitus? (Dr Manoj Kumar Dash Hyderabad)

Risk factors for type 2 diabetes can be divided in two types:

Genetic factors: Genetic factors for type 2 diabetes mellitus are not well defined and are not modifiable.

Environmental risk factors for type 2 diabetes include

• Ethnicity
• Family history of diabetes
• Obesity
• Sedentary lifestyle
• Unhealthy diet
• History of gestational diabetes mellitus
• Smoking and alcohol
• Drug–induced

 

An Inspirational Story

Mount Everest

Sir Edmund Hillary was the first man to climb Mount Everest. On May 29, 1953 he scaled the highest mountain then known to man-29,000 feet straight up. He was knighted for his efforts.

He even made American Express card commercials because of it! However, until we read his book, High Adventure, we don’t understand that Hillary had to grow into this success.

You see, in 1952 he attempted to climb Mount Everest, but failed. A few weeks later a group in England asked him to address its members. Hillary walked on stage to a thunderous applause. The audience was recognizing an attempt at greatness, but Edmund Hillary saw himself as a failure. He moved away from the microphone and walked to the edge of the platform. He made a fist and pointed at a picture of the mountain. He said in a loud voice, "Mount Everest, you beat me the first time, but I’ll beat you the next time because you’ve grown all you are going to grow… but I’m still growing!"

 

Public Forum (Press Release for use by the newspapers)

All diabetics must have an eye check up done

The vast majority of diabetic patients who develop diabetic retinopathy (eye involvement) have no symptoms until the very late stages (by which time it may be too late for effective treatment). Because the rate of progression may be rapid, therapy can be beneficial for both symptom amelioration as well as reduction in the rate of disease progression, it is important to screen patients with diabetes regularly for the development of retinal disease.

The eyes carry important early clues to heart disease, signaling damage to tiny blood vessels long before symptoms start to show elsewhere, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil ka Darbar & MTNL Perfect Health Mela. Diabetic people with retinopathy are more likely to die of heart disease over the next 12 years than those without it.

As per a study from the University of Sydney and the University of Melbourne in Australia and the National University of Singapore, people with retinopathy are nearly twice as likely to die of heart disease as people without it.

People with these changes in the eyes may be getting a first warning that damage is occurring in their arteries, and work to lower cholesterol and blood pressure.

Patients with retinopathy have a greater risk of incident cardiovascular disease (CVD) events, including heart attack, stroke, revascularization, and CVD death, compared with those without retinopathy.

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IJCP Special

Dr Good Dr Bad

Situation: A 44–year–old male came with painless blood in the urine.
Dr. Bad: Do not worry. It is benign condition.
Dr. Good: I need to rule out cancer of the urinary bladder.
Lesson: Cancer of the urinary bladder usually presents with painless blood in the urine.

Make Sure

Situation: A patient with uncomplicated gonorrhea comes to hospital for treatment.
Reaction: Oh my God! Why did I advise ampicillin to this patient?
Lesson: Make sure to remember that cure can be elicited by administering oral doxycycline to patients with uncomplicated gonorrhoea.

Mnemonic of the Day

Common drugs likely to cause haemolysis in G6PD deficiency: SIPPIN A Diet Coke

Sulfonamides 
Izoniazid 
Primaquine
Pyrimethamine
Ibuprofen 
Nitrofurantoin
Aspirin 
Dapsone
Chloramphenicol

Note: Chloroquine, quinine and quinidine are acceptable in the treatment of malaria

(Contributed by Dr Varesh Nagrath)

Quote of the Day

"Kind words can be short and easy to speak, But their echoes are truly endless." Mother Teresa

Are you fit to fly?

Heart patients

  1. Medically stable patients with pacemakers and implantable cardioverter–defibrillators are at low risk for inflight emergencies. They should carry a pacemaker card along with a copy of the most recent ECG done with and without a magnet.

  2. There is no evidence that airline electronics or airport security devices interfere with implanted pacemakers or ICDs.
 

International Medical Science Academy Update (IMSA)

Do not consider PSA velocity in deciding which men should be referred for prostate biopsy

Analyses from randomized trials of PSA screening found that PSA velocity added little or no independent prognostic information to PSA alone.

References

  1. Vickers AJ, Wolters T, Savage CJ, et al. Prostate–specific antigen velocity for early detection of prostate cancer: result from a large, representative, population–based cohort. Eur Urol 2009;56:753.

  2. Thompson IM, Ankerst DP, Chi C, et al. Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2006;98:529–34
 

Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name

Indication

DCI Approval Date

Propranol 1–ol 18gm + Ethanol 100% 45gm/100ml solution

For hygienic and surgical hand disinfection

18–Jan–10

 

Medi Finance

Q. What is the provision for taxation on gifts?

Ans. Future amount is taxable if the value of gift received in cash/kind exceeds Rs 5, 000.

 

Lab Medicine (Dr Arpan Gandhi and Dr Navin Dang)

Allergy testing

Allergies are hypersensitivities, overreactions of the immune system to substances that do not cause reactions in most people.  Immunoassay and Line Blot Tests are used to screen for type I allergen–specific IgE antibodies.

 

Lateral thinking

Read this………………

Ground

……………

feet feet feet feet feet feet

Send in your answer to emedinews@gmail.com

The answer for yesterday’s puzzle "neon light"

Correct answers received from: Dr Ashok Wasan, Dr Rajiv Bhatt, Dr Ashok Kumar,

 

Humor Section

Jokes

Did you hear that researchers have discovered that diarrhea is hereditary? It runs in your jeans

Fumy One Liners

Q: What’s the difference between a good lawyer and a great lawyer?

A: A good lawyer knows the law. A great lawyer knows the judge.

 

Readers Responses

  1. Hello, In one of your articles you mention AstroTurf®. We currently do not have a field in Delhi. Please fix your article to say synthetic turf and not our brand name. Thank you. Brittany Jackson. Marketing Associate

  2. Respected Dr. K. K. Aggarwal, You are a professional of such abilities that anyone would aspire to achieve. The whole country, including optometrists, respect you a lot. Your venture of EMedinews is good and promising. However the content (although personal opinion of writers) is expected to be edited before publication. In the issue of Aug.3, 2010, Dr. Nakipuria has gone overboard in disgracing the professional community of optometrists and we have strong objection to it. With respect to Dr. Nakipuria's comments, we raise strong objection to "Optometrist" being referred to as a "quack".
    a) World Council of Optometry, Affiliated to WHO, defines optometry as: Optometry is healthcare profession that is autonomous. educated and  regulated and optometrists are the primary healthcare practitioners of  the eye and visual system who provide comprehensive eye and vision care,  which includes refraction and dispensing, detection/diagnosis and  management of disease in the eye, and the rehabilitation of conditions  of the visual system".
    Reference: http://www.affordable-vision-correction.org/ppt14/sld073.htm
    Optometrists are responsible professionals and are respected world over for their work.
    a) It is surprising that a Central Council Member IMA has no knowledge of the
    above and calls optometrists by derogatory names.
    b) Optometry is currently a four-year degree course in 14 recognized universities.
    c) As members of optometry community, we strongly object to these remarks and request Dr. Nakipuria to withdraw his statement immediately. I am proud to be an optometrist.
    Optom. Rajesh Wadhwa, Guest Faculty-AIIMS, New Delhi, Usman Khan, Asit KumatJadhav,

        Note: Letter to editors are personal opinions. The letter did not say  that optometrists are quacks. The latter was in relation to all those who write the word Dr in front of their names. Emedinews respect all professions and professionals.

  1. Can a pediatrician see a adult patient- Medico legal aspect
    Dear Sir, I am a regular reader of E-Medinews since its inception. I want to know that, can a pediatrician see a adult patient for illness like URI, allergic rhinitis or bronchitis, malaria, typhoid etc. if he feels comfortable? Is there any medico-legal issue to treat adult patient? Because most of the time when a child comes to us for any seasonal problems then parents also want consultation for themselves then we have to treat them also.  If I feel that I am competent enough to see them, what is the medico-legal aspect of this, plz elaborate: Dr. Anuj K. Goyal, MBBS, MD (Pediatric), Newborn, Child & Adolescent Specialist
    eMedinews Responds: My personal opinion is yes. Every specialist is also MBBS and can practice basic health care. The judgment also said that Pediatric specialist should have attended the adult though it was in relation to an emergency.
 

Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

5th September: 3 PM to 5 PM – A dialogue with His Holiness Dalai Lama at Parliament Street Annexe in association with Acharya Sushil Muni Ahimsa Peace Award Trust

26th September: BSNL Dil ka Darbar A day–long interaction with top cardiologists of the city. 8 AM – 5 PM at MAMC Auditorium, Dilli Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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