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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

  Editorial ...

4th October 2010, Monday

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

Camphor – The effective & healthy mosquito repellent!

In the past, man would light ‘diyas’ and ‘dhoop’ and burn camphor on a regular basis as a part of daily puja. These helped to purify the air and keep harmful bacteria, viruses and mosquitoes away!

Camphor or ‘kapur’ is a waxy, white or transparent substance extracted from the wood of the Camphor Laurel tree found in Asia. Camphor has many known medicinal uses viz. it relieves nasal congestion and cough when rubbed on the chest as oil. Camphor is used as an ingredient in throat lozenges and cough syrups and in Vicks. Camphor is also used in some anti–itch ointments, creams and cooling gels because it is can be absorbed through skin and is effective at treating pain locally. It has an effect which makes it a favorite oil to be used in pain relieving massage blends for sore muscles and arthritic. Camphor is known to improve the quality of air making it a better for our lungs and heart.

Camphor is a natural mosquito repellent, with a round–the–clock effect. You do not need to burn camphor to achieve this. There are three easier ways to do it.

  1. Put 2 tablets of commercially available camphor on any warm surface e.g. lighting bulb.
  2. Place 2 tablets of camphor on different corners of the room; places where mosquitoes seem to love to stay! Leave them there and they will evaporate in a day or so keeping the air purer and mosquito free.
  3. Take a wide opened cup or plate with water. Drop 2 tablets of Camphor into the water. Keep the cup with water and camphor in your sleeping room. The quantity of water and camphor may differ from room size. Water evaporates at normal temperature. Camphor slowly starts dissolving in water. The water evaporates with Camphor odor. Adding little hot water gives instant action.
Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the HCFI Photo Gallery)

Heart Care Foundation of India teams up with AAFT
The Heart Care Foundation of India joined hands with Asian Academy of Film and Television (AAFT), the premier film, TV and Media school of India to create awareness on the subject of Good Health
In the photo: Dr KK Aggarwal, President HCFI and Sandeep Marwah, President of AAFT and Marwah Studios at a Press conference to announce the dates of 1st BSNL Dil Ka Darbar 2009.

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Driving risk in dementia

The American Academy of Neurology has updated guidelines for driving risk in patients with dementia . An accompanying systematic review found that although mild dementia increases the likelihood of failing an on–road driving test, 76 to 85 percent of patients with mild dementia were found to be safe drivers. Thus, mild cognitive impairment does not establish that a patient is an unsafe driver. A score of 24 or less on the Mini Mental Status Examination (MMSE) is useful in identifying patients at increased risk for unsafe driving.

(Reference: Iverson DJ, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:1316).

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

Best of performing arts to celebrate the Commonwealth Games

To coincide with the Commonwealth Games in the Capital, Sangeet Natak Akademi is hosting a ten–day festival of performing arts traditions here from October 4 and 13. "Desh Parv" will see participation of 1,400 artistes and 100 technical persons looking after design, lighting, security and cafeteria. In all, 40 shows in 100 hours will be staged at Meghdoot Theatre, Shri Ram Centre Auditorium, Rabindra Bhavan and Kathak Kedra's North Delhi Centre at Harijan Sevak Sangh. The festival has been segregated into five parts –– Kul Varnika (Commonwealth literature in performance), Desaj (diverse expression of the country), Nritya Rupa (dance of India), Natya Darshan (a vision of theatre) and Sangeet Marg (Paths of Indian music) encompassing all forms of performing arts. (Source: The Hindu)

  International News

(Dr Monica and Brahm Vasudev)

Diabetes risk may fall as magnesium intake climbs

Results of a new study by Dr. Ka He of the University of North Carolina at Chapel Hill and colleagues suggest that adequate intake of magnesium in diet can prevent diabetes. In the study, people who consumed the most magnesium in foods and from vitamin supplements were about half as likely to develop diabetes over the next 20 years as compared to individuals who took minimal amounts of magnesium. The results may explain in part why consuming whole grains, which are high in magnesium, is also associated with lower diabetes risk. The study is published in Aug 2010 issue of the journal Diabetes Care.

Air pollution raises risk of sudden cardiac arrest: Study

Fine particles of pollution that linger in the air can increase the risk of sudden cardiac arrest. Researchers compared data about air pollution levels in New York City and 8,216 out–of–hospital cardiac arrests that occurred in the city between 2002 and 2006. They found that a rise of 10 micrograms per cubic meter of air in small–particle air pollution was associated with a 4–10 % increase in the number of out–of–hospital cardiac arrests. Pollution–related cardiac arrests occurred when particulate levels were high but still below the current EPA safety threshold of 35 micrograms per cubic meter of air. (Sept. 20 in the American Journal of Epidemiology)

High blood sugar after surgery linked to surgical site infection

A study in the September issue of Archives of Surgery reports that high levels of blood glucose in the postoperative period may be an important risk factor for infection at the surgical site in patients having general surgery

Supplements fail to relieve joint pain in patients with knee or hip osteoarthritis.

According to a study published online in the BMJ, glucosamine and chondroitin, two popular suppleents taken for arthritis are not helpful. The meta–analysis reviewed pooled data from 10 placebo–controlled trials of the popular supplements that included more than 3,000 patients and showed that there were statistically significant, yet clinically insignificant improvements of joint pain in patients with knee or hip osteoarthritis. The two supplements also had no relevant effect on the more objective measurement of joint space narrowing.

  Hepatology Update

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

How do you approach a case of neonatal cholestasis?
  • PT (prothrombin time)
  • Blood counts
  • LFT
  • Electrolytes
  • Blood culture
  • Urine: microscopy and culture
  • Urine reducing substances
  • Random blood glucose (Pre feed)
  • Ascitic tap (if ascites)
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

What is IUI? What is the average success rate of IUI? How many cycles of IUI can we try?

IUI or intrauterine insemination is a simple OPD procedure. In this procedure washed capacitated sperms are introduced in the uterus. The ovary is stimulated by giving hormone injections to produce multiple follicles and the procedure is carried out when the eggs are about to be released. We have had a good success rate with this method and recommend it as the first–line of treatment in patients who have patent tubes and a reasonably good semen count. Success rate varies according to the indication but around 15% to 18% can be considered good. Most couples conceive within first three cycles of IUI, in subsequent cycles the positive outcome is less. One can try up to six IUI cycles then probably turn to IVF–ET (In Vitro Fertilization Pre–Embryo Transfer).

  Gastro Update: Question of the Day

How do you differentiate between large and small bowel diarrhea? (Dr Rajiv Khosla)

Diarrhea usually results from malabsorption, secretory states and inflammation. Steatorrhea is suggested by pale, smelly stools which would indicate either a small bowel problem or pancreatic insufficiency. In lactose intolerance, the diarrhea tends to be watery. These two are examples of small bowel diarrhea, and it is important to know the cause to distinguish between them, as the diarrheal patterns are different. It is very important to take a good history as watery diarrhea also occurs in colonic diseases like collagenous colitis, which should be typically thought of in an older patient who is using NSAIDs and presents with watery, nonbloody diarrhea. Patient history, examination findings and investigations all play a major part in diagnosing diarrhea. A bloody diarrhea, points to colitis and cramping abdominal pain with diarrhea and vomiting points to a small bowel pathology such as Crohn’s disease.

  Medicolegal Update

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

What is the nature of bullet wounds of the head?

In most of these injuries the bullet passes completely through the skull. As it enters the skull, it produces a clean cut hole in the outer table and a larger hole in the inner table. At the exit point, these conditions are reversed and the hole in the outer table is larger than the hole in the inner table. These facts are often of importance in determining the direction of fire in bullet injuries of the head. The track of a bullet through the brain tissues varies greatly, depending on the range and stability of the bullet. On the other hand, if it remains high velocity at the time of impact with the skull, there may be considerable damage from the cavitation effect within the skull.
  • Fissured fractures often radiate through the vault and base of the skull from the bullet entrance and exit holes.
  • In certain bullet injuries of the head, the bullet may fail to emerge from the skull and in these cases an area of bony comminuting is often found at the site of lodgment.
  • When a bullet strikes the head at a tangent, penetration of the skull may fail to occur, but the force of the bullet may be sufficient to fragment the inner table at the site of impact. Delayed pressure effects and cranial edema may be produced as a result of this.
  Medi Finance Update

What tax benefits can one get on a home loan?

Tax benefits can be claimed on both the principal and interest components of the home loan as per the Income Tax Act. These deductions are available to assesses, who have taken a loan to either buy or build a house.

  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

Drugs prohibited from the date of notification

Fixed dose combinations of Strychnine and Caffeine in tonics

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

No serology test like TB, ELISA or TB gold (gamma interferon) or Mantoux is conclusive for tuberculosis.

  IJCP Special

Dr Good Dr Bad

Situation: A mitral stenosis patient from a remote village came for Surgery.
Dr.Bad: You need mechanical valve.
Dr. Good: You need Bioprosthetic valve.
Lesson: Bioprosthetic valves are recommended for any patient who cannot or will not take oral anticlotting drugs or when there is a clear contraindication to them.

Make Sure

Situation: A patient with Chikungunya had persistent joint pain.
Reaction: Oh my God! Why was Hydroxychloroquine not given?
Lesson: Make sure that all patients with post Chikungunya arthritis are treated with Hydroxychloroquine to reduce chances of death.

SMS of the Day (Dr Chandresh Jardosh)

Bapu ne bola hai "Koi tumhe Email na kare to kuchh nahi, tum Email karte raho. Uski aatma ek din jaroor jaagegi."

ima election
  Mind Teaser

Read this…………………


Answer for yesterday’s Mind Teaser: "Three Musketeers".

Correct answers received from: Dr K. P. Rajalakshmi, Dr.Susheela Gupta, Dr Chandresh Jardosh, Dr Rawat Purushottam Singh

Answer for 2nd October Mind Teaser is: "A. 76 year old male with no other significant past medical history.
B. 64 year old female with congestive heart failure.
C. 49 year old female with HTN and TIA."

Correct answers received from:
Dr Anupam
Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr Chandresh Jardosh)
Pati– Aaj khane me kya Banaogi? Biwi– Jo aap kaho
P– Daal Chawal Banao
B– Abhi kal hi to khaye the.
P– Fir Dal Baati.
B– Mujhe heavy khane se allergy hai.
P– Parathe.
B– Raat ko parathe kaun khata hai.
P– Hotel se le aao
B– Roz roz hotel se nahi.
P– Idli Sambar
B– Isme time lagegaa, pehle bolte na.
P– Maggi hi bana lo, usme time bhi nahi lagegaa.
B– woh koi khana hai, pet hi nahi bhartaa.
P– Fir kya banaogi?
B– Jo aap kaho…

You are an Indian if you (Anuj Goel)
You peel the stamps off letters that the Postal Service missed to stamp.

  An Inspirational Story

Blessings Usually Come In Disguise
The only survivor of a shipwreck washed up on a small, uninhabited island. He prayed feverishly for God to rescue him, and every day he scanned the horizon for help, but none seemed forthcoming. Exhausted, he eventually managed to build a little hut out of driftwood to protect him from the elements and to store his few possessions. But then one day, after scavenging for food, he arrived home to find his little hut in flames, with the smoke rolling up to the sky.

The worst had happened; everything was lost. He was stung with grief and anger. "God, how could you do this to me!" he cried. Early the next day, however, he was awakened by the sound of a ship that was approaching the island. It had come to rescue him.

"How did you know I was here?" asked the weary man of his rescuers. "We saw your smoke signal," they replied. Never forget blessings do come in disguise!!

  Readers Responses
  1. Dear Dr. KK Aggarwal, I have a query regarding teeth clenching. Two yearsback one of my patients had to undergo an MTP for anencephalic baby diagnosed at 12 weeks. Since then she is suffering from teeth clenching whenever she sleeps. She has a 1-year-old son. It has become a habit. Dr Har Kiran Kaur
    eMedinewS responds: Nocturnal bruxism is related to masticatory system and headaches. Bruxism is believed to be a stress-related sleep disorder that occurs in both men and women, in children, and in adults. In most patients, bruxism results only in minor tooth wear; however, it can become extremely severe with damage occurring in essentially every part of the masticatory apparatus. Nocturnal bruxism should not be overlooked as an etiologic factor in muscular headaches. *Short-term acute therapy may involve physical therapy, nocturnal electromyographic biofeedback, and medication to relieve anxiety and improve sleep. *Long-term management* usually includes some form of stress reduction, change in lifestyle, and an occlusal splint or nightguard to protect the teeth and masticatory system.
    Try Escitalopram 10mg at 8am for 6 weeks with Clonazepam 0.25 mg hs in the first week
    Learn parasympathetic breathing
  2. Sir, without knowing what it contains and what are its pharmacological effects on body how can you advise grass juice. Simply in the name of alternative medicine, we should not preach to experiment on this precious human body. Vivek Kumar, varanasi
    eMedinewS responds:
    Wheat grass juice is rich in antioxidants such as carotenoids and flavonoids. (Acta Physiol Hung 1999;86(3-4):171-80)
    Wheat grass juice taken during FAC chemotherapy reduces myelotoxicity, dose reductions, and need for GCSF support, without diminishing efficacy of chemotherapy. (Nutr Cancer. 2007;58(1):43-8)
    Wheat grass juice is high in folic acid and B12.
    Kush – a Symbol of Purity
    "Dharmasaya Dharata" which means religion is what we practice. Hence whatever the wise people thought was good for health and hygiene has been enforced under the garb of religion. Several religious practices are imbued with health-enriching exercises and use of "kush" grass is not an exception to it. No traditional Hindu Indian puja ritual is complete without the use of "durva" (doob) and "kush" grass. Durva grass is used for Ganesh puja and signifies removal of obstacles from life. The peculiarity of durva grass is that if you plant it in one area of a ground it will go on multiplying on its own in a horizontal manner. This implies that a human family should be like a durva grass with spontaneous, effortless and obstacle-less growth.
    The second herb, which is used is "kush" grass known for its purity. In Ramayana, Valmiki named Sita’s two sons as Lav and Kush. At the time of their birth, Valmiki took a blade of "Kush" grass and broke it into two and he named the first son as Kush and other as Luv.
    Kush is a benevolent grass, a symbol of progress and alertness. The word "kushal buddhi" originates from the word "kush" meaning alert, pure and bright mind. Kush is a "satvik" plant and stands for intelligence. In Bhagwad Gita (shloka 6.10) Krishna says that for meditation one should sit on his or her own firm seat that is neither too high nor too low; covered with sacred *kush* grass; deer skin and a cloth, one over the other, in a clean area; "Kush" grass is used to make "asanas" (a mat for sitting) for worshipping and during "yagna"s. It is also used to make the "vedi" used during a marriage ceremony.
    The Garuda Purana describes rituals for a Panchak death. It is cited that when the death of a near relative takes place within the period of Panchak, within a year, five members of the family can die if proper ceremonies are not performed after the death. The rituals involve that before cremation four small dolls made of kush grass (described as the hair of Lord Vishnu) should be placed, accompanied by mantras, on shoulders and knees of the dead body before lighting the pyre. The Garuda Purana also talks about cremating a person whose body has not been found, for instance, in natural calamities, bomb blasts, drowning, etc. It prescribes that on the hearing of the news of the death of a person one should make an effigy of "kush" grass to represent the physical body of the deceased and follow the usual rituals of cremation. Medically it helps in
    reducing the post traumatic stress disorder.
    "Sankalp", a firm intent to do something, is a routine ritual in one's life. When one takes a "sankalp" to do something it becomes obligatory for him or her to do it. It is like taking a vow. "Kush" grass is often held in the hands before taking a sankalp.
    In Ayurveda, Kush grass is called "Desmostachya bipinnata". It is a clean, pure and brittle grass that grows in abundance in the plains and hills of India. It is acrid, cooling, oleaginous, aphrodisiac, and diuretic. The herb has been used in the treatment of blood disorders, asthma, thirst, jaundice, stone in the urinary bladder, disease of skin, uterus, etc.
    Chattisgarh, traditionally known for herbal medicines, uses Kush’s medicinal properties a lot in most of their herbal ingredients. The traditional healers of Chattisgarh use Kush sharbat (syrup) as a boon for female patients for gynecological problems. It is prepared from the extract of Kush root. Once prepared in bulk, the sharbat is used throughout the year.  A garland made from the roots of kush grass is also used for all sacred activities. Most Hindus believe that Lord Vishnu resides in stone (Saligram), tulsi plant, peepal tree and kush grass. Kush is supposed to be there in every house to signify the presence of Lord Vishnu.
    Every ritual has a health meaning. Whatever is offered to God can be taken in the body for the well-being of the soul. "Kush" grass root / leave juices should be consumed by everybody as a health drink. At least it should be offered in the form of a "charnamrut" whenever a ritual is being performed. It makes sense that *kush* grass might have medicinal effects of increasing the alertness in the body and in detoxification of the body.
Public Forum

(Press Release for use by the newspapers)

Heritage: Dance Competition at MTNL Perfect Health Mela

Heritage a special Dance competition will be held during the forthcoming MTNL Perfect Health Mela which is being organised by Heart Care Foundation of India jointly with various Departments of Delhi Government, NGOs and public sector undertakings from 23rd to 31st October at NDMC Grounds Laxmi Bai Nagar, New Delhi.

The competitions will include traditional dance forms of India like Odisi, Bharatnatyam and Kathak. The participants will be both from junior and senior groups. Over 20 dance schools will participate in the event.

Giving the details, Padma Shri and Dr BC Roy National Awardee Dr. K K Aggarwal, President, Heart Care Foundation of India and noted Kathak dance exponents Ms Nalini and Ms Kamalini said that dancing is good for health and classical dance is a mix of exercise and meditation. It is a known fact that dancers do not end up with serious lifestyle disorders.

  Forthcoming Events

CPLD 2010: Dept. of Gastroenterology & Human Nutrition, AIIMS and Dept. of Gastroenterology, PGIMER, Chandigarh are jointly organizing a conference on Current Perspective in Liver Diseases (CPLD) on 15th and 16th October at AIIMS, New Delhi.

eMedinewS Events: Register at emedinews@gmail.com

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

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

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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