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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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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 November 2010, Thursday

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

Most of the salt one eats is hidden away in processed foods

The major health effect of eating too much salt is a rise in blood pressure, reports the October 2010 issue of Harvard Men’s Health Watch. Eating salt expands blood volume. The extra volume in turn, may signal the kidneys to trigger a cascade of effects on hormones and blood vessels that increase blood pressure. Reducing intake of dietary salt lowers blood pressure, cuts the risk of heart attack and stroke, and saves lives. Even a modest cutback improves the flexibility of blood vessels and reduces urinary albumin loss, which protects the heart and the kidneys. Salt restriction also lowers the risk of kidney stones by reducing the amount of calcium in the urine.

Current guidelines set an upper limit of 2,300 mg of sodium a day. For people with high blood pressure (hypertension), middle–aged and older adults, the recommended upper limit of daily sodium intake is 1,500 mg.

Salt and sodium: A glossary
When it comes to health, it’s the sodium that counts, whether it comes from table salt or from other sources, such as baking soda (sodium bicarbonate) or MSG (monosodium glutamate). Because sodium is what matters, food labels list the content of sodium, not salt; it’s expressed as milligrams (mg) of sodium.
1,000 mg sodium = 1 g sodium
1 g sodium = 2.5 g salt
1 mmol sodium = 23 mg sodium

Dr KK Aggarwal
Editor in Chief
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Photo Feature (from the HCFI Photo Gallery)

Anmol

17th MTNL Perfect Health Mela 2010

Anmol a festival for children with special needs is a competition organized in the 17th MTNL Perfect Health Mela 2010.

Dr K K Aggarwal
IMSA Update

International Medical Science Academy (IMSA) Update

Tolvaptan in Hyponatremia

The long–term tolvaptan is safe and effective among patients with chronic hyponatremia.
(Ref: Berl T, et al. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol 2010;21:705).

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

Dengue menace abating in city, just 22 fresh cases reported on Tuesday

The dengue menace has started showing some signs of decline in the national capital with the city recording only 22 fresh cases on Tuesday compared to the average of 70 cases per day last week. The total number of patients this season has reached 5,605. Cases of dengue generally start showing a downward trend with the advent of winter as low temperature and less humidity are not conducive to the breeding of dengue-carrier aedes agypti mosquitoes. This year's total is more than double of that reported in 2006 when the number of cases was 2,537. (Source: The Times of India)

Mobile number portability set for November 25 launch

After a two–year–long delay, the Telecom Department has announced the much–awaited Mobile Number Portability (MNP) from November 25, allowing subscribers to change the operator while retaining their mobile number. This decision is expected to force the operators to offer quality services to retain their subscribers. To start with, the facility is being launched from Haryana. (Source: The Pioneer)

International News

(Dr Monica and Brahm Vasudev)

Ankylosing Spondylitis patients at higher heart attack risk

A new research says that patients with ankylosing spondylitis are at a greater risk of heart attack than the general population. Dr. Sylvain Mathieu from Clermont 1 University, Clermont–Ferrand, France, who headed the study, said that systemic inflammation and unhealthy lipid profiles might be compounding the effect of traditional cardiac risk factors in this patient group. The study is published in the October 1st online Arthritis Care & Research. The authors recommend that management of cardiovascular risk factors and control of systemic inflammation should be taken into account in ankylosing spondylitis.

Exercise to prevent Colds

A new 12–week study published online in the British Journal of Sports Medicine states has found that individuals who said they exercised at least five days a week had 43% fewer days with an upper respiratory tract infection than those who exercised no more than one day a week. Similarly, those who rated themselves as highly fit had 46% fewer days with a respiratory infection than those who reported low fitness. According to researchers, each spell of aerobic exercise results in a transient increase in the recirculation of immunoglobulins and neutrophils and natural killer cells, two cells involved in innate immune defenses.

HIV drug useful in chronic hepatitis B

A multicenter European cohort study, presented at the annual meeting of the American Association for the Study of Liver Diseases (AASLD), has found that tenofovir is safe and effective for treating hepatitis B. Tenofovir is a nucleotide analogue reverse transcriptase inhibitor (NRTI) used to treat HIV infection. It was especially useful among patients with hepatitis B not previously exposed to an NRTI drug.

Everolimus approved for benign brain tumor

Everolimus (Afinitor) has been given FDA approval as treatment of subependymal giant cell astrocytoma (SEGA), a benign brain tumor associated with tuberous sclerosis that is most often diagnosed in children and adolescents who are not candidates for surgical resection.

Low sperm quality linked to high dietary fat intake

As per a study presented at the 66th Annual Meeting of the American Society for Reproductive Medicine, a high intake of saturated and monounsaturated fat is associated with significantly low sperm concentration. While, increased intake of polyunsaturated fatty acids is associated with improved sperm motility and morphology. In the study, men with the highest intake of saturated fat had as much as 41% fewer sperm than those with the lowest intake, and those with the highest levels of monounsaturated fat had 46% fewer sperm than those with the lowest intake.

Gastro Update

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

What are the endoscopic findings in UC and CD?

  • Ulcerative colitis: On endoscopy, lesions in colon are typically diffuse, continuous extending proximally from rectum. The rectum is almost always involved. Mucosal pattern is lost, there is easy friability and the ulcers are broad and shallow.
  • Crohn’s disease: Characterized by skip lesions; rectum is frequently spared. On endoscopy, there are apthous lesions, deep ulcers and fissures with intervening edematous areas giving a "cobblestone" appearance. Even strictures may be seen as the depth of inflammation is transmural unlike in UC where the lesions are mucosal except in severe disease. Histologically, non caseating granulomas with fibrosis are seen in CD.
Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What looks promising, in the future, for the treatment of infertility?

There are many new and exciting studies underway. Cytoplasmic transfer, where cytoplasm from a donor’s egg is used with the mother’s own genetic information, looks very promising for women with premature ovarian failure or otherwise diminished ovarian reserve. There are new treatments for women with polycystic ovaries, and much hope for women with endometriosis.

For queries contact: banerjee.kaberi@gmail.com

Rabies Update

Dr. A. K. Gupta, Association for Prevention and Control of Rabies in India (APCRI), Author of "RABIES – the worst death"

Can rabies be transmitted through sexual intercourse?

Rabies virus is present in the semen and to some extent in vaginal secretions. Priapism, increased sexual libido and indulgence are seen in some patients, both male and female. Hence, in the exposed person, a full course of rabies post–exposure vaccination either by Intramuscular (IM) or Intradermal (ID) route should be given. If there is any doubt of Category III exposure i.e. abrasion on penis or in vagina, then serum or HRIG must also be given by IM route.

Medicolegal Update

Dr Sudhir Gupta, Asso. Professor, Forensic Medicine & Toxicology, AIIMS

Antiquity of Indian medicine & medical education

The history and antiquity of Indian medicine is well known in Veda and Sumhita 1400–1500 years BC. Many ancient Indian vedacharyas like Sage Vishwamitra were recognized in the annals of medical science. Acharya Sushrut recorded the first–ever surgical procedures in "Sushrut Samhita," a unique encyclopedia of surgery. He performed challenging operations in his era. In the Sushrut Samhita, he has detailed 300 types of operations and described treatment for twelve types of fractures and six types of dislocations. His details on human embryology are simply amazing. Sushrut used 125 types of surgical instruments including scalpels, lancets, needles, catheters and rectal speculums; mostly designed from the jaws of animals and birds. He has also described several stitching methods; the use of horse’s hair as thread and fibers of bark. Ancient Indians were the pioneers in amputation, caesarean and cranial surgery. Sushrut is venerated as the father of plastic surgery and the science of anesthesia.

Medi Finance Update

Salaried persons

Under terms of employment, dearness allowance and dearness pay should form part of basis salary as this will minimize tax incidence on house rent allowance, gratuity and commuted pension. Similarly, commission paid at a fixed percentage of turnover achieved by the employee will help to reduce tax incidence as it also forms part of salary.

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 combination of laxatives and/or anti-spasmodic drugs in enzyme preparations

Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

ADH

Also known as: Antidiuretic Hormone

  • To help detect, diagnose, and determine the cause of antidiuretic hormone (ADH) deficiency or excess
  • To investigate low blood sodium levels (hyponatremia)
  • To distinguish between the two types of diabetes insipidus
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IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetic nephropathy was found to have a high homocysteine levels.

Dr Bad: Homocysteine has no correlation with nephropathy.
Dr Good: You should control your homocysteine levels.
Lesson: Results of a nested case–control study suggest that hyperhomocysteinemia has an etiologic role in the pathogenesis of diabetic nephropathy. In the study, baseline plasma homocysteine concentrations and mean HbA1C levels during follow–up were significantly higher in patients who developed microalbuminuria than in those who remained normoalbuminuric. Multivariate logistic regression analysis showed that baseline plasma homocysteine level and mean HbA1C were independent predictors of microalbuminuria in type 2 diabetes.

Make Sure

Situation: A diabetic patient died of flu pneumonia.

Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

Quote of the Day (Dr GM Singh)

"Action to be effective must be directed to clearly conceived ends." Jawaharlal Nehru

Mind Teaser

Read this…………………

TENTGOODIONS

Answer for yesterday’s Mind Teaser: "Mixed up child"

Correct answers received from: Dr Kala Sarma, Dr Sudha Nayyar, Dr Vijay Kansal, Dr U Gaur, Dr. Suman Kumar Sinha, Dr. Susheela Gupta

Answer for 2nd November Mind Teaser: "Hand in hand"

Correct answers received from: Dr. Alok Deb, Dr.G.Padmanabhan, Dr. Neeraj Sharma, Dr MK Bhandari

Send your answer to ijcp12@gmail.com

Humor Section

Joke (Dr G M Singh)

Doctor’s Visit

A young woman wasn’t feeling well, and asked one of her co–workers to recommend a physician. "I know a great one in the city, but he is very expensive. Five hundred dollars for the first visit, and one hundred dollars for each one after that."

The woman went to the doctor’s office and, trying to save a little money, cheerily announced. "I’m back!"
Not fooled for a second, the doctor quickly examined her and said, "Very good, just continue the treatment I prescribed on your last visit."

An Inspirational Story

(For Soul Dr Muthumperumal Thirumalpillai)

Capture the Moment

The baby is teething, the children are fighting, and my husband just called and said to eat dinner without him. Okay, one of these days you’ll shout, "Why don’t you grow up and act your age?" … and they will
Or, "You guys get outside and find yourself something to do and don’t slam the door." … and they won’t.
You’ll straighten up their bedrooms all neat and tidy with bumper stickers discarded, bed–spread tucked and smoothed, toys all displayed on the shelves, hangers in the closets, animals caged, and you’ll say out loud, "Now I want you to stay this way!" … and they will.
Then you’ll prepare a perfect dinner with a salad that hasn’t been picked to death, a cake with no finger traces through the frosting, and you’ll say, "Now there’s a meal for company." … but you'll eat it alone.
And you’ll say, "I want complete privacy on the phone! No dancing around, no pantomimes, no demolition crews! Silence! Do you hear me?" … and you’ll have it.
No more plastic tablecloths stained with spaghetti, no more anxious nights under a vaporizer tent, no more dandelion bouquets, no more iron–on patches, no more wet–knotted shoe strings, no more tight boots, or rubber bands on pony tails.
Now, imagine your lipstick with a point. No baby sitter on New Year’s Eve. Washing clothes only once a week. No PTA meetings, no car pools, no blaring radios, having your own roll of tape, no more Christmas presents made out of toothpicks and paste, no more wet–oatmeal kisses, no tooth fairy, no giggles in the dark, no knees to Band–aid.
Only a memory of a voice crying, "Why don’t you grow up?" And in the silence will come the echo, "I did."

Readers Responses
  1. Dear Sir, I would like to wish a very happy and prosperous Diwali to eMedinewS team. eMedinewS has become a medium to keep up to date with all the happenings of medical world. Regards: Dr Anupam
Public Forum

(Press Release for use by the newspapers)

Avoid Sweets on Diwali

Padma Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India has urged upon people especially heart patients to desist from bursting crackers or even go near the noise–producing crackers on occasion of Diwali. Heart patients can suffer an attack leading to morbidity and mortality.

Not only crackers even the blowing of horns on the streets due to heavy Diwali traffic should be banned. People with high blood pressure and other heart aliments should take special precautions as exposure to loud sound can raise blood pressure and put strain on the heart. Loud sound can also cause insomnia, difficulty in concentration and irritability leading to loss of manpower and proneness to accidents.

Avoid sweets
People should avoid taking sweets. Instead, they can take fruits. Foundation has also called upon people to exchange fruits rather than sweets, on the occasion of Diwali.
Asthma and Pollution
Smoke from the fire crackers and sparklers consists of carbon, nitrogenous and sulphur components. This smoke can cause pharyngitis, bronchitis and precipitate or aggravate asthma in susceptible individuals which may be life threatening. People susceptible to upper and lower respiratory tract infection should stay indoors and not expose themselves to the smoke as it can precipitate infection, cough, wheezing or breathing problem. If one has to come out of the house, then he or she should place a multilayered thin wet cloth over the nose and face. The moisture in the cloth will stop inhalation of sulphur dioxide, nitrogen dioxide and other gaseous particles.
As far as possible one should not light crackers and sparkles inside the house. All doors, windows and fans should be open to let the fumes go out of the house, wherever possible, exhaust fans should be used. During firework display stay as far away as possible.
Asthma patients to consult doctors
Patients with known asthma (cardiac or bronchial) should consult their doctor for preventive measures. In spite of routine medications, if their symptoms worsen, they should immediately go to the nearest medical centre for evaluation. Pollution in the air can also cause rise in blood pressure, which can precipitate a heart attack.

Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

November 29, 2010, Monday, 9 AM – 1PM, Moolchand Medcity
"Update on Kidney Transplant".
No Fee. Entry by Invitation. Contact: 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 – 6PM – 2nd eMedinewS revisiting 2010, A Medical Update


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