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 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 …

5th April, 2011, Tuesday                                eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Patients with diabetes may have 70% increased risk for dying from liver disease

People with diabetes are 70% more likely to die from liver disease than those without the condition, according to findings presented at the Diabetes UK Annual Professional Conference. Over a six–year period to 2007, the researchers compared medical records data from 1,267 diabetes sufferers to 10,100 people without the condition, who all died of liver disease. The results showed that 24% of the patients with diabetes died of liver cancer compared to 9% of the non–diabetic patients. In contrast, more non–diabetic patients died from alcoholic liver disease, compared to those with diabetes, at 63% and 38%, respectively.

Diabetes patients have a higher risk of developing Parkinson’s disease

According to a study published in the journal Diabetes Care, individuals with diabetes are at a greater risk of being diagnosed with Parkinson’s disease.

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

CKD Update

Dr KK Aggarwal Speaks on
‘Estimated prevalence of CKD ’
 

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Vaishya Bhushan Award


Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India received the Vaishya Bhushan Award at the All India Vaishya Sammelan on 3rd April 2011

 
Dr K K Aggarwal
 
    National News

Health research in India poor: Lancet study

NEW DELHI: Expressing concern over the scarcity of research on the routine health-information system in both reports and published papers, which is crucial to track the response of the health system to the health needs of the population, a paper on “Research to achieve health care for all in India” published in the latest edition of The Lancet medical journal has suggested that major national organisations of health research in India come together to provide effective stewardship. Co-authored, among others, by Vishwa Mohan Katoch, Director-General of the Indian Council of Medical Research (ICMR), the paper suggests that these organisations collaboratively develop mechanisms that enable agreement on tangible mid-term and long-term targets for health research in the country, create a plan of action and methods to track the progress in research utilisation to achieve health care for all. Although solutions for India will have to be tailored to its circumstances, there are useful lessons to be learnt from the systematic efforts of other countries aimed at matching research with public health priorities to more effectively improve population health, says the paper written by Lalit Dandona and Rakhi Dandona along with Dr. Katoch. (Source: The Hindu, Apr 04, 2011)

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Parents: You can make a difference!

Despite this news from the CDC, a new study published this month in Medicine & Science in Sports & Exercise offers hope. Australian researchers studied a group of 165 children aged five through nine years, and followed them for one year. Children were exposed to a dietary intervention program, a physical activity program, or a combination of both; they also completed periodic surveys. All children lost weight and decreased their average screen time (the time they were exposed to television, video game and a computer); however results pointed to one major difference between individual subjects. Researchers concluded that there was a significant difference between children who received parental support and motivation, and children whose parents were uninvolved or indifferent about their lifestyle programs. Parents who were actively supportive of their children's efforts helped to reduce screen time by one hour per day. This could amount to an extra hour of much needed physical activity or play time for kids.

(Dr Monica and Brahm Vasudev)

Prostate cancer screening may not reduce death risk

According to a 20–year study of more than 9,000 Swedish men, published online in the British Medical Journal, researchers found no difference in the rate of prostate cancer deaths between the men who were periodically screened and those who weren’t.

Hands–free faucets may harbor more germs than manual types

Hands–free electronic faucets can save a lot of water –– and because you don’t have to touch them with your grubby fingers to turn them on, have widely been assumed to help fight the spread of germs, too. However, a team at the Johns Hopkins Hospital in Baltimore has discovered that at their facility, electronic faucets were more likely to be contaminated with Legionella bacteria than the old–fashioned manual type.

Analysis finds no association between vitamin D intake, cancer prevention

Institute of Medicine panel that recently published a definitive report on vitamin D and health outcomes also published a Perspective that focuses specifically on vitamin D and cancer in the New England Journal of Medicine. The committee’s meta–analysis revealed that the research is inconsistent and doesn’t establish a cause–effect relationship.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with A1c of 6.5%.
Dr Bad: Start a combination of Glimepiride and Metformin.
Dr Good: Start Metformin monotherapy.
Lesson: Metformin typically lowers fasting blood glucose concentrations by approximately 20% and A1c by 1.5%, a response similar to that achieved with a sulfonylurea. (Diabetes Care 1992;5:755 and N Engl J Med 1996 334:574)

Make Sure

Situation: A patient of jaundice with fever developed complications.
Reaction: Oh my God! Why were other causes of jaundice not suspected?
Lesson: Make sure that in a patient with jaundice and fever, causes other than viral hepatitis are looked into. In viral hepatitis, jaundice appears after the fever subsides.

 
    An Inspirational Story

(Dr Prachi Garg)

Money is yours but resources belong to the society

Germany is a highly industrialized country. It produces top brands like Benz, BMW, Siemens etc. The nuclear reactor pump is made in a small town in this country. In such a country, many will think its people lead a luxurious life. At least that was my impression before my study trip.

When I arrived at Hamburg, my colleagues who work in Hamburg arranged a welcome party for me in a restaurant. As we walked into the restaurant, we noticed that a lot of tables were empty. There was a table where a young couple was having their meal. There were only two dishes and two cans of beer on the table. I wondered if such simple meal could be romantic and whether the girl will leave this stingy guy. There were a few old ladies on another table. When a dish is served, the waiter would distribute the food for them, and they would finish every bit of the food on their plates. We did not pay much attention to them, as we were looking forward to the dishes we ordered. As we were hungry, our local colleague ordered more food for us.

As the restaurant was quiet, the food came quite fast. Since there were other activities arranged for us, we did not spend much time dining. When we left, there was still about one third of unconsumed food on the table.

When we were leaving the restaurant, we heard someone calling us. We noticed the old ladies in the restaurant were talking about us to the restaurant owner. When they spoke to us in English, we understood that they were unhappy about us wasting so much food. We immediately felt that they were really being too busybody. "We paid for our food, it is none of your business how much food we left behind," my colleague Gui told the old ladies.

The old ladies were furious. One of them immediately took her hand phone out and made a call to someone. After a while, a man in uniform claimed to be an officer from the Social Security organization arrived. Upon knowing what the dispute was, he issued us a 50 Mark fine. We all kept quiet. The local colleague took out a 50 Mark note and repeatedly apologized to the officer.

The officer told us in a stern voice, "Order what you can consume, money is yours but resources belong to the society. There are many others in the world who are facing shortage of resources. You have no reason to waste resources." Our face turned red. We all agreed with him in our hearts. The mindset of people of this rich country put all of us to shame.

WE REALLY NEED TO REFLECT ON THIS. We are from country which is not very rich in resources. To save face, we order large quantity and also waste food when we give others a treat. This incident taught us a lesson to think seriously about changing our bad habits. My colleague Xeroxed the fine ticket and gave a copy to each of us as a souvenir. All of us kept it and pasted on our wall to remind us that we shall never be wasteful.

ijcpgroup

Docconnect
Docconnect
 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

What are the precautions one should take after an IVF procedure?

The procedure demands no special precautions, but strenuous activity should be avoided. We advise the patients to be mentally and physically relaxed as much as possible. You can return to work if you wish, but first prefer to have a few days rest.

 
    Medicine Update

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

What is the BMI classification for children?

Body Mass Index (BMI) classification of children and adolescents is as below.

BMI percentile for age
Weight status
<5th percentile
Underweight
5th–84th percentile
Normal weight
85th–94th percentile
At risk for overweight
≥95th percentile
Overweight
 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What is a surgical error?

The word Surgery came from 'chirurgiae', which means ‘hand work’. However today in medical specialty, the term surgery incorporates uses of operative manual, various computerized instrumental techniques along with hand work on a patient for surgical procedure. The surgical operations are performed maintaining a standard with the best of his ability and capability by the surgeon without any problems or complications and the same is true in most surgeries in various hospitals. But, every year some patients complain of unnecessary harm to health and life due to performed surgical errors. Sometimes the damage caused is repairable and does not give rise to any long–term effects side by side. In some other cases, the negligence result in permanent disability or even a fatality.

  • All operations naturally carry with them a certain level of risk and there are also specific risks of each different procedure.
  • Each and every case where there may be problem during or following an surgical operation, risks should be carefully explained to a patient before the procedure goes ahead
  • An informed choice about having surgery and the possible complications must be explained in a language which the patient/legal heirs fully understand. Failure to do this may constitute negligence in itself.
  • The Delhi Medical Council has reiterated in many cases about informed consent.
 
    Legal Question of the Day

(Dr. M C Gupta)

Q. Is it necessary that the Investigation Officer (IO) should be present in the autopsy room when the autopsy is being conducted?

Ans. This is an unexpected question. I don’t know its genesis. I would respond as follows:

  • The answer can be as per law; convention; or, legal reasoning.
  • As per law, there is no law, to my knowledge, that stats that the IO should be present in the autopsy room. As a matter of fact, only an authorised person should be allowed at the time of conducting autopsy. The IO is not an authorised person.
  • As per convention, the police officer is often present at the time of autopsy in the USA. This may be compatible with a situation when police investigates crime in a dedicated manner without extraneous considerations and without trying to throw their weight around.
  • As per legal reasoning, the presence of the IO in the autopsy room may be objectionable for the following reasons:
    • The police is the prosecution. Autopsy constitutes expert opinion/evidence. The presence of the IO in the autopsy room would be objectionable because of the likelihood of collusion/undue influence.
    • The medical expert has a right to work independently and without hindrance. His authority cannot be undermined by "compulsory" presence of the IO.
  • If the IO insists on being present, the request should be gently but firmly declined. He has no business being there.
  • The above does not mean that there should be a friction between the IO and the autopsy surgeon. They have to work in co–operation towards the common objective of tackling crime in society for which purpose both are under a legal duty to perform their respective tasks.
  • When the autopsy surgeon wants, he can always request the IO to step inside the autopsy room. This may be desirable when there is a discrepancy between the injuries actually as actually present and as mentioned in the police papers, including form 25–35. In such a situation, the anomaly in the police report can be pointed out to him and he can be asked to sign the same. For example, the police papers might have mentioned as bruises what were actually spots of post mortem staining. Similarly, an obvious fatal injury might not have been mentioned in their report. Such interaction might even act as a source of valuable learning on the part of the police and such mistakes may thus be minimised in future.
  • The purpose of keeping away the IO is not to perform the autopsy secretly but to perform it in a free atmosphere devoid of police influence. Transparency is always a good principle. That is why it is always a good practice that the entire autopsy should be videographed. If this is being done, the possibility of undue police influence would decrease and the presence of the IO might not matter much.
 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Life Pre and Post Obesity surgery: FAQs

What should the diet plan for weight loss?

Reducing calories is one requirement for weight loss. Cutting only 100 extra calories a day from one’s diet will lead to a weight loss of 10 pounds in a year, while cutting 500 calories a day will lead to a loss of 50 pounds in a year.

About 25 to 30% of total calories should be from fat (mainly unsaturated fat, such as olive oil, corn oil, and safflower oil), 15 percent from protein, and 50 to 60% from carbohydrates (mainly complex carbohydrates, such as fruits and vegetables). Recommended total calories should be based on height, weight, age, and activity level. A plant-based diet, consisting of an abundance of fresh vegetables and fruit and limited in calories, seems to be a healthful one for most people.

 
    Head Injury Update

Dr Shameem Ahmed, Dr Atanu Borthakur, Dr Sajida Sultana, Dr Shabbir Khan. Dept. of Trauma and Neurosurgery, Hayat Hospital, Guwahati, Assam.

Primary care includes maintenance of airway, breathing and circulation. Surgery is required in 2-5% patients with large clot, compound injury or to reduce intra cranial pressure (ICP), so as to prevent brain ischemia and thus preventing brain damage. Surgery does not mean cure, it is a chance of survival.

 
    Mind Teaser

Read this…………………

I’M you

Yesterday’s eQuiz: Which is the most common HPV type causing cervical cancer:
a.HPV–16
b.HPV–18
c.HPV–31
d.HPV–33

Answer for Yesterday’s eQuiz: a.

Correct answers received from: Dr Parul Chopra Buttan, Dr Jaiyesh Kumar, Dr S Uadhyaya, Dr
K Raju, Prabha Luhadia, Dr Rajshree Aggarwal, Dr Rakesh Bhasin, Dr Deeptara Pathak, Dr Anil Bairaria.

Answer for 3rd April eQuiz: B. Anti –HPV antibodies are type specific with little or no cross reactivity
Correct answers received from: Dr Anupam Sethi Malhotra.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr. Veena Aggarwal)

The Leave Application

A leave letter to the headmaster: "As I am studying in this school I am suffering from headache.
I request you to leave me today"

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

What is the complete blood count test?

The complete blood count or CBC is one of the most commonly ordered blood tests. It is the calculation of the cellular elements of blood. These calculations are generally determined by special machines that analyze the different components of blood in less than a minute.

A major portion of the complete blood count is the measure of the concentration of white blood cells, red blood cells, and platelets in the blood. We recommend screening slides for all abnormal CBC parameters.

 
    Medi Finance Update

(Dr GM Singh)

Can I use PAN to pay the TDS deducted into government account?

No. You are required to take a separate Tax Deduction Account Number (TAN) by making an application in form 49B with the TIN facilitation center of NSDL.

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Calcium carbonate 600mg + Simethicone 80mg Chewable tablet
To relieve the uncomfortable symptoms of acid indigestion, heartburn, gas or sour stomach
28/05/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Two randomized trials evaluated HPV screening, in conjunction with cytology, for cervical cancer screening. HPV testing led to earlier detection of high–grade cervical lesions but identified large numbers of women, especially at younger ages, with lesions that would regress without treatment (Lancet Oncol 2009;10:672 and Lancet Oncol 2010;11:249.)

(Dr Vinay Sakhuja)

Latin Quotes

Accipere quam facere injurium praestat.

It is better to suffer an injustice than to do an injustice.

 
  Quote of the Day

(Mr Anil Jaju)

Anger is a Wide ball – Leave it
Fear is a No ball – Let it
Smile is a Sixer – Hit it
Friendship is a Wicket – Get it
Failure is Bouncer – Forget it
Problem is a Yorker – Face it
Success is a Century – Make it
Luck is a Free hit – Use it
Then u can rock the World Cup of Life...

 
    Readers Responses

1. Dear Sir, kindly refer to the communication by Dr Kunal Das regarding group Life, Accidental and Health insurance of doctors. It is a very commendable and practical suggestion and needs to be taken up by IMA and other medical associations with Insurance companies, IRDA and the Finance Ministry. As far as health insurance is considered I would like to have a clarification from you or one of your experts regarding the medical ethics of treating a fellow medical practitioner and their family in gratuitous manner by a practitioner of modern medicine. It is observed that medical practitioners do not hesitate to charge even their medical colleagues, which is against the ethics of the medical profession. Please let the readers know the factual position on this. Regards; Dr Suman Kumar Sinha, Consultant Psychiatrist, A/Prof. of Psychiatry, Lady Hardinge Medical College Convenor: Task force on NMHP, Indian Psychiatric Society.

2. Congratulations, 14 Saal Baad Seeta Ji (Cup) Ka Vanwaas Samapt Hua.Your similies were wonderful today morning. Dr Anupam

3. Dear Dr KKA, Our congrats to team India!!! You wrote superbly about the semis win also ……Congratulations to our great Indian team & the people of India for the splendid support! On behalf of our entire medical fraternity we congratulate Team India! Thanks for the prophetic wishes from your pen: Dr LVK Moorthy, President, IMA TNSB 2008–09.

 
    Public Forum

(Press Release for use by the newspapers)

Vaishya Bhushan for Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India was honored with the ‘Vaishya Bhushan Award’ at the All India Vaishya Sammelan

The awards were given by Minister of Science and Technology Mr. Pawan Kumar Bansal and Member of Parliament Mr. Girish Kumar Sanghi in a ceremony held at Siri Fort Auditorium. Over 2000 members of the public were present at the function.

Dr. KK Aggarwal was given this award because of his devoted and profound services in health care of the people.  Dr. Aggarwal is well-known for organizing the Perfect Health Mela every year for the last 16 years and integrating mythology with science. He is also a senior Lifestyle Cardiologist at Delhi’s Moolchand Medcity, Chairman Ethical Committee Delhi Medical Council and Past President, Delhi Medical Association. He has also served as the Head of Research and Academic Wings of IMA.

 
    Situation Vacant

Vacancy for a post of Consultant in Pediatric ICU at Medanta – The Medicity Hospital, Sector –38, Gurgaon.
Interested candidates may please contact: drneelam@yahoo.com/9811043475. *Eligibility: Post MD/DNB/DCH

 
    eMedinewS Special

1. eMedinewS audio lectures (This may take a few minutes to open)

2. eMedinewS ebooks (This may take a few minutes to open)

HCFI
Activities eBooks

  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein
 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

DELHI MEDICAL ASSOCIATION

Date: Thursday April 7, 2011
Symposium & Panel Discussion on "Anti Microbial Resistance"

Padama Shri and Dr B C Roy National Awardee Dr KK Aggarwal, Chairman, WHO Day,

Dr Vinod Khetarpal, President, DMA                                    
                   
PROGRAMME

CME: 8.30 pm – 10.00 pm
Topic: Minimising antibiotic resistance
Speaker Dr. Chandramani Punjabi, HOD Resperative Medicine Mata Chanan Devi Hospital
Topic: Management of sepsis and septic shock,
Speaker Professor Baljit Singh, Senior Anaesthetist & Intensivist G.B. Pant Hospital, New Delhi
3. Resistant HIV, Speaker Dr. Nalin Nag Sr. Consultant Internal Medicine Apollo Hospitals
4. Resistant TB, Speaker Dr. Rupak Singla HOD, TB & Chest Diseases LRS Hospital
5. Panel Discussion on Recent Developments Regarding Antimicrobial Resistance:
Moderator: Dr K K Aggarwal, Padama Shri and Dr B C Roy National Awardee

………………………………………………………………

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD , Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, Organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com

………………………………………………………………

May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com

………………………………………………………………

September 30 – October 02, 2011; XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do I assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics.
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org

………………………………………………………………

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta