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  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

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

 
  Editorial …

5th June 2012, Tuesday

Today is World Environment Day

New York plans a ban on big sizes of sugary drinks

New York City plans to enact a far–reaching ban on the sale of large sodas and other sugary drinks at restaurants, movie theaters and street carts, in the most ambitious effort yet by the administration of Mayor Michael R. Bloomberg to combat rising obesity. The proposed ban would affect virtually the entire menu of popular sugary drinks found in delis, fast–food franchises and even sports arenas, from energy drinks to pre–sweetened iced teas. The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first–in–the–nation plan, which could take effect as soon as next March.

Plain water intake is associated with less risk for type 2 diabetes in women: According to a study published online May 2 in the American Journal of Clinical Nutrition, women who drank water instead of fruit juice or sugary sodas appeared to have about a 7% less risk for developing type 2 diabetes.

High levels of exercise may prevent stiffening of arteries in middle-aged people: High levels of exercise help prevent stiffening of the arteries in middle-aged people, according to a study scheduled to be presented at the American College of Sports Medicine's annual meeting.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Today is World Environment Day

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

No Tobacco Day 2012

DMA and Heart Care Foundation of India demanded ban on Gutka, Tobacco and Tobacco Products in Delhi on the occasion of World No Tobacco Day.

A Poster was released for the same

 
Dr K K Aggarwal
 
    National News

Soon, breath test to tell tuberculosis in just 6 minutes

MUMBAI: A breath test to detect the deadly tuberculosis (TB) bacteria in six minutes flat has been developed in the US, with help from experts in Mumbai. Doctors from Hinduja Hospital in Mahim and the state–run JJ Hospital in Byculla have helped validate the prototype for the point–of–breath test, according to an article published in medical journal ‘Tuberculosis’ recently. The test could emerge as the quickest way to screen a patient for lung or pulmonary TB. "For years, researchers have grappled with a genuine point–of–care test for TB —one which can answer the question of TB or no TB before the patient leaves the clinic. This test is one which has the potential to do this," said Dr Zarir Udwadia from Hinduja Hospital who, along with JJ Hospital’s N N Ramraje, is one of the co–authors of the ‘Tuberculosis’ article. It works on the principle that every TB bacillus produces volatile organic compound. "The breath test detects these volatile organic compounds," Dr Michael Phillips, developer of the test and CEO of Menssana Research Inc, stated in a press release. (Source: TOI, Jun 3, 2012)

For comments and archives

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 Dr Monica and Brahm Vasudev)

AUA issues new guidelines at annual meeting

At the 2012 Annual Scientific Meeting, the American Urological Association (AUA) issued new guidelines on overactive bladder (OAB), microscopic hematuria, vasectomy, and urodynamics. (Source: Medscape)

For Comments and archives…

Varying safety, efficacy of approved stents

A comprehensive meta–analysis of randomized, clinical trials that tested approved drug–eluting stents (DES) against each other or bare–metal stents (BMS) has shown that DES are highly effective in reducing target vessel revascularization (TVR) compared with BMS and are not associated with an increased risk of adverse outcomes, including stent thrombosis. (Source: Medscape)

For Comments and archives…

Exercise worsens a CV risk factor in 10% of people

A group of exercise scientists have reported, for the first time, that exercise may not improve all cardiovascular risk factors in all people. In their paper published in PLoS One, which combined findings from six studies, Dr Claude Bouchard (Pennington Biomedical Research Center, Baton Rouge, LA) and colleagues showed that 8–13% of almost 1700 participants experienced an adverse response to exercise for one specific risk factor. (Source: Medscape)

For Comments and archives…

FDA, others recommend use of blunt–tip suture needles

Several government agencies have teamed up to issue a safety communication recommending the use of blunt–tip surgical suture needles to reduce the risk for needlestick injuries and possible subsequent bloodborne pathogen transmission to surgical personnel. The statement was issued yesterday by the US Food and Drug Administration (FDA), the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health, and the Occupational Safety and Health Administration (OSHA). According to the alert, blunt–tip suture needles, "which are not as sharp as standard (sharp–tip) suture needles, are designed to penetrate muscle and fascia and reduce the risk of needlesticks." (Source: Medscape)

For Comments and archives…

 
    Prayer Meeting

Dr. Vidya Prakash Sood (13/04/1936 – 03/03/2012)

A prayer meeting will be held to pay homage to the departed soul of Dr VP Sood
(Issue Editor – Asian Journal of Ear, Nose and Throat) who passed away peacefully on March 3, 2012 in USA.

Date: Sunday 10th June 2012
Venue: Chinmaya Mission (Auditorium), 89, Lodhi Road, New Delhi.
Time: 11 A.M – 12 Noon

(IJCP and eMedinews)

 
    Twitter of the Day

@DrKKAggarwal: The Science Of Hygiene Everybody is taught to learn about hygienic living and this should be a chapter in every… http://fb.me/QIXBF19y

@DeepakChopra: The light of the universe carries cosmic memory

 
    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Sugary Drinks Versus Sugary Mithai (sweets)

When we talk about health, everybody talks against soft drinks. They say that one should not substitute water with soft drinks. One should take not more than one soft drink a day.

For Comments and archives…

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What do you understand by Egg Donation?

If you’re over 40, and have not succeeded with other therapies, or if you have premature ovarian failure (POF), also known as early menopause, your treatment options are limited. One option is egg donation, which involves the use of eggs donated by another woman who is typically in her 20s or early 30s. If you are over 40, eggs from a younger woman are more likely to result in pregnancy and are less likely to end in miscarriage. Your chance of pregnancy is much higher in IVF cycles using donor eggs. The high success rate with egg donation confirms that egg quality is the primary barrier to pregnancy in older women.

For Comments and archives…

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Administration of Blood Components

The safety and efficacy of transfusion practice requires that medical, nursing and transfusion service staff have comprehensive policies and procedures for blood administration that are designed to prevent or reduce errors. The medical director of the transfusion service, the directors of the clinical services, and all personnel involved should collaborate in developing these. Policies and procedures are effective only when they are accessible, periodically reviewed for appropriateness and monitored for compliance.

For Comments and archives…

 
    An Inspirational Story

(Ms Ritu Sinha)

Most Excellent Adventures

My friend, Jessie and I have known each other since the earth’s crust was cooling……Or maybe it just seems that way!

Friendships get more precious as you get older, and when we hit our forties, we decided we needed to put in a little more work to keep our friendship strong, healthy and growing. Our solution? We pick out one Saturday a month and promise to do something. Sometimes it has been as little as getting together for a long lunch out. Other times we have added a movie or shopping. But at least once a quarter, we have an adventure!

Over the past few years these adventures have ranged from just hopping in the car and driving to a location which we picked with our eyes closed, (in other words, we played our own version of "Pin the tail on the donkey" using a map!) Other adventures involved an overnighter that took in a festival and a giant Christmas craft sale, or sometimes we just drove, stopping wherever we wanted. We have headed into downtown Atlanta or a suburb on the other side of the Metro area just to explore. We have been to an assortment of regional Food, Flower and Craft Festivals. We have headed out of state to Tennessee. We have gone on antique quests and bargain hunts. We have tried out new restaurants and new cuisines. We’ve gone on great Christian retreats and conferences, and we almost went to a foreign language film, but chickened out because we were too tired to read subtitles! (It had been one of those weeks at work!).

One of our adventures took us to a very small town in South Georgia. It was one of those watermelon or cotton or peanut festivals, and we enjoyed buying the hand–made gifts and eating the terrific regional foods. There was also a parade, with local dignitaries and beauty queens as well as the school marching bands and service groups. It was a real piece of small town Americana, and we had a great day! We waited for the parade to end near our car, and then pulled out behind it to head back to the big city. Unfortunately, the parade wasn’t over! We gasped in dismay when in the rear view mirrors we saw the high school band turn a corner and come up behind us! The band must have stopped to re–group and we slid into the gap unknowingly. We tried to turn off, but the side streets were still blocked for the parade.

So we did what any normal middle–aged women would do……we began smiling and waving! (Hasn’t every woman practiced this sometime during her life???) Everyone smiled and waved back! Of course, their smiling faces turned confused and puzzled as we passed and they saw no signs on our car. "Who are these women? And why are they in our parade???" they must have wondered. Finally, we turned a corner and a stern looking policeman directed us back to the highway.

Fun is always on the menu, whether it’s a weekend trip or a couple of hours over lunch. We talk (a lot!) and catch up on each other lives. Yes, we talk on the phone during the week sometimes, but you can’t really get down to the deep stuff over the phone. We share our struggles and our prayer concerns. We ask for and receive advice. And we laugh!

Don’t keep promising yourself that "someday soon" you will start making time for yourself…and your very best friend. Do it now. Pick up that phone and make a plan for THIS weekend. And for once a month after that, and don’t let anything get in the way. You need it. Your friend needs it. You’ll be a happier, healthier person for it! I guarantee it!

For Comments and archives…

 
   Cardiology eMedinewS

Big midsection may up risk of dying suddenly Read More

Dark Chocolate: Sweet prevention for CV events Read More

 
   Pediatric eMedinewS

AAP: Don’t use sensory disorder diagnosis Read More

Oral drug equals subcutaneous in kids’ arthritis Read More

Preemies have more psych problems later Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim of 2 lakhs of seven years duration needed a claim of Rs. 2.2 lakhs.
Dr. Bad: You will have to pay Rs. 20,000 from your pocket.
Dr. Good: You can claim cumulative bonus.
Lesson: Sum insured under the policy shall be progressively increased by 5% for each claim–free year of insured subject to maximum accumulation of 10 claim–free years of insurance.

For comments and archives

Make Sure

Situation: A patient with fever and cough developed complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure that a patient with fever and cough is not given antibiotics as presence of cough mostly signifies viral infection.

For comments and archives

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  Legal Question of the day

(Prof. M C Gupta, Advocate & Medico–legal Consultant)

Q. What are the main judgments against quackery?

Ans.

  • It is wrong for the following reasons:
    • A treating physician, a pathlab, an imaging centre and a surgeon –all these are service providers and provide service under a contract of service against service charges. The contract of service, whether written or unwritten or implied, does not include a term of contract that the service provider, in addition to providing service against payment received in cash, will also obtain from or give further payment to another service provider.
    • It is an unfair trade practice in terms of section 2(r)(6) of the Consumer Protection Act, 1986.
    • It is violative of regulation no. 6.4 and 6.5 of the MCI, 2002, regulations, reproduced below.

      "6.4 Rebates and Commission:

      6.4.1 A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A physician shall not directly or indirectly, participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.

      6.4.2 Provisions of para 6.4.1 shall apply with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study/work. Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision."
  • A physician is not a businessman or a trader. He is a service provider. It is legal to charge a commission in many trades. The sellers of stocks and debentures and even the government organisations like the LIC and the PPF organisation give commission to their agents. But the LIC agent gives a service to the person who gets his life insured and, as a service provider, it is illegal for him to pass on a part of the commission received to the beneficiary of his services.

For comments and archives

 
  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Hepatitis B Vaccine

Hepatitis B virus (HBV) is a DNA virus which infects and affects liver. It has a long incubation period (45–180 days). The sequelae of hepatitis B infection include: chronic active hepatitis, cirrhosis and hepatocellular carcinoma in a small percentage of cases.

HBV can be transmitted from infected mother to the child and various other routes (sexual, from use of contaminated needles, transfusion of contaminated blood, needle stick/sharp injury involving contaminated blood or body fluid) HBV vaccine induces antibody which is protective in >95 % of vaccines. HBV vaccine is the virus surface antigen (Hbs AG) prepared by recombinant DNA technology. The vaccine is given IM by qualified person following the infection control practices. Sterilized needle and syringe should be used for each child/person vaccinated. A total of three to four doses are given at 0, 1 and 3 months interval. One more dose of vaccine is administered in low responders in whom the antibody is not adequate. The protection is measured by estimating antibody to HbsAg. A value of 10–100 IU ensures that the vaccinated individual is protected.

Minor and transient adverse events may occur after Hep B immunization. These include soreness at infection site fever, nausea, dizziness, myalgia and arthralgia.

 
  Quote of the Day

(Dr GM Singh)

Wisdom is knowing what to do next, skill is knowing how to do it, and virtue is doing it. David Starr Jordan

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Thyroxine (T4)

  • This is a measurement of the total thyroxine in the serum, including both the physiologically active (free) form, and the inactive form bound to thyroxine–binding globulin (TBG). It is increased in hyperthyroidism and in euthyroid states characterized by increased TBG. Occasionally, hyperthyroidism will not be manifested by elevation of T4 (free or total), but only by elevation of T3 (triiodothyronine). Therefore, if thyrotoxicosis is clinically suspected, and T4 and FTI are normal, the test "T3–RIA" is recommended (this is not the same test as "T3 uptake," which has nothing to do with the amount of T3 in the patient’s serum).
  • T4 is decreased in hypothyroidism and in euthyroid states characterized by decreased TBG. A separate test for "T4" is available, but it is not usually necessary for the diagnosis of functional thyroid disorders.
 
    Mind Teaser

Read this…………………

Marina with acute renal failure moves into the diuretic phase after one week of therapy. During this phase the client must be assessed for signs of developing:

a. Hypovolemia
b. Renal failure
c. Metabolic acidosis
d. Hyperkalemia

Yesterday’s Mind Teaser: Mang Jose with rheumatoid arthritis states, "the only time I am without pain is when I lie in bed perfectly still". During the convalescent stage, the nurse in charge with Mang Jose should encourage:

a. Active joint flexion and extension
b. Continued immobility until pain subsides
c. Range of motion exercises twice daily
d. Flexion exercises three times daily

Answer for Yesterday’s Mind Teaser: a. Active joint flexion and extension

Correct answers received from: Dr KV Sarma, Dr PC Das, Dr Niraj Kumar, Dr Thakor Hitendrsinh G, Raju Kuppusamy, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, U Gaur.

Answer for 3rd June Mind Teaser: c. Assess the client’s feet for sensation and circulation
Correct answers received from: Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, U Gaur.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Senior Greeter, this is Priceless

Charley, a new retiree–greeter at Wal–Mart, just couldn’t seem to get to work on time. Every day he was 5, 10, 15 minutes late. But he was a good worker, really tidy, clean–shaven, sharp–minded and a real credit to the company and obviously demonstrating their "Older Person Friendly" policies.

One day the boss called him into the office for a talk. "Charley, I have to tell you, I like your work ethic, you do a bang–up job when you finally get here; but your being late so often is quite bothersome."

"Yes, I know boss, and I am working on it." "Well good, you are a team player. That’s what I like to hear."

"Yes sir, I understand your concern and I’ll try harder."

Seeming puzzled, the manager went on to comment, "It’s odd though you’re coming in late. I know you’re retired from the Armed Forces. What did they say to you there if you showed up in the morning so late and so often?"

The old man looked down at the floor, then smiled.

He chuckled quietly, then said with a grin, "They usually saluted and said, ‘Good morning, Admiral, can I get you a coffee, sir?’"

 
  Medicolegal Update

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

World Medical Association Declaration–WMA 5th World Conference on Medical Education

The prime concern of all Medical Associations in every country should dedicate themselves to marshalling the resources needed to provide for and guide quality medical education. This should be done in the context of appropriately sized classes with access to adequate faculty member, facilities and funding.

  • To focus professional and public support for medical education, medical associations in all countries should be acutely aware of the needs, opinions, expectations and personal dignity of their citizens.
  • The goal of medical education should be to produce competent and ethical physicians, who respect their roles in the physician patient relationship.
  • The elements of competence must include knowledge, skills, values behaviors and ethics, which provide quality preventive and curative care for individual patients and the community.
  • Research, teaching and ethical patient care are inseparable and essential to achieving the goal of physician competence.
  • An international core curriculum should be developed that will produce and maintain a competent physician whose skills transcend international borders.
  • Internationally standardized methods of assessing professional competence and performance should be developed and applied in undergraduate, graduate and continuing medical education.
  • Free and prompt international dissemination of professionally generated and analyzed medical information should be exchanged on epidemiological and public health problems to guide the development of public policies, the education of physician, and the public.
  • International standards should be established for the evaluation of educational programs across the country.

(Adopted by the 43rd World Medical Assembly Malta, November 1991)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Small weight gain a risk to kidneys

In healthy men of normal weight, relatively small increases in weight raise the risk of chronic kidney disease (CKD), said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India. Quoting a study reported in the Journal of the American Society of Nephrology, Dr Aggarwal said that CKD should be added to the list of conditions that are associated with weight gain, including diabetes and high blood pressure.

Obesity is a known risk factor for CKD, but weight gain in normal–weight individuals without high blood pressure or diabetes is now shown to be an added risk factor.

The experts followed 8792 healthy men ages 30 to 59 years with no known risk factors for CKD between 2002 and 2007. The prevalence of obesity was about 33 percent. The researchers observed a U–shaped association between changes in weight categories among normal–weight and overweight subjects and the development of CKD. Men who lost or gained a lot of weight (more than 0.75 kgs, or 1.7 pounds, per year) had the highest risk of developing CKD. Increased risk was seen among men with even small weight changes. The lowest risk observed was among those who gained or lost as little as 0.25 kgs, or 0.6 pounds, per year.

The findings suggest that weight gain within ‘the normal’ weight range is clearly one of the risk factors in developing CKD, and initial low body mass index does not counteract the deleterious effect of weight gain.

Avoidance of weight gain, even among lean individuals, is important to reduce the risk for this disease.

 
    Readers Response
  1. Dear Sir, I agree that Doctors are becoming a soft target of Media and shows like Satyameva Jayate. Omprakash Shukla.
 
    Forthcoming Events
Dr K K Aggarwal

4th Asia Pacific Vascular Intervention Course (APVIC–IV)

Date: June 8–10–2012

THE OBEROI, Dr. Zakir Hussain Marg, New Delhi
In association with ‘International Society of Endovascular Specialists’ ‘Vascular Society of India’ ‘Society of Cardiovascular Angiography & Interventions’

IYCNCON 2012

All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
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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 Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta