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

6th June 2011, Monday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

False Positive HIV report

I participated in a discussion on News 24 channel about a case with a false-positive HIV report on Tuesday night.

A so-called safai karamchari–turned–technician alleged that a Delhi–based medical laboratory had tested him ‘reactive’ for HIV and when he went for re–testing to another laboratory, the test was negative. The technician alleged that after seeing the report as HIV–reactive, his wife left him along with their child. He also alleged that he had undergone a lot of mental agony in his job as a result.

The response of the pathologist was that the said sample had been received from outside for HIV test and no lab technician had withdrawn the sample directly. The sample, which was brought to them from outside, tested ‘reactive’ for HIV by a rapid test and two different ELISA tests. The pathologist lab ordered for a direct sample test from the patient that was then found to be negative.

The alleging technician got the test repeated at Dr. Lal’s Lab and again at Stars Diagnostics. Dr. Lal’s Lab did combo test (with antigen) and reported the result as non reactive. Stars diagnostics also reported a negative result. He had shown the reactive report in both labs.

The situation is clear. It’s a case of false-positive HIV report. As one can have a false–reactive HIV test, one should go for proper pre test counseling. As per NACO policy, no HIV test can be done without pre and post test counseling.

In this case, the gynecologist ordered the test for the couple as a routine protocol and never pre counseled the couple. The pathologist did the test and gave the report without pre and/or post counseling. Also, the pathologist never wrote in the report that "HIV–reactive has to be interpreted clinically and may require further confirmatory test."

  1. In ELISA test,
  2. three different company kits should be reactive before labeling them as reactive test.
  3. Even if you confirm ELISA by three tests, the report should always be written as ‘reactive’ and never as ‘positive’. In a ‘reactive’ report, one should always write ‘post test counseling given and refer to the referring physician for further confirmatory tests and follow up tests as required."
  4. Every HIV ‘reactive’ case in a low risk behavior should be taken with a pinch of salt. In this case the wife tested negative and the husband had no history of high risk behavior. One should have interpreted the ‘reactive’ test as "requires further confirmation by either antigen test or Weston Blot or HIV RNA Load test."
  5. One should also not give a report as HIV ‘reactive’ without doing pre-confirmatory tests with three ELISAs. Even if one test is negative, one cannot label them as HIV ‘reactive’.

    If not handled properly, such disputes may continue to occur and will further damage the already damaged image of the medical profession.

Dr KK Aggarwal
Editor in Chief
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    Changing Practice – Evidence which has changed practice in last one year

Preoperative skin antisepsis

Preoperative skin cleansing with chlorhexidine–alcohol is superior to povidone–iodine. (N Engl J Med 2010;362:18)

 
  eMedinewS Audio PostCard

Diabetes Update

Dr Vinod Sanghi Speaks on
‘The CARE trial’

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

ENVIRONMENT DAY CELEBRATED

Delhi Mayor Prof Rajni Abbi released a poster with a message "Think of metro as your personal limousine; public park as your personal farm house, city river your personal swimming pool & keep them clean in a function organised to celebrate World Environment Day. In the Photo: Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal

 
Dr K K Aggarwal
 
    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

MoEF issues guidelines for ecotourism

Addressing the conflicting issues of wildlife versus tourism, Environment Ministry on Thursday came out with guidelines to develop and monitor the fragile ecosystems and cope with tourist pressure with emphasis on generation of local livelihood. Defining ecotourism as "responsible travel to natural areas" the Ministry stated that the purpose of these guidelines is to conserve the environment and improve the well-being of local people. According to the Ministry, most wilderness areas across India are fragile ecosystems while being major tourist attractions. However, unplanned tourism in such landscapes can destroy the very environment that attracts such tourism in the first place. Hence, there is a need to move towards a model of tourism that is compatible with these fragile landscapes. Clarifying its stand on protected areas, it stated that any core area in a Tiger Reserve from which relocation has been carried out, will not be used for tourism activities. Pilgrim sites which are invariable located inside Protected Areas must be designated as sacred groves, with strict building and expansion controls, in accordance with the Forest Conservation Act, 1980 and the Environment Protection Act, 1986. All transit camps and places of stay for such pilgrimage must be restricted to nominated days in a year. (Source: The Pioneer, June 03, 2011 )

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Decreased physical activity in the workplace has led to weight gain

You’ve heard it before, but new research reinforces the idea that sedentary desk jobs could be the primary cause of weight gain over the past five decades. In the early 1960’s, almost half the jobs in private industry in the U.S. required at least moderate intensity physical activity. Now less than 20% of occupations require this level of activity, leading Americans’ level of daily energy expenditure to drop significantly. Researchers from the Pennington Biomedical Research Center at the University of Louisiana conducted an analysis of occupational energy expenditure in the U.S. beginning in the year 1960 until the present, using data from the U.S. Bureau of Labor Statistics. They also gathered body weight data from different U.S. National Health and Nutrition Examination Surveys (NHANES).

Researchers used an energy balance model to predict people’s weights based on the average change in their occupation–related daily energy expenditure since 1960. For instance, from 1960 to 2006, the NHANES survey data and energy balance model lead researchers to estimate that the occupation–related daily energy expenditure decreased by 142 calories in men aged 50 – 60 years. Given a baseline weight of 76.9 kg in 1960, they calculated that the decreased activity would result in an increase in mean weight to 89.7 kilograms, which was close to the actual mean weight (as measured by the NHANES) of 91.8 kilograms in 2006. The same pattern was true in men of different ages as well as in women.

(Dr Monica and Brahm Vasudev)

Screening: Saliva test for cytomegalovirus proves accurate

A new test offers a rapid, inexpensive and highly accurate method for screening newborns for cytomegalovirus, which can cause permanent hearing loss, researchers said on Wednesday. Though one in 150 babies are born infected with cytomegalovirus — known as CMV and part of the herpes virus family — current tests are not effective for widespread screening, the scientists said. The new test does not require the culturing of blood samples; it employs saliva, easily obtained by swabbing the inside of a baby’s mouth. Of 17,662 newborns screened, all 85 infants identified as infected with CMV by a blood culture test also were identified by the new test, researchers reported in a paper published in The New England Journal of Medicine. Another 17,327 newborns were screened with a different saliva test. It was slightly less accurate, detecting CMV in 74 of 76 infants identified by culturing. (Source:
http://www.nytimes.com/2011/06/07/health/research/07screening.html, June 3, 2011)

Why the deaf see better than those who can hear

Deaf people have better eyesight than those who can hear, research shows. Scientists discovered that the retinas of people born deaf, or who lost their hearing early in life, developed differently from those in people who can hear. This gave them greater peripheral vision, allowing them to see more and thus increase their awareness of their surroundings and any potential hazards. (Source:
http://www.dailymail.co.uk/sciencetech/article–1393772/Why–deaf-better-hear.html?ito=feeds–newsxml, June 3, 2011,)

FDA finds no link between ARBs and cancer

The use of angiotensin receptor blockers (ARBs) to lower blood pressure is not associated with an increased risk of developing cancer, the FDA announced after a formal safety review. In a meta–analysis of 31 trials that included about 156,000 patients, the rate of incident cancers per 100 patient–years was 1.82 in the ARB group and 1.84 in the comparison group (RR 0.99, 95% CI 0.92 to 1.06), according to the agency. There also were no associations between the use of ARBs and the risk of cancer–related death or specific cancers, including those of the breast, lung, and prostate. "Based on our review and analysis of all currently available data regarding this potential safety signal, FDA has concluded that treatment with an ARB medication does not increase the risk of cancer," the agency stated. (Source: Medpage Today)

Gene therapy flunks limb ischemia test

A large phase III clinical trial failed to confirm the beneficial effects of a promising gene therapy for critical limb ischemia that had been seen in early studies, the investigators reported. Patients who received fibroblast growth factor (FGF) in the multicenter study did no better than those treated with placebo. At one year a similar proportion of patients in both treatment groups met the primary endpoint of major amputation or death. The gene therapy also failed to improve any of the trials’ secondary outcomes, Jill Belch, MD, of the University of Dundee in Scotland, and co–authors reported online in The Lancet. (Source: Medpage Today)

 
    Twitter of the Day

@DrKKAggarwal:Your attitude and the choices you make today, build the house you live in tomorrow. So, build wisely.

@SanjivChopra:"Live each moment completely and the future will take care of itself "Paramhansa Yogananda

 
    Spiritual Update

Hanuman Chalisa

Aur Devata Chitt Na Dharai
Hanumanat Sei Sarva Sukh Karai


Meaning: You need not hold any other demigod in mind. Hanumanaji alone will give all happiness.

Spiritual Significance: Only Hanumana is the source of all joys, and by remembering him all sufferings disappear. There are many paths for achieving inner happiness like bhakti marg, karma marg and, gnana marg. It is sufficient if one follows the path of Pranayama.

 
    An Inspirational Story

(Dr Prachi Garg)

Two wolves

A Cherokee elder sitting with his grandchildren told them, "In every life there is a terrible fight – a fight between two wolves.

One is evil: He is fear, anger, envy, greed, arrogance, self–pity, resentment, and deceit. The other is good: Joy, serenity, humility, confidence, generosity, truth, gentleness, and compassion."

A child asked, "Grandfather, which wolf will win?" The elder looked him in the eye. "The one you feed."

Lesson: Development of good character depends on everyday choices one makes.

 
    Pediatric Update

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

Prevention of diarrhea in children with HIV infection or who were born to an HIV–infected mother

Diarrhoea is a common cause of illness in children, especially in low and middle–income countries where it accounts for nearly 2.5 million deaths per year. Infants and children with HIV infection or maternal exposure through birth or breastfeeding to HIV infection may be more vulnerable to diarrhea due to weakened immune systems, nutritional deficiencies or from having other infections.

A review evaluated three interventions to assess whether they can prevent death or illness from diarrhea in infants and children with HIV infection or exposure: vitamin A, zinc and cotrimoxazole. Vitamin A and zinc may correct micronutrient deficiencies that are prevalent in children with HIV infection or exposure, as well as prevent other infections. Cotrimoxazole is an antibiotic that helps prevent opportunistic infections in immunocompromised hosts, and may also prevent other infections. This review found nine studies that addressed these interventions in infants or children with HIV infection. It indicated that vitamin A shows reduction of mortality and morbidity due to diarrhea in children with HIV infection and a trend in lower illness from diarrhea. Zinc prevented visits due to watery diarrhea and cotrimoxazole decreased death and respiratory infections.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim was advised MRI post discharge.
Dr. Bad: It will not be covered.
Dr. Good: It will be covered.
Lesson: Post hospitalization related medical expenses incurred during period upto 60 days after hospitalization of disease/illness/injury sustained are covered as part of the claim.

Make Sure

Situation: A 60–year–old male developed acute heart attack after consuming Viagra.
Reaction: Oh my God! Why was cardiac clearance not taken before?
Lesson: Make sure that all older patients get a cardiac clearance before they are given Viagra group of drugs.

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    SMS of the Day

(Dr GM Singh)

The only way to avoid being miserable is not to have enough leisure to wonder whether you are happy or not. George Bernard Shaw

 
    Medicolegal Update

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

Sudden death – Autopsy

Left ventricular hypertrophy is the second leading cause of sudden cardiac death in the adult in India

  • The longstanding raised high blood pressure, which has caused secondary damage to the wall of the main pumping chamber of the heart, the left ventricle. Once again, hypertrophy is associated with cardiac arrhythmias.
  • The mechanism of death in a majority of patients dying of sudden cardiac death is ventricular fibrillation and as a consequence there may be no prodromal symptoms associated with the death.
  • These patients may be going about their daily business and suddenly collapse without the typical features of myocardial infarction such as chest pain and shortness of breath. There are a number of cases in which patients feel the effect of myocardial ischemia. Myocardial ischemia is associated with referred pain, classically to the front of the chest, the left arm and the jaw. Patients may feel generally unwell, with nausea, dizziness and vomiting.
  • These symptoms may precede the death for any length of time between a few minutes and several hours.

I have conducted postmortem examination of four cases that were found dead in toilet during daily pursuits. Left ventricular hypertrophy in these cases resulted into sudden death.

 
    Vitamins—Open Secrets revealed

(Dr Jitendra Ingole, MD Internal Medicine)

Lead toxicity and possible preventive role of Vitamin C in its treatment

Lead toxicity continues to be a significant but underreported and underdiscovered health problem. Abnormal growth and development have been observed in infants of women exposed to lead during pregnancy, while children who are chronically exposed to lead are more likely to develop learning disabilities, behavioral problems, and to have a low IQ. In adults, lead toxicity may result in kidney damage, high blood pressure, and anemia. In a study of 747 older men, blood lead levels were significantly higher in those who reported total dietary vitamin C intakes averaging less than 109 mg/day compared to those who reported higher vitamin C intakes (1). A much larger study of 19,578 people, including 4,214 children from six to 16 years of age, found higher serum vitamin C levels to be associated with significantly lower blood lead levels (2).

A U.S. national survey of more than 10,000 adults found that blood lead levels were inversely related to serum vitamin C levels (3). Further, an intervention trial that examined the effects of vitamin C supplementation on blood lead levels in 75 adult male smokers found that 1,000 mg/day of vitamin C resulted in significantly lower blood lead levels over a four–week treatment period compared to placebo (4). A lower dose of 200 mg/day did not significantly affect blood lead levels, despite the finding that serum vitamin C levels were not different than those in the group who took 1,000 mg/day. The mechanism for the relationship between vitamin C intake and blood lead levels is not known, although it has been postulated that vitamin C may inhibit intestinal absorption or enhance urinary excretion of lead.

References

  1. Cheng Y, et al. Relation of nutrition to bone lead and blood lead levels in middle–aged to elderly men. The Normative Aging Study. Am J Epidemiol 1998;147(12):1162–74.
  2. Simon JA, et al. Relationship of ascorbic acid to blood lead levels. JAMA 1999;281(24):2289-93.
  3. Lee DH, et al. Graded associations of blood lead and urinary cadmium concentrations with oxidative–stress–related markers in the U.S. population: results from the third National Health and Nutrition Examination Survey. Environ Health Perspect 2006;114(3):350-4.
  4. Dawson EB, et al. The effect of ascorbic acid supplementation on the blood lead levels of smokers. J Am Coll Nutr 1999;18(2):166–70.
 
    Mind Teaser

Read this…………………

JUS 144 TICE

Yesterday’s Mind Teaser: A 37–year old, previously healthy postal worker in New Jersey is evaluated because of an enlarging sore on his right arm for 10 days. He denies trauma to the arm. The sore began as a painless, itchy papule that enlarged over one to two days, with small blisters forming on top of the papule that filled with clear fluid. As the blisters enlarged, extensive swelling developed around the sore. The blister broke down, forming a painless ulcer covered by a black scab. His symptoms include low–grade fever and malaise. He has not traveled outside of the mid–Atlantic area.

On physical examination, the patient is not in any obvious distress. Temperature is 99°F (37.2°C). There is a 3 cm ulcer located on the upper, outer aspect of the right arm. A black, adherent eschar covers the ulcer. The ulcer and eschar are surrounded by extensive non–pitting edema. Lymphadenopathy is present in the right axilla. Which of the following is the most likely diagnosis?

A. Cutaneous anthrax
B. Cat–scratch disease
C. Tularemia
D. Herpes simplex infection
E. Streptoccocal adenitis

Answer for Yesterday’s Mind Teaser: A. Cutaneous anthrax

Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr Rashida Saher, Dr T H Saherwala, Dr. Surendra Bahadur Mathur, Dr. Rajshree  Aggarwal, Dr Jainendra Upadhyay, Dr Neelam Nath, Dr.Deepali Chatterjee, Dr Anil Bairaria, Dr U Gaur, Dr.G.Padmanabhan

Answer for 4th June Mind Teaser: Repeat after me
Correct answers received from: Dr.K.Raju, Dr. Anupam Sethi Malhotra, Dr Vijay Kansal, Dr Mukesh K Bhandari, Dr Arun Chawla, Dr Y J. Vasavada

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

What is Alpha?

It is a mathematical measure of price volatility that attempts to isolate the price movements of a stock from those of the market. A stock with a high alpha is expected to perform well regardless of what happens to the market as a whole.

 
   Laugh a While

(Dr. GM Singh)

Calling Who?

A telephone rang. "Hello! Is your phone number 444–4444?" "Yes, it is," came the reply. "Thank God! Could you call 100 for me? I super–glued my finger to the phone."

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Montelukast sodium 10 mg Tablet, Montelukast sodium 4/5 mg Chewable Tablet and Montelukast sodium Oral Granules (Additional Indication).
For the relief of perennial allergic rhinitis in adults & pediatric patients 6 months of age and older.
11.09.10
 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Understanding Laparoscopic Sleeve Gastrectomy

LSG Operative technique

The surgeon stands between the patient’s legs and a five–trocar technique is used. Pneumoperitoneum is inserted via a Veress needle to the left upper quadrant. The first (optical) trocar is inserted to the left of the middle line, approximately 15 cm from the xiphoid. Under vision, a 5–mm subxiphoid trocaris inserted for placement of the specialized Nathanson’s liver retractor so that the gastroesophageal junction (GEJ) is exposed. A 12–mm trocar is inserted in the right upper quadrant. Two 5–mm trocars in the left upper quadrant (the lateral at the anterior axillary line) serve as working channels. The dissection begins 6 cm proximal to the pylorus. The short gastric vessels on the greater curvature of the stomach are taken down up to the GEJ using the Harmonic scalpel. Exposure is completed when the fundus is fully mobilized and dissected free from the left pillar of the right crus. Fat is cleared off the left side of the GEJ so that stapling would not be compromised. Fine adhesions to the pancreas, if present, are divided, and the lesser sac is totally freed.

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Association between acute care and cognitive function in older adults

A higher risk of cognitive decline and dementia has been postulated to occur in survivors of acute medical illness, particularly in older adults. In a prospective cohort study, higher rates of cognitive decline and incident dementia were observed among those who had had acute care hospitalization compared to those who did not (JAMA 2010;303:763).

 
    Public Forum

(Press Release for use by the newspapers)

Environment Day Celebrated

Delhi Mayor Prof Rajni Abbi released a poster with a message in a function organised to celebrate World Environment Day. Prof Rajni said "Think of metro as your personal limousine; public park as your personal farm house, city river your personal swimming pool AND keep them clean. My country clean Country"

On this occasion Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India said that all citizens of India should make efforts towards a safer and clean India.

Apart from external environment, we should also clean and look after our internal environment, he further added. He also appealed that manufacture of mercury instruments should be stopped. Environment health means not only reducing air pollution but also involves reducing the global warming, electromagnetic radiation pollution, and the noise pollution.

He said that one should switch over to CFL lamps as tube lights and bulbs consume more electricity compared to a CFL bulb. CFLs consume 75% less electricity and last 10 times longer. He recommended the use of CFL bulbs in fixtures that are kept switched on for more than two hours a day. A 23 watt compact fluorescent bulb can replace the 100 watts that a simple bulb requires. By just replacing 275 watt light bulbs that are switched on for four hours a day with 215 watt energy conservation lamps, one can save almost 18 kilowatt hours of electricity in an hour.

Mr. Satish Upadhaya Director IMCS said that one should saggregate the waste at source.

Dr. S.S. Agrawal, Professor, DIPSAR said that pollution, particularly if not tackled, may cause kidney failure and such other diseases. He also said that noise pollution not only disturbs the environment but also the ear health of a person. Experts have said that even listening to music with head phones, through iPod or a music CD player, can be harmful to the health of ear. Loudness of the sound is measured in decibels (dB) and any sound louder than 85 dB can cause hearing loss. The higher the decibel, the shorter the amount of time one is exposed to the sound before hearing loss occurs.

Eminent Kathak Dancers Ms Nalini and Ms Kamalini, said that one can be spiritually healthy only in an atmosphere of clean environment.

Acharya Dr. Sadhnaji Maharaj, President, World Fellowship of Religions, said that all the religions and dharmas talk about the importance of clean environment.

 
    Readers Responses
  1. On Tobacco day pics: Hi kishan gr8 work.. but enhance awareness by telling people as to why actually do they smoke and why on their own they mostly fail to quit! Everyone who smokes knows that it’s injurious to health. Regards: Nalini I Bajaj.
 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

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

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

 
    Forthcoming Events

National Conference on "Insight on Medico Legal Issues"
Date: Sunday, 10th July, 2011
Venue: Auditorium, Chinmaya Mission, 89, Lodhi Road, New Delhi – 10003

eMedinewS and Heart Care Foundation of India are jointly organizing the first ever National Conference on "Insight on Medico Legal Issues" to commemorate "Doctors’ Day".
The one-day conference will provide total insight into all the medicolegal and ethical issues concerning the practicing doctors. Both medical and legal experts will interact with the delegates on important issues.
You are requested to kindly register in advance as seats are limited. There will be no registration fee. You can register by sending your request at rekhapapola@gmail.com or at 9899974439.

Programme

Session: Ethical Issues in Medical Research (8 am – 8.30am)
Chairpersons: Dr T K Joshi
Moderators: Dr K K Aggarwal and Dr. Girish Tyagi
Topic        -        Speaker          -               Time
Rights of a patient in medical trial - Ajay Agrawal (Sr Advocate) - 8 am - 8.10 am
Ethical Issues in a medical trial - Dr Ranjit Roy Chaudhury 8.10 am – 8.20 am
Statutory permits required for conducting trials - Ms Priya Hingorani (Sr Advocate) - 8.20 am – 8.30 am

Session: Medical ethics and organ donations (8.30 – 9.00 am)
Chairpersons: Dr N V Kamat and Dr Anil Bansal
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Ethical issues in IVF practice - 8.30 am-8.37 am
100% voluntary blood donation - Dr N K Bhatia - 8.37 am-8.44 am 
Need for do not resuscitate laws in India - Dr Rajesh Chawla- 8.44 am-8.51am 
Ethical issues in organ transplantation Dr Neelam Mohan 8.51 am-8.58 am 

Session: Handling cases of death (9 am - 9.30 am)
Chairpersons: Mr S K Saggar and Dr Arvind Chopra
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
How to declare the death? Dr Ambrish Mithal  9.00 am-9.10 am
Spiritual considerations in a dying patient Dr S C Tewari  9.10 am-9.20 am
Medico legal and ethical issues in post mortem Dr G.K. Sharma 9.20 am-9.30 am

Session: Medical Insurance (9.30-10 am)
Chairpersons: Mr Vibhu Talwar, Dr H K Chopra and Dr Vinod Khetrapal
Moderators: Dr K K Aggarwal
Indemnity Insurance 9.30 am-9.40 am
Engaging a lawyer  Ms Meenakshi Lekhi (Sr Advocate)  9.40 am-9.50 am
Understanding various court procedures Maninder Acharya (Sr Advocate) 9.50 am – 10.00 am 

Session: How to handle medico legal cases? (10-10.30 am)
Chairpersons: Dr Anil Goyal and Dr Rajiv Ahuja
Moderators: Dr K K Aggarwal and Dr. Girish Tyagi
When to do the MLC? Dr M C Gupta (Sr Advocate) 10.00 am-10.10 am 
Checklist of MLC case Dr Sudhir Gupta 10.10 am-10.20 am 
Medico legal record keeping Mr Siddarth Luthra (Sr Advocate) 10.20 am –10.30 am

Session: Medical Consent (10.30-11 am)
Chairpersons: Dr Vinay Aggarwal and Dr P K Dave
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic Time Speaker
Types of consent Ms Indu Malhotra (Sr Advocate) 10.30 am-10.40 am 
Ideal consent Dr Manoj Singh 10.40 am-10.50 am

Session: Fallacies in acts applicable to medical profession (11-11.30 am)
Chairpersons: Dr Anup Sarya and Dr Sanjiv Malik
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
MTP, PNDT Dr Kaberi Banerjee  Act 11.00 -11.10 am
Organ Transplant Act Dr Anupam Sibbal  11.10-11.20 am
State Medical Councils and Medical Council of India Dr DK Diwan  11.20 –11.30 am

Session: Inauguration: 11.30 am to 12.00 noon
Invited Guests: Justice Vipin Sanghi, Dr KK Talwar, Dr Shiv Sarin and Dr A K Agarwal

Session: Professional misconduct and professional ethics (12.00 – 1.00 PM)
Chairpersons: Dr A K Agarwal, Dr. D S Rana and Dr H S Rissam
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic Time Speaker
Doctor-pharma relationship 12.00 -12.10 pm
Advertisement and medical practice Dr P Lal  12.10 pm-12.20 pm
Rights of a patient Dr Navin Dang 12.20 pm –12.30 pm
Rights of a doctor Dr Ajay Gambhir 12.30 pm-12.40 pm 
Kickbacks, touts and commercialization in medical practice Dr Ashok Seth 12.40 pm- 12.50 pm 
Complaints of a doctor against doctor 12.50 pm – 01.00 pm

Session: When it is not negligence?
Timings: 1.00 pm to 2.00 pm
Chairpersons: Dr Prem Kakkar and Dr S K Sama
Moderators: Dr K K Aggarwal and Dr. Girish Tyagi
What is medical negligence? Dr Girish Tyagi 1.00 pm-1.10 pm 
Medical accidents Dr Vijay Aggarwal  1.10 pm – 1.20 pm
Professional Misconduct Mr Mukul Rohatgi (Sr Advocate) 1.20 pm – 1.30 pm 
How to defend a complaint? Dr K K Aggarwal 1.30 pm- 1.40 pm 
Out of court settlement 1.40 pm – 1.50 pm
Compensation Vs Cancellation of License Dr O P Kalra 1.50 pm – 2.00 pm

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com

Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at
medifilmfestinhealthmela@gmail.com

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