emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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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 (07–08c); 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

ASAR Aamir Khan & Dr KK Aggarwal on Satyamev Jayate

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

 
  Editorial …

6th June 2012, Wednesday

Transit of Venus, Solar eclipse and lunar eclipse: the health effects

On June 5-6, 2012, Venus will pass in front of the Sun. This year, 2012, is our last chance to view this phenomenon, which will not be seen for another 100 years. During the transit, Venus passes between the Sun and the Earth. The planet becomes visible from Earth as a small dot against the Sun's disk. Venus is almost four times larger than the moon; it blocks a much smaller portion of the Sun's face than the moon does during a solar eclipse. This is because it is much further away from Earth. The transit of Venus requires similar precautions as are observed while viewing a solar eclipse.

Myths and facts about venous transit and solar/lunar eclipses

  1. One should protect their eyes and never look directly at the sun without proper protection. This applies to both the solar eclipse as well the Venus transit.
  2. The sun emits intense infrared and ultraviolet (UV) radiation. UV light can damage the skin and retina but retinal damage occurs earlier. The eyes can suffer permanent damage if they are exposed to direct sunlight for even just a few seconds.
  3. Protective eyewear should be worn to observe the sun safely. One can filter the solar photosphere’s rays or project its image onto a screen, like normal white paper or cardboard. Projection works well with or without a telescope or binoculars. However, you must never look through the telescope’s eyepiece or side-mounted finder scope when aiming a telescope or binocular at the sun to project a magnified sun’s image on a screen of white cardboard. Solar filters can also be used to view the sun during a partial eclipse or eyepiece, solar filter, solar projection screen, camera with sufficient memory and appropriate lens, cable release (including a spare), video camera, videotape, space blanket, sunscreen and a hat can be used.
  4. Watching lunar eclipse does not damage the eyes.
  5. There is no mention about the harmful effects of eclipse on pregnancy in Allopathy literature. In Mexico and in many parts of India there is a ‘belief’ that pregnant women are in danger of having a baby with a harelip during a solar eclipse. No such belief is prevalent for the lunar eclipse.
  6. Ayurveda indirectly mentions it under “air space vikrity” (disorders) and writes that the effect of these disorders on pregnancy can lead to the birth of a blind child or a child with low body energy. It also says that the child may be born with dog and elephant characteristics. It does not mention the word “eclipse” anywhere.
  7. Both Ayurveda and Dharma Shastra direct pregnant ladies to take precautions one should take them as otherwise the fear of giving birth to an abnormal child can cause abnormalities in the child. Those who have faith or fear that the eclipse can harm pregnant ladies should take precautions.
  8. Lunar eclipse may be associated with exacerbation of mental illnesses. In an Institute of Psychiatry & Human Behavior, Goa study a significant trend was observed for greater numbers of patients with non-affective psychoses on full moon days and on days of visible lunar eclipse, but no pattern was observed for mania or depression (Indian J Psychiatry. 1999 Jan; 41(1):60-5). There are some studies which talk about effects of full moon on rise in blood pressure, pulse and abnormal mental behavior and have linked them to high tides in the ocean.
  9. The traditional Ekadashi vrata (fast) 3 days before and fast on the day of full moon are advocated in Indian mythology to tame or control the mind, which is likely to get disturbed during full moon and lunar eclipse time. The ritual of observing Nirjala ekadashi 3 days before the current lunar eclipse on full moon day with vrata is also done with the belief that it prevents mental disturbances during full moon and during lunar eclipse by producing some dehydration in the body and the brain.
  10. More mosquitoes may grow during a lunar eclipse. A study on mosquitoes done in coastal marshland site in Chambers County, TX done in 1989 found that the density of certain species of the mosquitoes Aedes, Anopheles, Culex and Psorophora increased during the lunar eclipse and decreased when the full moon was exposed (J Am Mosq Control Assoc. 1994 Jun; 10 (2 Pt 1):222-4). In another study Dr. Thornton observed that dogs reject food while an eclipse was in progress.
  11. There are also some Vedic beliefs on this subject: There is a mention of eclipse in Shikshapatri where Bhagwan Swaminarayan says that at the time of a solar or lunar eclipse in areas where it is visible, one should stop all activities, meditate or chant the name of God in a purified state. After the eclipse, one should take cold bath with the clothes they are wearing and then make donations (especially cereals) according to their means (Shik 86/87). One should also not eat 12 hours before the solar and 9 hours before the lunar eclipse begins. One can drink water. No meals should be offered to the Gods during this pre-eclipse period; but, aarti and prayer can be done. One should get rid of the extra cooked food after the solar or lunar eclipse. One should not touch anything such as clothes, food, personal items, etc. during the eclipse.
  12. The only scientific explanation for the above is that during the lunar eclipse, the atmosphere behaves like amavasya (new moon) on purnima (full moon) day. Therefore one needs to observe precautions of both purnima (observe fast to prevent mental disturbances) and of new moon or amavasya (to prevent causalities occurring due to darkness in the outside atmosphere). Also, the full moon day can be windy and dusty. With a possible dark, windy and dusty atmosphere on lunar eclipse full moon day, dust may settle on the food or clothes. This may be a reason why food that has been kept for more than 9 hours before the eclipse is not eaten till the eclipse has passed. The same is true for the dirt-filled clothes, which should be washed when the eclipse ends.
  13. On the day of the lunar eclipse, a “full moon” is present in an atmosphere of “new moon”. The full moon effect on the environment also reflects on the mood and mind of a person. The high tides in the ocean reflect in the mind as mood disturbance. These mood changes may occur during every full moon and that is the reason why in India mythology it is advised to control the mind by observing a fast either on ekadashi ( 3 days before full moon) or on the day of full moon.
  14. The ‘sutak’ (9-hour period before the lunar eclipse starts) is also observed in Indian mythology as a period of physical and mental fast so as to avoid the effect of eclipse on the mind. During this period one is required not to eat cereals, if possible nothing by mouth and do pranayama and meditation. About 10% of the society, at any given point of time, is affected with anxiety or depression. The full moon as per Ayurveda is said to affect and exacerbate symptoms of anxiety or depression. The fluctuations in the mind can also be associated with fluctuations in upper systolic blood pressure. In a study from the Institute of Psychiatry & Human Behavior, Goa, a significant trend was observed for greater numbers of patients with non-affective psychoses on full moon days and on days of visible lunar eclipse, but no pattern was observed for mania or depression (Indian J Psychiatry. 1999 Jan; 41(1):60-5).
  15. If one believes in Indian mythology then one should observe the rituals as the fear of harmful effects of the mind, for example, in a pregnant lady can harm the fetus based on a common Vedic saying and principle “You are what you think”.

For More editorials…

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

Thin line between ethical and unethical acts

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.

 
Dr K K Aggarwal
 
    National News

BHU to set up state-of-the-art centre for stem cell research

Banaras Hindu University (BHU) is all set to establish a first-of-its-kind Stem Cell Research and Bone Marrow Transplantation Centre of Uttar Pradesh. To be established near the upcoming trauma centre, the state-of-the-art centre will facilitate research on both stem cells and bone marrow transplants and is expected to open new avenues of treatment for life-threatening ailments like cancer, cardiovascular and auto-immune disease in the state. “There are not many centres in the country that carry out such stem cell research. In Uttar Pradesh, though there is sporadic research going on, no such organised state-of-the- art facility is available,” said Prof Lalji Singh, vice-chancellor, BHU. “BHU will have a sophisticated Center like the stem research centre in Hyderabad and Mumbai, meant for inter-disciplinary research for development of new technology in stem cells. It will be a centralised facility where researchers from other life sciences departments as well as Indian Institute of Technology-BHU will be able to carry out research,” Singh told The Indian Express. The centre will be a ten-bed facility for patients who undergo stem cell as well as bone marrow transplant. (Source: Indian Express, Jun 04 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)

Score predicts risk for death in heart failure

A risk score derived from variables that are routinely gathered in the emergency department may help guide the decision to admit or discharge patients presenting with acute heart failure, researchers found. (Source: Medpage Today)

For comments and archives

CT overused to test for clots in lungs?

One-third of imaging tests performed to evaluate patients for possible pulmonary embolism may be unnecessary, a prospective observational study found. (Source: Medpage Today)

For comments and archives

Dog walking tied to increased overall physical activity: CDC

Dog owners who walk their pets are almost three times as likely to meet national recommendations for physical activity as those who don't, according to a new review from researchers at the Centers for Disease Control and Prevention. The meta-analysis of eight cross-sectional studies and one cohort study was presented Thursday at the American College of Sports Medicine's annual meeting in San Francisco. (Source: Medscape)

For comments and archives

Vascular reactivity in pre-diabetes improves with regular aerobic exercise

People with pre-diabetes who engage in regular aerobic exercise improve their vascular reactivity to nearly normal levels, even if they do not lose weight, researchers said in Philadelphia last weekend at the American Association of Clinical Endocrinologists 21st Annual Meeting and Clinical Congress. "Doctors should tell their patients with pre-diabetes to do moderate exercise," lead author Dr. Sabyasachi Sen, from Bay State Medical Center and Tufts University School of Medicine in Boston told Reuters Health. (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 AM – 12 Noon

(IJCP and eMedinews)

 
    Twitter of the Day

@DrKKAggarwal: Reduce weight first if facing infertility problem
http://blog.kkaggarwal.com/2012/04/21/reduce-weight-first-if-facing-infertility-problem/

@DeepakChopra: The present moment is alive vivid vibrant. Past and future are the fuzzy dreamlands of imagination.

 
    Spiritual Update

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

The Science behind Training and Development

Training in any field requires gaining knowledge, skills and positive mental attitude towards the object of learning. Knowledge is everything about what and why. In Yoga, it correlates with the Gyan (Gnana) Marg. The skill is all about how to do it and correlates with Karma Marg.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

Which surgery is recommended for infertility?

Laparoscopic treatment of minimal and mild endometriosis has been associated with a small but significant improvement in pregnancy rates. In a study, 29% of women who had their endometriosis treated conceived over nine months, in contrast to only 17% of women whose endometriosis was diagnosed, but not treated during laparoscopy. Treatment of moderate and severe endometriosis by laparoscopy and/or laparotomy increases pregnancy rates for women in whom no other causes of infertility have been found.

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)

The six most important words are “I admit I made a mistake”
The five most important words are “You did a good job”
The four most important words are “What is your opinion”
The three most important words are “If you please”
The two most important words are “Thank you”
The least important word is “I”

For comments and archives

 
    Cardiology eMedinewS

Thiazides best only for obese hypertensives Read More

Dark chocolate: Sweet prevention for CV events Read More

Medtronic's Resolute zotarolimus-eluting stent effective in NIDDM patients Read More

 
    Pediatric eMedinewS

Doctors save baby with smallest artificial heart Read More

IBD drugs may have no role in birth defects Read More

Violence May cause premature aging in children Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with migraine and palpitations came for treatment.
Dr. Bad: No drug is needed.
Dr. Good: Take verapamil.
Lesson: Verapamil is frequently used as a first choice for preventive migraine therapy because it is easy to use and has fewer side effects.

Make Sure

Situation: A patient developed fainting attack after sublingual nitrate.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with LVOT obstruction are not given sublingual nitrates.

 
  Legal Question of the day

(Prof. M C Gupta, Advocate & Medicolegal Consultant)

Q. I am a doctor. My relative bit his wife. She went to a government doctor. He treated her as an OPD case. OPD Medical notes were given to the patient as per practice. The injury was minor/simple. Moreover, the woman gave in writing under her signature that she did not want a medicolegal case. No MLC was made. The woman later filed a police complaint against the husband. The doctor came to know about it but still did not make an MLC. The doctor was produced in the magistrate’s court as an expert witness and deposed as above. He produced in the court the photocopy of the OPD register containing the details about woman’s treatment. He told the court that MLC could/should have been made but was not made because the woman did not want so. The magistrate found the husband guilty and awarded 2 years’ imprisonment and fine of Rs. 10,000/-.

My questions are:

  • Was the doctor bound to make an MLC?
  • What are the implications of two contradictory statements/approaches by the doctor? (he said MLC was not made because it was a minor simple injury and later said MLC could have been made but was not made because the woman did not want).
  • Can the medical officer entertain any settlement about medicolegal case?
  • Why was the doctor summoned? What is his role when he has no documentary support?
  • Can the following complaints be made against the doctor?
    • A criminal complaint for violation of section 39 CrPC and sections 177/201, IPC
    • Medical council complaint;
    • His employer (Health department)

Ans.

  • The doctor was not bound to make an MLC. Making or not making an MLC depends upon the discretion of the doctor and upon the rules of the organisation where he works. He has used his discretion correctly here.
  • The court is unlikely to read malafide contradiction in the alleged “contradictory statements”.
  • Nobody is allowed to arrive at a settlement for not making an MLC if it should have been made. This will amount to interference in the course of justice.
  • The doctor was most likely summoned to corroborate the accusation of cruelty manifested in the act of biting. It is wrong to say that he had no documentary support. The OPD register is a document.
  • All the three types of complaint mentioned by you are likely to be of no use.

For comments and archives

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  Quote of the Day

(Dr GM Singh)

Visits always give pleasure - if not the arrival, the departure. Portuguese Proverb

 
  Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Normal platelet count

The normal platelet count in adults ranges from 150,000 to 450,000/microL, with mean values of 237,000 and 266,000/microL in males and females, respectively.

 
    Mind Teaser

Read this…………………

What is the priority nursing assessment in the first 24 hours after admission of the client with thrombotic CVA?

a. Pupil size and papillary response
b. Cholesterol level
c. Echocardiogram
d. Bowel sounds

Yesterday’s Mind Teaser: 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

Answer for yesterday’s Mind Teaser: a. Hypovolemia

Correct answers received from: Dr BB Aggarwal, Yogindra Vasavada, Dr Kanta Jain, Dr Thakor Hitendrsinh G, Raju Kuppusamy, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Anil Bairaria.

Answer for 4th June Mind Teaser: a. Active joint flexion and extension

Correct answers received from: Dr PC Das.

Send your answer to ijcp12@gmail.com

For comments and archives

 
    Laugh a While

(Dr GM Singh)

Law of Bag/Box Occupancy

All bags and boxes in a given room must contain a cat within the earliest possible nanosecond.

 
    Medicolegal Update

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

Can medical interventions be stopped?

Every medical intervention, including artificial nutrition and hydration, may be terminated at the patient’s request. Specific legal cases have sanctioned the withholding or withdrawal of respirators, chemotherapy, blood transfusions, hemodialysis and major surgical operations. In Cruzan, the United States Supreme Court definitively stated that artificial nutrition and hydration are medical interventions that can be withheld or withdrawn under the guidelines that apply to other medical treatments.*

*Cruzan v. Director of Missouri Department of Health, 110 S. Ct. 2841 (1990).

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Working hard when tired not good for the health

Doing mental or physical work while exhausted may harm your health, according to a study from University of Alabama at Birmingham and published in International Journal of Psychophysiology.

Commenting on the study, Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India said that fatigued people have bigger spikes in blood pressure than well-rested people while doing a memorization test.

When fatigued people regard a task as worthwhile and achievable, they increase their effort to compensate for their diminished capability. As a result, the blood pressure of a tired person increases and remains elevated until the task is completed or the person gives up.

In this study, Wright and colleagues told 80 volunteers they could win a modest prize by memorizing two or six nonsense trigrams (meaningless, three-letter sequences) within two minutes. Compared to volunteers with low levels of fatigue, those with moderate fatigue had stronger blood pressure while doing the two-trigram memorization task.

 
    Readers Responses
  1. Dear Dr Aggarwal, I am a regular reader of your eMedinewS and like it very much. Through this, I wish to send a rejoinder to Mr. Aamir Khan that it is good on his part to highlight the social evils. But I do not approve of depicting the whole medical fraternity in bad light. Times have changed. There was a time when we treated patients on clinical examination alone and required lab tests in few complicated cases. But due to CPA & its unscrupulous use by people to extract money from doctors they need to safeguard themselves. Coming to generic medicines, we are only interested to cure the pts. If the govt take strong steps to supply genuine medicines & not allow the brands to flood the market why should we burden the patients? We will then have only our professional remuneration. A doctor is on duty for 24 hours a day at the cost of his personal & family life and gets much less than others viz. film stars who earn crores for their limited hours and that too in black. Lastly but not the least, as it is the doctor-patient relationship is at the lowest thanks to the media. Mr. Aamir Khan has not done the right thing. Dr. Tara Saxena Rewari, Haryana.
  2. Dear All, So what do our friends (who are trying to justify cut/ commissions) really want by doing so ?
    1. Should we start writing "Dr. XYZ sons Pvt. Clinic Ltd" in front of our hospitals ?
    2. Should we start behaving like common traders and start putting banners like "Pay for Kidney function tests and get the liver function test free " ?
    3. Should we go for year end sale sort of business or end of year clearance sale with banners shouting outside our hospitals- " 50 % off season discount on dehydration cases in winter and pneumonia cases in summer "?
    4. Should we start behaving like agents and deal brokers with our hospital board shining with words- "Get the best deal for your disease !! minimum brokerage charged if outside hospital services required" ? or words to this effect.
    NO, a big NO my dear friends !! We are into this profession by our choice. we have not been forced into this profession. We have starved for this degree, we have burnt the midnight oil for it.... we would have easily opted for something more lucrative career option as we were among the top most students in our school....but we opted for this profession by choice !! Ask any class 10th or 12th topper students or any medical student about the reason he /she joined this field, most probably the reply would be to serve the humanity.. but what happened after getting the degree ? We get metamorphosed from the noble healer to a trader ?

    Dear friends, still any "tees maar khan" who enters our clinic calls us "doctor sahab" most of the times irrespective of his position, wealth, fame and power....

    You must have been stopped by the traffic police at least once in your life for chaalan....Even if that police personnel doesn't listen to your explanation and gives the challan in your hand but still his last words to you would have been- " challan to bharna hi padega "DOCTOR SAHAB" !!!!!!!!! (my engineering friends have pointed this "special" treatment meted to medical professionals by police)....

    With regards, Dr Rajesh Garg

 

 
    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