emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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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

 
  Editorial …

7th February 2012, Tuesday

Govt. mulls six–and–a–half year MBBS with one–year rural stint (TOI)

The government is considering increasing the duration of MBBS course to six and a half years from the present five–and–a–half years. This may not be the answer and is likely to be opposed by the medical community. I have the following observations to make on this issue.

  1. Keep the length of MBBS course five–and–a–half years as it is presently.
  2. Keep MD three years as it is.
  3. 3. Keep DM 3 years as it is.
  4. Make a 6–month internship in rural area compulsory
  5. Make one month clinical posting in rural area each year in MBBS compulsory.
  6. Make 6–month clinical hands–on posting compulsory in MD as senior resident (three months in 2nd year and three month in 3rd year)
  7. Make 3–month hands–on posting as consultant compulsory during DM (2nd year)
  8. Salaries during these periods should be made tax free so that when they finish MBBS, MD or DM they have some money to invest and start practice. They should also be given additional rural inactive allowance during this period.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

Guest Editorial

(Dr MC Gupta, Advocate)

NCHRH Bill 2011

A. GENERAL COMMENTS ABOUT CERTAIN PROVISIONS THAT ARE VAGUE OR CONFUSING

  • The appellate scheme in respect of decisions against a health professional as seen in the Bill is very confusing. It needs to be looked into and properly drafted to avoid confusion and complications.
  • The scheme of registration of health professionals is very confusing. An example is section 57 (1). Overall, there is much confusion regarding the registration of a health professional. It is not clear if he has to get registered with both. This is contrary to the prevailing principle that once a physician’s name appears on the state register, he is automatically deemed to have his name registered in the National Medical Register. The same principle needs to be continued. There should be no direct registration with the national council.
    Moreover, the provisions for appeal against a decision of the state council are very confusing. These need to be looked into and streamlined.
  • Section 64. It is vague and the meaning is not clear.

B. SPECIFIC PROVISIONS

Section 51 (3): It reads "A person enrolled under this Act, before going abroad for the purpose of employment, service, professional assignment or post or position or for exploration of career opportunities or for carrying out any professional or related work, shall obtain the certificate of good standing from the respective National Council or the State Council."

Comment: This is irrational. If somebody works abroad, there is no reason why he must "obtain the certificate of good" as a mandatory requirement. The matter is between the health professional and the foreign employer.

59. (3) It reads "Any person,

  • who obtains a degree at graduate or post graduate or doctoral or post–doctoral or super speciality from a university or institution other than the university or institution referred to in sub–section (1); and
  • leaves India for the purposes of updating or acquiring higher education in the discipline of health or for employment and does not return within the period of three years or does not inform the respective Councils of his whereabouts during such period, then, it shall be construed as professional misconduct."

Comment: This is illogical and irrational. There is no reason why a health professional who has not studied in an institution funded by the government and who goes abroad for employment and does not return for 3 years should be deemed to have indulged in professional misconduct.

Schedule 7, Part 1 No. 8: It reads "accepts a position as a health practitioner previously held by another health practitioner without first communicating with him in writing".

Comment: It is illogical that if a patient under treatment of one health professional presents to another health professional for treatment, the latter should refuse treatment to the needy patient unless he has communicated with the former health professional in writing.

No.13. It is not clear and is confusing.

Schedule 7, Part 1

No. 20: Along with the ICMR guidelines, there is need to add "the provisions of the Drugs and Cosmetics Act, 1940"

No. 21, 22: These must be deleted. These are arbitrary and will open the health professionals to local politics. Absence from duty is a service issue and should be punished under service rules applicable to the employee. These are identical to regulations no. 7.23 and 7.24 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, which were later realised to be wrong and improper and were later deleted by the authorities. There are no reasons to introduce these.

 
  eMedinewS Audio PostCard

Stay Tuned with Dr Pramod Kumar,Cardiologist

Govt. mulls six–and–a–half year MBBS with
one–year rural stint (TOI)

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

3rd eMedinewS Revisiting 2011

Dr NP Singh was awarded with eMedinewS Faculty Award 2011 in the recently concluded 3rd eMedinewS Revisiting 2011 Conference

 
Dr K K Aggarwal
 
    National News

HIV Test before Marriage?

The Kerala Women’s Commission (KWC) has asked the state government to pass resolutions and, if necessary, a law to ensure that all those who get married undergo an HIV test. ‘This is an issue that is affecting the entire humanity and hence adequate measures have to be taken to safeguard all,’ KWC chairperson Justice (retd) D. Sreedevi said.

For comments and archives

Birds flatter to deceive, watchers on wings of despair

NEW DELHI: It was a day that began with much anticipation but ended in disappointment for the city’s birdwatchers. The annual Big Bird Day on Sunday recorded just 226 species of the winged visitors unlike last year’s 240. Bikram Grewal, the official score keeper, said it is an ill omen as the drop in count indicates a drop in the number species along the Yamuna. "The two places along the Yamuna where we monitor birds are the Okhla Bird Sanctuary and the Yamuna Biodiversity Park. Both places recorded a fall in the number of species. Okhla went down from 95 species in 2011 to 78 this year while at the Yamuna park, the count dropped from 84 last year to 65 this year," he said. (Source: TOI, Feb 6, 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

Lack of sunlight, vitamin D tied to stroke risk

Too much sunlight is bad for the skin, but not enough may be a risk factor for stroke, according to a study presented here at the American Stroke Association's International Stroke Conference. (Source: Medpage Today)

For comments and archives

Hidden Afib common in stroke of unknown cause

One patient in five with an unexplained stroke or transient ischemic attack has occult paroxysmal atrial fibrillation episodes on subsequent monitoring, researchers found. (Source: Medpage Today)

For comments and archives

Breastfeeding linked to better lung function

Children who were breastfed for at least four months had significantly better lung function at age 12 than did children who were not breastfed, data from a large cohort study showed. (Source: Medpage Today)

For comments and archives

Questions help tell memory loss from dementia

A simple questionnaire can help differentiate individuals experiencing normal age–related memory loss from those at risk for developing dementia, most notably by their orientation to time and patterns of repetitive speech, researchers found. On the 21–item Alzheimer’s Questionnaire, patients having trouble remembering the day, month, year, and time of day were almost 18 times more likely to have amnestic mild cognitive impairment, a precursor to dementia (OR 17.97, 95% CI 2.63 to 122.77, P=0.003), according to Michael Malek–Ahmadi, MSPH, and colleagues from the Banner Sun Health Research Institute in Sun City, Ariz. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: #AJOG What are the economical issues related to multiple pregnancies? The health care cost for delivery and…fb.me/1ruLQyuMI

@DeepakChopra: Spiritual support adds to your sense of being free, loving, and aware. Be open to those feelings, it’s the first step to transformation.

 
    Spiritual Update

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

One GOOD ACTION NEUTRALIZES 20 Bad Actions

In Mahabharata, we had five Pandavas fighting with hundred Kauravas. In terms of internal Mahabharata, the hundred Kauravas represents hundred negative tendencies a person can have. In Jainism, they are called ninety nine Atichars.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What could damage my fallopian tubes?

Infections, abdominal surgery, and other diseases, such as endometriosis, can cause scars to form between the end of the tube and the ovary. The tubes also can become damaged with adhesions or scar tissue inside the tube or can become completely blocked. You can get a tubal infection after your appendix ruptures or bursts. Surgery or endometriosis (lining of the uterus deposited in the lower part of the belly) can also damage your fallopian tubes.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

The hospital window

Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window. The other man had to spend all his time flat on his back. The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their involvement in the military service, where they had been on vacation.

Every afternoon when the man in the bed by the window could sit up, he would pass the time by describing to his roommate all the things he could see outside the window. The man in the other bed began to live for those one hour periods where his world would be broadened and enlivened by all the activity and color of the world outside. The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm in arm amidst flowers of every color and a fine view of the city skyline could be seen in the distance.

As the man by the window described all this in exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene. One warm afternoon the man by the window described a parade passing by. Although the other man couldn’t hear the band – he could see it. In his mind’s eye as the gentleman by the! e window portrayed it with descriptive words. Days and weeks passed.

One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away.

As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch, and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one elbow to take his first look at the real world outside. He strained to slowly turn to look out the window beside the bed. It faced a blank wall. The man asked the nurse what could have compelled his deceased roommate who had described such wonderful things outside this window. The nurse responded that the man was blind and could not even see the wall.

She said, "Perhaps he just wanted to encourage you."

For comments and archives

 
    Fitness Update

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

Obesity increases susceptibility to pain

Obesity is a leading cause of cardiovascular disease, stroke, diabetes, and a host of other diseases and conditions. Although previous research has also linked obesity with chronic pain, no large scale studies have been able to show a distinct association – until recently. The journal Obesity recently published a study that gives compelling evidence that obesity increases one’s susceptibility pain.

Between 2008 through 2010, the Gallup Organization surveyed 1,062,271 randomly selected Americans via phone interviews. Survey questions included height and weight, questions about pain and other conditions. A mere 19 percent of the sample was classified as low or normal BMI and 22 percent were classified as overweight. The remaining survey participants were obese, based upon the height and weight they gave in their phone interview. While the overweight group reported 20 percent higher rates of pain than the group with low to normal BMIs, chronic pain was 75 to 250 percent higher for those who were obese. More severe obesity was linked to more intense and more frequent pain.

For comments and archives

 
   Cardiology eMedinewS

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

Blood Pressure Measurement May Detect Proneness To Heart Attack

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Study Finds Low Risk for LVAD Exchange

Read More

Clot Busters OK for 'Wake-up' Strokes

Read More

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   Pediatric eMedinewS

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

Support by Mom Raises Kids' Brain Volume

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FDA Says Tamsulosin Safe In Pediatric Patients

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H1N1 Pandemic Flu Vaccine May Protect Kids Across Two Seasons

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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

An eye check–up is needed when you apply or renew for a license.

 
    Legal Question of the Day

(Dr MC Gupta, Advocate and Medico legal consultant)

Q. My friend, an MBBS with PGDGM (Geriatric Medicine–IGNOU), has a modest small nursing home in a small town where he treats ordinary ailments that can be managed in a small set up. There are two MD Medicine physicians in the same town. They have started threatening my friend that they would file a complaint to SMC that he is just a MBBS but still managing cases usually treated by MD Medicine physicians. My friend is trying to have an arrangement with an MD physician from a nearby city so that he may visit the nursing home at least once a week and may be able for a telephonic consultation on other days.

Would such an arrangement help in case a complaint is filed against him in the SMC by the jealous MD physicians or in case a patient dies and it is alleged that there was delay in referral?

Ans.

  1. The jealous MD physicians have no case. They probably know it and are unlikely to complain to the SMC. If they do, the complaint is unlikely to succeed.
  2. A complaint by a patient alleging medical negligence is a different thing and has to be decided on merits and documents. Your friend should try to abide by the MCI regulations, 2002. He should not be overzealous and should not venture beyond his discipline or capacity. He should maintain proper records.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetic kidney disease had high blood pressure (BP).
Dr Bad: It cannot be controlled.
Dr Good: We need to increase the number of antihypertensive medicines.
Lesson: Effective BP control is difficult to achieve in diabetic patients. The number of antihypertensive medications needed for BP control in diabetic patients is largely dependent on estimated glomerular filtration rate. Impaired kidney function could produce resistance to antihypertensive therapy in diabetic patients.

For comments and archives

Make Sure

Situation: A patient missed his second dose of Hepatitis B vaccine and developed Hepatitis B.
Reaction: Oh my God! Why was the vaccine not given between 1–2 months?
Lesson: Make sure that all patients who missed their second dose of vaccine at one month are given the same upto second month (1–2 months).

For comments and archives

 
  Quote of the Day

(Ramachandra Chittal)

No one gets a sudden rise, not even the sun, It takes time to rise to the peak of success, just keep your efforts going and be positive always. After failing to conquer the Himalaya twice, Edmund Hillary said, "I will come back again with more confidence because, as a mountain you cannot grow, but as a human I can".

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Porphyrin Tests

When a patient has symptoms that suggest an acute neurologic/psychiatric porphyria, such as abdominal pain, tingling in hands or feet, and/or confusion or hallucinations, or that suggest a cutaneous porphyria, such as reddening, blistering, or scarring on sun–exposed skin.

 
    Mind Teaser

Read this…………………

Which of the following statements about schizophrenia is false?

a) Schizophrenia cannot be cured.
b) There are many very effective treatments for schizophrenia.
c) People cannot live normal, productive lives while having hallucinations or delusions.
d) All of the above.
e) None of the above.

Yesterday’s Mind Teaser: Which of the following strategies might help someone with schizophrenia?

a) Labeling drawers and cupboards in the home
b) Buying soap and other personal hygiene items
c) Helping dole out medications in a pill dispenser
d) All of the above
e) None of the above

Answer for Yesterday’s Mind Teaser: d) All of the above

Correct answers received from: YJ Vasavada, Dr PC Das, Faustian.

Answer for5th February Mind Teaser: a) A Beautiful Mind
Correct answers received from: Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Anil Bairaria, Yogindra Vasavada.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Glad to be drunk

A completely inebriated man was stumbling down the street with one foot on the curb and one foot in the gutter. A cop pulled up and said, "I’ve got to take you in, pal. You’re obviously drunk." Our wasted friend asked, "Officer, are ya absolutely sure I’m drunk?"

"Yeah, buddy, I’m sure," said the copper. "Let’s go."

Breathing a sigh of relief, the wino said, "Thank goodness, I thought I was crippled."

 
  Medicolegal Update

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

Defeat a negligence claim by showing the absence of elements of medical negligence

  • If a physician can show that no physician–patient relationship exists, this "no duty" defense may suffice to defeat the plaintiff’s action. Where there is no duty owed to the patient by the physician, a negligence claim generally fails.
  • Doctors generally have no duty to treat new patients or patients of years past, with some exceptions. This may be true even where the physician is "on call". In some cases, even though a physician treats or diagnoses a condition, a duty exists only between the physician and the patient’s employer.
  • Courts rarely hold that the "no duty" defense applies and have even held that a simple telephone consultation between a physician and emergency department personnel may be sufficient to create a professional relationship between the physician and patient, with the attendant requirement to comply with such duty. Pre–certification review of a case may also create the potential for liability.
  • Physician who wishes to withdraw from the care of certain patients, plans to relocate his or her practice, or simple retires must notify affected patients in a manner in which an ordinary and reasonably prudent physician would do so in the same circumstances. Such notice is best made in writing and mailed postage paid to the patient’s last known address.
  • All patients receiving ongoing care for potentially serious ailments should be notified by certified mail, return receipt requested, at the last known address. Such patients should be informed that their physician will continue to see them for emergencies during a certain fixed and reasonable period of time. The physician may recommend a successor physician, provide a list of suitable physicians or offer to forward records or copies of records (at reasonable or no cost) to another physician chosen by the patient.

(Ref: American College of Legal Medicine, The Medical Malpractice Survival Handbook)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Can’t avoid anger: take aspirin

Emotionally stressful events, and more specifically, anger, immediately precede and appear to trigger the onset of acute heart attack.

Episodes of anger are capable of triggering the onset of acute heart attack and aspirin can reduce this risk. said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Angry people who can not control their anger should ask their doctors to consider taking aspirin. Quoting a Harvard study Dr Aggarwal said that doctors at the Deaconess Hospital, Harvard Medical School, Boston, interviewed 1623 patients (501 women) an average of 4 days after a heart attack.

The onset anger scale identified 39 patients with episodes of anger in the 2 hours before the onset of heart attack. The relative risk of heart attack in the 2 hours after an episode of anger was 23. Regular users of aspirin had a significantly lower relative risk (1.4) than nonusers (2.9).

Anger in response to stress is also of particular importance for the development of premature heart attack in young men. An episode of anger may also trigger an acute heart attack in the next 2 hours.

 
    Readers Response
  1. Sir, It is a great service and thoughtfulness to select topics of religious and medical science of day to day importance. Regards:Y.P.Sood
 
    Forthcoming Events

Ajmer Health Fair: Ajmer’s Largest Ever Super Specialty Health Camp

Date: February 11 and 12, 2012
Venue: Patel Stadium, Ajmer
Organizer: Heart Care Foundation of India

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund, Faridabad. It is a multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of the British Menopause Society and South Asian Federation of Menopause Societies and is an opportunity to hear international faculties.

For information contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048
Download forms at: http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

 
    eMedinewS Special

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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