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

 

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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 …

7th May 2012, Monday

Can Herbs Harm?

TOI reported that a corporate executive landed in the emergency with palpitations after consuming over a dozen cups of green tea within the span of a few hours. Green tea contain caffeine and can boosts heart rate.

The belief among some patients that "more is better" leads to significant side effects and potential harm from ingesting large quantities of herbal products.

Some facts

  1. Ephedra alkaloids (derived from Ephedra sinica or Ma huang) have been commonly combined with caffeine and marketed for weight loss and athletic enhancement. Ephedra use is linked to  hypertension, arrhythmias, myocardial infarction, stroke, and seizures.
  2. Ephedra or somlata, which Ayurvedic physicians believe was the source of somras, is widely used to control asthma, heart problems, rheumatism
  3. Some manufacturers substituted bitter orange (citrus aurantium) for ephedra in weight loss products. Citrus aurantium contains synephrine, an adrenergic agonist similar to phenylephrine and ephedrine, that has been associated with serious cardiovascular and neurological side effects.
  4. Plants containing pyrrolizidine alkaloid constituents can lead to liver toxicity secondary to venoocclusive lesions, resulting in parenchymal necrosis, fibrosis, and even cirrhosis. Hepatic injury result from the accumulation of toxic metabolites produced via the cytochrome system.
  5. Aristolochia is a Chinese herb included in weight loss herbal formulas associated with cases of nephropathy. It is also a probable human carcinogen associated with urothelial cancers.
  6. Herbal products can contain harmful contaminants including heavy metals. These may be incidental contaminants from plant raw materials or the manufacturing process.
  7. St. John's wort, has been associated with higher blood lead levels among women.
  8. Toxicities due to overuse have been documented with ginseng and licorice.
Herb-drug interactions
  1. The hyperforin component of St. John's wort induces the CYP3A4 system which metabolizes a number of drugs including protease inhibitors,cyclosporine, oral contraceptives, irinotecan, warfarin, and digoxin. Failure of anti-retroviral therapy, transplant rejection, and contraceptive failure have been reported. In addition, St. John's wort may produce the serotonin syndrome when taken with other serotonergic medications.
  2. Ginkgo biloba has anti platelet and antithrombotic effects and therefore has the potential to interact with anticoagulants such as warfarin, NSAIDs, and aspirin, leading to an increased risk for spontaneous hemorrhage and bleeding. Ginkgo biloba, found in Kashmir as Aziz tree, is used to treat brain disorders, enhance memory or control vitiligo (a skin disease)
  3. Grapefruit juice increases the bioavailability of certain calcium channel blockers by inhibiting the cytochrome P450 3A4 (CYP3A4) isoenzyme found in the liver and gut wall. The result of this inhibition is that more drug is absorbed and plasma concentrations increase.
  4. Saw palmetto is a berry grown in California but widely available in India to control early baldness. Saw palmetto is also known to increase the risk of bleeding. These supplements should be discontinued two weeks before surgery, including dental surgery.
  5. Herbs that have shown to specifically decrease blood sugar are flaxseed (linseed), cinnamon, whey protein and fenugreek (methi). Coca and coca may increase blood sugar .
  6. Dong quai (Chinese herb used to reduce PMS), red clover, soy and saw palmetto have androgenic as well as antiandrogenic (male hormone) effects and estrogenic as well as antiestrogenic (female hormone) effects and many other hormonal effects.
  7. Ephedra, green tea and hawthorn (thorn apple) and mistletoe present can increase the blood pressure.
  8. Garlic is a natural way to keep BP in check, but it may not always be good for those taking blood-thinning pills.
  9. Chondroitin is often used to treat osteoarthritis. People using chondroitin may suffer from bleeding complications during surgery.

(http://blogs.kkaggarwal.com/2012/05/can-herbs-harm/)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Monitoring LFT in a patient on statins

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day organized at DPS Mathura Road

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal delivers lecture on the occasion of World Earth Day. The event was organized by Heart Care Foundation of India, DPS Mathura Road and Ministry of Earth and Sciences

 
Dr K K Aggarwal
 
    National News

Traditional medicine to get separate drug control chief

NEW DELHI: India will have two separate drug controller generals – one for allopathic medicine and the other for traditional medicine. A day after TOI reported that the Steering Committee’s report on AYUSH (ayurveda, unani, siddha and homeopathy) has suggested a separate DGCI for ayurveda, siddha and unani drugs, minister of state for health S Gandhiselvan said the expenditure finance committee has approved creation of infrastructure for Central Drug Controller for AYUSH drugs. The world herbal market is estimated at $62 billion, of which China and India’s share are $19 billion and $1 billion, respectively. There are around 10, 000 ASU Drugs manufacturing units in the country. Azad said, "To ensure the quality and standards of ayurveda, siddha and unani (ASU) medicines and effective enforcement of the provisions of the Drugs & Cosmetic Act, the Ayurveda, Siddha and Unani Drugs’ Consultative Committee (ASUDCC), chaired by Drugs Controller General of India (DCGI), recommended creation of separate Central Drug Controller for ASU drugs. It will facilitate the increased acceptability of ayurveda, unani, siddha and homoeopathy medicines within the country and abroad." (Source: TOI, May 5, 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)

Lab values predict acute–on–chronic liver failure mortality

High international normalized ratio (INR), serum creatinine, and serum bilirubin levels independently predict mortality in patients with acute–on–chronic liver failure (ACLF). Although the causes of underlying liver disease and acute liver insults differ in Asia and Western countries, the mortality rates are similar, Hitendra Garg, MD, DM, assistant professor at the Institute of Liver and Biliary Sciences and member of the Department of Gastroenterology at the G.B. Pant Hospital in New Delhi, India, reported at the International Liver Congress 2012. Dr. Garg explained that chronic liver disease in the West is mainly of alcoholic (65%) and viral (17%) origin; in the East, the main causes are hepatitis B virus (HBV) infection (37%) and alcohol (34%). (Source: Medscape)

For comments and archives

Gene transfer stable and persistent in HIV–infected patients

Gene transfer using a retroviral vector that directs a patient’s T cells to recognize HIV appears to be safe and persistent, according to a study published May 2 in Science Translational Medicine. (Source: Medscape)

For comments and archives

Omega–3–rich diet may protect against Alzheimer’s disease

Increased consumption of omega–3 polyunsaturated fatty acids (PUFA) correlate significantly with lower plasma levels of beta–amyloid 42 (Aβ–42) in elderly individuals without dementia, researchers found. The association of higher omega-3 intake and lower plasma Aβ–42 they observed was independent of age, sex, ethnicity, education, and APOE genotype and has been "linked with reduced risk of incident Alzheimer’s disease (AD) and slower cognitive decline in our cohort," they note. The study, from Nikolaos Scarmeas, MD, MSc, associate professor of neurology, Columbia University Medical Center in New York City, and colleagues was published online May 2 in Neurology. (Source: Medscape)

For comments and archives

FDA must be proactive about postapproval drug safety: IOM

A report by the Institute of Medicine (IOM) instructs the US Food and Drug Administration (FDA) to make postmarketing research of drugs’ risks and benefits a priority and to develop a centralized system for managing all information about drugs throughout their life cycles. This report was prompted by several high–profile drugs found to be harmful once they were in widespread use, including Vioxx (rofecoxib, Merck), Avandia (rosiglitazone, GlaxoSmithKline), and selective serotonin reuptake inhibitors (in children). Initially undertaken as a response to these incidents, which occurred after the drugs had been approved, the IOM determined that simply looking at the issue from a postmarketing perspective was not enough and that the FDA needed to develop a way to prevent these problems in the future. (Source: Medscape)

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  Twitter of the Day

@DrKKAggarwal: My 5 Moments For Hand Hygiene Hand hygiene is the primary measure to reduce health care associated infections. http://fb.me/1vs7CKvHq

@DrKKAggarwal: Spirituality is not a contrived mood or behavior but a simple unaffected humanity.

 
    Spiritual Update

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

Anger Prevention

1. As per Shiva Puran, anger management is described under Neelkanth role of Lord Shiva. The colour blue means slow poison (one of them being anger) which is kept in the neck.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How is endometrial ablation done?

The nerves in the uterus cannot feel heat, cold, or electrical stimulation; endometrial ablation is usually performed using one of these technologies. The doctor may give you other medications the night before the endometrial ablation. These medications will make it easier to insert the devices used for the procedure into the uterus. There are several types of endometrial ablation, including:

  • Electrosurgery: This type of endometrial ablation is performed in a hospital operating room. During the procedure, your doctor will either put you to sleep or give you medications through your veins to make you unaware of the procedure. Using a special telescope, called a hysteroscope, the doctor will examine the inside of your uterus. Then the doctor will use a tool called a rollerball or other instruments that have electrical current to destroy the endometrium.
  • Balloon endometrial ablation: In this procedure, the doctor places a flexible latex balloon into the uterus. The balloon is then filled with hot fluid until it is big enough to rest against the endometrium and destroy the endometrium.
  • Bipolar radiofrequency: The doctor places a thin wand, or probe, into the uterus. When the device is turned on, it puts out short waves of energy that destroy the endometrium.
  • Cryoablation: The doctor inserts a very small probe into the uterus. It is cooled to a very low temperature so that it freezes and destroys the endometrium.

For comments and archives

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

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

Blood products

  • The preparation of blood components allows a single blood donation to provide treatment for 2 or 3 patients and also avoids the transfusion of elements of the whole blood that the patient may not require. Blood components can be also be collected by apheresis.
  • Plasma can transmit most of the infections present in whole blood and there are may very few indications for its transfusion.
  • Plasma derivatives are made by pharmaceutical manufacturing process from large volumes of plasma comprising may individual blood donations. Plasma used in this process should be individually tested prior to pooling to minimize the risks of transmitting infection.
  • Factors VIII and IX and immunoglobulins are also made by recombinant DNA technology and are often favored because there should be no risk of transmitting infectious agents to the patient. However, the costs are high and there have been some reported cases of complications.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

A sure and true blessing

How do you measure the goodness of God? Is it only in perfect answers to our prayers? Is it only when we are so focused on perfection that nothing less will do? Or is it in finding something worth holding on to when the whole world seems to be falling in a deep abyss?

Shawn Michael Toombs was born with spinal bifida. His mother, my friend, had the hopes and dreams of every new mother. A perfect painless delivery, a cuddly newborn with all their fingers and toes, and the ability to bring home her baby to a new and spotless nursery. She experienced very little of that, especially in the order listed. She had a very difficult delivery that ended in a C-section. Thankfully, her son had all his fingers and toes but also a sac on his back that contained tissue and cerebrospinal fluid and also nerves and part of the spinal cord. Before she had time to comprehend that the baby, who had made her happy just by moving inside her belly during the previous months, was not healthy, he had immediate surgery and then was put in a body cast……a series of casts that would be changed frequently over the next 3 years. She came home from the hospital without her sweet newborn. Her days were spent traveling from home to the hospital and trying to comprehend all the instructions that nurses and doctors were plowing her with. Extra minutes were spent on thinking of innovative ways to bath her baby, keep his dressings dry and scratch his itches up under the cast. One blessing found was that 92% of newborns born with a defect as severe as Shawns’ also have hydrocephalus. Shawn’s brain was fine and healthy.

In all probability, God had already instructed Shawn on his trials that he’d face on earth. He was a happy baby and took his medical crisis’s in stride. Maybe it was because that baby knew he was loved and prayed for from the moment of his conception.

As he grew, new problems were discovered and the hospital and doctor’s office staffs became his new friends. He had physical therapy, daily medications, catheterizations and a whole host of other therapies every day. His grandpa made him a turtle on wheels. His little casted body fit right into the turtle and he could use his hands to wheel around where ever he needed to go. So, while other toddlers were learning to crawl, he was wheeling his way everywhere! As he grew older, metal crutches were made for his wrists. I cannot tell you how everyone from church cheered when Shawn walked his little body into Sunday school. He had on a cute little suit… but no one noticed his attire or the large silver crutches. It was his smile that caught everyone’s attention… it went from one ear to the other.

Shortly after that, it was learned that his spine was severely curved, almost like a fish hook. All his intestines were being crowded to one side. It wasn't physically causing pain, but not allowing his internal organs to grow. They were to perform a surgery on his spine by inserting steel rods on each side of his spine, hopefully correcting the problem. He would be awake during this surgery so they could see if there was any paralysis. He came out of the surgery suite with no feeling from the chest down. Shawn would never use his metal crutches again. He was given a wheelchair instead. The boy was a menace on wheels at times. But, still a blessing. It was during this time his father chose to walk out of his life.

His grandfather concocted another riding round–about for Shawn. A lawnmower type machine where he could get out in the neighborhood and socialize. That worked well for years until he turned it over one day. It was several days before they realized he had broken his leg because he had no sensation from his chest down. The first of several broken bones. He handled that with his famous smile and attitude and another cast.

Shawn made many friends throughout school and rolled his wheelchair across the auditorium to receive his diploma. He got around in a camaro with modified gears and remained optimistic about everything except his father. His father would go years without even inquiring about his son. Shawn told me once that he thought his father was ashamed of him. "NO WAY," I told him. I tried to explain that his father probably just couldn’t handle the feeling that he thought he might be responsible for Shawn’s condition. It’s hard trying to keep to yourself how sorry and low down you think a man is while explaining to his son that he just has problems. All of us finally quit being nice about his father. Everyone loved Shawn and he couldn’t figure out why his dad didn’t. But, he was BLESSED with a wonderful stepfather who couldn't love him more and met all his needs with complete dedication.

For years he has endured many, many surgeries, catheters, needles, daily medications and hospitalizations, and now dialysis. His frequent urinary infections and crowded organs have virtually destroyed his kidneys. Because of his many physical problems, he is not a candidate for transplant. The dialysis treatments are hard and draining on Shawn but he still has that irresistible smile and that wonderful indomitable spirit. He is intelligent, good and strong. (And cute!) That’s how he got through the shock of seeing his father walk through the doors of the dialysis clinic. Not to see his son… but, for his own dialysis treatments. He didn’t say one word to Shawn – not one. The dialysis nurses try not to schedule their treatments where they can run into each other, but at times it still happens. His father has never spoken a word to his son on those rare times they are there together. But, Shawn still smiles. He realizes it’s his father’s loss to have chosen not to have a part in his life. I did mention how intelligent he is… right?

My friend’s life has not been easy. She has fought every fight to make sure that her son has had every advantage. Shawn has outlived every doctor’s estimation of his life’s expectations. My friend shared that she was afraid she’d lose it when the time finally came to let him go. I could only tell her to enjoy him every single minute. God doesn’t give us our children… He shares them with us. They have always been His. It’s our job to love them, mold them and prove to God how worthy we are of His decision to pick us as their parent. When Shawn leaves us, hopefully many, many years from now, I know God will tell him, "Well, done, my good and faithful servant." He’ll give my friend a high five and tell her, "You done well!" She has always known her true and sure blessing in Shawn!

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  Cardiology eMedinewS

Lower MI Death Risk Linked To Five Strategies Read More

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with high blood pressure was found to have low vitamin D levels.
Dr. Bad: Vitamin D has nothing to do with high blood pressure.
Dr. Good: It may be the cause of your high blood pressure.
Lesson: Data has shown that curing vitamin D deficiency can lower blood pressure.

For comments and archives

Make Sure

Situation: A patient with 105 degree fever was not responding to the paracetamol.
Reaction: Oh my God! Why was IM paracetamol given?
Lesson: Make sure to remember that when the fever is greater than 105 degree, giving only fever medicines will not work. The answer is tap water sponging to lower the temperature.

For comments and archives

 
  Legal Question of the day

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

Q. Doctors obtain medical education in government medical colleges at negligible cost and then go to USA . The country is the loser. What is the solution?

Ans.

  • It is a fact that many doctors want to go abroad as soon as they pass MBBS. This is particularly true of AIIMS graduates, the majority of whom prefer to go to USA.
  • It is also a fact that the politicians and the government have been issuing statements that doctors should stay in the country and should serve the poor people in the rural and remote areas.
  • Both the above facts, though contradictory, cannot be faulted. Doctors commit no illegality by going abroad. They have a right to do so, especially when the government is not able to give them jobs in India and is not able to ensure that the opportunities for postgraduate medical studies will be purely merit based.
  • The government has recently proposed that a ban will be enforced on doctors going to USA in such a manner that those going there for higher studies will have to return to India on the completion of the studies. The government would be well advised to enforce the ban in such a manner that no illegality or unconstitutionality is committed. The doctors should be ever ready to challenge such a scheme on legal grounds.
  • The real and lasting solution to the problem lies in the following approach:
    • Medical education, which is highly subsidised at present, should be allowed to follow market forces but with a caution that professional and academic standards are not compromised and the meritorious and the deserving are not denied educational opportunities because of poverty. This would mean that the government medical colleges, including AIIMS, should charge fees on the same lines as the private medical colleges. The result will be that the so–called menace of the so called capitation fee will cease to exist. The government must clearly specify the amount of fees payable by a student.
    • The government should ensure that those who cannot pay high fees should not be denied medical education simply because of inability to pay. The amount incurred on their medical education (referred to as the bond amount) should be recoverable from them through a bond executed before entering the medical college.
    • The mechanism for recovering the bond amount should be flexible and should allow different means of payment such as the following:
      • Lump sum payment on passing MBBS.
      • Monthly payment in instalments in the following manner:
        • The government should offer a government job at the regular government pay scales, allowances and designation etc.
        • Service and salary must start from the very next day immediately after passing MBBS. If this is not done, the bond should automatically be treated as lapsed/ineffective.
        • Bond amount should be payable in instalments equal to about one fourth of the basic salary plus NPA. The installment amount should be automatically deductible from the monthly salary.
    • It is to be noted that the bond system is perfectly valid in law and, in various forms, already exists in case of MBBS education imparted at AFMC; CMC Vellore; CMC, Ludhiana; and, Kerala (vide Kerala Government’s "G.O.(MS) No.533/2008/H&FWD dated 07.10.2008". It is incorrect to equate this system with the concept of bonded labour as defined in the Abolition of Bonded Labour System Act,1976.
    • If a bond is rendered ineffective in respect of a particular candidate, the bond amount should be recovered from the salaries of government officers responsible for such lapse. (If this is not done, the officers concerned would find it convenient to allow the bond to lapse for ulterior motives).
    • The fundamental rights of doctors as guaranteed in Articles 12 to 35 of the Constitution must be ensured before doctors are posted to rural or remote areas. Special focus needs to be given to the following:
      • ARTICLE 14: They must be ensured equality before law. For example: All doctors must be liable to be posted in rural/remote areas. No exemptions in respect of the "preferred" individuals should be allowed. Principles of natural justice must never be violated. Arbitrariness must be avoided.
      • ARTICLE 21: This article ensures right to "Protection of life and personal liberty". This right would include, as per court judgments, the following:
        • Right to life: In practical terms, this would mean adequate law and order situation; means of communication including roads, telephone and internet; posting in a place where there is a police post nearby and, preferably, a government servant of equivalent or higher rank is staying. It would also include right to safe housing, water supply and sanitation.
        • Right to health––In practical terms, this would mean that adequate facilities must exist for the doctor and his family as regards local treatment and treatment and transport to a referral centre.
      • ARTICLE 21A—This article ensures right to education up to age of 14 years. In practical terms, it would mean that educational facilities as mandated by this Article must be available for the dependents/family members of the doctor concerned.
    • PG medical education should be purely merit based and all reservations at PG level must stop.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

If you are right then there is no need to get angry, And if you are wrong then you don’t have any right to get angry.

 
  Rabies Update

(Dr AK Gupta, Author of Rabies the Worst Death)

Is there any role of systemic antibiotic treatment for animal bites infections?

Treatment with prophylactic antibiotics for 3 to 7 days is appropriate for dog bite wounds, unless the risk of infection is low or the wound is superficial. If frank cellulitis is evident, a 10– to 14–day course of treatment is more appropriate. Amoxicillin–clavulanate potassium is the antibiotic of choice for a dog bite. For patients who are allergic to penicillin, doxycycline is an acceptable alternative, except for children younger than eight years and pregnant women. Erythromycin can also be used, but the risk of treatment failure is greater because of antimicrobial resistance. Other acceptable combinations include clindamycin and a fluoroquinolone in adults or clindamycin and trimethoprim–sulfamethoxazole in children. When compliance is a concern, daily intramuscular injections of ceftriaxone are appropriate.

For comments and archives

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Cervical cancer is the only cancer suggested by WHO for routine screening.

 
    Mind Teaser

Read this…………………

Where are Chinese gooseberries from?

Yesterday’s Mind Teaser: Marco who was diagnosed with brain tumor was scheduled for craniotomy. In preventing the development of cerebral edema after surgery, the nurse should expect the use of:

a. Diuretics
b. Antihypertensive
c. Steroids
d. Anticonvulsants

Answer for Yesterday’s  Mind Teaser: C. Glucocorticoids (steroids) are used for their anti–inflammatory action, which decreases the development of edema.

Correct answers received from: Dr. Thakor Hitendrsinh G, Raju Kuppusamy, Kanta Jain, Dr.Chandresh Jardosh, Dr Jainendra Upadhyay, Dr Shiran, Gopal Das, Debashish

Answer for 5th May Mind Teaser: E. Four to five cups of fruit and vegetables.
Correct answers received from: Dr. Thakor Hitendrsinh G, Dr Ravi, Dr Prakash, Dr suresh

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

New Evening Classes For Men!!!

Evening classes for men. Starting this month! All are welcome! Open to men only!

Note: due to the complexity and level of difficulty of their contents, each course will accept a maximum of eight participants each.
Topic 7. Health watch: bringing her flowers is not harmful to your health. Graphics and audio tape.
Topic 8. Real men ask for directions when lost. Real–life testimonials.
Topic 9. Is it genetically impossible to sit quietly as she parallel parks? Driving simulation.
Topic 10. Learning to live: basic differences between mother and wife. Online class and role playing.
Topic 11. How to be the ideal shopping companion. Relaxation exercises, meditation and breathing techniques.
Topic 12. How to fight cerebral atrophy: remembering birthdays, anniversaries, other important dates and calling when you’re going to be late. Cerebral shock therapy sessions and full lobotomies offered.

 
    Medicolegal Update

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

WMA guidelines for clinical research combined with professional care

The mission of a medical doctor is to safeguard the health of the people. The Declaration of Geneva of the World Medical Association (WMA) binds the doctor with the words, "The health of my patient will be my first consideration." In the treatment of the sick person, the doctor must be free to use a new diagnostic and therapeutic measure, if in his/her judgment it offers hope of saving life, re–establishing health or alleviating suffering.

  • The potential benefits, hazards and discomfort of a new method should be weighed against the advantages of the best current diagnostic and therapeutic methods.
  • In any medical study, every patient including those of a control group, if any, should be assured of the best proven diagnostic and therapeutic method.
  • The refusal of the patient to participate in a study must never interfere with the doctor–patient relationship.
  • If the doctor considers it essential not to obtain informed consent, the specific reasons for this proposal should be stated in the experimental protocol for transmission to the independent committee.
  • The doctor can combine medical research with professional care, the objective being the acquisition of new medical knowledge, only to the extent that medical research is justified by its potential diagnostic or therapeutic value for the patient.

(Ref: 18th World Medical Assembly, Helsinki, Finland, 1964 and revised by the 29th World Medical Assembly, Tokyo, Japan, 1975).

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

May: International BP & Stroke Awareness Month

Talking to a gathering of doctors Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Dean, Board of Medical Education, Moolchand Medcity, said that May is International Blood Pressure and Stroke Awareness.

Giving the details, Dr. Aggarwal said that blood pressure should be checked at the same time and in the same arm whether monthly, semi annually or annually.

If one has borderline high blood pressure, one should take preventive measures immediately and not wait till the blood pressure gets dangerously high. Changes in lifestyle and nutrition can greatly impact blood pressure and help avoid lifelong medication.

One should not take blood pressure measurements immediately after taking coffee, cola or other drinks containing caffeine. One should also wait one hour after taking cold or allergy medicines. This can temporarily raise the blood pressure. Blood pressure should be taken while standing or sitting. One should not take the reading until the person has been in the same position for the couple of minutes.

Dr. Aggarwal said that the following people should have blood checkup done immediately:

  • If their family members have high blood pressure
  • Women who are pregnant
  • People above the age of 35
  • Overweight
  • Not physically active on a regular basis.
  • Takes more than 2 drinks per day in men or more than 1 drink per day in women.
  • Eats too much fatty food
  • Eats too much salt in the food

Blood pressure is a silent killer and the only way to know whether you have high blood pressure or not is to have it checked up.

At any age blood pressure should be kept lower than 120/80 mmHg.

Salient points

  • If uncontrolled, blood pressure can cause heart attack, paralysis and kidney failure.
  • High blood pressure is responsible for 67% of all heart attacks.
  • High blood pressure is responsible for 77% of all paralytic attacks
  • High blood pressure is associated with 74% of all heart failure cases
  • High blood pressure is responsible for 26% of all kidney diseases
  • High blood pressure causes more visits to doctors than any other condition.
  • High blood pressure is a risk factor for mental deterioration and dementia.

The five most common warning signs of stroke are

  • Sudden weakness in the face, arm or leg, particularly if the weakness occurs on only one side of the body
  • Sudden severe headache
  • Sudden vision disturbance in one or both eyes
  • Sudden confusion or difficulty speaking; and/or
  • Sudden dizziness, loss of balance, loss of coordination or difficulty walking.
 
    Readers Response
  1. Dear Sir, Emedinews is a real source of information: Regards Dr Suman
 
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Dr K K Aggarwal

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

 
    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)

HCFI
Activities eBooks

  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    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, Dr Usha K Baveja