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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
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


7th July, 2010, Wednesday

Weight gain after age 50 and the risk of diabetes

Gaining weight after age 50, especially around the waist, increases the risk of type 2 diabetes, as per a study published in the June 23-30 issue of JAMA.

After analyzing data from the Cardiovascular Health Study conducted from 1989 to 2007, the study reviewed information on more than 4,000 people over the age of 65 and found that compared to people whose weight remained stable after age 50, those who gained the most weight after 50 (more than 20 pounds) nearly tripled their risk of developing type 2 diabetes.

The magnitude of the increased risk associated with various measures appeared to decline with age, with about half the risk in individuals aged 75 years and older compared with those aged 65 to 74 years. However, the interaction with age was significant only for BMI at age 50 and at baseline and for fat mass.  (AMA News, input from Dr Brahm Vasudeva)

Dr KK Aggarwal
Editor in Chief

drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook  

 

Photo Feature (From HCFI file)

 

Akhand Heart Darbar Forum for Open Discussion

A pre event press conference was held at Hotel Le Meridian to announce the Akhand Heart Durbar on Dec, 21, 2003 at Maulana Azad Medical College, organised by Heart Care Foundation of India. The Akhand Heart Durbar provides a forum for open interaction between the public and cardiologists about heartrelated problems.

Dr k k Aggarwal

Ajay Jadeja during a Pre Event press conference. Also in the photo Padma Shri and Dr B C Roy  wardee Dr K K Aggarwal, President HCFI


 

News and Views

Spot the signs of TMJ disorders (Dr G M Singh)

TMJ (temporomandibular joint) disorders, affecting the jaw, are commonly triggered by grinding or clenching the teeth. TMJ disorders frequently have these symptoms:

  • Pain of muscle spasms in the facial muscles, the jaw joint, in or around the ear, shoulders or neck.

  • Painful chewing, yawning or talking.

  • Unusual sounds when opening or closing the mouth, such as clicking or popping noises.

  • Problems biting or chewing.

  • The jaw "locking up."

  • Difficulty hearing or ringing in the ears, feeling dizzy, or having headaches.
Degludec as effective as Lantus for patients with diabetes in mid-stage trial (Dr Brahma and Monica Vasudeva)

In a mid-stage clinical trial, an experimental insulin degludec, taken three times a week to treat diabetes was found to be as effective as once-daily Lantus insulin glargine injection. In patients taking degludec in the 16 week trial, the percentage of red blood cells to which sugar had attached, a measure of the illness’ severity, reduced by 1.5 points; a similar decline was reported for patients on Lantus.

Research suggests gut bacteria may influence weight

Between 10 trillion and 100 trillion microbes, mainly bacteria, reside in a person’s colon and small intestine. Researchers have recently discovered significant links between gut bacteria and weight and metabolism in mice and are starting to find similar associations in people.

Moldy homes, a serious risk for severe asthma attacks in some

A study published online on the American Thoracic Society’s journal Web site ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine reports that exposure to high levels of fungus may increase the risk of severe asthma attacks among people with certain chitinase gene variants.

MCI News

Ex-MCI Prez Ketan Desai sent to 14 days JC (PTI News)

A Delhi court on Tuesday remanded former Medical Council of India (MCI) president Ketan Desai to 14 days of judicial custody for allegedly possessing assets disproportionate to his known sources of income. Special CBI Judge O P Saini sent Desai to jail till July 20 after he was produced at the end of his eight-day custodial interrogation in the case. The court came down heavily on CBI for filing an application for extension of Desai's police custody by six more days. "You (CBI) cannot file such applications. The accused has already been in your custody for 14 days, which is the maximum period under the Act," the judge said, after which the probe agency withdrew the plea. CBI later filed a fresh application seeking judicial custody for the accused. The plea was allowed. Desai, who was granted bail on June 22 in a case of alleged corruption for allegedly taking bribe to accord sanction to a private medical college in Punjab, was arrested afresh in the assets case. He was granted bail as CBI failed to file a probe report against him within the prescribed limit of 60 days. CBI had registered the DA case against Desai and his wife and mother in May for having assets worth over Rs 24 crore. .

Rs.20 cr. recovered in Income Tax raids on 2 colleges (The Hindu)

The Income Tax Department on Friday recovered Rs.20 crore in unaccounted cash from two private educational institutions when the investigation directorate raided their premises here and in Coimbatore. For the first time, IT officials recovered Rs.11.5 crore cash from a single institution. The money had been collected from students as capitation fee. A press release from S. Ravichandran, Additional Director of IT (Head Quarters) (Investigation) stated that search and survey operations were held in ten cases. A total of 45 premises in Chennai, Arani, Kodaikanal, Cochin, Bangalore, Coimbatore and New Delhi were covered. More than 500 personnel of the department were involved in the operation. Over Rs.11.5 crore was found in a college in Chennai, in addition to evidences of receipt of capitation fee. In Coimbatore, the department unearthed a bank account in which unaccounted capitation fee to the tune of 7.5 crore had been deposited. This was in addition to unaccounted cash of Rs.1.5 crore. The colleges covered under the search included the offices Educational, Medical and Cultural Trust run by Bangaru Adigalar's family in Melmaruvathur and the engineering and medical colleges, Dr. MGR University, St. Peter's Engineering College, Avadi, and the Sri Krishna College of Engineering and Technology, Coimbatore.

The Central Bureau of Investigation on Friday registered a case against the medical college in Melmaruvathur for various irregularities and violations of the Medical Council of India norms. Sources in the agency said the college authorities had connived with former MCI president in getting recognition. A special team of the CBI's Anti-Corruption Branch raided the college on Friday. 

 

Legal Column

Forensic Column (Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS)

Rape and hymen-myth & medico-legal truth: Presence of hymen does not confirm virginity and vice versa

Rape is a crime which not only abuses the victim’s body but also gravely injured the SOUL of the victim.

As a medical jurist I would like to convey to all doctors examining such cases that rape is entirely a legal definition/crime and not a medical diagnosis. The issue of complete penetration, complete act or ejaculation is not at all necessarily required/ mandatory for constitution of rape, leave alone rupture of hymen. The Apex Court of India ruled on December 29, 2009 that rupture of hymen or injury on genitalia is not a necessary requirement to prove the offense of rape. That the ‘Presence of hymen does not confirm virginity and absence of hymen does not confirm defloration’ has been much deliberated upon in many academic as well as legal forums. The Rare Act “Rara Avis” of sexual act does not take into account, in medical examination, loss of virginity. Hymen is not a brittle membrane or curtain as is commonly perceived in our society. Instead, hymen is multiple folds of mucous membrane. The Swedish Association for Sexuality Education has renamed hymen as the ‘krans,’ or ‘vaginal corona’ in English, to clear up some confusion of misconceptions about female chastity as a myth from ancient time and the hymen is treated as virginity membrane across the world.

 

Experts’ Views

Interesting tips in Hepatology & Gastroenterology
(Dr Neelam Mohan, Consultant Pediatric, Gastroenterologist, Hepatologist, Therapeutic Endoscopist & Liver Transplant Physician Sir Ganga Ram Hospital, Delhi)

Obesity 

Few Facts about breast feeding and obesity

  • Previously breast fed children are less likely to be overweight or obese at school entry.
     
  • Breast feeding for at least 6 months was associated with a risk reduction of overweight and obesity of >30% & > 40% 
     
  • Barkers Hypothesis – SGA babies with rapid wt gain in early infancy

Problems associated with obesity in children

  • Hypertension
     
  • Dyslipidemia
     
  • Orthopaedic problems
     
  • Slipped epiphyses
     
  • Blounts disease
     
  • Endocrine
     
  • Diabetes
     
  • Insulin resistance
     
  • Polycystic ovarian disease
     
  • Respiratory
     
  • Asthma
     
  • Sleep apnoea
     
  • Neurological
     
  • Behavioural
     

Question of the Day (Dr Quresh Maskati)

When should a child be first taken to see an ophthalmologist?

If there has been birth trauma or there is a positive family history of congenital vision or eye defects or the pediatrician notices anything ‘kswrong’ with the eyes, the child should be examined as soon as possible after birth.

  • Even without this history, one ophthalmic examination within the first few months of birth and one more before the child goes to pre-school is ideal.

  • If this has not been done, then the first examination should be done at least before age of 5 years.

  • Detection of unequal spectacle number or refraction error only in one eye, can be rectified by using corrective glasses.
 

View Point

In this column, eminent Padma Awardees express their thoughts on Medical education. Today, we present the views of Padma Shri Awardee Prof. (Dr.) Prem K. Kakar

It is gratifying that medical education is on the upswing. Gradually and consistently more and more attention is being given to the medical education in the country. But one aspect which is currently creating problems for the medical education is want of training the doctors to serve people who live in the periphery and the villages have not been properly directed. I think special attention should be given to this aspect because majority of the public of India still is away from the cities. Incidentally, the number of new medical colleges are coming up whereas standard of medical education, though it is governed by the Medical Council of India, is, in fact, not what it should have been.

Therefore, special attention should be kept equally in all the medical qualities ensuring that the teaching provisions and facilities are adequate for equipping medicos to be worthy doctors who are really equipped to serve the ailing.

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Public Forum (Press Release for use by the newspapers)

Even low cholesterol may be harmful

Following the laws of nature can keep one healthy, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela. Misuse or overuse of anything is not good. If the uterus is not used for producing a baby it will produce a fibroid tumor, or if it is overused in producing babies, it can end up with cancer. The same is true with cholesterol levels. If cholesterol levels are high a heart attack may result, and if the cholesterol level is very low, it can cause cancer.

Quoting a study published in Journal of American College of Cardiology, Dr. Aggarwal said that if cholesterol is lowered more than normal using anti cholesterol drugs (statins), there is a small chance of developing cancer. This is one reason why cholesterol drugs should be given under medical supervision. Internationally there has been a move to make anti cholesterol drugs as over– the–counter drugs which is not the right move for India.

In the research, slight increase in cancer incidence was found in 13 trials studied. The increase in cancer incidence was found in statin users who achieved the lowest LDL bad cholesterol levels and did not involve any specific type or location of cancer.

 

An Inspirational Story

Generosity

Mahatma Gandhi went from city to city, village to village collecting funds for the Charkha Sangh. During one of his tours he addressed a meeting in Orissa.

After his speech a poor old woman got up. She was bent with age, her hair was grey and her clothes were in tatters. The volunteers tried to stop her, but she fought her way to the place where Gandhiji was sitting. "I must see him," she insisted and going up to Gandhiji touched his feet. Then from the folds of her sari she brought out a copper coin and placed it at his feet. Gandhiji picked up the copper coin and put it away carefully.

The Charkha Sangh funds were under the charge of Jamnalal Bajaj. He asked Gandhiji for the coin but Gandhiji refused. "I keep cheques worth thousands of rupees for the Charkha Sangh," Jamnalal Bajaj said laughingly "yet you won’t trust me with a copper coin."

"This copper coin is worth much more than those thousands," Gandhiji said. "If a man has several lakhs and he gives away a thousand or two, it doesn't mean much. But this coin was perhaps all that the poor woman possessed. She gave me all she had. That was very generous of her. What a great sacrifice she made. That is why I value this copper coin more than a crore of rupees."

 

IJCP Special

Dr Good Dr Bad

Situation: A patient with advanced LV dysfunction and heart failure came for advice.
Dr Bad: Go for mitral valve repair.
Dr Good: Mitral valve repair will not help you.
Lesson: The 2006 International Society for Heart and Lung Transplantation guidelines for cardiac transplant candidates say that isolated mitral valve repair (not associated with revascularization or ventricular restoration) should not be routinely performed in patients with advanced LV dysfunction and HF.

Make Sure

Situation: A patient of COPD with evidence of superadded chest infection was admitted to the hospital
Reaction: Oh, my god ! Septicemia! Why did you not choose doxycycline as an antibiotic?
Lesson: Make sure to prescribe doxycycline in patients of COPD with superadded chest infection as it is highly effective and a well–tolerated antibiotic in lower respiratory tract infection.

Mistakes in Clinical Practice

CPZ: Do not write CPZ for Compazine (Prochlorperazine). It can be mistaken as Chlorpromazine.

Quote of the Day (Dr. Santosh Sahi)

"The doors of wisdom are never shut." Ben Franklin

Milestones in Urology

Alexis Boyer (1757–1833) was a French surgeon, born in Corrèze. Boyer specialized in urological pathology, especially disorders of micturition. 

Mnemonic of the Day: Dr Varesh Nagrath

MCH 

 Motor neuron Disease
 Cerebral Diplegia
 Hereditary Spastic paraparesis

 

IMSA Update

International Medical Science Academy Update (IMSA)

Temporary suspension of rotavirus vaccine

Use of rotavirus vaccine (RV1, Rotarix) was temporarily suspended in the United States as of March 2010 due to contaminant virus found in the attenuated vaccine. (Available at: www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm205625.htm. Accessed on March 22, 2010)

 

Drug Update

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

DCI Approval Date

Risperidone long acting injection (Addl. Indication)

Indicated as monotherapy or as adjunctive therapy in lithium or valproate for the maintenance treatment of Bipolar–1 disorder.

29.08.2009

 

Medi Finance

Understanding Mutual Funds

Payment of Claim All claims under this policy shall be payable in Indian currency. All medical treatments for the purpose of this insurance will have to be taken in India only. For the purpose of settlement of claim a TPA (Third Party Administrator) is appointed by the insurer to scrutinize the claim documents and settle the same on cashless basis.

 

Lab Medicine (Dr Arpan Gandhi and Dr Navin Dang)

Indirect Antiglobulin Test

Also known as: IAT; Indirect Coomb's test; Antibody screen; Indirect Anti–human globulin test To detect antibodies directed against red blood cell antigens, in preparation for a blood transfusion, or during pregnancy and at delivery.

 

Humor Section

Patient to Dr Jhatka: "Whenever I drink coffee, I have this sharp, excruciating pain."
Dr Jhatka: "Try to remember to remove the spoon from the cup before drinking."

Funny Definitions

Fibula………………………Quicker than someone else

Medical bloopers on medical charts!

Many years ago the patient had frostbite of the right shoe.

 

Readers Responses

  1. Sir, This is regarding Maj. Prachi Garg's Abbreviation, regarding onset of rash in fever. During my student days which was long time back, it was taught that "Certain Silly People Make Typhus Typhoid", where C for Chickenpox, S for Scarlet fever & M for Measles. Dr.Rohini Dhillon.
  2. Hi Dr. KK, The puzzle of the day was very interesting.  It took me about 5 minutes to come to the right conclusion.  How is it that this will be possible only during 2010? Good to read these things also to keep yourself busy. Regards. Ashok Ahooja
  3.  The column by Dr Neelam Mohan is very educating. Make sure she continues. Dr A Saxena
  4. Hi Dr. Aggarwal, Today, the 6th of July is Dalai Lama' s Birth Day, one of His very special Quote
    " If you want others to be happy, practice Compassion, If you want to be happy,practice Compassion "
    Warm Regards, Dr. Santosh Sahi
 

Forthcoming Events

eMedinews Events: Register at emedinews@gmail.com

5th September: 3 PM to 5 PM A dialogue with His Holiness Dalai Lama at Parliament Street Annexe in association with Acharya Sushil Muni Ahimsa Peace Award Trust

12th September: BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city.
8 AM – 5 PM at MAMC Auditorium, Dilli Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM

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29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama

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31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

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