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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

7th July 2011, Thursday

Can lung cancer occur in non smokers?

I recently came across three women with lung cancer in one year. All had lung adenocarcinomas and were non smokers. My undergraduate teaching has been that lung cancers are practically unknown in non smokers. All three patients were from urban areas with no significant exposure to passive smoking and had not been using the rural ‘chulha’ burner for cooking. This motivated me to know more about this cancer.

Lung cancer is the leading cause of cancer deaths all over the world. It causes over one million deaths annually. Even in urban India, it is the number one cause of cancer. It is a well–known fact that exposure to tobacco smoke is the main factor responsible for it. The relationship is so well–established that if a non smoking person comes to us we tend to ignore a possibility of lung cancer and start looking for other cancers.

Lung cancer is also a significant health problem in those with no history of smoking. The term "never smoker" refers to individuals who have smoked fewer than 100 cigarettes in their lifetime. Lung cancer in never smokers comprises an estimated 15% of all lung cancer cases in men and 53% in women. In Asia, 60–80% of women with lung cancers are never smokers.

Despite the higher incidence of lung cancer in never smokers in women compared to men, the mortality is higher among never smoker men. Lung cancer occurs at a younger age in never smokers, especially in the Asians. The risk factors are secondhand smoke (environmental tobacco smoke), radon (uranium miners), exposure to asbestos, chromium, and arsenic, indoor air pollutants such as vapors from cooking oil and the smoke from burning coal (Asia), prior damage to the lungs, exposure to radiation or chemotherapy and exposure to human papillomavirus (HPV). Higher intake of fruits and vegetables may be protective against lung cancer.

Adenocarcinoma is more common in never smokers, light smokers, and former smokers, while squamous cell carcinoma and small cell lung cancer are seen with a higher incidence in heavy smokers.

The treatment is also different. The epidermal growth factor receptor (EGFR) pathway abnormalities seen in never smokers have been associated with a particular responsiveness to erlotinib and gefitinib, agents that inhibit EGFR tyrosine kinase.

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

Carboplatin dosing

For most patients, carboplatin dosing uses the Calvert formula, which is based upon desired exposure (area under the curve (AUC) of concentration X time) and the glomerular filtration rate (GFR). When the GFR is estimated based upon measured serum creatinine, limit the maximal GFR to 125 mL/min for this calculation.

 
  eMedinewS Audio PostCard

Padma Shri & Dr BC Roy National Awardee
Dr K K Aggarwal

eMedinewS Medical News of the day

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Doctors’ Day Observed by Delhi Medical Association

Delhi Medical Association observed Doctors’ Day on 1st July 2011 at DMA Hall, New Delhi. In the Photo: Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal along with other eminent doctors paying tribute to Dr BC Roy in whose honor this day is celebrated.

 
Dr K K Aggarwal
 
    National News

NIN’s new diet guidelines

HYDERABAD: Do a little bit of household work, walk briskly, run and play whatever sport you are interested in or simply dance. Just do whatever you can to give your body some exercise to burn those calories. This is not a suggestion but a medical prescription that has now come on record.

The National Institute of Nutrition (NIN) has come out with its new ‘Dietary Guidelines for Indians – A Manual’ and the ‘Guideline no. 9’ is considered the most important for the changing lifestyle of Indians. When NIN came out with its first manual in 1998, it had several guidelines except this one. "The economic transition has changed the lifestyles of people. It was taken for granted people would anyway give their body some physical exercise 15 years ago. This, however, is not happening and we have come up with the new guidelines," NIN director B Sesikeran told reporters here on Monday. The new manual was released by Indian Council of Medical Research (ICMR) director general V M Katoch at a one–day seminar on ‘National priorities in nutritional research’. The seminar was organized by NIN and Federation of All India ICMR Employees in connection with the ICMR centenary year celebrations.

Some earlier guidelines have also been revised in the new manual. While exclusive breast feeding was recommended for at least 4–6 months, now it is strictly for not less than six months. Food supplements which were from the 4th month onwards earlier should be made now only after six months. "The impression that only commercially available foods are nutritious is not correct. Low cost food supplements can be prepared at home," the guidelines said. The recommended consumption of vegetables has also been doubled. From the earlier 150 gm/day, it is now 300 gm/day. Salt intake which was 8 gm/day has been reduced to 6 gm/day. Sesikeran said it was being proposed to make the new manual available to everyone by providing for a facility where it can be downloaded.

The manual has come up with recommendations on a balanced diet for men and women separately, who lead sedentary lifestyles. Another important suggestion NIN scientists have come up with pertain to the use of microwave oven. Though microwave cooking is convenient, fast and preserves nutrients and also useful in reheating of food, it can reheat or cook unevenly and leave some cold spots in the food by which harmful bacteria can enter our body, the manual said. "It is discouraged to use large amounts or big pieces in the microwave oven. Otherwise mix the food in between for even heating or cooking. Never use partially heated food. Don’t cook frozen food in the microwave directly as it leaves some parts of the food partially cooked," the manual said. (Source: TOI, Jul 5, 2011)

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

(Dr Monica and Brahm Vasudev)

Copper slashes risk of hospital infections

The latest trial, conducted at three US facilities – has shown that the use of antimicrobial copper surfaces in intensive care units cuts down risks of hospital infection by 40.4 per cent. Antimicrobial copper touch surfaces on door knobs, railings and tray tables are made from copper alloys, such as brass and bronze, to prevent infections. These parts are often touched by people in hospitals and clinics, becoming sources of infection. Researchers at the Memorial Sloan Kettering Cancer Centre, New York, the Medical University of South Carolina and the Ralph H. Johnson VA Medical Centre, replaced bed rails, overbed tray tables, nurse call buttons and IV poles with antimicrobial copper versions, according to a Sloan Kettering statement.

Data presented by trial leader Michael Schmidt, professor of microbiology and immunology at Sloan Kettering, demonstrated a 97 per cent reduction in surface pathogens in rooms with copper surfaces. Schmidt said: "Bacteria present on ICU room surfaces are probably responsible for 35–80 per cent of patient infections, demonstrating how critical it is to keep hospitals clean." "The copper objects used in the clinical trial supplemented cleaning protocols, lowered microbial levels, and resulted in a statistically significant reduction in the number of infections contracted by patients treated in those rooms," he said. "Extensive lab tests have demonstrated copper’s antimicrobial efficacy against key organisms responsible for these infections, and clinical trials around the world are now reporting on its efficacy in busy, real–world environments," Schimidt concluded. (Source: TOI, Jul 4, 2011)

FDA approves once–daily bronchodilator for COPD

The US Food and Drug Administration (FDA) today approved a once–daily bronchodilator — indacaterol maleate (Arcapta Neohaler, Novartis Pharmaceuticals) — for chronic obstructive pulmonary disease (COPD) that promises better patient adherence than twice–a–day bronchodilators on the market. Indacaterol maleate is a new molecular entity in the ß2–adrenergic agonist class that helps relax muscles around lung airways to prevent COPD symptoms, such as wheezing and breathlessness. (Source: Medscape)

Ranibizumab improves diabetic macular edema

Ranibizumab injection (Lucentis, Genentech) in patients with diabetic macular edema (DME) resulted in significant, rapid, and sustained improvement in vision compared with placebo injections, regardless of whether the patient had achieved glucose control, according to data from the RISE and RIDE studies. Ranibizumab is a vascular endothelial growth factor inhibitor. David S. Boyer, MD, from the Retina–Vitreous Associates Medical Group in Los Angeles, California, presented the results in a late breaking clinical trials session here at the American Diabetes Association (ADA) 71st Scientific Sessions. (Source: Medscape)

 
    Fitness Update

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

Higher exercise intensity decreases cancer risk

A growing body of evidence supports the fact that exercise significantly lowers the rate of many types of cancer, including breast, colon and prostate cancer, according to the Centers for Disease Control and Prevention (CDC). To further test the impact of exercise on cancer, researchers from Finland wanted to determine if there is a relationship between exercise intensity and cancer prevention. As there are no studies to date that have been conducted on this subject, researchers used cancer mortality and leisure time physical activity intensity to assess whether a correlation exists.

Researchers recruited 2,560 men with no previous history of cancer to participate in the study. They assessed physical activity with questionnaires for an average follow–up period of 16.7 years. Over this time, a total of 181 deaths occurred as a result of cancer. Over this time, a total of 181 deaths occurred as a result of cancer. Researchers measured physical activity using units called MET (or metabolic equivalents of oxygen consumption), which are indicative of intensity. After a careful analysis, they found that men with leisure–time physical activity of more than 5.2 MET (which was the group with the highest score) had a significantly lower rate of cancer mortality compared with men whose mean intensity of physical activity was less than 3.7 MET (the group with the lowest score).

 
    Twitter of the Day

@DrKKAggarwal: http://www.itimes.com/users/iti475269/blogs
Anger management http://fb.me/13iyaVLZ9

@DeepakChopra:Digestion happens, the heart beats, neurons fire, life lives without any effort on your part. All we need is to stop interfering

 
    Spiritual Update

Science behind Hanuman Chalisa

Nava Nidhi

Haadi Vidya: Once a person acquires this vidya, he neither feels hunger nor thirst, and can remain without eating food or drinking water for several days at a stretch.

 
    An Inspirational Story

(Ritu Sinha)

The house with the golden windows

The little girl lived in a small, very simple, poor house on a hill and as she grew she would play in the small garden and as she grew she was able to see over the garden fence and across the valley to a wonderful house high on the hill – and this house had golden windows, so golden and shining that the little girl would dream of how magic it would be to grow up and live in a house with golden windows instead of an ordinary house like hers.

And although she loved her parents and her family, she yearned to live in such a golden house and dreamed all day about how wonderful and exciting it must feel to live there.

When she got to an age where she gained enough skill and sensibility to go outside her garden fence, she asked her mother is she could go for a bike ride outside the gate and down the lane. After pleading with her, her mother finally allowed her to go, insisting that she kept close to the house and didn’t wander too far. The day was beautiful and the little girl knew exactly where she was heading! Down the lane and across the valley, she rode her bike until she got to the gate of the golden house across on the other hill.

As she dismounted her bike and lent it against the gate post, she focused on the path that lead to the house and then on the house itself…and was so disappointed as she realized all the windows were plain and rather dirty, reflecting nothing other than the sad neglect of the house that stood derelict.

So sad she didn’t go any further and turned, heart broken as she remounted her bike… As she glanced up she saw a sight to amaze her…there across the way on her side of the valley was a little house and its windows glistened golden…as the sun shone on her little home.

She realized that she had been living in her golden house and all the love and care she found there was what made her home the ‘golden house’. Everything she dreamed was right there in front of her nose!

 
    Pediatric Update

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

How is croup diagnosed?

The diagnosis of croup is a clinical one, because complete blood count tends to be normal. Radiographs may be helpful in differentiation of other disease entities such as epiglottitis, retropharyngeal abscess, congenital abnormalities, a foreign body, or hemangioma. The classic radiographic finding in a patient with croup is the steeple sign. Distension of the hypopharynx and of the laryngeal ventricle and haziness or narrowing of the subglottic space may be seen on a lateral neck radiograph; however, the absence of this finding does not rule out croup, because almost half of patients have normal radiographs.

 
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    Did You Know

(Dr Uday Kakroo)

The University of Alaska spans four time zones.

 
    Contrary Proverbs

(Mr Vipin Sanghi)

Slow and steady wins the race. BUT Time waits for no man.

 
    Legal Question of the Day

(Dr MC Gupta, Advocate)

Q. I am an integrated medical practitioner. I am registered under the Maharashtra Medical Practitioners Act, 1961. I have a qualification in Indian medicine and I claim, on the basis of the following acts, rules, notifications etc. that I am legally competent and allowed to practice modern medicine/allopathy. Do you agree with my claim?

Ans.

  1. I do not agree with your claim. As a matter of fact, it is not a question of whether I agree or not. It is more a question of whether the courts, including the Supreme Court, agree or not.
  2. By the way, let me make it clear that there is nothing like integrated medicine or integrated medical practitioner. This term is not mentioned in any legislation or court judgment. On the other hand, the MCI circular no. MCI/Circular/10/1116–31–32/Anti–quackery/2010 dated 10–8–2010 sent to various authorities (Health Secretaries of all states; (Health directorates of all states; (Directors of Indian Systems of Medicine & Homeopathy of all states; Registrars of all State boards/Councils; District magistrates of all states; Superintendent of Police of districts of all states; and, Secretary–general of IMA) states in para 3 as follows: "There is no system of medicine recognised in our country like: 1—Electro–homeopathy; 2—Alternative System of medicine; 3—Integrated system of medicine or integrated medicine". Hence you are simply a practitioner of Indian Medicine and not of integrated medicine.
  3. Even otherwise, the word "integrated" does not occur anywhere in the Act under which you are registered.
  4. The acts, rules, notifications etc. referred by you are discussed below:

    1) According to MMP ACT 1961 section 2(fa) says that Indian medicine means astang ayurveda or siddha or unani whether supplemented or not by such modern advances as the central council from time to time by notification may declare under clause (e) of section 2 of the IMCC ACT 1970.

    My Response: This means nothing. It does not mean you are qualified to practice allopathy. This has been so held by the Supreme Court in Dr. Mukhtiar Chand & Ors. Vs. State Of Punjab & Ors., Date Of Judgment: 08/10/1998, K. T. Thomas, Syed Shah Mohammed Quadri, *AIR 1999, SC 468, *(1998 (7) SCC 579)

    Also section 25(1) says that a legally qualified medical practitioner under MMP ACT 1961,having right to practice any system of medicine shall, in all acts of the state legislature and in all central acts, i.e., IMCC Act 1970.

    My Response: You are trying to distort things. The Preamble to the Act reads— "An Act to regulate the qualifications and to provide for the registration of practitioners of the Ayurvedic, Siddha and Unani Systems of Medicine…". The words "any system of medicine" in your quote refer to any system out of the three systems mentioned. Also section 33(1)(i) says that the register mentioned under MMP ACT 1961, registered practitioners shall practice any system of medicine in the state.

    My Response: You are falsely trying to distort things. The register referred concerns only the three systems, namely, Ayurvedic, Siddha and Unani.

    2) IMCC ACT 1970, in which all practitioners of ISM are registered are having right and privilege of practicing any system of medicine have been protected under section 17(3)(b) of IMCC ACT 1970.

    My Response: Your statement is wrong. This has been so held by the Supreme Court in Dr. Mukhtiar Chand case.

    3) According to the state GAZZETE published by GOVT OF MAHARASHTRA dated 25/11/1992 it is clearly mentioned that "the govt. of Maharashtra here by directs that the Ayurvedic practitioners enrolled on the state register under MMP ACT1961 holding qualification specified in part A, B & A–1 of the schedule appended in the said act shall be eligible to practice the modern system of medicine which is known as allopathic system of medicine to the extent of the training they received in that system.

    My Response: I have not seen the said gazette notification. It appears you are again misquoting/misrepresenting. This is most likely so because the said notification is based upon the MMP ACT1, i961, which concerns only the three Indian systems mentioned above. The said notification is dated 1992 and stands over–ruled by the Mukhtiar Chand judgment dated 1998.

    4) When the food and drug commissioner issued a misguiding circular dated 18/12/1996 directing to all the chemists in Maharashtra not to honour the prescriptions of ISM doctors if it contains allopathic medicine, our organisation filed a writ petition in honourable HIGH COURT Mumbai bench, the honourable HIGH court Mumbai quashed the said circular & after that department of medical education & drug passed a GOVT. NOTIFICATION order dated 23/02/1999 that the practitioners registered under MMP ACT 1961 in part A, A–1,B&D can practice modern scientific system of medicine for the purpose of the Drug & Cosmetic Act 1940 (23 of 1940).

    My Response: The position stated by you is untenable. Mukhtiar Chand applies. MMPA has nothing to do with allopathy.

    5) In the letter issued by under–secretary b. h. Tayade dated 28/05/2007 under RIGHT TO INFORMATION ACT it is clearly informed that the Ayurvedic practitioners can practice allopathic system of medicine.

    My Response: Even if it is so stated (though not accepted) that it is so mentioned in some statement sought/given under RTI, it has no value. The purpose of RTI is to reveal official documents and not to inform about or interpret law. SC has already done that. Mukhtiar Chand is still valid.

    6) According to the CCIM resolution dated 30/08/1996 "institutionally qualified practitioners of ISM & those covered under IMCC ACT 1970 are eligible to practice Indian system of medicine & modern medicine which is known as allopathic medicine including surgery, gynecology & obstetrics based on their training & teaching. This training & teaching is included in the syllabus of CCIM. The meaning of the word modern advances means advances made in various branches of modern scientific medicine, clinical, non–clinical & bio–sciences.

    My Response: This resolution has no meaning. It cannot negate a SC judgment.

    7) According to the CCIM notification dated 30/10/1996 it is clearly mentioned that, The right of practitioners of ISM doctors to practice modern scientific system of medicine (Allopathic medicine) are protected under section 17(3)(b) of Indian Medicine Central Council Act, 1970.

    My Response: This notification was considered and not relied upon by the court in Dr. J. Kaleem Nawaz vs. State of Tamil Nadu & Ors., Madras, 29 October, 2010, M. Sathyanarayanan, J.
 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with dengue shock syndrome.
Dr. Bad: Give IV steroids.
Dr. Good: No IV steroids are indicated.
Lesson: IV steroids are no more effective than a placebo in reducing number of deaths, need for blood transfusions or the number of serious complications (Cochrane Database Syst Rev 2006;3:CD003488).

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh my God! Why was additional insulin given?
Lesson: Make sure that insulin dose is calculated correctly. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

 
  SMS of the Day

(Dr GM Singh)

Two things a man should never be angry at: what he can help, and what he cannot help. Thomas Fuller

 
  GP Pearls

(Dr Pawan Gupta)

Low levels of biological markers procalcitonin (PCT) and C–reactive protein (CRP) at 72 hours in addition to clinical criteria might improve the prediction of absence of severe complications in community–acquired pneumonia. (Thorax 2009 Nov;64(11):987–92).

 
    Medicolegal Update

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

What is the Trauma triad of death?

"Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life." Judith Herman, Trauma and Recovery

  • Trauma triad of death is a term in medicine describing the combination of hypothermia, acidosis and coagulopathy of blood.
  • In the cases of traumatic injuries if the cycle continues uninterrupted the three conditions share a complex relationship; each factor can compound the others, resulting in high mortality seen as sudden death in postmortem examination.
  • This combination is commonly seen in patients who have sustained severe traumatic injuries and results in a significant rise in the mortality rate.
  • Severe hemorrhage in trauma diminishes oxygen delivery, causing the patient’s body temperature to drop (hypothermia). This in turn can halt the coagulation which prevents the blood from clotting resulting in coagulopathy.
  • Due to the minimal level or absence of the blood–bound oxygen and nutrient, the body’s cells burn glucose an aerobically for energy which in turn increases the blood's acidity. Such an increase in acidity can reduce the efficiency of the heart muscles, further reducing the oxygen delivery and hence triggering a deadly cycle.
 
    Mind Teaser

Read this…………………

Q. Which one of the following is the most common location of hypertensive bleed in the brain?

1. Putamen/external capsule
2. Pons
3. Ventricles
4. Lobar white matter

Yesterday’s Mind Teaser: nooutwhere

Answer for Yesterday’s Mind Teaser: Out in the middle of nowhere

Correct answers received from: Dr Parvesh Sablok, Dr K Raju, Dr Muthumperumal Thirumalpillai,
Dr Neelam Nath, Dr Anil Bairaria, Dr Prabha Sanghi, Dr Chandresh  Jardosh, Dr KV Sarma.

Answer for 5th July June Mind Teaser
: 3. Cribriform plate
Correct answers received from: Dr Anupam, Dr Prachi, Dr Shreya, Febi Francis, Dr Sandhya.

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

What is Annuity?

An annuity is an investment that you make, either in a single lump sum or through installments paid over a certain number of years, in return for which you receive back a specific sum every year, every half–year or every month, either for life or for a fixed number of years. After the death of the annuitant or after the fixed annuity period expires for annuity payments, the invested annuity fund is refunded, perhaps along with a small addition, calculated at that time.

 
    Laugh a While

(Dr GM Singh)

Awesome Answers in IAS(Indian Administrative Service) Examination

Q. If it took eight men 10 hours to build a wall, how long would it take four men to build it?
A. No time at all it is already built. (UPSC 23rd Rank Opted for IFS)

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Lornoxicam 8mg/8mg + Thiocolchicoside 4mg/8mg Tablets
Additional higher strength

23/03/2010

 
    Public Forum

(Press Release for use by the newspapers)

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

Type 2 diabetics can reduce weight by WAIT Program

A short–term lifestyle modification program for overweight diabetic patients can lead to long–term benefits, said Padma Shri & Dr BC Roy National Awardee Dr K K Aggarwal and President, Heart Care Foundation of India.

In a study conducted by Dr Osama Hamdy at the Joslin Clinic in Boston, patients who had a mean A1c of 7.6% at baseline were able to lower their A1c to 6.6% after 12 weeks of the intensive program and remained at 7% after three years.

The name of the program is Why WAIT (Weight Achievement and Intensive Treatment) and it has been incorporated into regular practice at the clinic.

The researchers enrolled 141 patients with diabetes in the study, 127 with type 2 diabetes and 14 patients with type 1 diabetes. Average patient age was 53 and mean time from diagnosis was about 9.5 years. The study included 91 women. The average baseline weight of the participants was 240 pounds. Six of the patients dropped out of the study before completing the study period. The rest had at least two years of follow up, including 105 followed for 2.5 years and 70 patients with three years of follow–up.

The program included diet, exercise and weight–neutral or weight–negative medications. The diet was low in glycemic index, high in fiber, and low in saturated fat.

Patients were put on a structured strength and cardiovascular exercise program that gradually increased activity. For the first four sessions, patients were encouraged to exercise 20 to 40 minutes four days a week; during the next four the exercise prescription was increased to 40 to 45 minutes five days a week; and in the final four sessions patients were told to exercise 50 to 60 minutes six days a week. The patients also attended weekly teaching and behavioral support sessions. At the 12–week program's end, participants were instructed to follow the same plan on their own.

Intensive lifestyle changes can be successful and sustainable.

  1. Average weight loss after 12 week of the study was 24.1 pounds.
  2. Weight loss averaged 18.2 pounds at one year; 18.8 pounds at two years; and 17.2 pounds at both 2.5 years and at 3 years.
  3. HbA1c fell from 7.6% to 6.6% after 12 weeks and was 7% after one year, 6.9% at two years, 7% at 2.5 years, and 7% at three years.
  4. About 82% of patients achieved the goal of 7% after 12 weeks, but that declined to 47% at two years, 43% at 2.5 years, and 40% at three years.
 
    Readers Responses
  1. Dear Dr. Aggarwal, sometimes, when I’m stuck with a problem working on my PC or some other electronic device, and my son, Maneesh (oculo–plastic surgeon), solves it within no time, I utter the words: Rather than becoming a doctor you could have opted to be an electronics engineer. Likewise, your regular inputs on religious topics prompt me to say: Rather than becoming a doctor you could have opted to be a religious preacher! Thanks for providing us with regular updates on matters of spiritual interest besides useful information on all aspects of medicine. Dr. Narendra Kumar, ophthacare@gmail.com.
 
    Forthcoming Events

National Conference on "Insight on Medico Legal Issues"
Date: Sunday, 10th July, 2011
Venue: Auditorium, Chinmaya Mission, 89, Lodhi Road, New Delhi–110003

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

For Programme Details

Programme Schedule 10th July MEDICO LEGAL CONFERENCE
Time Session Chairperson Moderator Speaker Topic
8 Am–8:30 Am Ethical Issues in Medical Research   Dr KK Aggarwal
Dr Girish Tyagi
   
8 am–8.10 am       Ajay Agrawal Rights of a patient in medical trial
8.10–8.20 am       Dr Ranjit Roy Chaudhury Ethical Issues in a medical trial
8:20–8.30 am       Priya Hingorani Statutory permits required for conducting trials
8.30–9.10 am Medical ethics and organ donations Dr N V Kamat Dr KK Aggarwal    
8.30 am–8.40 am       Dr Anoop Gupta Ethical issues in IVF practice
8.40 am–8.50 am       Dr N K Bhatia 100% voluntary blood donation
8.50 am–9.00 am       Dr Rajesh Chawla Need for do not resuscitate laws in India
9.00 am–9.10 am       Dr Neelam Mohan Ethical issues in organ transplantation
9.10 am–9.30 am Handling cases of death Mr S K Saggar
Dr Arvind Chopra
Dr KK Aggarwal
Dr Girish Tyagi
   
9.10 am–9.20 am       Dr S C Tewari Spiritual considerations in a dying patient
9.20 am–9.30 am       Dr G.K. Sharma Medico legal and ethical issues in post mortem
9.30 am–9.50 am Medical Insurance Mr Vibhu Talwar
Dr H K Chopra
Dr Vinod Khetrapal
Dr KK Aggarwal    
9.30 am–9.40 am       Meenakshi Lekhi Engaging a lawyer
9.40 am–9.50 am       Maninder Acharya Understanding various court procedures
9.50 am–10.20 am How to handle medico legal cases? Dr Anil Goyal
Dr Rajiv Ahuja
Ajay Agrawal
Dr Girish Tyagi
   
9.50 am–10.00 am       Dr M C Gupta When to do the MLC?
10.00 am–10.10 am       Dr Sudhir Gupta Checklist of MLC case
10.10 am –10.20 am       Siddarth Luthra Medico legal record keeping
10.20–10.50 am Medical Consent Dr Vinay Aggarwal
Dr P K Dave
Dr KK Aggarwal
Dr Girish Tyagi
   
10.20 am–10.30 am       Indu Malhotra Types of consent
10.30 am–10.40 am       Dr Manoj Singh Ideal consent
10.40 am–10.50 am       Dr N P Singh Extended consent
10.50 am–11.20 am Fallacies in acts applicable to medical profession Dr Anup Sarya
Dr Sanjiv Malik
     
10.50 am–11.00 am       Dr Kaberi Banerjee MTP, PNDT Act
11.00 am–11.10 am   Dr Anupam Sibal   Dr Sandeep Guleria Organ Transplant Act
11.10 am to 12.00 noon Inauguration

Justice A K Sikri, Delhi High Court

Justice Vipin Sanghi, Delhi High Court

Dr HS Risam, Board of Director, MCI

Dr P Lal, Board of Director, MCI

Dr A K Agarwal, President DMCl
     
12.00 noon–1.00 PM Professional misconduct and professional ethics Dr A K Agarwal
Dr. D S Rana
Dr H S Rissam
Dr KK Aggarwal
Dr Girish Tyagi
   
12.00–12.10 pm       Dr Sanjiv Malik Doctor-pharma relationship
12.10 pm–12.20 pm       Dr M C Gupta Advertisement and medical practice
12.20 pm –12.30 pm       Dr Navin Dang Rights of a patient
12.30 pm–12.40 pm       Dr Ajay Gambhir Rights of a doctor
12.40 pm– 12.50 pm       Dr Ashok Seth Kickbacks, touts and commercialization in medical practice
1.00 pm to 2.00 pm When it is not a negligence? Dr Prem Kakkar
Dr S K Sama
Dr O P Kalra
Dr KK Aggarwal
Dr Girish Tyagi
  Complaints of a doctor against doctor
1.00 pm–1.10 pm       Dr Girish Tyagi What is medical negligence?
1.10 pm–1.20 pm       Dr Vijay Aggarwal Medical accidents
1.20 pm–1.30 pm       Mukul Rohatgi Professional Misconduct
1.30 pm–1.40 pm       Dr K K Aggarwal How to defend a complaint?

………………………………………………………………

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

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

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

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

………………………………………………………………

Medifilmfest (1st International Health Film Festival in Delhi)

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

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

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

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

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

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

………………………………………………………………

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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 Naveen Dang, Dr Pawan Gupta, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta