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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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  From the desk of editor in chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); 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

 
  Editorial ...

7th November 2010, Sunday

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

National Cancer Awareness Day…What can be done?

Today is National Cancer Awareness Day. It's also the birth anniversary of Madame Curie. While much has been done to control cancer………a lot still needs to be done.

  • Cancer should be declared as a ‘Notifiable Disease.’ Cancer notification will help reporting, detection, diagnosis confirmation, early therapeutic intervention and arranging remedial measures wherever therapeutics/ expertise are not available.
  • Cancer should be included in the National Rural Health Mission (NRHM) similar to the Govt.’s initiative to add lifestyle–related disease in NRHM.
  • The National Cancer Calendar should be zealously observed to focus cancer awareness on new and old problems that exist in our society that are related to cancers in Indian women, senior citizens, children, youth and middle–aged. These problems include Tobacco, HIV/AIDS, western lifestyles, freedom in sexual relations, depleting ozone layer, and atmospheric pollution. Educating people about Self Examination is an important part of cancer control. Such continuous and round–the–year cancer awareness though the National Cancer Calendar will leave deeper impact on the literate and illiterate population as well as those at the helm of policymaking about cancer.
  • Hepatitis B and HPV vaccination of the at–risk population can prevent most cancer in this population. Promotion of vaccination and reducing the cost of vaccines are thus the need of the hour.
  • New regional cancer centers should be set up and the existing regional cancer centers should be further strengthened and upgraded that are within reach to people who do not have access to these facilities in their areas. This would also take care of follow up of patients, which is an important part of cancer control.
  • More Centers of Excellence should initiate DM and M.Ch and integrated MD Radiotherapy courses, Integrated Postgraduation for oncological sciences M.Sc/DNB courses in Medical Physics. More trained doctors would be available to provide comprehensive cancer care.
  • Oncology as a clinical science should be introduced in the Undergraduate syllabi of MBBS, BAMS, BUMS and BHMS
  • The reach of the television media today is tremendous. This should be utilized to the full and they should be involved in creating more cancer-related programs that are more oriented towards prevention of cancer.
  • Stronger enforcement of tobacco, alcohol and food legislation
  • Improving the standards of cancer research to improve the understanding of cancer biology and development of more effective cancer treatment options.
Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
 
  Quote of the Day

"If men look like less seriously, they could very soon make it more perfect. GOD never takes his work seriously; therefore one looks out on his wonderful universe."

 
    Photo Feature (from the HCFI Photo Gallery)

 Vaishya Gaurav Award


Padma Shri and Dr BC Roy National Awardee was awarded the Vaishya Gaurav Award by Vaishya Panorma Group on 24th October, 2010.
 

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Nod for scientific institution in Thiruvananthapuram 

The Union Cabinet on Thursday approved the establishment of a national centre for molecular materials in Thiruvananthapuram at a cost of Rs. 76.7 crore. The centre will be the first of its kind in the country, pursuing high-end science and developing technologies in niche areas such as sensors for biomedical devices, materials for better harvesting of solar energy, and space electronics. (Source: The Hindu).

 
    International News

(Dr. GM Singh)

Tips to maintain proper posture for computer use

  • Leg position: Legs should be positioned comfortably, feet should be flat on the floor or on a footrest, with the legs and hips perpendicular (between 90 and 100 degrees) relative to the spine.
  • Chair position: If the computer is used by more than one person, a chair that’s comfortable is not the only consideration; you should be able to adjust its height, back angle, and armrest.
  • Back position: The small of the back should be supported with an adjustable lumbar support.
  • Wrist angle: Wrists should be in a neutral position for typing or using the mouse, not overly flexed or extended. A wrist rest can keep the hands in the neutral position.
  • Elbow angle: The angle of the elbows should be 90 degrees relative to the upper arms. The elbows should be close to the side of the body so that you do not bend your wrists to the side when typing.
  • Monitor position: The top of the monitor screen should be aligned with the computer user’s forehead. Kids should sit about 2 feet from the screen. If the monitor is used by the entire family, get one that is easily adjustable.
  • Keyboard height: The keyboard should be about 27 to 29 inches above the floor, and adjustable so it can be higher for taller people and lower for shorter people.
  • Foot position: Reet should rest comfortably on the floor. A raised footrest can help smaller people attain an ergonomically correct position.

(Dr Monica and Brahm Vasudev)

Vitamin E resolves NASH

Vitamin E may help resolve nonalcoholic steatohepatitis (NASH) in children, though it does not reduce SGPT levels, report Joel Lavine, MD, of Columbia University, and colleagues at an oral presentation at the annual meeting of the American Association for the Study of Liver Diseases (AASLD). Vitamin E use should be supported for children with NASH.

Adding monounsaturated fats to a low–cholesterol diet is useful

The addition of monounsaturated fat (MUFA) to a cholesterol–lowering dietary portfolio in patients with mild to moderate elevated cholesterol levels increased HDL by 12.5% and lowered LDL levels by 35%, found a study published in CMAJ.

Stroke patients more likely to die when hospitalized on weekends

People who go to the hospital with a stroke on a weekend are more likely to die within a week compared to those who go on a weekday according to a study in the journal Neurology. Before reaching that conclusion, Canadian researchers examined data from almost 21,000 stroke patients admitted to 11 stroke centers in the province of Ontario. Seven days after a stroke, patients admitted on weekends had an 8.1 % risk of dying vs 7% risk for those admitted on weekdays.

First non–drug treatment for asthma

Approximately 30 medical centers throughout the United States are offering the first non–drug treatment for asthma: bronchial thermoplasty. Bronchial thermoplasty uses radiofrequency waves to shrink the smooth muscle lining the airway.

Walking test may help predict risk of complications for heart-surgery patients

According to a new study, measuring the time it takes for an older patient to walk approximately 15 feet may improve a physician’s ability to gauge how likely that patient is to experience complications after heart surgery. The study was published online in the Journal of the American College of Cardiology. Elderly people who walk slowly have 3–folds greater chances of developing complications or death following heart surgery vs those who walk at a normal pace. Slow walkers were more than twice as likely to require prolonged hospitalization post surgery or be discharged to another health care facility.

 
    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Q. What are the precautions I should take after the IVF procedure?

A. The IVF procedure demands no special precautions, but strenuous activity should be avoided. We advise the patients to be mentally and physically relaxed as much as possible. You can return to work if you wish, but fist prefer to have a few days rest

Q. What if IVF fails the first time? How many times will I have to undergo the same procedure?

A. You can go through IVF as many times as you wish, but we advise up to five cycles at the most.

Q. Is IVF the last option?

A. IVF is the option, which has highest success rate and is also the most expensive. But, it is not "end of the road". Many women have conceived naturally or with intrauterine insemination, even after IVF. However, for those with blocked tubes and very poor sperm counts, it is the only option.

For queries contact: banerjee.kaberi@gmail.com

 
    Gastro Update

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

What are the drugs used in treatment of IBD?

The pharmacologic agents available for the treatment of IBD are sulfasalazine, 5– aminosalicylic acid analogs (oral and Injection), corticosteroids (oral and topical), immunosuppressive agents like 6–mercaptopurine, azathioprine, methotrexate, infliximab (TNF–α antibody) and antibiotics (metronidazole, ciprofloxacin). 5–ASA is effective as monotherapy to induce remission when used chronically in UC. However in CD the efficacy is poor. Immunomodulators like Azathiprine is used in steroid resistant/dependant cases.

 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Indian pharmacopoeia in British India

In British India, even after establishment of two English medical schools, the noted British John Forbes Royale wrote a very famous essay on "Antiquity of Hindu Medicine" in 1837 demonstrating the deep British interest/faith and undisputed acceptance of efficacy in Indian pharmacopoeia. But it did not survive long and an English pharmacopoeia in the name of Bengal Pharmacopoeia 1844 came into force in British India. European doctors and English medicine started dominating over Indian herbs and medicines. In 1845, the Grant Medical College came up in Mumbai and similarly the Irvin Hospital in Delhi, Prince of Wales Medical School Patna and King George Medical School were established during the British rule.

 
    Derma Update: Question of the Day

What is the ‘Atopic march’?

‘Atopic March’ refers to a triad of atopic dermatitis, allergic rhinitis and bronchial asthma. All these three tend to cluster in families with increased production of specific IgE antibodies. The ‘Atopic March’ is also known as ‘allergic march’. It indicates the natural history of allergic or atopic manifestations in a typical sequence of clinical symptoms and signs, appearing during a certain age period and persisting for a good number of years.1 While some features become more prominent with time, others disappear completely.2 In general, atopic dermatitis develops first, followed by asthma and then allergic rhinitis. The aetiopathogenetic connotation of ‘atopic march’ lies in the observations that patients with skin sensitization to house dust mite can develop airway sensitization to the same allergen.3

References

  1. Winberg E G. The atopic march. Curr Allergy Clinical Immunol 2005;18:4-5.
  2. Spergel JM, Pallers AS. Atopic dermatitis and the atopic march. J Allergy clin Immunol 2003;112 5:118-27.
  3. Spergel JM, Mizoguchi E, Brewer JP, et al. Epicutaneous sensitization with protein antigen induces localized allergic dermatitis and hyperresponsiveness to methacholine after single dose exposure to aerosolized antigen in mice. J Clin Invest 1998;101:144-22.
 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Iron deficiency anemia

Causes of anemia

In men and postmenopausal women, anemia is usually due to gastrointestinal blood loss from certain types of cancer (esophagus, stomach, colon), long–term use of aspirin or NSAIDS and peptic ulcer disease.

Tests to diagnose iron deficiency anemia

  • Serum iron: This test measures the amount of iron in your blood.
  • Serum ferritin: It is a protein that helps store iron in your body.
  • Transferrin level
  • Total iron–binding capacity (TIBC)
  • Reticulocyte count
  • Serum transferring receptor
 
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    Medi Finance Update

Equity Funds

Investing in stocks is also riskier than other investments as stock prices can fluctuate more than other types of investments. The market price of a stock will vary with the company’s financial performance, general economic conditions in the country in which it operates, as well as investor perceptions.

 
    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Preparations claiming to combat cough associated with asthma containing centrally–acting antitussive and/ or an antihistamine

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Smoking cessation and lung cancer

A systematic review showed that smoking cessation is beneficial even among patients with early or limited–stage lung cancer. Ongoing smoking by patients with early or limited–stage lung cancer was associated with an increased likelihood of all-cause mortality, tumor recurrence, and development of a second primary tumor.

(Ref: Parsons A, et al. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 2010;340:b5569).

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient with a history of myocardial infarction (MI) wanted to know his risk for another MI.
Dr Bad: You are at low risk.
Dr Good: You are at high risk.
Lesson: Diabetes mellitus should be considered as an MI equivalent rather than a coronary heart disease equivalent. Diabetic patients with MI have a higher long-term all-cause and cardiovascular mortality. In patients with MI, diabetes confers the same level of risk as a previous MI.

Make Sure

Situation: A patient developed rifampicin toxicity.
Reaction: Oh my God! Why was history of ayurvedic drug not taken?
Lesson: Make sure to ask your patient if he/she is also on ayurvedic drugs. Trikatu can enhance the action of anti TB drugs.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Anuj Goyal)

Just Five more minutes

While at the park one day, a woman sat down next to a man on a bench near a playground. "That’s my son over there," she said, pointing to a little boy in a red sweater who was gliding down the slide. "He’s a fine looking boy" the man said. "That’s my daughter on the bike in the white dress." Then, looking at his watch, he called to his daughter. "What do you say we go, Melissa?"

Melissa pleaded, "Just five more minutes, Dad. Please? Just five more minutes." The man nodded and Melissa continued to ride her bike to her heart’s content. Minutes passed and the father stood and called again to his daughter. "Time to go now?" Again Melissa pleaded, "Five more minutes, Dad. Just five more minutes." The man smiled and said, "OK." "My, you certainly are a patient father," the woman responded.

The man smiled and then said, "Her older brother Tommy was killed by a drunk driver last year while he was riding his bike near here. I never spent much time with Tommy and now I’d give anything for just five more minutes with him. I’ve vowed not to make the same mistake with Melissa. She thinks she has five more minutes to ride her bike. The truth is, I get five more minutes to watch her play."

Life is all about making priorities, what are your priorities? Give someone you love 5 more minutes of your time today!

Mind Teaser

Read this…………………

PUNISHMENT  

 Answer for yesterday’s Mind Teaser: "Working overtime"

Correct answers received from: Dr. A. K. Gupta, Dr Chandresh Jardosh,  Dr. K. P. Rajalakshmi, Dr. Parvesh Sablok, Dr. K.V. Sarma

Answer for 5th November Mind Teaser: "Working overtime"
Correct answers received from: Dr U Gaur, Dr.Nagendra Gupta,Dr Rashmi Chhibber,Dr.Alok Deb

Send your answer to ijcp12@gmail.com

Humor Section
(Joke Dr G M Singh)

Computer Error

An oldie but goodie…

I was having trouble with my computer. So I called Bob the computer guy, to come over. Bob clicked a couple of buttons and solved the problem. He gave me a bill for a minimum service call. As he was walking away, I called after him, "So, what was wrong?" He replied, "It was an ID ten T error."
I didn’t want to appear stupid, but nonetheless inquired, "An, ID ten T error? What’s that, in case I need to fix it again?"
The computer guy grinned… "Haven’t you ever heard of an ID ten T error before?"
"No," I replied.
"Write it down," he said, "and I think you’ll figure it out."
So I wrote out… I D 1 0 T I used to like Bob!

 
    Readers Responses
  1. To All Dear Readers of this Great Work by Brother KK  (a source of INSPIRATION to ALL)
    Diwali is popularly known as the festival of lights. Its an important five-day festival in Hinduism, Sikhism, Jainism and Buddhism. It is the most important festival of the year in India and is celebrated in many countries. Besides India, it is also a national holiday in Nepal, Guyana, Trinidad & Tobago, Mauritius, Malaysia, Singapore, Sri Lanka, Myanmar, Fiji, and Suriname. Last year, President Obama celebrated Diwali in White House for the first time.
    The day coincides with the homecoming of Lord Rama after his exile. It is also the celebration of the marriage of Lakshmi with Lord Vishnu. In Bengal, the festival is dedicated to the worship of Kali, the dark goddess of strength. Lord Ganesha, the symbol of auspiciousness and wisdom, is also worshiped in most Hindu homes on this day. In Jainism, Deepawali has an added significance of Lord Mahavira attaining the eternal bliss of nirvana (moksha) in 527 BC. In Sikhism, Deepawali also commemorates the return of Guru Har Gobind Ji to Amritsar after freeing 52 Hindu kings imprisoned in Fort Gwalior by defeating Emperor Jahangir. (Bandi Chhorh Divas).
    Diwali comes after the major harvest of crops in India and when the weather is at its best in the sub-continent. Diwali is in fact a celebration of human spirit which is at its core. Some Indian business communities begin the financial year on the first day of Diwali, hoping for prosperity the following year. Happy Diwali to all my friends and their families. Regards: Dr. N. K. Bhatia, Medical Director, Rotary Noida Blood Bank.
 
    Public Forum

(Press Release for use by the newspapers)

Patients with low heart function should not ignore winter

All heart patients should know the pumping status of their heart, which is called ejection fraction. If low these patients are at risk of sudden cardiac death during winter season, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.
 
The guidelines from American College of Cardiology and American Heart Association for device-based therapy of cardiac rhythm abnormalities suggest that an internal electric shock devise called an ICD therapy is indicated in all patients with heart functioning called LVEF of less than 35% due to prior heart attack (post 40 days) and who are symptomatic.
 
The guidelines further suggest that ICD therapy is indicated in patients with non-ischemic dilated cardiomyopathy (enlarged heart) who have an LVEF less than or equal to 35% and who are symptomatic.
 
ICD therapy is also indicated in patients with heart dysfunction due to prior heart attack who are at least 40 days post heart attack with LVEF less than 30% even if they have no symptoms.
 
ICD therapy is also indicated in patients post heart attack with LVEF less than 40% if they have irregular heart abnormality of non-sustained VT (Ventricular Tachycardia) on 24 hour ECG monitoring or inducible abnormal heart rhythm called VF (Ventricular fibrillation) or sustained VT at electrophysiological study.

 
    Forthcoming Events
eMedinewS Events: Register at emedinews@gmail.com

November 29, 2010, Monday, 9 AM – 1PM, Moolchand Medcity – “Update on Kidney Transplant”. No Fee. Entry by Invitation.  Contact: emedinews@gmail.com
 
eMedinewS Revisiting 2010

The 2nd eMedinewS  - revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08-09, 2011.

January 08, 2011, Saturday, 6PM – 9PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6PM – 2nd eMedinewS revisiting 2010, A Medical Update

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