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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 (07–08c); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

 
  Editorial …

9th May 2012, Wednesday

Bill to extend tenure of MCI Board of Governors slammed in LS (PTI)

Members in the Lok Sabha attacked the Government for its move to extend the tenure of the Board of Governors of the Medical Council of India by another year beyond May 14. Both ruling and opposition members described the Government’s move as "undemocratic" and demanded that the body should be constituted by electing members through democratic ways. Attacking the Government, Kakoli Ghosh Dastidar (Trinamool Congress) said she was not in favour of the bill moved by Health Minister seeking to extend the tenure of the board from the present two years to three years and supersede the amendment moved last year.

She said about the Indian Medical Council (Amendment) Bill, 2012. She also criticised the Government’s proposal to set up a National Commission for Human Resources for Health as an overarching regulatory body which could subsume councils like the MCI and the Dental Council of India in it saying "this kind of overarching body is not acceptable".

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
    eMedinewS Audio PostCard

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

Bad teeth are related to bad heart arteries

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day organized at DPS Mathura Road

Students of Delhi Public School, Mathura Road presented a beautiful skit, 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

Access global thesis database with mouse click at Allahabad University

ALLAHABAD: The research scholars and their guides at Allahabad University will access to detailed information of various thesis documented across the globe. And, all this at the click of a mouse. The Central Library of the Allahabad University has brought the galaxy of dissertation thesis database at the door steps of research scholars and faculty members at the click of a mouse. AU Central Library has been equipped with International dissertation and thesis database. This will make the full text of about three billion thesis, submitted after 1861, across the world available online for users. The university has procured the database at the cost of Rs 10 lakh. (Source: TOI, May 7, 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)

RA found sooner using newest disease criteria

The recently revised 2010 classification criteria for rheumatoid arthritis successfully identified affected patients in the U.K. earlier than a previous set of criteria did, a researcher reported at the annual meeting of the British Society for Rheumatology. (Source: Medpage Today)

For comments and archives

ACR issues lupus nephritis Tx guideline

Management guidelines for patients with lupus nephritis, including a detailed treatment algorithm for patients with moderate disease, have been released by the American College of Rheumatology (ACR). (Source: Medpage Today)

For comments and archives

Joggers live longer, possibly happier, lives

For those who diligently lace up their running shoes and brave the elements to jog at least an hour a week, there is a very real reward –– an average of six more years of life, Danish researchers found. (Source: Medpage Today)

For comments and archives

New guidance calls for ‘aggressive’ aneurysm care

Centers that don’t see many aneurysmal subarachnoid hemorrhages (aSAH) should consider transferring these patients to higher–volume centers, according to an updated guideline from the American Heart Association/American Stroke Association. (Source: Medpage Today)

For comments and archives

Meningococcal Vax good against group B strains

An investigational meningococcal vaccine generated strong immune responses against multiple serogroup B strains in a phase II clinical trial, researchers said. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Pre Meal Soups are Weight Friendly

@DeepakChopra: Life brings challenges, but step back for a moment and ask the deeper question. Why is life so difficult?

 
    Spiritual Update

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

Why did Dronacharya and Bhishma Pitamah have to die in Mahabharata?

The epic Mahabharata can also be understood as a science of inner Mahabharata happening in everybody’s mind.

Lord Krishna here symbolizes with consciousness and the five Pandavas with five positive qualities of a person and they are – righteousness (Yudhishthir), being in focus (Arjuna), and power to fight injustice (Bheem), helping others (Sahdev) and learning to be neutral in difficult situations (Nakul). Panchali indicates the 5 senses, which can only be controlled when these five forces are together.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

Mention some points of sexual dysfunction in men and women?

Sexual dysfunction in men. The most common type of sexual problem in men is erectile dysfunction. Many medical conditions can cause erectile dysfunction: high blood pressure, diabetes, blood vessel diseases, surgery that affects your bladder or genitals, nerve disease or injury, hormonal problems, depression.

Sexual dysfunction in women. Women with sexual dysfunction may have low sexual desire, difficulty becoming aroused, or difficulty reaching orgasm. Women may feel pain during sex, which is called dyspareunia. Many things can cause dyspareunia, including diseases such as endometriosis or those that affect a woman’s external genitals. Some women have a pain disorder called vaginismus, a condition in which the muscles around the vagina spasm and cause the vagina to close.

For comments and archives

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

(Dr. Sujay Shad, Senior Consultant Cardiac Surgeon and Director of Heart–Lung Transplantation, Sir Ganga Ram Hospital, New Delhi)

Heart: Failure, Therapies & Transplantation

When humanity must take over from medicine (Part 2)

In the heart of my hearts I knew we wouldn’t be able to find him a matching heart while he lived. What were my options for this terminal heart failure patient?

Option 1 is to do what is usual: put him on a ventilator. He wouldn’t be able to speak or even communicate. He would be in a room full of strangers (ICU doctors and nurses), no family no friends surrounding him. In a few days time, sepsis would intervene and poor Mr. Dass would slowly lose his kidney function, conscious state, and then his heart would undoubtedly stop. That time an enthusiastic young doctor and some bored nurses would commence a ritual of CPR. Mr. Dass would be ceremoniously declared dead despite heroic efforts.

The last few hours or days of his presence on mother earth would be the worst time of his difficult life. If his consciousness would be able to remember any of that he would remember an uncomfortable tube down the throat, suctioning in the throat that causes an uncomfortable cough, painful lines for vascular access, urinary catheter, forced turning in bed by unknown nurses, nakedness in front of unknown people, then finally huge rib cracking compressions on the chest.

Then the finality of escape from the clutches of those of us masquerading as care providers and physicians, who failed to see that this particular soul must move along.

(To be Contd.)

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

This is amazing, Randy Pausch 47–years–old, a computer science lecturer from Mellon University died of pancreatic cancer in 2008, but wrote a book "The last lecture" before then, one of the bestsellers in 2007. What a legacy to leave behind. In a letter to his wife Jai and his children, Dylan, Logan, and Chloe, he wrote this beautiful "guide to a better life" for his wife and children to follow. May you be blessed by his insight.

Points on how to improve your life

Personality

  • Don’t compare your life to others’. You have no idea what their journey is all about.
  • Don’t have negative thoughts of things you cannot control. Instead invest your energy in the positive present moment.
  • Don’t overdo; keep your limits
  • Don’t take yourself so seriously; no one else does.
  • Don’t waste your precious energy on gossip.
  • Dream more while you are awake.
  • Envy is a waste of time. You already have all you need.
  • Forget issues of the past. Don’t remind your partner of his/her mistakes of the past. That will ruin your present happiness.
  • Life is too short to waste time hating anyone. Don’t hate others.
  • Make peace with your past so it won’t spoil the present.
  • No one is in charge of your happiness except you.
  • Realize that life is a school and you are here to learn. Problems are simply part of the curriculum that appear and fade away like algebra class but the lessons you learn will last a lifetime.
  • Smile and laugh more.
  • You don’t have to win every argument. Agree to disagree.

Community

  • Call your family often.
  • Each day give something good to others.
  • Forgive everyone for everything.
  • Spend time with people over the age of 70 and under the age of 6.
  • Try to make at least three people smile each day.
  • What other people think of you is none of your business.
  • Your job will not take care of you when you are sick. Your family and friends will. Stay in touch.

Life

  • Put GOD first in anything and everything that you think, say and do.
  • GOD heals everything
  • Do the right things
  • However good or bad a situation is, it will change
  • No matter how you feel, get up, dress up and show up
  • The best is yet to come
  • Get rid of anything that isn’t useful, beautiful or joyful
  • When you awake alive in the morning, thank GOD for it
  • If you know GOD you will always be happy. So, be happy.

While you practice all of the above, share this knowledge with the people you love, people you school with, people you play with, people you work with and people you live with. Not only will it enrich YOUR life, but also that of those around you.

Remember, GOOD THINGS ARE FOR US TO SHARE……!!!!!!

For comments and archives

 
    Cardiology eMedinewS

Omega–3–Rich Diet May Protect Against Alzheimer’s Disease Read More

Two Drugs Better Than 1 For Children With Diabetes Read More

Endovascular Stents Help Some Babies with Hypoplastic Left Heart Syndrome Read More

 
    Pediatric eMedinewS

IL–6 Antibody Works In Arthritic Kids Read More

Pulse–Ox Works As Heart Defect Screen Read More

Mercury or Aneroid Devices For Measuring BP In Kids? Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure came with chronic anemia.
Dr. Bad: Give blood transfusion.
Dr. Good: You need to be investigated.
Lesson: Patient with heart failure and chronic anemia do not urgently need correction of anemia by the use of transfusion or erythropoiesis stimulating agents. Iron supplement is recommended only when clinically indicated.

For comments and archives

Make Sure

Situation: A female patient complained of lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: Oh my God! You should have done cervical swabs and consider starting antibiotics.
Lesson: Make sure to remember that women with such symptoms may have endometritis, which requires prompt diagnosis. It may respond to doxycycline and metronidazole.

For comments and archives

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    Legal Question of the day

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

Q. What is the present position about the challenge to the Clinical Establishment Act, 2010?

Ans.

  • The medical profession lost the following successive opportunities when a challenge could be mounted:
    • When the government put the CEA 2007 on the website and invited comments from various stake holders, including the IMA;
    • When the government put the CEA 2010 on the website and invited comments from various stake holders, including the IMA;
    • After the Lok Sabha passed it;
    • After the Vidhan Sabha passed it;
    • Before the President signed it;
  • The Act has been notified on 28–2–2011 and has become operational with effect from 1–3–2011 in the four states of Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim and in the UTs, including Delhi and Chandigarh. In addition, the Act has already been adopted in UP.
  • Every opportunity lost is another nail in the coffin of the freedom of the medical profession. The IMA must act fast and now.
  • A writ petition no. 14177 of 2011was filed in the High Court of Punjab and Haryana by Dr. Ramneek Singh Bedi and another against UOI and others and dismissed on 5-8-2011 by a division bench, apparently at the time of the first hearing. It appears that the petitioners did not press at all the illegality manifest in imposing a statutory duty on private establishments to provide treatment in emergency without a corresponding right to obtain fees for such treatment either from the patient or the statutory authority imposing such condition. I have read the judgment. It seems that the only point pressed was that less well equipped establishments may not be able to provide full and complete treatment, to which the court responded that nothing was expected from them beyond the facilities that exist.
  • Subsequently, a writ petition has been filed in Madras High Court and notice has been issued to the respondents who have probably not filed replies as yet. No further details about this WP are available to me.
  • Unfortunately, no WP has been filed in Delhi, Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim so far. I understand that the IMA is planning to file WPs in Delhi and Sikkim.
  • In all existing and future WPs on this issue, the petitioners must rely heavily upon the Report of the Law Commission submitted as "201st Report On Emergency Medical Care To Victims Of Accidents And During Emergency Medical Condition And Women Under Labour (Draft Model Law Annexed), August 2006" which contained detailed provisions for creating a state funded compensatory mechanism for compensating the medical profession for providing such statutorily mandated services.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Education is the ability to listen to almost anything without losing your temper. Robert Frost

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Rheumatoid Factor

To help diagnose rheumatoid arthritis (RA) and Sjogren’s syndrome: When a patient has fatigue, joint pain, weakness, or dry eyes or dry mouth then your doctor may suspect it to be due to RA or Sjogren’s syndrome.

 
  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Post exposure prophylaxis for blood–borne viruses: Need Evaluation

We understand that every exposure to blood and OPIM does not warrant administration of drugs for prophylaxis against blood-borne viruses (BBVs). First, we need to evaluate whether PEP is required or not. Need evaluation e. g. in case of HIV is shown in the table below. Two parameters are important, one the type of exposure and the level of HIV in the blood and body fluid involved in the exposure.

HIV Post exposure prophylaxis needs evaluation

Exposure

Status of source material– (see below)

HIV status–ve

HIV+ve and low risk (Asymptomatic)

HIV+ve and high risk (AIDS case)

HIV status unknown

Mucous membrane/non– intact skin; small volume (drops)

Consider 2–drug PEP

2–drug PEP

Consider 2–drug PEP

No PEP is required if the source blood is confirmed HIV and HBV–negative

Mucous membrane/non– intact skin; large volume (major blood splash)

2–drug PEP

3–drug PEP

Consider 2–drug PEP

Percutaneous exposure: not severe solid needle, superficial

2–drug PEP

3–drug PEP

Consider 2–drug PEP

Percutaneous exposure: severe large bore hollow needle, deep injury, visible blood in device, needle in patient artery/vein/blood injected

3–drug PEP

3–drug PEP

Consider 2–drug PEP

Next we will consider the drugs to be given for PEP.

For comments and archives

 
    Mind Teaser

Read this…………………

Nurse Maureen knows that the positive diagnosis for HIV infection is made based on which of the following:

a. A history of high risk sexual behaviors.
b. Positive ELISA and western blot tests
c. Identification of an associated opportunistic infection
d. Evidence of extreme weight loss and high fever

Yesterday’s Mind Teaser: Halfway through the administration of blood, the female client complains of lumbar pain. After stopping the infusion Nurse Hazel should:

a. Increase the flow of normal saline
b. Assess the pain further
c. Notify the blood bank
d. Obtain vital signs.

Answer for yesterday’s Mind Teaser: A. The blood must be stopped at once, and then normal saline should be infused to keep the line patent and maintain blood volume.

Correct answers received from: Dr PC Das, Dr Thakor Hitendrsinh G, Raju Kuppusamy, Dr Chandresh Jardosh, Dr Jainendra Upadhyay.

Answer for 7th May Mind Teaser: New Zealand

Correct answers received from: Dr B Rajammal.

Send your answer to ijcp12@gmail.com

For comments and archives

 
    Laugh a While

(Dr GM Singh)

Student who obtained 0% on an exam

Q1. In which battle did Napoleon die?
* His last battle

Q2. Where was the Declaration of Independence signed?
* At the bottom of the page

Q3. River Ravi flows in which state?
* Liquid

Q4. What is the main reason for divorce?
* Marriage

Q5. What is the main reason for failure?
* Exams

Q9. How can a man go eight days without sleeping?
*No problem, he sleeps at night.

Q10. How can you lift an elephant with one hand?
*You will never find an elephant that has only one hand.

Q13. How can you drop a raw egg onto a concrete floor without cracking it?
*Any way you want, concrete floors are very hard to crack.

 
    Medicolegal Update

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

How does the poison enter into the body?

The way the poison gets into the body is called the route of exposure or the route of absorption. The amount of poison that gets into the blood during a given time depends on the route.

  • Through the mouth by swallowing: This is the most common route of poisoning. Small children often swallow poison accidentally, and adults who want to poison themselves may swallow poison. If people eat, drink or smoke after they have been handling poisons, without first washing their hands, they may accidentally swallow some of the poison. This is a common cause of pesticide poisoning.
  • After ingestion, some poisons can pass through the gut walls and into the blood vessels. This can be stopped by giving activated charcoal (because this binds some poisons so that they cannot pass through the gut walls) or laxatives (to make the poison move through the gut and out of the body) more quickly.
  • Poisons that do not pass through the gut walls do not get into the blood and so cannot affect other parts of the body. For e.g., mercury metal cannot pass through the gut walls; if mercury from a thermometer is swallowed, it passes out of the body in the feces and does not cause poisoning.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Heart disease begin in childhood

All heart diseases begin in childhood and, therefore, preventive measures need to be started at that age, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Two major problems of childhood are pre–hypertension and obesity and if they can be tackled well in time, future heart diseases can be prevented. Pre–hypertension is a blood pressure of more than 120/80 and lower than 140/90 mmHg.

The Bogalusa Heart Study was the first study to give a message that coronary artery disease, atherosclerosis, hypertension and heart disease all begin in childhood. It was the longest and most detailed study of a biracial population of children and young adults in the world. In the study, 27% of young adults were found to have pre–hypertension, while only 13% had true high blood pressure.

School health programmes in India must focus on checking the blood pressure of children and also regarding their obesity status. Both can be controlled by promoting regular exercise and proper diet. A diet high in trans fats and refined carbohydrates like refined flour, sugar and rice promote both obesity and pre–hypertension.

 
    Readers Responses

Dear Editor, I wish to respond to Prof M.C. Gupta’s column. While congratulating him for his opinion on the burning issue, I like to add:

  1. The problem of shortage of doctors and even nursing staff for rural and slum population of the country has been created by the decision makers.
  2. Selection to technical courses especially MBBS or Postgraduate courses should be purely on merit.
  3. Economically poor students should be supported under cover of a bond (for loan) and the amount should be recovered without interest till a reasonable period of time, failing which interest should be levied.
  4. One year rural service should be made mandatory for all doctors and it should be a must for applying for postgraduation or study abroad. Immediately after graduation, most remain alone, and once made compulsory, will definitely go. It has become habit for doctors to approach high ups even for transfer to another locality in the same city, because they know cancellation of order is possible.
  5. Regarding selection by UPSC or State PSC, doctors passing out from a recognized medical college and University should not be levelled as failed, because the selection committees are not competent to do so. They should make a list on the basis of candidate’s performance on that date and offer appointment. What is the system followed is say for 5 posts, 60 appeared and the selection committee make a list of say 10 and none joins. The vacancy will continue for a long period as advertising again will take more time, if they do not forget. Officials found lazy in appointment should be punished by stoppage of increment and promotion.
  6. Doctors joining rural area where proper education of children and quality of life is not reasonably available, till the area is developed, the family of the doctor should be provided free residential accommodation in the city or town of their choice/availability.

    Do you agree with the suggestions? Regards: Dr. PC Das.
 
    Forthcoming Events
Dr K K Aggarwal


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

 
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