emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

10th February 2013, Sunday

The Justice Verma panel has suggested introducing new sections to deal with offences like disrobing, voyeurism, stalking and trafficking.

  1. Disrobing: Taking off the clothes
  2. Voyeurism (a perversion in which a person receives sexual gratification from seeing the genitalia of others or witnessing others sexual behavior)
  3. Trafficking: Human trafficking is the illegal trade of human beings mainly for the purposes of commercial sexual exploitation or forced labor.
  4. Stalking is a term commonly used to refer to unwanted or obsessive attention by an individual or group toward another person.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Chronic idiopathic constipation or functional constipation is a common condition affecting the GI tract, with a prevalence of between 4% and 20% (Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut 2011;60:209-18).

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Healthcare worker fatigue and patient safety

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

4th eMedinewS revisited all the happenings in the field of medicine in the year 2012.

 
Dr K K Aggarwal
    National News

Good performance to fetch more NRHM funds for states

MAHABALIPURAM: States have an opportunity to get additional funds under the National Rural Health Mission by scaling up their performance. But poor performance against important health indicators will surely be a 'disincentive'. Stating this at the National Child Survival and Development Summit, Union health and family welfare minister Ghulam Nabi Azad said, "We have decided to reward good performance by setting up an incentive fund under NRHM. States would now be able to receive additional funding for sector-wise reforms they may introduce such as free medicines, creation of public health cadre, inter-sectoral convergence and so on." He said since child health cannot be seen in isolation, factors like integration between departments and ministries and rational use of resources will play an important role. Citing an example, Nabi said, "We have seen that there is an artificial crisis of human resources in many states. But a closer look reveals that the reason behind the shortage is erratic distribution of the work force. This is something that will be seen as a disincentive." NRHM managing director Anuradha Gupta said the ministry was extremely serious about 'performance'. "We are coming up with a score card to assess the performance of the states and to instill a sense of competitive feeling among them so that they try to outdo the competitors," she said. (Source: TOI, Feb 8, 2013)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Child abuse some basic facts

  1. Child abuse involves a child under the age of 18.
  2. Child maltreatment is defined as unintentional harm or threat or harm to a child by a person who is acting in the role of caretaker. The caretaker means parents or an employee of a residential facility or any staff/person providing out of home care.
  3. The four major types of child abuse are – physical abuse, sexual abuse, emotional abuse and child neglect; 79% of the child abuse cases involve physical abuse.
  4. An abused child has as much as 50% chances of undergoing further abuse and 10% chances of dying, if the abuse is not detected at the initial presentation.
  5. More than 40 percent of deaths from child abuse occur among children younger than 12 months of age.

For comments and archives

    Valvular Heart Disease Update

Mitral stenosis in the elderly

Concurrent tricuspid valve surgery with chronic MR surgery

  • Tricuspid valve repair in patients with severe TR (Grade 1C).

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Pre-eclampsia risk linked to ozone levels

Higher levels of ozone (O3) exposure during the first trimester of pregnancy were associated with significant increases in rates of pre-eclampsia and preterm birth, Swedish investigators concluded. (Source: Medpage Today)

Hemodynamic complications common in traumatic brain injury

A new study shows that cerebral arterial vasospasm (VSP) and intracranial hypertension are common outcomes of combat-related traumatic brain injury (TBI), so much so that its authors are recommending daily transcranial Doppler (TCD) monitoring to better recognize and manage these complications. (Source: Medscape)

FDA nixes Rintatolimod for chronic fatigue syndrome

The US Food and Drug Administration (FDA) has sent Hemispherx Biopharma a Complete Response Letter (CRL) regarding the new drug application (NDA) for rintatolimod (Ampligen) for chronic fatigue syndrome (CFS), according to a news release February 5 from Hemispherx. (Source: Medscape)

Ramipril substantially improved walking times in PAD trial

After six months of treatment with ramipril, patients with peripheral artery disease (PAD) and intermittent claudication were able to walk significantly longer pain free and walk much farther on a treadmill, compared with their peers who received placebo, in a new study. (Source: Medscape)

 
    Twitter of the Day

@DrKKAggarwal: DMA considers it a criminal act of going to vote this Sunday for DMA election alone in a car. Pool atleast another four people.

@DeepakChopra: Love yourself. Love the world. There is no power stronger than love.

 
    Spiritual Update

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

The Five Interior Powers

To be in a state of happiness, bliss and ananda is what the ultimate goal of life is. Everybody is born with certain inherent powers, which if cultivated in the right direction will lead to inner happiness.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How can assisted reproductive techniques help couples diagnosed with endometriosis?

According to western figures, couples diagnosed with endometriosis have success rates with assisted reproductive technology (ART) procedures such as in vitro fertilization and embryo transfer (IVF–ET) that are similar to those for couples with other causes of infertility. Success rates for ART procedures vary greatly depending on a woman’s age. Nationally, live birth rates for IVF–ET are approximately 30-35% for women under age 35, 25% from ages 35 to 37, 15–20% from ages 38 to 40, and about 10% between 41 and 42. IVF–ET is the most effective treatment for moderate or severe endometriosis, particularly if surgery fails to restore fertility.

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

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

How much liver should be left behind with the donor?

At least 35% of the liver is left behind with the donor. CT volumetry is very important to calculate this volume.

For comments and archives

 
    An Inspirational Story

Faith

In the abyss between life and death resides only faith. Experts call this abyss "Motherhood."

Lying on a cold, hard bed only six months along with my first child, I faced the frightening implications of this truth. My body shook uncontrollably as abject terror clutched at me. My only lifeline was my husband's hand clutching mine over the abyss as love for life - mine and the tiny, still-unseen child's - burned deep in our hearts. One after another after another the nurses piled the bloody sheets into the corner until the doctor pronounced those fateful words, "The baby's coming."

Only then, with control slipping past me into a haze of drugs and fear, did I make that one, final leap - the leap from control to faith - the leap from childlessness into motherhood. My next recollection was my husband's hand once again holding mine as he said the words that officially changed my life, "We have a little girl."

The images of the next two months blurred together as ups and downs alternated at break-neck speed. One minute spent holding my two-pound and yet weightless daughter in my arms versus the next three weeks spent holding only tiny fingers through the isolet window-waiting for the next opportunity to take my baby out of the incubator again.

The drugs, powerful enough to keep her safe from infection, again and again blew through her small veins while all I could do was watch, pray, and hang onto the faith that somehow we would get through this. If we could just make it to the next horizon, through the next transfusion and the next round of drugs, then I could live again. Until then survival was my only goal.

In the darkness of a soul in crisis, my prayers became much deeper. No longer were they for selfish requests. Now they were centered wholly on the tiny baby God had entrusted to my care. The Lord has said, "Cast your burden upon the Lord, and He shall sustain you" (Psalms 55:22), and during those long days, that was what kept me going.

As good as that sounds, however, reality was that my only real positives at the time were formed by the negatives. "It's not pneumonia." "It's not an infection." "We won't have to put the IV in her head-this time." The struggle to live was being waged not only by the tiny baby lying helplessly in the incubator, but by her mother's spirit as well. Fear laced every call to the hospital, every question, every conversation. But always the faith remained. Somehow we would make it. Somehow God sustained me. Somehow.

Then in one faltered heartbeat the negatives became negatives again, and I faced a test of faith more terrifying than my own journey through the abyss - my baby's journey to the edge of the River Jordan. All her veins had been blown, and a new IV would have to go in her head - all the other options had been exhausted.

In utter desperation my husband and I left the hospital, and on a rain-soaked highway with the amber glow of the streetlights flashing above me, I reached a place that I never even knew existed - the place where faith no longer resides. "Why?" I asked the darkness around me. "Why?"

But God has promised, "I will never leave you, nor forsake you" (Hebrews 13:5), and I am here to tell you, He does send messengers to help when you ask. Truth is, mine was sitting right by my side - exactly where he had been through the whole ordeal. Slowly my husband reached over, took my hand, and spoke the words that I would cling to not only for this one night but for the rest of eternity. "She's going to be okay. You've just got to have faith."

Every day for the next five years that faith has been tested over and over again. Every time I let my baby-big girl, now-off at play school. Every time my second daughter lets go of my hand and walks off on her own. Every time one child or the other screams in pain or in fear at two o'clock in the morning - the words come back to me, "She's going to be okay. You've just got to have faith."

In the days to come, the phrase will only become more powerful. During the long nights when the girls fail to call and on the days when they experience their own grief, the words will be there to help me through. Time and again as I hold my children for one brief moment and then release them into the abyss, the words will be there.

Through school, best friends, boyfriends, first dates, first heartbreaks, in partnership with God and my husband, I will remain the rock on which these two girls can build their lives. Until someday in some beautiful sunlit church, I will watch from a front pew as they stand before God and pledge themselves to another forever. Then as they turn, kiss me, and walk away into their own lives, the words will again be there. "She's going to be okay. You've just got to have faith."

The day will come of course when the abyss will stretch before me again "when Christ, who is our life, shall appear, then shall you also appear with Him in glory". In some darkened room on another cold, hard bed I will step toward the abyss to make my final journey home. However, this time I will have not one but three sets of hands to hold onto. Then, looking up into the eyes of the two beautiful women my daughters have become, the sadness at our imminent parting will be there, but a greater understanding will hold me also.

Beyond a doubt, I know that as I slip from the darkness of this world into the light beyond, I will hear that voice one more time: "They're going to be okay. You've just got to have faith."

For comments and archives

 
    Cardiology eMedinewS

Second-generation CT reduces angiography radiation dose Read More

Walk speed is marker for HF hospitalization risk Read More

 
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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

 
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    Pediatric eMedinewS

Clinical rule may cut use of CT in kids Read More

New multispecialty surgical risk score for children Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with non–responding cough.
Dr. Bad: This may be TB.
Dr. Good: Rule out acidity.
Lesson: Chronic cough along with dysphonia/hoarseness, globus pharyngeus, mild dysphagia, chronic cough and nonproductive throat clearing are often important otolaryngologic manifestations of occult or silent GERD (Laryngoscope 1991;101:1).

Make Sure

Situation: A–28–year old male presents with increased frequency and occasional blood in urine. Examination of urine shows sterile pyuria.
Reaction: Oh my God! Why didn’t you check for TB?
Lesson: Make Sure to rule out TB in patients with frequency, dysuria and hematuria. Sterile pyuria is the first clue to diagnosis.

 
    Quote of the Day (Dr GM Singh)

Whatever is at the center of our life will be the source of our security, guidance, wisdom, and power. ~ Stephen Covey

 
    Mind Teaser

Read this…………………

Q: Stroke volume of the heart is determined by:

a. The degree of cardiac muscle strength (precontraction)
b. The intrinsic contractility of the cardiac muscle
c. The pressure gradient against which the muscle ejects blood during contraction
d. All of the above factors

Yesterday’s Mind Teaser: Heart rate is stimulated by all of the following EXCEPT:

a. Excess thyroid hormone
b. Increased levels of circulating catecholamines
c. The sympathetic nervous system
d. The vagus nerve

Answer for Yesterday’s Mind Teaser: b. Increased levels of circulating catecholamines

Correct answers received from: Dr Shashi Saini, Dr Thakor Hitendrsinh G, Dr PC Das, Rajiv Kohli,
Dr Suresh Arora, Dr Kanta Jain, Dr (Maj. Gen.) Anil Bairaria, Arpan Gandhi, Dr KV Sarma
.

Answer for 8th February Mind Teaser: b. The pulmonic valve must be open

Correct answers received from: Dr Jayashree Sen & Dr Bitaan Sen.

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr. Chandresh Jardosh)

Matka was caught by the police.
Police: How did you kill 20 people..?
Matka: Mai gaadi tez chala raha tha par jab maine brake lagaya, to pata laga ki brake fail ho
gaye hai. Phir maine saamne dekha to 2 aadmi ja rahe the…doosri taraf 1 barat ja rahi thi.
Ab aap batao mai gaadi kidhar modta..?

Police – Of course, jis taraf 2 aadmi the. Nuksan kam hota.
Matka - Exactly. Maine bhi yehi socha tha par woh 2 aadmi meri gaadi dekh kar barat me ghus gaye... Toh mai kya karta!!!

 
    Medicolegal Update

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

Legal medicine: Doctor in witness box under oath

When a doctor is called as a witness in the Court of Law, Oath has to be administered before he tenders his evidence.

A doctor as witness while administered the oath has to repeat, while standing… ‘the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth, so help me the almighty God".

If a Doctor wishes to give his evidences on solemn affirmation, he has to say that I solemnly affirm that the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth. The main objective of the oath is to find truthful statement and if any doctor/witness speaks a lie after administration of oath he is liable for punishment of perjury a criminal offence in our country as well as abroad. The Medical opinion of the doctor must be supported by reason/science and it is the reasons and not ipse dixit which is of importance in assessing the merit of the doctor’s opinion in the court of law.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Pregnancy has 10% mortality in dengue

The incidence of dengue in pregnancy is very low, but it is on a considerable rise especially in India. Although many cases may remain asymptomatic or manifest a mild form of disease, serious manifestations like severe dengue with hemorrhagic manifestations and shock can also occur and these are potentially life-threatening both to the mother and the baby.

Quoting a study by Dr Laxmi Maru and Dr Astha Jain from Mahatma Gandhi Memorial Medical College, Maharaja Yashwantrao Hospital, Indore, Madhya Pradesh, Padma Shri and Dr B C Roy Awardee Dr KK Aggarwal said that maternal mortality in dengue cases is 10%, which otherwise is around 0.4% in India and 0.1% in western countries under normal circumstances. Also, the mortality in severe dengue cases with hemorrhage or shock is 33%.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 26361 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

 
    Readers Responses
  1. This generic medicine issue, I will call it as stunt, will help the drug stores to sell drugs of cheaper quality and drugs of the company, which give them maximum profit. I think we are hurrying up in giving verdict in this matter. A serious and wide based national policy is to be framed and to be implemented. Dr Vivek Kumar, Varanasi.
 
    Forthcoming Events

ANNOUNCEMENT

Sri Aurobindo Ashram – Delhi Branch will organize the 6th Study Camp on ‘Mind-Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from June 8-14, 2013. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind-body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of the Mind-Body Medicine Clinic at AIIMS, and the author of Back to Health through Yoga, Eating Wisely and Well and Essays on Yoga. For more details, send an e-mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  DIET BOOK

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  Personal Cleanliness

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  Perfect Health Mela

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  Towards Well Being

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  Dil Ki Batein

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja