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FIRST NATIONAL 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 ...

10th November 2010, Wednesday

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

Spice in curry could prevent liver damage

Curcumin present in turmeric prevents liver damage from NASH, a new research from Saint Louis University suggests. Linked to obesity and weight gain, NASH affects 3 to 4 percent of adults in the US and can lead to liver fibrosis and possibly cirrhosis, liver cancer and death.

According to Dr Anping Chen, Director of research in the pathology department of Saint Louis University, curcumin is an effective therapy to treat and prevent liver fibrosis in NASH. High levels of blood leptin, glucose and insulin are commonly found in human patients with obesity and type 2 diabetes, which might contribute to NASH–associated liver fibrosis. The study noted that curcumin abolished the effects of leptin on activating hepatic stellate cells, which short–circuited the development of liver damage. The findings of the study were published in the September issue of the journal Endocrinology.  

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  Quote of the Day (Dr. G.M.Singh)

"Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all"

Dale Carnegie

 
    Photo Feature (from the HCFI Photo Gallery)

 Eco-fest – 17th MTNL Perfect Health Mela 2010

Children from Eco Clubs of different schools participated in large numbers in the 17th MTNL Perfect Health Mela in competitions like, aerobics.

 
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

U.S., India sign MoU for global diseases detection 

The United States and India on Monday signed a Memorandum of Understanding on establishing and operationalising a Global Diseases Detection Centre here. The agreement will facilitate the development of human resources, both in epidemiology and research, enable sharing of best practices for detection of and response to emerging infections, wherever required.The MoU would be implemented through an agreed plan between the National Centre for Disease Control (NCDC), India, and the Centres for Disease Control and Prevention (CDC), Atlanta. It would also facilitate advanced training in the fields of epidemiology, surveillance for emerging infectious diseases, and the health and mentoring of public health professionals internationally. The MoU also aims to build laboratory capacity in India for the diagnosis of emerging infectious diseases using well characterised reference material and advanced technology transfer. (Source: The Hindu)

 
    International News

(Dr Monica and Brahm Vasudev)

Sugar–sweetened beverages associated with increased risk for type 2 diabetes

According to an analysis of 11 previously published studies including more than 320,000 participants and published in the journal Diabetes Care, there appears to be an association between consumption of sugar–sweetened beverages and the risk of developing type 2 diabetes. The study showed that habitual drinkers, – those drinking one to two sugar–sweetened beverages a day on average, had a 26% greater risk of developing type 2 diabetes and a 20% increased risk for developing metabolic syndrome, compared to those who drank the beverages once a month or not at all.

Vitamin E consumption for stroke prevention may be harmful

According to the study, published in the British Medical Journal, taking vitamin E supplements does not reduce the risk of stroke, and may even be harmful. It raised the risk of a severe type of stroke by 22 %, while it lowered the risk of a milder kind by 10%.

Increased SHBG levels associated with reduced risk for type 2 diabetes with coffee consumption

Increased levels of sex hormone–binding globulin (SHBG) may account for the inverse association between caffeinated–coffee consumption and risk for type 2 diabetes in postmenopausal women, according to a study published online in the journal Diabetes.

Kids’ mild asthma no barrier to severe attacks

Near–fatal asthma exacerbations in children often arise in those with previously mild disease and are due to avoidable irritants, reports medpage.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is combined infertility?

In some cases, both the man and woman may be infertile or sub–fertile, and the couple’s infertility arises from the combination of these conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

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 other associated aspects in a case of IBD?

Growth

Routine assessment of growth (height and weight) and pubertal status (Tanner staging) are required at the time of presentation and every 3 to 6 months throughout the course of the disease.
Growth suppression in IBD may be related more to poor disease control than to corticosteroid use. Supplemental enteral feeding or cyclical enteral nutrition for children with Crohn’s disease in remission may improve growth and help maintain remission. In children with localized Crohn’s disease and poor growth who are in early puberty, impressive catch–up growth has been documented post resection of the diseased segment. Close collaboration with an endocrinologist (preferably in a joint clinic) is important for managing children who have growth failure.

 
    Medicolegal Update

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

Medical education in the British era

In the British era, the medical colleges trained the students in the principles and practices of medical science in accordance with the model adopted in Europe. The various English tablets/syrup/mixtures started to replace the Indian herbs and medicines. A strong resentment against acceptance of English medicines and rejection of the Indian medicines was observed in many part of the country. Towards the end of 1833, a Committee was appointed by William Bentinck, the Governor of Bengal to report on the state of medical education and also to suggest whether teaching/practice of indigenous medicine system should be continued /discontinued further or not? This today may translate into recognition or derecognition?

 
    ENT Update

Dr. Aru Handa MS, DNB (Department Co–coordinator and Senior Consultant Deptt. Of ENT Moolchand Medcity)

What is cochlear implant? How is it different from hearing aid ?

Cochlear implant is a device which is implanted in hearing impaired  individuals who have profound hearing loss and in individuals with severe to profound hearing loss but with no benefit in developing speech and language skills from powerful hearing aids.
Cochlear implant converts auditory signal into electric signals which in turn electrically stimulate cochlear nerve fibres. Hearing aids just amplify the auditory signal.

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Porphyrin Tests

When a patient has symptoms that suggest an acute neurologic/psychiatric porphyria, such as abdominal pain, tingling in hands or feet, and/or confusion or hallucinations, or that suggest a cutaneous porphyria, such as reddening, blistering, or scarring on sun–exposed skin

 
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    Medi Finance Update

Mutual Funds

The first fund classification is based on asset class. There are six types:

  • Money market funds
  • Bond funds (also known as Fixed income funds)
  • Balanced funds (also known as Diversified funds)
  • Asset allocation funds
  • Index funds
  • Equity funds
 
    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

Antidiarrheal formulations containing Kaolin or Pectin or Activated Charcoal

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Diagnostic criteria for fibromyalgia

The 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia provide an alternative approach to diagnosis that does not require a tender point examination but provide a scale for measurement of symptom severity that are characteristic of FM.

(Ref: Wolfe F, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600).

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetic kidney disease had high blood pressure (BP).
Dr Bad: It cannot be controlled.
Dr Good: We need to increase the number of antihypertensive medicines.
Lesson: Effective BP control is difficult to achieve in diabetic patients. The number of antihypertensive medications needed for BP control in diabetic patients is largely dependent on estimated glomerular filtration rate. Impaired kidney function could produce resistance to antihypertensive therapy in diabetic patients.

Make Sure

Situation: A patient missed his second dose of Hepatitis B vaccine and developed Hepatitis B.
Reaction: Oh my God! Why was the vaccine not given between 1–2 months?
Lesson: Make sure that all patients who missed their second dose of vaccine at one month are given the same upto second month (1–2 months).

 
    Lighter Side of Reading

An Inspirational Story

Wisdom for the Road

Cherish things while you still have them, before they’re gone, and you realize how precious they really are. Life can only be understood backwards, but it must be lived forwards.
Everything in life is temporary. So if things are going good, enjoy it because it won’t last forever. And if things are going bad, don’t worry because it won’t last forever either.
Destiny is not a matter of chance, it is a matter of choice; it is not a thing to be waited for, it is a thing to be achieved.
A journey of a thousand miles begins with a single step.
Never cross a bridge without knowing how to swim the tides.
If you could not add years to your life, add life to your years.

eQuiz

Read this…………………

A 76–year–old male is being treated for Acute Myeloid Leukemia. He presents with a chronic subdural hematoma that is evacuated. Postoperatively, patient develops seizures that do not respond to Lorazepam, Phenytoin and Levetiracetam. He is intubated and a Pentobarbital coma is induced with a loading dose appropriate for patient's weight. Continuous bedsides EEG monitor reports ongoing bursts of seizure activity. Pentobarbital dose is incrementally titrated till seizures are suppressed on day 2 of ICU. He developed severe hypotension and needed Norepinephrine and Vasopressin support. Infection screen is negative. The following are his pertinent labs before and during his ICU stay.  

Date/data

Pre–ICU

ICU 1

ICU 2

ICU 3

Bicarbonate

26

26

24

10

Anion gap

4

4

4

27

Lactate

>20

Osmolar gap

35

What is the explanation for this patient’s profound metabolic acidosis?

A. Profound sepsis
B. Blast Crisis
C. Propylene glycol toxicity
D. Adrenal insufficiency due to infiltration

(Contributed by Ashish Verma MD)  

Answer for yesterday’s Mind Teaser: "Gross incompetence"

Correct answers received from: Dr Rashmi Chhibber, Dr Nageshwar Rao, Dr Sudha Nayyar, Dr. K.P. Rajalakshmi, Dr.Susheela Gupta, Dr.Sanjeev Lehri & Dr.Nisha Bhatnagar, Dr.K.V.Sarma

Answer for 8th November Mind Teaser: "Day in day out"
Correct answers received from: Dr R S Bajaj, Dr G.Padmanabhan, Dr Rashmi Chhibber, Dr Shirish Singhal, Dr. T. Samraj, Dr Sukanta Sen, Dr Vijay Kansal, Dr Jainendra Upadhyay, Dr. Rajiv Dhir

Send your answer to ijcp12@gmail.com

Humor Section
(Joke Dr G M Singh)

Doctor, Doctor…

Patient: Doctor, Doctor, I feel like a pair of curtains.
Doctor: Well pull yourself together then.

 
    Readers Responses
  1. Dear sir, wonderful issue on Diwali, emedinews 5.11.10.Regards Dr Neelam Nath.
 
    Public Forum

(Press Release for use by the newspapers)

November Diabetes Awareness Month: 14th November World Diabetes Day

Diabetes mainly linked to obesity

Type 2 diabetes mellitus is strongly associated with obesity in all ethnic groups said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.
More than 80 percent of cases of type 2 diabetes can be attributed to obesity, which may also account for many diabetes–related deaths.

  1. There is a curvilinear relationship between BMI and the risk of type 2 diabetes.
  2. Lowest risk is associated with a BMI below 22 kg/m2.
  3. At a BMI greater than 35 kg/m2, the relative risk for diabetes adjusted for age increases to 61. The risk may further increase by a sedentary lifestyle or decrease by exercise.
  4. Weight gain after age 18 years in women and after age 20 years in men also increases the risk of type 2 diabetes.
  5. The Nurses’ Health Study, compared women with stable weight (those who gained or lost <5 kg) after the age of 18 years to women who gained weight. Those who had gained 5.0 to 7.9 kg had a relative risk of diabetes of 1.9; this risk increased to 2.7 for women who gained 8.0 to 10.9 kg.
  6. Similar findings were noted in men in the Health Professionals Study. The excess risk for diabetes with even modest weight gain is substantial.
  7. Weight gain precedes the onset of diabetes. Among Pima Indians (a group with a particularly high incidence of type 2 diabetes), body weight gradually increased 30 kg (from 60 kg to 90 kg) in the years preceding the diagnosis of diabetes. Conversely, weight loss is associated with a decreased risk of type 2 diabetes.
  8. Insulin resistance with hyperinsulinemia is characteristic of obesity and is present before the onset of hyperglycemia.
  9. After the onset of obesity, the first demonstrable changes are impairment in glucose removal and increased insulin resistance, which result in hyperinsulinemia.
  10. The hyperinsulinemia in turn increases hepatic very–low–density triglyceride synthesis, plasminogen activator inhibitor–1 synthesis, sympathetic nervous system activity, and sodium reabsorption. These changes contribute to hyperlipidemia and hypertension in obese subjects.
 
    Forthcoming Events
eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS , Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November
Venue: Moolchand Medcity Auditorium, 9-12 noon
Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani

9.00-9.30 AM: Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
9.30-10.00 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Hospital
10.00-10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30-11.00 AM: Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00-12.00 AM: Panel discussion
12.00: Lunch

(Registration free: email to 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, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

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

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