eMedinewS10th November 2013, Sunday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Suspension of Dr Ketan Desai at MCI was it on merit or a political move?

Dr. Ketan Desai’s license was  suspended in 2010. When MCI received a fax complaint from Dr. Kunal Shah they took an unprecedented action with a supersonic speed through the Ethics Sub- Committee within 24 hours without holding any official meeting and taking the decision via circulation through an email. One member of the then ethics committee strongly objected for the same at that time.

Fax complaints are not to be entertained as per MCI procedure. There is a specific format for receiving a complaint.  A fee has to be deposited.  A complaint has to be signed complaint, etc. But the same obviously was not followed.
There is no provision in MCI Act or Rules that a meeting of committee like Ethics Sub- Committee can be held without giving a proper notice of 10 days.

The executive decision could have been taken by the Board of Governors and later passed by the Ethics Committee by following the principles of natural justice. But the same was not done.

The decision to suspend licence of Dr. Ketan Desai by MCI was made within five months of Dr Saha filing a complaint to Gujarat Medical Council.  As per MCI Act 8.7, the MCI  has no powers to prematurely take the case with it  in five month (less than six months) when the case was still pending at the Gujarat Medical Council.

Even if it is argued that the council has power under MCI Act 8.1 to suo moto take over the case, as per clause 8.7, MCI also had to finish the matter within six month and the same was not done.  

If the matter was not decided within six months by the ethics committee , it was for the Board of Governors to have decided the same in time bound manner.

Recently one of the sitting Board of Governor wrote to the Chairman BOG that this matter should be taken up in the Board of Governors meeting on 22nd October and resolves the matter fully and decide finally. 

In the previous Board of Governors tenure even Dr. K.K. Talwar, the then Chairman, Board of Governors inclined that the matter to be discussed and finalized but was kept underground for almost a year.  

The matter did come for discussion in the Board of Governors meeting held on 22nd October but again the final decision was not taken and two of the sitting Board of Governors ended up in writing with dissent notes.

Following are the excerpts of one of the dissent letter:

“ After analyzing the entire records in reference to suspension of registration of Dr. Desai I have made the following observations:

  1. Dr. Kunal Saha had filed a complaint with Gujarat Medical Council on 5th May 2010.
  2. Dr. Kunal Saha had preferred an appeal by sending a fax to MCI on 8th of October 2010.
  3. The office of MCI decided to refer the appeal of Dr Kunal Saha under section 8.7 of code of Ethics, 2002 to Ethics Committee.
  4. MCI under section 8.7 can entertain/consider appeal/complaint of any person provided the concerned State Medical Council fails to decide the complaint within 6 months.
  5. In this case, MCI prematurely before completion of 6 months decided to refer the matter to Ethics Committee.
  6. Under section 8.7 of code of Ethics MCI can either impress upon the State Medical Council to decide the matter in a stipulated time or withdraw the complaint straight away or on the completion of stipulated time. Here in this case MCI had not followed either of these mandatory provisions and decided to refer the matter directly to Ethics Committee.
  7. The draft recommendation stating the suspension of the registration of Dr. Desai was prepared in the office and sent to all members of the Ethics Committee by Email with an advice to give their approval.
  8. From the records available in the MCI office it is seen that this Email was not sent to the members of the Ethics Committee from MCI office rather it was sent from the E-mail ID of Mr. Amit Kumar who was a member of Ethics Committee.
  9. The decision to suspend the registration of Dr. Ketan Desai as per the draft recommendation was based on two FIRs filed by CBI, but surprisingly the suspension of registration of Dr. Desai was done under section 7.7 of code of Ethics, 2002 of MCI. Section 7.7 deals the cases where in medical professional had signed false certificate or document. Considering the allegations in these two FIR sections 7.7 is completely irrelevant and cannot be applied.
  10. As per section 8.7, the Ethics Committee of MCI on receipt of complaint/appeal is required to decide the matter within 6 months from the date of receipt of the complaint/appeal with them. Here in the case of Dr. Desai the appeal was referred to Ethics Committee of MCI on 8th of October 2010 and as per section 8.7 the Ethics Committee is required to decide the matter finally within 6 months, that is, by 8th of April 2011. Instead of this almost 3 years have passed since the receipt of appeal by MCI, and no decision has been taken till date.
  11. The decision to suspend the registration of Dr. Ketan Desai was sent to Gujarat Medical Council on 9th October 2010 with a request to suspend the name of Dr. Ketan Desai from the role of State Medical Register. Gujarat Medical Council after obtaining the opinion from Former Chief Justice of India decided in its meeting of General Body that the request of MCI to suspend the name of Dr. Ketan Desai from the role of State Medical Register is not accepted and accordingly a communication along with the copy of the opinion of Former Chief Justice was sent to MCI in the month of December 2010. Thereafter MCI had neither referred this matter back to the Gujarat Medical Council for reconsideration nor challenged it in any court of law.This implies that MCI is in agreement with the decision of the Gujarat Medical Council.

In view of the above I am of the firm opinion that as per section 8.7 of code of Ethics 2002 of MCI, now Ethics Committee of MCI has no jurisdiction to deal with the case of suspension of registration of Dr. Desai.

Considering all of the above I recommend that the decision already taken by the Ethics Committee in its meeting held on 1/12/2011 and approved by the Board of Governors not to erase the name of Dr. Ketan Desai as he is not convicted by any competent court till date should be implemented forthwith, and a communication sent accordingly.   MCI had already revoked the decision to suspend the registration in case of Dr. Rakesh Verma as he is not convicted and of Dr. S.C. Jaiswal though he is convicted by competent court and in all other cases it has been a consistent stand of MCI that unless and until a Doctor is either convicted, MCI has no jurisdiction to suspend / erase their name from Indian Medical Register.  Accordingly, MCI, being a statutory authority, and obliged to adopt a uniform approach to all cases and apply the same in a non-discriminatory manner,   needs to immediately send the communication to Dr. Ketan Desai intimating the decision to revoke the  suspension of his registration from Indian Medical Register by MCI.

For these reasons, I recommend that the MCI should immediately revoke the earlier decision of suspension of Dr Desai’s registration from Indian Medical Register, and communicate the same to Dr. Ketan Desai, the Gujarat Medical Council and all other concerned.”

Winter Blood Pressure 5 Mm Hg Higher than Summer Blood Pressure

The systolic (top number) and diastolic (bottom number) blood pressures rise and fall with the change of seasons.

In a study by the Institute National de la Sante et de la Recherche Medicale of Paris and published in the journal Archives of Internal Medicine involving 8801 people aged 65 or older, average systolic blood pressure was five points higher during the winter than in summer.

Instances of high blood pressure (systolic blood pressure higher than 159, or diastolic higher than 94 mmHg) in the study were found in 33.4 percent of participants during winter but just 23.8 percent during summer.

The reason could be related to the baroreflex, a mechanism of blood pressure regulation that is modified in elderly subjects or a function of the sympathetic nervous system, which helps control involuntary actions such as stress response. A 5 mm change in blood pressure can explain why more heart patients die in winter.

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."


VIP’s on CPR 10 Mantra Video
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Who is a Good Teacher?

sprritual blog

A good teacher is the one who follows the principles of listening first, teaching in detail till confusion arises and then teaching with reasoning while going into the minutest details and finally summarizing the ‘take–home’ messages.

This is what Lord Krishna taught to Arjuna in Bhagavad Gita. In the first chapter, he only listens, in the second, he gives detailed counseling, from 2 to 17 chapters, he gives reasoning and in 18th chapter, he revises.

cardiology news

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 if 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, heartbroken 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!

News Around The Globe

News

  • A small phase I study has reported that reduced sodium intake lowered blood pressure (BP) and improved indicators of kidney health in people with stage 3 and 4 chronic kidney disease (CKD). Overall, salt restriction resulted in statistically significant and clinically important reductions in BP (mean reduction of systolic/diastolic BP 10/4 mm Hg), extracellular fluid volume, albuminuria and proteinuria. The study is published in the Nov. 7 issue of the Journal of the American Society of Nephrology.
  • A loss of peripheral bone mineral density (BMD) accompanied the spinal changes seen in patients with ankylosing spondylitis (AS), according to a study reported in the journal Arthritis Research & Therapy. High–resolution peripheral quantitative computed tomography revealed that AS patients had significantly less trabecular volumetric BMD at the ultra–distal radius and at the ultra–distal tibia compared with healthy controls.
  • Successful hepatitis C (HCV) treatment before a liver transplant markedly reduced the risk of re–infection, according to research reported at the annual meeting of the American Association for the Study of Liver Diseases. Without treatment, HCV re–infection of the transplanted liver is "universal." But 64% of patients successfully treated with the investigational agent sofosbuvir along with the standard medication ribavirin remained virus–free 12 weeks after the transplant.
  • A new prospective study has demonstrated a relationship between thyroid-function tests (TFTs) and mortality in elderly patients hospitalized for acute illness, then followed for 7 years. Low triiodothyronine (T3) levels were associated with all–cause and cardiovascular death, illustrating that such hospitalized older people with low levels of this hormone face a slimmer risk for survival. The findings are reported in the Journal of Clinical Endocrinology & Metabolism.
  • The US FDA has released a drug safety advisory with recommendations aimed at reducing the risk of spinal column bleeding after spinal intervention, including epidural procedures and lumbar puncture, in patients taking low–molecular–weight heparins. The agency is recommending that "health care professionals carefully consider the timing of spinal catheter placement and removal, and delay dosing of anticoagulant medications for some time interval after catheter removal," to decrease the risk of spinal bleeding and subsequent paralysis in these patients. The FDA said that these new timing recommendations, which can decrease the risk of epidural or spinal hematoma, will be added to the labels of anticoagulant drugs known as low molecular weight heparins, including Lovenox and generic enoxaparin products and similar products.

eMedinewS e–gifts to our readers

This is the age of smartphones. To improve usability and readability, eMedinewS has launched a mobile app of the newsletter for its readers. You can now also view eMedinewS on your smart phones or iPads.

The eMedinewS app is now available for free download.

The various icons for downloading are provided on the top of the newsletter. Choose the icon that is compatible with your device, whether iPhone, Android, Blackberry, iPad, Desktop/Windows phone or GSM
Click on the icon ‘e’ from the mail and download to install the app to the home screen of your mobile phone, iPad or Desktop. After you finish downloading, you will see an icon ‘e’ on the home screen of your device. That’s it.

Now you don’t need to type the address of the website in your web browser or log in to your email account every day to read the newsletter. Just click on the app and begin reading.

Rabies News (Dr. A K Gupta)

What are the rules every dog owner should follow?

  • You are the first one who greets newcomers; the dog is the last that gets attention.
  • If a dog is lying in your path, do not walk around the dog, either make the dog move or step over the dog.
  • If you establish eye contact with the dog, the dog must avert his gaze first. Tell the children not to have staring contest with the dog.
  • Dogs must not sleep in your bed.
  • Games of fetch or play with toys must be started and ended by the human.
  • Dog should not be allowed to lie on your furniture.
cardiology news

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

  • Beta–trace protein (BTP), a biomarker that has been associated with both kidney damage and an increased cardiovascular risk, may help identify high–risk atrial fibrillation patients, researchers from University of Birmingham in England have in the Nov. 5 issue of Chest. Among patients with atrial fibrillation who were on stable oral anticoagulant therapy, high plasma levels of the protein were associated with significantly elevated risks of embolic events, adverse cardiovascular events, death, and major bleeding. Adding information about BTP levels modestly improved the predictive ability of models that included two established risk scores –– CHAD2DS2–VASc and HAS–BLED –– as indicated by higher C–statistics.
  • Neovasc, the makers of a percutaneous treatment for refractory angina, have announced that the coronary sinus Reducer stent effectively reduced angina scores when compared with a sham procedure in patients with refractory angina. The company reported that the 104–patient CORSIRA study achieved the primary end point, which is a decrease in two or more Canadian Cardiovascular Society (CCS) angina score grades from baseline to six months in Reducer–treated patients compared with patients who were treated with a control procedure.
cardiology news

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

  • Two infectious disease experts have warned that a new polio outbreak in Syria caused by wild–type polio virus 1 (WPV1) and asymptomatic cases in Israel might endanger Europe and other neighboring regions, according to correspondence published online November 8 in the Lancet. The WHO has confirmed an outbreak of at least ten cases of polio in Syria, where vaccination coverage has dramatically decreased during the civil war. WPV1 has been isolated from sewage and feces from asymptomatic carriers in Israel since February 2013.
  • Findings from the Teen–Longitudinal Assessment of Bariatric Surgery (Teen–LABS) study suggest that teenagers who are severely obese and who undergo bariatric surgery have abundant comorbidities, but the rate and types of complications in the early postoperative period are similar to those in their adult counterparts. The study was published online November 4 in JAMA Pediatrics.
cardiology news

Depression should be treated in patients with diabetes

Presence of depression in diabetic patients is the most important factor leading to erectile dysfunction in such patients.

As per an India cum US study published in the Journal of Urology, depression and erectile dysfunction are related to each other in the form of a vicious cycle. Depression instigates erectile dysfunction and erectile dysfunction perpetuates the symptoms of depression.

  • India is the diabetic capital of the world and both the incidence and prevalence of diabetes are increasing day by day.
  • It is, therefore, important for the family physician to look for presence of depression in patients with diabetes.
  • Diabetic patients who complain of erectile dysfunction in the study also have higher prevalence of high blood pressure and cholesterol abnormalities. These patients were also of older age with uncontrolled diabetes, history of smoking and longer duration of diabetes.

It was also shown that patients who develop erectile dysfunction also had diabetes, eye disorders, neuropathy and peripheral vascular disease. Effective control of diabetes may reduce both depressive symptoms and erectile dysfunctions in such cases.

cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

Depression and obesity linked

Winter is related to depression and now the results of a 5-year study suggest that depression predicts an increase in abdominal obesity (visceral fat accumulation) said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. This is why depression increases the risk of diabetes and cardiovascular disease. People with depressive symptoms accumulate more visceral fat than their counterparts without depression.

The findings, reported in the journal Archives of General Psychiatry, come from a study of 2,088 well–functioning adults, between 70 and 79 years of age, who were enrolled in the Health, Aging, and Body Composition Study.

Abdominal obesity is determined by waist circumference. In the study, depression roughly doubled the odds of gaining visceral fat. One of the factors may be that depression is linked to more refined carbohydrate craving and resultant visceral obesity.

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 71933 people since 1st November 2012.

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

today emedipics

Eminent Personality were awarded during the recently concluded MTNL Perfect Health Mela

press release

Weight loss may improve sexual health of obese diabetes

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

A 25–year–old male is undergoing incision and drainage of abscess under general anesthesia with spontaneous respiration. The most efficient anaesthetic circuit is:

1.Mapleson A.
2.Mapleson B.
3.Mapleson C.
4.Mapleson D.

Yesterday’s Mind Teaser: A 5–year–old boy suffering from Duchenne muscular dystrophy has to undergo tendon–lengthening procedure. The most appropriate anaesthetic would be:

1. Induction with intravenous thiopentone and N2O and halothane for maintenance.
2. Induction with intravenous protocol and N2O and oxygen for maintenance.
3. Induction with intravenous suxamethonium and N2O and halothane for maintenance.
4. Inhalation induction with inhalation halothane and N2O and oxygen for maintenance.

Answer for yesterday’s Mind Teaser: 2.Induction with intravenous protocol and N2O and oxygen for maintenance.

Correct answers received from: DR.A.K.GAJJAR, Dr.K.V.Sarma, DR MONICA GANDHI, DR ARPAN GANDHI, arun gupta, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, DR AVTAR KRISHAN, Dr Avtar Krishan, Dr B K Agarwal, Arvind Gajjar,

Answer for 8th November Mind Teaser: 4.Rotation

Correct answers received from: Daivadheenam Jella

Send your answer to ijcp12@gmail.com



medicolegal update

Click on the image to enlarge

medicolegal update

A man was complaining to a railroad engineer. What’s the use of having a train schedule if the trains are always late?

The railroad engineer replied, "How would we know they were late, if we didn’t have a schedule?"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

medicolegal update

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for. Epicurus

medicolegal update

Dr KK Aggarwal: Sudden Cardiac Death By Dr k k Aggarwal http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: How to Handle Difficult People | LinkedIn http://tinyurl.com/kuf6zpm

Forthcoming events

GFIMS&R

Venue: Gold Field Institute of Medical Sciences & Research, Ballabgarh, Faridabad
Date: November 14, 2013
Time: 2.00 pm to 4.00 pm

Program Details
Floral welcome
Lighting of lamp & Saraswati vandana (Recorded):
Introduction: Dr Jasveer Singh 
Welcome: Dr (Col) Parduman Singh, Principal GFIMS&R       
Blessings: Dr Shashi Adhlakha, Secretary GFIMS &R 
Felicitation: Padma Shri Dr K K Aggarwal and Dr (Mrs) Veena Aggarwal, Dr Gajinder Goyal
Keynote Address on CPR: Padma Shri & Dr B C Roy National Awardee Dr K K Aggarwal, Eminent cardiologist, Moolchand Medcity, New Delhi
Demonstration of BLS of CPR by already trained persons (Medicos & Non Medicos) under guidance of Dr Nirupama Bansal    
Emergency of Cardiac arrest: Dr Gajinder Goyal, DM Cardiologist
Concluding remarks and Vote of thanks: Dr Jasveer Singh    

medicolegal update
  1. Dear Sir, emedinews is very informative. Regards: Dr Tripti

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)

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, Prof.(Dr).C V Raghuveer

medicolegal update

Our Sites