emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
emedinews is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
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; Member 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


11th May,Tuesday, 2010

MCI Autonomy should not be allowed to go: DMA

Dear Colleague

Congress or BJP as a political parties have always set an example that whenever one of their senior member is alleged for corruption, either he voluntarily quits or the party asks him to quit, until he proved himself as innocent. Same thing should have been done by Dr Ketan Desai, President, Medical Council of India after he was allegedly arrested by CBI on corruption charges. He should have quit from most posts till he is proved innocent as happened in the past. This is what most of the doctors atttending the Delhi Medical Association Special Requisition Executive Meeting on the issue of present crisis in Medical Council of India felt. The meeting chaired by President Dr Narender Saini and Secretary, Dr Ashwini Dalmia was attended by many stalwarts of the profession both active  in national and state politics. 

  1. The house felt that the autonomy of Medical Council of India at no cost should be allowed to go. If Medical Council of India is divided and the education part goes under a politician or an IAS officer, it will not be in the interest of medical profession.

  2. The house also condemned corruption at any cost and resolved that if corruption charges are proved against Dr. Ketan Desai or any of the members of MCI, the Association will take appropriate steps and remove them from primary membership of Indian Medical Association.

  3. The house also raised concern that why 149 member of Medical Council of India are not coming forward in favour or against corruption charges in MCI. Their silent otherwise will be taken by the general members of medical profession as a consent to corrupt practices existing in MCI.

  4. Many members raised concern that how come in Gwalior, three new private medical colleges are recognized but all the old government medical colleges are presently de–recognized.

  5. The house felt that to remove corruption MCI should have a public audit with transparency and dissemination of knowledge amongst members.

  6. The medical association should start a signature campaign to maintain autonomy of the Council.

  7. The house made a four–member committee of Dr KK Aggarwal, Dr. Sanjeev Malik, Dr. Vinay Aggarwal and Dr. Ramesh Dutta to have deliberations on the issue of present crisis in Medical Council of India and come out with a white paper.

  8. Many of the members also felt that is the whole system is corrupt and need a change as recognition or de–recognition of a college is done by the Health Ministry on the recommendation of Medical Council of India. The Health Ministry has a complete right to cross check the recommendations made by the MCI.

  9. One of my personal suggestions is that MCI instead of being made a fault finding body should work in the manner of a facilitation body where their job should be to help in removing deficiencies of various medical colleges. There should not be any concept of ‘de–recognition’. Their only concern should be to assist  removing thsee deficiencies so that recognition can be given. This is what ISO & JCI have been doing in recognizing various hospitals as per international standards.

        Many memebsr also felt that the national IMA should take a firm stand either they should openly support MCI functioning or oppose it openly. There is no point removing the photo of Dr Desai from the front page of the IMA website and keeping it in all other pages just to show off to the media. The IMA stand should be bold and open.



 

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor

 

Photo Feature(From file)


Release of Health Messages by Cricketers

Who can take no notice of the place that cricket has made in the hearts of Indians all through its advent. Cricketers are idols for not only youth but for all ages. People tend to copy everything from their lifestyle to dressing, habits and beliefs. Heart Care Foundation of India realizes the importance of the cricketers and believe strongly that if a health message is released by them will be able to reach out to a much wider population and ensure its implementation in one’s life. (Photo from file: cricketers and other sports personalities releasing health mwssages on no tobacco campaign)

Dr k k Aggarwal

International Medical Science Academy Update (IMSA): Practice Changing Updates

Mammography

U.S. Preventive Services Task Force recommendations now suggest routine screening of women with no risk factors starting at age 50, performing biannual screening until age 74, and no longer teaching breast self–examination. (Ann Intern Med 2009;151:716–26.)

News and Views (Dr Brahm and Monica Vasudeva)

1. Increased left ventricular mass may be sign of worsening kidney function

In men with high cardiovascular risk, increased left ventricular mass appears to be a sign of worsening kidney function, according to research presented at the American Society of Hypertension meeting. Left ventricular hypertrophy of at least moderate severity was associated with significantly increased risks of severe chronic kidney disease, hemodialysis, or a doubling in creatinine. For each 42 g/m2 increase in the left ventricular mass index, there was an elevation of risk of 45.7% for the doubling of creatinine, 51.9% for decline of glomerular filtration rate below 30 mL/min/1.73 m2, and 58.3% for the initiation of hemodialysis.

2. ESAs may increase risk for cardiovascular problems

According to a meta–analysis published online May 3 in the Annals of Internal Medicine, erythropoiesis–stimulating agents (ESAS) used to fight anemia caused by kidney failure increase the risk for cardiovascular events, such as heart attack, stroke, heart failure and thrombosis.

3. Stress at work may raise risk of heart disease for women under 50

Career women who have stressful jobs face a higher risk of heart disease, according to a study published in Occupational and Environmental Medicine.

4. Sleeping badly may contribute to adult diabetes

An interrupted night of sleep may raise the risk of diabetes, Dutch researchers concluded after evaluating nine healthy volunteers. The study is published in the Journal of Clinical Endocrinology & Metabolism. Halving the amount of sleep reduced the body’s ability to use insulin to process sugar –– known as insulin sensitivity –– by up to a quarter.

Mnemonic of the Day (Dr SM Garg): FRIEND

F – Few
R – Relationships
I – In
E – Earth
N – Never
D – Die

Quote of the Day: From the Upanishads

Watch your thoughts; they become words…
Watch your words; they become actions…
Watch your actions; they become habits...
Watch your habits; they become character…
Watch your character; it becomes your destiny.

Question of the Day: (Dr GM Singh)

In what circumstances would you recommend searching for a more unusual cause of PAD such as Buerger’s disease?

A: Buerger’s disease – also known as thromboangiitis obliterans – differs from peripheral arterial disease (PAD) in that it is caused by inflammation in the arterial wall along with the development of clots in the small and medium–sized arteries of the arms or legs, which block the arteries and restrict blood flow. It often affects a younger age group (under 40) than atherosclerotic PAD, and occurs more commonly in Eastern Europe and Asia. It may also affect the arms and can be associated with episodes of thrombophlebitis and Raynaud’s phenomenon. Other conditions to be considered in young patients with claudication include vasculitis, popliteal arterial cysts and popliteal entrapment syndrome due abnormal muscle insertions.

Stupid Question: (drsooneita@gmail.com)

You are smoking a cigarette and a cute woman in your office asks...
Stupid Question: Oh, so you smoke.
Answer: Gosh, it’s a miracle……… it was a piece of chalk and now it’s in flames!!!

eMedinewS Try this it Works: Is It ADHD Or ‘White–Coat’ phenomenon?

During a clinical interview, the excess motor activity of adults who have ADHD may be difficult to differentiate from the fidgety behavior of persons with anxiety caused by the medical setting (i.e, the white– coat phenomenon). In the case of ADHD, motor activity increases as the stimulating novelty of the interview diminishes and the patient struggles with impulses to move. With white– coat phenomenon, however, motor activity tends to decrease as the interview proceeds and the patient becomes more comfortable.

International Vaccines recommendations

Hepatitis B vaccination is sometimes recommended 2 months before travel.

Spiritual Learning

A group of scientists placed 5 monkeys in a cage and in the middle, a ladder with bananas on the top. Every time a monkey went up the ladder, the scientists soaked the rest of the monkeys with cold water.
After a while, every time a monkey went up the ladder, the others beat up the one on the ladder. After some time, no monkey dares to go up the ladder regardless of the temptation.

Scientists then decided to substitute one of the monkeys. The 1st thing new monkey did was to go up the ladder, immediately the other monkeys beat him up.
After several beatings, the new member learned not to climb the ladder even though never knew why.

A 2nd monkey was substituted and the same occurred. The 1st monkey participated on the beating for the 2nd monkey. A 3rd monkey was changed and the same was repeated (beating). The 4th was substituted and the beating was repeated and finally the 5th monkey was replaced………

What was left was a group of 5 monkeys that even though never received a cold shower, continued to beat up any monkey who attempted to climb the ladder.

If it was possible to ask the monkeys why they would beat up all those who attempted to go up the ladder….
I bet you the answer would be.."I don’t know– that’s how things are done around here."
Does it sound familiar?

"Only two things are infinite: The universe and human stupidity. And I am not so sure about the former" – Albert Einstein

Dr Good Dr Bad

Situation: In how many patients of DVT does embolization occur, asked the Junior to his Serior.
Dr Bad: Rare.
Dr Good: Common.
Lesson: Embolization occurs in about 50% of patients having proximal vein DVT.

Make Sure

Situation: A patient presents with recurrent scaling and itching of the scalp not responding to antikeratolytic agents.
Reaction: Oh my God! I forgot to prescribe antifungal agents.
Lesson: Make sure that patients with dandruff and seborrhoeic dermatitis are prescribed antifungal medications. Recent studies implicate pityrosporium yeast infection as the underlying cause.

IMADNB Joke of the Day (Dr Tarun Gupta)

BRUTALITY

Two ladies in a car disputed concerning the window, and at last called the conductor as referee.
"If this window is open," one declared, "I shall catch cold, and will probably die."
"If the window is shut, "the other announced, "I shall certainly suffocate." The two glared at each other.
The conductor was at a loss, but he welcomed the words of a man with a red nose who sat near. These were:
"First, open the window, conductor. That will kill one. Next, shut it. That will kill the other. Then we can have peace."

Formulae in obesity

Pounds and inches
Formula: Weight (lb)/(height (in))2 × 703
Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703.
Example: Weight = 150 lbs, Height = 5’5" (65")
Calculation: (150 ÷ (65)2) × 703 = 24.96

Milestones in Medicine

1743: Fran�ois de la Peyronie, a French surgeon,first described the disease in 1743. Peyronie’s disease is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting as many as 1% of men.

Lab Test (Dr Arpan Gandhi and Dr Navin Dang)

Chromogranin A

To help diagnose and monitor carcinoid tumors and other neuroendocrine tumors.

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

DCI Approval Date

Abatacept Injection 250mg/vial (Addl. Indication)

In moderately to severely active rheumatoid arithritis in adults and may be used as monotherapy or concomitantly with DMARDs other than TNF antagonists

20.02.09

IMA Election Updates

The IMA National President, Secretary and other office bearers’ elections are due to be announced by 1st July. The present crisis in Medical Council of India has already postponed its scheduled 6th May Working Committee meeting to 6th June. Will the IMA election be held in time.

Public Forum (Press Release for use by the newspapers)

12th May International Nurses Day

Make nurses’ safety a priority in the workplace

More than ten lakh needle stick injuries occur every year in hospitals in the US alone with majority of these resulting from needle sticks involving hollow–bore needles. About 60–80 % of all needle stick injuries go unreported.

Nurses account for 44% of health care workers who are a victim of Needle Stick Injuries. Nurses are more likely to be involved in a sharps injury than other hospital employees.

On the eve of the International Nurses Day, Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India, appealed to all healthcare set ups to make effective and definite policies to safeguard the interest of the nurses other health care workers.

Dr Aggarwal said that the amount of blood required for transmission for Hepatitis B virus is only 0.00004 ml.

Defining accidental blood exposure (ABE) he said that it involves any exposure or injury via the percutaneous or mucosal route involving blood, biological fluid contaminated with blood and/or blood–borne pathogens. These injuries expose workers to blood–borne pathogens such as Hepatitis B and C virus and HIV, the AIDS-causing virus.

Twenty or more diseases and pathogens causing them can be transmitted via blood which could be potentially fatal. These include HIV (AIDS), Hepatitis B, C & D, Dengue, Diphtheria, Herpes Simplex/Zoster, Malaria, Cryptococcosis, Staphylococcus aureus, Streptococcus pyogenes, Syphilis, Toxoplasmosis and Tuberculosis.

Though most reported needle stick injuries (NSI) involve nursing staff; other laboratory staff, physicians, hospital housekeepers, and other health care workers are also at risk. Majority of the needle stick injuries occur in the operating room (23%) followed by the patient room (18%), emergency room (15%), and procedure room (11%). Eighty–four percent of the needle stick injuries occur in the finger, 9% in the hand, and 5% in the arm.

Needle stick injuries occur during various hospital procedures, with finger/heel stick (20%) and injections (16%) being the most common. The "other" category (23%), include procedures such as handling instruments, suturing, being stuck by another employee, and picking up sharps off the floor. Other common procedures leading to injury included cleaning or disassembling sharps and injuries occurring during surgical procedures. About 88% of needle stick injuries can be avoided by using safety devices and by taking precautions at the work place. Most needle stick injuries occur after the device has been used and therefore exposed to potentially contaminated blood. Fifty percent of injuries occur between the time the procedure is completed and disposal of the device; 20 % are associated with disposal of the device.

More than 40 million oeople worldwide are positive for HIV. An estimated 270 million people worldwide are infected with Hepatitis C virus (HCV). About 360 million people worldwide have Chronic Hepatitis B infection.

Suggestions

1. Universal precautions for the needle stick injury

2. The use of IV catheters with safety features as they can reduce needle sticks. New, cost–effective, passive safety IV catheter minimizes the greatest exposure risk.

3. Other safety IV products require healthcare workers to change their technique or remember to retract or sheathe contaminated needles during IV catheter insertion, which EPINet classifies as a high–risk procedure due to the catheters’ large bore, blood–filled needles.

4. Postexposure prophylaxis, once the needle stick injury occurs.

 

Readers Responses

  1. Dear Dr Aggarwal: Thank you for the information disseminated through the e medinews. Dr G M Singh, while advocating some ideas on prevention of female feticide indicates that he has chartered into an area into which intellectuals are fond of travelling but have no experience of. This is to inform him through this mail that female feticide is an act largely committed by affluent and educated group of people (Data of GOI) and as the level of education of women rises the ratio becomes gloomier. It is actually a matter of property rights. All societies that have given ‘ls in effect’ property rights to women do not kill them. The other factor involved is the ability to say ‘NO’. In an education system which right from primary school teaches in its text books ‘Geeta paani laa. Shyam padhne jaa’ cannot expect its women to be assertive. He has completely missed out on the point that males are as much required as females for the natural balance of the social fabric so to dole out incentives for the girl child may be proper but no punishments for producing a male child. In fact everything he suggests as incentive for the girl child is put in a way as if a punishment for the male child to be brought into this world. It is also to be noted that the natural selection process in this part of the world also creates more male children than females and the normal ratio itself is in favour of the males: Arvind singh

  2. Heartiest Congratulations. Emedinews is an excellent effort. It is wonderful: Shashi P. Gupta
     
  3. EYE CARE ADVICE: Never ever use someone else’s spectacles! Eye refraction differs from person to person and even between the two eyes in one person. Go in for your own spectacles based on yearly professional eye examination findings be it for myopia, hypermetropia, astigmatism, presbyopia, aphakia or pseudophakia: Dr. Narendra Kumar
     
  4. Dear Dr KK Aggarwal, I suggest you to write the name of approving authority in the section of approved drugs: Dr AK Bhatnagar.
    eMedinewS responds: The column is from Drug Controller of India.
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eMedinewS–Padma Con 2010

Will be organized at
Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

 
 

eMedinewS–revisiting 2010

The second eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited .

 

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