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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 (07–08); 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 …

11th June 2011, Saturday                                eMedinewS Presents Audio News of the Day

Anti Tobacco Day Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Baba Ramdev Special: How to handle a patient on Satyagraha

I recall my MBBS days when I met Acharya Vinoba Bhave for the first time in 1975. When I was an intern, I was a part of the medical team who looked after him when he undertook a fast unto death. It was a voluntary decision taken by him after he was diagnosed to be suffering from LBBB heart rhythm and was advised a pacemaker. Instead of going for an artificial machine, he decided to call it a day and quit the world. It became a debate of the nation whether a person can decide to fast unto death or not. A case was also filed in the local court that he was trying to commit suicide but before the date of hearing, Acharya Vinoba Bhave left his body on the day of Amavasya, 10 am on Diwali day. Since then this subject has never been out of my thoughts and these memories of Acharya Vinoba Bhave once again became afresh with the recent episodes of Anna Hazare going on Satyagraha and later Baba Ram Dev sitting on fast unto death.

I also remember my days in 1986 when I was doing my Fellowship in Non-invasive Cardiology in Birmingham Alabama USA when I came across an article in US media about physician–assisted suicide, a term not defined by the Medical Council of India. Physician-assisted suicide was an unethical act in American dictionary at that time.

From medical point of view, if we are called to examine a patient on Satyagraha with a vow to fast unto death for practical purposes, he or she is committing suicide and if we as doctors are silent witness to the same, we are liable to be charged with an unethical act of assisting in physician–assisted suicide.

We should refuse to attend to any such patient and if we do choose to attend then it becomes our duty to forcibly treat that patient even if it amounts to calling the Police or the local administrative authorities. As medical fraternity, we should refuse to attend to such patients if we are not allowed to act and treat them medically.

I know that in the case of Acharya Vinoba Bhave, doctors from MGIMS, Nagpur and many invited from Bombay were simply spectators and were unable to offer any help to the dying saint. We are witnessing a similar phenomenon with Baba Ram Dev and the local treating doctors showing their helplessness.

At 8pm: Since 4 o clock onwards, I was firstly in Star TV and then in Aaj Tak commending on the health bulletin of Baba Ram Dev. He was forcibly admitted in a Haridwar Hospital by the Administration. As per the bulletin, he had a Vasovagal attack at 8pm. His pulse rate was 60 pm, blood pressure 110/78 HHmg and respiratory rate 18 per minute. There were few questions which raise medical concerns:

1. Why did Baba  Ramdev being a yogi could not sustain his starvation more than six days?
In my personal opinion, the answers is that he was not doing a yogic Satyagrah as he was not meditating and was not silent during the Satyagrah. His mind was active, agitative, exerting through by way of his yoga classes and addressing press conferences. When you are exerting, starvation effects are much earlier.

2. What might have happened to Baba Ram Dev when he was forcibly admitted?
In my personal opinion, he had vasovagal attack with mild dehydration.

3. Why his  pulse rate was low between 58-60 per minute?
In my opinion, in mild dehydration, pulse rate is increased and not reduced. May be his pulse rate always remains between 50-60 per minute. People who do regular yoga may have low pulse rate.

4. Why his respiratory rate was 18 per minute?
Answer is – maybe due to anxiety.

5. Why was he not in his senses when he was forcibly taken to hospital?
Probably it was due to vasovagal attack.

6. What is the duty of a doctor who is attending to such Satyagrahi patients?
His job is to treat the patient and even without consent if the life is in danger.

 

We will have more updates in our subsequent issues.

Dr KK Aggarwal
Editor in Chief
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  Changing Practice – Evidence which has changed practice in last one year

Timing of treatment for relapsed ovarian cancer

For most women, second–line treatment for relapsed ovarian cancer be initiated at the time when signs or symptoms of a disease recurrence are detected, rather than on the basis of an asymptomatic elevation in the CA–125 level. However, this decision should be individualized and based upon an active discussion between physicians and patients of the risks and benefits of early versus delayed treatment. (October 8, 2010)

(Ref: http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/125320s007lbl.pdf. Accessed on November 22, 2010)

 
  eMedinewS Audio PostCard

 Chronic Hepatitis B: Optimum vaccination schedule

Dr Neelam Mohan Speaks on
‘Hepatitis B: Impact of age at infection’

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

BSNL Health Camp

Heart Care Foundation of India (HCFI) organized a Health camp for the employees of BSNL. In the photo: Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President, HCFI delivering a health talk.

 
Dr K K Aggarwal
 
    National News

Patent on dengue medicine sought by Jodhpur–based research centre

Researchers at the Jodhpur–based Desert Medical Research Centre (DMRC) have developed a medicine to fight dengue and has sought a patent on the cure. According to official sources here, researchers at the Centre affiliated to the Indian Medical Research Council, have developed this medicine from the latex of Aak (calopropis procera), a common bush available in plenty in the desert regions of Rajasthan. They started research on this herb in 2008 and found that its latex had medicinal value to fight the dengue virus and mosquitoes that carry this deadly disease. Experiments undertaken by the researchers gave the results that this latex not only tackled the dengue virus successfully but also killed the mosquitoes. They also treated patients of dengue in western Rajasthan with this medicine given in liquid form, and were able to control the disease in the regions. Sources said that the DMRC had been informally conveyed about getting the patent certificate at the earliest. On its part DMRC has in anticipation of the clearance begun negotiations with private medical companies to give them licences to produce the medicine. (Source: The Pioneer, June 09, 2011)

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 Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

At home

  • Walk or ride a bike to the local store or library.
  • Work faster than your normal pace when doing housework.
  • Go for a walk after dinner instead of sitting in front of the television.

(Dr Monica and Brahm Vasudev)

Glucocorticoids should not be tapered too soon in vasculitis

Discontinuing glucocorticoid therapy early may significantly increase the risk of relapse in antineutrophil cytoplasmic antibody–associated vasculitis.

New male infertility test could ‘bring hope to millions’

LONDON: A groundbreaking new test for male infertility, which will save time, money and heartache for couples around the world, has been developed by Northern Ireland’s Queen’s University Belfast. The medical breakthrough, known as the SpermComet, has resulted from more than a decade’s research by Professor Sheena Lewis, who leads the Reproductive Medicine research group at Queen’s. The SpermComet provides unique information that no other test offers. By measuring damaged DNA in individual sperm, it can predict the success of infertility treatments and fast–track couples to the treatment most likely to succeed, leading to significantly reduced waiting times and improved chances of conception. (Source: http://timesofindia.indiatimes.com/home/science/New-male-infertility-test-could-bring-hope-to-millions/articleshow/8760609.cms, June 7, 2011)

 
  Twitter of the Day

@DrKKAggarwal: Dr K K Aggarwal in Manthan on Nirjal Ekadashi Part 2.MP3:
http://www.zshare.net/audio/91226888233f9528/

@DeepakChopra: #vmdhealthblog Did you know that bad oral health could lead to systemic diseases? Check out my health tip: http://bit.ly/Dpk_Oral

 
    Spiritual Update

Hanuman Chalisa

Tulsidas Sada Hari Chera
Keeje Nath Hriday Mah Dera


Meaning: Tulsidas, the eternal servant of the Lord, gives this promise in the name of Mahadeva, the lord of Gauri. O Lord, may you always reside in my heart.

Spiritual Significance: With Pranayama, one obtains the power to take conscious–based decisions. Anhata chakra and the heart is the seat for consciousness. One should meditate focusing awareness and breathing on the heart area with or without the sound YAM.

 
    An Inspirational Story

(Dr Anupam Sethi Malhotra)

The germ of a good idea

Somebody once said that the closest anyone ever comes to being perfect is when he or she applies for a job. Therein lies the germ of a good idea.

Suppose you’re feeling low. Your confidence has been shaken by some mistake or failure. Your self–esteem has escaped. You’re deflated. This is the time to write a letter of application for a job you would love to have. Whether the job is actually available or not isn’t important. The important thing is that you write the letter, putting your best foot forward. In the letter, emphasize your strengths and stay away from your weaknesses.

Write about your three proudest achievements. Tell why they were worthy accomplishments. Were you working in the face of long odds? If so, say so. What difficulties did you have to overcome? How many people did your accomplishments benefit?

Next, talk about how you have grown in your current job. Compare your skills today against those you had five years ago. Summarize your salary history. Chances are, you’ll be pleasantly surprised.

Here’s the most important part: Tell why you should be hired. What unique skill, talent, or ideas can you offer to improve your new employer’s business?

This self–appraisal could be just what it takes to regain your self–esteem. And who knows it might just give you some good ideas for improving what you’re doing where you are.

 
    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

How can one diagnose primary hypothyroidism in the setting of acute illness?

Hypothyroidism is a strong possibility if TSH is >25–30. (will be above 20 only 3% of the time in non thyroidal illness)

  • Subnormal free T4 in the absence of treatment with agents that suppress TSH (dopamine, corticosteroids, phenytoin, carbamazepine) is strongly suggestive of hypothyroidism.
  • Presence of goiter and anti–thyroid antibodies (peroxidase, thyroglobulin) favor primary hypothyroidism.
  • Elevated rT3 in the setting of TSH >10 renders diagnosis of hypothyroidism unlikely.
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    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

What is endometriosis?

In endometriosis, the endometrium (tissue from the lining of the uterus) forms and grows in places outside the uterus. These growths may cause pain and infertility. Up to 50% of women who have endometriosis may experience infertility. These lost endometrial cells respond to the body’s hormones in a similar manner as they would inside the uterus. Normally, the endometrium within the uterus thickens to prepare for an embryo. When pregnancy does not occur, the extra lining breaks down and is shed during menstruation.

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found to have high ESR and elevated CRP.
Dr Bad: You are suffering from an inflammatory disease.
Dr Good: It may be a part of diabetes.
Lesson: In diabetes, both ESR and CRP can be high at the same time and this can be due to IL–6 secretion by adipose tissue.

Make Sure

Situation: A patient on dialysis and on oral antacid developed aluminium toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminium toxicity in patients undergoing dialysis.

 
  SMS of the Day

(Dr GM Singh)

Men are like steel. When they lose their temper, they lose their worth. Chuck Norris

 
  Gyne Update

(Dr Maninder Ahuja, Secretary General IMS)

Treatment of confirmed osteoporosis in postmenopausal women

Treatment regimens are reserved for postmenopausal women with a confirmed diagnosis of osteoporosis by central DXA (T–score ≤–2.5 at the lowest measured site) or with a documented fragility fracture of the spine or hip.

Estrogen is indicated for the prevention of postmenopausal osteoporosis, especially in women with moderate to severe vasomotor symptoms. This means that estrogens can be prescribed only when indicated for hot flushes or mood disturbances or urogenital problems but once started for these indications can be continues upto sixty years of age or for six years with informed consent.

Estrogen comes in a variety of types (ie, estradiol, esterified estrogen, conjugated equine estrogen), formulations (oral, transdermal, intravaginal), dosages, and regimens (daily, biweekly, weekly, monthly). Estrogen therapy (ET) should only be prescribed to women who have undergone a hysterectomy. Estrogen/progestin therapy (EPT) is indicated for women with a uterus to prevent endometrial hyperplasia. Potential side effects include breast tenderness and uterine bleeding. Estrogen also increases the risk of venous thromboembolic events (VTE). Because of potential long–term cardiovascular and breast safety concerns raised by the Women’s Health Initiative (WHI) clinical trials, the FDA recommends that when prescribing medication to prevent osteoporosis only, physicians should consider all nonestrogen preparations first.

When prescribing ET/EPT, physicians should prescribe the smallest dose for the shortest amount of time to achieve treatment goals, and only when the benefits are believed to outweigh the risks for a specific patient.
 

 
  Rabies Update

(Dr AK Gupta, Author of "RABIES – the worst death")

Are there any survivors of human rabies?

Rabies is practically 100% fatal even today but easily preventable. Till date only seven survivors have been recorded. These patients survived not due to any specific anti–rabies therapy but following intensive life support and excellent nursing care. These patients survived for variable periods with residual neurological deficits.

A pregnant woman develops rabies. What should be done?

In case the mother develops rabies, as the rabies virus is not known to cross placental barrier, therefore the fetus is safe. Hence, the pregnant woman with rabies should be clinically managed and if induction of pregnancy or caesarean section is possible, the obstetrician should do it with some "personal precautions" and immunoprophylaxis (usually three doses of modern vaccine or if any accidental exposure is there, then full course of post–exposure vaccination either by IM or ID route should be given to the obstetrician.) Later, the newborn may be given full course of rabies PEP vaccination.

 
    Medicolegal Update

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

What is the 8th clause of Section 320 Indian Penal Code for doctors?

The eighth clause of Indian Penal Code 320 defines grievous hurts as "Any hurt which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits."

  • Ordinary pursuits means the patient is unable to visit the toilet, to bathe or brush his teeth, eat himself, walk or carry on such daily pursuits and requires mandatory help of other person for 20 days
  • The length of time during which an injured person is in pain, disease or is not able to pursue his ordinary daily routine work must be meticulously and satisfactorily observed by the doctor himself before certifying injury as a grievous injury.
  • It is employed not only in cases where violence has been used but also in cases where hurt has been caused without any assault, e.g., by administration of drugs, setting of traps etc. The extent of hurt and the intention of the offender are considered for giving punishment.
  • It is difficult for a doctor to prove that an injured person was in severe bodily pain for 20 days but it is easier to prove that he was unable to follow his ordinary profession/pursuits due to the hurt.
  • A mere stay of 20 days in the hospital doesn’t make injury grievous. The certifying doctor must rule out and document the feigned illness in medicolegal report.
 
  Vitamins - Open Secrets revealed

(Dr Jitendra Ingole, MD Internal Medicine)

Role of vitamin C in immunological system

Vitamin C affects several components of the human immune system; for example, vitamin C has been shown to stimulate both the production and function of leukocytes (white blood cells), especially neutrophils, lymphocytes, and phagocytes. Specific measures of functions stimulated by vitamin C include cellular motility chemotaxis, and phagocytosis. Neutrophils, which attack foreign bacteria and viruses, seem to be the primary cell type stimulated by vitamin C, but lymphocytes and other phagocytes are also affected. Additionally, several studies have shown that supplemental vitamin C increases serum levels of antibodies and C1q complement proteins in guinea pigs, which—like humans—cannot synthesize vitamin C and hence depend on dietary vitamin C. However, some studies have reported no beneficial changes in leukocyte production or function with vitamin C treatment. Vitamin C may also protect the integrity of immune cells. Neutrophils, mononuclear phagocytes, and lymphocytes accumulate vitamin C to high concentrations, which can protect these cell types from oxidative damage. In response to invading microorganisms, phagocytic leukocytes release non–specific toxins, such as superoxide radicals, hypochlorous acid ("bleach"), and peroxynitrite; these reactive oxygen species kill pathogens and, in the process, can damage the leukocytes themselves. Vitamin C, through its antioxidant functions, has been shown to protect leukocytes from such effects of auto–oxidation. Phagocytic leukocytes also produce and release cytokines, including interferons, which have antiviral activity. Vitamin C has been shown to increase interferon levels in vitro.

It is widely thought by the general public that vitamin C boosts the function of the immune system, and accordingly, may protect against viral infections and perhaps other diseases. While some studies suggest the biological plausibility of vitamin C as an immune enhancer, human studies published to date are conflicting. Further, controlled clinical trials of appropriate statistical power would be necessary to determine if supplemental vitamin C boosts the immune system.

References

  1. Levy R, Shriker O, Porath A, et al. Vitamin C for the treatment of recurrent furunculosis in patients with impaired neutrophil functions. J Infect Dis 1996;173(6):1502–05.
  2. Jariwalla RJ, Harakeh S. Antiviral and immunomodulatory activities of ascorbic acid. In: Harris JR (ed). Subcellular Biochemistry. Vol. 25. Ascorbic Acid: Biochemistry and Biomedical Cell Biology. New York: Plenum Press 1996:215–231.
 
    Mind Teaser

Read this…………………

A previously healthy 16–year–old boy is evaluated in the office for dysphagia. Starting this morning he had difficulty swallowing, with fluid regurgitating out of his nose when he tried to swallow milk. He also reported having "double–vision" while reading the morning newspaper. On physical examination, he is afebrile, his blood pressure is 120/70 mm Hg, and pulse is 70/min. He has bilateral ptosis and enlarged, sluggishly reactive pupils. The mouth is dry and the pharynx is injected. Muscle strength is good with normal deep tendon reflexes, and there are no sensory changes. The mental status examination is unremarkable. A patient with similar symptoms was evaluated yesterday. This patient was found to have diplopia, dysarthria, dysphonia, and dysphagia as well as hypotonia of the neck muscles.

Which of the following is the most likely diagnosis?

A. Botulism
B. Guillain–Barre polyradiculopathy
C. Myasthenia gravis
D. Poliomyelitis

Yesterday’s Mind Teaser: Urinary concentrating ability of the kidney is increased by:

1. ECF volume contraction
2. Increase in RBF
3. Reduction of medullary hyperosmolarity
4. Increase in GFR

Answer for Yesterday’s Mind Teaser: 1. ECF volume contraction

Correct answers received from: Dr K Raju, Dr Muthumperumal Thirumalpillai, Doraisami Sundaram,
Dr Surendra Bahadur Mathur, Dr Prabodh Kumar Gupta, Dr Jainendra Upadhyay, Dr Rashmi Chhibber,
Dr Deepali Chatterjee, Dr Anil Bairaria.

Answer for 9th June Mind Teaser: C. Immediately inform the local or state public health organization
Correct answers received from: Dr Jainendra Upadhyay, Dr NM Goyal, Dr Vijay Kansal.

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

What is short selling?

When an investor goes long on an investment, this means that he or she has bought a stock believing its price will rise in the future. Conversely, when an investor goes short he or she is anticipating a decrease in share price therefore "Short selling is the selling of a stock that the seller does not own." More specifically, a short selling means the sale of a security or any individual stock that is not owned by the seller at that point of time, but he promises to deliver it at time of delivery.

 
    Laugh a While

(Dr. GM Singh)

Two drunks were in a boat on the lake fishing. A bottle floats by and one of the drunks retrieves it. He pulls the cork out and a Genie appears. He announces: "I am the Genie of the lake and I grant you one wish!" The one drunk says: "Turn the lake into Beer!!" "So shall it be ", says the Genie and disappears. The other drunk says. "You idiot .......Now we’ll have to piss in the boat!!"

 
    Drug Update

List of Approved Drug From 01.01.2010 TO 31.8.2010

Drug Name

Indication

DCI Approval Date

Irinotecan HCl Trihydrate Injection 20 mg/ml (Pack Size 25ml)

For the treatment of metastatic colorectal cancer.

31.08.10

 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Laparoscopic Sleeve Gastrectomy: FAQs

How long will the patient be in the hospital?

In general, patients will stay in the hospital for 1 to 2 days after laparoscopic sleeve gastrectomy surgery.

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Immunization Practices: ACIP recommendations

In 2010, the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices expanded the recommendation for influenza vaccination to include all individuals 6 months of age and older.

 
    Public Forum

(Press Release for use by the newspapers)

Working hard when tired not good for the health

Doing mental or physical work while exhausted may harm your health, as per study from University of Alabama at Birmingham published in the International Journal of Psychophysiology.

Commenting on the study Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India, said that fatigued people have bigger spikes in blood pressure than well–rested people while doing a memorization test.

Dr SC Tewari, Professor & Head. Department of Nephrology, All India Institute of Medical Sciences said that when fatigued people regard a task as worthwhile and achievable, they increase their effort to compensate for their diminished capability. As a result, a tired person’s blood pressure increases and remains elevated until the task is completed or the person gives up.

In this study, Wright and colleagues told 80 volunteers they could win a modest prize by memorizing two or six nonsense trigrams (meaningless three–letter sequences) within two minutes. Compared to volunteers with low levels of fatigue, those with moderate fatigue had stronger blood pressure while doing the two–trigram memorization task.

Everyone cannot fast on Nirjala Ekadashi

Nirjala Ekadashi falls on Sunday, 12th June and as per Hindu tradition, a large number of patients undertake complete food and water fast on this day. It is said that if one has to do a single fast in a year, it should be on the day of Nirjala Ekadashi. It is the most difficult fast to undertake amongst the various Hindu fasts.

Every person is not fit to observe this fast, said Dr. KK Aggarwal. Patients with chronic diseases like diabetes, uncontrolled blood pressure, kidney diseases, liver diseases, heart diseases should not observe this fast. The elderly, very young children and pregnant ladies should also not undertake this fast.

Speaking about the different types of fasts, Dr. Aggarwal further said that fast can be a Falahaar fast, water fast and Nirjala fast.

 
    Readers Response
  1. Great information site for emedinews viewer, Thank you Sir/Madam: Rajesh Singh
 
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    Forthcoming Events

National Conference on "Insight on Medico Legal Issues"
Date: Sunday, 10th July, 2011
Venue: Auditorium, Chinmaya Mission, 89, Lodhi Road, New Delhi – 110003

eMedinewS and Heart Care Foundation of India are jointly organizing the first-ever National Conference on "Insight on Medico Legal Issues" to commemorate "Doctors’ Day".
The one–day conference will provide total insight into all the medicolegal and ethical issues concerning the practicing doctors. Both medical and legal experts will interact with the delegates on important issues.
You are requested to kindly register in advance as seats are limited. There will be no registration fee. You can register by sending your request at rekhapapola@gmail.com or at 9899974439.

Programme

Session: Ethical Issues in Medical Research (8 am–8.30am)
Chairpersons: Dr T K Joshi
Moderators: Dr K K Aggarwal and Dr Girish Tyagi

Topic: Rights of a patient in medical trial, Speaker: Ajay Agrawal (Sr Advocate), Time: 8 am–8.10 am
Topic: Ethical Issues in a medical trial, Speaker: Dr Ranjit Roy Chaudhury, Time: 8.10 am–8.20 am
Topic: Statutory permits required for conducting trials, Speaker: Ms Priya Hingorani (Sr Advocate), Time: 8.20 am–8.30 am

Session: Medical ethics and organ donations (8.30 am–9.00 am)
Chairpersons: Dr N V Kamat and Dr Anil Bansal
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic: Ethical issues in IVF practice, Time: 8.30 am–8.37 am
Topic: 100% voluntary blood donation, Speaker: Dr N K Bhatia, Time: 8.37 am–8.44 am
Topic: Need for do not resuscitate laws in India, Speaker: Dr Rajesh Chawla, Time: 8.44 am–8.51am
Topic: Ethical issues in organ transplantation, Speaker: Dr Neelam Mohan Time: 8.51 am–8.58 am

Session: Handling cases of death (9 am–9.30 am)
Chairpersons: Mr S K Saggar, Dr Arvind Chopra and Dr Ambrish Mithal
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic: How to declare the death?Time: 9.00 am-9.10 am
Topic: Spiritual considerations in a dying patient, Speaker: Dr S C Tewari, Time: 9.10 am-9.20 am
Topic: Medico legal and ethical issues in post mortem, Speaker: Dr G K Sharma, Time: 9.20 am-9.30 am

Session: Medical Insurance (9.30 am –10 am)
Chairpersons: Mr Vibhu Talwar, Dr H K Chopra and Dr Vinod Khetrapal Moderator: Dr K K Aggarwal
Topic: Indemnity Insurance Time: 9.30 am–9.40 am
Topic: Engaging a lawyer Speaker: Ms Meenakshi Lekhi (Sr Advocate) Time: 9.40 am–9.50 am
Topic: Understanding various court procedures Speaker: Maninder Acharya (Sr Advocate) Time: 9.50 am–10.00 am

Session: How to handle medico legal cases? (10 am–10.30 am)
Chairpersons: Dr Anil Goyal and Dr Rajiv Ahuja
Moderators: Dr K K Aggarwal and Dr. Girish Tyagi
Topic: When to do the MLC? Speaker: Dr M C Gupta (Advocate), Time: 10.00 am–10.10 am
Topic: Checklist of MLC case Speaker: Dr Sudhir Gupta Time: 10.10 am–10.20 am
Topic: Medicolegal record keeping Speaker: Mr Siddarth Luthra (Sr Advocate)
Time:
10.20 am–10.30 am
Topic: Extended Consent, Speaker: Dr NP Singh, Time: 10:50 am-11 am

Session: Medical Consent (10.30 am–11 am)
Chairpersons: Dr Vinay Aggarwal and Dr P K Dave
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic: Types of consent Speaker: Ms Indu Malhotra (Sr Advocate) Time: 10.30 am–10.40 am
Topic Ideal consent Speaker: Dr Manoj Singh Time: 10.40 am–10.50 am

Session: Fallacies in acts applicable to medical profession (11 am–11.30 am)
Chairpersons: Dr Anup Sarya, Dr Sanjiv Malik and Dr Anupam Sibbal
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic: MTP, PNDT Act, Speaker: Dr Kaberi Banerjee, Time: 11.00-11.10 am
Topic: Organ Transplant Act, Speaker: Dr Sandeep Guleria Time: 11.10-11.20 am
Topic: State Medical Councils and Medical Council of India, Speaker: Dr DK Diwan,
Time:
11.20–11.30 am

Session: Inauguration: 11.30 am to 12.00 noon
Invited Guests: Justice Vipin Sanghi, Dr KK Talwar, Dr Shiv Sarin and Dr A K Agarwal

Session: Professional misconduct and professional ethics (12.00 am–1.00 pm)
Chairpersons: Dr A K Agarwal, Dr D S Rana and Dr H S Rissam
Moderators: Dr K K Aggarwal and Dr Girish Tyagi
Topic: Doctor–pharma relationship Time: 12.00–12.10 pm
Topic: Advertisement and medical practice Speaker: Dr P Lal, Time: 12.10 pm–12.20 pm
Topic: Rights of a patient Speaker: Dr Navin Dang Time: 12.20 pm–12.30 pm
Topic: Rights of a doctor Speaker: Dr Ajay Gambhi, Time: 12.30 pm–12.40 pm
Topic: Kickbacks, touts and commercialization in medical practice Speaker: Dr Ashok Seth
Time:
12.40 pm–12.50 pm
Topic: Complaints of a doctor against doctor Time: 12.50 pm–01.00 pm

Session: When it is not negligence? (1.00 pm to 2.00 pm)
Chairpersons: Dr Prem Kakkar and Dr S K Sama
Moderators: Dr K K Aggarwal and Dr. Girish Tyagi
Topic: What is medical negligence? Speaker: Dr Girish Tyagi, Time: 1.00 pm–1.10 pm
Topic: Medical accidents Speaker: Dr Vijay Aggarwal Time: 1.10 pm–1.20 pm
Topic: Professional Misconduct Speaker: Mr Mukul Rohatgi (Sr Advocate) Time: 1.20 pm–1.30 pm
Topic: How to defend a complaint? Speaker: Dr K K Aggarwal Time: 1.30 pm–1.40 pm
Topic: Out of court settlement Time: 1.40 pm–1.50 pm
Topic: Compensation Vs Cancellation of License Speaker: Dr O P Kalra, Time: 1.50 pm–2.00 pm

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September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com

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Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at
medifilmfestinhealthmela@gmail.com

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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta