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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

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

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

11th November 2012, Sunday

Intermittent hormonal contraception

No hormonal contraceptive method is approved for use only at the time of intercourse.

In a systematic review of precoital and postcoital use of levonorgestrel as a method of contraception in women who had infrequent intercourse, intermittent use of levonorgestrel was safe and moderately effective as a contraceptive.

Regimen (0.75 mg of levonorgestrel within one hour after coitus), the pooled Pearl index was 5.1 pregnancies per 100 woman-years [Obstet Gynecol 2011;117:673].

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Do not give phosphate enemas in the elderly

Sodium phosphate enemas should be avoided in the elderly. Sodium phosphate enemas, even in standard doses, may lead to severe metabolic disorders (hyperphosphatemia, severe hypocalcemia, hypernatremia, hypokalemia) and may cause acute renal failure and even death in elderly patients with constipation (Ori Y, Rozen-Zvi B, Chagnac A, et al. Fatalities and severe metabolic disorders associated with the use of sodium phosphate enemas: a single center's experience. Arch Intern Med. 2012 Feb 13;172(3):263-5).

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

FDA OKs first drug-eluting stents for use in MI

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

National Workshop On Homoeopathy In Cardiology in 19th MTNL Perfect Health Mela 2012

Inaugurating the conference in a different way by doing CPR Haryana's health minister Rao Narendra Singh and Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India

 
Dr K K Aggarwal
    National News

CPR 10

click for video

Today in MTNL Perfect Health Mela

Indian Oil Heritage Inter Dancing School Competition

Date: 11th November, Sunday 2012
8 am - 5 pm Indian Oil’s “HERITAGE”- Inter Dance School Festival
Venue: Constitution Club of India, Rafi Marg, New Delhi
Organisers: Heart Care Foundation of India and Various Departments of Delhi Government Bharatnatyam-Jr, Bharatnatyami-Sr. Odissi-Jr.(Solo) & (Group),Odissi-Sr.(Solo) & (Group) Kathak – Jr., Kathak– Sr .
Ryan Global School presents Nukkad Natak, Theme: Eat Wise & Drop A Size; Debate Theme: He Who Indulges, Bulges
Cheer Leading Theme: Health Is Wealth

ZOONOSIS-2012

“Conference on Prevention of common diseases communicable from animals to human”
Organizers: Millennium India Education Foundation
Venue: Perfect Health Mela 2012- Conference Room, Constitution Club of India,Rafi Marg, New Delhi; Date: Nov 11 th 2012 Time: 12 -6pm;Topic : Brief about the conference & survey analysis,
Session 1: Update on Communicable Disease from Small/Pet/Companion Animals (Cats & Dog)
Session 2 Update on Communicable Disease from Birds /Poutry
Session 3 Update on Communicable Transborder and Food Borne Diseases

National Workshop on Pre Hospital Care in Heart Attack

In association with National Heart Institute
Date: 11th November, Sunday 2012
Time: 9 am - 12 noon
Venue: Constitution Club of India, Rafi Marg, New Delhi

  • Challenges in diagnosis and management of Acute Myocardial Infarction - Dr Vinod Sharma ,
  • Pre hospital diagnosis of acute myocardial infarction - Dr Sunil Modi
  • Pre hospital management of acute myocardial infarction - How you can get best out of available - Dr Tushar Roy
  • Pre hospital management of acute myocardial infarction - Brought perspective & take home messages - Dr KK Aggarwal

Live Recording of Health Interactive Program

With Dilli Aajtak, Date: 11th November, Sunday, 12 Noon, Anchor: Mr. Pratik Trivedi, Topic: Diabetes
Venue: Constitution Club of India, Rafi Marg, New Delhi,

Valedictory Function

Date: 11th November, Sunday 2012;Time : 3 pm - 4 pm;Chief Guest: Dr Kiran Walia;Hon’ble Minister for Education, Social Welfare,Women and Child Development, Govt. of Delhi;Venue: Constitution Club of India, Rafi Marg, New Delhi

Cultural Evening

Smt. Uma Lallo Sindhi Singer
Venue: Constitution Club of India, Rafi Marg, New Delhi
Date: 11th November, Sunday; Time : 6 pm

Symposium on Prayer, Health & Religion

Shri J. Veeraraghavan, Chairman, Bhavan’s K.M. Munshi Institute of Educational Leadership and Management has kindly consented to be the Chief Guest and deliver the Keynote Address.
Date: 11th November, Sunday 2012;Time: 5.00 pm;Venue: Constitution Club of India, Rafi Marg, New Delhi;
Moderator - Dr. K.K Aggarwal, Padma Shri & Dr. BC Roy National Awardee and President, Heart Care Foundation of India; Welcome Address by: Shri Ashok Pradhan, Director, BVB, Delhi Kendra

Bollywood Nite -A Musical Evening With Pop Singer Anand Parmar

Date: 11 November 2012, Time: 6 pm,
Venue: Constitution Club of India, Rafi Marg, New Delhi

Ahmedabad hospitals scrubbing out new virus

AHMEDABAD: The city may be reeling from a dengue outbreak but another virus has grabbed the attention of infectious disease specialists. Scrub typhus, a virus only marginally less deadly than the CCHF virus which causes the dreaded Congo fever, is being reported by city hospitals. The only comfort is that there are no reports of a scrub typhus outbreak in Gujarat. All the patients admitted here are from Rajasthan. Doctors say there is a steady influx of scrub typhus cases from Rajasthan, which like CCHF is spread by an insect bite. While CCHF is spread through ticks found on animals, the scrub typhus virus is spread through mites found in rice. Three patients — all women — were brought to Sterling Hospital in a critical condition with the scrub typhus viral fever. All women were from Lakhadvaas village in Rajasthan. Rajasthan Hospital has reported six-odd cases of scrub typhus viral fever. All patients — four women and two men — are from areas near Udaipur. (Source: TOI, Nov 10, 2012)

My Profession My Concern

Reduce the risk of patient harm resulting from falls

Legal implications

  • Patient death or serious disability associated with a fall while being cared for in a healthcare facility is one of the 28 never events.
  • In USA, the Federal Centers for Medicare and Medicaid Services do not reimburse hospitals for the treatment of eight major preventable errors. The hospitals cannot bill a patient for the cost of fixing these mistakes: Falls; Mediastinitis (an infection that can develop after heart surgery); Urinary tract infections resulting from catheters; Bed sores; Bloodstream infections resulting from catheters; Objects left in the body during surgery; Air embolisms and Blood incompatibility.

For comments and archives

Medical mistakes in Indian movies

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

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

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

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

 
    Valvular Heart Disease Update

The peak incidence of symptoms of aortic stenosis occurs between the ages of 40 and 60.

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

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Infective endocarditis often missed in at-risk patients

Men are more likely than women to be affected by infective endocarditis (IE), and left-sided disease is more common than right-sided disease. These findings come from a 12-year autopsy review designed to assess the pathology of the inflammatory condition and to determine how frequently the diagnosis is not made when the patient is alive. Furthermore, at autopsy, a disproportionate number of black IE patients were infected with methicillin-resistant Staphylococcus aureus (MRSA), and a "surprising" number of patients were dialysis-dependent, lead investigator Yaolin Zhou, MD, a resident in the Department of Pathology at the University of Alabama at Birmingham, reported here at the American Society for Clinical Pathology 2012 Annual Meeting. (Source: Medscape)

For comments and archives

Lower is better for cooling after cardiac arrest

A pilot trial examining which of two temperatures to use when cooling patients following a sudden cardiac arrest suggests that the lower one, 32°C (89.6°F), may improve outcomes compared with the higher, 34°C. Dr Esteban López-de-Sá (La Paz University Hospital, Madrid, Spain) reported the findings at a late-breaking trials-session at the American Heart Association 2012 Scientific Sessions. The results are also published online today in Circulation. (Source: Medscape)

For comments and archives

Back pain self-management: benefits big enough to matter?

Self-management interventions are widely recommended for patients with low back pain (LBP), but a systematic review with meta-analysis by Australian researchers suggests that its effects on pain and disability are likely to be small and are supported by only moderate-quality evidence. The study, by Vincinius C. Oliveira, a PhD candidate in the Arthritis & Musculoskeletal Research Group at the University of Sydney, Australia, and colleagues was published online October 27 and in the November print issue of Arthritis Care & Research. (Source: Medscape)

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: I uploaded a @YouTube video http://youtu.be/Mo6XfFIbSEE?a CPR Hindi film

@DeepakChopra: How can we bring more awareness to the need for kindness to animals? http://tinyurl.com/ao78x7l

 
    Spiritual Update

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

Spirituality The Key To Health

To stay healthy, one needs to eat right, get plenty of exercise and rest, and avoid bad habits such as smoking. But, now it is said that “what you believe in” can have a big impact on health and longevity.

For comments and archives

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

What is cryopreservation?

Extra embryos remaining after the embryo transfer may be cryopreserved (frozen) for future transfer. Cryopreservation makes future ART cycles simpler, less expensive, and less invasive than the initial IVF cycle, since the woman does not require ovarian stimulation or egg retrieval. There are two methods used to cryopreserve embryos: conventional (slow) freezing and “vitrification” or fast freezing.

For comments and archives

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

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Immunogenicity

Immunogenicity is the ability of an antigen to stimulate the production of its corresponding antibody in a person that lacks the antigen.

  • Immunogen = Antigen
    o D antigen, strong immunogen
    o Fya antigen, weak immunogen
  • Immune response depends on:
    o Chemical structure of the antigen
    o Number of red cells and amount of antigen they carry

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

Five kernels of corn

Many years ago during one of the early winters, the Pilgrims had very little food. Because their corn supply was almost gone, each Pilgrim was given only five grains of corn to plant. The following years they had more corn, but the Pilgrims wanted their children to always remember the sacrifices and the hardships that made the survival of their small settlement possible. So each year when they celebrated Thanksgiving, they placed five grains of corn by each plate. Some families still honor this tradition, so they won't forget the early days either.

For comments and archives

 
  Cardiology eMedinewS

AHA Hallway Buzz: FREEDOM gives edge to CABG for diabetics Read More

Prevention easier to swallow with polypill Read More

 
  Pediatric eMedinewS

Acute chorioamnionitis does not predict neonatal sepsis
Read More

Children with autism developmentally normal at 6 months Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A female with past history of DVT needed an OC prescription.
Dr Bad: Start OC patch (transdermal).
Dr Good: You cannot be on OC.
Lesson: There is a possibility of an increased risk of venous thromboembolism in oral contraceptive patch users.

For comments and archives

Make Sure

Situation: A female patient complained of lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: Oh my God! You should do cervical swabs and consider starting antibiotics.
Lesson: Make sure to remember that women with such symptoms may have endometritis, which requires prompt diagnosis. It may respond to doxycycline and metronidazole.

For comments and archives

 
    Legal Question of the Day (Dr M C Gupta)

Q. Is it legal to carry out a decoy operation for catching the violators of the PC-PNDT Act? If yes, what are the guidelines for the same?

Ans.

  1. A genuine and properly planned decoy or sting operation is legally permissible.
  2. The guidelines for a decoy operation are as follows:

    1. Seek participation of a woman who is 14 to 22 weeks pregnant and is willing to be involved in the decoy operation. Counsel the selected woman on the purpose of the decoy.

    2. An affidavit from the woman should be obtained stating that she is ready to take part in the decoy operation. Note the numbers on the currency notes to be used. These are to be mentioned in the affidavit. Give these currency notes to the decoy woman or the witness.

    3. Prepare two witnesses to accompany the woman.

    4. Keep an audio-video system handy if possible. Check beforehand if the pregnant woman and the witness can operate it correctly. They should be comfortable in using these. It is important to avoid any confusion in this regard.

    5. Keep ready three main witnesses and two inspectors. They should be friendly enough with each other to work as a team, with excellent nonverbal communication. They should be trained so as to gather and collect evidence, have a good knowledge of the Act and learn things to keep in mind for a decoy operation

    6. Appropriate Authorities should be available close by where the decoy operation is to take place.

    7. Upon learning that the decoy operation has been successful, Appropriate Authorities should take the accused in their custody.

    8. See to it that the accused is not able to make phone calls to anybody. All his phones should be switched off and other contacts not reachable.

    9. Search for the currency notes, verify and record after a Panchnama.

    10. Take a statement from the accused after inquiry.

    11. Statements from the co-accused (other paramedical staff, agent, PRO) should also be taken.

    12. The centre should be thoroughly inspected and all important documents in the case should be seized and sealed.

    13. All authorised, unauthorised machines should be taken into custody after sealing them. After a Panchnama, the accused should be given an acknowledgement of all seized machines and documents.

    14. Inspection report should be fully prepared. The entire premises, house, garage, hospital should be thoroughly searched for an unregistered machine.

    15. At the place of the crime, statements of the pregnant woman and the witnesses should be recorded and all the evidence in the form of audio, video cassettes should be taken into custody. The pregnant woman and the witnesses should be given copies of their statements and cassettes.

    16. After making sure that investigation has been carried out thoroughly, a case should be registered in the court after discussing the matter with lawyers.

    17. As the Appropriate Authority is the complainant, she / he or a representative should be present.

(Source: Proceedings of the National Workshop For State Appropriate Authorities and Nodal Officers Ministry of Health and Family Welfare, Government of India with United Nations Population Fund, UNFPA Manesar,
27-28 February 2012)

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  Quote of the Day (Dr GM Singh)

This is my simple religion. There is no need for temples; no need for complicated philosophy. Our own brain, our own heart is our temple; the philosophy is kindness. Dalai Lama

 
    Mind Teaser

Read this…………………

You have four chains. Each chain has three links in it. Although it is difficult to cut the links, you wish to make a single loop with all 12 links. What is the fewest number of cuts you must make to accomplish this task?

Yesterday’s Mind Teaser: When observing an ostomate do a return demonstration of the colostomy irrigation, the nurse notes that he needs more teaching if he:

A. Stops the flow of fluid when he feels uncomfortable
B. Lubricates the tip of the catheter before inserting it into the stoma
C. Hangs the bag on a clothes hook on the bathroom door during fluid insertion D. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled

Answer for Yesterday’s Mind Teaser: C. Hangs the bag on a clothes hook on the bathroom door during fluid insertion

Correct answers received from: Dr.K.V.Sarma, dr ajay Gandhi, Dr Kanta jain ,DR PC GOYAL, Dr Chandresh Jardosh Dr Pankaj Agarwal, Dr Jainendra Upadhyay , Dr Avtar Krishan,Dr. Thakor Hitendrsinh G

Answer for 9th November Mind Teaser: Pour the water from the 2nd glass into the 5th glass
Correct answers received from: Dr Chandresh Jardosh Dr Pankaj Agarwal, Dr Jainendra Upadhyay , Dr Avtar Krishan,Dr. Thakor Hitendrsinh G

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Funny Definitions

Seizure…………Roman emperor

 
    Medicolegal Update

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

Preparation of MLC in injury cases by the attending doctor

  • Injuries produced by a blunt weapon on tense skin covering the bones, as on scalp, eyebrow, iliac crest, shin, perineum, knee or elbow look like incised wounds. During the preparation of MLC report the doctors should keep in mind that he has to provide a clue about the weapon used, whether sharp–edged one or otherwise, the direction of the force, the duration of injury and the location of the wound, which may suggest mode of production i.e. suicide, accident, homicides along with whether the injury is fabricated or otherwise.
  • Wounds produced by a blunt weapon or by a fall on the hard surface, object, on tense structures/skin covering the bones, such as the scalp, eyebrow, iliac crest, shin, perineum, knee or elbow when the limb is flexed look like incised wounds; but, they are lacerated wound, also called split laceration. These wounds may mislead the doctor and the investigating authorities about a sharp weapon.
  • When incised–looking wounds are examined by doctor under magnifying lens, the edges of such wounds are found to be irregular with bruising and wounds are produced by blunt weapon.
  • An incised wound, cut, slash, and slice is a clean cut through the skin, it may or may not involve underlying tissues and structures. It is caused by a sharp–edged instrument, which is longer than the depth of wound. It is produced by infliction of an object having a sharp–cutting edge such as knife, razor, blade, scalpel, sword over the body.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Communicate better with your patients, Haryana Health Minister tells doctors

Over 500 homeopathic doctors participated in a workshop on Homeopathy in Cardiology conducted by Dr. Sameer Srivastava, Dr. Praveen Chandra, Dr. Aparna Jaswal, Dr. Praveen Chandra and Dr. Avdesh Pandey. The faculty from Homeopathy was represented by Dr. LM Khan and Dr. Manpreet S. Bindra.

Inaugurating the workshop, Shri Rao Narendra Singh, Health Minister, Haryana said that doctors should communicate with their patients better so as to avoid any litigation. He further added that more and more research is needed in homeopathic cardiology.

Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India said that in Allopathy there should be sessions of homeopathy so that one knows the strength and weaknesses of other systems of medicine.

The conclusions of the discussion were as follows:

  • Some homeopathic drugs, which can interact with allopathic drugs.
  • Homeopaths and Allopaths, both should know each other’s weaknesses and strengths.
  • Crataegus is a homeopathic tincture medicine, which has ACE-inhibitor like action.
  • Homeopathy does not differ in terms of lifestyle changes a person should adopt for prevention of heart diseases.
  • Tincture homeopathy is similar to Allopathy and Ayurveda.

National Workshop on Naturopathy and Yoga in Cardiology

A national workshop on Naturopathy and Yoga in cardiology was organized in association with National Duniya and Sevakram Naturopathy Centre, New Delhi. More than 300 delegates participated in the workshop. The chief guest for the function was Shri Alok Mehta. The summary of the discussions in the workshop were:

  • Meditation and pranayama are integral parts of cardiac care.
  • Pranayama is slower and deeper breathing.
  • Breathing at a speed of 4 times per minute for 20 minutes a day can reduce blood pressure and shift one to parasympathetic mode.
  • Yoga is not just Asans but involves 8 steps including pranayama, asan and meditation.
  • Meditation has similar effects in cardiology as that of the beta-blocker drugs.
  • Slower pranayama are more cardiac-friendly than faster breathing pranayama.

Delhi Medical Association organized a seminar on Nursing Home Problems

A National Seminar on Nursing Home Problems was organized in association with Delhi Medical Association, which was attended by over 200 nursing home owners. The conference was inaugurated by Dr. Harish Gupta, President Delhi Medical Association and coordinated by Dr. Anil Goel, Member, Delhi Medical Council and Dr. KK Aggarwal, President, Perfect Health Mela.

  • All nursing homes should display dengue and smog prevention guidelines in their premises.
  • The high rates of compensation being given to patients under Consumer Protection Act will end up in high fee structure for the patients.
  • The insurance companies should consider insuring OPD consultations.
  • Nursing homes should be given more infrastructural concessions by the Government.

Medico Masti in the Mela

Over 1000 college youth participated in various competitions like western dance, choreography, fashion show, rock band, poster making, slogan writing and mehendi. The festival was inaugurated by Shri Satish Goel Chairman Mujaffar Nagar Medical College. Shri Gajender Solanki Rashtriya Kavi was the star guest.

Following health messages were released.

  • Medical students should learn to write legibly and use electronic records as much as possible.
  • Medical students should inculcate the habit of all spending 10% of their time in community service.
  • Nursing students should learn the art of patient counseling and cognitive behavior therapy.
  • Medical students should learn the strengths and weaknesses of other systems of medicines.

Sahitya Kala Academy

A cultural evening was organized by Sahitya Kala Academy

 
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