eMedinewS
11th November 2014, Tuesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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

Recurrent Kidney Stones: IMA Guidelines

Lifetime prevalence of kidney stones is approximately 13% in men and 7% in women. Without treatment, approximately 35% to 50% of those with kidney stones will experience recurrence within 5 years from the first stone.

Here are some guidelines

  • Increase fluid intake to achieve at least 2 L of urine per day. "Increased fluid intake spread throughout the day can decrease stone recurrence by at least half with virtually no side effects. However, people who already drink the recommended amount of liquids, or when increased fluid intake is contraindicated, should not increase their fluid intake.
  • Available evidence shows no difference between intake of tap water or intake of a specific brand of mineral water in preventing kidney stones.
  • If drinking increased amounts of water is ineffective in preventing kidney stones, one may try pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol. These three types of drugs effectively reduced recurrence of composite calcium stones in patients who had a history of two or more stones. Combination therapy is no more effective than monotherapy. All these drugs were associated with adverse events. For thiazides, these were orthostasis, gastrointestinal upset, erectile dysfunction, fatigue, and muscle symptoms. Citrates are associated with gastrointestinal symptoms and allopurinol with rash, acute gout, and leukopenia.
  • Patients should reduce intake of colas and other soft drinks acidified with phosphoric acid, as lower consumption is linked to lower risk for stone recurrence.
  • Fruit-flavored soft drinks can be taken as they are often acidified with citric acid.
  • Patients should reduce consumption of dietary oxalate, typically found in chocolate, beets, nuts, rhubarb, spinach, strawberries, tea, and wheat bran.
  • Patients should eat less dietary animal protein and purines.
  • Patients should maintain normal dietary calcium.

(Ref: November 4 issue of the Annals of Internal Medicine)

News Around The Globe

  • A probiotic extract being developed from the human microbiome could offer potential drug-free topical therapy for patients with atopic dermatitis, and could protect against pathogenic biofilms, suggests new research presented recently at the American College of Allergy, Asthma & Immunology 2014.
  • A new study based on national insurance claims in the United States revealed that obese patients who had contemporary bariatric surgery went on to use fewer drugs for conditions such as type 2 diabetes, thereby lowering healthcare costs. The findings were presented at Obesity Week 2014.
  • Myxedema coma, a rare but potentially fatal form of decompensated hypothyroidism, can be identified according to key clinical signs and successfully treated in most patients with 500 µg of intravenous levothyroxine (L-thyroxine), suggests a new study presented at the 2014 Annual Meeting of the American Thyroid Association.
  • The risk for placenta accreta is 3 times higher in pregnancies achieved with in vitro fertilization using frozen embryo transfer than in those using fresh embryos, suggests a new study presented at the American Society for Reproductive Medicine 2014 Annual Meeting.
  • Electroencephalography (EEG) may help diagnose patients at risk for psychosis and even help determine the best treatment options for the disorder, suggest two new studies published online in Schizophrenia Research.

National News

  • Hansraj Ahir (MOS Ministry of Chemicals and Fertilizers)
    • The man who exposed the coal scam
    • He is a soft-spoken Lok Sabha member from Chandrapur in Vidarbha
    • Currently he is in his fourth-term as Lok Sabha member
    • Ahir is meticulous and systematic in his parliamentary duties, bagging the Sansad Ratna Award for the Best Parliamentarian in the 15th Lok Sabha.
  • PM's address at the Valedictory Function of the 6th World Ayurveda Congress: The biggest challenge is with people dedicated to Ayurveda – they themselves do not trust it fully. Ayurveda can make a global impact, like Yoga. Ayurveda practitioners should be dedicated to Ayurveda for serving mankind, not just as a profession.

    The Prime Minister, Shri Narendra Modi today said the biggest challenge to Ayurveda comes from people who have dedicated their life to it. They too do not trust it fully, he said. Seeking to dispel the notion of Ayurveda and Allopathy being competing streams of medical science, the Prime Minister described Ayurveda as a way of life. He said a disease can be cured by Allopathy; and if a person adopts Ayurveda, he can ensure that he remains healthy and free of disease.

    He called upon practitioners of Ayurveda to be dedicated to Ayurveda not just as a profession, but as a service to mankind. He was speaking at the valedictory function of the 6th World Ayurveda Congress. The Prime Minister said that Yoga had acquired global recognition for people who wanted a stress-free life and were moving towards holistic healthcare. Similarly, if Ayurveda is presented in the right spirit as a way of life, it too can acquire acceptance.

    The Prime Minister said it is essential for Ayurveda to reach people in a simple, effective way. For this, the modes of treatment should also be better packaged. Shri Narendra Modi said space has to be created in international medical and science publications, for articles on Ayurveda. But the effort for this has to come from the practitioners and researchers of Ayurveda, he added.
  • Shripad Yesso Naik: AAYUSH (Independent Charge) Health & Family Welfare

    Member of the 13th Lok Sabha, 14th Lok Sabha, 15th Lok Sabha and 16th Lok Sabha
    Born 4 October 1952, Adpai, North Goa district, Goa
    Nationality Indian
    Political party Bhartiya Janata Party
    Spouse(s) Nutan
    Children 3
    Residence Velha Goa
    Profession politician
    Religion Hindu
    In 1999, he was elected to the 13th Lok Sabha from Panaji constituency in Goa.
    As of 2014, he has held his seat in this constituency winning in 2004, 2009 and 2014 elections. As of 2014, he is a member of the 16th Lok Sabha. In 2014 Lokh Sabha Election he won with a margin of 105000 votes which is very high for a small state of Goa
  • Jagat Prakash Nadda
    1. A person who rose from ABVP leader to post of general secretary
    2. A Brahmin from Himachal Pradesh
    3. Nadda, a general secretary in the team of party presidents Nitin Gadkari, Rajnath Singh and Shah, was till recently one of the frontrunners for the post of BJP chief.
    4. As a national general secretary he was incharge of Punjab, Chhattisgarh and lately Jammu and Kashmir and was recently given charge of Maharashtra and Rajasthan.
    5. He started his political career as an ABVP activist in Bihar and later became chief of the Bhartiya Janata Yuva Morcha.
    6. His father is a vice-chancellor of Patna University
  • Ten things you would like to know about Dr Mahesh Sharma, Union Minister of State (Independent Charge)
    1. Dr. Mahesh Sharma is Member of Parliament, (Lok Sabha) from Gautam Budh Nagar constituency, U.P. and also member of Standing Committee on Health & Family Welfare and Member of Consultative Committee for the Ministry of Urban Development.
    2. Earlier Dr. Mahesh Sharma was elected as first MLA of Noida newly constituted Constituency.
    3. He is National Convener of Medical Cell (BJP), Member of BJP State Working Committee, (U.P.), Chairman of Kailash Group of Hospitals.
    4. He is Chairman of IMA Standing Committee for Public Relations.
    5. Dr Sharma was born on 30.09.1959 in middle class family of village Manethi, District Alwar (Rajasthan). His father Late Shri Kailash Chand Sharma was a school teacher with agriculture background. Mother is a pious housewife imbibed with virtue of hard work, rich Indian culture and sensitivity towards human values. Dr. Uma Sharma, his wife, is a well known Gynaecologist and Head of the Department of Obstetrics & Gynaecologist of Kailash Hospital & Heart Institute. She is also the Vice-Chairperson of Kailash Group of Hospitals. Dr. Sharma has one daughter; Dr. Pallavi Sharma who has completed MS (Eye Surgeon) and a son Dr. Kartik Sharma, MBBS with MHA (Masters in Hospital Administration) from Oxford (U.K.).
    6. Dr. Sharma is a staunch follower of Rastriya Swayam Sevak Sangh (RSS) since childhood. He was actively associated with ABVP during his student career and thereafter joined Bhartiya Janta Party as an active member.
    7. His early education till middle class was in remote village Manethi (Rajasthan). Then, he moved to Delhi and did his senior secondary education from ADVJ Hr sec School daryaganj.
    8. He graduated in Medicine from University College of Medical Sciences & Safdarjung Hospital, New Delhi. His areas of interest are Entrepreneurship, Development, Hospital & Personnel Management and Upliftment of rural society.
    9. He started his career as a General Physician in 1983 and chose Noida- then an upcoming area-as his “Karam Bhoomi” from a humble beginning of a small Clinic. His selfless service and friendly professional behaviour endeared him to all sections of the society. Soon he started a chain of hospitals at Noida, Gr. Noida, Rajashthan, Delhi, Haridwar and upcoming hospital at Khurja, Jewar, Dehradun, Faridabad and Noida Sector 71.
    10. He is also a Member of many national/social/professional organizations. He is actively contributing to social welfare and engaged in developing healthcare awareness.
  • Doctor Ministers and Health - Pharma Ministry Ministers

Cabinet Ministers

13. Maneka Sanjay Gandhi: Women and Child Development
14. Ananthkumar: Chemicals and Fertilizers (Pharma)
16. Jagat Prakash Nadda: Health & Family Welfare
26. Harsh Vardhan: Science and Technology Earth Sciences Ministers of State
32. Shripad Yesso Naik: AAYUSH (Independent Charge) Health & Family Welfare
37. Dr. Jitendra Singh: Development of North Eastern Region (Independent Charge) Prime Minister's Office Personnel, Public Grievances & Pensions Department of Atomic Energy Department of Space
39. Dr. Mahesh Sharma: Culture (Independent Charge) Tourism (Independent Charge) Civil Aviation
46. Hansraj Gangaram Ahir: Chemicals & Fertilizers (Pharma)
60. Y.S. Chowdary: Science and Technology Earth Science (Under Dr harsh Vardhan)

Dr KK Spiritual Blog

Search for happiness in the present moment

Happiness should not be considered as being synonymous with pleasure. Pleasure is transient and is always associated with pain later. Any transient addiction to any of the five senses will either lead to pleasure or pain. Pleasure leads to attachment resulting in more intense and greater desires, and if these are not fulfilled, they cause pain which manifest as anger, irritability or even a physical disease. This type of transient pleasure is chosen by the individuals who attach themselves not to the actions only, but also to its results.

The soul, which is an energized field of information and energy, is controlled by the person’s action, memory and desire. With every action, a memory is created which either gets stored or is r

ecirculated again as an action. If one does not control the desires, the recurrent actions may cause more problems than happiness.

True happiness, on the other hand, is internal happiness or the happiness of the soul or of the consciousness. It is often said, “You are what you eat; you are what you think; and you are what you do.” Hence, your own internal happiness will vary with what you eat, think, and do.

Living in the present moment leads to true happiness. If one is constantly lamenting about the past or fearing the future, he/she will never be able to live in the present. Not living in the present is bound to cause unhappiness. One should learn to live and enjoy the present which can only be done by attaching oneself to the actions and not to its results.

Doing one’s duty with devotion and discipline helps one to remain in the present. Performing good action is important, but it is equally important to maintain the purity of the mind at the same time. Because any intention in the thought creates the same chemical reaction as when the actual deed is done, abusing a person in thought is the same as abusing him in person. Cultivating positive actions in day-to-day life, like, giving or sharing etc., helps in acquiring internal happiness.

Thoughts ultimately get metabolized into various chemicals and hormones changing the internal biochemistry of the person; hence by thinking about cancer all the time, one can actually induce it over a period of time. And similarly, cancers can be cured by thinking positive over a period of time.

Internal happiness gives a deep feeling of satisfaction and is not associated with any transient chemical changes which are generally associated with bodily pleasure activities. People who are internally happy are always contented and are devoid of jealousy, anger, irritability, greed and ego.

One should learn to disassociate from, both, external pain as well as pleasure, and only then can one acquire true internal happiness.

Inspirational Story

The Falcon & the Branch

Once there was a king who received a gift of two magnificent falcons. They were peregrine falcons, the most beautiful birds he had ever seen. He gave the precious birds to his head falconer to be trained. Months passed, and one day the head falconer informed the king that though one of the falcons was flying majestically, soaring high in the sky, the other bird had not moved from its branch since the day it had arrived.

The king summoned healers and sorcerers from all the land to tend to the falcon, but no one could make the bird fly. He presented the task to the member of his court, but the next day, the king saw through the palace window that the bird had still not moved from its perch.

Having tried everything else, the king thought to himself, “May be I need someone more familiar with the countryside to understand the nature of this problem.” So he cried out to his court, “Go and get a farmer.” In the morning, the king was thrilled to see the falcon soaring high above the palace gardens. He said to his court, “Bring me the doer of this miracle.”

The court quickly located the farmer, who came and stood before the king. The king asked him, “How did you make the falcon fly?” With his head bowed, the farmer said to the king, “It was very easy, your highness. I simply cut the branch where the bird was sitting.”

Moral: We are all made to fly — to realize our incredible potential as human beings. But at times we sit on our branches, clinging to the things that are familiar to us. The possibilities are endless, but for most of us, they remain undiscovered. We conform to the familiar, the comfortable, and the mundane. So for the most part, our lives are mediocre instead of exciting, thrilling and fulfilling. Let us learn to destroy the branch of fear we cling to and free ourselves to the glory of flight.

Rabies News (Dr A K Gupta)

What are the common adverse reactions to HRIG?

In rare cases, the following adverse reactions to HRIG may occur:

  • Allergic reactions including fall in blood pressure, dyspnea, cutaneous reactions and in isolated cases reaching as far as anaphylactic shock, even when the patient has shown no hypersensitivity to previous administration of immunoglobulins.
  • Generalized reactions such as chills, fever, headache, malaise, nausea, vomiting, arthralgia and moderate back pain
  • Cardiovascular reactions, particularly if HRIG is inadvertently injected intravenously.
  • Local reactions such as local pain, tenderness or swelling at the injection site can be observed in rare cases.

Cardiology eMedinewS

  • A study presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2014 has suggested that the risk for cardiovascular disease is higher in patients with severe asthma and chronic use of oral corticosteroids as compared to those with moderate asthma whose use of oral corticosteroids is periodic.
  • A review of data on nearly 33,000 liver transplant recipients has pointed that some modifiable pretransplant risk factors can account for major adverse cardiovascular events in the first 3 months after surgery. The data were presented at the Liver Meeting 2014: American Association for the Study of Liver Diseases (AASLD).
emedipicstoday emedipics

21st Perfect Health Mela 15th October 2014

Self-Assessment-Quiz

 

expert_choice
press release

ACE inhibitors better ARBs in new meta–analysis in hypertensives

video of day

Other Blogs

Video Library

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Dr Good and Dr Bad

Situation: A middle–aged patient was found to have central obesity.
Dr Bad: It is normal.
Dr Good: Rule out diabetes.
Lesson: Findings of a prospective cohort study (1989–2007) of 4,193 men and women 65 years of age and older in the Cardiovascular Health Study suggest that among older adults, overall and central adiposity and weight gain during middle age and after the age of 65 years were associated with risk of diabetes.

Make Sure

Situation: An 18–year–old girl complained of purulent nasal discharge, nasal congestion, pain in the cheek and upper teeth for last 10 days. CT scan showed maxillary sinusitis.
Reaction: Remember to give macrolides.
Lesson: Make sure to remember that clarithromycin (macrolide) 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

eMedinewS Humor

Santa calls up the doc at 2 AM. "Doc, my wife is having severe abdomen pain. I think it's her appendix."

"What nonsense!" says the doc sleepily.

"I took out your wife's appendix two years ago. Go back to sleep."

Five minutes later, the phone rings and it's Santa again.

"Doc, I'm sure it's her appendix."

"Oh God!" the doctor groaned.

"Did you ever hear of anyone having a second appendix?"

"No...," says Santa. "But I'm sure you must have heard of someone having a second wife..!!!!"

Twitter of the Day

Dr KK Aggarwal: Avoid alcohol - if you cannot ask your doctor for your limit
Dr Deepak Chopra: Read about The Importance of A Strong Support Network in Recovering from Addiction here

Pediatrics eMedinewS

  • Many parents prefer to send their children to school with a packed lunch, believing that this food is far healthier than school lunches. However, a new study, published in the Journal of Nutrition Education and Behavior, claims this may not be the case. Researchers noted that both packed and school lunches almost entirely met nutrition standards, except school lunches were below energy and iron recommendations, while packed lunches exceeded fat and saturated fat recommendations.
  • In a study published November 4 in PLoS Medicine, Dr. Rakesh Bhattacharjee of the University of Chicago report that children with asthma who undergo adenotonsillectomy (AT) show significant improvements in several measures of disease severity. The study noted that both obstructive sleep apnea (OSA) - the most common indication for AT - and asthma are characterized by airway inflammation.

Quote of the Day

  • The roots of all goodness lie in the soil of appreciation for goodness. Dalai Lama

Wellness Blog

Hookah as bad as smoking

An hour of puffs from a hookah packs the same carbon monoxide punch as a pack–a–day cigarette habit.

Hookahs have grown in popularity in recent years and Hookah bars have appeared in cities all over the world that allow people to smoke these water pipes.

Users inhale tobacco smoke after it bubbles through water, a process that some people think filters toxins from the tobacco.

Hammond and a student, in a study published in the Journal of the American Medical Association, recruited 27 students who smoked water pipes for an hour on three different evenings in April 2006. Another five students did not smoke the hookahs but stayed in the room with those who did. The participants abstained from water pipe smoking for 84 hours before taking part in the study; the bowls of their water pipes were filled with water and 10 grams of Al Fakher mu'assal tobacco, and then heated with charcoal.

Researchers monitored carbon monoxide in the breath of the participants both before and after the experiment using a machine designed to detect if people are smokers.

The exhaled carbon monoxide in participants was an average of 42 parts per million, higher than that reported in cigarette smokers (17 parts per million). The study also found that carbon monoxide levels grew in the room where the subjects smoked hookahs and might reach environmentally unhealthy levels, as determined by the federal government, during longer sessions.

Smoking a water pipe for 45 minutes produces 36 times more tar than smoking a cigarette for five minutes.

ePress Release

Indians get diabetes on average 10 years earlier than their Western counterparts

Being an Indian is a risk factor for diabetes. Despite having lower overweight and obesity rates, India has a higher prevalence of diabetes compared to western countries; the risk for coronary artery disease is 2 to 4 times higher in diabetic subjects and in Indians, and it occurs prematurely in those with diabetes are few facts compiled by Heart Care Foundation of India to create awareness about how to control the diabetes menace in India.

“The public, private and government sectors should fight this epidemic of diabetes together,” said Padma Shri, National Science Communication and Dr B C Roy National Awardee, Dr KK Aggarwal president Heart Care Foundation of India and Senior National Vice President Indian Medical Association.

Diabetes challenges for India and Indians as compiled by the Foundation

  • Diabetes is a huge problem in India. The prevalence of diabetes increased ten-fold, from 1.2% to 12.1%, between 1971 and 2000. It is estimated that 61.3 million people aged 20-79 years live with diabetes in India (2011 estimates). This number is expected to increase to 101.2 million by 2030. An estimated 77.2 million people in India are said to have pre-diabetes.
  • Rough estimates show that the prevalence of diabetes in rural populations is one-quarter that of urban population for India and other Indian sub-continent countries such as Bangladesh, Nepal, Bhutan, and Sri Lanka. An ICMR study has shown that a lower proportion of the population is affected in states of Northern India (Chandigarh 0.12 million, Jharkhand 0.96 million) as compared to Maharashtra (9.2 million) and Tamil Nadu (4.8 million). The National Urban Survey conducted across the metropolitan cities of India reported a similar trend: 11.7 per cent in Kolkata (Eastern India), 6.1 per cent in Kashmir Valley (Northern India), 11.6 per cent in New Delhi (Northern India), and 9.3 per cent in West India (Mumbai) compared with (13.5 per cent in Chennai (South India), 16.6 per cent in Hyderabad (south India), and 12.4 per cent in Bangalore (South India).
  • Obesity is one of the major risk factors for diabetes, yet there has been little research focusing on this risk factor across India. Despite having lower overweight and obesity rates, India has a higher prevalence of diabetes compared to western countries suggesting that diabetes may occur at a much lower body mass index (BMI) in Indians compared with Europeans.
  • The most disturbing trend is a shift in age of onset of diabetes to a younger age. Indians get diabetes on average 10 years earlier than their Western counterparts. An upsurge in number of early-onset diabetes cases is also responsible for the development of various complications of diabetes due to longer disease duration. Diabetes control in individuals worsened with longer duration of the disease (9.9±5.5 years), with neuropathy being the most common complication (24.6 per cent) followed by cardiovascular complications (23.6 per cent), renal problems (21.1 per cent), retinopathy (16.6 per cent) and foot ulcers (5.5 per cent).
  • The risk for coronary artery disease is 2 to 4 times higher in diabetic subjects, and in Indians, and it occurs prematurely. Indians are genetically predisposed to the development of coronary artery disease due to dyslipidemia and low levels of high density lipoproteins; these determinants make Indians more prone to development of the complications of diabetes at an early age (20-40 years) compared with Caucasians (>50 years) and indicate that diabetes must be carefully screened and monitored regardless of patient age within India. The rate of cardiovascular disease mortality in India in the 30-59-year age group is double that in the U.S.
  • Lifestyle changes have lead to decreased physical activity, increased consumption of fat, sugar and calories, and higher stress levels, affecting insulin sensitivity and obesity. Eighty-six percent of adults consume less than five servings of fruits and vegetables a day. Many Indians have insufficient physically activity (26.4% among males and 25.6% among females).
  • Costs of diabetes care are alarmingly high. The annual cost for India due to diabetes was about $38 billion in 2011. According to the WHO, if one adult in a low-income family has diabetes, “as much as 25% of family income may be devoted to diabetes care.” According to the World Economic Forum, cardiovascular disease, cancer, chronic respiratory disease, diabetes and mental health conditions will cost India 126 trillion rupees between 2012 and 2030.
  • While HbA1c is the gold standard test around the world for insulin initiation and intensification, it is not easily available to a large section of Indian population.
  • There is a lack of “clinical inertia” for the commencement of insulin therapy in both the clinical and patient communities. The most common apprehensions are related to the complexities of the insulin regimen and concerns about weight gain, hypoglycemic events, and fear of insulin prick.
  • An inadequacy in Indian guidelines is also responsible for wide variation in treatment preferences across the country. The creation of simple and practical insulin guidelines that can be incorporated into routine clinical practice by primary health care physicians are desperately required to facilitate treatment and the initiation of insulin therapy throughout the country. Poor glycemic control, a factor that has been observed in the Indian diabetic population, is responsible for micro- and macrovascular changes that present with diabetes.

eMedi Quiz

Epidermodysplasia veruniciformis is caused by which of the following HPV serotypes:

a.1
b.3
c.5
d.11

Yesterday’s Mind Teaser: In a patient with a tumor in superior mediastinum compressing the superior vena cava, all the following veins would serve as alternate pathways for the blood to return to the right atrium, except:

1.Lateral thoracic vein.
2.Internal thoracic vein.
3.Hemiazygos vein.
4.Vertebral venous plexus.


Answer for yesterday’s Mind Teaser: 4.Vertebral venous plexus.

Correct answers received from: Dr BB Aggarwal, Dr Jainendra Upadhyay, Dr Avtar Krishan, Daivadheenam Jella.

Answer for 9th November Mind Teaser: 2.Propionyl CoA.

Correct answers received from: Dr K Raju, Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr BB Aggarwal.

Send your answer to email

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Choosing the best option in the judgment of the doctor is not medical negligence

In the case of Charan Singh vs Healing Touch Hospital And Ors on 24 April, 2003 (III(2003) CPJ 62 (NC)), the National Consumer Disputes Redressal Commission observed “it is a settled law when two choices are available, exercise of one, which is the best in the judgment of the doctor and anything else is available to contradict this, doctor in such circumstances cannot be held negligent.

medicolegal update
  1. Thanks dear Dr KK, Good information esp. on pediatrics, obesity and preventing diabetes. Dr VK
mission-suraksha.jpg

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