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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 …

12th February, 2011, Saturday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Sensitivity, specificity of HbA1c for diabetes diagnosis may decrease with age

According to a study published online Feb. 1 in the journal Diabetes Research and Clinical Practice, the sensitivity and specificity of glycated hemoglobin (HbA1c) cut–points for the diagnosis of diabetes decrease with age.

Researchers divided 90 Asian patients without diabetes into four age groups, and all patients underwent both an oral glucose tolerance test (OGTT) and an HbA1c test. Area under the receiver operator curve analysis was used to obtain the best cut–point (i.e., 6.2%) to diagnose diabetes in this population, using the results from the OGTT to validate diagnosis. Sensitivity and specificity of this cut–point decreased from 88.9% and 72.7% in the youngest group to 54.5% and 66.7% in the oldest group.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook

 
  eMedinewS Audio PostCard

 2nd eMedinewS revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal
Concerns about bisphosphonates

 

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

I asked God to take away my habits. God said: No, It is not for me to take away. but it is for you to give it up.

 
    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS Revisiting 2010

Doctors enjoy the Lively Cultural evening in the 2nd eMedinewS revisiting 2010 at Maulana Azad Medical College on 9th January 2011

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Children ‘edutained’ on TB

NEW DELHI: To educate students about tuberculosis, entertaining awareness games based on the model of popular television serial Kaun Banega Crorepati and cricket are now being freely distributed in many schools of the Capital. These interactive games endorsed by Government's Revised National TB Control Programme are being distributed in both public and government schools in Delhi, Kolkata and Hyderabad. The programme has been initiated even in some MCD schools. Compact discs have also been given to State TB Control Office of Delhi for distribution across its network. A specialised website has been dedicated to access and promote these games. A total of 2,000 CDs have been distributed and more than 7.5 lakh games have been downloaded. "About 20,000 children have benefited through computer and web–based games," said Hilmi Quraishi, director of Social Initiatives of ZMQ who developed the TB games. (Source: The Hindu, Feb 07, 2011)

 
    International News

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

February is Heart Health Month. Today’s tip

A bowl of oatmeal or whole–grain cereal has benefits that last all day. The fiber and complex carbohydrates in whole grains help you feel fuller longer; less temptation to overeat at lunch. They also help reduce LDL "bad" cholesterol. Make it a part of your weight loss strategy. Examples of whole grains include wild rice, popcorn, brown rice, barley, and whole–wheat flour.

(Dr Monica and Brahm Vasudev)

Celiac patients may be at increased risk for IHD

Patients with celiac disease have an increased risk for developing ischemic heart disease, according to a study in Circulation.

Preliminary study suggests antihistamines may increase risk of tumor development

More than dozen small studies have suggested that people with allergies are less likely to develop gliomas. However, in an analysis in the journal Cancer Epidemiology, Biomarkers & Prevention, when researchers looked at information from 419 patients who had glioma and 612 who did not, they found that antihistamine use "actually increased a person’s chance of developing a glioma.

Elective surgery for tetralogy of Fallot can be safely done before infants develop symptoms

Elective surgery for tetralogy of Fallot can be done early, long before infants develop symptoms, according to a study presented at the Pediatric and Congenital Cardiovascular Disease meeting.

Updated labeling for HIV drug Reyataz provides direction on use in pregnant women

The US FDA approved an update to the labeling for Reyataz (atazanavir) on February 7, 2011, to include dose recommendations for pregnant women infected with human immunodeficiency virus (HIV). Reyataz is a protease inhibitor that has been studied in both treatment-naive and treatment-experienced patients infected with HIV and is administered once daily as part of combination HIV therapy.

 
    IMT Update

Carotid IMT weak predictor of events. Femoral IMT predicts events & revascularization. Plaques in the carotid artery relate to CV death or non–fatal MI, plaques in femoral artery relate to revascularization. Evaluations of plaques provide better prediction than assessments of IMT in stable angina. (Ref: Eur Heart J 2001;22(1):62–72)

 
    Infertility Update

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

Are there any symptoms a woman/couple may notice that might indicate an inability to conceive?

Women who have extreme pain associated with ovulation or menstruation may be at risk for endometriosis and should seek expert care. Women who are annovulatory (don’t ovulate) or who have very irregular cycles may be at risk for polycystic ovarian disease and should seek expert care. Unmanaged, these diseases can cause serious barriers to fertility. However, early treatment and expert management can preserve a woman’s fertility.

For queries contact: banerjee.kaberi@gmail.com

 
    Pediatrics Update

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

What are the signs and symptoms of asthma?

The symptoms of asthma include shortness of breath, wheezing, and/or coughing. Sometimes these symptoms occur alone, sometimes in different combinations. Presence of similar complaints of asthma or atopy in family supports the diagnosis of asthma. Other respiratory illnesses have similar symptoms. But in children with asthma these symptoms usually keep coming back over several months or even years. So it’s important to also recognize a pattern or history of symptoms. Also note that a child can have asthma even though she/he never wheezes. In fact about 5% of asthmatic children have a cough as their only symptom. It’s also possible that a child who has frequent or prolonged "cold" symptoms has asthma, even though they’ve yet to have a recognizable asthma attack. Equally important to note is that all children who wheeze may not be asthma.

For queries contact: drneelam@yahoo.com

 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

How should exhumation be done?

Exhumation of corpse without valid legal order is a criminal offence – Indian Penal Code

  • Exhumation should be conducted preferably in the morning hours after proper sunrise.
  • More than two times of the digging area should be screened off.
  • There should be a presence of autopsy surgeon/forensic expert and magistrate along with concerned police official with the order of court.
  • The grave/place of cremation for which the order has been passed should be identified properly/authentically by police officer and an estimation of number of persons, whether single, double or multiple body/bodies should be made so that adequate arrangements can be done in advance.
  • The burial should be removed in layer of about 10cm and the condition of soil, water, any plantation growth, ants, cockroaches, and smell should be noted.
  • After removal of dirt above the dead body, it should be photographed from all the corners of grave in the original position found.
  • A drawing should be made of graveyard/depth and state of decomposition/skeletal remains of the body.
  • The dead body/its remains should be transferred in a plastic sheet covered with a cloth sheet.
  • Sample of soil, burial cloth, and any material found in grave, loosen hair / teeth/nail/should be collected and photographed.
  • The body should be shown to close relatives for identification.
  • The dug grave should be kept as it is for further burial after autopsy.
  • All the available details should be provided to the doctor with request to conduct the postmortem examination with any specific instruction or query related with forensic/medical examination to find out age, cause of death, details of injury, any poisoning, time since death etc.
  • Video of all procedure must be taken.
 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. What should the hospital/doctors do when the attendants of an unconscious patient with tracheostomy tube, IV lines, Ryle’s tube and indwelling catheter demand that all these be removed at their own risk and responsibility?

Ans.

  • A doctor’s duty is to save, not to take life. Taking life is homicide. Removal of these gadgets will be tantamount to an attempt to take life which also is a criminal act.
  • A doctor is supposed to give or withhold or withdraw or change treatment as per principles of medicine and not as per the orders of a layman or even the patient himself. A doctor who acts otherwise will be guilty of misconduct/negligence.
  • If the act of removing the appliances is done by the doctors or the hospital staff, the risk and responsibility are to be faced by the person doing the act. The relatives cannot be made responsible for the acts of the hospital staff.
  • Even if the relatives make a written request to the hospital to withdraw treatment/appliances, such written request has no meaning in law. Consent for treatment or its stoppage has to come from the patient or his authorised representative.
  • If the authorised representative makes a written request to the doctors to stop treatment when the result of stopping treatment might result in death, the doctors should not act upon the request because euthanasia is not allowed by law. In such a situation, the hospital should contact its advocate for necessary guidance.
 
    epatient

"e–patient" … The Impatient Patient

Dr. Parveen Bhatia: MS, FRCS (Eng.), FICS, FIAGES (Hon.), FMAS, FIMSA, Chairman, Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, Consultant Laparoscopic & Bariatric Surgeon & Medical Director, Global Hospital & Endosurgery Institute, New Delhi

Dr. Pulkit Nandwani: MD, DMAS (WALS), DMAS (CICE, France), Associate Consultant Gynaecologist and Laparoscopic surgeon, Bhatia Global Hospital & Endosurgery Institute, New Delhi

How should doctors deal with the empowered “e-patient”?

Keep your clinic open digitally. Technology has enabled organizations to provide effective service on a 24 by 7 basis. ATM has done this to banking, online reservations to travel industry. "My clinic never sleeps!" The same convenience can be provided to our patients if we net enable our services.

Studies have proven that patients still trust the information given by their physician than what is available on the net. The physician should now assume the role of Consultant helping his patient to sort the information available on the internet and arrive at informed and intelligent decisions. The medical professionals are still perceived to be the most important source of health information, and that information gathered online may complement rather than oppose the information delivered by medical professionals. Given time limited consultations, the Internet was perceived to be particularly useful for confirming and expanding on information received without ‘bothering’ the doctor.

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Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Tests for Adrenal Insufficiency & Addison’s Disease

Cortisol Levels normally vary in the blood, peaking in the early morning. If the adrenal gland is either not functioning normally or not being stimulated by ACTH, then cortisol levels will be consistently low. Cortisol levels are used, along with ACTH and ACTH stimulation tests, to help diagnose adrenal insufficiency.

 
    Medi Finance Update
  • Tax rebate under Section 88 on Tuition Fee to the extent of Rs.12,000 per child for two children.
  • Direct crediting of all refunds to the bank account of the tax payer through electronic clearance system (ECS).
 
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name

Indication

DCI Approval Date

Sertaconazole 2% w/v+ Zinc Pyrithione 1% w/v Shampoo

For the treatment in adults patients with dandruff/seborrheic dermatitis of the scalp

05/03/2010

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Atrial fibrillation: Lenient versus strict rate control

A randomized trial in patients with atrial fibrillation compared a lenient rate control strategy (resting heart rate <110 beats per minute) with a strict rate–control strategy (resting heart rate <80 beats per minute and heart rate during moderate exercise <110 beats per minute). There was no significant difference in the primary composite outcome at three years, but nearly nine times as many visits were required to achieve the strict rate control targets.

 
    IJCP Special

Dr Good Dr Bad

Situation: Embolization occurs in how many patient of DVT? (JR to SR).
Dr Bad: Rare!
Dr Good: Common!
Lesson: Embolization occurs in about 50% of patients with proximal vein DVT.

Make Sure

Situation: A 7–month–old infant presented with grunting respiration, fever, anorexia and irritability. On chest x–ray, pneumatoceles was present.
Reaction: Oh my God! Why did you not start erythromycin immediately?
Lesson: Make sure to remember that erythromycin is an effective drug for Staphylococcal acquired pneumonia.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

Twinkies and Root Beer

A little boy wanted to meet God. He knew it was a long trip to where God lived, so he packed his suitcase with Twinkies and a six–pack of Root Beer and he started his journey. When he had gone about three blocks, he met an elderly man. The man was sitting in the park just feeding some pigeons. The boy sat down next to him and opened his suitcase. He was about to take a drink from his root beer when he noticed that the man looked hungry, so he offered him a Twinkie.

The man gratefully accepted it and smiled at boy. His smile was so pleasant that the boy wanted to see it again, so he offered him a root beer. Again, the man smiled at him. The boy was delighted! They sat there all afternoon eating and smiling, but they never said a word. As it grew dark, the boy realized how tired he was and he got up to leave, but before he had gone more than a few steps, he turned around, ran back to the man, and gave him a hug. The man gave him his biggest smile ever.

When the boy opened the door to his own house a short time later, his mother was surprised by the look of joy on his face. She asked him, "What did you do today that made you so happy? "He replied, "I had lunch with God." But before his mother could respond, he added, "You know what? God’s got the most beautiful smile I’ve ever seen!"

Meanwhile, the elderly man, also radiant with joy, returned to his home. His son was stunned by the look of peace on his face and he asked," Dad, what did you do today that made you so happy?" He replied, "I ate Twinkies in the park with God." However, before his son responded, he added," You know, he’s much younger than I expected."

Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. People come into our lives for a reason, a season, or a lifetime. Embrace all equally!

— — — — — — — — — —

Mind Teaser

Read this…………………

MAKE – MAKE = ZERO

Yesterday’s Mind Teaser: I/8
Answer for Yesterday’s Mind Teaser: I over–ate

Correct answers received from: Dr Rakesh Bhasin, Dr K.P.Rajalakshmi, Dr (Maj. Gen.) Anil Bairaria, Dr K.V.Sarma, Dr K.Raju, Dr Parul Chopra Buttan

Answer for 10th February Mind Teaser: An outside chance
Correct answers received from: Dr Sudipto Samaddar

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)

Marriage are like old bed room slippers. they are well worn and have lost there appeal, but you don’t want to replace them with a new pair because they are too cosy and comfortable.

— — — — — — — — — —

Knowledge is amusing

The name of all the continents end with the same letter that they start with Asia, America, Australia, Europe.

 
    Readers Responses
  1. A heart check up for your valentine, what an idea sir ji. imabanarasbranch
 
    Public Forum

(Press Release for use by the newspapers)

Workshop on fetal and neonatal echocardiography and detection of neck artery thickness in children, adolescence and adults

International Medical Science Academy Delhi Chapter is organizing a workshop on fetal and neonatal echocardiography and also on the need for measuring neck artery wall thickness in children and young adults on Sunday, 13th February, 2011 at Moolchand Medcity.

Giving the details, Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee, Senior Consultant Moolchand Medcity and President Heart Care Foundation of India, said that 1% of the children born today have significant congenital heart diseases and the same can be diagnosed before 20 weeks by a high resolution colour Doppler ultrasound. If incompatible for life, such fetus can be aborted before 20 weeks. Coronary Heart Disease is no more a disease of high–risk pregnancies; therefore, all pregnancies need to be screened for presence of underlying heart diseases.

The workshop will be conducted by Dr. KK Aggarwal, Dr. Vandana Chadha, Foetal Echo Specialist at Moolchand Medcity and Dr. Savitri Srivastava, Neonatal Cardiologist from Escorts Heart Institute.

All children who are obese or overweight or have a family history of heart diseases or with faulty lifestyle should have their neck artery wall thickness measured to know their chances of future heart attacks.

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity, 8AM –10AM

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression in Children: Dr KK Aggarwal

Delhi Medical Council Inaugural CME on Managing Common Emergencies
Date: Sunday, 20 Feb., 2011
Programme – 1.00PM – 4.00PM
1.00 PM 1.30PM Lunch
1.30 PM 1.45PM Inauguration
1.45 PM 4.00PM Scientific Programme

Topics Time Speakers Chairpersons
RTA, Emerging Epidemic
1:45 PM – 2.05 PM
 
Dr MC Misra
Dr BK Dhaon, Dr Praveen Bhatia, Dr Chander Prakash
Acute Febrile Illness
2.05 PM – 2.25 PM
Dr N.P Singh
Dr OP Kalra, Dr SP Byotra,
Dr B Gupta
Haematuria – Red Alarm
2.25 PM – 2.45 PM
Dr Anil Goyal
Dr P.N Dogra, Dr. Rajeev Sood
Managing PPH – Saving Lives
2.45 PM – 3.05 PM
Dr Reva Tripathi
Dr Sharda Jain
Panel Discussion of Update of Lt. Side chest pain 3.05 PM – 3.50 PM Dr Purshottam Lal,
Dr Naresh Gupta
Dr PS Gupta, Dr K.K Aggarwal, Dr Ashok Seth

Vote of Thanks: 3.50 PM – 4.00 PM

Followed by Tea

Please Note: Prior Registration Is Mandatory (No Registration Charges)

For Registration e–mail to delhimedbalcouncil@gmail.com, SMS to Secretary – 9868116494 & Organizing Chairman – 9811101454

Organization: President: Dr Arun Aggarwal, Vice President: Dr Vinay Aggarwal, Secretary: Dr Girish Tyagi, Organizing Chairman: Dr Anil Goyal, CME Committee Members: Dr Anil Bansal, Dr Manoj Singh, Dr NP Singh, Dr Praveen Bhatia.

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