emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL 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 & 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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

 
  Editorial …

12th March 2013, Tuesday

ACC 2013 Update

  1. STREAM trial: Fibrinolysis with tenecteplase and contemporary antithrombotic therapy given before transport to a PCI-capable hospital coupled with timely coronary angiography is as effective as primary PCI in STEMI patients presenting within three hours of symptom onset who cannot undergio0 o primary PCI within one hour of first medical contact. To prevent intracranial hemorrhage the dose of tenecteplase needs to be halved in people aged 75 years and older. (New England Journal of Medicine)
  2. The first prospective international randomized controlled study focusing specifically on angina in patients with diabetes has shown that ranolazine (Ranexa, Gilead Sciences) is an effective treatment in this patient population. Results of the Type 2 Diabetes Evaluation of Ranolazine in Subjects with Chronic Stable Angina (TERISA) study were published in the Journal of the American College of Cardiology.
  3. A lower-profile, next-generation version of the Sapien transcatheter aortic-valve system known as the Sapien XT (Edwards Lifesciences) was associated with similar rates of death and stroke as the first-generation device, results from the PARTNER 2 trial show. The device, tested here in inoperable patients ("cohort B"), also appeared to improve on several procedural aspects of valve deployment, including lower anesthesia time and fewer vascular complications.
  4. Community volunteers, namely parents, can be trained to perform an accurate electrocardiogram (ECG) screening, according to the results of a new study presented at the ACC Scientific Sessions. Overall, the rate of technical error in nearly 4500 ECGs performed by community volunteers on five consecutive screening days was just 0.34%, a rate that was comparable to that of trained ECG technicians.
  5. Cangrelor cuts complications at PCI vs clopidogrel in CHAMPION-PHOENIX; bleeding a caution: a >11 000-patient randomized trial found that intravenous cangrelor (the Medicines Company) cut the risk of periprocedural complications at all kinds of PCI compared with taking a pill of clopidogrel, long a mainstay of such procedures.
  6. Watchman PREVAILs on safety for stroke prevention in Afib: Left atrial appendage closure with the Watchman device has gotten safer for stroke prevention in atrial fibrillation, according to results from the PREVAIL trial designed to allay FDA concerns.
  7. HPS2-THRIVE may signal the end for niacin: Results from a landmark study of specially formulated niacin in more than 25,000 high-risk patients appears to have extinguished any clinical role for niacin to reduce the risk of cardiovascular events in these patients.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Monitoring LFT in a patient on statins

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

A daylong conference, eMedinewS Revisiting 2012, was organized by eMedinewS, Heart Care Foundation of India and World Fellowship of Religions.

 
Dr K K Aggarwal
    National News

10% adults have kidney ailment

CHANDIGARH: Eight per cent to 10% of the adult population has some form of kidney ailment and every year lakhs of people die prematurely of kidney-related complications. This was stated by nephrologist Dr Raka Kaushal during a walkathon held at Sukhna Lake on Sunday. It was organized to mark the World Kidney Day. Dr Avinash Srivastava, a kidney transplant surgeon, said, "For healthy kidneys, be fit and active, check your blood pressure and blood sugar, quit smoking, eat healthy, keep weight under control and do not take over-the-counter pills."World Kidney Day is an initiative of International Society of Nephrology and is celebrated in the second week of March every year. (Source: TOI, Mar 11, 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Differential diagnosis of a child with potentially inflicted orthopedic trauma

  • Accidental injury
  • Normal bony variants
  • Birth trauma
  • Metabolic bone disease
  • Skeletal dysplasia (including osteogenesis imperfecta
  • Bone infection
  • Drug toxicity
  • Congenital insensitivity to pain

For Comments and archives…

    Valvular Heart Disease Update

Valvular sclerosis in end stage renal disease is associated with progressive stenosis and increased cardiovascular mortality.

(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)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

ACC: Is chelation plus vitamins a winning combo?

Vitamins alone won't improve outcomes for patients who've had a heart attack, but they do appear to have additive benefits when given in conjunction with chelation therapy, researchers reported at the American College of Cardiology meeting. (Source: Medpage Today)

ACC: CAD is disease of the ancients

Atherosclerosis was a plague among ancient peoples, even hunter-gatherers who were perceived to have a good diet and get plenty of exercise, researchers reported at the American College of Cardiology meeting. (Source: Medpage Today)

Efavirenz tied to neurological birth defects

The risk of neurological birth defects increases if a women with HIV-infection is taking efavirenz-based antiretroviral therapy, French researchers reported here at the annual Conference on Retroviruses and Opportunistic Infections. (Source: Medpage Today)

ACC: LDL may rise in winter months

LDL levels may increase during the winter months, according to the largest study to date to evaluate cholesterol levels by season. (Source: Medpage Today)

Spirituality may boost outcomes in ovarian Ca

Ovarian cancer patients who reported high levels of spirituality presurgery had better outcomes for stress and depression, as well as factors known to regulate tumor angiogenesis and inflammation, researchers reported at the meeting of the Society of Gynecologic Oncology. (Source: Medpage Today)

 
    Twitter of the Day

@DrKKAggarwal: ACC update 1. STREAM Trial: Fibrinolysis with tenecteplase and contemporary antithrombotic therapy given before... http://fb.me/KatgAzBf

@DrKKAggarwal: What is the secret to team building? I discuss in today's "Ask Deepak". Please watch & share http://tinyurl.com/cg99s6n

 
    Spiritual Update

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

Meditation can change the genes

Amarnath cave was chosen by Lord Shiva to narrate the secrets of meditation, immortality and creation of Universe to Parvati.

For Comments and archives…

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

What do you mean by third party reproduction?

The phrase “third party reproduction” refers to the use of eggs, sperm, or embryos that have been donated by a third person (donor) to enable an infertile individual or couple (intended recipient) to become parents. Donors may be known or anonymous to the intended recipient. “Third party reproduction” also includes traditional surrogacy and gestational carrier arrangements. Traditional surrogacy refers to a treatment in which a woman is inseminated with sperm for the purpose of conceiving for an intended recipient. The surrogate has a genetic and biological link to the pregnancy she might carry. In contrast, a gestational surrogate (also called a gestational carrier or uterine carrier) is an individual in which embryos created by the intended parents are transferred into the surrogate’s uterus, which has been prepared hormonally to carry a pregnancy.

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

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

Receiving and transportation of blood/components from blood bank

The designated person will collect blood/blood component from the blood bank and take it to the patient area in conditions suggested by blood bank. It is the duty of the blood bank to issue requested blood/blood component:

  • After satisfactorily identifying the intended recipient
  • After visual inspection.
  • After ensuring the right transportation conditions (including maintenance of cold chain).

For Comments and archives…

 
    An Inspirational Story

All for love and life

In a strange case, a woman donated her organ twice to save her husband from the jaws of death. In 2005, Surat-based Rameshbhai Patel’s life turned topsy–turvy when doctors at the Global Hospital in Hyderabad found him afflicted with liver cirrhosis. Only a liver transplantation could save him. Getting a donor was tough. But his wife Sharadaben stepped in and offered a part of her liver. The transplantation was successfully done in November 2005.

But 4 years later, another crisis struck the family when both the kidneys of Ramesbhai failed due to diabetic nephropathy. The worried couple rushed back to Hyderabad from Surat. He was put on dialysis. Sharadaben once again stepped in and donated her kidney. The transplantation was done in June end and Ramesbhai is completely recovered. "I am lucky to have a wife who is prepared to sacrifice any thing for me", said Rameshbahi after the operation.

Shardaben said: "Actually I am afraid to take even paracetamol tablet. But for my husband I can do anything." Love conquers everything. Sequential liver and kidney transplantation is rare, say nephrologists KS Naik and Dharmesh Kapoor of Global Hospital.

For comments and archives

 
   Cardiology eMedinewS

Veggies are good for the heart Read More

How not to get hypertension: Some clues from HARVEST Read More

 
   Pedia News

Guarding against infection key for HIV in kids Read More

Ultrasound may improve peripheral IV cannulation in children Read More

 
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Is washing of animal bite wound(s) essential?

The risk of rabies reduces by about 50% by just washing of wounds and application of antiseptics.

The maximum benefit of the wound washing is obtained when the fresh wound is cleaned immediately. It is important to remove saliva containing rabies virus at the site of bite by physical or chemical means. This can be done by prompt and gentle thorough washing with ordinary soap or detergent and flushing the wound with running tap water for at least 15 minutes.

Washing of the wound must be done as long as the wound is raw; irrespective of the time elapsed since the exposure. Care must be taken not to disturb the scab, if formed.

After washing with water and soap, disinfectants like Povidone Iodine or Surgical Spirit must be applied.

In extraneous circumstances, other alcoholic (>40%) preparations like Rum, Whisky or aftershave lotion may be applied on the wound. If soap or antiviral agent is not available, the wound should be thoroughly washed with water.

 
    IJCP Special

Dr Good Dr Bad

Situation: A pregnant lady developed amniotic fluid embolism syndrome (AFES).
Dr Bad: It’s a self–limiting disease.
Dr Good: Give symptomatic treatment.
Lesson: There is no specific treatment for AFES. The goal of therapy is to correct hypoxemia and hypotension, so that ischemic consequences (e.g., hypoxic brain injury, acute kidney injury) in the mother are prevented and adequate oxygen delivery to the fetus is ensured. This may require mechanical ventilation, vasopressors, inotropes, intravenous fluids, and blood products.

Make Sure

Situation: A patient with hiatus hernia developed severe symptoms after eating a ‘Paan’.
Reaction: Oh my God! Why was he given a peppermint?
Lesson: Make sure patients with reflex esophagitis are not given any food which can relax GI sphincter.

 
  Quote of the Day (Dr GM Singh)

Overall development of children should be nurtured within a safe, well–maintained indoor and outdoor environment.

 
    Mind Teaser

Read this…………………

Patients taking furosemide (Lasix) are instructed to notify their health care practitioner if they develop:

1. a change in appetite.
2. a disruption in sleep patterns.
3. increased urinary frequency
4. leg cramps.

Yesterday’s Mind Teaser: A 78-year-old man is scheduled for discharge after treatment for heart disease. His wife, who has chronic obstructive pulmonary disease, plans to care for him at home. She says that their grown children who live nearby will help. The best approach to discharge planning is to:

a. Arrange nursing home placement for the couple.
b. Consult the wife's health care practitioner about the wife's ability to care for her husband.
c. Contact the children to ascertain if they will definitely help.
d. Discuss community resources with the wife and offer to make referrals

Answer for Yesterday’s Mind Teaser: Discuss community resources with the wife and offer to make referrals

Correct answers received from: Dr K Raju, Dr Deepali Chatterjee, Dr KV Sarma, Dr (Maj. Gen.) Anil Bairaria, Dr Arpan Gandhi, Dr Pankaj Agarwal,
Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Jella, Muthumperumal Thirumalpillai, Dr Thakor Hitendrsinh G, Dr Avtar Krishan.

Answer for 10th March Mind Teaser: Acetaminophen (Tylenol) has an analgesic ceiling.

Correct answers received from: Dr B K Agarwal.

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Laugh a While (Dr GM Singh)

Murphy's Laws for Humor

If at first you don't succeed, destroy all evidence that you ever tried.

 
  Medicolegal Update

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

Instruments for shooting, stabbing, cutting are dangerous weapons

The doctor is not required to make speculation about the weapon of offence in a MLC case.

According to the Section 324 of IPC, any instrument for shooting, stabbing, cutting or any instrument used as a weapon of offence likely to cause death or by means of fire or any heated substance or by means of poison or any corrosive substance or by means of any explosive or by means of any substance, which is deleterious to the human body to inhale, to swallow, or to receive into the blood or by means of any animal - are all considered as dangerous weapons.

The duty of the attending doctor is to record all injuries, their dimensions as far as possible, and the body parts where the injuries are located, the nature of injury, whether simple or grievous, caused by sharp/blunt object, age or duration of injury along with the vital parameters like blood pressure, pulse, respiration and the mental status of the patient. When an investigating officer comes to the hospital, he needs some specific answers for his legal investigation and to book a case under law of the land.

  • Are the injuries present self–inflicted or fabricated? If yes, please mention the forensic justification.
  • Is there any sign, symptom or smell of alcohol or any drug intoxication? If yes, please opine about his mental status due the influence of intoxication; also preserve a blood sample.
  • Please opine if the injured or intoxicated patient is fit to record his statement? If no, please give due reasons and an approximate time interval for medical evaluation for his/her fitness for statement.
  • Is the condition of patient is critical, severe or serious? If so, the dying declaration must be recorded by the attending doctor in the presence of one or two witnesses.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Hepatitis A, E and Typhoid are the hygiene markers of a city

It is diseases such as jaundice with hepatitis A in children and E in adults, typhoid, cholera and gastroenteritis that reflect the hygiene status of a city and not the occurrence of dengue and malaria, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and National Vice President-Elect IMA.

Dr. Aggarwal said that food and water–borne diseases can be eradicated by the following public awareness formula: When in doubt follow the principle, "heat it, boil it, cook it, peel it or forget it". Explaining this, Dr, Aggarwal said that in an unhygienic environment, one can eat an orange or a banana but not tomato or apple. Other steps are:

  • Do not take salad that has been left open for more than 2 hours even if it is washed properly.
  • Do not take cooked food that has been left on the table for more than two hours.
  • Vegetables grown under the ground or over the surface of the ground should be washed properly before eating them raw. They may be the biggest source of worm infection in the brain, a condition called neurocysticercosis.
  • Boiled water is the safest water to drink.
  • Ice made from unhygienic water can be the source of most water–borne diseases.
  • It is our duty to keep our home and city as clean as possible. We must regard our city as our extended home, a garden as our farmhouse and roads as are our personal walking tracks.

Most food and water-borne diseases are self–inflicted and can be managed by a simple step of washing the hands before and after using the toilet and before and after consuming any food, added Dr Ajay Kumar, Sr. Gastroenterologist at Apollo Hospital, New Delhi.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 30629 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

 
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  1. Dear Sir, reading emedinews is very informative to us. Regards: Dr Jyoti
 
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