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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 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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

12th July 2011, Tuesday

Defer coronary interventions till medications and lifestyle management fail: Courage Trials

A study published in July 6 issue of Journal of American Medical Association has shown that majority of percutaneous coronary interventions (PCIs) performed for acute emergent indications in the USA are done for the right reasons but when there is a choice between a drug and a stent, the choice is always a stent.

The study showed that during acute interventions, 98.61% procedures were appropriate, 0.31% had uncertain benefits and 1.1% were inappropriate. However, when elective procedures were analyzed, only 50.4% were appropriate, 38% had uncertain benefits and 11.61% were inappropriate.

In elective procedures, most of the inappropriate procedures were in patients with no angina (53.8%), low risk ischemia on stress testing (71.6%) or inadequate anti angina therapy (95.81%). Ninety–four percent of them did not have high risk coronary anatomical findings.

In 2009, six organizations – The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, The Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association and the American Society of Nuclear Cardiology issued guidelines and defined what is appropriate and what is not appropriate.

When it comes to medical versus percutaneous interventions, the results of Courage Trials cannot be dismissed. As per the report, of every 1000 chronic stable angina patients undergoing angioplasty, two will die, 28 will have heart attack related to the procedures, 60–90 will have improved symptoms and 800 will have no usable benefit above that given by the drug treatment.

As per Gems Sten of University of Wisconsin, Madison, 85% of coronary interventions with stents in US are done in stable patients and of those at least 25% are asymptomatic at the time of stenting.

Heart attacks are not caused by a stable plaque or blockage that gradually occludes an artery; instead they are caused by a plaque which ruptures partially, causing sudden formation of a blood clot inside the artery, which then suddenly occludes the artery. Rupture and clotting is as likely to happen in a plaque that is causing only a 10% fixed blockage as in one that is causing an 80% blockage. Hence, stenting plaques that are causing greater degrees of fixed blockages will relieve an angina being caused by the blockage, but will not reduce the risk of future acute heart attacks, especially, since many of these heart attacks are associated with plaques which are labeled as insignificant at the time of angioplasty.

Preventing the acute rupture of plaque and thus preventing a heart attack is more of a medical problem than a plumbing problem and best treated with drugs and aggressive lifestyle changes.

Stabilizing the coronary artery plaque and making it less likely to rupture requires aggressive control of cholesterol, blood pressure, inflammation, regular exercise and heart friendly diet. Aggressive drug therapies will include aspirin, statin, beta blockers and other blood pressure reducing medicines.

The result of Courage Trials in patients with stable angina showed that patients receiving stent for stable angina are just as likely to have a heart attack or die as patients treated with aggressive drug therapy alone.

The Courage Trials published in the New England Journal of Medicine showed that at 36 months, there was no significant difference in health status between the patients treated with drugs or stent. The Courage Trials opined that people with coronary stable angina should be continued on drugs and aggressive lifestyle management and coronary interventions deferred till the aggressive treatment fails.

Dr KK Aggarwal
Group Editor in Chief
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  eMedinewS Audio PostCard

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

Defer Coronary interventions till medications and lifestyle management fail: Courage Trials

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issues

Justice AK Sikri, Hon’ble Judge Delhi High Court was the Chief Guest at the National Conference on Insight on Medico legal issues held on 10th July at Chinmaya Mission, New Delhi. In the Photo: Justice AK Sikri being felicitated at the conference

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time a conference was posted live on Facebook & Twitter

http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

Following are the Posts

Dr Ranjit Roy Chaudhary

  • Role of hospital in a drug trial–when a clinical trial takes place, director or principal, signs that this trial is going to be held in this institute. Head should also be held responsible in case something goes wrong.
  • Clinician trials should be carried out in transparecy, equity, ethics and according to the rules of the country.
  • Never start a clinical trial. Without approval of institute of ethics committee. Controlled double blind multicentre trial is the goal to rule out bias.
  • It is the clinical investigator who starts the trial and only he can stop the trial.
  • In a trial one must have no conflicts of interest.
  • In a trial one should be unbiased.
  • Hundred million dollars on one trial
  • You can go to jail if the trial forms are not properly filled up.
  • The patient must not be harmed.
  • Four cardinal principles in clinical trial: Autonomy, non malificence, beneficence & justice.

A bane of the well–heeled too

In India, two million new TB cases are reported every year. Two deaths occur every three minutes from the disease — making it one of the deadliest in the country. Pulmonary TB — that affects the lungs remains the No.1 killer essentially amongst the poor, but increasingly, extrapulmonary TB — affecting areas outside the lungs such as stomach, skin, eyes etc — is being diagnosed. "In our practice, we see on an average 20 new cases of pulmonary and 10 new cases of extrapulmonary TB in a month," says Dr Praveen Pandey, pulmonologist at Noida’s Fortis Hospital. (Source: TOI, Kolkata edition July 10, 2011)

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

 
    International News

(Dr Monica and Brahm Vasudev)

Generic–to–generic switches of AEDs may be problematic

Switching between different generic versions of antiepileptic drugs (AEDs) may cause greater changes in plasma drug concentrations compared with making a generic substitution of a brand–name product, a new study indicates. "Clinicians should be aware that most generic anticonvulsants are probably safe to prescribe for their patients," lead investigator Gregory Krauss, MD, from the Department of Neurology, Johns Hopkins University, Baltimore, Maryland, told Medscape Medical News. "However, they should consider asking patients and their pharmacists to minimize switches between various generic formulations, since they potentially could produce large swings in drug blood levels," Dr. Krauss advises. The study was published online June 29 in the Annals of Neurology. (Source: Medscape)

Major changes ahead for DSM –5 personality disorder criteria

With the goal of increasing relevancy for both clinicians and patients, the diagnostic criteria for personality disorders may undergo significant restructuring in the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5)."The change integrates disorder types with pathological personality traits and, most importantly, levels of impairment in what is known as ‘personality functioning,’ "according to a release from the American Psychiatric Association (APA).In the current edition of the manual, the disorders "are presented as rigid behavioral categories." However, the DSM–5 Personality and Personality Disorders Work Group is recommending cutting down the current 10 categories to the following 6 personality disorder types:

• Antisocial;
• Avoidant;
• Borderline;
• Narcissistic;
• Obsessive/compulsive; and
• Schizotypal.

However, a diagnosis for 1 of these types would also require significant impairment in both areas of personality functioning: self (how a patient views self and identifies and pursues life goals) and interpersonal (understanding others’ perspectives and forming close relationships). In addition, pathological personality traits will need to be present in at least 1 of 5 broad domains:

• Negative affectivity;
• Detachment;
• Antagonism;
• Disinhibition vs compulsivity; or
• Psychoticism.

(Source: Medscape)

Researchers find accurate way to predict miscarriage

British fertility researchers have developed an accurate way to predict which pregnancies are most likely to miscarry and say it could help target treatment at women who really need it. In a study presented at European Society for Human Reproduction and Embryology conference in Stockholm this week, researchers found six factors with the greatest impact on miscarriage risk – a history of subfertility, levels of progesterone and of human chorionic gonadotropin (hCG), fetus length, the extent of bleeding, and the baby’s gestational age. Individually, these factors were unable to predict accurately the risk of miscarriage, but when the researchers combined two of them – bleeding and hCG levels – to create a "Pregnancy Viability Index," they found this was a consistently reliable predictor of miscarriage."This research has, for the first time, offered us a robust tool to begin to attempt to rescue pregnancies threatening to miscarry when currently all we can do is fold our hands and hope for the best," said Dr. Kaltum Adam of Britain’s St Mary’s Hospital in Manchester, who led the study. (Source: Medscape)

 
    Fitness Update

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

Physical excerise in a bottle?? Red wine’s health–boosting ingredient resveratrol

A new research study published in the FASEB Journal, suggests that the "healthy" ingredient in red wine, resveratrol, may prevent the negative effects that spaceflight and sedentary lifestyles have on people.
The report describes experiments in subjects in a controlled laboratory environment that simulated the weightlessness of spaceflight. During the simulation, the group fed resveratrol did not develop insulin resistance or a loss of bone mineral density, as did those who were not fed resveratrol. According to Gerald Weissmann, M.D., Editor–in–Chief of the FASEB Journal, "There are overwhelming data showing that the human body needs physical activity, but for some of us, getting that activity isn’t easy. A low gravity environment makes it nearly impossible for astronauts. For the earthbound, barriers to physical activity are equally challenging, whether they be disease, injury, or a desk job. Resveratrol may not be a substitute for exercise, but it could slow deterioration until someone can get moving again."

Scientists studied lab subjects that underwent simulated weightlessness and were given a daily oral load of resveratrol. The control group showed a decrease in soleus muscle mass and strength, the development of insulin resistance, and a loss of bone mineral density and resistance to breakage. The group receiving resveratrol showed none of these complications. Study results further demonstrated some of the underlying mechanisms by which resveratrol acts to prevent the wasting adaptations to disuse–induced mechanical unloading. This study also suggests that resveratrol may be able to prevent the deleterious consequences of sedentary behaviors in humans. "If resveratrol supplements are not your cup of tea," Weissmann added, "then there’s good news. You can find it naturally in red wine, making it the toast of the Milky Way."

 
    Twitter of the Day

@DrKKAggarwal: #AJOR Overall, MRI resulted in no improvements over radiography in terms of disability, pain or general health… http://fb.me/MK2Vr3sP

@DeepakChopra: #CosmicConsciousness Only the witness of the mind can know the mind

 
    Spiritual Update

Science behind Hanuman Chalisa

Nava Nidhi

Prakya Sadhana: Through this Sadhana a Yogi can direct his disciples to take birth from the womb of a woman who is childless or cannot bear children.

 
    An Inspirational Story

(Ritu Sinha)

The story of a blind girl

There was a blind girl who hated herself just because she’s blind. She hated everyone, except her loving boyfriend. He’s always there for her. She said that if she could only see the world, she would marry her boyfriend. One day, someone donated a pair of eyes to her and then she can see everything, including her boyfriend. Her boyfriend asked her, "now that you can see the world, will you marry me?"

The girl was shocked when she saw that her boyfriend is blind too, and refused to marry him. Her boyfriend walked away in tears, and later wrote a letter to her saying:

"Just take care of my eyes dear."

This is how human brain changes when the status changed. Only few remember what life was before, and who’s always been there even in the most painful situations.

 
    Pediatric Update

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

What are the general management considerations in bronchiolitis?

Supportive care is the mainstay of therapy for infants with bronchiolitis. General management principles include:

  • Oxygen therapy when SpO2 is less than 93% with respiratory distress. Initiation and weaning of oxygen should take into account the clinical context including degree of respiratory distress, presence of comorbidity, feeding difficulty, apnea, and oxygen availability.
  • Nasogastric feeds or intravenous fluids should be implemented when the child is dehydrated, safe oral feeding cannot be maintained, or risk of aspiration is high.
  • Nebulized hypertonic (3%) saline should be considered as it may reduce the length of hospital stay and improve the clinical severity.
  • Bronchodilators (α–adrenergic or β–adrenergic agents, ipratropium) and corticosteroids should not be used routinely. Inhaled bronchodilators may be tried under close monitoring in selected individuals such as those with recurrent wheeze, a family history of asthma, or previous response to bronchodilators.
  • A recent trial described reduction in hospitalization in those receiving nebulized adrenaline combined with oral dexamethasone (1 mg/kg on day 1 followed by 0.6 mg/kg daily for 5 days).
  • Chest physiotherapy should not be used as it increases morbidity.
  • Use of palizumab and infection control measures are well described.
  • Antibiotics are not routinely recommended in bronchiolitis but may be used in children suspected of concomitant bacterial pneumonia.
 
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  Did You Know

(Dr Uday Kakroo)

A comet’s tail always points away from the sun.

 
    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

AST (aspartate aminotransferase)

This test is normally done to:

  • Check for liver damage
  • Check for liver disease, especially hepatitis and cirrhosis

High levels of AST may be caused by:

  • Recent or severe liver damage, such as hepatitis caused by a viral infection or drug reaction
  • Decay of a large tumor (necrosis)
  • Shock

Moderately high levels may be caused by:

  • Chronic diseases affecting the liver, such as cirrhosis
  • Heart attack or heart failure
  • Alcohol abuse
  • High doses of vitamin A
  • Kidney or lung damage
  • Mononucleosis
  • Duchenne muscular dystrophy
  • Some types of cancer
  • Myositis

Slightly high levels of AST may be caused by:

  • Fatty deposits in the liver
  • Medicines, such as statins, antibiotics, chemotherapy, aspirin, narcotics, and barbiturates
  • Alcohol abuse
 
  Contrary Proverbs

(Mr Vipin Sanghi)

Doubt is the beginning of wisdom. But Faith will move mountains.

 
  Legal Question of the Day

(Dr MC Gupta, Advocate)

What are the worst and the best provisions in the CEA 2010?

Ans.

A. The worst provision is section 12(2) which makes it mandatory to treat a patient in emergency for an extended period of time without making any provision for payment for the services mandatorily rendered.

B. The best feature is that the CEA can act as a virtual Anti–quackery Act as explained below:

  1. The biggest beneficiaries are going to be the solo practitioners and pathologists who start their pathology labs.
  2. Solo practitioners know that they find it very difficult when an MD in medicine, an MBBS and a quack are all bracketed together by the public. An ordinary doctor cannot fight the large number of quacks. The fight involves court cases (Consumer court; Police case; PIL) or complaints to medical council, but for reasons best known to the medical profession, the medical councils have not used their anti–quackery provisions and have been content with occasional lodging of complaints with the police. In any case, all these litigations are directed against a PERSON, who can defend himself in prolonged and lengthy ways. The complaint against the CEA will be directed not against the person/quack but against his establishment, whose licence will be cancelled, effectively stopping his practice.
  3. Pathologists having quality labs face tough and unfair competition from DMLT technicians. They will greatly benefit from the CEA because the labs run by quacks will lose their licence.
  4. The CEA authority will lack the delays and trappings of a court and action will be quick. Lawyers will not be needed. Doctors need not complain against quacks themselves. Like RTI, the complaint can be lodged by anybody. CEA will be forced to act. I don’t see any possibility that licence to practice allopathy may be given to non–allopaths. This will be against SC decisions and no government can make rules against SC judgments.

C. It is open to the states to make their own state CEA in which they can keep the beneficial features of the CEA, 2010, while, at the same time, they can get rid of the objectionable features. Things are moving on these lines in Punjab. I hope they proceed fast.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with PUO came for blood culture.
Dr Bad: Take 3ml of blood.
Dr Good: Take 10ml of blood.
Lesson: For each blood culture, minimum 10 ml to 20 ml of blood could be obtained. The yield of blood cultures in adults increases approximately by 3 per ml of blood culture.

Make Sure

Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis (IE).
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.

 
  SMS of the Day

(Dr GM Singh)

Be kind, for everyone you meet is fighting a hard battle. Plato

 
  GP Pearls

(Dr Pawan Gupta)

In patient with co–existent rhinitis, combination of inhaled corticosteroids and nasal steroids may provide better asthma control. (BMJ 2006;332:767–71)

 
    Medicolegal Update

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

What is drowning?

Drowning submersion is followed by struggle which subsides with exhaustion and drowning begins.

  • Breath holding lasts until carbon dioxide accumulation stimulates respiration resulting in inhalation of water. Gulping of water coughing and vomiting is rapidly followed by loss of consciousness.
  • Profound unconsciousness and convulsions are associated with involuntary respiratory movements and the aspiration of water. Respiratory failure precedes heart failure in one–third of cases it is coincident in one–third and follows it in the other third.
  • Death occurs within 2 to 3 minutes may be called" Instantaneous Deaths" and the death is almost invariable when the period of submersion exceeds 10 minutes. The survival rate from potentially fatal salt water submersion is about 80% whereas in fresh water it is less than 50%.
  • There are no pathological findings paths gnomonic of drowning. Consequently obtaining proof that the victim was alive on entering the water and excluding natural, traumatic and toxicological causes of death are critically important.
  • Some pathological changes are characteristic of drowning but the diagnosis is largely one of exclusion. Foam in the airways externally a fine white froth or foam is seen exuding from the mouth and nostrils.
  • The froth is sometimes tinged with blood producing a pinkish color. If the foam is wiped away then pressure on the chest wall will cause more to exude from the nostrils and mouth.
  • The foam is a mixture of water, air, mucus and possibly surfactant whipped up by respiratory efforts. Thus it is a vital phenomenon and indicates that the victim was alive at the time of submersion.
 
    Mind Teaser

Read this…………………

Which one of the following soft tissue sarcomas frequently metastasizes to lymph nodes?

1. Fibrosarcoma
2. Osteosarcoma
3. Embryonal rhabdomyosarcoma
4. Alveolar soft part sarcoma

Yesterday’s Mind Teaser: Right=right

Answer for Yesterday’s Mind Teaser: Equal rights

Correct answers received from: Dr K Raju, Dr Muthumperumal Thirumalpillai, Dr BB Aggarwal,
Dr Neelam Nath, Dr Chandresh Jardosh, Dr Anil Bairaria.

Answer for 10th July Mind Teaser: 1. Supracardiac
Correct answers received from: Dr K Raju, Dr Arpit, Dr Surya, Dr Sanath, Dr Priya.

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

What are gilt–edged securities?

Gilt–edged securities are government securities and bonds usually with a low interest rate. They are considered safest investments, as the government security is free from default risk. Originally such certificates were edged with gold and hence the name.

 
    Laugh a While

(Dr. Anupam Sethi Malhotra)

Awesome answers in IAS (Indian Administrative Service) examination

Q. What looks like half apple ?
A: The other half. (UPSC – IAS Topper )

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Diclofenac sodium SR Tablet 150 mg
For the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, painful postoperative pain following dental surgery etc.
26/03/2010
 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

World Population Day

This year World Population Day falls during a milestone year as we witness the birth of universe’s 7th billion inhabitant.

Addressing a gathering of doctors and nurses, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, said that today people are living longer and have a healthier life and simultaneously the couples are choosing to have fewer children. The increase in number of deliveries by reproductive techniques like In Vitro Fertilisation does not balance the reduced number of deliveries by choice. The provisional population figures of the 2011 census in India suggest that India’s population growth is finally slowing down. The decline in sex–ratio, however, is still a matter of concern. As per 2011 Indian Census, 7.1 million fewer girls than boys were noticed in the age group of 18 to 6 years.

Most of the sex selective abortions are done between 12–20 week of gestation. In developing countries the law should be so modified that termination of pregnancy after 12 weeks should only be on medical grounds and that too in the recognized hospitals.

Many diseases spread very fast in overcrowded places through respiratory droplets and nuclei infections like Tuberculosis, Measles etc. Another disease which is common due to overpopulated place is rheumatic heart disease which include damage of valve of the heart due to sore throat in children living in overcrowded places.

The normal respiratory hygiene involves staying 3 feet away from people who are coughing, snoring and singing. In India, practically all class rooms, cinema halls and public places do not follow these regimes due to scarcity of space.

 
    Readers Responses
  1. What would a doctor do in case the treatment goes on for more than three years such as that in chronic diseases (CHD, hypertension, diabetes, arthritis, psychiatric disorders, asthma etc.) Destroy a part of record and keep record of only last three year! What is the guideline in such cases. Should not the record be kept as long as the patient is under treatment or three years after cessation of treatment which ever is later. Dr Suman Sinha
    Insight on Medicolegal Issues responds: Your legal duty is to keep the reocrds for 3 years. The loop hole is the definition of commencement of treatment.
 
    Forthcoming Events

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

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

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

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

………………………………………………………………

Medifilmfest (1st International Health Film Festival in Delhi)

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

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

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

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

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

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

………………………………………………………………

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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta