Dr KK Aggarwal (Gp Editor in Chief)


14th October Wednesday 2009:

Beware of noise pollution


Everyday noise exposure over time has an impact upon our ability to hear and on the degree of hearing loss that develops. Constant exposure to loud noise can cause high frequency sensory neural hearing loss said Dr KK Aggarwal President Heart Care Foundation of India.


Noise pollution causes direct mechanical damage to cochlear inner ear structure.


The international guidelines for noise exposure are defined ? people who are continuously exposed to a noise level of greater than 85 dB must be under hearing conservation programme and should be provided hearing protection.


An exposure of 90 dB is allowed for 8 hours, 95 dB for 4 hours and 100 dB only for 2 hours. A shot blast of loud noise involving 120 to 155 dB can cause severe to profound sensorial hearing loss, pain and pain associated with loud noise. 


Hearing protection in the form of muffs or plugs is highly recommended anytime a person is exposed to loud noise.


The manufacture and sale of fire crackers generating a noise level of more than 125 dB at 4 meters distance from the point of bursting are prohibited. Most unregulated large bombs can produce a noise of more than 125 dB.

DMC Order Update: Can a patient complain after nine years?

No. as per DMC order DC/F.14/Comp.562/2009 dated 2nd September, 2009. The council examined a complaint of Shri J.S. Randhawa, President All India ITDC Workers Federation, alleging professional misconduct on the part of Dr. Arvind Kumar Khurana of Jaipur Golden Hospital. ?On perusal of the complaint, the Council noted that allegation of impropriety has been raised against Dr. A K Khurana regarding bills / certificates in respect of treatment of one Shri P.P. Singh in the year 2000.  The Delhi Medical Council observed that since the cause of action, in this matter, arose in the year 2000 and the complaint has been made after a period of almost nine years, the same does not merit consideration and stands rejected?.

Cocaine Vaccine Shows Promise for Treating Addiction


Immunization with an experimental anti-cocaine vaccine resulted in a substantial reduction in cocaine use in 38 percent of vaccinated patients in a clinical trial supported by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health. The study, published in the October issue of the Archives of General Psychiatry, is the first successful, placebo-controlled demonstration of a vaccine against an illicit drug of abuse.  The results of this study represent a promising step toward an effective medical treatment for cocaine addiction. Like vaccines against infectious diseases such as measles and influenza, the anti-cocaine vaccine stimulates the immune system to produce antibodies. Unlike antibodies against infectious diseases, which destroy or deactivate the disease-causing agents, anti-cocaine antibodies attach themselves to cocaine molecules in the blood, preventing them from passing through the blood-brain barrier. By preventing the drug?s entry into the brain, the vaccine inhibits or blocks the cocaine-induced euphoria.

In Health Care Today, It's Electronic All the Way

Inhalers may raise risk of asthma in some children

Common asthma reliever drugs taken by millions of children around the world may increase the risk of asthma attacks in some patients with a particular genetic make-up as per British scientists. The researchers found that salbutamol, as well as salmeterol are less effective in children with a specific gene variant and may in some cases make their asthma worse. The scientists said their findings suggest that carrying out genetic tests on children before treatment could be a more cost-effective way of treating them.

Joke of the day

You know you are a nurse when you compliment a complete stranger on his veins.

Law of the Garbage Truck

One day I hopped in a taxi and we took off for the airport. We were driving in the right lane when suddenly a black car jumped out of a parking space right in front of us. My taxi driver slammed on his brakes, skidded, and missed the other car by just inches! The driver of the other car whipped his head around and started yelling at us. My taxi driver just smiled and waved at the guy. And I mean, he was really friendly. So I asked, 'Why did you just do that? This guy almost ruined your car and sent us to the hospital!' This is when my taxi driver taught me what I now call, 'The Law of the Garbage Truck.'

He explained that many people are like garbage trucks. They run around full of garbage, full of frustration, full of anger, and full of disappointment. As their garbage piles up, they need a place to dump it and sometimes they'll dump it on you. Don't take it personally. Just smile, wave, wish them well, and move on. Don't take their garbage and spread it to other people at work, at home, or on the streets. The bottom line is that successful people do not let garbage trucks take over their day.
Life's too short to wake up in the morning with regrets, so.... Love the people who treat you right. Forgive the ones who don't. Life is ten percent what you make it and ninety percent how you take it!
Have a garbage-free day 

Hair loss revisiting


It is necessary that the family physician/general practitioner have knowledge to be able to screen the patient for possible common causes of hairloss. As some of them are reversible, especially if detected at an early stage, proper screening and early diagnosis is helpful.

Some common causes of treatable hair loss are -


1. Androgenic alopecia or common baldness : This is the commonest form of hairloss in which the patient loses hair in a pattern (that is why it is also called "pattern hairloss"), but never loses hair from a horseshoe shaped area in the back and the sides of the scalp. This form of hair loss is amenable to clinical diagnosis. If treated at onset, the speed of hair loss can be reduced and the eventual baldness be delayed in many patients by medications. Androgenic alopecia is amenable to surgical treatment, viz., follicular unit hair transplants, if the medicines do not work even when used for a period of 1 year.


2. Immunological causes: The commonest being alopecia areata. It is easily identifiable clinically because the patient develops a slick bald patch almost overnight. The hair in the affected area shed and the scalp appears totally smooth without any signs of infection or inflammation. The patch can develop on any part of the scalp or body. When this type of hair loss is extensive, it is reffered to as alopecia globalis (the patient in alopecia globalis has virtually no hair on the body). Treatment is notoriously difficult. Some patients see normal remission even without taking any drugs. For others, the usual line of treatment is either oral or intradermal, intralesional steroid administration. Drugs effective in androgenic alopecia have no role to play in alopecia areata.. 


3. Hormonal imbalances: is another easy to identify type of hair loss on basis of clinical observation and specific laboratory testing. One common hormonal imbalance leading to hair loss is hyperthyroidism. Distinguishing clinical features of this type of hair loss are that -

        There are no distinct bald patches (unlike alopecia areata), only diffuse thinning of hair.

        Diffuse hair loss is noticeable in the entire scalp (unlike androgenic alopecia in which the horseshoe shape area on sides and back of scalp experiences no hair loss).

        Hyperthyroisim is easy to confirm on basis of laboratory testing. If diagnosed early, treatment of hyperthyroidism will prevent further progression of hair loss. (source: Dr. Arvind Poswal)

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