emedinews
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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 & 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 …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

13th October 2012, Saturday

Eat Tomatoes, Guava, Watermelon and Grapefruit to Prevent Paralysis

Lycopene may lower stroke risk in men. Foods such as tomatoes, guava, watermelon, and grapefruit are good sources of lycopene. When tomatoes are cooked, the heat increases levels of cis-lycopene, which is easily absorbed by the body.

As per a report published in Oct. 9 issue of Neurology, by Jouni Karppi, PhD, of the University of Eastern Finland in Kuopio, compared with the men who had the lowest serum concentrations of the carotenoid, those with the highest concentrations had significantly lower risks of stokes.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update

Facts

  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is ischemic cardiomyopathy?

The term “ischemic cardiomyopathy” has been used to describe ischemic myocardial dysfunction. Most patients with ischemic cardiomyopathy have known coronary heart disease.

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Longer CPR efforts may improve survival chances

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that more than 10,000 members of the public will be certified in compression only CPR during the Mela.

 
Dr K K Aggarwal
    National News

Suspected polio case tests negative

PATNA: After remaining polio-free for around 21 months, the country reported its first suspected polio case in Darbhanga district on Thursday. However, UNICEF, India denied it to be a polio case. State chief of Unicef, Yameen Mazumder said, "Although, a case of wild poliovirus type 3 (WPV3) was reported at Darbhanga, the test was negative." Sources said an 18-month-old child at Darbhanga was suspected of carrying P3 polio virus though he was earlier vaccinated against polio. Sources said the child is reported to have nutrition deficiency. The stool test conducted at ERC Mumbai laboratory was found negative, Mazumder said. Surprisingly, state health minister Ashwini Kumar Choubey was not aware of the case. When contacted, he said, "I have no knowledge of any such case." Meanwhile, the union health ministry, in a statement issued on Thursday, said immunization drive would be launched in 28 districts of Bihar from next week as a precautionary measure. Notably, Bihar has not reported a single wild poliovirus type 3 (WPV3) case since January 2010. As per WHO norms, if there is no polio case for three consecutive years then only India would be declared polio-free. (Source: TOI, Oct 12, 2012)

For comments and archives

World Hospice and Palliative Care Day on Oct 13

CHANDIGARH: World Hospice and Palliative Care Day will be celebrated on 13 October. It is a unified day of action to celebrate and support hospice and palliative care around the world. The theme for this year is, ""Living to the end: palliative care for an ageing population. The Chandigarh model of Palliative Care which integrates palliative care into cancer care, is a joint project of the Department of Radiotherapy at PGIMER, Chandigarh & Indian Red Cross Society, UT Branch, Chandigarh. The Department of Radiotherapy, PGIMER will be celebrating the day on 12th October 2012 at the Chandigarh Hospice. As the theme this year is Palliative Care for the ageing population, the inmates of the Old Age Home from Sector 15 have been invited to the Hospice in Sector 43 to give them a day out & some entertainment. Palliative Care is an approach that improves the quality of life of patients and their families. It provides humane and compassionate care, for people in the last phases of an incurable disease, or those that need support, so that they may live as fully and comfortably as possible till the end. It offers a holistic approach of physical, emotional, social and spiritual care not only to the patient but also to their families, and caregivers through team work, education and empowerment. (Source: TOI, Oct 10, 2012)

For comments and archives

My Profession My Concern

Quality Control

Urinary catheter care bundle - Insertion

  1. Insert only for specific reasons
  2. Urinary output in critical ill
  3. Bladder outlet obstruction or neurogenic bladder dysfunction
  4. Prevent contamination of sacral wounds
  5. Terminal care
  6. Competent HCW to insert
  7. Aseptic technique
  8. Closed system with bag below bladder
  9. Review need for catheter daily
  10. Empty when ¾ full and use clean container for each patient
  11. Secure catheter to leg/abdomen
  12. Urine samples from sampling port only
  13. Hand hygiene and personal protective equipment (PPE) before and after any catheter care

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

 
    Valvular Heart Disease Update

Preventing valvular endocarditis

Highest risk procedures

  • All dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa.
  • Procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa.
  • Procedures in patients with ongoing gastrointestinal or genitourinary tract infection.
  • Procedures on infected skin, skin structure, or musculoskeletal tissue.
  • Surgery to place prosthetic heart valves or prosthetic intravascular or intracardiac materials

(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)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

2012 Nobel Prize in literature

The 2012 Nobel Prize in literature was awarded to Chinese author Mo Yan. He was described as “an extremely original narrator” whose fiction fuses folktales with history and contemporary concerns by the head of the Swedish Academy, Peter Englund.

For comments and archives

Fantastic new solution for aortic aneurysms

Multilayer flow modulator stents (MFMs) could be incredibly valuable for the resolution of complex thoracoabdominal aortic aneurysms. MFMs are not only effective; they also appear to carry no risk for loss of native side branches. Sherif Sultan, MD, FACS (Hon), from the Western Vascular Institute in Galway, Ireland, presented the results of a study of 55 cases of MFMs here at the American College of Surgeons 98th Annual Clinical Congress. (Source: Medscape)

For comments and archives

Troubled sleepers at risk for soft plaque

Obstructive sleep apnea has been linked with cardiovascular disease, but it also may be linked with the deadliest type of coronary artery plaque, a small study suggests. (Source: Medpage Today)

For comments and archives

Biomarker for asbestos-linked cancer works

Glycoprotein fibulin-3 can be used to identify patients with pleural mesothelioma and may be a useful biomarker for the asbestos-related illness, researchers reported. (Source: Medpage Today)

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: Cancer Risk in Light Drinking http://blog.kkaggarwal.com/2012/10/cancer-risk-in-light-drinking/ …

@DeepakChopra: Who is God? And can we know God? My #askdeepak replyhttp://tinyurl.com/9hzj2fl

 
    Spiritual Update

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

Cancer risk in light drinking

In Ayurveda it is mentioned that one should not take fermented things in the night and also should take the in limit in the day time. Alcohol is also a fermented drink and in excess is bad for the health. A large American cohort study has now shown that a substantial portion of the apparent increased risk for cancer among light to moderate drinkers is related to people lying about their drinking habits, according to study author Arthur Klatsky, MD, from Kaiser Permanente Medical Center, Oakland, California, who presented the results at the 2012 European Society for Medical Oncology Congress.

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What problems can occur in multiple pregnancies?

If you are pregnant with more than one baby, you may experience problems during the pregnancy. You may get high blood pressure or diabetes. You may not get enough iron. You may have too much amniotic fluid, which is the liquid that surrounds the baby during a pregnancy. Too much amniotic fluid is not good because it can cause premature labor. You may have problems delivering your babies. You will be more likely to need a C-section, which is when the babies are delivered through a surgical opening in your belly.

For comments and archives

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

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

Blood Donation - Gift of Liquid Love

HIV (types 1 and 2) can be transmitted via blood transfusions. Treponema causing Syphilis and Plasmodium resulting in malaria too can be transmitted. Hence it has been made mandatory that every donor must be tested for these infections. Human T cell lymphotropic virus (HTLV) implicated in endemic T-cell leukemia is another viruses transmitted in blood that can cause serious and fatal diseases.

For comments and archives

 
    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

Diagnostic test for amoebic liver abscess

Trophozoites are difficult to detect in aspirates of pus from amebic liver abscess as they are usually located in the wall of the abscess. However, serologic tests like indirect hemagglutination antibody titers and enzyme linked immunosorbent assay (ELISA) are sensitive markers to diagnose amebic abscess. Negative serological tests strongly point to a pyogenic etiology.

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

Doctor’s Service!

A doctor quickly entered the hospital after being called in for an urgent surgery. He changed his clothes and went directly to the surgery block. He saw the boy’s father walking back and forth in the hall waiting for the doctor.

Once seeing the doctor, the dad yelled: “Why did you take all this time to come? Don’t you know that my son’s life is in danger? Don’t you have the sense of responsibility?”

The doctor smiled and said: “I am sorry, I wasn’t in the hospital and I came the fastest I could… now, I wish you’d calm down so that I can do my work.” “Calm down?! What if your son was in this room right now, would you calm down? If your own son dies now what will you do?” said the father angrily.

The doctor smiled again and replied: “I will say what is said in the Holy Bible ‘From dust we came and to dust we return, blessed be the name of God.’ Doctors cannot prolong lives. Go and intercede for your son, we will do our best by God’s grace.”

“Giving advice when we’re not concerned is so easy” murmured the father. The surgery took some hours after which the doctor went out happy, “Thank God! Your son is saved!” And without waiting for the father’s reply he carried on his way running. “If you have any question, ask the nurse.”

“Why is he so arrogant? He couldn’t wait some minutes so that I ask about my son’s state?” commented the father when seeing the nurse minutes after the doctor left.

The nurse answered: “His son died yesterday in a road accident, he was in the burial when we called him for your son’s surgery.”

For comments and archives

 
  Cardiology eMedinewS

Telemonitoring for BP Control Can Work Read More

Study: More strokes in middle-age Read More

 
  Pediatric eMedinewS

Exercise may be worth the risk in kids with hemophilia Read More

Involve adolescents in end-of-life decisions Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient developed asthma within a year of menopause.
Dr. Bad: It is not asthma.
Dr. Good: It is associated with menopause.
Lesson: The onset of asthma within a year of menopause is a separate asthma phenotype.

For comments and archives

Make Sure

Situation: A patient with chest pain with normal ECG died half an hour later.
Reaction: Oh my God! Why was acute MI not suspected?
Lesson: Make sure all patients of chest pain are observed for 12 hours. ECG can be normal in acute heart attack for up to six hours.

For comments and archives

 
    Legal Question of the Day (Dr M C Gupta)

Q. Is there any rule that a dead body cannot be transported in an ambulance, whether owned by the government or a private person?

Ans.

  • It is for the owner to make rules regarding what to transport or not in the vehicle(s) owned by him, as long as such rules do not violate law.
  • I do not know of any law that is violated by transportation of a dead body in an ambulance.
  • Chapter V of the Motor Vehicles Act concerns CONTROL OF TRANSPORT VEHICLES. Section 66 of this chapter is titled “Necessity for permits”. Clauses b and c of Section 62(3) read:
    • to any transport vehicle used solely for police, fire brigade or ambulance purposes;
    • to any transport vehicle used solely for the conveyance of corpses and the mourners accompanying the corpses;”
  • It is clear that as per the scheme of law, there can be vehicles which may not be meant solely for the purpose of ambulance or conveyance of corpses, meaning thereby that there can be mixed use.

For comments and archives

 
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Platelet count

Thrombocytopenia (or low platelet count) is divided pathophysiologically into production defects and consumption defects based on examination of the bone marrow aspirate or biopsy for the presence of megakaryocytes.

  • Production defects are seen in Wiskott–Aldritch syndrome, May–Hegglin anomaly, Bernard–Soulier syndrome, Chediak–Higashi anomaly, Fanconi’s syndrome, aplastic anemia, marrow replacement, megaloblastic and severe iron deficiency anemias, uremia, etc.
  • Consumption defects are seen in autoimmune thrombocytopenias (including ITP and systemic lupus), DIC, TTP, congenital hemangiomas, hypersplenism, following massive hemorrhage and in many severe infections.
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  Quote of the Day (Dr GM Singh)

Make it thy business to know thyself, which is the most difficult lesson in the world. – Miguel de Cervantes

 
    Mind Teaser

Read this…………………

A client is admitted from the emergency department with severe-pain and edema in the right foot. His diagnosis is gouty arthritis. When developing a plan of care, which action would have the highest priority?

A. Apply hot compresses to the affected joints.
B. Stress the importance of maintaining good posture to prevent deformities.
C. Administer salicylates to minimize the inflammatory reaction.
D. Ensure an intake of at least 3000 ml of fluid per day.

Yesterday’s Mind Teaser: A client with head injury is confused, drowsy and has unequal pupils. Which of the following nursing diagnosis is most important at this time?

A. Altered level of cognitive function
B. High risk for injury
C. Altered cerebral tissue perfusion
D. Sensory perceptual alteration

Answer for Yesterday’s Mind Teaser: C. Altered cerebral tissue perfusion

Correct answers received from: Dr Pankaj Agarwal, Dr PC Das, Dr K Raju, Dr Chandresh Jardosh,
Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr PC Das, Anil Bairaria.

Answer for 11th October Mind Teaser: C. Apply a "shrinker" bandage with tighter arms around the proximal end of the affected limb.
Correct answers received from: Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G, Dr Avtar Krishan,
Dr PC Das, Anil Bairaria.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

Three sisters, ages 92, 94 and 96 live in a house together. One night the 96-year-old draws water for a bath. She puts her foot in and pauses. She yells to the other sisters: "Was I getting in or out of the bath?" The 94-year-old yells back: "I don't know. I'll come up and see." She starts up the stairs and pauses."Was I going up the stairs or down?" The 92-year-old is sitting at the kitchen table having a cup of tea listening to her sisters. She shakes her head and says" "I sure hope I never get that forgetful, knock on wood." She then yells: "I'll come up and help both of you as soon as I see who's at the door."

 
    Medicolegal Update

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

Facilitate cadaver organ retrieval for transplantation

In India, certain amendments to the Human Organ Transplant Act 1994 are required to enhance cadaver organ retrieval and transplantation to bridge the huge demand–supply gap. The pool of donors, including increasing the supply of organs by widening the definition of ‘near relatives’ by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures. The paired matching should be permitted i.e. if patient A’s donor does not match A, and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfill the need of their family member in need of a transplant.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Beware of food poisoning in Navratra

Its Navratra time again when people eat food made from kuttu and singhara flours. However, if the flour left over from last year is used, it can cause food poisoning, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Food poisoning is common. One in five episodes of diarrhea is likely to be due to a food poisoning. Each person, on an average has diarrhea once or twice per year. An average person will have a food poisoning once every 3 to 4 years.

Always consider a food-borne illness when a patient presents with a mixture of gastrointestinal symptoms: nausea, vomiting, abdominal pain, diarrhea and fever.

Botulism and some types of shellfish poisoning can present with paralysis; ciguatera fish poisoning or scombroid with headaches and tingling; amnesic shellfish poisoning with amnesia, hepatitis A or E and Listeria monocytogenes with meningitis or spontaneous abortion.

More than 200 known agents are capable of food poisoning (microbial causes, chemicals and other agents). Five organisms account for 90 percent of the deaths, most notably Salmonella spp. About 1.2% persons have complications such as intestinal perforation or invasive illness. Listeriosis, Shiga toxin producing E. coli and non typhoidal Salmonella are particularly associated with severe morbidity.

Food poisoning can be classified on the basis of onset of symptoms.

  • Rapid symptoms within 6-12 hours: are due to organisms that make a toxin in the food before the food is consumed. Symptom is predominantly vomiting. Examples are Staphylococcus aureus, Bacillus cereus emetic toxin and botulism.
  • Symptoms after 24 hours: are due to pathogens that make toxin once they have been ingested. They mainly cause diarrhea that may be watery (Vibrio cholerae or Escherichia coli) or bloody (Shiga toxin-producing E. coli).
  • Symptoms after variable time: are due to microbes that cause pathology by either damaging the epithelial cell surface or by actually invading across the intestinal epithelial cell barrier. They can produce a wide spectrum of clinical presentations from watery diarrhea (Cryptosporidium parvum, enteric viruses) to inflammatory diarrhea (Salmonella, Campylobacter, Shigella) or systemic disease (Listeria monocytogenes).

The food poisoning can also be classified depending on the type of symptoms vomiting or diarrhea. A sudden onset of nausea and vomiting is likely due to the ingestion of a preformed toxin, such as S. aureus enterotoxin or B. cereus emetic toxin, or a chemical irritant. There is no risk of person-to-person spread.

When food poisoning presents with diarrhea, the organisms are V. cholera, Clostridium perfringens, enterotoxigenic E. coli, B. cereus, rotavirus, Astroviruses, enteric Adenoviruses and Noroviruses, and the parasitic organisms, Cryptosporidium parvum and Cyclospora cayetanensis.

Some clinical clues should raise the suspicion that a food-borne microbe is causing inflammatory diarrhea. These include: Passage of diarrhea with blood or mucus, presence of severe abdominal pain and occurrence of fever. The most likely pathogens in patients with inflammatory diarrhea are Salmonella or Campylobacter.

 
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