December 14   2015, Monday

Dr KK AggarwalDr KK Aggarwal WMA welcomes recognition given to health in climate deal

The World Medical Association has shown consistently strong leadership in promoting the involvement of physicians in climate action since 2009. It supports the recent WHO Call to Action on climate and health, the Paris Platform for Healthy Energy and is an important partner in the "Our Climate, Our Health" campaign.

Commenting on today´s climate change agreement, Dr. Xavier Deau, Immediate Past President of the World Medical Association said: ´Today´s ambitious agreement gives us hope that the world´s governments now recognise the serious consequences for health as a result of climate change and the urgent need for global climate action. The final Paris agreement establishes an unprecedented framework to transition away from our carbon-intensive economies and towards protecting health from the devastating effects of climate change.

´We particularly welcome recognition in the agreement that governments should, when taking action to address climate change, respect, promote and consider their respective obligations on human rights and the right to health of the whole population.

´It is now vital that the global community works to strengthen health systems. Tackling social inequalities in health, particularly in the developing world, and tackling climate change must go hand in hand. Physicians around the world will continue to support action on climate change to ensure that governments are held accountable to today´s promises.

Breaking News

Thirdhand smoke on NICU surfaces

A pilot study has found that surfaces in the neonatal intensive care unit (NICU) are contaminated with nicotine, putting infants at risk of thirdhand smoke exposure. Thirdhand smoke is the residue left over from cigarette smoke, which can build up on indoor surfaces over time. In addition to containing toxic substances such as nicotine, it can combine with other chemicals in the environment to form new toxic substances and carcinogens. It is difficult to clean, and can remain on surfaces for 18 months or longer… (Medscape)

New guidelines recommend use of arteries rather than veins in heart bypass surgery

New clinical practice guidelines from The Society of Thoracic Surgeons recommend expanding the use of arteries from the chest and forearm rather than using veins from the leg when performing coronary artery bypass grafting (CABG) surgery in certain patients. The guidelines, posted online today, will appear in the February 2016 issue of The Annals of Thoracic Surgery. The new clinical practice guidelines offer evidence-based recommendations that include using:

• An internal thoracic artery to bypass the left anterior descending artery when bypass is needed.
• A second arterial graft (right internal thoracic artery or radial artery) as an adjunct to the left internal thoracic artery in appropriate patients, and
• A second arterial graft (right internal thoracic artery or radial artery) when grafting coronary targets with severe stenosis. (Science Daily)
IMA Digital TV
IMA Digital TV
Specialty Updates
• A dose of testosterone can help women to navigate better, suggested a report published in the journal Behavioral Brain Research. The research also highlights the different areas of the brain used by men and women in wayfinding tasks.

• New research published in The European Journal of Public Health reveals that poorer children are nearly three times as likely as their more well–off counterparts to be obese.

• The use of probiotics was not associated with significant improvements in the maintenance of remission in patients with ulcerative colitis, reported a Cochrane systematic review presented at the Advances in Inflammatory Bowel Diseases meeting.

• Patients with atrial fibrillation (AF) who received a left atrial appendage closure device (Watchman) or stayed on long–term warfarin therapy had similar rates of major bleeding during a mean follow–up of 3.1 years, suggested a pooled analysis of two randomized clinical trials published online in JACC: Cardiovascular Interventions. However, patients who received the device and were able to stop taking warfarin and clopidogrel at 6 months had lower rates of major bleeding from then onward, compared with patients receiving long-term warfarin.

• A new study published in Studies in Family Planning as part of the December special issue "Postpartum and Post–Abortion Contraception: From Research to Programs" analyzes data from 35 studies reported that counseling before discharge from a maternity unit likely has an impact on subsequent contraceptive use and that the integration of family planning into immunization and pediatric services is justified.

• Ophthalmologists receive fewer patient complaints overall compared with other physicians, but ophthalmologists working at academic centers receive a disproportionately higher number of complaints within the field, according to a study published in Ophthalmology.

• A "liquid biopsy" using blood plasma was able to detect estrogen receptor 1 (ESR1) mutations that affected the outcome of treatment in a large randomized drug trial presented at the 38th San Antonio Breast Cancer Symposium. An analysis of blood samples from metastatic breast cancer patients found that nearly 30% carried mutations that increased the risk of relapse and shortened their lives. But the two mutations responded differently to treatment with the mTOR.

• Japanese researchers report that twice–daily budesonide foam is better than once–daily budesonide foam for inducing complete mucosal healing in patients with distal ulcerative colitis (UC). Mucosal healing has recently been recognized as the most important therapeutic goal for UC.
Types of Memory

The easiest way to remember types of memory is by understanding the concept of Suno, Samjho, Jano and Karo (hearing, listening, knowledge and wisdom). Hearing is the shortest lasting memory. We hear and we forget is the rule. Once we listen and understand, the memory is longer lasting but the same memory become everlasting if we not only hear, understand and know but also incorporate the knowledge in our practice.

These principles have been used by marketing people in brand recall. I know many pharmaceuticals play a game and ask 100 doctors to enter into a competition in which they have to write the company’s brand a number of times in one minute and the one who writes the maximum number of times is given a prize. By repeatedly writing the brand name, you create a permanent impact of their brand in the soul and it is unlikely that you will forget the brand and its recall value will increase every time you think about the molecule.

The same principle has been used by devotees of Rama and Shiva where they ask people to write the name of Rama repeatedly everyday and the devotees of Shiva makes people writing the Om Namaha Shivai in a peace of a paper for years together. By doing so you inculcate the teachings of Lord Rama and Shiva.

Many spiritual Gurus give a Mantra, which is also based on the same principle. A mantra is nothing but a positive affirmation which you have to follow every minute of your life throughout your life. Once you start doing it a time will come when it will become a part of your sole consciousness and you will start living and behaving in a way as of your positive affirmation. For example, Brahma Kumaris say that always say a positive affirmation to yourself that I am a peaceful soul. After some time you will start behaving like a peaceful soul and you will lose agitation, anger and negative affirmations of life.
President’s Lecture

Deformity correction

Dr HR Jhunjhunwala, Mumbai

The iconic Dr Jhunjhunwala began his talk to a packed audience.

• Understanding the limb alignment and malalignment is a critical test for orthopedic surgeons who treat children and adults with deformities.
• Considerable efforts to improve functionality by straightening crooked bones to achieve anatomically correct alignment.
• The deformity must be characterized: If bone is angulated, what is the direction? What is the level of deformity? Where is the apex of deformity? Is the bone short or rotated on its axis?
• It is very important to know what the normal alignment is.
o The center of hip joining the center of ankle must fall in the center of the knee. This is normal mechanical axis.
o If it falls lateral to the center of the knee it is a valgus deviation of mechanical axis.
o If it falls medial to the center of the knee, it is a varus deviation of mechanical axis.
• Center of rotational axis (CORA) is the intersection point of the proximal and distal mechanical or anatomical axis lines.
• The axis line of the proximal bone segment is called the proximal mechanical axis or proximal anatomical axis line.
• The axis line of the distal bone segment is called the distal mechanical axis or distal anatomical axis line.

Presidential Guest Lecture

Turning an old leaf analyzing orthopedics

Dr SS Yadav, Mirpur

It’s a singular pleasure and privilege to deliver the Presidential guest lecture and for this I have to thank the organisers, said Dr S S Yadav in his talk. I strongly believe that if you need to move forward you have to look back and learn from the past. I am particularly addressing the youngsters in the profession as our ancestors have made a pavement for us and we must make a ‘need–based’ highway on this. Vit M is a very crucial vitamin and is needed to make the right decisions, Dr Yadav said.

• The existing facts
o There has been a phenomenal progress in the Specialty.
o There has been a ‘Tsunami’ of Techniques.
o There is a Sea of overwhelming confusion & complications.
o But anything that is new & costly is not always good.
o We have to be very–very careful…

• Philosophy of fracture treatment
o It has always generated controversy. There are no agreed recommendations in this regard. Natural healing is the Gold Standard.
o Basic requirement–Recall (Joseph Amesbury 1831)
o "To put the fragments of a fractured bone into their proper situation, which is called setting the fracture, is one thing. Keeping them there, during the uniting process is another".
o Some of the suggestions are so dynamic that their suggestion have not been bettered.

• The Existing – Confusion
o The present research is debatable?
o Much depends on education & training of the Surgeon.
o The Vendors are putting pressure on Surgeon, Hospital, Service Centers & the Patient himself (NET)
o The Journals are under pressure to publish some of the Debatable Manuscripts.
o Before the previous learning curve is over, a New Design comes in.

• Technology is very good for machines like computers & telephones, but in the human body we need to go a step further ‘Biology’. Thus, all technologies have got to be ‘biologically’ oriented.
• It is not always essential that a costly technique is more advantageous.
• We have made mistakes in the past.
• To keep ‘Balance’, the Pendulum must swing both ways.
• We always have been the followers since long. Let us be the ‘Leaders’ in advocating Simple, Biological & Cost–effective techniques. The Globe might/ will appreciate.
• Revisit the Old Themes on the New Canvases
o We have a rich heritage.
o Principle–based Research.
o Role of a role–model.
o Relive history & experience it.
o Headlines always do not reveal the Truth.
o Do not run, otherwise you will Run–away.
o Technique may change but not the good qualities of a doctor.
o Leave behind a strong & meaningful legacy.

• We have a treasured Past.
o We owe a lot to the Indians who taught us how to count, without which no worthwhile scientific discovery could have been made. Albert Einstein
o Our information age is rooted in Indian innovations including the number ‘zero’. Barack Obama
o Intellectual potentialities of the Indian Nation are unlimited. Andre Wei
o The deeper you dive, the more treasures you find. Mahatma Gandhi
o We need ‘Thought–Leaders’ in Ortho, who can be on the forefront of the ‘Need–based’ Innovation. Indian wisdom must prevail.

• Let us listen to our "Inner–Voice"
o It appears we have lost something. We are devoid of some important ingredients of our profession & commitment to our patients. Something has profoundly changed ourselves.
o A bright star has got its own energy but to light a lamp in the dark is more meaningful & powerful.
o Let us go through the ‘Old’ leaves and then turn to the ‘New’ pages to be the Leaders in the World.
• Most certainly we do not wish to create a situation of conflict when there is a potential threat to the National treasures.
• We do not only try the ring the bell and mobilize the International Community but also try to find the best ways of influencing the like–minded colleagues.
• After every Action, there is a Reaction & Repercussion. Making a point is more impotent than winning an argument.
• The Purpose Driven Life
o Man is Mortal and Life is very short. The curtain rises and the curtain fails.
o However, each day is a challenge and a challenge is an opportunity to solve the unsolved problems, especially those which are ‘Need–based’.
o There are common problems that concern us all, the majority and the society at large. Let us adopt a path, follow a direction that takes us to such a common goal. Let us now decide what should be on our Agenda?
The Year in Medicine 2015: News That Made a Difference
Landmark report from the IOM urges reform to avert diagnostic errors

A report from the Institute of Medicine (IOM) ‘Improving Diagnosis in Health Care’ says that little progress has been made in reducing diagnostic errors, which can have fatal consequences. As a result, "most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences." About 5% of US adults who seek outpatient care each year receive incorrect diagnoses. Diagnostic errors contribute to approximately 10% of patient deaths. Causes include poor collaboration among clinicians, patients, and their families; a healthcare system that does not support the diagnostic process; limited feedback to clinicians about their diagnostic performances and a culture that discourages disclosure of errors. (Medscape)
Legal Quote
Sanjeevan Medical Research Centre (Private) Ltd. & Ors. Vs State of NCT of Delhi & Anr Crl.M.C.No. 2358/2010

"It has been ruled that a private complaint may not be entertained unless complainant has produced prima facie evidence before the Court in the form of credible opinion given by another competent doctor. The investigating officer should, before proceedings against the doctor, accused of rash and negligent act or omission, obtain an independent and competent medical opinion preferably from a doctor in government service."
IMA Digital TV
Digital IMA
IMA White Paper on Live Surgeries


Sensationalism is to be avoided.


1. Educational goals must be clearly defined and assessed prior to organising live surgery.
2. Local rules, national requirements, licensing, and malpractice insurance must be in place.
3. Funding should be transparent and financial arrangements should be fully disclosed.


1. The surgeon has permission from MCI and State Medical council is informed.
2. MCI declared in 2005 that live surgeries were permissible even by foreign surgeons.
3. The surgeon and the supporting team are requested to declare conflicts of interest.
4. Companies cannot be allowed to exert any influence.
5. An independent committee should oversee all activities.
6. A code of conduct should be followed.
7. Live broadcasting of new procedures that have not been formally tested in randomised or prospective trials can give a misleading message and so should be avoided.
8. Careful screening and planning are mandatory.
9. A pre– and post–live case demonstration questionnaire should be filled out by the audience and would be helpful in determining whether the educational goals have been achieved.
10. Prospective study on potential risk for the patients (outcome, and complications) and a prospective study on potential educational benefit should be organised.
11. The independent committee should assess both the surgeons and the organising centres.


1. All cases of live surgery should be reported to assure safe practice and for the development and refinement of future guidelines
2. Every live surgery has to be followed by a review meeting to provide an opportunity to question the operating surgeon
3. Necessity of live surgery: It may be possible to sufficiently study individual cases with edited or unedited videos
4. Well edited videos can be educationally more effective than live surgery although the real-time aspect is not present
5. If it is determined ultimately that live surgery imposes significant risks to patients, it should be completely prohibited

(To be contd.)
IMA Satyagraha
IMA Poll
22nd MTNL Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India
Provisional programme for the ensuing meeting of the Central Council

Dear Colleague

The provisional programme for the ensuing meeting of the Central Council to be held from 27th (Sunday) to 28th (Monday) December, 2015 at Hotel Le Meridien, New Delhi is as below.

This year, the Central Council will not only have issues related to IMA but also have interactions with top luminaries of the country connected with issues related to health.

Kindly send your names, suggestions with questions related to the Agenda, in advance to us so that the same can be incorporated in the various discussions during the Central Council Meeting, as this CC Meeting is absolutely packed minute by minute. To conduct Central Council smoothly, we request your cooperation.

Please note that the whole meeting of the Central Council will be live webcast.

Dr A Marthanda Pillai                                                                                                                             Dr KK Aggarwal
National President                                                                                                                              Hony Secretary General

27–12–2015 (Sunday)
08:00 – 08:10 AM
Inviting of leaders to the Dais
Adornment of National President with the Presidential Medallion
08.10 – 08:20 AM
Invocation of the IMA Prayer
Flag Salutation
Homage to departed souls
Approval of Minutes of the 135th Ordinary Meeting of IMA Central Council
08:30 – 09:00 AM
Dr A Marthanda Pillai
Presidential Address
09:00 – 09:30 AM
Shri Ashok Chakradhar, Padma Shri Awardee
Laughter the best medicine
09:30 – 10:00 AM
Sh Rajat Sharma, Editor, India News
How media perceives the doctors
10:00 – 10:30 AM
Dr K K Aggarwal
Address by Honorary Secretary General
10:30 – 11:00 AM
Sidharth Luthra, Former ASG
CPA vs Council vs IPC vs specific laws
11:00 – 11:30 AM
CC Continues
Satyagraha Update
11:30 – 12:00 NOON
Sh D K Jain (invited)
National Consumer Dispute Redressal Commission
12:00 – 12:30 PM
IMA Update
Membership, Miscellaneous
12:30 – 01:00 PM
Justice Vipin Sanghi, Justice G S Sistani, High Court Judges (invited)
Duties of a medical professional
01:00 – 02:00 PM
02:00 – 02:30 PM
IMA Update
RNTCP, Child Sexual abuse, UNESCO
02:30 – 03:00 PM
Sh. Sushil Chandra, Member CBDT
Income tax and medical profession
03:00 – 03:30 PM
IMA Update
IMA Accreditation Council, CME Hours
03:30 – 04:00 PM
Sh. Maninder Singh, ASG
Legal open house
04:00 – 05:00 PM
Shri JP Nadda, Hon’ble Minister of Health
05.00 – 07.00 PM
Sh. Satyendra Kumar Jain, Health Minister, Delhi
Reception at 2 Raj Niwas Road
07.00 PM onwards
Banquet hosted by IMA HQs at Asiad Tower Garden (Asian Complex adjacent to Sri Fort Auditorium, New Delhi)
28–12–2015 (Monday)
08:30 – 09:00 AM
Dr Ved Prakash Mishra, MCI
Medical education
09:00 – 09:30 AM
CGP, AMS, AKN, JIMA, NPPS, NSSS, Health Scheme, Pension Scheme, HBI, International wing
Reports by wings of IMA
09:30 – 10:00 AM
10:00 – 10:30 AM
VP, FSC, BSC, YD wing, students wing, Disaster Management
IMA reports
10:30 – 11:00 AM
Shri B S Bassi, Police Commissioner, Delhi
Violence against doctors
11:00 – 11:30 AM
IMA Lybrate, IMA Kent, IMA USV Initiatives
New Initiatives
11:30 – 12:00 NOON
Shri Nalin Kohli, Media Personality
How to face a TV Debate
12:00 – 12:30 PM
Mental health, MMR, IMR, RTA, BMW disposal, Elderly care, safe sound, diabetic blindness, Mediation Cell
New initiatives
12:30 – 01:00 PM
01:00 – 02:00 PM
02:00 – 02:30 PM
Guest lecture
Pediatric Update
02:30 – 03:00 PM
Dr Harsh Vardhan, Minister of Science and Technology, GOI (invited)
Medical Research
03:00 – 03:30 PM
Mental health, MMR, IMR, RTA, BMW disposal, Elderly care, safe sound, diabetic blindness, Mediation Cell
New initiatives
03:30 – 04:00 PM
Shri Sanjay Jaiswal, Member of Parliament
Rural Health options
04:00 – 04:30 PM
CC Meeting
Other issues
04:30 – 05:00 PM
Shri G N Singh, DCGI
Pharmacovigilance Program
05:00 – 07:00 PM
IMA National Awards Function

Dr Jitendra Singh, Hon&rsble Minister of State of Science & Technology, as Chief Guest

Shri Rajyawardhan Rathore, Minister of State of Information & Broadcasting as Co-Chief Guest (Invited)
07.00 - 08.00 PM
Dr S S Agrawal

Shri Mukul Rohatgi, Attorney General of India

Dr Mahesh Sharma, Minister of State for Culture, Tourism & Civil Aviation
Installation of Team IMA – 2015-2016, followed by 136th Ordinary Meeting of Central Council of IMA

Chief Guest

Co-Chief Guest
08.00 PM onwards

Dr RVS Surendran
President, IMA Tamil Nadu State


At this moment of natural fury, Indian Medical Association stands with you to support and help. Indian Medical Association HQ Disaster Management Cell has appealed to its members for generous donation for the needy people affected by the flood.

Please inform us about the need and requirements to carry out the rehabilitation and Medical help to the affected people. IMA HQs will try to provide help in its best ability.

We also request you to inform us regularly about the activities done by IMA Tamil Nadu with regards current floods in the state.

Dr A Marthanda Pillai                                           Dr KK Aggarwal                                                  Dr Chetan N Patel
President                                                                Hon Sec General                                                         Chairman
IMA HQ                                                                           IMA HQ                                                             IMA HQ DMC
Health ministry notifies 5 NIB scientists as government analysts

The Union health ministry has notified 5 NIB scientists as government analysts for a specified class of drugs through a notification in exercise of the powers conferred under sub-section(2) of section 20 of the Drugs " Cosmetics Act, 1940. This follows the notification of five National Institute of Biologicals (NIB) labs as central drug testing labs. The class of drugs includes blood grouping reagents, human immunodeficiency virus, hepatitis B surface antigen, hepatitis C virus, human albumin, human normal immunoglobulin, human coagulation factor VIII and human coagulation factor IX, plasma protein fraction, fibrin sealant kit and anti-inhibitor coagulation complex, recombinant insulin and insulin analogues, r–Erythroprotein (EPO) and r–Granulocyte stimulating factor (G–CSF). The class of drugs also includes glucose test strips and fully automated analyser based glucose reagents … (Pharmabiz – Shardul Nautiyal)
WHO releases analysis of global health trends

A new comprehensive analysis of global health trends since 2000 and an assessment of the challenges for the next 15 years has been launched by the WHO. Titled "Health in 2015: from MDGs to SDGs", the report identifies the key drivers of progress in health under the United Nations Millennium Development Goals (MDGs). It lays out actions that countries and the international community should prioritize to achieve the new Sustainable Development Goals (SDGs), which come into effect on 1 January 2016. The 17 SDGs are broader and more ambitious than the MDGs, presenting an agenda that is relevant to all people in all countries to ensure that "no one is left behind." The new agenda requires that all 3 dimensions of sustainable development – economic, social and environmental – are addressed in an integrated manner.
1,700 additional beds to be added in AIIMS

1,700 new beds will be added to the existing capacity of country’s premier medical institute AIIMS. Union Health Minister JP Nadda said in the Parliament that the government is working on enhancing the capacity of capital’s medical institutes, which receive a large number of patients from across the country. "An additional 1,700 beds will be added in the existing capacity of AIIMS. This will be 71% more of the current capacity of the AIIMS. The capacity of Safdarjung hospital will be increased by adding 1,300 new beds." And the capacities of RML hospital and Lady Hardinge medical college will be increased by 38% and 35% respectively. (ET Healthworld)
Physicians favor malpractice screening panels to deter suits

A new Medscape survey on malpractice litigation has revealed that physicians favor expert medical panels that screen claims for merit before they proceed in court more than any other kind of tort reform. Eighty–one percent of physicians cited pretrial screening panels as one of the best ways to discourage malpractice suits compared with 62% who chose caps on noneconomic (pain and suffering) damages and 48% who said cases should be tried in special health courts. Screening panels, found in 17 states, are designed to sort out nonmeritorious claims and avoid expensive court battles… (Medscape)
Key findings from the World Malaria Report 2015

• Globally, the number of malaria cases fell from an estimated 262 million in 2000 (range 205–316 million) to 214 million in 2015 (range 149–303 million).
• Globally, the number of malaria deaths fell from an estimated 839 000 in 2000 (range 653 000 to 1.1 million), to 438 000 in 2015 (range 236 000–635 000).
• Among children under five, the estimated number of malaria deaths, globally, fell from 723 000 in 2000 (range 563 000–948 000) to 306 000 in 2015 (range 219 000–421 000). The bulk of this decrease occurred in the WHO African Region.
• Most malaria cases (88%) and deaths (90%) occurred in the WHO African Region in 2015.
• Two countries, Nigeria and Democratic Republic of Congo, accounted for more than 35% of global malaria deaths in 2015.
• The WHO South–East Asia Region accounted for 10% of global malaria cases and 7% of deaths in 2015.
• The WHO Eastern Mediterranean Region accounted for 2% of global malaria cases and 2% of deaths in 2015.
• In 2014, 16 countries reported zero indigenous cases of malaria: Argentina, Armenia, Azerbaijan, Costa Rica, Iraq, Georgia, Kyrgyzstan, Morocco, Oman, Paraguay, Sri Lanka, Tajikistan, Turkey, Turkmenistan, United Arab Emirates and Uzbekistan. Seventeen countries are reporting fewer than 1000 cases of malaria. (WHO)
Bioethical issues in medical practice
Protecting the privacy and confidentiality of patients

Smita N Deshpande
Head, Dept. of Psychiatry, De–addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

You are a member of an informal discussion group of doctors who meet regularly to discuss difficult cases. At all these discussions, the conversation is frank and detailed, with all details of the patients, social situation, family issues etc. are discussed threadbare. Sometimes this discussion spills over into the hospital lifts, corridors and canteens. When these issues are really interesting, you discuss them at home with your spouse– a doctor– as well. Many times the name, address, and other details of patients are discussed as well.

a) Do such discussions breach medical confidentiality?
b) At which places should medical cases be discussed?
c) Should interesting medical cases be discussed at home?

Any suggestions? Do write in!

Adapted from: Bioethics Case Studies (AUSN and EEI, November 2013):

Responses received

Medical discussions of difficult cases are very important from the doctor’s point of view and also from the patient’s point of view. They should definitely be discussed at home, in medical get-togethers, but not in lifts, hotels and public places. Medical science is based on discussions and exploration of the knowledge what one has. Dr BR Bhatnagar
Heart disease begin in childhood

All heart diseases begin in childhood and, therefore, preventive measures need to be started at that age. Two major problems of childhood are pre–hypertension and obesity and if they can be tackled well in time, future heart diseases can be prevented. Pre–hypertension is a blood pressure of more than 120/80 and lower than 140/90 mmHg. The Bogalusa Heart Study was the first study to give a message that coronary artery disease, atherosclerosis, hypertension and heart disease all begin in childhood. It was the longest and most detailed study of a biracial population of children and young adults in the world. In the study, 27% of young adults were found to have pre–hypertension, while only 13% had true high blood pressure. School health programmes in India must focus on checking the blood pressure of children and also regarding their obesity status. Both can be controlled by promoting regular exercise and proper diet. A diet high in trans fats and refined carbohydrates like refined flour, sugar and rice promote both obesity and pre–hypertension.
WP(C) No.8706/2015 titled “Indian Medical Association Vs. Union of India & Anr (NCERT)” Delhi High Court, New Delhi

Click here to read the proposed changes
IMA Live Webcast

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Inspirational Story
This is amazing, Randy Pausch 47–years–old, a computer science lecturer from Mellon University died of pancreatic cancer in 2008, but wrote a book "The last lecture" before then, one of the bestsellers in 2007. What a legacy to leave behind. In a letter to his wife Jai and his children, Dylan, Logan, and Chloe, he wrote this beautiful "Guide to a Better Life" for his wife and children to follow. May you be blessed by his insight.

Points on how to improve your life


• Don’t compare your life to others’. You have no idea what their journey is all about.
• Don’t have negative thoughts of things you cannot control. Instead invest your energy in the positive present moment.
• Don’t overdo; keep your limits
• Don’t take yourself so seriously; no one else does.
• Don’t waste your precious energy on gossip.
• Dream more while you are awake.
• Envy is a waste of time. You already have all you need.
• Forget issues of the past. Don’t remind your partner of his/her mistakes of the past. That will ruin your present happiness.
• Life is too short to waste time hating anyone. Don’t hate others.
• Make peace with your past so it won’t spoil the present.
• No one is in charge of your happiness except you.
• Realize that life is a school and you are here to learn. Problems are simply part of the curriculum that appear and fade away like algebra class but the lessons you learn will last a lifetime.
• Smile and laugh more.
• You don’t have to win every argument. Agree to disagree.


• Call your family often.
• Each day give something good to others.
• Forgive everyone for everything.
• Spend time with people over the age of 70 and under the age of 6.
• Try to make at least three people smile each day.
• What other people think of you is none of your business.
• Your job will not take care of you when you are sick. Your family and friends will. Stay in touch.


• Put GOD first in anything and everything that you think, say and do.
• GOD heals everything
• Do the right things
• However good or bad a situation is, it will change
• No matter how you feel, get up, dress up and show up
• The best is yet to come
• Get rid of anything that isn’t useful, beautiful or joyful
• When you awake alive in the morning, thank GOD for it
• If you know GOD you will always be happy. So, be happy.

While you practice all of the above, share this knowledge with the people you love, people you school with, people you play with, people you work with and people you live with. Not only will it enrich YOUR life, but also that of those around you.

Remember, good things are for us to share……!!!!!!
The exaggerated lepromin test seen in cases of Lucio phenomenon is called as:

a. Mitsuda’s reaction
b. Medina–Ramirez reaction
c. Fischer’s test
d. Fernandez reaction

Yesterday’s Mind Teaser: IRIS commonly occurs after how many weeks of ART initiation?

a. 1–4 weeks
b. 2–12 weeks
c. 12–24 weeks
d. After 6 months

Answer for Yesterday’s Mind Teaser: b. 2–12 weeks

Answers received from: Daivadheenam Jella, Dr Avtar Krishan, Sri hari reddy nallagatla, Dr.Bitaan Sen, Dr.Jayashree Sen

Answer for 12th December Mind Teaser: Weakness never begins in the arms or facial muscles

Answers received from: Daivadheenam Jella, Dr Avtar Krishan, Sri hari reddy nallagatla,
Readers column
Sir very nice information on health. Regards: Dr SP Shah
Student who obtained 0% on an exam

Q1. In which battle did Napoleon die?
A. His last battle

Q2. Where was the Declaration of Independence signed?
A. At the bottom of the page

Q3. River Ravi flows in which state?
A. Liquid

Q4. What is the main reason for divorce?
A. Marriage

Q5. What is the main reason for failure?
A. Exams

Q9. How can a man go eight days without sleeping?
A. No problem, he sleeps at night.

Q10. How can you lift an elephant with one hand?
A. You will never find an elephant that has only one hand.

Q13. How can you drop a raw egg onto a concrete floor without cracking it?
A. Any way you want, concrete floors are very hard to crack.
Press Release
Chennai Floods: Indian Medical Association and its digital partner Lybrate roll out initiatives to help flood hit victims

• Launch a toll-free helpline 1800 300 20672 on which people from the city can consult doctors for free

• People can also do consultation for free on the Lybrate mobile app and web using code CHENNAIRELIEF

New Delhi, Dec 13, 2015: To support the people of Chennai who are battling to bring their lives to normalcy post ravaging floods, Indian Medical Association along with its digital partner Lybrate, are offering free doctor consultation to the people of the city.

People based in Chennai and surrounding affected areas can consult doctors for free by calling on the Lybrate toll–free helpline number – – 1800 300 20672 or by using the coupon code CHENNAIRELIEF on its mobile app.

Supporting this this initiative, Padma Shri Awardee Dr. A Marthanda Pillai – National President, Padma Shri Awardee Dr. KK Aggarwal – Honorary Secretary General IMA & Dr. VS Surendran – State President, IMA Tamil Nadu branch said, "The devastating nature of the recent rains in Chennai and surrounding areas have left many homeless and suffering from severe healthcare complications. We are doing everything in our capacity to help make medical care available in the city through our local as well as State branches. We have also sent a team of volunteer doctors to assess the situation and provide emergency medical care. We also support this toll free number, which has been launched by our digital partner Lybrate offering free medical advice to patients. Together we hope that we can prevent all epidemics and help the city in all possible ways."

"The flood has dealt a crippling blow to the people of Chennai. We are leveraging our expertise of doctor consultation to help out the people of the city as remaining healthy once flood has receded is important. We are offering free doctor consultation to the people of the city and adjoining areas to ensure they can take help from healthcare experts in the most convenient manner," said Saurabh Arora, CEO, Lybrate.

The helpline will run for nine hours, starting at 9 in the morning and would be available for six days from Monday to Saturday.