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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 & 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

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eMediTube (videos), eMedipics, eMediSlide, eMediLaw


15th March 2013, Friday

Adult age 16 or 18

Of late there has been a debate about whether the adult age should be 16 or 18. Medically, there cannot be a line which divides an adolescent from an adult. It will always be a range.

Medically, we define age as either biological or chronological. Chronological age is calculated from the time of your birth but biological age is calculated depending upon how your body and hormones behave.

Chronological age is usually in legal terms validated with the bone age but calculation of bone age invariably will have some fallacies. Correct way to define age is pre-puberty and after-puberty. The age for the onset of puberty always will vary from person to person. The pre-puberty phase should be called as a childhood and post-puberty phase as adolescence. After the age of 18, one is an adult.

An adolescent before 18 and after the age of puberty in medical terms comes under the treatment of both the pediatrics and adults.

Therefore, this is a grey area where the person can behave both as adolescent and as an adult. It should be left to the doctors to decide whether he is physically or sexually mature to commit any crime or not.

The answer to the controversy at present medically is to call anybody above the age of 18 as an adult, upto the age of 16 and after puberty an adolescent between 16 to 18, a grey area where a panel of doctors should decide whether he should be called an adolescent or an adult.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Rhinitis medicamentosa

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

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

Dr K K Aggarwal
    National News

CEA to have doctor-friendly rules in the Act

To a delegation of IMA lead by Dr. N. Saini, Honorary Secretary General IMA, Mr. Brijesh Pathak, Chairman Department Related Parliamentary Standing Committee on Health and Family Welfare said that–

  • IMA suggestions for union health budget will be taken up in the departmental budget debate in parliament.
  • IMA’s viewpoint on MCI dissolution will be raised in the parliament.
  • IMA’s view on BSc Community Health Course will also be taken up and rules under CEA will be doctor-friendly.

He also assured that he would take up issues like non-payment of the liabilities of the RNTCP IMA project IMA recommendation on generic drugs and the problems faced by medical profession on issues related service doctors and PNDT Act.

For comments and archives

NEET PG Update

Dr Narender Saini

As per the directions of the H'ble Supreme Court of India and the guidance of the Medical Council of India, an amendment was made in the Post-Graduate Medical Education Act and published in Gazette of India .According to it, a single entrance examination was to be conducted from the session 2013 for admission to all post-graduation courses in all medical colleges of India, government and private alike, and was to be called National Eligibility Entrance test (NEET-PG).This decision was welcomed by all medicos. It saved us from the hassles and the expenses of appearing for the various entrance exams which were earlier conducted between the months of November to March. The biggest advantage was that it standardized the admission procedure and made it transparent especially with regards to the admission criteria and proceedings of various private institutions.

The National Board of Examination (NBE) conducted an online computer based test for NEET-PG 2013 in the months of November and December for which more than 90,000 students appeared. NBE announced that the results will be announced by 31st January, 2013. But the problem began when a group of private, aided, unaided, minority and some State institutions (as of now more than 90) filed a petition in the H'ble Supreme Court questioning the credibility of MCI as the regulatory body of medical education. The case has been going on since December and is being heard by a bench headed by H'ble Chief Justice Altamas Kabir. Meanwhile the H'ble Supreme Court has allowed all the Institutions to go ahead with their respective entrance exams and also has put a stay order on all the results including that of NEET-PG. The case has been going on since then and no verdict has been passed till now and neither the stay on the results has been lifted. This has an immense impact on the morale of about 90,000 doctors of our country.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Trafficking Vs Prostitution

Prostitution means the sexual exploitation or abuse of persons for commercial purposes. Trafficking, unlike prostitution, is not merely as a moral or law enforcement problem, but also involves human rights violation linked to gender discrimination and disparity in development.

For comments and archives

    Valvular Heart Disease Update

Echocardiographic screening of first-degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Repeat MRI no help after sciatica Tx

Follow-up MR images obtained among patients treated for sciatica found no discernible benefit for the repeat imaging study, researchers found. (Source: Medpage Today)

Weight gain in smokers who quit is OK for the heart

Weight gained after someone quits smoking has no effect on the cardiovascular benefits of butting out, at least among people without diabetes, researchers reported. (Source: Medpage Today)

ACC: BNP screen may halt heart failure

Screening asymptomatic patients at risk for heart failure and intervening based on B-type natriuretic peptide (BNP) status may help prevent heart failure, Irish researchers reported at the American College of Cardiology meeting. (Source: Medpage Today)

ACC: PTSD linked to metabolic syndrome

Patients diagnosed with post-traumatic stress disorder (PTSD) have a higher incidence of insulin resistance and metabolic syndrome than people without the disorder, increasing their risk of heart disease and diabetes, researchers reported at the American College of Cardiology meeting. (Source: Medpage Today)

FDA warns of arrhythmias with azithromycin

Patients with certain risk factors may be subject to life-threatening cardiac arrhythmias when taking azithromycin (Zithromax, Zmax), the FDA said Tuesday. Existing QT prolongation, bradycardia, and low blood levels of magnesium or potassium are among the risk factors associated with the threat, according to an FDA drug safety communication posted on the agency's website. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: How to get rid of negative thoughts http://blog.kkaggarwal.com/2013/03/how-to-get-rid-of-negative-thoughts/ …

@DeepakChopra: One of the most challenging obstacle addicts face is relapse. Pls read this article of our addiction expert

    Spiritual Update

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

How to get rid of negative thoughts

Darkness is absence of light and similarly negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring positive thoughts back. An ideal mind is the devil’s workshop and will always think negative.

For comments and archives

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

What are the symptoms of ectopic pregnancy?

Delayed or abnormal menstruation can be an early sign of an ectopic pregnancy. If pregnancy is confirmed, early abnormal levels of human chorionic gonadotropin (hCG), pelvic pain, and/or irregular bleeding in the first weeks of pregnancy can indicate an ectopic pregnancy. Till recently, ectopic pregnancies were often not diagnosed until 6 to 8 weeks into the pregnancy, when the patient was experiencing pelvic pain, irregular vaginal bleeding, possible internal bleeding and a tender feeling in the pelvis. Under these circumstances, this represented a life–threatening emergency, and major surgery (laparotomy) was required to remove the pregnancy and control bleeding.

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

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

Dietary recommendations in anemia

  • Improve food choice to increase amount of total dietary iron
  • Include a source of vitamin C at every meal
  • Include (meat, fish, poultry) at every meal if possible
  • Avoid drinking large amounts of tea or coffee with meals (both contain tannin)

Note: A high protein diet (1.5g/kg body weight) is desirable both for liver function and blood regeneration.

For comments and archives

   An Inspirational Story

Stock Market - Explained With Monkeys

Once upon a time in a village, a man announced to the villagers that he would buy monkeys for Rs 10. The villagers, seeing that there were many monkeys around, went out to the forest and started catching them.

The man bought thousands at Rs 10/- and as supply started to diminish, the villagers stopped their effort.

He further announced that he would now buy at Rs 20/-. This renewed the efforts of the villagers and they started catching monkeys again.

Soon the supply diminished even further and people started going back to their farms. The offer rate increased to Rs 25/- and the supply of monkeys became so little that it was an effort to even see a monkey, let alone catch it!

The man now announced that he would buy monkeys at Rs 50! However, since he had to go to the city on some business, his assistant would now buy on behalf of him.

In the absence of the man, the assistant told the villagers. Look at all these monkeys in the big cage that the man has collected. I will sell them to you at Rs 35 and when the man returns from the city, you can sell it to him for Rs 50."
The villagers squeezed up with all their savings and bought all the monkeys.

Then they never saw the man nor his assistant, only monkeys everywhere!

For comments and archives

   Cardiology eMedinewS

STREAM: First success for fibrinolysis before transport to PCI Read More

SELECT-ACS: Hints of myocardial sparing with inclacumab in NSTEMI Read More

   Pediatric eMedinewS

Pertussis incidence rises as fifth DTaP dose immunity wanes Read More

    Rabies Update

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

Is there a seasonal variation in dog bite cases?

Maximum dog bites are observed in the autumn months. It is observed that there is an increase during warm-weather months (May through August) and a corresponding decrease during colder months (November through March).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with laryngopharyngeal reflux was not responding.
Dr. Bad: Increase the drugs.
Dr. Good: What diet do you take?
Lesson: Foods and beverages containing caffeine (coffee, tea, sodas, etc), alcohol, chocolate and peppermints weaken the protective esophageal sphincters that normally hold stomach contents in the stomach and esophagus.

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh by God! Why was additional insulin given?
Lesson: Make sure that the insulin dose is correctly calculated. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

  Quote of the Day (Dr GM Singh)

Don't read success stories....you will only get a message; read failure stories...you will get some ideas to get success. Dr. APJ Abdul Kalam

    Mind Teaser

Read this…………………

A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, nurse Sarah knows that the client is most likely to experience:

a. hematuria.
b. weight loss.
c. increased urine output.
d. increased blood pressure.

Yesterday’s Mind Teaser: What is the number one cancer killer of women?

A. Colon cancer
B. Breast cancer
C. Lung cancer
D. Cervical cancer
E. Esophageal cancer

Answer for yesterday’s Mind Teaser: C. Lung cancer

Correct answers received from: Dr Bharat Bhushan Aggarwal, Dr PK Sahu, Dr Jella, Dr BB Gupta, Dr Shashi Saini, Dr PC Das, Dr B Srinivas, Anil Bairaria,
Dr KV Sarma, Dr Avtar Krishan, Dr Jainendra Upadhyay, Raju Kuppusamy,
Dr Chandresh Jardosh, Dr Jayashree Sen & Dr Bitaan Sen, Muthumperumal Thirumalpillai, Pushpa, Dr Kanta Jain.

Answer for 13th March Mind Teaser: Accepting the treatment decisions of the medical and nursing team.

Correct answers received from: Raju Kuppusamy, Dr Chandresh Jardosh,
Dr Jayashree Sen & Dr Bitaan Sen, Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

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

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    Laugh a While (Dr GM Singh)

Solitary Confinement

Three guys are convicted of a very serious crime, and they're all sentenced to 20 years in solitary confinement.

They're each allowed one thing to bring into the cell with them.

The first guy asks for a big stack of books. The second guy asks for his wife.

And the third guy asks for two hundred cartons of cigarettes.

At the end of the 20 years, they open up the first guy's cell. He comes out and says, "I studied so hard. I'm so bright now, I could be a lawyer. It was terrific."

They open up the second guy's door. He comes out with his wife, and they've got five new kids. He says. "It was the greatest thing of my life. My wife and I have never been so close. I have a beautiful new family. I love it."

They open up the third guy's door, and he's slapping at his pockets, saying "Anybody got a match?"

    Medicolegal Update

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

Medicine and law have been interrelated from the earliest times as per Gradwohl’s Legal Medicine. The role of the doctor and the police is nothing but like a solitary person, sage, Qazi and priest. They are an intermediary between God and man. The purpose of medicine is to maintain the patient in the best health, to overcome his diseases, injury and to lengthen his healthy life. The purpose of law is to maintain peace and order in the society, respect of humans through human rights and to provide equality of opportunity. To achieve these purposes medicine emerges from the laboratory by the scientific process and law emerges from the society by the process of experience.

"People follow medicine and Law follows people".

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Act fast: You can reduce the Damage and Death from Heart Attack if……?

Water–soluble aspirin and clot-dissolving drugs can stop most heart attacks in progress, reduce disability and save lives. They work best if given within one hour of when signs of heart attack begin to appear. It is therefore important to recognize the warning signs of a heart attack and act right away, said Padma Shri & Dr. B C Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

Every year, over 24 lakh people die of heart attacks in India. About half of those deaths take place within one hour of the onset of warning signs and before the patient ever reaches a hospital, added Dr Praveen Chandra, Chairman, Interventional Cardiology at Medanta – The Medicity.

The 5 warning signs of a heart attack, which everybody must know are:

  1. Pain or discomfort in the jaw, neck or back.
  2. Feeling weak, lightheaded, or faint.
  3. Chest pain or discomfort.
  4. Pain or discomfort in the arms or shoulder.
  5. Shortness of breath

Act fast

  1. Take 300 mg water–soluble aspirin and chew it if a heart attack is suspected.
  2. Get yourself rushed to a nearest heart centre for clot–dissolving therapy.
  3. You may require an emergency angiography and angioplasty to remove the clot.
  4. If there is a cardiac arrest, the bystander should follow the CPR 10 mantra: “within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 31112 people since 1st November 2012

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

    Readers Response
  1. Dear Sir, We are gaining lot of information from emedinews. Regards: Dr Shalu
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