emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
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; Member 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


15th May, Saturday, 2010

Dr Desai Denied Bail Again

Dear Colleague

The judicial custody of Dr. Desai, who appeared in the Patiala House court on Friday, was extended till the 28th of this month, when the matter will come up for hearing again. His bail application is also listed in the High Court for 3rd June.

In the mean time the government is all set to dissolve the 150-member MCI by a special emergency ordinance in the next few days. Being a full time job, it is to be seen who are the seven members who will run the council for the next one year till it is rectified by the Parliament or a new MCI is constituted. It is also to be seen who amongst the seven members becomes the chairman and the vice chairman of the council.

It is probable that unlike last time, Dr. Desai is not going to get the support of any Minister or Member of Parliament. It is equally likely that Dr. Desai's resignation may not be accepted and he may be terminated from the post of President MCI.

The government is also set to make a 5-member overarching body to head all the councils together (Dental, Medical, ISM, Nursing, Pharmacy) etc.

In the seven member team expected names are Dr. Venugopal, Dr. K S Reddy, Dr. P N Tandon, Dr. K K Talwar and  Dr. R C Deka, Dr. R Panda,  Dr. M S Valiathan, Dr. Rajendra A Badve and Dr. Devi Shetty.  It was also in the news that some of the members had shown their inability to spend expected time.

 

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor

 

Photo Feature (From HCFI file)

Cricket Bat and Wickets for Health Awareness

A cricket bat and wickets are an indispensable part of a cricketer's life. Heart Care Foundation of India invited Mr. Manoj Prabhakar, Mr. Gautam Gambhir and Mr. Surender Khanna in the press conference of Perfect Health Mela 2005, where a bat and wickets with health messages and Perfect Health Mela information were released.

Dr k k Aggarwal

International Medical Science Academy Update (IMSA): Practice Changing Updates

Arthrosclerosis

Ezetimibe may not be as helpful for arthrosclerosis as internists always assumed it was. (N Engl J Med 2009;361:2113–22)

DMC Update

Is a medical certificate issued by a doctor not registered with DMC, a valid certificate?

No. In order DMC/DC/F.14/Comp.280/2/2006 dated 15th February, 2006 DMC wrote to MCI in response to a letter of Shri SKM AO RML Hospital seeking clarification as to the credibility of medical certificates issued by Shri DSL of Chaudhary Ramdhan Lakra Memorial Hospital Hiran Kudna: the council observed "With reference to your letter No. MCI–211(2)(10)/2006–Ethics/24037 dated 3.2.2006 on the subject noted above, it is informed that Shri Dharam Chand Lakra is not registered with the Delhi Medical Council, hence, any medical certificate issued by him is not a valid document".

News and Views

Variation in BP linked to CVD

If the blood pressure fluctuates up and down over time, you may be at increased risk of cerebrovascular disease. In a cohort study, the risk of cerebrovascular disease (including infarcts and white matter hyperintensity volume) was greater in hypertensive individuals aged 65 years and above. A marked variation in BP across three separate measurements two years apart also put them at higher risk. (Adam Brickman, PhD, Columbia University’s College of Physicians and Surgeons)

Anti–Reflux Drugs Linked to Cardiac Birth Defects

The use of proton pump inhibitors for gastroesophageal reflux disease during pregnancy may be associated with cardiac birth defects, according to research presented at Digestive Disease Week 2010, held from May 1 to 5 in New Orleans.

Kidney Disease Therapy May Increase Cardiovascular Risks

For patients with chronic kidney disease, therapy with erythropoiesis–stimulating agents that target higher levels of hemoglobin increases the risk of stroke, hypertension and thrombosis, according to a meta–analysis published online May 3 in the Annals of Internal Medicine.

Nuts Lower Lipids

Eating nuts improves blood lipid levels, which may help ward off heart disease, researchers found. In a pooled analysis of 25 intervention trials, eating an average of 67 grams of nuts a day (2.4 ounces) reduced total cholesterol by 5.9% and LDL cholesterol by 7.4% (P<0.001 for both). (May 10, 2010 issue of Archives of Internal Medicine)

Quote of the Day

"If you’re sincere, praise is effective. If you’re insincere, it’s manipulative". Zig Ziglar

Mnemonics of the Day (Dr Prachi)

Use of Prophylactic antibiotics – APPLE

Amputations,
Prosthesis,
Penetrating wounds,
Large bowel surgery
Endocarditis

Question of the Day

What is the duration of treatment for ventilator–associated pneumonia?

All patients with HAP, VAP or HCAP should be evaluated after 72 hours of initial empiric antimicrobial therapy.  If the patient has improved after 72 hours, and a pathogen is isolated, antimicrobial therapy should be changed to a pathogendirected regimen based upon the susceptibility pattern.
Therapy should be continued to complete a total course of seven days. Treat upto 15 days if P. aeruginosa is the etiologic agent. If the patient has improved and no pathogen is identified, narrow the regimen, discontinuing therapy for Pseudomonas spp and MRSA.  If the patient has not improved at 72 hours and a resistant pathogen is identified, therapy can be changed to pathogen–directed treatment based upon the susceptibility pattern. In addition, failure to improve at 72 hours should prompt a search for infectious complications, other diagnoses or other sites of infection.

Suggested reading

1. Guidelines for the management of adults with hospital–acquired, ventilatorassociated, and healthcare–associated pneumonia. Am J Respir Crit Care Med 2005;171:388.

eMedinewS Try this it Works: Preventing niacin flush

Side effects can be avoided if the patient takes aspirin (usually 2 to 5 grains) before taking the niacin.

Dr Good Dr Bad

Situation: A patient with diabetic ketoacidosis (DKA) was admitted in ICU.
Dr Bad: Start low–dose insulin.
Dr Good: Start low–dose insulin and fast IV saline.
Lesson: Because patients with DKA are invariably dehydrated, priority should be given to fluid administration and the correction of electrolyte deficiencies.

Make Sure

Situation: A 49–year–old male was admitted in ICU with marked hyponatremia, high grade fever, diarrhea, cough, dyspnea and was not responding to beta-lactam drugs.
Reaction: Oh my God! Why did you not put the patient on macrolides along with beta-lactam drugs?
Lesson: Make sure to remember that seriously ill, ICU–hospitalized patients should always receive a macrolide in addition to beta-lactams to cover legionella.

IMANDB Joke of the Day (Dr Tarun Gupta)

CANDOR

Jeanette was wearing a new frock when her dearest friend called.
"I look a perfect fright," she remarked, eager for praise.
The dearest friend was thinking of her own affairs, and answered absent–mindedly:"Yes, you certainly do."
"Oh, you horrid thing!" Jeanette gasped. "I’ll never–never speak to you again!"

Formulae in clinical practice

Oxygen Uptake (VO2)

Formula: Vo2 = (CaO2 – CvO2) CO. × 10 = 1.39 (SaO2 – SvO2) × CO. × 10 Normal value: 150–400 ml/min.

Myth of the Day: Dr Gurinder Mohan Singh

Myth: Reading in dim light will worsen your vision

Fact: Though reading in dim light may not adversely affect eyesight, The eyes will get tired sooner. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is the best possible arrangement. A light shining over the shoulder causes a glare and make its more difficult to see the reading material.

Milestones in Gabapentin

1994: Parke–Davis company discovered effectiveness of Gabapentin in treating epilepsy.

Lab Test (Dr Arpan Gandhi and Dr Navin Dang)

Protein C and Protein S

To help evaluate a thrombotic episode; to determine whether you may have an inherited or acquired Protein C or Protein S deficiency.

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

DCI Approval Date

Nifedipine 0.3% + Lidocaine1.5% cream

For the treatment of anal fissures

26.02.09

DMC DMA Update

DMA has written to chief minister of Delhi to clear the name of DMA representative to the DMC at the earliest or DMA will stop its association with all Delhi Govt. projects. DMA had elected Dr Ashwini Dalmiya for the post. The Govt. had put the election results on hold for the last many months.

IMA update

The name of Dr Ketan Desai still lists on every page of IMA website (except the cover page) as President MCI even though he has resigned from the post.

Public Forum (Press Release for use by the newspapers)

Two or more drugs may interact with each other

Two or more prescription or over–the–counter drugs interact negatively with each other and cause adverse drug reactions, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India. To reduce the risk of drug reactions, one must follow the following guidelines:

  1. Read labels carefully.
  2. Understand the ingredients in each drug.
  3. Understand any possible side effects they can cause.
  4. Before taking a drug speak with the doctor or pharmacist if you don’t understand the drug label.
  5. Make sure the doctor is aware of all the drugs you are taking.
  6. Don’t mix pills.
  7. Don’t break capsules into any food or drink.
  8. Don’t take any medication with alcohol.
  9. Don’t take medication at the same time as vitamins or mineral supplements.

Readers Responses

  1. Sir, There is some printing mistake in eGFR formulae. 14 in place of 140 has been printed in 12th May 2010 emedinews. Dr Rajendra Kumar eMedinewS Responds: its 140–age × weight in Kgs/ 72 × serum creatinine.

  2. Congratulations on excellent reporting of facts. Hope GOD keeps giving you courage to live by your conscience and keep doing good for the society. KK, you are an icon in your own right and the name given to you by your parents should be enough encouragement for for you to stand by the TRUTH. May GOD empower you. I remain your friend: Ashish
     
  3. Dear Dr Aggarwal, information on travellers diarrhoea is very useful, With warm regards, Yours sincerely Dr Anup Dhir, M.Ch (Plastic Surgery), Senior Consultant Apollo Hospital, Secretary Indian Association of Aesthetic Plastic Surgeons, cosmetic plastic surgeon & andrologist.
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eMedinewS–Padma Con 2010

Will be organized at
Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

 
 

eMedinewS–revisiting 2010

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