emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL 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 and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee 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

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

 
  Editorial …

15th May 2012, Tuesday

Death risks higher for heart attack survivors living near major roadways

Heart attack survivors who live about 100 meters or less from a major roadway face increased risk of death from all causes, according to new research in the American Heart Association’s journal Circulation.

In the Determinants of MI Onset Study of 3,547 heart attack survivors (average age 62), researchers found:

  • Those living less than 100 meters from the roadway have a 27 percent increased risks of dying over 10 years than those living at least 1,000 meters away.
  • Those living 100 to 199 meters from the roadway have a 19 percent increased risks of death.
  • Those living 200 to 999 meters from the roadway have a 13 percent increased risk of death.

There is exposure to a combination of air pollution near these roadways and other exposure, such as excessive noise or stress from living close to the roadway, that may contribute to the study findings," said Murray A. Mittleman, M.D., Dr. PH, study author and director of the Cardiovascular Research Unit at Beth Israel Deaconess Medical Center in Boston, Mass.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Death risks higher for heart attack survivors living near major roadways

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day organized at DPS Mathura Road

World Earth Day was celebrated by Heart Care Foundation of India jointly with Delhi Public School

 
Dr K K Aggarwal
 
    National News

Kala–azar patients to be paid for wage loss

PATNA: The state government has been working actively on a novel move to compensate the loss of minimum wage suffered by kala–azar patients from poor and humble background admitted in various government hospitals of the state for treatment. The money required for the purpose would be raised with that provided from the CM Relief Fund (CMRF). Confirming this on Sunday, state health department secretary and Bihar State Health Society (BSHS) executive director Sanjay Kumar said, "Yes, it is under active consideration of the government and health department. The money for the purpose will come from the CMRF." While the formal decision with regard to providing succour to kala–azar patients from humble background to make minimum wage loss compensation to them has not yet been taken, the process in this regard has already started and the details were being worked out. As Kumar put it, each poor kala–azar patient being treatment in government hospital and his or her attendant would get Rs 151 per day by way of compensation for the loss of minimum wage, since the person concerned, in normal circumstances, would have been engaged in some work to eke out a living. "The aim is two–fold: to help the patient and to induce the families concerned to admit patients in hospitals, which, in turn, will increase the reportage of hidden or unidentified kala–azar cases in the state," Kumar said. Kumar said barring the seven districts of Bihar –– Kaimur, Rohtas, Aurangabad, Gaya, Nawada, Jamui and Banka –– having common border with Jharkhand, the remaining 31 districts have reported cases of kala-azar. However, of the 31, eleven districts, including Sitamarhi, Araria, Kishanganj, Vaishali, Muzaffarpur, East Champaran and Gopalganj, are most affected. (Source: TOI, May 14, 2012)

For comments and archives

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

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Antibiotics in environment fuel drug resistance?

Antibiotics found in river sediment, farmed soil, and other sources are polluting the environment and contributing to the rising rates of antibiotic resistance, a new report suggests. Antibiotic resistance occurs when a bacteria grows immune to the effect of an antibiotic or class of antibiotics. It has been called one of the world’s greatest health threats by the CDC, the FDA, and the World Health Organization. New research in Environmental Health Perspectives analyzed how antibiotics in the environment affect illness–causing bacteria including E. coli. The researchers found that antibiotic pollution in the environment has led to the proliferation of resistant bacteria. (Source: Medscape)

For Comments and archives…

Sun safety still not strong among the young

Young adults continue to risk developing skin cancer, despite some improvements in protective behavior, according to two analyses by the National Cancer Institute and the CDC. One longitudinal analysis found that about half of young adults are still getting at least one sunburn a year, even though more are using sunscreen and staying out of the sun, the agencies reported in the May 11 issue of Morbidity and Mortality Weekly Report. (Source: Medpage Today)

For Comments and archives…

Cancer associated with liver fluke undergoes genetic sequencing

Cholangiocarcinoma accounts for 10% to 25% of all primary liver cancers worldwide, and generally has a very poor prognosis. In certain parts of Southeast Asia, infection with the liver fluke Opisthorchis viverrini is a major public health problem and is associated with the development of cholangiocarcinoma. In a letter published online May 6 in Nature Genetics, researchers provide some insight into the "mutational landscape" that contributes to the development of O viverrini–related cholangiocarcinoma. (Source: Medscape)

For Comments and archives…

FDA Panel gives nod to new diet drug

An FDA advisory committee has voted 18–4, with one abstention, in favor of approving lorcaserin hydrochloride (Lorqess) as the first new weight–loss drug in more than a decade. The FDA’s Endocrinologic and Metabolic Drugs Advisory Committee on Thursday afternoon voted that the benefits of lorcaserin outweigh its risks, despite the modest weight loss provided by the drug and a lack of data to rule out heart valve issues. If approved, lorcaserin would be an option for those with a BMI of 30 or more, or a BMI of 27 with comorbidities related to obesity. (Source: Medpage Today)

For Comments and archives…

Vitamins B and E may relieve benign persistent breast pain

Vitamins E and B complex appear to alleviate benign persistent breast pain: in a recent controlled trial, 90.2% of women who took the vitamins were pain free after one month, compared to 9.8% of the control group. Dr. Christine Joy J. Aguirre–Trespeces, a general surgeon who led the study at Rufino Oro Iloilo Doctors’ Hospital in Iloilo City, the Philippines, told Reuters Health by email, "I would strongly recommend the use of low dose vitamin B complex 46 mg plus vitamin E 200 IU" for benign breast pain. (Source: Medscape)

For Comments and archives…

 
    Twitter of the Day

@DrKKAggarwal: Can Herbs Harm? TOI reported that a corporate executive landed in the emergency with palpitations after… ?. http://fb.me/1uo7v1SBC

@DeepakChopra: Life brings challenges, but step back for a moment and ask the deeper question. Why is life so difficult?

 
    Spiritual Update

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

Sachin’s Entry into the Rajya Sabha

Vedic science teaches us the concept of non–violent communication in making one happy and healthy. Of late, we have seen a lot of people commenting on first as to when Sachin Tendulkar should retire and recently whether he should or should not have accepted entry into the Rajya Sabha.

For Comments and archives…

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the psychological implications of Infertility?

Infertility is a medical condition that has many emotional aspects. Feelings such as anger, sadness, guilt, and anxiety are common and may affect your self esteem and self–image. You may find it difficult to share your feelings with family and friends, which can lead to isolation. Coming to a joint decision with your partner about goals and acceptable therapies is important. Setting endpoints for therapy may also be advisable.

For Comments and archives…

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

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

Leukocyte-depleted red cells

Description

  • Minimizes white cell immunizations in patients receiving repeated transfusions but, to achieve this, all blood components given to the patient must be leukocyte–depleted
  • Reduces risk of CMV transmission in special situations
  • Patients who have experienced two or more previous febrile non–hemolytic reactions to red cell transfusion

Contraindications: Will not prevent graft–vs–host disease; for this purpose, blood components should be irradiated where facilities are available (radiation dose: 25–20 Gy)

Administration

  • Same as whole blood
  • A leukocyte filter may also be used at the time of transfusion if leukocyte–depleted red cells or whole blood are not available

Alternative

  • Buffy coat–removed whole blood or red cell suspension is usually effective in avoiding febrile non–hemolytic transfusion reactions
  • The blood bank should express the buffy coat in a sterile environment immediately before transporting the blood to the bedside
  • Start the transfusion within 30 minutes of delivery and use a leukocyte filter, where possible
  • Complete transfusion within 4 hours of commencement

For Comments and archives…

 
    An Inspirational Story

(Dr GM Singh)

Listening… at Christmas and always

A few years after I left my secondary school in Manchester, I was invited to help out with the school’s Christmas Fair and I decided to have a go at being Father Christmas. I had recently grown my first full beard and thought that I would enter into the role by rubbing flour into my growth. Though I say it myself, I looked rather splendid and certainly I attracted lots of custom.

I was enjoying myself enormously, bringing a sense of magic to so many young children, but I was mystified by one young boy who paid for a second visit and then astonishingly for a third. The presents on offer were really pretty pitiful, so I asked him why he was coming to see me so often. He answered simply: "I just love talking to you".

It was then that I realized that, in many households, parents do not encourage their children to talk and really listen to them. This was a lesson that I have taken with me throughout my life. So, at home, at work, socially, always encourage family, friends, colleagues to talk about themselves and their feelings – and really listen.

Author: Roger Darlington

For Comments and archives…

 
   Cardiology eMedinewS

Shut ICD Off In Terminal Care Read More

Extra Weight In Midsection May Be Linked To Increased Risk Of SCD.
Read More

Statins May Help Elderly Patients With Hypertension Avoid Developing Afib. Read More

Titrating Beta–Blockers Likely Improves Outcomes in HF Patients with Systolic Dysfunction Read More

 
   Pediatric eMedinewS

Co–Sleeping May Protect Children From Weight Gain Read More

Causes Of Kids’ Disability Less Likely Physical Read More

Drug Info On Pediatric Use Still Lacking Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: An asymptomatic patient with no obvious underlying cardiac disease shows ventricular premature contractions (VPCs).
Dr. Bad: Anti–arrhythmics should be given.
Dr. Good: No treatment is needed.
Lesson: In the absence of cardiac disease, isolated asymptomatic VPCs regardless of configuration and frequency need no treatment.

For comments and archives

Make Sure

Situation: A patient with fever developed melena.
Reaction: Oh my God! why was platelet count not done?
Lesson: Make sure in all patients with fever, platelet counts are done.

For comments and archives

 
  Legal Question of the day

(Prof. M C Gupta, Advocate & Medico–legal Consultant)

Q. I have my own nursing home where I perform all Gyn–Obs procedures. I have done Dip.GO (Dr Dawn). Can I face some problem legally?

Ans.

  1. My understanding is that what is usually referred to as "Dawn DGO" is not recognised by the MCI.
  2. A complaint made against you to MCI can result in your being punished by the MCI/SMC.
  3. Such punishment can come handy to a patient who files a complaint against you in a consumer court.

For comments and archives

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  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Post–exposure chemoprophylaxis when source patient is drug–naïve

Basic regimen:

2 drugs (NRTIs)

(4 weeks therapy)

Zidovudine (AZT/ZDV) 300mg twice–daily is used for all types of exposure

+

Lamivudine (3TC) 150 mg twice–daily is added to increase the effectiveness of ZDV and to prevent resistance to ZDV

Both the drugs need to be given. A combination drug of both is available. Dose is one tablet twice–daily

Alternatives: Stavudine (d4T) 30–40mg twice a day + 3TC

Consider:

Tenofovir (TDF) + Emtrictabine (FTC) (Cases of suspected resistance – consult expert on HIV medicine)

Expanded regimen:

3 drugs (2 NRTIs + PI)

(4 weeks therapy)

Basic regimen (AZT/ZDV + 3TC)

+

Nelfinavir 750 mg thrice–daily or any other protease inhibitor (for higher risk categories – consult expert on HIV medicine)

Alternative: basic regimen+ any of PIs (boosted with Ritonavir† when possible): Lopinavir, Indinavir, Atazanavir, Saquinavir, Fosamprenavir

(For resistance – consult expert on HIV medicine)

†Requires cold chain

Drugs not recommended for PEP: ddI and D4t together; Nevirapine.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Time is free, but it's priceless. You can’t own it, but you can use it. You can’t keep it, but you can spend it. Once you’ve lost it you can never get it back. Harvey MacKay

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Fructosamine

  • To help monitor your blood sugar over time, especially if it is not possible to monitor using the A1c test
  • To help determine the effectiveness of changes to your diabetic treatment plan.
 
    Mind Teaser

Read this…………………

A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:

a. Ineffective health maintenance
b. Impaired skin integrity
c. Deficient fluid volume
d. Pain

Yesterday’s Mind Teaser: Nurse hazel receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following?

a. Liver disease
b. Myocardial damage
c. Hypertension
d. Cancer

Answer for Yesterday’s Mind Teaser: b. Myocardial damage

Correct answers received from: YJ. Vasavada, Dr Sushma Chawla, Niraj Gupta, Rajiv Kohli, Dr LC Dhoka, Chandra Pal Singh, Dr PC Das, Mannalal Bhansali, Dr Ragavan Sivaramakrishnan Moudgalya,
Dr Prabha Sanghi, Dr M Dutta, Dr Kanta Jain, Dr Thakor Hitendrsinh G, Dr BB Aggarwal, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Raju Kuppusamy, Dr SK Verma, Dr Avtar Krishan, Anil Bairaria,
Dr Amol Hartalkar.

Answer for 12th April Mind Teaser: c. Elevate the scrotum using a soft support
Correct answers received from: Dr LC Dhoka, Dr R ajendra Maskara, Dr M Dutta, Dr Thakor Hitendrsinh G, Dr BB Aggarwal, Muthumperumal Thirumalpillai, Dr PC Das.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

A man dies and goes to Heaven. He gets to meet God and asks God if he can ask him a few questions. "Sure," God says. "Go right ahead."
"OK," the man says. "Why did you make women so nice?"
God says, "So you would like them."
"OK," the guy says. "But how come you made them so beautiful?"
"So you would LOVE them," God replies.
The man ponders a moment and then asks, "But why did you make them such airheads?"
God says, "So they would love you back!"

 
  Medicolegal Update

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

Private Doctors can treat and report in MLC Cases: High Court

The foremost legal and ethical duty of doctor is to attend and treat the injuries and health of the patient/person produced before him. His primary effort should always be to save the life of the patient and then inform the police; but, all the injuries/findings observed by him must be documented clearly in medicolegal cases (MLCs). This means that the duty of the doctor to provide medical aid, even in MLCs, has been extended to the private doctors and has also been authenticated in many government orders and honorable courts.

Private doctors should not hesitate to entertain the MLC. But, after completing medical examination/treatment, a medicolegal report should be prepared as early as possible to avoid after–thought allegation. They should be prepared in duplicate, preferably with a ballpoint pen, in a clear and legible hand. Cutting/overwriting, etc. should be avoided as much as possible and all corrections should be properly initialed. Abbreviations of any sort should be avoided. A medicolegal register should be maintained in the casualty of every hospital and details of all MLCs should be entered in this register, including the time and date of examination and the name of the doctor who is dealing with the case. This would be of immense help for future reference, when the patient through the court/the police, requests for a copy of the medico legal report.

(Ref: Pattipati Venkaiah Vs State of Andhra Pradesh. 1985)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Side effects of certain drugs increase emergency room visits by elderly

Side effects from just three drugs are responsible for a full third of all emergency room visits by senior citizens who had adverse reactions to medications, said Padma Shri and Dr B C Roy Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

In 2004 and 2005, in the US, the blood thinner warfarin, the diabetes drug insulin and the heart drug digoxin caused about 58,000 emergency room visits a year in those 65 and older.

The major problem is that it’s hard to determine the correct dose for each drug.
The researchers looked at several surveys of emergency room visits from 2004 and 2005. The study findings are published in the journal Annals of Internal Medicine.

Forty-one drugs are on the list –– called the BEERS criteria –– of medications considered inappropriate for the elderly. But they accounted for just 3.6 percent of a total of about 177,000 annual emergency room visits.

Warfarin, insulin and digoxin (which have a number of trade names) posed many more problems. All three medications are well–known, commonly used drugs and all can create problems in some cases.

Warfarin, often prescribed to heart patients, prevents blood clots by thinning the blood, but can cause excessive bleeding if the blood becomes too thin. Insulin treats diabetes but can sometimes cause blood sugar levels to drop to dangerous levels. And digoxin, a long–used drug, can cause a variety of problems from nausea to erratic heartbeats.

Doctors can monitor the levels of all three drugs with blood tests.

 
    Readers Response
  1. Dear Dr, heat stroke and exhaustion are common in people with mental illness who are on regular medication. in the last ten years we found deaths are more in mentally ill patients during summer due hypothalamus; s dysfunction in heat management.the thermostat in the brain is affected for people taking antipsychotic medication. we have started displaying boards during summer in our clinic like this "BEWARE OF SUMMER" and tips to minimise the heat stroke. Dr.R.Mani, Chennai
 
    Forthcoming Events
Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

HCFI
Activities eBooks

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  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta