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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; 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

  Editorial ...

15th September, 2010, Wednesday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Making healthful food choices (harvard newsletter)

  • Limit liquid sugars. Liquid sugars, which are found in soft drinks, sports drinks, iced teas, and sweetened waters, have no benefits for health and are clearly linked to higher risk of obesity, diabetes, and perhaps heart disease. There is no reason to include these in your diet. Skip the sugary drinks and have some unsweetened tea or sparkling water instead.
  • Minimize refined carbohydrates. Highly processed wheat, rice, and other grains have the same effects in the body as table sugar. So minimize your intake of white bread, French fries, most breakfast cereals, and most high–carbohydrate packaged and processed foods, such as pretzels and chips. Instead, choose whole grains, high–fiber breakfast cereals, brown rice, steel–cut oats, and fruits and vegetables.
  • Choose healthy fats. Fish, nuts, and vegetable oils contain healthy monounsaturated and polyunsaturated fats, which help lower heart disease risk. Eat these foods regularly and in moderation. Don’t get caught up in the "low–fat" craze (for example, low-fat salad dressing) as you will be limiting your intake of these good fats and will likely instead be eating a diet high in refined carbohydrates. Limit saturated fat and cholesterol, and especially avoid eating trans fat, found in partially hydrogenated vegetable oils.
  • Don’t forget fiber. Eat plenty of foods that contain dietary fiber (the edible, indigestible parts of plant foods). Good sources include fruits, vegetables, whole grains, nuts, and dark chocolate. Fiber from grains helps lower the risk of heart disease. Your daily fiber goal depends on your age and sex, as follows:
             
    • Men ages 50 or younger: 38 grams 
    • Men over 50: 30 grams
    • Women ages 50 or younger: 25 grams
    • Women over 50: 21 grams.
  • Balance energy intake and output. The energy you take in should equal the energy you use. That means if you are sedentary and 5 feet 4 inches tall, you need far fewer calories to remain at your current weight than an active person who is 6 feet tall.

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the HCFI Photo Gallery)

Padma Shri and Dr BC Roy Natinal Awardee Dr KK Aggarwal being honored at a function organized by Acharya Sushil Muni Ahimsa Peace Award Trust on 5th September at Acharya Sushil Muni Ashram, Defence Colony.

 
Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

In a study including 50 patients with confirmed C. difficile infection, air sampling for one hour demonstrated C. difficile organisms in 12 percent of cases.

(Reference: Best EL, Fawley WN, Parnell P, et al. The potential for airborne dispersal of Clostridium difficile from symptomatic patients. Clin Infect Dis 2010;50:1450)

  National News

More suspected cases of dengue

Suspected cases of dengue fever are on a rise in the state capital (Lucknow). According to estimates gathered from the medical institutions and hospital, over two dozen suspected cases were reported during the weekend. Health officials pointed out that there was no need to worry as most of these cases were referred ones. However, they advised that those who have been ill with high fever, especially after returning from Delhi or National Capital Region (NCR), should consult a physician at the earliest to rule out the possibility of dengue. (Source: The Times of India)

  International News

(Dr Monica and Brahm Vasudev)

What are babies made of?

Children as young as four weeks old are being fed a poor diet of biscuits, ice–cream and soft drinks, according to new Australian research. A study published in the journal Nutrition & Dietetics found some month–old babies had been introduced to high fat, salt and sugar foods, despite health authorities recommending exclusive breastfeeding to six months of age.

Nonstick Cookware May Raise Kids’ Cholesterol

Kids who eat food cooked in nonstick pots and pans may have higher levels of LDL cholesterol, a large cross-sectional study found. At issue are the chemicals used in the manufacture of the cookware –– perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS), according to Stephanie J. Frisbee, MSc, of West Virginia University in Morgantown, and colleagues, who report the findings in the September Archives of Pediatrics & Adolescent Medicine.

Mentally stimulating activities may delay, not prevent, signs of Alzheimer’s

Mentally stimulating activities, such as reading and solving puzzles…can indeed delay the outset of Alzheimer’s disease, but not prevent it for good, according to Robert Wilson, PhD, of the Rush University Medical Center and the lead author of the study published online Sept. 1 in the journal Neurology.

Over half a million US children, teens now taking antipsychotics, FDA report says

More than 500,000 children and adolescents in America are now taking" antipsychotics, according to a September 2009 report by the Food and Drug Administration.

  Nutrition Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

Complimentary feeding practices between 6 and 24 months

Increase feeding frequency as the child ages.

  • Gradually increase food consistency and variety as the child ages, adapting the diet to the infant’s requirements and abilities
  • Feed mashed and semi–solid foods, softened with breast milk, if possible, and beginning at 6 months of age.
  • Feed energy–dense combinations of soft foods to 6– 11 month olds.
  • Introduce "finger foods" (snacks that can be eaten by children alone) beginning around 8 months of age.
  • Make the transition to the family diet at about 12 months of age.

References

  1. Brown KH, Dewey KG, Allen LH. Complementary feeding of young children in developing countries: A review of current scientific knowledge. WHO/ UNICEF, 1998.
  2. Dewey KG. Guiding principles for complementary feeding of the breastfed child. PAHO/ WHO, 2003.
  3. WHO. Complementary feeding: family foods for breastfed children. Geneva: World Health Organization, 2000.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Q A young couple married for last 4 months has visited infertility specialist for treatment. They are very stressed. How should we counsel them?

A. Firstly we have to ascertain that there are no gross medical problems in the couple. We have to ensure that there is no problem in performing regular intercourse. The lady’s menstrual cycle should be regular. Once this is ascertained the couple should be reassured that the chances of getting pregnant per month in a healthy couple  about 15-20%. The fertile period should be explained which is usually between day 12 and day 18 of a regular menstrual cycle. Infertility will only be defined once they are unable to conceive after trying for more than a year. The couple should be able to return in 6 months if conception does not occur. A basic semen analysis may also be done.

  ENT Update

Dr. Aru Handa MS, DNB (Dept Co–ordinator and Senior Consultant Deptt. of ENT Moolchand Medcity)

Prevention of ear pain while flying

It is better to take preventive measures at the slightest indication of ear blockage rather than wait till the ear pain becomes unbearable.

  • Maintain hydration. Keep taking sips of warm water.
  • Chew the candies given by air– hostess just before the descent or when you start feeling the pressure difference. Repeated swallowing, yawning, chewing, opening and closing the jaw and exercising the jaw helps.
  • If suffering from cold and sinus problem, take appropriate medication/s.
  • Topical and oral decongestants help in opening the eustachian tube blockage.
  • Valsalva’s maneuver (blowing of air through nose with both nose and mouth closed) helps in relieving the ear blockage, which occurs due to the development of relative negative middle ear pressure, at the time of descent. Same maneuver may worsen the blockage and pain, if performed after take off because then the ear blockage is due to relative positive middle ear pressure.
  • Consult ENT doctor if none of this works.
  Neurology Update: Question of the day

Q: Should CT/MRI be performed in children with recurrent headaches? (Dr Sujata Kanhare)

The routine use of neuroimaging is not indicated in children with recurrent headaches in whom the neurological examination is normal. Neuroimaging should be considered in children with

  • An abnormal neurological examination e.g. focal neurological deficit, signs of raised intracranial tension, altered sensorium, the co existence of seizures or both.
  • History suggestive of recent onset of severe headache, change in type of headache or if there are features suggestive of neurological dysfunction.

(Reference: Lewis DW, Ashwal S, Dahl G, et al. Practice parameter: Evaluation of children and adolescents with recurrent headaches: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002;59:490–8).

  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Who is a surrogate medical decision maker for patient?

Studies suggest that spouses and other family members generally do not know the preferences of patients regarding the termination of life–sustaining treatments; therefore, they may not reach the same decision that the patient would have reached.1 One study found that even though patients believed both their family (87 %) and doctors (90 %) could accurately represent their wishes, neither family members nor doctors were able to adequately predict patient wishes on scenario testing with agreement ranging from 59 to 88 %.2 This discrepancy emphasizes the importance of patient/surrogate discussions about preference prior to a loss of capacity. Unfortunately, these proactive discussions are rare and clinicians are usually left relying on the family for decisions.

References

  1. Emanuel EJ, Emanuel LL. Proxy decision making for incompetent patients: An ethical and empirical analysis. JAMA 1992;267:2067.
  2. Shalowitz D, Garrett–Mayer E, Wendler D. The accuracy of surrogate decision–makers. Arch Intern Med 2006;166:493.
  Medi Finance Update

Family

  • Always have an HUF account of your family; you can get Rs. 50,000 exemption every year. Association of persons or a family trust is another way of opening an account.
  • One can also have a separate account in the name of personal God (Artificial judicial person). Up to Rs. 50,000 exemption from income tax can be taken.
  Drug Update

Drugs prohibited for manufacture, sale and distribution from subsequent date

Drug Formulation

Effective date

Notification

Fixed dose combination of Phenobarbitone with Ergotamine and/or Belladona

Jan 1,2002

GSR 170(E)
dt.12.3.01

  Lab Update

Prostate specific antigen (PSA)

Ejaculation can increase PSA levels by upto 0.8 ng/mL, though levels return to normal within 48 hours.
There is no need to ask men to abstain from sexual activity prior to PSA measurement. However, if an initial measurement is high enough to potentially prompt an intervention (i.e., biopsy), but close to a borderline value, it is appropriate to repeat the PSA measurement after having the man abstain from ejaculation for at least 48 hours

  IJCP Special

Dr Good Dr Bad

Situation: A patient with inflammation was being regularly followed up.
Dr. Bad: Do sequential ESR.
Dr Good: Do sequential CRP.
Lesson: As patient’s condition worsens or improves, the ESR changes relatively slowly but the CRP concentrations changes rapidly.

Make Sure

Situation: A patient’s blood pressure was not responding on Arkamin.
Reaction: Oh My God! Why was the patient given Artamin?
Lesson: Make sure that prescription is written with the drug name spelled clearly.

Quote of the Day

"Achievement seems to be connected with action. Successful men and women keep moving. They make mistakes, but they don’t quit" Conrad Hilton, Founder of Hilton Hotels.
(Contributed by Dr. GM Singh)

Hypertension Alert

Hypertensive urgency

Severe hypertension (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥120 mmHg), with no acute signs of end–organ damage, is often called hypertensive urgency.

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  Mind Teaser

Read this…………………

you cont ol r

(Contributed by Dr. Jagjit Singh)

The answer for yesterday’s Mind Teaser: "The letter "e," which is the most common letter in the English language, does not appear once in the long paragraph.

Correct answers received from: Dr. Susheela Gupta, Dr Rawat Purushottam Singh, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Krishnan Balasubramanian, Antaresh Sablok, Dr.A.K.Saxena, Dr Kalpana Mohan, Dr Virender Prakash Gautam, Dr Puneet Kathuria, Dr Anupam Sethi Malhotra, Dr Jayashree B Keshav, In Charge - Scientific Publications, The Himalaya Drug Company, Dr. Anupam Sethi Malhotra

The answer for 13th September Puzzle: "Upside down"
Correct answers received from: Dr  U Gaur, Dr Rajeev Sethi, Dr Nidhi Rawal

The answer for 12th September Puzzle: "Yesterday, Today, and Tomorrow!"
Correct answers received from: Dr Pravin Tirkey, Prof .C V Raghuveer.
 
Send your answer to ijcp12@gmail.com

  Humor Section

Jokes

Interesting aspect of mathematical calculation in human life

Happiness

To be happy with a man, you must understand him a lot and love him a little.
To be happy with a woman, you must love her a lot and not try to understand her at all.
(Contributed by Dr. Dewat Ram Nakipuria)

Funny but true fact !!

Classics: Books, which people praise, but do not read.
(Dr Chandresh Jardosh)

  An Inspirational Story

In 1944, Emmeline Snively, director of the Blue Book Modeling Agency told modeling hopeful Norman Jean Baker, "You’d better learn secretarial work or else get married."
She went on to become Marilyn Monroe.
(Contributed by Hozie Kapadia)

  Readers Responses
  1. Expression of feelings is the most important point you highlighted today, do not take it as granted that your son, daughter, wife and very near dear one will understand your feelings without expressing, some time you have to express it and that some time is when they are grieved. Vivek Kumar, Varanasi.
  Public Forum

(Press Release for use by the newspapers)

Rainy foot precautions

Going barefoot in monsoon can be risky. Some who take off their shoes and socks suffer injuries such as cuts and puncture wounds. In some cases, those injuries develop infections that may require surgery.
There may be sharp objects under the water that cause injury said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela.

Safety tips

  1. Get vaccinated against tetanus. Teens and adults should get booster shots every 10 years.
  2. Wear sandals while walking in rains or around swimming pools. They'll help protect against cuts and abrasions and prevent contact with viruses and bacteria that can cause athlete's foot, plantar warts and other foot problems.
  3. Many worm infestations may occur through the infected water.
  4. Fungal infections of the foot are very common.
  5. Diabetics should never go barefoot, even indoors, because they may not "feel" a foot injury.
  6. If you suffer a puncture wound in the foot, see a doctor within 24 hours. A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications such as tissue and bone infections or damage to tendons or muscles in the foot.
  7. Inspect the feet on a routine basis for skin problems such as warts, calluses, ingrown toenails, suspicious moles, spots or freckles. The sooner they are detected, the easier it is to treat.
  8. Keep your feet dry always.
  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26th September: Sunday–BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city. 8 AM  5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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