emedinews
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FIRST NATIONAL DAILY 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 & 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

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

15th October 2012, Monday

Which mattress for low back pain?

Doctors often recommend very firm mattresses. But in one study of 313 people, those who slept on the medium-firm mattresses reported less pain when lying in bed as well as less pain-related disability compared with those with the firm mattresses.

Another waiting-room survey of 268 patients with low back pain, found that people who slept on orthopedic (very firm) mattresses had the poorest sleep quality, while there was no difference in sleep quality between medium and firm mattresses.

A softer mattress conforms to your body's natural curves, help the joints align favorably but you might also sink in so deeply that your joints twist and become painful during the night.

The best way to find the best mattress is to try out different ones. If you spend a night at a new place make note of how you feel after sleeping on the "new" bed.

Try putting a plywood board under your current mattress or sleep for a few nights with your mattress on the floor. (Source HealthBeat)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update

Facts

  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is stress-induced cardiomyopathy?

An uncommon but increasingly reported cause of an acute, usually ST-elevation coronary syndrome occurring in the absence of critical coronary artery disease is stress-induced cardiomyopathy. It is also called transient left ventricular apical ballooning, Takotsubo cardiomyopathy and broken heart syndrome. This disorder is typically precipitated by intense psychologic stress and primarily occurs in postmenopausal women. The characteristic finding of apical ballooning is seen on left ventriculography or echocardiography. All patients recover completely within 1 to 4 weeks.

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Monitoring LFT in a patient on statins

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that more than 10,000 members of the public will be certified in compression only CPR during the Mela.

 
Dr K K Aggarwal
    National News

Caught in tussle over prescriptions, Maharashtra chemists threaten 3-day strike

Mumbai: Over 50,000 chemists across Maharashtra are threatening to go on strike for three days starting October 16, putting the spotlight on a peculiar situation arising from the shortage of doctors. Chemists are getting booked by the State Food and Drug Administration (FDA) for giving medicines on prescriptions by “cross-party” practitioners, Prasad Danabe, Secretary of Retail and Dispensing Chemists Association (RDCA), told Business Line. There are regions in the country where registered doctors are not available and qualified homeopaths and ayurvedic practitioners prescribe medicines in the interest of patients, he says, explaining the practice of “cross-party” prescriptions. Though the Supreme Court does not allow such cross prescriptions, there is confusion in the retail segment, because State Government officials claim to have a notification that allows ayurvedic practitioners to prescribe allopathic drugs, he added. And yet, the State FDA books chemists when they do the same, he said.

Meetings between the Maharashtra FDA and the chemist and druggists associations in the past have not resolved the problem, he said, urging the State Government to bring in greater clarity on what is acceptable. Calling for transparent guidelines, he said, a list of doctors who can prescribe medicines should be circulated among chemists and they should be educated and not booked. The Maharashtra State Chemists and Druggists Association Secretary, Anil Navandar, pointed out that chemists were facing the brunt of the confusion, where they were booked or forced to comply with corrupt practices. About 6,000 chemists will be shut in Mumbai city alone if the strike does go through, said the All India Organisation of Chemists and Druggists’ President J. S. Shinde. (Source: The Hindu Business Line, Oct 12, 2012)

For comments and archives

My Profession My Concern

Quality Control

Clostridium difficile Care Bundle

  • Isolate all CDI patients in a single room with clinical hand washing sink and either en suite facilities or a designated toilet/commode until they are symptom free for at least 48 hours.
  • Review the patient’s antibiotic regimen and stop inappropriate antibiotics.
  • Check that all HCWs remove personal protective equipment (PPE) (gloves and aprons) immediately after each contact with CDI patient and their environment.
  • Ensure that HCWs perform hand hygiene with liquid soap and water immediately after removal of PPE.
  • Check that the CDI patient’s immediate environment and all patient care equipment has been cleaned today with a neutral detergent and disinfected with a sporicidal disinfectant.

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

 
    Valvular Heart Disease Update

Preventing valvular endocarditis

Which antibiotic — The choice of antibiotic is patient and procedure specific.

  • Patients with skin or musculoskeletal infections undergoing procedures should receive agents active against staphylococci and beta-hemolytic streptococci.
  • In patients with GI or GU tract infection, antibiotic therapy to prevent associated wound infection or sepsis should include an agent active against enterococci.

(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)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Pneumococcal vaccine recommendations published

An advisory committee to the Centers for Disease Control and Prevention has released recommendations on the use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals Inc, a subsidiary of Pfizer Inc) and 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23, Merck & Co Inc) in adults with immunocompromising conditions, according to an article published in the October 12 issue of the Morbidity and Mortality Weekly Report. (Source: Medscape)

New guidelines for vaccination of pneumococcal vaccine-naive persons include:

  • "(A)dults aged =19 years with immunocompromising conditions, functional or anatomic asplenia, [cerebrospinal] leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first, followed by a dose of PPSV23 at least 8 weeks later."
  • "Subsequent doses of PPSV23 should follow current PPSV23 recommendations for adults at high risk. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19&ndash64 years with functional or anatomic asplenia and for persons with immunocompromising conditions."
  • "(T)hose who received PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years, or later if at least 5 years have elapsed since their previous PPSV23 dose."

Guidelines for patients with previous vaccination with PPSV23 include:

  • "Adults aged =19 years with immunocompromising conditions, functional or anatomic asplenia, [cerebrospinal fluid] leaks, or cochlear implants, who previously have received =1 doses of PPSV23 should be given a PCV13 dose =1 year after the last PPSV23 dose was received."
  • "For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23."

For comments and archives

Structured vs routine observation of patients with syncope

A structured approach to the observation of unexplained syncope in intermediate-risk, older patients seen in the emergency department (ED) reduces hospital admission rates and medical costs associated with the typically unstructured diagnosis of fainting spells, new research suggests. (Source: Medscape)

For comments and archives

Frozen embryo transfer may improve IVF outcomes

In a new meta-analysis, outcomes of in vitro fertilization (IVF) were better after frozen embryo vs fresh embryo transfer, likely because of differences in endometrial preparation.

With frozen embryo transfer, endometrial priming may be achieved with the use of estradiol and progesterone, and the endometrial development can be controlled more precisely than with fresh embryo transfer, where controlled ovarian hyperstimulation (COH) with gonadotropins is used. (Source: Medscape)

For comments and archives

TOWER: Teriflunomide reduces relapse and disability in MS

Final results of a phase 3 trial comparing 2 doses of teriflunomide (Aubagio, Genzyme/Sanofi), 14 mg/d and 7 mg/d, vs placebo in patients with relapsing multiple sclerosis (MS), confirm significant reductions in annualized relapse rates and sustained accumulation of disability with the 14-mg dose vs placebo. Results with a second dose studied in this trial, 7 mg, showed a significant but smaller reduction in relapse rate but not in sustained accumulation of disability. Full results of the Teriflunomide Oral in people With relapsing-remitting MultiplE ScleRosis (TOWER) trial were presented here at the 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). (Source: Medscape)

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: Music As A Drug Our body is the largest pharmaceutical group in the world and has the capacity to heal each and... http://fb.me/2bTlAdSYM

@DrKKAggarwal: Is there a balance between self-care & self-centeredness? Watch the latest episode of #SpiritualSolutions http://tinyurl.com/8fp33mp

 
    Spiritual Update

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

How do I know I am relaxed?

When you are absorbed in any work, you lose track of time and your body awareness shifts from sympathetic to parasympathetic mode which is a healing mode. On the contrary, when you are stressed, you all the time look at the watch and you shift from parasympathetic to sympathetic mode. Meditation or yogic living basically involves living in the present.

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What would happen to the mother and the babies due to multiple pregnancies?

Multiple gestations are risky for the babies. Because there are too many babies in the womb, you may have a miscarriage. Or you could have a premature delivery when the babies may be born too early (but after 20 weeks of pregnancy) and have problems with lungs, stomach, or intestinal tract. They may have bleeding in the brain, which can cause problems with the baby's brain, nervous system, and hamper its development. One of the more common problems is cerebral palsy, a condition that affects movement. The mother might have health problems, too. Your blood pressure may get too high (called pre-eclampsia, pregnancy induced hypertension, or toxemia) and you may develop diabetes (high blood sugar).

For comments and archives

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

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

Advantages of disposable plastic bags

  • Convenience in storage and transportation
  • No breakage
  • Ease to transfuse
  • Less risk of transfusion reactions
  • Facilitates various blood components separation

For comments and archives

 
    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What are the indicators of fungal abscess?

When hepatic microabscess occur either alone or in association with splenic microabscess in an immunocompromized patient.

For comments and archives

 
    An Inspirational Story

How much do you make an hour?

With a timid voice and idolizing eyes, the little boy greeted his father as he returned from work, “Daddy, how much do you make an hour?” Greatly surprised, but giving his boy a glaring look, the father said: “Look, son, not even your mother knows that. Don’t bother me now, I’m tired.” “But Daddy, just tell me please!? How much do you make an hour,” the boy insisted.

The father finally giving up replied: “Twenty dollars per hour.” “Okay, Daddy? Could you loan me ten dollars?” the boy asked. Showing restlessness and positively disturbed, the father yelled: “So that was the reason you asked how much I earn, right?? Go to sleep and don’t bother me anymore!”

It was already dark and the father was meditating on what he had said and was feeling guilty. Maybe he thought, his son wanted to buy something. Finally, trying to ease his mind, the father went to his son’s room.

“Are you asleep son?” asked the father. “No, Daddy. Why?” replied the boy partially asleep. “Here’s the money you asked for earlier,” the father said. “Thanks, Daddy!” rejoiced the son, while putting his hand under his pillow and removing some money. “Now I have enough! Now I have twenty dollars!” the boy said to his father, who was gazing at his son, confused at what his son just said. “Daddy could you sell me one hour of your time?”

- Author Unknown

Source: http://www.motivationalwellbeing.com/motivational-stories-8.html

For comments and archives

 
  Cardiology eMedinewS

OSA linked to soft plaque Read More

Anemia Pre-Cardiac Surgery Predicts Bad Outcome Read More

 
  Pediatric eMedinewS

Mom's Depression Slows Baby's Development Read More

Air Pollution Exposure In Infancy May Hurt Lungs At 8 Years Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and also stop low dose aspirin.
Lesson: In dengue, low dose aspirin should be discontinued.

For comments and archives

Make Sure

Situation: A patient with cough of more than 4 weeks duration came with blood in his sputum.
Reaction: Oh my God! Why was TB not suspected earlier?
Lesson: Make sure that all patients with cough of more than 3 weeks duration are investigated for TB.

For comments and archives

 
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Lipase

Lipase is an enzyme produced by the pancreas to help digest fats, proteins, and carbohydrates.

  • Very high levels in blood can be due to acute pancreatitis.
  • High levels are also found with pancreatic duct obstruction, pancreatic cancer, and other pancreatic diseases.
  • Moderately increased lipase values may occur with kidney disease, salivary gland inflammation, a bowel obstruction, or peptic ulcer disease.

Low levels may indicate permanent damage to the lipase–producing cells in the pancreas.

 
  Quote of the Day (Dr GM Singh)

No matter how much you plan, it is tenacity, unyielding desire to succeed, and the ability to cope with change that will eventually prevail. Perry Payne

 
    Mind Teaser

Read this…………………

The nurse enters the room of a client with chronic obstructive pulmonary disease. The client's nasal cannula oxygen is running at a rate of 6 L per minute, the skin color is pink, and the respirations are 9 per minute and shallow. What is the nurse’s best initial action?

A. Take heart rate and blood pressure.
B. Call the physician.
C. Lower the oxygen rate.
D. Position the client in a Fowler's position.

Yesterday’s Mind Teaser: A 70-year-old female comes to the clinic for a routine checkup. She is 5 feet 4 inches tall and weighs 180 pounds. Her major complaint is pain in her joints. She is retired and has had to give up her volunteer work because of her discomfort. She was told her diagnosis was osteoarthritis about 5 years ago. Which would be excluded from the clinical pathway for this client?

A. Decrease the calorie count of her daily diet.
B. Take warm baths when arising.
C. Slide items across the floor rather than lift them.
D. Place items so that it is necessary to bend or stretch to reach them.

Answer for Yesterday’s  Mind Teaser: Inside information

Correct answers received from: Dr. P. C. Das, Dr.K.Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, DR Chandresh  Jardosh, Dr. Thakor Hitendrsinh G, y. j. vasavada

Answer for 12th October Mind Teaser: D. Ensure an intake of at least 3000 ml of fluid per day.
Correct answers received from: Dr jella

Send your answer to ijcp12@gmail.com

 
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    Laugh a While (Dr GM Singh)

Luggage

I couldn't find my luggage at the airport baggage area. So I went to the lost luggage office and told the woman there that my bags never showed up.

She smiled and told me not to worry as they were trained professionals and I was in good hands. "Now," she asked me, "has your plane arrived yet?"

 
    Medicolegal Update

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

What is medical fasting?

  • Various blood tests require a fasting of up to 12–16 hours so that a baseline normalcy of blood can be established.
  • The patient is asked to remain in a fasting state for medical reasons: surgery or other procedures of diagnostic or therapeutic intervention that require anesthetic. The presence of food in a person's system can cause complications when they are anesthetized; medical personnel strongly suggest that their patients fast for several hours before the procedure.
  • Some animal studies show that fasting every other day while eating double the normal amount of food on non–fasting days led to better insulin control, neuronal resistance to injury and health indicators similar to mice on calorie restricted diets.
  • Patient refusal of nutrition and hydration in terminal illness: "within the contexts of adequate palliative care, the refusal of food and fluids does not contribute to suffering among the terminally ill" and might actually contribute to a comfortable passage from life: "At least for some persons, starvation does correlate with reported euphoria."
  • In homeopathic medicine, fasting is seen as a way of cleansing the body of toxins, dead or diseased tissues, and giving the gastrointestinal system a rest. During fasts, water, fruit and vegetable juices are usually taken on choice.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Rules for preventing heart attack deaths

Heart attack deaths can be prevented said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

  1. Rule of 30 seconds: Chest pain, burning, discomfort, heaviness in the center of the chest lasting for over 30 seconds and not localized to a point unless proved otherwise is a heat pain.
  2. Rule of pinpointing finger: Any chest pain which can be pinpointed by a finger is not a heart pain.
  3. Rule of 40: First-onset acidity or first-onset asthma after the age of 40, rule out heart attack or heart asthma first
  4. Rule of 300: Chew a tablet of water-soluble 300 mg aspirin and take 300 mg clopidogrel tablet at the onset of cardiac chest pain. You will not die.
  5. Rule of 10: Within 10 minute of death for the next 10 minutes do effective chest compression with a speed of (10x10) 100 per minute. Most people can be saved.
  6. Rule of 180: Reach hospital within 180 minutes in heart attack to receive clot dissolving angioplasty or clot dissolving drugs.
 
    Readers Response
  1. Dear Sir, We like reading emedinews.Regards: Dr K Tripathi
 
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