April 15  2015, Wednesday
3 diet changes to help lower cholesterol levels (Harvard)
Dr KK AggarwalIf you have high cholesterol (a total cholesterol level of 240 milligrams per deciliter of blood or above), taking steps to lower it can greatly reduce your chances of having a heart attack. For every 10% drop in your cholesterol level, your heart attack risk falls by 20% to 30%.
  • Choose healthy fats. Avoid saturated fats, which increase unhealthy LDL levels and steer clear of trans fats, which both raise LDL and lower protective HDL. Instead, substitute healthier unsaturated fats found in fish, nuts, and vegetable oils.
  • Go with whole grains. Whole–grain breads, pastas, and cereals help prevent a blood sugar roller coaster and make you feel full longer. Many of these foods contain fiber, which can help lower LDL levels.
  • Make other healthy choices. Eat more fruits and vegetables. Ideally, substitute these for processed foods and sweets. Choose fat–free milk instead of whole milk. Opt for low–fat yogurt and pick brands that are not loaded with sugar.
213th Meeting of the Central Working Committee of Indian Medical Association at Hotel Radisson Blu, New Delhi.
  • Screening asymptomatic people for type 2 diabetes does not improve mortality after 10 years of follow-up, but detection and treatment of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) possibly delay progression to diabetes, suggests a systematic literature review published online in the Annals of Internal Medicine.
  • Almost 1 in 6 women with bipolar disorder develop hypothyroidism while being treated with lithium, suggests new research presented at the European Psychiatric Association (EPA) 23rd Congress.
  • Subdissociative ketamine is as safe and effective as morphine for short-term treatment of acute pain in the emergency department, suggests new research published online in Annals of Emergency Medicine.
  • An all-oral, interferon-free regimen consisting of ombitasvir, paritaprevir and ritonavir is effective at treating patients with genotype-4 chronic hepatitis C virus (HCV), suggests new research published online in The Lancet.
  • A quantitative fecal immunochemical test (FIT) predicts mucosal healing in ulcerative colitis at least as well as the more expensive fecal calprotectin (Fcal), suggests new research published online in The American Journal of Gastroenterology.
Dr KK Spiritual Blog
What is charity?

After returning from a free health check-up camp sometime back, I met a Professor of Cardiology from Lucknow and began to boast that I had seen 100 patients today free of charge. He said do not get excited. Charity is a positive, but still not the absolute positive, unless it is done without any motive or done secretly. He said that you were honored on the stage, you received blessings from the patients and people talked about you in positive sense. It was an investment in the long run and not an absolute charity. When you serve never get honored on the stage by the people to whom you are serving. If you get that then it is like give and take. The purpose of life should be to help others without any expectations.

Understanding helping others

Helping others should not harm somebody else. Even with your unconditional help, if you end up in promoting no.2 by superseding another senior deserving person, is not regarded as a help because the person you have helped will give you only one blessing but the person whom you have harmed may curse you 10 times. So, ultimately you end up with minus 8 points. Helping other means that you should give happiness to you, to the persons you have helped and also to others to whom you have not helped.

Helping always pays

The difference between American and Indian models is that Indians always think of now and do not invest in future. Americans always plan for the future. When we help somebody, we want that the same person should expect you by helping you when you are in need in a shorter run. But charity does not believe in that. Your job is to help others and negate your negative past karmas. You never know, may be decades later you get a help from a person to whom you helped decades earlier. Help should never be linked to returns.
Cardiology eMedinewS
  • The randomized BRIGHT study has shown that patients who received bivalirudin after an acute MI had significantly fewer net adverse clinical events (NACE) and bleeding events at 30 days and 1 year than those receiving heparin plus the GP IIb/IIIa inhibitor tirofiban and those receiving heparin alone. The findings were published in the Journal of the American Medical Association.
  • The Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) has warned of an increased risk of cardiovascular events in patients who take high doses of the anti-inflammatory ibuprofen.
Pediatrics eMedinewS
  • Of three surgical approaches for managing necrotizing enterocolitis in infants, peritoneal drainage followed by laparotomy had relatively low mortality risk (35%); however, at $398,173, the two-step approach had a higher price tag than the other alternatives, suggested an adjusted analysis of cost and mortality published online April 13 in Pediatrics.
  • The use of opioid pain relievers is common in pregnancy and is significantly associated with a neonatal opioid withdrawal syndrome, suggests a new research published online March 13 in Pediatrics.
Inspirational Story
The Mango Tree

Once upon a time, there lived a big mango tree. A little boy loved to come and play around it every day. He climbed to the tree top, ate the mangoes, and took a nap under the shadow… He loved the tree and the tree loved to play with him.

Time went by… The little boy grew, and he no longer played around the tree. One day, the boy came back to the tree with a sad look on his face. "Come and play with me," the tree asked the boy.

"I am no longer a kid, I don’t play around trees anymore." The boy replied, "I want toys. I need money to buy them." "Sorry, I don’t have money… but you can pick all my mangoes and sell them so you will have money."

The boy was so excited. He picked all the mangoes on the tree and left happily. The boy didn’t come back. The tree was sad. One day, the boy grown into a man returned. The tree was so excited. "Come and play with me," the tree said.

"I don’t have time to play. I have to work for my family. We need a house for shelter. Can you help me?" "Sorry, I don’t have a house, but you can chop off my branches to build your house." So the man cut all the branches off the tree and left happily. The tree was glad to see him happy but the boy didn’t come back afterward. The tree was again lonely and sad.

One hot summer day, the man returned and the tree was delighted. "Come and play with me!" The tree said. "I am sad and getting old. I want to go sailing to relax myself. Can you give me a boat?" "Use my trunk to build your boat. You can sail far away and be happy."

So the man cut the tree trunk to make a boat. He went sailing and didn’t come back for a long time. Finally, the man returned after he had been gone for so many years. "Sorry, my boy, but I don’t have anything for you anymore. No more mangoes to give you." The tree said.

"I don’t have teeth to bite," the man replied. "No more trunk for you to climb on." "I am too old for that now," the man said. "I really can’t give you anything… the only thing left is my dying roots," the tree said with sadness. "I don’t need much now, just a place to rest. I am tired after all these years," the man replied. "Good! Old tree roots are the best place to lean on and rest. Come sit down with me and rest."

The boy sat down and the tree was glad and smiled.

Moral: The tree in the story represents our parents. When we are young, we love to play with them. When we grow up, we leave them and only come back when we need help. Parents sacrifice their lives for us.
Wellness Blog
OTC drug does not mean it can be taken without a doctor’s advice

An over–the–counter antacid is often used to relieve mild cases of heartburn or acid reflux. Though they are available without a doctor’s prescription they should be taken only under a doctor’s advice.

As per American Academy of Family Physicians

  • There are different types of antacids that work in different ways.
  • One should talk to the doctor before taking an antacid.
  • To manage an ulcer, an antacid may need to be taken in conjunction with an antibiotic.
  • If one needs more calcium to help strengthen bones, one should prefer an antacid that contains calcium carbonate.
  • In some, antacids may have minor side effects such as nausea, headache, diarrhea or constipation.
  • One should read the label carefully to make sure that one is not allergic to any of the ingredients.
  • People with kidney disease may not be able to take all types of antacids.
  • An antacid may interact with other medications.
Make Sure
Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, came for follow up.
Reaction: Oh my God! Why didn’t you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.
Dr Good Dr Bad
Situation: A heart patient wanted to know if he could meditate under a pyramid.
Dr Bad: You cannot do it.
Dr Good: Go ahead.
Lesson: The effect of meditation under a pyramid is twice as strong as meditating outside the pyramid.

(Copyright IJCP)
eMedinewS Humor
Mr. Smith is Dead

A law firm receptionist answered the phone the morning after the firm’s senior partner had passed away unexpectedly.

"Is Mr. Smith there?" asked the client on the phone.

"I’m very sorry, but Mr. Smith passed away last night," the receptionist answered.

"Is Mr. Smith there?" repeated the client.

The receptionist was perplexed. "Perhaps you didn’t understand me I’m afraid Mr. Smith passed away last night."

"Is Mr. Smith there?" asked the client again.

"Ma’am, do you understand what I’m saying?" said the exasperated receptionist. "Mr. Smith is DEAD!"

"I understand you perfectly," the client sighed. "I just can’t hear it often enough."
eMedi Quiz
A patient has been allegedly bitten by cobra snake. The venom in such a bite would be:

1. Musculotoxic.
2. Vasculotoxic.
3. Cardiotoxic.
4. Neurotoxic.

Yesterday’s Mind Teaser: Mummification refers to:

1. Hardening of muscles after death.
2. Colliquative putrefaction.
3. Saponification of subcutaneous fat.
4. Dessication of a dead body.

Answer for yesterday’s Mind Teaser: 4. Dessication of a dead body.
Correct Answers received from: Dr K Raju, Tukaram Pagad, Dr KV Sarma, Dr Shangarpawar, Daivadheenam Jella, Dr Avtar Krishan, Dr G Madhusudhan.
Answer for 13th April Mind Teaser: 1. Pemphigus vulgaris.
Correct Answers receives: Dr Poonam Chablani, Dr Jainendra Upadhyay, Raju Kuppusamy, Dr KV Sarma, Daivadheenam Jella, Dr Avtar Krishan.
Rabies News (Dr A K Gupta)
What is "paralytic form" of rabies in animals?

Paralytic or dumb rabies refers to animals in which the behavioral changes are minimal or absent and the disease is manifested mainly by paralysis. This is first manifested by paralysis of the throat and masseter muscles, often with profuse salivation and inability to swallow. Dropping of lower jaw is common in dogs. The animals are not vicious and rarely attempt to bite. The paralysis progresses rapidly to all parts of the body leading to coma and death follows in a few hours.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh, SM Heart Care Foundation Fund, Post CAG
Kishan, SM Heart Care Foundation Fund, Post CHD Repair
Deepak, SM Heart Care Foundation Fund, CHD TOF
IMA News
FOGSI’s statement on impending PCPNDT issues
  1. FOGSI is aware that there are issues of PCPNDT going on in different states of India.
  2. We also understand that more number of persons face issues due to small errors of filling forms and record.
  3. FOGSI is not objecting the PCPNDT Act but is definitely working on:
    • Resolving issues related to interpretation of the Act.
    • Methods of implementation should be standardized in all states.
    • Code of appropriate authority and NIMC team should be standardized.
    • There should be graded punishment for form filling, which can be monetary fines and actual sex determination matter as decided by PCPNDT Act.
    • State medical councils should not expel a member unless officially proved guilty.
  4. Though FOGSI acknowledges that expression of protest may be different of different group of persons and organizations, FOGSI requests all the member societies under Federation to inform their members to wear a black badge on 15th April 2015 as mark of support to problems which our members are facing.
  5. Most important FOGSI does recognize that in any field or profession 2-3% are on the wrong side, which we identify and remaining 97% of members should not suffer.
  6. FOGSI sensitizes the issue and does not sensationalize the matters related to PCPNDT Act.
Dr. Prakash Trivedi                         Dr. Hrishikesh Pai
General FOGSI 2015                       Secretary
Sonal Namaste
What should you do if you don’t have soap and clean, running water?

Use a bottle of hand sanitizer. Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.
IMA has entered into a MoU with Antriksh Group. The group is developing a residential society exclusively for the member doctors of the IMA called ‘ANTRIKSH INDIAN MEDICAL GOLFTOWERS’, situated at Sector 150, Noida-Greater Noida Expressway, Noida. This residential society and the colony will comply to all the health parameters as defined by the IMA so the colony ends up into an environmentally healthy society.

IMA has been able to negotiate the following key items with the Antriksh Builders for IMA members:-
  • IMA members who wish to book apartment(s) in this society will get a discount of 20% on the basic sales price
  • Few additional charges such as Lease Rent, Fire Fighting Charges, Club Membership Charges have been completely waived off for the IMA members
  • In case any member wants to sell off their unit in the open market at any time during the construction, the first transfer fees which is typically around 2-5% of the cost of the apartment has been completely waived off for the members.
  • In case any member feels at the end of 1 year that the project is not worth investing, they can apply for cancellation and will get 100% refund, without any deduction.
  • Many financial schemes have been created to enable the IMA members choose the best suitable payment mode for them. One of them is EMI subvention scheme in which the buyer member will be required to pay only 10% of the total cost of the apartment. For next three years, until possession of apartments is offered, the developer will pay the pre-EMIs to the financing bank. And after one year of booking, if the IMA member is not satisfied with the value of the investment, they can apply for cancellation and get their money back.
  • Developers will also help the buyer member with loan arrangement.
  • The society once in frame will co-own the management of the Club House called “IMA House” and the Golf Club.
  • Relatives of IMA members will also be entitled to book flats in this scheme.
It is expected that once 200 member doctors buy apartments in this project, the market cost of the apartments will increase by minimum around 1000 Rs per sqft in 1 year time frame and by a minimum 2000 Rs. per sqft. In 2 years’ time frame. This will yield to a buyer who books under the subvention scheme, a profit of 200% and 400% over a period of 1 years and 2 years respectively. Buyers can keep that parameter as a benchmark of gauging the return on their investment.

The apartment buying agreement of the IMA member will be directly with the developer and IMA will not be party to it. IMA has only negotiated special terms for the members.

Members who wish to enquire about the project, visit project site or book may contact the special helpdesk created by Antriksh. The contact details are as follows:

Phone helpline: 92124 11999
Email helpline : antriksh.ima@gmail.com
Project website : www.antrikshimagolftowers.in
Antriksh Group website : www.antrikshgroup.com
IMA website : www.ima-india.org


Snapshot of key features of the project (as per project Brochure)
  • Lowest density sector in Delhi NCR leading to limited number of units and wide open areas
  • Project in the centre of a 9 Hole signature Golf Course
  • 3BHK and 4 BHK apartments having super area – 2025 sqft, 2425 sqft, 2900 sqft and 3475 sqft
  • Sector is located at the junction of 3 major expressways
  • Certified Green Building Concept
  • Ultramodern club house with Swimming Pool
  • Maximum sports facility including Cricket Academy
  • Sr. Sec School, Nursing Home, temple, Local market all within the township boundaries
  • 24x7 electricity and potable water supply
  • 3 tier security system with CCTV monitoring in centralized Hi-tech control room.
Some of the key features of ‘Health Friendly Homes’ concept created by IMA are as follows:
  • Air and Noise Pollution Control
  • Water Softening Plant
  • Mobile Tower Radiation Free Zone
  • Rain Water Harvesting
  • Eco friendly Garbage Disposal
  • Nursing Home/Healthcare Centre
  • First Aid Kits and First Aid Centres
  • 24×7 Ambulance Facility
  • Potable Water Supply
Facts about Tuberculosis (TB)
How does the program monitor the result of treatment (i.e. outcome) of the patients put on treatment?

  • The programme ensures that every patient who has been registered for treatment is given an outcome.
  • The programme monitors the treatment outcomes of patients by ‘Cohort’. Under RNTCP, a ‘cohort’ is a group of patients registered for treatment in a defined area, which could be district, State or the entire Country, in any quarter of the year.
  • All the patients registered in a particular ‘Cohort’ are reported for response to treatment (sputum conversion) and final outcome of treatment at specified time intervals.
  • The favorable outcome is cured (successfully treated) while the adverse outcomes are death, default and failure.
Doctors protest assault on Allahabad medico
Ishita Bhatia,TNN | Apr 13, 2015, 10.39 PM IST: MEERUT: A day after a doctor in Allahabad was assaulted by infuriated relatives of a deceased patient at Anand Hospital, city doctors tied black ribbons on their arms in protest. The doctors, who protested under the banner of the Indian Medical Association (IMA), did not stop work.

"The Allahabad incident is very sad and the IMA has decided to start a silent protest against it. Doctors will work but tie black ribbons around their arms. While the protest is a silent one for now, doctors across the state will go on an indefinite strike if the accused are not arrested by Tuesday morning," said Dr. Jitendra Chikara, president of IMA's Meerut chapter.

Meerut-based Dr Vishwajeet Bembi said, "The incident is a sad. Doctors are generally on the receiving end when it comes to such incidents. We cannot fight back but we will show our displeasure and continue to work silently."

Doctors told TOI that the protest was started after IMA (Uttar Pradesh) president Dr Sharad Agarwal issued instructions to doctors across the state to tie black ribbons.

Dr. Rohit Gupta, a doctor at Allahabad's Anand Hospital was brutally assaulted by a group of seven persons on Sunday early morning. The incident came a day after an 80-year-old patient named Virendra Pratap Jayaswal was admitted to the hospital due to sudden pain in the kidney. Gupta had arrived the hospital to see a patient when the news of the death of patient broke out and the patient's relatives thrashed him in the ICU.

The video of the doctor being assaulted went viral on social media and the doctors throughout the state planned to protest in the matter. Though the doctors in Allahabad went on a strike in Allahabad on Monday, other doctors protested by tying black ribbons on their arms.

Infuriated over death of a patient, relatives and family members had ransacked the intensive care unit and surgery theatre of an Anand Hospital in Allahabad and allegedly thrashed Dr Rohit Gupta on Sunday. Both sides have lodged cross FIRs against each other at Colonelganj police station. Irked over the incident, Allahabad Medical Association (AMA) had blocked Stanley Road and shutdown health services in the city.

The video of the doctor being assaulted went viral on social media. Dr Gupta is recuperating at another hospital. He alleged the mob snatched away his mobile and gold chain. Colonelganj police said they would go through CCTV footage to identify culprits and assured of strict action against the guilty.

According to reports, Virendra Pratap Jaiswal (63) of Katghar was admitted to a private hospital on Saturday on complaints of toothache. His condition started deteriorating in the night and he died during the course of treatment in the wee hours of Sunday.
Thiruvananthapuram: The Indian Medical Association (IMA) and ENT doctors association, under the National Initiative for Safe Sound (NISS) project, is organizing a cycle rally 'Kathoorku' (The Silent Wheel of Safe Sound) from Thiruvananthapuram on April 16.
Letter from AMC Association of Medical Consultants
AMC Association of Medical Consultants, a body of 8000 members regarding the Bandh. All radiologists in Maharashtra are members of the Association

Date: 13th April, 2015

Dear Dr Prarthana Utture

The Government of India has expressed serious concerns over the dwindling sex ratio in our country and the Prime Minister has launched his “Beti Bachao Beti Padhao” movement. Our Association has always supported the government in this endeavor. However, we are equally concerned that the PCPNDT act has become a draconian act and an increasing number of instances of harassment of our members on this issue has been brought to our notice. Minor deficiencies in the paper work have been equated with actual sex determination and invoked severe action including sealing of the machine and recently some doctors in Pune have been convicted for these technical violations.

We at AMC strongly oppose the harassment of doctors for minor deficiencies in paper work. We believe urgent changes in the rules of the PCPNDT Act are required to allow for a graded system of penalties: first warning the doctor if and when such deficiencies are noticed; monetary penalties and finally cancellation of registration if repeatedly the doctor is found to be deliberately committing these offences. If however a doctor is found guilty of actual sex determination, the government is free to take strong action against the doctor and such action will be definitely endorsed by the Association. We also want the government to implement the provisions of the PCPNDT act which actually provides for strong legal action against the patients and relatives of patients who actually get a sex determination done or demand it.

A list of demands has been handed over to the government by Indian Radiology & Imaging Association and the Health Minister has invited all interested associations for talks to discuss these issues. The date of the meeting is to be informed to us after the 12th of April 2015. We hope to take a large delegation to sit with the minister and the Appropriate Authorities under the PCPNDT act to sort our grievances and ensure that harassment of doctors ends immediately. We are aware that a group of doctors across the country have called for a strike on the 15th of April 2015 to draw the attention of the government to the atrocities against doctors under the Act. We call upon our members to show their solidarity with the movement initiated by these groups by wearing black batches on the 15th of April 2015. We will review our stand after the talks with the government and in case the talks fail we will consider intensifying our agitation if necessary with an indefinite strike till our demands are met.

Thanking you,

Yours Truly,

Dr Sudhir Naik        Dr Mukesh Gupta       Dr Suresh Rao
President-AMC       Hon. Secretary           Managing

Quote of the Day
You don't have to be great to start, but you have to start to be great. Zig Ziglar
IMA in Social Media
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Reader Response
This happens only in India. How it is that a doctor's name is removed from the MCI central register but still remains on State MCI register? Once the name is removed from the Medical Council of India, the doctor concerned cannot practice anywhere in India. With regards: Dr SC Parakh, Hyderabad
IMA Videos
News on Maps
IMA National Cancer & Tobacco Control Committee
Chairman:- Dr. Dilip Kumar Acharya

World Cancer Day

This was observed by many branches across the country, by way of arranging lectures on Prevention & Early Detection of Cancer, Talk Show, screwing camps etc. Details Information was sent to all CWC members prior to world Cancer Day via “enews”

World Conf on Tobacco or Health

Our committee Chairman presented his poster on “E cigarettes- A curse or a boon in Tobacco Control “In the world Conference on Tobacco or Health held in March 2015 at Abu Dhabi, UAE

IMA “Workshop on Control of NCD & Tobacco” is being organized on 2nd & 3rd May at Indore. There is no registration fee for the workshop. All CEC members are invited to participate.

Online Course on Tobacco Control

The School of Public Health, Johns Hopkins University, Baltimore, USA is already running a very good online course on all aspects of Tobacco Control. I have met them personally & discussed with them to offer it free of cost to all IMA members with a link from our web IMA website, with certificate co-signed by our President & Secretary.


All CWC members, branch President & Secy are requested to observe WNTD on 31st May by way organizing awareness rally, talk show, distributing pamphlets, conduct anti tobacco slogan/painting Competition. The committee & HO will send readymade press note & other details for WNTD which can be released by branches on the same date all over the country.

Indian Medical Association condemns assault on medical professionals
Two recent incidents on assault on medical professionals have shaken the medical profession. Firstly in Allahabad, where the relatives of a patients assaulted Dr. Rohit Gupta and secondly, in Delhi where Singer Mika Singh slapped an Eye Doctor who organized the event.

IMA has appealed to all its 2.5 lacs doctors not to hire the services of Mika Singh in future and also to boycott all the functions where he is involved, said Padmashri Awardee, Prof (Dr.) A. Marthanda Pillai, National President and Padmashri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.

The Association has also appealed its members to not to buy his Albums & CDs.

The Association has also written letters to the Prime Minister of India to come out with a Central Ordinance followed by a Central Act regarding assault on medical professionals while on duty.

In 14 States, such Acts/Ordinances are already in place.