January 16 2015, Friday
Swastha Bharat to take Swachh route to health
NEW DELHI: After Swachh Bharat (Clean India), the government is all set to launch a Swastha Bharat (Healthy India) campaign. Union health minister J P Nadda said on Wednesday that a mapping of disease pattern across the country reveals that areas that lack in sanitation and availability of clean water are facing higher burden of communicable diseases.

"We plan to collaborate with various ministries, for example urban development and water resources, to collaborate and fight together against the root causes for the spread of diseases," he said.

Giving example, the health minister said the high incidence of Japanese Encephalitis in parts of Eastern UP and Bihar is due to poor supply of potable water and sanitation problems.

"A temporary arrangement for dealing with the crisis could be to installation a RO water purifier system but as a long-term solution we must strive to provide water pipelines to all," he added.

Nadda, who has been conducted surprise inspections at top hospitals such as Safdarjung and RML over the last few weeks, said better sanitation in the hospital can help reduce infection risk too.

On reduction in health budget to the tune of Rs 6,000 crore, the minister said the finance ministry took the decision due to underutilization of funds and that it will not impact any major program.

"There is no dearth of funds to run key programmes. The decision to cut the budget was taken since funds lay unutilized," Nadda said.

A senior health ministry official blamed the states for under–utilisation of funds. "Health is a state subject. The health ministry’s role is limited to policy formulation, finance and technical assistance to them. But reports show several states have failed to utilise the funds leading to drastic cut in the budget allocation. However, once the services are optimized, our government will make sure that demands for funds are met," the official said.

The health ministry officials claim all six AIIMS will be made fully-functional by the end of February. "We are also initiating talks with Indian Medical Association and other key organisations to decide on rural posting for medical graduates," the health minister said. According to government reports, the country faces shortage of nearly one lakh doctors and a higher number of paramedical professionals. Employing the experts from alternative medicines in rural areas to supplement the health services has proved ineffective in stemming the crisis.
Women above 65 to take extra care of their health
Dr KK Aggarwal
  • Women aged 65 and above should take low dose aspirin routinely to prevent heart attack and paralysis.
  • All women are urged to exercise a minimum of 30 minutes per day, but women who need to lose weight or maintain weight loss are now advised to engage in 60 to 90 minutes of moderate–intensity activity on most, or preferably all days of the week.
  • A heart–healthy diet should be rich in fruits, whole grains and fiber foods with a limited intake of alcohol and sodium.
  • Saturated fat should be reduced to less than 7% of calories.
  • Women at very high risk for heart disease should try to lower their LDL ("bad") cholesterol to less than 70 mg/dL.
  • Women aged 65 and over should consider taking low-dose aspirin on a routine basis, regardless of their risk. Aspirin has been shown to prevent both heart attacks and stroke in this age group.
  • The upper dose of aspirin for high–risk women is 325 mg per day.
  • Hormone replacement therapy, selective estrogen receptor modulators nor antioxidant supplements such as vitamins C and E should be used to prevent heart disease.
  • Folic acid should also not be used to prevent cardiovascular disease.
  • Women should eat oily fish or some other source of omega–3 fatty acids at least twice a week.
  • Women should not only quit smoking but should use counseling, nicotine replacement or other forms of smoking cessation therapy.
Health Check Up and CPR 10 Camp at G B S S School, No-2, Ambedkar Nagar on 19th December 2014
Quote of the Day
Always bear in mind that your own resolution to succeed is more important than any other. Abraham Lincoln
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Dr KK Aggarwal: Heart risks detected by age 7 in overweight kids
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Dr Deepak Chopra: If we want a sustainable planet we need to realize that all of life depends on all of life #CosmicConsciousness
Make Sure
Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why was he not put on antioxidants?
Lasson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.
Government of India
Ministry of Health and Family Welfare

The Medical Professionals/Students and General Public are hereby informed that the Medical Education in the country is governed by the Indian Medical Council (IMC) Act, 1956 and various rules and regulations made thereunder which are mandatory and binding in nature. It is brought to the notice that migration of students from one medical college to another medical college in India is regulated under Clause 6 of Regulations on Graduate Medical Education (GME), 1997.

Clause 4 of Clause 6 of GME
Regulations states that:
"6(4) For the purpose of migration an applicant candidate shall first obtain ‘No Objection Certificate’ from the college where he is studying for the present and the university to which that college is affiliated and also from the college to which the migration is sought and the university to it that college is affiliated. He/She shall submit his application for migration within a period of 1 month of passing (Declaration of result of the 1st Professional MBBS examination) alongwith the above cited four ‘No Objection Certificates’ to:

(a) the Director of Medical Education of the State, if migration is sought from one college to another within the same State, or

(b) the Medical Council of India, if the migration is sought from one college to another located outside the State."

Forthwith the request for migration of a medical student may be sent to the respective authorities and no such application shall be sent to Ministry of Health & Family Welfare directly.

(Ali R Rizvi)
Joint Secretary, Medical Education
Doctors are sceptical about Indian Medical Association’s new code of conduct for hospitals

The Indian Medical Association’s (IMA) decision to draft a new code of medical ethics for hospitals and nursing homes has met scepticism from several doctors, who have questioned the effectiveness of such a voluntary code given that the association’s existing code for doctors has failed to stem corruption.

"The IMA action is purely symbolic," said Ravi Raghavan, a gastroenterologist in Bangalore and a member of the IMA, in an interview with The BMJ.

The association currently adopts the Medical Council of India’s (MCI) code for doctors but has no code for hospitals. The new code, which the association will draft together with hospital groups such as the Association of Healthcare Providers, aims to fill this gap. It will include guidelines on advertising and marketing of healthcare services and avoiding unnecessary medical procedures.

Source: http://www.bmj.com/content/350/bmj.h236

Determination regarding injury or death.
4B. Whether the injury or death of a person in the course of a clinical trial, has been caused due to such clinical trial or not, shall be determined by such authority and in such manner as may be prescribed.
Medical treatment and compensation for injury or death due to clinical trial.
4C. (1) Where a participant is injured or disabled in a clinical trial, the person or body permitted under section 4A and the sponsor shall provide such medical treatment and compensation in such manner as may be prescribed.
(2)Where death of a participant is caused due to clinical trial, the person or a body permitted under section 4A and the sponsor shall provide to his legal heir, such compensation, in such manner as may be prescribed.
Deferment of clinical data requirements by the Central Licensing Authority.
4D. Notwithstanding anything contained in this Chapter, the Central Licensing Authority may, in public interest, abbreviate, defer or waive off the pre–clinical and clinical data requirements for approval of clinical trial of drugs in case of life threatening or serious diseases or diseases of special relevance to the country.
Registration of Ethics Committee.
4E. The Ethics Committee, constituted in such manner as may be prescribed, for the purpose of giving approval to a clinical trial protocol and other related matters, shall be registered with the Central Licensing Authority in such manner as may be prescribed.
Functions and responsibilities of Ethics Committee
4F. (1) The Ethics Committee shall grant its approval to the clinical trial protocol and other related documents in such manner as may be prescribed.
(2) The Ethics Committee shall be responsible to oversee the conduct of clinical trial, safeguard the rights, safety and well being of all trial participants enrolled in the clinical trial
(3) The Ethics Committee shall make periodic review of the trial, based on the study of progress reports furnished by the investigators, and monitor internal audit reports furnished by the Sponsor, or by visiting the study sites in such manner as may be prescribed.
(4) The Ethics Committee shall have power to revoke its approval granted under sub-section (1) of section 4Fto a clinical trial protocol and other related documents, for reasons to be recorded in writing and communicated to the Investigator and to the Central Licensing Authority.
(5) The Ethics Committee shall perform such other functions and responsibilities as may be prescribed.
The Year in Medicine 2014: News That Made a Difference
9. Artificial Sweeteners and Salt

Artificial sweeteners made headlines in September, when researchers reported in Nature that aspartame, sucralose, and saccharin cause blood glucose abnormalities in mice and some humans. The changes in glucose tolerance seem to be driven by the gut microbiome and can be reproduced in germ-free mice by giving them gut microbes from a person who has consumed the sweeteners. And the debate on appropriate salt intake rages on: The results of the PURE study were presented at the Word Congress of Cardiology in May and published in an article in the New England Journal of Medicine in August. The PURE article suggests that moderate (as opposed to low) sodium intake may be best for CVD prevention. A separate study on salt reached very different conclusions. (Source: Medscape)
Wellness Blog

1. The right skin cream can keep your skin looking young: For reducing wrinkles, the topical treatment with the best evidence behind it is retinoic acid (as in Retin–A). The best ways to keep wrinkles at bay are using sunscreen and not smoking.
2. Antibacterial soap is best for keeping your skin clean: Many experts are concerned that the use of antibacterial soap could lead to more antibiotic-resistant bacteria. Antibacterial soap is not necessary for everyday use. Regular soap is fine. Thorough and consistent hand-washing, not antibacterial soap is what helps prevent the spread of infection.
Dr KK Spiritual Blog
You Cannot Serve Two Masters (God and Wealth)

This is true for both your internal spiritual journey as well as the external social journey in life. Wealth is an indicator of greed, which is one of the five known obstacles to the pathway of self-realization.

Greed according to the Patanjali is defined as possessing any material wealth more than your need.

Greed in turn is linked to attachment through any of the five senses and uncontrolled desires. Once desires are fulfilled more desires are created, which is nothing but greed. And when the desires are not fulfilled then greed gets converted into anger, which leads to loss of intellect and ultimately destruction of the body.

Lord Krishna in the Bhagavad Gita while explaining this to Arjuna has clearly mentioned the pathway of self destruction starting from attachment to loss of intellect and ultimately destruction of the self.

The Hindu mythology has always said that never be after money. When you are after money the knowledge or the wisdom will not follow you. The classical example given is that if you are after Saraswati (God of Knowledge), Laxmi (God of Wealth) follows you and if you are after Laxmi, Saraswati may not remain with you.

God is representative of your true self and that is your consciousness, which is nothing but "Satchitananda" or the triad of truthfulness, consciousness based decisions and internal bliss or happiness. To be in touch with your consciousness you have to control your five senses through your mind and detach yourself from the egocentric desires.

Greed and wealth are representatives of attachment to the material world through one of your five senses, therefore, if you want to be in touch with your consciousness you have to be detached from the materialistic world and wealth is one of them.

There is a classical description of this phenomenon in Mahabharata in the battle of Kurukshetra when Lord Krishna became the Sarathi of Arjuna and rode the five horses chariot. The symbolic representation of the whole thing is, Lord Krishna represents your true self or consciousness; Arjuna represents the ego and the intellect; the reins of the horses represent the unstable mind and five horses represent the ever changing five senses.

Using your ego and intellect if you can tighten your mind (reins), you will be able to control the five horses (the five senses) and then you will have all the time in the world to be with Lord Krishna (your own consciousness). On the other hand, if you let the reins loose (let the mind wonder) all the horses (senses) will get uncontrolled and wander here and there (one gets attached to the materialistic world). The mind and the intellect, instead of becoming the master, then becomes the servant of the five senses and will get detached from the true self or the consciousness.

Electricity is a good servant and a bad master is a well known saying. Something is true for the five senses. They are very good to the life provided they are controlled like servants and never treated like masters. Once they overpower you, they will create an umbrella of darkness over the mind and the intellect making you forget about the presence of soul in the body. Once this happens, you lose your dharma.

Whenever given a choice, always choose your consciousness as the master and not any of the five senses, mind, intellect or ego.
Inspirational Story
The Gift from God

It was a warm summer day when God placed it in her hands. She trembled with emotion as she saw how fragile it appeared. This was a very special gift that God was entrusting to her. A gift that would one day belong to the world. Until then, He instructed her, she was to be its guardian and protector. The woman said she understood and reverently took it home, determined to live up to the faith God had placed in her.

At first she barely let it out of her sight, protecting it from anything she perceived to be harmful to its well- being; watching with fear in her heart when it was exposed to the environment outside of the sheltered cocoon she had formed around it. But the woman began to realize that she could not shelter it forever. It needed to learn to survive the harsh elements in order to grow strong. So with gentle care she gave it more space to grow...enough to allow it to grow wild and untamed.

One day she became aware of how much the gift had changed. It no longer had a look of vulnerability about it. Now it seemed to glow with strength and steadiness, almost as if it were developing a power within. Month after month she watched as it became stronger and more powerful, and the woman remembered her promise. She knew deep within her heart that her time with the gift was nearing an end.

The inevitable day arrived when God came to take the gift and present it to the world. The woman felt a deep sadness, for she would miss its constant presence in her life. With heartfelt gratitude she thanked God for allowing her the privilege of watching over the precious gift for so many years. Straightening her shoulders, she stood proud, knowing that it was, indeed, a very special gift. One that would add to the beauty and essence of the world around it. And the mother let her child go.
Cardiology eMedinewS
  • A large–scale morbidity and mortality trial (PEGASUS–TIMI 54) that evaluated ticagrelor on top of low–dose aspirin therapy showed the drug significantly reduced the risk of major adverse cardiovascular events in high-risk patients with a history of MI.
  • New research has suggested that Urotensin II (UII), a peptide first isolated from teleost fish, could be used in the battle against cardiovascular disease. UII activates a G protein–coupled receptor called UT and regulates a number of signalling pathways including intracellular Calcium. The report is published in Pharmacological Reviews.
IJCP’s ejournals
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  • Indian Journal of Multidisciplinary Dentistry
  • Asian Journal of Diabetology
  • Asian Journal of Critical Care
  • Asian Journal of Clinical Cardiology
  • Asian Journal of Obs & Gyne
  • Asian Journal of Paediatric Practice
  • Asian Journal of Ear Nose and Throat
IMA in the News
  • Rural posting not to be mandatory for doctors: The Tribune
  • Obama health: pollution no problem: Rashtriya Sahara
  • Govt. to provide better medical facility in rural area: Dainik Bhaskar
  • ESIC cannot suddenly close medical college: Aggarwal: Vir Arjun
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Video of the Day
Dr K K Aggarwal head on with Arnab Goswami of Times Now on MCI Issues
h t t p : / / w w w . t i m e s n o w . t v / D e b a t e -
Heart Care Foundation of India announces the Mrs Abheeta Khanna Oration on Excellence in Sports and Health
Betiyan Hain Anmol, Bachao Dil Se, Medanta joins hands with Heart Care Foundation of India
Rural posting not to be mandatory for doctors
Govt seeks volunteers, asks IMA for proposals to improve coverage

Tribune News Service
New Delhi, January 14
Medical graduates can finally heave a sigh of relief with the government set to abandon the long–debated proposal of mandatory rural posting for doctors.
Health Minister JP Nadda today said the Ministry of Health didn’t want to move ahead with a proposal that doesn’t account for the opinion of stakeholders.
"I have appealed to the Indian Medical Association to show us the way forward on improving the coverage of villages with doctors since the IMA has itself spoken of "Chalo Gaon ki Aur.". On rural postings of doctors, we don’t want to move forward unless we have the stakeholders on board. We are waiting for their suggestions," Nadda said answering a Tribune query on the subject today. Nadda admitted India was short of 7.5 lakh doctors.
The IMA has been opposed to mandatory village posting for MBBS doctors since the time the previous Congress led UPA proposed making village posting a precondition for writing the medical PG exam. The BJP government under Harsh Vardhan as Health Minister recently dropped this precondition and asked the MCI to amend its three–year PG course to make one year of rural posting compulsory while medical graduates do their PG. But even the latter proposal now stands in abeyance with Ministry sources saying there is near consensus among stakeholders on encouraging voluntary village postings of doctors by incentivizing them. India has 25000 primary health centres, most of them are facing doctor shortage.
Health Secretary Luv Verma said in a recent meeting on the issue with the IMA and MCI there was a consensus on voluntary measures instead of mandatory to ensure doctors for rural areas.
The IMA, meanwhile, will hold regional consultations with stakeholders, including students before submitting its proposals on the issue to the government.

"We are in discussion with states to incentivise rural postings by offering good monthly salaries to doctors agreeing to serve in villages and finding other ways," said a ministry source.
Pediatrics eMedinewS
  • Daytime naps may be critical to a child's development, helping them remember newly learned skills and behavior, suggests a new study published in the Proceedings of the National Academy of Sciences.
  • New research published in the Journal of the Royal Society of Medicine suggests that circumcised boys are more likely than intact boys to develop autism spectrum disorder (ASD) before the age of 10.
eMedinewS Humor
The Anesthesiologist

Jill received a bill from the hospital for her recent surgery, and was astonished to see a $900 fee for the anesthesiologist. She called his office to demand an explanation.

"Is this some kind of mistake?" Jill asked when she got the doctor on the phone.

"No, not at all," the doctor said calmly.

"Well," said Jill, "that’s awfully costly for knocking someone out."
"Not at all," replied the doctor. "I knock you out for free. The 900 dollars is for bringing you back around."
Rabies News (Dr A K Gupta)
Is there carrier state of rabies in dogs?

A carrier state of rabies in dogs/cats has not yet been conclusively proven and established.
Dr Good Dr Bad
IJCP Book of Medical Records
IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.
If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us at: www.ijcpbookofmedicalrecords.com
  • First person and NGO to trained Maximum Number of Police People trained in Hands only CPR10 in one day
  • "First NGO and doctor to provide "hands on training" to 11543 people in "Hands Only CPR 10" in one day.
  • First individual doctor and NGO to provide "hands on training" to 8913 females in "Hands Only CPR 10" in one day.
eMedi Quiz
Injury to radial nerve in lower part of spiral groove:

1. Spares nerve supply to ex tensor carpi radialis longus.
2. Results in paralysis of anconeus muscle.
3. Leaves extension at elbow joint intact.
4. Weakens pronation movement.

Yesterday’s Mind Teaser: The cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:

1. Transitional
2. Stratified squamous
3. Stratified cuboidal.
4. Stratified columnar.

Answer for yesterday’s Mind Teaser: 1. Transitional

Correct Answers received from: Dr K V Sarma, Dr Rakesh Sharma Nohar, Dr Avtar Krishan.

Answer for 14th Jan Mind Teaser: 3. Lateral rectus and abducent nerve.

Correct Answers receives: Tukaram Pagad, Daivadheenam Jella.
News around the Globe
  • New research has identified a possible biomarker of Huntington’s disease characterized by deficits in the mitochondrial energy production process. Additionally, a novel synthetic triglyceride oil may be able to correct these deficits and may be a potential treatment of the condition. The findings are published online in Neurology.
  • A study of more than 1200 patients treated with disease-modifying antirheumatic drugs (DMARDs) has suggested that patients started on therapy within a few months of symptom onset will have more durable DMARD–free remissions than patients for whom therapy was delayed. The study is published online in the Annals of the Rheumatic Diseases.
  • The US Food and Drug Administration (FDA) has approved a novel implantable device for treating obesity. The VBLOC Vagal Blocking therapy is indicated for the treatment of obese adults who have a body mass index (BMI) of 40 to 45 kg/m2 or of >35 kg/m2 with comorbid conditions such as hypertension or dyslipidemia and who have failed to respond to at least one supervised weight management program within the past 5 years.
  • Adults with asthma are at increased risk for new–onset obstructive sleep apnea (OSA), suggests a new study published in the January 13 issue of JAMA.
  • A new study, published in the BMJ, finds that individuals working extra hours may be more likely to engage in risky alcohol consumption, putting them at higher risk of alcohol–related health problems, such as liver disease, mental disorders and heart disease.
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 https://www.youtube.com/watch?v=rjOel0aaqt0
Press Release of the Day
Low vitamin D linked to heart risk

Low blood levels of vitamin D are associated with an increased risk of cardiovascular problems such as heart attack and stroke, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and Sr. National Vice President Indian Medical association.

A 5–year research with participants in the Framingham Heart Study included 1,739 people, average age 59 years and living in Massachusetts City found that those with the lowest levels of vitamin D had a 62 percent greater risk of a cardiovascular event than those with the next highest levels.

According to a report published in the journal Circulation, an hour or so of sunlight on the skin each week allows the skin to produce blood levels of about 30 nanograms of vitamin D per liter of blood, more than enough to prevent a deficiency such as rickets.

Food sources of vitamin D include fortified milk and oily fishes such as salmon.

Recommendations from the U.S. Institute of Medicine call for a daily intake of vitamin D ranging from 200 International Units (IU) for young people, to 400 IU for the middle–aged, to 600 IU for older people. But getting that amount from food and sunlight may not be easy. A glass of fortified milk contains only about 100 IU of vitamin D. The suggested recommendation is 1,000 – 2,000 IU.

The cardiovascular risk associated with low vitamin D levels was especially greater for people who also had high blood pressure. Their incidence of cardiovascular events was double that of people with higher blood levels of vitamin D.
Reader Response
Dear Sir, Very informative newspaper. Regards: Dr Samay.