April 16  2015, Thursday
Psoriasis, a complex immune–mediated disease
Dr KK AggarwalPsoriasis is a complex immune–mediated disease and is a common disorder that affects men and women equally. The disease can manifest at any age; however, the peak times for disease onset are young adulthood (ages 20 to 30 years) and late middle age (ages 50 to 69 years).

There are several clinical subtypes of psoriasis. The most common presentation of psoriasis is plaque psoriasis, which presents as sharply defined erythematous plaques with overlying silvery scales. The most commonly affected areas include scalp, extensor surface of elbows, knees and back.

Psoriasis may also affect the joints. Psoriatic arthritis occurs in about 30 percent of patients with psoriasis, and precedes the skin manifestations in about 15 percent of patients.

In most patients, a diagnosis of psoriasis can be made by history and physical examination. But, sometimes, a skin biopsy is needed to rule out other conditions.

Numerous topical and systemic therapies are available for the treatment of psoriasis. The treatment approach for the individual patient depends on the severity of the disease, relevant comorbidities, patient preference (including cost and convenience), efficacy and evaluation of individual patient response.
213th Meeting of the Central Working Committee of Indian Medical Association at Hotel Radisson Blu, New Delhi.
  • The use of aspirin after newly diagnosed nonmetastatic prostate cancer does not lower disease-specific or overall mortality, suggests a large population-based study published in the April issue of the Journal of Urology.
  • Women have a significantly greater risk of developing posttraumatic stress disorder (PTSD) than men, regardless of the severity of the traumatic event, suggests a new prospective study presented at the Anxiety and Depression Association of America (ADAA) Conference 2015.
  • An intensified hospital-based program providing physical rehabilitation and information to patients coming out of the intensive care unit (ICU) did not appear to improve most outcomes in the RECOVER trial. The findings are published online April 13 in JAMA Internal Medicine.
  • The Royal College of Obstetricians and Gynaecologists (RCOG) released updated guidelines on preventing and treating thromboembolic disease in pregnancy, during childbirth, and after delivery. The guidelines were published online April 13.
  • Gene therapy is superior to haploidentical hematopoietic stem cell transplantation (HSCT) to treat X-linked severe combined immunodeficiency (SCID-X1), suggests a report published online April 13 in Blood.
Dr KK Spiritual Blog
You Get What You Give

A son and his father were walking on the mountains. Suddenly, his son falls, hurts himself and screams: "AAAhhhhhhhhhhh!!!"

To his surprise, he hears the voice repeating, somewhere in the mountain: "AAAhhhhhhhhhhh!!!"

Curious, he yells: "Who are you?" He receives the answer: "Who are you?" and then he screams to the mountain: "I admire you!" the voice answers: "I admire you!"

Angered at the response, he screams: "Coward!" He receives the answer: "Coward!"

The boy is surprised, but does not understand. Then the father explains: "People call this ECHO, but really this is LIFE. It gives you back everything you say or do. Our life is simply a reflection of our actions. If you want more love in the world, create more love in your heart. If you want more competence in your team, improve your competence. This relationship applies to everything, in all aspects of life. Life will give you back everything you have given to it. (Shared by Man Mohan Mundra)
Cardiology eMedinewS
  • The Micra transcatheter pacing system (TPS) has gained CE Mark approval in Europe. This will now enable European physicians to have access to a second leadless pacemaker.
  • A novel algorithm that includes measuring high-sensitivity cardiac troponin T (hs-cTnT) levels can safely and effectively rule out acute MI within 1 hour in patients presenting to the emergency department with chest pain, suggests a new study published April 13 in CMAJ.
Pediatrics eMedinewS
  • Children who had sleep problems at the age of 18 months were at an increased risk for behavioral and emotional problems at both age 18 months and age 5 years, reported a study published online April 13 in JAMA Pediatrics.
  • Suicide in youth is a result of a complex interplay of many factors; of these, bullying is only one, suggests new research presented at the Anxiety and Depression Association of America (ADAA) Conference 2015.
Make Sure
Situation: A chronic smoker developed cancer of lung.
Reaction: Oh my God!! Why was he not screened earlier for cancer of lung?
Lesson: Make sure that all chronic smokers are given an option for lung cancer screening with low dose spiral CT.
Dr Good Dr Bad
Situation: A patient wanted to know if a gel was available for use along with a condom for a high–risk sex.
Dr Bad: There is no such gel.
Dr Good: Yes, one such gel is available.
Lesson: In July 2010, the Centre for the AIDS Programme of Research in South Africa (CAPRISA) reported that a vaginal gel containing the antiretroviral drug tenofovir reduced the risk of male–to–female sexual transmission of HIV by approximately 40%. NIH funding provided the training and research infrastructure for this study.

(Copyright IJCP)
eMedinewS Humor
Upset is Unhealthy

The mother of a problem child was advised by a psychiatrist, "You are far too upset and worried about your son. I suggest you take tranquilizers regularly."

On her next visit the psychiatrist asked, "Have the tranquilizers calmed you down?"

"Yes," the boy’s mother answered.

"And how is your son now?" the psychiatrist asked.

"Who cares?" the mother replied.
eMedi Quiz
What percentage of your diet should fat make up?

1. About 10 percent of your daily calories.
2. About 20 percent of your daily calories.
3. About 30 percent of your daily calories.
4. About 40 percent of your daily calories.
5. There is no recommended amount of fat; you should strive to eat as little of it as possible.

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: Neurotoxic.

Correct Answers received from: Dr K Raju Dr Poonam Chablani, Dr Prabodh K Gupta, Daivadheenam Jella, Dr Avtar Krishan.

Answer for 14th April Mind Teaser: 4. Dessication of a dead body.

Correct Answers receives: Dr K Raju, Tukaram Pagad, Dr KV Sarma, Dr Shangarpawar, Daivadheenam Jella, Dr Avtar Krishan, Dr G Madhusudhan.
Rabies News (Dr A K Gupta)
If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular, anterior abdominal wall and the upper part of thigh
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
Letter of Appreciation
Dr KK Aggarwal
Hony Secretary General IMA HQ
New Delhi
Respected Sir

With immense pleasure and happiness, I would like to appreciate the proceedings of the 213th C.W. C. Meeting held on 11th April 2015 in Hotel Radisson Blu, New Delhi.

This is my 1st C.W.C. Meeting which I attended as the 1st State President IMA Telangana State. The meeting was conducted in a decent and dignified manner by maintaining the proposed timings; all the deliberations were useful to me and other participating IMA leaders. It has enlightened us on many issues pertaining to the Medical profession.

I appreciate Dr Marthanda Pillai, National President and Dr K K Aggarwal, Hony Secretary General and his office team (especially Mr. Sanjay) for their excellent organization.

Thanks & Regards
Dr K Shyam Sunder
President IMA Telangana State
Sonal Namaste
Over 200 diseases are caused by unsafe food containing harmful bacteria, parasites, viruses, chemical substances.
Facts about Tuberculosis (TB)
How many patients are successfully treated under RNTCP every year and how many patients have an adverse outcome?

Since the inception of the program, over 85% of the patients who are registered for treatment annually are being successfully treated. The most severe adverse outcome i.e. death has been maintained well below 5% during the same period.
Antriksh Indian Medical Golf Towers: IMA joins hands with Antriksh Group
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 Golf Towers’, situated at Sector 150, Noida-Greater Noida Expressway, Noida. This residential society and the colony will comply with all health parameters as defined by the IMA making it an environmentally healthy society.

IMA has been able to negotiate the following key items with Antriksh Group for its 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.
  • If at the end of 1 year, any member feels 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 to 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 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 Rs 1000 per sq ft in one year and by a minimum Rs 2000 per sq ft 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.

Contact details

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 with super area – 2025 sq ft, 2425 sq ft, 2900 sq ft and 3475 sq ft
  • Sector 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
Inspirational Story
The house with the golden windows

The little girl lived in a small, very simple, poor house on a hill and as she grew she would play in the small garden and as she grew she was able to see over the garden fence and across the valley to a wonderful house high on the hill – and this house had golden windows, so golden and shining that the little girl would dream of how magic it would be to grow up and live in a house with golden windows instead of an ordinary house like hers.

And although she loved her parents and her family, she yearned to live in such a golden house and dreamed all day about how wonderful and exciting it must feel to live there.

When she got to an age where she gained enough skill and sensibility to go outside her garden fence, she asked her mother if she could go for a bike ride outside the gate and down the lane.

After pleading with her, her mother finally allowed her to go, insisting that she kept close to the house and didn’t wander too far. The day was beautiful and the little girl knew exactly where she was heading! Down the lane and across the valley, she rode her bike until she got to the gate of the golden house across on the other hill.

As she dismounted her bike and lent it against the gate post, she focused on the path that lead to the house and then on the house itself…and was so disappointed as she realized all the windows were plain and rather dirty, reflecting nothing other than the sad neglect of the house that stood derelict.

So sad she didn’t go any further and turned, heartbroken as she remounted her bike …

As she glanced up she saw a sight to amaze her…there across the way on her side of the valley was a little house and its windows glistened golden …as the sun shone on her little home.

She realized that she had been living in her golden house and all the love and care she found there was what made her home the ‘golden house’. Everything she dreamed was right there in front of her nose!
Wellness Blog
Most uncontrolled asthmatics think they are controlled

Two thirds of patients with uncontrolled asthma think that their disease is well under control. Asthmatics on proper medicines can not only live a normal life but also reduce their future complications.

Uncontrolled asthmatics invariably end up with complications related to right heart due to persistent lack of oxygenation in the blood.

Dr Eric van Ganse, of University of Lyon, France, in a study published in the Annals of Allergy, Asthma, and Immunology, examined 1,048 subjects with inadequate asthma control. When asked how they would rate their asthma control over the past 14 days, over 69 percent considered themselves to be completely or well controlled. Failure to perceive inadequate asthma control was more likely to be found in patients between the ages of 41 and 50 years.

The reasons are:
  • Most asthmatics fail to perceive their level of disease control and with an uncontrolled state they often feel that their asthma is under control.
  • In severe asthma, low blood oxygen levels might impair a person’s ability to assess their own breathing difficulty.
  • The notion of asthma control seems poorly understood by asthmatic patients.
  • Mild to moderate asthma limits the activities of a person and over a period of time they take that as their normal limits.
Quote of the Day
Man’s troubles are rooted in extreme attention to senses, thoughts, and imagination. Attention should be focused internally to experience a quiet body and a calm mind. Buddha
IMA in Social Media
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Twitter @IndianMedAssn 872 followers
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Reader Response
Congratulations to the National President and Hony Secretary General for organizing a very effective and informative CWC meeting. It was well-managed and smooth. We hope that follow-up action will also be very effective. Thanks: Dr RD Dubey
IMA Videos
News on Maps
Blood sugar above 90 increases risk of new onset diabetes in hypertensive patients
Hypertension or high blood pressure is a risk factor for development of type 2 diabetes. If the high blood pressure is not managed effectively, the patient is at risk of developing new onset diabetes, which may adversely affect the function of the kidneys, leading to chronic kidney disease, said Padma Shri Awardee Dr A Marthanda Pillai National President Indian Medical Association and Padma Shri, Dr B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

In an analysis of the findings from the blood pressure lowering-arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA) published in the journal Diabetes Care, fasting blood sugar level higher than 90 mg/dL was found to be the major factor that predicted the development of new-onset diabetes in hypertensive patients. For every 18 mg/dL rise in blood sugar above the level of 90 mg/dL, the risk of developing diabetes increased nearly 6 times. Patients who were being treated with the combination of beta-blocker and diuretic had significantly greater chances of developing new-onset diabetes.

BMI, serum triglycerides and systolic BP were also identified as determinants of new-onset diabetes in these patients. In contrast, factors like high HDL cholesterol levels, moderate alcohol use and age older than 55 years were found to be protective against development of diabetes.