emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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 and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 
  Editorial …

17th April, 2011, Sunday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Super Bug Controversy

Whether the Super Bug is present in New Delhi/India or not is the recent controversy created by the journal Lancet. The research in the journal has shown that the bacteria were found to exist in water collected from various areas in Delhi. The enzyme NDM1 has been noted in the bacteria E. coli present in the urinary tract and GI tract of many people. As per the report, many asymptomatic people may be harboring the resistant bacteria and may end up with sepsis in susceptible situations.

The controversies are:

When the bacteria are present in many countries, why has there been a label of NDM1? Why not simply call it ‘Metallo–latamase 1’.

Is this an attack towards the rising popularity of medical tourism in India, which is affecting the European business as most of the Arabian countries are now choosing India as medical hub in preference to European countries like UK?

Is it a conspiracy or a marketing strategy towards a future antibiotic? In the context of computers, we often see a fear of virus being created and then weeks or months after, we find a new antivirus in the market. It is possible that some pharmaceutical company which is funding this research is in process of launching a new antibiotic which will work on the super bug in the coming months or years.

Whether this bug is present or not, nevertheless it is true that many of us do observe cases of gram negative sepsis resistant to all antibiotic including carbepenems.

It is the duty of the Government of India through the Ministry of Health to do a time–bound research and come out with facts as they are answerable to the general public in this regard. In the meantime, it becomes the duty of all of us to remove the fear from the public mind and spread the facts that any technique of safe water is good enough to tackle all bacteria including super bug.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook

 
    Changing Practice – Evidence which has changed practice in last one year

Dabigatran for patients with atrial fibrillation

  • In patients with atrial fibrillation for whom anticoagulant therapy is chosen, choose dabigatran rather than warfarin.
  • The randomized RE-LY trial, published in 2009, demonstrated that dabigatran 150 mg twice daily was more effective for stroke prevention than adjusted-dose warfarin in patients with atrial fibrillation.(1)
  • In the fall of 2010, the US FDA approved the use of dabigatran for patients with atrial fibrillation who are at risk for stroke.(2,3)
  • Start dabigatran 150 mg twice daily for patients. The 110 mg dose is suggested for patients older than 80 years or at higher risk of bleeding.
  • Warfarin is a reasonable choice in AF for patients who are already taking it and whose INR is relatively easy to control, for those who are not likely to comply with the twice daily dosing of dabigatran, for those where cost of medication is important, and for patients with a creatinine clearance less than 30 mL/min.

References

  1. Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361:1139.
  2. Approval history is available on the FDA website.
    http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label
    _ApprovalHistory#apphist/ (Accessed on September 13, 2010).
  3. http://www.boehringer
    -ingelheim.com/news/news_releases/press_releases/2010/27_october_2010_dabigatran.html
 
    eMedinewS Audio PostCard

 Diabetes Update

Dr. Vinod Sanghi Speaks on
‘Diabetes in India’

Audio PostCard
 
    Photo Feature

National Conference on Gynae Endocrinology 2011

The National Conference on Gynae Endocrinology 2011 is ongoing at AIIMS, New Delhi. The conference is organised by Dept. of Obs and Gyne, AIIMS and Gynaecology-Endocrine Society of India (GESI). In the photo: The organizing committee

 
Dr K K Aggarwal
 
    PROCEEDINGS OF THE NATIONAL CONFERENCE ON GYNAE ENDOCRINOLOGY - 2011

16th April 2011, Venue: JLN Auditorium, AIIMS, New Delhi
Organized by Gynaecological Endocrine Society of India (GESI) and Department of Obstetrics & Gynaecology, AIIMS In collaboration with FOGSI, ICOG, AOGD, DST

Hirsutism: Evidence-based management

Dr Alka Kriplani, Head of unit Dept. of Obstetrics and Gynaecology, AIIMS & Organizing Chairperson of the conference spoke on Hirsutism defined as excessive terminal hair growth in androgen-dependent areas on a woman’s body. Specifically, sites of hair growth include the lip, sideburn area, chin, and chest. Hirsutism affects between 5 and 10% of women of reproductive age. It can be a mild cosmetic problem that requires only cosmetic therapy or it can have important psychologic or medical impact. In most cases this is due to increased production of bioavailable circulating androgen levels, endogenous or exogenous or increased sensitivity of peripheral target organs. The most common cause of hirsutism is polycystic ovarian syndrome. Other causes are late onset congenital adrenal hyperplasia, Cushing’s syndrome ovarian, pituitary and adrenal tumors are rare causes of hirsutism and should be considered in older women particularly those who develop hirsutism rapidly. A variety of treatments exist to help minimize the appearance of unwanted hair.

Turning back the ageing clock with botox and fillers

Dr Amit Luthra, Consultant Dermatologist and Esthetic Surgeon spoke on Botox & fillers. Age catches up with everybody, be it the prince or the pauper, wrinkles start appearing. ‘Ageing gracefully’ has given way to ‘Ageing beautifully’. There was a time when surgical option was ‘the’ option for a face-lift but with the introduction of botulinum toxin A (BTX-A), we have an alternative. Botox or BTX-A interferes with the release of Acetylcholine at the muscle end-plate and cause muscle paralysis. BTX-A is used to get rid of the dynamic lines e.g. frown & forehead lines, crow’s feet, neck lines, bunny lines etc. while fillers like hyaluronic acid are used to remove the static lines and grooves e.g. nasolabial and mentolabial. It is also used to augment lips, cheeks, nose and chin. The non surgical options like botulinum toxin A & fillers may not give as gratifying results as a surgical facelift but severe the purpose of a “quick, before party, no downtime” facelift and do end up in turning back the ageing clock although temporarily. Contraindications for botox use include pregnancy lactation and neuromuscular disorders.

Hormonal contraception in HIV-positive women: Myths and reality

Dr. Sarita Agrawal, Professor and Head, Dept. of Obstetrics and Gynaecology, Chhattisgarh Institute of Medical Science spoke about the many myths regarding hormonal contraceptives in HIV infected women.

Infectivity: Are women more likely to transmit HIV if they are on hormonal contraception?

Evidence is conflicting as to whether hormonal methods increase genital shedding, either indirectly by increasing a woman’s susceptibility to STIs, or directly by affecting the concentration of virus in genital secretions through shedding of HIV-infected cells from the cervix or vagina.

  • Many other factors influence how infectious a woman with HIV is:
    • Stage of disease
    • Whether she also has a STI
    • Whether or not she is using ARV

The most important advice is to use condoms to minimize the chances that an uninfected partner will come into contact with genital secretions that might contain HIV.

  • Secondly will protect against other STDs.
  • Even if partner is already infected, condom can prevent superinfection with new viral strains which may be more aggressive and drug resistant

Life Style and Endocrinology

Dr Shirish Patwardhan, President, Association of Maharashtra Obs & Gynae Society (AMOGS) spoke about the detrimental effects of the faulty lifestyle on the endocrinological system. Stress, boredom (monotony), faulty eating habits, lack of physical activity and lack of sleep lead to hormonal imbalances. Frequent snacking, watching too much TV and substance abuse (alcohol, tobacco use) were some of the bad habits he talked about. There was a need to change our lifestyle - these changes in lifestyle he described as the Karodpati vaccine. The components of this Karodpati vaccine were: Sleep, Silence, Suryanamaskar, Sexual life &Walk, Sprouts, Swachyata (Cleanliness). All six components go hand in hand. One can’t get away with adhering to five and constantly neglecting one. Thus sleeping for 8-10 hours, meditating(silence) for 45 minutes per day, doing 12 Suryanamaskar per day, having a happy sexual life and a brisk walk (30 min or 3 km),consuming lots of sprouts and raw fruits and vegetables in between meals and maintaining swachyata or cleanliness go a long way in maintaining a healthy lifestyle. He also advised us to start consuming more of jaggery instead of sugar and switch over to unpolished rice.

Endocrine disrupting chemicals and reproduction

Dr Suhani Verma, Academic Coordinator & Sr. Consultant Obstetrician, Gynaecologist & IVF Specialist, In charge IVF Lab, Indraprastha Apollo Hospitals, New Delhi in her talk on Endocrine Disrupting Chemical (EDCs) and Reproduction stressed upon the fact that despite tremendous advances in Infertility and ART, there was significant decline in fertility rates globally over last decade. There was evidence that quantity and quality of semen in normal men was also declining. This she attributed to harmful effects of the chemicals which are contaminating the food we consume. It is estimated that over 100 new chemicals are being introduced into the world every year, yet less than 5% have been investigated for their effect on reproduction. EDCs are substances in our environment, food and consumer products that interfere with hormone biosynthesis, metabolism or action, resulting in a deviation from normal homeostatic control or reproduction. Most of EDCs are persistent, lipophilic with low water solubility, leading to their bioaccumulation in adipose tissue. A concerted awareness and effort by the clinical communities must be made to further address this issue and minimize the risk. Health care professionals must get educated in sources and effects of EDCs exposures in utero and across the life span.

Contraception counseling

Dr. Ritu Joshi, Consultant Gynecologist, Jaipur touched upon various aspects of counseling in her talk. Most healthcare providers agree that counseling for contraceptive choice is necessary and appropriate. Counseling is defined as a helping process where one person explicitly and purposefully gives her/his time, attention and skills to assist the client to explore their situation, identify and act upon solutions within the limitations of their given environment. Counseling around contraceptive choice should be tailored to the individual woman. Individual choice of contraceptive method is a strong determinant of continuation. Effective counseling may be related to timing: Counseling postpartum increases decision to use, and actual use of, contraception; counseling pre-abortion can substantially increase contraceptive use. Structured and/or motivational counseling can be particularly successful for both appropriate contraceptive choice and adherence.
The primary purpose of counseling regarding contraception is to

  • Facilitate an informed decision regarding choice of birth control method that meets her lifestyle, needs and contraceptive goals
  • Increase the reliable use of the birth control selected
  • Improve adherence and continuation
  • Address side effects and dissatisfaction
  • Assess change in lifestyle, needs and contraceptive goals

She concluded her talk with the message that counseling should occur on a regular/periodic basis to re-assess appropriate choice and acceptability. Proactive follow-up with your patients after prescribing a contraceptive

Myths and realities in contraception

Several myths surround the use of contraceptives. Prof. Dr. Suchitra N. Pandit, Consultant, Kokilaben Dhirubhai Ambani Hospital and Vice President – MOGS (2011-2012) briefly described the various myths and the reality. Here are a few:

Myth: Emergency (I- pill) is the best contraceptive. What works is only I-Pill like all the IPL matches!!
Reality: Emergency contraception is to be used only in emergency if no contraceptive has been used; failure rate 1-15%. Avoid making it a habit. All IPLS don’t always work well….!

Myth: A break every few months is necessary while taking pills.
Reality: No gap is necessary with low dose pills and estrogens free pills. There is no rationale for recommending pill free interval “to rest.” This does not avoid or eliminate serious side effects. This practice often results in an unwanted pregnancy.

Myth: The pill causes infertility when it is stopped.
Reality: Studies published in reputed International Journals have shown that even after use for 5 years women have not had any delay in conceiving in comparison to women who never took the pill.

Myth: Pill cannot be taken during breastfeeding.
Reality: Estrogen-free pill/progesterone only pill can be safely taken during breastfeeding. They do not affect the growth of the baby and quantity & quality of breast milk.

Myth: IUDs cause infections.
Reality: Risk of infection with IUDs has been overestimated historically. Small increase in risk of infection within first 3 weeks of IUD insertion; risk beyond 3 weeks is comparable to non-users.

Myth: IUDs can’t be used in nulliparous women.
Reality: IUDs can be used in nulliparous women’provided the woman wishes it, technique of insertion is correct, and there is a prior infection it should be first treated. Current guidelines recommend IUDs as an effective option in nulliparous women.

Myth: Condoms are only for men.
Reality: Condoms can be used by women, they are made slightly differently.

Thyroid in infertility

The combination of thyroid and infertility is a complicated one that affects both men and women. Dr. Laxmi Shrikhande, Consultant Gynecologist, Pune, National Vice President FOGSI 2012 gave an insight into these very common diseases and how they affect fertility. In males, thyroid antibodies cause alterations of the anatomical as well as functional semen parameters depending on the auto-immune response to the thyroid antibodies. In women, thyroid disease can be associated with failure to ovulate, failure for fertilized eggs to implant and ovarian failure, in extreme cases. Premature menopause may occur in some women.

Awareness of the thyroid status in the infertile couple is crucial, because of its significant, frequent and often reversible or preventable effect on infertility. Women presenting with infertility should be screened for thyroid function. Earlier guidelines mention it is unnecessary in asymptomatic patients but evidence today is clear that all patients with infertility should be screened. There may be a role of antithyroid antibodies in cases of repeated IVF failures, which needs more studies. A clinical challenge is to identify cases of subclinical hypothyroidism. If detected and treated it improves clinical outcomes.

Take home message: Routinely screen for thyroid dysfunction and if present treat it effectively to improve pregnancy rates.

 
    National News

Cyclone risk mitigation project for Gujarat soon

AHMEDABAD: The National Cyclone Risk Mitigation project of the central government which will be launched in Andhra Pradesh and Orissa, will cover Gujarat in the second phase. This was announced by M Shashidhar Reddy, vice-chairman of National Disaster Management Authority. The Government of India has taken a decision to implement the World Bank assisted National Cyclone Risk Mitigation project in nine states and four Union Territories that are vulnerable to risks of cyclone. Gujarat is one of the nine states. The objective of the project is to minimise vulnerability and make people disaster resilient and infrastructure disaster proof. The key objectives of the project include strengthening of cyclone tracking and monitoring system, early warning dissemination, preparation of disaster management plans at different levels, conservation and regeneration of mangrove forests, construction of cyclone shelters among others. (Source: The Times of India, Apr 15, 2011)

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology: Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Routine periodic fasting is good for your health, and your heart

Fasting has long been associated with religious rituals, diets, and political protests. Now new evidence from cardiac researchers at the Intermountain Medical Center Heart Institute demonstrates that routine periodic fasting is also good for your health, and your heart. Today, research cardiologists at the Intermountain Medical Center Heart Institute are reporting that fasting not only lowers one's risk of coronary artery disease and diabetes, but also causes significant changes in a person's blood cholesterol levels. Both diabetes and elevated cholesterol are known risk factors for coronary heart disease. The discovery expands upon a 2007 Intermountain Healthcare study that revealed an association between fasting and reduced risk of coronary heart disease, the leading cause of death among men and women in America. In the new research, fasting was also found to reduce other cardiac risk factors, such as triglycerides, weight, and blood sugar levels.

(Dr Monica and Brahm Vasudev)

Intensive diabetes self-management program may be effective for improving glycemic control in certain patients

A study of 953 patients published in the Archives of Internal Medicine has found a link between orlistat and kidney injuries. Canadian researchers found that 0.5 percent of new orlistat users were hospitalized for kidney problems in the year before starting on the medication. That number increased to two percent over the next year.

Orlistat may be linked to kidney damage

Dialysis patients with restless legs syndrome (RLS) who use short daily hemodialysis (SDHD) at home show improvements in RLS severity and in sleep disturbances after a year, according to a study published online March 17 in the Clinical Journal of the American Society of Nephrology.

(Dr Monica and Brahm Vasudev)

What is the risk of a child having epilepsy if one or both parents are epileptic? Does it depend upon the type of epilepsy experienced by the parents?

Yes, the risk of a child developing epilepsy depends on the type of parental epilepsy. The inheritance of epilepsy appears to be multifactorial. Mendelian inheritance only accounts for 1-2% of seizure disorders. In three common familial genetic disorders – childhood absence epilepsy, juvenile myoclonic epilepsy and benign rolandic epilepsy – genetic factors seem to be important. The risk of developing epilepsy is greater if the mother has epilepsy (about 5%) rather than the father (about 2%) or if the epilepsy developed in a parent before the age of 10. I normally quote a risk of about 1 in 10 – slightly higher than the lifetime prevalence of 5%.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with heat stroke had fever >106.
Dr Bad: Give Inj paracetamol.
Dr Good: Do cold sponging.
Lesson: Paracetamol does not work in heat stroke unless the fever is brought down to < 103.

Make Sure

Situation: A 20–year–old college student complained of dysuria, frequency and pyuria.
Reaction: Oh my God! Why did you not advise macrolide?
Lesson: Make sure to remember that macrolides are very effective against E. coli, S. saprophyticus and C. trachomatis infection.

 
    An Inspirational Story

(Dr Prachi Garg)

The soldiers and the trench story (leadership)

The story goes that sometime, close to a battlefield over 200 years ago, a man in civilian clothes rode past a small group of exhausted battle-weary soldiers digging an obviously important defensive position. The section leader, making no effort to help, was shouting orders, threatening punishment if the work was not completed within the hour.

"Why are you are not helping?" asked the stranger on horseback. "I am in charge. The men do as I tell them," said the section leader, adding, "Help them yourself if you feel strongly about it." To the section leader's surprise the stranger dismounted and helped the men until the job was finished. Before leaving the stranger congratulated the men for their work, and approached the puzzled section leader. "You should notify top command next time your rank prevents you from supporting your men - and I will provide a more permanent solution," said the stranger.

Up close, the section leader now recognized General Washington, and also the lesson he'd just been taught.

(This story is allegedly based on truth. Whatever, similar examples are found in history, and arise in modern times too, so please forgive the mythical possibility of the above attribution; the story's message is more important than its historical accuracy.)

 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

How do you know that a lady has an ovarian problem?

An ovarian problem can be due to many factors. In a polycystic ovarian syndrome (PCOS), the lady is usually overweight and has delayed periods. She has numerous maturing eggs; due to hormonal imbalance they are unable to mature regularly. In endometriosis, though the exact cause is not known, it has been postulated that some of the blood flow is slow and damages the tube and ovarian tissue. This leads to cyst formation and egg damage. The lady would present with pain, abdominal pain during periods, and pain during intercourse or irregular menstrual period.

Ovarian pain may be due to lack of good quantity of eggs. A girl is born with a fixed number of eggs and by the time she reaches menopause, there are no eggs remaining on her reserve. About 10-15 years before menopause, she enters a phase called reduced ovarian reserve, where though she is menstruating regularly, the quantity of the eggs is poor with less or no chance of conception. Some time this happens many years prior to menopause, it is then called premature ovarian failure.

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    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

When does one suspect croup?

Croup is a viral illness and the diagnosis is usually clinical. It typically presents with a constellation of:

  • Barky cough
  • Hoarse voice
  • High-pitched, inspiratory stridor

It usually follows a prodrome of mild fever, rhinorrhea, and sore throat. Symptoms tend to worsen during late night and early morning. The breath sounds are normal with no added sounds except stridor. Occasionally, there may be wheezing, indicating severe narrowing or associated bronchitis.

 
    Medicolegal Update

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

Doctors should avoid special efforts to “cover up” any medical fact

The media and general public are vastly becoming informed and law conscious. There is awareness of modern diagnostic/therapeutic methods. The standard of doctors/hospital, its opinion and method of medical/surgical interventions are being scrutinized from time to time in public as well as Court of law and media. The doctor should not avoid talking to the media but definitely not too much and too soon.. Prejudicial and sensational statements should not be made by doctor prior to trial. It is incumbent upon doctors to have good knowledge of the law governing their profession, in order not to transgress the law.

  • Doctors should totally avoid special efforts to “cover up” alleged medical negligence or unintentional wrong doing or inevitable medical accident.
  • It is a standard accepted universal fact that “Medicine is not mathematics but is a science of uncertainty and an art of probability. One thing that makes medicine so difficult is that there is no such thing as the average man can understand the intricacies. We can only say the reading is ‘within the range of normal’. Medicine is a biological science with the variability inherent in body physiology with the variability inherent in biological matters.
  • Forensic medicine is not an exact science as a mathematical calculation hence while making a forensic opinion it is required to deliberate that unexpected results are produced due to biological variations in case to case, there is an element of uncertainty and absolute proof is a rarity in any medical care delivery.
  • Doctors should bear in mind the essential difference between probability and proof. They should be reasonable in their opinions and should not overstate the likelihood of a relationship between cause and effect.
  • The doctor should be ready to defend every finding and conclusion on the report on clinical and scientific grounds in the court of law. He should be aware of professional and scientific viewpoints which might differ from his, and should be familiar with the latest scientific literature in relation to the subject involved.
  • The doctor in the Court of law may clarifying his testimony by means of photographs, maps, diagrams, charts, X-rays, skeletons, models, slides, films, tapes, etc., when they are properly verified.
 
    Legal Question of the Day

(Dr. M C Gupta)

Can the police commissioner ask a private doctor to perform an autopsy?

Q. Can a private doctor perform autopsy if asked to do so in writing by the police commissioner?

Ans.

  • The simple answer is - YES.
  • The police commissioner would probably make such a request only in unusual circumstances, such as when no arrangement can possibly be made for autopsy to be performed by a government doctor. It would be the doctor’s duty to assist the police.
  • It can be only a request, not an order. The doctor would be fully within his rights to decline the request. He can always say that he has no expertise or knowledge or skills or confidence or facilities to perform the autopsy. No professional can be ordered by a person without authority to give professional opinion or perform a professional task against his will.
 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Why should obesity be treated?

Weight loss in obese persons improves health. Weight losses of 10 to 20 pounds have been shown to lower blood pressure, blood cholesterol, and blood glucose (in persons with type 2 diabetes), and to improve other health problems. An obese person does not have to lose fifty or a hundred pounds to realize health benefits, however, for even modest losses of weight can lead to major health benefits.

 
    Mind Teaser

Read this …………………

YYUR

Yesterday’s eQuiz: What is not true about malrotation of the intestine?

a. In incomplete rotation the rotation is arrested at 180 degree.
b. The small intestine lies on the right with cecum in the midline.
c. Ladd's band extends from the Right upper quadrant to the cecum.
d. Hyper rotation is the most common form of intestinal malrotation.
                                    

Answer for yesterday’s Mind Teaser:
d.

Correct answers received from: Dr Jainendra Upadhyay, Dr Chandresh Jardosh

Answer for 15th April eQuiz: b.
Correct answers received from: Dr.K.Raju, Dr Anil Bairaria, Dr Muthumperumal Thirumalpillai, Dr Rahul Sharma, Dr. Amol R. Hartalkar.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr. GM Singh)

What is the chemical formula for water?

Little Johnny's teacher asks, "What is the chemical formula for water?" Little Johnny replies, "HIJKLMNO"!! The teacher, puzzled, asks, "What on Earth are you talking about? Little Johnny replies, "Yesterday you said it was H to O!"

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Hemoglobin A1c

The glycohemoglobin A1c test checks the long-term control of blood glucose levels in people with diabetes. Most doctors think the glycohemoglobin A1c level is the best way to check how well a person is controlling diabetes.

  • Glucose binds to hemoglobin in red blood cells at steady rate. Since red blood cells last 3 to 4 months, the glycohemoglobin A1c test shows how much glucose is in plasma part of blood.
  • Some medical conditions can increase A1c levels, but the results may still be within normal level. Conditions include Cushing's syndrome, pheochromocytoma, and polycystic ovary syndrome (PCOS).
 
    Medi Finance Update

(Prof. Dr. S. Arulrhaj, MD., FRCP (Glasg)

My Views on Health Budget – 2011

The Health Care sector in India is a key sector poised for substantial growth in the coming years. The Indian healthcare industry currently stands at USD 35 billion and has a future potential to reach over USD 75 billion by 2012 and an estimated USD 150 billion by 2017.

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name

Indication

DCI Approval Date

Cyanocobalamin 15mcg + Chromium Picolinate USP 250mcg + Folic Acid USP 1500 mcg + Nicotinamide IP100 mg + Pyridoxine 3mg + Selenious Acid USP 100mcg + Zinc Sulfate Monohydrate USP 61.8 mg eq. to 22.5 mg

For Mineral & Vitamin deficiency states in adult patients

06/07/10

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Gout: Lower dose colchicine

A lower dose regimen of colchicine may have similar efficacy and fewer side effects than a traditional, higher dose regimen for patients with acute gouty arthritis. This was supported by the results of a randomized, placebo–controlled trial that compared colchicine given as 1.2 mg followed by one additional dose of 0.6 mg an hour later (total dose 1.8 mg), versus 1.2 mg followed by 0.6 mg every hour for up to six hours (total dose 4.8 mg).

(Dr Vinay Sakhuja)

Latin Quotes

Adolescentum verecundum esse decet.

A young man ought to be modest.

 
  Quote of the Day

(Dr GM Singh)

There is nothing either good or bad, but thinking makes it so. Shakespeare

 
    Readers Responses

1. The article on non violent communication is one of the best I have ever read on Communication. More articles like this will help make our regular conversations more thoughtful, meaningful and productive leading to lesser stress and better response. This aspect of communication needs to be taught, practiced and perfected. Regards: Anup Soans.

2. Dear Dr KK Aggarwal, I am neither a lawyer nor have knowledge of judiciary but I feel uncomfortable reading editorial on Supreme Court Judgement on Binayak Sen's plea. It will be better if medinews concentrates only on direct medical issues. Regards: Dr MMA Faridi
eMedinewS Responds: Dear Doctor, This editorial was written because Binayak Sen is himself a medical doctor.
The main emphasis of the editorial was to emphasize on the facts that the decisions of temporary canceling the registration of the doctors on the ground of medical negligence is not scientific. We have not written in the editorial the merit or demerit of Dr. Sen but indirectly on the issue that Medical negligence with professional misconduct is not a ground for punishment. Thanks

 
    Public Forum

(Press Release for use by the newspapers )

Gum bacteria can cause preterm delivery

Proper dental care can prevent heart attacks, heart blockages, asthma and COPD. This was stated by Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India. Bacteria present in the gums have been linked to many diseases in the past.

Periodontal treatment should be included in prenatal care programs, as per a study in the Journal of Periodontology, which has shown that treating gum disease in pregnant women may prevent preterm birth.

The study has shown that while pregnant women, in whom the periodontal disease was treated, were no more likely to deliver their babies prematurely than women with no gum disease. Those who did not get treatment had a nearly 90-fold increased risk of premature delivery.

Another study found that the more bacteria women with periodontal disease had in their gums during and after pregnancy, the more likely they were to deliver their infants prematurely.

 
    eMedinewS Special

1. eMedinewS audio lectures (This may take a few minutes to open)

2. eMedinewS ebooks (This may take a few minutes to open)

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  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

Pesticides Safely

  Towards Well Being

 

 
    Forthcoming Events

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD, Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com

………………………………………………………………

May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com

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September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA from.
Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.

• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts

Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta