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  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 May 2011, Tuesday                                eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

We are living in Kalyuga and not in Ghore Kalyuga

The recently concluded Assembly Elections in West Bengal, Tamilnadu, Pondicheri, Assam and Kerala have proved that we are living in Kalyuga and not in ‘Ghore Kalyuga’ as the public has outrightly rejected the mandate in every State where corruption, directly or indirectly, was linked. In Vedantic language, corruption is defined in terms of Sat Yuga, Treta Yuga, Dwapar Yuga and Kalyuga. Sat Yuga is the era when the majority of people are Satyugis and Kalyuga is the era when the majority of people are Kalyugis.

Whether a person is a Satyugi or a Kalyugi is decided by four characteristics and these are – presence of truthfulness (Satya), hardwok (Tap), positive thoughts and Daya cum Daan. If all four characteristics are present in a person, he is Satyugi; if satya is absent, then the person is Treta Yugi; if first two characteristics are absent, the person is Dwapar Yugi and if only Daya and Daan are present, the person is Kalyugi.

Kalyugi people like Ravan were in the Treta Yuga. In Dwapar Yuga, there were Kalyugis like Kans and Duryodhan. Similarly, in Kalyuga, there are bound to be Satyugi people. The very fact there is a change of power in Tamil Nadu, it clearly shows that the 2G spectrum corruption charges did make an impact.

The 0–18 years population group made the Anna Hazaare Movement a success. This group was with him as this is the age group which has not tasted corruption as yet. Likewise in politics, it was the 18–25 years of population which made all the difference. Again this age group is relatively hone.

Dr KK Aggarwal
Editor in Chief
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    Changing Practice – Evidence which has changed practice in last one year

Timing of treatment for relapsed ovarian cancer

For most women, second–line treatment for relapsed ovarian cancer should be initiated at the time when signs or symptoms of a disease recurrence are detected, rather than on the basis of an asymptomatic elevation in the CA–125 level. However, this decision should be individualized and based upon an active discussion between physicians and patients of the risks and benefits of early versus delayed treatment.

 
  eMedinewS Audio PostCard

Rheumatoid arthritis Update

Dr Harvinder S Luthra Speaks on
‘Varied presentations: FUO’  

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth day 20011

World Earth Day 2011 (Theme: Global Warming) was observed in a function on 21st April. In the Photo: Award winning students of DPS, Mathura Road and distinguished guests.

 
Dr K K Aggarwal
 
    National News

Who says the medical profession is not a noble profession

  1. With every rise in inflation, the GP’s fee does not increase.
  2. The petrol charges have been hiked by Rs 5 a litre. Petrol in Delhi will now cost Rs 63.37 per litre compared to the previous Rs 58.37 per litre. But the GP’s fee has not increased.
  3. GPs still charge much less than electricians or plumbers.
  4. Most GPs will not charge money if they are called to certify a dead person. Will a cremation ground or a hearse van do the same?
  5. Most GPs would not charge a poor person a consultation fee. Will a shopkeeper do the same?
  6. All medical samples are distributed free by the doctors to their patients. Does a grocery shopkeeper do the same?
  7. Only a doctor and a journalist will enter a high-risk terrorist area (apart from police/army) to take care of the victims
  8. Only a doctor will travel 20 km to see a patient at 1a.m. in the morning in his own car and may end up charging for a consultation that is less than what a taxi would charge for the travel alone.
  9. In most corporate hospitals, the parking fee is 15–30Rs but still the doctors conduct free OPDs and do not charge from the patients
  10. Most doctors participate in free health camps without any compensation.

UN Decade of Action for road safety launched

NEW DELHI: "The Decade of Action for Road Safety", a plan promoted by United Nations (UN) to stabilise and reduce road traffic fatalities worldwide by the year 2020, has been launched here in India and a 100 other countries. In India, the UN decade of action for road safety was launched jointly by the International Road Federation (IRF), Institute of Road Traffic Education, (IRTE), All India Institute of Medical Sciences Apex Trauma Centre and Indian Department of Road Transport and Highways. Developed with the support of the World Health Organisation (WHO), the "plan for the decade" would enjoin all agencies, organisations and groups concerned to help minimise road accidents. Road users also would be involved in working towards strengthening preventive programmes, improving trauma care and monitoring progress of the efforts launched under the plan. (Source: The Hindu, May 13, 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)

Making the move to exercise for overweight and obese people

How much exercise are overweight and obese people getting? More than many might think, according to research findings by nurses from Case Western Reserve University’s Frances Payne Bolton School of Nursing. They reported their findings in the Journal of the American Academy of Nurse Practitioners article, "Exercise and exercise intentions among obese and overweight individuals." Deborah Walton Smith, who is now a senior lecturer at Gonzaga University, undertook the exercise study while a graduate student at Case Western Reserve. Also collaborating on the study were Joyce Fitzpatrick, the Elizabeth Ford Professor of Nursing, and Mary Quinn Griffin, assistant professor of nursing at Case Western Reserve.

(Dr Monica and Brahm Vasudev)

Anticholinergics associated with higher mortality than long-acting inhaled beta–agonists in COPD

Long–acting inhaled beta–agonists were associated with lower mortality than anticholinergics in a new study of chronic obstructive pulmonary disease (COPD). The retrospective cohort study used health administration data on more than 46,000 Canadian patients with COPD who were newly prescribed either a long–acting inhaled beta–agonist or an anticholinergic between 2003 and 2007. Patients were followed for up to 5.5 years, and results appeared in the May 3 Annals of Internal Medicine.

Omalizumab added to standard therapy may help control severe allergic asthma

Omalizumab may help control severe allergic asthma when added to standard therapy, a new study suggests appeared in the May 3 Annals of Internal Medicine.

Levothyroxine dose may be linked to fracture risk in older adults, study suggests

Levothyroxine, especially at higher doses, may be associated with increased fracture risk in older adults, according to a new study published online April 28 by BMJ.

 
    Spiritual Update

Hanuman Chalisa

Jam Kuber Digpal Jahan Te
Kabi Kabid Kahin Sake Kahan Te

Meaning: Even Yamraj (God of Death), Kuber (God of Wealth) and the Digpals (Deputies guarding the four corners of the Universe) have been vying with one another in offering homage to your glories. How then, can a mere poet give adequate expression of your super excellence.

Spiritual significance: The powers of Pranayama and Hanumana are endless. One can even win over the fear of death and desires of wealth by regular Pranayama.

 
    IJCP Special

Dr Good Dr Bad

Situation: A elderly patient with fever had a single episode of chills.
Dr. Bad: This is classical malaria.
Dr. Good: It can also be pneumonia.
Lesson: Single episode of chills is often seen in elderly patients with pneumonia.

Make Sure

Situation: A 42–year–old male developed acute heart attack after playing squash.
Reaction: Oh my God! Why had he not got a cardiac check up done yet?
Lesson: Make sure that after the age of 40 anybody going for anaerobic games should first get a cardiac clearance.

 
    An Inspirational Story

(Dr Prachi Garg)

The kind and the peace contest

There once was a king who offered a prize to the artist who would paint the best picture of peace. Many artists tried and submitted their work. The king looked at all the pictures. There were only two he really liked, and he had to choose between them.

One picture was of a calm lake, perfectly mirroring the peaceful, towering mountains all around it. Overhead was blue sky with fluffy, white clouds. It was the favorite of all who saw it. Truly, they thought, it was the perfect picture of peace.

The other picture had mountains, too, but these were rugged and bare. Above was an angry sky from which rain fell and in which lightening played. Down the side of one mountain tumbled a foaming waterfall. A less peaceful picture would be difficult to imagine. But when the king looked closely, he saw beside the waterfall a tiny bush growing in a crack in the rock. In the bush a mother bird had built her nest. There, in the midst of the rush of angry water, sat the mother bird on her nest in perfect peace.

Which picture would you have selected? The king chose the second picture. Do you know why?

"Because," explained the king, "peace does not mean to be in a place where there is no noise, trouble, or hard work. Peace means to be in the midst of all these things and still be calm in your heart. This is the real meaning of peace."

Lesson: Real peace is in your heart.

 
    Pediatric Update

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

How do we diagnose a case of Hereditary fructose intolerance?

Urine

  • Positive for reducing substances (fructosuria)
    • Positive Clinitest but negative Clinistix indicates that the reducing substance is not glucose
  • Fructose identified by chromatography

Serum

  • Conjugated hyperbilirubinemia
  • Elevated transaminases with progressive liver disease

Liver biopsy

  • Progressive fatty infiltration and fibrosis
  • Focal cytoplasmic dissolution
  • Abnormal appearance of glycogen and mitochondria
  • Plate–like and needle–like crystals in hepatocytes

Fructose tolerance test

  • Contraindicated because fructose–1–phosphate is competitive with glucose–1–phosphate for phosphorylase and therefore a sudden load of fructose–1–P will interfere with the conversion of glycogen to glucose which causes sudden hypoglycemia leading to shock and death.
ijcpgroup
Docconnect
Docconnect
 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

How can we evaluate the Female Recipient?

Routine medical and reproductive history should be checked for the women anticipating pregnancy. Abnormalities may require more detailed evaluation and treatment before proceeding with insemination.

A general physical examination includes a pelvic examination. Recommended tests include Blood group and Rh factor, HIV1 & 2, Rubella, Hepatitis B surface antigen, Hepatitis C antibody, VDRL.

Women with regular cyclic menses are assumed to be ovulating. FSH, LH and Estradiol tests are done to check the hormonal profile. Patients who fail to conceive after four to six well–timed, hysterosalpingography (HSG), laparoscopy, or other appropriate tests can be done to detect possible causes for their failure to conceive.

 
    Medicolegal Update

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

The Designer drugs are widely known as club drugs

Many a times I have came across to examine the criminally involved/injured in club/bar/disco fight person/teenager who is under influence of alcohol and drugs/date rape drug/designer drugs brought by police for forensic medical examination. The Designer drugs are widely known as Club Drugs for their prevalence at trendy night clubs and teenage rave parties. These drugs are synthetic substances created by changing the molecular structure of existing drugs normally amphetamines/methamphetamine and fentanyl to create new drugs with similar or enhanced/much enhanced pharmacological effects.

  • The effect of designer drugs varies widely, depending on potency and the latest recipe employed by their illicit manufacturer. Designer drugs initially came into vogue as an attempt to circumvent the narcotic law which strictly/legally bans various narcotic/psychotropic drugs and chemicals.
  • The most common drugs I heard of during the medical examination of legal cases in/around Delhi, are club drugs derived from methyl–enedioxy–methamphetamine (MDMA) sold as Ecstasy in rave parties. This drug produces feeling of euphoria initially which helps/increases rave energy for active and untired participation in club/party activities. When the dose of drug is increased, it generates paranoia and hallucination and psychologically treated as a strong performance–enhancer in rave parties. But, it finally causes depression and irrational violence resulting in many criminal act like rape/murder/severe car accident under the influence of this drug by the users.
  • Chronic symptoms of designer drugs use are confusion/irritability/amnesia/insomnia and severe anxiety and teenagers seen with such symptoms required immediate medical care.
  • The use of such drugs is dangerous for our future generation and against the culture of this great Indian nation. The existing India law for narcotic substances required amendment to go in a way such as Australia and New Zealand, but has gone the opposite direction and enacted sweeping bans based on chemical structure only, making chemicals illegal even before they are created
  • If even a theoretical chemical fits a set of rules regarding substitutions and alterations of an already banned drug, it too is banned. The controlled substance analogue law under both Australian Federal law and that of some individual states such as New South Wales is so broad that it would cover millions of compounds that have never been made, simply on the basis that they bear a vague resemblance to one of the drugs on the illegal list.
 
    Twitter of the Day

@DrKKAggarwal: Evidences that meditation works Stress: The term meditation is also referred to as the "relaxation response."

@DeepakChopra: Own your own feelings. Nobody else does. Accept that you don’t own the other person’s feelings. They do.

 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Planning labor and delivery

Women with a booking BMI >30 should have an informed discussion antenatally about possible intrapartum complications associated with a high BMI, and management strategies considered.

Observational studies have shown that there is a higher incidence of intrapartum complications among women with obesity compared to women with a healthy weight. There is an increased risk of slow labor progression, shoulder dystocia and emergency cesarean section. There is also an increased risk of primary postpartum hemorrhage. Caesarean section can be more technically difficult in these women and there is a higher risk of anesthetic complications compared to healthy–weight women. The decision for mode of delivery should therefore be taken only after careful consideration of the individual circumstances and in conjunction with the full multidisciplinary team and the woman herself.

Women should be given the opportunity to discuss how the complications outlined above can be minimized. Women with a booking BMI >30 should be referred to a consultant obstetrician to enable this discussion.

 
    Mind Teaser

Read this…………………

ch poorri

Yesterday’s Mind Teaser: An anesthetist orders a new attendant to bring the oxygen cylinder. He will ask the attendant to identify the correct cylinder by following color code:

a. Black cylinder with white shoulders
b. Black cylinder with gray shoulders
c. White cylinder with black shoulders
d. Grey cylinder with white shoulders

Answer for Yesterday’s Mind Teaser: a.

Correct answers received from: Dr MK Bhandari, Dr Y J Vasavada, Dr Neelam Nath, Dr (Maj. Gen.) Anil Bairaria, Dr Jainendra Upadhyay, Dr Gajveer Singh, Dr Prabha Sanghi, Dr A K Sharma.

Answer for 15th May Mind Teaser: c.
Correct answers received from: Dr Kunal, Dr Mayank, Dr Prachi, Dr Santosh, Dr Rashmi, Dr Anurag.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr. GM Singh)

Identity

A certain little girl, when asked her name, would reply, "I’m Mr. Sugarbrown’s daughter." Her mother told her this was wrong, she must say, "I’m Jane Sugarbrown." The Vicar spoke to her in Sunday School and said, "Aren’t you Mr. Sugarbrown’s daughter?" She replied, "I thought I was, but mother says I’m not."

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Non HDL Cholesterol = Total Cholesterol – HDL Cholesterol
Non HDL cholesterol is a strong predictor of cardiovascular risk.

 
    Medi Finance Update

(Dr GM Singh)

What is Amortization?

Amortization is a method of equated monthly payments over the life of a loan. Payments usually are made monthly but can be paid annually, quarterly, or on any other schedule. In the early part of a loan, repayment of interest is higher than that of principal. This relationship is reversed at the end of the loan.

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Ibuprofen 400mg + Chlorzoxazone 500mg Tablets
For the short term treatment of musculoskeletal pain associated with inflammation and spasm in adults only
07/04/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Knee osteoarthritis

According to results of an open 1–year pilot study, joint distraction can induce tissue structure modification in knee OA and could result in clinical benefit. No current treatment is able to induce such changes. (Ref: Intema F, Van Roermund PM, Marijnissen AC, et al. Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1–year pilot study. Ann Rheum Dis 2011 May 12. Epub ahead of print)

 
  Thought of the Day

Swami Vivekananda said: "Talk to Yourself Once In A Day…Otherwise You May Miss Meeting An EXCELLENT Person In this World.

 
    Readers Responses
  1. This is great part in this emedical news with audio ppt, thank you sir, your Dr.Rajesh
 
    Public Forum

(Press Release for use by the newspapers)

Guidelines on Health – Keep your BP under Control

New Delhi: Monday, 16 May 2011: In the light of the increasing incidence of various ailments Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India issued the following guidelines:

  • Keep your blood pressure lower than 120/80 mmHg.
  • Keep your blood cholesterol less than 160 mg%. Even 1% reduction in cholesterol reduces the chances of heart attack by 2%.
  • Uncontrolled diabetes and blood pressure can precipitate a heart attack. Keep these under check.
  • Eat less, walk more.
  • Regular exercise is good for health. The best exercise is walking, which is a brisker than brisk walking.
  • Soya products are good for health. These should form an essential ingredient of the diet.
  • Fruits are better than juices. Brown rice better than polished rice and jaggery better than white sugar. Eat high fibre diet.
  • Driving and drinking do not go together.
  • Pregnant women must not drink. It harms the baby in the womb.
  • Get your health checkup done once a year.
  • Salt intake should be restricted.
  • Avoid APC where A stands for achar, P for papad and C for chutney.
 
    eMedinewS Special

1. eMedinewS audio PPT (This may take a few minutes to download)

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

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  Playing Cards

  Dadi Ma ke Nuskhe

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  Mental Diseases

  Perfect Health Mela

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  Towards Well Being

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  How to Use

  Pesticides Safely

 
    Forthcoming Events

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

………………………………………………………………

Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at
medifilmfestinhealthmela@gmail.com

………………………………………………………………

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr AK 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.