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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
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


17h July, 2010, Saturday

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

FDA Panel votes not to remove rosiglitazone from the market albeit with more restrictions

In a surprise decision on rosiglitazone, advisors to the FDA have recommended keeping rosiglitazone on the market, though most did recommend stricter warning labels. The FDA will now decide which course to take. Six votes were taken by the 33 members of the panel on various issues. The voting pattern was as follows: 12 voted for the drug to be withdrawn;10 voted that for restricting its sales and enhancing warnings warnings on its label; 7 voted only to support enhanced warnings on the drug's label; and 3 voted that the drug should continue to be sold with its present warnings unchanged. One member abstained, and no one voted for a final option, to weaken the label's present heart warnings. Dr. Janet Woodcock, director of the FDA's drug center said that the agency is looking seriously at the recommendations of the panel and would consider its regulatory options.

Dr KK Aggarwal
Editor in Chief

drkkaggarwal Dr K K Aggarwal on Twitter
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Note: we regret some spelling mistakes in yesterday's edition due to computer mistake.

 

Photo Feature (From HCFI file)

Press Conference was held on October 26, 2004

A press conference was held on October 26, 2004 to announce the 11th MTNL Perfect Health Mela. The objective of Perfect Health Mela is to create awareness about the rising incidence of various lifestyle diseases and the much-needed education on their preventive measures.

Dr k k Aggarwal
In the photo: Arvinder Singh Lovely, the then Delhi Education Minister and R.S.P. Sinha, CMD, MTNL, addressing a press conference on the health mela. Also in the photo: Padma Shri and Dr B C Roy Awardee Dr. K K Aggarwal, President HCFI

 

News and Views

National (MCI Update)

CBI registers a case against Indore - Based Medical College and others

The Central Bureau of Investigation has registered a case against Indore-based Medical College, two senior Doctors of Safdarjung Hospital, New Delhi and unknown officials of Ministry of Health and Family Welfare u/s 120B IPC r/w sec 13(2) r/w 1391)(d) of PC Act, 1988, Sec. 464, 465, 468 & 471 IPC. It is alleged that in the year 2008, Medical Council of India refused permission to the Indore-based medical College for admissions for its second batch. The college had approached Hon’ble Supreme Court of India in this regard, wherein Hon’ble Apex Court asked both MCI and Ministry of Health and Family Welfare to conduct the inspection of the college afresh and inform the court on 26.9.2008. Accordingly, the inspection report given by the MCI inspectors again showed deficiencies in the infrastructure of the college especially the manpower. However, Ministry constituted its team of two doctors from Safdarjung Hospital, (Dr J S Dhupia and Dr D K Gupta), which conducted inspection on 25.9.2008. On 26.9.2008, Ministry of Health and family Welfare granted permission to the said college on the basis of the inspection conducted on 25.9.2008. But in another inspection conducted by the MCI Inspectors after about 10 days, the college was still found to be having deficiencies in its manpower resources. It is further alleged that on the day of inspections, false records were created regarding the availability at the time of inspection and employment of the doctors as college faculties, which became the basis for the grant of permission by the Ministry. Searches were conducted at 12 places in Delhi, Indore and Meerut, including the college premises, residences and offices of the two Doctors from Safdarjung Hospital as well as two placement agencies. Further investigation is continuing.


Doctor arrested for 'raping' patient
A 30-year-old woman was allegedly raped by a doctor following which he was arrested from Sarojini Nagar area in Lucknow.

ICC's Anti-Doping Code to come into effect from August 1

International Cricket Council has come out with its Anti-Doping Code to be effective from August 1 with modified whereabouts requirements after prolonged negotiations mainly due to BCCI's objection to the original clause stipulated by the WADA.

International

Glucosamine ineffective for low back pain (Dr. Monica and Brahm Vasudeva)

In a double-blind, randomized, placebo–controlled trial involving 250 patients older than 25 years of age with chronic low back pain and degenerative lumbar osteoarthritis, oral glucosamine did not reduce pain compared to placebo among after a 6–month intervention or one year of follow–up. The study was conducted at Oslo University Hospital Outpatient Clinic in Norway. The results appear in the July 7 Journal of the American Medical Association.

 PSA screening halves cancer mortality

A Swedish registry–based study has concluded that prostate–specific antigen (PSA) testing reduces mortality of prostate cancer by half over 14 years, although the risk of overdiagnosis is substantial and the number needed to treat is at least as high as in breast cancer screening.

Cancer diagnoses often given quickly and impersonally

A recent survey reports that almost 20% of cancer patients are informed of their diagnosis over the phone, and almost half are told in a conversation lasting less than 10 minutes. The data were gathered from a questionnaire given to 460 oncology patients referred to the National Institutes of Health (NIH) Clinical Center in Bethesda, Md. from around the U.S. and some foreign countries being treated there. A little more than one-third had lymphoma and leukemia, 22% had brain cancer, 14% had prostate cancer and 27% had some other type of cancer.

Some experts consider atrial fibrillation a top candidate for comparative effectiveness research

There are several treatments options for atrial fibrillation ranging from medications to surgery –– and are oftenmarketed aggressively by hospitals, but it is yet uncertain as to which will work best for the individual patient. Each treatment has associated side effects, some of them serious. Due to this lack of evidence regarding which treatment works best for certain patients, atrial fibrillation is a leading subject of comparative effectiveness research.

 

Legal Column

Forensic Column (Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS)

Medical Testimony of Doctor in the Court of law

A hospital/clinic/ medical care provider/doctor is neither a detective/detective office nor a curtain between injured/sick alleged criminal and police/judiciary. It is the primary and absolute transparent duty of a doctor to provide medical services to the sick and injured patient, who may be an alleged criminal, without any discrimination. However, when medical care records are required for judicial/police investigation, the records become medicolegal in nature and the treating doctor may be required to testify under oath in the court of law.

 

Experts’ Views

Interesting Tips in Hepatology & Gastroenterology

Dr. Neelam Mohan
Director Pediatric Gastroenterology, Hepatology and Liver Transplantation  Medanta Medicity

Type of food
%age of food
Sources
Uses
Carbohydrates (ideally complex)
60%
Potato, cereals, bread, etc.
Energy giving food
Fats
25%-30%
Butter, Ghee, Oil, Nuts, Milk etc.
Energy giving food
Proteins
15% 20%
Pulses, meat, egg, milk, fish etc
Muscles building for wear and tear
Minerals & vitamins (fruits and vegetables)
Calcium
1200 mg/day
Milk, cheese, spinach, Bajara, ragi etc
For developing bones
Iron
10 15 mg/day
Green leafy vegetables, jaggery etc
For blood

Question of the Day

What are the risks of electrical DC cardioversion in atrial fibrillation? (Dr. Subash Chandra, Bangalore)

The risks are as follows:

  1. Local complications: Chest wall injuries, burns

  2. Embolism: About 1–7% AF patients not on anti–coagulation before the procedure may develop arterial embolization after cardioversion. Rarely right heart emboli can occur, which lead to pulmonary embolism.

  3. Arrhythmias: include atrial premature beats, VPCs. Rarely, sinus arrest, AV block can occur. Malignant ventricular arrhythmias are rare.

  4. Airway compromise: Excessive sedation during cardioversion in the elderly may lead to respiratory depression.

  5. Myocardial depression: Rarely, mild myocardial damage and elevation of CK-MB. Very rarely, acute pulmonary edema can occur.

  6. Injuries to operator: The incidence is 1 in 1700 in one series; may present as extremity paresthesias.
 

Public Forum (Press Release for use by the newspapers)

Premature heart disease

Premature or early heart attacks is when a man gets it before age 55 or a woman before age 65, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela. The mean age for premature heart attack is 5354 yrs.

Family history is when any of the first-degree relative i.e. father, mother, brother, sister had suffered from an earlier or premature heart attack. Having a one-degree relative with a heart attack below age 55 increases the risk by 33%; two relatives increase risk by 50%.

Heart attacks in the young

Although coronary heart disease (CHD) primarily occurs in patients over the age of 40, younger men and women can be affected. Most studies have used an age cutoff of 40 to 45 years to define "young" patients with CHD or acute heart attack.

Advanced coronary blockage is seen in 2 percent of men aged 15 to 19. An advanced lesion is present in 20 and 8 percent of men and women aged 30 to 34, respectively, while 19 and 8 percent, respectively, have a >=40 percent stenosis of the left anterior descending artery. In the Framingham Heart Study, the incidence of an heart attack over a 10 year followup was 12.9/1000 in men 30 to 34 years old and 5.2/1000 in women 35 to 44 years old.

The incidence of heart attack is eight to nine times greater in men and women aged 55 to 64 years. In studies, 4 to 10 percent of patients with heart attack are less than 40 or 45 years of age. In some studies patients with heart disease less than 40 years of age, women comprise 5 to ten percent of patients.

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An Inspirational Story

A certain man planted a rose and watered it faithfully and before it blossomed, he examined it. He saw the bud that would soon blossom, but noticed thorns upon the stem and he thought, "How can any beautiful flower come from a plant burdened with so many sharp thorns? Saddened by this thought, he neglected to water the rose, and just before it was ready to bloom… it died.

So it is with many people. Within every soul there is a rose. The Godlike qualities planted in us at birth, grow amid the thorns of our faults. Many of us look at ourselves and see only the thorns, the defects. We despair, thinking that nothing good can possibly come from us. We neglect to water the good within us, and eventually it dies. We never realize our potential.

Some people do not see the rose within themselves; someone else must show it to them. One of the greatest gifts a person can possess is to be able to reach past the thorns of another, and find the rose within them. This is one of the characteristic of love… to look at a person, know their true faults and accepting that person into your life… all the while recognizing the nobility in their soul. Help others to realize they can overcome their faults. If we show them the "rose" within themselves, they will conquer their thorns. Only then will they blossom many times over.

 

IJCP Special

Dr Good Dr Bad

Situation: A dengue patient had a platelet count of 20,000/mL.
Dr Bad: Start platelets.
Dr Good: Wait and watch.
Lesson: No transfusions are needed unless the platelet count is <10,000 m/L.

Make Sure

Situation: A patient with organophosphorus poisoning died.
Reaction: Oh my God! Why was he not given adequate atropine in time.
Lesson: Make sure that no patient of organophosphorus poisoning dies. Timely atropine can save most of them.

Quote of the Day (Dr. Santosh Sahi)

"Surround yourself with only people who are going to lift you higher." Oprah Winfrey

Are you fit to fly?

Flying during pregnancy

  1. Air travel is not generally not a risk to normal pregnancy.

  2. Fetal hemoglobin has a high affinity for oxygen, and the fetus is generally not at risk due to the low oxygen hypoxic cabin environment.

Myths about Aging

Myth: Getting older is depressing so expect to be depressed.

Milestones in Diabetology

Matthew Dobson (17351784), an English physician, evaporated urine of a diabetic patient and found a substance that smelled like brown sugar and was also like sugar in taste. He noted: "The diabetes proves, in some cases, a very rapid consumption; I have known it terminate in less than 5 weeks. In others, it becomes a chronic complaint."

 

International Medical Science Academy Update (IMSA)

Although early reperfusion or revascularization to treat acute myocardial infarction may reduce the risk of ischemic mitral regurgitation (MR), revascularization in patients with chronic ischemic mitral regurgitation is less likely to reduce regurgitation.

 

Drug Update

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

DCI Approval Date

Fluvoxamine maleate100/150mg ER Tablets

For the treatment of obsessive compulsive disorder (OCD) and depression

19.08.2009

 

Medi Finance

Q. What is the provision if money is donated to an approved scientific research association?

A. Weighted deduction of 125% of the amount paid is allowed.

 

Lab Medicine (Dr Arpan Gandhi and Dr Navin Dang)

Laboratory Tests for Infertility for men

Semen analysis, free and total testosterone, Luteinizing hormone, Folliclestimulating hormone and Prolactin. In some instances, a biopsy of testicular tissue can identify the problem, for example, sperm production, abnormal growths, tumors, or incomplete growth or maturation of reproductive organs.

 

Humor Section

Jokes

Jhatka: Why are all these people running?
Man: This is a race, the winner will get the cup.
Jhatka: If only the winner will get the cup, then why are the others running?

Medical bloopers on medical charts!

Nitrates…………………………Cheaper than day rates

 

Readers Responses

  1. Dear Dr KK Agrawal Sir, I go through all your daily e-medinews articles, and I find them very useful and informative. This is my humble request to you to kindly publish on emedinews, your CME articles which you organize fortnightly, on Sundays at Moolchand Medcity or give hand outs /or summary of the articles. Since many of our friends wish to attend them, but cannot attend due to other commitments or unforeseen circumstances. Thanking you, Yours: Dr K P Singh, Dr Santosh Singh, Dr Pragat Singh, Dr Surender Yadav, Dr Pankaj Patel, Dr Manu Malvia, Dr Anayat, Dr Gayatri Gupta, Dr R K Jain, Dr Neetu Jain, Dr Nadeem Akhtar (All above from Fortis Escorts Heart Institute & Research Centre, Okhla Road, New Delhi 110025. There are many more people whose names are not mentioned in this list, but they too want to get advantages of the CMEs).

  2. 2. Dear Dr. Aggarwal: Reference to a query raised by Dr. Malini Kapoor regarding alcohol and heart in emedinews dated 16th July. It is established that light consumption is beneficial, but how much? According to American guidelines, men are permitted 2 drinks daily and women - 1 drink. Suggested one drink is 375 ml of beer, 45 ml of whiskey and 150 ml of wine preferably red wine. However the reasons why we do not recommend it for heart disease prevention are: it is addictive; high intake has serious health and social consequences, physical abuse, vehicle and work accidents. Dr. S K Parashar

 

Forthcoming Events

eMedinews Events: Register at emedinews@gmail.com

5th September: 3 PM to 5 PM A dialogue with His Holiness Dalai Lama at Parliament Street Annexe in association with Acharya Sushil Muni Ahimsa Peace Award Trust

12th September: BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city.
8 AM – 5 PM at MAMC Auditorium, Dilli Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM

30th October, Saturday: eMedinewS Update from 8 AM to 5 PM

29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama

30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM

31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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