July 17  2015, Friday
eMedinewS
editorial
Sunlight can reduce weight
Dr KK AggarwalA study from the Northwestern University reports that the timing, intensity and duration of light exposure during the day are linked to body weight.

People who had most of their daily exposure to even moderately bright light in the morning had a significantly lower body mass index than those who had most of their light exposure later in the day.

"The earlier this light exposure occurred during the day, the lower individuals’ body mass index," said co–lead author Kathryn Reid, research associate professor of neurology at Northwestern University Feinberg School of Medicine. "The later the hour of moderately bright light exposure, the higher a person’s BMI."

The influence of morning light exposure on body weight was independent of an individual’s physical activity level, caloric intake, sleep timing, age or season. It accounted for about 20 percent of a person’s BMI.

"Light is the most potent agent to synchronize your internal body clock that regulates circadian rhythms, which in turn also regulate energy balance," said study senior author Phyllis C. Zee, M.D. "The message is that you should get more bright light between 8 a.m. and noon." About 20 to 30 minutes of morning light is enough to affect BMI. (Science Daily)
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eMedipics
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A workshop conducted jointly by Heart Care Foundation of India, Indian Medical Association, Delhi Red Cross Society and Delhi Police with an aim of training 100 percent of PCR Staff by 14th August.
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News
  • Breast cancer survivors with a familial risk seem to have a high risk of gaining excess weight, suggests new research published online July 15 in Cancer Epidemiology, Biomarkers & Prevention. Researchers noted that women with a family history of the disease, including those who carry BRCA1 and BRCA2 gene mutations, gained weight at a greater rate than cancer-free women of the same age and menopausal status.
  • Brain imaging with single-photon emission computed tomography (SPECT) can distinguish post-traumatic stress disorder (PTSD) from traumatic brain injury (TBI) with high sensitivity, suggests new research published online in PLOS One.
  • Menopausal women with moderate vasomotor symptoms may find relief from escitalopram, low-dose dose oral 17-beta-estradiol (E2), or venlafaxine, suggested a pooled analysis of individual-level data from three randomized clinical trials. The findings are published online in Obstetrics & Gynecology.
  • A subthreshold diode micropulse laser (SDM) therapy restores sensitivity to inhibitors of vascular endothelial growth factor (VEGF) for treatment in patients with neovascular age-related macular degeneration (AMD) whose eyes no longer respond to treatment, suggests new research published in the journal Retina.
  • A novel drug, patiromer, has been shown to significantly lower potassium levels in patients with diabetes and kidney disease in a new study published in JAMA.
Top News from ADA 2015
No Mortality Risk with Sulfonylureas, Meta-Analysis shows

The use of sulfonylureas in patients with type 2 diabetes mellitus does not increase the risk of all-cause or CV mortality, suggest results of a new meta-analysis. There was also no increased risk of stroke or MI with the antidiabetic agents, reported Dr Dimitris Rados (Hospital de Clinic de Porto Alegro, Brazil). The results were similar when they included and excluded data from the UK Prospective Diabetes Study, the first study to suggest a potential mortality risk among patients treated with metformin plus a sulfonylurea. When analyzing the different sulfonylureas, investigators did observe a statistically significant increase in the risk of all-cause and CV mortality with glipizide, although they caution against making too much of the subgroup analysis given the small number of patients and clinical events.(Source: Medscape)
Cardiology eMedinewS
  • A study published July 15 in the Journal of the American Heart Association found an association between cardiac arrest and ischemic heart disease as a result of exposure to high levels of PM2.5 smoke for up to 2 days.
  • The prevalence of phenotype-diagnosed familial hypercholesterolemia is common among patients presenting with acute coronary syndromes (ACS), suggests an analysis from a European cohort study published in the European Heart Journal.
Pediatrics eMedinewS
  • A new study published in the American Journal of Preventive Medicine has reported that an increasing number of overweight adolescents do not consider themselves as such.
  • Disruptions in the structure and function of a brain region called the corpus callosum can explain the varied outcomes after a traumatic brain injury (TBI) in children and adolescents, suggested a study published July 15 in The Journal of Neuroscience.
Dr KK Spiritual Blog
Celebrity vs Social Celebrity

There is a very thin line between the two. Celebrity status means that more than 1% of the population admires you. You can be a politician, minister, sports man or a doctor to be a celebrity. Sachin Tendulkar is a classical example.

Social celebrity means you are a celebrity later, a social worker first. You take on social causes and do not endorse addicting products.

For example celebrities who are engaged in surrogate advertising and endorse surrogate products of tobacco and/or alcohol, soft drinks with more than 10% sugar, tea with milk and sugar, non dark pure chocolates etc. may be celebrities but definitely not social celebrities.
Events
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Make Sure
Situation: A patient on 10 units of insulin developed hypoglycemia after taking light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 grams of carbohydrates.
Dr Good Dr Bad
Situation: A patient with COPD developed Herpes zoster.
Dr Bad: They are not related.
Dr Good: They are related.
Lesson: People with chronic obstructive pulmonary disease, or COPD, are more likely to develop shingles than the general population (CMAJ 2011 Mar 22;183(5):E275–8).

(Copyright IJCP)
Wellness Blog
Apples during pregnancy and Asthma

Women who eat apples while pregnant may protect their child from developing asthma. A study showed that children of moms who munched on more than 4 apples per week were 37% less likely to have a history of wheezing and 53% less likely to have doctor–confirmed asthma, compared to moms who ate one or no apples per week while pregnant. The effect may be due to the phytochemical content of the apple, such as flavonoids, which have been shown to have beneficial effects on adult lung function. The study also found that eating fish during pregnancy may curb the risk of eczema in offspring. Children of mothers who ate fish once per week or more while pregnant had a 43% lower risk of eczema compared to children whose mothers avoided fish altogether.

High fat diet and breast cancer
According to a study from the National Cancer Institute in Bethesda, Maryland, eating a high–fat diet raises the risk of developing invasive breast cancer in middle–aged women. There was 32% increased risk of breast cancer among women with a high level of fats in their diet. The risk was seen for all types of fats (saturated, monounsaturated and polyunsaturated) and seemed to be confined to women who were not using hormone replacement therapy. The higher the fat intake, the higher was the risk for breast cancer.

Eat more fruits
People who eat a diet high in fruit and low in meat reduce their risk of developing colon cancer. A team from University of North Carolina in Chapel Hill observed three groups – people who ate a lot of fruit but little meat, people who ate a lot of vegetables and a moderate amount of meat, and people who simply ate a lot of meat. The people who recalled eating large or moderate amounts of meat were 70 percent more likely to have had a polyp than those who said they ate a lot of fruit but little meat. Just 18% of the people who said they ate a lot of fruit but little meat had a polyp, compared to 30% of the moderate meat–eaters and 32% of people in the high meat-eating group.
eMedi Quiz
In actinomycosis of the spine, the abscess usually erodes:

1. Intervertebral disc.
2. Into the pleural cavity.
3. Into the retroperitoneal space.
4. Towards the skin.

Yesterday’s Mind Teaser: All of the following are known risk factors for development of endometrial carcinoma except:

1. Obesity.
2. Family history.
3. Use of hormone replacement therapy
4. Early menopause.

Answer for yesterday’s Mind Teaser: 4. Early menopause.
Correct Answers received from: Dr Jainendra Upadhyay, Dr K V Sarma, Dr K C Sharma, Dr Pravin H Patel, Dr Avtar Krishan.
Answer for 15th July Mind Teaser: 2. Full term pregnancy
Correct Answers received: Dr Avtar Krishan.
eMedinewS Humor
A Horoscope for the Workplace

Senior Management: Catty, cut–throat, yet completely spineless, you are destined to remain at your current job for the rest of your life. Unable to make a single decision you tend to measure your worth by the number of meetings you can schedule for yourself. Best suited to marry other "Senior Managers," as everyone in your social circle is a "Senior Manager."
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Rabies News (Dr A K Gupta)
What is "paralytic form" of rabies in animals?

Paralytic or dumb rabies refers to animals in which the behavioral changes are minimal or absent and the disease is manifested mainly by paralysis. This is first manifested by paralysis of the throat and masseter muscles, often with profuse salivation and inability to swallow. Dropping of lower jaw is common in dogs. The animals are not vicious and rarely attempt to bite. The paralysis progresses rapidly to all parts of the body leading to coma and death follows in a few hours.
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
eIMA News
ITEM NO.2 / COURT NO.13 / SECTION IX/ SUPREME COURT OF INDIA
RECORD OF PROCEEDINGS/ Petition(s) for Special Leave to Appeal (C)......CC No(s)./ 9134/2015

(Arising out of impugned final judgment and order dated 24/12/2014 in WP No.

7846/2014 passed by the High Court of Bombay)

INDIAN MEDICAL ASSOCIATION, PUNE BRANCH Petitioner(s) VERSUS STATE OF MAHARASHTRA AND ORS. Respondent(s)

(with appln. (s) for c/delay in filing SLP and office report)

WITH S.L.P.(C)...CC No. 9954/2015; (With appln.(s) for c/delay in filing SLP and Office Report)

Date: 09/07/2015 These petitions were called on for hearing today.

CORAM : HON'BLE MR. JUSTICE A.K. SIKRI/ HON'BLE MR. JUSTICE ROHINTON FALI NARIMAN

For Petitioner(s)

Mr. V. Giri, Sr. Adv./ Mr. Annam D. N. Rao, Adv./ Mr. Nitesh, Adv./ Mr. A Venkatesh, Adv./ Ms. Neelam Jain, Adv./ Ms. Vaishali R., Adv./ Mr. Sudipto Sircar, Adv.

For Respondent(s)

Mr. Shekhar Naphde, Sr. Adv./ Mr. Arvind S. Avhad, Adv./ Mr. Nishant Ramakantrao Katneshwarkar, Adv./ Mr. Navin Prakash, Adv./ Mr. Abhisek Vikash, Adv./ Mr. Makarand D. Adkar, Adv./ Mr. Vijay Kumar, Adv./ Ms. Tasneem Ahmadi, Adv./ Mr. Shadam Farasat, AOR/ Mr. Mehmood Pracha, Adv./ Mr. Arun Mishra, Adv./ Ms. Divya Sharma, Adv./ Mr. Raj Kishor Choudhary, AOR/ Mr. V. K. Biju,Adv./ Ms. Aparna Jha,Adv.

UPON hearing the counsel the Court made the following ORDER

Delay condoned. The impugned order is only an interim order and that too a speaking order. We do not think that any valid ground is made out calling for our interference under Article 136 of the Constitution of India.

The special leave petitions are accordingly dismissed. However having regard to the nature of the disputes raised in the writ petitions, which are still pending before the High Court of Bombay, we request the High Court of Bombay to decide the writ petitions as expeditiously as possible.

(Ashok Raj Singh)                               (Suman Jain)
Court Master                                      Court Master

The case was prepared and fought by National IMA on behalf of IMA Pune. However we could not succeed in getting a stay in this matter.

Dr A M Pillai Dr KK Aggarwal
Constitution of Working Group for finalization of Bio-Medical Waste Management Rules, 2015
Government of India
E-mail: sanchita@nic.in
sansom_2859@yahoo.co.in
Telefax: 011-24695402
F.NO. 3-1/2000-HSMD (pt.)

Ministry of Environment, Forests and Climate Change
Indira Paryavaran Bhawan, Jor Bagh Road
Aliganj, New Delhi-1100 003
Website: moef.nic.in

Date: 6th July, 2015

Subject: Constitution of Working Group for finalization of Bio-Medical Waste Management Rules, 2015.

The Ministry of Environment, Forest and Climate Change has notified draft Bio-Medical Waste (Management and Handling) Rules, 2015 in the Gazette of India vide S.O.423 (E) on 25.05.2015. The draft Rules are available on the website of this Ministry at http://www.moef.gov.in. The draft rules have been notified seeking suggestions/objections/comments of the stakeholders within 60 days from the notification. The rules shall be finalized after the expiry of 60 days and after reviewing the suggestions/objections/comments received.

2. Therefore, to review the suggestions/objections/comments received and to finalise the rules, the Ministry hereby constitutes a Working Group with the following members:-
 
1
Additional Secretary, HSM Division, MoEF&CC.
Chairman
2
Chief Medical Officer (NFSG), Directorate General of Health Services, Ministry of Health, Nirman Bhawan, New Delhi.
Member
3
Joint Secretary, HSMD, MoEF&CC.
Member
4
Shri B Vinod Babu, Scientist D & In-charge HWM Division, CPCB, Delhi.
Member
5
National President, Indian Medical Association, I.P. Estate, New Delhi.
Member
6
Dr. C.S. Pandav, Head, Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Member
7
Dr. Shyamala Mani, Professor, National Institute of Urban Affairs, India Habitat Centre, New Delhi.
Member
8
President, CBWTFs Association of India, 307-308, Century Centre, Nr. Gujarat Samachar Press, Kanta Stri Vikas Gruh Road, Rajkot-360 002 (Gujarat).
Member
9
Representative of the Director General Armed Forces Medical Services, Ministry of Defence, Delhi.
Member
10
Representative from Toxic Links
Member
11
Director, HSMD, MoECC, New Delhi
Member Secretary
  1. The Working Group will have the following TORs.
    • To examine the comments received on the Draft Bio-Medical Rules, 2015.
    • To discuss the merits and de-merits of each comment and suggest revision in the Rule accordingly.
    • Suggest any new inclusions as per the evolving technologies.
    • Give finalized draft of Bio-Medical Rules, 2015.
  2. TA/DA, including Air-fare to the out stationed non-official members and sitting fee to the non-official members attending the meeting shall be paid by the Ministry as per the prevailing government rules. The tenure of the Group shall be co-terminus with publication of the final rules. The official members may claim their TA/DA from their respective organization.
  3. If required, other experts may be invited as special invites in the meetings of the Working Group which shall be organized by the Ministry at New Delhi or as decided by the Group.
(Sanchita Jindal)
Director
NEWS
The Community Preventive Services Task Force has recommended that diet and physical activity programs should be offered to people at risk of developing type 2 diabetes by healthcare systems and community organizations. (Annals of Internal Medicine)
Inspirational Story
The mouse trap

A mouse looked through the crack in the wall to see the farmer and his wife open a package. "What food might this contain?" the mouse wondered. He was devastated to discover it was a mousetrap.

Retreating to the farmyard, the mouse proclaimed the warning: "There is a mousetrap in the house! There is a mousetrap in the house!" The chicken clucked and scratched, raised her head and said "Mr. Mouse, I can tell this is a grave concern to you, but it is of no consequence to me. I cannot be bothered by it."

The mouse turned to the pig and told him "There is a mousetrap in the house! There is a mousetrap in the house!" The pig sympathized, but said "I am so very sorry, Mr. Mouse, but there is nothing I can do about it but pray. Be assured you are in my prayers."

The mouse turned to the cow and said "There is a mousetrap in the house! There is a mousetrap in the house!" The cow said "Wow, Mr. Mouse. I’m sorry for you, but it’s no skin off my nose." So, the mouse returned to the house, head down and dejected, to face the farmer’s mousetrap alone.

That very night a sound was heard throughout the house – like the sound of a mousetrap catching its prey. The farmer’s wife rushed to see what was caught. In the darkness, she did not see it was a venomous snake whose tail the trap had caught. The snake bit the farmer’s wife. The farmer rushed her to the hospital and she returned home with a fever.

Everyone knows you treat a fever with fresh chicken soup, so the farmer took his hatchet to the farmyard for the soup’s main ingredient. But his wife’s sickness continued, so friends and neighbors came to sit with her around the clock. To feed them, the farmer butchered the pig. The farmer’s wife did not get well, she died. So many people came for her funeral; the farmer had the cow slaughtered to provide enough meat for all of them.

The mouse looked upon it all from his crack in the wall with great sadness.

So, the next time you hear someone is facing a problem and think it doesn’t concern you, remember: when one of us is threatened, we are all at risk. We are all involved in this journey called life. We must keep an eye out for one another and make an extra effort to encourage one another. Each of us is a vital thread in another person’s tapestry.
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Quote of the Day
Sometimes it’s not the strength but gentleness that cracks the hardest shells. Richard Paul Evans
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Reader Response
Dear Sir, Very informative news. Regards: Dr Krishna
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Press Release
Delhi Police PCR van staff trained on tackling special cases while reviving a sudden cardiac arrest patient through the technique of hands only CPR 10

Emphasis laid on how patients suffering from hypothermia or low body temperature may need to be administered hands only CPR for over an hour to successfully revive them

Heart Care Foundation of India jointly with the Indian Medical Association, Delhi Red Cross Society and Delhi Police has taken up the challenge of training 100% of the Delhi Police PCR van staff on the life-saving technique of hands only CPR 10 by Independence Day 2015.

Addressing the gathering of 283 police men at the IMA today Padma Shri Awardee Dr K K Aggarwal - President of Heart Care Foundation of India and Honorary Secretary General of IMA said that administering Hands Only CPR 10 within the first minute of death due to a sudden cardiac arrest can save the life of 90% of the patients. People must be patient and not stop chest compressions till the person is not revived. Patients who suffer from hypothermia or have a body temperature less than 35oC can take over hours to get revived since only when their body temperature comes back to normal will the CPR be effective.”

There are instances in ancient literature where a newborn with hypothermia was declared dead but revived in the cremation ground when the environment heat brought his temperature to normal and the pressure on the chest had effects similar to a cardiac massage.

Adding to this, Dr. KK Aggarwal said that “The mantra to remember is: Within 10 minutes of death (earlier the better), for a minimum of 10 minutes (longer the better), compress the center of the chest of the deceased person continuously and effectively with a speed of 10×10 = 100 per minute”

Talking about the initiative, Padma Shri Awardee, Dr A Marthanda Pilliai, National President, IMA, said, “Hands only CPR is an extremely successful method of saving lives of people who have suffered a sudden cardiac arrest. A person does not need to be a medical practitioner or a certified trainer to perform it. Any person who knows the right technique can save a life through this method. Given that a PCR van is the first to reach any emergency situation, they can play a crucial role in helping provide emergency care. It is indeed makes us proud to say that together we will make Delhi the first city where each and every PCR van staff will be trained in this lifesaving technique and the public can dial 100 in case of an emergency. Exceptional cases will always be there. One must not lose hope and continue performing chest compressions till the ambulance reaches.”

A sudden cardiac arrest occurs when the electrical conducting system of the heart fails and the heart beats irregularly and very fast (more than 1000 times, technically called as ventricular fibrillation). Soon after the heart suddenly stops beating and the blood flow to the brain stops. As a result, the person becomes unconscious and stops normal breathing. A cardiac arrest is not the same as a heart attack, but it may be caused by a heart attack. In most cases, sudden cardiac arrest may be reversible in the first 10 minutes. This is possible because the brain remains alive during this period when the heart and respiration have stopped, a situation called clinical death.

It is important to act quickly for every minute lost reduces the chances of revival by 10%. So, if you wait 5 minutes, the chances of surviving are 50% less. The earlier you give CPR to a person in cardiac arrest, the greater the chance of a successful resuscitation. To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177.