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 & 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

 

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

18th August 2012, Saturday

CBI absolves Dr Ketan Desai in disproportionate assets case

As reported in The Times of India (Aug 17, 2012), Dr Ketan Desai, Former Chairman of Medical Council of India was cleared by the Central Bureau of Investigations in the disproportionate assets (DA) case pertaining to the allegations of a bribe of Rs 2 crore paid by a college in Punjab.

A closure report was filed by the CBI before the designated court in New Delhi, which is expected to give its verdict shortly. Dr Ketan Desai was also cleared by the CBI in cases filed against him at Hyderabad, Bhubaneswar, Dehradun and Chennai, owing to lack of proof against him.

At the time of filing the FIR, Dr Ketan Desai was shown to have assets worth 230% of his income. After a detailed investigation by the CBI, spanning almost 2 years, the CBI has now said that the value of shares and assets, which in fact did not exist had been inadvertently added. The 3.5 kg of gold that had been seized had been reported to the Income Tax department in 1997 and 2000.

In its report the CBI said that the said college had all the required facilities except for an auditorium. A high-level committee was set up three days after Dr Desai was arrested. The committee under the chairmanship of the additional secretary for health looked into the validity of MCI recommendation for the college in question. In its report submitted in May 2010, the committee stated that the existing facilities and faculty in the college seemed to be fully sufficient for undergraduate teaching and that the permission recommended by MCI was justified. The committee also noted the absence of an auditorium in its report. A copy of the report was marked to the Director of the CBI.

The Board of Governors, which replaced the dissolved MCI, reviewed the MCI report and took a final decision as was asked by the Health ministry. Their inspection also observed that college lacked an auditorium and granted permission for 4th batch in July 2010. According to the MCI officials, the auditorium is used for cultural programmes and convocation, and hence, as per rules, it is required only at the time of permission for the 5th batch.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

School Health Education

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Higgs – Boson, Consciousness and Health

Heart Care Foundation of India in association with International Centre for Spirituality and eMedinewS organized a seminar, Physics scholars, religious experts and doctors participated in the seminar.

 
Dr K K Aggarwal
 
    National News

Computer to lead way in hip replacement

The All India Institute of Medical Sciences (AIIMS) will become the first hospital in the country to perform computer assisted hip joint replacement on Saturday. The new technology will help patients in more accurate hip replacement with nominal extra charges. “The surgery will be performed by the surgeon. The computer will assist in ensuring accuracy of the plan of surgery. It also reduces outliers. The number of surgeries with hip being put in wrong angle would come down. As the cut on the body will be very small, patient will take less time to recover,” said Dr Rajesh Malhotra, professor, department of orthopaedics, AIIMS. So far, in hip replacements, doctors needed a bigger cut on the patient’s body for wider view for accurate placement to the implant. The new technique, computer assisted ‘navigation’ in joint replacement of hips will be a minimally invasive surgery with cut size of 10 cm or less. The procedure ensures increased longevity of joint replacement. “The computer navigates the movements of the surgeon. A patient is first registered with the computer and the plan for the surgery is fed. With the help of trackers, computer ensures that everything goes according to the fed plan,” said Dr Malhotra. “It shows green till movements of the doctor are all right. It shows red when the direction goes wrong, and yellow if the pre-decided direction is close,” he said. Trackers cost Rs 6,000, which will be an additional cost for the patients due to the new technique. Cost for hip transplant ranges from Rs 20,000 to Rs 3 lakh. The first surgery will be performed on Saturday as part of Asia’s first ever “cadaveric computer assisted hip replacement workshop.” AIIMS has one machine which has been in use for knee and spine replacements. Now it will be used in hip replacement too. The orthopaedic department of AIIMS conducts 50-70 surgeries a month which will be reduced to 30-50 after introduction of the new technique. Prof Hartmuth Kiefer, head, trauma and reconstructive surgery, Lukas Hospital, Germany will demonstrate computer assisted total hip replacement. He has performed nearly 3,700 surgeries in the last 10 years. “This is part of the learning curve. A doctor takes more time while learning a new procedure. But this will be covered soon,” added Dr Malhotra. (Source: Deccan Herald, Aug 16, 2012)

Delhi adopts humble sparrow as its state bird

NEW DELHI: Till some years back, the house sparrow was the quintessential 'chidiya', the most common image to come to mind when one discussed birds in Delhi's urban context. One day it dawned on the city that the little feathery creature has more or less vanished, its absence even more pronounced by the sudden over-population of pigeons. Finally, the sparrow has been recognized for its importance in the city's biodiversity. On Tuesday, it was declared the state bird of Delhi. This gives the sparrow special rights and the city has launched a huge campaign, 'Rise of the Sparrows', for its conservation. Nature Forever Society will collaborate with the government on compiling resources and data on the sparrow. A study on the house sparrow was carried out by TERI in 2010 where it was found that the city's changing landscape and habits of people had helped in the dwindling population of the house sparrow. (Source: TOI, Aug 15, 2012)

My profession my concern

Professor Suchitra N. Pandit, Kokilaben Dhirubhai Ambani Hospital & Research Centre, Mumbai, Vice President, FOGSI (2008 -2009) on the profession

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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 Dr Monica and Brahm Vasudev)

No profound difference between oral anticoagulants, comparison suggests

An indirect comparison of the new oral anticoagulant drugs, with all the caveats that such comparisons entail, suggests there is no profound difference between apixaban (Eliquis, Pfizer/Bristol-Myers Squibb), rivaroxaban (Xarelto, Bayer/Johnson & Johnson), or dabigatran (Pradaxa, Boehringer Ingelheim) in terms of efficacy. The higher dose of dabigatran, 150 mg, was superior to rivaroxaban in terms of lowering the risk of stroke or systemic embolism, while the risk of major bleeding was significantly lower with dabigatran 110 mg or apixaban when compared with rivaroxaban. (Source: Medscape)

Cancer treatment during pregnancy feasible

Women with breast cancer can be treated during pregnancy without putting fetal and maternal outcomes at substantially increased risk, according to an international study published online August 16 in the Lancet Oncology. (Source: Medscape)

Higher CRP linked to lower dementia risk in elderly

A new study provides additional evidence that a risk factor normally associated with a negative cognitive effect in relatively young elderly people may actually have a protective effect in some older individuals as well as their relatives. Researchers are reporting that parents and siblings of cognitively intact elderly individuals 75 years of age or older who have a high level of C-reactive protein (CRP), a biomarker for systemic inflammation, are also relatively free of dementia. (Source: Medscape)

Ocriplasmin useful for vitreomacular adhesions, macular holes

Significantly more patients who received ocriplasmin experienced resolution of vitreomacular adhesions and closure of macular holes than patients who received placebo, according to results from a study published in the August 16 issue of the New England Journal of Medicine. Despite the statistical significance of the results, only a small percentage of patients stand to benefit. Just 13.4% of the patients receiving ocriplasmin achieved nonsurgical resolution of vitreomacular adhesion at day 28. (Source: Medscape)

Radiation therapy benefits some older women with breast cancer. Guideline buster?

Clinicians might want to offer radiation therapy to some older women (70 to 79 years of age) with early breast cancer because it lowers the risk for recurrence and subsequent mastectomy, according to a new American observational study. The study of women in a "real-world" setting shows a benefit for radiation therapy after lumpectomy in this older patient population. This finding is in contrast to findings from a previous clinical trial, which prompted clinical guidelines to no longer recommend radiation therapy in this group. The study, published online August 13 in Cancer, showed that at 10 years, radiation therapy was associated with a lower absolute risk for mastectomy in the same breast, compared with no radiation therapy (3.2% vs 6.3%). (Source: Medscape)

 
  Twitter of the Day

@DrKKAggarwal: An efficacy, safety and tolerability study of ferrous ascorbate and folic acid (Phosfomin -XT) in iron... http://fb.me/26QNicRFP

@DeepakChopra: The addiction to security is the cause of all insecurity

 
    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Principles of Marriage

I am in the US to attend the marriage of my nephew Kunal. Though there was a mix of four cultures: Hinduism (my sister Bina), Jainism (My brother-in-law Naresh), Gujarati (Rechal, Kunal’s wife) and Western (being brought up in the US), the major principles still remained the same

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How is infertility evaluated?

Infertility is usually diagnosed if you don’t conceive after one year of unprotected intercourse. If you are concerned about fertility or have an obvious medical problem affecting your ability to conceive, such as amenorrhea, sexual dysfunction, a history of pelvic disease, or prior surgery, you should begin the infertility evaluation immediately. You will have various tests which may include ovulation detection and evaluation of your fallopian tubes, cervix, and uterus. Your partner will have a semen analysis. Most testing can be completed within three months, and appropriate treatment can be started immediately after the evaluation is completed. Preconception counseling is often beneficial as well. Because children born to women over 35 have a higher risk of chromosomal problems, you may wish to discuss these risks with your physician or a genetic counselor prior to attempting pregnancy. Prenatal testing may be performed after conception. Amniocentesis and chorionic villus sampling are two methods of prenatal testing. Blood testing and ultrasound may also be used as screening tests for certain birth defects.

For comments and archives

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Clinical Transfusion Practice

Blood sample collection and transportation

Blood sample collection

a. Collection of properly labeled blood sample from the intended recipient is critical for safe blood transfusion.
b. 2 ml of EDTA & 3 ml of plain samples of patients.
c. The person drawing the blood sample must identify the intended recipient, most effectively done by comparing the information on the patient’s identification band.
d. Always use at least two parameters to identify the patient e.g. complete name and ID number)
e. Samples should be transported in a secure manner which should include cold chain maintenance as well as safety issues.

Sample Labeling

  • Sample tubes should be labeled at bedside just before collection of blood sample.
  • Blood sample collection should be done one at a time for each patient to reduce the risk of error
  • Phlebotomist must label the blood sample tubes with the following details:
    • Name, age and sex of the patient
    • Hospital's Identification Number
    • Ward/Bed number.
    • Date of collection
    • Signature of the phlebotomist.

Alternate blood groups for transfusion

Although it is practiced to use blood/blood components of same blood group, but in case of nonavailability of blood component of specific group, other blood groups can also be used safely as given below: -

Dr K K Aggarwal

Note

  • No Rh consideration for FFP/CPP/Cryo
  • Single Donor Platelet (SDP) should be ABO and Rh compatible

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

The Secret of Success!

A young man asked Socrates, an ancient Greek philosopher, the secret of success. Socrates told the young man to meet him near the river the next morning. They met. Socrates asked the young man to walk with him toward the river.

When the water got up to their necks, Socrates took the young man by surprise and ducked him into the water. The man struggled to get out but Socrates was strong and kept him under water until he started turning blue. The young man struggled hard and finally managed to get up. The first thing he did was to gasp and take a deep breath.

Socrates asked, “What did you want the most when you were under the water?”

The man replied “Air”.

Socrates said: “That’s the most secret to success. When you want success as badly as you want air, you will get it. There is no other secret”.

Reflection: A burning desire is the starting point of all accomplishments. Just like a small fire cannot give much heat, a weak desire cannot produce great results…

For comments and archives

 
  Cardiology eMedinewS

Aspirin reduces platelet hyper reactivity in people with HIV Read More

Type O blood carries lower CHD risk Read More

 
  Pediatric eMedinewS

Early hepatitis A vaccine seropositivity persists Read More

Pegylated interferon therapy may slow growth in children Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with COPD developed Herpes zoster.
Dr Bad: They are not related.
Dr Good: There is an association between the two.
Lesson: People with chronic obstructive pulmonary disease, or COPD, are more likely than others to develop shingles (CMAJ 2011 Mar 22;183(5):E275-80).

For comments and archives

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking light breakfast.
Reaction: Oh my God! Why was 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.

For comments and archives

 
  Quote of the Day (Mr Vivek Kumar)

When you work, work as if everything depends on you. When you pray, pray as if everything depends on God. JRD Tata

 
    Legal Question of the Day (Dr M C Gupta)

Q. A 15-year-old unmarried girl presented with 32 weeks pregnancy with pre-eclampsia. Should the police be informed? Should an MLC be made? Will the answer be different if the age is 18 years?

Ans.

  1. The police needs to be informed when it appears that there is possibility of crime.
  2. Sexual intercourse with a female less than 15 years of age, even if married, amounts to rape in terms of section 375, IPC.
  3. Sexual intercourse with a female less than 15 years of age is also a crime under the Protection Of Children From Sexual Offences Act, 2012, which was published in the gazette on 20-6-2012 and is likely to be notified shortly.
  4. In view of the above, the police should be informed. MLC should be made. However, it can be a tricky situation. The doctor concerned may, for social reasons, at the request of the patient and her mother, who give in writing that they do not want a police case, use his discretion and decide not to report to the police. The possibility remains that he may be held liable later for concealment of crime. If he decides not to report, he should maintain excellently documented records in safe custody almost as if it were a medico-legal case. If the case goes to the court later and medical records are summoned, the same can then be provided. In that eventuality, the doctor may avoid liability for concealment by pleading doctor-patient confidentiality.
  5. Properly documented records are a must. There was a case in Maharashtra two months ago where "Caesarean section" was performed on a 16 year old unmarried girl who was six and a half months pregnant. No medical records were available. In such a case, the court is likely to hold the view that the so called "Caesarean section" was a sham, used as a device for illegal termination of pregnancy, and was not a "Caesarean section" performed for a proper medical indication.
  6. If the age is 18 years, the police need not be informed and MLC need not be made. However, if the adult woman gives in writing that she does not want the police to be informed and if it appears unlikely that a more serious crime like rape has been committed, the doctor may not inform the police and may not make the MLC. But, even though no formal MLC is made, all medical records should be carefully made as if it were an MLC because such cases are likely to result in civil or criminal litigation later and records of treatment may be demanded from the hospital later by the police/court/parties.

For comments and archives

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    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Tests for Celiac Disease

The best initial laboratory test for diagnosis of celiac disease is anti–tissue transglutaminase antibody (anti–tTG), IgA. If this test is positive, it is likely that the patient has celiac disease.

The doctor may request an

  • Intestinal biopsy to determine whether there is damage to the intestinal villi.
  • CBC (complete blood count) to look for anemia.
  • ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) to evaluate inflammation.
  • CMP (complete metabolic panel) to determine electrolyte, protein, and calcium levels and to verify the status of the kidney and liver.
  • Vitamin D, E, and B12 to measure vitamin deficiencies
  • Stool fat, to help evaluate malabsorption.
 
    Mind Teaser

Read this…………………

The 60th and 62nd British Prime Ministers of the UK had the same mother and father, but were not brothers. How do you account for this?

Yesterday’s Mind Teaser: The client has a good understanding of the means to reduce the chances of colon cancer when he states:

A. “I will exercise daily.”
B. “I will include more red meat in my diet.”
C. “I will have an annual chest x-ray.”
D. “I will include more fresh fruits and vegetables in my diet.”

Answer for Yesterday’s Mind Teaser: D. “I will include more fresh fruits and vegetables in my diet.”

Correct answers received from: Rameshwar Prasad, Dr Kanta Jain, Dr Kanta Jain, Dr BB Aggarwal,
Dr (Maj. Gen.) Anil Bairaria,, Dr K Raju, Dr Pankaj Agarwal, Dr Thakor Hitendrsinh G, YJ Vasavada,
Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr LC Dhoka, Dr shashi saini, Dr PC Das.

Answer for 16th August Mind Teaser: A. Give laxative the night before and a cleansing enema in the morning before the test
Correct answers received from: Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr LC Dhoka, Dr shashi saini, Dr PC Das.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

The well-behaved son

Lady 1: My son is very well-behaved.
Lady 2: How can you say that? Wasn't he arrested and imprisoned for 5 years.
Lady 1: Yes, but he got out after 2 years for good behavior inside the jail.

 
    Medicolegal Update

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

Malpractice

Supreme Court of Georgia echoed the Illinois decision, albeit with somewhat different wording

  • Every person who enters into a learned profession undertakes to bring to the exercise of his profession a reasonable degree of care and skill. He does not undertake to use the highest possible degree of skill, for there may be persons who, for having enjoyed a better education and greater advantages, are possessed of greater skill in their profession; but he undertakes that he will bring a fair, reasonable, and competent degree of skill…He is not responsible for an error in judgment…if such error arises from the peculiar circumstance of the case, and not from the want of proper care or competent skill on his part.
  • Nearly a half–century later, a state of New York appeals court issued an opinion as to what constitutes the standard of care of a medical physician. Although the lawsuit did not involve radiology, the court decision could have well applied to radiologic interpretation
  • The law requires a physician to possess the skill and learning which is possessed by the average member of the medical profession…and to apply that skill and learning with ordinary reasonable care. He is not liable for a mere error in judgment, provided he does what he thinks is best after a careful examination. He does not guarantee a good result.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Do not ignore transient brain dysfunction

TIA or transient ischemic attack or mini paralysis is "a brief episode of neurologic dysfunction caused by lack of blood supply in the focal brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack", said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India.

It is a neurological emergency; its early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.

The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.

TIA or minor non disabling ischemic paralysis is associated with a high early risk of recurrent paralysis. The paralysis risk in the first two days after TIA is approximately 4 to 10 percent. Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke.

Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, antiplatelet therapy and lifestyle modification, including smoking cessation.

For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, antiplatelet agents should be given. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages surgery is needed.

 
    Readers Response
  1. A new interpretation of national flag in spiritual parlance. Salutations to innovative mind of Dr KKA. To add further on the subject Tricolor means tolerance to all religious faith as Green for Islam, White for Christianity and Jainism and Saffron and Yellow/Orange-Sikhism. with best regards B K Singh
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal


Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
A non stop question answer-session between all the top cardiologists of the NCR region and the public. Event will be promoted through hoardings, our publications and the press. Public health discussions
http://www.heartcarefoundation.org

 
    eMedinewS Special

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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 Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta