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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 (March 10-13); National Vice President Elect Elect, Indian Medical Association; 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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

19th May 2013, Sunday

Cabinet nod to ordinance for elected MCI body

The Union Cabinet today cleared for the issue of an ordinance to pave the way for an elected body of the apex medical regulator.

The term of the Medical Council of India's Board of Governors has ended, rendering the apex medical regulator headless.

Sources said the Cabinet gave its approval to the note for the draft ordinance in this regard, which is likely to be issued by the President soon.

The need for issue of an ordinance came as the Indian Medical Council (Amendment) Bill, 2013, which allows for an elected apex medical regulator, is yet to be passed by Parliament even though it has been approved by the Cabinet.

The MCI was being run by a seven-member Board of Governors headed by its chairman -- all of whom were nominated by the government. The Board's term expired on May 13. The MCI is without a proper body since then.

The elected MCI body was disbanded by the government and a Board of Governors was installed.

The Indian Medical Council (Amendment) Bill, 2013 seeks to give government powers to remove the President or other MCI office-bearers if they are found indulging in corrupt practices or serious offences of "moral turpitude".

Once passed, the Bill seeks to bring about such necessary changes requiring the government to act in case of serious charges against MCI office-bearers.

The changes in the new law governing the apex medical regulator, proposed by the Union Health Ministry, include fixing tenure of the President of the elected-body of MCI to a maximum period of four years for two continuous terms.

Earlier, the MCI President could have a 5-year tenure and there was no limit on the number of terms. The changes have been necessitated as government had no control over the elected body under the present law governing it.

The new Bill also makes mandatory renewal of enrolment of doctors every 10 years in the registers maintained by the body or state councils. (Source Business standard)

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

Fifty percent of school children do not reveal sexual assault to anyone.

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal interview in IBN 7.

 
Dr K K Aggarwal
    National News

It is unethical to diagnose and not treat.

There is no evidence to suggest that Polypill or aspirin for primary prevention work.

Source: National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS): TRG 1 meeting on 07.05.2013 at Nirman Bhawan

At 104, Hari become the oldest man to get heart fixed

NEW DELHI: A 104-year-old man has become the oldest person in India and probably in the world to undergo successful angioplasty, reports TOI. Hari Singh, a resident of Dehradun, was operated on at a Noida hospital on Thursday night after he complained of being rushed to the emergency with severe chest pain. Dr Purushottam Lal, the operating cardiologist and chairman of the Metro group of hospitals, said the patient had two completely blocked arteries and one of the major arteries - left anterior descending (LAD) artery - showed 90-95% narrowing at the origin.

"We have checked all medical records. The maximum age when a patient has undergone angioplasty in the country is 94-years-old. Above the age of 100 no such cases have been reported so far," claimed Lal. He said had they not operated on the patient in time, he would have collapsed anytime. Singh Lal added, had underwent undergone an angioplasty before in the year 2001 also, he added.

"Papa had been complaining of about chest pain and fainting for the last few days and we even got him admitted to a local hospital. When his condition deteriorated, we rushed him to Noida where the life-saving procedure was conducted. Now, he is fine," said Satinder Pal Singh, the centenarian's son who is 65-year-old. He added, "We are three brothers and three sisters. Our eldest sister is 85-years-old. Our father was born in Abottabad in Pakistan and he migrated to India during the partition." The family claimed that Singh was born on January 15, 1909 which is also the date mentioned on his voter id card.

According to the doctors, the angioplasty procedure was performed though the arm. "The total procedure lasted time was less than 10 minutes and a total of 15 cc dye was used to protect his kidneys," said a senior cardiologist. Lal said that with the advanced technology and skills it is possible to perform angioplasty at any age now. "With increased longevity, the incidence of elderly people reporting with heart diseases has certainly gone up. But we are able to save lives through the use of technology," he said. Singh, however, also had kidney disease. In Singh's case, he had kidney disease too. "He was on dialysis and his blood pressure levels were low. There was always a risk of for sudden death due to severe bleeding or organ failure. But we were able to manage the case. He is likely to be discharged in a day or two," said a doctor. (Source: TOI, May 18, 2013)

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, every Thursday 4:30 PM in DD India

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Fifty percent of school children do not reveal sexual assault to anyone.

    Valvular Heart Disease Update

Bicuspid aortic valve can be associated with ventricular or atrial septal defect, hypoplastic left heart syndrome, patent ductus arteriosus, bicuspid pulmonic valve and Ebstein’s anomaly.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Risky squamous cell skin cancers can kill

Although most cutaneous squamous cell carcinomas are easily treated surgically, a small group of patients with specific disease risk factors develop metastases and ultimately die of the disease, a retrospective study determined. (Source: Medpage Today)

Depression may be stroke trigger in women

Depression appears to be a risk factor for stroke among middle-age women, even after accounting for other variables, an Australian study showed. (Source: Medpage Today)

Endometrial assessment guidelines released

A new clinical guide provides recommendations on endometrial assessment in perimenopausal and postmenopausal women and evaluates the indications and limitations of different assessment methods. The recommendations also address how to deal with inconclusive evaluations and persistent symptoms, as well as testing in women who use tamoxifen and unopposed estrogen. (Source: Medscape)

ASCO: Surveillance for early seminoma found safe

Most men with stage I seminoma can safely enter surveillance and avoid unnecessary therapy without jeopardizing survival, according to data from a large registry. (Source: Medpage Today)

New guidelines for alcohol misuse in adults released

Primary care physicians should ask all adults older than 18 years about their drinking habits, according to the final recommendation statement on alcohol misuse released this week by the US Preventive Services Task Force (USPSTF). (Source: Medscape)

 
    Twitter of the Day

@DrKKAggarwal: Porcine Whipworm Ova Safe for Treatment of IBD http://blog.kkaggarwal.com/2013/05/porcine-whipworm-ova-safe-for-treatment-of-ibd/ …

@DeepakChopra: #Theists are self aware luminous stardust beings. #Atheists are the nuclear debris of dead stars. #Perspective #CosmicConsciousness

 
    Spiritual Update

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

Who is responsible for subordinates’ mistakes?

As per Medical Council of India Act, doctor in charge of a case is responsible for mistakes of his juniors and staff working under him.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the psychological effects of Multiples on a family?

Many women with a multiple pregnancy do well; their families may experience significant stress. Even if medical problems are overcome and the infants survive without disability, the effect of multiple births on family life is profound and life–altering. The impact of a multiple birth clearly affects the parents, but also the babies, other siblings, and the extended family. Financial stresses may be overwhelming. Obvious additional costs include feeding, clothing, housing, and caring for multiple children.

 
    An Inspirational Story

Be Content About Your Life

Wonder if any of you ever had the feeling that life is bad, real bad…and you wish you were in another situation. Do you find that life seems to make things difficult for you, work sucks, life sucks, and everything seems to go wrong….

It was not until yesterday that I totally changed my views about life; after a conversation with one of my friends.

He told me despite taking 2 jobs, and bringing back barely above 1K per month, he is happy as he is. I wonder how he can be as happy as he is now, considering that he has to skimp his life with the low pay to support a pair of old-age parents, in-laws, wife, 2 daughters and the many bills of a household. He explained that it was through one incident that he saw in India……

That happened a few years ago when he was really feeling low and was touring India after a major setback. He said that right in front of his very eyes, he saw an Indian mother chopped off her child’s right hand with a chopper. The helplessness in the mother’s eyes, the scream of the pain from the innocent 4 years old child haunted him until today. You may ask why did the mother do so, has the child been naughty, was the child’s hand infected??

No, it was done for two simple words — to beg. The desperate mother deliberately caused the child to be handicapped so that the child could go out to the streets to beg. I cannot accept how this could happen, but it really did, just in another part of the world which I don’t see.

Taken aback by the scene, he dropped a small piece of bread he was eating half-way. And almost instantly, flock of 5 or 6 children swamped towards this small piece of bread which was then covered with sand, robbing of bits from one another. The natural reaction of hunger. Stricken by the happenings, he instructed his guide to drive him to the nearest bakery. He arrived at two bakeries and bought every single loaf of bread he found in the bakeries.

The owner was dumb folded, but willing sold everything. He spent less than $100 to obtain about 400 loaves of bread (this is less than $0.25/per loaf) and spend another $100 to get daily necessities. Off he went in the truck full of bread into the streets. As he distributed the bread and necessities to the children (mostly handicapped) and a few adults, he received cheers and bows from these unfortunate. For the first time in life he wondered how people could give up their dignity for a loaf of bread, which cost less than $0.25. He began to ask himself how fortunate he was as a Singaporean. How fortunate he was to be able to have a complete body, have a job, have a family, have the chance to complain what food is nice what isn’t, have the chance to be clothed, have the many things that these people in front of him are deprived of…..

Now I begin to think and feel it, too. Was my life really that bad? Perhaps….no,… it should not be bad at all….

What about you?

Maybe the next time you think your life is bad, think about the child who lost one hand to beg on the streets.

For comments and archives

 
    Cardiology eMedinewS

Women MI patients sicker than men Read More

 
    Pediatric eMedinewS

Formula supplementation may improve breast-feeding rates Read More

 
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

A previously immunized person is bitten again. What is the re-exposure IDRV schedule?

Following re-exposure the bitten person needs only two doses of 0.1 ml. of ID (intra dermal) dose at one site only on Day 0 and Day 3 and RIGs are not needed. Proper wound treatment is very important.

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient with uncontrolled diabetes came with cognitive impairment.
Dr Bad: This is dementia and nothing can be done.
Dr Good: Control your blood sugar.
Lesson: An analysis of over 3,000 individuals with established type 2 diabetes demonstrates a clear age–adjusted inverse relationship between cognitive function and the degree of chronic hyperglycemia as measured by A1c level (Diabetes Care 2009;32:221–6).

Make Sure

Situation: A patient developed dangerous arrhythmias in the immediate post CABG procedure.
Reaction: Oh my God! Why did you not correct his K+ value of 3.4 pre–operatively?
Lesson: Make Sure that pre–operative K+ value of <3.5 is corrected. Cardiac surgery patients who have serum potassium levels below 3.5 mmol/L are at high risk for perioperative arrhythmia.

 
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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

 
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    Quote of the Day (Dr GM Singh)

When you find yourself stressed, ask yourself one question: Will this matter in 5 years from now? If yes, then do something about the situation. If no, then let it go. Catherine Pulsifer

 
    Legal Question of the Day (Dr MC Gupta)

Q. Is it as per law to prohibit the use of diesel generator sets in a commercial area?

Ans.

  1. Right to life guaranteed by Article 21 of the Constitution includes right to breathe unpolluted air.
  2. In terms of an order dated 26-4-2013 the National Green Tribunal, New Delhi, the tribunal observed that the right to breathe fresh air and be free of noise pollution is the right of all people and cannot be restricted to Sector 19-C of Chandigarh. These observations were made during the course of hearing of a petition moved by the Sector 19 C Market Committee, challenging the decision of the Pollution Control Board of Chandigarh to ban DG sets in the market. The tribunal stated that though the decision was limited to the market of Sector 19-C, there is no reason why the same standard should not be applied to all other markets in Chandigarh. Hence Justice Swatanter Kumar, chief of NGT observed-- "There shall be complete prohibition of the use of such DG sets in any part of the commercial markets in all the sectors of UT Chandigarh". The tribunal order has been sent to the Chandigarh administration for effective implementation.

    The proceedings of the NGT were reported in the national dailies--

    http://articles.timesofindia.indiatimes.com/2013-04-28/chandigarh/38877863_1_noise-pollution-tribunal-order-ngt
  3. Pursuant to the above order, The Punjab Pollution Control Board issued a public notice banning the use of diesel generator sets in commercial areas of SAS Nagar, Mohali. It appears that the doctors having clinics/diagnostic centers in commercial areas are unhappy with this order. However, the fact is that the right to carry out one’s profession cannot override the fundamental right of others to enjoy an environment free from pollution. Those using the DG sets need to change to other modes of power supply or to challenge the order of the NGT. The latter would be the more difficult option.
 
   Mind Teaser

Read this…………………

Following prostate surgery, the retention catheter is secured to the client’s leg causing slight traction of the inflatable balloon against the prostatic fossa. This is done to:

A. Limit discomfort
B. Provide hemostasis
C. Reduce bladder spasms
D. Promote urinary drainage

Yesterday’s Mind Teaser: When developing a postoperative plan of care for an infant scheduled for cleft lip repair, Nurse Elaine should assign highest priority to which intervention?

a. Comforting the child as quickly as possible
b. Maintaining the child in a prone position
c. Restraining the child’s arms at all times, using elbow restraints
d. Avoiding disturbing any crusts that form on the suture line

Answer for Yesterday’s  Mind Teaser: a. Comforting the child as quickly as possible

Correct answers received from: Trupti Pagad, DR.JAYASHREE SEN& DR.BITAAN SEN, Dr Brig Pc Jain, Dr Prabha Sanghi, Tukaram Pagad, daivadheenam, Dr. P. C. Das & Dr. Mrs. S. Das, Dr.K.V.Sarma, Dr shashi saini, Dr. B.B. Gupta, Deepali Chatterjee, Dr Chandresh Jardosh, Dr.(Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, DrGajveer, Dr Nageswara Rao Patnala, Muthumperumal Thirumalpillai, Dr K P Chandra, Dr. Mahendra shah, Dr Avtar Krishan, Dr.Chandresh Jardosh

Answer for 17th May Mind Teaser: a. A sunken fontanel

Correct answers received from: Dr Prabha Sanghi, Muthumperumal Thirumalpillai Dr K P Chandra, Dr. Mahendra shah, Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr GM Singh)

Funny Questions and Answers

What is the opposite of ‘Dominos’?
Think...
Tired?
"Domi doesn't know"

 
    Medicolegal Update

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

What is the right to reject medical interventions?

The Nancy Beth Cruzan automobile accident case

Although mentally incapacitated patients have the same right, the Supreme Court allowed states to impose restrictions on how explicit and specific the patient’s prior wishes had to be. After this court ruling, some of Cruzan’s friends provided evidence that she had previously expressed wishes that she would want artificial feedings discontinued in such a scenario. As a result of this testimony, her feedings were terminated. Mentally competent patients need not be terminally ill to exercise this right to refuse interventions; they have the right regardless of health status. In addition, the right applies equally to withholding proposed treatments and to discontinuing initiated treatments. Of note, this right to refuse medical care does not imply a correlative right to demand treatment.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Excess Fat around the Waist May Increase Death Risk for Women

There is increasing evidence that excess abdominal fat is a risk factor for long–term conditions like diabetes and heart disease. However, a recent study from Harvard and the National Institutes of Health published in the journal Circulation links abdominal obesity and women's risk of premature death, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

As per the study, women who carry excess fat around their waists are at greater risk of dying early from cancer or heart disease than women with smaller waistlines, even if they were of normal weight.

In the study researchers followed more than 44,000 nurses over the course of 16 years to track their medical history and lifestyle. At the beginning of the study the women were asked to measure their waists and hips. Every two years, the women completed questionnaires about their health, providing information about their age, activity level, smoking status, diet, blood pressure and cholesterol levels.

They examined the cause of death for all women who died over the course of the study. In total, 3,507 deaths occurred. Of these, 1,748 were due to cancer and 751 were due to heart disease. They discovered that women with greater waist circumferences were more likely to die prematurely, particularly from heart disease, when compared to women with smaller waists. For example, women with waist size equal to or greater than 35 inches were approximately twice as likely to die of heart disease as were women with a waist size less than 28 inches, regardless of their body mass index.

Similarly, women with a waist size equal to or greater than 35 inches also were twice as likely to die of cancer as were women with a waist size less than 28 inches. Women who had a greater waist circumference and were also obese were at the greatest risk of premature death. Greater waist circumference is a sign of collecting excess fat around one’s midsection, called abdominal obesity. A healthy waist limit for women is 80 cm and for men is 85 cm. Waist circumference is determined by measuring around the waist at the navel line.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 50457 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

 
    Readers Responses
  1. Dear Sir, We found emedinews very informative. Regards: Dr Sapna
 
    Forthcoming Events
Dr K K Aggarwal

Enrollment for workshop

Heart Care Foundation of India under the aegis of Perfect Health Mela is organizing a series of skill workshops in the month of Oct as per the following programmes

Name
Date
Time
Place
Duration
Communication Skills 23rd October, Wednesday
8 am
Constitution Club of India
4 hours
Handling Media crisis Saturday 26th October
2 pm
Constitution Club of India
1 hour
Conflict Management 24th October Thursday
10 am
Constitution Club of India
2 hours
Organizational Behavior 24th October Thursday
8 am
Constitution Club of India
2 hours
Team Building 25th October, Friday
8 am
Constitution Club of India
2 hours
Time Management 25th October, Friday
10 am
Constitution Club of India
2 hours

The workshops will have experts interacting both theoretically and with practical demonstrations and interactions. If interested, kindly confirm your registration at rekhapapola@gmail.com. You can also forward this information to your interested friends and colleagues for a registration.

Dr KK Aggarwal
Padma Shri and Dr B.C. Roy National Awardee
President of Heart Care foundation of India

 
    eMedinewS Special

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  FAQs Good Eating

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  First Aid Basics

  Dil Ki Batein

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  Pesticides Safely

 
    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, Dr Usha K Baveja