emedinews
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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 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

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

 
    Health Videos …

Nobility of medical profession: Aamir Khan Controversy (Video 1 to Video 9)
Health and Religion: Bharatiya Vidya Bhavan and Heart Care Foundation of India
Take Care Holistically, DD India health series, Anchor Dr KK Aggarwal (Video 1–2)

 
  Editorial …

19th July 2012, Thursday

Fibrates can raise creatinine levels

In randomized trials, fibrates have been shown to increase creatinine levels. A population–based study showed a link between new fibrate use in elderly and nephrologist consultations and hospital admissions for a rise in creatinine level (1).

In the FIELD trial, the increase in serum creatinine with fenofibrate was reversible on discontinuation, and at the end of the trial fenofibrate treatment appeared to have slowed loss of renal function and reduced proteinuria (2).

References

  1. Zhao YY, Weir MA, Manno M, et al. New fibrate use and acute renal outcomes in elderly adults: a population–based study. Ann Intern Med 2012;156:560.
  2. Davis TM, Ting R, Best JD, et al. Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study. Diabetologia 2011;54:280.

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

To err is human

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

'Achcha to Hum Chalte Hain'

 Rajesh Khanna in Perfect Health Mela 
1995

 
Dr K K Aggarwal
 
    National News

My Profession My Concern

Another victory for IMA

With our collective effort under the flag of IMA, the union govt. is going to change its mindset in introduction of BRHC course by changing its name to B. Sc Community Health.

Since it will no more be a doctorate course, a university will notify the course. Sources in the regulatory body revealed that it has been suggested that new cadre will only provide "simple ambulatory care", which means that they will be trained to provide only OPD care and no "in–patient" health care. "Sick patients will be referred to the doctors and they will only handle cases that need simple ambulatory care." These community health workers will be posted only at the subcentre and not in primary health centres (PHCs) or hospitals. Dr. C. Srinivasa Raju, Chairman– IMA IT Committee, Secretary– Hospital Board of India – IMA AP State.

For comments and archives

ITBP rafting team traverses Ganga’s entire length, collects water samples

NEW DELHI: A 2,525–km rafting expedition, covering the entire length of the river Ganga, recently completed by the Indo–Tibetan Border Police (ITBP) is being keenly looked at by the environment ministry. The ITBP, which organized the expedition as part of its golden jubilee celebrations, took samples of the river water every 50 km along the journey from Gaumukh to Gangasagar. These samples have now been sent to a laboratory to check the level of pollution in the river. An ITBP official said, "The environment ministry has shown interest in our expedition and has asked for the lab test report to get a third party view of the pollution in the river." The "never–done–before" expedition comprised a 20–member river rafting team led by DIG SS Mishra and traversed through five states and 30 cities in 58 days. Along the way, it also created awareness about the need to keep Ganga clean. Mishra said that while the Ganga was cleanest in the upper reaches of Uttarakhand, it was dirtiest in UP and Bihar. Deputy commandant Tarun Kumar, who was part of the team, said, "At Ghatiya Ghat in Farrukhabad, we had to literally wade through at least a hundred bodies floating in shallow water." As part of the celebrations, the force also took a unique Mt Everest expedition where a 23–member team under DIG Prem Singh scaled the mountain with six personnel reaching the summit and then skiing down. They also cleared enormous garbage on the way. (Source: TOI, Jul 12, 2012)

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)

FDA OKs colon cleanse powder

The FDA has approved Prepopik, a powder mixture of sodium picosulfate, magnesium oxide, and citric acid, for use in colonoscopy preparation. The powder comes in two packets that are to be dissolved in cold water and taken separately, preferably the night before and morning of the procedure. If that schedule isn’t possible, it can be taken in the afternoon and then later in the evening before the procedure. Patients taking the colon cleanser should drink extra fluids before and after use to minimize loss of fluids and electrolyte imbalance, an FDA statement said. (Source: Medpage Today)

For comments and archives

OK to operate for gallstones without waiting

In patients with gallstone pancreatitis, the common practice of delaying surgery until laboratory values stabilize lengthens the hospital stay without benefit to patients, an observational study determined. (Source: Medpage Today)

For comments and archives

HRT for menopausal symptoms allowed in new consensus

Short–term hormone replacement therapy (HRT) is acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women, according to a new consensus statement endorsed by 15 leading medical organizations involved in women’s health. The new guidelines and rationale were issued jointly by the North American Menopause Society (NAMS), the American Society for Reproductive Medicine, and the Endocrine Society. (Source: Medscape)

For comments and archives

New test detects a wider range of ‘spice’ drugs

A new test that looks for chemical properties that are similar but not identical to currently available synthetic drugs promises to detect a wider range of these drugs, assisting law enforcement in screening for these agents, according to a new report. "The biggest difference (with this approach compared with available tests) is that this test is nontargeted," said study investigator Megan Grabenauer, PhD, a research chemist at RTI International. "Currently available tests are targeted, meaning they can only answer ‘yes’ or ‘no’ to the question, ‘Is drug A in this sample?,’ " she said. "If the answer is ‘No,’ current tests will only report, ‘No, drug A is not in this sample.’ This test will report, ‘No, drug A is not in this sample, but 2 new drugs, very similar to drug A, are present.’ "The study is published in the July 3 issue of Analytical Chemistry. (Source: Medscape)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Emedinews on Cancer Update–Dr Ashok Kumar Vaid
http://www.youtube.com/watch?v=XC2dZi19SYY

@DeepakChopra: Give up being right. Instead radiate peace, harmony, love, and laughter from your heart.

 
    Spiritual Update

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

Why do we need mind, intellect and ego?

Once a seeker asked a Rishi that acquiring or being in touch with one’s consciousness is the purpose of life and we know that mind, intellect and ego through Kama, Krodha, Lobha, Moha and Ahankara are the obstacles in our path, then why did God create mind, intellect and ego.

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)

What causes hyperprolactinemia?

Prolactin levels increase as a result of:

  • Certain medications, including commonly prescribed antidepressants, antipsychotics, and blood pressure medications
  • Herbs, including fenugreek, fennel seeds and red clover
  • Chest wall irritation (from surgical scars, shingles, or even a too–tight bra)
  • Stress
  • Certain foods
  • Exercise
  • Sleep (prolactin levels are highest at night)
  • Nipple stimulation
  • Hypothyroidism, or underactive thyroid
  • Pituitary tumors. These are usually very tiny, but account for about 30% of all cases of hyperprolactinemia.

For comments and archives

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

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

Blood Grouping systems & Principles, Blood Group Discrepancies & their possible solutions

Natural antibodies

  • Antibodies are formed against most of the major group antigens and are present in almost all individuals when the antigen is absent.
  • In most other minor systems, natural antibodies to the antigens are found occasionally but as their antigenicity is low, the immune antibodies are also rare (except – Kell & Duffy)
  • Most of them are IgM type
  • React poorly at body temperature (except anti–A & anti–B), but agglutinate RBCs at 5–20°C
  • Usually do not cross placenta.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

A mother love

A little boy came up to his mother in the kitchen one evening while she was fixing supper, and handed her a piece of paper that he had been writing on. After his Mom dried her hands on an apron, she read it, and this is what it said:

For cutting the grass: $5.00; for cleaning up my room this week: $1.00
For going to the store for you: $.50; Baby–sitting my kid brother while you went shopping: $.25
Taking out the garbage: $1.00; for getting a good report card: $5.00
For cleaning up and raking the yard: $2.00; Total owed: $14.75

Well, his mother looked at him standing there, and the boy could see the memories flashing through her mind. She picked up the pen, turned over the paper he’d written on, and this is what she wrote:

For the nine months I carried you while you were growing inside me: No Charge.

For all the nights that I've sat up with you, doctored and prayed for you: No Charge.

For all the trying times, and all the tears that you’ve caused through the years: No Charge.

For all the nights that were filled with dread, and for the worries I knew were ahead: No Charge.

For the toys, food, clothes, and even wiping your nose: No Charge.

Son, when you add it up, the cost of my love is: No Charge.

When the boy finished reading what his mother had written, there were big tears in his eyes, and he looked straight at his mother and said, "Mom, I sure do love you." And then he took the pen and in great big letters he wrote: "PAID IN FULL".

Lessons

You will never how much your parents worth till you become a parent
Be a giver not an asker, especially with your parents. There is a lot to give, besides money.

Advice: If your mom is alive and close to you give her a big kiss and ask her for forgiveness. If she is far away, call her. If she passed away, pray for her.

For comments and archives

 
    Cardiology eMedinewS

Echo for long–term risk after stroke Read More

Catheter not required for shock Dx Read More

 
    Pediatric eMedinewS

Low vitamin D may blunt effectiveness of asthma treatment Read More

Cool, dry weather boosts eczema risk Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient wanted to know if the cost of the spectacles would be covered by Mediclaim after cataract surgery.
Dr. Bad: It will be covered.
Dr. Good: It will not be covered.
Lesson: Mediclaim does not cover the cost of spectacles, contact lenses, hearing aids.

For comments and archives

Make Sure

Situation: A known epileptic child died of a seizure while swimming.
Reaction: Oh my God! Why was he allowed to swim?
Lesson: Make sure that patients with uncontrolled epilepsy are not allowed to swim.

For comments and archives

 
    Legal Question of the Day

(Dr MC Gupta)

Q. A patient dies on the operation table. Is there in obligation to inform the police for post mortem, even if the next of kin of the deceased is not willing for autopsy to ascertain the cause of death?

Ans.

  1. One either complains to police as a complainant when one is the aggrieved party/victim of crime. Or, one informs the police about the commission of crime. In the first case, if the patient’s relatives feel that there is criminal negligence resulting in death, it is for them, not the doctor, to lodge a police complaint. In the second case, if the doctors think that there is even the remotest possibility of foul play, they should inform the police. If the patient is already an MLC case, the police will have to be naturally informed. Otherwise, it is sufficient for the treating surgeon/anesthetist to simply inform the medical superintendent. Their job ends there. However, they must ensure proper documentation of various medical facts etc.
  2. Apart from the above, there is no requirement to inform the police in case of a death on the table (DOT), provided there is no standing order/rule to that effect.

For comments and archives

 
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    Fitness Update

(Rajat Bhatnagar, MonaVie www.mymonavie.com/sonraj)

New clues discovered to explain tendon injury

Tendon disorders cost the UK economy more than £7bn a year and now scientists at Queen Mary, University of London have identified a vital component of tendons which could help treat them. The research, published in the highly regarded Royal Society journal Interface, found that a component of tendons known as the interfascicular matrix (IFM) is essential for their function. "Tendon disorders are highly debilitating and painful, and may herald the end of an Olympic athlete’s career," said co–author Dr Hazel Screen, a senior lecturer in medical engineering at Queen Mary, University of London.

"Even today, with advancements in sports science, little is known about tendon health management, and we still do not understand why some people are more prone to tendon injury than others. However, we have now found that the matrix which binds the fascicles together in the tendon, the IFM, is essential for tendon function and that changes to this structure may be responsible for tendon injury."

 
  Quote of the Day

(Dr GM Singh)

True dignity is never gained by place, and never lost when honors are withdrawn. Philip Massinger

 
    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Low platelet counts and bleeding

  • In idiopathic thrombocytopenic purpura, minimal bleeding after trauma is uncommon unless the platelet count is less than 60,000/microL.
  • Self–limited bleeding, spontaneous bleeding requiring special attention (e.g., nasal packing for epistaxis) and severe life threatening bleeding does not occur until platelet counts are < 40,000, < 12,000, and < 6000/μL, respectively
 
    Mind Teaser

Read this…………………

A client with COPD is being prepared for discharge. The following are relevant instructions to the client regarding the use of an oral inhaler except:

A. Breath in and out as fully as possible before placing the mouthpiece inside the mouth.
B. Inhale slowly through the mouth as the canister is pressed down
C. Hold his breath for about 10 seconds before exhaling
D. Slowly breath out through the mouth with pursed lips after inhaling the drug

Yesterday’s Mind Teaser: Mario undergoes a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one–bottle water–seal drainage is instituted in the operating room. In the postanesthesia care unit Mario is placed in Fowler’s position on either his right side or on his back to

A. Reduce incisional pain
B. Facilitate ventilation of the left lung
C. Equalize pressure in the pleural space
D. Increase venous return

Answer for Yesterday’s Mind Teaser: B. Facilitate ventilation of the left lung.

Correct answers received from: Dr Pankaj Agarwal, Raju Kuppusamy, Dr Thakor Hitendrsinh G, Muthumperumal Thirumalpillai, Anil Bairaria, Dr KV Sarma, Dr KV Sarma, Dr Kanta Jain, Dr Avtar Krishan,
Dr Jainendra Upadhyay.

Answer for 17th July Mind Teaser: D. Delay resistance and increase the tuberculostatic effect

Correct answers received from:
Dr Chandresh Jardosh.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Help is on its way

A woman was at work when she received a phone call that her daughter was very sick with a fever. She left her work and stopped by the pharmacy to get some medication.

She got back to her car and found that she had locked her keys in the car. She didn’t know what to do, so she called home and told the baby sitter what had happened, the baby sitter told her that the fever was getting worse. She said, "You might find a coat hanger and use that to open the door." The woman looked around and found an old rusty coat hanger that had been thrown down on the ground, possibly by someone else who at some time or other had locked their keys in their car.

Then she looked at the hanger and said, "I don’t know how to use this." So she bowed her head and asked God to send her some help. Within five minutes an old rusty car pulled up, with a dirty, greasy, bearded man who was wearing an old biker skull rag on his head. The woman thought, "This is what you sent to help me?" But, she was desperate, so she was also very thankful.

The man got out of his car and asked her if he could help. She said, "Yes, my daughter is very sick. I stopped to get her some medication and I locked my keys in my car. I must get home to her, please, can you use this hanger to unlock my car?" He said, "Sure". He walked over to the car, and in less than a minute the car was opened.

She hugged the man and through her tears she said, "Thank you so much! You are a very nice man." The man replied, "Lady, I am not a nice man. I just got out of prison today, I was in prison for car theft and have only been out for about an hour."

The woman hugged the man again and with sobbing tears cried out loud, "Oh, Thank you God! You even sent me a Professional!"

 
  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Haemophilus influenzae type B vaccine

There are different types of Hib vaccines. The earliest one used contained polysaccharide capsule of H. influenzae type B. This vaccine was not a very good immunogen and the immune response was poor. Later, conjugate vaccines were developed. Currently, the Hib vaccine used has the polysaccharide along with the carrier proteins and is called "Hib conjugate vaccine". The conjugate vaccine induces better immune response. The carrier protein induces a T–cell dependent B–cell immune response to the polysaccharide.

Hib conjugate vaccines are liquid or freeze–dried preparations of PRP covalently bound to a carrier protein either to the nontoxic mutant diphtheria toxin CRM 197 tetanus toxoid (PRP–T), or meningococcal outer membrane protein (PRP–OMP).

Vaccination schedule

A 3–dose primary series is given at the same time as the primary series of Diphtheria–Tetanus–Pertussis (DPT) is given. The first dose may be given to infants as young as 6 weeks of age, and the second and third doses may be given at 4–8 week intervals along with DTP. For children aged >12 months who have not received their primary immunization series, a single dose of the vaccine is sufficient. The vaccine is not generally offered to children aged >24 months owing to the limited burden of Hib disease among children older than that age. In many industrialized countries, administering a booster dose during the child’s second year of life has provided additional benefit. If given, the booster dose should be administered to children aged between 12 to 18 months of age. However, a single dose of vaccine may be given in non vaccinated children (< 5 years of age) in areas where infection is prevalent.

 
    Medicolegal Update

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

World Medical Association Declaration on Principle-Undergraduate Medical Education & Faculty

The goal of medical education is to educate physicians who are entitled and consistent with their training to practice the profession without limitation. Medical Education leading to the first professional degree must be conducted by an organized faculty and the faculty must possess the appropriate academic qualifications that can only be achieved through formal training and experience

  • The first professional degree should represent completion of a curriculum that qualifies the student for a spectrum of career choices, including patient care, public health, clinical or basic research or medical education. Each career choice will require additional education beyond that required for the first professional degree.
  • The research to advance medical knowledge and the provision of the highest quality of care must occur in academic settings to demonstrate the highest medical standards.
  • The content, format and evaluation of the educational experience provided are the responsibility of the faculty with participation of National Medical Associations.
  • The faculty is responsible for providing its own obligatory basic curriculum in an academic environment of freedom in which learning and inquiry can thrive in a maximal way.
  • Frequent reviews of the curriculum, allowing for the needs of the community and for input from practicing physicians should be conducted by the faculty,
  • The proper administrative structure and academic records must be maintained. When the necessary elements are available the clinical education of practitioner and specialist can be sponsored by either a university or a hospital.

(Adopted by the 39th World Medical Assembly Madrid Spain, October 1987)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Diabetics should undergo cardiac evaluation

All diabetics should have their cardiac examination done as cardiovascular disease accounts for 65% of deaths in patients with type 2 diabetes, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Intensive and aggressive management of diabetes can reduce the risk of getting future heart attacks. As per the new guidelines, all patients with diabetes should have a blood pressure below 120/80 mmHg and fasting blood sugar lower than 90 mg%. The ABC of diabetes management is to keep abdominal circumference lower than 32 inches in women and lower than 35 inches in men, blood pressure lower than 120/80 mmHg and LDL cholesterol less than 100 mg%.

Do not ignore sudden hearing loss

Dr Aggarwal also said that unexplained, unilateral, sudden hearing loss should not be ignored and medical consultation should be taken immediately. A hearing loss of more than 30 dB is considered significant. Quite often these patients have associated ringing in the ears and vertigo. The cause may be viral infections and/or vascular insults. In such patients, hearing may be restored if they are treated early. CT scan needs to be done in such cases to rule out brain tumour.

Do not ignore exertional dental pain

He further said that a dental pain which comes on exertion and is relieved at rest, may be an indication of underlying severe heart blockage. Typically, heart attack patients often present to dentists, orthopaedicians, GI physicians or ENT surgeons. Any discomfort in the chest, arm, teeth, back of the neck or shoulders which comes on exertion and is relieved by rest, unless proved otherwise, should be considered cardiac in origin.

 
    Readers Responses
  1. Ayurvedic and Unani doctors are after all registered by medical council though in different para of medical council. So the onus lies with the govt. and policy makers, what they want to do with them. I feel they can be used for rural healthcare in positive and constructive way. Vivek Kumar, Varanasi.
 
    Forthcoming Events
Dr K K Aggarwal
Dr K K Aggarwal

IYCNCON 2012

All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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

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

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

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  Dil Ki Batein

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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