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  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

  Editorial ...

19th November 2010, Friday

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

FDA urges Consumers to be ‘smart’ about antibiotic use

The U.S. Food and Drug Administration has teamed up with the U.S. Centers for Disease Control and Prevention (CDC) and other health care professional, government, academic, international and industry partners to support ‘Get Smart About Antibiotics Week’ (Nov. 15–21) as part of a joint effort to encourage the appropriate use of antibiotics.

The FDA recommends the following:

  • Don’t skip doses and take your medicine as prescribed. Antibiotics are most effective when taken as prescribed.
  • Don’t save antibiotics. The drug is meant for a particular infection at that time. Don’t use leftover medicine. Taking the wrong drug can delay the appropriate treatment and your infection might get worse.
  • Don’t take antibiotics prescribed for others. Only a health care professional can determine the right treatment for your infection.
Dr KK Aggarwal
Editor in Chief
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  Quote of the Day

(By Dr. G.M.Singh)

"Problems are not stop signs, they are guidelines."

Robert H. Schuller

    Photo Feature (from the HCFI Photo Gallery)


Festival for Children with Special Needs

Anmol, a Festival for Children with Special Needs is an initiative of the Perfect Health Mela to provide a platform to show the tremendous hidden talent in them.

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

An interesting note from SC from The Hindu.

Court: what has been done to register unqualified medical practitioners?

The Supreme Court has sought the Centre’s response on the steps it has taken for registration of unqualified medical practitioners pursuant to its letter sent to all States in May 1996.

A Bench of Justices D.K. Jain and H.L. Dattu recently issued notice to the Union Health Ministry, during the hearing of a special leave petition filed by the Private Medical Practitioners Association of India (PMPAI) against two orders of the Madras High Court asking the Indian Medical Association (IMA) to take action against those doctors who were practising without licence. In its petition, the IMA sought a direction to authorities to consider the representations sent last year and initiate criminal prosecution against paramedical technicians, paramedical practitioners and physiotherapists prescribing allopathic medicines and administering allopathic treatment, and using ‘Dr.’ before their names in prescriptions and advertisements. The High court passed its orders on January 5 and February 23.

No specific complaint

In its appeal to the Supreme Court, the PMPAI said the association comprised practitioners who had 10–40 years of experience in various forms of medicine. The members were rendering medical service to the people living in remote villages at affordable cost. So far there had been no specific complaint or allegation against the members. However, the IMA was making attempts to eradicate the medical practitioners other than its members on the ground that the PMPAI members could not practise as they did not possess a valid licence. About 200 medical practitioners were arrested on the basis of the orders obtained from the High court.

Counsel for the petitioner association P. Somasundaram said that as early as in 1996 the Union Health Ministry addressed a letter to all States on the need for registration of unqualified medical practitioners, stating it would be desirable to enlist the existing unqualified medical practitioners on specified conditions and then adopt a strict attitude towards those who were carrying on practice in modern medicine without getting either registration or enlistment.

SLP can’t be withdrawn

Counsel said though the association was prepared to withdraw the SLP, it wanted to know what action had been taken pursuant to the letter sent to the States. It was at this juncture the Bench said it would not allow the SLP to be withdrawn and issued notice to the Health Ministry, asking it to file an affidavit in eight weeks on the steps taken pursuant to the 1996 letter.

The court asked Solicitor–General Gopal Subramaniam to render assistance in this case.


    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC http://www.isfdistribution.com)

Teen musicians win GRAMMY experience for songs about drug abuse

NIH collaborates with MusiCares and GRAMMY Foundation to honor teen musicians during National Drug Facts Week Three original music compositions that focus on personal experience living around drugs were the winners of the MusiCares and GRAMMY Foundation’s Teen Substance Abuse Awareness through Music Contest. The contest was created to celebrate National Drug Facts Week, a seven–day observance launched this week by the National Institute on Drug Abuse (NIDA).

Planned, higher intensity exercise may be important to weight loss and maintenance

A new study published online in the journal Obesity found that people who have lost weight and kept it off may not exercise more frequently than people who have never been overweight, but the way they exercise may be different. Looking at three groups of study participants, researchers found that the group who lost and maintained a significant amount of weight took part in 42 minutes per day of sustained moderate to vigorous exercise, the never overweight group did 26 minutes of exercise per day and the obese group did 19 minutes per day. According to the study’s authors, "Structured exercise may…be important because activity tends to be at a higher intensity during a sustained bout of activity. It is also possible that planned exercise is needed to achieve the amount of activity required by many individuals to sustain a weight loss."

(Dr Monica and Brahm Vasudev)

Poor sleep quality increases inflammation

People who sleep poorly or do not get enough sleep have higher levels of inflammation, a risk factor for heart disease and stroke (Dr Alanna Morris, a cardiology fellow at Emory University School of Medicine).

Repeat cardiac imaging equals high radiation

Almost 40% of patients undergoing myocardial perfusion imaging had repeated tests and were exposed to high doses of radiation, according to a retrospective, single–center study. The median estimated cumulative effective radiation dose received by more than 1,000 consecutive patients in the study was 121 mSv. Dr Andrew Einstein, of Columbia University Medical Center in New York City, reported at the American Heart Association annual meeting. That level of radiation exposure has been associated with increased cancer risks – and actually exceeds the level (≥5 mSv).

Sex of endoscopist no influence for women patients

Access to a female endoscopist did not increase screening colonoscopy in women, according to researchers who tested women’s oft–stated preference for a same–sex endoscopist. (Thomas D. Denberg, MD, PhD, currently with Harvard Vanguard/Atrius Health in Newton, Mass)

Too much sleep may raise stroke risk

Women who get more than 10 hours of sleep a night may increase their risk of incident stroke. Additionally, women who had six or less hours of sleep did not have an associated increased stroke risk, Alan Flint, MD, of the Harvard School of Public Health, reported at the American Heart Association meeting.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is the psychological impact of infertility?

Infertility can have societal repercussions and cause personal suffering. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood. Partners may become more anxious to conceive, ironically increasing sexual dysfunction. Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer. Couples undertaking IVF too face considerable stress. Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.

For queries contact: banerjee.kaberi@gmail.com

    Hepatology Update

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

What is Alagille syndrome?

Alagille syndrome is the name given to the condition to a particular type of liver disease, called Biliary Hypoplasia, in which the bile ducts inside the liver are smaller and fewer than normal, together with at least two other associated abnormalities in other parts of the body. The bile ducts outside the liver may also be smaller than normal. This condition is also sometimes called Arterio–Hepatic Dysplasia.

    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What is Cannabis poisoning?

Cannabis, also known as marijuana, Indian hemp, hashish, ganja, pot, dope and grass, is made from the Indian hemp plant Cannabis sativa. Cannabis is often abused and, in some countries it is used almost as much as alcohol or tobacco.

Cannabis harms the brain however it does not cause much harm to adults, unless it is injected. The signs and symptoms start within 10 minutes of smoking the drug and last for about 2–3 hours. When taken orally, the effects start to appear within 30–60 minutes and last for 2–5 hours. The major effects are a feeling of well–being, happiness and sleepiness; high doses may cause fear, panic and confusion, impaired balance, hallucinations, drowsiness, slurred speech, coughing if the drug is breathed in, as when smoking cigarettes. If the drug is injected it may cause more serious problems severe headache, dizziness, irregular breathing, fever, low blood pressure, unconsciousness.

  • If the patient is unconscious or drowsy, lay him or her on one side in the recovery position. Check breathing every 10 min. A patient who is anxious or confused should be kept in a quiet, warm room. If the cannabis was swallowed: there is no need to make the patient vomit.
  • If the patient is fully awake, breathing normally, and not vomiting: Give activated charcoal and water to drink.
  • If the patient is hallucinating or violent: Give chlorpromazine, 50-100 mg an adult dose, intramuscularly.
  • If cannabis has been injected: Monitor breathing, pulse, blood pressure, temperature. Supportive care, including oxygen and mechanical ventilation, should be given as needed. If low BP, keeping the patient lying with the feet higher than the head; intravenous fluids can be given.
  • If cannabis has been injected: Monitor breathing, pulse, blood pressure, temperature. Supportive care, including oxygen and mechanical ventilation, should be given as needed. If low BP, keep the patient lying with the feet higher than the head; intravenous fluids can be given.
    Rabies Update

Dr. AK Gupta, APCRI, Author of "RABIES – the worst death"

Why does a person not acquire immunity against natural rabies infection, as in other viral infections?

A person does not acquire immunity against natural rabies infection, as in other viral infections because there is no viremia in rabies and the virus is not accessible to the normal immune mechanism of the body. The antibody production starts only after traveling efferently from CNS via mostly autonomic nerves to different target organs. But by that time, the neuronal cells of patient’s brain stem are affected.

    Clinical Tips

5 steps to a pain–free back (Harvard News Letter)

Step 2. Maintain a healthy weight

Being overweight or obese can slow your recovery. Those extra pounds also increase the risk that back pain will return. The heavier you are, the greater the load your spine must carry. To make matters worse, if the bulk of your weight comes in the form of abdominal fat, rather than muscle, your center of gravity can shift forward, a condition that puts added pressure on your back. By maintaining a healthy weight, you can ease the burden on your spine.

To see if you are at a healthy (normal) weight, calculate your body mass index (BMI), which takes both your height and weight into consideration. Not only will you help your back if you maintain a normal BMI (in the range of 19–25), but you’ll also lower your risk for many diseases, including heart attack, stroke, diabetes, and high blood pressure.

    Lab Update

Dr Arpan Gandhi and Dr Navin Dang

Reticulocyte indices

With the advent of automated counting of reticulocytes, several reticulocyte parameters are available to clinicians and pathologists. These include reticulocyte volume, reticulocyte hemoglobin content, and reticulocyte hemoglobin concentration.

    Medi Finance Update

Should professional tax paid be allowed as deduction?

 Any amount paid as professional tax shall be allowed as deduction in the year of payment.

    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combination of a drug, standards of which are prescribed in the Second Schedule to the said Act with an Ayurvedic, Siddha or Unani drug

    IMSA Update

International Medical Science Academy (IMSA) Update

Reproductive effects of treatment of CIN

The risk of preterm delivery may increase in women with cervical intraepithelial neoplasia (CIN) who undergo more than one cervical conization. A retrospective study reported that, compared to women with one prior conization, the risk of preterm delivery increased three-fold in women with two prior conizations.

(Ref: Ortoft G, et al. After conisation of the cervix, the perinatal mortality as a result of preterm delivery increases in subsequent pregnancy. BJOG 2010;117:258).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure was not responding to treatment.
Dr. Bad: Increase the drugs.
Dr. Good: Reduce your salt intake to 2 gm of sodium per day.
Lesson: Reducing salt and water intake can help control CHF.

Make Sure

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped?
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy. Gingival hyperplasia is a known side effect of amlodipine.

    Lighter Side of Reading

An Inspirational Story

Struggle a Little – Then Fly!

A man found a cocoon of a butterfly, that he brought home.

One day a small opening appeared he sat and watched the butterfly for several hours. It struggled to force its body through that little hole. Then it seemed to stop making any progress. It appeared as if it had gotten as far as it could and it could go no farther.

So the man decided to help the butterfly. He took a pair of scissors and snipped off the remaining bit of the cocoon. The butterfly then emerged easily, but, it had a swollen body and small, shriveled wings. He continued to watch the butterfly, he expected that, at any moment, the wings would enlarge and the body would contract. Neither happened!

In fact, the butterfly spent the rest of its life crawling around with a swollen body and shriveled wings. It was never able to fly The man acted with well–intentioned kindness but he didn’t understand the consequences. The restricting cocoon and the struggle required to get through the tiny opening, were nature’s way of forcing fluid from the body of the butterfly once it achieved its freedom from the cocoon.

Sometimes struggles are exactly what we need in our life. If we were to go through life without any obstacles, it would cripple us. We would not be as strong as we could have been and we could never fly

So the next time you are faced with an obstacle, a challenge, or a problem, remember the butterfly.
Struggle a little – then fly!

— — — — — — — — — —

SMS of the day

The difference between dream and aim

Dream requires soundless sleep to see whereas aim requires sleepless efforts to achieve

— — — — — — — — — —

Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: |……| ome"
Answer for yesterday’s eQuiz:
"A long letter from home "

Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr. Rajiv Dhir, Dr. Harimohan Goel, Dr Sudipto Samaddar.

Answer for 17th November Mind Teaser: "Age before beauty"
Correct answers received from: Dr. Pradeep Meena, Dr. Suman Kumar Sinha, Dr.K.Raju, Dr.K.P.Rajalakshmi, Dr Rashmi Chhibber, .Dr. Prabha Sanghi, Dr. Satish Gunawant

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)


During the historic first manned mission to Mars, two Astronauts were charting the Martian surface. "Look at that," said one to the other, "how beautiful this alien landscape is, untouched by man."

At that point, he was cut off, as he found his radio communications knocked out by unknown interference. They followed the source of the interference until they reached the rim of a crater. "Do you see what the source of that noise is?" asked the first astronaut. "I don’t know," said the second, "but it might be coming from that Starbucks behind you.

    Readers Responses
  1. Dear Dr KK Aggarwal, it is a great effort to publish such a newsletter that is both entertaining and educating. Carry on with it. PNN Pisharody
  2. Dear Doctors, The Drugs Control Department of Kerala is out to impose Drug License for private hospitals in Kerala on the strength of a Kerala High Court order in WP (C) No. 38494/2003 (Y). For more details visit: http://www.qpmpa.org/images/stories/qpmpa/journal/7_JMS_September_2010.pdf  I request all private hospital owners in India to be on guard. The Drugs Control Departments in every state will try to impose the same in other states soon. QPMPA has filed an SLP in Apex Court. Join as a party to stop the Drugs Controllers: Kiran Krishnan
    Public Forum

(Press Release for use by the newspapers)

Most do not meet the exercise guidelines

Only an estimated 35% of urban people in Delhi meet the 2008 Physical Activity Guidelines, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

According to the 2008 guidelines, the minimum recommended aerobic physical activity required to produce substantial health benefits in adults is 150 minutes of moderate–intensity activity or 75 minutes of vigorous activity per week, or an equivalent combination of moderate and vigorous physical activity. In addition, muscle-strengthening exercises are recommended at least twice a week.

The 2010 guidelines call for adults to do at least 30 minutes of moderate–intensity activity five days per week, or 20 minutes of vigorous activity three days a week.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS, Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November
Venue: Moolchand Medcity Auditorium, 9 – 12 noon

Chairperson: Dr (Prof) S C Tiwari, Director Fortis Institute of Renal Sciences & Kidney Transplant

Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani

9.00 – 9.30 AM:
Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
9.30 – 10.00 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Hospital
10.00 – 10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30 – 11.00 AM: Kidney Transplant: managing difficult cases. Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00 – 12.00 AM: Panel discussion
12.00 Noon: Lunch

(Registration free: email to emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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