March 19  2015, Thursday
editorial
Alcohol: Benefits Vs Risk
Dr KK AggarwalThere is consensus that non drinkers should not start and the ones who drink can continue provided they do so in moderation and in absence of contraindications. People tend to consume more alcohol in winter and near the New Year.
  • Persons who have been lifelong abstainers cannot be easily compared with moderate or even rare drinkers. Recommending alcohol intake to them even if they would agree to drink is not justified.
  • The diseases that moderate alcohol use prevents (such as coronary heart disease, ischemic stroke, and diabetes) are most prevalent in the elderly, men, and people with coronary heart disease risk factors. For these groups, moderate alcohol use is associated with a substantial mortality benefit relative to abstention or rare drinking.
  • For young to middle-aged adults, especially women, moderate alcohol use increases the risk of the most common causes of death (such as trauma and breast cancer).
  • Women who drink alcohol should take supplemental folate to help decrease the risk of breast cancer.
  • Men under the age of 45 may also experience more harm than benefit from alcohol consumption. In this age group, moderate alcohol use is unlikely to provide any mortality benefit, but consumption of less than one drink daily appears to be safe if temporally removed from operation of dangerous equipment. For individuals with established contraindications to alcohol use, even this level of alcohol use is dangerous.
  • Men can tolerate more alcohol than women. The ideal therapeutic dose of alcohol is around 6 grams per day. Medically safe limits are 10 grams in one hour, 20 grams in a day and 70 grams in a week. (50% for the women).
eMedipics IMA,IJCP,HCFI
IMA initiative – TB Mukt Bharat
News
  • Genetic variations associated with autism spectrum disorders (ASDs) have been linked to better cognitive ability in individuals who do not have the condition, suggests new research published online in Molecular Psychiatry.
  • Women who are obese are around 40% more likely to develop certain forms of cancer than those of a healthy weight, suggest new data published in the British Journal of Cancer.
  • A new study suggests that weight-loss surgery reduces asthma-associated emergency visits, hospitalizations by half. The findings are published online in the Journal of Allergy and Clinical Immunology.
  • Researchers examining memory and effects on the aging brain report that men have worse memory performance than women as they age. Additionally, a gene that is a known risk factor for Alzheimer's disease was not found to be associated with worse memory performance. The findings are published in JAMA Neurology.
  • A new study published in the Journal of Allergy and Clinical Immunology revealed that majority of patients suffering from psoriasis showed significant recovery after just a single dose of an experimental treatment with a human antibody that blocks an immune signaling protein crucial to the disease.
IMA,IJCP,HCFI
Dr KK Spiritual Blog
The spiritual meaning of the word ‘Artha’

Dharma, Artha, Kama and Moksha are the four fundamental principles of our very existence which means earning righteously with a desire to fulfill the inner happiness.

Righteous earning is called ‘Artha’ and mistakenly it has been linked to materialistic money. In mythology, Artha is synonymous with Lakshmi, Saraswati and Kali where Lakshmi represents righteously earned materialistic wealth, Saraswati represents wealth of knowledge and Kali represents wealth of wisdom to fight the bad in you and in the society.

In any country, it is the wealth of knowledge, which is more important. India was ruled initially by warriors (Kali), later by money (Lakshmi) and in future will be ruled by knowledge (Saraswati).

It is the human resources, which today decide the growth of a company and the amount of money invested. If you have good human resources, your company is going to succeed.
IMA,IJCP,HCFI
Cardiology eMedinewS
  • New research suggests that fish oil supplementation (FOS) may reduce the overall atherothrombotic risk profile in patients with suspected CAD. The study presented at the American College of Cardiology (ACC) 2015 Scientific Sessions exhibited a significant association between FOS and decreased inflammation, thrombogenicity and lipid markers.
  • Vitamin D supplementation is ineffective for lowering blood pressure and should not be used for blood pressure control, suggests a meta-analysis published online March 16 in JAMA Internal Medicine.
Pediatrics eMedinewS
  • Lung ultrasound seems to have high specificity and sensitivity in the hands of trained clinicians for the diagnosis of childhood pneumonia, suggests a meta-analysis published online March 16 in Pediatrics.
  • Children with isolated linear skull fractures from minor blunt head trauma are at low risk for clinical deterioration and need for neurosurgical intervention if neurological assessment is normal, reports a new study published online March 16 in Pediatrics.
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Events
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Make Sure
Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to avoid painkillers in renal failure as most painkillers (barring nimesulide, paracetamol) are not kidney–friendly drugs.
Medicolegal
(Contributed by Dr Sudhir Gupta, Prof & Head, Forensic Medicine & Toxicology, AIIMS)

Q. A friend of mine has the following qualifications: BHMS, PG Diploma in Clinical Pathology, MSc Clinical Pathology from a recognized University. Can he run a Pathology Lab?

A. Running a pathology lab amounts to practicing pathology, which is a specialty of Allopathy/modern medicine. Nobody who is not a graduate in modern medicine can be a specialist in an Allopathic/modern medicine specialty. Your friend is not legally competent to run a pathology lab.
Dr Good Dr Bad
Situation: A patient came with black stools.
Dr. Bad: It is lower GI bleeding.
Dr. Good: It is upper GI bleeding.
Lesson: Black stools usually indicate upper GI bleeding.

(Copyright IJCP)
IJCP Book of Medical Records
IJCP’s ejournals
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eMedi Quiz
A vitreous aspirate has been collected in an emergency at 9 pm. What advice would you like to give to the staff on duty regarding the overnight storage of the sample?

1. The sample should be kept at 4°C.
2. The sample should be incubated at 37°C.
3. The sample should be refrigerated deep freezer.
4. The sample should be refrigerated for the initial 3 hours and then incubated at 37°C.


Yesterday’s Mind Teaser: A 60-year-old male presented to the emergency with breathlessness, facial swelling and dilated veins on the chest wall. The most common cause is:

1. Thymoma
2. Lung cancer.
3. Hodgkin's lymphoma.
4. Superior vena caval obstruction.

Answer for yesterday’s Mind Teaser: 3. Bone erosions.

Correct Answers received from: Dr Prabodh K Gupta, Prateek, Daivadheenam Jella, Dr Avtar Krishan, Dr KV Sarma.

Answer for 17th March Mind Teaser: 3. Bone erosions.

Correct Answers receives: Dr Avtar Krishan.
Rabies News (Dr A K Gupta)
What precautions should be taken while vaccinating by the ID route?
  • The ID injections must be administered by staff trained in this technique.
  • The Vaccine vials must be stored at +2°C to + 8°C after reconstitution.
  • The total content should be used as soon as possible, but at least within 8 hours.
  • The 0.1 ml. ID administration of cell–culture vaccine should create a wheal of at least 5 mm diameter with "peau de orange" appearance.
  • If ID dose is given subcutaneously then there is a possibility of poor immune response due to low antigen load. This may be life–threatening.
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh,
SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
IMA NEWS
Sonal Namaste
Handwashing is like a "do-it-yourself" vaccine; it involves 5 simple and effective steps (think Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness and stay healthy.
Facts about Tuberculosis (TB)
What are the symptoms of TB?
  • Symptoms of TB are specific to the site affected although there are some symptoms common to all types of TB
  • Symptoms of Pulmonary TB are:
    • Persistent cough for 2 weeks or more
    • Chest pain
    • Shortness of breath
    • Blood in sputum
  • Symptoms of Extra Pulmonary TB depend on the site/organ involved.
    • Brain TB: Meningitis
    • Lymph node TB: Enlarged Lymph nodes
    • Bone TB: Destruction of bones and Joints
    • Abdominal TB: Intestinal obstruction
  • Common symptoms
    • Weight loss
    • Fatigue
    • Evening rise of temperature (fever)
    • Night sweats
400 ghost teachers in private medical colleges in Punjab
Shimona Kanwar & Aditi Gyanesh, TNN | Mar 17, 2015, 06.33 AM IST

LUDHIANA/CHANDIGARH: The Punjab Medical Council has found that 400 doctors registered in the state have been drawing hefty salaries as full-time faculty in private medical colleges without taking regular classes.

On paper, the faculty members have been teaching at colleges in Punjab, Haryana and Himachal Pradesh. But in reality, they run beauty salons, hair transplant clinics and claim to have wonder treatments for heart ailments, according to the complaints received by PMC. They have also been running their own private clinics.

President of PMC, Dr GS Grewal, has issued an official release in which he has named four medical colleges with ghost teachers, including Maharishi Markandeshwar University, Ambala; Maharishi Markandeshwar University, Solan, in Himachal Pradesh; Adesh Institute of Medical Sciences & Research, Bathinda and Gian Sagar Medical College, Patiala.

Medical Council of India (MCI) doesn't allow part-time faculty in its recognized colleges. "We found plenty of such doctors in South India engaged in these malpractices. Punitive action which can be taken is suspending their teaching licenses for two to five years," said Dr K K Aggarwal, former member of the ethics committee of the MCI and honorary secretary general of Indian Medical Association, Delhi.

"Quite a few private medical colleges were running with ghost teachers who were being shown on the rolls but were actually working and practicing in different places hundreds of kilometres away," Grewal said, adding, "One of our council members, a cardiologist, is also working as assistant professor at a private medical college in Solan. I have requested MCI to send them all a notice." MCI has been forwarded the cases after which it may issue show-cause notices to the doctors.

Punjab has very few private medical colleges, but in the absence of a common entrance test, some malpractices exist, a senior Punjab government official said. "Had there been a common entrance test on the basis of merit, these private colleges could have taken care and not started such fraudulent practices," said Dr K K Talwar, adviser to Punjab chief minister on medical education and research.

Colleges with Ghost teachers

Maharishi Markandeshwar University, Ambala: 240 Maharishi Markandeshwar University, Solan: 84 Adesh Institute of Medical Sciences & Research, Bathinda: 48 Gian Sagar Medical College, Patiala: 64 Total: 436 Source: Punjab Medical Council
MCI News
Medical Council of India

Pocket-14, Sector-8, Dwarka, New Delhi-110077

No.MCI-Computer(401)/RFID/2014/165385 Date: 13.03.2015

To,

Deans/Principals

All the Medical Colleges

Sir/Madam,

The Medical Council of India had started Radio Frequency Identification (RFID) system for faculty identification, tracking & monitoring Solution in the year 2009 (copy enclosed)

The process of implementation of RFID system was discontinued during the tenure of Board of Governors. The Medical Council of India by a Notification dated 05.12.2013 issued by Ministry of Health & Family Welfare was reconstituted and the President of the Council constituted a Sub-Committee to study the RFID system and decided to implement the same. We seek your co-operation in the matter for which the detailed information required for RFID faculty identification tracking & monitoring Solution system and the same is annexed with the letter. Please ensure that the information should reach the MCI’s office at the earliest.

If you have any difficulty in understanding the enclosed required information, please feel free to contact Mr. Anupam Dhua, Computer Programmer at the following numbers:

011-25367038
011-25361330
Email: mci@bol.net.in

Yours faithfully

(Ashok K. Harit)
Deputy Secretary (Admn.)

RFID Faculty Identification System

Annexure

1. Prerequisites:

The below listed pointers will be provided to the vendor by the college:
  • Computer System at the college with printer. The Computer System should have i3 core processor, 4GB RAM, 1 TB Hard Disk.
  • Broadband Internet Connectivity (Preferred Leased Line)
  • Crimped CAT6 Network Connectivity till the Biometric Reader with Internet.
  • Submission of the Faculty Information on the Web-portal (Website for the project)
  • Softcopy of the necessary supportive documents in .pdf or jpg. Format.
  • Dedicated 3 pin (5Amp with earthing) power supply sockets near the reader.
  • Location of the readers should be accessible by all the faculties for fingerprint enrollment.
  • Availability of all faculties on the pre-decided day of which the appointment is given by the engineer’s visit to the college. Any extra visit charges of the engineer for the enrolment process will be borne by the college/faculty.
  • Electrical and Network assistance will be borne by the vendor’s engineer during his visit to the college.
  • One dedicated project coordinator of the college for the handover and documentation sign offs and the point of contacts for basic remote troubleshooting should be appointed by the college.
  • Any physical hampering/damage to the device by the college side will not be covered in warranty.
  • Correct verified employee list will be uploaded by the college authorities after 2 level verification by the project coordinator appointed by the college. Any fraudulent information will wholly be responsibility and liability to the college.
  • All faculties need to have a valid AADHAR CARD/Number as the integration is being done with postal address, contact number, email address and consignee name for all colleges will be given by MCI for shipment of devices and scheduling appointments.

    For copy of Notice visit: http://www.mciindia.org/circulars/Circular-All-Medical-Colleges-RFID.pdf
Media
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Inspirational Story
Determination and Persistence

This is a real life story of engineer John Roebling building the Brooklyn Bridge in New York, USA back in 1870. The bridge was completed in 1883, after 13 years.

In 1883, a creative engineer named John Roebling was inspired by an idea to build a spectacular bridge connecting New York with the Long Island. However, bridge building experts throughout the world thought that this was an impossible feat and told Roebling to forget the idea. It just could not be done. It was not practical. It had never been done before.

Roebling could not ignore the vision he had in his mind of this bridge. He thought about it all the time and he knew deep in his heart that it could be done. He just had to share the dream with someone else. After much discussion and persuasion he managed to convince his son Washington, an up and coming engineer, that the bridge in fact could be built.

Working together for the first time, the father and son developed concepts of how it could be accomplished and how the obstacles could be overcome. With great excitement and inspiration, and the headiness of a wild challenge before them, they hired their crew and began to build their dream bridge.

The project started well, but when it was only a few months underway a tragic accident on the site took the life of John Roebling. Washington was also injured and left with a certain amount of brain damage, which resulted in him not being able to talk or walk.

“We told them so.” “Crazy men and their crazy dreams.” “It’s foolish to chase wild visions.” Everyone had a negative comment to make and felt that the project should be scrapped since the Roebling’s were the only ones who knew how the bridge could be built.

In spite of his handicap Washington was never discouraged and still had a burning desire to complete the bridge and his mind was still as sharp as ever. He tried to inspire and pass on his enthusiasm to some of his friends, but they were too daunted by the task.

As he lay on his bed in his hospital room, with the sunlight streaming through the windows, a gentle breeze blew the flimsy white curtains apart and he was able to see the sky and the tops of the trees outside for just a moment.

It seemed that there was a message for him not to give up. Suddenly an idea hit him. All he could do was move one finger and he decided to make the best use of it. By moving this, he slowly developed a code of communication with his wife.

He touched his wife’s arm with that finger, indicating to her that he wanted her to call the engineers again. Then he used the same method of tapping her arm to tell the engineers what to do. It seemed foolish but the project was under way again.

For 13 years Washington tapped out his instructions with his finger on his wife’s arm, until the bridge was finally completed. Today the spectacular Brooklyn Bridge stands in all its glory as a tribute to the triumph of one man’s indomitable spirit and his determination not to be defeated by circumstances. It is also a tribute to the engineers and their team work, and to their faith in a man who was considered mad by half the world. It stands too as a tangible monument to the love and devotion of his wife who for 13 long years patiently decoded the messages of her husband and told the engineers what to do.

Perhaps this is one of the best examples of a never-say-die attitude that overcomes a terrible physical handicap and achieves an impossible goal.

Often when we face obstacles in our day-to-day life, our hurdles seem very small in comparison to what many others have to face. The Brooklyn Bridge shows us that dreams that seem impossible can be realised with determination and persistence, no matter what the odds are.
Wellness Blog
Myths
  1. The right skin cream can keep your skin looking young: For reducing wrinkles, the topical treatment with the best evidence behind it is retinoic acid (as in Retin-A). The best ways to keep wrinkles at bay are using sunscreen and not smoking.
  2. Antibacterial soap is best for keeping your skin clean: Many experts are concerned that the use of antibacterial soap could lead to more antibiotic-resistant bacteria. Antibacterial soap is not necessary for everyday use. Regular soap is fine. Thorough and consistent hand-washing, not antibacterial soap, is what helps prevent the spread of infection.
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IMA Humor
Trouble on the Roof

Mike and Rob were laying tile on a roof when a sudden gust of wind came and knocked down their ladder.

"I have an idea," said Mike. "We'll throw you down, and then you can pick up the ladder."

"What, do you think I'm stupid?" Rob replied." I have an idea. I'll shine my flashlight, and you can climb down on the beam of light."

"What, do you think I'm stupid?" Mike answers. "You'll just turn off the flashlight when I'm halfway there."
Quote of the Day
A question that sometimes drives me hazy: am I or are the others crazy? Albert Einstein
Reader Response
  1. We should go for legal steps along with lobbying. Alex Franklin
  2. Sir, I agree with the ethical issues relating to notification of TB; but, I face many problems after I notify it. Say for an example , if I notify Mr XYZ having pulmonary TB, RNTCP people go to his house and counsel him that he should quit private AKT and to start AKT under RNTCP, moreover they restrain the patient to come to me for follow up regarding non TB problems. In that way they literally snatch away the patient. I don't mind if patients get free drugs under RNTCP but they should keep patient in combined care; often they do negative counseling regarding private doctors. Sometime, many patients don't tolerate AKT under RNTCP while they do better with adjusted regimen of dose per kg rather than fixed dose as per in RNTCP. So, many patient discontinue AKT because of intolerance and become MDR. I hope you will look into this. Thank you sir. Dr Ronak Patel, Dahegam, Gujarat.
Nurses should be involved in TB for best counseling
Interacting with Principals of various Nursing Schools from NCR, Padma Shri Awardee Dr K K Aggarwal, Hony Secretary General, IMA said that the nurses are backbone of the society and they are part of an important chain in the process of providing ethical TB care to the patients.

TB is a notifiable disease and the same should be known not only to the doctors but also to the nurses.

Nurses can provide the best counseling. Most TB patients feel that TB is a stigma. Nurses can play a big role in removing that stigma from the minds of the people.

Incomplete treatment of TB can be risky; therefore, nurses can play a big role in motivating people to not to stop the treatment in between.

Dr. Aggarwal, further said that all the celebrities and important people in the society should come forward and learn to disclose their status of TB, so that there is no more stigma attached to the TB Care.