August 19  2015, Wednesday
eMedinewS
editorial
Clinicians should aggressively treat unhealthy lifestyles
Dr KK AggarwalUnhealthy behaviors should be managed as aggressively as hypertension, high cholesterol, and other heart disease risk factors, according to an American Heart Association policy statement published in the journal Circulation.

Doctors should create "interprofessional practices" to connect patients with behavior-change specialists.

They must implement five A’s when caring for patients
  1. Assess a patient’s risk behaviors for heart disease
  2. Advise change, such as weight loss or exercise
  3. Agree on an action plan
  4. Assist with treatment
  5. Arrange for follow–up care.
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eMedipics
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ICON 2015 IMACGP International Conference of Family Medicine organized by IMA HQs, New Delhi
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News
Obstetrics and Gynecology

Working more than 40 hours a week and regularly engaging in heavy lifting may impact women's ability to get pregnant, suggested a new study published in the journal Occupational & Environmental Medicine.

Endocrinology
Oncology


The incidence of cancer is not significantly higher in patients treated for acromegaly compared with the general population, reported a new study published in the Journal of Clinical Endocrinology & Metabolism.

Ophthalmology

Bevacizumab injections do not raise the risk for endophthalmitis compared with injections of its more costly counterpart, ranibizumab, reported a retrospective study published online in JAMA Ophthalmology.

Infectious Diseases

The efficacy of azithromycin against genital Mycoplasma genitalium infection continues to decline, and there does not seem to be a good alternative treatment, suggests a new study published online in Clinical Infectious Diseases.

Psychiatry

A new self-report questionnaire that assesses repetitive behaviors could help clinicians when diagnosing individuals with autism to assess the severity and frequency of such behaviors, reported a new study published in the Journal of Autism and Developmental Disorders.
Forthcoming DST school camps
St Mathew School, Paschim Vihar, D Block on 20th August
Cardiology eMedinewS
  • Postexercise ankle-brachial index (ABI) may be a useful predictor of cardiovascular outcomes in patients with peripheral artery disease, including those with a normal resting ABI, suggests new research published in the August 17 issue of JACC: Cardiovascular Interventions.
  • A new technology – the fetal ST segment analysis - that tracks the electrical activity of the fetal heart, offers no advantages over conventional technology in preventing birth complications, suggested a new study by the National Institutes of Health. The findings are published in the New England Journal of Medicine.
Pediatrics eMedinewS
Pediatrics
Critical Care

High-flow nasal cannula therapy is as safe and efficacious as conventional modes of noninvasive ventilation (NIV) in preterm infants, suggested a meta-analysis published online August 17 and in the September issue of Pediatrics.
Furthermore, it carries sharply lower odds of nasal trauma.

Pediatrics

A Norwegian study shows that girls aged two and a half years master most everyday activities better than boys - they are more capable of feeding and dressing themselves, they are better at participating in circle time in kindergarten, and they are out of nappies earlier than boys of the same age. The findings were published in the Early Childhood Educational Journal.
Dr KK Spiritual Blog
Why should we eat seasonal fruits and vegetables?

God has grown only those fruits and vegetables, which are necessary in that season in that particular location. For example, during summer, the body requires more liquids and regular flushing of the kidney because of extreme heat so that dehydration does not damage kidney. To prevent this, nature produces vegetables and fruits in this season that are juicier and increase urination.

All summer fruits e.g. mango, litchi, watermelon, musk melon, wood apple (bel), etc. are juicy fruits. All vegetables grown in summer such as bottle gourd (ghiya), snake gourd (torai), apple gourd (tinda) grow on creepers and they all have a mild diuretic action.

In summer, where the humidity is not so high like in Delhi, one need not take coconut water, which is only required as a treatment of humidity–related diseases. Therefore, nature grows coconuts only in the coastal areas.
Beneficiaries of Sameer Malik Heart Care Foundation Fund
IMA,IJCP,HCFI
Make Sure
Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.
Dr Good Dr Bad
Situation: A patient with migraine and palpitations came for treatment.
Dr. Bad: No drug is needed.
Dr. Good: Take verapamil.
Lesson: Verapamil is frequently used as a first choice for preventive migraine therapy because it is easy to use and has fewer side effects.

(Copyright IJCP)
eIMA Quiz
A client has undergone with penile implant. After 24 hours of surgery, the client’s scrotum was edematous and painful. The nurse should:

a. Assist the client with sitz bath
b. Apply warm soaks in the scrotum
c. Elevate the scrotum using a soft support
d. Prepare for a possible incision and drainage.

Yesterday’s Mind Teaser: Halfway through the administration of blood, the female client complains of lumbar pain. After stopping the infusion Nurse Hazel should:

a. Increase the flow of normal saline
b. Assess the pain further
c. Notify the blood bank
d. Obtain vital signs.

Answer for Yesterday’s Mind Teaser: a. Increase the flow of normal saline

Answers received from: Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr B R Bhatnagar, Daivadheenam Jella, Dr K Raju, Dr Avtar Krishan.

Answer for 17th August Mind Teaser: B. Giving yourself a treat, like comfort food or a cocktail.

Correct Answers received from: Dr Avtar Krishan, Dr Shangarpawar, Dr G Madhusudhan, Dr K Raju, Daivadheenam Jella, Dr Poonam Chablani, Dr Jainendra Upadhyay.
eMedinewS Humor
Nobel Prize

A man is driving down a country road, when he spots a farmer standing in the middle of a huge field of grass. He pulls the car over to the side of the road and notices that the farmer is just standing there, doing nothing, looking at nothing.

The man gets out of the car, walks all the way out to the farmer and asks him, "Ah excuse me mister, but what are you doing?"

The farmer replies, "I’m trying to win a Nobel Prize."

"How?" asks the man, puzzled.

"Well I heard they give the Nobel Prize to people who are out standing in their field."
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Rabies News (Dr A K Gupta)
What is "window period"?

It is the time taken by the anti-rabies vaccine to produce protective levels of antibodies in the patient. The window period is of 7–14 days.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Successfully trained 113241 people since 1st November 2012 in Hands-only CPR 10
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
eIMA News
News
  • Researchers are reporting an association between lower scores for executive function and an increased risk for stroke and coronary heart disease (CHD) that is independent of vascular risk factors such as hypertension and diabetes among elderly patients at increased risk for cardiovascular events but who are free from dementia. (Medscape)
  • The British Regional Heart Study indicates that mild hyponatremia, even within the normal sodium range, as well as hypernatremia are both associated with increased risk of cardiovascular disease and mortality in older men with no history of coronary heart disease, heart failure, or stroke. (Medscape)
  • The phenomenon of yo-yo dieting, or the intentional loss and then unintentional regain of 10 pounds or more, is not associated with overall cancer risk or specific risks for 12 cancers, according to investigators involved in the largest and most comprehensive study of its kind reported July 23 in the American Journal of Epidemiology.
IMA trains Jamshedpur doctors to raise awareness about Vitamin D deficiency
OPINION August 17, 2015, The Avenue Mail

Jamshedpur, August 17: The Indian Medical Association (IMA) organized a CME in Jamshedpur to discuss the various health threats faced by the Indian population due to Vitamin D deficiency.

A hidden ailment, Vitamin D deficiency can have a serious long-term impact on a person’s health making them vulnerable to diseases such as heart attacks, diabetes, and cancer.

The CME was an initiative under IMA’s Rise and Shine campaign and was attended by over 100 leading doctors in the city.

There are two forms of Vitamin D, Vitamin D3, which is synthesized in the body through the ultraviolet rays of the sun, and Vitamin D2, which is produced by the irradiation of ergosterol.

The major source of Vitamin D in humans is sunlight (95%), and the remaining amounts are derived from dietary sources.

Addressing the issue at the CME, Dr. Satish Kumar Prasad, Senior Specialist and Unit Head, Medicine, Tata Main Hospital, Jamshedpur said, “There is abundance of sunshine in the country, but still around 80% to 90% of people from all walks of life suffer from Vitamin D deficiency.

The reason for this is the sun-shy behavior of Indians, a predominantly vegetarian diet and a genetic pre-disposition.

The deficiency mostly goes undetected due to the vagueness of its symptoms. Thirty minutes of exposing the skin of the face and arms (without sunscreen) to sunlight during peak time (10 am to 3 pm) daily is adequate to prevent Vitamin D deficiency.

Adding to this, Dr. A Marthanda Pillai – National President and Dr. KK Aggarwal – Honorary Secretary General of the Indian Medical Association in a joint statement said, “A serious concern for the medical fraternity is that most people in our country are unaware that they are Vitamin D deficient.

Lately, the deficiency of Vitamin D has been identified as a risk factor for various cardiovascular ailments such as ischemic heart diseases, congestive heart failure, heart attacks and strokes”.

The Rise and Shine campaign is a National movement initiated by the Indian Medical Association under an unconditional educational grant from the pharmaceutical company, USV.

It aims at sensitizing IMA’s 2.5 lakh members across 30 states and 1700 branches over the next two years about the need to raise awareness about Vitamin D deficiency.
New model of care (Pre-emptive care model)
eBOOKs
Kindly sign this petition: For allowing parliament to function
Link: https://www.change.org/p/members-of-parliament-political-parties-parliament-to-function-urge-all-political-parties-to-have-a-collaborative-and-consultative-process-in-the-parliament

Tiny url to pass on to other members: http://tinyurl.com/qff68sf

To sign, we can login through Facebook or email account on the right hand side.

Dr Marthanda Pillai,                        Dr KK Aggarwal
IMA Digital TV – Webcast Done So far
23rd July 2015 – TB Notification

6th August 2015 - Breastfeeding and Neonatal Skin Care

13th August 2015 - All About Vitamin D - IMA USV Initiative
IMA,IJCP,HCFI IMA Digital TV IMA Digital TV
IMA Digital TV
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IMA IPMO Initiative
Kindly go to http://module.ima-india.org/ipmo/
and pledge your organs. Unless we do it, the public will not listen to us.

Team IMA
ICON 2015
Media
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Inspirational Story
Power of Thought: Hitting Unseen Target

Yogi Raman was a true master of the art of archery. One morning, he invited his favorite disciple to watch a display of his skill. The disciple had seen this more than a hundred times before, but he nevertheless obeyed his teacher. They went into the wood beside the monastery and when they reached a magnificent oak tree, Raman took a flower, which he had tucked in his collar and placed it on one of the branches. He then opened his bag and took out three objects: his splendid bow made of precious wood, an arrow and a white handkerchief embroidered with lilacs. The yogi positioned himself one hundred paces from the spot where he had placed the flower. Facing his target, he asked his disciple to blindfold him with the embroidered handkerchief.

The disciple did as his teacher requested. “How often have you seen me practice the noble and ancient sport of archery?” Raman asked him. “Every day,” replied his disciple. “And you have always managed to hit the rose from three hundred paces away.” With his eyes covered by the handkerchief, Yogi Raman placed his feet firmly on the ground, drew back the bowstring with all his might – aiming at the rose placed on one of the branches of the oak tree – and then released the arrow. The arrow whistled through the air, but it did not even hit the tree, missing the target by an embarrassingly wide margin. “Did I hit it?” said Raman, removing the handkerchief from his eyes. “No, you missed completely,” replied the disciple. “I thought you were going to demonstrate to me the power of thought and your ability to perform magic.”

“I have just taught you the most important lesson about the power of thought,” replied Raman. “When you want something, concentrate only on that: no one will ever hit a target they cannot see.”
Quote of the Day
Egotism is the anesthetic that dulls the pain of stupidity. Frank Leahy
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Reader Response
Dear Sir, Thanks for the updation. Regards: Dr Pallavi
Wellness Blog
Energy drinks may put heart at risk for sudden death

Energy drinks may raise blood pressure and prolong QT interval increasing the risk of sudden cardiac death.

In a meta–analysis by Sachin A. Shah at University of the Pacific in Stockton, Calif, with a pooled analysis of 93 people who consumed energy drinks, the QT interval on an ECG was significantly prolonged by 10 ms. The threshold level of regulatory concern is around 5 ms.

In another pooled analysis of 132 people by the same group, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks.

Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline. QT prolongation is associated with life–threatening arrhythmias.

Most energy drinks have caffeine. Drinks such as Monster, Red Bull, Rockstar, Full Throttle and AMP have three times the amount of caffeine as colas. A 16–oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as 5 cans of soda.
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Press Release
Dengue is preventable and manageable

Dengue has once again made its appearance in the capital causing extreme chaos and panic. However most dengue cases are preventable and it is extremely essential to educate the masses about its treatment, prevention and myths.

Speaking about the issue, Padma Shri Awardee, Dr KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA said, “Dengue is both preventable and manageable. The risk of complications is in less than 1% of dengue cases and, if warning signals are known to the public, all deaths from dengue can be avoided.A platelet transfusion is not needed if the platelet counts are more than 10,000. Unnecessary platelet transfusion can cause more harm than good”.
 
Symptoms experienced by patients suffering from Dengue
  • Fever is present in 90% cases
  • Headache, eye pain, body pain, and joint pain in 80% cases
  • Rash in 50% cases
  • Nausea or vomiting in 50 % and diarrhea in 30% cases
  • Cough, sore throat, and nasal congestion are present in 33% cases
Most dengue virus infections in adults are symptomatic (86%) and in children under the age of 15 years are asymptomatic or minimally symptomatic. Classic dengue fever is an acute febrile illness accompanied by headache, retroorbital pain, and marked muscle and joint pains.Symptoms typically develop between 4 and 7 days after the bite of an infected mosquito.The incubation period may range from 3 to 14 days.Fever typically lasts for five to seven days. The febrile period may also be followed by a period of marked fatigue that can last for days to weeks, especially in adults.Joint pain, body aches, and rash are more common in females.

Most complications of dengue occur after the fever is over. The two days after the last episode of the fever are crucial and during this period, a patient should be encouraged to take plenty of oral fluids mixed with salt and sugar. The main complication is leakage of capillaries and collection of blood outside the blood channels leading to intravascular dehydration. Giving fluids orally or by intravenous routes, if given at a proper time, can save fatal complications.

Physicians should remember the ‘Formula of 20’ i.e. rise in pulse by more than 20; fall of BP by more than 20; difference between lower and upper BP less than 20 and presence of more than 20 hemorrhagic spots on the arm after a tourniquet test suggest a high risk situation and the person needs immediate medical attention.

The onus of preventing dengue lies with the public and not with the Government authorities. The dengue mosquitoes are found only in water collected outside the house and not in dirty water in the drains. When suffering from dengue, one should NOT use aspirin for fever as aspirin also has antiplatelet effects.