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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; 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 …

20th February 2013, Wednesday

Indian cardiologist in the US received more than $100 000 in referral kickbacks

An Indian cardiologist in New Jersey, USA was arrested for having embezzled over Rs. 58 lakhs in kickback over a period of two years for referring patients for MRI and CT scan to a particular centre. He received US$ 100 for MRI and US$ 50 for CT scan. He is likely to face imprisonment and fine as per US laws.

In India, the medical profession is losing its reputation because the general population at large feels that such corrupt practices are also prevalent in Indian medical profession. I personally feel that the State Medical Councils should start taking actions against such people.

News

A US cardiologist has pleaded guilty to referring patients for diagnostic tests in exchange for money. From 2009 to 2011, Dr Shashi Agarwal, 60, solicited and received more than $100 000 in kickbacks for referring patients for MRI and CT scans.

He is the 10th person to plead guilty to receiving financial kickbacks for referring patients to Orange Community MRI.

The former executive director of Orange Community MRI, Chirag Patel, 37, admitted paying bribes to physicians since 2008.

Former owner and medical director, Dr Ashok Kumar Barbaria, pleaded guilty to the same charges.

Agarwal, who was in private practice, was paid for each patient he referred for an MRI or CT scan.

He agreed to refer as many as 20 patients a month and he was paid $100 cash for an MRI and $50 for each CT-scan referral.

He is scheduled to be sentenced on June 6, 2013 and could face up to five years in prison and a maximum fine of $250 000. He has agreed to forfeit the $101 750 in bribe money.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Dietary interventions: Soluble fiber, especially psyllium may offer benefits to stool frequency and stool consistency. There are less data to support the value of insoluble fiber. Bran, a form of insoluble fiber, is probably the most commonly used fiber. But, soluble fiber, specifically psyllium, is a better choice (Am J Gastroenterol 2005;100:S1-S4).

 
Dr K K Aggarwal
    eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Obesity reduces life expectancy

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Cricketer Surinder Khanna doing CPR10 with Dr KK Aggarwal in the recently concluded Mega Health Checkup camp in East Delhi

 
Dr K K Aggarwal
    National News

A new version of Mental Health Act likely

Bangalore: Union Health and Family Welfare Minister Ghulam Nabi Azad on Thursday said that his Ministry was considering a new legislation to replace the Mental Health Act, 1987. Delivering the 17th convocation address at NIMHANS, Mr. Azad said the proposal was to replace the existing Act with the Mental Healthcare Act, which would safeguard the rights of persons with mental illness. “The new legislation will also lay the foundation stone for a rights-based community-oriented protocol for the healthcare of persons with mental illness,” he said. Stating that the Mental Health Policy Group, set up by the Union Health Ministry in 2011, had made progress in drafting a mental health policy for the country, Mr. Azad said: “There have been several consultations, both regional and national, and the Bill is being processed now to be introduced in Parliament.” (Source: The Hindu, February 15, 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)

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

Types of child neglects

  • Physical neglect is failure to provide adequate food, cloth, shelter, hygiene, protection and safety.
  • Emotional neglect is failure to provide love, affection, security and emotional support.
  • Educational neglect is failure to enroll the child in school.
  • Medical neglect is refusal to seek or delay in seeking medical care when required.

For comments and archives

 
    Valvular Heart Disease Update

What is transcatheter aortic valve replacement?

Transcatheter aortic valve replacement is a potential option for patients with severe symptomatic aortic stenosis who are considered inoperable for surgical aortic valve replacement.

(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)

Depression may lower response to shingles Vax

Untreated major depression may hamper the protective effect of varicella zoster virus (VZV) vaccine against herpes zoster -- shingles -- in older individuals, researchers found. (Source: Medpage Today)

Eptifibatide plus tPA looks promising for ischemic stroke

A phase 2 study has suggested that the glycoprotein (gp) IIb/IIIa blocker eptifibatide can be safely combined with a reduced dose of tPA in the treatment of acute ischemic stroke, and there was a sufficient signal of efficacy to justify a phase 3 trial, the study authors say. Results of the Combined Approach to Lysis Utilizing Eptifibatide and rtPA in Acute Ischemic Stroke-Enhanced Regimen (CLEAR-ER) study were presented at the International Stroke Conference (ISC) 2013 last week by Opeolu Adeoye, MD, from the University of Cincinnati, Ohio. (Source: Medscape)

Fruits, vegetables cut metabolic acidosis in kidney disease

Adding fruits and vegetables to the diets of people with late-stage chronic kidney disease (CKD) is an effective alternative to sodium-based alkali supplementation therapy, according to findings from a study published online February 7 in the Clinical Journal of the American Society of Nephrology. (Source: Medscape)

Troponin I predicts event risk in CAD

In patients with stable coronary artery disease, troponin I levels measured with a high-sensitivity assay add prognostic information to conventional risk markers and troponin T levels, researchers found. (Source: Medpage Today)

Community intervention improves chronic disease risk factors

Community interventions to get people to become more physically active, to eat more healthily, and not to smoke/chew tobacco in three countries--China, India, and Mexico--have yielded encouraging results in a short period of just 18 to 24 months. They show that it is possible to reverse worsening trends over time in terms of risk factors for chronic disease, using simple interventions employing existing infrastructure and personnel, with the idea that the changes will be sustained once the project is finished. (Source: Medscape)

 
    Twitter of the Day

@DrKKAggarwal: Today's health question How often to repeat BMD test for osteoporosis? Yesterday's health question 1. GE (cont) http://tl.gd/l37dhd

@DrKKAggarwal: Please read my article "The State of the Union as Rorschach Test" published by SF Gate http://tinyurl.com/cru65cv

 
    Spiritual Update

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

Why do we do Pradakshina?

W e cannot draw a circle without a center point. The Lord is the center, source and essence of our lives. We go about doing our daily chores, recognizing Him as the focal point in our lives. This is the significance of pradakshina, which is a Sanskrit word meaning circumambulation or walking in a circle around the deity.

For comments and archives

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

What are the success rates of egg donation?

The success rates of egg donation depend on many factors but are generally independent of the age of the recipient. Success rates compiled by the CDC for the year 2000 show the average live birth rate per transfer of 43% for all egg donor programs. The major risk for donor egg programs is multiple gestations. In 2000, of the 3,436 pregnancies conceived with egg donation 2,992 resulted in a live birth. Of these, the multiple pregnancy rate was 40% with 36.6% being twins and 3.7% being triplets or greater. Because many of the pregnancies miscarry before the actual number of fetuses can be determined, the percentage of multiple pregnancies may actually be higher.

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

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

Procedure for requesting uncrossmatched blood

  • In life-saving emergency requirement of blood components, it is always preferable to communicate to the Blood Bank In-charge/technician on duty, on phone before sending such a request.
  • Notify the Blood bank by phone that uncrossmatched blood is required. In the meantime, send requisition form with all the required information. If the patient is unknown, then communicate that to blood bank.
  • Send properly labeled blood samples.
  • As soon as the emergency is over, complete all documentary formalities.

For comments and archives

 
    An Inspirational Story

Happiness is NOW, Don't Wait

We convince ourselves that life will be better after we get married, have a baby, then another. Then we are frustrated that the kids aren't old enough and we'll be more content when they are. After that, we're frustrated that we have teenagers to deal with. We will certainly be happy when they are out of that stage.

We tell ourselves that our life will be complete when our spouse gets his or her act together, when we get a nicer car, are we able to go on a nice vacation, or when we retire. The truth is, there's no better time to be happy than right now. If not now, when? Your life will always be filled with challenges. It's best to admit this to yourself and decide to be happy anyway.

Happiness is the way. So, treasure every moment that you have and treasure it more because you shared it with someone special, special enough to spend your time with...and remember that time waits for no one.

So, stop waiting....

--until your car or home is paid off
--until you get a new car or home
--until your kids leave the house
--until you go back to school
--until you finish school
--until you lose 10 lbs.
--until you gain 10 lbs.
--until you get married
--until you get a divorce
--until you have kids
--until you retire
--until summer
--until spring
--until winter
--until fall
--until you die

There is no better time than right now to be happy. Happiness is a journey, not a destination. So -- work like you don't need money, Love like you've never been hurt, And dance like no one's watching.

 
    Cardiology eMedinewS

High cardiac troponin I linked to higher MACE in diabetes patients
Read More

Screen highest-risk groups for cost savings in diabetes, prediabetes
Read More

 
    Pediatric eMedinewS

More evidence prenatal folic acid may lower autism risk Read More

Vision screening in toddlers flags amblyopia risks 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)

Can rabies be transmitted from man to man?

Man-to-man transmission of rabies is possible. Rabies can be transmitted following bite by a rabies patient. In 2004, three cases of human rabies were reported in U.S. following liver and kidney transplantation from rabies patients.

Transplantation of rabies infected cornea can cause rabies in recipient. Therefore, a careful neurological history of donor must be taken before cornea transplantation.

 
    IJCP Special

Dr Good Dr Bad

Situation: A 16–year–old female was diagnosed to have calcific lesions in the ventricles on a CT scan.
Dr Bad: This is a typical case of neurocysticercosis.
Dr Good: This is not neurocysticercosis.
Lesson: Calcification in neurocysticercosis is seen only in the parenchyma and not in ventricles or cisterns.

Make Sure

Situation: An 18–year–old girl complained of purulent nasal discharge, nasal congestion, pain in the cheek and upper teeth for last 10 days. CT scan showed maxillary sinusitis.
Reaction: Remember to give macrolides.
Lesson: Make sure to remember that clarithromycin 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

 
  Quote of the Day (Dr GM Singh)

An apology is the superglue of life. It can repair just about anything. Lynn Johnston

 
    Mind Teaser

Read this…………………

Which of the following may cause your hair to fall out by the fistful?

A. A medical condition like lupus, a thyroid disorder, or a recent high fever or case of the flu.
B. A fungal infection on the scalp.
C. Tight hairstyles (braids, extensions, cornrows, ponytails).
D. Hormonal shifts caused by pregnancy, changes in birth-control–pill use, or menopause.
E. All of the above and more.

Yesterday’s Mind Teaser: When should most women have their first mammogram?

A. At age 30.
B. At age 35.
C. At age 40.
D. At age 45.
E. At age 50.

Answer for yesterday’s Mind Teaser: C. You should get your first mammogram at age 40.

Correct answers received from: Pravin Lonsare, Dr Jella, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr AK Pandey, Dr Avtar Krishan,
Dr Tabassum Vali.

Answer for 18th February Mind Teaser: C. Once a year after age 21 and every two years after 30.

Correct answers received from: Dr Avtar Krishan, Dr Tabassum Vali

Send your answer to ijcp12@gmail.com

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

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    Laugh a While (Dr GM Singh)

History of Telecommunication

After having dug to a depth of 10 feet last year, Italian scientists found traces of copper wire dating back 100 years and came to the conclusion, that their ancestors already had a telephone network more than 100 years ago.

Not to be outdone by the Italians, in the weeks that followed, a Chinese archaeologist dug to a depth of 20 feet, and shortly after, a story in the China Daily read: ‘Chinese archaeologists, finding traces of 200 year old copper wire, have concluded their ancestors already had an advanced high–tech communications network a hundred years earlier than the Italian’s.

One week later, the Punjab Times, a local newspaper in India, reported the following: After digging as deep as 30 feet in his pasture near Amritsar, in the Indian state of Punjab, Dugdeep Singh, a self–taught archaeologist, reported that he found absolutely nothing. Dugdeep has therefore concluded that 300 years ago, India had already gone wireless.

 
    Medicolegal Update

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

Exhumation of corpse – America

In America, corpses are exhumed when there is a need to identify a body or to establish cause of death, for instance, in a case of suspected homicide.

  • President Zachary Taylor was exhumed in 1991 to determine whether or not he had been poisoned, and the famous outlaw Jesse James’s grave was excavated to prove that it was his body in the coffin. In addition, archaeological investigations often involve exhumation.
  • Under modern law, courts usually do not allow exhumation unless there are substantial and compelling reasons to do so.
  • In a landmark U.S. Supreme Court decision Justice Cardozo stated, "The dead are to rest where they have been lain unless reason of substance is brought forward for disturbing their repose."
  • Three general principles govern the law of disinterment in the United States. First, it is presumed that a "decently buried" body should remain undisturbed where it was placed unless good reason is given to do so. Second, disinterment is considered the private concern of the immediate family and the cemetery. Third, if there is disagreement among the close relatives regarding a proposal for exhumation the matter is adjudicated by a court of equity. The court considers (in order of importance) the wishes and religious beliefs of the deceased (if these can be determined), the wishes of the spouse of the deceased, the opinions of other close relatives, and the policies and regulations of the cemetery when determining if exhumation should be allowed.
  • California Labor Code stipulates that if it is suspected that a person has died as a result of injuries sustained in the course of his employment, the investigating appeals board may require an autopsy and, if necessary, the exhumation of the body for the purposes of autopsy. However, in accordance with the rules of equity, the close relatives can, if they wish, prevent the state (i.e., California) from either exhuming the body or performing the autopsy.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Stay away from stress during examination days

Exam stress can lead to depression and suicide. Prescriptions for anti depressant drugs, so called ‘happy drugs’ increase amongst teenagers in the age group 16-18 years in full time education during exam days. This figure crosses 20% in school population in the West. This was stated by Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

To create awareness about the rising problems of stress in the Indian context, Dr Aggarwal said that the fear of failure, fear of letting down are the two most common factors leading to suicide and depression.

Children also use drugs to keep awake during exams and end up with addictions. Anticipatory anxiety peaks before exams resulting in adverse affects on the body and mind and therefore, a suboptimal performance. Stress not only causes palpitations and tense muscles but also reduces the ability to make decisions, act or express oneself including organization of thoughts. Stress during exam makes it difficult to read and understand questions and even to recall terms and concepts.

A study has shown that 45 minutes of afternoon nap improves the declarative memory. Declarative memory is the memory of events learnt and understood earlier during the year. Not taking an afternoon nap or night sleep may cause the child end up with transient loss of declarative memory. Sleep appears to help "set" these declarative memories and makes them easier to recall. The other type of memory is "procedural memory," which applies to skills and has no impact with the midday nap.

Free writing can clear mental stress: By spending 30 minutes each day for four days to write out your innermost thoughts and feelings, one can significantly boost mental and physical health. In expressive writing therapy, students are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It's akin to keeping a journal, but more focused on the things that might be bothering you or triggering stress. While writing, the students need not worry about the punctuations. It's all about stepping back and thinking about things in a different way, making linkages. Writing out emotions eases stress and, in turn, boosts the immune system.

Memories of traumatic events are not suppressed by the people who have experienced them and can be clearly recalled. In a five-year study, scientists at Dalhousie University in Halifax found that pleasant events were more difficult to recall than unhappy ones.

HCFI Tips

  1. Children should not be compared: it can lead to anger or depression in the child.
  2. Appreciate unconditionally whatever the child has achieved.
  3. Avoid giving false promises such as “if you come first, you will get a bike". When that happens, "You are not yet 18 - so you can't get a license. This time, settle for a bicycle and later we'll get that bike". Broken promises hurt the child.
  4. Avoid anger chain. For example, the father unleashes his anger on the mother (because she does not answer back), and she takes it out on the child (because of the same reason). And the child takes it out on books or studies or younger sibling or hired help at home!
  5. Do not force your expectations on the child. For example, you should only become a doctor.
  6. Avoid giving the child two conflicting messages like mother asks child to study and father says - "do not force him."
  7. Make your child exercise daily, learn pranayama and meditation.
  8. Provide your child with balanced and nutritious diet. Avoid overeating or long hunger periods. Restrict caffeine, give more water.
  9. Ensure adequate sleep with a consistent schedule to improve concentration, memory and mood, it also reduces irritability.

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 29757 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. Sir, "Doctors are often blamed that they do not go to rural areas"
    I think the suggestions recommended are very practical and workable.
    I believe most of the doctors who go overseas because of two reasons: -
    1. To earn money (main reason)
    2. To achieve higher qualifications.

    If Indian govt seriously takes some measures, very rarely a doctor will leave the country. I know of few colleagues of mine who are working overseas and want to return back to India, but suitable jobs are not available for them.Regards.Neeraj.Dr.Neeraj GuptaAustralia.
 
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