emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
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; Member 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


20th May, 2010, Thursday

Can a Council debar one from practice on account of professional deficiency?

Dear Colleague

Both the State Councils as well as the MCI have been debarring doctors on account of ‘professional deficiency’. The legal provision is that the Council can only suspend a license on grounds of professional misconduct and professional deficiency does not come under the purview of the definition of professional misconduct.

Professional misconduct is a criminal offence and punishable under the act. Professional deficiency, on the other hand, is a civil deficiency which can only be compensated by money.

For professional deficiencies in practice, all doctors get their professional indemnity insurance done. No insurance company pays for criminal negligence or professional misconduct. They only pay for professional deficiencies.

The job of the Council can only be to define and quantify the professional deficiency and the case then has to be decided by the civil court in terms of the quantum of compensation and there the insurance company will invariably be a party.

What does MCI dissolved- really means?

Most of the doctors are feeling in the country that the MCI as an institution has been dissolved and that the MCI Act has become ineffective. MCI was never dissolved by the president of India.

MCI consists of an act, its defined functions, office, paid secretarial staff including secretaries (general, joint, deputy etc) and 150 elected members as representatives of the states, state councils or the government nominee.

The only thing which has happened is that by an ordinance, President of India has dissolved the 150 elected members to the council and replaced them with a team of six powerful, experienced, respectable eminent people from the same profession. They are free to appoint committees and sub committees to run the council efficiently.

The respect, integrity and credibility of the newly nominated members can not be doubted by anyone. The council functioning has not gone to any political leader or a non medical officer.

MCI was autonomous and will remain autonomous. It will still perform the same functions as it is suppose to do under the act. What will happen after one year can be a mater of debate and again the recommendations will have to come from the these six eminent medical people only.

Why the government had to change these 150 people is obvious from their actions. Every one including the government felt that rest 149 council members were either part of the corruption or were a silent witness and blind signing supporter to the policies of the council floated by the then president.

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor

 

Photo Feature (From file): Health awareness modules

Making The Most Of an Opportunity

Pandit Birju Maharaj, the dancing maestro was invited to a press conference of Perfect Health Mela 2008. Heart Care Foundation of India made the most of the presence of the well- known dancing ace to release a message "Let’s make Delhi Healthy and Smoke free". Noted Kathak exponent Shaswati Sen was also present on the occasion.  Also in the picture Dr KK Aggarwal and Dr K S Bhagotia.

Dr k k Aggarwal

International Medical Science Academy Update (IMSA): Practice Changing Updates

13–valent pneumococcal conjugate vaccine (PCV13)

A pneumococcal vaccine with additional serotype coverage was licensed in the United States in February 2010 and will replace the 7–valent vaccine for routine childhood immunization. (Licensure of a 13–valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children ––– Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Morb Mortal Wkly Rep 2010;59:258)

 

Mnemonics of the Day (Dr Prachi Garg)

4 As of Ankylosing Spondylitis

  • Apical fibrosis
  • Anterior uveitis
  • Aortic regurgitation
  • Achilles tendonitis

News and Views

Lixisenatide may improve glycemic control in type 2 diabetes inadequately controlled with metformin alone

Lixisenatide, a glucagon–like peptide–1 (GLP–1) receptor agonist, improves glycemic control in type 2 diabetics who are poorly controlled with metformin monotherapy. The study is published online in the journal Diabetic Medicine.

More lung cancers detected earlier with imaging becoming more affordable

With imaging becoming cheaper and safer, now more cases of lung cancers can be diagnosed at an earlier stage. CT scans generally cost more, even though they can detect few of the smallest of lung lesions.

A new drug combination for use in arthritis patients gets FDA approval

Vimovo (naproxen and esomeprazole magnesium) is FDA–approved for use in arthritis patients who are at risk of developing gastric ulcers.

Many hormonal changes, neurochemical reactions occur only during sleep

A large number of neurochemical reactions and hormonal change occur during sleep. These may affect weight, height and overall fitness. These results were noted by Harvard researchers at Brigham and Women’s Hospital. Ghrelin and leptin, the two weight–regulating hormones are controlled by the duration of sleep. Sleeping less also reduces thyrotropin production and alters thyroid metabolism.

Quote of the day (Vivek Kumar)

There are people who can walk away from you.
When people can walk away from you, let them walk.
Your destiny is never tied to anybody who left.
People leave you because they are not joined to you.
And if they are not joined to you, you can't make them stay.
Let them go.
And it doesn’t mean that they are a bad person, it just means that their part in your story is over.
And you’ve got to know when people’s part in your story is over so that you don’t keep trying to raise the dead…

You’ve got to know when it’s dead. You’ve got to know when it’s over.
Stop begging people to stay.
Let them go!!!
If you are holding on to something that doesn’t belong to you and was never intended for your life, then you need to…
LET IT GO!!!
If you are holding on to past hurts and pains …
LET IT GO!!!
If someone can’t treat you right, love you back, and see your worth…
LET IT GO!!!
If someone has angered you.
LET IT GO!!!
If you are holding on to some thoughts of evil and revenge…
LET IT GO!!!
If you are involved in a wrong relationship or addiction…
LET IT GO!!!
If you are holding on to a job that no longer meets your needs or talents…
LET IT GO!!!
If you have a bad attitude…
LET IT GO!!!
If you keep judging others to make yourself feel better…
LET IT GO!!!
If you’re stuck in the past and God is trying to take you to a new level in Him…
LET IT GO!!!
If you are struggling with the healing of a broken relationship…
LET IT GO!!!
If you keep trying to help someone who won’t even try to help themselves…
LET IT GO!!!
If you're feeling depressed and stressed…
LET IT GO!!!
If there is a particular situation that you are so used to handling yourself and God is saying ‘take your hands off of it’, then you need to…
LET IT GO!!!

Question of the Day

What is the role of levofloxacin in multidrug-resistant tuberculosis? (Dr S K Jain, New Delhi)

Research attributes the improved prognosis of multidrug–resistant tuberculosis (MDR–TB) over the past decade largely to the administration of quinolones. Quinolone antibiotics have considerable in vitro activity against M. tuberculosis and have become widely used in the treatment of MDR–TB.1,2 Moxifloxacin, levofloxacin, ofloxacin and ciprofloxacin have in vitro activity against M. tuberculosis.3 As a group, the quinolones are usually well–tolerated, with few treatment–limiting adverse effects. Rare complications include tenosynovitis (including reports of Achilles’ tendinitis and rupture) and cardiac conduction abnormalities; both appear to be class effects.

References

  1. Peloquin CA. Quinolones and tuberculosis. Ann Pharmacother 1996; 30:1034.

  2. Yew WW, Chan CK, Chau CH, et al. Outcomes of patients with multidrugresistant pulmonary tuberculosis treated with ofloxacin/levofloxacin–containing regimens. Chest 2000;117:744.

  3. Hu Y, Coates AR, Mitchison DA. Sterilizing activities of fluoroquinolones against rifampin–tolerant populations of Mycobacterium tuberculosis. Antimicrob Agents Chemother 2003;47:653.

eMedinewS Try this it Works: Preventing niacin flush

Side effects can be avoided if the patient takes aspirin (usually 2 to 5 grains) before taking the niacin.

Dr Good Dr Bad

Situation: Patient has an episode of TIA.
Dr Bad: Start aspirin 150 mg per day.
Dr Good: Start aspirin 300 mg per day.
Lesson: The recommended dose of aspirin for stroke prevention is 300 mg/day as against coronary artery disease prevention where the dose is 150 mg/day.

Make Sure

Situation: A patient came to ICU with acute GI bleeding.
Reaction: Oh! he had also received a painkiller from his dentist.
Lesson: Make sure before prescrbing NSAIDs that the patient is not on any other NSAID for some other illness.

IMANDB Joke of the Day (Prakash Rajpal)

Lady to baba

Baba mere pati roz raat to ghar se chale jaate hain.
Baba: yeh samasya hai ya invitation.

Formulae in clinical practice

Oxygen Delivery Index (DO2I)

Formula: Do2I = Do2
BSA – body surface area
Normal value= 520–720 (ml/min)/m2

Milestones in Orthopedics

1658-1759: Nicholas Andry in 1741, published a book called Orthopaedia. In this book, Andry presents the word 'Orthopaedic', which is derived from the Greek words 'straight' and 'child'.

Lab Test (Dr Arpan Gandhi and Dr Navin Dang)

Osmolality

To help evaluate the body's water and electrolyte balance; to investigate hyponatremia and increased or decreased urine production; to detect the ingestion of toxins such as methanol; to monitor the effectiveness of treatment for conditions affecting osmolality; to help determine the cause of chronic diarrhea.

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

DCI Approval Date

Levosulpride ER Tablet 100/150/200mg

For the treatment of depression and schizophrenia in adults

27.10.2009

 

Public Forum (Press Release for use by the newspapers)

Eating chocolate no baba but in pregnancy yes baba?

Indulging in chocolate during pregnancy could help ward off a serious complication of pregnancy known as pre-eclampsia according to a study published in the Journal of Epidemiology.

Sounding a note of caution, Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India, said that indiscriminate use of chocolate can increase obesity and worsen diabetes and heart disease.

Dark chocolate is rich in a chemical called theobromine, which stimulates the heart, relaxes smooth muscle and dilates blood vessels. In pre-eclampsia, blood pressure spikes during pregnancy and excess protein is released into the urine.

Dr. Elizabeth W. Triche, examined 2,291 women who delivered a single infant and found that women who consumed the most chocolate and those whose infants had the highest concentration of theobromine in their cord blood were the least likely to develop pre-eclampsia.

Women in the highest quarter for cord blood theobromine were 69 percent less likely to develop the complication than those in the lowest quarter. Women who ate five or more servings of chocolate each week in their third trimester of pregnancy were 40 percent less likely to develop pre-eclampsia than those who ate chocolate less than once a week. A similar, but weaker relationship between chocolate consumption and preeclampsia risk was seen in the first trimester. Women eating five or more servings of chocolate each week were at 19 percent lower risk than those who ate chocolate less than once a week.

Bacteria in gums can cause preterm delivery

Dr. Aggarwal further said that proper dental care can prevent heart attacks, heart blockages, asthma and COPD. Bacteria present in the gums have been linked to many diseases in the past. Periodontal treatment should also be included in prenatal care programs. The Journal of Periodontology has shown that treating gum disease in pregnant women may prevent preterm birth.

A study has shown that while pregnant women, whose periodontal disease was treated, were no more likely to deliver their babies prematurely than women with no gum disease, those who did not receive treatment had a nearly 90-fold increased risk of premature delivery. Another team found that the more bacteria women with periodontal disease had in their gums during and after pregnancy, the more likely they were to deliver their infants prematurely.

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eMedinewS–Padma Con 2010

Will be organized at
Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

 
 

eMedinewS–revisiting 2010

The second eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited .

 

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Readers Responses

  1. Hello Dr KK, The common mistakes in the management of heat stroke were very useful. I wonder, what is the chemistry on blood gases in a healthy young individual who presents with exertional heat stroke? Dr Vivek Chhabra. A: Severe acidosis

  2. An institution has been demolished by the acts of few! Undoubtedly the horrendous acts committed by the men at the helm of affairs for such a long time, went unabated on account of lack of accountability and supervision. They brought the profession into disrepute and ignominy. But then, since when do we demolish entire institutions such as the judiciary, the police, the army or, any other, equally afflicted organ of the hollowed–out polity of this country on similar grounds? Yes, radical treatment was necessary, certainly – a surgical removal of the diseased tissues – but did we have to remove the entire organ, just to demonstrate that some intervention has finally been made! We professionals need to redeem ourselves do a thorough introspection and act wisely. Good riddance of bad fish and hopefully no recurrence will be seen. May God bless the profession: Dr. Prof H.L. Kapoor, Formerly Director–Principal & Founder Head Radiation Oncololgy and Regional Cancer Centre Indira Gandhi Medical College Shimla. President IMA Mandi HP. EMEDINEWS reacts: See the edit above. The institution is not demolished, only the council members have been replaced.