emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL 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 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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

20th September 2011, Tuesday

Most people today survive a heart attack

Forty years ago, nearly 40% of heart attack victims who made it to the hospital never left, dying there from the attack or its complications. Today, that number is well below 10%. Younger victims fare even. Some people now go home as early as the next day.

Heart attack advances

  • Better awareness of heart attack warning signs
  • Most people today get to the hospital faster.
  • Use of clot removing angioplasty and stenting or a clot dissolving drugs, which can stop a heart attack before it can damage the heart muscle. This must be used within three hours.
  • Advances in drug therapy, especially anti platelet drugs and use of beta blockers and ACE inhibitor in heart failure.
  • Early ambulation helps prevent the formation of potentially deadly blood clots.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Most people today survive a heart attack

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issues

Doctors and General Public attended the Conference in a large number. In the photo:Invited guest of honor on the dais.

 

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

India battles polio virus from Pakistan

NEW DELHI: It’s cross–border terror of a different kind. India is on high alert against the deadly polio virus coming into the country from Pakistan and the health ministry has asked the Punjab government to mandatorily vaccinate all children aged 0–5 years coming to India from Pakistan. Booths have been set up at the Wagah border for people coming from Pakistan by foot or by the Indo–Pak bus service. Immunization officers have also been pressed into duty at the Attari station for passengers taking the train from Pakistan. The booths will administer polio drops every day for the next four months, considered to be the high transmission time for the contagious virus.

Pakistan till now has recorded 84 cases of polio of which 83 are of the P1 strain – the most dangerous since it travels faster and infects more people. India raised the alarm after China confirmed that polio had re–entered its territory after a gap of 10 years. Genetic analysis showed that four infants in China’s Xinjiang province were infected with polio virus imported from Pakistan. (Source: TOI, Sep 19, 2011)

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

(Dr Monica and Brahm Vasudev)

ICAAC: PPIs may be tied to C. diff diarrhea

Hospitalized patients on proton pump inhibitors (PPIs) have an increased risk of diarrhea associated with Clostridium difficile (CDAD), Japanese researchers reported. In a prospective cohort study of nearly 800 patients, those on the stomach acid–lowering medications were more than three times as likely to develop CDAD than those who were not taking them, according to Takatoshi Kitazawa, MD, of Teiko University in Tokyo. (Source: Medpage Today)

For comments and archives

Sudden death in epilepsy plunges with drug treatment

Epilepsy patients with previously uncontrolled seizures have a much lower rate of sudden death if they are given adjunctive anti–epilepsy drugs, a meta–analysis has found. In an examination of 112 trials, the odds ratio for sudden unexpected death (SUDEP) in patients randomly assigned to anti–epileptic drugs (AEDs) at efficacious doses versus those assigned to placebo was 0.17 (95% CI 0.05 to 0.57, P=0.0046), Philippe Ryvlin, MD, of Hospices Civils de Lyon in France, and colleagues reported online in The Lancet Neurology. (Source: Medpage Today)

For comments and archives

ESGO: Post–therapy PET predicts cervical cancer survival

Fewer than 2% of patients with advanced cervical cancer had asymptomatic recurrence after five years when PET imaging showed complete response to chemoradiation, investigators reported here. Neither symptomatic nor asymptomatic recurrence adversely affected the chances of successful salvage therapy. The findings suggest that post–therapy PET imaging can eliminate the need for resource–intensive follow–up in most cases, Shankar Siva, MD, of Peter MacCallum Cancer Center in East Melbourne, Australia, said at the European Society of Gynecological Oncology (ESGO) meeting. The results were published in the September issue of Cancer. (Source: Medpage Today)

For comments and archives

 
    Fitness Update

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

Study shows that aerobic exercise is more effective to reduce abdominal fat

Are you apple– or pear–shaped? Doctors sometimes use these simple comparisons to determine health risks of their patients. If you’re pear shaped, you are more prone to storing fat in the hips and thighs, whereas if you are apple–shaped, you are more likely to store fat in your stomach area. Much research points to the fact that abdominal fat, or fat stored in the stomach area, can increase the risk for heart and metabolic disease. A study recently published in the American Journal of Physiology aimed to identify the most effective form of exercise to get rid of fat in the abdominal area.

Researchers at Duke University Medical Center conducted a study that involved following 296 overweight and sedentary adults for eight months. Participants were randomized to one of three groups: aerobic training exercise, resistance training exercise or a combination of the two modes of exercise. The aerobic group performed exercises equivalent to 12 miles of jogging per week at 80% maximum heart rate. The resistance group performed three sets of 8 – 12 repetitions of various strength exercises, three times per week. The research clearly indicated that although both forms of exercise were effective at reducing body fat, aerobic exercise reduced abdominal fat more than weight training alone did.

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Attending the court as a defendant is different Attending the court as a Witness is different

@DeepakChopra: #CosmicConsciousness No great scientific discovery has ever been made except by those who kneel in wonder before the mystery of creation–AE

 
    Dr KK Answers

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

Can drugs lead to sexual dysfunction?

Always look for a reversible causes including drugs (thiazide diuretics, beta blockers, and lipid–lowering drugs)

For comments and archives

 
    Spiritual Update

How to relax the tensed muscles

Stressed muscles are tight, tense muscles. One must learn to relax the muscles. It will help the body to dissipate stress. Muscle relaxation takes a bit longer to learn than deep breathing. It also takes more time. Progressive muscle relaxation is performed in a quiet, secluded place. These are the steps as advocated by HealthBeat a Harvard Newsletter.

For comments and archives

 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Which law states that an MBBS doctor can do LSCS only in an emergency to save life? I think even the Consumer Act says that an MBBS can perform surgery if he/she has the experience of doing it.

Ans.

  1. Performing LSCS routinely may be held by the medical council as violative of regulation 7.20 of the MCI Regulations, 2002, reproduced below: "7.20 A Physician shall not claim to be specialist unless he has a special qualification in that branch."
  2. The Consumer Protection Act, 1986, says nothing of the sort mentioned by you. However, if a consumer goes to the Consumer Court/Forum in such a situation, the court is likely to refer the case to the medical council which is likely to hold as above.
  3. The court/council may take a different view if an MBBS routinely performs LSCS in a remote place where there is no specialist available for 50–100 km. around and the doctor is providing services to a community that might otherwise remain deprived of much needed medical care.

For comments and archives

 
    An Inspirational Story

(Dr. Anil Kumar Jain)

Her struggle……Part One

Today I remember when for the first time I told my mother that Sultan was my colleague, was earning more than me, was tall and of charming personality but was of different religion, my mother’s first reaction was of great surprise and she advised me never to meet him again and not to disclose it to my father. But it was the question of my life and Sultan and I were of the view that religion was a very personal thing and religious beliefs could remain intact even after marriage.

My mother told my father same day. He also advised me about the pros and cons of this inter religious marriage and tried his best to convince me otherwise. Sultan and I ultimately had a court–marriage with an understanding that we would remain inseparable in future even under the oddest circumstances. Sultan had no close relative and my parent and relatives were not present on the occasion.

As we had planned, we avoided pregnancy using condom and safe period upto two years of our marriage. These two years were the best years in my life. Our different religions could not dent our family affairs. My parent and other relatives never visited our home. My mother used to ring me occasionally, I visited my parent’s home several times but my parent never welcomed me and Sultan. But I was happy with Sultan and never expected more from my parent and other relatives. We were thankful to God that he gave us a beautiful life. Every thing was OK in my life.

The problem began when Sultan started losing weight and developing early fatigue. One of our family friends was a qualified Doctor and he prescribed some medicines to Sultan but he continued to lose weight. One day he visited our home and advised us both to visit a nearby ICTC (Integrated Counselling and Test Center for HIV and AIDS). When we visited the Center, we told the counselor about Sultan’s problem. He sent us to the doctor’s chamber. The doctor enquired in detail about Sultan’s problem and asked him about:

  • His extra marital or pre–marital sexual relations.
  • History of any blood transfusion in previous five years
  • Any habit of taking intravenous drugs and sharing needles while doing so.

Sultan said that once in a road accident his nasal bone had been fractured and he had been bleeding profusely. He was taken to a nearby hospital and was asked for one unit of blood transfusion. As he did not have a close relative to give him blood, he had to purchase it from a professional blood donor. This was about five years back. Sultan told the Doctor that he had no pre–marital or extra marital relation. He was advised to undergo HIV test and was also counseled about post test scenario. After an informed consent for the test, blood sample was taken. We were asked to come next day to collect the report.

Rest of the day was a very long day to me. Did Sultan have HIV infection? Did he have extramarital relations? Was my decision to marry him correct? If he turned out to be HIV–positive, should I convey it to my parents and should I continue my sexual relations with him? I was restless. By night, I was sure that he had already transmitted that infection to me. The other part of my brain was arguing that I should wait the result to come. I should not be so cruel even to think against Sultan. After all he was my Love. He was my choice. We vowed to remain inseparable in every circumstance whatsoever they might be. Was it true that he had been transfused blood? But he had no marks of injuries! He had never mentioned the incident to me. What would my future be, if he turned out to be HIV–positive. Had I also had become HIV–positive?

But we had married against the wishes of our parents and society. What of the promises and vows we had taken together? Could a virus of size 120 nm make us separate? Was this virus stronger than the society? What should I do?

(To be continued)

For comments and archives

 
    Medicine Update

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

How do you clean a child’s teeth?

Keep your baby’s mouth clean by gently brushing the gums and teeth with water and a soft infant toothbrush or gauze. Once your baby has 8 teeth, you can start using a child–sized toothbrush for daily cleanings.

Brush your child’s teeth 2 times a day. Start by using a fluoride–free toothpaste. When your child is able to spit and not swallow the toothpaste (usually around 2 to 3 years old), you should continue brushing his or her teeth using a pea–sized amount of fluoride toothpaste.

For comments and archives

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Hypokalemia

  • Hypokalemia or decrease in serum potassium is seen usually in states characterized by excess K+ loss, such as in vomiting, diarrhea, villous adenoma of the colorectum, certain renal tubular defects, hypercorticoidism, etc.
  • Redistribution hypokalemia is seen in glucose/insulin therapy, alkalosis (where serum K+ is lost into cells and into urine), and familial periodic paralysis.
  • Drugs causing hypokalemia include amphotericin, carbenicillin, carbenoxolone, corticosteroids, diuretics, licorice, salicylates and ticarcillin.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A smoker wanted to know his risk of lung cancer after quitting.
Dr Bad: It will become zero within a month.
Dr Good: There will always be some risk.
Lesson: In people who quit smoking, risk of lung cancer gradually falls for 15 years before it levels off and remains about twice that of someone who never smoked.

For comments and archives

Make Sure

Situation: An elderly patient with unstable angina presented with URTI and was found to be positive for C. pneumoniae infection.
Reaction: Remember to start macrolides immediately.
Lesson: Make sure to remember that erythromycin 2 g/day for 10–14 days reverses the increased risk of atherosclerosis. Sero–epidemiological studies have shown a strong association between C. pneumoniae infection and atherosclerosis in patients with cardiovascular disease.

For comments and archives

 
  Quote of the Day

(Dr. GM Singh)

Don’t be misled. Bad company corrupts good character.

 
  IDIOMS

In your face: An aggressive and bold confrontation

 
  The Political Ethics of Chanakya Pandit

Chapter One

Humbly bowing down before the Almighty Lord Sri Vishnu, the Lord of the three worlds, I recite maxims of the science of political ethics (niti) selected from the various sutras (scriptures)

 
  Medicolegal Update

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

What is hanging and Hangman’s fracture?

The location of the knot of the hanging rope is a major factor in determining the mechanics of cervical spine injury, with a submental knot or Hangman’s knot under the chin being the only location capable of producing the sudden, straightforward hyperextension injury that causes the classic "Hangman’s fracture". The cause of death in hanging depends on the conditions related to the event. When the body is released from a relatively high position, the major cause of death is severe trauma to the upper cervical spine. However, the injuries produced are highly variable. A hanging may induce one or more of the following medical conditions leading to death:

  • Closure of the airways/closure of carotid arteries causing cerebral ischemia/closure of the jugular vein causing apoplexy are the main causes of death in hanging along with the induction of carotid reflexes, which reduces heartbeat and may result in cardiac arrest.
  • Breaking of the neck/cervical fracture causes traumatic spinal cord injury or decapitation. Judicial hanging fractures the cervical spine. However, in some cases, the classic hangman fracture (bilateral fractures of the pars interarticularis of the C2 vertebra) is seen.
  • Death from a "hangman’s fracture" occurs mainly when the applied force is severe enough to also cause a severe subluxation of the C2 and C3 vertebra that crushes the spinal cord.
  • When cerebral circulation is compromised by any mechanism, arterial or venous, death occurs in 4 to 5 minutes from cerebral hypoxia, although the heart may continue to beat for some period after the brain can no longer be resuscitated.
  • The time of death in such cases is a matter of convention. In judicial hangings, death is pronounced at cardiac arrest, which may occur at times from several minutes up to 15 minutes or longer after hanging.

For comments and archives

 
    Mind Teaser

Read this…………………

T M
A U
H S
W T

Yesterday’s Mind Teaser: OturnedUT

Answer for Yesterday’s Mind Teaser: Turned inside out

Correct answers received from: Dr Ragavan Moudgalya, Dr Anupama, Dr Shrish, Dr Sanjay,
Dr Parttek, Dr Raj, Dr Nishant, Dr Piyush, Dr Kiran, Ritu Sinha, Dr Deepali Chatterjee, Dr K Raju, Rameshwar prasad, Dr Chandresh Jardosh, Dr Neelam Nath, Dr Anil Kumar Jain, Anil Bairaria.

Answer for 18th September Mind Teaser: a) ERCP should be the initial investigation in all cases of injuries to the ble duct to define the extent of injury.
Correct answers received from: Dr Somil, Dr Naveen, Dr Bharat, Dr Priyanshu, Dr Aaditya, Dr Jai,
Dr Tarun, Dr Vikas.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Three Professionals

A Mechanical, Electrical and Computer Engineer were riding together to an Engineering Seminar, the car began jerking and shuttering. The mechanical engineer, said, "I think the car has a faulty carburetor." The electrical engineer said, "No, I think the problem lies with the alternator." The computer engineer brightened up and said, "I know, let’s stop the car, all get out of the car and get back in again!"

 
    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
Indication
DCI Approval Date
Gatifloxacin 0.3% + Loteprednol Etabonate 0.5% + Benzalkonium Chloride 0.01% w/v Ophthalmic suspension
For postoperative steroid–repulsive inflammatory ocular conditions when ocular bacterial infections or a risk of bacterial infection exists
19.05.11
 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Long term use of pain killers can cause kidney cancer

A study published in Archives of Internal Medicine has shown that people who regularly take pain killer drugs ibuprofen or naproxen are 51 percent more likely to develop kidney cancer. There is no increased risk from taking aspirin or paracetamol, said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

The mechanism through which pain killers could cause kidney disease is the inhibition of prostaglandin synthesis with resulting papillary and tubular injury, and ultimately damage to DNA.

The study analysed data from 77,525 women in the Nurses’ Health Study and from 49,403 men in the Health Professionals Follow–up Study.

The risk was related to the duration of pain killer use. It was 19 percent lower if the pain killer was used for more than four years and less than ten years. The risk increased by 36% when the pain killer was used for more than four years. The risk increased almost three times for those who used these drugs regularly for 10 years or more.

The good news is that Kidney cancer is uncommon so the risk is small for average users. Two other important causes of kidney cancer are obesity and smoking. So people on pain killers should not smoke and should keep their weight under control to prevent kidney cancer.

For comments and archives

 
    Readers Response
  1. Dear Sir I am always inspired by Your ability to link spirituality with medicine. Regards Dr Arpit
 
    Forthcoming Events

International Heart Protection Summit (IHPS–2011)

Organized by Ministry of Health & Family Welfare Govt. of India & ASSOCHAM September 28th, 2011 at Hotel Ashok, Chanakyapuri, New Delhi
President: Dr. H.K. Chopra, Intl. President: Dr. Navin C. Nanda, Scientific Chairman: Dr. S.K. Parashar, Org. Secretary: Dr. O.S. Tyagi,
For Registration & Details: Contact – Mob. 9971622546, 8010222883,
E–mail: agnideep.mukherjee@assocham.com; sandeep.kochhar@assocham.com,
Website:www.assocham.org/ihps2011

……………………………………………………………………

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals

…more

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    eMedinewS Special

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta