emedinews
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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 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 November 2011, Sunday

Practicing dietary habits for a few months makes all the difference

  • You need only 500 mg of salt per day but most eat more than 3.5 grams in a day
  • One can live without sugar (without any kind of carbohydrate as long as some fat and protein are available).
  • Adopting diets low in salt, fat, sugar, or animal products can alter the food preferences.
  • Flavor and food preferences are more malleable when we’re young (indeed, in utero), but as adults, we can still work on them.
  • People who manage to follow a low–sodium diet for several months wind up preferring lower concentrations of salt in their food.
  • Tastes changes to liking for sweeter things after a month of drinking a sweetened energy drink.

For More editorials…

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

Practicing dietary habits for a few months makes
all the difference

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Divya Jyoti–An Inter Nursing School + College Health Festival

Nurses are the backbone of any medical services and need to be educated about all aspects of health.

 
Dr K K Aggarwal
 
    National News

Health spend set to double in 12th Plan

NEW DELHI: India’s allocation for health is all set to double. The Planning Commission has decided to increase its spending on health to 2.5% of the GDP in the 12th Five Year Plan that starts next year. This is in accordance with the recommendation made by the High Level Expert Group on universal health coverage that was constituted by the Commission. Syeda Hamid, member of the Planning Commission, said, "Nearly 2.5% of the GDP will be used in health sector during the next plan period. This will be a big jump."

The expert committee, headed by Dr K Srinath Reddy, had recommended that India should more than double its public spending on health by 2017 to reduce the tremendously high private out-of-pocket spending on medical bills. The group recommended increasing public spending by central and state governments from the current level of about 1.2% of the GDP to at least 2.5% by the end of the 12th Plan in 2017, and at least 3% of the GDP by 2022. India’s public spending on health as a proportion of the GDP is among the lowest in the world. The corresponding percentage is 1.8 in Sri Lanka, China (2.3) and Thailand (3.3). In 2009, private expenditure in India accounted for 67% of the total expenditure on health. (Source: TOI, Nov 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

Decline in vision problems in diabetes noted

Diabetes–related vision deficits declined significantly over the past 15 years, according to a study by the CDC. The proportion of adults with diabetes who reported vision impairment decreased from 26% in 1997 to 18.6% in 2010. (Source: Medpage Today)

For comments and archives

Breast MRI outcomes data not stellar

Breast MRI has demonstrated screening strength in at–risk populations, but there is limited evidence that it improves patient outcomes, according to meta–analysis results. Breast MRI has a higher sensitivity at 75% (95% CI 62 to 88) than mammography at 32% (95% CI 23 to 41), for the detection of breast cancer in known BRCA mutation carriers, or in women who have an increased risk of breast cancer because of family history, wrote Monica Morrow, MD, of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues. (Source: Medpage Today)

For comments and archives

Genes linked to hypertension ‘discovered’

LONDON: Scientists claim to have discovered five genes which cause high blood pressure, a key breakthrough they say may soon lead to a simple test that can predict when hypertension could trigger heart attacks or strokes. A British team says that the discovery, published in the ‘American Journal of Human Genetics’ also raises the hope of revolutionary treatments and a means to pinpoint those who are most at risk of a heart attack or stroke due to hypertension. (Source: TOI, Nov 18, 2011)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: #AJCC Noninvasive risk stratification for identification of patients at risk for sudden cardiac death. Dharmendra…fb.me/1qOv2mbkK

@DeepakChopra: Why compare yourself with others? No one in the entire world can do a better job of being you than you

 
    Spiritual Update

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

What is the Significance of "Gudhchari" on the Day of Marriage?

The description of horses has been mentioned in Ashwamedha Yagna, Dashrath in Ramayana, Bhagavad Gita with Krishna riding a rath, Kathopnishad describing the meaning of a chariot and in any marriage with the bridegroom riding a female horse.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Some Kind of Miracle

Everything comes gradually at its appointed hour–Ovid.

My mother had been in a deep sleep for three days, taking in no food at all, and a minimum of forced liquid. A "Do Not Resuscitate" sign hung over her bed. Every time I looked at the sign, I shuddered. The finality of the words chilled me, even though the heat in her bedroom was way too high.

She was 88 years old and had reached the end of a long illness. She was still in her own apartment, but I had arranged for round-the-clock nursing care for her; I did not leave her side during those three days.

On the fourth morning, a Sunday, I called my husband and asked him to pick me up and drive me home (some forty minutes from my mother’s apartment) so that I could get clean clothes. I had been wearing the same pair of jeans and blouse for four days, having had no idea when I arrived that the end was so near.

As we drove home that Sunday, my husband and I decided that before we went back to my mother’s apartment, we would stop at the funeral home to make arrangements. The doctor had said that she would not last more than a few days at most, and the previous evening, the visiting nurse agreed with his prognosis. We felt it would be better to make the funeral arrangements while we were still relatively calm, rather than after the emotional trauma of death had set in.

I also wanted to stop at the grocery store so there would be some food in the refrigerator for the nurses and myself.

Once at my house, I quickly showered and dressed, then threw a few clothes into a shopping bag. We got back into the car. Suddenly, I told my husband that I had changed my mind about stopping off at the funeral home. And I did not want to take time to buy groceries, either. Something inside me told me that we had to get back to my mother in a hurry–before it was too late.

I rang the bell in the lobby and the daytime nurse, Callie, buzzed me in. After the elevator ride up to the 22nd floor, I saw Callie at the end of the hall, a look of amazement on her face. "It’s some kind of miracle!" she exclaimed. "Your mother’s eyes are open!"

Hurrying into my mother’s bedroom, I was shocked to see that her eyes were open. She was propped up in the rented hospital bed, staring straight ahead. At first, I thought she was dead, and my heart started racing. But then she shifted her gaze and looked straight at me. She had a puzzled, questioning look on her face, as if to ask, "Where am I?" Or, perhaps, "Where am I going?" Then a grimace passed over her face–a grimace that I have replayed in my mind over and over again. Was it a grimace of physical pain? Of fear? Of sadness? I think by then, she felt no more pain, so it must have been a combination of fear and sadness–deep sadness at leaving, and fear of the unknown. She needed the comfort of being in my arms when she began her journey.

I held her frail body gently, and spoke to her softly, telling her how much I loved her. And then I could feel, and see, that she was gone.

I asked Callie how long my mother’s eyes had been open before I arrived. "Only a few minutes," she said. "When I heard you ring the bell downstairs, I said to your mother, ‘There’s your daughter. Now you just hold on there. Don’t you die before she gets here?’ And she did hold on. She waited for you."

Thinking about the fact that something told me not to stop for anything on the way back to my mother’s apartment, but to hurry as fast as I could; thinking about the fact that my mother opened her eyes when I rang the bell, and kept them open until I got there, so that I was able to say goodbye to her, I suspect that Callie was right. It was some kind of miracle. It was the Hand of Fate.

For comments and archives

 
    Cardiology eMedinewS

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

CSI News

Atrial Septal defect closure Device or Surgery– is the debate justified.

For comments and archives

More than one sugared drink a day is a cardiac risk factor

For comments and archives

Dialysis rooms to offer Pomegranate Juice

For comments and archives

New adult ALS changes from previous guidelines

For comments and archives

 
    Fitness Update

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

Women who are active have a lower risk of colon disease

New research from Sweden shows that physical activity may lower the risk of diverticular disease – a form of colon disease – while obesity and inactivity make people more susceptible to the condition. According to the National Institute of Diabetes and Digestive and Kidney Diseases, diverticular disease occurs when abnormal pouches form on the lining of the large intestine. Sometimes, these pouches become inflamed, which worsens the condition. The study, published in the American Journal of Gastroenterology is the largest to assess the relationship of weight and lifestyle with colon disease. Researchers administered a comprehensive survey to a group of over 36,000 Swedish women in 1997, and then followed the group of women for 12 years. The questions in the survey asked about exercise, diet, television watching, smoking, and other lifestyle choices. They found that overweight and obese women were 29 and 33 percent more likely to be hospitalized, respectively, than women who had normal BMIs. Similarly, women who were inactive (which researchers defined as exercising less than 30 minutes per day), had a much greater risk of being hospitalized and suffering complications related to diverticular disease.

For comments and archives

 
    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

There is no accurate guide to how much you can drink to stay under the limit. Blood alcohol concentration depends on your height, weight and fitness.

 
    Medicine Update

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

What are the features of chronic liver disease in children?

History

  • History of GI bleed/arthritis/ascites
  • Past history of jaundice/abdominal lump/failure to thrive
  • History of consanguinity
  • Family history of liver disease/death due to liver disease

For comments and archives

 
    Legal Question of the Day

(Dr. M C Gupta)

I was brought up in a rural area and did my schooling and junior college studies in a very small town place. For my MBBS and MD I had to stay in a metro city. Now it’s been 13 years since I left my town. However, all these years in a metro have ironically brought me closer to my home town in my heart. I am caught in a dilemma…there was a time when I desperately wanted to make it to a big city; today after being in a big city I feel I don’t belong here. For a young doctor without a support system in a city, life can be hard. Having worked in corporate hospitals for past three years, I have also realised that "medicine and doctors" is just one part of a political system that exists in any corporate hospital. Doctors are just "employees" and nothing more. And like any other corporate system, the more you lap up to the top management, the better your chances of survival, irrespective of your skill level. Besides this unhealthy environment of corporate set–up, I see other problems being in a city–

  • Expensive property rates
  • Very expensive housing
  • Cut–practice
  • A very commercial doctor–patient relationship
  • Constant threat of a medicolegal case
  • Great difficulty in setting up private practice due to many factors
  • Travelling time and traffic
  • Lack of quality family time
  • Excessive levels of stress

I do not think I am cut–out for the above. Hence I feel I should serve the people back in my home town, which would be much more satisfying. But obviously there are drawbacks like lack of tertiary care facilities, underutilisation of my skills, low income and problem with kids’ education etc. The last one is my major worry."

What are your thoughts?

My thoughts are as follows:

  1. I agree with all that you have written.
  2. However, I have the following comments: Ref: "I feel I should serve the people back in my home town, which would be much more satisfying. But obviously there are drawbacks like lack of tertiary care facilities, underutilisation of my skills, low income and problem with kids' education etc. The last one is my major worry."

My views:

  • Lack of tertiary care facilities for your patients in the community:
    • Lack of such facilities for your patients should not deter you. It is not that the lack is not there in your absence and will be there in your presence. If people like you go to such a place, some existing corporate hospital or nursing home may, sometime in future, feel encouraged to start a new tertiary care facility nearby using your expertise.
    • As regards tertiary care – such facilities do not improve the health level of a community. They are merely curative facilities that may marginally enhance the life span. The real improvement of health of a community (of which the best indicator is the estimated longevity at birth) occurs as a result of preventive, promotive and primary health care. This is not a hypothetical statement. Longevity has been highest and IMR lowest in Kerala for decades, even before the corporate hospital culture dedicated to tertiary care took root in India.
  • Lack of tertiary care facilities for your own professional skills—If you want to retain the special skills that you may have acquired in a corporate hospital, it should be possible to arrive at an arrangement with a corporate hospital whereby you practice those skills and provide the services periodically (weekly, monthly or 6–monthly or annually).
  • Lack of tertiary care facilities for your own family—This should not be a major problem at your professional and socio–economic level.
  • As regards the possibility of underutilisation of your skills:
    • Periodic professional visits to a corporate hospital under a proper arrangement can minimise that possibility.
    • Believe me, you will learn many new skills while in the new practice.
  • The possibility of less income is a relative thing. This may be offset, at least partially, by the following:
    • Less expenses in a town.
    • Payments in a corporate hospital are more likely to be by cheque issued by the hospital. Transactions in town practice may often be in cash.
    • More prestige and recognition in a town. (There may be relative facelessness in a corporate hospital)
    • You will be your own boss.
  • As regards kids’ education, I am sure there would be suitable arrangements possible.

For comments and archives

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    Rabies Update

(Dr AK Gupta, Author of Rabies the Worst Death)

A person has handled (or eaten) the raw meat of a rabid animal. What should be done?

He should receive full course of TCV. In extremely rare cases, if a person has eaten raw meat of a proven (laboratory Diagnosis) rabid animal and if he has oral lesions or ulcers or is apprehensive, he may even be given ARS/HRIG (full dose in gluteal region IM on Day 0 along with first dose of vaccine).

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient, diagnosed as a case of falciparum malaria came for prescription.
Dr Bad: Take quinine plus tetracycline.
Dr Good: Take artesunate.
Lesson: Artesunate (to be given in combination) is preferred over quinine plus tetracycline in patients with uncomplicated falciparum malaria as it is more effective, better–tolerated and more cost effective.

For comments and archives

Make Sure

Situation: A 20–year–old college student complained of dysuria, frequency and pyuria.
Reaction: Oh my God! Why did you not advise macrolide?
Lesson: Make sure to remember that macrolide are very effective against E. coli, S. saprophyticus and C. trachomatis infection.

For comments and archives

 
    Quote of the Day

(Dr GM Singh)

Life is too complicated, don’t try to find the unnecessary answer…… because the time you find the answer, life changes the questions.

 
    Mind Teaser

Read this…………………

The wave length used in narrow band UV B is:

a. 308 n m
b. 311 n m
c. 320 n m
d. 316 n m

Yesterday’s Mind Teaser: Endoscopic stone extraction from CBD is possible only in:

a) Multiple CBD stones
b) Intrahepatic stones
c) Multiple gallstones
d) Prior gastrectomy

Answer for Yesterday’s Mind Teaser: a) Multiple CBD stones

Correct answers received from: Prabha Sanghi, Dr Ravi, Dr Rakesh Bhasin, Yogindra Vasavada,
Dr Thakor Hitendrasinh G, Anil Bairaria, Dr Harkanwaljit Singh Saini, Raju Kuppusamy, Dr Sukla Das,
Dr PC Das, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr Neelam Nath.

Answer for 18th November Mind Teaser: d) It has extrahepatic spread in 50% cases.
Correct answers received from: Muthumperumal Thirumalpillai, Dr Avtar Krishan, Gita Arora, Dr Shabina Ahmed.

Send your answer to ijcp12@gmail.com

 
   Laugh a While

(Dr GM Singh)

Doctor, Doctor! I keep thinking I’m a frog!
Doc: So? What’s wrong with that?
I think I’m going to croak!

 
    Medicolegal Update

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

How is the age of a scar determined by doctor?

  • A scar is produced from the healing of wound made of fibrous tissue covered by epithelium without hair follicles, pigment.
  • The scars are bluish and reddish in the first week and look like angry face of an extremely fair complexion boy; they are also called angry scars.
  • In the second week, the scar is soft and sensitive on touch and looks pale. It remains so for about two months however its softness and sensitivity decrease.
  • After approximately two months and up to six months, the scar looks white and glistening; however, the softness changes to harder and harder and finally wrinkled
  • The shape of scar almost remains permanent and indicates the nature of weapon that caused the injury in majority of cases
  • As per IPC if a person is disfigured due to scar it becomes a grievous injury.
  • Bullet injuries causes mostly circular depressed scar seen in medicolegal cases.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Children & adolescents with congenital heart disease should avoid body piercing

Children and teenagers with congenital heart disease should be strongly discouraged from getting a tattoo or piercing their ears or other body parts, because it could lead to a potentially deadly infection of the heart called endocarditis, said Dr. KK Aggarwal, President, Heart Care Foundation of India.

Dr Aggarwal was interacting with teenagers visiting the Heart Care Foundation of India stall in the Ministry of Health and Family Welfare Pavilion at the ongoing IITF, Pragati Maidan.

Infective endocarditis occurs when bacteria or fungi attach and begin to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.

Most people are not aware that they should talk to their doctor before tattooing or piercing their body.
Body art in the form of tattoos and piercing has become increasingly popular among children and teenagers.
Most experts today strongly discourage all forms of body art. For those who cannot be dissuaded, the recommendation is to give antibiotics prior to tattooing or piercing, "with strong advice for prompt treatment of any signs of subsequent infection".

For comments and archives

 
    Readers Responses
  1. Dear Sir I really appreciate your effort. Regards: Dr JP Singh
 
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    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