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  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

 
  Editorial ...

20th December, 2010, Monday

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

Revisting Radilogy 2010

From Medscape Radiology: Top Radiology Stories for 2010 (Part I)

  1. The Future of Mammography: Radiology Residents’ Experiences, Attitudes, and Opinions (Am J Roentgenol. 2010;194(6):1680–1686) Surveyed radiology residents at 26 programs in New York and New Jersey. Three hundred forty–four residents completed the survey (response rate, 62%). The length of time spent training in breast imaging varied from no dedicated time (37%) to 1–8 weeks (40%) to more than 9 weeks (23%). Most respondents (97%) agreed that mammography is important to women’s health. More than 85% of residents believed that mammography should be interpreted by breast imaging specialists. Respondents shared negative views about mammography, agreeing with statements that the field was associated with a high risk of malpractice (99%), stress (94%), and low reimbursement (68%). Respondents endorsed several positive attributes of mammography, including job availability (97%), flexible work schedules (94%), and few calls or emergencies (93%). Most radiology residents (93%) said that they were likely to pursue subspecialty training, and 7% expressed interest in breast imaging fellowships. Radiology residents’ negative and positive views about mammography seem to be independent of time spent training in mammography and of future plans to pursue fellowship training in breast imaging. Systematic assessment of the plans and preferences of radiology residents can facilitate the development of strategies to attract trainees to careers in breast imaging.
  2. Breast Surgeons May Be as Qualified as Radiologists in Reading Mammograms: After he and his colleagues reviewed 10,020 mammograms performed at a surgeon-run South African breast health center, Justus Apffelstaedt, MD, FCS (SA), associate professor of surgery and head of the University of Stellenbosch’s Breast Clinic in South Africa, told attendees at the American Society of Breast Surgeons (ASBrS) 11th Annual Meeting that "with appropriate training, (breast surgeons) prove to be highly accurate primary mammography interpreters."
  3. New Data on Mammography Survival Benefit at Ages 40 to 49 Should End Debate, Expert Says: New data from a large Swedish study show that mammography screening in women aged 40 to 49 years results in a much greater reduction in mortality from breast cancer than has been previously reported. "This huge study from Sweden should end any debate" over the benefits of regular mammography screening in this age group, said a leading expert on mammography, Daniel Kopans, MD, professor of radiology at Harvard Medical School in Boston, Massachusetts, who was approached for comment. Beginning mammography at age 50 "has never had any scientific basis and should be dropped," he said. The issue leapt into headlines late last year, when the US Preventive Services Task Force (USPSTF) recommended against regular screening mammography in women 40 to 49 years, in direct contrast to the recommendations from other American authorities. At the time, top mammography experts, including Dr. Kopans, expressed outrage at this recommendation, saying that it would lead to lives being lost to breast cancer.
  4. CT Imaging and Related Risk for Cancer: Projected Cancer Risks From Computed Tomographic Scans Performed in the United States in 2007 Berrington de González AB, Mahesh M, Kim KP, et al Arch Intern Med. 2009;22:2071–2077 Radiation Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer Smith–Bindman R, Lipson J, Marcus R, et al Arch Intern Med. 2009;169:2078–2086

    Two recently published studies addressed the issue of CT–related radiation exposure. A multicenter study sponsored by the US National Institutes of Health and the National Cancer Institute in Bethesda, Maryland, estimated the number of cancers that would arise from all CT studies performed in the United States during the year 2007. Risk models with organ–specific radiation exposures were used to estimate age–specific cancer risks for each type of CT scan. Overall, approximately 29,000 future cancers could be related to CT scans performed in 2007 alone. The largest contributions to incident cancers were from abdominal and pelvic scans (14,000 cancers), followed by chest CT (41,000 cancers), head CT (4000 cancers), and CT angiography (2700 cancers). One third of the projected cancers were the result of CT exposure from ages 35 to 54 years, and 15% were related to exposure in patients younger than 18 years of age.

    A second retrospective cross–sectional study evaluated the radiation doses received by 1119 consecutive adult patients who had diagnostic CT. The study authors were surprised to find that radiation doses for common CT exams were higher and far more variable than previous estimates. Within each type of CT study, effective doses varied significantly both within and across institutions, with a mean 13–fold variation between the highest and lowest dose for each study type. The overall median dose of radiation for a routine abdomen/pelvis CT scan with contrast ranged from 12 mSv to 20 mSv, and for multiphase abdomen and pelvis CT scans, the dose ranged from 24 mSv to 45 mSv. These documented figures are considerably higher than those previously cited for abdominal CT radiation exposure (5–10 mSv). The investigators then estimated the number of patients who had each type of CT scan and the development of radiation–induced cancers. The risk for CT–related cancer varied by sex, age, and study type. There was a higher cancer risk in women and in patients with exposure at earlier ages. CT angiography was associated with the highest relative risk (1 cancer for every 150 examinations in 20–year–old women).
Dr KK Aggarwal
Editor in Chief
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    Ophthalmology: 10 Newer Developments During 2010

Dr. AK Grover MD (AIIMS), MANMS, FRCS (Glasgow), FIMSA; Awarded Padma Shri by Govt. of India; Chairman, Dept. of Ophthalmology, Sir Ganga Ram Hospital akgrover55@yahoo.com

  1. Cataract surgery by Femtosecond Lasers: Femtosecond lasers creating incisions for cataract surgery, creating perfectly round anterior capsular opening, dividing nucleus into segments to make phacoemulsification easier is now available commercially.
  2. Intraocular lenses that focus for all distances: Availability of lenses that improved contrast function for better quality of vision, "the aspheric lenses" are well established by now. Synchrony dual optics lens is now in clinical trials for giving the full range of accommodation needed to make cataractous eye ‘young’ again.
  3. ‘New shunt devices’ for better glaucoma management: New shunt devices like ‘Express’ for drainage in glaucoma patients which may mean success in those cases where nothing worked earlier, are now in common clinical use.
  4. Botulinum toxin (Botox) for watering eyes: Eyes with troublesome tearing, due to obstruction of canaliculi (the tear ducts) which required complex, surgical procedures, often with poor success rates, have been supplanted by use of Botox, well known so far for its cosmetic use. Botox injected in lacrimal gland gives relief lasting 6 months.
  5. Esthetic Oculoplastic surgery: Newer Horizons: Esthetics of the area reached newer heights with the increasing emphasis on ‘adding and preserving volume rather than reducing it. Use of ‘Fillers’ and fat transposition rather than excision in blepharoplasty is becoming the norm. Endoscopic techniques and less invasive ‘endotine fixations’ came into prominence.
  6. Pascal Lasers – Saving sight with less collateral damage: Studies show that Pascal Lasers, which fire numerous shots at once in patterns desired by surgeons, reduce the amount of flux of energy required for their effect resulting in reduced damage with better retention of visual quality.
  7. Newer Anti–VEGF drugs, preventing blindness in millions: Abnormal vessels are a bane to the eye, leading to blindness in age related macular degeneration, diabetic retinopathy and a number of other eye disease. The trials in the year established the role of newer anti Vascular Endothelial Growth Factor (VEGF) drugs in combating these diseases, saving sight for millions.
  8. Correction of myopia: Refractive surgery has covered new grounds by newer diagnostic equipment like Scheimpflug imaging for mapping of cornea, surgical tool like Femtosecond laser proving bladeless flap creation have created waves.
  9. Hope for infants with cataracts: Studies show that infants with cataract are increasingly being implanted with intraocular lenses, with more successful outcomes, reduced complications and improved quality of vision.
  10. New Hope for patients of corneal ectasia (Keratoconus): Treatment modality of collagen cross linking has been shown by medium to long term studies to stabilize bulging of cornea in patients of keratoconus who lose vision progressively if untreated. Intra Corneal rings like INTACS can improve the quality of vision significantly.
 
  SMS of the Day

(By Dr GM Singh)

It’s true that we don’t know what we've got until we lose it, but it’s also true that we don’t know what we've been missing until it arrives.

 
    Photo Feature (from the HCFI Photo Gallery)

17th MTNL Perfect Health Mela 2010

Students from various school with the science health Model in the Harmony – School Festival

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Govt for PPP in health sector

The Government is planning to promote public–private partnership (PPP) to bridge the gap between demand and supply in the health care facilities in the country, Union Health Minister Ghulam Nabi Azad on Thursday said but made it clear that the move is not aimed to privatise the sector. Public–Private Partnership in the context of the health sector can be a vital instrument for improving the health of the population. This partnership however would not mean privatisation of the health sector, Ghulam said at a function organised by BL Kapoor Memorial Hospital here. He added that the partnership was not meant to be a substitution for lesser provisioning of Government resources, nor an abdication of Government responsibility, but as a tool for augmenting the public health system. To corroborate his point on the role being played by the private sector in providing health facilities, he said, as per available estimates, 58 per cent of hospitals, 29 per cent of all beds, 81 per cent of all doctors, 77 per cent of outpatient cases in rural areas and 80 per cent in the urban areas are in the private sector. "Therefore, we need to look at PPP as a synergetic arrangement, which ensures, that the huge private sector also contributes to public health goals," the Health Minister said as he maintained that India, being home to a large population, has a great responsibility to provide adequate health care facilities to all those living in the country. Azad also informed that the Government has allowed corporates to set up medical colleges in the country and was open to the idea of promoting PPP for setting up medical colleges. (Source: The Times of India, December 17, 2010)

Kalam implores researchers to form Open Source networks

HYDERABAD: The concept of Free Software, wherein knowledge is created by the community for the community, without being driven by commercial interests, must be extended to research to solve problems in health care, agriculture, energy and safe drinking water, former President A.P.J. Abdul Kalam said. He was speaking at the inauguration of the three–day National Convention for Academics and Research on ‘Computing freedom for technology, education and research’ organised by the Free Software Movement of India (FSMI), a national coalition of regional free software movements, at the Mahindra Satyam campus here on Thursday. Mr. Kalam implored scientists, researchers and academics to embrace ‘open source philosophy’ in their respective fields, and work towards building ‘open source networks’ that can help pool talent, research and know–how from around the world. Such a platform can help evolve scientific solutions to problems, particularly those relevant to developing countries. (Source: The Hindu, December 17, 2010)

 
    International News

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

WHO makes global physical activity recommendations

The World Health Organization (WHO) has developed global recommendations on physical activity for health, in order to educate policy makers at all levels about the powerful effect of exercise on reducing the instances of chronic disease. The document, "Global Recommendations on Physical Activity for Health," offers recommendations for children, adults and seniors, and provides guidance on "the dose–response relationship between the frequency, duration, intensity, type and total amount of physical activity needed for the prevention of non–communicable chronic diseases," according to WHO.

(Dr GM Singh)

New Guidelines for Exercise in Type 2 Diabetes

The new joint guidelines issued by the American Diabetes Association and the American College of Sports Medicine stress the important role of physical activity in the management of type 2 diabetes. These guidelines are published concurrently in the December issue of Medicine & Science in Sports & Exercise and Diabetes Care. As per the expert panel, it is now well established that participation in regular physical activity improves blood glucose control and can prevent or delay type 2 diabetes mellitus, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life." Most of the benefits of exercise are realized through acute and long–term improvements in insulin action, achieved with both aerobic and resistance training.

  • For people who already have type 2 diabetes, the new guidelines recommend at least 150 minutes per week of moderate to vigorous aerobic exercise spread out at least 3 days during the week, with no more than 2 consecutive days between bouts of aerobic activity. These recommendations take into account the needs of those whose diabetes may limit vigorous exercise.
  • The panel specifically recommends that such moderate exercise correspond to approximately 40% to 60% of maximal aerobic capacity and states that for most people with type 2 diabetes, brisk walking is a moderate–intensity exercise.
  • The expert panel also recommends that resistance training be part of the exercise regimen. This should be done at least twice a week — ideally 3 times a week — on nonconsecutive days. The panel also recommends that people just beginning to do weight training be supervised by a qualified exercise trainer "to ensure optimal benefits to blood glucose control, blood pressure, lipids, and cardiovascular risk and to minimize injury risk."
  • Regular use of a pedometer is also encouraged. In a meta-analysis of 8 randomized controlled trials and 18 observational studies, people who used pedometers increased their physical activity by 27% over baseline. Having a goal, such as taking 10,000 steps per day, was an important predictor of increased physical activity, according to the expert panel.
  • Finally, the new guidelines emphasize that exercise must be done regularly to have continued benefits and should include regular training of varying types. The majority of people with type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity.

(Dr Monica and Brahm Vasudev)

Diarrhea vaccine patch failed in two patient studies

A vaccine patch to prevent diarrhea in travelers failed in two patient studies, prompting developer Intercell AG to scrap the project and widen its full–year loss forecast.

Article discusses organ recovery, paid donation as solution to transplant shortage

In New York City, on Long Island, and in the Hudson Valley, there are 7,800 people…all hoping for the heart or liver or kidney that could save their lives, but in 2009, fewer than 700 people received organs. In an effort "to improve those numbers, New York City is starting a pilot program in which, for the next five months, an organ–recovery team will trail ambulances responding to 911 calls, ready to leap in if the patient dies and is a viable donor. Meanwhile, Nobel laureate Gary Becker, of the University of Chicago, proposes paying people to become living organ donors. He maintains that unlike the current system, in which friends and relatives are often guilted into becoming donors, a market–based approach would compensate families fairly for their discomfort and risk.

Reducing salt intake may help lower blood pressure in patients with diabetes

Reducing salt intake can help lower blood pressure in patients with both type 1 and type 2 diabetes. Analysis of data from 11 studies that assessed blood pressure effects found that significant reduction of salt intake lowered systolic blood pressure by 7.04 mm Hg. Salt restriction lowered diastolic pressure among the 135 patients in these studies by 3.03 mm Hg.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is IUI? What is the average success rate of IUI? How many cycles of IUI can be tried?

IUI is a simple OPD procedure. In this procedure, washed capacitated sperms are put in the uterus. The ovary is stimulated by giving hormone injections to produce multiple follicles and the procedure is carried out when the eggs are about to be released. We have had a good success rate with this method and recommend it as the first line of treatment in patients who have patent tubes and a reasonably good semen count. Success rate varies according to the indication but around 15% to 18% can be considered good. Most couples conceive within first three cycles of IUI, in subsequent cycles the positive outcome is less. One can try up to six IUI cycles then probably turn to IVF–ET.

For queries contact: banerjee.kaberi@gmail.com

 
    Medicine Update

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

Common causes of hemoglobinuria

  • Acute glomerulonephritis
  • Burns
  • Malaria
  • Paroxysmal nocturnal hemoglobinuria
  • Haemolytic uraemic syndrome (HUS)
  • Pyelonephritis
  • Sickle cell anemia
  • Transfusion reactions
  • Thrombotic thrombocytopaenic purpura (TTP)
  • Exertional hemoglobinuria
  • Acute lead poisoning
 
    Medicolegal Update

Dr Sudhir Gupta, Asso Professor, Forensic Medicine & Toxicology, AIIMS

How is death finally certified?

Permanent and irreversible stoppage of respiration, circulation and brain function so called, tripod of life

  • Generally the practicing doctor diagnoses death by auscultation; but, this can be difficult in cases of excessive fat, emphysema, apex beat below the rib, poorly beating heart and shallow diaphragmatic respiration. All these conditions dampen the conduction of heart sound with body wall.
  • Diagnosis of recent death is also very difficult whenever the death of the person has not been observed. When a doctor is called to certify a patient ‘as dead’ that is brought by ambulance, he must insist that the body be removed to a well lit room where he can carry out his examination.
  • Even though the condition is satisfactory, there can be error during examination. The signs of life can be detected by special methods like Oscilloscope, ECG, and EEG etc.
  • It can never be assumed that attempted resuscitation is pointless. On the other hand, resuscitative measures should always be continued for half an hour.
  • In cases of electric shock, asphyxia particularly drowning and drug overdose, resuscitative measures should always be done
  • There is segmentation of blood in retinal blood vessels in ophthalmoscopic examination. If still there is little doubt, the patient should be taken to intensive care unit for further investigation of heart and brain function.

(Ref: Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of Forensic Medicine, Peepee Publisher)

 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q: Can an MBBS doctor who has had three years training in a specialty in a DNB accredited institute and has also been a senior resident in that specialty in a govt. hospital for three years but not having a post–graduate degree start private practice as a specialist? How?

A:

  • The legal requirements for a doctor are as follows:
    • One should not do something for which one is not competent;
    • One should not commit negligence;
    • One should not violate Rule 7.20 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, which reads as follows:

      "7.20 A Physician shall not claim to be specialist unless he has a special qualification in that branch".
  • In view of the above, you can be legally regarded as competent and can start private practice as a specialist but in a manner that does not attract violation of rule 7.20. This can be done by displaying your name on your letterhead/visiting card as follows:

    "Dr. ABC
    MBBS
    Formerly Senior Resident in ……………in …… Hospital
    Formerly DNB trainee at …… Hospital”
    The above shows that you are adequately trained in the specialty but you are not claiming more than what you are.
  • It would be in your own interest to preserve all records from your supervisors etc. during the period of training and to also obtain testimonials from them stating that you are fully trained and competent in the specialty and are fit enough to appear in or pass the final exam.
  • You are also advised to get membership of associations in your specialty and to publish papers related to your specialty.
 
   Medilaw – Medicolegal Judgement

(Dr KK Aggarwal)

When a patient consults a medical practitioner, whether consent given for diagnostic surgery, can be construed as consent for performing additional or further surgical procedure –– either as conservative treatment or as radical treatment –– without the specific consent for such additional or further surgery?

Consent given only for a diagnostic procedure, cannot be considered as consent for therapeutic treatment. Consent given for a specific treatment procedure will not be valid for conducting some other treatment procedure. The fact that the unauthorized additional surgery is beneficial to the patient, or that it would save considerable time and expense to the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence in an action in tort for negligence or assault and battery. The only exception to this rule is where the additional procedure though unauthorized, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such unauthorized procedure until patient regains consciousness and takes a decision.

  • It is quite possible that if the patient been conscious, and informed about the need for the additional procedure, the patient might have agreed to it.
  • It may be that the additional procedure is beneficial and in the interests of the patient.
  • It may be that postponement of the additional procedure (say removal of an organ) may require another surgery, whereas removal of the affected organ during the initial diagnostic or exploratory surgery would save the patient from the pain and cost of a second operation. Howsoever practical or convenient the reasons may be, they are not relevant. What is relevant and of importance is the inviolable nature of the patient’s right in regard to his body and his right to decide whether he should undergo the particular treatment or surgery or not. Therefore at the risk of repetition, we may add that unless the unauthorized additional or further procedure is necessary in order to save the life or preserve the health of the patient and it would be unreasonable (as contrasted from being merely inconvenient) to delay the further procedure until the patient regains consciousness and takes a decision, a doctor cannot perform such procedure without the consent of the patient. There can be a common consent for diagnostic and operative procedures where they are contemplated. There can also be a common consent for a particular surgical procedure and an additional or further procedure that may become necessary during the course of surgery.
  • Whether the doctor had falsely invented a case that patient was suffering from endometriosis to explain the unauthorized and unwarranted removal of uterus and ovaries, and whether such radical surgery was either to cover–up negligence in conducting diagnostic laparoscopy or to claim a higher fee?
 
    "e-patient" … The Impatient Patient

Dr. Parveen Bhatia: MS, FRCS (Eng.), FICS, FIAGES (Hon.), FMAS, FIMSA, Chairman, Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, Consultant Laparoscopic & Bariatric Surgeon & Medical Director, Global Hospital & Endosurgery Institute, New Delhi

Dr. Pulkit Nandwani: MD, DMAS (WALS), DMAS (CICE, France), Associate Consultant Gynaecologist and Laparoscopic surgeon, Bhatia Global Hospital & Endosurgery Institute, New Delhi

The Over Informed Patient

Internet "The influential web of information"

A recent survey showed how influential the internet has been in the patient's decision making:

  • Web information changed their decision about how to treat their illness 70%
  • Web information led them to ask new questions or take second opinion from another doctor 50%
  • Web information influenced their decision as to whether or not to visit a doctor 28%
  • Web information improved the way they take care of themselves 48%

Due to the extensive resources available on the net, e–patient is a highly informed patient. They use information technology to take informed decisions for themselves as well as their elderly relatives. They are arriving to your clinic armed with information they have found on the web, with a preconceived idea about their diagnosis and treatment options, more demanding regarding convenience and ease of access. They want to actively participate in therapeutic decisions and want all the decisions to be informed and intelligent.

 
    Ethical earning

What is reimbursable to a doctor?

Atrial fibrillation reversal can be billed under cardioversion.

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

H1N1 Influenza Flu

Laboratory confirmation of cases is done by swabs taken from nose, nasopharynx or throat preferably within 5 days of onset of illness. At this time RT–PCR technique is the authorized assay for confirmation of H1N1 virus infection.

 
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    Medi Finance Update

Q. What is the rate of standard deduction on the net annual value of income from house property?

Ans. 30% of net annual value shall be allowed as deduction from net annual value of income from house property.

 
    Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name
Indication
DCI Approval Date
Raltegravir (as Potassium) film coated Tablets 400mg In combination with other anti retroviral agents for the treatment of human immunodeficiency virus (HIV–1) infection in treatment experienced patients with evidence of HIV–1 replication despite ongoing retroviral therapy. 27–Jan–10
    IMSA Update

International Medical Science Academy (IMSA) Update

Diabetes mellitus and glucose–6–phosphate dehydrogenase deficiency

In patients at risk of G6PD deficiency, the possibility of haemolysis should be explored in case of diabetes crisis. In African patients with KPT2D diabetes, potentially oxidative hypoglycaemic agents should be avoided in the remission phase of the disease. G6PD deficiency and diabetes can aggravate each other, and diabetes could be aetiologically associated with G6PD deficiency.

(Ref: Carette C, et al. Diabetes mellitus and glucose–6–phosphate dehydrogenase deficiency: From one crisis to another. Diabetes Metab. 2010 Dec 10. Epub ahead of print)

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient had a strong family history of cancer.
Dr. Bad: Just get regular check ups.
Dr. Good: Take low dose aspirin.
Lesson: A new observational analysis published online in the Lancet reports that long–term daily aspirin may prevent cancer deaths. (Ref: Rothwell PM, et al. Effect of daily aspirin on long–term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet. 2010 Dec 6. Epub ahead of print)

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh, my God! Why did you not give him nimesulide?
Lasson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

The Crazy Philosopher

Once there was a philosopher who was very well known in the kingdom. On the one hand, he was very wise and everyone admired him. On the other hand, at times he seemed to be crazy. But people forgave his craziness because of his inner wisdom. They saw only his good side. The King cared for men of wisdom, so he liked the philosopher. He knew that sometimes people who are geniuses can act a little crazy. One day the philosopher left his house for good. At night he slept in a cave and during the day he roamed the streets trying to avoid people. Those who could get near him asked, "Why do you always roam around alone?"

The philosopher answered, "I keep to myself for a simple reason: because you people are all dishonest. I’m looking for an honest man. You may be friendly but you’re not honest." Everyone was shocked at the philosopher’s rude behavior, for each considered himself an honest person. But the philosopher said, "I myself am not honest, but I'm looking for an honest man."

One day a court officer brought the philosopher before the King and informed him, "Today a thief stole something. My fellow officer and I chased him and arrested him. As we were bringing him to jail we passed this crazy philosopher. He said to us, ‘Two big thieves have caught a little thief." The angry officer said to the king, "He called us thieves! How dare he!"

The King looked at the officer and then at the philosopher. He thought for a few seconds and then he said, "He’s right. We're all dishonest."

Then the King said, "If I were not the King, I would give up everything and live the same kind of life that this man is living. I would live a simple life and 1, too, would search for an honest person on earth. I’m King, but even for me honesty is something beyond my imagination. No matter how hard one tries to be honest, it is extremely difficult. He is looking for honesty in others. I would have tried much more sincerely to be honest had I not been king."

————————————

Mind Teaser

Read this…………………

estimate me
dont

Yesterday’s Mind Teaser: "1 knows"
Answer for yesterday’s Mind Teaser: "won by a nose"

Correct answers received from: Dr Sudipto Samaddar, Dr K Raju, Dr N C Prajapati

Answer for 18th December Mind Teaser: "The correct answers are 1, 4 & 5."
Correct answers received from: Dr Anupam

Send your answer to ijcp12@gmail.com

————————————

Laugh a While
(Contributed by Dr Prabha Sanghi)

Doctor Doctor I think I’m a moth.
So why did you come around then?
Well, I saw this light at the window…!

 
    Readers Responses
  1. Dear Dr KK Sir, emedinews has brought a wonderful change in opening their mail daily. We are addicted to it. All the News in it are useful for us. Dr Prachi
 
    Public Forum

(Press Release for use by the newspapers)

Women Beware of Alcohol on Christmas & New Year’s Eve

The amount of alcohol women can metabolise is 50% less than that of men. Christmas and New Year is the time when partying increases and women should be wary of either not starting alcohol or not indulging into high alcohol consumption if they are social drinkers, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Women who take alcohol can end up with fulminant liver failure if they consume six tablets of paracetamol, which is common for them to consume either to get rid of the hangover or for any incompetent illness.

The safe limit of alcohol in women is 5 gm of alcohol in one hour, 10 gm in one day, 35 gm in a week. 10 gm of alcohol is present in 30 ml of whisky and 50 ml of wine. Gin, vodka and whisky all contain same amount of alcohol in grams. It is quite common for women to drive after their husband/partner has consumed alcohol. They must remember that if they have consumed more than 50% amount of alcohol than their partner, they are more at risk while driving.

 
    Classifieds – Situation Vacant

Wanted a Senior Resident in Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation at Medanta, The Medicity, Gurgaon, Delhi (NCR). Those interested please contact: Dr. Neelam Mohan (9811043475), or Secretary to Dr. Neelam Mohan – Amit (9818200582).

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 9th 2011.

The one-day conference will revisit and cover all the new advances in the year 2010. There will also be a webcast of the event. The eminent speakers will be Padma Bhushan Dr Naresh Trehan (Cardiac Surgery); Padma Shri Dr KK Aggarwal (Revisiting 2010); Dr Neelam Mohan (Liver Transplant); Dr N K Bhatia (Transfusion Medicine); Dr Ambrish Mithal (Diabetes); Dr Anoop Gupta (Male Infertility); Dr Kaberi Banerjee (Female Infertility) and many more.

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

2nd eMedinewS Doctor of the Year Award

Dear Colleague, The Second eMedinews Doctor of the Year Award function will be held on 9th January, 2010 at Maulana Azad Medical College at 4 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 2010, send his/her biodata: Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee.


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