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
Dr KK Aggarwal

From the Desk of Editor in Chief
Padmashri 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; Elecetd Member, Delhi Medical Council; Past President, Delhi Medical Association; Past President, IMA New Delhi Branch; Past Hony Director, IMA AKN Sinha Institute; Past Chairman IMA Academy of Medical Specialities; Past Hony Finance Secretary National IMA; Editor in Chief IJCP Group of Publications & Hony Visiting Professor (Clinical Research) DIPSAR


Dear Colleague

21st February 2010, Sunday

BRMS is to be now "Diploma in Rural Health"

A meeting of State IMA leaders was held at New Delhi on 15th February 2010 to finalize the Rural Health Care model for India. Following are the excerpts.

  1. 70% of Indians live in villages without access to even basic Primary health care.

  2. Due to shortage of medical doctors, Governments are not able to provide Health manpower in many States of India inspite of best of their efforts.
     
  3. Globally, every country has developed a mid level Health workforce to deliver health to the remote corners of their country. e.g. bare foot doctors of China and Mobile mid level Health workers in Sub Southern Africa. Even developed countries like USA, UK , Australia, Malaysia have Physician Assistants, Nurse Practitioners and Assistant Medical Officers in their country.

  4. The Govt. of India has been exploring for many years the possibility of creating short–term medical graduates to fill this gap. Most efforts did not prove fruitful.

  5. The Govt. of India has now requested MCI to come out with a model based on the recommendation of the Task force of National Rural Health Mission which has proposed a 3–year Diploma course in Modern Medicine, BRMS. 

  6. The 84th Central Council meeting of IMA unanimously opposed the short–term Medical course and dissatisfaction of Member States were expressed in many ways. At this juncture, this meeting has created history in IMA. All the leaders expressed their State views, displeasure and support and finally agreed that IMA must support a Rural Health Model to offer Basic Primary Health Care to the people below the poverty line in India.

Idealist model is that only MBBS Doctors must offer Health Care to Rural Indians too

When idealistic model is not achievable, a realistic/interim model is needed. It is wise to examine this Realistic Model and make it safe for the public and profession. All the leaders carried out this exercise very well and the conclusions are as below:

New Rural Health Course should be a Health Sciences qualification not a Medical Science qualification. It will be Diploma with three letters only.

  1. Diploma in Rural Health – DRH
  2. Institution will be named as: Rural Medical School – Rural Health School
  3. Title shall be Rural Health Provider (RHP)
  4. Registration not in State Medical Councils & MCI under Schedule I
  5. Separate Register as a State Rural Health Register
  6. Posting will be in villages of birth – PHC, CHC, subcenters
  7. Only in Govt. service for 5 years
  8. Re-register every year for 5 years
  9. Selection Criteria, Infrastructure, Faculties & Curriculum all to be defined by the MCI
  10. They will be given exposure to work in Rural areas during the Course / Internship
  11. Their Competencies – Dos & Dont’s will be clearly stipulated by MCI.
  12. To be accepted and implanted by needed status only.

The above were unanimously agreed by the members present. (Dr. S. Arulrhaj, MD)

Dr KK Aggarwal
Chief Editor


News and Views

Metformin may smell

A report in this week’s Annals of Internal Medicine says metformin may smell like ‘dead fish,’ and pharmacists say they can identify it by its ‘old locker–room sweat socks’ odor. Extended–release forms of the drug, which are coated, or generic products may be the answer.

Smoking may increase risk of recurrence in patients with HPV–linked oral cancers

According to findings appearing in the journal Clinical Cancer Research, smokers who have an HPV–linked (oral) tumor are six times as likely to have a recurrence as those who have never smoked.

Pipes, cigars may increase risk of COPD

According to a study published in Annals of Internal Medicine, pipe and cigar smokers have more than double the risk for COPD. Those who also smoked cigarettes were at more than triple the risk.

Dangers of long–term cell phone usage

The WHO, American Cancer Society, National Cancer Institute, and the Food and Drug Administration have not found, from their review of studies, that wireless devices are a public health risk.

Combination hormones for menopause do not reduce CHD risk

Estrogen plus progestin therapy does not reduce coronary heart disease risk during the first three to six years of use in women who started therapy close to menopause. Combination hormone replacement therapy increases the risk for coronary heart disease in postmenopausal women, but this effect might be limited to the first years of use and to women who start therapy late in menopause. (Annals of Internal Medicine, Feb. 16, 2010)

SSRI may weaken effect of tamoxifen

The selective serotonin reuptake inhibitor paroxetine may inhibit the effectiveness of tamoxifen when the drugs are coprescribed in patients with breast cancer. (BMJ, Feb 8, 2010)

Patients with SVT may also have DVT

Many patients who present with superficial venous thrombosis also either have or soon develop venous thromboembolism. (Annals of Internal Medicine, Feb. 16, 2010)

11th March World Kidney Day

Reducing risk of developing kidney diseases (Dr N P Singh)

Keeping fit and active

Keeping fit helps to reduce blood pressure and therefore reduces the risk of chronic kidney disease. The concept "on the move for kidney health" is a worldwide collective march involving the public, celebrities and professionals moving across a public area by walking, running and cycling. Why not join them – by whatever means on 11th March.

Kidney terms (Dr GM Singh)

Bacteriuria

Presence of bacteria in the urine. Asymptomatic bacteriuria has at least 105 colony forming units (CFU)/ml – termed significant bacteriuria – on two successive cultures with or without pyuria in a patient without symptoms.

Conference Calendar

CTCOMCON 2010 (Combined Annual Meeting of 18th Asian Society for Cardiovascular & Thoracic Surgery & India Association of Cardiovascular Thoracic Surgeons 56th)
Date: February 26 – March 1, 2010
Venue: AIIMS, The Ashok, New Delhi

Diabetes Fact

MODY is maturity–onset diabetes of the young. The patient will have high fasting sugar, low fasting insulin, no antibodies, is autosomal dominant, no obesity, no hypertension, no dyslipidemia, no ketoacidosis

Thought for the day (BK Sapna)

Learning to talk properly to the self is a spiritual endeavour. When you make a mistake, do you talk lovingly to yourself in your mind, or do you tell yourself off? One habit recognises your divinity; the other subtly shapes a nature of sorrow. Remove the darkness of the mind and the world will be illuminated.

Public Forum (Press Release)

EMINENT WOMEN AWARDED

Eminent women of the society; Geeta Chandran, Nalini, Kamalini (Dancers), Dr. Neelam Mohan (Medicine), Anshu Gupta (Wellness), Sudha Gupta (Education), Anjali Gandhi, Neera Misra, Alka Lamba, Shelly Batra, Dr. Daya Misra (Social Welfare), Anita Pandey (Legal Affairs), Sheetal Jhunjhunwala, Anita Ahuja (Environment Protection), Pooja Jain (Business & Induatry), Shanta Serbjeet Singh (Journalism), Rekha Udit Tiwari (Ecology & Environment) & Binalakshmi Nepram (Peace Initiative) were awarded Dr. Sadhna International Women Empowerment Awards by Honorable Chief Minister of Delhi, Smt. Sheila Dikshit.

The awards were given by Dr. Sadhna International Women Rights Protection Trust every year on 21st February. Speaking on the occasion Smt. Dikskit said that the society must work toghther to stop female feticides. She also spoke about compulsory education of the girl child.

A Book 'SADHNA VITHI' was also released by the CM. The Book is written by Acharya Dr. Sadhna Ji Maharaj and contains Dr. Sadhna's writings on various spiritual subjects.

Others who were present on the occasion were Sardar Buta Singh (Former Home Minister), Dr. KK Aggarwal (President, Heart Care Foundation of India) & Sh. Arvinder Singh Lovely (MLA).

A symposium on women empowerment was also organized in association with Acharya Sushil Muni Memorial Trust, World Fellowship of Religions & Heart Care Foundation of India. Following resolutions were passed:

1. To have MTPs after 12 weeks only at designated centers. This will keep a check on female feticide.

2. To increase the budget provisions in the coming budget session for the welfare of the women.

Punjab & Sind Bank
 
action
docconnect
 
Central Bank of India
 
Nestle
 
nuspera
 
Docconnect

Question of the day

What is the role of immunomodulator therapy in ulcerative colitis?

Some patients with ulcerative colitis remain refractory despite intensive therapy. In these cases, immunomodulator therapy with either azathioprine or its metabolite, 6–mercaptopurine (6–MP), can be considered prior to referral for surgery. Testing for thiopurine methyltransferase (TPMT) activity should be considered before initiating therapy.
As surgery in ulcerative colitis is curative and, in many patients, does not require a stoma, most doctors are hesitant about using these potentially toxic medications. However, patients who do not desire surgery or those with more limited disease but with persistent or debilitating symptoms are candidates for longterm therapy with these drugs.

eMedinewS Try this it Works

Auscultation for pleural effusions

Percussing the sternum with one or two fingers while listening with the diaphragm of the stethoscope over the posterior hemithorax can more easily allow the listener to hear dullness replace tympany when the level of the effusion is reached. This allows greater confidence when performing the thoracentesis.

Dr Good Dr Bad

Situation: A diabetic patient developed depression.
Dr Bad: It's ok to have mild depression in diabetics.
Dr Good: You need treatment.
Lesson: Depression has been associated with poor glycemic control and with accelerated rates of coronary heart disease in diabetic patients (Source: Arch Intern Med 2007;167:1137)

Make Sure

A young dynamic executive with hypertension on atenolol was not able to follow his vigorous exercise routine.
Oh my God! You should have put him on nebivolol.
Make sure that all young executives are put on nebivolol as the beta–blocker of choice. It improves diastolic function and does not reduce the exercise capacity. (Source: Derg 2004;4(4):323–6)

Laughter the best medicine

GP referral to Urologist
‘I would be grateful if you would see this man, who is complaining of impertinence’.

Formulae in Critical Care

Cardiac index (CI)
Formula: CI = CO/BSA
CO: Cardiac output
BSA: Body surface area

Milestones in Neurology

Korbinian Brodmann (1868 – 1918) was a German neurologist who became famous for his definition of the cerebral cortex into 52 distinct regions from their cytoarchitectonic (histological) characteristics. These areas are now usually referred to as Brodmann areas. Some of these areas were later associated to nervous functions, such as areas 41 and 42 in the temporal lobe (related to hearing), areas 1, 2 and 3 in the postcentral gyrus of the parietal lobe (the somatosensory region), and the areas 17 and 18 in the occipital lobe (the primary visual areas).

Mistakes in Clinical Practice: Trailing zero after decimal point (1.0 mg)
1 mg can be mistaken as 10 mg if the decimal point is not seen
Do not use trailing zeros for doses expressed in whole numbers

Prostate– SMS of the day (Dr Anil Goyal)

Prostate is a walnut size accessory sex gland, weighing 18 – 20 gms in normal adult, located at the opening of the bladder neck, surrounding the urethera that carries urine from bladder to outside.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name Indication Approval Date
Luliconazole Cream 1%
For the treatment of cutaneous mycosis viz. Tinea pedis, Tinea corporis, Tinea cruris.
3.06.2009

(Advertorial section)

Silicic Acid and Herbs: A New Approach

Various clinical studies have proved that silicic acid as sodium metasilicate, has a synergistic effect with concomitant use of relevant herbal extracts when both are used in conjunction.  Interestingly, The most popular brands of silicic acid health Supplements, Available in the USA Market contain Herbal Extracts along with the Silicic acid as a major Ingredient. Sodium Metasilicate is NOW available in India as ZENIMMUNE Range of Products.

Advertising in emedinews

emedinews is the first daily emedical newspaper of the country. One can advertise with a singe insertion or 30 insertions in a month. Contact: drkk@ijcp.com. emedinews@gmail.com 

eMedinewS–PadmaCon 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 hangama and live webcast. Suggestions are invited.

Stress Management Workshop

A stress management workshop with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized on April 17–18, 2010.
Organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, In association with IMA New Delhi Branch and IMA Janak Puri Branch
Venue: Om Shanti Retreat Center, National Highway 8, Bilaspur Chowk Pataudi Road, Near Manesar.
Timings: On Saturday (2pm onwards) and Sunday (7am–4pm). There will be no registration charges, limited rooms, kindly book in advance, stay and food (satvik) will be provided. For booking e mail to emedinews@gmail.com or sms to Dr KK Aggarwal 9811090206/ BK Sapna 9811796962

Stroke Update Workshop for GPs

Indian stroke association and International Stroke Conference is organizing a Stroke Update Workshop on March 13–14, 2010 at AIIMS Auditorium. eMedinewS has tied up with the conference for free registration for first 200 GPs of NCR. Organizer: Dr Padma, Prof of Neurology, AIIMS, New Delhi SMS for free registration to 9717298178 or email to isacon2010@gmail.com

International Symposium on ‘Yogism for Healthy & Happy Living and Aging’

The 7th convocation of SVYASA Yoga University was organized on January 12, 2010. The concept Yogism was well received and we now plan to have an International Symposium on ‘Yogism for Healthy & Happy Living and Aging’ on December 6–7, 2010. There is considerable interest abroad to integrate alternate medicine with modern medicine in Medical schools. We feel Yoga, Meditation and Naturopathy should be integrated with modern medicine in promotion of positive health and healing: BC Harinath, Director, JBTDRC & Coordinator, BIC & Arogyadham Mahatma Gandhi Institute of Medical Sciences, Sevagram – 442102, Wardha, Maharashtra, India, TeleFax: +91 7152 284038, Home: +91 7152 260219, E-mail: bch@jbtdrc.org, bc_harinath@yahoo.com

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Readers Responses

  1. Dear Dr K K Aggarwal, Congratulations for all the decoration u deserve for all great deeds! Thanks. Yours sincerely: Dr. HK Jagtiani

  2. Hi KK, U know I need not express our concern and ur achievements in words, but so many have said so many good words, I felt that unless our name also appears in these columns, it may give a feeling that v have ignored u. Not the least, ur space in our hearts has grown more than before and we are unable to express our happiness. Is Veena also getting this enews? I am sure she must be among the first ones. Through these columns V convey our greetings to her and her family as well in us: Dr Krishan and Dr Prabha Arora, New Delhi

  3. Dear Sir, Heartiest congratulations! on getting very prestigious Padma Shri award. I wish you more and more grand awards in future. Regards: Hena Vasdeva

  4. Dear Dr Aggarwal: Please accept our heartiest congratulations on winning the prestigious award. Hard work always pays. May God bless you. With best wishes. Dr. Shashi Saini & VK Saini

  5. Dear Dr Aggarwal, Congratulations to you and your family. This was really well deserved. Wish you all the best. Dr Vivek Batra