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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

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  Editorial …

21st March 2013, Thursday

Do I need multivitamin tablets?

  1. Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin.
  2. If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation.
  3. Wheat grass and barley grass juice contain folic acid and vitamin B12.
  4. Anything which is green contains vitamin B.
  5. Anything which is red contains lycopene.
  6. Citrus foods contain vitamin C.
  7. All dry fruits contain vitamin E.
  8. Sunlight is an excellent source of vitamin D.
  9. Carrots contain vitamin A.
  10. Folic acid is lost if the food is boiled and the water is discarded.
  11. Vitamin D is not absorbed if exposed to sunlight is through glass.
  12. Vitamin D is not absorbed through clothes if you are fully-clothed in sunlight.

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

White rice linked to diabetes in Asians

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Vice-President (Elect) National IMA and Mr. Sandeep Marwah, Chairman, Asian Academy Film & Television Institute, Noida addressing a press conference

Dr K K Aggarwal
    National News

Eating vitamin A pills, deworming doesn’t cut child mortality

Two so-called magic bullets of the international health community's armoury — pre-school vitamin A supplementation, assumed to reduce child mortality by a quarter and intestinal deworming, assumed to improve child nutrition, growth, and cognitive development — have been shown to have no significant effect on child mortality. This was revealed in one of the largest trials ever: A five-year trial of Deworming and Enhanced Vitamin A supplementation (DEVTA) in one million pre-school children in Uttar Pradesh, a trial larger than all other vitamin A trials combined. Its primary aim was to assess how effective these interventions would be on mortality among children aged one to six years. The paper from the trial was published on Monday in the Lancet, more than six years after the study was completed. It was conducted by King George's Medical University in Lucknow, along with the University of Oxford. "The Vitamin A trial does not substantiate the earlier claim of 30% reduction in mortality. Even with full compliance, the mortality reduction was between 5 and 11%. If the mortality reduction is so small, it calls into question the cost-effectiveness of such interventions," explained Dr Shally Awasthi from the pediatrics department of the university. She is the lead author of the study. (Source: TOI, Mar 20, 2013)

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Trafficking types

  1. Forced or bonded Labour including domestic work
  2. Prostitution and Sex tourism
  3. Drug trafficking
  4. Forced employment in entertainment industries
  5. Entertainment (camel jockeying)
  6. Begging
  7. Organ trade viz. sale of kidneys
  8. Purchase and sale of babies for adoption
  9. Pornography
  10. Fraudulent or forced marriage

For comments and archives

    Valvular Heart Disease Update

Valvular sclerosis in end stage renal disease is associated with progressive stenosis and increased cardiovascular mortality.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

New moms at risk for depressive disorders

Almost one-fourth of women with suspected postpartum depression had bipolar disorders, and a majority of them had comorbid anxiety disorders, a review of 1,400 cases showed. (Source: Medpage Today) Osteopathic manual therapy (OMT) was effective in alleviating chronic low back pain to a clinically significant degree, a randomized study showed. (Source: Medpage Today)

Tamiflu resistance may be rising

The pandemic H1N1 influenza A strain -- now circulating as seasonal flu -- appears to be developing resistance to oseltamivir (Tamiflu) in Australia, a researcher is reporting at the annual meeting of the Australasian Society for Infectious Diseases. (Source: Medpage Today)

FDA clears travel packs for low T

The FDA has approved AndroGel 1.62%, a topical testosterone formulation, in a pocket-sized pack to treat men with hypogonadism, according to manufacturer AbbVie. (Source: Medpage Today)

Peer coaching improves glucose control in diabetes

Clinic-based peer health coaching significantly improved type 2 diabetes control among low-income primary-care patients, a 6-month randomized study found. The findings were published in the March/April issue of the Annals of Family Medicine by David H. Thom, MD, PhD, from the University of California, San Francisco, and colleagues. (Source: Medscape)

No extra complications with single-incision gynecologic laparoscopy

Complications are similar after single-incision and conventional gynecologic laparoscopy -- but that's not enough to justify widespread adoption of the single-incision approach at this point, say the authors of a systematic review and meta-analysis. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Curtain Raiser-CPR 10 UTSAV: http://youtu.be/uqZRvBF4EWw?a via @YouTube

@Dr Deepak Chopra: Our body is the universe localized

    Spiritual Update

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

Holasthak, the best time to remove hatred

You cannot hate a stranger. Negative thoughts are absence of positive thoughts and hatred is only withdrawl of love. The very fact you only ‘hate’ someone you loved once means that it is easy to bring the love back and remove the hatred.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the symptoms of hydrosalpinx?

Some women with hydrosalpinx may have constant or frequent pain in their lower belly or abdomen. A vaginal discharge can also be associated with this condition.

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Organ transplantation

Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient’s own body, for the purpose of replacing the recipient’s damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be re–grown from the patient’s own cells (stem cells, or cells extracted from the failing organs). Organs and/or tissues that are transplanted within the same person’s body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source. Organs that can be transplanted are the heart, kidneys, eyes, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed closely by the liver and then the heart. The cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than 10-fold.

For comments and archives

    An Inspirational Story (Dr GM Singh)

The whale rescuing experience

A 50-foot female humpback whale became entangled in a spider web of crab traps and lines. The whale was weighted down by hundreds of pounds of traps that caused her to struggle to stay afloat. She also had hundreds of yards of line rope wrapped around her tail, her torso and a line tugging in her mouth.

A fisherman spotted her just east of the Farallone Islands (outside the Golden Gate) and radioed an environmental group for help. Within a few hours, the rescue team arrived and determined that she was so bad off, the only way to save her was to dive in and untangle her – a very dangerous proposition. One slap of the tail could kill a rescuer.

They worked for hours with curved knives and eventually freed her. When she was free, the divers say she swam in what seemed like joyous circles. She then came back to each and every diver, one at a time, and nudged them, pushed them gently around – she thanked them. Some said it was the most incredibly beautiful experience of their lives.

The guy who cut the rope out of her mouth says her eye was following him the whole time, and he will never be the same.

May you, and all those you love, be so blessed and fortunate… to be surrounded by people who will help you get untangled from the things that are binding you.

And, may you always know the joy of giving and receiving gratitude.

For comments and archives

    Cardiology eMedinewS

Wrist PCI viable in unstable shock Read More

    Pediatric eMedinewS

Parental fear deters HPV Vax for teens Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Is there any specific treatment for clinical rabies?

There is no specific treatment for clinical rabies. Key to survival after exposure to rabies virus is administration of post-exposure prophylaxis (PEP) as soon as possible. Death is virtually inevitable once clinical signs develop. Medical management is supportive and palliative.

    IJCP Special

Dr Good Dr Bad

Situation: A patient on integrilin (eptifibatide) therapy had high grade fever.
Dr Bad: Give injection paracetamol.
Dr Good: Give tablet paracetamol.
Lesson: Minimize procedures including arterial and venous punctures, IM injections, nasogastric tubes, etc. while the patient is on integrilin therapy.

Make Sure

Situation: A diabetic hypertensive was denied a beta–blocker because of the traditional teaching.
Reaction: Oh my God! You should have used nebivolol.
Lesson: Make Sure that diabetics are not denied beta–blockers when indicated. Nebivolol has no side effect on glucose metabolism unlike atenolol.

  Quote of the Day (Dr GM Singh)

The greatest gift you can give another is the purity of your attention. Richard Moss

    Legal Question of the Day

(Dr MC Gupta, Advocate & Medico-legal Consultant)

Q. I find that consumer courts continue to issue notice to the doctor concerned when a patient files a complaint of medical negligence even without having a prior report from a competent doctor or committee of doctors to the effect that there is a prima facie case of medical negligence, in terms of Justice Katju’s judgment in the Martin F. D'Souza case. Why is it so?

Ans. It is so because the judgment titled as Martin F. D'Souza v. Mohd. Ishfaq, Supreme Court, decided on February 17, 2009, was later put in cold storage after it was practically overturned on 8 March 2010 by the judgment in V. Kishan Rao versus Nikhil Super Speciality Hospital & Another. As per this judgment, Justice Katju delivered the judgment "per incuriam".

Para 51 of the judgment reads:

"51. When a judgment is rendered by ignoring the provisions of the governing statute and earlier larger Bench decision on the point such decisions are rendered ‘Per incuriam’. This concept of ‘Per incuriam’ has been explained in many decisions of this Court. Justice Sabyasachi Mukharji (as his Lordship then was) speaking for the majority in the case of A.R. Antulay vs. R.S. Nayak and another reported in (1988) 2 SCC 602 explained the concept in paragraph 42 at page 652 of the report in following words:-

“Per incuriam” are those decisions given in ignorance or forgetfulness of some inconsistent statutory provision or of some authority binding on the court concerned, so that in such cases some part of the decision or some step in the reasoning on which it is based, is found, on that account to be demonstrably wrong."

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Mind Teaser

Read this…………………

A female client is admitted for treatment of chronic renal failure (CRF). Nurse Juliet knows that this disorder increases the client’s risk of:

a. Water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
b. A decreased serum phosphate level secondary to kidney failure.
c. An increased serum calcium level secondary to kidney failure.
d. Metabolic alkalosis secondary to retention of hydrogen ions.

Yesterday’s Mind Teaser: Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a female client’s uremia. Which finding signals a significant problem during this procedure?

a. Potassium level of 3.5 mEq/L
b. Hematocrit (HCT) of 35%
c. Blood glucose level of 200 mg/dl
d. White blood cell (WBC) count of 20,000/mm3

Answer for Yesterday’s Mind Teaser: d. White blood cell (WBC) count of 20,000/mm3

Correct answers: Dr Avtar Krishan, Tukaram Pagad, Rajiv Kohli, Dr K Raju, Dr BB Gupta, Dr Chandresh Jardosh.

Answer for 19th March Mind Teaser: c. Check the client’s pedal pulses frequently.

Correct answers received from: Dr KV Sarma, Dr Thakor Hitendrsinh G.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Student vs. Stock Broker

Deciding to take a day off from his important job, a young hot-shot broker went back to visit some of his professors at his old school. Entering the school, he saw a dog attacking a small child. He quickly jumped on the dog and strangled it.

The next day, the local paper reported the story with the headline "Valiant Student Saves Boy from Fearsome Dog."

The broker called the editor of the paper and strongly suggested that a correction be issued pointing out that he was no longer a student, but a successful Wall Street broker.

The following day, the paper issued a correction, with a headline that read, "Pompous Stock Broker Kills School Mascot."

    Medicolegal Update

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

What is the nature of bullet wounds of the head?

In most such cases, the bullet passes completely through the skull. As it enters the skull, it produces a clean cut hole in the outer table and a larger hole in the inner table. At the exit point, these conditions are reversed and the hole in the outer table is larger than the hole in the inner table. These facts are often of importance in determining the direction of fire in bullet injuries of the head. The track of a bullet through the brain tissues varies greatly, depending on the range and stability of the bullet. On the other hand, if it remains high velocity at the time of impact with the skull, there may be considerable damage from the cavitation effect within the skull.

  • Fissured fractures often radiate through the vault and base of the skull from the bullet entrance and exit holes.
  • In certain bullet injuries of the head, the bullet may fail to emerge from the skull and in these cases an area of bony comminuting is often found at the site of lodgment.
  • When a bullet strikes the head at a tangent, penetration of the skull may fail to occur, but the force of the bullet may be sufficient to fragment the inner table at the site of impact. Delayed pressure effects and cranial edema may be produced as a result of this.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Avoid alcohol during holi celebrations

Consumption of alcohol during holi can be dangerous. It makes one prone to accidents and people who drink may end up quarreling with each other unnecessarily, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and National Vice President Elect IMA.

There is no evidence that people who do not drink should drink during Holi. For social drinking, one should restrict the intake to less than 80 grams per week or 80 ml per day.

Alcohol impairs the intellect, which in turn impairs the power to judge individuals and discriminate between the opposites. The impairment in judgment can also lead to errors while driving leading to fatal accidents.

Three to four drinks are sufficient to raise the blood pressure to dangerously high levels in susceptible individuals. In patients who are prone to heart attacks, this dangerous rise in blood pressure can precipitate heart attack, paralysis and brain hemorrhage. The incidence of paralytic attacks is found to be high within 24 hours of heavy drinking.

Binge drinking (more than 5 pegs in one hour or six pegs in a day) is also associated with irregular heartbeats and increased incidence of sudden death. Heart and high blood pressure patients are therefore specifically cautioned not to indulge into heavy drinking.

Drinking one peg of alcohol (one ounce) in one hour can still be considered as safe (social drinking) as this amount of alcohol can be totally metabolized by the liver during one hour.

Consuming six tablets of paracetamol with alcohol, which is a common practice to reduce the hangover particularly by women, can produce fatal liver damage. Taking aspirin to reduce the hangover can also produce fatal hemorrhage in the stomach and hence should be avoided. The festival of Holi is to share happiness with each other while forgetting all the differences.

Similarly, the practice of consuming bhang, which can cause impairment in judgment and brain functioning, should also be avoided, added Dr Neelam Mohan Director Hepatology at Medanta -The Medicity.

Those who cannot restrict their alcohol intake should only take red wine as it contains antioxidants, polyphenols that slow cell deterioration. They also prevent plaque buildup and inhibit platelet formation. Natural sources of polyphenols are grape seeds, grape skin, aloe vera, green tea, chocolate and cocoa. The types of polyphenols in cocoa are flavonoids and flavanols, and contain catechins, epicatechins, and procyandins.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 31170 people since 1stNovember 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Responses
  1. Dear Sir, amazing coverups. Regards: Dr Shantonu.
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