emedinews
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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

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–7 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial…

21st September 2012, Friday

Sore Throats Mostly Viral, Not Strep

  • Most throat infections are viral and should not be treated with antibiotics, according to new guidelines from the Infectious Diseases Society of America, reports Medscape in the journal Clinical Infectious Diseases.
  • 70% of Americans with a sore throat receive antibiotics. However, bacteria are responsible for only 20% to 30% of pediatric cases and 5% to 15% of adult cases.
  • Although bacterial and viral throat infections often have overlapping symptoms, other symptoms, such as cough, rhinorrhea, hoarseness, and oral ulcers, strongly suggest a viral infection.
  • A sore throat is more likely to be caused by group A strep if the onset of pain is sudden, swallowing hurts, and a fever is present. Such cases can be evaluated using a stand–alone rapid antigen detection test. Because children younger than 3 years are unlikely to have strep throat, testing is unnecessary, with the exception of certain circumstances such as an infected older sibling.
  • Throat cultures should only be used to confirm negative antigen tests in children and adolescents.
  • They should be eschewed in adults because of their low risk for strep throat and even lower risk for complications such as rheumatic fever.
  • Once strep throat is confirmed, the treatment of choice remains a 10–day course of penicillin (or its congener amoxicillin), which has a narrow spectrum of activity, is cheaply available, and carries a low risk for adverse events.
  • Penicillin or amoxicillin is the choice for treating strep because they are very effective and safe in those without penicillin allergy, and there is increasing resistance of strep to the broader–spectrum — and more expensive — macrolides, including azithromycin.
  • The guidelines also recommend against tonsillectomy for children with repeated throat infection, except in very specific cases (e.g., children with obstructive breathing), because the risks of surgery are generally not worth the transient benefit.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

How is chronic idiopathic constipation defined?

Chronic idiopathic constipation, also known as functional constipation is generally defined as the persistent difficult or seemingly incomplete defecation and/or infrequent bowel movements (once every 3–4 days or less) in the absence of alarm symptoms or secondary causes. The prevalence varies widely and ranges from 4 to 20% of patients.

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Vitamin D intake associated with reduced risk for Crohn’s disease

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

A non–stop Interaction between Patients and Cardiologists

The Heart Care Foundation of India announced details of the forthcoming 4th Dil Ka Darbar at a press conference. The Darbar will be held on Sunday, 23rd September, 2012 at Talkatora Stadium. The event is being organized by Heart Care Foundation of India.

 
Dr K K Aggarwal
    National News

4th Dil Ka Darbar

September 23, 2012, 9:00 AM–6:00 PM , Tal Katora Indoor Stadium, Connaught Place, New Delhi

A non stop question answer–session between all top cardiologists of the NCR region and the public.

Now, films will have to justify smoking scenes

NEW DELHI: Come October 2, directors and producers of all new films will have to show "strong editorial justification" to Central Board of Film Certification (CBFC) for using smoking scenes in movies and TV programmes before it is cleared for public viewing. In case of both old and new films, a 30–second anti–tobacco health spot has to be mandatorily played before and in the middle of the film, if it shows a smoking scene. There also has to be a 20–second audio visual disclaimer prepared by the Union health ministry, which will also have to be shown by the movie theatre owners at the beginning and in the middle of the screening. In all new films, a static anti–tobacco message will also have to flash during a smoking scene. These are the final provisions that have been finalized by the ministry of health and information and broadcasting on the portrayal of smoking in films. The ministry of law vetted these proposals and cleared them for a final notification on Tuesday. The Supreme Court will be informed of these provisions on Thursday by the health ministry. "We will send these final notification for printing in the official gazette on Thursday," a ministry official told TOI.

A study, conducted by World Health Organization (WHO) and health ministry, had revealed that 76% of Indian movies had tobacco use shown in them, and 52.2% of children in India, who had their first smoke were influenced by tobacco use depicted in films. Anti tobacco organization HRIDAY says depiction of smoking scenes in films is a matter of grave concern as studies show a strong association between teenage smoking and portrayal of smoking in films. A study conducted by it had found that students who are highly exposed to tobacco use occurrences in movies have more than twice the risk of being a tobacco user as compared to those with low exposure. India is the world’s largest producer of movies, with more than 1,000 films being made in several languages annually. Another study, conducted by WHO and health ministry, had revealed that 76% of Indian movies showed tobacco use.

In India, 2,500 people die daily due to tobacco use. About 250 million people across the country use tobacco products like gutka, cigarettes and bidis. The health ministry says 40% of health problems stems from tobacco use. Tobacco will be responsible for 13% of all deaths in India. Studies suggest that more than 38.4 million bidi and 13.2 million cigarette smokers may die prematurely because of their addiction. Only 2% of Indian smokers quit successfully. One of the major influences on the uptake of teen tobacco use is the glamorization of tobacco use in movies and on TV.

Backed by evidence that smoking in movies causes youths to want to light up, WHO asked countries to enact enforceable policies that would severely restrict such depictions. WHO had recommended that all movies with scenes of smoking should be given an adult rating, with the possible exception of movies that reflect the dangers of tobacco use or that depict smoking by a historical figure, who was a smoker. Studies show that smoking continues to permeate movies, including those rated as suitable for youth. "Voluntary agreements to limit smoking in movies have not and cannot work," WHO had said. It added, "Logic and science now support enforceable policies to severely restrict smoking imagery in all film media."

Studies show that smoking in movies misleads youths into thinking that tobacco use is normal, acceptable, socially beneficial and more common that it really is. Studies also show that such movies rarely portray the harm of tobacco, instead portraying the product as conducive of a cool and glamorous lifestyle. Dr Douglas Bettcher, director of WHO's Tobacco Free Initiative, had said, "The more smoking adolescents see on screen, the more likely they are to start smoking. These simple policies can save generations of young people from a lifetime of addiction and an early death from tobacco." The WHO report also recommends that movie studios should certify that they received no payoffs from tobacco companies to display tobacco products or their use, stop displaying tobacco brands onscreen and require strong anti–tobacco advertisements before all movies that have tobacco imagery. (Source: TOI, Sept 20, 2012)

For comments and archives

My Profession My Concern

Quality standards for any clinical establishment

Hospital Compare, a quality tool provided by Medicare, currently provides performance data on 31 process measures in 5 clinical areas. These measures are adapted from JCI under "core measure set". (Heart attack, Heart failure, Pneumonia, Surgical care and Children’s asthma care)

Quality measures related to surgical care

  • Prophylactic antibiotic received within one hour prior to surgical incision: The percentage of surgical patients who received prophylactic antibiotics within one hour prior to surgical incision. US National average performance is 93 percent.
  • Prophylactic antibiotics discontinued within 24 hours after surgery end time: The percentage of surgical patients whose prophylactic antibiotics were discontinued within 24 hours after surgery end time. US National average performance is 95 percent.
  • Prophylactic antibiotic selection: The percentage of surgical patients who received prophylactic antibiotics consistent with current guidelines for their particular type of surgery. US National average performance is 97 percent.
  • Venous thromboembolism prophylaxis
    • The percentage of surgical patients with recommended venous thromboembolism (VTE) prophylaxis ordered anytime from hospital arrival to 24 hours after anesthesia end time. US National average performance is 94 percent.
    • The percentage of surgical patients who received appropriate venous thromboembolism (VTE) prophylaxis within 24 hours prior to anesthesia start time to 24 hours after anesthesia end time. US National average performance is 93 percent.
  • Perioperative blood glucose in cardiac surgery patients: The percentage of cardiac surgery patients with controlled 6 A.M. blood glucose (≤ 200 mg/dL) on postoperative day one and postoperative day two. US National average performance is 94 percent.
  • Appropriate hair removal: The percentage of surgical patients with no hair removal or hair removal with clippers or depilatory (and no shaving, which is considered inappropriate). US National average performance is 100 percent.
  • Beta blocker therapy: The percentage of surgical patients who were taking a beta blocker prior to hospital arrival who received a beta blocker during the perioperative period (24 hours prior to surgical incision through discharge from post–anesthesia care/recovery area). US National average performance is 93 percent.
  • Removal of urinary catheter: The percentage of surgical patients whose urinary catheters were removed on postoperative day one or postoperative day two, to reduce the risk of infection. US National average performance is 91 percent.

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

 
    Valvular Heart Disease Update

When can bypass surgery be combined with aortic valve replacement?

There are two settings in which aortic valve replacement and coronary artery bypass graft surgery (CABG) intersect:

  • Patients who are candidates for aortic valve replacement in whom coronary angiography demonstrates significant coronary artery disease that could be corrected at the time of valve replacement.
  • Patients who are candidates for CABG who also have AS that might be corrected at the same surgery.

(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)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Genetic test predicts autism risk with high degree of accuracy

Investigators have developed a genetic diagnostic classifier that is able to predict the risk of developing autism spectrum disorder (ASD) with more than 70% accuracy in persons of central European descent, new research shows. The study was published online September 11 in Molecular Psychiatry. (Source: Medscape)

For comments and archives

Obesity itself not diabetes risk

Having excess visceral fat and insulin resistance –– but not being obese in and of itself –– appears to put heavier patients at risk for prediabetes and diabetes, researchers found. (Source: Medpage Today)

For comments and archives

Thrombocytopenia common with heparin prophylaxis

Thrombocytopenia is common with routine heparin prophylaxis of venous thromboembolism, researchers warn. "What this study highlights is the need for vigilance even for…routine prophylactic use as we see thrombocytopenia quite commonly and the development of adverse complications when thrombocytopenia occurs," Dr. Tracy Y. Wang told Reuters Health by email. (Source: Medscape)

For comments and archives

Arsenic trioxide regimen helps in acute promyelocytic leukemia

For elderly patients with newly diagnosed acute promyelocytic leukemia (APL), arsenic trioxide (ATO) is safe and effective for remission induction and long–term post–remission therapy, a small study from China indicates. (Source: Medscape)

For comments and archives

 
   Twitter of the Day

@DrKKAggarwal: Ten bypass grafts at a go In a pathbreaking surgery conducted by Dr Ramakant Panda, a patient from Ludhiana was…http://fb.me/20DqGQ0CG

@DeepakChopra: Is total amount of energy and matter constant in the universe? Please watch my #askdeepak video reply http://tinyurl.com/9fhk7e7

 
    Spiritual Update

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

Ganesha: Oh My God!

We sing His appraisal, we worship His deity, we believe in His powers blindfolded and yet distance Him from us by pining to see what lies deep within us. God, to which the world bows down, has in fact been

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is embryo donation?

Embryo donation is a procedure that enables embryos either that were created by couples undergoing fertility treatment or that were created from donor sperm and donor eggs specifically for the purpose of donation to be transferred to infertile patients in order to achieve a pregnancy. Indications for embryo donation include untreatable infertility that involves both partners, untreatable infertility in a single woman, recurrent pregnancy loss thought to be related to embryonic factors, and genetic disorders affecting one or both partners. The process of embryo donation requires that the recipient couple undergo the appropriate medical and psychological screening recommended for all gamete donor cycles. In addition, the female partner undergoes an evaluation of her uterine cavity and then her endometrium is prepared with estrogen and progesterone in anticipation of an embryo transfer. Success rates with embryo donation depend on the quality of the embryos that were frozen, the age of the woman who provided the eggs, and the number of embryos transferred.

For comments and archives

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

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

Does donor need any rest after donating blood?

Yes. The donor should rest for about 20–30 minutes before resuming his routine work; it takes only 3–8 minutes to take blood from a donor.

For comments and archives

 
    Liver Abscess Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What is liver abscess?

A liver abscess is a local accumulation of pus in the liver. The abscess causes an increase of pressure within the liver as well as a killing of healthy surrounding liver tissue. The end result can be that an overwhelming infection can suddenly gain entrance into the blood stream at which point the patient gets extremely sick.

For comments and archives

 
   An Inspirational Story

Dirt Roads

By Paul Harvey

What’s mainly wrong with society today is that too many Dirt Roads have been paved.
There’s not a problem in America today, crime, drugs, education, divorce, delinquency that wouldn’t be remedied, if we just had more Dirt Roads, because Dirt Roads give character. People that live at the end of Dirt Roads learn early on that life is a bumpy ride.

That it can jar you right down to your teeth sometimes, but it’s worth it, if at the end is home…a loving spouse, happy kids and a dog. We wouldn’t have near the trouble with our educational system if our kids got their exercise walking a Dirt Road with other kids, from whom they learn how to get along. There was less crime in our streets before they were paved.

Criminals didn’t walk two dusty miles to rob or rape, if they knew they'd be welcomed by 5 barking dogs and a double barrel shotgun. And there were no drive by shootings.

Our values were better when our roads were worse!

People did not worship their cars more than their kids, and motorists were more courteous, they didn’t tailgate by riding the bumper or the guy in front would choke you with dust & bust your windshield with rocks.
Dirt Roads taught patience. Dirt Roads were environmentally friendly, you didn’t hop in your car for a quart of milk you walked to the barn for your milk. For your mail, you walked to the mail box.

What if it rained and the Dirt Road got washed out? That was the best part, then you stayed home and had some family time, roasted marshmallows and popped popcorn and pony rode on Daddy’s shoulders and learned how to make prettier quilts than anybody. At the end of Dirt Roads, you soon learned that bad words tasted like soap. Most paved roads lead to trouble, Dirt Roads more likely lead to a fishing creek or a swimming hole.

At the end of a Dirt Road, the only time we even locked our car was in August, because if we didn’t some neighbor would fill it with too much zucchini.

At the end of a Dirt Road, there was always extra springtime income, from when city dudes would get stuck, you’d have to hitch up a team and pull them out.

Usually you got a dollar…always you got a new friend…at the end of a Dirt Road!

(Source: http://www.inspire21.com/stories/educationstories)

For comments and archives

 
   Cardiology eMedinewS

Restless legs linked to CHD: New prospective data Read More

FDA panel rejects Lixivaptan for CHF Read More

 
   Pediatric eMedinewS

Sodium intake tied to higher BP in kids Read More

Helping kids be more sun–safe is a challenge: Study Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever without chills was diagnosed with gram–negative sepsis.
Dr. Bad: Diagnosis is wrong.
Dr. Good: You need intensive treatment.
Lesson: Patient with gram–negative species may have fever with or without chills.

For comments and archives

Make Sure

Situation: An asthmatic with respiratory rate of 37 developed respiratory arrest.
Reaction: Oh my God!! Why was the patient not put on the ventilator in time?
Lesson: Make sure to remember that a respiratory rate of > 35 is a warning signal to start ventilation therapy.

For comments and archives

 
  Quote of the Day (Dr GM Singh)

When you are at a loss of what to do, do nothing. Doing nothing can be very wise. When you pause doing things, you become more aware of God’s presence, and often an unexpected solution to your question will arise.

 
    Legal Question of the Day (Dr M C Gupta)

Q. I am an MBBS and have Master degrees in Diabetes and Endocrinology from European universities. I also have good experience in above fields in India and abroad. Please answer the following queries:

  • Can I name my clinic as "Diabetes Centre", even though I haven’t mentioned on my letterhead or sign board that I am a specialist?
  • Can register my clinic as "Diabetes Centre" under the Clinic Establishment Act in the state?
  • While filling up the proposal form for a professional indemnity insurance policy, in which category should I apply–– as a General Physician or as a Consulting Physician?

Ans.

  1. You will not be violating any law by naming your clinic as "Diabetes Centre". Even otherwise, there is no law that an MBBS cannot treat a diabetes patient.
  2. You will not be violating any law by naming your clinic as "Diabetes Centre" in the application form for registration under the state Clinic Establishments Act.
  3. You can apply in the category "Consulting Physician" in the professional indemnity insurance policy proposal form unless there is given in the concerned instructions etc. a definition of "Consulting Physician" to which you do conform. It is not necessary that a consulting physician should be an MD. The word consulting physician means a physician who provides medical consultation against consultation charges. Such consultation can be given by an MBBS also. It is not necessary that an MBBS should dispense drugs or attend to minor wounds and deliveries etc.
 
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    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

A/G ratio

  • Globulin is increased disproportionately to albumin (decreasing the albumin/globulin ratio) in states characterized by chronic inflammation and in B–lymphocyte neoplasms, like myeloma and Waldenström’s macroglobulinemia. More relevant information concerning increased globulin may be obtained by serum protein electrophoresis.
  • Decreased globulin may be seen in congenital or acquired hypogammaglobulinemic states. Serum and urine protein electrophoresis may help to better define the clinical problem.
 
    Rabies Update

(Dr. A. K. Gupta, Author of "RABIES – the worst death")

What is the role of monoclonal antibodies in rabies?

Monoclonal antibodies against rabies virus have been widely used in the diagnosis and immunological analysis of rabies. Human monoclonal antibodies to rabies virus G protein are also expected to be used as a replacement for rabies immunoglobulin (RIG) in the post–exposure treatment of rabies. In 1978, Wiktor reported the preparation of rabies virus monoclonal antibodies. Since then, rabies virus monoclonal antibody (mAb) technology has been more and more widely used in basic research and diagnosis of rabies.

 
    Mind Teaser

Read this…………………

Which initial nursing assessment finding would best indicate that a client has been successfully resuscitated after a cardio–respiratory arrest?

A. Skin warm and dry
B. Pupils equal and react to light
C. Palpable carotid pulse
D. Positive Babinski's reflex

Yesterday’s Mind Teaser: Chemical burns of the eye are treated with

A. Local anesthetics and antibacterial drops for 24 – 36 hours
B. Hot compresses applied at 15–minute intervals
C. Flushing of the lids, conjunctiva and cornea with tap or preferably sterile water
D. Cleansing the conjunctiva with a small cotton–tipped applicator

Answer for yesterday’s Mind Teaser: C. Flushing of the lids, conjunctiva and cornea with tap or preferably sterile water

Correct answers received from: Prabha Sanghi, Dr K Raju, YJ Vasavada, Dr BB Aggarwal, Dr Arvind Khanijo, Dr (Maj. Gen.) Anil Bairaria, Dr Parimal Shah, Raksha Vaishnav, Dr Ajay Gandhi, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Kanta Jain, Dr Thakor Hitendrsinh G, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr Avtar Krishan.

Answer for 19th September Mind Teaser: b. Type B
Correct answers received from: Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

Identity

A certain little girl, when asked her name, would reply, "I’m Mr. Sugarbrown’s daughter." Her mother told her this was wrong, she must say, "I’m Jane Sugarbrown." The Vicar spoke to her in Sunday School and said, "Aren’t you Mr. Sugarbrown’s daughter?" She replied, "I thought I was, but mother says I’m not."

 
    Medicolegal Update

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

Doctor & law

Doctor is neither a detective nor a curtain between injured/sick alleged criminal and police or judiciary.

  • The primary and absolutely transparent duty of a doctor/hospital is to provide medical services to sick and injured patient may be an alleged criminal, to save his health/limb and life without any discrimination.
  • When the medical care records are required for judicial/police investigation, the records becomes medicolegal in nature and the same may be required to be testified under oath in the court of law by the treating doctor.
  • The doctor should acquire the habit of making a careful note of all the facts observed by him with exact time and date.
  • The doctor should examine the facts which come to his knowledge in his special capacity as a medical man, draw his conclusions logically and correctly after a detailed consideration of the pros and cons of the case, and elaborate in the Court that interpretation, along with the medical grounds on which it is based.
  • Presumption is not proof, and conjecture is not evidence. The Court has no special medical knowledge. It relies on medical witness for an opinion and expects him to assist it with his special knowledge and experience in perusal of truth.
  • Presumption, assumption hypothesis, and mere conclusion on self defined interpretation are not a proof, and conjecture is not evidence.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

A mix of exercise protocol is better

A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Jut weight lifting alone has very little benefit, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India, Dil Ka Darbar to be held on 23rd September at Talkatora Stadium and MTNL Perfect Health Mela.

According to a study published in the journal American Journal of Cardiology, people in the weight–training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists.

Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score.

Both the aerobic–only group and the combined–exercise group also lowered their levels of bad triglycerides.

 
    Readers Response
  1. Sir, I would like to inform you about the picture "Kyon ki". In this picture the role of Om Puri as a medical professional in the end when he operates on Salman Khan is very derogatory. Please see the picture and comment. Thanks: Dr Shashi Saini
 
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    Our Contributors

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