emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
 
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

 
  Editorial …

23rd March 2012, Friday

HbA1c 5.7% as Pre diabetes Screen

Setting the hemoglobin A1c threshold to 5.7% when screening for pre diabetes would be a cost–effective strategy for making more people eligible for interventions to prevent progression to type 2 diabetes, according to a study published in the April issue of the American Journal of Preventive Medicine.

  1. The American Diabetes Association recommends HbA1c testing as a criterion by which to diagnose diabetes and pre diabetes.
  2. HbA1c value of 6.5% has been established as the diagnostic figure associated with diabetes
  3. 3 different professional organizations have recommended 3 different cutoffs: 6.0%, 5.7%, and 5.5%.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Dr Rashmi Singh

Crime Against Women - Dr Rashmi Singh

Audio PostCard
 
    Photo Feature (From HCFI Photo Gallery)

First Mega Ajmer Health Camp – 2012

For the first time, Mammography van was stationed at the camp venue.

 
Dr K K Aggarwal
 
    National News

Congratulations

Doctors from Bihar all now working in Delhi were awarded the Vishisht Bihari Samman on the occasion of the Bihar Shatabdi Utsav at Coronation Park. These awards were presented to three doctors for their outstanding achievements by Shri Nitish Kumar, Chief Minister of Bihar. These were–

Professor Ranjit Roy Chaudhury – Former Member, Board of Governors of MCI & presently with Apollo Hospitals

Professor Kameshwar Prasad – Professor of Neurology, AIIMS

Dr. Ashok Seth – Chief Cardiological Services, Fortis–Escorts Hospital

Dr. A. K. Singh – Former Director, Institute of Orthopedics, Safdarjung Hospital

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

 
    International News

Psoriasis Treatment Proves Effective Against Atherosclerosis

Adalimumab, a TNF inhibitor for the treatment of psoriasis, also reduces the vascular inflammation seen on CT in patients with concomitant coronary atherosclerosis, according to a pilot study presented at the American Academy of Dermatology 70th Annual Meeting.

For comments and archives

New Therapy Targets Skin and Atherosclerosis in Psoriasis

An oral immune modulator, VB–201, simultaneously improved psoriatic skin lesions and reduced atherosclerotic plaque in a phase 2 study, according to a study at American Academy of Dermatology 70th Annual Meeting.

For comments and archives

Half of MCI Patients With Amyloid on PET Convert to AD

Beta–amyloid burden present in the brains of healthy controls before the appearance of symptoms indicates potential for future cognitive impairment and Alzheimer’s disease according to study research presented at the Alzheimer’s Disease International (ADI) 27th International Conference.

For comments and archives

PROMIS to Compare mp–MRI With TRUS–Guided Biopsy

It soon might be possible to detect clinically significant prostate cancer and rule out insignificant prostate cancer using multiparametric MRI. The Prostate MR Imaging Study (PROMIS) will compare results from mp–MRI with those from transrectal ultrasound–guided biopsy and template prostate mapping, said Dr Hashim Ahmed at University College London, United Kingdom at the European Association of Urology (EAU) 27th Annual Congress.

For comments and archives

 
   Twitter of the Day

@DrKKAggarwal: #AJCC Cardiology eMedinewS Cortisol may cause multiple health…

@DeepakChopra: Understand Karma: No debt in the universe goes unpaid.

 
    Spiritual Update

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

How Do I Know That A Person Is A Good Person?

How do I come to know that someone has a spiritual bondage with me, or he or she is a human being.

  1. The person has a positive aura.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How PCOS are diagnosed?

Early Diagnosis: If you are diagnosed with PCOS and you have female children, you should watch them for symptoms and inform them that they are at risk, since there is a genetic tendency to inherit the syndrome. Early treatment of PCOS may decrease the development of acne and hirsutism.

Long–term Considerations: Women with PCOS, particularly those with insulin resistance, may be at a increased risk for diabetes, heart disease, cholesterol abnormalities, and endometrial cancer.

For comments and archives

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

(Dr. Bharat Singh, Director SBTC Delhi)

BLOOD TRANSFUSION IS IT REALY REQUIRED……?

Think & Decide!

Blood Transfusion is beneficial but associated with risk similar to the organ transplant.
Risks are due to HLA (Human Leukocyte Antigen), Red cell Antigens and Platelet refractoriness.
Risks are also due to transfusion transmitted infections like HIV, Hepatitis B, Hepatitis C, Malaria, Cytomegalovirus ………etc.
There are another hundreds of blood borne viruses which can be transmitted by the blood.
Presently blood is not screened for these infections due to high cost and being non mandatory by the statutory legal agencies.
The risks are more so with the fresh/warm blood because of inadequate testing and sensitivity of the rapid tests.
Use of Blood component is recommended in place of whole blood.
Therefore before prescribing blood transfusion thinks about the benefit and risks associated with blood transfusion
………………so therefore transfuse only when the benefits outweigh the risk

For comments and archives

 
   An Inspirational Story

(Ms Ritu Sinha)

The Midas Touch

We all know the story of the greedy king named Midas. He had a lot of gold and the more he had the more he wanted. He stored all the gold in his vaults and used to spend time every day counting it.

One day while he was counting a stranger came from nowhere and said he would grant him a wish. The king was delighted and said, "I would like everything I touch to turn to gold." The stranger asked the king, Are you sure?" The king replied, "Yes." So the stranger said, "Starting tomorrow morning with the sun rays you will get the golden touch." The king thought he must be dreaming, this couldn’t be true. But the next day when he woke up, he touched the bed, his clothes, and everything turned to gold. He looked out of the window and saw his daughter playing in the garden. He decided to give her a surprise and thought she would be happy. But before he went to the garden he decided to read a book. The moment he touched it, it turned into gold and he couldn’t read it. Then he sat to have breakfast and the moment he touched the fruit and the glass of water, they turned to gold. He was getting hungry and he said to himself, "I can’t eat and drink gold." Just about that time his daughter came running and he hugged her and she turned into a gold statue. There were no more smiles left.

The king bowed his head and started crying. The stranger who gave the wish came again and asked the king if he was happy with his golden touch. The king said he was the most miserable man. The stranger asked, "What would you rather have, your food and loving daughter or lumps of gold and her golden statue?" The king cried and asked for forgiveness. He said, "I will give up all my gold. Please give me my daughter back because without her I have lost everything worth having." The stranger said to the king, "You have become wiser than before" and he reversed the spell. He got his daughter back in his arms and the king learned a lesson that he never forget for the rest of his life.

For comments and archives

 
    Rabies Update

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

Can we apply local antibiotics or antimicrobial agents on the site of bite?

After cleansing of the bite wounds, local antimicrobial agents can be applied. Discourage local wound applicants like turmeric, neem, red chilli, lime, plant juices, coffee powder etc.

Can the animal bite wounds be cauterized?

Avoid cauterization of animal bite wounds. It amounts to malpractice and the doctor can be sued for compensation under COPRA.

 
   Cardiology eMedinewS

Psoriasis Treatment Proves Effective Against Atherosclerosis Read More

New Therapy Targets Skin and Atherosclerosis in Psoriasis Read More

Half of MCI Patients With Amyloid on PET Convert to AD Read More

 
   Pediatric eMedinewS

Extreme Prematurity Linked To Risk For Mental Health Problems
Read More

Early Ketogenic Diet Helps In Some Epilepsy Types Read More

Early Exposure To Smoking May Predict COPD Read More

 
    Microbial World: The Good and the Bad they do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity)

Minimizing the harm caused by resident normal oral bacterial flora

Our diet consists of carbohydrates, fats, proteins, vitamins, minerals and trace elements. Carbohydrates (Starch, glucose, sucrose, fructose) are broken down by bacteria, lactic acid is produced and as a result the pH in mouth drops to 4–5. This acid and the low pH harm the enamel and dentine and caries develops. Hence, a carbohydrate–rich diet is cariogenic. Proteins are important for matrix components of enamel, dentin and cementum. A low protein diet causes weakness of these structures, increase in cariogenic activity and defective matrix formation.

Fats in diet are rather good as they decrease the cariogenic activity. An in vitro experiment wherein oleic acid was applied on the tooth and this tooth was placed in a mixture of saliva plus acid, the result showed less decalcification of this tooth compared to control tooth without application of oleic acid. Inclusion of cod liver oil in diet reduces cariogenic activity.

Another thing which we can do is reduce the caries causing bacterial load in the oral cavity. Mutans streptococci and lactobacilli involved in causing caries can be reduced by oral application of chlorhexidine containing gels in individuals at risk. The chlorhexidine gels have been shown to be safe.

To sum up: Infections caused by resident oral bacterial flora can be prevented by drinking enough water/fluids to ensure good salivary flow; take balanced diet containing less carbohydrates/avoid eating sticky carbohydrate rich foods; maintain good general health; maintain good oral health; maintain healthy life style and consult Dental surgeon for any specific interventions which may be required in individual cases. Use oral rinse and chlorhexidine containing gels as recommended by Dental Surgeons.

For comments and archives

 
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    Legal Question of the Day

(Dr. M C Gupta (Former Professor and Dean))

Question by Mr Vivek Chabra: What is the legal standing of a summon which comes to a doctor’s address for a case in which he has made an MLC 10 years back. The doctor has moved on to become an NRI and the registered summon is received by the mother or brother. The NRI doctor cannot come all the way down due to short notice and expenses of traveling. What are the legal implications?

Court summon has sent a summon in respect of an MLC prepared 10 years ago, asking the doctor to appear but he lives abroad now. What to do?

QUESTION—A doctor prepared an MLC 10 years ago. Later he went abroad and became an NRI. A court summon was recently sent to his home address in India and was received by the relatives. He cannot come from abroad for court appearance. What are the legal implications?

ANSWER—

  1. MLC record does not contain the home address of a doctor. The MLC was most likely made by the doctor in discharge of his official duties while he was working in the hospital concerned. The court probably asked the state/police to summon the doctor as witness. The police most likely went to the hospital, who probably found from their service records the home address of the doctor and supplied the same to the police.
  2. The summon should not have been received by the relatives when the doctor is not living at the address in the summon. If the relatives told the process server (the person who brought the summon) that the doctor lived abroad, he should not have delivered the summon to his relatives and should have told this fact to the concerned authorities.
  3. It is everybody’s duty to assist in the proceedings of the court. The duty to assist the court lies primarily on the hospital where the MLC was made. If the doctor who made the MLC is not available for any reason, it is the duty of the hospital to offer to send another doctor, preferably from the FMT department, to assist the court as a witness.
  4. Now that the summon has been received by the relatives, the person who received the summon should appear before the court and inform it about the present address of the doctor for necessary action. The court would most likely ask the hospital to send somebody else as expert witness. If the court feels necessary, it can order for a video conference to be arranged with the doctor living abroad.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with non–responding cough.
Dr. Bad: It may be TB.
Dr. Good: Rule out acidity.
Lesson: Chronic cough along with dysphonia/hoarseness, globus pharyngeus, mild dysphagia, chronic cough and nonproductive throat clearing are often important otoaryngologic manifestations of occult or silent GERD. (Laryngoscope 1991;101:1)

For comments and archives

Make Sure

Situation: A–28–year old male presents with increased frequency and occasional blood in urine. Examination of urine shows sterile pyuria.
Reaction: Oh my God! Why didn’t you check for TB?
Lesson: Make Sure to rule out TB in patients with frequency, dysuria, hematuria. Sterile pyuria is the first clue to diagnosis.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Whatever is at the center of our life will be the source of our security, guidance, wisdom, and power. ~ Stephen Covey

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Multiple myeloma (MM)

MM may first be detected during routine wellness testing, showing up as an abnormal total protein level, an elevated calcium level, a low white or red blood cell count, and/or moderate to large amounts of protein in the urine.

Tests used as a follow–up to abnormal routine tests and to help diagnose the disease may include one or more of the following: Protein and Immunofixation Electrophoresis. These tests are used to diagnose and monitor multiple myeloma.

Bence Jones protein (free light chains) can be detected in the urine of some patients with multiple myeloma. The sample tested is usually a 24–hour urine because the total amount of Bence Jones protein in 24 hours is related to the amount of tumor that is present. Either the kappa or lambda light chains (but not both in the same patient) may be measured to help diagnose multiple myeloma and monitor the effectiveness of treatment.

Other tests like Serum free light chains (FLC), Quantitative Immunoglobulins. The multiple myeloma protein will be an IgG, IgA or, rarely, an IgD or IgE immunoglobulin.

 
    Mind Teaser

Read this…………………

In ulcerative coilitis with toxic megacolon lowest rate of recurrence is seen in

a) Complete proctocolectomy and Brook's ileostomy
b) Ileo rectal anastomoses
c) kock’s pouch
d) Ileo anal pull through procedure

Yesterday’s Mind Teaser: True about Ulcerative Colitis with malignancy

a) It has a better prognosis
b) Is related to disease activity
c) Is related to duration of ulcerative colitis
d) Malignancy is more in anorectal ulcerative colitis

Answer for yesterday’s Mind Teaser: c) Is related to duration of ulcerative colitis

Correct answers received from: Dr. Rachna Tucker, Dr.Ragavan Sivaramakrishnan Moudgalya, Dr. P. C. Das, DrValluriRamarao., Dr. Thakor Hitendrsinh G, Raju Kuppusamy, Dr.Chandresh Jardosh

Answer for 21st March Mind Teaser: a) Lignin
Correct answers received from: Arshad Hussain

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

TEACHER: George, go to the map and find North America.
GEORGE: Here it is!
TEACHER: Correct. Now, class, who discovered America?
CLASS: George!

 
    Medicolegal Update

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

Legal medicine: Doctor in witness box under oath

When a doctor is called in witness box of Court of Law, Oath has to be administered before he tenders his evidence.

A doctor as witness while administered the oath has to repeat, while standing… ‘the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth, so help me the almighty God".

If a Doctor wishes to give his evidences on solemn affirmation, he has to say that I solemnly affirm that the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth.The main objective of the oath is to find truthful statement and if any doctor/witness speaks a lie after administration of oath he is liable for punishment of perjury a criminal offence in our country as well as abroad. The Medical opinion of the doctor must be supported by reason/science and it is the reasons and not ipse dixit which is of importance in assesing the merit of the doctor’s opinion in the court of law.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Do not ignore anxiety attacks

Do not ignore attacks of anxiety or irritability as these may be an indication of underlying hyperfunctioning of a thyroid, a butterfly–shaped gland in the middle of the neck, located below the larynx (voice box) and above the clavicles (collarbones), said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

The thyroid produces two hormones, triidodothyronine (T3) and thyroxine (T4) that regulate how the body uses and stores energy (also known as the body’s metabolism). Thyroid function is controlled by a gland in the brain, known as the pituitary. The pituitary produces thyroid stimulating hormone (TSH), which stimulates the thyroid to produce T3 and T4.

When the thyroid hyper functions, it produces too much thyroid hormone. When this occurs, the body’s metabolism is increased, which can cause a variety of symptoms.

Most people with hyperthyroidism have symptoms, including one or more of the following:

  • Anxiety and irritability
  • Weakness (in particular of the upper arms and thighs, making it difficult to lift heavy items or climb stairs)
  • Tremors (of the hands)
  • Perspiring more than normal
  • Difficulty tolerating hot weather
  • Rapid or irregular heartbeats
  • Fatigue
  • Weight loss in spite of a normal or increased appetite
  • Frequent bowel movements.
  • In addition, some women have irregular menstrual periods or stop having their periods altogether. This can be associated with infertility.
  • Men may develop enlarged or tender breasts, or erectile dysfunction, which resolves when hyperthyroidism is treated.
 
    Readers Response
  1. Sir i am serving in state health service I have seen the working condition in rural area they are horrible no work culture no accommodation, many doctors used to live in 10×10 room, cook food them selves they can not keep their family over there no administrative power, I have not seen any government has taken any good step in 14 yrs of my service, all these discussions are done in AC room in new delhi or state capitols. for government IAS and pcs are more important doctors are never in their priority list. Dr Sundeep Nigam.
 
    Forthcoming Events
Dr K K Aggarwal

BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
    eMedinewS Special

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

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

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

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

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    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