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 Workshop on Stress Management and How to be Happy and Healthy

 
    Dr KK Aggarwal with Aamir Khan …

ASAR–Aamir Khan & Dr KK Aggarwal on Satyamev Jayate Watch Video
Docs vs Aamir Khan Headlines today 9th June 2012 7.30pm Watch Video
Aamir Khan Workshop with kids on dangerous areas Watch Video
DR KK Aggarwal on Doctor Bhagwan Hai ya Shaitan Watch Video

 
  Editorial …

23rd June 2012, Saturday

H5N1 Bird Flu Pandemic Just Three Mutations Away  

Influenza A virus subtype H5N1, also known as "bird flu", A(H5N1) or simply H5N1, is a subtype of the influenza A virus which can cause illness in humans and many other animal species. As per scientists the devastating bird flu H5N1 pandemic seems close to be a real threat and is just "three mutations" away from evolving into a strain that could easily transmit from human to human.

The papers revealed with only five mutations (amino acid substitutions), or four mutations plus reassortment, bird flu can become transmissible between mammals -- and potentially humans. Currently, bird flu can be transmitted from birds to humans, but not from humans to humans. The findings were published in the journal Science.

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

Box warning on label as well as package insert and other promotional literature of formulations containing Nimesulide

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Bimaare Ek Ilaj Anek

All pathy consensus organized by Heart Care Foundation of India in association with All India Radio

 
Dr K K Aggarwal
 
    National News

Suicide may soon be leading cause of death in India, reveals study

NEW DELHI: Four of India’s southern states — Tamil Nadu, Andhra Pradesh, Karnakata and Kerala — that together constitute 22% of the country’s population recorded 42% of suicide deaths in men and 40% of self–inflicted fatalities in women in 2010. Maharashtra and West Bengal together accounted for an additional 15% of suicide deaths. Delhi recorded the lowest suicide rate in the country. In absolute numbers, the most suicide deaths in individuals, aged 15 years or older, were in AP (28,000), Tamil Nadu (24,000) and Maharashtra (19,000). The first national study of deaths in India, published in the British Medical journal The Lancet on Friday, says that suicide has become the second–leading cause of death among the young in India. Of the total deaths by suicide in individuals aged 15 years or older, about 40% suicide deaths in men and about 56% in women occurred in individuals aged 15–29 years. Suicide deaths occurred at younger ages in women (average age 25 years) than in men (average age 34 years). Educated persons were at greater risk of completing a suicide. The risk of completing a suicide was 43% higher in men, who finished secondary or higher education, in comparison to those who had not completed primary education. Among women, the risk increased to 90%. (Source: TOI, Jun 22, 2012)

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 re build 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

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

FDA panel nixes semuloparin

An FDA advisory committee has overwhelmingly voted against the approval of semuloparin for prophylactic prevention of venous thromboembolism (VTE) in cancer patients undergoing chemotherapy. (Source: Medpage Today)

For comments and archives

PAP–NAPs may help reluctant CPAP patients

For patients resistant to positive airway pressure therapy (PAP), a "PAP–NAP" may boost compliance, a study suggests. The PAP–NAP procedure is a relatively new offering in some sleep centers. It consists of a daytime PAP session lasting up to 2 hours, during which a technologist or therapist works 1–on–1 with the patient, addressing specific needs to enhance continuous PAP (CPAP) comfort and tolerability. At SLEEP 2012: Associated Professional Sleep Societies 26th Annual Meeting, Jerald Simmons, MD, of Comprehensive Sleep Medicine Associates, Houston, Texas, and colleagues reported results of a retrospective study of 76 consecutive patients who underwent PAP–NAPs in their sleep centers. (Source: Medscape)

For comments and archives

IFN–gamma release assay favored for finding latent TB in pregnancy

The interferon–gamma release assay (IGRA) is more specific, at least as sensitive, and may better predict disease progression than the tuberculin skin test in pregnant women at risk of exposure to tuberculosis, according to a report this month in Obstetrics & Gynecology. (Source: Medscape)

For comments and archives

Exercise still needed after liposuction

Liposuction can help get rid of muffin tops, love handles, and other pockets of fat. But new research shows that removing fat from your abdominal area may cause you to gain dangerous visceral or belly fat. This type of fat is stored around the organs deep within your abdomen, and it increases your risk for heart disease and diabetes. That’s the bad news. The good news is that regular physical activity can help counteract this effect. That news appears in the July issue of the Journal of Clinical Endocrinology and Metabolism. (Source: Medscape)

For comments and archives

Hospitalizations, survival rates rising for centenarians

The eldest members of America’s growing aging population are being hospitalized at higher rates but are showing newfound resilience, with the vast majority surviving serious infections and even heart attacks during their hospital stays, a study shows. Anant Mandawat, AB, of the Departments of Internal Medicine at Yale School of Medicine, New Haven, Connecticut, and Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues report their findings in a research letter published online on June 18 in the Archives of Internal Medicine. (Source: Medscape)

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on Preventing Prostate Cancer in English: http://youtu.be/vKri2_2elr8 via @youtube

@DeepakChopra: Be kind to yourself and others. Come from love every moment you can.

 
    Spiritual Update

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

Bhoot, Pret and Pishaach

In Mythology, ‘Bhoot’ means the memories of known people whose unfulfilled desires keep on disturbing us. ‘Pret’ means the memories of unknown people whose unfulfilled desires keep coming to our mind during sleep and disturbing us. These unfulfilled desires of unknown people are instances, which we may have forgotten but still reach us through the cloud internet. When these memories when start disturbing our day to day life, they are defined as Pishaach.

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 are chocolate cysts?

Endometriosis may grow on the surface of the ovary as implants or invade inside the ovary and develop a blood–filled cyst called an endometrioma, or a "chocolate cyst." Chocolate cysts are so named because over time the blood they contain darkens to a deep reddish brown color. These cysts may be as small as a pea or grow to be larger than a grapefruit.

For comments and archives

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

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

Blood warmers

Patients who receive refrigerated blood at rates faster than 100 mL/minute for 30 minutes have an increased incidence of cardiac arrest as compared with a control group receiving blood warmed to 37°C. Rapid infusion of large volumes of cold blood can lower the temperature of the sinoatrial node to below 30°C, at which point ventricular arrhythmias occur. Transfusions at such rapid rates generally occur only in the operating room or trauma settings. There is no evidence that patients receiving 1 to 3 units of blood over several hours have a comparable risk of arrhythmias; therefore, routine warming of blood us bit recommended.

Several types of blood warmers are available: thermostatically controlled water baths; dry heat devices with electric warming plates; and high–volume countercurrent heat exchangers with water jackets. Warming devices must not raise the temperature of blood above 42°C. devices should have a visible thermometer and, ideally, and audible alarm that sounds before the 42°C limit is exceeded. It is helpful for the standard operating procedure for warming blood to include guidelines on performing temperature and alarm checks, and instructions on what action to take when warmers are out of range.

Conventional microwave ovens and microwave devices for thawing plasma are not designed for warming blood and can damage red cells.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

Why women cry

One day, a young boy asked his Mom. "Why are you crying?" "Because I’m a woman" she told him.
"I don’t understand," he said. His Mom just hugged him and said, "And you never will, but that’s okay."

Later the little boy asked his father, "Why does Mom seem to cry for no reason?" "All women cry for no reason" was all his dad could say.

The little boy grew up and became a man, still wondering why women cry. Finally, he put in a call to God.

When God got back to him, he asked, "God, why do women cry so easily?" God answered, "When I made woman, I decided she had to be special. I made her shoulders strong enough to carry the weight of the world, yet her arms gentle enough to give comfort. I gave her the inner strength to endure childbirth and the rejection that many times will come, even from her own children. I gave her a hardness that allows her to keep going and take care of her family and friends, even when everyone else gives up, through sickness and fatigue, without complaining. I gave her the sensitivity to love her children under any and all circumstances, even when her child has hurt her badly. She has the very special power to make a child's boo–boo feel better and to quell a teenager’s anxieties and fears.
I gave her strength to care for her husband, despite faults, and I fashioned her from his rib to protect his heart. I gave her wisdom to know that a good husband never hurts his wife but sometimes tests her strengths and her resolve to stand beside him unfalteringly.

For all of this hard work, I also gave her a tear to shed. It is her’s to use whenever needed and is her only weakness." "When you see her cry, tell her how much you love her and all she does for everyone. And even though she may still cry, you will have made her heart feel good." "She is special!"

For comments and archives

 
  Cardiology eMedinewS

Higher salt intake ups vascular damage markers Read More

Adding markers adds little to CV prediction Read More

 
  Pediatric eMedinewS

More parents delaying vaccines; most children never catch up Read More

Cycled lighting eases preemies’ fussing and crying Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A female with rheumatoid arthritis became pregnant while taking leflunomide.
Dr. Bad: You can continue to take it.
Dr. Good: Stop it immediately.
Lesson: In women with rheumatoid arthritis who become pregnant while taking leflunomide, healthy pregnancy outcomes usually occur, if the drug is discontinued at the earliest and a cholestyramine drug elimination procedure is done (Arthritis Rheum 2010;62:1494)

For comments and archives

Make Sure

Situation: A dengue patient with BP 100/90 developed shock.
Reaction: Oh my God! Why was rapid fluid challenge not given?
Lesson: Make sure that pulse pressure (upper minus lower blood pressure) is maintained above 40 in all patients with dengue

For comments and archives

 
    Health News Bulletin

Rare Hunter syndrome haunts Kolkata boy

The Times of India, Subhro Niyogi

Kolkata: Afflicted with a rare disease that requires a fortune to treat, the parents of a 10–year–old boy in Shibpur, Howrah, are groping in the dark even as their son gradually slips into an abyss. Arian Chowdhury is suffering from the Hunter syndrome, a genetic disease caused by mutation that leads to deposition of biomolecules in cells. As cells get progressively clogged, organs begin to fail, causing death. One in 2, 00,000 suffers from the disease. Except in developed nations, most patients die young with parents unable to afford the lifelong treatment of Rs. 1 crore a year. In severe cases, children survive till 11–12 years. Arian’s case is less severe. Doctors say he may live till 17–18. "His bones have become stiff and he is unable to bend his fingers or toes. There is facial deformity and his liver has enlarged. But his brain is still fine. The only way to arrest his condition is by injecting a critical enzyme that is deficient in his body," said child specialist and Institute of Child Health director Apurba Ghosh.

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  Quote of the Day

(Dr GM Singh)

Real glory springs from the silent conquest of ourselves. Joseph P. Thompson

 
    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Antidiuretic hormone

  • To help detect, diagnose, and determine the cause of antidiuretic hormone (ADH) deficiency or excess
  • To investigate low blood sodium levels (hyponatremia)
  • To distinguish between the two types of diabetes insipidus
 
    Legal Question of the day

(Prof. M C Gupta, Advocate & Medicolegal Consultant)

Q. I think the courts award too high compensation to patients and this will cripple the doctors. Am I right?

Ans.

  1. I don’t think you are right. The compensation awarded by Indian courts is modest and realistic. The highest compensation awarded so far by courts in India is on the following lines:
    1. Malay Kumar Ganguly case/Dr. Kunal Saha case—About Rs. 1.8 crore awarded by the SC. The NC had dismissed the complaint.
    2. Dhanaka case (against Nizam Institute)—NC awarded 15.5 lakh. The SC enhanced it to 1 crore.
    3. National table tennis player V Chandrasekhar was awarded Rs 19 lakh by the Supreme Court in February 1995 against Apollo Hospital, Chennai.
  2. A contrast is evident compared to the Western countries. In England, British actress Leslie Ash was awarded 5 million pounds (a little over Rs 37 crore) as compensation. She had brought the claim after contracting an MSSA (methicillin–sensitive staphylococcus aureus) infection while being treated by the Chelsea and Westminster Hospital in London for two cracked ribs in April 2004. As a result of the infection, she suffered severe mobility problems and even after four years walked with the aid of a stick. In contrast, Dr. Kunal Saha’s wife had died due to negligence. Dhanaka became paralysed and could not move. He died a few years after the judgment. Chandrashekhar suffered from partial paralysis and could not walk.
  3. The claim for compensation for more than Rs. One crore has to be filed in the NC. I know through personal experience that the NC has become very strict now–a–days in admitting complaints where the claimed amount is too much inflated. They persuade the complainant to go to the state commission where the limit is 20 lakhs to one crore.
  4. Courts see to it that individual doctors are not made to suffer. As a general guideline, the amount is awarded against the hospital and not against the individual doctor. For example, I quote the following from the Nizam Hospital/Dhanaka judgment—"In the result, OP1 to OP5 are liable to pay the compensation as determined hereunder. Since, however, OP1 is the institution in which OP2 to OP5 are employed, we hold that OP1 is singularly responsible for payment of compensation."
  5. Even in the case of individual practitioners, there is no reason why they should be worried about paying compensation as long as they have bought a professional indemnity policy, which is not costly at all.
  6. It is worth commenting that a factor that went against the hospital in the Nizam Institute case was that the hospital did not produce full medical records before the court and this led to an adverse inference against the hospital.
  7. My personal, and logical, belief is that the very process of keeping proper records will not only help the doctors/hospital win the cases but will also result in improved practices being employed in the hospital. There is no reason why every hospital should not have a monthly meeting where actual and potential medico–legal cases should not be discussed in detail. If we can have case presentations, seminars and CPCs, why should we not have a monthly MLCC (medico–legal case conference)? It is high time the officers in charge of hospitals, including teaching hospitals, whether government or private, should start thinking on these lines.

For comments and archives

 
  Microbial World: The Good and the Bad They Do

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

Injectable polio vaccine (IPV)

IPV contains inactivated polio virus. Doctors often advise parents to first give their child the IPV so that the baby develops antibodies against the disease, and then OPV, which will provide immunity to a larger community. This way not only is your child protected, but you can do your bit to make India polio–free. The vaccine is safer, induces humoral (systemic) immunity and no mucosal local immunity, immunity induced is shorter lasting than live attenuated vaccine.

 
    Mind Teaser

Read this…………………

Nurse Anna is aware that early adaptation of client with renal carcinoma is:

a. Nausea and vomiting
b. Flank pain
c. Weight gain
d. Intermittent hematuria

Yesterday’s Mind Teaser: An 83–year–old woman has several ecchymotic areas on her right arm. The bruises are probably caused by:

a. Increased capillary fragility and permeability
b. Increased blood supply to the skin
c. Self inflicted injury
d. Elder abuse

Answer for Yesterday’s Mind Teaser: a. Increased capillary fragility and permeability

Correct answers received from: Dr Deepti Dongaonkar, Rajiv Kohli, Dr Sushma Chawla, Dr Kanta Jain, Raju Kuppusamy, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G.

Answer for 21st June Mind Teaser: c. Permeability of capillary walls
Correct answers received from: Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

A newly married husband saved his wife’s mobile number on his mobile as "My life".
After one year of marriage he changed the number to "My Wife".
After 2 years of marriage he changed the number to "Home"
After 5 years of marriage he changed the number to "Hitler".
After 10 years of marriage he changed the number to "Wrong Number".

 
    Medicolegal Update

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

Difference between antemortem and postmortem bruises

  • Some people bruise easily, whereas others may have tougher skin tissue. Apply a cold compress to the bruise for at least 10 minutes to reduce swelling or the amount of bruising after an injury,
  • In some cases of brought dead or dead in arrival the doctor attending the case in emergency may be confused or is not be able to differentiate between antemortem bruise and postmortem artifact and the postmortem bruise is entered in MLC as injuries. I have seen such cases in AIIMS during autopsy.
  • Close examination by doctor in emergency may help to differentiate because in antemortem bruises there is swelling and damage to epithelium, coagulation and infiltration of the tissues blood and color changes. These signs are always absent in postmortem bruises.
  • It is seen that contusions and abrasions produced immediately after death show a very low degree of changes.
  • Appreciable bruising does not occur after 2–3 minutes of death due to arrest of heart and blood circulation, but by using great violence small bruises can be produced up to 3 hours after death where the tissue can be forcibly compressed against the bone or if the body is dropped on the ground from a height or from transport trolleys or running vehicle.
  • Some of the evidences of bleeding are seen without history of trauma due to tearing of small veins in the skin when the body is lifted from the scene of death and transportation handling and the same is called postmortem artifact.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Kidney patients more at risk for future heart attacks

Chronic kidney disease patients with kidney function less than 60% have now been added in the list of criteria for defining people at highest risk for future heart attacks, said Padma Shri and Dr B C Roy Awardee Dr KK Aggarwal President Heart Care Foundation of India.

In a large cohort Canadian study published in The Lancet led by Dr Marcello Tonelli at University of Alberta, patients with only chronic kidney disease had a significantly higher rate of heart attacks than those who only had diabetes. Those who had already had a heart attack had the highest overall rate of heart attacks.

Chronic kidney disease should be regarded as a coronary heart disease risk equivalent, similar to diabetes, as patients with the condition have high rates of cardiovascular events, particularly when they also have proteinuria.

When chronic kidney disease was defined more stringently with kidney function less than 45% and increased proteinuria, the rate of first heart attack was higher in those with both chronic kidney disease and diabetes than in those with either disorder alone.

 
    Readers Response
  1. Let us move forward from this fiasco of Aamir Khan Satyamev Jayate. Kuch zyada hi bhav de diya hai. We have more important things in life and more important duties to do, apne patients par dhyan de they are our lifeline. Vivek Kumar, Varanasi.
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal


Dr K K Aggarwal

IYCNCON 2012

All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

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

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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