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eMedinewS is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
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

  Editorial ...

23rd October 2010, Saturday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Perfect Health Mela to open for the public today

The 17th MTNL Perfect Health Mela will open to general public today at 8 am. The 10-day Mela, an annual event of the Heart Care Foundation of India, will end on 31st October. The Mela is organized in association with various departments of Government of Delhi. It will be a blend of health exhibitions, competitions, checkups, entertainment incorporating all pathies under one roof.

The Mela will be a perfect picnic spot for the public. Competitions like Inter School, Inter Nursing School/College, Inter Dancing School, Inter School for Children with Special Needs etc. are being organized during the Mela.

Seminars on ‘Women Empowerment’ and another on ‘Global Warming and Ethnic Crisis’ are also being organized as part of the Mela activities.

There will be special sessions for general practitioners on ‘Chest Pain’ and ‘Obesity’ on the 24th and 31st October, respectively, 2010. On 30th there will be a lively cultural evening for the doctors.

I take this opportunity to invite you all to the Mela and especially request my doctor colleagues to offer community service OPDs at the Mela venue.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
  Chikungunya Update

(RP Vashist, Consultant and Head Public Health, Govt. of Delhi)

Morbidity of Chikungunya

Chikungunya is a self-limiting illness. The causes of prolonged morbidity include:

  • Severe dehydration
  • Electrolyte imbalance and
  • Loss of glycemic control

Recovery is the rule. In about 3 to 5% cases, there may be incidence of prolonged arthritis

  Photo Feature (from the HCFI Photo Gallery)

 Padma Awardees’ Meet 

The 4th meeting of the Padma Awardees’ was held on Tuesday, 19th October, 2010 at Hotel Hans Plaza, New Delhi. The meeting was chaired by Dr. Ranjit Rai Choudhary, Member, Board of Governors, Medical Council of India.

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Conventional and chest-compression-only cardiopulmonary resuscitation for children

An observational study found that children who received conventional CPR were significantly more likely to have favorable neurologic outcomes at one month than those who received Compression-only cardiopulmonary resuscitation.

(Ref; Kitamura T, et al. Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. Lancet 2010;375:1347).

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Eastern India leads the pack in female tobacco users: Survey

Northern India has the least number of female tobacco users while eastern India leads the pack, according to India's first-ever adult tobacco survey. Around 20.3% women in India -- at 15 years and above -- use some form of tobacco, says the large scale survey conducted jointly by CDC Atlanta, IIPS Mumbai, WHO and the Union health ministry. However, northern and southern India record the lowest prevalence -- 3.7% and 13.7%, respectively. While one in five women in central India consume tobacco, the prevalence is one in three in eastern India. (Source: The Times of India)

Cabinet nod for NIMHANS' exalted status

The Union Cabinet has approved the Ministry of Health and Family Welfare's proposal to declare National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, as an Institute of National Importance on the lines of All India Institute of Medical Sciences, New Delhi; Post Graduate Institute of Medical Education and Research, Chandigarh; and Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry. The Cabinet also approved introduction of the "National Institute of Mental Health and Neuro Sciences Bangalore Bill, 2009" in Parliament. "This will facilitate NIMHANS to develop patterns of teaching, with the flexibility to device new courses, constantly evolving syllabi. The Institute will be able to take up new courses that are required and are not currently part of the MCI approved courses," said a statement issued by the government. (Source: The Times of India)

  International News

(Rajat Bhatnagar)

A new order for CPR, spelled C-A-B

The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in the journal Circulation.

Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing). "For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim's airway by tilting their head back, pinching the nose and breathing into the victim's mouth, and only then giving chest compressions," said Michael Sayre, M.D., co-author of the guidelines and chairman of the American Heart Association's Emergency Cardiovascular Care (ECC) Committee. "This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away."

(Dr Monica and Brahm Vasudev)

Hormone replacement therapy after menopause may worsen breast cancer

The Women's Health Initiative reports today that among post-menopausal women, the use of estrogen and progestin is not only linked to an increased risk of breast cancer, but the kind that kind of cancers that have higher fatality rates.

Fish oil supplements may not boost babies' cognitive development or prevent postpartum depression

A study published Oct. 20 in the Journal of the American Medical Association suggests that the DHA supplements taken by pregnant women show no clear cognitive benefit to their babies.

Screening newborns for hearing loss may improve lives of deaf children

Screening newborns for hearing loss, which allows for early diagnosis and therapy can significantly improve the lives of deaf and hearing-impaired children, who in the past often weren't diagnosed until age 2 or 3, according to a study in Journal of the American Medical Association.

  Hepatology Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

Is liver transplantation the solution for biliary atresia?

Liver transplantation is an option which is becoming increasingly useful to victims of certain liver diseases. The survival rates for transplant recipients have increased dramatically with improved surgical techniques and the development of new drugs which help overcome the problem of organ rejection.

In children with biliary atresia, liver transplantation is generally not attempted until the Kasai procedure has been performed. If this operation is not successful, and before complications of the resulting cirrhosis become severe and life threatening, liver transplantation may be attempted. It has been successful in numerous cases. However, as in all organ transplantation, success depends greatly upon the timely availability of suitably matched organs for donation, the time factor involved (a donated liver must be used within 16 hours for the operation to be successful), and other factors which are only now being investigated. The use of reduced-size and living-related transplants are aiding in the timing and availability of suitable donor organs.

  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

How long will it take after testing, before diagnosis is made and treatments begin?

There is no universal answer to this question except, "it depends." In some cases, surgery may be required: to remove endometrial lesions, to repair a septate uterus, to repair a man's varicocele. In other cases, treatment may begin the very next cycle. Couples can hasten the process by timing their first visit with a fertility expert to coincide with the woman's cycle. The first round of hormone tests should be done on either Day 2 or Day 3 of her cycle. If that first appointment is on Day 10 of her cycle, she'll have to wait until the next cycle to complete the testing process.

  Evidence-Based Medicine

Dr N P Singh (Nanu), Director Professor of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi

Endarterectomy is still safer than stenting in symptomatic carotid stenosis but stenting might be an acceptable alternative in patients younger than 70

In several large trials involving patients with symptomatic carotid artery stenosis, endovascular stenting carried greater periprocedural risk than open endarterectomy, but no single trial was large enough to identify subgroups that might be at particular risk with either procedure. To gain statistical power, investigators combined patient-level data from three such trials, yielding a sample of 3454 patients with moderate-to-severe stenosis who were assigned randomly to stenting or endarterectomy.
In an intent-to-treat analysis, significantly more patients assigned to stenting than to endarterectomy reached the primary outcome of any stroke or death within 120 days after randomization (8.9% vs. 5.8%) — a difference that was driven primarily by nondisabling ischemic strokes. Patients younger than 70 had similar outcomes with both treatments, whereas those 70 and older had significantly more primary outcome events with stenting than with endarterectomy (12.0% vs. 5.9%). No significant differences were seen in any other predefined subgroup.
Comment: Unless contraindications to surgery exist, endarterectomy remains the treatment of choice for patients with symptomatic carotid artery stenosis. This study suggests that stenting might be an acceptable alternative in patients younger than 70. But another concern is that recurrent stenosis might be more common after stenting than after endarterectomy — an effect that would be important to these younger patients and that cannot be discerned in these short-term data.
(Source: Journal Watch General Medicine October 14, 2010)

(Ref: Carotid Stenting Trialists' Collaboration. Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis: A preplanned meta-analysis of individual patient data. Lancet 2010 Sep 25; 376:1062)

  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What is Medical poisoning?

Abuse of drugs, chemicals or plants

Sometimes people are poisoned by medicines given to them by a doctor or another health care worker. They may be given the wrong medicine or be given the wrong dose of the right medicine. There are many reasons why this can happen.

  • The doctor may not know the patient is allergic to a medicine, or may prescribe the wrong dose because of a mistake in measuring it.
  • People may take drugs to change their mood or behavior, to feel relaxed, or to get more energy. This is called drug abuse because it is not a medical use of the drug. Some people abuse drugs such as heroin, cocaine or barbiturates. Drinking too much alcohol is an important kind of drug abuse. Other substances may produce some of the same effects.
  • Some people breathe in chemicals such as glue, paint, nail varnish remover, cigarette lighter gas, petrol or dry-cleaning fluid. This is sometimes called solvent sniffing or solvent abuse. People may breathe fumes from a cloth soaked in liquid or put chemicals or glue into a plastic bag and breathe deeply from the bag.
  • In many societies, people use plants or fungi for their hallucinogenic, stimulant or relaxing effects. Some plants may be eaten raw; others are cooked, made into drinks, or smoked. Two plants commonly used in this way are tobacco and cannabis.

Many of the drugs, chemicals and plants that are abused are poisonous if people take too much at one time or use them for many months or years. For example, alcohol causes liver damage, smoking causes lung cancer and cannabis can affect people's memory.

  Medi Finance Update

Taxation Tips

Any property transferred by an individend to his son-in-law or daughter-in-law of his brother do not attract provisions of section 64(1).
Provisions of Section 64 are not attracted if gifts are made by Husband to the wife, minor child or daughter-in- law of any of its male or female member.

  Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Demeclocycline Liquid Oral preparations

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

ASMA - Anti-Smooth Muscle Antibody

To help diagnose chronic active autoimmune hepatitis and distinguish it from other causes of liver injury.

mtnl perfect health mela
emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A patient with dengue had itchy rash.
Dr Bad: It’s an allergy
Dr Good: It’s a manifestation of the dengue fever.
Lesson: Itchy rash can be present in dengue or Chikungunya

Make Sure

Situation: A patient on treatment for tension type headache was found to have brain tumor on CT scan.
Reaction: Oh My God! Why was brain tumor not suspected early?
Lesson: Make sure that all patients with tension-type headache are investigated thoroughly to rule out brain tumor.

Quote of the Day (Dr G M Singh)
"Our doubts are traitors, and make us lose the good we oft might win, by fearing to attempt." William Shakespeare

Mnemonic of the Day (Dr Varesh Nagrath)

6PD deficiency

  Mind Teaser

Read this…………………

little LARGE
little LARGE
little little
little LARGE

Answer for yesterday’s Mind Teaser: "Highway overpass"

Correct answers received from: Dr R S Bajaj, Dr. Susheela Gupta,  Dr. K. V. Sarma, Dr. K. P. Rajalakshmi, Dr Jayashree B Keshav, Dr  Muthumperumal Thirumalpilla, Dr. G. Padmanabhan, Dr Virender Prakash Gautam, Dr Meera Rekhari, Dr. Shashi Saini, Dr. Prabha Sanghi.

Answer for 21st October Mind Teaser is: "Getting away from it all"
Correct answers received from: Dr Anurag Jain, Dr Virender Prakash Gautam, Dr.Satish Gunawant, Dr S. Upadhyaya, Dr Uma, Dr. K.Raju, Dr. G. Padmanabhan

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

Birthday Gift

A husband went to buy a birthday gift for his wife. Some friends had been invited over that night to celebrate her fortieth, and he wanted to get something special. At the store he spotted some cute little music boxes. One blue one was playing "Happy Birthday." Thinking they were all the same, he chose a red one and had it gift-wrapped. Later, at dinner, he gave it to his wife and asked her to open it..

When she lifted the lid, out came the tune to "The Old Gray Mare, She ain't What She Used to Be!"

  An Inspirational Story

(Contributed by Dr Anupam Sethi Malhotra)

One day a young lady was driving along with her father. They came upon a storm, and the young lady asked her father, “What should I do?"

He said "keep driving".

Cars began to pull over to the side, the storm was getting worse. "What should I do?" The young lady asked? "Keep driving," her father replied. On up a few feet, she noticed that eighteen wheelers were also pulling over. She told her dad, "I must pull over, I can barely see ahead. It is terrible, and everyone is pulling over!" Her father told her, "Don't give up, just keep driving!"

Now the storm was terrible, but she never stopped driving, and soon she could see a little more clearly. After a couple of miles she was again on dry land, and the sun came out. Her father said, "Now you can pull over and get out." She said "But why now?"

He said "When you get out, look back at all the people that gave up and are still in the storm, because you never gave up your storm is now over. This is a testimony for anyone who is going through "hard times".

Just because everyone else, even the strongest, gives up, you don't have to either...if you keep going, soon your storm will be over and the sun will shine upon your face again.

  Readers Responses
  1. Thanks to Dr K K Aggarwal for his excellent work. : Dr Anoop Verma
  Public Forum

(Press Release for use by the newspapers)

 MTNL Perfect Health Mela to open Today

17th MTNL Perfect Health Mela is being organized by Heart Care Foundation of India jointly with various Departments of Delhi Government, NGOs and public sector undertakings from 23rd to 31st October at NDMC Grounds Laxmi Bai Nagar, New Delhi. The Mela will be inaugurated formally today for public at 11 am.

The mela will be an entertainment forum with various academies and organizations putting their shows in the evenings. All through the day different entertaining programs in the form of competitions will be held. The major activities of the Mela will be Swagat (inaugural function), Harmony (inter school festival), Heritage (inter dancing school festival), Divya Jyoti (inter nursing school festival), Medico Masti (inter medical college and college festival), Anmol (festival for children with special needs), Swasthya Pavilion (general and specialty checkups), Health Darbar (public audience with medical experts), Medline (live video conferencing between Delhi & Mumbai doctors interacting with patients),  Bid adieu (valedictory function), Eco-festival (involving various eco school clubs), Jaago India (media festival). A special day will be devoted for the care of women and a Vishwa Dharma Sammellan will be organized in collaboration with World Fellowship of Religions.
The Mela will create awareness about all aspects of health for people from all sections of the society and all walks of life incorporating all pathies under one roof using cost- effective infotainment modules. The focus of the Mela this year is on the “Rising Lifestyle Disorders”.

The mela will be a perfect mix of health checkups and health information through competitions and entertainment.

  Other attractions

  1. Hourly chest compression cardiopulmonary resuscitation (CPR) classes will also be held in the mela. Death is reversible provided chest compressions at the rate of 100 per minute are given over 10 minutes and within 10 minutes of cardiac arrest (of clinical death).
  2. Over 30 colleges including Medical, Pharmacy, Homeopathy and Business schools will be participating in Medico Masti, an inter college festival, in the Mela. In Medico Masti, events like fashion show, choreography, western dance, Indian dance, classical dance, T-shirt painting, pot painting, mehendi, etc will be organised. More than 2000 students from various colleges will be participating in non-stop competitions where prizes will be given on the spot. Students should take this opportunity and come forward to showcase their hidden talent as the mela can prove to be the perfect platform.
  3. Over 1500 nurses from various hospitals, nursing schools and colleges will be participating in the day-long event 'Divya Jyoti' on Friday, 29th October. The event will include competitions like Skit, Painting, Poster making & Slogan writing, Model Making, etc which will be judged by eminent judges. All nursing schools and colleges of the city will be participating in the event. Nurses will also provide free counselling and checkups to the visitors at large.
  4. There will be daily Health Darbars to answer queries from the public. This will be a unique forum as all pathies will be represented under one roof.
  5. 50% discount will be available on all branded drugs.
  6. All basic annual blood tests will be available at a nominal registration fee of Rs 110/- only. The tests will include lipid profile, liver, kidney tests and sugar.
  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

17th MTNL Perfect Health Mela 2010

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists
17th MTNL Perfect Health Mela 2010 day programme
Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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