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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

 
  Editorial …

23rd January, 2011, Sunday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Guidelines Updated for Use of 23–Valent Pneumococcal Polysaccharide Vaccine in Adults

  • New guidelines now include smoking and asthma as indications for which PPSV23 vaccination is recommended.
  • Recommendations remain unchanged regarding revaccination among the adult patient groups at greatest risk for invasive pneumococcal disease (IPD), those with functional or anatomic asplenia and those with immunocompromising conditions.
  • Adults aged 19 to 64 years with chronic or immunosuppressive medical conditions, including asthma, should receive PPSV23.
  • For adults aged 19 to 64 years who smoke cigarettes, PPSV23 administration and smoking cessation guidance are recommended.
  • Unless there are medical indications for PPSV23, routine administration of PPSV23 is no longer recommended for Alaska Natives or American Indians younger than 65 years. However, for Alaska Natives and American Indians aged 50 to 64 years who reside in areas where the risk for IPD is increased, public health authorities may recommend PPSV23 administration in certain situations.
  • At age 65 years, all persons should receive PPSV23 vaccination. Persons given PPSV23 for any indication before age 65 years should be given another dose of PPSV23 at 65 years or older if 5 years or more have passed since their previous dose. Persons who receive PPSV23 at or after age 65 years should receive only a single dose.
  • For most persons for whom PPSV23 is indicated, the ACIP does not recommend routine revaccination. For persons aged 19 to 64 years with functional or anatomic asplenia and for persons with immunocompromising conditions, a second dose of PPSV23 should be given 5 years after the first dose. However, because of uncertainty regarding clinical benefit and safety, the ACIP does not recommend multiple revaccinations.

Underlying medical conditions or other indications for administration of PPSV23 among adults aged 19 to 64 years include the following:

  • Immunocompetent persons with chronic heart disease (excluding hypertension); chronic lung disease including chronic obstructive pulmonary disease, emphysema, and asthma; diabetes mellitus; cerebrospinal fluid leaks; cochlear implant; alcoholism; chronic liver disease, including cirrhosis; and cigarette smoking
  • Persons with functional or anatomic asplenia (sickle cell disease and other hemoglobinopathies; congenital or acquired asplenia, splenic dysfunction, or splenectomy)
  • Immunocompromised persons with congenital or acquired immunodeficiencies (including B– (humoral) or T–lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders other than chronic granulomatous disease); HIV infection; chronic renal failure; nephrotic syndrome; leukemias; lymphomas; Hodgkin's disease; generalized malignancy; diseases requiring treatment with immunosuppressive drugs, including long–term systemic corticosteroids or radiation therapy; solid organ transplantation; and multiple myeloma.

(MMWR Morb Mortal Wkly Rep 2010;59:1102–1106)

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  eMedinewS Audio PostCard

  2nd eMedinewS revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal "Mammography survival benefit"

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

"Fear is that little darkroom where negatives are developed."

Michael Pritchard

 
    Photo Feature (from the HCFI Photo Gallery)

2md eMedinewS Revisiting 2010

Padma Shri and Dr BC Roy National Awardee Dr K K Aggarwal Summing up the major events of the year 2010 in the 2nd eMedinewS revisiting 2010 at Maulana Azad Medical College on 9th January 2011.

 
Dr K K Aggarwal
 
    National News

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

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

Two more test positive for Congo fever

Ahmedabad: The spectre of the Congo fever was revived on Friday with two persons testing positive for the Crimean–Congo Haemorrhagic Fever (CCHF) which has claimed three lives so far. The State Government and the medical fraternity here had heaved a sigh of relief on Thursday as all the 58 samples of the first batch analysed by the Pune–based National Institute of Virology (NIV) had tested negative. The two new positive cases include Rehman, husband of the first victim Amina Momin, State Health Minister Jay Narayan Vyas told journalists on Friday. Meanwhile, a team of experts from Bhopal are checking the cattle in the villages surrounding Kolat from where the first CCHF case was reported. A team from Surat is also engaged in catching rodents which too might be the carrier of the deadly CCHF virus. The medical fraternity here has called for extreme hygiene discipline and physical barriers for preventing the spread of the CCHF infection. The cattle are carriers of the CCHF virus without themselves showing any symptoms, Dr Akhil Mukim told an awareness programme organised by the Gujarat Media Club (GMC). Livestock handlers, slaughter house workers, cattle pound people and hospital staff are most vulnerable groups to be affected by the virus as it spreads through body fluids, Dr Mukim cautioned. (Source: The Pioneer, January 22, 2011)

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC http://www.isfdistribution.com)

Habitual physical activity reduces depressive symptoms and improves emotional well–being

This comprehensive research monitored 5,451 men and 1,277 women, aged 20–88 years and discovered a correlation between cardio–respiratory fitness and reduced depression and enhanced emotional well–being. The subjects engaged in regular walking, jogging and running for their exercise.

(Dr Monica and Brahm Vasudev)

Trial identifies factors for risky coronary lesions

Coronary lesions that cause recurrent events in patients who’ve undergone successful percutaneous coronary intervention often appear mild on angiography. But, results of the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) trial reported in the Jan. 20 issue of the New England Journal of Medicine have shown that these lesions have characteristics that show up on ultrasound. These lesions are also more likely to be thin–cap fibroatheromas and to have a large plaque burden and small luminal area as determined by intravascular ultrasound. According to the researchers, although such lesion characteristics are conducive to the occurrence of a subsequent event, they are not sufficient to predict which atheromas will undergo plaque progression in the intermediate term.

Antioxidants may enhance male fertility

A Cochrane review states that prenatal vitamins may be a good idea for men as well as women. Among couples undergoing fertility treatments, men taking antioxidants were over 4–fold more likely than controls to get their partner pregnant and see a successful live birth, according to Marian G. Showell, of the University of Auckland, New Zealand, and coauthors.

New plaque tracer may give clues to Alzheimer’s

A small study in the Journal of the American Medical Association states that a new contrast agent may be useful in identifying beta–amyloid plaques with PET scans in the brains of living patients. This approach may be helpful in predicting who will develop Alzheimer’s disease.

A new topical drug for head lice

Spinosad (Natroba Topical Suspension 0.9%; ParaPRO) has been given the FDA approval for the treatment of head lice infestations in people aged 4 years and older.

Escitalopram, a non hormonal effective therapeutic option for menopausal hot flashes

As per a new study reported in the Journal of the American Medical Association (January 19 issue), antidepressant treatment with escitalopram, a selective serotonin reuptake inhibitor (SSRI) significantly reduced frequency and severity of menopausal hot flashes compared with placebo.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

How to choose a fertility center?

A couple whose infertility is mostly due to a male factor should seek ART treatment only in a center in which ICSI is available.

For queries contact: banerjee.kaberi@gmail.com

 
    Pediatric Update

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

What is the prevalance of chronic hepatitis C in India?

Most of the reported studies from India seem to suggest a north south divide, wherein genotype 3 predominates in the north, east and west India, whereas genotype 1 is commoner in south India .In two studies from Mumbai the prevalence of HCV in multiple transfused thallasemics was 16.7% and17.5% respectively. In multiple transfused haemophiliac patients, the prevalence of HCV was found to be around 23.9%. In a group of multi–transfused children with varied diagnosis, from Delhi, the prevalence of HCV was 26.6%. The prevalence of HCV was an alarming 92% among IV drug abusers from Manipur. In a study from Hyderabad that comprised of both renal transplant and renal failure patients on haemodialysis, the HCV prevalence was as high as 46%. More recently, a study from Delhi, noted that the prevalence of HCV in 208 patients undergoing haemodialysis was 4.3%. Another report from Hyderabad estimated the prevalence of HCV in their haemodialysis patients to be 13.23%.

 
    Medicolegal Update

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

What is the presumption in the case of conduct of pre-natal diagnostic techniques?

  • Notwithstanding anything in the Indian Evidence Act, 1872 (1 of 1872), the court shall presume unless the contrary is proved that the pregnant woman has been compelled by her husband or relative to undergo pre-natal diagnostic technique and such person shall be liable for abetment of offence under sub–section (3) of section 23 and shall be punishable for the offence specified under that section.
  • 4th month of intrauterine life of fetus: Quickening is nothing but the perception of movement of fetus by mother, it confirms that the mother knows that she is pregnant. Section 316 of Indian Penal Code says that causing death of quick unborn child by act amounting to culpable homicide.
  • 7th month of intrauterine life: Viability
  • 9th month of intrauterine life: Full term fetus
 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. What is the definition (with references) of: Hospital death, Surgical death, Anaesthetic death and Death on Operation table (DOT)?

A.

These are not legal or strict scientific/medical terms and hence, as far as I know, there are no strict definitions and references. From a general legal perspective, the meanings that a court is likely to attach to these terms are as follows:

  • Hospital death: Death of a patient that occurs in a hospital.
  • Surgical death: Death of a patient who was subjected to a procedure by a surgeon.
  • Anaesthetic death: Death of a patient related to administration of anesthesia.
  • Death on Operation table (DOT): Death that occurs while the patient is still on the operation table. This would include deaths that might be attributable to or related to the anesthetic or surgical procedure that was being carried out.
 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Triglycerides

  • Markedly increased triglycerides (>500 mg/dL) usually indicate a nonfasting patient (i.e., one having consumed any calories within 12–14 hour period prior to specimen collection).
  • If patient is fasting, hypertriglyceridemia is seen in hyperlipoproteinemia types I, IIb, III, IV, and V. Exact classification theoretically requires lipoprotein electrophoresis, but this is not usually necessary to assess a patient's risk to atherosclerosis.
  • Cholestyramine, corticosteroids, estrogens, ethanol, miconazole (intravenous), oral contraceptives, spironolactone, stress, and high carbohydrate intake are known to increase triglycerides.
  • Decreased serum triglycerides are seen in abetalipoproteinemia, chronic obstructive pulmonary disease, hyperthyroidism, malnutrition, and malabsorption states.
 
    Medi Finance Update

Regarding any income from assets transferred to spouse, who is liable to be taxed?

When a asset is transferred by an individual to his/her spousefor an insufficient consideration directly, income from such assets shall be deemed to be the income by transferor.

 
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name

Indication

DCI Approval Date

Piroxicam 20mg tab & Paracetamol 500mg tab combikit

For treatment of fever and pain associated with acute upper respiratory tract inflammation, acute musculoskeletal disorders, pain after operative intervetion and following trauma, chronic condition like rheumatoid arthritis, osteoarthritis etc for short term management of acute painful episodes.

19/01/2010

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Our Contributors

  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Seasonal influenza vaccine

Vaccination with recent seasonal influenza vaccines induced little or no cross–reactive antibody response to 2009 H1N1 in any age group.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with liver tenderness had TLC of 18000.
Dr. Bad: It is sepsis.
Dr. Good: It is classical liver abscess.
Lesson: Liver abscess usually has liver tenderness and TLC of more than 15000.

Make Sure

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why didn’t you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

The tortoise and hare, by this time, had become pretty good friends and they did some thinking together. Both realised that the last race could have been run much better. So the tortoise and hare decided to do the last race again, but to run as a team this time. They started off, and this time the hare carried the tortoise till the riverbank. There, the tortoise took over and swam across with the hare on his back. On the opposite bank, the hare again carried the tortoise and they reached the finishing line together. Both the tortoise and hare felt a greater sense of satisfaction than they'd felt earlier.

The moral of the story? It’s good to be individually brilliant and to have strong core competencies; but unless you’re able to work in a team and harness each other’s core competencies, you’ll always perform below par because there will always be situations at which you’ll do poorly and someone else does well.

Teamwork is mainly about situational leadership, letting the person with the relevant core competency for a situation take leadership.

— — — — — — — — — —

Mind Teaser

Read this…………………

right=right

Yesterday’s Mind Teaser: black coat
Answer for yesterday’s Mind Teaser:
Black overcoat

Correct answers received from: Dr Satish Gunawant, Dr Manjesha, Dr Sudipto Samaddar, Dr Rohini Vaswani, Dr K.Raju, Dr Rakesh Bhasin, Dr Chandresh Jardosh,  

Answer for 21st January Mind Teaser: Diamond in the rough
Correct answers received from: Dr Neelam Nath, Dr (Maj. Gen.) Anil Bairaria, Dr Jainendra Upadilla, Dr Rakesh Bhasin, Dr Rajalakshmai Krishnamoorthy, Dr Maneesh Gupta

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr S L Watwani)

Law of the Result

When you try to prove to someone that a machine won't work, it will.

 
    Readers Responses
  1. So enlightening, So knowledgeable, So appreciating, the achievers Hats off to your team. Dr V K Bhatia. drvkbhatia@yahoo.com
 
    Public Forum

(Press Release for use by the newspapers)

Natural food and not Supplements for preventing heart disease

One should take seasonal and locally grown natural foods and vegetables grown out of organic farms said Padma Shri & Dr BC Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. Eating less, dinner lighter than lunch, eating natural and in moderation – are few of the mantras. Eating food supplements can be harmful.

According to the American Heart Association, supplementation with beta carotene and vitamin E, either alone or in combination with each other or other antioxidant vitamins does not prevent heart disease.

High dose vitamin E supplementation (400 IU/day) may be associated with an increase in all–cause mortality.

Supplementation with vitamin C does not prevent second heart attack.

Beta carotene supplementation may be dangerous and should be discouraged.

Vitamin E supplementation may be of benefit for only secondary prevention of heart patients with chronic renal failure who are undergoing hemodialysis.

The American Heart Association concluded that current data do not justify the use of antioxidant supplements for the prevention or treatment of cardiovascular disease risk.

The above recommendations apply to supplementation only. Diets high in natural antioxidants are associated with lower cardiovascular mortality.

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Conference Column

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression: : Dr KK Aggarwal

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