(incorporating eIMA News)

January 23 2016,Saturday


Kesari dal being reintroduced: Too early for IMA to call it 100% safe

Dr SS Agarwal and Dr KK Aggarwal

Three new varieties of kesari dal, Ratan, Prateek and Mahateora, which have low p-N oxalyl- L-p-diaminopropionic acid (P-ODAP) content, have been released for general cultivation. Kesari dal or lathyrus sativus is commonly known as grass pea. The Indian Council of Agricultural Research (ICAR) has developed these three new strains in collaboration with State agriculture universities

ODAP is found in the seeds of Kesari Dal at a constant concentration of 0.5%. While, the ODAP content in these varieties is in the range of 0.07-0.10%, which is safe for human consumption. It has been shown that the concentration of ODAP increases in plants grown under stressful conditions.

Kesari dal, a key Rabi pulse crop, is mainly cultivated in the states of Madhya Pradesh, Chhattisgarh, Maharashtra, Bihar and West Bengal. Arhar dal is expensive and often retailers mix the cheap khesari dal because of similarity in appearance.

It is learnt that the ICAR admitted that a research panel headed by India Council of Medical Research has proposed lifting the ban.  In the new varieties of the dal, the toxicity is "negligible." The proposal is now being considered by the Food Safety and Standards Authority of India (FSSAI).

IMA would like to know more about the studies, animal studies and long term follow ups before our members can call it 100% safe for human consumption.

Lathyrism, a disorder of spastic paraparesis occurs in association with increased dietary intake of food plants with neurotoxic potential. Neurolathyrism is associated with prolonged consumption of the grass pea. Exposed persons suffer a slowly developing spastic paraparesis with cramps, paresthesias and numbness, accompanied by bladder symptoms and impotence. Some patients have tremors and other involuntary movements in their arms. Pathologic studies have demonstrated a loss of myelinated fibers in the corticospinal and spinocerebellar tracts. The toxin appears to be the neuroexcitatory amino acid, beta-N-oxalylaminoalanine. There is no treatment.


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Toxic shock syndrome puts teen on life support

What do you see in this slide?

You are practicing in a suburban area of your city and a 11 year old girl in 6th class asks you school excuse for the abdominal pain that has kept her out of school for the last 3 days.  She adds she was feverish, had loose bowels and did not vomit.  Exam is normal.  Being a reputed doctor in the area, you should:

A. Inquire about why she needs a school excuse.
B. Decline to give a school excuse based on the lack of objective findings and historical facts that should keep her out of school.
C. Ask about school performance and social interaction at school
D. All of the above
E. None of the above


If you were to lower the M.B.B.S and PG course duration,


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  • April 1st: tOPV would not be available after this date.
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Legal Quote - Poonam Verma vs Ashwin Patel & Ors on 10 May, 1996 AIR 2111, 1996 SCC (4) 332

Bioethical issues in medical practice - Appendicitis in a young boy


Heart Patients should avoid living on top floors of high-rise buildings- HCFI

According to a recent study, heart patients residing in lower floors of high-rise buildings had a higher chance of surviving sudden cardiac arrests as opposed to those who live on higher floors. The reason being, the time it takes for a first responder arriving at the building to reach the patient having a cardiac arrest increases when the patient lives on a higher floor.  In addition to this there exists an overall lack of awareness about the importance of Hands-only CPR 10 as a life-saving technique that can help revive a sudden cardiac arrest patient within ten minutes of their death.

The study that was conducted on a sample of 5,998 patients found that on an average, it took responders about 6 minutes from the time of receiving the SOS phone to arrive at the building. But it took them an average of 3 minutes between arriving at the building and first contact with the patient for those lived on the first or second floor, compared to an average of almost 5 minutes for those who lived on or above the third floor. 4.2% of those who lived below the third floor of their buildings survived cardiac arrests as opposed to only 2.6% of those who stayed on higher floors. Thus medically, it is suggested that living on the higher floors of high-rise building can be fatal for heart patients.

Keeping this in mind, the leading National NGO Heart Care Foundation of India recommends that doctors must ensure that each and every family member and those in regular contact with the heart patient must be trained in the easy to learn and perform technique of Hands Only CPR. In addition to this, they must discourage them from residing on higher floors in society buildings. All societies must also have Automated External Defibrillators (AEDs) readily available in the lobby, on certain floors or the elevators.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal Honorary Secretary General IMA & President HCFI said, “It is the responsibility of all doctors to inform heart patients and their patients about the dangers of living on higher floors of high-rise buildings. For those who do, it is essential that each and every family member and building staff is trained in the life-saving technique of hands only CPR which can be performed by anyone and can help revive patients who have suffered a sudden cardiac arrest within ten minutes of their death. Societies must also ensure that an AED is available. Around 240,000 people die every year due to heart attacks and we believe about 50% of them can be saved if 20% of the population learns hands only CPR. What people need to remember is two things, one CPR must not be practiced on a person who is breathing, has a pulse rate and is clinically alive. It must be administered within ten minutes of someone’s death and continued till the ambulance arrives or the person is revived.”

The HCFI Hands- Only CPR 10 mantra is: Within 10 minutes of death (earlier the better), for a minimum of 10 minutes (adults 25 minutes and children 35 minutes), compress the center of the chest of the deceased person continuously and effectively with a speed of 10×10 = 100 per minute.

Continuous compression only CPR compresses the heart between the sternum and the back bone and builds up the pressure that keeps the oxygenated blood flowing to the brain and keeps the person alive until a defibrillator becomes available or expert medical help arrives. Therefore, if you see someone collapse from sudden cardiac arrest, acting promptly can save his or her life. It is important to act quickly for every minute lost reduces the chances of revival by 10%. So, if you wait 5 minutes, the chances of surviving are 50% less. The earlier you give CPR to a person in cardiac arrest, the greater the chance of a successful resuscitation. To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177.