emedinews
Head Office: 39 Daryacha, Hauz Khas Village, New Delhi, 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

 
  Editorial …

24th February, 2011, Thursday                                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

Cell phones may be harmful

Holding a cell phone to the ear for an extended period of time increases activity in regions of the brain closest to the antenna. Glucose metabolism in the orbitofrontal cortex and temporal pole increased significantly when the phone was turned on and muted, compared with when it was off (P=0.004), Nora Volkow, MD, director of the National Institute on Drug Abuse, and colleagues reported in the Feb. 23 issue of the Journal of the American Medical Association.

Human brain is sensitive to the effects of radiofrequency–electromagnetic fields from acute cell phone exposures," co–author Gene–Jack Wang, MD, of Brookhaven National Laboratory in Long Island. Volkow and colleagues conducted a crossover study at Brookhaven National Laboratory, enrolling 47 patients who had one cell phone placed on each ear while they lay in a PET scanner for 50 minutes. The researchers scanned patients’ brain glucose metabolism twice –– once with the right cell phone turned on but muted, and once with both phones turned off. There was no difference in whole–brain metabolism whether the phone was on or off. But glucose metabolism in the regions closest to the antenna –– the orbitofrontal cortex and the temporal pole –– was significantly higher when the phone was turned on (35.7 versus 33.3 mcmol/100 g per minute, P=0.004). Regression analyses confirmed that the regions expected to have the greatest absorption of radiofrequency and electromagnetic fields from cell phone exposure were indeed the ones that showed the larger increases in glucose metabolism. The effects on neuronal activity could be due to changes in neurotransmitter release, cell membrane permeability, cell excitability, or calcium efflux.

The take–home message, users should try to use headsets and reduce cell phone use if at all possible. Restricting cell phone use in young children certainly is not unreasonable.


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

 Treating Diabetes Post 2010

Dr Ambrish Mithal speaks on
‘Changes in the management of diabetes’

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

A true one love doesn’t start in morning and doesn’t end in evening. It starts when u don't need it and ends when u got it the most.

 
    Photo Feature (from the HCFI Photo Gallery)

2nd emedinewS revisiting 2010

Sardar Buta Singh, Former Union Home Minister was felicitated at the 2nd eMedinewS: Revisiting 2010 held on 9th January this year at Maulana Azad Medical College, New Delhi.

 
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

Indigenous critical care ventilators rolled out

COIMBATORE: Now Indian hospitals need no longer depend on imported ventilators for critical care of its patients. ‘Inventa’, India’s first indigenous critical care ventilator, has started rolling out of Coimbatore. A joint project of the Society for Bio–Medical Technology (SBMT), a division of the Defence Research and Development Organisation (DRDO), National Institute for Mental Health and Neuro Sciences (NIMHANS), Bangalore, and the PSG College of Technology, Coimbatore, ‘Inventa’ is gaining entry into Indian hospitals, albeit slowly. The ventilator, manufactured by a Coimbatore–based firm, can be used by patients admitted to Intensive Care Units and all those who require assisted breathing. "The work, which began in 2003, has borne fruit and commercial production has begun. The first lot of 100 units has been sold out. It is a fully indigenous product that is sleek, portable and cost–effective," W. Selvamurthy, Distinguished Scientist and Chief Controller of Research and Development, DRDO, said here on Monday. (Source: The Hindu, Feb 22, 2011).

Cashless facility for patients

Moolchand is proud to have been selected by India’s leading insurance companies (National Insurance Company Ltd., United India Insurance Company Ltd., The New India Assurance Company Ltd. and The Oriental Insurance Company Ltd.) to extend cashless facility for patients.

 
    International News

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

February is Heart Health Month

Vegetables and fruits in your diet is easy. Keep vegetables washed and cut in your refrigerator for quick snacks. Keep fruit in a bowl in your kitchen so that you’ll remember to eat it. Choose recipes that have vegetables or fruits as the main ingredient, such as vegetable stir–fry or fresh fruit mixed into salads.

(Contributed by Dr Jitendra Ingole, MD Internal Medicine, Asst Professor (Medicine) SKN Medical College, Pune)

Fiber consumption may protect against CVD, infectious, respiratory, and cancer mortality

Compared with people who consume low levels of dietary fiber, those who consume high levels have decreased rates of all–cause, cardiovascular, infectious, and respiratory mortality, according to a study published online Feb. 14 in Archives of Internal Medicine. Higher fiber intake also was related to decreased cancer mortality, but only among men, said Yikyung Park, Sc.D., of the nutritional epidemiology branch of the National Cancer Institute, Rockville, Md., and her associates. The study findings suggest that choosing fiber–rich foods may have across–the–board health benefits, and may reduce the risk of premature death from all causes, they noted.

Many observational studies examining the effect of dietary fiber on mortality have been limited by small sample sizes, narrow ranges of fiber intakes, and inadequate control for confounding factors; and therefore many of the studies have produced inconsistent results.

The investigators examined the issue using data from a large cohort – participants in the National Institutes of Health/American Association of Retired Persons Diet and Health Study. The NIH/AARP study involved more than 567,000 men and women, aged 50–71 years, residing in six states and two metropolitan areas, who completed detailed questionnaires about their diets in 1995–96 and were followed for a mean of 9 years. For this analysis, the responses of 219,123 men and 168,999 women were assessed. Compared with people in the lowest quintile of fiber consumption, those in the highest quintile had a 22% lower risk of death from all causes, Dr. Park and her colleagues reported.
(Source: Archives of Internal Medicine Feb 14, 2011)

(Dr Monica and Brahm Vasudev)

No link between heart attack and mini birth control pills

A new study has shown that there is no link between heart attack and mini birth control pills. The mini pills contain the hormone Progestin. (Cedars Sinai Medical Centre)

Early BP lowering no help in acute stroke

Lowering blood pressure early during acute stroke did nothing to improve outcomes and may actually impair patients’ ability to live independently later on, researchers affirmed in a randomized trial. Candesartan (Atacand) started within 30 hours of stroke onset and given over seven days did not affect the combined six–month rate of death from vascular causes, myocardial infarction, or stroke compared with placebo (11.7% versus 11.3%, adjusted hazard ratio 1.09, P=0.52), Eivind Berge, MD, of Oslo University Hospital Ullevål, and colleagues found.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

How long should a woman continue to try fertility treatments before choosing another option?

This is a personal decision based on each couple’s needs and resources. Drs. Yakov Epstein and Helane Rosenberg offer some excellent advice on making this decision in their book, "Getting Pregnant When You Thought You Couldn’t." They introduce an exercise called "moving the line." At each phase of treatment, you draw a hypothetical line about how far you’ll go, and then focus on treatment to that point. But you give yourself permission to move the line should it be appropriate. This enables couples to focus on where they are right now without worrying about next steps that may never need to be taken.

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 role of percutaneous drainage in management of liver abscess?

Percutaneous drainage is indicated in management of liver abscesses that require more than just a medical management. Even multiloculated liver abscesses can be managed with aggressive percutaneous techniques that include disruption of loculations and placement of large bore catheters. Indications are:

  • Volume of abscess is large and there is risk of spontaneous rupture(specially left lobe abscesses).
  • When actual rupture has occurred, then along with abscess cavity drainage of extraneous collection.
  • When there is lack of response to medical therapy.
  • When there is evidence of liver failure.

Absence of a secure route is the only contraindication.

For queries contact: drneelam@yahoo.com

 
    Medicolegal Update

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

False negative chemical analysis report of viscera–autopsy

The doctor who is conducting autopsy in case of death due to poisoning and after ruling out any other cause of death in the case and based on clinical evidence and conclusive opinion formed that the death is due to poisoning and even have clinical evidence to suggest the specific, he has all the authority to inform the investigating officer and mention on the postmortem report his conclusive opinion that he is preserving viscera for chemical analysis.

The false negative test report may be due to:

  • Delay in chemical analysis
  • Improper preservation
  • Use of wrong analytical technique
  • Early disintegration of poison
  • Complete metabolism
  • Lack of suitable test for certain poison
  • In accordance with a judicial pronouncement, the doctor who has conducted the postmortem examination on the basis of his examination and findings in post mortem where he found the signs suggestive of poisoning can give his opinion that the cause of death is due to poisoning in spite of a negative viscera report.
 
    Legal Question of the Day

(Contributed by Dr Akash Deep)

Q. Can an MBBS with one year residency in Pathology run a pathology lab for simple routine investigations (CBC, urine, stool, simple biochemistry etc.) without stating/declaring in the report that he is a pathologist?

Ans.

  1. One–year residency in pathology does not make a person a pathologist.
  2. Nobody but a Pathologist can practice Pathology. Running a lab amounts to practice of Pathology, whether the person signs as a Pathologist or not.
  3. Carrying out simple lab tests on one’s own patients by a GP without carrying them out for patients under the treatment of other doctors does not amount to running a Path Lab and is permissible.

To summarize, an MBBS with one–year residency in Pathology is not entitled as per law to run a Pathology Lab.

 
    Useful Websites

(Dr Surendernikhil Gupta)

KidSurvival

Toward a Consensus on Guiding Principles for Health Systems Strengthening

http://www.childsurvival.net/?content=com_articles&artid=307

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Creatinine

Increased: Renal failure including prerenal, drug–induced (aminoglycosides, vancomycin, others), acromegaly.

Decreased: Loss of muscle mass, pregnancy.

 
    Medi Finance Update

Industry specific funds provide an opportunity to capitalize on the strength of a particular sector of the economy. Investing a significant portion of your portfolio in one industry can be risky, especially if that industry falls on hard times. However, the upside can be equally as good if the industry performs well. (We have seen this in the technology sector.)

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Etoricoxib 1%+ Menthol 5% Spray
For the topical treatment of acute musculoskeletal pain
16/03/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

BP control in type 2 diabetes

The randomized ACCORD BP trial compared systolic blood pressure targets of <120 or <140 in patients with type 2 diabetes at high risk for cardiovascular events. There was no significant difference in the primary composite cardiovascular endpoint, but there were more adverse events with the lower BP goal.

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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
 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was diagnosed with sarcopenia.
Dr. Bad: It is related to diabetes.
Dr. Good: It is not related to diabetes.
Lesson: In the Korean Sarcopenic Obesity Study (KSOS), type 2 diabetes was associated with increased risk of sarcopenia. These characteristics may contribute to physical disability and metabolic disorders in older adults with diabetes.

Make Sure

Situation: A patient who had multiple blunt trauma on his abdomen is admitted for management.
Reaction: Oh my God! Why did you not do a peritoneal lavage?
Lesson: Make sure to perform a peritoneal lavage in patients of multiple blunt trauma to exclude peritoneal haemorrhage from ruptured abdominal organs as the peritoneal reaction is often mild and a thorough clinical examination is not possible.

Exercise tips

In a nutshell, exercise can:

  • Reduce your chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
  • Lower your risk of developing hypertension and diabetes.
  • Reduce your risk for colon cancer and some other forms of cancer.
  • Improve your mood and mental functioning.
  • Keep your bones strong and joints healthy.
  • Help you maintain a healthy weight.
  • Help you maintain your independence well into your later years.
 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr. Anupam Sethi Malhotra)

Do not interfere in others’ business unless asked

Most of us create our own problems by interfering too often in others’ affairs. We do so because somehow we have convinced ourselves that our way is the best way, our logic is the perfect logic and those who do not conform to our thinking must be criticized and steered to the right direction, our direction. This thinking denies the existence of individuality and consequently the existence of God. God has created each one of us in a unique way. No two human beings can think or act in exactly the same way. All men or women act the way they do because God within them prompts them that way.

There is God to look after everything. Why are you bothered? Mind your own business and you will keep Your peace.

………………………………

Mind Teaser

Read this…………………

minI’LL BE THEREute

Yesterday’s Mind Teaser: roforkad

Answer for Yesterday’s Mind Teaser: Fork in the road

Correct answers received from: Dr K V Sarma, Dr K P Rajalakshmi, Dr Riyazul Qamar Khan, Dr Sudipto Samaddar, Dr Maneesh Gupta, Dr K Raju, Dr (Maj. Gen.) Anil Bairaria, Dr Rajiv Dhir, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai.

Answer for 22nd February Mind Teaser: Getting away from it all
Correct answers received from: Dr Rashmi, Dr K.V.Sarma, Dr Vijay Kansal, Dr Rakesh Bhasin, Dr Neelam Nath, Dr Gaur.

Send your answer to ijcp12@gmail.com

………………………………

Laugh a While
(Dr. GM Singh)

Science

Scientists have shown that the moon is moving away at a tiny, although measurable distance from the earth every year. If you do the math, you can calculate that 85 million years ago the moon was orbiting the earth at a distance about 35 feet from the earth’s surface.

This would explain the death of the dinosaurs – the tallest ones, anyway.

………………………………

Knowledge is amusing

All polar bears are left handed

 
    Readers Responses
  1. Dear Dr Aggarwal, This pertains to the article - Punjab and Haryana High court order regarding illegible handwriting of doctors. There is no 2nd opinion about it. But the solution is not in doctors’ hands. In an OPD of 250 patients, to see them all and documenting the prescription is a big task. In USA, medical transcription was started for this purpose. Doctor in any govt hospital or dispensary is not provided any typist or any secretary. So how should he do it? Computerization may be the answer. Let the govt provide an IT assistant in each PHC/Hospital etc and a dictaphone to the doctor who can record his findings and notes into dictaphone and later the IT assistant gives a print out and same is signed by the doctor. Is this asking too much?? Sincerely: DR R S Bajaj, Consultant Paediatrician, Rohini, Sector 13, Delhi.
 
    Public Forum

(Press Release for use by the newspapers)

Airport noise and blood pressure

People living near airports experience both chronic and acute blood pressure increases in response to aircraft sounds, even during sleep said Dr. K.K. Aggarwal Padma Shri and Dr B C Roy National Awardee and President Heart Care Foundation of India.

An analysis from the Hypertension and Exposure to Noise Near Airports (HYENA) study, published in the European Heart Journal, suggests that the blood pressure spikes not only in response to aircraft sounds, but also to traffic or indoor sounds like snoring of the same intensity.

For the study, 140 volunteers living near the airports of Athens (Greece), Malpensa (Italy), Arlanda (Sweden), and Heathrow (UK) wore blood–pressure monitors that checked their blood pressure at 15–minute intervals throughout the night. Noise levels were recorded by specialized devices, with a noise event defined as LAmax >35 dB. In the study systolic blood pressure increased by a mean of 6.2 mm Hg and diastolic by a mean of 7.4 mm Hg within 15 minutes of an "aircraft event," but that other sources of noise, including traffic sounds and indoor noise––mostly snoring––also produced blood–pressure spikes.

The noise levels were lower than that tend to actually wake people from sleep. The noises were affecting blood pressure at a subconscious level.

Very high blood pressure

Hypertensive urgency must be distinguished from emergency. Urgency is defined as severely elevated blood pressure (i.e. upper systolic >220 mm Hg or lower diastolic >120 mm Hg) with no evidence of target organ damage. A hypertensive emergency, on the other hand, is a condition in which elevated blood pressure results in target organ damage.

Hypertensive emergency requires immediate therapy to decrease blood pressure within minutes to hours.

 
    Forthcoming Events

ICC Cricket World Cup 2011

World Cup Schedule… very very creative

http://www.cricbuzz.com/cricket–schedule/series/228/icc–world–cup–2011

6th Annual Conference of Indian Academy of Nephrology (IANCON-2011)

Date: March 12–13, 2011
Venue: Taj Deccan, Banjara Hills, Hyderabad–34
Faculty: Dr MS Amarsen, Dr KV Jhony, Dr SC Dash, Dr Kashivishweswaran, Dr V Sakhuja, Dr RK Sharma, Dr Girishnarayan, Dr Anuradha, Dr SK Agarwal, Dr P Sundarajan, Dr P Keshivya, Dr Ravi Raju, Dr Dilip Pahari, Dr LC Sharma, Dr Sanjeev Saxena, Dr Sanjay Gupta, Dr Abhijit Tarapdhar, Dr PP Verma, Dr Harun Rashid, Dr Sampath Kumar, Dr Sanjib Sharma, Dr S Padmanabhan.
Topics: CKD Symposium (From India, Nepal, Bangladesh), Newer concepts in the pathogenesis of hypertension, Fluid and Electrolyte & AKI, RAAS in treatment of Diabetic Nephropathy, Primary Prevention of CKD: Trials & tribulation in Indian condition, Vitamin–D andchronic kidney disease, Mycophenolate Vs Cyclyophosphamide in Lupus nephritis, Individual zinganemia therapy, How to monitor Immunosuppression minimization, Obesity Diabetes epidemic, Life Style changes & therapeutics, BKV and CMV Nephropathy, Leptospira and Acute Kidney Injury, HIV Nephropathy, Hypophosphatemia and Renal Disease, Immunosuppressant and risk of Malignancy, Pregnancy ARF, Expanding Dialysis services in Andhra Pradesh,Making kidney transplant easier for less privileged, Cardiovascular risk reduction in CKD

Organizing Secretary: Dr. Sree Bhushan Raju, Associate Professor, Dept of Nephrology, NIMS, Hyderabad
Contact: Mob: 09848492951, sreebhushan@hotmail.com
Website: www.ian2011.in
Note: "Prof SC Dash oration in Nephrology" from this year onwards. Three awards each in oral, poster and imaging in Nephrology sessions

Registration for Delegates Amount
Up to 15th February 2011
 
Rs. 1500/–
Up to 5th March 2011
Rs. 2000/–
Spot registration
Rs. 2500/–
Student
Rs. 500/–

DD/Cheque in favor of "IANCON– 2011" payable at Hyderabad. Add Rs 100/– for outstation cheque.

eMedinewS Events: Register at emedinews@gmail.com

World Fellowships of Religions and Perfect Health Parade

First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof
Subject: Global Warming, Ethnic Crises, How to be Healthy
Date: Sunday 3rd April, 2011
Venue: Maulana Azad Medical College, New Delhi
Time: 8 AM – 4 PM
Register: rekhapapola@gmail.com

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