emedinews
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  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 on Social Media …

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 …

24th June 2012, Sunday

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

It may be stated that the manufacture, sale and distribution of Nimesulide formulations for human use in children below 12 years of age was prohibited under Section 26A of Drugs and Cosmetics Act, 1940 vide Gazette Notification no. GSR 82(E) dated 10.02.2011.

The DTAB in its 60 meeting held on. 10.10.2011 considered the use of Nimesulide in population of 12 years and above and after deliberations recommended that the following Box Warning should be mentioned on label as well as package insert and other promotional literature of formulations containing Nimesulide:

"Use of Nimesulide should ordinarily be restricted to 10 days if longer clinical use is warranted, liver function test should be assessed periodically".

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

H5N1 Bird Flu Pandemic Just Three Mutations Away

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2012

Students of Delhi Public School on the occasion of the World Earth Day celebration at DPS Mathura school premises. The Event was jointly organized by Heart Care Foundation of India, Delhi Public School and Ministry of Earth Sciences.

 
Dr K K Aggarwal
 
    National News

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.

Monsoon downgraded from April prediction, to be 96% of average

NEW DELHI: The Met office has downgraded the monsoon from its April prediction of 99% of long–term average to 96% in the latest forecast released on Friday, but is still rating the four–month rainfall season as normal. There a slightly higher probability of a below normal monsoon, but as this requires rainfall to slip to less than 90% of average, the Met is not radically altering its prediction. The Met feels the July forecast will provide a firmer assessment. El Nino conditions, or a warming of the east Pacific, could affect September rains and have been factored into downgrading the monsoon a notch. But emergence of El Nino late in the monsoon season and a likely time lag of one–two months can help India escape its worst effect. "The latest forecasts from a majority of dynamical and statistical models indicate ENSO neutral conditions are most likely (with a probability of about 60%) to prevail during the monsoon season. There is also substantial probability (about 36%) for emergence of weak El Nino during later part of the monsoon season," the Met said.

Director General of Indian Meteorological Department LS Rathore said, "At present, we are witnessing ENSO neutral conditions. However, by the end of the season there are strong indications of weak El Nino conditions. This is expected to affect September rainfall." Rathore, however, is hopeful of the monsoon doing well. "We are witnessing an improvement of 2%–3% each day and by the end of June total rainfall should go up to about 85%. Thankfully, quantum of rain for June of the total 89 cm is quite low. July and August together get about 65% of the total rainfall and prediction for both months is reasonably good," said Rathore. (Source: TOI, Jun 23, 2012)

For comments and archives

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)

Good coronary collaterals up risk of restenosis post–PCI

Patients with good coronary collateral circulation are at increased risk of restenosis following PCI, a new meta–analysis has found. (Source: Medscape)

For comments and archives

Template may help resolve rhinoplasty ethical problems

Few medical procedures are as fraught with ethical quandaries as aesthetic rhinoplasty. Therefore, Kian Karimi, MD, from the Pacific Eye & Ear Specialists, Los Angeles, California, and colleagues provide a new template to help resolve these ethical problems. The template, published online June 18 in the Archives of Facial Plastic Surgery, may help surgeons sort out some of the more difficult questions. (Source: Medscape)

For comments and archives

New dengue test approved by the FDA

The DENV–1–4 Real Time RT PCR Assay, developed by the US Centers for Disease Control and Prevention (CDC), was recently authorized for use by the US Food and Drug Administration (FDA), according to a CDC news release. Unlike other approved assays that detect antibodies against the dengue virus, the CDC test is the first approved assay that detects the dengue virus itself. The test uses equipment that is already used in influenza tests and thus can be run in laboratories that perform real–time polymerase chain reaction (PCR) assays. (Source: Medscape)

For comments and archives

New ACIP recommendations on pneumococcal, influenza vaccines

An advisory committee to the US Centers for Disease Control and Prevention (CDC) today voted 14 to 1 in favor of recommending the addition of 13–valent pneumococcal conjugate vaccine (PCV13) to 23–valent pneumococcal polysaccharide vaccine (PPSV23) for adults with immunocompromising conditions. The Advisory Committee on Immunization Practices (ACIP) also unanimously recommended an influenza vaccine dosing schedule for children aged 3 months through 6 years. (Source: Medscape)

For comments and archives

PTSD not unusual after MI

One patient in eight may develop posttraumatic stress disorder (PTSD) after a heart attack or unstable angina, a meta–analysis determined. And for patients who do, the likelihood of another event or death is doubled, Donald Edmondson, PhD, of Columbia University Medical Center in New York City, and colleagues reported online in PLoS ONE. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on Patients with acidity should avoid…: http://youtu.be/CfI6VK9RqEg via @youtube

@DeepakChopra: Every wisp of experience that comes our way is registered in the brain & body. Cultivating joy & compassion will enhance well being.

 
    Spiritual Update

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

Tyaga, Vairagya and Sanyasa

These are the three terms described in Bhagavad Gita and Vedic literature. Tyaga is at the level of physical body, Vairagya at the level of mind and Sanyasa at the level of the soul. For example, one can do Tyaga of house, food and wife etc.

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 the risks of hysteroscopy?

Only 1% of women have complications from an office hysteroscopy. Complications with operative hysteroscopy include absorption of fluid, infection, bleeding and uterine perforation. If a perforation occurs during an operative hysteroscopy, you may need another procedure to ensure there is no damage to nearby organs such as your intestines, bladder, or blood vessels.

For comments and archives

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

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

ANAEMIA

Anaemia is one of the common health problems, especially amongst the women, in the developing countries.

An anaemic person feels

  • Tiredness
  • Easy fatigability
  • Generalized muscular weakness
  • Lethargy
  • Headache
  • Looks pale
  • Attacks of faintness
  • Menstrual disturbances
  • Loss of weight and appetite
  • Palpitations
  • Breathlessness
  • Severe anaemia leads to heart problems
  • Depression
  • Irritability
  • Listlessness–lassitude & weakness

Iron deficiency is the commonest cause of anaemia world–over. The other main cause is the deficiency of Vit. B–12 and Folic acid. Iron obtained from diet replaces the loss of iron from the body. Requirement of iron is 1mg.daily in a normal adult. It increases to

1.5 mg daily in females. Average daily requirement of Folic acid or folate is 100–200 micrograms. A minor amount of trace elements like zinc, cobalt, copper & vitamin C etc. is required for proper Red Cells Maturation.

Dietary Recommendations in Anaemia:

  1. Improve food choice to increase amount of total dietary iron
  2. Include a source of vitamin C at every meal
  3. Include (meat, fish, poultry) at every meal if possible
  4. Avoid drinking large amounts of tea or coffee with meals (both contain tannin)

NOTE: A high protein diet (1.5g/kg body weight) is desirable both for liver function and blood regeneration.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

When God created mothers

When the Good Lord was creating mothers, He was into His sixth day of "overtime" when the angel appeared and said. "You’re doing a lot of fiddling around on this one."

And God said, "Have you read the specs on this order?" She has to be completely washable, but not plastic. Have 180 moveable parts…all replaceable. Run on black coffee and leftovers. Have a lap that disappears when she stands up. A kiss that can cure anything from a broken leg to a disappointed love affair. And six pairs of hands."

The angel shook her head slowly and said. "Six pairs of hands… no way." "It’s not the hands that are causing me problems," God remarked, “It’s the three pairs of eyes that mothers have to have."

"That’s on the standard model?" asked the angel. God nodded. "One pair that sees through closed doors when she asks, ‘What are you kids doing in there?’ when she already knows. Another here in the back of her head that sees what she shouldn’t but what she has to know, and of course the ones here in front that can look at a child when he goofs up and say. ‘I understand and I love you’ without so much as uttering a word."

"God," said the angel touching his sleeve gently, "Get some rest tomorrow…"

"I can’t," said God, "I’m so close to creating something so close to myself. Already I have one who heals herself when she is sick…can feed a family of six on one pound of hamburger…and can get a nine–year–old to stand under a shower."

The angel circled the model of a mother very slowly. "It’s too soft," she sighed.

"But tough!" said God excitedly. "You can imagine what this mother can do or endure."

"Can it think?"

"Not only can it think, but it can reason and compromise," said the Creator.

Finally, the angel bent over and ran her finger across the cheek.

"There’s a leak," she pronounced. "I told You that You were trying to put too much into this model."

"It’s not a leak," said the Lord, "It’s a tear."

"What’s it for?"

"It’s for joy, sadness, disappointment, pain, loneliness, and pride."

"You are a genius, "said the angel.

Somberly, God said, "I didn’t put it there."

For comments and archives

 
    Cardiology eMedinewS

Normal saline is not normal, may be harmful Read More

Mixed results for fish oil in AFib prevention Read More

FDA turns down Xarelto for ACS patients Read More

 
    Pediatric eMedinewS

Docs say soda tax may be option Read More

Oral magnesium supplements improve cystic fibrosis in children
Read More

Hypertension in kids a growing problem Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was on aerobic exercise protocol.
Dr Bad: Continue it.
Dr Good: Add resistance training also.
Lesson: According to a study published in the Journal of the American Medical Association, people with diabetes should mix aerobics with weight training to get the best results in lowering blood sugar.

For comments and archives

Make Sure

Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

For comments and archives

 
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    Health News Bulletin

Now, undergo bypass surgery while you're awake

The Times of India, Hetal Vyas

Bangalore: Guruswamy, a 55–year–old semi–literate farmer, was shocked when he was first told that he'd be awake while undergoing bypass surgery. He did not readily agree to it and was counseled for over two weeks. When he eventually underwent the surgery with his eyes open, it was an unforgettable experience. Awake–heart surgeries are becoming a boon for those suffering from lung, chest and muscle–related diseases. The patient, undergoing such a surgical process, is not given general anesthesia but is given anesthesia in the spine bone. It enables the patient to remain conscious and undergo painless surgery. At least 10–15 such operations performed in prominent hospitals across the city every year. Says Dr Vivek Jawali, chief cardiothoracic surgeon, Fortis Hospitals: "A patient is first counseled about the procedure. Only if he/she agrees, it is done. About 96% patients are okay with it, only 4% refuses after counseling."Dr CN Manjunath, director, Sri Jayadeva Institute of Cardiovascular Science and Research Institute, said: "Such surgeries are done on a routine basis. Those with respiratory difficulties, history of tuberculosis, not suitable for general anaesthesia and can’t be kept on ventilator are advised to undergo awake–heart surgery." Experts said the biggest challenge is that the patient is awake and able to listen to the conversation of doctors in the operation room. "Hearing doctors asking for various instruments like knife and a pair of scissors can really scare patients. So doctors are advised to have minimum conversation during surgery," added Dr Manjunath.

 
    Quote of the Day

(Dr GM Singh)

Self–confidence

You must find the best way to behave towards others. If you learn how to behave correctly, you will manage to conquer those people you want to, whatever the position. Through kindness, you will also gain a great deal from difficult and unpleasant people.

 
    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Serum creatinine

Increase in serum creatinine is seen any renal functional impairment. Because of its insensitivity in detecting early renal failure, the creatinine clearance is significantly reduced before any rise in serum creatinine occurs. The renal impairment may be due to intrinsic renal lesions, decreased perfusion of the kidney, or obstruction of the lower urinary tract and nephrotoxic drugs and other chemicals.

 
    Legal Question of the day

(Prof. M C Gupta Advocate & Medico–legal Consultant)

Q. What are your views about the NEET? Should it be opposed?

Ans.

  • NEET stands for National Eligibility cum Entrance Test which is meant to be a single examination for MBBS and dental undergraduate seats in all medical colleges in the country. The proposal for the NEET was apparently initiated by the central government (Ministry of Health) and the MCI. The issue had come before the Supreme Court and the court gave go ahead for the test the MCI announced the date as 13th May, 2012. Some state governments, including West Bengal, objected to it. The Centre wanted to defer to the wishes of states, and approached the SC for permission to delay the test by one year. On 16–12–2011, at the instance of the SC, the UOI and the MCI withdrew their pleas for deferment of the test by one year.
  • A single test is desirable for the following reasons:
    • It will remove or curtail the countrywide disparities in the merit of students admitted to and completing the MBBS course. Such disparity is injurious to the quality of medical education.
    • It will make easy for students the process of seeking admission to MBBS. It will drastically reduce the number of tests for which a candidate has to apply with a resultant decrease in the cost and stress of multiple applications, application fees, visiting examination centres (which involves expenses for travel and stay, especially for young girls who have to be accompanied by parents) etc.
    • It will bring in a sense of national integration.
    • It will reduce the menace of private medical colleges selling seats for illegal capitation fees.
    • It will help in grading the quality of medical colleges. The best colleges may be deemed to be those which are most sought after by the qualifying candidates.
  • Such a test should ideally be held in the languages in which the students study at 10+2 level. The NEET should be given in regional languages in addition to English.
  • The syllabus at 10+2 level in various states should be such that it conforms to the requirements of the NEET test.
  • Improvements in the NEET will be needed from year to year on the basis of experience gained. However, such improvement is a continuous and never ending process and the existence of a fool–proof plan for the NEET should not be insisted upon or agreed upon.
  • In the circumstances, it is on the right lines that the SC has seen to it that the central government and the MCI withdraw their last moment objections to their own plans which were apparently for extraneous reasons. There is no need to oppose the NEET.
  • As a concept and policy, it would be desirable that admission to all degree and diploma courses, where science with biology are essential qualifications, should be done on the basis of an all India test like the NEET. This would bring within its ambit all medical courses (including the AYUSH systems), dental courses, and paramedical courses like nursing, physiotherapy, MLT, optometry, radiography etc. This will help in raising standards, promoting national integration and removing corruption in education.
  • As a matter of fact, employment in medical, dental and paramedical jobs should also be ideally on the basis of national level eligibility tests. This will help remove the disparities in the pay scales in central and state jobs. After all, the principle of equal pay for equal work should apply.

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)

Pulse Polio programme

The Pulse Polio programme is a government–led programme which aims to eradicate polio from the country by vaccinating all children under the age of five, against polio. Every child is given OPV drops on special "Pulse Polio National Immunization Days".

It is important to ensure that all children up to 5 years of age are given the OPV drops in addition to the routine polio vaccines given as per the immunization schedule. This is the only way to ensure that the child and the community are protected from polio. The OPV is given in several doses to ensure that the disease is controlled and eventually eradicated. Such repeated immunizations have made several countries around the world polio–free.

 
    Mind Teaser

Read this…………………

A male client with tuberculosis asks Nurse Brian how long the chemotherapy must be continued. Nurse Brian’s accurate reply would be:

a. 1 to 3 weeks
b. 6 to 12 months
c. 3 to 5 months
d. 3 years and more

Yesterday’s Mind Teaser: 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

Answer for Yesterday’s Mind Teaser: d. Intermittent hematuria

Correct answers received from: Dr LC Dhoka, Dr ValluriRamarao, Dr Kanta jain, Dr PC Das, Dr U Gaur, Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G, Yogindra Vasavada, Muthumperumal Thirumalpillai, Anil Bairaria.

Answer for 22nd June Mind Teaser: a. Increased capillary fragility and permeability
Correct answers received from: Dr Anupam Sethi Malhotra, Dr shashi saini, Dr B Rajammal.

Send your answer to ijcp12@gmail.com

 
   Laugh a While

(Dr GM Singh)

Recently, while I was on a shopping trip in a department store, I heard a little five–year–old talking to his mother on the down escalator.

He said, ‘Mommy, what do they do when the basement gets full of steps?’"

 
    Medicolegal Update

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

Lacerated wound

The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound as seen in MLC cases.

  • Lacerations are tears or splits of skin, mucous membranes, muscle or internal organs produced by application of blunt force to a broad area of the body, which crushes or stretches the tissues beyond the limits of their elasticity.
  • Crush injury from a direct blow may produce an irregular or stellate laceration with a variable degree of devitalized tissue, abrasion and visible contamination.
  • Do not close a laceration if there is visible contamination, debris, non–viable tissue or signs of infection. Wounds may involve vascular areas of the face and scalp where the risk of infection is low or extremities where infection becomes a greater risk, along with the possibility of tendon and nerve damage. The elderly and patients on chronic steroid therapy may present with "wet tissue paper" skin tears following relatively minor trauma.
  • When produced by a blunt weapon, such as club, crowbar, stone, brick etc., a lacerated wound is usually accompanied by a considerable amount of bruising of the surrounding and underlying tissues, and has inverted and irregular edges. The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound.
  • When a heavy weight such as the wheel of a heavy cart or a truck passes over an extremity, by its shearing and grinding force, it tears the skin from the underlying tissue and crushes the muscles and soft part lying beneath it realizing considerable blood and fat in them.
  • Crush injury syndrome or fat emboli may follow a lacerated wound. The tear, avulsion, split are types of laceration.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Eat more fruits and vegetables to quit smoking

Researchers led by Jeffrey P. Haibach, from the University of Buffalo in New York and published in the journal Nicotine and Tobacco Research have shown that smokers who eat fruits and vegetables four or more times per day are 3 times more likely to be abstinent from all tobacco products, including cigarettes, at 14–month follow–up, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Smokers who eat more fruits and vegetables also exhibit fewer measures of dependence. They are less likely to smoke 20 or more cigarettes per day, to smoke within 30 minutes of waking, or to have nicotine dependence.

People who eat more fruits and vegetables may be more health conscious to begin with and therefore be more amenable to smoking cessation. People who smoke cigarettes are more likely to binge drink, use illicit drugs, and exercise less.

 
    Readers Responses
  1. Dear Dr KK Aggarwal, You are doing a great service. Your newsletter is not only full of news but also inspirational stories and entertainment material. Keep up the good work. Dr. Harkanwaljit Singh Saini.
 
    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

 
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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, Dr Usha K Baveja