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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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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 (07–08c); 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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  Editorial …

25th January 2012, Wednesday

Test blood sugar in all hospitalized patients

Hyperglycemia in hospitalized patients is associated with a greater risk for complications, as reported by Umpierrez and colleagues in the March 2002 issue of the Journal of Clinical Endocrinology & Metabolism.

  • All patients, independent of a prior diagnosis of diabetes, should undergo blood glucose testing on admission.
  • Hyperglycemia is linked to prolonged hospital stay, increased incidence of infections and death in non–critically ill hospitalized patients.
  • Hyperglycemia affects 32% to 38% of patients in community hospitals and is not restricted to individuals with a history of diabetes.
  • Better blood sugar control is associated with fewer hospital complications in general medicine and surgery patients.
  • All diabetics or hyperglycemia (glucose > 140 mg/dL) should have an A1c test, if not tested in last 2 or 3 months.
  • For most hospitalized patients with noncritical illness, the pre meal glucose target is less than 140 mg/dL and the target for a random blood glucose level is less than 180 mg/dL.
  • Anti diabetic treatment should be re–evaluated when glucose levels drop below 100 mg/dL and should be modified if glucose levels are below 70 mg/dL.
  • Go for tighter control of blood sugar in patients not prone to hypoglycemia.
  • Opt for a higher target range (200 mg/dL) for patients with terminal illness or limited life expectancy, or who are at high risk for hypoglycemia.
  • Patients with diabetes who receive insulin at home should receive a scheduled regimen of subcutaneous insulin during hospitalization.
  • To prevent peri operative hyperglycemia, all patients with type 1 diabetes and most patients with type 2 diabetes who undergo surgery, should be treated with intravenous continuous insulin infusion or subcutaneous basal insulin with as–needed bolus insulin.
  • All patients with high glucose values (140 mg/dL) on admission, and all patients receiving enteral or parenteral nutrition, should be monitored with bedside capillary point–of–care glucose testing, independent of diabetes history.
  • At least 1 to 2 hours before intravenous continuous insulin infusion is discontinued, all patients with type 1 and type 2 diabetes should be transitioned to scheduled subcutaneous insulin therapy.

(Source: The Clinical Guidelines Subcommittee of The Endocrine Society, American Diabetes Association, the American Heart Association, the American Association of Diabetes Education, the European Society of Endocrinology, and the Society of Hospital Medicine, January 2012 issue of the Journal of Clinical Endocrinology & Metabolism)

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Dr KK Aggarwal
Group Editor in Chief

 
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Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Anand Mohan Central Bank of India on Emedinews Revisiting

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    Photo Feature (from the HCFI Photo Gallery)

3rd eMedinewS Revisiting 2011

Dr Neelam Mohan, Medanta Medicity was awarded with eMedinewS distinguished Lecture Award in the recently concluded 3rd eMedinewS Revisiting 2011

 
Dr K K Aggarwal
 
    National News

India takes up fight against mental disorders at WHO summit

NEW DELHI: India has pushed the world into joining hands to fight against mental disorders like depression, anxiety, schizophrenia and bipolar disorders. With depression expected to be the leading cause of disease burden globally by 2030, the World Health Organization (WHO) has announced a resolution on "Global Burden of Mental Disorders and the need for a comprehensive, coordinated response at the country level" at the end of its annual board meeting on Monday. The resolution was moved on January 20 by India in Geneva by Union health secretary P K Pradhan. (Source: TOI, Jan 24, 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

H5N1 flu investigators agree to stop research for 60 days

Two teams of H5N1 influenza virus researchers who were recently asked to limit the amount of information they published for security reasons have agreed to halt their studies for 60 days to give governments and others time to develop a plan for handling the information that has come from their research. (Source: Medscape Medical News)

For comments and archives

Measles outbreak shows disease still a threat

A measles outbreak in a Pennsylvania hospital underlines the need for staff members to be immunized against the virus, the CDC said. And clinicians also need to include measles in the differential diagnosis of patients with a fever and a rash –– especially if they have a recent history of international travel, the agency said in the Jan. 2 issue of Morbidity and Mortality Weekly Report. In general, domestic measles transmission has been stopped, the agency noted, but "importations" continue. (Source: Medpage Today)

For comments and archives

Dentists overuse antibiotics in children

A survey has suggested that most dentists tend to overprescribe antibiotics in children, researchers report in an article published in the January issue of the Journal of the American Dental Association. The study, in which 154 North Carolina dentists indicated how they would treat hypothetical cases, found that adherence to professional prescribing guidelines ranged from 10% to 42%. (Source: Medscape Medical News)

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    Twitter of the Day

@DrKKAggarwal: Taking Calcium supplements–Is it safe? Taking calcium supplements can increase kidney stones. However, the (cont) http://tl.gd/fgeeq5

@DeepakChopra: Just as a wave is a movement of the whole ocean, you are the energy of the cosmos. Don’t underestimate your power.

 
    Spiritual Update

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

The Deeper Meaning of "Lord Shiva"

Most of us worship Lord Shiva without understanding the deep meaning of him. In Hindu mythology, Shiva is one of the three forms of God (Brahma, Vishnu & Mahesh). The Parmatama or spirit or what is called as GOD can be classified as a mixture of three forces representing Generator,

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    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is the percentage of miscarriage occurring after ART?

According to western figures, miscarriage may occur after ART, even after ultrasound identifies a pregnancy in the uterus. Miscarriage occurs after ultrasound in nearly 15% of women younger than age 35, in 25% at age 40, and in 35% at age 42 following ART procedures. In addition, there is approximately a 5% chance of ectopic pregnancy with ART.

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    An Inspirational Story

(Dr GM Singh)

8 Lies of my Mother

This story begins when I was a child: I was born poor. Often we hadn’t enough to eat. Whenever we had some food, Mother often gave me her portion of rice. While she was transferring her rice into my bowl, she would say "Eat this rice, son! I’m not hungry."

This was Mother’s First Lie.

As I grew, Mother gave up her spare time to fish in a river near our house; she hoped that from the fish she caught, she could give me a little bit more nutritious food for my growth. Once she had caught just two fish, she would make fish soup. While I was eating the soup, mother would sit beside me and eat the what was still left on the bone of the fish I had eaten, My heart was touched when I saw it. Once I gave the other fish to her on my chopstick but she immediately refused it and said, "Eat this fish, son! I don’t really like fish."

This was Mother’s Second Lie.

Then, in order to fund my education, Mother went to a Match Factory to bring home some used matchboxes, which she filled with fresh matchsticks. This helped her get some money to cover our needs. One wintry night I awoke to find Mother filling the matchboxes by candlelight. So I said, "Mother, go to sleep; it’s late: you can continue working tomorrow morning." Mother smiled and said "Go to sleep, son! I’m not tired."

This was Mother’s Third Lie. When I had to sit my Final Examination, Mother accompanied me. After dawn, Mother waited for me for hours in the heat of the sun. When the bell rang, I ran to meet her… Mother embraced me and poured me a glass of tea that she had prepared in a thermos. The tea was not as strong as my Mother’s love, Seeing Mother covered with perspiration, I at once gave her my glass and asked her to drink too. Mother said "Drink, son! I’m not thirsty!".

This was Mother’s Fourth Lie.

After Father’s death, Mother had to play the role of a single parent. She held on to her former job; she had to fund our needs alone. Our family’s life was more complicated. We suffered from starvation. Seeing our family’s condition worsening, my kind Uncle who lived near my house came to help us solve our problems big and small. Our other neighbors saw that we were poverty stricken so they often advised my mother to marry again. But Mother refused to remarry saying "I don’t need love."

This was Mother’s Fifth Lie.

After I had finished my studies and gotten a job, it was time for my old Mother to retire but she carried on going to the market every morning just to sell a few vegetables. I kept sending her money but she was steadfast and even sent the money back to me. She said, "I have enough money."

That was Mother’s Sixth Lie.

I continued my part–time studies for my Master’s Degree. Funded by the American Corporation for which I worked, I succeeded in my studies. With a big jump in my salary, I decided to bring Mother to enjoy life in America but Mother didn’t want to bother her son; she said to me "I’m not used to high living."

That was Mother’s Seventh Lie.

In her dotage, Mother was attacked by cancer and had to be hospitalized. Now living far across the ocean, I went home to visit Mother who was bedridden after an operation. Mother tried to smile but I was heartbroken because she was so thin and feeble but Mother said, "Don’t cry, son! I’m not in pain."

That was Mother’s Eighth Lie.

Telling me this, her eighth lie, she died. YES, MOTHER WAS AN ANGEL!

M – O – T – H – E – R

"M" is for the Million things she gave me
"O" means Only that she’s growing old
"T" is for the Tears she shed to save me
"H" is for her Heart of gold
"E" is for her Eyes with love–light shining in them
"R" means Right, and right she’ll always be

Put them all together, they spell "MOTHER" a word that means the world to me.

For those of you who are lucky to be still blessed with your Mom’s presence on Earth, this story is beautiful. For those who aren’t so blessed, this is even more beautiful.

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    Cardiology eMedinewS

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

The causes of "drug–resistant" hypertension include

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Treat risk and not LDL–cholesterol targets, new perspective argues

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Silent strokes may scatter memory

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    Pediatric eMedinewS

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

Jaundice in a child – when to worry?: Dr Neelam Mohan

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Blood in stool – common thoughts: Dr Sutapa Ganguly

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Pitfalls in diagnosis of acute pancreatitis: Dr Lalit Bharadia

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Asymptomatic gall stones in children: Dr Naresh Shanmugam

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Plenary Session: Kola vari – Why the girl child? Sex selection – issues & concerns: Dr MKC Nair

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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Diabetes and Driving

Be aware of your own warning signs. Although a mild hypoglycemia may not seem to impair your driving, it is very important to act before your judgment is affected.

 
    IJCP Special

Dr Good Dr Bad

Situation: A 45–year–old male came with chest pain and normal ECG.
Dr Bad: Take antacids.
Dr Good: It can be a cardiac pain.
Lesson: ECG can be normal in the first six hours of acute heart attack.

For comments and archives

Make Sure

Situation: The patient missed her last dose of hepatitis B vaccine as she was out of station at 6th month.
Reaction: Oh my God! Why was the vaccine not given between 4–6 months.
Lesson: Make sure that all patients are given the complete vaccine regimen. The correct regimen is 0, 1–2 months and 4–months.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Sometimes in the winds of change we find our true direction.

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Mycoplasma pneumoniae IgG and IgM

Blood tests for antibody to M. pneumoniae are done:

  • To determine if M. pneumoniae is the cause of a respiratory tract infection.
  • To help diagnose a systemic infection that is thought to be due to mycoplasma.
 
    Mind Teaser

Read this…………………

r

road
……
a
……
d

Yesterday’s Mind Teaser: you cont ol r

Answer for yesterday’s Mind Teaser: you are out of control

Correct answers received from: Rajiv Kohli, Dr Anupam Sethi Malhotra, Dr Manjesha, Theogaraj Samraj, Prabha Sanghi, Dr Amit Kochar, Dr Mrs S Das, Dr PC Das, Ritu Sinha, Dr Mukesh Sharma,
Dr Alexander Daniel Sunad, Dr Chandresh Jardosh.

Answer for 23rd January Mind Teaser: life after death
Correct answers received from: Dr PC Das, Dr Thakor Hitendrasinh G, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr Vijay Kansal, Sudipto Samaddar, Dr A Rama Devi.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Smart Kid

So little Johnnie comes home with his report card for 5th grade, and shows it to his mother. His Mom reads the report card and gets more and more upset as she sees his grades. "Johnnie, you have 5 "F’s" and a "D" in Math! Wait until your Father sees this!"

So Johnnie’s dad comes home from his job at the lab, looks the report card over thoughtfully. Johnnie’s Mom says, "Well, aren’t you going to say SOMETHING to him??"

Johnnie’s dad pulls him aside, and says, "Son, I think you are putting too much time and effort in on your Math."

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Work-related Stress can kill

Job stress raises the risk of heart disease by disrupting the body’s internal systems, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

The findings from a long–running study involving more than 10,000 British civil servants also suggest stress–induced biological changes may play a more direct role than previously thought.
The researchers measured stress among the civil servants by asking questions about their job demands such as how much control they had at work, how often they took breaks, and how pressed for time they were during the day.

The team conducted seven surveys over a 12–year period and found chronically stressed workers – people determined to be under severe pressure in the first two of the surveys – had a 68 percent higher risk of developing heart disease. The link was strongest among people under 50.

Stressed workers also eat unhealthy food, smoke, drink and skip exercise – all behaviors linked to heart disease.
In the study, stressed workers also had lowered heart rate variability – a sign of a poorly–functioning weak heart – and higher–than–normal levels of cortisol, a "stress" hormone that provides a burst of energy for a fight–or–flight response.

Too much cortisol circulating in the blood stream can damage blood vessels and the heart.

 
    Readers Responses
  1. Respected doctor sahib, many thanks for the very valuabe suggestions. wish you will keep us guiding all the time, wish you all the best in life upto handreds of years.regards: A N Arora
 
    Forthcoming Events

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

 
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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