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

 
  Editorial …

25th May 2012, Friday

NIH study finds sigmoidoscopy reduces colorectal cancer rates

Flexible sigmoidoscopy, a screening test for colorectal cancer that is less invasive and has fewer side effects than colonoscopy, is effective in reducing the rates of new cases and deaths due to colorectal cancer, according to research sponsored by the National Cancer Institute, part of the National Institutes of Health. In a study that spanned almost 20 years, researchers found that overall colorectal cancer mortality (deaths) was reduced by 26% and incidence (new cases) was reduced by 21% as a result of screening with sigmoidoscopy. These results appeared online on May 21, 2012, in the New England Journal of Medicine.

Sigmoidoscopy involves examination of the lower colon using a thin, flexible sigmoidoscope, to view the anus, rectum, and sigmoid colon. It has fewer side effects, requires less bowel preparation and poses a lower risk of bowel perforation than colonoscopy.

The most important message is that, regardless of modality chosen, colorectal cancer screening lowers mortality from colorectal cancer, and all individuals 50 and over should be screened.

From 1993 to 2001, a total of 154,900 men and women aged 55 through 74 were randomly assigned to receive flexible sigmoidoscopy screening or usual care as part of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial. People in the usual care group (i.e. control group) only received screening if they asked for it, or if their physician recommended it. This large population–based randomized trial was designed to determine the effects of screening on cancer–related mortality. Participants assigned to the flexible sigmoidoscopy group were screened once on entering the study (baseline) and again three years to five years later. The participants were followed for approximately 12 years to collect data on cancer diagnoses and deaths.

  • Overall, after an average of nearly 12 years, participants in the screening group had a 21% lower incidence of colorectal cancer overall and a 26% lower rate of colorectal cancer mortality than participants in the usual care group. This means that, over the course of 10 years, if 1,000 people followed the PLCO protocol of two sigmoidoscopy screenings, there would be approximately three fewer new cases and one fewer death from colorectal cancer than in a comparable group not receiving regular screenings.
  • The incidence of distal colorectal cancer was reduced by 29%, and mortality from distal colorectal cancer was reduced by 50%, in the screening group.
  • While there was no statistically significant decline in deaths from proximal colorectal cancer, the incidence of proximal colorectal cancer was reduced by 14% in the screening group.

"This is the second major trial that has shown that sigmoidoscopy is effective in reducing the risk of dying of colorectal cancer. Sigmoidoscopy is less invasive than colonoscopy and carries a lower risk of the colon being perforated, which may make it more acceptable as a screening test to some patients," said Barnett Kramer, M.D., director of NCI’s Division of Cancer Prevention. "There are several effective screening tests for colorectal cancer, and the most effective screening test is the one that people choose to take."

The researchers estimated that if they had used colonoscopy rather than sigmoidoscopy in this study, they would have identified 16% more cancers, two–thirds of which would have been proximal cancers. However, they were not able to determine what effect that may have had on proximal colorectal cancer mortality. There has been some controversy about how effective colonoscopy is in decreasing colorectal cancer mortality in different regions of the colon, with some studies suggesting that it is more effective against distal than proximal tumors. Sigmoidoscopy has never been directly compared to colonoscopy in a definitive clinical trial.

False–positive sigmoidoscopy results were observed in 20% of men and 13% of women in the screening group, but some of these false positives could have been the result of false–negative colonoscopies done to follow up on suspicious sigmoidoscopy findings. Approximately 22% of people in the screening group were sent for follow–up colonoscopies during the screening phase of the trial. (Source NIH)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

concept of stress management

Audio PostCard
 
    Photo Feature (From HCFI Photo Gallery)

World Earth Day organized at
DPS Mathura Road

World Earth Day was celebrated by Heart Care Foundation of India jointly with Delhi Public School

 
Dr K K Aggarwal
 
    Did you know?

Calendar for July 2012

Dr K K Aggarwal

This year, July has 5 Fridays, 5 Saturdays and 5 Sundays. This happens once every 823 years. This is the only time we will see and live this event. This is called money bags.

 
    National News

Stroke scale’s desi avatar at All India Institute of Medical Sciences

NEW DELHI: Two months ago, when Ramesh Chauhan was admitted to AIIMS after a stroke, he underwent a special test–health stroke scale–to measure the level of cognitive deficit he had suffered. He was asked to read English tongue–twisters and recognize pictures of cookie jars, among other objects. A UP–based farmer, Chauhan says he flunked the test not only because of the clots in his brain but also on account of the unfamiliar terms and objects he was asked to identify. Spelling relief for lakhs of patients like Chauhan, who are ill at ease with the English language, doctors at AIIMS have developed a Hindi version of the health stroke scale. It uses objects like balloon, lock, spoon, tiger, bus and telephone–relatively easier to identify – to assess the comprehensive abilities of patients. To check their language skills, simple words in Hindi like ‘namaskar’ and ‘mama’ have been added to the scale.

Dr Kameshwar Prasad, head of the neurology department, the brain behind the new scale, says the Hindi version will facilitate accurate assessment and treatment of over 75% of those who do not know English. "The test helps us decide whether clot busters should be given to the patient," said Prasad. "If the assessment is not right, drug administration and management of the patient becomes difficult as has been the case so far. Poor patients coming from rural backgrounds were often unable to identify objects in the English version of the scale or read sentences. "Doctors had to pitch in and explain to them the sentences in Hindi or use new subjects from the surroundings for the test," said Amit Kumar, a researcher part of Dr Prasad’s team, who recently validated the efficacy of the Hindi version through a clinical trial. Around 107 patients admitted at the emergency department and neurology wards of AIIMS underwent the trial. The study has been published in the latest issue of Neurology, India. (Source: TOI, May 21, 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)

ARDS clarified in new definition

A new definition of acute respiratory distress syndrome (ARDS) clarifies some aspects of the condition and eliminates a confusing category of lung injury, attendees at the annual meeting of the American Thoracic Society were told. The resulting definition stratifies ARDS into three categories – mild, moderate, and severe – and relies mainly on the degree of the patient’s hypoxia to distinguish between them. A key change from the 1994 definition developed by the American–European Consensus Conference and used since then is the elimination of acute lung injury (ALI) as a clinical category. Details of the new definition and the process used to reach it were described here and in a simultaneous online publication in the Journal of the American Medical Association. (Source: Medpage Today)

For comments and archives

HCV patients may be able to delay therapy

Hepatitis C patients without significant fibrosis may be able to delay triple therapy and wait for simpler, shorter, and potentially all–oral regimens that are currently under investigation, researchers said at Digestive Disease Week (DDW) in San Diego. (Source: Medpage Today)

For comments and archives

Herbal, dietary supplements take toll on liver

Patients taking herbal and dietary supplements may be at risk for liver injury severe enough to warrant an organ transplant, researchers said at Digestive Disease Week (DDW) in San Diego. (Source: Medpage Today)

For comments and archives

In Sight: Healthy heart cells from HF patient’s skin

For the first time, skin cells taken from advanced heart failure patients were able to be coaxed in the lab to regenerate into healthy, patient–specific heart muscle cells, researchers found. In addition, the new heart cells successfully integrated with existing rat heart tissue in vitro, Lior Gepstein, MD, from Rambam Medical Center in Haifa, Israel, and colleagues reported online in the European Heart Journal. (Source: Medpage Today)

For comments and archives

 
   Twitter of the Day

@DrKKAggarwal: Add fiber to the diet only slowly

@DeepakChopra: Our choices create time lines for the future evolution of the universe.

 
    Spiritual Update

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

Handling anger during the attack

  1. As per Yoga Sutras of Patanjali, anger management involves ‘thinking the opposite’ at that moment of anger. Or at the time of anger, one should learn to be in silence and take deep breaths.
  2. As per Lord Buddha, during anger, one should think differently.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is the treatment of infertility for women having endometriosis?

For infertile women with suspected minimal or mild endometriosis, a decision must be made whether to perform laparoscopy before starting treatments to enhance fertility. Clearly, factors such as a woman’s age, duration of infertility, and pelvic pain must be considered. Other infertility factors may co–exist and impact success rates and treatment outcome. If pain also is a concern, laparoscopy and surgical treatment seem prudent. In addition, laparoscopy and possible laparotomy are recommended when moderate or severe endometriosis is suspected.

For comments and archives

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

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

What does pre transplant evaluation include?

Pre transplant Immunizations: Most units including ours consider live vaccines to be contraindicated after liver transplant because of the risk of dissemination secondary to immunosuppression. It is therefore better to complete normal immunizations before transplant. These include – BCG, DPT + Hib, Hepatitis B, Measles, MMR. It’s suggested to give even optional vaccine such as Hepatitis A, Typhoid, Chickenpox, Influenza, Rotavirus and Pneumococcal vaccines. The vaccination schedule may be expedited and may differ from the normal recommendations.

Management of hepatic complications: It is important to ensure that specific hepatic complications are appropriately managed while the patient waits for transplant. These include portal hypertension, esophageal varices, ascites, hypoproteinemia etc.

Nutritional support: It has been demonstrated in several studies that nutritional status at liver transplant is an important prognostic factor in survival i.e. better outcome is seen in patients with good nutritional status. The patient needs to be on a high calorie diet (150–200% calories good protein intake) with two times the RDA of multi vitamins and in patients with Cholestasis, supplementation with fat–soluble vitamins like vitamin A, D, E, and K is done. In patients with cholestasis, MCT oil as in coconut oil is used for cooking. If a child is not able to feed well orally then tube feed supplementation is done, which could be for overnight feeds or during the day as per the need.

For comments and archives

 
   An Inspirational Story

(Ms Ritu Sinha)

The Acorn Planter

In the 1930s, a young traveler was exploring the French Alps. He came upon a vast stretch of barren land. It was desolate. It was forbidding. It was ugly. It was the kind of place you hurry away from.

Then, suddenly, the young traveler stopped dead in his tracks. In the middle of this vast wasteland was a bent-over old man. On his back was a sack of acorns. In his hand was a four–foot length of iron pipe.

The man was using the iron pope to punch holes in the ground. Then from the sack he would take an acorn and put it in the hole. Later the old man the traveler, "I’ve planted over 100,000 acorns. Perhaps only a tenth of them will grow." The old man’s wife and son had died, and this was how he chose to spend his final years. "I want to do something useful," he said.

Twenty–five years later the now–not–as–young traveler returned to the same desolate area. What he saw amazed him. He could not believe his own eyes. The land was covered with a beautiful forest two miles wide and five miles long. Birds were singing, animals were playing, and wild flowers perfumed the air.

The traveler stood there recalling the desolation that once was; a beautiful oak forest stood there now – all because someone cared.

For comments and archives

 
   Cardiology eMedinewS

Sex talk helps heart attack patients Read More

Psoriasis and heart disease Read More

PAH drug cleared of long–term liver damage Read More

 
   Pediatric eMedinewS

Same–day discharge for pediatric appendectomy is safe Read More

Preeclampsia ups child’s CV risk profile Read More

Laparoscopic sleeve gastrectomy curbs pediatric obesity Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A pregnant female had glucose intolerance.
Dr Bad: It will not affect your child.
Dr Good: Your child may be susceptible to type 2 diabetes.
Lesson: Maternal glucose intolerance may impair fetal insulin sensitivity (but not beta cell function), and consequently ‘program’ the susceptibility to type 2 diabetes.

For comments and archives

Make Sure

Situation: A patient who had blood in the urine one month back was found to have large bladder cancer.
Reaction: Oh my God! Why was a cystoscopy not done at that time?
Lesson: Make sure that all painless bleeding in the urine are investigated for cancer at the first presentation.

For comments and archives

 
    Legal Question of the day

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

Q. What are the legal features of a dying declaration?

Ans.

  • The following four statements are found in the legal dictionary: http://legal–dictionary. thefreedictionary.com/Dying+Declaration
    • A DD is a "statement by a person who is conscious and knows that death is imminent concerning what he or she believes to be the cause or circumstances of death that can be introduced into evidence during a trial in certain cases."
    • A dying declaration is considered credible and trustworthy evidence based upon the general belief that most people who know that they are about to die do not lie. As a result, it is an exception to the Hearsay rule, which prohibits the use of a statement made by someone other than the person who repeats it while testifying during a trial, because of its inherent untrustworthiness. If the person who made the dying declaration had the slightest hope of recovery, no matter how unreasonable, the statement is not admissible into evidence. A person who makes a dying declaration must, however, be competent at the time he or she makes a statement, otherwise, it is inadmissible.
    • A dying declaration is usually introduced by the prosecution, but can be used on behalf of the accused.
    • As a general rule, courts refuse to admit dying declarations in civil cases, even those for Wrongful Death, or in criminal actions for crimes other than the Homicide of the decedent.
  • As per V V Pillay’s "Textbook of Forensic medicine and Toxicology", 16th edition, 2011 (Paras Medical Publisher, Delhi):
    • "A DD is a "statement, written or oral, made by a person who is on the verge of dying as a result of unnatural causes".
    • A person who is accused of crime cannot make a DD. It can only be made by a person who is the victim of crime.
    • Statements unconnected with the actual crime are not admissible in a DD.
    • A DD has the same measure of worth as a statement made on oath in a court.
    • A DD is valid even if the declarant lives for some days after making the declaration but, in that case, it may be relied on only as corroborative evidence.
    • It must be recorded in the presence of two witnesses and must be written in the language in which the declarant prefers to speak. No information must be elicited by asking leading questions. No prompting or suggestions should be made and no undue influence should be imposed on the declarant.
    • If the dying person is unable to speak but is able to make gestures in answers to questions, it can be recorded after deciphering the gestures. The medical officer recording the declaration should only mention the precise nature of gestures made and should not interpret them himself. Interpretation is done subsequently by the court. (NOTE—I do not agree with certain aspects of e and f above).
  • A recent SC judgment titled Sharda Vs. State of Rajasthan, decided by Judges Aftab Alam and Deepak Verma on 15.12.2009, throws important light on how to evaluate a DD:
    http://advocatessociety.com/General/ReadMoreJudgementUpdate.aspx?jid=573

    "Digest: Indian Evidence Act,1872, Sec. 32 – Dying Declaration – Requirements of Oath and Cross–Examination – Requirements of oath and cross–examination are dispensed with and the reason in law to accept the veracity of deceased statement indicates that a person who is on a death bed would not tell a lie to falsely implicate an innocent person, but if the dying declaration is to be completely excluded in a given case, it may even amount to miscarriage of justice as the victim alone being the eye–witness in a serious crime, the exclusion of the statement would leave the court without a scrap of evidence – A dying declaration is entitled by law to be given greater weightage but with an observation that accused had no chance of cross-examination and right of cross-examination is essential for eliciting the truth as an obligation of oath, therefore, the dying declaration should be such which inspires full confidence of the court of its correctness – The court has to be on guard that such statement of deceased was not as a result of either tutoring, prompting or product of imagination, the court must be further satisfied that deceased was in a fit state of mind after a clear opportunity to observe and identify the assailants – Once the court is satisfied that the aforesaid requirement and also to the fact that declaration was true and voluntary, it can base its conviction without any further corroboration, it is not an absolute rule of law that the dying declaration cannot form the sole basis of conviction unless it is corroborated, the rule requiring corroboration is merely a rule of prudence – The present case revolves around the three dying declarations of deceased, no charge leveled against appellant u/s 498–A IPC and the said charge was not found proved against other co–accused, therefore no necessity to critically examine other evidence – As per the first dying declarations no liability can be fastened on the appellant or anyone else as cross–examination fully establishes that she had sustained burn injuries on her own while cooking food – In her second statement, she stated that no one had put her to fire and no one should be blamed for it – The third statement was an afterthought and has been got prepared after the deceased appears to have been tutored to say so by her Parents, therefore, it has to be completely ignored (para 17, 23, 24, 29, 30, 33 & 34)".

For comments and archives

 
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  Quote of the Day

(Dr GM Singh)

God gives every bird its food, but He does not throw it into its nest. JG Holland

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Only tissue diagnosis is conclusive. Where tissue diagnosis is not possible, clinical correlation along with radiology findings is mandatory.

 
    Mind Teaser

Read this…………………

A client has been diagnosed with disseminated intravascular coagulation (DIC). Which of the following is contraindicated with the client?

a. Administering heparin
b. Administering coumadin
c. Treating the underlying cause
d. Replacing depleted blood products

Yesterday’s Mind Teaser: Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may indicate all of the following except:

a. Effects of radiation
b. Chemotherapy side effects
c. Meningeal irritation
d. Gastric distension

Answer for yesterday’s Mind Teaser: d. Gastric distension

Correct answers received from: Dr LC Dhoka, Dr Sushma Chawla, Dr BB Aggarwal, Dr Prabha sanghi,
Dr ValluriRamarao, Dr Thakor Hitendrsinh G, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Raju Kuppusamy, Yogindra Vasavada, Dr Avtar Krishan, Anil Bairaria, Dr U Gaur.

Answer for 23rd May Mind Teaser: c. Bleeding tendencies
Correct answers received from: Shirish Singhal, Dr U Gaur, Y J vasavada, Prof Chetana Vaishnavi.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Here are few great reasons to allow drinking in the workplace...

  1. It’s an incentive to show up.
  2. It reduces stress.
  3. It leads to more honest communications.
  4. It reduces complaints about low pay.
  5. It cuts down on time off because you can work with a hangover.
  6. Employees tell management what they think, not what management wants to hear.
  7. It helps save on heating costs in the winter.
  8. It encourages carpooling.
  9. Increases job satisfaction because if you have a bad job you don't care.
  10. It eliminates vacations because people would rather come to work.
  11. It makes fellow employees look better.
  12. It makes the cafeteria food taste better.
  13. Bosses are more likely to hand out raises when they have had a couple of drinks.
  14. Salary negotiations are a lot more profitable.
 
    Medicolegal Update

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

Antiquity of Indian medicine & medical education – Charak Samhita

Acharya Charak has been crowned as the Father of Medicine. His renowned work, the "Charak Samhita" is considered as an encyclopedia of Ayurveda. His principles, diagnoses, and cures retain their potency and truth even after a couple of millennia. At the time when in Europe, the science of anatomy was confused with different theories, Acharya Charak revealed through his innate genius and enquiries the facts on human anatomy, embryology, pharmacology, blood circulation and diseases like diabetes, tuberculosis, heart disease, etc. In "Charak Samhita" he has described the medicinal qualities and functions of 100,000 herbal plants. He has proved the correlation of spirituality and physical health and contributed greatly to diagnostic and curative medical sciences. He has enumerated the ethical charter for medical practitioners two centuries prior to the Hippocratic Oath.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Why do commercial and foods cooked by ‘Halwaiis’ taste better?

Hydrogenated oils containing trans fats are tastier than foods cooked in plant oils. Most hydrogenated oils involve hydrogenation of palm oils. Hydrogenation increases their shelf life, makes them easier to cook and spoil less easily. French fries, microwave popcorns and food cooked by traditional halwaiis are cooked in hydrogenated trans fats, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Most commercial catered food prepared from trans fats are tasty and often people overeat by atleast 500 calories because of the taste provided by the hydrogenated oils.

Per serving, 5 grams of trans fatty acids is present in French fries, 6 gm in breaded fish burger, 5 gm in breaded chicken nuggets, 2 gm in biscuits, 2.7 gm in margarine, 2 gm in cakes, 1.6 gm in corn chips, 1.2 gm in microwave popcorn and 1.1 gm in pizza.

Four gm of trans fats are present in one parantha, 3.4 gm in one poori, 5.2 gm in one bhatura, 1.7 gm in one dosa, 6.1 gm in one tikki, 3 gm in one samosa, 2 gm in one serving of pakoda, 2.9 gm in one serving of vegetable pulao and 3.6 gm in one serving of halwa.

Just about 2.6 gm a day of trans fats, half as much contained in a packet of French fries can raise the risk of heart disease significantly.

Some trans fats occur naturally in foods, especially those of animal origin. The chemical configuration of trans fatty acids confers harmful effects, including adverse influences on blood LDL– and HDL–cholesterol concentrations. They raise LDL and lower HDL cholesterols.

By comparison, consumption of saturated fats also raises the LDL cholesterol concentration, but does not lower HDL. Thus, while saturated fats adversely affect the lipid profile, they may not be as harmful as trans fatty acids.

Trans fatty acids may also interfere with the desaturation and elongation of n–3 (omega–3) fatty acids. These are important for the prevention of heart disease and complications of pregnancy. In an analysis from the Nurses’ Health Study, for each increase of 2 percent of energy from trans fat, the relative risk for incident coronary heart disease was 1.93. There are no known physiologic benefits related to the consumption of trans fatty acids; thus, reduction in their intake makes sense.

A clue to their presence are the words "partially hydrogenated" on the list of package ingredients. Since 2006, the US Food and Drug Administration (FDA) has made it a requirement that Nutrition Facts labels portray trans fat content. FDA estimates that the average daily intake of trans fat in the U.S. population is about 5.8 grams or 2.6% of calories per day for individuals 20 years of age and older. On average, Americans consume approximately 4 to 5 times as much saturated fat as trans fat in their diet.

FDA’s label requirement is that if a dietary supplement contains a reportable amount of trans fat, which is 0.5 gram or more, dietary supplement manufacturers must list the amounts on the Supplement Facts panel. The FDA final rule on trans fatty acids requires that the amount of trans fat in a serving be listed on a separate line under saturated fat on the Nutrition Facts panel.

However, trans fats do not have to be listed if the total fat in a food is less than 0.5 gram (or 1/2 gram) per serving.

All restaurants in New York have banned all the food items which contain more than 0.5 gm of trans fats in one serving.

Guidelines

  • Check the Nutrition Facts panel: Choose foods lower in saturated fat, trans fat and cholesterol.
  • Choose alternative fats. Replace saturated and trans fats in your diet with mono- and polyunsaturated fats. These fats do not raise LDL (or "bad") cholesterol levels and have health benefits when eaten in moderation. Sources of monounsaturated fats include olive and canola oils. Sources of polyunsaturated fats include soybean, corn, sunflower oils, and foods like nuts.
  • Choose vegetable oils (except coconut and palm kernel oils) and soft margarines (liquid, tub, or spray) more often because the combined amount of saturated and trans fats is lower than the amount in solid shortenings, hard margarines, and animal fats, including butter.
  • Consider fish. Most fish are lower in saturated fat than meat. Some fish, such as mackerel, sardines and salmon, contain omega–3 fatty acids that are being studied to determine if they offer protection against heart disease.
  • Limit foods high in cholesterol such as liver and other organ meats, egg yolks and full–fat dairy products, like whole milk.
  • Choose foods low in saturated fat such as fat free or 1% dairy products, lean meats, fish, skinless poultry, whole grain foods and fruit and vegetables.
 
    Readers Response
  1. Sir, this is in response to "Mahabharata can never happen in today’s era". This story may tickle the funny bone, but Mahabharata like situations can happen. This is my personal story. "Mahabharata is the story of war between Pandavas and Kauravas. Pandavas were seemingly right but Kauravas had more influence over the blind king Dhritrashtra. Vidur was the employee of Dhritrashtra but his righteousness obliged him to favor Pandavas. The war went on for several years.

    The result of the war today. Pandavas lured by the luxuries of Canada suddenly lost all interest in the war. Dhritrashtra nabbed some two crores and went aloof. Kauravas won the crown of Asst. Professor. Vidur lost everything – the friends, the humor, the confidence, the faith. Krishna – the neutral observer – kept smiling." Dr. Anupam Sethi Malhotra
 
    Forthcoming Events
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

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

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  Pesticides Safely

 
    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