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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

 

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  Editorial …

25th July 2011, Monday

Barundanga – the new addition to date rape drugs

Burundanga is in the news for its bad effects as it is being used for criminal activities like rape or to rob passengers. The drug is passed on to the victim through business cards, pamphlets, drink etc. Thorough touch the skin can absorb a very small quantity and can lead to adverse effects.

It is a voodoo powder obtained from a Colombian local plant of the nightshade family called barrachera, or "drunkenbinge". It is a new addition to the date rape group of drugs.

Traditionally it has been used for religious ceremonies. The powder when ingested causes victims to lose their will and memory, a condition well described as chemical hypnotism.

Medically the refined the powder contains scopolamine, a medical drug. It is used in the treatment of nausea, motion sickness, and gastrointestinal cramps. It is also used as a pre surgical drug for the purpose of impairing memory of surgical trauma. It provides an initial knockout effect, before the anaesthesia proper is administered, and has the added benefit of preventing long term memory formation during the period of time. At one time scopolamine was given to women during childbirth.

Like any other date rape drugs, it is colorless, smell less and tasteless and can easily me mixed with any liquid. In powdered form scopolamine can be easily mixed into food or drink, or blown directly into victims’ faces, forcing them to inhale it.

One ingested the victim can't say no; has no will and becomes open to suggestion; from the moment it's given, the victim remembers absolutely nothing of what happened (ante grade amnesia).  For this reason this has been used as a “truth serum” by law enforcement agencies and knockout drug by criminals.

Scopolamine has a selective effect on memory. The planning and manipulation of information remain unaffected. Victims remain active in terms of cognitive but are unable to retain information. It blocks the release of acetylcholine. It affects brain functioning amygdala, a brain area that controls aggression and anxiety. This explains the calming effect it has on the drug.

For comments

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Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Gatifloxcin banned but not the eye drops

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight
on Medicolegal Issues

Advocate Ms Indu Malhotra was felicitated at the National Conference on Insight on Medico legal issues. .

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

Soon, Tricolour to flutter high on Jaipur

JAIPUR: The capital skyline is set to acquire a new dimension with the national flag being hoisted at a height of 206 feet throughout the year. An initiative of Flag Foundation of India, the flag itself would be of 48 feet wide and 72 feet in length and weigh about 27 kg. The Jaipur Development Authority (JDA) has received a letter from the state government to identify the land where a pole of the required height can be installed, said sources. A direction was given to the authorities after the Flag Foundation of India, of which Member of Parliament from Kurukshetra, Naveen Jindal is the founder president, has showed eagerness to install the flag in the city. Flag Foundation India CEO, Commander (Rtd) K V Singh, said: "The letter was written to the Government of Rajasthan in December 2010, to install national flag in the capital. FFI plans to install national flags at all the district headquarters of the country." "The cities which have these poles installed will have national flags fly 24 hours throughout the year. The 206 feet flag mast will have a decorated crest and a high voltage light falling on the flag at night making it more beautiful." The FFI has installed such flag poles in Kurukshetra, Orissa, Kanyakumari, and Bangalore. (Source: TOI, Jul 19, 2011) 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

(Dr Monica and Brahm Vasudev)

Is ticagrelor approved for ACS?

Antiplatelet drug ticagrelor has been approved by FDA for reducing thrombotic events in patients with acute coronary syndrome who are candidates for stenting. For comments and archives

Seaweed: Rich source of nutrition for heart

Scientists have identified seaweeds, that form an important element of Chinese and Japanese cuisine, as a rich new source of nutrition for the heart which could rival milk products as sources of these so–called "bioactive peptides". Bioactive peptides, obtained mainly from milk products, not only provide nutrition, but have a drug–like effect in treating or preventing certain diseases, reports the Journal of Agricultural and Food Chemistry. Maria Hayes, chemist at the Teagasc Food Research Centre, Ireland and colleagues Ciarán Fitzgerald, Eimear Gallagher and Deniz Tasdemir turned their attention to seaweeds as a source of protein that work like bioactive peptides, according to a Teagasc statement. Their review of almost 100 scientific studies concluded that some seaweed proteins work just like milk products to reduce blood pressure, like the popular ACE inhibitor drugs. (Source: TOI, Jul 21, 2011)

For comments and archives

Two metabolic defects turn ‘jolly’ fat risk

Obesity is a recognized risk factor for heart disease, but it is the location of fat –– in the belly or in the liver –– that combines to drive metabolic defects that produce hypertriglyceridemia, researchers found. Between two groups of obese patients with similar BMI and visceral fat volume, patients with higher liver and subcutaneous abdominal fat were found to have increased very low density lipoprotein1 (VLDL1) levels, Jan Borén, MD, of the University of Gothenburg in Sweden, and colleagues reported. In addition, those with increased plasma levels of apolipoprotein C–III (apoC–III) were more likely to have impaired triglyceride clearance, the authors wrote in Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association. (Source: Medpage Today) For comments and archives

Lysis plus contrast okay in stroke

Stroke patients treated with intravenous thrombolysis did not have an increased incidence of cerebral hemorrhage when exposed to iodinated contrast media, data from a retrospective review showed. About 4% to 6% of patients developed post–thrombolysis brain hemorrhage, regardless of whether they received intravenous iodinated contrast, Niall J.J. MacDougall, MRCP, of the University of Glasgow, in Glasgow, Scotland, and colleagues reported. (Source: Medpage Today) For comments and archives

 
    Fitness Update

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

Exercise helps rid the body of toxins, UNB researcher says

The results of a recent study by Amelia Beaney, a nursing researcher at the University of New Brunswick, indicates an association between pre– and post–cancer treatment and physical activity. Beaney used cross–sectional surveys to document the physical activity levels of cancer patients in the Horizon Health Network who had completed acute cancer treatment. She found that those who reported being moderate to highly physically active before cancer treatment were seven times more likely to be moderate to highly active after completion of cancer treatment. For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on IBN 7on Hooka bad for Health http://t.co/okj1yGc via @youtube

@DeepakChopra: #CosmicConsciousness Nothing belongs to us. We belong to the world.

 
    Dr KK Answers

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

What to opt: Medical or surgical revascularization in patients with coronary heart blockages with reduced left ventricular function (heart pumping)?

Up to 50% of patients with low pumping function of the heart due to coronary heart blockages have a significant amount of viable hibernating heart muscles. Many earlier studies have shown that, when compared to drugs, surgical revascularization of hibernating heart muscles improves both survival and heart function. The Surgical Treatment for Ischemic Heart Failure (STICH) trial was the first randomized trial to compare the combination of optimal medical therapy and surgical revascularization with optimal medical therapy alone in patients with stable heart disease, heart pumping function 0f 35 percent or less, and coronary artery blockages amenable to coronary artery bypass graft (CABG) surgery.

Compared to optimal medical therapy alone, optimal medical therapy plus CABG surgery resulted in no significant improvement in all–cause mortality at a median follow–up of 56 months (36 versus 41 percent with medical therapy alone). In all patients with heart pumping function of 35 percent or less and coronary artery blockages amenable to CABG surgery, one should opt for an initial course of optimal medical therapy alone rather than optimal medical therapy plus CABG surgery. This is based on the significant morbidity associated with CABG surgery. However one should opt for CABG surgery in presence of ongoing anginal symptoms despite optimal medical therapy. (N Engl J Med 2011;364:1607)

For comments and archives

 
    Spiritual Update

The Deeper Meaning of "Lord Shiva"

Lord Shiva is worshipped along with his entire family in the month of Shravan on every Monday. Shiva is given a bath with milk, water, curd, ghee, honey or sugar, ganga jal etc. Belpatra, Samipatra, Kusha and Doob are offered to please him. Most of us worship Lord Shiva without understanding the d

For comments and archives

 
    An Inspirational Story

(Dr Anupam Sethi Malhotra)

A monk and his disciple reached a river bank. They had to cross it to reach their monastery. The river was full and the flow heavy. But they could walk across the river. A young woman was on the bank. She had to cross the river but could not cross it alone. She sought the help of the monk. He immediately picked her up and carried her on his back, across the river. When they reached the other side of the river, he lowered her to the ground. She thanked him. They went in different directions.

The disciple was tremendously shocked to see the monk carry a woman on his back. He believed that it was against their vow of chastity to touch a woman. But he did not dare to question his teacher. He was constantly being disturbed by the incident and after three months, one day he asked the teacher why he had broken the vows of chastity and celibacy.

The monk laughed and remarked, I carried her across the river and left her at the bank. You have been carrying that burden for three months! Clearly the sage had kept his vow but the disciple had been breaking the vow of chastity in his mind all those days!

The story teaches that the merit of an action is determined by our attitude. The saintly and scholarly sage had done an act of charity without affecting his vow of chastity. We must do our duty without caring for reward or recognition or ridicule. It is said, Do your duty. That is your beauty.

Happy are those who are merciful to others; God will be merciful to them! Happy are the pure in heart; they will see God! For comments and archives

 
    Idioms

(By Ritu Sinha)

A taste of your own medicine: When you are mistreated the same way you mistreat others.

 
    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What are the common causes of ALF in adults?

The common causes of ALF in adults in India are viral hepatitis (Hepatitis E > Hepatitis A), hepatitis B, drug induced, Wilson’s disease, autoimmune hepatitis, acute fatty liver of pregnancy/HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) syndrome, Budd–Chiari syndrome and malignant infiltration.

For comments and archives

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

BNP and NT–proBNP

BNP or NT–proBNP may be used to help diagnose heart failure and to grade the severity of that heart failure. BNP and NT–proBNP levels decrease in most patients who have been taking drug therapies for heart failure, such as ACE inhibitors, beta blockers, and diuretics. Levels of both BNP and NT–proBNP tend to increase with age. Levels of NT–proBNP and BNP are increased in persons with kidney disease.

While both BNP and NT–proBNP will rise with left ventricle dysfunction and either can be measured, they are not interchangeable and the results cannot be directly compared. For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A female on bisphosphonate developed femoral fracture.
Dr. Bad: They are unrelated.
Dr. Good: It may be related to the drug.
Lesson: February 23 issue of JAMA has shown that bisphosphonates can cause atypical femoral fractures. For comments and archives

Make Sure

Situation: A patient with CKD developed acute renal failure.
Reaction: Oh my God!! Why was injection diclofenac given!
Lesson: Make sure that CKD patients are not given any painkiller. Even a single dose can precipitate renal failure. For comments and archives

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    Quote of the Day

(Dr GM Singh)

Success usually comes to those who are too busy to be looking for it. Henry David Thoreau

 
    Medicolegal Update

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

What is the Continuing Treatment Rule?

In medical practice, when a physician retires or moves and sells his or her practice to a succeeding health care provider, patients records are often sold as part of the transaction. However, physicians should be warned that many states have medical record retention acts, and these acts usually do not provide an exception for record-keeping requirements even in such a transfer.

  • When the patient treatment continues for a period of time, during which it is difficult to ascertain when the negligence occurred. Some jurisdictions have adopted a "continuing treatment" rule to determine the time of injury for purposes of the statute of limitations.
  • The continuing treatment rule provides another exception to the statute of limitations by extending the time allowed for the filing of a complaint.
  • The malpractice action would only accrue, thus activating the statute of limitations, when treatment of the medical condition ceases.

(Ref: American College Of Legal Medicine, the Medical Malpractice Survival Handbook 2007)

For comments and archives

 
    Mind Teaser

Read this…………………

The mother of a one and a half year old child gives history of a white reflex from one eye for the past one month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:

1. Congenital cataract
2. Retinoblastoma
3. Endophthalmitis
4. Coats of disease

Yesterday’s Mind Teaser: japmadean

Answer for Yesterday’s Mind Teaser: made in Japan

Correct answers received from: Dr Suhail Khuroo, Dr Rashmi Chhibber, Dr Neelam Nath, Dr Anupama, Dr Jotendar, Dr Sudesh, Dr Priya, Dr Krish, Dr Piyush, Dr Sikhar, Dr Muthumperumal Thirumalpillai, Dr Chandresh Jardosh

Answer for 23rd July june Mind Teaser: 3. Gating
Correct answers received from: Dr. Prashant Bharadwaj, Dr Prachi, Dr Shweta, Dr Geeta, Dr Jatin, Dr Subodh

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

Transfer Pricing

  • Standard deduction of variation of 5% on arm’s length price outdated. New variation to be notified. Applicable from AY 2012–13 onwards.
  • TPO to determine the arm’s length price of additional international transactions other than those referred by the AO.
  • Additional powers of survey conferred on the TPO. Applicable from 01.06.2011
  • Filing of Accountant’s Report in Form No. 3CEB extended to 30 November. (w.e.f 01.04.2011) Applicable to AY . 2011–12
 
   Laugh a While

(Mr Sudesh Kumar)

It takes a thousand workers 2 build a castle, Million soldiers to protect a country, but just One woman to make a Happy Home ……… A Good Maid servant !

For comments and archives

 
    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
Indication
DCI Approval Date
Hydroquinone USP 2% w/w + Tretinoin USP 0.025% w/w + Allantoin USP 1%w/w Gel
For treatment of hyperpigmentary disorders
31.01.11
 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online (English/Hindi/Audio/Video/Photo)

Chaturmas: time to strengthen inner healing

The "Chaturmas" begins on the Ekadashi in the month of Ashadha and ends with the Ekadashi in the month of Kartik and has got both spiritual and health implications said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela. It’s a period when no marriages and auspicious functions are held.

Four months of monsoon are called holy months of the year or chaturmas coincide with many festivals. Chaturmas starts with Guru Poornima, a festival to worship your teacher.

Next comes the month of Shravana, in which Mondays are worshipped for Lord Shiva. The Narali Poornima in this month, which marks the end of heavy rain and the throwing of the coconut in the sea, appeases the sea and it calms down. Nag Panchami and Gokul Ashtami are parts of this month.

Bhadrapad is the next. The first half is dedicated to the worship of Ganapati, the lord of removal of obstacles and the second half to shradhs when religious ceremonies are held in memory of the departed souls.

The month of Ashwin starts with the "Navratri" through Dusshera to Diwali. Kojagiri Purnima in this month is the bright Purnima. The last two days of Ashwin and the first two days of Kartik are usually the days of the Diwali festival. Ekadashi in the first half of the month of Kartik marks the end of the Chaturmas.

The days of monsoon are not usually healthy days. But, for doctors it is a healthy season as they get a large number of patients.

Health implications

  • In the monsoon, all the three doshas as per Ayurveda (movement, metabolism and structure) are vitiated.
  • Vata aggravation is predominant in rainy season leading to movement disorders.
  • Light diet and less oily food is advised, as digestive power is weak.
  • Weak digestion also leads to stomach upsets.
  • Ground worms come to the surface and contaminate underground and surface vegetables.
  • Community feasts, marriages, social functions, gatherings are therefore prohibited in this season.
  • River water gets contaminated.
  • Observance of regular fast counteracts these unhealthy conditions.
  • Snake bites are common. Nagpanchami represents not to kill them unnecessarily as most of them are not poisonous.
  • Green leafy vegetables are avoided in the Shravan month, Curd in Bhadrapad, Milk in Ashwin and Pulses (split variety) and oils in Kartik.
  • In rainy season, Vata dosha is aggravated. Green vegetables aggravate vata and hence are avoided.
  • In Bhadrapad month, pitta is accumulating and hence pitta producing foods are avoided (curd and fermented foods).
  • In Kartik, the kapha dosha accumulates and hence oils are restricted.
  • In allopathy, vata is movement, pitta is metabolism and kapha is structural functions.
  • One should abstain from tea, coffee, sugar, rice, wheat etc and avoid garlic and onion as it can stimulate unnecessary excitements and cause indigestion.
  • Chaturmas is the time to meditate, read spiritual scriptures, and strengthen inner immunity by meditation.
  • In Chaturmas, the negative thinking and emotions are common due to vata imbalance and hence most agreements and important celebrations are avoided during this period.

For comments and archives

 
    Readers Responses
  1. Respected sir read your article on ‘A New helpline policy from MOH’. It is a strong rebut on the silly guideline. Who gives them such idiotic ideas. Dr Sundeep Nigam
 
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.

...more

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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Pawan Gupta (drpawangupta2006@yahoo.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta