emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org

 

  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

25th October 2012, Thursday

US, Indian Physicians report Success with Recycled ICDs

The largest study to date has shown that it is possible to reuse explanted implantable cardioverter defibrillators (ICDs) after they have been resterilized. The devices were removed and brought to a large medical center in India, frequently in luggage of the participating physician or their family members, and reimplanted in at-risk patients. The retrospective report is based on the experiences of electrophysiologists at Holy Family Hospital in Mumbai, India and is published in the October 15, 2012 issue of the Annals of Internal Medicine.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Dietary interventions: Soluble fiber, especially psyllium may offer benefits to stool frequency and stool consistency. There are less data to support the value of insoluble fiber. Bran, a form of insoluble fiber, is probably the most commonly used fiber. But, soluble fiber, specifically psyllium, is a better choice (Am J Gastroenterol 2005;100:S1-S4).

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Obesity reduces life expectancy

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

MCD South Zone to Train its Teachers on Health & Hygiene at Perfect Health Mela

Addressing a press conference, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Mr. Satish Upadhyay, Chairman Education Committee, MCD South Zone said that MCD South Zone in association with Heart Care Foundation of India will be organizing a training program for its teachers on 7th November, 2012, Wednesday, at Constitution Club of India.

 
Dr K K Aggarwal
    National News

Osteoporosis rising among youth: doctors

THIRUVANANTHAPURAM, The threshold age for osteoporosis — traditionally thought to be somewhere around 50 or 60 years — appears to be shifting downwards in Kerala, orthopaedics from a private clinic in the city who addressed a press conference here on Friday said. A sedentary lifestyle and marked reduction in the levels of Vitamin D in the body could be said to be the main reasons for rising incidence of the disease that was also known as the ‘silent thief,’ Thomas M. George and George Selvaraj said. Dr. George said the problem had been noticed among IT employees who had a sedentary lifestyle. Bone mineral density tests done on many such persons had returned readings indicative of bone density problems. It was also surprising that in Kerala, where there was plenty of sunlight, many persons had a deficiency of Vitamin D, he said. Dr. Selvaraj said regular exercise was a sure-shot counter to the onset of osteoporosis. “While there are exercises such as swimming that mostly strengthen muscles, walking is one activity that strengthens bones too. Any weight-bearing exercise is good for the bones,” he added. When an aged person falls down and suffers a fracture, people normally say that the fracture was caused due to the fall. It is usually the other way round; aged persons fall down because their bones snap. Osteoporosis has its socio-economic implications too, in that such falls often leave aged persons bed-ridden and critically dependent on care givers,” the doctors said. Tests for bone mineral density were not widely available under the public health system and were also not very cheap, the doctors pointed out. In reply to a question, they said that while extensive data on the incidence of osteoporosis was available in the western countries, the situation in Kerala was the exact opposite. (Source: The Hindu, October 20, 2012)

For comments and archives

My Profession My Concern

Recommendations of the Expert Advisory Group Meeting on the 14th Oct, 2004

Administration of antibiotics

The indications for which antibiotic therapy is recommended are:

  • Premature rupture of membranes
  • Prolonged labour
  • Anything requiring manual intervention
  • UTI
  • Puerperal sepsis
  • There should be instructions for the ANMs that after starting the woman on antibiotics, she should inform the PHC Medical Officer.

For comments and archives

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 rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    Valvular Heart Disease Update

Mitral stenosis in the elderlyMitral stenosis in the elderly

Valvular mitral stenosis is rarely seen in elderly patients. Mitral obstruction may be produced by protuberant mitral annular calcification (MAC). It is present in 6% of the elderly population.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

HCV admissions rise while HIV ones fall

Hospital admission rates for people with hepatitis C have risen nearly five-fold over a 15-year period, a researcher said at the annual IDWeek meeting. (Source: Medpage Today)

For comments and archives

Staph vaccine linked to multiorgan failure and death

A trial of an experimental vaccine against Staphylococcus aureus to prevent bacteremia and wound infections after surgery has produced disappointing results, despite eliciting a robust immunologic response. Vance Fowler Jr., MD, MHS, professor of medicine in the division of infectious diseases at the Duke University Medical Center in Durham, North Carolina, presented results from the trial of V710 vaccine (Merck) in a late-breaker session here at the ID Week 2012. (Source: Medscape)

For comments and archives

Bike helmets reduce risk for fatal head injury

Although there is strong evidence that use of bicycle helmets cuts down on nonfatal head injuries, until now there has been little solid evidence of their effectiveness in preventing fatal head injuries. A newly published Canadian study now concludes what many medical authorities and advocacy groups have long suspected: nonuse of bicycle helmets is also associated with increased risk of sustaining fatal head injuries. (Source: Medscape)

For comments and archives

Cheaper drug cuts surgery site infections

The use of povidone-iodine nasal solution immediately before surgery should be considered as an alternative option to five days use of mupirocin ointment to prevent Staphylococcus aureus and other deep surgical site infections. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Early Glutamine Supplementation Yields Long-Lasting Benefits In... http://fb.me/1EcZWtfvs

@DeepakChopra: There’s a fascinating connection between social networks and where the human brain is going. My article http://tinyurl.com/9ezpo9z

 
    Spiritual Update

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

On 8th Navaratri, enjoy a purified mind

Maha Gauri is worshipped on the Eight Day of Navaratri. SHE looks as white as moon and jasmine. White means purity of mind. She has three Eyes and four hands. SHE is dressed in a white sari.

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)

Where can one get support?

Support can come from many different areas. Books can offer information and understanding about the emotional aspects of infertility. Support groups and meetings can reduce the feeling of isolation and provide an opportunity to learn from others who are experiencing infertility. Individual and couple counseling offer the chance to talk with an experienced professional who will help you sort out your feelings, identify coping mechanisms, and help you choose solutions to your problems.

For comments and archives

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

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

Coordinated long-range planning is needed for the development and integration of such diverse activities, together with careful consideration of priorities and optimal use of resources.

For comments and archives

 
    An Inspirational Story

Talk to Me

As you got up this morning, I watched you, and hoped you would talk to me, even if it was just a few words, asking my opinion or thanking me for something good that happened in your life yesterday. But I noticed you were too busy, trying to find the right outfit to wear. When you ran around the house getting ready, I knew there would be a few minutes for you to stop and say hello, but you were to busy.

At one point, you had to wait fifteen minutes with nothing to do except sit in a chair. Then I saw you spring to your feet. I thought you wanted to talk to me but you ran to the phone and called a friend to get the latest gossip instead. I watched patiently all day long. With all your activities, I guess you were too busy to say anything to me.

I noticed that before lunch you looked around, maybe you felt embarrassed to talk to me, that is why you didn't bow your head. You glanced three or four tables over and you noticed some of your friends talking to me briefly before they ate, but you didn't.

That's okay. There is still more time left, and I hope that you will talk to me yet. You went home and it seems as if ! you had lots of things to do. After a few of them were done, you turned on the TV. I don't know if you like TV or not, just about anything goes there and you spend a lot of time each day in front of it not thinking about anything, just enjoying the show.

I waited patiently again as you watched the TV and ate your meal, but again you didn't talk to me. Bedtime I guess you felt too tired. After you said goodnight to your family, you plopped into bed and fell asleep in no time.

That's okay because you may not realize that I am always there for you. I've got patience, more than you will ever know. I even want to teach you how to be patient with others as well. I love you so much that I wait everyday for a nod, prayer or thought or a thankful part of your heart.

It is hard to have a one-sided conversation. Well, you are getting up once again. And once again I will wait, with nothing but love for you. Hoping that today you will give me some time. Have a nice day!

For comments and archives

 
    Cardiology eMedinewS

Heart Attacks Twice as Deadly for Women Read More

Transport To Hospital By Ambulance Improves Heart Attack Survival
Read More

 
    Pediatric eMedinewS

Sleepy Athletes More Likely To Be Injured Read More

Caffeine Therapy Improves Outcomes In Premature Infants Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes wanted to know if he could do aerobic exercise.
Dr. Bad: You cannot do it.
Dr. Good: You can do it.
Lesson: People with type 2 diabetes should get 150 minutes of aerobics exercise every week.

For comments and archives

Make Sure

Situation: A patient on binasal oxygen developed nasal mucosal damage.
Reaction: Oh my God! Why was the oxygen given at 4 liter per minute?
Lesson: Make sure that oxygen via nasal catheter is not given at a rate of more than 3 liter per minute.

For comments and archives

 
    Legal Question of the Day (Dr MC Gupta)

Q. What is your advice in the following situation:

“I passed MBBS examination in India and got temporary registration as an intern with the state medical council of my home state. I did not apply for permanent registration. I started my postgraduate studies and got my MD degree. Then I got myself registered on permanent basis in the home state. Even my MD degree has been registered with the SMC as an additional qualification.”Now the questions are:

a) Is my MD degree valid?
b) Since I practiced on provisional registration, what is the consequence?
c) I applied on the basis of provisional registration every time. Is it proper?
d) What can be done now?

Ans.

  • It was irresponsible and unwise of you not to get permanent registration after completion of internship.
  • Your provisional registration was under section 25(2) of the IMC Act, 1956, which reads as follows:

    “(2) A person who has passed the qualifying examination of any university or Medical Institution in India for the grant of a recognized medical qualification shall be entitled to be registered provisionally in a State Medical Register for the purpose of enabling him to be engaged in employment in a resident medical capacity in any approved institution, or in the Medical Service of the Armed Forces of the Union, and for no other purpose, on production of proper evidence that he has been selected for such employment.”
  • If your provisional registration expired before joining MD course or during postgraduation and you neither got it neither renewed nor got permanent registration, you acted in violation of the IMC Act, 1956. It was also a lapse on the part of the institution where you studied for postgraduation. Such lapse is not expected in a government medical college. If the institution concerned was a private medical college, such lapse is explainable because their whole energies are concentrated not on giving education or following rules but on making money.
  • You are unnecessarily confused and worried at this stage. I do not see where the problem as of now is.
  • Answers to your 4 queries are as follows:
    • Is my MD degree valid? Yes. It is valid. The degree is given by the university. Only the university or a court can declare it invalid. Such declaration is rare.
    • Since I practiced on provisional registration, what is the consequence?
      If your provisional registration never lapsed, there are no consequences. If it was time bound and lapsed after the internship period of one year, the consequences are that you might be held liable for practicing medicine without being an RMP. In practical terms, there is unlikely to be any risk or liability.
    • I applied on the basis of provisional registration every time. Is it proper?
      If the provisional registration had expired and you quoted an invalid/expired registration no., it was not proper. It amounts to knowingly give a false statement.
    • What can be done now?
      • You can be wiser for future not to break rules.
      • You should keep quiet and not unnecessarily advertise the lapse on your part. You should remember the saying--"Do not tell your secrets to your friends so that they may not harm you when they become your enemies".
 
Our Social
Network sites
… Stay Connected

        FaceBook
  > Dr K K Aggarwal
  > eMedinewS
  > Hcfi NGO
  > IJCP Group

        Twitter
  > Dr K K Aggarwal
  > eMedinewS
  > HCFIindia
  > IJCP Group

        Blog
  > Dr K K Aggarwal
  > eMedinewS
  > HCFI-NGO
  > IJCP Group

        You Tube
  > Dr K K Aggarwal
  > eMedinewS

Docconnect
ioc
central bank
 

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

 
eMedinewS Apps
Archives
Archive
Archive
Archive
Archive
Archive
Alert
 
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Phosphorus

Hypophosphatemia can be seen in a variety of biochemical derangements, including acute alcohol intoxication, sepsis, hypokalemia, malabsorption syndromes, hyperinsulinism, hyperparathyroidism, and as result of drugs, e.g., acetazolamide, aluminum–containing antacids, anesthetic agents, anticonvulsants, and estrogens (incl. oral contraceptives). Citrates, mannitol, oxalate, tartrate, and phenothiazines may produce spuriously low phosphorous by interference with the assay.

 
  Quote of the Day (Dr GM Singh)

If you are grateful, gratitude will increase in you and you will be given more. Sri Sri Ravi Shankar

 
    Mind Teaser

Read this…………………

A boat has a ladder that has six rungs. Each rung is one foot apart. The bottom rung is one foot from the water. The tide rises at 12 inches every 15 minutes. High tide peaks in one hour. When the tide is at its highest, how many rungs are under water?

Yesterday’s Mind Teaser: Joey is a 46 year-old radio technician who is admitted because of mild chest pain. He is 5 feet, 8 inches tall and weighs 190 pounds. He is diagnosed with a myocardial infarct. Morphine sulfate, Diazepam (Valium) and Lidocaine are prescribed.

The physician orders 8 mg of Morphine Sulfate to be given IV. The vial on hand is labeled 1 ml/ 10 mg. The nurse should administer:

A. 8 minims
B. 10 minims
C. 12 minims
D. 15 minims

Answer for Yesterday’s Mind Teaser: C. 12 minims

Correct answers received from: Dr Kanta Jain, Dr.K.Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr. Thakor Hitendrsinh G

Answer for 23rd October Mind Teaser: remain unchanged

Correct answers received from:
Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr. Thakor Hitendrsinh G

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

Healthy lifestyle

A woman walked up to a little old man rocking in a chair on his porch. "I couldn't help noticing how happy you look," she said. "What's your secret for a long happy life?"

"I smoke three packs of cigarettes a day," he said. "I also drink a case of whiskey a week, eat fatty foods, and never exercise."

"That's amazing," the woman said. "How old are you?'

"Twenty-six," he said.

 
    Medicolegal Update

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

What is Sec 314 of the IPC?

Sec. 314 IPC provides that whoever, with intent to cause the miscarriage of the woman with child, does any act that causes the death of such woman, shall be punished with imprisonment of either description of a term which may extend to ten years or shall also be liable to fine. If the act is done without the consent of the woman, shall be punished with imprisonment for life or with punishment above mentioned.

  • The explanation to this section says that it is not essential to this offence that the offender should know that the act is likely to cause death.
  • A person who attempted to cause miscarriage of a pregnant woman but was unsuccessful in the process and when pregnant girl died several weeks later having developed septicemia without it having been established that the person was responsible for septicemia, the person cannot be held guilty under Sec 314 of IPC.

(Ref: Vatchalabai Maruti Kgar v. State of Maharashtra, 1993 Cri LJ 702 (Bom)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Yash Chopra’s death should not cause treatment panic: Not all dengue is serious

The mortality of dengue is less than 1% and that too only in selected cases said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India. Dr Aggarwal said that the forthcoming MTNL Perfect Health Mela will focus on identification, prevention and treatment of severe dengue.

There are three groups of patients with dengue, who need attention.

  • Patients with coexisting medical conditions, such as pregnancy, infancy, old age, obesity, diabetes mellitus, renal failure, and chronic hemolytic diseases, may increase the risk of severe dengue and/or complicate management. Referral for hospitalization is recommended for such patients regardless of other findings. Hospitalization should also be considered for patients who may have difficulties with outpatient follow-up or with timely self-referral should complications develop (e.g., patients who live alone or who live far from a health care facility without a reliable means of transport).
  • Patients with "alarm signs” i.e. severe abdominal pain or tenderness, persistent vomiting, abrupt change from fever to hypothermia, mucosal bleeding, liver enlargement on physical exam, or abnormal mental status, such as disorientation.
  • Patients with blood pressure <90/60 mmHg or fall in blood pressure by 20, hematocrit >50% or rise in hematocrit by more than 20, difference between upper and lower blood pressure less than 20, evidence of bleeding other than petechiae, true platelet count less than 20000, rise in pulse by 20.

Not all dengue is serious

  • The current strains 1 and 3 are not serious.
  • First attack of dengue is usually not serious.
  • Dengue is not serious if one can maintain the difference between upper and lower blood pressure more than 40
  • Dengue is not serious if one can maintain blood volume and avoid intravascular dehydration.

Facts about dengue

  • Dengue is a febrile illness that is caused by any one of four serotypes of this flavivirus (DEN-1, DEN-2, DEN-3, and DEN-4).
  • It is endemic in more than 100 countries in tropical and subtropical regions of the world and causes an estimated 50 million infections annually worldwide.
  • The greatest risk factor for the development of dengue hemorrhagic fever (DHF) or dengue shock syndrome is secondary infection with a different dengue serotype from the original infecting virus. Thus, severe disease occurs primarily in patients who reside in hyperendemic areas where multiple serotypes circulate simultaneously.
  • Mosquito control is the most effective approach to the prevention of dengue transmission. There is no licensed vaccine available for preventing dengue.
  • Patients with dengue fever should be cautioned to maintain their fluid intake to avoid dehydration and to take paracetamol as needed for fevers and myalgias. Aspirin or nonsteroidal antiinflammatory agents should generally be avoided.
  • It is important to manage plasma leakage in dengue hemorrhagic fever with aggressive intravascular volume repletion to prevent or reverse hypovolemic shock. Blood transfusion is appropriate only in patients with significant bleeding. The adequacy of fluid repletion should be assessed by serial determination of hematocrit, blood pressure, pulse, and urine output.
  • Prophylactic platelet transfusion has no role.
  • Early identification of patients at higher risk for shock and other complications of dengue are important. Patients with suspected dengue who have none of the warning signs for more severe illness and can maintain their fluid intake can be managed as outpatients, but may need daily re-evaluation.
  • Duration of illness – The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with resolution of fever. Plasma leakage generally first becomes evident between 24 hours before and 24 hours after defervescence.

Insecticide spraying does not help

  • Insecticide spraying in response to dengue outbreaks is not highly effective against A. aegypti mosquitoes, which frequently breed inside houses.
  • Community-based approaches involving education of the population in efforts to reduce breeding sites, such as discarded tires and other containers that accumulate standing water, have shown some promise.

Treatment

  • Exclude other treatable diagnoses. Patients at risk for dengue can acquire other diseases with similar clinical features, such as malaria, typhoid fever, and leptospirosis. Symptoms in patients with dengue virus infections resolve in 5 to 7 days.
  • Patients with dengue fever should be cautioned to maintain their intake of oral fluid to avoid dehydration. Fever and myalgias can be managed as needed with paracetamol. Aspirin or nonsteroidal antiinflammatory agents should generally be avoided because of the risk of bleeding complications and in children because of the potential risk of Reye's syndrome.
  • Gastrointestinal bleeding or menorrhagia in patients with DHF, and occasionally in patients with dengue fever as well, can be severe enough to require blood transfusion.
  • Platelet transfusions have not been shown to be effective at preventing or controlling hemorrhage, but may be warranted only in patients with severe thrombocytopenia (<10,000/mm3) and active bleeding.
  • Prophylactic platelet transfusions in patients with severe thrombocytopenia but without active bleeding are generally not recommended.
  • Administration of intravenous vitamin K1 is recommended for patients with severe liver dysfunction or prolonged prothrombin time.
  • Use of a histamine H2 receptor antagonist or proton pump inhibitor is reasonable in patients with gastrointestinal bleeding, although there is no evidence of benefit.
  • Plasma leakage in DHF is important to manage with aggressive intravascular volume repletion to prevent or reverse hypovolemic shock
  • In mild cases, oral rehydration may be sufficient. However, in patients with established intravascular fluid loss, intravenous fluid administration is recommended. Blood transfusion is appropriate in patients with significant bleeding; subsequent hematocrit measurements must be interpreted with caution since it is also critical to assess the adequacy of fluid repletion.
  • For patients with hypotensive shock, an initial bolus of 5% dextrose in normal saline or Ringer's lactate (20 mL per kg of body weight) infused over 15 minutes is recommended, followed by continuous infusion (10 to 20 mL/kg per hour depending on the clinical response) until vital signs and urine output normalize. For patients who improve, the infusion rate should then be gradually reduced until it matches plasma fluid losses.
  • The adequacy of fluid repletion should be assessed by serial determination of hematocrit, blood pressure, pulse and urine output. Patients with shock on presentation should initially have vital signs measured at least every 30 minutes and hematocrit measured every two to four hours.
  • Narrowing of the pulse pressure is an indication of hypovolemia in children even with a normal systolic blood pressure.
  • Normalization of the hematocrit is an important goal of early fluid repletion
  • Patients can develop shock for one to two days after initial fluid resuscitation, which represents the period of increased vascular permeability in DHF.
  • Most patients who present for medical attention before profound shock develops and who receive appropriate fluid therapy will recover quickly.
  • Usually no more than 48 hours of intravenous fluid therapy are required.
  • Discharge from the hospital is appropriate when patients have been afebrile for at least 24 hours and have normal oral intake, urine output, and hematocrit.
 
    Readers Responses
  1. Dear Sir, we like your emedinews. Regards:Dr Tapan
 
    Forthcoming Events


19th MTNL Perfect Health Mela 2012 Programme

Dr K K Aggarwal
Dr K K Aggarwal
Dr K K Aggarwal
 
    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)

HCFI
Activities eBooks

  DIET BOOK

  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  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