eMedinewS25th October 2013, Friday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Can a doctor expose other doctor’s misconduct?

A trial court has directed the Delhi government to provide protection to three doctors of Babu Jagjivan Ram hospital who exposed two doctors for giving a false autopsy report and pressuring their juniors in an alleged murder case.

Additional sessions judge Kamini Lau directed the principal secretary health and director health services, to ensure that Dr Bhim Singh and his team, including Dr Javed and Dr Sameer, who exposed the misdoings in their department, are not harassed by authorities.

The court also asked the government to take action against Dr Suresh Seth, DMS of BJRM hospital, and autopsy surgeon Dr Sudesh, for giving false autopsy report of a woman by making it an unnatural death though it was a natural death and pressurizing juniors.

Dr. Sudesh is currently lodged in judicial custody in another corruption and cheating case.

"The conduct of Dr. Suresh who is the controlling authority and the officer who allegedly exerted pressure on committee members to save Dr. Sudesh and so also the conduct of the Dr. Sudesh is directed to be placed before the principal secretary (health & family welfare) and director, directorate of health services for information and appropriate action against them in accordance with the procedure established by law under intimation to this court, "it said.

The court asked the government to explore the possibility of videographing post- mortem procedure.

Issues

  • Can a doctor expose misconduct of other doctors?
    MCI: 1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.
  • Is it a professional misconduct?
    Yes only after the person is convicted MCI: 7.5 Conviction by Court of Law: Conviction by a Court of Law for offences involving moral turpitude / Criminal acts

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."


VIP’s on CPR 10 Mantra Video
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

The spiritual prescription "I am sorry"

sprritual blogTwo hardest words for a doctor to say: "I’m sorry."

Most defense lawyers counsel doctors not to apologize to patients. Their view is that if you say you’re sorry for something, you are implicitly taking some degree of responsibility for whatever has happened or in other words you are pleading guilty. The complainant’s lawyers may use a doctor’s apology to the maximum extent possible to show the doctor knew what they did was wrong. The usual approach is to deny and defend. But,

  • Apologizing after a medical error is the humane thing to do.
  • Patients often sue simply because it’s the only way to find out what went wrong.
  • Erecting a wall of silence is “enough to make someone very angry. And it’s awfully easy for an angry person to find a lawyer who will listen to them. At that point, it’s too late for sorry.
  • Over 35 states in the USA have passed laws prohibiting doctors’ apologies from being used against them in court. (apology laws)
  • By promptly disclosing medical errors and offering earnest apologies and fair compensation one can hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits Apology the spiritual answer
  • The word ’sorry’ is synonymous with apology.
  • To err is human, to admit one’s error is superhuman.
  • Sorry should be heartfelt and not ego felt. You should not only say sorry but it should look like that you are sorry.
  • Tremendous courage is entailed to face the victim of our wrong doing and apologise.
  • It is generally seen that those who are in harmony with their life and consequently with themselves, find it easier to say ’I’m sorry’. They are the positive, conscientious ones who are at peace only after making amends for their misdeeds.
  • The word ’sorry’ in itself is imbued with so much potential and power. Within a fraction of a second, grave mistakes are diluted, tepid and estranged relations are brought alive, animosity and rancor are dissolved, misunderstandings resolved and tense situations ease out resulting in harmony and rapprochement.
  • To forgive and forget is a common spiritual saying
  • Remember we all make mistakes and seek forgiveness form GOD every day.
cardiology news

Anger, Envy & Insults

Near Tokyo lived a great Samurai, now old, who decided to teach Zen Buddhism to young people. One afternoon, a warrior – known for his complete lack of scruples – arrived there. The young and impatient warrior had never lost a fight. Hearing of the Samurai’s reputation, he had come to defeat him, and increase his fame.

All the students were against the idea, but the old man accepted the challenge. All gathered on the town square, and the young man started insulting the old master. He threw a few rocks in his direction, spat in his face, shouted every insult under the sun – he even insulted his ancestors.

For hours, he did everything to provoke him, but the old man remained impassive. At the end of the afternoon, by now feeling exhausted and humiliated, the impetuous warrior left.

Disappointed by the fact that the master had received so many insults and provocations, the students asked, "How could you bear such indignity? Why didn’t you use your sword, even knowing you might lose the fight, instead of displaying your cowardice in front of us all?"

"If someone comes to you with a gift, and you do not accept it, who does the gift belong to?" asked the old Samurai. "He who tried to deliver it," replied one of his disciples.

“The same goes for envy, anger and insults." said the master. "When they are not accepted, they continue to belong to the one who carried them."

News Around The Globe

20th MTNL Perfect Health Mela Programme Brouchure

20th MTNL Perfect Health Mela 2013 Hangout on Air with Google

News

FAIMS elections 2013 Results Congratulations
President.             M K Singh    171:132
Vice President       O P Kharbanda
G Sec                Lalit Dar
Jt Sec                 R K Yadav
Treasurer         Vinay Goyal
Executive
S Agarwala, S S Kale, B K Khaitan, K Luthra, Biplab Mishra, K Prasad, Sanjay Agarwal

  • A new study published in Rheumatology has suggested that women who walk with flat feet are 50% more likely than those with normal or high arches to have low back pain.
  • Bacterial communities isolated from the urine of women with urinary incontinence differ depending on the type of incontinence, according to a study that, for the first time, suggests that bladder microbiota could play a role in this condition.
  • Updated opinion statement of the American College of Obstetricians and Gynecologists (ACOG) states that physicians should carefully counsel women who are considering elective surgery that is not traditionally recommended and, ideally, jointly make the decision with them. The statement is published in the November issue of Obstetrics & Gynecology. As per the authors, after the physician has provided information and careful counseling, the patient and physician will often reach a mutually acceptable decision. If the patient and physician cannot reach an agreement, then referral or second opinion may be appropriate.
  • A large number of HIV-infected men with early syphilis may have neurosyphilis, despite low serum titers and no symptoms, according to a new study presented at the 14th European AIDS Conference. In the study, 92% of the patients in the study showed positive for neurosyphilis by cerebrospinal fluid examination.
  • Adults without symptoms or risk factors should not be screened for chronic kidney disease (CKD), according to new guidelines from the American College of Physicians (ACP). The new evidence-based recommendations, published online October 21 in the Annals of Internal Medicine, address screening, monitoring, and treatment of adults with stage 1 to 3 CKD.
  • Over 9.3 lakh Indians with the world’s most dangerous air borne disease – tuberculosis, are currently going undetected and being ’missed’ by the countrys health system as reported in TOI, Oct 23, 2013. Around 3 million people - equal to one in three people falling ill with TB are not being detected globally. What is bad news for India is that 31% of those are in India. India is presently home to around 26% of the world TB patients – 1 in 4 globally. According to the World TB Report 2013 released on Wednesday, 75% of the estimated missed cases – people who were either not diagnosed or diagnosed but not reported were in 12 countries. In order of total numbers, India led the list followed by South Africa, Bangladesh, Pakistan, Indonesia, China, Congo, Mozambique, Nigeria, Ethiopia, Philippines and Myanmar.

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Rabies News (Dr. A K Gupta)

Can RIG and rabies vaccine be administered in the same syringe?

RIG should never be administered in the same syringe or at the same anatomical site as vaccine administration.

cardiology news

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

  • By sequencing the whole exome—the part of the genome that codes for protein—researchers found two new mutations on genes related to inherited dilated cardiomyopathy, which will improve the ability to detect people with the disease. Dr Rafik Tadros (Montreal Heart Institute, QC) presented the study at the Canadian Cardiovascular Congress (CCC) 2013. By using this type of genetic screening—instead of only looking for mutations in five genes known to be related to this disease, as recommended in Canadian guidelines—they greatly improved the ability to detect individuals with dilated cardiomyopathy. It was found that mutations in TTN and BAG3 , which were not part of the usual genetic screening, account for a significant proportion of familial dilated cardiomyopathy. "It’s important to identify and appropriately manage other family members who might also have this genetic mutation, which puts them at risk for heart failure or heart transplant or sudden cardiac death," said Dr Rafik Tadros.
  • For patients requiring blood thinner drugs there is good news. The risk of bleeding, a major cause of death after a heart surgery or thrombosis in the veins, can now be assessed using a new method developed by Indian doctors reports the TOI, Oct 22, 2013. The Genetic Bleeding Risk (GBR) score has been developed at Sir Ganga Ram Hospital on the basis of genetic and non-genetic factors associated with bleeding in patients on long-term blood clotting therapy, said Risha Nahar, scientist at the hospital's Centre of Medical Genetics. Bleeding risk prediction scores, available at present, are mostly derived from the white population and, more importantly, none have evaluated the predictive significance of genetic risk factors so far.
cardiology news

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

  • Apnea is classically attributed to the respiratory syncytial virus (RSV), but all major bronchiolitis pathogens are linked with apnea in hospitalized infants, according to a prospective, multicenter study. "We demonstrate that multiple viruses are associated with apnea, and the risk of apnea is not increased with RSV in comparison to other viruses," Dr. Alan R. Schroeder from Santa Clara Valley Medical Center in San Jose, California, told Reuters Health by email. "Therefore, practitioners should not order viral testing simply to evaluate the risk of apnea."
  • Bottle-feeding is associated with hypertrophic pyloric stenosis (HPS), according to a population-based case-control study. The effect is most pronounced in the children of older and multiparous women. Jarod P. McAteer, MD, MPH, from the Division of Pediatric General and Thoracic Surgery at Seattle Children's Hospital in Washington, and colleagues published the results of their study online October 21 in JAMA Pediatrics.
cardiology news

Glucose, insulin & potassium treatment prevent cardiac arrest but not MI

According to a study presented at the American College of Cardiology meeting and published online in the Journal of the American Medical Association, by Dr Harry Selker at Tufts Medical Center, Boston, MA, individuals with symptoms of heart attack who were given a treatment containing glucose, insulin and potassium by paramedics were less likely to experience cardiac arrest, compared to patients who did not receive the treatment, although the treatment may not prevent patients from progressing to a heart attack.

In the trial, paramedics from 13 cities were trained to administer the solution after determining that an individual was likely having or about to have a heart attack." Individuals "who received the solution immediately after being diagnosed with acute coronary syndrome...were 50% less likely to experience cardiac arrest or die compared to those who received the placebo." The findings "were even more pronounced for people with more severe ST–elevation heart attacks." However, the treatment did not reduce progression to MI.

cardiology news

Total CPR since 1st November 2012 – 65021 trained

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

Media advocacy through Web Media

Thousands participate in inter school health festival at health Mela

Inaugurating Ecofest, an inter nursing school health festival, held at Perfect Health Mela, Mr. B P Singh Head NCSTC and Mr A P Singh ZM LIC, said that one should not play with both internal and external environment. The Mela is being organized by Heart Care Foundation of India at Constitution Club of India

As is the microcosm so is the macrocosm is a saying from the Upanishads, which means that environment affects the body and the collective consciousness of the people affects the environment. The recurrent cyclones in the ocean also reflect the negative state of mind in the collective consciousness of the people.

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal President Heart Care Foundation of India said that Diwali is a festival when there is Amavasya outside and Purnima inside i.e. after purification of mind, body and soul, a process done during Navratra and Dussehra ends up in purification of heart on Diwali Amavasya day and with resultant inner happiness represented by inner Purnima.

Burning of crackers is not only harmful for the lungs through air pollution but also to the heart through noise pollution.

Children were also told to avoid sweets, which contain 30% sugar and also trans fats as they can spoil the biochemistry of sugar and cholesterol metabolism in the body and ultimately lead to heart diseases.

Prizes were given to the winners of the Harmony Inter School Festival (Inter School/Competitions)

Bharatnatyam Jr Solo

1st Gopika U (Creative Rhythm), 2nd Mitra Suresh (Creative Rhythm), 3rd Akshara S Nair (Creative Rhythm)

Bharatnatyam Sr Solo
1st B Somya (Nritya Bharti), 2nd Tanisqa Chauhan (Kala Samriddhi), 3rd Shirin Kaul (Sadhna – The School of Arts)

Do not ignore stroke
In a panel discussion organised at the Mela, Dr. Vipul Gupta from Medanta – The Medicity, Gurgaon and Dr Vinay Goyal from AIIMS both noted neurologists and Dr K K Aggarwal in a joint statement said that paralysis can be cured if the patient can reach the hospital in less than four and a half hours.

Homoeopaths and Ayurveda Doctors should learn basics of cardiac investigations

All doctors from other recognized pathies should update their knowledge in modern investigations, said Dr Sameer Shrivastava from Escorts Heart Institute.

Do not ignore early morning chest pain

Dr. Vivek Kumar from Max Health Care said that heart attacks are most common in early hours of the day

Dengue stall attracts crowd
MCD and NDMC are displaying live mosquitoes as well as big models of mosquitoes at the Mela venue. A large number of dengue patients are also coming for consultation from all pathies. Dengue mosquito can easily be distinguished from other mosquitoes because of the presence of stripes on its body.

Thousands learn at Food Adulteration stall of DST
Department of Science & Technology is creating awareness about prevention of food adulteration. Commenting on the same, Dr. Aggarwal said that excessive use of permissible colours can be hazardous to health.

Transport Department creating awareness on safe driving
People with uncontrolled diabetes, sugar and angina should not drive without medical clearance. The requirements for commercial driving are different from non-commercial driving. No doctor should give a certificate of medical fitness to a driver unless he has examined the patient himself. Giving wrong certificate may be professional misconduct and can lead to erasure of name from the medical register.

Following health messages were released.

  1. Twenty or more diseases can be transmitted via blood which can be potentially fatal.
  2. The amount of blood required for transmission for Hepatitis B virus is only 0.00004 ml.
  3. High blood pressure is responsible for 67% of heart attacks, 77% of paralytic attacks, 74% of heart failure cases and 26% of kidney diseases.
  4. High blood pressure causes more visits to doctor than any other condition.
  5. High blood pressure, high cholesterol and diabetes are silent killers.
  6. A 5 mm reduction in upper blood pressure reading and 2 mm reduction in lower blood pressure reading of the community can reduce the incidence of heart attack, paralysis and heart failure by up to 40%.
  7. Ayurveda totally prohibits taking salt with the milk.
  8. As per Charak Samhita, too much of pippalli, alkali and salt are bad for the health.
  9. 3D Echo ejection fraction is much more reliable and reproducible than 2D Echo based ejection fraction.
  10. Diabetes is considered as coronary heart disease equivalent and one in five patients in diabetes will have abnormal exercise test.

About HCFI : The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National Commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 65021 people since 1st November 2012.

The CPR 10 Mantra is – “Within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

today emedipics

Thousands participate in inter school health festival at health Mela

press release

Monitoring LFT in a patient on statins

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

What is a healthy blood-pressure level?

Which of the following is not a good approach to managing stress?
A.110/70.
B.125/85.
C. 135/90
D. 140/95.
E. 150/95.

Yesterday’s Mind Teaser: Which of the following is not a good approach to managing stress?

A.Talking directly to the person who is causing the stress.
B. Giving yourself a treat, like comfort food or a cocktail.
C. Accepting that there are things beyond your control.
D. Trying cognitive-behavioral therapy to learn new coping skills.
E. Working out regularly.

Answer for yesterday’s Mind Teaser:B. Giving yourself a treat, like comfort food or a cocktail.

Correct answers received from: Dr. V.P. Thakral, DR P K SAHU, Prabha Sanghi, Archna Parwani , Dr Arpan Gandhi, Dr.K.V.Sarma, daivadheenam, DR AVTAR KRISHAN

Answer for 23rd October Mind Teaser: C. Yes, and the headaches are more severe.

Correct answers received from:Dr U Gaur, Dr. Sushma Chawla

Send your answer to ijcp12@gmail.com



medicolegal update

Click on the image to enlarge

medicolegal update

Customer: I have a huge problem. A friend has placed a screen saver on my computer, but every time I move the mouse, it disappears.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation:A foreigner with a single loose stool developed sepsis.

Reaction: Oh my God! Why were antibiotics not started in time?

Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

medicolegal update

Happy is the man who can do only one thing; in doing it, he fulfills his destiny. Joseph Joubert

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health

Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

medicolegal update

Dear Sir, The MEla is a right mix of education and entertainment. Regards: Dr Shagun

Forthcoming Events

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India
20th PHM 2013 20th PHM 2013
20th PHM 2013 20th PHM 2013
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