emedinews
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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 & 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 to15 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 …

26th January 2013, Saturday

eMedinewS wishes all its readers Happy 64th Republic Day

eMedinewS Congrates and Salutes all Padma Awardee Doctors of the year 2013

Padma Bhushan
Dr. Maharaj Kishan Bhan, Civil Service, Delhi

Padma Shri

Dr. Sudarshan K. Aggarwal, Medicine, Delhi
Dr. C. Venkata S. Ram alias Chitta Venkata Sundara Ram Medicine, Andhra Pradesh
Dr. Rajendra Achyut Badwe, Medicine, Maharashtra
Dr. Taraprasad Das, Medicine, Orissa
Prof. (Dr.) T.V. Devarajan, Medicine, Tamil Nadu
Prof. (Dr.) Saroj Chooramani Gopal, Medicine, Uttar Pradesh
Dr. Pramod Kumar Julka, Medicine, Delhi
Dr. Gulshan Rai Khatri, Medicine, Delhi
Dr. Ganesh Kumar Mani, Medicine, Delhi
Dr. Amit Prabhakar Maydeo, Medicine, Maharashtra
Dr. Sundaram Natarajan, Medicine, Maharashtra
Prof. Krishna Chandra Chunekar, Medicine, Uttar Pradesh
Dr. Vishwa Kumar Gupta Medicine (Homeopathy), Delhi

Got my heart angiography done today

My mother got a bypass, my elder brother got angioplasty and my other brother had a heart attack in the past. With a strong family history and being a doctor, I made sure that I take precautions and live a lifestyle so that I can avoid getting blockages in my heart arteries. I believe in following what I teach and preach.

I conduct lifestyle program in Moolchand Hospital which help people in avoiding getting blockages in the heart and those who have, to help stopping its progression.

I am happy to share that today in the morning I got my CT Angiography of the heart at Harsh Mahajan Centre in Hauz Khaz and my heart arteries were as clean as that of a newborn with a calcium score of ’zero’ . It only helps in demystifying the myth that everybody above an age will develop some blockages and, secondly, with a discipline lifestyle it is possible to prevent heart blockages.

Just to share my lifestyle which does not mean I am enforcing it, includes – no tea, no coffee, no egg, no non-veg, no cigarette, no alcohol and as far as possible, no white sugar, white rice and whit maida and eating carbohydrate based cereals only once in a day.

Just on the lighter side, don’t carry on the message” That if I have to stop all the above then it is better to have a heart blockage. aap jee kis liye rahe ho, itna sab kuchh chhodne se achchha to heart blockage hi ho jaye.”

….more

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What is the role of bulk laxatives in constipation?

Bulk forming laxatives primarily exert their laxative effect by absorbing water and increasing fecal mass and accelerating bowel transit. Psyllium seed, methylcellulose, calcium polycarbophil and wheat dextran are examples of bulk laxatives.

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

A soda a day raises heart disease risk by 20%

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

A daylong conference, eMedinewS Revisiting 2012, organized by eMedinewS, Heart Care Foundation of India and World Fellowship of Religions. Large Number of Doctors registered them for the conference.

 
Dr K K Aggarwal
 
    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Child neglect

Child neglect is the most prevalent form of child abuse accounting to 50% of cases reported.

For comments and archives

    National News

Leprosy eliminated from capital

NEW DELHI: Leprosy has been eliminated from the capital as a public health problem, Delhi health minister AK Walia said on Thursday. He said the incidence rate of leprosy has dropped from 4.5 cases per 10,000 population in 2001 to 0.8 cases at present. "As per WHO guidelines, when the number of leprosy patients comes down below one case per 10,000 populations, the disease is said to have been eliminated as a public health problem," Walia said. He added that 1,340 patients from the city are taking treatment for leprosy from various healthcare institutions. Apart from them, 1,602 patients from other states and country are taking treatment in Delhi hospitals. Leprosy is a disease caused by the bacteria Mycobacterium leprae and it affects mainly the skin and nerves. The symptoms appear very slowly, taking on an average 2-5 years to manifest. (Source: TOI, Jan 25, 2013)

Dial 1800111321 for complaint against food in trains

NEW DELHI: If you have any grievance against the food served on trains, just dial 1800111321 to lodge your complaint. The toll-free number launched by railways is operational from 7am to 10am throughout the week. Concerned over increasing number of complaints against catering service in trains and stations, railway minister Pawan Kumar Bansal announced a slew of measures, including the toll-free number, to improve the quality of food for passengers. "Anyone can call the toll-free number and register his or her complaint and it will be addressed," said Bansal here. "The complaint can relate to anything including overcharging, less quantity or substandard quality. It will be addressed on real-time basis," he said. The number has been operational since January 18 and till date 26 complaints have been received. Assuring the passengers of action against erring catering contractors, Bansal said mobile squads have been formed to keep a regular check on contractors in trains and stations and the toll-free number will be displayed in coaches and stations prominently to make passengers aware about the facility. Admitting that the quality of curd served in trains is not good, Bansal said "we are finalising a policy to ensure that only curd prepared by reputed companies are served". Similarly, efforts are on to improve the menu in trains like Rajdhani, Shatabdi and Duronto. (Source: TOI, Jan 24, 2013)

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

The onset of symptoms in bicuspid aortic stenosis is associated with a poor prognosis. Intervention is recommended for symptomatic aortic stenosis.

(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)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Oscillator no help in ARDS

High-frequency oscillatory ventilation (HFOV) held no benefit for patients with moderate-to-severe acute respiratory distress syndrome (ARDS), two trials showed, and in one of them it was actually associated with worse outcomes. (Source: Medpage Today)

New nor virus strain hits US

In the middle of a punishing influenza season, a new strain of norovirus from Australia has come on the scene, and it is not yet clear how nasty this bug will be, the Centers for Disease Control and Prevention (CDC) announced today. In its latest Morbidity and Mortality Weekly Report, the CDC identified the Aussie newcomer as GII.4 Sydney. First spotted in March 2012, the strain already has triggered acute gastroenteritis outbreaks in the United Kingdom and other countries. (Source; Medscape)

Shortages of second-line TB drugs spotlighted in survey

A majority of US tuberculosis (TB) control programs with 1 or more multidrug-resistant (MDR) cases report a shortage of second-line agents to fight this challenging infection, a nationwide survey reveals. (Source: Medscape)

Liposomal vincristine 'appears to be a step forward'

A new formulation of an old drug — vincristine encapsulated in liposomes — offers oncologists a new tool, and "appears to be a step forward in the successful use of vincristine, which still has utility and widespread use after half a century." (Source: Medscape)

 
  Twitter of the Day

@DrKKAggarwal: Even a handicapped can do CPR: http://youtu.be/uE7oqTgrk2k?a via@YouTube

@DeepakChopra: Rewire your brain for higher consciousness by paying attention to love, compassion, and joy.

 
    Spiritual Update

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

My answer is yes, now tell me your problem

This was the best statement I have ever come across in my life. One of the medical superintendents at Moolchand Hospital when he joined had this statement on the wall above his head. It clearly indicates that he was sitting to solve the problem and not to create problems.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What do you understand by minimally invasive surgery?

Type of surgery features small or no incisions. Surgeons view your body’s organs with the help of small telescopes and tiny cameras. Surgical repairs are made with tiny instruments.

Common procedures are:

  • Laparoscopy, in which a telescope with a camera (called a laparoscope) is inserted through a small incision in your belly. This allows the surgeon to visually examine your pelvis (lower belly).
  • Hysteroscopy, in which a different type of telescope with a camera (called a hysteroscope) is inserted through your vagina and cervix. It views the inside your uterus (womb).
 
    Tat Tvam Asi………and the Life Continues……

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

Why is CT scan Triphasic Angiography carried out on the donor ?

A CT scan triphasic angiography provides information on the vascular anatomy which is important for the surgeon to know and volumetry is performed on donor liver by using special software which calculates the volume of various parts of the liver.

For comments and archives

 
    An Inspirational Story

The Value of Knowledge

A giant ship engine failed. The ship’s owners tried one expert after another, but none of them could figure but how to fix the engine. Then they brought in an old man who had been fixing ships since he was a young.

He carried a large bag of tools with him, and when he arrived, he immediately went to work. He inspected the engine very carefully, top to bottom. Two of the ship’s owners were there, watching this man, hoping he would know what to do.

After looking things over, the old man reached into his bag and pulled out a small hammer. He gently tapped something. Instantly, the engine lurched into life. He carefully put his hammer away. The engine was fixed!

A week later, the owners received a bill from the old man for ten thousand dollars. “What?!” the owners exclaimed. “He hardly did anything!” So they wrote the old man a note saying, “Please send us an itemized bill.”

The man sent a bill that read: Tapping with a hammer…… $ 2.00; Knowing where to tap……… $ 9,998.00

Effort is important, but knowing where to make an effort makes all the difference! Keep studying hard. Don’t give up!

For comments and archives

 
  Cardiology eMedinewS

Depression After Stroke Boosts Death Risk Read More

 
  Pediatric eMedinewS

Open-access scheduling speeds pediatric subspecialty visits Read More

Dietary supplement offers hope for schizophrenia prevention Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A PUO patient was advised CT chest by a GP. He came for a second opinion.
Dr Bad: There is no need.
Dr Good: Go ahead.
Lesson: CT scanning of the chest is invaluable in the identification of small nodules (indicative of fungal, mycobacterial, or nocardial infection or malignancy). The identification of hilar or mediastinal adenopathy may prompt biopsy by mediastinoscopy providing a diagnosis of lymphoma, histoplasmosis, or sarcoidosis.

Make Sure

Situation: A patient’s blood pressure was not responding on Arkamin (clonidine).
Reaction: Oh my God! Why was the patient given Artamin (D–penicillamine)?
Lesson: Make sure that prescription is written with the drug name spelled clearly.

 
  Quote of the Day (Dr GM Singh)

Study while others are sleeping; work while others are loafing; prepare while others are playing; and dream while others are wishing. William Arthur Ward

 
    Legal Question of the Day (Dr MC Gupta, Former Professor and Dean)

Can a hospital leave the running of the ICU entirely to an MD (Anesthesia) without the involvement of a physician?

Q. Can a hospital leave the running of the ICU entirely to an MD (Anesthesia) without the involvement of a physician on a short tem/long term basis? Is there any need of a physician in an ICU managed by an MD (Anesthesia) with fellowship of one year in critical care practice? Can there be any legal liability in such situations?

Ans.

  • I am unable to think of any valid reason for this question being asked. The possible situations are:
    • An ICU admission involves heavy charges from a patient and these will be split among the doctors providing ICU care. The MD (Anesthesia) person will earn more if he does not have to share.
    • There is no MD (Medicine) available.
    • The hospital wants to save money by doing away with the services of a physician.
  • All the above reasons or others like them are faulty. Even a medical student or a nurse or a man on the street (and, hence, a lawyer or a judge) will say without hesitation that a physician should always be available in the ICU.
  • Another way of looking at it is that a patient presents with a medical, surgical, gynaecological or pediatric problem and is usually under treatment of a specialist in the respective ward before he is transferred to the ICU. No patient is ever admitted in an “anesthesia ward”. It is against common sense and against principles of patient care that a patient transferred from a medicine ward to an ICU should be deprived of the attention of a physician.
  • The following legal liabilities may arise:
    • The hospital may be sued under the Clinical Establishments Act or a related act under which it is registered for not having a properly staffed ICU as per rules.
    • A patient may sue the hospital for unfair trade practice which, in terms of section 2 (r) (1) (ii) of the CPA, means that the service provider “falsely represents that the services are of a particular standard, quality or grade”.
    • A patient may sue the hospital for deficiency in service.
    • If the patient suffers negligence, which is quite likely in the absence of a physician, he may sue the hospital for negligence.
    • If the negligence suffered is of a gross nature, he may file a criminal case against the owner of the hospital and the doctors.
    • A complaint may be made to the medical council.
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    Mind Teaser

Read this…………………

After Billroth II Surgery, the client developed dumping syndrome. Which of the following should the nurse exclude in the plan of care?

A. Sit upright for at least 30 minutes after meals
B. Take only sips of H2O between bites of solid food
C. Eat small meals every 2-3 hours
D. Reduce the amount of simple carbohydrate in the diet

Yesterday’s Mind Teaser: A patient received spinal anesthesia 4 hours ago during surgery. The patient has been on the unit for ½ hours and now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2°C), and respirations are 30 breaths/min. The patient's skin is pale and the dressing is dry and intact. The most appropriate nursing intervention is to:

a. Call the physician and report the findings.
b. Medicate the patient for pain.
c. Place the patient in a high Fowler position and administer oxygen.
d. Place the patient in a reverse Trendelenburg position and open the IV line.

Answer for Yesterday’s Mind Teaser: Medicate the patient for pain.

Correct answers received from: Dr Jainendra Upadhyay, Dr Jella, Dr PC Das, Dr KV Sarma, Ravuri Sreenivas, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr PK Sahu, Dr Sudesh Agrawal, Dr Sushma Chawla.

Answer for 24th January Mind Teaser: Explain to the patient what will happen during the hospitalization

Correct answers received from: Dr Jella, Ravuri Sreenivas, Dr Chandresh Jardosh, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

Priceless definitions

Yawn

An honest opinion openly expressed...

 
    Medicolegal Update

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

Aruna is clearly not in coma

  • Aruna accepts the food in normal course and responds by facial expressions. She responds to commands intermittently by making sounds. She makes sounds when she has to pass stool and urine which the nursing staff identifies and attends to by leading her to the toilet.
  • Thus, there was some variance between the allegations in the writ petition and the counter affidavit of KEM Hospital. Supreme Court, by order dated 24 January, 2011 appointed a team of three very distinguished doctors of Mumbai to examine Aruna thoroughly and submit a report about her physical and mental condition.
  • The committee after thorough examination gave the opinion that she has evidence of intact auditory, visual, somatic and motor primary neural pathways. However no definitive evidence for awareness of auditory, visual, somatic and motor stimuli was observed during our examinations.
  • On perusal of the report of the committee of three doctors the honorable SC noted that there are many technical terms which have been used therein which a non–medical man would find it difficult to understand. We, therefore, request the doctors to submit a supplementary report by the next date of hearing in which the meaning of these technical terms in the report is also explained.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Is 24X7 actullay 24X7 in hospitals?

24X7 actually don’t work in the emergency services. Many studies now have established that heart pateints suffering cardiac arrest at night or on the weekend are less likely to survive than those who have a heart attack during weekdays or weekday evenings. The above findings were true even for paralysis treated on the weekend and found it to be deadlier than those that are treated on a weekday.

The same is true for India said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India & National Vice President Elect IMA.

In most holidays and at night efficient staff and doctors may not be available specifically on the weekend days.

He said that bad time to get admitted in the hospitals are weekends, holidays, especially Diwali, Holi, Xmas and new years eve, all nights, early morning period, full moon period and winter.

As per a study in Journal of the American Medical Association hospitals simply don't work the same at night as they do during the day. The poor survival on nights and weekends is due to a delay getting critical procedures or a delay in diagnosing the cardiac arrest in the first place. At night even a difference in seconds, makes a significant impact.

Up to 98,000 preventable in-hospital deaths occur every year in the United States, and the rate of medical errors is higher at night.

The study analyzed survival rates for 86,748 adults who had suffered cardiac arrest events in one of 507 hospitals participating in the American Heart Association's National Registry of Cardiopulmonary Resuscitation. Survival was divided into hourly time segments, with day/evening specified as 7 a.m. to 10:59 p.m., night as 11 p.m. to 6:59 a.m., and weekends as 11 p.m. Friday to 6:59 a.m. Monday. Overall survival was 14.7 percent for nights/weekends, and 19.8 percent for weekdays.

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 25057 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, 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.”

 
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