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

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

 
  Editorial …

26th August 2011, Friday

Should we do routine HPV test in women?

Most doctors continue to recommend annual cervical cancer screening, despite guidelines recommending that low-risk women be tested every three years reports American Journal of Obstetrics and Gynecology on Aug. 18.

Centers for Disease Control and Prevention have mentioned three clinical situation in a woman between the ages of 30 and 60 years of age with a current normal Pap test:

  • No current human papillomavirus (HPV) test results and history of 2 consecutive normal Pap test results,
  • A current negative HPV test result and a history of 2 consecutive normal Pap test results
  • A current negative HPV test result and no history of Pap tests.

In all three cases, guidelines would support extending the screening interval up to three years.

For comments

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Should we do routine HPV test in women?

Audio PostCard
 
    Photo Feature (From HCFI Photo Gallery)

NCR to benefit from MTNL Perfect Health Mela
in October

The “18th Perfect Health Mela 2011” will be held from 14th to 23rd October 2011 at NDMC Grounds Laxmi Bai Nagar, New Delhi  Releasing Mela Poster, Dr. K K Aggarwal, Padma Shri & Dr. B.C. Roy Awardee, President Heart Care Foundation of India and MTNL Perfect Health Mela and Mr. Sandeep Marwah Director, Asian Academy of Film and Television, Mr Ashok Tyagi and Mr RK Singh.

 
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

Now, 1-yr paid internship must for BDS students

In a move that will benefit thousands of students of dental colleges, the Centre on Wednesday green-signalled the four-year academic course plus a year’s rotational compulsory paid internship for Bachelor of Dental Science (BDS) students. The new 4+1 year BDS course will be applicable from the academic session of 2008-09. According to the Dental Council of India (DCI), the Health Ministry conveyed its approval to the DCI Revised BDS Course (3rd Amendment) Regulations, 2011 to re-introduce the 4+1 year rotational compulsory paid internship in BDS Course w.e.f. the academic year 2011-12. It means, the batches admitted during the year 2008-09 will be the first beneficiary of the revised course. A notification for the new course will be issued soon following which a dental intern would too be eligible for a stipend equal to the medical (MBBS) interns. The new course also envisages three-month rural training for students during internship to sensitise them to the need of the villagers who have no access to medical facilities.

(Source: The Pioneer, August 24, 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 GM Singh)

Slow-release NSAIDs are linked to higher risk of GI bleeding

A systematic review of observational studies on NSAIDs and upper-GI bleeding and perforation has revealed that the risk of gastrointestinal complications caused by NSAID use varies according to which NSAID was given and by dosage. The overall relative risk of upper-GI bleeding and perforation for traditional NSAIDS that were not cox-2s was 4.50 (95% confidence interval 3.82-5.31). Lower relative risks were observed for ibuprofen (2.69, 95% CI 2.17-3.33), rofecoxib (2.12, 95% CI 1.59-2.84), aceclofenac (1.44, 95% CI 0.65-3.2) and celecoxib (1.42, 95% CI 0.85-2.37), while the relative risk for diclofenac was estimated at 3.98 (95% CI 3.36-4.72) and naproxen 5.63 (95% CI 3.83-8.28). The study also found that NSAIDs with a long half-life or slow-release formulation were associated with a greater risk of GI bleeding or perforation, reinforcing advice that the risks and benefits of taking NSAIDs need to be weighed very carefully and that prolonged use should be avoided if at all possible.

For comments and archives

(Dr Monica and Brahm Vasudev)

Add homocysteine to improve CVD risk stratification

Risk stratification for cardiovascular disease (CVD) improved significantly with the addition of homocysteine level to the Framingham Risk Score as per a study in the Journal of the American College of Cardiology. Homocysteine level >15 µmol/L predict a 172% increased risk of CVD.

For comments and archives

National Institutes of Health Revises Conflict of Interest Rules

The National Institutes of Health revised on Tuesday its 16-year-old conflict of interest rules for medical researchers, lowering the amount of money that constitutes a financial conflict and expanding the required disclosures. The 1995 regulations effectively put responsibility for tracking scientists' financial conflicts of interest on their universities. The rule required researchers to disclose conflicts to their institutions, which then had to assure the NIH the conflict had been managed, reduced or eliminated. The new rule extends that requirement so researchers report not only the fact of a conflict of interest, but also its details such as value, specific nature, why it is a conflict and the impact it might have on research. It lowers the amount a researcher must disclose if received from an industry or held in company stock to $5,000 from about $10,000.

(Source: Medscape)

For comments and archives

 
   Fitness Update

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

Weight training in older adults is necessary to prevent loss of lean body mass

Sarcopenia is the medical term for the loss of muscle mass and strength that typically occurs in aging adults. This loss of lean body mass often leads to lower functionality and lower quality of life. New research published in Medicine & Science in Sports & Exercise, however, reiterates the importance of resistance training to prevent the loss of lean muscle mass. Authors of the study aimed to review all of the recent literature to determine how different training programs affected people of different ages.

Researchers included data from 49 studies, evaluating a total of 1,328 patients over the age of 50, in this meta-analysis. After performing various statistical tests to ensure that results from different studies were compatible, they found that higher volume interventions (resistance training regimens that increased the volume of weight lifted progressively over time) were significantly more effective. Additionally, they found that programs were more effective is started earlier in life, presumably to prevent sarcopenia before it begins.

For comments and archives

 
   Twitter of the Day

@DrKKAggarwal: #AJD Minocycline–EDTA Solution to Reduce Catheter–Related Bacteremia Dialysis patients had significantly fewer... fb.me/JmOboj1f

@DeepakChopra: Today I will relinquish all resentments and grievances and Be Peace

 
    Dr KK Answers

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

How common is vein clots in pregnancy?

The risk of vein and lung clots is increased in pregnancy especially in the post partum period, particularly in those undergoing caesarean delivery. Overall, the risk in low risk pregnant women after 20 weeks is quite low (estimated as less than 1 per 3000) and approaches the background risk in non pregnant women. Routine blood thinning of pregnant women on bed rest is not recommended unless other risk factors for VTE are present. However, the presence of single or multiple risk factors like marked obesity, prior episode of vein clots markedly increases the risk of clots during pregnancy.

For comments and archives

 
    Spiritual Update

Why Lord Ganesha Never Suffered from Diabetes

Today the developing world is facing an epidemic of potbelly obesity-related diabetes and the same has been linked to eating refined carbohydrates especially refined sugar

For comments and archives

 
    An Inspirational Story

(Dr. Anupam Sethi Malhotra)

10 keys to bring more inspiration into your life

Have you ever asked yourself what is inspiration?

When the word inspiration is broken down into its component parts, it simply means "in - spirit". When you are living "in - spirit" You feel excited about yourself and your life. You have a special connection with all parts of your mind and body. The question is how can we connect to our spirit at all times to take that actions that make all things possible? Below are 10 keys to open your doors to your inspiration.

  1. The first key to inspiration is enjoyment. It would take a spiritual master to get inspired about doing the dishes. So find something that really excites you. It can be anything that you really enjoy.
  2. The second key is love. When you are actively pouring love into what you are doing, this will guarantee that you are opening yourself to experiencing more inspiration.
  3. The third key is to trust yourself. Listen to that little voice inside yourself and know that this comes from heart. This is called intuition.
  4. The fourth key is to follow what your intuition tells you. The more you listen to it, the stronger your intuition will become. If you don't pay attention, that little voice gets fainter and fainter until you can no longer hear it.
  5. The fifth key is to keep telling yourself "I can". These are some of the most powerful words that you can ever use. When you say this to yourself often enough, you build abridge between yourself and your inspiration.
  6. The sixth key is not to listen to anyone that says "no you can't". They might think that they may not be able to, and try to project this negative belief onto you, but remember to keep telling yourself that, "I can!"
  7. The seventh key is to believe in yourself. When you are backed by a strong belief in yourself and your dreams, nothing is impossible.
  8. The eighth key is to avoid negativity. Ask yourself, do you really need to read the newspaper or watch the news on TV everyday ? Nothing kills inspiration quicker than being surrounded by bad news.
  9. The ninth key is acceptance. Accept that on some days you feel much more inspired than on others. This is normal, nobody can be completely inspired every minute of the day.
  10. The tenth key is possibly the most important of all. Take action every day, no matter how small a step it seems. Action is the fuel to the fires of inspiration. Make it a daily practice to keep your fire burning. The taking of actions, no matter how small, will fill you with inspiration for taking the next step

For comments and archives

 
    Gastro Update

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

What is pancreatitis?

Pancreatitis is defined as inflammation of the pancreas resulting in acinar cell injury caused by the destructive effect of pancreatic enzymes. It is further classified into acute, chronic and recurrent.

For comments and archives

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Phosphorous

Phosphorus test is done to diagnose and/or monitor treatment of various conditions that cause calcium and phosphorus imbalances.

It is often done along with other tests, such as those for calcium, parathyroid hormone (PTH), and/or vitamin D, to help

For comments and archives

 
    Rabies Update

(Dr. AK Gupta) Author of "RABIES – the worst death".)

What are the rules that every dog owner should follow?

  • Communicate to a dog that you are his pack leader. Take the dog for a pack walk daily where the dog is made to heel behind the human who is holding the lead.
  • All humans must eat before the dogs. The leader always eats first.
  • No table scraps should be fed to the dogs during a meal.
  • Feedings must be at a scheduled time.
  • Humans must not let the dog go through any doorways first, or up or down the stairs first. Dogs must always go after the humans.
  • When you have left the house or the room, even for a minute and come back in the room, ignore the dog for a few minutes.
  • A simple obedience command should be given before any pleasurable interaction with the dog.
  • You should not lie on the floor to watch TV when the dog is around Human should never put himself in an equal or lesser height position than the dog.
  • If a dog is lying in your path, do not walk around the dog, either make the dog move or step over the dog.
  • If you establish eye contact with the dog, the dog must avert his gaze first. Tell the children not to have staring contest with the dog.
  • Dogs must not sleep in your bed.
  • Games of fetch or play with toys must be Started and Ended by the Human.
  • Dog should not be allowed to lie on your furniture.
  • No tug–of–war, as this is a game of power and you may lose the game.
  • Dogs need to be taught a drop it or release command. Any objects the dog has in his possession should be able to be taken away by all humans.
  • Dogs should not be allowed to pull on the leash.
  • When you put his food dish down, he must wait until you give the "OK" to eat it.
  • Small dogs or puppies who demand to be picked up or put down should not get what they want until they sit or do another acceptable quiet behavior.
  • Dogs should never be left unsupervised with children.
  • When you are around your dog, avoid emotions.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A woman, aged 35 years, with a current normal Pap test came with no current HPV test results and history of 2 consecutive normal Pap tests.
Dr Bad: Go for annual pap smear test.
Dr Good: Get the Pap smear done every three years.
Lesson: Many physicians recommend the HPV and Pap co-tests for cervical cancer screening on an annual basis, despite guidelines that call for re-screening every three years. According to guidelines from the American Cancer Society in 2002 and the American College of Obstetricians and Gynecologists in 2003 recommend the co-test for women age 30 and up. If the results are normal on both tests, a three-year interval is recommended until the next screening. (Ref: Roland KB, et al. Human papillomavirus and Papanicolaou tests screening interval recommendations in the United States. Am J Obstet Gynecol 2011 Jun 12. Epub ahead of print)

For comments and archives

Make Sure

Situation: A neonate in an ICU being administered IV calcium exhibits signs of inflammation and necrosis at injection site.
Reaction: Oh my God! Why didn’t you observe the IV site carefully.
Lasson: Make Sure that all hypocalcemic neonates are put on a cardiac monitor while receiving calcium infusions and the IV site is closely observed, because extravasation of calcium can produce severe interstitial necrosis.

For comments and archives

 
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  Quote of the Day

(Dr GM Singh)

Success is nothing more than a few simple disciplines, practiced every day. Jim Rohn

 
    Idioms

(Ms Ritu Sinha)

Excuse my French: Please forgive me for cussing.

 
    G P Pearls

(Dr Pawan Gupta)

Macrolides also have anti-inflammatory action.

 
    Medicolegal Update

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

Doctors should avoid special efforts to “cover up” any medical fact

The media and general public are vastly becoming informed and law conscious. There is awareness of modern diagnostic/therapeutic methods. The standard of doctors/hospital, its opinion and method of medical/surgical interventions are being scrutinized from time to time in public as well as Court of law and media. The doctor should not avoid talking to the media but definitely not too much and too soon.. Prejudicial and sensational statements should not be made by doctor prior to trial. It is incumbent upon doctors to have good knowledge of the law governing their profession, in order not to transgress the law.

  • Doctors should totally avoid special efforts to “cover up” alleged medical negligence or unintentional wrong doing or inevitable medical accident.
  • It is a standard accepted universal fact that “Medicine is not mathematics but is a science of uncertainty and an art of probability. One thing that makes medicine so difficult is that there is no such thing as the average man can understand the intricacies. We can only say the reading is ‘within the range of normal’. Medicine is a biological science with the variability inherent in body physiology with the variability inherent in biological matters.
  • Forensic medicine is not an exact science as a mathematical calculation hence while making a forensic opinion it is required to deliberate that unexpected results are produced due to biological variations in case to case, there is an element of uncertainty and absolute proof is a rarity in any medical care delivery.
  • Doctors should bear in mind the essential difference between probability and proof. They should be reasonable in their opinions and should not overstate the likelihood of a relationship between cause and effect.
  • The doctor should be ready to defend every finding and conclusion on the report on clinical and scientific grounds in the court of law. He should be aware of professional and scientific viewpoints which might differ from his, and should be familiar with the latest scientific literature in relation to the subject involved.
  • The doctor in the Court of law may clarifying his testimony by means of photographs, maps, diagrams, charts, X-rays, skeletons, models, slides, films, tapes, etc., when they are properly verified.

For comments and archives

 
    Medi Finance Update

(Dr GM Singh)

What is debt-to-capital ratio?

Debt-to-capital ratio is the ratio of a company’s liabilities to its total capital. This figure reflects long-term debt-to-capital, which is the ratio of long-term liabilities (those that won’t be paid off in one year) to total capital. The higher the level of debt, the more important it is for a company to have positive earnings and steady cash flow.

 
    Mind Teaser

Read this…………………

Which one of the following is not used as tumor marker in testicular tumors?

1. AFP
2. LDH
3. HCG
4. CEA

Yesterday’s Mind Teaser: HPV genes with oncogenic potential include:

a. E4.E5
b. E5,E6
c. E6,E7
d. E7,E8

Answer for yesterday’s Mind Teaser: c. E6,E7

Correct answers received from: Dr.(Maj. Gen.) Anil Bairaria, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Sanjaya, Dr Anupama, Dr Shreyesh, Dr Ritu, Dr Shashi

Answer for 24th August Mind Teaser:1. Dorsal venous complex
Correct answers received from: Dr.K.V.Sarma, Dr Priyanka Sharma, Dr Yogindra Vasavada, Dr Valluri Ramarao, Dr.Pallipalayam Sivaramakrishan Ragavan.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr Chandresh Jardosh)

Conference: The confusion of one man multiplied by the number present.

 
    Drug Update

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

Drug Name
Indication
DCI Approval Date
Ferrous Ascorbate 100mg + Folic Acid IP 1.5mg + Cyanocobalamin IP 15mcg + Zinc Sulphate Monohydrate Eq. to Elemental Zinc 22.5mg Tablet
For the treatment of iron deficiency anaemia
05.01.11
 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

NCR to benefit from MTNL Perfect Health Mela in October

The country’s popular “18th Perfect Health Mela 2011” will be held from 14th to 23rd October 2011 at NDMC Grounds Laxmi Bai Nagar, New Delhi.

The Mela is being organised by Heart Care Foundation of India jointly with Health Department, Govt. of Delhi, MTNL, NDMC, MCD, LIC, Dept. Of Science & Technology, Govt. of India, Coca Cola India Ltd., World Fellowship of Religions, etc.

18th in a row, the brainchild of Heart Care Foundation of India, the Mela attracts 3-5 lakh members of the public over a duration of 10 days.

The Mela is organised every year between Dusshehra and Diwali and creates health awareness about all aspects of health among people from all walks of life and all ages, incorporating all pathies under one roof through the medium of infotainment. The Mela is the right mix of health picnic, exhibition, competition and infotainment.

Addressing a press conference and releasing Mela Poster, Dr. K K Aggarwal, Padma Shri & Dr. B.C. Roy Awardee, President of Heart Care Foundation of India and MTNL Perfect Health Mela and Mr. Sandeep Marwah Director, Asian Academy of Film and Television said that the event will provide a unique opportunity for the NCR people to have their heart and general health check up done and know all about prevention.

Dr. P K Sharma, MHO, NDMC, Dr. N K Yadav, MHO, MCD , Dr K S Bhagotia CMO, DHS, Mr. Sunil Kumar PGM, MTNL, Dr Sadhna Ji Maharaj from World Fellowship of Religions in a joint statement said that the Mela will be a right place to know everything that is happening in medicine.

The Mela will be a mix of exhibitions, checkups, competitions, and infotainment under one roof and will be a perfect health picnic spot for the schools and families.

For comments and archives

 
    Readers Responses
  1. Dear Sir, Public Forum on Do not eat curd in Bhadon month is very informative. Thanks a lot for the updation. Regards: Dr Ravi

 
    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 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