Letters to the editor
1. The father of our nation, Mahatma Gandhi had told long ago"do not see, do not hear and do not talk bad" The GURU of our cme's group DR.K.K.AGGARWAL as per his knowledge and experience says in addition to we have to follow " DO NOT EAT, READ, DO AND THINK BAD". DR.G.M.SINGH
2. Respected Dr. K K Aggarwal Sir: history of optometry was good article; please convey my thanks to Dr. Narendra Kumar for reminding us the brief history of optometry. Pl start similar topics on all medical branches. Dr. Pramod Lokegaonkar
3. Congratulation Kissu, your articles are very informative and uptodate, even beats some of the articles we see here in the USA. Keep up the good work of educating all of us in the field. Amal(Dolly)
4. I would like to conclude the controversy regarding intra cardiac adrenaline that it is not to be practiced at all in any condition be it anaphylaxis or be it cardiac arrest. I am not aware of any literature or reference published in 21st century supporting intra cardiac adrenaline. I have definitely heard of doctors who have lost their jobs / license to practice after giving intra cardiac adrenaline in the UK NHS. However, if you do not have Intravenous access than one can give adrenaline via another intravascular and easy route which is intra osseos route (even in adults, though hardly practiced in India for reasons I do not know, may be lack of availability of intra osseous needles of adult size) and of course via tracheal route in an intubated position (dose: 3mg diluted in 10-20ml of sterile water) as practiced by Intensivists & Emergency Physicians. Dr Vivek Chhabra, MD, Emergency Physician - Certified Provider - ALS - Resuscitation Council (UK) and Australian Resuscitation Council 2007
5. Thanks Dr K. K. Aggarwal for this highly appreciable initiative. The intra arterial thiopentone problem is a real hazard for we anesthetist. Mostly happens with "short GA cases where iv is secured in OT only with no iv drip. So always have a running iv line for iv thio injection because blood column rise in drip will alert you about intra arterial cannulation. If still it happens than do not remove that cannula from artery in panic. Instead inject excessive saline through that cannula to dilute the already injected thiopentone. Thanks. Dr GIRISH CALLY. @ 919810031679
6. DCI approved drugs: This was the best article so far. GKGupta
7. Sir: Thanks for your quick response. Point is well made and taken but I still have not seen availability of 2mg IR Alprazolam. Instant release above 0.5 mg is rare. Even SR preparations of 2mg is difficult to find. But point is made. Suman
Dr Good Dr Bad
Situation: A patient with chronic anemia has hemoglobin of 4 mg/dl.
Dr Bad: The patient needs whole blood transfusion
Dr Good: The patient needs packed red cell transfusion
Lesson: In chronic anemia, packed red cell transfusion is the treatment of choice, as the hemoglobin level can be raised without overloading the circulation.
Phosphorus Levels May Predict Heart Disease (Dr Prachi Garg)
Elevated blood levels of phosphorus are associated with a higher risk of heart disease. US researchers studied the link between phosphorus levels and coronary artery calcification (CAC) in nearly 900 healthy adults in the Spokane Heart Study, a long term investigation of heart disease risk factors. CAC is an early sign of hardening of the arteries. At the start of the study, 28 percent of participants had CAC. After six years of follow up, another 33 percent had developed CAC, and the level of CAC increased among those who already had the condition. The association between phosphorus levels and CAC was strong even after the researchers adjusted for other factors. (Society of Nephrology, news release, Nov. 5, 2009)
Red, processed meats linked to prostate cancer (Dr Prachi Garg)
Men who eat a lot of red meat and processed meats may have a higher risk of developing prostate cancer than those who limit such foods. Researchers at the National Cancer Institute found that among more than 175,000 men they followed for nine years, those who ate the most red and processed meats had heightened risks of developing any stage of prostate cancer, or advanced cancer in particular. The findings, reported in the American Journal of Epidemiology, add to a conflicting body of research on meat intake and prostate cancer risk. Because studies over the years have come to different conclusions, experts generally consider the evidence linking red and processed meats to the disease to be limited and inconclusive.
Health Tip: Keep a Health Journal
The American Academy of Family Physicians suggests your journal include the following:
1. Any injuries you have had or illnesses for which you have been treated.
2. Any time you were hospitalized, including when and why.
3. Any allergies you have to foods, medications, household items, pollens, etc.
4. Any past surgeries or procedures.
5. All prescription and over the counter medications, vitamins or supplements taken. Be sure to include the dose and how often you take them.
6. Diseases, illnesses or health conditions that have affected immediate family members.
Folate Levels in Pregnancy Tied to ADHD in Offspring
Low folate levels during pregnancy are associated with higher odds for attention deficit/hyperactivity disorder in offspring aged 7 to 9, new research has found. The findings seem to support the long held belief that folic acid levels in expectant mothers influence their children’s nervous system development. The researchers also found that children of mothers with low folate levels had notably smaller head circumference at birth, which may indicate a slower rate of prenatal brain growth. The study was released online Oct. 28 in advance of publication in an upcoming print issue of the Journal of Child Psychology and Psychiatry.
Funny clinical notes (Dr. Minakshi)
The patient refused autopsy.
A doctor, a lawyer and a manager were discussing the relative merits of having a wife or a mistress. The lawyer says: "For sure a mistress is better. If you have a wife and want a divorce, it causes all sorts of legal problems."
The doctor says: "It's better to have a wife because the sense of security lowers your stress and is good for your health."
The manager says: "You're both wrong. It's best to have both so that when the wife thinks you're with the mistress and the mistress thinks you're with your wife - you can go to the office and do some work.
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