August 26   2015, Wednesday
eMedinewS
editorial
Major relief for medical profession
Dr KK AggarwalBombay High Court quashes prosecution under PCPNDT Act against two radiologists

Tuesday, 25 August 2015 - 8:15am IST | Agency: DNA

The doctors had initially moved the Pune sessions court, challenging the prosecution and seeking that it be quashed and set aside. After their plea was turned down, they moved the HC.

In a major relief to visiting radiologists at nursing homes and genetic centres, the Bombay High Court has ruled that it is not the duty of a radiologist to maintain details in Form F. It is pure clerical work which is required to be done by the clinic, and the doctor can't be prosecuted for non-maintenance of details in the form, the court observed while quashing a criminal complaint against two radiologists.

Justice ML Tahilyani, in his nine-page order, while quashing the prosecution initiated against two Pune doctors, Dr Ranjeet Ghatge and Dr Sanjay Kadyan, charged under section 25 and rule 9 (4) of the Pre-Conception Pre-Natal Diagnostic Techniques Act, said, "In my opinion, they cannot be prosecuted for not maintaining particular record, which is required to be maintained by the genetic clinic."

Ghatge was a visiting radiologist at Dr Purohit Nursing Home, Pune, while Kadyan used to work as a visiting radiologist at Dr Kashyap Nursing Home, Pune. They were booked by the authorities after several irregularities were found in the record maintained in Form F at the two nursing homes.

The doctors had initially moved the Pune sessions court, challenging the prosecution and seeking that it be quashed and set aside. After their plea was turned down, they moved the HC.

Counsel Niranjan Mundargi and advocates Rajeev Chavan and Amit Karkhanis, appearing for the doctors, argued, "The main accused, who were running the genetic centres, in both cases have been discharged by the trial court. It is not clear from the complaint whether the complete record of the genetic centre was taken by the authorities; whether any other hard copies of the sonography were found and whether all USG reports were examined to determine that the doctors had not maintained USG reports of the particular patient."

The judge, after examining the rules and the Act, noted, "Minute details mentioned in Form F are, in my opinion, to be filled by the staff members of the clinic. The person/doctor conducting ultrasonography on a pregnant woman will keep complete record of the ultrasonography done by him and not the details of Form F."
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eMedipics
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Beneficiaries of Sameer Malik Heart Care Foundation Fund, tuesday meeting
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Cardiology eMedinewS
  • For patients who develop in-stent restenosis following PCI with a drug-eluting stent (DES), treatment with an everolimus-eluting stent (EES) yields the best angiographic and clinical outcomes, with lower risks of restenosis and need for revascularization compared with other therapies, suggests new research published in the Lancet.
  • Obese atrial fibrillation patients have a lower chance of arrhythmia recurrence if they have high levels of cardiorespiratory fitness, and risk continues to decline as exercise capacity increases as part of treatment, suggested a study published in the Journal of the American College of Cardiology.
Pediatrics eMedinewS
Pediatrics
Psychiatry

A new population-based study, published online August 24 in Pediatrics, suggests that infants born prematurely or those who demonstrate poor fetal growth are at an increased risk of developing attention-deficit/hyperactivity disorder (ADHD), and the risk persists even among early term infants

Pediatrics
Critical Care

Using birth weight rather than body surface measurements may lead to more correctly positioned umbilical arterial catheters in newborns, suggests new research published online in Archives of Disease in Childhood Fetal & Neonatal Edition.
Dr KK Spiritual Blog
The Concept of Second Opinion

In legal system when you are not satisfied with a judge, you re–appeal in the same court and if you are still not satisfied, you go to double bench before going to higher court.

Practice the same when you take a second opinion about your health.

Never go to a different doctor. First go to the same doctor and ask him to give his opinion again and, if you are not satisfied, then go to a team of two doctors and finally go to a doctor with qualification higher than the initial doctor. If your second opinion is from another doctor, it may be wrong or partial.
Beneficiaries of Sameer Malik Heart Care Foundation Fund
IMA,IJCP,HCFI
Make Sure
Situation: A patient was brought to the ICU in cardiogenic shock.

Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?

Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 trial suggest that this intervention is much better than thrombolytic therapy in such patients.
Dr Good Dr Bad
Situation: A patient with high blood pressure came with nasal congestion.

Dr Bad: Take nasal decongestant drops.

Dr Good: Take only saline nasal drops.

Lesson: Decongestant nasal drops can acutely raise the blood pressure.

(Copyright IJCP)
eIMA Quiz
What is not true for HNPCC?

a) It is the most common hereditary colorectal cancer syndrome in USA
b) It is associated with MMR gene mutation
c) It is associated with APC mutation
d) It is associated with carcinoma colon and extraintestinal cancers

Yesterday’s Mind Teaser: Which of the following is not true for malignancy of familial adenomatous polyposis?

a) Adrenals
b) Thyroid
c) Astrocytomas
d) Hepatoblastomas

Answer for Yesterday’s Mind Teaser: c) Astrocytomas

Answers received from: Dr Shangarpawar, Dr Ridu Kumar Sharma, Dr Poonam Chablani, Dr K V Sarma, Raghu Chaks, Dr G Madhusudhan, Dr K Raju, Dr Avtar Krishan.

Answer for 24th August Mind Teaser: c) It is a partial shunt

Correct Answers received from: Dr Avtar Krishan, Raghu Chaks.
IMA Humor
The CEO of a large TPA dies and goes to heaven. St. Peter shows him to a lovely villa, wonderful music, great views, full staff of servants, gourmet meals, etc. The CEO says, "This is terrific!"

"Don’t get too comfortable," says St. Peter. "You’re only approved for a three–day stay."
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Rabies News (Dr A K Gupta)
Can rabies vaccine be given to a child with chicken pox or measles?

As rabies is 100% fatal, there is no contraindication for antirabies vaccination. Rabies vaccine can be given to a child with chicken pox or measles and it is effective. If possible administration of measles vaccine should be postponed by a fortnight after the completion of antirabies immunization.
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CPR 10
Successfully trained 113241 people since 1st November 2012 in Hands-only CPR 10
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
eIMA News
  • IMA TSK organised a CME on 22nd August at IMA Hall. Dr S Buragohain spoke on "Cough-Differential diagnosis & Management" and Dr LB Nath spoke on "Reading a chest X-Ray". It was followed by an interactive session. Dr Prasant Kr. Agarwal Pathologist (M.D.)
  • A study, published August 18 in the BMJ, from an analysis of more than 150,000 healthcare professionals in the United States, found that overall, light to moderate drinking (alcohol intake of <15 g/day for women and <30 g/day for men) was associated with a small but nonsignificant increase in cancer risk in both women and men.
  • The liver mass that former US President Jimmy Carter recently had resected has been identified as melanoma, and it has already spread to four regions in his brain, according to news presented at a briefing in Atlanta.
  • The US FDA has received reports of severe allergic reactions and herpes zoster in patients with actinic keratosis treated with ingenol mebutate gel, the agency warned August 21.
  • Compounded or repackaged drugs that have been stored in 3 mL and 5 mL syringes manufactured by Becton-Dickinson should not be administered to patients "unless there is no suitable alternative available," the US Food and Drug Administration (FDA) advised in a safety alert August 18.
  • Obesity increases the risk for colorectal cancer among individuals with Lynch syndrome, a form of hereditary nonpolyposis colon cancer, but regular use of aspirin appears to eliminate the increased risk. (August 17 in the Journal of Clinical Oncology)
  • Addyi (flibanserin), the first drug designed to boost libido in premenopausal women, won US FDA approval. The drug, which will have a label indication for hypoactive sexual desire disorder, was twice rejected by the agency in earlier attempts.
News
Oncology
Gastroenterology

Nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of developing colorectal cancer by a degree similar to aspirin, although both types of drugs must be taken consistently for a number of years to have a benefit, suggests new research published online August 24 in the Annals of Internal Medicine.

Diabetes
Obesity

A tiny osmotic mini-pump placed just beneath the skin's surface to continuously deliver exenatide results in better glucose control and weight loss in patients with type 2 diabetes compared with sitagliptin, suggest results from a new research.

Infectious Diseases
Nephrology

Patients with Ebola virus disease have more extensive kidney damage and electrolyte imbalance even in early stages of the illness than previously recognized, suggests new study, stating that addressing these problems through aggressive management of hypovolemia with intravenous fluid and electrolyte support may reduce deaths. The findings were published in The Lancet Infectious Diseases.

Obstetrics and Gynecology
First-trimester screening tests for preeclampsia have low positive predictive value, and there are no data demonstrating that they lead to improved outcomes, pointed a committee opinion published by the American College of Obstetricians and Gynecologists in the September issue of Obstetrics & Gynecology.

Rheumatology
Pulmonary Medicine

Rheumatoid factor (RF) and antibodies against cyclic citrullinated peptide (anti-CCP) are among the laboratory factors associated with interstitial lung disease (ILD) in rheumatoid arthritis (RA), suggests new research published in Clinical Rheumatology.
eBOOKs
Kindly sign this petition: For allowing parliament to function
Link: https://www.change.org/p/members-of-parliament-political-parties-parliament-to-function-urge-all-political-parties-to-have-a-collaborative-and-consultative-process-in-the-parliament

Tiny url to pass on to other members: http://tinyurl.com/qff68sf

To sign, we can login through Facebook or email account on the right hand side.

Dr Marthanda Pillai,                        Dr KK Aggarwal
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IMA IPMO Initiative
Kindly go to http://module.ima-india.org/ipmo/
and pledge your organs. Unless we do it, the public will not listen to us.

Team IMA
ICON 2015
Inspirational Story
Few things that help you to survive

If you feel tired and hopeless, GOD knows how hard you try. When you already cry for a long time and your heart is still hurt, GOD has counted your tear drops.

If you think that your life is still waiting for something and the time seems just come and pass by…GOD is still accompanying you.

When you feel alone and your friends are too busy to make a phone call, GOD is always with you. When you think that you have tried everything and don’t know what to do anymore, GOD has the answers.

When everything makes no sense to you and you feel stressed…GOD is your comfort. When you see "a bit" of hope…GOD is whispering to you.

When everything works so clear and you want to praise HIM, GOD has blessed you. When you feel beautiful things is happening and you are fulfilled with wonders, GOD has smiled to you.

When you have aims and dreams to reach, GOD has opened your eyes and call your name. Remember, Where ever you are and where ever you will be GOD knows.
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Wellness Blog
Depression should be treated in patients with diabetes

Presence of depression in diabetic patients is the most important factor leading to erectile dysfunction in such patients.

An India cum US study published in the Journal of Urology found that depression and erectile dysfunction are related to each other in the form of a vicious cycle. Depression instigates erectile dysfunction and erectile dysfunction perpetuates the symptoms of depression.

India is the diabetic capital of the world and both the incidence and prevalence of diabetes are increasing day by day. It is, therefore, important for the family physician to look for presence of depression in patients with diabetes.

Diabetic patients who complained of erectile dysfunction in the study also had higher prevalence of high blood pressure and cholesterol abnormalities. These patients were also of older age with uncontrolled diabetes, history of smoking and longer duration of diabetes.

It was also shown that patients who develop erectile dysfunction also had diabetes, eye disorders, neuropathy and peripheral vascular disease. Effective control of diabetes may reduce both depressive symptoms and erectile dysfunctions in such cases.
Reader Response
Dear Sir, Very informatory news. Regards: Dr Tripta
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Press Release
Dengue mosquitos bite during the day and breed in clean, fresh water

Dengue cases are on the rise, and everyone is rushing to find ways to protect him or herself from the disease. However what most people must remember while taking necessary precautions is that dengue mosquitos only bite during the day and breed in clean, fresh water. Often people remain unaware of these facts and protect themselves from bites during the nights by using mosquito nets and repellent creams. They also feel that they are the safest when in clean urban environments, not realizing that mosquitos could be breeding in the clean water filled bucket kept in their backyard.

Remaining in well–screened or air–conditioned buildings during the day can reduce the risk of exposure. When outside during the day, one should wear clothing that reduces the amount of exposed skin and use an effective mosquito repellent.

Speaking about the issue, Padma Shri Awardee Dr KK Aggarwal, President HCFI & Honorary Secretary General IMA said, “With the rising incidence of dengue in the city, it is extremely important that adequate precautions be taken against the disease. While dengue is only dangerous in 1% of the cases, dramatic plasma leakage can develop suddenly causing complications. Keeping this in mind, substantial attention must be placed upon the early identification of patients at higher risk of shock syndrome and other complications. Staying well hydrated is key for patients suffering from dengue.”

To prevent complications due to dramatic plasma leakage, the following clinical parameters must be kept in mind:

Duration of illness: The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with the resolution of fever. Plasma leakage first becomes evident between 24 hours before and 24 hours after the fever is over.

Alarm signs: Severe abdominal pain, persistent vomiting, an abrupt change from fever to hypothermia, or abnormal mental status, such as disorientation, are noted in a minority of patients.

Hematocrit: An elevation of the hematocrit is an indication that plasma leakage has already occurred and that fluid repletion is urgently required.

Platelet count: Severe thrombocytopenia (<100,000/mm3) is one of the clinical criteria for dengue hemorrhagic fever and usually precedes overt plasma leakage

Serum aspartate transaminase (SGOT): Mild elevations in serum transaminases are common in both dengue fever and dengue hemorrhagic fever. However, levels are significantly higher in patients with dengue hemorrhagic fever and elevated SGOT levels are noted earlier in illness.

Patients with suspected dengue who do not have any of the above indicators can be safely managed as outpatients as long as close clinical observation is assured. They must regularly consume fluids as the dangers of dengue come with dehydration. Platelet transfusion is only needed when the counts are less than 10,000, and there is active bleeding. In all other scenarios, platelet transfusion is unnecessary and can cause more harm than good. Prevention of dengue is always better than cure since it is a painful illness.

A patient should be hospitalized only when:
  • Blood pressure <90/60 mmHg
  • Hematocrit >50 percent
  • Evidence of bleeding other than petechiae