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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

 

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  Editorial …

27th August 2011, Saturday

Was Lord Ganesha born of a stem cell transplant?

Today West claims that they can make human bladder tissue from the human skin cells. But was not lord Ganesha created by Parvati from the dirt of her body? The dirt from allopathic point of view would equate to the cells of her skin. In today’s terms Ganesha birth can be explained as the origin of stem cell baby birth in the literature.

First identified in the hematopoietic blood system stem cells are present in many other tissues. All stem cells are capable of self–renewal and they can differentiate.

Self–renewal is the ability to proliferate without the loss of differentiation potential and without undergoing biologic aging. Stem cells can divide symmetrically (in which both daughter cells are either stem cells or differentiated cells) or asymmetrically (yielding both a stem cell and a more differentiated cell)

Stem cells can be either totipotent, pluripotent, multipotent, or unipotent. Totipotent cells can produce all cell types (embryonic and extra embryonic placenta). Pluripotent cells can only make cells of the embryo proper. Multipotent cells can only make cells within a given germ layer.
Unipotent cells make cells of a single cell type.

In 2006 Shinya Yamanaka and colleagues introduced genes expressed in pluripotent cells into mature cells by a process, called reprogramming and induced a pluripotent state in a previously differentiated cell type. These cells are now called induced pluripotent cells (iPS).

iPS technology has revolutioned science today. A keratinocyte derived from the skin can be induced to become a pluripotent stem cell. Also a cell taken from an individual can be induced to become a cell type capable of forming any other cell type. A skin obtained from a patient with a degenerative brain disorder is now used as a drug after getting converted into a pluripotent cell.

Today the recognition that a cell taken from an individual can be induced to become pluripotent (a cell type capable of forming any other cell type in that individual's body) has provided unprecedented opportunities for regenerative medicine.

Today most easily accessible patient cell types, such as skin fibroblasts or blood cells are being reprogrammed to iPS.

Theoretically therefore it is possible to make any tissue from iPS. That means the skin cells can make liver, brain, heart or I fact the whole baby.

It looks that this technology claimed by the Western scientists of converting skin cell into iPS cell was available in our Vedic era and the birth of Ganesha by Parvati might have been an example of the first human baby made from the skin iPS.

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Was Lord Ganesha born of a stem cell transplant?

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    Photo Feature (from the HCFI Photo Gallery)

"18th Perfect Health Mela 2011"

The "18th Perfect Health Mela 2011" will be held from 14th to 23rd October 2011 at NDMC Grounds Laxmi Bai Nagar, New Delhi. Addressing a press conference Dr. K K Aggarwal, Padma Shri & Dr. B.C. Roy Awardee, President Heart Care Foundation of India and MTNL Perfect Health Mela.

 
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

Cholera origin traced to Bay

Biologists have confirmed long–standing suspicions that the Bay of Bengal has been the epicentre of several distinct waves of global transmission of cholera driving the five–decades–old seventh cholera pandemic. Researchers at the National Institute of Cholera and Enteric Diseases (NICED), Calcutta, and their collaborators at the Wellcome Trust Sanger Institute in Cambridge, UK, and in other countries have shown that a cholera pandemic active since 1961 has spread in three distinct waves from the Bay of Bengal region. Their analysis of the genomes of 154 strains of the cholera bacteria isolated from diverse geographical regions over the past century has shown that a single source population in the Bay of Bengal has periodically radiated into Asia, Africa, Europe, and North and South America. The results of this analysis will appear in the journal Nature. Microbiologists have long suspected that the delta regions in the northern Bay of Bengal have played a role in the spread of cholera. "The humidity, the ecology, and the crowded living conditions here appear conducive for transmission as well as for the emergence of new variants of cholera," said G. Balakrish Nair, director of NICED and a member of the team. The study, which analysed genomes of cholera bacteria to determine their genetic distance from each other, has revealed several distinct transmission events.

In the first wave, for instance, the cholera germ spread from the Bengal basin into eastern and central Africa during 1967–89, into Europe during 1974–75, and into South America, via Africa, during 1981–85. The second wave from 1992 to 2002 again carried the microbe into east Africa. In the third wave, it moved from Nepal to Haiti between 2004 and 2009, and from the Bengal basin into southeast Asia between 2003 and 2007. (Source: The Telegraph, August 25 , 2011)

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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 Monica and Brahm Vasudev)

The natural remedy for superbugs? Coriander oil could be used to cure food poisoning and MRSA, say scientists

Coriander oil could be used to cure a host of infections including food poisoning and the superbug MRSA, say researchers. The herb extract is resistant to a range of toxic bacteria which cause infections that are resistant to drugs, a study has found. Portuguese scientists tested samples of the oil – taken from the seeds of a coriander plant – against 12 lethal bacteria. All showed reduced growth and most were killed by a solution containing less than 1.6 per cent of the oil. The team from the University of Beira Interior found the oil attacks and kills the outer membrane of bacteria cells, including salmonella, E.coli and MRSA. Dr Fernanda Domingues, who co–authored the study, said coriander oil could help the millions who suffer from food–borne illnesses every year. ‘It could become a natural alternative to common antibiotics,’ she said. ‘We envisage the use of coriander in lotions, mouth rinses and even pills, to fight multidrug–resistant bacterial infections that otherwise could not be treated. (Source: http://www.dailymail.co.uk/health/article–2029248/Coriander–oil–used–cure–food–poisoning–MRSA–say-scientists.html#ixzz1VvpOf8Qm

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Half of U.S. adults will be obese by 2030, report says

Based on trends, half of the adults in the United States will be obese by 2030 unless the government makes changing the food environment a policy priority, according to a report released Thursday on the international obesity crisis in the British medical journal the Lancet. Those changes include making healthful foods cheaper and less–healthful foods more expensive largely through tax strategies, the report said. Changes in the way foods are marketed would also be called for, among many other measures. A team of international public health experts argued that the global obesity crisis will continue to grow worse and add substantial burdens to health–care systems and economies unless governments, international agencies and other major institutions take action to monitor, prevent and control the problem. Changes over the past century in the way food is made and marketed have contributed to the creation of an "obesogenic" environment in which personal willpower and efforts to maintain a healthful weight are largely impossible, the report noted.
(Source: http://www.washingtonpost.com/national/health–science/half–of–us–adults–will–be–obese–by-2030–report–says/2011/08/25/gIQAYthweJ_story.html, Aug 25, 2011)

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Starving to stay thin? Be prepared for heart disease

Additional tests may not always be necessary for diagnosis

This must come up as a wake–up call for young girls starving to be size zero. Scientists have found that under–nutrition during adolescent years is associated with an increased risk of coronary heart disease in later life. A study of almost 8,000 women who were children, teenagers or young adults during the Dutch famine in 1944–45 conducted by researchers from the University Medical Centre in Utrecht, the Netherlands, has shown that under–nutrition – particularly in adolescent years – is associated with an increased risk of coronary heart disease in later life. Women, who were between 10 and 17 years at the start of the famine and who had been severely exposed to it, had a statistically significant 38% increased risk of coronary heart disease in later life. After incorporating factors like age at the start of the famine, smoking, and education, there was a 27% higher risk of heart disease for the severely exposed women as compared to those unexposed.
The study published on Thursday in the European Heart Journal has provided the maiden direct evidence that acute under–nutrition during the time that children are growing up can have an important impact on their future health. Doctors recommend that women eat 2,000 calories a day to stay healthy. (Source: TOI, Aug 26, 2011)

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  Fitness Update

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

Milk better than water to rehydrate kids

Active children need to be watered with milk. It’s a more effective way of countering dehydration than a sports drink or water itself, say researchers at McMaster University. That’s particularly important during hot summer weather, says Brian Timmons, research director of the Child Health and Exercise Medicine Program at McMaster and principal investigator of the study. "Children become dehydrated during exercise, and it’s important they get enough fluids, particularly before going into a second round of a game. Milk is better than either a sports drink or water because it is a source of high quality protein, carbohydrates, calcium and electrolytes." He added that milk replaces sodium lost in sweat and helps the body retain fluid better. As well, the milk provides protein needed by children for muscle development and growth which is not found in the other drinks.

The study of eight to 10–year–olds involved exercising in a climate chamber, then receiving a drink and being measured for hydration. Timmons, an assistant professor of pediatrics of the Michael G. DeGroote School of Medicine, said active children and adults usually don’t drink enough to stay hydrated during exercise, so they often have a "hydration disadvantage" when they start their next period of exercise. He said that one per cent dehydration can have up to a 15 per cent decrease in performance, with an increased heart rate, core temperature and less ability to keep going. More significant dehydration comes with an increased risk of heat–related illness such as heat stroke.

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  Twitter of the Day

@DrKKAggarwal: #AJENT Many parents underestimate kids’ asthma symptoms Parents of kids with asthma don’t always realize when… fb.me/1aOTntTh5

@DeepakChopra: #CosmicConsciousness Mental processes can alter reality

 
    Dr KK Answers

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

At what stage we should advice hunger striker to take feed and at what stage should we tell him that if he continues hunger strike it would endanger his life ?

Appearance of ketones in the urine means fat is breaking down. Till the fat in the body is up to 7% in males and 10% in females there is no risk to life. Below that fat levels the effects of starvation and muscle wasting starts due to proteins breakdown. Clinically patients will present with an intense desire to eat. At this time the hunger stroke should be broken.

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    Spiritual Update

Rome was not built in a Day

With ‘Abhyas’ or constant practice, one can conquer all the obstacles in life. The sutra "Rome was not built in a day" has a deep spiritual meaning. In the path for self–realization, regular practice is the principle behind all paths: Bhakti, Karma or the Gnana marg. Persistence is the key…

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    An Inspirational Story

(Ms Ritu Sinha)

A field mouse or an Osprey

Life offers two choices.

We can live scurrying for survival or soaring to the unlimited heights. The choices are modelled by two these two creatures.

A few months back while sitting in a boat fishing with a couple of friends, I noticed a field mouse on the river bank. He emerged out of his hole, darted in a couple of directions, and then scurried back. I thought of the existence of this little creature. His life is spent running around, frightened and frantic, following his nose. He darts here, scurries there, turns in circles, but never really sees much beyond his nose. He is trying to sniff his way to successful living, which defined, by a mouse's existence, is finding some daily morsel to consume, to sustain him, so that he can carry on for the rest of his life, frightened and frantic. Sound familiar.

A few minutes later I glanced up and noticed soaring high above was an Osprey.

Rather than a picture of a frightened and frantic existence, I saw a wide winged creature using the air currents to maneuver majestically in the unlimited heights. Rather than sniffing out a meager existence, this keen eyed hunter with a panoramic view of the river and lake beneath, was simply waiting for the appropriate time to swoop and capture his prey. The amazing creature, rather than return to some tiny hole in the river bank, glides toward a nest fashioned at the top of the tallest of trees.

The strength in his wings, the power in his talons, the amazing capacity of his vision, the effortless capacity to soar, It is the osprey, not the field mouse that models our human potential.

I don’t know about you, but it is easy for me to decide which creature I want to exemplify my life. I want to soar. I want to explore. I want to see the big picture. I want to conquer. I want to climb higher, go farther, dive deeper, and experience more. I want my soul enlarged, my mind expanded, my heart enlivened and my spirit energized. I want the scurrying to stop. I want the frantic darting about following my nose, to end. I want new strength, fresh thinking, clear vision and resolved courage.

I want to be more and more like the osprey and less like the field mouse, for to live like this field mouse is to insult my creator and deny my true destiny.

For comments and archives

 
    Gastro Update

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

What are the characteristics of IBD?

Ulcerative colitis (UC) is characterized by diffuse mucosal inflammation limited to the colon. Disease extent can be divided into distal or more extensive disease.

  • "Distal" disease refers to colitis confined to the rectum (proctitis) or rectum and sigmoid colon (proctosigmoiditis). More extensive disease includes "left sided colitis" (up to the splenic flexure).
  • "Extensive colitis" (up to the hepatic flexure), and pancolitis (affecting the whole colon)in around 60–80% of the children.

In contrast to UC, Crohn’s disease is characterized by patchy, transmural inflammation, which may affect any part of the gastrointestinal tract. It may be defined by location (terminal ileal, colonic, ileocolic, upper gastrointestinal), or by pattern of disease (inflammatory, fistulating, or stricturing).

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Reticulocyte count

A reticulocyte count is a blood test that measures how fast red blood cells called reticulocytes are made and released from the bone marrow into the blood. Reticulocytes remain in the blood for about 2 days before developing into mature RBCs. Normally, about 1–2% of RBCs in the blood are reticulocytes. Reticulocyte count is done to

  • Check if anemia is due to fewer RBCs being made or by a greater loss of RBCs
  • Check how well bone marrow is working to make RBCs.
  • Check to see if treatment for anemia is working.

Increased reticulocyte count: Loss of blood, hemolysis, high altitude; a higher reticulocyte count during anemia treatment means that iron replacement treatment or other treatment to reverse the anemia is working.

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes was found to have high pesticide levels in the blood.
Dr Bad: They are not related.
Dr Good: They are related.
Lesson: Individuals with moderately high blood levels of organ chlorine pesticides have a greater chance of developing type 2 diabetes. (Aug. 4 in Diabetes Care)

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Make Sure

Situation: A patient with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/70 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored, it is an impending sign that the patient is going into shock.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

When you doubt your power. You give power to your doubt.

 
  IDIOMS

(Ms Ritu Sinha)

Everything but the Kitchen Sink: Almost everything and anything has been included.

 
  G P Pearls

(Dr Pawan Gupta)

Stool DNA test is available for diagnosing cancer of colon.

 
    Medicolegal Update

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

Medical literature must exist in the public domain to serve as legitimate evidence in court

Do not misrepresent the document/medical literatures in the Court of Law; drawing a contrary conclusion from passages accurately interpreted does not constitute misrepresentation.

  1. The electronic files to which other debaters would be denied access are not published. However, files and documents which other debaters may access, even if they have no subscribe to a commercial service to do so, satisfy the publication rule.
  2. The advent of the Internet has created a new form of publication – electronic documents like this e-medinews. Electronic documents are accepted as published if they are accessible by the general public.
  3. The portion of a document read as evidence cannot be taken out of context. When a document is cut in a manner which lends the quoted passage a meaning other than what would be derived from a more complete reading, you are misrepresenting the document. This does not mean, however, that you are responsible for drawing the same conclusions from information as the author of the document.
  4. One paragraph or even one part of a paragraph may be all that is necessary to substantiate the point a doctor want to make in a court room. Reading the remainder of the document, even if it establishes a context for the evidence, is unnecessary and time consuming. The document must potentially be available to any debater researching the topic or lawyer/interested party of cross examination side
  5. Drawing a contrary conclusion from passages accurately interpreted does not constitute misrepresentation. The fact that the author of the document reached a different conclusion from the information argues – perhaps persuasively – against your conclusion. However, you have not misused the evidence.
  6. Read the used evidence literature verbatim in the court of law. Documents must be presented in the words of the author. When you paraphrase evidence, you argue in a circle. A document obviously will seem to support your point if you are allowed to read into the record only what you think it says.

For comments and archives

 
    Mind Teaser

Read this…………………

Which one of the following is the common cause of congenital Hydrocephalus is?

1 Craniosynostosis.
2 Intra uterine meningitis
3 Aqueductal stenosis
4 Malformations of great vein of Galen.

Yesterday’s Mind Teaser: Which one of the following is not used as tumor marker in testicular tumors?

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

Answer for Yesterday’s Mind Teaser: 4. CEA

Correct answers received from: Dr Surendra Bahadur Mathur, Dr Chandresh Jardosh,
Dr Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr Anil Bairaria, Dr Prachi, Dr Richa, Dr Anmol, Dr Priya.

Answer for 25th August Mind Teaser: c. E6,E7
Correct answers received from: Dr Valluri Ramaro, Dr YJ Vasavada, Dr Renu Yadav, Dr Anupam,
Dr Shobha, Dr Kanak, Dr Mayank, Dr Sumit.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr. Prabha Sanghi)

One evening while working in the ER, I received a call from a patient who had recently visited the department. She said to me, "You all gave me this subscription for depositories, but I still can’t go to the toilet." I had to think about that for a minute.

 
    Drug Update

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

Drug Name

Indication

DCI Approval Date

Beclomethasone Dipropionate IP 100mcg + Formoterol Fumarate Dihydrate BP Eq. to Formoterol Fumarate 6 mcg Metered Dose Inhaler

For the treatment of bronchial asthma where use of inhaled corticosteroid therapy found appropriate

05.01.11

 
    Public Forum

(Press Release for use by the newspapers)

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Walk at a pace of 4mph for 90 minutes a week

Physical activity involving moderate–intensity exercise for 15 minutes a day or 90 minutes a week can reduce deaths from any cause by 14% and increase life expectancy by three years said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Quoting a study published in the August 16 in The Lancet, Dr Aggarwal said that beyond the minimal amount of 15 minutes of daily exercise, each additional 15 minutes was associated with a further reduction in all–cause mortality risk by 4% and in all–cancer mortality risk by 1%.

These benefits of exercise are seen in all age groups, in both sexes, and in persons at risk for cardiovascular disease.

The current guideline is to do 150 minutes of exercise per week.

Moderate intensity exercise refers to a level of exertion during exercise that raises your heart rate to a point where you sweat and feel you’re working, yet you’re able to carry on a conversation. You can talk, but you can’t sing.

Example is walking at a pace of 4mph.

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    Readers Response
  1. 1982 me Singapore me unka apna Lokpal–Bill Lagu Hone ke bad Ek hi Din me 142 Neta aur Corrupt Officers Arrest huye" Aaj singapore mai only 1% people are poor and no any tax are paid by people to govt, 90% money are white and 1% unemployed. Jaago Bhai Jaago. Regards: Dr Chandresh Jardosh
 
    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.

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