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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 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

 
  Editorial ...

27th November 2010, Saturday

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

Patients with abnormal LFTs can take statins

Long–term use of statins does not increase the risk of liver disease in patients with abnormal liver function, and can actually improve liver function, according to a new study as reported by medlineplus.

The study in fact shows that statins provide a substantially greater cardiovascular benefit in patients with abnormal liver function than in those with normal liver function. The study published in the Nov. 24 issue of The Lancet, included 437 patients with moderately abnormal liver tests with non–alcoholic fatty liver disease. Statins were given to 227 patients, while the other 210 controls received no treatment. After three years of follow–up, the patients taking statins did not have a higher rate of liver problems than those in the control group. Levels of SGPT decreased or normalized in the patients taking statins but worsened in the control group.

Patients with abnormal liver tests who took statins had a 39% to 68% reduced risk of cardiovascular events such as heart attack and stroke. The risk–to–benefit ratio of long–term atorvastatin favors statin administration even for patients with moderately abnormal liver tests.

Dr KK Aggarwal
Editor in Chief
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  SMS of the Day

(By Dr GM Singh)

"The best doctors anywhere and no one denies it are sunshine, water, rest, air, exercise and diet. These 6 will gladly attend you, if only you are willing. Your mind they’ll ease; your will they’ll mend and charge you not a rupee."

 
    Photo Feature (from the HCFI Photo Gallery)

 Heritage – Festival of Classical Dances

Bharatnatayam was organized as dance competition (Group) in the recently concluded 17th MTNL Perfect Health Mela 2010. Students of various Dancing Schools from Delhi and NCR participated in large numbers in the competition.

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

30 per cent increase in medical seats likely

HYDERABAD: Medical aspirants will have a better chance of securing a seat in state colleges next academic year as the number of medical seats in the state might increase by an average of 30 per cent, thanks to the new Medical Council of India rules. According to the recent MCI guidelines for admissions, medical colleges which have 1,100 beds can admit up to 250 students. This would mean that several top medical colleges in the state can increase their seats by 20 to even 50 per cent. (Source: The Times of India, Nov 24, 2010)

 
    International News

(Dr Monica and Brahm Vasudev)

Sophisticated testing not necessary for assessing heart disease risk

Expensive and sophisticated tests are not necessary for assessing a patient’s risk for heart disease. Instead, a basic assessment that includes cholesterol level, blood pressure, age, sex, family history and whether an individual smokes or has diabetes is the strongest tool a doctor can use in predicting the likelihood of heart disease in people who don’t have any symptoms of disease, according to a joint statement released Nov. 15 by the American College of Cardiology and the American Heart Association.

Weight gain may increase risk of heart disease

According to research presented at the American Heart Association meeting, in a study encompassing some 81,000 men and women from Denmark, researchers found that for every 8.8 pound increase in the weight portion of an individual’s body–mass index (BMI) that person’s risk for developing ischemic heart disease rose by more than 50 percent.

Men who do not get enough sleep may be increasing their risk for cardiovascular disease

After analyzing results of an ultrasound analysis involving more than 600 middle–aged black and white patients drawn from across the country, doctors found that an extra hour of sleep translated into .021 mm less intima–media thickness (IMT), among men. Women, by contrast, only experienced. 002 mm less IMT as a result of an extra hour of sleep.

Adding surgery to medications may benefit diabetic patients with heart disease

In a study encompassing more than 1,500 patients who underwent an imaging procedure called stress myocardial perfusion SPECT or MPS, doctors found that combining "a revascularization procedure – either bypass surgery or angioplasty" with medications to lower cholesterol and blood pressure may help reduce clogging of blood vessels better than drugs alone.

 
    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Does one need to get admitted for the IVF process?

A patient undergoing IVF does not require admission. However, one should visit the center 3–5 times during monitoring cycle. On the day of egg collection, the patient would need to fast for 6 hours and come to clinic (the procedure takes about half an hour). Patients can go home after the effect of anesthesia weans off which takes about 2–3 hours. The next scheduled visit is after 2–3 days for the embryo transfer, which again takes about half an hour and patients are free to go home after resting for one hour.

For queries contact: banerjee.kaberi@gmail.com

 
    Medicine Update

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

Steps to Improving Self–Esteem

  • Try to stop thinking negative thoughts about yourself. If you’re used to focusing on your shortcomings, start thinking about positive aspects of yourself that outweigh them. When you catch yourself being too critical, counter it by saying something positive about yourself. Each day, write down three things about yourself that make you happy.
  • Aim for accomplishments rather than perfection. Some people become paralyzed by perfection. Instead of holding yourself back with thoughts like, "I won’t audition for the play until I lose 10 pounds," think about what you’re good at and what you enjoy, and go for it.
  • View mistakes as learning opportunities. Accept that you will make mistakes because they are part of learning. Remind yourself that a person’s talents are constantly developing, and everyone excels at different things — it’s what makes people interesting.
  • Try new things. Experiment with different activities that will help you get in touch with your talents. Then take pride in new skills you develop.
  • Recognize what you can change and what you can’t. If you realize that you’re unhappy with something about yourself that you can change, then start today. If it’s something you can’t change (like your height), then start to work toward loving yourself the way you are.
  • Set goals. Think about what you’d like to accomplish, then make a plan for how to do it. Stick with your plan and keep track of your progress.
  • Take pride in your opinions and ideas. Don’t be afraid to voice them.
  • Make a contribution. Tutor a classmate who’s having trouble, help clean up your neighborhood, participate in a walkathon for a good cause, or volunteer your time in some other way. Feeling like you’re making a difference and that your help is valued can do wonders to improve self–esteem.
  • Exercise! You’ll relieve stress, and be healthier and happier.
  • Have fun. Ever found yourself thinking stuff like "I’d have more friends if I were thinner"? Enjoy spending time with the people you care about and doing the things you love. Relax and have a good time — and avoid putting your life on hold.
 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What are incised–looking and incised wounds?

The wounds produced by a blunt weapon or by a fall on the hard surface/object, on tense structures/skin covering the bones, such as the scalp, eyebrow, iliac crest, shin, perineum, knee or elbow when the limb is flexed look like incised wounds; however, they are lacerated wounds, also called split lacerations caused by blunt force and create confusion in the mind of police official about sharp weapon. Under magnifying lens, the edges of such wounds are found to be irregular with bruising. Such wounds are also produced by broken glass pieces, broken crockery, which have the characteristics of incised wounds but the edges appear parallel with one end of the wound an injury to a finger/body as a neatly incised laceration/split laceration or incised looking wound caused by broken glass

A neatly incised laceration is an incised wound

An incised wound, cut, slash, and slice is a clean cut through the skin that may or may not involve underlying tissues and structures and is caused by a sharp–edged instrument, such as knife, razor, blade, scalpel, sword, which is longer than the depth of wound.

Significance for doctors and police officials

  • Provides clue about the weapon used is sharp edged one and the direction of the force.
  • Duration of injury can be determined.
  • Location of the wound may suggest mode of production i.e. suicide, accident, homicides, fabricated or otherwise
 
    Inf Update : Question of the Day

What is Indoor Residual Spraying?

Indoor residual spraying (IRS) is the application of small amounts of insecticide to the interior walls of houses to kill or sometimes repel malaria–transmitting mosquitoes. IRS is a highly effective, proven malaria prevention strategy that saves lives. DDT is one of the WHO–approved insecticides for IRS. It is more effective and less expensive than many other insecticides in many situations, so it is a very "competitive" choice for IRS programs.
The use of the insecticide DDT for IRS is very different from the massive agricultural applications. If used correctly, it poses no known risk to human health. Malaria, on the other hand, kills more than one million people each year, the vast majority of whom are African children.

(Suggested reading: USAID’s Support for Malaria Control in Countries Using DDT).

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Allergy testing

Allergies are hypersensitivities, overreactions of the immune system to substances that do not cause reactions in most people.
Allergen specific IgE testing: Immunoassay and LINE BLOT TESTS are blood tests that are used to screen for type I allergen–specific IgE antibodies.

 
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    Medi Finance Update

Personal Accident Individual

Exclusions

  • Injury or disease directly or indirectly caused by or arising from or attributable to War, invasion, act of foreign enemy/war–like operations (whether war be declared or not)
  • Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness.
 
    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

List of drugs prohibited for import

Phenacetin

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Preparticipation sports examination in children

2010 consensus guidelines for preparticipation sports physical evaluation endorse the use of a standardized evaluation form that includes a cardiovascular history. The form is available at www.pesportsevaluation.org

(Ref: The American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Preparticipation Physical Evaluation, 4th ed. Bernhardt, D, Roberts, W (Eds). American Academy of Pediatrics, Elk Grove, IL. 2010)

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with chronic kidney disease but no history of heart disease came for lipid lowering treatment.
Dr Bad: There is no need.
Dr Good: Go ahead with it.
Lesson: Treatment with a combo pill –– simvastatin/ezetimibe is associated with a 17% reduction in major atherosclerotic events and a 15% reduction in the risk of major vascular events, both compared with placebo, according to findings from the Study of Heart And Renal Protection (SHARP) trial.

Make Sure

Situation: A patient with Chikungunya had persistent joint pains.
Reaction: Oh my God! Why was a trial of HCQS not given?
Lesson: Make sure that all patients of Chikungunya fever with persistent joint pains are given a trial of hydroxychloroquinine.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Major V V Narayanan)

What should one feel after giving?

We all know the story of Eklavya. When Dronacharya asked him for his right thumb as "Guru Dakshina", he unhesitatingly cut off the thumb and gave it to Dronacharya. There is a little known sequel to this story.

Eklavya was asked whether he ever regretted the act of giving away his thumb. He replied, and the reply has to be believed to be true, as it was asked to him when he was dying. His reply was, "Yes! I regretted this only once in my life. It was when Pandavas were coming in to kill Dronacharya who was broken hearted on the false news of death of his son Ashwathama and had stopped fighting. It was then that I regretted the loss of my thumb. If the thumb was there, no one could have dared hurt my Guru?"

The message to us is clear. Give and never regret giving!

— — — — — — — — — —

Mind Teaser

Read this…………………

Y Y guy guy

Yesterday’s Mind Teaser: "1234 US"
Answer for yesterday’s Mind Teaser: "Count on us"

Correct answers received from: 
Dr. K P Rajalakshmi, Dr Deepti Katyal Uppal, Dr Joshi Sachin

Answer for 25th November Mind Teaser: "A long letter from home"
Correct answers received from: Dr U gaur

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)

Doctor, Doctor, I can’t get to sleep.

Sit on the edge of the bed and you’ll soon drop off.

 
    Readers Responses
  1. Respected Sir, the contents in emedinews are very informative and cover all aspects of medicine in small measures. Regards: Dr Anupam
 
    Public Forum

(Press Release for use by the newspapers)

Smoking women at risk of rectal cancer

Women who smoke are at twice the risk of developing cancer of the rectum and the risk goes up with the increase in number of cigarettes smoked per day, smoke duration and older age at smoking cessation, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

He was interacting with a group of women at the Heart Care Foundation of India stall in the Ministry of Health and Family Welfare pavilion at the IITF, Pragati Maidan.

He advised women to avoid inflicting such violence on their body, to take better care of their health and to quit smoking. Quoting a study published in the Journal of National Cancer Institute, Dr. KK Aggarwal said that women should never smoke. Current smokers are 95% more likely to develop rectal cancer. Though the no. 1 cancer in women in urban areas is breast cancer and in rural areas is cancer of the cervix, the cancer of the rectum is on the rise.

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS, Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November 2010
Venue: Moolchand Medcity Auditorium, 9 – 12 noon

Chairperson: Dr (Prof) S C Tiwari, Director Fortis Institute of Renal Sciences & Kidney Transplant Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani
9.00 – 9.30 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Medicity
9.30 – 10.00 AM: Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
10.00 – 10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30 – 11.00 AM: Kidney Transplant: managing difficult cases. Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00 – 12.00 AM: Panel discussion

Panelists:
1. Dr. (Prof.) S C Tiwari
2. Dr. K K Aggarwal
3. Dr. S V Kotwal
4 .Dr. Ambar Khaira
5. Dr. Saurabh Misra
6 All Speakers

12.00 Noon: Lunch

(Registration free: email to emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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