emedinews
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FIRST NATIONAL 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

 

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 …

27h December 2011, Tuesday

Rheumatology Update 2011 (ACR)

  1. Treatment with hydroxychloroquine in SLE was significantly protective against the development (50%) of renal failure (Dr Michele Petri, Johns Hopkins University in American College of Rheumatology annual meeting 2011).
  2. Monotherapy with etanercept can keep some rheumatoid arthritis (RA) patients in long–term remission. Combination therapy with etanercept and methotrexate is considered standard of care for RA (Dr Roy Fleischmann, University of Texas Southwestern Medical School in Dallas at American College of Rheumatology annual meeting 2011).
  3. Treatment with the oral Janus kinase inhibitor tofacitinib resulted in statistically significant and clinically meaningful improvements in all RA patient–reported outcomes (Dr Vibeke Strand, Stanford University, Palo Alto, Calif.)
  4. Treatment of early RA with glucosteroids provides relief of symptoms, but the therapy comes with a price – worrisome changes in body fat composition that are significantly increased within the first year (Dr Michael Nurmohamed, at Jan van Breemen Research Institute/Reade, Amsterdam).
  5. Long–term treatment with the biologic agent etanercept reduces a RA patient’s risk of heart attack and malignancy, and may also reduce the risk of death, when compared with therapy using disease–modifying anti–rheumatic drugs (Dr Duncan Porter, of the University of Glasgow in Scotland).
  6. Long–term treatment with the biologic agent etanercept reduces a RA patient’s risk of heart attack and malignancy, and may also reduce the risk of death, when compared with therapy using disease–modifying anti–rheumatic drugs (Dr Duncan Porter, University of Glasgow, Scotland).
  7. RA patients try almost anything to relieve symptoms –– including special jewelry, household oils and even homemade concoctions. Dr Ashutosh Tamhane, at University of Alabama at Birmingham, found that 76% of patients used store–bought lotions for treatment of RA, and 80% utilized heat treatments. About 21% of patients took fish oil supplements; 27% utilized jewelry such as copper chains; 19% tried garlic; and 4% took raisins soaked in vodka or gin for relief (American College of Rheumatology 2011).
  8. A strategy of methotrexate–based tight control in early RA was more effective in preventing joint damage if the initial regimen also included low–dose prednisone. Among patients who received methotrexate plus prednisone, 78% were erosion–free at two years compared with 67% of those who received methotrexate plus placebo, reported Johannes W.G. Jacobs, MD, University Medical Center Utrecht in the Netherlands, and colleagues.
  9. Even short courses of glucocorticoids in conditions such as lupus, RA and many other diseases can be associated with the development of osteonecrosis (Steven C. Vlad, MD, Boston University School of Medicine, at the annual meeting of the American College of Rheumatology 2011).
  10. Patients with RA who respond well initially to methotrexate monotherapy may be able to maintain a good outcome on that drug alone, with no radiographic progression (Dr James R. O'Dell, University of Nebraska Medical Center, Omaha)

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Rheumatology Update 2011 (ACR)

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Divya Jyoti Nurses Festival

Fun is an integral part of maintaining health. The nurses and university college students participated in Nurses youth festival.

 
Dr K K Aggarwal
 
    National News

Hunger situation in India worse than sub–Sahara

If all the sacks of grains in India’s federally held stocks were to be laid next to one another, it could stretch up to the moon and back. Yet, India is among 29 countries with the highest levels of hunger, stunted children and poorly fed women, according to the International Food Policy Research Institute (IFPRI)’s "Global Hunger Index 2010". Despite a strong economy that has been predicted to overtake China’s within three years by the Economist magazine, India ranked 67th among 85 countries in terms of access to food. It also ranks below several Sub–Saharan nations, such as Cameroon, Kenya, Nigeria, and Sudan, even though per capita income in these countries is much lower than India’s. The report points to widespread hunger in a country that is the world’s largest producer of milk and edible oils, and second–largest producer of wheat and sugar. So, India’s hunger is a problem of access to food, rather than output or availability. (Source: Hindustan Times, December 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

Prostate exams could do more harm than good

Earlier this year, the U.S. Preventive Services Task Force gave the prostate specific antigen (PSA) test a D grade, recommending that it no longer be used. The test, now routinely performed on about 75 percent of all men over the age of 50, could do more harm for patients than good. Detection of very slow–growing cancers with the PSA test results in treatments that can have multiple debilitating side effects. If left alone, many of these cancers would spread slowly in patients that would die first from old age or other conditions. The PSA test can also result in false positives that lead to unnecessary biopsies, unnecessary surgery, and unnecessary cost.

For comments and archives

New food pyramid: My plate

U.S. Department of Agriculture and the Department of Health and Human Services: MyPlate is meant to replace –– and improve upon –– the decades-old food pyramid. The new MyPlate icon is made up of five components –– fruits, vegetables, grains, protein, and dairy, with dairy, a discretionary group, off to the side, representing a glass of milk or a cup of yogurt. Together, fruits and vegetables take up half the plate; grains and proteins make up the second half.

Dr K K Aggarwal

For comments and archives

Cell phones either cause cancer or they don’t

Early in the year, a study from the University of Manchester that analyzed newly diagnosed cases of brain cancer over a 10–year period from 1998 on found that, despite increased cell phone use, there was no statistically significant change in the incidence of brain cancer. Three months later, after reviewing dozens of studies, a panel of experts told the World Health Organization that "cell phones may cause brain cancer," putting them in the same category at engine exhaust and DDT. And children, are at an increased risk due to their thinner skulls and scalps.

For comments and archives

 
   Cardiology eMedinewS

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

Paradigm Shift in the Treatment of Diabetes

Read More

Xience Stent Safe in Post Market Study

Read More

SVT: How to Perform EP Study

Read More

Cardiac Resynchronization Therapy

Read More

 
    Twitter of the Day

@DrKKAggarwal: #AJENT Sleep–disordered breathing linked to cognitive impairment Sleep–disordered breathing is associated with a…fb.me/1vcimucVQ

@DeepakChopra: Love is the beginning of the journey, its end, and the journey itself.

 
    Spiritual Update

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

Vedic Principles behind Cognitive Behavior Therapy

What is counseling?

A: The mental process involves generation of a thought or idea, which is analyzed and then acted upon. Thought, analysis and action therefore are the primary three process of human mind. Counseling involves action at all three levels.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

This is Good!

The story is told of a king in Africa who had a close friend with whom he grew up. The friend had a habit of looking at every situation that ever occurred in his life (positive or negative) and remarking, "This is good!"

One day the king and his friend were out on a hunting expedition. The friend would load and prepare the guns for the king. The friend had apparently done something wrong in preparing one of the guns, for after taking the gun from his friend, the king fired it and his thumb was blown off.

Examining the situation the friend remarked as usual, "This is good!" To which the king replied, "No, this is NOT good!" and proceeded to send his friend to jail.

About a year later, the king was hunting in an area that he should have known to stay clear of. Cannibals captured him and took them to their village. They tied his hands, stacked some wood, set up a stake and bound him to the stake. As they came near to set fire to the wood, they noticed that the king was missing a thumb. Being superstitious, they never ate anyone that was less than whole. So untying the king, they sent him on his way.

As he returned home, he was reminded of the event that had taken his thumb and felt remorse for his treatment of his friend. He went immediately to the jail to speak with his friend. "You were right," he said, "it was good that my thumb was blown off." And he proceeded to tell the friend all that had just happened. "And so I am very sorry for sending you to jail for so long.

It was bad for me to do this." "No," his friend replied, "This is good!" "What do you mean, ‘This is good’? How could it be good that I sent my friend to jail for a year?" "If I had NOT been in jail, I would have been with you."

Situations may not always seem pleasant while we are in them, but the promise of God is clear. If we love Him and live our lives according to His precepts, even that which seems to be bleak and hopeless will be turned by God for His glory and our benefit. Hold on, God is faithful! May God bless you this week as you seek His will in every situation.

For comments and archives

 
    Fitness Update

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

Discovery of a New Muscle Repair Gene

An international team of researchers from England and the Charité –– Universitätsmedizin Berlin has presented new findings regarding the function of muscle stem cells, which are published in the current issue of the journal Nature Genetics. The researchers investigated several families with children suffering from a progressive muscle disease. Using a genetic analysis technique known as "next generation sequencing", the scientists identified a defective gene called MEGF10 responsible for the muscle weakness.

For comments and archives

 
  Legal Question of the Day

(Dr MC Gupta, Advocate & Medico–legal Consultant)

Q. Can an MBBS legally perform surgery for hernia, piles, fistula, removal of uterus or appendix and cesarean section etc.?

Ans.

  • An MBBS is a graduate in surgery and hence he cannot be legally denied the right to perform surgery. However, law operates not in vacuum but in a real situation with respect to time, place and person. All the surgeries mentioned by you could be validly performed in a remote place where there is no surgeon available to alleviate the suffering of people, especially in emergency. None of these would be expected to be done by an MBBS, where qualified surgeons are easily available.
  • No hard and fast rule can be made applicable in all situations. However, I suggest the following guidelines would seem appropriate:
    • An MBBS doctor can undertake those surgeries about which he has been taught/trained in his MBBS course and in which he is experienced.
    • He should preferably not undertake surgery involving general anesthesia.
    • He should not routinely hold out as a surgeon, especially when a qualified surgeon is available in the area.
    • Relaxation in the above norms may be permissible in emergencies where it is a question of saving life.
  • Attention is drawn to the following guidelines issued by the AP Medical Council regarding surgery that may be performed by MBBS doctors.

    "What can an MBBS Doctor do:–

    • He can do all the Minor Surgical Procedures for which he is trained in MBBS Course and Houseman Ship.
    • He can do Deliveries and its related procedures as trained.
    • He can do National Programmes like Tubectomies & Vasectomies.
    • In emergencies if a qualified surgeon is not available in the near vicinity as a life–saving measures he can do first aid and a Surgical Procedure based on his experience.
    • He should not do Elective Major Surgical procedures and the care should be taken to refer to a nearby Hospital where a Surgeon/Gynecologist available."
      http://imaapstate.blogspot.com/2010/12/can–mbbs–doctor–do-surgery.html
  • As regards performing a Caesarean section by an MBBS doctor, I would like to state as follows:
    • Generally speaking, the LSCS operation is to be conducted by a gyn–obs specialist.
    • There can be following situations when a person who is not a gyn–obs specialist may justifiably conduct such surgery:
      • When it has to be performed in sudden emergency to save life;
      • When a gyn–obs specialist is not available/accessible;
      • When the patient/relatives are not willing to go to a gyn–obs specialist and insist in writing that the surgery must be performed by a non–gyn–obs specialist, provided the latter has experience, confidence and facilities;
      • When the doctor concerned is in service and the employer gives written instructions that he or she should perform the surgery;
      • When the MBBS doctor is under training by or under supervision of a gyn–obs specialist.
  • In Surinder Kumar (Laddi) and Anr. V. Dr. Santosh Menon and Ors. 2000;(III) CPJ 517, the Punjab State Consumer Commission held that there is no bar against an MBBS performing a Caesarean section merely on the ground that the doctor does not have a qualification in Gynae–Obs.

For comments and archives

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emedinews revisiting 2011
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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Can an epilepsy patient drive?

Controlled epilepsy means no seizures for 6–12 months.

 
    Medicine Update

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

What is the approach to diagnosis of a case of IBD?

  • History: A complete history inclusive of recent travel, medication, dietary and family history, and a detailed bowel history with stool frequency, consistency, urgency, and presence of blood, mucus, or pus per rectum. Abdominal pain, malaise, fever, weight loss, and symptoms of extraintestinal manifestations of IBD (joint, cutaneous and eye) should be asked for.
  • General examination: Includes well–being, weight and height centiles, pubertal status using Tanner staging, pulse rate, BP, abdominal examination for tenderness, distension, masses including inspection of perianal area for skin tags, fissures, ulcers, and/or edema suggesting Crohn’s disease.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is atresia?

Atresia is a degenerative process that occurs regardless of whether you are pregnant, have normal menstrual cycles, use birth control, or are undergoing infertility treatment. Smoking appears to accelerate atresia and is linked to earlier menopause.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A 30–year–old female with a diabetic mother came for a check–up
Dr Bad: You are also at risk of heart disease.
Dr Good: You cannot be at risk.
Lesson: As per results of the Fremantle Diabetes Study, a maternal family history of diabetes confers relative protection against cardiovascular disease in female patients but not in male patients with type 2 diabetes. Paternal family history is associated with risks equivalent to those without a family history of diabetes.

For comments and archives

Make Sure

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make sure, to evaluate the patient thoroughly and only moderately tap the ascitic fluid since over–enthusiastic tapping can be life–threatening.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Serenity Prayer

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Plasma Free Metanephrine

  • To help diagnose or rule out pheochromocytoma
  • Related tests: Catecholamines Plasma and Urine, Urine Metanephrines, Vanillylmandelic acid (VMA)
 
    Mind Teaser

Read this…………………

The frequency of NVP (Nevirapine) resistance with single dose is:

a. 60 – 70%
b. 20 – 30%
c. 50 – 50%
d. 3 – 40%

Yesterday’s Mind Teaser: dice dice

Answer for Yesterday’s Mind Teaser: Paradise

Correct answers received from: Prabha Sanghi, Bina Sawhney, Dr KV Sarma, Yogindra Vasavada, Sudipto Samaddar, Raju Kuppusamy, Dr Thakor Hitendrasinh G, Dr Chandresh Jardosh, Anil Bairaria,
Dr NeelamNath.

Answer for 23rd December Mind Teaser: Back seat driver
Correct answers received from: Dr NeelamNath, Rajiv Sridharan, Dr Anupam Sethi Malhotra.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Classroom Psychology – Final Exam

A psychology professor at the University of Miami knew his students expected a terrifyingly long final exam.
To play with their minds a little (what do you expect from a psychology professor?) he only put ONE question on the final exam. He watched the reactions of the students as they all opened the exams and saw the one question. Initially they all looked relieved, but as the difficulty of the question began to sink in, those relieved faces sagged to confusion and consternation. All, that is, except for one student. He read the question, tapped his pencil into his palm a few times, then jotted something down on the test paper. He walked up to the professor, handed him the final, and walked out. The professor blinked in surprise, looked at what the student wrote, and smiled. The professor wrote "100%" on the top of that student’s test.

The Question: What is courage? The Student’s Answer: This is.

 
  Medicolegal Update

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

What is exhumation?

The word exhumation literally means "out of ground". It is derived from Latin words ex meaning "out of", and humus, meaning "ground".

  • It is done in cases where there is a complaint of foul play, controversy or dispute related with any unnatural or natural death of a person or persons or if death was allegedly due to any criminal action.
  • Exhumation is necessary, when the first post–mortem was inadequate, and it is thought that a second postmortem may bring some more facts to light.
  • The dead body can only be exhumed when there is a written order from executive magistrate or Higher Court of Law of the land.
  • In case of exhumation the concerned police official should approach the appropriate government hospital in writing along with the order of exhumation to constitute a medical board of at least three qualified and experience doctors.
  • Material found in exhumation/spot and further examination should be done as per law.
  • Resting places and the norm of many cultures is that the dead should not be disturbed. However, for a variety of reasons, they are disturbed through the process of exhumation.

(Ref: Anil Aggrawal’s Internet Journal of Forensic Medicine and Toxicology Volume 2, Number 2, July–December 2001)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Reduce weight first if facing infertility problem

Both obese men and women can face fertility problems unless they reduce their weight. Reducing weight as the first step can bring back their fertility said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

  1. Obese men are more than three times as likely to have low sperm counts compared with their normal–weight peers. A study published in the journal Fertility and Sterility showed that the heaviest men were at triple the risk of having a low count of progressively motile sperms –– sperms that swim forward in a straight line.
  2. Increased body fat can also contribute to lower testosterone levels and higher estrogen levels.
  3. Obese men were also 1.6 times more likely than overweight or normal–weight men to have a high percentage of abnormally shaped sperm.
  4. There is a trend toward increasing likelihood of erectile dysfunction with increasing BMI.
  5. Obesity is associated with a greater risk of impotence.
  6. Obesity is also associated with metabolic syndrome and polycystic ovarian disease (PCOD) in women and associated infertility.

For comments and archives

 
    Readers Response
  1. Dear Sir, Thanks for the Health Statics update: Regards Dr Anupama
 
    Forthcoming Events

Lecture on Buddism and Astronomy

By Prof. Trinh X. Thuan

UNESCO Kalinga Awardee, 2009; Prof. of Astronomy, University of Virginia, USA; UNESCO Kalinga Awardee for Popularisation of Science by UNESCO, Kalinga Chair awardee by Department of Science & Technology, Government of India.

Organised by Heart Care Foundation of India in association with Nehru Planetarium on behalf of RVPSP, Dept. of Science & Technology Govt.of India

At Nehru Planetarium Chankyapuri New Delhi on 27th Dec 2011 at 10.30 am

No fee, to register email to drkakroo@gmail.com, 9810301261

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

3rd eMedinewS Revisiting 2011

Dr Ajay Kriplani (Surgical management of diabetes); Dr N K Bhatia ( What’s new in transfusion medicine); Dr Kaberi Banerjee (Fertility update); Dr Amit Bahrgava (Cancer update 2011), Onco Radiation update (Rajiv Gandhi Cancer Institute); Dr Ambrish Mithal (Vitamin D update), Dr Praveen Chandra (Interventional Cardiology update); Revisting 2011 (Dr K K Aggarwal), Portfolio management (Central Bank of India); Insurance update (LIC India); General Insurance (Doogar Associates)

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

 
    eMedinewS Special

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2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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    Our Contributors

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