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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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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

 
  Editorial …

27th January, 2011, Thursday                       eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

eMedinewS Congratulates  all Padma Bhusan and Padma Shri Awardee

Padma Bhushan

  1. Analjit Singh: Youngest son of Bhai Mohan Singh, founder of pharma firm Ranbaxy Laboratories; and uncle of billionaire brothers Malvinder and Shivinder Singh. Following a family division in 1989, the pharma business went to his older brother and he got the smaller Max India. He has since built it into $1 billion (sales) Max Group with interests in healthcare, insurance, clinical research and packaging. New York Life is his partner in life insurance. Made big move with an early investment in cellular services provider Hutchison Max. Sold that stake to Hutchison, pocketing $150 million. Has minor stake in Vodafone Essar. Mr. Analjit Singh is the Founder & Chairman of Max India Limited, Chairman of Max New York Life Insurance Company Limited; Max Healthcare Institute Limited and Max Bupa Health Insurance Company Limited. He has been the driving force behind the Max India Group’s sustained growth and success since the mid 80’s. A self made entrepreneur, Mr. Analjit Singh has been leading the charge of reinventing and restructuring the Max India Group with a vision to be amongst India’s most admired companies for Service Excellence.
  2. Late Shri K. Raghavan Thirumulpad: Was an Ayurvedic scholar and physician hailing from Kerala. He was born on 20 May 1920 at Chingoli, Alappuzha District of Kerala. He died on November 21, 2010 at the age of 90 at his residence in Chalakudi. Thirumulpad studied Sanskrit, Tharkam (Indian Philosophy), Jyothisham (Indian astrology) and Vyakarana (Grammar) under various teachers. Later he studied Ayurveda under Shri. P.Vasudevan Nambisan and passed the graduation exam called Vaidyabhooshanam. From a very young age he was attracted by Gandhian thought and living and started using and propagating Khadi (the hand-woven cotton fabric which once symbolized Indian nationalism). Raghavan Thirumulpad was very much influenced by Ruskin's essay, Unto This Last, and tried to implement its ethos in his day-to-day practice of medicine. This was a shift in the trend of ayurvedic practice that prevailed all over India in that time. He gave more stress to the life-style modifications in his treatment and the least importance was given to medicine. Maximum stress was laid on the importance of physical exercise in the prevention of diseases. He promoted a style highlighting wholesome food, sound sleep, moderated sex and optimal exercise as the four pillars on which a healthy life is built. Thirumulpad taught a number of young ayurvedic graduates to practice Ayurveda in a more logical scientific but simple style. He resided during his lifetime at Chalakudy. V.K.R.T.Foundation consisting of his students celebrated his 90th birthday on May 23, 2010 at Chalakudy as "Navathi Pranamam". Many important personalities including Dr.Rajan Gurukkal, V.C., M.G.University, Dr.K.G.Poulose, V.C.Kerala Kalamandalam, Dr.C.Ratnakaran, and Pro.V.C.Kerala University of Health participated. Releasing of 9 of these books was the highlight of the occasion.
  3. Dr Keki Byramjee Grant, one of India’s most renowned cardiologists and the oldest practicing physician in the country, passed away in Pune on Jan 3rd 2011. He was 90 years old. He was the founder of Pune based Ruby Hall Clinic.

Padma Shri

  1. Dr.A. Marthanda Pillai, a dedicated and academically well accepted famous Neuro Surgeon is in the list of Padma Shri Award for the year 2010-2011. He is the first IMA Past National Vice -President and Past president of Kerala State getting this prestigious National Award. Dr. A. Marthanda Pillai When he was in the government Service he contributed his skill and administrator capacity for converting the Neurosurgery Department one of the best in national level. He did thousands of Brain and spinal surgeries and saved thousands of lives of poor. In the government service he was role model and also in private after retirement. In the private sector he is the Managing director of Ananthapuri Hospital and research institute. He is accepting only nominal fee as consultation so as to make him accessible to poor patients. Academically he is excellent and his contribution to Neuro surgery is innumerable. He is visiting surgeon to several leading hospitals in India and abroad.
  2. Dr Mansoor Hasan: Former HOD Cardiology, KGMU Lucknow: Way back in the 1970s, a long queue of patients hailing from different parts of Uttar Pradesh outside the cardiology department of the All-India Institute of Medical Sciences (AIIMS) in New Delhi had upset a young medico from King George's Medical College. He had asked one of them from where did he come and the visitor had replied that he belonged to Ballia. When the medico returned to his city Lucknow, he started mobilizing resources for setting up a centre for heart patients. Today, the place is called Lari Cardiology. (TOI)
  3. Dr. Shyama Prasad Mandal, Orthopaedic, Delhi:  He is a retired consultant at Ganga Ram Hospital, did his medical school from MCh (Liverpool)   UK, MS from AIIMS New Delhi and MBBS from Calcutta Medical College.
  4. Dr. Indira Hinduja: Is an MD in Gynaecology and Obstetrics and she was awarded the PhD degree for her thesis entitled 'Human In Vitro Fertilization and Embryo Transfer' from the Bombay University when she was a full time practicing Obstetrician and Gynaecologist on the clinical faculty of the Seth G.S. Medical College and King Edward Memorial Hospital, Bombay. This significant contribution lies in combining her basic successful surgical skills with those of experimental embryology, endocrinology and cell biology, which led to the first ever, scientifically documented ‘test tube baby’ in the country on 6th August 1986. This creditable achievement has been the result of the collaborated efforts of the KEM Hospital and Institute for Research in Reproduction (ICMR). She is the pioneer on Gamete Intra Fallopian Transfer (GIFT) technique resulting in the birth of India’s first GIFT baby on 4th January 1988. She is also credited for developing a oocyte donation technique for menopausal and premature ovarian failure patients, giving the country’s first baby out of this technique on 24th January 1991.
    She is very active in the field of research and is involved in a number of research projects.  For her outstanding performances, she has been felicitated on many occasions. She is also the recipient of many awards, amongst which Young Indian Award (1987), Outstanding Lady Citizen of Maharashtra State Jaycee Award (1987), Bharat Nirman Award for Talented Ladies (1994), International Women’s Day Award by the Mayor of Bombay (1995; 2000), Life time Achievement Award by Federation of Obstetrics & Gynaecological Society of India (1999) and Dhanvantari Award by The Governor of Maharashtra (2000) are a few.   Dr Hinduja's research work has resulted more than 100 publications in national and international medical journals.
  5. Dr. Jose Chacko Periappuram (born April 28, 1958) MBBS, FRCS (Glasgow), FRCS (Edinburgh), FRCS (CTh)(UK) is an Indian Cardiac Surgeon at Mar Augustine Memorial Lisie Hospital, Kerala who performed the first successful human-to-human Heart Transplant in the state of Kerala, India. He worked at Medical Trust Hospital before this where he performed many of his historic achievements such as the first Heart Transplant, Beating heart, Awake Bypass and Total Arterial Revascularization surgeries. A heart surgeon by profession, and a philanthropist by nature, Dr. Chacko along with his core team of professionals and generous donors, have dedicated their time, skills and resources in reaching out to those in need.
  6. Dr. Pukhraj Bafna, Pediatrics, Chhattisgarh: is a National Trainer, Adolescent Education, IAP. He has pioneer work in adolescent medicine
  7. Prof. (Dr.) Sivapatham Vittal, Endocrinology, Tamil Nadu: Known as the ‘Father of Endocrine Surgery,' played a pivotal role in the establishment of the department of endocrine surgery at Madras Medical College. Dr. Vittal received the B.C. Roy award in 1995 for developing surgical endocrinology.
  8. Prof. (Dr.) Madanur Ahmed Ali, Gastroenterology ,  Tamil Nadu : Department of Surgical Gastroenterology, Dr. Mehta's Hospitals Pvt. Ltd., 2, McNichols Road, 3rd Lane, Chetpet, Chennai-600031.
  9. Azad Moopen, a Kerala physician-turned-entrepreneur based in the United Arab Emirates: Is founder and Chairman D.M. Healthcare, has also received India’s top most honour for overseas Indians - the Pravasi Bharatiya Samman Award - for this year.
  10. Dr. K. Anji Reddy, Founder-chairman of Dr Reddy's Group of Companies; Awarded with Padma Shri in 2001. Dr. K. Anji Reddy is a pioneer in the pharmaceutical research in India and is founder-chairman of Dr Reddy's Group of Companies. He did his B.Sc in Pharmaceuticals and Fine chemicals from Bombay University and subsequently completed his PhD in Chemical Engineering from National Chemical Laboratory, Pune, in 1969. Dr. K. Anji Reddy served in PSU Indian Drugs and Pharmaceuticals Limited from 1969 to 1975. Dr. Reddy was the founder-Managing Director of Uniloids Ltd from 1976 to 1980 and Standard Organics Limited from 1980 to 1984.  In 1984, Dr. K. Anji Reddy founded Dr. Reddy's Laboratories and soon the company established new benchmarks in the Indian Pharmaceutical industry. Dr. Reddy's Laboratories transformed Indian bulk drug industry from import-dependent in mid-80s to self-reliant in mid-90s and finally into the export-oriented industry that it is presently. In 1993, Dr. Reddy's became the first company to take up drug discovery research in India and in April 2001 it became the first non-Japanese Asian pharmaceutical company to list on NYSE. By the end of fiscal year 2005, Dr. Reddy's Laboratories was India's second largest pharmaceutical company and the youngest among its peer group. Dr. K. Anji Reddy has received many awards and honors. These include Sir PC Ray award (conferred twice, in 1984 and 1992); Federation of Asian Pharmaceutical Associations (FAPA)'s FAPA-Ishidate Award for Pharmaceutical Research in 1998; leading business magazine Business India voted him Businessman of the Year in 2001; CHEMTECH Foundation bestowed on him the Achiever of the Year award in the year 2000 and the 'Hall of Fame' award in 2005, for his Entrepreneurship, Leadership and thrust on Innovation; and in 2001, he was awarded the Padma Shri by the Government of India.
Dr KK Aggarwal
Editor in Chief
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  eMedinewS Audio PostCard

  2nd eMedinewS revisiting 2010

Revisiting the year 2010 with Dr KK Aggarwal
Obesity and ‘Let’s Move’ Campaign

Audio PostCard
 
  SMS of the Day

(By Dr  Chandresh Jardosh)

If one can do it, you too can do it. If none could do it, you must do it.

 
    Photo Feature (from the HCFI Photo Gallery)

Global healthcare industry meets in Dubai

HH Sheikh Hamdan bin Rashid Al Maktoum, Deputy Ruler of Dubai and UAE Minister of Finance, talks to Aziz Koleilat, General Manager, GE Health Care Middle East as Simon Page (far right) Divisional Director of the Life Sciences Division of organisers IIR Middle East looks on.

 
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

New hope for mothers and babies

Valsad (Gujarat): When the women’s self–help groups (SHG) come together for their routine meetings in this tribal–dominated district of Gujarat, high on their agenda are issues related to reproductive and child health. The discussions revolve round neo–natal care, institutional deliveries, post–natal care and normal growth of children. Little wonder then that the results have been impressive. There are no home deliveries any more as traditional dais (midwives) get more from the government to refer deliveries to health facilities than they would for delivering at home. The village health and nutrition days — known as Mamta Diwas — are observed with much fanfare, with women thronging anganwadi centres and health sub–centres for counselling, immunisation and check–ups. Exclusive breast–feeding is an accepted best practice, and only iodised salt is used in kitchens. Once infamous for malnutrition and high infant and maternal mortality deaths, Valsad is now cited as a role model for change. A change brought about by women themselves — 35,000 of them, who are members of 22,000 SHGs associated with the Valsad District Cooperative Milk Producers Union, often referred to as the Vasudhara scheme. (Source: The Hindu, Jan 25, 2011)

 
    International News

(Contributed by Nilesh Aggarwal)

Arab Health 2011 Healthcare industry salutes excellence  

Innovation and pioneering spirit ‘alive and well’ at Arab Health Achievement and Innovation Awards

Pioneers of excellence in healthcare throughout the region were saluted by their peers for their considerable achievements and contributions towards innovation and development, at the annual Arab Health Achievement and Innovation Awards 2011. In all, twelve awards categories were celebrated as more than 800 international and regional leading healthcare professionals gathered at a gala dinner last night (25 January 2010) at the Grand Hyatt Hotel, Dubai. A panel of expert judges was assembled, to provide a shortlist out of the 200 nominations received, consisting of Fadi El-Jardali, Accreditation Canada International; Dr. Joel J. Nobel, Founder and President Emeritus ECRI; Ashraf Ismail, Managing Director M.E., Joint Commission International; Malek El Husseini, Business Development Director, GE Healthcare M.E. and Brian Johnston, Chief Executive of The Australian Council on Healthcare Standards.
 
The highlight of the evening was the award for the Outstanding Contribution of an Individual to the Middle East Healthcare Industry. This was awarded to Professor Hossam Hamdy, Vice-Chancellor of Medical & Health Sciences Colleges at the University of Sharjah, who also serves as a Senior Consultant in Pediatric Surgery at Qassimi Hospital. Professor Hamdy is considered an international authority in all areas of medical education. In addition a new award was introduced this year, the Sultan Bin Abdulaziz Humanitarian City Award for Excellence in Rehabilitation Services. The award is designed to acknowledge the vital role physiotherapy plays and recognises those who provide support for the increasing numbers of disabled people throughout the region.
 
The inaugural award was shared by Hamad Medical Corporation (HMC) in Qatar and National Commercial Bank (NCB) in Saudi Arabia. HMC was recognized for its community-based rehabilitation centre at the Rumailah Hospital which houses more than 300 beds for geriatrics and patients requiring physical rehabilitation. NCB was praised for its invaluable support of community-based Al Ahli health programmes. The awards are traditionally celebrated during the Arab Health Exhibition and Congress, which is the flagship event of IIR Middle East's Life Science Division and the Arab world’s premier event for the healthcare sector which finishes on Thursday 27 January.

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

Exercise dosing to retain resistance training adaptations in young and older adults

Researchers at the University of Alabama at Birmingham wanted to find out what old and young exercisers had to do in order to maintain strength gains made through resistance training. They found that both groups could maintain gains with once–a–week training, though older participants required more training to maintain muscle mass gain. Seventy adults recruited from two age groups, 60–75 and 20–35, participated in a two phase exercise trial. Phase one consisted of resistance training done 3 days per week for 16 weeks. Both groups gained considerable strength and muscle mass. In phase two, participants were randomly assigned to quit exercising, do the same exercises once a week or exercise once a week but only complete one–third of the exercises they had done during phase one. Old and young exercisers who stopped completely lost all gains. Participants who performed full workouts once a week maintained their strength, and in some instances among the younger participants, gained strength.

(Dr GM Singh)

Is it true that calcium supplements may interact with blood pressure medications?

Ans: Yes. In large amounts, calcium supplements may interact with some blood pressure medications. Interactions may occur with:

  • Thiazide diuretics. Taking 1,500 mg or more of calcium with thiazide diuretics — such as chlorothiazide, hydrochlorothiazide and indapamide — can result in milk-alkali syndrome, a serious condition. In general, avoid taking more than 1,500 mg of calcium (supplements and food sources combined) a day if you’re taking a thiazide diuretic. If you take calcium supplements while taking a thiazide diuretic, talk to your doctor about the appropriate dose and have your blood pressure and calcium levels checked.
  • Calcium channel blockers. When given through an intravenous (IV) line, calcium may decrease the effects of calcium channel blockers, such as nifedipine, verapamil, diltiazem and others. In fact, IV calcium is used to help reverse calcium channel blocker overdose. There’s no evidence that oral calcium supplements interfere with calcium channel blockers. To be safe, check your blood pressure regularly if taking calcium channel blockers and calcium supplements at the same time.

Calcium supplements don’t appear to interact with other commonly prescribed blood pressure medications, such as:

  • Beta blockers, such as atenolol, bisoprolol, propranolol and others
  • Angiotensin–converting enzyme (ACE) inhibitors, such as captopril, lisinopril and others
  • Angiotensin II receptor blockers, such as losartan, valsartan, and others
  • Renin inhibitors, such as aliskiren

Talk to your doctor if you take high blood pressure medications and calcium supplements and are concerned about interactions.

(Dr Monica and Brahm Vasudev)

Clinical decision support systems of doubtful value: Study

As per a new report published online in the journal Archives of Internal Medicine, electronic health records (EHRs) with clinical decision support systems (CDSs) show no consistent association with quality of care regardless of the keen support extended by the US government. CDSs are designed as a guide to physicians on clinical issues such as medication management, appropriate antibiotic use, screening tests, and preventive matters such as diet and exercise.

Cognitive behavioral therapy decreases risk for recurrent cardiac events

Results from a randomized controlled trial, the Secondary Prevention in Uppsala Primary Health Care Project says that cognitive behavioral therapy (CBT) reduces rates of recurrent acute myocardial infarctions (AMIs) and coronary heart disease events in patients with coronary heart disease. The findings are reported in the January 24 issue of the Archives of Internal Medicine. The study focused on emotional factors and the management of stress with the use of CBT.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are assisted reproductive techniques?

Assisted reproductive techniques are commonly used for the treatment of the female partners of men with moderate or severe oligospermia and/or azoospermia.

For queries contact: banerjee.kaberi@gmail.com

 
    Pediatric Update

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

NEW 2010 AHA Guidelines: The ABCs of CPR are rearranged to CAB

The 2010 AHA Guidelines for CPR and ECC now recommends a CAB sequence (Chest compressions, Airway, Breathing/ventilations), which are documented in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in the November 2 supplemental issue of Circulation: Journal of the American Heart Association, and represent an update to previous guidelines issued in 2005; which earlier recommended sequence of CPR, previously known by the initials "ABC": Airway, Breathing/ventilation, and Chest compressions (or Circulation).

The changes are starting CPR with 30 compressions followed by 2 ventilations, which should theoretically delay ventilations by only about 18 seconds for the lone rescuer and by an even a shorter interval for 2 rescuers. The CAB sequence for infants and children is recommended in order to simplify training with the hope that more victims of sudden cardiac arrest will receive bystander CPR. It offers the advantage of consistency in teaching rescuers, whether their patients are infants, children, or adults.

The new guidelines also discuss resuscitation of infants and children with various congenital heart diseases and pulmonary hypertension.

 
    "e–patient" … The Impatient Patient

Dr. Parveen Bhatia MS, FRCS (Eng.), FICS, FIAGES (Hon.), FMAS, FIMSA, Chairman, Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, Consultant Laparoscopic & Bariatric Surgeon & Medical Director, Global Hospital & Endosurgery Institute, New Delhi

Dr. Pulkit Nandwani MD, DMAS (WALS), DMAS (CICE, France), Associate Consultant Gynaecologist and Laparoscopic surgeon, Bhatia Global Hospital & Endosurgery Institute, New Delhi

Advantages of "e–patients"

Despite patients’ desire to use the Internet for health information, some patients are reluctant to discuss this information in the clinical encounter. In a study of women seeking information about hormone replacement therapy, participants worried about appearing to over–step the boundary between "expert" and "patient". They were reluctant to challenge the doctor’s expertise, and were wary of putting unnecessary pressures on the busy practitioner. Another study found that while patients actively searched the Internet at home, once in the doctor’s office they "gave up the searcher attitude" and assumed roles of passive receivers of information. These patients preferred not to reveal that they used the Internet because of the negative reactions they anticipated receiving from physicians. These results support the view that while searching the Internet is often personally empowering for patients, this sense of empowerment does not necessarily translate into self–efficacy in interactions with health care providers.

Whether health information found on the Internet is empowering for patients appears to depend on patients’ personal use of the information they retrieve as well as on physicians’ responses to these patients. While searching for online health information helps patients become pro–active and more self–reliant in managing illness, it does not necessarily facilitate communication in the clinical encounter. Patients may be hesitant to appear to "challenge" medical authority by initiating conversations about Internet information.
Furthermore, physicians may not be open to dialogue. Patients’ reports of feeling more empowered, and physicians’ reports that the Internet allows them to have discussions with patients on a more equal level, suggests that the Internet is playing a role in altering the traditional power imbalance in the patient–provider relationship, thus significantly affecting the way health care decisions are made and the way patients experience treatment within the clinical encounter.

    Medicolegal Update

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

What is abortion and miscarriage?

  • According to Webster’s Ninth New Collegiate Dictionary, "abortion is the expulsion of a non–viable fetus; a spontaneous expulsion of the fetus during the first 12 weeks of gestation."
  • Abortion is the spontaneous or artificially induced expulsion of an embryo or fetus. As used in legal context, it usually refers to induced abortion.
  • Miscarriage is the expulsion of the fetus before it is viable and especially between 12th and 28th weeks of pregnancy. The distinction between abortion, miscarriage, and premature labor is not recognized in law and all are referred to as abortion.
  • These are terms used to signify expulsion of the contents of a pregnant uterus during the 1st, 2nd and 3rd trimesters of pregnancy respectively.
  • A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. A miscarriage is medically referred to as a spontaneous abortion.
  • The World Health Organization defines this non survivable state as an embryo or fetus weighing 500 grams or less, which typically corresponds to a fetal age (gestational age) of 20 to 22 weeks or less.
 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. I am a pathologist with the qualifications MD, DNB, FRCP and have my laboratory at Patna. It is not registered. My banker wants to know the details of registration of my pathology lab. None of the other labs here is registered. What shall I do?

Ans.

  • Registration of anything has to be under some law. Some of the possible examples are:
    • Under the Indian Partnership Act, 1932: Registration as a firm: either as a sole proprietary firm or as a partnership firm;
    • Under the Companies Act: Registration as a company;
    • Under the Societies Registration Act, 1860: Registration as a society
    • Under the Income Tax Act—Registration as:

      ONE—A profession or business while submitting your individual income tax return, declaring therein that you are having income from your professional concern titled as "ABC lab".

      OR

      TWO—A profession or business while submitting your HUF (Hindu Undivided Family) income tax return, declaring therein that the HUF is having income from the professional concern titled as "ABC lab".
       
    • Under the Clinical Establishments Act: There is no such Act in Bihar at present;
    • Under some other Act where such registration may be required or possibly declared for diverse purposes, such as: service Tax Act; Local municipality act etc.
    • Registration with the NABL
  • It appears that your banker is involved because you might want a loan. You should tell your banker that your lab is not registered. You should ask him as to what exactly his requirements are and what exactly you should do to fulfil those requirements. If he is interested in giving you loan, (which is a profitable business for a bank), he will himself tell you what to do. If he is not helpful, you can go to some other bank for loan.
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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum uric acid

  • Increase in serum uric acid levels: Idiopathic, renal failure, disseminated neoplasms, toxemia of pregnancy, psoriasis, liver disease, sarcoidosis, ethanol consumption, etc. Many drugs elevate uric acid, including most diuretics, catecholamines, ethambutol, pyrazinamide, salicylates, and large doses of nicotinic acid.
  • Decrease in serum uric acid levels: Wilson’s disease, Fanconi’s syndrome, xanthinuria, and (paradoxically) in some neoplasms, including Hodgkin’s disease, myeloma, and bronchogenic carcinoma. It may not be of clinical significance.
 
    Medi Finance Update

Q. Are trusts required to file return of income?

Ans. Trusts are also required to file return of income, if the voluntary contributions or other income exceeds the exemption limit.

 
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name
Indication
DCI Approval Date
Cinnarizine 20mg + Dimenhydrinate 40mg tablets
For the treatment of vertigo
03/02/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Screening for anorexia nervosa

Hypoleptinemia represents a state marker of acute anorexia nervosa and is useful for a laboratory–based diagnostic screening.

(Ref: Föcker M, et al. Screening for anorexia nervosa via measurement of serum leptin levels. J Neural Transm 2011 Jan 22. Epub ahead of print)

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with COPD needed oxygen.
Dr. Bad: Use binasal cannula.
Dr. Good: Use Venturi mask.
Lesson: Venturi mask helps in washing out carbon dioxide.

Make Sure

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on sulfa?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

We’ll see

Once upon a time, there was a farmer in the central region of China. He didn’t have a lot of money and, instead of a tractor, he used an old horse to plow his field. One afternoon, while working in the field, the horse dropped dead. Everyone in the village said, "Oh, what a horrible thing to happen." The farmer said simply, "We'll see." He was so at peace and so calm, that everyone in the village got together and, admiring his attitude, gave him a new horse as a gift. Everyone’s reaction now was, "What a lucky man." And the farmer said, "We’ll see."

A couple days later, the new horse jumped a fence and ran away. Everyone in the village shook their heads and said, "What a poor fellow!" The farmer smiled and said, "We’ll see." Eventually, the horse found his way home, and everyone again said, "What a fortunate man." The farmer said, "We’ll see." Later in the year, the farmer’s young boy went out riding on the horse and fell and broke his leg. Everyone in the village said, "What a shame for the poor boy." The farmer said, "We’ll see." Two days later, the army came into the village to draft new recruits. When they saw that the farmer’s son had a broken leg, they decided not to recruit him. Everyone said, "What a fortunate young man." The farmer smiled again and said "We’ll see."

Moral of the story: There’s no use in overreacting to the events and circumstances of our everyday lives. Many times what looks like a setback, may actually be a gift in disguise. And when our hearts are in the right place, all events and circumstances are gifts that we can learn valuable lessons from.

As Fra Giovanni once said: "Everything we call a trial, a sorrow, or a duty, believe me… the gift is there and the wonder of an overshadowing presence."

………………………………

Mind Teaser

Read this…………………

ie.

Yesterday’s Mind Teaser: DOX DOX

Answer for Yesterday’s Mind Teaser: Pair o’ DOX (paradox)

Correct answers received from: Dr Prachi, Dr Anupam

Answer for 25th January Mind Teaser: The temperature
Correct answers received from: Dr Uma, Dr Vijay Kansal

Send your answer to ijcp12@gmail.com

— — — — — — — — — — — —

Laugh a While
(Contributed by Dr. GM Singh)

Where is God?

A couple had two little boys, ages 8 and 10, who were excessively mischievous. They were always getting into trouble and their parents knew that, if any mischief occurred in their town, their sons were probably involved. The boys’ mother heard that a clergyman in town had been successful in disciplining children,so she asked if he would speak with her boys.The clergyman agreed, but asked to see them individually. So the mother sent her 8–year–old in first that morning, with the older boy to see the clergyman in the afternoon. The clergyman, a huge man with a booming voice, sat the younger boy down and asked him sternly,"Where is God?"

The boy’s mouth dropped open, but he made no response,sitting there with his mouth hanging open, wide eyed. So the clergyman repeated the question in an even sterner tone, "Where is God!!?" Again the boy made no attempt to answer. So the clergyman raised his voice even more and shook his finger in the boy’s face and bellowed, "Where is God!?"

The boy screamed and bolted from the room, ran directly home and dove into his closet, slamming the door behind him.When his older brother found him in the closet, he asked, "What happened?" The younger brother, gasping for breath, replied, "We are in BIG trouble this time, dude. God is missing – and they think WE did it!"

 
    Readers Responses
  1. Respected Dr KK Sir, I must praise you for bringing out eMedinewS consistently without fail everyday for Medical Fraternity. Dr Anupam
 
    Public Forum

(Press Release for use by the newspapers)

Lowering sugar to lower than normal in diabetics may be harmful

In managing patients with type 2 diabetes, controlling diabetes to lower than normal may be harmful, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

A large study of diabetics with a high risk of heart disease, called ACCORD trial, has found that lowering blood sugar levels to what is considered normal for healthy people may prove deadly for some. In the study, older patients who underwent intensive therapy to reach near normal level of blood sugar at higher rate of deaths than a group of patients in the same study with slightly higher levels of sugar.

The normal average blood sugar of last three months, called A1c, is 6% or below. For diabetics, their aim should be to keep their A1c levels between 7 and 7.5.

 
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Conference Column

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression: : Dr KK Aggarwal

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