April 27  2015, Monday
editorial
Vedic Interpretation of earthquake
Dr KK Aggarwal The current earthquake incidence can be interpreted on many levels.

As per Deepak Chopra, there are seven types of people with different consciousness levels.

The first level is people with Fight and Flight response, who either fight or flight an adversity. Second level is people with reactive response, who are fault finders when an adversity comes.

Third, fourth and fifth levels are people with restful alertness, intuitive, and creative responses respectively. These people treat every adversity as an opportunity to do something different and work in the interest of the community.

Finally sixth and seventh levels are the people with visionary and sacred responses. These people are people with wisdom who understand consciousness and treat the microcosm within the body and the macrocosm of the nature as one.

People who share the fight, flight or reactive response, they would interpret it as if the God is punishing us for our sins.

Those who are in the restful alertness, intuitive or creative response, would think of earthquake as a creative opportunity to create a globalization-based new humanity on the culture or compassion instead of exploitation. Finally those who are with visionary or sacred response might see a link between the turbulence in collective consciousness of the people and the turbulence in nature.

Many theorists propose that the earth is a living biological organism. This is known as GAIA hypothesis. We and other biological organisms are just patterns of behavior in this living biological organism that we call Mother Earth. When we are agitated and turbulent our extended body or Mother Earth reflect that turbulence. In other words, the turbulence in nature and the turbulence in human beings co-arise inter-dependently.

We all know that during full moon, the mind is more agitated than during the new moon. The high tides in the ocean influence the high tides (vata function) in the human body and the human mind.

Many intellectuals have suggested that turbulence in nature can be managed by collective meditation (more than 1% of the population together at the same time) or through rituals by introducing intentions in the field of pure potentiality. This uses the principles of dharna, Dhyana, and samadhi of Yoga Sutras of Patanjali. This was the original purpose of yagnas which unfortunately today have become as empty rituals as they are not based on basic methodology of true consciousness.

Earthquake can be considered as a localized pralay involving the element of earth. The classic pralay will involve all five elements. If an earthquake like instance occurs affecting the whole earth, it will be the pralay mentioned in Purans.
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eMedipics IMA,IJCP,HCFI
Heart Care Foundation of India, a leading national non-profit organization celebrated World Earth Day jointly with Indian Medical Association, the Ministry of Earth Sciences, Govt. of India
News
  • Nearly 11,000 extra deaths due to malaria may have occurred in 2014 because of disruptions in health care services caused by the Ebola outbreak in West Africa, a new study suggests.
  • NSAID use is associated with increased risks of bleeding and cardiovascular disease, including myocardial infarction and stroke regardless of the type of NSAID or duration of use or the type of antithrombotic agent. These risks were examined in relation to antithrombotic agent use in a cohort of patients (Danish National Registry), specifically following a first MI, who were receiving aspirin, clopidogrel, an oral anticoagulant, or any combination of these medications. (JAMA 2015;313:805.) (Source: Upodate)
  • The American Diabetes Association (ADA) has published a condensed version of their Standards of Medical Care in Diabetes designed to provide essential information for primary care providers (PCPs) in the spring 2015 issue of Clinical Diabetes.
  • Optimal red blood cell (RBC) folate concentrations should exceed 400 ng/mL in women of reproductive age to prevent neural tube defects (NTDs), suggest the World Health Organization (WHO) guidelines described in an article published in the April 24 issue of the Morbidity and Mortality Weekly Report.
  • The European Medicines Agency has recommended approval of Nivolumab, the first programmed-death (PD) immune checkpoint inhibitor immunotherapy for use as first-line treatment and also for use in previously treated patients with advanced (unresectable or metastatic) melanoma.
IMA,IJCP,HCFI
Dr KK Spiritual Blog
Spiritual Prescriptions: Satsang

Satsang is a common household word and is often held many residential colonies. Traditionally, Satsang means the regular meeting of a group of elderly or women of an area with a common intention of attaining inner happiness or peace through Bhajans or devotional songs for a particular God or Gods. In Satsang, people realize that it is the Self, communing with Self.

The Sanskrit word ‘Satsang’ literally means gathering together for guidance, mutual support or in search of truth. It may involve talking together, eating together, working together, listening together or praying together.

Most scriptures describe Sat and asat. They discriminate that this world is maya (asat) and God is Divine. Furthermore, they state that maya is not yours; Divine is yours.

Sang means to join, not just coming close, but to join. And how do you join? Only with love, which acts as glue. So Satsang is: Sat—Divine. Sang—loving association. In non–traditional Satsang, people verbally express themselves to others in an uninhibited way. Here, each participant talks free of judgment of others, and self. In this way, each person is able to see many viewpoints, which may serve to diminish the rigidity of their own.

Satsang is one way of acquiring spiritual well–being. Many scientific studies have shown that when mediation or chanting is done in groups it has more benefits than when done individually. Maharishi Mahesh Yogi once said that if 1% of the population meditates or chants together it will have a positive influence on the entire society.

Satsang also helps in creating a network of people with different unique talents. Satsangi groups are often considered in a very deep–rooted friendship.

Adi Shankaracharya in his book Bhaja Govindam also talks about satsang in combination with sewa and simran and says that together the three can make one acquire spiritual well-being. Nirankaris and Sikhs also give importance to satsang and in fact every true Sikh is supposed to participate in the Gurudwara on a regular basis.

Chanting of mantra or listening to discourses in a satsang helps to understand spirituality through gyan marga. Group chanting continued on a regular basis is one of the ways of meditation mentioned in the shastras. It shifts consciousness from sympathetic to the parasympathetic mode.

The medical educational programs of doctors of today can be called medical satsangs as whatever is discussed is for the welfare of the society.

Satsang also inculcates in us, one of the laws of Ganesha, the law of big ears, which teaches everyone to have the patience to listen to the others.

In satsang, nobody is small or big, everybody has a right to discuss or give his or her views. Over a period of time, most people who regularly attend satsang, start working from the level of their spirit and not the ego.
Cardiology eMedinewS
  • A novel breast arterial calcification (BAC) score that uses findings from standard digital mammography predicts underlying coronary calcification and cardiovascular disease risk, reported a new study presented at the American Roentgen Ray Society 2015 Annual Meeting.
  • The new oral anticoagulant edoxaban has received approval recommendation from the European Medicines Agency (EMA) Committee for Medicinal Products for Human Use (CHMP) for use in the prevention of stroke and systemic embolism in patients with nonvalvular AF, as well as for prevention and treatment of recurrent venous thromboembolism.
Zoonosis Update
Common zoonotic pathogens causing canine gastroenteritis include Salmonella, Campylobacter, Cryptosporidium and Giardia; dogs with diarrhea should have a stool specimen examined for these pathogens.

In addition, numerous parasitic diseases can be transmitted from dogs to humans through feces, including toxocariasis, cutaneous larva migrans (Ancylostoma caninum and A. braziliense), echinococcosis, and dipylidiasis. (uptodate)

1981 Athens earthquake
During the five days after the 1981 Athens earthquake, the incidence of cardiac deaths rose from the normal average of 2.6 deaths per day to an average of 5.4, with a peak of 8 deaths per day

?An increased relative risk of acute MI (2.4) and cardiovascular death was observed after the 1994 Los Angeles earthquake, which occurred in the early morning, compared to the week before the disaster In contrast, the San Francisco earthquake of 1989, which occurred in the afternoon, was not associated with an increase in acute MIs; these data suggest that an MI is more likely to occur if an extreme emotional stress is superimposed upon the normal circadian pattern or a second trigger, such as abrupt awakening in the morning

?During the initial eight days after six blizzards in Massachusetts from 1974 to 1978, a 22 percent increase in ischemic deaths per day was reported in comparison to preceding and subsequent control weeks

?During the six weeks immediately following the Hanshin-Awaji, Japan earthquake there were 10 cardiovascular or sudden deaths compared to three during the same period in the previous year
A study of 42 elderly patients with well controlled hypertension who lived near the epicenter reported that one to two weeks after the earthquake (when aftershocks were frequent), there were transient increases in blood pressure, blood viscosity determinants, and fibrin turnover.(uptodate)
Pediatrics eMedinewS
  • The malaria vaccine RTS,S/AS01 was associated with preventing a greater proportion of malaria cases in infants and young children compared with control vaccines, suggested the results of a phase III clinical trial published in The Lancet. However, the vaccine's efficacy improved when children and infants received booster doses.
  • The American Thyroid Association (ATA) has released its first guidelines for managing benign and cancerous thyroid nodules in children. The guidelines were published in Thyroid. The guidelines propose that some patients should be given therapeutic options so that aggressive therapy won't be used when there is little possibility of benefit.
Make Sure
Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose stool.
Inspirational Story
Hiding their weaknesses and highlighting their strength

There was a King who had only one eye and one leg. He asked all the painters to draw a beautiful portrait of him. But none of them could because how could they paint him beautifully with the defects in 1 eye and 1 leg.

Eventually one of them agreed and drew a classic picture of the King. It was a fantastic picture and surprised everyone.

He painted the King aiming for a hunt. Targeting with one eye closed and one leg bent …

Moral: Why can’t we all paint pictures like this for others.

Hiding their weaknesses and highlighting their strength....!!!!
Events
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Dr Good Dr Bad
Situation: An elderly type 2 diabetic patient with cancer lung came with A1c of 7.5%.
Dr Bad: This is high. You need insulin therapy.
Dr Good: This result is ok.
Lesson: As per the 2007 American College of Physicians (ACP) guidelines, A1C goal is > 7% for type 2 diabetic patients who are elderly or frail or have a limited lifespan due to comorbid condition.

(Copyright IJCP)
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IJCP Book of Medical Records
Quote of the Day
A happy family is but an earlier heaven. George Bernard Shaw
Wellness Blog
Diagnosis of hypertension in childhood requires repeated BP measurements

Hypertension should be confirmed based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP =95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community–based pediatric practice. Pediatrics 2013;131:e415.
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 trained
IMA Humor
What It Means

Five year old Becky answered the door when the Census taker came by.

She told the Census taker that her daddy was a doctor and wasn’t home, because he was performing an appendectomy.

"My," said the census taker, "that sure is a big word for such a little girl. Do you know what it means?"

"Sure! Fifteen hundred bucks, and that doesn’t even include the anesthesiologist!"
eMedi Quiz
In all of the following conditions neuraxial blockade is absolutely contraindicated, except:

1. Patient refusal.
2. Coagulopathy
3. Severe hypovolemia.
4. Pre-existing neurological deficits.

Yesterday’s Mind Teaser: A 25-year-old male is undergoing incision and drainage of abscess under general anesthesia with spontaneous respiration. The most efficient anesthetic circuit is:

1. Mapleson A.
2. Mapleson B.
3. Mapleson C.
4. Mapleson D.

Answer for yesterday’s Mind Teaser: 1. Mapleson A.

Correct Answers received from: : Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr Avtar Krishan, Daivadheenam Jella, Dr.MadhuSudhan G

Answer for 25th April Mind Teaser: c.5

Correct Answers received: Dr.MadhuSudhan G
Rabies News (Dr A K Gupta)
Can a rabies vaccine be given to a pregnant woman?

Following animal bite, rabies vaccine can be given to a pregnant woman. Medical termination of pregnancy should not be done as a routine clinical practice.
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
eIMA News
Dear Colleague

In relation to the recent Nepal earthquake IMA line of action
1) IMA Control Room: SMS 9868141136/9426378078

2) All state and local branches to send similar appeal to all members

3) Make a list of Volunteers (sex, age, qualification, preferred date, city and state, mobile no. and e-mail)

4) Form response Team (crash team) with minimum one family practitioner. one surgeon, one anesthetist and two or three paramedical staff.

5) Help establish contacts with local NGO's (To set up base at affected area- on site Control room)

6) Information regarding do and don't during earthquake to all members. Read http://tinyurl.com/lxqpygl

7 ) Help finding list of police stations and phone numbers in affected areas.

8 ) Collect drugs, donations, blood

9 ) IMA disaster team has contacted: All India Pharmacist Revolution Udyog Development Foundation for medicines. ( Amitav 9811560662 )

10 ) We need to contact airlines for providing free tickets for our volunteers for travel to affected areas. IMA is contacting INDIGO airlines. Mr. Niraj Batra, niraj.batra@goindigo.in, 9818424639, Kamal 9953224847

11) For details contact Dr Neeraj Gupta @ drpawangupta2006@yahoo.com or Dr Chetal Patel Chairman Disaster Cell, IMA,drcnpatel@gmail.com

12. IMA Nepal Numbers: Dr Anjani Kumar Jha, 9779851117538, President Nepal Medical Association & Dr Mukti Ram Shreshta, Secretary Nepal Medical Association, +9779851004791
DEALING WITH DISASTER: EARTHQUAKE

The movement of the ground in an earthquake is rarely the direct cause of injuries; most are caused by falling objects or collapsing buildings. Many earthquakes are followed (several hours or even days letter) by further tremors, usually of progressive decreasing intensity. To reduce the destructive effects of earthquakes a number of precautions are essentail for people living in risk areas:

Earthquake safety

Tell the facts about earthquake to your family members
Construct new buildings with earthquake resistant method and strengthen the old buildings Insure your house and family members
Take the training for first aid and fire fighting Do not keep cots near the glass window
Do not keep heavy and fragile things in the shelves
Do not hang photo frames, mirrors, or glasses up your bed
Keep your important documents, some cash and necessary articles ready in a bag Identify special skills of neighbour (medical, technical) so that it can be utilized in emergency Ensure that all electrical and gas appliances in houses,
together with all pipes connected to them, are firmly fixed. Avoid storing heavy objects and materials in high positions. Hold family evacuation drill and ensure that
the whole family knows what to do in case of an earthquake. Prepare a family emergency kit. During Earthquake
Do not panic, keep calm.
If already inside, than Stay indoors. Get under a heavy desk or table and hang on to it. Move to the central part of the building.
If fire breaks out, drop on the floor and crawl towards the exist
If you are out doors during the quake, keep away from buildings, trees and electricity lines. Walk towards open places, in a calm and composed manner.
If you are driving, quickly but carefully move your car as far out of traffic as possible and stop. Do not stop on or under a bridge or overpass or under trees, light posts, power lines, or signs. Stay inside the car until shaking stops
If you are in a school, get under a desk or table.
Keep away from the Stairs.

AFTER THE EARTHQUAKE
Do not be afraid of the aftershocks
Listen to radio-TV and other media for Government Announcement
Check for injuries to yourself and those around you. Take first aid where you can Extinguish fire, if any
Examine walls, floors, doors, staircases and windows
to make sure that the building is not in danger of collapsing. Do not enter into the unsafe or risky houses or buildings Inspect for Gas leaks-If you smell gas or hear blowing or hissing noises, open a window and quickly leave the building.
Do not light your kitchen stove if you suspect a gas leak. Do not keep telephone lines busy unnecessarily
Switch off electric line
Do not go simply to look at the striken area. This will hamper rescue work
Make sure that water is safe to drink and food stored at home is fit to eat.

List of Medicine/ Instrument/Material
A. MEDICINE
• Inj Dexona
• Inj Hydrocortison
• Inj Avil
• Inj Laxis
• Inj Dicloran
• Inj TT
• Inj Aciloc
• Xylocaine 2% with adrenaline
• Inj CaImpose
• Inj Epsoline
• Inj Lyforan
• Inj Dopaminen
• Inj Adrenaline

B. I/V FLUID
• Dexa 5%
• RL
• DNS
• NS
• Mennitol (20 %, 100 ml)
• Mephentrine
• Heamacel
• Etpandar

C. TAB/CAP
• IBU/Para
• Dicloran
• Avil
• Wysolone
• Lasix
• Domstal
• Cetrizine
• Lomefen
• Sporidex
• Voveran
• Soframycin
• Liq. Betadine
• Liq. Savlon
• Spirit

D. SURGICAL
• Cotton
• Bandage 1.5", 2", 3"
• Surgical Pad
• Dressing Materials
• Suture Materials
• Cotton Thread
• 3-0
• Ethicon
• Vicryl

E. INSTRUMENT
o BP Dial/ Mercury
o Stethoscope
o Torch
o Thermometer
o ECG
o Tongue-depressor
o Resuccitation
Laryngoscope set
Ambubag with connection
Airway small/medium/large
Indotracheal tube
• 4.5, 5.5, 6.7, 8, 9
Torch
Foot suction pump

The Kerala State Human Rights Commission has ordered the Health Department to pay Rs. 3 lakh as compensation to the next-of-kin of a patient, who died after being denied timely medical treatment at the Alappuzha Medical College Hospital. The order, issued by Commission member (Judicial) R. Natarajan, pertains to the death of Haridas, 65, who hailed from Sree Shakthi Nivas, Valiyamaram ward, Alappuzha, on August 18, 2013. The action was taken on the basis of a complaint submitted by Saraswathi, wife of the deceased. As per the complaint, the patient was admitted to the hospital after he complained of severe pain and swelling in the left leg. After preliminary examination, the patient was referred to the General Medicine and Orthopaedics Departments. However, the patient, who was admitted at 10 a.m. on the particular day, was not provided treatment until 4 p.m. The death was reported nearly 30 minutes later. (Hindu)

UDUPI: The family members of a woman who died six days after delivery in a private hospital here staged a protest on Friday, alleging medical negligence. Varsha (23) of Kurkalu near Udyavara died on Friday morning. She was the wife of Devadas. She was admitted to Adarsha Hospital on April 17 and gave birth to a baby girl the following day. Post delivery, Varsha had heavy bleeding and her condition worsened, and she was shifted to Kasturba Medical College (KMC) Hospital, Manipal.
Letter to Editor
1. Dear Dr. K K ji: Mission Jan Jagriti will feel obliged to supply any amount of Blood Components for the victims of this tragedy through collaborative efforts of IMA. Also send required manpower and reagents for Blood Banking Services. Please let me know if we could be if some assistance. Dr. N. K. Bhatia, 9811210662

2. I volunteer myself for 5 days for Nepal disaster. It will be honor to me if I get opportunity to do so. Naveen Kandpal, naveen_ms1973@rediffmail.com,

3. There was a distress incidence at a renowned gynaecology hospital in Amravati last ev. A pt. post LSCS, 2nd day, recovering well post-op, shifted on oral, suddenly collapsed. Could not be revived. Within no time a mob of 200 people gathered & started abusing the doctor couple. Things were starting to go out of hand. Amravati IMA has a Rapid Action What's App group. It was activated & about 60-70 active IMA members reached within minutes. Seeing the doctors in large numbers, the mob didn't dare to assault the doctors. The contacts in police department were also activated by those present. For a change, police too was cooperative. Relatives have filed an FIR. Police have registered a case of death due to unknown cause. No charges have been framed. Body shifted at 2 am to morgue for post mortem by a panel of doctors tomorrow. Relatives tried to damage property while shifting the body, but the sheer number of doctors prevented an unruly incident. Situation under control by 2 am. Moral: Unite & help each other or perish. Dr. S. S. Utture

4. I would like to inform you that I want to join the medical team going for medical help to the earthquake affected people. If, IMA is planning to send such a team, please enroll me as the first name. Thanks, Dr. K.C. Agaja, General Surgeon, Vadodara, +919879728962

5. I volunteer myself for 5 days for Nepal disaster. It will be honor to me if I get opportunity to do so. Naveen Kandpal

6. I would like to volunteer for helping out in Nepal. I'm a practising anaesthetist and intensivist at Jindal hospital, Hisar, Haryana. Mobile no. 9896539130. Please let me know. Dr Ritu Chopra

7. Dear sir
I am physician ..ready to go to Nepal in medical team
Kindly guide me
Thnx

8. I am a Neurologist at Indore in India. I was trained at the AIIMS New Delhi.
I am willing to offer help in whatever way I can.
Please revert back.
-- Dr Pravar Passi
Consultant Neurologist
MBBS (AIIMS), MD (AIIMS), DNB
DM Neurology (AIIMS), MNAMS
Sonal Namaste
It is estimated that two million deaths occur every year from contaminated food or drinking water.
Malaria cases on the rise in Delhi as temperatures soar to 40 degrees
By ASTHA SAXENA: PUBLISHED: 21:54 GMT, 25 April 2015 : With the onset of summer, cases of malaria have registered a rise. During the last week, city people have been facing a tough time as the mercury hovered around 40 degree Celsius. The maximum temperature recorded on Saturday was 39.1 degree Celsius and minimum was 22.2 degree Celsius. “I feel dazed throughout the day. I have been missing my college from last few days. I don’t feel like eating anything. Doctor said that the symptoms are of viral fever which is very common these days,” said Anita Khanna, a resident of Lajpat Nagar. With the onset of summer, cases of malaria have registered a rise. From the last one week, city people have been facing a tough time as the mercury hovered around 40 degree Celsius +1 With the onset of summer, cases of malaria have registered a rise. From the last one week, city people have been facing a tough time as the mercury hovered around 40 degree Celsius

Malaria is caused by the plasmodium parasite that is passed from one human to another by the bite of infected Anopheles mosquitoes.

There are two types of malaria -- Falciparum and Vivax. While the former is more common and curable, the latter is dangerous and may lead to death, if not properly taken care of. “The cases of malaria have started to come. We are receiving two to three cases in a week. But as the temperature will rise, the numbers will also increase. We are suggesting people to take proper medication and use mosquito repellents at home,” said Dr Ajay Aggarwal, head of department, internal medicine, Fortis hospital, Noida. According to the latest report by the World Health Organisation (WHO), since the year 2000 malaria mortality rates have decreased by 47 per cent worldwide.

It is estimated that more than four million malaria-related deaths have been averted, approximately 97 per cent of which have been children under five.

Experts warn of malaria's adverse impact on reproductive
Press Trust of India | New Delhi April 25, 2015: Malaria can have a serious impact on reproductive health, experts said on the occasion of World Malaria Day today as they pointed out that, although rare, the disease can hamper semen quality in males and increase miscarriage risks in women.

When a man suffers from high-grade fever during malaria, he may develop severe azoospermia (no measurable level of sperm in semen), necrozoospermia (sperm in semen is either dead or immobile) or oligospermia (low sperm count), experts said.
However, in most of the cases, recovery occurs once the person is cured of malaria. Thus, success rates are comparatively low among couples who try to conceive around the period when the male partner is affected with malaria or has just recovered from the disease.
"Not many are aware that a parasitic disease like malaria can affect the reproductive health of both men and women. We sometimes see that quinine and chloroquine, the anti-malarial alkaloids that are used to treat the disease, impact the quality of sperm and blood levels of some reproductive hormones in males.
"In some cases, they also hamper the egg quality in females. Malaria also increases miscarriage risks. However, more research needs to be done to ascertain the exact effects of malaria on male and female infertility," said Dr Kaberi Banerjee, a leading IVF and infertility specialist.

Dr KK Aggarwal, Secretary General of Indian Medical Association (IMA), said, "The vulnerable group when it comes to malaria are children, pregnant women and the elderly. Malaria in pregnancy can cause a low birth weight infant, abortions and premature delivery and should not be ignored and treated early.

"An unexpected abortion of this nature can cause long-term infertility in patients." Being diagnosed with malaria during pregnancy can harm both the mother and the unborn foetus. It can cause severe parasitic infection and anaemia in the foetus thus becoming a major cause of maternal mortality. The disease can also cause premature birth or low weight, which leads to increased risk of neonatal mortality, he added.

Experts suggested that malaria should be suspected in patients with any febrile illness. “Groups at high risk for severe malaria and its consequences include young children (6 to 36 months) and pregnant women. "Artemisinin-based therapies are the mainstay of recommended malaria treatments today, and their efficacy must be preserved, as no new class of anti-malarial medicines is expected to enter the market within the next few years,” Dr K.K. Aggarwal from Indian Medical Association told Mail Today.

City doctors say that young children are more susceptible to malaria as they have low immunity. “Young kids are more vulnerable to malaria as they have not built up immunity to the disease. Moreover, early diagnosis is extremely important. "Simple symptoms of fever which could be malaria are sometimes under-diagnosed or subdued with antibiotics,” Dr Sanjeev Bagai, vice-chairman and director, Manipal hospital, Dwarka told Mail Today. “Almost three-four cases are coming to us in a week and the number is going to rise in the coming weeks.

"People should not ignore any type of fever and must consult a doctor,” added Dr Bagai. World Malaria Day is observed annually on April 25.

Violence against doctors
• Today more than 5 million U.S. hospital workers from many occupations perform a wide variety of duties. They are exposed to many safety and health hazards, including violence. Recent data indicate that hospital workers are at high risk for experiencing violence in the workplace. According to estimates of the Bureau of Labor Statistics (BLS), 2,637 nonfatal assaults on hospital workers occurred in 1999¬a rate of 8.3 assaults per 10,000 workers. This rate is much higher than the rate of nonfatal assaults for all private¬ sector industries, which is 2 per 10,000 workers.

• Doctors in the state should be offered protection considering the increase in the number of attacks on hospitals and doctors, said the president of the Indian medical Association (IMA) Tamil Nadu branch, Dr R V S Surendran. "For quite some time in Tamil Nadu, doctors and hospitals have become the targets of anti-social elements. In the past two months alone, there have been 20 such incidents. And in most of the cases, it is not even the relatives of the patient who are involved in the attack," he said. Anti-social elements gain mileage out of the emotional, physical and financial strength that relatives are in, following a hospital death and induce violence into the situation, said National President of IMA, Marthanda Pillai. "It is sheer foolishness to blame the doctors and hospital for all deaths that occur in hospitals. One can never assure 100% success rate in all the medical procedures that are performed in a hospital," the doctor added
Legal discrepancy
Form F in PCPNDT Act:
DECLARATION OF DOCTOR/PERSON CONDUCTING PRE NATAL DIAGNOSTIC PROCEDURE/TEST

I, ______________________________________ (name of the person conducting ultrasonography/image scanning) declare that while conducting ultrasonography/image scanning on Ms./ Mr.____________________________(name of the pregnant woman or the person undergoing pre natal diagnostic procedure/ test), I have neither detected nor disclosed the sex of her fetus to anybody in any manner Issue: I have neither detected nor disclosed the sex of her fetus

Comments:

1. This undertaking no one can give. Everyone knows the ex when he or she is doing the ultrasound

2. The preamble after the amendment reads as follows:“ An Act to provide for the prohibition of sex selection, before or after conception, and for regulation of pre-natal diagnostic techniques for the purposes of detecting genetic abnormalities or metabolic disorders or chromosomal abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of their misuse for sex determination leading to female feticide and for matters connected therewith or incidental thereto.”

3. The very fact in preamble, there is provision for detecting sex linked disorders how come one can write I have not detected the sex.
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Reader Response
Dear National President Dr AMP & Hony Secy Gen Dr KKA, Vanakkam. This is one of the best effective programme that can be undertaken by the Doctors to show their sincere commitment to help the society they live in. It is an opportunity for us to highlight the value of Blood Donation by being Donors ourselves and set an example. You have thought well, introduced and passed the resolution on Blood Donation at the CWC and are following up. May God bless you well for your efforts to execute such noble service to our society through our great IMA. Regards: Dr LVK Moorthy
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News on Maps
Gums bacteria can cause preterm delivery
Proper dental care can prevent heart attacks, heart blockages, asthma and COPD. This was stated by Padma Shri, Dr B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA. Bacteria present in the gums have been linked to many diseases in the past.

Periodontal treatment should be included in prenatal care programs, as per a study in the Journal of Periodontology, which has shown that treating gum disease in pregnant women may prevent preterm birth.

The study has shown that while pregnant women, in whom the periodontal disease was treated, were no more likely to deliver their babies prematurely than women with no gum disease, those who did not get treatment had a nearly 90-fold increased risk of premature delivery.

Another study found that the more bacteria women with periodontal disease had in their gums during and after pregnancy, the more likely they were to deliver their infants prematurely.