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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

28th October 2012, Sunday

Diet, Weight Loss May Not Lower Diabetes Complications.

A large, 11-year Federal study was stopped two years early when it became clear that diet and weight loss did not contribute to a lower heart attack and stroke risk for overweight people with type 2 diabetes. The subjects in the diet and exercise program ate a controlled-calorie diet and did moderate exercise for 175 or more minutes a week. Mary E. Evans, a physician at the National Institute of Health's National Institute of Diabetes and Digestive and Kidney Diseases, which paid for the study, said, "We were hoping that a weight-loss program would help reduce cardiovascular disease, but now we have the answer that it doesn't."

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

One randomized, placebo-controlled trial has shown significant benefits for stool frequency, and in the proportion of patients fulfilling the Rome criteria for functional constipation for up to 6 months of PEG (Am J Gastroenterol 2005;100:S1-S4).

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Intensive medical treatment prevents second stroke not intra cranial stenting

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to focus on revival after sudden death

The forthcoming 19th MTNL Perfect Health Mela is being organized by Heart Care Foundation of India jointly with Health Department, Government of NCT Delhi.

In the photo: Hon'ble Dr. A.K. Walia, Minister of Health and Family Welfare, Government of NCT Delhi, and Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela addressing a press conference

 
Dr K K Aggarwal
    National News

Dengue on the rise in Delhi, 39 fresh cases

NEW DELHI: There is no end to the dengue outbreak in the city. With 39 new cases reported on Friday, total number of such cases has reached 835, up from last year's 641. Two patients confirmed positive for the mosquito-borne viral infection have died so far. The outbreak witnessed over last two months has also led to a verbal duel between the state health department and the municipal corporations with the former accusing the latter of adopting lackadaisical approach in the beginning. "The household checking, anti-larval operations and fogging activities which are needed to check mosquito-breeding have to be planned strategically and must be carried out well in advance. The corporations have clearly failed in this, which is why we have dengue outbreak situation every year," said state health minister A K Walia. He said that mosquito-breeding checks, prevention and notification of diseases like dengue, malaria and chikungunya was the responsibility of the corporations. (Source: TOI, Oct 27, 2012)

For comments and archives

My Profession My Concern

Doctors appeal against MCI punishment

A group of doctors attached to the Melmaruvathur Adiparasakthi Institute of Medical Sciences, Melmaruvathur, has gone on appeal against a decision by the Medical Council of India erasing their names from the State and National medical registers for three to five years, reports the Hindu. The doctors have filed a writ petition in the Madras High Court against the MCI punishment meted out to them on the grounds that there is no material evidence for such action, and that the action was unduly harsh.

In August this year, the MCI declared that the names of 32 doctors attached to the college be erased from the registries on the grounds that they had provided falsified information to the Council via Form A. The form is to be filled when a doctor joins a medical college.

The MCI charged that the doctors had declared that they were full-time faculty, while they were actually part-time staff at the college. “These doctors were accused of giving false and misleading information regarding their working as full time faculty,” according to the MCI’s public notice.

A. S. Baalaji, legal counsel for the doctors, said the ethics committee (of the MCI) had conducted an enquiry subsequent to issuing a show cause notice. Despite the lack of evidence to show that the petitioners had provided falsified information, it had proceeded to recommend erasure of names.

All the petitioners, 20 of them, were working full time in the medical college, Mr. Baalaji explained, and had private practice after college. “There is no violation with that. Even in government medical colleges, medical faculty are allowed to practice after office hours.”Their contention is also that the punishment meted out to them was unprecedentedly harsh. They have shown that the maximum censure meted out to doctors so far, for an offence like working in two medical colleges simultaneously, has been two years. In some cases, Mr. Baalaji said, the erring doctors were even let off with an admonishment after they apologised to the Council.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Mitral stenosis in the elderly

Mitral stenosis remains a valvular disease of predominantly young people, and rheumatic fever remains the leading cause of mitral stenosis in all age groups.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Fewer legs lost to PAD

A significant drop in the numbers of lower extremity amputations among patients with peripheral artery disease has occurred since 2000, but wide geographic differences in this practice persist, a national study of Medicare recipients found. (Source: Medpage Today)

For comments and archives

Overactive bladder guidelines released

The American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) have released a new clinical guideline on the diagnosis and treatment of nonneurogenic overactive bladder (OAB) in adults. It was published online October 23 in the Journal of Urology. (Source: Medscape)

For comments and archives

GERD symptoms improved by electrical stimulation

Over the course of 1 year in patients with gastroesophageal reflux disease (GERD), lower esophageal sphincter electrical stimulation (LES-EST) improved symptoms, lowered esophageal acid exposure, and reduced proton pump inhibitor (PPI) use. The treatment had no gastrointestinal side effects or adverse events, according to a study presented here at the American College of Gastroenterology (ACG) 2012 Annual Scientific Meeting and Postgraduate Course on October 23. (Source: Medscape)

For comments and archives

Roflumilast improves lung function in moderate to severe COPD

After 6 months of treatment with roflumilast, compared with placebo, lung function improved in patients with moderate to severe chronic obstructive pulmonary disease (COPD), according to a randomized controlled trial. However, the clinical importance of such improvement is unclear. Nicola Alexander Hanania, MD, from the Baylor College of Medicine in Houston, Texas, presented the study findings here at CHEST 2012: American College of Chest Physicians Annual Meeting. (Source: Medscape)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: MTNL Perfect Health Mela To Focus On Revival After Sudden Death The forthcoming 19th MTNL Perfect Health Mela... http://fb.me/sw9nNTqj

@DeepakChopra: Behind every experience is "I" and it is universal#CosmicConsciousness

 
    Spiritual Update

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

Promoting peaceful death

Having a peaceful death is a common wish. Many cultures and religious beliefs offer practical ways to enhance a peaceful death.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the risks and complications?

An sonohysterography (SHG) is a very safe procedure. It may cause mild cramping, spotting, or discharge. Some women may experience cramps for several hours. The most common serious complication with SHG is pelvic infection; however, this occurs less than 1% of the time and usually occurs in the presence of pre-existing tubal disease.

For comments and archives

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

How is blood formed?

Blood consists of RBCs WBCs, Platelet suspended in plasma. In early embryonic life blood cells are formed in liver and spleen. But by the 5th month, hemopoiesis (i.e., formation of blood.) occurs in bone marrow and lymphatic tissues. At birth the entire bone marrow is red and active. Gradually as the child grows the marrow only in the flat bones and vertebrae remains red. The RBCs, granulocytes of WBC and platelets are mainly produce by bone marrow. The lymphocytes, monocytes, plasma cells are formed in the lymphoid and reticuloendothelial tissues. The orderly proliferation of the cells in the bone marrow and their release into circulation is carefully regulated according to the needs of body. Everyday in our body new blood cells are being produced in the bone marrow and every day old cells are dying and are being removed from the body.

Red blood cells have life of 120 days - which means any red cell formed in the body will live for the next 120 days and when it becomes old and senile it is thrown out. White cells for a couple of weeks and platelets for a few days. Thus, every day new cells are added to the circulation and old are removed from it

For comments and archives

 
    An Inspirational Story (Dr GM Singh)

The cockroach theory for self-development response vs reaction

At a restaurant, a cockroach suddenly flew from somewhere and sat on a lady. She started screaming out of fear. With a panic stricken face and trembling voice, she started jumping, with both her hands desperately trying to get rid of the cockroach. Her reaction was contagious, as everyone in her group also got panicky.

The lady finally managed to push the cockroach away but ...it landed on another lady in the group. Now, it was the turn of the other lady in the group to continue the drama.

The waiter rushed forward to their rescue. In the relay of throwing, the cockroach next fell upon the waiter.

The waiter stood firm, composed himself and observed the behavior of the cockroach on his shirt. When he was confident enough, he grabbed it with his fingers and threw it out of the restaurant.

Sipping my coffee and watching the amusement, the antenna of my mind picked up a few thoughts and started wondering, was the cockroach responsible for their histrionic behavior?

If so, then why was the waiter not disturbed? He handled it near to perfection, without any chaos.

It is not the cockroach, but the inability of the ladies to handle the disturbance caused by the cockroach that disturbed the ladies.

I realized that, it is not the shouting of my father or my boss or my wife that disturbs me, but it's my inability to handle the disturbances caused by their shouting that disturbs me.

It's not the traffic jams on the road that disturbs me, but my inability to handle the disturbance caused by the traffic jam that disturbs me.

More than the problem, it's my reaction to the problem that creates chaos in my life.

Lessons learnt from the story:
I understood, I should not react in life.
I should always respond.
The women reacted, whereas the waiter responded.

Reactions are always instinctive whereas responses are always well thought of, just and right to save a situation from going out of hand, to avoid cracks in relationship, to avoid taking decisions in anger, anxiety, stress or hurry.

For comments and archives

 
    Cardiology eMedinewS

Novel drug stars in phase III PAH trial Read More

CV risk factors add up to PAD Read More

 
    Pediatric eMedinewS

Tight glucose control no harm to IQ in critically ill kids Read More

PFO-closure trials RESPECT and PC miss primary end point Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: An HIV+ patient was found to have increased upper trunk subcutaneous adipose tissue (SAT).
Dr. Bad: It has no significance
Dr. Good: It makes you prone to diabetes.
Lesson: In the study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM) trial, increased upper trunk subcutaneous adipose tissue (SAT) and decreased leg SAT are associated with higher 2-hour glucose in HIV infection. These body fat characteristics may identify HIV-infected patients with normal fasting glucose but even so at increased risk for diabetes (Diabetes Care 2011 Nov;34(11):2448-53).

For comments and archives

Make Sure

Situation: An elderly patient with unstable angina presented with URTI and was found to be positive for C. pneumoniae infection.
Reaction: Remember to start macrolides immediately.
Lesson: Make sure to remember that erythromycin 2 g/day for 10-14 days reverses the increased risk of atherosclerosis. Sero-epidemiological studies have shown a strong association between C. pneumoniae infection and atherosclerosis in patients with cardiovascular disease.

For comments and archives

 
    Legal Question of the Day (Dr MC Gupta)

Q. Why should a few inaccuracies in filling the form-F lead to sealing of the ultrasound machine? What public interest is served by doing so? Is it not a violation of the fundamental rights?

Ans.

  1. Inaccuracies in filling the form-F amount to violation of sections 5 and 6 of the PC&PNDT Act in terms of the proviso to section 4, reproduced below:

    “Provided that the person conducting ultrasonography on a pregnant woman shall keep complete record thereof in the clinic in such manner, as may be prescribed, and any deficiency or inaccuracy found therein shall amount to contravention of the provisions of section 5 or section 6 unless contrary is proved by the person conducting such ultrasonography;”

    Violation of sections 5 and 6 is sufficient to seal the machine.
  2. The public interest served is this—If a centre is allowed to violate the PC&PNDT law, it would mean abetment to female foeticide.
  3. Such sealing is not in violation of any FR.
 
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    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Hypokalemia

  • Hypokalemia or decrease in serum potassium is seen usually in states characterized by excess K+ loss, such as in vomiting, diarrhea, villous adenoma of the colorectum, certain renal tubular defects, hypercorticoidism, etc.
  • Redistribution hypokalemia is seen in glucose/insulin therapy, alkalosis (where serum K+ is lost into cells and into urine) and familial periodic paralysis.
  • Drugs causing hypokalemia include amphotericin, carbenicillin, carbenoxolone, corticosteroids, diuretics, licorice, salicylates and ticarcillin.
 
    Quote of the Day (Dr GM Singh)

Just for today don’t be angry. Just for today don’t worry. Just for today be grateful and humble. Just for today be honest. Just for today be kind to others.

 
    Mind Teaser

Read this…………………

Joey asks the nurse why he is receiving the injection of Morphine after he was hospitalized for severe anginal pain. The nurse replies that it:

A. Will help prevent erratic heart beats
B. Relieves pain and decreases level of anxiety
C. Decreases anxiety
D. Dilates coronary blood vessels

Yesterday’s Mind Teaser: A man is traveling with a fox and two chickens, if he leaves the fox alone with the chickens the fox will eat the chickens. He comes to a river and needs to cross it, he finds a small boat that can carry only him and one animal, how does he get himself, the fox and two chickens across the river safely?

Answer for Yesterday’s Mind Teaser: Take the fox over, return with nothing. Go over with one chicken, return with the fox. Go over with the second chicken, return with nothing. Finally, take the fox over.

Correct answers received from: Dr Jainendra Upadhyay, Dr PC Das, Dr Bhavuk Garg, Dr Kanta Jain,
Dr Manu Shankar, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Thakor Hitendrsinh G,
Dr K Raju.
Answer for 26th October Mind Teaser: Light the first fuse on both ends and the second fuse at only one end. When the first fuse burns out you know 30 minutes have passed. Light the other end of the second fuse and when it burns out, 45 minutes have passed.
Correct answers received from: Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Thakor Hitendrsinh G,
Dr K Raju.

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr GM Singh)

Teacher: George, go to the map and find North America.
George: Here it is!
Teacher: Correct. Now, class, who discovered America?
Class: George!

 
    Medicolegal Update

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

No Narcoanalysis without valid consent, rules Supreme Court of India

The most exhausting/frustrating and laborious parts of a criminal investigation are extracting information from uncooperative accused persons and suspects by investigators in India as well as abroad. Since no individual should be forcibly subjected to any of these techniques of interrogation in question, whether in the context of investigation in any criminal cases or otherwise. The narcoanalysis test began to be used with a presumption that it provides a simply, nonviolent method of finding out the truth. In a world where until quite recently, torture was employed in criminal cases, perhaps narcoanalysis is a simple, civilized way of conducting criminal investigation.

  • The Supreme Court of India said that so–called narcoanalysis, brain mapping and polygraph tests cannot be conducted on any person without their consent.
  • The apex court further said the confession of guilt during the course of the tests can’t be treated as evidence in court.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

The health effects of the climate change

The sudden cshange in climate in Delhi with stormy rains will cause more attacks of asthma, dengue and malaria, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India.

Dr. Aggarwal said that untimely rain will further add to the menace of dengue, malaria mosquitoes’ growth.

In areas where construction is going on, collection of rain water will promote breeding of the mosquitoes. Aedis mosquito larva grows faster when the temperature is between 30-32 degrees. In Delhi, the maximum temperature for the last five days has been 33 degrees, which means that the atmosphere is conducive for early larval growth. Rain water collection will also increase cases of jaundice and typhoid. This year, most cases of mixed infection have been reported which means some patients having dengue and malaria, dengue and typhoid together.

All school children irrespective of territory, MCD, NDMC or Delhi Government, should be assigned home work to identify the breeding places. Unless it is done, dengue cases will occur even beyond Diwali, which is usually the end of dengue cases.

The change in season will also lead to the start of respiratory viral illnesses, which can worsen asthma with the anticipated Diwali pollution in the days to come.

 
    Readers Responses
  1. Dear Dr Agarwal, I fully agree with you regarding the need for seat belt for the passengers sitting on rear seat. All the new cars have already made provision for it. This is specially important for the kids sitting on rear seat. The mass education of the benefits can save many lives. Regards: Dr R S Bajaj,Consultant Paediatrician, Rohini
 
    Forthcoming Events


19th MTNL Perfect Health Mela 2012 Programme

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    eMedinewS Special

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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, Dr Usha K Baveja