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Address: 39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: www.ijcpgroup.com

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Member,
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)


 

FIRST NATIONAL DAILY MEDICAL NEWSPAPER OF INDIA

             You can download past issues from www.emedinews.in

28th December Monday

Dear Colleague,

Rural medical colleges with 3 years course to start in India: Dr Ketan Desai (IMA Opposes it)


If passed by the parliament India will soon have rural medical colleges with three years condensed course affiliated to district hospitals. The medical students getting admissions will be from certified rural areas and will be able to practice or get a government job in the same or another  certified rural area only. They will not be registered under "regular IMC register" but under a "separate register" and will need to get a yearly certification for the first five years after which they will be entitled for a permanent registration "under the rural register". For life they can only practice in a certified rural area only.


Talking at the inauguration of National IMA conference at Hyderabad the MCI President Dr Ketan Desai justified the move and requested the IMA to support and not oppose this move. The central council debated on the issue with majority not in favour of it and wanted more discussions on this move.

He said out of 2100 medical colleges in the world (71 countries) India has 300 (14%). In the last decade while the number of medical seats has doubled there has been no change in the PHC and CHC postings with 70% of them still lying vacant. Even if we increase the medical colleges to 1000 the PHC will not have doctors, added De Desai. We need a separate system.
 
Around 34,000 medical students are enrolled every year in India (50 % reserved category, 15% of rest from All India quota and 85% from local quota). Thus hardly 8-9000 medical students get medical seats from local areas.


He further said that out of 9 lac students who appear for entrance exams every year 4.5 lac get passing marks but only 8-9000 ends up getting a seat.  It is obvious that most of them will (90%) belong to the affluent class which represents only 2% of the society. Most local intelligent students never end up getting a medical seat as they were never groomed under a proper teaching infra structure. A rural medical college thus is the only answer, concluded Dr Desai.

Later the central council of IMA debated the issue and passed an unanimous resolution that "IMA opposes the MCI/Govt move". IMA was against coming out with a condensed 3 years course and discrimination between rural and urban doctors. IMA CC constituted a 5 member committee to form a draft resolution against this move. The committee members are Dr N K Grover, Dr R Ramesh, Dr Arul Raj, Dr G Raju and Dr S Daga.  

 
Some of the points raised were
1. How can a doctors course be shorter than nurses cours
2. How can they be called doctor with a condensed course
3. Who will be able to stop their migration to other countries
4. How can one stop them from migrating to urban areas
5. When the country can not check quacks how will they check migration of rural doctors to urban areas
6. Why discriminate between rural and urban patients and give then doctors with condensed course.
7. Would it not amount to producing more quacks?
8. Will the govt. also think of bringing condensed crash degree courses for pilots, lawyers, charted accountants?

 

Dr KK Aggarwal

Editor

 


DO YOU KNOW ??
 
 The Following List of Food Items Contain Aluminium...
 
 Many breads and cakes, pastries, biscuits, especially non-plain biscuits, and chocolate biscuits. Many processed breakfast foods, some jams, marmalades and honeys, the latter from the use of aluminium extractors. Many self-raising flours, chemicals, baking powders, flavouring and colouring agents, dried and processed potato chips, certain salts and condiments, sauces and pickles. Much bacon is aluminium contaminated, also sausages, meat and pork pies and the like. Some milk is also contaminated, and many beverages, including some stouts, many aerated drinks and some soda waters, much ice-cream and frozen food. Some cold tap water is contaminated by the use of softening agents, or fluoridation or chlorination processes, and many hot-water supplies in the kitchen give an aluminium reaction. Many prepared soups, some coffee extracts, many chocolates and sweets, custard powders, and jellies contain Aluminium.
 
 Imagine How much Aluminium we take Everyday ?

Global health summit in Delhi
AAPI, BAPIO and CPIO along with IMA and other specialist organisations  are organizing global health  care summit on 2/3rd January at Hotel Maurya Sheraton. The deliberations will focus on workable projects to be conducted in the country. You can register at
www.aapiglobalhaelthcaresummit.com or contact Dr N Saini 9810252127 India Coordinator.

 Sanofi Pasteur withdraws 800,000 doses of pediatric H1N1 vaccine

  According to an announcement by the CDC, Sanofi Pasteur has withdrawn about 800,000 doses of its pediatric influenza A (H1N1) monovalent vaccine (for children aged 6 to 35 months) in a single  dose, prefilled syringe (0.25 mL) due to deficient antigen levels. Both the CDC and FDA are in agreement that the "small decrease in antigen content is unlikely to result in a clinically significant reduction in immune response among persons who have received the vaccine." "For this reason, there is no need to revaccinate persons who have received vaccine from these lots," they note. Questions and answers regarding the withdrawn vaccine are available on the CDC Web site.

FDA approves Tiotropium for reducing COPD exacerbations 

The US FDA has approved an expanded indication for the inhaled, long  acting anticholinergic agent tiotropium bromide (Spiriva HandiHaler, Boehringer Ingelheim Pharmaceuticals, Inc) for reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD). These exacerbations can be caused by infection and environmental irritants and are defined as new  onset or increase in symptoms (including cough, sputum, wheezing, or difficulty breathing) that lasted for at least 3 days and required a change in treatment that could include hospitalization.

First generic Donepezil orally disintegrating tablets for Alzheimer' Dementia approved 

The first generic versions of donepezil HCl orally disintegrating tablets (Aricept ODT) for the treatment of dementia related to Alzheimer's disease was approved by the US FDA. The orally disintegrating formulation dissolves on the tongue, facilitating drug administration in older or disabled patients who may have difficulty swallowing.

Study finds new asthma gene 

A recenthed in the New England Journal of Medicine has reported finding a new gene that is linked to moderate  to  severe childhood  onset asthma. The DENND1B gene was found to be located on chromosome 1. This gene causes release of cytokines, which drive the oversensitive response seen in patients with asthma. The Genomewide association study (GWAS), which uses automated genotyping tools to scan the entire human genome and to identify gene variants contributing to disease risk, had earlier identified only one other asthma  susceptibility gene, ORMDL3, located on chromosome 17.  Several genes related to asthma remain undiscovered. Due to this heterogeneity, asthma presents differently in different patients as well as different manifestations in childhood  onset vs adult  onset asthma.

New unhealthy cholesterol found 

A study from Oxford University reports finding a new unhealthy cholesterol has been found. According to the researchers, this new cholesterol, lipoprotein (a) or Lp (a), cannot be controlled by cutting down on dietary fats or taking a statin drug, but high levels do not carry the same risk as the well  known LDL cholesterol. One in six people carries one or more of the genes for Lp(a), said Professor Martin Farrall, the lead author of the study. The study is published in NEJM.

Early warning signs of Alzheimer' disease

Early diagnosis of Alzheimer'[disease allows prompt treatment of reversible symptoms.

1.Forgetfulness: People with early Alzheimer' may regularly forget important information they've just recently learned. In contrast, occasional lapses such as misplacing objects or forgetting names are normal and occur in most people with advancing age.

2.Difficulty completing tasks: In early Alzheimer' disease, the affected individual forgotten how to perform activities viz. cook a meal, balance a checkbook, or use a computer program.

3.Disorientation: Getting lost in the neighborhood, or forgetting your way home or how you got to a particular place may indicate Alzheimer's.
4.Misplacing objects: Increased tendency to misplace objects can be a sign of early Alzheimer's disease.
 

5.Lapses in judgment: Showing strange behaviors, for example, putting on several heavy layers of clothing on a warm day, wearing the same clothes day after day, should raise suspicion of Alzheimer's.


Did you know?
 

1.The smallest bone in the human body is the stapes bone which is located in the ear.
2.Humans are born with 300 bones in their body, however when a person reaches adulthood they only have 206 bones. Many of them join together to make a single bone.
3.One quarter of the bones in your body, are in your feet.
4.Your ribs move about 5 million times a year, every time you breathe.
5.Human thigh bones are stronger than concrete.
6.The strongest bone in your body is the femur (thighbone), and it's hollow.

Famous words...

1.The doctor of the future will give no medicine, but will interest his patients in the care of the human body, in diet, and in the cause and prevention of disease...Thomas Edison

2.All that man needs for good health and healing can be found in nature, it is the job of science to find it ...Paracelsus, Father of Pharmacology, 1493-1541

3.There are two obstacles to vibrant health and longevity: ignorance and complacency.... World Health Organization

4.When a man is laboring under the pain of any distemper, it is then that he recollects there is a God, and that he himself is but a man....Pliny

Laugh a while.. 

A husband brought his wife to the psychiatrist. Husband: My wife thinks she' a chicken. 
Psychiatrist: That' terrible. How long has she been this way? Husband: For three years.
Psychiatrist: Why didn' you bring her to see me sooner? Husband: We needed the eggs.

Doctor (to nurse): Ask the accident victim what his name is, so we can notify his family.
Nurse (a few minutes later): He says his family knows his name.

First man: Call me a doctor - call me a doctor! Second man: What is the matter? Are you sick? First man: No, I'e just graduated from medical school!

 Take home messages from the Medicine Update 2009, MAMC

Red cell transfusion:

1.      The level of anemia does not correlate with tissue oxygenation if appropriate compensatory changes, like reduction in blood viscosity, have taken place.

2.      Stored blood is not a very good oxygen carrier.

3.      Research shows more mortality and morbidity occur due to blood transfusion than due the effect of low hemoglobin.

4.      Avoid transfusion when hemoglobin is not less than 7 gm/dl.

5.      Avoid transfusion in chronic anemia. 

6.      In acute blood loss (even 1.5-2 litres) push IV crystalloids first. Assess and reassess. Transfuse only one unit of blood if absolutely required. Then assess further requirement even more strictly. 

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emedinews: revisiting 2009
IJCP Group, Heart care Foundation of India and World Fellowships of Religions are  is organizing emedinews: revisiting 2009, day long conference on the top health happenings in the year 2009 on 10th Jan 2010 at Maulana Azad Auditorium. There is no registration fee however advanced information is required.  Top experts (Dr KK Aggarwal (revisiting 2009), Dr Naresh Trehan (whats new in cardiac surgery), Dr Ajay Kriplani (Current Trends in the Management of Morbid Obesity), Dr Praveen Chandra (The Indications of Interventional Treatment in Cardiology), Dr Kaberi Banerjee (IVF- Where We Stand Today?), Dr N K Bhatia (TTI infections), Dr V Raina ( molecular genetics), Dr Ajit Saxena (ED and male infertility), Dr S C Tewari (Nephroprotection), Dr. Ambrish Mithal (Diabetes), Dr Vanita Arora (ECG arrhythmias), Dr N Subramanium (Current concept in Male infertility ), Dr Neelam Mohan (Coeliac Disease), Dr. Sanjay Chaudhary (Eye Update), Dr Harish Parashar (aluminum toxicity), Dr Praveen Khillani (Whats new in field of critical care in past decade?), will deliver lectures.

CME will be followed by lively cultural evening guest performances by Shabani Kashyap, Vipin Aneja and perfomances by medical professional singers Dr Praveen Khillani, Dr Lalita and Dr N Subramanium, Dr Lata Tandon, Dr Arti Pathak, Dr Sudipto Pakrasi, Dr Harjeet Kaur, Dr Ramni Narsimhan, Dr Sanjay Chugh (on the drum), Dr Yash Gulati (Anchor) Dr Reshma Aggarwal (Anchor), doctors of the year award, dance and dinner. For registration mail emedinews@gmail.com. We have crossed 1200 registrations.
 

Eye care snippets by Dr. Narendra Kumar (OptometryToday@gmail.com)

CASE HISTORY

History taking is an important diagnostic technique in refraction. Several factors have a bearing in disclosing the actual trouble and requirement of the patient as also in determining an accurate and comfortable prescription for eyewear. These are: age, occupation, work surroundings, general health, ocular disturbances, headache, other symptoms, and history of previous check-up.

Age helps in determining the basic source of complaint; whether the patient has been wearing no correction or a given correction without modification for some time. Age also helps in determining the nature of the correction; the correction which is good for a young child may have to be modified for an old patient.

Occupation and work surroundings have their own importance; a presbyopic who may be a carpenter, gardener, teacher or watch-maker, may find an add for an arbitrary near point practically useless for his particular purpose, and the near add, thus, should be modified according to an individual's particular need. Likewise glare and insufficient illumination may present peculiar symptoms requiring expert counseling besides prescription for glasses.

General health particularly high blood pressure, diabetes and toxaemia of pregnancy produce marked changes not only in vision but sometimes in the eye itself.  Likewise tooth infection, kidney impairment, toxic effects, and painful (and excessive loss of blood in) menstruation may cause changes in refraction.

Ocular disturbances produce subjective as well as objective symptoms. Subjective symptoms are pain, irritation, burning sensation, inability to face normal sunlight, feeling of foreign body in eyes, strain, ocular fatigue, blurring, and doubling.  Objective symptoms are stye, conjunctivitis, lacrimation, blepharitis, wrinkled brows and lids, highly constricted pupils, and head tilting to one side.

Headache is the most common complaint of refraction cases.  The location of pain should be noted as to whether the headache is frontal, occipital or temporal. The onset of headache and its relation to the use of eyes also needs to be ascertained. The duration and type of headache is to be noted as to whether there is dull, sharp, throbbing or pulsating pain. 

Other symptoms include dizziness, nausea, vomiting with headache, vertigo, and rainbow colours around light. Normal, less than normal or over discharge of tears, irregularity in corneal surface, lenticular changes and vitreous opacities also need attention.

History of previous check-up deals with the nature of complaint in the first place, the care with which the correction was worn, and the length of time between changes in corrections.  Also to be asked is about any other type of attention received such as orthoptics, contact lenses or medication, and the results.

Every practitioner in the course of time develops his own particular procedure to take down the case history.  There are no standard rules than can be applied in all cases in a generalised way. The history taking, however, continues throughout the eye examination of the patient.
 

jeet Kaur, Dr Ramni Narsimhan, Dr Yash Gulati (Anchor) Dr Reshma Aggarwal (Anchor), doctors of the year award, dance and dinner. For registration mail  emedinews@gmail.com. We have crossed 1200 registrations.
 

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Also if you like emedinews you can FORWARD it to your email addresses
 

 Eye care snippets by Dr. Narendra Kumar (OptometryToday@gmail.com)

 


 

 

 

 



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