February 28  2015, Saturday
Nail Hygiene
Dr KK Aggarwal
  • Nails can harbor dirt and germs and contribute to the spread of many infections.
  • Keep nails short.
  • Trim nails often.
  • Scrub the underside of nails with soap or water each time you wash your hands.
  • Clean any nail grooming tools before use.
  • Nail grooming tools should be sterilized before use in saloon.
  • Avoid biting nails.
  • Avoid chewing nails.
  • Avoid cutting cuticles as they act as barriers to prevent infection.
  • Never rip or bite a hang nail, instead clip it with a clear sterilized nail trimmer (a hang nail is small torn piece of skin next to finger nail or toe nail).
  • Infections of the finger nails or toe nails are often characterized by swelling of the skin or thickening of the nail. In some cases these infections may be serious and need to be treated by a doctor.
20th MTNL Perfect Health Mela 27th October 2013
News Around the Globe
  • Individuals with attention-deficit/hyperactivity disorder (ADHD) are more than twice as likely to die prematurely compared with their counterparts without the disorder, suggests new research published online February 26 in the Lancet.
  • Both lifestyle intervention and use of metformin reduce the risk for type 2 diabetes among women with a history of gestational diabetes mellitus (GDM) reported a new analysis of Diabetes Prevention Program Outcomes Study (DPPOS). The study is published online in the Journal of Clinical Endocrinology & Metabolism.
  • The US Food and Drug Administration (FDA) has approved the combination of ceftazidime-avibactam to treat adults with complicated intra-abdominal or urinary tract infections, including kidney infections.
  • Tenofovir alafenamide fumarate, a prodrug version of the antiviral tenofovir disoproxil fumarate, has a better bone and renal safety profile when used to treat HIV than the original formulation, suggests new research presented at the Conference on Retroviruses and Opportunistic Infections 2015.
  • Drinking coffee may reduce the risk for multiple sclerosis (MS), suggest new data from two large population-based studies that will be presented at the upcoming American Academy of Neurology (AAN) 67th Annual Meeting.
Dr KK Spiritual Blog
The Concept of Second Opinion

In legal system when you are not satisfied with a judge, you re–appeal in the same court and if you are still not satisfied, you go to double bench before going to higher court.

Practice the same when you take a second opinion about your health.

Never go to a different doctor. First go to the same doctor and ask him to give his opinion again and, if you are not satisfied, then go to a team of two doctors and finally go to a doctor with qualification higher than the initial doctor. If your second opinion is from another doctor, it may invariably be wrong or partial.
Cardiology eMedinewS
  • Patients with heart failure commonly struggled with nine activities of daily living (ADL), which often worsened over time and were a powerful predictor of all-cause death and hospitalization during a mean follow-up of 3.2 years, suggested a new study published in Circulation: Heart Failure.
  • Younger women may ignore the earliest symptoms of an impending heart attack, such as pain and dizziness, and delay seeking emergency medical care, thus contributing to disproportionally high death rates of young women as compared to similarly aged men, suggests a new study published in Circulation: Cardiovascular Quality and Outcomes.
Pediatrics eMedinewS
  • A small case series suggests that inadequate physical screening may lead to unidentified undescended testes (UDT) in teenage boys with learning disabilities. The findings are published in Archives of Disease in Childhood.
  • Adding the probiotic Lactobacillus rhamnosus GG to standard peanut oral immunotherapy could boost response rates, according to results from a new study conducted among peanut-allergic children 1 to 10 years of age. The study is published online in the Journal of Allergy and Clinical Immunology.
Make Sure
Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.
Dr Sudhir Gupta, Asso Professor, Forensic Medicine & Toxicology, AIIMS

What are the medicolegal issues in criminal abortion?
  • The doctor should maintain a detailed record about the symptoms, general condition and signs present in the genitalia. He should not disclose the information about the woman having undergone criminal abortion. He should urge her to make a statement which may be taken as evidence against a person who has performed the operation. If the death is imminent he should arrange for a dying declaration.
  • The investigating police officer should visit the scene/place of criminal abortion.
  • The police officer investigating a case of criminal abortion, should see that in such type of cases there are certain duties of a doctor, attending and treating a patient suffering from the effects of a criminal abortion induced by another qualified/unqualified person.
  • The statement of the patient, their relatives, attendants etc. should be recorded.
  • Linen on which the patient is lying, the undergarments and other clothing of the patient should be keenly watched for blood stains or for smell of any other disinfectant.
  • A detailed clinical examination should be carried out to assess the physical and the mental state of the patient to find out whether the history given earlier is contradictory or not.
  • The place should be thoroughly searched for any instruments used to procure abortion or any discarded swabs or any abortifacient drugs or prescription of medicines etc.
Section 312 IPC: causing miscarriage; Section 313 IPC: causing miscarriage without woman’s consent; Section 314 IPC: death caused by act done with intent to cause miscarriage; Section 315 IPC: act done with intent to prevent child being born alive or to cause it to die after birth; Section 316: causing death of quick unborn child by act amounting to culpable homicide.
Dr Good Dr Bad
Situation: A 65–year–old male needed pneumonia vaccination.
Dr. Bad: Take it every five years.
Dr. Good: Take it once for life.
Lesson: After the age of 65, pneumonia vaccination is given only once for life.

(Copyright IJCP)
Inspirational Story
The Touchstone

When the great library of Alexandria burned, the story goes, one book was saved. But it was not a valuable book; and so a poor man, who could read a little, bought it for a few coppers.

The book wasn't very interesting, but between its pages there was something very interesting indeed. It was a thin strip of vellum on which was written the secret of the "Touchstone"!

The touchstone was a small pebble that could turn any common metal into pure gold. The writing explained that it was lying among thousands and thousands of other pebbles that looked exactly like it. But the secret was this: The real stone would feel warm, while ordinary pebbles are cold.

So the man sold his few belongings, bought some simple supplies, camped on the seashore, and began testing pebbles.

He knew that if he picked up ordinary pebbles and threw them down again because they were cold, he might pick up the same pebble hundreds of times. So, when he felt one that was cold, he threw it into the sea. He spent a whole day doing this but none of them was the touchstone. Yet he went on and on this way. Pick up a pebble. Cold - throw it into the sea. Pick up another. Throw it into the sea.

The days stretched into weeks and the weeks into months. One day, however, about mid-afternoon, he picked up a pebble and it was warm. He threw it into the sea before he realized what he had done. He had formed such a strong habit of throwing each pebble into the sea that when the one he wanted came along, he still threw it away. So it is with opportunity. Unless we are vigilant, it's easy to fail to recognize an opportunity when it is in hand and it's just as easy to throw it away.
Wellness Blog
Depression Should Be Treated In Patients with Diabetes

Presence of depression in diabetic patients is the most important factor leading to erectile dysfunction in such patients.

An India cum US study published in the Journal of Urology, depression and erectile dysfunction are related to each other in the form of a vicious cycle. Depression instigates erectile dysfunction and erectile dysfunction perpetuates the symptoms of depression.
  1. India is the diabetic capital of the world and both the incidence and prevalence of diabetes are increasing day by day.
  2. It is, therefore, important for the family physician to look for presence of depression in patients with diabetes.
  3. Diabetic patients who complain of erectile dysfunction in the study also have higher prevalence of high blood pressure and cholesterol abnormalities. These patients were also of older age with uncontrolled diabetes, history of smoking and longer duration of diabetes.
It was also shown that patients who develop erectile dysfunction also had diabetes, eye disorders, neuropathy and peripheral vascular disease.

Effective control of diabetes may reduce both depressive symptoms and erectile dysfunctions in such cases.
IJCP Book of Medical Records
IJCP’s ejournals
Twitter of the Day
Dr KK Aggarwal: Some Alcohol Terms Dr K K Aggarwal 1. Do not start if you do not drink Limit if you take and can not stop 3. (cont) http://youtu.be/NMIK16PyBrY?a via @YouTube

Dr Deepak Chopra: The most positive action we can take about the past is to change our perception of it http://bit.ly/DC_Ananda #ananda
eMedi Quiz

All of the following drugs act on cell membrance, except:

1. Nystatin.
2. Griseofulvin.
3. Amphotericin B
4. Polymixin B.

Yesterday’s Mind Teaser: Granulocytopenia, gingival hyperplasia and facila hirsutism are all possible side effects of one of the following anticonvulsant drugs.

1. Phenytoin.
2. Valproate.
3. Carbamazepine.
4. Phenobarbitone.

Answer for yesterday’s Mind Teaser: 1. Phenytoin.
Correct Answers received from: Dr Bharat Bhushan Aggarwal, Daivadheenam Jella, Dr Prabodh K Gupta, Arvind Diwaker, Dr Avtar Krishan, Dr Shangarpawar, Dr K V Sarma.
Answer for 26th Feb Mind Teaser: 2. MEN II.
Correct Answers receives: Dr Shangarpawar. Nirmala Agarwal, Dr Poonam Chablani, Daivadheenam Jella, Tukaram Pagad.

CPR 10
Total CPR since 1st November 2012 – 101090 trained
Rabies News (Dr A K Gupta)
Can rabies vaccine be given to a child with chicken pox or measles?

As rabies is 100% fatal, there is no contraindication for antirabies vaccination. Rabies vaccine can be given to a child with chicken pox or measles and it is effective. If possible administration of measles vaccine should be postponed by a fortnight after the completion of antirabies immunization.
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
Physician leaders warn governments over autonomy of medical profession
A warning to governments around the world not to try to dismantle medical professional self-governing bodies has come from the World Medical Association and the Standing Committee of European Doctors.

Following the dismissal last week of the case brought by the Turkish Government to dismiss the governing bodies of the Ankara Chamber of Medicine, WMA leaders issued a statement today saying that the importance of this case extended far beyond Turkey as attempts to dismantle professional self-governing bodies were occurring in many countries and many forms around the world.

They declared: ‘The case in Turkey has been a shame for a democratic nation with a rich cultural heritage. It has been an assault on humanity and an attack on the autonomy of our profession. On the other hand, this case and others have proven that there are still judges that have remained independent and brave enough to exercise their duties loyal to the law and not the aspirations of the government.

‘The Turkish people can be proud of their doctors, lawyers and judges who live up to values of justice and humanity and who withstand the forces of intimidation and segregation.’

Dr. Xavier Deau, President of the WMA, added: ‘It is highly regrettable that medical bodies around the world are experiencing threats in many different ways to their independence or even existence. We believe that a self-governing medical profession is in the best interests of patients around the world and the WMA will continue to support any medical association whose independence is being threatened’.

Dr. Katrín Fjeldsted, President of the Standing Committee of European Doctors (CPME) pointed out: ‘The CPME strongly condemns any measures undermining international standards of medical neutrality. Physicians are united by their professional ethics which require them to provide medical care for those in need, independent of the administrative or political status of the patient.’

Schemes & Initiatives of IMA
Dear Colleague,

This is to gently draw your kind attention to our earlier request to ensure the nomination of a Chairman / Scheme Coordinator of some extremely important schemes and initiatives as appended below at your State / local level and provide us the completed communication details for our records.

As already informed to you earlier, Team IMA led by Padma Shri Awardee Dr. (Prof.) M. Marthanda Pillai, National President, IMA, has felt the dire need for a prompt implementation to make the best performing State Branch / Local Branch / Member eligible for a special award to be announced for these initiatives to be presented by the end of the year.

The Awards shall be based on a scoring system wherein credit points will be awarded for each activity conducted by the branches / Members. A statement of the schemes / initiatives, their respective contact persons, Criteria of award, Prize detail and scoring system is appended to this communication.

For details about the activities to be conducted in each scheme / initiative, you may get in touch with the respective contact person as mentioned against each. The website of IMA – www.ima-india.org may also be consulted for detailed and updated information about the same. For any additional / missing detail, please feel free to contact the Team IMA office at IMA HQs. (Email: hsg@ima-india.org, np@ima-india.org).

You are requested to kindly implement this initiative at a war footing in your area with proper reporting to this office for assessment for the Award.

Thanking you and with kind regards,

Yours sincerely,

Dr K K Aggarwal
Honorary Secretary General

IMA Schemes and initiatives for implementation:-

Name of IMA scheme / initiative: IMA Health Scheme
Dr. Ashok S. Adhao
9423103966, 9822473651
Hony. Secretary:
Dr. Alex Franklin
of award:
Maximum number of members enrolled
Prize detail:
Rs. 11,000/- + Gold Medal
Scoring system: initiative
10 points for each block of 100 members enrolled for the scheme /

Name of IMA scheme/initiative:
IMA Pension Scheme

Dr. Sudipto Roy
Hony. Secretary:
Dr. K.V.Devadas
of award:
Maximum number of members enrolled
Prize detail:
Rs. 11,000/- + Gold Medal
Scoring system: initiative
10 points for each block of 100 members enrolled for the scheme /

Name of IMA scheme/initiative:
IMA Care of Elderly (> 65 years of age)

Dr. V.U. Seethi
National Coordinator:
Dr. D. R. Rai
of award:
Best campaign for care of oldest old.
Prize detail:
Rs. 11,000/- + Gold Medal
Scoring system: offering
10% discount
10 points for each campaign / 10 points per hospital in branch / State

Remarks: IMA/HBI/ Members to provide 10% discount to the elderly in their fee.
UNICEF, IMA help doctors to handle CSA better
Feb 27, 2015 | Age Correspondent | Mumbai: UNICEF and the Indian Medical Association (IMA) on Thursday joined hands to strengthen the response of medical practitioners in the city in identifying, reporting and treating cases of child sexual abuse (CSA).

Announcing the collaboration, Unicef India and IMA said they would equip medical practitioners with detailed understanding of diverse facets of CSA, along with relevant legal provisions.

A set of 10 key action points on CSA for medical practitioners was released at a press conference in Mumbai. The key points cover important steps to be taken by them while handling cases of child abuse, including reporting the crime, providing free medical treatment, treating every case of assault as a medical emergency and informing the child helpline. These messages will be distributed to over 2.5 lakh doctors through 30 state-level branches and 1,700 district branches of IMA. Doctors are liable to face up to one-year imprisonment and/or fine for refusing to perform medical examination in child sexual assault cases (Section 166B of the IPC), (Pocso, 2012).

Addressing the conference, David McLoughlin, Unicef India Deputy Representative said, “Violence against children is all too often unseen, unheard and underreported. This partnership with the medical fraternity of the country will play a key role in strengthening care for child survivors and bringing new ideas and expertise to support our mission in generating awareness among medical and allied professionals”.

In a joint statement, IMA honorary secretary general Dr K.K. Aggarwal, said, “Medical professionals have a critical role to play in the prevention, detection and response to sexual offences against children. They are often the first point of contact who come across a child abuse case and are required to take prompt action to ensure immediate and effective treatment of the child.”
Quote of the Day
Success usually comes to those who are too busy to be looking for it. Henry David Thoreau
IMA in Social Media
https://www.facebook.com/ima.national 28158 likes

https://www.facebook.com/imsaindia 46216 likes

https://www.facebook.com/imayoungdoctorswing 842 likes

Twitter @IndianMedAssn 809 followers

http://imahq.blogspot.com/ www.ima-ams.org

http://www.imacgpindia.com/ http://www.imacgponline.com/


Reader Response
  1. Sir, IMA Gujarat State has decided the names of most of the projects and the office will receives within two days from IMA GSB Office. We will take IMA Activities to a new heights.

    The State Working Committee meeting held on last Sunday 22-2-2015 deliberated the various projects and initiatives. For the first time the meeting lasts for more than 4 hours which begins with a very good lecture on Hybrid Leadership Qualities. Dr. Chetan N. Patel, President, IMA GSB.
IMA Videos
News on Maps
IMA Humor
Teacher: "Tell me, Johnny, which is the best time to pick pears? Spring, summer, autumn or winter?"

Johnny: "The best time to pick pears is when the farmer is not at home and there's no dog on the farm."
Press Release of the Day
Indian needs extra health budget fort Rare Diseases

Rare Diseases day was observed on 27th February to raise awareness about rare diseases and improve access to treatment and medical representation for individuals with rare diseases and their families.

Addressing a press meet Padma Shi Awardees, Dr A Marthanda Pillai and Dr K K Aggarwal; National President and Honorary Secretary General IMA, said that rare diseases does not mean they should be rarely read.

A Supreme Court Judgment (appeal 2867 of 2012) quoted "Finally, we hope and believe that the institutions and individuals providing medical services to the public at large educate and update themselves about any new medical discipline and rare diseases so as to avoid tragedies such as the instant case where a valuable life could have been saved with a little more awareness and wisdom from the part of the doctors and the Hospital. "

IMA has advised the medical students not to ignore reading about rare disease and the practicing doctors to update their knowledge about rare diseases.

IMA wants separate budget for the same In two recent high court judgments, the court had said "....on account of lack of Government planning, there is ‘pricing out’ of orphan drugs for rare and chronic diseases, like Gaucher. The enzyme replacement therapy is so expensive that there is a breach of constitutional obligation of the Government to provide medical aid on fair, reasonable, equitable and affordable basis. By their inaction, the Central and the State Governments have violated Articles 14 and 21 of the Constitution.
  • "... Just because someone is poor, the State cannot allow him to die. In fact, Government is bound to ensure that poor and vulnerable sections of society have access to treatment for rare and chronic diseases........"
  • ".............After all, health is not a luxury and should not be the sole possession of a privileged few."
The court also took serious note of the limited availability of affordable treatment for persons with neglected diseases like Haemophillia and ensured that the State Government provide treatment free of cost, as part of its obligation under Article 21 of the Constitution of India.

Some of the rare disease

Amyotrophic Lateral Sclerosis; Cystic Fibrosis; Ebstein Anomaly; Factor XII Deficiency; Fanconi Anemia; Friedreich Ataxia; Gaucher Disease; Hirschsprung Disease; Huntington Disease; Multiple Endocrine Neoplasia Type 1; Tourette Syndrome; Wegener Granulomatosis; Weil Disease; Zollinger-Ellison Syndrome; von Willebrand Diseases etc.
About the Editor
National Science Communication and Dr B C Roy National Awardee, Honorary Secretary General IMA, Immediate Past Senior National Vice President IMA, Professor of Bioethics SRM University, Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand, President Heart Care Foundation of India, Chairman Legal Cell Indian Academy of Echocardiography, Editor in Chief IJCP Group of Publications & eMedinewS, Member Ethics Committee Medical Council of India (2013-14), Chairman Ethical Committee Delhi Medical Council (2009-14), Elected Member Delhi Medical Council (2004-2009), Chairman IMSA Delhi Chapter (March 10- March13), Director IMA AKN Sinha Institute (08-09), Finance Secretary IMA (07-08), Chairman IMAAMS (06-07), President Delhi Medical Association (05-06)