emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

 
  Editorial …

30th April 2012, Monday

Smoking and obesity do not go together

Obese people should not smoke as the combination may be deadly.

Smoking and obesity are independent predictors of mortality, but smoking and being obese especially increase the mortality risk as per the American Journal of Clinical Nutrition.

Obese smokers have a 6 to 8 times greater risk of dying compared with normal weight people who never smoke.

Among smokers with a large waist, the risk of dying is five times greater than among people with the smallest waists who never smoke.

If you are overweight and smoke, fixing either one can markedly improve your chances for a normal life span. Fix both, and the probability of benefit is huge.

If one is obese and smokes and has to choose between weight loss and smoking cessation to improve health, the latter will have a greater protective effect. Smoking cessation is associated with significantly lower mortality risk in every weight group. Smoking cessation has a great effect on lowering risk of dying, one which far outweighs the slight increased risk from the associated increase in weight.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Smoking and obesity do not go together

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2012

Students of Delhi Public School taking pledge to save the mother earth on the occasion of the World Earth Day celebrations at DPS Mathura school premises on April 20, 2012. The Event was jointly organized by Heart Care Foundation of India, Delhi Public School and Ministry of Earth Sciences.

 
Dr K K Aggarwal
 
    National News

Govt nod for integrated vaccine park

NEW DELHI: The country’s first integrated vaccine centre (IVC) – a single site that will produce six important vaccines administered to Indian children – has crossed the final hurdle. The Cabinet Committee on Economic Affairs (CCEA) on Thursday approved the Union health ministry’s Rs 594–crore park proposal. Spread over 100 acres at Chengalpattu near Chennai, the park will produce all six primary vaccines used in the country’s Universal Immunization Programme (UIP), besides manufacturing several new–generation vaccines. The CCEA said the complex will be the nodal centre for research, manufacture and supply of vaccines at affordable prices for the UIP. Pentavalent combination (DPT plus Hep B plus Hib), BCG, measles, Hepatitis B, Human Rabies, Hib and Japanese Encephalitis vaccines will be manufactured in the IVC. The annual capacity of IVC is expected to be around 585 million doses. The vaccines manufactured in the IVC complex are proposed to meet about 75% of the total requirement of vaccines covered under the UIP and is likely to meet the requirements of the major disease preventable vaccines in the country to a large extent. (Source: TOI, Apr 27, 2012)

For comments and archives

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

 
    International News

Rare fungal disease basidiobolomycosis mimics GI cancer

Gastrointestinal basidiobolomycosis is rare, but physicians need to be aware of it, particularly in the southwest, according to a report online March 22 in Clinical Infectious Diseases. The disease is caused by the saprophytic fungus Basidiobolus ranarum. "Our study aims to draw attention to this emerging fungal infection in the desert southwestern United States. At the present time, gastrointestinal basidiobolomycosis remains a very unusual and rare infection sporadically reported from arid climates around the world," Dr. Holenarasipur R. Vikram told Reuters Health. "Since the clinical and radiographic manifestations of this infection closely resemble those seen with an abdominal malignancy," he added, "confirmatory diagnosis is often delayed." The guidelines were released at the American Academy of Neurology’s 64th Annual Meeting and appear in the April 24 issue of Neurology. (Source: Medscape)

For comments and archives

Oral steroids effective in MS

Outcomes for multiple sclerosis patients in relapse who were treated with oral methylprednisolone were no different than those of similar patients who received intravenous steroids, researchers reported t the American Academy of Neurology meeting. (Source: Medpage Today)

For comments and archives

Early menopause may pose mortality risk

Menopause before age 47 significantly increased the risk of osteoporosis, fragility fractures, and premature mortality over the next 30 years, Swedish investigators reported. (Source: Medpage Today)

For comments and archives

PET/CT helps diagnose cardiac device infection

PET/CT imaging can help distinguish between active infection of a cardiac electronic device and normal residual post–implant inflammation, a small study found. (Source: Medpage Today)

For comments and archives

Folate level IDs patients for new NSCLC chemo

Testing for folate receptor expression helped determine which non–small cell lung cancer patients (NSCLC) would most likely benefit from treatment with an investigational chemotherapy conjugate, according to results of a phase II trial. (Source: Medpage Today)

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: Reduce Weight First If Facing Infertility Problem
http://blog.kkaggarwal.com/2012/04/21/reduce–weight–first–if–facing–infertility–problem/

@DrKKAggarwal: Flow is possible only in the absence of resistance #SpiritualSolutions

 
    Spiritual Update

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

The Science behind Training and Development

Training in any field requires gaining knowledge, skills and positive mental attitude towards the object of learning.

The knowledge is everything about what and why. In Yoga, it correlates with the Gyan (Gnana) Marg. The skill is all about how to do it and correlates with Karma Marg.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What causes hydrosalpinx?

Hydrosalpinx is commonly caused by an old infection in the fallopian tubes. These infections may be caused by a sexually transmitted disease. Other causes include previous surgery (particularly surgeries on the tube) or severe adhesions in the pelvis.

For comments and archives

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

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

Can we separate blood into its components?

Yes. Now with technical advancement, we can separate the components of blood and store them. For example, plasma can be separated from the whole blood and stored up to 1 year in frozen state at – 86°C labeled as Fresh Frozen Plasma. Similarly, other components like Platelet Concentrate (can be stored as a life saving measure up to 5 days now at 22–24° C in a platelet incubator and agitator); Cryoprecipitate (which is very useful in treating bleeding disorders due to the deficiency of factor VIII and IX); Factor VIII and IX; Albumin, Globulin and many others.

Truly speaking these days in good quality blood banks, almost 100% blood collected is converted into components and stored. The patients may not require whole blood e.g. a patient whose hemoglobin is low and is thus anemic may just require Packed Cells i.e. only red cells or a patient with burns may need more of plasma than cells; or a patient with hemophilia may just require factor VIII.

Component therapy has revolutionized the blood transfusion services all over the world.

Now with the advent of cell separators, it is now possible to draw a particular component from the donor directly and the remaining constituents go back to the donor. Few blood banks in our country have this facility.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Depression – clinical or self–induced?

There is one type of illness in the world that affects more people than anything else and is very deadly. If untreated this illness could affect everything you do. What is this illness? Depression. Serious depression requires professional treatment. Self–induced depression is something each of us can change.

Everyone’s circumstances are different and the pressures we face from day to day vary, but really some of the causes self–induced depressions are common: low self–esteem, hurtful thinking and a bad attitude.

Although these affect people on a global scale and cause much heartache, how can we change the way we think, feel, and cultivate a cheerful attitude? Like with any obstacle there will be stumbling blocks, but they can be avoided.

First we must look at ourselves, truly and honestly examining our motives for what we do and what we wish to achieve. If you are dissatisfied because you feel you haven’t or can’t do anything, then one step is needed – to set goals.

Always start your goals relatively small and easy to attain. Think of them as sand; one grain may be insignificant but as a group they form the beach.

Once you have set and attained small goals for yourself, move on to slightly larger, more challenging goals. Examples might be like competing in a sporting event, studying at college or getting a part time job. And most importantly of all, talk to people about your goals. Talk to people who have reached higher goals, for they can give you much encouragement.

It takes more than just setting goals to be happy. It takes positive thinking. How can we attain this?

There are a number of factors that can make us think negatively and one of those is diet.

In my opinion, a person who eats a lot of take out and fast food is feeding their body junk which mostly consists of fat, saturated fat, cholesterol, sugar and is generally low in vitamins and minerals. Start by eating better foods, more fruit and veggies, meat products and high fiber meals which give the body much–needed minerals. If your physical body is happy, it’s much easier for your mental body or "thinking ability" to be happy.

Next, exercise. A half–hour a day is recommended for positive well–being. Why is exercise so important?

Because it gets oxygen running around the body more easily which helps us think better and helps us sleep better. If you are having difficulties sleeping, a little more physical work or exercise during the day may be needed.

Thinking is also linked to what we do. For example: if you do something that you hate doing everyday, it will show in your attitude. This probably explains why so many people are angry in the work place. If you don’t like what you do, but have no choice in doing it, try to give yourself some hobbies or activities you really enjoy doing (Lego is always a good one for me).

Hobbies are just like lifelong invisible friends. If all else fails, you can turn to them.

If thinking positive becomes that difficult, think back to a time in your life when you were happier, or think about good memories you had, or generally think of things that make you smile.

Remember, everything you wear costs money but to wear a smile is free. A smile can be the difference between an average day and a great day and also offers you some brief exercise (smiling requires the movement of certain facial muscles).

If you follow these steps, positive change is inevitable.

To be happy depends not only on good health mentally, how we think and feel, but also on how healthy we are physically. So start making positive goals, treating your body to healthier foods, and stay motivated in life by doing things you love or think is fun, and thus you can enjoy the precious life you have.

For comments and archives

 
  Cardiology eMedinewS

Cingulotomy gives Lasting Relief To Long–Term OCD Patients Read More

FDG PET/CT Can Identify Infections Around Implanted Device Read More

ACE Inhibitors Better Arbs In New Meta–Analysis In Hypertensives
Read More

 
  Pediatric eMedinewS

Earlier Treatment Better For Children With Subluxed Lenses Read More

Breast–Feeding Past 6 Months Lowers Risk For HIV Transmission
Read More

 
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    IJCP Special

Dr Good Dr Bad

Situation: A heart patient wanted to know if he could eat chocolates.
Dr. Bad: Go for white chocolates.
Dr. Good: Go for dark chocolates.
Lesson: Santiago State University researchers have shown that people who eat dark chocolates have lower levels of blood pressure, LDL cholesterol and higher levels of HDL cholesterol than those who eat white chocolates.

For comments and archives

Make Sure

Situation: A patient with chest pain and who had normal ECG died half an hour later.
Reaction: Oh my God! Why was acute MI not suspected?
Lesson: Make sure all patients of chest pain are observed for 12 hours. ECG can be normal in acute heart attack for up to six hours.

For comments and archives

 
  Legal Question of the day

(Prof. M C Gupta Advocate & Medico–legal Consultant)

Q. A student completes MBBS course. There is no bond between him and the government for rendering compulsory rural service. Can such a requirement be imposed later? If imposed later, would it not constitute restriction on his right to freely practice a vocation?

Ans.

  1. No such requirement can be imposed later except in conformity with law.
  2. It will not constitute restriction on his right to freely practice a vocation. Practicing the vocation of a doctor means treating patients. Asking someone to treat patients in a rural setting does not constitute restriction on treating patients.

For comments and archives

 
  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Prevention Of Blood Borne Infections

All HCWs must follow standard work precautions at all the times while providing health care services; follow the correct protocols for sterilization and disinfection; safe disposal of waste; educate themselves about post exposure management and prophylaxis and take immunization against HBV.

On account of the window period in blood borne viruses (HIV, HBV, HCV and others) the HCWs must consider all the patients and all specimens potentially infectious and practice blood and body fluid precautions at all times while giving care to patients.

Standard work precautions include:

  • Hand hygiene, hand hygiene and hand hygiene;
  • Use of personal protective equipment (barrier precautions) like use of latex or vinyl gloves, gown/apron, protective eyewear or mask and protective foot cover, as indicated.
  • Take Hepatitis B virus vaccine, be protected;
  • Minimize invasive interventions, oral drugs in place of injection wherever possible;
  • Handle sharps, needle and syringes carefully. Do not bend, break, re–cap used needles;
  • Handle carefully the hollow bore needle to prevent deep injuries;
  • Dispose needles immediately in specified sharp containers containing 1% sodium hypochlorite. Do not leave used needles on table/trolley or bed/use safe autodestruct–auto retract needles;
  • Never pass used sharps from one person to another directly, place the sharp on the surface/trolley to be picked up by the surgeon;
  • Use forceps instead of fingers for guiding sutures;
  • Follow correct protocols of biomedical waste management/disposal and sharps disposal (plastic sharps container made of plastic containing 1% fresh bleach)
 
  Quote of the Day

(Dr GM Singh)

How many seemingly impossible things have been accomplished by resolute men because they had to do, or die. Napoleon Bonaparte

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Platelet count

Thrombocytopenia (or low platelet count) is divided pathophysiologically into production defects and consumption defects based on examination of the bone marrow aspirate or biopsy for the presence of megakaryocytes.

  • Production defects are seen in Wiskott–Aldritch syndrome, May–Hegglin anomaly, Bernard–Soulier syndrome, Chediak–Higashi anomaly, Fanconi’s syndrome, aplastic anemia, marrow replacement, megaloblastic and severe iron deficiency anemias, uremia, etc.
  • Consumption defects are seen in autoimmune thrombocytopenias (including ITP and systemic lupus), DIC, TTP, congenital hemangiomas, hypersplenism, following massive hemorrhage and in many severe infections.
 
    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Weight management and breast cancer rehab

Currently, overweight and obesity are known to increase risk of developing breast cancer in older women. In addition, many women who develop breast cancer gain weight during treatment. According to experts, weight gain and obesity can lead to poorer outcomes during recovery and increased risk for other conditions like diabetes and heart disease. Overweight cancer patients also may experience poorer outcomes after surgery due to more time spent in operation, higher risk of infection, and slower healing, as well as more swelling and tiredness and greater decline in overall health. Healthcare professionals are encouraged to promote weight management through the entire treatment course to improve outcomes and avoid negative side effects.

Exercise and dietary changes have been shown numerous times to help weight loss and weight maintenance, with the best results achieved by combining the two. Maintaining a healthy weight and eating more fruits and vegetables has been associated with lower risk of developing cancer in a variety of studies. Consuming at least five servings of fruits and vegetables each day as part of a balanced diet and exercising at for at least 30 minutes five days a week is recommended to help with weight control and decrease risk of chronic disease.

For comments and archives

 
    Mind Teaser

Read this…………………

Which of the following may cause your hair to fall out by the fistful?

A. A medical condition like lupus, a thyroid disorder, or a recent high fever or case of the flu.
B. A fungal infection on the scalp.
C. Tight hairstyles (braids, extensions, cornrows, ponytails).
D. Hormonal shifts caused by pregnancy, changes in birth–control–pill use, or menopause.
E. All of the above and more.

Yesterday’s Mind Teaser: Since sunscreen–awareness campaigns began, have skin–cancer rates decreased?

A. Yes, fewer people are getting skin cancer.
B. No, skin–cancer rates and deaths from the disease are on the upswing.
C. No, skin cancer is on the rise, but fatalities are down.
D. Skin–cancer rates have been stable over the past decade.
E. Yes, but only among older women.

Answer for Yesterday’s  Mind Teaser: B. no, skin–cancer rates and skin–cancer deaths are on the upswing.

Correct answers received from: Muthumperumal Thirumalpillai, Chanchal Das, Shipra, Dr Ketan, Dr Arvind, Bhawna Chandra, Dr GP Das.

Answer for 27th April Mind Teaser: D. 30 minutes of exercise at least four times a week.
Correct answers received from: Dr. P. C. Das, Dr.Uma Gaur

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Two guys, one old and one young, are pushing their carts around Wal–Mart when they collide. The older guy says to the younger guy, "Sorry about that. I’m looking for my wife, and I guess I wasn’t paying attention to where I was going."

The younger guy says, "That’s OK, it’s a coincidence. I'm looking for my wife, too…I can’t find her and I'm getting a little desperate."

The older guy says, "Well, Maybe I can help you find her… What does she look like?"
The young guy says, "Well, she is 27 years old, tall, with red hair, blue eyes, is buxom, long legs, and is wearing short shorts. What does your wife look like?"

To which the first old guy says, "Doesn’t matter, … let’s look for yours."

 
    Medicolegal Update

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

Facilitate cadaver organ retrieval for transplantation

In India, certain amendments to the Human Organ Transplant Act 1994 are required to enhance cadaver organ retrieval and transplantation to bridge the huge demand–supply gap. The pool of donors, including increasing the supply of organs by widening the definition of ‘near relatives’ by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures. The paired matching should be permitted i.e. if patient A’s donor does not match A, and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfill the need of their family member in need of a transplant.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

My 5 Moments For Hand Hygiene

Hand hygiene is the primary measure to reduce health care associated infections. The "My 5 Moments for Hand Hygiene" approach defines the key moments when health–care workers should perform hand hygiene, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal who is also President of Heart Care Foundation of India.

This evidence–based, field–tested, user–centered approach is designed to be easy to learn, logical and applicable in a wide range of settings.

This approach recommends health–care workers to clean their hands

  • before touching a patient
  • before clean/aseptic procedures
  • after body fluid exposure/risk
  • after touching a patient
  • after touching patient surroundings

Hospital–acquired infections are classified as under:

  • Hospital–acquired (or nosocomial) infections (HAIs) are infections that occur 48 hours or more after admission and did not appear to be incubating at the time of admission.
  • Ventilator–associated pneumonia (VAP) is a type of hospital acquired infection that develops more than 48 to 72 hours after endotracheal intubation.
  • Healthcare–associated infections (HCAIs) are infections that occur in a non–hospitalized patient with extensive healthcare contact, as defined by one or more of the following:
    • Intravenous therapy, wound care, or intravenous chemotherapy within the prior 30 days
    • Residence in a nursing home or other long–term care facility
    • Hospitalization in an acute care hospital for two or more days within the prior 90 days
    • Attendance at a hospital or hemodialysis clinic within the prior 30 days

Hand hygiene technique

  • When decontaminating hands with an alcohol-based hand rub, apply product to the palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry.
  • When washing hands with soap and water, wet hands first with water, and rub hands together vigorously for at least 20 seconds, covering all surfaces of the hands and fingers. Rinse hands with water and dry thoroughly with a disposable towel. Use towel to turn off the faucet.
  • Liquid, bar, leaflet or powdered forms of plain soap are acceptable when washing hands with soap and water. When bar soap is used, small bars of soap and soap racks that facilitate drainage should be used.
  • Multiple-use cloth towels of the hanging or roll type are not recommended for use in health-care settings.
 
    Readers Response
  1. I liked the word financial health. It may sound rude and materialistic but it helps you to do good in your life when you are financially secure. Vivek Kumar, Varanasi.
 
    Forthcoming Events
Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
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3. eMedinewS audio lectures (This may take a few minutes to open)

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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