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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 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 (07–08c); 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 May 2012, Wednesday

Osteoporosis (Part 1)

Excerpts from a programme moderated by Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India

Panelists: Dr. Rajesh Malhotra, Professor, Dept. of Orthopedics, AIIMS; Dr. Ambrish Mithal, Chairman, Dept. of Oncology and Metabolic Disorders, Medanta Medicity and Dr. Alka Kriplani, Professor, Dept. of Obstetrics and Gynecology, AIIMS.

Following are the salient points of the discussion.

  1. Osteoporosis is a silent killer and is responsible for minimal trauma fractures in the hip, spine and ribs later in life.
  2. More than 3 crore people in India suffer either from osteopenia or osteoporosis; 40% of the people above the age of 50 are suffering either from osetopenia or osteoporosis.
  3. In women, post menopausal fractures in patients with osteoporosis occur much more than the cancers combined (uterus, breast and ovary).
  4. In India, osteoporosis is the second commonest diseases both in men and women after coronary artery disease.
  5. Senile osteoporosis and post menopausal osteoporosis are different.
  6. In postmenopausal osteoporosis, osteoporosis occurs much more in the spine, which is a cancellous bone. On the contrary, in senile osteoporosis, bones are 50-50, cancellous as well as cortical. Osteoporosis occurs both in the spine and hip.
  7. The commonest fractures in osteoporosis are spine fractures in postmenopausal women; one-third of these fractures remain silent. The other common sets of fractures are in hip and wrist.
  8. Femoral osteoporosis is both 50:50 for cancellous and cortical bone.
  9. To overcome osteoporosis, one must remember the following mnemonic ABCDE: A means adequate sunlight, B means avoiding bone toxins, C means adequate calcium, D means fortification or supplementation of Vitamin D and E means exercise.
  10. When we talk about adequate sunlight, it means 40 minutes of interrupted exposure to ultraviolet B rays. More the exposure time more will be vitamin D synthesis. But Indians, especially women, do not want tanning of the skin and so do not get adequate vitamin D.
  11. Adequate vitamin D absorption from sunlight is from 10 am to 4 pm but this is the time when people avoid sun exposure. Even if you get exposure from 8 am to 10 am in the morning and 4 pm to 6 pm in the evening it is fine. The exposure of the body should be above the trunk (face and above the arm). Exposure must be for duration of 40 minutes. Interrupted sun exposure i.e. 20 minutes in the morning and 20 minutes in the evening will not work. It is not adequate for vitamin D synthesis.
  12. In India, about 80% people have vitamin D deficiency.
  13. Vitamin D deficiency is much more important than calcium supplementation. If Vitamin D cannot be acquired from sunlight, vitamin D supplementation is needed.
  14. Bone toxins must be avoided. They are alcohol and smoking. Smoking is dangerous as it accelerates bone destruction. Excess of 80 ml of alcohol or 80 gm of alcohol can accelerate bone destruction. The third toxin includes drugs (steroids etc.), which can accelerate bone loss.
  15. Calcium: Adequate calcium intake comes from milk, curd and paneer. Ideally one should take a glass of milk in the morning and a glass of milk in the evening and curd and paneer in the afternoon for adequate calcium intake. Calcium is also present in pulses such as Black gram - urad daal and sesame seeds. Calcium is also present in Chuna taken with paan but it may not be a completely absorbable form of calcium.
  16. When choosing between calcium citrate and calcium carbonate, calcium citrate is better, the absorption is better; it does not interfere with acids with H2 blockers. It has to be taken in a fasting state.
  17. Calcium requirement is approximately 1000 mg per day.
  18. Vitamin D requirement internationally is 800 units but for Indian, it is 2000 units. Up to 1000 IU is okay, but in obese people 2000 units are required.
  19. Vitamin D supplementation should be in the native form i.e. the raw form of vitamin D is better than the active form. It is always better to give calcium separately and vitamin D separately.
  20. The supplementation must start when the boys and girls are in the schoolgoing age. Remember osteoporosis begins in the schoolgoing age but manifests later in life.
  21. The bone stores and bone bank are finished by the time we are 30. After that we only consume bone.

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 on

osteoporosis

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2012

Students of Delhi Public School presenting a beautiful skit on the occassion of World Earth Day.

 
Dr K K Aggarwal
 
    National News

Delhi budget: Lifeline for 10,000 poor HIV patients

NEW DELHI: The budget has good news for poor HIV/AIDS patients. In a unique initiative, the state government has proposed monthly financial assistance of Rs 1,000 for patients suffering from the disease. While orphaned children infected with HIV/AIDS will get Rs 2,050 per month, other children will get Rs 1,750 per month. The budget has earmarked an initial corpus of Rs 5 crore for the ambitious health scheme. This scheme was among the key highlights of Delhi government's budget for 2012-13 in the health sector, for which Rs 2,124 crore (14.16% of the total outlay) has been allocated. (Source: TOI, May 29, 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

(Contributed by Dr Monica and Brahm Vasudev)

Usual tools underestimate CVD risk in RA

Cardiovascular disease (CVD) develops so quickly in patients with rheumatoid arthritis (RA) that standard tools for estimating CV risk miss most cases, according to a team of researchers from the Mayo Clinic. (Source: Medscape)

For comments and archives

Tight glucose control no help to kidneys

Intensive glucose control for type 2 diabetes may help control some markers of kidney health, but doesn't clearly prevent clinical kidney problems, a meta-analysis determined. (Source: Medpage Today)

For comments and archives

Prediction and prevention of type 1 diabetes

Drugs aimed at halting the molecular destruction of beta cells are likely the next step in the quest to stop the progression of autoimmune type 1 diabetes, according to research presented here at the American Association of Clinical Endocrinologists 21st Annual Meeting and Clinical Congress by a pioneer in the field. (Source: Medscape)

For comments and archives

Safe to switch thiopurines in IBD patients

A majority of patients with inflammatory bowel disease who are unable to tolerate azathioprine may be able to take the related drug mercaptopurine safely, a researcher said. (Source: Medscape)

For comments and archives

(Contributed by Dr SK Verma, Consultant Ophthalmologist)

A contact lens in eye will check your blood sugar level

A new colour changing contact lens developed by Dr. Jun Hu et al at the University of Akron in Ohio USA can detect glucose level in tears, a mirror image of blood sugar. The sugar molecules act like the proton on pH test displacing a colour dye embedded on the lens and the lens changes the colour. The person wearing the lens wouldn't notice the change unless he sees the mirror or seen by others. It could replace the frequent skin prick tests used to monitor the blood sugar level of diabetic patients. The researchers are now designing an application that will calculate sugar level from a camera phone snap of the eye. The lens is currently at the prototype phase but researchers say they could be commercially available within three years if all goes well. (Courtesy Daily Mail UK 26th May, 2012)

 
    Twitter of the Day

@DrKKAggarwal: Smoking can cause mutation in genes

@DeepakChopra: The relative is the self sacrifice of the absolute

 
    Spiritual Update

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

Get your body insured and serviced regularly

Recently, in my hospital, the echo machine whose new model cost about Rs. 30-40 lakhs, needed a service. The machine was insured but not in service contract with the company. The company representative did not come for a week and when I called them up, they said that they will not come to look at the machine unless they are paid Rs. 15,000 per visit charges. They said that our hospital is paying only Rs. 5000 per visit to them.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is hyperprolactinemia?

Hyperprolactinemia is a condition wherein too much prolactin is present in the blood of women who are not pregnant and in men. In women, this leads to a decline in the body's production of progesterone after ovulation which, in turn, can lead to irregular ovulation and infrequent menstruation, cause you to stop menstruating altogether, or cause your breasts to start producing milk, a condition called galactorrhea. Men also can experience galactorrhea. High prolactin levels in men can also lead to impotence, reduced libido and infertility.

For comments and archives

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

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

Dosage of factor VIII and alternatives for treatments of Hemophila A
Severity of bleed Dosage Supplied as: Factor VIII concentrate or cryoprecipitate*
  (500 IU/ bottle) (80-100 IU/ pack)
Mild bleed
Nose, gums,etc.
14 IU/kg 1-2 bottles (adult) 1 pack/ 6 kg
Moderate bleed
Joint, muscle, gastrointestinal tract, surgery
20 IU/kg 2-4 bottles (adult) 1 pack/4 kg
Major bleed
e.g. cerebral
40 IU/kg 4-6 bottles (adult) 1 pack/2 kg
Prophylaxis for major surgery 60 IU/kg 6-10 bottles (adult) 1 pack/1 kg
Note * Cryoprecipitate containing 80-100 IU of Factor VIII, usually obtained from 250 ml of fresh frozen plasma.
1. For a mild moderate or severe bleed, repeat dose 12-hourly if bleeding persists or swelling is increasing. With more severe bleeds, it is usually necessary to continue treatment with half of total daily dose 12-hourly for 2-3 days or occasionally longer.
2. For prophylaxis for major surgery, start therapy 8 hours before surgery. Continue 12-hourly therapy for 48 hours postoperatively. If no bleeding occurs, scale down gradually over next 3-5 days.
3. As adjunct to factor replacement in mucosal or gastrointestinal bleeding as surgery, give fibrinolytic inhibitor: Tranexamic acid (oral): 500-1000 mg 3times/day. Do not use for hematuria.
4. In an emergency, use fresh frozen plasma to treat bleeding in hemophiliacs (Give three packs initially) if none of the above are available.
5. Careful assessment of the patient’s fluid intake is important to avoid fluid overload when using fresh frozen plasma or large doses of cryoprecipitate.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

A Child's Love

I was off to go back to work one evening and my two children were busy sewing things on the sewing machine. My eleven year old daughter was, in the midst of her project, going to assist her older brother in making a little cushion. I left, and in a few hours returned to find a mess in the kitchen, front room, and both children sitting in front of the television.

Having had a long day, I was very short with my greeting to them and then I noticed the material my daughter had used. It had been purchased to make a color coordinated baby blanket, and now had chunks cut out of almost every piece of fabric. Not stopping to listen, I exploded at the children and explained how angry I was at what had been done.

My daughter listened to me sheepishly, not trying to defend herself at all, but the pain could be seen written across her face. She retreated to her room quietly, and spent some time in there alone before she came out to say good night and once again apologize for the mistake she had made.

A few hours later, as I was preparing to go to bed, there on my bed lay a beautiful, little cushion made out of the forbidden fabric, with the words "I LOVE MOM". Alongside it was a note apologizing again, and the innocence in which she had taken the fabric.

To this day, I still get tears in my eyes when I think of how I reacted and still feel the pain of my actions. It was I who then sheepishly went to her and apologized profusely for my actions. I display with great pride the cushion on my bed, and use it as a constant reminder that nothing in this world is greater than a child's love.

For comments and archives

 
    Cardiology eMedinewS

Phentermine returns for weight loss, but at a low dose Read More

Aspirin response in PAD predicts long-term risk Read More

FAME II: FFR pinpoints stable CAD patients who fare worse with OMT Read More

 
    Pediatric eMedinewS

More relatives, friends caring for kids: Report Read More

Social ties move kids to exercise Read More

Risk factors for early-onset lymphoma ID'd Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A hypertensive patient came with a morning blood pressure of 160/100.
Dr. Bad: It is a physiological phenomenon
Dr. Good: It needs to be controlled.
Situation: Although the morning BP surge is a physiological phenomenon, in the hypertensive patients, the degree of morning BP surge is exaggerated and is an independent risk for advancing the atherosclerotic process and target organ damage and triggering cardiovascular events. Hypertension 2007;49(4):771-2.

For comments and archives

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh my God! Why did you not give him nimesulide?
Lesson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

For comments and archives

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  Legal Question of the day

(Prof. M C Gupta, Advocate & Medicolegal Consultant)

How common are prescription errors? How can they be reduced?

Q. How common are prescription errors in the hands of doctors? How can they be reduced?

Ans.

1. Medical prescriptions play an important role in litigation against doctors. It is in their own interest that they should learn the proper method of prescribing and thereby reduce the possibility of litigation.

2. Ranadeb Biswas et al studied in Calcutta Medical College more than 6000 new prescriptions for fresh patients in medical, pediatrics and gynae OPDs in 1997-98.

Ranadeb Biswas, P. Chatterjee, Malay Mundle: Prescribing Habits of Physicians in Medical College, Calcutta. Indian Journal of Community Medicine:Vol. 25, No. 4 (2000-10 - 2000-12)

http://www.indmedica.com/journals.php?journalid=7&issueid=48&articleid=585&action=article

a. The results were as follows:

Provisional diagnosis was mentioned in only 13.6% of prescriptions. 73% of available drugs were tablets, 24.9% syrups, 1.9% injections and only 0.2% were ointments. 2.57 drugs were prescribed per encounter, of which 32.6% were by generic names, 44.5% of encounters had an antibiotic, 1.82% had an injection but only 18.77% of drugs belonged to the Hospital formulary. Average consultation time was 127.99 +- 21.9 Sec. and average dispensing time being 49.13 +- 8.45 Sec. 51.54% of drugs were actually dispensed, 21.43% of drugs were adequately labelled, only 44.67% of the patients knew the correct dosage of drugs given to them.

b. The conclusions were as follows:

Prescriptions are generally not according to recommended guidelines. There is also need to train pharmacists to properly label and explain the dosage of drugs as only 44.67% patients could tell the correct dosage of the drugs dispensed.

3. A large study was carried out by Professor Tony Avery, Professor of Primary Health Care, University of Nottingham, for the General Medical Council of Britain.

http://www.gmc-uk.org/news/13017.asp

GP prescribing – a good standard but improvement possible

A. It found that:

a. While the vast majority of prescriptions written by family doctors are appropriate and effectively monitored, around 1 in 20 has an error.

b. Few prescriptions were associated with significant risks to patients but it’s important that we do everything we can to avoid all errors.

c. Where there were errors, most were classed as mild or moderate, but around 1 in every 550 prescription items was judged to contain a serious error.

d. The most common errors were missing information on dosage, prescribing an incorrect dosage, and failing to ensure that patients got necessary monitoring through blood tests.

B. The authors suggested that improvements can be made to reduce the error rate:

a. A greater role for pharmacists in supporting GPs

b. Better use of computer systems

c. Extra emphasis on prescribing in GP training.

C. Commenting on the research, Professor Sir Peter Rubin, Chair of the General Medical Council, said:

‘GPs are typically very busy, so we have to ensure they can give prescribing the priority it needs. Using effective computer systems to ensure potential errors are flagged and patients are monitored correctly is a very important way to minimise errors. Doctors and patients could also benefit from greater involvement from pharmacists in supporting prescribing and monitoring. We will be leading discussions with relevant organisations, including the RCGP and the CQC, and the Chief Pharmacist in the Department of Health, to ensure that our findings are translated into actions that help protect patients.’

D. Professor Tony Avery of the University of Nottingham’s medical school, who led the research, said:

‘Few prescriptions were associated with significant risks to patients but it’s important that we do everything we can to avoid all errors. GPs must ensure they have ongoing training in prescribing, and practices should ensure they have safe and effective systems in place for repeat prescribing and monitoring. I’d also encourage doctors to share their experiences of prescribing issues both informally within their practices, and also formally where appropriate through local or national reporting systems. Prescribing is a skill, and it is one that all doctors should take time to develop and keep up-to-date.’

4. It is thus clear that prescription errors are common.

a. In the Indian study:

i) Provisional diagnosis was mentioned in only 13.6% of prescriptions.

ii) Only 21.43% of drugs were adequately labelled

iii) Only 44.67% of the patients knew the correct dosage of drugs given to them.

b. In the British study:

i) The prescription error rate was around 1 in 20. Errors were mostly mild or moderate but 1 in every 550 prescription items was judged to contain a serious error.

ii) The most common errors were missing information on dosage, prescribing an incorrect dosage, and failing to ensure that patients got necessary monitoring through blood tests.

5. It is clear that doctors need better training about how to prescribe. Both the Indian and British study emphasise the need for support from pharmacists to be made available to doctors.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Victory is won not in miles but in inches. Win a little now, hold your ground, and later, win a little more. Louis L'Amour

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum phosphorus

Hyperphosphatemia or high serum phosphorus levels may occur in myeloma, Paget’s disease of bone, osseous metastases, Addison’s disease, leukemia, sarcoidosis, milk–alkali syndrome, vitamin D excess, healing fractures, renal failure, hypoparathyroidism, diabetic ketoacidosis, acromegaly, and malignant hyperpyrexia. Drugs causing serum phosphorous elevation include androgens, furosemide, growth hormone, hydrochlorothiazide, oral contraceptives, parathormone, and phosphates.

 
    Mind Teaser

Read this…………………

A male client’s left tibia was fractured in an automobile accident, and a cast is applied. To assess for damage to major blood vessels from the fracture tibia, the nurse in charge should monitor the client for:

a. Swelling of the left thigh
b. Increased skin temperature of the foot
c. Prolonged reperfusion of the toes after blanching
d. Increased blood pressure

Yesterday’s Mind Teaser: Patricia, a 20-year-old college student with diabetes mellitus requests additional information about the advantages of using a pen like insulin delivery devices. The nurse explains that the advantages of these devices over syringes includes:

a. Accurate dose delivery
b. Shorter injection time
c. Lower cost with reusable insulin cartridges
d. Use of smaller gauge needle.

Answer for yesterday’s Mind Teaser: a. Accurate dose delivery

Correct answers received from: Dr LC Dhoka, Dr Thakor Hitendra singh, Dr Avtar Krishan, Dr. Sushma Chawla, Dr. B. B. Aggarwal, Dr Prabha Sanghi, Dr. Prashant Bharadwaj, Prof. Chetana Vaishnavi, Dr Kanta jain, Dr.Chandresh Jardosh, Raju Kuppusamy, Dr. Mrs. S. Das, Muthumperumal Thirumalpillai, Dr. P. C. Das, Dr U Gaur, Dr Jainendra Upadhyay

Answer for 28th May Mind Teaser:b. Vital signs

Correct answers received from: Dr. Mrs. S. Das, Muthumperumal Thirumalpillai, Dr. P. C. Das, Dr U Gaur, Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

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)

BCG vaccine

BCG vaccine is prevents tuberculosis caused by Mycobacterium tuberculosis, which is a slow growing acid-fast, very sturdy and resistant organism. Infection is airborne and the newborn needs protection right after birth. So BCG vaccine should be given right at/after birth. BCG vaccine is given as a single dose, intradermal injection by a trained medical professional following the infection control practices. Adverse events are few and include infection site abscess and lymphadenitis.

For comments and archives

 
    Laugh a While

(Dr Anupam Sethi Malhotra)

A judge was interviewing a woman regarding her pending divorce, and asked, "What are the grounds for your divorce?"

She replied, "About four acres and a nice little home in the middle of the property with a stream running by."

"No," he said, "I mean what is the foundation of this case?"

"It is made of concrete, brick and mortar," she responded.

"I mean," he continued, "What are your relations like?" "I have an aunt and uncle living here in town, and so do my husband's parents."

He said, "Do you have a real grudge?" "No," she replied, "We have a two-car carport and have never really needed one."

"Please. . ." he tried again, "is there any infidelity in your marriage?" "Yes, both my son and daughter have stereo sets. We don't necessarily like the music, but the answer to your question is yes."

"Ma'am, does your husband ever beat you up?" "Yes," she responded, "About twice a week he gets up earlier than I do."

Finally, in frustration, the judge asked, "Lady, why do you want a divorce?"

"Oh, I don't want a divorce," she replied. "I've never wanted a divorce. My husband does. He says he can't communicate with me!!"

 
    Medicolegal Update

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

How a doctor will assess the severity of stab wounds by external examination?

The severity is based exclusively on the location and depth of penetration seen in autopsy.

  • The important medical considerations include the type of weapon used e.g. knife length, shape, straight or serrated, and manner of assault, whether the stabbing is overhand/underhand.
  • The gender of the assailant may have some importance, in that women tend to stab "overhand." Penetration tends to be deeper with the "underhand" thrust.
  • Stab wounds to the chest should always be considered dangerous and likely to cause death until proven otherwise.
  • Central stab wounds, below the clavicles and to either side of the breastbone means sternum, can result in penetration of the heart. Chest wounds can result in puncture and rupture of the lung or marked bleeding within the chest cavity causing hemothorax.
  • Stab wounds to the abdomen will often result in an exploratory laparotomy to rule out serious damage. Slow bleeding inside the abdomen is extremely difficult to diagnose, and should be considered a possibility in every case.
  • Stab wounds to the upper back can involve the lung or heart.
  • Stab wounds to the lower and middle back can involve the kidneys and ureters. Evaluation of stab wounds to the back that may have punctured the kidney will require intravenous pyelography for evaluation. The presence of blood in the urinalysis indicates injury to the kidney, bladder or ureter.
  • Examination for sensation, movement and pulses of the victim should be carefully done and documented in case of stab wounds to the hands/legs that do not lacerate nerves, blood vessels, or tendon structures.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Sangat and smoking

Sewa, Simran and Sangat are the three principles of life as per the most Vedic literature. Even Adi Shankracharya described Sangat as the main force for living a spiritual life.

Sangat is the company of people you live with. Living in the company of good people makes one good and the reverse is also true said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India.

The same is now being proved in the allopathic context. A new research published in the New England Journal of Medicine has shown that when one person quits smoking, than others are likely to follow. One person quitting can cause a ripple effect, making others more likely to kick the habit.

1. If your spouse stops smoking, you're 67 percent less likely to continue smoking.

2. If your friend kicks the habit, it's about 36 percent less likely that you'll be smoking.

3. When a sibling gives up cigarettes, your risk of smoking decreases by 25 percent.

4. It drops by 34 percent if a co-worker in a small office quits smoking. It's sort of like watching dominoes. If one falls, it very quickly causes others to fall.

People are not quitting on their own; they're quitting in droves.

We should treat people in groups, rather than as individuals. Friends and family need to be involved. If you want to quit, try to get close friends and family to quit as well.

Quitting smoking may have the side benefit of improving social well-being, just as it improves physical health.

 
    Readers Responses

"Message to AMIRKHAN - READ AND SHARE ALL MEDICOS N DOCTORS.

Dear Mr. Amir Khan, “NOT ALL DOCTORS ARE GREEDY” “THERE IS NO PROFESSION THAT IS ABSOLUTELY CLEAN” “DOCTORS ARE OBLIGED TO SERVE BY CHOICE, NOT BY COMPULSION”

Sir, I have been a big fan or your work, life and principles. I am also a fan of ‘Satyamev Jayate’. But I was shocked to see the episode on 27th May, 2012. You are an Icon. You should have thought well and done your homework before doing such a biased show. There are only two people in the film industry who are being taken seriously by the thinking class of society, You and Amitabh Bacchhan. So, when you give such a biased and one sided version of a story, it hurts. Speaking about such a thing on a “commercial” TV show is bad. (I am sure you have taken a big amount, only doctor are supposed to do charity and social work, not actors!!! Right!) I want to highlight few important points here. And yes I am qualified to make observations as I am a medical student. 1. Your guests and audience (the words were almost put in their mouth) said that private colleges charge a capitation fee of 40 – 50 Lakhs for MBBS, you should have also produced some evidence of such practice. Like you call a victim in all your episodes, why not here? And do the same story on Engineering, Architecture, Law and MBA colleges, do you think they are clean? Why target doctors alone?
2. You said that since 2001, the government has opened 31 medical colleges and 106 private institutes were opened. Please note that today in India, there are a total of 181 Private and 152 Govt Medical colleges. So the number is not as bad as you projected. Don’t project only the time period which suits your story. Either give a complete picture or do not give a picture at all! And also, please find out how many of these private colleges are owned by politicians? 95% of Private colleges in India are owned and run by politicians. It is a bloody nexus between politicians and MCI. The corruption by politicians is to be blamed for the mess, not doctors!!!
3. One of your guests (Dr. Gulhati) said that doctors ask for 30% commission from Pharma companies to write their drugs. That is baseless, over-the-roof and sensationalizing the matter. That is as true as “Most Leading actors ask newcomers to sleep with them” or “Lawyers take money from both the sides in a legal battle” or “Most chartered accountants teach their clients how to save tax and also pass info to taxman on where his client saved tax”. I know all of you will shout “Where is the proof?”So are doctors!!! I am not trying to sensationalize things as you did on your show by shedding those fake tears, but just trying to project that allegations are easy to make. I know you will say that this was the opinion of our guest, and not yours. But you provided a platform for these fake allegations.
4. You compared the numbers of Licenses cancelled in England and in India. I must say your team is quite resourceful and please collect and compare following details also.
a. Number of doctors beaten on duty by goons from various political outfits in government hospitals in UK and India in last 10 years, and also the number of people convicted for such crime.
b. The Stipend (Salary a postgraduate trainee doctor/intern gets) or Salary and accommodation facilities provided to the doctors of the two countries.
c. The duty hours and working conditions of the doctors of the two countries.
d. The academic and research infrastructure being provided to the medical students.
5. You said that the most brilliant students who take up medicine, should take it only for service to mankind, they should go to other fields if they want to earn. Why? Are we living in imperialism? Are doctors not allowed to earn and spend a good life? You asked Dr. Devi Shetty whether he could do humanitarian work and also Earn at same time? This is like asking Amir Khan or Shahrukh Khan their income and generalizing it for every actor in the industry (Even junior artists). Sir, just as there are only few Khans and Kapoors, there are even fewer Devi Shettys and Naresh Trehans who run their chain of Multi-specialty hospitals spread all over the country. See what it takes to become a doctor and then give such “Geeta-Gyan”.
a. Five and half years of MBBS training and 1 more year of Compulsory Rural Internship at Rs. 15000 - 20000 per month. (Any other field e.g. Engineering, Management, a person would become Postgraduate in this much time and start earning double the amount.) If one doesn’t study further, the pay at this step is 22,000 per month.
b. After above 6 and half years of Graduation, 3 more years of Postgraduation, followed again by compulsory rural / Government job for 1 year or pay Rs. 25 Lakhs bond. If one doesn’t study further, the pay at this step is 40,000 per month.
c. After this above 10 and half years, 3 more years of Superspeciality, followed by 1 year of Govt job or a Bond of Rs. 2 Crores. And the seats are so few with tough competition, there tends to be a gap of a year or two in preparing for various entrance exams.
6. Why only Doctors are being forced to work in rural and government hospitals after their study? Why only we should pay government if we don’t want to do it? The rural/Govt sector needs help of Engineers, Lawyers, Chartered Accountants and MBAs also. Why aren’t the Engineers sent to rural areas to design and monitor roads and industrials development? Why aren’t the Lawyers forced to work as Public prosecutors before they can join some big foreign corporate firm? Why aren’t the CAs asked to work in CAG office and various other government financial sectors before joining Multinational Giants? Now government wants that doctors should not immigrate to other countries without asking them. Why? Are the IIT/IIM students stopped before they flee to foreign countries for big fat salaries? So, why us? What is it that government of society has done for doctors that they should repay? They bloody can’t even protect them from goons while on duty.

7. You say that doctors are writing unnecessary and costly medications. Do we decide the price of a drug? Do we manufacture or give license to drug manufacturers? Controlling the price of essential drugs is a government job. We are helpless.

Sir, it’s easy to point fingers. We don’t say that all is well. But all is not well anywhere. It’s a different thing creating awareness about dowry or female feticide. But it’s entirely different to comment on such a technical and complicated issue without getting into the details of it.

You have maligned the entire medical fraternity. For every 10 doctors who are doing wrong, there are more than 1000 healers. You owe us an apology!!!
This issue is not as simple as you think it is! Please show stories which are unbiased and straight-forward.
You cannot do justice to such an issue, especially after charging a whooping amount for creating awareness!!! (We hear that Amir has charged 3 crores per episode of Satyamev Jayate in which he spreads the message to doctors that they should not make money and do social service!!! How sacred!!! I don’t know if its true, but well, it’s the season of allegations!)
“We Doctors may be doing little social service, but at least we are not charging for it!”

Dr Atul Agarwal

 
    Forthcoming Events
Dr K K Aggarwal

4th Asia Pacific Vascular Intervention Course (APVIC-IV)

Date: June 8-10-2012

THE OBEROI, Dr. Zakir Hussain Marg, New Delhi
In association with 'International Society of Endovascular Specialists' 'Vascular Society of India' 'Society of Cardiovascular Angiography & Interventions'

IYCNCON 2012

All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

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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    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