emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist 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

 

eMedinewS Presents Audio News of the Day

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  Editorial …

30th June 2011, Thursday

Can the fetus in the womb listen?

Amarnath Yatra starts from: 29th June to 13th August.

There is a lot of research in modern medicine, which suggests that we should name our child before he or she is born, talk to the baby and make the baby listen to the music. It is said that between 12–16 weeks the baby is ready to listen and respond to the external stimuli. This has led to the concept of ‘conscious pregnancy’ based on Abhimanyu concept.

It may be true in the West to look for western evidences and try to prove whether it is true or not, but as Indians we have enough Vedic evidence that it is true. There are three instances in Vedic literature I know of, that prove this. Vedic proof not only relates to the fact that the fetus can hear but even provides evidence that the fertilized egg too can hear.

As per the Vedic literature, the first evidence is the incidence of pigeon ova listening to Shiva in Amarnath cave, second is the birth of Sage Ashtavakra and the third is the birth of Abhimanyu in Mahabharata.

  • The birth of immortal pigeons: In the tale of Amarnath Cave, the cave was chosen by Shiva for narrating the secrets of immortality and creation of Universe to Parvati. To ensure that no living being could hear the Immortal Tale, he created Rudra named Kalagni and ordered him to spread fire to eliminate every living thing in and around the Holy Cave. Then, He started narrating the secret of immortality to Parvati. But by chance, one egg which was lying beneath the Deer skin remained protected. It is believed to be non living and more over it was protected by Shiva–Parvati Asana. The pair of pigeons which were born out of this egg became immortal having heard the secret of immortality (Amar Katha).
  • Birth of Sage Ashtavakra (Stories from Mahabharata): Long ago, there was a learned Rishi Uddalaka. One of his disciples Kahoda, pleased his Guru exceedingly with his devotion. So impressed was Uddalaka, that when Kahoda finished his studies, he married his daughter Sujata to him. Sujata became pregnant. She was in the habit of sitting near her father and husband while they were teaching. Her unborn child attained mastery over the Vedas by listening to his grandfather. Kahoda was not equally skilled as his Guru and made a number of mistakes while reciting the scriptures. Unable to bear these errors, the child started correcting them from his mother’s womb! Humiliated before his disciples, Kahoda cursed his son, saying, "As you insulted your father, may you be born with eight bends in your body!" Accordingly, the child was born with his body crooked in eight places, and was named Ashtavakra (one with eight deformations).
  • The birth of Abhimanyu: As an unborn child in his mother’s womb, Abhimanyu learned the knowledge of entering the deadly and virtually impenetrable Chakravyuha from Arjuna, his father. He overheard Arjuna talking about this with his wife Subhadra. Arjuna explains to Subhadra in detail, the technique of attacking and escaping from various vyuhas (an array of army formation) such as Makaravyuha, Kurmavyuha, Sarpavyuha etc. After explaining all the vyuhas, he explains about the technique of cracking Chakravyuha. Arjuna explains to her how to enter the Chakravyuha. When he was about to explain how to exit from the Chakravyuha, he realizes that Subhadra is asleep and stops expounding on the Chakravyuha further. As a result, the baby Abhimanyu in the womb did not get a chance to learn how to come out of it.
Dr KK Aggarwal
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    Changing Practice – Resource which has changed practice in last one year

Timing of treatment for relapsed ovarian cancer

For most women, second–line treatment for relapsed ovarian cancer be initiated at the time when signs or symptoms of a disease recurrence are detected, rather than on the basis of an asymptomatic elevation in the CA–125 level. However, this decision should be individualized and based upon an active discussion between physicians and patients of the risks and benefits of early versus delayed treatment.

 
  eMedinewS Audio PostCard

Padma Shri & Dr BC Roy National Awardee
Dr K K Aggarwal on

eMedinewS Medical News of the day

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS revisiting

A major attraction of 2nd eMedinewS revisiting was 'Early Bird' prizes. In the photo: Dr N Subramanium drawing out the name of the lucky winners

 
Dr K K Aggarwal
 
    National News

Mystery disease yet to be identified

PATNA: Ambiguity still prevails over the mystery disease which has claimed more than 50 lives of children in Muzaffarpur district. Though, encephalitis was supposed to be the disease, which has now taken an endemic form, preliminary reports of the National Institute of Virology (NIV), Pune, has cast doubts over it. Even the exact nature of virus has not been determined yet. The disease broke out on June 14 with doctors applying line of treatment based on the symptoms of the disease. Health secretary Sanjay Kumar said, "The report of NIV team, Pune, which was recently in the state to collect samples, confirms absence of three viruses tested for. The three viruses ruled out by the NIV, Pune, are: Japanese encephalitis virus, Chandipura virus and Nepah virus." He said that though it is certain that the children who have died so far had reported inflammation of brain, whether it is encephalitis or what are the exact causes of the disease, are yet to be ascertained. Till now, blood and cerebrospinal fluid tests have been carried out, Kumar said, adding the NIV, Pune, has now asked for brain tissue samples saying it would help to diagnose the disease in a better way. (Source: TOI, June 28, 2011)

Ranthambore to have biosphere reserve for tigers

About 11,500 squares kilometre area around the Ranthambore National Park would be made a biosphere reserve to accommodate the increasing number of tigers in this forest in Sawai Madhopur. This was announced by Union Environment and Forests Minister Jairam Ramesh on Friday after his meeting with Chief Minister Ashok Gehlot. Talking to the media, Ramesh said forest parts of Dhaulpur and Jhalawara would come under it and it would create kind of corridor between Ranthambore and these areas, to allow big cats to move around in bigger areas. He said that State Government has been asked to send the proposal for the clearance from his Ministry. Ramesh said that to save the reserve forests, the State Government would create eco–friendly zones around its 27 reserve forests that are facing the threat from illegal mining and mushrooming of hotels. He said a bypass road would be built, to divert the traffic from Sariska Tiger Reserve. The Centre would bear 50 per cent cost of this ‘20–crore project. Ramesh said that he would visit Jaisalmer to have a first–hand idea about having a cheetah reserve there and also re–demarcate the Desert Sanctuary. (Source: The Pioneer, June 24, 2011)

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

(Dr Monica and Brahm Vasudev)

Screen time driving youth obesity epidemic

Too much time parked in front of the television or computer screen is driving the epidemic of childhood obesity in the U.S., according to a new policy statement from the American Academy of Pediatrics. And it’s not just that many teens are couch potatoes, the academy argues in the July issue of Pediatrics: TV advertising drives sales of junk food, children and teens tend to snack while watching TV or online, and late–night use may interfere with sleep. (Source: Medpage Today)

ADA: Older diabetics better at keeping weight off

Weight loss among diabetic, overweight patients was most durable in those who lost more than 10% of their body weight in the first year and in those 65 and older, researchers said here. Compared with individuals who lost less than 5% of body weight in the first year of the trial, participants in the Look AHEAD (Action for Health in Diabetes) trial were nearly 10 times more likely to have maintained weight loss after four years (OR 9.8, 95% CI 6.99 to 13.74), said Donna Ryan, MD, of the Pennington Biomedical Research Center in Baton Rouge, La. "The strongest predictor of year four weight loss was year one weight loss," Ryan said at the annual meeting of the American Diabetes Association. (Source: Medpage Today)

Level of diastolic function predicts death

The presence of moderate or severe diastolic dysfunction in patients with preserved systolic function independently predicted mortality, a retrospective study determined. (Source: Medpage Today)

ADA: Type 2 diabetics can alter lifestyles

A short–term lifestyle modification program for overweight diabetic patients seen in clinical practice showed long–term benefits for many of the participants, researchers reported here. In a study conducted at the Joslin Clinic in Boston, patients who had a mean glycated hemoglobin (HbA1c) of 7.6% at baseline were able to lower the HbA1c to 6.6% (P<0.001) after 12 weeks of the intensive program and remained at 7% after three years, also a significant reduction from baseline (P<0.01). (Source: Medpage Today)

EUROPACE: Adding CRT to CABG boosts HF outcomes

Implanting a cardiac resynchronization therapy (CRT) device at the time of coronary artery bypass grafting in patients with ischemic heart failure improves outcomes over CABG alone, a small, randomized trial showed. The addition of CRT improved left ventricular systolic function, reduced signs of dyssynchrony, and ultimately reduced mortality through 18 months of follow–up (P<0.05 for all), according to Alexander Romanov, MD, of the Novosibirsk State Research Institute of Circulation Pathology in Russia. (Source: Medpage Today)

 
    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Why fasts, cleansing to start diets doom the results: brain chemistry works against weight loss

If you’ve been trying to lose weight and suspect your body’s working against you, you may be right, according to a University of Illinois study published in Obesity. "When obese persons reduce their food intake too drastically, their bodies appear to resist their weight loss efforts. They may have to work harder and go slower in order to outsmart their brain chemistry," said Gregory G. Freund, a professor in the U of I College of Medicine and a member of U of I’s Division of Nutritional Sciences. He particularly cautions against beginning a diet with a fast or cleansing day, which appears to trigger significant alterations in the immune system that work against weight loss. "Take smaller steps to start your weight loss and keep it going," he said.

In the study, the scientist compared the effects of a short–term fast on two groups of mice. For 12 weeks, one group consumed a low–fat diet (10 percent fat); the other group was fed a high–fat (60 percent fat) and had become obese. The mice were then fasted for 24 hours. In that time, the leaner mice lost 18 percent of their body weight compared to 5 percent for the obese mice. Freund said that there is an immune component to weight loss that has not been recognized. "Our data show that fasting induces an anti–inflammatory effect on a lean animal’s neuroimmune system, and that effect is inhibited by a high–fat diet. Some of the brain–based chemical changes that occur in a lean animal simply don’t occur in an obese animal," he said. This breakdown occurs because obese animals resist downregulation of genes that activate the interleukin–1 (IL–1) system and associated anti–inflammatory cytokines, he said.

The scientist also studied differences in the behavior of the two groups of mice, monitoring how much they moved, administering tests to discern the animals’ ability to learn and remember, and noting whether the mice exhibited signs of depression or anxiety. The results suggest that beginning a diet with a fast or near–fast may alter brain chemistry in a way that adversely affects mood and motivation, undermining the person’s weight–loss efforts. Beginning a weight–loss program in a depressed frame of mind and with decreased motivation doesn’t bode well for the diet’s success, he noted.

 
    Twitter of the Day

@DrKKAggarwal: Padma Shri Dr KK Aggarwal on Right communication at the right time saves … http://t.co/NpMM4NW via @youtube

@DeepakChopra:To shift your identity to your innermost being is to affirm your perfection

 
    Spiritual Update

Science behind Hanuman Chalisa

When a child is in the womb of the mother, his Soul software is downloaded from the mother and frequently uploaded/updated by the Spirit software.

 
    An Inspirational Story

(Ritu Sinha)

Live and work

Father was a hardworking man who delivered bread as a living to support his wife and three children. He spent all his evenings after work attending classes, hoping to improve himself so that he could one day find a better paying job. Except for Sundays, Father hardly ate a meal together with his family. He worked and studied very hard because he wanted to provide his family with the best money could buy.

Whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family. The day came when the examination results were announced. To his joy, Father passed, and with distinctions too! Soon after, he was offered a good job as a senior supervisor which paid handsomely. Like a dream come true, Father could now afford to provide his family with life’s little luxuries like nice clothing, fine food and vacation abroad.

However, the family still did not get to see father for most of the week. He continued to work very hard, hoping to be promoted to the position of manager. In fact, to make himself a worthily candidate for the promotion, he enrolled for another course in the Open University. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

Father’s hard work paid off and he was promoted. Jubilantly, he decided to hire a maid to relieve his wife from her domestic tasks. He also felt that their three–room flat was no longer big enough; it would be nice for his family to be able to enjoy the facilities and comfort of a condominium. Having experienced the rewards of his hard work many times before, Father resolved to further his studies and work at being promoted again. The family still did not get to see much of him. In fact, sometimes Father had to work on Sundays entertaining clients. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

As expected, Father’s hard work paid off again and he bought a beautiful condominium overlooking the coast of Singapore. On the first Sunday evening at their new home, Father declared to his family that he decided not to take anymore courses or pursue any more promotions. From then on he was going to devote more time to his family.

Father did not wake up the next day.

 
    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What are the physical manifestations of vitamin A deficiency?

Signs and symptoms of vitamin A deficiency include the following:

  1. Bitot spots–Areas of abnormal squamous cell proliferation and keratinization of the conjunctiva can be seen in young children with VAD.
  2. Blindness due to retinal injury: Vitamin A has a major role in phototransduction. The cone cells are responsible for the absorption of light and for color vision in bright light. The rod cells detect motion and are responsible for night vision. In the rod cells of the retina, all–trans–retinol is converted into 11–cis –retinol, which then combines with a membrane–bound protein called opsin to yield rhodopsin. A similar type of reaction occurs in the cone cells of the retina to produce iodopsin. The visual pigments absorb light at different wavelengths, according to the type of cone cell they occupy. VAD leads to a lack of visual pigments; this reduces the absorption of various wavelengths of light, resulting in blindness.
  3. Poor adaptation to darkness (nyctalopia)
  4. Dry skin
  5. Dry hair
  6. Pruritus
  7. Broken fingernails
  8. Keratomalacia
  9. Xerophthalmia
  10. Corneal perforation
  11. Follicular hyperkeratosis (phrynoderma) secondary to blockage of hair follicles with plugs of keratin.
  12. Other signs of VAD include excessive deposition of periosteal bone secondary to reduced osteoclastic activity, anemia, keratinization of mucous membranes, and impairment of the humoral and cell–mediated immune system.
 
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    Did You Know

(Dr Uday Kakroo)

The song, Auld Lang Syne, is sung at the stroke of midnight in almost every English–speaking country in the world to bring in the new year.

 
    Legal Question of the Day

(Dr MC Gupta, Advocate)

Q. I hold a permanent registration in Karnataka and have got PG seat in Gujarat. I have been asked to cancel the Karnataka registration and to get registered with the Gujarat Medical Council within 30 days. I have the following queries:

Ans. Firstly, I am very glad that you want to fight against injustice. The problem faced by you is faced by thousands of doctors every year but everybody takes it lying down. The MCI, the SMCs, the Universities and Medical Colleges and the IMA, all are aware of this injustice and suffering against doctors and are competent to take suo moto action and should do so but everybody prefers to sleep. I am glad you are awake.

Are the registration rules same for students planning to pursue PG course in a state different from their home state?

No.

What are the steps I can take to retain my Karnataka registration?

Nobody can take away your Karnataka registration. You should go to court immediately.

Which type of court I must file a case in?

An urgent writ petition in the Gujarat High Court.

Will I be permitted to join the course and attend classes etc., including practical/clinical work, during the pendency of the case?

Yes. You should move an urgent stay application against the order "to cancel the Karnataka registration and to get registered with the Gujarat Medical Council". Your prayer should include an interim prayer that you may be allowed to join the course like any other student during the pendency of the writ petition. There is no reason why the urgent stay application and the interim prayer should not be granted.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with suspected malaria was found to have low hemoglobin.
Dr. Bad: It cannot be malaria.
Dr. Good: It can be malaria.
Lesson: Low hemoglobin is seen in 41% of malaria. (Clin Infect Dis 1998;27:142)

Make Sure

Situation: A diabetic patient with blood pressure of 130/90 developed acute heart attack.
Reaction: Oh my God!: Why was his blood pressure was not kept below 120/80.
Lesson: Make sure that all patients with diabetes have a goal blood pressure of less than 120/80 mmHg.

 
  SMS of the Day

(Ritu Sinha)

Life is like a game of cards. The hand that is dealt you represents determinism; the way you play it is free will. Jawaharlal Nehru

 
  GP Pearls

(Dr Pawan Gupta)

The ACCORD trial and the VADT trial showed that intensive glucose control in type 2 diabetes is associated with higher mortality than is conventional glucose control. However, UKPDS 34 indicated that intensive treatment might significantly reduce cardiovascular events and mortality. The answer to the discrepancy between these results is the difference in the length of diabetic periods. Patients with history of more then 8 years should aim at A1c of 7.5% to 8.5%. (Lancet 2010;375:1433)

 
    Medicolegal Update

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

Why is sometimes poison not detected in chemical analysis by Forensic Lab?

In some cases no trace of poison is found on analysis although from other circumstantial evidence it is quite certain that poison was the cause of illness or death. The possible explanations of a negative finding are:

  • The poison may have been eliminated due to vomiting, stomach wash or diarrhea
  • The poison may have disappeared from the lungs by evaporation or oxidation
  • The poison after absorption could have been detoxified, conjugated and eliminated from the system.
  • Some drugs are rapidly metabolized, making extraction difficult.
  • Biological toxins and venoms, which may be protein in nature, cannot be separated from body tissues.
  • Some organic poison, especially alkaloids may deteriorate and cannot be detected due to oxidation during life, or due to faulty preservation, or a long interval of time, or from decomposition of the body,
  • If the poison acts slowly and death is delayed following production of irreversible organic changes, the poison may be completely metabolized and excreted.
  • Many drugs may be present in very small amounts and these may require considerable amount of viscera for their identification.
  • When the wrong or insufficient material sent for analysis.
 
  Vitamins—Open Secrets revealed

(Dr Jitendra Ingole, MD Internal Medicine)

How much vitamin C should you be taking each day?

Although RDA for vitamin C are pegged at 60mg per day, but increasing amount of research indicates that this amount may not be sufficient at all. The debate continues on required amount of Vitamin C, but on thing is clear—60mg per day may not be sufficient to maintain normal health. It might be sufficient enough to prevent scurvy, but increased amounts are required in significant quantities in infections, stress, surgery, and trauma.

Dosing schedule: Evidence points that taking any amount more than 250 to 500 mg Ascorbic acid at one time does NOT accomplish anything. The difference in blood saturation between a 500 mg and a 2,500 mg dosage of Vitamin C is hardly anything. Complete blood saturation occurs at 1000 mg daily in divided dosages (250mg 6 hrly). Excess amounts are excreted into the urine. In divided dosages, ascorbic acid achieves 100% utilization. Divided dosages ensure complete tissue saturation. Further, it is unlikely that the consumption of five servings of fruits and vegetables recommended daily will provide 200 to 300 mg of Vitamin C. Fruits and vegetables in commonly consumed quantities typically provide only 10 to 20 mg in one serving. (A point to consider here is: How many of us do really take 5 servings of fruits per day ?)

In conclusion: The best dosing schedule would be: Taking 250 mg of ascorbic acid four times a day will provide optimal levels of vitamin C throughout 24 hours and will ensure vitamin C level of approximately 60 to 70 µmol/L.

References

  1. Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415–23.
  2. Hampl JS, Taylor CA, Johnston CS. Low vitamin C intakes among American adults: who is at risk?
    J Am Diet Assoc 1999;99(suppl):A11.
 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Inorganic phosphorus

Hyperphosphatemia 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.

Hypophosphatemia can be seen in a variety of biochemical derangements, including acute alcohol intoxication, sepsis, hypokalemia, malabsorption syndromes, hyperinsulinism, hyperparathyroidism, and as result of drugs.

 
    Mind Teaser

Read this…………………

o2ne

Yesterday’s Mind Teaser: Preservation is:

1. Persistent and inappropriate repletion of the same thoughts.
2. When a patient feels very distressed about it.
3. Characteristic of schizophrenia.
4. Characteristic of obsessive compulsive disorder (OCD).

Answer for Yesterday’s Mind Teaser: 1. Persistent and inappropriate repletion of the same thoughts.

Correct answers received from: Dr Rakesh Bhasin, Dr K Raju, Dr Jainendra Upadhyay, Dr Neelam Nath.

Answer for 28th June Mind Teaser
: 1. Symptoms do not normally reflect understandable physiological or pathological mechanisms.
Correct answers received from: Dr U Gaur, Dr Anupam Sethi Malhotra, Dr Jainendra Upadhyay,
Dr Rakesh Bhasin, Dr (Maj. Gen.) Anil Bairaria, Dr Rashida Malek, Dr TH Saherwala, Dr Deepali Chatterjee, Dr KV Sarma, Dr Surendra Bahadur Mathur.

Send your answer to ijcp12@gmail.com

 
    Medi Finance Update

(Dr GM Singh)

Transfer Pricing

  • Standard deduction of variation of 5% on arm’s length price outdated. New variation to be notified. Applicable from AY 2012–13 onwards.
  • TPO to determine the arm’s length price of additional international transactions other than those referred by the AO.
  • Additional powers of survey conferred on the TPO. Applicable from 01.06.2011
  • Filing of Accountant’s Report in Form No. 3CEB extended to 30 November. (w.e.f 01.04.2011) Applicable to AY. 2011–12
 
    Laugh a While

(Dr GM Singh)

The bride, upon her engagement, went to her mother and said, "I’ve found a man just like father!" Mother replied, "So what do you want from me, sympathy?"

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Buserelin Acetate injection 1mg/ml (Additional Indication)
Indicated for the palliative (initial & maintenance treatment) of patients with hormone–dependent advanced carcinoma of the prostate gland (Stage D).
08.09.10
 
    IMSA Update

International Medical Science Academy (IMSA) Update

American Academy of Neurology: Mild dementia increases the likelihood, but does not establish, that a patient is an unsafe driver.

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Doctors must learn all aspects of spirituality

Spiritual, religious, and cultural beliefs and practices play a significant role in the lives of patients who are seriously ill and dying, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Doctors should be taught the importance of prayer, meditation and spiritual needs of the patients.

In addition to providing an ethical foundation for clinical decision making, spiritual and religious traditions provide a conceptual framework for understanding the human experience of death and dying, and the meaning of illness and suffering.

The importance of spiritual and religious beliefs in coping with illness, suffering, and dying is supported by clinical studies as well as individual narrative descriptions.

Most patients derive comfort from their religious and spiritual beliefs as they face the end of life, and some find reassurance through a belief in continued existence after physical death.

However, religious concerns can also be a source of pain and spiritual distress, for example, if a patient feels punished or abandoned by God.

A common goal for the dying patient, family members, and the health care professional is for a meaningful dying experience. Such an experience includes support for the patient’s suffering, the avoidance of undesired artificial prolongation of life, involvement of family and/or close friends, resolution of remaining life conflicts, and attention to spiritual issues that surround the meaning of illness and death.

Although doctors lack the expertise to address spiritual concerns in depth, they should be able to discuss spirituality with their patients and identify those in spiritual distress so that appropriate referral may be made to spiritual care providers. A spiritual history should be recorded as part of a new patient evaluation, and spiritual issues re–addressed periodically through the course of the illness.

For patients facing the end of life, spiritual care is interdisciplinary collaborative care, and requires the participation of all members of the healthcare team. Clinicians should clarify the patient’s concerns, beliefs, fears, and spiritual needs, and be sensitive to comments that may indicate spiritual distress. Active listening and supportive dialogue may help patients work through existential issues and find peace. Patients who are in spiritual distress should be referred to certified and trained spiritual care professionals such as chaplains, spiritual directors, pastors, counselors and clergy.

 
    Readers Responses
  1. Dear Dr Aggarwal, Your newsletter continues to be fascinating even to a non medical person. The addition of ‘apps’ is very innovative and also very useful. With best wishes, Yours sincerely: Er Anuj Sinha, Director, Vigyan Prasar.
 
    Forthcoming Events

National Conference on "Insight on Medico Legal Issues"
Date: Sunday, 10th July, 2011
Venue: Auditorium, Chinmaya Mission, 89, Lodhi Road, New Delhi–110003

eMedinewS and Heart Care Foundation of India are jointly organizing the first-ever National Conference on "Insight on Medico Legal Issues" to commemorate "Doctors’ Day".
The one–day conference will provide total insight into all the medicolegal and ethical issues concerning the practicing doctors. Both medical and legal experts will interact with the delegates on important issues.
You are requested to kindly register in advance as seats are limited. There will be no registration fee. You can register by sending your request at rekhapapola@gmail.com or at 9899974439.

For Programme
Details

Programme Schedule 10th July MEDICO LEGAL CONFERENCE
Time Session Chairperson Moderator Speaker Topic
8 Am -8:30 Am Ethical Issues in Medical Research   Dr KK Aggarwal
Dr Girish Tyagi
   
8 am -8.10 am       Ajay Agrawal Rights of a patient in medical trial
8.10 - 8.20 am       Dr Ranjit Roy Chaudhury Ethical Issues in a medical trial
8:20 -8.30 am       Priya Hingorani Statutory permits required for conducting trials
8.30 – 9.10 am Medical ethics and organ donations Dr N V Kamat Dr KK Aggarwal    
8.30 am-8.40 am       Dr Anoop Gupta Ethical issues in IVF practice
8.40 am-8.50 am       Dr N K Bhatia 100% voluntary blood donation
8.50 am-9.00am       Dr Rajesh Chawla Need for do not resuscitate laws in India
9.00 am-9.10 am       Dr Neelam Mohan Ethical issues in organ transplantation
9.10 am-9.30 am Handling cases of death Mr S K Saggar
Dr Arvind Chopra
Dr KK Aggarwal
Dr Girish Tyagi
   
9.10 am-9.20 am       Dr S C Tewari Spiritual considerations in a dying patient
9.20 am-9.30 am       Dr G.K. Sharma Medico legal and ethical issues in post mortem
9.30 am-9.50 am Medical Insurance Mr Vibhu Talwar
Dr H K Chopra
Dr Vinod Khetrapal
Dr KK Aggarwal    
9.30 am-9.40 am       Meenakshi Lekhi Engaging a lawyer
9.40 am-9.50 am       Maninder Acharya Understanding various court procedures
9.50 am-10.20 am How to handle medico legal cases? Dr Anil Goyal
Dr Rajiv Ahuja
Ajay Agrawal
Dr Girish Tyagi
   
9.50 am-10.00 am       Dr M C Gupta When to do the MLC?
10.00 am-10.10 am       Dr Sudhir Gupta Checklist of MLC case
10.10 am –10.20 am       Siddarth Luthra Medico legal record keeping
10.20-10.50 am Medical Consent Dr Vinay Aggarwal
Dr P K Dave
Dr KK Aggarwal
Dr Girish Tyagi
   
10.20 am-10.30 am       Indu Malhotra Types of consent
10.30 am-10.40 am       Dr Manoj Singh Ideal consent
10.40 am-10.50 am       Dr N P Singh Extended consent
10.50 am-11.20 am Fallacies in acts applicable to medical profession Dr Anup Sarya
Dr Sanjiv Malik
     
10.50 am-11.00 am       Dr Kaberi Banerjee MTP, PNDT Act
11.00 am-11.10 am       Dr Anupam Sibbal Organ Transplant Act
11.10 am to 12.00 noon Inauguration Justice A K Sikrai
Justice Vipin Sanghi
Dr A K Agarwal
     
12.00 noon – 1.00 PM Professional misconduct and professional ethics Dr A K Agarwal
Dr. D S Rana
Dr H S Rissam
Dr KK Aggarwal
Dr Girish Tyagi
   
12.00 -12.10 pm       Dr Sanjiv Malik Doctor-pharma relationship
12.10 pm-12.20 pm       Dr M C Gupta Advertisement and medical practice
12.20 pm –12.30 pm       Dr Navin Dang Rights of a patient
12.30 pm-12.40 pm       Dr Ajay Gambhir Rights of a doctor
12.40 pm- 12.50 pm       Dr Ashok Seth Kickbacks, touts and commercialization in medical practice
1.00 pm to 2.00 pm When it is not a negligence? Dr Prem Kakkar
Dr S K Sama
Dr O P Kalra
Dr KK Aggarwal
Dr Girish Tyagi
  Complaints of a doctor against doctor
1.00 pm-1.10 pm       Dr Girish Tyagi What is medical negligence?
1.10 pm – 1.20 pm       Dr Vijay Aggarwal Medical accidents
1.20 pm – 1.30 pm       Mukul Rohatgi Professional Misconduct
1.30 pm- 1.40 pm       Dr K K Aggarwal How to defend a complaint?

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September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com

………………………………………………………………

Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at
medifilmfestinhealthmela@gmail.com

………………………………………………………………

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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta