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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

30th September 2012, Sunday

HC Relief For Doctors Using USG Machines

The Bombay high court has allowed portable ultrasonography machines to be taken to patients’ home for any purpose other than sex determination. However, this will be subject to installation of the silent observer (SIOB), a device which monitors scans done by USG machines, reports Times of India.

A division bench of Chief Justice Mohit Shah and Justice Nitin Jamdar was hearing a petition filed by three Mumbai–based cardiologists and an anaesthetist challenging the BMC's order restraining them from taking the machines outside the clinics/hospitals, where the machines are registered.

Their petition said Pre–conception and Pre-natal Diagnostic Techniques Act (PCPNDT) relates to restrictions on genetic clinics/institutions and doctors who deal with sex determination. Also, the Act and all government orders should be restricted to doctors operating within that field only. "You cannot have a statute dealing with genetics applying to doctors dealing with cardiology or anaesthesia or anything other than genetics," argued their counsel J P Cama.

He said other forms of medicines like cardiology, anaesthesia and vascular surgery also require the portable machines. "Any restriction you impose must be upon those doctors who deal with sex determination.

You cannot expect a cardiology patient to go to a clinic or hospital in emergency," said Cama. The judges asked what is the guarantee that the machine will not be misused.

"How do we ensure you will not misuse it?" asked Justice Shah. Allaying the court’s apprehension, Cama said his clients are willing to have the SIOB installed in their machines and have it certified by BMC medical officer. "It (SIOB) will guard against its misuse," said Cama.

The judges, in their order, said the doctors can take their machines out of the clinics/hospitals where such machines are registered subject to installation of a SIOB and verification by the chief medical officer of BMC.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What is the role of bulk laxatives in constipation?

Bulk forming laxatives primarily exert their laxative effect by absorbing water and increasing fecal mass and accelerating bowel transit. Psyllium seed, methylcellulose, calcium polycarbophil and wheat dextran are examples of bulk laxatives.

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

A soda a day raises heart disease risk by 20%

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Health, Hygiene and Happiness

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal gave a lecture on Health, Hygiene and Happiness at National Science Centre on 29th September 2012 to earmark World Heart Day.

 
Dr K K Aggarwal
    National News

Nod to new 3.5 yr course for village health officers

New Delhi, Sep 26 (PTI) In a bid to meet shortage of doctors in rural India, the Health Ministry today approved a new 3.5 year course to create a cadre of community health officers for delivering basic medicare services in villages. Christened as "BSc in Community Health", the course would be imparted through Medical Council of India (MCI) recognised rural health schools to be set up in villages in conjunction with district hospitals.

For comments and archives

Around 95% of Indians with epilepsy don't get treatment: Study

NEW DELHI: Nearly 95% people with epilepsy in India don't receive any treatment. Anti-epileptic drugs aren't available to almost 50% patients in the public sector with less than 40% actually receiving generic medicines instead of the expensive branded ones. Neurocysticercosis (parasitic disease of the nervous system) is responsible for about 30% of seizure disorders in the Indian subcontinent. Epilepsy is often associated with substantial stigma, with most people with epilepsy less likely to be sent to school, find employment or marry. Around 14 people per 1,000 population (median lifetime prevalence) are expected to suffer from epilepsy in countries like India with higher estimates in children and young adults, and in rural areas.These are the findings of a study by University of Oxford and published in the British medical journal The Lancet on Friday. More than 85% of the global burden of epilepsy occurs in low-income countries including India. The World Health Organization says epilepsy accounted for about 0.5% of the global burden of disease or more than 7 million disability-adjusted life-years. Head injury is a common cause of epilepsy worldwide. The Lancet said epilepsy needed to be brought into the agenda of non-communicable diseases. It was not mentioned in the UN General Assembly meeting in New York to address the global burden of non-communicable diseases, and yet it represents a substantial burden of ill health. (Source: TOI, Sep 28, 2012)

For comments and archives

My Profession My Concern

Include this in your practice

Monitoring liver function tests for statin therapy

Check baseline SGOT and SGPT levels prior to initiating statin therapy. Routine monitoring of these levels is not necessary for patients on statins. In 2012, the FDA revised its labeling information on statins to only recommend liver function testing prior to initiation of statin therapy and to only repeat such testing for clinical indications.

Source: http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Valvular Heart Disease Update

Should one go for annual echo after valve replacement?

In asymptomatic patients without evidence of left ventricular or valve dysfunction, routine annual echocardiography is not indicated in patients with mechanical valves or during the first five years with bioprosthetic valves. Repeat evaluation with echocardiography should be performed any time there is a change in clinical status.

(Experts: Dr Ganesh K Mani, Dr. Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Thyroxine therapy improves QoL in subclinical hypothyroidism

Thyroxine therapy significantly improves quality of life in patients with subclinical hypothyroidism (SCH), researchers have shown. (Source: Medscape)

For comments and archives

Unlike SARS, new virus doesn't transmit easily, WHO says

A novel coronavirus -- a member of the same family as the pathogen that caused SARS -- does not appear to pass easily among people, according to the World Health Organization. "From the information available thus far," the agency said in a statement, "it appears that the novel coronavirus cannot be easily transmitted from person-to-person." (Source: Medpage Today)

For comments and archives

Humira gets OK for ulcerative colitis

Adalimumab (Humira) has been approved to treat moderate to severe ulcerative colitis in adults who don't respond to corticosteroids or immunosuppressive drugs, the FDA announced Friday. (Source: Medpage Today)

For comments and archives

Eating cherries may cut gout attacks

Patients with gout sharply decreased their risk for painful disease attacks by including cherries in their diet, a large observational study found. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: 5% High Risk Patients Get Heart Attacks During Perioperative Periodhttp://blog.kkaggarwal.com/2012/09/5–high–risk–patients–get–heart–attacks–
during–perioperative–period/

@DeepakChopra: The best use of imagination is creativity. The worst use of imagination is anxiety

 
    Spiritual Update

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

Always respect viewpoints of others

There is an old saying that one is proud of his or her own intelligence and somebody else’s partner and wealth. Most disputes occur when there is an ego clash and that occurs when you want your point to be noticed by everybody. But remember that for every situation, invariably, there will be multiple opinions.

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Does obesity affect the chances of getting pregnant with treatment and having a healthy baby?

There is an increasing amount of evidence that many complications of pregnancy for the mother (gestational diabetes, preeclampsia,) and her baby (birth defects) are increased iIn obese women. In addition, obese women have an increased chance of a cesarean section for delivery.

For comments and archives

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

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

Socially the inadequate awareness amongst general population regarding blood donation is responsible in making this commodity very scarce. Due to the paucity of funds, adequate amounts of educative programs for promoting voluntary blood donations are not available. Thus, it becomes difficult to reach the masses to motivate them to come forward for blood donation.

A greater stress has been laid on voluntary (non-remunerated) blood donation since the hazards of commercial blood have resulted in endangering the life of the recipient from dreadful diseases like hepatitis and AlDS.

The major aim of blood transfusion has been to make transfusion safe and beneficial. The other aims of improvement in blood have been prolongation of the shelf life of blood, its optimum utilization and development of synthetic substances to supplement the human source. Through better understanding of red cell metabolism, the red cell preservatives now improvised, can preserve the red cells for transfusion unto 49 days as against 21 days earlier.

For comments and archives

 
    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

Multiple vs solitary liver abscess- clinical significance

  • Multiple – 20 – 25 % of all cases
  • Mostly pyogenic
  • Majority (2/3rd of multiple pyogenic liver abscesses) are confined to theright side of liver
  • Mortality may be almost twice that in solitary cases
  • Multiple amebic liver abscesses have more complications and mortality.

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

Temper Control

There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the fence.

The first day the boy had driven 37 nails into the fence. Over the next few weeks as he learned to control his anger, the number of nails hammered daily, gradually dwindled down. He discovered it was easier to hold his temper than to drive those nails into the fence. Finally the day came when the boy didn’t lose his temper at all. He told his father about it and the father suggested that the boy now pull out one nail for each day that he was able to hold his temper.

The days passed and the young boy was finally able to tell his father that all the nails were gone. The father took his son by the hand and led him to the fence. He said "you have done well, my son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar just like this one."

You can put a knife in a man and draw it out. It won’t matter how many times you say I’m sorry, the wound is still there.

Make sure you control your temper the next time you are tempted to say something you will regret later.

For comments and archives

 
    Cardiology eMedinewS

Success seen for TPA in carotid artery stroke Read More

100 Million will die by 2030 if world fails to tackle climate change: Report Read More

 
    Pediatric eMedinewS

Respiratory viruses differ in inner–city, suburban infants Read More

Low IQ not always inherited Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found to have high ESR and elevated CRP.
Dr Bad: You are suffering from an inflammatory disease.
Dr Good: It may be a part of diabetes.
Lesson: In diabetes, both ESR and CRP can be high at the same time and this can be due to IL–6 secretion by adipose tissue.

For comments and archives

Make Sure

Situation: A patient on dialysis and on oral antacid developed aluminium toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminium toxicity in patients undergoing dialysis.

For comments and archives

 
    Quote of the Day (Dr GM Singh)

If you have controlled your mind you are the conqueror of the whole world. Swami Sivananda

 
    Legal Question of the Day (Dr M C Gupta)

Q. My friends say that their PG degree is recognized by the state medical council but not by the MCI. How is this possible when a State Medical Council is a part of the MCI?

Ans.

  • What your friends say is wrong. It is not within the power of a State Medical Council to recognize or not recognize a medical degree. Recognition is granted by the MCI.
  • There was an anomaly that a few Diplomas, such as those in Orthopedics and Radiology, granted by the College of Physicians and Surgeons, Mumbai, were recognized by the Maharashtra Medical Council but not by the MCI. I understand that this anomaly has been removed now.
  • State Medical Councils are not a part of the MCI. Each medical council is established under a separate law.
  • I think it would be a good idea to scrap the State Medical Council laws and to modify the MCI Act, 1956, to provide for a unified set up of central and state councils.
 
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

T3 uptake

It measures the amount of thyroxine–binding globulin (TBG) in the patient’s serum. When TBG is increased, T3 uptake is decreased, and vice versa. T3 uptake does not measure the level of T3 or T4 in serum.

  • Increased T3 uptake (decreased TBG) in euthyroid patients is seen in chronic liver disease, protein–losing states, and with use of the following drugs: Androgens, barbiturates, bishydroxycoumarin, chlorpropamide, corticosteroids, danazol, d–thyroxine, penicillin, phenylbutazone, valproic acid, and androgens. It is also seen in hyperthyroidism.
  • Decreased T3 uptake (increased TBG) may occur due to the effects of exogenous estrogens (including oral contraceptives), pregnancy, acute hepatitis, and in genetically–determined elevations of TBG. Drugs that increase TBG include clofibrate, lithium, methimazole, phenothiazines and propylthiouracil. It may also occur in hypothyroidism.
 
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   Rabies Update (Dr. A. K. Gupta, Author of "RABIES – the worst death")

Does treatment of provoked bites differ from unprovoked bites?

Provocation is subjective and relative and specific to each dog/cat. However, obvious gross provocation viz., stamping, hitting, chasing, etc possibly suggest that the animal may not be rabid. However, the wound treatment of animal bites is the same.

 
   Fitness Update (Rajat Bhatnagar, MonaVie, www.mymonavie.com/sonraj)

Physical activity improves symptoms in people with irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a condition characterized by abdominal pain, cramping, and other symptoms. The causes of IBS are mainly unknown, and lifestyle change is the primary strategy for treatment. Last year, research published in the American Journal of Gastroenterology looked at the role of physical activity on improving symptoms in people with IBS. The study found that people who exercised were less likely to experience increased severity of IBS symptoms compared to their less active peers. The authors concluded that exercise can decrease IBS symptoms and should be included in the treatment protocol by physicians.

 
    Mind Teaser

Read this…………………

Either weigh or whey

Yesterday’s Mind Teaser: somewhere rainbow

Answer for Yesterday’s Mind Teaser: Somewhere over the rainbow.

Correct answers received from: Dr. P. C. Das, Kanta Jain, Dr. Thakor Hitendrsinh G, Dr.K.Raju, Dr.Chandresh Jardosh, Dr.K.V.Sarma,

Answer for 28th September Mind Teaser: B. "As one ages, visual changes are noted as part of degenerative changes. This is normal."
Correct answers received from: Dr. P. C. Das, Kanta Jain, Dr. Thakor Hitendrsinh G, Dr.K.Raju, Dr.Chandresh Jardosh, Dr.K.V.Sarma,

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr GM Singh)

Mum: If you wash your face, Sammy, you can have one slice of chocolate cake. But if you wash your neck, too, you can have two slices.
Sammy: What if I have a bath?

 
    Medicolegal Update

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

What was counter affidavit of Dean, KEM Hospital in Aruna Shaunbag case?

  • Aruna accepts the food in normal course and responds by facial expressions. She responds to commands intermittently by making sounds. She makes sounds when she has to pass stool and urine, which the nursing staff identifies and attends to by leading her to the toilet.
  • Thus, there was some variance between the allegations in the writ petition and the counter affidavit of KEM Hospital. Supreme Court, by order dated 24 January, 2011 appointed a team of three very distinguished doctors of Mumbai to examine Aruna thoroughly and submit a report about her physical and mental condition.
  • The committee after thorough examination gave the opinion that she has evidence of intact auditory, visual, somatic and motor primary neural pathways. However, no definitive evidence for awareness of auditory, visual, somatic and motor stimuli was observed during our examinations.
  • On perusal of the report of the committee of three doctors the honorable SC noted that there are many technical terms which have been used therein which a non–medical man would find it difficult to understand. We, therefore, request the doctors to submit a supplementary report by the next date of hearing in which the meaning of these technical terms in the report is also explained.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Blood sugar goals

Correction and prevention of low blood sugar is beneficial to hospitalized patients, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

For most non–critically ill hospitalized patients with diabetes, one should have a target blood sugar of <180 mg/dL. In non–critically ill hospitalized patients, lower blood glucose levels may decrease the risk of poor clinical outcomes, but also increase the risk of hypoglycemia. A reasonable sugar goal to avoid low blood sugar is to achieve fasting blood glucose concentrations not less than 90 to 100 mg/dL.

Preventing a Peptic Ulcer

An ulcer is a breakdown in the lining of the stomach or the first part of the small intestine. A type of bacterial infection is the most frequent cause, but lifestyle factors may also raise the risk said Dr Aggarwal.

One may follow these preventive steps that may ward off a peptic ulcer:

  1. Limit alcohol to no more than two drinks daily.
  2. Stop smoking or chewing tobacco.
  3. If you need to take painkillers, avoid anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen or aspirin.
  4. Consider, with your doctor’s approval, paracetamol instead.
 
    Readers Responses
  1. Dear Sir, Emedinews is good source of information. Regards:Dr Samarth
 
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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