October 30   2015, Friday
Dr KK AggarwalDr KK Aggarwal
National medical associations to focus on Vitamin D deficiency and its prevention

Vitamin D deficiency is highly prevalent in India. The reasons for this widespread deficiency include a predominantly vegetarian diet, sedentary lifestyle characterized by long hours spent in indoor spaces, sun-shy behavior of individuals and over-dependence on technology as modes of recreation and entertainment. Majority of the population remains unaware that it is in fact Vitamin D deficiency which is the cause of their vague aches and pains and long-term deterioration of over-all health and well-being.

Seeing the current scenario, the WMA urged National medical associations to support continued research and education on the topic of vitamin D insufficiency during its recent General Assembly. The leaders were of the opinion that vitamin D deficiency is not a country-centric issue, but has global significance given a series of studies that show that deficiency of vitamin D deficiency can also be linked to impaired growth and development of diseases such as osteoporosis, type 2 diabetes, cardiovascular ailments, cancer, among several others.

Adopting preventive actions in high-risk populations at risk may help to control the rising prevalence of vitamin D deficiency that should include large scale awareness campaigns of both doctors and patients. These preventive actions are particularly important in high risk groups - young children, the elderly and pregnant women. In many cases, sun exposure is generally not recommended because it can increase the risk of skin cancer.

World Medical Association recommends the following for all national medical associations:

• Support continued research in vitamin D and its metabolites

• Invest in educating physicians about innovations in vitamin D and its impact on an individual’s health

• Encourage physicians to consider measuring the serum levels of 25-hydroxyvitamin D in patients at risk of vitamin D deficiency

• Monitor development of dietary recommendations for vitamin D
Breaking news
New guideline stresses ultrasound for JIA imaging

The European League against Rheumatism (EULAR)-Pediatric Rheumatology European Society (PReS) task force has produced nine "points to consider" when using imaging for the diagnosis and management of juvenile idiopathic arthritis (JIA) based on a systematic literature review. The guidelines are published in the Annals of the Rheumatic Diseases. (Medscape)

Point one: Ultrasound and magnetic resonance imaging (MRI) are better than clinical exams, and clinicians should consider using both types of imaging in making evaluations.

Point two: Conventional x-ray, MRI, and/or ultrasound may be used to resolve diagnostic doubt after clinical exams.

Point three: Conventional x-rays are usually adequate for assessing joint damage when that is required, but ultrasound or MRI may detect such damage earlier in the disease process.

Point four: In certain situations, such as evaluating possible inflammation of the temporomandibular joint (TMJ) and axial involvement, imaging may be more helpful than clinical exams.

Point five: Imaging may aid in JIA prognosis.

Point six: Ultrasound and MRI are usually more sensitive than clinical exams in monitoring JIA disease activity; in axial disease and TMJ involvement, MRI should be considered.

Point seven: Clinicians should consider evaluating joint damage on a regular schedule, though the particular imaging method may depend on the particular joints of interest.

Point eight: Ultrasound can accurately guide placement of intra-articular injections.

Point nine: When JIA is clinically inactive, MRI and ultrasound may detect inflammation and this can inform subsequent monitoring.
Dr Good Dr Bad
Specialty Updates
• The incidence of metastatic prostate cancer fell by approximately 50% within 7 years of the start of widespread PSA use in 1990 as reported in the New England Journal of Medicine. For individuals aged 40 years and older, the median age at diagnosis has fallen from 71.8 years to 69.8 years for advanced prostate cancer, a difference of 2 years.

• A new position statement from the Consortium of Multiple Sclerosis Centers (CMSC) concludes that prescribers should be the ones to decide on the best treatment for each individual patient with multiple sclerosis (MS).

• Sex differences exist in effectiveness, dose use, and safety for the novel oral anticoagulant (NOAC) dabigatran (Pradaxa, Boehringer Ingelheim) for patients with atrial fibrillation (AF), suggests a study published online October 27, 2015 in Circulation: Cardiovascular Quality and Outcomes.

• A repetitive "habit cough" (HC) with no organic cause can be remedied in most children with simple behavioral therapy, according to research published online October 16 in the Journal of Allergy and Clinical Immunology. The clinical criteria of HC consist of repetitive coughing up to several times per minute for extended periods, and even all day, and a total absence of coughing during sleep.

• Despite the number of diets that purport to help people with irritable bowel syndrome, rigorous evidence supporting their use is lacking, experts said here at the American College of Gastroenterology 2015 Annual Meeting.

• A body mass index (BMI) of less than 28 alone may be a tool to prescreen younger postmenopausal women for osteoporosis, reports a study published in Maturitas.

• A study in Gut says that sessile serrated adenomas (SSAs) without dysplasia have a lengthy mean dwell time of 17 years before becoming dysplastic and then rapidly converting to carcinoma. SSAs, prototype polyps of the serrated neoplasia pathway, are precursors to roughly 15% of colorectal cancers, but those with dysplasia or carcinoma, predominantly small flat polyps less than 10 mm in size in the proximal colon, are rarely observed.

• Months after surviving a harrowing battle with Ebola virus infection, most patients still report various disease-related complaints, often including eye diseases such as uveitis, researchers reported at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH).

• Dr. Enkelejda Kasneci of the University of Tübingen in Germany and colleagues report in the journal Optometry and Vision Science that some people who have vision field loss in both eyes due to glaucoma can pass a standard driving test by increasing their visual scanning - mostly by moving the head and eyes more frequently - to compensate for loss of visual field due to glaucoma.

• The American Academy of Pediatrics (AAP) has published new guidelines to improve safety for youths who play football in view of the ongoing concerns about the injuries sustained by young football players and how these may impact long-term health. These guidelines are published in the journal Pediatrics.
The Vedic meaning of Mahamritunjaya Mantra and the Gayatri Mantra
Any activity should always engage the 3 H model of Heart, the Head and the Hand. The same has been advocated by the western scholars of today. This means that when doing any work, ask the head for choices, then refer these choices to the heart to choose one and finally order the hands to carry out that action.

In his book ‘The Seven Spiritual Laws of Success’, Deepak Chopra also writes that conscious–based decisions are the best decisions. Before taking any decision he recommends asking the body for the signals of comfort or discomfort and if the signals of discomfort are perceived, then one should not carry out that action.

All the above concepts come from our ancient Vedic knowledge. The two main mantras of our times are the Mahamritunjaya Mantra and the Gayatri Mantra.

The Mahamritunjaya Mantra is from the Rig Veda and needs initiation for attaining any Siddhi. This is the greatest reliever from all evils and reads as under: Aum Trayambakam Yajamahe, Sugandham Pushtivardhanam; Urva Rukamiva Bandhanan, Mrityor Mokshiye Mamritat. It means we worship Shiva – The Three–Eyed Lord; who is fragrant and nourishes all beings; May he protect us (bandhanan) from all big (urva) diseases (aarookam). May he liberate us (mokshiye) from death (mrityor), For the sake of immortality (mamritat, amrit); as the cucumber is automatically liberated, from its bondage from the creeper when it fully ripens.

The meaning of the mantra is the importance of the third eye and the benefits of its opening. The two eyes are at the level of the physical body. The third eye means the eyes of the mind and the eyes of the soul. It also indicates that in difficulty one should look inward from the eyes of the mind and ask for the choices. Like the cucumber, one should chose the good ones and drop the bad choices.

The mantra for the conscious–based decision comes from Gayatri mantra: Om Bhur Bhuvaha Suvaha Thath Savithur Varenyam Bhargo Devasya Dheemahi Dhiyo Yonaha Prachodayath. It means we meditate on the glory of the Creator; who has created the Universe; who is worthy of Worship; who is the embodiment of Knowledge and Light; who is the remover of all Sin and Ignorance; may He enlighten our Intellect. The Gayatri mantra talks about the importance of conscious–based decisions and its directions to the intellect to choose the right and not the convenient actions.

The Gayatri mantra is the Vedic prayer to illuminate the intellect. Gayatri is considered as Vedasara –– "the essence of the Vedas." Veda means knowledge, and this prayer fosters and sharpens the knowledge–yielding faculty. As a matter of fact, the four mahavakyas or ‘core–declarations’ enshrined in the four Vedas are implied in this Gayatri mantra.

Choosing the right decision from the consciousness was later defined by Buddha. He taught that before any action ask yourself the following four questions and if the answer to any of the question is no, not to indulge in that actions. These four questions are: Is it the truth, is it necessary, will the actions bring happiness to you and to the others.
The Proposed ART Regulation Bill

ART Bill

The spirit of the ART bill is against the nation and medical fraternity. On one hand the Prime Minister is promoting Make in India, on the other hand the same Govt is against surrogacy for Foreign couples.

If adoption can be allowed for foreign couples, why not surrogacy. If other medical treatments are allowed, why not surrogacy for couples, who have tried for years of assisted treatment and now surrogacy is the only way to attain genetic parenthood. This is discrimination.

There are other aspects of the bill too which are in poor spirit. Holding the doctor guilty till proven otherwise, is unheard of anywhere in the country and the world.

Our policy makers need to be answerable to the public, patients, doctors and surrogates before taking out such draconian legislation.

Dr Kaberi Banerjee
Medical Director, AFGC
Lajpat Nagar, New Delhi.
Padma Forum condoles the sad demise of Prof Ranjit Roy Chaudhury, the face behind clinical trial regulations
• Very sad, a true legend, a soft spoken giant, it was a privilege to know him. May his soul rest in peace. Dr AK Grover

• My heartfelt condolences… I pray his soul may rest in peace and for strength to family members to bear this loss. VS Mehta

• A big loss for the family and the country. I pray for his peace. Dr Kamal K Sethi

• My heartfelt condolences on the sad demise of a great soul. May his soul rest in peace. Ashok Rajgopal

• Very sad to know the demise of such a giant in the field of medicine. He will be remembered by his contribution. Our condolences to the bereaved family. RIP Professor Ranjit. Dr Narmada P Gupta

• A great man, a respected friend and a visionary and leader for all doctors. I am shocked at his sudden demise. My heartfelt condolences to all ‘near and dear ones’. While we are extremely saddened by his demise, his smiles and deeds will always be alive with us. May his noble soul rest in peace. Dr Ashok Seth.

• Condolences on the sad demise of Professor Ranjit Roy Chaudhary. He will be remembered as a great doyen of Pharmacology, with a social commitment. Balram Bhargava

• The sudden demise of Prof Ranjit Roy Chaudhury is a national loss and a big void for the medical fraternity. He was a symbol par excellence. May his noble soul rest in peace and God give strength to his family more particularly Mrs Chaudhury to bear this sudden loss. Dr GR Khatri

• Very sad to hear about the demise of a person who has shaped the course of so many policies and given new directions to the way we do clinical research in India. May God rest his noble soul in peace and give strength to the family in these difficult times. Ashok Vaid

• A great teacher and mentor. Always ready to help and guide. Heartfelt condolences to the family. May God grant strength to the family to bear this sudden loss. May his soul rest in peace. Prof KK Talwar

• Heartfelt condolences. RIP Prof Chaudhury. Dr AB Soin

• It is a very very sad news. The sudden and untimely death of Prof Ranjit Roy Chaudhary is a huge loss. Such a lively optimist, full of enthusiasm, never say die man. It was a pleasure to have worked together in MCI and several committees, including at ILBS. I would personally miss him a lot. Hope God blessed that soul and he rests in Heaven in peace and the family can bear the loss. Dr SK Sarin.

• I am extremely sad to learn about the sad demise of Prof Ranjit Roy Chaudhury who left for heavenly abode. I had few chances to meet with him. I very clearly remember meeting him in PGI Chandigarh when Prof KK Talwar was the Director there and I was highly impressed with his vision, forward thinking and selfless dedication. We pray to Almighty God to rest his soul in peace. Ashok K Hemal
Legal Quote
Dr. Suresh Gupta vs. Government of N.C.T. of Delhi and another AIR 2004 SC 4091 Appeal (crl.) 778 of 2004

“To convict, …, a doctor, the prosecution has to come out with a case of high degree of negligence on the part of the doctor. Mere lack of proper care, precaution and attention or inadvertence might create civil liability but not a criminal one. The courts have, therefore, always insisted in the case of alleged criminal offence against doctor causing death of his patient during treatment, that the act complained against the doctor must show negligence or rashness of such a higher degree as to indicate a mental state which can be described as totally apathetic towards the patient. Such gross negligence alone is punishable.”
Estate Planning: Partition

Partition is another tool of estate planning. Under this tool one can make partition of assets/properties or even income in a manner one wants his heirs to own or share. It is a good tool to avoid dispute among the family members and can be done during one’s lifetime as well as after death. It can either be mutual (amicable) or through a court. But taking it as a tool of estate planning, one should do it during lifetime after considering all factors and wishes.

(Source: IJCP)
Industry News
India beats China in investor safety: India is ranked eighth globally when it comes to protection of minority investors, ahead of many developed economies including the US, Germany and Japan. China is ranked much lower at 134th and India is ranked best among all BRICS countries (Brazil, Russia, India, China and South Africa). This is part of the latest “Doing Business 2016” report of the World Bank that covers 189 economies and where India’s overall ranking for ease of doing business has remained low at 130th position, despite an improvement since the last year. Singapore, New Zealand and Hong Kong are jointly at the first position. (Asian Age – PTI)

More and more Indian consumers using mobile apps to manage finances: A survey done by Amdocs revealed that Indian consumers are increasingly comfortable using mobile applications for managing their finances, and paying for utilities bills and household groceries. They are increasingly using social networking channels to buy products and services advertised on social networks, pay utility bills, and transfer money to friends and family. (Dqindia.com)

Startup India initiative: Prime Minister Narendra Modi's Startup India initiative is taking shape, with the help of inputs from such stars of the startup world as SoftBank President Nikesh Arora, Snapdeal Chief Executive Officer Kunal Bahl, Oyo Rooms founder Ritesh Agarwal and former Infosys director Mohandas Pai. A host of venture capital (VC) funds and angel investors have also come forth with their suggestions. A detailed policy to encourage startups is likely to be unveiled in December. (The Economic Times- Ruchika Chitravanshi)

Hay Group to nurture 100 Indian start-ups: Hay Group's NextBig100 program has selected 100 entrepreneurs to transform their startups into successful companies of the future. The selected startups include Competition Buzz, Zooter, Beatroot, Krave On, The Online Yogi, ShutterSteam, YouthConnect, PickMe, Floh and Travel Triangle, among others. (Business Standard- PTI)
Inspirational Story
Always grab the first opportunity

A young man wished to marry the farmer’s beautiful daughter. He went to the farmer to ask his permission. The farmer looked him over and said, "Son, go stand out in that field. I’m going to release three bulls, one at a time. If you can catch the tail of any one of the three bulls, you can marry my daughter." The young man stood in the pasture awaiting the first bull.

The barn door opened and out ran the biggest, meanest–looking bull he had ever seen. He decided that one of the next bulls had to be a better choice than this one, so he ran over to the side and let the bull pass through the pasture out the back gate. The barn door opened again. Unbelievable. He had never seen anything so big and fierce in his life. It stood pawing the ground, grunting, slinging slobber as it eyed him. Whatever the next bull was like, it had to be a better choice than this one. He ran to the fence and let the bull pass through the pasture, out the back gate.

The door opened a third time. A smile came across his face. This was the weakest, scrawniest little bull he had ever seen. This one was his bull. As the bull came running by, he positioned himself just right and jumped at just the exact moment. He grabbed… but the bull had no tail!

Life is full of opportunities. Some will be easy to take advantage of, some will be difficult. But once we let them pass (often in hopes of something better), those opportunities may never again be available.

So always grab the first opportunity.
Winter Asthma

Any breathlessness after the age of 40, appearing for the first time in winter, is cardiac asthma unless proved otherwise. Such patients should immediately have their blood pressure check-up done and if high needs immediate medical attention. First-onset breathlessness can also be an indication of angina or heart attack. However, the more common is winter asthma or acute exacerbation of winter COPD (chronic bronchitis). Asthma is reversible airway obstruction and COPD is irreversible airway obstruction. Sudden exposure to cold, humidity, pollution at lower levels in atmosphere can precipitate asthma in susceptible individuals. Winter is the time to increase the dose of asthma medicines.

If a person can speak a full sentence, the asthma attack is mild; if a person speaks broken sentences the asthma attack is moderate and if the person is able to speak only words then the asthma attack is severe. Severe attack of asthma needs immediate hospitalization.
A press conference was organized to announce the dates of the 22nd Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India. The Mela will take place from Nov 4-8, 2015 at the Talkatora Stadium in New Delhi
MTNL Perfect Health Mela 2015.

Pls click here for details
IMA Digital TV
An increase in which of the following parameters will shift the O2 dissociation curve to the left.

1. Temperature.
2. Partial pressure of CO2
3. 2,3 DPG concentration.
4. Oxygen affinity of hemoglobin.

Yesterday’s Mind Teaser: The parameters of sensitivity and specificity are used for assessing:

1. Criterion validity.
2. Construct validity.
3. Discriminant validity.
4. Content validity.

Answer for Yesterday’s Mind Teaser: 1. Criterion validity.

Answers received from: Dr Jainendra Upadhyay, Dr Poonam Chablani, Daivadheenam Jella, Raghavendra Chakurkar, Dr K Raju, Dr Avtar Krishan.

Answer for 28th October Mind Teaser: 4. X-ray diffraction.

Answers received from: Dr Poonam Chablani, Raghavendra Chakurkar.
The Leave Application

Another leave letter written to the headmaster: "As my headache is paining, please grant me leave for the day."
Defensive Medicine

Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital,
New Delhi

The rate of cesarean section deliveries is growing all over the country. Obstetricians are often accused of using cesarean section to increase their income. On the other hand, issues such as increasing maternal age, precious babies, mothers’ insistence, safety and ease, parents’ schedule preferences, and preferences for doctor’s and hospital’s office hour delivery all result in increasing operative deliveries. However all doctors believe that ‘natural is the way to go’ in pregnancy. Yet operative deliveries are undertaken to avoid the smallest risk to mother or child. What do you think?

a. Is caesarean section a part of defensive medicine?
b. Do you agree to cesarean section deliveries in general?
c. Can such sections lead to complications for the baby such as prematurity and therefore, should they be always avoided?
d. If no to cesarean section, then what is the alternative?
e. Should there be definite essential requirements for cesarean section?

Adapted and shortened from: UNESCO, 2011. Casebook on Human Dignity and Human Rights, Bioethics Core Curriculum Casebook Series, No. 1, UNESCO: Paris, 144 pp.

Do write in with views and your solutions!
Breaking news
Health ministry to upgrade manpower and drug testing infrastructure across country

The Union health ministry has recently recruited around 31 assistant drug inspectors at Central Drugs Standard Control Organisation (CDSCO) and sanctioned another 470 technical staff posts as a part of manpower upgradation programme. An amount of Rs. 1,750 crore has already been sanctioned for upgradation of manpower at the CDSCO and state level. As a part of the plan, drug testing infrastructure in the country will also be upgraded. According to a senior CDSCO official, “Around 80 drug inspectors were recruited at the CDSCO last year as a part of the process.” While State drug control departments have been allocated Rs. 850 crore, CDSCO has been allocated Rs. 900 crore for enhancing manpower and capacities of minilabs at port offices and mobile labs. A total of additional 1195 posts were sanctioned for the upgradation of manpower and labs under the 12th Five Year Plan, as per official sources…. (Healthtechnology.in)
Indian Medical Association National Satyagraha for a Healthy India
IMA Digital TV
IMA Satyagraha, suggested slogans
• Writing prescription drugs by a non-MBBS is injurious to health of the community.

• Writing prescription drugs by unqualified people can be dangerous.

• Allow doctors to treat patients irrespective of patients’ income.(If compensation is not capped, we can't do this)

• When there is capping of Rs 2 lakh for a sterilization death, why not for other procedures?

• When there is a compensation of Rs 30,000/- for a sterilization failure, why not for other procedures?

• Allow us to treat poor and rich equally.

• Non pelvic ultrasound providers should be out of PCPNDT Act.

• Unless caught doing sex determination, no criminal offence shall be registered.

• If any prospective parent asks for sex determination, they should be booked under a non bailable offense.

• More patients will die if doctors are not provided protection during duty hours.
• Death does not mean negligence.

• Money spent does not mean you will get a cure.

• Including single clinic and small establishments under Clinical Establishment Act will make treatment costly.

• How can we treat patients using outdated standard treatment guidelines made by government?

• How can government decide the charges of a clinical establishment?
Revoke Ban On Surrogacy For Foreigners

Dear Sir,

This is with reference to the announcement from the Indian Council of Medical Research (ICMR) that the government has decided to limit surrogacy to "Indian married couples only and not to foreigners" has now been put in place.

I strongly believe that putting a ban on surrogacy for foreign couples to have children through surrogate mothers in India is not a solution at all rather it contradicts with the existing laws under articles 14 and 21 of the Constitution, and directly curtails/interferes with “the right of reproductive autonomy” which is a facet of the “right of privacy” under article 21 of the Constitution. On one side, these childless couples will now be deprived from enjoying the joy of parenthood and on the other; the surrogates will not be empowered financially. Thus the decision would be seen as discriminatory for all the parties involved in the gestational surrogacy arrangements as there is no reasoning or justification of excluding foreigners for coming to India for surrogacy. Therefore, the right to bear a child or the right to become a parent by surrogacy cannot be curtailed by Government guidelines or an unjustified statutory enactment which has no nexus with the object sought to be achieved. The assisted reproductive technology (ART) centres offering, In-vitro fertilization and surrogacy services were surprised with the delivered mail from ICMR despite a deadline of November 14 for giving objections and suggestions to the proposed draft of the new Assisted Reproductive Technology (Regulation) Bill.

If we go back to a few years ago, clearly, there was initially no bar on surrogacy in India for foreign single persons or foreign unmarried couples till 2012, but now the proposed ART Bill, 2014, is a clear bar for foreign single persons and foreign unmarried couples to have the benefit of surrogacy in India. This is despite the fact that Section 41 of the Juvenile Justice (Care and Protection of Children) Act, 2000, permits intra and inter-country adoptions to a person irrespective of marital status subject to the approval by a competent court which may allow a child to be given in adoption.

When we talk about offering surrogacy, it gives genetic relationship with the biological parents. Prospective parents who could not otherwise have children have all the parental rights over the child born from an Indian surrogate mother. Therefore, we believe if an existing law made by the Parliament, children from India are permitted to be adopted by foreigners, irrespective of a couple or single adoptive parents, subject to checks, clearances, permissions and screening by a court, a similar logic must prevail for surrogacy as well.

I sincerely hope suggestions will be taken seriously taken into consideration by the Government of India, and there would be change in the approach in view of the current decision about putting a ban on surrogacy to foreigners.

Rita Bakshi
International Fertility Centre
Surrogacy facility only for Indians

The Centre on Wednesday told the Supreme Court that it was not in support of commercial surrogacy and that a new law would be enacted to allow only Indian couples to use the facility. The Centre stated that surrogacy to the needy infertile married Indian couples will be provided for altruistic purposes after examination of their cases by a competent authority. “The government does not support commercial surrogacy and scope is limited to Indian married infertile couples only,” the affidavit stated. The consultation process is on to finalise the Assisted Reproductive Techniques (Regulation) Bill, 2014 to make provisions containing the issue of surrogacy and rights of the surrogate mothers… (Deccan Herald)
Report of IMA National Health Scheme from January2015 to September 2015
The aim of starting the IMA National Health Scheme is to provide financial assistance to the scheme member and his/her spouse, child (ren) and parent(s) on the event of hospitalization, diagnosis and management of diseases

The Constitution & Byelaws were adopted on 27th December 2014 at the 75th Central Council of IMA at Ahmedabad, Gujarat. The Scheme started functioning from the month of January 2015. There was a positive response from the members and it was well accepted by the members.

IMA National Health Scheme report from January 2015 to August 2015 was presented before the 214th CWC meeting held at Hotel Uday Samundra Kovalam on 19th & 20th September 2015. The detailed report was given in the Agenda item No.B.23 page 142 and the accounts were presented in a power point presentation by the Scheme Treasurer Dr. Sunoj. He presented the details of the scheme and its benefits to the CWC members. Many members actively participated in the discussion. The accounts and report were passed on 19th September 2015 in the 214th Working committee.

Previous Report from January 2015 to August 2015 was presented on 12th April 2015 in the 213th CWC meeting at Hotel Radisson Blu, Dwarka, New Delhi. It is the first time that a CWC meeting was called within 100 days of the new team of IMA taking over; all the agenda papers prepared by the Honorary Secretary General. Congratulations! He included all the reports of the new wings of IMA started and were discussed threadbare.

IMA National Health Scheme report was given as agenda item No.B.27 on page 121 in the 213th CWC meeting at Hotel Radisson Blu, Dwarka, New Delhi – Detailed agenda papers presented before the CWC members. Reports and accounts were presented and passed on 12th April 2015 in the 213th CWC. Report and scheme byelaw, fee structure - age wise were passed. Cooperation of all the state branches is requested and Secretary presented a power point presentation before the 213th CWC and cleared all doubts of the members.

Many suggestions came up during the discussion and secretary promised that they would be considered without affecting the viability of scheme. All the features about the scheme is given in eMedinewS-eIMA News; there were lots of enquiries and many joined in the new scheme. So far 173 members have joined, especially of young age group. Along with National president, the Secretary visited different states and presented a power point presentation to the members of branches. As a Membership drive Secretary visited different branches – Dhule, Bombay and Nagpur. Many have expressed their eagerness and are making use of their desire to join.

Gujarat, especially Vadodara branch is helping the scheme in membership drive with the help of Dr Chetan Patel. Maximum registration is from Dhule branch of Maharashtra and Kerala. Hon. Secretary and finance officer Dr. Sunoj attended the President and Secretaries meet at Hotel Karl Residency, Bombay on 8th and 9th August 2015 and presented report of activities of National Health Scheme and Dr Sunoj presented a power point presentation about National Health Scheme and its benefit. I remember with gratitude Dr Ravi Wankedkar and Madam Ravi for their earnest efforts in the membership drive. Dr Chetan Patel state president of Gujarat has shown keen interest and gave many innovative suggestions.

I am indebted to our National President Dr A Marthanda Pillai for his long reaching vision to start the new scheme and ably supported by our Hon. Secretary General Dr KK Aggarwal in all aspects for the promotion of the scheme. State coordinators have to be nominated from state branches and request all other states which have not given the name of State coordinators to propose the name of state coordinators from their state New website for N.H.S is launched in the end of July 2015 as- www.imnhs.com. If you visit the website you can download the application form and also get all necessary details including Byelaw of the scheme.

I have to thank my Chairman Dr Asok Adhao, Vice chairman D. Jayaramdas, Joint Secretary Dr Pawan Gupta, Vigilance Officer Dr RN Tandon and finance officer Dr Sunoj for their support in performing my duties. State Coordinators - Dr Sasidharan Pillai of Kerala, Dr Chetan Patel from Gujarat, Dr Vijay Mali from Maharashtra and Dr CN Raja from Tamil Nadu also helped me a lot for enrolling members and I remember them with gratitude.


Dr. Alex Franklin
Hon Secretary National H.S
Two-thirds of population worldwide under 50 infected with HSV-1: WHO

More than 3.7 billion people under the age of 50 – or 67% of the population – are infected with herpes simplex virus type 1 (HSV-1), according to WHO’s first global estimates of HSV-1 infection published today in the journal PLOS ONE.
Herpes simplex virus is categorized into 2 types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both HSV-1 and HSV-2 are highly infectious and incurable. HSV-1 is primarily transmitted by oral-oral contact and in most cases causes orolabial herpes or “cold sores” around the mouth. HSV-2 is almost entirely sexually transmitted through skin-to-skin contact, causing genital herpes.

The new estimates highlight, however, that HSV-1 is also an important cause of genital herpes. Some 140 million people aged 15-49 years are infected with genital HSV-1 infection, primarily in the Americas, Europe and Western Pacific. Fewer people in high-income countries are becoming infected with HSV-1 as children, likely due to better hygiene and living conditions, and are instead at risk of contracting it genitally through oral sex after they become sexually active. “Access to education and information on both types of herpes and sexually transmitted infections is critical to protect young people’s health before they become sexually active,” says Dr Marleen Temmerman, Director of WHO’s Department of Reproductive Health and Research... (WHO)
Global temperatures to increase by 3 degrees Celsius

An assessment by European Commission's Joint Research Centre (JRC) shows that current climate commitments submitted by 155 countries for The 2015 United Nations Climate Change Conference, COP21, would increase global temperature by around 3 degrees Celsius. This is despite current efforts to cut emissions and to limit the temperature increase to below 2 degrees Celsius. … (NDTV)
IMA Digital TV
GP Tip: A different approach to percussion

The traditional method is to strike the terminal phalanx of the middle finger of the non-dominant hand with the tip of the middle finger of the dominant hand. Another way is to strike the non-dominant middle finger with a reflex hammer. It’s easier to perform, is more easily reproduced, provides more audible notes, and is less painful to the struck phalanx as it prevents any injury by the nails.

(Source: IJCP)
Readers column
Dear Dr KK Aggarwal, we enjoy reading emedinews daily, thank you very much. Carry on the good work. Warm Regards: Dr Santosh.
Over 50 doctors attended the IMA Rise & Shine CME on Vitamin D deficiency in Patiala

IMA Digital TV
Press Release
Over 100 stage shows, 50,000 visitors, 60 hours of fun filled activities only at HCFI’s 22nd MTNL Perfect Health Mela

To feature first of its kind daily live webcasts by leading dignitaries including Attorney General Mr. Mukul Rohatgi, Chairman Medanta Dr. Naresh Trehan

The festive season is here, and various exhibitions and fairs are sprucing up in every nook and corner of the city. Bringing a different flavor to the ever so popular events culture of Delhi comes Heart Care Foundation of India’s annual flagship event, the MTNL Perfect Health Mela. In its 22nd edition the Mela will take place on Nov 4-8, 2015 at the Talkatora Stadium in New Delhi from 8 am to 8 pm.

Organized by the Heart Care Foundation of India (HCFI), in association with the Indian Medical Association, Ministry of Science & Technology, Earth Sciences, Textile, and AYUSH – Government of India, NDMC, MCD and MTNL; the Perfect Health Mela is a mélange of entertainment, lifestyle exhibitions, competitions, workshops, health education and check-ups. The event is based on the concept that an extremely effective way of creating mass awareness about preventive health measures is through entertainment.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President HCFI & Honorary Secretary General IMA said, "Preventive health education is key in an era characterized by premature heart attacks and strokes and an increased incidence of lifestyle diseases such as hypertension, diabetes, heart disease and obesity. People are often oblivious to the severe damage they cause to their overall health by adopting unhealthy lifestyle choices like eating junk food, smoking, consuming alcohol, not exercising. In addition to this education about timely treatment especially in the cases of sudden cardiac arrest and strokes can help save numerous lives. This is the primary aim of HCFI's annual event, the MTNL Perfect Health Mela. The medium used to impart this education is a mix of on-ground health check-ups, entertainment, workshops, and competitions."

In its 22nd edition, the Perfect Health Mela will have some first of its kind activities such as a daily live webcast service being hosted by MTNL and coordinated by eMedinexus, a one of its kind social communications platform for the medical fraternity. Dr KK Aggarwal will host a special webcast on medical negligence and legal issues with renowned dignitaries including the Attorney General of India – Mr. Mukul Rohatgi and the Chairman of Medanta – the Medicity – Dr. Naresh Trehan on November 5th as a part of this initiative. In addition to this, medical teams from Medanta and National Heart Institute will be providing live check-up and telemedicine facilities at the Mela venue.

Speaking about MTNL’s association with the event, Sh. A K Srivastava, Executive Director, MTNL Delhi said, “We are extremely happy to be associated with the Perfect Health Mela yet again as the title sponsor. This year in addition to providing tele-medicine facilities at the venue for patients with doctors from leading hospitals, we will also be providing free Wi-Fi facilities for all visitors.”

Supporting the event, Dr. P K Sharma, Medical Health Officer, NDMC and Dr. N K Yadav, Medical Health Officer SMCD in a joint statement said, “We believe that health and sanitation are key contributors to the overall health of a nation. And hence, special focus will be laid this year on how to ensure the water you use, the food you consume, the air you inhale, the earth where you live, are all pure and healthy. We encourage everyone to come and attend the event to learn about healthy lifestyle measures in a fun-filled way.”

Other features of the Mela will include:

• Over 60 handlooms and craft stalls where visitors can shop for their Diwali gifts

• The Indian Medical Association will be launching the UNESCO chairs in bioethics on November 7th in the presence of six health vice chancellors

• A special focus will also be given at the Mela towards preventive education about dengue and swine flu

• The Mela venue will be a completely no smoking zone

• The chief guest for the inauguration ceremony on Nov 4th will be none other than Padma Vibhushan awardee Dr. Sonal Mansingh

Delivering preventive health advice on the occasion of World Stroke Day, Dr K K Aggarwal added, “A stroke occurs when the blood supply to your brain is interrupted or reduced. This deprives your brain of oxygen and nutrients, which can cause brain cells to die. The primary cause of this is a choked or leaked artery. Stroke is an acquired lifestyle induced ailment aggravated due to obesity, physical inactivity, regular heavy or binge drinking, smoking, hypertension, high cholesterol levels, diabetes, sleep apnea, family history and heart disease. Recognition of stroke symptoms through the F.A.S.T technique can help save a person’s life. If a person’s Face is dropping, has Arm weakness and Speech difficulty; Timely intervention is key by calling an ambulance. India is facing a stroke and heart disease epidemic, and we must work towards amending our high-stress lifestyle to reverse this trend and save lives."

For more information about the event, please visitwww.perfecthealthmela.com. Entry to the Mela is free for all.
Digital IMA