emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
 
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & 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 9 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 December 2012, Sunday

Biggest Cardiology Stories of 2012 from Heart Wire

Cardiac surgery

  • The biggest advance this year in cardiac surgery in the US is the availability, under a few reasonable FDA conditions, of the Edwards transcatheter valve for inoperable and, more recently, very high-risk patients with aortic stenosis.
  • The requirement for a "heart team" in the selection of candidates for transcatheter aortic-valve replacement (TAVR) should ensure appropriate use of this technique.
  • FREEDOM trial results clearly demonstrate better five-year survival in diabetics with CABG as opposed to PCI, regardless of extent of coronary artery disease.
  • Initial results of the (National Heart, Lung, and Blood Institute's) NHLBI's Cardiac Surgery Clinical Research Network's (CTSN) Severe Ischemic Mitral Regurgitation trial comparing valve repair and valve replacement will be available in 2013.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

Register for 4th eMedinewS–revisiting 2012 conference

    Constipation Update

When should enemas be used in a patient with constipation?

Enemas (tap water, sodium phosphate, soapsuds) should be used only as needed for constipation in the older adult, i.e., after several days of constipation in order to prevent fecal impaction. Adverse effects can include fluid and electrolyte abnormalities with phosphate enemas and rectal mucosal damage with soapsuds enemas.

In elderly patients, sodium phosphate enemas should not be used for the treatment of constipation as they may lead to severe metabolic disorders associated with a high mortality and morbidity (Ori Y, et al. Fatalities and severe metabolic disorders associated with the use of sodium phosphate enemas: a single center’s experience. Arch Intern Med 2012 Feb 13;172(3):263–5).

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Longer CPR efforts may improve
survival chances

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Students’ form various schools took active part in the MTNL perfect Health Mela and give educative messages via skits and play.

 
Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Health research funds up five-fold in 12th Plan: Ghulam Nabi Azad

PUNE: Union health and family welfare minister Ghulam Nabi Azad said on Friday that more than Rs 10,000 crore were earmarked for the department of health research and Indian Council of Medical Research (ICMR) in the 12th Plan, almost five times the funds allocated in the 11th Plan. He said that under the 12th Plan, the ministry aimed to establish multidisciplinary research units in 150 government medical colleges and a network of 250 laboratories at regional, state and district levels to manage epidemics. He was speaking at a function organised to inaugurate the bio-safety level 4 (BSL-4) laboratory at the National Institute of Virology (NIV) in Pashan. Azad said that health has been given a central position in the 12th Plan and the outlay for health, including health research, has gone up substantially. "Other projects the ministry would focus on in the 12th Plan include setting up of 50 rural health units at the block level and providing aid to researchers for projects involving development of affordable technologies, reagents and method of public use. Steps will be planned to strengthen the existing ICMR institutes and set up new centres in deficit areas, to update standard treatment guidelines regularly, benchmark and accredit health research institutions and support human resource development to produce qualified researchers," the minister said.

Azad added that the NIV has played a major role in studying diseases of national and international concern like SARS, avian influenza, besides the influenza A H1N1 pandemic. The WHO has designated NIV as a collaborating centre for emerging diseases, national influenza centre and H5 reference laboratory. He said that the laboratory network was being strengthened in the country. As many as 16 new laboratories - 14 BSL-2 and two BSL-3 - have been set up to work on viral diseases and tuberculosis. The number of laboratories working on research has gone up from two to 46 in a span of one year.

Director General, ICMR, and secretary of department of health research V M Katoch, National Disaster Management Authority member J K Bansal, NIV director A C Mishra and state forest minister Patangrao Kadam were also present. The BSL-4 laboratory at NIV is the country's first laboratory with such high grading and unique capacity of testing highly infectious and dangerous viruses. (Source: TOI, Dec 29, 2012)

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

What are the five main issues for managing and advising a patient with a prosthetic heart valve?

  • Antithrombotic therapy to prevent valve thrombosis and thromboembolism
  • Evaluation of valve function
  • Endocarditis prophylaxis
  • Safety of exercise
  • Pregnancy

(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)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Fibromyalgia underdiagnosed, report Mayo Clinic Experts

The first population study to compare the prevalence of diagnosed fibromyalgia (FM) to the general population prevalence of people reporting symptoms that met the updated 2010 American College of Rheumatology (ACR) diagnostic criteria indicates that FM may be more common than previously thought and that most FM cases are not being diagnosed, especially in men. (Source: Medscape)

Do soldiers today have healthier hearts?

The prevalence of atherosclerosis among combat casualties appears to have fallen dramatically since analyses conducted in the Korean and Vietnam wars, researchers reported. (Source: Medpage Today)

Diabetes increases risk for fracture-related hospitalization

Adults diagnosed with diabetes are at significantly increased risk for fracture-related hospitalization, according to results from an analysis of data from a large, community-based study. The new findings, from the Atherosclerosis Risk in Communities (ARIC) Study, were published online December 17 in Diabetes Care by Andrea L.C. Schneider, PhD, from the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, and colleagues. (Source: Medscape)

Hypoglycemia raises in-hospital mortality risk

Hypoglycemia, both insulin-induced and spontaneous, increased the risk for mortality among hospitalized patients, a retrospective cohort study has found. The findings were published online December 17 in Diabetes Care by Rajesh Garg, MD, from the Division of Endocrinology, Diabetes, and Hypertension and the Center for Clinical Investigation, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and colleagues. (Source: Medscape)

 
    Twitter of the Day

@DrKKAggarwal: Gang rapes will not stop unless alcohol drinking is prohibited more than social limits. The person who serves should be punished.

@DeepakChopra: Love is the ultimate truth at the heart of the universe and transcends all boundaries.

 
    Spiritual Update

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

Do what you do to God

  1. There are two types of people who believe in Dvaita or Advaita philosophy.
  2. People who believe in Dvaita philosophy, for them God and human beings are different.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How can assisted reproductive techniques help couples diagnosed with endometriosis?

According to western figures, couples diagnosed with endometriosis have success rates with assisted reproductive technology (ART) procedures such as in vitro fertilization and embryo transfer (IVF–ET) that are similar to those for couples with other causes of infertility. Success rates for ART procedures vary greatly depending on a woman’s age. Nationally, live birth rates for IVF–ET are approximately 30-35% for women under age 35, 25% from ages 35 to 37, 15–20% from ages 38 to 40, and about 10% between 41 and 42. IVF–ET is the most effective treatment for moderate or severe endometriosis, particularly if surgery fails to restore fertility.

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

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

How much liver should be left behind with the donor?

At least 35% of the liver is left behind with the donor. CT volumetry is very important to calculate this volume.

 
    An Inspirational Story

Determination

In 1883, a creative engineer named John Roebling was inspired by an idea to build a spectacular bridge connecting New York with the Long Island. However, bridge building experts throughout the world thought that this was an impossible feat and told Roebling to forget the idea. It just could not be done. It was not practical. It had never been done before.

Roebling could not ignore the vision he had in his mind of this bridge. He thought about it all the time and he knew deep in his heart that it could be done. He just had to share the dream with someone else. After much discussion and persuasion he managed to convince his son Washington, an up and coming engineer, that the bridge in fact could be built.

Working together for the first time, the father and son developed concepts of how it could be accomplished and how the obstacles could be overcome. With great excitement and inspiration, and the headiness of a wild challenge before them, they hired their crew and began to build their dream bridge.

The project started well, but when it was only a few months underway a tragic accident on the site took the life of John Roebling. Washington was injured and left with a certain amount of brain damage, which resulted in him not being able to walk or talk or even move.
"We told them so."
"Crazy men and their crazy dreams."

"It`s foolish to chase wild visions."

Everyone had a negative comment to make and felt that the project should be scrapped since the Roeblings were the only ones who knew how the bridge could be built. In spite of his handicap Washington was never discouraged and still had a burning desire to complete the bridge and his mind was still as sharp as ever.

He tried to inspire and pass on his enthusiasm to some of his friends, but they were too daunted by the task. As he lay on his bed in his hospital room, with the sunlight streaming through the windows, a gentle breeze blew the flimsy white curtains apart and he was able to see the sky and the tops of the trees outside for just a moment.

It seemed that there was a message for him not to give up. Suddenly an idea hit him. All he could do was move one finger and he decided to make the best use of it. By moving this, he slowly developed a code of communication with his wife.

He touched his wife's arm with that finger, indicating to her that he wanted her to call the engineers again. Then he used the same method of tapping her arm to tell the engineers what to do. It seemed foolish but the project was under way again.

For 13 years Washington tapped out his instructions with his finger on his wife's arm, until the bridge was finally completed. Today the spectacular Brooklyn Bridge stands in all its glory as a tribute to the triumph of one man's indomitable spirit and his determination not to be defeated by circumstances. It is also a tribute to the engineers and their team work, and to their faith in a man who was considered mad by half the world. It stands too as a tangible monument to the love and devotion of his wife who for 13 long years patiently decoded the messages of her husband and told the engineers what to do.

Perhaps this is one of the best examples of a never-say-die attitude that overcomes a terrible physical handicap and achieves an impossible goal.

Often when we face obstacles in our day-to-day life, our hurdles seem very small in comparison to what many others have to face. The Brooklyn Bridge shows us that dreams that seem impossible can be realized with determination and persistence, no matter what the odds are.

Even the most distant dream can be realized with determination and persistence.

For comments and archives

 
    Cardiology eMedinewS

Sliding-scale hydration prevents contrast nephropathy Read More

Poor antiplatelet response with clopidogrel does not predict mortality
Read More

 
    Pediatric eMedinewS

Kids younger than 5 years at risk for repeat adenoidectomy Read More

Obesity declining in low-income preschool-aged kids? Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient presented with sub–clinical hyper function of the thyroid.
Dr. Bad: No treatment is needed.
Dr. Good: You need to be on treatment.
Lesson: A study published in April 2012 in the journal Archives of Internal Medicine has shown that sub–clinical hyperthyroidism is associated with higher risks of overall mortality, cardiovascular mortality and arterial fibrillation.

Make Sure

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on a sulfa drug?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

 
    Quote of the Day (Dr GM Singh)

I love you without knowing how, or when, or from where. I love you straightforwardly, without complexities or pride; so I love you because I know no other way. Pablo Neruda

 
    Legal Question of the Day (Dr MC Gupta)

Q. Punjab assembly has passed an amendment to the Punjab Tax Act, 2011, exempting hospitals outside municipal limits from local taxes, saying that these hospitals are not commercial entities and are doing social service. Can this be challenged in the court being discriminatory against hospitals situated within municipal limits? How can a hospital become commercial just being inside municipal limits?

Ans.

  1. I do not think it can be successfully challenged.
  2. The above decision reflects a policy decision. It is the duty, right and privilege of the state to govern the state. The judiciary, the legislature and the executive are independent and have to act in co-ordination avoiding mutual conflict. However, all the three are subservient to the Constitution and, therefore, their actions are subject to judicial review.
  3. As per the above paradigm, it is the prerogative of the state to formulate policies that would help it achieve the goals of governance. The courts cannot find fault with such policies unless the policy violates law or the provisions of the Constitution or is otherwise against public interest.
  4. A policy can be attacked and struck down on the ground that it is arbitrary. It can be held as discriminatory if it treats differently two identically placed individuals or groups who are treated differently without there being identifiable logical differences, the so called “intelligible differentia”.
  5. The two groups of hospitals (those situated within or outside municipal limits) are clearly differentiable and hence the action of the government is not arbitrary.
  6. Moreover, the policy to exempt hospitals situated outside municipal limits from payment of taxes on the ground that they are not commercial entities and are doing social service cannot be held as against public interest. As a matter of fact, it serves public interest to encourage establishment of hospitals in non-urban areas.
 
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    Mind Teaser

Read this…………………

After Billroth II surgery, the client developed dumping syndrome. Which of the following should the nurse exclude in the plan of care?

A. Sit upright for at least 30 minutes after meals
B. Take only sips of H2O between bites of solid food
C. Eat small meals every 2-3 hours
D. Reduce the amount of simple carbohydrate in the diet

Yesterday’s Mind Teaser: Included in the plan of care for the immediate post-gastroscopy period will be:

A. Maintain NGT to intermittent suction
B. Assess gag reflex prior to administration of fluids
C. Assess for pain and medicate as ordered
D. Measure abdominal girth every 4 hours

Answer for Yesterday’s Mind Teaser: B. Assess gag reflex prior to administration of fluids

Correct answers received from: Dr Chetna Bansal, Dr PK Sahu, Dr KV Sarma, Dr Kanta Jain, Dr Monica Gandhi, Dr Arpan Gandhi, Dr Jella, Dr Pankaj Agarwal, Dr Thakor Hitendrsinh G, Dr Jainendra Upadhyay, DR Avtar Krishan, Muthumperumal Thirumalpillai.

Answer for 28th December Mind Teaser: A. Checking the back and sides of the operative dressing

Correct answers received from: Muthumperumal Thirumalpillai, Dr PK Sahu.

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr GM Singh)

Funny meanings...

Smile: A curve that can set a lot of things straight!

 
    Medicolegal Update

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

Abrasion injury in medicolegal cases

Mechanical momentum means mass with velocity discharged into the human body by a moving object or weapon or itself due to impact of moving body against a surface produces injuries over the body. In the first case, the counter force is provided by the body and in the second case, by the rigidity of the object/weapon/surface/wall against which the victim falls by himself or is forced to fall by external reason. In most cases it is seen that the mechanical injuries produced over the body are due to a combination of above two forces. Abrasion is one of the most superficial injuries and involves destruction of the superficial layers of the skin, caused by fall on a rough surface, or being dragged by a vehicle. Abrasions are of different types based on the pattern of the causative force viz. scratches, grazes, pressure, impact or imprint abrasions. A doctor can help legal investigation by his evaluation and documentation of abrasions as below.

  • They give an idea about the site of impact and direction of the force.
  • They may be the only external signs of a serious internal injury.
  • Patterned abrasions may help in relating the wound to the object which produced them.
  • The age of the injury can be determined, which helps to corroborate with the alleged time of assault.
  • Dirt, dust, grease, sand in the open wounds may connect the injuries to the scene of crime
  • Character and manner of the injury may be known from its distribution.
    • In throttling, crescent abrasions due to fingernails are found on the neck
    • In smothering, abrasions may be seen around the mouth or nose.
    • In sexual assaults, abrasions may be found on the breasts, genitals, inside of the thighs and around the anus.
    • Abrasions on the face of the assailant indicate a struggle.
    • Abrasions on the victim may show whether the fingernails of the assailant were long, irregular or even broken.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Should a diabetic with tight sugar control drive?

Worldwide, diabetics are required to produce proof of good blood sugar control to keep their driving license. A study by Dr. Donald A. Redelmeier, professor of medicine at the University of Toronto has shown that diabetics, who keep their blood sugar tightly controlled, run the risk of having traffic accidents due to low blood sugar, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. The risk was substantial, accounting for almost 50 percent of the accidents. The accidents were mostly related to severe hypoglycemia in association with strict blood sugar control. The findings were published in the journal PLoS Medicine.

For the study, researchers collected data on 795 diabetic drivers. They found that one in 14 of the drivers had been involved in car accidents. Those with low blood sugar were more likely to have had an accident than were diabetics whose blood sugar was not as well controlled. Moreover, the risk for having a car accident increased fourfold if the person had a history of hypoglycemia.

Diabetics should not drive if they feel dizzy or have other symptoms of hypoglycemia. If a diabetic person has had a hypoglycemic episode the previous day, he or she should not drive the car next day.

Patients with diabetes should drive only if their diabetes is under control and there is no evidence of end organ disease.

 
    Readers Responses
  1. Thanks a lot. Keep publishing from various experts across all specialties. With regards: Dr JJP Mishra.
 
    Forthcoming Events

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi

8am-8pm

Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/

rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

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

4. eMedinewS ebooks (This may take a few minutes to open)

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja