June 30  2015, Tuesday
eMedinewS
editorial
A Soda a day ups CVD Risk by 30%: NHANES Study
Dr KK Aggarwal American adults consume on average about 15% of their calories from sugars added to foods during processing, with a whopping 37% of the added sugar consumed in sugar–sweetened beverages, suggests an analysis of data extending back about 25 years.

Regularly drinking as little as one 12–ounce sugary soda a day may increase the risk of cardiovascular disease by about 30%—independent of total calories, obesity, or other risk factors, as per a study published in JAMA Internal Medicine.

Epidemiologic studies have linked high consumption of added sugar with an increased risk of type 2 diabetes, obesity, and hypertension.

The American Heart Association recommends less than 100 calories a day (about 5% of total daily calories) for women and 150 calories a day (about 7.5% of total daily calories) for men from added sugars.

The risk of CVD mortality becomes elevated once added sugar intake surpasses 15% of daily calories—equivalent to drinking one 20–ounce Mountain Dew soda in a 2000-calorie daily diet.

The risk rises exponentially as sugar intake increases, peaking with a fourfold increased risk of CVD death for individuals who consume one–third or more of their daily calories in added sugar.

eMedinewS Recommendations
  • Do not consume > 80 ml of cold drinks in a day
  • Avoid sweets containing > 30% sugar.
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IMA /AIOS Diabetes and Diabetic Blindness Awareness Program
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Cardiology eMedinewS
  • The US Department of Veterans Affairs (VA) and the US Department of Defense approved a joint clinical practice guideline for the management of dyslipidemia for cardiovascular disease (CVD) risk reduction in adults. A synopsis of the guideline is published in Annals of Internal Medicine.
  • Lower systolic blood pressure in patients being treated for hypertension is associated with a reduced risk of atrial fibrillation, suggest data from the Losartan Intervention For Endpoint (LIFE) hypertension study published in the journal Hypertension.
Pediatrics eMedinewS
  • Women who consume a high-fiber diet during pregnancy may reduce the risk of their offspring developing asthma, suggests a new study published in Nature Communications.
  • Teenaged boys who spend too many hours in front of the computer or television without participating in enough weight-bearing exercise could develop weaker bones as they age, suggests a Norwegian study published in BMJ Open.
Dr KK Spiritual Blog
Five Types of People from Nastik to Astik

Following are the five types of people
  1. Nastik – the one who does not believe in God.
  2. Astik – for whom God exists.
  3. Those who see God in themselves (I and the God are the same)
  4. Tatvamasi (God not only exists in me but also in you)
  5. God is in everybody
People who believe that God exists are fearful people and they always fear God. People who see God in themselves, live a disciplined Satvik life and do not indulge in activities which are not God-friendly.

People who believe that God is not only in me but you also, treat every person the same way as they treat themselves.

People for whom God is everywhere, always work for the welfare of the society.
Events
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Make Sure
Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to avoid painkillers in renal failure as most painkillers (barring nimesulide, paracetamol) are not kidney-friendly drugs.
Dr Good Dr Bad
Situation: A patient with metabolic syndrome was found to have impaired kidney function.
Dr Bad: They are unrelated.
Dr Good: They are related.
Lesson: People with metabolic syndrome have a higher risk for reduced kidney function - development of eGFR <60 ml/min per 1.73 m2 and microalbuminuria or overt proteinuria (Clin J Am Soc Nephrol. 2011 Oct;6(10):2364-73).

(Copyright IJCP)
IMA Humor
Four surgeons were taking a coffee break and discussing their work. The first surgeon said, "I think that accountants are the easiest to operate on. You open them up and everything inside is numbered."

The second surgeon said, "I think that librarians are the easiest to operate on. You open them up and everything is in alphabetical order."

The third surgeon said, "I think that electricians are the easiest to operate on. You open them up and everything is color coded."

The fourth surgeon said, "I think that lawyers are the easiest to operate on. They're heartless, spineless, gutless and their heads and their ass are interchangeable."
eMedi Quiz
All of the following are the electrocardiographic features of severe hyperkalemia except.

1. Peaked T waves.
2. Presence of U waves.
3. Sine wave pattern.
4. Loss of P waves.

Yesterday’s Mind Teaser: All of the following infections are often associated with acute intravascular hemolysis except:

1. Clostridium tetani.
2. Bartonella bacilliformis.
3. Plasmodium falciparum.
4. Babesia microti.

Answer for yesterday’s Mind Teaser: 1. Clostridium tetani.

Correct Answers received from: Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr Bitaan Sen & Dr Jayashree Sen, Dr K Raju, Dr G Madhusudhan, Dr Pravin H Patel.

Answer for 26th June Mind Teaser: 4. Neurotoxic.

Correct Answers received: Daivadheenam Jella, Dr Avtar Krishan.
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Rabies News (Dr A K Gupta)
What is "furious form" of rabies in animals?

The excitative phase follows the prodromal phase in some animals. The animal becomes irrational and may aggressively use its teeth, claws, horns, or hooves. The expression is one of anxiety with dilated pupils. Noise invites attack. Rabid animals roam extensively and attack other animals, including humans and any moving object. Cats usually manifest furious type of rabies.
IJCP Book of Medical Records
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CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
eIMA News
IMA /AIOS Diabetes and Diabetic Blindness Awareness Program
The first ever high altitude Cycling expedition to create and spread awareness about Diabetes and Diabetic Blindness in the remote, far off and most adverse areas of our country, was embarked upon by Dr. Balbir Singh Bhaura and his team. The troupe underwent extreme sub zero weather conditions through the highest mountain passes and motorable roads for service of the community as part of Akal Eye Hospital's Corporate Social Responsibility, and the expedition was organized under the joint aegis of the Indian Medical Association (Prevention of Diabetic Blindness Project) and All India Ophthalmological Society (Diabetic Blindness awareness Initiative). The Cycling expedition, which commenced on 7th June from Manali, successfully completed the mission, and reached its final destination Leh on 16th June. En route, the team conducted diabetes and diabetic retinopathy screening and awareness campaign at Manali, Keelong, Pestou, Sarchu, Whisky Nallah, Tso Kar Lake and Lato. A commendable feat indeed, and this will certainly be a landmark event in our continuing tirade against Diabetic Blindness in the country. Hearty congratulations to the Alkali Hospital High altitude Cycling Expedition Team.
IMA TSK CME
IMA TSK organised a CME on 27th June in which Orthopedician Prof Dr Ranjit Kr Baruah spoke on “Osteoarthritis of Knee Joint" and Dr (Mrs) Prerna Keshan Agarwal spoke on “Postmenopausal Osteoporosis". It was followed by an interactive session; 45 members attended the CME. Dr Prasant Kr Agarwal, Hony Secy, IMA TSK
Meet on Vitamin-D Deficiency
By Express News Service: Kochi: The Indian Medical Association (IMA) on Friday organised a continuing medical education (CME) programme to discuss the various health threats faced by people of the country due to deficiency of vitamin-D. The CME was an initiative launched under the IMA’s new ‘Rise and Shine’ programme, which was attended by over 70 leading doctors from the city.

Addressing the gathering, endocrinologist Bobby K Mathew said, “vitamin-D plays a crucial role in the absorption of calcium and phosphorus from the food we eat and minerals that are essential for healthy bones. In addition to benefiting the bone, vitamin-D wards off diseases like cancer, diabetes and heart attack.”

IMA national president A Marthanda Pillai and honorary secretary general Dr K K Aggarwal in a joint statement said, “a serious concern for the medical fraternity is that the majority of the people in our country are unaware of the fact that they are vitamin-D deficient.”

Metabolic Disorders and Endocrinology chairman Ambrish Mittal and IMA, North Paravoor branch, secretary Sasidharan in a joint statement said, “vitamin-D deficiency is rapidly gaining epidemic status, yet it is the most under-diagnosed and under-treated nutritional deficiency in India and the world.”
Awareness on Child Abuse Law for Docs
By Express News Service: Published: 29th June 2015 03:59 AM

Thiruvananthapuram: The Indian Medical Association (IMA) has said that children, parents and others will be imparted more awareness against child sexual abuse, which is on a rise in recent times. The Association declared this at a national workshop on Prevention of Child Sexual Abuse here. As present, law against child sexual abuse is very much complicated and most of the people are not aware of it. The IMA would take the lead in creating awareness, Association national president Dr Marthanda Pillai said. The doctors would also be made aware of various laws such as POCSA Act, he said while inaugurating the workshop. The awareness for doctors are very much needed as their reports on sexual abuse are very crucial in many cases, it was opined in the workshop.
Medical staff protest attacks on them
PUDUCHERRY, June 28, 2015, S. PRASAD

Urge the Chief Minister to provide adequate protection

A large number of doctors, nurses and paramedical staff took out a massive rally on Saturday to protest against frequent attacks on doctors by relatives of patients.

The rally held under the aegis of the Puducherry chapter of Indian Medical Association and Confederation of Health Employees Association began at Swadeshi Mills on Maraimalaiadigal Salai and culminated in front of the Puducherry Government General Hospital.

At the end of the rally, G. Sriramulu, IMA Puducherry chapter president and G. Sreenivasan, secretary, submitted a memorandum to Chief Minister N. Rangasamy demanding the government to provide adequate protection to doctors and to take stringent action against those indulging in attacks against doctors and hospitals.

Dr. Sriramulu said that there had been an increase in the number of attacks on doctors and nurses in the city. Such attacks would demoralise the medical fraternity and would lead to fear and reluctance on the part of doctors to treat sick patients.

“Doctors should not be held responsible for the death of a patient due to unforeseen circumstances. We can no longer tolerate attacks and would like to stress the government to enact an ordinance immediately,” he said.
News
  • Selective serotonin reuptake inhibitors used to reduce symptoms of menopause may increase the risk of bone fractures, suggests new research published in a journal from The BMJ, Injury Prevention.
  • By creating the highest resolution image of the Ebola virus, researchers have identified a viral protein called VP35 that helps the virus escape attack from the immune system, shedding light on how Ebola infection could be prevented. The findings are published in the journal Cell Reports.
  • A new study has found the cognitive behavioral therapy (CBT) used to reduce chronic tics in people with Tourette syndrome can also alter the functioning of their brains. Researchers noted that CBT normalized activity in the supplementary motor area of the brains of patients with Tourette syndrome. The findings of the study will be presented at the First World Congress on Tourette syndrome and Tic Disorders.
  • The European League Against Rheumatism (EULAR) has released a new set of recommendations on imaging for the diagnosis and monitoring of patients with spondyloarthritis (SpA), emphasizing the importance of MRI for early diagnosis. The data were published in the July issue of Annals of the Rheumatic Diseases.
  • A new study suggests that chemically analyzing breath specimens from patients in intensive care can reveal bacterial infection in the lower respiratory tract of ventilated patients at risk of developing pneumonia. The findings are published in the journal Thorax.
Media
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Inspirational Story
Happiness is a Voyage

We convince ourselves that life will be better once we are married, have a baby, then another. Then we get frustrated because our children are not old enough and that all will be well when they are older. Then we are frustrated because they reach adolescence and we must deal with them. Surely we’ll be happier when they grow out of the teen years.

We tell ourselves our life will be better when our spouse gets his/her act together, when we have a nicer car, when we can take a vacation, when we finally retire. The truth is that there is no better time to be happy than right now.

If not, then when? Your life will always be full of challenges. It is better to admit as much and to decide to be happy in spite of it all. For the longest time, it seemed that life was about to start. Real life…

But there was always some obstacle along the way, an ordeal to get through, some work to be finished, some time to be given, a bill to be paid. Then life would start.

I finally came to understand that those obstacles were life. That point of view helped me see that there isn’t any road to happiness.

Happiness IS the road. So, enjoy every moment.

Stop waiting for school to end, for a return to school, to lose ten pounds, to gain ten pounds, for work to begin, to get married, for Friday evening, for Sunday morning, waiting for a new car, for your mortgage to be paid off, for spring, for summer, for fall, for winter, for the first or the fifteenth of the month, for your song to be played on the radio, to die, to be reborn… before deciding to be happy.

Happiness is a voyage, not a destination. There is no better time to be happy than… NOW! Live and enjoy the moment.
Quote of the Day
The greatest obstacle to discovery is not ignorance - it is the illusion of knowledge. Daniel J Boorstin
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Reader Response
Dear Sir, Thanks for the useful information. Regards: Dr Kanchan
Wellness Blog
Preventing heat disorders

During summer, susceptible children and adolescents can develop heat stroke, which can even lead to death if not identified and treated in time.
  • Heat index is more important than the atmospheric temperature. A 42 degree temperature may feel like 46 degrees if the heat index is high.
  • Avoid prolonged exposure to sun when the temperature is high. Use an umbrella if you need to go out.
  • Wear light cotton clothes to avoid heat absorption.
  • Make sure that you are properly hydrated before you step out in the heat. The requirement of water in summer is 500 ml more than that in winter.
  • Summer drinks should be refreshing and cool such as panna, khas khas, rose petal water, lemon water, bel sharbat and sattu sharbat.
  • Any drink with more than 10% sugar becomes a soft drink and so should be avoided. Ideally, the percentage of sugar, jaggery or khand should be 3%, which is the percentage present in oral rehydration drink.
  • You should pass urine at least once in 8 hours. This is a sign of adequate hydration.
  • If you develop heat cramps, drink plenty of lemon water with sugar and salt.
  • Heat exertion presents with fever and sweating. If you develop heat exertion, drink plenty of oral fluids, mixed with water, lemon and sugar. Presence of sweating is good sign.
  • If a person develops high grade fever, i.e. more than 104 degrees Fahrenheit with dry armpits, this is a sign of impending heat stroke, which is a medical emergency. The temperature here may be more than 106 degree Fahrenheit. Fever should be brought down rapidly within minutes to save the life.
  • People, who have been advised to restrict their fluid intake on medical grounds, should discuss their fluid requirement in summer with their doctor.
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Press Release
Doctors to spent 10% of their time to community service

IMA has asked all its 2.5lac members to devote 10% of their time to community service.

Giving the details Padma Shri Awardee Dr A Marthanda Pillai, National President IMA and Padma Shri Awardee Dr K K Aggarwal Honorary Secretary General IMA said that, IMA members on an average see one crore patients every day.

It is the duty of doctors to guide patients who cannot afford treatment.

IMA new project “JISKA KOI NAHI USKA IMA” is so designed that every patient who needs treatment & cannot afford, be properly guided.

Every doctor must know central & State schemes for poor & local NGO’s who can provide treatment subsidy.