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 and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 
  Editorial …

31st March, 2011, Thursday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

India in the final as expected

The predictions of eMedinewS came true and India beat Pakistan and entered the finals of the ICC World Cup comfortably. When India began the innings, initially it appeared that they would score 350. As the innings progressed, even a score of 220 looked unachievable. But in the end, 260 proved to a fighting total and a competitive score. Pakistan never could accelerate their run rate.

The serotonin levels of not only of Indian players but also of the politicians and public kept rising as the match was coming in the grip of India. For the first time, one could see even Dhoni getting excited with each fall of wicket. Worry on the face of Tendulkar was evident every time Pakistan scored a run. India has never lost a match to Pakistan in the World Cup and they maintained their tradition.

When Sachin Tendulkar was on 85, it seemed that he would achieve his 100th century in this match itself. But at that time, superstition took over the cricket with the thought that whenever Sachin scores a century India may not win. The very fact that he got out for 85 raised the hope that India is going to win.  We all know it has no scientific basis but that is how superstition works.

Good Luck India – Come Back with the World Cup.

Medical Profession is proud of you

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
 
  eMedinewS Audio PostCard

CKD Update

Dr KK Aggarwal Speaks on
‘Categories of CKD’

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Medifinance Conference On Portfolio Management for Doctors and update on Budget 2011

Speakers on the Desk in the recently concluded Medifinance Conference organized at Auditorium, Delhi TB Association, Lodhi Road, New Delhi on 13th March 2011.

 
Dr K K Aggarwal
 
    National News

Congratulations to New MCI, Secretary Prof.(Dr.) Sangeeta Sharma

eMedinewS extends its best wishes to Prof.(Dr.) Sangeeta Sharma on taking over as Secretary Medical Council of India.

Major changes in MBBS curriculum proposed

NEW DELHI, March 30, 2011, The Hindu: A graduate would have to pass an exit exam or licentiate examination in order to practise medicine

The Board of Governors of the Medical Council of India (MCI) has proposed major changes in the undergraduate curriculum and training programme that would create an “Indian Medical Graduate,” who will have necessary competence to assume his or her role as a healthcare provider.

The “Indian Medical Graduate” will have to pass an exit exam or a licentiate examination after an internship to get licence to practise anywhere in the country. The national-level exit exam is expected to set a standard for doctors. The MCI also proposes to introduce the National Eligibility-cum-Entrance Test from 2012.

The proposals will have to be approved by the Ministry of Health and Family Welfare before their implementation in 2012.

Importantly, an ‘elective' subject had been added to the ‘core' subjects to allow flexible learning options in the curriculum and the options include clinical electives, laboratory postings and or community exposure in areas that students were not normally exposed to as part of the regular curriculum.

An additional weightage of 5 per cent would be given to candidates for putting in six months of intensive rural service during the M. Med course. The duration after finishing MBBS course would be M. Med (2 years); one more year will get candidate an MD degree. Candidate would get dual degrees after four years and he or she has a choice to go on a fellowship programme or a Ph D programme or a DM degree in five years.

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

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Protect against the sun

Sun damage is one of the leading causes of aging skin, according to the Mayo Clinic. Constant exposure to the sun’s rays can cause wrinkles, fine lines, sun spots and other skin conditions. Wear sunscreen anytime you’ll be out in the sun for more than a few minutes, apply a broad spectrum (blocks both UVA and UVB rays) SPF 15 or higher. Cover up by wearing a wide–brimmed hat and long–sleeved clothing when appropriate and stay out of the sun during the most intense sunlight hours of 10 am. To 4 p.m.

(Dr GM Singh)

Cord–blood pH an important indicator of perinatal outcome

Low pH in cord blood can signal major adverse neonatal outcomes, including death, seizures, and cerebral palsy, according to a BMJ meta–analysis. Analysts examined 51 studies, together including almost a half–million infants. They found low cord arterial–blood pH to be associated with higher risks for neonatal mortality (odds ratio, 16.9), hypoxic ischemic encephalopathy (13.8), intraventricular hemorrhage or periventricular leukomalacia (2.9), and cerebral palsy (2.3). The authors say that further studies would be needed to attach longer–term prognostic significance to low pH levels in cord blood. In the meantime, they recommend "increased initial surveillance" in low–pH babies.

(Dr Monica and Brahm Vasudev)

FDA approves drug for metastatic melanoma

The FDA approved the biologic drug ipilimumab (Yervoy) to treat late–stage melanoma. It’s the first drug with clinical data showing that it prolongs overall survival the condition, the agency said.

Controversy

An FDA advisory panel says menthol cigarettes are more addictive than regular ones, but a study in a cancer journal suggests they are no more addictive and might even be less likely to cause lung cancer.

Drug prevents type 2 diabetes in majority of high–risk individuals

Pioglitazone taken once a day in the morning prevented type 2 diabetes in more than 70 percent of individuals whose obesity, ethnicity and other markers put them at highest risk for the disease, US scientists report. The team also noted a 31 percent decrease in the rate of thickening of the carotid artery, the major vessel that supplies blood to the brain. The study, which enrolled 602 participants through The University of Texas Health Science Center San Antonio and seven collaborating centers, is described in the New England Journal of Medicine and has direct implications for the care of 40 million Americans who are pre–diabetic. Pioglitazone was well tolerated by participants, with weight gain and fluid retention observed at the dose used in the study.

 
    IJCP Special

Dr Good Dr Bad

Situation: A pregnant dead lady needed immediate LSCS to deliver the baby.
Dr Bad: Make a horizontal incision.
Dr Good: Make a vertical incision.
Lesson: Use a vertical skin incision to provide fast entry, adequate uterine exposure, and access to the diaphragm, which may be useful for further resuscitative interventions.

Make Sure

Situation: A patient with UTI developed kidney failure.
Reaction: Oh my God! Why were long–term antibiotics not considered?
Lesson: Make sure antibiotics are continued in a patient with UTI till three urine cultures are negative.

 
    An Inspirational Story

(Dr Prachi Garg)

Stone Soup A story about Sharing

Many years ago three soldiers, hungry and weary of battle, came upon a small village. The villagers, suffering a meager harvest and the many years of war, quickly hid what little they had to eat and met the three at the village square, wringing their hands and bemoaning the lack of anything to eat. The soldiers spoke quietly among themselves and the first soldier then turned to the village elders. "Your tired fields have left you nothing to share, so we will share what little we have: the secret of how to make soup from stones."

Naturally the villagers were intrigued and soon a fire was put to the town’s greatest kettle as the soldiers dropped in three smooth stones. "Now this will be a fine soup", said the second soldier; "but a pinch of salt and some parsley would make it wonderful!" Up jumped a villager, crying "What luck! I’ve just remembered where some’s been left!" And off she ran, returning with an apronful of parsley and a turnip. As the kettle boiled on, the memory of the village improved: soon barley, carrots, beef and cream had found their way into the great pot.

 
    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

What is artificial insemination with donor semen?

The alternative to ART for many couples, including those who fail ART, is artificial insemination with donor sperm. This time–tested method has a very high success rate in apparently normal female recipients: 50% pregnancy rate with six cycles of insemination. Children born from pregnancies resulting from donor insemination grow and develop normally, both physically and psychologically.

 
    Hepatology Update

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

Medical management of neonatal cholestasis

Central acting drugs

  • Ondansetron (<12 years) 2–4mg twice–daily
  • Naltriaxone 6 –20 mg/day
  • Termaprazine
  • Terfenadine 1–3mg/kg/day
  • Carbamazepine
 
    Medicolegal Update

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

What is Somnolentia?

  • Somnolentia is that state of mind when a person is in a condition in between sleep and awake. It is often termed as sleep–drunkenness.
  • The state of mind is comparable with that of a person, who is suddenly arousing from deep sleep.
  • In such a state, a person may behave very abnormally for a short period, say for a few minutes. During the period his mind is untouched with the reality and the circumstance.
  • When suddenly awaken from a deep sleep, such person may perform some violent act without awareness and understanding.
  • He has diminished responsibility for any criminal act performed by him during such a state of mind.
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ijcpgroup
ijcpgroup
Docconnect
 
    Legal Question of the Day

(Dr M C Gupta, Advocate)

Q. It is very important to know in an accident case whether the driver or the victim is under influence of alcohol. It is depressing that there are no arrangements for measuring alcohol content in blood or breath when MLC is prepared. Is this not undesirable? What should be done?

Ans.

  1. In general, it is undesirable. Your concern is valid.
  2. A doctor’s job is to give treatment and make necessary tests/measurements and maintain records within the resources available. He should do his job without being depressed or mentally worked up.
  3. The above does not mean the doctor should be a passive spectator to deficiencies in the system. The system will not change unless he demands change.
  4. What should be done is this:
    • When an MLC is made, the doctor should clearly write in the MLC on the following lines: —"Clinical findings about consciousness, general behavior and manner of speech have been written above. However, It is not possible to give a definite opinion as to whether the person examined has consumed alcohol or not. No facilities exist for blood or breath analysis for alcohol." When 10 such MLCs reach the courts, they would give directions to the government to ensure that necessary facilities/equipment are available. Please note that this will need some courage on the part of the doctor to write this. Doctors are often too much afraid of or manipulated by the police and the hospital superintendent that writing the above factual statement may seem an insurmountable problem to them. (I may mention that when I was posted in the AIIMS Casualty in 1971, I used to write MLC in Hindi and never had anyone complain about it. I had not committed any illegality and I would have stood my ground even before the director, AIIMS, if necessary. It is that courage I am talking of)
    • Doctors posted in emergency should send a representation, under acknowledgement, to the hospital authorities requesting them to make the facilities avail

The solutions to problems are often available but most people prefer not to exert and make effort.

 
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Life Pre and Post Obesity surgery: FAQS

Life after Bariatric surgery

The best exercise for bariatric surgery patients achieves a balance of three fitness keystones: Endurance, Flexibility, Strength.

Start slowly. With your Physiotherapist’s consent, try a few light stretches in bed the morning after your surgery. Walk, walk, walk during the initial recovery period. Walk several times a day, even if you can only last for two or three minutes. Until your Physiotherapist gives the OK, walk on flat even surfaces. In the weeks following surgery, engage in short bursts of cardiovascular exercise in order to build cardiovascular endurance. From days two to seven following surgery, walk for three to five minutes at a time, four to six times a day. The first week following surgery, walk 5 to 15 minutes, 3 times a day.

Flexibility exercise for bariatric surgery patients improves coordination, increases blood flow to muscles resulting in less soreness and more energy and improves chronic problems such as low back pain. To get started, we highly recommend a beginner’s yoga class.

Avoid abdominal exercises until they have been approved by your doctor usually at least four to six weeks after surgery. Lift weights after your doctor has informed you that your wounds are sufficiently healed. Gastric bypass patients are at greater risk for osteoporosis. Weight bearing exercise is a great way to battle bone loss. Swimming and weight training are excellent low impact exercises. They are recommended as parts of a post gastric surgery exercise program.

 
    Head Injury Update

Dr Shameem Ahmed, Dr Atanu Borthakur, Dr Sajida Sultana, Dr Shabbir Khan. Dept. of Trauma and Neurosurgery, Hayat Hospital, Guwahati, Assam.

India accounts for 1 million accidents per year and over 100,000 death/year. Overall, 1 accident per minute and 1 death in every 4 minutes. Per 1 million km driven, there are 6 deaths in India. In the US, the figure is 1 death per 1.6 million km driven. Almost 100,000 accidents occur when the driver falls asleep behind the wheels and among them 12000 die. Number of deaths in road accidents in India was 80,262 in the year 2001 which increased to 1,01,555 in 2006. Death traps in road are caused mainly by truck/lorry followed by two–wheeler, bus and car.

 
    Mind Teaser

Read this…………………

buckDROPet

Yesterday’s Mind Teaser: t
                                      s u
                                      i h
                                      t s

Answer for Yesterday’s Mind Teaser: Sit down and shut up

Correct answers received from: Dr Manjesha, Dr Chandresh Jardosh, Dr (Maj. Gen.) Anil Bairaria, Dr Sudipto Samaddar, Dr Rakesh Bhasin, Dr K.Raju, Dr C.Vaishnavi, Dr Madh,u Sinha, Dr Neelam Nath, Dr Rashmi Chhibber, Dr Suman Bala, Dr Y J Vasavada, Dr Anupam Sethi Malhotra, Dr Bina Sawhney, Dr Meera Rekhari

Answer for 28th March Mind Teaser
: Equal rights
Correct answers received from: Dr C.Vaishnavi, Dr Amol R. Hartalkar, Dr K.P.Rajalakshmi, Dr Bina Sawhney

Send your answer to ijcp12@gmail.com

………………………………

 
    Laugh a While

(Dr.Veena Aggarwal)

The Leave Application

An employee applied for leave as follows:

Another gem from CDAC. Leave-letter from an employee who was performing his daughter’s wedding:
“as I am marrying my daughter, please grant a week’s leave..”

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Hypercalcemia

  • Conditions causing hypercalcemia: Malignant neoplasms (with or without bone involvement), primary and tertiary hyperparathyroidism, sarcoidosis, vitamin D intoxication, milk–alkali syndrome, Paget’s disease of bone (with immobilization), thyrotoxicosis, acromegaly, and diuretic phase of renal acute tubular necrosis.
  • For a given total calcium level, acidosis increases the physiologically active ionized form of calcium.
  • Prolonged tourniquet pressure during venipuncture may spuriously increase total calcium.
 
    Medi Finance Update

(Dr GM Singh)

I have deducted tax from payments disbursed but used the same for some urgent financial needs. What are the consequences?

It is an offence to misuse the tax deducted at source. It should have been remitted to government account within the time allowed. The failure attracts tax, interest, penalty and also rigorous imprisonment up to seven years.

 
    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
Indication
DCI Approval Date
Rosuvastatin Calcium Tablet (Additional Indication)
Risk reduction of MI, stroke and arterial revascularisation procedure in patients without clinically evident CHD but with multiple risk factors
24/05/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Antibiotic prophylaxis and UTIs

Data from a time to event analysis suggest antibiotic prophylaxis discontinuation in the majority of patients (children under the age of 18 years) with persistent vesicoureteral reflux who initially present with a febrile urinary tract infection, once their elimination habits have been optimized.

 
  Quote of the Day

(Dr Vasant Shenoy)

Life is just like a sea, we are moving without an end.
Nothing stays with us, what remains is just the memories of some people who touched us as waves.

 
    Readers Responses

Dear Sir, I would like to bring to your notice that most doctors in India are involved in private practice. They work day and night for earning their living. But, God forbid if they are in any accident, then their work practice suffers and they also do not have any safety net for themselves and their family. I suggest that there should a mechanism of Group Insurance – Accident and Disability Insurance. Of course, each doctor can buy this insurance as an individual, but buying as a group – like IMA then it can become very cheap and affordable. I would like to plead to the present IMA Chairpersons to initiate such a proposal to the appropriate forum. Also, a health insurance may also be done. With Regards: Dr Kunal Das.

 
    Public Forum

(Press Release for use by the newspapers)

Conference on Indian Parampara opens on Sunday 3rd April, 2011

Dr. S.Y. Qureshi, Chief Election Commissioner of India will open the one–day 8th World Fellowship of Religions on Sunday, 3rd April, 2011 at Maulana Azad Medical College. The sammelan will focus on Global Warming, Ethnic Crises and Science Behind Indian Rituals.

Giving the details, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, co–organiser of the event, said that the current nuclear disaster and tsunami episode in Japan with over 20,000 deaths have made it necessary for people to talk about global peace and safety.

‘As is the macrocosm so is the microcosm’ is a well–known vedic saying which shows that consciousness of the people influences the environment. The sum total of tsunami–like negative thoughts happening in the society ultimately results into a tsunami–like episode in the universe. Subjects like ethnic crisis are the subjects of Kalyug.

In Bhagwad Gita, pralaya has been described as an era with sun in the sky and water everywhere on the earth. Probably, the vedic description at that time was talking about global warming.

 
    eMedinewS Special

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

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

HCFI
Activities eBooks

  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein
 
    Situation Vacant

Vacancy for a post of Consultant in Pediatric ICU at Medanta – The Medicity Hospital, Sector –38, Gurgaon.
Interested candidates may please contact: drneelam@yahoo.com/9811043475.

*Eligibility: Post MD/DNB/DCH

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Sunday 3rd April, 2011, World Fellowships of Religions and Perfect Health Parade First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof on Global Warming, Ethnic Crises, How to be Healthy
Venue: Maulana Azad Medical College Auditorium, New Delhi;Time: 8 AM – 4 PM.
Parade through tableaus to be flagged off at 10 am from outside MAMC to move till 5 pm on different predefined routes in Delhi to create awareness about health matters.
Parade Route: Vikas Marg – Shahdara – Seemapuri – Guru Tegh Bhadur Hospital – Seelampur Pusta – Gandhinagar, to ISBT Kashmiri Gate – Civil Lines – Delhi University North Campus – Azadpur – Punjabi Bagh – Mayapuri – Raja Garden – Janakpuri – Tilak Nagar – Tihar Jail Road – Delhi Cantt. – R.K Puram – Munirka – IIT Gate – Panchsheel Park – Chirag Delhi Flyover – Nehru Place – Modi Mill Flyover – Ashram – Nizamuddin – Sunder Nagar – Pragati Maidan – ITO – finally culminate at Maulana Azad Medical College at 4pm. Full day conference on ethnic crisis and global warming. Pre lunch session to be addressed by religious representatives who would talk on what each religion has to say. Post lunch to be addressed by doctors from all streams of medicinal practice (allopathy, ISM)
Register: rekhapapola@gmail.com

………………………………………………………………

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD , Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com

………………………………………………………………

May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com

………………………………………………………………

September 30 – October 02, 2011;XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do i assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org

………………………………………………………………

ICC Cricket World Cup 2011
http://www.cricbuzz.com/cricket–schedule/series/228/icc–world–cup–2011

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