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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10-13); 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…
eMediTube (videos), eMedipics, eMediSlide, eMediLaw

31st May 2013, Friday

Today is World No Tobacco Day

The theme for 2013 is: ban tobacco advertising, promotion and sponsorship.

Water Hygiene

Safe water is an essential commodity for prevention of most water and food-borne diseases like diarrhea, typhoid and jaundice. These diseases are 100% preventable. All of them can be lethal if not prevented, diagnosed or treated in time.

Transmission of parasitic infections can also occur with contaminated water. Here are a few tips:

  1. Travelers should avoid consuming tap water.
  2. Avoid ice made from tap water.
  3. Avoid any food rinsed in tap water.
  4. Chlorination kills most bacterial and viral pathogens.
  5. Chlorination does not kill giardia cysts.
  6. Chlorination does not kill amoeba cysts.
  7. Chlorination does not kill cryptosporidium.
  8. Boiled water is safe.
  9. Treated water is safe.
  10. Bottled water is safe.
  11. Carbonated drinks, wine and drinks made with boiled water are safe.
  12. Freezing does not kill the organisms that cause diarrhea. Ice in drinks is not safe unless it has been made from adequately boiled or filtered water.
  13. Alcohol does not sterilize water or the ice. Mixed drinks may still be contaminated.
  14. Hot tea and coffee are the best alternates to boiled water.
  15. Bottled drinks should be requested without ice and should be drunk from the bottle with a straw rather than with a glass.
  16. Boiling water for 3 minutes followed by cooling to room temperature will kill bacterial parasites.
  17. Adding two drops of 5% sodium hydrochloride (bleach) to quarter of water (1 liter) will kill most bacteria in 30 minutes.
  18. Adding five drops of tincture of iodine to a quarter of water (1 liter) will kill bacteria within 30 minutes.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Proton–pump inhibitors to carry warning
about C

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

CPR 10 camp was organized by Heart Care Foundation of India at EPFO (Employees Provident Fund Organization), Wazirpur on 30th May 2013

Dr K K Aggarwal
    National News

Centre firm on ‘barefoot doctors’

New Delhi: The Union health ministry has signalled its intentions to go ahead with plans to introduce a cadre of rural health care providers through a new BSc course, ignoring objections from a parliamentary panel, as reported in the Business Standard. The ministry told Delhi High Court this week that it had sent a draft cabinet note on the three-and-a-half-year course in community health to the Prime Minister’s Office for comments. This is standard procedure before the matter is sent to the cabinet.

The so-called “barefoot doctors” who pass the new BSc course will primarily support public and preventive health activities but also possess skills to deal with simple injuries, infections, and other conditions that do not necessarily require MBBS-qualified doctors. A medical lobby has opposed the government’s proposal to introduce the course, whose supporters have accused these doctors of trying to protect their turf. After listening to both sides, the parliamentary panel on health this year asked the government to drop the proposal without elaboration, while acknowledging the need to improve rural health services. “It’s been a long wait. We’re hoping the cabinet will clear this quickly and we’ll see the course start,” said Meenakshi Gautham, a public health specialist in Delhi who had filed a petition in Delhi High Court in 2009 seeking early implementation of the proposal.

The National Board of Examinations had earlier this month approved the curriculum for the course, drafted by a panel of experts appointed by the Medical Council of India. Several panels of medical experts have since 1999 called for the introduction of an educational programme to create rural health care workers with skill levels higher than those of auxiliary nurse-midwives but below those of MBBS doctors. The proposal for an alternative health education programme emerged amid concerns that the existing MBBS education was not preparing doctors to serve in rural areas. Mandatory rural service has been debated in the past but remains largely unimplemented. The Indian Medical Association, a body of mainly private doctors, has run a campaign against the proposed course, claiming that its graduates would be “half-baked doctors”. It says implementation of the proposal would mean rural inhabitants would receive substandard care. But supporters of the course have accused it of trying to protect the interests of town and city-based doctors. “The IMA has consistently ignored the reality of the rural health needs of India and concentrated on turf protection,” said Kunchala M. Shyamprasad, a former cardio-thoracic surgeon and member of a government task force on health education. Some public health experts say that Assam and Chhattisgarh have already demonstrated successful models of such a course. A study by the Delhi-based Public Health Foundation of India has found that rural healthcare providers in Chhattisgarh, trained under a short course, were at times as competent as MBBS doctors in dealing with infections, injuries and maternal health. (Source: The Telegraph, May 29, 2013)

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

    Valvular Heart Disease Update

The left, right, and noncoronary cusps of the aortic valve are visualized by transthoracic echocardiography in the parasternal short-axis view (as well as in a subcostal short-axis view). The left cusp is adjacent to the main pulmonary artery, the right cusp is adjacent to the right ventricular outflow track and the noncoronary cusp is adjacent to the interatrial septum. Aortic valve motion can be visualized in M-mode and two-dimensional views.

(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)

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Preventing the recurrence of maltreatment

In the context of the federal child welfare performance measurement system, recurrence of maltreatment refers to circumstances in which children that have previously been substantiated as victims of abuse or neglect experience another incident of substantiated maltreatment. Multiple episodes of maltreatment can lead to: (1) more serious short and long term negative consequences (2) entry into the juvenile justice system and (3) juvenile delinquency.

(Source: Carnochan S, Rizik-Baer D, Austin MJ. J Evid Based Soc Work. 2013 May;10(3):161-178)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

ACA result: More young adults in the ED

The number of emergency department visits by young adults covered by a parent's private insurance through the Affordable Care Act (ACA) rose significantly from 2009 to 2011, researchers found. (Source: Medpage Today)

Heartburn raises cancer risk, antacids may offer protection

Common antacids might help protect against the development of squamous cancers of the pharynx and larynx, according to data from a large study evaluating the association between heartburn and the use of medications. (Source: Medscape)

Intense glucose control not needed in ICU

There's no need for intensive insulin therapy to control blood sugar in the intensive care unit (ICU), and clinicians shouldn't push levels below 140 mg/dL, according to a new scientific statement from the American College of Physicians. (Source: Medpage Today)

Quantified hydration status predicts hospital readmissions in acute-HF patients

Volume overload measured using a novel technique known as bioelectrical impedance vector analysis, which allows researchers to quantify hydration status, was significantly associated with an increased risk of hospital readmissions in patients with acute heart failure, according to a new study presented at the Heart Failure Congress 2013. (Source: Medscape)

Tamiflu resistance confirmed in H7N9 flu cases

Chinese researchers reported, for the first time, clinical evidence of oseltamivir (Tamiflu) resistance in patients infected with the novel avian H7N9 flu. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: Smoking makes you 5 years older http://bit.ly/145zLqV #Health

@DeepakChopra: Personal identity is a collection of ideas & the source of conflict . Our true self is universal & is infinite love #CosmicConsciousness

    Spiritual Update

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

Sewa the best dharma

Offering help is the best service to the humanity. As per Sikhism, Sewa (unconditional service), Simran (meditation) and Satsang (company of good people) is the trio for acquiring happiness and spiritual health.

For comments and archives

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

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the risks of hysteroscopy?

Only 1% of women have complications from an office hysteroscopy. Complications with operative hysteroscopy include absorption of fluid, infection, bleeding and uterine perforation. If a perforation occurs during an operative hysteroscopy, you may need another procedure to ensure there is no damage to nearby organs such as your intestines, bladder, or blood vessels.

   An Inspirational Story

A new pair of shoes

When I got sober my sponsor told me that I had to be willing to change everything about my life -- everything. So, I wore blue jeans and switched to slacks. I wore western shirts and switched to T-shirts. But the one thing I just couldn't give up was my cowboy boots.

I went to my sponsor and said, "Surely I won't get drunk over a silly pair of cowboy boots. I'm willing to change a lot of things, and if needed I could even give up those boots, but it seems so silly." My sponsor said, "I don't know how silly it is, or if you'll get drunk over those cowboy boots, but I can tell that you are not 'entirely' willing, though."

"Okay, okay," I said. "I'll prove it to you. I'll give up the boots for 30 days just to demonstrate my willingness to God." So, I bought a pair of tennis shoes, and after 30 days of not wearing my cowboy boots, wearing tennis shoes instead, the strangest thing happened -- my feet stopped hurting.

That's how it was getting sober and giving up the high life. I never stopped to think that the boots were causing my feet to hurt, or the booze was causing my life to hurt. I got willing to give up the stuff, one day at a time, for 30 days, then 60 days, then 90 days ... and my life stopped hurting.

And every day I do something different, some change in some small way. Maybe I just put my socks on different, or drive to work a new way. Every day, I try to do Little Things in a Big Way so that when Big Things happen I can handle them in a Little Way.

For comments and archives

   Cardiology eMedinewS

Balloon proves mettle for stent restenosis Read More

   Pediatric eMedinewS

Iodine key for IQ; Pregnancy deficiency affects kids' brains Read More

    Schizophrenia- split in personality

(Dr Amit Singh, MBBS, AMC, DPH, FRANZCP (BT), MPM (Melbourne University), Box Hill Hospital, Melbourne, Australia)

Different types of schizophrenia are as follows:

  • Paranoid
  • Undifferentiated
  • Catatonic
  • Residual
  • Disorganized
  • Early-onset
  • Late-onset
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can RIGs be safely injected into already infected animal bite wounds?

RIGs can be safely injected into already infected animal bite wounds following proper wound cleansing and administration of appropriate antibiotics.

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was on aerobic exercise protocol.
Dr Bad: Continue it.
Dr Good: Add resistance training also.
Lesson: According to a study published in the Journal of the American Medical Association, people with diabetes should mix aerobics with weight training to get the best results in lowering blood sugar.

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 remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

  Quote of the Day (Dr GM Singh)

Any man's life will be filled with constant and unexpected encouragement if he makes up his mind to do his level best each day. Booker T. Washington

    Mind Teaser

Read this…………………

Helen is diagnosed with myasthenia gravis and pyridostigmine bromide therapy is started. The dosage is frequently changed during the first week. While the dosage is being adjusted, the nurse’s priority intervention is to:

A. Administer the medication exactly on time
B. Administer the medication with food or mild
C. Evaluate the client’s muscle strength hourly after medication
D. Evaluate the client’s emotional side effects between doses

Yesterday’s Mind Teaser: The initial nursing goal for a client with myasthenia gravis during the diagnostic phase of her hospitalization would be to:

A. Develop a teaching plan
B. Facilitate psychologic adjustment
C. Maintain the present muscle strength
D. Prepare for the appearance of myasthenic crisis

Answer for yesterday’s Mind Teaser: C. Maintain the present muscle strength

Correct answers received from: Dr.Bitaan Sen & Dr.Jayashree Sen, Dr. B.B. Gupta, Dr. P. C. Das, Dr Monica Gandhi, DR AYYAVOO, Dr Pankaj Agarwal, DR ARPAN GANDHI, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr. Thakor Hitendrsinh G, Yamini Alsi, Dr UmaGaur, DR P K SAHU.

Answer for 29th May Mind Teaser: C. Rapid but brief symptomatic improvement

Correct answers received from: Dr UmaGaur, DR P K SAHU.

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Laugh a While (Dr GM Singh)

We spend the first twelve months of our children's lives teaching them to walk and talk and the next twelve telling them to sit down and shut up. Phyllis Diller

    Medicolegal Update

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

Lacerated wound

The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound as seen in MLC cases.

  • Lacerations are tears or splits of skin, mucous membranes, muscle or internal organs produced by application of blunt force to a broad area of the body, which crushes or stretches the tissues beyond the limits of their elasticity.
  • Crush injury from a direct blow may produce an irregular or stellate laceration with a variable degree of devitalized tissue, abrasion and visible contamination.
  • Do not close a laceration if there is visible contamination, debris, non–viable tissue or signs of infection. Wounds may involve vascular areas of the face and scalp where the risk of infection is low or extremities where infection becomes a greater risk, along with the possibility of tendon and nerve damage. The elderly and patients on chronic steroid therapy may present with "wet tissue paper" skin tears following relatively minor trauma.
  • When produced by a blunt weapon, such as club, crowbar, stone, brick etc., a lacerated wound is usually accompanied by a considerable amount of bruising of the surrounding and underlying tissues, and has inverted and irregular edges. The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound.
  • When a heavy weight such as the wheel of a heavy cart or a truck passes over an extremity, by its shearing and grinding force, it tears the skin from the underlying tissue and crushes the muscles and soft part lying beneath it realizing considerable blood and fat in them.
  • Crush injury syndrome or fat emboli may follow a lacerated wound. The tear, avulsion, split are types of laceration.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

31st May is World No Tobacco Day: Benefits of smoking

Speaking in a lighter vein, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA said that smoking also has many advantages.

  • Smokers don’t get old (they die in young age).
  • Smokers don’t get second heart attack (first heart attack may be fatal for them).
  • Smoking cures a cancer in six months (most smoking related lung cancers patients die in six months).
  • Wives don’t suspect smokers (smoker husbands often have erectile dysfunction).
  • Thieves don’t enter smoker’s house (most smokers will develop COPD and continue to cough in the night).
  • There is no fight between smoker brothers (smoking treatment is costly and the patient may have to sell his property for the treatment; once there is no property, the chances of any property-related quarrels are zero).

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 54166 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Sir, emedinews is a good source of information. Regards: Dr Tapan
    Forthcoming Events

Enrollment for workshop

Heart Care Foundation of India under the aegis of Perfect Health Mela is organizing a series of skill workshops in the month of Oct as per the following programmes

Communication Skills 23rd October, Wednesday
8 am
Constitution Club of India
4 hours
Handling Media crisis Saturday 26th October
2 pm
Constitution Club of India
1 hour
Conflict Management 24th October Thursday
10 am
Constitution Club of India
2 hours
Organizational Behavior 24th October Thursday
8 am
Constitution Club of India
2 hours
Team Building 25th October, Friday
8 am
Constitution Club of India
2 hours
Time Management 25th October, Friday
10 am
Constitution Club of India
2 hours

The workshops will have experts interacting both theoretically and with practical demonstrations and interactions. If interested, kindly confirm your registration at rekhapapola@gmail.com. You can also forward this information to your interested friends and colleagues for a registration.

Dr KK Aggarwal
Padma Shri and Dr B.C. Roy National Awardee
President of Heart Care foundation of India

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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