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FIRST NATIONAL 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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

31st July 2011, Sunday

Children & Adolescent Mobile Users at No Greater Risk of Brain Cancer

There has been a concern about the possibility of developing brain tumors since children have a developing nervous system and their head circumference is smaller, the radiofrequency electromagnetic fields may penetrate regions that are deeper in their brains. However, a new study has shown that children and adolescents who use mobile phones are not at a statistically significant increased risk of brain cancer compared to their peers who do not use mobile phones. The study was published on July 27 in the Journal of The National Cancer Institute.

Emedinews Comments: Is the study applicable to India where there is a lot of active and passive mobile radiation exposure? Is there any study available about the cancer risk taking into account both ionizing and non ionizing radiations? Till their safety is certified, one should use mobile phones only when one is mobile and definitely less than 2 hours a day.

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Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Children & Adolescent Mobile Users at No Greater Risk of Brain Cancer

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medicolegal Issues

Hon’ble Justice AK Sikri was felicitated at the National Conference on Insight on Medico legal issues.

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

Blood donors soon to be issued universally accepted master card

To ensure timely availability of blood to the donors or their relatives, blood donors will soon be issued universally accepted master donor card which would be valid throughout the country. For instance, a blood donor from Delhi having such a card will be eligible to approach any blood bank (including private sector) in any other State for himself or for his immediate family in case of emergency. Conceived by the National Aids Control Organisation (NACO), a pilot project would be soon rolled out from Delhi wherein cards having a hologram, a logo and a photo identity will be issued to the blood donors.
The universal cards whose validity will be for a year are expected to do away the major drawbacks under the existing system where blood donors are turned away by the blood banks in case they are not registered with them (not donated blood earlier). (Source: The Pioneer, July 26, 2011)

For comments and archives

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

(Dr Monica and Brahm Vasudev)

WHO: Hepatitis toll ‘in millions’

Medical experts are calling for global action to tackle the viruses that cause the liver disease hepatitis. The first worldwide estimates in drug users show 10 million have hepatitis C while 1.3 million have hepatitis B. Writing in the Lancet, experts say only a fraction of those who could benefit are receiving antiviral drugs. Only one in five infants around the world are vaccinated against hepatitis B at birth, they say. The figures, published in the Lancet, show about 67% of injecting drug users in the world have been exposed to hepatitis C, while around 10% have come into contact with hepatitis B.
(Source: http://www.bbc.co.uk/news/health–14314347, 28 July 2011)

For comments and archives

Tylenol maker lowers maximum dose

McNeil Consumer Healthcare has announced it is lowering the maximum daily dose instructions for Extra Strength Tylenol to six pills a day (3,000 mg) to reduce the risk of acetaminophen overdose. The currently recommended maximum dose is eight pills a day (4,000 mg). (Source: Medpage Today)

For comments and archives

Liver cancer linked to metabolic syndrome

Patients with metabolic syndrome had as much as a twofold increased risk of liver cancer as compared with people who did not have the syndrome, data from the National Cancer Institute showed. Metabolic syndrome was associated with a significantly increased risk of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). The risk for HCC was greater, associated with a hazard ratio of 2.13 versus individuals without metabolic syndrome. Moreover, 43% of the patients with liver cancer had no previously established risk factors for the cancer, investigators reported online in Hepatology.
(Source: Medpage Today)

For comments and archives

 
    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Healthy lifestyle reduces the risk of sudden cardiac death

Sudden cardiac death (SCD) accounts for more than half of all cardiac deaths in the United States, an estimated 300,000 cases each year according to the Heart Rhythm Society. A new study published in the Journal of the American Medical Association, which is the first to investigate the lifestyle determinants of the condition, reveals that exercise is a key factor in preventing sudden cardiac death. Researchers from Harvard University collected data from a total of 81,722 women who were enrolled in the study, which took place from 1984 until 2010. Participants were divided into three groups, according to the following lifestyle factors: nutrition, exercise and smoking. Women in the healthiest lifestyle category ate a healthy, balanced diet, did not smoke, and engaged in 30 minutes of physical activity per day. These women were 92% less likely to suffer from sudden cardiac death as compared to their counterparts in the other two lifestyle groups, who were classified as having a riskier and less healthy lifestyle.

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: #IJMD The levels of the enzyme alkaline phosphatase have proved to be a good indicator of gingival health and disease… http://fb.me/P7u2mdqY

@DeepakChopra: #CosmicConsciousness. Illness begins with "I". Wellness begins with "We–"

 
    Dr KK Answers

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

What should be ideal Hb of a patient with CKD?

Hemoglobin (Hb) levels above 11 g/dL in patients with chronic kidney disease (CKD) and dialysis patients have been associated with death, cardiovascular risk, and stroke. The US FDA recommends that patients with CKD receive erythropoietin–stimulating agent therapy only when Hb is below 10 g/dL and patients on dialysis should maintain their hemoglobin in the 10–11 g/dL range.

For comments and archives

 
    Spiritual Update

Can one combine Allopathy with Ayurveda?

Combining Eastern philosophy with the Western technology: This concept is based on ancient eastern philosophy spread internationally by the new age guru Dr. Deepak Chopra. It deals with health not merely on physical grounds but also on mental, social, spiritual and environmental aspects. The concep

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

The LITTLE Things

As you might know, the head of a major company survived the tragedy of "9/11" in New York because his son started kindergarten. Another fellow was alive because it was his turn to bring donuts.

One woman was late because her alarm clock didn’t go off in time. One was late because of being stuck on the NJ Turnpike because of an auto accident. One of them missed his bus. One spilled food on her clothes and had to take time to change. One’s car wouldn’t start. One went back to answer the telephone. One had a child that dawdled and didn’t get ready as soon as he should have. One couldn’t get a taxi. The one that struck me was the man who put on a new pair of shoes that morning, took the various means to get to work but before he got there, he developed a blister on his foot. He stopped at a drugstore to buy a Band–Aid. That is why he is alive today. Now when I am stuck in traffic…miss an elevator… turn back to answer a ringing telephone… all the little things that annoy me… I think to myself… this is exactly where God wants me to be at this very moment.

The next time your morning seems to be going wrong, the children are slow getting dressed, you can’t seem to find the car keys, you hit every traffic light… don’t get mad or frustrated; God is at work watching over you.

May God continue to bless you with all those annoying little things – and may you remember and appreciate their possible purpose.

For comments and archives

 
    Idioms

(By Ritu Sinha)

Back to square one: Having to start all over again

 
    Pediatric Update

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

When does one suspect croup?

Croup is a viral illness and the diagnosis is usually clinical. It typically presents with a constellation of:

• Barky cough,
• Hoarse voice
• High–pitched, inspiratory stridor

It usually follows a prodrome of mild fever, rhinorrhea and sore throat. Symptoms tend to worsen during late night and early morning. The breath sounds are normal with no added sounds except stridor. Occasionally, there may be wheezing, indicating severe narrowing or associated bronchitis.

For comments and archives

 
  Infertility Update

(Dr Kaberi Banerjee, Dr. Kaberi Banerjee, Infertility and IVF Specialist, Max Hospital)

What is the importance of Measles, Mumps, and Rubella (MMR) vaccine?

MMR vaccine contains live attenuated virus. Vaccination therefore should be administered before pregnancy to avoid the possibility of intrauterine infection, and pregnancy should be avoided for one month after vaccination. Consequently, inadvertent MMR administration during pregnancy is not an indication for pregnancy termination.

For comments and archives

 
  GP Pearls

(Dr Pawan Gupta)

All cases of lymphadenitis should undergo FNAC/Cytology/Mycobact, culture of pus and tissue/smear exam with ZN stain and fluorescence to differentiate non tubercular mycobacteria (NTM) from Mycobacterium tuberculosis. Sometimes glands increase in size or form a sinus or new glands appear. This may be due to NTM infections, which may respond to clarithromycin and rifabutin with or without ethambutol. On smear, the dead NTM will look like tubercular but shall be identified in culture (no growth of dead bacterium).

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  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Insulin–like growth factor–1 (IGF–1)

IGF–1 test may be ordered, along with a GH stimulation test, when a child has symptoms of GH deficiency, such as a slowed growth rate and short stature. They also may be ordered when adults have symptoms that the doctor suspects may be due to a GH deficiency. An IGF–1 also may be ordered when a doctor suspects that a person has an underactive pituitary gland and at intervals to monitor patients on GH therapy.

IGF–1 testing may be ordered, along with a GH suppression test, when a child has symptoms of gigantism, an adult shows signs of acromegaly, and/or when a doctor suspects that a patient has hyperpituitarism.

To identify diseases caused by deficiencies and overproduction of growth hormone (GH), also to evaluate pituitary function. and to monitor the effectiveness of GH treatment.

This test is prescribed as part of an evaluation of pituitary function, when you have symptoms of slow growth, short stature, and delayed development or decreased bone density, reduced muscle strength, and increased lipids that suggest insufficient GH and IGF–1 production. Also when you have symptoms of gigantism (in children) or acromegaly (in adults) that suggest excess GH and IGF–1 production.

IGF–1 may be ordered with other pituitary hormone tests, such as adrenocorticotropic hormone (ACTH), to help diagnose hypopituitarism. It may be used to monitor the effectiveness of treatment for growth hormone deficiencies and growth hormone insensitivity.

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with community acquired pneumonia due to S. pneumoniae came with resistance to penicillin and erythromycin.
Dr Bad: This may happen.
Dr Good: It is multidrug–resistant S. pneumoniae.
Lesson: Multidrug–resistant S. pneumoniae (MDRSP) is defined as resistance to more than one antimicrobial class (e.g, penicillin–resistant and macrolide-resistant).

For comments and archives

Make Sure

Situation: A patient with human bite developed infection.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure all patients with human bite are timely put on beta–lactam/beta lactamase inhibitor antibiotics.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

A man is but the product of his thoughts, what he thinks, he becomes. Mahatma Gandhi

 
    Medicolegal Update

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

Hair and fiber, found on human body or at the scene of crime, are commonly used in investigation in cases of assaults, sexual offences, bestiality

  • Hair comprises mainly two parts: Shaft is the part above the skin; root lies below the skin. The root has a bulb as a base, embedded in hair follicle. The cuticular scales cover the shaft. The shaft has two layers: outer one is called cortex, and the inner one medulla.
  • The hair pigment is present in the cortex. The cuticular scales present around the cortex are non–nucleated cells originating from follicle, and are keratinized. The medulla consists of cylinder–like cells produced by matrix cells. The ratio of medullar diameter to that of the shaft is known as medullar index.
  • The medullary column is present in the centre of the cortex. The pigment granules present in the cortex consist of melanin. It is made up of several units of monomer, consisting of indole and quinone. It contains amino acids like dihydroxy phenylalanine and tyrosine.
  • The medullary cells contain large amount of glycogen.
  • Macroscopic and microscopic examination of hair is done in the Forensic Laboratory, to distinguish it from fiber and to ascertain whether the hair is of a human hair or an animal and to fix the individual identity.

For comments and archives

 
    Mind Teaser

Read this…………………

Contact lens wear is proven to have deleterious effects on the corneal physiology. Which of the following statements is incorrect in connection with contact lens wear?

1. The level of glucose availability in the corneal epithelium is reduced.
2. There is a reduction in hemidesmosome density.
3. There is increased production of CO2 in the epithelium.
4. There is a reduction in glucose utilization by corneal epithelium.

Yesterday’s Mind Teaser: A 30–year–old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph. at 1 meter distance. His complaints are blurring of newsprint at 30 cm. that clears up in about two minutes. The most probable diagnosis is:

1. Hypermetropia
2. Presbyopia
3. Accommodative inertia
4. Cycloplegia

Answer for Yesterday’s Mind Teaser: 3. Accommodative inertia.

Correct answers received from: Dr Anurag Julka, Dr K Raju, Dr Chandresh Jardosh, Dr Surendra Bahadur Mathur, Dr Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay.

Answer for 29th July June Mind Teaser: d. Urine dip for nitrites and leukocytes esterase should be routinely used for diagnosis
Correct answers received from: Dr Priyanka Sharma, Dr Seema Sharma, Dr Anupama.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

There were three men in a lifeboat in shark infested water – a lawyer, doctor and a minister. All of a sudden the boat began to spring a leak, so as they were bailing out the water one of them looked over the side and printed there were the words: ‘maximum capacity 2 persons’, so they decided to draw straws and see who would jump overboard and save the other two. The lawyer drew the short straw and said: "Well I will see you on shore and then he jumped out of the boat and began to swim and the sharks instead of attacking him formed a clear lane like an honor guard. "It’s a miracle they did n’t attack him!", said the minister. "Oh it’s no miracle, just professional courtesy", said the doctor.

For comments and archives

 
    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
Indication
DCI Approval Date
Gatifloxacin Eye drop 5 mg/ml
For the treatment of bacterial conjunctivitis caused by susceptible strains.
21.02.11
 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online (English/Hindi/Audio/Video/Photo)

Hepatitis B more deadly than HIV

Chanakya started the concept of ‘Vishkanya’ or a "poisonous girl". Today, a ‘Vishkanya’ may represent a sexually active girl with hepatitis C, hepatitis B and/or HIV infections, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Over 200 diseases can be transmitted through blood including hepatitis B virus, hepatitis C virus and HIV. HIV, Hepatitis B and Hepatitis C all can be transmitted through blood products or sexual route. The prevalence of HIV is 0.3% in the general population and that of hepatitis C is up to 5%.

Hepatitis B is the most infectious of the three blood-borne viruses. It gets transmitted by percutaneous and mucosal exposures and HUMAN BITES. It can also be transmitted by FOMITES such as FINGER STICK BLOOD SUGAR CHECK, multi dose medication vials, jet gun injectors, and endoscopes. The virus can SURVIVE ON COUNTERTOPS FOR UPTO SEVEN DAYS and remains capable of causing infection.

Transmission of hepatitis C virus can occur from infected fluid splashes to the conjunctiva. Hepatitis C virus can survive on environmental surfaces for up to 16 HOURS. Testing of all health care workers for hepatitis C virus should be performed after needle sticks, sharp injuries, mucosal, or non intact exposure to hepatitis C virus positive blood. The average incidence of seroconversion to hepatitis C virus after unintentional needle sticks or sharps exposures from hepatitis C virus positive source is 1.8 percent (range, 0–7 percent).

The first step after being exposed to blood or bodily fluids is to wash the area well with soap and water. EXPRESSING FLUID BY SQUEEZING the wound will not reduce the risk of blood–borne infection.

Give Hepatitis B vaccine to all unvaccinated persons after exposure to blood. If the exposed blood is positive for HBV and the exposed person is unvaccinated, treatment with hepatitis B immune globulin is recommended. For comments and archives

 
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  1. Thanks for including me in your list of recipients of daily emedinews – it is truly a treasure house of information – much appreciated.
 
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.

...more

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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