emedinews
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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 December, 2010, Friday                                eMedinewS Presents Audio News of the Day

2nd eMedinewS – revisiting 2010 at http://www.docconnect.com on 9th January 2011

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

Avoid Binge Drinking at the New Year Celebrations

During New Year celebrations many of us can put ourselves including our family, and our community in danger of experiencing many harmful health and safety outcomes from binge drinking.

Binge drinking is defined as 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women. One American drink is 40 ml of whisky (13 grams) and one India drink is 30 ml (10 grams) of whisky. Drinking too much, including binge drinking, is a leading preventable cause of death. More than 15% of adults report binge drinking. It is most common in men, adults in the 18–34 age range. Most people who binge drink are not alcohol–dependent or alcoholics and often engage in this behavior without realizing the health and social problems of their drinking. Alcohols can also be mixed with date rape drugs which are colorless and odorless.

Binge drinking increases the chances of:

  • Road traffic accidents
  • Violence against others and sexual assaults.
  • Risky sexual behaviors that can lead to HIV, sexually transmitted diseases (STDs), and unintended pregnancy.
  • Alcohol poisoning.
  • Babies born with fetal alcohol spectrum disorders.
  • Over time, binge drinking can lead to liver disease, certain cancers, heart disease, and other chronic diseases.

What can one do?

  • Choose not to binge drink and help others not to do it.
  • Avoid mixing alcohol with energy drinks, which can mask the depressant effects of alcohol.
  • Avoid drinking and driving
  • A rough formula is ‘one peg can impair driving for one hour.’
  • Avoid purchasing or serving alcohol to children and teenagers.
  • Choose not to drink if you are pregnant, or may become pregnant.
  • Talk about your drinking behavior and request counseling when required.
  • Participate in community efforts to prevent binge drinking.
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

  Topic: eMedinewS Top 10 Health Stories of 2010

National Programme for Prevention & Control of Cancer, Diabetes, CVD and Stroke (NPCDS) started in the Country

Audio PostCard
 
  Quote of the Day

(By Dr Prachi Garg)

"Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy."

Thich Nhat Hahn

 
    Photo Feature (from the HCFI Photo Gallery)

 1st eMedinewS Revisiting 2009

Padma Bhushan Dr Naresh Trehan and Padma Shri & Dr BC Roy National Awardee Dr KK Aggarwal at 1st eMedinewS Revisiting 2009, a day–long CME.

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

eMedinewS Revisiting 2010 to have a live webcast

eMedinewS Revisiting 2010 will have a live webcast on www.docconnect.com on 9th January, 2010. Those who will not be able to attend the conference can watch the proceedings live on the website. The webcast was a great success last year. The conference will have eminent speakers. Look out for the program details in the forthcoming editions of eMedinewS. We expect 1000 doctors to attend conference live and 1000 doctors to see it through the website.

2005 repeating itself in 2011

Indore: Strange as it may seem, the calendar for 2005 is all set to be repeated in 2011. In case you happen not to believe this, look at the calendars of these two years and you will find them totally identical. For example, the first day of both the years is Saturday; January 26 falls on a Wednesday; and August 15 on Monday. (Source: The Hindu, December 30, 2010)

 
    International News

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

Statement stresses importance of exercise in diabetes

People who engage in regular physical activity (PA) may reduce their risk for developing type 2 diabetes mellitus (T2DM), and people with T2DM may reduce symptoms and complications and increase quality of life by participating in regular PA, according to a statement published in the December issue of Medicine & Science in Sports & Exercise. A joint committee of the American College of Sports Medicine and the American Diabetes Association compiled a position statement to stress the importance –– now well–established in high–quality studies –– of exercise and fitness for controlling symptoms and improving outcomes in people with T2DM. According to the statement, a combination of PA and weight loss can lower the risk for T2DM by 58 percent in high–risk populations, and regular PA improves blood glucose, lipid profiles, and blood pressure; reduces cardiovascular events and mortality; and improves quality of life. The authors note that most of the benefits PA provides for diabetes management are a result of acute and chronic improvements in insulin action, which is accomplished with resistance and aerobic training.

(Dr Monica and Brahm Vasudev)

Almost half of psoriasis patients have metabolic syndrome

According to a study published in the Archives of Dermatology involving more than 6,500 adults, 40% of patients with psoriasis were found to have the metabolic syndrome.

FDA approves 60–Second HIV test

The US FDA has approved a single–use rapid test (INSTI HIV–1) that detects antibodies to HIV–1 in as little as 60 seconds. The test utilizes flow–through rather than lateral–flow technology to reduce processing time.

FDA denies Jet Lag indication for sleep disorder drug

The FDA has again rejected an application to add jet lag to the list of approved indications for armodafinil (Nuvigil), prompting its manufacturer to drop the effort once and for all. Armodafinil is approved for excessive sleepiness associated with treated obstructive sleep apnea, narcolepsy, and changing work shifts.

Acid–suppressants drugs linked to pneumonia

A meta–analysis has found that drugs that suppress acid reflux may modestly increase the risk of both community– and hospital–acquired pneumonia. In the analysis, use of PPI predicted a 27% elevated risk of pneumonia overall (95% confidence interval 1.11 to 1.46). Histamine2 receptor blockers increased overall pneumonia risk by 22% compared with nonuse (95% CI 1.09 to 1.36).

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

How to retrieve sperms in patients with Klinefelter syndrome?

Sperm retrieval rates are higher in Klinefelter syndrome patients with serum testosterone near the reference range ( >250 ng/dL).

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 percent pregnancy rate with six cycles of insemination. Children born from pregnancies resulting from donor insemination grow and develop normally, both physically and psychologically.

For queries contact: banerjee.kaberi@gmail.com

 
    Hepatology Update

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

What is Wilson disease?

Wilson disease (WD; also known as hepatolenticular degeneration) is a familial, lethal neurological disease accompanied by chronic liver disease leading to cirrhosis. The pattern of inheritance is autosomal recessive.

WD occurs worldwide with an average prevalence of 30 affected individuals per million population. Absent or reduced function of ATP7B protein leads to decreased hepatocellular excretion of copper into bile which results in copper accumulation and injury of liver and failure to incorporate copper into ceruloplasmin. Over a period of time, copper is released into the bloodstream and deposited in other organs, like brain, kidneys, and cornea. It can present clinically as liver disease, as a progressive neurological disorder, or as psychiatric illness.

Wilson disease presents with liver disease more often in children and younger adult patients than in older adults. Symptoms at any age are frequently nonspecific.

 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Duty of care in administration of treatment to undertaken patient

Ingredient of mens rea exist where there is a charge of criminal negligence.

  • The ingredient of medical negligence is the duty of care. Person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed with skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties.
  • The standard of this reasonable care is definitely a flexible criterion, capable of setting the boundaries of legal liability of the professionals depending on the duties founded on principles of torts or contracts.
  • A medical practice acceptable to the profession on the day of medical care delivered he can’t be held liable for negligence merely because a better alternative course of treatment was available or a more skilled doctor would not have chosen to follow or resort to that practice which the accused followed.
  • The term negligence is not an absolute but relative and comparative one. No absolute standard can be laid by which negligence can be infallibly measured in a case. All the facts have to be taken in to account to determine whether negligence occurred or not.
  • He should not be held liable for taking one choice out of the different schools of treatment (Medical Council Act (102 of 1956), S.20A).
 
    Men’s health: Preventing your top 10 threats (Mayo Clinic)

Suicide

Suicide is another leading men’s health risk. An important risk factor for suicide among men is depression. If you think you may be depressed, consult your doctor. Treatment is available. If you’re contemplating suicide, call for emergency medical help or go the nearest emergency room.
 
    Rabies Update

Dr. AK Gupta, APCRI, Author of "RABIES – the worst death"

Name the rabies–free countries

There are about 59 countries that do not report rabies. Few countries are free of rabies as a result of their privileged geographical situation & the strict application of stringent legislation. Such countries include Australia, New Zealand, Japan, Hong Kong, Singapore, Great Britain, Antarctica, Malaysia, Guyana, Jamaica, and Uruguay in America; Bahrain, Qatar, Scandinavia, Spain, Portugal, Fiji, Papua New Guinea in Oceania. In India, the islands of Andaman and Nicobar and Lakshadweep are free of rabies. The islands of Lakshadweep are also free from dogs (WHO–APCRI, 2004).
 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. Is it legally valid to allow a patient to go home on short leave while still admitted in the hospital? If yes, what precautions should be taken in case some mishap occurs while he is away, especially if he is an illiterate patient?

A.

  • I think it would not be proper to use the word leave here. A patient gets admitted for treatment and there should ordinarily be no question of discharging him before treatment is complete. The question or concept of "leave" does not arise.
  • If a patient gets admitted for treatment, he can be discharged in due course only after treatment. If he wants to go midway for some urgent personal work and the physician agrees, he can be discharged on request, to be readmitted later. The discharge formalities (discharge summary etc.) should be completed as usual. It should be clearly written that the patient is being discharged on request.
  • If the patient wants to go midway but the physician does not agree with this approach because of the seriousness of the condition, he can’t be confined to hospital forcibly. In such a situation, he should be discharged on request against medical advice, sometimes written as LAMA (left against medical advice) with full documentation of his condition, including case summary and results of investigations and necessary advice, with proper informed consent for discharge. If the patient does not give consent but leaves forcibly on his own, 2–3 doctors should jointly document the circumstances. (Informed consent for discharge would mean a written statement by the patient that he has been explained and has understood that his condition is serious and he is not fit for discharge and may suffer serious consequences, including death or disability, if treatment is discontinued). If the patient is illiterate, he should be explained as above in the presence of some relative who should testify that the patient has been fully explained as written in his presence. The patient should also put his thumb impression.
 
    Medilaw – Medicolegal Judgement

(Dr KK Aggarwal)

Can DMC initiate enquire in a criminal case?

No, one has to go through the DMC/DC/F.14.Comp. 720/2010/dated/26th July, 2010 where the council observed. On perusal of the complaint, the Delhi Medical Council observed that allegation of Dr. DKG being accused of offenses of under the Indian Penal Code, being subject matter of criminal jurisprudence, hence, if the same is proved against the alleged doctor in the Court of Law, such judgment can be taken into consideration for initiating disciplinary action against a registered doctor, however, till such time, no action would be deemed plausible".

 
    Ethical earning

What is reimbursable to a doctor?

If the patient is coming to show reports, he should pay consultation fees. This is what the practice is when he is admitted.

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Plasma Free Metanephrine

To help diagnose or rule out a pheochromocytoma.

Related tests: Catecholamines, Plasma and Urine; Urine Metanephrines; Vanillylmandelic acid (VMA)

 
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  Docconnect Dr Veena Aggarwal
  Docconnect Dr Aru Handa
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  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
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    Medi Finance Update

(By CA Arun Kishore, Arun Kishore & Co., Chartered Accountants)

Can one claim leave travel expenses for family twice in a block of four years?

Yes.

 
    Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name
Indication
DCI Approval Date
Calcium acetate 435mg + Magnesium carbonate 235mg tablets
For the management of hyperphosphatemia in adults patients with renal failure being treated with dialysis (hemodialysis or peritoneal dialysis
5/3/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Chronic daily headache

Chronic daily headache usually consists of a mixture of migraine and tension–type headaches (TTH), with the more severe headaches having migraine features and the less severe headaches fitting the definition of TTH.

(Ref: Couch JR. Update on Chronic Daily Headache. Curr Treat Options Neurol. 2010 Nov 20. Epub ahead of print)

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient of ulcerative colitis was a chain smoker.
Dr. Bad: Stop it.
Dr. Good: Shift to nicotine patch and slowly withdraw it.
Lesson: Nicotine has remittance producing properties in ulcerative colitis.

Make Sure

Situation: A patient developed rifampicin toxicity.
Reaction: Oh my God! Why was history of Ayurvedic drugs not taken?
Lesson: Make sure to enquire if a patient is also on Ayurvedic drugs. Trikatu can enhance the action of anti TB drugs.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prabha Sanghi)

Life Is a Gift

Today before you say an unkind word – Think of someone who can’t speak.
Today before you complain about the taste of your food – Think of someone who has nothing to eat..
Today before you complain about your husband or wife – Think of someone who’s crying out to GOD for a companion.
Today before you complain about life – Think of someone who went too early to heaven…
Today before whining about the distance you drive Think of someone who walks the same distance with their feet.
And when you are tired and complain about your job – Think of the unemployed, the disabled, and those who wish they had your job.
And when depressing thoughts seem to get you down – Put a smile on your face and think: you’re alive and still around.
I pray this moves around the entire Universe.

— — — — — — — — — —

Mind Teaser

Read this…………………

I right I

Yesterday’s Mind Teaser: "tree ri_ge tree"
Answer for yesterday’s Mind Teaser:
Partridge in a pair (of) tree(s)

Correct answers received from: Dr K Raju, Dr Rohini Vaswani, Dr Sudipto Samaddar, Dr Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr Neelam Nath

Answer for 29th December Mind Teaser: Paralegals
Correct answers received from: Dr U Gaur, Dr Anurag Jain, Dr Sudipto Samaddar, Dr G Padmanabhan, Dr C Vaishnavi  

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr Mukul Tiwari)

On a Septic Tank Truck: Yesterday’s Meals on Wheels

 
    Readers Responses

Letter to Editor
Dear Dr Aggarwal, Lots of thanks for the informative bulletin; every doctor finds some thing interesting & informative as per his choice. Regarding doctors; charges, TPAs & other insurance companies especially CGHS are making things very tight. The charges for all the procedures, surgeries & consultations are so low one cannot imagine (e.g. CGHS – OPD consultation Rs 50/–; indoor visit Rs 63/– only for Specialist/ Super Specialist). I request YOU & other senior faces of our fraternity to intervene in this matter so that qualified doctors don’t feel humiliated. Dr VK Goel

 
    Public Forum

(Press Release for use by the newspapers)

Not all need bypass or angioplasty: new guidelines released

"Appropriate Use Criteria for Coronary Revascularization," is the first set of guidelines which clarify under what conditions people with chest pain should be treated with just medication and therapy –– or with this combination plus revascularization, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Revascularization is the medical procedure in which proper blood flow to the heart is restored through bypass surgery or use of a balloon–tipped catheter that breaks up plaque in the arteries.

The guidelines categorize people by four main criteria: severity and type of symptoms; plaque levels in the arteries; amount of ischemia (how badly the heart muscle is starved for blood and oxygen, based on stress testing); and whether they already use heart medication. The guidelines were developed by a 17–member panel of experts from the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, the Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the American Heart Association and the American Society of Nuclear Cardiology.

The guidelines call for revascularization only if the potential for health and quality–of–life improvements outweigh the possible risks.

People with plaque buildup in less than three arteries and little heart muscle at risk, who experience symptoms only during strenuous exercise and are not on medication are not considered candidates for revascularization. The exception would be people already on the best available heart medication to combat severe symptoms.

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 9th 2011.

The one–day conference will revisit and cover all the new advances in the year 2010. There will also be a webcast of the event. The eminent speakers will be Padma Bhushan Dr Naresh Trehan (Cardiac Surgery); Padma Shri Dr KK Aggarwal (Revisiting 2010); Dr Neelam Mohan (Liver Transplant); Dr N K Bhatia (Transfusion Medicine); Dr Ambrish Mithal (Diabetes); Dr Anoop Gupta (Male Infertility); Dr Kaberi Banerjee (Female Infertility) and many more.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

2nd eMedinewS Doctor of the Year Award

Dear Colleague, The Second eMedinews Doctor of the Year Award function will be held on 9th January, 2011 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2010, send his/her biodata: Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee.

IMSA Workshop on Rheumatoid Arthritis

Date: Sunday, January 16, 2010 ; Venue: Moolchand Medicity, New Delhi; Time: 10–12 Noon

Speakers:

  1. Understanding Biologics: Dr Rohini Handa, Former Head Rheumatology, AIIMS
  2. All what a practitioner should know about rheumatoid arthritis: Dr Harvinder S Luthra, Chief of Rheumatology, Mayo Clinic, Rochester USA

No fee. Register emedinews@gmail.com or sms 9899974439

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