eMedinewS31st May 2014, Saturday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

4 ways to put off joint replacement

  • Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Swimming, walking, or riding a stationary bike are the way to go.
  • Take care when using your joints: By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away.
  • Try nonsurgical approaches before turning to surgery: Treatment with steroid injections is one approach. Benefits can last anywhere from 4 to 6 months — however, it doesn’t work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis.
  • Get pain relief: Use NSAIDS. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. "It doesn’t rebuild joints, but it does seem to help with the pain.
  • If you can’t escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it’s time to consider a joint replacement.

Guest Editorial

Suggestions for the new Health Minister
(Dr Ranjit Roy Chaudhury)

My priority suggestions for the new Health Minister are as below:

  • Formation of a Medical Education Commission
  • Advisory Committee to the Minister of Health
  • Setting up a Department of Quality Medicines for all
  • Committee to consider pros and cons for a All India Public Health Service
  • Merger of all four Departments of Health and Department of Pharmaceuticals
  • Establishment of a National Accreditation Council
  • Formation of a National Ethics Council
  • Formation of a Health and Medicines Insurance Board
  • Formation of a IT and Health Board
  • Commission to consider maximal ethical use of Traditional Medicine Practitioners and pharmacists and non medical practitioners in delivery of primary health care and Universal Health Care
  • Establishment of a Centre State Health Advisory committee
  • Research Task Forces to be set up in the following areas with representation of all systems of medicine and other disciplines
  • MCH and Reproduction
  • Tuberculosis (TB)
  • Coronary heart disease
  • Diabetes
  • HIV and AIDS
  • Stroke
  • Pulmonary disease
  • Cancer
  • Kidney disease
  • Hypertension
  • Commission on Promotive and Positive Health with representation of All systems of Medicine and Yoga

News Around The Globe

National News

A brief summary of the events of 28th Feb. 2014 in the GSVM Medical College, Kanpur and thereafter the Court proceedings and relief given by the High Court Allahabad, Lucknow Bench till date

A tale of terror unleashed at night on innocent Medical College Students leaving scars and handicap for life. It is a tale of gross violation of Human Rights by those very people whose sole important job is to protect it. On 28th Feb 2014 at about 7.00 PM Mr Irfan Solanki, MLA of Samajwadi Party got into a scuffle with two medical students outside the GSVM Medical College Campus near the Medical College Gate. They and other medical students who gathered to help them were mercilessly beaten by the MLA, his gunner, goons and bodyguards. Then the MLA called SSP Mr Yashaswi Yadav who came with heavy police force and few trucks of PAC along with 500 SP workers and charged inside the Medical College Campus after breaking the main gate. Once inside he brutalized the Students, Teachers, Principal, Professors, Wardens and Proctor of the College. Then he ordered the PAC, RAF and QRT to enter the hostel, charge inside and bash up the students, break their backs with lathi charge and fire at them.

The police with the SSP leading them dragged the students from each room, beat them, destroyed their books, valuables, laptops, mobiles, bikes and cars, fired at them from close range and pushed them from 1st, 2nd floor and terrace all the time abusing them in the filthiest slang. They even urinated on their books!! Most of the students were peacefully studying at the time for their exams. This continued till 2PM at night leaving more than 600 students injured. Even 2 juvenile/adolescents who had come to see their elder brothers in the hostel were not spared and mercilessly beaten dragged and dumped in jail without medicines, food or water.

Then 60 students were missing next morning, 40 taken away by police to unknown places (? Thanas). When teachers and parents went to search for them to the SSP’s house and asked about them the SSP abused them and even the DM did not know about their whereabouts and seemed helpless. After 48 hours parents came to know there were 26 students in different Thanas without clothes, food, medicines. The police were ordered by SSP to beat them without any consideration or hesitation. They were treated most inhumanly like even stripping them.

After 48 hours, one boy was rescued from Swaroop Nagar Thana by Professor Arati Lalchandani on learning that he was serious. He narrated how SSP told police to beat them in custody no matter what happened. He was serious. One Professor, HOD Community Medicine Dr RP Sharma and one handicapped boy were freed from far-off Thana (Kotwali) after 24 hours and reported absconded with lodging of false FIRs against them in serious CrPC.

Twenty-four students were shifted to jail after 48 hours from different Thanas. Their medicolegal examination done at CHC Kalyanpur before arrest stated that they were serious with head injury and fatal problems and advised CT MRI; they were also advised to be admitted to Emergency. Yet they were sent directly to jail barracks and not even kept in Jail Dispensary. Many of the injured and jailed medical students were physically handicapped. Two were juveniles who by law could not be jailed or even FIR lodged against them.

Very serious FIRs like 7 Criminal Act were lodged against all the 24 students and even Prof RP Sharma, HOD Comm Med. They were released after 6 days on 6th March 2014 after Dr Arati Lalchandani pleaded with one Kanpur Minister Mr Shiv Kumar Beria, who was moved by the narration of the episode, to get them released otherwise some of them would die in jail.

They were very serious on release and many even collapsed at the feet of Dr Lalchandani. They were admitted directly to ICU of GSVM Medical College and one in Regency Hospital, Kanpur who needed highly specialized care. The medical examination of all 24 students showed that they were very serious and on the verge of fatality. In ICU, CT, MRI, endoscopy, ultrasound and other tests revealed that they had internal injuries and fractures. It was an extreme case of human rights violation by the SSP Kanpur Mr Yashaswi Yadav.

It was a night of horror for Miraj 14 years old who had come to stay with his elder brother who was a student of final year MBBS. He was also brutally beaten by the police and dragged at night 2 PM to a far–off police station and kept overnight without food medicines, clothes and then next day brought to Swaroop Nagar police station where he became very serious. Then on second day Dr Arati Lalchandani on hearing that Miraj was in the Swaroop Nagar Thana rushed to the Thana and rescued him and brought him to the LT -3 where all the Medical College students, faculty and IMA doctors were spending their day and night. Then his parents who were in a far of village were informed about his condition. His elder brother was under arrest with 24 other students for 6 days.

Role of IMA

The IMA President Dr Arati Lalchandani who is also the Director, Professor and Head of PG Department of Medicine and also the President of Teachers Association of GSVM Medical College, Kanpur was called on her mobile several times by the Principal GSVM Medical College and the students on the night of 28th Feb. 2014 that the police had entered the campus and were beating them and firing at them, pushing them from the top floors. Dr Arati called 100 number as well as the SSP, and local police station Swaroop Nagar but no one responded. Then she called the ADGPs at Lucknow and all the important persons but most of them replied that the SSP was very close to the CM, headstrong and arrogant and would not listen to them. Moreover they could not contact him on wireless or mobile.

At night many students jumped over the boundary wall and gates of the medical college and though seriously injured they escaped to their relatives or railway station and even some spent the night on the pavements. About 8 students sought shelter in the home of Dr Arati Lalchandani. They all had run with torn clothes without chappals and bleeding from various sites. Right up to the next morning the whole city was totally disturbed and on reading about the previous night events in the Newspapers the whole city was shocked.

So the President IMA Kanpur Dr Arati Lalchandani informed all the members of IMA and Medical College Faculty to collect in the LT 3 of the GSVM Medical College. More than 3000 medicos collected inside the medical college campus, all shocked injured and very angry with the UP police and administration. The campus and especially the hostels were totally vandalized; all the articles in the room coolers, laptops, books, almirah, doors windows, all personal articles, cars, two wheelers broken and destroyed. All the workers, staff, mess, servants had run away so they had nothing to eat.

The IMA President Dr Arati Lalchandani immediately arranged for food, water, tea and snacks for all the students, all IMA members and even the media people. About 250 media people had also collected in support of the medicos because when the police had entered the campus they were ordered by SSP to beat up to media people take away their cameras and throw them outside. Even the media people had fractures, bruises, wounds and one photographer Vaibhav had received head injuries and lacerations of the ear.

The IMA President Dr Arati Lalchandani, Secretary Dr Ravi Kumar, along with the executive members of IMA arranged for good Audio Visual system with double mikes to address the gathering. A social media team of tech–savvy students was organized for full networking through Facebook, Whatsapp, YouTube, Google, Yahoo, and Twitter.

Dr Arati Lalchandani continuously addressed Press Conferences in the LT3 in full view and hearing of all the doctors there.

All the lectures, rallies, press conferences etc. were held round the clock inside the medical college campus. All the meals for all medicos and IMA members and media personnel was provided inside the campus by Halwais and cooks who were present round the clock and cooked fresh food and snacks for the people. For full six days the IMA Kanpur provided all the necessities to the medical college inmates.

There was unprecedented and very good support from the various schools, colleges, IIT, coaching centers, vyapaar mandal, dal mill and other factory workers, Lawyers, Income tax, NGOs, chemists, Dental surgeons, Pharmacists, karamcharis association of Uttar Pradesh, Nurses Association Uttar Pradesh, Kanpur University, Faculty Students and Staff Union, Shopkeepers and Retailers of Kanpur.

The National Headquarter IMA and the UPIMA, and all the IMA branches of Uttar Pradesh responded to the call of Kanpur IMA with lightning speed and within 24 hours all the doctors of Uttar Pradesh and India had joined Kanpur in expressing solidarity to fight against the Goondaism of police and administration.

Personal messages and regular communication was exchanged with the Secretary General IMA HQ Dr NS Saini, President UP IMA Dr Ravi Mehra, Secretary UP IMA Dr Sanjai Jain, Dr DR Rai of IMA Head quarter, Dr Anil Goel President IMA New Delhi, Dr Vijay Pal, Dr AP Singh, Dr Sharad Agarwal, Dr MB Saxena, Dr Ashok Agarwal, Dr Rakesh Kumar Gupta, Dr Naim of KGMC, Dr RK Gupta, Dr Ajai Lekhi, Dr Bhupendra Patel, Dr Yuvraj Sharma, Dr Pankaj Agnihotri, Dr Rajiv, Dr Pradumna Bhargava, Dr Harit Chaturvedi, Dr Dinesh Goswami, Dr Anup Saraya, Dr Mohsin Vali, Dr Ashwini, Dr Vipul Tyagi, Dr AM Khan and many others from outside Kanpur who offered physical, moral, financial and logistic support.

Within a couple of days acting with exceptional promptness and zeal the President IMA Headquarter Dr Jitendra B Patel, Secretary General IMA HQ Dr N Saini, President UP IMA Dr Ravi Mehra, Past President Dr DR Rai, Dr Sanjay Jain Secretary UP IMA, Dr MB Saxena, Dr Chauhan and others reached Kanpur and addressed the doctors in the Medical College each delivering very strong unforgettable very encouraging and brilliant speeches. This gave us lot of courage to fight the war with intimidating enemies.

Dr Narendra Saini, Secretary General IMA Head Quarter and Dr Sanjay Jain Secretary UP IMA also put in a petition to the NHRC and got a probe ordered for violation of human rights. Dr Saini also met the Chief Justice of Supreme Court. Dr Saini and his team from IMA HQ also met the President of India Mr Pranab Mukherjee with an album of events which moved the President to tears and he promised to do something concrete for the medicos.

Dr Mohsin Wali, Dr Pankaj Agnihotri, Dr Harit Chaturvedi, Dr Vipul Tyagi, Dr Yuvraj Sharma and others were very helpful in helping us to negotiate with all the VIPs of India.

Dr Harshvardhan of BJP and an ex-student of the GSVM Medical College Kanpur has been very helpful and fearlessly spoke against the UP Govt and gave us full throttle support. He was in Hong Kong at the time of the incident campaigning for Mr Modi but cut short his visit and called Dr Arati Lalchandani from the airport at midnight just after his landing in Delhi. He immediately contacted all the important people at the center and garnered support for us from all quarters.

There were widespread rallies, strikes, protests all over India very well stage-managed by the Secretary General IMA Head Quarter Dr Narendra Saini. There was a great impact all over the country of these protests especially those at KGMC Lucknow, New Delhi and Meerut.

The media i.e. electronic media, print media and web media provided us with photos, prints, videos in hard and soft form which gave us plenty of evidence of the atrocities, the police, MLA and his goons and all others involved so that we could flash it through all available multimedia resources. The media people also equipped us with modern audio visual and multimedia paraphernalia so that we could efficiently put up our case to the nation. People from the neighboring apartments, multistory buildings and even passers-by provided us with evidence from their mobile phone gallery.

More than one lakh bills, posters, howlers, handouts, pamphlets were distributed in the city to project our stand. About 30,000 students of the coaching mandi joined us to protect the medicos. A head count of five kilometer long rally was taken out each day in the campus which attracted International Media attention. Even Ms Margot Cohen of Yahoo covered the event. On the fifth evening the High Court Allahabad, Lucknow Bench took Suo Moto cognizance of the events and ordered a probe.

Since then a fast track judicial enquiry is going on with a double bench at the High Court. An SIT is conducting enquiry in the GSVM campus in the presence of two faculty members. Justice Chauhan of the High Court along with Mr Amarjeet Tripathi Law Secretary come to Kanpur regularly to conduct enquiry, record statements, affidavit and cross examination in the circuit house. Amicus curie Mr Jaideep Mathur is helping the students and counseling the medicos.

All in all a very fair and fast paced enquiry with regular fair and favorable orders are being passed by the honorable high court which is bringing us very close to the deliverance of full justice in the matter.

The IMA has spent 5.5 lakh rupees in these past months since 28 Feb. 2014 but a very good contribution has been received from all the IMA members. The UP IMA made a very substantial contribution by giving us a very good lawyer Mr Anil Tiwari and Dr AM Khan who have instilled in us the confidence of victory.

Final justice will be the quashing of FIRs against the students, and punishment to the SSP Mr Yashaswi Yadav and the MLA Mr Irfan Solanki. However, we have gained three quarters victory by showing our unity, solidarity and full support of media against very formidable enemies.

Kanpur IMA and GSVM Medical College whole heartedly thanks all the doctors of the nation especially very strong IMA Headquarters and UP IMA for the excellent way they have organized and guided the whole movement to victory for doctors.

Dr Vikas Mishra
Jt Sec to President

Dr Ravi Kumar
Secretary

Dr Arati Lalchandani
President

Zee News – Health Wealth Shows

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Total CPR since 1st November 2012 – 88972 trained

cpr10 Mantra 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 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Health Check Up Camp at Modern Era Public School, 16th May 2014

press release

Weight loss may improve sexual health of obese diabetes

video of day video of day

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Make Sure

Situation: A patient on ACE inhibitor developed angioedema.
Reaction: Oh my God! Why was ACE inhibitor continued?
Lesson: Make sure that patients on ACE inhibitors are advised to watch for symptoms of urticaria and stop the drug immediately in case swelling of lip, face or tongue develops (Br J Clin Pharmacol 1999;48(6):861–5).

eMedinewS Humor

Tech support

Tech support: "Okay Colin, let’s press the control and escape keys at the same time. That brings up a task list in the middle of the screen. Now type the letter "P" to bring up the Program Manager."

Customer: I don’t have a P.

Tech support: On your keyboard, Colin.

Customer: What do you mean?

Tech support: "P" on your keyboard, Colin.

Customer: I’M NOT GOING TO DO THAT!!

Quote of the Day

It is wise to direct your anger towards problems – not people; to focus your energies on answers – not excuses. William Ward

 

Twitter of the Day

Dr KK Aggarwal: Obesity is a disease By Dr k k Aggarwal http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Is there a difference between Alternative Medicine & Integrative Medicine ?http://tinyurl.com/nfbwx98

 

International News

  • The US Food and Drug Administration (FDA) has approved the first–ever nasal testosterone replacement therapy for use in adult males with conditions associated with deficiency or absence of endogenous testosterone, including primary hypogonadism or hypogonadotropic hypogonadism.
  • An updated scientific statement from the American Heart Association (AHA) and the American Stroke Association (ASA) has concluded that physical activity and exercise advice should be incorporated into the management of stroke survivors. The scientific statement is published online May 20 in Stroke.
  • A study published in the June issue of the American Journal of Infection Control revealed that use of an ultraviolet environmental disinfection system after routine discharge cleaning of contact precautions rooms and other high–risk areas was associated with reduced rates of hospital–acquired infections caused by multidrug–resistant organisms (MDRO) or Clostridium difficile (CD).
  • A study published in the May issue of Gastrointestinal Endoscopy has revealed that despite both radiofrequency ablation (RFA) and complete endoscopic mucosal resection (EMR) being effective in eliminating dysplastic Barrett’s esophagus, resection results in 5 times more complications than ablation.
  • Standalone balloon dilation appears to be as effective as functional endoscopic sinus surgery (FESS) for patients with chronic rhinosinusitis refractory to medical therapy, according to follow–up results from the REMODEL trial. The findings were published online in the American Journal of Rhinology & Allergy.

Rabies News (Dr A K Gupta)

What is IM pre–exposure vaccination schedule?

The regimen is three IM injections on days 0, 7 and 28.

Cardiology eMedinewS

  • A new study published online May 29 in the Canadian Journal of Cardiology has pointed that patients treated with implantable cardioverter defibrillators (ICDs) who do not receive follow–up within 12 weeks may have a significantly increased risk of mortality.
  • Long–term results from the Scandinavian Candesartan Acute Stroke Trial (SCAST) have shown that blood pressure lowering with candesartan provides no benefit on vascular events or death in patients with acute stroke. The novel findings were presented at the XXIII European Stroke Conference (ESC).

Pediatrics eMedinewS

  • Among severely obese adolescents, laparoscopic adjustable gastric–band surgery appears to be a reasonable option for weight loss after all other interventions have failed, reported a study presented at the 2014 European Congress on Obesity.
  • More than three–quarters of children with active epilepsy have behavioral problems and/or cognitive impairment, report findings from the Children with Epilepsy in Sussex Schools (CHESS) study. The findings were published online May 26 in Pediatrics.

Dr K K Spiritual Blog

The Seven Dhatus in Ayurveda

As per Ayurveda physiology, food is Brahman and contains the same consciousness as in us and this consciousness is the essence of any food.

Any food digested is converted into three portions, the gross undigested food is converted into waste (feces); the middle one is converted in one of the Dhatus and the subtlest form gets converted into ojas or the immunity.

As per standard Ayurveda, food once eaten is converted into the first Dhatu i.e. Rasa. Once the formation of Rasa is complete, the remaining is converted into Rakta (blood).The left over essence of food makes Mamsa (muscles), left over of which makes (Medha (adipose tissue) and so on to form Asthi (Bone), Majja (bone marrow) and Shukra (sperm/ova).

As per this physiology, the second Dhatu will only form once the first Dhatu is of good quality and so on and at any step in Dhatu, if not formed properly, subsequent Dhatu will also show defective formation.

For example, defective Dhatu at the stage of Asthi (bone) will have normal plasma (blood), muscle and adipose tissue but may have an impaired immunity/sperm/bone marrow. Similarly, defective Dhatu at the level of bone marrow may have only impaired immunity with no impairment of other Dhatus. On the other hand, impairment of Dhatus at the level of plasma or blood will involve all other Dhatus in sickness. Isolated disorders of Shukra may have no involvement of other Dhatus at all.

This Ayurveda principle can help us in answering many unanswered questions in modern allopathy. Like – why in typhoid fever all the organs are involved and why in azoospermia no other organ is involved.

Upanishads talk about formation of Dhatus in much more detail. According to them, different types of food make different types of Dhatus. The fiery foods like oil and ghee are responsible for formation of Karamendriyan (part of shukra), bone and bone marrow (Dhatu).

The earthy foods are responsible for formation of Gnanandriyan and Manas (shukra) and muscle (flesh) and water in food is responsible for formation of Rasa and Rakta (plasma and blood) and Pran (Shukra).

That means every different type of food would make different types of Dhatus and a balanced food with a combination of fire, water and earth will only be responsible for formation of shukra, immunity or the essence.

Wellness Blog

Alternative Therapies Lower BP

A group of experts has reviewed all the existing studies and concluded that there are indeed alternative treatments for lowering blood pressure – with aerobic exercise leading the pack as far as strong evidence goes.

Other alternative treatments – namely isometric handgrip and dynamic resistance exercises and guided breathing –– also got high grades when it came to reducing high blood pressure in some patients, according to a scientific statement from the American Heart Association published online in the journal Hypertension.

"The evidence is not as strong for transcendental meditation and acupuncture, but they may help as well," said co–senior author Sanjay Rajagopalan, MD, professor of cardiovascular medicine at Ohio State University School of Medicine in Columbus.

For the report, an expert panel headed by the University of Michigan’s Robert D. Brook, MD, reviewed 1,000 studies published from 2006 to 2011. They divided the studies into three major classes of alternative treatments: behavioral therapies, noninvasive procedures and devices, and exercise. The panel did not review dietary and herbal treatments. Based on the level of evidence, they gave each an "A," "B," or "C" recommendation –– with "A" being the highest –– for implementation into clinical practice.

The panel found:

  • Exercise–based regimens did the best overall, with dynamic aerobic exercises getting an "A" class of recommendation, with a level of evidence of I, the highest possible.
  • Dynamic resistance exercises got a "B" and isometric handgrip exercises got a "C" grade, with levels of evidence of IIA and IIB, respectively.
  • Still, 4 weeks of isometric hand grip exercises resulted in some of the most impressive improvements in several studies –– a 10% drop in systolic and diastolic blood pressure. However, isometric exercise should be avoided among people with severely uncontrolled hypertension (180/110 mm Hg or higher).
  • As for noninvasive procedures or devices, device–guided breathing got a "B" with a level of evidence of II. Device–guided slow breathing proved most effective in lowering blood pressure when performed for 15–minute sessions three to four times a week. Acupuncture also got a "B," but its level of evidence was III, meaning no benefit.
  • Among behavioral techniques, transcendental meditation and biofeedback both received "B" grades, with IIBs for levels of evidence. Yoga got a C, with level of evidence of III, or no benefit, as did other meditation techniques.
  • The alternative approaches that work reduce systolic blood pressure by only 2 to 10 mm Hg; whereas standard doses of a blood pressure–lowering drug reduce systolic blood pressure by about 10 to 15 mm Hg.
  • Alternative approaches are best for patients with blood pressure levels over 120/80 mm Hg who can’t tolerate or don’t respond well to standard medications.

Inspirational Story

Family

I ran into a stranger as he passed by, "Oh excuse me please," was my reply. He said, "Please excuse me too; I wasn’t watching for you." We were very polite, this stranger and I. We went on our way saying good–bye.

But at home a difference is told, how we treat our loved ones, young and old. Later that day, cooking the evening meal, my son stood beside me very still. As I turned, I nearly knocked him down. "Move out of the way," I said with a frown. He walked away, his little heartbroken. I didn't realize how harshly I’d spoken.

While I lay awake in bed, God’s still small voice came to me and said, "While dealing with a stranger, common courtesy you use, but the children you love, you seem to abuse. Go and look on the kitchen floor, you’ll find some flowers there by the door. Those are the flowers he brought for you. He picked them himself: pink, yellow and blue. He stood very quietly not to spoil the surprise, and you never saw the tears that filled his little eyes."

By this time, I felt very small, and now my tears began to fall. I quietly went and knelt by his bed, "Wake up, little one, wake up," I said. "Are these the flowers you picked for me?" He smiled, "I found ‘them, out by the tree. I picked ‘them because they’re pretty like you. I knew you’d like ‘them, especially the blue."

I said, "Son, I’m very sorry for the way I acted today; I shouldn’t have yelled at you that way." He said, "Oh, Mom, that’s okay. I love you anyway." I said, "Son, I love you too, and I do like the flowers, especially the blue."

Are you aware that if we died tomorrow, the company that we are working for could easily replace us in a matter of days. But the family we left behind will feel the loss for the rest of their lives. And come to think of it, we pour ourselves more into work than to our own family – an unwise investment indeed, don't you think?

So what is behind the story? Do you know what the word FAMILY means?

FAMILY = (F) ATHER (A) ND (M) OTHER, (I) (L) OVE (Y) OU!

ePress Release

Non–cigarette Nicotine Sources

31st May is World No Tobacco Day: The theme this year is "Raise taxes on tobacco".

Besides cigarettes, tobacco is also smoked in the form of cigars, pipes, and water pipes (hookah) said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association. on the occasion of World No Tobacco Day.

Tobacco in the form of chewing tobacco and snuff is not smoked but is absorbed through buccal mucosal membrane.

Electronic cigarettes (e–cigarettes) use a liquid nicotine cartridge, rather than tobacco.

Cigar and pipe smoking causes less lung cancers: The smoke from cigars and pipes is not inhaled as deeply into the lungs as is that from cigarettes. The risk of lung cancer from smoking cigars and pipes is lower than the risk of smoking cigarettes, but higher than the risk of a nonsmoker.

Water pipes or hookahs cause COPD and lung cancer: The amount of nicotine and toxins varies based on the type of tobacco used and how it is smoked. Water pipe smoking is associated with lung cancer and COPD.

Smokeless tobacco is linked to oral cancer: Smokeless tobacco is available as chewing tobacco or snuff. Different processing techniques, particularly "curing", can result in markedly different contents of toxins in smokeless products. Health risks for certain diseases may be substantially less than with smoking but it causes cancer of the oral cavity and provides sufficient nicotine exposure to cause nicotine addiction.

Electronic cigarettes: Electronic cigarettes (e–cigarettes) use an electronic delivery system that aerosolizes nicotine, producing a vapor similar to cigarettes but containing fewer traditional toxins.

E–cigarette devices are composed of three parts: a plastic tube, an electronic heating element, and a liquid nicotine cartridge. The user presses a button that simultaneously releases a puff of vaporized nicotine while illuminating the device tip (that simulates the lit end of a cigarette).

E–cigarettes do reduce the desire to smoke traditional cigarettes and have been prescribed by clinicians to aid in smoking cessation. However, the US FDA has not approved the use of any e-cigarettes given safety concerns.

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 88972 people since 1stNovember 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."

eMedi Quiz

An early systolic murmur may be caused by all of the following except:

1. Small ventricular septal defect.
2. Papillary muscle dysfunction.
3. Tricuspid regurgitation.
4. Aortic stenosis.

Yesterday’s Mind Teaser: All of the following are TRUE regarding HIV infection in children except:

a. Most of the children present with clinical symptoms during the neonatal period.
b. They usually present with non specific symptoms of immunodeficiency
c. Skin is one of the most commonly involved organs with HIV infection
d. Children may remain asymptomatic upto the age of 8–10 years

Answer for Yesterday’s Mind Teaser: a. Most of the children present with clinical symptoms during the neonatal period.

Correct Answers received from: Dr Avtar Krishan, Deepali Chatterjee, Raju Kuppusamy, Jayant Gaikwad,
Dr Vijayalakshmi Seshadri, Tukaram Pagad.

Answer for 28th May Mind Teaser: C. 60 minutes at least three or four days a week.

Correct Answers received from: Arvind Diwaker, Nirmala Agarwal, Dr K V Sarma, Dr Jainendra Upadhyay, Dr Bitaan Sen, Dr Jayashree Sen, Dr Prakash Khalap, Dr Sushma Chawla.

Send your answer to ijcp12@gmail.com

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  1. I salute you, Dr Aggarwal, Sir, for regularly sending me the wonderful E Medicine News. I am grateful to you Sir, for making illiterate people in medicine literate. I try to follow what you say in the news letters. Regards and Best Wishes: Joginder Singh IPS Retd. Former Director CBI
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