June 1  2015, Monday
eMedinewS
editorial
5 ways to boost bone strength early (Harvard)
Dr KK Aggarwal
  1. Monitor your diet. Get enough calcium and vitamin D, ideally through the foods you eat. Although dairy products may be the richest sources of calcium, a growing number of foods, such as orange juice, are calcium–fortified. Fruits, vegetables and grains provide other minerals crucial to bone health, such as magnesium and phosphorus.
  2. Maintain a reasonable weight. This is particularly important for women. Menstrual periods often stop in women who are underweight — due to a poor diet or excessive exercise — and that usually means that estrogen levels are too low to support bone growth.
  3. Don’t smoke, and limit alcohol intake. Smoking and too much alcohol both decrease bone mass.
  4. Make sure your workouts include weight–bearing exercises. Regular weight–bearing exercise like walking, dancing, or step aerobics can protect your bones. Also include strength training as part of your exercise routine.
  5. Talk with your doctor about your risk factors. Certain medical conditions (like celiac disease) and some medications (steroids and others) can increase the chances that you will develop osteoporosis. It’s important to talk with your
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IMA-USV Vitamin D Deficiency CME held on 24-5-2015 at IMA House, New Delhi
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News
  • For patients with persistent or recurring diverticulitis, elective resection improves quality of life more than conservative management of the disease, suggest results from the DIRECT study presented at the Digestive Disease Week 2015.
  • The American Heart Association/American Stroke Association (AHA/ASA) has released a new guideline on the diagnosis and treatment of spontaneous intracerebral hemorrhage (ICH) that updates the guideline published in 2010 and incorporates the results of new studies published in the interim. The guideline was published online May 29 and will appear in the July issue of Stroke.
  • The immunotherapy nivolumab has beaten chemotherapy in a subset of patients with lung cancer in a phase 3 trial to show an improvement in survival compared with docetaxel. The results will be presented at the American Society of Clinical Oncology (ASCO) 2015 Annual Meeting.
  • Transobturator tape can be effective in reducing stress urinary incontinence in women with neurogenic bladder dysfunction due to spinal cord injury, suggests new research published online in Spinal Cord.
  • Optical coherence tomography angiography (OCTA) noninvasively detects choroidal neovascularization in eyes with central serous chorioretinopathy with an accuracy similar to fluorescein angiography, reported an observational study published online in JAMA Ophthalmology.
Dr KK Spiritual Blog
How to remove negative thoughts

Darkness is absence of light and similarly negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring positive thoughts back. Ideal mind is devils workshop and will always think negative. Here are the ways by which you can remove negative thoughts.
  • Think differently as taught by Adi Shankaracharya. Once Menaka approached Arjuna with lust and said that she wanted to have a son like him with him. Arjuna said that why wait for 25 years, consider me as you son from today.
  • Think opposite as taught by Patanjali. For example, if you are thinking of stealing, then silently start thinking of charity.
  • Think positive as taught by Buddha. Make a list of positive actions to be done today the first thing in the morning and concentrate on that list. Divert your mind to the pending jobs in hand. This is a type of behavioral therapy.
Cardiology eMedinewS
  • Bridge therapy during warfarin interruption for invasive procedures in patients with a history of venous thromboembolism may increase the risk of bleeding, according to a study published online May 26 in JAMA Internal Medicine.
  • Perioperative ß-blockade was associated with lower 30-day mortality in patients with three to four cardiac risk factors undergoing noncardiac surgery, but with increased mortality in patients with no cardiac risk factors, suggested a retrospective cohort study published online May 27 in JAMA Surgery.
Pediatrics eMedinewS
  • Some plastic teething toys used by infants might contain chemicals that could interfere with the production of hormones needed for normal growth and development, suggested a small German study that conducted lab tests on 10 plastic teethers. The results were published in the Journal of Applied Toxicology.
  • Infusions of stem cells in children may provide pain relief and reduce the severity of recessive dystrophic epidermolysis bullosa, a rare and debilitating skin condition, for which no cure currently exists, suggested a study published in the Journal of Investigative Dermatology.
Make Sure
Situation: A patient on penicillin antibiotic developed a relapse of fever while still on antibiotic.

Reaction: Oh my God! Why was the antibiotic continued for so long?

Lesson: Make sure
that drug fever is always excluded in such situations. Antibiotics are the most common cause of drug fever, accounting for approximately one–third of episodes. This especially applies to beta–lactams, sulfonamides and nitrofurantoin (Am J Med Sci 1987;294:275).
Dr Good Dr Bad
Situation: A patient with renovascular hypertension needed a painkiller.

Dr Bad: Take any painkiller but avoid nimesulide

Dr Good: Take Nimesulide

Lesson: Nimesulide, in animal studies, has shown to reduce high blood pressure. Chronic treatment with nimesulide lowered hypertension and cardiac hypertrophy partly through the release of atrial natriuretic peptide in 2K1C rats (Peptides. 2015 Apr 4;69:1-8).

(Copyright IJCP)
Inspirational Story
Keep Your Dream

I have a friend named Monty Roberts who owns a horse ranch in San Ysidro. He has let me use his house to put on fund–raising events to raise money for youth at risk programs.

The last time I was there he introduced me by saying, "I want to tell you why I let Jack use my horse. It all goes back to a story about a young man who was the son of an itinerant horse trainer who would go from stable to stable, race track to race track, farm to farm and ranch to ranch, training horses. As a result, the boy–s high school career was continually interrupted. When he was a senior, he was asked to write a paper about what he wanted to be and do when he grew up.

That night he wrote a seven–page paper describing his goal of someday owning a horse ranch. He wrote about his dream in great detail and he even drew a diagram of a 200–acre ranch, showing the location of all the buildings, the stables and the track. Then he drew a detailed floor plan for a 4,000–square–foot house that would sit on a 200–acre dream ranch.

He put a great deal of his heart into the project and the next day he handed it in to his teacher. Two days later he received his paper back. On the front page was a large red F with a note that read, "See me after class."

The boy with the dream went to see the teacher after class and asked, "Why did I receive an F?"

The teacher said, "This is an unrealistic dream for a young boy like you. You have no money. You come from an itinerant family. You have no resources. Owning a horse ranch requires a lot of money. You have to buy the land. You have to pay for the original breeding stock and later you'll have to pay large stud fees. There’s no way you could ever do it." Then the teacher added, "If you will rewrite this paper with a more realistic goal, I will reconsider your grade."

The boy went home and thought about it long and hard. He asked his father what he should do. His father said, "Look, son, you have to make up your own mind on this. However, I think it is a very important decision for you." Finally, after sitting with it for a week, the boy turned in the same paper, making no changes at all.

He stated, "You can keep the F and I’ll keep my dream."

Monty then turned to the assembled group and said, "I tell you this story because you are sitting in my 4,000-square-foot house in the middle of my 200–acre horse ranch. I still have that school paper framed over the fireplace." He added, "The best part of the story is that two summers ago that same schoolteacher brought 30 kids to camp out on my ranch for a week." When the teacher was leaving, he said, "Look, Monty, I can tell you this now. When I was your teacher, I was something of a dream stealer. During those years I stole a lot of kids’ dreams. Fortunately you had enough gumption not to give up on yours."

"Don’t let anyone steal your dreams. Follow your heart, no matter what."
eMedinewS Humor
After 15 years of marriage the wife asked her husband to describe her.

The husband looked at her slowly and without blinking an eye, said, "ABCDEFGHIJK."

"What does that mean?" She asked.

"Adorable, Beautiful, Cute, Delightful, Elegant, Fashionable, Gorgeous and Hot!!!" he replied.

Smiling, the wife asked, "So sweet of you honey. What about IJK?"

He replied, "I’m Just Kidding!
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Wellness Blog
Restricting salt in diet can lower heart disease risk
  • Restricting salt in the diet can lower the risk of developing heart disease by 25% and the risk of dying from heart disease by 20%.
  • Dietary intake of sodium among Indians is excessively high. Among hypertensive individuals, lowering sodium is quite well established to lower blood pressure, but now it has been shown that reducing salt also has an effect on cardiovascular disease.
  • According to a Harvard Medical School study published in British Medical Journal, when people with pre hypertension (blood pressure more than 120/80 and lower than 140/90), reduced their salt intake by about 25 to 35%, they were 25% less likely to develop cardiovascular disease 10 to 15 years after the trial ended. There was also a 20 percent lower death rate from cardiovascular disease among those who cut their salt consumption.
  • Salt restriction is best achieved by avoiding salted, salt cured and salt smoked foods such as lunch meat, hot dogs, ham, olives, pickles and regular salted canned foods, and other prepared foods, which often use more salt than homemade equivalents. Foods we would never think of as salty, such as breakfast cereals, cookies, and even some soft drinks often contain copious additions of sodium.
  • WHO recommends limiting the salt intake to less than 5 grams per day.
eMedi Quiz
A hybrid teledematology is

a. Combination of store and forward and mobile teledematology
b. Combination of store and forward and video conference
c. Combination of online discussion group and author-based second opinion teledermatology
d. Combination of online discussion group and video conference

Yesterday’s Mind Teaser: Counseling and health and occupational screening require which of the following teledermatology tools?

a. Videoconference
b. Mobile teledermatology
c. Store and forward teledermatology
d. Online discussion group

Answer for yesterday’s Mind Teaser: a. Videoconference

Correct Answers received from: Dr Avtar Krishan, Dr. G. Madhusudhan, Dr.K.Raju

Answer for 30th May Mind Teaser: d. All of above

Correct Answers received: Dr.K.Raju, Daivadheenam Jella
Rabies News (Dr A K Gupta)
What does humanizing your dog mean?
  • Talking to your dog like he/she is a person.
  • Treating your dog like he/she is a person.
  • Allowing dogs to do what they want because it will hurt their "feelings."
  • Dressing them up in little doggie clothes.
Remember, humanizing your dog is fulfilling your own human needs, not your dogs. Humanizing dogs does more harm than good.
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IJCP Book of Medical Records
IJCP’s ejournals
Letter to Editor
Dear Editor,

With increasing drug resistance, the doses of AKT medicines are now in the toxic ranges.

Ethambutol causes Retrobulbar Neuritis and Toxic Amblyopia in certain persons.

It is often missed till many days have passed, by which time it is too late and visual recovery chances fade.

It should be mandatory for the Physician giving AKT to WARN THE PATIENT THAT HE SHOULD IMMEDIATELY REPORT BACK TO THE PHYSICIAN IN THE EVENT OF ANY BLURRED VISION.

Since the patients have not been made aware of this potential sight-threatening side-effect of Ethambutol, they often lose valuable time by going to opticians, ophthalmologists, etc. who, too, may not ask for history of AKT in their busy practice and patient, too, may not disclose due to social stigma.

It is a matter of grave concern as the visual loss is irreversible usually after 15 days of duration. Hence prompt stoppage of Ethambutol is of paramount importance.
Dr Hemang D Koppikar. Ophthalmologist.
Reader Response
Dear Sir, very informative news. Regards: Dr Shravan
Quote of the Day
Determine what specific goal you want to achieve. Then dedicate yourself to its attainment with unswerving singleness of purpose, the trenchant zeal of a crusader. Paul J. Meyer
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
eIMA News
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The Supreme Court on Friday sentenced a man to seven years in jail for causing the death of a pregnant woman in a botched-up operation in Delhi.

The convict, Riyazuddin, had claimed he was just a compounder, while the lower courts had held him guilty as a doctor.

Sushmita was found dead in the operation theatre by her husband, while Riyazuddin and two other women doctors had reportedly fled the clinic.

While no evidence could be brought on record against the two women doctors and they could not be identified by Sushmita’s family, the lower courts noted Riyazuddin had asked for reports from diagnostic centres by signing on documents as ‘Dr Riyazuddin’ and he further met all visitors in the clinic as a doctor.

Applicable laws
Section 314 in The Indian Penal Code: 314. Death caused by act done with intent to cause miscarriage.—Whoever, with intent to cause the miscarriage of a woman with child, does any act which causes the death of such woman, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine; If act done without woman’s consent.—And if the act is done without the consent of the woman, shall be punished either with 1(imprisonment for life), or with the pun­ishment above mentioned. Explanation.—It is not essential to this offence that the of­fender should know that the act is likely to cause death.

Section 34 in The Indian Penal Code
37 (34. Acts done by several persons in furtherance of common intention.—When a criminal act is done by several persons in furtherance of the common intention of all, each of such persons is liable for that act in the same manner as if it were done by him alone.) MTP Act

5. (2) Notwithstanding anything contained in the Indian Penal Code, the termination of pregnancy by a person who is not a registered medical practitioner shall be an offence punishable with rigorous imprisonment for a term which shall not be less than two years but which may extend to seven years under that Code, and that Code shall, to this extent, stand modified.
(3) Whoever terminates any pregnancy in a place other than that mentioned in section 4, shall be punishable with rigorous imprisonment for a term which shall not be less than two years but which may extend to seven years.
Delhi high Court Decision: From the facts of the case the knowledge that the act of appellant Riyazuddin was likely to cause death of Sushmita is clearly attributable hence while upholding the conviction of Riyazuddin for offence punishable under Section 314 IPC and Section 5(2) and 5(3) of the MTP Act we also hold him guilty for offence punishable under Section 304 IPC. Section 304 in The Indian Penal Code

304. Punishment for culpable homicide not amounting to murder.—Whoever commits culpable homicide not amounting to murder shall be punished with 1(imprisonment for life), or imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine, if the act by which the death is caused is done with the intention of causing death, or of causing such bodily injury as is likely to cause death, or with imprisonment of either description for a term which may extend to ten years, or with fine, or with both, if the act is done with the knowledge that it is likely to cause death, but without any intention to cause death, or to cause such bodily injury as is likely to cause death.

Why not 304A
The Supreme Court in the decision reported as 2008 (14) SCC 479 Mahadev Prasad Kaushik vs. State of U.P.& Anr. drew a distinction between Section 304 and Section 304A IPC. It held that Section 304A carves out cases where death is caused by doing a rash or negligent act which does not amount to culpable homicide not amounting to murder within the meaning of Section 299 or culpable homicide amounting to murder under Section 300 IPC. In other words, Section 304A excludes all the ingredients of Section 299 as also of Section 300 IPC. When intention or knowledge is

the 'motivating force' of the act complained of, Section 304A will have to make room for the graver and more serious charge of culpable homicide not amounting to murder or amounting to murder as the facts disclose. The section has application to those cases where there is neither intention to cause death nor knowledge that the act in all probability will cause death.

Section 304A in The Indian Penal Code
279 (304A. Causing death by negligence.—Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.)

Section 299 in The Indian Penal Code
299. Culpable homicide.—Whoever causes death by doing an act with the intention of causing death, or with the intention of causing such bodily injury as is likely to cause death, or with the knowledge that he is likely by such act to cause death, commits the offence of culpable homicide. Illustrations
(a) A lays sticks and turf over a pit, with the intention of thereby causing death, or with the knowledge that death is likely to be thereby caused. Z believing the ground to be firm, treads on it, falls in and is killed. A has committed the offence of culpable homicide.
(b) A knows Z to be behind a bush. B does not know it A, intend­ing to cause, or knowing it to be likely to cause Z’s death, induces B to fire at the bush. B fires and kills Z. Here B may be guilty of no offence; but A has committed the offence of culpable homicide.
(c) A, by shooting at a fowl with intent to kill and steal it, kills B who is behind a bush; A not knowing that he was there. Here, although A was doing an unlawful act, he was not guilty of culpable homicide, as he did not intend to kill B, or to cause death by doing an act that he knew was likely to cause death. Explanation 1.—A person who causes bodily injury to another who is labouring under a disorder, disease or bodily infirmity, and thereby accelerates the death of that other, shall be deemed to have caused his death. Explanation 2.—Where death is caused by bodily injury, the person who causes such bodily injury shall be deemed to have caused the death, although by resorting to proper remedies and skilful treatment the death might have been prevented. Explanation 3.—The causing of the death of child in the mother’s womb is not homicide. But it may amount to culpable homicide to cause the death of a living child, if any part of that child has been brought forth, though the child may not have breathed or been completely born.

Section 300 in The Indian Penal Code
300. Murder.—Except in the cases hereinafter excepted, culpable homicide is murder, if the act by which the death is caused is done with the intention of causing death, or— (Secondly) —If it is done with the intention of causing such bodily injury as the offender knows to be likely to cause the death of the person to whom the harm is caused, or— (Thirdly) —If it is done with the intention of causing bodily injury to any person and the bodily injury intended to be in­flicted is sufficient in the ordinary course of nature to cause death, or— (Fourthly) —If the person committing the act knows that it is so imminently dangerous that it must, in all probability, cause death or such bodily injury as is likely to cause death, and commits such act without any excuse for incurring the risk of causing death or such injury as aforesaid.

Illustrations
(a) A shoots Z with the intention of killing him. Z dies in consequence. A commits murder.
(b) A, knowing that Z is labouring under such a disease that a blow is likely to cause his death, strikes him with the intention of causing bodily injury. Z dies in consequence of the blow. A is guilty of murder, although the blow might not have been suffi­cient in the ordinary course of nature to cause the death of a person in a sound state of health. But if A, not knowing that Z is labouring under any disease, gives him such a blow as would not in the ordinary course of nature kill a person in a sound state of health, here A, although he may intend to cause bodily injury, is not guilty of murder, if he did not intend to cause death, or such bodily injury as in the ordinary course of nature would cause death.
(c) A intentionally gives Z a sword-cut or club-wound sufficient to cause the death of a man in the ordinary course of nature. Z dies in consequence. Here, A is guilty of murder, although he may not have intended to cause Z’s death.
(d) A without any excuse fires a loaded cannon into a crowd of persons and kills one of them. A is guilty of murder, although he may not have had a premeditated design to kill any particular individual. Exception 1.—When culpable homicide is not murder.—Culpable homicide is not murder if the offender, whilst deprived of the power of self-control by grave and sudden provocation, causes the death of the person who gave the provocation or causes the death of any other person by mistake or accident. The above exception is subject to the following provisos:—
(First) —That the provocation is not sought or voluntarily pro­voked by the offender as an excuse for killing or doing harm to any person.
(Secondly) —That the provocation is not given by anything done in obedience to the law, or by a public servant in the lawful exer­cise of the powers of such public servant.
(Thirdly) —That the provocation is not given by anything done in the lawful exercise of the right of private defence. Explanation.—Whether the provocation was grave and sudden enough to prevent the offence from amounting to murder is a question of fact.

Illustrations
(a) A, under the influence of passion excited by a provocation given by Z, intentionally kills. Y, Z’s child. This is murder, in as much as the provocation was not given by the child, and the death of the child was not caused by accident or misfortune in doing an act caused by the provocation.
(b) Y gives grave and sudden provocation to A. A, on this provo­cation, fires a pistol at Y, neither intending nor knowing him­self to be likely to kill Z, who is near him, but out of sight. A kills Z. Here A has not committed murder, but merely culpable homicide.
(c) A is lawfully arrested by Z, a bailiff. A is excited to sudden and violent passion by the arrest, and kills Z. This is murder, in as much as the provocation was given by a thing done by a public servant in the exercise of his powers.
(d) A appears as witness before Z, a Magistrate, Z says that he does not believe a word of A’s deposition, and that A has per­jured himself. A is moved to sudden passion by these words, and kills Z. This is murder.
(e) A attempts to pull Z’s nose, Z, in the exercise of the right of private defence, lays hold of A to prevent him from doing so. A is moved to sudden and violent passion in consequence, and kills Z. This is murder, in as much as the provocation was given by a thing done in the exercise of the right of private defence.
(f) Z strikes B. B is by this provocation excited to violent rage. A, a bystander, intending to take advantage of B’s rage, and to cause him to kill Z, puts a knife into B’s hand for that purpose. B kills Z with the knife. Here B may have committed only culpable homi­cide, but A is guilty of murder. Exception 2.—Culpable homicide is not murder if the offender, in the exercise in good faith of the right of private defence of person or property, exceeds the power given to him by law and causes the death of the person against whom he is exercising such right of defence without premeditation, and without any intention of doing more harm than is necessary for the purpose of such defence. Illustration Z attempts to horsewhip A, not in such a manner as to cause grievous hurt to A. A draws out a pistol. Z persists in the assault. A believing in good faith that he can by no other means prevent himself from being horsewhipped, shoots Z dead. A has not committed murder, but only culpable homicide. Exception 3.—Culpable homicide is not murder if the offender, being a public servant or aiding a public servant acting for the advancement of public justice, exceeds the powers given to him by law, and causes death by doing an act which he, in good faith, believes to be lawful and necessary for the due discharge of his duty as such public servant and without ill-will towards the person whose death is caused. Exception 4.—Culpable homicide is not murder if it is committed without premeditation in a sudden fight in the heat of passion upon a sudden quarrel and without the offender having taken undue advantage or acted in a cruel or unusual manner. Explanation.—It is immaterial in such cases which party offers the provocation or commits the first assault. Exception 5.—Culpable homicide is not murder when the person whose death is caused, being above the age of eighteen years, suffers death or takes the risk of death with his own consent. Illustration A, by instigation, voluntarily causes, Z, a person under eighteen years of age to commit suicide. Here, on account of Z’s youth, he was incapable of giving consent to his own death; A has therefore abetted murder.
IMA Swachch Bharat Swastha Bharat
Observe IMA Hygiene Hour Every Friday 4-5 PM. Do one hour cleanliness awareness drive.
Monosodium glutamate (MSG) in Chinese food has long been purported to cause a flushing reaction as part of the "MSG syndrome."
However, randomized placebo controlled studies raise questions whether MSG reproducibly causes symptoms in most individuals who believe they react to this additive.

When MSG is ingested in large doses, however, it causes an increase in an acetylcholine like substance that may result in flushing in susceptible individuals

MSG symptom complex
Perhaps the best known adverse reaction to a food additive is the MSG symptom complex. This is not an allergic reaction. The MSG symptom complex typically appears 1 to 14 hours after ingestion. Reported symptoms include headache, myalgia, backache, neck pain, nausea, diaphoresis, tingling, flushing, palpitations, and chest heaviness.

Children have been reported with shivering, chills, irritability, screaming, and delirium. It is due to an exaggerated sensitivity to this compound, which is metabolized after ingestion to glutamate, a major excitatory amino acid neurotransmitter.
Allergic and asthmatic reactions
A small number of case reports have implicated MSG in causing urticaria and angioedema.

IMA Kent safe water initiative: Lead in water
1. Lead in drinking water is absorbed more completely than lead in food

2. It account for more than 50 percent of the lead that is ingested by children

3. Municipal water supplies are controlled and regulated to prevent contamination at the source

4. However, once the water reaches the home, it is rarely regulated, tested, or treated.

5. EPA action level for lead in water is 15 parts per billion (ppb).

6. Most lead-contamination of household water is caused by copper plumbing that is joined with lead solder

7. Lead pipes may contribute to lead-contamination, but lead plumbing usually is old enough to have its inner surface coated with mineral deposits, which prevent leaching of lead into the water supply.

8. Other potential sources for lead contamination include storage cisterns, sources of water that are outside the municipal water districts, and aging water coolers and water heaters, particularly in areas where the water has a relatively low pH

9. Acidity and elevated temperature increase the ability of the water to leach lead from the solder or pipes, as does standing in the pipes for extended periods of time (eg, overnight).

10. The ability of home water filters or purifiers to remove lead depends upon the type of filter. Ion-exchange, reverse-osmosis filters, and distillation are effective in removing lead, but the most commonly available home filters (glass fiber and carbon) usually include packaging material that specifies that they do not efficiently remove heavy metals.Water to be used for cooking or drinking should come from the cold tap because hot water is more able to leach lead from the pipes. In addition, the water should be run for some time before it is collected; this flushes the water that has a higher lead content (caused by standing in the pipes) down the drain.(Uptodate)
Indore:
An elderly woman patient admitted to MY Hospital, with multiple problems, died allegedly due to medical negligence of a staff nurse, who administered her wrong injection. As the nurse accepted to her mistake, son of the deceased, Rajesh Singh, recorded her confession on his mobile phone.

Taking a "serious" note of quality issues related to global giant Nestle's famous noodle brand Maggi, the government has asked the Food Safety and Standards Authority of India to look into the matter. Last month, the UP Food Safety and Drug Administration had asked Nestle India to withdraw a batch of Maggi noodles "which were manufactured in February 2014" after it found high levels of added MSG, a taste enhancer, in the noodles and lead beyond permissible limits.

Max Healthcare has acquired 76% stake in Pushpanjali Crosslay Hospital in the outskirt of Delhi in a deal worth Rs 287 crore. "Max Healthcare has entered into adefinitive agreement with the promoters of NCR-based Pushpanjali Crosslay Hospital (PCH) through a combination of fresh investment and acquisition of shares from existing promoters," said Rahul Khosla, managing director at Max India.
Key Resolutions and Decisions: 68th World Health Assembly – 26th May
Item 14.3 Adolescent health: The WHA noted the report contained in document A68/15. The Union for International Cancer Control and the NCD Alliance delivered a joint statement.

Statement of the Union for International Cancer Control on behalf of the NCD Alliance

68th World Health Assembly Agenda Item 14.3 Adolescent Health


Honourable Chair, distinguished delegates,

Thank you for the opportunity to deliver this statement on behalf of the Union for International Cancer Control, NCD Child and the NCD Alliance – a network of 2,000 civil society organisations united against noncommunicable diseases.

The overlap between NCDs and adolescent health is significant. Cancers, diabetes (both type 1 and type 2), respiratory diseases (such as asthma), congenital and acquired heart disease, mental illnesses and many endemic NCDs all affect adolescents.

It is estimated that over half of the 38 million NCD deaths every year are associated with behaviours that began or were reinforced during adolescence. Adolescents are often at greater risk of exposure to key NCD risk factors, such as tobacco use and exposure to second hand smoke, unhealthy diet, physical inactivity, direct and indirect effects of harmful use of alcohol, as well as injuries and unsafe sexual behaviors. Specific attention to adolescents should therefore inform global and national approaches to tobacco, alcohol, nutrition and physical activity, reproductive health, chronic illness, and mental and neurological health.

A life course approach, utilizing integrated services, to NCD prevention is vital. Health systems have to be strengthened to respond to NCDs and give particular attention to children and adolescents, thereby improving health outcomes of the adults and older persons of tomorrow.

Adolescence comes with unique health challenges, but also provides powerful entry points to ensure the health and wellbeing of populations. We look forward to work with Member States and the WHO to develop a framework for accelerated action for adolescent health, closely aligned with the updated Global Strategy for Women’s, Children’s and Adolescents’ Health
National Consumer Disputes Redressal Commission (NCDRC) president Justice DK Jain on Friday opposed certain amendments to the Consumer Protection Act 1986, including creation of a separate authority to file class action law suits, saying it may lead to "parallel jurisdiction".

A middle-aged cancer epidemic is being blamed on the West's poor diet and overly generous portions. Spiraling rates of obesity meant that cancer - once seen as a disease of old age - was now increasingly being diagnosed up to two decades earlier than in the past. Their figures suggest one in five cancer deaths in Britain is caused by excess weight. Speaking at the American Society of Clinical Oncology (ASCO) annual conference in Chicago, experts said "staggering" rates of obesity were responsible for the growth of 10 common cancers. Being lean doesn't mean you won't get these diseases, necessarily, but being obese might mean you get them earlier in life.

People with mental illnesses are much more likely to smoke cigarettes than are those without such ailments, according to a study recently published in The Lancet.
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Press Release
Anti fever drugs will not reduce fever in patient with heat stroke

Over 1,000 people have died across India because of heat stroke. Heat stroke is a medical emergency and deaths can be prevented if treatment is started early. The commonest mistake done in treating patient with high fever due to heat stroke is giving anti fever medicine and waiting for it to respond, said Padma Shri Awardee, Dr A Marthanda Pillai, National President, IMA and Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.

The only treatment of very high fever in cases of heat stroke is rapid reduction of body temperature by physical means.

Rapid reduction in body temperature can be accomplished by cool or tepid (20 degree centigrade), no cold, bathing preferably using damp sponges. Submersion should be avoided so that body heat loss by evaporation can occur.

Alcohol aids nothing to tepid water sponges. Cooling blankets should also be avoided.

In heat stroke the core body temperature is usually more than 40 degree centigrade and patient rapidly developed altered mental status. If not treated in time most patient died of multi organ failure.

The difference between heat exhaustion and heat stroke is presence of sweating in heat exhaustion, added Dr Aggarwal. Till the armpits are wet patient is in heat exhaustion and not heat stroke.